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Kim DK, Lee KC, Kim JK. Sacroiliitis in inflammatory bowel disease on abdominal computed tomography: prevalence, misses, and associated factors. Scand J Rheumatol 2024:1-7. [PMID: 38686835 DOI: 10.1080/03009742.2024.2337453] [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: 12/20/2023] [Accepted: 03/28/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVE To evaluate the prevalence and rate of a missed diagnosis of sacroiliitis on abdominal computed tomography (CT) in patients with inflammatory bowel disease (IBD). Factors associated with sacroiliitis were also assessed. METHOD This retrospective study included 210 patients with IBD (mean age 31.1 years) who underwent abdominal CT. Based on a validated abdominal CT scoring tool, bilateral sacroiliac (SI) joints on abdominal CT in the whole study population were retrospectively reviewed. Subsequently, patients were classified into the 'patients with sacroiliitis' group and the 'patients without sacroiliitis' group. Univariate and multivariate regression analyses were used to clarify the factors associated with sacroiliitis. RESULTS Sacroiliitis was identified in 26 out of 210 patients (12.4%). However, sacroiliitis was recognized on the primary reading in only five of these 26 patients (19.2%) and was missed on the initial report in the remaining 21 patients (80.8%). Among the 21 patients, 20 (95.2%) were finally diagnosed with axial spondyloarthritis (axSpA). There was a higher prevalence of female sex (p = 0.04), upper gastrointestinal involvement (p = 0.04), and back pain (p < 0.01) in patients with sacroiliitis than in those without sacroiliitis. However, on multivariate analysis, back pain was the only factor associated with sacroiliitis (p = 0.01). CONCLUSION Physicians should carefully evaluate SI joints on abdominal CT in patients with IBD to enable early detection of sacroiliitis, potentially leading to an early diagnosis of axSpA. In addition, if patients with IBD present with back pain, the possibility of sacroiliitis should be considered.
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Affiliation(s)
- D K Kim
- Department of Radiology, The Armed Forces Capital Hospital, Seongnam, Republic of Korea
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - K-C Lee
- Department of Radiology, The Armed Forces Capital Hospital, Seongnam, Republic of Korea
- Department of Radiology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - J K Kim
- Department of Radiology, The Armed Forces Capital Hospital, Seongnam, Republic of Korea
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Lee S, Jue M, Lee K, Paulson B, Oh J, Cho M, Kim JK. Early-stage diagnosis of bladder cancer using surface-enhanced Raman spectroscopy combined with machine learning algorithms in a rat model. Biosens Bioelectron 2024; 246:115915. [PMID: 38081101 DOI: 10.1016/j.bios.2023.115915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/24/2023] [Accepted: 12/04/2023] [Indexed: 12/30/2023]
Abstract
Early diagnosis and accurate assessment of tumor development facilitate early bladder cancer resection and initiation of drug therapy. This study enabled an early, accurate, label-free, noninvasive diagnosis of bladder tumors by analyzing nano-biomarkers in a single drop of urine through surface-enhanced Raman spectroscopy (SERS). In a standard N-butyl-N-4-hydroxybutyl nitrosamine-induced rat model of bladder cancer, cancer stage and polyp tumor development were monitored using a small endoscope with a diameter of 1.2 mm in a minimally invasive manner without the need to kill the rats. Samples were divided into cancer-free, early-stage, and polyp-form cancer. Training data were classified according to micro-cystoscopic 5-aminolevulinic acid fluorescence diagnosis, and specimens were postmortem verified through histopathological analysis. A drop of urine from each sample group was placed on an Au-coated zinc oxide nanoporous chip to filter nano-biomaterials and selectively enhance the Raman signals of nanoscale analytes via SERS. Principal component analysis was used to reduce the dimensionality of the collected Raman spectra, and partial least squares discriminant analysis was used to find diagnostic clusters based on the labeled samples. The combination of SERS and machine learning achieved an accuracy ≥99.6% in diagnosing both early- and polyp-stage bladder tumors. With an area under the receiver operating characteristic curve greater than 0.996, the accuracy of the diagnosis in the rat model suggests that SERS-based diagnostic methods are promising when coupled with machine learning. Low-cost, label-free, and noninvasive surface-enhanced Raman spectra are ideal for developing clinically relevant point-of-care diagnostic techniques.
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Affiliation(s)
- Sanghwa Lee
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, 05505, Republic of Korea
| | - Miyeon Jue
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, 05505, Republic of Korea; Apollon, Inc., 68 Achasan-ro, Seongdong-gu, Seoul, 05505, Republic of Korea
| | - Kwanhee Lee
- Department of Biomedical Engineering, College of Medicine, University of Ulsan, Seoul, 05505, Republic of Korea
| | - Bjorn Paulson
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, 05505, Republic of Korea; Morgridge Institute for Research, Madison, WI, 53715, USA
| | - Jeongmin Oh
- Department of Biomedical Engineering, College of Medicine, University of Ulsan, Seoul, 05505, Republic of Korea
| | - Minju Cho
- Department of Biomedical Engineering, College of Medicine, University of Ulsan, Seoul, 05505, Republic of Korea
| | - Jun Ki Kim
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, 05505, Republic of Korea; Department of Biomedical Engineering, College of Medicine, University of Ulsan, Seoul, 05505, Republic of Korea.
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Whitcroft KL, Altundag A, Balungwe P, Boscolo-Rizzo P, Douglas R, Enecilla MLB, Fjaeldstad AW, Fornazieri MA, Frasnelli J, Gane S, Gudziol H, Gupta N, Haehner A, Hernandez AK, Holbrook EH, Hopkins C, Hsieh JW, Huart C, Husain S, Kamel R, Kim JK, Kobayashi M, Konstantinidis I, Landis BN, Lechner M, Macchi A, Mazal PP, Miri I, Miwa T, Mori E, Mullol J, Mueller CA, Ottaviano G, Patel ZM, Philpott C, Pinto JM, Ramakrishnan VR, Roth Y, Schlosser RJ, Stjärne P, Van Gerven L, Vodicka J, Welge-Luessen A, Wormald PJ, Hummel T. Position paper on olfactory dysfunction: 2023. Rhinology 2023; 61:1-108. [PMID: 37454287 DOI: 10.4193/rhin22.483] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
BACKGROUND Since publication of the original Position Paper on Olfactory Dysfunction in 2017 (PPOD-17), the personal and societal burden of olfactory disorders has come sharply into focus through the lens of the COVID-19 pandemic. Clinicians, scientists and the public are now more aware of the importance of olfaction, and the impact of its dysfunction on quality of life, nutrition, social relationships and mental health. Accordingly, new basic, translational and clinical research has resulted in significant progress since the PPOD-17. In this updated document, we present and discuss currently available evidence for the diagnosis and management of olfactory dysfunction. Major updates to the current version include, amongst others: new recommendations on olfactory related terminology; new imaging recommendations; new sections on qualitative OD and COVID-19 OD; updated management section. Recommendations were agreed by all co-authors using a modified Delphi process. CONCLUSIONS We have provided an overview of current evidence and expert-agreed recommendations for the definition, investigation, and management of OD. As for our original Position Paper, we hope that this updated document will encourage clinicians and researchers to adopt a common language, and in so doing, increase the methodological quality, consistency, and generalisability of work in this field.
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Affiliation(s)
- K L Whitcroft
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
- and UCL Ear Institute, Faculty of Brain Sciences, University College London, London, UK
- and The Centre for Olfactory Research and Applications, Institute of Philosophy, School of Advanced Studies, University of London, London, UK
| | - A Altundag
- Department of Otorhinolaryngology, Istanbul Surgery Hospital, Istanbul, Turkey
| | - P Balungwe
- Faculté de Médecine, Université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo
- and Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo
| | - P Boscolo-Rizzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - R Douglas
- Department of Otorhinolaryngology, University of Auckland, New Zealand
| | - M L B Enecilla
- Department of Otorhinolaryngology-Head and Neck Surgery, St. Luke's Medical Center, Global City, Philippines
- and Department of Otolaryngology - Head and Neck Surgery, Asian Hospital and Medical Center, Muntinlupa, Philippines
- and Department of Otorhinolaryngology, Medical Center Taguig, Taguig, Philippines
| | - A W Fjaeldstad
- The Centre for Olfactory Research and Applications, Institute of Philosophy, School of Advanced Studies, University of London, London, UK
- and Department of Otorhinolaryngology, University Clinic for Flavour, Balance and Sleep, Regional Hospital Gødstrup, Herning, Denmark
- and Department of Clinical Medicine, Flavour Institute, Aarhus University, Aarhus, Denmark
- and Center for Eudaimonia and Human Flourishing, Linacre College, University of Oxford, Oxford, UK
| | - M A Fornazieri
- Department of Clinical Surgery, Universidade Estadual de Londrina and Pontifícia Universidade Católica do Paraná, Londrina, Brazil
| | - J Frasnelli
- Research Chair in Chemosensory Neuroanatomy, Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- and Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Montréal, QC, Canada
| | - S Gane
- The Centre for Olfactory Research and Applications, Institute of Philosophy, School of Advanced Studies, University of London, London, UK
- and Royal National Throat Nose and Ear Hospital, UCLH, London
| | - H Gudziol
- Department of Otorhinolaryngology, University of Jena, Jena, Germany
| | - N Gupta
- Department of Otorhinolaryngology, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - A Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - A K Hernandez
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
- and Department of Otolaryngology - Head and Neck Surgery, Asian Hospital and Medical Center, Muntinlupa, Philippines
- and Department of Otolaryngology - Head and Neck Surgery, Philippine General Hospital, University of the Philippines - Manila, Manila, Philippines
| | - E H Holbrook
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - C Hopkins
- Guys and St Thomas NHS Trust, London, United Kingdom
| | - J W Hsieh
- Rhinology-Olfactology Unit, Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Geneva Medical School, Geneva, Switzerland
| | - C Huart
- Department of Otorhinolaryngology, Cliniques universitaires Saint-Luc, Brussels, Belgium
- and Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - S Husain
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - R Kamel
- Department of Otorhinolaryngology, Cairo University, Cairo, Egypt
| | - J K Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University, College of Medicine, Seoul, Republic of Korea
| | - M Kobayashi
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - I Konstantinidis
- Smell and Taste Clinic, Second Academic Otorhinolaryngology Department, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - B N Landis
- Rhinology-Olfactology Unit, Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Geneva Medical School, Geneva, Switzerland
| | - M Lechner
- Division of Surgery and Interventional Science, University College London, London, UK
- and UCL Cancer Institute, University College London, London, UK
- and ENT Department, Homerton Healthcare NHS Foundation Trust, London, UK
| | - A Macchi
- ENT Clinic, University of Insubria, ASST Sette Laghi, Varese, Italy
| | - P P Mazal
- Servicio de Otorrinolaringología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - I Miri
- Service Médecine Physique Réadaptation fonctionnelle, Institut Mohamed Kassab d'Orthopédie, Mannouba, Tunisia
| | - T Miwa
- Department of Otorhinolaryngology, Kanazawa Medical University, Uchinada, Kahoku, Ishikawa, Japan
| | - E Mori
- Department of Otorhinolaryngology, Jikei University, School of Medicine, Tokyo, Japan
| | - J Mullol
- Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic, Universitat de Barcelona
- IDIBAPS
- CIBERES. Barcelona, Catalonia, Spain
| | - C A Mueller
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
| | - G Ottaviano
- Department of Neurosciences DNS, Otolaryngology Section, University, Padua, Italy
| | - Z M Patel
- Department of Otolaryngology, Stanford University School of Medicine, Stanford, California, USA
| | - C Philpott
- Norwich Medical School, University of East Anglia, Norwich, UK
- and The Smell and Taste Clinic, James Paget University Hospital, Gorleston, UK
| | - J M Pinto
- Section of Otolaryngology-Head and Neck Surgery, The University of Chicago Medicine and Biological Sciences, Chicago, IL, USA
| | - V R Ramakrishnan
- Department of Otolaryngology-Head and Neck Surgery, Indiana University of School Medicine, Indianapolis, IN, USA
| | - Y Roth
- The Institute for Nose and Sinus Therapy and Clinical Investigations, Department of Otolaryngology - Head and Neck Surgery, Edith Wolfson Medical Center, Tel Aviv University Sackler Faculty of Medicine, Holon, Israel
| | - R J Schlosser
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - P Stjärne
- Section of Rhinology, Department of Otorhinolaryngology, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden
| | - L Van Gerven
- Department of Otorhinolaryngology, UZ Leuven, Belgium
- and Department of Neurosciences, Experimental Otorhinolaryngology, KU Leuven, Belgium
- and Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Unit, KU Leuven, Belgium
| | - J Vodicka
- Department of Otorhinolaryngology and Head and Neck Surgery, Hospital Pardubice, Faculty of Health Studies, University of Pardubice, Pardubice, Czech Republic
| | - A Welge-Luessen
- University Hospital Basel - Otorhinolaryngology, Basel, Switzerland
| | - P J Wormald
- Department of Surgery-Otorhinolaryngology Head and Neck Surgery, University of Adelaide, Adelaide, SA, Australia
| | - T Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
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Kim JK, Tam M, Karp JM, Oh C, Kim G, Solomon E, Concert CM, Vaezi AE, Li Z, Tran T, Zan E, Corby P, Feron-Rigodon M, Del Vecchio Fitz C, Goldberg JD, Hochman T, Givi B, Jacobson A, Persky M, Hu KS. A Phase II Trial Evaluating Rapid Mid-Treatment Nodal Shrinkage to Select for Adaptive Deescalation in p16+ Oropharyngeal Cancer Patients Undergoing Definitive Chemoradiation. Int J Radiat Oncol Biol Phys 2023; 117:S68-S69. [PMID: 37784553 DOI: 10.1016/j.ijrobp.2023.06.374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The purpose of this study is to determine if rapid mid-treatment nodal shrinkage (RMNS) can identify patients with p16+ oropharyngeal cancer (OPC) who can be safely deescalated with reduced dose chemoradiation therapy (CRT). The primary endpoint was 2-year progression free survival (PFS). MATERIALS/METHODS Inclusion criteria were as follows: T1-3, N1, M0 (AJCC 8th edition) p16+ OPC with <10 pack-year smoking history. All patients were initially planned for standard dose CRT (70 Gy) and weekly cisplatin. Patients were evaluated with a CT scan at week 4 for RMNS, defined as >40% nodal volumetric reduction from baseline. If RMNS was achieved, they proceeded to deescalated CRT (60 Gy). If not, they received standard CRT. Biomarker correlates were collected at baseline and week 4 of CRT including plasma TTMV (tumor tissue modified viral) HPV DNA and MRI diffusion weighted imaging (DWI). Univariate logistic regression analyses (UVA) were performed to evaluate predictors of RMNS. Odds ratios with 95% CI are reported, using a p<0.05 for statistical significance with a two-sided test. Wilcoxon rank sum tests were used to evaluate differences between the two groups using p < 0.05, 2-sided) for statistical significance. All statistical procedures were performed using R () with no adjustments for multiple testing. RESULTS Thirty-six patients were enrolled: median age: 60 years; 81% male; primary site: 36% base of tongue, 53% tonsil, 11% both; T-stage: 39% T1, 50% T2, 11% T3; N-stage: 100% N1; any smoking history: 58% yes, 42% no; 67% (n = 24) had RMNS and received deescalated CRT while the remaining proceeded to standard CRT. At a median follow-up of 32.4 months, 2-year PFS between the standard and deescalated groups were 91.7% vs 90.9%, respectively (p = 0.97). All patients with recurrence underwent successful salvage treatment with 2-year OS 100% for all patients. On UVA, rapid TTMV HPV DNA clearance (baseline to week 4) (OR 12.0 [1.65-250], p = 0.034), lower MRI diffusivity (ADC) at baseline (OR 0.79 [0.61-0.97], p = 0.042) and week 4 (OR 0.76 [0.60-0.91], p = 0.009), and higher MRI diffusional kurtosis at baseline (OR 1.09 [1.01-1.21], p = 0.051) and week 4 (OR 1.24 [1.09-1.52], p = 0.009) were significantly associated with RMNS. When comparing the deescalated and standard cohorts, the mean baseline and week 4 MRI ADC were significantly lower and week 4 MRI diffusional kurtosis was significantly higher in the deescalated group. CONCLUSION In this phase II study, rapid mid-treatment nodal shrinkage appeared to select favorable risk p16+ oropharynx cancer patients for treatment de-escalation. Rapid clearance of TTMV HPV DNA at week 4 as well as MRI DWI biomarkers of low ADC and high diffusional kurtosis values were correlated with RMNS. A larger study is planned to incorporate RMNS and biomarkers for further treatment de-escalation. Additional trial information is available at ClinicalTrials.gov (Identifier: NCT03215719).
