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Aguilar M, Ali Cavasonza L, Alpat B, Ambrosi G, Arruda L, Attig N, Aupetit S, Azzarello P, Bachlechner A, Barao F, Barrau A, Barrin L, Bartoloni A, Basara L, Başeǧmez-du Pree S, Battarbee M, Battiston R, Bazo J, Becker U, Behlmann M, Beischer B, Berdugo J, Bertucci B, Bindi V, Boella G, de Boer W, Bollweg K, Bonnivard V, Borgia B, Boschini MJ, Bourquin M, Bueno EF, Burger J, Cadoux F, Cai XD, Capell M, Caroff S, Casaus J, Castellini G, Cernuda I, Cervelli F, Chae MJ, Chang YH, Chen AI, Chen GM, Chen HS, Cheng L, Chou HY, Choumilov E, Choutko V, Chung CH, Clark C, Clavero R, Coignet G, Consolandi C, Contin A, Corti C, Coste B, Creus W, Crispoltoni M, Cui Z, Dai YM, Delgado C, Della Torre S, Demirköz MB, Derome L, Di Falco S, Dimiccoli F, Díaz C, von Doetinchem P, Dong F, Donnini F, Duranti M, D'Urso D, Egorov A, Eline A, Eronen T, Feng J, Fiandrini E, Finch E, Fisher P, Formato V, Galaktionov Y, Gallucci G, García B, García-López RJ, Gargiulo C, Gast H, Gebauer I, Gervasi M, Ghelfi A, Giovacchini F, Goglov P, Gómez-Coral DM, Gong J, Goy C, Grabski V, Grandi D, Graziani M, Guerri I, Guo KH, Habiby M, Haino S, Han KC, He ZH, Heil M, Hoffman J, Hsieh TH, Huang H, Huang ZC, Huh C, Incagli M, Ionica M, Jang WY, Jinchi H, Kang SC, Kanishev K, Kim GN, Kim KS, Kirn T, Konak C, Kounina O, Kounine A, Koutsenko V, Krafczyk MS, La Vacca G, Laudi E, Laurenti G, Lazzizzera I, Lebedev A, Lee HT, Lee SC, Leluc C, Li HS, Li JQ, Li JQ, Li Q, Li TX, Li W, Li ZH, Li ZY, Lim S, Lin CH, Lipari P, Lippert T, Liu D, Liu H, Lu SQ, Lu YS, Luebelsmeyer K, Luo F, Luo JZ, Lv SS, Majka R, Mañá C, Marín J, Martin T, Martínez G, Masi N, Maurin D, Menchaca-Rocha A, Meng Q, Mo DC, Morescalchi L, Mott P, Nelson T, Ni JQ, Nikonov N, Nozzoli F, Nunes P, Oliva A, Orcinha M, Palmonari F, Palomares C, Paniccia M, Pauluzzi M, Pensotti S, Pereira R, Picot-Clemente N, Pilo F, Pizzolotto C, Plyaskin V, Pohl M, Poireau V, Putze A, Quadrani L, Qi XM, Qin X, Qu ZY, Räihä T, Rancoita PG, Rapin D, Ricol JS, Rodríguez I, Rosier-Lees S, Rozhkov A, Rozza D, Sagdeev R, Sandweiss J, Saouter P, Schael S, Schmidt SM, Schulz von Dratzig A, Schwering G, Seo ES, Shan BS, Shi JY, Siedenburg T, Son D, Song JW, Sun WH, Tacconi M, Tang XW, Tang ZC, Tao L, Tescaro D, Ting SCC, Ting SM, Tomassetti N, Torsti J, Türkoğlu C, Urban T, Vagelli V, Valente E, Vannini C, Valtonen E, Vázquez Acosta M, Vecchi M, Velasco M, Vialle JP, Vitale V, Vitillo S, Wang LQ, Wang NH, Wang QL, Wang X, Wang XQ, Wang ZX, Wei CC, Weng ZL, Whitman K, Wienkenhöver J, Willenbrock M, Wu H, Wu X, Xia X, Xiong RQ, Xu W, Yan Q, Yang J, Yang M, Yang Y, Yi H, Yu YJ, Yu ZQ, Zeissler S, Zhang C, Zhang J, Zhang JH, Zhang SD, Zhang SW, Zhang Z, Zheng ZM, Zhu ZQ, Zhuang HL, Zhukov V, Zichichi A, Zimmermann N, Zuccon P. Antiproton Flux, Antiproton-to-Proton Flux Ratio, and Properties of Elementary Particle Fluxes in Primary Cosmic Rays Measured with the Alpha Magnetic Spectrometer on the International Space Station. PHYSICAL REVIEW LETTERS 2016; 117:091103. [PMID: 27610839 DOI: 10.1103/physrevlett.117.091103] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Indexed: 06/06/2023]
Abstract
A precision measurement by AMS of the antiproton flux and the antiproton-to-proton flux ratio in primary cosmic rays in the absolute rigidity range from 1 to 450 GV is presented based on 3.49×10^{5} antiproton events and 2.42×10^{9} proton events. The fluxes and flux ratios of charged elementary particles in cosmic rays are also presented. In the absolute rigidity range ∼60 to ∼500 GV, the antiproton p[over ¯], proton p, and positron e^{+} fluxes are found to have nearly identical rigidity dependence and the electron e^{-} flux exhibits a different rigidity dependence. Below 60 GV, the (p[over ¯]/p), (p[over ¯]/e^{+}), and (p/e^{+}) flux ratios each reaches a maximum. From ∼60 to ∼500 GV, the (p[over ¯]/p), (p[over ¯]/e^{+}), and (p/e^{+}) flux ratios show no rigidity dependence. These are new observations of the properties of elementary particles in the cosmos.
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Kim JH, Chung CH, Lau CH, Goggins WB, Lau JTF, Griffiths SM. Adverse events and poisoning from over-the-counter traditional Chinese medicine: a population-based survey. Hong Kong Med J 2016; 22 Suppl 2:S23-S28. [PMID: 26908339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
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103
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Lim JY, Jung SH, Kim JB, Choo SJ, Chung CH, Lee JW. Critical illness-related corticosteroid insufficiency in patients with low cardiac output syndrome after cardiac surgery. Intensive Care Med Exp 2015. [PMCID: PMC4798453 DOI: 10.1186/2197-425x-3-s1-a546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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104
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Aguilar M, Aisa D, Alpat B, Alvino A, Ambrosi G, Andeen K, Arruda L, Attig N, Azzarello P, Bachlechner A, Barao F, Barrau A, Barrin L, Bartoloni A, Basara L, Battarbee M, Battiston R, Bazo J, Becker U, Behlmann M, Beischer B, Berdugo J, Bertucci B, Bindi V, Bizzaglia S, Bizzarri M, Boella G, de Boer W, Bollweg K, Bonnivard V, Borgia B, Borsini S, Boschini MJ, Bourquin M, Burger J, Cadoux F, Cai XD, Capell M, Caroff S, Casaus J, Castellini G, Cernuda I, Cerreta D, Cervelli F, Chae MJ, Chang YH, Chen AI, Chen GM, Chen H, Chen HS, Cheng L, Chou HY, Choumilov E, Choutko V, Chung CH, Clark C, Clavero R, Coignet G, Consolandi C, Contin A, Corti C, Gil EC, Coste B, Creus W, Crispoltoni M, Cui Z, Dai YM, Delgado C, Della Torre S, Demirköz MB, Derome L, Di Falco S, Di Masso L, Dimiccoli F, Díaz C, von Doetinchem P, Donnini F, Duranti M, D'Urso D, Egorov A, Eline A, Eppling FJ, Eronen T, Fan YY, Farnesini L, Feng J, Fiandrini E, Fiasson A, Finch E, Fisher P, Formato V, Galaktionov Y, Gallucci G, García B, García-López R, Gargiulo C, Gast H, Gebauer I, Gervasi M, Ghelfi A, Giovacchini F, Goglov P, Gong J, Goy C, Grabski V, Grandi D, Graziani M, Guandalini C, Guerri I, Guo KH, Haas D, Habiby M, Haino S, Han KC, He ZH, Heil M, Hoffman J, Hsieh TH, Huang ZC, Huh C, Incagli M, Ionica M, Jang WY, Jinchi H, Kanishev K, Kim GN, Kim KS, Kirn T, Korkmaz MA, Kossakowski R, Kounina O, Kounine A, Koutsenko V, Krafczyk MS, La Vacca G, Laudi E, Laurenti G, Lazzizzera I, Lebedev A, Lee HT, Lee SC, Leluc C, Li HL, Li JQ, Li JQ, Li Q, Li Q, Li TX, Li W, Li Y, Li ZH, Li ZY, Lim S, Lin CH, Lipari P, Lippert T, Liu D, Liu H, Liu H, Lolli M, Lomtadze T, Lu MJ, Lu SQ, Lu YS, Luebelsmeyer K, Luo F, Luo JZ, Lv SS, Majka R, Mañá C, Marín J, Martin T, Martínez G, Masi N, Maurin D, Menchaca-Rocha A, Meng Q, Mo DC, Morescalchi L, Mott P, Müller M, Nelson T, Ni JQ, Nikonov N, Nozzoli F, Nunes P, Obermeier A, Oliva A, Orcinha M, Palmonari F, Palomares C, Paniccia M, Papi A, Pauluzzi M, Pedreschi E, Pensotti S, Pereira R, Picot-Clemente N, Pilo F, Piluso A, Pizzolotto C, Plyaskin V, Pohl M, Poireau V, Putze A, Quadrani L, Qi XM, Qin X, Qu ZY, Räihä T, Rancoita PG, Rapin D, Ricol JS, Rodríguez I, Rosier-Lees S, Rozhkov A, Rozza D, Sagdeev R, Sandweiss J, Saouter P, Schael S, Schmidt SM, von Dratzig AS, Schwering G, Scolieri G, Seo ES, Shan BS, Shan YH, Shi JY, Shi XY, Shi YM, Siedenburg T, Son D, Song JW, Spada F, Spinella F, Sun W, Sun WH, Tacconi M, Tang CP, Tang XW, Tang ZC, Tao L, Tescaro D, Ting SCC, Ting SM, Tomassetti N, Torsti J, Türkoğlu C, Urban T, Vagelli V, Valente E, Vannini C, Valtonen E, Vaurynovich S, Vecchi M, Velasco M, Vialle JP, Vitale V, Vitillo S, Wang LQ, Wang NH, Wang QL, Wang RS, Wang X, Wang ZX, Weng ZL, Whitman K, Wienkenhöver J, Willenbrock M, Wu H, Wu X, Xia X, Xie M, Xie S, Xiong RQ, Xu NS, Xu W, Yan Q, Yang J, Yang M, Yang Y, Ye QH, Yi H, Yu YJ, Yu ZQ, Zeissler S, Zhang C, Zhang JH, Zhang MT, Zhang SD, Zhang SW, Zhang XB, Zhang Z, Zheng ZM, Zhuang HL, Zhukov V, Zichichi A, Zimmermann N, Zuccon P. Precision Measurement of the Helium Flux in Primary Cosmic Rays of Rigidities 1.9 GV to 3 TV with the Alpha Magnetic Spectrometer on the International Space Station. PHYSICAL REVIEW LETTERS 2015; 115:211101. [PMID: 26636836 DOI: 10.1103/physrevlett.115.211101] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Indexed: 06/05/2023]
Abstract
Knowledge of the precise rigidity dependence of the helium flux is important in understanding the origin, acceleration, and propagation of cosmic rays. A precise measurement of the helium flux in primary cosmic rays with rigidity (momentum/charge) from 1.9 GV to 3 TV based on 50 million events is presented and compared to the proton flux. The detailed variation with rigidity of the helium flux spectral index is presented for the first time. The spectral index progressively hardens at rigidities larger than 100 GV. The rigidity dependence of the helium flux spectral index is similar to that of the proton spectral index though the magnitudes are different. Remarkably, the spectral index of the proton to helium flux ratio increases with rigidity up to 45 GV and then becomes constant; the flux ratio above 45 GV is well described by a single power law.
