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Lauri FM, Mejia-Renteria H, Lee JM, Van Der Hoeven N, De Waard G, Macaya F, Goto S, Liontou C, Koo BK, Van Royen N, Escaned J. P5511Improving the diagnostic accuracy of quantitative flow ratio (QFR): a proposal of QFR-fractional flow reserve (FFR) hybrid approach. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Cho MS, Kim J, Park JK, Kim TH, Lee JM, Park JB, Park HW, Kang KW, Shim JM, Uhm JS, Kim JB, Kim CS, Lee YS, Choi EK, Joung BY. P5796Prevalence and correlates of left atrial enlargement based on left atrial volume index in korean patients with non-valvular atrial fibrillation: data from comparison study of drugs for symptom control. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Cottrell J, Yip J, Chan Y, Chin CJ, Damji A, de Almeida JR, Desrosiers M, Janjua A, Kilty S, Lee JM, Macdonald KI, Meen EK, Rudmik L, Sommer DD, Sowerby L, Tewfik MA, Vescan AD, Witterick IJ, Wright E, Monteiro E. Quality indicators for the diagnosis and management of chronic rhinosinusitis. Int Forum Allergy Rhinol 2018; 8:1369-1379. [PMID: 29999592 DOI: 10.1002/alr.22161] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 05/07/2018] [Accepted: 05/14/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Chronic rhinosinusitis (CRS) has been identified as a high-priority disease category for quality improvement. To this end, this study aimed to develop CRS-specific quality indicators (QIs) to evaluate diagnosis and management that relieves patient discomfort, improves quality of life, and prevents complications. METHODS A guideline-based approach, proposed in 2012 by Kötter et al. was used to develop QIs for CRS. Candidate indicators (CIs) were extracted from 3 practice guidelines and 1 international consensus statement on the diagnosis and management of CRS. Guidelines were evaluated using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool. Each CI and its supporting evidence was summarized and reviewed by an expert panel based on validity, reliability, and feasibility of measurement. Final QIs were selected from CIs utilizing the modified RAND Corporation-University of California, Los Angeles (RAND/UCLA) appropriateness methodology. RESULTS Thirty-nine CIs were identified after literature review and evaluated by our panel. Of these, 9 CIs reached consensus as being appropriate QIs, with 4 requiring additional discussion. After a second round of evaluations, the panel selected 9 QIs as appropriate measures of high-quality care. CONCLUSION This study proposes 9 QIs for the diagnosis and management of patients with CRS. These QIs can serve multiple purposes, including documenting the quality of care; comparing institutions and providers; prioritizing quality improvement initiatives; supporting accountability, regulation, and accreditation; and determining pay-for-performance initiatives.
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Cho H, Ahn H, Lee DH, Lee JH, Jung YJ, Chang Y, Nam JY, Cho YY, Lee DH, Cho EJ, Yu SJ, Lee JM, Kim YJ, Yoon JH. Entecavir and tenofovir reduce hepatitis B virus-related hepatocellular carcinoma recurrence more effectively than other antivirals. J Viral Hepat 2018; 25:707-717. [PMID: 29316069 DOI: 10.1111/jvh.12855] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 11/13/2017] [Indexed: 12/15/2022]
Abstract
Nucleos(t)ide analogues (NAs) have been shown to decrease the risk of hepatocellular carcinoma (HCC) recurrence. This study evaluated whether high-potency NAs (entecavir and tenofovir disoproxil fumarate [TDF]) reduce the risk of tumour recurrence more potently than low-potency NAs after curative treatment of hepatitis B virus (HBV)-related HCC. This study included 607 consecutive HBV-related HCC patients treated with surgical resection or radiofrequency ablation. The patients were categorized into three groups according to antiviral treatment: group A (no antiviral; n = 261), group B (low-potency NA; n = 90) and group C (high-potency NA; n = 256). The primary end-point was recurrence-free survival (RFS). During the duration of follow-up, the median RFS was 29.4, 25.1, and 88.2 months in groups A, B and C, respectively (P < .001, log-rank test). The multivariate Cox analysis indicated that group C had a significantly longer RFS than both group A (adjusted hazard ratio [HR] = 0.39, P < .001) and group B (adjusted HR = 0.47, P < .001). When baseline characteristics were balanced using inverse probability weighting, group C still had a significantly longer RFS than group A (adjusted HR = 0.46, P < .001) and group B (adjusted HR = 0.59, P = .007). Group C had significantly lower risk of viral breakthrough than group B (HR = 0.19, P < .001). Viral breakthrough was an independent risk factor for shorter RFS among groups B and C (adjusted HR = 2.03, P = .007, time-dependent Cox analysis). Antiviral agents with high genetic barrier to resistance (entecavir and TDF) reduced the risk of HCC recurrence compared with other antivirals and no antiviral treatment, especially in patients with high baseline viral load.
