76
|
Park YH, Cho EY, Lee JE, Nam SJ, Yang JH, Ahn JS, Im YH. P1-12-15: Adjuvant Trastuzumab Effect on HER2−Positive Breast Cancers According to Hormonal Receptor (HR) Status: Crosstalk between ER and EGFR/HER2 Pathway May Prevent Trastuzumab from Improving Outcomes in HER2−Positive and HR-Positive Breast Cancers. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p1-12-15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Crosstalk between growth factor receptor, especially the EGFR/HER2 pathway, and ER pathways has been associated with endocrine resistance. Thus, combination therapy targeting both ER and EGFR/HER2 signaling to block the crosstalk between these pathways and eliminate escape routes have been proven effective in both preclinical and clinical models. Anti-HER2 directed therapy has been reported to restore hormone sensitivity in HER2−positive breast cancers. Adding trastuzumab to conventional treatment has been a standard treatment of choice in HER2−positive breast cancer irrespective of hormonal receptor (HR) status. The purpose of the study is to evaluate adding effect of 1 year of trastuzumab to conventional adjuvant treatment in patients with HER2−positive breast cancer who received surgery according to HR status.
Patients and Methods: We retrospectively analyzed the clinicopathologic characteristics and outcomes of 618 postoperative HER2−positive breast cancer patients between 2001 and 2008 at the Samsung Medical Center. Most of HER2−positive patients in our institute were treated with 1 year of trastuzumab as a part of adjuvant therapy since 2007 (post-trastuzumab era) compared with 2000–2006 (pre-trastuzumab era). Clinical outcomes including recurrence-free survival (RFS) were analyzed between pre-trastuzumab and post-trastuzumab era according to HR status. We performed Cox regression multivariate analysis for relapse using variables from univariate analysis by log-rank test for relapse. Clinical presentations and clinicopathologic characteristics were evaluated at the time of recurrence between both eras.
Results: The median age at diagnosis was 46 years (range, 22–79). During the median 60.0 months of follow-up, the 5-year recurrence rate was 20.2%. The 618 patients were divided into two groups (patients who received (n=175) and did not receive (n=443) adjuvant trastuzumab). Recurrence rate was much lower in post-trastuzumab era than in pre-trastuzumab era (13.6% vs. 32.3%, p<0.0001). Improving outcomes due to adding trastuzumab in patients with HER2+ve/HR-ve patients showed significant benefit from trastuzumab throughout the follow-up period (p=0.004). However, this improving effect appeared not to be consistent with statistical significance in HER2+ve/HR+ve patients (p=0.135). The analyses were performed according to quantitative ER Allred scores in HER2+ve/ER+ve patients, the effect of adding trastuzumab appeared to be mitigated as time over without any statistical significance (p=0.975). Young age (≤35) (hazard ratio (HR) 2.4, p<0.0001), trastuzumab use (HR 0.4, p=0.001), and node positivity (HR 2.8, p<0.0001) were identified as independent prognostic factors for recurrence in Cox-regression multivariate analysis. Limiting to HER2+ve/ER+ve patients, the statistical significances of trastuzumab use as independent factors were not maintained in Cox-regression models (p=0.074 for trastuzumab use).
Conclusion: Cross-talk between ER and EGFR/HER2 pathways may mitigate trastuzumab effect in HER2+ve/ER+ve breast cancers. Further study is warranted.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-12-15.
Collapse
|
77
|
Park YH, Im SA, Cho EY, Ahn JH, Kim S, Keam B, Han W, Park IA, Noh DY, Lee JE, Nam SJ, Yang JH, Ahn JS, Im YH. P2-12-19: Nomogram To Predict Recurrence and To Avoid Unnecessary Adjuvant Chemotherapy Based on Ki67 Index and ER Status in Hormone Receptor (HR)-Positive Breast Cancers with Low Number of Nodal Metastases (≤3) (NCT01273415). Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p2-12-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Hormone receptor (HR) positive breast cancers characterized with ER-associated genes are differentiated luminal B from luminal A tumors mainly by proliferation genes. According to NCCN guideline 2011, node positivity has been a main determinant to decide adjuvant chemotherapy with category 1. However, the experts’ panel at the St. Gallen Consensus in 2009 do not provides definite indications to give or withhold chemotherapy in patient group with intermediate criteria including low numbers (1-3, N1) of involved lymph nodes. Thus, in cases of limited number of nodal metastases, the role of biologic factors including Ki67 index needs to be defined. The aims of this study are to evaluate of Ki67 index as a useful surrogate marker to predict recurrence and to avoid unnecessary adjuvant chemotherapy and to develop nomogram based on Ki67 index to determine adjuvant therapeutic options in HR-positive in N0 and N1 breast cancers.
