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Choi E, Souza VC, Dillon JA, Kebreab E, Mueller ND. Comparative analysis of thermal indices for modeling cold and heat stress in US dairy systems. J Dairy Sci 2024:S0022-0302(24)00733-1. [PMID: 38608948 DOI: 10.3168/jds.2023-24412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 03/04/2024] [Indexed: 04/14/2024]
Abstract
Quantifying the impact of thermal stress on milk yields is essential to effectively manage present and future risks in dairy systems. Despite the existence of numerous heat indices designed to communicate stress thresholds, little information is available regarding the accuracy of different indices in estimating milk yield losses from both cold and heat stress at large spatio-temporal scales. To address this gap, we comparatively analyzed the performance of existing thermal indices in capturing US milk yield response to both cold and heat stress at the national scale. We selected four commonly used thermal indices: the Temperature and Humidity Index (THI), Black Globe Humidity Index (BGHI), Adjusted Temperature and Humidity Index (THIadj), and Comprehensive Climate Index (CCI). Using a statistical panel regression model with observational and reanalysis weather data from 1981-2020, we systematically compared the patterns of yield sensitivities and statistical performance of the four indices. We found that the US state-level milk yield variability was better explained by the THIadj and CCI, which combine the effects of temperature, humidity, wind, and solar radiation. Our analysis also reveals a continuous and nonlinear responses of milk yields to a range of cold to heat stress across all four indices. This implies that solely relying on fixed thresholds of these indices to model milk yield changes may be insufficient to capture cumulative thermal stress. Cold extremes reduced milk yields comparably to those impacted by heat extremes on the national scale. Additionally, we found large spatial variability in milk yield sensitivities, implying further limitations to the use of fixed thresholds across locations. Moreover, we found decreased yield sensitivity to thermal stress in the most recent two decades, suggesting adaptive changes in management to reduce weather-related risks.
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Affiliation(s)
- E Choi
- Department of Ecosystem Science and Sustainability & Department of Soil and Crop Sciences, Colorado State University, Fort Collins, CO 80523.
| | - V C Souza
- Department of Animal Science, University of California, Davis, CA 95616
| | - J A Dillon
- Department of Soil and Crop Sciences, Colorado State University, Fort Collins, CO 80523
| | - E Kebreab
- Department of Animal Science, University of California, Davis, CA 95616
| | - N D Mueller
- Department of Ecosystem Science and Sustainability & Department of Soil and Crop Sciences, Colorado State University, Fort Collins, CO 80523; Department of Soil and Crop Sciences, Colorado State University, Fort Collins, CO 80523.
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Shah LM, Patel H, Faisaluddin M, Kwapong YA, Patel BA, Choi E, Satti DI, Oyeka CP, Hegde S, Dani SS, Sharma G. Rural/urban disparities in the trends and outcomes of peripartum cardiomyopathy in delivery hospitalizations. Curr Probl Cardiol 2024; 49:102433. [PMID: 38301915 DOI: 10.1016/j.cpcardiol.2024.102433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 01/29/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND Rural-urban disparities in peripartum cardiomyopathy (PPCM) are not well known. We examined rural-urban differences in maternal, fetal, and cardiovascular outcomes in PPCM during delivery hospitalizations. METHODS We used 2003-2020 data from the National Inpatient Sample for delivery hospitalizations in individuals with PPCM. The 9th and 10th editions of the International Classification of Diseases were used to identify PPCM and cardiovascular, maternal, and fetal outcomes. Rural and urban hospitalizations for PPCM were 1:1 propensity score-matched using relevant clinical and sociodemographic variables. Odds of in-hospital mortality were assessed using logistic regression. RESULTS Among 72,880 delivery hospitalizations with PPCM, 4,571 occurred in rural locations, while 68,309 occurred in urban locations. After propensity matching, there were a total of 4,571 rural-urban pairs. There was significantly higher in-hospital mortality in urban compared to rural hospitalizations (adjusted OR 1.54, 95% CI 1.10-1.89). Urban PPCM hospitalizations had significantly higher cardiogenic shock (2.9% vs. 1.3%), mechanical circulatory support (1.0% vs. 0.6%), cardiac arrest (2.3% vs. 0.9%), and VT/VF (4.5% vs. 2.1%, all p <.05). Additionally, urban PPCM hospitalizations had worse maternal and fetal outcomes as compared to rural hospitalizations, including higher preterm delivery, gestational diabetes, and fetal death (all p<.05). Notably, significantly more rural individuals were transferred to a short-term hospital (including tertiary care centers) compared to urban individuals (13.5% vs. 3.2%, p<.0001). CONCLUSIONS There are significant rural-urban disparities in delivery hospitalizations with PPCM. Worse outcomes were associated with urban hospitalizations, while rural PPCM hospitalizations were associated with increased transfers, suggesting inadequate resources and advanced sickness.
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Affiliation(s)
- Lochan M Shah
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Johns Hopkins University School of Medicine, MD, United States
| | - Harsh Patel
- Department of Cardiology, Southern Illinois University, Springfield, IL, United States
| | | | - Yaa A Kwapong
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Johns Hopkins University School of Medicine, MD, United States
| | - Bhavin A Patel
- Department of Internal Medicine, Trinity Health Oakland/Wayne State University, Pontiac, MI, United States
| | - Eunjung Choi
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Johns Hopkins University School of Medicine, MD, United States
| | - Danish Iltaf Satti
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Johns Hopkins University School of Medicine, MD, United States
| | - Chigolum P Oyeka
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Johns Hopkins University School of Medicine, MD, United States
| | - Shruti Hegde
- Department of Cardiology, Southern Illinois University, Springfield, IL, United States
| | - Sourbha S Dani
- Lahey Hospital & Medical Center, Boston, MA, United States
| | - Garima Sharma
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Johns Hopkins University School of Medicine, MD, United States; Inova Schar Heart and Vascular Institute, Inova Fairfax Medical Campus, Falls Church, VA, United States.
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Kim SJ, Jo Y, Park SJ, Ji E, Lee JY, Choi E, Baek JY, Jang IY, Jung HW, Kim K, Ryu D, Yoo HJ, Kim BJ. Metabolomic profiles of ovariectomized mice and their associations with body composition and frailty-related parameters in postmenopausal women. J Endocrinol Invest 2024:10.1007/s40618-024-02338-x. [PMID: 38493245 DOI: 10.1007/s40618-024-02338-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/12/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Menopause, a dramatical estrogen-deficient condition, is considered the most significant milestone in women's health. PURPOSE To investigate the metabolite changes attributed to estrogen deficiency using random forest (RF)-based machine learning (ML) modeling strategy in ovariectomized (OVX) mice as well as determine the clinical relevance of selected metabolites in older women. METHODS AND RESULTS Untargeted and targeted metabolomic analyses revealed that metabolites related to TCA cycle, sphingolipids, phospholipids, fatty acids, and amino acids, were significantly changed in the plasma and/or muscle of OVX mice. Subsequent ML classifiers based on RF algorithm selected alpha-ketoglutarate (AKG), arginine, carnosine, ceramide C24, phosphatidylcholine (PC) aa C36:6, and PC ae C42:3 in plasma as well as PC aa 34:1, PC aa C34:3, PC aa C36:5, PC aa C32:1, PC aa C36:2, and sphingosine in muscle as top featured metabolites that differentiate the OVX mice from the sham-operated group. When circulating levels of AKG, arginine, and carnosine, which showed the most significant changes in OVX mice blood, were measured in postmenopausal women, higher plasma AKG levels were associated with lower bone mass, weak grip strength, poor physical performance, and increased frailty risk. CONCLUSIONS Metabolomics- and ML-based methods identified the key metabolites of blood and muscle that were significantly changed after ovariectomy in mice, and the clinical implication of several metabolites was investigated by looking at their correlation with body composition and frailty-related parameters in postmenopausal women. These findings provide crucial context for understanding the diverse physiological alterations caused by estrogen deficiency in women.
