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de la Torre A, Zager B, Bahrami F, Upton MH, Kim J, Fabbris G, Lee GH, Yang W, Haskel D, Tafti F, Plumb KW. Momentum-independent magnetic excitation continuum in the honeycomb iridate H 3LiIr 2O 6. Nat Commun 2023; 14:5018. [PMID: 37596328 PMCID: PMC10439105 DOI: 10.1038/s41467-023-40769-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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 08/07/2023] [Indexed: 08/20/2023] Open
Abstract
Understanding the interplay between the inherent disorder and the correlated fluctuating-spin ground state is a key element in the search for quantum spin liquids. H3LiIr2O6 is considered to be a spin liquid that is proximate to the Kitaev-limit quantum spin liquid. Its ground state shows no magnetic order or spin freezing as expected for the spin liquid state. However, hydrogen zero-point motion and stacking faults are known to be present. The resulting bond disorder has been invoked to explain the existence of unexpected low-energy spin excitations, although data interpretation remains challenging. Here, we use resonant X-ray spectroscopies to map the collective excitations in H3LiIr2O6 and characterize its magnetic state. In the low-temperature correlated state, we reveal a broad bandwidth of magnetic excitations. The central energy and the high-energy tail of the continuum are consistent with expectations for dominant ferromagnetic Kitaev interactions between dynamically fluctuating spins. Furthermore, the absence of a momentum dependence to these excitations are consistent with disorder-induced broken translational invariance. Our low-energy data and the energy and width of the crystal field excitations support an interpretation of H3LiIr2O6 as a disordered topological spin liquid in close proximity to bond-disordered versions of the Kitaev quantum spin liquid.
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Affiliation(s)
- A de la Torre
- Department of Physics, Brown University, Providence, RI, 02912, USA.
| | - B Zager
- Department of Physics, Brown University, Providence, RI, 02912, USA
| | - F Bahrami
- Department of Physics, Boston College, Chestnut Hill, MA, 02467, USA
| | - M H Upton
- Advanced Photon Source, Argonne National Laboratory, Argonne, IL, 60439, USA
| | - J Kim
- Advanced Photon Source, Argonne National Laboratory, Argonne, IL, 60439, USA
| | - G Fabbris
- Advanced Photon Source, Argonne National Laboratory, Argonne, IL, 60439, USA
| | - G-H Lee
- Advanced Light Source, Lawrence Berkeley National Laboratory, Berkeley, 94720, USA
| | - W Yang
- Advanced Light Source, Lawrence Berkeley National Laboratory, Berkeley, 94720, USA
| | - D Haskel
- Advanced Photon Source, Argonne National Laboratory, Argonne, IL, 60439, USA
| | - F Tafti
- Department of Physics, Boston College, Chestnut Hill, MA, 02467, USA
| | - K W Plumb
- Department of Physics, Brown University, Providence, RI, 02912, USA.
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Chiang CH, Lee GH, Chiang TH, Tang PU, Fang CT. Disseminated Mycobacterium avium complex infection as a differential diagnosis of tuberculosis in HIV patients. Int J Tuberc Lung Dis 2021; 24:922-927. [PMID: 33156759 DOI: 10.5588/ijtld.19.0602] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Disseminated Mycobacterium avium complex infection (DMAC) has symptoms and microscopic findings similar to those of TB in HIV patients. To inform a clinical algorithm-based differential diagnosis, we aimed to characterise the clinical features of DMAC.METHODS: This was a retrospective cohort study of 192 HIV-positive patients with culture-confirmed mycobacterial infections hospitalised during 1996-2016 at a major HIV/AIDS treatment centre in Taiwan.RESULTS: HIV patients with DMAC (n = 58) had a three times higher 1-year mortality than those with TB (n = 98) (48.3% vs. 16.3%, P < 0.001). DMAC and TB were not distinguishable by the WHO TB screening criteria (fever, cough, night sweats or weight loss). Nevertheless, DMAC was characterised by a lower median CD4 count (5.0 cells/µL vs. 38.5 cells/µL, P < 0.001), lower median body mass index (BMI) (17.7 kg/m² vs. 19.7 kg/m², P = 0.002) and the absence of chest radiographic findings (P < 0.001). Simultaneous presence of CD4 <20 cells/µl, BMI <18.5 kg/m² and negative chest radiographic finding had a 98% specificity for diagnosing DMAC against TB or other types of mycobacterial infections.CONCLUSION: DMAC is an important differential diagnosis of TB in HIV patients. A simple rule based on CD4, BMI and chest radiography may inform the decision to start anti-DMAC treatment in patients with mycobacterial infection.