Patients and Methods
We retrospectively analyzed the clinicopathologic characteristics and outcomes of 953 postoperative HR-positive N0 and N1 breast cancer patients between 2004 and 2007 at the Samsung Medical Center. We constructed nomogram based on Cox regression model using independent factors demonstrated in multivariate analysis and validated externally in a cohort of 895 patients treated at Seoul National University Hospital.
Results: In Cox regression multivariate analysis, ER-ve/PgR+ve and Ki67 index were identified as independent factors.
Nomogram base on Cox-regression model showed an AUC of 0.75 (95% CI, 0.72−0.77) in the training set. The validation set showed a good discrimination with an AUC of 0.63 (95% CI, 0.60−0.66). We defined low nomogram score as less than 53, and high nomogram score as 53 or more from the cut-off value of the nomogrma ROC curve. Patients who received anthracycline-containing adjuvant chemotherapy with high nomogram scores showed better RFS with statistical significance than those who did not receive anthracycline-containing adjuvant chemotherapy with high nomogram scores (p<0.0001). In contrast, the patients with low nomogram scores did not show any benefit from anthracycline-containing adjuvant chemotherapy (p=0.804). When the patients with high nomogram scores divided into two groups according to Allred ER scores (0-4 vs 5–8), the patients with high ER Allred scores (5-8) and high nomogram scores did not show any benefit from anthracycline-containing chemotherapy (p=0.283). Main benefit from adjuvant chemotherapy is focused on the patients with low ER Allred scores (0-4) and high nomogram score (p=0.022).
Conclusion: Ki67 index is useful as a valuable surrogate marker to predict recurrence and to avoid unnecessary chemotherapy. Nomogram based on Ki67 index is constructed and validated to determine adjuvant therapeutic options in HR-positive N0 and N1 breast cancers.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-12-19.
Collapse
|
78
|
Lee ML, Mue TS, Huang FW, Yang JH, Sheu JK. High-performance GaN metal-insulator-semiconductor ultraviolet photodetectors using gallium oxide as gate layer. OPTICS EXPRESS 2011; 19:12658-12663. [PMID: 21716508 DOI: 10.1364/oe.19.012658] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
In this study, gallium nitride (GaN)-based metal-insulator-semiconductor (MIS) ultraviolet (UV) photodetectors (PDs) with a gallium oxide (GaO(x)) gate layer formed by alternating current bias-assisted photoelectrochemical oxidation of n-GaN are presented. By introducing the GaO(x) gate layer to the GaN MIS UV PDs, the leakage current is reduced and a much larger UV-to-visible rejection ratio (R(UV/vis)) of spectral responsivity is achieved. In addition, a bias-dependent spectral response results in marked increase of the R(UV/vis) with bias voltage up to ~10(5). The bias-dependent responsivity suggests the possible existence of internal gain in of the GaN MIS PDs.
Collapse
|
79
|
Yang JH, Yan CX, Chen XJ, Zhu YS. Expression of Aquaglyceroporins in Epithelial Ovarian Tumours and Their Clinical Significance. J Int Med Res 2011; 39:702-11. [PMID: 21819701 DOI: 10.1177/147323001103900302] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Protein levels of aquaglyceroporins AQP3, AQP7 and AQP9 were measured by immunohistochemistry and Western blotting in epithelial ovarian tumour tissue from 98 patients and in normal ovary tissue from 20 persons with uterine myoma. AQP3 and AQP9 proteins were detected immunohistochemically in the basolateral membranes of benign and borderline tumour cells and were found to be distributed throughout the plasma membranes of malignant tumour cells. AQP7 protein was localized in the plasma membranes of benign tumour cells but, in borderline and malignant tumour cells, it was selectively stained in the nuclear membrane. Western blotting showed significantly higher AQP7 and AQP9 protein expression in malignant and borderline tumours than in benign tumour and normal ovarian tissue. AQP9 expression level was positively and significantly correlated with tumour grade and histological type. It was concluded that a high level of aquaglyceroporin expression may be an important factor in ovarian carcinogenesis.
Collapse
|
80
|
Yang JH, Sohn YH, Ko SY, Choi SE, Kim MH, Oh HB. Anthropological analysis of Koreans using HLA class II diversity among East Asians. ACTA ACUST UNITED AC 2011; 76:282-8. [PMID: 20522202 DOI: 10.1111/j.1399-0039.2010.01511.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Human leukocyte antigens (HLAs) are useful markers for anthropological investigations because the allele and haplotype distributions at these loci vary widely among ethnic groups. HLA frequencies in Koreans, however, have not previously been analyzed on a phylogenetic basis. We determined the allele frequencies of four HLA class II (HLA-DRB1, -DQA1, -DQB1, and -DPB1) loci in 149 unrelated Korean individuals using a sequence-based typing method. A total of 29 HLA-DRB1, 17 HLA-DQA1, 16 HLA-DQB1, and 15 HLA-DPB1 alleles were identified. The most common allele at each locus was DRB1*0901, DQA1*0102, DQB1*0301, and DPB1*0501, respectively. Four-locus allelic association analysis showed the existence of 25 DRB1-DQA1-DQB1-DPB1 haplotypes with a frequency greater than 0.010. A dataset comprising ethnicity-specific information from published literature and the dbMHC database, as well as the allele frequencies determined in this study, was subjected to phylogenetic analysis. The analysis showed that Koreans are most closely related to Japanese and Han Chinese from Shandong province. Correspondence analyses showed that the current Korean population is located in a position intermediate between the northern and southern East Asian groups, supporting the theory of a bi- and/or multidirectional route of migration of early Korean settlers. This report can be used for anthropological studies, and may also be of use in the International Hematopoietic Stem Cell Sharing program.