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Affiliation(s)
- S J Kim
- Department of Convergence Medicine, Asan Institute for Life Sciences, Asan Medical Center,, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, South Korea
| | - Y Jo
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, 61005, South Korea
| | - S J Park
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea
| | - E Ji
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea
| | - J Y Lee
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea
| | - E Choi
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea
| | - J-Y Baek
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea
| | - I Y Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea
| | - H-W Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea
| | - K Kim
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea
- Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea
| | - D Ryu
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, 61005, South Korea.
| | - H J Yoo
- Department of Convergence Medicine, Asan Institute for Life Sciences, Asan Medical Center,, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, South Korea.
| | - B-J Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, South Korea.
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Choi E, Uribe K, Ipek EG, Vaught A, Gammie JS, Wang H, Minhas AS. Preconception Counseling for a Patient With a Mechanical Tricuspid Valve. JACC Case Rep 2024; 29:102159. [PMID: 38361564 PMCID: PMC10865114 DOI: 10.1016/j.jaccas.2023.102159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 10/23/2023] [Accepted: 11/09/2023] [Indexed: 02/17/2024]
Abstract
A 37-year-old woman with mechanical tricuspid valve thrombosis presented for preconception consultation. Multimodality imaging confirmed a malfunctioning bileaflet mechanical tricuspid valve with both leaflets fixed and open. This case highlights the key discussions held by the multidisciplinary pregnancy heart team.
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Affiliation(s)
- Eunjung Choi
- Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Katelyn Uribe
- Division of Maternal Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Esra Gucuk Ipek
- Heart and Vascular Center, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Arthur Vaught
- Division of Maternal Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - James S. Gammie
- Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Hanghang Wang
- Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Anum S. Minhas
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Rajendran A, Minhas AS, Kazzi B, Varma B, Choi E, Thakkar A, Michos ED. Sex-specific differences in cardiovascular risk factors and implications for cardiovascular disease prevention in women. Atherosclerosis 2023; 384:117269. [PMID: 37752027 PMCID: PMC10841060 DOI: 10.1016/j.atherosclerosis.2023.117269] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 05/13/2023] [Accepted: 08/31/2023] [Indexed: 09/28/2023]
Abstract
Cardiovascular disease (CVD) is the leading cause of mortality for women globally. Sex differences exist in the relative risks conferred by traditional CVD risk factors, including diabetes, hypertension, obesity, and smoking. Additionally, there are female-specific risk factors, including age of menarche and menopause, polycystic ovary syndrome, infertility and the use of assisted reproductive technology, spontaneous pregnancy loss, parity, and adverse pregnancy outcomes, as well as female-predominant conditions such as autoimmune diseases, migraines, and depression, that enhance women's cardiovascular risk across the lifespan. Along with measurement of traditional risk factors, these female-specific factors should also be ascertained as a part of cardiovascular risk assessment to allow for a more comprehensive overview of the risk for developing cardiometabolic disorders and CVD. When present, these factors can identify women at elevated cardiovascular risk, who may benefit from more intensive preventive interventions, including lifestyle changes and/or pharmacotherapy such as statins. This review describes sex differences in traditional risk factors and female-specific/female-predominant risk factors for CVD and examines the role of coronary artery calcium scores and certain biomarkers that can help further risk stratify patients and guide preventive recommendations.
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Affiliation(s)
- Aardra Rajendran
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Anum S Minhas
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Brigitte Kazzi
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Bhavya Varma
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Eunjung Choi
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Aarti Thakkar
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Erin D Michos
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Kim M, Byun SJ, Park SG, Kim B, Oh YK, Cho KH, Kim JH, Choi E. Assessment of Bladder Filling Type on Radiation Dose to Organs at Risk in MR-Guided Intracavity Brachytherapy for Cervical Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e657. [PMID: 37785948 DOI: 10.1016/j.ijrobp.2023.06.2088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) In this study, we evaluated whether the classification of bladder shape affects the absorbed dose (Gy) of OARs and its geometrical position to normal organs in MR-guided intracavitary brachytherapy (ICBT). MATERIALS/METHODS In this study, 269 patients who underwent MR-guided ICBT for cervical cancer from 2016 to 2022 were included. The applicator-inserted bladder filling type (BFT) classification was divided into three types (tilted, curved, and other shapes: group E). The anatomical positional relationship between the uterus and its surroundings was measured on pre-MR images and ICBT simulation MR images. Spearman's rank correlation analysis was used for bladder volume and OAR dose according to BFT. Anatomical differences were analyzed by ANOVA by measuring the distance from the center to both bladder walls. RESULTS In the correlation analysis considering the shape of the bladder, the tilted, curved, and group E had Spearman's ρ of 0.211; -0.323, 0.412; -0.307 and -0.035; -0.209 for maximum absorbed dose (D2cc) of bladder and small bowel, respectively. It was statistically significant in the tilted type and curved type. The average left and right bladder lengths differences of the tilted type were the highest at 8.47 cm and 7.11 cm, respectively. It was a statistically significant between bladder shape and the difference in left and right bladder lengths differences (p< 0.01). CONCLUSION In this study, it was confirmed that bladder distension increased the maximum bladder dose (D2cc) and decreased the maximum bowel dose (D2cc) to the tilted type and curved type. In addition, if the left and right bladder lengths are measured in pre-MR, the degree of bladder distension can be evaluated in advance by checking the shape of the bladder in the case of the tilting type before ICBT. Based on these findings, a prospective study is needed to evaluate the effect of ICBT on cervical cancer treatment outcomes through bladder type classification.