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Affiliation(s)
- J K Kim
- Department of Radiation Oncology, NYU Langone Health, New York, NY
| | - M Tam
- Department of Radiation Oncology, NYU Langone Health, New York, NY
| | - J M Karp
- NYU Grossman School of Medicine, Department of Radiation Oncology, New York City, NY
| | - C Oh
- Biostatistics, Department of Population Health, NYU Langone Health, New York, NY
| | - G Kim
- NYU Langone Health, New York, NY
| | - E Solomon
- Weill Cornell Medicine, Cornell University, New York, NY
| | - C M Concert
- Department of Radiation Oncology, NYU Langone Health, New York, NY
| | - A E Vaezi
- Perlmutter Cancer Center NYU Langone Long Island, Mineola, NY
| | - Z Li
- Department of Medical Oncology, NYU Langone Health, New York, NY
| | - T Tran
- Department of Otolaryngology, NYU Langone Health, New York, NY
| | - E Zan
- NYU School of Medicine and Langone Medical Center, New York, NY, United States
| | - P Corby
- University of Pennsylvania, School of Dental Medicine, Philadelphia, PA
| | | | | | - J D Goldberg
- New York University School of Medicine, New York, NY
| | - T Hochman
- NYU Langone Medical Center, New York, NY
| | - B Givi
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - A Jacobson
- Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, NY
| | - M Persky
- Department of Otolaryngology, NYU Langone Health, New York, NY
| | - K S Hu
- NYU Langone Medical Center, New York, NY
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Kim MG, Jue M, Lee KH, Lee EY, Roh Y, Lee M, Lee HJ, Lee S, Liu H, Koo B, Jang YO, Kim EY, Zhen Q, Kim SH, Kim JK, Shin Y. Deep Learning Assisted Surface-Enhanced Raman Spectroscopy (SERS) for Rapid and Direct Nucleic Acid Amplification and Detection: Toward Enhanced Molecular Diagnostics. ACS Nano 2023; 17:18332-18345. [PMID: 37703463 DOI: 10.1021/acsnano.3c05633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
Surface-enhanced Raman scattering (SERS) has evolved into a robust analytical technique capable of detecting a variety of biomolecules despite challenges in securing a reliable Raman signal. Conventional SERS-based nucleic acid detection relies on hybridization assays, but reproducibility and signal strength issues have hindered research on directly amplifying nucleic acids on SERS surfaces. This study introduces a deep learning assisted ZnO-Au-SERS-based direct amplification (ZADA) system for rapid, sensitive molecular diagnostics. The system employs a SERS substrate fabricated by depositing gold on uniformly grown ZnO nanorods. These nanorods create hot spots for the amplification of the target nucleic acids directly on the SERS surface, eliminating the need for postamplification hybridization and Raman reporters. The limit of detection of the ZADA system was superior to those of the conventional amplification methods. Clinical validation of the ZADA system with coronavirus disease 2019 (COVID-19) samples from human patients yielded a sensitivity and specificity of 92.31% and 81.25%, respectively. The integration of a deep learning program further enhanced sensitivity and specificity to 100% and reduced SERS analysis time, showcasing the potential of the ZADA system for rapid, label-free disease diagnosis via direct nucleic acid amplification and detection within 20 min.
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Affiliation(s)
- Myoung Gyu Kim
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, 50 Yonsei Ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Miyeon Jue
- Biomedical Engineering Research Center, Asan Medical Center, Seoul 05505, Republic of Korea
- Apollon, Inc., 68 Achasan-ro, Seongdong-gu, Seoul 05505, Republic of Korea
| | - Kwan Hee Lee
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Eun Yeong Lee
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, 50 Yonsei Ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Yeonjeong Roh
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, 50 Yonsei Ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Minju Lee
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, 50 Yonsei Ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Hyo Joo Lee
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, 50 Yonsei Ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Sanghwa Lee
- Biomedical Engineering Research Center, Asan Medical Center, Seoul 05505, Republic of Korea
| | - Huifang Liu
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, 50 Yonsei Ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Bonhan Koo
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, 50 Yonsei Ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Yoon Ok Jang
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, 50 Yonsei Ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Eui Yeon Kim
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, 50 Yonsei Ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Qiao Zhen
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, 50 Yonsei Ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Jun Ki Kim
- Biomedical Engineering Research Center, Asan Medical Center, Seoul 05505, Republic of Korea
- Department of Biomedical Engineering, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Yong Shin
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, 50 Yonsei Ro, Seodaemun-gu, Seoul 03722, Republic of Korea
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Cho MJ, Kim CE, Shin YH, Kim JK, Pack CG. Influence of Chemical and Genetic Manipulations on Cellular Organelles Quantified by Label-Free Optical Diffraction Tomography. Anal Chem 2023; 95:13478-13487. [PMID: 37523497 DOI: 10.1021/acs.analchem.3c01349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
Label-free optical diffraction tomography provides three-dimensional imaging of cells and organelles, along with their refractive index (RI) and volume. These physical parameters are valuable for quantitative and accurate analysis of the subcellular microenvironment and its connections to intracellular biological properties. In biological and biochemical cell analysis, various invasive cell manipulations are used, such as temperature change, chemical fixation, live cell staining with fluorescent dye, and gene overexpression of exogenous proteins. However, it is not fully understood how these various manipulations affect the physicochemical properties of different organelles. In this study, we investigated the impact of these manipulations on the cellular properties of single HeLa cells. We found that after cell fixation and an increase in temperature, the RI value of organelles, such as the nucleus and cytoplasm, significantly decreased overall. Interestingly, unlike the cell nuclei, cytoplasmic RI values were hardly detected after membrane permeation, indicating that only intracytoplasmic components were largely lost. Additionally, our findings revealed that the expression of GFP and GFP-tagged proteins significantly increased the RI values of organelles in living cells compared to the less effective RI changes observed with chemical fluorescence staining for cell organelles. The result demonstrates that distinct types of invasive manipulations can alter the microenvironment of organelles in different ways. Our study sheds new light on how chemical and genetic manipulations affect organelles.
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Affiliation(s)
- Min Ju Cho
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Chae-Eun Kim
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Yeon Hui Shin
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Jun Ki Kim
- Asan Institute for Life Sciences, Asan Medical Center, Seoul 05505, Republic of Korea
- Department of Biomedical Engineering, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Chan-Gi Pack
- Asan Institute for Life Sciences, Asan Medical Center, Seoul 05505, Republic of Korea
- Department of Biomedical Engineering, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
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Hyun J, Lee PH, Lee J, Yang Y, Kim JH, Kim TO, Kang SJ, Kim JK, Lee JS, Lee SW. Ten-year prognostic value of coronary CT angiography in asymptomatic patients with type 2 diabetes. Rev Esp Cardiol (Engl Ed) 2023; 76:700-707. [PMID: 36716990 DOI: 10.1016/j.rec.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 01/04/2023] [Indexed: 01/30/2023]
Abstract
INTRODUCTION AND OBJECTIVES The United Kingdom Prospective Diabetes Study (UKPDS) risk score has limited value for predicting coronary artery disease (CAD) events. We investigated the additive value of coronary computed tomography angiography (CCTA) on top of the UKPDS risk score in predicting 10-year adverse cardiac events in asymptomatic patients with type 2 diabetes. METHODS We evaluated 589 asymptomatic diabetic patients without a history of CAD who underwent CCTA. The primary outcome was a composite of cardiac death, nonfatal myocardial infarction, unstable angina requiring hospitalization, and revascularization. We estimated the discrimination and reclassification ability for the prediction models, which included combinations of the UKPDS category, severity of stenosis, and coronary artery calcium score by CCTA. RESULTS The incidence of the primary outcome was 12.4%. During 10 years of follow-up, patients without plaque by CCTA tended to have a low CAD event rate, while those with obstructive CAD tended to have a high event rate, irrespective of the baseline UKPDS risk category. The model that included only the UKPDS category had a Harrell's c-index of 0.658; adding the degree of stenosis to the model significantly increased the c-index by 0.066 (P=.004), while adding coronary artery calcium score increased the c-index by only 0.039 (P=.056). Overall, CCTA information in addition to the UKPDS risk category improved the reclassification rate for predicting the primary outcome. CONCLUSIONS In asymptomatic patients with type 2 diabetes, CCTA information for CAD provided significant incremental discriminatory power beyond the UKPDS risk score category for predicting 10-year adverse coronary events.
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Affiliation(s)
- Junho Hyun
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. https://twitter.com/@jhhyun0609
| | - Pil Hyung Lee
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | - Junghoon Lee
- Department of Internal Medicine, Division of Cardiology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yujin Yang
- Department of Cardiology, Daejeon Veterans Hospital, Daejeon, Korea
| | - Ju Hyeon Kim
- Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Korea University College of Medicine, Korea
| | - Tae Oh Kim
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Soo-Jin Kang
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jun Ki Kim
- Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Sung Lee
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seung-Whan Lee
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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8
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Ghasemi M, Oh J, Jeong S, Lee M, Bohlooli Darian S, Oh K, Kim JK. Fabry-Perot Interferometric Fiber-Optic Sensor for Rapid and Accurate Thrombus Detection. Biosensors (Basel) 2023; 13:817. [PMID: 37622903 PMCID: PMC10452065 DOI: 10.3390/bios13080817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 07/28/2023] [Accepted: 08/14/2023] [Indexed: 08/26/2023]
Abstract
We present a fiber-optic sensor based on the principles of a Fabry-Perot interferometer (FPI), which promptly, sensitively, and precisely detects blood clot formation. This sensor has two types of sensor tips; the first was crafted by splicing a tapered fiber into a single-mode fiber (SMF), where fine-tuning was achieved by adjusting the tapered diameter and length. The second type is an ultra-compact blood FPI situated on the core of a single-mode fiber. The sensor performance was evaluated via clot-formation-indicating spectrum shifts induced by the varied quantities of a thrombin reagent introduced into the blood. The most remarkable spectral sensitivity of the micro-tip fiber type was approximately 7 nm/μL, with a power sensitivity of 4.1 dB/μL, obtained with a taper fiber diameter and length of 55 and 300 μm, respectively. For the SMF type, spectral sensitivity was observed to be 8.7 nm/μL, with an optical power sensitivity of 0.4 dB/μL. This pioneering fiber-optic thrombosis sensor has the potential for in situ applications, healthcare, medical monitoring, harsh environments, and chemical and biological sensing. The study underscores the scope of optical technology in thrombus detection, establishing a platform for future medical research and application.
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Affiliation(s)
- Marjan Ghasemi
- Department of Physics, Yonsei University, Seoul 03722, Republic of Korea; (M.G.); (S.J.); (M.L.)
| | - Jeongmin Oh
- Department of Biomedical Engineering, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea; (J.O.); (S.B.D.)
| | - Sunghoon Jeong
- Department of Physics, Yonsei University, Seoul 03722, Republic of Korea; (M.G.); (S.J.); (M.L.)
| | - Mingyu Lee
- Department of Physics, Yonsei University, Seoul 03722, Republic of Korea; (M.G.); (S.J.); (M.L.)
| | - Saeed Bohlooli Darian
- Department of Biomedical Engineering, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea; (J.O.); (S.B.D.)
| | - Kyunghwan Oh
- Department of Physics, Yonsei University, Seoul 03722, Republic of Korea; (M.G.); (S.J.); (M.L.)
| | - Jun Ki Kim
- Department of Biomedical Engineering, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea; (J.O.); (S.B.D.)
