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Kang J, Cheon J, Yoon H, Kim N, Heo S. Adrenalectomy for the treatment of hypotension in a cat with phaeochromocytoma associated with caudal vena cava syndrome. J Small Anim Pract 2024; 65:352-356. [PMID: 38169034 DOI: 10.1111/jsap.13696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/16/2023] [Accepted: 12/06/2023] [Indexed: 01/05/2024]
Abstract
An 11-year-old spayed female, Persian cat was referred to the Jeonbuk Animal Medical Center for evaluation of a 2-month history of lethargy and anorexia. Physical examination revealed tachycardia and hypotension. Abdominal imaging via sonography and CT identified a right adrenal gland mass causing severe deviation and compression of the caudal vena cava. After stabilising the blood pressure and heart rate through positive inotropes and fluid therapy, right adrenalectomy was performed. Surgery confirmed the adrenal gland mass was severely compressing the caudal vena cava. Histopathological examination revealed that the mass was a pheochromocytoma. After adrenalectomy, blood pressure and heart rate stabilised and remained unaffected 8 months postsurgery. This report describes a rare case of an adrenal pheochromocytoma leading to caudal vena cava compression in a cat presenting with hypotension.
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Affiliation(s)
- J Kang
- Department of Veterinary Surgery, College of Veterinary Medicine, Jeonbuk National University, Iksan, 54596, South Korea
| | - J Cheon
- Department of Veterinary Surgery, College of Veterinary Medicine, Jeonbuk National University, Iksan, 54596, South Korea
| | - H Yoon
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan, 54596, South Korea
| | - N Kim
- Department of Veterinary Surgery, College of Veterinary Medicine, Jeonbuk National University, Iksan, 54596, South Korea
| | - S Heo
- Department of Veterinary Surgery, College of Veterinary Medicine, Jeonbuk National University, Iksan, 54596, South Korea
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2
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Kop M, Kim N, Shimoda B, Unebasami E, Weldon RH, Nakasone CK. The prevalence of bilateral and ipsilateral radiographic osteoarthritis is high in White, Asian and Native Hawaiian/Pacific Islanders presenting for unilateral knee or hip arthroplasty. Arch Orthop Trauma Surg 2024; 144:1565-1573. [PMID: 38386068 DOI: 10.1007/s00402-024-05252-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 02/17/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND It is estimated that one-third of patients presenting with unilateral joint pain have contralateral osteoarthritis (OA) at first presentation. Most studies have primarily examined White patient cohorts. The purpose of this study was to determine the prevalence of contralateral joint OA for patients presenting for unilateral total knee (TKA), unicompartmental knee (UKA) or total hip arthroplasty (THA) among Asian, Native Hawaiian/Pacific Islander and White patients. METHODS Bilateral radiographic reports at initial presentation of 2,312 subjects who underwent unilateral arthroplasties (332 UKAs, 933 TKAs and 1,047 THAs) were reviewed. The presence of contralateral OA was recorded and compared by racial group and type of arthroplasty performed. Parametric statistical analyses were performed to determine differences between groups. Multivariable analyses were completed for each arthroplasty group to determine the influence on the presence of contralateral OA, presented as odds ratios and 95% confidence intervals. RESULTS Contralateral joint OA was present in 86.7%, 90.4% and 70.4% of UKA, TKA and THA patients, respectively. Concurrent hip OA was present in 41.6% and 59.5% of UKA and TKA patients. No racial differences in the prevalence of contralateral knee OA were found for knee arthroplasty patients. White patients (74.6%) had a greater prevalence of contralateral hip OA compared to Asians (66.5%, p = 0.037) amongst THA recipients. Increased age and body mass index were significantly associated with the presence of contralateral knee OA. Increased age, being male and being White were significant contributors for the presence of contralateral hip OA. CONCLUSION The prevalence of contralateral joint OA and concurrent hip OA is high in all three racial groups. Due to the extensive prevalence of contralateral and concurrent knee and hip OA, bilateral radiographic evaluation should be considered for all patients presenting with unilateral hip or knee pain due to OA.
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MESH Headings
- Humans
- Male
- Female
- Arthroplasty, Replacement, Hip
- Arthroplasty, Replacement, Knee
- Osteoarthritis, Hip/diagnostic imaging
- Osteoarthritis, Hip/epidemiology
- Osteoarthritis, Hip/surgery
- Native Hawaiian or Other Pacific Islander
- Prevalence
- Knee Joint/surgery
- Osteoarthritis, Knee/diagnostic imaging
- Osteoarthritis, Knee/epidemiology
- Osteoarthritis, Knee/surgery
- White People
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Affiliation(s)
- Mikaela Kop
- University of Hawai'I, John A Burns School of Medicine, 651 Ilalo Street, Honolulu, HI, 96813, USA
| | - Nathan Kim
- University of Hawai'I, John A Burns School of Medicine, 651 Ilalo Street, Honolulu, HI, 96813, USA
| | - Brent Shimoda
- University of Hawai'I, John A Burns School of Medicine, 651 Ilalo Street, Honolulu, HI, 96813, USA
| | - Emily Unebasami
- University of Hawai'I, John A Burns School of Medicine, 651 Ilalo Street, Honolulu, HI, 96813, USA
| | - Rosana Hernandez Weldon
- University of Hawai'i Office of Public Health Studies, 1960 East-West Road, Honolulu, HI, 96822, USA
| | - Cass K Nakasone
- Straub Medical Center Bone and Joint Center, 888 South King Street, Honolulu, HI, 96814, USA.
- Department of Surgery, University of Hawai'i, John A Burns School of Medicine, 1356 Lusitana Street, Honolulu, HI, 96813, USA.
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3
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Rodencal J, Kim N, He A, Li VL, Lange M, He J, Tarangelo A, Schafer ZT, Olzmann JA, Long JZ, Sage J, Dixon SJ. Sensitization of cancer cells to ferroptosis coincident with cell cycle arrest. Cell Chem Biol 2024; 31:234-248.e13. [PMID: 37963466 PMCID: PMC10925838 DOI: 10.1016/j.chembiol.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/19/2023] [Accepted: 10/13/2023] [Indexed: 11/16/2023]
Abstract
Ferroptosis is a non-apoptotic form of cell death that can be triggered by inhibiting the system xc- cystine/glutamate antiporter or the phospholipid hydroperoxidase glutathione peroxidase 4 (GPX4). We have investigated how cell cycle arrest caused by stabilization of p53 or inhibition of cyclin-dependent kinase 4/6 (CDK4/6) impacts ferroptosis sensitivity. Here, we show that cell cycle arrest can enhance sensitivity to ferroptosis induced by covalent GPX4 inhibitors (GPX4i) but not system xc- inhibitors. Greater sensitivity to GPX4i is associated with increased levels of oxidizable polyunsaturated fatty acid-containing phospholipids (PUFA-PLs). Higher PUFA-PL abundance upon cell cycle arrest involves reduced expression of membrane-bound O-acyltransferase domain-containing 1 (MBOAT1) and epithelial membrane protein 2 (EMP2). A candidate orally bioavailable GPX4 inhibitor increases lipid peroxidation and shrinks tumor volumes when combined with a CDK4/6 inhibitor. Thus, cell cycle arrest may make certain cancer cells more susceptible to ferroptosis in vivo.
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Affiliation(s)
- Jason Rodencal
- Department of Biology, Stanford University, Stanford, CA 94305, USA
| | - Nathan Kim
- Department of Biology, Stanford University, Stanford, CA 94305, USA
| | - Andrew He
- Departments of Pediatrics and Genetics, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Veronica L Li
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305, USA; Sarafan ChEM-H, Stanford University, Stanford, CA 94035, USA
| | - Mike Lange
- Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA 94720, USA; Department of Nutritional Sciences and Toxicology, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Jianping He
- Department of Biological Sciences, University of Notre Dame, Notre Dame, IN 46556, USA
| | - Amy Tarangelo
- Department of Biology, Stanford University, Stanford, CA 94305, USA
| | - Zachary T Schafer
- Department of Biological Sciences, University of Notre Dame, Notre Dame, IN 46556, USA
| | - James A Olzmann
- Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA 94720, USA; Department of Nutritional Sciences and Toxicology, University of California, Berkeley, Berkeley, CA 94720, USA; Chan Zuckerberg Biohub, San Francisco, CA 94158, USA
| | - Jonathan Z Long
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305, USA; Sarafan ChEM-H, Stanford University, Stanford, CA 94035, USA
| | - Julien Sage
- Departments of Pediatrics and Genetics, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Scott J Dixon
- Department of Biology, Stanford University, Stanford, CA 94305, USA.
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Larkin A, Kim JS, Kim N, Baek SH, Yamada S, Park K, Tai K, Yanagi Y, Park JH. Accuracy of artificial intelligence-assisted growth prediction in skeletal Class I preadolescent patients using serial lateral cephalograms for a 2-year growth interval. Orthod Craniofac Res 2024. [PMID: 38321788 DOI: 10.1111/ocr.12764] [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] [Accepted: 01/23/2024] [Indexed: 02/08/2024]
Abstract
OBJECTIVE To investigate the accuracy of artificial intelligence-assisted growth prediction using a convolutional neural network (CNN) algorithm and longitudinal lateral cephalograms (Lat-cephs). MATERIALS AND METHODS A total of 198 Japanese preadolescent children, who had skeletal Class I malocclusion and whose Lat-cephs were available at age 8 years (T0) and 10 years (T1), were allocated into the training, validation, and test phases (n = 161, n = 17, n = 20). Orthodontists and the CNN model identified 28 hard-tissue landmarks (HTL) and 19 soft-tissue landmarks (STL). The mean prediction error values were defined as 'excellent,' 'very good,' 'good,' 'acceptable,' and 'unsatisfactory' (criteria: 0.5 mm, 1.0 mm, 1.5 mm, and 2.0 mm, respectively). The degree of accurate prediction percentage (APP) was defined as 'very high,' 'high,' 'medium,' and 'low' (criteria: 90%, 70%, and 50%, respectively) according to the percentage of subjects that showed the error range within 1.5 mm. RESULTS All HTLs showed acceptable-to-excellent mean PE values, while the STLs Pog', Gn', and Me' showed unsatisfactory values, and the rest showed good-to-acceptable values. Regarding the degree of APP, HTLs Ba, ramus posterior, Pm, Pog, B-point, Me, and mandibular first molar root apex exhibited low APPs. The STLs labrale superius, lower embrasure, lower lip, point of lower profile, B', Pog,' Gn' and Me' also exhibited low APPs. The remainder of HTLs and STLs showed medium-to-very high APPs. CONCLUSION Despite the possibility of using the CNN model to predict growth, further studies are needed to improve the prediction accuracy in HTLs and STLs of the chin area.
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Affiliation(s)
- A Larkin
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, Arizona, USA
| | - J-S Kim
- Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - N Kim
- Department of Convergence Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - S-H Baek
- Department of Orthodontics, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - S Yamada
- Department of Dental Informatics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - K Park
- Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - K Tai
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, Arizona, USA
- Private Practice of Orthodontics, Okayama, Japan
| | - Y Yanagi
- Department of Dental Informatics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - J H Park
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, Arizona, USA
- Graduate School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
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Johns C, Kwon YS, Rahimi AS, Liu Y, Cauble M, Alluri PG, Arbab M, Nwachukwu CR, Kim N. Racial Difference in Outcomes in Breast Cancer Patients with Residual Nodal Disease after Neoadjuvant Chemotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e186. [PMID: 37784814 DOI: 10.1016/j.ijrobp.2023.06.1044] [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) African Americans (AA) requiring neoadjuvant chemotherapy (NAC) have been associated with worse outcomes. Residual nodal disease (ypN+) after NAC represents a highly unfavorable risk factor. We hypothesized that even within this unfavorable subgroup, that racial differences in outcome would persist. MATERIALS/METHODS An IRB-approved retrospective review of breast cancer (BC) patients in a multi-institutional study was performed between 2005-2018 to identify ypN+ patients (excluding metastatic or inflammatory BC). Clinico-pathologic parameters stratified by race were collected and analyzed. For molecular subtype analyses, patients were stratified into triple negative (TN), hormone receptor (HR)+/HER2-, and HR+/HER2+, and HR-/HER2+ subtypes. Overall survival (OS), disease free survival (DFS) and recurrence outcomes were obtained, and univariate and multivariate (MVA) logistic regression models were constructed and analyzed. RESULTS Among 404 ypN+ patients, 107 (26%) were AA, and 297 (74%) were non-AA. Median follow-up for the non-AA group was 3.8 years (y) (IQR 2.4-6.3) and 3.5y (IQR 2.0-6.2) for the AA group. Clinical and pathologic patient characteristics (age, molecular subtypes, BRCA status, histology, grade, smoking status, primary surgery type, axillary/reconstruction surgery rates, margin status, stage) were without significant statistical differences between the non-AA and AA group, except the non-AA group had proportionally more cN3 disease (10.5% vs. 5.1%; p = .01). Despite this, AA demonstrated worse OS and DFS outcomes (Table). AA also had significantly worse local (15% vs. 6.7%, p = .02), regional (11.2% vs. 5.1%, p = .05) and distant recurrences (32.7% vs. 22.6%, p = .05) compared to non-AA. On MVA for OS and DFS, HR+ status, clinical stage, and AA race (HR 2.1 (CI 1.3-3.4), p = .004 and HR 1.7 (CI 1.1-2.6), p = .01 respectively) remained significant. Molecular subtype analysis demonstrated that AA with HR+/HER2- but not the TN subtypes demonstrated significantly worse outcomes (Table). Utilization of endocrine therapy was not different between AA and non-AA patients (94% vs. 97%, p = 0.3) to explain this discrepancy. Worse outcomes in HER2 subtype for AA group was suggested but could not be statistically verified due to insufficient sample size. There was no discernible difference in chemotherapy and radiation therapy regimen or compliance between the AA and non-AA groups. CONCLUSION AA patients who fail to achieve nodal clearance with NAC had higher local, regional and distant recurrence, and worse survival compared to non-AA, particularly those with non-TN status. These differences could not be readily explained by therapeutic disparity, or compliance. These hypothesis generating findings suggest need to explore biological implications, and alternative therapeutic strategies for this unfavorable subgroup.
