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Kim EM, Kim SJ, Choi GB, Lee J, Koo MM, Kim J, Kim YW, Lee J, Kim JH, Seo TH. A Graphene-Based Polymer-Dispersed Liquid Crystal Device Enabled through a Water-Induced Interface Cleaning Process. Nanomaterials (Basel) 2023; 13:2309. [PMID: 37630894 PMCID: PMC10459967 DOI: 10.3390/nano13162309] [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] [Received: 07/20/2023] [Revised: 08/04/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023]
Abstract
We report the use of four-layer graphene (4LG) as a highly reliable transparent conductive electrode (TCE) for polymer-dispersed liquid crystal (PDLC)-based smart window devices. The adhesion between 4LG and the substrate was successfully improved through a water-induced interface-cleaning (WIIC) process. We compared the performance of a device with a WIIC-processed 4LG electrode with that of devices with a conventional indium tin oxide (ITO) electrode and a 4LG electrode without a WIIC. With the application of the WIIC process, the PDLC smart window with a 4LG electrode exhibited reduced turn-on voltage and haze compared to 4LG without the WIIC process and characteristics comparable to those of the ITO electrode. The WIIC-processed 4LG electrode demonstrated enhanced electrical properties and better optical performance, leading to improved device efficiency and reliability. Furthermore, our study revealed that the WIIC process not only improved the adhesion between 4LG and the substrate but also enhanced the compatibility and interfacial interactions, resulting in the superior performance of the smart window device. These findings suggest that 4LG with WIIC holds great promise as a transparent conductive electrode for flexible smart windows, offering a cost-effective and efficient alternative to conventional ITO electrodes.
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Affiliation(s)
- Eun Mi Kim
- Green Energy and Nano Technology & R&D Group, Korea Institute of Industrial Technology (KITECH), Gwangju 61012, Republic of Korea; (E.M.K.); (S.J.K.); (Y.W.K.); (J.L.)
- School of Materials Science & Engineering, Chonnam National University, Gwangju 61186, Republic of Korea
| | - Su Jin Kim
- Green Energy and Nano Technology & R&D Group, Korea Institute of Industrial Technology (KITECH), Gwangju 61012, Republic of Korea; (E.M.K.); (S.J.K.); (Y.W.K.); (J.L.)
- School of Materials Science & Engineering, Chonnam National University, Gwangju 61186, Republic of Korea
| | - Go Bong Choi
- Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, Republic of Korea;
| | - Jaegeun Lee
- School of Chemical Engineering, Pusan National University, Busan 46261, Republic of Korea;
| | - Min Mo Koo
- Automotive Materials & Components R&D Group, Korea Institute of Industrial Technology (KITECH), Gwangju 61012, Republic of Korea; (M.M.K.); (J.K.)
| | - Jaewoong Kim
- Automotive Materials & Components R&D Group, Korea Institute of Industrial Technology (KITECH), Gwangju 61012, Republic of Korea; (M.M.K.); (J.K.)
| | - Young Won Kim
- Green Energy and Nano Technology & R&D Group, Korea Institute of Industrial Technology (KITECH), Gwangju 61012, Republic of Korea; (E.M.K.); (S.J.K.); (Y.W.K.); (J.L.)
| | - Jongho Lee
- Green Energy and Nano Technology & R&D Group, Korea Institute of Industrial Technology (KITECH), Gwangju 61012, Republic of Korea; (E.M.K.); (S.J.K.); (Y.W.K.); (J.L.)
| | - Jin Hyeok Kim
- School of Materials Science & Engineering, Chonnam National University, Gwangju 61186, Republic of Korea
- Optoelectronic Convergence Research Center, Department of Materials Science and Engineering, Chonnam National University, Gwangju 61186, Republic of Korea
| | - Tae Hoon Seo
- Green Energy and Nano Technology & R&D Group, Korea Institute of Industrial Technology (KITECH), Gwangju 61012, Republic of Korea; (E.M.K.); (S.J.K.); (Y.W.K.); (J.L.)
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2
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Shin Y, Kim YW, Kang HJ, Lee JH, Byun JE, Yang JY, Lee JW. Stretchable and Skin-Mountable Temperature Sensor Array Using Reduction-Controlled Graphene Oxide for Dermatological Thermography. Nano Lett 2023; 23:5391-5398. [PMID: 36971404 DOI: 10.1021/acs.nanolett.2c04752] [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: 06/15/2023]
Abstract
Since thermometry of human skin is critical information that provides important aspects of human health and physiology, accurate and continuous temperature measurement is required for the observation of physical abnormalities. However, conventional thermometers are uncomfortable because of their bulky and heavy features. In this work, we fabricated a thin, stretchable array-type temperature sensor using graphene-based materials. Furthermore, we controlled the degree of graphene oxide reduction and enhanced the temperature sensitivity. The sensor exhibited an excellent sensitivity of 2.085% °C-1. The overall device was designed in a wavy meander shape to provide stretchability for the device so that precise detection of skin temperature could be performed. Furthermore, polyimide film was coated to secure the chemical and mechanical stabilities of the device. The array-type sensor enabled spatial heat mapping with high resolution. Finally, we introduced some practical applications of skin temperature sensing, suggesting the possibility of skin thermography and healthcare monitoring.
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Affiliation(s)
- Yujin Shin
- Department of Materials Science and Engineering, Pusan National University, Geumjeong-gu, Busan 46241, Republic of Korea
| | - Young Won Kim
- Department of Materials Science and Engineering, Pusan National University, Geumjeong-gu, Busan 46241, Republic of Korea
| | - Hyun Jin Kang
- Department of Materials Science and Engineering, Pusan National University, Geumjeong-gu, Busan 46241, Republic of Korea
| | - Ju Ha Lee
- Department of Materials Science and Engineering, Pusan National University, Geumjeong-gu, Busan 46241, Republic of Korea
| | - Jeong Eun Byun
- Department of Materials Science and Engineering, Pusan National University, Geumjeong-gu, Busan 46241, Republic of Korea
| | - Jin-Young Yang
- Department of Biological Sciences, Pusan National University, Geumjeong-gu, Busan 46241, Republic of Korea
| | - Jung Woo Lee
- Department of Materials Science and Engineering, Pusan National University, Geumjeong-gu, Busan 46241, Republic of Korea
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Bourquard T, Lee K, Al-Ramahi I, Pham M, Shapiro D, Lagisetty Y, Soleimani S, Mota S, Wilhelm K, Samieinasab M, Kim YW, Huh E, Asmussen J, Katsonis P, Botas J, Lichtarge O. Functional variants identify sex-specific genes and pathways in Alzheimer's Disease. Nat Commun 2023; 14:2765. [PMID: 37179358 PMCID: PMC10183026 DOI: 10.1038/s41467-023-38374-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
The incidence of Alzheimer's Disease in females is almost double that of males. To search for sex-specific gene associations, we build a machine learning approach focused on functionally impactful coding variants. This method can detect differences between sequenced cases and controls in small cohorts. In the Alzheimer's Disease Sequencing Project with mixed sexes, this approach identified genes enriched for immune response pathways. After sex-separation, genes become specifically enriched for stress-response pathways in male and cell-cycle pathways in female. These genes improve disease risk prediction in silico and modulate Drosophila neurodegeneration in vivo. Thus, a general approach for machine learning on functionally impactful variants can uncover sex-specific candidates towards diagnostic biomarkers and therapeutic targets.
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Affiliation(s)
- Thomas Bourquard
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Kwanghyuk Lee
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Ismael Al-Ramahi
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, 77030, USA
- Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX, 77030, USA
- Center for Alzheimer's and Neurodegenerative Diseases, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Minh Pham
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Dillon Shapiro
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Yashwanth Lagisetty
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, 77030, USA
- Department of Biology and Pharmacology, UTHealth McGovern Medical School, Houston, TX, 77030, USA
| | - Shirin Soleimani
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Samantha Mota
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Kevin Wilhelm
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Maryam Samieinasab
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Young Won Kim
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Eunna Huh
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Jennifer Asmussen
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Panagiotis Katsonis
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Juan Botas
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, 77030, USA
- Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX, 77030, USA
- Center for Alzheimer's and Neurodegenerative Diseases, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Olivier Lichtarge
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, 77030, USA.
- Center for Alzheimer's and Neurodegenerative Diseases, Baylor College of Medicine, Houston, TX, 77030, USA.
- Computational and Integrative Biomedical Research Center, Baylor College of Medicine, Houston, TX, 77030, USA.
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Park AH, Baek S, Kim YW, Chandramohan S, Suh EK, Seo TH. Defect-selective-etched porous GaN as a buffer layer for high efficiency InGaN/GaN light-emitting diodes. PLoS One 2022; 17:e0277667. [PMCID: PMC9671350 DOI: 10.1371/journal.pone.0277667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 11/01/2022] [Indexed: 11/19/2022] Open
Abstract
Substrate-induced biaxial compressive stress and threading dislocations (TDs) have been recognized to severely impair the performance, stability, and reliability of InGaN/GaN light-emitting diodes (LEDs) for quite some time. In this study, a defect-selective-etched (DSE) porous GaN layer is fabricated employing electro-chemical etching and applied as a buffer layer for the development of InGaN/GaN LEDs with high quantum efficiency. Based on the analysis of photoluminescence and micro-Raman spectra, it has been revealed that the overgrown GaN epilayer on the DSE porous GaN has a relatively low TDs and relaxation of compressive stress in comparison to the conventional GaN epilayer. The remarkable improvement in the internal quantum efficiency of the InGaN/GaN LEDs is directly attributable to the strong radiative recombination in InGaN/GaN multi-quantum-wells caused by stress relaxation and TDs annihilation. Our findings indicate that the use of DSE porous GaN as a buffer layer may be a viable approach for producing crystalline GaN epilayers and high-performance LEDs.
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Affiliation(s)
- Ah Hyun Park
- R&D Center, Marine Equipment Technology Solutions, Busan, Republic of Korea
| | - Seungjae Baek
- Maritime ICT R&D Center, Korea Institute of Ocean Science and Technology, Busan, Republic of Korea
| | - Young Won Kim
- Green Energy & Nano Technology R&D Group, Korea Institute of Industrial Technology, Gwangju, Republic of Korea
| | - S. Chandramohan
- Department of Physics and Nanotechnology, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India
- School of Semiconductor and Chemical Engineering, Semiconductor Physics Research Center, Jeonbuk National University, Jeonju, Republic of Korea
| | - Eun-Kyung Suh
- School of Semiconductor and Chemical Engineering, Semiconductor Physics Research Center, Jeonbuk National University, Jeonju, Republic of Korea
- * E-mail: (THS); (EKS)
| | - Tae Hoon Seo
- Green Energy & Nano Technology R&D Group, Korea Institute of Industrial Technology, Gwangju, Republic of Korea
- * E-mail: (THS); (EKS)
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Kim YW, Akin S, Yun H, Xu S, Wu W, Jun MBG. Enhanced Performance of Triboelectric Nanogenerators and Sensors via Cold Spray Particle Deposition. ACS Appl Mater Interfaces 2022; 14:46410-46420. [PMID: 36198071 DOI: 10.1021/acsami.2c09367] [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: 06/16/2023]
Abstract
In this study, a high-performance triboelectric nanogenerator (TENG) is developed based on cold spray (CS) deposition of composite material layers. Composite layers were fabricated by cold spraying of micron-scale tin (Sn) particles on aluminum (Al) and polytetrafluoroethylene (PTFE) films, which led to improved TENG performance owing to functionalized composite layers as friction layers and electrodes, respectively. As-sprayed tin composite layers not only enhanced the flow of charges by strong adhesion to the target layer but also formed a nano-microstructure on the surface of the layers, thereby increasing the surface area during friction. More importantly, the electricity generation performance was improved more than 6 times as compared to the TENG without CS deposition on it. From parametric studies, the TENG using the cold-sprayed composite layer produced an electrical potential of 1140 V for a simple structure with a 25.4 × 25.4 mm2 contact area. We also optimize the geometry and fabrication process of the TENG to increase the manufacturing efficiency while reducing the processing cost. The resultant sprayed layers and structures exhibited sustainable robustness by showing consistent electrical performance after the mechanical adhesion test. The proposed manufacturing approach is also applicable for processing three-dimensional (3D) complex layers owing to the technological convergence of a cold spray gun attached to a robotic arm, which makes possible to fabricate the 3D TENG. To elaborate, a composite layer having the shape of a 3D ball is produced, and the exercise status of the ball is monitored in real-time. The fabricated 3D ball using the TENG transmitted a distinguishable signal in real-time according to the state of the ball. The proposed TENG sensing system can be utilized as a self-powered sensor without the need of a battery, amplifier, and rectifier. The results of this study can potentially provide insights for the practical material design and fabrication of self-powered TENG systems.
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Affiliation(s)
- Young Won Kim
- School of Mechanical Engineering, Purdue University, West Lafayette, Indiana 47906, United States
| | - Semih Akin
- School of Mechanical Engineering, Purdue University, West Lafayette, Indiana 47906, United States
| | - Huitaek Yun
- Indiana Manufacturing Competitiveness Center (IN-MaC), Purdue University, West Lafayette, Indiana 47906, United States
| | - Shujia Xu
- School of Industrial Engineering, Purdue University, West Lafayette, Indiana 47906, United States
| | - Wenzhuo Wu
- School of Industrial Engineering, Purdue University, West Lafayette, Indiana 47906, United States
| | - Martin Byung-Guk Jun
- School of Mechanical Engineering, Purdue University, West Lafayette, Indiana 47906, United States
- Indiana Manufacturing Competitiveness Center (IN-MaC), Purdue University, West Lafayette, Indiana 47906, United States
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6
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Han J, Rhee SM, Kim YW, Park SH, Oh JH. Three-dimensionally printed recombinant human parathyroid hormone-soaked nanofiber sheet accelerates tendon-to-bone healing in a rabbit model of chronic rotator cuff tear. J Shoulder Elbow Surg 2022; 31:1628-1639. [PMID: 35337954 DOI: 10.1016/j.jse.2022.02.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 01/23/2022] [Accepted: 02/08/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Recombinant human parathyroid hormone (rhPTH) promotes tendon-to-bone healing in humans and animals with rotator cuff tear (RCT). However, problems regarding repeated systemic rhPTH injections in humans exist. This study was conducted to evaluate the effect of topical rhPTH administration using 3-dimensionally (3D) printed nanofiber sheets on tendon-to-bone healing in a rabbit RCT model compared to that of direct topical rhPTH administration. METHODS Eighty rabbits were randomly assigned to 5 groups (n = 16 each). To create the chronic RCT model, we induced complete supraspinatus tendon tears in both shoulders and left them untreated for 6 weeks. All transected tendons were repaired in a transosseous manner with saline injection in group A, hyaluronic acid (HA) injection in group B, 3D-printed nanofiber sheet fixation in group C, rhPTH and HA injection in group D, and 3D-printed rhPTH- and HA-soaked nanofiber sheet fixation in group E. Genetic (messenger RNA expression evaluation) and histologic evaluations (hematoxylin and eosin and Masson trichrome staining) were performed in half of the rabbits at 4 weeks postrepair. Genetic, histologic, and biomechanical evaluations (mode of tear and load to failure) were performed in the remaining rabbits at 12 weeks. RESULTS For genetic evaluation, group E showed a higher collagen type I alpha 1 expression level than did the other groups (P = .008) at 4 weeks. However, its expression level was downregulated, and there was no difference at 12 weeks. For histologic evaluation, group E showed greater collagen fiber continuity, denser collagen fibers, and more mature tendon-to-bone junction than did the other groups (P = .001, P = .001, and P = .003, respectively) at 12 weeks. For biomechanical evaluation, group E showed a higher load-to-failure rate than did the other groups (P < .001) at 12 weeks. CONCLUSION Three-dimensionally printed rhPTH-soaked nanofiber sheet fixation can promote tendon-to-bone healing of chronic RCT.
