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Jin T, Park KS, Nam SE, Lim SH, Kim JH, Noh WC, Yoo YB, Park WS, Yun IJ. CTLA4 expression profiles and their association with clinical outcomes of breast cancer: a systemic review. Ann Surg Treat Res 2024; 106:263-273. [PMID: 38725802 PMCID: PMC11076949 DOI: 10.4174/astr.2024.106.5.263] [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] [Received: 01/15/2024] [Revised: 02/16/2024] [Accepted: 03/03/2024] [Indexed: 05/12/2024] Open
Abstract
Purpose The cytotoxic T-lymphocyte-associated protein 4 (CTLA4) is involved in the progression of various cancers, but its biological roles in breast cancer (BRCA) remain unclear. Therefore, we performed a systematic multiomic analysis to expound on the prognostic value and underlying mechanism of CTLA4 in BRCA. Methods We assessed the effect of CTLA4 expression on BRCA using a variety of bioinformatics platforms, including Oncomine, GEPIA, UALCAN, PrognoScan database, Kaplan-Meier plotter, and R2: Kaplan-Meier scanner. Results CTLA4 was highly expressed in BRCA tumor tissue compared to normal tissue (P < 0.01). The CTLA4 messenger RNA levels in BRCA based on BRCA subtypes of Luminal, human epidermal growth factor receptor 2, and triple-negative BRCA were considerably higher than in normal tissues (P < 0.001). However, the overexpression of CTLA4 was associated with a better prognosis in BRCA (P < 0.001) and was correlated with clinicopathological characteristics including age, T stage, estrogen receptors, progesterone receptors, and prediction analysis of microarray 50 (P < 0.01). The infiltration of multiple immune cells was associated with increased CTLA4 expression in BRCA (P < 0.001). CTLA4 was highly enriched in antigen binding, immunoglobulin complexes, lymphocyte-mediated immunity, and cytokine-cytokine receptor interaction. Conclusion This study provides suggestive evidence of the prognostic role of CTLA4 in BRCA, which may be a therapeutic target for BRCA. Furthermore, CTLA4 may influence BRCA prognosis through antigen binding, immunoglobulin complexes, lymphocyte-mediated immunity, and cytokine-cytokine receptor interaction. These findings help us understand how CTLA4 plays a role in BRCA and set the stage for more research.
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Affiliation(s)
- TongYi Jin
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea
- Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
| | - Kyoung Sik Park
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea
- Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
- Department of Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Sang Eun Nam
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea
- Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
- Department of Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Seung Hwan Lim
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea
- Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
- Department of Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Jong Hyun Kim
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea
- Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
- Department of Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Woo Chul Noh
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea
- Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
- Department of Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Young Bum Yoo
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea
- Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
- Department of Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Won Seo Park
- Department of Surgery, Kyung Hee University School of Medicine, Seoul, Korea
| | - Ik Jin Yun
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea
- Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
- Department of Surgery, Konkuk University Medical Center, Seoul, Korea
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Suh HN, Lee JY, Kang HJ, Park EM, Yun IJ, Kim WS, Choi K, Hwang JH. A Comparison Between GalT-/-; hCD39;hCD55 and GalT-/-; hCD39;hCD46;hCD55;TBM Pig Kidneys Transplanted in Nonhuman Primates. Cell Transplant 2024; 33:9636897231217382. [PMID: 38229498 PMCID: PMC10798062 DOI: 10.1177/09636897231217382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 11/09/2023] [Accepted: 11/14/2023] [Indexed: 01/18/2024] Open
Abstract
Because there is a shortage of donor kidneys, researchers are exploring the possibility of using genetically modified pig kidneys for transplantation. Approaches involving knockout of carbohydrate genes or knockin of protective proteins have been attempted to determine the best gene modifications. In this study, we utilized GalT-/-;hCD39;hCD55 and GalT-/-;hCD39;hCD46;hCD55;thrombomodulin (TBM) pigs for transplantation in nonhuman primates (NHPs). The NHPs survived for 4 weeks after kidney transplantation (4 WAT) from the GalT-/-;hCD39;hCD55 pig and for 6 WAT from the GalT-/-;hCD39;hCD46;hCD55;TBM pig. However, messenger RNA (mRNA) sequencing and immunohistochemistry analysis revealed that the 6 WAT kidney exhibited more severe apoptosis, inflammation, loss of renal function, and renal fibrosis than the 4 WAT kidney. These results indicate that additional knockin of complement regulator (hCD46) and coagulation regulator (TBM) is not enough to prevent renal damage, suggesting that improved immune suppression is needed for more prolonged survival.
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Affiliation(s)
- Han Na Suh
- Animal Model Research Group, Korea Institute of Toxicology, Jeongeup, Republic of Korea
- Center for Companion Animal New Drug Development, Korea Institute of Toxicology, Jeongeup, Republic of Korea
| | - Ju Young Lee
- Animal Model Research Group, Korea Institute of Toxicology, Jeongeup, Republic of Korea
| | - Hee Jung Kang
- Department of Laboratory Medicine, Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Chuncheon-si, Republic of Korea
| | - Eun Mi Park
- Department of Laboratory Medicine, Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Chuncheon-si, Republic of Korea
| | - Ik Jin Yun
- Department of Surgery, School of Medicine, Konkuk University, Seoul, Korea
| | - Wan Seop Kim
- Department of Pathology, School of Medicine, Konkuk University, Seoul, Korea
| | - Kimyung Choi
- Department of Transgenic Animal Research, Optipharm Inc, Cheongju-si, Republic of Korea
| | - Jeong Ho Hwang
- Animal Model Research Group, Korea Institute of Toxicology, Jeongeup, Republic of Korea
- Center for Companion Animal New Drug Development, Korea Institute of Toxicology, Jeongeup, Republic of Korea
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3
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Lim B, Jang MJ, Oh SM, No JG, Lee J, Kim SE, Ock SA, Yun IJ, Kim J, Chee HK, Kim WS, Kang HJ, Cho K, Oh KB, Kim JM. Comparative transcriptome analysis between long- and short-term survival after pig-to-monkey cardiac xenotransplantation reveals differential heart failure development. Anim Cells Syst (Seoul) 2023; 27:234-248. [PMID: 37808548 PMCID: PMC10552608 DOI: 10.1080/19768354.2023.2265150] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/27/2023] [Indexed: 10/10/2023] Open
Abstract
Cardiac xenotransplantation is the potential treatment for end-stage heart failure, but the allogenic organ supply needs to catch up to clinical demand. Therefore, genetically-modified porcine heart xenotransplantation could be a potential alternative. So far, pig-to-monkey heart xenografts have been studied using multi-transgenic pigs, indicating various survival periods. However, functional mechanisms based on survival period-related gene expression are unclear. This study aimed to identify the differential mechanisms between pig-to-monkey post-xenotransplantation long- and short-term survivals. Heterotopic abdominal transplantation was performed using a donor CD46-expressing GTKO pig and a recipient cynomolgus monkey. RNA-seq was performed using samples from POD60 XH from monkey and NH from age-matched pigs, D35 and D95. Gene-annotated DEGs for POD60 XH were compared with those for POD9 XH (Park et al. 2021). DEGs were identified by comparing gene expression levels in POD60 XH versus either D35 or D95 NH. 1,804 and 1,655 DEGs were identified in POD60 XH versus D35 NH and POD60 XH versus D95 NH, respectively. Overlapped 1,148 DEGs were annotated and compared with 1,348 DEGs for POD9 XH. Transcriptomic features for heart failure and inhibition of T cell activation were observed in both long (POD60)- and short (POD9)-term survived monkeys. Only short-term survived monkey showed heart remodeling and regeneration features, while long-term survived monkey indicated multi-organ failure by neural and hormonal signaling as well as suppression of B cell activation. Our results reveal differential heart failure development and survival at the transcriptome level and suggest candidate genes for specific signals to control adverse cardiac xenotransplantation effects.
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Affiliation(s)
- Byeonghwi Lim
- Department of Animal Science and Technology, Chung-Ang University, Anseong, Republic of Korea
| | - Min-Jae Jang
- Department of Animal Science and Technology, Chung-Ang University, Anseong, Republic of Korea
| | - Seung-Mi Oh
- Department of Animal Science and Technology, Chung-Ang University, Anseong, Republic of Korea
| | - Jin Gu No
- Animal Biotechnology Division, National Institute of Animal Science, RDA, Wanju, Republic of Korea
| | - Jungjae Lee
- Department of Animal Science and Technology, Chung-Ang University, Anseong, Republic of Korea
| | - Sang Eun Kim
- Animal Biotechnology Division, National Institute of Animal Science, RDA, Wanju, Republic of Korea
| | - Sun A. Ock
- Animal Biotechnology Division, National Institute of Animal Science, RDA, Wanju, Republic of Korea
| | - Ik Jin Yun
- Departments of Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Junseok Kim
- Departments of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Hyun Keun Chee
- Departments of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Wan Seop Kim
- Departments of Pathology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Hee Jung Kang
- Department of Laboratory Medicine, Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Kahee Cho
- Primate Organ Transplantation Centre, Genia Inc., Seongnam, Republic of Korea
| | - Keon Bong Oh
- Animal Biotechnology Division, National Institute of Animal Science, RDA, Wanju, Republic of Korea
| | - Jun-Mo Kim
- Department of Animal Science and Technology, Chung-Ang University, Anseong, Republic of Korea
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Hwang SA, Park KS, Kim WS, Shin KC, Ahn YR, Kim JS, Chee HK, Yang HS, Oh KB, Choi KM, Hwang JH, Hur CG, Yun IJ. Current Status of Genetically Engineered Pig to Monkey Kidney Xenotransplantation in Korea. Transplant Proc 2023:S0041-1345(23)00225-7. [PMID: 37179178 DOI: 10.1016/j.transproceed.2023.03.060] [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] [Received: 03/14/2023] [Accepted: 03/28/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND In South Korea, pig-to-nonhuman primate trials of solid organs have only been performed recently, and the results are not sufficiently satisfactory to initiate clinical trials. Since November 2011, we have performed 30 kidney pig-to-nonhuman primate xenotransplantations at Konkuk University Hospital. METHODS Donor αGal-knockout-based transgenic pigs were obtained from 3 institutes. The knock-in genes were CD39, CD46, CD55, CD73, and thrombomodulin, and 2-4 transgenic modifications with GTKO were done. The recipient animal was the cynomolgus monkey. We used the immunosuppressants anti-CD154, rituximab, anti-thymocyte globulin, tacrolimus, mycophenolate mofetil, and steroids. RESULTS The mean survival duration of the recipients was 39 days. Except for a few cases for which survival durations were <2 days because of technical failure, 24 grafts survived for >7 days, with an average survival duration of 50 days. Long-term survival was observed 115 days after the removal of the contralateral kidney, which is currently the longest-recorded graft survival in Korea. We confirmed functioning grafts for the surviving transplanted kidneys after the second-look operation, and no signs of hyperacute rejection were observed. CONCLUSIONS Although our survival results are relatively poor, they are the best-recorded results in South Korea, and the ongoing results are improving. With the support of government funds and the volunteering activities of clinical experts, we aim to further improve our experiments and contribute to the commencement of clinical trials of kidney xenotransplantation in Korea.