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Affiliation(s)
- C Johns
- UT Southwestern Medical Center, Dallas, TX
| | - Y S Kwon
- University of Texas Southwestern Medical Center, Dallas, TX
| | - A S Rahimi
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Y Liu
- Department of Population and Data Sciences, University of Texas Southwestern, Dallas, TX
| | - M Cauble
- UT Southwestern Medical Center, Dallas, TX
| | - P G Alluri
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - M Arbab
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - C R Nwachukwu
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - N Kim
- Vanderbilt University Department of Radiation Oncology, Nashville, TN
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6
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Rahimi AS, Kim N, Leitch M, Gu X, Parsons DDM, Nwachukwu CR, Alluri PG, Lu W, Nichols EM, Becker SJ, Ahn C, Zhang Y, Spangler A, Farr D, Wooldridge R, Bahrami S, Stojadinovic S, Lieberman M, Neufeld S, Timmerman RD. Multi-Institutional Phase II Trial Using Dose Escalated Five Fraction Stereotactic Partial Breast Irradiation (S-PBI) with GammaPod TM for Early-Stage Breast Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e203. [PMID: 37784857 DOI: 10.1016/j.ijrobp.2023.06.1082] [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) We report on our early experience of a multi-institutional phase II study of dose escalated five fraction stereotactic partial breast irradiation (S-PBI) for early-stage breast cancer after partial mastectomy using the GammaPodTM stereotactic radiation system. MATERIALS/METHODS Patient eligibility included DCIS or invasive epithelial histologies, AJCC clinical stage 0, I, or II with tumor size < 3 cm, and negative margins. Prior safety of Phase I dose escalation has been reported. Dose was 40 Gy delivered in 5 fractions to the CTV, and minimum dose 30 Gy in 5 fractions to the PTV. CTV margin was 1 cm and PTV margin 3 mm. For PTV cavities larger than 100cc, dose was reduced to 35Gy in 5 fractions to the CTV and 30 Gy in 5 fractions to the PTV. Primary endpoint of the study is to determine the 3-year patient global cosmesis score (4-point scale excellent, good, fair, or poor) and adverse cosmesis using a dose escalated approach with smaller PTV margins than conventional methods. Both patients and physicians completed baseline and subsequent cosmesis outcome questionnaires. Treatment related toxicity was graded using the NCI version 4.0 and RTOG/EORTC late radiation scale. RESULTS From 3/2019-10/2021, 74 patients were treated respectively. Of these, 38 were treated to 40Gy and 36 were treated to 35 Gy. Median follow up (f/u) was 24 months (mo), range (r) 3-39mo. Median age was 63 years (r 43-77). Histology included 28 DCIS, and 46 invasive carcinomas. 45/46 invasive tumors were ER+. 60/74 (81%) patients received endocrine therapy, and 7/74 patient received chemotherapy. There were 221 acute grade 1 toxicities, and 28 Grade 2 toxicities. No grade 3 or higher acute toxicities were reported (< 90 days). The most common Grade 2 toxicities were radiation dermatitis (10), breast pain (8), blister (4), skin infection (2), nipple discharge (2), and fatigue (2). In the late period, there were 54 Grade 1 late toxicities, 4 Grade 2 late toxicities, and no Grade 3 or higher late toxicities. Grade 2 toxicities included fibrosis (2), and pain (2). Two patients developed grade 1 asymptomatic nonpalpable fat necrosis both diagnosed at 12 months after radiation treatments. The most common grade 1 late toxicities were breast pain (14), hyperpigmentation (8), fibrosis (10), and fatigue (5). Physicians scored cosmesis excellent or good 70/73 (95.8%), 58/60 (96.7%), 36/36 (100%),17/17(100%) respectively at baseline, 12 months, 24 months, and 36months post SBRT, while patients scored the same periods 62/71 (83.7%), 53/59 (89.8%), 33/36 (91.6%), 17/18 (94.4%). There have been no reports of disease recurrences. CONCLUSION Results at 24-month median follow-up, of our dose escalated stereotactic partial breast 5 fraction regimen, has low acute and late toxicity, while maintaining high proportion of excellent/good cosmetic outcomes. Continued analysis of all cohorts is in progress. CLINICAL TRIALS gov identifier is NCT03581136.
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Affiliation(s)
- A S Rahimi
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - N Kim
- Vanderbilt University Department of Radiation Oncology, Nashville, TN
| | - M Leitch
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - X Gu
- Stanford University Department of Radiation Oncology, Palo Alto, CA
| | - D D M Parsons
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - C R Nwachukwu
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - P G Alluri
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - W Lu
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - E M Nichols
- University of Maryland School of Medicine, Baltimore, MD
| | - S J Becker
- University of Maryland School of Medicine, Baltimore, MD
| | - C Ahn
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX
| | - Y Zhang
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - A Spangler
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - D Farr
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - R Wooldridge
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - S Bahrami
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - S Stojadinovic
- University of Texas Southwestern Medical Center, Dallas, TX
| | - M Lieberman
- University of Texas Southwestern Medical Center, Dallas, TX
| | - S Neufeld
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - R D Timmerman
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
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Woods K, Shen ZL, Xu Z, Zhang H, Natsuaki Y, Cheng K, Li V, Kim N, Ma L, Chang E. Hippocampal sparing radiation therapy for brain metastases: treatment techniques and clinical implementation. Chin Clin Oncol 2023; 12:56. [PMID: 37964545 DOI: 10.21037/cco-23-73] [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: 08/01/2023] [Accepted: 10/17/2023] [Indexed: 11/16/2023]
Abstract
High doses of radiation to the hippocampus have been correlated with increased cognitive decline following radiation therapy for brain metastases. To mitigate these effects, a variety of hippocampal sparing techniques have been implemented for both whole brain radiation therapy (WBRT) and stereotactic radiosurgery (SRS). The goal of this review article is to provide a practical resource for the clinical implementation of hippocampal-sparing radiation therapy, starting with a brief background on the function and delineation of the hippocampal structure, as well as radiation effects on the hippocampus and the most widely recommended dose constraints. Considerations for treatment simulation are discussed, including options for cranial immobilization and optional head tilt. Hippocampal sparing has been demonstrated for WBRT using helical TomoTherapy, static intensity-modulated radiation therapy (IMRT), and volumetric-modulated arc therapy (VMAT) with a variety of patient setup positions, beam arrangements, and planning parameters. Tomotherapy has been shown to achieve slightly greater hippocampal sparing in some studies, while VMAT enables the most efficient treatment delivery. Hippocampal sparing has also been evaluated in a wide range of studies for both GammaKnife and linear accelerator (LINAC)-based SRS, with the proximity of metastases to the hippocampus being the most significant predictor of hippocampal dose. The methods and resulting hippocampal doses from these studies on both WBRT and SRS are discussed, as well as the role of automation in hippocampal sparing radiation therapy.
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Affiliation(s)
- Kaley Woods
- Department of Radiation Oncology, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Zhilei Liu Shen
- Department of Radiation Oncology, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Zhengzheng Xu
- Department of Radiation Oncology, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Hualin Zhang
- Department of Radiation Oncology, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Yutaka Natsuaki
- Department of Radiation Oncology, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Karen Cheng
- Department of Radiation Oncology, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Vivian Li
- Department of Radiation Oncology, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Nathan Kim
- Department of Radiation Oncology, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Lijun Ma
- Department of Radiation Oncology, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Eric Chang
- Department of Radiation Oncology, Keck School of Medicine of USC, Los Angeles, CA, USA
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8
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Kwon YS, Parsons DDM, Kim N, Lu W, Gu X, Stojadinovic S, Alluri PG, Arbab M, Lin MH, Chen L, Gonzalez Y, Chiu TD, Zhang Y, Timmerman RD, Rahimi AS. Assessment of Cardiac Radiation Dose in the Co-60 Prone Based Stereotactic Partial Breast Irradiation (CP-sPBI) Using the Distance from the Heart to the Planning Treatment Volume as a Surrogate Marker. Int J Radiat Oncol Biol Phys 2023; 117:e682. [PMID: 37786008 DOI: 10.1016/j.ijrobp.2023.06.2144] [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) Irradiation of the breast has shown to provide sharp dose gradients using Co-60 prone based stereotactic partial breast irradiation (CP-sPBI), a contemporary device for stereotactic radiotherapy for breast cancer (BC) for accelerated partial breast irradiation (APBI). In addition, the precise setup of CP-sPBI permits a small planning treatment volume (PTV) margin of 3 mm creating a greater distance from PTV to organs at risk. However, to date the factors that influence dose gradients and subsequent cardiac doses of ionizing radiation using CP-sPBI have not been well-studied. Here we evaluate distance of the heart to the lumpectomy PTV cavity and how this effects cardiac dose. MATERIALS/METHODS A retrospective database of 113 consecutive patients treated by CP-sPBI for APBI from March 2019 to February 2023 who were treated with 30 Gy in 5 fractions were queried for analysis. The minimum distance from the heart to the PTV (hP) was measured in either the axial or sagittal view. A group of 28 patient cases were randomly selected to achieve an even distribution of 28 cases with hP < 2.75 cm and hP ≥ 2.75 cm to compare cardiac toxicities based on hP. Descriptive analyses were performed to evaluate various cardiac dosimetric parameters based on laterality of BC and hP, using the student's t test. RESULTS The mean (range) hP was 4.58 cm (0.80-12.23) for all cases. The subgroup analyses of 28 patient cases with cardiac parameters showed the heart mean (range) dose of 1.20 Gy (0.01-2.11). The mean and max heart dose to the left-sided BC were similar to those to the right-sided BC (mean dose: 1.20 vs. 1.19 Gy; P = 0.97 and max dose: 10.47 vs. 5.66 Gy; P = 0.06). An inverse correlation between hP and mean heart dose was shown with the correlation coefficient of -0.81. Using a cutoff of 2.75 cm hP, the differences between hP < 2.75 and hP ≥ 2.75 cm for all cardiac dosimetric evaluations were all statistically significant, including mean (1.67 vs. 0.79 Gy; p<0.01) and maximal heart dose (14.48 vs. 4.11 Gy; p<0.01) CONCLUSION: CP-sPBI treatment delivery system was able to achieve acceptable clinically relevant heart dosimetric parameters when delivering 5 fraction APBI with a mean heart dose of 1.20 Gy for all locations of PTV cavity volume in the breast. Due to CP-sPBIs excellent dose fall-off characteristics, APBI using CP-SPBI showed clinically acceptable cardiac dosimetric parameters, particularly for PTVs located > 2.75 cm from the heart.
