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Nam B, Bang SY, Park Y, Jo S, Shin JH, Lee S, Joo KB, Kim TH. POS0030 CLINICAL AND GENETIC FACTORS ASSOCIATED WITH RADIOGRAPHIC PROGRESSION IN PATIENTS WITH ANKYLOSING SPONDYLITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundAnkylosing spondylitis (AS) is a heritable inflammatory disease eventually leading to spinal fusion 1. Severity of structural damage is highly variable, some patients develop almost no change in spinal structure for long disease duration, whereas others have total ankylosis even in the early stage of disease.ObjectivesTo identify clinical and genetic factors associated with severe radiographic damage in patients with AS.MethodsWe newly generated genome-wide variant data (833K, KoreanChip) of 444 AS patients. The severity of radiographic damage was assessed using the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). To identify clinical and genetic factors associated with severe radiographic damage, multiple linear regression analyses were performed. Human AS osteoprogenitor cells were used for functional validation. Pathway analysis was also conducted.ResultsA total 444 AS patients (male 90.3%) were enrolled. The median mSASSS at baseline was 7.7 (5.5-16.8). The patients were observed for 9.6 (7.9-11.3) years. Within this period, the median mSASSS score increased to 14.0 (7.0-36.8). The most influential clinical factor of final mSASSS was baseline mSASSS (β = 0.818, p < 0.001). Peripheral joint involvement was associated with decreased possibility of severe radiographic damage (β = -0.221, p < 0.001). Eye involvement, longer follow up duration, and increased age at enrollment were associated with increased final mSASSS (β = 0.165, p < 0.001; β = 0.039, p < 0.001; β = 0.010, p = 0.002, respectively). Ryanodine receptor 3 (RYR3) gene was associated with severe radiographic damage (β = 1.105, p = 1.97x10-06). Treatment with Rhodamine B, a ligand of RYR3, induced extracellular matrix mineralization of AS osteoprogenitors in vitro. For the pathway analysis, PI3K-Akt signaling pathway and focal adhesion pathway were associated with severe radiographic damage in AS.ConclusionThis study identified clinical and genetic factors that contributed to better understanding of the pathogenesis and biology associated with radiographic damage in AS.References[1]Li Z, Brown MA. Progress of genome-wide association studies of ankylosing spondylitis. Clinical & Translational Immunology. 2017;6(12):e163.Disclosure of InterestsNone declared
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Jo S, Lee JS, Nam B, Lee YL, Kim H, Lee EY, Park YS, Kim TH. SOX9 + enthesis cells are associated with spinal ankylosis in ankylosing spondylitis. Osteoarthritis Cartilage 2022; 30:280-290. [PMID: 34826571 DOI: 10.1016/j.joca.2021.11.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 11/09/2021] [Accepted: 11/17/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Although cartilage degeneration and invasion of the subchondral bone plate in entheseal lesion has been considered to consequently lead bony ankylosis in ankylosing spondylitis (AS), no evident mechanisms are known. DESIGN To identify histopathological and physiological changes in enthesitis-related ankylosis in AS, we performed molecular characterization of transcription factors and surface markers, and transcriptome analysis with human tissues. Entheseal tissue containing subchondral bone was obtained from the facet joints of 9 patients with AS and 10 disease controls, and assessed by using differential staining techniques. Enthesis cells were isolated, characterized, stimulated with TNF and/or IL-17A, and analysed by cell-based experimental tools. RESULTS We found diffusely distributed granular tissue and cartilage in the subchondral bone in AS. Co-expression of SOX9, a specific transcription factor in cartilage, and matrix metalloproteinase 13 (MMP13) was found in the granular tissues within the subchondral bone from AS patients. Intriguingly, SOX9 expression was significantly higher in AS enthesis cells than controls and correlated with TNFR1 and IL-17RA expressions, which is important for high reactivity to TNF and IL-17A cytokines. Co-stimulation by TNF and IL-17A resulted in accelerated mineralization/calcification features, and increased OCN expression in AS enthesis cells. Furthermore, SOX9 overexpression in enthesis leads to promoting mineralization feature by TNF and IL-17A stimuli. Finally, OCN expression is elevated in the destructive enthesis of advanced AS. CONCLUSION These findings provide insight into the links between inflammation and the mineralization of entheseal tissue as the initiation of spinal ankylosis, emphasizing the importance of SOX9+ enthesis cells.
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Affiliation(s)
- S Jo
- Hanyang University Institute for Rheumatology Research, Hanyang University Hospital for Rheumatic Diseases, Seoul 04763, Republic of Korea
| | - J S Lee
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea; GENOME INSIGHT Inc., Daejeon 34141, Republic of Korea
| | - B Nam
- Hanyang University Institute for Rheumatology Research, Hanyang University Hospital for Rheumatic Diseases, Seoul 04763, Republic of Korea
| | - Y L Lee
- Hanyang University Institute for Rheumatology Research, Hanyang University Hospital for Rheumatic Diseases, Seoul 04763, Republic of Korea
| | - H Kim
- Department of Pathology, Hanyang University Seoul Hospital, Seoul 04763, Republic of Korea
| | - E Y Lee
- Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Y-S Park
- Department of Orthopedic Surgery, Guri Hospital, Hanyang University College of Medicine, Guri 11923, Republic of Korea
| | - T-H Kim
- Hanyang University Institute for Rheumatology Research, Hanyang University Hospital for Rheumatic Diseases, Seoul 04763, Republic of Korea; Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul 04763, Republic of Korea.
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Lee JS, Yun JY, Kang SH, Lee SJ, Choi JH, Nam B, Lee SH, Chung YC, Kim CH. Korean Medication Algorithm for Schizophrenia 2019, Second Revision: Treatment of Psychotic Symptoms. Clin Psychopharmacol Neurosci 2020; 18:386-394. [PMID: 32702217 PMCID: PMC7383009 DOI: 10.9758/cpn.2020.18.3.386] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/28/2020] [Accepted: 03/12/2020] [Indexed: 12/26/2022]
Abstract
Objective In 2001, the Korean College of Neuropsychopharmacology and the Korean Society for Schizophrenia Research developed the Korean Medication Algorithm Project for Schizophrenia (KMAP-SPR 2001, revised 2006) through a consensus of expert opinion. The present study was carried out to support the second revision of the KMAP-SPR. Methods Based on clinical guidelines and studies on the treatment of psychotic symptoms in schizophrenia, the Executive committee completed a draft of KMAP-SPR 2019. To obtain an expert consensus, a Review committee of 100 Korean psychiatrists was formed and 69 responded to a 30-item questionnaire. Based on their responses, the KMAP-SPR 2019 was finalized. Results The revised schizophrenia algorithm now consists of 5 stages. At Stage 1, monotherapy with atypical antipsychotics was recommended by expert reviewers as the first-line strategy. At Stage 2, most reviewers recommended the use of typical or atypical antipsychotic drugs not used at Stage 1. At Stage 3, many reviewers agreed with the administration of clozapine. At Stage 4, a combination of clozapine and other agents such as antipsychotics, mood stabilizers, antidepressants, or electroconvulsive therapy was recommended. At Stage 5, most reviewers recommended combined treatment with an antipsychotic other than clozapine; and a mood stabilizer, antidepressant, or electroconvulsive therapy. At any stage, prescribing long-acting injectable antipsychotics at the discretion of the clinician was recommended. Conclusion Compared with previous versions, the KMAP-SPR 2019 now recommends using clozapine earlier in treatment-refractory schizophrenia. In addition, the use of long-acting injectable antipsychotics is now considered to be available at any stage.