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Affiliation(s)
- C-H Chiang
- School of Medicine, College of Medicine, National Taiwan University, Taipei
| | - G-H Lee
- School of Medicine, College of Medicine, National Taiwan University, Taipei
| | - T-H Chiang
- School of Medicine, College of Medicine, National Taiwan University, Taipei
| | - P-U Tang
- School of Medicine, College of Medicine, National Taiwan University, Taipei
| | - C-T Fang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
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3
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Yang MJ, Lee GH, Kim JH, Hwang JC, Yoo BM. Hepatobiliary and Pancreatic: Management of a benign bilio-enteric stricture by a novel covered stent with a long lasso. J Gastroenterol Hepatol 2019; 34:1477. [PMID: 31290160 DOI: 10.1111/jgh.14747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 05/26/2019] [Indexed: 12/09/2022]
Affiliation(s)
- M J Yang
- Department of Gastroenterology, Ajou University School of Medicine, Suwon, South Korea
| | - G-H Lee
- Department of Gastroenterology, Ajou University School of Medicine, Suwon, South Korea
| | - J H Kim
- Department of Gastroenterology, Ajou University School of Medicine, Suwon, South Korea
| | - J C Hwang
- Department of Gastroenterology, Ajou University School of Medicine, Suwon, South Korea
| | - B M Yoo
- Department of Gastroenterology, Ajou University School of Medicine, Suwon, South Korea
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Hartono JL, Koh T, Lee GH, Tan PS, Muthiah M, Aw MM, Madhavan K, Kow A, Lim KB. Predictors of Non-adherence to Immunosuppressive Therapy in Asian Liver Transplant Recipients. Transplant Proc 2018; 49:1419-1424. [PMID: 28736016 DOI: 10.1016/j.transproceed.2017.02.049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 02/23/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Adherence to immunosuppressive medications has been shown to affect post-transplant outcomes. We aimed to determine the level of adherence to immunosuppressive therapy in liver transplant (LT) recipients and to elucidate factors associated with it, as well as patient preferences on the dosing schedule. METHODS LT recipients were recruited during transplant clinic follow-up. A validated Morisky 8-item questionnaire was completed by patients to assess their adherence to immunosuppressive therapy. Adherence was determined by the sum of the responses to the questionnaire. Low, medium, and high adherence were defined by a Morisky score of >2, 1 to 2, and 0, respectively. Data on the patient's socio-economic and clinical background, dosing schedule of immunosuppressant medications, and patient preferences were included in the questionnaire. RESULTS A total of 107 LT recipients were approached and 75 completed the questionnaire. The majority of patients (48/74, 64.9%) preferred a once-daily medication regimen. The proportion of high adherence was 24/75 (32.0%), medium adherence was 51/75 (42.7%), and low adherence was 19/75 (25.3%). Multivariate analysis showed younger age and post-transplant duration >5 years as independent predictors for low adherence. Among low-adherence patients, 16/19 (84.2%) patients were on a twice-daily regimen, and, of these, 14/16 (87.5%) preferred their medications to be reduced to once daily. CONCLUSIONS A significant proportion (68%) of LT recipients had low to moderate adherence to medications, with younger age and longer post-transplant duration of >5 years as independent predictors. Early identification of at-risk patients is essential to allow implementation of measures to improve adherence. Simplifying medication regimens to once daily is a potential way to improve adherence.
