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Jogerst K, Gupta N, Kosiorek HE, Lee YS, Abujbarah S, Cronin P, Casey W, Pockaj B. Reducing Chronic Opioid Use: Long-term Impacts of Enhanced Recovery after Mastectomy Protocols. Ann Surg 2024:00000658-990000000-00889. [PMID: 38757265 DOI: 10.1097/sla.0000000000006344] [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: 05/18/2024]
Abstract
OBJECTIVE This study investigates Enhanced Recovery After Surgery (ERAS®) protocols' impact on long-term opioid and sedative use following mastectomy with or without implant-based breast reconstruction (IBBR). SUMMARY BACKGROUND DATA ERAS® protocols for patients undergoing mastectomy with or without IBBR are associated with decreased length of stay, increased rate of same-day discharge, decreased postoperative pain, and decreased postoperative opioid requirements. However, less is known about their effect on opioid and sedative use beyond 90 days after surgery. METHODS A retrospective review of all patients undergoing mastectomy with or without IBBR at a single institution between January 2013 and December 2019. Mastectomy ERAS® protocols were implemented in February 2017, creating two groups: pre-ERAS® and ERAS®. Baseline characteristics and prevalence of chronic opioid and sedative use were compared. Univariable and multivariable logistic regression predicted factors associated with increased odds of chronic opioid and sedative use. RESULTS 756 patients were evaluated: 405 pre-ERAS® and 351 ERAS®. Post-ERAS®, chronic opioid use decreased in opioid-naïve (40% vs. 30%, P=0.024) and opioid-tolerant patients (58% vs. 37%, P=0.002), with no increase in chronic sedative use. There were decreased odds of chronic opioid use for all ERAS® patients (OR=0.57, 95% CI: 0.42-0.76)), and of IBBR patients, those receiving subcutaneous implants (OR=0.31, 95% CI: 0.20-0.48). There was increased chronic opioid-use odds if undergoing bilateral surgery (OR=1.54, 95% CI: 1.14-2.08), two-stage reconstruction (OR=9.78, 95% CI: 5.94-16.09), and for patients with higher PACU pain scores (OR=1.09, 95% CI: 1.03-1.14) or >150 discharge OMEs (OR=2.63, 95% CI: 1.48-4.68). CONCLUSION ERAS® protocols for mastectomy patients with or without IBR are associated with decreases in chronic opioid use, without concomitant increases in chronic sedative use.
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Affiliation(s)
- Kristen Jogerst
- Department of General Surgery. Division of Surgical Oncology. Mayo Clinic Arizona, Phoenix, AZ, USA
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Nikita Gupta
- Mayo Clinic School of Medicine. Arizona Campus, Phoenix, AZ, USA
| | - Heidi E Kosiorek
- Department of Research-Biostatistics. Mayo Clinic Arizona, Phoenix, AZ, USA
| | - Yeonsoo S Lee
- Mayo Clinic School of Medicine. Arizona Campus, Phoenix, AZ, USA
| | - Sami Abujbarah
- Mayo Clinic School of Medicine. Arizona Campus, Phoenix, AZ, USA
| | - Patricia Cronin
- Department of General Surgery. Division of Surgical Oncology. Mayo Clinic Arizona, Phoenix, AZ, USA
| | - William Casey
- Department of Surgery. Division of Plastic Surgery. Mayo Clinic Arizona, Phoenix, AZ, USA
| | - Barbara Pockaj
- Department of General Surgery. Division of Surgical Oncology. Mayo Clinic Arizona, Phoenix, AZ, USA
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Kim IK, Lee CS, Bae JH, Han SR, Alshalawi W, Kim BC, Lee IK, Lee DS, Lee YS. Perioperative outcomes of laparoscopic low anterior resection using ArtiSential ® versus robotic approach in patients with rectal cancer: a propensity score matching analysis. Tech Coloproctol 2024; 28:25. [PMID: 38231341 DOI: 10.1007/s10151-023-02895-y] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 11/26/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND Total mesorectal excision using conventional straight fixed devices may be technically difficult because of the narrow and concave pelvis. Several laparoscopic articulating tools have been introduced as an alternative to robotic systems. The aim of this study was to compare perioperative outcomes between laparoscopic low anterior resection using ArtiSential® and robot-assisted surgery for rectal cancer. METHODS This retrospective study included 682 patients who underwent laparoscopic or robotic low anterior resection for rectal cancer from September 2018 to December 2021. Among them, 82 underwent laparoscopic surgery using ArtiSential® (group A) and 201 underwent robotic surgery (group B). A total of 73 [group A; 66.37 ± 11.62; group B 65.79 ± 11.34] patients were selected for each group using a propensity score matching analysis. RESULTS There was no significant difference in the baseline characteristics between group A and B. Mean operative time was longer in group B than A (163.5 ± 61.9 vs 250.1 ± 77.6 min, p < 0.001). Mean length of hospital stay was not significantly different between the two groups (6.2 ± 4.7 vs 6.7 ± 6.1 days, p = 0.617). Postoperative complications, reoperation, and readmission within 30 days after surgery were similar between the two groups. Pathological findings revealed that the circumferential resection margins were above 10 mm in both groups (11.00 ± 7.47 vs 10.17 ± 6.25 mm, p = 0.960). At least 12 lymph nodes were sufficiently harvested, with no significant difference in the number harvested between the groups (20.5 ± 9.9 vs 19.7 ± 7.3, p = 0.753). CONCLUSIONS Laparoscopic low anterior resection using ArtiSential® can achieve acceptable clinical and oncologic outcomes. ArtiSential®, a multi-joint and articulating device, may serve a feasible alternative approach to robotic surgery in rectal cancer.
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Affiliation(s)
- I K Kim
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - C S Lee
- Department of Colorectal Surgery, Hansol Hospital, Seoul, Republic of Korea
| | - J H Bae
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - S R Han
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - W Alshalawi
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Surgery, King Saud Medical City, Riyadh, Saudi Arabia
| | - B C Kim
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - I K Lee
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - D S Lee
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Y S Lee
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Moon HH, Jin K, Choi YJ, Cho KJ, Lee YS, Lee JH. Imaging findings of granular cell tumours of the head and neck. Clin Radiol 2023; 78:e1075-e1080. [PMID: 37806818 DOI: 10.1016/j.crad.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/08/2023] [Accepted: 09/02/2023] [Indexed: 10/10/2023]
Abstract
AIM To review the imaging characteristics of granular cell tumours in the head and neck and assess their associations with pathological findings. MATERIALS AND METHODS Eleven patients (10 [91%] women, mean age 43 years) with histopathologically confirmed granular cell tumours were included in this study. Preoperative imaging studies were performed, including computed tomography (CT), magnetic resonance imaging (MRI), or ultrasound. The location of the tumours, their imaging features, and histopathological findings were analysed. RESULTS Among the 11 granular cell tumours, four (36%), three (27%), and two (18%) tumours were found in the submucosal layer, subcutaneous layer, and intramuscular area, respectively. On CT, all tumours exhibited homogeneous iso-attenuating enhancement compared with adjacent muscle, and nine out of the 11 tumours (81%) demonstrated well-defined margins. On T2-weighted imaging (T2WI), four out of five tumours (80%) demonstrated iso-signal intensity compared with adjacent muscles, and four tumours (80%) exhibited homogeneous signal intensity. The apparent diffusion coefficient (ADC) values ranged from 0.68-0.81 × 10-3 mm2/s. Histopathological examination revealed densely packed tumour cells with variable amounts of fibrous stroma. CONCLUSION Granular cell tumours were characterised by well-defined and iso-signals on T2WI and low mean ADC values, and were predominantly located in the submucosal, subcutaneous, or intramuscular areas in middle-aged women. The characteristic locations, demographic characteristics, and imaging findings can help to differentiate granular cell tumours from other soft-tissue tumours in the head and neck.
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Affiliation(s)
- H H Moon
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - K Jin
- Department of Health Care Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Y J Choi
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
| | - K-J Cho
- Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Y S Lee
- Department of Otolaryngology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - J H Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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Lee YS, Schommer J, Borkar S, Brennan E, Zganjar A, Colibaseanu DT, Spaulding AC, Lyon TD. Features associated with travel distance for radical cystectomy in Florida: Implications for access to care. Urol Oncol 2023; 41:485.e9-485.e16. [PMID: 37474414 DOI: 10.1016/j.urolonc.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/05/2023] [Accepted: 07/03/2023] [Indexed: 07/22/2023]
Abstract
INTRODUCTION Characteristics associated with travel distance for radical cystectomy (RC) remain incompletely defined but are needed to inform efforts to bridge gaps in care. Therefore, we assessed features associated with travel distance for RC in a statewide dataset. METHODS We identified RC patients in the Florida Inpatient Discharge dataset from 2013 to 2019. Travel distance was estimated using zip code centroids. The primary outcome was travel >50 miles for RC. Secondary outcomes included inpatient mortality, nonhome discharge, and inpatient complications. U.S. County Health Rankings were included as model covariates. Mixed effects logistic regression models accounting for clustering within hospitals were utilized. RESULTS We identified 4,209 patients, of whom 2,284 (54%) traveled <25 miles, 654 (16%) traveled 25 to 50 miles, and 1271 (30%) traveled >50 miles. Patients who traveled >50 miles primarily lived in central and southwest Florida. Following multivariable adjustment, patients traveling >50 miles were less likely to be Hispanic/Latino (odds ratio [OR] 0.35, 95% CI: 0.23-0.51), and more likely to reside in a county with the lowest health behavior (OR 6.48, 95% CI: 3.81-11.2) and lowest socioeconomic (OR 7.63, 95% CI: 5.30-11.1) rankings compared to those traveling <25 miles (all P < 0.01). Travel distance >50 miles was associated with treatment at a high-volume center and significantly lower risks of inpatient mortality, nonhome discharge, and postoperative complications (all P < 0.02). CONCLUSION These data identify characteristics of patients and communities in the state of Florida with potentially impaired access to RC care and can be used to guide outreach efforts designed to improve access to care.
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Affiliation(s)
- Yeonsoo S Lee
- Mayo Clinic Alix School of Medicine, Jacksonville, FL
| | | | - Shalmali Borkar
- Division of Health Care Delivery Research, Mayo Clinic, Jacksonville, FL
| | - Emily Brennan
- Division of Health Care Delivery Research, Mayo Clinic, Jacksonville, FL
| | | | - Dorin T Colibaseanu
- Division of Colon and Rectal Surgery, Mayo Clinic, Jacksonville, FL; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL
| | - Aaron C Spaulding
- Division of Health Care Delivery Research, Mayo Clinic, Jacksonville, FL; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL
| | - Timothy D Lyon
- Department of Urology, Mayo Clinic, Jacksonville, FL; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL.
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Choi KH, Mun SM, Seol Y, Lee YK, Lee JH, Lee IK, Lee YS, Jang H. The Role of Postoperative Radiotherapy in T4 Rectal Cancer with Synchronous Distant Metastasis. Int J Radiat Oncol Biol Phys 2023; 117:e288. [PMID: 37785066 DOI: 10.1016/j.ijrobp.2023.06.1279] [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) Studieson the role of surgery and local treatment in M1 rectal cancer have been actively studied recently. However, there is still controversy because no significant results have been reported for local control. The purpose of this study was to analyze the local control rates of postoperative radiotherapy for tumor stage T4 in M1 rectal cancer. MATERIALS/METHODS We investigated local recurrence after surgery for M1 rectal cancer that was operated at Seoul St. Mary's Hospital between 1995 and 2021. Locoregional recurrence rates were compared in patients who received postoperative pelvic radiotherapy and those who did not. In addition, an analytical comparison was performed only for patients with T4 rectal cancer. Statistical analysis was performed using the log rank test, and a p-value of less than 0.05 was considered significant. RESULTS During the investigation period, a total of 206 patients underwent surgery for M1 rectal cancer. There were 55 patients with T4 tumor stage. Of the 55 patients, 11 patients received radiotherapy after surgery, and 44 patients received systemic treatment such as chemotherapy after surgery without radiotherapy. During a median follow-up of 22 months, locoregional recurrence occurred in 1 (RT group) and 25 (no RT group) patients, respectively. Log-rank analysis of locoregional recurrence showed a significant difference between the two groups (p- value = 0.008). Death occurred in 10 (RT group) and 38 (no RT group) patients, respectively. The 2-year locoregional recurrence free-survival rates were 45.5% and 53.0%, respectively, and there was no significant difference between the two groups in the log-rank analysis. CONCLUSION Pelvic radiotherapy could be expected to improve locoregional recurrence in stage T4 of rectal cancer with synchronous distant metastasis. It would be warranted to prove this in a large-scale prospective study.
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Affiliation(s)
- K H Choi
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - S M Mun
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - Y Seol
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - Y K Lee
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - J H Lee
- Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea, Republic of (South) Korea
| | - I K Lee
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - Y S Lee
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - H Jang
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
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Lee YS, Jenkins AS, Gonzalez-Albo G, Ball CT, Porter SB, Dora CD. Tranexamic Acid Was Not Associated With a Reduction in Bleeding Complications Related to Holmium Laser Enucleation of the Prostate. Urology 2023; 180:209-213. [PMID: 37437611 DOI: 10.1016/j.urology.2023.06.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/25/2023] [Accepted: 06/29/2023] [Indexed: 07/14/2023]
Abstract
OBJECTIVE To compare outcomes in males given perioperative tranexamic acid (TXA) during holmium laser enucleation of the prostate (HoLEP) to a historical cohort that did not receive TXA. METHODS Our cohort included HoLEP patients (N = 1037) from August 2018 through November 2022. Exclusion criteria included history of stroke, transient ischemic attack, or coronary stent placed within 18 months. The primary predictor was TXA during HoLEP. The primary outcome variable was a return to the operating room (RTOR) for bleeding. Secondary outcomes included catheter reinsertion, transfusion, and clotting complications. Multivariable models evaluating associations of TXA with outcomes were adjusted for potential confounders. RESULTS In our cohort, 214/1035 had one or more complications with 81 having a Clavien-Dindo Grade of 3a or higher, 114/1037 with catheter reinsertion, 36/1037 RTOR for bleeding, and 15/1035 had a transfusion. TXA use was not associated with 30-day RTOR. 3.7% of those without TXA had a RTOR, and 3.1% of those with TXA had a RTOR (adjusted odds ratio 0.63, 95% CI 0.28-1.38, P = .25). Transfusion rates were higher for those without TXA (2.0%) compared to with (0.5%). This was statistically significant after adjustment (adjusted odds ratio 0.13, 95% CI 0.03-0.69, P = .016) and after correction for multiple testing (corrected P = .048). TXA use was not associated with catheter reinsertion or clotting complications. CONCLUSION Routine perioperative intravenous TXA in HoLEP patients was not associated with a reduction of RTOR for bleeding, catheter reinsertion, or clotting complications. TXA was associated with decreased transfusions with a low overall event rate of 1.4%.