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Affiliation(s)
- Sun Ae Hwang
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea
| | - Kyoung Sik Park
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea
| | - Wan Seop Kim
- Department of Pathology, Konkuk University School of Medicine, Seoul, Korea
| | - Ki Cheul Shin
- Department of Ophthalmology, Konkuk University Medical Center, Seoul, Korea
| | - Yu Rim Ahn
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea
| | - Jun Seok Kim
- Department of Thoracic and Cardiovascular Surgery, Konkuk University School of Medicine, Seoul, Korea
| | - Hyun Keun Chee
- Department of Thoracic and Cardiovascular Surgery, Konkuk University School of Medicine, Seoul, Korea
| | - Hyun Suk Yang
- Department of Cardiology, Konkuk University School of Medicine, Seoul, Korea
| | - Keon Bong Oh
- Animal Biotechnology Division, National Institute of Animal Science, Wanju-gun, Korea
| | - Ki Myung Choi
- Department of Transgenic Animal Research, Optipharm, Inc., Cheongju-si, Republic of Korea
| | - Jeong Ho Hwang
- Non-Human Primate Minipig Translational Toxicology Research, Korea Institute of Toxicology, Jeonbuk, Korea
| | | | - Ik Jin Yun
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea.
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Hwang SA, Shin KC, Park KS, Ahn YR, Kim WS, Kang HJ, Kim JS, Chee HK, Yang HS, Oh KB, Hwang JH, Yun IJ. Comparison of Graft Survival Between Full-Thickness and Lamellar Pig-to-Monkey Corneal Xenotransplantation from the Same Genetically Engineered Pig Model with Minimal Immunosuppression. Transplant Proc 2023:S0041-1345(23)00226-9. [PMID: 37147194 DOI: 10.1016/j.transproceed.2023.03.065] [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] [Received: 03/14/2023] [Accepted: 03/28/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND The graft survival rate of full-thickness corneal xenotransplantation (XTP) with minimal immunosuppression in genetically engineered pigs is unknown, whereas lamellar corneal XTP shows satisfactory results. We compared graft survival between full-thickness and lamellar transplantations in the same genetically engineered pig. METHODS Six pig-to-monkey corneal transplantations were performed on 3 transgenic pigs. Two corneas harvested from 1 pig were transplanted into 2 monkeys using full-thickness and lamellar corneal xenotransplantation. The transgenic donor pigs used were α1,3-galactosyltransferase gene-knockout + membrane cofactor protein (GTKO+CD46) in one recipient and GTKO+CD46+ thrombomodulin (TBM) in the other. RESULTS The graft survival time for GTKO+CD46 XTP was 28 days. With the addition of TBM, the survival differences between lamellar and full-thickness XTP were 98 days versus 14 days and >463 days (ongoing) versus 21 days, respectively. An excessive number of inflammatory cells was observed in failed grafts, but none were in the recipient's stromal bed. CONCLUSIONS Unlike full-thickness corneal XTP, lamellar xenocorneal transplantation does not exhibit surgical complications, such as retrocorneal membrane or anterior synechia. The graft survival of lamellar XTP in this study was not as good as in our previous experiments, although the survival period was superior to that of full-thickness XTP. The difference in graft survival based on transgenic type is not definitive. Further studies using transgenic pigs and minimal immunosuppression need to focus on improving graft survival of lamellar XTP and using a larger sample size to determine the potential of full-thickness corneal XTP.
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Affiliation(s)
- Sun Ae Hwang
- Department of Surgery, Konkuk University School of Medicine, Seoul, South Korea
| | - Ki Cheul Shin
- Department of Ophthalmology, Konkuk University Medical Center, Seoul, South Korea
| | - Kyoung Sik Park
- Department of Surgery, Konkuk University School of Medicine, Seoul, South Korea
| | - Yu Rim Ahn
- Department of Surgery, Konkuk University School of Medicine, Seoul, South Korea
| | - Wan Seop Kim
- Department of Pathology, Konkuk University School of Medicine, Seoul, South Korea
| | - Hee Jung Kang
- Department of Laboratory Medicine, Hallym University College of Medicine, Anyang-si, South Korea
| | - Jun Seok Kim
- Department of Thoracic and Cardiovascular Surgery, Konkuk University School of Medicine, Seoul, South Korea
| | - Hyun Keun Chee
- Department of Thoracic and Cardiovascular Surgery, Konkuk University School of Medicine, Seoul, South Korea
| | - Hyun Suk Yang
- Department of Cardiology, Konkuk University School of Medicine, Seoul, South Korea
| | - Keon Bong Oh
- Animal Biotechnology Division, National Institute of Animal Science, Wanju-gun, South Korea
| | - Jeong Ho Hwang
- Non-Human Primate Minipig Translational Toxicology Research, Korea Institute of Toxicology, Jeonbuk, Jeollabuk-do, South Korea
| | - Ik Jin Yun
- Department of Surgery, Konkuk University School of Medicine, Seoul, South Korea.
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Nam SE, Jin T, Park KS, Saindane M, Noh WC, Yoo YB, Park WS, Yun IJ. Vitamin D receptor ( VDR) mRNA overexpression is associated with poor prognosis in breast carcinoma. Ann Surg Treat Res 2022; 103:183-194. [PMID: 36304189 PMCID: PMC9582618 DOI: 10.4174/astr.2022.103.4.183] [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: 08/11/2022] [Revised: 09/07/2022] [Accepted: 09/17/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose The prognostic value of vitamin D receptor gene (VDR) expression in breast cancer development is unclear. Here, we aimed to investigate whether VDR expression can be used as a prognostic indicator of breast cancer. Methods We used various public bioinformatics platforms: Oncomine, GEPIA, UALCAN, Kaplan-Meier plotter, UCSC XENA, bc-GenExMiner, WebGestalt, and STRING database. Results We found that VDR was upregulated in breast cancer in comparison to normal tissues. Overexpression of VDR was significantly associated with worse overall survival in breast cancer. The expression of VDR was related to age, TNM stages, estrogen receptor status, progesterone receptor status, human epidermal growth factor receptor 2 status, basal-like (PAM 50) status, triple-negative breast cancer (TNBC) status, and basal-like (PAM 50) & TNBC status (P < 0.05). Increased VDR expression in breast cancer was significantly associated with older age. The 5 hub genes for VDR were NCOA1, EP300, CREBBP, and RXRA. Conclusion Our investigation offers hints about the prognostic role of VDR in breast cancer. The findings suggest that VDR expression might be used as a marker to determine a breast cancer patient's prognosis. Nevertheless, further validation is warranted.
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Affiliation(s)
- Sang Eun Nam
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea.,Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea.,Department of Surgery, Konkuk University Medical Center, Seoul, Korea
| | - TongYi Jin
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea.,Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
| | - Kyoung Sik Park
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea.,Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea.,Department of Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Madhuri Saindane
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea.,Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
| | - Woo Chul Noh
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea.,Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
| | - Young Bum Yoo
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea.,Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea.,Department of Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Won Seo Park
- Department of Surgery, Kyung Hee University School of Medicine, Seoul, Korea
| | - Ik Jin Yun
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea.,Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea.,Department of Surgery, Konkuk University Medical Center, Seoul, Korea
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Yun IJ. To which journal should you submit your academic achievements? Korean J Transplant 2022; 36:81. [PMID: 35919204 PMCID: PMC9296976 DOI: 10.4285/kjt.22.0030] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Ik Jin Yun
- Editor-in-Chief of Korean Journal of Transplantation
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Yun IJ. What is a good medical journal? Has KJT succeeded in achieving this goal? Korean J Transplant 2022; 36:1. [PMID: 35769435 PMCID: PMC9235524 DOI: 10.4285/kjt.22.0329] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Ik Jin Yun
- Editor-in-Chief of Korean Journal of Transplantation
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9
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Jin TY, Park KS, Nam SE, Yoo YB, Park WS, Yun IJ. BRCA1/2 Serves as a Biomarker for Poor Prognosis in Breast Carcinoma. Int J Mol Sci 2022; 23:ijms23073754. [PMID: 35409110 PMCID: PMC8998777 DOI: 10.3390/ijms23073754] [Citation(s) in RCA: 2] [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: 03/08/2022] [Revised: 03/24/2022] [Accepted: 03/27/2022] [Indexed: 11/16/2022] Open
Abstract
BRCA1/2 are breast cancer susceptibility genes that are involved in DNA repair and transcriptional control. They are dysregulated in breast cancer, making them attractive therapeutic targets. Here, we performed a systematic multiomics analysis to expound BRCA1/2 functions as prognostic biomarkers in breast cancer. First, using different web-based bioinformatics platforms (Oncomine, TIMER 2.0, UALCAN, and cBioportal), the expression of BRCA1/2 was assessed. Then, the R package was used to analyze the diagnostic value of BRCA1/2 in patients. Next, we determined the relationship between BRCA1/2 mRNA expression and prognosis in patients (PrognoScan Database, R2: Kaplan Meier Scanner and Kaplan−Meier Plotter). Subsequently, the association of BRCA1/2 with mutation frequency alteration and copy number alterations in breast cancer was investigated using the cBioportal platform. After that, we identified known and predicted structural genes and proteins essential for BRCA1/2 functions using GeneMania and STRING db. Finally, GO and KEGG pathway enrichment analyses were performed to elucidate the potential biological functions of the co-expression genes of BRCA1/2. The BRCA1/2 mRNA level in breast cancer tissues was considerably higher than in normal tissues, with AUCs of 0.766 and 0.829, respectively. Overexpression of BRCA1/2 was significantly related to the worse overall survival (p < 0.001) and was correlated to clinicopathological characteristics including lymph nodes, estrogen receptors, and progesterone receptors (p < 0.01). The alteration frequencies of both the gens have been checked, and the results show that BRCA1 and BRCA2 show different alteration frequencies. Their mutation sites differ from each other. GO and KEGG showed that BRCA1/2 was mainly enriched in catalytic activity, acting on DNA, chromosomal region, organelle fission, cell cycle, etc. The 20 most frequently changed genes were closely related to BRCA1/2, including PALB2 and RAD51 relatively. Our study provides suggestive evidence of the prognostic role of BRCA1/2 in breast cancer and the therapeutic target for breast cancer. Furthermore, BRCA1/2 may influence BRCA prognosis through catalytic activity, acting on DNA, chromosomal regions, organelle fission, and the cell cycle. Nevertheless, further validation is warranted.
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Affiliation(s)
- Tong Yi Jin
- Department of Surgery, Konkuk University School of Medicine, Seoul 05030, Korea; (T.Y.J.); (S.E.N.); (Y.B.Y.); (I.J.Y.)
- Research Institute of Medical Science, Konkuk University School of Medicine, Seoul 05030, Korea
| | - Kyoung Sik Park
- Department of Surgery, Konkuk University School of Medicine, Seoul 05030, Korea; (T.Y.J.); (S.E.N.); (Y.B.Y.); (I.J.Y.)
- Research Institute of Medical Science, Konkuk University School of Medicine, Seoul 05030, Korea
- Department of Surgery, Konkuk University Medical Center, Seoul 05030, Korea
- Correspondence:
| | - Sang Eun Nam
- Department of Surgery, Konkuk University School of Medicine, Seoul 05030, Korea; (T.Y.J.); (S.E.N.); (Y.B.Y.); (I.J.Y.)
- Research Institute of Medical Science, Konkuk University School of Medicine, Seoul 05030, Korea
- Department of Surgery, Konkuk University Medical Center, Seoul 05030, Korea
| | - Young Bum Yoo
- Department of Surgery, Konkuk University School of Medicine, Seoul 05030, Korea; (T.Y.J.); (S.E.N.); (Y.B.Y.); (I.J.Y.)
- Research Institute of Medical Science, Konkuk University School of Medicine, Seoul 05030, Korea
- Department of Surgery, Konkuk University Medical Center, Seoul 05030, Korea
| | - Won Seo Park
- Department of Surgery, Kyung Hee University School of Medicine, Seoul 02447, Korea;
| | - Ik Jin Yun
- Department of Surgery, Konkuk University School of Medicine, Seoul 05030, Korea; (T.Y.J.); (S.E.N.); (Y.B.Y.); (I.J.Y.)