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Affiliation(s)
- Y S Kwon
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - D D M Parsons
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - N Kim
- Vanderbilt University Department of Radiation Oncology, Nashville, TN
| | - W Lu
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - X Gu
- Stanford University Department of Radiation Oncology, Palo Alto, CA
| | - S Stojadinovic
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - P G Alluri
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - M Arbab
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - M H Lin
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - L Chen
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Y Gonzalez
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - T D Chiu
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - Y Zhang
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - R D Timmerman
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - A S Rahimi
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
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9
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Patel KH, Tringale KR, Kim N, Boe L, Reyngold M, Wu AJ, Zinovoy M, Romesser PB, Cuaron J, Pappou E, Nusrat M, Mulhall J, Crane CH, Hajj C. Risk of Sexual Dysfunction in Men Treated with Pelvic Radiation Therapy for Locally Advanced Rectal Cancer: 20 Years of Experience with 451 Patients. Int J Radiat Oncol Biol Phys 2023; 117:S104-S105. [PMID: 37784276 DOI: 10.1016/j.ijrobp.2023.06.062] [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) Radiation therapy (RT) is commonly used in the treatment of locally advanced rectal cancer (LARC), but data on its impact on men's sexual health is limited. Given the rising incidence of rectal cancer in younger men, sexual function is an important quality of life factor. We hypothesized that men with LARC treated with RT would be at increased risk of sexual dysfunction compared to men who did not receive RT. MATERIALS/METHODS This is a single institution retrospective analysis of outcomes of men ≤50 years diagnosed with LARC between 1999 and 2019. Primary outcomes of erectile dysfunction (ED), ejaculatory dysfunction (EjD), and testosterone deficiency (TD) were assessed via ICD-9/10 codes, and TD was captured with free testosterone <300 ng/dL. Cumulative incidences were calculated with death as a competing risk and p values were calculated using Gray's test. Subdistribution hazard ratios from competing risk regression models were used. RESULTS The combined study sample included 451 men: 347 received RT as part of their multimodality treatment, and 104 did not. Median time to last follow up was 5.6 years (IQR 3.3-8.7). Age at diagnosis, stage, and medical comorbidities for sexual dysfunction were similar between the two groups (p>0.05). Cumulative incidence estimates are shown in Table 1, showing a higher cumulative incidence of ED in the RT group, but no difference in EjD or TD between the 2 groups. On univariable analysis, RT, smoking, dyslipidemia, peripheral artery disease, depression, prostate cancer/hyperplasia, closed or current ileostomy, and undergoing rectal cancer surgery were all independent risk factors for ED (p<0.05). On multivariable analysis, RT maintained statistical significance as an independent risk factor for ED (HR 3.87, 95% CI 1.93-7.75, p<0.001). Within the RT group, IMRT compared to 3D (HR 1.54, 95% CI 1.02-2.32, p = 0.040) and groin RT (HR 2.60, 95% CI 1.21-5.59, p = 0.014) were independent risk factors for ED. Within the RT group, groin RT also approached significance as a risk factor for TD (HR 3.61, 95% CI 0.98-13.3, p = 0.054). No RT dose thresholds to external genitals or penile bulb were identified that increased risks of ED, EjD, or TD. CONCLUSION RT for LARC independently increases risk of ED but not EjD or TD. IMRT might increase the risk of ED due to increased scatter dose to the genitals and including the inguinal nodes in the target volumes increases the dose to the genitals/testicles, which could translate into a higher risk for ED and TD. Future research on proton RT and prophylactic sildenafil is needed in men ≤50 to decrease the risk of ED.
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Affiliation(s)
- K H Patel
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - K R Tringale
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - N Kim
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - L Boe
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - M Reyngold
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - A J Wu
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - M Zinovoy
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - P B Romesser
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - J Cuaron
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - E Pappou
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - M Nusrat
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - J Mulhall
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - C H Crane
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - C Hajj
- Memorial Sloan Kettering Cancer Center, New York, NY
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10
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Simmons A, Sher DJ, Kim N, Leitch M, Haas JA, Gu X, Ahn C, Gao A, Spangler A, Morgan HE, Farr D, Wooldridge R, Seiler S, Goudreau S, Bahrami S, Neufeld S, Mendez C, Lieberman M, Timmerman RD, Rahimi AS. Financial Toxicity and Patient Experience Outcomes on a Multi-Institutional Phase I Single Fraction Stereotactic Partial Breast Irradiation Protocol for Early-Stage Breast Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e259-e260. [PMID: 37784994 DOI: 10.1016/j.ijrobp.2023.06.1212] [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) Given the demonstrated financial toxicity (FT) of radiation treatment on breast cancer patients shown in both conventional and our recent 5 fraction stereotactic APBI (S-PBI) study, we assessed the FT, as well as patient-reported utility, quality-of-life and patient experience measures, on patients treated in our phase I single fraction S-PBI trial. MATERIALS/METHODS A phase I single fraction dose escalation trial of S-PBI for early-stage breast cancer was conducted. Women with in-situ or stage I-II (AJCC 6) invasive breast cancer following breast conserving surgery were treated with S-PBI in 1 fraction to a total dose of 22.5, 26.5 or 30 Gy (Clinical trials.gov ID NCT02685332). At one month follow-up, patients were asked to complete our novel "Patient Perspective Cost and Convenience of Care Questionnaire". Patients also completed the EQ-5D-5L, including the visual analogue scale of overall health (VAS), at enrollment, 6, 12-, 24-, 36-, and 48-month follow-up. RESULTS Of 29 patients enrolled and treated, questionnaire data was available for all patients. Our trial encompassed a wide range of annual household incomes, education, and employment status. Overall, 44.8% (n = 13/29) of patients reported that radiation treatment presented a financial burden. Interestingly, no demographic information, such as patient race, marital status, education, household income, or employment during treatment predicted perceived FT. Patients reporting FT trended towards younger age (median 64 vs 70.5) and having a cancer related co-pay similar to our 5 fraction S-PBI FT trial; however, due to the small size of this study, this did not reach significance (p = 0.24 and 0.10, respectively). VAS and utility scores were calculated per the EQ-5D-5L and remained unchanged from baseline through 4-year follow-up. Likewise, there was no difference in the utility or VAS between patients who reported FT and those who did not. Interestingly, while patient reported cosmesis was similar for all patients at enrollment, patients who reported FT noted significantly worse cosmesis scores (fair/poor vs good/excellent) at 6 month and 2-year follow-ups (p = 0.01 and 0.04, respectively). Finally, patients were surveyed on treatment related disruption to their daily activities and enjoyment of life. The median values were 0 (scale 0-10, with 0 being no disruption) regardless of perceived FT. Patients were also uniformly satisfied with treatment time with a median score of 10 (scale 0-10, 10 being most satisfied). CONCLUSION Here, we show that despite using SPBI in a single fraction, nearly half of the patients treated still reported FT of treatment. Importantly, single fraction S-PBI has no negative impact on patient VAS or utility scores, and all patients were uniformly satisfied with treatment time without significant disruption to their life.
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Affiliation(s)
- A Simmons
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - D J Sher
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - N Kim
- Vanderbilt University Department of Radiation Oncology, Nashville, TN
| | - M Leitch
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - J A Haas
- Department of Radiation Oncology, Perlmutter Cancer Center at New York University Langone Hospital - Long Island, Mineola, NY
| | - X Gu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - C Ahn
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX
| | - A Gao
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX
| | - A Spangler
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | | | - D Farr
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - R Wooldridge
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - S Seiler
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - S Goudreau
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - S Bahrami
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - S Neufeld
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - C Mendez
- Department of Radiation Oncology, Perlmutter Cancer Center at New York University Langone Hospital - Long Island, Mineola, NY
| | - M Lieberman
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - R D Timmerman
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - A S Rahimi
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
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11
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Gonzalez Y, Chen L, Lee H, Kim N, Arbab M, Alluri PG, Zhang Y, Chiu TD, Iqbal Z, Zhuang T, Cai B, Kim H, Pompos A, Jiang SB, Godley AR, Timmerman RD, Lin MH, Rahimi AS, Parsons DDM. Dosimetric Comparison of Adaptive Radiotherapy Modalities for Stereotactic Partial Breast Irradiation. Int J Radiat Oncol Biol Phys 2023; 117:S163-S164. [PMID: 37784408 DOI: 10.1016/j.ijrobp.2023.06.260] [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) An increase in the availability of adaptive radiotherapy (ART) platforms have proven to be effective in the treatment of a variety of sites. In this study, we aim to evaluate the effectiveness of non-adaptive RT and 3 different ART platforms: (1) CBCT-based, (2) CT-based, and (3) MRI-based for stereotactic partial breast irradiation (SPBI). MATERIALS/METHODS Data were collected from 32 patients (16 left and 16 right breast) treated at a single institution. 16 patients (8 left and 8 right) treated using the non-ART platform were re-planned onto two different ART platforms, CBCT- and MRI-based. The remaining 16 patients treated using CT-based adaptive platform were not re-planned due to the prone patient treatment position (others systems supine). All cases were planned to 30 Gy in 5 fractions. Plan quality was evaluated based on pre-defined planning goals to the OARS: ipsilateral and contralateral lungs (Dmean, Dmax, V20 Gy, V9 Gy), ipsilateral (V15 Gy, V30 Gy) and contralateral breasts (Dmax), heart (Dmean, Dmax, V3 Gy, V1.5 Gy), skin (Dmax, V36.5 Gy), and rib (Dmax, V30 Gy). Target goals were defined by Dmax, Dmin, gradient index, and paddock conformality index. Re-planned cases were compared within the cohort using a paired t-test and a 2-sided t-test was used comparing to the CT-based platform. RESULTS Comparing the left and right breast cohort across all platforms, the CT-based ART system showed a signification dose reduction in Dmean (p<0.001 for all platforms), Dmax (p<0.001 for left breast, p<0.03 for right breast) and V9 Gy (p<0.004 for left breast, p<0.001 for right breast) to the ipsilateral lung, V15 Gy (p<0.004 for left breast cohort) to the ipsilateral breast, and Dmax to the contralateral breast (p<0.001) and ribs (p = 0.01, p<0.001, p = 0.01 for CBCT-ART, MRI-ART, and non-ART for left breast cohort only). On average, the MR-Linac platform showed the least degree of OAR sparing across nearly all dosimetric parameters evaluated when compared to all modalities, especially for contralateral lung Dmean and Dmax (p<0.05 for all dosimetric parameters for all platforms) and contralateral breast Dmax (p<0.003 for all platforms). The CBCT-based platform showed superior dose reduction in contralateral lung mean (p<0.03 for all platforms) and heart Dmean (p = 0.065, p<0.001, p = 0.045 for non-adaptive, MRI-ART, and CT-ART for left breast and p<0.008 for right breast). PTV coverage was comparable across all platforms, averaging at approximately 95%. The CT-based ART platform showed a significantly reduced gradient index relative to the CBCT- and MRI-based platforms (p<0.001). CONCLUSION For SPBI treatments, the CT-based ART platforms displayed a higher degree of OAR sparing for many of the dosimetric parameters recorded relative to the other ART and non-ART platforms presented. The MRI-based system typically showed less reduced OAR sparing; however, the advantage of the system is shown if soft tissue contrast is needed. PTV coverage remained comparable across all platforms.
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Affiliation(s)
- Y Gonzalez
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - L Chen
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - H Lee
- Washington University School of Medicine in St. Louis, St. Louis, MO
| | - N Kim
- Vanderbilt University Department of Radiation Oncology, Nashville, TN
| | - M Arbab
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - P G Alluri
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - Y Zhang
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - T D Chiu
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Z Iqbal
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - T Zhuang
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - B Cai
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - H Kim
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - A Pompos
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - S B Jiang
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - A R Godley
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - R D Timmerman
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - M H Lin
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - A S Rahimi
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - D D M Parsons
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
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12
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Jan R, Kim N, Asaf S, Lubna, Asif S, Du XX, Kim EG, Jang YH, Kim KM. OsCM regulates rice defence system in response to UV light supplemented with drought stress. Plant Biol (Stuttg) 2023; 25:902-914. [PMID: 37641387 DOI: 10.1111/plb.13564] [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: 03/12/2023] [Accepted: 07/16/2023] [Indexed: 08/31/2023]
Abstract
Studies on plant responses to combined abiotic stresses are very limited, especially in major crop plants. The current study evaluated the response of chorismate mutase overexpressor (OxCM) rice line to combined UV light and drought stress. The experiments were conducted in pots in a growth chamber, and data were assessed for gene expression, antioxidant and hormone regulation, flavonoid accumulation, phenotypic variation, and amino acid accumulation. Wild-type (WT) rice had reduced the growth and vigour, while transgenic rice maintained growth and vigour under combined UV light and drought stress. ROS and lipid peroxidation analysis revealed that chorismate mutase (OsCM) reduced oxidative stress mediated by ROS scavenging and reduced lipid peroxidation. The combined stresses reduced biosynthesis of total flavonoids, kaempferol and quercetin in WT plants, but increased significantly in plants with OxCM. Phytohormone analysis showed that SA was reduced by 50% in WT and 73% in transgenic plants, while ABA was reduced by 22% in WT plants but increased to 129% in transgenic plants. Expression of chorismate mutase regulates phenylalanine biosynthesis, UV light and drought stress-responsive genes, e.g., phenylalanine ammonia lyase (OsPAL), dehydrin (OsDHN), dehydration-responsive element-binding (OsDREB), ras-related protein 7 (OsRab7), ultraviolet-B resistance 8 (OsUVR8), WRKY transcription factor 89 (OsWRKY89) and tryptophan synthase alpha chain (OsTSA). Moreover, OsCM also increases accumulation of free amino acids (aspartic acid, glutamic acid, leucine, tyrosine, phenylalanine and proline) and sodium (Na), potassium (K), and calcium (Ca) ions in response to the combined stresses. Together, these results suggest that chorismate mutase expression induces physiological, biochemical and molecular changes that enhance rice tolerance to combined UV light and drought stresses.