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Affiliation(s)
- Yeonsoo S Lee
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Jacksonville, FL
| | - Anna S Jenkins
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Jacksonville, FL
| | | | - Colleen T Ball
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL
| | - Steven B Porter
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL
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Lee YS, Campany M, Fullerton S, Malik R, Dorsey C, Mercado D, Allen A, Erben Y. State of Gender-Based Microaggressions Among Surgeons and Development of Simulation Workshops for Addressing Microaggressions for Surgical Trainees and Students. Ann Vasc Surg 2023; 95:285-290. [PMID: 36963719 DOI: 10.1016/j.avsg.2023.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/02/2023] [Accepted: 03/04/2023] [Indexed: 03/26/2023]
Abstract
BACKGROUND Microaggressions are statements or actions taken in a discriminatory manner. Microaggressions can be subtle or explicit, intentional or unintentional, but regardless of the type of microaggressions, it is important to identify and address them, as they are linked to physician burnout and add to levels of depression, anxiety, and stress. In this study, we evaluated the prevalence, quality, and impacts of gender-based microaggressions on surgeons and surgical trainees using simulation-based education. Further, we plan to iteratively develop more simulation sessions based on the findings of this study. METHODS We used simulation-based education to develop and implement microaggression scenarios. Those scenarios were performed by standardized patients (trained actors) who demonstrated the different microaggression situations previously seen at the workplace and wards. Published tools to address gender-based microaggressions were outlined in preparation (prebrief) for a discussion of recorded simulations. A debrief of developing potential resolutions as learners and future allies and how similar microaggressions may have been perpetuated in our own careers followed each scenario. Additionally, an 11-item survey was developed based on validated surveys of sexist and Microaggressions Experience and Stress Scale and disseminated through email listservs and social media links. Data collection occurred from November to December 2022. RESULTS When surveyed after the workshop, 100% of participants (n = 6) said that they would recommend this session to follow colleagues, and 100% completely agreed the content of the simulation was relevant to their future practice. Further, 100% of participants agreed or completely agreed that their ability to perform these tasks (addressing microaggressions) has improved after this course. Most respondents to the disseminated survey (n = 147) were vascular surgeons (95/147; 64.6%) and identified as White (93/147; 63.3%), and as women (142/147; 96.6%). Most were identified as targets of gender-based microaggressions (128/147; 87.1%) and or silent witnesses to such microaggressions (87/147; 59.2%). However, there were reports of having a perpetrator of a microaggression (2/147; 1.4%), a nonsilent witness (3/147; 2.0%), or having no target, witness, or perpetrator (3/147; 2.0%). Of the quality of microaggressions, the most common impacts were when the targeted individual attempted to hide their emotions to not appear too emotional (described in the literature as "leaving gender at the door") (32/147; 21.8%), were told that women no longer experience discrimination (25/147; 17.0%), and were asked when one would have children (24/147; 16.3%). The most stressful types of microaggressions were ones in which male peers were the only ones receiving recognition for work (55/147; 37.4%), targets were told women no longer experience discrimination (49/147; 33.3%), and in which men spoke about women in degrading terms regarding their gender or on topics related to their gender (35/147; 23.8%). Qualitative responses to the survey included comments remarking on the relevancy and prevalence of gender-based microaggressions, reasons for silence, the personal and professional impacts (e.g., pay equity) of microaggressions and gender bias, and future areas of work to address bias in medicine. CONCLUSIONS Given the prevalence of microaggressions seen in surgery, especially among vascular surgeons, future steps include discussion of how techniques can be developed and applied to other types of microaggressions (e.g., due to race/ethnicity, sexuality, disability, religion), implementation of future workshops that address intersectionality in scenarios and potentially virtual sessions to increase accessibility to these types of training options for learners at other institutions.
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Affiliation(s)
- Yeonsoo S Lee
- Mayo Clinic Alix School of Medicine, Mayo Clinic Florida, Jacksonville, FL
| | - Megan Campany
- Mayo Clinic Alix School of Medicine, Mayo Clinic Arizona, Scottsdale, AZ
| | - Shalyn Fullerton
- Mayo Clinic Alix School of Medicine, Mayo Clinic Florida, Jacksonville, FL
| | - Rafay Malik
- Mayo Clinic Alix School of Medicine, Mayo Clinic Florida, Jacksonville, FL
| | - Chelsea Dorsey
- Section of Vascular Surgery and Endovascular Therapy, The University of Chicago Medicine and Biological Sciences, Chicago, IL
| | - Deisy Mercado
- Simulation Center, Mayo Clinic Florida, Jacksonville, FL
| | - Amy Allen
- Simulation Center, Mayo Clinic Florida, Jacksonville, FL
| | - Young Erben
- Division of Vascular and Endovascular Surgery, Mayo Clinic Florida, Jacksonville, FL.
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Long ME, Lee YS, Vegunta S. Cervical cancer screening in menopause: when is it safe to exit? Menopause 2023; 30:972-979. [PMID: 37527477 DOI: 10.1097/gme.0000000000002222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
IMPORTANCE AND OBJECTIVE Despite a decreasing incidence of cervical cancer in North America overall, disparities in screening and cervical cancer rates persist, especially in the postmenopausal age group. METHODS We reviewed the literature regarding cervical cancer screening considerations for postmenopausal persons, with a focus on cervical cancer in postmenopausal persons, existing guidelines, screening methods, and gaps in care. DISCUSSION AND CONCLUSION Postmenopausal persons are an important population at risk because age 65 years in the United States and up to 70 years in some parts of Canada is a milestone for screening cessation if the criteria are met. Unfortunately, inadequate screening is common, with most women 65 years or older discontinuing ( exiting ) screening despite not meeting the criteria to do so. Screening cessation recommendations are nuanced, and if not all criteria are met, screening should be continued until they are. Cervical cancer screening should be stopped at the recommended age if adequate screening has occurred or at any age if life expectancy is limited or the patient has had a hysterectomy in the absence of high-grade preinvasive cervical lesions or cervical cancer. Human papillomavirus infection, which is causally linked to almost all cervical cancer cases, can persist or reactivate from a prior infection or can be newly acquired from sexual contact. With more persons aging with a cervix in place, the potential for cervical cancer has increased, and higher cancer rates may be observed if recommended screening is not adhered to. We propose an algorithm based on current cervical cancer screening guidelines to aid providers in identifying whether exit criteria have been met. Until adequate screening has been confirmed, cervical cancer screening should continue.
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Affiliation(s)
- Margaret E Long
- From the Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN
| | - Yeonsoo S Lee
- Student, Mayo Clinic Alix School of Medicine, Mayo Clinic College of Medicine and Science, Scottsdale, AZ
| | - Suneela Vegunta
- Division of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, AZ
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Singh R, Pollock JR, Moore ML, Lee YS, Hudson M, Bendok BR, Patel NP. Clinical Examination of the Cranial Nerves. N Engl J Med 2023; 389:e2. [PMID: 37407003 DOI: 10.1056/nejmvcm2103640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Affiliation(s)
- Rohin Singh
- From the Department of Neurosurgery, Mayo Clinic, Phoenix, AZ
| | | | - M Lane Moore
- From the Department of Neurosurgery, Mayo Clinic, Phoenix, AZ
| | - Yeonsoo S Lee
- From the Department of Neurosurgery, Mayo Clinic, Phoenix, AZ
| | - Miles Hudson
- From the Department of Neurosurgery, Mayo Clinic, Phoenix, AZ
| | | | - Naresh P Patel
- From the Department of Neurosurgery, Mayo Clinic, Phoenix, AZ
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Schaaf AL, Lee YS, Myers AA, Schommer J, Gonzalez G, Chen A, Petrou S. Complex Urethral Diverticulectomy: Is a Synchronous Prophylactic Autologous Fascial Sling Needed? Urogynecology (Phila) 2023; 29:330-335. [PMID: 37235804 DOI: 10.1097/spv.0000000000001311] [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] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
IMPORTANCE Urethral diverticulectomy is performed with or without concomitant pubovaginal sling (PVS). Patients with complex UD are more frequently offered concomitant PVS. However, there is paucity of literature comparing postoperative incontinence rates for patients with simple versus complex UD. OBJECTIVE The objective of this study is to examine postoperative stress urinary incontinence (SUI) rates after Urethral Diverticulectomy without concomitant PVS for both complex and simple cases. STUDY DESIGN A retrospective cohort study was conducted among 55 patients who underwent Urethral Diverticulectomy from 2007 to 2021. Preoperative SUI was patient-reported and confirmed with cough stress test result. Complex cases were defined as circumferential or horseshoe configurations, prior diverticulectomy, and/or anti-incontinence procedure. Primary outcome was postoperative SUI. Secondary outcome was interval PVS. Complex and simple cases were compared using the Fisher exact test. RESULTS Median age was 49 years (interquartile range, 36-58 years). Median follow-up was 5.4 months (IQR, 2-24 months). Thirty of 55 (55%) cases were simple, and 25 of 55 (45%) complex. Preoperative SUI was present in 19/57 (35%) (11 complex vs 8 simple, P = 0.25). Stress urinary incontinence persisted postoperatively in 10 of 19 (52%) (6 complex vs 4 simple, P = 0.48). De novo SUI occurred in 7 of 55, 12% (4 complex vs 3 simple, P = 0.68). Overall, 17 of 55 (31%) patients had postoperative SUI (10 complex vs 7 simple, P = 0.24). Of those, 8 of 17 underwent subsequent PVS placement (P = 0.71) and 9 of 17 had resolution of pad use after physical therapy (P = 0.27). CONCLUSIONS We did not find evidence of an association between complexity and postoperative SUI. Age at surgery and preoperative frequency were the strongest predictors of postoperative SUI in this cohort. Our findings suggest successful complex urethral diverticulum repair does not require concomitant PVS.
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Affiliation(s)
| | | | | | | | | | - Anita Chen
- Department of Gynecology, Mayo Clinic, Jacksonville, FL
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11
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Lee JM, Lee YS, Lee YJ, Lee JH, Han TY, Choi JE. Generalized painful papulovesicular eruption following the COVID-19 BNT162b2 mRNA vaccine. J Eur Acad Dermatol Venereol 2023. [PMID: 36914917 DOI: 10.1111/jdv.19043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/07/2023] [Indexed: 03/16/2023]
Affiliation(s)
- J M Lee
- Department of Dermatology, Nowon Eulji Medical Center, Eulji University, Seoul, South Korea
| | - Y S Lee
- Department of Dermatology, Nowon Eulji Medical Center, Eulji University, Seoul, South Korea
| | - Y J Lee
- Department of Dermatology, Nowon Eulji Medical Center, Eulji University, Seoul, South Korea
| | - J H Lee
- Department of Dermatology, Nowon Eulji Medical Center, Eulji University, Seoul, South Korea
| | - T Y Han
- Department of Dermatology, Nowon Eulji Medical Center, Eulji University, Seoul, South Korea
| | - J E Choi
- Department of Dermatology, Nowon Eulji Medical Center, Eulji University, Seoul, South Korea
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12
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Katz IT, Ngure K, Kamolloh K, Ogello V, Okombo M, Thuo NB, Owino E, Garrison LE, Lee YS, Nardell MF, Anyacheblu C, Bukusi E, Mugo N, Baeten JM, Haberer JE. Multi-level Factors Driving Pre-exposure Prophylaxis Non-initiation Among Young Women at High Risk for HIV in Kenya. AIDS Behav 2023; 27:106-118. [PMID: 35930203 DOI: 10.1007/s10461-022-03748-9] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2022] [Indexed: 01/29/2023]
Abstract
Few studies have focused on understanding pre-exposure prophylaxis (PrEP) non-initiation among young, high-risk women in sub-Saharan Africa. This study aimed to qualitatively explore why young women in Kenya at high-risk for HIV chose not to enroll in a PrEP adherence trial. We performed 40 semi-structured interviews with young high-risk women assessing concerns about PrEP and/or study participation. We also assessed community-level factors influencing decision-making around PrEP through 10 focus groups involving peers, young men, caregivers, and community leaders. Our qualitative data reflect the complexity of navigating barriers preventing PrEP initiation in settings where taking PrEP may be perceived as immoral behavior. Framed within the context of risk perception, the decision to start PrEP may run counter to the potential risk of losing support from one's community. Our findings suggest that approaches addressing social norms, while de-medicalizing HIV prevention services, are needed to further increase PrEP uptake among young Kenyan women.
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Affiliation(s)
- Ingrid T Katz
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA. .,Harvard Medical School, Boston, MA, USA. .,Massachusetts General Hospital Center for Global Health, Boston, MA, USA. .,Harvard Global Health Institute, Cambridge, MA, USA. .,Division of Women's Health, Brigham and Women's Hospital, 1620 Tremont St. - 3rd Floor, Boston, MA, 02120, USA.
| | - Kenneth Ngure
- Department of Community Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | | | | | - Moses Okombo
- Kenya Medical Research Institute, Nairobi, Kenya
| | | | - Esther Owino
- Kenya Medical Research Institute, Nairobi, Kenya
| | - Lindsey E Garrison
- Massachusetts General Hospital Center for Global Health, Boston, MA, USA
| | - Yeonsoo S Lee
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Mayo Clinic Alix School of Medicine, Scottsdale, AZ, USA
| | - Maria F Nardell
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Chiemelie Anyacheblu
- Harvard T.H Chan School of Public Health, Boston, MA, USA.,SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Elizabeth Bukusi
- Kenya Medical Research Institute, Nairobi, Kenya.,Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA
| | - Nelly Mugo
- Kenya Medical Research Institute, Nairobi, Kenya.,Department of Global Health, Medicine, and Epidemiology, University of Washington, Seattle, WA, USA
| | - Jared M Baeten
- Department of Global Health, Medicine, and Epidemiology, University of Washington, Seattle, WA, USA.,Gilead Sciences, Foster City, CA, USA
| | - Jessica E Haberer
- Harvard Medical School, Boston, MA, USA.,Massachusetts General Hospital Center for Global Health, Boston, MA, USA
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13
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Lee YS, Khan AA. Financial Toxicity for Female Patients with Urinary Incontinence. Curr Urol Rep 2023; 24:33-39. [PMID: 36527587 DOI: 10.1007/s11934-022-01130-9] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW Urinary incontinence (UI) is a common global condition that has been noted to disproportionately affect women. In this review, the authors present discussion of factors contributing to cost of care and various modalities of cost-effective care for UI for female patients. RECENT FINDINGS We found insurance and out-of-pocket (OOP) costs strongly impact of costs for patients. Further, in evaluation of UI, diagnosis can be a costly multi-step process for effective treatment. Treatment can be multimodal, including non-surgical (e.g., pessary, vaginal insert, pelvic floor muscle training, or PFMT), of which PFMT is a cost-effective, effective, and accessible treatment. Pharmacologic management is generally second-line for overactive bladder, but anti-muscarinic drugs and beta-3 agonists are cost-effective depending on willingness-to-pay and the health system in which they are acquired, respectively. Surgical management is considered the most cost-effective treatment as willingness-to-pay increased, with minimally invasive slings being the mainstay. Other relatively novel treatments are also discussed (e.g., EMSELLA) but require further research. Additionally, we discuss systematic barriers in decisions to seek care for urinary incontinence. Urologists are key agents in treating UI for their female patients, and seeking cost-effective options for treatment remains pivotal for quality care.
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Affiliation(s)
- Yeonsoo S Lee
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Aqsa A Khan
- Department of Urology, Mayo Clinic, Phoenix, AZ, USA.
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14
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Kwon S, Lee SR, Choi EK, Ahn HJ, Song HS, Lee YS. Comparison of adhesive single-lead ECG device and Holter test for atrial fibrillation monitoring. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.414] [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
There is insufficient validation of diagnostic benefits of extended monitoring with an adhesive single-lead ECG device compared to Holter test for routine medical care of AF patients.
Purpose
The study aimed to compare AF detection rates between 72-hour monitoring using an adhesive single-lead ECG device (mobiCARE MC-100, Seers Technology, Republic of Korea) and 24-hour Holter test among AF patients at outpatient clinics.
Methods
A total of 200 AF patients indicated for Holter test at cardiology outpatient clinics enrolled in the study. Study participants equipped both Holter and MC-100 for the first 24 hours (Figure 1). After then, only MC-100 continued ECG monitoring for additional 48 hours. AF detection during the first 24 hours was compared between two devices. The diagnostic benefits of extended monitoring with MC-100 were evaluated.
Results
During the first 24 hours, both monitoring methods detected AF in the same 40/200 (20.0%) patients (20 patients with paroxysmal and persistent AF each). Compared to 24-hour Holter, MC-100 increased AF detection rate by 1.5-fold (58/200; 29.0%) and 1.6-fold (64/200; 32.0%) with 48- and 72-hour monitoring, respectively (Figure 2A). With MC-100, the number of newly discovered patients with paroxysmal AF was 20/44 (45.5%), 18/44 (40.9%), and 6/44 (13.6%) for 24-, 48-, and 72-hour monitoring. Compared to 24-hour Holter, 72-hour monitoring with MC-100 increased the detection rate of paroxysmal AF by 2.2-fold (44/20). If only the episodes lasting over 30 seconds were counted as AF with MC-100, the detection rate of paroxysmal AF was decreased by 9.1% (Figure 2B).