- Research Institute of Medical Science, Konkuk University School of Medicine, Seoul 05030, Korea
- Department of Surgery, Konkuk University Medical Center, Seoul 05030, Korea
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Yun IJ. Turning point for the COVID-19 era and the Korean Journal of Transplantation. Korean J Transplant 2021; 35:207. [PMID: 35769852 PMCID: PMC9235454 DOI: 10.4285/kjt.21.1228] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Ik Jin Yun
- Editor-in-Chief, Korean Journal of Transplantation
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11
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Ahn C, Lee S, Kim YH, Oh J, Yun IJ, Ahn HJ, Seo SH, Jeong JC, Kim MS, Ha J, Kim SI, Moon IS, Cho WH. Improving self-sufficiency in organ transplantation in Korea. Korean J Transplant 2021; 35:137-142. [PMID: 35769245 PMCID: PMC9235443 DOI: 10.4285/kjt.21.0022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 09/10/2021] [Revised: 09/24/2021] [Accepted: 09/24/2021] [Indexed: 11/26/2022] Open
Abstract
After attaining a qualified medical capacity in organ transplantation, Korea has been struggling to increase the number of deceased organ transplants to reach self-sufficiency. As one of these efforts, Korea revised the organ transplantation law in 2010 by adding three articles the mandatory reporting based on the recommendation of the 3rd Global Consultation on Organ Transplantation of Madrid in 2010. Along with the new constitution, considerable efforts have been initiated to upgrade the deceased organ transplantation system while maintaining the virtues of fairness, justice, and transparency. The Korean Society of Transplantation played a critical role in revising the law as well as in establishing organizations such as the Korean Organ Donation Agency (KODA; 2009), the Vitallink (2009), and the Korean Organ Transplantation Registry (KOTRY; 2010). By the activities of these professional organizations, Korea could implement fundamental programs such as mandatory reporting and could develop various education programs for organ donation for students and the general population. As a result, the number of deceased donors increased from 1.08 p.m.p. (2000) to 9.23 p.m.p.(2020). Further efforts are needed to increase the number of organ donor cardholders and family consent rates by well-designed, target-specific education programs to overcome traditional negative cultural barriers toward organ donation. The community atmosphere of honoring and thanking donors and their families should be nurtured by national and regional activities of life-sharing weeks linked with organ donor memorial parks.
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Affiliation(s)
- Curie Ahn
- Division of Nephrology, National Medical Center, Seoul, Korea
- Vitallink, Seoul, Korea
| | - Samuel Lee
- Department of Surgery, KangNam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Yeong Hoon Kim
- Division of Nephrology, Inje University Busan Paik Hospital, Busan, Korea
| | - Jieun Oh
- Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
| | - Ik Jin Yun
- Department of Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Hyung Joon Ahn
- Department of Surgery, Kyung Hee University Medical Center, Seoul, Korea
| | | | - Jong Cheol Jeong
- Division of Nephrology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Myung Soo Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Jongwon Ha
- Department of Surgery, Transplantation Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Soon Il Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | | | - Won Hyun Cho
- Department of Surgery, Keimyung University School of Medicine, Daegu, Korea
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12
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Park MY, Krishna Vasamsetti BM, Kim WS, Kang HJ, Kim DY, Lim B, Cho K, Kim JS, Chee HK, Park JH, Yang HS, Rallabandi HR, Ock SA, Park MR, Lee H, Hwang IS, Kim JM, Oh KB, Yun IJ. Comprehensive Analysis of Cardiac Xeno-Graft Unveils Rejection Mechanisms. Int J Mol Sci 2021; 22:ijms22020751. [PMID: 33451076 PMCID: PMC7828557 DOI: 10.3390/ijms22020751] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/05/2021] [Accepted: 01/11/2021] [Indexed: 12/13/2022] Open
Abstract
Porcine heart xenotransplantation is a potential treatment for patients with end-stage heart failure. To understand molecular mechanisms of graft rejection after heart transplantation, we transplanted a 31-day-old alpha-1,3-galactosyltransferase knockout (GTKO) porcine heart to a five-year-old cynomolgus monkey. Histological and transcriptome analyses were conducted on xenografted cardiac tissue at rejection (nine days after transplantation). The recipient monkey's blood parameters were analyzed on days -7, -3, 1, 4, and 7. Validation was conducted by quantitative real-time PCR (qPCR) with selected genes. A non-transplanted GTKO porcine heart from an age-matched litter was used as a control. The recipient monkey showed systemic inflammatory responses, and the rejected cardiac graft indicated myocardial infarction and cardiac fibrosis. The transplanted heart exhibited a total of 3748 differentially expressed genes compared to the non-transplanted heart transcriptome, with 2443 upregulated and 1305 downregulated genes. Key biological pathways involved at the terminal stage of graft rejection were cardiomyopathies, extracellular interactions, and ion channel activities. The results of qPCR evaluation were in agreement with the transcriptome data. Transcriptome analysis of porcine cardiac tissue at graft rejection reveals dysregulation of the key molecules and signaling pathways, which play relevant roles on structural and functional integrities of the heart.
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Affiliation(s)
- Min Young Park
- Department of Animal Science and Technology, College of Biotechnology and Natural Resources, Chung-Ang University, Gyeonggi-do 17546, Korea; (M.Y.P.); (D.-Y.K.); (B.L.)
| | - Bala Murali Krishna Vasamsetti
- Animal Biotechnology Division, National Institute of Animal Science, RDA, Jeollabukdo 55365, Korea; (B.M.K.V.); (H.R.R.); (S.A.O.); (M.-R.P.); (H.L.); (I.-S.H.)
| | - Wan Seop Kim
- Department of Pathology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Korea;
| | - Hee Jung Kang
- Department of Laboratory Medicine, Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Dongan-gu, Anyang 14068, Korea;
| | - Do-Young Kim
- Department of Animal Science and Technology, College of Biotechnology and Natural Resources, Chung-Ang University, Gyeonggi-do 17546, Korea; (M.Y.P.); (D.-Y.K.); (B.L.)
| | - Byeonghwi Lim
- Department of Animal Science and Technology, College of Biotechnology and Natural Resources, Chung-Ang University, Gyeonggi-do 17546, Korea; (M.Y.P.); (D.-Y.K.); (B.L.)
| | - Kahee Cho
- Primate Organ Transplantation Centre, Genia Inc., Sungnam 13201, Korea;
| | - Jun Seok Kim
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Korea; (J.S.K.); (H.K.C.)
| | - Hyun Keun Chee
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Korea; (J.S.K.); (H.K.C.)
| | - Jung Hwan Park
- Department of Nephrology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Korea;
| | - Hyun Suk Yang
- Department of Cardiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Korea;
| | - Harikrishna Reddy Rallabandi
- Animal Biotechnology Division, National Institute of Animal Science, RDA, Jeollabukdo 55365, Korea; (B.M.K.V.); (H.R.R.); (S.A.O.); (M.-R.P.); (H.L.); (I.-S.H.)
| | - Sun A. Ock
- Animal Biotechnology Division, National Institute of Animal Science, RDA, Jeollabukdo 55365, Korea; (B.M.K.V.); (H.R.R.); (S.A.O.); (M.-R.P.); (H.L.); (I.-S.H.)
| | - Mi-Ryung Park
- Animal Biotechnology Division, National Institute of Animal Science, RDA, Jeollabukdo 55365, Korea; (B.M.K.V.); (H.R.R.); (S.A.O.); (M.-R.P.); (H.L.); (I.-S.H.)
| | - Heasun Lee
- Animal Biotechnology Division, National Institute of Animal Science, RDA, Jeollabukdo 55365, Korea; (B.M.K.V.); (H.R.R.); (S.A.O.); (M.-R.P.); (H.L.); (I.-S.H.)
| | - In-Sul Hwang
- Animal Biotechnology Division, National Institute of Animal Science, RDA, Jeollabukdo 55365, Korea; (B.M.K.V.); (H.R.R.); (S.A.O.); (M.-R.P.); (H.L.); (I.-S.H.)
| | - Jun-Mo Kim
- Department of Animal Science and Technology, College of Biotechnology and Natural Resources, Chung-Ang University, Gyeonggi-do 17546, Korea; (M.Y.P.); (D.-Y.K.); (B.L.)
- Correspondence: (J.-M.K.); (K.B.O.); (I.J.Y.); Tel.: +82-2-2030-7583 (I.J.Y.); Fax: +82-2-2030-7749 (I.J.Y.)
| | - Keon Bong Oh
- Animal Biotechnology Division, National Institute of Animal Science, RDA, Jeollabukdo 55365, Korea; (B.M.K.V.); (H.R.R.); (S.A.O.); (M.-R.P.); (H.L.); (I.-S.H.)
- Correspondence: (J.-M.K.); (K.B.O.); (I.J.Y.); Tel.: +82-2-2030-7583 (I.J.Y.); Fax: +82-2-2030-7749 (I.J.Y.)
| | - Ik Jin Yun
- Department of Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Korea
- Correspondence: (J.-M.K.); (K.B.O.); (I.J.Y.); Tel.: +82-2-2030-7583 (I.J.Y.); Fax: +82-2-2030-7749 (I.J.Y.)
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13
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Shin HS, Yun IJ, Chee HK, Kim JS, Park JH, Yang HS, Kim WS, Shin KC, Park KS, Oh KB. Nine years experiences of solid organ xenotransplantation. Korean Journal of Transplantation 2020. [DOI: 10.4285/atw2020.po-1154] [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: 11/04/2022] Open
Affiliation(s)
- Hye Sun Shin
- Department of Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Ik Jin Yun
- Department of Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Hyun Keun Chee
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Jun Seok Kim
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Jung Hwan Park
- Division of Nephrology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea
| | - Hyun Suk Yang
- Division of Cardiology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea
| | - Wan Seop Kim
- Department of Pathology, Konkuk University Medical Center, Seoul, Korea
| | - Ki Cheul Shin
- Department of Ophthalmology, Konkuk University Medical Center, Seoul, Korea
| | - Kyoung Sik Park
- Department of Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Keon Bong Oh
- Animal Biotechnology Division, National Institute of Animal Science, Wanju, Korea
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14
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Yun IJ, Shin KC, Shin HS, Kim WS, Saindane M, Oh KB, Kang HJ, Ahn YR. First experience of α1,3-galactosyltransferase gene-knockout (GTKO) transgenic pig to nonhuman primate lamellar corneal xenotransplantation. Korean Journal of Transplantation 2020. [DOI: 10.4285/atw2020.po-1167] [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: 11/04/2022] Open
Affiliation(s)
- Ik Jin Yun
- Department of Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Ki Cheul Shin
- Department of Ophthalmology, Konkuk University Medical Center, Seoul, Korea
| | - Hye Sun Shin
- Department of Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Wan Seop Kim
- Department of Pathology, Konkuk University Medical Center, Seoul, Korea
| | - Madhuri Saindane
- Department of Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Keon Bong Oh
- Division of Animal Biotechnology, National Institute of Animal Science, Wanju, Korea
| | - Hee Jung Kang
- Department of Laboratory Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Yu Rim Ahn
- Department of Surgery, Konkuk University Medical Center, Seoul, Korea
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15
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Saindane M, Rallabandi HR, Park KS, Heil A, Nam SE, Yoo YB, Yang JH, Yun IJ. Prognostic Significance of Prostaglandin-Endoperoxide Synthase-2 Expressions in Human Breast Carcinoma: A Multiomic Approach. Cancer Inform 2020; 19:1176935120969696. [PMID: 33223820 PMCID: PMC7656875 DOI: 10.1177/1176935120969696] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 10/03/2020] [Indexed: 01/24/2023] Open
Abstract
Prostaglandin-endoperoxide synthase-2 (PTGS2) plays a pivotal role in inflammation and carcinogenesis in human breast cancer. Our aim of the study is to find the prognostic value of PTGS2 in breast cancer. We conducted a multiomic analysis to determine whether PTGS2 functions as a prognostic biomarker in human breast cancer. We explored PTGS2 mRNA expressions using different public bioinformatics portals. Oncomine, Serial Analysis of Gene Expression (SAGE), GEPIA, ULCAN, PrognoScan database, Kaplan-Meier Plotter, bc-GenExMiner, USC XENA, and Cytoscape/STRING DB were used to identify the prognostic roles of PTGS2 in breast cancer. Based on the clinicopathological analysis, decreased PTGS2 expressions correlated positively with older age, lymph node status, the human epidermal growth factor receptor 2 (HER2) status (P < .0001), estrogen receptor (ER+) expression (P < .0001) Luminal A (P < .0001), and Luminal B (P < .0001). Interestingly, progesterone receptor (PR) (P < .0001) negative showed a high expression of PTGS2. Prostaglandin-endoperoxide synthase-2 was downregulated in breast cancer tissues than in normal tissues. In the PrognoScan database and, Kaplan-Meier Scanner, downregulated expressions of PTGS2 associated with poor overall survival (OS), relapse-free survival (RFS), and distant metastasis-free survival. The methylation levels were significantly higher in the Luminal B subtype. Through oncomine coexpressed gene analysis, we found a positive correlation between PTGS2 and interleukin-6 (IL-6) expression in breast cancer tissues. These results indicate that downregulated expressions of PTGS2 can be used as a promising prognostic biomarker and Luminal B hyper methylation may play an important role in the development of breast cancers. However, to clarify our results, extensive study is required.
