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Shin A, Zhang SC, Gasho JO, Silos K, Polishchuk T, Bennett J, Kamrava M, Guthier CV, Nikolova A, Steers J, Mak RH, Lewis JH, Atkins KM. Left Anterior Descending Coronary Artery-Optimized Knowledge-Based Radiotherapy Planning in Patients with Locally Advanced Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e718. [PMID: 37786095 DOI: 10.1016/j.ijrobp.2023.06.2223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The left anterior descending (LAD) coronary artery volume receiving 15 Gy (V15 Gy) has been associated with major adverse cardiac events and mortality in patients with locally advanced non-small cell lung cancer (LA-NSCLC) treated with radiotherapy (RT). However, coronary arteries are not routinely contoured as standard-of-care and there is limited data describing coronary-sparing planning techniques. Our objective was to evaluate whether LAD-sparing could be improved compared to real-world plans using a commercial knowledge-based planning (KBP) software without clinically unacceptable tradeoffs to other critical organs at risk (OAR). MATERIALS/METHODS Retrospective replanning analysis was conducted on 31 RT plans developed for patients with LA-NSCLC. Each case was manually replanned with volumetric modulated arc radiotherapy (VMAT) optimized for LAD V15 Gy sparing with a prescription dose of 60 Gy. The resulting plans were used to create an LAD-optimized KBP model. The model included both KBP-generated objectives and additional point objectives to meet LAD (V15 Gy < 10%), lung (V5 Gy < 60%, V20 < 30%, mean < 17 Gy), heart (mean < 20 Gy), spinal cord (D0.03cc < 45 Gy), esophagus (V60 Gy < 17%, mean < 34 Gy), and planning target volume (PTV; D95% = 100%). The LAD-optimized model was deployed to replan 33 additional VMAT plans for LA-NSCLC with prescription dose 60 Gy, delivered between 2018 and 2022. Dose constraints or objectives were only unmet with KBP when not met in the original plan. Descriptive statistics were used to compare dosimetric parameters between original and LAD-optimized KBP plans. RESULTS For the 33 plans identified for LAD-optimized KBP replanning, the original plans had a mean LAD V15 Gy of 17.9% (standard error [SE], 3.9%), while the LAD-optimized KBP plans had a significantly lower mean LAD V15 Gy of 5.9% (SE, 1.9%; p = 0.031). There was no significant difference in mean heart dose between the original and LAD-optimized KBP plans (8.4 Gy [SE 6.6 Gy] vs. 7.3 Gy [SE 5.8 Gy]; p = 0.48). Of these 33 KBP plans, 42% (n = 14) had mean reductions in LAD V15 Gy from 40.5% (SE 4.3%) to 10.5% (SE 3.5%; p = 0.0002), with 9/14 now able to meet < 10%, without affecting other critical OAR objectives (p > 0.5 for lungs, esophagus, spinal cord). 45% (n = 15) originally had an LAD V15 Gy < 1%, which were unchanged using KBP (p > 0.3). Four plans (12%) had higher LAD V15 Gy in the KBP vs. original plan (2/4 still meeting < 10%), due to the model prioritizing other OARs to a greater degree. CONCLUSION Improvements in LAD-sparing was achievable in more than 40% of plans without apparent clinically significant tradeoffs in other critical OARs and without corresponding change in MHD. This result underscores the importance of standard implementation of LAD contouring and dose constraints, particularly given the discordance between whole heart and LAD dose exposure.
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Affiliation(s)
- A Shin
- Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA
| | - S C Zhang
- Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA
| | - J O Gasho
- Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA
| | - K Silos
- Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA
| | - T Polishchuk
- Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA
| | - J Bennett
- Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA
| | - M Kamrava
- Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA
| | - C V Guthier
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, MA
| | - A Nikolova
- Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA
| | - J Steers
- Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA
| | - R H Mak
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, MA
| | - J H Lewis
- Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA
| | - K M Atkins
- Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA
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Larsen F, Good H, Shin A, Derouet M, Zhang L, Asfaha S. A27 DNA HYPOMETHYLATION INDUCED BY 5-AZA-CDR OR LOSS OF DNMT1 INHIBITS COLITIS-ASSOCIATED COLORECTAL CANCER. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991352 DOI: 10.1093/jcag/gwac036.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Colorectal cancer is the second leading cause of cancer death in Canada. A major risk factor for the development of colorectal cancer is chronic inflammation leading to colitis-associated cancer (CAC). We previously described a CAC mouse model in which tumors arise from DCLK1+ tuft cells following loss of the tumor suppressor adenomatous polyposis coli (APC) and induction of colitis. Interestingly, both colitis and CAC display epigenetic changes that modulate gene expression. However, the impact of DNA methylation changes on colonic tumorigenesis is not known. Thus, we hypothesize that inhibition of DNA methylation in DCLK1+ tuft cells reduces colonic tumorigenesis. Purpose In this study, we aim to investigate the role of DNA methylation in CAC by inhibiting DNA methylation using genetic and pharmacologic means. Method Using a publicly available dataset (GSE75214) of gene expression data analyzed by microarray from colonic biopsies of patients with ulcerative colitis and Crohn’s Disease with active disease, we examined the expression of DNA methyltransferases (DNMTs). Expression of DNMTs in mice with colitis was additionally examined by RT-qPCR and global DNA methylation levels measured by 5-mC ELISA. In separate experiments, Dclk1-CreERT2/Apcf/f mice were crossed to DNMT1f/f mice to knock-out the DNA methyltransferase DNMT1 in DCLK1+ tuft cells. Dclk1/Apcf/f and Dclk1/Apcf/f/DNMT1f/f mice were then administered three doses of tamoxifen followed by 2.5% dextran sodium sulfate (DSS) for five days to induce colitis. Fourteen weeks later, we assessed colonic tumor number and size. In a separate cohort of Dclk1/Apcf/f mice, we induced colitis and treated the mice with six doses of the DNA de-methylating drug 5-AZA-2’-deoxycytidine (5-AZA) or vehicle, and assessed colonic tumor number. To examine DNA methylation changes, we then treated WT mice with 5-AZA and DSS and isolated intestinal epithelial cells. From the intestinal epithelial cell, we isolated DNA and ran the Infinium MouseMethylation BeadChip Array. Result(s) Patients with IBD were found to have increased expression of DNMT1 compared to healthy controls. Mice treated with DSS similarly had increased DNMT1 expression, as well as, global methylation levels compared to controls. Deletion of DNMT1 in DCLK1+ cells significantly inhibited the number and size of colonic tumors. Treatment of mice with 5-AZA decreased global and gene specific DNA methylation levels, and significantly reduced both the number of mice with tumors, and the average colonic tumor number and size per mouse. Conclusion(s) Our findings demonstrate that colitis in both patients and mice is associated with DNA methylation. Furthermore, DNA hypomethylation by 5-AZA treatment or loss of DNMT1 reduces CAC formation suggesting that altered DNA methylation plays a critical role in colonic tumorigenesis. Disclosure of Interest None Declared
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Affiliation(s)
- F Larsen
- Department of Medicine, Western University, London, Canada
| | - H Good
- Department of Medicine, Western University, London, Canada
| | - A Shin
- Department of Medicine, Western University, London, Canada
| | - M Derouet
- Department of Medicine, Western University, London, Canada
| | - L Zhang
- Department of Medicine, Western University, London, Canada
| | - S Asfaha
- Department of Medicine, Western University, London, Canada
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Shin JW, Shin A, Park SS, Lee JM. Haplotype-specific insertion-deletion variations for allele-specific targeting in Huntington's disease. Mol Ther Methods Clin Dev 2022; 25:84-95. [PMID: 35356757 PMCID: PMC8933729 DOI: 10.1016/j.omtm.2022.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 03/01/2022] [Indexed: 11/25/2022]
Abstract
Huntington's disease (HD) is a dominantly inherited neurodegenerative disease caused by an expanded CAG repeat in huntingtin (HTT). Given an important role for HTT in development and significant neurodegeneration at the time of clinical manifestation in HD, early treatment of allele-specific drugs represents a promising strategy. The feasibility of an allele-specific antisense oligonucleotide (ASO) targeting single-nucleotide polymorphisms (SNPs) has been demonstrated in models of HD. Here, we constructed a map of haplotype-specific insertion-deletion variations (indels) to develop alternative mutant-HTT-specific strategies. We mapped indels annotated in the 1000 Genomes Project data on common HTT haplotypes, revealing candidate indels for mutant-specific HTT targeting. Subsequent sequencing of an HD family confirmed candidate sites and revealed additional allele-specific indels. Interestingly, the most common normal HTT haplotype carries indels of big allele length differences at many sites, further uncovering promising haplotype-specific targets. When patient-derived cells carrying the most common HTT diplotype were treated with ASOs targeting the mutant alleles of candidate indels (rs772629195 or rs72239206), complete mutant specificity was observed. In summary, our map of haplotype-specific indels permits the identification of allele-specific targets in HD subjects, potentially contributing to the development of safe HTT-lowering therapeutics that are suitable for early treatment in HD.
