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Lee J, Lee DK, Kwon WK, Lee S, Oh CS, Görlinger K, Kim TY. Effect of ultrafiltration on whole blood coagulation profile during cardiopulmonary bypass in cardiac surgery: a retrospective analysis. Korean J Anesthesiol 2024; 77:236-245. [PMID: 38287212 PMCID: PMC10982537 DOI: 10.4097/kja.23698] [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: 09/21/2023] [Revised: 01/02/2024] [Accepted: 01/07/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Ultrafiltration (UF) would enhance coagulation profiles by concentrating coagulation elements during cardiopulmonary bypass (CPB) for cardiac surgery. METHODS We retrospectively reviewed electronic medical records of 75 patients who had undergone cardiac surgery with rotational thromboelastometry-based coagulation management in a university hospital and analyzed the UF-induced changes in the maximum clot firmness (MCF) of extrinsically activated test with tissue factor (EXTEM) during CPB in 30 patients. RESULTS The median volume of filtered-free water was 1,350 ml, and median hematocrit was significantly increased from 22.5% to 25.5%. As the primary measure, UF significantly increased the median MCF-EXTEM from 48.0 mm to 50.5 mm (P = 0.015, effect size r = 0.44). The area under the receiver operating characteristic curve pre-UF MCF-EXTEM for discrimination of any increase of MCF-EXTEM after applying UF was 0.89 (95% CI [0.77, 1.00], P < 0.001), and its cut-off value was 50.5 mm (specificity of 81.8% and sensitivity of 84.2% in Youden's J statistic). In the secondary analyses using the cut-off value, UF significantly increased the median MCF-EXTEM from 40.5 mm to 42.5 mm in 18 patients with pre-UF MCF-EXTEM ≤ 50.5 mm. However, it did not increase MCF-EXTEM in 12 patients with pre-UF MCF-EXTEM > 50.5 mm. There was a significant interaction between pre-UF MCF-EXTEM values and applying UF (P < 0.001 for the subgroup, P = 0.046 for UF, P = 0.003 for interaction). CONCLUSIONS Applying UF improved clot firmness, and the improvement was more pronounced when pre-UF MCF-EXTEM had been reduced during CPB.
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Affiliation(s)
- Jaemoon Lee
- Department of Anesthesiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Dong-Kyu Lee
- Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Won-Kyoung Kwon
- Department of Anesthesiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Sookyung Lee
- Department of Anesthesiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Chung-Sik Oh
- Department of Anesthesiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Klaus Görlinger
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, Essen, Germany
- Medical Department, TEM Innovations GmbH/Werfen PBM, Munich, Germany
| | - Tae-Yop Kim
- Department of Anesthesiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
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Park S, Shim M, Lee G, You YA, Kim SM, Hur YM, Ko H, Park MH, Na SH, Kim YH, Cho GJ, Bae JG, Lee SJ, Lee SH, Lee DK, Kim YJ. Urinary metabolite biomarkers of pregnancy complications associated with maternal exposure to particulate matter. Reprod Toxicol 2024; 124:108550. [PMID: 38280687 DOI: 10.1016/j.reprotox.2024.108550] [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: 11/22/2023] [Revised: 01/02/2024] [Accepted: 01/23/2024] [Indexed: 01/29/2024]
Abstract
Particulate matter 2.5 (PM2.5) is associated with reproductive health and adverse pregnancy outcomes. However, studies evaluating biological markers of PM2.5 are lacking, and identifying biomarkers for estimating prenatal exposure to prevent pregnancy complications is essential. Therefore, we aimed to explore urine metabolites that are easy to measure as biomarkers of exposure. In this matched case-control study based on the PM2.5 exposure, 30 high PM2.5 group (>15 μg/m3) and 30 low PM2.5 group (<15 μg/m3) were selected from air pollution on pregnancy outcome (APPO) cohort study. We used a time-weighted average model to estimate individual PM exposure, which used indoor PM2.5 and outdoor PM2.5 concentrations by atmospheric measurement network based on residential addresses. Clinical characteristics and urine samples were collected from participants during the second trimester of pregnancy. Urine metabolites were quantitatively measured using gas chromatography-mass spectrometry following multistep chemical derivatization. Statistical analyses were conducted using SPSS version 21 and MetaboAnalyst 5.0. Small for gestational age and gestational diabetes (GDM) were significantly increased in the high PM2.5 group, respectively (P = 0.042, and 0.022). Fifteen metabolites showed significant differences between the two groups (P < 0.05). Subsequent pathway enrichment revealed that four pathways, including pentose and glucuronate interconversion with three pentose sugars (ribose, arabinose, and xylose; P < 0.05). The concentration of ribose increased preterm births (PTB) and GDM (P = 0.044 and 0.049, respectively), and the arabinose concentration showed a tendency to increase in PTB (P = 0.044). Therefore, we identified urinary pentose metabolites as biomarkers of PM2.5 and confirmed the possibility of their relationship with pregnancy complications.
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Affiliation(s)
- Sunwha Park
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, Korea
| | - Minki Shim
- College of Pharmacy, Chung-Ang University, Seoul, Korea
| | - Gain Lee
- Graduate program in system health science and engineering, Ewha Womans University, Seoul, Korea
| | - Young-Ah You
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, Korea
| | - Soo Min Kim
- Graduate program in system health science and engineering, Ewha Womans University, Seoul, Korea
| | - Young Min Hur
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, Korea
| | - Hyejin Ko
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, Korea
| | - Mi Hye Park
- Department of Obstetrics and Gynecology, Ewha Womans University Seoul Hospital, Korea
| | - Sung Hun Na
- Department of Obstetrics and Gynecology, Kangwon National University, School of Medicine, Korea
| | - Young-Han Kim
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Korea
| | - Geum Joon Cho
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Korea
| | - Jin-Gon Bae
- Department of Obstetrics and Gynecology, Keimyung University, School of Medicine, Dongsan Medical Center, Korea
| | - Soo-Jeong Lee
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Korea
| | | | - Dong-Kyu Lee
- College of Pharmacy, Chung-Ang University, Seoul, Korea.
| | - Young Ju Kim
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, Korea; Graduate program in system health science and engineering, Ewha Womans University, Seoul, Korea.
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Lee HJ, Kim D, Choi HJ, Kim S, Shin M, Kwak S, Lee DK, Kang WH. Potential role of the cell-penetrating peptide-conjugated soluble N-ethylmaleimide-sensitive factor attachment protein receptor motif of vesicle-associated membrane protein 2-patterned peptide in novel cosmeceutical skin product development. J Cosmet Dermatol 2024; 23:666-675. [PMID: 37698157 DOI: 10.1111/jocd.15984] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 05/08/2023] [Revised: 07/26/2023] [Accepted: 08/21/2023] [Indexed: 09/13/2023]
Abstract
AIM This study aimed to investigate and verify the effect of cell-penetrating peptide (CPP)-conjugated soluble N-ethylmaleimide-sensitive factor attachment protein receptor (SNARE) motif of vesicle-associated membrane protein 2 (VAMP2)-patterned peptide (INCI name: Acetyl sh-Oligopeptide-26 sh-Oligopeptide-27 SP, trade name: M.Biome-BT) on improving skin function in vitro. METHODS The cytotoxicity of CPP-conjugated SNARE motif of VAMP2-patterned peptide (CVP) was investigated using the 3-(4,5-dimethylthiazol-2yl)-2,5-diphenyl tetrazolium bromide (MTT) assay against B16-F10 cells and human dermal fibroblasts (HDFs) and a reconstructed skin irritation test. The anti-wrinkle activity of M.Biome-BT was determined by assessing the release of norepinephrine and dopamine in PC-12 cells via ELISA. The skin-whitening effects of CVP were assessed in B16-F10 cells by measuring the intra- and extracellular melanin contents and expression levels of melanin production-related genes, such as microphthalmia-associated transcription factor (MITF), tyrosinase (TYR), tyrosinase-related protein-1 (TRP-1), and TRP-2. RESULTS CVP is not cytotoxic to B16-F10 cells and HDFs, and no skin irritation was observed. CVP treatment considerably diminished K+ -induced norepinephrine and dopamine secretion compared with the non-treated control group (62% and 40%, respectively). Additionally, the inhibition ability of CVP on norepinephrine and dopamine release was comparable to that of botulinum neurotoxin type A (BoNT/A). CVP also increased intracellular melanin content in a dose-dependent manner, whereas extracellular melanin content decreased (76%-85%). However, CVP treatment did not affect the mRNA expression of MITF, TYR, TRP-1, and TRP-2. These results suggest that CVP does not inhibit melanin production; however, it may induce a whitening effect by inhibiting melanin transport. CONCLUSIONS Taken together, our findings indicate that CVP could be used as an active and safe cosmeceutical ingredient for antiaging applications.
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Affiliation(s)
- Hyo Jin Lee
- Gwanggyo R&D Center, Medytox Inc., Suwon-si, Korea
| | - Daehoon Kim
- Gwanggyo R&D Center, Medytox Inc., Suwon-si, Korea
| | | | - Suhyeok Kim
- Gwanggyo R&D Center, Medytox Inc., Suwon-si, Korea
| | - Minhee Shin
- Gwanggyo R&D Center, Medytox Inc., Suwon-si, Korea
| | | | - Dong-Kyu Lee
- Gwanggyo R&D Center, Medytox Inc., Suwon-si, Korea
| | - Won-Ho Kang
- Gwanggyo R&D Center, Medytox Inc., Suwon-si, Korea
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Lee C, Lee DK, Wei IA, Qiu TA, Rubakhin SS, Roper MG, Sweedler JV. Relations between Glucose and d-Amino Acids in the Modulation of Biochemical and Functional Properties of Rodent Islets of Langerhans. ACS Omega 2023; 8:47723-47734. [PMID: 38144114 PMCID: PMC10733910 DOI: 10.1021/acsomega.3c05983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 11/06/2023] [Accepted: 11/10/2023] [Indexed: 12/26/2023]
Abstract
The cell-to-cell signaling role of d-amino acids (d-AAs) in the mammalian endocrine system, particularly in the islets of Langerhans, has drawn growing interest for their potential involvement in modulating glucose metabolism. Previous studies found colocalization of serine racemase [produces d-serine (d-Ser)] and d-alanine (d-Ala) within insulin-secreting beta cells and d-aspartate (d-Asp) within glucagon-secreting alpha cells. Expressed in the islets, functional N-methyl-d-aspartate receptors are involved in the modulation of glucose-stimulated insulin secretion and have binding sites for several d-AAs. However, knowledge of the regulation of d-AA levels in the islets during glucose stimulation as well as the response of islets to different levels of extracellular d-AAs is limited. In this study, we determined the intracellular and extracellular levels of d-Ser, d-Ala, and d-Asp in cultures of isolated rodent islets exposed to different levels of extracellular glucose. We found that the intracellular levels of the enantiomers demonstrated large variability and, in general, were not affected by extracellular glucose levels. However, significantly lower levels of extracellular d-Ser and d-Ala were observed in the islet media supplemented with 20 mM concentration of glucose compared to the control condition utilizing 3 mM glucose. Glucose-induced oscillations of intracellular free calcium concentration ([Ca2+]i), a proxy for insulin secretion, were modulated by the exogenous application of d-Ser and d-Ala but not by their l-stereoisomers. Our results provide new insights into the roles of d-AAs in the biochemistry and function of pancreatic islets.
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Affiliation(s)
- Cindy
J. Lee
- Department
of Chemistry and the Beckman Institute, University of Illinois Urbana-Champaign, Urbana, Illinois 61801, United States
| | - Dong-Kyu Lee
- Department
of Chemistry and the Beckman Institute, University of Illinois Urbana-Champaign, Urbana, Illinois 61801, United States
| | - I-An Wei
- Department
of Chemistry and Biochemistry, Florida State
University, Tallahassee, Florida 32306, United States
| | - Tian A. Qiu
- Department
of Chemistry and the Beckman Institute, University of Illinois Urbana-Champaign, Urbana, Illinois 61801, United States
| | - Stanislav S. Rubakhin
- Department
of Chemistry and the Beckman Institute, University of Illinois Urbana-Champaign, Urbana, Illinois 61801, United States
| | - Michael G. Roper
- Department
of Chemistry and Biochemistry, Florida State
University, Tallahassee, Florida 32306, United States
| | - Jonathan V. Sweedler
- Department
of Chemistry and the Beckman Institute, University of Illinois Urbana-Champaign, Urbana, Illinois 61801, United States
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Buchholz V, Hazard R, Lee DK, Liu DS, Zhang W, Chen S, Aly A, Barnett S, Le P, Weinberg L. Textbook outcomes after oesophagectomy: a single-centre observational study. BMC Surg 2023; 23:368. [PMID: 38066440 PMCID: PMC10704701 DOI: 10.1186/s12893-023-02253-7] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 10/28/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Textbook outcomes is a composite quality assurance tool assessing the ideal perioperative and postoperative course as a unified measure. Currently, its definition and application in the context of oesophagectomy in Australia is unknown. The aim of this study was to assess the textbook outcomes after oesophagectomy in a single referral centre of Australia and investigate the association between textbook outcomes and patient, tumour, and treatment characteristics. METHODS An observational study was retrospectively performed on patients undergoing open, laparoscopic, or hybrid oesophagectomy between January 2010 and December 2019 in a single cancer referral centre. A textbook outcome was defined as the fulfillment of 10 criteria: R0 resection, retrieval of at least 15 lymph nodes, no intraoperative complications, no postoperative complications greater than Clavien-Dindo grade III, no anastomotic leak, no readmission to the ICU, no hospital stay beyond 21 days, no mortality within 90 days, no readmission related to the surgical procedure within 30 days from admission and no reintervention related to the surgical procedure. The proportion of patients who met each criterion for textbook outcome was calculated and compared. Selected patient-related parameters (age, gender, BMI, ASA score, CCI score), tumour-related factors (tumour location, tumour histology, AJCC clinical T and N stage and treatment-related factor [neoadjuvant chemotherapy and surgical approach]) were assessed. Disease recurrence and one year survival were also evaluated. RESULTS 110 patients who underwent oesophagectomy were included. The overall textbook outcome rate was 24%. The difference in rates across the years was not statistically significant. The most achieved textbook outcome parameters were 'no mortality in 90 days' (96%) and 'R0 resection' (89%). The least frequently met textbook outcome parameter was 'no severe postoperative complications' (58%), followed by 'no hospital stays over 21 days' (61%). No significant association was found between patient, tumour and treatment characteristics and the rate of textbook outcome. Tumour recurrence rate and overall long term survival was similar between textbook outcome and non-textbook outcome groups. Patients with R0 resection, no intraoperative complication and a hospital stay less than 21 days had reduced mortality rates. CONCLUSIONS Textbook outcome is a clinically relevant indicator and was achieved in 24% of patients. Severe complications and a prolonged hospital stay were the key criteria that limited the achievement of a textbook outcome. These findings provide meticulous evaluation of oesophagectomy perioperative care and provide a direction for the utilisation of this concept in identifying and improving surgical and oncological care across multiple healthcare levels.
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Affiliation(s)
- Vered Buchholz
- Department of Surgery, Austin Health, University of Melbourne, Heidelberg, Melbourne, Australia
| | - Riley Hazard
- Department of Anesthesia, Austin Health, Melbourne, VIC, Australia
| | - Dong-Kyu Lee
- Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - David S Liu
- Department of Surgery, Austin Health, University of Melbourne, Heidelberg, Melbourne, Australia
- General and Gastrointestinal Surgery Research and Trials Group, The University of Melbourne, Austin, USA
- Division of Cancer Surgery, The Peter MacCallum Cancer Centre, Melbourne, Precinct, VIC, Australia
| | - Wendell Zhang
- Department of Anesthesia, Austin Health, Melbourne, VIC, Australia
| | - Sharon Chen
- Department of Anesthesia, Austin Health, Melbourne, VIC, Australia
| | - Ahmed Aly
- Department of Surgery, Austin Health, University of Melbourne, Heidelberg, Melbourne, Australia
| | - Stephen Barnett
- Department of Surgery, Austin Health, University of Melbourne, Heidelberg, Melbourne, Australia
| | - Peter Le
- Division of Cancer Surgery, The Peter MacCallum Cancer Centre, Melbourne, Precinct, VIC, Australia
| | - Laurence Weinberg
- Department of Surgery, Austin Health, University of Melbourne, Heidelberg, Melbourne, Australia.
- Department of Anesthesia, Austin Health, Melbourne, VIC, Australia.
- Department of Critical Care, University of Melbourne, Victoria, Australia.
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Buchholz V, Hazard R, Yin Z, Tran N, Yip SWS, Le P, Kioussis B, Hinton J, Liu DS, Lee DK, Weinberg L. The impact of intraoperative and postoperative fluid balance on complications for transthoracic esophagectomy: a retrospective analysis. BMC Res Notes 2023; 16:315. [PMID: 37932807 PMCID: PMC10629189 DOI: 10.1186/s13104-023-06574-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: 06/03/2023] [Accepted: 10/13/2023] [Indexed: 11/08/2023] Open
Abstract
OBJECTIVE Transthoracic esophagectomy is associated with significant morbidity and mortality. Therefore, it is imperative to optimize perioperative management and minimize complications. In this retrospective analysis, we evaluated the association between fluid balance and esophagectomy complications at a tertiary hospital in Melbourne, Australia, with a particular focus on respiratory morbidity and anastomotic leaks. Cumulative fluid balance was calculated intraoperatively, postoperatively in recovery postoperative day (POD) 0, and on POD 1 and 2. High and low fluid balance was defined as greater than or less than the median fluid balance, respectively, and postoperative surgical complications were graded using the Clavien-Dindo classification. RESULTS In total, 109 patients, with an average age of 64 years, were included in this study. High fluid balance on POD 0, POD1 and POD 2 was associated with a higher incidence of anastomotic leak (OR 8.59; 95%CI: 2.64-39.0). High fluid balance on POD 2 was associated with more severe complications (of any type) (OR 3.33; 95%CI: 1.4-8.26) and severe pulmonary complications (OR 3.04; 95%CI: 1.27-7.67). For every 1 L extra cumulative fluid balance in POD 1, the odds of a major complication increase by 15%, while controlling for body mass index (BMI) and American Society of Anaesthesiologists (ASA) class. The results show that higher cumulative fluid balance is associated with worsening postoperative outcomes in patients undergoing transthoracic esophagectomy. Restricted fluid balance, especially postoperatively, may mitigate the risk of postoperative complications - however prospective trials are required to establish this definitively.
