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Won DS, Lee KB, Park JH, Zeng CH, Kim MH, Lee DH. Balloon neck-plasty to create a wide-necked aneurysm in the elastase-induced rabbit model. Neuroradiology 2024; 66:825-834. [PMID: 38438630 DOI: 10.1007/s00234-024-03326-x] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 02/24/2024] [Indexed: 03/06/2024]
Abstract
PURPOSE The elastase-induced aneurysm (EIA) model in rabbits has been proposed for translational research; however, the adjustment of aneurysm neck size remains challenging. In this study, the technical feasibility and safety of balloon neck-plasty to create a wide-necked aneurysm in rabbit EIA model were investigated. METHODS Male New Zealand White rabbits (N = 15) were randomly assigned to three groups: group A, EIA creation without neck-plasty; group B, neck-plasty immediately after EIA creation; group C, neck-plasty 4 weeks after EIA creation. The diameter of balloon used for neck-plasty was determined 1 mm larger than origin carotid artery diameter. All rabbits were euthanized 4 weeks after their final surgery. Aneurysm neck, height, dome-to-neck (D/N) ratio, and histologic parameters were compared among the groups. RESULTS Aneurysm creation was technically successful in 14 out of 15 rabbits (93.3%), with one rabbit experiencing mortality due to an adverse anesthetic event during the surgery. Saccular and wide-necked aneurysms were successfully created in all rabbits. Aneurysm neck was significantly greater in groups B and C compared to group A (all P < .05). D/N ratio was significantly lower in groups B and C compared to group A (all P < .05). Additionally, tunica media thickness, vessel area, and luminal area were significantly greater in groups B and C compared to group A (all P < .05). These variables were found to be significantly greater in group B compared to group C (all P < .05). CONCLUSION The creation of a wide-necked aneurysm using balloon neck-plasty after elastase induction in rabbits has been determined to be technically feasible and safe.
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Affiliation(s)
- Dong-Sung Won
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
- Department of Radiology, Asan Medical Center, Research Institute of Radiology, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea
| | - Ki Baek Lee
- Department of Radiologic Technology, Chungbuk Health and Science University, Cheongju, Republic of Korea
| | - Jung-Hoon Park
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | - Chu Hui Zeng
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
- Department of Radiology, Asan Medical Center, Research Institute of Radiology, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea
| | - Mi Hyeon Kim
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
- Department of Radiology, Asan Medical Center, Research Institute of Radiology, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea
| | - Deok Hee Lee
- Department of Radiology, Asan Medical Center, Research Institute of Radiology, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea.
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Bhuiyan MSA, Kim YK, Lee DH, Chung Y, Lee DJ, Kang JM, Lee SH. Evaluation of non-additive genetic effects on carcass and meat quality traits in Korean Hanwoo cattle using genomic models. Animal 2024; 18:101152. [PMID: 38701710 DOI: 10.1016/j.animal.2024.101152] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 03/26/2024] [Accepted: 03/29/2024] [Indexed: 05/05/2024] Open
Abstract
The traditional genetic evaluation methods generally consider additive genetic effects only and often ignore non-additive (dominance and epistasis) effects that may have contributed to genetic variation of complex traits of livestock species. The available dense single nucleotide polymorphisms (SNPs) panels offer to investigate the potential benefits of including non-additive genetic effects in the genomic evaluation models. Data from 16 971 genotyped (Illumina Bovine 50 K SNP chip) Korean Hanwoo cattle were used to estimate genetic variance components and prediction accuracy of genomic breeding values (GEBVs) for four carcass and meat quality traits: carcass weight (CWT), eye muscle area (EMA), back fat thickness (BFT) and marbling score (MS). Five different genetic models were evaluated through including additive, dominance and epistatic interactions (additive by additive, A × A; additive by dominance, A × D and dominance by dominance, D × D) successively in the models. The estimates of additive genetic variances and narrow sense heritabilities (ha2) were found similar across the evaluated models and traits except when additive interaction (A × A) was included. The dominance variance estimates relative to phenotypic variance ranged from 1.7-3.4% for CWT and MS traits, whereas, they were close to zero for EMA and BFT traits. The magnitude of A × A epistatic heritability (haa2) ranged between 14.8 and 27.7% in all traits. However, heritability estimates for A × D and D × D epistatic interactions (had2 and hdd2) were quite low compared to haa2 and were contributed only 0.0-9.7% of the total phenotypic variation. In general, broad sense heritability (hG2) estimates were almost twice (ranging between 0.54 and 0.68) the ha2 for all of the investigated traits. The inclusion of dominance effects did not improve the prediction accuracy of GEBV but improved 2.0-3.0% when epistatic effects were included in the model. More importantly, rank correlation revealed that partitioning of variance components considering dominance and epistatic effects in the model would enable to re-rank of top animals with better prediction of GEBV. The present result suggests that dominance and epistatic effects could be included in the genomic evaluation model for better estimates of variance components and more accurate prediction of GEBV for carcass and meat quality traits in Korean Hanwoo cattle.
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Affiliation(s)
- M S A Bhuiyan
- Division of Animal and Dairy Science, Chungnam National University, Daejeon 34134, Republic of Korea
| | - Y K Kim
- Division of Animal and Dairy Science, Chungnam National University, Daejeon 34134, Republic of Korea; Quantomic Research & Solution, Yuseong-gu, Daejeon 34134, Republic of Korea
| | - D H Lee
- Division of Animal and Dairy Science, Chungnam National University, Daejeon 34134, Republic of Korea; Quantomic Research & Solution, Yuseong-gu, Daejeon 34134, Republic of Korea
| | - Y Chung
- Division of Animal and Dairy Science, Chungnam National University, Daejeon 34134, Republic of Korea
| | - D J Lee
- Division of Animal and Dairy Science, Chungnam National University, Daejeon 34134, Republic of Korea
| | - J M Kang
- Division of Animal and Dairy Science, Chungnam National University, Daejeon 34134, Republic of Korea
| | - S H Lee
- Division of Animal and Dairy Science, Chungnam National University, Daejeon 34134, Republic of Korea.
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Yoon JT, Kwon B, Choi JH, Hwang SM, Kim M, Hwang S, Song Y, Lee DH. Author Correction: In Vitro Head-to-Head Comparison of Flow Reduction between Fibered and Non-Fibered Pushable Coils. Neurointervention 2024:neuroint.2024.00031.e1. [PMID: 38472153 DOI: 10.5469/neuroint.2024.00031.e1] [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] [Subscribe] [Scholar Register] [Received: 01/01/1970] [Accepted: 01/01/1970] [Indexed: 03/14/2024] Open
Affiliation(s)
- Jong-Tae Yoon
- Department of Radiology, AMIST, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Boseong Kwon
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon Ho Choi
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sun Moon Hwang
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Mihyeon Kim
- Department of Radiology, AMIST, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sungbin Hwang
- Department of Radiology, AMIST, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yunsun Song
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Deok Hee Lee
- Department of Radiology, AMIST, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Yoon JT, Kwon B, Choi JH, Hwang SM, Kim M, Hwang S, Song Y, Lee DH. In Vitro Head-to-Head Comparison of Flow Reduction between Fibered and Non-Fibered Pushable Coils. Neurointervention 2024; 19:31-38. [PMID: 38373422 PMCID: PMC10910180 DOI: 10.5469/neuroint.2024.00031] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 02/07/2024] [Accepted: 02/12/2024] [Indexed: 02/21/2024] Open
Abstract
PURPOSE To compare the embolization effects of a non-fibered pushable coil with a conventional fibered pushable coil in an in vitro bench-top experiment. MATERIALS AND METHODS A simplified vascular phantom with 4 channels (1 for the non-fibered coil, 1 for the fibered coil, and 2 for continuous circuit flow) was used. A single coil of the longest length was inserted to evaluate the effect of single-coil embolization, and 3 consecutive coils were inserted to assess the effect of multiple-coil embolization. Post-embolization angiography was performed to obtain flow variables (time to peak [TTP], relative peak intensity [rPI], and angiographic flow reduction score [AFRS]) from time density curves. The packing densities of the two coil types were calculated, and the AFRS of each channel was determined by dividing the TTP by the rPI. RESULTS When inserting a single coil, the conventional fibered coil demonstrated better flow reduction, as indicated by a higher AFRS (25.6 vs. 17.4, P=0.034). However, the non-fibered coil exhibited a significantly higher packing density (12.9 vs. 2.4, P=0.001). Similar trends were observed with multiple coils. CONCLUSION The conventional fibered pushable coil showed better flow reduction efficiency, while the non-fibered pushable coil had a higher packing density, likely due to the flexibility of the coil loops. A better understanding of the distinct characteristics of different pushable coils can enhance the outcomes of various vascular embolization.
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Affiliation(s)
- Jong-Tae Yoon
- Department of Radiology, AMIST, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Boseong Kwon
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon Ho Choi
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sun Moon Hwang
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Mihyeon Kim
- Department of Radiology, AMIST, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sungbin Hwang
- Department of Radiology, AMIST, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yunsun Song
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Deok Hee Lee
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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AlAli M, Kwon B, Song Y, Lee DH. Facilitated Retrograde Access via the Facial Vein for Transvenous Embolization of the Cavernous Sinus Dural Arteriovenous Fistula with Isolated Ophthalmic Venous Drainage. Neurointervention 2024; 19:39-44. [PMID: 38213194 PMCID: PMC10910183 DOI: 10.5469/neuroint.2023.00493] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/07/2024] [Accepted: 01/09/2024] [Indexed: 01/13/2024] Open
Abstract
Management of cavernous sinus dural arteriovenous fistula (CSDAVF) continues to present significant challenges, particularly when the inferior petrosal sinus is thrombosed, collapsed, or angiographically invisible. In this study, we introduce facilitated retrograde access via the facial vein, which is employed in the transvenous embolization of CSDAVF with isolated superior ophthalmic venous drainage. We also present illustrative cases and technical points.
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Affiliation(s)
- Meshari AlAli
- Department of Radiology, College of Medicine, Majmaah University, Al Majmaah, Saudi Arabia
| | - Boseong Kwon
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yunsun Song
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Deok Hee Lee
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Lee KB, Kim MH, Yoon JT, Song Y, Kwon B, Hwang SM, Choi JH, Lee DH. A simplified cranial cavity model to understand the relationship between intracranial pressure and dural sinus pressure. Interv Neuroradiol 2024; 30:57-63. [PMID: 35679068 PMCID: PMC10956465 DOI: 10.1177/15910199221107440] [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] [Received: 03/23/2022] [Accepted: 05/27/2022] [Indexed: 11/15/2022] Open
Abstract
Although accurate intracranial pressure (ICP) monitoring is essential for the diagnosis and treatment of severe brain diseases, current methods are performed invasively. Therefore, a safe and less invasive ICP measurement is required. The purpose of our study was to develop a simplified cranial cavity model for a better understanding of the relationship between the ICP and the pressure measurement within the dural venous sinus (DVS) to support the validity of using sinus pressure as the surrogate of the ICP. The in-house cranial cavity model had three components: the brain part, the DVS part, and the subarachnoid space (SAS) part. Pressure in other parts was measured when the pressure in the SAS part and, separately, brain part was increased from 0 (baseline) to 50 mmHg at intervals of 10 mmHg. When the pressure in the SAS part was increased from 10 to 50 mmHg at 10 mmHg interval, pressures of both the brain and DVS parts increased without significant difference (all P > 0.05). However, pressures in both the SAS and DVS parts differed while the pressure in the brain part was increased. The pressures in both parts showed about 70% of the increase in the brain part. Nevertheless, the pressures in the SAS and DVS parts were not significantly different (P > 0.05). A simplified in-house cranial cavity model was developed consisting of three compartments to represent the actual intracranial spaces. The pressure measurement within the DVS was feasible to use as a surrogate for the ICP measurement.
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Affiliation(s)
- KB Lee
- Department of Radiologic Technology, Chungbuk Health & Science University, Cheongju 28150, Republic of Korea
| | - MH Kim
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - J-T Yoon
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Y Song
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - B Kwon
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - SM Hwang
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - JH Choi
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - DH Lee
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
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Kang DW, Park SK, Yu YL, Lee Y, Lee DH, Kang S. Effectiveness of next-generation sequencing for patients with advanced non-small-cell lung cancer: a population-based registry study. ESMO Open 2024; 9:102200. [PMID: 38194884 PMCID: PMC10820286 DOI: 10.1016/j.esmoop.2023.102200] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 10/25/2023] [Accepted: 11/17/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Despite the growing use of next-generation sequencing (NGS) in the management of advanced non-small-cell lung cancer (NSCLC), there is little evidence that its use leads to improved clinical outcomes. This study aimed to compare the effectiveness of NGS with that of single-gene testing (SGT) alone in patients with advanced NSCLC. MATERIALS AND METHODS This was a retrospective cohort study conducted on patients diagnosed with advanced lung adenocarcinoma between 2017 and 2018 from a nationwide, population-based database. We identified patients who had SGT exclusively (SGT group) or underwent upfront NGS or NGS following SGT as an initial evaluation (NGS group). Patients were followed up until death or the end of the study (31 December 2019). The adjusted hazard ratio (aHR) for death was estimated using the Cox proportional hazards model. The factors affecting the adoption of NGS were identified. RESULTS Of 8566 patients diagnosed with advanced lung adenocarcinoma, 402 and 6932 patients were assigned to the NGS and SGT groups, respectively. More NGS was carried out in younger patients, those with higher incomes, and those living in urban areas. After balancing these confounders through matching, no difference was observed in the median overall survival and risk of death between the NGS and SGT groups [18.5 versus 19.7 months, log-rank P = 0.783; aHR 0.98, 95% confidence interval (CI) 0.84-1.14, respectively]. Only in a subgroup for whom epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) inhibitors were not indicated, NGS was associated with better survival outcomes (14.1 versus 9.0 months, log-rank P = 0.006; aHR 0.82, 95% CI 0.69-0.97). CONCLUSIONS In the real world, NGS for all-comers in patients with advanced NSCLC did not increase survival outcomes. When health care resources to support equal access to NGS are limited, upfront SGT followed by NGS may be a more efficient strategy.
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Affiliation(s)
- D-W Kang
- School of Pharmacy, Sungkyunkwan University, Suwon
| | - S-K Park
- College of Pharmacy, The Catholic University of Korea, Bucheon
| | - Y L Yu
- Center for Gynecologic Cancer, Research Institute and Hospital, National Cancer Center, Goyang
| | - Y Lee
- Department of Internal Medicine, National Cancer Center, Goyang
| | - D H Lee
- Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul
| | - S Kang
- Center for Gynecologic Cancer, Research Institute and Hospital, National Cancer Center, Goyang; Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea.