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Affiliation(s)
| | | | - Kyoung Sik Park
- Konkuk University, School of Medicine, Seoul, South Korea.,Research Institute of Medical Science, School of Medicine, Konkuk University, Seoul, South Korea
| | - Alexander Heil
- Institute of Botany and Molecular Genetics, RWTH Aachen University, Aachen, Germany
| | - Sang Eun Nam
- Konkuk University, School of Medicine, Seoul, South Korea.,Research Institute of Medical Science, School of Medicine, Konkuk University, Seoul, South Korea
| | - Young Bum Yoo
- Konkuk University, School of Medicine, Seoul, South Korea.,Research Institute of Medical Science, School of Medicine, Konkuk University, Seoul, South Korea
| | - Jung-Hyun Yang
- Konkuk University, School of Medicine, Seoul, South Korea.,Research Institute of Medical Science, School of Medicine, Konkuk University, Seoul, South Korea
| | - Ik Jin Yun
- Konkuk University, School of Medicine, Seoul, South Korea.,Research Institute of Medical Science, School of Medicine, Konkuk University, Seoul, South Korea
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16
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Yun IJ. Living and publishing in the era of the COVID-19 pandemic. Korean Journal of Transplantation 2020; 34:133. [PMID: 35769062 PMCID: PMC9186858 DOI: 10.4285/kjt.2020.34.3.133] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Ik Jin Yun
- Editor-in-Chief, Korean Journal of Transplantation
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17
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Yun IJ. The Korean Journal of Transplantation’s quantum leap toward becoming an international journal for the advancement of Asian transplantation. Korean J Transplant 2020; 34:1. [PMID: 35770261 PMCID: PMC9188931 DOI: 10.4285/kjt.2020.34.1.1] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Ik Jin Yun
- Editor-in-Chief, Korean Journal of Transplantation
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18
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Yun IJ. Just we begin the new era of Korean Journal of Transplantation. Korean J Transplant 2019; 33:19. [PMID: 35769148 PMCID: PMC9186923 DOI: 10.4285/jkstn.2019.33.2.19] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Ik Jin Yun
- Editor-in-Chief, Korean Journal of Transplantation
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19
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Hwang JH, Park SW, Kim KH, Yang WY, Hwang JJ, Lee SA, Kim JS, Park JB, Chee HK, Yun IJ. Regression of varicose veins after cyanoacrylate closure of incompetent great saphenous veins without a localized concomitant procedure. J Vasc Surg Venous Lymphat Disord 2019; 7:375-381. [DOI: 10.1016/j.jvsv.2018.10.016] [Citation(s) in RCA: 6] [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] [Received: 07/02/2018] [Accepted: 10/22/2018] [Indexed: 11/29/2022]
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20
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Lee SJ, Kim JS, Chee HK, Yun IJ, Park KS, Yang HS, Park JH. Seven Years of Experiences of Preclinical Experiments of Xeno-Heart Transplantation of Pig to Non-Human Primate (Cynomolgus Monkey). Transplant Proc 2018; 50:1167-1171. [PMID: 29731087 DOI: 10.1016/j.transproceed.2018.01.041] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 12/20/2017] [Accepted: 01/22/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND The absolute shortage of donors compared with patients requiring transplantation is currently an unsolved problem, and the only possible solution may be xenotransplantation. To establish a successful clinical trial, a preclinical study using nonhuman primates is essential. Starting in November 2011, our team initiated heterotopic abdominal heart xenotransplantation, the first in the Republic of Korea. We present here the initial 7-year results. METHODS A total of 22 xenotransplantation procedures have been performed since 2011. Single transgenic pig (alpha-galactosidase transferase knockout [GalT KO], n = 16), double transgenic pig (GalT KO + CD46, n = 3, and GalT KO + CD39, n = 2), and triple transgenic pig (GalT KO + CD46 + CD70, n = 1) models were used. Our baseline regimen of immunosuppressants comprised CD154 ab, rituximab, anti-thymocyte globulin, tacrolimus, mycophenolate mofetil, and steroids. RESULTS The mean graft survival was 16 ± 16.27 days, and the mean graft survival was significantly longer in cases performed since 2014 (7.5 ± 8.03 days vs 24.67 ± 17.50; P = .01). Although the donor heart ischemic time was decreased per annum, no correlations could be found between ischemic time and survival days of the graft. Double or triple genetic manipulated hearts exhibited significantly better survival (11.63 ± 11.29 days vs 30.83 ± 20.34 days; P = .03). When the ratio of heart weight (grams) to nonhuman primate weight (kilograms) was lower, the results tended to be better (P < .05). The rate of immediate postoperative bleeding (9%, n = 2) causing death was relatively high in the earlier period, but there have been no serious surgical complications affecting graft survival since 2013. CONCLUSIONS Investigation of effective and optimal target genes for each organ to further progression toward better results is important. In addition, the immunosuppressive regimen needs to be further studied and constantly refined.
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Affiliation(s)
- S J Lee
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - J S Kim
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - H K Chee
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.
| | - I J Yun
- Department of Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - K S Park
- Department of Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - H S Yang
- Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - J H Park
- Department of Nephrology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
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21
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Ock SA, Oh KB, Hwang S, Yun IJ, Ahn C, Chee HK, Kim H, Ullah I, Im GS, Park EW. Immune molecular profiling of whole blood drawn from a non-human primate cardiac xenograft model treated with anti-CD154 monoclonal antibodies. Xenotransplantation 2018; 25:e12392. [PMID: 29582477 DOI: 10.1111/xen.12392] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 01/17/2018] [Accepted: 02/22/2018] [Indexed: 12/17/2022]
Abstract
Most studies of xenografts have been carried out with complex immunosuppressive regimens to prevent immune rejection; however, such treatments may be fatal owing to unknown causes. Here, we performed immune molecular profiling following anti-CD154 monoclonal antibody (mAb) treatment in heterotopic abdominal cardiac xenografts from α-1,3-galactosyltransferase-knockout pigs into cynomolgus monkeys to elucidate the mechanisms mediating the undesirable fatal side effects of immunosuppressive agents. Blood samples were collected from healthy monkeys as control and then at 2 days after xenograft transplantation and just before humane euthanasia; 94 genes related to the immune system were analyzed. The basic immunosuppressive regimen included cobra venom factor, anti-thymocyte globulin, and rituximab, with and without anti-CD154 mAbs. The maintenance therapy was followed with tacrolimus, MMF, and methylprednisolone. The number of upregulated genes was initially decreased on Day 2 (-/+ anti-CD154 mAb, 22/13) and then increased before euthanasia in recipients treated with anti-CD154 mAbs (-/+ anti-CD154 mAb, 30/37). The number of downregulated genes was not affected by anti-CD154 mAb treatment. Additionally, the number of upregulated genes increased over time for both groups. Interestingly, treatment with anti-CD154 mAbs upregulated coagulation inducers (CCL2/IL6) before euthanasia. In conclusion, immunosuppressive regimens used for cardiac xenografting affected upregulation of 6 inflammation genes (CXCL10, MPO, MYD88, NLRP3, TNFα, and TLR1) and downregulation of 8 genes (CCR4, CCR6, CD40, CXCR3, FOXP3, GATA3, STAT4, and TBX21).
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Affiliation(s)
- Sun A Ock
- Animal Biotechnology Division, National Institute of Animal Science, Rural Development Administration, Wanju-gun, Jeollabuk-do, Korea
| | - Keon Bong Oh
- Animal Biotechnology Division, National Institute of Animal Science, Rural Development Administration, Wanju-gun, Jeollabuk-do, Korea
| | - Seongsoo Hwang
- Animal Biotechnology Division, National Institute of Animal Science, Rural Development Administration, Wanju-gun, Jeollabuk-do, Korea
| | - Ik Jin Yun
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea
| | - Curie Ahn
- Division of Nephrology, Seoul National University College of Medicine, Seoul, Korea.,Designed Animal & Transplantation Research institute, Institute of Green BioScience & Technology, Seoul National University, Pyeongchang, Gangwon-do, Korea
| | - Hyun Ken Chee
- Department of Cardiothoracic Surgery, Konkuk University School of Medicine, Seoul, Korea
| | - Hwajung Kim
- Division of Nephrology, Seoul National University College of Medicine, Seoul, Korea
| | - Imran Ullah
- Animal Biotechnology Division, National Institute of Animal Science, Rural Development Administration, Wanju-gun, Jeollabuk-do, Korea
| | - Gi-Sun Im
- Animal Biotechnology Division, National Institute of Animal Science, Rural Development Administration, Wanju-gun, Jeollabuk-do, Korea
| | - Eung Woo Park
- Animal Biotechnology Division, National Institute of Animal Science, Rural Development Administration, Wanju-gun, Jeollabuk-do, Korea
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22
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Kang MC, Kim JH, Ryu SW, Moon JY, Park JH, Park JK, Park JH, Baik HW, Seo JM, Son MW, Song GA, Shin DW, Shin YM, Ahn HY, Yang HK, Yu HC, Yun IJ, Lee JG, Lee JM, Lee JH, Lee TH, Yim H, Jeon HJ, Jung K, Jung MR, Jeong CY, Lim HS, Hong SK. Prevalence of Malnutrition in Hospitalized Patients: a Multicenter Cross-sectional Study. J Korean Med Sci 2018; 33:e10. [PMID: 29215819 PMCID: PMC5729651 DOI: 10.3346/jkms.2018.33.e10] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 10/14/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Malnutrition is associated with many adverse clinical outcomes. The present study aimed to identify the prevalence of malnutrition in hospitalized patients in Korea, evaluate the association between malnutrition and clinical outcomes, and ascertain the risk factors of malnutrition. METHODS A multicenter cross-sectional study was performed with 300 patients recruited from among the patients admitted in 25 hospitals on January 6, 2014. Nutritional status was assessed by using the Subjective Global Assessment (SGA). Demographic characteristics and underlying diseases were compared according to nutritional status. Logistic regression analysis was performed to identify the risk factors of malnutrition. Clinical outcomes such as rate of admission in intensive care units, length of hospital stay, and survival rate were evaluated. RESULTS The prevalence of malnutrition in the hospitalized patients was 22.0%. Old age (≥ 70 years), admission for medical treatment or diagnostic work-up, and underlying pulmonary or oncological disease were associated with malnutrition. Old age and admission for medical treatment or diagnostic work-up were identified to be risk factors of malnutrition in the multivariate analysis. Patients with malnutrition had longer hospital stay (SGA A = 7.63 ± 6.03 days, B = 9.02 ± 9.96 days, and C = 12.18 ± 7.24 days, P = 0.018) and lower 90-day survival rate (SGA A = 97.9%, B = 90.7%, and C = 58.3%, P < 0.001). CONCLUSION Malnutrition was common in hospitalized patients, and resulted in longer hospitalization and associated lower survival rate. The rate of malnutrition tended to be higher when the patient was older than 70 years old or hospitalized for medical treatment or diagnostic work-up compared to elective surgery.
