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Lee H, Chung H, Park JC, Shin SK, Lee SK, Lee YC. Heterogeneity of mucosal mast cell infiltration in subgroups of patients with esophageal chest pain. Neurogastroenterol Motil 2014; 26:786-93. [PMID: 24602134 DOI: 10.1111/nmo.12325] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Accepted: 01/30/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND Although there is growing evidence that an increase in mucosal mast cells (MMCs) in the small and large intestine is associated with visceral hypersensitivity, few studies have evaluated MMCs in humans with esophageal symptoms. The aim of this study was to investigate esophageal MMC distribution in patients with non-cardiac chest pain (NCCP) and to examine the association between the number of gut MMCs and other functional gastrointestinal disorders. METHODS Forty-two consecutive NCCP patients and 10 healthy controls completed a questionnaire for bowel symptoms, chest pain intensity score, and psychologic depression. Esophageal, duodenal, and rectal MMCs were identified immunohistochemically and quantified by image analysis. KEY RESULTS Numbers of MMCs were significantly higher in NCCP patients vs healthy controls (11.8 ± 5.6 vs 7.6 ± 3.7 MMCs/high-power field, p = 0.026). In comparison of subgroups classified by 24-h impedance-pH monitoring, esophageal MMC counts were highest in the hypersensitive esophagus group (p < 0.01) and were also significantly increased in the functional chest pain group (p < 0.05). A positive correlation between esophageal and duodenal MMC counts was observed in patients with functional dyspepsia (FD; Spearman ρ = 0.604, p = 0.037). In particular, patients with clinical overlap with irritable bowel syndrome showed a strong positive correlation between esophageal and rectal MMC numbers (Spearman ρ = 0.857, p = 0.010). CONCLUSIONS & INFERENCES Among NCCP patients, increased MMC infiltration occurs in subgroups with hypersensitive esophagus and functional chest pain. In subpopulations with overlap with FD or irritable bowel syndrome, esophageal MMC counts demonstrated significant positive correlations with duodenal or rectal MMC counts.
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Park SW, Lee H, Lee HJ, Chung H, Park JC, Shin SK, Lee SK, Lee YC. Esophageal mucosal mast cell infiltration and changes in segmental smooth muscle contraction in noncardiac chest pain. Dis Esophagus 2014; 28:512-9. [PMID: 24766344 DOI: 10.1111/dote.12231] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Mast cells release potent mediators that alter enteric nerve and smooth muscle functions and may contribute to the pathogenesis of functional gastrointestinal disorders. The goal of this study was to determine if mucosal mast cell infiltration was associated with smooth muscle segmental changes in esophageal contraction. All patients with noncardiac chest pain (NCCP) were divided into two groups consisting of patients with non-erosive reflux disease or functional chest pain (FCP) according to the results of ambulatory 24 hours esophageal pH monitoring and high-resolution manometry. Pressure-volume (PV) was calculated by multiplying the length of the esophageal segment, duration of the contraction, and mean pressure over the entire space-time box (P mean). Quantification of mast cells was performed in five consecutive nonoverlapping immunostained sections. Spearman correlation analysis showed that the distal segment PV correlated with the mast cell count in all of the patients combined and in patients with FCP with correlation coefficients of 0.509 and 0.436, respectively (P = 0.004 and P = 0.042). Similar findings were observed for the segmental ratio of distal to proximal smooth muscle PV in all patients and in patients with FCP (correlation coefficients 0.566; P = 0.001 and correlation coefficients 0.525; P = 0.012, respectively). Mucosal mast cell infiltration was associated with distal esophageal contraction as a key pathophysiologic factor of NCCP.