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Affiliation(s)
- Jun Wan Shin
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA 02114, USA.,Department of Neurology, Harvard Medical School, Boston, MA 02115, USA
| | - Aram Shin
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Seri S Park
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Jong-Min Lee
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA 02114, USA.,Department of Neurology, Harvard Medical School, Boston, MA 02115, USA.,Medical and Population Genetics Program, Broad Institute of M.I.T. and Harvard, Cambridge, MA 02142, USA
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Shin A, Choi SR, Ha YJ, Lee YJ, Lee EB, Kang EH. POS0217 ALL-CAUSE AND CAUSE SPECIFIC MORTALITY AMONG PATIENTS WITH BEHCET’S DISEASE VERSUS GENERAL POPULATION. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundBehcet’s disease (BD) is a systemic vasculitis with multiorgan involvement.ObjectivesTo compare the risk of all-cause and cause specific mortality among patients with BD compared to general populationMethodsUsing the 2002-2017 Korea National Health Insurance database, we conducted a cohort study among BD patients compared to general population matched on age and sex at a 1:5 ratio. The primary outcome was death of any cause, and the secondary outcomes were cause-specific mortality for top 5 causes of death. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs), comparing BD patients versus general population.ResultsThe PS-matched study cohort (mean age 42.1 years; 32.0% male) included 32288 BD patients and 161440 controls. During a mean follow-up of 9.6 years, 2214 deaths occurred. The HR [95%] for all-cause mortality was 10.6 [9.6-11.6]. The Top 5 causes of death derived from malignancy, cardiovascular disease, infection, respiratory disease, and injury: the HR [95%] for mortality from these causes were 8.5 [7.2-10.1], 10.8 [8.6-13.6], 14.6 [8.1-26.3], 12.0 [8.5-17.0], and 8.0 [5.0-13.0], respectively.ConclusionThis population-based cohort study warns exceptionally heavy burden of the disease showing approximately 10 times higher mortality of BD patients compared to general population. In line with this, risk of cause specific mortality was also significantly higher among the BD patients, for 5 top causes of death.Disclosure of InterestsNone declared
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Shin A, Ha YJ, Lee YJ, Lee EB, Kang EH. POS0282 UPDATE ON COMPARATIVE CARDIOVASCULAR SAFETY OF FEBUXOSTAT VERSUS ALLOPURINOL AMONG PATIENTS WITH GOUT. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundGout is associated with an increased risk of cardiovascular (CV) disease.ObjectivesTo update comparative CV safety of febuxostat versus allopurinol among patients with goutMethodsUsing the 2011-2019 Korea National Health Insurance database, we conducted a cohort study comparing gout patients initiating febuxostat versus allopurinol, with study participants matched on a propensity score (PS) for>60 covariates at a 1:1 ratio. The primary outcome was composite CV outcome of myocardial infarction, coronary revascularization, and stroke. Secondary outcomes were CV and all-cause mortalities in addition to individual components of the primary outcome. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs), comparing febuxostat versus allopurinol initiators.ResultsWe included 160,930 febuxostat users PS-matched on 160,930 allopurinol users (mean age 59.3 years, 79.6% male). During a mean follow-up of 250 days, the incidence rate of the primary outcome was 2.27 and 2.06 per 100 person-years for allopurinol and febuxostat users respectively, with the PS-matched HR [95% CI] of 1.03 [0.95-1.12]. Analysis on secondary outcomes also showed a similar result except for all-cause mortality with a significantly reduced risk among febuxostat users with a PS-matched HR [95% CI] of 0.84 [0.78-0.91] (Table 1).Table 1.Comparative cardiovascular safety between febuxostat and allopurinolFebuxostat N = 160,930Allopurinol (Ref) N= 160,930HR (95% CI)EventsPYaIR [95% CI]EventsPYaIR(95% CI]Composite CV endpoint2635128,1932.06 [1.98-2.13]2,09992,5122.27 [2.17-2.37]1.03 [0.95-1.12]MI468129,8730.36 [0.33-0.39]34193,8080.36 [0.33-0.40]1.13 [0.91-1.39]Coronary revascularization1085129,2330.84 [0.79-0.89]85693,2930.92 [0.86-0.98]1.10 [0.96-1.26]Stroke or TIA1490129,1631.15 [1.10-1.21]1,18793,2521.27 [1.20-1.35]0.99 [0.90-1.10]Death2558130,1761.97 [1.89-2.04]2,20194,0072.34 [2.24-2.44]0.84 [0.78-0.91]aIR is per 100 person-years. IR=incidence rate, HR=hazard ratio, CI=confidence interval, MI=myocardial infarction, PY=person-years, TIA=transient ischemic attackConclusionThis large population-based cohort study showed a similar CV safety profile between febuxostat and allopurinol users but found a 16% reduced all-cause mortality among febuxostat users compared to allopurinol, primarily derived from non-CV death reduction.Disclosure of InterestsNone declared
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Shin A, Waxman DJ. Impact of neonatal activation of nuclear receptor CAR (Nr1i3) on Cyp2 gene expression in adult mouse liver. Toxicol Sci 2022; 187:298-310. [PMID: 35285501 DOI: 10.1093/toxsci/kfac032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Perinatal exposure to environmental chemicals is proposed to reprogram development and alter disease susceptibility later in life. Supporting this, neonatal activation of the nuclear receptor CAR (Nr1i3) by TCPOBOP induces persistent expression of mouse hepatic Cyp2 genes into adulthood, attributed to long-term epigenetic memory of the early life exposure [Hepatology (2012) 56:1499-1509]. Here, we confirm that the same high-dose (15x ED50) neonatal TCPOBOP exposure used in that work induces prolonged (12 weeks) increases in hepatic Cyp2 expression; however, we show that the persistence of expression can be fully explained by the persistence of residual TCPOBOP in liver tissue. When the long-term presence of TCPOBOP in tissue was eliminated by decreasing the neonatal TCPOBOP dose 22-fold (0.67x ED50), strong neonatal increases in hepatic Cyp2 expression were still obtained but did not persist into adulthood. Furthermore, the neonatal ED50-range TCPOBOP exposure did not sensitize mice to a subsequent, low-dose TCPOBOP treatment. In contrast, neonatal treatment with phenobarbital, a short half-life (t1/2=8 h) agonist of CAR and of PXR (Nr1i2), induced high-level neonatal activation of Cyp2 genes and also altered their responsiveness to low-dose phenobarbital exposure at adulthood by either increasing (Cyp2b10) or decreasing (Cyp2c55) expression. Thus, neonatal xenobiotic exposure can reprogram hepatic Cyp2 genes and alter their responsiveness to exposures later in life. These findings highlight the need to carefully consider xenobiotic dose, half-life and persistence in tissue when evaluating the long-term effects of early life environmental chemical exposures.
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Affiliation(s)
- Aram Shin
- Department of Biology and Bioinformatics Program, Boston University, Boston, Massachusetts 02215, USA
| | - David J Waxman
- Department of Biology and Bioinformatics Program, Boston University, Boston, Massachusetts 02215, USA
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Shin A, Park EH, Dong YH, Ha YJ, Lee YJ, Lee EB, Song YW, Kang EH. Comparative risk of osteoporotic fracture among patients with rheumatoid arthritis receiving TNF inhibitors versus other biologics: a cohort study. Osteoporos Int 2020; 31:2131-2139. [PMID: 32514765 DOI: 10.1007/s00198-020-05488-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 06/01/2020] [Indexed: 12/19/2022]
Abstract
UNLABELLED In this population-based cohort study on comparative osteoporotic fracture risks between different biologic disease-modifying drugs among patients with rheumatoid arthritis (RA), we did not find a significant difference in the risk of osteoporotic fractures between RA patients receiving TNF inhibitors versus abatacept or tocilizumab. INTRODUCTION We aimed to investigate the comparative risk of osteoporotic fractures between rheumatoid arthritis (RA) patients who initiated TNF inhibitors (TNFis) versus abatacept or tocilizumab. METHODS Using the Korea National Health Insurance Service datasets from 2002 to 2016, RA patients who initiated TNFis, abatacept, or tocilizumab were identified. The primary outcome was a composite end point of non-vertebral fractures and hospitalized vertebral fractures; secondary outcomes were two components of the primary outcome and fractures occurring at the humerus/forearm. Propensity score (PS) matching with a variable ratio up to 10 TNFi initiators per 1 comparator drug initiator was used to adjust for > 50 baseline confounders. We estimated hazard ratios (HRs) and 95% confidence interval (CI) of fractures comparing TNFi initiators to abatacept and to tocilizumab by Cox proportional hazard models stratified by a matching ratio. RESULTS After PS-matching, 2307 TNFi initiators PS-matched on 588 abatacept initiators, and 2462 TNFi initiators on 640 tocilizumab initiators were included. A total of 77 fractures occurred during a mean follow-up of 454 days among TNFi and abatacept initiators and 83 fractures during 461 days among TNFi and tocilizumab initiators. The PS-matched HR (95% CI) was 0.91 (0.48-1.71) comparing TNFi versus abatacept initiators, and 1.00 (0.55-1.83) comparing TNFi versus tocilizumab initiators. Analysis on vertebral and non-vertebral fractures showed similar results. CONCLUSIONS In this nationally representative cohort, we did not find a significant difference in the risk of fractures between TNFi initiators versus abatacept or tocilizumab among RA patients.
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Affiliation(s)
- A Shin
- Division of Rheumatology Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - E H Park
- Division of Rheumatology Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Y-H Dong
- Faculty of Pharmacy School of Pharmaceutical Science, National Yang-Ming University, Taipei, Taiwan
- Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Y-J Ha
- Division of Rheumatology Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Y J Lee
- Division of Rheumatology Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - E B Lee
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Y W Song
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology and College of Medicine, Seoul National University, Seoul, South Korea
| | - E H Kang
- Division of Rheumatology Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
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Park EH, Shin A, Ha YJ, Lee YJ, Lee EB, Song YW, Kang EH. THU0178 PREDICTORS OF BIOLOGIC DISEASE MODIFYING ANTI-RHEUMATIC DRUG INITIATION AMONG PATIENTS WITH RHEUMATOID ARTHRITIS IN KOREA. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Background:Biological disease-modifying anti-rheumatic drugs (bDMARDs) have significantly improved clinical prospects for patients with rheumatoid arthritis (RA).Objectives:To identify predictors of bDMARDs initiation in RA patients.Methods:Using 2002-2016 Korea National Health Insurance Service database, we conducted a nested case-control study on RA patients. Four conventional DMARD (cDMARD) users were selected by risk set sampling per each bDMARD user, matched on the calendar year/month of RA diagnosis. Potential predictors were separately assessed for two periods, 1 year after RA diagnosis and 1 year prior to bDMARD initiation, by logistic regression analyses estimating odds ratio (OR) and 95% confidence interval (CI).Results:The study included 27,940 cDMARD users and 6,985 bDMARD users. Younger age, initial use of a less potent cDMARD (sulfasalazine), corticosteroid use, and higher maximal methotrexate (MTX) dose during 1 year post-diagnosis were positive predictors for later bDMARD initiation, while male gender, initial use of a potent cDMARD (MTX, leflunomide, or tacrolimus), initial MTX dose of ≥10mg/wk, and initial cDMARD combination were negative predictors (Table 1). Use of non-MTX DMARDs (leflunomide, sulfasalazine, or tacrolimus), higher # of cDMARD used, subcutaneous administration of MTX, corticosteroid therapy, and higher maximal MTX dose were positive predictors of subsequent bDMARD. Although higher comorbidity score during 1 year before bDMARD initiation was a positive predictor, the effect was heterogenous by involved systems (Table 2).Table 1.Predictors of bDMARD initiation among RA patients during 1-year post-diagnosisPredictorsOR(95% CI)P-valueAge (/1 year)0.977(0.974-0.980)<0.001Sex (male vs. female)0.850(0.787-0.918)<0.0011st cDMARD at RA diagnosis (yes vs. no) Methotrexate0.540(0.476-0.614)<0.001 Leflunomide0.463(0.388-0.552)<0.001 Sulfasalazine1.305(1.197-1.424)<0.001 Tacrolimus0.181(0.083-0.395)<0.001Initial MTX dose (≥10mg/week vs. <10mg/week)0.539(0.506-0.575)<0.001Initial cDMARD combination (yes vs. no)0.621(0.530-0.727)<0.001Subcutaneous MTX use (yes vs. no)1.456(1.156-1.834)0.001Maximal MTX dose (/1mg)1.012(1.008-1.016)<0.001Corticosteroids use (yes vs. no)2.805(2.345-3.355)<0.001Table 2.Predictors of bDMARD initiation among RA patients during 1-year prior to bDMARD initiationPredictorsOR(95% CI)P-valueAge (/1 year)0.970(0.967-0.974)<0.001Non-MTX cDMARD use (yes vs. no)1 Leflunomide1.765(1.573-1.980)<0.001 Sulfasalazine1.465(1.297-1.654)<0.001 Tacrolimus2.070(1.796-2.387)<0.001 Subcutaneous MTX use (yes vs. no)1.731(1.577-1.900)<0.001Maximal MTX dose (/1mg)2.568(1.921-3.433)<0.001Glucocorticoid use (yes vs. no)1.015(1.010-1.021)<0.001Comorbidity index (/1 point)1.124(1.076-1.175)<0.001Individual comorbidities (yes vs. no) Stroke/ transient ischemic attack0.764(0.626-0.932)0.008 Atrial fibrillation0.666(0.455-0.973)0.036 Diabetes mellitus1.208(1.076-1.356)0.001 Joint replacement therapy1.788(1.341-2.384)<0.001 Hepatitis B infection1.559(1.238-1.964)<0.001 Hepatitis C infection2.117(1.532-2.925)<0.001 Chronic obstructive pulmonary disease1.118(1.012-1.234)0.0281MTX was excluded since all bDMARD initiators were required to use MTX before bDMARD initiation.Conclusion:In this population-based nationwide study, we identified period-specific predictors of bDMARD initiation among RA patients in Korea. Overall, initial aggressive RA treatment after RA diagnosis were associated with less use of later bDMARD, while highly intensive therapy observed just before bDMARD initiation reflects refractory nature of RA during this period.Disclosure of Interests:None declared