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Xu S, Nam SM, Kim JH, Das R, Choi SK, Nguyen TT, Quan X, Choi SJ, Chung CH, Lee EY, Lee IK, Wiederkehr A, Wollheim CB, Cha SK, Park KS. Palmitate induces ER calcium depletion and apoptosis in mouse podocytes subsequent to mitochondrial oxidative stress. Cell Death Dis 2015; 6:e1976. [PMID: 26583319 PMCID: PMC4670935 DOI: 10.1038/cddis.2015.331] [Citation(s) in RCA: 135] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 10/02/2015] [Accepted: 10/12/2015] [Indexed: 12/14/2022]
Abstract
Pathologic alterations in podocytes lead to failure of an essential component of the glomerular filtration barrier and proteinuria in chronic kidney diseases. Elevated levels of saturated free fatty acid (FFA) are harmful to various tissues, implemented in the progression of diabetes and its complications such as proteinuria in diabetic nephropathy. Here, we investigated the molecular mechanism of palmitate cytotoxicity in cultured mouse podocytes. Incubation with palmitate dose-dependently increased cytosolic and mitochondrial reactive oxygen species, depolarized the mitochondrial membrane potential, impaired ATP synthesis and elicited apoptotic cell death. Palmitate not only evoked mitochondrial fragmentation but also caused marked dilation of the endoplasmic reticulum (ER). Consistently, palmitate upregulated ER stress proteins, oligomerized stromal interaction molecule 1 (STIM1) in the subplasmalemmal ER membrane, abolished the cyclopiazonic acid-induced cytosolic Ca2+ increase due to depletion of luminal ER Ca2+. Palmitate-induced ER Ca2+ depletion and cytotoxicity were blocked by a selective inhibitor of the fatty-acid transporter FAT/CD36. Loss of the ER Ca2+ pool induced by palmitate was reverted by the phospholipase C (PLC) inhibitor edelfosine. Palmitate-dependent activation of PLC was further demonstrated by following cytosolic translocation of the pleckstrin homology domain of PLC in palmitate-treated podocytes. An inhibitor of diacylglycerol (DAG) kinase, which elevates cytosolic DAG, strongly promoted ER Ca2+ depletion by low-dose palmitate. GF109203X, a PKC inhibitor, partially prevented palmitate-induced ER Ca2+ loss. Remarkably, the mitochondrial antioxidant mitoTEMPO inhibited palmitate-induced PLC activation, ER Ca2+ depletion and cytotoxicity. Palmitate elicited cytoskeletal changes in podocytes and increased albumin permeability, which was also blocked by mitoTEMPO. These data suggest that oxidative stress caused by saturated FFA leads to mitochondrial dysfunction and ER Ca2+ depletion through FAT/CD36 and PLC signaling, possibly contributing to podocyte injury.
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Kang DH, Jang JY, Park SJ, Kim DH, Yun SC, Song JM, Park SW, Chung CH, Song JK, Lee JW. Watchful observation versus early aortic valve replacement for symptomatic patients with normal flow, low-gradient severe aortic stenosis. Heart 2015; 101:1375-81. [DOI: 10.1136/heartjnl-2015-307528] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 06/08/2015] [Indexed: 11/03/2022] Open
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107
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Chung CH, Guthrie VB, Masica DL, Tokheim C, Kang H, Richmon J, Agrawal N, Fakhry C, Quon H, Subramaniam RM, Zuo Z, Seiwert T, Chalmers ZR, Frampton GM, Ali SM, Yelensky R, Stephens PJ, Miller VA, Karchin R, Bishop JA. Genomic alterations in head and neck squamous cell carcinoma determined by cancer gene-targeted sequencing. Ann Oncol 2015; 26:1216-1223. [PMID: 25712460 PMCID: PMC4516044 DOI: 10.1093/annonc/mdv109] [Citation(s) in RCA: 139] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Revised: 01/23/2015] [Accepted: 02/18/2015] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND To determine genomic alterations in head and neck squamous cell carcinoma (HNSCC) using formalin-fixed, paraffin-embedded (FFPE) tumors obtained through routine clinical practice, selected cancer-related genes were evaluated and compared with alterations seen in frozen tumors obtained through research studies. PATIENTS AND METHODS DNA samples obtained from 252 FFPE HNSCC were analyzed using next-generation sequencing-based (NGS) clinical assay to determine sequence and copy number variations in 236 cancer-related genes plus 47 introns from 19 genes frequently rearranged in cancer. Human papillomavirus (HPV) status was determined by presence of the HPV DNA sequence in all samples and corroborated with high-risk HPV in situ hybridization (ISH) and p16 immunohistochemical (IHC) staining in a subset of tumors. Sequencing data from 399 frozen tumors in The Cancer Genome Atlas and University of Chicago public datasets were analyzed for comparison. RESULTS Among 252 FFPE HNSCC, 84 (33%) were HPV positive and 168 (67%) were HPV negative by sequencing. A subset of 40 tumors with HPV ISH and p16 IHC results showed complete concordance with NGS-derived HPV status. The most common genes with genomic alterations were PIK3CA and PTEN in HPV-positive tumors and TP53 and CDKN2A/B in HPV-negative tumors. In the pathway analysis, the PI3K pathway in HPV-positive tumors and DNA repair-p53 and cell cycle pathways in HPV-negative tumors were frequently altered. The HPV-positive oropharynx and HPV-positive nasal cavity/paranasal sinus carcinoma shared similar mutational profiles. CONCLUSION The genomic profile of FFPE HNSCC tumors obtained through routine clinical practice is comparable with frozen tumors studied in research setting, demonstrating the feasibility of comprehensive genomic profiling in a clinical setting. However, the clinical significance of these genomic alterations requires further investigation through application of these genomic profiles as integral biomarkers in clinical trials.
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Aguilar M, Aisa D, Alpat B, Alvino A, Ambrosi G, Andeen K, Arruda L, Attig N, Azzarello P, Bachlechner A, Barao F, Barrau A, Barrin L, Bartoloni A, Basara L, Battarbee M, Battiston R, Bazo J, Becker U, Behlmann M, Beischer B, Berdugo J, Bertucci B, Bigongiari G, Bindi V, Bizzaglia S, Bizzarri M, Boella G, de Boer W, Bollweg K, Bonnivard V, Borgia B, Borsini S, Boschini MJ, Bourquin M, Burger J, Cadoux F, Cai XD, Capell M, Caroff S, Casaus J, Cascioli V, Castellini G, Cernuda I, Cerreta D, Cervelli F, Chae MJ, Chang YH, Chen AI, Chen H, Cheng GM, Chen HS, Cheng L, Chou HY, Choumilov E, Choutko V, Chung CH, Clark C, Clavero R, Coignet G, Consolandi C, Contin A, Corti C, Cortina Gil E, Coste B, Creus W, Crispoltoni M, Cui Z, Dai YM, Delgado C, Della Torre S, Demirköz MB, Derome L, Di Falco S, Di Masso L, Dimiccoli F, Díaz C, von Doetinchem P, Donnini F, Du WJ, Duranti M, D'Urso D, Eline A, Eppling FJ, Eronen T, Fan YY, Farnesini L, Feng J, Fiandrini E, Fiasson A, Finch E, Fisher P, Galaktionov Y, Gallucci G, García B, García-López R, Gargiulo C, Gast H, Gebauer I, Gervasi M, Ghelfi A, Gillard W, Giovacchini F, Goglov P, Gong J, Goy C, Grabski V, Grandi D, Graziani M, Guandalini C, Guerri I, Guo KH, Haas D, Habiby M, Haino S, Han KC, He ZH, Heil M, Hoffman J, Hsieh TH, Huang ZC, Huh C, Incagli M, Ionica M, Jang WY, Jinchi H, Kanishev K, Kim GN, Kim KS, Kirn T, Kossakowski R, Kounina O, Kounine A, Koutsenko V, Krafczyk MS, La Vacca G, Laudi E, Laurenti G, Lazzizzera I, Lebedev A, Lee HT, Lee SC, Leluc C, Levi G, Li HL, Li JQ, Li Q, Li Q, Li TX, Li W, Li Y, Li ZH, Li ZY, Lim S, Lin CH, Lipari P, Lippert T, Liu D, Liu H, Lolli M, Lomtadze T, Lu MJ, Lu SQ, Lu YS, Luebelsmeyer K, Luo JZ, Lv SS, Majka R, Mañá C, Marín J, Martin T, Martínez G, Masi N, Maurin D, Menchaca-Rocha A, Meng Q, Mo DC, Morescalchi L, Mott P, Müller M, Ni JQ, Nikonov N, Nozzoli F, Nunes P, Obermeier A, Oliva A, Orcinha M, Palmonari F, Palomares C, Paniccia M, Papi A, Pauluzzi M, Pedreschi E, Pensotti S, Pereira R, Picot-Clemente N, Pilo F, Piluso A, Pizzolotto C, Plyaskin V, Pohl M, Poireau V, Postaci E, Putze A, Quadrani L, Qi XM, Qin X, Qu ZY, Räihä T, Rancoita PG, Rapin D, Ricol JS, Rodríguez I, Rosier-Lees S, Rozhkov A, Rozza D, Sagdeev R, Sandweiss J, Saouter P, Sbarra C, Schael S, Schmidt SM, Schulz von Dratzig A, Schwering G, Scolieri G, Seo ES, Shan BS, Shan YH, Shi JY, Shi XY, Shi YM, Siedenburg T, Son D, Spada F, Spinella F, Sun W, Sun WH, Tacconi M, Tang CP, Tang XW, Tang ZC, Tao L, Tescaro D, Ting SCC, Ting SM, Tomassetti N, Torsti J, Türkoğlu C, Urban T, Vagelli V, Valente E, Vannini C, Valtonen E, Vaurynovich S, Vecchi M, Velasco M, Vialle JP, Vitale V, Vitillo S, Wang LQ, Wang NH, Wang QL, Wang RS, Wang X, Wang ZX, Weng ZL, Whitman K, Wienkenhöver J, Wu H, Wu X, Xia X, Xie M, Xie S, Xiong RQ, Xin GM, Xu NS, Xu W, Yan Q, Yang J, Yang M, Ye QH, Yi H, Yu YJ, Yu ZQ, Zeissler S, Zhang JH, Zhang MT, Zhang XB, Zhang Z, Zheng ZM, Zhuang HL, Zhukov V, Zichichi A, Zimmermann N, Zuccon P, Zurbach C. Precision Measurement of the Proton Flux in Primary Cosmic Rays from Rigidity 1 GV to 1.8 TV with the Alpha Magnetic Spectrometer on the International Space Station. PHYSICAL REVIEW LETTERS 2015; 114:171103. [PMID: 25978222 DOI: 10.1103/physrevlett.114.171103] [Citation(s) in RCA: 129] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Indexed: 06/04/2023]
Abstract
A precise measurement of the proton flux in primary cosmic rays with rigidity (momentum/charge) from 1 GV to 1.8 TV is presented based on 300 million events. Knowledge of the rigidity dependence of the proton flux is important in understanding the origin, acceleration, and propagation of cosmic rays. We present the detailed variation with rigidity of the flux spectral index for the first time. The spectral index progressively hardens at high rigidities.