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Affiliation(s)
- Min Chang Kang
- Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Ji Hoon Kim
- Department of Surgery, University of Ulsan College of Medicine, Gangneung Asan Hospital, Gangneung, Korea
| | - Seung Wan Ryu
- Department of Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Jae Young Moon
- Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Je Hoon Park
- Department of Surgery, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea
| | - Jong Kyung Park
- Division of Colorectal Surgery, Department of Surgery, St. Paul's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jong Hoon Park
- Department of Surgery, Daegu Fatima Hospital, Daegu, Korea
| | - Hyun Wook Baik
- Department of Internal Medicine, Bundang Jesaeng Hospital, Seongnam, Korea
| | - Jeong Meen Seo
- Division of Pediatric Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Myoung Won Son
- Department of Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Geun Am Song
- Division of Gastroenterology, Department of Internal Medicine, Pusan National University College of Medicine, Busan, Korea
| | - Dong Woo Shin
- Department of Surgery, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Yeon Myung Shin
- Division of Gastrointestinal Surgery, Department of Surgery, Kosin University College of Medicine, Gospel Hospital, Busan, Korea
| | - Hong Yup Ahn
- Department of Statistics, Dongguk University, Seoul, Korea
| | - Han Kwang Yang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hee Chul Yu
- Department of Surgery, Chonbuk National University Medical School, Jeonju, Korea
| | - Ik Jin Yun
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea
| | - Jae Gil Lee
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Myeong Lee
- Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jung Hwa Lee
- Nutrition Team, Kyung Hee University Medical Center, Seoul, Korea
| | - Tae Hee Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea
| | - Haejun Yim
- Department of Burn Surgery and Critical Care, Burn Center, Hallym University Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Hyun Jeong Jeon
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Kyuwhan Jung
- Department of Surgery, Jeju National University Hospital, Jeju, Korea
| | - Mi Ran Jung
- Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Chi Young Jeong
- Department of Surgery, Gyeongsang National University Hospital, Jinju, Korea
| | - Hee Sook Lim
- Department of Food and Nutrition, Yeonsung University, Anyang, Korea
| | - Suk Kyung Hong
- Division of Acute Care Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
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Ock SA, Lee J, Oh KB, Hwang S, Yun IJ, Ahn C, Chee HK, Kim H, Park JB, Kim SJ, Kim Y, Im GS, Park E. Molecular immunology profiles of monkeys following xenografting with the islets and heart of α-1,3-galactosyltransferase knockout pigs. Xenotransplantation 2016; 23:357-69. [PMID: 27511303 DOI: 10.1111/xen.12249] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Accepted: 06/18/2016] [Indexed: 11/29/2022]
Abstract
Effective immunosuppression strategies and genetically modified animals have been used to prevent hyperacute and acute xenograft rejection; however, the underlying mechanisms remain unknown. In this study, we evaluated the expression of a comprehensive set of immune system-related genes (89 genes, including five housekeeping genes) in the blood of cynomolgus monkeys (~5 yr old) used as graft recipients, before and after the xenografting of the islets and heart from single and double α-1,3-galactosyltransferase (GalT) knockout (KO) pigs (<6 weeks old). The immunosuppressive regimen included administration of cobra venom factor, anti-thymocyte globulin, rituximab, and anti-CD154 monoclonal antibodies to recipients before and after grafting. Islets were xenografted into the portal vein in type 1 diabetic monkeys, and the heart was xenografted by heterotopic abdominal heart transplantation. Genes from recipient blood were analyzed using RT(2) profiler PCR arrays and the web-based RT(2) profiler PCR array software v.3.5. Recipients treated with immunosuppressive agents without grafting showed significant downregulation of CCL5, CCR4, CCR6, CD4, CD40LG, CXCR3, FASLG, CXCR3, FOXP3, GATA3, IGNG, L10, IL23A, TRAF6, MAPK8, MIF, STAT4, TBX21, TLR3, TLR7, and TYK2 and upregulation of IFNGR1; thus, genes involved in protection against viral and bacterial infection were downregulated, confirming the risk of infection. Notably, C3-level control resulted in xenograft failure within 2 days because of a 7- to 11-fold increase in all xenotransplanted models. Islet grafting using single GalT-KO pigs resulted in upregulation of CXCL10 and MX1, early inflammation, and acute rejection-associated signals at 2 days after xenografting. We observed at least 5-fold upregulation in recipients transplanted with islets grafts from single (MX1) or double (C3, CCR8, IL6, IL13, IRF6, CXCL10, and MX1) GalT-KO pigs after 77 days; single GalT-KO incurred early losses owing to immune attacks. Our results suggest that this novel, simple, non-invasive, and time-efficient procedure (requiring only 1.5 ml blood) for evaluating graft success, minimizing immune rejection, and blocking infection.
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Affiliation(s)
- Sun A Ock
- Animal Biotechnology Division, National Institute of Animal Science, Rural Development Administration, Wanju-gun, Jeollabuk-do, Korea. ,
| | - Jungkyu Lee
- Animal Biotechnology Division, National Institute of Animal Science, Rural Development Administration, Wanju-gun, Jeollabuk-do, Korea
| | - Keon Bong Oh
- Animal Biotechnology Division, National Institute of Animal Science, Rural Development Administration, Wanju-gun, Jeollabuk-do, Korea
| | - Seongsoo Hwang
- Animal Biotechnology Division, National Institute of Animal Science, Rural Development Administration, Wanju-gun, Jeollabuk-do, Korea
| | - Ik Jin Yun
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea
| | - Curie Ahn
- Transplantation Center, Seoul National University Hospital, Seoul, Korea.,Designed Animal & Transplantation Research Institute, Institute of Green BioScience & Technology, Seoul National University, Pyeongchang, Gangwon-do, Korea
| | - Hyun Keun Chee
- Department of Cardiothoracic Surgery, Konkuk University School of Medicine, Seoul, Korea
| | - Hwajung Kim
- Transplantation Center, Seoul National University Hospital, Seoul, Korea
| | - Jae Berm Park
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Joo Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Youngim Kim
- Animal Biotechnology Division, National Institute of Animal Science, Rural Development Administration, Wanju-gun, Jeollabuk-do, Korea
| | - Gi-Sun Im
- Animal Biotechnology Division, National Institute of Animal Science, Rural Development Administration, Wanju-gun, Jeollabuk-do, Korea
| | - EungWoo Park
- Animal Biotechnology Division, National Institute of Animal Science, Rural Development Administration, Wanju-gun, Jeollabuk-do, Korea
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Affiliation(s)
- Ik Jin Yun
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea
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25
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Kim JS, Park SW, Yun IJ, Hwang JJ, Lee SA, Chee HK, Hwang JH. Retrograde Endovenous Laser Ablation through Saphenopopliteal Junctional Area for Incompetent Small Saphenous Vein: Comparison with Antegrade Approach. Korean J Radiol 2016; 17:364-9. [PMID: 27134525 PMCID: PMC4842856 DOI: 10.3348/kjr.2016.17.3.364] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 03/02/2016] [Indexed: 11/28/2022] Open
Abstract
Objective To evaluate the safety and efficacy of retrograde endovenous laser ablation (EVLA) and to compare it with the conventional antegrade EVLA for incompetent small saphenous vein (SSV). Materials and Methods Small saphenous vein was cannulated via two approaches under ultrasound-guidance. One method involved puncturing the SSV cranially at mid-calf (the antegrade group). If the antegrade puncture into the SSV failed twice, the other approach for puncture was selected that involved puncturing the SSV toward the ankle (the retrograde group). Patients were evaluated in terms of technical & clinical success, closure rates of the SSV, and complications including pain, bruising, or paresthesia at all follow-up visits. Results The 1470 nm endovenous laser was used in all limbs. Technical success was seen in all limbs in both groups (100%). Closure rate in both groups showed about 95%, without significant difference (p = 0.685). Similar linear endovenous energy density was supplied during the EVLA in both groups (p = 0.876). Three frequent complications including bruising, pain, and paresthesia did not show statistical significance between groups (p = 0.465, 0.823, 1.000, respectively). Major complications were absent in both groups. Conclusion The EVLA for the incompetent SSV using a retrograde approach is safe and effective and should be considered the alternative method if the antegrade access fails due to vasospasm or small SSV diameter.
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Affiliation(s)
- Jun Seok Kim
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 05030, Korea
| | - Sang Woo Park
- Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 05030, Korea
| | - Ik Jin Yun
- Department of Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 05030, Korea
| | - Jae Joon Hwang
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 05030, Korea
| | - Song Am Lee
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 05030, Korea
| | - Hyun Keun Chee
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 05030, Korea
| | - Jin Ho Hwang
- Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 05030, Korea
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Park JA, Park SW, Chang IS, Hwang JJ, Lee SA, Kim JS, Chee HK, Yun IJ. The 1,470-nm bare-fiber diode laser ablation of the great saphenous vein and small saphenous vein at 1-year follow-up using 8-12 W and a mean linear endovenous energy density of 72 J/cm. J Vasc Interv Radiol 2014; 25:1795-800. [PMID: 25156646 DOI: 10.1016/j.jvir.2014.07.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 07/08/2014] [Accepted: 07/08/2014] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To demonstrate 1-year outcomes after low-energy endovenous laser ablation (EVLA) of incompetent saphenous veins with linear endovenous energy density (LEED) of 80 J/cm or lower with the use of a 1,470-nm diode laser. MATERIALS AND METHODS Incompetent saphenous veins in 236 patients (355 limbs; Clinical/Etiology/Anatomy/Pathophysiology classifications of C2-C4) were treated by EVLA with a bare-tipped 1,470-nm laser with LEED no greater than 80 J/cm (mean, 72.4 J/cm) and laser power of 8-12 W. Patients were evaluated clinically and with duplex ultrasonography at 1 week and 1, 3, 6, and 12 months after EVLA to assess the technical and clinical success and complication rates. RESULTS In the 355 limbs, the technical success rate was 100%. The great saphenous vein (GSV) remained occluded in all 229 limbs (100%) after 1 week, 202 of 203 limbs (99.5%) after 1 month, 157 of 158 limbs after 3 months (99.3%), all 99 limbs after 6 months (100%), and all 41 limbs after 1 year (100%). The small saphenous vein (SSV) remained occluded in all 103 limbs (100%) after 1 week, all 94 limbs (100%) after 1 month, 68 of 69 limbs (98.5%) after 3 months, 40 of 41 limbs (97.5%) after 6 months, and all 14 limbs after 1 year (100%). Two GSVs and two SSVs were recanalized and underwent repeated EVLA. No major complications occurred, although bruising (21% of cases), pain (15%), and paresthesia (4%) were observed. CONCLUSIONS Low-energy EVLA with the use of a 1,470-nm laser with LEED of 80 J/cm or lower is an effective, safe, and technically successful option for the treatment of incompetent saphenous veins.