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Affiliation(s)
- M Kim
- Department of Radiation Oncology, Keimyung University Dongsan Hospital, Daegu, Korea, Republic of (South) Korea
| | - S J Byun
- Department of Radiation Oncology, Keimyung University Dongsan Hospital, Daegu, Korea, Republic of (South) Korea; Department of Radiation Oncology, Keimyung University School of medicine, Daegu, Korea, Republic of (South) Korea
| | - S G Park
- Department of Radiation Oncology, Keimyung University Dongsan Hospital, Daegu, Korea, Republic of (South) Korea; Department of Radiation Oncology, Keimyung University School of medicine, Daegu, Korea, Republic of (South) Korea
| | - B Kim
- Department of Radiation Oncology, Keimyung University Dongsan Hospital, Daegu, Korea, Republic of (South) Korea
| | - Y K Oh
- Department of Radiation Oncology, Keimyung University Dongsan Hospital, Daegu, Korea, Republic of (South) Korea; Department of Radiation Oncology, Keimyung University School of medicine, Daegu, Korea, Republic of (South) Korea
| | - K H Cho
- Department of Radiation Oncology, Keimyung University Dongsan Hospital, Daegu, Korea, Republic of (South) Korea
| | - J H Kim
- Department of Radiation Oncology, Keimyung University Dongsan Hospital, Daegu, Korea, Republic of (South) Korea; Department of Radiation Oncology, Keimyung University School of medicine, Daegu, Korea, Republic of (South) Korea
| | - E Choi
- Department of Radiation Oncology, Keimyung University Dongsan Hospital, Daegu, Korea, Republic of (South) Korea; Department of Radiation Oncology, Keimyung University School of medicine, Daegu, Korea, Republic of (South) Korea
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Gifford KA, Kieffer KA, Choi E. How Do Postgraduate Trainees Prepare for New Clinical Learning Environments. J Grad Med Educ 2023; 15:252-256. [PMID: 37139202 PMCID: PMC10150812 DOI: 10.4300/jgme-d-22-00300.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 08/27/2022] [Accepted: 01/11/2023] [Indexed: 05/05/2023] Open
Abstract
Background Transitioning to a new clinical learning environment (CLE) requires learning new skills, roles, teams, workflows, and culture. We previously identified activities and questions to guide orientation in the categories of who, what, where, when, why, and how. There is limited literature about how learners plan for this transition. Objective Describe how postgraduate trainees prepare for a clinical rotation, based on qualitative analysis of narrative responses within a simulated orientation experience. Methods In June 2018, incoming residents and fellows in multiple specialties at Dartmouth Hitchcock Medical Center completed an online simulated orientation that asked how they intended to prepare for their first rotation. We used directed content analysis to code their anonymously collected responses using the orientation activities and question categories from our prior study. We used open coding to describe additional themes. Results Narrative responses were available for 97% (116 of 120) of learners. While 46% (53 of 116) of learners listed preparations related to what happens in the CLE, responses fitting into other question categories were less frequent: who (9%, 11 of 116), where (7%, 8 of 116), when (4%, 5 of 116), why (<1%, 1 of 116), and how (0%, 0 of 116). Learners also infrequently described activities to aid the transition: reading orientation materials (11%, 13 of 116), speaking with a colleague (11%, 13 of 116), and arriving early (3%, 3 of 116). They more frequently commented on content reading (40%, 46 of 116), asking for advice (28%, 33 of 116), and self-care (12%, 14 of 116). Conclusions When describing preparation for a new CLE, residents focused on tasks in the what category more than understanding the system and learning goals in other categories.
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Affiliation(s)
- Kimberly A. Gifford
- Kimberly A. Gifford, MD, is Clinical Associate Professor of Pediatrics, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University
| | - Kelly A. Kieffer
- Kelly A. Kieffer, MD, MS, is Associate Professor of Medicine, Vice Chair for Education, Department of Medicine, Geisel School of Medicine at Dartmouth
| | - Eunjung Choi
- Eunjung Choi, MD, is Instructor, Division of Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine
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Shah LM, Patel H, Kwapong Y, Patel BA, Choi E, Satti DI, Oyeka C, Hegde S, Dani SS, Sharma G. RURAL/URBAN DISPARITIES IN PERIPARTUM CARDIOMYOPATHY. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)02586-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Choi E, Su C, Wu J, Aredo J, Neal J, Leung A, Backhus L, Marchand L, Liang S, Cheng I, Wakelee H, Han S. OA01.01 Second Primary Lung Cancer among Lung Cancer Survivors Who Never Smoked. J Thorac Oncol 2023. [DOI: 10.1016/j.jtho.2022.09.119] [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: 01/30/2023]
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Gifford KA, Choi E, Kieffer KA. Resources for clinical learning environment orientation. Med Educ Online 2022; 27:2013404. [PMID: 34905448 PMCID: PMC8676697 DOI: 10.1080/10872981.2021.2013404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 11/03/2021] [Accepted: 11/29/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Each clinical learning environment (CLE) requires learners to navigate a different set of complex interactions to engage in safe patient care while learning from real patients. Orientation forms the foundation for learning, yet CLE models in the literature are primarily written for an educator audience and practical advice for orienting learners to a new CLE is limited. To address this gap, we designed resources to support both supervisors and learners in the orientation process. MATERIALS/METHODS We reviewed the CLE literature to select critical content for orientation and interviewed high performing residents to identify their best practices. We synthesized the literature and resident interviews into a visually appealing and easy to digest infographic designed to simultaneously remind teachers of the critical areas to cover in orientation and empower learners to ask about them. We integrated these principles into an online module for Graduate Medical Education onboarding and surveyed users about how well they could meet the module learning objectives. RESULTS We organized the literature review and resident advice regarding questions learners should ask about a new CLE into the typical question categories (why, who, what, when, where, and how) and described strategies for orientation to each category. Our infographic has been incorporated into CLE orientation for multiple types of learners at our institution. After completing the orientation module, 112/124(90%) residents indicated that they could, 'Orient yourself or a learner to a clinical learning environment using orientation questions' moderately to extremely well. DISCUSSION We developed resources that can be used by educators to create orientation materials and by learners to ensure they understand important features, resources, and expectations in a new CLE. Because the foundational principles of CLE apply to a variety of clinical settings and learner types, the resources may be broadly applicable.
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Affiliation(s)
| | - Eunjung Choi
- Cardiology Fellow, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Kelly A Kieffer
- Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
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Bae N, Lee S, Choi E, Ahn H, Ahn H, Kwon S, Han K, Oh S, Lip G. Impact of mental disease on the risk of atrial fibrillation in patients with diabetes mellitus: a nationwide population-based study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Diabetes mellitus (DM) is known to increase the risk of mental disorders, which increases the health care burden in these patients. Also, DM is one of the risk factors leading to atrial fibrillation (AF), and the presence of concomitant AF and DM adds to the increased risks of stroke and death. It is uncertain whether mental disease is an independent risk factor of incident AF in patients with DM.
Purpose
To investigate whether diabetic patients with mental disease have an increased risk of AF.
Methods
Using the Korea National Health Insurance Service database, we enrolled 2,512,690 patients diagnosed with DM without AF between 2009 and 2021. Newly diagnosed AF was identified during the follow-up period. We compared the risk of AF between patients with mental disease and those without.
Results
Among the total population, 828,929 (32.99%; mean age 61.58±11.28; 56.71% female) patients were diagnosed with mental diseases (Figure 1). Anxiety (564,786 patients, 68.13%) was the most common mental disease, while depression was the second most common (313,773 patients, 37.85%). Diabetic patients with mental diseases had a higher percentage of women, hypertension, dyslipidemia, chronic kidney failure, congestive heart failure, obstructive sleep apnea, and thyroid disease. During a median 7.0 years (IQR 5.93–8.07) follow-up, 34,523 were diagnosed new-onset AF (4.66 per 1,000 person-year). In multivariate analysis, diabetic patients with mental disorders showed a higher risk of new-onset AF (HR 1.19; 95% CI 1.17–1.21; p-value <0.0001) (Figure 2). Among mental diseases, depression, insomnia, and anxiety were associated with increased risks of new-onset AF (HR 1.15; 95% CI 1.12–1.17; HR 1.15; 95% CI 1.13–1.18; and HR 1.19; 95% CI, 1.67–1.21; all p-value <0.0001, respectively), whereas bipolar disorder and schizophrenia showed non-statistically significant trends (due to small numbers). Subgroup analyses showed that younger age had significant interactions with depression, insomnia, and anxiety.