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Jin SM, Park SW, Yoon KH, Min KW, Song KH, Park KS, Park JY, Park IB, Chung CH, Baik SH, Choi SH, Lee HW, Lee IK, Kim DM, Lee MK. Anagliptin and sitagliptin as add-ons to metformin for patients with type 2 diabetes: a 24-week, multicentre, randomized, double-blind, active-controlled, phase III clinical trial with a 28-week extension. Diabetes Obes Metab 2015; 17:511-5. [PMID: 25523633 DOI: 10.1111/dom.12429] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 12/06/2014] [Accepted: 12/15/2014] [Indexed: 12/20/2022]
Abstract
We conducted a 24-week, multicentre, double-blind, randomized study with a 28-week extension to compare the efficacy and safety of anagliptin and sitagliptin as an add-on to metformin in patients with type 2 diabetes. Patients inadequately controlled on metformin were randomized to either anagliptin (100 mg twice daily, n = 92) or sitagliptin (100 mg once daily, n = 88). The primary endpoint was the change in glycated haemoglobin (HbA1c) from baseline to week 24. The mean changes in HbA1c were -0.85 ± 0.70% (p < 0.0001) for anagliptin and -0.83 ± 0.61% (p < 0.0001) for sitagliptin, with a mean difference of -0.02% (95% confidence interval of difference, -0.22 to 0.18%). In both groups, the fasting proinsulin : insulin ratio significantly decreased from baseline, with improved insulin secretion. Safety profiles were similar in each group. In conclusion, the non-inferiority of the efficacy of anagliptin to sitagliptin as an add-on therapy was established with regard to efficacy and safety.
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Kim MK, Rhee EJ, Han KA, Woo AC, Lee MK, Ku BJ, Chung CH, Kim KA, Lee HW, Park IB, Park JY, Chul Jang HC, Park KS, Jang WI, Cha BY. Efficacy and safety of teneligliptin, a dipeptidyl peptidase-4 inhibitor, combined with metformin in Korean patients with type 2 diabetes mellitus: a 16-week, randomized, double-blind, placebo-controlled phase III trial. Diabetes Obes Metab 2015; 17:309-12. [PMID: 25475929 PMCID: PMC6680285 DOI: 10.1111/dom.12424] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 11/28/2014] [Accepted: 12/01/2014] [Indexed: 12/01/2022]
Abstract
The aim of the present study was to assess the efficacy and safety of teneligliptin in combination with metformin in Korean patients with type 2 diabetes mellitus who were inadequately controlled with metformin monotherapy. Patients [glycated haemoglobin (HbA1c) 7.0-10.0%, on stable metformin ≥1000 mg/day] were randomized 2 : 1 to receive 20 mg teneligliptin plus metformin (n = 136) or placebo plus metformin (n = 68). The primary endpoint was the change in HbA1c levels from baseline to week 16. The mean baseline HbA1c was 7.9% in the teneligliptin group and 7.8% in the placebo group. The differences between the teneligliptin and placebo groups regarding changes in HbA1c and fasting plasma glucose levels were -0.78 % and -1.24 mmol/l (22.42 mg/dl), respectively, at week 16. The incidence of adverse events was similar between the groups. The addition of teneligliptin once daily to metformin was effective and generally well tolerated in Korean patients with type 2 diabetes.
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Aguilar M, Aisa D, Alpat B, Alvino A, Ambrosi G, Andeen K, Arruda L, Attig N, Azzarello P, Bachlechner A, Barao F, Barrau A, Barrin L, Bartoloni A, Basara L, Battarbee M, Battiston R, Bazo J, Becker U, Behlmann M, Beischer B, Berdugo J, Bertucci B, Bigongiari G, Bindi V, Bizzaglia S, Bizzarri M, Boella G, de Boer W, Bollweg K, Bonnivard V, Borgia B, Borsini S, Boschini MJ, Bourquin M, Burger J, Cadoux F, Cai XD, Capell M, Caroff S, Casaus J, Cascioli V, Castellini G, Cernuda I, Cervelli F, Chae MJ, Chang YH, Chen AI, Chen H, Cheng GM, Chen HS, Cheng L, Chikanian A, Chou HY, Choumilov E, Choutko V, Chung CH, Clark C, Clavero R, Coignet G, Consolandi C, Contin A, Corti C, Coste B, Crispoltoni M, Cui Z, Dai M, Delgado C, Della Torre S, Demirköz MB, Derome L, Di Falco S, Di Masso L, Dimiccoli F, Díaz C, von Doetinchem P, Donnini F, Du WJ, Duranti M, D'Urso D, Eline A, Eppling FJ, Eronen T, Fan YY, Farnesini L, Feng J, Fiandrini E, Fiasson A, Finch E, Fisher P, Galaktionov Y, Gallucci G, García B, García-López R, Gargiulo C, Gast H, Gebauer I, Gervasi M, Ghelfi A, Gillard W, Giovacchini F, Goglov P, Gong J, Goy C, Grabski V, Grandi D, Graziani M, Guandalini C, Guerri I, Guo KH, Habiby M, Haino S, Han KC, He ZH, Heil M, Hoffman J, Hsieh TH, Huang ZC, Huh C, Incagli M, Ionica M, Jang WY, Jinchi H, Kanishev K, Kim GN, Kim KS, Kirn T, Kossakowski R, Kounina O, Kounine A, Koutsenko V, Krafczyk MS, Kunz S, La Vacca G, Laudi E, Laurenti G, Lazzizzera I, Lebedev A, Lee HT, Lee SC, Leluc C, Li HL, Li JQ, Li Q, Li Q, Li TX, Li W, Li Y, Li ZH, Li ZY, Lim S, Lin CH, Lipari P, Lippert T, Liu D, Liu H, Lomtadze T, Lu MJ, Lu YS, Luebelsmeyer K, Luo F, Luo JZ, Lv SS, Majka R, Malinin A, Mañá C, Marín J, Martin T, Martínez G, Masi N, Maurin D, Menchaca-Rocha A, Meng Q, Mo DC, Morescalchi L, Mott P, Müller M, Ni JQ, Nikonov N, Nozzoli F, Nunes P, Obermeier A, Oliva A, Orcinha M, Palmonari F, Palomares C, Paniccia M, Papi A, Pauluzzi M, Pedreschi E, Pensotti S, Pereira R, Pilo F, Piluso A, Pizzolotto C, Plyaskin V, Pohl M, Poireau V, Postaci E, Putze A, Quadrani L, Qi XM, Räihä T, Rancoita PG, Rapin D, Ricol JS, Rodríguez I, Rosier-Lees S, Rozhkov A, Rozza D, Sagdeev R, Sandweiss J, Saouter P, Sbarra C, Schael S, Schmidt SM, Schuckardt D, Schulz von Dratzig A, Schwering G, Scolieri G, Seo ES, Shan BS, Shan YH, Shi JY, Shi XY, Shi YM, Siedenburg T, Son D, Spada F, Spinella F, Sun W, Sun WH, Tacconi M, Tang CP, Tang XW, Tang ZC, Tao L, Tescaro D, Ting SCC, Ting SM, Tomassetti N, Torsti J, Türkoğlu C, Urban T, Vagelli V, Valente E, Vannini C, Valtonen E, Vaurynovich S, Vecchi M, Velasco M, Vialle JP, Wang LQ, Wang QL, Wang RS, Wang X, Wang ZX, Weng ZL, Whitman K, Wienkenhöver J, Wu H, Xia X, Xie M, Xie S, Xiong RQ, Xin GM, Xu NS, Xu W, Yan Q, Yang J, Yang M, Ye QH, Yi H, Yu YJ, Yu ZQ, Zeissler S, Zhang JH, Zhang MT, Zhang XB, Zhang Z, Zheng ZM, Zhuang HL, Zhukov V, Zichichi A, Zimmermann N, Zuccon P, Zurbach C. Precision Measurement of the (e^{+}+e^{-}) Flux in Primary Cosmic Rays from 0.5 GeV to 1 TeV with the Alpha Magnetic Spectrometer on the International Space Station. PHYSICAL REVIEW LETTERS 2014; 113:221102. [PMID: 25494065 DOI: 10.1103/physrevlett.113.221102] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Indexed: 06/04/2023]
Abstract
We present a measurement of the cosmic ray (e^{+}+e^{-}) flux in the range 0.5 GeV to 1 TeV based on the analysis of 10.6 million (e^{+}+e^{-}) events collected by AMS. The statistics and the resolution of AMS provide a precision measurement of the flux. The flux is smooth and reveals new and distinct information. Above 30.2 GeV, the flux can be described by a single power law with a spectral index γ=-3.170±0.008(stat+syst)±0.008(energy scale).