Conclusion
Compared to Holter, AF detection rates could be improved with an adhesive single-lead device, especially for patients with paroxysmal AF. This device is expected to be useful for AF detection among patients whose conventional ECG tests were ineffective in documenting AF episodes.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The Korea Medical Device Development Fund grant funded by the Korean government (the Ministry of Science and ICT, the Ministry of Trade, Industry and Energy, the Ministry of Health & Welfare, Republic of Korea, the Ministry of Food and Drug Safety)
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Affiliation(s)
- S Kwon
- Seoul National University Hospital , Seoul , Korea (Republic of)
| | - S R Lee
- Seoul National University Hospital , Seoul , Korea (Republic of)
| | - E K Choi
- Seoul National University Hospital , Seoul , Korea (Republic of)
| | - H J Ahn
- Seoul National University Hospital , Seoul , Korea (Republic of)
| | - H S Song
- Seers Technology , Seongnam , Korea (Republic of)
| | - Y S Lee
- Seers Technology , Seongnam , Korea (Republic of)
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15
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Park H, Yu HT, Kim TH, Park J, Park JK, Kang KW, Shim J, Kim JB, Choi EK, Park HW, Lee YS, Joung B. Oral anticoagulation therapy in atrial fibrillation patients with advanced chronic kidney disease: CODE-AF Registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.628] [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 and objectives
Advanced chronic kidney disease (CKD), including end-stage renal disease (ESRD) on dialysis, increases thromboembolic risk among patients with atrial fibrillation (AF). This study examined the comparative safety and efficacy of direct-acting oral anticoagulant (DOAC) compared to warfarin or no OAC among AF patients with advanced CKD or ESRD on dialysis.
Methods
Using data from the COmparison study of Drugs for symptom control and complication prEvention of AF (CODE-AF) registry, 260 non-valvular AF patients with advanced CKD (defined as estimated glomerular filtration rate [eGFR] <3 0ml/min per 1.73 m2) or ESRD on dialysis were enrolled from June 2016 to July 2020. The study population was categorized into DOAC, warfarin, and no OAC group, and differences in major or clinically relevant non-major (CRNM) bleeding, stroke/systemic embolism (SE), myocardial infarction/critical limb ischemia (CLI), and death were assessed.
Results
During a median 24 months of follow-up, major or CRNM bleeding risk was significantly reduced in the DOAC group compared to the warfarin group (hazard ratio [HR] 0.21, 95% confidence interval [CI] 0.05 to 0.95, p=0.042). In addition, the risk of composite adverse clinical outcome (major or CRNM bleeding, stroke/SE, myocardial infarction/CLI, and death) was significantly reduced in the DOAC group compared to the no OAC group (HR 0.32, 95% CI 0.11 to 0.96, p=0.043).
Conclusion
Among AF patients with advanced CKD or ESRD on dialysis, DOAC was associated with a lower risk of major or CRNM bleeding compared to warfarin and a lower risk of composite adverse clinical outcome compared to no OAC.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Korean Healthcare Technology R&D project funded by the Ministry of Health & Welfare (HI15C1200, HC19C0130)
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Affiliation(s)
- H Park
- Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - H T Yu
- Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - T H Kim
- Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - J Park
- Ewha Womans University School of Medicine , Seoul , Korea (Republic of)
| | - J K Park
- Hanyang university medical center , Seoul , Korea (Republic of)
| | - K W Kang
- Eulji University College of Medicine , Seoul , Korea (Republic of)
| | - J Shim
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - J B Kim
- Kyunghee University , Seoul , Korea (Republic of)
| | - E K Choi
- Seoul National University Hospital , Seoul , Korea (Republic of)
| | - H W Park
- Chonnam National University School of Medicine , Gwangju , Korea (Republic of)
| | - Y S Lee
- Daegu Catholic University Medical Center , Daegu , Korea (Republic of)
| | - B Joung
- Yonsei University College of Medicine , Seoul , Korea (Republic of)
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16
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Verhey EM, Kandi LA, Lee YS, Morris BE, Casey WJ, Rebecca AM, Marks LA, Howard MA, Teven CM. Outcomes of Lymphovenous Anastomosis for Lower Extremity Lymphedema: A Systematic Review. Plast Reconstr Surg Glob Open 2022; 10:e4529. [PMID: 36225843 PMCID: PMC9542573 DOI: 10.1097/gox.0000000000004529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 07/27/2022] [Indexed: 06/16/2023]
Abstract
UNLABELLED Lymphovenous anastomosis (LVA) is a microsurgical treatment for lymphedema of the lower extremity (LEL). This study systematically reviews the most recent data on outcomes of various LVA techniques for LEL in diverse patients. METHODS A comprehensive literature search was conducted in the Ovid MEDLINE, Ovid EMBASE, and Scopus databases to extract articles published through June 2021. Studies reporting data on objective postoperative improvement in lymphedema and/or subjective improvement in quality of life for patients with LEL were included. Extracted data comprised demographics, number of patients and lower limbs, duration of symptoms before LVA, surgical technique, duration of follow-up, and objective and subjective outcomes. RESULTS A total of 303 articles were identified and evaluated, of which 74 were ultimately deemed eligible for inclusion in this study, representing 6260 patients and 2554 lower limbs. The average patient age ranged from 22.6 to 76.14 years. The duration of lymphedema before LVA ranged from 12 months to 11.4 years. Objective rates of improvement in lymphedema ranged from 23.3% to 100%, with the greatest degree of improvement seen in patients with early-stage LEL. CONCLUSIONS LVA is a safe and effective technique for the treatment of LEL of all stages. Several emerging techniques and variations may lead to improved patient outcomes.
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Affiliation(s)
- Erik M. Verhey
- From the Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, Ariz
| | - Lyndsay A. Kandi
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic, Phoenix, Ariz
| | - Yeonsoo S. Lee
- From the Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, Ariz
| | - Bryn E. Morris
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic, Phoenix, Ariz
| | - William J. Casey
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic, Phoenix, Ariz
| | - Alanna M. Rebecca
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic, Phoenix, Ariz
| | - Lisa A. Marks
- Mayo Clinic Libraries, Mayo Clinic, Scottsdale, Ariz
| | - Michael A. Howard
- Division of Plastic Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Chad M. Teven
- Division of Plastic Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Ill
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17
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Xu AJ, Mishra K, Lee YS, Zhao LC. Robotic-Assisted Lower Genitourinary Tract Reconstruction. Urol Clin North Am 2022; 49:507-518. [DOI: 10.1016/j.ucl.2022.05.003] [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: 12/01/2022]
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18
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Pace LE, Tung N, Lee YS, Hamilton JG, Gabriel C, Revette A, Raja S, Jenkins C, Braswell A, Morgan K, Levin J, Block J, Domchek SM, Nathanson K, Symecko H, Spielman K, Karlan B, Kamara D, Lester J, Offit K, Garber JE, Keating NL. Challenges and Opportunities in Engaging Primary Care Providers in BRCA Testing: Results from the BFOR Study. J Gen Intern Med 2022; 37:1862-1869. [PMID: 34173196 PMCID: PMC9198181 DOI: 10.1007/s11606-021-06970-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/04/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Engaging primary care providers (PCPs) in BRCA1/2 testing and results disclosure would increase testing access. The BRCA Founder OutReach (BFOR) study is a prospective study of BRCA1/2 founder mutation screening among individuals of Ashkenazi Jewish descent that sought to involve participants' PCPs in results disclosure. We used quantitative and qualitative methods to evaluate PCPs' perspectives, knowledge, and experience disclosing results in BFOR. METHODS Among PCPs nominated by BFOR participants to disclose BRCA1/2 results, we assessed the proportion agreeing to disclose. To examine PCP's perspectives, knowledge, and willingness to disclose results, we surveyed 501 nominated PCPs. To examine PCPs' experiences disclosing results in BFOR, we surveyed 101 PCPs and conducted 10 semi-structured interviews. RESULTS In the BFOR study overall, PCPs agreed to disclose their patient's results 40.5% of the time. Two hundred thirty-four PCPs (46.7%) responded to the initial survey. Responding PCPs were more likely to agree to disclose patients' results than non-responders (57.3% vs. 28.6%, p<0.001). Among all respondents, most felt very (19.7%) or somewhat (39.1%) qualified to share results. Among PCPs declining to disclose, insufficient knowledge was the most common reason. In multivariable logistic regression, feeling qualified was the only variable significantly associated with agreeing to disclose results (OR 6.53, 95% CI 3.31, 12.88). In post-disclosure surveys (response rate=55%), PCPs reported largely positive experiences. Interview findings suggested that although PCPs valued the study-provided educational materials, they desired better integration of results and decision support into workflows. CONCLUSION Barriers exist to incorporating BRCA1/2 testing into primary care. Most PCPs declined to disclose their patients' BFOR results, although survey respondents were motivated and had positive disclosure experiences. PCP training and integrated decision support could be beneficial. TRIAL REGISTRATION ClinicalTrials.gov (NCT03351803), November 24, 2017.
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Affiliation(s)
- Lydia E Pace
- Brigham and Women's Hospital, Boston, MA, USA. .,Harvard Medical School, Boston, MA, USA.
| | - Nadine Tung
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Yeonsoo S Lee
- Mayo Clinic Alix School of Medicine, Scottsdale, AZ, USA
| | | | | | | | - Sahitya Raja
- Rush Medical College at Rush University, Chicago, IL, USA
| | | | | | - Kelly Morgan
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jeffrey Levin
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jeremy Block
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Susan M Domchek
- Basser Center for BRCA, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Katherine Nathanson
- Basser Center for BRCA, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Heather Symecko
- Basser Center for BRCA, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kelsey Spielman
- Basser Center for BRCA, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Beth Karlan
- David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Daniella Kamara
- David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Jenny Lester
- David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Kenneth Offit
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Nancy L Keating
- Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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19
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Park H, Yu HT, Kim TH, Park J, Park JK, Kang KW, Shim J, Kim JB, Kim J, Choi EK, Park HW, Lee YS, Joung B. Resting heart rate and cardiovascular outcomes in patients with atrial fibrillation: CODE-AF registry. Europace 2022. [DOI: 10.1093/europace/euac053.182] [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: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
The prognostic significance of resting heart rate and its therapeutic target in atrial fibrillation (AF) is uncertain.
Purpose
The aim of this study was to investigate the relationships between resting heart rate and cardiovascular outcomes in patients with AF.
Methods
A total of 8,886 patients with AF was included from the COmparison study of Drugs for symptom control and complication prEvention of AF (CODE-AF) registry. Patients were categorized according to baseline heart rate, and cardiovascular outcomes were accessed during a median follow-up of 30 months. The primary outcome was a composite of cardiovascular death, hospitalization due to heart failure, and myocardial infarction/critical limb ischemia.
Results
Compared to heart rate ≥100 beats per minute (bpm), heart rate 80-99 bpm was associated with the lowest risk of primary outcome (adjusted hazard ratio [HR] 0.56, 95% confidence interval [CI] 0.40-0.79, p=0.001). In subgroup of patients with heart failure with preserved ejection fraction (HFpEF), heart rate between 80-99 bpm was associated with reduced risk of primary outcome compared to heart rate ≥100 bpm (HR 0.40, 95% CI 0.16-0.98, p=0.045). However, in patients with heart failure with reduced ejection fraction (HFrEF), there was no association between resting heart rate and cardiovascular outcomes (P for interaction 0.001).
Conclusion
Resting heart rate was associated with cardiovascular outcomes in patients with AF, and those with a resting heart rate between 80-99 bpm had the lowest risk of adverse events. The impact of resting heart rate on adverse events persisted in patients with concomitant HFpEF but was not apparent in those with concomitant HFrEF.
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Affiliation(s)
- H Park
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - HT Yu
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - TH Kim
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - J Park
- Ewha Womans University School of Medicine, Seoul, Korea (Republic of)
| | - JK Park
- Hanyang University Seoul Hospital, Seoul, Korea (Republic of)
| | - KW Kang
- Eulji University College of Medicine, Seoul, Korea (Republic of)
| | - J Shim
- Korea University Medical Center, Seoul, Korea (Republic of)
| | - JB Kim
- Kyung Hee University Hospital, Seoul, Korea (Republic of)
| | - J Kim
- University of Ulsan College of Medicine, Seoul, Korea (Republic of)
| | - EK Choi
- Seoul National University Hospital, Seoul, Korea (Republic of)
| | - HW Park
- Chonnam National University School of Medicine, Gwangju, Korea (Republic of)
| | - YS Lee
- Daegu Catholic University Medical Center, Daegu, Korea (Republic of)
| | - B Joung
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
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20
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Sugianto R, Toh JY, Wong SF, Tint MT, Colega MT, Lee YS, Yap F, Shek LPC, Tan KH, Godfrey KM, Chong YS, Tai BC, Chong MFF. Dietary patterns of 5-year-old children and their correlates: findings from a multi-ethnic Asian cohort. Br J Nutr 2022; 127:763-772. [PMID: 33910654 PMCID: PMC7612427 DOI: 10.1017/s0007114521001434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
There is limited data on the dietary patterns of 5-year-old children in Asia. The study examined childhood dietary patterns and their maternal and child correlates in a multi-ethnic Asian cohort. Based on caregiver-reported 1-month quantitative FFQ of 777 children from the Growing Up in Singapore Towards healthy Outcomes cohort, cluster analysis identified two mutually exclusive clusters. Children in the 'Unhealthy' cluster (43·9 %) consumed more fries, processed meat, biscuits and ice cream, and less fish, fruits and vegetables compared with those in the 'Healthy' cluster (56·1 %). Children with mothers of lower educational attainment had twice the odds of being assigned to the 'Unhealthy' cluster (adjusted OR (95 % CI) = 2·19 (95 % CI 1·49-3·24)). Children of Malay and Indian ethnicities had higher odds of being assigned to the 'Unhealthy' cluster (adjusted OR = 25·46 (95 % CI 15·40, 42·10) and 4·03 (95 % CI 2·68-6·06), respectively), relative to Chinese ethnicity. In conclusion, this study identified two dietary patterns in children, labelled as the 'Unhealthy' and 'Healthy' clusters. Mothers' educational attainment and ethnicity were two correlates that were associated with the children's assignments to the clusters. These findings can assist in informing health promotion programmes targeted at Asian children.
