151
|
Kim HJ, Kim JB. Commentary: Gastroepiploic Artery for Completing Total-Arterial Revascularization? Semin Thorac Cardiovasc Surg 2021; 34:100-101. [PMID: 33662557 DOI: 10.1053/j.semtcvs.2021.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 02/16/2021] [Indexed: 11/11/2022]
|
152
|
Kim HJ, Kim HJ, Kim JB, Jung SH, Choo SJ, Chung CH, Lee JW. Prosthesis-patient mismatch after surgical aortic valve replacement in patients with aortic stenosis. Interact Cardiovasc Thorac Surg 2021; 31:152-157. [PMID: 32594112 DOI: 10.1093/icvts/ivaa085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 03/10/2020] [Accepted: 03/11/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES The issue of prosthesis-patient mismatch (PPM) after surgical aortic valve replacement (SAVR) has been a controversial topic. We sought to evaluate the long-term clinical impacts of PPM in patients undergoing SAVR in an updated, homogeneous cohort. METHODS Using the prospective institutional database, we identified 895 adult patients (median age 66, interquartile range 58-72; 45.6% women) who underwent isolated SAVR from January 2000 to March 2016. Those with pure aortic insufficiency and concomitant other cardiac operations were excluded from this study cohort. The presence of a significant PPM was defined as an indexed effective orifice area 0.85 cm2/m2 or less. The outcome of interest was all-cause deaths. Propensity score matching was performed for adjusting bias. RESULTS Significant PPM was present in 247 patients (27.6%). During the follow-up period (mean 71.2 ± 51.04 months), 134 patients (15%) died. Survival rates at 10 and 15 years were 78.3% vs 83.8% and 71.3% vs 57.6% in the PPM and non-PPM groups (P = 0.972). Risk factor analysis indicated that developing PPM was not associated with a risk of death. After propensity score matching (1:1), developing PPM was not a risk factor for long-term death as well (P = 0.584). CONCLUSIONS Significant PPM was common after SAVR in patients with aortic stenosis. However, there was no significant difference in survival rate between those with and without PPM.
Collapse
|
153
|
Kim SH, Jang H, Park NY, Kim Y, Kim SY, Lee MY, Hyun JW, Kim HJ. Discontinuation of Immunosuppressive Therapy in Patients With Neuromyelitis Optica Spectrum Disorder With Aquaporin-4 Antibodies. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2021; 8:8/2/e947. [PMID: 33622675 PMCID: PMC7903808 DOI: 10.1212/nxi.0000000000000947] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 11/12/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate the outcomes of immunosuppressive therapy (IST) discontinuation in patients with neuromyelitis optica spectrum disorder (NMOSD) after a sustained remission period. METHODS We retrospectively reviewed the medical records of 17 patients with antiaquaporin-4 antibody-positive NMOSD who discontinued IST after a relapse-free period of ≥3 years. RESULTS IST was discontinued at a median age of 40 years (interquartile range [IQR], 32-51) after a median relapse-free period of 62 months (IQR, 52-73). Among the 17 enrolled patients, 14 (82%) relapsed at a median interval of 6 months (IQR, 4-34) after IST discontinuation, 3 (18%) of whom experienced severe attacks; notably, all 3 of these patients had a history of severe attack before IST. These 3 patients received steroids, followed by plasma exchange for acute treatment, but 2 exhibited poor recovery and significant disability worsening at 6 months after relapse. CONCLUSIONS IST discontinuation may increase the risk of relapse in seropositive patients with NMOSD even after 5 years of remission. Given the potentially devastating consequence of a single attack of NMOSD, caution is advised with IST discontinuation, particularly in patients with severe attack before IST.
Collapse
|
154
|
Kim HJ, Nakashima I, Viswanathan S, Wang KC, Shang S, Miller L, Yountz M, Wingerchuk DM, Pittock SJ, Levy M, Berthele A, Totolyan N, Palace J, Barnett MH, Fujihara K. Eculizumab in Asian patients with anti-aquaporin-IgG-positive neuromyelitis optica spectrum disorder: A subgroup analysis from the randomized phase 3 PREVENT trial and its open-label extension. Mult Scler Relat Disord 2021; 50:102849. [PMID: 33676197 DOI: 10.1016/j.msard.2021.102849] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/04/2021] [Accepted: 02/17/2021] [Indexed: 11/19/2022]
Abstract
Background Eculizumab, a terminal complement inhibitor, significantly reduced the risk of relapse compared with placebo in patients with anti-aquaporin-4 immunoglobulin G-positive (AQP4+) neuromyelitis optica spectrum disorder (NMOSD) in the PREVENT trial. We report efficacy and safety analyses in Asian patients in PREVENT and its open-label extension (OLE). Methods PREVENT was a double-blind, randomized, phase 3 trial. Patients with AQP4+ NMOSD were randomly assigned (2:1) to receive intravenous eculizumab (maintenance dose, 1200 mg/2 weeks) or placebo. Patients who completed PREVENT could receive eculizumab in an OLE. Analyses were performed in a prespecified subgroup of Asian patients. Results Of 143 patients enrolled, 52 (36.4%) were included in the Asian subgroup (eculizumab, n = 37; placebo, n = 15); 45 Asian patients received eculizumab in the OLE. Most Asian patients (86.5%) received concomitant immunosuppressive therapy. During PREVENT, one adjudicated relapse occurred in patients receiving eculizumab and six occurred in patients receiving placebo in the Asian subgroup (hazard ratio, 0.05; 95% confidence interval: 0.01-0.35; p = 0.0002). An estimated 95.2% of Asian patients remained relapse-free after 144 weeks of eculizumab treatment. Upper respiratory tract infections, headache, and nasopharyngitis were the most common adverse events with eculizumab in the Asian subgroup. Conclusion Eculizumab reduces the risk of relapse in Asian patients with AQP4+ NMOSD, with a benefit-risk profile similar to the overall PREVENT population. The benefits of eculizumab were maintained during long-term therapy. Clinical trial registration ClinicalTrials.gov identifiers: NCT01892345 (PREVENT); NCT02003144 (open-label extension).
Collapse
|
155
|
Han SC, Kim J, Han MC, Chang KH, Park K, Kim HJ, Kim DW, Kim JS. Monitoring beam-quality constancy considering uncertainties associated with ionization chambers in Daily QA3 device. PLoS One 2021; 16:e0246845. [PMID: 33596210 PMCID: PMC7888663 DOI: 10.1371/journal.pone.0246845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/26/2021] [Indexed: 11/21/2022] Open
Abstract
This study evaluates the changes occurring in the X-ray energy of a linear accelerator (LINAC) using a Daily QA3 detector system. This is accomplished by comparing the Daily QA3 results against those obtained using a water phantom. The X-energy levels of a LINAC were monitored over a duration of 1 month using the Daily QA3 system. Moreover, to account for the uncertainty, the reproducibility of the Daily QA3 ionization-chamber results was assessed by performing repeated measurements (12 per day). Subsequently, the energy-monitoring results were compared with the energy-change results calculated using the water-phantom percentage depth dose (PDD) ratio. As observed, the 6- and 10-MV beams experienced average daily energy-level changes of (-0.30 ± 0.32)% and (0.05 ± 0.38)%, respectively, during repeated measurements. The corresponding energy changes equaled (-0.30 ± 0.55)% and (-0.05 ± 0.48)%, respectively, when considering the measurement uncertainty. The Daily QA3 measurements performed at 6 MV demonstrated a variation of (2.15 ± 0.81)% (i.e., up to 3%). Meanwhile, the corresponding measurements performed using a water phantom demonstrated an increase in the PDD ratio from 0.577 to 0.580 (i.e., approximately 0.5%). At 10 MV, the energy variation in the Daily QA3 measurements equaled (-0.41 ± 0.82)% (i.e., within 1.5%), whereas the corresponding water phantom PDD ratio remained constant at 0.626. These results reveal that the Daily QA3 system can be used to monitor small energy changes occurring within radiotherapy machines. This demonstrates its potential for use as a secondary system for monitoring energy changes as part of the daily quality-assurance workflow.
Collapse
|
156
|
Cree BAC, Bennett JL, Kim HJ, Weinshenker BG, Pittock SJ, Wingerchuk D, Fujihara K, Paul F, Cutter GR, Marignier R, Green AJ, Aktas O, Hartung HP, Williams IM, Drappa J, She D, Cimbora D, Rees W, Ratchford JN, Katz E. Sensitivity analysis of the primary endpoint from the N-MOmentum study of inebilizumab in NMOSD. Mult Scler 2021; 27:2052-2061. [PMID: 33538237 PMCID: PMC8564264 DOI: 10.1177/1352458521988926] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background: In the N-MOmentum trial, the risk of an adjudicated neuromyelitis optica
spectrum disorder (NMOSD) attack was significantly reduced with inebilizumab
compared with placebo. Objective: To demonstrate the robustness of this finding, using pre-specified
sensitivity and subgroup analyses. Methods: N-MOmentum is a prospective, randomized, placebo-controlled, double-masked
trial of inebilizumab, an anti-CD19 monoclonal B-cell-depleting antibody, in
patients with NMOSD. Pre-planned and post hoc analyses were
performed to evaluate the primary endpoint across a range of attack
definitions and demographic groups, as well as key secondary endpoints. Results: In the N-MOmentum trial (ClinicalTrials.gov: NCT02200770), 174 participants
received inebilizumab and 56 received placebo. Attack risk for inebilizumab
versus placebo was consistently and significantly reduced, regardless of
attack definition, type of attack, baseline disability, ethnicity, treatment
history, or disease course (all with hazard ratios < 0.4 favoring
inebilizumab, p < 0.05). Analyses of secondary endpoints
showed similar trends. Conclusion: N-MOmentum demonstrated that inebilizumab provides a robust reduction in the
risk of NMOSD attacks regardless of attack evaluation method, attack type,
patient demographics, or previous therapy. The N-MOmentum study is registered at ClinicalTrials.gov: NCT2200770.
Collapse
|
157
|
Hyun JW, Shin HS, Kim SH, Kong SY, Yoo H, Gwak HS, Kim HJ. CYFRA 21-1 levels in cerebrospinal fluid as a putative therapeutic monitoring biomarker for patients with leptomeningeal carcinomatosis: A pilot study. Cancer Biomark 2021; 28:81-89. [PMID: 32176621 DOI: 10.3233/cbm-190187] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND To investigate the feasibility of cerebrospinal fluid (CSF) CYFRA 21-1 levels as a therapeutic monitoring biomarker in leptomeningeal carcinomatosis (LMC) patients undergoing ventriculo-lumbar perfusion (VLP) chemotherapy. METHODS The levels of CYFRA 21-1 in 42 CSF samples from 15 LMC patients were analyzed using an electrochemiluminescence immunoassay. Samples were collected at individual time points during VLP chemotherapy. Therapeutic outcomes were measured as improvements in the Karnofsky Performance Status (KPS) score and decreasing intracranial pressure (ICP) as the main endpoint of VLP chemotherapy. Changes in CSF CYFRA 21-1 levels, protein levels, and cytology results were also investigated. We subsequently evaluated whether these changes were correlated with KPS score and ICP. RESULTS The CSF CYFRA 21-1 levels at individual time points were associated with KPS score and ICP. The KPS scores (p= 0.007) and ICP (p= 0.018) of patients with high CSF CYFRA 21-1 levels were significantly different from those of patients with low CSF CYFRA 21-1 levels. By contrast, CSF protein levels and cytological responses were not significantly associated with KPS scores and ICP. CONCLUSIONS CSF CYFRA 21-1 may have utility as a therapeutic monitoring biomarker to design personalized therapeutic strategies in LMC patients undergoing VLP chemotherapy.