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Swampillai AJ, Waqar S, Park JC, Modi N, Kersey TL, Sleep TJ. The development of a virtual reality training programme for ophthalmology: study must take into account visual acuity and stereopsis. Eye (Lond) 2014; 28:503. [PMID: 24556883 DOI: 10.1038/eye.2014.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Park JC, Freegard TJ. If it can happen, it will happen: trapped phacoemulsification pedal during cataract surgery. Can J Ophthalmol 2014; 49:e11. [PMID: 24513370 DOI: 10.1016/j.jcjo.2013.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 09/16/2013] [Indexed: 11/29/2022]
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Kang WS, Kwon JS, Kim HB, Jeong HY, Kang HJ, Jeong MH, Cho JG, Park JC, Kim YS, Ahn Y. A macrophage-specific synthetic promoter for therapeutic application of adiponectin. Gene Ther 2014; 21:353-62. [PMID: 24500526 PMCID: PMC3975813 DOI: 10.1038/gt.2014.3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Revised: 11/19/2013] [Accepted: 12/16/2013] [Indexed: 11/09/2022]
Abstract
Foam cell formation from macrophage is a major cause of atherosclerosis. An efficient macrophage-specific promoter is required for the targeting to macrophages. In this study, we develop a macrophage-specific synthetic promoter for the therapeutic application of adiponectin (APN), an antiatherogenic gene. Synthetic promoter-146 (SP146), registered on the NCBI website (http://www.ncbi.nlm.nih.gov/nuccore/DQ107383), was tested for promoter activities in two non-macrophage cell lines (293 T, HeLa) and a macrophage cell line (RAW264.7, bone marrow-derived macrophages). To enforce macrophage specificity, partial elements of p47(phox) including the PU.1 site with various lengths (-C1, -C2 and -C3) were inserted next to the synthetic promoters. SP146-C1 showed the highest specificity and efficacy in RAW264.7 cells and was selected for development of an APN-carrying macrophage-specific promoter. Green fluorescent protein (GFP)- or APN-expressing lentivirus under SP146-C1 (Lenti-SP-GFP or Lenti-SP-APN, respectively) showed the highest expression efficacy in RAW264.7 cells compared with the non-macrophage cell lines. APN overexpression in RAW264.7 cells successfully inhibited intracellular lipid accumulation, and atherosclerotic lesions and lipid accumulation were significantly reduced by Lenti-SP-APN in ApoE-/- atherosclerosis mice. In conclusion, the synthetic promoter SP146-C1, combined with a p47(phox) promoter element, was successfully developed to target macrophage, and macrophage-specific introduction of APN under SP146-C1 was shown to ameliorate the atherosclerotic pathology.
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Abstract
Piwi-interacting RNAs (piRNAs) are recently discovered, endogenous small non-coding RNAs. piRNAs protect the genome from invasive transposable elements (TE) and sustain integrity of the genome in germ cell lineages. Small RNA-sequencing data can be used to detect piRNA activations in a cell under a specific condition. However, identification of cell specific piRNA activations requires sophisticated computational methods. As of now, there is only one computational method, proTRAC, to locate activated piRNAs from the sequencing data. proTRAC detects piRNA clusters based on a probabilistic analysis with assumption of a uniform distribution. Unfortunately, we were not able to locate activated piRNAs from our proprietary sequencing data in chicken germ cells using proTRAC. With a careful investigation on data sets, we found that a uniform or any statistical distribution for detecting piRNA clusters may not be assumed. Furthermore, small RNA-seq data contains many different types of RNAs which was not carefully taken into account in previous studies. To improve piRNA cluster identification, we developed piClust that uses a density based clustering approach without assumption of any parametric distribution. In previous studies, it is known that piRNAs exhibit a strong tendency of forming piRNA clusters in syntenic regions of the genome. Thus, the density based clustering approach is effective and robust to the existence of non-piRNAs or noise in the data. In experiments with piRNA data from human, mouse, rat and chicken, piClust was able to detect piRNA clusters from total small RNA-seq data from germ cell lines, while proTRAC was not successful. piClust outperformed proTRAC in terms of sensitivity and running time (up to 200 folds). piClust is currently available as a web service at http://epigenomics.snu.ac.kr/piclustweb.
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Park SW, Choi AR, Lee HJ, Chung H, Park JC, Shin SK, Lee SK, Lee YC, Kim JE, Lee H. The effects of statins on the clinical outcomes of Clostridium difficile infection in hospitalised patients. Aliment Pharmacol Ther 2013; 38:619-27. [PMID: 23888883 DOI: 10.1111/apt.12439] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 05/24/2013] [Accepted: 07/12/2013] [Indexed: 12/21/2022]
Abstract
BACKGROUND An association between exposure to statin drugs and favourable treatment outcomes for various types of infections has been established. AIM To determine the clinical characteristics and treatment outcomes of Clostridium difficile infection (CDI) among hospitalised patients taking statin drugs. METHODS The medical records were reviewed for consecutive in-patients with CDI confirmed by positive toxin assay (A or B), C. difficile culture, or the presence of pseudomembrane on endoscopy. Treatment success was defined as the resolution of diarrhoea within 6 days of therapy. The primary end points were assessed by average symptom recovery time and treatment response (success or failure). RESULTS Among 949 patients, the overall response to metronidazole was 91.9%. The baseline characteristics showed some differences between statin users and statin non-users with respect to mean disease severity score. In the multivariate analysis, successful treatment response was significantly associated with the absence of exposure to proton pump inhibitors (PPIs) (OR = 0.690, 95% CI = 0.513-0.929, P = 0.014) and with exposure to statins (OR = 1.449, 95% CI = 1.015-2.070, P = 0.041). Contrary to the treatment response, univariate and multivariate analyses failed to show that exposure to PPIs or statins affected symptom recovery times. Sixty-day CDI recurrence rates for those patients with statin exposure were significantly lower compared with those patients without statin exposure (3% vs. 7.3%, respectively; RR = 0.393, 95% CI = 0.167-0.926, P = 0.033). CONCLUSION Prior statin exposure in patients with C. difficile infection is associated with a successful response to treatment.