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Cornelissen L, Kim SE, Lee JM, Brown EN, Purdon PL, Berde CB. Electroencephalographic markers of brain development during sevoflurane anaesthesia in children up to 3 years old. Br J Anaesth 2018; 120:1274-1286. [PMID: 29793594 PMCID: PMC6617966 DOI: 10.1016/j.bja.2018.01.037] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 01/30/2018] [Accepted: 01/30/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND General anaesthetics generate spatially defined brain oscillations in the EEG that relate fundamentally to neural-circuit architecture. Few studies detailing the neural-circuit activity of general anaesthesia in children have been described. The study aim was to identify age-related changes in EEG characteristics that mirror different stages of early human brain development during sevoflurane anaesthesia. METHODS Multichannel EEG recordings were performed in 91 children aged 0-3 yr undergoing elective surgery. We mapped spatial power and coherence over the frontal, parietal, temporal, and occipital cortices during maintenance anaesthesia. RESULTS During sevoflurane exposure: (i) slow-delta (0.1-4 Hz) oscillations were present in all ages, (ii) theta (4-8 Hz) and alpha (8-12 Hz) oscillations emerge by ∼4 months, (iii) alpha oscillations increased in power from 4 to 10 months, (iv) frontal alpha-oscillation predominance emerged at ∼6 months, (v) frontal slow oscillations were coherent from birth until 6 months, and (vi) frontal alpha oscillations became coherent ∼10 months and persisted in older ages. CONCLUSIONS Key developmental milestones in the maturation of the thalamo-cortical circuitry likely generate changes in EEG patterns in infants undergoing sevoflurane general anaesthesia. Characterisation of anaesthesia-induced EEG oscillations in children demonstrates the importance of developing age-dependent strategies to monitor properly the brain states of children receiving general anaesthesia. These data have the potential to guide future studies investigating neurodevelopmental pathologies involving altered excitatory-inhibitory balance, such as epilepsy or Rett syndrome.
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Kim HY, Nam JY, Lee JH, Lee HA, Chang Y, Lee HY, Cho H, Lee DH, Cho YY, Cho EJ, Yu SJ, Lee JM, Kim YJ, Yoon JH. Intensity of surveillance for hepatocellular carcinoma determines survival in patients at risk in a hepatitis B-endemic area. Aliment Pharmacol Ther 2018; 47:1490-1501. [PMID: 29611209 DOI: 10.1111/apt.14623] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 02/01/2018] [Accepted: 03/01/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Data are insufficient regarding the survival benefit of surveillance for hepatocellular carcinoma (HCC). AIM To investigate the effectiveness of HCC surveillance in a hepatitis B-endemic population. METHODS This retrospective cohort study included 1402 consecutive patients who were newly diagnosed with HCC between 2005 and 2012 at a single tertiary hospital in Korea. The primary endpoint was overall survival. Lead-time and length-time biases were adjusted (sojourn time = 140 days) and sensitivity analyses were performed. RESULTS The most common aetiology was hepatitis B (80.4%). Cirrhosis was present in 78.2%. HCC was diagnosed during regular surveillance (defined as mean interval of ultrasonography <8 months, n = 834), irregular surveillance (n = 104) or nonsurveillance (n = 464). Patients in the regular surveillance group were diagnosed at earlier stages ([very] early stage, 64.4%) than the irregular surveillance (40.4%) or nonsurveillance (26.9%) groups and had more chance for curative treatments (52.4%) than the irregular surveillance (39.4%) or nonsurveillance (23.3%) groups (all P < 0.001). Mortality risk was significantly lower in the regular surveillance group (adjusted hazard ratio [aHR], 0.69; 95% [CI], 0.57-0.83) but not in the irregular surveillance group (aHR, 0.94; 95% CI, 0.69-1.28) compared with the nonsurveillance group after adjusting for confounding factors and lead-time. When the subjects were restricted to cirrhotic patients or Child-Pugh class A/B patients, similar results were obtained for mortality risk reduction between groups. CONCLUSIONS HCC surveillance was associated with longer survival owing to earlier diagnosis and curative treatment. Survival advantage was significant with regular surveillance but not with irregular surveillance.
