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Kim D, Heo YJ, Jeong HW, Baek JW, Han JY, Lee JY, Jin SC, Baek HJ. Usefulness of the Delay Alternating with Nutation for Tailored Excitation Pulse with T1-Weighted Sampling Perfection with Application-Optimized Contrasts Using Different Flip Angle Evolution in the Detection of Cerebral Metastases: Comparison with MPRAGE Imaging. AJNR Am J Neuroradiol 2019; 40:1469-1475. [PMID: 31371358 DOI: 10.3174/ajnr.a6158] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 06/27/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Contrast-enhanced T1-weighted sampling perfection with application-optimized contrasts by using different flip angle evolution (SPACE) with the delay alternating with nutation for tailored excitation (DANTE) pulse could suppress the blood flow signal and provide a higher contrast-to-noise ratio of enhancing lesion-to-brain parenchyma than the MPRAGE sequence. The purpose of our study was to evaluate the usefulness of SPACE with DANTE compared with MPRAGE for detecting brain metastases. MATERIALS AND METHODS Seventy-one patients who underwent contrast-enhanced SPACE with DANTE and MPRAGE sequences and who were suspected of having metastatic lesions were included. Two neuroradiologists determined the number of enhancing lesions, and diagnostic performance was evaluated using figure of merit, sensitivity, positive predictive value, interobserver agreement, and reading time. Contrast-to-noise ratiolesion/parenchyma and contrast-to-noise ratiowhite matter/gray matter were also assessed. RESULTS SPACE with DANTE (observer one, 328; observer two, 324) revealed significantly more small (<5 mm) enhancing lesions than MPRAGE (observer one, 175; observer two, 150) (P < 0.001 for observer 1, P ≤ .0001 for observer 2). Furthermore, SPACE with DANTE showed significantly higher figure of merit and sensitivity and shorter reading time than MPRAGE for both observers. The mean contrast-to-noise ratiolesion/parenchyma of SPACE with DANTE (52.3 ± 43.1) was significantly higher than that of MPRAGE (17.5 ± 19.3) (P ≤ .0001), but the mean contrast-to-noise ratiowhite matter/gray matter of SPACE with DANTE (-0.65 ± 1.39) was significantly lower than that of MPRAGE (3.08 ± 1.39) (P ≤ .0001). CONCLUSIONS Compared with MPRAGE, SPACE with DANTE significantly improves the detection of brain metastases.
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Adhikari G, Adhikari P, de Souza EB, Carlin N, Choi S, Djamal M, Ezeribe AC, Ha C, Hahn IS, Jeon EJ, Jo JH, Joo HW, Kang WG, Kang W, Kauer M, Kim GS, Kim H, Kim HJ, Kim KW, Kim NY, Kim SK, Kim YD, Kim YH, Ko YJ, Kudryavtsev VA, Lee HS, Lee J, Lee JY, Lee MH, Leonard DS, Lynch WA, Maruyama RH, Mouton F, Olsen SL, Park BJ, Park HK, Park HS, Park KS, Pitta RLC, Prihtiadi H, Ra SJ, Rott C, Shin KA, Scarff A, Spooner NJC, Thompson WG, Yang L, Yu GH. Search for a Dark Matter-Induced Annual Modulation Signal in NaI(Tl) with the COSINE-100 Experiment. PHYSICAL REVIEW LETTERS 2019; 123:031302. [PMID: 31386435 DOI: 10.1103/physrevlett.123.031302] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Indexed: 06/10/2023]
Abstract
We present new constraints on the dark matter-induced annual modulation signal using 1.7 years of COSINE-100 data with a total exposure of 97.7 kg yr. The COSINE-100 experiment, consisting of 106 kg of NaI(Tl) target material, is designed to carry out a model-independent test of DAMA/LIBRA's claim of WIMP discovery by searching for the same annual modulation signal using the same NaI(Tl) target. The crystal data show a 2.7 cpd/kg/keV background rate on average in the 2-6 keV energy region of interest. Using a χ-squared minimization method we observe best fit values for modulation amplitude and phase of 0.0092±0.0067 cpd/kg/keV and 127.2±45.9 d, respectively.
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Kim YJ, Lim YW, Paik HR, Lee JY, Kim SY. What influences use of dental services by the Korean disabled people? The role of perceived barriers in dental care system. COMMUNITY DENTAL HEALTH 2019; 36:101-105. [PMID: 31070873 DOI: 10.1922/cdh_4456young05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To identify the perceived barriers to dental care for disabled people in South Korea using the revised Andersen's model of access to health care. BASIC RESEARCH DESIGN Cross-sectional analytic interview study. PARTICIPANTS Korean people with a disability residing in residential facilities, or those at home who attend vocational rehabilitation facilities, special schools, or welfare facilities, were sampled from Seoul and non-Seoul areas in 2016 and were interviewed face-to-face. In total, 456 disabled Koreans, or their primary caregivers participated. RESULTS Household income, disability duration and perceived barriers in the dental care system were perceived to impact on dental care utilisation, while the need for dental care services did not significantly explain the use of dental care by disabled people in South Korea. Those with low household incomes were less likely to use dental care services, compared to people with moderate and high household incomes. As disability duration increased, disabled people were more likely to use dental services. Those who perceived the barriers to dental care as higher were less likely to use dental services. CONCLUSION These data suggest that policies are needed to support disabled people with low household incomes. Lowering barriers in the dental care system may encourage people with disabilities to access timely and adequate dental services.