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Affiliation(s)
- Jung Ah Park
- Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, 143-729 Seoul, Republic of Korea
| | - Sang Woo Park
- Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, 143-729 Seoul, Republic of Korea.
| | - Il Soo Chang
- Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, 143-729 Seoul, Republic of Korea
| | - Jae Joon Hwang
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, 143-729 Seoul, Republic of Korea
| | - Song Am Lee
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, 143-729 Seoul, Republic of Korea
| | - Jun Seok Kim
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, 143-729 Seoul, Republic of Korea
| | - Hyun Keun Chee
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, 143-729 Seoul, Republic of Korea
| | - Ik Jin Yun
- Department of Surgery, Konkuk University Hospital, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, 143-729 Seoul, Republic of Korea
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Park SW, Yun IJ, Hwang JJ, Lee SA, Kim JS, Chee HK, Chang IS. Fluoroscopy-guided endovenous sclerotherapy using a microcatheter prior to endovenous laser ablation: comparison between liquid and foam sclerotherapy for varicose tributaries. Korean J Radiol 2014; 15:481-7. [PMID: 25053908 PMCID: PMC4105811 DOI: 10.3348/kjr.2014.15.4.481] [Citation(s) in RCA: 8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Accepted: 04/15/2014] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To compare the efficacy and adverse effects of endovenous foam sclerotherapy (EFS) and liquid sclerotherapy (ELS) using a microcatheter for the treatment of varicose tributaries. MATERIALS AND METHODS From December 2007 to January 2009, patients with venous reflux in the saphenous vein were enrolled. The foam or liquid sclerosant was injected through a microcatheter just before endovenous laser ablation (EVLA). Patients were evaluated for the technical success, clinical success, and procedure-related complications during the procedure and follow-up visits. RESULTS A total of 94 limbs were included: 48 limbs (great saphenous vein [GSV], 35; small saphenous vein [SSV], 13) were managed using EFS and EVLA (foam group; FG), and 46 limbs (GSV, 37; SSV, 9) were treated by ELS and EVLA (liquid group; LG). Varicose tributaries demonstrated complete sclerosis in 92.7% with FG and in 71.8% with LG (p = 0.014). Bruising (78.7% in FG vs. 73.2% in LG, p > 0.05), pain or tenderness (75.6% in FG vs. 51.2% in LG, p = 0.0237) were noted. Hyperpigmentation (51.2% in FG vs. 46.2% in LG, p > 0.05) was found. CONCLUSION Endovenous foam sclerotherapy using a microcatheter is more effective than ELS for eliminating remnant varicose tributaries prior to EVLA. However, EFS is more commonly associated with local complications such as pain or tenderness than ELS. Furthermore, both techniques seem to prolong the duration of hyperpigmentation along with higher costs.
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Affiliation(s)
- Sang Woo Park
- Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 143-729, Korea
| | - Ik Jin Yun
- Department of Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 143-729, Korea
| | - Jae Joon Hwang
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 143-729, Korea
| | - Song Am Lee
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 143-729, Korea
| | - Jun Seok Kim
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 143-729, Korea
| | - Hyun Keun Chee
- Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 143-729, Korea
| | - Il Soo Chang
- Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 143-729, Korea
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Bae SH, Park HS, Han HS, Yun IJ. Omega-3 Polyunsaturated Fatty Acid for Cholestasis due to Bile Duct Paucity. Pediatr Gastroenterol Hepatol Nutr 2014; 17:121-4. [PMID: 25061589 PMCID: PMC4107220 DOI: 10.5223/pghn.2014.17.2.121] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 06/06/2014] [Accepted: 06/11/2014] [Indexed: 12/02/2022] Open
Abstract
Omega (ω)-3 polyunsaturated fatty acids appear to be effective in preventing and treating parenteral nutrition-associated liver disease, and several mechanisms were proposed for this observation. An 8-week-old male infant with cholestasis and acholic stool was diagnosed non-syndromic intrahepatic interlobular bile duct paucity by open-wedge liver biopsy. Initially he was treated with usual supportive medical therapy, including ursodeoxycholic acid. However, the clinical status and laboratory tests did not improve. Omega (ω)-3 polyunsaturated fatty acids (initially intravenous administration and oral administration later), were started and his liver function, including aminotransferase level and bilirubin levels normalized, and the ivory stool color turned green. We report the possible effectiveness of ω-3 polyunsaturated fatty acids as a potent choleretic agent for non-syndromic intrahepatic interlobular bile duct paucity, a very rare structural pediatric hepatic disease.
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Affiliation(s)
- Sun Hwan Bae
- Department of Pediatrics, Konkuk University School of Medicine, Seoul, Korea
| | - Hee Sun Park
- Department of Radiology, Konkuk University School of Medicine, Seoul, Korea
| | - Hye Seung Han
- Department of Pathology, Konkuk University School of Medicine, Seoul, Korea
| | - Ik Jin Yun
- Department of General Surgery, Konkuk University School of Medicine, Seoul, Korea
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Kim JM, Kwon CHD, Yun IJ, Lee KW, Yu HC, Suh KS, Joh JW, Cho BH. A multicenter experience with generic mycophenolate mofetil conversion in stable liver transplant recipients. Ann Surg Treat Res 2014; 86:192-8. [PMID: 24783178 PMCID: PMC3996716 DOI: 10.4174/astr.2014.86.4.192] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Revised: 12/02/2013] [Accepted: 12/04/2013] [Indexed: 11/30/2022] Open
Abstract
Purpose Generic substitution of brand-name medications can lead to significant cost savings and is an accepted medical practice. This study evaluated clinical and safety outcomes among liver transplant recipients whose mycophenolate mofetil (MMF) was converted from the brand-name formulation (Cellcept) to a generic formulation (My-rept). Methods Clinical data from multiple centers were prospectively collected for determination of complications, safety, and quality of life after in 154 clinically stable, adult liver transplant recipients whose MMF was converted to a generic formulation between April 2010 and September 2012. This protocol was approved by Institutional Review Boards of all involved sites. Results In eight patients (5.19%), nine instances of drug-related complications occurred after medication conversion. Half of these complications were gastrointestinal disorders (n = 4), and most (7 of 9) were mild. No significant differences were noted in mean pre- and postconversion gastrointestinal symptoms via a rating system (8.9 vs. 10.4) or gastrointestinal quality-of-life index scores (125.6 vs. 123.1). More than 90% of patients reported a status of "about the same" when questioned about the brand-name and generic formulation using the Patient Overall Treatment Effect and Investigator Overall Treatment Effect measures. The incidence of serious adverse events was 5.8%. Acute rejection occurred in two patients, with no graft loss or death. Conclusion Clinical experience as well as research data showed that generic MMF was comparable in efficacy to the brand-name drug. Given the lack of adverse events and the safety findings, conversion from brand-name MMF to generic MMF should be encouraged.
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Affiliation(s)
- Jong Man Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Choon Hyuck David Kwon
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ik Jin Yun
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea
| | - Kwang-Woong Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hee Chul Yu
- Department of Surgery, Chonbuk National University Medical School, Jeonju, Korea
| | - Kyung-Suk Suh
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jae-Won Joh
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Baik Hwan Cho
- Department of Surgery, Chonbuk National University Medical School, Jeonju, Korea
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Park SW, Kim JS, Yun IJ, Hwang JJ, Lee SA, Chee HK, Chang SH, Shin DH, Jung HG, Chang IS. Clinical outcomes of endovascular treatments for critical limb ischemia with chronic total occlusive lesions limited to below-the-knee arteries. Acta Radiol 2013; 54:785-9. [PMID: 23975668 DOI: 10.1258/ar.2012.120217] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Diabetes mellitus tends to have the greatest impact on the smaller vessels and contributes significantly to occlusive disease from the popliteal artery distally. PURPOSE To evaluate the clinical outcomes after a balloon angioplasty with or without stent placement in diabetic patients with critical limb ischemia (CLI) by chronic total occlusion (CTO) limited to below-the-knee (BTK) arteries. MATERIAL AND METHODS From August 2005, patients who presented CLI and CTO limited to the BTK arteries, and who underwent endovascular treatment, were included in this study. The primary endpoints evaluated were technical success, limb salvage, and primary patency. The secondary endpoints evaluated were 30-day access site, intervention site, and systemic complications. Patency and limb salvage were evaluated using the Kaplan-Meier method and compared using Fisher's exact test. RESULTS The BTK endovascular treatment (EVT) was performed on 64 limbs. Technical success rate was 93.8% and limb salvage rate was 90.6%. Three of four limbs with technical failure and three of 60 limbs with technical success underwent BTK amputation and the comparison of these rates were significantly different (75% vs. 5%, P = 0.002). Primary patency rates for the limbs were 75% and 59.1% at 6-month and 12-month follow-up, respectively. Minor complications disappeared through the follow-up periods and there was no 30-day complication or systemic adverse events for the treated vessel. CONCLUSION Even though EVT for CLI in patients with diabetes and CTO in isolated BTK arteries does not have comparable primary patency, it can lead to a very high rate of limb salvage. This result can accentuate the importance of more blood flow to the foot by means of successful revascularization using EVT rather than long-term patency in CTO of isolated BTK arteries.
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Affiliation(s)
| | - Jun Seok Kim
- Department of Thoracic and Cardiovascular Surgery
| | | | | | - Song Am Lee
- Department of Thoracic and Cardiovascular Surgery
| | | | | | | | - Hong Geun Jung
- Department of Orthopaedic Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Korea
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Lee HJ, Park SW, Chang IS, Jo YI, Park JH, Lee JH, Yun IJ, Hwang JJ, Lee SA. A comparison of standard dual-tip hemodialysis catheter split lumen hemodialysis catheter. Clin Imaging 2012; 37:251-5. [PMID: 23465976 DOI: 10.1016/j.clinimag.2012.06.001] [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] [Received: 02/06/2012] [Revised: 04/13/2012] [Accepted: 06/01/2012] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare a split lumen (SLC) with the standard dual-tip hemodialysis catheter (DTC). MATERIALS AND METHODS The patients who underwent DTC insertion or SLC insertion were enrolled. Initial catheter dwell times (ICDT) and catheter-related complications were compared. RESULTS SLC (n=80) and DTC (n=133) were enrolled. ICDT was 71.94 days (SLC) and 68.55 days (DTC) (P=.76). Catheter migration was detected in 10.5% and 12.4% (SLC) and in 1.7% and 2.0% (DTC) (P=.0026). CONCLUSIONS SLC did not extend the ICDT compared to DTC. Furthermore, SLC was more prone to catheter-related complications, particularly catheter migration, than DTC.
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Affiliation(s)
- Hui Jin Lee
- Department of Radiology and Research Institute of Medical Science, Konkuk University Medical Center, Seoul, Korea
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Park SW, Hwang JJ, Yun IJ, Lee SA, Kim JS, Chang SH, Chee HK, Chang IS. Randomized Clinical Trial Comparing Two Methods for Endovenous Laser Ablation of Incompetent Perforator Veins in Thigh and Great Saphenous Vein Without Evidence of Saphenofemoral Reflux. Dermatol Surg 2012; 38:640-6. [DOI: 10.1111/j.1524-4725.2011.02261.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [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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Lee EK, Chang SH, Kim DK, Cheon BS, Hong YS, Kang BJ, Nam SE, Sim JH, Lee HW, Yun IJ. Outcomes of Early Liver Transplantation in a Hospital That Is Starting to Perform Liver Transplantation. Korean J Transplant 2011. [DOI: 10.4285/jkstn.2011.25.3.184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Eun Kyoung Lee
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea
| | - Seong-Hwan Chang
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea
| | - Duk-Kyung Kim
- Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Bo Sung Cheon
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea
| | - Young-Sang Hong
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea
| | - Byoung Joon Kang
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea
| | - Sang Eun Nam
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea
| | - Jae Hoon Sim
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea
| | - Hae-Won Lee
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea
| | - Ik Jin Yun
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea
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Park SW, Lee SA, Hwang JJ, Yun IJ, Kim JS, Chang SH, Chee HK, Chang IS. Early results of endovenous ablation with a 980-nm diode laser for an incompetent vein of Giacomini. Korean J Radiol 2011; 12:481-6. [PMID: 21852909 PMCID: PMC3150676 DOI: 10.3348/kjr.2011.12.4.481] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Accepted: 03/25/2011] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE We wanted to evaluate the effectiveness of endovenous ablation of the incompetent vein of Giacomini using a 980-nm diode laser. MATERIALS AND METHODS A total of 18 patients (18 limbs, 4%) had the incompetent vein of Giacomini. Retrograde reflux originating from the great saphenous vein was noted in sixteen limbs and paradoxical diastolic anterograde reflux from the saphenopopliteal junction was observed in two limbs. After tumescent anesthesia, laser ablation using a 980-nm wavelength laser fiber was performed under ultrasound and/or fluoroscopic guidance. Patients were evaluated clinically and with duplex ultrasound at one week and at one, three, six and twelve months after laser ablation for the technical and clinical success. RESULTS In the 18 limbs, the technical success rate was 100%. Continued closure of the vein of Giacomini was seen in 18 of 18 limbs after one month, in 12 of 12 limbs after three and six months and in six of six limbs after twelve months. No recanalization of the vein and no major complications occurred. CONCLUSION Endovenous laser ablation with a 980-nm wavelength is an effective and safe procedure for treating an incompetent vein of Giacomini.