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Affiliation(s)
- Jian Han
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Republic of Korea
| | - Sung Min Rhee
- Department of Orthopaedic Surgery, KyungHee University Medical Center, Seoul, Republic of Korea
| | - Young Won Kim
- School of Mechanical Engineering, Purdue University, West Lafayette, IN, USA
| | - Suk Hee Park
- School of Mechanical Engineering, Pusan National University, Republic of Korea.
| | - Joo Han Oh
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Republic of Korea.
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Kim SW, Kim YW, Seo TH, Kim YK. Investigation of the Ligand Exchange Process on Gold Nanorods by Using Laser Desorption/Ionization Time-of-Flight Mass Spectrometry. Materials 2022; 15:ma15134406. [PMID: 35806530 PMCID: PMC9267759 DOI: 10.3390/ma15134406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 01/27/2023]
Abstract
The ligand exchange process on gold nanorods (Au NRs) was explored by using laser desorption/ionization time-of-flight mass spectrometry (LDI-TOF-MS). Cetyltrimethylammonium bromide (CTAB) adsorbed on Au NRs was replaced with alkanethiol derivatives presenting different functional groups. The ligand exchange process was investigated under various conditions, such as in the presence of different functional groups in the ligands and with different concentrations of CTAB. The ligand-exchanged Au NRs were characterized by using a combination of UV–Vis spectroscopy and LDI-TOF-MS. Based on the results, it was revealed that LDI-TOF-MS analysis can provide crucial and distinct information about the degree of ligand exchange on Au NRs.
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Affiliation(s)
- Seung-Woo Kim
- Department of Chemistry, Dongguk University, 30 Pildong-ro, Jung-gu, Seoul 04620, Korea;
| | - Young Won Kim
- Green Energy & Nano Technology R&D Group, Korea Institute of Industrial Technology, 6 Cheomdan-gwagiro 208-gil, Buk-gu, Gwangju 61012, Korea;
| | - Tae Hoon Seo
- Green Energy & Nano Technology R&D Group, Korea Institute of Industrial Technology, 6 Cheomdan-gwagiro 208-gil, Buk-gu, Gwangju 61012, Korea;
- Correspondence: (T.H.S.); (Y.-K.K.)
| | - Young-Kwan Kim
- Department of Chemistry, Dongguk University, 30 Pildong-ro, Jung-gu, Seoul 04620, Korea;
- Correspondence: (T.H.S.); (Y.-K.K.)
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8
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Hsu TK, Asmussen J, Koire A, Choi BK, Gadhikar MA, Huh E, Lin CH, Konecki DM, Kim YW, Pickering CR, Kimmel M, Donehower LA, Frederick MJ, Myers JN, Katsonis P, Lichtarge O. A general calculus of fitness landscapes finds genes under selection in cancers. Genome Res 2022; 32:916-929. [PMID: 35301263 PMCID: PMC9104707 DOI: 10.1101/gr.275811.121] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 03/14/2022] [Indexed: 11/24/2022]
Abstract
Genetic variants drive the evolution of traits and diseases. We previously modeled these variants as small displacements in fitness landscapes and estimated their functional impact by differentiating the evolutionary relationship between genotype and phenotype. Conversely, here we integrate these derivatives to identify genes steering specific traits. Over cancer cohorts, integration identified 460 likely tumor-driving genes. Many have literature and experimental support but had eluded prior genomic searches for positive selection in tumors. Beyond providing cancer insights, these results introduce a general calculus of evolution to quantify the genotype-phenotype relationship and discover genes associated with complex traits and diseases.
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Affiliation(s)
- Teng-Kuei Hsu
- Department of Biochemistry and Molecular Biology, Baylor College of Medicine, Houston, Texas 77030, USA
| | - Jennifer Asmussen
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77030, USA
| | - Amanda Koire
- Program in Quantitative and Computational Biosciences, Baylor College of Medicine, Houston, Texas 77030, USA
| | - Byung-Kwon Choi
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77030, USA
| | - Mayur A Gadhikar
- Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA
| | - Eunna Huh
- Department of Pharmacology and Chemical Biology, Baylor College of Medicine, Houston, Texas 77030, USA
| | - Chih-Hsu Lin
- Program in Quantitative and Computational Biosciences, Baylor College of Medicine, Houston, Texas 77030, USA
| | - Daniel M Konecki
- Program in Quantitative and Computational Biosciences, Baylor College of Medicine, Houston, Texas 77030, USA
| | - Young Won Kim
- Program in Integrative Molecular and Biomedical Sciences, Baylor College of Medicine, Houston, Texas 77030, USA
| | - Curtis R Pickering
- Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA
| | - Marek Kimmel
- Departments of Statistics and Bioengineering, Rice University, Houston, Texas 77005, USA
- Department of Systems Engineering and Biology, Silesian University of Technology, 44-100 Gliwice, Poland
| | - Lawrence A Donehower
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas 77030, USA
| | - Mitchell J Frederick
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas 77030, USA
| | - Jeffrey N Myers
- Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA
| | - Panagiotis Katsonis
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77030, USA
| | - Olivier Lichtarge
- Department of Biochemistry and Molecular Biology, Baylor College of Medicine, Houston, Texas 77030, USA
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77030, USA
- Program in Quantitative and Computational Biosciences, Baylor College of Medicine, Houston, Texas 77030, USA
- Department of Pharmacology and Chemical Biology, Baylor College of Medicine, Houston, Texas 77030, USA
- Program in Integrative Molecular and Biomedical Sciences, Baylor College of Medicine, Houston, Texas 77030, USA
- Computational and Integrative Biomedical Research Center, Baylor College of Medicine, Houston, Texas 77030, USA
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Buisson EM, Park S, Kim M, Kang K, Yoon S, Lee JE, Kim YW, Lee NK, Jeong MA, Kang B, Lee SB, Factor VM, Seo D, Kim H, Jeong J, Kim HJ, Choi D. Transplantation of patient-specific bile duct bioengineered with chemically reprogrammed and microtopographically differentiated cells. Bioeng Transl Med 2022; 7:e10252. [PMID: 35079629 PMCID: PMC8780056 DOI: 10.1002/btm2.10252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/17/2021] [Accepted: 08/20/2021] [Indexed: 01/01/2023] Open
Abstract
Cholangiopathy is a diverse spectrum of chronic progressive bile duct disorders with limited treatment options and dismal outcomes. Scaffold- and stem cell-based tissue engineering technologies hold great promise for reconstructive surgery and tissue repair. Here, we report a combined application of 3D scaffold fabrication and reprogramming of patient-specific human hepatocytes to produce implantable artificial tissues that imitate the mechanical and biological properties of native bile ducts. The human chemically derived hepatic progenitor cells (hCdHs) were generated using two small molecules A83-01 and CHIR99021 and seeded inside the tubular scaffold engineered as a synergistic combination of two layers. The inner electrospun fibrous layer was made of nanoscale-macroscale polycaprolactone fibers acting to promote the hCdHs attachment and differentiation, while the outer microporous foam layer served to increase mechanical stability. The two layers of fiber and foam were fused robustly together thus creating coordinated mechanical flexibility to exclude any possible breaking during surgery. The gene expression profiling and histochemical assessment confirmed that hCdHs acquired the biliary epithelial phenotype and filled the entire surface of the fibrous matrix after 2 weeks of growth in the cholangiocyte differentiation medium in vitro. The fabricated construct replaced the macroscopic part of the common bile duct (CBD) and re-stored the bile flow in a rabbit model of acute CBD injury. Animals that received the acellular scaffolds did not survive after the replacement surgery. Thus, the artificial bile duct constructs populated with patient-specific hepatic progenitor cells could provide a scalable and compatible platform for treating bile duct diseases.
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Affiliation(s)
- Elina Maria Buisson
- Department of SurgeryHanyang University College of MedicineSeoulRepublic of Korea
- HY Indang Center of Regenerative Medicine and Stem Cell ResearchHanyang UniversitySeoulRepublic of Korea
| | - Suk‐Hee Park
- School of Mechanical EngineeringPusan National UniversityBusanRepublic of Korea
| | - Myounghoi Kim
- Department of SurgeryHanyang University College of MedicineSeoulRepublic of Korea
- HY Indang Center of Regenerative Medicine and Stem Cell ResearchHanyang UniversitySeoulRepublic of Korea
| | - Kyojin Kang
- Department of SurgeryHanyang University College of MedicineSeoulRepublic of Korea
- HY Indang Center of Regenerative Medicine and Stem Cell ResearchHanyang UniversitySeoulRepublic of Korea
| | - Sangtae Yoon
- Department of SurgeryHanyang University College of MedicineSeoulRepublic of Korea
- HY Indang Center of Regenerative Medicine and Stem Cell ResearchHanyang UniversitySeoulRepublic of Korea
| | - Ji Eun Lee
- Digital Manufacturing Process GroupKorea Institute of Industrial TechnologySiheungsiGyeonggi‐doRepublic of Korea
| | - Young Won Kim
- Digital Manufacturing Process GroupKorea Institute of Industrial TechnologySiheungsiGyeonggi‐doRepublic of Korea
- Present address:
Current address: School of Mechanical EngineeringPurdue UniversityWest LafayetteIndianaUSA
| | - Nak Kyu Lee
- Digital Manufacturing Process GroupKorea Institute of Industrial TechnologySiheungsiGyeonggi‐doRepublic of Korea
| | - Mi Ae Jeong
- Department of Anesthesiology and pain medicineHanyang University College of MedicineSeoulRepublic of Korea
| | - Bo‐Kyeong Kang
- Department of RadiologyHanyang University, College of medicineSeoulRepublic of Korea
| | - Seung Bum Lee
- Laboratory of Radiation Exposure & TherapeuticsNational Radiation Emergency Medical Center, Korea Institute of Radiological & Medical ScienceSeoulRepublic of Korea
| | - Valentina M. Factor
- Laboratory of Molecular PharmacologyCenter for Cancer Research, National Cancer Institute, National Institutes of HealthBethesdaMarylandUSA
| | | | - Hyunsung Kim
- Department of PathologyHanyang University College of MedicineSeoulRepublic of Korea
| | - Jaemin Jeong
- Department of SurgeryHanyang University College of MedicineSeoulRepublic of Korea
- HY Indang Center of Regenerative Medicine and Stem Cell ResearchHanyang UniversitySeoulRepublic of Korea
| | - Han Joon Kim
- Department of SurgeryHanyang University College of MedicineSeoulRepublic of Korea
- HY Indang Center of Regenerative Medicine and Stem Cell ResearchHanyang UniversitySeoulRepublic of Korea
| | - Dongho Choi
- Department of SurgeryHanyang University College of MedicineSeoulRepublic of Korea
- HY Indang Center of Regenerative Medicine and Stem Cell ResearchHanyang UniversitySeoulRepublic of Korea
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10
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Koire A, Katsonis P, Kim YW, Buchovecky C, Wilson SJ, Lichtarge O. A method to delineate de novo missense variants across pathways prioritizes genes linked to autism. Sci Transl Med 2021; 13:13/594/eabc1739. [PMID: 34011629 DOI: 10.1126/scitranslmed.abc1739] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 03/01/2021] [Indexed: 12/31/2022]
Abstract
Genotype-phenotype relationships shape health and population fitness but remain difficult to predict and interpret. Here, we apply an evolutionary action method to de novo missense variants in whole-exome sequences of individuals with autism spectrum disorder (ASD) to unravel genes and pathways connected to ASD. Evolutionary action predicts the impact of missense variants on protein function by measuring the fitness effect based on phylogenetic distances and substitution odds in homologous gene sequences. By examining de novo missense variants in 2384 individuals with ASD (probands) compared to matched siblings without ASD, we found missense variants in 398 genes representing 23 pathways that were biased toward higher evolutionary action scores than expected by random chance; these pathways were involved in axonogenesis, synaptic transmission, and neurodevelopment. The predicted fitness impact of de novo and inherited missense variants in candidate genes correlated with the IQ of individuals with ASD, even for new gene candidates. Taking an evolutionary action method, we detected those missense variants most likely to contribute to ASD pathogenesis and elucidated their phenotypic impact. This approach could be applied to integrate missense variants across a patient cohort to identify genes contributing to a shared phenotype in other complex diseases.
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Affiliation(s)
- Amanda Koire
- Program in Quantitative and Computational Biosciences, Baylor College of Medicine, Houston, TX, USA.,Medical Scientist Training Program, Baylor College of Medicine, Houston, TX, USA.,Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Panagiotis Katsonis
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Young Won Kim
- Program in Integrative Molecular and Biomedical Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Christie Buchovecky
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA.,Division of Carrier Screening and Prenatal Testing, SEMA4, Stamford, CT, USA
| | - Stephen J Wilson
- Department of Biochemistry, Baylor College of Medicine, Houston, TX, USA
| | - Olivier Lichtarge
- Program in Quantitative and Computational Biosciences, Baylor College of Medicine, Houston, TX, USA. .,Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA.,Department of Biochemistry, Baylor College of Medicine, Houston, TX, USA
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11
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Kim Y, Kim YW, Lee SB, Kang K, Yoon S, Choi D, Park SH, Jeong J. Hepatic patch by stacking patient-specific liver progenitor cell sheets formed on multiscale electrospun fibers promotes regenerative therapy for liver injury. Biomaterials 2021; 274:120899. [PMID: 34034028 DOI: 10.1016/j.biomaterials.2021.120899] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 09/01/2020] [Revised: 05/10/2021] [Accepted: 05/15/2021] [Indexed: 12/15/2022]
Abstract
Recently, use of cell sheets with bio-applicable fabrication materials for transplantation has been an attractive approach for the treatment of patients with liver failure. However, renewable and scalable cell sources for engineered tissue patches remain limited. We previously reported a new type of proliferating bipotent human chemically derived hepatic progenitor cells (hCdHs) developed by small molecule-mediated reprogramming. Here, we developed a patient-specific hepatic cell sheet constructed from liver biopsy-derived hCdHs on a multiscale fibrous scaffold by combining electrospinning and three-dimensional printing. Analysis of biomaterial composition revealed that the high-density electrospun sheet was superior in increasing the functional properties of hCdHs. Furthermore, the hepatic patch assembled by multilayer stacking with alternate cell sheets of hCdHs and human umbilical vein endothelial cells (HUVECs) recapitulated a liver tissue-like structure, with histological and morphological shape and size similar to those of primary human hepatocytes, and exhibited a significant increase in hepatic functions such as albumin secretion and activity of cytochrome P450 during in vitro hepatic differentiation compared with that in hCdH cells cultured in a two-dimensional monolayer. Interestingly, in the hepatic patch, the induction of functional hepatocytes was associated with both the electrospun fibrous-facilitated oncostatin M signaling and selective activation of AKT signaling by HUVECs. Notably, upon transplantation into a mouse model of therapeutic liver repopulation, the hepatic patch effectively repopulated the damaged parenchyma and induced the restoration of liver function with healthy morphology in the lobe and an improved survival rate (>70%) in mice. Overall, these results suggested that liver biopsy-derived hCdHs can be an efficient alternative source for developing hepatic cell sheets and patches with potential clinical applications in tissue engineering to advance liver regeneration.