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Affiliation(s)
- R Jan
- Division of Plant Biosciences, School of Applied Biosciences, College of Agriculture and Life Science, Kyungpook National University, Daegu, South Korea
- Coastal Agriculture Research Institute, Kyungpook National University, Daegu, South Korea
| | - N Kim
- Division of Plant Biosciences, School of Applied Biosciences, College of Agriculture and Life Science, Kyungpook National University, Daegu, South Korea
| | - S Asaf
- Natural and Medical Science Research Center, University of Nizwa, Nizwa, Oman
| | - Lubna
- Natural and Medical Science Research Center, University of Nizwa, Nizwa, Oman
| | - S Asif
- Division of Plant Biosciences, School of Applied Biosciences, College of Agriculture and Life Science, Kyungpook National University, Daegu, South Korea
| | - X-X Du
- Biosafty Division, National Academy of Agriculture Science, Rural Development, Administration, Jeonju, South Korea
| | - E-G Kim
- Division of Plant Biosciences, School of Applied Biosciences, College of Agriculture and Life Science, Kyungpook National University, Daegu, South Korea
| | - Y-H Jang
- Division of Plant Biosciences, School of Applied Biosciences, College of Agriculture and Life Science, Kyungpook National University, Daegu, South Korea
| | - K-M Kim
- Division of Plant Biosciences, School of Applied Biosciences, College of Agriculture and Life Science, Kyungpook National University, Daegu, South Korea
- Coastal Agriculture Research Institute, Kyungpook National University, Daegu, South Korea
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13
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Grimes B, Jacob W, Liberman AR, Kim N, Zhao X, Masison DC, Greene LE. The Properties and Domain Requirements for Phase Separation of the Sup35 Prion Protein In Vivo. Biomolecules 2023; 13:1370. [PMID: 37759770 PMCID: PMC10526957 DOI: 10.3390/biom13091370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/05/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
The Sup35 prion protein of budding yeast has been reported to undergo phase separation to form liquid droplets both at low pH in vitro and when energy depletion decreases the intracellular pH in vivo. It also has been shown using purified proteins that this phase separation is driven by the prion domain of Sup35 and does not re-quire its C-terminal domain. In contrast, we now find that a Sup35 fragment consisting of only the N-terminal prion domain and the M-domain does not phase separate in vivo; this phase separation of Sup35 requires the C-terminal domain, which binds Sup45 to form the translation termination complex. The phase-separated Sup35 not only colocalizes with Sup45 but also with Pub1, a stress granule marker protein. In addition, like stress granules, phase separation of Sup35 appears to require mRNA since cycloheximide treatment, which inhibits mRNA release from ribosomes, prevents phase separation of Sup35. Finally, unlike Sup35 in vitro, Sup35 condensates do not disassemble in vivo when the intracellular pH is increased. These results suggest that, in energy-depleted cells, Sup35 forms supramolecular assemblies that differ from the Sup35 liquid droplets that form in vitro.
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Affiliation(s)
- Bryan Grimes
- Laboratory of Cell Biology, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Walter Jacob
- Laboratory of Cell Biology, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Amanda R. Liberman
- Laboratory of Cell Biology, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Nathan Kim
- Laboratory of Cell Biology, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Xiaohong Zhao
- Laboratory of Cell Biology, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Daniel C. Masison
- Laboratory of Biochemistry and Genetics, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Lois E. Greene
- Laboratory of Cell Biology, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
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14
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Rodencal J, Kim N, Li VL, He A, Lange M, He J, Tarangelo A, Schafer ZT, Olzmann JA, Sage J, Long JZ, Dixon SJ. A Cell Cycle-Dependent Ferroptosis Sensitivity Switch Governed by EMP2. bioRxiv 2023:2023.07.19.549715. [PMID: 37502927 PMCID: PMC10370086 DOI: 10.1101/2023.07.19.549715] [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: 07/29/2023]
Abstract
Ferroptosis is a non-apoptotic form of cell death characterized by iron-dependent lipid peroxidation. Ferroptosis can be induced by system xc- cystine/glutamate antiporter inhibition or by direct inhibition of the phospholipid hydroperoxidase glutathione peroxidase 4 (GPX4). The regulation of ferroptosis in response to system xc- inhibition versus direct GPX4 inhibition may be distinct. Here, we show that cell cycle arrest enhances sensitivity to ferroptosis triggered by GPX4 inhibition but not system xc- inhibition. Arrested cells have increased levels of oxidizable polyunsaturated fatty acid-containing phospholipids, which drives sensitivity to GPX4 inhibition. Epithelial membrane protein 2 (EMP2) expression is reduced upon cell cycle arrest and is sufficient to enhance ferroptosis in response to direct GPX4 inhibition. An orally bioavailable GPX4 inhibitor increased markers of ferroptotic lipid peroxidation in vivo in combination with a cell cycle arresting agent. Thus, responses to different ferroptosis-inducing stimuli can be regulated by cell cycle state.
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Affiliation(s)
- Jason Rodencal
- Department of Biology, Stanford University, Stanford, CA 94305, USA
| | - Nathan Kim
- Department of Biology, Stanford University, Stanford, CA 94305, USA
| | - Veronica L. Li
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Andrew He
- Departments of Pediatrics and Genetics, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Mike Lange
- Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA 94720, USA
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Jianping He
- Department of Biological Sciences, University of Notre Dame, Notre Dame, IN 46556, USA
| | - Amy Tarangelo
- Department of Biology, Stanford University, Stanford, CA 94305, USA
| | - Zachary T. Schafer
- Department of Biological Sciences, University of Notre Dame, Notre Dame, IN 46556, USA
| | - James A. Olzmann
- Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA 94720, USA
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, Berkeley, CA 94720, USA
- Chan Zuckerberg Biohub, San Francisco, CA 94158, USA
| | - Julien Sage
- Departments of Pediatrics and Genetics, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Jonathan Z. Long
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Scott J. Dixon
- Department of Biology, Stanford University, Stanford, CA 94305, USA
- Lead contact
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15
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Kim N, Anneser E, Chu MT, Nguyen KH, Stopka TJ, Corlin L. Household conditions, COVID-19, and equity: Insight from two nationally representative surveys. Res Sq 2023:rs.3.rs-3129530. [PMID: 37461724 PMCID: PMC10350171 DOI: 10.21203/rs.3.rs-3129530/v1] [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] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
Background With people across the United States spending increased time at home since the emergence of COVID-19, housing characteristics may have an even greater impact on health. Therefore, we assessed associations between household conditions and COVID-19 experiences. Methods We used data from two nationally representative surveys: the Tufts Equity Study (TES; n = 1449 in 2021; n = 1831 in 2022) and the Household Pulse Survey (HPS; n = 147,380 in 2021; n = 62,826 in 2022). In the TES, housing conditions were characterized by heating/cooling methods; smoking inside the home; visible water damage/mold; age of housing unit; and self-reported concern about various environmental factors. In TES and HPS, household size was assessed. Accounting for sampling weights, we examined associations between each housing exposure and COVID-19 outcomes (diagnosis, vaccination) using separate logistic regression models with covariates selected based on an evidence-based directed acyclic graph. Results Having had COVID-19 was more likely among people who reported poor physical housing condition (odds ratio [OR] = 2.32; 95% confidence interval [CI] = 1.17-4.59; 2021), visible water damage or mold/musty smells (OR = 1.50; 95% CI = 1.10-2.03; 2022), and larger household size (5+ versus 1-2 people; OR = 1.53, 95% CI = 1.34-1.75, HPS 2022). COVID-19 vaccination was less likely among participants who reported smoke exposure inside the home (OR = 0.53; 95% CI = 0.31-0.90; 2022), poor water quality (OR = 0.42; 95% CI = 0.21-0.85; 2021), noise from industrial activity/construction (OR = 0.44; 95% CI = 0.19-0.99; 2022), and larger household size (OR = 0.57; 95% CI = 0.46-0.71; HPS 2022). Vaccination was also positively associated with poor indoor air quality (OR = 1.96; 95% CI = 1.02-3.72; 2022) and poor physical housing condition (OR = 2.27; 95% CI = 1.01-5.13; 2022). Certain heating/cooling sources were associated with COVID-19 outcomes. Conclusions Our study found poor housing conditions associated with increased COVID-19 burden, which may be driven by systemic disparities in housing, healthcare, and financial access to resources during the COVID-19 pandemic.
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16
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Stanford KE, Zhao X, Kim N, Masison DC, Greene LE. Overexpression of Hsp104 by Causing Dissolution of the Prion Seeds Cures the Yeast [ PSI+] Prion. Int J Mol Sci 2023; 24:10833. [PMID: 37446010 DOI: 10.3390/ijms241310833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/20/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
The yeast Sup35 protein misfolds into the infectious [PSI+] prion, which is then propagated by the severing activity of the molecular chaperone, Hsp104. Unlike other yeast prions, this prion is unique in that it is efficiently cured by the overexpression as well as the inactivation of Hsp104. However, it is controversial whether curing by overexpression is due to the dissolution of the prion seeds by the trimming activity of Hsp104 or the asymmetric segregation of the prion seeds between mother and daughter cells which requires cell division. To answer this question, we conducted experiments and found no difference in the extent of curing between mother and daughter cells when half of the cells were cured by Hsp104 overexpression in one generation. Furthermore, curing was not affected by the lack of Sir2 expression, which was reported to be required for asymmetric segregation of the [PSI+] seeds. More importantly, when either hydroxyurea or ethanol were used to inhibit cell division, the extent of curing by Hsp104 overexpression was not significantly reduced. Therefore, the curing of [PSI+] by Hsp104 overexpression is not due to asymmetric segregation of the prion seeds, but rather their dissolution by Hsp104.
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Affiliation(s)
- Katherine E Stanford
- Laboratory of Cell Biology, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Xiaohong Zhao
- Laboratory of Cell Biology, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Nathan Kim
- Laboratory of Cell Biology, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Daniel C Masison
- Laboratory of Biochemistry and Genetics, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Lois E Greene
- Laboratory of Cell Biology, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
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Kazemimoghadam M, Yang Z, Chen M, Rahimi A, Kim N, Alluri P, Nwachukwu C, Lu W, Gu X. A deep learning approach for automatic delineation of clinical target volume in stereotactic partial breast irradiation (S-PBI). Phys Med Biol 2023; 68:10.1088/1361-6560/accf5e. [PMID: 37084739 PMCID: PMC10325028 DOI: 10.1088/1361-6560/accf5e] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 04/21/2023] [Indexed: 04/23/2023]
Abstract
Accurate and efficient delineation of the clinical target volume (CTV) is of utmost significance in post-operative breast cancer radiotherapy. However, CTV delineation is challenging as the exact extent of microscopic disease encompassed by CTV is not visualizable in radiological images and remains uncertain. We proposed to mimic physicians' contouring practice for CTV segmentation in stereotactic partial breast irradiation (S-PBI) where CTV is derived from tumor bed volume (TBV) via a margin expansion followed by correcting the extensions for anatomical barriers of tumor invasion (e.g. skin, chest wall). We proposed a deep-learning model, where CT images and the corresponding TBV masks formed a multi-channel input for a 3D U-Net based architecture. The design guided the model to encode the location-related image features and directed the network to focus on TBV to initiate CTV segmentation. Gradient weighted class activation map (Grad-CAM) visualizations of the model predictions revealed that the extension rules and geometric/anatomical boundaries were learnt during model training to assist the network to limit the expansion to a certain distance from the chest wall and the skin. We retrospectively collected 175 prone CT images from 35 post-operative breast cancer patients who received 5-fraction partial breast irradiation regimen on GammaPod. The 35 patients were randomly split into training (25), validation (5) and test (5) sets. Our model achieved mean (standard deviation) of 0.94 (±0.02), 2.46 (±0.5) mm, and 0.53 (±0.14) mm for Dice similarity coefficient, 95th percentile Hausdorff distance, and average symmetric surface distance respectively on the test set. The results are promising for improving the efficiency and accuracy of CTV delineation during on-line treatment planning procedure.
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Affiliation(s)
- Mahdieh Kazemimoghadam
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas TX, 75390 USA
| | - Zi Yang
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas TX, 75390 USA
| | - Mingli Chen
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas TX, 75390 USA
| | - Asal Rahimi
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas TX, 75390 USA
| | - Nathan Kim
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas TX, 75390 USA
| | - Prasanna Alluri
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas TX, 75390 USA
| | - Chika Nwachukwu
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas TX, 75390 USA
| | - Weiguo Lu
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas TX, 75390 USA
| | - Xuejun Gu
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas TX, 75390 USA
- Department of Radiation Oncology, Stanford University, Stanford, CA 94305
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18
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Petsagkourakis I, Riera-Galindo S, Ruoko TP, Strakosas X, Pavlopoulou E, Liu X, Braun S, Kroon R, Kim N, Lienemann S, Gueskine V, Hadziioannou G, Berggren M, Fahlman M, Fabiano S, Tybrandt K, Crispin X. Improved Performance of Organic Thermoelectric Generators Through Interfacial Energetics. Adv Sci (Weinh) 2023:e2206954. [PMID: 37132565 PMCID: PMC10369274 DOI: 10.1002/advs.202206954] [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] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/20/2023] [Indexed: 05/04/2023]
Abstract
The interfacial energetics are known to play a crucial role in organic diodes, transistors, and sensors. Designing the metal-organic interface has been a tool to optimize the performance of organic (opto)electronic devices, but this is not reported for organic thermoelectrics. In this work, it is demonstrated that the electrical power of organic thermoelectric generators (OTEGs) is also strongly dependent on the metal-organic interfacial energetics. Without changing the thermoelectric figure of merit (ZT) of polythiophene-based conducting polymers, the generated power of an OTEG can vary by three orders of magnitude simply by tuning the work function of the metal contact to reach above 1000 µW cm-2 . The effective Seebeck coefficient (Seff ) of a metal/polymer/metal single leg OTEG includes an interfacial contribution (Vinter /ΔT) in addition to the intrinsic bulk Seebeck coefficient of the polythiophenes, such that Seff = S + Vinter /ΔT varies from 22.7 µV K-1 [9.4 µV K-1 ] with Al to 50.5 µV K-1 [26.3 µV K-1 ] with Pt for poly(3,4-ethylenedioxythiophene):p-toluenesulfonate [poly(3,4-ethylenedioxythiophene):poly(4-styrenesulfonate)]. Spectroscopic techniques are used to reveal a redox interfacial reaction affecting locally the doping level of the polymer at the vicinity of the metal-organic interface and conclude that the energetics at the metal-polymer interface provides a new strategy to enhance the performance of OTEGs.