Conclusion
Mental diseases, especially depression, insomnia, and anxiety, showed an increased risk of AF in patients with DM. Awareness and prompt diagnosis and management of AF would be necessary for these high-risk populations at risk of incident AF.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- N Bae
- Seoul National University Hospital, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - S Lee
- Seoul National University Hospital, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - E Choi
- Seoul National University Hospital, Seoul National University College of Medicine, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - H Ahn
- Seoul National University Hospital, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - H Ahn
- Seoul National University Hospital, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - S Kwon
- Seoul National University Hospital, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - K Han
- Soongsil University, Department of Statistics and Actuarial Science , Seoul , Korea (Republic of)
| | - S Oh
- Seoul National University Hospital, Seoul National University College of Medicine, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - G Lip
- Liverpool Heart and Chest Hospital, Liverpool Centre for Cardiovascular Science, University of Liverpool , Liverpool , United Kingdom
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Shin SY, Jung M, Byeon K, Kang K, Park Y, Hwang Y, Lee S, Jin E, Roh S, Kim J, Ahn J, Lee S, Choi E, Ahn M, Lip G. External validation of the biomarker based ABCD score in atrial fibrillation patients with a non gender CHA2DS2 VASc score 0 to 1, A Korean multicenter retrospective cohort. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Patients with low to intermediate risk atrial fibrillation (AF), defined as non-gender CHA2DS2-VASc score of 0–1, are still at risk of stroke. This study verified the usefulness of ABCD score (Age [≥60 years], B-type natriuretic peptide [BNP] or N-terminal pro-BNP [≥300 pg/ml], Creatinine clearance [<50 ml/min/1.73 m2], and Dimension of the left atrium [≥45 mm]) for stroke risk stratification in non-gender CHA2DS2-VASc score 0–1.
Methods
This multi-center cohort study retrospectively analyzed AF patients with non-gender CHA2DS2-VASc score 0–1. The primary endpoint was the incidence of stroke with or without anti-thrombotic treatment (ATT). An ABCD score was also validated.
Results
Overall, 2694 patients (56.3±9.5 years; female, 726 [26.9%]) were followed-up for 4.0±2.8 years. The overall stroke rate was 0.84/100 person-years (P-Y), stratified as follows: 0.46/100P-Y for an ABCD score 0; 1.02/100P-Y for an ABCD score≥1. The ABCD score was superior to the non-gender CHA2DS2-VASc score in stroke risk stratification (C-index=0.618, P=0.015; net reclassification improvement=0.576, P=0.040; integrated differential improvement=0.033, P=0.066). ATT was prescribed in 2353 patients (86.5%), and the stroke rate was significantly lower in patients receiving non-vitamin K antagonist oral anticoagulant (NOAC) therapy and an ABCD score≥1 than in those without ATT (0.44/100P-Y versus 1.55/100 P-Y; hazard ratio=0.26, 95% confidence interval 0.11–0.63, P=0.003).
Conclusion
The biomarker-based ABCD score demonstrated improved stroke risk stratification in AF patients with non-gender CHA2DS2-VASc score 0–1. Furthermore, NOAC with an ABCD score≥1 was associated with significantly lower stroke rate in AF patients with a non-gender CHA2DS2-VASc score 0–1.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Korean Disease Control and Prevention Agency
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Affiliation(s)
- S Y Shin
- Chung-Ang University Hospital , Seoul , Korea (Republic of)
| | - M Jung
- Chung-Ang University Hospital , Seoul , Korea (Republic of)
| | - K Byeon
- Chung-Ang University Hospital , Seoul , Korea (Republic of)
| | - K Kang
- Chung-Ang University Hospital , Seoul , Korea (Republic of)
| | - Y Park
- Gachon University Gil Medical Center , Incheon , Korea (Republic of)
| | - Y Hwang
- St. Vincent's Hospital , Suwon , Korea (Democratic People's Republic of)
| | - S Lee
- Kangbuk Samsung Hospital , Seoul , Korea (Republic of)
| | - E Jin
- Kyunghee University , Seoul , Korea (Republic of)
| | - S Roh
- Korea University Guro Hospital , Seoul , Korea (Democratic People's Republic of)
| | - J Kim
- Korea University Ansan Hospital, Cardiology , Ansan-Si , Korea (Republic of)
| | - J Ahn
- Pusan National University Hospital , Pusan , Korea (Republic of)
| | - S Lee
- Seoul National University Hospital , Seoul , Korea (Republic of)
| | - E Choi
- Seoul National University Hospital , Seoul , Korea (Republic of)
| | - M Ahn
- Wonju Severance Christian Hospital , Wonju , Korea (Republic of)
| | - G Lip
- University of Liverpool , Liverpool , United Kingdom
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Choi E, Kazzi B, Varma B, Ortengren AR, Minhas AS, Vaught AJ, Bennett WL, Lewey J, Michos ED. The Fourth Trimester: a Time for Enhancing Transitions in Cardiovascular Care. Curr Cardiovasc Risk Rep 2022; 16:219-229. [PMID: 36159207 PMCID: PMC9490714 DOI: 10.1007/s12170-022-00706-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2022] [Indexed: 01/26/2023]
Abstract
Purpose of Review The "fourth trimester" concept, defined as the first 12 weeks after delivery (and beyond), is a critical window of time for clinicians to intervene to optimize women's cardiovascular health after pregnancy. A timely and comprehensive postpartum cardiovascular assessment should be performed in all women following delivery in order to (1) follow up medical conditions present prior to conception, (2) evaluate symptoms and signs of common postpartum complications, and (3) identify risk factors and prevent future adverse cardiovascular outcomes. In this review, we aim to discuss major maternal cardiovascular risk factors such as hypertensive disorders of pregnancy, gestational diabetes mellitus, postpartum weight retention, and postpartum depression, as well as lactation as a potential protective risk modifying factor. Additionally, we will review effectiveness of outpatient interventions to enhance transitions in cardiovascular care during the fourth trimester. Recent Findings A seamless hand-off from obstetric to primary care, and potentially cardiology, is needed for early detection and management of hypertension, weight, glycemic control, stress and mood, and long-term cardiovascular risk. Additionally, the use of telemedicine, blood pressure self-monitoring, remote activity monitoring, and behavioral health coaches are potentially feasible modalities to augment clinic-based care for cardiovascular risk factors and weight management, but additional studies are needed to study their long-term effectiveness. Summary Development of a comprehensive postpartum care plan with careful consideration of each patient's risk profile and access to resources is critical to improve maternal morbidity and mortality, reduce health disparities, and achieve long-term cardiovascular health for women. Supporting postpartum well-being of women during this transition period requires a multidisciplinary approach, especially primary care engagement, and planning should start before delivery.