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Affiliation(s)
- R Sugianto
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - JY Toh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - SF Wong
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - MT Tint
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - MT Colega
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - YS Lee
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
- Khoo Teck Puat-National University Children’s Medical Institute, National University Hospital and National University Health System, Singapore
| | - F Yap
- Duke-NUS Medical School, Singapore
- KK Women’s and Children’s Hospital, Singapore
| | - LPC Shek
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
- Khoo Teck Puat-National University Children’s Medical Institute, National University Hospital and National University Health System, Singapore
| | - KH Tan
- Duke-NUS Medical School, Singapore
- KK Women’s and Children’s Hospital, Singapore
| | - KM Godfrey
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
| | - YS Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - BC Tai
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - MFF Chong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
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21
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Jacobs JW, Peabody Lever JE, Lee YS, Bryan KM, Booth GS, Njoku IO, Arvisais-Anhalt S, Araj E, Park JY. The Importance of Accurately Defining Gender and Sex in Pathology. Am J Clin Pathol 2022; 158:153. [PMID: 35150126 PMCID: PMC9391684 DOI: 10.1093/ajcp/aqac008] [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)
| | | | | | | | | | | | | | - Ellen Araj
- UT Southwestern Medical Center, Dallas, TX, USA,UT Southwestern Medical Center, Dallas, TX, USA
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22
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Begasse de Dhaem O, Kiarashi J, Armand CE, Charleston L, Szperka CL, Lee YS, Rajapakse T, Seng EK, VanderPluym JH, Starling AJ. Ten Eleven things to facilitate participation of underrepresented groups in headache medicine research. Headache 2021; 61:951-960. [PMID: 34125956 PMCID: PMC10091268 DOI: 10.1111/head.14124] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 04/01/2021] [Accepted: 04/05/2021] [Indexed: 12/17/2022]
Affiliation(s)
| | - Jessica Kiarashi
- Department of Neurology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Cynthia E Armand
- Department of Neurology, Albert Einstein College of Medicine, Montefiore Headache Center, Bronx, NY, USA
| | - Larry Charleston
- Department of Neurology and Ophthalmology, Michigan State University College of Human Medicine, East Lansing, MI, USA
| | - Christina L Szperka
- Department of Neurology, Children's Hospital of Philadelphia & Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Yeonsoo S Lee
- Department of Medicine, Mayo Clinic Alix School of Medicine, Scottsdale, AZ, USA
| | - Thilinie Rajapakse
- Department of Neurology, Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada
| | - Elizabeth K Seng
- Department of Psychology, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.,Department of Psychology, Albert Einstein College of Medicine, Bronx, NY, USA
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23
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Kim HJ, Lee HS, Kazmi SZ, Hann HJ, Kang T, Cha J, Choi S, Swan H, Kim H, Lee YS, Ahn HS. Familial risk for endometriosis and its interaction with smoking, age at menarche and body mass index: a population-based cohort study among siblings. BJOG 2021; 128:1938-1948. [PMID: 34028167 DOI: 10.1111/1471-0528.16769] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To quantify familial risk of endometriosis among full siblings and examine interactions between family history and smoking, age at menarche or body mass index (BMI). DESIGN, SETTING AND POPULATION Population-based nationwide cohort study. METHODS Using data from the Korean National Health Insurance and Screening Programme databases on kinship, healthcare utilisation, lifestyle and anthropometrics, we identified 2 109 288 women with full siblings and their environmental risk factors from 2002 to 2018. Familial risks were estimated using Cox proportional-hazards models, represented as incidence risk ratios (IRR) with 95% CI. Interaction between family history and smoking, age at menarche or BMI were assessed on an additive scale. MAIN OUTCOME MEASURES IRR of endometriosis among women with and without affected siblings. RESULTS From 19 195 women with affected siblings, 1126 developed endometriosis with an incidence of 35.45/10 000 person-years. Familial risk of endometriosis with versus without affected siblings was increased to IRR 2.75 (95% CI 2.25-3.36), and the highest risk was with affected twins (IRR 6.98; 95% CI 4.19-11.62). Women with both a family history and either smoking, early menarche or low BMI had a significantly higher risk of endometriosis compared with the general population and can be regarded as a high-risk group, the IRRs were 4.28 (95% CI 2.43-7.55), 3.47 (95% CI 2.82-4.26) and 3.09 (95% CI 2.68-3.56), respectively. Substantial effect modification of the associations was noted by smoking and early menarche, as their combined risk with family history exceeded the sum of their individual risks, which was also statistically significant. CONCLUSION Genetic factors are the primary contributor to the familial aggregation of endometriosis. Significant gene-environment interaction exists between family history and smoking or early menarche.
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Affiliation(s)
- H J Kim
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea
| | - H-S Lee
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea
| | - S Z Kazmi
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea
| | - H J Hann
- Medical Research Institute, College of Medicine, Ewha Womans University, Seoul, Korea
| | - T Kang
- Health and Wellness College, Sungshin Women's University, Seoul, Korea
| | - J Cha
- Department of Public Health, Korea University, Seoul, Korea
| | - S Choi
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea
| | - H Swan
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea
| | - H Kim
- Department of Obstetrics and Gynaecology, Seoul National University Hospital, Seoul, Korea
| | - Y S Lee
- Department of Health Informatics and Management, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - H S Ahn
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea
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24
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Jin HY, Lee CS, Lee YS. Laparoscopic extended right hemicolectomy with D3 lymph node dissection using a new articulating instrument. Tech Coloproctol 2020; 25:235-237. [PMID: 32926244 PMCID: PMC7884364 DOI: 10.1007/s10151-020-02345-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 09/03/2020] [Indexed: 01/12/2023]
Affiliation(s)
- H Y Jin
- Division of Colorectal Surgery, Department of Surgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - C S Lee
- Division of Colorectal Surgery, Department of Surgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Y S Lee
- Division of Colorectal Surgery, Department of Surgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
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25
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Abstract
Women have historically faced gendered patterns of disadvantage during times of emergency. Evidence demonstrates differences in gendered exposures and inequities during acute crises such as natural disasters and pandemics, including Covid-19, and longer-term emergencies such as climate change. These patterns, without intervention, may be perpetuated in future crises. Threats to women's health in times of emergency can arise from restricted access to health care, economic disadvantages, and harmful social norms. During crises, women face additional barriers to accessing maternal, contraceptive, and abortion care, likely exacerbating existing inequities in reproductive health outcomes. Gendered inequalities in financial and economic stability can become even more stark. Globally, women perform the majority of health care and unpaid caregiving work, but face barriers to affording costs of living and obtaining health insurance due to over-representation in low-wage jobs. Finally, gendered expectations of social roles contribute to increased vulnerabilities, such as displacement and poverty. Violence against women rises in times of emergency and pathways to escaping trauma can be limited. In addition to directly addressing women's unique barriers and providing support in times of emergency through bolstering health care access, economic, and social support systems, thoughtful solutions such as trauma-informed care, increasing the number of women in leadership roles, educational initiatives, and advocacy from health professionals are needed to protect and advance women's health.
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Affiliation(s)
- Yeonsoo S Lee
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, USA
| | - Maya Behn
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Kathryn M Rexrode
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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26
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Pace LE, Lee YS, Tung N, Hamilton JG, Gabriel C, Raja SC, Jenkins C, Braswell A, Domchek SM, Symecko H, Spielman K, Karlan BY, Lester J, Kamara D, Levin J, Morgan K, Offit K, Garber J, Keating NL. Comparison of up-front cash cards and checks as incentives for participation in a clinician survey: a study within a trial. BMC Med Res Methodol 2020; 20:210. [PMID: 32807084 PMCID: PMC7430023 DOI: 10.1186/s12874-020-01086-9] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 07/22/2020] [Indexed: 12/28/2022] Open
Abstract
Background Evidence is needed regarding effective incentive strategies to increase clinician survey response rates. Cash cards are increasingly used as survey incentives; they are appealing because of their convenience and because in some cases their value can be reclaimed by investigators if not used. However, their effectiveness in clinician surveys is not known. In this study within the BRCA Founder OutReach (BFOR) study, a clinical trial of population-based BRCA1/2 mutation screening, we compared the use of upfront cash cards requiring email activation versus checks as clinician survey incentives. Methods Participants receiving BRCA1/2 testing in the BFOR study could elect to receive their results from their primary care provider (PCP, named by the patient) or from a geneticist associated with the study. In order to understand PCPs’ knowledge, attitudes, experiences and willingness to disclose results we mailed paper surveys to the first 501 primary care providers (PCPs) in New York, Boston, Los Angeles and Philadelphia who were nominated by study participants to disclose their BRCA1/2 mutation results obtained through the study. We used alternating assignment stratified by city to assign the first 303 clinicians to receive a $50 up-front incentive as a cash card (N = 155) or check (N = 148). The cash card required PCPs to send an activation email in order to be used. We compared response rates by incentive type, adjusting for PCP characteristics and study site. Results In unadjusted analyses, PCPs who received checks were more likely to respond to the survey than those who received cash cards (54.1% versus 41.9%, p = 0.046); this remained true when we adjusted for provider characteristics (OR for checks 1.61, 95% CI 1.01, 2.59). No other clinician characteristics had a statistically significant association with response rates in adjusted analyses. When we included an interaction term for incentive type and city, the favorable impact of checks on response rates was evident only in Los Angeles and Philadelphia. Conclusions An up-front cash card incentive requiring email activation may be less effective in eliciting clinician responses than up-front checks. However, the benefit of checks for clinician response rates may depend on clinicians’ geographic location. Trial registration ClinicalTrials.gov (NCT03351803), November 24, 2017.
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Affiliation(s)
- Lydia E Pace
- Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA. .,Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
| | - Yeonsoo S Lee
- Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA
| | - Nadine Tung
- Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA, 02215, USA
| | - Jada G Hamilton
- Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA
| | - Camila Gabriel
- Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA, 02215, USA
| | - Sahitya C Raja
- Rush Medical College at Rush University, 600 S Paulina St Suite 202, Chicago, IL, 60612, USA
| | - Colby Jenkins
- Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA, 02215, USA.,Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA, 02215, USA
| | - Anthony Braswell
- David Geffen School of Medicine at the University of California, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA
| | - Susan M Domchek
- Basser Center for BRCA, University of Pennsylvania, West Tower, Centre Square, 1500 Market St, Philadelphia, PA, 19102, USA
| | - Heather Symecko
- Basser Center for BRCA, University of Pennsylvania, West Tower, Centre Square, 1500 Market St, Philadelphia, PA, 19102, USA
| | - Kelsey Spielman
- Basser Center for BRCA, University of Pennsylvania, West Tower, Centre Square, 1500 Market St, Philadelphia, PA, 19102, USA
| | - Beth Y Karlan
- David Geffen School of Medicine at the University of California, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA
| | - Jenny Lester
- David Geffen School of Medicine at the University of California, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA
| | - Daniella Kamara
- David Geffen School of Medicine at the University of California, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA
| | - Jeffrey Levin
- Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA
| | - Kelly Morgan
- Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA
| | - Kenneth Offit
- Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA
| | - Judy Garber
- Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA, 02215, USA
| | - Nancy L Keating
- Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA.,Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
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27
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Park YH, Lee YS, Seo YM, Seo H, Park JS, Bae HS, Park JC. Midkine Promotes Odontoblast-like Differentiation and Tertiary Dentin Formation. J Dent Res 2020; 99:1082-1091. [PMID: 32442055 DOI: 10.1177/0022034520925427] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Autophagy is an intracellular self-degradation process that is essential for tissue development, cell differentiation, and survival. Nevertheless, the role of autophagy in tooth development has not been definitively identified. The goal of this study was to investigate how autophagy is involved in midkine (MK)-mediated odontoblast-like differentiation, mineralization, and tertiary dentin formation in a mouse tooth pulp exposure model. In vitro studies show that MK and LC3 have similar expression patterns during odontoblast-like cell differentiation. Odontoblast-like cell differentiation is promoted through MK-mediated autophagy, which leads to increased mineralized nodule formation. Subcutaneous transplantation of hydroxyapatite/tricalcium phosphate with rMK-treated human dental pulp cells led to dentin pulp-like tissue formation through MK-mediated autophagy. Furthermore, MK-mediated autophagy induces differentiation of dental pulp cells into odontoblast-like cells that form DSP-positive tertiary dentin in vivo. Our findings may provide 1) novel insight into the role of MK in regulating odontoblast-like differentiation and dentin formation in particular via autophagy and 2) potential application of MK in vital pulp therapy.
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Affiliation(s)
- Y H Park
- Laboratory for the Study of Regenerative Dental Medicine, Department of Oral Histology-Developmental Biology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Y S Lee
- Laboratory for the Study of Regenerative Dental Medicine, Department of Oral Histology-Developmental Biology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Y M Seo
- Laboratory for the Study of Regenerative Dental Medicine, Department of Oral Histology-Developmental Biology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - H Seo
- Laboratory for the Study of Regenerative Dental Medicine, Department of Oral Histology-Developmental Biology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - J S Park
- Department of Dental Hygiene, Seoyeong University, Gwang-ju, Republic of Korea
| | - H S Bae
- Department of Oral Hygiene, Namseoul University, Cheonan, Republic of Korea
| | - J C Park
- Laboratory for the Study of Regenerative Dental Medicine, Department of Oral Histology-Developmental Biology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
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28
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Kalhan TA, Un Lam C, Karunakaran B, Chay PL, Chng CK, Nair R, Lee YS, Fong MCF, Chong YS, Kwek K, Saw SM, Shek L, Yap F, Tan KH, Godfrey KM, Huang J, Hsu CYS. Caries Risk Prediction Models in a Medical Health Care Setting. J Dent Res 2020; 99:787-796. [PMID: 32311276 DOI: 10.1177/0022034520913476] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Despite development of new technologies for caries control, tooth decay in primary teeth remains a major global health problem. Caries risk assessment (CRA) models for toddlers and preschoolers are rare. Among them, almost all models use dental factors (e.g., past caries experience) to predict future caries risk, with limited clinical/community applicability owing to relatively uncommon dental visits compared to frequent medical visits during the first year of life. The objective of this study was to construct and evaluate risk prediction models using information easily accessible to medical practitioners to forecast caries at 2 and 3 y of age. Data were obtained from the Growing Up in Singapore Towards Healthy Outcomes (GUSTO) mother-offspring cohort. Caries was diagnosed using modified International Caries Detection and Assessment System criteria. Risk prediction models were constructed using multivariable logistic regression coupled with receiver operating characteristic analyses. Imputation was performed using multiple imputation by chained equations to assess effect of missing data. Caries rates at ages 2 y (n = 535) and 3 y (n = 721) were 17.8% and 42.9%, respectively. Risk prediction models predicting overall caries risk at 2 and 3 y demonstrated area under the curve (AUC) (95% confidence interval) of 0.81 (0.75-0.87) and 0.79 (0.74-0.84), respectively, while those predicting moderate to extensive lesions showed 0.91 (0.85-0.97) and 0.79 (0.73-0.85), respectively. Postimputation results showed reduced AUC of 0.75 (0.74-0.81) and 0.71 (0.67-0.75) at years 2 and 3, respectively, for overall caries risk, while AUC was 0.84 (0.76-0.92) and 0.75 (0.70-0.80), respectively, for moderate to extensive caries. Addition of anterior caries significantly increased AUC in all year 3 models with or without imputation (all P < 0.05). Significant predictors/protectors were identified, including ethnicity, prenatal tobacco smoke exposure, history of allergies before 12 mo, history of chronic maternal illness, maternal brushing frequency, childbearing age, and so on. Integrating oral-general health care using medical CRA models may be promising in screening caries-susceptible infants/toddlers, especially when medical professionals are trained to "lift the lip" to identify anterior caries lesions.