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Affiliation(s)
- Yohan Kim
- Department of Surgery, Hanyang University College of Medicine, Seoul, 04763, Republic of Korea; HY Indang Center of Regenerative Medicine and Stem Cell Research, Hanyang University, Seoul, 04763, Republic of Korea
| | - Young Won Kim
- Digital Manufacturing Process Group, Korea Institute of Industrial Technology, 113-58 Seohaean-ro, Siheungsi, Gyeonggi-do, 15014, Republic of Korea
| | - Seung Bum Lee
- Laboratory of Radiation Exposure & Therapeutics, National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Science, Seoul, 01812, Republic of Korea
| | - Kyojin Kang
- Department of Surgery, Hanyang University College of Medicine, Seoul, 04763, Republic of Korea
| | - Sangtae Yoon
- Department of Surgery, Hanyang University College of Medicine, Seoul, 04763, Republic of Korea; HY Indang Center of Regenerative Medicine and Stem Cell Research, Hanyang University, Seoul, 04763, Republic of Korea
| | - Dongho Choi
- Department of Surgery, Hanyang University College of Medicine, Seoul, 04763, Republic of Korea; HY Indang Center of Regenerative Medicine and Stem Cell Research, Hanyang University, Seoul, 04763, Republic of Korea.
| | - Suk-Hee Park
- School of Mechanical Engineering, Pusan National University, Busan, 46241, Republic of Korea.
| | - Jaemin Jeong
- Department of Surgery, Hanyang University College of Medicine, Seoul, 04763, Republic of Korea; HY Indang Center of Regenerative Medicine and Stem Cell Research, Hanyang University, Seoul, 04763, Republic of Korea.
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12
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Ko SJ, Cho J, Choi SM, Park YS, Lee CH, Lee SM, Yoo CG, Kim YW, Lee J. Phase Angle and Frailty Are Important Prognostic Factors in Critically Ill Medical Patients: A Prospective Cohort Study. J Nutr Health Aging 2021; 25:218-223. [PMID: 33491037 PMCID: PMC7548529 DOI: 10.1007/s12603-020-1487-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 07/27/2020] [Indexed: 01/27/2023]
Abstract
OBJECTIVES To investigate whether phase angle (PhA) measured by bioelectrical impedance analysis (BIA) and frailty are associated with the outcomes of critical illnesses. DESIGN A single-center prospective cohort study. SETTING Medical intensive care unit (ICU) in Seoul National University Hospital, Seoul, Republic of Korea. PARTICIPANTS 97 patients who were admitted to the medical ICU. MEASUREMENTS On admission, PhA was measured by BIA, and frailty was assessed by the Korean Modified Barthel Index (KMBI) scoring system. Patients were classified according to PhA and KMBI scores, and their impact on the outcomes of critical illnesses was evaluated. RESULTS The patients' mean age was 62.4 ± 16.4 years, and 56 of the patients (57.7%) were men. Having a high PhA above 3.5 at the time of ICU admission was associated with lower in-hospital mortality (adjusted OR 0.42, p = .042), and a shorter duration of ICU stay (5.6 days vs. 9.8 days, p = .016) compared to those with a low PhA. Other indices measured by BIA were not significantly associated with outcomes of critical illnesses. Frailty (KMBI > 60) was associated with more mechanical ventilation days (2.3 days vs. 7.1 days; p = .018). CONCLUSION Both PhA and frailty are important prognostic factors predicting the outcomes of critical illnesses. Low PhA scores were associated with increased mortality and a longer duration of ICU stay, and frailty was associated with more mechanical ventilation days.
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Affiliation(s)
- S J Ko
- Jinwoo Lee, MD, Department of Internal Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Seoul, 03080, Republic of Korea; E-mail:
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13
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Kim YW, Al‐Ramahi I, Koire A, Wilson SJ, Konecki DM, Mota S, Soleimani S, Botas J, Lichtarge O. Harnessing the paradoxical phenotypes of APOE ɛ2 and APOE ɛ4 to identify genetic modifiers in Alzheimer's disease. Alzheimers Dement 2020; 17:831-846. [PMID: 33576571 PMCID: PMC8247413 DOI: 10.1002/alz.12240] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/08/2020] [Accepted: 10/22/2020] [Indexed: 01/05/2023]
Abstract
The strongest genetic risk factor for idiopathic late‐onset Alzheimer's disease (LOAD) is apolipoprotein E (APOE) ɛ4, while the APOE ɛ2 allele is protective. However, there are paradoxical APOE ɛ4 carriers who remain disease‐free and APOE ɛ2 carriers with LOAD. We compared exomes of healthy APOE ɛ4 carriers and APOE ɛ2 Alzheimer's disease (AD) patients, prioritizing coding variants based on their predicted functional impact, and identified 216 genes with differential mutational load between these two populations. These candidate genes were significantly dysregulated in LOAD brains, and many modulated tau‐ or β42‐induced neurodegeneration in Drosophila. Variants in these genes were associated with AD risk, even in APOE ɛ3 homozygotes, showing robust predictive power for risk stratification. Network analyses revealed involvement of candidate genes in brain cell type‐specific pathways including synaptic biology, dendritic spine pruning and inflammation. These potential modifiers of LOAD may constitute novel biomarkers, provide potential therapeutic intervention avenues, and support applying this approach as larger whole exome sequencing cohorts become available.
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Affiliation(s)
- Young Won Kim
- Program in Integrative Molecular and Biomedical SciencesBaylor College of MedicineHoustonTexasUSA
| | - Ismael Al‐Ramahi
- Jan and Dan Duncan Neurological Research InstituteHoustonTexasUSA
- Department of Molecular and Human GeneticsBaylor College of MedicineHoustonTexasUSA
| | - Amanda Koire
- Graduate Program in Quantitative and Computational BiosciencesBaylor College of MedicineHoustonTexasUSA
- Medical Scientist Training ProgramBaylor College of MedicineHoustonTexasUSA
| | - Stephen J. Wilson
- Biochemistry and Molecular BiologyBaylor College of MedicineHoustonTexasUSA
| | - Daniel M. Konecki
- Graduate Program in Quantitative and Computational BiosciencesBaylor College of MedicineHoustonTexasUSA
| | - Samantha Mota
- Department of Molecular and Human GeneticsBaylor College of MedicineHoustonTexasUSA
| | - Shirin Soleimani
- Department of Molecular and Human GeneticsBaylor College of MedicineHoustonTexasUSA
| | - Juan Botas
- Jan and Dan Duncan Neurological Research InstituteHoustonTexasUSA
- Department of Molecular and Human GeneticsBaylor College of MedicineHoustonTexasUSA
- Graduate Program in Quantitative and Computational BiosciencesBaylor College of MedicineHoustonTexasUSA
| | - Olivier Lichtarge
- Program in Integrative Molecular and Biomedical SciencesBaylor College of MedicineHoustonTexasUSA
- Jan and Dan Duncan Neurological Research InstituteHoustonTexasUSA
- Department of Molecular and Human GeneticsBaylor College of MedicineHoustonTexasUSA
- Graduate Program in Quantitative and Computational BiosciencesBaylor College of MedicineHoustonTexasUSA
- Medical Scientist Training ProgramBaylor College of MedicineHoustonTexasUSA
- Biochemistry and Molecular BiologyBaylor College of MedicineHoustonTexasUSA
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14
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Kim YW, Al‐Ramahi I, Koire A, Botas J, Lichtarge O. Identifying genetic modifiers of
APOE
in Alzheimer’s disease using evolutionary information and regression analyses. Alzheimers Dement 2020. [DOI: 10.1002/alz.043497] [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)
| | | | | | - Juan Botas
- Baylor College of Medicine Houston TX USA
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15
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Lee SH, Park JS, Kim SY, Kim DS, Kim YW, Chung MP, Uh ST, Park CS, Park SW, Jeong SH, Park YB, Lee HL, Shin JW, Lee JH, Jegal Y, Lee HK, Kim YH, Song JW, Park MS. Clinical features and prognosis of patients with idiopathic pulmonary fibrosis and chronic obstructive pulmonary disease. Int J Tuberc Lung Dis 2020; 23:678-684. [PMID: 31315699 DOI: 10.5588/ijtld.18.0194] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
<sec> <title>BACKGROUND</title> Idiopathic pulmonary fibrosis (IPF) and chronic obstructive pulmonary disease (COPD) share common risk factors. They could therefore be expressed in a single patient. However, the prevalence, clinical characteristics and prognosis of individuals with comorbid IPF and COPD are not known. </sec> <sec> <title>METHOD</title> From 2003 to 2007, the Korean Interstitial Lung Disease Study Group created a register for idiopathic interstitial pneumonia using 2002 ATS/ERS (American Thoracic Society/European Respiratory Society) criteria. Of the 1546 IPF patients assessed, 143 had decreased lung function consistent with COPD (IPF-COPD). COPD was diagnosed based on age (≥40 years) and pulmonary function (forced expiratory volume in 1 sec [FEV1]/forced vital capacity [FVC] ratio < 0.7). </sec> <sec> <title>RESULTS</title> The median age of the IPF-COPD group was 71.0 years (interquartile range 66.0-76.0); most patients were male (88.1%). FVC (%) was significantly higher in the IPF-COPD group; however, FEV1 (%) was significantly lower in the IPF-COPD group (P < 0.001). Diffusing capacity of the lung for carbon monoxide (DLCO) was not significantly different between the two groups. In survival analysis, age and FVC (%), but not COPD, were significantly associated with prognosis (respectively P = 0.003, 0.001 and 0.401). COPD severity was also not related to prognosis (P = 0.935). </sec> <sec> <title>CONCLUSION</title> The prevalence of IPF-COPD was estimated to be ∼9.2% among all IPF patients; prognosis of patients with IPF-COPD was not worse than those with IPF alone. </sec>.
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Affiliation(s)
- S H Lee
- Yonsei University College of Medicine, Seoul, Department of Internal Medicine, National University College of Medicine, Division of Pulmonary and Critical Care Medicine, Seoul National University Bundang Hospital, Seoul
| | - J S Park
- Department of Internal Medicine, National University College of Medicine, Division of Pulmonary and Critical Care Medicine, Seoul National University Bundang Hospital, Seoul
| | - S Y Kim
- Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Institute of Chest Diseases, Yonsei University College of Medicine, Seoul
| | - D S Kim
- Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul
| | - Y W Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul
| | - M P Chung
- Division of Pulmonary and Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul
| | - S T Uh
- Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul
| | - C S Park
- Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Gyeonggi-do
| | - S W Park
- Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Gyeonggi-do
| | - S H Jeong
- Division of Pulmonology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon
| | - Y B Park
- Division of Pulmonary, Allergy & Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul
| | - H L Lee
- Pulmonary Division, Department of Internal Medicine, Inha University Hospital, Incheon
| | - J W Shin
- Division of Pulmonary Medicine, Department of Internal Medicine, Chung Ang University College of Medicine, Seoul
| | - J H Lee
- Department of Internal Medicine, Ewha Womans University School of Medicine, Ewha Medical Research Institute, Seoul
| | - Y Jegal
- Division of Pulmonary Medicine, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan
| | - H K Lee
- Division of Critical Care and Pulmonary Medicine, Department of Internal Medicine, Inje University Pusan Paik Hospital, Busan
| | - Y H Kim
- Division of Allergy and Pulmonology, Department of Internal Medicine, Bucheon St Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul, South Korea
| | - J W Song
- Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul
| | - M S Park
- Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Institute of Chest Diseases, Yonsei University College of Medicine, Seoul
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16
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Kwak N, Kim HR, Yoo CG, Kim YW, Han SK, Yim JJ. Multidrug-resistant tuberculosis over 20 years at a referral hospital in South Korea: trends and outcomes. Int J Tuberc Lung Dis 2020; 23:174-180. [PMID: 30808449 DOI: 10.5588/ijtld.18.0295] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING A referral centre in South Korea. OBJECTIVE To investigate trends in drug resistance, treatment modalities and outcomes, and adverse events of multidrug-resistant tuberculosis (MDR-TB) over two decades. DESIGN MDR-TB patients treated at Seoul National Hospital University between 1996 and 2015 were divided into four 5-year cohorts according to the date of initial diagnosis. Changes in demographic characteristics, drug resistance, drugs used, treatment outcomes and adverse events over time were elucidated. RESULTS Between 1996 and 2015, 418 patients were treated for MDR-TB: 86 patients between 1996 and 2000, 125 between 2001 and 2005, 123 between 2006 and 2010, and 84 between 2011 and 2015. The proportion of patients with positive acid-fast bacilli sputum (60.5-29.7%, P < 0.001) or cavities on chest radiographs (86.0-40.5%, P < 0.001) decreased over time. Resistance to pyrazinamide, fluoroquinolones, cycloserine and p-aminosalicylic acid decreased. Later-generation fluoroquinolones (77.9-90.5%) and linezolid (0-26.2%) became more frequently prescribed. The treatment success rate increased (45.3-88.1%, P < 0.001); neurological adverse events, including peripheral neuropathy also increased (4.7-13.1%, P = 0.027). CONCLUSION MDR-TB patients presented with less severe disease and better resistance profiles over time in South Korea, with treatment outcomes improving continuously.