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Lee DH, Heo H, Suh CH, Shim WH, Kim E, Jo S, Chung SJ, Lee CS, Kim HS, Kim SJ. Improved diagnostic performance of susceptibility-weighted imaging with compressed sensing-sensitivity encoding and neuromelanin-sensitive MRI for Parkinson's disease and atypical Parkinsonism. Clin Radiol 2024; 79:e102-e111. [PMID: 37863747 DOI: 10.1016/j.crad.2023.09.019] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 08/08/2023] [Accepted: 09/18/2023] [Indexed: 10/22/2023]
Abstract
AIM To verify the diagnostic performance of the loss of nigrosome-1 on susceptibility-weighted imaging (SWI) with compressed sensing-sensitivity encoding (CS-SENSE) and neuromelanin on neuromelanin-sensitive (NM) magnetic resonance imaging (MRI) for the diagnosis of Parkinson's disease (PD) and atypical Parkinsonism. MATERIALS AND METHODS A total of 195 patients who underwent MRI between October 2019 and February 2020, including SWI, with or without CS-SENSE, and NM-MRI, were reviewed retrospectively. Two neuroradiologists assessed the loss of nigrosome-1 on SWI and neuromelanin on the NM-MRI. The result of N-3-fluoropropyl-2-beta-carbomethoxy-3-beta-(4-iodophenyl) nortropane positron-emission tomography (PET) was set as the reference standard. RESULTS When CS-SENSE was applied for nigrosome-1 imaging on SWI, the non-diagnostic scan rate was lowered significantly from 19.3% (17/88) to 5.6% (6/107; p=0.004). Diagnosis of PD and atypical Parkinsonism based on the loss of nigrosome-1 on SWI and based on NM-MRI showed good diagnostic value (area under the curve [AUC] 0.821, 95% confidence interval [CI] = 0.755-0.875: AUC 0.832, 95% CI = 0.771-0.882, respectively) with a substantial inter-reader agreement (κ = 0.791 and 0.681, respectively). Combined SWI and neuromelanin had a similar discriminatory ability (AUC 0.830, 95% CI = 0.770-0.880). Similarly, the diagnosis of PD was excellent. CONCLUSIONS CS-SENSE may add value to the diagnostic capability of nigrosome-1 on SWI to reduce the nondiagnostic scan rates. Furthermore, loss of nigrosome-1 on SWI or volume loss of neuromelanin on NM-MRI may be helpful for diagnosing PD.
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Affiliation(s)
- D H Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea; Department of Radiology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - H Heo
- Department of Convergence Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - C H Suh
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
| | - W H Shim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - E Kim
- Philips Healthcare Korea, Seoul, Republic of Korea
| | - S Jo
- Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - S J Chung
- Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - C S Lee
- Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - H S Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - S J Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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Ryu JC, Kwon B, Song Y, Lee DH, Chang JY, Kang DW, Kwon SU, Kim JS, Kim BJ. Effect of Intravenous Thrombolysis Prior to Mechanical Thrombectomy According to the Location of M1 Occlusion. J Stroke 2024; 26:75-86. [PMID: 38186184 PMCID: PMC10850451 DOI: 10.5853/jos.2023.01529] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 09/06/2023] [Accepted: 09/26/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND AND PURPOSE The additive effects of intravenous thrombolysis (IVT) before mechanical thrombectomy (MT) remain unclear. We aimed to investigate the efficacy and safety of IVT prior to MT depending on the location of M1 occlusion. METHODS We reviewed the cases of patients who underwent MT for emergent large-vessel occlusion of the M1 segment. Baseline characteristics as well as clinical and periprocedural variables were compared according to the location of M1 occlusion (i.e., proximal and distal M1 occlusion). The main outcome was the achievement of functional independence (modified Rankin Scale score, 0-2) at 3 months after stroke. The main outcomes were compared between the proximal and distal groups based on the use of IVT before MT. RESULTS Among 271 patients (proximal occlusion, 44.6%; distal occlusion, 55.4%), 33.9% (41/121) with proximal occlusion and 24.7% (37/150) with distal occlusion underwent IVT prior to MT. Largeartery atherosclerosis was more common in patients with proximal M1 occlusion; cardioembolism was more common in those with distal M1 occlusion. In patients with proximal M1 occlusion, there was no association between IVT before MT and functional independence. In contrast, there was a significant association between the use of IVT prior to MT (odds ratio=5.30, 95% confidence interval=1.56-18.05, P=0.007) and functional independence in patients with distal M1 occlusion. CONCLUSION IVT before MT was associated with improved functional outcomes in patients with M1 occlusion, especially in those with distal M1 occlusion but not in those with proximal M1 occlusion.
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Affiliation(s)
- Jae-Chan Ryu
- Department of Neurology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Boseong Kwon
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yunsun Song
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Deok Hee Lee
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jun Young Chang
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong-Wha Kang
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sun U. Kwon
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong S. Kim
- Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Bum Joon Kim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Moon E, Park W, Song Y, Lee DH, Ahn JS, Park JC. Mass Effect After Flow Diversion for Unruptured Large and Giant Cavernous or Paraclinoid Internal Carotid Artery Aneurysm. World Neurosurg 2023; 180:e108-e116. [PMID: 37690582 DOI: 10.1016/j.wneu.2023.08.129] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVE The mass effect associated with large or giant intracranial aneurysms is difficult for traditional endovascular treatment. This study investigated whether flow diverters can relieve the aneurysmal mass effect caused by aneurysmal compression symptoms. METHODS Fifty-five patients with unruptured large and giant intracranial aneurysms treated by a flow diverter at our institution from January 2014 to February 2022 were retrospectively evaluated. RESULTS In this study, 53 patients were included. Initially, 27 patients (51.9%), including 10 with compressive optic neuropathy, 12 with third nerve palsy, 2 with facial hyperesthesia, and 11 with sixth nerve palsy, were symptomatic. The symptom duration was shorter in the improved group (n = 2.2 ± 4.0 vs. n = 3.1 ± 3.9, P = 0.49). Thrombus formation following the flow diversion procedure was typically observed on magnetic resonance imaging (MRI) performed immediately and was not significantly associated with symptomatic improvement (OR = 0.395; 95% CI (0.058-2.698), P = 0.343). However, symptomatic improvement was seen in most patients when the aneurysm size decreased on MRI. A reduction in the aneurysm size on the MRI at the 3-month follow-up was correlated with symptomatic improvement in the multivariate analysis (OR = 0.08, 95% CI (0.013-0.485), P < 0.05). CONCLUSIONS A flow diverter might help alleviate compression symptoms caused by large or giant intracranial aneurysms. Shrinkage of the aneurysm within 3 months postoperatively and a shorter duration of symptoms contribute to the favorable outcomes of mass effect. Ultimately, prompt treatment is crucial for improving symptomatic intracranial artery aneurysms.
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Affiliation(s)
- Eunji Moon
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Wonhyoung Park
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yunsun Song
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Deok Hee Lee
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae Sung Ahn
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jung Cheol Park
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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Adhikari G, Carlin N, Choi JJ, Choi S, Ezeribe AC, França LE, Ha C, Hahn IS, Hollick SJ, Jeon EJ, Jo JH, Joo HW, Kang WG, Kauer M, Kim BH, Kim HJ, Kim J, Kim KW, Kim SH, Kim SK, Kim WK, Kim YD, Kim YH, Ko YJ, Lee DH, Lee EK, Lee H, Lee HS, Lee HY, Lee IS, Lee J, Lee JY, Lee MH, Lee SH, Lee SM, Lee YJ, Leonard DS, Luan NT, Manzato BB, Maruyama RH, Neal RJ, Nikkel JA, Olsen SL, Park BJ, Park HK, Park HS, Park KS, Park SD, Pitta RLC, Prihtiadi H, Ra SJ, Rott C, Shin KA, Cavalcante DFFS, Scarff A, Spooner NJC, Thompson WG, Yang L, Yu GH. Search for Boosted Dark Matter in COSINE-100. Phys Rev Lett 2023; 131:201802. [PMID: 38039466 DOI: 10.1103/physrevlett.131.201802] [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] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 10/30/2023] [Indexed: 12/03/2023]
Abstract
We search for energetic electron recoil signals induced by boosted dark matter (BDM) from the galactic center using the COSINE-100 array of NaI(Tl) crystal detectors at the Yangyang Underground Laboratory. The signal would be an excess of events with energies above 4 MeV over the well-understood background. Because no excess of events are observed in a 97.7 kg·yr exposure, we set limits on BDM interactions under a variety of hypotheses. Notably, we explored the dark photon parameter space, leading to competitive limits compared to direct dark photon search experiments, particularly for dark photon masses below 4 MeV and considering the invisible decay mode. Furthermore, by comparing our results with a previous BDM search conducted by the Super-Kamionkande experiment, we found that the COSINE-100 detector has advantages in searching for low-mass dark matter. This analysis demonstrates the potential of the COSINE-100 detector to search for MeV electron recoil signals produced by the dark sector particle interactions.
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Affiliation(s)
- G Adhikari
- Department of Physics and Wright Laboratory, Yale University, New Haven, Connecticut 06520, USA
| | - N Carlin
- Physics Institute, University of São Paulo, 05508-090, São Paulo, Brazil
| | - J J Choi
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Republic of Korea
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - S Choi
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Republic of Korea
| | - A C Ezeribe
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - L E França
- Physics Institute, University of São Paulo, 05508-090, São Paulo, Brazil
| | - C Ha
- Department of Physics, Chung-Ang University, Seoul 06973, Republic of Korea
| | - I S Hahn
- Department of Science Education, Ewha Womans University, Seoul 03760, Republic of Korea
- Center for Exotic Nuclear Studies, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- IBS School, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
| | - S J Hollick
- Department of Physics and Wright Laboratory, Yale University, New Haven, Connecticut 06520, USA
| | - E J Jeon
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - J H Jo
- Department of Physics and Wright Laboratory, Yale University, New Haven, Connecticut 06520, USA
| | - H W Joo
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Republic of Korea
| | - W G Kang
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - M Kauer
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - B H Kim
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - H J Kim
- Department of Physics, Kyungpook National University, Daegu 41566, Republic of Korea
| | - J Kim
- Department of Physics, Chung-Ang University, Seoul 06973, Republic of Korea
| | - K W Kim
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - S H Kim
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - S K Kim
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Republic of Korea
| | - W K Kim
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- IBS School, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
| | - Y D Kim
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- IBS School, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
- Department of Physics, Sejong University, Seoul 05006, Republic of Korea
| | - Y H Kim
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- IBS School, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
- Korea Research Institute of Standards and Science, Daejeon 34113, Republic of Korea
| | - Y J Ko
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - D H Lee
- Department of Physics, Kyungpook National University, Daegu 41566, Republic of Korea
| | - E K Lee
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - H Lee
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- IBS School, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
| | - H S Lee
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- IBS School, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
| | - H Y Lee
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - I S Lee
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - J Lee
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - J Y Lee
- Department of Physics, Kyungpook National University, Daegu 41566, Republic of Korea
| | - M H Lee
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- IBS School, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
| | - S H Lee
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- IBS School, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
| | - S M Lee
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Republic of Korea
| | - Y J Lee
- Department of Physics, Chung-Ang University, Seoul 06973, Republic of Korea
| | - D S Leonard
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - N T Luan
- Department of Physics, Kyungpook National University, Daegu 41566, Republic of Korea
| | - B B Manzato
- Physics Institute, University of São Paulo, 05508-090, São Paulo, Brazil
| | - R H Maruyama
- Department of Physics and Wright Laboratory, Yale University, New Haven, Connecticut 06520, USA
| | - R J Neal
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - J A Nikkel
- Department of Physics and Wright Laboratory, Yale University, New Haven, Connecticut 06520, USA
| | - S L Olsen
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - B J Park
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- IBS School, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
| | - H K Park
- Department of Accelerator Science, Korea University, Sejong 30019, Republic of Korea
| | - H S Park
- Korea Research Institute of Standards and Science, Daejeon 34113, Republic of Korea
| | - K S Park
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - S D Park
- Department of Physics, Kyungpook National University, Daegu 41566, Republic of Korea
| | - R L C Pitta
- Physics Institute, University of São Paulo, 05508-090, São Paulo, Brazil
| | - H Prihtiadi
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - S J Ra
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - C Rott
- Department of Physics, Sungkyunkwan University, Suwon 16419, Republic of Korea
- Department of Physics and Astronomy, University of Utah, Salt Lake City, Utah 84112, USA
| | - K A Shin
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - D F F S Cavalcante
- Physics Institute, University of São Paulo, 05508-090, São Paulo, Brazil
| | - A Scarff
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - N J C Spooner
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - W G Thompson
- Department of Physics and Wright Laboratory, Yale University, New Haven, Connecticut 06520, USA
| | - L Yang
- Department of Physics, University of California San Diego, La Jolla, California 92093, USA
| | - G H Yu
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- Department of Physics, Sungkyunkwan University, Suwon 16419, Republic of Korea
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Park S, Kwon B, Lee DH, Ahn JS, Song Y. Ruptured Medullary Hemangioblastoma Mimicking a Craniocervical Junction Dural Arteriovenous Fistula with a Pseudoaneurysm. Neurointervention 2023; 18:209-213. [PMID: 37866937 PMCID: PMC10626037 DOI: 10.5469/neuroint.2023.00451] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 10/14/2023] [Accepted: 10/15/2023] [Indexed: 10/24/2023] Open
Abstract
Hemangioblastomas (HBMs) are rare vascular tumors commonly located in the posterior fossa of adults. A mid-50s patient presented with sudden unconsciousness. Computed tomography scans revealed acute hemorrhages around the posterior fossa, predominantly in the subarachnoid space. Digital subtraction angiography (DSA) revealed an 8-mm round lesion filled with contrast agent, fed by the C1 segmental artery of the left vertebral artery (VA), showing early venous drainage to the spinal cord and brainstem. Emergent embolization was attempted under suspicion of a ruptured dural arteriovenous fistula, resulting in parent artery occlusion due to feeder selection failure. Follow-up DSA after a month depicted a persistent aneurysm via collaterals from both VAs. Consequently, the decision was made to proceed with surgical intervention, leading to the resection of the lesion, confirming its diagnosis as a HBM through histological examination. This case underscores the potential for misdiagnosis when HBMs with an intratumoral shunt mimic vascular shunt lesions.
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Affiliation(s)
- Sangil Park
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Boseong Kwon
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Deok Hee Lee
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae-Sung Ahn
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yunsun Song
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Yeom S, Lee DH, Lim SC. Clinical outcomes of sinonasal inverted papilloma: a retrospective analysis of 139 cases. J Laryngol Otol 2023; 137:1154-1157. [PMID: 36876322 DOI: 10.1017/s0022215123000361] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
OBJECTIVES Sinonasal inverted papilloma has a high tendency for recurrence, local bone destruction and risk of malignant transformation. Therefore, complete resection of the tumour is required, and close follow up is essential. This article describes the clinical outcomes, recurrence rate and malignant transformation rate of sinonasal inverted papilloma. METHODS In this study, 139 patients diagnosed with sinonasal inverted papilloma in our hospital from December 2010 to May 2022 were retrospectively analysed. All patients underwent endoscopic surgery. RESULTS Sinonasal inverted papilloma occurred more often in males than in females. The mean age of patients with sinonasal inverted papilloma was 67.3 ± 5.7 years at diagnosis. The most prevalent site of origin was the maxillary sinus (50.4 per cent). The recurrence rate was 5.75 per cent, and the malignant transformation rate was 6.5 per cent. CONCLUSION All patients in this study underwent endoscopic surgery. Meticulous resection and regular long-term follow ups are crucial to reducing sinonasal inverted papilloma recurrence after surgery.