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Affiliation(s)
- Eunjung Choi
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA
| | - Brigitte Kazzi
- Department of Medicine, Johns Hopkins University School of Medicine, MD 21287 Baltimore, USA
| | - Bhavya Varma
- Department of Medicine, Johns Hopkins University School of Medicine, MD 21287 Baltimore, USA
| | | | - Anum S. Minhas
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA
| | - Arthur Jason Vaught
- Division of Maternal Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA
| | - Wendy L. Bennett
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21287 USA
| | - Jennifer Lewey
- Division of Cardiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA
| | - Erin D. Michos
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD 21287 USA
- Division of Cardiology, Johns Hopkins Hospital, 600 N. Wolfe Street, Blalock 524-B, Baltimore, MD 21287 USA
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Park J, Cho S, Lee K, Choi E, Jung W, Kim S, Park G, Song S, Kang C, Ma M, Yoo D, Paeng K, Ock CY. 94P Performance validation of an artificial intelligence-powered programmed death-ligand 1 (PD-L1) combined positive score analyzer in urothelial cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.126] [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: 11/26/2022] Open
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15
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Dubinskaya A, Heard J, Choi E, Cohen T, Anger J, Eilber K, Scott V. Female Sexual Dysfunction Resources: Women and Healthcare Providers Need More Options. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.05.107] [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: 11/15/2022]
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16
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Choi E, Xu P, El-Khatib F, Kavoussi P, Yafi F. Subcutaneous testosterone enanthate-autoinjector: Assessment of its post-market safety and efficacy profiles. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.590] [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: 10/18/2022]
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Huynh L, Huang E, Choi E, Yafi F. Is immediate preoperative blood glucose or hemoglobin A1c a risk factor for infection following penile prosthesis placement? A systematic review of literature. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.443] [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: 11/26/2022]
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18
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Choi E, Barnard J, Horns J, Paudel N, Das R, Yafi F, Hotaling J. Acne, folliculitis and post-operative infection rates of penile prosthetic implants. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.441] [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: 11/25/2022]
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Osman M, El-Khatib F, Dianatnejad S, Nguyen J, Choi E, Towe M, Yafi F. Differences in the gut microbiome composition between men with Peyronie's Disease and a matched cohort: A pilot study. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.573] [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: 10/18/2022]
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Jiang D, Barnard J, Choi E, Furr J, Lentz A, van Renterghem K, Selph P, Yafi F. Immediate salvage with inflatable penile prosthesis in an infected field: A contemporary multi-institutional cohort. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.435] [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: 11/24/2022]
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21
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Osman M, El-Khatib F, Dianatnejad S, Nguyen J, Choi E, Towe M, Yafi F. Differences in the gut microbiome composition between men with erectile dysfunction and a matched cohort: A pilot study. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.572] [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: 11/17/2022]
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22
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Choi E, Xu P, Loeb C, El-Khatib F, Yafi F, Kavoussi P. Intramuscular testosterone cypionate vs subcutaneous testosterone enanthate: Comparing the outcomes in hypogonadal men. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.594] [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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Choi E, Mathews LM, Paik J, Corretti MC, Wu KC, Michos ED, Hays AG, Mukherjee M. Multimodality Evaluation of Aortic Insufficiency and Aortitis in Rheumatologic Diseases. Front Cardiovasc Med 2022; 9:874242. [PMID: 35497991 PMCID: PMC9039512 DOI: 10.3389/fcvm.2022.874242] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 03/21/2022] [Indexed: 12/17/2022] Open
Abstract
Aortic insufficiency is commonly observed in rheumatologic diseases such as ankylosing spondylitis, systemic lupus erythematosus, antiphospholipid syndrome, Behçet's disease, granulomatosis with polyangiitis, and Takayasu arteritis. Aortic insufficiency with an underlying rheumatologic disease may be caused by a primary valve pathology (leaflet destruction, prolapse or restriction), annular dilatation due to associated aortitis or a combination of both. Early recognition of characteristic valve and aorta morphology on cardiac imaging has both diagnostic and prognostic importance. Currently, echocardiography remains the primary diagnostic tool for aortic insufficiency. Complementary use of computed tomography, cardiac magnetic resonance imaging and positron emission tomography in these systemic conditions may augment the assessment of underlying mechanism, disease severity and identification of relevant non-valvular/extracardiac pathology. We aim to review common rheumatologic diseases associated with aortic insufficiency and describe their imaging findings that have been reported in the literature.
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Affiliation(s)
- Eunjung Choi
- Dartmouth-Hitchcock Medical Center, Heart and Vascular Center, Lebanon, NH, United States
| | - Lena M. Mathews
- Division of Cardiology, Johns Hopkins University, Baltimore, MD, United States
| | - Julie Paik
- Division of Rheumatology, Johns Hopkins University, Baltimore, MD, United States
| | - Mary C. Corretti
- Division of Cardiology, Johns Hopkins University, Baltimore, MD, United States
| | - Katherine C. Wu
- Division of Cardiology, Johns Hopkins University, Baltimore, MD, United States
| | - Erin D. Michos
- Division of Cardiology, Johns Hopkins University, Baltimore, MD, United States
| | - Allison G. Hays
- Division of Cardiology, Johns Hopkins University, Baltimore, MD, United States
| | - Monica Mukherjee
- Division of Cardiology, Johns Hopkins University, Baltimore, MD, United States
- *Correspondence: Monica Mukherjee
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Jiang D, Barnard J, Choi E, Furr J, Lentz A, van Renterghem K, Selph P, Yafi FA. Immediate Salvage with Inflatable Penile Prosthesis in an Infected Field: A Contemporary Multi-institutional Cohort. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.01.388] [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: 11/28/2022]
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25
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Osman MM, El-Khatib FM, Dianatnejad S, Nguyen J, Choi E, Towe M, Yafi FA. Differences in the Gut Microbiome Composition Between Men with Erectile Dysfunction and A Matched Cohort: A Pilot Study. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.01.063] [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: 10/18/2022]
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26
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Choi E, Barnard J, Horns J, Paudel N, Das R, Yafi F, Hotaling J. Acne, Folliculitis and Post-Operative Infection Rates of Penile Prosthetic Implants. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.01.374] [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: 11/26/2022]
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27
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Choi E, Byun E, Kwon SU, Kim N, Suh CH, Kwon H, Han Y, Kwon TW, Cho YP. Carotid Plaque Composition Assessed by CT Predicts Subsequent Cardiovascular Events among Subjects with Carotid Stenosis. AJNR Am J Neuroradiol 2021; 42:2199-2206. [PMID: 34711554 DOI: 10.3174/ajnr.a7338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 07/28/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Currently, the characteristics of carotid plaques are considered important factors for identifying subjects at high risk of stroke. This study aimed to test the hypothesis that carotid plaque composition assessed by CTA is associated with an increased risk of future major adverse cardiovascular events among asymptomatic subjects with moderate-to-severe carotid artery stenosis. MATERIALS AND METHODS This single-center, retrospective cohort study included 194 carotid plaques from 176 asymptomatic subjects with moderate-to-severe carotid artery stenosis. The association of CTA-determined plaque composition with the risk of subsequent adverse cardiovascular events was analyzed. RESULTS During a median follow-up of 41 months, the adverse cardiovascular event incidence among 194 carotid plaques was 19.6%. There were significant differences in plaque Hounsfield units (P < .001) and spotty calcium presence (P < .001) between carotid plaques from subjects with and without subsequent adverse cardiovascular events. Multivariable analysis revealed carotid plaque Hounsfield unit density (P < .001) and spotty calcium (P < .001) as independent predictors of subsequent adverse cardiovascular events. In association with moderate carotid artery stenosis, the plaque Hounsfield unit values were significantly lower among carotid plaques from subjects who experienced subsequent adverse cardiovascular events (P = .002), strokes (P = .01), and cardiovascular deaths (P = .04); the presence of spotty calcium was significantly associated with the occurrence of adverse cardiovascular events (P = .001), acute coronary syndrome (P = .01), and cardiovascular death (P = .04). CONCLUSIONS Carotid plaque Hounsfield unit density and spotty calcium were independent predictors of a greater risk of adverse cardiovascular event occurrence.
