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Chung CH, Tung WK. Providing Emergency Medical Assistance in the Vicinity of the Hospital. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490790901600201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Siu AYC, Chung CH. The Use of Ultrasonography to Assess Patients with Right Lower Quadrant Pain in the Emergency Department. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490790701400202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Acute appendicitis is always a clinical challenge to emergency physicians. Clinical examination or blood tests are notoriously unreliable in making the diagnosis, especially in the early phase of the disease. Computed tomogram can facilitate the diagnosis, however it is usually not easily accessible to emergency physicians. Bedside ultrasonography is now frequently used by emergency physicians in various situations for the assessment of patients. This study aimed at exploring the potential use of bedside ultrasonography in the diagnosis of acute appendicitis in patients presenting with right lower quadrant abdominal pain.
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Chiu HS, Chan KF, Chung CH, Ma K, Au KW. A Comparison of Emergency Department Admission Diagnoses and Discharge Diagnoses: Retrospective Study. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490790301000202] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective To study the accuracy of emergency department admission diagnosis and the effect of investigations on diagnostic accuracy. Design Retrospective study in a two-month period. Setting Accident & Emergency Department of a public general hospital, which had four in-patient specialties – Medicine, Surgery, Paediatrics and Orthopaedics. Subjects All cases admitted through the emergency department in the study period. Main outcome measures Degree of correlation between emergency department admission diagnosis and hospital discharge diagnosis. Results Of all admission diagnoses, 71.4% fully or partially matched the final discharge diagnoses. The accuracy of diagnosis was statistically better in traumatic cases, the male sex and young adults. Diagnostic accuracy varied with the specialty involved and investigations taken. Conclusion History and physical examination remained the most important diagnostic tools in the emergency department. In general, simple investigations available at the emergency department were not helpful in improving diagnostic accuracy.
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Chung CH. Closed Reduction Techniques for Acute Anterior Shoulder Dislocation: from Egyptians to Australians. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490790401100309] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Acute anterior shoulder dislocation is a common presentation to emergency departments. A standard technique for reduction does not exist. Most dislocations can be reduced by one or more simple manoeuvres involving traction-countertraction, leverage and/or pulsion. The better-known methods are discussed, highlighting the manoeuvres, virtues and drawbacks.
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Cheng CC, Chung CH. A 6-Year Epidemiological Study of Pulmonary Embolism in an Emergency Department. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490790501200403] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective To identify the epidemiology and early clinical features of patients with pulmonary embolism with a view to facilitate making the correct diagnosis. Methodology A retrospective study of patients admitted through the emergency department with a discharge diagnosis of pulmonary embolism in the computerised Clinical Management System from 1st January 1999 to 31st December 2004 in a public emergency general hospital in Hong Kong. Results Twenty-two patients were newly diagnosed to have pulmonary embolism and included in the study. The patients' clinical features and investigation findings were analysed. Old age and immobilisation were the most common risk factors identified. Nine patients were found to have deep vein thrombosis but none of them complained of calf pain during consultation in the emergency department. Most patients had symptoms of shortness of breath and chest pain on presentation. Fourteen patients had type 1 respiratory failure. The electrocardiogram and chest X-ray findings were non-specific. All the patients with D-dimer done showed positive results. CT scans were used in all patients to make the final diagnosis. Nineteen patients received low molecular weight heparin followed by warfarin and three patients had thrombolytic therapy. Conclusion Pulmonary embolism is not a commonly diagnosed disease in Hong Kong. The symptoms are non-specific and it is difficult to make the correct diagnosis in the emergency department.
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Chung CH. Window of the Soul. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490790801500401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Siu AYC, Kwok SL, Chung CH, Lai KK. A Rare Cause of Necrotizing Fasciitis: Psoas Abscess. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490790501200409] [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] Open
Abstract
Necrotizing fasciitis always carries very high mortality and morbidity rates. It can be due to group A beta-haemolytic streptococci, which are traditionally described as the flesh-eating bacteria. More commonly, it is related to a mixed growth of bacteria that can be secondary to trauma or surgery. Secondary necrotizing fasciitis due to concomitant soft tissue infection is uncommon. We reported a fatal case of necrotizing fasciitis which was caused by a coexisting psoas abscess. A search for concomitant soft tissue infection is warranted in patients presenting with necrotizing fasciitis. This article also reviewed the clinical tools that may help to make an early diagnosis of the disease.