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Affiliation(s)
- T A Kalhan
- Faculty of Dentistry, National University of Singapore, Singapore
| | - C Un Lam
- Chief Dental Officer's Office, Ministry of Health, College of Medicine Building, Singapore
| | - B Karunakaran
- Faculty of Dentistry, National University of Singapore, Singapore
| | - P L Chay
- Dental Service, KK Women's and Children's Hospital, Singapore
| | - C K Chng
- Dental Service, KK Women's and Children's Hospital, Singapore
| | - R Nair
- Radboud University Medical Centre, Radboud Institute for Health Sciences, Department of Dentistry-Quality and Safety of Oral Healthcare, Nijmegen, the Netherlands.,Dr. D. Y. Patil Dental College & Hospital, Pune, Maharashtra, India
| | - Y S Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Division of Paediatric Endocrinology and Diabetes, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore
| | - M C F Fong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Y S Chong
- Chief Dental Officer's Office, Ministry of Health, College of Medicine Building, Singapore.,Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - K Kwek
- Dental Service, KK Women's and Children's Hospital, Singapore
| | - S M Saw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - L Shek
- Division of Paediatric Allergy, Immunology & Rheumatology, National University Hospital, Singapore
| | - F Yap
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore.,Department of Paediatrics, Duke-National University of Singapore Graduate Medical School, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - K H Tan
- Dental Service, KK Women's and Children's Hospital, Singapore.,Duke-National University of Singapore Graduate Medical School, Singapore
| | - K M Godfrey
- MRC Lifecourse Epidemiology Unit & NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - J Huang
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | - C-Y S Hsu
- Faculty of Dentistry, National University of Singapore, Singapore
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29
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Al-Memar M, Bobdiwala S, Fourie H, Mannino R, Lee YS, Smith A, Marchesi JR, Timmerman D, Bourne T, Bennett PR, MacIntyre DA. The association between vaginal bacterial composition and miscarriage: a nested case-control study. BJOG 2019; 127:264-274. [PMID: 31573753 PMCID: PMC6972675 DOI: 10.1111/1471-0528.15972] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2019] [Indexed: 01/31/2023]
Abstract
Objective To characterise vaginal bacterial composition in early pregnancy and investigate its relationship with first and second trimester miscarriages. Design Nested case–control study. Setting Queen Charlotte’s and Chelsea Hospital, Imperial College Healthcare NHS Trust, London. Population 161 pregnancies: 64 resulting in first trimester miscarriage, 14 in second trimester miscarriage and 83 term pregnancies. Methods Prospective profiling and comparison of vaginal bacteria composition using 16S rRNA gene‐based metataxonomics from 5 weeks’ gestation in pregnancies ending in miscarriage or uncomplicated term deliveries matched for age, gestation and body mass index. Main outcome measures Relative vaginal bacteria abundance, diversity and richness. Pregnancy outcomes defined as first or second trimester miscarriage, or uncomplicated term delivery. Results First trimester miscarriage associated with reduced prevalence of Lactobacillus spp.‐dominated vaginal microbiota classified using hierarchical clustering analysis (65.6 versus 87.7%; P = 0.005), higher alpha diversity (mean Inverse Simpson Index 2.5 [95% confidence interval 1.8–3.0] versus 1.5 [1.3–1.7], P = 0.003) and higher richness 25.1 (18.5–31.7) versus 16.7 (13.4–20), P = 0.017), compared with viable pregnancies. This was independent of vaginal bleeding and observable before first trimester miscarriage diagnosis (P = 0.015). Incomplete/complete miscarriage associated with higher proportions of Lactobacillus spp.‐depleted communities compared with missed miscarriage. Early pregnancy vaginal bacterial stability was similar between miscarriage and term pregnancies. Conclusions These findings associate the bacterial component of vaginal microbiota with first trimester miscarriage and indicate suboptimal community composition is established in early pregnancy. While further studies are required to elucidate the mechanism, vaginal bacterial composition may represent a modifiable risk factor for first trimester miscarriage. Tweetable abstract Vaginal bacterial composition in first trimester miscarriage is associated with reduced Lactobacillus spp. abundance and is independent of vaginal bleeding. Vaginal bacterial composition in first trimester miscarriage is associated with reduced Lactobacillus spp. abundance and is independent of vaginal bleeding.
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Affiliation(s)
- M Al-Memar
- Tommy's National Centre for Miscarriage Research, Imperial College London, London, UK.,Imperial College Parturition Research Group, Division of the Institute of Reproductive and Developmental Biology, Imperial College London, London, UK
| | - S Bobdiwala
- Tommy's National Centre for Miscarriage Research, Imperial College London, London, UK.,Imperial College Parturition Research Group, Division of the Institute of Reproductive and Developmental Biology, Imperial College London, London, UK
| | - H Fourie
- Tommy's National Centre for Miscarriage Research, Imperial College London, London, UK.,Imperial College Parturition Research Group, Division of the Institute of Reproductive and Developmental Biology, Imperial College London, London, UK.,Queen Charlotte's Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - R Mannino
- Tommy's National Centre for Miscarriage Research, Imperial College London, London, UK.,Imperial College Parturition Research Group, Division of the Institute of Reproductive and Developmental Biology, Imperial College London, London, UK
| | - Y S Lee
- Tommy's National Centre for Miscarriage Research, Imperial College London, London, UK.,Imperial College Parturition Research Group, Division of the Institute of Reproductive and Developmental Biology, Imperial College London, London, UK.,Queen Charlotte's Hospital, Imperial College Healthcare NHS Trust, London, UK.,March of Dimes European Preterm Birth Research Centre, Imperial College London, London, UK
| | - A Smith
- School of Medicine, Cardiff University, Cardiff, UK
| | - J R Marchesi
- March of Dimes European Preterm Birth Research Centre, Imperial College London, London, UK.,Division of Integrative Systems Medicine and Digestive Disease, Imperial College London, London, UK.,School of Biosciences, Cardiff University, Cardiff, UK
| | - D Timmerman
- Department of Obstetrics and Gynaecology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - T Bourne
- Tommy's National Centre for Miscarriage Research, Imperial College London, London, UK.,Imperial College Parturition Research Group, Division of the Institute of Reproductive and Developmental Biology, Imperial College London, London, UK.,Queen Charlotte's Hospital, Imperial College Healthcare NHS Trust, London, UK.,Department of Obstetrics and Gynaecology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - P R Bennett
- Tommy's National Centre for Miscarriage Research, Imperial College London, London, UK.,Imperial College Parturition Research Group, Division of the Institute of Reproductive and Developmental Biology, Imperial College London, London, UK.,Queen Charlotte's Hospital, Imperial College Healthcare NHS Trust, London, UK.,March of Dimes European Preterm Birth Research Centre, Imperial College London, London, UK
| | - D A MacIntyre
- Tommy's National Centre for Miscarriage Research, Imperial College London, London, UK.,Imperial College Parturition Research Group, Division of the Institute of Reproductive and Developmental Biology, Imperial College London, London, UK.,Queen Charlotte's Hospital, Imperial College Healthcare NHS Trust, London, UK.,March of Dimes European Preterm Birth Research Centre, Imperial College London, London, UK
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30
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Loy SL, Cheung YB, Chong M, Müller-Riemenschneider F, Lek N, Lee YS, Tan KH, Chern B, Yap F, Chan J. Maternal night-eating pattern and glucose tolerance during pregnancy: study protocol for a longitudinal study. BMJ Open 2019; 9:e030036. [PMID: 31601588 PMCID: PMC6797284 DOI: 10.1136/bmjopen-2019-030036] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Coordinating eating schedules with day-night cycles has been shown to improve glucose regulation in adults, but its association with gestational glycaemia is less clear. A better understanding on how eating time can influence glucose levels in pregnancy may improve strategies for gestational glycaemic control. This study aims to examine the association of maternal night-eating pattern with glucose tolerance in the second trimester of pregnancy, and to investigate how lifestyle factors may be related to night-eating pattern. METHODS AND ANALYSIS This is an observational longitudinal study that targets to recruit 200 pregnant women at 18-24 weeks' gestation from the KK Women's and Children's Hospital in Singapore. Data collection includes sociodemographics, lifestyle habits and obstetric information. Maternal dietary intake is collected using the 4-day food diary and food frequency questionnaire; while 24-hour physical activity, sedentary behaviour, sleep and light exposure are captured using the accelerometer at 18-24 weeks' gestation. Continuous glucose monitoring at 18-24 weeks' gestation, oral glucose tolerance test and insulin test at 24-28 weeks' gestation are performed to assess glycaemic outcomes. Multivariable generalised linear models will be used to analyse the association of maternal night-eating pattern (consumption of meal and snack during 1900-0659 hours) with glycaemic measures, and the associated factors of night-eating pattern, controlling for potential confounders. Recruitment began in March 2019 and is estimated to end in November 2020. ETHICS AND DISSEMINATION Ethical approval has been granted by the Centralised Institutional Review Board of SingHealth, Singapore (reference 2018/2529). The results will be presented at conferences and disseminated in journal articles. TRIAL REGISTRATION NUMBER NCT03803345.
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Affiliation(s)
- See Ling Loy
- Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Yin Bun Cheung
- Programme in Health Services & Systems Research and Center for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
- Center for Child Health Research, Tampere University, Tampere, Finland
| | - Mary Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Institute of Social Medicine, Epidemiology and Health Economics, Charité University Medical Centre Berlin, Berlin, Germany
| | - Ngee Lek
- Duke-NUS Medical School, 8 College Road, Singapore, Singapore
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Y S Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore
- Division of Paediatric Endocrinology, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Kok Hian Tan
- Duke-NUS Medical School, 8 College Road, Singapore, Singapore
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Bernard Chern
- Duke-NUS Medical School, 8 College Road, Singapore, Singapore
- Department of Obstetrics & Gynaecology, KK Women's and Children's Hospital, Singapore, Singapore
| | - Fabian Yap
- Duke-NUS Medical School, 8 College Road, Singapore, Singapore
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Jerry Chan
- Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, Singapore
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31
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Kang HW, Kim WY, Jin SJ, Kim YH, Min TJ, Lee YS, Kim JH. Clinical evaluation of anesthesia for high-risk cesarean section at a tertiary medical center: retrospective study for 8 years (2009-2016). J Int Med Res 2019; 47:4365-4373. [PMID: 31331228 PMCID: PMC6753575 DOI: 10.1177/0300060519859749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective The number of high-risk pregnancies is increasing in tertiary medical centers. Therefore, we investigated perioperative outcomes based on risk factors to ascertain proper maternal and neonatal management. Methods We reviewed the medical records of patients receiving cesarean sections over an 8-year period. Clinical parameters for anesthesia and the neonatal outcome were compared among high-risk groups after subdivision by the number of clinical risk factors. The groups were as follows: group A (one risk factor), group B (two risk factors), and group C (three or more risk factors). Results Patient age, estimated blood loss (EBL), and volume of transfused red blood cell (RBC) were higher in group B than group A. Birth weight, 1- and 5-minute Apgar scores, and gestational age were lower while the frequency of neonatal intensive care unit (NICU) admission was higher in group B than group A. Group C patients were significantly older than group A or B patients. Birth weight, 1- and 5-minute Apgar scores and gestational age were significantly lower while frequency of NICU admission was higher in group C than group A and B. Conclusion The number of maternal risk factors was positively associated with adverse outcomes in the neonates.
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Affiliation(s)
- H W Kang
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea
| | - W Y Kim
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea
| | - S J Jin
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Y H Kim
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea
| | - T J Min
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Y S Lee
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea
| | - J H Kim
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea
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Wen JJ, Huang H, Lee SJ, Jang H, Knight J, Lee YS, Fujita M, Suzuki KM, Asano S, Kivelson SA, Kao CC, Lee JS. Observation of two types of charge-density-wave orders in superconducting La 2-xSr xCuO 4. Nat Commun 2019; 10:3269. [PMID: 31332190 PMCID: PMC6646325 DOI: 10.1038/s41467-019-11167-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 02/27/2019] [Accepted: 06/13/2019] [Indexed: 11/26/2022] Open
Abstract
The discovery of charge- and spin-density-wave (CDW/SDW) orders in superconducting cuprates has altered our perspective on the nature of high-temperature superconductivity (SC). However, it has proven difficult to fully elucidate the relationship between the density wave orders and SC. Here, using resonant soft X-ray scattering, we study the archetypal cuprate La2-xSrxCuO4 (LSCO) over a broad doping range. We reveal the existence of two types of CDW orders in LSCO, namely CDW stripe order and CDW short-range order (SRO). While the CDW-SRO is suppressed by SC, it is partially transformed into the CDW stripe order with developing SDW stripe order near the superconducting Tc. These findings indicate that the stripe orders and SC are inhomogeneously distributed in the superconducting CuO2 planes of LSCO. This further suggests a new perspective on the putative pair-density-wave order that coexists with SC, SDW, and CDW orders. To fully elucidate the relationship between density wave orders and superconductivity in high-Tc cuprates remains difficult. Here, the authors reveal two types of charge-density-wave orders and their intertwined relationship with spin-density-wave order and superconductivity in La2-xSrxCuO4.
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Affiliation(s)
- J-J Wen
- SLAC National Accelerator Laboratory, Menlo Park, California, 94025, USA
| | - H Huang
- SLAC National Accelerator Laboratory, Menlo Park, California, 94025, USA
| | - S-J Lee
- SLAC National Accelerator Laboratory, Menlo Park, California, 94025, USA
| | - H Jang
- SLAC National Accelerator Laboratory, Menlo Park, California, 94025, USA.,PAL-XFEL, Pohang Accelerator Laboratory, Gyeongbuk, 37673, South Korea
| | - J Knight
- SLAC National Accelerator Laboratory, Menlo Park, California, 94025, USA
| | - Y S Lee
- SLAC National Accelerator Laboratory, Menlo Park, California, 94025, USA.,Department of Applied Physics, Stanford University, Stanford, CA, 94305, USA
| | - M Fujita
- Institute for Materials Research, Tohoku University, Sendai, 980-8577, Japan
| | - K M Suzuki
- Institute for Materials Research, Tohoku University, Sendai, 980-8577, Japan
| | - S Asano
- Institute for Materials Research, Tohoku University, Sendai, 980-8577, Japan
| | - S A Kivelson
- Departments of Physics, Stanford University, Stanford, CA, 94305, USA
| | - C-C Kao
- SLAC National Accelerator Laboratory, Menlo Park, California, 94025, USA
| | - J-S Lee
- SLAC National Accelerator Laboratory, Menlo Park, California, 94025, USA.