Collapse
|
81
|
Kim YD, Lee JH, Jung YH, Cha MJ, Choi HY, Nam CM, Yang JH, Cho HJ, Nam HS, Lee KY, Heo JH. Effect of warfarin withdrawal on thrombolytic treatment in patients with ischaemic stroke. Eur J Neurol 2011; 18:1165-70. [PMID: 21314856 DOI: 10.1111/j.1468-1331.2011.03363.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND PURPOSE Abruptly discontinuing warfarin may induce a rebound prothrombotic state. Thrombolytic agents may also paradoxically induce prothrombotic conditions, which include platelet activation and thrombin generation. Therefore, prothrombotic states may be enhanced by withdrawing warfarin in patients under thrombolytic treatment. This study was aimed to determine whether patients with warfarin withdrawal have different clinical outcomes from those without warfarin use after thrombolytic treatment. METHODS A total of 148 consecutive patients with atrial fibrillation who were not on anticoagulants at admission and who received thrombolysis were included in this study. We compared the outcomes between a warfarin withdrawal group and a no-warfarin group. RESULTS Fourteen patients (9.5%) were included in the warfarin withdrawal group. Although baseline National Institute of Health Stroke Scale (NIHSS) scores, recanalization rates, and hemorrhage frequencies did not differ between the groups, the warfarin withdrawal group showed poorer outcomes. Increased NIHSS scores during the first 7days were more frequent in the warfarin withdrawal group (57.1% vs. 26.9%, P=0.029). The median percent improvement in NIHSS scores at 24h after thrombolysis was also lower in the warfarin withdrawal group. After adjusting for covariates, warfarin withdrawal was a strong predictor of poor functional outcome at 3months (modified Rankin score≥3) (odds ratio, 17.067, 95% CI 2.703-107.748). CONCLUSIONS Discontinuing warfarin was associated with early neurologic deterioration and poor long-term outcomes after thrombolytic treatment.
Collapse
|
82
|
Lee HJ, Han JY, Yook JH, Choi JS, Ahn HK, Kim MY, Song IO, Yang JH, Nava-Ocampo AA. A prospective cohort study of pregnancy outcomes of women inadvertently exposed to methylephedrine in the 1st trimester of pregnancy. J OBSTET GYNAECOL 2011; 30:563-6. [PMID: 20701502 DOI: 10.3109/01443615.2010.487577] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
No information is currently available on the safety of methylephedrine, a component of various cold medications available in South Korea. With previous approval by an Institutional Review Board, 349 women inadvertently exposed to methylephedrine during the 1st trimester of pregnancy and an age- and gravidity-matched control group, were enrolled in a prospective cohort study. Study outcomes, for example gestational age at birth, birth weight and major and minor malformations were evaluated in 282 cases and 280 controls. Exposure to methylephedrine was at a gestational age of 4.0 weeks (median), at doses ranging from 52.5 to 1,575 mg/day, for a median duration of 3 (range: 1-30) days. No differences were observed between cases and controls in any of the pregnancy outcomes studied. There were 4/265 (1.5%) babies born with major malformations in the case group and 4/260 (1.5%) in the control group. In conclusion, inadvertent exposure to methylephedrine as a component of over-the counter oral cold remedies in early pregnancy was not associated with an increased rate of adverse pregnancy outcomes. Co-exposure with acetaminophen, cigarette smoking or alcohol did not appear to modify the outcomes.
Collapse
|
83
|
Park YH, Ok ON, Seo JJ, Cho EY, Lee JE, Nam SJ, Yang JH, Ahn JS, Im YH. Abstract P2-06-01: Ki67 Proliferative Index as an Invaluable Biomarker in Hormone Receptor (HR)-Positive Breast Cancer: Ki67 Labelling Index Can Reflect the Differences between Luminal A and B Subtypes Better Than HER2 Expression. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p2-06-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Differentiation by multigene signatures with excellent performance of hormone receptor (HR)-positive BC largely related to their proliferation genes. Despite questions about its usefulness, there is increasing evidence that Ki67 is a valuable prognostic marker. Standardization of Ki67 pathological assessment is the main problem to interpret reported trials.