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Chung CH. Beware of the Anticoagulated Elderly with Minor Head Injury. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490790501200202] [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] Open
Abstract
A 69-year-old man first presented to the emergency department after a fall. He had no history of loss of consciousness or vomiting. He sustained a 3 cm long laceration over the right occipital region of the head. There was no fracture in the X-rays of the skull. He was on warfarin because of cardiac problem. He was discharged after suturing. He re-attended the next morning because of left sided weakness. Non-contrast brain computed tomogram showed acute subdural haematoma. Burr holes were performed subsequently. Special precautions should be undertaken in managing the elderly with minor head injury, with a lower threshold for computed tomography and coagulation profile studies.
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Chung CH, Lai KK. Beware of the Migrating Chest Pain and Widened Mediastinum: Case Series on Aortic Dissection. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490790200900206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective Aortic dissection is not a rare life-threatening emergency. Undiagnosed and untreated aortic dissection is associated with a high mortality. A review of cases in the hospital may provide a baseline picture to guide clinical decisions. Design Retrospective case review for a period of 3 years and 4 months. Setting District general hospital near the Hong Kong – Shenzhen ‘border’ with 24-hour Accident & Emergency service but without cardiothoracic surgical capability. Population All cases coded as ‘aortic dissection’ in the computerized ‘Clinical Management System’ of the hospital. Main outcome measures Date, sex, age, history of hypertension, presenting symptoms, pulse deficit, chest X-ray findings, pericardial effusion, A&E diagnosis, type of dissection and patient outcome. Results From August 1998 to November 2001, 26 cases of aortic dissection were identified. There were 19 males and 7 females. Age range was 26 to 90 years (mean 65.04 ± SD 15.04, median 66.50, mode 65). In the plain chest X-rays, widened superior mediastinum (>8 cm) was present in 19 patients (73.1%) and pleural effusion in three (11.5%). Pericardial effusion was found in six patients (23.1%). As regard to outcome, 11 were discharged home (42.3%), 14 were transferred to cardiothoracic surgical unit (where two subsequently died) and one died in the hospital. Conclusion The prevalence of aortic dissection may be more common than is generally appreciated by emergency physicians. Owing to its variable clinical presentations mimicking other diseases, the diagnosis of aortic dissection is easily missed. Higher clinical vigilance should be exercised for this potentially deadly condition.
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Abstract
Objectives To study the characteristics and nature of injuries relating to horse riding in the local setting and to compare the findings with those reported in the medical literature. Methods A prospective survey of patients with horse-related injuries attending the accident and emergency department of a public district hospital in Hong Kong within the year 2002. The data were analysed and compared with previous studies. Results Fifty-five patients were collected in the study. The mean age was 32.7 years. Forty-four (80.0%) of them were riders and 11 (20.0%) were non-riders. Thirteen (23.6%) were grooms. Fifteen patients (27.3%) were admitted and seven (46.7%) of those admitted required operations. There was no fatality. Thirty-nine patients (70.9%) suffered from single injury while the rest (29.1%) had multiple injuries. Most injuries (60.0%) were minor but fractures or dislocations occurred in 16 patients (29.1%). Isolated head and facial injuries occurred in 14.5% of patients. Most were simple concussion. Thirteen patients (23.6%) suffered from isolated upper limb injuries, with more than half sustaining fractures or dislocations. Falling from horse (60.0%) was the most frequent mechanism of injury. Among the non-riding patients, 72.7% were kicked or trodden by horse. There was no association between rider's status, previous riding or injury experiences, or the presence of supervision at the time of riding with the rate of admission. Conclusion Horse riding and working with horses can be an occupation or recreation with potential dangers. In our study, characteristics of patients, mechanisms and types of injuries were similar to other western studies. However, professional riders and those with more riding experiences were not exempted from severe injuries requiring admission. Moreover, previous injury experiences and the presence of supervision did not help reduce the admission rate either. Perhaps, as suggested by other studies, the quality of horsemanship and supervision appeared to be more important to reduce accidents. Further proper large scale controlled epidemiological studies will definitely help to improve the understanding of horse-related injuries.