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Affiliation(s)
- I Petsagkourakis
- Laboratory of Organic Electronics, Department of Science and Technology (ITN), Linköping University, SE-601 74, Norrköping, Sweden
| | - S Riera-Galindo
- Laboratory of Organic Electronics, Department of Science and Technology (ITN), Linköping University, SE-601 74, Norrköping, Sweden
| | - T-P Ruoko
- Laboratory of Organic Electronics, Department of Science and Technology (ITN), Linköping University, SE-601 74, Norrköping, Sweden
| | - X Strakosas
- Laboratory of Organic Electronics, Department of Science and Technology (ITN), Linköping University, SE-601 74, Norrköping, Sweden
| | - E Pavlopoulou
- Institute of Electronic Structure and Laser, Foundation for Research and Technology, 71110, Heraklion, Crete, Greece
| | - X Liu
- Laboratory of Organic Electronics, Department of Science and Technology (ITN), Linköping University, SE-601 74, Norrköping, Sweden
| | - S Braun
- Laboratory of Organic Electronics, Department of Science and Technology (ITN), Linköping University, SE-601 74, Norrköping, Sweden
| | - R Kroon
- Laboratory of Organic Electronics, Department of Science and Technology (ITN), Linköping University, SE-601 74, Norrköping, Sweden
| | - N Kim
- Laboratory of Organic Electronics, Department of Science and Technology (ITN), Linköping University, SE-601 74, Norrköping, Sweden
| | - S Lienemann
- Laboratory of Organic Electronics, Department of Science and Technology (ITN), Linköping University, SE-601 74, Norrköping, Sweden
| | - V Gueskine
- Laboratory of Organic Electronics, Department of Science and Technology (ITN), Linköping University, SE-601 74, Norrköping, Sweden
| | - G Hadziioannou
- Bordeaux INP, CNRS, Univ. Bordeaux, LCPO, F-33600, UMR 5629, Pessac, France
| | - M Berggren
- Laboratory of Organic Electronics, Department of Science and Technology (ITN), Linköping University, SE-601 74, Norrköping, Sweden
- Wallenberg Wood Science Center, Linköping University, 602 23, Norrköping, Sweden
| | - M Fahlman
- Laboratory of Organic Electronics, Department of Science and Technology (ITN), Linköping University, SE-601 74, Norrköping, Sweden
| | - S Fabiano
- Laboratory of Organic Electronics, Department of Science and Technology (ITN), Linköping University, SE-601 74, Norrköping, Sweden
| | - K Tybrandt
- Laboratory of Organic Electronics, Department of Science and Technology (ITN), Linköping University, SE-601 74, Norrköping, Sweden
| | - X Crispin
- Laboratory of Organic Electronics, Department of Science and Technology (ITN), Linköping University, SE-601 74, Norrköping, Sweden
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19
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Yun J, Yun S, Park JE, Cheong EN, Park SY, Kim N, Kim HS. Deep Learning of Time-Signal Intensity Curves from Dynamic Susceptibility Contrast Imaging Enables Tissue Labeling and Prediction of Survival in Glioblastoma. AJNR Am J Neuroradiol 2023; 44:543-552. [PMID: 37105676 PMCID: PMC10171378 DOI: 10.3174/ajnr.a7853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 03/21/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND AND PURPOSE An autoencoder can learn representative time-signal intensity patterns to provide tissue heterogeneity measures using dynamic susceptibility contrast MR imaging. The aim of this study was to investigate whether such an autoencoder-based pattern analysis could provide interpretable tissue labeling and prognostic value in isocitrate dehydrogenase (IDH) wild-type glioblastoma. MATERIALS AND METHODS Preoperative dynamic susceptibility contrast MR images were obtained from 272 patients with IDH wild-type glioblastoma (training and validation, 183 and 89 patients, respectively). The autoencoder was applied to the dynamic susceptibility contrast MR imaging time-signal intensity curves of tumor and peritumoral areas. Representative perfusion patterns were defined by voxelwise K-means clustering using autoencoder latent features. Perfusion patterns were labeled by comparing parameters with anatomic reference tissues for baseline, signal drop, and percentage recovery. In the validation set (n = 89), a survival model was created from representative patterns and clinical predictors using Cox proportional hazard regression analysis, and its performance was calculated using the Harrell C-index. RESULTS Eighty-nine patients were enrolled. Five representative perfusion patterns were used to characterize tissues as high angiogenic tumor, low angiogenic/cellular tumor, perinecrotic lesion, infiltrated edema, and vasogenic edema. Of these, the low angiogenic/cellular tumor (hazard ratio, 2.18; P = .047) and infiltrated edema patterns (hazard ratio, 1.88; P = .009) in peritumoral areas showed significant prognostic value. The combined perfusion patterns and clinical predictors (C-index, 0.72) improved prognostication when added to clinical predictors (C-index, 0.55). CONCLUSIONS The autoencoder perfusion pattern analysis enabled tissue characterization of peritumoral areas, providing heterogeneity and dynamic information that may provide useful prognostic information in IDH wild-type glioblastoma.
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Affiliation(s)
- J Yun
- From the Departments of Convergence Medicine (J.Y., N.K.)
- Radiology and Research Institute of Radiology (J.Y., J.E.P., N.K., H.S.K.), Asan Medical Center
| | - S Yun
- Department of Radiology (S.Y.), Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - J E Park
- Radiology and Research Institute of Radiology (J.Y., J.E.P., N.K., H.S.K.), Asan Medical Center
| | - E-N Cheong
- Medical Science and Asan Medical Institute of Convergence Science and Technology (E.-N.C.), University of Ulsan College of Medicine, Seoul, Korea
| | - S Y Park
- Department of Statistics and Data Science (S.Y.P.), Korea National Open University, Seoul, Korea
| | - N Kim
- From the Departments of Convergence Medicine (J.Y., N.K.)
- Radiology and Research Institute of Radiology (J.Y., J.E.P., N.K., H.S.K.), Asan Medical Center
| | - H S Kim
- Radiology and Research Institute of Radiology (J.Y., J.E.P., N.K., H.S.K.), Asan Medical Center
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20
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Kim N, Vargas P, Fortuna K, Wagemans J, Rediers H. Draft Genome Sequences of 27 Rhizogenic Agrobacterium Biovar 1 Strains, the Causative Agent of Hairy Root Disease. Microbiol Resour Announc 2023; 12:e0012423. [PMID: 37098915 DOI: 10.1128/mra.00124-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
Rhizogenic Agrobacterium biovar 1 strains are important plant pathogens that cause hairy root disease in Cucurbitaceae and Solanaceae crops cultivated under hydroponic conditions. In contrast to tumorigenic agrobacteria, only a few genome sequences of rhizogenic agrobacteria are currently available. Here, we report the draft genome sequences of 27 rhizogenic Agrobacterium strains.
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Affiliation(s)
- N Kim
- Laboratory for Process Microbial Ecology and Bioinspirational Management, Centre of Microbial and Plant Genetics, Leuven, Belgium
- Leuven Plant Institute, KU Leuven, Leuven, Belgium
| | - P Vargas
- Laboratory for Process Microbial Ecology and Bioinspirational Management, Centre of Microbial and Plant Genetics, Leuven, Belgium
- Leuven Plant Institute, KU Leuven, Leuven, Belgium
| | - K Fortuna
- Leuven Plant Institute, KU Leuven, Leuven, Belgium
- Laboratory of Gene Technology, Department of Biosystems, KU Leuven, Leuven, Belgium
| | - J Wagemans
- Leuven Plant Institute, KU Leuven, Leuven, Belgium
- Laboratory of Gene Technology, Department of Biosystems, KU Leuven, Leuven, Belgium
| | - H Rediers
- Laboratory for Process Microbial Ecology and Bioinspirational Management, Centre of Microbial and Plant Genetics, Leuven, Belgium
- Leuven Plant Institute, KU Leuven, Leuven, Belgium
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21
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Ghasemzadeh N, Kim N, Amlani S, Madan M, Shavadia JS, Chong AY, Bagherli A, Bagai A, Saw J, Singh J, Dehghani P. A Review of ST-Elevation Myocardial Infarction in Patients with COVID-19. Heart Fail Clin 2023; 19:197-204. [PMID: 36863811 PMCID: PMC9973551 DOI: 10.1016/j.hfc.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
The Coronavirus disease 2019 (COVID-19) pandemic has led to a significant increase in worldwide morbidity and mortality. Patients with COVID-19 are at risk for developing a variety of cardiovascular conditions including acute coronary syndromes, stress-induced cardiomyopathy, and myocarditis. Patients with COVID-19 who develop ST-elevation myocardial infarction (STEMI) are at a higher risk of morbidity and mortality when compared with their age- and sex-matched STEMI patients without COVID-19. We review current knowledge on the pathophysiology of STEMI in patients with COVID-19, clinical presentation, outcomes, and the effect of the COVID-19 pandemic on overall STEMI care.
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Affiliation(s)
| | - Nathan Kim
- Northeast Georgia Health System, Gainesville, GA 30501, USA
| | - Shy Amlani
- William Osler Health System, Brampton, 2100 Bovaird Drive East, Ontario L6R 3J7, Canada
| | - Mina Madan
- Schulich Heart Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Jay S Shavadia
- Royal University Hospital, Saskatchewan Health, University of Saskatchewan Saskatoon, 103 Hospital Drive, Saskatchewan S7N 0W8, Canada
| | - Aun-Yeong Chong
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada
| | - Alireza Bagherli
- Windsor Regional Hospital, 1030 Ouellette Avenue, Windsor, Ontario N9A 1E1, Canada
| | - Akshay Bagai
- Terrence Donnelly Heart Centre, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada
| | - Jacqueline Saw
- Vancouver General Hospital, Vancouver, 12th Avenue, Vancouver, British Columbia V5Z 1M9, Canada
| | - Jyotpal Singh
- Prairie Vascular Research Inc, Regina, 1440 14 Avenue, Saskatchewan S4P 0W5, Canada
| | - Payam Dehghani
- Prairie Vascular Research Inc, Regina, 1440 14 Avenue, Saskatchewan S4P 0W5, Canada.
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22
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Kasthuri V, Laguna A, Kim N, Yoon J, Ahn S. Abstract No. 289 Modern Search Analytics: What Are Patients Asking ecan Uterine Artery Embolization? J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.356] [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: 02/27/2023] Open
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23
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Kasthuri V, Kim N, Laguna A, Yoon J, Ahn S. Abstract No. 604 Modern Search Analytics: What Are Patients Asking about Prostate Artery Embolization? J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.462] [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: 02/27/2023] Open
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24
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Kim N, Song JY, Yang H, Kim MJ, Lee K, Shin YH, Rhee SY, Hwang J, Kim MS, Fond G, Boyer L, Kim SY, Shin JI, Lee SW, Yon DK. National trends in suicide-related behaviors among youths between 2005-2020, including COVID-19: a Korean representative survey of one million adolescents. Eur Rev Med Pharmacol Sci 2023; 27:1192-1202. [PMID: 36808368 DOI: 10.26355/eurrev_202302_31226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
OBJECTIVE It is difficult to conclude that COVID-19 is associated with a decrease in the suicide attempts rate by comparing only a short-term period. Therefore, it is necessary to examine attempted suicide rates through a trend analysis over a longer period. This study aimed to investigate an estimated long-term trend regarding the prevalence of suicide-related behaviors among adolescents in South Korea from 2005 to 2020, including COVID-19. SUBJECTS AND METHODS We sourced data from a national representative survey (Korea Youth Risk Behavior Survey) and analyzed one million Korean adolescents aged 13 to 18 years (n=1,057,885) from 2005 to 2020. The 16-year trends regarding the prevalence of sadness or despair and suicidal ideation and attempt and the trend changes before and during COVID-19. RESULTS Data of 1,057,885 Korean adolescents was analyzed (weighted mean age, 15.03 years; males, 52.5%; females, 47.5%). Although the 16-year trend in the prevalence of sadness or despair and suicide ideation and attempt consistently decreased (prevalence of sadness or despair between 2005-2008, 38.0% with 95% confidence interval [CI], 37.7 to 38.4 vs. prevalence in 2020, 25.0% [24.5 to 25.6]; suicide ideation between 2005-2008, 21.9% [21.6 to 22.1] vs. prevalence in 2020, 10.7% [10.3 to 11.1]; and suicide attempt between 2005-2008, 5.0% [4.9 to 5.2] vs. prevalence in 2020, 1.9% [1.8 to 2.0]), the downward slope decreased during COVID-19 (βdiff in sadness, 0.215 with 95% CI 0.206 to 0.224; βdiff in suicidal ideation, 0.245 [0.234 to 0.256]; and βdiff in suicide attempt, 0.219 [0.201 to 0.237]) compared with pre-pandemic period. CONCLUSIONS This study found that the observed risk of suicide-related behaviors during the pandemic was higher than expected through long-term trend analysis of the prevalence of sadness/despair and suicidal ideation and attempts among South Korean adolescents. We need a profound epidemiologic study of the change in mental health due to the pandemic's impact and the establishment of prevention strategies for suicide ideation and attempt.