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33
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Loy SL, Cheung YB, Soh SE, Ng S, Tint MT, Aris IM, Bernard JY, Chong YS, Godfrey KM, Shek LP, Tan KH, Lee YS, Tan HH, Chern BSM, Lek N, Yap F, Chan SY, Chi C, Chan JKY. Female adiposity and time-to-pregnancy: a multiethnic prospective cohort. Hum Reprod 2019; 33:2141-2149. [PMID: 30285230 DOI: 10.1093/humrep/dey300] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 09/15/2018] [Indexed: 12/26/2022] Open
Abstract
STUDY QUESTION Are higher overall and central adiposity associated with reduced fecundability, measured by time-to-pregnancy (TTP), in Asian women? SUMMARY ANSWER Higher overall adiposity, but not central adiposity, was associated with longer TTP in Asian women. WHAT IS KNOWN ALREADY High body mass index (BMI) has been associated with a longer TTP, although the associations of body composition and distribution with TTP are less clear. There are no previous studies of TTP in Asian women, who have a relatively higher percentage of body fat and abdominal fat at relatively lower BMI. STUDY DESIGN, SIZE, DURATION Prospective preconception cohort using data from 477 Asian (Chinese, Malay and Indian) women who were planning to conceive and enrolled in the Singapore PREconception Study of long-Term maternal and child Outcomes (S-PRESTO) study, 2015-2017. PARTICIPANTS/MATERIALS, SETTING, METHODS Women's mean age was 30.7 years. Overall adiposity was assessed by BMI, sum of 4-site skinfold thicknesses (SFT) and total body fat percentage (TBF%, measured using air displacement plethysmography); central adiposity was assessed by waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and A body Shape Index (ABSI). Pregnancy occurring within one year from recruitment was ascertained by ultrasonography. Those who did not conceive within one year of recruitment, were lost to follow-up, or initiated fertility treatment were censored. TTP was measured in cycles. Discrete-time proportional hazards models were used to estimate the fecundability ratio (FR) and 95% confidence interval (CI) for each anthropometric measure in association with fecundability, adjusting for confounders. MAIN RESULTS AND THE ROLE OF CHANCE Compared to women with a normal BMI of 18.5-22.9 kg/m2, women with higher BMI of 23-27.4 and ≥27.5 kg/m2 showed lower FR of 0.66 (95% CI 0.45, 0.97) and 0.53 (0.31, 0.89), respectively. Compared to women in the lowest quartile of SFT (25-52.9 mm), those in the highest quartile of ≥90.1 mm showed lower FR of 0.58 (95% CI 0.36, 0.95). Compared to women in the lowest quartile of TBF% (13.6-27.2%), those in the upper two quartiles of 33.0-39.7% and ≥39.8% showed lower FR of 0.56 (95% CI 0.32, 0.98) and 0.43 (0.24, 0.80), respectively. Association of high BMI with reduced fecundability was particularly evident among nulliparous women. Measures of central adiposity (WC, WHR, WHtR, ABSI) were not associated with fecundability. LIMITATIONS REASONS FOR CAUTION Small sample size could restrict power of analysis.The analysis was confined to planned pregnancies, which could limit generalizability of findings to non-planned pregnancies, estimated at around 44% in Singapore. Information on the date of last menstrual period for each month was not available, hence the accuracy of self-reported menstrual cycle length could not be validated, potentially introducing error into TTP estimation. Measures of exposures and covariates such as cycle length were not performed repeatedly over time; cycle length might have changed during the period before getting pregnant. WIDER IMPLICATIONS OF THE FINDINGS Other than using BMI as the surrogate measure of body fat, we provide additional evidence showing that higher amounts of subcutaneous fat that based on the measure of SFT at the sites of biceps, triceps, suprailiac and subscapular, and TBF% are associated with longer TTP. Achieving optimal weight and reducing total percentage body fat may be a potential intervention target to improve female fertility. The null results observed between central adiposity and TTP requires confirmation in further studies. STUDY FUNDING/COMPETING INTEREST(S) This research is supported by Singapore National Research Foundation under its Translational and Clinical Research Flagship Programme and administered by the Singapore Ministry of Health's National Medical Research Council, (NMRC/TCR/004-NUS/2008; NMRC/TCR/012-NUHS/2014). Additional funding is provided by the Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore. Y.S.C., K.M.G., F.Y. and Y.S.L. have received reimbursement to speak at conferences sponsored by companies selling nutritional products. Y.S.C., K.M.G. and S.Y.C. are part of an academic consortium that has received research funding from Abbott, Nutrition, Nestle and Danone. Other authors declared no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- S L Loy
- Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Y B Cheung
- Center for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore.,Tampere Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - S E Soh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore
| | - S Ng
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore
| | - M T Tint
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore
| | - I M Aris
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.,Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore
| | - J Y Bernard
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.,Early Origins of the Child's Health and Development Unit, Centre for research in Epidemiology and Statistics Sorbonne Paris Cité, Inserm, Villejuif, France
| | - Y S Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.,Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore.,Department of Obstetrics & Gynaecology, National University Hospital, Singapore, Singapore
| | - K M Godfrey
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom.,National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, UK
| | - L P Shek
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - K H Tan
- Duke-NUS Medical School, Singapore, Singapore.,Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Y S Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - H H Tan
- Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - B S M Chern
- Duke-NUS Medical School, Singapore, Singapore.,Department of Obstetrics & Gynaecology, KK Women's and Children's Hospital, Singapore, Singapore
| | - N Lek
- Duke-NUS Medical School, Singapore, Singapore.,Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - F Yap
- Duke-NUS Medical School, Singapore, Singapore.,Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - S Y Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.,Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore.,Department of Obstetrics & Gynaecology, National University Hospital, Singapore, Singapore
| | - C Chi
- Department of Obstetrics & Gynaecology, National University Hospital, Singapore, Singapore
| | - J K Y Chan
- Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore
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Lim DH, Lee S, Han JY, Choi MS, Hong JS, Lee YS. MicroRNA miR-252 targets mbt to control the developmental growth of Drosophila. Insect Mol Biol 2019; 28:444-454. [PMID: 30582233 DOI: 10.1111/imb.12562] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Developmental growth is an intricate process involving the coordinated regulation of the expression of various genes, and microRNAs (miRNAs) play crucial roles in diverse processes throughout animal development. The ecdysone-responsive miRNA, miR-252, is normally upregulated during the pupal and adult stages of Drosophila development. Here, we found that overexpression of miR-252 in the larval fat body decreased total tissue mass through a reduction in both cell size and cell number, causing a concomitant decrease in larval size. Furthermore, miR-252 overexpression led to a delayed larval-to-pupal transition with defective anterior spiracle eversion, as well as a decrease in adult size and mass. Conversely, adult flies lacking miR-252 showed an increase in mass compared with control flies. We found that miR-252 directly targeted mbt, encoding a p21-activated kinase, to repress its expression. Notably, co-overexpression of mbt rescued the developmental and growth defects associated with miR-252 overexpression, indicating that mbt is a biologically relevant target of miR-252. Overall, our data support a role for the ecdysone/miR-252/mbt regulatory axis in growth control during Drosophila development.
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Affiliation(s)
- D-H Lim
- College of Life Sciences and Biotechnology, Korea University, Seoul, 02841, South Korea
- Institute of Animal Molecular Biotechnology, Korea University, Seoul, 02841, South Korea
| | - S Lee
- College of Life Sciences and Biotechnology, Korea University, Seoul, 02841, South Korea
- Institute of Animal Molecular Biotechnology, Korea University, Seoul, 02841, South Korea
| | - J Y Han
- College of Life Sciences and Biotechnology, Korea University, Seoul, 02841, South Korea
| | - M-S Choi
- College of Life Sciences and Biotechnology, Korea University, Seoul, 02841, South Korea
- Institute of Animal Molecular Biotechnology, Korea University, Seoul, 02841, South Korea
| | - J-S Hong
- College of Life Sciences and Biotechnology, Korea University, Seoul, 02841, South Korea
- Institute of Animal Molecular Biotechnology, Korea University, Seoul, 02841, South Korea
| | - Y S Lee
- College of Life Sciences and Biotechnology, Korea University, Seoul, 02841, South Korea
- Institute of Animal Molecular Biotechnology, Korea University, Seoul, 02841, South Korea
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35
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Chung MS, Choi YJ, Kim SO, Lee YS, Hong JY, Lee JH, Baek JH. A Scoring System for Prediction of Cervical Lymph Node Metastasis in Patients with Head and Neck Squamous Cell Carcinoma. AJNR Am J Neuroradiol 2019; 40:1049-1054. [PMID: 31072971 DOI: 10.3174/ajnr.a6066] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 04/13/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND PURPOSE An accurate and comprehensive assessment of lymph node metastasis in patients with head and neck squamous cell cancer is crucial in daily practice. This study constructed a predictive model with a risk scoring system based on CT characteristics of lymph nodes and tumors for patients with head and neck squamous cell carcinoma to stratify the risk of lymph node metastasis. MATERIALS AND METHODS Data included 476 cervical lymph nodes from 191 patients with head and neck squamous cell carcinoma from a historical cohort. We analyzed preoperative CT images of lymph nodes, including diameter, ratio of long-to-short axis diameter, necrosis, conglomeration, infiltration to adjacent soft tissue, laterality and T-stage of the primary tumor. The reference standard comprised pathologic results. Multivariable logistic regression analysis was performed to develop the risk scoring system. Internal validation was performed with 1000-iteration bootstrapping. RESULTS Shortest axial diameter, ratio of long-to-short axis diameter, necrosis, and T-stage were used to develop a 9-point risk scoring system. The risk of malignancy ranged from 7.3% to 99.8%, which was positively associated with increased scores. Areas under the curve of the risk scoring systems were 0.886 (95% CI, 0.881-0.920) and 0.879 (95% CI, 0.845-0.914) in internal validation. The Hosmer-Lemeshow goodness-of-fit test indicated that the risk scoring system was well-calibrated (P = .160). CONCLUSIONS We developed a comprehensive and simple risk scoring system using CT characteristics in patients with head and neck squamous cell carcinoma to stratify the risk of lymph node metastasis. It could facilitate decision-making in daily practice.
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Affiliation(s)
- M S Chung
- From the Department of Radiology (M.S.C.), Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Y J Choi
- Departments of Radiology and Research Institute of Radiology (Y.J.C., J.H.L., J.H.B.)
| | - S O Kim
- Clinical Epidemiology and Biostatistics (S.O.K.)
| | | | - J Y Hong
- Oncology (J.Y.H.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - J H Lee
- Departments of Radiology and Research Institute of Radiology (Y.J.C., J.H.L., J.H.B.)
| | - J H Baek
- Departments of Radiology and Research Institute of Radiology (Y.J.C., J.H.L., J.H.B.)
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Shin HR, Bae HS, Kim BS, Yoon HI, Cho YD, Kim WJ, Choi KY, Lee YS, Woo KM, Baek JH, Ryoo HM. PIN1 is a new therapeutic target of craniosynostosis. Hum Mol Genet 2019; 27:3827-3839. [PMID: 30007339 PMCID: PMC6216213 DOI: 10.1093/hmg/ddy252] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 07/05/2018] [Indexed: 01/14/2023] Open
Abstract
Gain-of-function mutations in fibroblast growth factor receptors (FGFRs) cause congenital skeletal anomalies, including craniosynostosis (CS), which is characterized by the premature closure of craniofacial sutures. Apert syndrome (AS) is one of the severest forms of CS, and the only treatment is surgical expansion of prematurely fused sutures in infants. Previously, we demonstrated that the prolyl isomerase peptidyl-prolyl cis-trans isomerase interacting 1 (PIN1) plays a critical role in mediating FGFR signaling and that Pin1+/- mice exhibit delayed closure of cranial sutures. In this study, using both genetic and pharmacological approaches, we tested whether PIN1 modulation could be used as a therapeutic regimen against AS. In the genetic approach, we crossbred Fgfr2S252W/+, a mouse model of AS, and Pin1+/- mice. Downregulation of Pin1 gene dosage attenuated premature cranial suture closure and other phenotypes of AS in Fgfr2S252W/+ mutant mice. In the pharmacological approach, we intraperitoneally administered juglone, a PIN1 enzyme inhibitor, to pregnant Fgfr2S252W/+ mutant mice and found that this treatment successfully interrupted fetal development of AS phenotypes. Primary cultured osteoblasts from Fgfr2S252W/+ mutant mice expressed high levels of FGFR2 downstream target genes, but this phenotype was attenuated by PIN1 inhibition. Post-translational stabilization and activation of Runt-related transcription factor 2 (RUNX2) in Fgfr2S252W/+ osteoblasts were also attenuated by PIN1 inhibition. Based on these observations, we conclude that PIN1 enzyme activity is important for FGFR2-induced RUNX2 activation and craniofacial suture morphogenesis. Moreover, these findings highlight that juglone or other PIN1 inhibitors represent viable alternatives to surgical intervention for treatment of CS and other hyperostotic diseases.
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Affiliation(s)
- H R Shin
- BK21 Program, Department of Molecular Genetics and Dental Pharmacology and Therapeutics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - H S Bae
- BK21 Program, Department of Molecular Genetics and Dental Pharmacology and Therapeutics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - B S Kim
- BK21 Program, Department of Molecular Genetics and Dental Pharmacology and Therapeutics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - H I Yoon
- BK21 Program, Department of Molecular Genetics and Dental Pharmacology and Therapeutics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Y D Cho
- BK21 Program, Department of Molecular Genetics and Dental Pharmacology and Therapeutics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea.,Department of Periodontology, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - W J Kim
- BK21 Program, Department of Molecular Genetics and Dental Pharmacology and Therapeutics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - K Y Choi
- Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Y S Lee
- BK21 Program, Department of Molecular Genetics and Dental Pharmacology and Therapeutics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - K M Woo
- BK21 Program, Department of Molecular Genetics and Dental Pharmacology and Therapeutics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - J H Baek
- BK21 Program, Department of Molecular Genetics and Dental Pharmacology and Therapeutics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - H M Ryoo
- BK21 Program, Department of Molecular Genetics and Dental Pharmacology and Therapeutics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
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37
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Brown RG, Chan D, Terzidou V, Lee YS, Smith A, Marchesi JR, MacIntyre DA, Bennett PR. Prospective observational study of vaginal microbiota pre- and post-rescue cervical cerclage. BJOG 2019; 126:916-925. [PMID: 30854760 PMCID: PMC6750128 DOI: 10.1111/1471-0528.15600] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [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] [Accepted: 12/10/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To investigate the relation between vaginal microbiota composition and outcome of rescue cervical cerclage. DESIGN Prospective observational study. SETTING Queen Charlotte's and Chelsea Hospital, London. POPULATION Twenty singleton pregnancies undergoing a rescue cervical cerclage. METHODS Vaginal microbiota composition was analysed in women presenting with a dilated cervix and exposed fetal membranes before and 10 days following rescue cervical cerclage and was correlated with clinical outcomes. MAIN OUTCOME MEASURES Composition of vaginal bacteria was characterised by culture-independent next generation sequencing. Successful cerclage was defined as that resulting in the birth of a neonate discharged from hospital without morbidity. Unsuccessful cerclage was defined as procedures culminating in miscarriage, intrauterine death, neonatal death or significant neonatal morbidity. RESULTS Reduced Lactobacillus spp. relative abundance was observed in 40% of cases prior to rescue cerclage compared with 10% of gestation age-matched controls (8/20, 40% versus 3/30, 10%, P = 0.017). Gardnerella vaginalis was over-represented in women presenting with symptoms (3/7, 43% versus 0/13, 0%, P = 0.03, linear discriminant analysis, LDA (log 10) and cases culminating in miscarriage (3/6, 50% versus 0/14, 0%, P = 0.017). In the majority of cases (10/14, 71%) bacterial composition was unchanged following cerclage insertion and perioperative interventions. CONCLUSIONS Reduced relative abundance of Lactobacillus spp. is associated with premature cervical dilation, whereas high levels of G. vaginalis are associated with unsuccessful rescue cerclage cases. The insertion of a rescue cerclage does not affect the underlying bacterial composition in the majority of cases. TWEETABLE ABSTRACT Preterm cervical dilatation associates with reduced Lactobacillus spp. Presence of Gardnerella vaginalis predicts rescue cerclage failure.
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Affiliation(s)
- R G Brown
- Queen Charlotte's & Chelsea Hospital, Imperial College Healthcare National Health Service Trust, London, UK.,Imperial College Parturition Research Group, Division of the Institute of Reproductive and Developmental Biology, Imperial College London, London, UK
| | - D Chan
- Queen Charlotte's & Chelsea Hospital, Imperial College Healthcare National Health Service Trust, London, UK.,Imperial College Parturition Research Group, Division of the Institute of Reproductive and Developmental Biology, Imperial College London, London, UK
| | - V Terzidou
- Imperial College Parturition Research Group, Division of the Institute of Reproductive and Developmental Biology, Imperial College London, London, UK.,Chelsea & Westminster Hospital, Chelsea & Westminster National Health Service Foundation Trust, London, UK
| | - Y S Lee
- Imperial College Parturition Research Group, Division of the Institute of Reproductive and Developmental Biology, Imperial College London, London, UK
| | - A Smith
- School of Biosciences, Cardiff University, Cardiff, UK
| | - J R Marchesi
- School of Biosciences, Cardiff University, Cardiff, UK.,Centre for Digestive and Gut Health, Imperial College London, London, UK
| | - D A MacIntyre
- Imperial College Parturition Research Group, Division of the Institute of Reproductive and Developmental Biology, Imperial College London, London, UK
| | - P R Bennett
- Queen Charlotte's & Chelsea Hospital, Imperial College Healthcare National Health Service Trust, London, UK.,Imperial College Parturition Research Group, Division of the Institute of Reproductive and Developmental Biology, Imperial College London, London, UK
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38
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Hepting M, Chaix L, Huang EW, Fumagalli R, Peng YY, Moritz B, Kummer K, Brookes NB, Lee WC, Hashimoto M, Sarkar T, He JF, Rotundu CR, Lee YS, Greene RL, Braicovich L, Ghiringhelli G, Shen ZX, Devereaux TP, Lee WS. Three-dimensional collective charge excitations in electron-doped copper oxide superconductors. Nature 2018; 563:374-378. [PMID: 30429543 DOI: 10.1038/s41586-018-0648-3] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 08/22/2018] [Indexed: 11/09/2022]
Abstract
High-temperature copper oxide superconductors consist of stacked CuO2 planes, with electronic band structures and magnetic excitations that are primarily two-dimensional1,2, but with superconducting coherence that is three-dimensional. This dichotomy highlights the importance of out-of-plane charge dynamics, which has been found to be incoherent in the normal state3,4 within the limited range of momenta accessible by optics. Here we use resonant inelastic X-ray scattering to explore the charge dynamics across all three dimensions of the Brillouin zone. Polarization analysis of recently discovered collective excitations (modes) in electron-doped copper oxides5-7 reveals their charge origin, that is, without mixing with magnetic components5-7. The excitations disperse along both the in-plane and out-of-plane directions, revealing its three-dimensional nature. The periodicity of the out-of-plane dispersion corresponds to the distance between neighbouring CuO2 planes rather than to the crystallographic c-axis lattice constant, suggesting that the interplane Coulomb interaction is responsible for the coherent out-of-plane charge dynamics. The observed properties are hallmarks of the long-sought 'acoustic plasmon', which is a branch of distinct charge collective modes predicted for layered systems8-12 and argued to play a substantial part in mediating high-temperature superconductivity10-12.