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Affiliation(s)
- Sang Woo Park
- Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, Seoul, Korea
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Chang IS, Chee HK, Park SW, Yun IJ, Hwang JJ, Lee SA, Kim JS, Chang SH, Jung HG. The primary patency and fracture rates of self-expandable nitinol stents placed in the popliteal arteries, especially in the P2 and P3 segments, in Korean patients. Korean J Radiol 2011; 12:203-9. [PMID: 21430937 PMCID: PMC3052611 DOI: 10.3348/kjr.2011.12.2.203] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2010] [Accepted: 12/10/2010] [Indexed: 11/28/2022] Open
Abstract
Objective We wanted to evaluate the status of self-expandable nitinol stents implanted in the P2 and P3 segments of the popliteal artery in Korean patients. Materials and Methods We retrospectively analyzed 189 consecutive patients who underwent endovascular treatment for stenoocclusive lesions in the femoropopliteal artery from July 2003 to March 2009, and 18 patients who underwent stent placement in popliteal arterial P2 and P3 segments were finally enrolled. Lesion patency was evaluated by ultrasound or CT angiography, and stent fracture was assessed by plain X-rays at 1, 3, 6 and 12 months and annually thereafter. Results At the 1-month follow-up, stent fracture (Type 2) was seen in one limb (up to P3, 1 of 18, 6%) and it was identified in seven limbs at the 3-month follow-up (Type 2, Type 3, Type 4) (n = 1: up to P2; n = 6: P3). At the 6-month follow-up, one more fracture (Type 1) (up to P3) was noted. At the 1-year follow-up, there were no additional stent fractures. Just four limbs (up to P2) at the 2-year follow-up did not have stent fracture. The primary patency was 94%, 61% and 44% at 1, 3 and 6 months, respectively, and the group with stent implantation up to P3 had a higher fracture rate than that of the group that underwent stenting up to P2 (p < 0.05). Conclusion We suggest that stent placement up to the popliteal arterial P3 segment and over P2 in an Asian population can worsen the stent patency owing to stent fracture. It may be necessary to develop a stent design and structure for the Asian population that can resist the bending force in the knee joint.
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Affiliation(s)
- Il Soo Chang
- Department of Radiology, Konkuk University Hospital, Seoul 143-729, Korea
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Moon HW, Noh J, Yun YM, Kim HY, Yun IJ, Song J, Kim JQ. The effect of CYP2C9, VKORC1 genotypes and old age on warfarin pharmacologic sensitivity in korean patients with thromboembolic disease. Ann Clin Lab Sci 2011; 41:229-235. [PMID: 22075505] [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: 05/31/2023]
Abstract
The therapeutic dose of warfarin is dependent upon intrinsic patient characteristics that are highly variable. We assessed the effects of CYP2C9, VKORC1 1173 C/T polymorphisms, and old age on warfarin dosing and sensitivity by measuring plasma S-/R-warfarin levels in Korean patients. INR and the plasma S-/R-warfarin concentrations were determined in 58 patients who had the VKORC1 1173C/T CYP2C9 genotypes, were on a long-term anticoagulation regimen with warfarin, and took a daily dose of warfarin. The pharmacokinetic sensitivity of warfarin was significantly higher in the CYP2C9 *1/*3 genotypes than in the CYP2C9 *1/*1 genotypes [ratio of S-warfarin concentration/dose, 0.53 vs. 0.21; p=0.01]. Pharmacodynamic sensitivity in older patients (≥ 75 years) with the CYP2C9 *1/*1 and VKORC1 1173 TT genotypes was significantly higher as compared to younger patients (<75 years) [Ratio of INR/S-warfarin concentration, 4.88 vs. 3.41; p = 0.026]. The CYP2C9*3 allele and old age (≥ 75 years) with the VKORC1 1173 T allele were also associated with increased risk of over-anticoagulation. The increase of over-anticoagulation risk and warfarin sensitivity is related to the CYP2C9*3 allele and old age with the VKORC1 1173 T allele in Korean patients with thromboembolic disease. These findings suggest that a lower initial and maintenance dose should be considered for the patients with CYP2C9 *3 allele and advanced age in this patient population. However, due to the limited number of patients in the study population, our finding needs to be confirmed by a larger, well-controlled study.
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Affiliation(s)
- Hee-Won Moon
- Department of Laboratory Medicine, Konkuk University Hospital, 4-12, Hwayang-dong, Gwangjin-gu, Seoul, South Korea
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Moon HW, Yun YM, Hur M, Park JH, Lee HW, Chang SH, Yun IJ. [An experience of ABO-incompatible kidney transplantation using plasmapheresis and anti-CD20 monoclonal antibody]. Korean J Lab Med 2010; 29:585-8. [PMID: 20046092 DOI: 10.3343/kjlm.2009.29.6.585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Due to an extreme shortage of cadaveric kidneys, many centers in Japan successfully performed ABO-incompatible kidney transplantations using plasmapheresis, splenectomy and immunosuppression. Recently, a protocol including anti-CD20 monoclonal antibody (rituximab) and antigen-selective immunoadsorption has been used for ABO-incompatible transplantation in Europe. In Korea, ABO-incompatible kidney transplantation has been rarely performed. We report an experience of successful ABO-incompatible kidney transplantation using plasmapheresis and rituximab. The patient was a 32-yr-old female suffering from chronic renal failure, and her blood type was O, Rh+. The donor was her husband, and his blood type was B, Rh+. A combination therapy including 5 times of plasmapheresis starting from 10 days before transplantation with 2-day interval, intravenous gammaglobulin, rituximab at 2 weeks before transplantation and potent immunosuppression successfully decreased the titers of anti-A and anti-B antibodies to 1:2 and 1:1, respectively. The kidney transplantation was successful without any sign of hyperacute or acute rejection.
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Affiliation(s)
- Hee-Won Moon
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea
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Park SW, Yun IJ, Hwang JJ, Lee SA, Kim JS, Chang SH, Chee HK, Kim HC, Sun K, Park SJ. Fluoroscopy-Guided Endovenous Foam Sclerotherapy Using a Microcatheter in Varicose Tributaries Followed by Endovenous Laser Treatment of Incompetent Saphenous Veins. Dermatol Surg 2009; 35:804-12. [PMID: 19389098 DOI: 10.1111/j.1524-4725.2009.01136.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Sang Woo Park
- Department of Radiology, Kunkuk University Hosptial, Seoul, Korea
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Min SI, Yun IJ, Kang JM, Park YJ, Min SK, Ahn C, Kim SJ, Ha J. Moderate-to-severe early-onset hyperuricaemia: a prognostic marker of long-term kidney transplant outcome. Nephrol Dial Transplant 2009; 24:2584-90. [PMID: 19395726 DOI: 10.1093/ndt/gfp192] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Hyperuricaemia commonly occurs in renal transplant recipients (RTRs), but the effects of post-transplant hyperuricaemia on kidney transplant outcome have not been clearly established. This work was designed to explore the impact of hyperuricaemia on renal transplant outcome. METHODS The authors examined this issue by analysing the clinical outcome of 281 RTRs. Hyperuricaemia (defined as UA > 7.0 mg/dl in men and >6.0 mg/dl in women for at least two consecutive tests, n = 121) was classified as early onset (within 1 year of transplant, n = 90) or late onset (n = 31). Graft function was estimated using the MDRD Study Equation 7 (eGFR(MDRD)). RESULTS As late-onset hyperuricaemia was found to be induced by a progressive decline in the graft function (P < 0.01), data from early-onset hyperuricaemic recipients were used. Early-onset moderate-to-severe hyperuricaemia (defined as UA >or= 8.0 mg/dl) was found to be a significant risk factor for chronic allograft nephropathy (P = 0.035) and a poorer graft survival (P = 0.026) by multivariate analysis, whereas mild hyperuricaemia was not. The impact of moderate-to-severe hyperuricaemia on renal transplant survival was dependent on the duration of exposure. Likewise, the detrimental effect of early-onset hyperuricaemia on the graft function was dependent on UA levels and exposure time. After control of the baseline graft function by analysis of only recipients with a good graft function at 1 year post-transplantation (eGFR(MDRD) > 60 ml/min), moderate-to-severe early-onset hyperuricaemia was also found to be a marker of long-term graft dysfunction and failure. CONCLUSION Moderate-to-severe early-onset hyperuri- caemia may be a prognostic marker of the long-term graft outcome in RTRs, which needs further investigation.
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Affiliation(s)
- Sang Il Min
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
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Bae SY, Yun IJ, Lee KY, Seong MK, Yoo YB, Chang SH, Kim JS. A Comparative Study about Complications of Laparoscopic Appendectomy in Children and Adults. J Korean Surg Soc 2009. [DOI: 10.4174/jkss.2009.76.2.90] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Soo Youn Bae
- Department of Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Korea
| | - Ik Jin Yun
- Department of Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Korea
| | - Kyung Yung Lee
- Department of Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Korea
| | - Moo Kyung Seong
- Department of Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Korea
| | - Young Bum Yoo
- Department of Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Korea
| | - Seong Hwan Chang
- Department of Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Korea
| | - Jee Soo Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kim W, Hong S, Do E, Suk K, Yun IJ, Lee W. Keumsa Linteusan suppresses invasion of cancer cells through the inhibition of cellular adhesion and MMP‐9 expression. Anim Cells Syst (Seoul) 2009. [DOI: 10.1080/19768354.2009.9647201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Park SW, Hwang JJ, Yun IJ, Lee SA, Kim JS, Chang SH, Chee HK, Hong SJ, Cha IH, Kim HC. Endovenous Laser Ablation of the Incompetent Small Saphenous Vein with a 980-nm Diode Laser: Our Experience with 3Years Follow-up. Eur J Vasc Endovasc Surg 2008; 36:738-42. [PMID: 18851921 DOI: 10.1016/j.ejvs.2008.08.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2008] [Accepted: 08/10/2008] [Indexed: 11/17/2022]
Affiliation(s)
- S W Park
- Department of Radiology, Konkuk University Hospital, Seoul, Republic of Korea
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Park SW, Yun IJ, Hwang JJ, Lee SA, Kim JS, Chang SH, Chee HK, Hong SJ. Endovenous laser ablation of varicose veins after direct percutaneous puncture: early results. Dermatol Surg 2007; 33:1243-9. [PMID: 17903158 DOI: 10.1111/j.1524-4725.2007.33260.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Although endovenous laser ablation has been demonstrated to effectively occlude incompetent saphenous veins, it does not treat branch varicosities directly. OBJECTIVE The objective was to evaluate the technical feasibility and early results of the direct ablation of branch varicosities using a 980-nm diode laser. MATERIALS AND METHODS From July to August 2005, 17 patients (21 limbs; male:female ratio, 7:10; mean age, 50.1 years; range, 24-62 years) with varicose veins were enrolled in this study. Endovenous laser ablation was performed in incompetent saphenous veins. Thereafter, branch varicosities were percutaneously punctured and a direct laser ablation was performed using a 400-microm laser fiber. Patients were evaluated at 1 week and at 1-, 3-, and 6-month intervals. RESULTS Technical success in branch varicosities was achieved in 11 of 15 limbs (71.4%). Continued closure of treated saphenous veins was evident in 11 of 11 limbs (100%) at 1-month follow-up. Successful ablation in varicose tributaries was seen in 6 of 11 limbs (54.5%) at 1-month follow-up and ablation failed in 5 limbs. One of the 11 limbs (9%) had a skin burn that required treatment. CONCLUSION Despite partly successful occlusion, we suggest that direct laser ablation cannot replace classic methods of treating branch varicosities, because of its high failure rate and the risk of skin burns.