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Kim DW, Park JC, Rim TT, Jung UW, Kim CS, Donos N, Cha IH, Choi SH. Socioeconomic disparities of periodontitis in Koreans based on the KNHANES IV. Oral Dis 2013; 20:551-9. [PMID: 24033864 DOI: 10.1111/odi.12168] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2012] [Revised: 06/26/2013] [Accepted: 07/12/2013] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The aim of this study was to identify the socioeconomic factors associated with the prevalence of periodontitis in Koreans. METHODS Cross-sectional data from 12 763 subjects, 15 years old and above, who underwent periodontal examinations were obtained from the Korean National Health and Nutrition Examination Survey IV (2007-209). Multivariate linear and logistic regression analyses were applied to estimate the association between socioeconomic indicators and prevalence of periodontitis. RESULTS A significant association was found between increasing age and periodontitis. Participants with higher income were less likely to have periodontitis (aOR = 0.9 and 95% CI = 0.78-0.98, and aOR = 0.7 and 95% CI = 0.60-0.80 in the middle and highest quintiles of monthly household income, respectively). In addition, participants living in rural areas were less likely to have periodontitis (aOR = 0.9 and 95% CI = 0.81-0.99), and current smokers were more likely to have periodontitis (aOR = 1.7 and 95% CI = 1.49-1.89). The analysis of comorbidities revealed that individuals with diabetes mellitus (DM) were significantly more likely to have periodontitis (aOR = 1.4 and 95% CI = 1.18-1.68). CONCLUSIONS In a rapidly increasing Korean population, the lower socioeconomic groups as well as individuals with DM were significantly more likely to present with periodontitis.
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Park JC, Kwon BJ, Kang HS, Kim JE, Kim KM, Cho YD, Han MH. Single-stage extracranial carotid artery stenting and intracranial aneurysm coiling: technical feasibility and clinical outcome. Interv Neuroradiol 2013; 19:228-34. [PMID: 23693048 DOI: 10.1177/159101991301900213] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 03/24/2013] [Indexed: 11/15/2022] Open
Abstract
The coexistence of carotid artery stenosis and cerebral aneurysm in a patient presents challenges for treatment decision-making. The purpose of this study was to evaluate the technical feasibility and clinical outcome after single-stage extracranial carotid artery stenting (CAS) and ipsilateral intracranial aneurysm coiling in a single institution. From March 2005 to February 2011, 17 patients with 21 aneurysms underwent single-stage CAS and coiling for ipsilateral aneurysms. There were symptomatic atherosclerotic carotid stenoses with unruptured aneurysms in eight, ruptured or symptomatic aneurysms with simultaneous asymptomatic carotid stenoses in two and asymptomatic lesions in seven. CAS was followed by aneurysm coiling in all 17 patients. Clinical and radiological data were reviewed. There were two procedure-related complications: acute in-stent thrombosis in one and premature aneurysmal rupture in the other. After aneurysm coiling, complete occlusion was demonstrated in 17 aneurysms and near-total occlusion in four. No neurological deficit was found at discharge and follow-up outcomes were excellent in all the patients (mean, 32.9 months). Follow-up imaging studies were performed in all the patients, including neck CT angiography in 14 (mean, 26.1 months), brain MR angiography in 14 (mean, 31.2 months), and conventional angiography in three (mean, 14.7 months). They revealed two asymptomatic, mild carotid re-stenoses and one major aneurysmal recanalization requiring re-coiling. A single-stage CAS and coiling procedure appears to be feasible and the complication rate seems to be reasonable. We suggest that there is no need for separate therapeutic procedures when a patient has carotid artery stenosis and accompanying ipsilateral intracranial aneurysm.