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Lee E, Shin A, Lee J, Ha YJ, Lee YJ, Lee EB, Song YW, Kang EH. FRI0067 ALL-CAUSE AND CAUSE-SPECIFIC MORTALITY OF PATIENTS WITH RHEUMATOID ARTHRITIS IN KOREA: A NATION-WIDE POPULATION-BASED STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Rheumatoid arthritis (RA) is a chronic inflammatory disease associated with excess mortality.Objectives:To compare all-cause and cause-specific mortality between RA patients versus general population, using a nationally representative cohort from Korea National Health Insurance Service database (KNHIS).Methods:Patients with RA aged ≥ 40 years were identified from 2010-2016 KNHIS database and their annual cohorts were constructed per each calendar year. RA patients of each cohort were required to have prevalent RA on January 1stof the given calendar year. The KNHIS were linked with Korea national mortality data to obtain cause of death information and to estimate expected deaths of RA patients in reference to mortality data of the general population in Korea. Standardized mortality ratio (SMR) with a 95% confidence interval (CI) was calculated to compare mortality of RA patients and general population.Results:A total of 6,404 deaths occurred among 79,440 RA patients during 2011-2016 period, showing all-cause SMR (95% CI) of 1.45 (1.42-1.49) compared to general population. The SMR was 1.72 (1.59-1.85) for biologics users and 1.43 (1.39-1.46) for non-users, versus general population. The annual SMR of RA patients showed a growing trend of mortality over time particularly among biologics users (Table 1). The SMRs for common causes of death among RA patients showed approximately tripled risk of dying due to pulmonary and infectious causes compared to general population (Table 2). There was approximately 20% increased risk of cardiovascular deaths but 8% decreased risk of cancer-related deaths among RA patients compared to general population (Table 2).Table 1.Annual all-cause SMR of RA patients compared to 2010 general populationCalendar year1RA patientsBiologics usersBiologics non-users20111.00 (0.92−1.07)1.13 (0.87−1.39)0.98 (0.90−1.06)20121.13 (1.06−1.21)0.98 (0.75−1.22)1.15 (1.07−1.23)20131.22 (1.14−1.30)1.29 (1.04−1.54)1.21 (1.13−1.29)20141.30 (1.23−1.38)1.53 (1.26−1.79)1.28 (1.20−1.36)20151.45 (1.38−1.53)1.81 (1.53−2.09)1.41 (1.33−1.50)20161.45 (1.37−1.52)1.94 (1.66−2.22)1.39 (1.31−1.47)CI, confidence interval; RA, rheumatoid arthritis; SMR, standardized mortality ratio12010 data were used to identify RA diagnosis dates but were not included for SMR estimation since diagnosis dates of RA were unclear for those who had RA in 2010.Table 2.Cause-specific SMR comparing RA patients versus general populationCause of deathRA patientsBiologics usersBiologics non-usersInfection3.12 (2.93−3.13)4.12 (3.36−4.88)3.03 (2.83−3.23)Cancer0.92 (0.87−0.97)0.98 (0.81−1.14)0.91 (0.85−0.96)Respiratory13.14 (2.97−3.32)4.64 (3.89−5.38)3.01 (2.83−3.19)Cardiovascular21.18 (1.12−1.25)1.26 (1.03−1.50)1.18 (1.11−1.25)CI, confidence interval; RA, rheumatoid arthritis; SMR, standardized mortality ratio1Includes pulmonary infections and chronic lung diseases (J00-J98, U04);2Includes atherosclerotic and non-atherosclerotic deaths (I00-I99).Conclusion:The all-cause mortality of RA patients during 2011-2016 was overall 45% greater than that of general Korean population, which increased annually over the study period. The increased mortality was more prominent among biologics users than non-users. The risk of infectious and respiratory deaths were tripled among RA patients compared to general population.References:[1]Sokka T, et al. Mortality in rheumatoid arthritis: 2008 update. Clin Exp Rheumatol. 2008;26(5 Suppl 51):S35-61.Acknowledgments:NoneDisclosure of Interests:None declared
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Lee J, Shin A, Choi JY, Kang D, Lee JK. Adherence to recommended intake of calcium and colorectal cancer risk in the HEXA study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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11
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Anderson EC, Frankino PA, Higuchi-Sanabria R, Yang Q, Bian Q, Podshivalova K, Shin A, Kenyon C, Dillin A, Meyer BJ. X Chromosome Domain Architecture Regulates Caenorhabditis elegans Lifespan but Not Dosage Compensation. Dev Cell 2019; 51:192-207.e6. [PMID: 31495695 DOI: 10.1016/j.devcel.2019.08.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 06/26/2019] [Accepted: 08/06/2019] [Indexed: 12/21/2022]
Abstract
Mechanisms establishing higher-order chromosome structures and their roles in gene regulation are elusive. We analyzed chromosome architecture during nematode X chromosome dosage compensation, which represses transcription via a dosage-compensation condensin complex (DCC) that binds hermaphrodite Xs and establishes megabase-sized topologically associating domains (TADs). We show that DCC binding at high-occupancy sites (rex sites) defines eight TAD boundaries. Single rex deletions disrupted boundaries, and single insertions created new boundaries, demonstrating that a rex site is necessary and sufficient to define DCC-dependent boundary locations. Deleting eight rex sites (8rexΔ) recapitulated TAD structure of DCC mutants, permitting analysis when chromosome-wide domain architecture was disrupted but most DCC binding remained. 8rexΔ animals exhibited no changes in X expression and lacked dosage-compensation mutant phenotypes. Hence, TAD boundaries are neither the cause nor the consequence of DCC-mediated gene repression. Abrogating TAD structure did, however, reduce thermotolerance, accelerate aging, and shorten lifespan, implicating chromosome architecture in stress responses and aging.
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Affiliation(s)
- Erika C Anderson
- Howard Hughes Medical Institute and Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Phillip A Frankino
- Howard Hughes Medical Institute and Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Ryo Higuchi-Sanabria
- Howard Hughes Medical Institute and Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Qiming Yang
- Howard Hughes Medical Institute and Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Qian Bian
- Howard Hughes Medical Institute and Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA 94720, USA
| | | | - Aram Shin
- Howard Hughes Medical Institute and Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Cynthia Kenyon
- Calico Life Sciences, South San Francisco, CA 94080, USA
| | - Andrew Dillin
- Howard Hughes Medical Institute and Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Barbara J Meyer
- Howard Hughes Medical Institute and Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA 94720, USA.
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Rampersaud A, Lodato NJ, Shin A, Waxman DJ. Widespread epigenetic changes to the enhancer landscape of mouse liver induced by a specific xenobiotic agonist ligand of the nuclear receptor CAR. Toxicol Sci 2019; 171:315-338. [PMID: 31236583 PMCID: PMC6760311 DOI: 10.1093/toxsci/kfz148] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 06/13/2019] [Accepted: 06/17/2019] [Indexed: 12/13/2022] Open
Abstract
CAR (Nr1i3), a liver nuclear receptor and xenobiotic sensor, induces drug, steroid and lipid metabolism and dysregulates genes linked to hepatocellular carcinogenesis, but its impact on the liver epigenome is poorly understood. TCPOBOP, a halogenated xenochemical and highly specific CAR agonist ligand, induces localized chromatin opening or closing at several thousand mouse liver genomic regions, discovered as differential DNase-hypersensitive sites (ΔDHS). Active enhancer and promoter histone marks induced by TCPOBOP were enriched at opening DHS and TCPOBOP-inducible genes. Enrichment of CAR binding and CAR motifs was seen at opening DHS and their inducible drug/lipid metabolism gene targets, and at many constitutively open DHS located nearby. TCPOBOP-responsive cell cycle and DNA replication genes co-dependent on MET/EGFR signaling for induction were also enriched for CAR binding. A subset of opening DHS and many closing DHS mapping to TCPOBOP-responsive target genes did not bind CAR, indicating an indirect mechanism for their changes in chromatin accessibility. TCPOBOP-responsive DHS were also enriched for induced binding of RXRA, CEBPA and CEBPB, and for motifs for liver-enriched factors that may contribute to liver-specific transcriptional responses to TCPOBOP exposure. These studies elucidate the enhancer landscape of TCPOBOP-exposed liver and the widespread epigenetic changes that are induced by both direct and indirect mechanisms linked to CAR activation. The global maps of thousands of environmental chemical-induced epigenetic changes described here constitute a rich resource for further research on xenochemical effects on liver chromatin states and the epigenome.
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Affiliation(s)
- Andy Rampersaud
- Department of Biology and Bioinformatics Program, Boston University, Boston, MA USA
| | - Nicholas J Lodato
- Department of Biology and Bioinformatics Program, Boston University, Boston, MA USA
| | - Aram Shin
- Department of Biology and Bioinformatics Program, Boston University, Boston, MA USA
| | - David J Waxman
- Department of Biology and Bioinformatics Program, Boston University, Boston, MA USA
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Connell M, Shin A, James-Stevenson T, Xu H, Imperiale TF, Herron J. Systematic review and meta-analysis: Efficacy of patented probiotic, VSL#3, in irritable bowel syndrome. Neurogastroenterol Motil 2018; 30:e13427. [PMID: 30069978 PMCID: PMC6249050 DOI: 10.1111/nmo.13427] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 06/20/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND VSL#3 is a patented probiotic for which several clinical trials suggest benefits on motor function, bloating, and symptoms of irritable bowel syndrome (IBS). OBJECTIVES To quantify effects of VSL#3 on abdominal pain, stool consistency, overall response, abdominal bloating, and quality of life (QOL) in IBS through meta-analysis. METHODS MEDLINE (OvidSP and PubMed), EMBASE, Web of Science, and Scopus were searched up to May 2017. Using a fixed effects model, we pooled data from intention-to-treat analyses of randomized trials (RCTs) comparing VSL#3 to placebo in IBS. Data were reported as relative risk (RR), overall mean difference (MD), or standardized MD (SMD) with 95% confidence intervals (CI). Quality of evidence was rated using the GRADE approach. KEY RESULTS Among 236 citations, 5 RCTs (243 patients) were included. No significant differences were observed for abdominal pain (SMD = -0.03; 95% CI -0.29 to 0.22), bloating (SMD = -0.15; 95% CI -0.40 to 0.11), proportion of bowel movements with normal consistency (overall MD = 0; 95% CI -0.09 to 0.08), or IBS-QOL (SMD = 0.08; 95% CI -0.22 to 0.39). VSL#3 was associated with a nearly statistically significant increase in overall response (RR = 1.39; 95% CI 0.99-1.98). CONCLUSIONS & INFERENCES In this systematic review and meta-analysis, there was a trend toward improvement in overall response with VSL#3, but no clear evidence effectiveness for IBS. However, the number and sample sizes of the trials are small and the overall quality of evidence for 3 of the 5 outcomes was low. Larger trials evaluating validated endpoints in well-defined IBS patients are warranted.