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Lee JM, Jeon JH, Moon IS, Choi JY. Benefits of active middle ear implants over hearing aids in patients with sloping high tone hearing loss: comparison with hearing aids. ACTA OTORHINOLARYNGOLOGICA ITALICA 2018; 37:218-223. [PMID: 28516965 PMCID: PMC5463512 DOI: 10.14639/0392-100x-1146] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 01/15/2017] [Indexed: 11/24/2022]
Abstract
In this retrospective chart review we compared the subjective and objective benefits of active middle ear implants (AMEIs) with conventional hearing aids (HAs) in patients with sloping high tone hearing loss. Thirty-four patients with sensorineural hearing loss were treated with AMEIs. Of these, six had sloping high tone hearing loss and had worn an HA for more than 6 months. Objective assessments, a pure-tone audiogram, as well as a word recognition test, and the Korean version of the Hearing in Noise Test (K-HINT), and a subjective assessment, the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire, were performed. Tests were conducted under three circumstances: 1) the unaided state before surgery; 2) the HA-aided state before surgery; and 3) the AMEI-aided state 3 months after surgery. The average high-frequency hearing gain (≥ 2 kHz) was significantly better with AMEIs than with HAs. Although the result had no statistical significance, AMEIs showed a superior word recognition score (WRS) compared to HAs. However, the most comfortable hearing level at which the WRS was tested was significantly decreased with an AMEI compared to an HA. In the K-HINT, patients with an AMEI showed greater recognition than those fitted with an HA under both quiet and noisy conditions. The APAHB scores revealed that patients were more satisfied with an AMEI rather than an HA on all subscales. The use of vibroplasty in patients with sloping high tone loss resulted in positive hearing outcomes when compared to conventional HAs. Based on the data from this study, AMEIs provided better objective and subjective results and could, therefore, be a better alternative for the treatment of sloping hearing loss.
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Wu V, Siu J, Yip J, Lee JM. Endoscopic management of maxillary sinus inverted papilloma attachment sites to minimize disease recurrence. J Otolaryngol Head Neck Surg 2018; 47:24. [PMID: 29618385 PMCID: PMC5885307 DOI: 10.1186/s40463-018-0271-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 03/27/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Inverted papillomas (IPs) are benign neoplasms, most commonly arising from the mucosal lining of the maxillary sinus. IPs can have single or multifocal sites of attachment. Although pedicle location is an important factor to consider in surgical planning, it is less clear whether the location or number of IP attachment sites hold any prognostic value. Herein, we aimed to determine the prognostic significance of the number and location of attachment sites of IPs originating from the maxillary sinus when managed by a pure endoscopic approach. METHODS This was a single-center, single-surgeon retrospective chart review. Patients with maxillary sinus IPs who were managed by endoscopic approaches only, from January 1, 2010 to June 30, 2016, were identified. Demographic data, operative technique, number and location of IP attachment sites, follow-up duration, recurrence, and presence of malignant transformation were captured. RESULTS Twenty-eight maxillary IP patients (61% males) were included, with a mean age of 54.9 (standard deviation (SD): 16.5) years. Approximately 36% of patients were referred from other institutions for management of recurrent IPs after failing previous surgical treatment. All patients were managed with an endoscopic approach, and all required an endoscopic medial maxillectomy to facilitate access to the maxillary sinus. At a mean follow-up of 31.1 (SD: 22.6) months, there were no recurrences identified. IPs with single (46%) and multifocal (54%) attachments were predominately to the medial and lateral walls. Maxillary IPs with multifocal attachments most frequently involved 2-3 walls of the sinus. Osteitis (36%) was commonly seen. CONCLUSION IPs originating from the maxillary sinus frequently had multifocal attachments, but this did not impact disease recurrence. Despite the surgical challenges of accessing all of the maxillary sinus walls, IPs originating from the maxillary sinus can be effectively managed via a pure endoscopic approach.
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Cessna JT, Fitzgerald R, Zimmerman BE, Laureano-Pérez L, Bergeron DE, van Wyngaardt F, Smith M, Jackson T, Howe B, da Silva CJ, Iwahara A, da Cruz PAL, Zhang M, Liu H, Liang J, Fréchou C, Bobin C, Cassette P, Kossert K, Nähle O, Marganiec-Gałązka J, Joseph L, Ravindra A, Kulkarni DN, Yunoki A, Sato Y, Lee KB, Lee JM, Agung, Dziel T, Listkowska A, Tymiński Z, Sahagia M, Antohe A, Ioan MR, Luca A, Krivosek M, Ometakova J, Javornik A, Zalesakova M, García-Toraño Martinez E, Roteta M, Mejuto M, Nedjadi Y, Juget F, Yuan MC, Yeh CY, Yeltepe E, Dirican A, Keightley J, Pearce A. Results of an international comparison of activity measurements of 68Ge. Appl Radiat Isot 2018; 134:385-390. [PMID: 29248210 PMCID: PMC10996930 DOI: 10.1016/j.apradiso.2017.10.052] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 10/30/2017] [Accepted: 10/30/2017] [Indexed: 11/25/2022]
Abstract
An international key comparison, identifier CCRI(II)-K2.Ge-68, has been performed. The National Institute of Standards and Technology (NIST) served as the pilot laboratory, distributing aliquots of a 68Ge/68Ga solution. Results for the activity concentration, CA, of 68Ge at a reference date of 12h00 UTC 14 November 2014 were submitted by 17 laboratories, encompassing many variants of coincidence methods and liquid-scintillation counting methods. The first use of 4π(Cherenkov)β-γ coincidence and anticoincidence methods in an international comparison is reported. One participant reported results by secondary methods only. Two results, both utilizing pure liquid-scintillation methods, were identified as outliers. Evaluation using the Power-Moderated Mean method results in a proposed Comparison Reference Value (CRV) of 621.7(11)kBqg-1, based on 14 results. The degrees of equivalence and their associated uncertainties are evaluated for each participant. Several participants submitted 3.6mL ampoules to the BIPM to link the comparison to the International Reference System (SIR) which may lead to the evaluation of a Key Comparison Reference Value and associated degrees of equivalence.