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Affiliation(s)
- J L Hartono
- Yong Yoo Lin School of Medicine, National University of Singapore, Singapore; Division of Gastroenterology and Hepatology, National University Health System, Singapore
| | - T Koh
- Department of Pharmacy, National University Health System, Singapore; National University Centre for Organ Transplantation, National University Health System, Singapore
| | - G H Lee
- Yong Yoo Lin School of Medicine, National University of Singapore, Singapore; Division of Gastroenterology and Hepatology, National University Health System, Singapore; National University Centre for Organ Transplantation, National University Health System, Singapore
| | - P S Tan
- Yong Yoo Lin School of Medicine, National University of Singapore, Singapore; Division of Gastroenterology and Hepatology, National University Health System, Singapore; National University Centre for Organ Transplantation, National University Health System, Singapore
| | - M Muthiah
- Yong Yoo Lin School of Medicine, National University of Singapore, Singapore; Division of Gastroenterology and Hepatology, National University Health System, Singapore; National University Centre for Organ Transplantation, National University Health System, Singapore
| | - M M Aw
- Yong Yoo Lin School of Medicine, National University of Singapore, Singapore; Department of Pediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore
| | - K Madhavan
- Yong Yoo Lin School of Medicine, National University of Singapore, Singapore; Division of Hepatobiliary and Pancreatic Surgery, National University Health System, Singapore; National University Centre for Organ Transplantation, National University Health System, Singapore
| | - A Kow
- Yong Yoo Lin School of Medicine, National University of Singapore, Singapore; Division of Hepatobiliary and Pancreatic Surgery, National University Health System, Singapore; National University Centre for Organ Transplantation, National University Health System, Singapore
| | - K B Lim
- Yong Yoo Lin School of Medicine, National University of Singapore, Singapore; Division of Gastroenterology and Hepatology, National University Health System, Singapore; National University Centre for Organ Transplantation, National University Health System, Singapore.
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Choudhury A, Jindal A, Maiwall R, Sharma MK, Sharma BC, Pamecha V, Mahtab M, Rahman S, Chawla YK, Taneja S, Tan SS, Devarbhavi H, Duan Z, Yu C, Ning Q, Jia JD, Amarapurkar D, Eapen CE, Goel A, Hamid SS, Butt AS, Jafri W, Kim DJ, Ghazinian H, Lee GH, Sood A, Lesmana LA, Abbas Z, Shiha G, Payawal DA, Dokmeci AK, Sollano JD, Carpio G, Lau GK, Karim F, Rao PN, Moreau R, Jain P, Bhatia P, Kumar G, Sarin SK. Liver failure determines the outcome in patients of acute-on-chronic liver failure (ACLF): comparison of APASL ACLF research consortium (AARC) and CLIF-SOFA models. Hepatol Int 2017; 11:461-471. [PMID: 28856540 DOI: 10.1007/s12072-017-9816-z] [Citation(s) in RCA: 119] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Accepted: 07/30/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIMS Acute-on-chronic liver failure (ACLF) is a progressive disease associated with rapid clinical worsening and high mortality. Early prediction of mortality and intervention can improve patient outcomes. We aimed to develop a dynamic prognostic model and compare it with the existing models. METHODS A total of 1402 ACLF patients, enrolled in the APASL-ACLF Research Consortium (AARC) with 90-day follow-up, were analyzed. An ACLF score was developed in a derivation cohort (n = 480) and was validated (n = 922). RESULTS The overall survival of ACLF patients at 28 days was 51.7%, with a median of 26.3 days. Five baseline variables, total bilirubin, creatinine, serum lactate, INR and hepatic encephalopathy, were found to be independent predictors of mortality, with AUROC in derivation and validation cohorts being 0.80 and 0.78, respectively. AARC-ACLF score (range 5-15) was found to be superior to MELD and CLIF SOFA scores in predicting mortality with an AUROC of 0.80. The point scores were categorized into grades of liver failure (Gr I: 5-7; II: 8-10; and III: 11-15 points) with 28-day cumulative mortalities of 12.7, 44.5 and 85.9%, respectively. The mortality risk could be dynamically calculated as, with each unit increase in AARC-ACLF score above 10, the risk increased by 20%. A score of ≥11 at baseline or persisting in the first week was often seen among nonsurvivors (p = 0.001). CONCLUSIONS The AARC-ACLF score is easy to use, dynamic and reliable, and superior to the existing prediction models. It can reliably predict the need for interventions, such as liver transplant, within the first week.