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Aguilar M, Aisa D, Alvino A, Ambrosi G, Andeen K, Arruda L, Attig N, Azzarello P, Bachlechner A, Barao F, Barrau A, Barrin L, Bartoloni A, Basara L, Battarbee M, Battiston R, Bazo J, Becker U, Behlmann M, Beischer B, Berdugo J, Bertucci B, Bigongiari G, Bindi V, Bizzaglia S, Bizzarri M, Boella G, de Boer W, Bollweg K, Bonnivard V, Borgia B, Borsini S, Boschini MJ, Bourquin M, Burger J, Cadoux F, Cai XD, Capell M, Caroff S, Casaus J, Cascioli V, Castellini G, Cernuda I, Cervelli F, Chae MJ, Chang YH, Chen AI, Chen H, Cheng GM, Chen HS, Cheng L, Chikanian A, Chou HY, Choumilov E, Choutko V, Chung CH, Clark C, Clavero R, Coignet G, Consolandi C, Contin A, Corti C, Coste B, Cui Z, Dai M, Delgado C, Della Torre S, Demirköz MB, Derome L, Di Falco S, Di Masso L, Dimiccoli F, Díaz C, von Doetinchem P, Du WJ, Duranti M, D'Urso D, Eline A, Eppling FJ, Eronen T, Fan YY, Farnesini L, Feng J, Fiandrini E, Fiasson A, Finch E, Fisher P, Galaktionov Y, Gallucci G, García B, García-López R, Gast H, Gebauer I, Gervasi M, Ghelfi A, Gillard W, Giovacchini F, Goglov P, Gong J, Goy C, Grabski V, Grandi D, Graziani M, Guandalini C, Guerri I, Guo KH, Habiby M, Haino S, Han KC, He ZH, Heil M, Hoffman J, Hsieh TH, Huang ZC, Huh C, Incagli M, Ionica M, Jang WY, Jinchi H, Kanishev K, Kim GN, Kim KS, Kirn T, Kossakowski R, Kounina O, Kounine A, Koutsenko V, Krafczyk MS, Kunz S, La Vacca G, Laudi E, Laurenti G, Lazzizzera I, Lebedev A, Lee HT, Lee SC, Leluc C, Li HL, Li JQ, Li Q, Li Q, Li TX, Li W, Li Y, Li ZH, Li ZY, Lim S, Lin CH, Lipari P, Lippert T, Liu D, Liu H, Lomtadze T, Lu MJ, Lu YS, Luebelsmeyer K, Luo F, Luo JZ, Lv SS, Majka R, Malinin A, Mañá C, Marín J, Martin T, Martínez G, Masi N, Maurin D, Menchaca-Rocha A, Meng Q, Mo DC, Morescalchi L, Mott P, Müller M, Ni JQ, Nikonov N, Nozzoli F, Nunes P, Obermeier A, Oliva A, Orcinha M, Palmonari F, Palomares C, Paniccia M, Papi A, Pedreschi E, Pensotti S, Pereira R, Pilo F, Piluso A, Pizzolotto C, Plyaskin V, Pohl M, Poireau V, Postaci E, Putze A, Quadrani L, Qi XM, Rancoita PG, Rapin D, Ricol JS, Rodríguez I, Rosier-Lees S, Rozhkov A, Rozza D, Sagdeev R, Sandweiss J, Saouter P, Sbarra C, Schael S, Schmidt SM, Schuckardt D, Schulz von Dratzig A, Schwering G, Scolieri G, Seo ES, Shan BS, Shan YH, Shi JY, Shi XY, Shi YM, Siedenburg T, Son D, Spada F, Spinella F, Sun W, Sun WH, Tacconi M, Tang CP, Tang XW, Tang ZC, Tao L, Tescaro D, Ting SCC, Ting SM, Tomassetti N, Torsti J, Türkoğlu C, Urban T, Vagelli V, Valente E, Vannini C, Valtonen E, Vaurynovich S, Vecchi M, Velasco M, Vialle JP, Wang LQ, Wang QL, Wang RS, Wang X, Wang ZX, Weng ZL, Whitman K, Wienkenhöver J, Wu H, Xia X, Xie M, Xie S, Xiong RQ, Xin GM, Xu NS, Xu W, Yan Q, Yang J, Yang M, Ye QH, Yi H, Yu YJ, Yu ZQ, Zeissler S, Zhang JH, Zhang MT, Zhang XB, Zhang Z, Zheng ZM, Zhuang HL, Zhukov V, Zichichi A, Zimmermann N, Zuccon P, Zurbach C. Electron and positron fluxes in primary cosmic rays measured with the alpha magnetic spectrometer on the international space station. PHYSICAL REVIEW LETTERS 2014; 113:121102. [PMID: 25279617 DOI: 10.1103/physrevlett.113.121102] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Indexed: 06/03/2023]
Abstract
Precision measurements by the Alpha Magnetic Spectrometer on the International Space Station of the primary cosmic-ray electron flux in the range 0.5 to 700 GeV and the positron flux in the range 0.5 to 500 GeV are presented. The electron flux and the positron flux each require a description beyond a single power-law spectrum. Both the electron flux and the positron flux change their behavior at ∼30 GeV but the fluxes are significantly different in their magnitude and energy dependence. Between 20 and 200 GeV the positron spectral index is significantly harder than the electron spectral index. The determination of the differing behavior of the spectral indices versus energy is a new observation and provides important information on the origins of cosmic-ray electrons and positrons.
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113
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Accardo L, Aguilar M, Aisa D, Alpat B, Alvino A, Ambrosi G, Andeen K, Arruda L, Attig N, Azzarello P, Bachlechner A, Barao F, Barrau A, Barrin L, Bartoloni A, Basara L, Battarbee M, Battiston R, Bazo J, Becker U, Behlmann M, Beischer B, Berdugo J, Bertucci B, Bigongiari G, Bindi V, Bizzaglia S, Bizzarri M, Boella G, de Boer W, Bollweg K, Bonnivard V, Borgia B, Borsini S, Boschini MJ, Bourquin M, Burger J, Cadoux F, Cai XD, Capell M, Caroff S, Carosi G, Casaus J, Cascioli V, Castellini G, Cernuda I, Cerreta D, Cervelli F, Chae MJ, Chang YH, Chen AI, Chen H, Cheng GM, Chen HS, Cheng L, Chikanian A, Chou HY, Choumilov E, Choutko V, Chung CH, Cindolo F, Clark C, Clavero R, Coignet G, Consolandi C, Contin A, Corti C, Coste B, Cui Z, Dai M, Delgado C, Della Torre S, Demirköz MB, Derome L, Di Falco S, Di Masso L, Dimiccoli F, Díaz C, von Doetinchem P, Du WJ, Duranti M, D'Urso D, Eline A, Eppling FJ, Eronen T, Fan YY, Farnesini L, Feng J, Fiandrini E, Fiasson A, Finch E, Fisher P, Galaktionov Y, Gallucci G, García B, García-López R, Gast H, Gebauer I, Gervasi M, Ghelfi A, Gillard W, Giovacchini F, Goglov P, Gong J, Goy C, Grabski V, Grandi D, Graziani M, Guandalini C, Guerri I, Guo KH, Haas D, Habiby M, Haino S, Han KC, He ZH, Heil M, Henning R, Hoffman J, Hsieh TH, Huang ZC, Huh C, Incagli M, Ionica M, Jang WY, Jinchi H, Kanishev K, Kim GN, Kim KS, Kirn T, Kossakowski R, Kounina O, Kounine A, Koutsenko V, Krafczyk MS, Kunz S, La Vacca G, Laudi E, Laurenti G, Lazzizzera I, Lebedev A, Lee HT, Lee SC, Leluc C, Levi G, Li HL, Li JQ, Li Q, Li Q, Li TX, Li W, Li Y, Li ZH, Li ZY, Lim S, Lin CH, Lipari P, Lippert T, Liu D, Liu H, Lolli M, Lomtadze T, Lu MJ, Lu YS, Luebelsmeyer K, Luo F, Luo JZ, Lv SS, Majka R, Malinin A, Mañá C, Marín J, Martin T, Martínez G, Masi N, Massera F, Maurin D, Menchaca-Rocha A, Meng Q, Mo DC, Monreal B, Morescalchi L, Mott P, Müller M, Ni JQ, Nikonov N, Nozzoli F, Nunes P, Obermeier A, Oliva A, Orcinha M, Palmonari F, Palomares C, Paniccia M, Papi A, Pauluzzi M, Pedreschi E, Pensotti S, Pereira R, Pilastrini R, Pilo F, Piluso A, Pizzolotto C, Plyaskin V, Pohl M, Poireau V, Postaci E, Putze A, Quadrani L, Qi XM, Rancoita PG, Rapin D, Ricol JS, Rodríguez I, Rosier-Lees S, Rossi L, Rozhkov A, Rozza D, Rybka G, Sagdeev R, Sandweiss J, Saouter P, Sbarra C, Schael S, Schmidt SM, Schuckardt D, Schulz von Dratzig A, Schwering G, Scolieri G, Seo ES, Shan BS, Shan YH, Shi JY, Shi XY, Shi YM, Siedenburg T, Son D, Spada F, Spinella F, Sun W, Sun WH, Tacconi M, Tang CP, Tang XW, Tang ZC, Tao L, Tescaro D, Ting SCC, Ting SM, Tomassetti N, Torsti J, Türkoğlu C, Urban T, Vagelli V, Valente E, Vannini C, Valtonen E, Vaurynovich S, Vecchi M, Velasco M, Vialle JP, Vitale V, Volpini G, Wang LQ, Wang QL, Wang RS, Wang X, Wang ZX, Weng ZL, Whitman K, Wienkenhöver J, Wu H, Wu KY, Xia X, Xie M, Xie S, Xiong RQ, Xin GM, Xu NS, Xu W, Yan Q, Yang J, Yang M, Ye QH, Yi H, Yu YJ, Yu ZQ, Zeissler S, Zhang JH, Zhang MT, Zhang XB, Zhang Z, Zheng ZM, Zhou F, Zhuang HL, Zhukov V, Zichichi A, Zimmermann N, Zuccon P, Zurbach C. High statistics measurement of the positron fraction in primary cosmic rays of 0.5-500 GeV with the alpha magnetic spectrometer on the international space station. PHYSICAL REVIEW LETTERS 2014; 113:121101. [PMID: 25279616 DOI: 10.1103/physrevlett.113.121101] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Indexed: 06/03/2023]
Abstract
A precision measurement by AMS of the positron fraction in primary cosmic rays in the energy range from 0.5 to 500 GeV based on 10.9 million positron and electron events is presented. This measurement extends the energy range of our previous observation and increases its precision. The new results show, for the first time, that above ∼200 GeV the positron fraction no longer exhibits an increase with energy.
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Nah HW, Lee JW, Chung CH, Choo SJ, Kwon SU, Kim JS, Warach S, Kang DW. New brain infarcts on magnetic resonance imaging after coronary artery bypass graft surgery: Lesion patterns, mechanism, and predictors. Ann Neurol 2014; 76:347-55. [DOI: 10.1002/ana.24238] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 07/26/2014] [Accepted: 07/26/2014] [Indexed: 11/06/2022]
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Chung CH, Lee JW, Slebos RJ, Howard JD, Perez J, Kang H, Fertig EJ, Considine M, Gilbert J, Murphy BA, Nallur S, Paranjape T, Jordan RC, Garcia J, Burtness B, Forastiere AA, Weidhaas JB. A 3'-UTR KRAS-variant is associated with cisplatin resistance in patients with recurrent and/or metastatic head and neck squamous cell carcinoma. Ann Oncol 2014; 25:2230-2236. [PMID: 25081901 DOI: 10.1093/annonc/mdu367] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND A germline mutation in the 3'-untranslated region of KRAS (rs61764370, KRAS-variant: TG/GG) has previously been associated with altered patient outcome and drug resistance/sensitivity in various cancers. We examined the prognostic and predictive significance of this variant in recurrent/metastatic (R/M) head and neck squamous cell carcinoma (HNSCC). PATIENTS AND METHODS We conducted a retrospective study of 103 HNSCCs collected from three completed clinical trials. KRAS-variant genotyping was conducted for these samples and 8 HNSCC cell lines. p16 expression was determined in a subset of 26 oropharynx tumors by immunohistochemistry. Microarray analysis was also utilized to elucidate differentially expressed genes between KRAS-variant and non-variant tumors. Drug sensitivity in cell lines was evaluated to confirm clinical findings. RESULTS KRAS-variant status was determined in 95/103 (92%) of the HNSCC tumor samples and the allelic frequency of TG/GG was 32% (30/95). Three of the HNSCC cell lines (3/8) studied had the KRAS-variant. No association between KRAS-variant status and p16 expression was observed in the oropharynx subset (Fisher's exact test, P = 1.0). With respect to patient outcome, patients with the KRAS-variant had poor progression-free survival when treated with cisplatin (log-rank P = 0.002). Conversely, KRAS-variant patients appeared to experience some improvement in disease control when cetuximab was added to their platinum-based regimen (log-rank P = 0.04). CONCLUSIONS The TG/GG rs61764370 KRAS-variant is a potential predictive biomarker for poor platinum response in R/M HNSCC patients. CLINICAL TRIAL REGISTRATION NUMBERS NCT00503997, NCT00425750, NCT00003809.
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Chang JH, Ji M, Hong HL, Choi SH, Kim YS, Chung CH, Sung H, Kim MN. Sternal Osteomyelitis Caused by Gordonia bronchialis after Open-Heart Surgery. Infect Chemother 2014; 46:110-4. [PMID: 25024874 PMCID: PMC4091373 DOI: 10.3947/ic.2014.46.2.110] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 09/03/2013] [Accepted: 09/03/2013] [Indexed: 11/27/2022] Open
Abstract
We report the case of a deep sternal wound infection with sternal osteomyelitis caused by Gordonia bronchialis after open-heart surgery. The isolate was identified as a G. bronchialis by 16S rRNA and hsp65 gene sequencing, having initially been misidentified as a Rhodococcus by a commercial phenotypic identification system.