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Affiliation(s)
- E Choi
- From the Departments of Surgery (E.C., E.B., H.K., Y.H., T.-W.K., Y.-P.C.)
| | - E Byun
- From the Departments of Surgery (E.C., E.B., H.K., Y.H., T.-W.K., Y.-P.C.)
| | | | - N Kim
- Clinical Epidemiology and Biostatistics (N.K.)
| | - C H Suh
- Radiology and Research Institute of Radiology (C.H.S.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - H Kwon
- From the Departments of Surgery (E.C., E.B., H.K., Y.H., T.-W.K., Y.-P.C.)
| | - Y Han
- From the Departments of Surgery (E.C., E.B., H.K., Y.H., T.-W.K., Y.-P.C.)
| | - T-W Kwon
- From the Departments of Surgery (E.C., E.B., H.K., Y.H., T.-W.K., Y.-P.C.)
| | - Y-P Cho
- From the Departments of Surgery (E.C., E.B., H.K., Y.H., T.-W.K., Y.-P.C.)
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Yoo Y, Park S, Choi E, Sung SH. The role of intraoperative frozen section analysis in joint arthroplasty with CD66b immunohistochemical staining. Malays J Pathol 2021; 43:405-411. [PMID: 34958062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The preoperative diagnosis of infection during joint arthroplasty is important for clinical management. However, the evaluation of polymorphonuclear leukocytes (PMNs) during frozen section analysis is sometimes difficult due to frozen artifacts. In the present study, we sought to investigate the utility of intraoperative fresh frozen section (FFS) examination for diagnosis of infection and to evaluate whether the neutrophil-specific surface marker CD66b helps to improve the diagnostic accuracy of infection. A consecutive series of 65 original frozen sections at the time of resection arthroplasty was retrospectively reviewed compared with corresponding permanent sections. The presence of PMNs was determined using intraoperative FFS and permanent sections. Furthermore, CD66b staining was performed to identify PMNs clearly. The ratio of male to female patients was 21:42. The mean age was 70 years. Postoperatively, 25 of 65 cases were histologically diagnosed with infection (25/65; 39%). The sensitivity and specificity of intraoperative FFS relative to permanent section histology were 100% (25/25) and 95% (38/40), respectively. Among 40 patients without infection, two showed false-positive results during intraoperative FFS diagnosis (2/40, 5%). In addition, on CD66b staining, six cases (9%) experienced changes in results, which altered the sensitivity and specificity of intraoperative FFS compared with permanent histology only to 87% and 87%, respectively. In conclusion, the diagnostic performance of intraoperative FFS is high and comparable to yields of permanent section histology. Therefore, intraoperative FFS is highly suitable diagnostic method for detection of infection during joint arthroplasty. And CD66b immunostaining facilitates delicate identification of PMNs, especially in equivocal cases.
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Affiliation(s)
- Y Yoo
- Ewha Womans University College of Medicine, Department of Pathology, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Republic of Korea
| | - S Park
- Ewha Womans University College of Medicine, Department of Pathology, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Republic of Korea
| | - E Choi
- Ewha Womans University College of Medicine, Department of Pathology, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Republic of Korea.
| | - S H Sung
- Ewha Womans University College of Medicine, Department of Pathology, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Republic of Korea
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Wu J, Ding V, Luo S, Choi E, Hellyer J, Myall N, Henry S, Wood D, Stehr H, Ji H, Nagpal S, Hayden Gephart M, Wakelee H, Neal J, Han S. P62.02 A Predictive Model to Guide Brain MRI Surveillance in Patients With Metastatic Lung Cancer: Impact on Real World Outcomes. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.647] [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: 11/28/2022]
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30
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Ellebrecht C, Choi E, Radaelli E, Payne A. 470 Engineering chimeric antigen receptor (CAR) T cells for treatment of γδ T cell lymphomas. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.494] [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: 10/21/2022]
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31
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Jang Y, Choi E, Rhee MK, Yoon H, Park NS, Chiriboga DA. Older Korean Americans' concern about Alzheimer's disease: the role of immigration-related factors and objective and subjective cognitive status. Aging Ment Health 2021; 25:807-813. [PMID: 32003243 PMCID: PMC7392805 DOI: 10.1080/13607863.2020.1720596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 12/20/2019] [Accepted: 01/18/2020] [Indexed: 10/25/2022]
Abstract
Objectives: The present study examined the associations between immigration-related factors and objective and subjective cognitive status with older Korean Americans' concern about developing Alzheimer's Disease (AD). It was hypothesized that (1) AD concern would be associated with immigration-related factors and (2) self-rated cognitive status would mediate the relationship between cognitive performance (Mini Mental State Examination (MMSE) scores) and concern about AD.Method: Using data from the Study of Older Korean Americans (n = 2061, mean age = 73.2; 66.8% female), the direct and indirect effect models were tested.Results: Korean American immigrants with a higher level of acculturation had better cognitive performance, more positive self-ratings of cognitive status, and a lower level of concern about AD. Both poor cognitive performance and negative self-ratings of cognitive status were associated with increased concern about AD. Supporting the mediation hypothesis, the indirect effect of cognitive performance on AD concern through self-rated cognitive status was significant (bias corrected 95% confidence interval for the indirect effect = -.012, -.003).Conclusion: The mediation model not only helps us better understand the psychological mechanisms that underlie the link between cognitive status and AD concern but also highlights the potential importance of subjective perceptions about cognitive status as an avenue for interventions.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - E. Choi
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - M. K. Rhee
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - H. Yoon
- School of Social Work, Texas State University, San Marcos, Texas, USA
| | - N. S. Park
- School of Social Work, University of South Florida, Tampa, FL, USA
| | - D. A. Chiriboga
- Department of Child and Family Studies, University of South Florida, Tampa, FL, USA
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Hsue W, Sharpe AN, Darling SL, Visser LC, Choi E, Stern JA. Aorto-left atrial fistula secondary to infective aortic endocarditis and endarteritis in a cat with valvular aortic stenosis. J Vet Cardiol 2021; 35:101-107. [PMID: 33906113 DOI: 10.1016/j.jvc.2021.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 03/11/2021] [Accepted: 03/16/2021] [Indexed: 11/16/2022]
Abstract
A cat previously diagnosed with valvular aortic stenosis developed acute respiratory distress. A new continuous heart murmur was noted on physical exam. Echocardiographic examination revealed vegetative lesions on the aortic valve and continuously shunting blood flow from the aorta into the left atrium. Despite initial treatment for left-sided congestive heart failure, the cat died suddenly. In addition to confirming aortic valve endocarditis and an acquired aorto-left atrial shunt, pathological examination identified vegetative lesions on the luminal surface of the ascending aorta. Although antemortem aerobic blood culture, 16s bacterial ribosomal DNA PCR, and Bartonella PCR failed to identify causative organisms, Escherichia coli was identified on postmortem tissue culture of the aortic lesion. This represented a unique case of primary valvular aortic stenosis with secondary infective aortic endocarditis, infective aortic endarteritis, and aorto-left atrial fistula in a cat. It highlighted potential adverse outcomes of aortic stenosis that are more commonly recognized in humans and dogs.