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Affiliation(s)
- Vered Buchholz
- Department of Surgery, Austin Health, University of Melbourne, Melbourne, Australia
| | - Riley Hazard
- Department of Anesthesia, Austin Health, Melbourne, Australia
| | - Zoe Yin
- Department of Anesthesia, Austin Health, Melbourne, Australia
| | - Nghiep Tran
- Department of Anesthesia, Austin Health, Melbourne, Australia
| | | | - Peter Le
- Department of Anesthesia, Austin Health, Melbourne, Australia
| | | | - Jake Hinton
- Department of Anesthesia, Austin Health, Melbourne, Australia
| | - David S Liu
- Department of Surgery, Austin Health, University of Melbourne, Melbourne, Australia
- General and Gastrointestinal Surgery Research Group, The University of Melbourne, Austin Precinct, Melbourne, Australia
| | - Dong-Kyu Lee
- Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Laurence Weinberg
- Department of Anesthesia, Austin Health, Melbourne, Australia.
- Department of Critical Care, University of Melbourne, Melbourne, Australia.
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Weinberg L, Scurrah N, Neal-Williams T, Zhang W, Chen S, Slifirski H, Liu DS, Armellini A, Aly A, Clough A, Lee DK. The transit of oral premedication beyond the stomach in patients undergoing laparoscopic sleeve gastrectomy: a retrospective observational multicentre study. BMC Surg 2023; 23:335. [PMID: 37924061 PMCID: PMC10625241 DOI: 10.1186/s12893-023-02246-6] [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] [Accepted: 10/21/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Antiemetic and analgesic oral premedications are frequently prescribed preoperatively to enhance recovery after laparoscopic sleeve gastrectomy. However, it is unknown whether these medications transit beyond the stomach or if they remain in the sleeve resection specimen, thereby negating their pharmacological effects. METHODS A retrospective cohort study was performed on patients undergoing laparoscopic sleeve gastrectomy and receiving oral premedication (slow-release tapentadol and netupitant/palonosetron) as part of enhanced recovery after bariatric surgery program. Patients were stratified into the Transit group (premedication absent in the resection specimen) and Failure-to-Transit group (premedication present in the resection specimen). Age, sex, body mass index, and presence of diabetes were compared amongst the groups. The premedication lead time (time between premedications' administration and gastric specimen resection), and the premedication presence or absence in the specimen was evaluated. RESULTS One hundred consecutive patients were included in the analysis. Ninety-nine patients (99%) were morbidly obese, and 17 patients (17%) had Type 2 diabetes mellitus. One hundred patients (100%) received tapentadol and 89 patients (89%) received netupitant/palonosetron. One or more tablets were discovered in the resected specimens of 38 patients (38%). No statistically significant differences were observed between the groups regarding age, sex, diabetes, or body mass index. The median (Q1‒Q3) premedication lead time was 80 min (57.8‒140.0) in the Failure-to-Transit group and 119.5 min (85.0‒171.3) in the Transit group; P = 0.006. The lead time required to expect complete absorption in 80% of patients was 232 min (95%CI:180‒310). CONCLUSIONS Preoperative oral analgesia and antiemetics did not transit beyond the stomach in 38% of patients undergoing laparoscopic sleeve gastrectomy. When given orally in combination, tapentadol and netupitant/palonosetron should be administered at least 4 h before surgery to ensure transition beyond the stomach. Future enhanced recovery after bariatric surgery guidelines may benefit from the standardization of premedication lead times to facilitate increased absorption. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry; number ACTRN12623000187640; retrospective registered on 22/02/2023.
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Affiliation(s)
- Laurence Weinberg
- Department of Anesthesia, Austin Health, Heidelberg, Australia.
- Department of Critical Care, The University of Melbourne, Austin Health, Heidelberg, Australia.
| | - Nick Scurrah
- Department of Anesthesia, Austin Health, Heidelberg, Australia
| | | | - Wendell Zhang
- Department of Anesthesia, Austin Health, Heidelberg, Australia
| | - Sharon Chen
- Department of Anesthesia, Austin Health, Heidelberg, Australia
| | - Hugh Slifirski
- Department of Anesthesia, Austin Health, Heidelberg, Australia
| | - David S Liu
- Department of Surgery, Austin Health, University of Melbourne, Heidelberg, Australia
- General and Gastrointestinal Surgery Research Group, The University of Melbourne, Austin Precinct, Heidelberg, Australia
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Parkville, Australia
| | | | - Ahmad Aly
- Department of Surgery, Austin Health, University of Melbourne, Heidelberg, Australia
| | - Anthony Clough
- Department of Surgery, Box Hill Hospital, Box Hill, Australia
- Melbourne Centre for Bariatric Surgery, Melbourne, Australia
| | - Dong-Kyu Lee
- Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
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Kwak S, Lee JY, Kim MJ, Lee HJ, Lee DK, Kang J, Kang WH, Son WC, Cruz DJM. Combination of PD-1 Checkpoint Blockade and Botulinum Toxin Type A1 Improves Antitumor Responses in Mouse Tumor Models of Melanoma and Colon Carcinoma. Immunol Invest 2023; 52:749-766. [PMID: 37403798 DOI: 10.1080/08820139.2023.2232403] [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: 07/06/2023]
Abstract
BACKGROUND Tumor innervation has been shown to be utilized by some solid cancers to support tumor initiation, growth, progression, and metastasis, as well as confer resistance to immune checkpoint blockade through suppression of antitumor immunologic responses. Since botulinum neurotoxin type A1 (BoNT/A1) blocks neuronal cholinergic signaling, its potential use as an anticancer drug in combination with anti-PD-1 therapy was investigated in four different syngeneic mouse tumor models. METHODS Mice implanted with breast (4T1), lung (LLC1), colon (MC38), and melanoma (B16-F10) tumors were administered a single intratumoral injection of 15 U/kg BoNT/A1, repeated intraperitoneal injections of 5 mg/kg anti-PD-1 (RMP1-14), or both. RESULTS Compared to the single-agent treatments, anti-PD-1 and BoNT/A1 combination treatment elicited significant reduction in tumor growth among B16-F10 and MC38 tumor-bearing mice. The combination treatment also lowered serum exosome levels in these mice compared to the placebo control group. In the B16-F10 syngeneic mouse tumor model, anti-PD-1 + BoNT/A1 combination treatment lowered the proportion of MDSCs, negated the increased proportion of Treg cells, and elicited a higher number of tumor-infiltrating CD4+ and CD8+ T lymphocytes into the tumor microenvironment compared to anti-PD-1 treatment alone. CONCLUSION Our findings demonstrate the synergistic antitumor effects of BoNT/A1 and PD-1 checkpoint blockade in mouse tumor models of melanoma and colon carcinoma. These findings provide some evidence on the potential application of BoNT/A1 as an anticancer drug in combination with immune checkpoint blockade and should be further explored.
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Affiliation(s)
- Seongsung Kwak
- Pharmacology and Toxicology Department, Medytox Gwanggyo R&D Center, Yeongtong-gu, Suwon-si, Republic of Korea
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ji-Young Lee
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Min Ju Kim
- Pharmacology and Toxicology Department, Medytox Gwanggyo R&D Center, Yeongtong-gu, Suwon-si, Republic of Korea
| | - Hyo Jin Lee
- Pharmacology and Toxicology Department, Medytox Gwanggyo R&D Center, Yeongtong-gu, Suwon-si, Republic of Korea
| | - Dong-Kyu Lee
- Pharmacology and Toxicology Department, Medytox Gwanggyo R&D Center, Yeongtong-gu, Suwon-si, Republic of Korea
| | - Jiyeon Kang
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Won-Ho Kang
- Medytox Korea Co. Ltd., Medytox Gwanggyo R&D Center, Yeongtong-gu, Suwon-si, Republic of Korea
| | - Woo-Chan Son
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Deu John M Cruz
- Pharmacology and Toxicology Department, Medytox Gwanggyo R&D Center, Yeongtong-gu, Suwon-si, Republic of Korea
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9
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Ratnasekara V, Weinberg L, Johnston SA, Fletcher L, Nugraha P, Cox DRA, Hu R, Meyer I, Yoshino O, Perini MV, Muralidharan V, Nikfarjam M, Lee DK. Multimodal intrathecal analgesia (MITA) with morphine for reducing postoperative opioid use and acute pain following hepato-pancreato-biliary surgery: A multicenter retrospective study. PLoS One 2023; 18:e0291108. [PMID: 37682837 PMCID: PMC10490836 DOI: 10.1371/journal.pone.0291108] [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: 05/04/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
INTRODUCTION The optimal analgesic modality for patients undergoing hepato-pancreato-biliary (HPB) surgery remains unknown. The analgesic effects of a multimodal intrathecal analgesia (MITA) technique of intrathecal morphine (ITM) in combination with clonidine and bupivacaine compared to ITM alone have not been investigated in these patients. METHODS We performed a multicenter retrospective study of patients undergoing complex HPB surgery who received ITM, bupivacaine, and clonidine (MITA group) or ITM-only (ITM group) as part of their perioperative analgesia strategy. The primary outcome was the unadjusted oral morphine equivalent daily dose (oMEDD) in milligrams on postoperative day 1. After adjusting for age, body mass index, hospital allocation, type of surgery, operation length, and intraoperative opioid use, postoperative oMEDD use was investigated using a bootstrapped quantile regression model. Other prespecified outcomes included postoperative pain scores, opioid-related adverse events, major complications, and length of hospital stay. RESULTS In total, 118 patients received MITA and 155 patients received ITM-only. The median (IQR) cumulative oMEDD use on postoperative day 1 was 20.5 mg (8.6:31.0) in the MITA group and 52.1 mg (18.0:107.0) in the ITM group (P < 0.001). There was a variation in the magnitude of the difference in oMEDD use between the groups for different quartiles. For the MITA group, on postoperative day 1, patients in the 25th percentile required 14.0 mg less oMEDD (95% CI: -25.9 to -2.2; P = 0.025), patients in the 50th percentile required 27.8 mg less oMEDD (95% CI: -49.7 to -6.0; P = 0.005), and patients in the 75th percentile required 38.7 mg less oMEDD (95% CI: -72.2 to -5.1; P = 0.041) compared to patients in the same percentile of the ITM group. Patients in the MITA group had significantly lower pain scores in the postoperative recovery unit and on postoperative days 1 to 3. The incidence of postoperative respiratory depression was low (<1.5%) and similar between groups. Patients in the MITA group had a significantly higher incidence of postoperative hypotension requiring vasopressor support. However, no significant differences were observed in major postoperative complications, or the length of hospital stay. CONCLUSION In patients undergoing complex HPB surgery, the use of MITA, consisting of ITM in combination with intrathecal clonidine and bupivacaine, was associated with reduced postoperative opioid use and resulted in superior postoperative analgesia without risk of respiratory depression when compared to patients who received ITM alone. A randomized prospective clinical trial investigating these two intrathecal analgesic techniques is justified.
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Affiliation(s)
| | - Laurence Weinberg
- Department of Anaesthesia, Austin Health, Heidelberg, Australia
- Department of Critical Care, The University of Melbourne, Austin Health, Heidelberg, Australia
| | | | - Luke Fletcher
- Department of Anaesthesia, Austin Health, Heidelberg, Australia
- Department of Critical Care, The University of Melbourne, Austin Health, Heidelberg, Australia
- Data Analytics Research and Evaluation (DARE) Centre, Austin Health, Heidelberg, Australia
| | - Patrick Nugraha
- Department of Anaesthesia, Austin Health, Heidelberg, Australia
| | | | - Raymond Hu
- Department of Anaesthesia, Austin Health, Heidelberg, Australia
| | - Ilonka Meyer
- Department of Anaesthesia, Austin Health, Heidelberg, Australia
| | - Osamu Yoshino
- Department of Surgery, Austin Health, The University of Melbourne, Melbourne, Australia
| | - Marcos Vinius Perini
- Department of Surgery, Austin Health, The University of Melbourne, Melbourne, Australia
| | | | - Mehrdad Nikfarjam
- Department of Surgery, Austin Health, The University of Melbourne, Melbourne, Australia
| | - Dong-Kyu Lee
- Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
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10
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Qiu TA, Lee CJ, Huang C, Lee DK, Rubakhin SS, Romanova EV, Sweedler JV. Biodistribution and racemization of gut-absorbed L/D-alanine in germ-free mice. Commun Biol 2023; 6:851. [PMID: 37587187 PMCID: PMC10432453 DOI: 10.1038/s42003-023-05209-y] [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: 01/02/2023] [Accepted: 08/03/2023] [Indexed: 08/18/2023] Open
Abstract
Microbiome-derived metabolites are important for the microbiome-gut-brain axis and the discovery of new disease treatments. D-Alanine (D-Ala) is found in many animals as a potential co-agonist of the N-methyl-D-aspartate receptors (NMDAR), receptors widely used in the nervous and endocrine systems. The gut microbiome, diet and putative endogenous synthesis are the potential sources of D-Ala in animals, although there is no direct evidence to show the distribution and racemization of gut-absorbed L-/D-Ala with regards to host-microbe interactions in mammals. In this work, we utilized germ-free mice to control the interference from microbiota and isotopically labeled L-/D-Ala to track their biodistribution and racemization in vivo. Results showed time-dependent biodistribution of gut-absorbed D-Ala, particularly accumulation of gut-absorbed D-Ala in pancreatic tissues, brain, and pituitary. No endogenous synthesis of D-Ala via racemization was observed in germ-free mice. The sources of D-Ala in mice were revealed as microbiota and diet, but not endogenous racemization. This work indicates the importance of further investigating the in vivo biological functions of gut-microbiome derived D-Ala, particularly on NMDAR-related activities, for D-Ala as a potential signaling molecules in the microbiome-gut-brain axis.
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Affiliation(s)
- Tian Autumn Qiu
- Department of Chemistry, University of Illinois Urbana-Champaign, Urbana, IL, USA
- Beckman Institute, University of Illinois Urbana-Champaign, Urbana, IL, USA
- Department of Chemistry, Michigan State University, East Lansing, MI, USA
| | - Cindy J Lee
- Department of Chemistry, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Chen Huang
- Neuroscience Program, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Dong-Kyu Lee
- Department of Chemistry, University of Illinois Urbana-Champaign, Urbana, IL, USA
- College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea
| | - Stanislav S Rubakhin
- Department of Chemistry, University of Illinois Urbana-Champaign, Urbana, IL, USA
- Beckman Institute, University of Illinois Urbana-Champaign, Urbana, IL, USA
- Neuroscience Program, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Elena V Romanova
- Department of Chemistry, University of Illinois Urbana-Champaign, Urbana, IL, USA
- Beckman Institute, University of Illinois Urbana-Champaign, Urbana, IL, USA
- Neuroscience Program, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Jonathan V Sweedler
- Department of Chemistry, University of Illinois Urbana-Champaign, Urbana, IL, USA.
- Beckman Institute, University of Illinois Urbana-Champaign, Urbana, IL, USA.
- Neuroscience Program, University of Illinois Urbana-Champaign, Urbana, IL, USA.
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Ludski J, Carp B, Makar T, Yii M, Lee DK, Weinberg L. Outcomes and complications of nonagenarians undergoing cardiac surgery: a scoping review protocol. BMJ Open 2023; 13:e072293. [PMID: 37463807 PMCID: PMC10357299 DOI: 10.1136/bmjopen-2023-072293] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
INTRODUCTION Continually rising life expectancy and a shift towards an ageing population are resulting in an increasing population of nonagenarians. By 2030, the global population of nonagenarians is expected to exceed 30 million. The incidence of symptomatic cardiac disease is reported to occur in 25% of those aged over 75 years. Therefore, the number of nonagenarians undergoing cardiac surgery is also expected to increase. A linear relationship between advanced age and surgical risk has previously been demonstrated; however, it is not yet known whether this knowledge extends to the perioperative course and mortality of nonagenarians undergoing cardiac surgery. This scoping review aims to review the literature, assess whether a deficiency exists in the published literature and potentially identify knowledge gaps to guide future efforts to improve the understanding of nonagenarians undergoing cardiac surgery. METHODS AND ANALYSIS Following the relevant aspects of the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Review guidelines, electronic databases of MEDLINE, EMBASE and the Cochrane Library will be systematically searched, with additional reference tracking of eligible studies. Studies reporting the outcomes of nonagenarians undergoing open cardiac surgery or minimally invasive cardiac surgery requiring cardiopulmonary bypass will be included. Screening and data extraction will be performed by two reviewers independently. The data will be analysed and summarised descriptively with a narrative approach. Qualitative data that capture quality-of-life outcomes will be subjected to thematic analysis where feasible. Additionally, reporting results will highlight similarities and differences in nonagenarian selection for surgery. ETHICS AND DISSEMINATION Ethics approval was not required. The findings will be disseminated through professional networks, conference presentations and publications in scientific journals.