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Affiliation(s)
- Jung Suk Lee
- Department of Psychiatry, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Je-Yeon Yun
- Department of Psychiatry, Seoul National University Hospital, Seoul, Korea.,Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Korea
| | - Shi Hyun Kang
- Department of Adult Psychiatry, National Center for Mental Health, Seoul, Korea
| | - Seung Jae Lee
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Joon-Ho Choi
- Department of Psychiatry, Hanyang University College of Medicine and Mental Health Institute, Seoul, Korea
| | - Beomwoo Nam
- Department of Psychiatry, Konkuk University School of Medicine, Chungju, Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Young-Chul Chung
- Department of Psychiatry, Chonbuk National University Medical School, Jeonju, Korea
| | - Chan-Hyung Kim
- Institute of Behavioral Science in Medicine and Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea
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Abstract
Background:Irisin, exercise-mediated myokine, is one of the most recently discovered hormones. Irisin has been shown to play multifunctional roles including anti-inflammation by suppressing secretion of NF kß, TNF-α, IL-6, and other pro-inflammatory cytokines from macrophages and adipocytes [1]. Thus, several attempts have been made to investigate irisin in chronic inflammatory rheumatic diseases. And recent evidences show that serum irisin concentration is lower in patients with osteoarthritis, rheumatoid arthritis, and behcet disease than health individuals [2-4]. Furthermore, one study showed that serum irisin level was negatively correlated with radiographic severity of knee osteoarhtiritis [2]. However, no previous study has investigated irisin in patients with ankylosing spondylitis (AS).Objectives:To assess the serum level of irisin, and evaluate the possible relationship of irisin with disease activity in patients with AS.Methods:Male patients with AS fulfilled the modified New York criteria (n=119), and healthy male controls (n=30) were enrolled. Serum irisin level was measured by ELISA (Cusabio, CSB-EQ027943HU). Disease activity was assessed by acute phase reactants, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). Clinical characteristics and serum irisin level of the AS group were compared with those of the control group using Student t-test for normally distributed continuous measures and Mann-Whitney U test for non-normally distributed continuous measures. To evaluate the correlations of serum Irisin level and AS disease activity, Spearman’s correlation test was used. AS patients were grouped into the high BASDAI group (BASDAI ≥ 4, n=45) and the Low BASDAI group (BASDAI < 4, n=74). And serum irisin level was also compared between two groups.Results:AS group had lower serum irisin concentration compared with healthy control group (60.50 [23.68-131.15] vs. 124.69 [79.58-192.90], p=0.013), while age and body mass index were not significantly different between groups. There was no significant correlation between irisin level and disease activities. However, High BASDAI group showed significantly lower irisin level than low BASDAI group (44.64 [18.13-85.89] vs. 65.68 [31.81-165.31], p=0.011).Conclusion:AS patients have lower serum irisin concentrations than healthy controls. AS patients with severe symptoms tend to have lower serum level of irisin than those with less severe symptoms.References:[1]H. Askari, et al. A glance at the therapeutic potential of irisin against diseases involving inflammation, oxidative stress, and apoptosis: an introductory review. Pharmacol Res. 2018[2]Mao Y, et al. Association of Irisin and CRP Levels with the Radiographic Severity of Knee Osteoarthritis. Genet Test Mol Biomarkers. 2016[3]Rania M. Gamal, et al. Preliminary study of the association of serum irisin levels with poor sleep quality in rheumatoid arthritis patients. Sleep Med. 2020[4]A. Icli, et al. Novel myokine: irisin may be an independent predictor for subclinic atherosclerosis in Behcet’s disease. J. Investig. Med. 2016Disclosure of Interests:None declared
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Jeong H, Nam B, Jo SJ, Lee WC, Yim HW. Clinical Usefulness of the Geriatric Depression Scale to Identify the Elderly at Risk of Suicide. Psychiatry Investig 2020; 17:481-486. [PMID: 32403208 PMCID: PMC7265027 DOI: 10.30773/pi.2019.0299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 03/12/2020] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE Population-based suicidal screening can be an important intervention method to reduce suicidal attempt rate in community. However, directly asking about suicidal behavior may be burdensome to non-mental health workers. This study aimed to evaluate the clinical usefulness of the Geriatric Depression Scale-15 (GDS-15) in identifying the elderly at risk of suicide in community. METHODS Nine hundred forty-eight over 60 years of age participated in this study. All participants completed the GDS-15. A trained interviewer interviewed each participant for suicidality including suicidal ideation, plan, and prior attempt using the Structured Clinical Interview for DSM-IV. RESULTS When the cut-off score of 10 in the GDS-15 was applied to identify the elderly at risk of suicide, the proportion of directly asking about suicidal behavior by non-mental health workers was reduced by 33.1%; however, 19.5% at risk of suicide were missed. When the cut-off was changed to 6, 100% at risk of suicide were covered by the GDS-15. CONCLUSION Screening for suicidality using GDS-15 is a promising way to reduce the proportion of directly asking about suicidal behavior by non-mental health workers among the high-risk suicidal elderly in a community setting.
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Affiliation(s)
- Hyunsuk Jeong
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Beomwoo Nam
- Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Republic of Korea
| | - Sun-Jin Jo
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Won-Chul Lee
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyeon Woo Yim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Woo YS, Yoon BH, Song JH, Seo JS, Nam B, Lee K, Lee J, Jung YE, Kim MD, Lee JG, Wang SM, Kwon YJ, Bahk WM. Clinical correlates associated with the long-term response of bipolar disorder patients to lithium, valproate or lamotrigine: A retrospective study. PLoS One 2020; 15:e0227217. [PMID: 31923220 PMCID: PMC6953788 DOI: 10.1371/journal.pone.0227217] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 12/13/2019] [Indexed: 12/16/2022] Open
Abstract
Background Although mood stabilizers such as lithium (LIT), valproate (VAL), and lamotrigine (LMT) appear to be efficacious treatments for bipolar disorder (BD) in research settings, the long-term response to these mood stabilizers in clinical practice is highly variable among individuals. Thus, the present study examined the characteristics associated with good or insufficient responses to long-term treatment with LIT, VAL, or LMT for BD. Methods This study retrospectively analyzed the medical records of patients who visited an outpatient clinic with a diagnosis of BD I or II. Data from patients who were treated with one of three mood stabilizing medications (LIT, VAL, or LMT) for more than 6 months were selected, and the long-term treatment responses were evaluated using the Alda scale. For the purposes of this study, two response categories were formed: insufficient response (ISR), including non-response or poor response (Alda total score ≤ 6), and good response (GR; Alda total score ≥ 7). Results Of the 645 patients included in the present study, 172 were prescribed LIT, 320 were prescribed VAL, and 153 were prescribed LMT for at least 6 months. A binary logistic regression analysis revealed that a diagnosis of BD II (odds ratio [OR], 8.868; 95% confidence interval [CI], 1.123–70.046; p = 0.038), comorbid alcohol/substance use disorder (OR, 4.238; 95% CI, 1.154–15.566; p = 0.030), and a history of mixed episodes (OR, 4.363; 95% CI, 1.191–15.985; p = 0.026) were significant predictors of LIT-ISR. Additionally, a depressive-predominant polarity significantly predicted LMT-GR (OR, 8.586; 95% CI, 2.767–26.644; p < 0.001). Conclusion The present findings demonstrated that patients with a diagnosis of BD II, a comorbid alcohol/substance problem, or a history of mixed episodes were not likely to respond to LIT treatment. Additionally, LMT might be a better treatment choice for patients with a depressive-predominant polarity.
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Affiliation(s)
- Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Bo-Hyun Yoon
- Department of Psychiatry, Naju National Hospital, Naju, Republic of Korea
| | - Jye-Heon Song
- Department of Psychiatry, Naju National Hospital, Naju, Republic of Korea
| | - Jeong Seok Seo
- Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Republic of Korea
| | - Beomwoo Nam
- Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Republic of Korea
| | - Kwanghun Lee
- Department of Psychiatry, College of Medicine, Dongguk University, Gyeongju, Republic of Korea
| | - Jonghun Lee
- Department of Psychiatry, School of Medicine, Catholic University of Daegu, Daegu, Republic of Korea
| | - Young-Eun Jung
- Department of Psychiatry, School of Medicine, Jeju National University, Jeju, Republic of Korea
| | - Moon-Doo Kim
- Department of Psychiatry, School of Medicine, Jeju National University, Jeju, Republic of Korea
| | - Jung Goo Lee
- Department of Psychiatry, Haeundae Paik Hospital, Paik Institute for Clinical Research, College of Medicine, Inje University, Busan, Republic of Korea
- Department of Health Science and Technology, Graduate School of Inje University, Busan, Republic of Korea
| | - Sheng-Min Wang
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Young-Joon Kwon
- Department of Psychiatry, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- * E-mail:
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Shim IH, Lee J, Kim MD, Jung YE, Min KJ, Kwon YJ, Kim JS, Lee K, Woo YS, Nam B, Seo JS, Lee JG, Jon DI, Sohn I, Park SY, Yoon BH, Bahk WM. The prevalence and diagnostic classification of mixed features in patients with major depressive episodes: A multicenter study based on the DSM-5. Int J Methods Psychiatr Res 2019; 28:e1773. [PMID: 30786322 PMCID: PMC6877217 DOI: 10.1002/mpr.1773] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 01/09/2019] [Accepted: 01/12/2019] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES The purpose of this study was to evaluate the prevalence of mixed features using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and to examine how patients with mixed states would be classified using the DSM-5. METHODS In total, 12 hospitals participated in this study, and data on the demographic characteristics and clinical diagnoses of patients treated between October 2013 and September 2016 were obtained. We reviewed the data for opposite-polarity symptoms according to the DSM-5 criteria and the research-based diagnostic criteria. RESULTS Of the 859 patients included in the final analysis, the prevalence of mixed features in patients with major depressive episodes based on the DSM-5 remained low. Patients with major depressive disorder were more likely to be classified as experiencing anxious distress and/or a cluster-B personality disorder in mixed state patients not diagnosed with DSM-5 mixed features, whereas more mixed state patients with bipolar disorder were diagnosed with mixed features using the DSM-5. CONCLUSIONS The prevalence of mixed features did not increase significantly when the DSM-5 was used, and patients with mixed states were more likely to be classified as having anxious distress and/or a cluster-B personality disorder in addition to mixed features.