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Lee JH, Kim HJ, Han KD, Han JH, Bang CH, Park YM, Lee JY, Lee SJ, Park YG, Lee YB. Incidence and prevalence of alopecia areata according to subtype: a nationwide, population-based study in South Korea (2006-2015). Br J Dermatol 2019; 181:1092-1093. [PMID: 31102412 DOI: 10.1111/bjd.18145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Heo YJ, Jeong HW, Baek JW, Kim ST, Jeong YG, Lee JY, Jin SC. Pointwise Encoding Time Reduction with Radial Acquisition with Subtraction-Based MRA during the Follow-Up of Stent-Assisted Coil Embolization of Anterior Circulation Aneurysms. AJNR Am J Neuroradiol 2019; 40:815-819. [PMID: 30975655 DOI: 10.3174/ajnr.a6035] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 03/11/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Time-of-flight MR angiography, though widely used after coil embolization, is associated with limitations owing to magnetic susceptibility and radiofrequency shielding following stent-assisted coil embolization. We evaluated the pointwise encoding time reduction with radial acquisition (PETRA) sequence in subtraction-based MRA (qMRA) using an ultrashort TE relative to TOF-MRA during the follow-up of stent-assisted coil embolization for anterior circulation aneurysms. MATERIALS AND METHODS Twenty-five patients (3 men and 22 women; mean age, 59.1 ± 14.0 years) underwent stent-assisted coil embolization for anterior circulation aneurysms and were retrospectively evaluated using TOF-MRA and PETRA qMRA data from the same follow-up session. Two neuroradiologists independently reviewed both MRA findings and subjectively graded flow within the stents (relative to the latest DSA findings) and occlusion status (complete occlusion or neck/aneurysm remnant). Interobserver and intermodality agreement for TOF-MRA and PETRA qMRA were evaluated. RESULTS The mean score for flow visualization within the stents was significantly higher in PETRA qMRA than in TOF-MRA (P < .001 for both observers), and good interobserver agreement was reported (κ = 0.63). The aneurysm occlusion status of PETRA qMRA (observer 1, 92.0%; observer 2, 88.0%) was more consistent with DSA than with TOF-MRA (observer 1, 76.0%; observer 2, 80.0%), and there was a better intermodality agreement between DSA and PETRA qMRA than between DSA and TOF-MRA. CONCLUSIONS These findings indicate that PETRA qMRA is a useful follow-up technique for patients who have undergone stent-assisted coil embolization for anterior circulation aneurysms.
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Ha C, Adhikari G, Adhikari P, Barbosa de Souza E, Carlin N, Choi S, Djamal M, Ezeribe AC, Hahn IS, Jeon EJ, Jo JH, Joo HW, Kang WG, Kang W, Kauer M, Kim GS, Kim H, Kim HJ, Kim KW, Kim NY, Kim SK, Kim YD, Kim YH, Ko YJ, Kudryavtsev VA, Lee HS, Lee J, Lee JY, Lee MH, Leonard DS, Lynch WA, Maruyama RH, Mouton F, Olsen SL, Park BJ, Park HK, Park HS, Park KS, Pitta RLC, Prihtiadi H, Ra SJ, Rott C, Shin KA, Scarff A, Spooner NJC, Thompson WG, Yang L, Yu GH. First Direct Search for Inelastic Boosted Dark Matter with COSINE-100. PHYSICAL REVIEW LETTERS 2019; 122:131802. [PMID: 31012610 DOI: 10.1103/physrevlett.122.131802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Indexed: 06/09/2023]
Abstract
A search for inelastic boosted dark matter (IBDM) using the COSINE-100 detector with 59.5 days of data is presented. This relativistic dark matter is theorized to interact with the target material through inelastic scattering with electrons, creating a heavier state that subsequently produces standard model particles, such as an electron-positron pair. In this study, we search for this electron-positron pair in coincidence with the initially scattered electron as a signature for an IBDM interaction. No excess over the predicted background event rate is observed. Therefore, we present limits on IBDM interactions under various hypotheses, one of which allows us to explore an area of the dark photon parameter space that has not yet been covered by other experiments. This is the first experimental search for IBDM using a terrestrial detector.
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Lee JY, Kim JH, Rho JY. Development of Rapid and Specific Detection for the Human Aichivirus A Using the Loop-Mediated Isothermal Amplification from Water Samples. Indian J Microbiol 2019; 59:375-378. [PMID: 31388217 PMCID: PMC6646635 DOI: 10.1007/s12088-019-00803-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 04/01/2019] [Indexed: 11/26/2022] Open
Abstract
Human Aichivirus A (AiV-A) is classified as a Kobuvirus, group IV positive sense single strand RNA viruses. The first outbreak of AiV-A was reported from Aichi Prefecture, Japan in 1989. AiV-A exists not only among clinical patients, such as diarrhea, but also in a variety of water environments, as its occurrence is reported across a wide geographical range, from developing to advanced countries. For diagnose of AiV-A from water samples, mostly polymerase chain reaction (PCR) system have been developed. However, loop-mediated isothermal amplification (LAMP) assay has not been applied. In this study, developed a LAMP method to achieve a rapid, specific and highly sensitive detection of AiV-A. The method developed in this study is aimed specifically at AiV-A. Through a specific and non-specific selection and sensitivity test process for the five prepared LAMP primer sets, one primer set and optimum reaction temperature were selected. A newly developed method was more rapid (approximately 2–8 h), specific and equivalent detection of AiV-A than with the conventional PCRs. In addition, confirm system of positive LAMP reaction was developed by using the restriction enzyme Aci I and Hae III. For evaluation and verification of developing LAMP assay, a was applied to twenty cDNA from groundwater samples. This study proved rapid and specific diagnosis of AiV-A from water samples, and it is also demanded to be applicable to other environmental, clinical and food samples.