Collapse
|
158
|
Messina S, Mariano R, Geraldes R, Kim SH, Satukijcha C, Vecchio D, Chua YY, Taylor J, George N, Cavey A, Diaz AR, Reeve S, Everett R, De Luca G, Leite MI, Kim HJ, Palace J. The influence of smoking on the pattern of disability and relapse risk in AQP4-positive Neuromyelitis Optica Spectrum Disorder, MOG-Ab Disease and Multiple Sclerosis. Mult Scler Relat Disord 2021; 49:102773. [PMID: 33540279 DOI: 10.1016/j.msard.2021.102773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 01/06/2021] [Accepted: 01/14/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND the role of smoking on clinical outcomes of central nervous system (CNS) inflammatory disorders is unclear. To assess the effect of smoking on relapses and disability in neuromyelitis optica with aquaporin-4-antibodies (NMOSD-AQP4-Ab), Myelin Oligodendrocyte Glycoprotein-antibodies associated disease (MOGAD) and relapsing remitting Multiple Sclerosis (MS) patients. METHODS in a UK cohort of 101 NMOSD-AQP4-Ab, 70 MOGAD and 159 MS, and a Korean cohort of 97 NMOSD-AQ4-Ab, time to first relapse, annualised relapse rate, onset relapse severity and recovery, time to Expanded Disability Status Score(EDSS)/secondary progressive MS (SPMS) were compared between never-smokers and ever-smokers. All clinical data were collected under the local ethics between January 2017 and January 2019. RESULTS Smoking did not affect the risk of relapse in any of the diseases. The risk of reaching EDSS 6.0 in the UK NMOSD-AQP4-Ab cohort was higher in ever smokers but this did not achieve significance (HR 2.12, p=0.068). When combining the UK and Korea NMOSD-AQP4-Ab cohorts, poorer recovery from the onset attack was significantly more frequent in the ever-smokers versus the never smokers (55% vs 38%, p=0.04). In the MS cohort the risk of reaching EDSS 6 and SPMS was significantly higher in the ever-smokers (HR=2.67, p=0.01 and HR=3.18, p=0.001). In MOGAD similar patterns were seen without reaching significance. CONCLUSIONS In NMOSD-AQP4-Ab smoking associates with worse disability not through an increased risk of relapses but through poor relapse recovery. As in MS, smoking cessation should be encouraged in NMOSD-AQP4-Ab.
Collapse
|
159
|
Yoon YH, Ko Y, Kim KW, Kang DY, Ahn JM, Ko E, Park H, Cho SC, Kim HJ, Kim JB, Choo SJ, Lee SA, Kim DH, Park DW, Park SJ. Prognostic Value of Baseline Sarcopenia on 1-year Mortality in Patients Undergoing Transcatheter Aortic Valve Implantation. Am J Cardiol 2021; 139:79-86. [PMID: 33164764 DOI: 10.1016/j.amjcard.2020.10.039] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 01/01/2023]
Abstract
There is limited data regarding the association between sarcopenia and clinical outcomes in patients who underwent transcatheter aortic valve implantation (TAVI). From the prospective ASAN-TAVI registry, we evaluated a total of 522 patients with severe aortic stenosis who underwent TAVI between March 2010 and November 2018. Routine pre-TAVI computed tomography scan was used to calculate the skeletal muscle index (SMI), which was defined as skeletal muscle area at the L3 level divided by height squared; subject patients were classified into the gender-specific tertile groups of SMI. The patients' mean age was 79 years and 49% were men. Mean SMI values were 41.3 ± 6.7 cm2/m2 in men and 34.1 ± 6.5 cm2/m2 in women. The Kaplan-Meier estimates of all-cause mortality at 12 months were higher in the low-tertile group than in the mid- and high-tertile groups (15.5%, 7.1%, and 6.2%, respectively; p = 0.036). In multivariate analysis, low-tertile of SMI was an independent predictor of mortality (vs high-tertile of SMI, hazard ratio 2.69; 95% confidence interval, 1.18 to 6.12; p = 0.019). The all-cause mortality was substantially higher in the groups with high-surgical risk plus low SMI tertile. The risk assessment with addition of SMI on conventional STS-PROM score was significantly improved by statistical measures of model reclassification and discrimination. In patients who underwent TAVI, sarcopenia measured by SMI was significantly associated with an increased risk of 1-year mortality. The prognostic impact of SMI-measured sarcopenia was more prominent in patients with high surgical risks.
Collapse
|
160
|
Kwon Y, Park SJ, Kim HJ, Kim JB, Jung SH, Choo SJ, Lee JW. OUP accepted manuscript. Interact Cardiovasc Thorac Surg 2021; 34:354-360. [PMID: 35188960 PMCID: PMC8860419 DOI: 10.1093/icvts/ivab309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 09/14/2021] [Accepted: 10/06/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Right mini-thoracotomy approach may enhance the visualization of mitral valve (MV) visualization during redo MV surgery, thereby minimizing the risk of reoperative median sternotomy. We described the clinical outcomes of redo MV surgery by mini-thoracotomy and full-sternotomy approach. METHODS Of 730 consecutive adult patients who underwent redo MV surgery between 2002 and 2018 at our institution, we identified 380 patients (age: 56.0 [14.8] years) after excluding those who underwent concomitant aortic valve or coronary artery surgeries. RESULTS The clinical outcomes in patients who underwent mini-thoracotomy (MINI group; n = 168) and full-sternotomy (STERN group; n = 218) were described. The early and overall mortality in the MINI group was 4.3% (7/162) and 17.3% (28/162), with the rates of early major complications as follows: low cardiac output syndrome, 5.6% (9/162); early stroke, 6.8% (11/162); new-onset dialysis, 6.2% (10/162); prolonged ventilation, 15.4% (25/162); and postoperative bleeding requiring exploration, 7.4% (12/162). In the STERN group, the early mortality was 11.0% (24/218), whereas the risk of low cardiac output syndrome, early stroke, new-onset dialysis, prolonged ventilation, and postoperative bleeding was 12.4% (27/218), 14.2% (31/218), 17.0% (37/218), 33.0% (72/218), and 10.1% (22/218), respectively. The duration of intensive care unit and hospital stay was 2.0 [range 1.0, 3.0] and 8.0 [6.0, 13.0], respectively, in the MINI group and 3.0 [2.0, 7.0] and 14.0 [8.0, 29.0], respectively, in the STERN group. CONCLUSIONS Mini-thoracotomy may be a viable alternative to conventional sternotomy for redo MV surgery.
Collapse
|
161
|
Lee JE, Jang SH, Hur SH, Bang HY, Bae IK, Kim HJ. LC-MS/MS and GC-MS/MS cross-checking analysis method for 247 pesticide residues in sweet pepper ( Capsicum annuum). INTERNATIONAL JOURNAL OF FOOD PROPERTIES 2021. [DOI: 10.1080/10942912.2021.1993251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
162
|
Pyo WK, Kim HJ, Kim JB, Jung SH, Choo SJ, Chung CH, Lee JW. Comparative Surgical Outcomes of Prosthetic and Native Valve Endocarditis. Korean Circ J 2021; 51:504-514. [PMID: 34085423 PMCID: PMC8176072 DOI: 10.4070/kcj.2020.0448] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/15/2020] [Accepted: 01/12/2021] [Indexed: 01/18/2023] Open
Abstract
In the present study, the patterns and clinical outcomes of prosthetic valve endocarditis (PVE) surgery were analyzed as compared with native valve endocarditis (NVE). The proportion of PVE among surgical infective endocarditis increased gradually through the study period. Patients with PVE was characterized by old age and more extensive infective lesions. PVE group showed notably higher early and overall mortality, and valve reinfection as well. PVE carried significant perioperative risks, and was an independent risk factor of overall mortality. Background and Objectives As a consequence of a growing number of patients undergoing prosthetic heart valve replacement, the incidence of prosthetic valve endocarditis (PVE) has increased. The study aims to analyze patterns and outcomes of PVE surgery as compared with native valve endocarditis (NVE). Methods We enrolled 269 patients (aged 58.0±15.7 years) who underwent valve surgery for infective endocarditis (IE) between 2013 and 2019. Of these, 56 had PVE whereas remainder (n=213) had NVE. Clinical outcomes were compared and multivariable analyses were conducted to determine risk factors for mortality. Results The proportion of PVE among surgical IE gradually increased from 15.4% (11/71) in the first time-quartile to 29.5% (18/61) in the last time-quartile (p=0.055). PVE patients were older, and more commonly had aorto-mitral curtain involvement and abscess formation than NVE group. Early mortality was 14.3% and 6.1% in PVE and NVE group, respectively (p=0.049). Postoperatively, PVE group had higher incidences of low cardiac output syndrome (p=0.027), new-onset dialysis (p=0.006) and reoperation for bleeding (p=0.004) compared to NVE group, but stroke rates were comparable (p=0.503). During follow-up (648.8 patient-years), PVE group showed significantly higher risks of overall mortality (p<0.001), valve reinfection (p<0.001) and permanent pacemaker implantation (p<0.001) than NVE group. On multivariable analysis, PVE (hazard ratio, 2.67; 95% confidence interval, 1.40–5.07; p=0.003) along with age, chronic kidney disease, multi-valve involvement, and causative organisms of Staphylococcus aureus or fungus were independent risk factors of overall mortality. Conclusions PVE carried significant perioperative risks, and was an independent risk factor of overall mortality.
Collapse
|
163
|
Ryu SW, Jeon BB, Kim HJ, Kim JB, Jung SH, Choo SJ, Chung CH, Lee JW. Surgical Outcomes of Malignant Primary Cardiac Tumor: A 20-Year Study at a Single Center. THE KOREAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2020; 53:361-367. [PMID: 33115972 PMCID: PMC7721522 DOI: 10.5090/kjtcs.20.061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 09/14/2020] [Accepted: 09/19/2020] [Indexed: 11/17/2022]
Abstract
Background Malignant primary cardiac tumors are extremely rare, but have a poor prognosis. This study evaluated the surgical outcomes of patients with this disease. Methods Forty patients who underwent surgery for malignant primary cardiac tumors between January 1998 and December 2018 were enrolled. Participants were divided into 3 groups based on resection margins (R0, 14 patients; R1, 11 patients; and R2, 11 patients) and their surgical outcomes were compared. Heart transplantation was performed in 4 patients with unresectable tumors. Results Early mortality was reported in 2 cases (5%) due to postoperative bleeding and cerebral hemorrhage secondary to brain metastasis. The 1- and 2-year survival rates were 67.5% and 42.5%, respectively. The median survival time of the patients was 20.3 months (range, 9.2–37.6 months). The median survival time was 48.7, 20.3, and 4.8 months in patients with R0, R1, and R2 resections, respectively (p=0.023). Tumor recurrence occurred in 21 patients (61.7%), including 4 cases of local recurrence and 17 cases of distant metastasis. In patients who underwent heart transplantation, the median survival time was 29.5 months, with 3 cases of distant metastasis. Conclusion Although surgery for malignant primary cardiac tumors has a poor prognosis, complete resection of the tumor may improve surgical outcomes.
Collapse
|
164
|
Lee JO, Lee CH, Kim HJ, Kim JB, Jung SH, Joo SJ, Chung CH, Lee JW. Simple Interrupted Suturing for Aortic Valve Replacement in Patients with Severe Aortic Stenosis. THE KOREAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2020; 53:332-338. [PMID: 33115976 PMCID: PMC7721519 DOI: 10.5090/kjtcs.20.066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/24/2020] [Accepted: 09/09/2020] [Indexed: 11/16/2022]
Abstract
Background Attaining an adequate effective orifice area (EOA) is definitive goal in aortic valve replacement (AVR). The simple interrupted suture (SIS) technique could be a solution to achieve this goal, but limited data are available in the literature. This study aimed to compare hemodynamic differences between the SIS and non-everting mattress suture (NMS) techniques. Methods From our database, 215 patients who underwent AVR for severe aortic stenosis were extracted to form the overall cohort. From March 2015 to November 2016, the SIS technique was used in 79 patients, while the NMS technique was used in 136 patients. Hemodynamic outcomes were evaluated, as detected by transthoracic echocardiography and computed tomography. Results There were no significant differences in baseline characteristics between the 2 groups. On immediate postoperative echocardiography, the SIS group showed a significantly wider EOA (1.6±0.4 vs. 1.4±0.5 cm2, p=0.007) and a lower mean pressure gradient (PG) (13.3±5.4 vs. 17.0±6.0 mm Hg, p<0.001) than the NMS group. On follow-up echocardiography, the SIS group continued to have a wider EOA (1.6±0.4 vs. 1.4±0.3 cm2, p<0.001) and a lower mean PG (11.0±5.1 vs. 14.1±5.5 mm Hg, p<0.001). There was no significant difference in paravalvular leakage. Conclusion The SIS technique for AVR was associated with a wider EOA and a lower mean PG. The SIS technique could be a reasonable option for AVR.