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Affiliation(s)
- In Hee Shim
- Department of Psychiatry, Cancer Center, Dongnam Institute of Radiological and Medical Sciences, Busan, Republic of Korea
| | - Jonghun Lee
- Department of Psychiatry, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea
| | - Moon-Doo Kim
- Department of Psychiatry, School of Medicine, Jeju National University, Jeju, Republic of Korea
| | - Young-Eun Jung
- Department of Psychiatry, School of Medicine, Jeju National University, Jeju, Republic of Korea
| | - Kyung Joon Min
- Department of Psychiatry, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Young-Joon Kwon
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University, Cheonan, Republic of Korea
| | - Ji Sun Kim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University, Cheonan, Republic of Korea
| | - Kwanghun Lee
- Department of Psychiatry, College of Medicine, Dongguk University, Gyeongju, Republic of Korea
| | - Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Beomwoo Nam
- Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Republic of Korea
| | - Jeong Seok Seo
- Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Republic of Korea
| | - Jung Goo Lee
- Department of Psychiatry, Haeundae Paik Hospital, College of Medicine, Inje University and Paik Institute for Clinical Research, Department of Health Science and Technology, Graduate School of Inje University, Busan, Republic of Korea
| | - Duk-In Jon
- Department of Psychiatry, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Inki Sohn
- Department of Psychiatry, Keyo Hospital, Uiwang, Republic of Korea
| | - Sung-Yong Park
- Department of Psychiatry, Keyo Hospital, Uiwang, Republic of Korea
| | - Bo-Hyun Yoon
- Department of Psychiatry, Naju National Hospital, Naju, Republic of Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Jung YE, Kim MD, Bahk WM, Woo YS, Nam B, Seo JS, Jang SH, Sung HM, Shim IH, Yoon BH, Kim JS, Kwon YJ. Validation of the Korean Version of the Depression in Old Age Scale and Comparison with Other Depression Screening Questionnaires Used in Elderly Patients in Medical Settings. Clin Psychopharmacol Neurosci 2019; 17:369-376. [PMID: 31352703 PMCID: PMC6705099 DOI: 10.9758/cpn.2019.17.3.369] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 02/27/2018] [Accepted: 03/02/2018] [Indexed: 11/18/2022]
Abstract
Objective The Depression in Old Age Scale (DIA-S) is a new screening tool for assessing depression in the elderly. The primary aims of this study were to describe the validation of the Korean version of the DIA-S (K-DIA-S) and to compare its validity with that of other depression screening questionnaires used in elderly outpatients in medical settings. Methods A total of 385 elderly outpatients completed the K-DIA-S and underwent the Mini International Neuropsychiatric Interview to diagnose depressive disorders. Other measures included the 15-item short form of the Geriatric Depression Scale (SGDS), the 9-item depression module of the Patient Health Questionnaire (PHQ-9), and the Montgomery–Asberg Depression Rating Scale (MADRS). Reliability and validity tests, an optimal cutoff point estimate, and receiver operating characteristic curve analysis were performed to investigate the diagnostic validity of the K-DIA-S. Areas under the curves (AUCs) for the K-DIA-S, SGDS, and PHQ-9 were compared statistically. Results The K-DIA-S showed good internal consistency and strong correlations with the SGDS (r = 0.853), PHQ-9 (r = 0.739), and MADRS (r = 0.772). The cut-off point of the K-DIA-S that can be recommended for screening depressive symptoms was a score of 4. For “any depressive disorder”, the AUC (standard error) for the K-DIA-S was 0.896 (0.015), which was significantly larger than that for the PHQ-9 (p = 0.033). Conclusion The present findings suggest that the K-DIA-S has good psychometric properties and is a valid and reliable tool for assessing depressive symptoms in elderly populations and medically ill patients.
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Affiliation(s)
- Young-Eun Jung
- Department of Psychiatry, Jeju National University School of Medicine, Jeju, Korea
| | - Moon-Doo Kim
- Department of Psychiatry, Jeju National University School of Medicine, Jeju, Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Beomwoo Nam
- Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Korea
| | - Jeong Seok Seo
- Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Korea
| | - Sae-Heon Jang
- Department of Psychiatry, Bongseng Memorial Hospital, Busan, Korea
| | - Hyung-Mo Sung
- Department of Psychiatry, Gumi CHA Medical Center, CHA University, Gumi, Korea
| | - In Hee Shim
- Department of Psychiatry, Cancer Center, Dongnam Institute of Radiological & Medical Sciences, Busan, Korea
| | - Bo-Hyun Yoon
- Department of Psychiatry, Naju National Hospital, Naju, Korea
| | - Ji Sun Kim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Young-Joon Kwon
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
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Woo YS, Yoon BH, Jeon BH, Seo JS, Nam B, Lee SY, Jae YM, Jang SH, Eun HJ, Won SH, Lee K, Lee J, Bahk WM. Switching Antipsychotics to Blonanserin in Patients with Schizophrenia: An Open-label, Prospective, Multicenter Study. Clin Psychopharmacol Neurosci 2019; 17:423-431. [PMID: 31352709 PMCID: PMC6705098 DOI: 10.9758/cpn.2019.17.3.423] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 10/25/2018] [Accepted: 10/26/2018] [Indexed: 12/26/2022]
Abstract
Objective This study was performed to investigate the efficacy and tolerability of blonanserin in schizophrenic patients who were previously treated with other antipsychotics but, due to insufficient response, were switched to blonanserin. Methods A total of 52 patients with schizophrenia who were unresponsive to treatment with antipsychotic monotherapy or combination therapy were recruited into this 12-week, open-label, prospective, multicenter study. Patients were switched to blonanserin from their existing antipsychotics over a maximum 2-week tapering-off period. Efficacy was primarily evaluated using the 18-item Brief Psychiatric Rating Scale (BPRS). Assessments were performed at baseline, and at weeks 1, 2, 4, 8, and 12. Results Switching to blonanserin resulted in a significant decrease in the mean total score on the BPRS from baseline (56.8 ± 9.4) to week 12 (42.1 ± 13.8, p < 0.001). The most common adverse events were extrapyramidal symptoms (n = 12, 23.1%), insomnia (n = 10, 19.2%), and emotional arousal (n = 6, 11.5%). Overweight or obese patients (body mass index ≥ 23 kg/m2, n = 33) who switched to blonanserin exhibited significant weight loss from 75.2 ± 9.3 kg at baseline to 73.5 ± 9.2 kg at week 12 (p = 0.006). The total cholesterol (baseline, 236.1 ± 47.6 mg/dl; endpoint [week 12], 209.9 ± 28.0 mg/dl; p = 0.005) and prolactin levels (baseline, 80.0 ± 85.2 ng/ml; endpoint [week 12], 63.2 ± 88.9 ng/ml; p = 0.003) were also significantly improved in patients with hypercholesterolemia or hyperprolactinemia. Conclusion The results of the present study suggest that switching to blonanserin may be an effective strategy for schizophrenic patients unresponsive to other antipsychotic treatments.
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Affiliation(s)
- Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Bo-Hyun Yoon
- Department of Psychiatry, Naju National Hospital, Naju, Korea
| | - Bong-Hee Jeon
- Department of Psychiatry, Naju National Hospital, Naju, Korea
| | - Jeong Seok Seo
- Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Korea
| | - Beomwoo Nam
- Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Korea
| | - Sang-Yeol Lee
- Department of Psychiatry, Wonkwang University School of Medicine, Iksan, Korea
| | - Young-Myo Jae
- Department of Psychiatry, Bongseng Memorial Hospital, Busan, Korea
| | - Sae-Heon Jang
- Department of Psychiatry, Bongseng Memorial Hospital, Busan, Korea
| | - Hun Jeong Eun
- Department of Neuropsychiatry, Presbyterian Medical Center-Jesus Hospital, Jeonju, Korea
| | - Seung-Hee Won
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Kwanghun Lee
- Department of Psychiatry, College of Medicine, Dongguk University, Gyeongju, Korea
| | - Jonghun Lee
- Department of Psychiatry, School of Medicine, Catholic University of Daegu, Daegu, Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Yun JY, Lee JS, Kang SH, Nam B, Lee SJ, Lee SH, Choi J, Kim CH, Chung YC. Korean Treatment Guideline on Pharmacotherapy of Co-existing Symptoms and Antipsychotics-related Side Effects in Patients with Schizophrenia. ACTA ACUST UNITED AC 2019. [DOI: 10.16946/kjsr.2019.22.2.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Je-Yeon Yun
- Seoul National University Hospital, Seoul, Korea
- Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jung Suk Lee
- Department of Psychiatry, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Shi Hyun Kang
- Adult Psychiatry, Division of Medical Services, National Center for Mental Health, Seoul, Korea
| | - Beomwoo Nam
- Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Korea
| | - Seung Jae Lee
- Department of Psychiatry, School of Medicine, Kyoungpook National University, Daegu, Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Inje University, Ilsan-Paik Hospital, Goyang, Korea
| | - Joonho Choi
- Department of Psychiatry, Hanyang University Guri Hospital, Guri, Korea
| | - Chan-Hyung Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Young-Chul Chung
- Department of Psychiatry, Chonbuk National University Medical School, Jeonju, Korea
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Shim SH, Lee J, Song JH, Nam B, Yoon BH, Jin HY, Sung HM, Jeong JH, Jang SH, Jon DI, Woo YS, Bahk WM. Screening with the Korean Version of the Mood Disorder Questionnaire for Bipolar Disorders in Adolescents: Korean Validity and Reliability Study. Clin Psychopharmacol Neurosci 2018; 16:316-323. [PMID: 30121982 PMCID: PMC6124865 DOI: 10.9758/cpn.2018.16.3.316] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 08/25/2017] [Accepted: 08/26/2017] [Indexed: 11/18/2022]
Abstract
Objective This study aimed to evaluate the validity and reliability of a Korean version of the Mood Disorder Questionnaire-Adolescent version (K-MDQ-A) as a screening instrument for bipolar disorders in adolescents. Methods One hundred two adolescents with bipolar disorders and their parents were recruited from November 2014 to November 2016 at 7 training hospitals. One hundred six controls were recruited from each middle school in two cities of South Korea. The parent version of the original MDQ-A was translated into Korean. The parents of all participants completed the K-MDQ-A. The diagnoses of bipolar disorders were determined based on the Korean version of K-SADS-PL. The test-retest reliability with a 10-month interval was investigated in 33 bipolar adolescents. Results K-MDQ-A yielded a sensitivity of 0.90 and a specificity of 0.92 when using a cut-off score of endorsement of 5 items, indicating that symptoms occurred in the same time period and caused moderate or serious problems. The internal consistency of the K-MDQ-A was good. The correlations between each item and the total score ranged from 0.40 to 0.76 and were all statistically significant. Factor analysis revealed 3 factors that explained 61.25% of the total variance. The mean total score was significantly higher in bipolar adolescents (7.29) than in controls (1.32). The Pearson correlation coefficient for the total test-retest score was 0.59 (p<0.001). Conclusion The K-MDQ-A completed by parents showed the excellent validity and reliability and may be a useful screening tool for adolescents with bipolar disorders attending in- and outpatient psychiatric clinics.