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Affiliation(s)
- A Choudhury
- Department of Hepatology and Transplant, Institute of Liver and Biliary Sciences (ILBS), New Delhi, 110 070, India.,Department of Hepatology, Institute of Liver and Biliary Sciences (ILBS), New Delhi, 110 070, India
| | - A Jindal
- Department of Hepatology and Transplant, Institute of Liver and Biliary Sciences (ILBS), New Delhi, 110 070, India.,Department of Hepatology, Institute of Liver and Biliary Sciences (ILBS), New Delhi, 110 070, India
| | - R Maiwall
- Department of Hepatology and Transplant, Institute of Liver and Biliary Sciences (ILBS), New Delhi, 110 070, India.,Department of Hepatology, Institute of Liver and Biliary Sciences (ILBS), New Delhi, 110 070, India
| | - M K Sharma
- Department of Hepatology and Transplant, Institute of Liver and Biliary Sciences (ILBS), New Delhi, 110 070, India.,Department of Hepatology, Institute of Liver and Biliary Sciences (ILBS), New Delhi, 110 070, India
| | - B C Sharma
- Department of Hepatology and Transplant, Institute of Liver and Biliary Sciences (ILBS), New Delhi, 110 070, India.,Department of Hepatology, Institute of Liver and Biliary Sciences (ILBS), New Delhi, 110 070, India
| | - V Pamecha
- Department of Hepatology and Transplant, Institute of Liver and Biliary Sciences (ILBS), New Delhi, 110 070, India
| | - M Mahtab
- Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - S Rahman
- Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Y K Chawla
- Department of Hepatology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - S Taneja
- Department of Hepatology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - S S Tan
- Department of Gastroenterology and Hepatology, Selayang Hospital, Kepong, Malaysia
| | - H Devarbhavi
- Department of Gastroenterology and Hepatology, St John Medical College, Bangalore, India
| | - Z Duan
- Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Chen Yu
- Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Q Ning
- Department of Infectious Disease, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Ji Dong Jia
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - D Amarapurkar
- Department of Gastroenterology and Hepatology, Bombay Hospital and Medical Research Centre, Mumbai, India
| | - C E Eapen
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - A Goel
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - S S Hamid
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - A S Butt
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - W Jafri
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - D J Kim
- Hallym University Chuncheon Sacred Heart Hospital, Center for Liver and Digestive Diseases, Chuncheon, Gangwon-Do, Republic of Korea
| | - H Ghazinian
- Department of Hepatology, Nork Clinical Hospital of Infectious Diseases, Yerevan, Armenia
| | - G H Lee
- Department of Gastroenterology and Hepatology, National University Health System, Singapore, Singapore
| | - Ajit Sood
- Department of Gastroenterology, Dayanand Medical College, Ludhiana, India
| | - L A Lesmana
- Division of Hepatology, University of Indonesia, Jakarta, Indonesia
| | - Z Abbas
- Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
| | - G Shiha
- Department of Internal Medicine, Egyptian Liver Research Institute and Hospital, Cairo, Egypt
| | - D A Payawal
- Department of Hepatology, Cardinal Santos Medical Center, Manila, Philippines
| | - A K Dokmeci
- Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey
| | - J D Sollano
- Cardinal Santos Medical Center, Metro Manila, Philippines
| | - G Carpio
- Cardinal Santos Medical Center, Metro Manila, Philippines
| | - G K Lau
- The Institute of Translational Hepatology, Beijing, China
| | - F Karim
- Sir Salimur Rehman Medical College, Mitford Hospital, Dhaka, Bangladesh
| | - P N Rao
- Asian Institute of Gastroenterology, Hyderabad, India
| | - R Moreau
- Inserm, U1149, Centre de recherche sur l'Inflammation (CRI), UMR_S 1149, Labex INFLAMEX, Université Paris Diderot Paris 7, Paris, France
| | - P Jain
- Department of Hepatology and Transplant, Institute of Liver and Biliary Sciences (ILBS), New Delhi, 110 070, India.,Department of Hepatology, Institute of Liver and Biliary Sciences (ILBS), New Delhi, 110 070, India
| | - P Bhatia
- Department of Hepatology and Transplant, Institute of Liver and Biliary Sciences (ILBS), New Delhi, 110 070, India.,Department of Clinical Research, Institute of Liver and Biliary Sciences (ILBS), New Delhi, 110 070, India
| | - G Kumar
- Department of Hepatology and Transplant, Institute of Liver and Biliary Sciences (ILBS), New Delhi, 110 070, India.,Department of Hepatology, Institute of Liver and Biliary Sciences (ILBS), New Delhi, 110 070, India
| | - S K Sarin
- Department of Hepatology and Transplant, Institute of Liver and Biliary Sciences (ILBS), New Delhi, 110 070, India. .,Department of Hepatology, Institute of Liver and Biliary Sciences (ILBS), New Delhi, 110 070, India.