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Affiliation(s)
- M Connell
- Division of Gastroenterology and Hepatology, Indianapolis, Indiana
| | - A Shin
- Division of Gastroenterology and Hepatology, Indianapolis, Indiana
| | | | - H Xu
- Department of Biostatistics, Indiana University, Indianapolis, Indiana
| | - T F Imperiale
- Division of Gastroenterology and Hepatology, Indianapolis, Indiana
| | - J Herron
- Indiana University School of Medicine, Indianapolis, Indiana
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Lee J, Shin A, Cho S, Choi JY, Kang D, Lee JK. Adherence to cancer prevention guideline and colorectal cancer risk in the hexa study. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.2085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Lee J, Shin A, Park J. Trend in incidence of inflammatory bowel diseases in Korea using National Health Insurance database, 2004–2015. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.05.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Shin A, Fazio E, Zhang L, Good H, Asfaha S. A246 ROLE OF DOUBLECORTIN-LIKE KINASE 1 (DCLK1) POSITIVE TUFT CELLS IN COLITIS-ASSOCIATED COLORECTAL CANCER. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy009.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Shin
- Department of Medicine, Department of Pathology and Laboratory Medicine, Schulich School of Medicine & Dentistry, Western University; London Regional Cancer Program, Lawson Health Research Institute, London, ON, Canada
| | - E Fazio
- Department of Medicine, Department of Pathology and Laboratory Medicine, Schulich School of Medicine & Dentistry, Western University; London Regional Cancer Program, Lawson Health Research Institute, London, ON, Canada
| | - L Zhang
- Department of Medicine, Department of Pathology and Laboratory Medicine, Schulich School of Medicine & Dentistry, Western University; London Regional Cancer Program, Lawson Health Research Institute, London, ON, Canada
| | - H Good
- Department of Medicine, Department of Pathology and Laboratory Medicine, Schulich School of Medicine & Dentistry, Western University; London Regional Cancer Program, Lawson Health Research Institute, London, ON, Canada
| | - S Asfaha
- Department of Medicine, Department of Pathology and Laboratory Medicine, Schulich School of Medicine & Dentistry, Western University; London Regional Cancer Program, Lawson Health Research Institute, London, ON, Canada
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Lee M, Jung S, Choi J, Lee J, Shin A, Lee Y. 0344 TRENDS IN PRESCRIPTIONS OF SEDATIVE-HYPNOTICS AMONG KOREAN ADULTS: A NATIONWIDE PRESCRIPTION DATABASE STUDY 2011–2015. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Choi J, Lee J, Jung S, Kim S, Choi Y, Shin A, Lee Y. 0343 USE OF SEDATIVE-HYPNOTICS AND MORTALITY: A POPULATION-BASED RETROSPECTIVE COHORT STUDY. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Shin A, Shin B, Shin JW, Kim KH, Atwal RS, Hope JM, Gillis T, Leszyk JD, Shaffer SA, Lee R, Kwak S, MacDonald ME, Gusella JF, Seong IS, Lee JM. Novel allele-specific quantification methods reveal no effects of adult onset CAG repeats on HTT mRNA and protein levels. Hum Mol Genet 2017; 26:1258-1267. [PMID: 28165127 PMCID: PMC6075029 DOI: 10.1093/hmg/ddx033] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 12/08/2016] [Accepted: 01/19/2017] [Indexed: 01/26/2023] Open
Abstract
Huntington's disease (HD) reflects dominant consequences of a CAG repeat expansion mutation in HTT. Expanded CAG repeat size is the primary determinant of age at onset and age at death in HD. Although HD pathogenesis is driven by the expanded CAG repeat, whether the mutation influences the expression levels of mRNA and protein from the disease allele is not clear due to the lack of sensitive allele-specific quantification methods and the presence of confounding factors. To determine the impact of CAG expansion at the molecular level, we have developed novel allele-specific HTT mRNA and protein quantification methods based on principles of multiplex ligation-dependent probe amplification and targeted MS/MS parallel reaction monitoring, respectively. These assays, exhibiting high levels of specificity and sensitivity, were designed to distinguish allelic products based upon expressed polymorphic variants in HTT, including rs149 109 767. To control for other cis-haplotype variations, we applied allele-specific quantification assays to a panel of HD lymphoblastoid cell lines, each carrying the major European disease haplotype (i.e. hap.01) on the mutant chromosome. We found that steady state levels of HTT mRNA and protein were not associated with expanded CAG repeat length. Rather, the products of mutant and normal alleles, both mRNA and protein, were balanced, thereby arguing that a cis-regulatory effect of the expanded CAG repeat is not a critical component of the underlying mechanism of HD. These robust allele-specific assays could prove valuable for monitoring the impact of allele-specific gene silencing strategies currently being explored as therapeutic interventions in HD.
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Affiliation(s)
- Aram Shin
- Molecular Neurogenetics Unit, Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Baehyun Shin
- Molecular Neurogenetics Unit, Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Neurology, Harvard Medical School, Boston, MA 02115, USA
| | - Jun Wan Shin
- Molecular Neurogenetics Unit, Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Neurology, Harvard Medical School, Boston, MA 02115, USA
| | - Kyung-Hee Kim
- Molecular Neurogenetics Unit, Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Neurology, Harvard Medical School, Boston, MA 02115, USA
| | - Ranjit S. Atwal
- Molecular Neurogenetics Unit, Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Neurology, Harvard Medical School, Boston, MA 02115, USA
| | - Jennifer M. Hope
- Molecular Neurogenetics Unit, Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Tammy Gillis
- Molecular Neurogenetics Unit, Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA
| | - John D. Leszyk
- Proteomics and Mass Spectrometry Facility, University of Massachusetts Medical School, Worcester, MA 01655, USA
| | - Scott A. Shaffer
- Proteomics and Mass Spectrometry Facility, University of Massachusetts Medical School, Worcester, MA 01655, USA
| | - Ramee Lee
- CHDI Foundation, Princeton, NJ 08540, USA
| | - Seung Kwak
- CHDI Foundation, Princeton, NJ 08540, USA
| | - Marcy E. MacDonald
- Molecular Neurogenetics Unit, Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Neurology, Harvard Medical School, Boston, MA 02115, USA
- Medical and Population Genetics Program, The Broad Institute of M.I.T. and Harvard, Cambridge, MA 02142, USA
| | - James F. Gusella
- Molecular Neurogenetics Unit, Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA
- Medical and Population Genetics Program, The Broad Institute of M.I.T. and Harvard, Cambridge, MA 02142, USA
- Department of Genetics, Harvard Medical School, Boston, MA 02115, USA
| | - Ihn Sik Seong
- Molecular Neurogenetics Unit, Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Neurology, Harvard Medical School, Boston, MA 02115, USA
| | - Jong-Min Lee
- Molecular Neurogenetics Unit, Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Neurology, Harvard Medical School, Boston, MA 02115, USA
- Medical and Population Genetics Program, The Broad Institute of M.I.T. and Harvard, Cambridge, MA 02142, USA
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Pope A, Shin A, Barr P, Smith A, Fyfe A, Wu F, Looi J, Gabriel R, van Pelt N. CT Coronary Angiography can Safely Exclude Significant Coronary Artery Disease in Patients Undergoing Isolated Valve or Ascending Aorta Surgery. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sim JA, Shin JS, Park SM, Chang YJ, Shin A, Noh DY, Han W, Yang HK, Lee HJ, Kim YW, Kim YT, Jeong SY, Yoon JH, Kim YJ, Heo DS, Kim TY, Oh DY, Wu HG, Kim HJ, Chie EK, Kang KW, Yun YH. Association between information provision and decisional conflict in cancer patients. Ann Oncol 2015; 26:1974-1980. [PMID: 26116430 DOI: 10.1093/annonc/mdv275] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 06/16/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In this study, we aimed to identify demographic and clinical variables that correlate with perceived information provision among cancer patients and determine the association of information provision with decisional conflict (DC). PATIENTS AND METHODS We enrolled a total of 625 patients with cancer from two Korean hospitals in 2012. We used the European Organization for Research and Treatment of Cancer (EORTC) quality-of-life questionnaire (QLQ-INFO26) to assess patients' perception of the information received from their doctors and the Decisional Conflict Scale (DCS) to assess DC. To identify predictive sociodemographic and clinical variables for adequate information provision, backward selective logistic regression analyses were conducted. In addition, adjusted multivariate logistic regression analyses were carried out to identify clinically meaningful differences of perceived level of information subscales associated with high DC. RESULTS More than half of patients with cancer showed insufficient satisfaction with medical information about disease (56%), treatment (73%), other services (83%), and global score (80%). In multiple logistic regression analyses, lower income and education, female, unmarried status, type of cancer with good prognosis, and early stage of treatment process were associated with patients' perception of inadequate information provision. In addition, Information about the medical tests with high DCS values clarity [adjusted odds ratio (aOR), 0.54; 95% confidence interval (CI) 0.30-0.97] and support (aOR, 0.53; 95% CI 0.33-0.85) showed negative significance. For inadequate information perception about treatments and other services, all 5 DCS scales (uncertainty, informed, values clarity, support, and effective decision) were negatively related. Global score of inadequate information provision also showed negative association with high DCS effective decision (aOR, 0.43; 95% CI 0.26-0.71) and DCS uncertainty (aOR, 0.46; 95% CI 0.27-0.77). CONCLUSION This study found that inadequate levels of perceived information correlated with several demographic and clinical characteristics. In addition, sufficient perceived information levels may be related to low levels of DC.
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Affiliation(s)
- J A Sim
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul
| | - J S Shin
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul; Department of Education & Human Resources Development, Seoul National University Hospital, Seoul, Korea
| | - S M Park
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul
| | - Y J Chang
- Research Institute and Hospital, National Cancer Center, Goyang-si
| | - A Shin
- Department of Preventive Medicine
| | - D Y Noh
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Surgery
| | - W Han
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Surgery
| | - H K Yang
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Surgery
| | - H J Lee
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Surgery
| | - Y W Kim
- Department of Internal Medicine, Seoul National University College of Medicine and Hospital, Seoul
| | - Y T Kim
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul
| | - S Y Jeong
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Surgery
| | - J H Yoon
- Department of Internal Medicine, Seoul National University College of Medicine and Hospital, Seoul; Liver Research Institute, Seoul National University College of Medicine, Seoul
| | - Y J Kim
- Department of Internal Medicine, Seoul National University College of Medicine and Hospital, Seoul; Liver Research Institute, Seoul National University College of Medicine, Seoul
| | - D S Heo
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Internal Medicine, Seoul National University College of Medicine and Hospital, Seoul
| | - T Y Kim
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Department of Internal Medicine, Seoul National University College of Medicine and Hospital, Seoul
| | - D Y Oh
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul
| | - H G Wu
- Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Departments of Radiation Oncology
| | - H J Kim
- Departments of Radiation Oncology
| | - E K Chie
- Departments of Radiation Oncology
| | - K W Kang
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul; Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;; Nuclear Medicine, Seoul National University College of Medicine and Hospital, Seoul
| | - Y H Yun
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul; Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul;.
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Wallraven C, Shin A, Biessmann F. Valence and arousal underlie evaluation of emotional and conversational facial expressions across cultures. J Vis 2014. [DOI: 10.1167/14.10.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Galkina EI, Shin A, Coser KR, Shioda T, Kohane IS, Seong IS, Wheeler VC, Gusella JF, MacDonald ME, Lee JM. HD CAGnome: a search tool for huntingtin CAG repeat length-correlated genes. PLoS One 2014; 9:e95556. [PMID: 24751919 PMCID: PMC3994101 DOI: 10.1371/journal.pone.0095556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 03/28/2014] [Indexed: 11/19/2022] Open
Abstract
Background The length of the huntingtin (HTT) CAG repeat is strongly correlated with both age at onset of Huntington’s disease (HD) symptoms and age at death of HD patients. Dichotomous analysis comparing HD to controls is widely used to study the effects of HTT CAG repeat expansion. However, a potentially more powerful approach is a continuous analysis strategy that takes advantage of all of the different CAG lengths, to capture effects that are expected to be critical to HD pathogenesis. Methodology/Principal Findings We used continuous and dichotomous approaches to analyze microarray gene expression data from 107 human control and HD lymphoblastoid cell lines. Of all probes found to be significant in a continuous analysis by CAG length, only 21.4% were so identified by a dichotomous comparison of HD versus controls. Moreover, of probes significant by dichotomous analysis, only 33.2% were also significant in the continuous analysis. Simulations revealed that the dichotomous approach would require substantially more than 107 samples to either detect 80% of the CAG-length correlated changes revealed by continuous analysis or to reduce the rate of significant differences that are not CAG length-correlated to 20% (n = 133 or n = 206, respectively). Given the superior power of the continuous approach, we calculated the correlation structure between HTT CAG repeat lengths and gene expression levels and created a freely available searchable website, “HD CAGnome,” that allows users to examine continuous relationships between HTT CAG and expression levels of ∼20,000 human genes. Conclusions/Significance Our results reveal limitations of dichotomous approaches compared to the power of continuous analysis to study a disease where human genotype-phenotype relationships strongly support a role for a continuum of CAG length-dependent changes. The compendium of HTT CAG length-gene expression level relationships found at the HD CAGnome now provides convenient routes for discovery of candidates influenced by the HD mutation.