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Affiliation(s)
- Se-Hoon Shim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Jonghun Lee
- Department of Psychiatry, Catholic University of Daegu College of Medicine, Daegu, Korea
| | - Jye-Heon Song
- Department of Psychiatry, Naju National Hospital, Naju, Korea
| | - Beomwoo Nam
- Department of Psychiatry, Konkuk University School of Medicine, Chungju, Korea
| | - Bo-Hyun Yoon
- Department of Psychiatry, Naju National Hospital, Naju, Korea
| | - Ha-Young Jin
- Department of Psychology, Chungbuk National University, Cheongju, Korea
| | - Hyung-Mo Sung
- Department of Psychiatry, CHA University, Gumi, Korea
| | - Jong-Hyun Jeong
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sae-Heon Jang
- Department of Psychiatry, Bongseng Memorial Hospital, Busan, Korea
| | - Duk-In Jon
- Department of Psychiatry, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Nam B. Proper administration of psychostimulants. J Korean Med Assoc 2018. [DOI: 10.5124/jkma.2018.61.8.502] [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: 11/06/2022] Open
Affiliation(s)
- Beomwoo Nam
- Department of Psychiatry, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea
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Nam B, Bae S, Kim SM, Hong JS, Han DH. Comparing the Effects of Bupropion and Escitalopram on Excessive Internet Game Play in Patients with Major Depressive Disorder. Clin Psychopharmacol Neurosci 2017; 15:361-368. [PMID: 29073748 PMCID: PMC5678483 DOI: 10.9758/cpn.2017.15.4.361] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 07/26/2017] [Accepted: 07/27/2017] [Indexed: 11/30/2022]
Abstract
Objective Several studies have suggested the efficacy of bupropion and escitalopram on reducing the excessive internet game play. We hypothesized that both bupropion and escitalopram would be effective on reducing the severity of depressive symptoms and internet gaming disorder (IGD) symptoms in patients with both major depressive disorder and IGD. However, the changes in brain connectivity between the default mode network (DMN) and the salience network were different between bupropion and escitalopram due to their different pharmacodynamics. Methods This study was designed as a 12-week double blind prospective trial. Thirty patients were recruited for this research (15 bupropion group+15 escitalopram group). To assess the differential functional connectivity (FC) between the hubs of the DMN and the salience network, we selected 12 regions from the automated anatomical labeling in PickAtals software. Results After drug treatment, the depressive symptoms and IGD symptoms in both groups were improved. Impulsivity and attentional symptoms in the bupropion group were significantly decreased, compared to the escitalopram group. After treatment, FC within only the DMN in escitalopram decreased while FC between DMN and salience network in bupropion group decreased. Bupropion was associated with significantly decreased FC within the salience network and between the salience network and the DMN, compared to escitalopram. Conclusion Bupropion showed greater effects than escitalopram on reducing impulsivity and attentional symptoms. Decreased brain connectivity between the salience network and the DMN appears to be associated with improved excessive IGD symptoms and impulsivity in MDD patients with IGD.
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Affiliation(s)
- Beomwoo Nam
- Department of Psychiatry, Konkuk University School of Medicine, Chungju, Korea
| | - Sujin Bae
- Industry Academic Cooperation Foundation, Chung-Ang University, Seoul, Korea
| | - Sun Mi Kim
- Department of Psychiatry, Chung-Ang University Hospital, Seoul, Korea
| | - Ji Seon Hong
- Department of Psychiatry, Chung-Ang University Hospital, Seoul, Korea
| | - Doug Hyun Han
- Department of Psychiatry, Chung-Ang University Hospital, Seoul, Korea
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DeVylder JE, Oh HY, Nam B, Sharpe TL, Lehmann M, Link BG. Prevalence, demographic variation and psychological correlates of exposure to police victimisation in four US cities. Epidemiol Psychiatr Sci 2017; 26:466-477. [PMID: 27834166 PMCID: PMC6998899 DOI: 10.1017/s2045796016000810] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Accepted: 10/08/2016] [Indexed: 12/16/2022] Open
Abstract
Aims Victimisation by the police is purported to be widespread in cities in the USA, but there is limited data on police-public encounters from community samples. This is partly due to an absence of measures for assessing police violence exposure from the standpoint of civilians. As such, the demographic distribution and mental health correlates of police victimisation are poorly understood. The aims of this study were to present community-based prevalence estimates of positive policing and police victimisation based on assessment with two novel measures, and to test the hypotheses that (1) exposure to police victimisation would vary across demographic groups and (2) would be associated with depression and psychological distress. METHODS The Survey of Police-Public Encounters study surveyed adults residing in four US cities to examine the prevalence, demographic distribution and psychological correlates of police victimisation. Participants (N = 1615) completed measures of psychological distress (K-6 scale), depression (Patient Health Questionnaire 9) and two newly constructed measures of civilian-reported police-public encounters. Both measures were developed to assess police victimisation based on the WHO domains of violence, which include physical violence (with and without a weapon, assessed separately), sexual violence (inappropriate sexual contact, including public strip searches), psychological violence (e.g., threatening, intimidating, stopping without cause, or using discriminatory slurs) and neglect (police not responding when called or responding too late). The Police Practices Inventory assesses lifetime history of exposure to positive policing and police victimisation, and the Expectations of Police Practices Scale assesses the perceived likelihood of future incidents of police victimisation. Linear regression models were used to test for associations between police-public encounters and psychological distress and depression. RESULTS Psychological violence (18.6%) and police neglect (18.8%) were commonly reported in this sample and a substantial minority of respondents also reported more severe forms of violence, specifically physical (6.1%), sexual (2.8%) and physical with a weapon (3.3%). Police victimisation was more frequently reported by racial/ethnic minorities, males, transgender respondents and younger adults. Nearly all forms of victimisation (but not positive policing) were associated with psychological distress and depression in adjusted linear regression models. CONCLUSIONS Victimisation by police appears to be widespread, inequitably distributed across demographic groups and psychologically impactful. These findings suggest that public health efforts to both reduce the prevalence of police violence and to alleviate its psychological impact may be needed, particularly in disadvantaged urban communities.
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Affiliation(s)
- J. E. DeVylder
- School of Social Work, University of Maryland, Baltimore, MD, USA
| | - H. Y. Oh
- University of California Berkeley, School of Public Health, Berkeley, CA, USA
| | - B. Nam
- School of Social Work, University of Maryland, Baltimore, MD, USA
| | - T. L. Sharpe
- School of Social Work, University of Maryland, Baltimore, MD, USA
| | - M. Lehmann
- School of Social Work, University of Maryland, Baltimore, MD, USA
| | - B. G. Link
- School of Public Policy, University of California Riverside, Riverside, CA, USA
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Nam B, Ahn M, Kim T. Multiphasic personality inventory on pneumo-or hemo-thorax: Retrospective cross-sectional analysis of military candidate in Korea. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
ObjectivesThe aim of this study was to identify association between pneumo- or hemo-thorax and psychological distress using the Military Personality Inventory (MPI).MethodsA retrospective cross-sectional study was conducted with 19-yr-old examinees who were admitted to the Military Manpower Administration in Korea from February 2009 to January 2010. A total number of 1955 young men were enrolled in this study. The normal volunteer group (n = 1561) comprise individuals who did not have pneumo- or hemo-thorax. The pneumo- or hemo-thorax group (n = 394) included individuals with pneumo- or hemo-thorax. This group was divided into two subgroups, group A (treated with conservative care or chest tube insertion, n = 341) and group B (treated with wedge resection, n = 53).ResultsWe compared each of three groups (Control group, Group A, Group B) using the analysis of covariant (ANCOVA). The somatization subscale score of the neurosis category was significantly higher for group A (P < 0.001) and showed higher tendency for Group B than the control group (P = 0.073). The other categories (validity scale; anxiety, depression, and personality disorder subscales for neurosis scale; and psychopath scale) showed no significant difference in the MPI among Group A, Group B and Control group.ConclusionConservative care or chest tube insertion group had higher somatization symptoms than control group. Wedge resection group had higher somatization tendency than control group. Individuals with pneumo- or hemo-thorax history may be concerned about their body shape or their general condition. Therefore, supportive intervention and psychiatric education may be needed for them to relieve somatic distress.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Kang NI, Koo BH, Kim SW, Kim JH, Nam B, Lee BJ, Lee SH, Lee SJ, Lee SH, Jung MH, Hahn SW, Chung YC. Efficacy and Tolerability of Paliperidone Extended-release in the Treatment of First-episode Psychosis: An Eight-week, Open-label, Multicenter Trial. Clin Psychopharmacol Neurosci 2016; 14:261-9. [PMID: 27489380 PMCID: PMC4977821 DOI: 10.9758/cpn.2016.14.3.261] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 01/03/2016] [Accepted: 01/04/2016] [Indexed: 11/18/2022]
Abstract
Objective We investigated the efficacy and tolerability of paliperidone extended-release (ER) tablets in patients with first-episode psychosis (n=75). Methods This was an 8-week, open-label, multicenter trial. The primary outcome variable was scores on the Positive and Negative Syndrome Scale (PANSS); secondary measures included the Scale for the Assessment of Negative Symptoms (SANS), the Cognitive Assessment Interview (CAI), and the Global Assessment of Functioning (GAF). To assess safety, we measured drug-related adverse events, weight, lipid-related variables, and prolactin and administered the Simpson–Angus Rating Scale (SARS), the Abnormal Involuntary Movement Scale (AIMS), the Barnes Akathisia Scale (BAS), the Arizona Sexual Experiences Scale (ASEX), and the Udvalg for Kliniske Undersogelser side effect rating scale (UKU). Results The administration of paliperidone ER resulted in significant improvement in the PANSS, SANS, CAI, and GAF scores (p<0.001) over time. This improvement was evident as early as 1 week. The most frequent adverse events were akathisia, somnolence, anxiety, and sedation, which were well tolerated. Modest increases in weight and lipid profiles were also noted. Prolactin levels were substantially increased at the endpoint in both male and female patients. Conclusion These results indicate that paliperidone ER is effective and is characterized by good tolerability in the treatment of positive and negative symptoms and cognitive functioning in first-episode psychosis.