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LeVasseur CM, Wawrose R, Pitcairn S, Donaldson WF, Lee JY, Anderst WJ. Dynamic functional nucleus is a potential biomarker for structural degeneration in cervical spine discs. J Orthop Res 2019; 37:965-971. [PMID: 30747456 DOI: 10.1002/jor.24252] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 02/05/2019] [Indexed: 02/04/2023]
Abstract
If intervertebral disc degeneration can be identified early, preventative treatments may be initiated before symptoms become disabling and costly. Changes in disc mechanics, such as the decrease in the compressive modulus of the nucleus, are some of the earliest signs of degeneration. Therefore, in vivo changes in the disc response to compressive load may serve as a biomarker for pending or early disc degeneration. The aim of this study was to assess the potential for using in vivo dynamic disc deformation to identify pathologic structural degeneration of the intervertebral disc. A validated model-based tracking technique determined vertebral motion from biplane radiographs collected during dynamic flexion/extension and axial rotation of the cervical spine. A computational model of the subaxial intervertebral discs was developed to identify the dynamic functional nucleus of each disc, that is, the disc region that underwent little to no additional compression during dynamic movements. The size and location of the dynamic functional nucleus was determined for 10 C5/C6 spondylosis patients, 10 C5/C6/C7 spondylosis patients, and 10 asymptomatic controls. The dynamic functional nucleus size was sensitive (significantly smaller than controls in 5 of 6 measurements at the diseased disc) and specific (no difference from controls in 9 of 10 measurements at non-diseased discs) to pathologic disc degeneration. These results provide evidence to suggest that structural disc degeneration, manifested by changes in the disc response to functional loading, may be identified in vivo from dynamic imaging collected during functional movements. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 9999:1-7, 2019.
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Guan P, Wong SF, Lim JQ, Ng CCY, Soong PL, Sim CQX, Ong CK, Rajasegaran V, Myint SS, Lee JY, Tan HK, Iyer NG, Soo KC, Teh BT, Tay ABG. Mutational Signatures in Mandibular Ameloblastoma Correlate with Smoking. J Dent Res 2019; 98:652-658. [PMID: 30917298 DOI: 10.1177/0022034519837248] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Ameloblastoma is a rare tumor of odontogenic epithelium, the low incidence rate of which precludes statistical determination of its molecular characterizations. Despite recent genomic and transcriptomic profiling, the etiology of ameloblastomas remains poorly understood. Risk factors of ameloblastoma development are also largely unknown. Whole exome sequencing was performed on 11 mandibular ameloblastoma samples. We identified 2 convergent mutational signatures in ameloblastoma: 1) a signature found in multiple types of lung cancers with probable etiology of tobacco carcinogens (COSMIC signature 4) and 2) a signature present in gingivobuccal oral squamous cell carcinoma and correlated with tobacco-chewing habits (COSMIC signature 29). These mutational signatures highlight tobacco usage or related mutagens as one possible risk factor of ameloblastoma, since the association of BRAF mutations and smoking was demonstrated in multiple studies. In addition to BRAF hotspot mutations (V600E), we observed clear inter- and intratumor heterogeneities. Interestingly, prior to BRAF mutation, important genes regulating odontogenesis mutated (e.g., corepressor BCOR), possibly playing important roles in tumorigenesis. Furthermore, recurrent mutations in the CDC73 gene, the germline mutations of which predispose patients to the development of jaw tumors, were found in 2 patients, which may lead to recurrence if not targeted by therapeutic drugs. Our unbiased profiling of coding regions of ameloblastoma genomes provides insights to the possible etiology of mandibular ameloblastoma and highlights potential disease risk factors for screening and prevention, especially for Asian patients. Because of the limited sample size and incomplete habitual, dietary, and occupational data, a causal link between tobacco usage and ameloblastoma still requires further investigations.
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Li YB, Shen CP, Yuan CZ, Adachi I, Aihara H, Al Said S, Asner DM, Aushev T, Ayad R, Badhrees I, Ban Y, Bansal V, Beleño C, Berger M, Bhardwaj V, Bhuyan B, Bilka T, Biswal J, Bondar A, Bozek A, Bračko M, Cao L, Červenkov D, Chen A, Cheon BG, Chilikin K, Cho K, Choi SK, Choi Y, Cinabro D, Cunliffe S, Di Carlo S, Doležal Z, Dong TV, Drásal Z, Eidelman S, Fast JE, Fulsom BG, Garg R, Gaur V, Gabyshev N, Garmash A, Giri A, Goldenzweig P, Greenwald D, Grube B, Hayasaka K, Hayashii H, Hsu CL, Iijima T, Inami K, Inguglia G, Ishikawa A, Itoh R, Iwasaki M, Iwasaki Y, Jacobs WW, Jia S, Jin Y, Joffe D, Joo KK, Karyan G, Kawasaki T, Kichimi H, Kim DY, Kim HJ, Kim JB, Kim KT, Kim SH, Kinoshita K, Kodyš P, Korpar S, Kotchetkov D, Križan P, Kroeger R, Krokovny P, Kumita T, Kuzmin A, Kwon YJ, Lee JY, Lee SC, Li LK, Li Gioi L, Libby J, Liventsev D, Lubej M, MacNaughton J, Masuda M, Matsuda T, Merola M, Miyabayashi K, Miyata H, Mizuk R, Mohanty GB, Mussa R, Nakano E, Nakao M, Nath KJ, Nayak M, Niiyama M, Nishida S, Ono H, Onuki Y, Pakhlov P, Pakhlova G, Pal B, Pardi S, Park SH, Paul S, Pedlar TK, Pestotnik R, Piilonen LE, Popov V, Prencipe E, Russo G, Sakai Y, Salehi M, Sandilya S, Santelj L, Sanuki T, Savinov V, Schneider O, Schnell G, Schueler J, Schwanda C, Schwartz AJ, Seino Y, Senyo K, Sevior ME, Shibata TA, Shiu JG, Shwartz B, Solovieva E, Starič M, Sumihama M, Sumiyoshi T, Sutcliffe W, Takizawa M, Tanida K, Tao Y, Tenchini F, Trabelsi K, Uchida M, Uglov T, Unno Y, Uno S, Urquijo P, Van Tonder R, Varner G, Wang B, Wang CH, Wang MZ, Wang P, Wang XL, Won E, Yang SB, Ye H, Yelton J, Yin JH, Yusa Y, Zhang ZP, Zhilich V, Zhukova V. First Measurements of Absolute Branching Fractions of the Ξ_{c}^{0} Baryon at Belle. PHYSICAL REVIEW LETTERS 2019; 122:082001. [PMID: 30932568 DOI: 10.1103/physrevlett.122.082001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Revised: 01/27/2019] [Indexed: 06/09/2023]