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Affiliation(s)
- N Kwak
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul
| | - H-R Kim
- Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Science, Seoul, Republic of Korea
| | - C-G Yoo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul
| | - Y W Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul
| | - S K Han
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul
| | - J-J Yim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul
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17
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Kim YW, Kwon BS, Lim SY, Lee YJ, Cho YJ, Yoon HI, Lee JH, Lee CT, Park JS. Diagnostic value of bronchoalveolar lavage and bronchial washing in sputum-scarce or smear-negative cases with suspected pulmonary tuberculosis: a randomized study. Clin Microbiol Infect 2019; 26:911-916. [PMID: 31759097 DOI: 10.1016/j.cmi.2019.11.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 11/06/2019] [Accepted: 11/09/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Bronchoalveolar lavage (BAL) and bronchial washing (BW) are two major methods used to obtain high-quality respiratory specimens from patients with suspected pulmonary tuberculosis (TB) but a sputum-scarce or smear-negative status. We aimed to compare the value of BAL and BW in the diagnosis of TB in such patients. METHODS We enrolled patients with suspected pulmonary TB but with a sputum-scarce or smear-negative status who were referred for bronchoscopy between October 2013 and January 2016. Participants were randomized into the BAL and BW groups for evaluation. The primary outcome was the diagnostic yield for TB detection. Secondary outcomes included culture positivity, positivity of nucleic acid amplification tests (NAATs) for Mycobacterium tuberculosis and procedure-related complications. RESULTS A total of 94 patients were assessed and 91 (43 in the BAL group, 48 in the BW group) were analysed. Twenty-one patients (48.8%) in the BAL group and 30 (62.5%) in the BW group had a final diagnosis of pulmonary TB. The detection rate of M. tuberculosis by culture or NAAT was significantly higher in BAL specimens than in BW specimens (85.7% vs 50.0%, p 0.009). The procedure-related complications were hypoxic events, 2/43 (4.7%) in the BAL group and 5/48 (10.4%) in the BW group; and post-bronchoscopic fever, 3/43 (7.0%) in the BAL group and 4/48 (8.3%) in the BW group. DISCUSSION As long as it is tolerable, BAL rather than BW, should be used to obtain specimens for the diagnosis of pulmonary TB in sputum-scarce or smear-negative cases.
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Affiliation(s)
- Y W Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - B S Kwon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - S Y Lim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Y J Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Y-J Cho
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - H I Yoon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - J H Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - C-T Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - J S Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
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18
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Kim YW. Single-Port Laparoscopic Surgery for Huge Ovarian Cyst Using Foley Catheter. J Minim Invasive Gynecol 2019. [DOI: 10.1016/j.jmig.2019.09.717] [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: 10/25/2022]
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19
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Kim M, Hwang JY, Choo KS, Ryu H, Reid SNS, Kim YW, Kim TU, Kim JH. Comparison of image quality of abdominopelvic CT in paediatric patients: low osmolar contrast media versus less iodine-containing iso-osmolar contrast media at different peak kilovoltages. Clin Radiol 2019; 74:896.e9-896.e16. [PMID: 31431254 DOI: 10.1016/j.crad.2019.06.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 06/21/2019] [Indexed: 10/26/2022]
Abstract
AIM To evaluate the effect of iso-osmolar contrast media (IOCM) at different tube voltages on image quality for abdominal computed tomography (CT) in paediatric patients. MATERIALS AND METHODS The low osmolar contrast media (LOCM) group and IOCM group consisted of 101 and 102 CT examinations, respectively, in patients <18 years old. Images were reviewed retrospectively. Objective measurement of the contrast enhancement and noise were analysed and contrast-to-noise ratios (CNRs) of the abdominal aorta, portal vein, and liver were calculated. Four radiologists participated in subjective analysis using a four-point scale system to evaluate degrees of contrast enhancement, image noise, beam-hardening artefact, and overall image quality. Reader performance for correctly differentiating the two kinds of contrast media was evaluated. RESULTS Regarding the objective measurement, contrast enhancement was significantly higher in the LOCM group (p<0.05). In subjective analysis, only CT using 120 kVp showed significantly stronger enhancement in the LOCM group (p=0.002), and sensitivity to differentiate the IOCM was 80.6%. Overall sensitivity and specificity for correctly differentiating IOCM were 57.1%, and 56.9%, respectively. CONCLUSION The application of IOCM was found to be feasible for performing paediatric abdominopelvic CT with a low tube voltage protocol. Although objective measurements of contrast enhancement were significantly lower in the IOCM group, subjective contrast enhancement and image quality assessments were not statistically different between groups.
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Affiliation(s)
- M Kim
- Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea
| | - J Y Hwang
- Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea; Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Geumo-ro 20, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea.
| | - K S Choo
- Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea
| | - H Ryu
- Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea
| | - S N S Reid
- College of Creative Human Resource, School of Liberal Arts Education, Kyungsung University, Busan, 48434, Republic of Korea
| | - Y W Kim
- Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea
| | - T U Kim
- Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea
| | - J H Kim
- Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea
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20
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Kwon HY, Kim BR, Kim YW. Association of preoperative anemia and perioperative allogenic red blood cell transfusion with oncologic outcomes in patients with nonmetastatic colorectal cancer. ACTA ACUST UNITED AC 2019; 26:e357-e366. [PMID: 31285680 DOI: 10.3747/co.26.4983] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background We investigated whether preoperative anemia and perioperative blood transfusion (pbt) are associated with overall survival and recurrence-free survival in patients with nonmetastatic colorectal cancer. Methods From 1 January 2009 to 31 December 2014, 1003 patients with primary colorectal cancer were enrolled in the study. Perioperative clinical and oncologic outcomes were analyzed based on the presence of preoperative anemia and pbt. Results Preoperative anemia was found in 468 patients (46.7%). In the anemia and no-anemia groups, pbt was performed in 44% and 15% of patients respectively. Independent predictors for pbt were preoperative anemia, higher American Society of Anesthesiologists score, laparotomy, lengthy operative time, advanced TNM stage, T4 stage, and 30-day morbidity. The use of pbt, but not preoperative anemia, was found to be an independent adverse prognostic factor for overall survival. In terms of recurrence-free survival, the presence of preoperative anemia was similarly not a significant prognostic factor, but the use of pbt was an independent factor for an unfavourable prognosis. Conclusions The use of pbt, but not preoperative anemia, was independently associated with worse overall and recurrence-free survival in nonmetastatic colorectal cancer. For better oncologic outcomes, our findings indicate a need to reduce the use of blood transfusion during the perioperative period.
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Affiliation(s)
- H Y Kwon
- Division of Colorectal Surgery, Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, R.O.K
| | - B R Kim
- Health Promotion Center, Wonju Severance Christian Hospital, Wonju, R.O.K.,Division of Gastroenterology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, R.O.K
| | - Y W Kim
- Division of Colorectal Surgery, Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, R.O.K.,Big Data Research Group, Yonsei University Wonju College of Medicine, Wonju, R.O.K
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21
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Huang KL, Mashl RJ, Wu Y, Ritter DI, Wang J, Oh C, Paczkowska M, Reynolds S, Wyczalkowski MA, Oak N, Scott AD, Krassowski M, Cherniack AD, Houlahan KE, Jayasinghe R, Wang LB, Zhou DC, Liu D, Cao S, Kim YW, Koire A, McMichael JF, Hucthagowder V, Kim TB, Hahn A, Wang C, McLellan MD, Al-Mulla F, Johnson KJ, Lichtarge O, Boutros PC, Raphael B, Lazar AJ, Zhang W, Wendl MC, Govindan R, Jain S, Wheeler D, Kulkarni S, Dipersio JF, Reimand J, Meric-Bernstam F, Chen K, Shmulevich I, Plon SE, Chen F, Ding L. Pathogenic Germline Variants in 10,389 Adult Cancers. Cell 2019; 173:355-370.e14. [PMID: 29625052 DOI: 10.1016/j.cell.2018.03.039] [Citation(s) in RCA: 501] [Impact Index Per Article: 100.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 02/24/2018] [Accepted: 03/15/2018] [Indexed: 12/20/2022]
Abstract
We conducted the largest investigation of predisposition variants in cancer to date, discovering 853 pathogenic or likely pathogenic variants in 8% of 10,389 cases from 33 cancer types. Twenty-one genes showed single or cross-cancer associations, including novel associations of SDHA in melanoma and PALB2 in stomach adenocarcinoma. The 659 predisposition variants and 18 additional large deletions in tumor suppressors, including ATM, BRCA1, and NF1, showed low gene expression and frequent (43%) loss of heterozygosity or biallelic two-hit events. We also discovered 33 such variants in oncogenes, including missenses in MET, RET, and PTPN11 associated with high gene expression. We nominated 47 additional predisposition variants from prioritized VUSs supported by multiple evidences involving case-control frequency, loss of heterozygosity, expression effect, and co-localization with mutations and modified residues. Our integrative approach links rare predisposition variants to functional consequences, informing future guidelines of variant classification and germline genetic testing in cancer.
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Affiliation(s)
- Kuan-Lin Huang
- Department of Medicine, Washington University in St. Louis, Saint Louis, MO 63108, USA; McDonnell Genome Institute, Washington University in St. Louis, Saint Louis, MO 63108, USA
| | - R Jay Mashl
- Department of Medicine, Washington University in St. Louis, Saint Louis, MO 63108, USA; McDonnell Genome Institute, Washington University in St. Louis, Saint Louis, MO 63108, USA
| | - Yige Wu
- Department of Medicine, Washington University in St. Louis, Saint Louis, MO 63108, USA; McDonnell Genome Institute, Washington University in St. Louis, Saint Louis, MO 63108, USA
| | - Deborah I Ritter
- Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - Jiayin Wang
- School of Management, Xi'an Jiaotong University, Xi'an, Shanxi, China
| | - Clara Oh
- Department of Medicine, Washington University in St. Louis, Saint Louis, MO 63108, USA
| | - Marta Paczkowska
- Computational Biology Program, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | | | - Matthew A Wyczalkowski
- Department of Medicine, Washington University in St. Louis, Saint Louis, MO 63108, USA; McDonnell Genome Institute, Washington University in St. Louis, Saint Louis, MO 63108, USA
| | - Ninad Oak
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Adam D Scott
- Department of Medicine, Washington University in St. Louis, Saint Louis, MO 63108, USA; McDonnell Genome Institute, Washington University in St. Louis, Saint Louis, MO 63108, USA
| | - Michal Krassowski
- Computational Biology Program, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | | | - Kathleen E Houlahan
- Computational Biology Program, Ontario Institute for Cancer Research, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Reyka Jayasinghe
- Department of Medicine, Washington University in St. Louis, Saint Louis, MO 63108, USA; McDonnell Genome Institute, Washington University in St. Louis, Saint Louis, MO 63108, USA
| | - Liang-Bo Wang
- Department of Medicine, Washington University in St. Louis, Saint Louis, MO 63108, USA; McDonnell Genome Institute, Washington University in St. Louis, Saint Louis, MO 63108, USA
| | - Daniel Cui Zhou
- Department of Medicine, Washington University in St. Louis, Saint Louis, MO 63108, USA; McDonnell Genome Institute, Washington University in St. Louis, Saint Louis, MO 63108, USA
| | - Di Liu
- Department of Medicine, Washington University in St. Louis, Saint Louis, MO 63108, USA
| | - Song Cao
- Department of Medicine, Washington University in St. Louis, Saint Louis, MO 63108, USA; McDonnell Genome Institute, Washington University in St. Louis, Saint Louis, MO 63108, USA
| | - Young Won Kim
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Amanda Koire
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Joshua F McMichael
- McDonnell Genome Institute, Washington University in St. Louis, Saint Louis, MO 63108, USA
| | | | - Tae-Beom Kim
- Departments of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Abigail Hahn
- Institute for Systems Biology, Seattle, WA 98109, USA
| | - Chen Wang
- Department of Health Sciences Research and Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, MN 55905 USA
| | - Michael D McLellan
- McDonnell Genome Institute, Washington University in St. Louis, Saint Louis, MO 63108, USA
| | - Fahd Al-Mulla
- Dasman Diabetes Institute and Molecular Pathology Laboratory, Kuwait University, Kuwait
| | - Kimberly J Johnson
- Brown School Master of Public Health Program, Washington University in St. Louis, Saint Louis, MO 63108, USA
| | | | - Olivier Lichtarge
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Paul C Boutros
- Computational Biology Program, Ontario Institute for Cancer Research, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Benjamin Raphael
- Lewis-Sigler Institute, Princeton University, Princeton, NJ 08544, USA
| | - Alexander J Lazar
- Departments of Pathology and Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Wei Zhang
- Department of Cancer Biology and Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston Salem, NC 27157 USA
| | - Michael C Wendl
- McDonnell Genome Institute, Washington University in St. Louis, Saint Louis, MO 63108, USA; Department of Genetics, Washington University in St. Louis, Saint Louis, MO 63108, USA; Department of Mathematics, Washington University in St. Louis, Saint Louis, MO 63108, USA
| | - Ramaswamy Govindan
- Department of Medicine, Washington University in St. Louis, Saint Louis, MO 63108, USA
| | - Sanjay Jain
- Department of Medicine, Washington University in St. Louis, Saint Louis, MO 63108, USA
| | - David Wheeler
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Shashikant Kulkarni
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA; Baylor Genetics, Houston, TX 77021, USA
| | - John F Dipersio
- Department of Medicine, Washington University in St. Louis, Saint Louis, MO 63108, USA; Siteman Cancer Center, Washington University in St. Louis, Saint Louis, MO 63108, USA
| | - Jüri Reimand
- Computational Biology Program, Ontario Institute for Cancer Research, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Funda Meric-Bernstam
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Ken Chen
- Departments of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | | | - Sharon E Plon
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA; Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Feng Chen
- Department of Medicine, Washington University in St. Louis, Saint Louis, MO 63108, USA; Siteman Cancer Center, Washington University in St. Louis, Saint Louis, MO 63108, USA.
| | - Li Ding
- Department of Medicine, Washington University in St. Louis, Saint Louis, MO 63108, USA; McDonnell Genome Institute, Washington University in St. Louis, Saint Louis, MO 63108, USA; Department of Genetics, Washington University in St. Louis, Saint Louis, MO 63108, USA; Siteman Cancer Center, Washington University in St. Louis, Saint Louis, MO 63108, USA.
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23
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Noh BJ, Han CS, Park JS, Lee J, Kim YW, Park YK. ALK-positive anaplastic large-cell lymphoma with primary bone involvement: A rare case and review of the literature. Malays J Pathol 2018; 40:161-167. [PMID: 30173234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Primary bone lymphoma (PBL) is an uncommon type of extranodal lymphoma involvement. An anaplastic large-cell lymphoma (ALCL) is an extremely rare type of PBL, and it remains unclear whether ALCLs that primarily involve the bone exhibit favourable or unfavourable biological behaviour, and whether they are similar to ALCLs in general, or not. We reported a case of ALK-positive ALCL with primary bone involvement, and reviewed the clinicopathological features of 22 previously reported cases. An ALCL with primary bone involvement mostly affects younger patients with a preponderant towards the involvement of axial-bone. The prognosis of an ALCL that primarily involves bone is unfavourable, compared with PBL generally. The ALK-positive ALCLs in PBLs had less decedents than the ALK-negative ALCLs with a statistical non-significance (p=0.198).
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Affiliation(s)
- B J Noh
- University of Ulsan College of Medicine, Gangneung Asan Hospital, Department of Pathology, Gangneung, 25440, Korea.