- Biomedical Engineering Research Center, Asan Institute for Life Science, Asan Medical Center, Seoul 05505, Republic of Korea
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9
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Kim Y, Choi WJ, Oh J, Lee K, Kim JK. Smartphone-Based Rigid Endoscopy Device with Hemodynamic Response Imaging and Laser Speckle Contrast Imaging. Biosensors (Basel) 2023; 13:816. [PMID: 37622902 PMCID: PMC10452712 DOI: 10.3390/bios13080816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/11/2023] [Accepted: 08/13/2023] [Indexed: 08/26/2023]
Abstract
Modern smartphones have been employed as key elements in point-of-care (POC) devices due to remarkable advances in their form factor, computing, and display performances. Recently, we reported a combination of the smartphone with a handheld endoscope using laser speckle contrast imaging (LSCI), suggesting potential for functional POC endoscopy. Here, we extended our work to develop a smartphone-combined multifunctional handheld endoscope using dual-wavelength LSCI. Dual-wavelength LSCI is used to monitor the changes in dynamic blood flow as well as changes in the concentration of oxygenated (HbO2), deoxygenated (Hbr), and total hemoglobin (HbT). The smartphone in the device performs fast acquisition and computation of the raw LSCI data to map the blood perfusion parameters. The flow imaging performance of the proposed device was tested with a tissue-like flow phantom, exhibiting a speckle flow index map representing the blood perfusion. Furthermore, the device was employed to assess the blood perfusion status from an exteriorized intestine model of rat in vivo during and after local ischemia, showing that blood flow and HbO2 gradually decreased in the ischemic region whereas hyperemia and excess increases in HbO2 were observed in the same region right after reperfusion. The results indicate that the combination of LSCI with smartphone endoscopy delivers a valuable platform for better understanding of the functional hemodynamic changes in the vasculatures of the internal organs, which may benefit POC testing for diagnosis and treatment of vascular diseases.
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Affiliation(s)
- Youngkyu Kim
- Biomedical Engineering Research Center, Asan Medical Center, Seoul 05505, Republic of Korea;
| | - Woo June Choi
- School of Electrical and Electronics Engineering, Chung-Ang University, Seoul 06974, Republic of Korea;
| | - Jeongmin Oh
- Department of Biomedical Engineering, College of Medicine, University of Ulsan, Seoul 05505, Republic of Korea; (J.O.); (K.L.)
| | - Kwanhee Lee
- Department of Biomedical Engineering, College of Medicine, University of Ulsan, Seoul 05505, Republic of Korea; (J.O.); (K.L.)
| | - Jun Ki Kim
- Biomedical Engineering Research Center, Asan Medical Center, Seoul 05505, Republic of Korea;
- Department of Biomedical Engineering, College of Medicine, University of Ulsan, Seoul 05505, Republic of Korea; (J.O.); (K.L.)
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10
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Lee S, Jue M, Cho M, Lee K, Paulson B, Jo H, Song JS, Kang S, Kim JK. Label-free atherosclerosis diagnosis through a blood drop of apolipoprotein E knockout mouse model using surface-enhanced Raman spectroscopy validated by machine learning algorithm. Bioeng Transl Med 2023; 8:e10529. [PMID: 37476064 PMCID: PMC10354754 DOI: 10.1002/btm2.10529] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/28/2023] [Accepted: 04/12/2023] [Indexed: 07/22/2023] Open
Abstract
The direct preventative detection of flow-induced atherosclerosis remains a significant challenge, impeding the development of early treatments and prevention measures. This study proposes a method for diagnosing atherosclerosis in the carotid artery using nanometer biomarker measurements through surface-enhanced Raman spectroscopy (SERS) from single-drop blood samples. Atherosclerotic acceleration is induced in apolipoprotein E knockout mice which underwent a partial carotid ligation and were fed a high-fat diet to rapidly induce disturbed flow-induced atherosclerosis in the left common carotid artery while using the unligated, contralateral right carotid artery as control. The progressive atherosclerosis development of the left carotid artery was verified by micro-magnetic resonance imaging (micro-MRI) and histology in comparison to the right carotid artery. Single-drop blood samples are deposited on chips of gold-coated ZnO nanorods grown on silicon wafers that filter the nanometer markers and provide strong SERS signals. A diagnostic classifier was established based on principal component analysis (PCA), which separates the resultant spectra into the atherosclerotic and control groups. Scoring based on the principal components enabled the classification of samples into control, mild, and severe atherosclerotic disease. The PCA-based analysis was validated against an independent test sample and compared against the PCA-PLS-DA machine learning algorithm which is known for applicability to Raman diagnosis. The accuracy of the PCA modification-based diagnostic criteria was 94.5%, and that of the machine learning algorithm 97.5%. Using a mouse model, this study demonstrates that diagnosing and classifying the severity of atherosclerosis is possible using a single blood drop, SERS technology, and machine learning algorithm, indicating the detectability of biomarkers and vascular factors in the blood which correlate with the early stages of atherosclerosis development.
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Affiliation(s)
- Sanghwa Lee
- Biomedical Engineering Research CenterAsan Medical CenterSeoulRepublic of Korea
| | - Miyeon Jue
- Biomedical Engineering Research CenterAsan Medical CenterSeoulRepublic of Korea
| | - Minju Cho
- Biomedical Engineering Research CenterAsan Medical CenterSeoulRepublic of Korea
| | - Kwanhee Lee
- Biomedical Engineering Research CenterAsan Medical CenterSeoulRepublic of Korea
| | - Bjorn Paulson
- Biomedical Engineering Research CenterAsan Medical CenterSeoulRepublic of Korea
| | - Hanjoong Jo
- Wallace H. Coulter Department of Biomedical EngineeringEmory University and Georgia Institute of TechnologyAtlantaGeorgiaUSA
| | - Joon Seon Song
- Department of PathologyUniversity of Ulsan College of Medicine, Asan Medical CenterSeoulRepublic of Korea
| | - Soo‐Jin Kang
- Department of CardiologyUniversity of Ulsan College of Medicine, Asan Medical CenterSeoulRepublic of Korea
| | - Jun Ki Kim
- Biomedical Engineering Research CenterAsan Medical CenterSeoulRepublic of Korea
- Department of Biomedical EngineeringUniversity of Ulsan, College of MedicineSeoulRepublic of Korea
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11
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Hyun J, Lee PH, Lee J, Yang Y, Kim JH, Kim TO, Kang SJ, Kim JK, Lee JS, Lee SW. Ten-year prognostic value of coronary CT angiography in asymptomatic patients with type 2 diabetes. Rev Esp Cardiol 2023. [DOI: 10.1016/j.recesp.2023.01.001] [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: 03/31/2023]
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12
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Kim JK, Loo C, Kim JS, Pranskevich C, Gordon OK. Can Acupuncture be a Part of the Treatment for Breast Cancer-Related Lymphedema? A Systematic Review of the Safety and Proposed Model for Care. Lymphology 2023; 56:27-39. [PMID: 38019877] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Acupuncture is a potential therapy for breast cancer-related lymphedema (BCRL). Despite a recent meta-analysis on efficacy, data on acupuncture safety in BCRL are lacking. Current clinical guidelines recommend avoiding needling in the upper extremity affected by lymph node dissection. We undertook a systematic review focusing on acupuncture safety and treatment protocols in clinical trials for BCRL. Literature searches were conducted in PubMed, Ovid, CINAHL, and Cochrane library. Eight clinical trials on acupuncture for BCRL were analyzed. The Standards of Acupuncture intervention (STRICTA 2010) and Cochrane risk of bias (RoB2 2019) were applied to assess methods for acupuncture interventions within Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. Quantity and severity of adverse events (AE) were reviewed. A total of 189 subjects participated in 8 clinical trials with 2965 acupuncture treatments. No serious adverse events (SAE) were reported regardless of treatment laterality or protocol, with only a single grade 2 skin infection in 2,965 total treatments (0.034%), including 1,165 bilateral and 225 ipsilateral treatments. Our comprehensive review of clinical trials of acupuncture for BCRL demonstrated no significant adverse events in 2,965 treatments, including 1,390 in the affected limb. An approach for routine integration of acupuncture into BCRL maintenance therapy is proposed.
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Affiliation(s)
- J K Kim
- Disney Family Cancer Center, Providence St Joseph Medical Center, Burbank, CA, USA
- Emperors College Traditional Oriental Medicine, Santa Monica, CA, USA
| | - C Loo
- Licensed Acupuncturist, Los Angeles, CA, USA
| | - J S Kim
- Undergraduate, Cornell University, Ithaca, NY, USA
| | - C Pranskevich
- Disney Family Cancer Center, Providence St Joseph Medical Center, Burbank, CA, USA
| | - O K Gordon
- Disney Family Cancer Center, Providence St Joseph Medical Center, Burbank, CA, USA
- St John Cancer Institute and UCLA Geffen School of Medicine, Los Angeles, California, USA
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13
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Paulson B, Darian SB, Kim Y, Oh J, Ghasemi M, Lee K, Kim JK. Spectral Multiplexing of Fluorescent Endoscopy for Simultaneous Imaging with Multiple Fluorophores and Multiple Fields of View. Biosensors (Basel) 2022; 13:33. [PMID: 36671868 PMCID: PMC9855833 DOI: 10.3390/bios13010033] [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] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 12/22/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
Complex clinical procedures and small-animal research procedures can benefit from dual-site imaging provided by multiple endoscopic devices. Here, an endoscopic system is proposed which enables multiple fluorescence microendoscopes to be spectrally multiplexed on a single microscope base, enabling light sources and optical relays to be shared between endoscopes. The presented system is characterized for resolution using USAF-1951 resolution test charts and for modulation transfer function using the slanted edge method. Imaging is demonstrated both directly and with microendoscopes attached. Imaging of phantoms was demonstrated by targeting USAF charts and fiber tissues dyed for FITC and Texas Red fluorescence. Afterwards, simultaneous liver and kidney imaging was demonstrated in mice expressing mitochondrial Dendra2 and injected with Texas Red-dextran. The results indicate that the system achieves high channel isolation and submicron and subcellular resolution, with resolution limited by the endoscopic probe and by physiological movement during endoscopic imaging. Multi-channel microendoscopy provides a potentially low-cost means of simultaneous multiple endoscopic imaging during biological experiments, resulting in reduced animal harm and potentially increasing insight into temporal connections between connected biological systems.
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Affiliation(s)
- Bjorn Paulson
- Biomedical Engineering Research Center, Asan Institute for Life Science, Asan Medical Center, Seoul 05505, Republic of Korea
| | - Saeed Bohlooli Darian
- Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Youngkyu Kim
- Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Jeongmin Oh
- Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Marjan Ghasemi
- Department of Physics, Yonsei University, Seoul 03722, Republic of Korea
| | - Kwanhee Lee
- Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Jun Ki Kim
- Biomedical Engineering Research Center, Asan Institute for Life Science, Asan Medical Center, Seoul 05505, Republic of Korea
- Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
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14
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Lee S, Oh J, Lee K, Cho M, Paulson B, Kim JK. Diagnosis of Ischemic Renal Failure Using Surface-Enhanced Raman Spectroscopy and a Machine Learning Algorithm. Anal Chem 2022; 94:17477-17484. [PMID: 36480771 DOI: 10.1021/acs.analchem.2c03634] [Citation(s) in RCA: 3] [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: 12/13/2022]
Abstract
To diagnose renal function using a biochip capable of detecting SERS and to assess Raman measurements taken from a bilateral renal ischemia model and the feasibility of early diagnosis was done. After generating a bilateral renal ischemia rat model, blood and urine were collected. After confirming the presence of renal injury and function, liquid drops were placed onto a Raman chip whose surface had been enhanced with Au-ZnO nanorods. SERS biomarkers that diffused into the nanogaps were selectively amplified. Raman signals varied based on the severity of the renal function, and these differences were confirmed statistically. These results confirm that renal ischemia leads to renal dysfunction and that surface-enhanced Raman spectroscopy and a machine learning algorithm can be used to track signals in the urine from the release of SERS biomarkers.
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Affiliation(s)
- Sanghwa Lee
- Biomedical Engineering Research Center, Asan Medical Center, Seoul 05505, Republic of Korea
| | - Jeongmin Oh
- Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Kwanhee Lee
- Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Minju Cho
- Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Bjorn Paulson
- Biomedical Engineering Research Center, Asan Medical Center, Seoul 05505, Republic of Korea
| | - Jun Ki Kim
- Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
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15
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Choi WJ, Li Y, Wang RK, Kim JK. Automated counting of cerebral penetrating vessels using optical coherence tomography images of a mouse brain in vivo. Med Phys 2022; 49:5225-5235. [PMID: 35616390 DOI: 10.1002/mp.15775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 05/17/2022] [Accepted: 05/17/2022] [Indexed: 11/08/2022] Open
Abstract
RATIONALE AND OBJECTIVES Penetrating blood vessels emanating from cortical surface vasculature and lying deep in the cortex are essential vascular conduits for the shuttling of blood from superficial pial vessels to the capillary beds in parenchyma for the nourishment of neuronal brain tissues. Locating and counting the penetrating vessels is beneficial for the quantification of a course of ischemia in blood occlusive events such as stroke. This paper seeks to demonstrate and validate a method for automated penetrating vessel counting that uses optical coherence tomography (OCT). MATERIALS AND METHODS This paper proposes an OCT method that effectively identifies and grades the cortical penetrating vessels in perfusion. The key to the proposed method is the harnessing of vascular features found in the penetrating vessels, which are distinctive from those of other vessels. In particular, with an increase in the light attenuation and flow turbulence, the contrast in the mean projection of the OCT datacube decreases, whereas that in the maximum projection of the Doppler frequency variance datacube increases. By multiplying the inversion of the former with the latter, its binary thresholding is sufficient to highlight the penetrating vessels and allows for their counting over the projection image. RESULTS A computational method that leverages the decrease in mean OCT projection intensity and the increase in Doppler frequency variance at the penetrating vessel is developed. It successfully identifies and counts penetrating vessels with a high accuracy of over 87%. The penetrating vessel density is observed to be significantly reduced in the mouse model of focal ischemic stroke. CONCLUSION The OCT analysis is effective for counting penetrating blood vessels in mice brains and may be applied to the rapid diagnosis and treatment of stroke in stroke models of small animals. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Woo June Choi
- School of Electrical and Electronics Engineering, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, Korea
| | - Yuandong Li
- Department of Bioengineering, University of Washington, Seattle, WA, 98195, USA
| | - Ruikang K Wang
- Department of Bioengineering, University of Washington, Seattle, WA, 98195, USA
| | - Jun Ki Kim
- Department of Convergence Medicine, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Seoul, 05505, Korea.,Asan Institute for Life Science, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea
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Kim Y, Cho M, Paulson B, Kim SH, Kim JK. Minimizing Motion Artifacts in Intravital Microscopy Using the Sedative Effect of Dexmedetomidine. Microsc Microanal 2022; 28:1-8. [PMID: 35599594 DOI: 10.1017/s1431927622000708] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Among intravital imaging instruments, the intravital two-photon fluorescence excitation microscope has the advantage of enabling real-time 3D fluorescence imaging deep into cells and tissues, with reduced photobleaching and photodamage compared with conventional intravital confocal microscopes. However, excessive motion of organs due to involuntary movement such as breathing may result in out-of-focus images and severe fluorescence intensity fluctuations, which hinder meaningful imaging and analysis. The clinically approved alpha-2 adrenergic receptor agonist dexmedetomidine was administered to mice during two-photon fluorescence intravital imaging to alleviate this problem. As dexmedetomidine blocks the release of the neurotransmitter norepinephrine, pain is suppressed, blood pressure is reduced, and a sedation effect is observed. By tracking the quality of focus and stability of detected fluorescence in two-photon fluorescence images of fluorescein isothiocyanate-sensitized liver vasculature in vivo, we demonstrated that intravascular dexmedetomidine can reduce fluorescence fluctuations caused by respiration on a timescale of minutes in mice, improving image quality and resolution. The results indicate that short-term dexmedetomidine treatment is suitable for reducing involuntary motion in preclinical intravital imaging studies. This method may be applicable to other animal models.