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Affiliation(s)
- S Yeom
- Department of Otolaryngology - Head and Neck Surgery, Chonnam National University Medical School and Hwasun Hospital, Hwasun, South Korea
| | - D H Lee
- Department of Otolaryngology - Head and Neck Surgery, Chonnam National University Medical School and Hwasun Hospital, Hwasun, South Korea
| | - S C Lim
- Department of Otolaryngology - Head and Neck Surgery, Chonnam National University Medical School and Hwasun Hospital, Hwasun, South Korea
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14
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Won DS, Kim MH, Lee KB, Yoon JT, Park Y, Lee DH. A modified method of elastase-induced saccular aneurysm creation in rabbits: Schematic representation of the method. Interv Neuroradiol 2023; 29:548-554. [PMID: 35733403 PMCID: PMC10549710 DOI: 10.1177/15910199221109762] [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] [Received: 04/20/2022] [Revised: 06/01/2022] [Accepted: 06/08/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The purpose of our study was to investigate the safety and effectiveness of a modified technique using a short guiding catheter for instillation of elastase in comparison with the previously described method of creating elastase-induced aneurysm in rabbits. METHODS Following right common carotid artery (RCCA) access using an arterial sheath and inflating the Fogarty balloon in the subclavian artery, a short guiding catheter was used for the instillation of the elastase in the experimental group (n = 5) while it was performed with a microcatheter in the control group (n = 5). The procedure duration was recorded from the RCCA puncture to the sheath removal. The histological changes were characterized using H&E and Masson's trichrome (MT) staining. RESULTS The procedure time was 23 ± 2 min in the experimental group and 29 ± 2 min in the control group. All the rabbits (100%) in the experimental group survived without neurologic deficits, but two rabbits (40%) survived in the control group. All aneurysms were created in the saccular shape (100%) with a neck size of 2.3 ± 0.29 mm, a width of 2.75 ± 0.36 mm, and height of 6.37 ± 0.46 mm, and a dome to neck ratio of 1.21 ± 0.23. The aneurysm walls were partly thickened due to the degradation of the media tunica and adventitia proliferation with loss of the internal elastic lamina. CONCLUSION By using a short guiding catheter, we could instill the elastase in a more effective and safe manner in the creation of the elastase-induced aneurysm model in rabbits.
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Affiliation(s)
- Dong-Sung Won
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Mi Hyeon Kim
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ki Baek Lee
- Department of Radiologic Technology, Chungbuk Health & Science University, Cheongju, Republic of Korea
| | - Jong Tae Yoon
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yubeen Park
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | - Deok Hee Lee
- Department of Radiologic Technology, Chungbuk Health & Science University, Cheongju, Republic of Korea
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15
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Ryu JC, Yoon JT, Kim BJ, Kim MH, Moon EJ, Suh PS, Roh YH, Moon HH, Kwon B, Lee DH, Song Y. Impact of a selective lens dose reduction protocol in 3D rotational angiography on radiation exposure to the eye lens during cerebral angiography: a randomized controlled trial. J Neurointerv Surg 2023:jnis-2023-020730. [PMID: 37739793 DOI: 10.1136/jnis-2023-020730] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/29/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND We aimed to investigate the radiation dose to the eye lens (lens dose) during cerebral angiography and to evaluate the effectiveness of the lens dose reduction protocol for 3-dimensional rotational angiography (3D-RA) in reducing overall lens dose exposure. METHODS We conducted a randomized, controlled clinical trial at a tertiary hospital with patients undergoing cerebral angiography. The lens dose reduction protocol in 3D-RA involved raising the table to position the patient's eye lens away from the rotation axis. The lens dose was estimated by measuring the entrance surface air kerma using a photoluminescent glass dosimeter. The lens doses of 3D-RA, overall examination, and image quality were analyzed and compared between the two groups. RESULTS A total of 20 participants (mean age, 58±9.4 years; including 12 men [60%]) were enrolled and randomly assigned to either the conventional group or the dose reduction group. The median lens dose in 3D-RA was significantly lower in the dose reduction group compared with the conventional group (1.1 mGy vs 4.5 mGy, p<0.001). The total dose was significantly lower in the dose reduction group (median of 7.5 mGy vs 10.2 mGy, p=0.003). In the conventional group, 3D-RA accounted for 46% of the total lens dose, while in the dose reduction group, its proportion decreased to 16%. No significant differences were observed in the image quality between the groups. CONCLUSION The lens dose reduction protocol resulted in a significant reduction in the lens dose of the 3D-RA as well as entire cerebral angiography, while maintaining the image quality.
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Affiliation(s)
- Jae-Chan Ryu
- Neurology, Korea University Ansan Hospital, Ansan, Korea (the Republic of)
| | - Jong-Tae Yoon
- Radiology, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
| | - Byung Jun Kim
- Advanced Therapies, Siemens Healthineers Co Ltd, Seoul, Korea (the Republic of)
| | - Mi Hyeon Kim
- Radiology, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
| | - Eun Ji Moon
- Radiology, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
| | - Pae Sun Suh
- Radiology, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
| | - Yun Hwa Roh
- Radiology, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
| | - Hye Hyeon Moon
- Radiology, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
| | - Boseong Kwon
- Radiology, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
| | - Deok Hee Lee
- Radiology, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
| | - Yunsun Song
- Radiology, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
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Chung J, Cheong JH, Kim JM, Lee DH, Yi HJ, Choi KS, Ahn JS, Park JC, Park W. Is Fetal-Type Posterior Cerebral Artery a Risk Factor for Recurrence in Coiled Internal Carotid Artery-Incorporating Posterior Communicating Artery Aneurysms? Analysis of Conventional Statistics, Computational Fluid Dynamics, and Random Forest With Hyper-Ensemble Approach. Neurosurgery 2023; 93:611-621. [PMID: 37057916 DOI: 10.1227/neu.0000000000002458] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 01/20/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND The fetal-type posterior cerebral artery (FPCA) has been regarded as the risk factor for recurrence in coiled internal carotid artery-incorporating posterior communicating artery (ICA-PCoA) aneurysm. However, it has not been proven in previous literature studies. OBJECTIVE To reveal the impact of FPCA on the recurrence of ICA-PCoA aneurysms using conventional statistical analysis, computational fluid dynamics (CFD) simulation, and random forest with hyper-ensemble approach (RF with HEA). METHODS Vascular parameters and clinical information from patients who underwent coil embolization ICA-PCoA aneurysms from January 2011 to December 2016 were obtained. Conventional statistical analysis was applied to a total of 95 cases obtained from patients with a follow-up of more than 6 months. For CFD simulation, 3 sets of three-dimensional models were used to understand the hemodynamical characteristics of various FPCAs. The RF with HEA was applied to reinforce the clinical data analysis. RESULTS The conventional statistical analysis fails to reveal that FPCA is a risk factor. CFD analysis shows that the diameter of FPCA alone is less likely to be a risk factor. The RF with HEA shows that the impact of FPCA is also minor compared with that of the packing density in the recurrence of coiled ICA-PCoA aneurysms. CONCLUSION The gathered results of all 3 analyses show more clear evidence that FPCA is not a risk factor for coiled ICA-PCoA aneurysms. Hence, we may conclude that FPCA itself is doubtful to be the major risk factor in the recurrence of coiled ICA-PCoA aneurysms.
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Affiliation(s)
- Jaewoo Chung
- Department of Neurosurgery, Dankook University, Cheonan, Republic of Korea
| | - Jin Hwan Cheong
- Department of Neurosurgery, Hanyang University Guri Hospital, Guri, Republic of Korea
| | - Jae Min Kim
- Department of Neurosurgery, Hanyang University Guri Hospital, Guri, Republic of Korea
| | - Deok Hee Lee
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Hyeong-Joong Yi
- Department of Neurosurgery, Hanyang University Medical Center, Seoul, Republic of Korea
| | - Kyu-Sun Choi
- Department of Neurosurgery, Hanyang University Medical Center, Seoul, Republic of Korea
| | - Jae Sung Ahn
- Department of Neurosurgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Jung Cheol Park
- Department of Neurosurgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Wonhyoung Park
- Department of Neurosurgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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17
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Ryu JC, Yoon JT, Kim BJ, Kim MH, Moon EJ, Suh PS, Roh YH, Moon HH, Kwon B, Lee DH, Song Y. Reduction of Radiation Dose to Eye Lens in Cerebral 3D Rotational Angiography Using Head Off-Centering by Table Height Adjustment: A Prospective Study. Korean J Radiol 2023; 24:681-689. [PMID: 37404110 DOI: 10.3348/kjr.2023.0169] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/29/2023] [Accepted: 04/24/2023] [Indexed: 07/06/2023] Open
Abstract
OBJECTIVE Three-dimensional rotational angiography (3D-RA) is increasingly used for the evaluation of intracranial aneurysms (IAs); however, radiation exposure to the lens is a concern. We investigated the effect of head off-centering by adjusting table height on the lens dose during 3D-RA and its feasibility in patient examination. MATERIALS AND METHODS The effect of head off-centering during 3D-RA on the lens radiation dose at various table heights was investigated using a RANDO head phantom (Alderson Research Labs). We prospectively enrolled 20 patients (58.0 ± 9.4 years) with IAs who were scheduled to undergo bilateral 3D-RA. In all patients' 3D-RA, the lens dose-reduction protocol involving elevation of the examination table was applied to one internal carotid artery, and the conventional protocol was applied to the other. The lens dose was measured using photoluminescent glass dosimeters (GD-352M, AGC Techno Glass Co., LTD), and radiation dose metrics were compared between the two protocols. Image quality was quantitatively analyzed using source images for image noise, signal-to-noise ratio, and contrast-to-noise ratio. Additionally, three reviewers qualitatively assessed the image quality using a five-point Likert scale. RESULTS The phantom study showed that the lens dose was reduced by an average of 38% per 1 cm increase in table height. In the patient study, the dose-reduction protocol (elevating the table height by an average of 2.3 cm) led to an 83% reduction in the median dose from 4.65 mGy to 0.79 mGy (P < 0.001). There were no significant differences between dose-reduction and conventional protocols in the kerma area product (7.34 vs. 7.40 Gy·cm², P = 0.892), air kerma (75.7 vs. 75.1 mGy, P = 0.872), and image quality. CONCLUSION The lens radiation dose was significantly affected by table height adjustment during 3D-RA. Intentional head off-centering by elevation of the table is a simple and effective way to reduce the lens dose in clinical practice.
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Affiliation(s)
- Jae-Chan Ryu
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong-Tae Yoon
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea
| | - Byung Jun Kim
- Advanced Therapies, Siemens Healthineers Ltd., Seoul, Korea
| | - Mi Hyeon Kim
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea
| | - Eun Ji Moon
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Pae Sun Suh
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yun Hwa Roh
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hye Hyeon Moon
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Boseong Kwon
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Deok Hee Lee
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yunsun Song
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Lee HJ, Lee DH, Lee DH, Kim JY. Posttraumatic Growth Inventory-Expanded: Factor Structure, Test-Retest Reliability, and Validity in Trauma-Exposed and Bereaved Adults. Omega (Westport) 2023:302228231177847. [PMID: 37220767 DOI: 10.1177/00302228231177847] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Posttraumatic growth (PTG) is a positive psychological change experienced after trauma and it has gained global recognition in recent years. The present study aimed to validate a South Korean version of the Posttraumatic Growth Inventory-Expanded (K-PTGI-X) for use with trauma-exposed and bereaved samples. A national sample comprising South Korean adults was used for the analysis. As a result, the 4-factor bi-factor model was best supported in both the trauma and bereaved groups in terms of personal strength, new possibilities, spiritual-existential change, and being able to relate to others. Additionally, the K-PTGI-X showed satisfying reliability, concurrent validity, and discriminant validity. Lastly, regarding the group differences, women showed higher rates of PTG than men and the bereaved group exhibited higher spiritual and existential growth in the PTG than the trauma group. Given these results, implications for adaptation in various fields when assessing and encouraging PTG in practical settings are discussed.
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Affiliation(s)
- Hwa Jung Lee
- Traumatic Stress Center, Department of Education, Sungkyunkwan University, Seoul, South Korea
| | - Dong Hun Lee
- Traumatic Stress Center, Department of Education, Sungkyunkwan University, Seoul, South Korea
| | - Deok Hee Lee
- Traumatic Stress Center, Department of Education, Sungkyunkwan University, Seoul, South Korea
| | - Ji Yun Kim
- Department of Wesley Creative Convergence, Hyupsung University, Hwaseong, South Korea
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Galffy G, Lugowska I, Poddubskaya EV, Cho BC, Ahn MJ, Han JY, Su WC, Hauke RJ, Dyar SH, Lee DH, Serwatowski P, Estelles DL, Holden VR, Kim YJ, Vladimirov V, Horvath Z, Ghose A, Goldman A, di Pietro A, Wang J, Murphy DA, Alhadab A, Laskov M. A phase II open-label trial of avelumab plus axitinib in previously treated non-small-cell lung cancer or treatment-naïve, cisplatin-ineligible urothelial cancer. ESMO Open 2023; 8:101173. [PMID: 37141847 DOI: 10.1016/j.esmoop.2023.101173] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 01/17/2023] [Accepted: 02/06/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND We hypothesized that avelumab plus axitinib could improve clinical outcomes in patients with advanced non-small-cell lung cancer (NSCLC) or urothelial carcinoma (UC). PATIENTS AND METHODS We enrolled previously treated patients with advanced or metastatic NSCLC, or untreated, cisplatin-ineligible patients with advanced or metastatic UC. Patients received avelumab 800 mg every 2 weeks (Q2W) and axitinib 5 mg orally two times daily. The primary endpoint was objective response rate (ORR). Immunohistochemistry was used to assess programmed death-ligand 1 (PD-L1) expression (SP263 assay) and the presence of CD8+ T cells (clone C8/144B). Tumor mutational burden (TMB) was assessed by whole-exome sequencing. RESULTS A total of 61 patients were enrolled and treated (NSCLC, n = 41; UC, n = 20); 5 remained on treatment at data cut-off (26 February 2021). The confirmed ORR was 31.7% in the NSCLC cohort and 10.0% in the UC cohort (all partial responses). Antitumor activity was observed irrespective of PD-L1 expression. In exploratory subgroups, ORRs were higher in patients with higher (≥median) CD8+ T cells in the tumor. ORRs were higher in patients with lower TMB (<median) in the NSCLC cohort and higher TMB (≥median) in the UC cohort. Treatment-related adverse events (TRAEs) occurred in 93.4% of patients, including grade ≥3 TRAEs in 55.7%. Avelumab exposures with 800 mg Q2W dosing were similar to those observed with 10 mg/kg Q2W dosing. CONCLUSIONS In previously treated patients with advanced/metastatic NSCLC, ORR appeared to be superior to anti-PD-L1 or anti-programmed cell death protein 1 monotherapy, irrespective of PD-L1 status, whereas in untreated, cisplatin-ineligible patients with advanced/metastatic UC, ORR was lower than expected, potentially limited by small patient numbers. TRIAL REGISTRATION Clinicaltrial.gov NCT03472560; https://clinicaltrials.gov/ct2/show/NCT03472560.