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Affiliation(s)
- N Kim
- Department of Neuropsychiatry, Seoul National University College of Medicine, Seoul, South Korea.
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25
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Parsons D, Joo M, Iqbal Z, Godley A, Kim N, Spangler A, Albuquerque K, Sawant A, Zhao B, Gu X, Rahimi A. Stability and reproducibility comparisons between deep inspiration breath-hold techniques for left-sided breast cancer patients: A prospective study. J Appl Clin Med Phys 2023; 24:e13906. [PMID: 36691339 PMCID: PMC10161105 DOI: 10.1002/acm2.13906] [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: 08/30/2022] [Revised: 12/06/2022] [Accepted: 12/23/2022] [Indexed: 01/25/2023] Open
Abstract
PURPOSE Deep inspiration breath-hold (DIBH) is crucial in reducing the lung and cardiac dose for treatment of left-sided breast cancer. We compared the stability and reproducibility of two DIBH techniques: Active Breathing Coordinator (ABC) and VisionRT (VRT). MATERIALS AND METHODS We examined intra- and inter-fraction positional variation of the left lung. Eight left-sided breast cancer patients were monitored with electronic portal imaging during breath-hold (BH) at every fraction. For each patient, half of the fractions were treated using ABC and the other half with VRT, with an equal amount starting with either ABC or VRT. The lung in each portal image was delineated, and the variation of its area was evaluated. Intrafraction stability was evaluated as the mean coefficient of variation (CV) of the lung area for the supraclavicular (SCV) and left lateral (LLat) field over the course of treatment. Reproducibility was the CV for the first image of each fraction. Daily session time and total imaging monitor units (MU) used in patient positioning were recorded. RESULTS The mean intrafraction stability across all patients for the LLat field was 1.3 ± 0.7% and 1.5 ± 0.9% for VRT and ABC, respectively. Similarly, this was 1.5 ± 0.7% and 1.6 ± 0.8% for VRT and ABC, respectively, for the SCV field. The mean interfraction reproducibility for the LLat field was 11.0 ± 3.4% and 14.9 ± 6.0% for VRT and ABC, respectively. Similarly, this was 13.0 ± 2.5% and 14.8 ± 9% for VRT and ABC, respectively, for the SCV. No difference was observed in the number of verification images required for either technique. CONCLUSIONS The stability and reproducibility were found to be comparable between ABC and VRT. ABC can have larger interfractional variation with less feedback to the treating therapist compared to VRT as shown in the increase in geometric misses at the matchline.
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Affiliation(s)
- David Parsons
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Mindy Joo
- Department of Radiation Oncology, Inova Fairfax Hospital, Falls Church, Virginia, USA
| | - Zohaib Iqbal
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Andrew Godley
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Nathan Kim
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ann Spangler
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Kevin Albuquerque
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Amit Sawant
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Bo Zhao
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Xuejun Gu
- Department of Radiation Oncology, Stanford University, Palo Alto, California, USA
| | - Asal Rahimi
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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26
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Montalvo SK, Kim N, Nwachukwu C, Alluri P, Parsons D, Lin M, Cai B, Zhuang T, Hrycushko B, Chen L, Timmerman R, Rahimi A. On the feasibility of improved target coverage without compromising organs at risk using online adaptive stereotactic partial breast irradiation (A-SPBI). J Appl Clin Med Phys 2022; 24:e13813. [PMID: 36350273 PMCID: PMC9924103 DOI: 10.1002/acm2.13813] [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: 03/08/2022] [Revised: 08/26/2022] [Accepted: 09/18/2022] [Indexed: 11/11/2022] Open
Abstract
PURPOSE Describe an early-adopting institution's experience with online adaptive radiation for stereotactic partial breast irradiation. METHODS AND MATERIALS Retrospective review of 22 women treated between May 2021 and March 2022 with adaptive stereotactic partial breast irradiation. A total of 106 of 110 fractions were evaluated for dosimetric changes in target coverage and organ-at-risk (OAR) dose. Patient set up with stereotactic wooden frame and adapted per fraction. Treatment and planning times were collected prospectively by radiation therapists. RESULTS Scheduled PTV30 Gy was <95% in 72.1% and <90% in 38.5% of fractions, and both PTV and CTV coverage were improved significantly after adaption, and 83.7% of fractions were delivered as adapted per physician choice. There was no difference in OAR coverage. Average adaptive treatment planning took 15 min and average time-on-couch was 34.4 min. CONCLUSIONS Adaptive stereotactic breast irradiation resulted in improved target coverage with equivalent dosing to OARs in an efficient and tolerated treatment time. Improved target coverage allowed for decreased PTV margins compared to prior trial protocols that may improve acute and late toxicities.
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Affiliation(s)
- Steven K. Montalvo
- Department of Radiation OncologyUT Southwestern Harold C. Simmons Cancer CenterDallasTexasUSA
| | - Nathan Kim
- Department of Radiation OncologyUT Southwestern Harold C. Simmons Cancer CenterDallasTexasUSA
| | - Chika Nwachukwu
- Department of Radiation OncologyUT Southwestern Harold C. Simmons Cancer CenterDallasTexasUSA
| | - Prasanna Alluri
- Department of Radiation OncologyUT Southwestern Harold C. Simmons Cancer CenterDallasTexasUSA
| | - David Parsons
- Department of Radiation OncologyUT Southwestern Harold C. Simmons Cancer CenterDallasTexasUSA
| | - Mu‐Han Lin
- Department of Radiation OncologyUT Southwestern Harold C. Simmons Cancer CenterDallasTexasUSA
| | - Bin Cai
- Department of Radiation OncologyUT Southwestern Harold C. Simmons Cancer CenterDallasTexasUSA
| | - Tingliang Zhuang
- Department of Radiation OncologyUT Southwestern Harold C. Simmons Cancer CenterDallasTexasUSA
| | - Brian Hrycushko
- Department of Radiation OncologyUT Southwestern Harold C. Simmons Cancer CenterDallasTexasUSA
| | - Liyuan Chen
- Department of Radiation OncologyUT Southwestern Harold C. Simmons Cancer CenterDallasTexasUSA
| | - Robert Timmerman
- Department of Radiation OncologyUT Southwestern Harold C. Simmons Cancer CenterDallasTexasUSA
| | - Asal Rahimi
- Department of Radiation OncologyUT Southwestern Harold C. Simmons Cancer CenterDallasTexasUSA
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LaVigne A, Dyson T, Jamerson T, Kim N, Asrari F, Wright J, Aguh C, Alcorn S. Development of gRADient: An Inclusive Tool for Objective Measurement of Radiation Acute Skin Toxicity across Skin Tones in Breast Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kim PJ, Skabelund Z, Kalim S, Lee CH, Kim N, Nguyen K, Emam H, Knobloch L, Deguchi T, Kim M, Kim DG. Sex dependent differences of temporomandibular condylar bone mineral density distribution. Cranio 2022:1-7. [PMID: 36302258 DOI: 10.1080/08869634.2022.2137131] [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] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this study was to examine whether bone mineral density (BMD) distribution in the mandibular condyle and facial morphology are associated with temporomandibular joint osteoarthritis (TMJ OA) using clinical cone beam computed tomography (CBCT) images. METHODS CBCT images of 35 adults (16 male and 19 female) were examined to obtain TMJ OA counts, cephalometric analyses, and histograms of gray values that are proportional to BMD. Mean, standard deviation (SD), and low and high gray values at the 5th and 95th percentiles (Low5 and High5) of the histograms were measured. RESULTS The female group had significantly higher values of TMJ OA counts, mean, and SD on the right mandibular condyle, High5 on both sides, and all gray value parameters for total (right + left) than the male group. CONCLUSION Comprehensive analysis of BMD distribution in the mandibular condyle can provide useful information for prognosis of TMJ OA.
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Affiliation(s)
- Paul J Kim
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Zachary Skabelund
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Sonya Kalim
- Division of Oral & Maxillofacial Radiology, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Christine H Lee
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Nathan Kim
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Kristen Nguyen
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Hany Emam
- Division of Oral and Maxillofacial Surgery and Anesthesiology, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Lisa Knobloch
- Division of Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Toru Deguchi
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Minji Kim
- Department of Orthodontics, Graduate School of Clinical Dentistry, Ewha Womans University, Seoul, Korea
| | - Do-Gyoon Kim
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, USA
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Shah NV, Kim DJ, Patel N, Beyer GA, Hollern DA, Wolfert AJ, Kim N, Suarez DE, Monessa D, Zhou PL, Eldib HM, Passias PG, Schwab FJ, Lafage V, Paulino CB, Diebo BG. The 5-factor modified frailty index (mFI-5) is predictive of 30-day postoperative complications and readmission in patients with adult spinal deformity (ASD). J Clin Neurosci 2022; 104:69-73. [PMID: 35981462 DOI: 10.1016/j.jocn.2022.07.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 04/28/2022] [Revised: 07/19/2022] [Accepted: 07/24/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND There is limited research regarding the association between the mFI-5 and postoperative complications among adult spinal deformity (ASD) patients. METHODS Using the National Surgical Quality Improvement Project (NSQIP) database, patients with Current Procedural Terminology (CPT) codes for > 7-level fusion or < 7-level fusion with International Classification of Diseases, Ninth Revision (ICD-9) codes for ASD were identified between 2008 and 2016. Univariate analyses with post-hoc Bonferroni correction for demographics and preoperative factors were performed. Logistic regression assessed associations between mFI-5 scores and 30-day post-operative outcomes. RESULTS 2,120 patients met criteria. Patients with an mFI-5 score of 4 or 5 were excluded, given there were<20 patients with those scores. Patients with mFI-5 scores of 1 and 2 had increased 30-day rates of pneumonia (3.5 % and 4.3 % vs 1.6 %), unplanned postoperative ventilation for > 48 h (3.1 % and 4.3 % vs 0.9 %), and UTIs (4.4 % and 7.4 % vs 2.0 %) than patients with a score of 0 (all, p < 0.05). Logistic regression revealed that compared to an mFI-5 of 0, a score of 1 was an independent predictor of 30-day reoperations (OR = 1.4; 95 % CI 1.1-18). A score of 2 was an independent predictor of overall (OR = 2.4; 95 % CI 1.4-4.1) and related (OR = 2.2; 95 % CI 1.2-4.1) 30-day readmissions. A score of 3 was not predictive of any adverse outcome. CONCLUSION The mFI-5 score predicted complications and postoperative events in the ASD population. The mFI-5 may effectively predict 30-day readmissions. Further research is needed to identify the benefits and predictive value of mFI-5 as a risk assessment tool.
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Affiliation(s)
- Neil V Shah
- Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, USA.
| | - David J Kim
- Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, USA
| | - Neil Patel
- Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, USA
| | - George A Beyer
- Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, USA
| | - Douglas A Hollern
- Department of Orthopedic Surgery, USC Verdugo Hills Hospital, Los Angeles, CA, USA
| | - Adam J Wolfert
- Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, USA
| | - Nathan Kim
- Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, USA
| | - Daniel E Suarez
- Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, USA
| | - Dan Monessa
- Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, USA
| | - Peter L Zhou
- Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, USA
| | - Hassan M Eldib
- Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, USA
| | - Peter G Passias
- Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA
| | - Frank J Schwab
- Department of Orthopaedic Surgery, Lenox Hill Hospital, Northwell Health, New York, NY, USA
| | - Virginie Lafage
- Department of Orthopaedic Surgery, Lenox Hill Hospital, Northwell Health, New York, NY, USA
| | - Carl B Paulino
- Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, USA; Department of Orthopaedic Surgery, New York Presbyterian-Brooklyn Methodist Hospital, Brooklyn, NY, USA
| | - Bassel G Diebo
- Department of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, USA; Department of Orthopaedic Surgery, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
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Kim C, Komisaruk B, Kim N, Goldstein S, Yee A, Goldstein I. Surgical Outcomes of PGAD/GPD Patients with Sacral Radiculopathy Associated with Tarlov Cyst. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.05.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abidoye O, Kim N, Fombi J. An Interesting Case Report of Myasthenia Gravis Exacerbation Induced by Durvalumab. Cureus 2022; 14:e26985. [PMID: 35989744 PMCID: PMC9381854 DOI: 10.7759/cureus.26985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
Immune checkpoint inhibitors are novel therapy for a wide range of malignancies. They have been associated with numerous side effects resulting in pulmonary, dermatological, gastrointestinal, and neurological complications. There are few reported cases of myasthenia gravis exacerbation from immune checkpoint inhibitors. We present a case of an 82-year-old woman with a history of myasthenia gravis in remission and non-small cell lung cancer who presented with diplopia, dyspnea, and generalized weakness after three cycles of durvalumab. She was diagnosed with a myasthenic crisis and was treated with high-dose steroids and plasmapheresis.