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Affiliation(s)
- Nam-In Kang
- Department of Psychiatry, Maeumsarang Hospital, Wanju, Korea
| | - Bon-Hoon Koo
- Department of Psychiatry, Yeungnam University, Gyeongsan, Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Jong-Hoon Kim
- Department of Psychiatry, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
| | - Beomwoo Nam
- Department of Psychiatry, Konkuk University School of Medicine, Cheongju, Korea
| | - Bong-Ju Lee
- Department of Psychiatry, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Sang-Hyuk Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Seung Jae Lee
- Department of Psychiatry, Kyoungpook National University School of Medicine, Daegu, Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Myung Hun Jung
- Department of Psychiatry, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Sang Woo Hahn
- Department of Psychiatry, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Young-Chul Chung
- Department of Psychiatry, Chonbuk National University Hospital, Jeonju, Korea.,Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
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Balasuriya U, Carossino M, Cook R, Nam B, Timoney P, Loynachan A. Establishment of persistent equine arteritis virus infection in primary cells isolated from the equine male reproductive tract. J Equine Vet Sci 2016. [DOI: 10.1016/j.jevs.2016.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Carossino M, Loynachan A, Campos J, Nam B, Canisso I, Go Y, Timoney P, Shuck K, Henney P, Troedsson M, Cook R, Swerczek T, Squires E, Bailey E, Balasuriya U. Sites of persistent equine arteritis virus infection in the reproductive tract of the long-term carrier stallion. J Equine Vet Sci 2016. [DOI: 10.1016/j.jevs.2016.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Nam B, Kwon Y, Lee K, Jon D, Shon I, Seo J. The Characteristics of Alcohol Pharmacokinetics of Korean Female. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.1681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
IntroductionThe systematized and proper sized research of alcohol pharmacokinetics in Korean has not reported ever.Objectives and aimAim of this study is to measure the β value and alcohol pharmacokinetic factors in Korean adult female and the relationship between the β value and some variables including age, smoking, total body water, drinking capacity, BMI, blood cholesterol, body fat and body fat ratio.MethodsNinety-one subjects were randomly divided into two groups. One group was provided as much as 0.35 mg/mL/kg of alcohol and the other as much as 0.70 mg/mL/kg, and blood alcohol concentration was measured 15, 30, 45, 60, 90, 120, 180, and 240 min after the women finished drinking.ResultsThe subjects’ mean alcohol elimination rate (β) was −0.002379 mg/100 mL·h, and there was no statistically significant difference in elimination rate between the two groups. The mean time to reach maximum blood alcohol concentration was 45 minutes, alcohol absorption rate was 0.1123 ± 0.1799 g/L/min, and the area under the concentration curve was 109.15 ± 62.95. Among the factors that correlated with alcohol metabolism, alcohol absorption rate and follicle-stimulating hormone were statistically significant, but age, body mass index, and body fat percentage were not significantly correlated with alcohol metabolism.ConclusionsThese results suggest that the β values for healthy Korean females can differ from the cut-offs that are currently used in Korea, which suggests that the legal limit for driving under intoxication should be adjusted.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Kang Y, Lee K, Shen L, Yeh K, Hong Y, Park Y, Yang S, Shin D, Zang D, Kang W, Chung I, Kim Y, Ryoo B, Park S, Nam B, Ryu M. Randomized Phase Ii Study of Capecitabine and Cisplatin with or Without Sorafenib in Patients with Metastatic Gastric Cancer: Stargate Study. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu334.1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Jeong H, Yim HW, Jo SJ, Nam B, Kwon SM, Choi JY, Yang SK. The effects of care management on depression treatment in a psychiatric clinic: a randomized controlled trial. Int J Geriatr Psychiatry 2013; 28:1023-30. [PMID: 23255054 DOI: 10.1002/gps.3920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Accepted: 11/21/2012] [Indexed: 11/11/2022]
Abstract
OBJECTIVE This study aims to examine whether care management has an effect on adherence to depression treatment in a psychiatric clinic in Korea. METHODS Fifty-seven patients with depression aged 60 years or over participated in the study. They were all low-income patients screened in the community and treated in a psychiatric clinic. The study design was a double-blind randomized controlled trial. The patients were randomly assigned to intervention (n = 29) or usual care (n = 28) groups. Intervention patients received depression care management for 6 months. Primary endpoint was an increase in remission rate as assessed using the 17-item Hamilton Depression Rating Scale score at 6 months. Secondary endpoints included improvement in treatment adherence, improvement in health-related quality of life, and a reduction in feelings of hopelessness. RESULTS Patients in the care management intervention group showed a higher remission rate than those in the usual care group (55% vs. 29%, p = 0.0421). Intervention patients were significantly more likely to adhere to the treatment (59% vs. 18%, p = 0.0016). The hopelessness score at the 6-month assessment was significantly lower in the intervention group than the usual care group (23.5 vs. 25.7, p = 0.0443). However, there was not a significant group difference in the quality of life. CONCLUSIONS We found that care management not only contributed to reducing depressive symptoms in geriatric patients suffering from depression but also increased the treatment adherence rate, which in turn increased the remission rate. Care management intervention is both feasible and effective in psychiatric clinics in Korea.
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Affiliation(s)
- Hyunsuk Jeong
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea; Clinical Research Center for Depression, Seoul, Korea
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Tillisch K, Labus J, Nam B, Bueller J, Smith S, Suyenobu B, Siffert J, McKelvy J, Naliboff B, Mayer E. Neurokinin-1-receptor antagonism decreases anxiety and emotional arousal circuit response to noxious visceral distension in women with irritable bowel syndrome: a pilot study. Aliment Pharmacol Ther 2012; 35:360-7. [PMID: 22221140 PMCID: PMC4073664 DOI: 10.1111/j.1365-2036.2011.04958.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Irritable bowel syndrome is characterised by chronic abdominal pain and frequent comorbid anxiety. The substance P ⁄ neurokinin-1 receptor system is implicated in the regulation of both pain and anxiety, suggesting a potential therapeutic target in IBS. AIM To determine whether inhibition of the neurokinin-1 receptor (NK1R) will change pain ratings and brain responses to experimental visceral pain and anxiety symptoms in women with IBS or not. METHODS Rome II positive IBS women were recruited for a double-blind, placebo-controlled, cross-over study of NK1R antagonist AV608. Treatment periods were 3 weeks with a 2-week washout period. Functional MRI during a visceral distension paradigm was performed before first treatment and after treatment blocks. SPM8 was used to compare brain activity during painful and nonpainful visceral stimuli in regions associated with emotional arousal and interoception. Negative affect, anxiety symptoms and pain ratings were assessed. RESULTS Eleven subjects completed the study and eight subjects provided fMRI data. AV608, compared with placebo, was associated with reduced anxiety, negative affect, and pain ratings. During AV608 treatment, the amygdala, hippocampus and anterior cingulate gyrus showed decreased activity during visceral distension. AV608 was also associated with decreases in activity in brain regions associated with interoception (posterior insula, anterior mid-cingulate gyrus). CONCLUSIONS Chronic treatment with AV608 in IBS is associated with improved mood and pain ratings and activity of emotional arousal related brain regions. This suggests that further exploration of NK1R antagonists is warranted in visceral pain disorders, particularly in patients with comorbid anxiety symptoms.