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Lee SH, Oh JS, Lee KB, Lee JM, Hwang SH, Lee MK, Kwon EH, Kim CS, Choi IH, Yeo IY, Yoon JY, Im JM. Evaluation of abundance of artificial radionuclides in food products in South Korea and sources. JOURNAL OF ENVIRONMENTAL RADIOACTIVITY 2018; 184-185:46-52. [PMID: 29334620 DOI: 10.1016/j.jenvrad.2018.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 01/04/2018] [Accepted: 01/08/2018] [Indexed: 06/07/2023]
Abstract
Food samples are collected nationwide from January 2016 to February 2017 and their contents of artificial radionuclides are measured to address the growing concerns regarding the radioactive contamination of food products in Korea. Specifically, 900 food samples are collected for this study and their contents of representative artificial radionuclides 134Cs, 137Cs, 239,240Pu, and 90Sr are analyzed. The analysis shows that the activity concentrations of 137Cs in fish range from minimum detectable activity (MDA) to 340 mBq/kg of fresh weight. The concentration factor (CF) determined for 137Cs as a measure of its bioavailability is calculated to be ca. 74 and found to be very similar to that (100) recommended by the International Atomic Energy Agency. With an MDA of <0.221 mBq/kg, the results reveal that 239,240Pu values in fish are below the MDA. The activity concentrations of 137Cs and 90Sr are lower than the MDA in both shellfish and seaweed, while the activity concentrations of 239,240Pu in shellfish range from 0.26 to 2.18 mBq/kg, and for seaweed samples range from 2.07 to 3.38 mBq/kg. The atom ratios of 240Pu/239Pu in shellfish caught at the Korean coast vary from 0.209 to 0.237, with a mean of 0.227. The higher 240Pu/239Pu atom ratio determined in shellfish is thought to be caused by the plutonium transported from the Pacific Proving Grounds rather than other sources such as the Fukushima nuclear power plant accident. The activity concentrations of 137Cs in mushrooms are found to vary from 1.0 to 21.4 Bq/kg, with the highest concentrations observed in the Oak (shiitake) and Sarcodon asparatus. 134Cs is detected in three mushroom specimens collected from Jeju Island and about 3-3.6% of 137Cs present in the wild mushrooms native to the Jeju Island are introduced as a result of the Fukushima nuclear plant accident. The annual effective doses of 137Cs received through consumption of mushrooms and fish are 2.0 × 10-4 mSv yr-1 and 3.9 × 10-5 mSv yr-1, and those values are negligible compared to the annual effective doses limit of 1 mSv yr-1.
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Bhansali AP, Stamates MM, Lee JM, Wong RH. Solitary Infiltrating Meningioma of the Trochlear Nerve: Case Report. J Neurol Surg Rep 2018; 79:e63-e64. [PMID: 29951350 PMCID: PMC6018071 DOI: 10.1055/s-0038-1661005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Accepted: 11/30/2017] [Indexed: 11/17/2022] Open
Abstract
We report the case of a solitary meningioma infiltrating the trochlear nerve, the first in a patient without a neurocutaneous disorder or cavernous sinus involvement. The patient presented with diplopia was found to have a focal enhancing mass encompassing the trochlear nerve. Following surgical resection, pathological examination showed meningioma infiltrating the nerve itself, demonstrated on the included pathology images. A review of the literature and discussion of meningiomas infiltrating cranial nerves are included.
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Stamates MM, Lee JM, Merrell RT, Shinners MJ, Wong RH. Combined Open and Endoscopic Endonasal Skull Base Resection of a Rare Endometrial Carcinoma Metastasis. J Neurol Surg Rep 2018; 79:e9-e13. [PMID: 29479514 PMCID: PMC5823696 DOI: 10.1055/s-0038-1635098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 01/12/2018] [Indexed: 11/25/2022] Open
Abstract
In the absence of significant extracranial disease, patients with solitary brain metastases have shown benefit with resection. Brain lesions due to endometrial cancer are uncommon, and the only described skull base involvement is limited to the pituitary gland. We report the case of a 60-year-old female with endometrial cancer who presented with weeks of right cheek pain and numbness that was accompanied by headaches. We describe the magnetic resonance imaging (MRI) findings and surgical resection of a solitary endometrial metastasis involving the infratemporal fossa, middle fossa, cavernous sinus, trigeminal nerve, and nasal sinuses. Due to extensive nasal and lateral involvement, a combined open and endoscopic approach was planned. The patient was discharged home without complication. She underwent adjuvant radiotherapy. Despite its suspected indolent course, intracranial endometrial adenocarcinoma metastases are gaining higher prevalence. This case report documents the first direct neural spread of an endometrial primary, and highlights the potential for extra-axial sites of metastasis.