The aims of the study are to evaluate the role Ki67 as prognostic marker to predict relapse in HR-positive BC patients (luminal A and B) in adjuvant setting using prospective patients’ cohort. In addition, cut-off value and significant level of Ki67 were investigated comparing with other biomarkers including HER2 in luminal BCs.
Method: We retrospectively analyzed the clinicopathologic characteristics of 1,070 postoperative breast cancer patients including Ki67 and clinical outcomes in terms of relapse free survival (RFS) between 2004 and 2007 at the Samsung Medical Center. Ki67 labelling index was measured in quantitative and semiquantitative method, independently. The percentage of positive nuclei stained for Ki67 was calculated each section based on the approximately 1,000 carcinoma cell nuclei. In addition, Ki67 was graded on a scale from 0 to 4, where 0 = staining of 0-4% of tumor cells, 1 = staining of 5-25% of tumor cells, 2 = 26-50% of tumor cells, 3 = staining of 51-75% of tumor cells, and 4 = staining of more than 76% of tumor cells. ROC curve was drawn to evaluate the usefulness of Ki67 index to get AUC then, find out the proper cut-off value of Ki67 to predict relapse. Multivariate analyses with Cox-regression model were performed. Results: Among 1,564 patients who received curative surgery for invasive breast cancer from January 2004 to June 2007, 1,070 patients with HR-positive were included in this analysis excluding 494 with HER2-enriched or triple negative breast cancer patients. Median follow-up duration was 56.9 months (range 36-77 months). Median age was 46 years (range 22-83 years). Ki67 threshold >19.5%, corresponding to a sensitivity 78.3%, a specificity 51.6% was chosen as cut-off value for relapse in adjuvant patients’ cohort. The AUC was 0.689 (P<0.0001 by Mann-Whitney U test). Overall relapse rate was 5.6%. In univariate analysis by log-rank test for relapse, ER negativity (p=0.010), HER2 positivity (p=0.017), histologic (p=0.001), and nuclear grade (p=0.012), lymphovascular invasion (P<0.0001), TNM stage (0.001), and Ki67 (P<0.0001) were identified risk factors to predict relapse. However, ER negativity, Ki67, and stage were identified as independent risk factors for relapse (Hazard Ratio (HR) 2.7, p=0.031 for ER negativity, HR 3.4, p <0.0001 for Ki67, HR 1.6, p=0.017 for stage) in Cox-regression multivariate analysis. Conclusion: Ki67 could strongly predict clinical outcomes for patients with luminal. 19.5% may be useful cut-off value of Ki67 labelling index. Ki67 may be a better biomarker to predict clinical outcomes than HER2 expression in luminal BCs. ER-/PR+ subset probably has different biology with other luminal BCs. Prospective clinical trials to choose therapeutic option using Ki67 are warranted.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-06-01.
Collapse
|
84
|
Zheng DD, Yang JH, Tao Q, Geng M, Lin J, Yang XJ, Song JP, Li HX, Han LH, Jiang WP. Mutations in the beta-myosin heavy chain gene in southern Chinese families with hypertrophic cardiomyopathy. J Int Med Res 2010; 38:810-20. [PMID: 20819418 DOI: 10.1177/147323001003800308] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
In this study, 14 unrelated hypertrophic cardiomyopathy (HCM) probands were scanned by polymerase chain reaction-single-strand conformation polymorphism analysis and DNA sequencing. Three mis-sense mutations of the beta-myosin heavy chain gene, MYH7, were found: valine (Val) 606 methionine (Met), arginine (Arg) 694 leucine (Leu), and Arg 723 glycine (Gly). All are reported here for the first time in Chinese subjects. The results showed that: Val606Met is an intermediate malignancy mutation; Arg694Leu is a novel mutation with a benign phenotype; and the Arg723Gly mutation is linked to malignancy - it can lead not only to HCM but also to dilated cardiomyopathy at various ages. The clinical symptoms associated with Arg723Gly emerged early and caused more severe clinical manifestation and poorer prognosis in females than in males. Mis-sense mutations were not detected in the myosin binding protein C, cardiac, cardiac troponin T type 2, or cardiac troponin I type 3 genes. The MYH7 gene may be an HCM mutation hotspot in the Chinese and have unique features in this study population.