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Moon JS, Cheong NR, Yang SY, Kim IS, Chung HJ, Jeong YW, Park JC, Kim MS, Kim SH, Ko HM. Lipopolysaccharide-induced indoleamine 2,3-dioxygenase expression in the periodontal ligament. J Periodontal Res 2013; 48:733-9. [PMID: 23488665 DOI: 10.1111/jre.12063] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2013] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND OBJECTIVE Indoleamine 2,3-dioxygenase (IDO) is a tryptophan-oxidizing enzyme with immune-inhibitory effects. The aim of this study was to investigate the expression of IDO by lipopolysaccharide (LPS), a component of gram-negative bacteria, in human periodontal ligament (PDL) cells. MATERIAL AND METHODS Human PDL cells and gingival fibroblasts (GFs) were prepared from explants of human PDLs and from gingival tissues of clinically healthy donors, respectively. Real-time RT-PCR, western blotting and the IDO enzyme assay were performed to determine the expression of IDO following LPS treatment of cells. LPS was injected into mice tail veins to evaluate the effects of LPS in vivo in the maxillary first molar. Immunofluorescence staining and histological analysis were followed to localize IDO in mouse PDL. RESULTS The level of expression of IDO mRNA in primary human PDL cells after LPS treatment was increased in a dose-dependent manner, reaching a peak 8 h after LPS treatment. The expression and activities of IDO protein were significantly increased in comparison with those of the control. In addition, the increased production of kynurenine in culture medium was observed 72 h after LPS treatment. In the immunofluorescence findings, stronger immunoreactivities were shown in PDL than in gingival tissues in the maxillae. In accordance with the immunofluorescence findings, LPS treatment induced a strong up-regulation of IDO mRNA in human PDL cells, whereas human GFs showed only a weak response to LPS. CONCLUSION These results clearly show that IDO was induced by LPS in primary human PDL cells, suggesting that PDL might be involved in the regulation of oral inflammatory disease.
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Oh SH, Hwang YC, Yang H, Kang JH, Hur SW, Jung NR, Jang WG, Lee KN, Oh WM, Park JC, Kim SH, Koh JT. SHP is involved in BMP2-induced odontoblast differentiation. J Dent Res 2012; 91:1124-9. [PMID: 23010719 DOI: 10.1177/0022034512461916] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Small Heterodimer Partner (SHP) interacts with diverse transcription factors such as Runx2 and regulates many cellular events including differentiation, proliferation, and energy metabolism. SHP is reported to be a positive regulator of BMP2-induced bone formation. This study aimed to clarify the role of SHP in odontoblast differentiation and matrix mineralization. Rat tooth germs were isolated, and gene expression was determined by RT-PCR and real-time PCR. Localization of SHP protein expression was identified by immunofluorescent analysis. Primary human dental pulp cells (HDPCs) were cultured with BMP2 and/or Ad-siSHP. Matrix mineralization was evaluated by Alizarin red staining. Transient transfection experiment was performed with the SHP or Dlx5 expressional plasmids and the DSPP gene. In tooth germs from post-natal days 3 to 9, BMP-2 and SHP expression increased with DSPP and DMP1 mRNA expression. In an immunostaining study, SHP was expressed in odontoblasts and surrounding osteoblasts. When HDPCs were cultured with BMP2 in mineralization-inducing medium, SHP expression also increased with an increase in DSPP expression. Down-regulation of SHP by Ad-siSHP inhibited matrix mineralization. In transient transfection experiments, overexpression of SHP was shown to enhance DSPP promoter activity through interactions between SHP and Dlx5. These results suggest that SHP may mediate BMP2 signaling to promote mineralization of the dentin matrix.