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Affiliation(s)
- Jarryd Ludski
- Department of Anesthesia, Austin Health, Heidelberg, Victoria, Australia
| | - Bradly Carp
- Department of Anesthesia, Austin Health, Heidelberg, Victoria, Australia
| | - Tim Makar
- Department of Anesthesia, Austin Health, Heidelberg, Victoria, Australia
| | - Michael Yii
- Department of Cardiac Surgery, Epworth Eastern Hospital, Box Hill, Victoria, Australia
| | - Dong-Kyu Lee
- Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Korea (the Republic of)
| | - Laurence Weinberg
- Department of Anesthesia, Austin Health, Heidelberg, Victoria, Australia
- Department of Critical Care, University of Melbourne, Parkville, Victoria, Australia
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Belletti A, Lee DK, Yanase F, Naorungroj T, Eastwood GM, Bellomo R, Weinberg L. Changes in SedLine-derived processed electroencephalographic parameters during hypothermia in patients undergoing cardiac surgery with cardiopulmonary bypass. Front Cardiovasc Med 2023; 10:1084426. [PMID: 37469479 PMCID: PMC10352607 DOI: 10.3389/fcvm.2023.1084426] [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: 10/30/2022] [Accepted: 06/19/2023] [Indexed: 07/21/2023] Open
Abstract
Objective Processed electroencephalography (pEEG) is used to monitor depth-of-anesthesia during cardiopulmonary bypass (CPB). The SedLine device has been recently introduced for pEEG monitoring. However, the effect of hypothermia on its parameters during CPB is unknown. Accordingly, we aimed to investigate temperature-induced changes in SedLine-derived pEEG parameters during CPB. Design Prospective observational study. Setting Cardiac surgery operating theatre. Participants 28 patients undergoing elective cardiac surgery with CPB. Interventions We continuously measured patient state index (PSI), suppression ratio (SR), bilateral spectral edge frequency (SEF) and temperature. We used linear mixed modelling with fixed and random effects to study the interactions between pEEG parameters and core temperature. Measurements and main results During CPB maintenance, the median temperature was 32.1°C [interquartile range (IQR): 29.8-33.6] at the end of cooling and 32.8°C (IQR: 30.1-34.0) at rewarming initiation. For each degree Celsius change in temperature during cooling and rewarming the PSI either decreased by 0.8 points [95% confidence interval (CI): 0.7-1.0; p < 0.001] or increased by 0.7 points (95% CI: 0.6-0.8; p < 0.001). The SR increased by 2.9 (95% CI: 2.3-3.4); p < 0.001) during cooling and decreased by 2.2 (95% CI: 1.7-2.7; p < 0.001) during rewarming. Changes in the SEF were not related to changes in temperature. Conclusions During hypothermic CPB, temperature changes led to concordant changes in the PSI. The SR increased during cooling and decreased during rewarming. Clinicians using SedLine for depth-of-anesthesia monitoring should be aware of these effects when interpreting the PSI and SR values.
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Affiliation(s)
- Alessandro Belletti
- Department of Intensive Care, Austin Hospital, Heidelberg, VIC, Australia
- Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Dong-Kyu Lee
- Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Fumitaka Yanase
- Department of Intensive Care, Austin Hospital, Heidelberg, VIC, Australia
- Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia
| | - Thummaporn Naorungroj
- Department of Intensive Care, Austin Hospital, Heidelberg, VIC, Australia
- Department of Intensive Care, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Glenn M. Eastwood
- Department of Intensive Care, Austin Hospital, Heidelberg, VIC, Australia
| | - Rinaldo Bellomo
- Department of Intensive Care, Austin Hospital, Heidelberg, VIC, Australia
- Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia
- Department of Critical Care, The University of Melbourne, Melbourne, VIC, Australia
- Data Analytics Research and Evaluation Centre, The University of Melbourne and The Austin Hospital, Melbourne, VIC, Australia
| | - Laurence Weinberg
- Department of Critical Care, The University of Melbourne, Melbourne, VIC, Australia
- Department of Anaesthesia, Austin Hospital, Heidelberg, VIC, Australia
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13
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Lee DK, Rubakhin SS, Sweedler JV. Chemical Decrosslinking-Based Peptide Characterization of Formaldehyde-Fixed Rat Pancreas Using Fluorescence-Guided Single-Cell Mass Spectrometry. Anal Chem 2023; 95:6732-6739. [PMID: 37040477 DOI: 10.1021/acs.analchem.3c00612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Approaches for the characterization of proteins/peptides in single cells of formaldehyde-fixed (FF) tissues via mass spectrometry (MS) are still under development. The lack of a general method for selectively eliminating formaldehyde-induced crosslinking is a major challenge. A workflow is shown for the high-throughput peptide profiling of single cells isolated from FF tissues, here the rodent pancreas, which possesses multiple peptide hormones from the islets of Langerhans. The heat treatment is enhanced by a collagen-selective multistep thermal process assisting efficient isolation of islets from the FF pancreas and, subsequently, their dissociation into single islet cells. Hydroxylamine-based chemical decrosslinking helped restore intact peptide signals from individual isolated cells. Subsequently, an acetone/glycerol-assisted cell dispersion was optimized for spatially resolved cell deposition onto glass slides, while a glycerol solution maintained the hydrated state of the cells. This sample preparation procedure allowed peptide profiling in FF single cells by fluorescence-guided matrix-assisted laser desorption ionization MS. Here, 2594 single islet cells were analyzed and 28 peptides were detected, including insulin C-peptides and glucagon. T-distributed stochastic neighbor embedding (t-SNE) data visualization demonstrated that cells cluster based on cell-specific pancreatic peptide hormones. This workflow expands the sample availability for single-cell MS characterization to a wide range of formaldehyde-treated tissue specimens stored in biobanks.
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Affiliation(s)
- Dong-Kyu Lee
- Department of Chemistry, University of Illinois Urbana-Champaign, Urbana, Illinois 61801, United States
| | - Stanislav S Rubakhin
- Department of Chemistry, University of Illinois Urbana-Champaign, Urbana, Illinois 61801, United States
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, Illinois 61801, United States
| | - Jonathan V Sweedler
- Department of Chemistry, University of Illinois Urbana-Champaign, Urbana, Illinois 61801, United States
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, Illinois 61801, United States
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14
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Weinberg L, Aitken SAA, Kaldas P, Fletcher L, Lloyd-Donald P, Le P, Do D, Caruana CB, Walpole D, Ischia J, Ma R, Tan CO, Lee DK. Postoperative complications and hospital costs following open radical cystectomy: A retrospective study. PLoS One 2023; 18:e0282324. [PMID: 36827411 PMCID: PMC9956632 DOI: 10.1371/journal.pone.0282324] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 02/10/2023] [Indexed: 02/26/2023] Open
Abstract
OBJECTIVES To evaluate primarily the relationship between postoperative complications and hospital costs, and secondarily the relationship between postoperative complications and mortality, following radical cystectomy. METHODS Postoperative complications were retrospectively examined for 147 patients undergoing radical cystectomy at a university hospital between January 2012 and July 2021. Complications were defined and graded using the Clavien-Dindo classification system. In-hospital cost was calculated using an activity-based costing methodology. Regression modelling was used to investigate the relationships among a priori selected perioperative variables, complications, and costs. The effect of complications on postoperative mortality was ascertained using time-dependent coefficients in a Cox proportional hazards regression model. RESULTS 135 (92%) patients experienced one or more postoperative complications. The medians of hospital cost for patients who experienced no complications and those who experienced complications were $42,796.3 (29,222.9-53,532.5) and $81,050.1 (49,614.8-122,533.6) respectively, p < 0.001. Hospital costs were strongly associated with complication severity: Clavien-Dindo grade II complications increased costs by 45.2% (p < 0.001, 95% CI 19.1%-76.6%), and Clavien-Dindo grade III to V complications increased costs by 107.5% (p < 0.001, 95% CI 52.4%-181.8%). Each additional count of complication and increase in Clavien-Dindo complication grade increased the risk of mortality 1.28-fold (RR = 1.28, p = 0.006, 95% CI 1.08-1.53) and 2.50-fold (RR = 2.50, p = 0.012 95% CI 1.23-5.07) respectively. CONCLUSIONS These findings demonstrate a high prevalence of complications following cystectomy and significant associated increases in hospital costs and mortality. Postoperative complications are a key target for cost-containment strategies. TRIAL REGISTRATION Trial Registration: Australian New Zealand Clinical Trials Registry (ACTRN:12622000057785.
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Affiliation(s)
- Laurence Weinberg
- Department of Anesthesia, Austin Health, Heidelberg, Australia
- Department of Surgery, The University of Melbourne, Austin Health, Heidelberg, Australia
- Department of Critical Care, The University of Melbourne, Austin Health, Heidelberg, Australia
- * E-mail:
| | | | - Peter Kaldas
- Department of Surgery, The University of Melbourne, Austin Health, Heidelberg, Australia
| | - Luke Fletcher
- Department of Surgery, The University of Melbourne, Austin Health, Heidelberg, Australia
- Data Analytics Research and Evaluation (DARE) Centre, Austin Health, Heidelberg, Australia
| | | | - Peter Le
- Department of Anesthesia, Austin Health, Heidelberg, Australia
| | - Daniel Do
- Department of Anesthesia, Austin Health, Heidelberg, Australia
| | | | - Dominic Walpole
- Department of Anesthesia, Austin Health, Heidelberg, Australia
| | - Joseph Ischia
- Department of Surgery, The University of Melbourne, Austin Health, Heidelberg, Australia
| | - Ronald Ma
- Business Intelligence Unit, Austin Health, Heidelberg, Australia
| | - Chong Oon Tan
- Department of Anesthesia, Austin Health, Heidelberg, Australia
| | - Dong-Kyu Lee
- Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
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15
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Hong SH, Lee JY, Seo S, Shin B, Jeong CH, Bae E, Kim J, Lee D, An B, Shim M, Shin JH, Lee DK, Kim YJ, Han SB. Lipidomic Analysis of Cervicovaginal Fluid for Elucidating Prognostic Biomarkers and Relevant Phospholipid and Sphingolipid Pathways in Preterm Birth. Metabolites 2023; 13:metabo13020177. [PMID: 36837795 PMCID: PMC9963162 DOI: 10.3390/metabo13020177] [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: 12/19/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 01/27/2023] Open
Abstract
Cervicovaginal fluid (CVF) is an excellent specimen for monitoring preterm birth (PTB) as it characterizes cervical metabolites, the vaginal environment, and specific host immune responses. However, extensive lipid analysis of CVF to explain PTB has not been studied. In this study, we performed a systematic analysis combining high-throughput lipid analysis and omics to discover the unique metabolic properties of the cervix. Liquid chromatography-high resolution mass spectrometry successfully detected a total of 190 lipids in the CVF of 30 PTB and 30 term birth (TB) pregnant women. The whole lipidomics dataset analyzed by combining multivariate and univariate statistical analysis revealed 35 lipid biomarkers, including phospholipids and sphingolipids. Remarkably, sphingomyelin, which plays a physiologically essential role in sphingolipids, was significantly downregulated in PTB. Metabolic pathway study provides a close relationship between vaginal microbial organization and cell membrane formation, further supporting the robustness of our findings. Sphingolipids and phospholipids, which were determined to be important lipids for predicting PTB in our study, showed a high value of receiver operating characteristic (ROC) curve >0.7, indicating that a lipid diagnostic test and understanding the mechanism of lipids is highly related to the vaginal microbiome. Therefore, our result has high potential as a predictor of PTB.
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Affiliation(s)
- Se Hee Hong
- College of Pharmacy, Chung-Ang University, Seoul 06974, Republic of Korea
| | - Ji-Youn Lee
- College of Pharmacy, Chung-Ang University, Seoul 06974, Republic of Korea
| | - Sumin Seo
- College of Pharmacy, Chung-Ang University, Seoul 06974, Republic of Korea
| | - Bohyun Shin
- College of Pharmacy, Chung-Ang University, Seoul 06974, Republic of Korea
| | - Cho Hee Jeong
- College of Pharmacy, Chung-Ang University, Seoul 06974, Republic of Korea
| | - Eunbin Bae
- College of Pharmacy, Chung-Ang University, Seoul 06974, Republic of Korea
| | - Jiyu Kim
- College of Pharmacy, Chung-Ang University, Seoul 06974, Republic of Korea
| | - Donghee Lee
- College of Pharmacy, Chung-Ang University, Seoul 06974, Republic of Korea
| | - Byungchan An
- College of Pharmacy, Chung-Ang University, Seoul 06974, Republic of Korea
| | - Minki Shim
- College of Pharmacy, Chung-Ang University, Seoul 06974, Republic of Korea
| | - Jung Hoon Shin
- College of Pharmacy, Chung-Ang University, Seoul 06974, Republic of Korea
| | - Dong-Kyu Lee
- College of Pharmacy, Chung-Ang University, Seoul 06974, Republic of Korea
- Correspondence: (D.-K.L.); (Y.J.K.); (S.B.H.)
| | - Young Ju Kim
- Department of Obstetrics and Gynecology, Ewha Medical Research Institute, College of Medicine, Ewha Womans University, Seoul 07984, Republic of Korea
- Correspondence: (D.-K.L.); (Y.J.K.); (S.B.H.)
| | - Sang Beom Han
- College of Pharmacy, Chung-Ang University, Seoul 06974, Republic of Korea
- Correspondence: (D.-K.L.); (Y.J.K.); (S.B.H.)
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16
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Shin B, Hong SH, Seo S, Jeong CH, Kim J, Bae E, Lee D, Shin JH, Shim M, Han SB, Lee DK. Hepatocellular Metabolic Abnormalities Induced by Long-Term Exposure to Novel Brominated Flame Retardant, Hexabromobenzene. Toxics 2023; 11:101. [PMID: 36850976 PMCID: PMC9962401 DOI: 10.3390/toxics11020101] [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] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
Novel brominated flame retardants (NBFRs) are widely used to avoid environmental accumulation concerns and because of the regulations imposed on classical BFRs. However, recent studies have not revealed the negative effects of NBFR accumulation and exposure on humans. We conducted a metabolomics study on hexabromobenzene (HBB), one of the NBFRs, to investigate its effect on hepatocytes. Gas chromatography-mass spectrometry-based metabolite profiling was performed to observe metabolic perturbations by treating human livertissue-derived HepG2 cell lines with HBB for maximum 21 days. Metabolic pathway enrichment using 17 metabolite biomarkers determined via univariate and multivariate statistical analysis verified that long-term accumulation of HBB resulted in distinct diminution of eight amino acids and five other metabolites. Molecular docking of the biomarker-related enzymes revealed the potential molecular mechanism of hepatocellular response to HBB exposure, which disrupts the energy metabolism of hepatic cells. Collectively, this study may provide insights into the hidden toxicity of bioaccumulating HBB and unveil the risks associated with non-regulated NBFRs.
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17
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Abstract
Non-invasive mapping of cerebral perfusion is critical for understanding neurovascular and neurodegenerative diseases. However, perfusion MRI methods cannot be easily implemented for whole-brain studies in mice because of their small size. To overcome this issue, a transient hypoxia stimulus was applied to induce a bolus of deoxyhemoglobins as an endogenous paramagnetic contrast in blood oxygenation level-dependent (BOLD) MRI. Based on stimulus-duration-dependent studies, 5 s anoxic stimulus was chosen, which induced a decrease in arterial oxygenation to 59%. Dynamic susceptibility changes were acquired with whole-brain BOLD MRI using both all-vessel-sensitive gradient-echo and microvascular-sensitive spin-echo readouts. Cerebral blood flow (CBF) and cerebral blood volume (CBV) were quantified by modeling BOLD dynamics using a partial-volume-corrected arterial input function. In the mouse under ketamine/xylazine anesthesia, total CBF and CBV were 112.0 ± 15.0 ml/100 g/min and 3.39 ± 0.59 ml/100 g (n = 15 mice), respectively, whereas microvascular CBF and CBV were 85.8 ± 6.9 ml/100 g/min and 2.23 ± 0.27 ml/100 g (n = 7 mice), respectively. Regional total vs. microvascular perfusion metrics were highly correlated but a slight mismatch was observed in the large-vessel areas and cortical depth profiles. Overall, this non-invasive, repeatable, simple hypoxia BOLD-MRI approach is viable for perfusion mapping of rodents.
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Affiliation(s)
- DongKyu Lee
- Center for Neuroscience Imaging Research (CNIR), Institute for Basic Science (IBS), Suwon, Republic of Korea
| | - Thuy Thi Le
- Center for Neuroscience Imaging Research (CNIR), Institute for Basic Science (IBS), Suwon, Republic of Korea.,Department of Biomedical Engineering, Sungkyunkwan University, Suwon, Republic of Korea.,Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, Republic of Korea
| | - Geun Ho Im
- Center for Neuroscience Imaging Research (CNIR), Institute for Basic Science (IBS), Suwon, Republic of Korea
| | - Seong-Gi Kim
- Center for Neuroscience Imaging Research (CNIR), Institute for Basic Science (IBS), Suwon, Republic of Korea.,Department of Biomedical Engineering, Sungkyunkwan University, Suwon, Republic of Korea.,Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, Republic of Korea
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18
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Woodford SF, Miles LF, Lee DK, Weinberg L. A Software-Guided Approach to Hemodynamic Management in a Renal Transplant Recipient: A Case Report. A A Pract 2022; 16:e01622. [PMID: 36137007 PMCID: PMC9521586 DOI: 10.1213/xaa.0000000000001622] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2022] [Indexed: 11/05/2022]
Abstract
The function of renal allografts in the perioperative period is partly dependent on minimizing hemodynamic instability. We have developed hemodynamic monitoring software-named the "pressure field"-that was utilized in a 68-year-old high-risk kidney transplant recipient. The "pressure field" was used to individualize fluid and drug administration and replicate the preoperative hemodynamics. The patient received net zero fluid intraoperatively and had an uneventful postoperative course. We found the pressure field method helpful to manage perioperative hemodynamics in this high-risk patient.