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Affiliation(s)
- Youngkyu Kim
- Biomedical Engineering Research Center, Asan Medical Center, Seoul 05505, Republic of Korea
| | - Minju Cho
- Biomedical Engineering Research Center, Asan Medical Center, Seoul 05505, Republic of Korea
| | - Bjorn Paulson
- Biomedical Engineering Research Center, Asan Medical Center, Seoul 05505, Republic of Korea
| | - Sung-Hoon Kim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-Gil, Songpa-gu, Seoul 05505, Republic of Korea
| | - Jun Ki Kim
- Biomedical Engineering Research Center, Asan Medical Center, Seoul 05505, Republic of Korea
- Department of Convergence Medicine, University of Ulsan, College of Medicine, 88, Olympic-ro 43-Gil, Seoul 05505, Republic of Korea
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Liu H, Zou Q, Kim MG, Qiao Z, Nguyen DTT, Koo B, Lee HJ, Jang YO, Kim JK, Shin Y. Homobifunctional Imidoester Combined Black Phosphorus Nanosheets Used as Cofactors for Nucleic Acid Extraction. BioChip J 2022. [DOI: 10.1007/s13206-022-00046-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Lee S, Tak E, Cho YJ, Kim J, Lee J, Lee R, Lee K, Kwon M, Yoon YI, Lee SG, Namgoong JM, Kim JK. Nano-biomarker-Based Surface-Enhanced Raman Spectroscopy for Selective Diagnosis of Gallbladder and Liver Injury. BioChip J 2022. [DOI: 10.1007/s13206-022-00045-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Choi WJ, Yoon JK, Paulson B, Lee CH, Yim JJ, Kim JI, Kim JK. Image Correlation-Based Method to Assess Ciliary Beat Frequency in Human Airway Organoids. IEEE Trans Med Imaging 2022; 41:374-382. [PMID: 34524956 DOI: 10.1109/tmi.2021.3112992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Ciliary movements within the human airway are essential for maintaining a clean lung environment. Motile cilia have a characteristic ciliary beat frequency (CBF). However, CBF measurement with current video microscopic techniques can be error-prone due to the use of the single-point Fourier transformation, which is often biased for ciliary measurements. Herein, we describe a new video microscopy technique that harnesses a metric of motion-contrast imaging and image correlation for CBF analysis. It can provide objective and selective CBF measurements for individual motile cilia and generate CBF maps for the imaged area. The measurement performance of our methodology was validated with in vitro human airway organoid models that simulated an actual human airway epithelium. The CBF determined for the region of interest (ROI) was equal to that obtained with manual counting. The signal redundancy problem of conventional methods was not observed. Moreover, the obtained CBF measurements were robust to optical focal shifts, and exhibited spatial heterogeneity and temperature dependence. This technique can be used to evaluate ciliary movement in respiratory tracts and determine whether it is non-synchronous or aperiodic in patients. Therefore, our observations suggest that the proposed method can be clinically adapted as a screening tool to diagnose ciliopathies.
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Yu HY, Lee S, Ju H, Kim Y, Shin JH, Yun H, Ryu CM, Heo J, Lim J, Song S, Lee S, Hong KS, Chung HM, Kim JK, Choo MS, Shin DM. Intravital imaging and single cell transcriptomic analysis for engraftment of mesenchymal stem cells in an animal model of interstitial cystitis/bladder pain syndrome. Biomaterials 2021; 280:121277. [PMID: 34861510 DOI: 10.1016/j.biomaterials.2021.121277] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 11/08/2021] [Accepted: 11/23/2021] [Indexed: 11/15/2022]
Abstract
Mesenchymal stem cell (MSC) therapy is a promising treatment for various intractable disorders including interstitial cystitis/bladder pain syndrome (IC/BPS). However, an analysis of fundamental characteristics driving in vivo behaviors of transplanted cells has not been performed, causing debates about rational use and efficacy of MSC therapy. Here, we implemented two-photon intravital imaging and single cell transcriptome analysis to evaluate the in vivo behaviors of engrafted multipotent MSCs (M-MSCs) derived from human embryonic stem cells (hESCs) in an acute IC/BPS animal model. Two-photon imaging analysis was performed to visualize the dynamic association between engrafted M-MSCs and bladder vasculature within live animals until 28 days after transplantation, demonstrating the progressive integration of transplanted M-MSCs into a perivascular-like structure. Single cell transcriptome analysis was performed in highly purified engrafted cells after a dual MACS-FACS sorting procedure and revealed expression changes in various pathways relating to pericyte cell adhesion and cellular stress. Particularly, FOS and cyclin dependent kinase-1 (CDK1) played a key role in modulating the migration, engraftment, and anti-inflammatory functions of M-MSCs, which determined their in vivo therapeutic potency. Collectively, this approach provides an overview of engrafted M-MSC behavior in vivo, which will advance our understanding of MSC therapeutic applications, efficacy, and safety.
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Affiliation(s)
- Hwan Yeul Yu
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; ToolGen Inc., Seoul, South Korea
| | - Seungun Lee
- Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Department of Physiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hyein Ju
- Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Department of Physiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Youngkyu Kim
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, South Korea; Department of Convergence Medicine, University of Ulsan, College of Medicine, Seoul, South Korea
| | - Jung-Hyun Shin
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - HongDuck Yun
- Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Department of Physiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Chae-Min Ryu
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jinbeom Heo
- Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Department of Physiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jisun Lim
- Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Department of Physiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sujin Song
- Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Department of Physiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sanghwa Lee
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, South Korea; Department of Convergence Medicine, University of Ulsan, College of Medicine, Seoul, South Korea
| | - Ki-Sung Hong
- Department of Stem Cell Biology, School of Medicine, Konkuk University, Seoul, South Korea; Mirae Cell Bio Co., Ltd., Seoul, South Korea
| | - Hyung-Min Chung
- Department of Stem Cell Biology, School of Medicine, Konkuk University, Seoul, South Korea; Mirae Cell Bio Co., Ltd., Seoul, South Korea
| | - Jun Ki Kim
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, South Korea; Department of Convergence Medicine, University of Ulsan, College of Medicine, Seoul, South Korea
| | - Myung-Soo Choo
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
| | - Dong-Myung Shin
- Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Department of Physiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
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21
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Kim Y, Kim TK, Shin Y, Tak E, Song GW, Oh YM, Kim JK, Pack CG. Characterizing Organelles in Live Stem Cells Using Label-Free Optical Diffraction Tomography. Mol Cells 2021; 44:851-860. [PMID: 34819398 PMCID: PMC8627838 DOI: 10.14348/molcells.2021.0190] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/27/2021] [Accepted: 09/09/2021] [Indexed: 01/10/2023] Open
Abstract
Label-free optical diffraction tomography (ODT), an imaging technology that does not require fluorescent labeling or other pre-processing, can overcome the limitations of conventional cell imaging technologies, such as fluorescence and electron microscopy. In this study, we used ODT to characterize the cellular organelles of three different stem cells-namely, human liver derived stem cell, human umbilical cord matrix derived mesenchymal stem cell, and human induced pluripotent stem cell-based on their refractive index and volume of organelles. The physical property of each stem cell was compared with that of fibroblast. Based on our findings, the characteristic physical properties of specific stem cells can be quantitatively distinguished based on their refractive index and volume of cellular organelles. Altogether, the method employed herein could aid in the distinction of living stem cells from normal cells without the use of fluorescence or specific biomarkers.
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Affiliation(s)
- Youngkyu Kim
- Asan Institute for Life Sciences, Asan Medical Center, Seoul 05505, Korea
| | - Tae-Keun Kim
- Asan Institute for Life Sciences, Asan Medical Center, Seoul 05505, Korea
| | - Yeonhee Shin
- Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Eunyoung Tak
- Asan Institute for Life Sciences, Asan Medical Center, Seoul 05505, Korea
- Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Gi-Won Song
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Yeon-Mok Oh
- Department of Pulmonary and Critical Care Medicine, Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Jun Ki Kim
- Asan Institute for Life Sciences, Asan Medical Center, Seoul 05505, Korea
- Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Chan-Gi Pack
- Asan Institute for Life Sciences, Asan Medical Center, Seoul 05505, Korea
- Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea
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22
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Chun EJ, Kim JK, Yang SY, Kim SS, Kim CW. Development of a nucleic acid-based lateral flow assay to diagnose ordinary scabies. J Eur Acad Dermatol Venereol 2021; 36:e282-e285. [PMID: 34758167 DOI: 10.1111/jdv.17810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 09/17/2021] [Accepted: 10/27/2021] [Indexed: 11/26/2022]
Affiliation(s)
- E J Chun
- Department of Dermatology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - J K Kim
- Department of Dermatology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - S Y Yang
- Department of Dermatology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - S S Kim
- Department of Dermatology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - C W Kim
- Department of Dermatology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
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23
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Moon Y, Hyun J, Oh J, Lee K, Lee YS, Kim JK. A Wi-Fi-Based Mask-Type Laryngoscope for Telediagnosis During the COVID-19 Pandemic: Instrument Validation Study. J Med Internet Res 2021; 23:e31224. [PMID: 34518154 PMCID: PMC8525626 DOI: 10.2196/31224] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/25/2021] [Accepted: 09/13/2021] [Indexed: 11/17/2022] Open
Abstract
Background Owing to the COVID-19 pandemic, social distancing has become mandatory. Wireless endoscopy in contactless examinations promises to protect health care workers and reduce viral spread. Objective This study aimed to introduce a contactless endoscopic diagnosis system using a wireless endoscope resembling a mask. Methods The Wi-Fi–based contactless mask endoscopy system comprises a disposable endoscope and a controller. First, the effective force applied by the tip during insertion was evaluated in a simple transoral model consisting of a force sensor on a simulated oropharynx wall. Second, the delay in video streaming was evaluated by comparing the frame rate and delays between a movement and its image over direct and Wi-Fi connections. Third, the system was applied to a detailed laryngopharyngeal tract phantom. Results The smartphone-controlled wireless endoscopy system was successfully evaluated. The mean, maximum, and minimum collision forces against the wall of the transoral model were 296 mN (30 gf), 363 mN (37 gf), and 235 mN (24 gf), respectively. The delay resulting from the wireless connection was 0.72 seconds. Using the phantom, an inexperienced user took around 1 minute to orient the endoscope to a desired area via the app. Conclusions Device articulation does not pose a significant risk of laryngopharyngeal wall penetration, and latency does not significantly impede its use. Contactless wireless video streaming was successful within the access point range regardless of the presence of walls. The mask endoscope can be controlled and articulated wirelessly, minimizing contact between patients and device operators. By minimizing contact, the device can protect health care workers from infectious viruses like the coronavirus.
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Affiliation(s)
- Youngjin Moon
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea.,Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jaeho Hyun
- Department of Biomedical Engineering, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jeongmin Oh
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | - Kwanhee Lee
- Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yoon Se Lee
- Department of Otorhinolaryngology - Head and Neck Surgery, Asan Medical Center, Seoul, Republic of Korea
| | - Jun Ki Kim
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea.,Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea
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24
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Kim JK. Prognostic implication of left atrial strain in patients undergoing totally thoracoscopic ablation of atrial fibrillation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is a common form of arrhythmia and associated with poor quality of life. Totally thoracoscopic ablation (TTA) is a novel minimally invasive strategy for symptomatic atrial fibrillation (AF) refractory to other therapy. However, some of patients undergoing TTA are still exposed to a risk of AF recurrence.
Purpose
The aim of this study is to investigate prognostic factors related with AF recurrence after TTA, and to determine the prognostic implication of left atrial (LA) strain in this population.
Methods
This was a prospective observational study. Between February 2012 and March 2015, left atrial appendage (LAA) was harvested from patients who underwent TTA in our Medical Center. Degree of LAA fibrosis was expressed as the percentage of area of positive collagen staining in the total area of the image of specimen. All echocardiographic parameters were measured in preoperative echocardiography. The primary outcome was any recurrence of AF detected in 12- lead electrocardiogram or holter monitoring during 5 years of follow-up.
Results
Out of 150 patients who underwent TTA during the study period, 129 were eligible for analysis with appropriate surgery, LAA specimen, and echocardiographic images. A mean age was 54.4±8.8 years, and 123 patients (95.3%) were male. Twenty four patients (18.6%) had paroxysmal AF and a mean CHA2DS2 VASc score was 1.1±1.2. A median value of peak longitudinal LA strain (reservoir strain) was 15.2% (IQR 12.1–19.2), and the median value of LAA fibrosis was 38.5% (IQR 33.0–44.7). Among clinical and echocardiographic variables, peak longitudinal LA strain (p<0.001) and left ventricular ejection fraction (p=0.044) were significantly associated with degree of LAA fibrosis (Figure). Of 129 patients, 47 (36.4%) experienced recurrent AF during the median 3.9 years of follow-up. In a multivariable Cox regression analysis using clinical, echocardiographic and operative parameters, peak longitudinal LA stain was the only predictor of recurrent AF (adjusted HR 0.89, 95% CI 0.81–0.98, p=0.024; Table).