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Nah HW, Lee JW, Chung CH, Choo SJ, Kwon SU, Kim JS, Warach S, Kim EG, Kang DW. Abstract 22: New Silent Brain Infarcts after Coronary Artery Bypass Graft Surgery: Lesion Patterns, Mechanism, and Predictors. Stroke 2014. [DOI: 10.1161/str.45.suppl_1.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives:
To investigate the lesion patterns and predictors of silent brain infarction after coronary artery bypass graft (CABG) surgery and propose a mechanism.
Background:
New brain infarcts after CABG are markedly more frequent than clinically evident stroke and are thought to be associated with postoperative cognitive decline. Thus, identification of the mechanism and risk factors of postoperative silent brain infarction may be clinically relevant.
Methods:
This was a prospective pre- and postoperative brain MRI study in consecutive patients who underwent isolated CABG. Preoperative MRI included diffusion-weighted imaging (DWI) and magnetic resonance angiography. DWI was repeated on postoperative day 3. Clinical variables, intraoperative findings, and laboratory findings were compared between patients with and without new brain infarcts on DWI.
Results:
Of a total of 127 included patients, 35 (27.6%) showed new brain infarcts on DWI. Most lesions were clinically silent, were located in the cortical territory (80%), were small (<1.5 cm) in diameter (89%), and were not related to the underlying cerebral arterial abnormality (80%) (Figure). Old age (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.03-1.15), use of cardiopulmonary bypass (OR, 3.12; 95% CI, 1.13-8.57), a moderate to severe aortic plaque (OR, 21.17; 95% CI, 2.01-222.58), and high levels of high-sensitivity C-reactive protein (OR, 1.35; 95% CI, 1.08-1.70) were independent predictors of new brain infarction.
Conclusions:
New brain infarcts on DWI after CABG are frequent and mostly silent. Aortogenic embolisms and a systemic inflammatory response may contribute to the pathogenesis of new brain infarcts.
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Yang JH, KIM JB, Jung SH, Choo SJ, Lee JW, Chung CH. Short term and intermediate results of hybrid procedure in high risk patients needing aortic arch repair. J Cardiothorac Surg 2013. [PMCID: PMC3844641 DOI: 10.1186/1749-8090-8-s1-o45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Rhee EJ, Lee WY, Min KW, Shivane VK, Sosale AR, Jang HC, Chung CH, Nam-Goong IS, Kim JA, Kim SW. Efficacy and safety of the dipeptidyl peptidase-4 inhibitor gemigliptin compared with sitagliptin added to ongoing metformin therapy in patients with type 2 diabetes inadequately controlled with metformin alone. Diabetes Obes Metab 2013; 15:523-30. [PMID: 23320436 DOI: 10.1111/dom.12060] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2012] [Revised: 12/21/2012] [Accepted: 12/21/2012] [Indexed: 11/28/2022]
Abstract
AIMS This study was designed to assess the efficacy and safety of a dipeptidyl peptidase-4 inhibitor, gemigliptin versus sitagliptin added to metformin in patients with type 2 diabetes. METHODS We conducted a double-blind, randomized, active-controlled trial in 425 Asian patients with inadequately controlled type 2 diabetes being treated with metformin alone. Eligible patients were randomized into three groups: 50 mg gemigliptin qd, 25 mg gemigliptin bid or sitagliptin 100 mg qd added to ongoing metformin treatment for 24 weeks. Haemoglobin A1c (HbA1c) and fasting plasma glucose (FPG) were measured periodically, and oral glucose tolerance tests were performed at baseline and 24 weeks after starting the treatment regimen. RESULTS Twenty-four weeks later, adding gemigliptin (50 mg/day) to ongoing metformin therapy significantly improved glycaemic control. Reduction in HbA1c caused by 50 mg gemigliptin qd (-0.77% ± 0.8) was non-inferior to that caused by 100 mg sitagliptin qd (-0.8% ± 0.85). Proportion of patients achieving HbA1c <7% while taking 25 mg gemigliptin bid (50%) or 50 mg gemigliptin qd (54.07%) was comparable to the results with 100 mg sitagliptin qd (48.87%). There were significant decreases in FPG, postprandial glucose and AUC0-2 h glucose, as well as increases in GLP-1 and β cell sensitivity to glucose (supported by homeostasis model assessment of β-cell function, postprandial 2-h c-peptide and insulinogenic index) in patients receiving gemigliptin treatment with their metformin therapy. There was no increased risk of adverse effects with this dose of gemigliptin compared with sitagliptin 100 mg qd. CONCLUSIONS Addition of gemigliptin 50 mg daily to metformin was shown to be efficacious, well tolerated and non-inferior to sitagliptin in patients with type 2 diabetes mellitus.
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Aguilar M, Alberti G, Alpat B, Alvino A, Ambrosi G, Andeen K, Anderhub H, Arruda L, Azzarello P, Bachlechner A, Barao F, Baret B, Barrau A, Barrin L, Bartoloni A, Basara L, Basili A, Batalha L, Bates J, Battiston R, Bazo J, Becker R, Becker U, Behlmann M, Beischer B, Berdugo J, Berges P, Bertucci B, Bigongiari G, Biland A, Bindi V, Bizzaglia S, Boella G, de Boer W, Bollweg K, Bolmont J, Borgia B, Borsini S, Boschini MJ, Boudoul G, Bourquin M, Brun P, Buénerd M, Burger J, Burger W, Cadoux F, Cai XD, Capell M, Casadei D, Casaus J, Cascioli V, Castellini G, Cernuda I, Cervelli F, Chae MJ, Chang YH, Chen AI, Chen CR, Chen H, Cheng GM, Chen HS, Cheng L, Chernoplyiokov N, Chikanian A, Choumilov E, Choutko V, Chung CH, Clark C, Clavero R, Coignet G, Commichau V, Consolandi C, Contin A, Corti C, Costado Dios MT, Coste B, Crespo D, Cui Z, Dai M, Delgado C, Della Torre S, Demirkoz B, Dennett P, Derome L, Di Falco S, Diao XH, Diago A, Djambazov L, Díaz C, von Doetinchem P, Du WJ, Dubois JM, Duperay R, Duranti M, D'Urso D, Egorov A, Eline A, Eppling FJ, Eronen T, van Es J, Esser H, Falvard A, Fiandrini E, Fiasson A, Finch E, Fisher P, Flood K, Foglio R, Fohey M, Fopp S, Fouque N, Galaktionov Y, Gallilee M, Gallin-Martel L, Gallucci G, García B, García J, García-López R, García-Tabares L, Gargiulo C, Gast H, Gebauer I, Gentile S, Gervasi M, Gillard W, Giovacchini F, Girard L, Goglov P, Gong J, Goy-Henningsen C, Grandi D, Graziani M, Grechko A, Gross A, Guerri I, de la Guía C, Guo KH, Habiby M, Haino S, Hauler F, He ZH, Heil M, Heilig J, Hermel R, Hofer H, Huang ZC, Hungerford W, Incagli M, Ionica M, Jacholkowska A, Jang WY, Jinchi H, Jongmanns M, Journet L, Jungermann L, Karpinski W, Kim GN, Kim KS, Kirn T, Kossakowski R, Koulemzine A, Kounina O, Kounine A, Koutsenko V, Krafczyk MS, Laudi E, Laurenti G, Lauritzen C, Lebedev A, Lee MW, Lee SC, Leluc C, León Vargas H, Lepareur V, Li JQ, Li Q, Li TX, Li W, Li ZH, Lipari P, Lin CH, Liu D, Liu H, Lomtadze T, Lu YS, Lucidi S, Lübelsmeyer K, Luo JZ, Lustermann W, Lv S, Madsen J, Majka R, Malinin A, Mañá C, Marín J, Martin T, Martínez G, Masciocchi F, Masi N, Maurin D, McInturff A, McIntyre P, Menchaca-Rocha A, Meng Q, Menichelli M, Mereu I, Millinger M, Mo DC, Molina M, Mott P, Mujunen A, Natale S, Nemeth P, Ni JQ, Nikonov N, Nozzoli F, Nunes P, Obermeier A, Oh S, Oliva A, Palmonari F, Palomares C, Paniccia M, Papi A, Park WH, Pauluzzi M, Pauss F, Pauw A, Pedreschi E, Pensotti S, Pereira R, Perrin E, Pessina G, Pierschel G, Pilo F, Piluso A, Pizzolotto C, Plyaskin V, Pochon J, Pohl M, Poireau V, Porter S, Pouxe J, Putze A, Quadrani L, Qi XN, Rancoita PG, Rapin D, Ren ZL, Ricol JS, Riihonen E, Rodríguez I, Roeser U, Rosier-Lees S, Rossi L, Rozhkov A, Rozza D, Sabellek A, Sagdeev R, Sandweiss J, Santos B, Saouter P, Sarchioni M, Schael S, Schinzel D, Schmanau M, Schwering G, Schulz von Dratzig A, Scolieri G, Seo ES, Shan BS, Shi JY, Shi YM, Siedenburg T, Siedling R, Son D, Spada F, Spinella F, Steuer M, Stiff K, Sun W, Sun WH, Sun XH, Tacconi M, Tang CP, Tang XW, Tang ZC, Tao L, Tassan-Viol J, Ting SCC, Ting SM, Titus C, Tomassetti N, Toral F, Torsti J, Tsai JR, Tutt JC, Ulbricht J, Urban T, Vagelli V, Valente E, Vannini C, Valtonen E, Vargas Trevino M, Vaurynovich S, Vecchi M, Vergain M, Verlaat B, Vescovi C, Vialle JP, Viertel G, Volpini G, Wang D, Wang NH, Wang QL, Wang RS, Wang X, Wang ZX, Wallraff W, Weng ZL, Willenbrock M, Wlochal M, Wu H, Wu KY, Wu ZS, Xiao WJ, Xie S, Xiong RQ, Xin GM, Xu NS, Xu W, Yan Q, Yang J, Yang M, Ye QH, Yi H, Yu YJ, Yu ZQ, Zeissler S, Zhang JG, Zhang Z, Zhang MM, Zheng ZM, Zhuang HL, Zhukov V, Zichichi A, Zuccon P, Zurbach C. First result from the Alpha Magnetic Spectrometer on the International Space Station: precision measurement of the positron fraction in primary cosmic rays of 0.5-350 GeV. PHYSICAL REVIEW LETTERS 2013; 110:141102. [PMID: 25166975 DOI: 10.1103/physrevlett.110.141102] [Citation(s) in RCA: 123] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Indexed: 06/03/2023]
Abstract
A precision measurement by the Alpha Magnetic Spectrometer on the International Space Station of the positron fraction in primary cosmic rays in the energy range from 0.5 to 350 GeV based on 6.8 × 10(6) positron and electron events is presented. The very accurate data show that the positron fraction is steadily increasing from 10 to ∼ 250 GeV, but, from 20 to 250 GeV, the slope decreases by an order of magnitude. The positron fraction spectrum shows no fine structure, and the positron to electron ratio shows no observable anisotropy. Together, these features show the existence of new physical phenomena.