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Affiliation(s)
- Ekaterina I. Galkina
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Aram Shin
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Kathryn R. Coser
- Massachusetts General Hospital Cancer Center, Charlestown, Massachusetts, United States of America
| | - Toshi Shioda
- Massachusetts General Hospital Cancer Center, Charlestown, Massachusetts, United States of America
| | - Isaac S. Kohane
- Children’s Hospital Informatics program, Children’s Hospital, Boston, Massachusetts, United States of America
- Center for Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
- i2b2 National center for Biomedical Computing, Boston, Massachusetts, United States of America
| | - Ihn Sik Seong
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Vanessa C. Wheeler
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - James F. Gusella
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Marcy E. MacDonald
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Jong-Min Lee
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- * E-mail:
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Shin A, Camilleri M, Kolar G, Erwin P, West CP, Murad MH. Systematic review with meta-analysis: highly selective 5-HT4 agonists (prucalopride, velusetrag or naronapride) in chronic constipation. Aliment Pharmacol Ther 2014; 39:239-53. [PMID: 24308797 DOI: 10.1111/apt.12571] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 09/29/2013] [Accepted: 11/11/2013] [Indexed: 12/16/2022]
Abstract
BACKGROUND Highly selective 5-HT4 agonists have been suggested for the treatment of chronic constipation (CC). AIM To assess the effects of highly selective 5-HT4 agonists (prucalopride, velusetrag or naronapride) on patient-important clinical efficacy outcomes and safety in adults with CC. METHODS We searched the medical literature in January 2013 using MEDLINE/Pubmed, Embase, Cochrane Library, and Web of Science/Scopus for randomised, controlled trials of highly selective 5-HT4 agonists in adults with CC, with no minimum duration of therapy (maximum 12 weeks) or date limitations. Data were extracted from intention-to-treat analyses, pooled using a random-effects model, and reported as relative risk (RR), mean differences, or standardised mean differences with 95% confidence intervals (CI). RESULTS Main outcomes included stool frequency, Patient-Assessment of Constipation Quality of Life (PAC-QOL), PAC of symptoms (PAC-SYM) and adverse events. Thirteen eligible trials were identified: 11 prucalopride, 1 velusetrag, 1 naronapride. Relative to control, treatment with highly selective 5-HT4 agonists was superior for all outcomes: mean ≥3 spontaneous complete bowel movements (SCBM)/week (RR = 1.85; 95% CI 1.23-2.79); mean ≥1 SCBM over baseline (RR = 1.57; 95% CI 1.19, 2.06); ≥1 point improvement in PAC-QOL and PAC-SYM scores. The only active comparator trial of prucalopride and PEG3350 suggested PEG3350 is more efficacious for some end points. Adverse events were more common with highly selective 5-HT4 agonists, but were generally minor; headache was the most frequent. Most trials studied prucalopride. CONCLUSION Demonstration of efficacy on patient-important outcomes and a favourable safety profile support the continued use and development of highly selective 5-HT4 agonists in the treatment of chronic constipation.
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Affiliation(s)
- A Shin
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), College of Medicine, Mayo Clinic, Rochester, MN, USA
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Lee SY, Lim TG, Chen H, Jung SK, Lee HJ, Lee MH, Kim DJ, Shin A, Lee KW, Bode AM, Surh YJ, Dong Z. Esculetin suppresses proliferation of human colon cancer cells by directly targeting β-catenin. Cancer Prev Res (Phila) 2013; 6:1356-64. [PMID: 24104353 DOI: 10.1158/1940-6207.capr-13-0241] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The Wnt pathway is a promising therapeutic and preventive target in various human cancers. The transcriptional complex of β-catenin-T-cell factor (Tcf), a key mediator of canonical Wnt signaling, has been implicated in human colon cancer development. Current treatment of colon cancer depends on traditional cytotoxic agents with limited effects. Therefore, the identification of natural compounds that can disrupt the β-catenin-TcF complex to suppress cancer cell growth with fewer adverse side effects is needed. To identify compounds that inhibit the association between β-catenin and Tcf, we used computer docking to screen a natural compound library. Esculetin, also known as 6,7-dihydroxycoumarin, is a derivative of coumarin and was identified as a potential small-molecule inhibitor of the Wnt-β-catenin pathway. We then evaluated the effect of esculetin on the growth of various human colon cancer cell lines and its effect on Wnt-β-catenin signaling in cells and in an embryonic model. Esculetin disrupted the formation of the β-catenin-Tcf complex through direct binding with the Lys312, Gly307, Lys345, and Asn387 residues of β-catenin in colon cancer cells. In addition, esculetin effectively decreased viability and inhibited anchorage-independent growth of colon cancer cells. Esculetin potently antagonized the cellular effects of β-catenin-dependent activity, and in vivo treatment with esculetin suppressed tumor growth in a colon cancer xenograft mouse model. Our data indicate that the interaction between esculetin and β-catenin inhibits the formation of the β-catenin-Tcf complex, which could contribute to esculetin's positive therapeutic and preventive effects against colon carcinogenesis.
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Affiliation(s)
- Sung-Young Lee
- The Hormel Institute, University of Minnesota, 801 16th Ave NE, Austin, MN 55912.
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Kim SY, S Hong Y, K Shim E, Kong SY, Shin A, Baek JY, Jung KH. S-1 plus irinotecan and oxaliplatin for the first-line treatment of patients with metastatic colorectal cancer: a prospective phase II study and pharmacogenetic analysis. Br J Cancer 2013; 109:1420-7. [PMID: 23963147 PMCID: PMC3776990 DOI: 10.1038/bjc.2013.479] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 07/09/2013] [Accepted: 07/29/2013] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND S-1 is an oral fluoropyrimidine that mimics infusional 5-fluorouracil. The aim of this phase II trial was to explore the clinical efficacy of the triplet regimen TIROX, which consists of S-1, irinotecan and oxaliplatin. METHODS Forty-two chemo-naive patients with metastatic colorectal cancer (mCRC) were planned to be enrolled and be treated with irinotecan 150 mg m(-2) followed by oxaliplatin 85 mg m(-2) on day 1 and S-1 80 mg m(-2) per day from day 1 to 14 every 3 weeks. Polymorphisms in the UGT1A1, UGT1A6, UGT1A7 and CYP2A6 genes were analysed. RESULTS Between July 2007 and February 2008, 43 patients were enrolled. An objective response was noted in 29 patients (67.4%, 95% confidence interval: 53.4-81.4), of which 2 achieved durable complete responses. The median progression-free survival was 10.0 months and the median overall survival was 19.2 months. Significant grade 3 or 4 adverse events were neutropenia (45.2%), febrile neutropenia (9.5%), diarrhoea (7.1%) and vomiting (9.5%). Increased gastrointestinal toxicities were associated with the presence of UGT1A6*2 or UGT1A7*3 and an improved tumour response was noted in those without variant alleles of CYP2A6 or UGT1A1*60. CONCLUSION The combination of S-1, irinotecan and oxaliplatin showed favourable efficacy and tolerability in untreated patients with mCRC.
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Affiliation(s)
- S Y Kim
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 410-769, Korea
| | - Y S Hong
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Seoul 138-736, Korea
| | - E K Shim
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 410-769, Korea
| | - S-Y Kong
- Department of Laboratory Medicine, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 410-769, Korea
| | - A Shin
- Molecular Epidemiology Branch, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 410-769, Korea
| | - J Y Baek
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 410-769, Korea
| | - K H Jung
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Seoul 138-736, Korea
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Vijayvargiya P, Camilleri M, Shin A, Breen M, Burton D. Simplifying the measurement of gastric accommodation using SPECT. Neurogastroenterol Motil 2013; 25:542-6. [PMID: 23413813 PMCID: PMC3656126 DOI: 10.1111/nmo.12099] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Accepted: 01/07/2013] [Indexed: 01/04/2023]
Abstract
BACKGROUND Non-invasive single photon emission computed tomography (SPECT) has been validated as a test for postprandial gastric volume accommodation, with volumes measured twice over 30 min and averaged. The purpose of this study is to simplify the SPECT measurement of gastric accommodation. METHODS The primary aim of this study was to compare two postprandial gastric volume measurements with data collected retrospectively from 443 patients and healthy volunteers who had undergone SPECT in the last decade. The differences in the two gastric volumes were compared in the entire group and each subgroup, and the correlation between the two measurements and their differences across a wide range of gastric volumes were plotted. KEY RESULTS There was a median difference of <2% (P = 0.041) between postprandial scan 1 (757 mL) and scan 2 (743 mL), with significant correlation (rs = 0.859, P < 0.01) and excellent agreement (SD 60 mL) between the two scans across the entire range of observed postprandial gastric volumes. CONCLUSIONS & INFERENCES A single postprandial scan can detect gastric accommodation with the same accuracy as averaging two postprandial scans. These data support simplifying SPECT measurement of postprandial gastric volume with a scan in the first 15 min after a meal.
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Affiliation(s)
- P Vijayvargiya
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Mayo Clinic, Rochester, MN 55905,, USA
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Shin A, Camilleri M, Nadeau A, Nullens S, Rhee JC, Jeong ID, Burton DD. Interpretation of overall colonic transit in defecation disorders in males and females. Neurogastroenterol Motil 2013; 25:502-8. [PMID: 23406422 PMCID: PMC3656138 DOI: 10.1111/nmo.12095] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Accepted: 01/11/2013] [Indexed: 01/05/2023]
Abstract
BACKGROUND There is little information regarding gender-specific measurements of colonic transit and anorectal function in patients with defecation disorders (DD). To compare overall colonic transit by gender in DD. METHODS In 407 patients with constipation due to DD diagnosed by a single gastroenterologist (1994-2012), DD was characterized by anorectal manometry, balloon expulsion test, and colonic transit by scintigraphy. The primary endpoint was overall colonic transit (geometric center, GC) at 24 h (GC24). Effects of gender in DD on colonic transit, and comparison with transit in 208 healthy controls were assessed by Mann-Whitney rank sum test. Secondary endpoints were maximum anal resting (ARP) and squeeze (ASP) pressures. We also tested association of the physiological endpoints among DD females by pregnancy history and among DD patients by colectomy history. KEY RESULTS The DD patients were 67 males (M) and 340 females (F). Significant differences by gender in DD patients were observed in GC24 (median: M: 2.2; F: 1.8; P = 0.01), ARP (median: M: 87.8 mmHg; F: 82.4 mmHg; P = 0.04), and ASP (median: M: 182.4 mmHg; F: 128.7 mmHg; P < 0.001). GC24 was slower in DD compared with same-gender healthy controls. GC24 did not differ among DD females by pregnancy history. Anorectal functions and upper GI transit did not differ among DD patients by colectomy history. CONCLUSIONS & INFERENCES Patients with DD have slower colonic transit compared with gender-matched controls. Among DD patients, males have higher ARP and ASP, and females have slower colonic transit. Although the clinical significance of these differences may be unclear, findings suggest that interpretation of these tests in suspected DD should be based on same-gender control data.
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Affiliation(s)
- A. Shin
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER); Mayo Clinic; Rochester; MN; USA
| | - M. Camilleri
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER); Mayo Clinic; Rochester; MN; USA
| | - A. Nadeau
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER); Mayo Clinic; Rochester; MN; USA
| | - S. Nullens
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER); Mayo Clinic; Rochester; MN; USA
| | - J. C. Rhee
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER); Mayo Clinic; Rochester; MN; USA
| | - I. D. Jeong
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER); Mayo Clinic; Rochester; MN; USA
| | - D. D. Burton
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER); Mayo Clinic; Rochester; MN; USA
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Camilleri M, Iturrino J, Bharucha AE, Burton D, Shin A, Jeong ID, Zinsmeister AR. Performance characteristics of scintigraphic measurement of gastric emptying of solids in healthy participants. Neurogastroenterol Motil 2012; 24:1076-e562. [PMID: 22747676 PMCID: PMC3465511 DOI: 10.1111/j.1365-2982.2012.01972.x] [Citation(s) in RCA: 115] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Gastric emptying (GE) is measured in pharmacodynamic and diagnostic studies. Our aim was to assess inter- and intra-subject coefficients of variation (COV) of scintigraphic GE measurements in healthy subjects, and associations of GE with gender and body mass index (BMI). METHODS Data from participants with scintigraphic measurements of gastric emptying of solids were analyzed. Primary endpoints were gastric emptying T(1/2) (GE T(1/2) ) and GE at 1, 2, 3, and 4 h. KEY RESULTS The patient cohort consisted of 105 males and 214 females; at least two studies were performed in 47 subjects [16 males (M), 32 females (F)]. Inter-subject COV (COV(inter) ) for GE T(1/2) were similar in M and F: overall 24.5% (M 26.0%, F 22.5%); COV are predictably lowest for GE at 4 h (COV(inter) 9.6%). COV(intra) for T(1/2) and GE at 4 h were overall 23.8% and 12.6%, and were similar to COV(inter) values. Gender (but not age or BMI) was significantly associated with GE T1/2 [P < 0.001, F 127.6 ± 28.7 (SD) min; M 109.9 ± 28.6 min] and with GE at 1 h and 2 h. Repeat GE T(1/2) values in 47 participants were significantly correlated (r = 0.459, P < 0.001) with median difference of -6 min (mean -1.6, range -56 to 72 min). Bland-Altman plots showed Δ GE T(1/2) similarly distributed across mean GE T(1/2) 100-155 min, and across studies conducted 90-600 days apart. CONCLUSIONS & INFERENCES Inter-subject variations in scintigraphic GE results are only slightly higher than the intra-subject measurements, which are also reproducible over time in healthy volunteers. Gender, but not BMI, is significantly associated with GE results.