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Affiliation(s)
- Stephen F. Woodford
- From the Department of Anaesthesia, Austin Health, Heidelberg, Vic, Australia
- Macquarie Medical School, Blood Pressure and Vascular Function Laboratory, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Lachlan F. Miles
- From the Department of Anaesthesia, Austin Health, Heidelberg, Vic, Australia
- Department of Critical Care, The University of Melbourne, Austin Health, Heidelberg, Vic, Australia
| | - Dong-Kyu Lee
- Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Laurence Weinberg
- From the Department of Anaesthesia, Austin Health, Heidelberg, Vic, Australia
- Department of Critical Care, The University of Melbourne, Austin Health, Heidelberg, Vic, Australia
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19
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Lee JY, Seo S, Shin B, Hong SH, Kwon E, Park S, Hur YM, Lee DK, Kim YJ, Han SB. Development of a New Biomarker Model for Predicting Preterm Birth in Cervicovaginal Fluid. Metabolites 2022; 12:metabo12080734. [PMID: 36005605 PMCID: PMC9416165 DOI: 10.3390/metabo12080734] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/28/2022] [Accepted: 08/04/2022] [Indexed: 11/16/2022] Open
Abstract
Preterm birth (PTB) is a social problem that adversely affects not only the survival rate of the fetus, but also the premature babies and families, so there is an urgent need to find accurate biomarkers. We noted that among causes, eubiosis of the vaginal microbial community to dysbiosis leads to changes in metabolite composition. In this study, short chain fatty acids (SCFAs) representing dysbiosis were derivatized using (N-tert-butyldimethylsilyl-N-methyltrifluoroacetamide, MTBSTFA) and targeted analysis was conducted in extracted organic phases of cervicovaginal fluid (CVF). In residual aqueous CVF, polar metabolites produced biochemistry process were derivatized using methoxyamine and N,O-bis(trimethylsilyl)trifluoroacetamide (BSTFA), and non-targeted analysis were conducted. Nine SCFAs were quantified, and 58 polar metabolites were detected in 90 clinical samples using gas chromatography/mass spectrometry (GC/MS). The criteria of statistical analysis and detection rate of clinical sample for development of PTB biomarkers were presented, and 19 biomarkers were selected based on it, consisting of 1 SCFA, 2 organic acids, 4 amine compounds, and 12 amino acids. In addition, the model was evaluated as a suitable indicator for predicting PTB without distinction between sample collection time. We hope that the developed biomarkers based on microbiota-derived metabolites could provide useful diagnostic biomarkers for actual patients and pre-pregnancy.
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Affiliation(s)
- Ji-Youn Lee
- College of Pharmacy, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Korea
| | - Sumin Seo
- College of Pharmacy, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Korea
| | - Bohyun Shin
- College of Pharmacy, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Korea
| | - Se Hee Hong
- College of Pharmacy, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Korea
| | - Eunjin Kwon
- Department of Obstetrics and Gynecology and Ewha Medical Research Institute, College of Medicine, Ewha Womans University, Seoul 07984, Korea
| | - Sunwha Park
- Department of Obstetrics and Gynecology and Ewha Medical Research Institute, College of Medicine, Ewha Womans University, Seoul 07984, Korea
| | - Young Min Hur
- Department of Obstetrics and Gynecology and Ewha Medical Research Institute, College of Medicine, Ewha Womans University, Seoul 07984, Korea
| | - Dong-Kyu Lee
- College of Pharmacy, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Korea
- Correspondence: (D.-K.L.); (Y.J.K.); (S.B.H.)
| | - Young Ju Kim
- Department of Obstetrics and Gynecology and Ewha Medical Research Institute, College of Medicine, Ewha Womans University, Seoul 07984, Korea
- Correspondence: (D.-K.L.); (Y.J.K.); (S.B.H.)
| | - Sang Beom Han
- College of Pharmacy, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Korea
- Correspondence: (D.-K.L.); (Y.J.K.); (S.B.H.)
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20
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Weinberg L, Ratnasekara V, Tran AT, Kaldas P, Neal-Williams T, D’Silva MR, Hua J, Yip S, Lloyd-Donald P, Fletcher L, Ma R, Perini MV, Nikfarjam M, Lee DK. The Association of Postoperative Complications and Hospital Costs Following Distal Pancreatectomy. Front Surg 2022; 9:890518. [PMID: 35711711 PMCID: PMC9195500 DOI: 10.3389/fsurg.2022.890518] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 04/13/2022] [Indexed: 12/09/2022] Open
Abstract
Background Understanding the financial implications associated with the complications post-distal pancreatectomy (DP) may be beneficial for the future optimisation of postoperative care pathways and improved cost-efficiency. The primary outcome of this retrospective study was the characterisation of the additional cost associated with postoperative complications following DP. The secondary outcome was the estimation of the prevalence, type and severity of complications post-DP and the determination of which complications were associated with higher costs. Methods Postoperative complications were retrospectively examined for 62 adult patients undergoing distal pancreatectomy at an Australian university hospital between January 2012 and July 2021. Complications were defined and graded using the Clavien–Dindo (CVD) classification system. In-hospital cost of index admission was calculated using an activity-based costing methodology and was reported in US dollars at 2021 rates. Regression modelling was used to investigate the relationships among selected perioperative variables, complications and costs. Results 45 patients (72.6%) experienced one or more postoperative complications. The median (IQR) hospital cost in US dollars was 31.6% greater in patients who experienced complications compared to those who experienced no complications ($40,717.8 [27,358.0–59,834.3] vs. $30,946.9 [23,910.8–46,828.1]). Costs for patients with four or more complications were 43.5% higher than for those with three or fewer complications (p = 0.015). Compared to patients with no complications, the median hospital costs increased by 17.1% in patients with minor complications (CVD grade I/II) and by 252% in patients who developed major complication (i.e., CVD grade III/IV) complications. Conclusion Postoperative complications are a key target for cost-containment strategies. Our findings demonstrate a high prevalence of postoperative complications following distal pancreatectomy with number and severity of postoperative complications being associated with increased hospital costs. (Registered in the Australian New Zealand Clinical Trials Registry [No. ACTRN12622000202763]).
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Affiliation(s)
- Laurence Weinberg
- Department of Anaesthesia, Austin Health, Heidelberg, Australia
- Department of Critical Care, The University of Melbourne, Austin Health, Heidelberg, Australia
- Department of Surgery, The University of Melbourne, Austin Health, Heidelberg, Australia
- Correspondence: Laurence Weinberg
| | | | - Anthony T. Tran
- Department of Anaesthesia, Austin Health, Heidelberg, Australia
| | - Peter Kaldas
- Department of Surgery, The University of Melbourne, Austin Health, Heidelberg, Australia
| | | | | | - Jackson Hua
- Department of Anaesthesia, Austin Health, Heidelberg, Australia
| | - Sean Yip
- Department of Anaesthesia, Austin Health, Heidelberg, Australia
| | | | - Luke Fletcher
- Department of Anaesthesia, Austin Health, Heidelberg, Australia
- Data Analytics Research and Evaluation (DARE) Centre, Austin Health, Heidelberg, Australia
| | - Ronald Ma
- Business Intelligence Unit, Austin Health, Heidelberg, Australia
| | - Marcos V. Perini
- Department of Surgery, The University of Melbourne, Austin Health, Heidelberg, Australia
| | - Mehrdad Nikfarjam
- Department of Surgery, The University of Melbourne, Austin Health, Heidelberg, Australia
| | - Dong-Kyu Lee
- Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
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21
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Byun J, Kwak S, Kwon JH, Shin M, Lee DK, Rhee CH, Kang WH, Oh JW, Cruz DJM. Comparative Pharmacodynamics of Three Different Botulinum Toxin Type A Preparations following Repeated Intramuscular Administration in Mice. Toxins (Basel) 2022; 14:toxins14060365. [PMID: 35737026 PMCID: PMC9227525 DOI: 10.3390/toxins14060365] [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] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 05/23/2022] [Accepted: 05/23/2022] [Indexed: 12/10/2022] Open
Abstract
Botulinum neurotoxin type A (BoNT/A) causes muscle paralysis by blocking cholinergic signaling at neuromuscular junctions and is widely used to temporarily correct spasticity-related disorders and deformities. The paralytic effects of BoNT/A are time-limited and require repeated injections at regular intervals to achieve long-term therapeutic benefits. Differences in the level and duration of effectivity among various BoNT/A products can be attributed to their unique manufacturing processes, formulation, and noninterchangeable potency units. Herein, we compared the pharmacodynamics of three BoNT/A formulations, i.e., Botox® (onabotulinumtoxinA), Xeomin® (incobotulinumtoxinA), and Coretox®, following repeated intramuscular (IM) injections in mice. Three IM injections of BoNT/A formulations (12 U/kg per dose), 12-weeks apart, were administered at the right gastrocnemius. Local paresis and chemodenervation efficacy were evaluated over 36 weeks using the digit abduction score (DAS) and compound muscle action potential (CMAP), respectively. One week after administration, all three BoNT/A formulations induced peak DAS and maximal reduction of CMAP amplitudes. Among the three BoNT/A formulations, only Coretox® afforded a significant increase in paretic effects and chemodenervation with a prolonged duration of action after repeated injections. These findings suggest that Coretox® may offer a better overall therapeutic performance in clinical settings.
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Affiliation(s)
- Jaeyoon Byun
- Medytox Gwanggyo R&D Center, 114 Central town-ro, Yeongtong-gu, Suwon-si 16506, Korea; (J.B.); (S.K.); (J.-H.K.); (M.S.); (D.-K.L.); (W.-h.K.)
- Department of Stem Cell and Regenerative Biotechnology, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Korea
| | - Seongsung Kwak
- Medytox Gwanggyo R&D Center, 114 Central town-ro, Yeongtong-gu, Suwon-si 16506, Korea; (J.B.); (S.K.); (J.-H.K.); (M.S.); (D.-K.L.); (W.-h.K.)
| | - Jin-Hee Kwon
- Medytox Gwanggyo R&D Center, 114 Central town-ro, Yeongtong-gu, Suwon-si 16506, Korea; (J.B.); (S.K.); (J.-H.K.); (M.S.); (D.-K.L.); (W.-h.K.)
| | - Minhee Shin
- Medytox Gwanggyo R&D Center, 114 Central town-ro, Yeongtong-gu, Suwon-si 16506, Korea; (J.B.); (S.K.); (J.-H.K.); (M.S.); (D.-K.L.); (W.-h.K.)
| | - Dong-Kyu Lee
- Medytox Gwanggyo R&D Center, 114 Central town-ro, Yeongtong-gu, Suwon-si 16506, Korea; (J.B.); (S.K.); (J.-H.K.); (M.S.); (D.-K.L.); (W.-h.K.)
| | - Chang-Hoon Rhee
- Medytox Osong R&D Center, 102 Osongsaengmyeong 4-ro, Osong-eup, Heungdeok-gu, Cheongju-si 28161, Korea;
| | - Won-ho Kang
- Medytox Gwanggyo R&D Center, 114 Central town-ro, Yeongtong-gu, Suwon-si 16506, Korea; (J.B.); (S.K.); (J.-H.K.); (M.S.); (D.-K.L.); (W.-h.K.)
| | - Jae-Wook Oh
- Department of Stem Cell and Regenerative Biotechnology, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Korea
- Correspondence: (J.-W.O.); (D.J.M.C.); Tel.: +82-2-2049-6271 (J.-W.O.); +82-31-8065-8254 (D.J.M.C.)
| | - Deu John M. Cruz
- Medytox Gwanggyo R&D Center, 114 Central town-ro, Yeongtong-gu, Suwon-si 16506, Korea; (J.B.); (S.K.); (J.-H.K.); (M.S.); (D.-K.L.); (W.-h.K.)
- Correspondence: (J.-W.O.); (D.J.M.C.); Tel.: +82-2-2049-6271 (J.-W.O.); +82-31-8065-8254 (D.J.M.C.)
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22
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Weinberg L, Li SY, Louis M, Karp J, Poci N, Carp BS, Miles LF, Tully P, Hahn R, Karalapillai D, Lee DK. Reported definitions of intraoperative hypotension in adults undergoing non-cardiac surgery under general anaesthesia: a review. BMC Anesthesiol 2022; 22:69. [PMID: 35277122 PMCID: PMC8915500 DOI: 10.1186/s12871-022-01605-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 02/28/2022] [Indexed: 11/25/2022] Open
Abstract
Background Intraoperative hypotension (IOH) during non-cardiac surgery is common and associated with major adverse kidney, neurological and cardiac events and even death. Given that IOH is a modifiable risk factor for the mitigation of postoperative complications, it is imperative to generate a precise definition for IOH to facilitate strategies for avoiding or treating its occurrence. Moreover, a universal and consensus definition of IOH may also facilitate the application of novel and emerging therapeutic interventions in treating IOH. We conducted a review to systematically record the reported definitions of intraoperative hypotension in adults undergoing non-cardiac surgery under general anaesthesia. Methods In accordance with Cochrane guidelines, we searched three online databases (OVID [Medline], Embase and Cochrane Library) for all studies published from 1 January 2000 to 6 September 2020. We evaluated the number of studies that reported the absolute or relative threshold values for defining blood pressure. Secondary aims included evaluation of the threshold values for defining IOH, the methodology for accounting for the severity of hypotension, whether the type of surgical procedure influenced the definition of IOH, and whether a study whose definition of IOH aligned with the Perioperative Quality Initiative-3 workgroup (POQI) consensus statement for defining was more likely to be associated with determining an adverse postoperative outcome. Results A total of 318 studies were included in the final qualitative synthesis. Most studies (n = 249; 78.3%) used an absolute threshold to define hypotension; 150 (60.5%) reported SBP, 117 (47.2%) reported MAP, and 12 (4.8%) reported diastolic blood pressure (DBP). 126 (39.6%) used a relative threshold to define hypotension. Of the included studies, 153 (48.1%) did not include any duration variable in their definition of hypotension. Among the selected 318 studies 148 (46.5%) studies defined IOH according to the POQI statement. When studies used a “relative blood pressure change” to define IOH, there was a weaker association in detecting adverse postoperative outcomes compared to studies who reported “absolute blood pressure change” (χ2(2) = 10.508, P = 0.005, Cramér’s V = 0.182). When studies used the POQI statement definition of hypotension or defined IOH by values higher than the POQI statement definition there were statistical differences observed between IOH and adverse postoperative outcomes (χ2(1) = 6.581, P = 0.037, Cramér’s V = 0.144). When both the duration of IOH or the numbers of hypotensive epochs were evaluated, we observed a significantly stronger relationship between the definition of IOH use the development of adverse postoperative outcomes. (χ2(1) = 4.860, P = 0.027, Cramér’s V = 0.124). Conclusions Most studies defined IOH by absolute or relative changes from baseline values. There are substantial inconsistencies in how IOH was reported. Further, definitions differed across different surgical specialities. Our findings further suggest that IOH should be defined using the absolute values stated in the POQI statement i.e., MAP < 60–70 mmHg or SBP < 100 mmHg. Finally, the number of hypotensive epochs or time-weighted duration of IOH should also be reported. Supplementary Information The online version contains supplementary material available at 10.1186/s12871-022-01605-9.
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23
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Weinberg L, Lee DK, Bergin H, Koshy AN, Tully PA, Meyerov J, Louis M, Yang BO, Grover-Johnson O, Scurrah N, Cosic L, Story D, Bellomo R. MEasuring the impact of Anesthetist-administered medications volumeS on intraoperative flUid balance duRing prolonged abdominal surgEry (MEASURE Study). Minerva Anestesiol 2022; 88:334-342. [PMID: 35164486 DOI: 10.23736/s0375-9393.22.15918-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND The contribution of intraoperative anesthetist-administered medications (IAAMs) to the total volume of intraoperative intravenous (IV) fluid therapy and their association with postoperative outcomes has never been formally investigated. METHODS We performed a retrospective study of adult patients undergoing pancreaticoduodenectomy. The volume of IAAMs, crystalloids and colloids, blood and blood products, blood loss, urine output and intraoperative fluid balance were collected. The contribution of IAAMs to the total intraoperative IV fluid volume and postoperative complications was evaluated. RESULTS A total of 152 consecutive patients were included. The median volume of IAAMs was 363.8 mL (interquartile range [IQR], (241.0-492.5) delivered at a median rate of 0.61 mL kg hr-1 (0.40-0.87) over a median duration of surgery of 489 minutes (416.3-605.3). This increased the total administered fluid volume by 5.2% (95% confidence intervals [CI]: 4.6, 5.9%) (Cohen's d=1.33, P<0.001). The volume of IAAMs was comparable to the intraoperative colloid volume administered (median colloid volume, 400 mL). Overall, fluid volumes correlated significantly with the severity of complications (P=0.011), and the correlation strength increased when the IAAMs volume was included (P=0.005). On addition of IAAMs, the area under the receiver operator characteristic curve for prediction of postoperative complications increased from 0.580 (95%CI: 0.458, 0.701) to 0.603 (95%CI: 0.483, 0.723), P=0.041). CONCLUSIONS IAAMs significantly increased the total administered fluid volume during pancreaticoduodenectomy. Their inclusion increases the accuracy of postoperative complications predictions. These findings support their inclusion in fluid volumes and balances in future interventional studies.