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Affiliation(s)
- K Tillisch
- Center for Neurobiology of Stress, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
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Ryu SY, Lee W, Kim K, Park S, Kim B, Kim M, Choi S, Nam B, Cho C. Are there any candidates for adjuvant hysterectomy among patients with locally advanced bulky cervical cancer initially treated with cisplatin-based chemoradiation? J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e15504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Park IH, Lee KS, Kang HS, Kwon Y, Kim SW, Lee S, Jung SY, Shin KH, Ko K, Nam B, Ro J. A phase Ib study of preoperative lapatinib, paclitaxel, and gemcitabine combination therapy in women with HER2-positive early breast cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e11069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Park J, Kim H, Shim J, Woo S, Choi J, Nam B. An interim analysis of a phase II study of the combination of TACE and sorafenib in patients with unresectable hepatocellular carcinoma in National Cancer Center Korea (COTSUN KOREA, NCT00919009). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
253 Background: Transarterial chemoembolization (TACE) is the palliative treatment for patients with unresectable HCC. TACE-induced ischemic injury is known to increase circulating VEGF and related with poor prognosis.The aim of this study is to evaluate efficacy and safety of combined TACE with sorafenib, VEGFR inhibitor in unresectable HCC patients. Methods: This study is a non-randomized, open-labeld, single-arm, phase II investigator-initiated clinical study. Estimated number of subjects was 50 under the assumption of 3.2 months of median time to progression (TTP) with TACE alone. All patients are Child-Pugh class A or superb B. Sorafenib begins to be administered on 3 days after the first session of TACE and will be subsequently administered up to 24 weeks. Efficacy of TACE was evaluated after 4 weeks from TACE by dynamic CT. Repeated TACE is performed “on demand” in case of PR or SD according to CT/MRI evaluation. Results: A total of 50 patients were enrolled for this interim analysis. Male was 84% and mean age was 61.5years. Causes of underlying chronic liver disease were HBV in 28 patients (65.1%). Patients were categorized into modified UICC stage II (15, 30.0%), III (24, 48.0%) and IVA (11, 22.0%). Median follow-up period was 5.3 months (range, 1.0–13.1). The size of index lesions was ranged from 1.0 cm to 13.1 cm, and number of lesions was between 1 and 5. Number of TACE sessions was 1.0 (range, 1–4). Common adverse events (AE) during sorafenib therapy were elevation of serum AST/ALT (96.8%), hypocalcemia (90.0%), thrombocytopenia (84.0%), and hyperbilirubinemia (76.0%). Hand-foot skin reaction was most frequently observed among AE of NCI CTCAE grade 3 or higher (40.0%), followed by elevation of serum ALT (38.0%). Dose reduction of sorafenib was needed most commonly due to hand-food skin reaction (n=29). Median TTP was 5.1 months (range, 3.8–6.3). Conclusions: Adverse events were approved as acceptable by independent monitoring system. Preliminary evidence of antitumor activity was also observed. This trial can be safely performed with close monitoring in inoperable and/or unresectable HCC patients. No significant financial relationships to disclose.
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Affiliation(s)
- J. Park
- Center for Liver Cancer, National Cancer Center, Goyang, South Korea; Center for Clinical Trial, National Cancer Center, Goyang, South Korea
| | - H. Kim
- Center for Liver Cancer, National Cancer Center, Goyang, South Korea; Center for Clinical Trial, National Cancer Center, Goyang, South Korea
| | - J. Shim
- Center for Liver Cancer, National Cancer Center, Goyang, South Korea; Center for Clinical Trial, National Cancer Center, Goyang, South Korea
| | - S. Woo
- Center for Liver Cancer, National Cancer Center, Goyang, South Korea; Center for Clinical Trial, National Cancer Center, Goyang, South Korea
| | - J. Choi
- Center for Liver Cancer, National Cancer Center, Goyang, South Korea; Center for Clinical Trial, National Cancer Center, Goyang, South Korea
| | - B. Nam
- Center for Liver Cancer, National Cancer Center, Goyang, South Korea; Center for Clinical Trial, National Cancer Center, Goyang, South Korea
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Lee KS, Ro J, Park IH, Kim EA, Nam B. Phase II study of irinotecan plus capecitabine in patients with anthracycline and taxane pretreated metastatic breast cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.1093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
1093 Background: Irinotecan (I) and capecitabine (X) have demonstrated single agent activity against breast cancer by different antitumor mechanism without cross-resistance. To assess the objective response rate (RR) of IX combination in metastatic breast cancer (MBC) patients (pts) was the primary end point. Methods: Anthracycline- and taxane-pretreated pts with measurable disease, age ≥ 18 years, adequate organ functions, and ECOG performance score (PS) 0–2 were eligible. Sample size of 36 was calculated with Simon's two stage minimax design. Pts received I 80 mg/m2 intravenously on days 1 and 8 and X 1,000 mg/m2 orally twice daily on days 1–14 of every 21-day cycle. Results: Between September 2006 and April 2008, 36 pts with median age of 50 years (range, 28–71) were enrolled. Median follow-up was 17 months (range, 8.3+ - 27.7+). Among 35 evaluable pts excluding 1-consent withdrawal, 86% received at least one prior chemotherapy for MBC; 20% had stage IV disease with 66% lung/37% liver metastases; 80% had PS 0–1; 77% had hormone receptor (HR) positive tumors, 20% triple negative disease and 3% HER-2 positive tumors. Overall RR was 60% (95% CI, 43.5–74.5) with median response duration of 6.3 months (range, 1.0+-17.1+); 2 CR (6%), 19 PR (54%), 8 SD (23%), and 6 PD (17%) with similar RR between HR+ (63%) versus triple negative disease (57%). Median survival was not reached with 76% estimated survival at 1-year, and median progression free survival (PFS) was 7.3 months (range, 0.7–21.1+). Pts received a median of 8 cycles of treatment (range, 1–26+). G1, G2, and G3 hand-foot syndrome were observed in 34%, 17%, and 0%, respectively. NCI grade ≥ 3 adverse events were: neutropenia (60%); asthenia, diarrhea, and vomiting (9%, each); transaminase elevation and febrile neutropenia (6%, each); abdominal pain, anorexia, fatigue, myalgia, and nausea (3%, each). Conclusions: I and X combination by this schedule and doses is highly efficacious in anthracyline- and taxane-pretreated MBC pts with manageable toxicities. Further investigation of this combination in phase III trials is warranted. No significant financial relationships to disclose.
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Affiliation(s)
- K. S. Lee
- National Cancer Center, Gyeonggi-do, Republic of Korea
| | - J. Ro
- National Cancer Center, Gyeonggi-do, Republic of Korea
| | - I. H. Park
- National Cancer Center, Gyeonggi-do, Republic of Korea
| | - E. A. Kim
- National Cancer Center, Gyeonggi-do, Republic of Korea
| | - B. Nam
- National Cancer Center, Gyeonggi-do, Republic of Korea
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Im S, Lee K, Lee E, Kwon Y, Noh D, Park I, Ahn J, Ahn J, Kim J, Nam B, Ro J. Remarkable complete pathologic response rate after preoperative paclitaxel, gemcitabine, and trastuzumab chemotherapy in HER2 positive stage II/III breast cancer: a phase II multicenter study. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-5105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Abstract #5105
Background: Preoperative paclitaxel (P) and gemcitabine (G) combination therapy given on D1/D8 every 3 weeks (wks) for 4 cycles was well tolerated and effective in stage II/III breast cancer (BC) in our previous phase II study, with an 18% pathological complete response (pCR) rate. Adding trastuzumab (H) to the preoperative chemotherapy increases both of the clinical and pathological response rates in HER2 positive BC patients (pts). Thus far, the highest pCR rate reported in the literature was obtained with anthracycline-based regimens in combination with trastuzumab. This study evaluated whether non-anthracycline combination chemotherapy with PGH could improve the pCR rate in HER2 positive BC. Methods: HER2 positive, stage II/III BC pts with cytologically confirmed axillary lymph node (LN), ≥ 18 years of age, with adequate organ function, and good performance status were eligible. No prior therapy was allowed. Pts received H intravenously (iv) at 4 mg/kg on D1 of the first cycle with subsequent weekly doses of 2 mg/kg in combination with P 80 mg/m2 and G 1,200 mg/m2, iv, on D1/D8 every 3 wks for 6 cycles. Within 2 wks postoperatively, patients received H 6 mg/kg every 3 wks for 11 cycles with tamoxifen or an aromatase inhibitor for 5 years if indicated. All pts received postoperative radiation therapy. Initial evaluation included sonogram and MRI of the breast, MUGA scan, or echocardiogram, and PET-CT. Results: All 53 planned pts were enrolled between April 2007 and February 2008. The median age was 43 years (range, 26–61 years), the median primary tumor size by sonogram was 5.3 cm (range, 2.0 to > 12 cm) with 89 % ≥ stage IIIA, 42% T3/T4, and 28% N3. Twenty four tumors (45%) were multiple and 20 tumors (38%) were ER positive. By May 2008, 47 patients completed surgery with a 74% breast conservation rate. Twenty-eight of 47 (60%; 95% CI, 45-72) patients achieved pCR in both the tumor and lymph node, with 68% (32/47; 95% CI, 54-80) pCR in the primary tumor, and 77% (36/47; 95% CI, 63-86) pCR in the axillary LN. Median metastatic focus in 21 positive LNs (n=11 pts) was 1 mm (range, <1–13mm). Grade III/IV adverse events (AE) were neutropenia (53%), febrile neutropenia (4%), and transient elevation of AST/ALT (9%). After 6 cycles of PGH chemotherapy, all patients maintained above normal LVEF. Conclusions: A remarkably high pCR was obtained by non-anthracyline based PGH combination therapy for HER2 positive stage II/III breast cancer. This combination is well tolerated with mild degree of AEs.
 Supported by NCC Grant No 0610240-3. Trastuzumab, paclitaxel, and gemcitabine were supplied by Roche, CJ Cheiljedang CO., and Eli Lilly and CO., respectively.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5105.