Abstract
We present the first measurements of absolute branching fractions of Ξ_{c}^{0} decays into Ξ^{-}π^{+}, ΛK^{-}π^{+}, and pK^{-}K^{-}π^{+} final states. The measurements are made using a dataset comprising (772±11)×10^{6} BB[over ¯] pairs collected at the ϒ(4S) resonance with the Belle detector at the KEKB e^{+}e^{-} collider. We first measure the absolute branching fraction for B^{-}→Λ[over ¯]_{c}^{-}Ξ_{c}^{0} using a missing-mass technique; the result is B(B^{-}→Λ[over ¯]_{c}^{-}Ξ_{c}^{0})=(9.51±2.10±0.88)×10^{-4}. We subsequently measure the product branching fractions B(B^{-}→Λ[over ¯]_{c}^{-}Ξ_{c}^{0})B(Ξ_{c}^{0}→Ξ^{-}π^{+}), B(B^{-}→Λ[over ¯]_{c}^{-}Ξ_{c}^{0})B(Ξ_{c}^{0}→ΛK^{-}π^{+}), and B(B^{-}→Λ[over ¯]_{c}^{-}Ξ_{c}^{0})B(Ξ_{c}^{0}→pK^{-}K^{-}π^{+}) with improved precision. Dividing these product branching fractions by the result for B^{-}→Λ[over ¯]_{c}^{-}Ξ_{c}^{0} yields the following branching fractions: B(Ξ_{c}^{0}→Ξ^{-}π^{+})=(1.80±0.50±0.14)%, B(Ξ_{c}^{0}→ΛK^{-}π^{+})=(1.17±0.37±0.09)%, and B(Ξ_{c}^{0}→pK^{-}K^{-}π^{+})=(0.58±0.23±0.05)%. For the above branching fractions, the first uncertainties are statistical and the second are systematic. Our result for B(Ξ_{c}^{0}→Ξ^{-}π^{+}) can be combined with Ξ_{c}^{0} branching fractions measured relative to Ξ_{c}^{0}→Ξ^{-}π^{+} to yield other absolute Ξ_{c}^{0} branching fractions.
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Lee JY, Bi R, Pareja F, Geyer FC, Brown D, Wen HY, Norton L, Hicks J, Weigelt B, Reis-Filho JS. Abstract P2-01-02: Whole exome sequencing analysis of the progression from ductal carcinoma in situ to invasive ductal carcinoma. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-01-02] [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
Introduction: Ductal carcinoma in situ (DCIS) is a bona fide non-obligate precursor of invasive carcinoma. Single cell sequencing studies have revealed intra-lesion genetic heterogeneity in DCIS and shown that progression to invasive ductal carcinoma (IDC) may occur through different mechanisms, including the selection of a subpopulation of tumor cells, acquisition of new genetic alterations or multi-clonal invasion. Here, we sought to investigate the genetic heterogeneity of DCIS, and to document further the clonal selection process accompanying progression to IDC.
Materials and methods: Synchronous DCIS (n=16) and IDC (n=15) samples from 14 patients were microdissected separately, and DNA samples of tumor and matched normal tissues were subjected to whole-exome sequencing (WES; n=27) or massively parallel targeted sequencing of all coding regions of ≥410 cancer-related genes (n=4). Somatic genetic alterations and mutational signatures were identified using state-of-the-art bioinformatics algorithms. PyClone was employed to define the clonal architecture of each DCIS and IDC and infer the clonal shifts accompanying progression from DCIS to IDC.
Results: DCIS were found to harbor recurrent somatic mutations affecting PIK3CA (50%), GATA3 (44%), TP53 (38%), CBFB (19%), PTEN (13%), and AKT1 (13%), which are genes known to be significantly mutated in invasive breast cancers. Despite the genomic similarities between matched DCIS and IDCs, NOTCH2 and MYC were found to be amplified solely in the IDC component of two cases, and PPM1D amplification was restricted to the DCIS component of another case. The mutational signature ascribed to aging (i.e. signature 1) was the predominant mutational signature in the DCIS and IDCs analyzed. PyClone analysis revealed that all synchronous DCIS and IDC studied here were clonally related and confirmed the previous observation that DCIS displays intra-lesion genetic heterogeneity. Evidence of clonal selection in the progression from DCIS to IDC was observed in three cases, whereby a minor DCIS subclone likely constituted the substrate for the development of IDC. In one of these cases, from a patient with a BRCA1 germline pathogenic mutation, we observed a shift from the mutational signature associated with defective homologous recombination DNA repair (i.e. signature 3) to the APOBEC-related mutational signatures (i.e. signatures 2 and 13) in the progression from DCIS to IDC.
Conclusion: Intra-lesion genetic heterogeneity is a common feature in DCIS synchronously diagnosed with IDC. Our findings corroborate the notion that DCIS is a direct non-obligate precursor of IDC, and that clonal selection in the progression of DCIS to IDC may be present in a subset of cases, but is unlikely to constitute the most frequent mechanism of progression.
Citation Format: Lee JY, Bi R, Pareja F, Geyer FC, Brown D, Wen HY, Norton L, Hicks J, Weigelt B, Reis-Filho JS. Whole exome sequencing analysis of the progression from ductal carcinoma in situ to invasive ductal carcinoma [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-01-02.