Collapse
|
165
|
Kim HJ, Kim JB, Kim SO, Yun SC, Lee S, Lim C, Choi JW, Hwang HY, Kim KH, Lee SH, Yoo JS, Sung K, Je HG, Hong SC, Kim YJ, Kim SH, Chang BC. A Risk Prediction Model for Operative Mortality after Heart Valve Surgery in a Korean Cohort. THE KOREAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2020. [DOI: 10.5090/kjtcs.20.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
166
|
Yoon H, Kim HJ, Shin HR, Kim BS, Kim WJ, Cho YD, Ryoo HM. Nicotinamide Improves Delayed Tooth Eruption in Runx2+/- Mice. J Dent Res 2020; 100:423-431. [PMID: 33143523 DOI: 10.1177/0022034520970471] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Patients with cleidocranial dysplasia (CCD) caused by mutations in RUNX2 have severe dental anomalies, including delayed or absent eruption of permanent teeth. This requires painful and expensive surgical/orthodontic intervention because of the absence of medicine for this condition. Here, we demonstrate that nicotinamide, a vitamin B3 and class III histone deacetylase inhibitor, significantly improves delayed tooth eruption in Runx2+/- mice, a well-known CCD animal model, through the restoration of decreased osteoclastogenesis. We also found that Csf1 mRNA and protein levels were significantly reduced in Runx2+/- osteoblasts as compared with wild type whereas RANKL and OPG levels had no significant difference between wild type and Runx2+/- osteoblasts. The nicotinamide-induced restoration of osteoclastogenesis of bone marrow-derived macrophages in Runx2+/- mice was due to the increased expression of RUNX2 and CSF1 and increased RANKL/OPG ratio. RUNX2 directly regulated Csf1 mRNA expression via binding to the promoter region of the Csf1 gene. In addition, nicotinamide enhanced the RUNX2 protein level and transacting activity posttranslationally with Sirt2 inhibition. Taken together, our study shows the potential and underlying molecular mechanism of nicotinamide for the treatment of delayed tooth eruption by using the Runx2+/- murine model, suggesting nicotinamide as a candidate therapeutic drug for dental abnormalities in patients with CCD.
Collapse
|
167
|
Park SJ, Oh JK, Kim SO, Lee SA, Kim HJ, Lee S, Jung SH, Song JM, Choo SJ, Kang DH, Chung CH, Song JK, Lee JW, Kim DH, Kim JB. Determinants of clinical outcomes of surgery for isolated severe tricuspid regurgitation. Heart 2020; 107:403-410. [PMID: 33139325 DOI: 10.1136/heartjnl-2020-317715] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/29/2020] [Accepted: 10/03/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Although the incidence of patients with isolated tricuspid regurgitation (TR) is increasing, data regarding the clinical outcomes of isolated TR surgery are limited. This study sought to investigate the prognostic implications according to procedural types, and to identify preoperative predictors of clinical outcomes after isolated TR surgery. METHODS Among consecutive 2610 patients receiving tricuspid valve (TV) procedure, we analysed 238 patients (age, 59.6 years; 143 females) who underwent stand-alone TV surgery (repair, 132; replacement, 106) for severe TR. Primary outcome was the composite of all-cause mortality and heart transplantation. Clinical outcomes between the repair and the replacement groups were compared after adjusting with the inverse probability of treatment weighting (IPTW) method. RESULTS During follow-up (median, 4.1 years), 53 patients died and 4 received heart transplantation. Multivariable analysis revealed that age (p=0.001), haemoglobin level (p=0.003), total bilirubin (p=0.040), TR jet area (p=0.005) and right atrial (RA) pressure (p=0.022) were independent predictors of the primary outcome. After IPTW adjustment, there were no significant intergroup differences in the risk of primary outcome (HR 1.01; 95% CI 0.55 to 1.87). In the subgroup analysis, tricuspid annular diameter was identified as a significant effect modifier (p=0.012) in the comparison between repair versus replacement, showing a trend favouring replacement in patients with annular diameter >44 mm. CONCLUSIONS The outcomes of stand-alone severe TR surgery were independently associated with the severity of TR and RA pressure. In selected patients with severe annular dilation >44 mm, replacement may become a feasible option.
Collapse
|
168
|
Specovius S, Zimmermann HG, Oertel FC, Chien C, Bereuter C, Cook LJ, Lana Peixoto MA, Fontenelle MA, Kim HJ, Hyun JW, Jung SK, Palace J, Roca-Fernandez A, Diaz AR, Leite MI, Sharma SM, Ashtari F, Kafieh R, Dehghani A, Pourazizi M, Pandit L, Dcunha A, Aktas O, Ringelstein M, Albrecht P, May E, Tongco C, Leocani L, Pisa M, Radaelli M, Martinez-Lapiscina EH, Stiebel-Kalish H, Hellmann M, Lotan I, Siritho S, de Seze J, Senger T, Havla J, Marignier R, Tilikete C, Cobo Calvo A, Bichuetti DB, Tavares IM, Asgari N, Soelberg K, Altintas A, Yildirim R, Tanriverdi U, Jacob A, Huda S, Rimler Z, Reid A, Mao-Draayer Y, de Castillo IS, Yeaman MR, Smith TJ, Brandt AU, Paul F. Cohort profile: a collaborative multicentre study of retinal optical coherence tomography in 539 patients with neuromyelitis optica spectrum disorders (CROCTINO). BMJ Open 2020; 10:e035397. [PMID: 33122310 PMCID: PMC7597491 DOI: 10.1136/bmjopen-2019-035397] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Optical coherence tomography (OCT) captures retinal damage in neuromyelitis optica spectrum disorders (NMOSD). Previous studies investigating OCT in NMOSD have been limited by the rareness and heterogeneity of the disease. The goal of this study was to establish an image repository platform, which will facilitate neuroimaging studies in NMOSD. Here we summarise the profile of the Collaborative OCT in NMOSD repository as the initial effort in establishing this platform. This repository should prove invaluable for studies using OCT to investigate NMOSD. PARTICIPANTS The current cohort includes data from 539 patients with NMOSD and 114 healthy controls. These were collected at 22 participating centres from North and South America, Asia and Europe. The dataset consists of demographic details, diagnosis, antibody status, clinical disability, visual function, history of optic neuritis and other NMOSD defining attacks, and OCT source data from three different OCT devices. FINDINGS TO DATE The cohort informs similar demographic and clinical characteristics as those of previously published NMOSD cohorts. The image repository platform and centre network continue to be available for future prospective neuroimaging studies in NMOSD. For the conduct of the study, we have refined OCT image quality criteria and developed a cross-device intraretinal segmentation pipeline. FUTURE PLANS We are pursuing several scientific projects based on the repository, such as analysing retinal layer thickness measurements, in this cohort in an attempt to identify differences between distinct disease phenotypes, demographics and ethnicities. The dataset will be available for further projects to interested, qualified parties, such as those using specialised image analysis or artificial intelligence applications.
Collapse
|
169
|
Jarius S, Paul F, Weinshenker BG, Levy M, Kim HJ, Wildemann B. Neuromyelitis optica. Nat Rev Dis Primers 2020; 6:85. [PMID: 33093467 DOI: 10.1038/s41572-020-0214-9] [Citation(s) in RCA: 213] [Impact Index Per Article: 53.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/25/2020] [Indexed: 12/11/2022]
Abstract
Neuromyelitis optica (NMO; also known as Devic syndrome) is a clinical syndrome characterized by attacks of acute optic neuritis and transverse myelitis. In most patients, NMO is caused by pathogenetic serum IgG autoantibodies to aquaporin 4 (AQP4), the most abundant water-channel protein in the central nervous system. In a subset of patients negative for AQP4-IgG, pathogenetic serum IgG antibodies to myelin oligodendrocyte glycoprotein, an antigen in the outer myelin sheath of central nervous system neurons, are present. Other causes of NMO (such as paraneoplastic disorders and neurosarcoidosis) are rare. NMO was previously associated with a poor prognosis; however, treatment with steroids and plasma exchange for acute attacks and with immunosuppressants (in particular, B cell-depleting agents) for attack prevention has greatly improved the long-term outcomes. Recently, a number of randomized controlled trials have been completed and the first drugs, all therapeutic monoclonal antibodies, have been approved for the treatment of AQP4-IgG-positive NMO and its formes frustes.
Collapse
|
170
|
Ahn JM, Kim H, Kwon O, Om SY, Heo R, Lee S, Kim DH, Kim HJ, Kim JB, Jung SH, Choo SJ, Song JM, Kang DH, Chung CH, Lee JW, Song JK. Differential clinical features and long-term prognosis of acute aortic syndrome according to disease entity. Eur Heart J 2020; 40:2727-2736. [PMID: 31220232 DOI: 10.1093/eurheartj/ehz153] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 08/20/2018] [Accepted: 03/25/2019] [Indexed: 01/16/2023] Open
Abstract
AIMS To evaluate the acute and long-term prognosis of acute aortic syndrome (AAS) according to the disease entity [intramural haematoma (IMH) vs. aortic dissection (AD)] and the anatomical location (type A vs. B). METHODS AND RESULTS A total of 1012 patients [672 with AD and 340 with IMH (33.6%)] were enrolled between 1993 and 2015. Compared with AD patients, IMH patients were older and had higher frequency of female sex and distal aorta involvement. The overall crude in-hospital mortality of AAS was 8.6%; type A AD [15.0%; adjusted hazard ratio (aHR) 30.4; 95% confidence interval (CI) 8.62-107.3; P < 0.001], type A IMH (8.0%; aHR 4.85; 95% CI 1.29-18.2; P = 0.019), type B AD (5.0%; aHR 3.51; 95% CI 1.00-12.4; P = 0.051), and type B IMH [1.5%; aHR 1.00 (reference)]. During a median follow-up duration of 8.5 years (interquartile range: 4.0-13.5 years), AD (aHR 2.78; 95% CI 1.87-4.14; P < 0.001) and type A (aHR 2.28; 95% CI 1.45-3.58; P < 0.001) was associated with a higher risk of aortic death. After 90 days, a risk of aortic death was no longer associated with anatomical location (aHR 0.74; 95% CI 0.40-1.36; P = 0.33), but remained associated with disease entity (aHR 1.83; 95% CI 1.10-3.04; P = 0.02). CONCLUSION The clinical features, response to treatment strategy, and outcomes of IMH patients were distinct from those of AD patients. Both early and late survival was better for IMH than for AD. In addition to the anatomical location of AAS, the disease entity is an independent factor associated with both acute and long-term mortality in patients with AAS. Further investigation is necessary to confirm the prognostic implication of disease entity in different patient populations.