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Affiliation(s)
- M Camilleri
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), College of Medicine, Mayo Clinic, Rochester, MN 55905, USA.
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Kou Y, Koag MC, Cheun Y, Shin A, Lee S. Application of hypoiodite-mediated aminyl radical cyclization to synthesis of solasodine acetate. Steroids 2012; 77:1069-74. [PMID: 22583912 DOI: 10.1016/j.steroids.2012.05.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Revised: 04/23/2012] [Accepted: 05/01/2012] [Indexed: 12/18/2022]
Abstract
Solasodine acetate, an anticancer steroidal alkaloid, was synthesized from diosgenin in 8 steps with an overall yield of 23%. A key synthetic step involves the formation of 5/6-oxazaspiroketal moiety via hypoiodite-mediated aminyl radical cyclization of a steroidal primary amine.
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Affiliation(s)
- Yi Kou
- The Division of Medicinal Chemistry, College of Pharmacy, University of Texas at Austin, Austin, TX 78712, United States
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Jeong ID, Camilleri M, Shin A, Iturrino J, Boldingh A, Busciglio I, Burton D, Ryks M, Rhoten D, Zinsmeister AR. A randomised, placebo-controlled trial comparing the effects of tapentadol and oxycodone on gastrointestinal and colonic transit in healthy humans. Aliment Pharmacol Ther 2012; 35:1088-96. [PMID: 22348605 DOI: 10.1111/j.1365-2036.2012.05040.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Revised: 01/11/2012] [Accepted: 01/31/2012] [Indexed: 12/23/2022]
Abstract
BACKGROUND Tapentadol is a mu-opioid receptor agonist and norepinephrine reuptake inhibitor. In clinical trials, tapentadol provided somatic pain relief comparable to mu-opioids such as oxycodone, with significantly less gastrointestinal adverse effects. The acute effects of tapentadol on gastrointestinal and colonic transit are unclear. AIM To compare acute effects of oral tapentadol and oxycodone on gastric, small bowel and colonic transit of solids in 38 healthy human subjects. METHODS In a randomised, parallel-group, double-blind, placebo-controlled study of the effects of identical-appearing tapentadol immediate release (IR), 75 mg t.d.s., or oxycodone IR, 5 mg t.d.s., for 48 h, we measured gastric (GE), small bowel (SBT measured as colonic filling at 6 h) and colonic transit by validated scintigraphy. Drug was commenced on the evening before the start of the transit test. The primary endpoints were overall colonic transit (geometric centre, GC) at 24 h and GE half-time (t1/2 ). ancova of transit data included gender or BMI as covariates. Adverse effects were summarised. RESULTS At the doses tested, oxycodone and tapentadol significantly delayed GE t1/2 and SBT, but not overall colonic transit, compared to placebo. Transit profiles in all regions were not significantly different between oxycodone and tapentadol at the doses tested. Both oxycodone and tapentadol were associated with nausea and central effects attributable to central opiate effects. CONCLUSIONS Tapentadol significantly delayed gastric emptying t1/2 and small bowel transit, similar to oxycodone. These data suggest that acute administration of tapentadol may not have significant advantages over standard mu-opioids, in terms of the potential to avoid upper gastrointestinal motor dysfunction.
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Affiliation(s)
- I D Jeong
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Mayo Clinic, Rochester, MN, USA
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Boffetta P, Hazelton WD, Chen Y, Sinha R, Inoue M, Gao YT, Koh WP, Shu XO, Grant EJ, Tsuji I, Nishino Y, You SL, Yoo KY, Yuan JM, Kim J, Tsugane S, Yang G, Wang R, Xiang YB, Ozasa K, Nagai M, Kakizaki M, Chen CJ, Park SK, Shin A, Ahsan H, Qu CX, Lee JE, Thornquist M, Rolland B, Feng Z, Zheng W, Potter JD. Body mass, tobacco smoking, alcohol drinking and risk of cancer of the small intestine--a pooled analysis of over 500,000 subjects in the Asia Cohort Consortium. Ann Oncol 2011; 23:1894-8. [PMID: 22147734 DOI: 10.1093/annonc/mdr562] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The evidence for a role of tobacco smoking, alcohol drinking, and body mass index (BMI) in the etiology of small intestine cancer is based mainly on case-control studies from Europe and United States. SUBJECTS AND METHODS We harmonized the data across 12 cohort studies from mainland China, Japan, Korea, Singapore, and Taiwan, comprising over 500,000 subjects followed for an average of 10.6 years. We calculated hazard ratios (HRs) for BMI and (only among men) tobacco smoking and alcohol drinking. RESULTS A total of 134 incident cases were observed (49 adenocarcinoma, 11 carcinoid, 46 other histologic types, and 28 of unknown histology). There was a statistically non-significant trend toward increased HR in subjects with high BMI [HR for BMI>27.5 kg/m2, compared with 22.6-25.0, 1.50; 95% confidence interval (CI) 0.76-2.96]. No association was suggested for tobacco smoking; men drinking>400 g of ethanol per week had an HR of 1.57 (95% CI 0.66-3.70), compared with abstainers. CONCLUSIONS Our study supports the hypothesis that elevated BMI may be a risk factor for small intestine cancer. An etiologic role of alcohol drinking was suggested. Our results reinforce the existing evidence that the epidemiology of small intestine cancer resembles that of colorectal cancer.
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Affiliation(s)
- P Boffetta
- The Tisch Cancer Institute and Institute for Translational Epidemiology, Mount Sinai School of Medicine, New York, NY 10029, USA.
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Cho YA, Kim J, Cho ER, Shin A. Dietary patterns and the prevalence of metabolic syndrome in Korean women. Nutr Metab Cardiovasc Dis 2011; 21:893-900. [PMID: 20674302 DOI: 10.1016/j.numecd.2010.02.018] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Revised: 01/29/2010] [Accepted: 02/12/2010] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND AIMS The role of dietary patterns in metabolic syndrome has not been adequately investigated in Asian women. We aimed to identify dietary patterns and to evaluate the cross-sectional relationship between dietary patterns and the prevalence of metabolic syndrome in Korean women. METHODS AND RESULTS In a cross-sectional study of 4984 women aged 30-79 years, dietary patterns were derived from 16 food groups using factor analysis. Metabolic syndrome was defined based on the Adult Treatment Panel III of the National Cholesterol Education Program (ATPIII NCEP) criteria as having three or more risk factors using a modified obesity index. Logistic regression was used to estimate the association between dietary pattern and the prevalence of metabolic syndrome. Three dietary patterns (Western, healthy and traditional) were identified. Higher consumption of the healthy pattern was inversely associated with metabolic syndrome (OR [95% CI] for highest vs. lowest quartile: 0.58 [0.50-0.91]; P for trend = 0.012) and most components of metabolic syndrome. In a stratified analysis by menopausal status, the inverse association of the healthy dietary pattern and metabolic syndrome was statistically significant only among postmenopausal women (OR [95% CI] for highest vs. lowest quartile: 0.60 [0.40-0.86]; P for trend = 0.004). The Western and traditional patterns showed no association with metabolic syndrome, but were related to some individual risk factors for metabolic syndrome. CONCLUSIONS These results suggest that the healthy dietary pattern is associated with a reduced risk for metabolic syndrome in Korean women, particularly in postmenopausal women.
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Affiliation(s)
- Y A Cho
- Cancer Epidemiology Branch, Division of Cancer Epidemiology and Management, Research Institute, National Cancer Center, 111 Jungbalsanro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, South Korea.
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Shin A, Park S, Shin HR, Park EH, Park SK, Oh JK, Lim MK, Choi BY, Boniol M, Boffetta P. Population attributable fraction of infection-related cancers in Korea. Ann Oncol 2011; 22:1435-1442. [PMID: 20974652 DOI: 10.1093/annonc/mdq592] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- A Shin
- Cancer Epidemiology Branch, Division of Cancer Epidemiology and Management
| | - S Park
- Cancer Registration and Statistics Branch, Division of Cancer Registration and Surveillance, National Cancer Center, Goyang-si, Korea
| | - H R Shin
- Cancer Registration and Statistics Branch, Division of Cancer Registration and Surveillance, National Cancer Center, Goyang-si, Korea; Data Analysis and Interpretation Group, Biostatistics and Epidemiology Cluster, International Agency for Research on Cancer, Lyon, France.
| | - E-H Park
- Cancer Registration and Statistics Branch, Division of Cancer Registration and Surveillance, National Cancer Center, Goyang-si, Korea
| | - S K Park
- Department of Preventive Medicine; Cancer Research Institute; Institute of Health Policy and Management, Seoul National University College of Medicine, Seoul
| | - J-K Oh
- Cancer Risk Appraisal and Prevention Branch, National Cancer Information Center, National Cancer Center, Goyang-si
| | - M-K Lim
- Cancer Risk Appraisal and Prevention Branch, National Cancer Information Center, National Cancer Center, Goyang-si
| | - B Y Choi
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - M Boniol
- Data Analysis and Interpretation Group, Biostatistics and Epidemiology Cluster, International Agency for Research on Cancer, Lyon, France
| | - P Boffetta
- Data Analysis and Interpretation Group, Biostatistics and Epidemiology Cluster, International Agency for Research on Cancer, Lyon, France
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Yun EH, Lim MK, Oh JK, Park JH, Shin A, Sung J, Park EC. Combined effect of socioeconomic status, viral hepatitis, and lifestyles on hepatocelluar carcinoma risk in Korea. Br J Cancer 2010; 103:741-6. [PMID: 20648009 PMCID: PMC2938251 DOI: 10.1038/sj.bjc.6605803] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background: The independent and combined effects of socioeconomic status (SES), viral hepatitis, and other lifestyle factors on hepatocellular carcinoma (HCC) risk have not been investigated among Koreans. Methods: From the National Cancer Center Hospital, 207 HCC cases and 828 age- and gender-matched controls aged 30 years or older were recruited. Socio-demographic and behavioural risk factors were ascertained through personal interview, and infection with hepatitis B and C viruses was determined by their serologic markers. Multivariate logistic regression and synergy index methods were applied for statistical analysis. Results: HB surface antigen (HbsAg) and anti-HCV-positive rates were 149.3 and 185.1 times higher in cases than controls, respectively. Lifetime alcohol consumption (odds ratio: 2.96, 95% CI: 1.29–6.79), cigarette smoking (OR: 3.53, 95% CI: 1.31–9.52), and family income (OR: 17.07, 95% CI: 4.27–68.25) were independently associated with the risk of HCC in subjects with or without viral hepatitis. Synergistic interaction on HCC risk was observed between low income and HBsAg positivity (SI: 3.12, 95% CI: 1.51–6.47) and between low income and heavy alcohol intake (SI: 2.93, 95% CI: 1.24–6.89). Conclusion: The inverse association with SES suggests SES as an independent and synergistic predictor of HCC. Heavy alcohol intake also showed a combined effect with low SES on HCC risk.