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24
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Lee HB, Kim YW, Kim SH, Park SH, Choi JP, Aranas C. A Modular Solder System with Hierarchical Morphology and Backward Compatibility. Small 2018; 14:e1801349. [PMID: 30019844 DOI: 10.1002/smll.201801349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 05/28/2018] [Indexed: 06/08/2023]
Abstract
A modular solder system with hierarchical morphology and micro/nanofeatures in which solder nanoparticles are distributed on the surface of template micropowders is reported. A core-shell structure of subsidiary nanostructures, which improved the intended properties of the modular solder is also presented. In addition, polymer additives can be used not only as an adhesive (like epoxy resin) but also to impart other functions. By combining all of these, it is determined that the modular solder system is able to increase reflowability on a heat-sensitive plastic substrate, oxidation resistance, and electrical conductivity. In this respect, the system could be readily modified by changing the structure and composition of each constituent and adopting backward compatibility with which the knowledge and information attained from a previously designed solder can offer feedback toward further improving the properties of a newly designed one. In practice, In-Sn-Bi nanoparticles engineered on the surface of Sn-Zn micropowders result in pronounced reflowing on a flexible Au-coated polyethylene terephthalate (PET) substrate even at the low temperature of 110 °C. Depending on their respective concentrations, the incorporation of CuO@CeO2 nanostructures and poly(3,4-ethylenedioxythiophene) polystyrene sulfonate (PEDOT:PSS) polymers increases oxidation resistance and electrical conductivity of the modular solder.
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Affiliation(s)
- Han Bit Lee
- Digital Manufacturing Process Group, Korea Institute of Industrial Technology, 113-58 Seohaean-ro, Siheung-si, Gyeonggi-do, 15014, Republic of Korea
| | - Young Won Kim
- Digital Manufacturing Process Group, Korea Institute of Industrial Technology, 113-58 Seohaean-ro, Siheung-si, Gyeonggi-do, 15014, Republic of Korea
| | - Sang Hoon Kim
- Digital Manufacturing Process Group, Korea Institute of Industrial Technology, 113-58 Seohaean-ro, Siheung-si, Gyeonggi-do, 15014, Republic of Korea
| | - Suk Hee Park
- Digital Manufacturing Process Group, Korea Institute of Industrial Technology, 113-58 Seohaean-ro, Siheung-si, Gyeonggi-do, 15014, Republic of Korea
| | - Joon-Phil Choi
- Department of Mining and Materials Engineering, McGill University, 3610 University Street, Montreal, Quebec, H3A 0C5, Canada
| | - Clodualdo Aranas
- CanmetMATERIALS, Natural Resources Canada, 183 Longwood Road South, Hamilton, Ontario, L8P 0A5, Canada
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25
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Abstract
Background: Glufosinate-containing herbicide is increasingly used in agriculture. Its poisoning is a worldwide concern. More and more patients are poisoned by glufosinate. The aim of this study was to determine the factors associated with mortality of patients with acute poisoning of glufosinate. Methods: This was a retrospective cohort study conducted from January 1998 to October 2015. Using a multivariate logistic analysis, data for the total population were retrospectively analyzed to determine the factors associated with mortality. Various variables were compared in survivors and non-survivors. Significant predictive variables, Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system, the Simplified Acute Physiology Score (SAPS) II, and Sequential Organ Failure Assessment (SOFA) score were compared by analyzing receiver operating characteristic (ROC) curves. Results: A total of 253 patients (mean age: 58 years) were enrolled. Of the 253 patients, 219 (86.6%) survived and 34 (13.4%) died. Decreased Glasgow Coma Scale (GCS) and bicarbonate (HCO3−), use of mechanical ventilator, and use of vasopressors (dopamine, dobutamine, norepinephrine) were associated with mortality. The areas under the curve in the ROC curve analysis for the predictive variables, SOFA score, APACHE II scoring system, and SAPS II were 0.952, 0.829, 0.927, and 0.944, respectively. Conclusion: Four predictive variables (GCS < 9, HCO3− < 16.0 mmol/L, mechanical ventilator apply, and use of vasopressors) were associated with mortality in the total population of patients with acute poisoning of glufosinate. These predictive variables had good discriminative power for predicting mortality of patients with acute poisoning of glufosinate-containing herbicide compared to APACHE II, SOFA, and SAPS II.
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Affiliation(s)
- JH Lee
- Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - YW Kim
- Department of Emergency Medicine, Inje University College of Medicine, Busan, Republic of Korea
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26
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Kim YW, Lee HB, Yeon SM, Park J, Lee HJ, Yoon J, Park SH. Enhanced Piezoelectricity in a Robust and Harmonious Multilayer Assembly of Electrospun Nanofiber Mats and Microbead-Based Electrodes. ACS Appl Mater Interfaces 2018; 10:5723-5730. [PMID: 29355300 DOI: 10.1021/acsami.7b18259] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Here, we present a simple yet highly efficient method to enhance the output performance of a piezoelectric device containing electrospun nanofiber mats. Multiple nanofiber mats were assembled together to harness larger piezoelectric sources in the as-spun fibers, thereby providing enhanced voltage and current outputs compared to those of a single-mat device. In addition to the multilayer assembly, microbead-based electrodes were integrated with the nanofiber mats to deliver a complexed compression and tension force excitation to the piezoelectric layers. A vacuum-packing process was performed to attain a tight and well-organized assembly of the device components even though the total thickness was several millimeters. The integrated piezoelectric device exhibited a maximum voltage and current of 10.4 V and 2.3 μA, respectively. Furthermore, the robust integrity of the device components could provide high-precision sensitivity to perceive small pressures down to approximately 100 Pa while retaining a linear input-output relationship.
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Affiliation(s)
- Young Won Kim
- Micro/Nano Scale Manufacturing R&D Group, Korea Institute of Industrial Technology , Hanggaul-ro 143, Sangnok-gu, 426-910 Ansan-si, Gyeonggi-do, Republic of Korea
- Department of Mechanical Engineering, Hanyang University , Ansan-si, Gyeonggi-do 15588, Republic of Korea
| | - Han Bit Lee
- Micro/Nano Scale Manufacturing R&D Group, Korea Institute of Industrial Technology , Hanggaul-ro 143, Sangnok-gu, 426-910 Ansan-si, Gyeonggi-do, Republic of Korea
- Department of Mechanical Engineering, Hanyang University , Ansan-si, Gyeonggi-do 15588, Republic of Korea
| | - Si Mo Yeon
- Micro/Nano Scale Manufacturing R&D Group, Korea Institute of Industrial Technology , Hanggaul-ro 143, Sangnok-gu, 426-910 Ansan-si, Gyeonggi-do, Republic of Korea
| | - Jeanho Park
- Micro/Nano Scale Manufacturing R&D Group, Korea Institute of Industrial Technology , Hanggaul-ro 143, Sangnok-gu, 426-910 Ansan-si, Gyeonggi-do, Republic of Korea
| | - Hye Jin Lee
- Micro/Nano Scale Manufacturing R&D Group, Korea Institute of Industrial Technology , Hanggaul-ro 143, Sangnok-gu, 426-910 Ansan-si, Gyeonggi-do, Republic of Korea
| | - Jonghun Yoon
- Department of Mechanical Engineering, Hanyang University , Ansan-si, Gyeonggi-do 15588, Republic of Korea
| | - Suk Hee Park
- Micro/Nano Scale Manufacturing R&D Group, Korea Institute of Industrial Technology , Hanggaul-ro 143, Sangnok-gu, 426-910 Ansan-si, Gyeonggi-do, Republic of Korea
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27
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Abstract
The era where surgical excision alone was the sole treatment of venous malformation (VM) is now over. A multidisciplinary approach that utilizes both traditional surgical therapy and endovascular therapy is now the standard of care. Endovascular therapy utilizing primarily both embolization therapy and sclerotherapy is the treatment of choice for surgically ‘inaccessible' VM lesions. Surgical therapy of VM lesions has been shown to be more effective when combined with supplemental endovascular therapy.
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Affiliation(s)
- B B Lee
- Department of Surgery, Georgetown University, Washington, DC, USA
| | - J Laredo
- Department of Surgery, Georgetown University, Washington, DC, USA
| | - Y W Kim
- Department of Surgery, SungKyunKwan University
- SamSung Medical Centre, Seoul, Korea
| | - R Neville
- Department of Surgery, Georgetown University, Washington, DC, USA
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28
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Lu H, Villafane N, Dogruluk T, Grzeskowiak CL, Kong K, Tsang YH, Zagorodna O, Pantazi A, Yang L, Neill NJ, Kim YW, Creighton CJ, Verhaak RG, Mills GB, Park PJ, Kucherlapati R, Scott KL. Engineering and Functional Characterization of Fusion Genes Identifies Novel Oncogenic Drivers of Cancer. Cancer Res 2017; 77:3502-3512. [PMID: 28512244 DOI: 10.1158/0008-5472.can-16-2745] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 03/07/2017] [Accepted: 04/27/2017] [Indexed: 01/22/2023]
Abstract
Oncogenic gene fusions drive many human cancers, but tools to more quickly unravel their functional contributions are needed. Here we describe methodology permitting fusion gene construction for functional evaluation. Using this strategy, we engineered the known fusion oncogenes, BCR-ABL1, EML4-ALK, and ETV6-NTRK3, as well as 20 previously uncharacterized fusion genes identified in The Cancer Genome Atlas datasets. In addition to confirming oncogenic activity of the known fusion oncogenes engineered by our construction strategy, we validated five novel fusion genes involving MET, NTRK2, and BRAF kinases that exhibited potent transforming activity and conferred sensitivity to FDA-approved kinase inhibitors. Our fusion construction strategy also enabled domain-function studies of BRAF fusion genes. Our results confirmed other reports that the transforming activity of BRAF fusions results from truncation-mediated loss of inhibitory domains within the N-terminus of the BRAF protein. BRAF mutations residing within this inhibitory region may provide a means for BRAF activation in cancer, therefore we leveraged the modular design of our fusion gene construction methodology to screen N-terminal domain mutations discovered in tumors that are wild-type at the BRAF mutation hotspot, V600. We identified an oncogenic mutation, F247L, whose expression robustly activated the MAPK pathway and sensitized cells to BRAF and MEK inhibitors. When applied broadly, these tools will facilitate rapid fusion gene construction for subsequent functional characterization and translation into personalized treatment strategies. Cancer Res; 77(13); 3502-12. ©2017 AACR.
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Affiliation(s)
- Hengyu Lu
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Nicole Villafane
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas.,Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Turgut Dogruluk
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Caitlin L Grzeskowiak
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Kathleen Kong
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Yiu Huen Tsang
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Oksana Zagorodna
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Angeliki Pantazi
- Division of Genetics, Brigham and Women's Hospital, Boston, Massachusetts
| | - Lixing Yang
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts
| | - Nicholas J Neill
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Young Won Kim
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Chad J Creighton
- Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas
| | - Roel G Verhaak
- The Jackson Laboratory, Genomic Medicine, Farmington, Connecticut
| | - Gordon B Mills
- Department of Systems Biology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Peter J Park
- Division of Genetics, Brigham and Women's Hospital, Boston, Massachusetts.,Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts
| | - Raju Kucherlapati
- Division of Genetics, Brigham and Women's Hospital, Boston, Massachusetts.,Department of Genetics, Harvard Medical School, Boston, Massachusetts
| | - Kenneth L Scott
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas. .,Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas
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Koire A, Kim YW, Wang J, Katsonis P, Jin H, Lichtarge O. Codon-level co-occurrences of germline variants and somatic mutations in cancer are rare but often lead to incorrect variant annotation and underestimated impact prediction. PLoS One 2017; 12:e0174766. [PMID: 28350864 PMCID: PMC5370158 DOI: 10.1371/journal.pone.0174766] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 10/13/2016] [Accepted: 03/15/2017] [Indexed: 12/16/2022] Open
Abstract
Cancer cells explore a broad mutational landscape, bringing the possibility that tumor-specific somatic mutations could fall in the same codons as germline SNVs and leverage their presence to produce substitutions with a larger impact on protein function. While multiple, temporally consecutive mutations to the same codon have in the past been detected in the germline, this phenomenon has not yet been explored in the context of germline-somatic variant co-occurrences during cancer development. We examined germline context at somatic mutation sites for 1395 patients across four cancer cohorts (breast, skin, colon, and head and neck) and found 392 codon-level co-occurrences between germline and somatic variants, including over a dozen in well-known cancer genes. We found that for the majority of these co-occurrence events, traditional somatic calling led to an inaccurate representation of the protein site and a significantly lower predicted impact on protein fitness. We conclude that these events often lead to imprecise annotation of somatic variants but do not appear to be a frequent source of driver events during cancer development.
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Affiliation(s)
- Amanda Koire
- Program in Structural and Computational Biology and Molecular Biophysics, Baylor College of Medicine, Houston, Texas, United States of America
- Medical Scientist Training Program, Baylor College of Medicine, Houston, Texas, United States of America
- * E-mail:
| | - Young Won Kim
- Program in Integrative Molecular and Biomedical Sciences, Baylor College of Medicine, Houston, Texas, United States of America
| | - Jarey Wang
- Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, Texas, United States of America
| | - Panagiotis Katsonis
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, United States of America
| | - Haijing Jin
- Program in Structural and Computational Biology and Molecular Biophysics, Baylor College of Medicine, Houston, Texas, United States of America
| | - Olivier Lichtarge
- Program in Structural and Computational Biology and Molecular Biophysics, Baylor College of Medicine, Houston, Texas, United States of America
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, United States of America
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Na YR, Gu GJ, Jung D, Kim YW, Na J, Woo JS, Cho JY, Youn H, Seok SH. Correction: GM-CSF Induces Inflammatory Macrophages by Regulating Glycolysis and Lipid Metabolism. J I 2017; 198:3000. [DOI: 10.4049/jimmunol.1700174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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31
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Kim YW, Kim JH, Yoon SH, Lee JH, Lee CH, Shin CS, Park YS. Vertebral bone attenuation on low-dose chest CT: quantitative volumetric analysis for bone fragility assessment. Osteoporos Int 2017; 28:329-338. [PMID: 27480628 DOI: 10.1007/s00198-016-3724-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [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: 12/11/2015] [Accepted: 07/26/2016] [Indexed: 01/09/2023]
Abstract
UNLABELLED This study evaluated the use of low-dose chest computed tomography (LDCT) for detecting bone fragility. LDCT-measured vertebral bone attenuation by volumetric methods showed good correlation with bone mineral density (BMD) measured by dual-energy x-ray absorptiometry (DXA, and good diagnostic performance for identifying osteoporosis and compression fractures. The results of this study suggest the feasibility of obtaining comprehensive information on bone health in subjects undergoing LDCT. INTRODUCTION Osteoporosis is a prevalent but underdiagnosed disease that increases fracture risk. This study evaluated the utility of vertebral attenuation derived from low-dose chest computed tomography (LDCT) compared to dual-energy x-ray absorptiometry (DXA) for detecting bone fragility. METHODS A total of 232 subjects (78 men and 154 women) aged above 50 years who underwent both LDCT and DXA within 30 days were evaluated. LDCT-measured bone attenuation in Hounsfield units (HU) of four vertebrae (T4, T7, T10, and L1) was evaluated using volumetric methods for correlation with DXA-measured bone mineral density (BMD) and for the diagnosis of compression fractures, osteoporosis, and low BMD (osteoporosis or osteopenia) in men and women, with DXA measurements as the reference standard. RESULTS The average attenuation of the four vertebrae showed strong correlation with DXA-measured BMD of the lumbar spine (r = 0.726, p < 0.05). In receiver-operating characteristic (ROC) analyses, the area under the curve (AUC) across LDCT-measured thresholds of the average attenuation to distinguish compression fractures was 0.827, and a threshold of 129.5 HU yielded 90.9 % sensitivity and 64.4 % specificity. Similarly, average attenuation showed high AUCs and good diagnostic performance for detecting osteoporosis and low BMD in both men and women. Among 44 subjects with compression fractures, the average bone attenuation showed strong negative correlation with both the worst fracture grade (r = -0.525, p < 0.05) and cumulative fracture grade score (r = -0.633, p < 0.05). CONCLUSION LDCT-measured bone attenuation by volumetric methods showed good correlation with BMD measured by DXA and good diagnostic performance for identifying bone fragility.