Collapse
|
85
|
Yang JH, Liu XB. Controlling vibrational resonance in a multistable system by time delay. CHAOS (WOODBURY, N.Y.) 2010; 20:033124. [PMID: 20887064 DOI: 10.1063/1.3481343] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The phenomenon of vibrational resonance in a delayed multistable system that is excited by biharmonic signals is investigated in the present paper. Different from the former theory, the appearance and the disappearance of the vibrational resonance are controlled by adjusting the time delay parameter instead of modulating the amplitude of the high-frequency signal. The motion of the orbit within or between the different potential wells can also be controlled. Furthermore, based on both the methods of numerical simulation and analytical analysis, the behavior of delay-induced multiple vibrational resonance and its mechanism are investigated and discussed. The multiple vibrational resonance, which is quantified by the response amplitude at the low-frequency, is found to be periodic in the delay parameter with two periods, i.e., the periods of the two driven signals. The method used in this paper gives a new way for controlling vibrational resonance in a multistable system.
Collapse
|
86
|
Kim HJ, Lee HJ, Yang JH, Yeo IS, Yi JS, Lee IW, Lee SB, Ryu SY, Kim JK, Yang PS. The influence of carotid artery catheterization technique on the incidence of thromboembolism during carotid artery stenting. AJNR Am J Neuroradiol 2010; 31:1732-6. [PMID: 20595362 DOI: 10.3174/ajnr.a2141] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Thromboembolic events related to CAS continue to be the main limitation to the widespread use of this technique as a first-line treatment for carotid occlusive disease. Our aim was to evaluate thromboembolism during CAS using DWI for catheterization techniques of the carotid artery. MATERIALS AND METHODS Thirty-two consecutive patients with symptomatic carotid stenosis underwent CAS involving 1 of 2 carotid artery catheterization techniques: One used a 7F or 8F catheter (group 1, n = 16) and the other used a coaxial system in which a 7F or 8F catheter was used in conjunction with a 4F or 5F catheter (group 2, n = 16). DWI was performed before and after CAS. Clinical variables, the number and location of NES on DWI after CAS, were compared between the 2 groups. RESULTS NES on DWI occurred in 53% of all patients. The incidence of NES was significantly higher in patients 65 years of age and older versus those younger than 65 years of age (P = .013). All NESs were asymptomatic, and their rate of occurrence did not differ significantly between groups 1 and 2. The incidence of NES in the other territories that were outside that of the treated carotid artery (P = .004) and the incidence of multiple NESs (P = .04) were significantly higher in group 1. CONCLUSIONS NES in the other territories mainly arises from the atherosclerotic aortic arch and arch vessels during the manipulation of endoluminal devices. The carotid artery catheterization technique using the coaxial system with a 7F or 8F catheter in conjunction with a 4F or 5F catheter reduced the incidence of NES in the other territories.
Collapse
|
87
|
Moon MH, Cho JY, Kim JH, Min JY, Yang JH, Kim MY. In-utero development of the fetal anal sphincter. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2010; 35:556-559. [PMID: 20183865 DOI: 10.1002/uog.7598] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To investigate the in-utero development of the fetal anal sphincter using transabdominal ultrasound. METHODS This was a cross-sectional study in which the diameter of the fetal anal sphincter was measured sonographically once in 631 well-dated, non-anomalous fetuses scanned between 19 and 38 weeks of gestation. Visualization rates were determined. Regression analysis was used to assess the relationship between the diameter of the fetal anal sphincter and gestational age (GA), and reference values including the mean and 95% reference interval were calculated for each GA. RESULTS The sonographic visualization rate of the fetal anal sphincter increased with gestational age, plateauing at 90-100% between 23-34 weeks of gestation. There was a significant positive relationship between fetal anal sphincter diameter and GA, which was best described by the equation: anal sphincter diameter (mm) = - 0.014 x GA(2) + 1.107 x GA - 11.664 (R(2) = 0.62). CONCLUSION We have provided reference values for the in-utero development of the fetal anal sphincter throughout gestation.
Collapse
|
88
|
Yang JH, Kim YM, Chung HS, Cho J, Lee HM, Kang GH, Kim EC, Lim T, Cho YS. Comparison of four manikins and fresh frozen cadaver models for direct laryngoscopic orotracheal intubation training. Emerg Med J 2009; 27:13-6. [DOI: 10.1136/emj.2008.066456] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
89
|
Ji Y, Sun Y, Xie JH, Yang JH, Liu Y, Du KM. A novel HLA-DRB1*120204 allele found in a Chinese individual. ACTA ACUST UNITED AC 2009; 74:462-3. [PMID: 19737371 DOI: 10.1111/j.1399-0039.2009.01340.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The HLA-DRB1*120204 allele differs by a single synonymous nucleotide change from the DRB1*120201 allele at position 203 in exon 2 from C to G.