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Dombrowski ME, Morales-Restrepo A, Fourman MS, Vaudreuil N, Lee JY. Prophylactic perioperative dexamethasone decreases the incidence of postoperative C5 palsies after a posterior cervical laminectomy and fusion. Spine J 2019; 19:253-260. [PMID: 29800704 DOI: 10.1016/j.spinee.2018.05.031] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 04/20/2018] [Accepted: 05/16/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Postoperative C5 palsy is a well-known complication of cervical decompression procedures. Studies have shown that posterior laminectomy and fusions confer the greatest risk of C5 palsy. Despite this, pharmacologic preventive measures remain unknown. We hypothesize that prophylactic perioperative dexamethasone (DEX) will decrease the rate of postoperative C5 palsy in patients undergoing a multilevel posterior cervical laminectomy and fusion. PURPOSE The purpose of this study was to assess the safety and efficacy of prophylactic perioperative DEX in decreasing the rate of postoperative C5 palsy. DESIGN This is a retrospective, single-institution clinical study. PATIENT SAMPLE The patient population included all patients undergoing multilevel posterior cervical laminectomy and instrumented fusion procedures for myeloradiculopathy or myelopathy, who also received a course of perioperative dexamethasone. Surgeries occurred between 2012 and 2017 at a single tertiary care center by a single surgeon with at least 1 year of follow-up. Patients who underwent decompression procedures other than multilevel posterior cervical laminectomy and instrumented fusions; had trauma, fracture; underwent decompression not including C5-level, insulin-dependent diabetes mellitus; and had documented adverse reactions to steroids were excluded. OUTCOME MEASURES Preoperative demographics and postoperative complications, including development of postoperative C5 palsy, were considered as outcome measures. MATERIALS AND METHODS A total of 189 consecutive patients who underwent multilevel posterior cervical laminectomy and instrumented fusion and received prophylactic perioperative DEX were reviewed. The rate of C5 palsy was investigated and compared with our historical control rate of C5 palsy before the institutional implementation of perioperative DEX. Demographics were reviewed, and risk factor stratification was analyzed. The safety of using DEX was investigated by examining postoperative complications. The clinical course of patients who developed C5 palsy was then reported. RESULTS Postoperative C5 palsy occurred in 5 of the 138 patients (3.6%) meeting the inclusion criteria. Patients receiving perioperative DEX had a significantly decreased rate of postoperative C5 palsy compared with those who did not (3.6% vs. 9.5%, p=.01). Age was the only risk factor that was significantly correlated with development of C5 palsy (72.71±7.76 vs. 61.07±10.59, p=.02). Infection, seroma, and wound complication rates were 2.8%, 2.17%, and 1.44%, respectively, in patients receiving prophylactic DEX. All five patients receiving DEX who developed C5 palsy recovered with no residual deficits at an average of 16.8 weeks postoperatively. CONCLUSIONS Perioperative prophylactic DEX therapy is a safe and effective way to decrease the incidence of C5 palsies in patients who undergo multilevel posterior laminectomy and fusion for myeloradiculopathy or myelopathy.
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Yun MJ, Kim YC, Lim YJ, Choi GH, Ha M, Lee JY, Ham BM. The Differential Flow of Epidural Local Anaesthetic via Needle or Catheter: A Prospective Randomized Double-blind Study. Anaesth Intensive Care 2019; 32:377-82. [PMID: 15264734 DOI: 10.1177/0310057x0403200313] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The extent of epidural anaesthesia and pattern of spread of contrast medium, using different injection techniques, has not been well documented. Therefore, in this prospective, randomized, double-blind study, the extent of anaesthesia and pattern of spread of contrast medium following an epidural bolus injection, via either a Tuohy needle or an epidural catheter, were compared. The study had two parts. In the first, 59 of 79 patients scheduled for a lower extremity operation under epidural anaesthesia were randomly allocated to one of the two groups. Anaesthesia was achieved with an epidural injection of 10 to 15 ml (including a 3 ml test dose) of 0.75% ropivacaine and fentanyl 25 μg via either a Tuohy needle (Group N, n=31) or a catheter (Group C, n=28). The level of sensory anaesthesia was recorded. In the second part, the remaining 20 patients were randomized to initially receive 5 ml of contrast medium via either a Tuohy needle (Group NE, n=10) or a catheter (Group CE, n=10). The extent of spread was recorded radiologically. Unilateral or missed blocks and additional dose requirement were absent in Groups N and C. No differences were found in the extent of sensory anaesthesia or the spread of contrast medium. Twenty per cent of catheter tips lay outside the lateral margins of the vertebral bodies. We found that an epidural bolus injection, via either a Tuohy needle or a catheter, made no difference in regard to spread of local anaesthetic or contrast medium in the epidural space.