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Affiliation(s)
- G Galffy
- Department of Pulmonology, Pulmonology Hospital Törökbálint, Törökbálint, Hungary.
| | - I Lugowska
- Early Phase Clinical Trials Unit, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland; Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | | | - B C Cho
- Division of Medical Oncology, Yonsei Cancer Center, Severance Hospital, Seoul
| | - M-J Ahn
- Department of Hematology & Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul
| | - J-Y Han
- Center for Lung Cancer, National Cancer Center, Goyang, Republic of Korea
| | - W-C Su
- Division of Hematology and Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - R J Hauke
- Department of Oncology, Nebraska Cancer Specialists, Omaha
| | - S H Dyar
- Department of Hematology & Oncology, Saint Francis Hospital Cancer Center, Greenville, USA
| | - D H Lee
- Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | | | - D L Estelles
- Department of Oncology, Consorcio Hospitalario Provincial de Castellon, Castellon, Spain
| | - V R Holden
- Oncology Hematology Associates, Springfield, USA
| | - Y J Kim
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - V Vladimirov
- GBUZ of Stavropol Territory Pyatigorsk Inter-regional Oncology Dispensary, Pyatigorsk, Stavropol Territory, Russia
| | - Z Horvath
- Bács-Kiskun Megyei Kórház Onkoradiológiai Központ, Kecskemet, Hungary
| | - A Ghose
- Department of Medical Oncology/Hematology, Arizona Oncology Associates, Tempe
| | | | | | | | | | | | - M Laskov
- LLC University Clinic of Headache, Moscow, Russia
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20
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Ryu JC, Kwon B, Song Y, Lee DH, Chang JY, Kang DW, Kwon SU, Kim JS, Kim BJ. Delayed low cerebellar perfusion status is associated with poor outcomes in top-of-basilar occlusion treated with thrombectomy. Front Neurol 2023; 14:1161198. [PMID: 37181547 PMCID: PMC10166797 DOI: 10.3389/fneur.2023.1161198] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 03/27/2023] [Indexed: 05/16/2023] Open
Abstract
Background and purpose Top-of-basilar artery occlusion (TOB) is one of the most devastating strokes despite successful mechanical thrombectomy (MT). We aimed to investigate the impact of initial low cerebellum perfusion delay on the outcomes of TOB treated with MT. Methods We included patients who underwent MT for TOB. Clinical and peri-procedural variables were obtained. Perfusion delay in the low cerebellum was defined as (1) time-to-maximum (Tmax) >10 s lesions or (2) relative time-to-peak (rTTP) map >9.5 s with a diameter of ≥6 mm in the low cerebellum. The good functional outcome was defined as the achievement of a modified Rankin Scale score of 0-3 at 3 months after stroke. Results Among the 42 included patients, 24 (57.1%) patients showed perfusion delay in the low cerebellum. The admission National Institutes of Health Stroke Scale (NIHSS) score was significantly higher in those with perfusion delay [17 (12-24) vs. 8 (6-15), P = 0.002]. Accordingly, the proportion of good functional outcomes was lower in those with perfusion delay than in those without [5 (20.8%) vs. 13 (72.2%), P = 0.003]. From the multivariable analysis, the admission NIHSS score [odds ratio (OR) = 0.86, 95% confidence intervals (CIs) = 0.75-0.98, P = 0.021] and low cerebellum perfusion delay (OR = 0.18, 95% Cis = 0.04-0.86, P = 0.031) were independently associated with the 3-month functional outcomes. Conclusion We found that initial perfusion delay proximal to TOB in the low cerebellum might be a predictor for poor functional outcomes in TOB treated with MT.
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Affiliation(s)
- Jae-Chan Ryu
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Boseong Kwon
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yunsun Song
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Deok Hee Lee
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jun Young Chang
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Dong-Wha Kang
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sun U. Kwon
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jong S. Kim
- Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea
| | - Bum Joon Kim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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21
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Ryu JC, Lee DH, Chang JY, Kang DW, Kwon SU, Kim BJ. Silent brain infarcts after carotid or vertebrobasilar artery stenting. J Neuroimaging 2023. [PMID: 36868784 DOI: 10.1111/jon.13097] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/30/2023] [Accepted: 02/20/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND AND PURPOSE Stenting is an important treatment for preventing stroke. However, the effect of vertebrobasilar stenting (VBS) might be limited because of relatively high periprocedural risks. Silent brain infarcts (SBIs) are known as a predictor for future stroke. Because of anatomical differences, factors for SBIs might be different between carotid artery stenting (CAS) and VBS. We compared the characteristics of SBIs between VBS and CAS. METHODS We included patients who underwent elective VBS or CAS. Diffusion-weighted imaging was performed pre- and post-procedure to detect new SBIs. Clinical variables, occurrence of SBIs, and procedure-related factors were compared between CAS and VBS. Moreover, we investigated predictors of SBIs in each group separately. RESULTS Ninety-two (34.2%) out of 269 patients had SBIs. SBIs were more frequently observed in VBS (29 [56.6%] vs. 63 [28.9%], p<.001). The risk of SBIs outside the stent-inserted vascular territory was higher in VBS compared to CAS (14 [48.3%] vs. 8 [12.7%], p<.001). Larger-diameter stents (odds ratio: 1.28, 95% confidence interval: 1.06-1.54, p = .012) and prolonged procedure time (1.01, [1.00-1.03], p = .026) increased the risk of SBIs in CAS, whereas only age increased the risk of SBIs in VBS (1.08 [1.01-1.16], p = .036). CONCLUSIONS Compared to CAS, VBS was associated with longer procedure time, more residual stenosis, and more SBIs, especially outside the stent-inserted vascular territory. The risk of SBIs after CAS was associated with stent size and procedural difficulty. Only age was associated with SBIs in VBS. The pathomechanism of SBIs after VBS and CAS may be different.
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Affiliation(s)
- Jae-Chan Ryu
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Deok Hee Lee
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jun Young Chang
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Dong-Wha Kang
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sun U Kwon
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Bum Joon Kim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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22
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Lee KB, Suh CH, Song Y, Kwon B, Kim MH, Yoon JT, Lee DH. Trends of Expanding Indications of Woven EndoBridge Devices for the Treatment of Intracranial Aneurysms: A Systematic Review and Meta-analysis. Clin Neuroradiol 2023; 33:227-235. [PMID: 36036257 DOI: 10.1007/s00062-022-01207-5] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 07/20/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Woven EndoBridge (WEB) was introduced for the endovascular therapy of wide-neck intracranial aneurysms. The safety and efficacy have been evaluated through several meta-analyses. However, these reviews did not cover the expanding indications in detail. Therefore, we aimed to show the changing trends for intracranial aneurysm treatment using the WEB device. METHODS A systematic review and meta-analysis was conducted with PubMed, Embase, and Cochrane databases. We searched for studies that reported baseline characteristics of aneurysms and the WEB devices, which had treated more than 20 aneurysms consecutively. The pooled proportions of aneurysm indications and used WEB device types were obtained. To evaluate the changing indications for the treated aneurysm size, including the neck diameter, a trend line and linear regression model was measured. RESULTS A total of 27 cohorts were included encompassing 1831 aneurysms treated with the WEB. A total of 86% were used in the four major locations as on-label indications (middle cerebral artery bifurcation; 34%, anterior communicating artery; 26%, basilar tip; 18%, internal carotid artery terminus; 7%). Among off-label indications, the most common location was the posterior communicating artery (8%), followed by the anterior cerebral artery including the pericallosal artery (6%). The median aneurysm size and neck diameter was 7 mm and 4.6 mm, respectively. The WEB device has been used for the treatment of smaller aneurysms than the initial indication. Also, the proportion for ruptured aneurysm treatment was increased up to 15%. CONCLUSION The mechanical and technical development of the WEB resulted in expanding the indications for the treatment of intracranial aneurysms. The off-label indications accounted for 14% in total and an increasing number of small aneurysms are treated with WEB devices. Moreover, the proportion for ruptured aneurysm treatment was currently increased up to 14% more than in the beginning.
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Affiliation(s)
- Ki Baek Lee
- Department of Radiologic Technology, Chungbuk Health & Science University, Cheongju, Korea (Republic of)
| | - Chong Hyun Suh
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, 05505, Seoul, Korea (Republic of)
| | - Yunsun Song
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, 05505, Seoul, Korea (Republic of)
| | - Boseong Kwon
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, 05505, Seoul, Korea (Republic of)
| | - Mi Hyeon Kim
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, 05505, Seoul, Korea (Republic of)
| | - Jong-Tae Yoon
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, 05505, Seoul, Korea (Republic of)
| | - Deok Hee Lee
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, 05505, Seoul, Korea (Republic of).
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23
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Ryu JC, Bae JH, Ha SH, Kwon B, Song Y, Lee DH, Chang JY, Kang DW, Kwon SU, Kim JS, Kim BJ. In-stent restenosis and stented-territory infarction after carotid and vertebrobasilar artery stenting. BMC Neurol 2023; 23:79. [PMID: 36803229 PMCID: PMC9942307 DOI: 10.1186/s12883-023-03110-z] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/07/2023] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND Prognosis after vertebrobasilar stenting (VBS) may differ from that after carotid artery stenting (CAS). Here, we directly compared the incidence and predictors of in-stent restenosis and stented-territory infarction after VBS and compared them with those of CAS. METHODS We enrolled patients who underwent VBS or CAS. Clinical variables and procedure-related factors were obtained. During the 3 years of follow-up, in-stent restenosis and infarction were investigated in each group. In-stent restenosis was defined as reduction in the lumen diameter > 50% compared with that after stenting. Factors associated with the occurrence of in-stent restenosis and stented-territory infarction in VBS and CAS were compared. RESULTS Among 417 stent insertions (93 VBS and 324 CAS), there was no statistical difference in in-stent restenosis between VBS and CAS (12.9% vs. 6.8%, P = 0.092). However, stented-territory infarction was more frequently observed in VBS than in CAS (22.6% vs. 10.8%; P = 0.006), especially a month after stent insertion. HbA1c level, clopidogrel resistance, and multiple stents in VBS and young age in CAS increased the risk of in-stent restenosis. Diabetes (3.82 [1.24-11.7]) and multiple stents (22.4 [2.4-206.4]) were associated with stented-territory infarction in VBS. However, in-stent restenosis (odds ratio: 15.1, 95% confidence interval: 3.17-72.2) was associated with stented-territory infarction in CAS. CONCLUSIONS Stented-territory infarction occurred more frequently in VBS, especially after the periprocedural period. In-stent restenosis was associated with stented-territory infarction after CAS, but not in VBS. The mechanism of stented-territory infarction after VBS may be different from that after CAS.
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Affiliation(s)
- Jae-Chan Ryu
- grid.267370.70000 0004 0533 4667Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae-Han Bae
- grid.267370.70000 0004 0533 4667Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang Hee Ha
- grid.256155.00000 0004 0647 2973Department of Neurology, Gil Medical Center, Gachon University, Incheon, Korea
| | - Boseong Kwon
- grid.267370.70000 0004 0533 4667Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yunsun Song
- grid.267370.70000 0004 0533 4667Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Deok Hee Lee
- grid.267370.70000 0004 0533 4667Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jun Young Chang
- grid.267370.70000 0004 0533 4667Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong-Wha Kang
- grid.267370.70000 0004 0533 4667Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sun U. Kwon
- grid.267370.70000 0004 0533 4667Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong S. Kim
- grid.267370.70000 0004 0533 4667Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Bum Joon Kim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Park SJ, Kim H, Piao M, Kang HJ, Fassah DM, Jung DJS, Kim SY, Na SW, Beak SH, Jeong IH, Yoo SP, Hong SJ, Lee DH, Lee SH, Haque MN, Shin DJ, Kwon JA, Jo C, Baik M. Effects of genomic estimated breeding value and dietary energy to protein ratio on growth performance, carcass trait, and lipogenic gene expression in Hanwoo steer. Animal 2023; 17:100728. [PMID: 36870258 DOI: 10.1016/j.animal.2023.100728] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 02/12/2023] Open
Abstract
"Genome-based precision feeding" is a concept that involves the application of customised diets to different genetic groups of cattle. We investigated the effects of the genomic estimated breeding value (gEBV) and dietary energy to protein ratio (DEP) on growth performance, carcass traits, and lipogenic gene expression in Hanwoo (Korean cattle) steers. Forty-four Hanwoo steers (BW = 636 kg, age = 26.9 months) were genotyped using the Illumina Bovine 50 K BeadChip. The gEBV was calculated using genomic best linear unbiased prediction. Animals were separated into high gEBV of marbling score or low-gMS groups based on the upper and lower 50% groupings of the reference population, respectively. Animals were assigned to one of four groups in a 2 × 2 factorial arrangement: high gMS/high DEP (0.084 MJ/g), high gMS/low DEP (0.079 MJ/g), low gMS/high DEP, and low gMS/low DEP. Steers were fed concentrate with a high or low DEP for 31 weeks. The BW tended to be higher (0.05 < P < 0.1) in the high-gMS groups compared to the low-gMS groups at 0, 4, 8, 12, and 20 weeks. The average daily gain (ADG) tended to be lower (P = 0.08) in the high-gMS group than in the low-gMS group. Final BW and measured carcass weight (CW) were positively correlated with the gEBV of carcass weight (gCW). The DEP did not affect ADG. Neither the gMS nor the DEP affected the MS and beef quality grade. The intramuscular fat (IMF) content in the longissimus thoracis (LT) tended to be higher (P = 0.08) in the high-gMS groups than in the low-gMS groups. The mRNA levels of lipogenic acetyl-CoA carboxylase and fatty acid binding protein 4 genes in the LT were higher (P < 0.05) in the high-gMS group than in the low-gMS group. Overall, the IMF content tended to be affected by the gMS, and the genetic potential (i.e., gMS) was associated with the functional activity of lipogenic gene expression. The gCW was associated with the measured BW and CW. The results demonstrated that the gMS and the gCW may be used as early prediction indexes for meat quality and growth potential of beef cattle.
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Affiliation(s)
- S J Park
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - H Kim
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - M Piao
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - H J Kang
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - D M Fassah
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - D J S Jung
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - S Y Kim
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - S W Na
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - S-H Beak
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - I H Jeong
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - S P Yoo
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - S J Hong
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - D H Lee
- Division of Animal and Dairy Science, Chungnam National University, Daejeon 34134, Republic of Korea
| | - S H Lee
- Division of Animal and Dairy Science, Chungnam National University, Daejeon 34134, Republic of Korea
| | - M N Haque
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - D-J Shin
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - J A Kwon
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - C Jo
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea; Institutes of Green Bio Science Technology, Pyeongchang-daero, Daehwa-myeon, Pyeongchang-gun, Gangwon 25354, Republic of Korea
| | - M Baik
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Science, College of Agriculture and Life Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea; Institutes of Green Bio Science Technology, Pyeongchang-daero, Daehwa-myeon, Pyeongchang-gun, Gangwon 25354, Republic of Korea.