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6
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Jung DH, Hwang S, Song GW, Ahn CS, Moon DB, Ha TY, Kim KH, Park GC, Kim BS, Park IJ, Lim SB, Kim JC, Yoo MW, Byeon JS, Jung HY, Lee GH, Myung SJ, Choe J, Choi JY, Park HW, Lee SG. Survival Benefit of Early Cancer Detection Through Regular Endoscopic Screening for De Novo Gastric and Colorectal Cancers in Korean Liver Transplant Recipients. Transplant Proc 2016; 48:145-51. [PMID: 26915860 DOI: 10.1016/j.transproceed.2015.12.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 12/10/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND De novo malignancy is not uncommon after liver transplantation (LT). Gastric cancer is one of the most common malignancies in both the Korean general population and LT recipients, and colorectal cancer prevalence is gradually increasing. METHODS Among 3690 adult recipients who underwent LT from January 1999 and December 2013, the screening patterns and prognosis of 26 cases of gastric cancer and 22 cases of colorectal cancer were analyzed. RESULTS For gastric cancer, the mean patient age was 54.6 ± 6.2 years at LT and 59.5 ± 6.7 years at cancer diagnosis, with a post-transplant interval of 60.2 ± 29.8 months. Patients were divided into regular (n = 18) and non-regular (n = 8) screening groups, with early cancer found in 14 and 0 patients; their 2-year survival rates after cancer diagnosis were 93.1% and 33.3% (P = .006), respectively. Endoscopic resection was successfully performed in 8 patients, all in the regular screening group. For colorectal cancer, the mean patient age was 53.3 ± 6.1 years at LT and 58.1 ± 6.7 years at cancer diagnosis, with a post-transplant interval of 54.3 ± 38.0 months. Patients were divided into regular (n = 19) and non-regular (n = 3) screening groups, with early cancer found in 12 and 0 patients; their 2-year survival rates after cancer diagnosis of 92.3% and 33.3% (P = .003), respectively. Endoscopic resection was successfully performed in 6 patients, all in the regular screening group. CONCLUSIONS LT recipients are strongly advised to undergo regular screening studies for various de novo malignancies, especially cancers common in the general population. Regular endoscopic screening contributes to the timely detection of gastric and colorectal cancers, improving post-treatment survival outcomes.
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Affiliation(s)
- D H Jung
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - S Hwang
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | - G W Song
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - C S Ahn
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - D B Moon
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - T Y Ha
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - K H Kim
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - G C Park
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - B S Kim
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - I J Park
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - S B Lim
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J C Kim
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - M W Yoo
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J S Byeon
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - H Y Jung
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - G H Lee
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - S J Myung
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J Choe
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J Y Choi
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - H W Park
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - S G Lee
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Gong EJ, Kim DH, Ahn JY, Choi KS, Jung KW, Lee JH, Choi KD, Song HJ, Lee GH, Jung HY, Kim JH, Roh JL, Choi SH, Nam SY, Kim SY. Routine endoscopic screening for synchronous esophageal neoplasm in patients with head and neck squamous cell carcinoma: a prospective study. Dis Esophagus 2016; 29:752-759. [PMID: 26471351 DOI: 10.1111/dote.12404] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [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: 12/11/2022]
Abstract
Early detection of synchronous esophageal squamous cell neoplasm (ESCN) in head and neck squamous cell carcinoma (HNSCC) patients can significantly affect their prognosis. We investigated the prevalence of synchronous ESCN and the risk factors for developing ESCN in patients with HNSCC, and evaluated the effect of routine endoscopic screening in these patients. Subjects who were diagnosed as HNSCC from May 2010 to January 2014 were eligible. All patients underwent conventional white light endoscopic examinations with narrow band imaging and Lugol chromoendoscopy. Among 458 subjects screened, 28 synchronous ESCN were detected in 24 patients (5.2%). The prevalence of ESCN was greatest in patients with hypopharyngeal cancer (20.9%). In multivariate analysis, pyriform sinus involvement was independent risk factor for developing synchronous ESCN (odds ratio 171.2, P < 0.001). During the follow-up period (median, 24 months), the 3-year overall survival rates was significantly lower in patients with ESCN than in patients without ESCN (54.2% vs. 78.3%, P = 0.0013). Routine endoscopic screening for detecting synchronous ESCN should be recommended for patients with HNSCC, especially those with pyriform sinus involvement.