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Ellsworth GB, Lensing SY, Ogilvie CB, Lee JY, Goldstone SE, Berry-Lawhorn JM, Jay N, Stier EA, Logan JS, Einstein MH, Saah A, Mitsuyasu RT, Aboulafia D, Palefsky JM, Wilkin TJ. A delayed dose of quadrivalent human papillomavirus vaccine demonstrates immune memory in HIV-1-infected men. PAPILLOMAVIRUS RESEARCH (AMSTERDAM, NETHERLANDS) 2018; 6:11-14. [PMID: 29807211 PMCID: PMC6121157 DOI: 10.1016/j.pvr.2018.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 04/20/2018] [Accepted: 05/23/2018] [Indexed: 12/20/2022]
MESH Headings
- Adult
- Antibodies, Neutralizing/blood
- Antibodies, Viral/blood
- HIV Infections/complications
- HIV Infections/immunology
- Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18/administration & dosage
- Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18/immunology
- Humans
- Immunologic Memory
- Male
- Middle Aged
- Papillomavirus Infections/immunology
- Papillomavirus Infections/prevention & control
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Boakye LAT, Fourman MS, Spina NT, Laudermilch D, Lee JY. "Post-Decompressive Neuropathy": New-Onset Post-Laminectomy Lower Extremity Neuropathic Pain Different from the Preoperative Complaint. Asian Spine J 2018; 12:1043-1052. [PMID: 30322252 PMCID: PMC6284122 DOI: 10.31616/asj.2018.12.6.1043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 04/25/2018] [Indexed: 12/22/2022] Open
Abstract
Study Design Level III retrospective cross-sectional study. Purpose To define and characterize the presentation, symptom duration, and patient/surgical risk factors associated with ‘postdecompressive neuropathy (PDN).’ Overview of Literature PDN is characterized by lower extremity radicular pain that is ‘different’ from pre-surgical radiculopathy or claudication pain. Although it is a common constellation of postoperative symptoms, PDN is incompletely characterized and poorly understood. We hypothesize that PDN is caused by an intraoperative neuropraxic event and may develop early (within 30 days following the procedure) or late (after 30 days following the procedure) within the postoperative period. Methods Patients who consented to undergo lumbar laminectomy with or without an instrumented fusion for degenerative lumbar spine disease were followed up prospectively from July 2013 to December 2014. Relevant data were extracted from the charts of the eligible patients. Patient demographics and surgical factors were identified. Patients completed postoperative questionnaires 3 weeks, 3 months, 6 months, and 1 year postoperatively. Questions were designed to characterize the postoperative pain that differed from preoperative pain. A diagnosis of PDN was established if the patient exhibited the following characteristics: pain different from preoperative pain, leg pain worse than back pain, a non-dermatomal pain pattern, and nocturnal pain that often disrupted sleep. A Visual Analog Scale was used to monitor the pain, and patients documented the effectiveness of the prescribed pain management modalities. Patients for whom more than one follow-up survey was missed were excluded from analysis. Results Of the 164 eligible patients, 118 (72.0%) completed at least one follow-up survey at each time interval. Of these eligible patients, 91 (77.1%) described symptoms consistent with PDN. Additionally, 75 patients (82.4%) described early-onset symptoms, whereas 16 reported symptoms consistent with late-onset PDN. Significantly more female patients reported PDN symptoms (87% vs. 69%, p=0.03). Patients with both early and late development of PDN described their leg pain as an intermittent, constant, burning, sharp/stabbing, or dull ache. Early PDN was categorized more commonly as a dull ache than late-onset PDN (60% vs. 31%, p=0.052); however, the difference did not reach statistical significance. Opioids were significantly more effective for patients with early-onset PDN than for those with late-onset PDN (85% vs. 44%, p=0.001). Gabapentin was most commonly prescribed to patients who cited no resolution of symptoms (70% vs. 31%, p=0.003). Time to symptom resolution ranged from within 1 month to 1 year. Patients’ symptoms were considered unresolved if symptoms persisted for more than 1 year postoperatively. In total, 81% of the patients with early-onset PDN reported complete symptom resolution 1 year postoperatively compared with 63% of patients with late-onset PDN (p=0.11). Conclusions PDN is a discrete postoperative pain phenomenon that occurred in 77% of the patients who underwent lumbar laminectomy with or without instrumented fusion. Attention must be paid to the constellation and natural history of symptoms unique to PDN to effectively manage a self-limiting postoperative issue.
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91
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Kim U, Lee JY, Jo MW, Do YK. ISQUA18-1170Does Heterogeneity in Reporting Patient Experience Matter?: An Anchoring Vignette Approach. Int J Qual Health Care 2018. [DOI: 10.1093/intqhc/mzy167.58] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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92
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Shim JS, Han SH, Jha N, Hwang ST, Ahn W, Lee JY, Ryu JJ. Effect of Irradiance and Exposure Duration on Temperature and Degree of Conversion of Dual-Cure Resin Cement for Ceramic Restorations. Oper Dent 2018; 43:E280-E287. [PMID: 30106334 DOI: 10.2341/17-283-l] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study investigated the effects of irradiance and exposure duration on dual-cured resin cements irradiated through ceramic restorative materials. A single light-curing unit was calibrated to three different irradiances (500, 1000, and 1500 mW/cm2) and irradiated to three different attenuating materials (transparent acryl, lithium disilicate, zirconia) with 1-mm thicknesses for 20 or 60 seconds. The changes in irradiance and temperature were measured with a radiometer (or digital thermometer) under the attenuating materials. The degree of conversion (DC) of dual-cure resin cement after irradiation at different irradiances and exposure durations was measured with Fourier transform near infrared spectroscopy. Two-way analysis of variance revealed that irradiance ( p<0.001) and exposure duration ( p<0.001) significantly affected temperature and DC. All groups showed higher DCs with increased exposure times ( p<0.05), but there were no statistically significant differences between the groups irradiated with 1000 mW/cm2 and 1500 mW/cm2 ( p>0.05). Higher-intensity irradiances yielded higher temperatures ( p<0.05), but exposure time did not affect temperature when materials were irradiated at 500 mW/cm2 ( p>0.05).