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Kim Y, Park JC, Molnar MZ, Shah A, Benner D, Kovesdy CP, Kopple JD, Kalantar-Zadeh K. Correlates of low hemoglobin A1c in maintenance hemodialysis patients. Int Urol Nephrol 2012; 45:1079-90. [PMID: 22684796 DOI: 10.1007/s11255-012-0208-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 05/16/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE The optimal target for glycemic control has not been established for diabetic maintenance hemodialysis (MHD) patients. METHODS A 6-year cohort (October 2001- December 2006) of 347 diabetic MHD patients with HbA1c data was examined for associations between HbA1c and mortality. Death hazard ratios (HR) were estimated using Cox regressions and cubic splines. RESULTS In these 347 patients (age, 59 ± 11 years; 49 % women; 28 % African Americans; and 55 % Hispanics), each 0.5 % decline in HbA1c below 6 % was associated with a 4.7 times higher death risk (HR = 4.7; 95 % CI 1.7-12.7) in the fully adjusted model. Factors associated with lower HbA1c levels (<6 % compared to 6-7 %) were: Hispanic ethnicity (OR = 2.9; 95 % CI 1.1-7.9), higher mid-arm muscle circumstance (OR = 1.1; 95 % CI 1.0-1.3), higher total iron-binding capacity (OR = 1.03; 95 % CI 1.01-1.05), and higher iron saturation ratio (OR = 1.14; 95 % CI 1.03-1.26). HbA1c levels >7 % showed a consistent trend toward elevated mortality risk (HR = 1.18; 95 % CI 0.99-1.41) after multivariate adjustment. CONCLUSIONS In diabetic MHD patients with burnt-out diabetes, characterized by HbA1c <6 %, even lower HbA1c levels are associated with significantly higher death risk. Additional studies are needed to determine the optimal target for HbA1c levels in different subgroups of diabetic MHD patients.
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Lee H, Park JC, Shin SK, Lee SK, Lee YC. Efficacy of leukotriene receptor antagonist for erosive esophagitis: a preliminary retrospective comparative study. Dis Esophagus 2011; 25:595-9. [PMID: 22211520 DOI: 10.1111/j.1442-2050.2011.01299.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
While diagnostic overlap exists between gastroesophageal reflux disease and eosinophilic esophagitis especially on histological findings, therapeutic approaches for the two disease entities are very different. Recently, anti-inflammatory treatment, in addition to acid suppressants, has been investigated for gastroesophageal reflux disease. This study investigated whether the incidence of endoscopic erosive esophagitis was lower in recipients of long-term leukotriene receptor antagonist (LTRA) treatment. This retrospective comparative study included 207 recipients of an LTRA and an equal number of controls who underwent screening upper endoscopic examination. Twenty-two (10.6%) and 51 (24.6%) cases of erosive esophagitis were detected in the LTRA and control groups, respectively (P < 0.001). A significantly higher incidence of minimal change esophagitis was also found in the controls compared with the LTRA group (14.5% vs. 2.4%, P < 0.001). On multivariate analysis, LTRA treatment was significantly and inversely associated with erosive esophagitis (odds ratio [OR], 0.25; 95% confidence interval [CI], 0.13 to 0.46). Within the LTRA treatment group, an increased risk of erosive esophagitis was strongly associated with the presence of hiatal hernia (OR, 5.89; 95% CI, 2.20-15.73, P < 0.001) and short duration of LTRA treatment (OR, 0.64; 95% CI, 0.37-0.89, P= 0.022). In conclusion, this preliminary retrospective analysis demonstrated that patients who underwent long-term treatment with a LTRA had low incidence of endoscopic minimal change esophagitis.
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Park JC, Ramasamy B, Ling RH, Prasad S. Endophthalmitis following vitrectomy. Eye (Lond) 2011; 26:482; author reply 483. [PMID: 22173074 DOI: 10.1038/eye.2011.329] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Lee HB, Park JC, Lee YS, Jeung IC, Park EK. Unexpected synchronous follicular lymphoma of paraaortic and pelvic lymph nodes in a patient with endometrial carcinoma: a case report. EUR J GYNAECOL ONCOL 2011; 32:334-335. [PMID: 21797129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Multiple neoplasms in a patient occur rarely. There has only been one case report about synchronous endometrial carcinoma and follicular lymphoma of the paraaortic and pelvic lymph node (LN) until now. CASE REPORT The patient was 64 years old and had vaginal spotting for four months. She was diagnosed with endometrioid endometrial carcinoma by endometrial biopsy. In intraoperative inspection, the whole paraaortic and pelvic LN had formed into a massive tumor bundle following the aorta and iliac vessels. The diagnosis was endometrial carcinoma FIGO Stage IB with synchronous follicular lymphoma Stage III. We performed adjuvant chemotherapy and radiotherapy. Currently, the patient has no evidence of recurrence for either carcinoma. CONCLUSION Lymph node dissection was included in the staging and debulking operation of the endometrial carcinoma. An inaccurate result of the frozen section can not rule out metastasis of endometrial carcinoma and surgeons can fall into a dilemma regarding treatment.