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Ha SH, Ryu JC, Bae JH, Koo S, Kwon B, Lee DH, Chang JY, Kang DW, Kwon SU, Kim JS, Kim BJ. Early Response to Endovascular Thrombectomy after Stroke: Early, Late, and Very Late Time Windows. Cerebrovasc Dis 2023; 52:28-35. [PMID: 35671740 DOI: 10.1159/000525083] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 01/03/2022] [Accepted: 04/26/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND AND PURPOSE Endovascular thrombectomy (EVT) has benefits in selected patients 6-24 h after stroke onset. However, the response to EVT >24 h after stroke onset is still unclear. We compared the early response to EVT in patients with different time windows. METHODS Patients who underwent EVT in an emergency setting were enrolled and categorized according to when EVT was performed: within 6 (early), 6-24 (late), and >24 h (very late) after stroke onset. Early neurological improvement (ENI) and deterioration (END) were defined as improvement and worsening, respectively, of National Institutes of Health Stroke Scale (NIHSS) score by ≥4 points after EVT. The three groups' clinical characteristics and response to EVT were compared. We also investigated factors associated with ENI and END. RESULTS During study period, 274 patients underwent EVT (109 early, 104 late, and 61 very late). Patients who underwent EVT very late were younger (p = 0.007), had smaller ischemic cores, and had lower initial NIHSS scores (8 ± 5) than those who underwent EVT early (14 ± 6) and late (13 ± 7; p < 0.001). Stroke mechanisms also differed according to the time window (p < 0.001): cardioembolism was more common after early EVT, whereas large-artery atherosclerosis was more prevalent among patients who underwent EVT very late. ENI was significantly more common after early (60.6%) and late EVT (51.0%) than after very late EVT (29.5%; p = 0.001); however, rates of END did not differ (11.0%, 13.5%, and 4.9%, respectively). ENI was independently associated with male, higher NIHSS score, and early and late EVT. END was associated with failure of recanalization. CONCLUSIONS ENI was more observed and associated with early and late EVT. Highly selected patients receiving very late EVT may not benefit from ENI but may still have a chance to prevent END. The occurrence of END was associated not with time window but with failure of recanalization.
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Affiliation(s)
- Sang Hee Ha
- Department of Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea,
| | - Jae-Chan Ryu
- Department of Neurology, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea
| | - Jae-Han Bae
- Department of Neurology, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea
| | - Sujin Koo
- Graduate School of Converging Clinical and Public Health, Ewha Womans University, Seoul, Republic of Korea
| | - Boseong Kwon
- Department of Radiology, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea
| | - Deok Hee Lee
- Department of Radiology, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea
| | - Jun Young Chang
- Department of Neurology, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea
| | - Dong-Wha Kang
- Department of Neurology, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea
| | - Sun U Kwon
- Department of Neurology, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea
| | - Jong-Sung Kim
- Department of Neurology, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea
| | - Bum Joon Kim
- Department of Neurology, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea
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Ryu JC, Bae JH, Ha SH, Kwon B, Song Y, Lee DH, Kim BJ, Kang DW, Kwon SU, Kim JS, Chang JY. Association between lipid profile changes and risk of in-stent restenosis in ischemic stroke patients with intracranial stenosis: A retrospective cohort study. PLoS One 2023; 18:e0284749. [PMID: 37163551 PMCID: PMC10171672 DOI: 10.1371/journal.pone.0284749] [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] [Received: 07/14/2022] [Accepted: 04/05/2023] [Indexed: 05/12/2023] Open
Abstract
OBJECTIVE The risk of ischemic stroke with intracranial stenosis is associated with various serum lipid levels. However, the effects of changes in the lipid profile on the risk of in-stent restenosis have not been verified. Therefore, we investigated the association between the occurrence of in-stent restenosis at 12-month follow-up and changes in various lipid profiles. METHODS In this retrospective cohort study, we included ischemic stroke patients who had undergone intracranial stenting for symptomatic intracranial stenosis between February 2010 and May 2020. We collected data about serum low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), and triglyceride (TG) levels, and calculated the TC/HDL-C and LDL-C/HDL-C ratios at baseline and after 12 months. We conducted multivariable logistic regression analyses to verify the association between various lipid profile changes and in-stent restenosis at 12 months. RESULTS Among the 100 patients included in the study (mean age, 60.8 ± 10.0 years; male: 80 [80.0%]), in-stent restenosis was found in 13 (13.0%) patients. The risk of in-stent restenosis of more than 50% was significantly decreased when TC/HDL-C ratio (odds ratio [OR] 0.22, [95% confidence interval (CI) 0.05-0.87]) and LDL-C/HDL-C ratio (OR 0.23, [95% CI 0.06-0.93]) decreased or when HDL-C levels (OR 0.10, [95% CI 0.02-0.63]) were increased at 12 months compared with baseline measurements. CONCLUSIONS Improvement of HDL-C levels, TC/HDL-C ratio, and LDL-C/HDL-C ratio were associated with decreased risk of in-stent restenosis at 12-month follow-up. Management and careful monitoring of various lipid profiles including HDL-C levels, TC/HDL-C ratio, and LDL-C/HDL-C ratio may be important to prevent in-stent restenosis in patients with intracranial stenting.
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Affiliation(s)
- Jae-Chan Ryu
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae-Han Bae
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang Hee Ha
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Boseong Kwon
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yunsun Song
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Deok Hee Lee
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Bum Joon Kim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong-Wha Kang
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sun U Kwon
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong S Kim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jun Young Chang
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Lee KB, Sheen JJ, Yoon JT, Kim MH, Maeng JY, Hwang SM, Choi JH, Lee DH. Feasibility of a silicone vascular phantom replicating real arterial contrast filling dynamics on cerebral angiography: An in-vitro pilot study. PLoS One 2023; 18:e0280395. [PMID: 36649351 PMCID: PMC9844885 DOI: 10.1371/journal.pone.0280395] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 12/28/2022] [Indexed: 01/18/2023] Open
Abstract
Some cerebral arterial silicone phantoms have been used in preclinical evaluations. However, typical silicone-based phantoms are limited in their capacity to reproduce real contrast filling dynamics of the human cerebral artery. This study aimed to develop a cerebral arterial silicone phantom to analyze the feasibility of real contrast filling dynamics. The fluid circulation phantom system consisted of a cerebral arterial silicone phantom without or with additional devices, a pump, an injection system, a pressure-monitoring system, a constant-temperature bath, and a venous drainage container. Vascular resistance was reproduced with a plastic cistern only or a plastic cistern filled with a sponge pad. Three phantom groups were constructed as follows: a) the cerebral arterial silicone phantom used as the control group (type A), b) phantom with the incorporated plastic cistern (type B), and c) phantom with the incorporated plastic cistern filled with a sponge pad (type C). The contrast concentration-time curve patterns of the three groups obtained from digital subtraction angiography (DSA) were compared. Consequently, the DSA pattern of the type C phantom was the most similar to that obtained from the control group as the reference data, which showed the broadest full-width-at-half-maximum and the area under the curve values and the highest maximum contrast concentration. In conclusion, we could emulate the arterial contrast filling dynamics of clinical cerebral angiography by applying a small cistern filled with a sponge pad at the drainage side of the phantom.
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Affiliation(s)
- Ki Baek Lee
- Department of Radiologic Technology, Chungbuk Health & Science University, Cheongju, Republic of Korea
| | - Jae Jon Sheen
- Department of Neurosurgery, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jong-Tae Yoon
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Mi Hyeon Kim
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jun Young Maeng
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sun Moon Hwang
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Joon Ho Choi
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Deok Hee Lee
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- * E-mail:
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Ryu JC, Choi YH, Kim MH, Moon EJ, Kim Y, Kwon B, Song Y, Lee DH. Endovascular Treatment of Arterial Steno-Occlusive Lesions in Symptomatic Moyamoya Disease. Neurointervention 2022; 17:161-167. [PMID: 36217815 PMCID: PMC9626607 DOI: 10.5469/neuroint.2022.00332] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/22/2022] [Indexed: 11/29/2022] Open
Abstract
The efficacy and safety of endovascular treatment (EVT) for moyamoya disease (MMD) have rarely been investigated. The objective of this study was to summarize the clinical outcomes of EVT for MMD and determine the potential role of EVT in treating symptomatic steno-occlusive lesions in MMD. Reports from January 2000 to December 2021 describing EVT in MMD were collected through a literature search. The search terms included “moyamoya”, “stent”, “angioplasty”, and “endovascular”. Data regarding baseline demographics, previous medical history, treated vessel, periprocedural complications, and angiographical recurrence were retrieved. This review included 10 studies with details of 19 patients undergoing a total of 31 EVT procedures. Twenty-one EVTs were performed as initial treatments for MMD, and 10 were performed as additional treatments for angiographical recurrence. The mean follow-up period of the initial EVTs was 9.0±11.9 months, with angiographical recurrence in 11 (68.8%) cases. The mean follow-up period of additional EVTs was 4.3±3.9 months, and seven (70.0%) EVTs showed restenosis of the re-treated vessel. Across all initial and additional EVTs, there were no differences in characteristics between the recurrence and non-recurrence groups. Overall, two periprocedural complications (9.5%) occurred, one vessel rupture and one massive intracerebral hemorrhage with subarachnoid hemorrhage. EVT plays a limited role in the management of symptomatic intracranial arterial steno-occlusive lesions of MMD. Recent advances in understanding the pathomechanism of MMD may urge neuro-interventionists to find a new endovascular approach with better balloon angioplasty or stenting mechanisms.
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Affiliation(s)
- Jae-Chan Ryu
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yun Hyeok Choi
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Mi Hyeon Kim
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Ji Moon
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Youngjin Kim
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Boseong Kwon
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yunsun Song
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Deok Hee Lee
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Ha SH, Ryu JC, Bae JH, Koo S, Kwon B, Song Y, Lee DH, Chang JY, Kang DW, Kwon SU, Kim JS, Kim BJ. High serum total cholesterol associated with good outcome in endovascular thrombectomy for acute large artery occlusion. Neurol Sci 2022; 43:5985-5991. [DOI: 10.1007/s10072-022-06269-4] [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] [Received: 05/01/2022] [Accepted: 07/04/2022] [Indexed: 10/17/2022]
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Lee HJ, Lee DH, Jeon HJ, Lee DH, Yook V, Jeon JY. Development and Validation of the Self-Rating Suicide Risk Screening Questionnaire. Omega (Westport) 2022:302228221119029. [PMID: 35968773 DOI: 10.1177/00302228221119029] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
Since suicide is one of the major health problems worldwide, the goal of the present study is to develop a psychometrically sound suicide risk screening tool named Suicide Screening Questionnaire- Self-Rating (SSQ-SR) to quantify the risk of suicidal behavior. The development process includes item generation, item revision and refinement, and validation. A total sample of 2,238 adults in South Korea was used for analysis. The results of factor analysis showed that the SSQ-SR, containing 25 items, supported a three-factor model: "Situational factors," "Negative self-perceptions and mental health factors," and "Suicidal thoughts and behaviors." Also, SSQ-SR showed satisfying internal consistency, concurrent validity and discriminant validity. Lastly, the results of ROC analysis showed a cut-off point of 33.5 for the low-risk group and 36.5 for the high-risk group. Considering these results, the current results demonstrate the SSQ-SR is a valid scale and therefore can contribute to future suicide-related studies and prevention.
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Affiliation(s)
- Hwa Jung Lee
- Department of Education, Traumatic Stress Center, Sungkyunkwan University, Seoul, Republic of Korea
| | - Dong Hun Lee
- Department of Education, Traumatic Stress Center, Sungkyunkwan University, Seoul, Republic of Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Deok Hee Lee
- Department of Education, Traumatic Stress Center, Sungkyunkwan University, Seoul, Republic of Korea
| | - Vidal Yook
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ji Yeol Jeon
- Department of Education, Traumatic Stress Center, Sungkyunkwan University, Seoul, Republic of Korea
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Kwon B, Lee KB, Yoon JT, Choi JH, Lee DH, Song Y. Safety and Effectiveness of the Novel Catheter 3.0 System for Diagnostic Cerebral Angiography: A Pilot Study. Neurointervention 2022; 17:143-151. [PMID: 35897165 PMCID: PMC9626612 DOI: 10.5469/neuroint.2022.00248] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 07/01/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose The purpose of this study was to evaluate the safety and effectiveness of a new angiographic system (Catheter 3.0 system) using a 5 French (Fr), large-bore angiography catheter, a 0.032-inch stiff guidewire, and a continuous flushing system in diagnostic cerebral angiography. Materials and Methods This retrospective study included 30 consecutive patients who underwent transfemoral cerebral angiography using the Catheter 3.0 system from October 2019 to March 2020. As the control group, we included 30 consecutive patients examined before the Catheter 3.0 system was introduced. Procedural outcomes, including technical success, procedure time, dose metrics, procedure-related complications, and image quality were reviewed and analyzed. Results All transfemoral cerebral angiographies were performed for a diagnosis of unruptured intracranial aneurysms. The Catheter 3.0 system showed a significantly shorter fluoroscopy time (6.2 vs. 9.7 minutes, P=0.008) and lower fluoroscopy dose (387.2 vs. 614.4, P=0.002) compared with the conventional 4-Fr catheter system. The Catheter 3.0 system also showed better results in terms of procedural time (21.0 vs. 22.5 minutes, P=0.072) and technical success rate (98.1% vs. 94.0%, P=0.078), although a statistical significance was not reached. The complication rate and qualitative assessment of the digital subtraction angiography (DSA) image quality were similar between the two groups. Conclusion The Catheter 3.0 system using a 5 Fr catheter with a large inner diameter was convenient, effective, and safe compared with the conventional system in diagnostic cerebrovascular angiography.
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Affiliation(s)
- Boseong Kwon
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ki Baek Lee
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea
| | - Jong-Tae Yoon
- Department of Radiologic Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon Ho Choi
- Department of Radiologic Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Deok Hee Lee
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yunsun Song
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Deniwar MA, Kwon B, Song Y, Park JC, Lee DH. Use of a Rigid-Tipped Microguidewire for the Endovascular Treatment of Cavernous Sinus Dural Arteriovenous Fistulas with an Occluded Inferior Petrosal Sinus. J Korean Neurosurg Soc 2022; 65:688-696. [PMID: 35853478 PMCID: PMC9452388 DOI: 10.3340/jkns.2021.0250] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 11/24/2021] [Indexed: 11/27/2022] Open
Abstract
Objective Transvenous embolization (TVE) via an occluded inferior petrosal sinus (IPS) in a cavernous sinus dural arteriovenous fistula (CSDAVF) is challenging, often requiring navigation of a microcatheter through resistive obstacles between the occluded IPS and shunted pouch (SP), although the reopening technique was successfully performed. We report five cases of successful access to the cavernous sinus (CS) or SP using the rigid-tipped microguidewire such as chronic total occlusion (CTO) wire aiming to share our initial experience with this wire.
Methods In this retrospective study, four patients with CSDAVF underwent five procedures using the CTO wire puncture during transfemoral transvenous coil embolization. Puncture success, shunt occlusion, and complications including any hemorrhage and cranial nerve palsy were evaluated.
Results Despite successful access through the occluded IPS, further entry into the target area using neurointerventional devices was impossible due to a short-segment stricture before the CS (three cases) and a membranous barrier within the CS (two cases). However, puncturing these structures using the rigid-tipped microguidewire was successful in all cases. We could advance the microcatheter over the rigid-tipped microguidewire for the navigation to the SP and achieved complete occlusion of the SP without complications.
Conclusion The use of the rigid-tipped microguidewire in the TVE via the occluded IPS of the CSDAVF would be feasible and safe.