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Affiliation(s)
- E J Gong
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - D H Kim
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
| | - J Y Ahn
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - K-S Choi
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - K W Jung
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - J H Lee
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - K D Choi
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - H J Song
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - G H Lee
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - H-Y Jung
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - J H Kim
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - J-L Roh
- Department of otolaryngology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - S-H Choi
- Department of otolaryngology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - S Y Nam
- Department of otolaryngology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - S Y Kim
- Department of otolaryngology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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8
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Ryu HS, Lee SA, Lee GH, Chung YS, Kim WS. Subjective apnoea symptoms are associated with daytime sleepiness in patients with moderate and severe obstructive sleep apnoea: a retrospective study. Clin Otolaryngol 2016; 41:395-401. [PMID: 27086649 DOI: 10.1111/coa.12659] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Most previous studies have failed to show a relation between daytime sleepiness and apnoea severity in patients with obstructive sleep apnoea (OSA). We determined the relation between daytime sleepiness and subjective and objective apnoea severity in newly diagnosed patients with moderate-to-severe OSA. DESIGN Retrospective cross-sectional study. SETTING Tertiary referral centre. PARTICIPANTS A total of 559 adults with newly diagnosed moderate and severe OSA. MAIN OUTCOME MEASURES Daytime sleepiness was evaluated using the Epworth Sleepiness Scale (ESS). Subjective and objective apnoea severities were assessed using the Sleep Breathing Scale (SBS) and polysomnography respectively. Sleep quality and depressive symptoms were evaluated using Medical Outcomes Study-Sleep Scale and Beck Depression Inventory (BDI) respectively. RESULTS The mean ESS score was 9.8 (SD 5.0). ESS score was correlated with SBS score (P < 0.001), apnoea-hypopnoea index (AHI) (P = 0.027), minimal oxygen saturation (MinSaO2 ) (P = 0.021), body mass index (BMI) (P = 0.007) and BDI score (P < 0.001). Linear regression analysis showed that higher SBS (P = 0.005) and BDI scores (P < 0.001) were associated with higher ESS score after controlling for gender, BMI and AHI. Apnoea-hypopnoea index, MinSaO2 and BMI were not independently related to ESS score. CONCLUSIONS Daytime sleepiness was related to subjective OSA symptoms but not objective apnoea severity measured by polysomnography in patients with moderate-to-severe OSA. These findings suggest the usefulness of the subjective apnoea severity as an indicator of OSA disease severity.