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Affiliation(s)
- M Hepting
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory and Stanford University, Menlo Park, CA, USA
| | - L Chaix
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory and Stanford University, Menlo Park, CA, USA.,Université Grenoble Alpes, CNRS, Institut Néel, Grenoble, France
| | - E W Huang
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory and Stanford University, Menlo Park, CA, USA.,Department of Physics, Stanford University, Stanford, CA, USA
| | - R Fumagalli
- Dipartimento di Fisica, Politecnico di Milano, Milan, Italy
| | - Y Y Peng
- Dipartimento di Fisica, Politecnico di Milano, Milan, Italy.,Department of Physics and Seitz Materials Research Lab, University of Illinois, Urbana, IL, USA
| | - B Moritz
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory and Stanford University, Menlo Park, CA, USA
| | - K Kummer
- European Synchrotron Radiation Facility (ESRF), Grenoble, France
| | - N B Brookes
- European Synchrotron Radiation Facility (ESRF), Grenoble, France
| | - W C Lee
- Department of Physics, Binghamton University, Binghamton, NY, USA
| | - M Hashimoto
- Stanford Synchrotron Radiation Lightsource, SLAC National Accelerator Laboratory, Menlo Park, CA, USA
| | - T Sarkar
- Department of Physics, Center for Nanophysics and Advanced Materials, University of Maryland, College Park, MD, USA
| | - J-F He
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory and Stanford University, Menlo Park, CA, USA.,Department of Physics, University of Science and Technology of China, Hefei, China
| | - C R Rotundu
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory and Stanford University, Menlo Park, CA, USA
| | - Y S Lee
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory and Stanford University, Menlo Park, CA, USA
| | - R L Greene
- Department of Physics, Center for Nanophysics and Advanced Materials, University of Maryland, College Park, MD, USA
| | - L Braicovich
- Dipartimento di Fisica, Politecnico di Milano, Milan, Italy.,European Synchrotron Radiation Facility (ESRF), Grenoble, France
| | - G Ghiringhelli
- Dipartimento di Fisica, Politecnico di Milano, Milan, Italy.,CNR-SPIN, Politecnico di Milano, Milan, Italy
| | - Z X Shen
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory and Stanford University, Menlo Park, CA, USA.
| | - T P Devereaux
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory and Stanford University, Menlo Park, CA, USA.
| | - W S Lee
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory and Stanford University, Menlo Park, CA, USA.
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39
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Lee YS, Lee SH, Gadde UD, Oh ST, Lee SJ, Lillehoj HS. Allium hookeri supplementation improves intestinal immune response against necrotic enteritis in young broiler chickens. Poult Sci 2018. [PMID: 29538713 DOI: 10.3382/ps/pey031] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Three hundred birds (1 day old) were randomly assigned to 6 groups (n = 50 birds/treatment) and fed a basal diet (control) or basal diet supplemented with Allium hookeri (AH) root (1 or 3%). At day 14, half of the birds in each group were orally challenged with E. maxima 41A (1 × 104 cells/chicken), followed by C. perfringens infection (1 × 109 cfu/chicken) on day 18. Necrotic enteritis (NE)-associated infections and intestinal immune response were assessed by average body weight gain, lesion score, and oocyst shedding. The effect of dietary supplementation, AH, on transcript levels of pro-inflammatory cytokines, and tight junction proteins and mucin protein in the jejunum, were quantified by quantitative real-time (qRT)-PCR. At day 20, birds fed with diet supplementation (3% of AH) significantly weighted more than the control group. Although the NE-challenged had significantly reduced average body weight gain, there was no significance in the effect between diet × NE-challenge interactions on the average body weight gain. Among the NE-challenged groups, gut lesion score and oocyst shedding were significantly decreased in birds given AH (1 or 3%) compared to the control group. There was a correlation between diet and NE infection with regards to interleukin (IL)-17A, and inducible nitric oxide synthase (iNOS). The up-regulated transcript levels of cytokines IL-8, IL-17A, iNOS, and LITAF by NE challenged groups were significantly reduced by AH (1 or 3%) supplementation. Down-regulated expression levels of tight junction (TJ) proteins: junctional adhesion molecule 2 (JAM2), occluding, and intestinal mucin 2 (MUC2) by NE challenge, was up-regulated by the addition of AH (1 or 3%) supplementation. All TJ proteins (JAM2, ZO1, Ocluddin and MUC2) in the jejunum had a significant diet × NE-challenge interaction. These findings demonstrate that dietary supplementation of AH in chicken feed could be beneficially used to improve chicken health against NE.
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Affiliation(s)
- Y S Lee
- Animal Bioscience and Biotechnology Laboratory, Beltsville Agricultural Research Center, Agricultural Research Service, United States Department of Agriculture, Beltsville, MD, USA.,College of Animal Life Sciences, Kangwon National University, Chuncheon, 200-701, South Korea
| | - S H Lee
- National Institute of Agricultural Sciences, Rural Department Administration, 166, Nongsaengmyeong-ro, Isoe-Myeon, Wanju-Gun, Jeollabuk-do, South Korea
| | - U D Gadde
- Animal Bioscience and Biotechnology Laboratory, Beltsville Agricultural Research Center, Agricultural Research Service, United States Department of Agriculture, Beltsville, MD, USA
| | - S T Oh
- Animal Bioscience and Biotechnology Laboratory, Beltsville Agricultural Research Center, Agricultural Research Service, United States Department of Agriculture, Beltsville, MD, USA
| | - S J Lee
- College of Animal Life Sciences, Kangwon National University, Chuncheon, 200-701, South Korea
| | - H S Lillehoj
- Animal Bioscience and Biotechnology Laboratory, Beltsville Agricultural Research Center, Agricultural Research Service, United States Department of Agriculture, Beltsville, MD, USA
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40
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Lee S, Lim J, Lee YS. Violet-blue emission property of the cerium-ion doped CaHfO 3 : Doping and temperature dependence. LUMINESCENCE 2018; 33:1257-1261. [PMID: 30156366 DOI: 10.1002/bio.3543] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 07/11/2018] [Accepted: 07/17/2018] [Indexed: 11/10/2022]
Abstract
We investigated the emission property of perovskite CaHfO3 polycrystals with various concentrations of cerium ion (Ce3+ ). With a wide range of UV photoexcitation, we observed a strong emission near 430 nm which should originate from 5d-4f transitions in the Ce3+ ions. Combining these emission spectra with the photoluminescence excitation spectra, we estimated the Stokes shift to be 6700 cm-1 , irrespective of the Ce3+ ion doping concentration. We found that the violet-blue emissions in Ce3+ ions showed non-trivial temperature dependence in their peak position and intensity. We found interesting low-temperature behavior of the violet-blue emission, which might be attributed to the thermal lattice effect in CaHfO3 . We also discussed our results with those of the similar materials, perovskite zirconates. Our systematic studies provide useful information on the host material CaHfO3 for a future study on the violet-blue emission of Ce3+ ions.
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Affiliation(s)
- Seungmin Lee
- Department of Physics, Soongsil University, Seoul, South Korea
| | - Junhwi Lim
- Department of Physics, Soongsil University, Seoul, South Korea
| | - Y S Lee
- Department of Physics, Soongsil University, Seoul, South Korea
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41
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Cho MS, Kim J, Park JK, Kim TH, Lee JM, Park JB, Park HW, Kang KW, Shim JM, Uhm JS, Kim JB, Kim CS, Lee YS, Choi EK, Joung BY. P5796Prevalence and correlates of left atrial enlargement based on left atrial volume index in korean patients with non-valvular atrial fibrillation: data from comparison study of drugs for symptom control. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5796] [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 Cho
- Asan Medical Center, Heart Institute, Seoul, Korea Republic of
| | - J Kim
- Asan Medical Center, Heart Institute, Seoul, Korea Republic of
| | - J K Park
- Hanyang University, Seoul, Korea Republic of
| | - T H Kim
- Yonsei University, Seoul, Korea Republic of
| | - J M Lee
- Kyunghee University, Seoul, Korea Republic of
| | - J B Park
- Ewha University, Seoul, Korea Republic of
| | - H W Park
- Chonnam National University Hospital, Gwangju, Korea Republic of
| | - K W Kang
- Eulji University Hospital, Daejeon, Korea Republic of
| | - J M Shim
- Korea University, Seoul, Korea Republic of
| | - J S Uhm
- Yonsei University, Seoul, Korea Republic of
| | - J B Kim
- Kyunghee University, Seoul, Korea Republic of
| | - C S Kim
- Yonsei University, Seoul, Korea Republic of
| | - Y S Lee
- Catholic University of Daegu, Daegu, Korea Republic of
| | - E K Choi
- Seoul National University, Seoul, Korea Republic of
| | - B Y Joung
- Yonsei University, Seoul, Korea Republic of
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42
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Lee YS, Park HW, Shin DG, Jung BC. P2872Angiotensin II-mediated oxidative stress increased the vulnerability of ventricular arrhythmia in cardiac hypertrophy rabbit model, which is suppressed by CaMKII inhibitor. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2872] [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)
- Y S Lee
- Catholic University of Daegu, Daegu, Korea Republic of
| | - H W Park
- Yonsei University College of Medicine, Cardiology, Seoul, Korea Republic of
| | - D G Shin
- Yeungnam University, cardiology, Daegu, Korea Republic of
| | - B C Jung
- Fatima General Hospital, cardiology, Daegu, Korea Republic of
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43
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Gadde U, Oh ST, Lee YS, Davis E, Zimmerman N, Rehberger T, Lillehoj HS. The Effects of Direct-fed Microbial Supplementation, as an Alternative to Antibiotics, on Growth Performance, Intestinal Immune Status, and Epithelial Barrier Gene Expression in Broiler Chickens. Probiotics Antimicrob Proteins 2018; 9:397-405. [PMID: 28421423 DOI: 10.1007/s12602-017-9275-9] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The objective of this study was to investigate the effects of Bacillus subtilis-based probiotic supplementation in broiler chicken diets on growth performance, feed efficiency, intestinal cytokine, and tight junction (TJ) protein mRNA expression. Zero-day-old broiler chicks (n = 140) were randomly assigned to one of five dietary treatments: basal diet (CON); basal diet supplemented with either antibiotic bacitracin methylene disalicylate (BMD); or probiotics, namely, B. subtilis strain 1781 (PB1), a combination of B. subtilis strain 1104 + strain 747 (PB2), or B. subtilis strain 1781 + strain 747 (PB3). Body weight and feed intake were measured at 14 days of age, and the feed conversion ratio (FCR) was calculated. At 14 days of age, ileal samples were collected and used for intestinal cytokine, TJ protein, and mucin gene expression analysis using qRT-PCR. The chickens supplemented with antibiotic (BMD) and B. subtilis strain 1781 alone (PB1) had significantly higher body weights compared to controls of the same age. Dietary supplementation with antibiotic (BMD) or probiotics (PB1, PB2, PB3) significantly improved the feed efficiency as evidenced by decreased FCR compared to controls. No differences were observed in the expression of IL1β, IL17F, IFNγ, and MUC2 gene among the different treatment groups. However, elevated expression of IL6 (BMD, PB1, PB2), IL8 (PB2), and TNFSF15 (PB1, PB2, PB3) compared to controls was observed in the ileum. IL2 and IL10 expression was upregulated in chicks in the PB2 and PB3 groups, and IL4 was elevated in the PB1 group. IL13 was elevated in all probiotic-fed groups (PB1, PB2, PB3). Probiotic supplementation was also shown to significantly increase the expression of TJ proteins JAM2, ZO1 (PB2, PB3), and occludin (PB1, PB2). Taken together, B. subtilis supplementation altered intestinal immune activity and influenced gut barrier integrity through increased tight junction gene expression.
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Affiliation(s)
- U Gadde
- Animal Biosciences and Biotechnology Laboratory, Beltsville Agricultural Research Center, Agricultural Research Service, USDA, 10300 Baltimore Ave, Bldg. 1043, Beltsville, MD, 20705, USA
| | - S T Oh
- Animal Biosciences and Biotechnology Laboratory, Beltsville Agricultural Research Center, Agricultural Research Service, USDA, 10300 Baltimore Ave, Bldg. 1043, Beltsville, MD, 20705, USA
| | - Y S Lee
- Animal Biosciences and Biotechnology Laboratory, Beltsville Agricultural Research Center, Agricultural Research Service, USDA, 10300 Baltimore Ave, Bldg. 1043, Beltsville, MD, 20705, USA
| | - E Davis
- Agro Biosciences Inc., 10437 Innovation Drive, Wauwatosa, WI, 53226, USA
| | - N Zimmerman
- Agro Biosciences Inc., 10437 Innovation Drive, Wauwatosa, WI, 53226, USA
| | - T Rehberger
- Agro Biosciences Inc., 10437 Innovation Drive, Wauwatosa, WI, 53226, USA
| | - Hyun S Lillehoj
- Animal Biosciences and Biotechnology Laboratory, Beltsville Agricultural Research Center, Agricultural Research Service, USDA, 10300 Baltimore Ave, Bldg. 1043, Beltsville, MD, 20705, USA.
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44
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Kim DS, Son E, Lee YS, Lee YM, Park YH, Kim DH, Lee KW. Herbal Complex DKB114 for Hyperuricemia and Gout. Am J Transl Res 2018. [DOI: 10.1055/s-0038-1644979] [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: 10/28/2022]
Affiliation(s)
- DS Kim
- Korean Herbal Medicine Research Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Dajeon 34054, Republic of Korea
| | - E Son
- Korean Herbal Medicine Research Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Dajeon 34054, Republic of Korea
| | - YS Lee
- Korean Herbal Medicine Research Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Dajeon 34054, Republic of Korea
| | - YM Lee
- Korean Herbal Medicine Research Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Dajeon 34054, Republic of Korea
| | - YH Park
- Dongkook Pharmaceutical Co., LTD, Gyeonggi Bio-Center, 147, Gwanggyo-ro, Yeongtong-gu, Suwon-city, Gyeonggi-do, Republic of Korea
| | - DH Kim
- Dongkook Pharmaceutical Co., LTD, Gyeonggi Bio-Center, 147, Gwanggyo-ro, Yeongtong-gu, Suwon-city, Gyeonggi-do, Republic of Korea
| | - KW Lee
- Dongkook Pharmaceutical Co., LTD, Gyeonggi Bio-Center, 147, Gwanggyo-ro, Yeongtong-gu, Suwon-city, Gyeonggi-do, Republic of Korea
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45
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Sakwinska O, Foata F, Berger B, Brüssow H, Combremont S, Mercenier A, Dogra S, Soh SE, Yen JCK, Heong GYS, Lee YS, Yap F, Meaney MJ, Chong YS, Godfrey KM, Holbrook JD. Does the maternal vaginal microbiota play a role in seeding the microbiota of neonatal gut and nose? Benef Microbes 2017; 8:763-778. [PMID: 29022384 DOI: 10.3920/bm2017.0064] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The acquisition and early maturation of infant microbiota is not well understood despite its likely influence on later health. We investigated the contribution of the maternal microbiota to the microbiota of infant gut and nose in the context of mode of delivery and feeding. Using 16S rRNA sequencing and specific qPCR, we profiled microbiota of 42 mother-infant pairs from the GUSTO birth cohort, at body sites including maternal vagina, rectum and skin; and infant stool and nose. In our study, overlap between maternal vaginal microbiota and infant faecal microbiota was minimal, while the similarity between maternal rectal microbiota and infant microbiota was more pronounced. However, an infant's nasal and gut microbiota were no more similar to that of its own mother, than to that of unrelated mothers. These findings were independent of delivery mode. We conclude that the transfer of maternal vaginal microbes play a minor role in seeding infant stool microbiota. Transfer of maternal rectal microbiota could play a larger role in seeding infant stool microbiota, but approaches other than the generally used analyses of community similarity measures are likely to be needed to quantify bacterial transmission. We confirmed the clear difference between microbiota of infants born by Caesarean section compared to vaginally delivered infants and the impact of feeding mode on infant gut microbiota. Only vaginally delivered, fully breastfed infants had gut microbiota dominated by Bifidobacteria. Our data suggest that reduced transfer of maternal vaginal microbial is not the main mechanism underlying the differential infant microbiota composition associated with Caesarean delivery. The sources of a large proportion of infant microbiota could not be identified in maternal microbiota, and the sources of seeding of infant gut and nasal microbiota remain to be elucidated.