Collapse
|
171
|
Abudinén F, Adachi I, Aihara H, Akopov N, Aloisio A, Ameli F, Anh Ky N, Asner DM, Aushev T, Aushev V, Babu V, Baehr S, Bahinipati S, Bambade P, Banerjee S, Bansal S, Baudot J, Becker J, Behera PK, Bennett JV, Bernieri E, Bernlochner FU, Bertemes M, Bessner M, Bettarini S, Bhardwaj V, Bianchi F, Bilka T, Bilokin S, Biswas D, Bračko M, Branchini P, Braun N, Browder TE, Budano A, Bussino S, Campajola M, Casarosa G, Cecchi C, Červenkov D, Chang MC, Chang P, Cheaib R, Chekelian V, Cheon BG, Chilikin K, Chirapatpimol K, Cho HE, Cho K, Cho SJ, Choi SK, Cinabro D, Corona L, Cremaldi LM, Cunliffe S, Dash N, Dattola F, De La Cruz-Burelo E, De Nardo G, De Nuccio M, De Pietro G, de Sangro R, Destefanis M, De Yta-Hernandez A, Di Capua F, Doležal Z, Dong TV, Dort K, Dossett D, Dujany G, Eidelman S, Ferber T, Ferlewicz D, Fiore S, Fodor A, Forti F, Fulsom BG, Ganiev E, Garg R, Garmash A, Gaur V, Gaz A, Gebauer U, Gellrich A, Geßler T, Giordano R, Giri A, Gobbo B, Godang R, Goldenzweig P, Golob B, Gomis P, Gradl W, Graziani E, Greenwald D, Hadjivasiliou C, Halder S, Hartbrich O, Hayasaka K, Hayashii H, Hearty C, Hedges MT, Heredia de la Cruz I, Hernández Villanueva M, Hershenhorn A, Higuchi T, Hill EC, Hirata H, Hoek M, Hohmann M, Hsu CL, Hu Y, Inami K, Inguglia G, Irakkathil Jabbar J, Ishikawa A, Itoh R, Jackson P, Jacobs WW, Jaffe DE, Jang EJ, Jia S, Jin Y, Joo C, Kaliyar AB, Kandra J, Karyan G, Kato Y, Kichimi H, Kiesling C, Kim CH, Kim DY, Kim HJ, Kim SH, Kim YK, Kimmel TD, Kinoshita K, Kleinwort C, Kodyš P, Koga T, Kohani S, Komarov I, Korpar S, Kraetzschmar TMG, Križan P, Krokovny P, Kuhr T, Kumar M, Kumar R, Kumara K, Kurz S, Kwon YJ, Lacaprara S, La Licata C, Lanceri L, Lange JS, Lee IS, Lee SC, Leitl P, Levit D, Lewis PM, Li C, Li LK, Li YB, Libby J, Lieret K, Li Gioi L, Liptak Z, Liu QY, Liventsev D, Longo S, Luo T, MacQueen C, Maeda Y, Manfredi R, Manoni E, Marcello S, Marinas C, Martini A, Masuda M, Matsuoka K, Matvienko D, Meggendorfer F, Meier F, Merola M, Metzner F, Milesi M, Miller C, Miyabayashi K, Mizuk R, Azmi K, Mohanty GB, Moser HG, Mrvar M, Müller FJ, Mussa R, Nakamura I, Nakao M, Nakazawa H, Natochii A, Niebuhr C, Nisar NK, Nishida S, Nouxman MHA, Ogawa K, Ogawa S, Ono H, Oskin P, Ozaki H, Pakhlov P, Paladino A, Panta A, Paoloni E, Pardi S, Park H, Park SH, Paschen B, Passeri A, Pathak A, Patra S, Paul S, Pedlar TK, Peruzzi I, Peschke R, Piccolo M, Piilonen LE, Polat G, Popov V, Praz C, Prencipe E, Prim MT, Purohit MV, Rad N, Rados P, Rasheed R, Reif M, Reiter S, Remnev M, Ripp-Baudot I, Ritter M, Ritzert M, Rizzo G, Robertson SH, Rodríguez Pérez D, Roney JM, Rosenfeld C, Rostomyan A, Rout N, Sahoo D, Sakai Y, Sanders DA, Sandilya S, Sangal A, Santelj L, Sato Y, Savinov V, Scavino B, Schwanda C, Schwartz AJ, Seddon RM, Seino Y, Selce A, Senyo K, Serrano J, Sevior ME, Sfienti C, Shiu JG, Sibidanov A, Simon F, Sobie RJ, Soffer A, Solovieva E, Spataro S, Spruck B, Starič M, Stefkova S, Stottler ZS, Stroili R, Strube J, Sumihama M, Sumiyoshi T, Summers DJ, Sutcliffe W, Svidras H, Tabata M, Takizawa M, Tamponi U, Tanaka S, Tanida K, Tanigawa H, Taras P, Tenchini F, Tonelli D, Torassa E, Trabelsi K, Uchida M, Uglov T, Unger K, Unno Y, Uno S, Urquijo P, Ushiroda Y, Vahsen SE, van Tonder R, Varner GS, Varvell KE, Vinokurova A, Vitale L, Waheed E, Wakai M, Wakeling HM, Wang CH, Wang MZ, Wang XL, Warburton A, Watanabe M, Watanuki S, Webb J, Wehle S, Welsch M, Wessel C, Wiechczynski J, Windel H, Won E, Wu LJ, Xu XP, Yabsley B, Yan W, Yang SB, Ye H, Yonenaga M, Yuan CZ, Yusa Y, Zani L, Zhou QD, Zhukova VI. Search for Axionlike Particles Produced in e^{+}e^{-} Collisions at Belle II. PHYSICAL REVIEW LETTERS 2020; 125:161806. [PMID: 33124872 DOI: 10.1103/physrevlett.125.161806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 09/08/2020] [Indexed: 06/11/2023]
Abstract
We present a search for the direct production of a light pseudoscalar a decaying into two photons with the Belle II detector at the SuperKEKB collider. We search for the process e^{+}e^{-}→γa, a→γγ in the mass range 0.2<m_{a}<9.7 GeV/c^{2} using data corresponding to an integrated luminosity of (445±3) pb^{-1}. Light pseudoscalars interacting predominantly with standard model gauge bosons (so-called axionlike particles or ALPs) are frequently postulated in extensions of the standard model. We find no evidence for ALPs and set 95% confidence level upper limits on the coupling strength g_{aγγ} of ALPs to photons at the level of 10^{-3} GeV^{-1}. The limits are the most restrictive to date for 0.2<m_{a}<1 GeV/c^{2}.
Collapse
|
172
|
Kim HJ, Kim JB. Commentary: To spare or not to spare, the question is still valid for some. J Thorac Cardiovasc Surg 2020; 164:502-503. [PMID: 33158562 DOI: 10.1016/j.jtcvs.2020.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 10/04/2020] [Accepted: 10/06/2020] [Indexed: 11/28/2022]
|
173
|
Ahn Y, Koo HJ, Lee S, Kim DH, Song JM, Kang DH, Song JK, Kim HJ, Kim JB, Jung SH, Choo SJ, Chung CH, Lee JW, Kang JW, Yang DH. Preoperative Cardiac Computed Tomography Characteristics Associated with Recurrent Aortic Regurgitation after Aortic Valve Re-Implantation. Korean J Radiol 2020; 21:181-191. [PMID: 31997593 PMCID: PMC6992440 DOI: 10.3348/kjr.2019.0446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 09/25/2019] [Indexed: 12/30/2022] Open
Abstract
Objective To identify the preoperative cardiac computed tomography (CT) factors influencing postoperative recurrent aortic regurgitation (AR) in patients who underwent aortic valve repair with the re-implantation technique (David operation) due to AR. Materials and Methods A total of 117 patients (age, 49.4 ± 15.6 years; 83 males) who underwent the David operation for AR were included in this retrospective study. Aortic root profiles including the aortic regurgitant orifice area (ARO) and the aortic cusp asymmetry ratio of the areas (ASRarea), which is defined as the maximum/minimum areas among the three cusp areas at the level of the commissures, were measured on preoperative cardiac CT scans. Clinical and CT findings were compared between a group with recurrent AR grade < 3 (no, trivial, or mild AR) and recurrent ≥ 3 + AR. To determine the optimal cut-off values of ASR and ARO, the receiver operating characteristic (ROC) curve was used. Cox regression analysis was used for the analysis of the factors affecting recurrent 3 + AR. Results Postoperatively, recurrent 3 + AR developed in 17 (14.5%) patients and occurred within a median of 268 days (interquartile range: 78–582 days). The cut-off ARO value for discriminating the patients with recurrent 3 + AR was > 24 mm2 (sensitivity, 76.5%; specificity 64.8%), and the area under the ROC curve (AUC) was 0.72. For ASRarea, the cut-off value was > 1.58 (sensitivity, 76.5%; specificity, 58.0%) and the AUC was 0.64. Multivariable Cox regression showed that ARO > 24 mm2 (hazard ratio = 3.79, p = 0.020) was a potential independent parameter for recurrent 3 + AR. ROC for the linear regression model showed that the AUC for both ARO and ASRarea was 0.73 (95% confidence interval, 0.64–0.81, p < 0.001). Conclusion ARO and ASRarea detected on preoperative cardiac CT would be potentially helpful for identifying AR patients who may benefit from the David operation.
Collapse
|
174
|
Lee MY, Yong KP, Hyun JW, Kim SH, Lee SH, Kim HJ. Incidence of interattack asymptomatic brain lesions in NMO spectrum disorder. Neurology 2020; 95:e3124-e3128. [PMID: 32928976 DOI: 10.1212/wnl.0000000000010847] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 07/22/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine whether aquaporin-4 (AQP4) antibody-seropositive patients with neuromyelitis optica spectrum disorder (NMOSD) develop new asymptomatic brain lesions during the interattack period. METHODS Of 296 consecutive AQP4 antibody-seropositive patients in the NMOSD database of the National Cancer Center from May 2005 to November 2019, 145 patients, who had serial brain MRI scans over an interval of at least 1 year during relapse-free period after immunosuppressive therapy, with 370 longitudinally assessed brain MRI scans were included in this study. We retrospectively analyzed them for presence of new subclinical brain lesions during the relapse-free period. RESULTS Five of 145 patients (3.4%) had detectable new, asymptomatic brain lesions in the deep white matter over a total observed relapse-free period of 708 person-years. All the lesions were smaller than 6 mm and assessed to be nonspecific. No brain lesion characteristic of NMOSD or gadolinium-enhancing lesion was identified. CONCLUSIONS Asymptomatic brain lesions are rarely observed on conventional MRI in clinically stable AQP4 antibody-seropositive patients with NMOSD after immunosuppressive therapy and brain MRI lesions characteristic of NMOSD are not seen in the relapse-free period. These findings may provide further insight regarding currently known diagnostic and disease-monitoring strategies in NMOSD.
Collapse
|
175
|
Whittam DH, Cobo-Calvo A, Lopez-Chiriboga AS, Pardo S, Gornall M, Cicconi S, Brandt A, Berek K, Berger T, Jelcic I, Gombolay G, Oliveira LM, Callegaro D, Kaneko K, Misu T, Capobianco M, Gibbons E, Karthikeayan V, Brochet B, Audoin B, Mathey G, Laplaud D, Thouvenot E, Cohen M, Tourbah A, Maillart E, Ciron J, Deschamps R, Biotti D, Rostasy K, Neuteboom R, Hemingway C, Forsyth R, Matiello M, Webb S, Hunt D, Murray K, Hacohen Y, Lim M, Leite MI, Palace J, Solomon T, Lutterotti A, Fujihara K, Nakashima I, Bennett JL, Pandit L, Chitnis T, Weinshenker BG, Wildemann B, Sato DK, Kim SH, Huda S, Kim HJ, Reindl M, Levy M, Jarius S, Tenembaum S, Paul F, Pittock S, Marignier R, Jacob A. Treatment of MOG-IgG-associated disorder with rituximab: An international study of 121 patients. Mult Scler Relat Disord 2020; 44:102251. [PMID: 32629363 PMCID: PMC7895306 DOI: 10.1016/j.msard.2020.102251] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/25/2020] [Accepted: 05/29/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To assess the effect of anti-CD20 B-cell depletion with rituximab (RTX) on relapse rates in myelin oligodendrocyte glycoprotein antibody-associated disorder (MOGAD). METHODS Retrospective review of RTX-treated MOGAD patients from 29 centres in 13 countries. The primary outcome measure was change in relapse rate after starting rituximab (Poisson regression model). RESULTS Data on 121 patients were analysed, including 30 (24.8%) children. Twenty/121 (16.5%) were treated after one attack, of whom 14/20 (70.0%) remained relapse-free after median (IQR) 11.2 (6.3-14.1) months. The remainder (101/121, 83.5%) were treated after two or more attacks, of whom 53/101 (52.5%) remained relapse-free after median 12.1 (6.3-24.9) months. In this 'relapsing group', relapse rate declined by 37% (95%CI=19-52%, p<0.001) overall, 63% (95%CI=35-79%, p = 0.001) when RTX was used first line (n = 47), and 26% (95%CI=2-44%, p = 0.038) when used after other steroid-sparing immunotherapies (n = 54). Predicted 1-year and 2-year relapse-free survival was 79% and 55% for first-line RTX therapy, and 38% and 18% for second-/third-line therapy. Circulating CD19+B-cells were suppressed to <1% of total circulating lymphocyte population at the time of 45/57 (78.9%) relapses. CONCLUSION RTX reduced relapse rates in MOGAD. However, many patients continued to relapse despite apparent B-cell depletion. Prospective controlled studies are needed to validate these results.