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Affiliation(s)
- S Im
- 1 Seoul National University Hospital, Seoul, Republic of Korea
- 2 National Cancer Center, Goyang-si, Republic of Korea
- 3 Asan Medical Center, Seoul, Republic of Korea
- 4 Samsung Medical Center, Seoul, Republic of Korea
- 5 Seoul National University Bundang Hospital, Sungnam-si, Republic of Korea
| | - K Lee
- 1 Seoul National University Hospital, Seoul, Republic of Korea
- 2 National Cancer Center, Goyang-si, Republic of Korea
- 3 Asan Medical Center, Seoul, Republic of Korea
- 4 Samsung Medical Center, Seoul, Republic of Korea
- 5 Seoul National University Bundang Hospital, Sungnam-si, Republic of Korea
| | - E Lee
- 1 Seoul National University Hospital, Seoul, Republic of Korea
- 2 National Cancer Center, Goyang-si, Republic of Korea
- 3 Asan Medical Center, Seoul, Republic of Korea
- 4 Samsung Medical Center, Seoul, Republic of Korea
- 5 Seoul National University Bundang Hospital, Sungnam-si, Republic of Korea
| | - Y Kwon
- 1 Seoul National University Hospital, Seoul, Republic of Korea
- 2 National Cancer Center, Goyang-si, Republic of Korea
- 3 Asan Medical Center, Seoul, Republic of Korea
- 4 Samsung Medical Center, Seoul, Republic of Korea
- 5 Seoul National University Bundang Hospital, Sungnam-si, Republic of Korea
| | - D Noh
- 1 Seoul National University Hospital, Seoul, Republic of Korea
- 2 National Cancer Center, Goyang-si, Republic of Korea
- 3 Asan Medical Center, Seoul, Republic of Korea
- 4 Samsung Medical Center, Seoul, Republic of Korea
- 5 Seoul National University Bundang Hospital, Sungnam-si, Republic of Korea
| | - I Park
- 1 Seoul National University Hospital, Seoul, Republic of Korea
- 2 National Cancer Center, Goyang-si, Republic of Korea
- 3 Asan Medical Center, Seoul, Republic of Korea
- 4 Samsung Medical Center, Seoul, Republic of Korea
- 5 Seoul National University Bundang Hospital, Sungnam-si, Republic of Korea
| | - J Ahn
- 1 Seoul National University Hospital, Seoul, Republic of Korea
- 2 National Cancer Center, Goyang-si, Republic of Korea
- 3 Asan Medical Center, Seoul, Republic of Korea
- 4 Samsung Medical Center, Seoul, Republic of Korea
- 5 Seoul National University Bundang Hospital, Sungnam-si, Republic of Korea
| | - J Ahn
- 1 Seoul National University Hospital, Seoul, Republic of Korea
- 2 National Cancer Center, Goyang-si, Republic of Korea
- 3 Asan Medical Center, Seoul, Republic of Korea
- 4 Samsung Medical Center, Seoul, Republic of Korea
- 5 Seoul National University Bundang Hospital, Sungnam-si, Republic of Korea
| | - J Kim
- 1 Seoul National University Hospital, Seoul, Republic of Korea
- 2 National Cancer Center, Goyang-si, Republic of Korea
- 3 Asan Medical Center, Seoul, Republic of Korea
- 4 Samsung Medical Center, Seoul, Republic of Korea
- 5 Seoul National University Bundang Hospital, Sungnam-si, Republic of Korea
| | - B Nam
- 1 Seoul National University Hospital, Seoul, Republic of Korea
- 2 National Cancer Center, Goyang-si, Republic of Korea
- 3 Asan Medical Center, Seoul, Republic of Korea
- 4 Samsung Medical Center, Seoul, Republic of Korea
- 5 Seoul National University Bundang Hospital, Sungnam-si, Republic of Korea
| | - J Ro
- 1 Seoul National University Hospital, Seoul, Republic of Korea
- 2 National Cancer Center, Goyang-si, Republic of Korea
- 3 Asan Medical Center, Seoul, Republic of Korea
- 4 Samsung Medical Center, Seoul, Republic of Korea
- 5 Seoul National University Bundang Hospital, Sungnam-si, Republic of Korea
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Ro J, Park I, Lee K, Kang H, Kim S, Kwon Y, Lee E, Nam B. Comparable efficacies between premenopausal and postmenopausal metastatic breast cancer patients by letrozole with and without goserelin as first line hormone therapy: a phase II parallel group study. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-6134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Abstract #6134
Background: The use of goserelin in premenopausal patients(pts) is to produce castrated level of estradiol (E2), and the remaining peripheral E2 production is inhibited by letrozole, which would accomplish comparable clinical outcomes as in postmenopausal metastatic breast cancer (MBC) pts by letrozole alone.
 Methods: Hormone receptor positive pre- and postmenopausal pts with MBC were eligible. Letrozole 2.5 mg once a day was administered with goserelin 3.6 mg every 4 weeks in premenopausal pts and serial serum E2, FSH, LH were measured. Bone mineral density (BMD) and serum bone turnover markers were also checked (n=34).
 Results: Among total 78 pts enrolled, 32 pre- and 38 postmenopausal pts were assessed for efficacy and adverse events (AE). The median age was 42 years (range, 32–52) for pre- and 53 years (range, 33–70) for postmenopausal pts. Baseline characteristics were similar in the two groups, except for significantly longer disease free interval in postmenopausal pts (22.2 months vs. 41.2 months, P=0.01). Clinical benefit (CR+ PR+ SD ≥ 24 weeks) rates (62.5% vs. 68.4%, P=0.62), and objective response (CR + PR) rates (28.1 % vs. 23.7%, P=0.79) were comparable between the two groups. Median TTP was 8.6 months vs. 9.6 months (P=0.61) with a median follow-up of 11.6 months and 14.6 months, respectively. In multivariate analysis, strong ER status was significantly associated with clinical benefit rate (P=0.01), and HER2 positivity (P<0.001) and stage IV presentation (P=0.05) with shorter TTP. In premenopausal pts, the mean E2 level was dropped from 62.3 ± 81.8 pg/mL at baseline to 12.3 ± 2.2 pg/mL at week 2. AEs were mild with significantly more hot flushes in premenopausal pts. In premenopausal pts without bisphosphonate treatment, there was a trend of rising serum levels of osteocalcin (OC) (0% vs. 165%, P=0.065), bone alkaline phosphatase (bALP) (0% vs. 28%, P=0.055), and C-telopeptide (CTx) (0% vs. 108%, P=0.095), as well as a significant reduction in both lumbar spine (P=0.044) and femur (P=0.027) BMD. In contrast, in premenopausal pts with bone metastasis on bisphosphonate, there was no significant change in OC, bALP, CTx, and both BMD. In postmenopausal pts without bisphosphonate treatment, no significant change in OC, bALP, CTx, and femur BMD, while in pts with bone metastasis on bisphosphonate treatment, a significant decrease in OC (0% vs. -22%, P=0.050) and CTx (0% vs. -41%, P=0.020) and increase in both BMD (P=0.044, P=0.038 respectively) were observed.
 Conclusions: Clinical efficacies by letrozole and goserelin therapy in premenopausal MBC pts were comparable to those in postmenopausal pts by letrozole with mild AEs. While a modest increase in both bone formation and resorption especially in premenopausal pts, concurrent bisphosphonate therapy could stabilize bone metabolism in patients even with bone metastasis.
 Supported by NCC Grant No NCS-0610240-3. Letrozole for premenopausal group was supplied by Novartis.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 6134.