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Affiliation(s)
- H S Ryu
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - S A Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - G H Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Y S Chung
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - W S Kim
- Department of Pulmonary Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Kim HJ, Lee GH, Ryoo S, Oh SY, Lee JB, Kim JH, Shin C, Lee SH. Role of confirmatory interferon-gamma release assays in school outbreaks of tuberculosis in South Korea. Int J Tuberc Lung Dis 2016; 19:576-81. [PMID: 25868027 DOI: 10.5588/ijtld.14.0636] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To investigate the usefulness of confirmatory QuantiFERON(®) (QFT) testing among tuberculin skin test (TST) positive contacts to diagnose latent tuberculous infection (LTBI) in tuberculosis (TB) outbreaks among adolescents. DESIGN We used the Korean national claims database to identify the development of active TB disease in relation to initial TST (cut-off 10 mm induration) and subsequent QFT results. RESULTS A total of 7475 contacts in 89 schools were divided into four groups: TST- (n = 5714), TST+/QFT+ (n = 534), TST+/QFT- (n = 697) and TST+ only (n = 530). The mean duration of follow-up was 3.9 ± 0.9 years. For contacts with no LTBI treatment (n = 6868), TB incidence rates per 1000 person-years (py) and the adjusted hazard ratio (HR) compared with TST- individuals were as follows: TST+/QFT+, 66.2/1000 py (HR 35.59, 95%CI 14.03-90.31, P < 0.001); TST+ only, 10.1/1000 py (HR 5.16, 95%CI 2.91-9.17, P < 0.001); TST+/QFT-, 4.0/1000 py (HR 2.05, 95%CI 1.05-4.01, P = 0.035); and TST- 2.0/1000 py. The TB progression rate was significantly higher in TST+/QFT+ than in TST+/QFT- individuals (HR 16.82, 95 CI 5.84-48.46, P < 0.001). CONCLUSION A confirmatory QFT for TST+ contacts could reduce the number of candidates for LTBI treatment after school TB outbreaks.
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Affiliation(s)
- H J Kim
- Korean Institute of Tuberculosis, Osong, Republic of Korea
| | - G-H Lee
- Korean Institute of Tuberculosis, Osong, Republic of Korea
| | - S Ryoo
- Korean Institute of Tuberculosis, Osong, Republic of Korea
| | - S-Y Oh
- Korean Institute of Tuberculosis, Osong, Republic of Korea
| | - J-B Lee
- Korean Institute of Tuberculosis, Osong, Republic of Korea
| | - J H Kim
- Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
| | - C Shin
- Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
| | - S H Lee
- Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
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10
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Park JY, Chang Y, Lee GH. Multi-modal imaging and cancer therapy using lanthanide oxide nanoparticles: current status and perspectives. Curr Med Chem 2015; 22:569-81. [PMID: 25439587 DOI: 10.2174/0929867322666141128162843] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 11/04/2014] [Accepted: 11/27/2014] [Indexed: 11/22/2022]
Abstract
Biomedical imaging is an essential tool for diagnosis and therapy of diseases such as cancers. It is likely true that medicine has developed with biomedical imaging methods. Sensitivity and resolution of biomedical imaging methods can be improved with imaging agents. Furthermore, it will be ideal if imaging agents could be also used as therapeutic agents. Therefore, one dose can be used for both diagnosis and therapy of diseases (i.e., theragnosis). This will simplify medical treatment of diseases, and will be also a benefit to patients. Mixed (Ln(1x)Ln(2y)O3, x + y = 2) or unmixed (Ln2O3) lanthanide (Ln) oxide nanoparticles (Ln = Eu, Gd, Dy, Tb, Ho, Er) are potential multi-modal imaging and cancer therapeutic agents. The lanthanides have a variety of magnetic and optical properties, useful for magnetic resonance imaging (MRI) and fluorescent imaging (FI), respectively. They also highly attenuate X-ray beam, useful for X-ray computed tomography (CT). In addition gadolinium-157 ((157)Gd) has the highest thermal neutron capture cross section among stable radionuclides, useful for gadolinium neutron capture therapy (GdNCT). Therefore, mixed or unmixed lanthanide oxide nanoparticles can be used for multi-modal imaging methods (i.e., MRI-FI, MRI-CT, CT-FI, and MRICT- FI) and cancer therapy (i.e., GdNCT). Since mixed or unmixed lanthanide oxide nanoparticles are single-phase and solid-state, they can be easily synthesized, and are compact and robust, which will be beneficial to biomedical applications. In this review physical properties of the lanthanides, synthesis, characterizations, multi-modal imagings, and cancer therapy of mixed and unmixed lanthanide oxide nanoparticles are discussed.
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Affiliation(s)
| | | | - G H Lee
- Department of Chemistry and Department of Nanoscience and Nanotechnology, College of Natural Sciences, Kyungpook National University (KNU), Taegu 702-701, South Korea.