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Affiliation(s)
- Y W Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Seoul National University, 101 Daehak-Ro, Jongno-Gu, Seoul, 110-744, Republic of Korea
| | - J H Kim
- Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - S H Yoon
- Department of Radiology, Institute of Radiation Medicine, Seoul National University Medical Research Center, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - J H Lee
- Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - C-H Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Seoul National University, 101 Daehak-Ro, Jongno-Gu, Seoul, 110-744, Republic of Korea
| | - C S Shin
- Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Y S Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Seoul National University, 101 Daehak-Ro, Jongno-Gu, Seoul, 110-744, Republic of Korea.
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Park HM, Han SS, Lee EC, Lee SD, Yoon HM, Eom BW, Kim SH, Ryu KW, Park SJ, Kim YW, Park B. Randomized clinical trial of preoperative skin antisepsis with chlorhexidine gluconate or povidone–iodine. Br J Surg 2016; 104:e145-e150. [DOI: 10.1002/bjs.10395] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 07/04/2016] [Accepted: 09/06/2016] [Indexed: 11/11/2022]
Abstract
Abstract
Background
Skin antiseptic agents are used to prevent surgical-site infection (SSI); few trials have reported the superiority of any specific agent in clean-contaminated abdominal surgery. This RCT was designed to compare the effectiveness of chlorhexidine gluconate and povidone–iodine.
Methods
Consecutive patients who underwent clean-contaminated upper gastrointestinal or hepatobiliary–pancreatic open surgery between 2011 and 2014 were assigned randomly to either chlorhexidine gluconate or povidone–iodine. The primary endpoint was the occurrence of SSI within 30 days of surgery. Secondary endpoints included causative organisms and risk factors for SSI.
Results
A total of 534 patients were randomized; 31 (5·8 per cent) developed an SSI. There was no difference in the overall SSI rate in the chlorhexidine gluconate and povidone–iodine groups: 15 of 267 (5·6 per cent) and 16 of 267 (6·0 per cent) respectively (P = 0·853). The most common causative organism was Enterococcus faecalis. In subgroup analysis, biliary–pancreatic surgery had a higher SSI rate (26 of 127, 20·5 per cent) than upper gastrointestinal (2 of 204, 1·0 per cent) and hepatic (3 of 203, 1·5 per cent) resection. Both age (60 years and over) and type of incision were associated with the risk of SSI.
Conclusion
No difference was detected between chlorhexidine gluconate and povidone–iodine antiseptics for prevention of SSI. Registration number: NCT01495117 (http://www.clinicaltrials.gov).
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Affiliation(s)
- H M Park
- Centre for Liver Cancer, National Cancer Centre, South Korea
| | - S-S Han
- Centre for Liver Cancer, National Cancer Centre, South Korea
| | - E C Lee
- Centre for Liver Cancer, National Cancer Centre, South Korea
| | - S D Lee
- Centre for Liver Cancer, National Cancer Centre, South Korea
| | - H M Yoon
- Centre for Gastric Cancer, National Cancer Centre, South Korea
| | - B W Eom
- Centre for Gastric Cancer, National Cancer Centre, South Korea
| | - S H Kim
- Centre for Liver Cancer, National Cancer Centre, South Korea
| | - K W Ryu
- Centre for Gastric Cancer, National Cancer Centre, South Korea
| | - S-J Park
- Centre for Liver Cancer, National Cancer Centre, South Korea
| | - Y W Kim
- Centre for Gastric Cancer, National Cancer Centre, South Korea
| | - B Park
- Biometric Research Branch, Research Institute and Hospital, National Cancer Centre, South Korea
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Na YR, Gu GJ, Jung D, Kim YW, Na J, Woo JS, Cho JY, Youn H, Seok SH. GM-CSF Induces Inflammatory Macrophages by Regulating Glycolysis and Lipid Metabolism. J I 2016; 197:4101-4109. [DOI: 10.4049/jimmunol.1600745] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 09/13/2016] [Indexed: 12/24/2022]
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Abstract
A lymphatic malformation (LM) is the most common form of congenital vascular malformation (CVM). The new Hamburg classification of CVM distinguishes the truncular (T) form from the extratruncular (ET) form of LMs. Both are consequences of a developmental arrest at the different stages of lymphangiogenesis as a result of defective genes. The purpose of this review was to evaluate the current management results of both forms of LMs. A retrospective review of the clinical data of 315 patients with a diagnosis of LMs treated between September 1994 and December 2001 was performed. Lymphoscintigraphy was the most frequent diagnostic test. The patients with the ET form were treated with sclerotherapy with OK-432 and/or ethanol. Combinations of CDP (complex decongestive physiotherapy) and/or compressotherapy were used to treat all the T-form patients. In addition, surgery, either reconstructive or ablative, was offered to patients with the T form who failed to respond to the proper CDP. A multidisciplinary team performed the management of LM, and the results were evaluated every 6 months. Among 797 patients with CVM, 315 were confirmed to have LMs, either as the T form (226) or the ET form (89). Another 66 LMs were diagnosed with hemolymphatic malformations (HLM). Most of the ET forms (89/315) were the cystic type (70/89), while the T forms included aplasia and/or an obstruction (204/226). The ET form was most frequent in the head, neck, and thorax (69/89). The T form was located most frequently to the extremities (202/226), mostly to the lower limb (180/202). Two hundred and twenty-six T forms belonged to the various clinical stages: stages I-32, II-104, III-48, IV-18, and an unclear stage-24. The ET form was treated with sclerotherapy using OK-432 (108/120) and absolute ethanol (12/120). Among the 11 patients with the multiple ET form, 7 patients underwent perioperative sclerotherapy with OK-432 and a subsequent surgical excision. The clinical response of the T form at the extremity to CDP was excellent to good in a majority of clinical stages I to II (121/136) but decreased to a good to fair degree in stages III to IV (31/66). The additional surgical therapy, either reconstructive (10/19) or ablative (9/19), provided limited success in improving CDP efficacy, owing mainly to poor compliance. The long-term outcome of the initial success through self-motivated home-maintenance care during the follow-up period of up to 48 months was totally dependent on patient compliance. OK-432 sclerotherapy to 51 ET forms has shown excellent results on 88.9% of the cystic type (40/45) and 50% (3/6) of the cavernous type (minimum follow-up for 24 months). Seventeen ET forms in 7 patients were treated with a preoperative OK-432 sclerotherapy and a subsequent surgical excision, which provided good to excellent results in 14 for a minimum of 24 months. Primary lymphedema, which is the T form of LMs, can be managed safely by a combination of CDP with compressotherapy. Patients with good compliance can benefit from additional surgical therapy, either reconstructive or ablative. The ET form, particularly the cystic type, can be treated with various scleroagents that are preferably less toxic as the primary therapy. A surgical excision with or without perioperative sclerotherapy provides good results for patients with the localized cavernous type of the ET form. A multidisciplinary team approach is essential for the proper care of LM.
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Affiliation(s)
- B B Lee
- Department of Surgery, Sungkyunkwan University School of Medicine and Samsung Medical Center, Seoul, Korea.
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Park JM, Kim HI, Han SU, Yang HK, Kim YW, Lee HJ, An JY, Kim MC, Park S, Song KY, Oh SJ, Kong SH, Suh BJ, Yang DH, Ha TK, Hyung WJ, Ryu KW. Who may benefit from robotic gastrectomy?: A subgroup analysis of multicenter prospective comparative study data on robotic versus laparoscopic gastrectomy. Eur J Surg Oncol 2016; 42:1944-1949. [PMID: 27514719 DOI: 10.1016/j.ejso.2016.07.012] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 07/05/2016] [Accepted: 07/14/2016] [Indexed: 01/02/2023] Open
Abstract
AIMS Robotic gastrectomy for gastric cancer has been proven to be a feasible and safe minimally invasive procedure. However, our previous multicenter prospective study indicated that robotic gastrectomy is not superior to laparoscopic gastrectomy. This study aimed to identify which subgroups of patients would benefit from robotic gastrectomy rather than from conventional laparoscopic gastrectomy. METHODS A prospective multicenter comparative study comparing laparoscopic and robotic gastrectomy was previously conducted. We divided the patients into subgroups according to obesity, type of gastrectomy performed, and extent of lymph node dissection. Surgical outcomes were compared between the robotic and laparoscopic groups in each subgroup. RESULTS A total of 434 patients were enrolled into the robotic (n = 223) and laparoscopic (n = 211) surgery groups. According to obesity and gastrectomy type, there was no difference in the estimated blood loss (EBL), number of retrieved lymph nodes, complication rate, open conversion rate, and the length of hospital stay between the robotic and laparoscopic groups. According to the extent of lymph node dissection, the robotic group showed a significantly lower EBL than did the laparoscopic group after D2 dissection (P = 0.021), while there was no difference in EBL in patients that did not undergo D2 dissection (P = 0.365). CONCLUSION Patients with gastric cancer undergoing D2 lymph node dissection can benefit from less blood loss when a robotic surgery system is used.
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Affiliation(s)
- J M Park
- Department of Surgery, Chung-Ang University College of Medicine, Seoul, South Korea
| | - H I Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - S U Han
- Department of Surgery, Ajou University College of Medicine, Gyeonggido, South Korea
| | - H K Yang
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Y W Kim
- Center for Gastric Cancer, National Cancer Center, Gyeonggido, South Korea
| | - H J Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - J Y An
- Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - M C Kim
- Department of Surgery, Dong-A University College of Medicine, Busan, South Korea
| | - S Park
- Department of Surgery, Korea University College of Medicine, Seoul, South Korea
| | - K Y Song
- Department of Surgery, The Catholic University of Korea, Seoul, South Korea
| | - S J Oh
- Department of Surgery, Inje University College of Medicine, Busan, South Korea
| | - S H Kong
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - B J Suh
- Department of Surgery, Inje University College of Medicine, Busan, South Korea
| | - D H Yang
- Department of Surgery, Hallym University College of Medicine, Seoul, South Korea
| | - T K Ha
- Department of Surgery, Hanyang University College of Medicine, Seoul, South Korea
| | - W J Hyung
- Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - K W Ryu
- Center for Gastric Cancer, National Cancer Center, Gyeonggido, South Korea.
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Kim YW, Seong MW, Kim TS, Yoo CG, Kim YW, Han SK, Yim JJ. Evaluation of Xpert(®) MTB/RIF assay: diagnosis and treatment outcomes in rifampicin-resistant tuberculosis. Int J Tuberc Lung Dis 2016; 19:1216-21. [PMID: 26459536 DOI: 10.5588/ijtld.15.0183] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING The Xpert(®) MTB/RIF assay is endorsed by the World Health Organization for the detection of rifampicin (RMP) resistant tuberculosis (TB). OBJECTIVE To evaluate Xpert for its diagnostic accuracy in detecting RMP-resistant TB and its impact on treatment outcomes. DESIGN Patients with available phenotypic drug susceptibility testing (DST) results and those in whom RMP-resistant pulmonary TB was diagnosed using Xpert were evaluated. The accuracy and turnaround time (TAT) of Xpert for determining RMP-resistant TB was calculated. The TATs for treatment between patients diagnosed with RMP-resistant TB using Xpert and those diagnosed without the assay (phenotypic DST group) were compared. RESULTS In 321 patients, when phenotypic DST was used as the gold standard, Xpert sensitivity and specificity for RMP resistance diagnosis was respectively 100% and 98.7%; the positive and negative predictive values were respectively 86.2% and 100%. The Xpert group had a much shorter interval from initial evaluation to commencing second-line anti-tuberculosis treatment (64 vs. 2 days, P < 0.001), and negative conversion of mycobacterial cultures (197 vs. 62.5 days, P < 0.001) than the phenotypic DST group. CONCLUSION Xpert was accurate at diagnosing RMP resistance in this setting with an intermediate TB burden and a low level of RMP resistance. Xpert might reduce disease transmission by reducing the sputum culture conversion times for patients with RMP-resistant TB.
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Affiliation(s)
- Y W Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - M-W Seong
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - T S Kim
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - C-G Yoo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Y W Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - S K Han
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - J-J Yim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
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Kim YW, Hong JM, Park DG, Choi JW, Kang DH, Kim YS, Zaidat OO, Demchuk AM, Hwang YH, Lee JS. Effect of Intracranial Atherosclerotic Disease on Endovascular Treatment for Patients with Acute Vertebrobasilar Occlusion. AJNR Am J Neuroradiol 2016; 37:2072-2078. [PMID: 27313131 DOI: 10.3174/ajnr.a4844] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Accepted: 04/24/2016] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND PURPOSE Although intracranial atherosclerotic disease is often encountered during endovascular treatment for acute vertebrobasilar occlusions, its clinical implication is not well-known. We aimed to evaluate whether intracranial atherosclerotic disease influences the clinical outcomes following endovascular treatment of acute vertebrobasilar occlusive stroke. MATERIALS AND METHODS Fifty-one patients with acute vertebrobasilar occlusive stroke were included. The onset-to-groin puncture time was ≤12 hours, and aspiration- or stent-based thrombectomy was used as the primary treatment method. Following primary endovascular treatment, intracranial atherosclerotic disease (IAD group) was angiographically diagnosed when a fixed focal stenosis was observed at the occlusion site, whereas embolism (embolic group) was diagnosed if no stenosis was observed. Clinical and treatment variables were compared in both groups, and IAD was evaluated as a prognostic factor for clinical outcomes. RESULTS The baseline NIHSS score tended to be lower (14 versus 22, P = .097) in the IAD group (n = 19) than in the embolic group (n = 32). The procedural time was longer in the IAD group (96 versus 61 minutes, P = .002), despite similar rates of TICI 2b-3 (89.5% versus 87.5%, P = 1.000). The NIHSS score at 7 days was higher (21 versus 8, P = .060) and poor outcomes (mRS 4-6 at 3 months) were more frequent in the IAD group (73.7% versus 43.8%, P = .038). IAD (odds ratio, 5.469; 95% CI, 1.09-27.58; P = .040) was independently associated with poor outcomes. CONCLUSIONS An arterial occlusion related to IAD was associated with a longer procedural time and poorer clinical outcome. Further studies are warranted to elucidate the appropriate endovascular strategy.