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Lee SS, Lee CM, Kim TH, Kim JJ, Lee JM, Kim HJ, Ha CY, Kim HJ, Jung WT, Lee OJ, Kim DY. Frequency and risk factors of drug-induced liver injury during treatment of multidrug-resistant tuberculosis. Int J Tuberc Lung Dis 2018; 20:800-5. [PMID: 27155184 DOI: 10.5588/ijtld.15.0668] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES To investigate the risk factors for drug-induced liver injury (DILI) during the treatment of multidrug-resistant tuberculosis (MDR-TB) and to compare the frequency of DILI in patients with and those without chronic liver disease (CLD). SETTING This was a retrospective observational cohort study including 299 consecutive patients who started MDR-TB treatment from January 2009 to December 2013. DESIGN Of the 299 patients, 35 had alcoholic liver disease (ALD group), 16 had hepatitis B virus infection (HBV group) and 11 had hepatitis C virus infection (HCV group). The remaining 237 patients without CLD were selected as the control group. RESULTS DILI occurred in 29 (9.7%) patients. The frequency of DILI was significantly higher in the ALD (17.1%, P = 0.038), HBV (31.3%, P = 0.005) and HCV groups (27.3%, P = 0.037) than in the control group (6.3%). Among all patients taken together, having HBV and HCV infection were independent risk factors for the occurrence of DILI during MDR-TB treatment. CONCLUSION DILI during MDR-TB treatment occurred more frequently in patients with CLD due to ALD, HBV and HCV infection than in those without CLD.
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Wu V, Cusimano MD, Lee JM. Extent of Surgery in Endoscopic Transsphenoidal Skull Base Approaches and the Effects on Sinonasal Morbidity. Am J Rhinol Allergy 2018; 32:52-56. [DOI: 10.2500/ajra.2018.32.4499] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background Endoscopic transsphenoidal skull base surgery (ETSS) is now considered the criterion standard approach for resection of pituitary adenomas and other midline anterior skull base lesions. Normal sinonasal structures are resected during ETSS, which raises concerns for nasal morbidity and patient-based outcome. Objective To perform a surgical outcome assessment by examining whether the extent of ETSS approaches affected patient-specific sinonasal quality of life as measured by the 22-item Sino-Nasal Outcome Test (SNOT-22). Methods A single-center prospective cohort study of patients operated on by the same skull base team between 2012 and 2016. Patients with completed pre- and postoperative SNOT-22 were included. The primary outcome was SNOT-22 scores at preoperative, 0–1 month, 2–4 months, >5 months follow-up. Age, sex, tumor pathology, surgical procedure, and intraoperative cerebral spinal fluid leak repair were also obtained. Results Of the 249 ETSS performed, 148 patients (59%) had at least one completed SNOT-22; 45 (18%) met the inclusion criteria. Sinonasal quality of life based on SNOT-22 at the 0–1-month follow-up was significantly worse than the presurgical levels (p < 0.05). However, there was a return of SNOT-22 scores to preoperative levels at 2–4 months (p > 0.05), which was sustained at >5 months (p > 0.05). Factors such as the extent of ETSS, a previous nasal surgery, repair of an intraoperative cerebral spinal fluid leak, and the tumor pathology did not affect SNOT-22 scores at any follow-up intervals (p > 0.05). Conclusion Sinonasal quality of life worsened after ETSS at 0–1 month follow-up but returned to preoperative levels at 2–4 months and remained at postoperative levels >5 months. Analysis of these data will allow us to educate our patients that the anticipated nasal morbidity after ETSS is usually only transient and should be expected to recover to preoperative levels.
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Lee J, Seo SW, Yang JJ, Jang YK, Lee JS, Kim YJ, Chin J, Lee JM, Kim ST, Lee KH, Lee JH, Kim JS, Kim S, Yoo H, Lee AY, Na DL, Kim HJ. Longitudinal cortical thinning and cognitive decline in patients with early- versus late-stage subcortical vascular mild cognitive impairment. Eur J Neurol 2017; 25:326-333. [PMID: 29082576 DOI: 10.1111/ene.13500] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 10/20/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Biomarker changes in cognitively impaired patients with small vessel disease are largely unknown. The rate of amyloid/lacune progression, cortical thinning and cognitive decline were evaluated in subcortical vascular mild cognitive impairment (svMCI) patients. METHODS Seventy-two svMCI patients were divided into early stage (ES-svMCI, n = 39) and late stage (LS-svMCI, n = 33) according to their Clinical Dementia Rating Sum of Boxes score. Patients were annually followed up with neuropsychological tests and brain magnetic resonance imaging for 3 years, and underwent a second [11 C] Pittsburgh compound B (PiB) positron emission tomography scan within a mean interval of 32.4 months. RESULTS There was no difference in the rate of increase in PiB uptake or lacune number between the ES-svMCI and LS-svMCI. However, LS-svMCI showed more rapid cortical thinning and cognitive decline than did the ES-svMCI. CONCLUSIONS We suggest that, whilst the rate of change in pathological burden did not differ between ES-svMCI and LS-svMCI, cortical thinning and cognitive decline progressed more rapidly in the LS-svMCI.