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Affiliation(s)
- O Sakwinska
- 1 Nestlé Research Center, Vers-Chez-Les-Blanc, 1000 Lausanne, Switzerland
| | - F Foata
- 1 Nestlé Research Center, Vers-Chez-Les-Blanc, 1000 Lausanne, Switzerland
| | - B Berger
- 1 Nestlé Research Center, Vers-Chez-Les-Blanc, 1000 Lausanne, Switzerland
| | - H Brüssow
- 1 Nestlé Research Center, Vers-Chez-Les-Blanc, 1000 Lausanne, Switzerland
| | - S Combremont
- 1 Nestlé Research Center, Vers-Chez-Les-Blanc, 1000 Lausanne, Switzerland
| | - A Mercenier
- 1 Nestlé Research Center, Vers-Chez-Les-Blanc, 1000 Lausanne, Switzerland
| | - S Dogra
- 2 Singapore Institute for Clinical Sciences (SICS), Agency for Science and Technology Research (A*STAR), 30 Medical Drive, 117609 Singapore.,3 Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, 119228 Singapore
| | - S-E Soh
- 2 Singapore Institute for Clinical Sciences (SICS), Agency for Science and Technology Research (A*STAR), 30 Medical Drive, 117609 Singapore.,4 Vishuo BioMedical Pte Ltd, 03-33/35A, Teletech Park, 2O Science Park Road, Singapore
| | - J C K Yen
- 5 Department of Reproductive Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899 Singapore
| | - G Y S Heong
- 6 Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899 Singapore.,7 Duke-NUS Medical School, 8 College Road, 169857 Singapore.,8 Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 1E Kent Ridge Road, 119228 Singapore
| | - Y S Lee
- 2 Singapore Institute for Clinical Sciences (SICS), Agency for Science and Technology Research (A*STAR), 30 Medical Drive, 117609 Singapore.,3 Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, 119228 Singapore.,9 Division of Paediatric Endocrinology and Diabetes, Khoo Teck Puat - National University Children's Medical Institute, National University Health System, 1E Kent Ridge Road, 119228 Singapore
| | - F Yap
- 10 Department of Paediatric Endocrinology, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899 Singapore
| | - M J Meaney
- 2 Singapore Institute for Clinical Sciences (SICS), Agency for Science and Technology Research (A*STAR), 30 Medical Drive, 117609 Singapore.,11 Ludmer Centre for Neuroinformatics and Mental Health, Douglas University Mental Health Institute, McGill University, 3755 Côte-Ste-Catherine Montreal, QC H3T 1E2 Canada
| | - Y-S Chong
- 2 Singapore Institute for Clinical Sciences (SICS), Agency for Science and Technology Research (A*STAR), 30 Medical Drive, 117609 Singapore.,8 Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 1E Kent Ridge Road, 119228 Singapore
| | - K M Godfrey
- 12 MRC Lifecourse Epidemiology Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, United Kingdom.,13 NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, MP 218 Tremona Road, SO16 6YD Southampton, United Kingdom
| | - J D Holbrook
- 2 Singapore Institute for Clinical Sciences (SICS), Agency for Science and Technology Research (A*STAR), 30 Medical Drive, 117609 Singapore.,13 NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, MP 218 Tremona Road, SO16 6YD Southampton, United Kingdom
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46
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Chen LW, Tint MT, Fortier MV, Aris IM, Shek LPC, Tan KH, Chan SY, Gluckman PD, Chong YS, Godfrey KM, Rajadurai VS, Yap F, Kramer MS, Lee YS. Which anthropometric measures best reflect neonatal adiposity? Int J Obes (Lond) 2017; 42:501-506. [PMID: 28990589 DOI: 10.1038/ijo.2017.250] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [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: 04/19/2017] [Revised: 09/05/2017] [Accepted: 09/27/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND Studying the determinants and the long-term consequences of fetal adipose accretion requires accurate assessment of neonatal body composition. In large epidemiological studies, in-depth body composition measurement methods are usually not feasible for cost and logistical reasons, and there is a need to identify anthropometric measures that adequately reflect neonatal adiposity. METHODS In a multiethnic Asian mother-offspring cohort in Singapore, anthropometric measures (weight, length, abdominal circumference, skinfold thicknesses) were measured using standardized protocols in newborn infants, and anthropometric indices (weight/length, weight/length2 (body mass index, BMI), weight/length3 (ponderal index, PI)) derived. Neonatal total adiposity was measured using air displacement plethysmography (ADP) and abdominal adiposity using magnetic resonance imaging (MRI). Correlations of the anthropometric measures with ADP- and MRI-based adiposity were assessed using Pearson's correlation coefficients (rp), including in subsamples stratified by sex and ethnicity. RESULTS Study neonates (n=251) had a mean (s.d.) age of 10.2 (2.5) days. Correlations between ADP-based fat mass (ADPFM) and anthropometric measures were moderate (rp range: 0.44-0.67), with the strongest being with weight/length, weight, BMI and sum of skinfolds (rp=0.67, 0.66, 0.62, 0.62, respectively, all P<0.01). All anthropometric measures except skinfold thicknesses correlated more strongly with ADP-based fat-free mass than ADPFM, indicating that skinfold measures may have more discriminative power in terms of neonatal total body adiposity. For MRI-based measures, weight and weight/length consistently showed strong positive correlations (rp⩾0.7) with abdominal adipose tissue compartments. These correlations were consistent in boys and girls, across different ethnic groups, and when conventional determinants of neonatal adiposity were adjusted for potential confounding. Abdominal circumference was not strongly associated with ADPFM or abdominal fat mass. CONCLUSIONS Simple anthropometric measures (weight and weight/length) correlated strongly with neonatal adiposity, with some evidence for greater discriminative power for skinfold measures. These simple measures could be of value in large epidemiological studies.
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Affiliation(s)
- L-W Chen
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - M-T Tint
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - M V Fortier
- Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore, Singapore
| | - I M Aris
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - L P-C Shek
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - K H Tan
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore.,Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
| | - S-Y Chan
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - P D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.,Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Y-S Chong
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - K M Godfrey
- MRC Lifecourse Epidemiology Unit & NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - V S Rajadurai
- Department of Neonatology, KK Women's and Children's Hospital, Singapore, Singapore
| | - F Yap
- Duke-National University of Singapore Graduate Medical School, Singapore, Singapore.,Department of Pediatric Endocrinology, KK Women's and Children's Hospital, Singapore, Singapore
| | - M S Kramer
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Departments of Pediatrics and of Epidemiology, Biostatistics and Occupational Health, McGill University Faculty of Medicine, Montreal, Quebec, Canada
| | - Y S Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.,Khoo Teck Puat- National University Children's Medical Institute, National University Health System, Singapore, Singapore
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47
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Seo Kyung H, Park JY, Kim HD, Lee Dea Y, Choi Doo J, Lee Jea W, Lee YS, Lee SE, Kim Geum S. Antioxidant and anti-inflammatory Studies of mushrooms. Am J Transl Res 2017. [DOI: 10.1055/s-0037-1608556] [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: 10/18/2022]
Affiliation(s)
- H Seo Kyung
- Rual Development Adiministration, Eumseing, Korea, Republic of (South)
| | - JY Park
- Rual Development Adiministration, Eumseing, Korea, Republic of (South)
| | - HD Kim
- Rual Development Adiministration, Eumseing, Korea, Republic of (South)
| | - Y Lee Dea
- Rual Development Adiministration, Eumseing, Korea, Republic of (South)
| | - J Choi Doo
- Rual Development Adiministration, Eumseing, Korea, Republic of (South)
| | - W Lee Jea
- Rual Development Adiministration, Eumseing, Korea, Republic of (South)
| | - YS Lee
- Rual Development Adiministration, Eumseing, Korea, Republic of (South)
| | - SE Lee
- Rual Development Adiministration, Eumseing, Korea, Republic of (South)
| | - S Kim Geum
- Rual Development Adiministration, Eumseing, Korea, Republic of (South)
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48
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Kim Hyung D, Kim GS, Lee SE, Lee Dae Y, Seo Kyung H, Lee YS, Lee Jae W, Choi Doo J. Protective effect of Saururus chinensis extract against an endocrine disruptor in mouse testicular germ cell line. Am J Transl Res 2017. [DOI: 10.1055/s-0037-1608422] [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: 10/18/2022]
Affiliation(s)
- D Kim Hyung
- Department of Herbal Crop Research, NIHHS, RDA, Eumseong, Korea, Republic of (South)
- Department of Biochemistry, School of Life Sciences, Chungbuk National University, Cheongju, Korea, Republic of (South)
| | - GS Kim
- Department of Herbal Crop Research, NIHHS, RDA, Eumseong, Korea, Republic of (South)
| | - SE Lee
- Department of Herbal Crop Research, NIHHS, RDA, Eumseong, Korea, Republic of (South)
| | - Y Lee Dae
- Department of Herbal Crop Research, NIHHS, RDA, Eumseong, Korea, Republic of (South)
| | - H Seo Kyung
- Department of Herbal Crop Research, NIHHS, RDA, Eumseong, Korea, Republic of (South)
| | - YS Lee
- Department of Herbal Crop Research, NIHHS, RDA, Eumseong, Korea, Republic of (South)
| | - W Lee Jae
- Department of Herbal Crop Research, NIHHS, RDA, Eumseong, Korea, Republic of (South)
| | - J Choi Doo
- Department of Herbal Crop Research, NIHHS, RDA, Eumseong, Korea, Republic of (South)
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49
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Lee YS, Lee Jae W, Choi Doo J, Kim GS, Seo Kyung H, Kim Hyung D, Lee Seung E, Kwon DY, Lee DY. Potentiating Activity of Shikonin with Membrane-permeabilizing agents or ATPase inhibitors against Methicillin-resistant Staphylococcus aureus. Am J Transl Res 2017. [DOI: 10.1055/s-0037-1608102] [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: 10/18/2022]
Affiliation(s)
- YS Lee
- Department of Herbal Crop Research, National Institute of Horticultural and Herbal Science, Rural Development Administration (RDA), Eumsung, Chungbuk, Korea, Republic of (South)
| | - W Lee Jae
- Department of Herbal Crop Research, National Institute of Horticultural and Herbal Science, Rural Development Administration (RDA), Eumsung, Chungbuk, Korea, Republic of (South)
| | - J Choi Doo
- Department of Herbal Crop Research, National Institute of Horticultural and Herbal Science, Rural Development Administration (RDA), Eumsung, Chungbuk, Korea, Republic of (South)
| | - GS Kim
- Department of Herbal Crop Research, National Institute of Horticultural and Herbal Science, Rural Development Administration (RDA), Eumsung, Chungbuk, Korea, Republic of (South)
| | - H Seo Kyung
- Department of Herbal Crop Research, National Institute of Horticultural and Herbal Science, Rural Development Administration (RDA), Eumsung, Chungbuk, Korea, Republic of (South)
| | - D Kim Hyung
- Department of Herbal Crop Research, National Institute of Horticultural and Herbal Science, Rural Development Administration (RDA), Eumsung, Chungbuk, Korea, Republic of (South)
| | - E Lee Seung
- Department of Herbal Crop Research, National Institute of Horticultural and Herbal Science, Rural Development Administration (RDA), Eumsung, Chungbuk, Korea, Republic of (South)
| | - DY Kwon
- Department of Oriental Pharmacy, College of Pharmacy and Wonkwang-Oriental Medicines Research Institute, Wonkwang University, Iksan, Jeonbuk, Korea, Republic of (South)
| | - DY Lee
- Department of Herbal Crop Research, National Institute of Horticultural and Herbal Science, Rural Development Administration (RDA), Eumsung, Chungbuk, Korea, Republic of (South)
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50
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Park JL, Lee YS, Song MJ, Hong SH, Ahn JH, Seo EH, Shin SP, Lee SJ, Johnson BH, Stampfer MR, Kim HP, Kim SY, Lee YS. Epigenetic regulation of RNA polymerase III transcription in early breast tumorigenesis. Oncogene 2017; 36:6793-6804. [PMID: 28846112 DOI: 10.1038/onc.2017.285] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 06/13/2017] [Accepted: 07/03/2017] [Indexed: 02/07/2023]
Abstract
RNA polymerase III (Pol III) transcribes medium-sized non-coding RNAs (collectively termed Pol III genes). Emerging diverse roles of Pol III genes suggest that individual Pol III genes are exquisitely regulated by transcription and epigenetic factors. Here we report global Pol III expression/methylation profiles and molecular mechanisms of Pol III regulation that have not been as extensively studied, using nc886 as a representative Pol III gene. In a human mammary epithelial cell system that recapitulates early breast tumorigenesis, the fraction of actively transcribed Pol III genes increases reaching a plateau during immortalization. Hyper-methylation of Pol III genes inhibits Pol III binding to DNA via inducing repressed chromatin and is a determinant for the Pol III repertoire. When Pol III genes are hypo-methylated, MYC amplifies their transcription, regardless of its recognition DNA motif. Thus, Pol III expression during tumorigenesis is delineated by methylation and magnified by MYC.
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Affiliation(s)
- J-L Park
- Personalized Genomic Medicine Research Center, KRIBB, Daejeon, Korea.,Department of Functional Genomics, University of Science and Technology, Daejeon, Korea
| | - Y-S Lee
- Rare Cancer Branch, Research Institute, National Cancer Center, Goyang-si, Korea
| | - M-J Song
- Department of Environmental Medical Biology, Yonsei University College of Medicine, Seoul, Korea
| | - S-H Hong
- Rare Cancer Branch, Research Institute, National Cancer Center, Goyang-si, Korea
| | - J-H Ahn
- Department of Life and Nanopharmaceutical Sciences and Department of Oriental Pharmacy, Kyung Hee University, Seoul, Korea
| | - E-H Seo
- Personalized Genomic Medicine Research Center, KRIBB, Daejeon, Korea.,Department of Functional Genomics, University of Science and Technology, Daejeon, Korea
| | - S-P Shin
- Immunotherapeutics Branch, Research Institute, National Cancer Center, Goyang-si, Korea
| | - S-J Lee
- Immunotherapeutics Branch, Research Institute, National Cancer Center, Goyang-si, Korea
| | - B H Johnson
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, USA
| | - M R Stampfer
- Biological Systems and Engineering Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - H-P Kim
- Department of Environmental Medical Biology, Yonsei University College of Medicine, Seoul, Korea.,Institute of Tropical Medicine, Yonsei University College of Medicine, Seoul, Korea.,Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - S-Y Kim
- Personalized Genomic Medicine Research Center, KRIBB, Daejeon, Korea.,Department of Functional Genomics, University of Science and Technology, Daejeon, Korea
| | - Y S Lee
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, USA.,Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
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