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Affiliation(s)
- Y W Kim
- From the Departments of Neurology (Y.W.K., Y.H.H.).,Radiology (Y.W.K., D.-H.K., Y.S.K.)
| | - J M Hong
- Departments of Neurology (J.M.H., D.G.P., J.S.L.)
| | - D G Park
- Departments of Neurology (J.M.H., D.G.P., J.S.L.)
| | - J W Choi
- Radiology (J.W.C.), Ajou University School of Medicine and Hospital, Suwon, Republic of Korea
| | - D-H Kang
- Radiology (Y.W.K., D.-H.K., Y.S.K.).,Neurosurgery (D.-H.K.), Kyungpook National University School of Medicine and Hospital, Daegu, Republic of Korea
| | - Y S Kim
- Radiology (Y.W.K., D.-H.K., Y.S.K.)
| | - O O Zaidat
- Radiology (J.W.C.), Ajou University School of Medicine and Hospital, Suwon, Republic of Korea
| | - A M Demchuk
- Radiology (J.W.C.), Ajou University School of Medicine and Hospital, Suwon, Republic of Korea
| | - Y H Hwang
- From the Departments of Neurology (Y.W.K., Y.H.H.)
| | - J S Lee
- Departments of Neurology (J.M.H., D.G.P., J.S.L.)
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Cho H, Kim YW, Suh CH, Jung JY, Um YJ, Jung JH, Kim HA. Concordance between the tuberculin skin test and interferon gamma release assay (IGRA) for diagnosing latent tuberculosis infection in patients with systemic lupus erythematosus and patient characteristics associated with an indeterminate IGRA. Lupus 2016; 25:1341-8. [PMID: 26985011 DOI: 10.1177/0961203316639381] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 02/23/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE We investigated the agreement between the tuberculin skin test (TST) and the QuantiFERON-TB gold (QFT-G) assay in the diagnosis of latent tuberculosis infection (LTBI) in patients with systemic lupus erythematosus (SLE). Furthermore, we evaluated the factors associated with indeterminate results in the QFT-G assay in patients with SLE. METHODS We enrolled 136 patients with SLE prospectively, and compared them to 66 patients with rheumatoid arthritis (RA). In addition to the TST, QFT-G assay, patients' medications, and Bacillus Calmette-Guérin (BCG) vaccination status were also investigated. A positive TST or QFT-G assay result without an active tuberculosis lesion on chest x-ray was considered to indicate a diagnosis of LTBI. RESULTS The prevalence of LTBI was 26.5% in patients with SLE and 30.3% in patients with RA. The agreement between the TST and QFT-G assay was fair in SLE patients, but poor in RA patients. BCG vaccination was one factor associated with discordance between TST and QFT-G. Older age and higher SLE Disease Activity Index (SLEDAI) score were associated with a negative TST/positive QFT-G result in patients with SLE. Higher SLEDAI score and increased glucocorticoid dose were associated with an indeterminate result in the QFT-G assay for patients with SLE. CONCLUSIONS Agreement between the QFT-G assay and TST in patients with SLE was found to be fair. However, BCG vaccination status, age, and SLEDAI score are all factors that could result in discordance between the two tests. Indeterminate results from the QFT-G assay may be caused by a higher SLEDAI score or increased glucocorticoid dose.
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Affiliation(s)
- H Cho
- Department of Rheumatology, Ajou University School of Medicine, Suwon, Korea
| | - Y W Kim
- Department of Rheumatology, Ajou University School of Medicine, Suwon, Korea
| | - C-H Suh
- Department of Rheumatology, Ajou University School of Medicine, Suwon, Korea
| | - J-Y Jung
- Department of Rheumatology, Ajou University School of Medicine, Suwon, Korea
| | - Y-J Um
- Department of Rheumatology, Ajou University School of Medicine, Suwon, Korea
| | - J-H Jung
- Department of Rheumatology, Ajou University School of Medicine, Suwon, Korea
| | - H-A Kim
- Department of Rheumatology, Ajou University School of Medicine, Suwon, Korea
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Abstract
SETTING After several changes in treatment modalities, it is time to re-evaluate treatment outcomes of multidrug-resistant tuberculosis (MDR-TB). OBJECTIVE To evaluate treatment outcomes, elucidate changes in outcomes over time and identify predictors of treatment success for MDR-TB. DESIGN Patients diagnosed with MDR-TB at a tertiary referral centre in South Korea between January 2006 and December 2010 were included. Treatment modalities and outcomes were assessed. Predictors of treatment success were analysed using multiple logistic regression. The treatment modalities and outcomes of these patients were compared with those of MDR-TB patients between January 1996 and December 2005. RESULTS Of the 123 MDR-TB patients diagnosed during the later study period, treatment was successful in 103 (83.7%). Extensive drug resistance (OR 0.31, P = 0.044) and additional resistance to fluoroquinolones (OR 0.23, P = 0.039) were inversely associated with treatment success. The treatment success rate improved from 53.5% in 1996-2000 to 68.8% in 2001-2005 and 83.7% in 2006-2010 (P < 0.001). Improved outcomes were accompanied with more frequent use of later-generation fluoroquinolones and linezolid and less frequent surgical resection. CONCLUSION Treatment outcomes for MDR-TB improved at a tertiary referral centre in South Korea. The improvement was associated with more frequent use of later-generation fluoroquinolones and linezolid.
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Affiliation(s)
- N Kwak
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H-R Kim
- Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Science, Seoul, Republic of Korea
| | - C-G Yoo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Y W Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - S K Han
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - J-J Yim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
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Lee JK, Lee J, Park SS, Heo EY, Park YS, Lee CH, Lee SM, Yoon HI, Yim JJ, Yoo CG, Chung HS, Kim YW, Han SK, Kim DK. Effect of inhalers on the development of haemoptysis in patients with non-cystic fibrosis bronchiectasis. Int J Tuberc Lung Dis 2015; 18:363-70. [PMID: 24670577 DOI: 10.5588/ijtld.13.0255] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The association of inhaler use with haemoptysis has rarely been reported in patients with non-cystic fibrosis (CF) bronchiectasis. OBJECTIVE To elucidate the effect of inhaler use on the development of haemoptysis in patients with non-CF bronchiectasis. METHODS In a case-crossover study of 192 non-CF bronchiectasis patients with a history of haemoptysis and inhaler use, the risk of haemoptysis associated with the use of inhalers was elucidated. Two inhaled corticosteroids/long-acting β₂-agonists (ICS/LABA), one long-acting muscarinic antagonist and one short-acting β₂-agonist (SABA) were evaluated. The case and control periods were defined respectively as 030 and 180210 days before haemoptysis. RESULTS The risk of haemoptysis during the case period was 3.51 times higher than during the control period with any use of inhalers (95%CI 1.966.28). The results of clinically significant haemoptysis showed good agreement with those of total events. These associations were consistent with the sensitivity analyses. In the sub-analysis according to inhaler type, ICS/LABA and SABA were significantly associated with an increased risk of haemoptysis (aOR 2.62, 95%CI 1.255.45; aOR 2.51, 95%CI 2.235.15). CONCLUSIONS In patients with non-CF bronchiectasis, the use of inhalers, especially including 2-agonist, was associated with an increased risk of haemoptysis.
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Affiliation(s)
- J-K Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - J Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - S S Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - E Y Heo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Y S Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - C H Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - S-M Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H I Yoon
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - J-J Yim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - C-G Yoo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H S Chung
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Y W Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - S K Han
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - D K Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
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Lee JH, Nam BH, Ryu KW, Ryu SY, Park YK, Kim S, Kim YW. Comparison of outcomes after laparoscopy-assisted and open total gastrectomy for early gastric cancer. Br J Surg 2015; 102:1500-5. [PMID: 26398912 DOI: 10.1002/bjs.9902] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 12/16/2014] [Accepted: 06/19/2015] [Indexed: 12/24/2022]
Abstract
BACKGROUND The aim of this study was to compare the results of laparoscopy-assisted total gastrectomy with those of open total gastrectomy for early gastric cancer. METHODS Patients with gastric cancer who underwent total gastrectomy with curative intent in three Korean tertiary hospitals between January 2003 and December 2010 were included in this multicentre, retrospective, propensity score-matched cohort study. Cox proportional hazards regression models were used to evaluate the association between operation method and survival. RESULTS A total of 753 patients with early gastric cancer were included in the study. There were no significant differences in the matched cohort for overall survival (hazard ratio (HR) for laparoscopy-assisted versus open total gastrectomy 0.96, 95 per cent c.i. 0.57 to 1.65) or recurrence-free survival (HR 2.20, 0.51 to 9.52). The patterns of recurrence were no different between the two groups. The severity of complications, according to the Clavien-Dindo classification, was similar in both groups. The most common complications were anastomosis-related in the laparoscopy-assisted group (8.0 per cent versus 4.2 per cent in the open group; P = 0.015) and wound-related in the open group (1.6 versus 5.6 per cent respectively; P = 0.003). Postoperative death was more common in the laparoscopy-assisted group (1.6 versus 0.2 per cent; P = 0.045). CONCLUSION Laparoscopy-assisted total gastrectomy for early gastric cancer is feasible in terms of long-term results, including survival and recurrence. However, a higher postoperative mortality rate and an increased risk of anastomotic leakage after laparoscopic-assisted total gastrectomy are of concern.
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Affiliation(s)
- J H Lee
- Department of Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - B-H Nam
- Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, Seoul, Korea
| | - K W Ryu
- Centre for Gastric Cancer, National Cancer Centre, Goyang-si, Gyeonggi-do, Seoul, Korea
| | - S Y Ryu
- Department of Surgery, Chunnam National University Whasoon Hospital, Seoul, Korea
| | - Y K Park
- Department of Surgery, Chunnam National University Whasoon Hospital, Seoul, Korea
| | - S Kim
- Department of Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Y W Kim
- Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, Seoul, Korea
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Kim YW, Kwak N, Seong MW, Kim EC, Yoo CG, Kim YW, Han SK, Yim JJ. Accuracy of the Xpert® MTB/RIF assay for the diagnosis of extra-pulmonary tuberculosis in South Korea. Int J Tuberc Lung Dis 2015; 19:81-6. [PMID: 25519795 DOI: 10.5588/ijtld.14.0500] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING The Xpert(®) MTB/RIF assay has been endorsed by the World Health Organization for the detection of pulmonary and extra-pulmonary tuberculosis (EPTB). OBJECTIVE To determine the accuracy of the Xpert assay in diagnosing EPTB in South Korea, a country with an intermediate TB burden. DESIGN We retrospectively reviewed the medical records of 1429 patients in whom the Xpert assay using EPTB specimens was requested between 1 January 2011 and 31 October 2013 in a tertiary referral hospital in South Korea. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the diagnosis of EPTB and detection of rifampicin (RMP) resistance were calculated. RESULTS Using culture as gold standard, the sensitivity, specificity, PPV and NPV of the assay were respectively 67.7%, 98.1%, 60% and 98.6%. Using a composite reference standard, the sensitivity, specificity, PPV and NPV were respectively 49.3%, 100%, 100% and 95.1%. The sensitivity, specificity, PPV and NPV for the detection of RMP resistance among specimens with positive results for Mycobacterium tuberculosis were respectively 80%, 100%, 100% and 97.7%. CONCLUSION The Xpert assay showed acceptable sensitivity in certain groups and excellent specificity in diagnosing EPTB and detecting RMP resistance in an intermediate TB burden country.
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Affiliation(s)
- Y W Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - N Kwak
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - M-W Seong
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - E-C Kim
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - C-G Yoo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Y W Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - S K Han
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - J-J Yim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
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Na YR, Hong JH, Lee MY, Jung JH, Jung D, Kim YW, Son D, Choi M, Kim KP, Seok SH. Proteomic Analysis Reveals Distinct Metabolic Differences Between Granulocyte-Macrophage Colony Stimulating Factor (GM-CSF) and Macrophage Colony Stimulating Factor (M-CSF) Grown Macrophages Derived from Murine Bone Marrow Cells. Mol Cell Proteomics 2015; 14:2722-32. [PMID: 26229149 DOI: 10.1074/mcp.m115.048744] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Indexed: 12/27/2022] Open
Abstract
Macrophages are crucial in controlling infectious agents and tissue homeostasis. Macrophages require a wide range of functional capabilities in order to fulfill distinct roles in our body, one being rapid and robust immune responses. To gain insight into macrophage plasticity and the key regulatory protein networks governing their specific functions, we performed quantitative analyses of the proteome and phosphoproteome of murine primary GM-CSF and M-CSF grown bone marrow derived macrophages (GM-BMMs and M-BMMs, respectively) using the latest isobaric tag based tandem mass tag (TMT) labeling and liquid chromatography-tandem mass spectrometry (LC-MS/MS). Strikingly, metabolic processes emerged as a major difference between these macrophages. Specifically, GM-BMMs show significant enrichment of proteins involving glycolysis, the mevalonate pathway, and nitrogen compound biosynthesis. This evidence of enhanced glycolytic capability in GM-BMMs is particularly significant regarding their pro-inflammatory responses, because increased production of cytokines upon LPS stimulation in GM-BMMs depends on their acute glycolytic capacity. In contrast, M-BMMs up-regulate proteins involved in endocytosis, which correlates with a tendency toward homeostatic functions such as scavenging cellular debris. Together, our data describes a proteomic network that underlies the pro-inflammatory actions of GM-BMMs as well as the homeostatic functions of M-BMMs.