Conclusions
Peak longitudinal LA strain was associated with LAA fibrosis, and was a significant predictor of recurrent AF after TTA
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J K Kim
- Samsung Medical Center, Seoul, Korea (Republic of)
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25
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Chun EJ, Kim JK, Yang SY, Kim SS, Kim CW. Changes in the incidence of contagious infectious skin diseases after the COVID-19 outbreak. J Eur Acad Dermatol Venereol 2021; 36:e3-e4. [PMID: 34487408 PMCID: PMC8657312 DOI: 10.1111/jdv.17640] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 09/02/2021] [Indexed: 11/26/2022]
Affiliation(s)
- E J Chun
- Department of Dermatology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - J K Kim
- Department of Dermatology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - S Y Yang
- Department of Dermatology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - S S Kim
- Department of Dermatology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - C W Kim
- Department of Dermatology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
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26
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Hong SN, Kim JK, Kim JA, Cha H, Kim JY, Lim HS, Eun KM, Kim DW. Viral stimulation modulates endotype-related ACE2 expression in eosinophilic chronic rhinosinusitis. Rhinology 2021; 59:460-469. [PMID: 34282808 DOI: 10.4193/rhin21.001] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Angiotensin-converting enzyme 2 (ACE2), a receptor targeted by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is highly expressed in the nasal mucosa. Chronic rhinosinusitis (CRS) shows diverse endotypes and is aggravated by viral infection. Whether viral stimulation and CRS endotype influence ACE2 expression remains unclear. We investigated the expression of ACE2 and the transmembrane protease, serine 2 (TMPRSS2), which mediate the entry of SARS-CoV-2 into cells, and assessed polyinosinic:polycytidylic acid (poly[I:C])-induced changes based on CRS endotype. METHODOLOGY ACE2 and TMPRSS2 expression was evaluated based on CRS phenotype, endotype, and tissue type. Correlations between ACE2/TMPRSS2 expression and inflammatory mediators in nasal polyps (NP) were examined. Air-liquid interface culture experiments were performed to assess the effects of major cytokines or poly(I:C) stimulation on ACE2/TMPRSS2 expression in primary epithelial cells from healthy nasal mucosa, eosinophilic NP (ENP), and non-eosinophilic NP (NENP). RESULTS In primary nasal epithelial cells, interleukin (IL)-13 decreased ACE2 expression but increased TMPRSS2. Eosinophilic CRS showed lower ACE2 expression than non-eosinophilic CRS, regardless of CRS phenotype. CRS endotype was an independent factor associated with ACE2/TMPRSS2 expression in NP. Serum and tissue eosinophilic marker levels were inversely correlated with ACE2 expression, whereas tissue neutrophilic marker levels and ACE2 expression were positively correlated in NP. ACE2 expression was suppressed in ENP tissues; however, a combination of poly(I:C) and IL-13 induced ACE2/TMPRSS2 upregulation in ENP. CONCLUSIONS ENP tissues have lower ACE2 expression than NENP; however, viral stimulation promotes ACE2/TMPRSS2 upregulation in ENP.
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Affiliation(s)
- S-N Hong
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Republic of Korea.,Sensory Organ Research Institute, Seoul National University Medical Research Center
| | - J K Kim
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Republic of Korea.,Sensory Organ Research Institute, Seoul National University Medical Research Center
| | - J-A Kim
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Republic of Korea.,Sensory Organ Research Institute, Seoul National University Medical Research Center
| | - H Cha
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Republic of Korea.,Sensory Organ Research Institute, Seoul National University Medical Research Center
| | - J Y Kim
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Republic of Korea.,Sensory Organ Research Institute, Seoul National University Medical Research Center
| | - H-S Lim
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Republic of Korea.,Sensory Organ Research Institute, Seoul National University Medical Research Center
| | - K M Eun
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Republic of Korea.,Sensory Organ Research Institute, Seoul National University Medical Research Center
| | - D W Kim
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Republic of Korea.,Sensory Organ Research Institute, Seoul National University Medical Research Center
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27
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Lee S, Namgoong JM, Kim Y, Cha J, Kim JK. Multimodal imaging of laser speckle contrast imaging combined with mosaic filter-based hyperspectral imaging for precise surgical guidance. IEEE Trans Biomed Eng 2021; 69:443-452. [PMID: 34260344 DOI: 10.1109/tbme.2021.3097122] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To enable a real-time surgical guidance system that simultaneously monitors blood vessel perfusion, oxygen saturation, thrombosis, and tissue recovery by combining multiple optical imaging techniques into a single system: visible imaging, mosaic filter-based snapshot hyperspectral imaging (HSI), and laser speckle contrast imaging (LSCI). METHODS The multimodal optical imaging system was demonstrated by clamping blood vessels in the small intestines of rats to create areas of restricted blood flow. Subsequent tissue damage and regeneration were monitored during procedures. Using LSCI, vessel perfusion was measured, revealing the biological activity and survival of organ tissues. Blood oxygen saturation was monitored using HSI in the near-infrared region. Principal component analysis was used over the spectral dimension to identify an HSI wavelength combination optimized for hemodynamic biomarker visualization. HSI and LSCI were complimentary, identifying thrombus generation and tissue recovery, which was not possible in either modality alone. RESULTS AND CONCLUSION By analyzing multimodal tissue information from visible imaging, LSCI perfusion imaging, and HSI, a recovery prognosis could be determined based on the blood supply to the organ. The unique combination of the complementary imaging techniques into a single surgical microscope holds promise for improving the real-time determination of blood supply and tissue prognosis during surgery. SIGNIFICANCE Precise real-time monitoring for vascular anomalies promises to reduce the risk of organ damage in precise surgical operations such as tissue resection and transplantation. In addition, the convergence of label-free imaging technologies removes delays associated with the injection and diffusion of vascular monitoring dyes.
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28
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Kim Y, Oh J, Choi SH, Jung A, Lee JG, Lee YS, Kim JK. A Portable Smartphone-Based Laryngoscope System for High-Speed Vocal Cord Imaging of Patients With Throat Disorders: Instrument Validation Study. JMIR Mhealth Uhealth 2021; 9:e25816. [PMID: 34142978 PMCID: PMC8277344 DOI: 10.2196/25816] [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] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/17/2021] [Accepted: 05/13/2021] [Indexed: 11/13/2022] Open
Abstract
Background Currently, high-speed digital imaging (HSDI), especially endoscopic HSDI, is routinely used for the diagnosis of vocal cord disorders. However, endoscopic HSDI devices are usually large and costly, which limits access to patients in underdeveloped countries and in regions with inadequate medical infrastructure. Modern smartphones have sufficient functionality to process the complex calculations that are required for processing high-resolution images and videos with a high frame rate. Recently, several attempts have been made to integrate medical endoscopes with smartphones to make them more accessible to people in underdeveloped countries. Objective This study aims to develop a smartphone adaptor for endoscopes, which enables smartphone-based vocal cord imaging, to demonstrate the feasibility of performing high-speed vocal cord imaging via the high-speed imaging functions of a high-performance smartphone camera, and to determine the acceptability of the smartphone-based high-speed vocal cord imaging system for clinical applications in developing countries. Methods A customized smartphone adaptor optical relay was designed for clinical endoscopy using selective laser melting–based 3D printing. A standard laryngoscope was attached to the smartphone adaptor to acquire high-speed vocal cord endoscopic images. Only existing basic functions of the smartphone camera were used for HSDI of the vocal cords. Extracted still frames were observed for qualitative glottal volume and shape. For image processing, segmented glottal and vocal cord areas were calculated from whole HSDI frames to characterize the amplitude of the vibrations on each side of the glottis, including the frequency, edge length, glottal areas, base cord, and lateral phase differences over the acquisition time. The device was incorporated into a preclinical videokymography diagnosis routine to compare functionality. Results Smartphone-based HSDI with the smartphone-endoscope adaptor could achieve 940 frames per second and a resolution of 1280 by 720 frames, which corresponds to the detection of 3 to 8 frames per vocal cycle at double the spatial resolution of existing devices. The device was used to image the vocal cords of 4 volunteers: 1 healthy individual and 3 patients with vocal cord paralysis, chronic laryngitis, or vocal cord polyps. The resultant image stacks were sufficient for most diagnostic purposes. The cost of the device including the smartphone was lower than that of existing HSDI devices. The image processing and analytics demonstrated the successful calculation of relevant diagnostic variables from the acquired images. Patients with vocal pathologies were easily differentiable in the quantitative data. Conclusions A smartphone-based HSDI endoscope system can function as a point-of-care clinical diagnostic device. The resulting analysis is of higher quality than that accessible by videostroboscopy and promises comparable quality and greater accessibility than HSDI. In particular, this system is suitable for use as an accessible diagnostic tool in underdeveloped areas with inadequate medical service infrastructure.
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Affiliation(s)
- Youngkyu Kim
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea.,Department of Convergence Medicine, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Jeongmin Oh
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | - Seung-Ho Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, Seoul, Republic of Korea
| | - Ahra Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Eulji Medical Center, Eulji University School of Medicine, Seoul, Republic of Korea
| | - June-Goo Lee
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea.,Department of Convergence Medicine, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Yoon Se Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, Seoul, Republic of Korea
| | - Jun Ki Kim
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea.,Department of Convergence Medicine, College of Medicine, University of Ulsan, Seoul, Republic of Korea
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29
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Kim DK, Lim HS, Eun KM, Seo Y, Kim JK, Kim YS, Kim MK, Jin S, Han SC, Kim DW. Subepithelial neutrophil infiltration as a predictor of the surgical outcome of chronic rhinosinusitis with nasal polyps. Rhinology 2021; 59:173-180. [PMID: 33129200 DOI: 10.4193/rhin20.373] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Neutrophils present as major inflammatory cells in refractory chronic rhinosinusitis with nasal polyps (CRSwNP), regardless of the endotype. However, their role in the pathophysiology of CRSwNP remains poorly understood. We investigated factors predicting the surgical outcomes of CRSwNP patients with focus on neutrophilic localization. METHODS We employed machine-learning methods such as the decision tree and random forest models to predict the surgical outcomes of CRSwNP. Immunofluorescence analysis was conducted to detect human neutrophil elastase (HNE), Bcl-2, and Ki-67 in NP tissues. We counted the immunofluorescence-positive cells and divided them into three groups based on the infiltrated area, namely, epithelial, subepithelial, and perivascular groups. RESULTS On machine learning, the decision tree algorithm demonstrated that the number of subepithelial HNE-positive cells, Lund-Mackay (LM) scores, and endotype (eosinophilic or non-eosinophilic) were the most important predictors of surgical outcomes in CRSwNP patients. Additionally, the random forest algorithm showed that, after ranking the mean decrease in the Gini index or the accuracy of each factor, the top three ranking factors associated with surgical outcomes were the LM score, age, and number of subepithelial HNE-positive cells. In terms of cellular proliferation, immunofluorescence analysis revealed that Ki-67/HNE-double positive and Bcl-2/HNE-double positive cells were significantly increased in the subepithelial area in refractory CRSwNP. CONCLUSION Our machine-learning approach and immunofluorescence analysis demonstrated that subepithelial neutrophils in NP tissues had a high expression of Ki-67 and could serve as a cellular biomarker for predicting surgical outcomes in CRSwNP patients.
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Affiliation(s)
- D-K Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital and Institute of New Frontier Research, Hallym University College of Medicine, Chuncheon, Republic of Korea; Division of Big Data and Artificial Intelligence, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - H-S Lim
- Department of Otorhinolaryngology-Head and Neck Surgery, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - K M Eun
- Department of Otorhinolaryngology-Head and Neck Surgery, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Y Seo
- Department of Otorhinolaryngology-Head and Neck Surgery, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - J K Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Y S Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - M-K Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - S Jin
- Department of Otorhinolaryngology-Head and Neck Surgery, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - S C Han
- Department of Otorhinolaryngology-Head and Neck Surgery, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - D W Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
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Choi SJ, Park KJ, Heo C, Park BW, Kim M, Kim JK. Radiomics-based model for predicting pathological complete response to neoadjuvant chemotherapy in muscle-invasive bladder cancer. Clin Radiol 2021; 76:627.e13-627.e21. [PMID: 33762138 DOI: 10.1016/j.crad.2021.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 12/21/2020] [Accepted: 02/11/2021] [Indexed: 12/29/2022]
Abstract
AIM To develop and validate a radiomics-based model for predicting response to neoadjuvant chemotherapy (NAC) using baseline computed tomography (CT) images in patients with muscle-invasive bladder cancer (MIBC). MATERIALS AND METHODS A radiomics signature for predicting pathological complete response (pCR) was developed using radiomics features selected by a random forest classifier on baseline CT images, and imaging predictors were identified in the training set (87 patients). By incorporating imaging predictors and radiomics signature, an imaging-based model was constructed using multivariate logistic regression analysis and validated in an independent validation set consisting of 48 patients with CT from outside institutions. The performance and clinical usefulness of the imaging-based model for predicting pCR were evaluated using area under the receiver operating characteristic curve (AUC) and decision curve analysis. Using a cut-off determined in the training set, the positive likelihood ratios of the imaging-based model were calculated and compared with imaging and histological predictors. RESULTS The radiomics signature was developed based on six stable radiomics features. An imaging-based model incorporating radiomics signature, tumour shape, tumour size, and clinical stage showed good performance for predicting pCR in both the training (AUC, 0.85; 95% confidence interval [CI], 0.78-0.93) and validation (AUC, 0.75; 95% CI, 0.60-0.86) sets, providing a larger net benefit in decision curve analysis. The imaging-based model showed a higher positive likelihood ratio (1.91) for pCR than imaging and histological predictors (1.33-1.63). CONCLUSIONS The radiomics-based model using baseline CT images may predict the response of patients with MIBC to NAC.
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Affiliation(s)
- S J Choi
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - K J Park
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - C Heo
- Institute for Life Sciences, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea
| | - B W Park
- Institute for Life Sciences, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea
| | - M Kim
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - J K Kim
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Ahn D, Lee GJ, Choi YS, Park JW, Kim JK, Kim EJ, Lee YH. Timing and clinical outcomes of tracheostomy in patients with COVID-19. Br J Surg 2021; 108:e27-e28. [PMID: 33640938 PMCID: PMC7799185 DOI: 10.1093/bjs/znaa064] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 10/05/2020] [Indexed: 01/06/2023]
Abstract
In this retrospective multicentre cohort study that included 27 COVID-19 patients who underwent tracheostomy, the mean time between intubation and tracheostomy was 15.8 days and the negative conversion time of COVID-19 was 43.1 days. Eleven patients (40.7%) died of COVID-19 and the use of percutaneous dilatation tracheostomy was significantly associated with in-hospital death. Timely tracheostomy could be performed in COVID-19 patients, regardless of duration of intubation or positivity of COVID-19 test, with an open surgical tracheostomy as a preferable technique.