Collapse
|
176
|
Kim HJ, Lee KJ, Park J, Shin GH, Park H, Yu K, Choi SY. Photoconductivity Switching in MoTe 2/Graphene Heterostructure by Trap-Assisted Photogating. ACS APPLIED MATERIALS & INTERFACES 2020; 12:38563-38569. [PMID: 32846468 DOI: 10.1021/acsami.0c09960] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Negative photoconductivity (NPC), a reduction in photoconductivity under light illumination, could provide low power consumption and high-speed frequency response. The NPC has been generally observed in low-dimensional materials, which can be easily affected by the trapping of photocarriers. However, a gradual transition between NPC and positive photoconductivity (PPC) by controlling the light intensity has not been reported. In this study, a gradual and reversible switching between NPC and PPC is achieved in a van der Waals heterostructure of graphene and MoTe2. The initially observed NPC state becomes a PPC state with the increase in light intensity. The switching between NPC and PPC is considered to originate from the hole trapping in MoTe2. The hole trapping can induce a shift in the Fermi level of MoTe2 and thus change the junction characteristics between the graphene and MoTe2, which determine the photoresponse type (NPC or PPC). Notably, the switching from one state to the other can also be reversed, depending on the gate bias. The stable and reversible effect upon light illumination and application of a gate voltage could be used in optoelectronic devices and optical communications.
Collapse
|
177
|
Hyun JW, Lee HL, Jeong WK, Lee HJ, Shin JH, Min JH, Kim BJ, Kim SW, Shin HY, Oh J, Kim W, Shin HJ, Oh SY, Kim H, Lim YM, Huh SY, Cho EB, Nam TS, Lee SH, Kim SY, Kang SY, Han SG, Sohn EH, Baek SH, Kim BJ, Lee SS, Seok JM, Hong YH, Oh SI, Kim JK, Shin KJ, Kwon O, Cho JY, Bae JS, Kim SY, Kim Y, Lee MY, Kim SH, Kim HJ. Comparison of MOG and AQP4 antibody seroprevalence in Korean adults with inflammatory demyelinating CNS diseases. Mult Scler 2020; 27:964-967. [PMID: 32779521 DOI: 10.1177/1352458520948213] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We aimed to compare seroprevalence of anti-myelin oligodendrocyte glycoprotein (MOG) and anti-aquaporin-4 (AQP4) antibodies in Korean adults with inflammatory demyelinating diseases (IDDs) of the central nervous system (CNS), based on a multicenter nationwide database. Sera were analyzed using a live cell-based assay for MOG and AQP4 antibodies. Of 586 Korean adults with IDDs of the CNS, 36 (6.1%) and 185 (31.6%) tested positive for MOG and AQP4 antibodies, respectively. No participant showed double positivity. Seroprevalence of MOG antibodies was about five times lower than that of AQP4 antibodies in a large cohort of Korean adults with IDDs of the CNS.
Collapse
|
178
|
Cho JW, Choo SJ, Lee CH, Kim HJ, Kim JB, Jung SH, Chung CH, Shinn SH, Lee JW. A 10-year study of surgical results of descending aorta aneurysm repair following chronic aortic dissection. J Vasc Surg 2020; 72:1288-1297. [PMID: 32723689 DOI: 10.1016/j.jvs.2020.01.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 01/13/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Patients presenting with descending aortic aneurysms developing after aortic dissection often undergo continued aortic expansion which may require operative interventions to address the risk of aortic rupture. In light of the current advances in various treatment options, including endovascular approaches, we analyzed our experience with open surgical repair (OSR) of aneurysms of the descending aorta following aortic dissection. METHODS Patients who underwent open repair for aneurysmal changes of the descending aorta after chronic dissection were retrospectively studied. The 30-day operative mortality rate, midterm survival, and major complications were analyzed. Patients were divided into two categories; primary chronic type B aortic dissection and remnant repaired type A aortic dissection (RTAAD). RESULTS There were 149 patients with enlargement of the descending thoracic aorta developing after aortic dissection. Of these, 49 patients had medical management, while the remaining 100 patients received OSR. These patients were included in the present analysis. The 30-day mortality and permanent paraplegia rates were 9% and 4%, respectively. The 1-, 3-, and 5-year survival rates were 83%, 80.9%, and 76.1%, respectively. The 1- and 5-year survival rates between the primary chronic type B aortic dissection and remnant RTAAD groups showed no significant between-group differences at 86.7% and 84.3%, and 80% and 71.3%, respectively (P = .289). The overall outcomes of other complications such as renal injury, bleeding reoperation, and extracorporeal membrane oxygenation support showed no significant between-group differences, including an insignificantly higher neurologic complication rate in the remnant RTAAD group. The survival rate in patients with Marfan syndrome was significantly higher than in the patients without Marfan syndrome (P = .033). CONCLUSIONS OSR for descending aortic aneurysms developing after chronic aortic dissection showed good early and mid- to long-term outcomes, with acceptably low complication rates. OSR for descending aortic aneurysm after chronic aortic dissection associated with Marfan syndrome also showed good early and mid- to long-term outcomes.
Collapse
|
179
|
Adare A, Afanasiev S, Aidala C, Ajitanand NN, Akiba Y, Akimoto R, Al-Ta'ani H, Alexander J, Angerami A, Aoki K, Apadula N, Aramaki Y, Asano H, Aschenauer EC, Atomssa ET, Awes TC, Azmoun B, Babintsev V, Bai M, Bannier B, Barish KN, Bassalleck B, Bathe S, Baublis V, Baumgart S, Bazilevsky A, Belmont R, Berdnikov A, Berdnikov Y, Bing X, Blau DS, Boyle K, Brooks ML, Buesching H, Bumazhnov V, Butsyk S, Campbell S, Castera P, Chen CH, Chi CY, Chiu M, Choi IJ, Choi JB, Choi S, Choudhury RK, Christiansen P, Chujo T, Chvala O, Cianciolo V, Citron Z, Cole BA, Connors M, Csanád M, Csörgő T, Dairaku S, Datta A, Daugherity MS, David G, Denisov A, Deshpande A, Desmond EJ, Dharmawardane KV, Dietzsch O, Ding L, Dion A, Donadelli M, Drapier O, Drees A, Drees KA, Durham JM, Durum A, D'Orazio L, Edwards S, Efremenko YV, Engelmore T, Enokizono A, Esumi S, Eyser KO, Fadem B, Fields DE, Finger M, Finger M, Fleuret F, Fokin SL, Frantz JE, Franz A, Frawley AD, Fukao Y, Fusayasu T, Gainey K, Gal C, Garishvili A, Garishvili I, Glenn A, Gong X, Gonin M, Goto Y, Granier de Cassagnac R, Grau N, Greene SV, Grosse Perdekamp M, Gunji T, Guo L, Gustafsson HÅ, Hachiya T, Haggerty JS, Hahn KI, Hamagaki H, Hanks J, Hashimoto K, Haslum E, Hayano R, He X, Hemmick TK, Hester T, Hill JC, Hollis RS, Homma K, Hong B, Horaguchi T, Hori Y, Huang S, Ichihara T, Iinuma H, Ikeda Y, Imrek J, Inaba M, Iordanova A, Isenhower D, Issah M, Isupov A, Ivanischev D, Jacak BV, Javani M, Jia J, Jiang X, Johnson BM, Joo KS, Jouan D, Kamin J, Kaneti S, Kang BH, Kang JH, Kang JS, Kapustinsky J, Karatsu K, Kasai M, Kawall D, Kazantsev AV, Kempel T, Khanzadeev A, Kijima KM, Kim BI, Kim C, Kim DJ, Kim EJ, Kim HJ, Kim KB, Kim YJ, Kim YK, Kinney E, Kiss Á, Kistenev E, Klatsky J, Kleinjan D, Kline P, Komatsu Y, Komkov B, Koster J, Kotchetkov D, Kotov D, Král A, Krizek F, Kunde GJ, Kurita K, Kurosawa M, Kwon Y, Kyle GS, Lacey R, Lai YS, Lajoie JG, Lebedev A, Lee B, Lee DM, Lee J, Lee KB, Lee KS, Lee SH, Lee SR, Leitch MJ, Leite MAL, Leitgab M, Lewis B, Lim SH, Linden Levy LA, Litvinenko A, Liu MX, Love B, Maguire CF, Makdisi YI, Makek M, Malakhov A, Manion A, Manko VI, Mannel E, Masumoto S, McCumber M, McGaughey PL, McGlinchey D, McKinney C, Mendoza M, Meredith B, Miake Y, Mibe T, Mignerey AC, Milov A, Mishra DK, Mitchell JT, Miyachi Y, Miyasaka S, Mohanty AK, Moon HJ, Morrison DP, Motschwiller S, Moukhanova TV, Murakami T, Murata J, Nagae T, Nagamiya S, Nagle JL, Nagy MI, Nakagawa I, Nakamiya Y, Nakamura KR, Nakamura T, Nakano K, Nattrass C, Nederlof A, Nihashi M, Nouicer R, Novitzky N, Nyanin AS, O'Brien E, Ogilvie CA, Okada K, Oskarsson A, Ouchida M, Ozawa K, Pak R, Pantuev V, Papavassiliou V, Park BH, Park IH, Park SK, Pate SF, Patel L, Pei H, Peng JC, Pereira H, Peresedov V, Peressounko DY, Petti R, Pinkenburg C, Pisani RP, Proissl M, Purschke ML, Qu H, Rak J, Ravinovich I, Read KF, Reynolds R, Riabov V, Riabov Y, Richardson E, Roach D, Roche G, Rolnick SD, Rosati M, Rukoyatkin P, Sahlmueller B, Saito N, Sakaguchi T, Samsonov V, Sano M, Sarsour M, Sawada S, Sedgwick K, Seidl R, Sen A, Seto R, Sharma D, Shein I, Shibata TA, Shigaki K, Shimomura M, Shoji K, Shukla P, Sickles A, Silva CL, Silvermyr D, Sim KS, Singh BK, Singh CP, Singh V, Slunečka M, Soltz RA, Sondheim WE, Sorensen SP, Soumya M, Sourikova IV, Stankus PW, Stenlund E, Stepanov M, Ster A, Stoll SP, Sugitate T, Sukhanov A, Sun J, Sziklai J, Takagui EM, Takahara A, Taketani A, Tanaka Y, Taneja S, Tanida K, Tannenbaum MJ, Tarafdar S, Taranenko A, Tennant E, Themann H, Todoroki T, Tomášek L, Tomášek M, Torii H, Towell RS, Tserruya I, Tsuchimoto Y, Tsuji T, Vale C, van Hecke HW, Vargyas M, Vazquez-Zambrano E, Veicht A, Velkovska J, Vértesi R, Virius M, Vossen A, Vrba V, Vznuzdaev E, Wang XR, Watanabe D, Watanabe K, Watanabe Y, Watanabe YS, Wei F, Wei R, White SN, Winter D, Wolin S, Woody CL, Wysocki M, Yamaguchi YL, Yang R, Yanovich A, Ying J, Yokkaichi S, You Z, Younus I, Yushmanov IE, Zajc WA, Zelenski A, Zolin L. Erratum: Evolution of π^{0} Suppression in Au+Au Collisions from sqrt[s_{NN}]=39 to 200 GeV [Phys. Rev. Lett. 109, 152301 (2012)]. PHYSICAL REVIEW LETTERS 2020; 125:049901. [PMID: 32794791 DOI: 10.1103/physrevlett.125.049901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Indexed: 06/11/2023]
Abstract
This corrects the article DOI: 10.1103/PhysRevLett.109.152301.