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Affiliation(s)
- Laurence Weinberg
- Department of Anesthesia, Austin Health, Victoria, Australia - .,Department of Critical Care, University of Melbourne, Victoria, Australia - .,Department of Surgery, University of Melbourne, Austin Health, Victoria, Australia -
| | - Dong-Kyu Lee
- Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, South Korea
| | - Hannah Bergin
- Department of Anesthesia, Austin Health, Victoria, Australia
| | - Anoop N Koshy
- Department of Cardiology, Austin Health, Victoria, Australia
| | - Patrick A Tully
- Department of Anesthesia, Austin Health, Victoria, Australia
| | - Joshua Meyerov
- Department of Anesthesia, Austin Health, Victoria, Australia
| | - Maleck Louis
- Department of Anesthesia, Austin Health, Victoria, Australia
| | - Bobby Ou Yang
- Department of Anesthesia, Austin Health, Victoria, Australia
| | | | | | - Luka Cosic
- Department of Anesthesia, Austin Health, Victoria, Australia
| | - David Story
- Department of Anesthesia, Austin Health, Victoria, Australia.,Department of Critical Care, University of Melbourne, Victoria, Australia
| | - Rinaldo Bellomo
- Department of Critical Care, University of Melbourne, Victoria, Australia.,Department of Intensive Care, Austin Health, Victoria, Australia
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Jahng G, Yoo CH, Jin S, Lee D, Cho H. Simulation of microvascular MRI signal changes in the presence of amyloid‐beta plaques or microbleeds. Alzheimers Dement 2021. [DOI: 10.1002/alz.050702] [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: 11/08/2022]
Affiliation(s)
- Geon‐Ho Jahng
- Kyung Hee University Hospital at Gangdong Seoul South Korea
- Kyung Hee University Seoul South Korea
| | | | - Seokha Jin
- Ulsan National Institute of Science and Technology Ulsan South Korea
| | - DongKyu Lee
- Ulsan National Institute of Science and Technology Ulsan South Korea
| | - HyungJoon Cho
- Ulsan National Institute of Science and Technology Ulsan South Korea
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25
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Lee K, Lee DK, Yang D, Mishra R, Kim DJ, Liu S, Xiong Q, Kim SK, Lee KJ, Yang H. Superluminal-like magnon propagation in antiferromagnetic NiO at nanoscale distances. Nat Nanotechnol 2021; 16:1337-1341. [PMID: 34697489 DOI: 10.1038/s41565-021-00983-4] [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] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 08/11/2021] [Indexed: 06/13/2023]
Abstract
Magnon-mediated angular-momentum flow in antiferromagnets may become a design element for energy-efficient, low-dissipation and high-speed spintronic devices1,2. Owing to their low energy dissipation, antiferromagnetic magnons can propagate over micrometre distances3. However, direct observation of their high-speed propagation has been elusive due to the lack of sufficiently fast probes2. Here we measure the antiferromagnetic magnon propagation in the time domain at the nanoscale (≤50 nm) with optical-driven terahertz emission. In non-magnetic-Bi2Te3/antiferromagnetic-insulator-NiO/ferromagnetic-Co trilayers, we observe a magnon velocity of ~650 km s-1 in the NiO layer. This velocity far exceeds previous estimations of the maximum magnon group velocity of ~40 km s-1, which were based on the magnon dispersion measurements of NiO using inelastic neutron scattering4,5. Our theory suggests that for magnon propagation at the nanoscale, a finite damping makes the dispersion anomalous for small magnon wavenumbers and yields a superluminal-like magnon velocity. Given the generality of finite dissipation in materials, our results strengthen the prospects of ultrafast nanodevices using antiferromagnetic magnons.
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Affiliation(s)
- Kyusup Lee
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore, Singapore
| | - Dong-Kyu Lee
- Department of Materials Science and Engineering, Korea University, Seoul, Korea
| | - Dongsheng Yang
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore, Singapore
| | - Rahul Mishra
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore, Singapore
- Centre for Applied Research in Electronics, Indian Institute of Technology Delhi, New Delhi, India
| | - Dong-Jun Kim
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore, Singapore
| | - Sheng Liu
- Division of Physics and Applied Physics, School of Physical and Mathematical Sciences, Nanyang Technological University, Singapore, Singapore
| | - Qihua Xiong
- State Key Laboratory of Low-Dimensional Quantum Physics and Department of Physics, Tsinghua University, Beijing, P. R. China
- Beijing Academy of Quantum Information Sciences, Beijing, P. R. China
- Beijing Innovation Center for Future Chips, Tsinghua University, Beijing, P. R. China
| | - Se Kwon Kim
- Department of Physics, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Korea
| | - Kyung-Jin Lee
- Department of Physics, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Korea.
| | - Hyunsoo Yang
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore, Singapore.
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26
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Jung SH, Kim D, Jung KS, Lee DK. Color Preference for Host-Seeking Activity of Aedes albopictus and Culex pipiens (Diptera: Culicidae). J Med Entomol 2021; 58:2446-2452. [PMID: 34104944 DOI: 10.1093/jme/tjab100] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Indexed: 06/12/2023]
Abstract
A cue for long-range vision allows mosquitoes to identify hosts and differentiate the ecological niches (e.g., habitats). However, the visual factors involved in attracting mosquitoes to a host are complex and have not been fully understood. Therefore, we assessed color preference to Aedes albopictus (Skuse) and Culex pipiens (Conquillett) as diurnal and nocturnal species, respectively, using seven fundamental colors including black, white, red, yellow, green, blue, and purple with each trap at 100 lux in a laboratory. We used a binary behavioral assay using the Mosquito Preference Index (MPI) as a preference ratio with a range of 0-1. Our analyses showed that Ae. albopictus had a greater response to black (MPIs, 0.7), followed closely by red, blue, and purple (MPIs, 0.6). We also found that red, blue, and purple were significantly higher (P < 0.05) than those of green (MPI, 0.5), white (MPI, 0.3), and yellow (MPI, 0.2). Similarly, the MPIs for Cx. pipiens were significantly higher at black and red (MPIs, 0.7; P < 0.05) compare to those of white and yellow (MPIs, 0.3; P < 0.05). The color preference of Ae. albopictus showed significant correlation to luminous intensities (L-value) (r = -0.640; P = 0.000) and blue intensities (b-value) (r = -0.372; P = 0.000) for all seven colors. In addition, Cx. pipiens negatively correlated (r = -0.703; P = 0.000) between color preference and L-value. Our analyses provide a greater understanding of how color plays a role in visual sensory stimuli, and how that could potentially affect mosquito host-seeking behavior.
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Affiliation(s)
- Sun Ho Jung
- Department of Health & Environment, Kosin University, Busan, Republic of Korea
| | - Dongmin Kim
- Department of Health & Environment, Kosin University, Busan, Republic of Korea
- Florida Medical Entomology Laboratory, University of Florida, Vero Beach, FL, USA
| | - Ki-Suck Jung
- Sacred Heart Hospital, Hallym University, Anyang, Republic of Korea
- Korea Centers for Disease Control and Prevention, Osong, Republic of Korea
| | - Dong-Kyu Lee
- Department of Health & Environment, Kosin University, Busan, Republic of Korea
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27
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Weinberg L, Ou Yang B, Cosic L, Klink S, Le P, Li JK, Koshy AN, Jones D, Bellomo R, Tan CO, Lee DK. Factors influencing early and long-term survival following hip fracture among nonagenarians. J Orthop Surg Res 2021; 16:653. [PMID: 34717695 PMCID: PMC8557574 DOI: 10.1186/s13018-021-02807-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 06/11/2021] [Accepted: 10/20/2021] [Indexed: 11/19/2022] Open
Abstract
Background The outcomes of nonagenarian patients undergoing orthopaedic surgery are not well understood. We investigated the 30-day mortality after surgical treatment of unilateral hip fracture. The relationship between postoperative complications and mortality was evaluated. Methods We performed a single-centre retrospective cohort study of nonagenarian patients undergoing hip fracture surgery over a 6-year period. Postoperative complications were graded according to the Clavien–Dindo classification. Correlation analyses were performed to evaluate the relationship between mortality and pre-specified mortality risk predictors. Survival analyses were assessed using Cox proportional hazards regression modelling.
Results The study included 537 patients. The 30-day mortality rate was 7.4%. The mortality rate over a median follow-up period of 30 months was 18.2%. Postoperative complications were observed in 459 (85.5%) patients. Both the number and severity of complications were related to mortality (p < 0.001). Compared to patients who survived, deceased patients were more frail (p = 0.034), were at higher ASA risk (p = 0.010) and were more likely to have preoperative congestive heart failure (p < 0.001). The adjusted hazard ratio for mortality according to the number of complications was 1.3 (95% CI 1.1, 1.5; p = 0.003). Up to 21 days from admission, any increase in complication severity was associated significantly greater mortality [adjusted hazard ratio: 3.0 (95% CI 2.4, 3.6; p < 0.001)].
Conclusion In a nonagenarian cohort of patients undergoing hip fracture surgery, 30-day mortality was 7.4%, but 30-month mortality rates approached one in five patients. Postoperative complications were independently associated with a higher mortality, particularly when occurring early.
Supplementary Information The online version contains supplementary material available at 10.1186/s13018-021-02807-6.
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Affiliation(s)
- Laurence Weinberg
- Department of Anaesthesia, Austin Health, 145 Studley Rd, Melbourne, VIC, 3084, Australia. .,Department of Surgery, The University of Melbourne, Austin Health, Melbourne, VIC, 3084, Australia. .,Department of Critical Care, The University of Melbourne, Melbourne, VIC, 3084, Australia.
| | - Bobby Ou Yang
- Department of Anaesthesia, Austin Health, 145 Studley Rd, Melbourne, VIC, 3084, Australia
| | - Luka Cosic
- Department of Anaesthesia, Austin Health, 145 Studley Rd, Melbourne, VIC, 3084, Australia
| | - Sarah Klink
- Department of Anaesthesia, Austin Health, 145 Studley Rd, Melbourne, VIC, 3084, Australia
| | - Peter Le
- Department of Anaesthesia, Austin Health, 145 Studley Rd, Melbourne, VIC, 3084, Australia
| | - Jasun Kai Li
- Department of Anaesthesia, Austin Health, 145 Studley Rd, Melbourne, VIC, 3084, Australia
| | - Anoop Ninan Koshy
- Department of Cardiology, Austin Health, Melbourne, VIC, 3084, Australia
| | - Daryl Jones
- Department of Intensive Care, Austin Health, Melbourne, VIC, 3084, Australia
| | - Rinaldo Bellomo
- Department of Intensive Care, Austin Health, Melbourne, VIC, 3084, Australia.,Department of Critical Care, The University of Melbourne, Melbourne, VIC, 3084, Australia
| | - Chong Oon Tan
- Department of Anaesthesia, Austin Health, 145 Studley Rd, Melbourne, VIC, 3084, Australia
| | - Dong-Kyu Lee
- Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Ilsandong-gu, Goyang, 10326, Republic of Korea
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Shaylor R, Desmond F, Lee DK, Koshy AN, Hui V, Tang GT, Fink M, Weinberg L. The Impact of Intraoperative Donor Blood on Packed Red Blood Cell Transfusion During Deceased Donor Liver Transplantation: A Retrospective Cohort Study. Transplantation 2021; 105:1556-1563. [PMID: 33464032 PMCID: PMC8221718 DOI: 10.1097/tp.0000000000003395] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 07/05/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Blood from deceased organ donors, also known as donor blood (DB), has the potential to reduce the need for packed red blood cells (PRBCs) during liver transplantation (LT). We hypothesized that DB removed during organ procurement is a viable resource that could reduce the need for PRBCs during LT. METHODS We retrospectively examined data on LT recipients aged over 18 y who underwent a deceased donor LT. The primary aim was to compare the incidence of PRBC transfusion in LT patients who received intraoperative DB (the DB group) to those who did not (the nondonor blood [NDB] group). RESULTS After a propensity score matching process, 175 patients received DB and 175 did not. The median (first-third quartile) volume of DB transfused was 690.0 mL (500.0-900.0), equivalent to a median of 3.1 units (2.3-4.1). More patients in the NDB group received an intraoperative PRBC transfusion than in the DB group: 74.3% (95% confidence intervals, 67.8-80.8) compared with 60% (95% confidence intervals, 52.7-67.3); P = 0.004. The median number of PRBCs transfused intraoperatively was higher in the NDB group compared with the DB group: 3 units (0-6) compared with 2 units (0-4); P = 0.004. There were no significant differences observed in the secondary outcomes. CONCLUSIONS Use of DB removed during organ procurement and reinfused to the recipient is a viable resource for reducing the requirements for PRBCs during LT. Use of DB minimizes the exposure of the recipient to multiple donor sources.
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Affiliation(s)
- Ruth Shaylor
- Department of Anesthesia, Austin Health, Heidelberg, VIC, Australia
| | - Fiona Desmond
- Department of Anesthesia, Austin Health, Heidelberg, VIC, Australia
| | - Dong-Kyu Lee
- Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Seoul, Republic of Korea
| | | | - Victor Hui
- Department of Anesthesia, Austin Health, Heidelberg, VIC, Australia
| | - Gia Toan Tang
- Department of Surgery, University of Melbourne, Austin Health, Heidelberg, VIC, Australia
| | - Michael Fink
- Department of Surgery, University of Melbourne, Austin Health, Heidelberg, VIC, Australia
| | - Laurence Weinberg
- Department of Anesthesia, Austin Health, Heidelberg, VIC, Australia
- Department of Surgery, University of Melbourne, Austin Health, Heidelberg, VIC, Australia
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29
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Zumpf C, Cacho J, Grasse N, Quinn J, Hampton-Marcell J, Armstrong A, Campbell P, Negri MC, Lee DK. Influence of shrub willow buffers strategically integrated in an Illinois corn-soybean field on soil health and microbial community composition. Sci Total Environ 2021; 772:145674. [PMID: 33663956 DOI: 10.1016/j.scitotenv.2021.145674] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 02/02/2021] [Accepted: 02/02/2021] [Indexed: 06/12/2023]
Abstract
Soil serves many important ecological functions and is an integral part of our existence as a society. However, concerns for soil health are growing globally, in part due to the negative impacts of agricultural management on soil resources. The production of perennial bioenergy crops on marginal land in row-crop production systems is one solution that could improve land-use efficiency and address the sustainability of cropland management. Because the relationship between crop management and the environment is complex, more research is needed to evaluate the potential benefits perennial bioenergy crop production has on soil health, as well as other ecosystem services. In this study, shrub willow buffers were strategically integrated into a corn-soybean cropping system with the main objective of reducing nitrate-N leaching from grain crop production while producing biomass for bioenergy. Two buffer systems (defined by landscape positions) were included for comparison, one on marginal land with exposure to nitrate-N leaching from upslope grain (southern plots) and one on fertile soils with less nitrate-N leaching potential (northern plots). Evaluation of soil (chemistry, bulk density, microbial community) and shrub willow vegetation properties (fine roots, leaf litter decomposition, and nutrient uptake dynamics), showed that landscape position plays an important role in (1) the dynamics of soil chemical properties, (2) shrub willow's influence and productivity, and (3) the provision of additional ecosystem services such as reductions in nitrous oxide emissions and nitrate-N leaching. In addition, the combination of crop type and landscape position (N-grain, N-willow, S-grain, and S-willow) influenced the species composition of the soil microbial community, resulting in unique and identifiable communities. These results highlight the potential application of shrub willow buffers for ecosystem service provision and support of ecosystem processes; however, understanding the relationship between the microbial community, crop type, and landscape is important for understanding the sustainability of the design.
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Affiliation(s)
- Colleen Zumpf
- Argonne National Laboratory, Environmental Science Division, 9700 S. Cass Avenue, Lemont, IL 60439, USA.
| | - Jules Cacho
- Argonne National Laboratory, Environmental Science Division, 9700 S. Cass Avenue, Lemont, IL 60439, USA
| | - Nora Grasse
- Argonne National Laboratory, Environmental Science Division, 9700 S. Cass Avenue, Lemont, IL 60439, USA
| | - John Quinn
- Argonne National Laboratory, Environmental Science Division, 9700 S. Cass Avenue, Lemont, IL 60439, USA
| | - Jarrad Hampton-Marcell
- Argonne National Laboratory, Bioscience Division, 9700 S. Cass Avenue, Lemont, IL 60439, USA
| | - Abigail Armstrong
- Argonne National Laboratory, Environmental Science Division, 9700 S. Cass Avenue, Lemont, IL 60439, USA
| | - Patty Campbell
- Argonne National Laboratory, Environmental Science Division, 9700 S. Cass Avenue, Lemont, IL 60439, USA
| | - M Cristina Negri
- Argonne National Laboratory, Environmental Science Division, 9700 S. Cass Avenue, Lemont, IL 60439, USA
| | - D K Lee
- University of Illinois Urbana-Champaign, Crop Science Department, 1102 S. Goodwin Ave., Urbana, IL, USA
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30
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Kim D, Rusch TW, Lee DK. Response of Culex pipiens pallens to Visual and Olfactory Stimuli from a Mosquito Trap. J Am Mosq Control Assoc 2021; 37:76-82. [PMID: 34184047 DOI: 10.2987/20-6966.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This study examined Culex pipiens pallens responses to different combinations of colors and chemicals employed via a mosquito trap under semifield conditions. Our results indicated that Cx. p. pallens has color and chemical concentration preferences. Culex p. pallens had a 38.0% greater response to white than black color treated traps. Further, Cx. p. pallens showed differences in olfactory attraction depending on the chemical and concentration. Culex p. pallens was 107.6% more attracted to traps employing 500 ppm ammonia than control (i.e., unscented). Similarly, Cx. p. pallens was 117.5%, 128.8%, and 140.3% more attracted to traps employing, respectively, 1,000, 10,000, and 20,000 ppm of ammonia hydrogen carbonate compared to controls. And the response to lactic acid showed that Cx. p. pallens was most attracted to concentrations of 100 and 500 ppm (135.7% and 142.9%, respectively) compared to controls.