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Affiliation(s)
- D Ahn
- Department of Otolaryngology-Head and Neck Surgery, Kyungpook National University, Daegu, Korea
| | - G J Lee
- Department of Otolaryngology-Head and Neck Surgery, Kyungpook National University, Daegu, Korea
| | - Y S Choi
- Department of Otolaryngology-Head and Neck Surgery, Yeungnam University, Daegu, Korea
| | - J W Park
- Department of Otolaryngology-Head and Neck Surgery, Keimyung University, Daegu, Korea
| | - J K Kim
- Department of Otolaryngology-Head and Neck Surgery, Catholic University of Daegu, Daegu, Korea
| | - E J Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Catholic University of Daegu, Daegu, Korea
| | - Y H Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kyungpook National University, Daegu, Korea
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Pack CG, Paulson B, Shin Y, Jung MK, Kim JS, Kim JK. Variably Sized and Multi-Colored Silica-Nanoparticles Characterized by Fluorescence Correlation Methods for Cellular Dynamics. Materials (Basel) 2020; 14:ma14010019. [PMID: 33374548 PMCID: PMC7793086 DOI: 10.3390/ma14010019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/15/2020] [Accepted: 12/21/2020] [Indexed: 02/06/2023]
Abstract
Controlling the uptake of nanoparticles into cells so as to balance therapeutic effects with toxicity is an essential unsolved problem in the development of nanomedicine technologies. From this point of view, it is useful to use standard nanoparticles to quantitatively evaluate the physical properties of the nanoparticles in solution and in cells, and to analyze the intracellular dynamic motion and distribution of these nanoparticles at a single-particle level. In this study, standard nanoparticles are developed based on a variant silica-based nanoparticle incorporating fluorescein isothiocyanate (FITC) or/and rhodamine B isothiocyanate (RITC) with a variety of accessible diameters and a matching fluorescent cobalt ferrite core-shell structure (Fe2O4/SiO2). The physical and optical properties of the nanoparticles in vitro are fully evaluated with the complementary methods of dynamic light scattering, electron microscopy, and two fluorescence correlation methods. In addition, cell uptake of dual-colored and core/shell nanoparticles via endocytosis in live HeLa cells is detected by fluorescence correlation spectroscopy and electron microscopy, indicating the suitability of the nanoparticles as standards for further studies of intracellular dynamics with multi-modal methods.
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Affiliation(s)
- Chan-Gi Pack
- Asan Institute for Life Science, Asan Medical Center, Seoul 05505, Korea; (C.-G.P.); (B.P.)
- Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea;
| | - Bjorn Paulson
- Asan Institute for Life Science, Asan Medical Center, Seoul 05505, Korea; (C.-G.P.); (B.P.)
| | - Yeonhee Shin
- Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea;
| | - Min Kyo Jung
- Neural Circuits Group, Korea Brain Research Institute, Daegu 41062, Korea;
| | - Jun Sung Kim
- Research and Development Center, H-MED Incorporated, Seoul 03761, Korea
- Correspondence: (J.S.K.); (J.K.K.); Tel.: +82-2-3010-8619 (J.K.K.)
| | - Jun Ki Kim
- Asan Institute for Life Science, Asan Medical Center, Seoul 05505, Korea; (C.-G.P.); (B.P.)
- Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea;
- Correspondence: (J.S.K.); (J.K.K.); Tel.: +82-2-3010-8619 (J.K.K.)
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Kim JK, Choi JH, Kim BS, Shin YS. Association of Anterior Cerebral Artery Variants and Cerebral Infarction in Patients with Balloon-Assisted Coil Embolization for Unruptured Internal Carotid Artery Aneurysms. World Neurosurg 2020; 147:e69-e77. [PMID: 33253946 DOI: 10.1016/j.wneu.2020.11.118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 11/19/2020] [Accepted: 11/20/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND Balloon-assisted coiling (BAC) is an endovascular treatment that may be associated with increased complications and thromboembolic events compared with other coiling techniques. We compared clinical outcomes of endovascular treatment (simple coiling, stent-assisted coiling, and BAC) in patients with unruptured intracranial aneurysms at the internal carotid artery and assessed risk factors that could cause cerebral infarction in patients who underwent BAC. METHODS We retrospectively reviewed the records of 528 patients with 544 aneurysms who underwent endovascular treatment for unruptured intracranial aneurysms between January 2013 and November 2019. Demographic features, clinical information, balloon inflation time, fetal posterior cerebral artery, anterior cerebral artery (ACA) variants, and angiographic results were analyzed to determine risk factors for cerebral infarction. RESULTS There were no significant differences among the 3 groups in terms of general characteristics. In the BAC group, 14 of 39 patients showed a significantly higher incidence of cerebral infarction on diffusion magnetic resonance imaging compared with the stent-assisted coiling (37/238) and simple coiling (21/267) groups (P < 0.001). There was no significant difference between the ACA variants (normal vs. hypoplasia or aplasia) and cerebral infarction in the simple coiling and stent-assisted coiling groups, but the proportion of aplasia or hypoplasia in the BAC group was significantly higher (P = 0.001). CONCLUSIONS There is a significant association between anatomic ACA variants and cerebral infarction occurrence after BAC. Identifying the variant of the anatomic ACA using digital subtraction angiography would help to predict cerebral infarction after BAC.
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Affiliation(s)
- Jun Ki Kim
- Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea
| | - Jai Ho Choi
- Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea
| | - Bum Soo Kim
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea
| | - Yong Sam Shin
- Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea.
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Jue M, Pack CG, Oh S, Paulson B, Lee K, Kim JK. SERS Effect on Spin-Coated Seeding of Tilted Au-ZnO Nanorods for Low-Cost Diagnosis. Materials (Basel) 2020; 13:ma13235321. [PMID: 33255438 PMCID: PMC7727838 DOI: 10.3390/ma13235321] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/16/2020] [Accepted: 11/23/2020] [Indexed: 01/21/2023]
Abstract
Uniformly parallel Au-coated ZnO nanorods have previously been shown to amplify local Raman signals, providing increased sensitivity to disease markers in the detection of inflammation and cancer. However, practical and cost-effective fabrication methods of substrates for surface-enhanced Raman spectroscopy (SERS) fail to produce highly uniform surfaces. Here, the feasibility of Raman enhancement on less-uniform substrates is assessed. ZnO nanorod structures were fabricated by hydrothermal synthesis, starting from spin-coated seed substrates. Following analysis, the nanostructures were coated with Au to create stochastically variant substrates. The non-uniformity of the fabricated Au-coated ZnO nanorod structures is confirmed morphologically by FE-SEM and structurally by X-ray diffraction, and characterized by the angular distributions of the nanorods. Monte Carlo finite element method simulations matching the measured angular distributions and separations predicted only moderate increases in the overall Raman enhancement with increasing uniformity. Highly variant substrates exhibited approximately 76% of the Raman enhancement of more uniform substrates in simulations and experiments. The findings suggest that, although highly inhomogeneous Au-coated ZnO nanorod substrates may not attain the same Raman enhancement as more uniform substrates, the relaxation of fabrication tolerances may be economically viable.
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Affiliation(s)
- Miyeon Jue
- Asan Institute for Life Science, Asan Medical Center, Seoul 05505, Korea; (M.J.); (C.-G.P.); (B.P.); (K.L.)
| | - Chan-Gi Pack
- Asan Institute for Life Science, Asan Medical Center, Seoul 05505, Korea; (M.J.); (C.-G.P.); (B.P.); (K.L.)
- Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Seakhee Oh
- Department of Pediatrics, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul 05505, Korea;
| | - Bjorn Paulson
- Asan Institute for Life Science, Asan Medical Center, Seoul 05505, Korea; (M.J.); (C.-G.P.); (B.P.); (K.L.)
| | - Kwanhee Lee
- Asan Institute for Life Science, Asan Medical Center, Seoul 05505, Korea; (M.J.); (C.-G.P.); (B.P.); (K.L.)
| | - Jun Ki Kim
- Asan Institute for Life Science, Asan Medical Center, Seoul 05505, Korea; (M.J.); (C.-G.P.); (B.P.); (K.L.)
- Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea
- Correspondence: ; Tel.: +82-2-3010-8619
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35
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Lee S, Namgoong JM, Jue M, Joung Y, Ryu CM, Shin DM, Choo MS, Kim JK. Selective Detection of Nano-Sized Diagnostic Markers Using Au-ZnO Nanorod-Based Surface-Enhanced Raman Spectroscopy (SERS) in Ureteral Obstruction Models. Int J Nanomedicine 2020; 15:8121-8130. [PMID: 33122904 PMCID: PMC7589161 DOI: 10.2147/ijn.s272500] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 07/16/2020] [Accepted: 10/01/2020] [Indexed: 12/12/2022] Open
Abstract
Background This study investigated the diagnosis of renal diseases using a biochip capable of detecting nano-sized biomarkers. Raman measurements from a kidney injury model were taken, and the feasibility of early diagnosis was assessed. Materials and Methods Rat models with mild and severe unilateral ureteral obstructions were created, with the injury to the kidney varying according to the tightness of the stricture. After generating the animal ureteral obstruction models, urine was collected from the kidney and bladder. Results and Discussion After confirming the presence of renal injury, urine drops were placed onto a Raman chip whose surface had been enhanced with Au-ZnO nanorods, allowing nano-sized biomarkers that diffused into the nanogaps to be selectively amplified. The Raman signals varied according to the severity of the renal damage, and these differences were statistically confirmed. Conclusion These results confirm that ureteral stricture causes kidney injury and that signals in the urine from the release of nano-biomarkers can be monitored using surface-enhanced Raman spectroscopy.
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Affiliation(s)
- Sanghwa Lee
- Biomedical Engineering Research Center, Asan Medical Center, Seoul 05505, Republic of Korea
| | - Jung-Man Namgoong
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Miyeon Jue
- Biomedical Engineering Research Center, Asan Medical Center, Seoul 05505, Republic of Korea
| | - Yujin Joung
- Biomedical Engineering Research Center, Asan Medical Center, Seoul 05505, Republic of Korea
| | - Chae-Min Ryu
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea.,Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Dong-Myung Shin
- Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Myung-Soo Choo
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Jun Ki Kim
- Biomedical Engineering Research Center, Asan Medical Center, Seoul 05505, Republic of Korea.,Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
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Moon Y, Oh J, Hyun J, Kim Y, Choi J, Namgoong J, Kim JK. Cost-Effective Smartphone-Based Articulable Endoscope Systems for Developing Countries: Instrument Validation Study. JMIR Mhealth Uhealth 2020; 8:e17057. [PMID: 32909951 PMCID: PMC7516686 DOI: 10.2196/17057] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 03/22/2020] [Accepted: 06/15/2020] [Indexed: 01/08/2023] Open
Abstract
Background Endoscopes are widely used for visualizing the respiratory tract, urinary tract, uterus, and gastrointestinal tracts. Despite high demand, people in underdeveloped and developing countries cannot obtain proper access to endoscopy. Moreover, commercially available endoscopes are mostly nonarticulable as well as not actively controlled, limiting their use. Articulating endoscopes are required for some diagnosis procedures, due to their ability to image wide areas of internal organs. Furthermore, actively controlled articulating endoscopes are less likely to harm the lumen than rigid endoscopes because they can avoid contact with endothelial tissues. Objective The study aimed to demonstrate the feasibility and acceptability of smartphone-based wide-field articulable endoscope system for minimally invasive clinical applications in developing and less developed countries. Methods A thin articulable endoscope system that can be attached to and actively controlled by a smartphone was designed and constructed. The system consists of a flexible endoscopic probe with a continuum mechanism, 4 motor modules for articulation, a microprocessor for controlling the motor with a smartphone, and a homebuilt app for streaming, capturing, adjusting images and video, and controlling the motor module with a joystick-like user interface. The smartphone and motor module are connected via an integrated C-type On-The-Go (OTG) USB hub. Results We tested the device in several human-organ phantoms to evaluate the usability and utility of the smartphone-based articulating endoscope system. The resolution (960 × 720 pixels) of the device was found to be acceptable for medical diagnosis. The maximum bending angle of 110° was designed. The distance from the base of the articulating module to the tip of the endoscope was 45 mm. The angle of the virtual arc was 40.0°, for a curvature of 0.013. The finest articulation resolution was 8.9°. The articulating module succeeded in imaging all 8 octants of a spherical target, as well as all 4 quadrants of the indices marked in human phantoms. Conclusions The portable wide-field endoscope was successfully controlled using a smartphone, yielding clear images with a resolution of 960 × 720 pixels at realistic focal distances. Actively and precisely controlled articulating movements have resulted in minimally invasive monitoring in the narrow space of internal organs providing a wide-area view. We found our smartphone-based active articulated endoscope to be suitable for point-of-care applications in developing and less developed countries.
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Affiliation(s)
- Youngjin Moon
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea.,Department of Convergence Medicine, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Jeongmin Oh
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | - Jaeho Hyun
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | - Youngkyu Kim
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | - Jaesoon Choi
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea.,Department of Biomedical Engineering, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Jeongman Namgoong
- Department of Surgery, Asan Medical Center, Seoul, Republic of Korea
| | - Jun Ki Kim
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea.,Department of Convergence Medicine, College of Medicine, University of Ulsan, Seoul, Republic of Korea
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Kim JK, Chun EJ, Yang SY, Kim KS, Kim SS, Kim CW. Development and efficacy of a nested real-time quantitative polymerase chain reaction to identify the cytochrome c oxidase subunit 1 gene of Sarcoptes scabiei var. hominis for diagnosis and monitoring of ordinary scabies. Br J Dermatol 2020; 183:1116-1117. [PMID: 32594512 DOI: 10.1111/bjd.19340] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/17/2020] [Accepted: 06/20/2020] [Indexed: 11/28/2022]
Affiliation(s)
- J K Kim
- Department of Dermatology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - E J Chun
- Department of Dermatology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - S Y Yang
- Department of Dermatology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - K S Kim
- Department of Dermatology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - S S Kim
- Department of Dermatology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - C W Kim
- Department of Dermatology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
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Kim JK, Casa D, Huang X, Gog T, Kim BJ, Kim J. Montel mirror based collimating analyzer system for high-pressure resonant inelastic X-ray scattering experiments. J Synchrotron Radiat 2020; 27:963-969. [PMID: 33566005 DOI: 10.1107/s1600577520005792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 04/27/2020] [Indexed: 06/12/2023]
Abstract
Resonant inelastic X-ray scattering (RIXS) is increasingly playing a significant role in studying highly correlated systems, especially since it was proven capable of measuring low-energy magnetic excitations. However, despite high expectations for experimental evidence of novel magnetic phases at high pressure, unequivocal low-energy spectral signatures remain obscured by extrinsic scattering from material surrounding the sample in a diamond anvil cell (DAC): pressure media, Be gasket and the diamond anvils themselves. A scattered X-ray collimation based medium-energy resolution (∼100 meV) analyzer system for a RIXS spectrometer at the Ir L3-absorption edge has been designed and built to remediate these difficulties. Due to the confocal nature of the analyzer system, the majority of extrinsic scattering is rejected, yielding a clean low-energy excitation spectrum of an iridate Sr2IrO4 sample in a DAC cell. Furthermore, the energy resolution of different configurations of the collimating and analyzing optics are discussed.