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Affiliation(s)
- Mohamed Adel Deniwar
- Department of Radiology, Research Institutue of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Department of Neurosurgery, Mansoura University Hospitals, Mansoura, Egypt
| | - Boseong Kwon
- Department of Radiology, Research Institutue of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yunsun Song
- Department of Radiology, Research Institutue of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jung Cheol Park
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Deok Hee Lee
- Department of Radiology, Research Institutue of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Keum N, Chen QY, Lee DH, Manson JE, Giovannucci E. Vitamin D supplementation and total cancer incidence and mortality by daily vs. infrequent large-bolus dosing strategies: a meta-analysis of randomised controlled trials. Br J Cancer 2022; 127:872-878. [PMID: 35676320 PMCID: PMC9427835 DOI: 10.1038/s41416-022-01850-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/23/2022] [Accepted: 05/06/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Efficacy of vitamin D supplementation may vary by dosing strategies and adiposity. To address such heterogeneity, we performed a meta-analysis of randomised controlled trials of vitamin D supplementation and total cancer outcomes. METHODS PubMed and Embase were searched through January 2022. Summary relative risk (SRR) and 95% confidence interval (CI) were estimated using the DerSimonian-Laird random-effects model. RESULTS For total cancer incidence (12 trials), the SRR for vitamin D supplementation vs. control group was 0.99 (95% CI, 0.94-1.03; P = 0.54; I2 = 0%). No significant association was observed regardless of whether the supplement was given daily or infrequently in a large-bolus. Yet, among trials testing daily supplementation, a significant inverse association was observed among normal-weight individuals (SRR, 0.76; 95% CI, 0.64-0.90; P = 0.001, I2 = 0%), but not among overweight or obese individuals (Pheterogeneity = 0.02). For total cancer mortality (six trials), the SRR was 0.92 (95% CI, 0.82-1.03; P = 0.17; I2 = 33%). A significant inverse association emerged (SRR, 0.87; 95% CI, 0.78-0.96; P = 0.007; I2 = 0%) among studies testing daily supplementations but not among studies that testing infrequent large-bolus supplementations (Pheterogeneity = 0.09). CONCLUSIONS For vitamin D supplementation, daily dosing, but not infrequent large-bolus dosing, reduced total cancer mortality. For total cancer incidence, bolus dosing did not reduce the risk and the benefits of daily dosing were limited to normal-weight individuals.
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Affiliation(s)
- N Keum
- Department of Food Science and Biotechnology, Dongguk University, Goyang, South Korea. .,Departments of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
| | - Q-Y Chen
- Department of Food Science and Biotechnology, Dongguk University, Goyang, South Korea
| | - D H Lee
- Departments of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - J E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA.,Departments of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - E Giovannucci
- Departments of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.,Departments of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
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Kwon H, Lee D, Lee DH, Suh DC, Kwon SU, Kang DW, Kim JS. Etiology-Related Outcome of Endovascular Therapy in Posterior Circulation Stroke Compared to Anterior Circulation Stroke. J Stroke 2022; 24:245-255. [PMID: 35677979 PMCID: PMC9194548 DOI: 10.5853/jos.2022.01095] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 05/13/2022] [Indexed: 11/23/2022] Open
Abstract
Background and Purpose We investigated the impact of stroke etiology on the endovascular treatment (EVT) procedure and clinical outcome of posterior circulation stroke (PCS) patients with EVT compared to anterior circulation stroke (ACS) patients.
Methods We retrospectively analyzed ischemic stroke patients who underwent EVT between January 2012 and December 2020. Enrolled ACS and PCS patients were compared according to etiologies (intracranial arterial steno-occlusion [ICAS-O], artery-to-artery embolic occlusion [AT-O], and cardioembolic occlusion [CA-O]). EVT procedure and favorable clinical outcomes at 3 months (modified Rankin Scale 0–2) were compared between the ACS and PCS groups for each etiology.
Results We included 419 patients (ACS, 346; PCS, 73) including 88 ICAS-O (ACS, 67; PCS, 21), 66 AT-O (ACS, 50; PCS, 16), and 265 CA-O (ACS, 229; PCS, 36) patients in the study. The onset-to-recanalization time was longer in the PCS group than in the ACS group (median 628.0 minutes vs. 421.0 minutes, P=0.01). In CA-O patients, the door-to-puncture time was longer, whereas the puncture-to-recanalization time was shorter in the PCS group than in the ACS group. The proportions of successful recanalization and favorable clinical outcomes were similar between the ACS and PCS groups for all three etiologies. Low baseline National Institutes of Health Stroke Scale (NIHSS) scores and absence of intracerebral hemorrhage at follow-up imaging were associated with favorable clinical outcomes in both groups, whereas successful recanalization (odds ratio, 11.74; 95% confidence interval, 2.60 to 52.94; P=0.001) was only associated in the ACS group.
Conclusions The proportions of successful recanalization and favorable clinical outcomes were similar among all three etiologies between PCS and ACS patients who underwent EVT. Initial baseline NIHSS score and absence of hemorrhagic transformation were related to favorable outcomes in the PCS and ACS groups, whereas successful recanalization was related to favorable outcomes only in the ACS group.
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Affiliation(s)
- Hanim Kwon
- Department of Neurology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dongwhane Lee
- Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeugbu, Korea
| | - Deok Hee Lee
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dae Chul Suh
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sun U. Kwon
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong-Wha Kang
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong S. Kim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Correspondence: Jong S. Kim Department of Neurology, Stroke Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-3442 Fax: +82-2-474-4691 E-mail:
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Choi E, Gwon JG, Kwon SU, Lee DH, Kwon TW, Cho YP. Management strategy for extracranial carotid artery aneurysms: A single-center experience. Medicine (Baltimore) 2022; 101:e29327. [PMID: 35583543 PMCID: PMC9276323 DOI: 10.1097/md.0000000000029327] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 04/01/2022] [Indexed: 01/04/2023] Open
Abstract
ABSTRACT This single-center, retrospective study aimed to describe the anatomic and clinical characteristics of extracranial carotid artery aneurysms (ECAAs) and to compare various ECAA management strategies in terms of outcomes.A total of 41 consecutive patients, who underwent treatment for ECAAs between November 1996 and May 2020, were included in this study. The ECAAs were anatomically categorized using the Attigah and Peking Union Medical College Hospital (PUMCH) classifications. The possible study outcomes were restenosis or occlusion of the ipsilateral carotid artery after treatment and treatment-associated morbidity or mortality.The 41 patients were stratified into three groups according to the management strategies employed: surgical (n = 25, 61.0%), endovascular (n = 10, 24.4%), and conservative treatment (n = 6, 14.6%). A palpable, pulsatile mass was the most common clinical manifestation (n = 16, 39.0%), and degenerative aneurysms (n = 29, 65.9%) represented the most common pathogenetic or etiological mechanism. According to the Attigah classification, type I ECAAs (n = 24, 58.5%) were the most common. Using the PUMCH classification, type I ECAAs (n = 26, 63.4%) were the most common. There was a higher prevalence of Attigah type I ECAAs among patients who underwent surgical treatment compared with those who underwent endovascular treatment (64.0% vs 40.0%, P = .09), whereas patients with PUMCH type IIa aneurysms were more likely to receive endovascular treatment (12.0% vs 30.0%). False aneurysms were more likely to be treated using endovascular techniques (20% vs 70%, P = 0.02). Except for two early internal carotid artery occlusions (one each among patients who underwent surgical and endovascular treatments, respectively), there were no early or late restenoses or occlusions during follow-up. Cranial nerve injuries were noted in three patients after surgical treatment, and late ipsilateral strokes occurred in two patients (one each among patients who underwent endovascular and conservative treatment, respectively). There were no other treatment-associated complications or deaths during the study period. CONCLUSIONS Both surgical and endovascular treatments could be performed safely for ECAAs with good long-term results according to anatomic location and morphology.
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Affiliation(s)
- Eol Choi
- Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea
| | - Jun Gyo Gwon
- Department of Surgery, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Sun U. Kwon
- Department of Neurology, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea
| | - Deok Hee Lee
- Department of Radiology, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea
| | - Tae-Won Kwon
- Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea
| | - Yong-Pil Cho
- Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea
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Ren S, Wang J, Ying J, Mitsudomi T, Lee DH, Wang Z, Chu Q, Mack PC, Cheng Y, Duan J, Fan Y, Han B, Hui Z, Liu A, Liu J, Lu Y, Ma Z, Shi M, Shu Y, Song Q, Song X, Song Y, Wang C, Wang X, Wang Z, Xu Y, Yao Y, Zhang L, Zhao M, Zhu B, Zhang J, Zhou C, Hirsch FR. Corrigendum to 'Consensus for HER2 Alterations Testing in Non-small Cell Lung Cancer': [ESMO Open Volume 7 Issue 1 (2022) 100395]. ESMO Open 2022; 7:100482. [PMID: 35461023 DOI: 10.1016/j.esmoop.2022.100482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- S Ren
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai
| | - J Wang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
| | - J Ying
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - T Mitsudomi
- Department of Surgery, Kindai University Faculty of Medicine, Osaka, Japan
| | - D H Lee
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Z Wang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
| | - Q Chu
- Department of Oncology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - P C Mack
- Center of Thoracic Oncology/Tisch Cancer Institute and Icahn School of Medicine, Mount Sinai, New York, USA
| | - Y Cheng
- Department of Thoracic Oncology, Jilin Cancer Hospital, Changchun, China
| | - J Duan
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
| | - Y Fan
- Department of Medical Oncology, Cancer Hospital of the University of Chinese Academy of Sciences/Zhejiang Cancer Hospital, Hangzhou
| | - B Han
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai
| | - Z Hui
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
| | - A Liu
- Department of Oncology, The Second Affiliated Hospital of Nanchang University, Nanchang
| | - J Liu
- Department of Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian
| | - Y Lu
- Department of Thoracic Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu; Huaxi Student Society of Oncology Research, West China School of Medicine, Sichuan University, Chengdu
| | - Z Ma
- Department of Respiratory Medicine, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Zhengzhou
| | - M Shi
- Department of Medical Oncology, The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing
| | - Y Shu
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University/Jiangsu Provincial People's Hospital, Nanjing
| | - Q Song
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan
| | - X Song
- Department of Respiration Medicine, Shanxi Provincial Cancer Hospital, Taiyuan
| | - Y Song
- Department of Respiratory Medicine, General Hospital of Eastern Theater Command, Nanjing
| | - C Wang
- Department of Lung Cancer, Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center of Cancer, Tianjin
| | - X Wang
- Department of Oncology, Qilu Hospital of Shandong University, Jinan
| | - Z Wang
- Department of Oncology, Shandong Cancer Hospital and Institute, Jinan
| | - Y Xu
- Department of Radiation Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai
| | - Y Yao
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an
| | - L Zhang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou
| | - M Zhao
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang
| | - B Zhu
- Department of Oncology, Xinqiao Hospital, The Army Medical University, Chongqing, China
| | - J Zhang
- Division of Medical Oncology, Department of Internal Medicine, University of Kansas Medical Center, Kansas City; Department of Cancer Biology, University of Kansas Cancer Center, University of Kansas Medical Center, Kansas City, USA
| | - C Zhou
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai.
| | - F R Hirsch
- Center of Thoracic Oncology/Tisch Cancer Institute and Icahn School of Medicine, Mount Sinai, New York, USA
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Ahn S, Moon DG, Cho S, Lee H, Han DE, Lee DH. Postoperative Progress of Modified Grid Incision and Sealing with Collagen Fleece for Treatment of Peyronie's Disease. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.01.079] [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: 10/18/2022]
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Kim H, Jang J, Song MJ, Kim G, Park CH, Lee DH, Lee SH, Chung JH. Attenuation of intrinsic aging of the skin via elimination of senescent dermal fibroblasts with senolytic drugs. J Eur Acad Dermatol Venereol 2022; 36:1125-1135. [PMID: 35274377 DOI: 10.1111/jdv.18051] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [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: 11/02/2021] [Accepted: 02/15/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Skin aging is caused by numerous factors that result in structural and functional changes in cutaneous components. Research has shown that senescent cells are known to accumulate in skin aging, however, the role of senescent cells in skin aging has not been defined. OBJECTIVES To elucidate the role of senescent cell in skin aging, we evaluated the effect of known senolytic drugs on senescent dermal fibroblasts. METHODS Primary human dermal fibroblasts (HDFs) were induced to senescence by long-term passaging, UV irradiation, and H2O2 treatment. Cell viability was measured after treatment of ABT-263 and ABT-737 on HDFs. Young and aged hairless mice were intradermally injected with drugs or vehicle on the dorsal skin for 10 days. Skin specimens were obtained and reverse-transcription quantitative PCR, western blotting, and histological analysis were performed. RESULTS We found that ABT-263 and ABT-737 induced selective clearance of senescent dermal fibroblasts, regardless of the method of senescence induction. Aged mouse skin treated with ABT-263 or ABT-737 showed increased collagen density, epidermal thickness, and proliferation of keratinocytes, as well as decreased senescence-associated secretory phenotypes, such as MMP-1 and IL-6. CONCLUSIONS Taken together, our results indicate that selective clearance of senescent skin cells can attenuate and improve skin aging phenotypes and that senolytic drugs may be of potential use as new therapeutic agents for treating aging of the skin.
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Affiliation(s)
- H Kim
- Department of Dermatology, Seoul National University College of Medicine.,Department of Biomedical Sciences, Seoul National University Graduate School.,Institute of Human-Environmental Interface Biology, Medical Research Center, Seoul National University
| | - J Jang
- Department of Dermatology, Seoul National University College of Medicine.,Institute of Human-Environmental Interface Biology, Medical Research Center, Seoul National University
| | - M J Song
- Department of Dermatology, Seoul National University College of Medicine.,Department of Biomedical Sciences, Seoul National University Graduate School.,Institute of Human-Environmental Interface Biology, Medical Research Center, Seoul National University
| | - G Kim
- Department of Dermatology, Seoul National University College of Medicine.,Department of Biomedical Sciences, Seoul National University Graduate School.,Institute of Human-Environmental Interface Biology, Medical Research Center, Seoul National University
| | - C-H Park
- Department of Dermatology, Seoul National University College of Medicine.,Institute of Human-Environmental Interface Biology, Medical Research Center, Seoul National University
| | - D H Lee
- Department of Dermatology, Seoul National University College of Medicine.,Institute of Human-Environmental Interface Biology, Medical Research Center, Seoul National University
| | - S-H Lee
- Department of Dermatology, Seoul National University College of Medicine.,Institute of Human-Environmental Interface Biology, Medical Research Center, Seoul National University
| | - J H Chung
- Department of Dermatology, Seoul National University College of Medicine.,Department of Biomedical Sciences, Seoul National University Graduate School.,Institute of Human-Environmental Interface Biology, Medical Research Center, Seoul National University.,Institute on Aging, Seoul National University, Seoul, Republic of Korea
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Lee KB, Jeong S, Lee DH. Idiopathic Intracranial Hypertension in Asians: A New Perspective and the Need for Scrutiny. Neurointervention 2022; 17:65-66. [PMID: 35144327 PMCID: PMC8891586 DOI: 10.5469/neuroint.2021.00507] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 01/26/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Ki Baek Lee
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea
| | - Soo Jeong
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Deok Hee Lee
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Kim JG, Kang CH, Choi JC, Song Y, Suh DC, Lee DH. Clinical Outcomes of Endovascular Treatment for Carotid Artery Dissection Without Intracranial Large Vessel Occlusion in Patients With Cerebral Ischemia Presentation. Front Neurol 2022; 12:713190. [PMID: 35185743 PMCID: PMC8847726 DOI: 10.3389/fneur.2021.713190] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 12/20/2021] [Indexed: 11/13/2022] Open
Abstract
Background and PurposeWe describe the clinical characteristics and outcomes (including the long-term patency of endovascular treatment [EVT]) of patients with acute ischemic strokes (AISs) featuring carotid artery dissection (CAD) but not intracranial large vessel occlusion.MethodsWe retrospectively reviewed patients who underwent EVT for spontaneous or post-traumatic AISs with CAD over a 13 year period from September 2005 to November 2018. The indications for EVT in patients with AIS-related CAD were a pretreatment diffusion-weighted imaging-Alberta Stroke Program early computed tomography (ASPECT) score > 6 and, clinical-diffusion mismatch. But, if the patients showed fluctuated ischemic symptoms, the joint decision by a stroke neurologist and neurointerventionist was done according to the onset-to-door time, symptoms, patient data, and the initial neuroimaging findings whether indicated that EVT was appropriate.ResultsTwenty-two dissected carotid arteries underwent balloon angioplasty and/or stent placement. The patients were 6 women and 16 men of median age 46 years. Twelve lacked any trauma history. Recombinant tissue plasminogen activator was prescribed for two (9.1%) patients. Four developed symptomatic intracranial hemorrhages (18.2%) but 86.4% exhibited modified Rankin scores ≤ 2.ConclusionsAlthough attention to the hemorrhagic complication is required, EVT for selective patients with cerebral ischemia associated with CAD may be safe and acceptable treatment strategy for reconstruction of luminal patency, with good clinical outcomes. Prospective large-scale randomized studies are required to optimize EVT for CAD patients.