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Affiliation(s)
- E H Yun
- Branch of Cancer Risk Appraisal & Prevention, National Cancer Information Center, National Cancer Control Institute, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyangsi, Gyeonggi-do 410-769, Republic of Korea
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Cho YA, Kim J, Park KS, Lim SY, Shin A, Sung MK, Ro J. Effect of dietary soy intake on breast cancer risk according to menopause and hormone receptor status. Eur J Clin Nutr 2010; 64:924-32. [PMID: 20571498 DOI: 10.1038/ejcn.2010.95] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Although high soy consumption may be associated with lower breast cancer risk in Asian populations, findings from epidemiological studies have been inconsistent. OBJECTIVE We investigated the effects of soy intake on breast cancer risk among Korean women according to their menopausal and hormone receptor status. METHODS We conducted a case-control study with 358 incident breast cancer patients and 360 age-matched controls with no history of malignant neoplasm. Dietary consumption of soy products was examined using a 103-item food frequency questionnaire. RESULTS The estimated mean intakes of total soy and isoflavones from this study population were 76.5 g per day and 15.0 mg per day, respectively. Using a multivariate logistic regression model, we found a significant inverse association between soy intake and breast cancer risk, with a dose-response relationship (odds ratios (OR) (95% confidence interval (CI)) for the highest vs the lowest intake quartile: 0.36 (0.20-0.64)). When the data were stratified by menopausal status, the protective effect was observed only among postmenopausal women (OR (95% CI) for the highest vs the lowest intake quartile: 0.08 (0.03-0.22)). The association between soy and breast cancer risk did not differ according to estrogen receptor (ER)/progesterone receptor (PR) status, but the estimated intake of soy isoflavones showed an inverse association only among postmenopausal women with ER+/PR+ tumors. CONCLUSIONS Our findings suggest that high consumption of soy might be related to lower risk of breast cancer and that the effect of soy intake could vary depending on several factors.
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Affiliation(s)
- Y A Cho
- Cancer Epidemiology Branch, Division of Cancer Epidemiology and Management, Research Institute, National Cancer Center, Gyeonggi-do, South Korea
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Abstract
SUMMARY Postmenopausal women were assessed to determine the association between dietary intake of various food groups and low bone mineral density. Among dietary factors, high consumption of protein-containing food and dairy products was associated with a reduced risk for low bone mineral density. INTRODUCTION There have been several studies regarding the correlation between bone mineral density and dietary intake. In this study, we assessed the association between dietary habit and low bone mineral density among Korean postmenopausal women. METHODS Bone mineral density of the lumbar spine was measured by dual energy X-ray absorptiometry in 2,501 subjects. A brief food frequency questionnaire, which included 16 food items, was used in this cross-sectional survey. RESULTS After adjusting for other risk factors related to low bone mineral density, a high intake frequency of protein-source food was associated with a lower risk for osteopenia (odds ratio (OR), 0.68; 95% confidence interval (CI), 0.54-0.87 for high vs. low intake frequency; p for trend, 0.02) and osteoporosis (OR, 0.76; 95% CI, 0.39-0.83 for high vs. low intake frequency; p for trend, 0.003), and a high intake frequency of dairy food was associated with a decreased risk for osteopenia (OR, 0.73; 95% CI, 0.57-0.94 for high vs. low intake frequency; p for trend, 0.018). CONCLUSION These results suggest that adequate nutrient intake is essential to maintain bone health in postmenopausal women.
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Affiliation(s)
- A Shin
- Cancer Epidemiology Branch, Division of Cancer Epidemiology and Management, Research Institute, National Cancer Center, 111 Jungbalsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Korea
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Neeson P, Shin A, Tainton KM, Guru P, Prince HM, Harrison SJ, Peinert S, Smyth MJ, Trapani JA, Kershaw MH, Darcy PK, Ritchie DS. Ex vivo culture of chimeric antigen receptor T cells generates functional CD8+ T cells with effector and central memory-like phenotype. Gene Ther 2010; 17:1105-16. [PMID: 20428216 DOI: 10.1038/gt.2010.59] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The anti-tumor efficacy of adoptively transferred T cells requires their in vivo persistence and memory polarization. It is unknown if human chimeric antigen receptor (CAR)-expressing T cells can also undergo memory polarization. We examined the functional status of CAR CD8(+) T cells, re-directed to Lewis Y antigen (LeY-T), throughout a period of ex vivo expansion. Immediately before culture CD8(+) T cells comprised a mixture of phenotypes including naive (CD45RA(+)/CCR7(+)/CD27(+)/CD28(+)/perforin-), central memory (CM, CD45RA(-)/CCR7(lo)/CD27(+)/CD28(+)/perforin(lo)), effector memory (EM, CD45RA(-)/CCR7(-)/CD27(+)/CD28(+)/perforin(mod)) and effector (Eff, CD45RA(+)/CCR7(-)/CD27(-)/CD28(-)/perforin(hi)) cells. After transduction and expansion culture of peripheral blood mononuclear cells from normal donors or multiple myeloma patients, CD8(+) LeY-T cells polarized to EM- and CM-like phenotype. CD8(+) LeY-T cells differed from starting CD8(+) CM and EM T cells in that CD27, but not CD28, was downregulated. In addition, CD8(+) LeY-T cells expressed high levels of perforin, similar to starting CD8(+) Eff. CD8(+) LeY-T cells also showed hallmarks of both memory and Eff function, underwent homeostatic proliferation in response to interleukin (IL)-15, and showed interferon (IFN)-γ production and cytotoxicity in response to Le-Y antigen on OVCAR-3 (human ovarian adenocarcinoma) cells. This study confirms CD8(+) LeY-T cells have a CM- and EM-like phenotype and heterogeneous function consistent with potential to persist in vivo after adoptive transfer.
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Affiliation(s)
- P Neeson
- Hematology and Immunology Translational Research Lab, Peter MacCallum Cancer Center, Melbourne, Australia.
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Schnurr M, Orban M, Robson NC, Shin A, Braley H, Airey D, Cebon J, Maraskovsky E, Endres S. ISCOMATRIX adjuvant induces efficient cross-presentation of tumor Ag by dendritic cells via rapid cytosolic Ag delivery and processing via tripeptidyl peptidase II. J Immunol 2009. [DOI: 10.4049/jimmunol.0990022] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Gwack J, Shin A, Kim CS, Ko KP, Kim Y, Jun JK, Bae J, Park SK, Hong YC, Kang D, Chang SH, Shin HR, Yoo KY. CagA-producing Helicobacter pylori and increased risk of gastric cancer: a nested case-control study in Korea. Br J Cancer 2006; 95:639-41. [PMID: 16909137 PMCID: PMC2360680 DOI: 10.1038/sj.bjc.6603309] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
In a nested-case control study of 100 cases of gastric cancer and 400 matched controls in relation to virulence factors of Helicobacter pylori in a Korean cohort, CagA seropositivity was significantly associated with a higher risk of gastric cancer among H. pylori-infected subjects (OR=3.57, 95% CI 1.05–12.14).
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Affiliation(s)
- J Gwack
- Department of Preventive Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-799, Korea
| | - A Shin
- Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - C-S Kim
- Department of Preventive Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-799, Korea
| | - K-P Ko
- Department of Preventive Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-799, Korea
| | - Y Kim
- Department of Preventive Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-799, Korea
| | - J K Jun
- Department of Preventive Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-799, Korea
| | - J Bae
- Department of Preventive Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-799, Korea
| | - S K Park
- Department of Preventive Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-799, Korea
| | - Y-C Hong
- Department of Preventive Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-799, Korea
| | - D Kang
- Department of Preventive Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-799, Korea
| | - S-H Chang
- Department of Preventive Medicine, Konkuk University College of Medicine, 322 Danwol-dong, Chungju-si, Chungcheongbuk-do 380-701, Korea
| | - H-R Shin
- Research Institute for National Cancer Control and Evaluation, National Cancer Center, 809 Madu1-dong, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Korea
| | - K-Y Yoo
- Department of Preventive Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-799, Korea
- National Cancer Center, 809 Madu1-dong, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Korea
- Department of Preventive Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-799, Korea. E-mail:
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Choi JY, Shin A, Park SK, Chung HW, Cho SI, Shin CS, Kim H, Lee KM, Lee KH, Kang C, Cho DY, Kang D. Genetic polymorphisms of OPG, RANK, and ESR1 and bone mineral density in Korean postmenopausal women. Calcif Tissue Int 2005; 77:152-9. [PMID: 16151677 DOI: 10.1007/s00223-004-0264-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2005] [Accepted: 05/06/2005] [Indexed: 10/25/2022]
Abstract
To evaluate the effects of genetic polymorphisms of OPG, RANK, and ESR1, which regulate osteoclastogenesis, on bone mineral density (BMD), a cross-sectional study was conducted in 650 Korean postmenopausal women. BMDs of the distal radius and the calcaneus were measured by dual energy X-ray absorptiometry (DXA). Genetic polymorphisms of OPG 163 A > G, 1181 G > C; RANK 421 C > T, 575 T > C; and ESR1 1335 C > T, 2142 G > A were determined by matrix-assisted laser desorption/ionization-time of flight (MALDI-ToF) mass spectrometry. The differences between the BMDs of the genotypes of OPG, RANK, and ESR1 were analyzed by multiple linear regression model adjusted for age and body mass index. Women with the OPG 1181 CC genotype had higher BMDs at the distal radius (7%) and calcaneus (10%) than those with the GG genotype; and these differences were statistically significant (P = 0.001 and P = 0.007, respectively). A significant association was also observed between RANK 575 T > C and calcaneus BMD (P for trend = 0.017). No significant association was observed between BMDs and the polymorphisms of ESR1. The association between OPG 1181 G > C and BMD was profound in subjects with the RANK 575 TT or ESR1 2142 GG genotypes; women with OPG 1181 CC had higher BMDs at the distal radius (11%) and calcaneus (11%) than those with OPG 1181 GG only in women with RANK 575 TT genotype (P = 0.002 and P = 0.021, respectively). These results suggest that OPG genetic polymorphisms, especially with the RANK 575 TT or ESR1 2142 GG genotypes, are related to low BMD in postmenopausal Korean women.
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Affiliation(s)
- J Y Choi
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
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Shin A, Shin HR, Kang D, Park SK, Kim CS, Yoo KY. A nested case-control study of the association of Helicobacter pylori infection with gastric adenocarcinoma in Korea. Br J Cancer 2005; 92:1273-5. [PMID: 15756269 PMCID: PMC2361980 DOI: 10.1038/sj.bjc.6602467] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
In a nested case–control study of 86 cases of gastric adenocarcinoma in relation to Helicobactor pylori infection in the Korean Multi-center Cancer Cohort, the H. pylori IgG seropositivity was 83.7% and that of the 344 matched controls was 80.8%, with a matched odds ratio for H. pylori infection of 1.06 (95% CI, 0.80–1.40).