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Kim H, Kim CY, Kim DW, Lee IS, Lee GH, Park JC, Lee SJ, Lee KY. Wear performance of self-mating contact pairs of TiN and TiAlN coatings on orthopedic grade Ti-6Al-4V. Biomed Mater 2010; 5:044108. [PMID: 20683130 DOI: 10.1088/1748-6041/5/4/044108] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Both titanium nitride (TiN) and titanium aluminum nitride (TiAlN) have shown great wear resistance potential in metallic medical devices as protective, hard thin film coatings. In the present study, the effects of TiN and TiAlN coating layers on the wear performance of Ti-6Al-4V were compared and analyzed. TiN and TiAlN coatings with a thickness of 3 microm were deposited by a cathodic vacuum arc ion plating technique on the surface of Ti-6Al-4V. Wear tests were conducted by using a pin-on-disk-type tribotester with a point contact self-mating pair in a linear reciprocal motion. A sliding distance of 20 mm per cycle at 1 Hz was used under a load of 15 N under ambient conditions with no lubricant. The wear resistance of TiN and TiAlN coatings is superior to that of uncoated Ti-6Al-4V at the early stage of sliding contact. Until a measurable amount of wear was detected, the number of sliding cycles of the TiAlN coating pair was longer than TiN. After the first detection of wear from the coating layers, the rate of wear of the TiN coating pairs was significantly higher than that of TiAlN (p < 0.05), and it was close to that of the uncoated pairs. In conclusion, the TiAlN coating is superior to TiN from the viewpoint of wear resistance under the test conditions used in this study.
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Kim YJ, Park JC, Kim JH, Shin SK, Lee SK, Lee YC, Chung JB. Histologic diagnosis based on forceps biopsy is not adequate for determining endoscopic treatment of gastric adenomatous lesions. Endoscopy 2010; 42:620-6. [PMID: 20623445 DOI: 10.1055/s-0030-1255524] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND STUDY AIMS Controversy persists around the treatment of gastric low-grade dysplasia (LGD). The aim of this study was to investigate possible indications for the endoscopic resection of gastric LGD through analysis of the histologic discrepancies between specimens of gastric LGD obtained by forceps biopsy and by endoscopic mucosal resection (EMR), and of their clinicopathologic characteristics. PATIENTS AND METHODS The study involved 293 gastric LGD that were histologically proven on the basis of forceps biopsy in Severance Hospital between January 2004 and December 2007. Twenty cases were regularly followed up, and the remaining 273 were resected by EMR. We performed univariate and multivariate analyses of clinical and endoscopic characteristics including lesion size, number of biopsy fragments, and endoscopic appearance, in order to analyze the factors affecting histologic discrepancies. RESULTS Of the 273 lesions resected by EMR, 207 (75.8 %) showed concordant histology, whereas for 51 (18.7 %) the histology was upgraded after endoscopic resection. Lesion size, absence of whitish discoloration, and the presence of spontaneous bleeding were found by univariate analysis to be statistically significant factors predicting an upgraded histology after EMR ( P = 0.026, P < 0.001, and P = 0.025, respectively). Multivariate analysis also showed absence of whitish discoloration to be a statistically significant factor influencing histologic discrepancies ( P = 0.001, odds ratio 5.29, 95 % confidence interval 1.95 - 14.37). Perforation and bleeding rates associated with EMR for LGD were 0.7 % and 6.2 %, respectively. Twenty patients who did not undergo EMR were followed up for a mean of 22 months, and 3 were revealed to have adenocarcinoma and 1 high-grade dysplasia on the latest histologic exam. CONCLUSIONS We should consider endoscopic resection for gastric LGD that are 2 cm or more in size and do not have whitish discoloration.