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Jung JS, Chung CH, Lee SH, Cho SH, Lee JH, Ryu JG, Song H, Lee JW, Choo SJ. Flow characteristics of LIMA radial composite sequential bypass grafting and single LIMA and saphenous vein sequential bypass grafting performed under OPCAB. THE JOURNAL OF CARDIOVASCULAR SURGERY 2012; 53:537-544. [PMID: 22854531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIM The present study was aimed to compare the hemodynamic flow characteristics of LIMA radial artery composite sequential bypass grafting and with single LIMA and saphenous vein sequential bypass grafting performed by off-pump coronary artery bypass grafting (OPCAB). METHODS Between March 2007 and February 2008, 121 OPCAB patients were prospectively divided into two groups; Group I (N.=70, left internal thoracic artery [LITA]-left anterior descending [LAD] and Ao-SV sequential grafting), and Group II (N.=51, LITA-RA sequential grafting). The mean flow, pulsatility index (PI) and back flow (BF) were measured using the Transit-time flow meter (TTFM). In Group II, the proximal (p-LITA) and distal LITA (d-LITA) flow in relation to the RA side branch anastomosis were measured separately. RESULTS The mean flow and PI of the proximal SV sequential graft and that of the RA graft were 64.4 ± 37.3 mL/min and 2.6 ± 1.6 versus 27.3 ± 18.6 mL/min and 4.1 ± 4.4, respectively (P<0.05). In Group I, the mean LITA flow, PI, and BF were 26.9 ± 16.4 mL/min, 2.6 ± 1.5, and 3.1 ± 6.1% whereas in Group II those of the p-LITA were 37.3 ± 21.6 mL/min, 2.3 ± 1.0, and 2.0 ± 3.5% and the d-LITA were 18.8 ± 12.2 mL/min, 3.9 ± 3.3 and 7.4 ± 11.8% (P<0.01). CONCLUSION The results of the present data suggest the hemodynamic flow characteristics of composite bypass grafting to be inferior to the single LIMA and separate aorta-saphenous vein bypass grafting strategy. However, a longer follow up is warranted to assess the implications of these findings on graft durability.
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Kang DH, Kim YJ, Kim SH, Sun BJ, Kim DH, Yun SC, Song JM, Choo SJ, Chung CH, Song JK, Lee JW, Sohn DW. Early surgery versus conventional treatment for infective endocarditis. N Engl J Med 2012; 366:2466-73. [PMID: 22738096 DOI: 10.1056/nejmoa1112843] [Citation(s) in RCA: 557] [Impact Index Per Article: 46.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The timing and indications for surgical intervention to prevent systemic embolism in infective endocarditis remain controversial. We conducted a trial to compare clinical outcomes of early surgery and conventional treatment in patients with infective endocarditis. METHODS We randomly assigned patients with left-sided infective endocarditis, severe valve disease, and large vegetations to early surgery (37 patients) or conventional treatment (39). The primary end point was a composite of in-hospital death and embolic events that occurred within 6 weeks after randomization. RESULTS All the patients assigned to the early-surgery group underwent valve surgery within 48 hours after randomization, whereas 30 patients (77%) in the conventional-treatment group underwent surgery during the initial hospitalization (27 patients) or during follow-up (3). The primary end point occurred in 1 patient (3%) in the early-surgery group as compared with 9 (23%) in the conventional-treatment group (hazard ratio, 0.10; 95% confidence interval [CI], 0.01 to 0.82; P=0.03). There was no significant difference in all-cause mortality at 6 months in the early-surgery and conventional-treatment groups (3% and 5%, respectively; hazard ratio, 0.51; 95% CI, 0.05 to 5.66; P=0.59). The rate of the composite end point of death from any cause, embolic events, or recurrence of infective endocarditis at 6 months was 3% in the early-surgery group and 28% in the conventional-treatment group (hazard ratio, 0.08; 95% CI, 0.01 to 0.65; P=0.02). CONCLUSIONS As compared with conventional treatment, early surgery in patients with infective endocarditis and large vegetations significantly reduced the composite end point of death from any cause and embolic events by effectively decreasing the risk of systemic embolism. (EASE ClinicalTrials.gov number, NCT00750373.).
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Ko GTC, Yeung CY, Leung WYS, Chan KW, Chung CH, Fung LM, Ip TP, Kum G, Lau KP, Lau IT, Li JKY, Siu SC, Tsang MW, Yeung VTF, Tong PCY, So WY, Chan JCN. Cost implication of team-based structured versus usual care for type 2 diabetic patients with chronic renal disease. Hong Kong Med J 2011; 17 Suppl 6:9-12. [PMID: 22147352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
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Chung CH, Huang CC, Chiu HH, Huang CC, Chen JS. Endoscopic evolution of rectal stercoral ulcer presenting with a large bleeding pseudodiverticulum in a patient with chronic constipation. Endoscopy 2011; 43 Suppl 2 UCTN:E77-8. [PMID: 21425018 DOI: 10.1055/s-0030-1255572] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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Lee EJ, Choi KH, Ryu JS, Jeon SB, Lee SW, Park SW, Park SJ, Lee JW, Choo SJ, Chung CH, Jung SH, Kang DW, Kim JS, Kwon SU. Stroke risk after coronary artery bypass graft surgery and extent of cerebral artery atherosclerosis. J Am Coll Cardiol 2011; 57:1811-8. [PMID: 21527154 DOI: 10.1016/j.jacc.2010.12.026] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Revised: 12/08/2010] [Accepted: 12/15/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVES We aimed to define the relationship between cerebral atherosclerosis and stroke after coronary artery bypass grafting (CABG). BACKGROUND Although cerebral atherosclerosis may play a crucial role in the advent of post-CABG stroke, only extracranial carotid artery disease has been extensively studied, and the effects of atherosclerosis on the mechanisms underlying post-CABG stroke remain unclear. METHODS Pre-operative magnetic resonance angiography was performed on 1,367 consecutive CABG patients to assess intracranial and extracranial cerebral atherosclerosis. Disease severity was evaluated by atherosclerosis score, as determined by the number of steno-occlusions of cerebral arteries and the degree thereof. Post-CABG strokes (within 14 days) were classified as atherosclerotic (strokes attributable to pre-defined atherosclerosis) or other (strokes caused by other mechanisms). Associations between post-CABG stroke and each type of atherosclerotic disease (extracranial carotid artery disease, intracranial, extracranial, or extracranial and/or intracranial cerebral atherosclerosis), differentiated according to the involved arteries, were analyzed. RESULTS Stroke occurred in 33 patients, and the atherosclerosis score was independently associated with stroke development (odds ratio: 1.35; 95% confidence interval: 1.16 to 1.56). Atherosclerotic stroke was defined in 15 (45%), and constituted >40% of both immediate (within 24 h) and delayed strokes. Intracranial, extracranial, and extracranial and/or intracranial cerebral atherosclerosis were significantly associated with stroke. CONCLUSIONS Cerebral atherosclerosis was closely related to the occurrence of post-CABG stroke, being both an independent risk factor for and the cause of a significant proportion of strokes. Pre-operative evaluation of intracranial and extracranial cerebral arteries, apart from the extracranial carotid artery, may be useful to predict the likelihood of post-CABG stroke.
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Park SJ, Kim YH, Park DW, Yun SC, Ahn JM, Song HG, Lee JY, Kim WJ, Kang SJ, Lee SW, Lee CW, Park SW, Chung CH, Lee JW, Lim DS, Rha SW, Lee SG, Gwon HC, Kim HS, Chae IH, Jang Y, Jeong MH, Tahk SJ, Seung KB. Randomized trial of stents versus bypass surgery for left main coronary artery disease. N Engl J Med 2011; 364:1718-27. [PMID: 21463149 DOI: 10.1056/nejmoa1100452] [Citation(s) in RCA: 446] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Percutaneous coronary intervention (PCI) is increasingly used to treat unprotected left main coronary artery stenosis, although coronary-artery bypass grafting (CABG) has been considered to be the treatment of choice. METHODS We randomly assigned patients with unprotected left main coronary artery stenosis to undergo CABG (300 patients) or PCI with sirolimus-eluting stents (300 patients). Using a wide margin for noninferiority, we compared the groups with respect to the primary composite end point of major adverse cardiac or cerebrovascular events (death from any cause, myocardial infarction, stroke, or ischemia-driven target-vessel revascularization) at 1 year. Event rates at 2 years were also compared between the two groups. RESULTS The primary end point occurred in 26 patients assigned to PCI as compared with 20 patients assigned to CABG (cumulative event rate, 8.7% vs. 6.7%; absolute risk difference, 2.0 percentage points; 95% confidence interval [CI], -1.6 to 5.6; P=0.01 for noninferiority). By 2 years, the primary end point had occurred in 36 patients in the PCI group as compared with 24 in the CABG group (cumulative event rate, 12.2% vs. 8.1%; hazard ratio with PCI, 1.50; 95% CI, 0.90 to 2.52; P=0.12). The composite rate of death, myocardial infarction, or stroke at 2 years occurred in 13 and 14 patients in the two groups, respectively (cumulative event rate, 4.4% and 4.7%, respectively; hazard ratio, 0.92; 95% CI, 0.43 to 1.96; P=0.83). Ischemia-driven target-vessel revascularization occurred in 26 patients in the PCI group as compared with 12 patients in the CABG group (cumulative event rate, 9.0% vs. 4.2%; hazard ratio, 2.18; 95% CI, 1.10 to 4.32; P=0.02). CONCLUSIONS In this randomized trial involving patients with unprotected left main coronary artery stenosis, PCI with sirolimus-eluting stents was shown to be noninferior to CABG with respect to major adverse cardiac or cerebrovascular events. However, the noninferiority margin was wide, and the results cannot be considered clinically directive. (Funded by the Cardiovascular Research Foundation, Seoul, Korea, and others; PRECOMBAT ClinicalTrials.gov number, NCT00422968.).
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Cho WC, Yoo DG, Kim JB, Lee JW, Choo SJ, Jung SH, Chung CH. Aortic Valve Replacement for Aortic Stenosis and Concomitant Coronary Artery Bypass: Long-term Outcomes and Predictors of Mortality. THE KOREAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2011; 44:131-6. [PMID: 22263139 PMCID: PMC3249288 DOI: 10.5090/kjtcs.2011.44.2.131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Revised: 10/13/2010] [Accepted: 10/13/2010] [Indexed: 11/16/2022]
Abstract
Background We evaluated the surgical results and predictors of long-term survival in patients who underwent coronary artery bypass grafting (CABG) at the time of an aortic valve replacement (AVR) due to aortic stenosis. Materials and Methods Between January 1990 and December 2009, 183 consecutive patients underwent CABG and concomitant aortic valve replacement for aortic stenosis. The mean follow-up period was 59.8±3.3 months and follow-up was possible in 98.3% of cases. Predictors of mortality were determined by Cox regression analysis. Results There were 5 (2.7%) in-hospital deaths. Follow-up of the in-hospital survivors documented late survival rates of 91.5%, 74.8%, and 59.6% at 1, 5, and 10 postoperative years, respectively. Age (p<0.001), a glomerular filtration rate (GFR) less than 60 mL/min (p=0.006), and left ventricular (LV) mass (p<0.001) were significant predictors of mortality in the multivariate analysis. Conclusion The surgical results and long-term survival of aortic valve replacement with concomitant CABG in patients with aortic stenosis and coronary artery disease were acceptable. Age, a GFR less than 60 mL/min, and LV mass were significant predictors of mortality.