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Kang Y, Jamison K, Jaywant A, Dams-O’Connor K, Kim N, Karakatsanis NA, Butler T, Schiff ND, Kuceyeski A, Shah SA. Longitudinal alterations in gamma-aminobutyric acid (GABAA) receptor availability over ∼ 1 year following traumatic brain injury. Brain Commun 2022; 4:fcac159. [PMID: 35794871 PMCID: PMC9253887 DOI: 10.1093/braincomms/fcac159] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/24/2022] [Accepted: 06/14/2022] [Indexed: 11/25/2022] Open
Abstract
Longitudinal alterations of gamma-aminobutyric acid (GABAA) receptor availability following traumatic brain injury have remained uncharacterized and may reflect changes in neuronal structure and function linked to cognitive recovery. We measured GABAA receptor availability using the tracer [11C]flumazenil in nine adults with traumatic brain injury (3–6 months after injury, subacute scan) and in 20 non-brain-injured individuals. A subset of subjects with traumatic brain injury (n = 7) were scanned at a second chronic time-point, 7–13 months after their first scan; controls (n = 9) were scanned for a second time, 5–11 months after the first scan. After accounting for atrophy in subjects with traumatic brain injury, we find broad decreases in GABAA receptor availability predominantly within the frontal lobes, striatum, and posterior-medial thalami; focal reductions were most pronounced in the right insula and anterior cingulate cortex (p < 0.05). Greater relative increase, compared to controls, in global GABAA receptor availability appeared between subacute and chronic scans. At chronic scan (>1 year post-injury), we find increased pallidal receptor availability compared to controls. Conversely, receptor availability remained depressed across the frontal cortices. Longitudinal improvement in executive attention correlated with increases in receptor availability across bilateral fronto-parietal cortical regions and the anterior-lateral aspects of the thalami. The specific observations of persistent bi-frontal lobe reductions and bilateral pallidal elevation are consistent with the anterior forebrain mesocircuit hypothesis for recovery of consciousness following a wide range of brain injuries; our results provide novel correlative data in support of specific cellular mechanisms underlying persistent cognitive deficits. Collectively, these measurements support the use of [11C]flumazenil to track recovery of large-scale network function following brain injuries and measure response to therapeutics.
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Affiliation(s)
- Y Kang
- Department of Mathematics, Howard University , Washington, DC 20059 , USA
| | - K Jamison
- Department of Radiology, Weill Cornell Medicine , 407 E. 61 St., Rm 208, New York, NY 10065 , USA
| | - A Jaywant
- Department of Rehabilitation Medicine, Weill Cornell Medicine , New York, NY 10065 , USA
- Department of Psychiatry, Weill Cornell Medicine , New York, NY 10065 , USA
| | - K Dams-O’Connor
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai , New York, NY 10029 , USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai , New York, NY 10029 , USA
| | - N Kim
- Department of Radiology, Weill Cornell Medicine , 407 E. 61 St., Rm 208, New York, NY 10065 , USA
| | - N A Karakatsanis
- Department of Radiology, Weill Cornell Medicine , 407 E. 61 St., Rm 208, New York, NY 10065 , USA
| | - T Butler
- Department of Radiology, Weill Cornell Medicine , 407 E. 61 St., Rm 208, New York, NY 10065 , USA
| | - N D Schiff
- Department of BMRI & Neurology, Weill Cornell Medicine , New York, NY 10065 , USA
| | - A Kuceyeski
- Department of Radiology, Weill Cornell Medicine , 407 E. 61 St., Rm 208, New York, NY 10065 , USA
| | - S A Shah
- Department of Radiology, Weill Cornell Medicine , 407 E. 61 St., Rm 208, New York, NY 10065 , USA
- Department of BMRI & Neurology, Weill Cornell Medicine , New York, NY 10065 , USA
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Craine A, Scott A, Desai D, Alshawabkeh L, Adler E, Kim N, Contijoch F. 442 Myocardial Work Estimation With Ct Aids Evaluation Of Regional Right Ventricular Function. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kim MJ, Lee KH, Lee JS, Kim N, Song JY, Shin YH, Yang JM, Lee SW, Hwang J, Rhee SY, Yon DK, Shin JI, Choi YJ. Trends in body mass index changes among Korean adolescents between 2005-2020, including the COVID-19 pandemic period: a national representative survey of one million adolescents. Eur Rev Med Pharmacol Sci 2022; 26:4082-4091. [PMID: 35731079 DOI: 10.26355/eurrev_202206_28978] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
OBJECTIVE The impact of the coronavirus disease 2019 (COVID-19) pandemic on weight gain in children and adolescents remains unknown. We aimed to identify an estimated 15-year trend in mean body mass index (BMI) changes and prevalence of obesity and overweight among Korean adolescents from 2005 to 2020, including the period of the COVID-19 pandemic. PATIENTS AND METHODS We analyzed data taken from a nationwide survey (Korea Youth Risk Behavior Survey), between 2005 and 2020. Representative samples of one million Korean adolescents aged 13-18 years (n=1,057,885) were examined. The 15-year trends in mean BMI and proportion of obesity or overweight, and the changes due to the COVID-19 pandemic were analyzed. RESULTS The data of 1,057,885 Korean adolescents were analyzed (mean age: 14.98 years; females, 48.4%). The estimated weighted mean BMI was 20.5 kg/m2 [95% confidence interval (CI), 20.4-20.5] from 2005 to 2008 and 21.5 kg/m2 (95% CI, 21.4-21.6) in 2020 (during the COVID-19 pandemic). Although the 15-year trend of mean BMI gradually increased, the change in mean BMI before and during the pandemic significantly lessened (βdiff, -0.027; 95% CI, -0.028 to -0.026). The 15-year (2005-2020) trend changes in the prevalence of obesity and overweight were similar (obesity prevalence from 2005-2008, 3.2%; 95% CI, 3.1-3.3 vs. obesity prevalence in 2020, 8.6%; 95% CI, 8.2-9.0; βdiff, -0.309; 95% CI, -0.330 to -0.288). CONCLUSIONS The 15-year trend of overall mean BMI and obesity and overweight prevalence demonstrated a significant increase; however, its slope decreased during the pandemic. These landmark results suggest the need for the development of precise strategies to prevent pediatric obesity and overweight during the COVID-19 pandemic.
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Affiliation(s)
- M J Kim
- Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
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Kim N, Lee J, Oh E, Jekarl D, Lee D, Im K, Cho S. Immunotherapy: OFF-THE-SHELF PARTIAL HLA MATCHING SARS-COV-2 ANTIGEN SPECIFIC T CELL THERAPY: A NEW POSSIBILITY FOR COVID- 19 TREATMENT. Cytotherapy 2022. [PMCID: PMC9035761 DOI: 10.1016/s1465-3249(22)00303-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Jeong I, Ahn G, Shin S, Kim K, Kim N, Han J, Woo G. W073 Carnobacterium divergens bacteremia: A case report and literature review. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kim N, Shin Y, Park Y, Park H. Ventricular Assist Device Implantation for Infant End-Stage Heart Failure - A Single-Center Experience. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Simon J, Shapiro M, Larkin L, Kim N, Patel S, Kingsberg S. Onset of Flibanserin Treatment Effect in Postmenopausal Women Assessed by Subdomain Scores of the Female Sexual Function Index (FSFI). J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.01.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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39
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Ghasemzadeh N, Kim N, Amlani S, Madan M, Shavadia JS, Chong AY, Bagherli A, Bagai A, Saw J, Singh J, Dehghani P. A Review of ST-elevation Myocardial Infarction in Patients with COVID-19. Cardiol Clin 2022; 40:321-328. [PMID: 35851455 PMCID: PMC8960128 DOI: 10.1016/j.ccl.2022.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Nathan Kim
- Northeast Georgia Health System, Gainesville, GA 30501, USA
| | - Shy Amlani
- William Osler Health System, Brampton, 2100 Bovaird Drive East, Ontario L6R 3J7, Canada
| | - Mina Madan
- Schulich Heart Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Jay S Shavadia
- Royal University Hospital, Saskatchewan Health, University of Saskatchewan Saskatoon, 103 Hospital Drive, Saskatchewan S7N 0W8, Canada
| | - Aun-Yeong Chong
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada
| | - Alireza Bagherli
- Windsor Regional Hospital, 1030 Ouellette Avenue, Windsor, Ontario N9A 1E1, Canada
| | - Akshay Bagai
- Terrence Donnelly Heart Centre, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada
| | - Jacqueline Saw
- Vancouver General Hospital, Vancouver, 12th Avenue, Vancouver, British Columbia V5Z 1M9, Canada
| | - Jyotpal Singh
- Prairie Vascular Research Inc, Regina, 1440 14 Avenue, Saskatchewan S4P 0W5, Canada
| | - Payam Dehghani
- Prairie Vascular Research Inc, Regina, 1440 14 Avenue, Saskatchewan S4P 0W5, Canada.
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Jeong S, Park J, Kim N, Kim H. Hypovascular Cellular Tumor in Primary Central Nervous System Lymphoma is Associated with Treatment Resistance: Tumor Habitat Analysis Using Physiologic MRI. AJNR Am J Neuroradiol 2022; 43:40-47. [PMID: 34824097 PMCID: PMC8757556 DOI: 10.3174/ajnr.a7351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 09/20/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND PURPOSE The microenvironment of lymphomas is known to be highly variable and closely associated with treatment resistance and survival. We tried to develop a physiologic MR imaging-based spatial habitat analysis to identify regions associated with treatment resistance to facilitate the prediction of tumor response after initial chemotherapy in patients with primary central nervous system lymphoma. MATERIALS AND METHODS Eighty-one patients with pathologically confirmed primary central nervous system lymphoma were enrolled. Pretreatment physiologic MR imaging was performed, and K-means clustering was used to separate voxels into 3 spatial habitats according to ADC and CBV values. Associations of spatial habitats and clinical and conventional imaging predictors with time to progression were analyzed using Cox proportional hazards modeling. The performance of statistically significant predictors for time to progression was assessed using the concordance probability index. RESULTS The 3 spatial habitats of hypervascular cellular tumor, hypovascular cellular tumor, and hypovascular hypocellular tumor were identified. A large hypovascular cellular habitat was most significantly associated with short time to progression (hazard ratio, 2.83; P = . 017). The presence of an atypical finding (hazard ratio, 4.41; P = . 016), high performance score (hazard ratio, 5.82; P = . 04), and high serum lactate dehydrogenase level (hazard ratio, 1.01; P = .013) was significantly associated with time to progression. A predictive model constructed using the habitat score and other imaging parameters showed a concordance probability index for prediction of time to progression of 0.70 (95% CI, 0.54-0.87). CONCLUSIONS A hypovascular cellular tumor habitat is associated with treatment resistance in primary central nervous system lymphoma, and its assessment may refine prechemotherapy imaging-based response prediction for patients with primary central nervous system lymphoma.