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Oh TK, Jeon JH, Lee JM, Kim MS, Kim JH, Lim H, Kim SE, Eom W. Association of high-dose postoperative opioids with recurrence risk in esophageal squamous cell carcinoma: reinterpreting ERAS protocols for long-term oncologic surgery outcomes. Dis Esophagus 2017; 30:1-8. [PMID: 28859395 DOI: 10.1093/dote/dox074] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 05/23/2017] [Indexed: 12/11/2022]
Abstract
Esophageal squamous cell carcinoma (ESCC) is associated with a poor prognosis and high postoperative recurrence rate. Although postoperative opioid use has been associated with cancer recurrence, its relevance in ESCC has not been determined. Therefore, this study investigated whether high-dose postoperative opioid use was associated with recurrence risk in patients with ESCC. For this retrospective analysis, the medical records of patients who were diagnosed with ESCC and who underwent surgery between January 2006 and December 2010 in the National Cancer Center, Korea were evaluated. Total opioid administration over a 10-day period, from during surgery to postoperative day 9, was calculated. A cutoff value was determined using receiver operating characteristic curve analysis, and patients were classified into the high-use and low-use groups. The primary and secondary outcomes of the study were freedom from recurrence and overall survival, respectively. After propensity score matching, the effect of opioid use on freedom from recurrence and overall survival was evaluated using the Kaplan-Meier method. The final analysis set included 258 patients. The cumulative opioid dose cutoff point was 1783.5 mg of oral morphine. High-dose postoperative opioid use was a significant factor affecting recurrence (Hazard ratio [HR], 2.162; 95% confidence interval [CI], 1.583-2.954; P < 0.0001). In contrast, postoperative opioid use was not associated with death (HR, 1.274; 95% CI, 0.922-1.761; P = 0.1422). In patients with ESCC, compared with low-dose opioid use, high-dose intraoperative and postoperative opioid use was significantly associated with an increased risk of recurrence. However, opioid dosage did not affect overall survival.
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Goo DE, Yang SB, Kim YJ, Lee JM, Lee WH, Song D, Park SI. Arterial Embolism Occurring During Percutaneous Thrombectomy of Dialysis Graft. Cardiovasc Intervent Radiol 2017; 40:1866-1872. [PMID: 28779218 DOI: 10.1007/s00270-017-1754-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 07/18/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the incidence, management methods and follow-up results of arterial embolism during percutaneous thrombectomy of hemodialysis grafts. MATERIALS AND METHODS After Institutional Review Board approval, the radiologic database of our department for percutaneous thrombectomy procedure in hemodialysis access was retrospectively reviewed. Between 1998 and June 2014, 2975 percutaneous thrombectomy procedures using thromboaspiration technique were performed in 1524 patients with thrombosed hemodialysis grafts. After thrombectomy, angioplasty was performed for significant stenoses. The incidence of arterial embolism was analyzed according to the location/shape of the arteriovenous graft. Percutaneous management methods of arterial embolism and long-term follow-up results by fistulography were also evaluated. RESULTS Arterial embolism was documented by angiography in 117 cases (3.9%). Of these, three were symptomatic and subsided after embolectomy. The incidence was significantly correlated with the location/shape of the graft (p = 0.001). Arterial emboli were retrieved using occlusion balloon/Fogarty balloon (n = 58), guiding catheter-assisted aspiration (n = 36), sheath-assisted aspiration (n = 2) and back-bleeding technique (n = 3). Others were observed without intervention (n = 17) or surgically removed (n = 1). Arterial emboli were completely retrieved in 86 cases and partially retrieved in 13 cases. Ulnar artery rupture occurred in one case due to over-inflation of the occlusion balloon. Follow-up fistulography performed in 60 patients among whom 99 percutaneous embolectomies were done revealed arterial stenosis/occlusion in 7 and residual emboli in one patient. In observed patients without intervention, follow-up documented complete resolution of the emboli without arterial stenosis in 9 patients. CONCLUSION Radiologically perceivable arterial embolism is uncommon during percutaneous thrombectomy of thrombosed dialysis grafts. The majority of the emboli can be retrieved by percutaneous techniques, but may induce arterial damage in some patients. Clinical observation can be another option for patients without ischemic symptoms.