Collapse
|
180
|
Yoo IH, Kim W, Shim Y, Choi SA, Kim SY, Kim H, Lim BC, Hwang H, Choi J, Kim KJ, Kim Y, Hyun JW, Kim SH, Choi K, Kim HJ, Chae JH. Clinical Spectrum of Myelin Oligodendrocyte Glycoprotein-Immunoglobulin G-Associated Disease in Korean Children. J Clin Neurol 2020; 16:461-469. [PMID: 32657068 PMCID: PMC7354962 DOI: 10.3988/jcn.2020.16.3.461] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 04/17/2020] [Accepted: 04/17/2020] [Indexed: 11/29/2022] Open
Abstract
Background and Purpose The myelin oligodendrocyte glycoprotein (MOG) antibody is detected at a high rate in childhood acquired demyelinating syndrome (ADS). This study aimed to determine the diagnostic value of the MOG antibody in ADS and the spectrum of MOG-antibody-positive demyelinating diseases in children. Methods This study included 128 patients diagnosed with ADS (n=94) or unexplained encephalitis (n=34). The MOG antibody in serum was tested using an in-house live-cell-based immunofluorescence assay. Results The MOG antibody was detected in 48 patients (46 ADS patients and 2 encephalitis patients, comprising 23 males and 25 females). Acute disseminated encephalomyelitis (ADEM) (35.4%) was the most-common diagnosis, followed by the unclassified form (17.4%), isolated optic neuritis (ON) (15.2%), neuromyelitis optica spectrum disorder (13.0%), multiple sclerosis (MS) (10.8%), other clinically isolated syndromes [monophasic event except ADEM, isolated ON, or transverse myelitis (TM)] (8.7%), and unexplained encephalitis (4.3%). At the initial presentation, 35 out of the 46 patients with ADS had brain lesions detected in magnetic resonance imaging, and 54% of these 35 patients had encephalopathy. Nine of the 11 patients without brain lesions exhibited only ON. Thirty-nine percent of the patients experienced a multiphasic event during the mean follow-up period of 34.9 months (range 1.4–169.0 months). Encephalopathy at the initial presentation was frequently confirmed in the monophasic group (p=0.011). Conclusions MOG antibodies were identified in all pediatric ADS phenotypes except for monophasic TM. Therefore, the MOG antibody test is recommended for all pediatric patients with ADS, especially before a diagnosis of MS and for patients without a clear diagnosis.
Collapse
|
181
|
Seon Y, Hwang SH, Lee JM, Lee KB, Heo DH, Han MJ, Kim HJ. The primary system for measurement of beta emitting radioactive gases at KRISS. Appl Radiat Isot 2020; 164:109238. [PMID: 32554125 DOI: 10.1016/j.apradiso.2020.109238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 04/10/2020] [Accepted: 05/18/2020] [Indexed: 11/30/2022]
Abstract
Korea Research Institute of Standards and Science (KRISS) is developing a length-compensated proportional counting (LCPC) system as a primary system for standardization of beta emitting radioactive gases. The pilot experiment was performed with 85Kr and the optimized high voltage and pressure were found to be 1700 V and 0.203 MPa, respectively. The total activity of 85Kr was deduced by the length compensation of each count. The expanded uncertainty was estimated to be around 0.8% (k = 2) for the 85Kr measurement.
Collapse
|
182
|
Hyun JW, Kwon YN, Kim SM, Lee HL, Jeong WK, Lee HJ, Kim BJ, Kim SW, Shin HY, Shin HJ, Oh SY, Huh SY, Kim W, Park MS, Oh J, Jang H, Park NY, Lee MY, Kim SH, Kim HJ. Value of Area Postrema Syndrome in Differentiating Adults With AQP4 vs. MOG Antibodies. Front Neurol 2020; 11:396. [PMID: 32581992 PMCID: PMC7287121 DOI: 10.3389/fneur.2020.00396] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 04/17/2020] [Indexed: 12/30/2022] Open
Abstract
Objectives: To compare the frequency of area postrema syndrome (APS) in adults with anti-aquaporin-4 (AQP4) and anti-myelin oligodendrocyte glycoprotein (MOG) antibodies. Methods: APS is defined as acute or subacute, single or combined, episodic or constant nausea, vomiting, or hiccups, persisting for at least 48 h, which cannot be attributed to any other etiology. The presence of APS was investigated in 274 adults with AQP4 antibodies and 107 adults with MOG antibodies from 10 hospitals. Results: The study population comprised Korean adults (≥18 years). At the time of disease onset, 14.9% (41/274) adults with AQP4 antibodies had APS, while none of the participants with MOG antibodies developed APS (p < 0.001). During the course of the disease, 17.2% (47/274) adults with AQP4 antibodies had APS in contrast to 1.9% (2/107) adults with MOG antibodies with APS (p < 0.001). Conclusions: APS, one of the core clinical characteristics of individuals with AQP4 antibodies, is an extremely rare manifestation in Korean adults with MOG antibodies.
Collapse
|
183
|
Yong KP, Kim HJ. Disease modifying therapies and infection risks in multiple sclerosis-a decision-making conundrum. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:722. [PMID: 32617342 PMCID: PMC7327337 DOI: 10.21037/atm.2020.01.119] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
|
184
|
Lee MJ, Lee JM, Kim S, Park HJ, Jeon CS, Hong HJ, Choi SM, Cho SK, Ahn JS, Kim HJ. Development of a Gas Chromatography-Flame Ionization Method for the Detection and Quantification of 12 Flavoring Agents in Supplementary Feed. J AOAC Int 2020; 103:710-714. [DOI: 10.1093/jaocint/qsz005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 10/03/2019] [Accepted: 10/04/2019] [Indexed: 11/13/2022]
Abstract
Abstract
A flavoring agent is a compound that serves to add flavor with a pleasant scent and is used as a feed additive. Current flavor analysis methods include reflux pretreatment, titration, neutralization titration, and inversion; these are all analytical methods in which deviations and errors between experiments are generated. Titration methods are characterized by difficult selectivity analysis both for mixtures containing two or more types of flavoring agents and also for very low content samples. Current analysis methods are therefore particularly unsuitable for these sample types. Thus, more precise and accurate analysis of flavor agents is needed. This study intends to develop and verify a multi-component simultaneous analysis method that can accurately confirm the guaranteed content of 12 flavor agents of supplementary feeds distributed in the market, the goal being to establish a universally trusted method. Method validation was performed according to the International Conference on Harmonization (ICH) and International Union of Pure and Applied Chemistry (IUPAC) guidelines. Method
validation was performed in terms of linearity, sensitivity, selectivity, accuracy, and precision. The limits of detection (LOD) for the instrument employed in these experiments ranged from 0.44–4.77 mg/kg, and the limits of quantification (LOQ) ranged from 1.32–14.31 mg/kg. Average recoveries of the 12 flavoring agents ranged from 75.1–111.4%. Maximum %RSD values for intraday and interday peak area variation are 13.09% and 13.08%, respectively. A novel and simple method for detecting 12 flavoring agents in animal feed supplements using a gas chromatography-flame ionization detector (GC-FID) was developed.
Collapse
|
185
|
Kwon Y, Park SJ, Kim HJ, Kim JB. Complete Resection of Cardiac Angiosarcoma Invading Right Heart and Right Coronary Artery. Ann Thorac Surg 2020; 110:e501-e503. [PMID: 32454015 DOI: 10.1016/j.athoracsur.2020.04.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 03/27/2020] [Accepted: 04/01/2020] [Indexed: 11/25/2022]
Abstract
Complete surgical resection is the most critical factor to achieve better long-term outcomes in treating primary cardiac sarcomas; however, it is oftentimes hampered when there is extensive tumor involvement into important cardiac apparatus. Here, we report a case of successful complete resection of a cardiac sarcoma infiltrating the right atrioventricle, tricuspid valve, and right coronary artery.
Collapse
|
186
|
Yun JK, Chong BK, Kim HJ, Lee IS, Gong CS, Kim BS, Lee GD, Choi S, Kim HR, Kim DK, Park SI, Kim YH. Comparative outcomes of robot-assisted minimally invasive versus open esophagectomy in patients with esophageal squamous cell carcinoma: a propensity score-weighted analysis. Dis Esophagus 2020; 33:5610078. [PMID: 31665266 DOI: 10.1093/dote/doz071] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/16/2019] [Indexed: 02/06/2023]
Abstract
Robots are increasingly used in minimally invasive surgery. We evaluated the clinical benefits of robot-assisted minimally invasive esophagectomy (RAMIE) in comparison with the conventional open esophageal surgery. From 2012 to 2016, 371 patients with esophageal squamous cell carcinoma underwent an Ivor Lewis or McKeown procedure at our institution. Of these, 130 patients underwent laparoscopic gastric conduit formation followed by RAMIE, whereas 241 patients underwent conventional esophageal surgery, including laparotomy and open esophagectomy (OE). We compared the short- and long-term clinical outcomes of these patients using the propensity score-based inverse probability of treatment weighting technique (IPTW). Among the early outcomes, the OE group showed a higher incidence of pneumonia (P = 0.035) and a higher requirement for vasopressors (P = 0.001). Regarding the long-term outcomes, all-cause mortality was significantly higher (P = 0.001) and disease-free survival was lower (P = 0.006) in the OE group. Wound-related problems also occurred more frequently in the OE group (P = 0.020) during the long-term follow-up. There was no statistical intergroup difference in the recurrence rates (P = 0.191). The Cox proportional-hazard analysis demonstrated that wound problems (HR 0.16, 95% CI 0.02-0.57; P = 0.017), pneumonia (HR 0.23, 95% CI 0.06-0.68; P = 0.019), and use of vasopressors (HR 0.14, 95% CI 0.08-0.25; P = 0.001) were independent predictors of mortality. RAMIE could be a better surgical option for selected patients with esophageal squamous cell carcinoma.
Collapse
|
187
|
Kim HJ, Lee EJ, Jung SH, Lee JW, Kim JS, Kim JB, Kwon SU. Cerebral atherosclerosis and early ischemic stroke after left-sided valve replacement surgery. J Thorac Cardiovasc Surg 2020; 163:967-976.e6. [PMID: 32616350 DOI: 10.1016/j.jtcvs.2020.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 05/04/2020] [Accepted: 05/04/2020] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Studies have rarely investigated whether cerebral atherosclerosis increases the risk of stroke after valve replacement surgery. This study evaluated the influence of cerebral atherosclerosis on the risk of stroke after left-sided valve replacement surgery. METHODS Between 2005 and 2015, preoperative magnetic resonance angiography was performed for 2085 patients who underwent left-sided valve replacement surgery in a tertiary single center to assess intracranial and extracranial cerebral atherosclerosis. The severity was retrospectively assessed on the basis of the atherosclerosis score, determined by the number of steno-occlusions of the cerebral arteries and the degree of atherosclerosis. Associations between cerebral atherosclerosis and postoperative stroke (within 30 days) were evaluated; the overall influence of total cerebral atherosclerosis, and the individual effects of intracranial and extracranial cerebral atherosclerosis on the risk of postoperative stroke were assessed using multivariable models. RESULTS Preoperative cerebral atherosclerosis was identified in 626 (30.0%) patients, whereas intracranial cerebral atherosclerosis and extracranial cerebral atherosclerosis were identified in 367 (17.1%) and 412 (19.8%) patients, respectively. Stroke occurred in 54 (2.6%) patients, and the total cerebral atherosclerosis score was independently associated with an increased risk of stroke (odds ratio, 1.23; 95% confidence interval, 1.06-1.44). The intracranial cerebral atherosclerosis scores (odds ratio, 1.44; 95% confidence interval, 1.16-1.78), but not the extracranial cerebral atherosclerosis scores, independently predicted the incidence of stroke. CONCLUSIONS Intracranial cerebral atherosclerosis was an important predictor of postoperative stroke, suggesting the necessity of further studies on the feasibility of preoperative screening for cerebral atherosclerosis in patients undergoing left-sided valve replacement surgery.
