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Rim CH, Yoon WS, Park S. Safety and Efficacy of Moderate-Intensity Stereotactic Body Radiation Therapy for Ultra-Central Lung Tumor. Medicina (Kaunas) 2024; 60:538. [PMID: 38674184 PMCID: PMC11051908 DOI: 10.3390/medicina60040538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/08/2024] [Accepted: 03/21/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: Ultra-central (UC) lung tumors are defined as those abutting the proximal bronchial tree. Stereotactic body radiation therapy (SBRT) for UC tumors is difficult because of concerns about severe toxicities. Therefore, we report the safety and efficacy of moderate-intensity SBRT for UC tumors at our institution. Materials and Methods: From January 2017 to May 2021, we treated 20 patients with UC tumors with SBRT at a dose of 45-60 Gy in 10 fractions. The primary endpoints were local control (LC) and overall survival (OS). Results: The median follow-up time was 15.8 months (range: 2.7-53.8 months). Ten of the 20 patients (50.0%) showed a complete response, five (25.0%) had a partial response, two (10.0%) had stable disease, and three (15.0%) showed progressive disease (PD). The response and disease control rates were 75.0% and 85.0%, respectively. Patients with PD showed local progression at median 8.3 months (range: 6.8-19.1 months) after SBRT. One-year and 2-year OS rates were 79.4% and 62.4%, respectively. One-year and 2-year LC rates are 87.1% and 76.2%, respectively. Eight patients died due to a non-radiation therapy related cause. One patient experienced grade 5 massive hemoptysis 6 months after SBRT, resulting in death. One patient experienced grade 2 esophageal pain and two experienced grade 2 radiation pneumonitis. Otherwise, no grade 3 or higher toxicities were reported. Conclusions: Moderate-intensity SBRT offers effective control of UC tumors and is a well-tolerated treatment for such tumors.
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Affiliation(s)
| | | | - Sunmin Park
- Department of Radiation Oncology, Korea University Ansan Hospital, Ansan-si 15355, Gyeonggi-do, Republic of Korea; (C.H.R.); (W.S.Y.)
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Lee W, Shin MY, Go E, Lim HC, Jeon JY, Kwon Y, Lee Y, Kim TS, Lee SK, Bahk YY. Seroprevalence of Measles IgG Antibodies in Married Immigrant Women from Multicultural Families in Korea. Infect Chemother 2023; 55:368-376. [PMID: 37503780 PMCID: PMC10551720 DOI: 10.3947/ic.2023.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/25/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Although an effective vaccine has been available, measles still causes mast morbidity and mortality world widely. In Korea, a small number of measles cases have been reported through exposure to imported cases among young people with vaccine-induced measles immunity. Recently due to international migration including marriage, marriage migrants were the second-largest group of foreign population in Korea. Our study was carried out to obtain positive rate of measles antibody among married immigrant women from 12 countries in 10 Gun-Counties and 6 Cities, Korea. MATERIALS AND METHODS A total of 547 blood samples were collected from maternal multicultural members from 12 countries. The measles-specific IgG antibody was measured by ELISA (Enzyme-linked immunosorbent assay; Enzygnost® Anti-measles virus/IgG, Siemens Healthcare Diagnostics Products GmbH, Marburg, Germany). We performed a simple logistic regression to test whether the measles antibody seroprevalence differed by participant age, location, or country of birth and then calculated the likelihood ratio statistics to determine whether measles antibody seroprevalence differed by country of birth. RESULTS Overall positive measles seroprevalence was 75.3% (95% confidence interval: 71.7 - 78.9). Participants aged 20 - 24 years, 25 - 29 years, and 30 - 63 years has respective seropositivities of 52.5%, 55.3%, and 82.7%. In this study, the geometric mean titers of participants aged 21 - 29 years were slightly lower than those of participants aged over 30 years, which were 1,372 mIU/ml and 2,261 mIU/ml, respectively (average of total participants: 2,027 mIU/ml). CONCLUSION The study provides detailed information about seroimmunity of the married immigrant population in Korea, which is important for measles elimination. Since the 1980s, most vaccine-preventable diseases including measles have been well-controlled. Nevertheless, sporadic measles outbreaks are still reported. Thus, special attention should be paid to the possible importation of infectious diseases such as measles by immigration.