Collapse
|
90
|
Modi HN, Srinivasalu S, Suh SW, Yang JH. Grade 4 spondylolisthesis of the L5 vertebra associated with dural ectasia in neurofibromatosis. Singapore Med J 2009; 50:e287-e292. [PMID: 19710961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Spondylolisthesis associated with neurofibromatosis is rare, and only 12 cases have been reported so far. However, only one report of grade 4 spondylolisthesis with neurofibromatosis has been reported in the literature. A 15-year-old boy with neurofibromatosis was admitted for back pain and neurological claudication. Radiograph showed grade 4 spondylolisthesis of the L5 vertebra with scalloping of the L4-L5 vertebrae. L4-L5 laminectomy, reduction, L3-S1 posterior instrumentation and fusion were performed. The reduction of the spondylisthesis was done entirely from the posterior approach using pedicle screws. Radiography at four months showed a broken S1 screw with a loss of reduction. The patient was re-operated on, to provide additional stability with pelvic fixation. He was pain-free with a good fusion at the two-year follow-up. Adequate posterior stabilisation with fusion gives good results in grade 4 spondylolisthesis associated with neurofibromatosis and dural ectasia.
Collapse
|
91
|
Han JY, Yang JH, Chung JH, Choi JS, Ahn HK, Ryu HM, Kim MY, Cho SI, Nava-Ocampo AA. Teratogen risk counselling by internet: A prospective cohort study. J OBSTET GYNAECOL 2009; 25:427-31. [PMID: 16183573 DOI: 10.1080/01443610500160584] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Although the internet may play a role in providing proper teratogen-risk counselling for pregnant women, the experience with this type of service has not been reported. We aimed to compare the pregnancy outcome of women counselled by the internet to women that received typically in-clinic teratogen risk counselling in the clinic. In a prospective cohort design, 1,011 patients were counselled in the clinic and 235 patients were counselled via the internet. Teratogen risk counselling was provided according with the information obtained from medical literature and specialised software. Information about pregnancy outcome (delivery, spontaneous abortion, or termination of pregnancy and major malformations) was obtained from 903 (89.3%) patients from the clinic group and 141 (60%) from the internet group. The amount of alcohol, cigarettes smoked, and millirads of X-ray were greater ( p < 0.05) in patients counselled by internet than in clinic. The rate of deliveries, ongoing pregnancies, pregnancy terminations, and spontaneous abortions were similar between clinic and internet (chi2 = 1.32; p = 0.7). Of 498 babies born to mothers counselled in the clinic, major malformations were identified in 3.6%. Of 67 babies born to mothers counselled by internet, major malformations were present in 1.5% ( p = 0.6). Teratogen-risk counselling by internet and clinic seems to have a similar efficacy in pregnancy outcome.
Collapse
|
92
|
Cho YJ, Han JY, Choi JS, Ahn HK, Ryu HM, Kim MY, Yang JH, Nava-Ocampo AA, Koren G. Prenatal multivitamins containing folic acid do not decrease prevalence of depression among pregnant women. J OBSTET GYNAECOL 2009; 28:482-4. [PMID: 18850419 DOI: 10.1080/01443610802196658] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Several studies have reported an association between depression and folic acid deficiency. We investigated whether intake of prenatal multivitamins containing folic acid (MVandFA) was associated with decreased rates of depression among pregnant women. A questionnaire was given to 1,314 low-risk pregnant women. Of them, 1,277 (97.2%) women completed the questionnaire. The overall prevalence of depression was 8.1%. Of 652 participants who did not take MVandFA, 9.4% had depression, whereas 6.9% of 624 women who had MVandFA had depression (p = 0.11). In a multivariate logistic regression analysis, family history of depression (adjusted OR 3.7; 95% CI 1.9-7.3) and premenstrual syndrome (adjusted OR 3.0, 95% CI 1.8-4.8) were identified as risk factors for depression during pregnancy. In conclusion, intake of MVandFA was not associated with lower rates of depression during pregnancy whereas family history of depression and personal history of premenstrual syndrome were significant risk factors.
Collapse
|
93
|
Cho J, Kang GH, Kim EC, Oh YM, Choi HJ, Im TH, Yang JH, Cho YS, Chung HS. Comparison of manikin versus porcine models in cricothyrotomy procedure training. Emerg Med J 2008; 25:732-4. [PMID: 18955605 DOI: 10.1136/emj.2008.059014] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
94
|
Ahn HK, Choi JS, Han JY, Kim MH, Chung JH, Ryu HM, Kim MY, Yang JH, Koong MK, Nava-Ocampo AA, Koren G. Pregnancy outcome after exposure to oral contraceptives during the periconceptional period. Hum Exp Toxicol 2008; 27:307-13. [PMID: 18684801 DOI: 10.1177/0960327108092290] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To evaluate whether periconceptional exposure to oral contraceptives (OCs) increased adverse pregnancy outcomes, 136 pregnant women taking OCs within the periconceptional period were identified at the Korean Motherisk Program. Of them, 120 pregnant women accepted to participate in their study and were followed up until completion of the pregnancy. A control group of 240 age- and gravidity-matched pregnant women exposed to non-teratogen drugs for at least 1 month before pregnancy was also included. The median gestational age at delivery was 39.1 (27.0-41.0) weeks in the exposed group and 39.3 (27.4-42.0) weeks in the control group (P = 0.19). In the exposed group, 7.1% of babies were born with low birth weight versus 2.6% in the control group (P = 0.068). The number of preterm deliveries or babies born large for gestational age did not differ between the two groups. In the exposed group, the rate of birth defects was 3.2% (n = 3/99) versus 3.6% (n = 7/193) in the control group (P = 1.0). There were 15 women who took high doses of progesterone (emergency contraception) and no adverse fetal outcomes were observed. In conclusion, periconceptional exposure to OCs does not appear to increase the risk for adverse pregnancy outcomes.