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Affiliation(s)
- Yi Rang Na
- From the ‡Department of Microbiology and Immunology, and Institute of Endemic Disease, Seoul National University College of Medicine, 103 Daehak-ro, Chongno-gu, Seoul 110-799, South Korea
| | - Ji Hye Hong
- §Department of Applied Chemistry, Kyung Hee University, 1732 Deogyeong-daero, Giheung-gu, Yongin-si, Gyeonggi-do 446-701, South Korea
| | - Min Yong Lee
- §Department of Applied Chemistry, Kyung Hee University, 1732 Deogyeong-daero, Giheung-gu, Yongin-si, Gyeonggi-do 446-701, South Korea
| | - Jae Hun Jung
- §Department of Applied Chemistry, Kyung Hee University, 1732 Deogyeong-daero, Giheung-gu, Yongin-si, Gyeonggi-do 446-701, South Korea
| | - Daun Jung
- From the ‡Department of Microbiology and Immunology, and Institute of Endemic Disease, Seoul National University College of Medicine, 103 Daehak-ro, Chongno-gu, Seoul 110-799, South Korea
| | - Young Won Kim
- From the ‡Department of Microbiology and Immunology, and Institute of Endemic Disease, Seoul National University College of Medicine, 103 Daehak-ro, Chongno-gu, Seoul 110-799, South Korea
| | - Dain Son
- From the ‡Department of Microbiology and Immunology, and Institute of Endemic Disease, Seoul National University College of Medicine, 103 Daehak-ro, Chongno-gu, Seoul 110-799, South Korea
| | - Murim Choi
- ¶Department of Biomedical Science, Seoul National University College of Medicine, 103 Daehak-ro, Chongno-gu, Seoul 110-799, South Korea
| | - Kwang Pyo Kim
- §Department of Applied Chemistry, Kyung Hee University, 1732 Deogyeong-daero, Giheung-gu, Yongin-si, Gyeonggi-do 446-701, South Korea;
| | - Seung Hyeok Seok
- From the ‡Department of Microbiology and Immunology, and Institute of Endemic Disease, Seoul National University College of Medicine, 103 Daehak-ro, Chongno-gu, Seoul 110-799, South Korea
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Sim JA, Shin JS, Park SM, Chang YJ, Shin A, Noh DY, Han W, Yang HK, Lee HJ, Kim YW, Kim YT, Jeong SY, Yoon JH, Kim YJ, Heo DS, Kim TY, Oh DY, Wu HG, Kim HJ, Chie EK, Kang KW, Yun YH. Association between information provision and decisional conflict in cancer patients. Ann Oncol 2015; 26:1974-1980. [PMID: 26116430 DOI: 10.1093/annonc/mdv275] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 06/16/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In this study, we aimed to identify demographic and clinical variables that correlate with perceived information provision among cancer patients and determine the association of information provision with decisional conflict (DC). PATIENTS AND METHODS We enrolled a total of 625 patients with cancer from two Korean hospitals in 2012. We used the European Organization for Research and Treatment of Cancer (EORTC) quality-of-life questionnaire (QLQ-INFO26) to assess patients' perception of the information received from their doctors and the Decisional Conflict Scale (DCS) to assess DC. To identify predictive sociodemographic and clinical variables for adequate information provision, backward selective logistic regression analyses were conducted. In addition, adjusted multivariate logistic regression analyses were carried out to identify clinically meaningful differences of perceived level of information subscales associated with high DC. RESULTS More than half of patients with cancer showed insufficient satisfaction with medical information about disease (56%), treatment (73%), other services (83%), and global score (80%). In multiple logistic regression analyses, lower income and education, female, unmarried status, type of cancer with good prognosis, and early stage of treatment process were associated with patients' perception of inadequate information provision. In addition, Information about the medical tests with high DCS values clarity [adjusted odds ratio (aOR), 0.54; 95% confidence interval (CI) 0.30-0.97] and support (aOR, 0.53; 95% CI 0.33-0.85) showed negative significance. For inadequate information perception about treatments and other services, all 5 DCS scales (uncertainty, informed, values clarity, support, and effective decision) were negatively related. Global score of inadequate information provision also showed negative association with high DCS effective decision (aOR, 0.43; 95% CI 0.26-0.71) and DCS uncertainty (aOR, 0.46; 95% CI 0.27-0.77). CONCLUSION This study found that inadequate levels of perceived information correlated with several demographic and clinical characteristics. In addition, sufficient perceived information levels may be related to low levels of DC.
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Affiliation(s)
- J A Sim
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul
| | - J S Shin
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul; Department of Education & Human Resources Development, Seoul National University Hospital, Seoul, Korea
| | - S M Park
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul
| | - Y J Chang
- Research Institute and Hospital, National Cancer Center, Goyang-si
| | - A Shin
- Department of Preventive Medicine
| | - D Y Noh
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Surgery
| | - W Han
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Surgery
| | - H K Yang
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Surgery
| | - H J Lee
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Surgery
| | - Y W Kim
- Department of Internal Medicine, Seoul National University College of Medicine and Hospital, Seoul
| | - Y T Kim
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul
| | - S Y Jeong
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Surgery
| | - J H Yoon
- Department of Internal Medicine, Seoul National University College of Medicine and Hospital, Seoul; Liver Research Institute, Seoul National University College of Medicine, Seoul
| | - Y J Kim
- Department of Internal Medicine, Seoul National University College of Medicine and Hospital, Seoul; Liver Research Institute, Seoul National University College of Medicine, Seoul
| | - D S Heo
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Internal Medicine, Seoul National University College of Medicine and Hospital, Seoul
| | - T Y Kim
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Internal Medicine, Seoul National University College of Medicine and Hospital, Seoul
| | - D Y Oh
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul
| | - H G Wu
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Departments of Radiation Oncology
| | - H J Kim
- Departments of Radiation Oncology
| | - E K Chie
- Departments of Radiation Oncology
| | - K W Kang
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul; Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Nuclear Medicine, Seoul National University College of Medicine and Hospital, Seoul
| | - Y H Yun
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul; Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;.
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Kim IY, Cha SW, Ahn JH, Kim YW. Factors affecting the restaging accuracy of magnetic resonance imaging after preoperative chemoradiation in patients with rectal cancer. Eur J Surg Oncol 2015; 41:493-8. [PMID: 25648465 DOI: 10.1016/j.ejso.2014.12.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 12/26/2014] [Indexed: 01/11/2023] Open
Abstract
PURPOSES We evaluated patient or tumor factors associated with the preoperative restaging accuracy of magnetic resonance imaging (MRI) for determining T and N stages as well as circumferential resection margin (CRM) involvement after chemoradiation (CRT) in patients with locally advanced rectal cancer. METHODS Seventy-seven patients with rectal cancer that were treated with preoperative CRT (50.4 Gy) followed by radical resection were included. Post-CRT MRI was performed approximately 4 weeks after preoperative CRT. RESULTS The median tumor distance from the anal verge was 6 cm, 48 (62%) of which were anterior and 29 (38%) posterior. The median tumor diameter was 3 cm. A stage-by-stage comparison showed that correct staging occurred in 62%, 43%, and 86% of patients for T staging, N staging, and CRM prediction, respectively. Shorter distance to the anal verge (<5 cm), smaller tumor diameter (<1 cm), and anterior tumor location were associated with incorrect T staging. There were no significant variables in terms of N staging accuracy. Shorter tumor distance and anterior tumor location were associated with incorrect CRM prediction. CONCLUSIONS Our findings suggest that specific tumor factors such as small, distal, or anterior rectal tumors are closely associated with the accuracy of MRI after preoperative CRT.
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Affiliation(s)
- I Y Kim
- Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - S W Cha
- Department of Radiology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - J H Ahn
- Department of Radiology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Y W Kim
- Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
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Pinato DJ, Karamanakos G, Arizumi T, Adjogatse D, Kim YW, Stebbing J, Kudo M, Jang JW, Sharma R. Dynamic changes of the inflammation-based index predict mortality following chemoembolisation for hepatocellular carcinoma: a prospective study. Aliment Pharmacol Ther 2014; 40:1270-81. [PMID: 25327965 DOI: 10.1111/apt.12992] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 08/27/2014] [Accepted: 09/28/2014] [Indexed: 12/19/2022]
Abstract
BACKGROUND Transarterial chemoembolisation (TACE) is a standard treatment for unresectable, intermediate stage hepatocellular carcinoma (HCC). Survival after TACE, however, can be highly variable, with no suitable biomarker predicting therapeutic outcome. The inflammation-based index (IBI) has previously been shown to independently predict overall survival (OS) in all stages of HCC. AIM To explore the prognostic ability of IBI as a predictor of survival after TACE. METHODS Baseline staging, biochemical and clinicopathological features including IBI were studied in a derivation set of 64 patients undergoing TACE for intermediate stage HCC. Dynamic changes in IBI before and after TACE were studied as predictors of survival using both a univariate and multivariate Cox regression model and further validated in two independent patient cohorts from Korea (n = 76) and Japan (n = 577). RESULTS Pre-treatment IBI predicted for OS in the derivation set (P = 0.001). Other univariate predictors of OS included radiological response to TACE (P < 0.001), pre-TACE CLIP score (P < 0.01), tumour diameter >5 cm (P = 0.05) and AFP ≥400 (P < 0.001). Normalisation of IBI post-TACE was associated with radiological response by mRECIST criteria and improved OS (P < 0.001). Normalisation of IBI remained a significant multivariate predictor of OS in both the derivation and validation sets (P < 0.001). CONCLUSIONS Normalisation of IBI after TACE is shown to be an independent predictor of survival and may be integrated into the retreatment criteria for repeat TACE in intermediate stage HCC. IBI and its dynamic changes after treatment are validated as a biomarker allowing the stratification of patients with a significant survival advantage following initial TACE.
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Affiliation(s)
- D J Pinato
- Division of Experimental Medicine, Imperial College London, Hammersmith Hospital, London, UK
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Kang J, Park HM, Kim YW, Kim YH, Varghese S, Seok HK, Kim YG, Kim SH. Control of mesenchymal stem cell phenotype and differentiation depending on cell adhesion mechanism. Eur Cell Mater 2014; 28:387-403. [PMID: 25422949 DOI: 10.22203/ecm.v028a27] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Control of cell-matrix adhesion has become an important issue in the regulation of stem cell function. In this study, a maltose-binding protein (MBP)-linked basic fibroblast growth factor (FGF2)-immobilised polystyrene surface (PS-MBP-FGF2) was applied as an artificial matrix to regulate integrin-mediated signalling. We sought to characterise human mesenchymal-stem cell (hMSC) behaviour in response to two different mechanisms of cell adhesion; (i) FGF2-heparan sulphate proteoglycan (HSPG)-mediated adhesion vs. (ii) fibronectin (FN)-integrin-mediated adhesion. Heparin inhibited hMSC adhesion to PS-MBP-FGF2 but not to FN-coated surface. The phosphorylation of focal adhesion kinase, cytoskeletal re-organisation, and cell proliferation were restricted in hMSCs adhering to PS-MBP-FGF2 compared to FN-coated surface. Expression of MSC markers, such as CD105, CD90 and CD166, decreased in hMSCs expanded on PS-MBP-FGF2 compared to expression in cells expanded on FN-coated surface. hMSCs that were expanded on FN-coated surface differentiated into osteogenic and adipogenic cells more readily than those that were expanded on PS-MBP-FGF2. Furthermore, we characterised the N-linked glycan structures of hMSCs depending on the cell adhesion mechanism using mass spectrometry (MS)-based quantitative techniques. MS analysis revealed that 2,3-sialylated glycans, a potential marker of stem cell function, were more abundant on hMSCs expanded on FN-coated surface than on those expanded on PS-MBP-FGF2. Thus, the differentiation potential of hMSCs is controlled by the type of adhesion substrate that might provide an idea for the design of biomaterials to control stem cell fate. Elucidation of the glycan structure on the cell membrane may help characterise hMSC function.
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Affiliation(s)
- J Kang
- Center for Biomaterials, Medical Engineering Institute, Korea Institute of Science and Technology, Seoul 136-79, Republic of
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Lee JH, Nam BH, Ryu KW, Ryu SY, Kim YW, Kim S, Park YK. Tumor differentiation is not a risk factor for lymph node metastasis in elderly patients with early gastric cancer. Eur J Surg Oncol 2014; 40:1771-6. [PMID: 25245539 DOI: 10.1016/j.ejso.2014.07.042] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 07/16/2014] [Accepted: 07/29/2014] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The aim of this study was to identify risk factors for lymph node metastasis in elderly patients (70 years or more) with early gastric cancer. METHODS We reviewed the prospectively collected database of 6893 patients with early gastric cancer who had undergone curative gastrectomy in 3 tertiary cancer centers between January 2003 and December 2009 in Korea. Patients were sorted into 4 groups according to age: less than 50, fifties, sixties, and 70 years or more. Risk factors for lymph node metastasis in early gastric cancer were analyzed. RESULTS One thousand and thirty five patients (15.0%) were 70 years or more. As age increased, the frequency of large differentiated tumor, lymphatic and submucosa invasion increased. Old age was associated with a lower risk for lymph node metastasis in patients with early gastric cancer (Odds ratio [OR], OR, 0.622; 95% CI, 0.5466-0.830, P = 0.010). Ulceration or differentiation of tumor was not associated with lymph node metastasis in elderly patients with early gastric cancer. CONCLUSIONS Elderly patients with undifferentiated type histology early gastric cancer without other risk factors for lymph node metastasis may be candidates for endoscopic resection.
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Affiliation(s)
- J H Lee
- Department of Surgery, Sungkyunkwan University School of Medicine, South Korea
| | - B-H Nam
- Center for Clinical Trial, National Cancer Center, South Korea
| | - K W Ryu
- Center for Gastric Cancer, National Cancer Center, South Korea
| | - S Y Ryu
- Department of Surgery, Chonnam National University Hwasoon Hospital, South Korea
| | - Y W Kim
- Center for Gastric Cancer, National Cancer Center, South Korea
| | - S Kim
- Department of Surgery, Sungkyunkwan University School of Medicine, South Korea
| | - Y K Park
- Department of Surgery, Chonnam National University Hwasoon Hospital, South Korea.
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Lee J, Park YS, Lee CH, Lee SM, Yoo CG, Kim YW, Han SK, Yim JJ. Antiplatelet or anticoagulant therapy might not increase the risk of haemoptysis in patients with bronchiectasis. Int J Tuberc Lung Dis 2013; 17:989-91. [PMID: 23651792 DOI: 10.5588/ijtld.12.0807] [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: 11/10/2022] Open
Abstract
The aim of this study was to assess whether the use of antiplatelets and anticoagulants increased haemoptysis in patients with bronchiectasis. Cases (n = 242) with a history of haemoptysis were compared with controls (n = 242) without a history of haemoptysis. Of the 242 case patients, 16.5% took antiplatelets compared with 19.8% of controls (P = 0.346). The proportion of warfarin users did not differ between cases and controls (3.3% vs. 2.5%, P = 0.588). The use of these agents might not be associated with increased risk of haemoptysis in patients with bronchiectasis.
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Affiliation(s)
- J Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
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Lee HY, Seong MW, Park SS, Hwang SS, Lee J, Park YS, Lee CH, Lee SM, Yoo CG, Kim YW, Han SK, Yim JJ. Diagnostic accuracy of Xpert® MTB/RIF on bronchoscopy specimens in patients with suspected pulmonary tuberculosis. Int J Tuberc Lung Dis 2013; 17:917-21. [PMID: 23621953 DOI: 10.5588/ijtld.12.0885] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To determine the diagnostic accuracy of the Xpert® MTB/RIF assay using samples obtained through bronchoscopy in patients with suspected pulmonary tuberculosis (PTB). DESIGN We retrospectively reviewed the records of patients with suspected PTB for whom the Xpert MTB/RIF assay was performed on bronchoscopy specimens. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the diagnosis of active PTB were calculated for acid-fast bacilli (AFB) smear microscopy and the Xpert assay using culture of Mycobacterium tuberculosis from sputum or bronchoscopy specimens as a reference standard. RESULTS A total of 132 patients were included in the final analysis. Of these, 38 had culture-confirmed PTB. The sensitivity of the Xpert assay using bronchial washing or bronchoalveolar lavage (BAL) fluid for the diagnosis of PTB was 81.6%, and specificity was 100%. The PPV and NPV were 100% and 92.1%, respectively. The sensitivity and specificity of AFB smear microscopy were respectively 13.2% and 98.8%. CONCLUSION The Xpert assay on bronchoscopy specimens provided an accurate diagnosis of PTB in patients who had a negative AFB smear or who could not produce sputum.
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Affiliation(s)
- H Y Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
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