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Affiliation(s)
- J K Kim
- Center for Artificial Low Dimensional Electronic Systems, Institute for Basic Science (IBS), Pohang 790-784, Republic of Korea
| | - Diego Casa
- Advanced Photon Source, Argonne National Laboratory, Lemont, IL 60439, USA
| | - Xianrong Huang
- Advanced Photon Source, Argonne National Laboratory, Lemont, IL 60439, USA
| | - Thomas Gog
- Advanced Photon Source, Argonne National Laboratory, Lemont, IL 60439, USA
| | - B J Kim
- Center for Artificial Low Dimensional Electronic Systems, Institute for Basic Science (IBS), Pohang 790-784, Republic of Korea
| | - Jungho Kim
- Advanced Photon Source, Argonne National Laboratory, Lemont, IL 60439, USA
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Kim JK, Ranjith KM, Burkhardt U, Prots Y, Baenitz M, Valldor M. Impact of inversion symmetry on a quasi-1D S = 1 system. J Phys Condens Matter 2020; 32:225802. [PMID: 31997776 DOI: 10.1088/1361-648x/ab7134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Here, we report the synthesis and magnetic properties of a novel, centrosymmetric, quasi-1D spin chain system La3VWS3O6, with hexagonal crystal structure (P63/m, a = 9.460 76(3), c = 5.518 09(2) Å). Pure powders were obtained by solid-state reactions from La2O3, WO3 and metal powders of V and W. X-ray powder diffraction, specific heat, magnetization, 139La-nuclear magnetic resonance (NMR), and electric resistivity measurements indicate that the compound is a low dimensional magnet with an S = 1 spin chain that exhibits no sign of magnetic ordering above 2 K. A single ion anisotropy (D/k B ~ 10 K), caused by magneto-crystalline effects, is probably responsible for a thermodynamic entropy release at lower temperatures, which concurs with 139La-NMR data. By detailed comparison with non-centrosymmetric Ba3V2S4O3, having a very similar magnetic lattice, it is obvious that the presence of crystallographic inversion symmetry has an effect on the behaviour of the magnetic chains.
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Affiliation(s)
- J K Kim
- Max Planck Institute for Chemical Physics of Solids, Nöthnitzer Str. 40, 01187 Dresden, Germany. Department of Physics, Pohang University of Science and Technology, Pohang 790-784, Republic of Korea
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Paulson B, Lee S, Jue M, Lee K, Lee S, Kim GB, Moon Y, Lee JY, Kim N, Kim JK. Stereotaxic endoscopy for the ocular imaging of awake, freely moving animal models. J Biophotonics 2020; 13:e201960188. [PMID: 32017450 DOI: 10.1002/jbio.201960188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 01/07/2020] [Accepted: 01/23/2020] [Indexed: 06/10/2023]
Abstract
Stereotaxic instruments are increasingly used in research animals for the study of disease, but typically require restraints and anesthetic procedures. A stereotaxic head mount that enables imaging of the anterior chamber of the eye in alert and freely mobile mice is presented in this study. The head mount is fitted based on computed tomography scans and manufactured using 3D printing. The system is placed noninvasively using temporal mount bars and a snout mount, without breaking the skin or risking suffocation, while an instrument channel stabilizes the ocular probes. With a flexible micro-endoscopic probe and a confocal scanning laser microscopy system, <20 μm resolution is achieved in vivo with a field of view of nearly 1 mm. Discomfort is minimal, and further adaptations for minimally invasive neuroscience, optogenetics and auditory studies are possible.
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Affiliation(s)
- Bjorn Paulson
- Biomedical Engineering Research Center, Asan Institute for Life Science, Asan Medical Center, Seoul, South Korea
| | - Sangwook Lee
- Department of Convergence Medicine, College of Medicine, University of Ulsan, Seoul, South Korea
| | - Miyeon Jue
- Biomedical Engineering Research Center, Asan Institute for Life Science, Asan Medical Center, Seoul, South Korea
| | - Kyungsung Lee
- Biomedical Engineering Research Center, Asan Institute for Life Science, Asan Medical Center, Seoul, South Korea
| | - Sanghwa Lee
- Biomedical Engineering Research Center, Asan Institute for Life Science, Asan Medical Center, Seoul, South Korea
| | | | - Youngjin Moon
- Biomedical Engineering Research Center, Asan Institute for Life Science, Asan Medical Center, Seoul, South Korea
- Department of Convergence Medicine, College of Medicine, University of Ulsan, Seoul, South Korea
| | - Joo Yong Lee
- Department of Ophthalmology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, South Korea
| | - Namkug Kim
- Department of Convergence Medicine, College of Medicine, University of Ulsan, Seoul, South Korea
| | - Jun Ki Kim
- Biomedical Engineering Research Center, Asan Institute for Life Science, Asan Medical Center, Seoul, South Korea
- Department of Convergence Medicine, College of Medicine, University of Ulsan, Seoul, South Korea
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Choi WJ, Paulson B, Yu S, Wang RK, Kim JK. Mean-Subtraction Method for De-shadowing of Tail Artifacts in Cerebral OCTA Images: A Proof of Concept. Materials (Basel) 2020; 13:ma13092024. [PMID: 32357466 PMCID: PMC7254351 DOI: 10.3390/ma13092024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 01/25/2023]
Abstract
When imaging brain vasculature with optical coherence tomography angiography (OCTA), volumetric analysis of cortical vascular networks in OCTA datasets is frequently challenging due to the presence of artifacts, which appear as multiple-scattering tails beneath superficial large vessels in OCTA images. These tails shadow underlying small vessels, making the assessment of vascular morphology in the deep cortex difficult. In this work, we introduce an image processing technique based on mean subtraction of the depth profile that can effectively reduce these tails to better reveal small hidden vessels compared to the current tail removal approach. With the improved vascular image quality, we demonstrate that this simple method can provide better visualization of three-dimensional vascular network topology for quantitative cerebrovascular studies.
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Affiliation(s)
- Woo June Choi
- School of Electrical and Electronics Engineering, Chung-Ang University, Seoul 06974, Korea; (W.J.C.); (S.Y.)
| | - Bjorn Paulson
- Biomedical Engineering Research Center, Asan Institute for Life Science, Asan Medical Center, Seoul 05505, Korea;
| | - Sungwook Yu
- School of Electrical and Electronics Engineering, Chung-Ang University, Seoul 06974, Korea; (W.J.C.); (S.Y.)
| | - Ruikang K. Wang
- Department of Bioengineering, University of Washington, Seattle, WA 98195, USA;
| | - Jun Ki Kim
- Biomedical Engineering Research Center, Asan Institute for Life Science, Asan Medical Center, Seoul 05505, Korea;
- Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea
- Correspondence: ; Tel.: +82-2-3010-8619
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You MK, Lee YJ, Kim JK, Baek SA, Jeon YA, Lim SH, Ha SH. The organ-specific differential roles of rice DXS and DXR, the first two enzymes of the MEP pathway, in carotenoid metabolism in Oryza sativa leaves and seeds. BMC Plant Biol 2020; 20:167. [PMID: 32293285 PMCID: PMC7161295 DOI: 10.1186/s12870-020-02357-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 03/24/2020] [Indexed: 05/08/2023]
Abstract
BACKGROUND Deoxyxylulose 5-phosphate synthase (DXS) and deoxyxylulose 5-phosphate reductoisomerase (DXR) are the enzymes that catalyze the first two enzyme steps of the methylerythritol 4-phosphate (MEP) pathway to supply the isoprene building-blocks of carotenoids. Plant DXR and DXS enzymes have been reported to function differently depending on the plant species. In this study, the differential roles of rice DXS and DXR genes in carotenoid metabolism were investigated. RESULTS The accumulation of carotenoids in rice seeds co-expressing OsDXS2 and stPAC was largely enhanced by 3.4-fold relative to the stPAC seeds and 315.3-fold relative to non-transgenic (NT) seeds, while the overexpression of each OsDXS2 or OsDXR caused no positive effect on the accumulation of either carotenoids or chlorophylls in leaves and seeds, suggesting that OsDXS2 functions as a rate-limiting enzyme supplying IPP/DMAPPs to seed carotenoid metabolism, but OsDXR doesn't in either leaves or seeds. The expressions of OsDXS1, OsPSY1, OsPSY2, and OsBCH2 genes were upregulated regardless of the reductions of chlorophylls and carotenoids in leaves; however, there was no significant change in the expression of most carotenogenic genes, even though there was a 315.3-fold increase in the amount of carotenoid in rice seeds. These non-proportional expression patterns in leaves and seeds suggest that those metabolic changes of carotenoids were associated with overexpression of the OsDXS2, OsDXR and stPAC transgenes, and the capacities of the intermediate biosynthetic enzymes might be much more important for those metabolic alterations than the transcript levels of intermediate biosynthetic genes are. Taken together, we propose a 'Three Faucets and Cisterns Model' about the relationship among the rate-limiting enzymes OsDXSs, OsPSYs, and OsBCHs as a "Faucet", the biosynthetic capacity of intermediate metabolites as a "Cistern", and the carotenoid accumulations as the content of "Cistern". CONCLUSION Our study suggests that OsDXS2 plays an important role as a rate-limiting enzyme supplying IPP/DMAPPs to the seed-carotenoid accumulation, and rice seed carotenoid metabolism could be largely enhanced without any significant transcriptional alteration of carotenogenic genes. Finally, the "Three Faucets and Cisterns model" presents the extenuating circumstance to elucidate rice seed carotenoid metabolism.
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Affiliation(s)
- MK You
- Department of Genetic Engineering and Graduate School of Biotechnology, College of Life Sciences, Kyung Hee University, Yongin, 17104 Republic of Korea
| | - YJ Lee
- Department of Genetic Engineering and Graduate School of Biotechnology, College of Life Sciences, Kyung Hee University, Yongin, 17104 Republic of Korea
| | - JK Kim
- Division of Life Sciences and Bio-Resource and Environmental Center, Incheon National University, Incheon, 22012 Republic of Korea
| | - SA Baek
- Division of Life Sciences and Bio-Resource and Environmental Center, Incheon National University, Incheon, 22012 Republic of Korea
| | - YA Jeon
- College of Agriculture and Life Sciences, Chungnam National University, Daejeon, 34134 Republic of Korea
| | - SH Lim
- National Academy of Agricultural Science, Rural Development Administration, Jeonju, 54874 Republic of Korea
| | - SH Ha
- Department of Genetic Engineering and Graduate School of Biotechnology, College of Life Sciences, Kyung Hee University, Yongin, 17104 Republic of Korea
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Kim TK, Lee BW, Fujii F, Lee KH, Lee S, Park Y, Kim JK, Lee SW, Pack CG. Mitotic Chromosomes in Live Cells Characterized Using High-Speed and Label-Free Optical Diffraction Tomography. Cells 2019; 8:cells8111368. [PMID: 31683735 PMCID: PMC6912651 DOI: 10.3390/cells8111368] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 09/18/2019] [Revised: 10/21/2019] [Accepted: 10/30/2019] [Indexed: 12/16/2022] Open
Abstract
The cell nucleus is a three-dimensional, dynamic organelle organized into subnuclear compartments such as chromatin and nucleoli. The structure and function of these compartments are maintained by diffusion and interactions between related factors as well as by dynamic and structural changes. Recent studies using fluorescent microscopic techniques suggest that protein factors can access and are freely mobile in heterochromatin and in mitotic chromosomes, despite their densely packed structure. However, the physicochemical properties of the chromosome during cell division are not fully understood. In the present study, characteristic properties such as the refractive index (RI), volume of the mitotic chromosomes, and diffusion coefficient (D) of fluorescent probes inside the chromosome were quantified using an approach combining label-free optical diffraction tomography with complementary confocal laser-scanning microscopy and fluorescence correlation spectroscopy. Variations in these parameters correlated with osmotic conditions, suggesting that changes in RI are consistent with those of the diffusion coefficient for mitotic chromosomes and cytosol. Serial RI tomography images of chromosomes in live cells during mitosis were compared with three-dimensional confocal micrographs to demonstrate that compaction and decompaction of chromosomes induced by osmotic change were characterized by linked changes in chromosome RI, volume, and the mobilities of fluorescent proteins.
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Affiliation(s)
- Tae-Keun Kim
- Asan Institute for Life Sciences, Asan Medical Center, Seoul 05505, Korea.
| | - Byong-Wook Lee
- Asan Institute for Life Sciences, Asan Medical Center, Seoul 05505, Korea.
| | - Fumihiko Fujii
- Division of Physical Pharmacy, Faculty of Pharmaceutical Sciences, Kobe Gakuin University, Kobe 650-8586, Japan.
| | | | - Sanghwa Lee
- Asan Institute for Life Sciences, Asan Medical Center, Seoul 05505, Korea.
| | - YongKeun Park
- Tomocube Inc., Daejeon 34051, Korea.
- Department of Physics, Korea Advanced Institute of Science and Technology, Daejeon 34141, Korea.
| | - Jun Ki Kim
- Asan Institute for Life Sciences, Asan Medical Center, Seoul 05505, Korea.
- Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea.
| | - Sang-Wook Lee
- Department of Radiation Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea.
| | - Chan-Gi Pack
- Asan Institute for Life Sciences, Asan Medical Center, Seoul 05505, Korea.
- Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea.