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Abstract
Psoas abscess is an uncommon clinical entity. It can be a primary infection with no obvious source of infection or a secondary infection from other sites, e.g. gastrointestinal tract or spinal pathology. The triads of presentation: fever, loin pain and limitation of hip movement may not be found in all patients. The correct diagnosis can be made with a vigilant clinical examination and appropriate investigation, for example ultrasonography. We present two cases of psoas abscess. One was a primary case and the other was secondary to carcinoma of caecum. Both of them presented with recent onset of back pain. Emergency physicians consider psoas abscess as one of the differential diagnosis for patient complaining of low back pain.
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Lau KH, Ng CP, Chung CH. Carotid-Cavernous Fistula: An Uncommon and Easily Missed Complication of Head Trauma. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490790501200211] [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] Open
Abstract
A 57-year-old woman attended the emergency department complaining of protrusion of the right eyeball for three days. The history revealed that she had head injury in a road traffic accident about five weeks ago. The accident had caused a fracture of the right angle of the mandible that was fixed internally by the maxillo-facial surgeon. Subsequent angiogram showed a right direct carotid-cavernous fistula. Endovascular therapy was successful in obliterating the fistula. She recovered well. Although carotid-cavernous fistula is an uncommon complication of head injury, emergency physicians should be aware of this condition because of its potential mortality and morbidity.
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Siu AYC, Chung CH. A Case Series of Using Aspiration Catheter for the Management of Spontaneous Pneumothorax. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490790301000405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction Catheter aspiration is a relatively new treatment for spontaneous pneumothorax in emergency departments in Hong Kong. It causes less pain and shortens hospitalisation. However, there is limited local experience especially in regard to the target group that can be benefited. We reported on the initial experience of catheter aspiration in the management of spontaneous pneumothorax in our emergency department. Method Patients (age >=16 years) presenting with spontaneous pneumothorax were recruited. Patients with history of asthma or chronic obstructive airway disease were excluded. History of smoking, previous pneumothorax and pleurodesis were recorded. The aspiration catheter was inserted by the Seldinger technique. The extent of pneumothorax was assessed from the chest X-ray and initial aspirated volume. Successful patients were observed in the department and discharged if chest X-rays were reassuring after 12 hours. Factors associated with the outcome of patients were analysed. Result Seventeen patients were recruited from October 1999 to September 2000. Their age ranged from 16 to 40 years (mean 22.6). The overwhelming majority (16) was male. Twelve cases (70.6%) occurred on the left side. Five patients had previous pneumothorax and one had previous pleurodesis. Fifteen succeeded in immediate re-expansion, but seven re-collapsed during observation. The overall success rate was 47.1%. Initial aspiration volume >2,000 ml was associated with early failure (p=0.01). Conclusion Our initial experience did not support catheter aspiration to completely replace chest drain in the initial management of spontaneous pneumothorax. The procedure is likely to fail if the initial aspirated volume is greater than 2,000 ml. Further study is needed to identify the subgroup that may be benefited.
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Ho MK, Chung CH. A Prospective, Randomised Clinical Trial Comparing Oral Diclofenac Potassium and Intramuscular Diclofenac Sodium in Acute Pain Relief. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490790401100202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Objectives To compare the efficacy of oral (PO) diclofenac potassium (Cataflam®) and intramuscular (IM) diclofenac sodium (Voltaren®) in acute pain relief, with a hypothesis of equivalence between the two. Patients and methods In this prospective randomised single center clinical study, adult Chinese patients attending the emergency department and suffering from renal colic, acute musculoskeletal injury or arthritis were enrolled. They were randomly assigned either 75 mg of IM Voltaren® or 75 mg of PO Cataflam®. Pain was assessed by the Visual Analogue Scale (VAS) and evaluations were performed at baseline, 30 minutes, 1 hour and 2 hours after treatment. Blood pressure, pulse rate and respiratory rate were also recorded at similar time intervals. Results We recruited 46 cases in the Voltaren® group and 45 cases in the Cataflam® group. Both treatment groups showed statistically highly significant reduction (P<0.0001) in pain VAS, systolic blood pressure and pulse rate compared with the baseline. Voltaren® was statistically more effective in pain relief at 30 minutes (P=0.012) and 1 hour (P=0.010) but not at 2 hours (P=0.311) compared with Cataflam®. The changes in blood pressure, pulse rate and respiratory rate were not statistically significant between the two treatment groups at all time points. Conclusion IM Voltaren® was more effective in acute pain relief compared with PO Cataflam®.