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Affiliation(s)
- Sang Woo Park
- Department of Radiology, Konkuk University Hospital, Seoul, Korea
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Abstract
To develop an effective protocol of gene transfer into glomeruli, an ex vivo gene delivery system using rat mesangial cells (RMC) as a vector was examined. RMC genetically engineered with a retrovirus harboring the Escherichia coli beta-galactosidase gene was used to estimate the efficacy of gene delivery and the location of the cells within the kidney. The RMC expressing beta-galactosidase, RMCLZ1, was cultured in vitro and the cells were injected into the left kidney through the renal artery of a normal Sprague Dawley rat. At least 1 x 10(6) RMCLZ1 was required for effective gene delivery into glomeruli. One hour and 1, 4, and 14 d after injection, glomeruli were isolated from the left kidneys injected with the cells and the expression of beta-galactosidase in each glomeruli was evaluated. One hour and 1 d after injection, more than 90 and 80%, respectively, of glomeruli from the left kidney showed strong beta-galactosidase activity, while no activity of beta-galactosidase was found in the glomeruli from the right kidneys. The number of glomeruli stained by X-gal and the intensity decreased with time. Fourteen days after injection, about 35% of the glomeruli retained the RMCLZ1. X-gal and periodic acid-Schiff staining of frozen sections obtained 14 d after injection allowed the estimation of the site where the mesangial cells injected were located. The mesangial cells were found mainly in two different locations, the glomerular capillary and the mesangium. The majority (about 90%) of the mesangial cells were located in the glomerular capillary and about 9% of the cells were in the mesangial area. Occasionally, the positive staining was found in proximal tubules and the interlobular artery. Although additional methods are required for the site-specific targeting of the mesangial area, the ex vivo gene transfer to glomeruli is feasible and may be a useful tool for future investigations in the pathological mechanisms of glomerular injury.
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Affiliation(s)
- H J Kim
- Hyonam Kidney Laboratory, Soon Chun Hyang University, Seoul, Korea
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Kim HJ, Kim SI, Yun IJ, Kwak JH, Yu SH. Gene Delivery into Rat Glomerulus Using a Mesangial Cell Vector. Mol Cells 2000. [DOI: 10.1007/s100590000027] [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: 10/27/2022] Open
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Jung SE, Yun IJ, Youn YK, Lee JE, Ha J, Noh DY, Kim SJ, Oh SK, Choe KJ. Effect of protease inhibitor on ischemia-reperfusion injury to rat liver. World J Surg 1999; 23:1027-31. [PMID: 10512942 DOI: 10.1007/s002689900618] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Liver failure due to ischemia-reperfusion injury, believed to be closely related to the generation of oxygen-free radicals, is a serious problem during liver surgery. Gabexate mesilate, a synthetic protease inhibitor, suppresses the extracellular release of oxygen-free radicals in the microvascular endothelium. To determine its effects on ischemia-reperfusion injury to the liver, we performed experiments with rats. We divided the animals into two ischemia-reperfusion groups: an experimental group, which underwent ischemic injury for 30 minutes, along with the infusion of gabexate mesilate, and a control group, which underwent injury only. Each group was then divided into four subgroups: ischemic injury only and 60-, 120-, and 180-minute reperfusion injury. The test parameters were tumor necrosis factor alpha (TNFalpha) and interleukin-6 (IL-6) in serum and superoxide dismutase (SOD), catalase, and malondialdehyde (MDA) in liver and lung tissues. The experimental group had a significantly higher liver SOD and catalase levels and a significantly lower level of liver and lung MDA than the control groups. TNFalpha levels in the experimental groups were significantly lower during the early phase, but a comparison of IL-6 levels between the two groups yielded no differences. Levels of lung catalase and SOD were not significantly different between the two groups. We concluded that protease inhibitor suppressed liver ischemia-reperfusion injury, and that it was due to an increase of antioxidant or suppression of oxygen-free radicals. The roles of TNFalpha and IL-6 in liver reperfusion injury were not clear, though TNFalpha might have had an effect during the early phase. With liver ischemia-reperfusion injury, the mechanism of lung involvement might be different from that of liver involvement.
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Affiliation(s)
- S E Jung
- Department of Surgery, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-ku, Seoul 110-744, Korea
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Noh DY, Yun IJ, Kang HS, Kim YC, Kim JS, Chung JK, Lee DS, Lee MC, Moon WK, Youn YK, Oh SK, Choe KJ. Detection of cancer in augmented breasts by positron emission tomography. Eur J Surg 1999; 165:847-51. [PMID: 10533759 DOI: 10.1080/11024159950189339] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
OBJECTIVE To assess the diagnostic efficiency of positron emission tomography with 18-fluorine fluorodeoxyglucose in detecting breast cancer in augmented breasts. DESIGN Retrospective study. SETTING University hospital, Korea. SUBJECT 9 cases or 8 patients with breasts augmented with paraffin or silicone. INTERVENTION FDG-PET, mammography, and ultrasonography RESULTS The mammogram detected the breast cancer in only 1 of 3 patients, and ultrasonography gave a false positive result in 1 patient with an augmented breast. In contrast, PET predicted all the cancers and 5/6 benign lesions. 2/3 breast cancers had axillary FDG uptake interpreted as showing metastatic involvement, and in 1 case with cancer with no axillary lymph node involvement there was no FDG uptake in the axilla, which correlated with the pathological finding. CONCLUSIONS Although the high cost of PET makes its use as a screening test for all patients with augmented breasts unrealistic, it would be the best diagnostic choice if other methods failed.
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Affiliation(s)
- D Y Noh
- Department of Surgery, Seoul National University College of Medicine, Chongno Gu, Korea
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Noh DY, Yun IJ, Kim JS, Kang HS, Lee DS, Chung JK, Lee MC, Youn YK, Oh SK, Choe KJ. Diagnostic value of positron emission tomography for detecting breast cancer. World J Surg 1998; 22:223-7; discussion 227-8. [PMID: 9494412 DOI: 10.1007/s002689900374] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Positron emission tomography (PET) is an imaging method that employs radionuclide and tomography techniques. PET has high sensitivity for detecting breast cancer, both the primary tumor and axillary node metastasis. From June 1995 to November 1996 a total of 27 patients underwent breast operations based on PET results at Seoul National University Hospital. Whole-body PET images were obtained beginning 60 minutes after injection of 370 MBq (10 mCi) 18F-fluorodeoxyglucose. Regional scans were also obtained with transmission images. We compared the PET results with those from the physical examination and mammography. All cases were histologically confirmed. The diagnostic accuracy of PET was excellent for the primary tumor mass (97%) compared with that of the physical examination (78%) and mammography (67%). For axillary lymph node metastasis, PET had outstanding detection accuracy (96%) compared with the physical examination and mammography (74% and 60%, respectively). Whole-body PET scans made it possible to see all of the metastatic lesions at a glance in cases of metastatic or recurrent breast cancer. There was a probable correlation between the standard uptake value (SUV) and the number of axillary lymph node metastases, but in this study statistical significance was not proved because of the small number of cases. PET also could detect breast cancer in paraffin-augmented breasts. We concluded that PET is a highly sensitive, accurate diagnostic tool for breast cancer and that SUV, after more studies, could be used as an important prognostic factor.
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Affiliation(s)
- D Y Noh
- Department of Surgery, Seoul National University, College of Medicine, Korea
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Han S, Yun IJ, Noh DY, Choe KJ, Song SY, Chi JG. Abnormal expression of four novel molecular markers represents a highly aggressive phenotype in breast cancer. Immunohistochemical assay of p53, nm23, erbB-2, and cathepsin D protein. J Surg Oncol 1997; 65:22-7. [PMID: 9179263 DOI: 10.1002/(sici)1096-9098(199705)65:1<22::aid-jso5>3.0.co;2-q] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND In view of the cumulative results to date, p53, nm23, erbB-2, and cathepsin D are the most promising investigational prognostic factors in breast cancer. OBJECTIVES The clinical utility of these molecular markers to predict recurrence was evaluated. METHODS Archival pathology tissues of 100 breast cancer patients were analyzed by immunohistochemical assay. Molecular biologic data were merged with clinicopathologic variables. RESULTS Thirty-two patients (32%) had recurrence of disease at a median follow-up of 48 months (range 26-72 months). Investigational factor expression had statistical correlation for recurrence with increasing coexpression: one variable 20.6%, two variables 34.2%, three variables 47.1%, four variables 80.0% (P = 0.003). In univariate analysis, lymph node metastasis, tumor size, erbB-2 protein overexpression, and loss of nm23 protein expression were significant variables to determine recurrence; in multivariate analysis, node status and tumor size emerged as the most significant variables for recurrence. CONCLUSIONS Coexpression of the studied investigational variables functioned as significant prognostic correlates for recurrence. These findings suggest that the studied investigational prognostic factors possess the ability to discriminate a highly aggressive phenotype in breast cancer.
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Affiliation(s)
- S Han
- Department of Surgery, Inje University Sanggye Paik Hospital, Seoul, South Korea.
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Suh JS, Yoo KY, Kwon OJ, Yun IJ, Han SH, Noh DY, Choe KJ. Menstrual and reproductive factors related to the risk of breast cancer in Korea. Ovarian hormone effect on breast cancer. J Korean Med Sci 1996; 11:501-8. [PMID: 9008099 PMCID: PMC3054251 DOI: 10.3346/jkms.1996.11.6.501] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
To support the ovarian hormone hypothesis in the etiology of breast cancer, a hospital-based case-control study with community controls was conducted to evaluate the relationship of intervals among menstrual and reproductive events to the risk of breast cancer in Korea. The cases were 190 breast cancer patients, who had been histologically diagnosed at Seoul National University Hospital from Jan. 1, 1993 to Jun. 30, 1994. Included were cancer-free women, who had undertaken the Gynecological examination at the same hospital (n=190). Women recruited for a survey of diabetes prevalence in Yonchon County, adjacent to Seoul City, were taken as a community control group (n=190). Information on menstrual and reproductive factors with other life-styles was collected through a direct interview by the well-trained interviewers. The adjusted odds ratios and the 95% confidence intervals were based on the unconditional logistic regression model. Likelihood ratio test for trend was applied for the ordinal variables. Early age at menarche, late age at natural menopause, late age at first full term pregnancy, and fewer number of full term pregnancies are independently associated with the high risk of breast cancer in Korea. Moreover, the interval between the age at menarche and the age at natural menopause of community controls (29.9+/-6.15 years) was significantly shortened compared to breast cancer cases (34.9+/-4.42 years). Particularly noteworthy was that intervals between the age at menarche and the age at first full term pregnancy of both control groups (9.0+/-3.72 years for hospital controls; 7.2+/-4.04 years for community controls) were significantly shortened compared to breast cancer cases (11.0+/-4.51 years). These findings support the hypothesis that the longer exposure to ovarian hormones during the reproductive years, the higher the risk of breast cancer.
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Affiliation(s)
- J S Suh
- Department of Surgery, Seoul City Boramae Hospital, Dongjak-Ku, Korea
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