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Kim JK, Jin C, Park J, Iloska M, Kim M, Seo D, Jung J, Kim T, Kim J. Synthesis of Boron Nitride Nanotubes Incorporated with Pd and Pt Nanoparticles for Catalytic Oxidation of Carbon Monoxide. Ind Eng Chem Res 2019. [DOI: 10.1021/acs.iecr.9b03954] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Jun Ki Kim
- R&D Center, NAiEEL Technology, Chungnam National University, 99 Daehak-ro, CCI(W1)708, Yuseong-gu, Daejeon 34134, Republic of Korea
| | - Chongguang Jin
- Materials Science and Chemical Engineering Department, Stony Brook University, Stony Brook, New York 11794, United States
| | - Jongho Park
- Materials Science and Chemical Engineering Department, Stony Brook University, Stony Brook, New York 11794, United States
| | - Marija Iloska
- Materials Science and Chemical Engineering Department, Stony Brook University, Stony Brook, New York 11794, United States
| | - Minjee Kim
- Materials Science and Chemical Engineering Department, Stony Brook University, Stony Brook, New York 11794, United States
| | - Duckbong Seo
- R&D Center, NAiEEL Technology, Chungnam National University, 99 Daehak-ro, CCI(W1)708, Yuseong-gu, Daejeon 34134, Republic of Korea
| | - Junghwan Jung
- R&D Center, NAiEEL Technology, Chungnam National University, 99 Daehak-ro, CCI(W1)708, Yuseong-gu, Daejeon 34134, Republic of Korea
| | - Taejin Kim
- Materials Science and Chemical Engineering Department, Stony Brook University, Stony Brook, New York 11794, United States
| | - Jaewoo Kim
- R&D Center, NAiEEL Technology, Chungnam National University, 99 Daehak-ro, CCI(W1)708, Yuseong-gu, Daejeon 34134, Republic of Korea
- Nuclear Materials Research Division, Korea Atomic Energy Research Institute, Daeduk-daero 111, Daejeon 34134, Republic of Korea
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Eun L, Kim SK, Kim JK. P4641Are coronary artery abnormalities in Kawasaki disease associated with iron deficiency anemia? Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Purpose
Coronary artery abnormalities (CAA) are the most important complication of Kawasaki disease (KD). Iron deficiency anemia (IDA) is prevalent micronutrient deficiencies and its association with KD remains unknown. We hypothesized the presence of IDA could be a predictor of CAA.
Methods
This retrospective study included 173 KD patients, divided into two groups by absence (Group 1) and presence (Group 2) of CAA. The odds ratio (OR) with 95% confidence interval (CI) was calculated using a logistic regression model to estimate the association between CAA and other indicators. Due to the collinearity between the IDA indicators, each indicator was paired with anemia in 3 models.
Results
The 3 indicators of IDA, serum iron, iron saturation and ferritin, were all significantly higher in Group 1 than in Group 2. Three sets of models including anemia with iron indicators produced the odd ratio (OR) of CAA of 3.513, 3.171, and 2.256, respectively. The 3 indicators of IDA were negatively associated with CAA, by OR of 0.965, 0.914, and 0.944, respectively. The Area under the curve (AUC) of ferritin, iron saturation, serum iron, anemia, and Kobayashi score was 0.907 (95% CI, 0.851–0.963), 0.729 (95% CI, 0.648–0.810), 0.711 (95% CI, 0.629–0.793), 0.638 (95% CI, 0.545–0.731), and 0.563 (95% CI, 0.489–0.636) respectively.
Figure 1 & 3
Conclusion
The indicators of IDA, especially ferritin, were highly associated with CAA, so that they were stronger predictors compared to the Kobayashi score. The IDA indicators can be used to predict CAA development and suggest the need for early intervention.
Acknowledgement/Funding
None
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Affiliation(s)
- L Eun
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - S K Kim
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - J K Kim
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
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Choi SY, Kim MH, Lee KM, Kim JK, Woo JY, Cho YR. P5661Validation of CHA2DS2-VA score (excluding female sex) in non-valvular atrial fibrillation patients: a nationwide population-based study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Sex category (Sc, ie, female sex) confers 1 point on CHA2DS2-VASc score. So, no woman with atrial fibrillation (AF) can have a CHA2DS2-VASc score of 0. This study aimed to compare CHA2DS2-VA (excluding female sex) and CHA2DS2-VASc score in Korean AF patients.
Methods
Using the Korean National Health Insurance Service database, we analyzed the risk of ischemic stroke in non-valvular AF patients between 2013 and 2017. The predictive value of the CHA2DS2-VA and CHA2DS2-VASc scores for ischemic stroke was evaluated by c-statistic difference and net reclassification improvement (NRI). The propensity score matching method was used to balance covariates across male and female AF patients.
Results
A total of 182,133 patients with AF (49.2% women) were included to this study. The adjusted incidence rate (IR) of ischemic stroke was not significantly different between males and females (0.89%/y and 0.90%/y, respectively, p=0.411) in low-risk patients without risk factor. Also, no sex difference was found in high-risk patients with above 2 risk factors for ischemic stroke (4.46%/y for male and 4.49%/y for male, p=0.498). In c-statistic analysis for ischemic stroke, there was no significant difference between the CHA2DS2-VA and CHA2DS2-VASc scores (AUC 0.662 vs. 0.664, z=1.572, p=0.116). When compared with CHA2DS2-VASc score, CHA2DS2-VA score was not significantly inferior in net reclassification improvement (NRI 0.031, 95% CI 0.002–0.037, p=0.118) for ischemic stroke.
C-statistics
Conclusions
In Korean AF patients, the CHA2DS2-VA score excluding female sex is a useful risk scoring system for ischemic stroke.
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Affiliation(s)
- S Y Choi
- Daeu Health College, Department of Biomedical Laboratory Science, Daegu, Korea (Republic of)
| | - M H Kim
- Dong-A University, Department of Cardiology, College of Medicine, Busan, Korea (Republic of)
| | - K M Lee
- Dong-A University, Department of Cardiology, College of Medicine, Busan, Korea (Republic of)
| | - J K Kim
- Dong-A University, Department of Cardiology, College of Medicine, Busan, Korea (Republic of)
| | - J Y Woo
- Dong-A University, Department of Cardiology, College of Medicine, Busan, Korea (Republic of)
| | - Y R Cho
- Dong-A University, Department of Cardiology, College of Medicine, Busan, Korea (Republic of)
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Abstract
Summary
A within-cluster resampling method is proposed for fitting a multilevel model in the presence of informative cluster size. Our method is based on the idea of removing the information in the cluster sizes by drawing bootstrap samples which contain a fixed number of observations from each cluster. We then estimate the parameters by maximizing an average, over the bootstrap samples, of a suitable composite loglikelihood. The consistency of the proposed estimator is shown and does not require that the correct model for cluster size is specified. We give an estimator of the covariance matrix of the proposed estimator, and a test for the noninformativeness of the cluster sizes. A simulation study shows, as in Neuhaus & McCulloch (2011), that the standard maximum likelihood estimator exhibits little bias for some regression coefficients. However, for those parameters which exhibit nonnegligible bias, the proposed method is successful in correcting for this bias.
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Affiliation(s)
- D Lee
- Department of Statistics, Iowa State University, 2438 Osborn Drive, Ames, Iowa 50011, USA
| | - J K Kim
- Department of Statistics, Iowa State University, 2438 Osborn Drive, Ames, Iowa 50011, USA
| | - C J Skinner
- Department of Statistics, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK
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Kim TK, Lee BW, Fujii F, Kim JK, Pack CG. Physicochemical Properties of Nucleoli in Live Cells Analyzed by Label-Free Optical Diffraction Tomography. Cells 2019; 8:cells8070699. [PMID: 31295945 PMCID: PMC6679011 DOI: 10.3390/cells8070699] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 05/15/2019] [Revised: 06/27/2019] [Accepted: 07/09/2019] [Indexed: 12/15/2022] Open
Abstract
The cell nucleus is three-dimensionally and dynamically organized by nuclear components with high molecular density, such as chromatin and nuclear bodies. The structure and functions of these components are represented by the diffusion and interaction of related factors. Recent studies suggest that the nucleolus can be assessed using various protein probes, as the probes are highly mobile in this organelle, although it is known that they have a densely packed structure. However, physicochemical properties of the nucleolus itself, such as molecular density and volume when cellular conditions are changed, are not yet fully understood. In this study, physical parameters such as the refractive index (RI) and volume of the nucleoli in addition to the diffusion coefficient (D) of fluorescent probe protein inside the nucleolus are quantified and compared by combining label-free optical diffraction tomography (ODT) with confocal laser scanning microscopy (CLSM)-based fluorescence correlation spectroscopy (FCS). 3D evaluation of RI values and corresponding RI images of nucleoli in live HeLa cells successfully demonstrated varying various physiological conditions. Our complimentary method suggests that physical property of the nucleolus in live cell is sensitive to ATP depletion and transcriptional inhibition, while it is insensitive to hyper osmotic pressure when compared with the cytoplasm and nucleoplasm. The result demonstrates that the nucleolus has unique physicochemical properties when compared with other cellular components.
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Affiliation(s)
- Tae-Keun Kim
- Asan Institute for Life Sciences, Asan Medical Center, Seoul 05505, Korea
| | - Byong-Wook Lee
- Asan Institute for Life Sciences, Asan Medical Center, Seoul 05505, Korea
| | - Fumihiko Fujii
- Division of Physical Pharmacy, Faculty of Pharmaceutical Sciences, Kobe Gakuin University, Kobe 650-8586, Japan
| | - Jun Ki Kim
- Asan Institute for Life Sciences, Asan Medical Center, Seoul 05505, Korea.
- Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea.
| | - Chan-Gi Pack
- Asan Institute for Life Sciences, Asan Medical Center, Seoul 05505, Korea.
- Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea.
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Paulson B, Lee S, Kim Y, Moon Y, Kim JK. Miniaturized omnidirectional flexible side-view endoscope for rapid monitoring of thin tubular biostructures. Biomed Opt Express 2019; 10:2264-2274. [PMID: 31149372 PMCID: PMC6524575 DOI: 10.1364/boe.10.002264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 03/27/2019] [Accepted: 03/27/2019] [Indexed: 06/09/2023]
Abstract
Endoscopic imaging allows longitudinal observation of epithelial pathologies in tubular organs throughout the body. However, the imaging and optical diagnosis of tubular biostructures such as small animal models and small pediatric organs require appropriately miniaturized devices. A miniaturized catadioptric flexible side-view endoscope is proposed with omnidirectional field of view (FOV) in the transverse direction and sub-mm-scale feature resolution. The FOV in the longitudinal direction is 50°. Images are unwrapped and stitched together to form composite images of the target by two different algorithms, revealing a composite FOV of more than 3.5 cm × 360°. The endoscope is well suited for minimally invasive rapid monitoring of thin tubular organs in pediatric patients, as well as for imaging of small animal disease models at near-cellular resolution.
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Affiliation(s)
- Bjorn Paulson
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, 88, Olympic-ro 43-gil, Seoul, 05505, South Korea
- Department of Convergence Medicine, University of Ulsan, College of Medicine, 88, Olympic-ro 43-gil, Seoul, 05505, South Korea
| | - SangHwa Lee
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, 88, Olympic-ro 43-gil, Seoul, 05505, South Korea
- Department of Convergence Medicine, University of Ulsan, College of Medicine, 88, Olympic-ro 43-gil, Seoul, 05505, South Korea
| | - Youngkyu Kim
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, 88, Olympic-ro 43-gil, Seoul, 05505, South Korea
- Department of Convergence Medicine, University of Ulsan, College of Medicine, 88, Olympic-ro 43-gil, Seoul, 05505, South Korea
| | - Youngjin Moon
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, 88, Olympic-ro 43-gil, Seoul, 05505, South Korea
- Department of Convergence Medicine, University of Ulsan, College of Medicine, 88, Olympic-ro 43-gil, Seoul, 05505, South Korea
| | - Jun Ki Kim
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, 88, Olympic-ro 43-gil, Seoul, 05505, South Korea
- Department of Convergence Medicine, University of Ulsan, College of Medicine, 88, Olympic-ro 43-gil, Seoul, 05505, South Korea
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Chua ME, Kim JK, Rivera KC, Ming JM, Flores F, Farhat WA. The use of postoperative prophylactic antibiotics in stented distal hypospadias repair: a systematic review and meta-analysis. J Pediatr Urol 2019; 15:138-148. [PMID: 30527683 DOI: 10.1016/j.jpurol.2018.10.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 09/22/2018] [Accepted: 10/16/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION The current literature on the use of antibiotics perioperatively for many pediatric procedures, including hypospadias, is inconsistent. There is currently no clear evidence for the use of postoperative antibiotic prophylaxis for stented distal hypospadias repair. OBJECTIVE This study aims to synthesize and assess the available literature on the use versus non-use of postoperative antibiotic prophylaxis for stented distal hypospadias repair. METHODOLOGY Systematic literature search was performed on March 2018 for evaluation of trials that assessed the use and non-use of postoperative prophylactic antibiotics among stented distal hypospadias repair in children. Methodological quality of the studies was assessed according to the study design as recommended by the Cochrane Collaboration. The outcome assessed includes composite overall posthypospadias repair complications of infection and wound healing complications. The event rate for each treatment group was extracted to extrapolate intervention relative risk (RR) and corresponding 95% confidence interval (CI). Mantel-Haenszel method with random effect model was used in pooling of effect estimates from the included studies. Heterogeneity was assessed with subgroup analysis performed according to the study design. Publication bias was likewise determined. The protocol of this review was registered in PROSPERO (CRD42018087301) and reported in accordance with preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. RESULT A total of seven studies (four cohorts, three randomized controlled trials) with 986 stented distal hypospadias repairs (408 with no post-operative prophylactic antibiotics and 578 given postoperative prophylactic antibiotics) were included for the meta-analysis. Moderate to serious risk of bias was noted among the cohort studies, while the included randomized controlled trials (RCT) were of high risk of bias. Inconsistencies of effect estimates between subgroups and publication bias with small study effect were likely present. The overall pooled effect estimates comparing treatment groups showed no significant difference for outcomes of overall composite postoperative complication (RR 0.93, 95% CI 0.45, 1.93). Assessment of composite infection related complications and wound healing complications likewise did not show any significant between-group differences (RR 1.28, 95% CI 0.49, 3.35 and RR 1.01, 95% CI 0.48, 2.12; respectively) (Table). Asymptomatic bacteriuria was noted to be significantly higher among the intervention group with no postoperative prophylactic antibiotics (RR 4.01, 95% CI 1.11, 14.54). CONCLUSION The available evidence to date was assessed to be of high risk. The low level of evidence generated suggests that there is limited utility in the use of postoperative prophylactic antibiotics to prevent clinically significant posthypospadias repair complications.
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Affiliation(s)
- M E Chua
- Institute of Urology, St. Luke's Medical Center-Quezon City, Philippines; Division of Urology, The Hospital for Sick Children, Toronto, Canada
| | - J K Kim
- Division of Urology, The Hospital for Sick Children, Toronto, Canada; Faculty of Medicine, University of Toronto, Toronto, Canada
| | - K C Rivera
- Institute of Urology, St. Luke's Medical Center-Quezon City, Philippines
| | - J M Ming
- Department of Surgery, Section of Urology, University of New Mexico, USA
| | - F Flores
- Department of Surgery, Section of Urology, Philippines Children's Medical Center, Philippines
| | - W A Farhat
- Division of Urology, The Hospital for Sick Children, Toronto, Canada.
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