Collapse
|
95
|
Song WY, Shin TI, Kang SM, Kim SW, Yang JH, Park MH, Yang CW, Yoon DH. Controllable dimension of ZnO nanowalls on GaN/c-Al2O3 substrate by vapor phase epitaxy method. JOURNAL OF NANOSCIENCE AND NANOTECHNOLOGY 2008; 8:4783-4786. [PMID: 19049108 DOI: 10.1166/jnn.2008.ic52] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Vertically well-aligned ZnO nanowalls were successfully synthesized at 950-1050 degrees C. Ar gas was introduced into the furnace at a flow rate of 2000-2500 sccm. An Au thin film with a thickness of 3 nm was used as a catalyst. The ZnO nanowalls were successfully grown on the substrate and most of them had nearly the same thickness and were oriented perpendicular to the substrate. The morphology and chemical composition of the ZnO nanowalls were examined as a function of the growth conditions examined. It was found that the grown ZnO nanowalls have a single-crystalline hexagonal structure and preferred c-axis growth orientation based on the X-ray diffraction and high-resolution transmission electron microscope measurements. The room temperature photoluminescence showed a strong free-exciton emission band with negligible deep level emission, indicating the high optical property of our ZnO nanowall samples.
Collapse
|
96
|
Lee SW, Kim MY, Yang JH, Moon MH, Cho JY. Sonographic findings of uterine sacculation during pregnancy. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2008; 32:595-597. [PMID: 18726934 DOI: 10.1002/uog.6118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
|
97
|
Pan H, Yi JB, Shen L, Wu RQ, Yang JH, Lin JY, Feng YP, Ding J, Van LH, Yin JH. Room-temperature ferromagnetism in carbon-doped ZnO. PHYSICAL REVIEW LETTERS 2007; 99:127201. [PMID: 17930547 DOI: 10.1103/physrevlett.99.127201] [Citation(s) in RCA: 138] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2006] [Revised: 01/19/2007] [Indexed: 05/25/2023]
Abstract
We report ferromagnetism in carbon-doped ZnO. Our first-principles calculations based on density functional theory predicted a magnetic moment of 2.02 mu(B) per carbon when carbon substitutes oxygen in ZnO, and an ferromagnetic coupling among magnetic moments of the carbon dopants. The theoretical prediction was confirmed experimentally. C-doped ZnO films deposited by pulsed-laser deposition showed ferromagnetism with Curie temperatures higher than 400 K. The measured magnetic moment based on the content of carbide in the films [(1.5-3.0) mu(B) per carbon] was in agreement with the theoretical prediction. The magnetism is due to the Zn-C system in the ZnO environment.
Collapse
|
98
|
Lee J, Im YH, Lee SH, Cho EY, Choi YL, Ko YH, Kim JH, Nam SJ, Kim HJ, Ahn JS, Park YS, Lim HY, Han BK, Yang JH. Evaluation of ER and Ki-67 proliferation index as prognostic factors for survival following neoadjuvant chemotherapy with doxorubicin/docetaxel for locally advanced breast cancer. Cancer Chemother Pharmacol 2007; 61:569-77. [PMID: 17508214 DOI: 10.1007/s00280-007-0506-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2006] [Accepted: 04/22/2007] [Indexed: 10/23/2022]
Abstract
BACKGROUND The aim of the study was to identify reliable predictive biological markers for treatment outcome following neoadjuvant adriamycin/docetaxel (AT) chemotherapy in locally advanced breast cancer patients. MATERIALS AND METHODS This study was a phase II study on AT neoadjuvant chemotherapy in locally advanced breast cancer patients. Patients received 50 mg/m(2) of doxorubicin intravenously (IV) over 15 min followed by docetaxel 75 mg/m(2) infused over 1 h, repeated every 3 weeks for three cycles. Surgery was performed within 3-4 weeks following the last cycle of chemotherapy. We analyzed the pre-treatment and post-treatment expression levels of ER, PgR, HER-2, Ki-67 proliferation index, and p53 and examined the correlation between the markers and clinical parameters with treatment response, overall survival and relapse-free survival following neoadjuvant treatment. RESULTS From July 2001 to September 2004, 61 patients were enrolled. The meaningful parameters adversely influencing survival were post-treatment ER(-) status (P = 0.013) and post-treatment Ki-67 index above 1.0% (P = 0.013). At the multivariate level, the post-treatment Ki-67 proliferation index < or = 1.0 was the only meaningful prognostic factor for better survival (P = 0.033). Notably, tumors with Ki-67 index < or = 1.0 were more likely to express ER with statistical significance (P = 0.002). Tumors with ER(+) and Ki-67 index < or = 1.0 showed the highest survival rate, followed by ER(+) and Ki-67 index > 1.0%, ER(-) and Ki-67 < or = 1.0%, and ER(-) and Ki-67 > 1.0% with the worst survival (P = 0.033). CONCLUSION Collectively, post-treatment ER status and Ki-67 proliferation index were prognostic of overall survival following neoadjuvant AT chemotherapy.