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Affiliation(s)
- Joong-Goo Kim
- Department of Neurology, Jeju National University Hospital, School of Medicine, Jeju National University, Jeju, South Korea
| | - Chul-Hoo Kang
- Department of Neurology, Jeju National University Hospital, School of Medicine, Jeju National University, Jeju, South Korea
| | - Jay Chol Choi
- Department of Neurology, Jeju National University Hospital, School of Medicine, Jeju National University, Jeju, South Korea
| | - Yunsun Song
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Dae Chul Suh
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Deok Hee Lee
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
- *Correspondence: Deok Hee Lee
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Lu G, Chung J, Park JC, Ahn JS, Kwun BD, Lee DH. Comparison of Visual Outcomes of Ophthalmic Artery Aneurysms Treated with Microsurgical Clipping and Endovascular Coiling. Neurointervention 2022; 17:18-27. [PMID: 35045591 PMCID: PMC8891588 DOI: 10.5469/neuroint.2020.00185] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 01/04/2022] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Post-treatment visual deficit is a major concern associated with both microsurgical clipping and endovascular coiling for the treatment of ophthalmic artery (OphA) aneurysms of the internal carotid artery. We aimed to compare the safety and effectiveness of the 2 modalities. MATERIALS AND METHODS We retrospectively reviewed and compared the baseline characteristics and postoperative visual and angiographic outcomes of OphA aneurysms treated by clipping or coiling between January 2010 and August 2018 at our hospital. In addition, the balloon occlusion test was performed to evaluate the safety of OphA occlusion. RESULTS This study included 56 aneurysms treated by clipping and 82 aneurysms treated by coiling. Both the immediate and follow-up rates of incomplete aneurysm occlusion were comparable between the 2 groups (21.4% vs. 22.0%; 24.4% vs. 23.6%). The incidence of post-treatment visual deficits was higher in the clipping group than in the coiling group (16.1% vs. 2.4%; P=0.010). We observed total ipsilateral OphA occlusion in 6 patients and near occlusion in 3 patients during endovascular coiling; however, only 1 patient with near OphA occlusion showed a post-treatment visual field defect. CONCLUSION OphA aneurysms treated by endovascular coiling exhibited an aneurysm occlusion rate similar to that of microsurgical clipping with fewer post-treatment visual deficits. The total occlusion of OphA with adequate collaterals did not cause post-treatment visual deficits.
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Affiliation(s)
- Guangdong Lu
- Department of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jaewoo Chung
- Department of Neurosurgery, Dankook University Hospital, Cheonan, Korea
| | - Jung Cheol Park
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Sung Ahn
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Byung Duk Kwun
- Department of Neurosurgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Deok Hee Lee
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Choi YH, Yook V, Yang K, Cho Y, Lee DH, Lee HJ, Lee DH, Jeon HJ. Development and validation study of the suicide screening questionnaire-observer rating (SSQ-OR). Front Psychiatry 2022; 13:945051. [PMID: 36032221 PMCID: PMC9411983 DOI: 10.3389/fpsyt.2022.945051] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/18/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Observer rating scales are necessary to evaluate the risk of suicide because individuals at risk for suicide are often unwilling to seek help on their own. Reliability and validity were evaluated for the newly developed Suicide Screening Questionnaire-Observer Rating (SSQ-OR). METHODS Preliminary items were assessed by 251 experts online and 25 questions were selected. 328 individuals at high-risk and 661 controls from 12 Crisis Response Centers and 5 university counseling centers were recruited to complete SSQ-OR, Beck Scale for Suicide Ideation (BSSI) and Patient Health Questionnaire-9 (PHQ-9). In a 6 months follow-up, we reached out to 176 participants to ask whether they had experienced a suicidal thought, plan, or attempt since the baseline assessment. Cronbach's α, Mann-Whitney U test, Spearman's correlation, factor analyses, Receiver operating characteristic (ROC) analysis and logistic regression analysis were used to verify the SSQ-OR. RESULTS Structural validity was supported by a two-factor solution using exploratory and confirmatory factor analyses. Excellent model fit indices for the two-factor structure using exploratory factor analysis were confirmed (RMSEA = 0.033, TLI = 0.980, CFI = 0.983). The SSQ-OR demonstrated strong internal consistency. The concurrent validity based on the correlations with other self-reported indicators of suicidal potential-BSSI and PHQ-9- revealed substantial relationships. The high-risk group was effectively characterized by a cut-off point of 4, with a sensitivity of 0.73 and a specificity of 0.79. The SSQ-OR scores were significant predictors of suicidal thoughts and behaviors within 6 months. CONCLUSIONS The SSQ-OR exhibits sound psychometric properties, and could be used as a complement to a self-report or clinical-administered scale to screen suicide risk comprehensively.
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Affiliation(s)
- Young-Hwan Choi
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Vidal Yook
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kyojin Yang
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Yaehee Cho
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Deok Hee Lee
- Department of Education, Traumatic Stress Center, Sungkyunkwan University College of Education, Seoul, South Korea
| | - Hwa Jung Lee
- Department of Education, Traumatic Stress Center, Sungkyunkwan University College of Education, Seoul, South Korea
| | - Dong Hun Lee
- Department of Education, Traumatic Stress Center, Sungkyunkwan University College of Education, Seoul, South Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, South Korea
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Niu J, Maurice-Dror C, Lee DH, Kim DW, Nagrial A, Voskoboynik M, Chung HC, Mileham K, Vaishampayan U, Rasco D, Golan T, Bauer TM, Jimeno A, Chung V, Chartash E, Lala M, Chen Q, Healy JA, Ahn MJ. First-in-human phase 1 study of the anti-TIGIT antibody vibostolimab as monotherapy or with pembrolizumab for advanced solid tumors, including non-small cell lung cancer. Ann Oncol 2021; 33:169-180. [PMID: 34800678 DOI: 10.1016/j.annonc.2021.11.002] [Citation(s) in RCA: 108] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/25/2021] [Accepted: 11/05/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND In this first-in-human phase 1 study, we investigated the safety and efficacy of the anti-TIGIT antibody vibostolimab as monotherapy or in combination with pembrolizumab. METHODS Part A enrolled patients with advanced solid tumors and part B enrolled patients with non-small cell lung cancer (NSCLC). Patients received vibostolimab 2.1-700 mg alone or with pembrolizumab 200 mg in part A and vibostolimab 200 mg alone or with pembrolizumab 200 mg in part B. Primary end points were safety and tolerability. Secondary end points included pharmacokinetics and objective response rate (ORR) per RECIST v1.1. RESULTS Part A enrolled 76 patients (monotherapy, 34; combination therapy, 42). No dose-limiting toxicities were reported. Across doses, 56% of patients receiving monotherapy and 62% receiving combination therapy had treatment-related adverse events (TRAEs); grade 3-4 TRAEs occurred in 9% and 17% of patients, respectively. The most common TRAEs were fatigue (15%) and pruritus (15%) with monotherapy and pruritus (17%) and rash (14%) with combination therapy. Confirmed ORR was 0% with monotherapy and 7% with combination therapy. In part B, 39 patients had anti-PD-1/PD-L1-naïve NSCLC (all received combination therapy) and 67 had anti-PD-1/PD-L1-refractory NSCLC (monotherapy, 34; combination therapy, 33). In patients with anti-PD-1/PD-L1-naive NSCLC: 85% had TRAEs-the most common were pruritus (38%) and hypoalbuminemia (31%); confirmed ORR was 26%, with responses occurring in both PD-L1-positive and PD-L1-negative tumors. In patients with anti-PD-1/PD-L1‒refractory NSCLC: 56% receiving monotherapy and 70% receiving combination therapy had TRAEs-the most common were rash and fatigue (21% each) with monotherapy and pruritus (36%) and fatigue (24%) with combination therapy; confirmed ORR was 3% with monotherapy and 3% with combination therapy. CONCLUSION Vibostolimab plus pembrolizumab was well tolerated and demonstrated antitumor activity in patients with advanced solid tumors, including patients with advanced NSCLC.
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Affiliation(s)
- J Niu
- Medical Oncology, Banner MD Anderson Cancer Center, Gilbert, USA.
| | - C Maurice-Dror
- Medical Oncology Division, Rambam Health Care Campus, Haifa, Israel
| | - D H Lee
- Department of Oncology, Asan Medical Center, Seoul, South Korea
| | - D-W Kim
- Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, South Korea
| | - A Nagrial
- Medical Oncology, Blacktown Hospital, Blacktown, Australia; Medical Oncology, University of Sydney, Sydney, Australia
| | - M Voskoboynik
- Alfred Health and Monash University, Melbourne, Australia
| | - H C Chung
- Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - K Mileham
- Levine Cancer Institute, Atrium Health, Charlotte, USA
| | - U Vaishampayan
- Oncology/Internal Medicine, Karmanos Cancer Center, Detroit, USA
| | - D Rasco
- START Center for Cancer Care, San Antonio, USA
| | - T Golan
- The Oncology Institute, Sheba Medical Center at Tel-Hashomer, Tel Aviv University, Tel Aviv, Israel
| | - T M Bauer
- Drug Development, Sarah Cannon Research Institute/Tennessee Oncology, PLLC, Nashville, USA
| | - A Jimeno
- Medicine, University of Colorado, Anschutz Cancer Pavilion, Aurora, USA
| | - V Chung
- Medical Oncology, City of Hope National Medical Center, Duarte, USA
| | - E Chartash
- Oncology Early Development, Merck & Co., Inc., Kenilworth, NJ, USA
| | - M Lala
- OED-QP2IO, Merck & Co., Inc., Kenilworth, NJ, USA
| | - Q Chen
- BARDS, Merck & Co., Inc., Kenilworth, NJ, USA
| | - J A Healy
- Oncology Early Development, Merck & Co., Inc., Kenilworth, NJ, USA
| | - M-J Ahn
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Kim BJ, Lee Y, Kwon B, Chang JY, Song YS, Lee DH, Kwon SU, Kim JS, Kang DW. Clinical-Diffusion Mismatch Is Associated with Early Neurological Improvement after Late-Window Endovascular Treatment. Cerebrovasc Dis 2021; 51:331-337. [PMID: 34638120 DOI: 10.1159/000519310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 05/03/2021] [Accepted: 08/25/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Clinical-diffusion mismatch (CDM) and perfusion-diffusion mismatch (PDM) are used to select patients for endovascular thrombectomy (EVT) in the late-window period. As CDM well reflects true penumbra, we hypothesized that patients with CDM and PDM would respond better to EVT than those with PDM only at the late-window period. METHODS Acute ischemic stroke patients who received EVT 6-24 h after stroke onset were included. PDM (perfusion-/diffusion-weighted image (DWI) lesion volume >1.8) was used to select candidates for EVT in this time-period in our center. CDM was defined according to the DAWN trial criteria. Response to EVT was compared between patients with and without CDM. Early neurological improvement (ENI) was defined as improvement >4 points on National Institutes of Health Stroke Scale (NIHSS) score 1 day after EVT. Multivariable analysis was performed to investigate independent factors associated with ENI. The correlation between DWI lesion volume and NIHSS score was investigated in those with and without CDM. RESULTS Among 94 patients enrolled, all patients had PDM and 44 (46.3%) had CDM. Forty-eight patients (51.1%) showed ENI. The prevalence of hypertension, initial NIHSS score, improvement in NIHSS score after EVT, and prevalence of ENI were greater in patients with CDM than those without. ENI was independently associated with onset-to-door time (odds ratio [95% confidence interval]: 0.998 [0.997-1.000]; p = 0.042), complete recanalization (23.912 [2.238-255.489]; p = 0.009), initial NIHSS score (1.180 [1.012-1.377]; p = 0.034), and the presence of CDM (5.160 [1.448-18.386]; p = 0.011). The correlation between DWI lesion volume and initial NIHSS score was strong in patients without CDM (r = 0.731) but only moderate in patients with CDM (r = 0.355). CONCLUSION Patients with both CDM and PDM had a better response to late-window EVT than those with PDM only.
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Affiliation(s)
- Bum Joon Kim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yoojin Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Boseong Kwon
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.,Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jun Young Chang
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yun Sun Song
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Deok Hee Lee
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sun U Kwon
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jong S Kim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Dong-Wha Kang
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Choi SY, Hong JY, Kim HJ, Lee GY, Cheong SH, Jung HJ, Bang CH, Lee DH, Jue MS, Kim HO, Park EJ, Ko JY, Son SW. Mask-induced dermatoses during the COVID-19 pandemic: a questionnaire-based study in 12 Korean hospitals. Clin Exp Dermatol 2021; 46:1504-1510. [PMID: 34081799 PMCID: PMC8239570 DOI: 10.1111/ced.14776] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/20/2021] [Accepted: 05/31/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND During the coronavirus disease 2019 (COVID-19) pandemic, various adverse skin reactions to long-term mask wearing have been reported. AIM To assess the clinical features of mask-induced dermatoses and to recommend prevention and treatment options. METHODS From April to August 2020, questionnaires including topics such as demographic information, pre-existing skin disorders, reported mask-related symptoms, daily mask-wearing duration and frequency, types of masks used and whether the participant was a healthcare worker, were distributed to patients in 12 hospitals. Dermatologists assessed skin lesions, confirmed diagnosis and recorded treatments. RESULTS Itchiness was the most frequent symptom, mostly affecting the cheeks. The most common skin disease was new-onset contact dermatitis (33.94%), followed by new-onset acne (16.97%) and worsening of pre-existing acne (16.97%). Daily wearing of masks was significantly (P = 0.02) associated with new-onset contact dermatitis. More than half of patients with pre-existing skin problems experienced disease worsening while wearing masks. Longer duration of wearing (> 6 h/day, P = 0.04) and use of cotton masks (P < 0.001) significantly increased acne flare-up. Healthcare workers had a higher incidence of skin disease. Skin lesions were generally mild and well tolerated with topical treatment. The study had some limitations: the effect of seasonal characteristics and other risk factors were not assessed, and the patients were visiting dermatological clinics and had interest in their skin status, thus, there may have been selection bias. CONCLUSION Mask-induced/-triggered dermatoses contribute to increase the dermatological burden during the pandemic.