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Affiliation(s)
- W Hsue
- William R. Pritchard Veterinary Medical Teaching Hospital, University of California - Davis, One Garrod Drive, Davis, CA 95616, USA.
| | - A N Sharpe
- William R. Pritchard Veterinary Medical Teaching Hospital, University of California - Davis, One Garrod Drive, Davis, CA 95616, USA
| | - S L Darling
- William R. Pritchard Veterinary Medical Teaching Hospital, University of California - Davis, One Garrod Drive, Davis, CA 95616, USA
| | - L C Visser
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California - Davis, One Garrod Drive, Davis, CA 95616, USA
| | - E Choi
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California - Davis, One Garrod Drive, Davis, CA 95616, USA
| | - J A Stern
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California - Davis, One Garrod Drive, Davis, CA 95616, USA
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Choi E, Towe M, Huynh L, El-Khatib F, Yafi F, Ahlering T. 015 Predictive Ability of Free Testosterone on Sexual Function in Prostate cCncer. J Sex Med 2021. [DOI: 10.1016/j.jsxm.2021.01.085] [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: 10/21/2022]
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Huynh L, Huang E, Choi E, El-Khatib F, Yafi F. 153 Is Immediate Preoperative Blood Glucose or Hemoglobin a1c a Risk Factor for Infection Following Penile Prosthesis Placement? A Systematic Review of Literature. J Sex Med 2021. [DOI: 10.1016/j.jsxm.2021.01.008] [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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35
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Xu P, Choi E, El-Khatib F, Kavoussi P, Yafi F. 034 Post-market Safety and Efficacy Profile of Subcutaneous Testosterone Enanthate-autoinjector. J Sex Med 2021. [DOI: 10.1016/j.jsxm.2021.01.103] [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: 11/26/2022]
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36
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Choi E, Xu P, Loeb C, El-Khatib F, Yafi F, Kavoussi P. 027 Comparison of Outcomes for Hypogonadal Men Treated with Intramuscular Testosterone Cypionate Versus Subcutaneous Testosterone Enanthate. J Sex Med 2021. [DOI: 10.1016/j.jsxm.2021.01.097] [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: 10/21/2022]
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37
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El-Khatib F, Huynh L, Osman M, Choi E, Yafi F, Ahlering T. 158 Penile Length Shortening Following Robot-assisted Radical Prostatectomy: Impacts on Erections and Sexual Bother. J Sex Med 2021. [DOI: 10.1016/j.jsxm.2021.01.013] [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: 11/24/2022]
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38
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Masterson J, Zhao H, Choi E, Anger J. 124 Sex, Drugs, and Ischemic Priapism: Insights into the Culture Surrounding Recreational use of Intracavernosal Injectables in an Urban Population. J Sex Med 2021. [DOI: 10.1016/j.jsxm.2021.01.143] [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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Abstract
Raynaud's phenomenon, which is characterized by episodic digital pallor, cyanosis and rubor upon exposure to cold environment or to stress, is relatively common, although the prevalence depends on the climate. Still, it is under-diagnosed, under-treated, and often confused with other conditions. Primary Raynaud's phenomenon (i.e., Raynaud disease) must be distinguished from secondary Raynaud's phenomenon (i.e., Raynaud syndrome) as long-term morbidity and outcomes differ vastly between the two conditions. Additionally, the practitioner must differentiate between Raynaud's phenomenon and related vascular disorders, such as acrocyanosis, pernio, and livedo reticularis. In this article, we review differences between the conditions and suggest an approach to diagnosis and treatment strategy for these disorders.
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Affiliation(s)
- Eunjung Choi
- Heart and Vascular Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Stanislav Henkin
- Heart and Vascular Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
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40
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Choi E, Wiseman T, Gordon C, Betihavas V. Beyond the Biomedical Paradigm! The Biomedical, Socioeconomic and Demographic Predictors of Heart Failure Readmissions. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.019] [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: 11/25/2022]
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41
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Choi E, Luo S, Tammemägi M, Aredo J, Marchand L, Cheng I, Wakelee H, Han S. PR01.02 Smoking Cessation After Lung Cancer Diagnosis and Risk of Second Primary Lung Cancer: The Multiethnic Cohort Study. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2020.10.079] [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: 10/22/2022]
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42
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Choi E, El-Khatib F, Huynh L, Yafi F, Ahlering T. Climacturia and incontinence in post-radical prostatectomy. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34041-6] [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: 10/23/2022] Open
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43
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Kim B, Lee N, Lee C, Lee Y, Lee S, Hwang H, Kim E, Choi E. 213 Increased 11β-hydroxysteroid dehydrogenase type 1 contributes to the impaired barrier in aged skin. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.218] [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: 10/24/2022]
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44
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El-Khatib F, Huynh L, Choi E, Osman M, Yafi F, Ahlering T. Penile length shortening following robot-assisted radical prostatectomy: Impacts on erections, sexual bother, and recovery. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33796-4] [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: 11/28/2022] Open
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45
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Choi E, Towe M, Huynh L, El-Khatib F, Yafi F, Ahlering T. Free testosterone predicts preoperative sexual function in men over 60 years of age with prostate cancer. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32623-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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46
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Osman M, El-Khatib F, Su H, Huynh L, Choi E, Yafi F, Ahlering T. Climacturia after robot assisted radical prostatectomy: Does pre-operative erectile dysfunction affect who recovers? EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33797-6] [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] Open
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47
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Hwang K, Dokgo K, Choi E, Burch JL, Sibeck DG, Giles BL, Hasegawa H, Fu HS, Liu Y, Wang Z, Nakamura TKM, Ma X, Fear RC, Khotyaintsev Y, Graham DB, Shi QQ, Escoubet CP, Gershman DJ, Paterson WR, Pollock CJ, Ergun RE, Torbert RB, Dorelli JC, Avanov L, Russell CT, Strangeway RJ. Magnetic Reconnection Inside a Flux Rope Induced by Kelvin-Helmholtz Vortices. J Geophys Res Space Phys 2020; 125:e2019JA027665. [PMID: 32714734 PMCID: PMC7375157 DOI: 10.1029/2019ja027665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 01/29/2020] [Accepted: 03/03/2020] [Indexed: 06/11/2023]
Abstract
On 5 May 2017, MMS observed a crater-type flux rope on the dawnside tailward magnetopause with fluctuations. The boundary-normal analysis shows that the fluctuations can be attributed to nonlinear Kelvin-Helmholtz (KH) waves. Reconnection signatures such as flow reversals and Joule dissipation were identified at the leading and trailing edges of the flux rope. In particular, strong northward electron jets observed at the trailing edge indicated midlatitude reconnection associated with the 3-D structure of the KH vortex. The scale size of the flux rope, together with reconnection signatures, strongly supports the interpretation that the flux rope was generated locally by KH vortex-induced reconnection. The center of the flux rope also displayed signatures of guide-field reconnection (out-of-plane electron jets, parallel electron heating, and Joule dissipation). These signatures indicate that an interface between two interlinked flux tubes was undergoing interaction, causing a local magnetic depression, resulting in an M-shaped crater flux rope, as supported by reconstruction.