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Affiliation(s)
- Woojoo Lee
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Mi Yeong Shin
- Department of Health Research, Jeollanam-do Institute of Health and Environment, Muan, Korea
| | - Eunbyeul Go
- Department of Health Research, Jeollanam-do Institute of Health and Environment, Muan, Korea
| | - Hyun-Cheol Lim
- Department of Health Research, Jeollanam-do Institute of Health and Environment, Muan, Korea
| | - Ji-Yoon Jeon
- Department of Health Research, Jeollanam-do Institute of Health and Environment, Muan, Korea
| | - Yerim Kwon
- Department of Biotechnology, College of Biomedical and Health Science, Konkuk University, Chungju, Korea
| | - Yerin Lee
- Department of Biotechnology, College of Biomedical and Health Science, Konkuk University, Chungju, Korea
| | - Tong-Soo Kim
- Convergence Research Center for Insect Vectors, Incheon National University, Incheon, Korea
| | - Sung-Keun Lee
- Department of Pharmacology, College of Medicine, Inha University, Incheon, Korea.
| | - Young Yil Bahk
- Department of Biotechnology, College of Biomedical and Health Science, Konkuk University, Chungju, Korea
- Research Institute for Biomedical & Health Science, Konkuk University, Chungju, Korea.
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Kim Y, Sohn JH, Kim C, Park SY, Lee SH. The Clinical Value of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio for Predicting Hematoma Expansion and Poor Outcomes in Patients with Acute Intracerebral Hemorrhage. J Clin Med 2023; 12:jcm12083004. [PMID: 37109337 PMCID: PMC10145379 DOI: 10.3390/jcm12083004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 04/06/2023] [Accepted: 04/19/2023] [Indexed: 04/29/2023] Open
Abstract
There is little knowledge of the effect of inflammatory markers on the prognoses of hematoma expansion (HE) in patients with intracranial hemorrhage (ICH). We evaluated the impact of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) on HE and worse outcomes after acute ICH. This study included 520 consecutive patients with ICH from the registry database enrolled over 80 months. Patients' whole blood samples were collected upon arrival in the emergency department. Brain computed tomography scans were performed during hospitalization and repeated at 24 h and 72 h. The primary outcome measure was HE, defined as relative growth >33% or absolute growth <6 mL. A total of 520 patients were enrolled in this study. Multivariate analysis showed that NLR and PLR were associated with HE (NLR: odds ratio [OR], [95% CI] = 1.19 [1.12-1.27], p < 0.001; PLR: OR, [95% CI] = 1.01 [1.00-1.02], p = 0.04). Receiver operating characteristic curve analysis revealed that NLR and PLR could predict HE (AUC of NLR: 0.84, 95% CI [0.80-0.88], p < 0.001; AUC of PLR: 0.75 95% CI [0.70-0.80], p < 0.001). The cut-off value of NLR for predicting HE was 5.63, and that of PLR was 23.4. Higher NLR and PLR values increase HE risk in patients with ICH. NLR and PLR were reliable for predicting HE after ICH.
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Affiliation(s)
- Yejin Kim
- Institute of New Frontier Research Team, Hallym University, Chuncheon 24252, Republic of Korea
| | - Jong-Hee Sohn
- Institute of New Frontier Research Team, Hallym University, Chuncheon 24252, Republic of Korea
- Department of Neurology, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon 24252, Republic of Korea
| | - Chulho Kim
- Institute of New Frontier Research Team, Hallym University, Chuncheon 24252, Republic of Korea
- Department of Neurology, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon 24252, Republic of Korea
| | - So Young Park
- Department of Endocrinology and Metabolism, Kyung Hee University Hospital, Seoul 02447, Republic of Korea
| | - Sang-Hwa Lee
- Institute of New Frontier Research Team, Hallym University, Chuncheon 24252, Republic of Korea
- Department of Neurology, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon 24252, Republic of Korea
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Choi JM, Seo SY, Kim PJ, Kim YS, Lee SH, Sohn JH, Kim DK, Lee JJ, Kim C. Prediction of Hemorrhagic Transformation after Ischemic Stroke Using Machine Learning. J Pers Med 2021; 11:863. [PMID: 34575640 PMCID: PMC8470833 DOI: 10.3390/jpm11090863] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 08/25/2021] [Accepted: 08/28/2021] [Indexed: 12/27/2022] Open
Abstract
Hemorrhagic transformation (HT) is one of the leading causes of a poor prognostic marker after acute ischemic stroke (AIS). We compared the performances of the several machine learning (ML) algorithms to predict HT after AIS using only structured data. A total of 2028 patients with AIS, who were admitted within seven days of symptoms onset, were included in this analysis. HT was defined based on the criteria of the European Co-operative Acute Stroke Study-II trial. The whole dataset was randomly divided into a training and a test dataset with a 7:3 ratio. Binary logistic regression, support vector machine, extreme gradient boosting, and artificial neural network (ANN) algorithms were used to assess the performance of predicting the HT occurrence after AIS. Five-fold cross validation and a grid search technique were used to optimize the hyperparameters of each ML model, which had its performance measured by the area under the receiver operating characteristic (AUROC) curve. Among the included AIS patients, the mean age and number of male subjects were 69.6 years and 1183 (58.3%), respectively. HT was observed in 318 subjects (15.7%). There were no significant differences in corresponding variables between the training and test dataset. Among all the ML algorithms, the ANN algorithm showed the best performance in terms of predicting the occurrence of HT in our dataset (0.844). Feature scaling including standardization and normalization, and the resampling strategy showed no additional improvement of the ANN's performance. The ANN-based prediction of HT after AIS showed better performance than the conventional ML algorithms. Deep learning may be used to predict important outcomes for structured data-based prediction.