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Kim HM, Lee BR, Lee ES, Kwon MH, Huh JH, Kwon BE, Park EK, Chang SY, Kweon MN, Kim PH, Ko HJ, Chung CH. iNKT cells prevent obesity-induced hepatic steatosis in mice in a C-C chemokine receptor 7-dependent manner. Int J Obes (Lond) 2017; 42:270-279. [PMID: 28811651 PMCID: PMC5803573 DOI: 10.1038/ijo.2017.200] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 06/19/2017] [Accepted: 07/21/2017] [Indexed: 02/08/2023]
Abstract
Non-alcoholic fatty liver disease and non-alcoholic steatohepatitis are characterized by an increase in hepatic triglyceride content with infiltration of immune cells, which can cause steatohepatitis and hepatic insulin resistance. C-C chemokine receptor 7 (CCR7) is primarily expressed in immune cells, and CCR7 deficiency leads to the development of multi-organ autoimmunity, chronic renal disease and autoimmune diabetes. Here, we investigated the effect of CCR7 on hepatic steatosis in a mouse model and its underlying mechanism. Our results demonstrated that body and liver weights were higher in the CCR7−/− mice than in the wild-type (WT) mice when they were fed a high-fat diet. Further, glucose tolerance and insulin sensitivity were markedly diminished in CCR7−/− mice. The number of invariant natural killer T (iNKT) cells was reduced in the livers of the CCR7−/− mice. Moreover, liver inflammation was detected in obese CCR7−/− mice, which was ameliorated by the adoptive transfer of hepatic mononuclear cells from WT mice, but not through the transfer of hepatic mononuclear cells from CD1d−/− or interleukin-10-deficient (IL-10−/−) mice. Overall, these results suggest that CCR7+ mononuclear cells in the liver could regulate obesity-induced hepatic steatosis via induction of IL-10-expressing iNKT cells.
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Aguilar M, Ali Cavasonza L, Ambrosi G, Arruda L, Attig N, Aupetit S, Azzarello P, Bachlechner A, Barao F, Barrau A, Barrin L, Bartoloni A, Basara L, Başeğmez-du Pree S, Battarbee M, Battiston R, Becker U, Behlmann M, Beischer B, Berdugo J, Bertucci B, Bindel KF, 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, 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, Creus W, Crispoltoni M, Cui Z, Dai YM, Delgado C, Della Torre S, Demakov O, 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, Guo KH, 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 Y, Li ZH, Li ZY, Lim S, Lin CH, Lipari P, Lippert T, Liu D, Liu H, Lordello VD, Lu SQ, Lu YS, Luebelsmeyer K, Luo F, Luo JZ, Lv SS, Machate F, Majka R, Mañá C, Marín J, Martin T, Martínez G, Masi N, Maurin D, Menchaca-Rocha A, Meng Q, Mikuni VM, Mo DC, Morescalchi L, Mott P, Nelson T, Ni JQ, Nikonov N, Nozzoli F, 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, 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, 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. Precision Measurement of the Boron to Carbon Flux Ratio in Cosmic Rays from 1.9 GV to 2.6 TV with the Alpha Magnetic Spectrometer on the International Space Station. PHYSICAL REVIEW LETTERS 2016; 117:231102. [PMID: 27982618 DOI: 10.1103/physrevlett.117.231102] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Indexed: 06/06/2023]
Abstract
Knowledge of the rigidity dependence of the boron to carbon flux ratio (B/C) is important in understanding the propagation of cosmic rays. The precise measurement of the B/C ratio from 1.9 GV to 2.6 TV, based on 2.3 million boron and 8.3 million carbon nuclei collected by AMS during the first 5 years of operation, is presented. The detailed variation with rigidity of the B/C spectral index is reported for the first time. The B/C ratio does not show any significant structures in contrast to many cosmic ray models that require such structures at high rigidities. Remarkably, above 65 GV, the B/C ratio is well described by a single power law R^{Δ} with index Δ=-0.333±0.014(fit)±0.005(syst), in good agreement with the Kolmogorov theory of turbulence which predicts Δ=-1/3 asymptotically.
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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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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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95
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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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97
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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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98
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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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