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Oh KH, Yang SW, Park JM, Seol JH, Iemura S, Natsume T, Murata S, Tanaka K, Jeon YJ, Chung CH. Control of AIF-mediated cell death by antagonistic functions of CHIP ubiquitin E3 ligase and USP2 deubiquitinating enzyme. Cell Death Differ 2011; 18:1326-36. [PMID: 21293491 DOI: 10.1038/cdd.2011.3] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Apoptosis inducing factor (AIF) is a mitochondrial oxidoreductase that scavenges reactive oxygen species under normal conditions. Under certain stresses, such as exposure to N-methyl-N'-nitro-N'-nitrosoguanidine (MNNG), AIF is truncated and released from the mitochondria and translocated into the nucleus, where the truncated AIF (tAIF) induces caspase-independent cell death. However, it is unknown how cells decide to kill themselves or operate ways to survive when they encounter stresses that induce the release of tAIF. Here, we demonstrated that USP2 and CHIP contribute to the control of tAIF stability. USP2 deubiquitinated and stabilized tAIF, thus promoting AIF-mediated cell death. In contrast, CHIP ubiquitinated and destabilized tAIF, thus preventing the cell death. Consistently, CHIP-deficient cells showed an increased sensitivity to MNNG. On the other hand, knockdown of USP2 attenuated MNNG-induced cell death. Moreover, exposure to MNNG caused a dramatic decrease in CHIP level, but not that of USP2, concurrent with cell shrinkage and chromatin condensation. These findings indicate that CHIP and USP2 show antagonistic functions in the control of AIF-mediated cell death, and implicate the role of the enzymes as a switch for cells to live or die under stresses that cause tAIF release.
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Park DW, Kim YH, Song HG, Ahn JM, Oh J, Kim WJ, Lee JY, Kang SJ, Lee SW, Lee CW, Park SW, Yun SC, Jung SH, Choo SJ, Chung CH, Lee JW, Park SJ. Long-Term Comparison of Drug-Eluting Stents and Coronary Artery Bypass Grafting for Multivessel Coronary Revascularization. J Am Coll Cardiol 2011; 57:128-37. [PMID: 21211683 DOI: 10.1016/j.jacc.2010.09.022] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2010] [Revised: 09/17/2010] [Accepted: 09/28/2010] [Indexed: 11/18/2022]
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Moon D, Lee JW, Kim YS, Cho WC, Jung SH, Choo SJ, Chung CH. Midterm Results of Aortic Valve Replacement Using Tissue Valve. THE KOREAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2010. [DOI: 10.5090/kjtcs.2010.43.6.627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Park DW, Kim YH, Yun SC, Lee JY, Kim WJ, Kang SJ, Lee SW, Lee CW, Kim JJ, Choo SJ, Chung CH, Lee JW, Park SW, Park SJ. Long-Term Outcomes After Stenting Versus Coronary Artery Bypass Grafting for Unprotected Left Main Coronary Artery Disease. J Am Coll Cardiol 2010; 56:1366-75. [PMID: 20946993 DOI: 10.1016/j.jacc.2010.03.097] [Citation(s) in RCA: 114] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2009] [Revised: 02/01/2010] [Accepted: 03/08/2010] [Indexed: 11/26/2022]
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Choi DK, Chin JH, Lee EH, Lim OB, Chung CH, Ro YJ, Choi IC. Prophylactic control of post-operative nausea and vomiting using ondansetron and ramosetron after cardiac surgery. Acta Anaesthesiol Scand 2010; 54:962-9. [PMID: 20626355 DOI: 10.1111/j.1399-6576.2010.02275.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the efficacy of ondansetron and ramosetron in the reduction of post-operative nausea and vomiting (PONV) associated with patient-controlled analgesia (PCA) after cardiac surgery. METHODS A total of 320 patients scheduled for elective cardiac surgery were enrolled. Patients were randomly assigned to one of four treatment regimens (n=80 in each group): no prophylactic antiemetics (group P); intravenous (i.v.) ondansetron 4 mg at the end of surgery and 12 mg added to PCA (group O); i.v. ramosetron 0.3 mg at the end of surgery and no antiemetics added to PCA (group R1); and i.v. ramosetron 0.3 mg at the end of surgery and 0.6 mg added to PCA (group R2). RESULTS The incidence of PONV during the 48-h post-operative period was lower in groups O (46%), R1 (54%), and R2 (35%) compared with group P (71%, P<0.001). The incidence and severity of nausea were lower in groups O, R1, and R2 than in group P during the 24-h post-operative period, whereas the incidence and severity of nausea during 24-48 h after surgery were lower in groups O and R2, but not in group R1, than in group P. Compared with group P (53%), the frequency of rescue antiemetic usage was significantly lower in groups O (34%) and R2 (29%), but not in group R1 (43%). CONCLUSION The addition of either ondansetron or ramosetron to PCA can reduce the incidence of PONV during 48 h after cardiac surgery.
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Chung CH. Breaking the Guinness World Record in Cardiopulmonary Resuscitation Training – Hong Kong, 24 January 2010. HONG KONG J EMERG ME 2010. [DOI: 10.1177/102490791001700301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Lim JY, Choo SJ, Chung CH, Jung CH, Lee JW, Lee CK, Choi KJ. Delayed ascending aortic pseudoaneurysm in an adult onset Still's disease patient with previous mitral valve and aortic root replacement. Thorac Cardiovasc Surg 2010; 58:243-4. [PMID: 20514585 DOI: 10.1055/s-0029-1240745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
A 59-year-old female patient with adult onset Still's disease (AOSD) presented with hemoptysis and pseudoaneurysm from an aortic root vent cannulation site that was created 4 years earlier for combined mitral and aortic valve surgery. The pseudoaneurysm was successfully repaired and the patient remained well during a follow-up period of 20 months.
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Chung CH, Siu AYC, Po LLK, Lam CY, Wong PCY. Comparing the effectiveness of video self-instruction versus traditional classroom instruction targeted at cardiopulmonary resuscitation skills for laypersons: a prospective randomised controlled trial. Hong Kong Med J 2010; 16:165-170. [PMID: 20519751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
OBJECTIVE To determine whether in the local lay Hong Kong population, video self-instruction about cardiopulmonary resuscitation has comparable results to traditional classroom instructions. DESIGN Prospective randomised single-blind controlled trial. SETTING A first-aid training organisation in Hong Kong. PARTICIPANTS Cantonese applicants for cardiopulmonary resuscitation courses aged between 18 and 70 years were recruited into the study. They were randomised into two groups. Those selected for self-learning were given a kit (consisting of a mini-manikin, a video compact disc, and an instruction manual) and sent home. The other group underwent usual classroom training. Both groups were examined together; the examiners remained blinded to the background training of the subjects. Those who passed were asked to come back for re-examination after 1 year. MAIN OUTCOME MEASURES The examination passing rates initially and after 1 year. RESULTS During a 1-year period between 1 April 2007 to 31 March 2008, 256 subjects were recruited into this study, 124 for self-learning and 132 for classroom training. The age range was 18 to 62 (mean, 39; standard deviation, 10) years. There was no significant difference in passing rate between the two groups at the initial examination or at the re-examination after 1 year. Notably, 28 (23%) of the participants of the self-learning group taught cardiopulmonary resuscitation to relatives and friends. CONCLUSION Video self-learning resulted in cardiopulmonary resuscitation performance as good as traditional classroom training.
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Kim HW, Chung CH. Hemodynamic Instability due to Adrenal Insufficiency after Open Heart Surgery. THE KOREAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2010. [DOI: 10.5090/kjtcs.2010.43.2.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Oh SJ, Koh SH, Chung CH. Wide thumb and the first web reconstruction using a neurovascularised instep free flap. J Plast Reconstr Aesthet Surg 2010; 63:1565-8. [PMID: 20308027 DOI: 10.1016/j.bjps.2010.02.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2009] [Revised: 02/11/2010] [Accepted: 02/12/2010] [Indexed: 10/19/2022]
Abstract
Deformed hands result in palmar defects of the thumb. The sensate instep free flap can be used for wide palmar coverage of the thumb. Three hands with palmar defects of the thumb extended to the first web space underwent soft-tissue reconstruction using a neurovascular instep free flap. These flaps provided sensate coverage with static two-point discrimination values of 8-15 mm. Key pinch strengths of reconstructed thumbs were nearly half of those on the normal side. Donor foot morbidity was minimal with no hyperkeratosis. The neurovascular instep free flap supplies sensate, similar pliable and tough glabrous skin to the palmar surface of the thumb extended to the first web area.
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Chung CH, Man CY. The Thrombolysis Era: From Heart Attack to Brain Attack. HONG KONG J EMERG ME 2010. [DOI: 10.1177/102490791001700101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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139
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Jeon SB, Lee JW, Kim SJ, Chung CH, Kwon SU, Choi CG, Choo SJ, Nah HW, Kim JS, Kang DW. New Cerebral Lesions on T2*-Weighted Gradient-Echo Imaging after Cardiac Valve Surgery. Cerebrovasc Dis 2010; 30:194-9. [DOI: 10.1159/000317108] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2009] [Accepted: 04/16/2010] [Indexed: 11/19/2022] Open
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140
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Chung CH, Aulino J, Muldowney NJ, Hatakeyama H, Baumann J, Burkey B, Netterville J, Sinard R, Yarbrough WG, Cmelak AJ, Slebos RJ, Shyr Y, Parker J, Gilbert J, Murphy BA. Nuclear factor-kappa B pathway and response in a phase II trial of bortezomib and docetaxel in patients with recurrent and/or metastatic head and neck squamous cell carcinoma. Ann Oncol 2009; 21:864-870. [PMID: 19850643 DOI: 10.1093/annonc/mdp390] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Our previous study has shown that nuclear factor-kappa B (NF-kappaB)-signaling pathway was associated with a higher rate of recurrence in head and neck squamous cell carcinoma (HNSCC). The combination of bortezomib, an NF-kappaB inhibitor by inhibition of proteasomes, plus docetaxel was assessed for efficacy and toxicity. MATERIALS AND METHODS Patients with recurrent and/or metastatic HNSCC were enrolled on a phase II bortezomib/docetaxel trial (bortezomib 1.6 mg/m(2) and docetaxel 40 mg/m(2) on days 1 and 8 of a 21-day cycle). Response was assessed using RECIST. Tissue specimens were evaluated for the presence of human papillomavirus (HPV) and expression of NF-kappaB-associated genes. RESULTS Twenty-one of 25 enrolled patients were assessable for response; one partial response (PR, 5%), 10 stable disease (SD, 48%) and 10 progressive disease (PD, 48%). Patients with PR/SD had significantly longer survival compared with patients with PD and the regimen was well tolerated. Only one of 20 tumors was positive for HPV. Patients with PD had higher expression of NF-kappaB and epidermal growth factor receptor-associated genes in their tumors by gene expression analysis. CONCLUSION Further understanding of treatment resistance and interactions between bortezomib and docetaxel may provide novel approaches in managing HNSCC.