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Affiliation(s)
- S.Y. Jeong
- From the Department of Radiology and Research Institute of Radiology (S.Y.J., J.E.P., H.S.K.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - J.E. Park
- From the Department of Radiology and Research Institute of Radiology (S.Y.J., J.E.P., H.S.K.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - N. Kim
- JAPEX LLC (N.K.), Seoul, Korea
| | - H.S. Kim
- From the Department of Radiology and Research Institute of Radiology (S.Y.J., J.E.P., H.S.K.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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Choi E, Byun E, Kwon SU, Kim N, Suh CH, Kwon H, Han Y, Kwon TW, Cho YP. Carotid Plaque Composition Assessed by CT Predicts Subsequent Cardiovascular Events among Subjects with Carotid Stenosis. AJNR Am J Neuroradiol 2021; 42:2199-2206. [PMID: 34711554 DOI: 10.3174/ajnr.a7338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 07/28/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Currently, the characteristics of carotid plaques are considered important factors for identifying subjects at high risk of stroke. This study aimed to test the hypothesis that carotid plaque composition assessed by CTA is associated with an increased risk of future major adverse cardiovascular events among asymptomatic subjects with moderate-to-severe carotid artery stenosis. MATERIALS AND METHODS This single-center, retrospective cohort study included 194 carotid plaques from 176 asymptomatic subjects with moderate-to-severe carotid artery stenosis. The association of CTA-determined plaque composition with the risk of subsequent adverse cardiovascular events was analyzed. RESULTS During a median follow-up of 41 months, the adverse cardiovascular event incidence among 194 carotid plaques was 19.6%. There were significant differences in plaque Hounsfield units (P < .001) and spotty calcium presence (P < .001) between carotid plaques from subjects with and without subsequent adverse cardiovascular events. Multivariable analysis revealed carotid plaque Hounsfield unit density (P < .001) and spotty calcium (P < .001) as independent predictors of subsequent adverse cardiovascular events. In association with moderate carotid artery stenosis, the plaque Hounsfield unit values were significantly lower among carotid plaques from subjects who experienced subsequent adverse cardiovascular events (P = .002), strokes (P = .01), and cardiovascular deaths (P = .04); the presence of spotty calcium was significantly associated with the occurrence of adverse cardiovascular events (P = .001), acute coronary syndrome (P = .01), and cardiovascular death (P = .04). CONCLUSIONS Carotid plaque Hounsfield unit density and spotty calcium were independent predictors of a greater risk of adverse cardiovascular event occurrence.
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Affiliation(s)
- E Choi
- From the Departments of Surgery (E.C., E.B., H.K., Y.H., T.-W.K., Y.-P.C.)
| | - E Byun
- From the Departments of Surgery (E.C., E.B., H.K., Y.H., T.-W.K., Y.-P.C.)
| | | | - N Kim
- Clinical Epidemiology and Biostatistics (N.K.)
| | - C H Suh
- Radiology and Research Institute of Radiology (C.H.S.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - H Kwon
- From the Departments of Surgery (E.C., E.B., H.K., Y.H., T.-W.K., Y.-P.C.)
| | - Y Han
- From the Departments of Surgery (E.C., E.B., H.K., Y.H., T.-W.K., Y.-P.C.)
| | - T-W Kwon
- From the Departments of Surgery (E.C., E.B., H.K., Y.H., T.-W.K., Y.-P.C.)
| | - Y-P Cho
- From the Departments of Surgery (E.C., E.B., H.K., Y.H., T.-W.K., Y.-P.C.)
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Ma E, Kutlu S, Kim N, Mitchell C, Vajjala V, Carrazana E, Viereck J, Liow K. Evaluating whether EEG could predict Alzheimer's disease onset in preclinical patients with the ApoE4 allele. Alzheimers Dement 2021. [DOI: 10.1002/alz.049677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Enze Ma
- John A. Burns School of Medicine Honolulu HI USA
| | - Selin Kutlu
- John A. Burns School of Medicine Honolulu HI USA
| | - Nathan Kim
- University of Hawaii at Manoa Honolulu HI USA
| | | | - Vimala Vajjala
- John A. Burns School of Medicine Honolulu HI USA
- Hawaii Pacific Neuroscience Honolulu HI USA
| | - Enrique Carrazana
- John A. Burns School of Medicine Honolulu HI USA
- Hawaii Pacific Neuroscience Honolulu HI USA
| | - Jason Viereck
- John A. Burns School of Medicine Honolulu HI USA
- Hawaii Pacific Neuroscience Honolulu HI USA
| | - Kore Liow
- John A. Burns School of Medicine Honolulu HI USA
- Hawaii Pacific Neuroscience Honolulu HI USA
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Zang E, West J, Kim N, Pao C. U.S. regional differences in physical distancing: Evaluating racial and socioeconomic divides during the COVID-19 pandemic. PLoS One 2021; 16:e0259665. [PMID: 34847174 PMCID: PMC8631641 DOI: 10.1371/journal.pone.0259665] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 10/22/2021] [Indexed: 12/23/2022] Open
Abstract
Health varies by U.S. region of residence. Despite regional heterogeneity in the outbreak of COVID-19, regional differences in physical distancing behaviors over time are relatively unknown. This study examines regional variation in physical distancing trends during the COVID-19 pandemic and investigates variation by race and socioeconomic status (SES) within regions. Data from the 2015-2019 five-year American Community Survey were matched with anonymized location pings data from over 20 million mobile devices (SafeGraph, Inc.) at the Census block group level. We visually present trends in the stay-at-home proportion by Census region, race, and SES throughout 2020 and conduct regression analyses to examine these patterns. From March to December, the stay-at-home proportion was highest in the Northeast (0.25 in March to 0.35 in December) and lowest in the South (0.24 to 0.30). Across all regions, the stay-at-home proportion was higher in block groups with a higher percentage of Blacks, as Blacks disproportionately live in urban areas where stay-at-home rates were higher (0.009 [CI: 0.008, 0.009]). In the South, West, and Midwest, higher-SES block groups stayed home at the lowest rates pre-pandemic; however, this trend reversed throughout March before converging in the months following. In the Northeast, lower-SES block groups stayed home at comparable rates to higher-SES block groups during the height of the pandemic but diverged in the months following. Differences in physical distancing behaviors exist across U.S. regions, with a pronounced Southern and rural disadvantage. Results can be used to guide reopening and COVID-19 mitigation plans.
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Affiliation(s)
- Emma Zang
- Department of Sociology, Yale University, New Haven, Connecticut, United States of America
| | - Jessica West
- Center for the Study of Aging and Human Development, Duke University, Durham, North Carolina, United States of America
| | - Nathan Kim
- Department of Sociology, Yale University, New Haven, Connecticut, United States of America
| | - Christina Pao
- Department of Sociology, University of Oxford, Oxford, United Kingdom
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Kazemimoghadam M, Chi W, Rahimi A, Kim N, Alluri P, Nwachukwu C, Lu W, Gu X. Saliency-Guided Deep Learning Network for Automatic Target Delineation in Post-Operative Stereotactic Partial Breast Irradiation. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kazemimoghadam M, Chi W, Rahimi A, Kim N, Alluri P, Nwachukwu C, Lu W, Gu X. Saliency-guided deep learning network for automatic tumor bed volume delineation in post-operative breast irradiation. Phys Med Biol 2021; 66:10.1088/1361-6560/ac176d. [PMID: 34298539 PMCID: PMC8639319 DOI: 10.1088/1361-6560/ac176d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/23/2021] [Indexed: 11/12/2022]
Abstract
Efficient, reliable and reproducible target volume delineation is a key step in the effective planning of breast radiotherapy. However, post-operative breast target delineation is challenging as the contrast between the tumor bed volume (TBV) and normal breast tissue is relatively low in CT images. In this study, we propose to mimic the marker-guidance procedure in manual target delineation. We developed a saliency-based deep learning segmentation (SDL-Seg) algorithm for accurate TBV segmentation in post-operative breast irradiation. The SDL-Seg algorithm incorporates saliency information in the form of markers' location cues into a U-Net model. The design forces the model to encode the location-related features, which underscores regions with high saliency levels and suppresses low saliency regions. The saliency maps were generated by identifying markers on CT images. Markers' location were then converted to probability maps using a distance transformation coupled with a Gaussian filter. Subsequently, the CT images and the corresponding saliency maps formed a multi-channel input for the SDL-Seg network. Our in-house dataset was comprised of 145 prone CT images from 29 post-operative breast cancer patients, who received 5-fraction partial breast irradiation (PBI) regimen on GammaPod. The 29 patients were randomly split into training (19), validation (5) and test (5) sets. The performance of the proposed method was compared against basic U-Net. Our model achieved mean (standard deviation) of 76.4(±2.7) %, 6.76(±1.83) mm, and 1.9(±0.66) mm for Dice similarity coefficient, 95 percentile Hausdorff distance, and average symmetric surface distance respectively on the test set with computation time of below 11 seconds per one CT volume. SDL-Seg showed superior performance relative to basic U-Net for all the evaluation metrics while preserving low computation cost. The findings demonstrate that SDL-Seg is a promising approach for improving the efficiency and accuracy of the on-line treatment planning procedure of PBI, such as GammaPod based PBI.
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Affiliation(s)
- Mahdieh Kazemimoghadam
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - Weicheng Chi
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
- School of Software Engineering, South China University of Technology, Guangzhou, Guangdong 510006, People's Republic of China
| | - Asal Rahimi
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - Nathan Kim
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - Prasanna Alluri
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - Chika Nwachukwu
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | | | - Xuejun Gu
- Stanford University, Palo Alto, CA, United States of America
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Zang E, Kim N. Intergenerational upward mobility and racial differences in mortality among young adults: Evidence from county-level analyses. Health Place 2021; 70:102628. [PMID: 34280713 PMCID: PMC8328956 DOI: 10.1016/j.healthplace.2021.102628] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 11/21/2022]
Abstract
Inspired by the influential "deaths of despair" narrative, which emphasizes the role of worsening economic opportunity in driving the increasing mortality for non-Hispanic Whites in the recent decades, a rising number of studies have provided suggestive evidence that upward mobility levels across counties may partly explain variations in mortality rates. A gap in the literature is the lack of life-course studies examining the relationship between early-life upward mobility and later-life mortality across counties. Another gap is the lack of studies on how the relationship between upward mobility and mortality across counties varies across diverse sociodemographic populations. This study examines differences across race and sex in the relationship between early-life intergenerational upward mobility and early adulthood mortality at the county level. We use administrative data on upward mobility and vital statistics data on mortality across 3030 counties for those born between 1978 and 1983. We control for a variety of county-level socioeconomic variables in a model with fixed effects for state and year. Subgroup analyses by educational attainment and urban status were also performed for each race-sex combination. Results show strong negative relationships between early-life upward mobility and early adulthood mortality across racial-sex combinations, with a particularly greater magnitude for non-Hispanic Black males. In addition, individuals without a college degree and living in urban counties are particularly affected by early life upward mobility. The findings of this study highlight the vulnerability of less-educated, young urban Black males, due to the intersecting effects of the urban context, education, race, and sex.
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Affiliation(s)
- Emma Zang
- Department of Sociology, Yale University, New Haven, CT, USA.
| | - Nathan Kim
- Institution for Social and Policy Studies, Yale University, New Haven, CT, USA
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Song Y, Lim J, Lim T, Im K, Kim N, Nam Y, Jeon Y, Ko H, Park I, Shin J, Cho S. Human mesenchymal stem cells derived from umbilical cord and bone marrow exert immunomodulatory effects in different mechanisms. Cytotherapy 2021. [DOI: 10.1016/s1465324921003455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kim N, Im K, Jeon Y, Oh E, Chung N, Lee J, Song Y, Lee J, Cho S. A prospective phase I/II clinical study evaluating the clinical and immune responses of repeated MSCs infusions in steroid-refractory chronic GVHD patients. Cytotherapy 2021. [DOI: 10.1016/s1465324921002978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Ryu K, Lee T, Baek D, Park J, Kim N. A study on accumulator analysis for the valve performance evaluation system of nuclear power plants. KERNTECHNIK 2021. [DOI: 10.1515/kern-2019-0080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
To evaluate the valves used in the nuclear power plants are working properly under the required conditions, the performance and capacity test should be performed. In the test system, the accumulator was employed to control the large amount of high pressure and high temperature steam generated in the boiler precisely. In the accumulating process, the steam is often condensed. In order to prevent condensation, it is needed to install heaters and preheat the accumulator. However, if the size of the accumulator becomes large, the installation of the heater may not be easy. Therefore, when the test is conducted, the system was preheated by the latent heat generated from the phase change. Insufficient thermal insulation may cause temperature differences and it can cause mechanical problems in the accumulator structure. If insulation is sufficient, the temperature difference is indicated by the height. As the cooled condensate moves downwards, the condensate is discharged by the drain valve control and the temperature difference of the structure can be disappeared. The results of this paper can be applied to the conceptualization of equipment that uses latent heat and for the design of high-precision steam experimental devices or the design of high-capacity steam utilization systems.
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Affiliation(s)
- K. Ryu
- Korea Institute of Machinery and Materials 156 Gajeongbuk-Ro Yuseong-Gu Daejeon 34103 Korea Republic of Korea
| | - T. Lee
- Korea Institute of Machinery and Materials 156 Gajeongbuk-Ro Yuseong-Gu Daejeon 34103 Korea Republic of Korea
| | - D. Baek
- Korea Institute of Machinery and Materials 156 Gajeongbuk-Ro Yuseong-Gu Daejeon 34103 Korea Republic of Korea
| | - J. Park
- Korea Institute of Machinery and Materials 156 Gajeongbuk-Ro Yuseong-Gu Daejeon 34103 Korea Republic of Korea
| | - N. Kim
- Korea Atomic Energy Research Institute 111, Daedeok-daero 989 beon-gil, Yuseong-gu Daejeon , Republic of Korea
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Kim N, Chang J, Keum K, Suh C, Kim Y. A 40 Gy in 15 Fractions and Volumetric-Modulated Arc Therapy (VMAT) can Reduce Radiation-Related Toxicity in Patients with Breast Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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