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Park JC, Kovesdy CP, Duong U, Streja E, Rambod M, Nissenson AR, Sprague SM, Kalantar-Zadeh K. Association of serum alkaline phosphatase and bone mineral density in maintenance hemodialysis patients. Hemodial Int 2010; 14:182-92. [PMID: 20345388 PMCID: PMC5509753 DOI: 10.1111/j.1542-4758.2009.00430.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Recent studies indicate that serum alkaline phosphatase (AlkPhos), a surrogate of high turnover bone disease, is associated with coronary artery calcification and death risk in maintenance hemodialysis (MHD) patients. The association between AlkPhos and bone mineral density (BMD) is not well studied. We studied the association between AlkPhos and dual-energy X-ray absorptiometry-assessed BMD in a group of MHD patients in Southern California. In 154 MHD patients, aged 55.3 +/- 13.6 years, including 42% women, 38% Hispanics, 42% African Americans, and 55% diabetics, the mean serum AlkPhos was 121 +/- 63 U/L (median: 101, Q(25-75): 81-141); 36% had AlkPhos>/=120 U/L and 50% had a total T-score< or =-1. Whereas the total BMD did not correlate with age (r=0.01, P=0.99) or body mass index (r=0.10, P=0.22), it correlated negatively with AlkPhos (r=-0.25, P=0.002), including after multivariate adjustment (r=-0.24, P=0.003). The proportion of patients with a high coronary artery calcification score>400 was incrementally higher across worsening BMD tertiles (P trend=0.04). The BMD was significantly worse in MHD patients with serum AlkPhos> or =120 U/L compared with <120 U/L (1.01 +/- 0.016 vs. 1.08 +/- 0.013 g/cm(2), respectively, P<0.001). The multivariate adjusted odds ratio of AlkPhos> or =120 U/L for having a total T-score<-1.0 was 2.3 (1.1-4.8, P=0.037). Among routine clinical and biochemical markers, serum AlkPhos> or =120 U/L was a better predictor of total T-score< or =-1 in MHD patients. An association exists between higher serum AlkPhos and worse dual-energy X-ray absorptiometry-assessed BMD in MHD patients. Given these findings, studies are indicated to examine whether interventions that lower serum AlkPhos improve BMD in MHD patients.
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Park JC, Mundasad MV, Tole DM. Piggyback intraocular lens implant to correct severe refractive error after penetrating keratoplasty in pseudophakes. Br J Ophthalmol 2009; 93:272. [DOI: 10.1136/bjo.2008.147702] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Park JC, Ross AH, Tole DM, Sparrow JM, Penny J, Mundasad MV. Evaluation of a new cataract surgery referral pathway. Eye (Lond) 2008; 23:309-13. [PMID: 18259209 DOI: 10.1038/sj.eye.6703075] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
AIMS To compare the quality of referrals and listing rates of direct optometric referrals vs traditional GP referrals for cataract surgery. METHODS A retrospective cohort of 124 patients referred for cataract surgery was identified (62 via optometric pathway and 62 via GP pathway). The quality of the referral was assessed by establishing if it contained adequate information relating to the College of Optometrists' referral framework document. Age, sex, drug history, listing rate, operative rate, and visual acuity (best corrected) at referral and at the postoperative visit were recorded and compared between the two referral pathways using the Fisher's exact test. RESULTS Optometric referrals, relative to GP referrals, were more likely to include information relating to objective visual loss (100 vs 87%, P=0.0061) and to counsel the patient (97 vs 18%, P=0.0001). GP referrals, relative to optometric referrals, were more likely to comment on personal circumstances (32 vs 3%, P=0.0001), past medical history (95 vs 68%, P=0.0001), and drug history (94 vs 69%, P=0.0009). Operative rates were higher for the optometric direct referrals relative to GP referrals (87 vs 69%, P=0.0284). There was no difference in the visual acuity before or after surgery between the pathways. CONCLUSIONS Optometric direct cataract referrals provide better information on objectively measured vision and better delivery of preoperative counselling. Traditional GP referrals contain better medical history, drug information, and details of personal circumstances. Rates of surgery were slightly higher with optometric referrals.
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Kim DH, Park JC. Completion sleeve pneumonectomy for suture line recurrence of lung cancer after sleeve lobectomy. Thorac Cardiovasc Surg 2007; 55:512-4. [PMID: 18027339 DOI: 10.1055/s-2007-989289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The most appropriate treatment for suture line recurrence of lung cancer after bronchial sleeve lobectomy is completion pneumonectomy. While completion pneumonectomy may not be justified from an oncological point of view due to the positive bronchial resection margin, completion tracheal sleeve pneumonectomy is an optimal surgical procedure. We carried out two cases of completion tracheal sleeve pneumonectomy for suture line recurrence of lung cancer after bronchial sleeve lobectomy of the right upper lobe and achieved good results, which suggests that completion tracheal sleeve pneumonectomy for suture line recurrence after bronchial sleeve lobectomy is a good treatment modality for selected patients.