Collapse
|
99
|
Yang JH, Li LH, Lee S, Jo IH, Lee SY, Ryu PD. Effects of adrenalectomy on the excitability of neurosecretory parvocellular neurones in the hypothalamic paraventricular nucleus. J Neuroendocrinol 2007; 19:293-301. [PMID: 17355319 DOI: 10.1111/j.1365-2826.2007.01531.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Glucocorticoids are well known to inhibit the release of hypophysiotrophic hormones from neurones originating in the paraventricular nucleus (PVN), but the cellular mechanisms of the inhibition are not well understood. Here, we examined the effects of adrenalectomy (ADX) on the spontaneous firing activity in the neurosecretory parvocellular PVN neurones of rat brain slices. The neurones were identified by injecting a retrograde dye into the pituitary stalk and classified according to their electrophysiological properties. The intranuclear distribution, electrophysiological properties, and hypophysiotrophic hormone phenotype of the labelled type II PVN neurones were similar to neurosecretory parvocellular PVN neurones. In the neurones of sham-operated rats under the cell-attached recording mode, we observed three spontaneous activity patterns: tonic regular (24%), tonic irregular (36%), and silent (40%). Noradrenaline (100 microM) induced an excitatory or an inhibitory effect on the spontaneous activity. Noradrenergic excitation was blocked by prazosin (2 microM, alpha(1)-adrenoceptor antagonist), and mimicked by phenylephrine (100 microM, alpha(1)-adrenoceptor agonist), whereas noradrenergic inhibition was blocked by yohimbine (2 microM, alpha(2)-adrenoceptor antagonist) and mimicked by clonidine (50 microM, alpha(2)-adrenoceptor agonist). In the neurones of ADX rats, we found burst firing in 35% of neurones tested and an increase in the frequency of spontaneous firing. The burst firing was not observed in the neurones of the sham-operated rats. ADX caused a 1.7-fold increase in the proportion of neurones showing the noradrenergic excitation. Supplementation of the ADX rats with corticosterone (10 mg pellet) reversed the ADX-induced burst firing, and the potentiation of noradrenergic excitation. In summary, our results show that removal of corticosterone by ADX can elevate the neuronal excitability by increasing the spontaneous firing rate and by potentiating the alpha(1)-adrenoceptor-mediated noradrenergic excitation, and it can facilitate hormone release by inducing burst firing. Our results provide new insight to the cellular mechanisms of the feedback inhibition by glucocorticoids in the neurosecretory parvocellular neurones of the PVN.
Collapse
|
100
|
Qiao WM, Yoon SH, Mochida I, Yang JH. Waste polyvinylchloride derived pitch as a precursor to develop carbon fibers and activated carbon fibers. WASTE MANAGEMENT (NEW YORK, N.Y.) 2007; 27:1884-90. [PMID: 17157493 DOI: 10.1016/j.wasman.2006.10.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2005] [Revised: 09/10/2006] [Accepted: 10/04/2006] [Indexed: 05/12/2023]
Abstract
Polyvinylchloride (PVC) was successfully recycled through the solvent extraction from waste pipe with an extraction yield of ca. 86%. The extracted PVC was pyrolyzed by a two-stage process (260 and 410 degrees C) to obtain free-chlorine PVC based pitch through an effective removal of chlorine from PVC during the heat-treatment. As-prepared pitch (softening point: 220 degrees C) was spun, stabilized, carbonized into carbon fibers (CFs), and further activated into activated carbon fibers (ACFs) in a flow of CO2. As-prepared CFs show comparable mechanical properties to commercial CFs, whose maximum tensile strength and modulus are 862 MPa and 62 GPa, respectively. The resultant ACFs exhibit a high surface area of 1200 m2/g, narrow pore size distribution and a low oxygen content of 3%. The study provides an effective insight to recycle PVC from waste PVC and develop a carbon precursor for high performance carbon materials such as CFs and ACFs.
Collapse
|