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Affiliation(s)
- S Y Choi
- Department of Dermatology, Ilsan Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - J Y Hong
- Department of Dermatology, Chungnam National University Sejong Hospital, Chungnam National University College of Medicine, Sejong, Korea
| | - H J Kim
- Department of Dermatology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - G-Y Lee
- Department of Dermatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S H Cheong
- Department of Dermatology, Konyang University, Daejeon, Korea
| | - H J Jung
- Department of Dermatology, National Medical Center, Seoul, Korea
| | - C H Bang
- Department of Dermatology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - D H Lee
- Department of Dermatology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - M-S Jue
- Department of Dermatology, Veterans Health Service Medical Center, Seoul, Korea
| | - H O Kim
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
| | - E J Park
- Department of Dermatology, College of Medicine, Hallym University, Seoul, Korea
| | - J Y Ko
- Department of Dermatology, Hanyang University College of Medicine and Hanyang University Seoul Hospital, Seoul, Korea
| | - S W Son
- Department of Dermatology, Korea University College of Medicine, Seoul, Korea
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Cho SH, Denewar M, Park W, Ahn JS, Kwun BD, Lee DH, Park JC. Corrigendum to "Intraprocedural Rupture of Unruptured Cerebral Aneurysms During Coil Embolization: A Single-Center Experience" [World Neurosurgery 105 (2017) 177-183]. World Neurosurg 2021; 149:511. [PMID: 33744167 DOI: 10.1016/j.wneu.2021.02.082] [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] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Su Hee Cho
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Mohammed Denewar
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Wonhyoung Park
- Department of Neurosurgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jae Sung Ahn
- Department of Neurosurgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Byung Duk Kwun
- Department of Neurosurgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Deok Hee Lee
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jung Cheol Park
- Department of Neurosurgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
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Al-Abdulwahhab AH, Lee DH, Song Y, Suh DC. Staged Approach for Stent-Assisted Coiling of Cerebral Aneurysms after Failure of Initial Intra-Saccular Catheterization. Neurointervention 2021; 16:46-51. [PMID: 33618505 PMCID: PMC7946552 DOI: 10.5469/neuroint.2020.00374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 02/03/2021] [Indexed: 11/28/2022] Open
Abstract
Purpose Microcatheter navigation into an aneurysm sac can present difficulties through negative interactions between the deployed stent mesh and microcatheter. We hypothesized that endothelialization of the stent mesh would minimize these interactions. We aimed to assess the feasibility of staged coiling after stenting by reviewing our experiences with unavoidably staged embolization cases. Materials and Methods Between 2011 and 2019, 7 patients (mean age 57.2 years, range 49–76 years) including 5 females, experienced 9 unruptured aneurysms treated with staged stenting and coiling due to unstable microcatheter navigation into the aneurysm after stent placement. The aneurysms were in the paraclinoid internal carotid artery (ICA) (n=3), ophthalmic origin ICA (n=1), superior cerebellar artery origin (n=2), basilar tip (n=2), and the middle cerebral artery bifurcation (n=1). The stents used were the Neuroform Atlas (n=4), Neuroform EZ (n=2), and Low-profile Visualized Intraluminal Support Blue (n=1). Results The mean interval between stenting and coiling was 15 weeks (range, 12–21 weeks). The average navigation time between the first roadmap imaging and microcatheter insertion in the sac was 14 minutes (range, 8–20 minutes). One aneurysm was occluded without further coiling on follow-up. Staged coiling successfully treated the remaining aneurysms (n=8). No complications were identified. Conclusion In cases of difficult intra-saccular catheterization, intentional staged coiling may be a feasible option for stent-assisted coiling of the cerebral aneurysms.
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Affiliation(s)
- Abdulrahman Hamad Al-Abdulwahhab
- Diagnostic and Interventional Radiology Department, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar City, Saudi Arabia
| | - Deok Hee Lee
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yunsun Song
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dae Chul Suh
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Kwon B, Song Y, Hwang SM, Choi JH, Maeng J, Lee DH. Injection of contrast media using a large-bore angiography catheter with a guidewire in place: Physical factors influencing injection pressure in cerebral angiography. Interv Neuroradiol 2020; 27:558-565. [PMID: 33307913 DOI: 10.1177/1591019920980876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND We have used a contrast injection scheme termed as "guided catheterization method (guided method)." By using a large-bore 5-Fr catheter and 0.032-in guidewire, a contrast medium could be injected without removing the guidewire. Using a neurovascular phantom, we studied the influence of leaving the guidewire on the contrast injection pressure. Image quality was compared with that obtained using a 4-Fr regular angiography catheter (conventional method). METHODS Actual contrast injection pressure, flow rate, flow volume, and several variables from the time-density curve (TDC) were obtained using the guided method and the conventional method. Catheterization parameters included flow rate, the viscosity of a contrast medium (CM), and catheter length. The pressure limit of a contrast injector was set as 1200 psi. Digital subtraction angiography (DSA) images on the neurovascular phantom were acquired. The DSA images were processed, and TDC on a specific region of interest was obtained. Variables from TDC were calculated and compared between the different catheters. RESULTS The ranges of actual contrast injection pressure with the conventional and the guided method were 138-299 psi and 184-451 psi, respectively. A minimal reduction of the actual flow rate was found under some conditions with the guided method. Comparable opacifications in DSA images were achieved in all conditions. Although peak intensity was different by flow rate or CM, all TDC variables did not differ based on the catheter. There were no significant harmful events during the 90 experiments. CONCLUSIONS With adjustment of the pressure limit, cerebral angiography using the 5-Fr, large-bore catheter without removal of the guidewire is feasible, safe, and expected to provide image quality comparable to that of the 4-Fr regular catheter.
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Affiliation(s)
- Boseong Kwon
- Department of Radiology, Research Institute of Radiology, 65526Asan Medical Center, 37994University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yunsun Song
- Department of Radiology, Research Institute of Radiology, 65526Asan Medical Center, 37994University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seon Moon Hwang
- Department of Radiology, Research Institute of Radiology, 65526Asan Medical Center, 37994University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Joon Ho Choi
- Department of Radiology, Research Institute of Radiology, 65526Asan Medical Center, 37994University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Junyoung Maeng
- Department of Radiology, Research Institute of Radiology, 65526Asan Medical Center, 37994University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Deok Hee Lee
- Department of Radiology, Research Institute of Radiology, 65526Asan Medical Center, 37994University of Ulsan College of Medicine, Seoul, Republic of Korea
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Yim Y, Jung SC, Kim JY, Kim SO, Kim BJ, Lee DH, Park W, Park JC, Ahn JS. Added diagnostic values of three-dimensional high-resolution proton density-weighted magnetic resonance imaging for unruptured intracranial aneurysms in the circle-of-Willis: Comparison with time-of-flight magnetic resonance angiography. PLoS One 2020; 15:e0243235. [PMID: 33270756 PMCID: PMC7714200 DOI: 10.1371/journal.pone.0243235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 05/08/2020] [Accepted: 11/17/2020] [Indexed: 01/18/2023] Open
Abstract
Background Advanced imaging methods can enhance the identification of aneurysms of the infundibula, which can reduce unnecessary follow-ups or further work-up, fear, and anxiety in patients. Purpose This study aimed to evaluate the added diagnostic value of three-dimensional proton density-weighted vessel wall magnetic resonance imaging (3D-PD MRI) in identifying aneurysms from index lesions refer to vascular bulging lesions without vessels arising from the apex, observed using volume-rendered TOF-MRA in the circle-of-Willis compared with time-of-flight magnetic resonance angiography (TOF-MRA). Study type Retrospective. Population A total of 299 patients who underwent 3D-PD MRI, digital subtraction angiography (DSA), and TOF-MRA between January 2012 and December 2016 were retrospectively enrolled in this study. Field strength/sequence 3 Tesla, 3D-PD MRI. Assessment Three neuroradiologists independently evaluated TOF-MRA and 3D-PD MRI combined with TOF-MRA for the determination of intracranial aneurysms in patients with index lesions within the circle of Willis. Final diagnoses were made by another neuroradiologist and neurointerventionist in consensus using DSA as the reference standard. The diagnostic performance and proportions of undetermined lesions on TOF-MRA and 3D-PD MRI with TOF-MRA were assessed based on the final diagnoses. Statistical tests The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the diagnosis of unruptured intracranial aneurysms were calculated for each imaging modality. Results Of 452 lesions identified on volume-rendered TOF-MRA images, 173 (38%) aneurysms and 276 (61%) infundibula were finally diagnosed on DSA. 3D-PD MRI with TOF-MRA showed superior diagnostic performance (p = .001; accuracy, 85.5% versus 95.4%), superior area under the receiver operating characteristic curve over TOF-MRA (p = .001; 0.837 versus 0.947), and a lower proportion of undetermined lesions than TOF-MRA (p = .001; 25.1% versus 2.3%). Data conclusion For unruptured intracranial aneurysms in the circle of Willis, 3D-PD MRI can complement TOF-MRA to improve diagnostic performance and lower the proportion of undetermined lesions.
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Affiliation(s)
- Younghee Yim
- Department of Radiology, Chung-Ang University Hospital, Seoul, Korea
| | - Seung Chai Jung
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
- * E-mail:
| | - Jung Youn Kim
- Department of Radiology, Kangbuk Samsung Hospital, Seoul, Korea
| | - Seon-Ok Kim
- Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Byung Jun Kim
- Department of Radiology, University of Korea College of Medicine, Seoul, Korea
| | - Deok Hee Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Wonhyoung Park
- Department of Neurosurgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jung Cheol Park
- Department of Neurosurgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jae Sung Ahn
- Department of Neurosurgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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50
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Perets R, Bar J, Rasco DW, Ahn MJ, Yoh K, Kim DW, Nagrial A, Satouchi M, Lee DH, Spigel DR, Kotasek D, Gutierrez M, Niu J, Siddiqi S, Li X, Cyrus J, Chackerian A, Chain A, Altura RA, Cho BC. Safety and efficacy of quavonlimab, a novel anti-CTLA-4 antibody (MK-1308), in combination with pembrolizumab in first-line advanced non-small-cell lung cancer. Ann Oncol 2020; 32:395-403. [PMID: 33276076 DOI: 10.1016/j.annonc.2020.11.020] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [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: 06/04/2020] [Revised: 11/13/2020] [Accepted: 11/20/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Quavonlimab (MK-1308), a novel anti-CTLA-4 antibody, in combination with pembrolizumab was investigated in a phase I study. PATIENTS AND METHODS Dose-escalation (DE) phase: patients with advanced/metastatic solid tumors received an initial flat dose of quavonlimab as monotherapy [25 mg (cohort 1), 75 mg (cohort 2), or 200 mg (cohort 3)] followed by four treatments of the same quavonlimab dose plus pembrolizumab every 3 weeks (Q3W). Dose-confirmation phase (DC): patients with stage IIIB/IV non-small-cell lung cancer (NSCLC) received first-line quavonlimab [25 mg Q3W (arm A), 25 mg Q6W (arm B), 75 mg Q6W (arm C), or 75 mg Q3W (arm E)] plus pembrolizumab. Primary objectives were safety and tolerability and establishment of the recommended phase II dose (RP2D) of quavonlimab when used with pembrolizumab. Objective response rate (ORR) was a secondary endpoint. Efficacy based on PD-L1 expression, tumor mutational burden (TMB), and changes in circulating CD4+/CD8+ cells were exploratory endpoints. RESULTS Thirty-nine patients were enrolled in DE [n = 14 (cohort 1); n = 17 (cohort 2); n = 8 (cohort 3)] and 134 in DC [n = 40 (arm A); n = 40 (arm B); n = 40 (arm C); n = 14 (arm E)]. Maximum-tolerated dose was not reached. Grade 3-5 treatment-related adverse events (AEs; graded according to NCI CTCAE v4.03) occurred in 0%, 23.5%, and 75.0% of patients in DE cohorts 1, 2, and 3, respectively, and 35.0%, 30.0%, 35.0%, and 57.1% of patients in DC arms A, B, C, and E, respectively. Efficacy was observed at all dose levels/schedules in patients with NSCLC. ORRs were 40.0% [95% confidence interval (CI), 24.9-56.7; arm A], 37.5% (95% CI, 22.7-54.2; arm B), 27.5% (95% CI, 14.6-43.9; arm C), and 35.7% (95% CI, 12.8-64.9; arm E). PD-L1 expression and total number of circulating CD4+ cells correlated with ORR. CONCLUSIONS Quavonlimab 25 mg Q6W plus pembrolizumab demonstrated similar efficacy and a better safety profile among all quavonlimab doses/schedules evaluated; this regimen was the chosen RP2D.
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Affiliation(s)
- R Perets
- Department of Oncology, Rambam Medical Center, Technion-Israel Institute of Technology, Haifa, Israel
| | - J Bar
- Cancer Center, Chaim Sheba Medical Center at Tel HaShomer, Ramat Gan, and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | | | - M-J Ahn
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University of Medicine, Seoul, South Korea
| | - K Yoh
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - D-W Kim
- Department of Hemato Oncology, Medical Oncology Center, and Personalized Cancer Medicine Center, Seoul National University Hospital, Seoul, South Korea
| | - A Nagrial
- Department of Cancer and Hematology, Blacktown Hospital and University of Sydney, Sydney, Australia
| | - M Satouchi
- Department of Thoracic Oncology, Hyogo Cancer Center, Akashi, Japan
| | - D H Lee
- Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - D R Spigel
- Department of Medical Oncology, Sarah Cannon Research Institute/Tennessee Oncology, PLLC, Nashville, USA
| | - D Kotasek
- Department of Medical Oncology, Adelaide Cancer Centre and University of Adelaide, Kurralta Park, Australia
| | - M Gutierrez
- Department of Hematology, Hematology Oncology, and Medical Oncology, Hackensack University Medical Center, Hackensack, USA
| | - J Niu
- Department of Medical Oncology, Banner MD Anderson Cancer Center, Gilbert, USA
| | - S Siddiqi
- MRL, Merck & Co., Inc., Kenilworth, NJ, Kenilworth, USA
| | - X Li
- MRL, Merck & Co., Inc., Kenilworth, NJ, Kenilworth, USA
| | - J Cyrus
- MRL, Merck & Co., Inc., Kenilworth, NJ, Kenilworth, USA
| | - A Chackerian
- Department of Discovery Oncology, Merck & Co., Inc., Kenilworth, USA
| | - A Chain
- MRL, Merck & Co., Inc., Kenilworth, NJ, Kenilworth, USA
| | - R A Altura
- MRL, Merck & Co., Inc., Kenilworth, NJ, Kenilworth, USA
| | - B C Cho
- Division of Medical Oncology, Yonsei Cancer Center, Seoul, South Korea.
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