Collapse
|
188
|
Kim WK, Kim HJ, Kim JB, Jung SH, Choo SJ, Chung CH, Lee JW. Exclusion versus preservation of the left atrial appendage in rheumatic mitral valve surgery. Heart 2020; 106:1839-1846. [PMID: 32376607 DOI: 10.1136/heartjnl-2019-316387] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 04/02/2020] [Accepted: 04/08/2020] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES This study aimed to evaluate the impact of left atrial appendage exclusion on clinical outcomes in patients with atrial fibrillation (AF) undergoing rheumatic mitral surgery. METHODS We retrospectively reviewed 1226 consecutive patients with AF (54.5±11.6 years; 68.2% females) who underwent rheumatic mitral valve (MV) surgery from 1997 to 2016. The left atrial appendage was preserved in 836 (68.2%) and excluded in 390 (31.8%) patients. Surgical AF ablation was performed in 506 (60.5%) and 304 (77.9%) patients with preserved and excluded left atrial appendage, respectively. For baseline adjustment, propensity matching was used. RESULTS During a median follow-up of 63.4 months (IQRs, 20-111 months), there were no significant intergroup differences in the risks of mortality (2.77% vs 3.03%/patient-years) and thromboembolic events (0.91% vs 1.02%/patient-years). In the 258 pairs of propensity-score matched patients, death (2.77% vs 3.03%/patient-years) and thromboembolism (1.36% vs 0.82%/patient-years) outcomes were comparable for both groups. In a subgroup undergoing ablation (n=810), there were no significant differences in the adjusted risks of death (HR, 0.67; 95% CI, 0.34 to 1.32) and thromboembolism (HR, 0.47; 95% CI, 0.18 to 1.26). In a subgroup not undergoing ablation (n=416), however, left atrial appendage preservation tended to have higher adjusted risks for death (HR, 2.24; 95% CI, 0.98 to 5.13) and thromboembolism (HR, 4.41; 95% CI, 0.97 to 20.1). CONCLUSIONS Left atrial appendage preservation did not seem to have greater risks of adverse clinical events in patients with AF undergoing rheumatic MV surgery particularly when ablation procedure is combined.
Collapse
|
189
|
Caria G, Urquijo P, Adachi I, Aihara H, Al Said S, Asner DM, Atmacan H, Aushev T, Babu V, Badhrees I, Bahinipati S, Bakich AM, Behera P, Beleño C, Bennett J, Bhuyan B, Bilka T, Biswal J, Bozek A, Bračko M, Browder TE, Campajola M, Červenkov D, Chang P, Cheaib R, Chekelian V, Chen A, Cheon BG, Chilikin K, Cho HE, Cho K, Choi Y, Choudhury S, Cinabro D, Cunliffe S, Dash N, De Nardo G, Di Capua F, Di Carlo S, Doležal Z, Dong TV, Eidelman S, Epifanov D, Fast JE, Ferber T, Ferlewicz D, Fulsom BG, Garg R, Gaur V, Gabyshev N, Garmash A, Giri A, Goldenzweig P, Greenwald D, Grzymkowska O, Guan Y, Hartbrich O, Hayasaka K, Hayashii H, Higuchi T, Hou WS, Hsu CL, Iijima T, Inami K, Inguglia G, Ishikawa A, Itoh R, Iwasaki M, Iwasaki Y, Jacobs WW, Jeon HB, Jia S, Jin Y, Joffe D, Joo KK, Kaliyar AB, Kang KH, Karyan G, Kawasaki T, Kichimi H, Kim CH, Kim DY, Kim HJ, Kim KT, Kim SH, Kinoshita K, Kodyš P, Korpar S, Kotchetkov D, Križan P, Kroeger R, Krohn JF, Krokovny P, Kuhr T, Kumar R, Kwon YJ, Lange JS, Lee IS, Lee JK, Lee SC, Li LK, Li YB, Li Gioi L, Libby J, Lieret K, Liventsev D, Luo T, MacQueen C, Masuda M, Matsuda T, Matvienko D, Merola M, Metzner F, Miyabayashi K, Mohanty GB, Moon TJ, Mori T, Mussa R, Nakamura KR, Nakao M, Nath KJ, Nayak M, Nisar NK, Nishida S, Nishimura K, Ogawa K, Ono H, Onuki Y, Oskin P, Pakhlov P, Pakhlova G, Pal B, Pang T, Park H, Park SH, Patra S, Paul S, Pedlar TK, Pestotnik R, Piilonen LE, Popov V, Prencipe E, Prim MT, Rabusov A, Resmi PK, Ritter M, Rozanska M, Russo G, Sahoo D, Sakai Y, Sandilya S, Santelj L, Sanuki T, Savinov V, Schneider O, Schnell G, Schueler J, Schwanda C, Schwartz AJ, Seino Y, Senyo K, Sevior ME, Shebalin V, Shiu JG, Shwartz B, Simon F, Sokolov A, Solovieva E, Starič M, Stottler ZS, Sumiyoshi T, Sutcliffe W, Takizawa M, Tamponi U, Tanida K, Tenchini F, Trabelsi K, Uchida M, Uglov T, Uno S, Usov Y, Vahsen SE, Van Tonder R, Varner G, Varvell KE, Vossen A, Waheed E, Wang B, Wang CH, Wang MZ, Wang P, Wang XL, Watanuki S, Wiechczynski J, Won E, Yamamoto H, Yang SB, Ye H, Yin JH, Yuan CZ, Zhang ZP, Zhilich V, Zhukova V, Zhulanov V. Measurement of R(D) and R(D^{*}) with a Semileptonic Tagging Method. PHYSICAL REVIEW LETTERS 2020; 124:161803. [PMID: 32383937 DOI: 10.1103/physrevlett.124.161803] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 03/10/2020] [Indexed: 06/11/2023]
Abstract
The experimental results on the ratios of branching fractions R(D)=B(B[over ¯]→Dτ^{-}ν[over ¯]_{τ})/B(B[over ¯]→Dℓ^{-}ν[over ¯]_{ℓ}) and R(D^{*})=B(B[over ¯]→D^{*}τ^{-}ν[over ¯]_{τ})/B(B[over ¯]→D^{*}ℓ^{-}ν[over ¯]_{ℓ}), where ℓ denotes an electron or a muon, show a long-standing discrepancy with the standard model predictions, and might hint at a violation of lepton flavor universality. We report a new simultaneous measurement of R(D) and R(D^{*}), based on a data sample containing 772×10^{6} BB[over ¯] events recorded at the ϒ(4S) resonance with the Belle detector at the KEKB e^{+}e^{-} collider. In this analysis the tag-side B meson is reconstructed in a semileptonic decay mode and the signal-side τ is reconstructed in a purely leptonic decay. The measured values are R(D)=0.307±0.037±0.016 and R(D^{*})=0.283±0.018±0.014, where the first uncertainties are statistical and the second are systematic. These results are in agreement with the standard model predictions within 0.2, 1.1, and 0.8 standard deviations for R(D), R(D^{*}), and their combination, respectively. This work constitutes the most precise measurements of R(D) and R(D^{*}) performed to date as well as the first result for R(D) based on a semileptonic tagging method.
Collapse
|
190
|
Kim W, Park EY, Hyun JW, Huh SY, Park NY, Jang H, Kim SH, Kim HJ. Validation of the Korean Version of the 12-Item Multiple Sclerosis Walking Scale and Application to Neuromyelitis Optica Spectrum Disorder. J Clin Neurol 2020; 16:270-276. [PMID: 32319244 PMCID: PMC7174128 DOI: 10.3988/jcn.2020.16.2.270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/13/2019] [Accepted: 11/15/2019] [Indexed: 01/29/2023] Open
Abstract
Background and Purpose Gait problems are a primary complaint in patients with multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). The 12-item Multiple Sclerosis Walking Scale (MSWS-12) is a patient-reported measure assessing the impact of MS on the walking ability. We aimed to adapt and validate the Korean version of the MSWS-12 for the Korean population with MS and NMOSD. Methods Thirty-four MS and 35 NMOSD patients were recruited. The MSWS-12 questionnaire was translated into the Korean language and evaluated for its validity and reliability in these patients. Results The MS and NMOSD patients had mean ages of 35.9 and 42.1 years, respectively, median disease durations of 5.6 and 7.2 years, median Expanded Disability Status Scale (EDSS) scores of 2.75 (range, 0–6.5) and 3.5 (range, 0–7.5), and median baseline MSWS-12 total scores of 25 [interquartile range (IQR), 2.60–53.65] and 25 (IQR, 7.29–50.00). The baseline MSWS-12 total score in the patients with MS showed strong correlations with scores for the EDSS, timed 25-foot walk (T25FW), Multiple Sclerosis Impact Scale-29 (MSIS-29) physical dimension, and 36-item Short-Form Health Survey (SF-36) physical component summary (PCS), with Spearman's correlation coefficients (ρ) of 0.922, 0.756, 0.933, and −0.874, respectively. In patients with NMOSD, the baseline MSWS-12 total score showed strong correlations with scores for the EDSS, MSIS-29 physical dimension, and SF-36 PCS (ρ=0.769, 0.910, and −0.852, respectively), and moderate correlations with scores for the T25FW and Fatigue Severity Scale-9 (ρ=0.597 and 0.630, respectively). Conclusions The Korean version of the MSWS-12 appears to be a valid and reliable scale that can be used for Korean patients with MS. The MSWS-12 can also be applied to patients with NMOSD.
Collapse
|
191
|
Jung KH, Kim HJ, Park W, Lim MJ, Kang T, Kang MJ, Kim KB, Ahn HS. Incidence, survival, and risk of cardiovascular events in adult inflammatory myopathies in South Korea: a nationwide population-based study. Scand J Rheumatol 2020; 49:323-331. [PMID: 32286141 DOI: 10.1080/03009742.2019.1707281] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Epidemiological studies on inflammatory myopathies (IMs) show widely variable results, and studies on Asians are lacking. Despite emerging interest in the cardiovascular disease (CVD) risk associated with IMs, the prevalence of CVD in IM patients and its impact on mortality remain unclear. We conducted a nationwide, population-based study on the incidence, mortality, and associated major CVD events of IMs in the Republic of Korea over 11 years. METHOD Using the nationwide, population-based National Health Insurance claims database and the Rare Intractable Disease registration programme, we estimated incidence, mortality, and CVD occurrence. Survival was examined using the Kaplan-Meier method. Mortality rate in IMs with CVD was analysed by Cox proportional hazards regression. RESULTS There were 3014 incident cases, 640 of whom died during the study period. The mean annual incidence was 7.16/106. Dermatomyositis (DM) and polymyositis (PM) had 5 year survival rates of 76.8% and 79.3%, respectively. Cardiovascular events occurred in 155 patients and 40.6% of IM patients with CVD died. Acute myocardial infarction in men had the highest risk of any CVD event in both DM [standardized incidence ratio (SIR) 4.2, 95% confidence interval (95% CI) 2.4-7.2] and PM (SIR 3.5, 95% CI 1.8-7.0). Haemorrhagic stroke had the highest hazard ratio (HR) in both DM (HR 2.31, 95% CI 1.13-4.70) and PM patients (HR 2.10, 95% CI 1.03-4.27) compared with the general population with CVD. CONCLUSION We found persistently low incidence, poor survival, and high major CVD incidence in IMs, and increased mortality in IMs with CVD.