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Park YH, Han DW, Suh H, Ryu GH, Hyon SH, Cho BK, Park JC. Protective effects of green tea polyphenol against reactive oxygen species-induced oxidative stress in cultured rat calvarial osteoblast. Cell Biol Toxicol 2003; 19:325-37. [PMID: 14703119 DOI: 10.1023/b:cbto.0000004986.51081.c5] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The injurious effects of reactive oxygen species on osteoblasts and the potential protective role played by green tea polyphenols (GtPP) were investigated using primarily cultured rat calvarial osteoblasts. Oxidative stress was induced in cultured osteoblasts, either by adding 100 mmol/L H2O2 or by the action of 40 U/L xanthine oxidase (XO) in the presence of xanthine (250 micromol/L). After incubation, the cellular viability, function and morphology were evaluated. Both treatments produced a significant reduction in osteoblast viability, as assessed by a two-colored fluorescence staining method combined with flow cytometric analysis and MTT assay. A significant reduction in the alkaline phosphatase activity was observed after H2O2 addition, whereas XO did not have the same effect. On the microscopic observations, the morphological changes and intracellular ultrastructural damages were remarkably induced by both treatments. The H2O2-induced alterations were prevented by pre-incubating the osteoblasts with 200 microg/ml GtPP for 1 h. When the oxidative stress was induced by XO, the cellular viability and morphology was also maintained at the same polyphenol concentration. These results demonstrate that GtPP can act as a biological antioxidant in a cell culture experimental model and protect cells from oxidative stress-induced toxicity.
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Shin WS, Park JC, Pardue JH. Oxygen dynamics in petroleum hydrocarbon contaminated salt marsh soils: III. A rate model. ENVIRONMENTAL TECHNOLOGY 2003; 24:831-843. [PMID: 12916836 DOI: 10.1080/09593330309385620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
A model describing oxygen dynamics due to crude oil biodegradation under flooded conditions in saltwater wetlands was developed. The model is composed of three non-linear ordinary differential equations (ODEs) that simulate oxygen uptake, cell growth, and oil degradation simultaneously. The model equations were solved by using a stiff version of ODE solver, ODEPACK, which employs a multistep method and allows the change of step sizes and order of methods (ie., Gear's method). The results of model simulation were compared with experimental data obtained from a fully aerated microcosm study. The results of model simulation indicate that dissolved oxygen concentration in the overlying water rapidly depleted below 3 mg l(-1) unless the reaeration coefficient was higher than 2.0 day(-1). Active aerobic biodegradation of crude oil did not occur under flooded conditions because (i) dissolved oxygen is rapidly depleted, (ii) reaeration is not sufficient enough to replenish dissolved oxygen and (iii) the oil dissolution rate constant decreases over time. The model may lead to better understanding of oxygen demand for a long bioremediation period. The results of this study may be applicable for the establishment of an engineered bioremediation strategy.
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Lee WK, Lee KW, Kwak EJ, Yang SW, Yang KS, Park JC, Joo HS, Lee WJ, Lee WB. Effects of environmental endocrine disruptors on the sex differentiation in Korean rockfish, Sebastes schlegeli. WATER SCIENCE AND TECHNOLOGY : A JOURNAL OF THE INTERNATIONAL ASSOCIATION ON WATER POLLUTION RESEARCH 2003; 47:65-70. [PMID: 12830942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The effects of estradiol-17beta, methyltestosterone, tributyltin, bisphenol A and 2,4-dinitrophenol on sex differentiation were investigated in the Korean rockfish, Sebastes schlegeli. The 51 day-old fry with undifferentiated gonads were fed with food containing the chemicals at 0.05, 0.5, 5, 50 and 100 micro/g diet for 29 days. Sex ratio and gonadal abnormality after the chemical treatment were determined by histological examination of gonads. In control group, the sex ratio of fry was 1:1.3 (female:male), and more males than females appeared. The sex of fry fed with estradiol-17beta at 5, 50 and 100 micro/g diet was all females. Feminization of the fry was induced by exogenic estradiol-17beta. In the methyltestosterone group, sex ratio of fry was 1:10.2 in 0.05 micro/g diet, 1:2.4 in 0.5 micro/g diet, 1:3.1 in 5 micro/g diet, 1:1.2 in 50 micro/g diet and 1:2.3 in 100 micro/g diet. Masculinization of the fry was induced by methyltestosterone at the lowest concentration. Furthermore, intersex of the fry was observed. The number of intersex fry was 23.3, 25.0 and 35.3 at 0.5, 5 and 50 micro/g diet of methyltestosterone, respectively. Sex ratio of bisphenol A group showed no difference with that of the control. The sex of fry fed with 2,4-dinitrophenol at 5, 50 and 100 micro/g diet was all females. 2,4-dinitrophenol should be considered as a new member of endocrine disruptors. In tributyltin group, the sex ratio of fry at 100 micro/g diet of tributyltin was 5.4:1. Tributyltin induced the feminization of the fry at the highest dose. Tributyltin showed an estrogenic effect in the Korean rockfish in contrast to an androgenic effect in gastropods.
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