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Affiliation(s)
- Jeong-Myeong Choi
- Department of Convergence Software, Hallym University, Chuncheon 24252, Korea; (J.-M.C.); (S.-Y.S.); (Y.-S.K.)
| | - Soo-Young Seo
- Department of Convergence Software, Hallym University, Chuncheon 24252, Korea; (J.-M.C.); (S.-Y.S.); (Y.-S.K.)
| | - Pum-Jun Kim
- Institute of New Frontier Research Team, Hallym University College of Medicine, Chuncheon 24252, Korea; (P.-J.K.); (S.-H.L.); (J.-H.S.); (D.-K.K.); (J.-J.L.)
| | - Yu-Seop Kim
- Department of Convergence Software, Hallym University, Chuncheon 24252, Korea; (J.-M.C.); (S.-Y.S.); (Y.-S.K.)
| | - Sang-Hwa Lee
- Institute of New Frontier Research Team, Hallym University College of Medicine, Chuncheon 24252, Korea; (P.-J.K.); (S.-H.L.); (J.-H.S.); (D.-K.K.); (J.-J.L.)
- Department of Neurology, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Korea
| | - Jong-Hee Sohn
- Institute of New Frontier Research Team, Hallym University College of Medicine, Chuncheon 24252, Korea; (P.-J.K.); (S.-H.L.); (J.-H.S.); (D.-K.K.); (J.-J.L.)
- Department of Neurology, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Korea
| | - Dong-Kyu Kim
- Institute of New Frontier Research Team, Hallym University College of Medicine, Chuncheon 24252, Korea; (P.-J.K.); (S.-H.L.); (J.-H.S.); (D.-K.K.); (J.-J.L.)
- Department of Otorhinolaryngology and Head and Neck Surgery, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Korea
| | - Jae-Jun Lee
- Institute of New Frontier Research Team, Hallym University College of Medicine, Chuncheon 24252, Korea; (P.-J.K.); (S.-H.L.); (J.-H.S.); (D.-K.K.); (J.-J.L.)
- Department of Anesthesiology and Pain Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Korea
| | - Chulho Kim
- Institute of New Frontier Research Team, Hallym University College of Medicine, Chuncheon 24252, Korea; (P.-J.K.); (S.-H.L.); (J.-H.S.); (D.-K.K.); (J.-J.L.)