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31
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Chang SK, Kim J, Lee D, Yoo CH, Jin S, Rhee HY, Ryu CW, Lee JK, Cho H, Jahng GH. Mapping of microvascular architecture in the brain of an Alzheimer's disease mouse model using MRI. NMR Biomed 2021; 34:e4481. [PMID: 33590547 DOI: 10.1002/nbm.4481] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 11/15/2020] [Accepted: 01/08/2021] [Indexed: 06/12/2023]
Abstract
Increasing evidence suggests that alterations in cerebral microvasculature play a critical role in the pathogenesis of Alzheimer's disease (AD). The objective of this study was to characterize and evaluate the cerebral microvascular architecture of AD transgenic (Tg) mice and compare it with that of non-Tg mice using brain microvascular indices obtained by MRI. Seven non-Tg mice and 10 5xFAD Tg mice were scanned using a 7-T animal MRI system to measure the transverse relaxation rates of R2 and R2* before and after the injection of the monocrystalline iron oxide nanoparticle contrast agent. After calculating ΔR2* and ΔR2, the vessel size index (VSI), mean vessel diameter (mVD), mean vessel density, mean vessel-weighted image (MvWI) and blood volume fraction (BVf) were mapped. Voxel-based analyses and region of interest (ROI)-based analyses were performed to compare the indices of the non-Tg and Tg groups. Voxel comparisons showed that BVf, mVD, VSI and MvWI were greater in the Tg group than in the non-Tg group. Additionally, the ROI-based analysis showed that ΔR2*, BVf, mVD, MvWI and VSI increased in several brain regions of the Tg group compared with those in the non-Tg group. VSI and mVD increased in Tg mice; these findings indicated microvascular disruption in the brain that could be related to damage to the neurovascular unit in AD caused by cerebral amyloid angiopathy.
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Affiliation(s)
- Suk-Ki Chang
- Hallym University Medical Center, Hwasung, Republic of Korea
| | - JeongYeong Kim
- Department of Physics, Undergraduate School, Kyung Hee University, Seoul, Republic of Korea
| | - DongKyu Lee
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea
| | - Chang Hyun Yoo
- Department of Physics, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Seokha Jin
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea
| | - Hak Young Rhee
- Department of Neurology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Chang-Woo Ryu
- Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Jong Kil Lee
- Department of Pharmacy, College of Pharmacy, Kyung Hee University, Seoul, Republic of Korea
| | - HyungJoon Cho
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea
| | - Geon-Ho Jahng
- Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
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Meyerov J, Louis M, Lee DK, Fletcher L, Banyasz D, Miles LF, Ma R, Tosif S, Koshy AN, Story DA, Bellomo R, Weinberg L. Associations between preoperative anaemia and hospital costs following major abdominal surgery: cohort study. BJS Open 2021; 5:6218127. [PMID: 33834189 PMCID: PMC8032965 DOI: 10.1093/bjsopen/zraa070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 12/09/2020] [Indexed: 11/28/2022] Open
Abstract
Background Determining the cost-effectiveness and sustainability of patient blood management programmes relies on quantifying the economic burden of preoperative anaemia. This retrospective cohort study aimed to evaluate the hospital costs attributable to preoperative anaemia in patients undergoing major abdominal surgery. Methods Patients who underwent major abdominal surgery between 2010 and 2018 were included. The association between preoperative patient haemoglobin (Hb) concentration and hospital costs was evaluated by curve estimation based on the least-square method. The in-hospital cost of index admission was calculated using an activity-based costing methodology. Multivariable regression analysis and propensity score matching were used to estimate the effects of Hb concentration on variables related directly to hospital costs. Results A total of 1286 patients were included. The median overall cost was US $18 476 (i.q.r.13 784–27 880), and 568 patients (44.2 per cent) had a Hb level below 13.0 g/dl. Patients with a preoperative Hb level below 9.0 g/dl had total hospital costs that were 50.6 (95 per cent c.i. 14.1 to 98.9) per cent higher than those for patients with a preoperative Hb level of 9.0–13.0 g/dl (P < 0.001), 72.5 (30.6 to 128.0) per cent higher than costs for patients with a Hb concentration of 13.1–15.0 g/dl (P < 0.001), and 62.4 (21.8 to 116.7) per cent higher than those for patients with a Hb level greater than 15.0 g/dl (P < 0.001). Multivariable general linear modelling showed that packed red blood cell (PRBC) transfusions were a principal cost driver in patients with a Hb concentration below 9.0 g/dl. Conclusion Patients with the lowest Hb concentration incurred the highest hospital costs, which were strongly associated with increased PRBC transfusions. Costs and possible complications may be decreased by treating preoperative anaemia, particularly more severe anaemia.
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Affiliation(s)
- J Meyerov
- Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia
| | - M Louis
- Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia
| | - D K Lee
- Department of Anaesthesiology and Pain Medicine, Korea University Guro Hospital, Guro-Gu, Seoul, South Korea
| | - L Fletcher
- Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia
| | - D Banyasz
- Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia
| | - L F Miles
- Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia
| | - R Ma
- Business Intelligence Unit, Austin Health, Heidelberg, Victoria, Australia
| | - S Tosif
- Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia
| | - A N Koshy
- Department of Cardiology, Austin Health, Heidelberg, Victoria, Australia
| | - D A Story
- Department of Critical Care, University of Melbourne, Melbourne, Victoria, Australia
| | - R Bellomo
- Department of Critical Care, University of Melbourne, Melbourne, Victoria, Australia.,Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia.,Data Analytics Research and Evaluation Centre, Austin Hospital and University of Melbourne, Melbourne, Victoria, Australia
| | - L Weinberg
- Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia.,Department of Critical Care, University of Melbourne, Melbourne, Victoria, Australia.,University of Melbourne Department of Surgery, Austin Health, Victoria, Australia
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33
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Seo JH, Lee HJ, Seo DW, Lee DK, Kwon OW, Kwak MK, Lee KH. A Prosthetic Socket with Active Volume Compensation for Amputated Lower Limb. Sensors (Basel) 2021; 21:s21020407. [PMID: 33435553 PMCID: PMC7827594 DOI: 10.3390/s21020407] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/05/2021] [Accepted: 01/05/2021] [Indexed: 12/03/2022]
Abstract
Typically, the actual volume of the residual limb changes over time. This causes the prosthesis to not fit, and then pain and skin disease. In this study, a prosthetic socket was developed to compensate for the volume change of the residual limb. Using an inflatable air bladder, the proposed socket monitors the pressure in the socket and keeps the pressure distribution uniform and constant while walking. The socket has three air bladders on anterior and posterior tibia areas, a latching type 3-way pneumatic valve and a portable control device. In the paper, the mechanical properties of the air bladder were investigated, and the electromagnetic analysis was performed to design the pneumatic valve. The controller is based on a hysteresis control algorithm with a closed loop, which keeps the pressure in the socket close to the initial set point over a long period of time. In experiments, the proposed prosthesis was tested through the gait simulator that can imitate a human’s gait cycle. The active volume compensation of the socket was successfully verified during repetitive gait cycle using the weight loads of 50, 70, and 90 kg and the residual limb model with a variety of volumes. It was confirmed that the pressure of the residual limb recovered to the initial state through the active control. The pressure inside the socket had a steady state error of less than 0.75% even if the volume of the residual limb was changed from −7% to +7%.
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Affiliation(s)
- Ji-Hyeon Seo
- Daegu Research Center for Medical Devices, Korea Institute of Machinery and Materials, Daegu 42994, Korea; (J.-H.S.); (H.-J.L.); (D.-K.L.); (O.-W.K.)
- School of Mechanical Engineering, College of Engineering, Kyungpook National University, Daegu 41566, Korea;
| | - Hyuk-Jin Lee
- Daegu Research Center for Medical Devices, Korea Institute of Machinery and Materials, Daegu 42994, Korea; (J.-H.S.); (H.-J.L.); (D.-K.L.); (O.-W.K.)
| | - Dong-Wook Seo
- Department of Radio Communication Engineering/Interdisciplinary Major of Maritime AI Convergence, Korea Maritime and Ocean University, Busan 49112, Korea;
| | - Dong-Kyu Lee
- Daegu Research Center for Medical Devices, Korea Institute of Machinery and Materials, Daegu 42994, Korea; (J.-H.S.); (H.-J.L.); (D.-K.L.); (O.-W.K.)
| | - Oh-Won Kwon
- Daegu Research Center for Medical Devices, Korea Institute of Machinery and Materials, Daegu 42994, Korea; (J.-H.S.); (H.-J.L.); (D.-K.L.); (O.-W.K.)
| | - Moon-Kyu Kwak
- School of Mechanical Engineering, College of Engineering, Kyungpook National University, Daegu 41566, Korea;
| | - Kang-Ho Lee
- Daegu Research Center for Medical Devices, Korea Institute of Machinery and Materials, Daegu 42994, Korea; (J.-H.S.); (H.-J.L.); (D.-K.L.); (O.-W.K.)
- Correspondence:
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34
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Weinberg L, Lee DK, Gan C, Ianno D, Ho A, Fletcher L, Banyasz D, Tosif S, Jones D, Bellomo R, Karalapillai D. The association of acute hypercarbia and plasma potassium concentration during laparoscopic surgery: a retrospective observational study. BMC Surg 2021; 21:31. [PMID: 33413263 PMCID: PMC7792046 DOI: 10.1186/s12893-020-01034-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 06/20/2020] [Accepted: 12/27/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND It is uncertain whether increases in PaCO2 during surgery lead to an increase in plasma potassium concentration and, if so, by how much. Hyperkalaemia may result in cardiac arrhythmias, muscle weakness or paralysis. The key objectives were to determine whether increases in PaCO2 during laparoscopic surgery induce increases in plasma potassium concentrations and, if so, to determine the magnitude of such changes. METHODS A retrospective observational study of adult patients undergoing laparoscopic abdominal surgery was perfomed. The independent association between increases in PaCO2 and changes in plasma potassium concentration was assessed by performing arterial blood gases within 15 min of induction of anaesthesia and within 15 min of completion of surgery. RESULTS 289 patients were studied (mean age of 63.2 years; 176 [60.9%] male, and mean body mass index of 29.3 kg/m2). At the completion of the surgery, PaCO2 had increased by 5.18 mmHg (95% CI 4.27 mmHg to 6.09 mmHg) compared to baseline values (P < 0.001) with an associated increase in potassium concentration of 0.25 mmol/L (95% CI 0.20 mmol/L to 0.31 mmol/L, P < 0.001). On multiple regression analysis, PaCO2 changes significantly predicted immediate changes in plasma potassium concentration and could account for 33.1% of the variance (r2 = 0.331, f(3,259) = 38.915, P < 0.001). For each 10 mmHg increment of PaCO2 the plasma potassium concentration increased by 0.18 mmol/L. CONCLUSION In patients receiving laparoscopic abdominal surgery, there is an increase in PaCO2 at the end of surgery, which is independently associated with an increase in plasma potassium concentration. However, this effect is small and is mostly influenced by intravenous fluid therapy (Plasma-Lyte 148 solution) and the presence of diabetes. Trial registration Retrospectively registered in the Australian New Zealand Clinical Trials Registry (Trial Number: ACTRN12619000716167).
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Affiliation(s)
- Laurence Weinberg
- Department of Anaesthesia, Austin Health, 145 Studley Road, Heidelberg, 3084, Australia. .,Department of Surgery, The University of Melbourne, Austin Health, Heidelberg, 3084, Australia.
| | - Dong-Kyu Lee
- Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Guro-Gu, Seoul, 08308, Republic of Korea
| | - Chrisdan Gan
- Department of Anaesthesia, Austin Health, 145 Studley Road, Heidelberg, 3084, Australia
| | - Damian Ianno
- Department of Anaesthesia, Austin Health, 145 Studley Road, Heidelberg, 3084, Australia
| | - Alexander Ho
- Department of Anaesthesia, Austin Health, 145 Studley Road, Heidelberg, 3084, Australia
| | - Luke Fletcher
- Department of Anaesthesia, Austin Health, 145 Studley Road, Heidelberg, 3084, Australia
| | - Daniel Banyasz
- Department of Anaesthesia, Austin Health, 145 Studley Road, Heidelberg, 3084, Australia
| | - Shervin Tosif
- Department of Anaesthesia, Austin Health, 145 Studley Road, Heidelberg, 3084, Australia
| | - Daryl Jones
- Department of Intensive Care, Austin Health, 145 Studley Road, Heidelberg, 3084, Australia.,School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, 3004, Australia
| | - Rinaldo Bellomo
- Department of Intensive Care, Austin Health, 145 Studley Road, Heidelberg, 3084, Australia
| | - Dharshi Karalapillai
- Department of Anaesthesia, Austin Health, 145 Studley Road, Heidelberg, 3084, Australia.,Department of Intensive Care, Austin Health, 145 Studley Road, Heidelberg, 3084, Australia
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Caretta L, Oh SH, Fakhrul T, Lee DK, Lee BH, Kim SK, Ross CA, Lee KJ, Beach GSD. Relativistic kinematics of a magnetic soliton. Science 2020; 370:1438-1442. [PMID: 33335059 DOI: 10.1126/science.aba5555] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 05/19/2020] [Accepted: 11/13/2020] [Indexed: 11/02/2022]
Abstract
A tenet of special relativity is that no particle can exceed the speed of light. In certain magnetic materials, the maximum magnon group velocity serves as an analogous relativistic limit for the speed of magnetic solitons. Here, we drive domain walls to this limit in a low-dissipation magnetic insulator using pure spin currents from the spin Hall effect. We achieve record current-driven velocities in excess of 4300 meters per second-within ~10% of the relativistic limit-and we observe key signatures of relativistic motion associated with Lorentz contraction, which leads to velocity saturation. The experimental results are well explained through analytical and atomistic modeling. These observations provide critical insight into the fundamental limits of the dynamics of magnetic solitons and establish a readily accessible experimental framework to study relativistic solitonic physics.
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Affiliation(s)
- Lucas Caretta
- Department of Materials Science and Engineering, Massachusetts Institute of Technology (MIT), Cambridge, MA 02139, USA
| | - Se-Hyeok Oh
- Department of Nano-Semiconductor and Engineering, Korea University, Seoul 02841, Korea
| | - Takian Fakhrul
- Department of Materials Science and Engineering, Massachusetts Institute of Technology (MIT), Cambridge, MA 02139, USA
| | - Dong-Kyu Lee
- Department of Materials Science and Engineering, Korea University, Seoul 02841, Korea
| | - Byung Hun Lee
- Department of Materials Science and Engineering, Massachusetts Institute of Technology (MIT), Cambridge, MA 02139, USA
| | - Se Kwon Kim
- Department of Physics, Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, Korea
| | - Caroline A Ross
- Department of Materials Science and Engineering, Massachusetts Institute of Technology (MIT), Cambridge, MA 02139, USA
| | - Kyung-Jin Lee
- Department of Nano-Semiconductor and Engineering, Korea University, Seoul 02841, Korea.,Department of Materials Science and Engineering, Korea University, Seoul 02841, Korea.,Department of Physics, Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, Korea.,KU-KIST Graduate School of Converging Science and Technology, Korea University, Seoul 02841, Korea
| | - Geoffrey S D Beach
- Department of Materials Science and Engineering, Massachusetts Institute of Technology (MIT), Cambridge, MA 02139, USA.
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Koo HC, Kim SB, Kim H, Park TE, Choi JW, Kim KW, Go G, Oh JH, Lee DK, Park ES, Hong IS, Lee KJ. Rashba Effect in Functional Spintronic Devices. Adv Mater 2020; 32:e2002117. [PMID: 32930418 DOI: 10.1002/adma.202002117] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/28/2020] [Indexed: 06/11/2023]
Abstract
Exploiting spin transport increases the functionality of electronic devices and enables such devices to overcome physical limitations related to speed and power. Utilizing the Rashba effect at the interface of heterostructures provides promising opportunities toward the development of high-performance devices because it enables electrical control of the spin information. Herein, the focus is mainly on progress related to the two most compelling devices that exploit the Rashba effect: spin transistors and spin-orbit torque devices. For spin field-effect transistors, the gate-voltage manipulation of the Rashba effect and subsequent control of the spin precession are discussed, including for all-electric spin field-effect transistors. For spin-orbit torque devices, recent theories and experiments on interface-generated spin current are discussed. The future directions of manipulating the Rashba effect to realize fully integrated spin logic and memory devices are also discussed.