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93
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Lee B, Park JE, Bjørnerud A, Kim JH, Lee JY, Kim HS. Clinical Value of Vascular Permeability Estimates Using Dynamic Susceptibility Contrast MRI: Improved Diagnostic Performance in Distinguishing Hypervascular Primary CNS Lymphoma from Glioblastoma. AJNR Am J Neuroradiol 2018; 39:1415-1422. [PMID: 30026384 DOI: 10.3174/ajnr.a5732] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 05/01/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND PURPOSE A small subset of primary central nervous system lymphomas exhibits high cerebral blood volume, which is indistinguishable from that in glioblastoma on dynamic susceptibility contrast MR imaging. Our study aimed to test whether estimates of combined perfusion and vascular permeability metrics derived from DSC-MR imaging can improve the diagnostic performance in differentiating hypervascular primary central nervous system lymphoma from glioblastoma. MATERIALS AND METHODS A total of 119 patients (with 30 primary central nervous system lymphomas and 89 glioblastomas) exhibited hypervascular foci using the reference method of leakage-corrected CBV (reference-normalized CBV). An alternative postprocessing method used the tissue residue function to calculate vascular permeability (extraction fraction), leakage-corrected CBV, cerebral blood flow, and mean transit time. Parameters were compared using Mann-Whitney U tests, and the diagnostic performance to distinguish primary central nervous system lymphoma from glioblastoma was calculated using the area under the curve from the receiver operating characteristic curve and was cross-validated with bootstrapping. RESULTS Hypervascular primary central nervous system lymphoma showed similar leakage-corrected normalized CBV and leakage-corrected CBV compared with glioblastoma (P > .05); however, primary central nervous system lymphoma exhibited a significantly higher extraction fraction (P < .001) and CBF (P = .01) and shorter MTT (P < .001) than glioblastoma. The extraction fraction showed the highest diagnostic performance (the area under the receiver operating characteristic curve [AUC], 0.78; 95% confidence interval, 0.69-0.85) for distinguishing hypervascular primary central nervous system lymphoma from glioblastoma, with a significantly higher performance than both CBV (AUC, 0.53-0.59, largest P = .02) and CBF (AUC, 0.72) and MTT (AUC, 0.71). CONCLUSIONS Estimation of vascular permeability with DSC-MR imaging further characterizes hypervascular primary central nervous system lymphoma and improves diagnostic performance in glioblastoma differentiation.
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Cho KI, Cho BR, Jeon DW, Rha SW, Lee JY, Lim HS, Jin DK, Ahn HS, Park SW. P3801Effect of nebivolol on gender-different efficacy and safety in Korean patients with hypertension: result from BENEFIT-KOREA study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3801] [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: 11/13/2022] Open
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95
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Bell KM, Yan Y, Hartman RA, Lee JY. Influence of follower load application on moment-rotation parameters and intradiscal pressure in the cervical spine. J Biomech 2018; 76:167-172. [PMID: 29929892 DOI: 10.1016/j.jbiomech.2018.05.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 05/15/2018] [Accepted: 05/30/2018] [Indexed: 10/28/2022]
Abstract
The objective of this study was to implement a follower load (FL) device within a robotic (universal force-moment sensor) testing system and utilize the system to explore the effect of FL on multi-segment cervical spine moment-rotation parameters and intradiscal pressure (IDP) at C45 and C56. Twelve fresh-frozen human cervical specimens (C3-C7) were biomechanically tested in a robotic testing system to a pure moment target of 2.0 Nm for flexion and extension (FE) with no compression and with 100 N of FL. Application of FL was accomplished by loading the specimens with bilateral cables passing through cable guides inserted into the vertebral bodies and attached to load controlled linear actuators. FL significantly increased neutral zone (NZ) stiffness and NZ width but resulted in no change in the range of motion (ROM) or elastic zone stiffness. C45 and C56 IDP measured in the neutral position were significantly increased with application of FL. The change in IDP with increasing flexion rotation was not significantly affected by the application of FL, whereas the change in IDP with increasing extension rotation was significantly reduced by the application of FL. Application of FL did not appear to affect the specimen's quantity of motion (ROM) but did affect the quality (the shape of the curve). Regarding IDP, the effects of adding FL compression approximates the effect of the patient going from supine to a seated position (FL compression increased the IDP in the neutral position). The change in IDP with increasing flexion rotation was not affected by the application of FL, but the change in IDP with increasing extension rotation was, however, significantly reduced by the application of FL.
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Go DJ, Lee JY, Kang MJ, Lee EY, Lee EB, Yi EC, Song YW. Urinary vitamin D-binding protein, a novel biomarker for lupus nephritis, predicts the development of proteinuric flare. Lupus 2018; 27:1600-1615. [PMID: 29958502 DOI: 10.1177/0961203318778774] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Lupus nephritis (LN) is a major complication of systemic lupus erythematosus (SLE). Conventional biomarkers for assessing renal disease activity are imperfect in predicting clinical outcomes associated with LN. The aim of this study is to identify urinary protein biomarkers that reliably reflect the disease activity or predict clinical outcomes. A quantitative proteomic analysis was performed to identify protein biomarker candidates that can differentiate between SLE patients with and without LN. Selected biomarker candidates were further verified by enzyme-linked immunosorbent assay using urine samples from a larger cohort of SLE patients ( n = 121) to investigate their predictive values for LN activity measure. Furthermore, the association between urinary levels of a selected panel of potential biomarkers and prognosis of LN was assessed with a four-year follow-up study of renal outcomes. Urinary vitamin D-binding protein (VDBP), transthyretin (TTR), retinol binding protein 4 (RBP4), and prostaglandin D synthase (PTGDS) were significantly elevated in SLE patients with LN, especially in patients with active LN ( n = 21). Among them, VDBP well correlated with severity of proteinuria (rho = 0.661, p < 0.001) and renal SLE Disease Activity Index (renal SLEDAI) (rho = 0.520, p < 0.001). In the four-year follow-up, VDBP was a significant risk factor (hazard ratio 9.627, 95% confidence interval 1.698 to 54.571, p = 0.011) for the development of proteinuric flare in SLE patients without proteinuria ( n = 100) after adjustments for multiple confounders. Urinary VDBP correlated with proteinuria and renal SLEDAI, and predicted the development of proteinuria.