Collapse
|
192
|
Yong KP, Kim HJ. Smelling the danger. Mult Scler 2020; 26:1960-1961. [PMID: 32228208 DOI: 10.1177/1352458520912380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
193
|
Hyun JW, Kwon YN, Lee HL, Jeong WK, Lee HJ, Kim BJ, Kim SW, Shin HY, Shin HJ, Oh SY, Lee MY, Kim SH, Huh SY, Kim W, Park MS, Kim SY, Kim SM, Kim HJ. Recurrence of clinical events at the same anatomical location in patients with MOG antibody-associated disease. Mult Scler 2020; 27:449-452. [PMID: 32228287 DOI: 10.1177/1352458520913970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Likelihood of clinical events occurring within the same anatomical location in patients with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) was retrospectively investigated. METHODS A total of 236 clinical events in 90 patients with MOGAD from nine referral hospitals were analyzed via logistic regression, and odds ratios (ORs) were calculated. Anatomical lesion location was divided into four groups; optic nerve, spinal cord, cerebral hemisphere, and brainstem/cerebellum. RESULTS At all locations, there was an increased likelihood of a second attack occurring at the same location as the initial event (cerebral hemisphere OR = 22.14, brainstem/cerebellum OR = 18.4, spinal cord OR = 9.1, and optic nerve OR = 7.8). There was an increased likelihood of a third attack occurring at the same location as the initial event in the optic nerve (OR = 14.9), cerebral hemisphere (OR = 11.7), and spinal cord (OR = 6.7). There were positive trends toward a third clinical event occurring at the same location as the first and/or second events if the event was in the optic nerve (OR = 13.5), cerebral hemisphere (OR = 6.9), or spinal cord (OR = 5.7). CONCLUSIONS The current study suggests that clinical relapses of MOGAD during early stage tend to recur at the same anatomical locations in the central nervous system.
Collapse
|
194
|
Lee M, Han J, Kim YR, Kwak N, Kim JH, Park O, Shin S, Moon HS, Kim HJ, Jang MJ, Yim JJ. Multidrug-resistant tuberculosis in South Korea: a retrospective analysis of national registry data in 2011-2015. Int J Tuberc Lung Dis 2020; 23:850-857. [PMID: 31439118 DOI: 10.5588/ijtld.18.0658] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) poses a threat to public health as a result of high treatment costs and unsatisfactory outcomes.OBJECTIVE: To elucidate trend, demographic and clinical characteristics and treatment outcomes of patients with MDR-TB between 2011 and 2015 in South Korea.METHOD: Data of patients with MDR-TB diagnosed between 1 January 2011 and 31 December 2015 were retrieved from the nationwide Internet-based TB notification system and analysed retrospectively.RESULTS: During the study period, 5192 MDR-TB patients were notified. We identified an increasing number of MDR-TB patients among foreign populations (from 1.3% to 7.7%), decreasing resistance rates to other anti-TB drugs (e.g., resistance to pyrazinamide, from 40.9% to 28.2%), a decreasing interval from treatment initiation to negative conversion of sputum culture (from 165.7 to 103.7 days) and shortening of treatment duration (719.7 to 613.2 days). However, treatment success rates did not change, and had an average of 65.7%.CONCLUSION: Despite decreasing resistance rates to other drugs and faster treatment responses, treatment outcomes did not improve during the study period. Strict management of MDR-TB patients on treatment should be adopted to improve treatment outcomes.
Collapse
|
195
|
Liu Y, Dash A, Krez A, Kim HJ, Cunningham M, Schwab F, Hughes A, Carlson B, Samuel A, Marty E, Moore H, McMahon DJ, Carrino JA, Bockman RS, Stein EM. Low volumetric bone density is a risk factor for early complications after spine fusion surgery. Osteoporos Int 2020; 31:647-654. [PMID: 31919536 DOI: 10.1007/s00198-019-05245-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 11/20/2019] [Indexed: 12/17/2022]
Abstract
UNLABELLED This study aims to investigate lumbar spine (LS) volumetric bone density (vBMD) as a risk factor for complications (pseudoarthrosis, instrumentation failure, adjacent fractures), re-operation, and time to complication after fusion. INTRODUCTION Lumbar spine (LS) fusion surgery is increasingly performed worldwide. Complications after fusion result in significant morbidity and healthcare costs. Multiple factors, including osteoporosis, have been suggested to contribute to risk of complications and re-operation. However, most studies have used DXA, which is subject to artifact in patients with spine pathology, and none have investigated the relationship between BMD and timing of post-operative complications. This study aims to investigate LS volumetric bone density (vBMD) as a risk factor for complications (pseudoarthrosis, instrumentation failure, adjacent fractures), re-operation, and time to complication after fusion. METHODS We evaluated a cohort of 359 patients who had initial LS fusion surgery at our institution, had pre-operative LS CTs and post-operative imaging available for review. Demographic factors, smoking status, vBMD, and details of surgical procedure were related to likelihood and timing of post-operative complications. RESULTS Mean age was 60 ± 14 years, vBMD 122 ± 37 g/cm3. Median follow-up was 11 months. Skeletal complications occurred in 47 patients (13%); 34 patients (10%) required re-operation. Low vBMD (directly measured and estimated using HU) and smoking were associated with increased risk of skeletal complications. Each increase in baseline vBMD of 10 g/cm3 decreased the complication hazard and increased the complication-free duration in time-to-event analysis (hazard ratio 0.91, 95% CI 0.83-0.98, p < 0.02). CONCLUSIONS Low vBMD was a significant risk factor for early post-operative complications in patients undergoing LS fusion. Prospective studies are needed to confirm these findings and to elucidate the optimal timing for follow-up and strategies for prevention of post-operative complications in this population.
Collapse
|
196
|
Kim HJ, Oh SY, Won SY, Kim HJ, Kim TK, Ko BC, Woo SY, Park EC. Associations between earplug use and hearing loss in ROK military personnel. BMJ Mil Health 2020; 167:398-401. [PMID: 32139412 PMCID: PMC8639962 DOI: 10.1136/jramc-2019-001378] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 12/14/2019] [Accepted: 12/17/2019] [Indexed: 12/05/2022]
Abstract
Introduction The easiest way to prevent noise-induced hearing loss (NIHL) is to wear earplugs. The Republic of Korea (ROK) Ministry of National Defense (MND) is supplying earplugs to prevent NIHL, but many patients still suffer from this. We speculated that earplugs would have a high NIHL rate, depending on the rate of use of earplugs, regardless of the rate of supply. Therefore, we conducted this study to investigate the relationship between the use of earplugs and hearing loss by ROK military personnel. Methods The study used data from the Military Health Survey conducted in 2014–2015, which included 13 470 questionnaires completed by ROK military personnel. Hearing loss and earplug use were self-reported. Logistic regression analysis was used to assess associations between earplug use and hearing loss. Results The study sample included 13 470 ROK military personnel (response rate of 71.2%) (Army, 8330 (61.8%); Navy/Marines, 2236 (16.6%); and Air Force, 2904 (21.6%)). Overall, 18.8% of Korean military personnel reported that they always wore earplugs, and 2.8% reported hearing loss. In logistic regression analysis, there were significant differences in the rates of hearing loss associated with wearing earplugs sometimes (OR=1.48, 95% CI 1.07 to 2.05) and never wearing earplugs (OR=1.53, 95% CI 1.12 to 2.10). In subgroup analysis, in Air Force, non-combat branch, forward area and long-term military service personnel increased hearing loss was associated with not wearing earplugs. Conclusion Our study confirmed that within the ROK military, there is an association between hearing loss and lack of earplug use. In the ROK MND, Army, Navy/Marines and Air Force headquarters must provide guidelines for the use of earplugs during field training to protect military personnel’s hearings and, if necessary, need to be regulated or institutionalised.
Collapse
|
197
|
Hyun JW, Kim GS, Kim SH, Cho JY, Kim HJ, Lee GK, Kim HJ, Kwon SU. Fatal Simultaneous Multi-organ Failure Following Pembrolizumab Treatment for Refractory Thymoma. Clin Lung Cancer 2020; 21:e74-e77. [DOI: 10.1016/j.cllc.2019.10.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 10/08/2019] [Accepted: 10/13/2019] [Indexed: 10/25/2022]
|
198
|
Woo SY, Kim HJ, Kim BR, Ahn HC, Jang BN, Park EC. Support from superiors reduces depression in Republic of Korea military officers. BMJ Mil Health 2020; 167:378-382. [PMID: 32111677 PMCID: PMC8639903 DOI: 10.1136/jramc-2019-001343] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 12/03/2019] [Accepted: 12/10/2019] [Indexed: 11/03/2022]
Abstract
BACKGROUND The prevalence of depression is relatively high in the Korean military. Social support is a protective factor against depression and is classified into four categories: emotional support-having the sense of feeling loved; instrumental support-receiving material assistance; informational support-receiving advice; appraisal support-feeling valued and respected for one's abilities. OBJECTIVE To investigate the effect of support from one's superior on depression among Republic of Korea (ROK) military officers. METHODS 2047 participants from the 2015 Military Health Survey were included in the study. The Korean version of the Beck Depression Inventory was used to measure depression, and a self-reported questionnaire was used to assess support from one's superior. A chi-squared test and multiple logistic regression were used to analyse the data. RESULTS Of the 2047 participants, 177 (8.6%) had depression. Military officers who did not receive support from their superior were more likely to have depression than than those who did receive support (OR=2.09, 95% CI 1.30 to 3.36). Additionally, military personnel who did not receive emotional or appraisal support were more likely to have depression (emotional support: OR=2.37, 95% CI 1.31 to 4.29; appraisal support: OR=1.56, 95% CI 1.48 to 2.75). CONCLUSIONS Our study found that depression in military officers was associated with lack of support from superiors. In particular, emotional support and appraisal support had a statistically significant effect. Therefore, we suggest that the ROK armed forces consider early intervention and management for high-risk groups. A social support programme and organisational atmosphere are also needed to improve supportive ability and skills of superiors.
Collapse
|
199
|
Koo HJ, Choe J, Kang DY, Ko E, Ahn JM, Park DW, Park SJ, Kim HJ, Kim JB, Choo SJ, Kang JW, Yang DH. Computed Tomography Features of Cuspal Thrombosis and Subvalvular Tissue Ingrowth after Transcatheter Aortic Valve Implantation. Am J Cardiol 2020; 125:597-606. [PMID: 31839148 DOI: 10.1016/j.amjcard.2019.11.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 10/30/2019] [Accepted: 11/01/2019] [Indexed: 01/17/2023]
Abstract
Post-transcatheter aortic valve implantation (TAVI) computed tomography (CT) findings have not been fully elucidated, except hypoattenuating leaflet thickening (HALT). The objective of this study was to describe cardiac CT findings after TAVI, and investigate factors associated with HALT. This retrospective study included patients who underwent TAVI and post-TAVI cardiac CT scans. On CT, abnormal findings such as hypoattenuating subvalvular thickening (HAST), thrombus within the sinus of Valsalva, HALT, and leaflet motion limitation were thoroughly reviewed. Clinical and CT findings were compared between patients with HALT and those without HALT. Logistic regression analysis was performed to determine factors associated with HALT. A total of 138 patients (64 male, mean 78.5 ± 5.2 years of age) with post-TAVI CT scans were included. The median duration from TAVI to CT was 17.5 days (interquartile range, 3 to 390.8 days). HAST and thrombus within the sinus of Valsalva were detected in 32 (23%) and 5 (4%) patients, respectively. HALT and leaflet motion limitations were found in 25 (18%) and 20 (14%) of patients, respectively. Pannus was diagnosed in 2 patients. TAVI device implant duration (odds ratio [OR], 1.5; p = 0.01), hypertension (OR, 0.2; p = 0.03), and HAST (OR, 4.9; p = 0.003) were associated with HALT. Implant durations were longer in patients with HAST, HALT, or leaflet motion limitation (p < 0.05, for all). In conclusion, HAST, HALT, thrombus within the sinus of Valsalva, and leaflet motion limitation are not uncommon after TAVI. Implant duration, hypertension, and HAST are associated with HALT.
Collapse
|
200
|
Thompson AJ, Cohen JA, Kim HJ, Geurts J. MSJ 2020 - Editorial comment. Mult Scler 2020; 26:134. [PMID: 32052712 DOI: 10.1177/1352458519899322] [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]
|