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Bruggeman M, Collins SM, Done L, Đurašević M, Duch MA, Gudelis A, Hyža M, Jevremović A, Kandić A, Korun M, Ilie S, Lee JM, Lee KB, Luca A, Margineanu RM, Pantelica A, Serrano I, Šešlak B, Tugulan LC, Verheyen L, Vodenik B, Vukanac I, Zeng Z, Zorko B. Systematic influences on the areas of peaks in gamma-ray spectra that have a large statistical uncertainty. Appl Radiat Isot 2017; 134:51-55. [PMID: 28673731 DOI: 10.1016/j.apradiso.2017.06.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 05/23/2017] [Accepted: 06/13/2017] [Indexed: 10/19/2022]
Abstract
A method is presented for calculating the expected number of counts in peaks that have a large relative peak-area uncertainty and appear in measured gamma-ray spectra. The method was applied to calculations of the correction factors for peaks occurring in the spectra of radon daughters. It was shown that the factors used for correcting the calculated peak areas to their expected values decrease with an increasing relative peak-area uncertainty. The accuracy of taking the systematic influence inducing the correction factors into account is given by the dispersion of the correction factors corresponding to specific peaks. It was shown that the highest accuracy is obtained in the peak analyses with the GammaVision and Gamma-W software.
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Siddique MP, Jang WJ, Lee JM, Ahn SH, Suraiya S, Kim CH, Kong IS. groEL is a suitable genetic marker for detecting Vibrio parahaemolyticus by loop-mediated isothermal amplification assay. Lett Appl Microbiol 2017; 65:106-113. [PMID: 28585379 DOI: 10.1111/lam.12760] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 04/18/2017] [Accepted: 05/18/2017] [Indexed: 01/13/2023]
Abstract
A groEL gene-based loop-mediated isothermal amplification (LAMP) assay was developed to detect Vibrio parahaemolyticus in contaminated seafood and water. The assay was optimized and conducted at 63°C for 40 min using Bacillus stearothermophilus (Bst) DNA polymerase, large fragment. Amplification was analysed via multiple detection methods, including opacity, formation of white precipitate, DNA intercalating dyes (ethidium bromide and SYBR Green I), metal ion-binding indicator dye, calcein, and 2% agarose gel electrophoresis. A characteristic ladder-like band pattern on agarose gel and the desired colour changes when using different dyes were observed in positive cases, and these were species-specific for V. parahaemolyticus when compared with other closely related Vibrio spp. The limit of detection (LoD) of this assay was 100 fg per reaction, 100-fold higher than that for conventional polymerase chain reaction (PCR). When tested on artificially contaminated seafood and seawater, the LoDs of the LAMP assay were 120 and 150 fg per reaction respectively, and those of conventional PCR were 120 and 150 pg per reaction respectively. Based on our results, the groEL gene-based LAMP assay is rapid, specific, sensitive, and reliable for detecting V. parahaemolyticus, and it could be used in field diagnosis. SIGNIFICANCE AND IMPACT OF THE STUDY The loop-mediated isothermal amplification (LAMP) assay using groEL gene (an abundant, highly conserved gene and member of the groESL chaperone gene family) provided rapid, species-specific and highly sensitive method for detecting Vibrio parahaemolyticus, the leading causal agent of seafood-borne diseases worldwide. Moreover, groEL LAMP revealed high efficiency than conventional PCR assay for V. parahaemolyticus using template both from pure culture and artificially contaminated seafood and water, which indicated the applicability in the field and environmental screening purpose for the organism.
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Lee JM, Au M. Onodi cell mucocele: Case report and review of the literature. EAR, NOSE & THROAT JOURNAL 2017; 95:E4-8. [PMID: 27657326 DOI: 10.1177/014556131609500905] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Onodi cell mucoceles are rare entities that can cause devastating ocular complications if not treated promptly. Delays in the diagnosis are possible because of the wide range of differential diagnoses of unilateral retrobulbar optic neuropathy. We describe a new case of Onodi cell mucocele in a 39-year-old woman, and we present a comprehensive review of the literature on this entity. To the best of our knowledge, no review of Onodi cell mucoceles has been previously published. Our review found that 69% of patients with an Onodi cell mucocele experienced an improvement in vision after surgical decompression. The vast majority of these patients underwent endoscopic decompression; the timing of surgical decompression did not appear to affect outcomes in terms of vision. Onodi cell mucocele requires a high degree of clinical suspicion for diagnosis and a multidisciplinary approach to management that involves primary care physicians, ophthalmologists, and otolaryngologists. Early surgical treatment via an endoscopic approach is recommended for most patients, regardless of the duration of their ophthalmologic signs and symptoms.