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Affiliation(s)
- J Ro
- 1 Research Institute and Hospital, National Cancer Center, Goyang-si, Korea
| | - I Park
- 1 Research Institute and Hospital, National Cancer Center, Goyang-si, Korea
| | - K Lee
- 1 Research Institute and Hospital, National Cancer Center, Goyang-si, Korea
| | - H Kang
- 1 Research Institute and Hospital, National Cancer Center, Goyang-si, Korea
| | - S Kim
- 1 Research Institute and Hospital, National Cancer Center, Goyang-si, Korea
| | - Y Kwon
- 1 Research Institute and Hospital, National Cancer Center, Goyang-si, Korea
| | - E Lee
- 1 Research Institute and Hospital, National Cancer Center, Goyang-si, Korea
| | - B Nam
- 1 Research Institute and Hospital, National Cancer Center, Goyang-si, Korea
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Nam B, Lee K, Kim T, Ro J. Survival differences in patients with brain metastases according to breast cancer subtypes. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.11507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
11507 Background: Brain metastases (BM) occur in as many as one-third of patients with metastatic breast cancer (MBC). Incidences and prognoses by triple receptor subtypes in BM have not been well delineated. Methods: Retrospectively, prognoses were assessed according to clinical characteristics, triple receptor subtypes, and receipt of trastuzumab therapy by univariate and multivariate analyses. ER/PR/HER2 were tested by IHC with HER2 FISH for IHC 2+ and for all 118 consecutive primary BC. Results: Between 8/2001 and 4/2006, 138 of 805 pts (17.1%) with MBC presented with BM at NCC Korea. More pts with triple negative and HER2+ tumors developed BM (see table ). The median age was 47 years. They were single (9%), multiple (80%), or leptomeningeal disease with or without multiple BM (11%). As initial therapy, 104 pts received WBRT, 8, intrathecal therapy (IT), 9, WBRT with IT, and 17 others. Of 56 HER2+ pts, 45 received trastuzumab either before (n=25) or after (n=13), or continuously before and after BM diagnosed (n=7). By 10/2006, 117 pts died with a median survival of 4.5 months. Multivariate analyses indicated age, tumor receptor subtypes, leptomeningeal presentation and number of extracranial disease sites as significant factors. Receipt of trastuzumab therapy after BM was a significant variable for survival in HER2+ diseases (3.8 vs. 13.4 mo, p=0.0000). Pts with triple negative subtype lived shortest compared with other types (p=0.0035). Conclusions: More pts with triple negative and HER2+ disease developed BM. HER2+ disease gained a significant survival benefit by trastuzumab therapy. Supported by NCC Grant 0610240 and 0510520. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- B. Nam
- Research Institute and Hospital, NCC, Goyang-si, Republic of Korea
| | - K. Lee
- Research Institute and Hospital, NCC, Goyang-si, Republic of Korea
| | - T. Kim
- Research Institute and Hospital, NCC, Goyang-si, Republic of Korea
| | - J. Ro
- Research Institute and Hospital, NCC, Goyang-si, Republic of Korea
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Kim J, Jeong J, Nam B, Kim S, Cho C, Kim B, Lee J, Kim Y, Bae D, Kang S. A phase II trial of radiation therapy with concurrent paclitaxel chemotherapy in high-risk endometrial cancer patients after staging operation: An interim analysis of a prospective multicenter trial (KGOG2001). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.16069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
16069 Background: This is an interim report of a prospective multicenter phase II trial to evaluate 2-year disease free survival rate, toxicity, overall survival rate and recurrence rate in high-risk endometrial cancer patients who received concurrent chemoradiotherapy after staging operation. Methods: Thirty four patients with endometrial cancer from 17 medical centers in Korea have enrolled the study. The cell types were all endometrioid type and they had no prior chemotherapy. They were in either stage III or IV and all received staging operation including total hysterectomy, bilateral salpingo-oophorectomy, pelvic and paraaortic lymph node dissection and washing cytology. Concurrent chemoradiotherapy was performed with paclitaxel (60 mg/m2/weekly, 6 cycles) and external field irradiation (5 fractions/week, total 4,500–5,040 cGy). Primary end point was 2-year disease free survival rate. Overall survival rate and recurrence rate were secondary end points. Toxicity of the treatment was also evaluated. Results: The expected number of subjects to complete the trial is 56. The trial was activated on 5th June 2005 and median follow up period is 5.8 (0–11) months until December 2006. 19 patients (55.8%) have completed treatment regimen and 14 patients (41.1%) are still receiving treatment. 1 patient (2.9%) died during treatment of the disease and 1 patient (2.9%) was lost during the follow up period. Disease free survival is 94.1% (32/34) and no recurrence has occurred so far. Toxicities have occurred in 52.9% (18/34) with gastrointestinal symptoms (13/34, 38.2%) such as diarrhea and constipation being the most common ones. Conclusions: This interim report suggest a possibility that a concurrent chemoradiotherapy for high-risk endometrial cancer may be an optimal treatment option to improve disease free survival rate. [Table: see text]
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Affiliation(s)
- J. Kim
- Severance Hospital, Seoul, Republic of Korea; National cancer center, Seoul, Republic of Korea; Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea; Keimyung University Dongsan Medical Center, Daegu, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea; Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea; Seoul National University Hospital,
| | - J. Jeong
- Severance Hospital, Seoul, Republic of Korea; National cancer center, Seoul, Republic of Korea; Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea; Keimyung University Dongsan Medical Center, Daegu, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea; Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea; Seoul National University Hospital,
| | - B. Nam
- Severance Hospital, Seoul, Republic of Korea; National cancer center, Seoul, Republic of Korea; Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea; Keimyung University Dongsan Medical Center, Daegu, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea; Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea; Seoul National University Hospital,
| | - S. Kim
- Severance Hospital, Seoul, Republic of Korea; National cancer center, Seoul, Republic of Korea; Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea; Keimyung University Dongsan Medical Center, Daegu, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea; Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea; Seoul National University Hospital,
| | - C. Cho
- Severance Hospital, Seoul, Republic of Korea; National cancer center, Seoul, Republic of Korea; Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea; Keimyung University Dongsan Medical Center, Daegu, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea; Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea; Seoul National University Hospital,
| | - B. Kim
- Severance Hospital, Seoul, Republic of Korea; National cancer center, Seoul, Republic of Korea; Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea; Keimyung University Dongsan Medical Center, Daegu, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea; Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea; Seoul National University Hospital,
| | - J. Lee
- Severance Hospital, Seoul, Republic of Korea; National cancer center, Seoul, Republic of Korea; Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea; Keimyung University Dongsan Medical Center, Daegu, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea; Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea; Seoul National University Hospital,
| | - Y. Kim
- Severance Hospital, Seoul, Republic of Korea; National cancer center, Seoul, Republic of Korea; Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea; Keimyung University Dongsan Medical Center, Daegu, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea; Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea; Seoul National University Hospital,
| | - D. Bae
- Severance Hospital, Seoul, Republic of Korea; National cancer center, Seoul, Republic of Korea; Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea; Keimyung University Dongsan Medical Center, Daegu, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea; Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea; Seoul National University Hospital,
| | - S. Kang
- Severance Hospital, Seoul, Republic of Korea; National cancer center, Seoul, Republic of Korea; Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea; Keimyung University Dongsan Medical Center, Daegu, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea; Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea; Seoul National University Hospital,
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Yao Y, Grogan J, Zehnder M, Lendenmann U, Nam B, Wu Z, Costello CE, Oppenheim FG. Compositional analysis of human acquired enamel pellicle by mass spectrometry. Arch Oral Biol 2001; 46:293-303. [PMID: 11269863 DOI: 10.1016/s0003-9969(00)00134-5] [Citation(s) in RCA: 87] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Relatively little is known about the formation of the acquired enamel pellicle other than that it involves the selective adsorption of specific proteins from oral fluids. Previous studies on the identification of pellicle components have relied largely on immunological or enzymatic detection and have been hampered by the fact that only minute quantities of pellicle can be removed from tooth surfaces. The present work describes an improved method of harvesting pellicle that combines mechanical and chemical removal; this approach was used to investigate systematically the desorption of in vitro pellicle components with different solutions. Eleven major in vitro pellicle proteins were identified by using a combination of electrophoretic separation and matrix-assisted laser desorption/ionization-reflectron time-of-flight mass spectrometry. A similar analysis of in vivo-formed pellicle revealed the presence of intact statherin, lysozyme, albumin and amylase. Further analysis of in vivo pellicle by liquid chromatography-electrospray ionization mass spectrometry suggested the presence of numerous low molecular-weight fragments of precursor proteins. The protein composition of in vitro whole-salivary pellicle adsorbed to hydroxyapatite and that of in vivo enamel pellicle differed for proline, the result of a reduction in the content of acidic proline-rich proteins in the in vivo samples. Unique features of the oral environment such as enzymatic activities or mineral surface properties may account for these differences between in vivo and in vitro pellicle formation.
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Affiliation(s)
- Y Yao
- Department of Periodontology and Oral Biology, Boston University Goldman School of Dental Medicine, 700 Albany Street, Suite W201, Boston, MA 02118, USA
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Abstract
Age-related hearing loss (presbycusis) is a multifactorial process that results chiefly from the accumulating effects of noise damage and aging on the cochlea. Noise damage is typically evidenced clinically by a discrete elevation (notch) of the auditory thresholds in the 3-6 kHz region of the audiogram whereas aging affects the highest frequencies first. To determine whether the presence of such high-frequency notches influences auditory aging, we examined the 15 year change in audiometric thresholds in 203 men from the Framingham Heart Study cohort. The mean age at the first hearing test was 64 years (range 58-80). Occupational and recreational noise exposure over the 15 years was assumed to be minimal due to the age of the subjects. The presence or absence of a notch was determined using a piecewise linear/parabolic curve fitting strategy. A discrete elevation of the pure-tone thresholds of 15-34 dB in the 3-6 kHz region was deemed a small notch (N1), and elevations of 35 dB or greater were deemed large notches (N2). Absence of a notch (N0) was encoded those ears with <15 dB elevation in the 3-6 kHz region. The presence and absence of notches correlated with the subjects' history of noise exposure. The 15 year pattern of change in age-adjusted pure-tone thresholds varied significantly by notch category. There was less change over time in the notch frequencies (3-6 kHz) and significantly greater change in the adjacent frequency of 2 kHz in the N2 group as compared to the N0 and N1 groups. The adjacent frequency of 8 kHz showed a significant, but smaller, change in the N1 group as compared to the N0 and N2 groups. The change at 2 kHz was independent of the starting hearing level at E15, whereas the changes at 4-8 kHz were influenced by the hearing level at E15. These data suggest that the noise-damaged ear does not 'age' at the same rate as the non-noise damaged ear. The finding of increased loss at 2 kHz suggests that the effects of noise damage may continue long after the noise exposure has stopped. The mechanism for this finding is unknown but presumably results from prior noise-induced damage to the cochlea.
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Affiliation(s)
- G A Gates
- Department of Otolaryngology, Head and Neck Surgery, University of Washington School of Medicine, Seattle, WA, USA.
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Lee CH, Lee CE, Jin J, Nam B. 1H NMR study of spin dynamics in the I2-doped PBMPV conducting polymers. Phys Rev B Condens Matter 1996; 53:1896-1899. [PMID: 9983649 DOI: 10.1103/physrevb.53.1896] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Michel A, Nam B, Vittal V. Computer generated Lyapunov functions for interconnected systems: Improved results with applications to power systems. ACTA ACUST UNITED AC 1984. [DOI: 10.1109/tcs.1984.1085483] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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