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Affiliation(s)
- Hyun Cheol Koo
- Center for Spintronics, Korea Institute of Science and Technology, Seoul, 02792, South Korea
- KU-KIST Graduate School of Converging Science and Technology, Korea University, Seoul, 02841, South Korea
| | - Seong Been Kim
- Center for Spintronics, Korea Institute of Science and Technology, Seoul, 02792, South Korea
- KU-KIST Graduate School of Converging Science and Technology, Korea University, Seoul, 02841, South Korea
| | - Hansung Kim
- Center for Spintronics, Korea Institute of Science and Technology, Seoul, 02792, South Korea
- KU-KIST Graduate School of Converging Science and Technology, Korea University, Seoul, 02841, South Korea
| | - Tae-Eon Park
- Center for Spintronics, Korea Institute of Science and Technology, Seoul, 02792, South Korea
| | - Jun Woo Choi
- Center for Spintronics, Korea Institute of Science and Technology, Seoul, 02792, South Korea
| | - Kyoung-Whan Kim
- Center for Spintronics, Korea Institute of Science and Technology, Seoul, 02792, South Korea
| | - Gyungchoon Go
- Department of Materials Science and Engineering, Korea University, Seoul, 02841, South Korea
| | - Jung Hyun Oh
- Department of Materials Science and Engineering, Korea University, Seoul, 02841, South Korea
| | - Dong-Kyu Lee
- Department of Materials Science and Engineering, Korea University, Seoul, 02841, South Korea
| | - Eun-Sang Park
- Center for Spintronics, Korea Institute of Science and Technology, Seoul, 02792, South Korea
- KU-KIST Graduate School of Converging Science and Technology, Korea University, Seoul, 02841, South Korea
| | - Ik-Sun Hong
- KU-KIST Graduate School of Converging Science and Technology, Korea University, Seoul, 02841, South Korea
| | - Kyung-Jin Lee
- KU-KIST Graduate School of Converging Science and Technology, Korea University, Seoul, 02841, South Korea
- Department of Materials Science and Engineering, Korea University, Seoul, 02841, South Korea
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Sung TY, Lee DK, Bang J, Choi J, Shin S, Kim TY. Remifentanil-based propofol-supplemented vs. balanced sevoflurane-sufentanil anesthesia regimens on bispectral index recovery after cardiac surgery: a randomized controlled study. Anesth Pain Med (Seoul) 2020; 15:424-433. [PMID: 33329845 PMCID: PMC7724124 DOI: 10.17085/apm.20022] [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: 05/19/2020] [Revised: 07/01/2020] [Accepted: 07/16/2020] [Indexed: 12/16/2022] Open
Abstract
Background The present study was to compare the potential impact of remifentanil-based propofol-supplemented anesthesia regimen vs. conventional sevoflurane-sufentanil balanced anesthesia on postoperative recovery of consciousness indicated by bispectral index (BIS) values in patients undergoing cardiac surgery. Methods Patients undergoing cardiac surgery were randomly allocated to get the remifentanil-based propofol-supplemented anesthesia employing target-controlled infusion (TCI) of remifentanil and propofol (Group-PR, n = 15) or a balanced-anesthesia employing sevoflurane-inhalation and TCI-sufentanil (Group-C, n = 19). In Group-PR, plasma concentration (Cp) of TCI-remifentanil was fixed at 20 ng/ml, and the effect-site concentration of TCI-propofol was adjusted within 0.8–2.0 μg/ml to maintain BIS value of 40–60. In Group-C, sevoflurane dosage was adjusted within 1–1.5 minimum alveolar concentration to maintain BIS of 40–60, and Cp of TCI-sufentanil was fixed at 0.4 ng/ml. The inter-group difference in the time for achieving postoperative BIS > 80 (T-BIS80) in the intensive care unit was determined as the primary outcome. The inter-group difference in the extubation time was determined as the secondary outcome. Results T-BIS80, was shorter in Group-PR than Group-C (121.4 ± 64.9 min vs. 182.9 ± 85.1 min, respectively; the difference of means –61.5 min; 95% CI –115.7 to –7.4 min; effect size 0.812; P = 0.027). The extubation time was shorter in Group-PR than in Group-C (434.7 ± 131.3 min vs. 946.6 ± 393.3 min, respectively, P < 0.001). Conclusions Compared with the conventional sevoflurane-sufentanil balanced anesthesia, the remifentanil-based propofol-supplemented anesthesia showed significantly faster postoperative conscious recovery in patients undergoing cardiac surgery.
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Affiliation(s)
- Tae-Yun Sung
- Department of Anesthesiology and Pain Medicine, Konyang University Hospital, College of Medicine, Konyang University, Daejeon, Korea
| | - Dong-Kyu Lee
- Department of Anesthesiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jiyon Bang
- epartment of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jimin Choi
- Department of Anesthesiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Saemi Shin
- College of Life Science and Biotechnology, Korea University, Seoul, Korea
| | - Tae-Yop Kim
- Department of Anesthesiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
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Lee DK, Rubakhin SS, Kusmartseva I, Wasserfall C, Atkinson MA, Sweedler JV. Removing Formaldehyde-Induced Peptidyl Crosslinks Enables Mass Spectrometry Imaging of Peptide Hormone Distributions from Formalin-Fixed Paraffin-Embedded Tissues. Angew Chem Int Ed Engl 2020; 59:22584-22590. [PMID: 32762062 DOI: 10.1002/anie.202008847] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 06/29/2020] [Revised: 08/05/2020] [Indexed: 12/14/2022]
Abstract
Linking molecular and chemical changes to human disease states depends on the availability of appropriate clinical samples, mostly preserved as formalin-fixed paraffin-embedded (FFPE) specimens stored in tissue banks. Mass spectrometry imaging (MSI) enables the visualization of the spatiotemporal distribution of molecules in biological samples. However, MSI is not effective for imaging FFPE tissues because of the chemical modifications of analytes, including complex crosslinking between nucleophilic moieties. Here we used an MS-compatible inorganic nucleophile, hydroxylamine hydrochloride, to chemically reverse inter- and intra-crosslinks from endogenous molecules. The analyte restoration appears specific for formaldehyde-reactive amino acids. This approach enabled the MSI-assisted localization of pancreatic peptides expressed in the alpha, beta, and gamma cells. Pancreatic islet-like distributions of islet hormones were observed in human FFPE tissues preserved for more than five years, demonstrating that samples from biobanks can effectively be investigated with MSI.
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Affiliation(s)
- Dong-Kyu Lee
- Department of Chemistry and Beckman institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, 405 S. Mathews Ave., Urbana, IL, 61801, USA
| | - Stanislav S Rubakhin
- Department of Chemistry and Beckman institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, 405 S. Mathews Ave., Urbana, IL, 61801, USA
| | - Irina Kusmartseva
- Department of Pathology, Immunology and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL, 32610, USA
| | - Clive Wasserfall
- Department of Pathology, Immunology and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL, 32610, USA
| | - Mark A Atkinson
- Department of Pathology, Immunology and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL, 32610, USA
| | - Jonathan V Sweedler
- Department of Chemistry and Beckman institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, 405 S. Mathews Ave., Urbana, IL, 61801, USA
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Lee DK, Park S, Long NP, Min JE, Kim HM, Yang E, Lee SJ, Lim J, Kwon SW. Research Quality-Based Multivariate Modeling for Comparison of the Pharmacological Effects of Black and Red Ginseng. Nutrients 2020; 12:nu12092590. [PMID: 32858896 PMCID: PMC7551003 DOI: 10.3390/nu12092590] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/21/2020] [Accepted: 08/23/2020] [Indexed: 11/16/2022] Open
Abstract
Black ginseng has various pharmacological activities, but only few studies have compared its pharmacological effects with those of red ginseng. We conducted an integrative systematic literature evaluation and developed a non-inferiority test based on the multivariate modeling approach to compare the pharmacological effects of red ginseng and black ginseng. We searched reported studies on the pharmaceutical effects and composition of ginsenosides and assigned numeric scores using nonlinear principal component analysis, based on discretization measures for the included publications. Downstream weighted linear regression models were constructed to study the eight major biological activities that are generally known to be exhibited by red ginseng. Our statistical model, based on available ordinal information gathered from previous literature, helped in comparing the overlapping effects of black ginseng. Black ginseng showed antioxidant effects comparable to those of red ginseng; however, this variant was inferior to red ginseng in enhancing immunity, relieving fatigue, alleviating depression/anxiety, decreasing body fat, and reducing blood pressure. We have showed a cost-efficient method to indirectly evaluate the biological effects of ginseng products using data from published articles. This method can also be used to compare the nutritional and medicinal value of herbal medicines that share similar compositions of bioactive compounds.
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Affiliation(s)
- Dong-Kyu Lee
- College of Pharmacy, Seoul National University, Seoul 08826, Korea; (D.-K.L.); (N.P.L.); (J.E.M.); (H.M.K.); (S.J.L.)
| | - Seongoh Park
- Department of Statistics, Sungshin Women’s University, Seoul 02844, Korea;
| | - Nguyen Phuoc Long
- College of Pharmacy, Seoul National University, Seoul 08826, Korea; (D.-K.L.); (N.P.L.); (J.E.M.); (H.M.K.); (S.J.L.)
| | - Jung Eun Min
- College of Pharmacy, Seoul National University, Seoul 08826, Korea; (D.-K.L.); (N.P.L.); (J.E.M.); (H.M.K.); (S.J.L.)
| | - Hyung Min Kim
- College of Pharmacy, Seoul National University, Seoul 08826, Korea; (D.-K.L.); (N.P.L.); (J.E.M.); (H.M.K.); (S.J.L.)
| | - Eugine Yang
- College of Pharmacy, Ewha Womans University, Seoul 03760, Korea;
| | - Seul Ji Lee
- College of Pharmacy, Seoul National University, Seoul 08826, Korea; (D.-K.L.); (N.P.L.); (J.E.M.); (H.M.K.); (S.J.L.)
| | - Johan Lim
- Department of Statistics, Seoul National University, Seoul 08826, Korea;
| | - Sung Won Kwon
- College of Pharmacy, Seoul National University, Seoul 08826, Korea; (D.-K.L.); (N.P.L.); (J.E.M.); (H.M.K.); (S.J.L.)
- Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul 08826, Korea
- Correspondence: ; Tel.: +82-2-880-7844; Fax: +82-886-7844
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Lee DK, Kang MS, Cho H. MRI size assessment of cerebral microvasculature using diffusion-time-dependent stimulated-echo acquisition: A feasibility study in rodent. Neuroimage 2020; 215:116784. [PMID: 32276059 DOI: 10.1016/j.neuroimage.2020.116784] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 03/18/2020] [Accepted: 03/21/2020] [Indexed: 11/19/2022] Open
Abstract
In this study, a stimulated-echo (STE) method was employed to robustify the cerebral vessel size estimation near air-tissue, bone-tissue interfaces, and large vessels. The proposed solution is to replace the relaxation rate change from gradient-echo (GRE) with that from STE with long diffusion time after the injection of an intravascular contrast agent, superparamagnetic iron oxide nanoparticles. The corresponding diffusion length of STE is shorter than the length over which the unwanted macroscopic field inhomogeneities but is still longer than the correlation length of the fields induced by small vessels. Therefore, the unwanted field inhomogeneities are refocused, while preserving microscopic susceptibility contrast from cerebral vessels. The mean vessel diameter (dimensionless) derived from the diffusion-time-varying STE method was compared to the mean vessel diameter obtained by a conventional spin-echo (SE) and GRE combination based on Monte-Carlo proton diffusion simulations and in vivo rat experiments at 7 T. The in vivo mean vessel diameter from the MRI experiments was directly compared to available reference mouse brain vasculature obtained by a knife-edge scanning microscope (KESM), which is considered to be the gold standard. Monte-Carlo simulation revealed that SE and GRE-based MR relaxation rate changes (ΔR2 and ΔR2∗, respectively) can be enhanced using single STE-based MR relaxation rate change (ΔRSTE) by regulating diffusion time, especially for small vessels. The in vivo mean vessel diameter from the STE method demonstrated a closer agreement with that from the KESM compared to the combined SE and GRE method, especially in the olfactory bulb and cortex. This study demonstrates that STE relaxation rate changes can be used as consistent measures for assessing small cerebral microvasculature, where macroscopic field inhomogeneity is severe and signal contamination from adjacent large vessels is significant.
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Affiliation(s)
- D K Lee
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea
| | - M S Kang
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea
| | - H Cho
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea.
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Weinberg L, Lee DK, Koshy AN, Leong KW, Tosif S, Shaylor R, Pillai P, Miles LF, Drucker A, Pearce B. Potassium levels after liver reperfusion in adult patients undergoing cadaveric liver transplantation: A retrospective cohort study. Ann Med Surg (Lond) 2020; 55:111-118. [PMID: 32477508 PMCID: PMC7251297 DOI: 10.1016/j.amsu.2020.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 04/03/2020] [Revised: 04/29/2020] [Accepted: 05/04/2020] [Indexed: 01/20/2023] Open
Abstract
Background Hyperkalemia is a common cause of arrhythmias in patients undergoing liver transplantation. We examined the pattern of change of potassium levels during and immediately after reperfusion of the donor liver. Materials and methods Potassium levels of 30 consecutive adult patients undergoing cadaveric liver transplantation were assessed before and after liver reperfusion. Changes in potassium levels over 13 predefined timepoints were analyzed. Primary aim: to describe the pattern of change of potassium levels during the reperfusion period. Correlation between changes in potassium levels during reperfusion and a-priori variables were investigated. Results Baseline median (IQR) potassium levels were 4.1 (3.8:4.5) mmol/L. Thirteen patients (43%) developed hyperkalemia, 10 (33%) of whom developed severe hyperkalemia. Potassium levels peaked at 80 s post reperfusion, plateaued until 2 min, before returning toward baseline values at 5 min. There was a strong association between pre-reperfusion/baseline potassium levels and peak potassium values during reperfusion (95%CI: 0.26 to 0.77, p < 0.001). A baseline potassium level of 4.45 mmol/L was a good predictor of reperfusion hyperkalemia with a sensitivity of 69.2% and specificity of 94.1% (AUC = 0.894, 95%CI: 0.779 to 1.000, p < 0.001). Conclusion Hyperkalemia during cadaveric liver transplantation is common affecting almost 1 in 2 patients during reperfusion. During reperfusion potassium levels peaked within 2 min and over a third of patients developed severe hyperkalemia. Higher peak potassium levels correlated strongly with higher pre-reperfusion potassium values. These findings guide clinicians with timing of sampling of blood to check for hyperkalemia and identify modifiable factors associated with the development of hyperkalemia. Hyperkalemia during the reperfusion phase of cadaveric liver transplantation is common. Potassium levels peaked at 80 s post reperfusion, plateaued for 2 min, and returned to baseline at 5 min. There was a strong association between pre-reperfusion potassium levels and peak potassium values during reperfusion. Timing of blood sampling to check for hyperkalemia is paramount. A baseline potassium level of greater than 4.45 mmol/L was a good predictor of reperfusion hyperkalemia.
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Affiliation(s)
- Laurence Weinberg
- Austin Health, Victoria, Australia.,Department of Surgery, Austin Health, University of Melbourne, Victoria, Australia
| | - Dong-Kyu Lee
- Department of Anesthesiology and Pain Medicine, Korea University, Guro Hospital, Guro-Gu, Seoul, Republic of Korea
| | | | - Kai Wen Leong
- Department of Anesthesia, Austin Health, Victoria, Australia
| | - Shervin Tosif
- Department of Anesthesia, Austin Health, Victoria, Australia
| | - Ruth Shaylor
- Department of Anesthesia, Austin Health, Victoria, Australia
| | - Param Pillai
- Department of Anesthesia, Austin Health, Victoria, Australia
| | | | | | - Brett Pearce
- Department of Anesthesia, Austin Health, Victoria, Australia
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Choi GM, Oh JH, Lee DK, Lee SW, Kim KW, Lim M, Min BC, Lee KJ, Lee HW. Optical spin-orbit torque in heavy metal-ferromagnet heterostructures. Nat Commun 2020; 11:1482. [PMID: 32198358 PMCID: PMC7083953 DOI: 10.1038/s41467-020-15247-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 04/18/2019] [Accepted: 02/21/2020] [Indexed: 11/23/2022] Open
Abstract
Spin current generation through the spin-orbit interaction in non-magnetic materials lies at the heart of spintronics. When the generated spin current is injected to a ferromagnet, it produces spin-orbit torque and manipulates magnetization efficiently. Optically generated spin currents are expected to be superior to their electrical counterparts in terms of the manipulation speed. Here we report optical spin-orbit torques in heavy metal/ferromagnet heterostructures. The strong spin-orbit coupling of heavy metals induces photo-excited carriers to be spin-polarized, and their transport from heavy metals to ferromagnets induces a torque on magnetization. Our results demonstrate that heavy metals can generate spin-orbit torque not only electrically but also optically. It is known that torques can be exerted on spins in a ferromagnet (FM) layer when an in-plane electric current is injected into a heavy metal (HM) layer in contact with the FM layer. Here, the authors demonstrate that torques can be generated without the current injection by shining instead circularly polarized light on the HM.
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Affiliation(s)
- Gyung-Min Choi
- Department of Energy Science, Sungkyunkwan University, Suwon, 16419, Korea. .,Center for Integrated Nanostructure Physics, Institute for Basic Science (IBS), Suwon, 16419, Korea. .,Center for Spintronics, Korea Institute of Science and Technology, Seoul, 02972, Korea.
| | - Jung Hyun Oh
- Department of Materials Science and Engineering, Korea University, Seoul, 02841, Korea
| | - Dong-Kyu Lee
- Department of Materials Science and Engineering, Korea University, Seoul, 02841, Korea
| | - Seo-Won Lee
- Department of Materials Science and Engineering, Korea University, Seoul, 02841, Korea
| | - Kun Woo Kim
- Center for Theoretical Physics of Complex Systems, Institute for Basic Science (IBS), Daejeon, 34051, Korea
| | - Mijin Lim
- Department of Physics, Pohang University of Science and Technology, Pohang, 37673, Korea
| | - Byoung-Chul Min
- Center for Spintronics, Korea Institute of Science and Technology, Seoul, 02972, Korea
| | - Kyung-Jin Lee
- Department of Materials Science and Engineering, Korea University, Seoul, 02841, Korea. .,KU-KIST Graduate School of Converging Science and Technology, Korea University, Seoul, 02841, Korea.
| | - Hyun-Woo Lee
- Department of Physics, Pohang University of Science and Technology, Pohang, 37673, Korea.