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Affiliation(s)
- K.‐J. Hwang
- Southwest Research InstituteSan AntonioTXUSA
| | - K. Dokgo
- Southwest Research InstituteSan AntonioTXUSA
| | - E. Choi
- Southwest Research InstituteSan AntonioTXUSA
| | - J. L. Burch
- Southwest Research InstituteSan AntonioTXUSA
| | | | - B. L. Giles
- NASA Goddard Space Flight CenterGreenbeltMDUSA
| | - H. Hasegawa
- Institute of Space and Astronautical ScienceJapan Aerospace Exploration AgencySagamiharaJapan
| | - H. S. Fu
- School of Science and EnvironmentBeihang UniversityBeijingChina
| | - Y. Liu
- School of Science and EnvironmentBeihang UniversityBeijingChina
| | - Z. Wang
- School of Science and EnvironmentBeihang UniversityBeijingChina
| | | | - X. Ma
- Physical Sciences DepartmentEmbry‐Riddle Aeronautical UniversityDaytona BeachFLUSA
| | - R. C. Fear
- School of Physics and AstronomyUniversity of SouthamptonSouthamptonUK
| | | | | | - Q. Q. Shi
- School of Earth and Space SciencesPeking UniversityPekingChina
| | - C. P. Escoubet
- European Space Research and Technology CentreNoordwijkthe Netherlands
| | | | | | | | - R. E. Ergun
- Laboratory for Atmospheric and Space PhysicsUniversity of Colorado at BoulderBoulderCOUSA
| | - R. B. Torbert
- Space Science CenterUniversity of New HampshireDurhamNHUSA
| | | | - L. Avanov
- NASA Goddard Space Flight CenterGreenbeltMDUSA
- The Goddard Planetary Heliophysics InstituteUniversity of Maryland, Baltimore CountyBaltimoreMDUSA
| | - C. T. Russell
- Institute of Geophysics and Planetary PhysicsUniversity of California, Los AngelesLos AngelesCAUSA
| | - R. J. Strangeway
- Institute of Geophysics and Planetary PhysicsUniversity of California, Los AngelesLos AngelesCAUSA
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Nelson WL, Chemey AT, Hertz M, Choi E, Graf DE, Latturner S, Albrecht-Schmitt TE, Wei K, Baumbach RE. Superconductivity in a uranium containing high entropy alloy. Sci Rep 2020; 10:4717. [PMID: 32170108 PMCID: PMC7070041 DOI: 10.1038/s41598-020-61666-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 02/21/2020] [Indexed: 12/01/2022] Open
Abstract
High entropy alloys (HEA) are an unusual class of materials where mixtures of elements are stochastically arrayed on a simple crystalline lattice. These systems exhibit remarkable functionality, often along several distinct axes: e.g., the examples [TaNb]1-x(TiZrHf)x are high strength and damage resistant refractory metals that also exhibit superconductivity with large upper critical fields. Here we report the discovery of an f-electron containing HEA, [TaNb]0.31(TiUHf)0.69, which is the first to include an actinide ion. Similar to the Zr-analogue, this material crystallizes in a body-centered cubic lattice with the lattice constant a = 3.41(1) Å and exhibits phonon mediated superconductivity with a transition temperatures Tc ≈ 3.2 K and upper critical fields Hc2 ≈ 6.4 T. These results expand this class of materials to include actinide elements, shows that superconductivity is robust in this sub-group, and opens the path towards leveraging HEAs as functional waste forms for a variety of radioisotopes.
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Affiliation(s)
- W L Nelson
- National High Magnetic Field Laboratory, Florida State University, Tallahassee, FL, 32310, USA
- Department of Physics, Florida State University, Tallahassee, FL, 32306, USA
| | - A T Chemey
- Department of Chemistry, Florida State University, Tallahassee, FL, 32306, USA
| | - M Hertz
- Department of Chemistry, Florida State University, Tallahassee, FL, 32306, USA
| | - E Choi
- National High Magnetic Field Laboratory, Florida State University, Tallahassee, FL, 32310, USA
| | - D E Graf
- National High Magnetic Field Laboratory, Florida State University, Tallahassee, FL, 32310, USA
| | - S Latturner
- Department of Chemistry, Florida State University, Tallahassee, FL, 32306, USA
| | | | - K Wei
- National High Magnetic Field Laboratory, Florida State University, Tallahassee, FL, 32310, USA
| | - R E Baumbach
- National High Magnetic Field Laboratory, Florida State University, Tallahassee, FL, 32310, USA.
- Department of Physics, Florida State University, Tallahassee, FL, 32306, USA.
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Lee K, Kim J, Kim Y, Sohn H, So B, Choi E. Histopathological and Aetiological Diagnosis in Brain Tissues from Cattle with Neurological Signs in Korea, 2008–2018. J Comp Pathol 2020. [DOI: 10.1016/j.jcpa.2019.10.052] [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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50
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Kim W, Lee W, Huh E, Choi E, Jang YP, Kim YK, Lee TH, Oh MS. Ephedra sinica Stapf and Gypsum Attenuates Heat-Induced Hypothalamic Inflammation in Mice. Toxins (Basel) 2019; 12:toxins12010016. [PMID: 31905825 PMCID: PMC7020418 DOI: 10.3390/toxins12010016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 12/14/2019] [Accepted: 12/27/2019] [Indexed: 12/26/2022] Open
Abstract
Ephedra sinica Stapf (EH) exert toxic effects, such as excitability, cardiac arrhythmia, and others. On the contrary, in traditional herbal medicine, EH and gypsum (GF) are used most often to treat symptoms caused by external stressors. The hypothalamus plays a crucial role in thermal homeostasis. Inflammatory response in the hypothalamus by thermal stressors may affect thermal and energy homeostasis. This study investigates the effect of EH and GF against heat-induced mouse model. Mice were divided into four groups: saline, saline plus heat, EH plus heat, and GF plus heat treated groups. Heat stress was fixed at 43 °C for 15 min once daily for 3 days. Weight and ear and rectal temperature measurements were made after terminating heat stress. Hypothalamus tissue was collected to evaluate the HSP70, nuclear factor kappa-Β (NF-kB), and interleukin (IL)-1β protein expression levels. EH and GF treatment suppressed the increased body temperature. EH significantly ameliorated heat-induced body weight loss, compared to gypsum. Regulatory effects of EH and GF for body temperature and weight against heat stress were mediated by IL-1β reduction. EH showed significant HSP70 and NF-kB inhibition against heat stress. EH and GF contribute to the inhibition of heat-induced proinflammatory factors and the promotion of hypothalamic homeostasis.
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Affiliation(s)
- Wonnam Kim
- Division of Pharmacology, College of Korean Medicine, Semyung University, 65 Semyung-ro, Jecheon 27136, Korea
| | - Wonil Lee
- Department of Life and Nanopharmaceutical Sciences, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea
| | - Eugene Huh
- Department of Life and Nanopharmaceutical Sciences, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea
- Department of Medical Science of Meridian, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea
| | - Eunjung Choi
- Department of Life and Nanopharmaceutical Sciences, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea
| | - Young Pyo Jang
- Department of Life and Nanopharmaceutical Sciences, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea
- Department of Oriental Pharmaceutical Science, College of Pharmacy Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea
| | - Yun-Kyung Kim
- Department of Herbal Medicine, College of Pharmacy, Wonkwang University, 460 Iksan-daero, Iksan 54538, Korea
| | - Tae-Hee Lee
- Department of Formulae Pharmacology, School of Oriental Medicine, Gachon University, 1342 Seongnamdae-ro, Sujeong-gu, Seongnam 13120, Korea
| | - Myung Sook Oh
- Department of Life and Nanopharmaceutical Sciences, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea
- Department of Oriental Pharmaceutical Science, College of Pharmacy Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea
- Kyung Hee East-West Pharmaceutical Research Institute, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea
- Correspondence: ; Tel.: +82-2-961-9436
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