- Department of Neurology, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Korea
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Rim CH, Park S, Shin IS, Yoon WS. Is the Concurrent Use of Sorafenib and External Radiotherapy Feasible for Advanced Hepatocellular Carcinoma? A Meta-Analysis. Cancers (Basel) 2021; 13:2912. [PMID: 34200809 PMCID: PMC8230463 DOI: 10.3390/cancers13122912] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/07/2021] [Accepted: 06/09/2021] [Indexed: 02/07/2023] Open
Abstract
We evaluate the feasibility of a concurrent application of sorafenib and external beam radiation therapy (EBRT) for advanced hepatocellular carcinoma (HCC). PubMed, Embase, Medline, and Cochrane Library were searched up to 9 April 2021. The primary endpoint was grade ≥3 complications, and the secondary endpoint was overall survival (OS). Subgroup analyses were performed for studies with the EBRT targets, intrahepatic vs. non-intrahepatic lesions (e.g., extrahepatic metastases or malignant vessel involvement only). Eleven studies involving 512 patients were included in this meta-analysis. Pooled rates of gastrointestinal, hepatologic, hematologic, and dermatologic grade ≥3 toxicities were 8.1% (95% confidence interval (CI): 4.8-13.5, I2 = ~0%), 12.9% (95% CI: 7.1-22.1, I2 = 22.4%), 9.1% (95% CI: 3.8-20.3, I2 = 51.3%), and 6.8% (95% CI: 3.8-11.7, I2 = ~0%), respectively. Pooled grade ≥3 hepatologic and hematologic toxicity rates were lower in studies targeting non-intrahepatic lesions than those targeting intrahepatic lesions (hepatologic: 3.3% vs. 17.1%, p = 0.041; hematologic: 3.3% vs. 16.0%, p = 0.078). Gastrointestinal and dermatologic grade ≥3 complications were not significantly different between the subgroups. Regarding OS, concurrent treatment was more beneficial than non-concurrent treatment (odds ratio: 3.3, 95% CI: 1.3-8.59, p = 0.015). One study reported a case of lethal toxicity due to tumor rupture and gastrointestinal bleeding. Concurrent treatment can be considered and applied to target metastatic lesions or local vessel involvement. Intrahepatic lesions should be treated cautiously by considering the target size and hepatic reserve.
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Affiliation(s)
- Chai Hong Rim
- Department of Radiation Oncology, Ansan Hospital, Korea University Medical College, Ansan 15355, Korea; (S.P.); (W.S.Y.)
| | - Sunmin Park
- Department of Radiation Oncology, Ansan Hospital, Korea University Medical College, Ansan 15355, Korea; (S.P.); (W.S.Y.)
| | - In-Soo Shin
- Graduate School of Education, Dongguk University, Seoul 04620, Korea;
| | - Won Sup Yoon
- Department of Radiation Oncology, Ansan Hospital, Korea University Medical College, Ansan 15355, Korea; (S.P.); (W.S.Y.)
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Jung S, Park J, Ko KS. Lipopolysaccharide-induced innate immune responses are exacerbated by Prohibitin 1 deficiency and mitigated by S-adenosylmethionine in murine macrophages. PLoS One 2020; 15:e0241224. [PMID: 33175859 PMCID: PMC7657527 DOI: 10.1371/journal.pone.0241224] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 10/09/2020] [Indexed: 12/21/2022] Open
Abstract
Prohibitin 1 (Phb1) is a pleiotropic protein with multiple functions in mammalian cells including cell cycle regulation and mitochondrial protein stabilization. It has been proposed as a potential therapeutic target for a variety of diseases including inflammatory diseases. In this study, we investigated the potential immune-modulatory functions of Phb1 and anti-inflammatory properties of S-adenosylmethionine (SAMe) using macrophages, which play a major role in the innate immune system. The results showed that expressions of Phb1 mRNA and protein were reduced in lipopolysaccharide (LPS)-stimulated RAW 264.7 cells (p<0.05). Phb1 knockdown further ameliorated the mRNA expression of pro- and anti-inflammatory cytokines such as TNF-α, IL-1α, IL-1β, IL-6, and IL10 in LPS-stimulated RAW 264.7 cells. SAMe significantly attenuated LPS-induced inflammatory responses such as IL-1β, IL-10, Nos2, and NO production in the presence of siPhb1. Luciferase reporter assay was conducted to determine the mechanisms underlying the effects of Phb1 and SAMe on the immune system. The luciferase activity of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) was significantly increased in LPS-treated RAW 264.7 cells. In addition, the luciferase reporter assay showed increased NF-κB activation in Phb1 knockdown RAW 264.7 cells (p<0.1) and SAMe treatment attenuated the NF-κB luciferase activity in Phb1 knockdown RAW 264.7 cells. Based on the results, we concluded that Phb1 possibly modulates the inflammatory response whereas SAMe has an anti-inflammatory effect on Phb1 knockdown macrophage cells. Furthermore, Phb1 expression level has potential properties of affecting on innate immune system by modulating the NF-κB signaling pathway.
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Affiliation(s)
- Soohan Jung
- Department of Biomedical Sciences, College of Medicine, Seoul National University, Seoul, Korea
| | - Jaehee Park
- Department of Nutritional Science and Food Management, College of Science and Industry Convergence, Ewha Womans University, Seoul, Korea
| | - Kwang Suk Ko
- Department of Nutritional Science and Food Management, College of Science and Industry Convergence, Ewha Womans University, Seoul, Korea
- * E-mail:
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