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Kang M, Jin S, Lee D, Cho H. MRI Visualization of Whole Brain Macro- and Microvascular Remodeling in a Rat Model of Ischemic Stroke: A Pilot Study. Sci Rep 2020; 10:4989. [PMID: 32193454 PMCID: PMC7081185 DOI: 10.1038/s41598-020-61656-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 02/28/2020] [Indexed: 01/14/2023] Open
Abstract
Using superparamagnetic iron oxide nanoparticles (SPION) as a single contrast agent, we investigated dual contrast cerebrovascular magnetic resonance imaging (MRI) for simultaneously monitoring macro- and microvasculature and their association with ischemic edema status (via apparent diffusion coefficient [ADC]) in transient middle cerebral artery occlusion (tMCAO) rat models. High-resolution T1-contrast based ultra-short echo time MR angiography (UTE-MRA) visualized size remodeling of pial arteries and veins whose mutual association with cortical ischemic edema status is rarely reported. ΔR2-ΔR2*-MRI-derived vessel size index (VSI) and density indices (Q and MVD) mapped morphological changes of microvessels occurring in subcortical ischemic edema lesions. In cortical ischemic edema lesions, significantly dilated pial veins (p = 0.0051) and thinned pial arteries (p = 0.0096) of ipsilateral brains compared to those of contralateral brains were observed from UTE-MRAs. In subcortical regions, ischemic edema lesions had a significantly decreased Q and MVD values (p < 0.001), as well as increased VSI values (p < 0.001) than normal subcortical tissues in contralateral brains. This pilot study suggests that MR-based morphological vessel changes, including but not limited to venous blood vessels, are directly related to corresponding tissue edema status in ischemic stroke rat models.
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Affiliation(s)
- MungSoo Kang
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea
| | - SeokHa Jin
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea
| | - DongKyu Lee
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea
| | - HyungJoon Cho
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea.
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Kang MH, Lee DK, Kim JS, Oh JS. Effects of the abdominal draw-in maneuver on transversus abdominis thickness, electromyography activity of the trunk muscles, and kinematics of the lumbo-pelvic-hip complex during L & L tasks. ISOKINET EXERC SCI 2020. [DOI: 10.3233/ies-192134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Min-Hyeok Kang
- Department of Physical Therapy, International University of Korea, Jinju, Korea
| | - Dong-Kyu Lee
- Department of Physical Therapy, Graduate School, Inje University, Gimhae, Korea
| | - Jun-Seok Kim
- Department of Physical Therapy, Gimhae College, Gimhae, Korea
| | - Jae-Seop Oh
- Department of Physical Therapy, Inje University, Gimhae, Korea
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Abstract
In ferromagnetic trilayers, a spin-orbit-induced spin current can have a spin polarization of which direction is deviated from that for the spin Hall effect. Recently, magnetization switching in ferromagnetic trilayers has been proposed and confirmed by the experiments. In this work, we theoretically and numerically investigate the switching current required for perpendicular magnetization switching in ferromagnetic trilayers. We confirm that the tilted spin polarization enables field-free deterministic switching at a lower current than conventional spin-orbit torque or spin-transfer torque switching, offering a possibility for high-density and low-power spin-orbit torque devices. Moreover, we provide analytical expressions of the switching current for an arbitrary spin polarization direction, which will be useful to design spin-orbit torque devices and to interpret spin-orbit torque switching experiments.
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Affiliation(s)
- Dong-Kyu Lee
- Department of Materials Science and Engineering, Korea University, Seoul, 02841, Korea
| | - Kyung-Jin Lee
- Department of Materials Science and Engineering, Korea University, Seoul, 02841, Korea.
- KU-KIST Graduate School of Converging Science and Technology, Korea University, Seoul, 02841, Korea.
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Lee DH, Park JS, Lee YS, Han J, Lee DK, Kwon SW, Han DH, Lee YH, Bae SH. SQSTM1/p62 activates NFE2L2/NRF2 via ULK1-mediated autophagic KEAP1 degradation and protects mouse liver from lipotoxicity. Autophagy 2020; 16:1949-1973. [PMID: 31913745 DOI: 10.1080/15548627.2020.1712108] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [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: 12/15/2022] Open
Abstract
Lipotoxicity, induced by saturated fatty acid (SFA)-mediated cell death, plays an important role in the pathogenesis of nonalcoholic fatty liver disease (NAFLD). The KEAP1 (kelch like ECH associated protein 1)-NFE2L2/NRF2 (nuclear factor, erythroid 2 like 2) pathway is a pivotal defense mechanism against lipotoxicity. We previously reported that SQSTM1/p62 has a cytoprotective role against lipotoxicity through activation of the noncanonical KEAP1- NFE2L2 pathway in hepatocytes. However, the underlying mechanisms and physiological relevance of this pathway have not been clearly defined. Here, we demonstrate that NFE2L2-mediated induction of SQSTM1 activates the noncanonical KEAP1-NFE2L2 pathway under lipotoxic conditions. Furthermore, we identified that SQSTM1 induces ULK1 (unc-51 like autophagy activating kinase 1) phosphorylation by facilitating the interaction between AMPK (AMP-activated protein kinase) and ULK1, leading to macroautophagy/autophagy induction, followed by KEAP1 degradation and NFE2L2 activation. Accordingly, the activity of this SQSTM1-mediated noncanonical KEAP1-NFE2L2 pathway conferred hepatoprotection against lipotoxicity in the livers of conventional sqstm1- and liver-specific sqstm1-knockout mice. Moreover, this pathway activity was evident in the livers of patients with nonalcoholic fatty liver. This axis could thus represent a novel target for NAFLD treatment. Abbreviations: ACACA: acetyl-CoA carboxylase alpha; ACTB: actin beta; BafA1: bafilomycin A1; CM-H2DCFDA:5-(and-6)-chloromethyl-2',7'-dichlorodihydrofluorescein diacetate; CQ: chloroquine; CUL3: cullin 3; DMSO: dimethyl sulfoxide; FASN: fatty acid synthase; GSTA1: glutathione S-transferase A1; HA: hemagglutinin; Hepa1c1c7: mouse hepatoma cells; HMOX1/HO-1: heme oxygenase 1; KEAP1: kelch like ECH associated protein 1; MAP1LC3B/LC3B: microtubule-associated protein 1 light chain 3; MEF: mouse embryonic fibroblast; MTORC1: mechanistic target of rapamycin kinase complex 1; MTT: 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide; NAC: N-acetyl-L-cysteine; NAFLD: nonalcoholic fatty liver disease; NASH: nonalcoholic steatohepatitis; NFE2L2/NRF2: nuclear factor, erythroid 2 like 2; NQO1: NAD(P)H quinone dehydrogenase 1; PA: palmitic acid; PARP: poly (ADP-ribose) polymerase 1; PRKAA1/2: protein kinase AMP-activated catalytic subunits alpha1/2; RBX1: ring-box 1; ROS: reactive oxygen species; SESN2: sestrin 2; SFA: saturated fatty acid; siRNA: small interfering RNA; SQSTM1/p62: sequestosome 1; SREBF1: sterol regulatory element binding transcription factor 1; TBK1: TANK binding kinase 1; TUNEL: terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling; ULK1: unc-51 like autophagy activating kinase.
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Affiliation(s)
- Da Hyun Lee
- Severance Biomedical Science Institute, Yonsei University College of Medicine , Seoul, Republic of Korea.,Brain Korea 21 PLUS Project for Medical Science, Yonsei University , Seoul, South Korea
| | - Jeong Su Park
- Severance Biomedical Science Institute, Yonsei University College of Medicine , Seoul, Republic of Korea
| | - Yu Seol Lee
- Severance Biomedical Science Institute, Yonsei University College of Medicine , Seoul, Republic of Korea.,Brain Korea 21 PLUS Project for Medical Science, Yonsei University , Seoul, South Korea
| | - Jisu Han
- Severance Biomedical Science Institute, Yonsei University College of Medicine , Seoul, Republic of Korea
| | - Dong-Kyu Lee
- Research Institute of Pharmaceutical Sciences, Seoul National University , Seoul, Republic of Korea
| | - Sung Won Kwon
- Research Institute of Pharmaceutical Sciences, Seoul National University , Seoul, Republic of Korea.,College of Pharmacy, Seoul National University , Seoul, Republic of Korea
| | - Dai Hoon Han
- Department of Surgery, Yonsei University College of Medicine , Seoul, Republic of Korea
| | - Yong-Ho Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine , Seoul, Republic of Korea
| | - Soo Han Bae
- Severance Biomedical Science Institute, Yonsei University College of Medicine , Seoul, Republic of Korea
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Kim D, Lee DK, Kim SM, Park W, Sim U. Photoelectrochemical Water Splitting Reaction System Based on Metal-Organic Halide Perovskites. Materials (Basel) 2020; 13:E210. [PMID: 31947866 PMCID: PMC6981555 DOI: 10.3390/ma13010210] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 12/31/2019] [Accepted: 01/02/2020] [Indexed: 12/20/2022]
Abstract
In the development of hydrogen-based technology, a key challenge is the sustainable production of hydrogen in terms of energy consumption and environmental aspects. However, existing methods mainly rely on fossil fuels due to their cost efficiency, and as such, it is difficult to be completely independent of carbon-based technology. Electrochemical hydrogen production is essential, since it has shown the successful generation of hydrogen gas of high purity. Similarly, the photoelectrochemical (PEC) method is also appealing, as this method exhibits highly active and stable water splitting with the help of solar energy. In this article, we review recent developments in PEC water splitting, particularly those using metal-organic halide perovskite materials. We discuss the exceptional optical and electrical characteristics which often dictate PEC performance. We further extend our discussion to the material limit of perovskite under a hydrogen production environment, i.e., that PEC reactions often degrade the contact between the electrode and the electrolyte. Finally, we introduce recent improvements in the stability of a perovskite-based PEC device.
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Affiliation(s)
- Dohun Kim
- Department of Materials Science and Engineering, Chonnam National University, Gwangju 61186, Korea; (D.K.); (D.-K.L.)
| | - Dong-Kyu Lee
- Department of Materials Science and Engineering, Chonnam National University, Gwangju 61186, Korea; (D.K.); (D.-K.L.)
| | - Seong Min Kim
- Department of Bioengineering, School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan;
| | - Woosung Park
- Division of Mechanical Systems Engineering, Institute of Advanced Materials and Systems, Sookmyung Women’s University, Seoul 04310, Korea
| | - Uk Sim
- Department of Materials Science and Engineering, Chonnam National University, Gwangju 61186, Korea; (D.K.); (D.-K.L.)
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48
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Lim Y, Lee DK, Kim SM, Park W, Cho SY, Sim U. Low Dimensional Carbon-Based Catalysts for Efficient Photocatalytic and Photo/Electrochemical Water Splitting Reactions. Materials (Basel) 2019; 13:E114. [PMID: 31881793 PMCID: PMC6982202 DOI: 10.3390/ma13010114] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 12/21/2019] [Accepted: 12/23/2019] [Indexed: 01/14/2023]
Abstract
A universal increase in energy consumption and the dependency on fossil fuels have resulted in increasing severity of global warming, thus necessitating the search of new and environment-friendly energy sources. Hydrogen is as one of the energy sources that can resolve the abovementioned problems. Water splitting promotes ecofriendly hydrogen production without the formation of any greenhouse gas. The most common process for hydrogen production is electrolysis, wherein water molecules are separated into hydrogen and oxygen through electrochemical reactions. Solar-energy-induced chemical reactions, including photocatalysis and photoelectrochemistry, have gained considerable attention because of the simplicity of their procedures and use of solar radiation as the energy source. To improve performance of water splitting reactions, the use of catalysts has been widely investigated. For example, the novel-metal catalysts possessing extremely high catalytic properties for various reactions have been considered. However, due to the rarity and high costs of the novel-metal materials, the catalysts were considered unsuitable for universal use. Although other transition-metal-based materials have also been investigated, carbon-based materials, which are obtained from one of the most common elements on Earth, have potential as low-cost, nontoxic, high-performance catalysts for both photo and electrochemical reactions. Because abundancy, simplicity of synthesis routes, and excellent performance are the important factors for catalysts, easy optimization and many variations are possible in carbon-materials, making them more attractive. In particular, low-dimensional carbon materials, such as graphene and graphitic carbon nitride, exhibit excellent performance because of their unique electrical, mechanical, and catalytic properties. In this mini-review, we will discuss the performance of low-dimensional carbon-based materials for water splitting reactions.
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Affiliation(s)
- Yoongu Lim
- Department of Materials Science & Engineering, Chonnam National University, Gwangju 61186, Korea; (Y.L.); (D.-K.L.)
| | - Dong-Kyu Lee
- Department of Materials Science & Engineering, Chonnam National University, Gwangju 61186, Korea; (Y.L.); (D.-K.L.)
| | - Seong Min Kim
- Department of Bioengineering, School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan;
| | - Woosung Park
- Division of Mechanical Systems Engineering, Institute of Advanced Materials and Systems, Sookmyung Women’s University, Seoul 04310, Korea
| | - Sung Yong Cho
- Department of Environment and Energy Engineering, Chonnam National University, Gwangju 61186, Korea
| | - Uk Sim
- Department of Materials Science & Engineering, Chonnam National University, Gwangju 61186, Korea; (Y.L.); (D.-K.L.)
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49
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Cheng MH, Dien BS, Lee DK, Singh V. Sugar production from bioenergy sorghum by using pilot scale continuous hydrothermal pretreatment combined with disk refining. Bioresour Technol 2019; 289:121663. [PMID: 31234074 DOI: 10.1016/j.biortech.2019.121663] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 06/14/2019] [Accepted: 06/15/2019] [Indexed: 06/09/2023]
Abstract
Chemical-free pretreatments are attracting increased interest because they generate less inhibitor in hydrolysates. In this study, pilot-scaled continuous hydrothermal (PCH) pretreatment followed by disk refining was evaluated and compared to laboratory-scale batch hot water (LHW) pretreatment. Bioenergy sorghum bagasse (BSB) was pretreated at 160-190 °C for 10 min with and without subsequent disk milling. Hydrothermal pretreatment and disk milling synergistically improved glucose and xylose release by 10-20% compared to hydrothermal pretreatment alone. Maximum yields of glucose and xylose of 82.55% and 70.78%, respectively were achieved, when BSB was pretreated at 190 °C and 180 °C followed by disk milling. LHW pretreated BSB had 5-15% higher sugar yields compared to PCH for all pretreatment conditions. The surface area improvement was also performed. PCH pretreatment combined with disk milling increased BSB surface area by 31.80-106.93%, which was greater than observed using LHW pretreatment.
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Affiliation(s)
- Ming-Hsun Cheng
- Department of Agricultural and Biological Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Bruce S Dien
- Bioenergy Research Unit, National Center for Agricultural Utilization Research, USDA-ARS, Peoria, IL 61604, USA
| | - D K Lee
- Department of Crop Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Vijay Singh
- Department of Agricultural and Biological Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
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Jung S, Park J, Shin D, Jeong HY, Lee D, Jeon I, Cho H, Park N, Yoo J, Baek J. Innentitelbild: Paramagnetic Carbon Nanosheets with Random Hole Defects and Oxygenated Functional Groups (Angew. Chem. 34/2019). Angew Chem Int Ed Engl 2019. [DOI: 10.1002/ange.201909272] [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: 11/10/2022]
Affiliation(s)
- Sun‐Min Jung
- School of Energy and Chemical Engineering/Center for Dimension-Controllable Organic Frameworks Ulsan National Institute of Science and Technology (UNIST) 50 UNIST-gil Ulsan 44919 South Korea
| | - Jungmin Park
- School of Materials Science and Engineering/Low-Dimensional Carbon Materials Center Ulsan National Institute of Science and Technology (UNIST) 50 UNIST-gil Ulsan 44919 South Korea
| | - Dongbin Shin
- Department of Physics Ulsan National Institute of Science and Technology (UNIST) 50 UNIST-gil Ulsan 44919 South Korea
| | - Hu Young Jeong
- UNIST Central Research Facilities (UCRF) Ulsan National Institute of Science and Technology (UNIST) 50 UNIST-gil Ulsan 44919 South Korea
| | - DongKyu Lee
- School of Life Sciences Ulsan National Institute of Science and Technology (UNIST) 50 UNIST-gil Ulsan 44919 South Korea
| | - In‐Yup Jeon
- Department of Chemical Engineering Wonkwang University 460 Iksandae-ro, Iksan Jeonbuk 54538 South Korea
| | - HyungJoon Cho
- School of Life Sciences Ulsan National Institute of Science and Technology (UNIST) 50 UNIST-gil Ulsan 44919 South Korea
| | - Noejung Park
- Department of Physics Ulsan National Institute of Science and Technology (UNIST) 50 UNIST-gil Ulsan 44919 South Korea
- Theory Department Max Planck Institute for the Structure and Dynamics of Matter Center for Free Electron Laser Science 22761 Hamburg Germany
| | - Jung‐Woo Yoo
- School of Materials Science and Engineering/Low-Dimensional Carbon Materials Center Ulsan National Institute of Science and Technology (UNIST) 50 UNIST-gil Ulsan 44919 South Korea
| | - Jong‐Beom Baek
- School of Energy and Chemical Engineering/Center for Dimension-Controllable Organic Frameworks Ulsan National Institute of Science and Technology (UNIST) 50 UNIST-gil Ulsan 44919 South Korea
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