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141
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Song H, Kim MJ, Chung CH, Choo SJ, Song MG, Song JM, Kang DH, Lee JW, Song JK. Factors associated with development of late significant tricuspid regurgitation after successful left-sided valve surgery. Heart 2009; 95:931-6. [PMID: 19321491 DOI: 10.1136/hrt.2008.152793] [Citation(s) in RCA: 116] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Persistent significant tricuspid regurgitation (TR) after successful left-sided valve surgery is frequently reported. OBJECTIVES To evaluate the incidence, risk factors and clinical impact of development of late significant TR after successful left-sided valve surgery. METHODS AND RESULTS 638 patients (356 men, mean age 52 (SD 14) years) who had mild (<or=grade 2/4) TR and underwent successful surgery without any procedure for TR were analysed. Development of significant TR was defined as a TR increase by more than one grade and final TR grade >or=3/4 at follow-up echocardiography. Clinical events were defined as cardiovascular death, repeated open-heart surgery, and congestive heart failure requiring hospital admission. The overall incidence of late significant TR was 7.7% (49/638). Age (hazard ratio (HR), 1.0, 95% CI, 1.0 to 1.1; p = 0.005), female gender (HR, 5.0; 95% CI 2.0 to 12.7; p = 0.001), rheumatic aetiology (HR, 3.8; 95% CI 1.4 to 10.3; p = 0.011), atrial fibrillation (Af) (HR, 2.6; 95% CI 1.1 to 6.4; p = 0.035) and peak pressure gradient of TR at follow-up (HR, 1.1; 95% CI 1.0 to 1.1; p<0.001) were independent factors associated with development of late significant TR. During clinical follow-up of 101 (24) months, patients who developed late significant TR showed a significantly lower 8-year clinical event-free survival rate (76 (6) vs 91 (1)%, p<0.001). CONCLUSIONS Several clinical variables were independent risk factors for development of late significant TR. Early surgical intervention for TR in selected patients with these risk factors may be justified, even though they have only mild TR.
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Lee MY, Koh SB, Koh JH, Nam SM, Shin JY, Shin YG, Kong ID, Ryu SY, Lee TY, Park JK, Chung CH. Relationship between gamma-glutamyltransferase and metabolic syndrome in a Korean population. Diabet Med 2008; 25:469-75. [PMID: 18346161 DOI: 10.1111/j.1464-5491.2008.02415.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS To investigate associations between gamma-glutamyltransferase (GGT) and components of metabolic syndrome (MS), insulin resistance and inflammatory markers in the Korean population. METHODS The 3508 subjects enrolled in this survey participated in the Korean Rural Genomic Cohort (KRGC) study. Written consent was obtained from the local ethical committee. Of these participants, 1437 were men (mean age 56.9 +/- 7.9 years) and 2071 were women (mean age 55.8 +/- 8.1 years). We measured GGT levels and various biochemical markers. To examine insulin resistance status, we used the homeostasis assessment method for insulin resistance (HOMA-IR). For inflammatory marker, we used C-reactive protein (CRP) levels. RESULTS Serum GGT levels were significantly higher in the MS group compared to the healthy patient group [23 (5-1403) vs. 19 (5-1920) IU/l; P = 0.01]. The prevalence of MS and adjusted relative risk were both significantly increased from the lowest to highest GGT quartiles; these results persisted after adjustments for multiple confounders. Positive correlations were established between GGT and HOMA-IR or CRP. CONCLUSION These results suggest that GGT levels may be a surrogate marker of insulin resistance, inflammation and MS.
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143
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Chung CH, Freiberger A, Kalkum M, Luntz SP, Shakur H, Seiler CM. CRASH2 in Germany [ISRCTN86750102]. Trials 2006; 7:22. [PMID: 16790038 PMCID: PMC1552086 DOI: 10.1186/1745-6215-7-22] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2006] [Accepted: 06/21/2006] [Indexed: 11/10/2022] Open
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144
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Chung CH, Szeto YK, Lai KK. 'Fracture' of the penis: a case series. Hong Kong Med J 2006; 12:197-200. [PMID: 16760547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
OBJECTIVES To examine the epidemiology of penile 'fracture' and its presenting characteristics in the local population. DESIGN Retrospective study. SETTING District hospital, Hong Kong. PATIENTS Patients with a discharge diagnosis of 'fractured' penis during a 7-year period from August 1998 to August 2005. MAIN OUTCOME MEASURES Age, time of attendance, cause, symptoms, signs, emergency department diagnosis, site of rupture, operative findings, and final outcome. RESULTS A total of 11 patients were identified. The mean age was 44 years (range, 30-63 years). The interval between time of injury and presentation ranged from 17 minutes to 7 days. Seven (64%) cases were attributed to sexual intercourse, three (27%) to penile manipulation, and one (9%) to rolling over the erect penis during sleep. Ten patients underwent surgery; all had primary suturing of the tunica tear, while two also required primary urethral repair. At follow-up, three (27%) patients had erectile dysfunction, one had mild penile deformity and one had a mild urethral stricture. CONCLUSION Emergency physicians and surgeons, as well as family physicians, should be familiar with the presentation of 'fractured' penis, as prompt diagnosis and early surgical repair are instrumental in ensuring a successful outcome with minimal complications. The public should also be educated to seek medical attention immediately, as delay or failure to report may result in permanent physical and psychological disabilities that could otherwise have been avoided.
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Thitaram SN, Chung CH, Day DF, Hinton A, Bailey JS, Siragusa GR. Isomaltooligosaccharide increases cecal Bifidobacterium population in young broiler chickens. Poult Sci 2005; 84:998-1003. [PMID: 16050115 DOI: 10.1093/ps/84.7.998] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A newly developed compound derived by fermentation, isomaltooligosaccharide (IMO), was hypothesized to enrich cecal bifidobacterial populations and reduce colonization levels of Salmonella in the ceca of broiler chickens. Broiler starter diets were prepared with final IMO concentrations of 1% (wt/wt), 2% (wt/wt), and 4% (wt/wt) and a control diet without IMO supplementation. Chickens were divided into 4 groups and challenged with 10(8) cell of Salmonlella enterica ser. Typhimurium with 200 microg/mL nalidixic acid resistant (S. Typhimurium Nalr) after 7 d of placement. The experiment was done in 3 replications. IMO-supplemented diets resulted in significantly higher cecal bifidobacteria compared with the control diet (P < 0.05). However, there was no significant difference in bifidobacteria counts among the treatment groups. Chickens fed diets with 1% IMO had a significant 2-log reduction in the level of inoculated S. Typhimurium Nalr (P < 0.05) present in, the ceca compared with the control group, but no differences were found between the control group and the groups fed 2 or 4% IMO for S. Typhimurium Nalr. No differences in feed consumption, feed conversion, or feed efficiency compared with the control group were observed; however, the result showed a significant reduction in weight for birds fed 1% IMO diet compared with those fed the control diet.
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146
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Chung CH, Wang CH, Tzen CY, Liu CP. Intrahepatic cholestasis as a paraneoplastic syndrome associated with pheochromocytoma. J Endocrinol Invest 2005; 28:175-9. [PMID: 15887866 DOI: 10.1007/bf03345363] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Pheochromocytoma is a rare tumor of chromaffin cells that secrete catecholamines and several cytokines. The clinical manifestations are protean and may include hypertension, weight loss, sweating, palpitation, headache, anxiety, tremor, nausea, vomiting, and hypercalcemia. The tumor can mimic many unrelated diseases, leading to significant delay and difficulty in diagnosis. We report a case of a 37-yr-old male admitted with jaundice, dark urine, fever, and signs of a systemic inflammatory response. Abdominal computed tomography revealed a heterogeneously enhancing tumor between the pancreatic tail and left kidney. There was no evidence of obstruction to bile flow, neoplastic involvement of the liver or bile ducts, or infectious etiology. The tumor was removed and found to be a pheochromocytoma. Immunohistochemical analysis revealed the presence of interleukin-1beta in the tumor cells. After surgery, the jaundice resolved without further treatment, leading us to the conclusion that it was a paraneoplastic phenomenon possibly related to interleukin-1beta production. We suggest that occult pheochromocytoma should be added to the differential diagnosis of unexplained intrahepatic cholestasis.
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147
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Chung CH, Day DF. Efficacy of Leuconostoc mesenteroides (ATCC 13146) isomaltooligosaccharides as a poultry prebiotic. Poult Sci 2004; 83:1302-6. [PMID: 15339004 DOI: 10.1093/ps/83.8.1302] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The complex dietary carbohydrates, called prebiotics, have been used to control Salmonella and improve intestinal bacterial balance in broilers. Leuconostoc mesenteroides (ATCC 13146) isomaltooligosaccharides (IMO) stimulate growth of Bifidobacterium and Lactobacillus and are not used by Salmonella or Escherichia coli. We tested the efficacy of these IMO as a prebiotic. IMO, compared with fructooligosaccharides (FOS) as sole carbon source, promoted growth of chicken cecal isolates and Bifidobacterium. Cecal isolates and Salmonella typhimurium grown in mixed culture on IMO reduced the Salmonella population. Cecal isolates grown on IMO showed higher viable counts and faster growth than Salmonella, indicating a potential value for these oligomers for poultry intestinal microflora modification.
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Yang S, Lee DS, Chung CH, Cheong MY, Lee CJ, Jung MW. Long-term synaptic plasticity in deep layer-originated associational projections to superficial layers of rat entorhinal cortex. Neuroscience 2004; 127:805-12. [PMID: 15312893 DOI: 10.1016/j.neuroscience.2004.06.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2004] [Indexed: 10/26/2022]
Abstract
Superficial layers of the entorhinal cortex (EC) relay the majority of cortical input projections to the hippocampus, whereas deep layers of the EC mediate a large portion of hippocampal output projections back to other cortical areas, suggesting a functional segregation between superficial and deep layers of the EC as input and output structures of the hippocampus, respectively. However, deep layers of the EC send associational projections to superficial layers, suggesting a potential interaction between neocortical input and hippocampus-processed output in superficial layers. This possibility was investigated by examining whether deep to superficial EC projections support long-term synaptic plasticity, and whether they interact with other pathways in superficial layers in rat medial EC slice preparations. Synaptic responses of the deep-to-superficial layer projections were verified based on field potential profiles, paired-pulse facilitation, physical separation between superficial and deep layers, and pharmacological manipulation. Long-term potentiation (LTP) was reliably induced in the deep-to-superficial layer projections by burst stimulations that emulated theta or sharp wave electroencephalogram (EEG),and it was blocked by an N-methyl-d-aspartate receptor antagonist (D-2-amino-5-phosphonopentanoic acid) and a calcium channel blocker (nifedipine). Prolonged low frequency stimulation induced long-term depression. A weak stimulation of deep layers, which induced a small degree of LTP by itself, generated a much larger degree of LTP when paired with a strong stimulation of superficial layers, indicating that the deep-to-superficial layer projections cooperate with other pathways in the superficial EC to enhance synaptic weights. Our results suggest that neocortical input and hippocampal output information are integrated in superficial layers of the EC.
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Cheung CP, Chiu HS, Chung CH. Small bowel perforation after radiotherapy for cervical carcinoma. Hong Kong Med J 2003; 9:461-3. [PMID: 14660815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
Radiotherapy is the treatment of choice for carcinoma of the uterine cervix. We report on a 62-year-old Chinese woman with cervical carcinoma, in whom a small bowel perforation developed 5 months after radiotherapy. Ten centimetres of small bowel, including the perforation site, were resected. No bowel adhesion was detected during the operation. The postoperative course was uneventful, and the patient was discharged home 7 days after surgery. Histological examination confirmed post-irradiation injury. The presenting complaints of patients with bowel perforation following radiotherapy vary, and signs of peritonitis may be absent. Emergency physicians must be alert for these complications in patients who have been treated with radiotherapy.
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150
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Chung CH. Subtle perforation of the oesophagus by a foreign body. Hong Kong Med J 2003; 9:290-2. [PMID: 12904618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
A case of subtle oesophageal perforation caused by a foreign body is described. A 48-year-old woman had had a chicken bone impacted in the upper oesophagus for 4 days. At presentation, the bone was dislodged at endoscopy, and two small round depressions at opposite sides of the oesophageal wall were visible. The chest X-ray findings were normal. Computed tomography of the thorax detected a small amount of air in the mediastinum. The water-soluble contrast swallow test showed no evidence of leakage. The patient was successfully treated using conservative measures.
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