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Lee JM, Kim ES, Chun HJ. Gastrointestinal: Unexpected cause of refractory vomiting. J Gastroenterol Hepatol 2017; 32:543. [PMID: 28320066 DOI: 10.1111/jgh.13584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/18/2016] [Indexed: 12/09/2022]
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Kim CH, Lee JM, Yoo JK, Kim JS, Kim SU, Chang KT, Choo YK. Inhibitory Effect of Imiquimod-Induced Psoriasis-Like Skin Inflammation in Mice by Histamine H4 Receptor Agonist 4-Methylhistamine. Scand J Immunol 2017; 83:409-17. [PMID: 26900758 DOI: 10.1111/sji.12420] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 02/10/2016] [Indexed: 01/02/2023]
Abstract
Psoriasis is a chronic inflammatory immune-mediated autoimmune skin disorder. The histamine H4 receptor (H4R) agonist 4-methylhistamine (4-MH) plays an important role in immunomodulation of inflammatory responses associated with allergic inflammatory diseases. In this study, we investigated the effects of H4R agonist 4-MH on the development of imiquimod (IMQ)-induced psoriasis-like skin inflammation in mice and explored the immunoregulatory mechanism involved. The total clinical severity scores were significantly ameliorated by treatment with 4-MH (20 mg/kg) and 4-MH (40 mg/kg). Histological analysis of the skin revealed that 4-MH (20 mg/kg) and 4-MH (40 mg/kg) significantly attenuated the psoriatic phenotypes, including epidermal hyperplasis, hyperkeratosis and lymphocytes infiltration. Treatment with 4-MH (20 mg/kg) and 4-MH (40 mg/kg) led to reductions in the levels of Th1 cytokines (TNF-α, IFN-α, and IL-27) in the serum and dorsal skin, whereas Th17 cytokines levels (IL-17A and IL-23) did not change in response to treatment with 4-MH (20 mg/kg) and 4-MH (40 mg/kg). Furthermore, the number of CD4(+) CD25(+) FoxP3(+) regulatory T (Treg) cells was significantly increased by treatment with 4-MH (40 mg/kg). Taken together, these results imply that H4R agonist 4-MH might be an effective immunomodulatory approach for treatment of patients with psoriasis and the effects may be related to inhibited epidermal alteration, selectively reduced Th1 pro-inflammatory cytokines, and recruited CD4(+) CD25(+) FoxP3(+) Treg cells.
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Lee JM, Derkinderen P, Kordower JH, Freeman R, Munoz DG, Kremer T, Zago W, Hutten SJ, Adler CH, Serrano GE, Beach TG. The Search for a Peripheral Biopsy Indicator of α-Synuclein Pathology for Parkinson Disease. J Neuropathol Exp Neurol 2017; 76:2-15. [DOI: 10.1093/jnen/nlw103] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Chiu LLY, To WTH, Lee JM, Waldman SD. Scaffold-free cartilage tissue engineering with a small population of human nasoseptal chondrocytes. Laryngoscope 2016; 127:E91-E99. [PMID: 27861930 DOI: 10.1002/lary.26396] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 09/12/2016] [Accepted: 09/14/2016] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Cartilage tissue engineering is a promising approach to provide suitable materials for nasal reconstruction; however, it typically requires large numbers of cells. We have previously shown that a small number of chondrocytes cultivated within a continuous flow bioreactor can elicit substantial tissue growth, but translation to human chondrocytes is not trivial. Here, we aimed to demonstrate the application of the bioreactor to generate large-sized tissues from a small population of primary human nasoseptal chondrocytes. STUDY DESIGN Experimental study. METHODS Chondrocytes were cultured in the bioreactor using different medium compositions, with varying amounts of serum and with or without growth factors. Resulting engineered tissues were analyzed for physical properties, biochemical composition, tissue microstructure, and protein localization. RESULTS Bioreactor-cultivated constructs grown with serum and growth factors (basic fibroblast growth factor and transforming growth factor beta 2) had greater thickness, as well as DNA and glycosaminoglycan (GAG) contents, compared to low serum and no growth factor controls. These constructs also showed the most intense proteoglycan and collagen II staining. CONCLUSION The combination of bioreactor conditions, serum, and growth factors allowed the generation of large, thick scaffold-free human cartilaginous tissues that resembled the native nasoseptal cartilage. There also may be implications for patient selection in future clinical applications of these engineered tissues because their GAG content decreased with donor age. LEVEL OF EVIDENCE NA. Laryngoscope, 127:E91-E99, 2017.
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Belliveau MJ, Wang JCM, Nijhawan N, Latta EK, Lee JM. Staged endonasal-external resection of esthesioneuroblastoma involving the nasolacrimal duct and lacrimal sac. Can J Ophthalmol 2016; 51:e173-e175. [PMID: 27938977 DOI: 10.1016/j.jcjo.2016.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 06/18/2016] [Indexed: 11/27/2022]
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