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Kim YI, Kim Y, Lee JY, Jang SJ. Prognostic Value of the Metabolic and Volumetric Parameters of 11C-Methionine Positron-Emission Tomography for Gliomas: A Systematic Review and Meta-Analysis. AJNR Am J Neuroradiol 2018; 39:1629-1634. [PMID: 29954817 DOI: 10.3174/ajnr.a5707] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 03/29/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Several studies have demonstrated that 11C-methionine positron-emission tomography provides information on prognosis. PURPOSE We performed a systematic review and meta-analysis of the prognostic value of the metabolic and volumetric parameters of 11C-methionine-PET for gliomas. DATA SOURCES A systematic search was performed using the following combination of keywords: "methionine," "PET," "glioma," and "prognosis." STUDY SELECTION The inclusion criteria were the use of 11C-methionine-PET as an imaging tool, studies limited to gliomas, studies including metabolic parameters (tumor-to-normal ratio) and/or volumetric parameters (metabolic tumor volume), and studies reporting survival data. The electronic search first identified 181 records, and 14 studies were selected. DATA ANALYSIS Event-free survival and overall survival were the outcome measures of interest. The effect of the tumor-to-normal ratio and metabolic tumor volume on survival was determined by the effect size of the hazard ratio. Hazard ratios were extracted directly from each study when provided or determined by analyzing the Kaplan-Meier curves. DATA SYNTHESIS The combined hazard ratios of the tumor-to-normal ratio for event-free survival was 1.74 with no significance and that of the tumor-to-normal ratio for overall survival was 2.02 with significance. The combined hazard ratio of the metabolic tumor volume for event-free survival was 2.72 with significance and that of the metabolic tumor volume for overall survival was 3.50 with significance. LIMITATIONS The studies selected were all retrospective, and there were only 4 studies involving the metabolic tumor volume. CONCLUSIONS The present meta-analysis of 11C-methionine-PET suggests that the tumor-to-normal ratio for overall survival and the metabolic tumor volume for event-free survival and overall survival are significant prognostic factors for patients with gliomas.
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Seo HM, Moon GT, Song YM, Gee HY, Park YM, Lee JY, Lee JH. Expression of YAP and TAZ in molluscum contagiosum virus infected skin. Br J Dermatol 2018; 179:188-189. [PMID: 29330849 DOI: 10.1111/bjd.16333] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Kim J, Lee BS, Kim B, Na I, Lee J, Lee JY, Park MR, Kim H, Sohn I, Ahn K. Identification of atopic dermatitis phenotypes with good responses to probiotics (Lactobacillus plantarum CJLP133) in children. Benef Microbes 2018; 8:755-761. [PMID: 29035111 DOI: 10.3920/bm2017.0034] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The therapeutic effect of probiotics in atopic dermatitis (AD) remains controversial and varies according to the individual patient. We aimed to identify a population of AD patients with a good clinical response to probiotic treatment. We recruited 76 children with a median age of 7.1 years who suffered from moderate to severe AD. After a 2-week washout period, all patients were given Lactobacillus plantarum CJLP133 at a dosage of 1×1010 colony-forming units once a day for 12 weeks. We measured eosinophil counts in the peripheral blood, the proportion of CD4+CD25+Foxp3+ regulatory T (Treg) cells in CD4+ T cells, serum total immunoglobulin E (IgE) levels, and specific IgE against common allergens before the start of the treatment (T1) and at discontinuation (T2). Responders were defined as patients with at least a 30% reduction in the SCORing of AD (SCORAD) index after treatment. There were 36 responders and 40 non-responders after probiotic treatment. The median SCORAD was reduced from 29.5 (range 20.6-46.3) at T1 to 16.4 (range 6.3-30.8) at T2 in the responder group (P<0.001). In multivariable logistic regression analysis, a good clinical response was significantly associated with high total IgE levels (aOR 5.1, 95% CI 1.1-23.6), increased expression of transforming growth factor (TGF)-β (aOR 4.6, 95% CI 1.3-15.9), and a high proportion of Treg cells in CD4+ T cells (aOR 3.7, 95% CI 1.1-12.7) at T1. In the responder group, the proportion of Treg cells was significantly increased after 12 weeks of treatment (P=0.004), while TGF-β mRNA expression was decreased (P=0.017). Our results suggest that a subgroup of patients with a specific AD phenotype showing an immunologically active state (high total IgE, increased expression of TGF-β, high numbers of Treg cells) may benefit from probiotic treatment with L. plantarum CJLP133.
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Lee JY, Kim M, Yang HK, Kim HM, Cho J, Kim YM, Lim IS, Cheong HK, Kim HS, Sohn I, Kim J, Ahn K. Reliability and validity of the Atopic Dermatitis Symptom Score (ADSS). Pediatr Allergy Immunol 2018; 29:290-295. [PMID: 29350788 DOI: 10.1111/pai.12865] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/11/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND We have developed the Atopic Dermatitis Symptom Score (ADSS) by which patients or parents can easily assess and record AD symptoms on a daily basis in a smartphone application. The aim of this study was to evaluate the reliability and validity of the ADSS. METHODS We enrolled 307 children and adolescents with AD. Parents or caregivers were asked to record daily symptoms of the patients (itching, sleep disturbance, erythema, dryness, oozing, and edema) using a scale of 0-4. Statistical analyses consisted of the test-retest reliability, concurrent validity, minimal clinically important difference (MCID), responsiveness, floor or ceiling effects, and screening accuracy. Receiver-operating characteristic analyses were conducted to evaluate the ADSS cutoff point for predicting severe AD (SCORing AD [SCORAD] ≥40). RESULTS Test-retest reliability between daytime and night-time ADSS was good (intraclass correlation coefficient, 0.82 [95% CI: 0.70-0.90]). An increase in ADSS was significantly associated with an increase in SCORAD (r = 0.64, P < .0001) (concurrent validity). The MCID was 4.1 points for the ADSS. There was a significant association between changes in ADSS and SCORAD (r = 0.56, P < .0001), indicating good responsiveness. At the optimal ADSS cutoff value of 7.0, sensitivity, specificity, and positive and negative predictive values were 88.4%, 78.6%, 21.1%, and 99.1%, respectively (screening accuracy). CONCLUSIONS The ADSS can be a useful tool for self-assessment of skin symptoms in children with AD.
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