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Affiliation(s)
- A Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-799, Republic of Korea
| | - H R Shin
- Division of Cancer Control and Epidemiology, National Cancer Center Research Institute, 809 Madu1-dong, Ilsan-gu, Goyang-si, Gyeonggi-do 411-769, Republic of Korea
| | - D Kang
- Department of Preventive Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-799, Republic of Korea
| | - S K Park
- Department of Preventive Medicine, Konkuk University College of Medicine, 322 Danwol-Dong, Chungju, Chungcheongbuk-Do 380-701, Republic of Korea
| | - C-S Kim
- Department of Preventive Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-799, Republic of Korea
| | - K-Y Yoo
- Department of Preventive Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-799, Republic of Korea
- Department of Preventive Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-799, Republic of Korea. E-mail:
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Gorbach PM, Galea JT, Amani B, Shin A, Celum C, Kerndt P, Golden MR. Don't ask, don't tell: patterns of HIV disclosure among HIV positive men who have sex with men with recent STI practising high risk behaviour in Los Angeles and Seattle. Sex Transm Infect 2004; 80:512-7. [PMID: 15572626 PMCID: PMC1744943 DOI: 10.1136/sti.2004.010918] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES A high incidence of HIV continues among men who have sex with men (MSM) in industrialised nations and research indicates many MSM do not disclose their HIV status to sex partners. Themes as to why MSM attending sexually transmitted infection (STI) clinics in Los Angeles and Seattle do and do not disclose their HIV status are identified. METHODS 55 HIV positive MSM (24 in Seattle, 31 in Los Angeles) reporting recent STI or unprotected anal intercourse with a serostatus negative or unknown partner from STI clinics underwent in-depth interviews about their disclosure practices that were tape recorded, transcribed verbatim, coded, and content analysed. RESULTS HIV disclosure themes fell into a continuum from unlikely to likely. Themes for "unlikely to disclose" were HIV is "nobody's business," being in denial, having a low viral load, fear of rejection, "it's just sex," using drugs, and sex in public places. Themes for "possible disclosure" were type of sex practised and partners asking/disclosing first. Themes for "likely to disclose" were feelings for partner, feeling responsible for partner's health, and fearing arrest. Many reported non-verbal disclosure methods. Some thought partners should ask for HIV status; many assumed if not asked then their partner must be positive. CONCLUSIONS HIV positive MSM's decision to disclose their HIV status to sex partners is complex, and is influenced by a sense of responsibility to partners, acceptance of being HIV positive, the perceived transmission risk, and the context and meaning of sex. Efforts to promote disclosure will need to address these complex issues.
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Affiliation(s)
- P M Gorbach
- Department of Epidemiology, School of Public Health, Box 951772, University of California Los Angeles, Los Angeles, CA 900095-1772, USA.
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Lee KM, Abel J, Ko Y, Harth V, Park WY, Seo JS, Yoo KY, Choi JY, Shin A, Ahn SH, Noh DY, Hirvonen A, Kang D. Genetic polymorphisms of cytochrome P450 19 and 1B1, alcohol use, and breast cancer risk in Korean women. Br J Cancer 2003; 88:675-8. [PMID: 12618873 PMCID: PMC2376333 DOI: 10.1038/sj.bjc.6600761] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
A case-control study was performed to assess the potential influence of CYP19 Arg(264)Cys and CYP1B1 Leu(432)Val polymorphisms on breast cancer risk in a series of Korean breast cancer patients and controls. The results suggest that the CYP19 Arg(264)Cys polymorphism modifies breast cancer risk (OR=1.5, 95% CI=1.1-2.2), especially in association with alcohol consumption (P for interaction=0.04), whereas the CYP1B1 Leu(432)Val polymorphism appears to play no role here.
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Affiliation(s)
- K-M Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Cancer Research Institute, 28 Yongon-Dong Chongno-Gu, Seoul 110-799, Korea
| | - J Abel
- Department of Experimental Toxicology, Research Institute of Environmental Health, Heinrich-Heine-University, Auf'm Hennekamp 50, 40225 Düsseldorf, Germany
| | - Y Ko
- Department of Internal Medicine, University of Bonn, Wilhelmstreet 35-37, 53111 Bonn, Germany
| | - V Harth
- Department of Internal Medicine, University of Bonn, Wilhelmstreet 35-37, 53111 Bonn, Germany
| | - W-Y Park
- Department of Biochemistry, Seoul National University College of Medicine, 28 Yongon-Dong Chongno-Gu, Seoul 110-799, Korea
| | - J-S Seo
- Department of Biochemistry, Seoul National University College of Medicine, 28 Yongon-Dong Chongno-Gu, Seoul 110-799, Korea
| | - K-Y Yoo
- Department of Preventive Medicine, Seoul National University College of Medicine, Cancer Research Institute, 28 Yongon-Dong Chongno-Gu, Seoul 110-799, Korea
| | - J-Y Choi
- Department of Preventive Medicine, Seoul National University College of Medicine, Cancer Research Institute, 28 Yongon-Dong Chongno-Gu, Seoul 110-799, Korea
| | - A Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, Cancer Research Institute, 28 Yongon-Dong Chongno-Gu, Seoul 110-799, Korea
| | - S-H Ahn
- Department of Surgery, Ulsan University College of Medicine, 388-1 Pungnab-Dong Songpa-Gu, Seoul, Korea
| | - D-Y Noh
- Department of Surgery, Seoul National University College of Medicine, 28 Yongon-Dong Chongno-Gu, Seoul 110-799, Korea
| | - A Hirvonen
- Finnish Institute of Occupational Health, FIN-00250 Helsinki, Finland
| | - D Kang
- Department of Preventive Medicine, Seoul National University College of Medicine, Cancer Research Institute, 28 Yongon-Dong Chongno-Gu, Seoul 110-799, Korea
- Department of Preventive Medicine, Seoul National University College of Medicine, Cancer Research Institute, 28 Yongon-Dong Chongno-Gu, Seoul 110-799, Korea. E-mail:
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Chartock LR, Shin A. Psychiatrists' hours by work setting. Psychiatr Serv 1996; 47:133. [PMID: 8825246 DOI: 10.1176/ps.47.2.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- L R Chartock
- Psychiatry, Cambridge Hospital, Harvard Medical School, Massachusetts 02139, USA
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Rosenbloom AJ, Pinsky MR, Bryant JL, Shin A, Tran T, Whiteside T. Leukocyte activation in the peripheral blood of patients with cirrhosis of the liver and SIRS. Correlation with serum interleukin-6 levels and organ dysfunction. JAMA 1995. [PMID: 7540697 DOI: 10.1001/jama.1995.03530010072037] [Citation(s) in RCA: 88] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Leukocyte adhesion plays an important role in inflammation. Adhesion molecules such as CD11b on polymorphonuclear neutrophil leukocytes (PMNs) up-regulate in response to tumor necrosis factor-alpha, interleukin-8 (IL-8), and other mediators that are involved in systemic inflammatory response syndrome (SIRS). This study examined the behavior of CD11b and other membrane molecules in SIRS in relation to serum cytokines and the severity of illness. DESIGN Survey study. SETTING Liver transplantation intensive care unit at a tertiary care center. PATIENTS A consecutive sample of 22 patients admitted to the liver transplantation intensive care unit for complications related to cirrhosis of the liver in the absence of other disease. Sixteen of the patients developed SIRS and multiple organ dysfunction syndrome with suspected bacterial infections. Seven control subjects were also studied. MAIN OUTCOME MEASURES Modified Goris organ failure score and Acute Physiology and Chronic Health Evaluation II score. RESULTS Mean serum IL-6 levels, but not IL-1 beta or tumor necrosis factor-alpha levels, correlated with organ failure (r = 0.79, P < .001). Leukocyte cell-surface markers fluctuated from day to day. The mean of several values was more stable. Mean CD11b and CD35 on PMNs correlated with serum IL-6 level (r = 0.75, P < .001, and r = 0.77, P < .005, respectively). Up-regulation of both CD11b and CD35 display on PMNs correlated with organ failure (r = 0.74, P < .001, and r = 0.71, P < .01, respectively). Polymorphonuclear neutrophil leukocyte L-selectin, CD31, and CD16 were simultaneously decreased, consistent with PMN activation. Monocytes appeared to be activated, but the pattern of surface molecule display was different. CONCLUSIONS In human SIRS, the circulating monocyte and PMN pools undergo alterations suggestive of leukocyte activation, including up-regulation of PMN CD11b in correlation with the serum IL-6 level and severity of organ dysfunction.
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Affiliation(s)
- A J Rosenbloom
- Department of Anesthesiology, University of Pittsburgh Medical Center, PA 15213, USA
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Abstract
We have examined regulation of the E2F transcription factor during differentiation of muscle cells. E2F regulates many genes involved in growth control and is also the target of regulation by diverse cellular signals, including the RB family of growth suppressors (e.g., the retinoblastoma protein [RB], p107, and p130). The following aspects of E2F function and regulation during muscle differentiation were investigated: (i) protein-protein interactions, (ii) protein levels, (iii) phosphorylation of the E2F protein, and (iv) transcriptional activity. A distinct E2F complex was present in differentiated cells but not in undifferentiated cells. The p130 protein was a prominent component of the E2F complex associated with differentiation. In contrast, in undifferentiated cells, the p107 protein was the prominent component in one of three E2F complexes. In addition, use of a differentiation-defective muscle line provided genetic and biochemical evidence that quiescence and differentiation are separable events. Exclusive formation of the E2F-p130 complex did not occur in this differentiation-defective line; however, E2F complexes diagnostic of quiescence were readily apparent. Thus, sole formation of the E2F-p130 complex is a necessary event in terminal differentiation. Other changes in E2F function and regulation upon differentiation include decreased phosphorylation and increased repression by E2F. These observations suggest that the regulation of E2F function during terminal differentiation may proceed through differential interaction within the RB family and/or phosphorylation.
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Affiliation(s)
- E K Shin
- Department of Biochemistry, Tufts University School of Medicine, Boston, Massachusetts 02111
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Oczkowski WJ, Ginsberg JS, Shin A, Panju A. Venous thromboembolism in patients undergoing rehabilitation for stroke. Arch Phys Med Rehabil 1992; 73:712-6. [PMID: 1642519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To determine the incidence of venous thromboembolism during rehabilitation for stroke and to identify factors that alter its risk. DESIGN Cohort. SETTING Tertiary care stroke rehabilitation program. PATIENTS 102 consecutive patients undergoing rehabilitation for stroke. INTERVENTIONS Impedance plethysmography (IPG) as routine screening and in patients with symptoms of deep venous thrombosis (DVT). MAIN OUTCOME MEASURES DVT, pulmonary embolism (PE), death from PE. RESULTS Venous thromboembolism was documented in 11 patients (11%) an average of 60 days after stroke onset (range 14-138 days); 2 patients (2%) died from PE. DVT was found on routine IPG screening in six patients and verified by IPG in two clinically symptomatic patients. The odds of developing venous thromboembolism was 17.6 (95% confidence interval: 2.2-143.5) in patients who were bedridden or wheelchair-bound at the time of admission. CONCLUSIONS The incidence of venous thromboembolism is high and greatest in bedridden or wheelchair-bound patients undergoing stroke rehabilitation; randomized trials evaluating the safety and efficacy of screening and/or prophylaxis in such patients are required.
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Affiliation(s)
- W J Oczkowski
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
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49
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Ginsberg JS, Shin A, Turpie AG, Hirsh J. Detection of previous proximal venous thrombosis with Doppler ultrasonography and photoplethysmography. Arch Intern Med 1989; 149:2255-7. [PMID: 2679475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
To evaluate the reliability of two noninvasive tests, the photoplethysmograph (PPG) and venous Doppler ultrasound, in determining the presence or absence of previous proximal deep vein thrombosis (DVT), we performed a blinded retrospective cohort study of patients with objectively confirmed (DVT+) or refuted (DVT-) previous episodes of suspected DVT. Twenty-nine of 33 DVT+ patients had abnormal PPG and/or reflux by venous Doppler ultrasound, whereas 39 of 49 DVT- patients had normal PPG and no Doppler reflux (sensitivity, 88%; specificity, 80%). Of 33 DVT+ patients, 20 had abnormal Doppler results (sensitivity, 61%), in contrast to 46 of 49 DVT- patients with normal results (specificity, 94%). Moreover, 23 of 33 DVT+ patients showed abnormal PPG results (sensitivity, 70%), whereas 40 of 49 DVT- patients had normal PPG (specificity, 82%). Based on our findings, the presence of Doppler reflux is specific for previous proximal DVT, whereas a combination of normal PPG and Doppler ultrasound is reliable for excluding previous proximal DVT. Abnormal PPG with normal Doppler ultrasound does not reliably predict the presence or absence of previous DVT. However, this occurred in only 16 of 82 patients. Therefore, the combination of PPG and venous Doppler ultrasound can reliably predict the presence or absence of previous proximal DVT in most patients.
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Affiliation(s)
- J S Ginsberg
- Department of Medicine, McMaster University, Hamilton, Canada
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Matsushita K, Hagiya A, Shin A, Kawana N, Yoshii Y. [Introduction of primary nursing. A discussion]. Kango Tenbo 1988; 13:1313-20. [PMID: 3216701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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