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11
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Comino I, Šuligoj T, Al-Hassi HO, Lee GH, Sousa C, Landy J, Ciclitira PJ, Knight SC, Bernardo D. Constitutive gut-homing capacity on circulating myeloid dendritic cells in coeliac disease. Rev Esp Enferm Dig 2015; 106:64-5. [PMID: 24689721 DOI: 10.4321/s1130-01082014000100013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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12
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Jung KW, Jung HY, Myung SJ, Kim SO, Lee J, Yoon IJ, Seo SY, Lee JH, Kim DH, Choi KD, Song HJ, Lee GH, Murray JA, Romero Y, Kim JH. The effect of age on the key parameters in the Chicago classification: a study using high-resolution esophageal manometry in asymptomatic normal individuals. Neurogastroenterol Motil 2015; 27:246-57. [PMID: 25521290 DOI: 10.1111/nmo.12482] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 11/10/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND High-resolution manometry using the Chicago classification, which utilizes parameters including integrated relaxation pressure (IRP), distal contractile integral (DCI), and contractile front velocity (CFV), shows better diagnostic ability than previous conventional criteria. However, the current normal cut-off values for the Chicago classification are based on individuals aged 19-48 years and do not include older people. Here, we aimed to assess the normal values for the Chicago classification in individuals aged 20-67 years and compare the parameters across age groups. METHODS Fifty-four asymptomatic healthy individuals (27 male and 27 female; age range. 20-67 years) were prospectively enrolled. To evaluate the effect of age and sex on manometric profiles, we attempted to enroll equal numbers of male and female subjects for each decade. Manometry was performed in both the supine and sitting positions. KEY RESULTS The distal latency (DL) was significantly shorter with increasing age in both measurement positions. Furthermore, IRP was significantly higher with increasing age in both positions. Spearman's ranked correlation coefficient analysis indicated that DCI and IRP in both positions were positively correlated with age. CONCLUSIONS & INFERENCES Age affects the key parameters currently used in the Chicago classification, including IRP, DCI, and DL. Larger prospective studies with older subjects are needed to determine the age-related normal values for the Chicago classification system.
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Affiliation(s)
- K W Jung
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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13
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Abstract
There have been recent advances in genetic testing enabling accurate diagnosis of polyposis syndromes by identifying causative gene mutations, which is essential in the management of individuals with polyposis syndrome and predictive genetic testing of their extended families. There are some similarities in clinical presentation of various polyposis syndromes, which may pose a challenge to diagnosis. In this review, we discuss the clinical presentation of the main polyposis syndromes and the process of genetic testing, including the latest advancement and future of genetic testing. We aim to reiterate the importance of genetic testing in the management of polyposis syndromes, potential pitfalls associated with genetic testing and recommendations for healthcare professionals involved with the care of polyposis patients.
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Affiliation(s)
- G H Lee
- The Polyposis Registry, St Mark's Hospital, Harrow, UK; Department of Surgery and Cancer, Imperial College London, London, UK
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14
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Affiliation(s)
- G H Lee
- Department of Gastroenterology and Hepatology, National University Hospital, Singapore
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15
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Kroeker R, Bellanca RU, Lee GH, Thom JP, Worlein JM. Alopecia in three macaque species housed in a laboratory environment. Am J Primatol 2014; 76:325-34. [PMID: 24243351 PMCID: PMC4066655 DOI: 10.1002/ajp.22236] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [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: 02/05/2013] [Revised: 08/26/2013] [Accepted: 10/21/2013] [Indexed: 12/16/2022]
Abstract
Alopecia is a persistent problem in captive macaque populations and despite recent interest, no factors have been identified that can unequivocally explain the presence of alopecia in a majority of cases. Seasonal, demographic, and environmental factors have been identified as affecting alopecia presentation in rhesus macaques, the most widely studied macaque species. However, few studies have investigated alopecia rates in other macaque species. We report alopecia scores over a period of 12 months for three macaque species (Macaca nemestrina, M. mulatta, and M. fascicularis) housed at three indoor facilities within the Washington National Primate Research Center (WaNPRC) in Seattle. Clear species differences emerged with cynomolgus (M. fascicularis) showing the lowest alopecia rates and pigtails (M. nemestrina) the highest rates. Further analysis of pigtail and rhesus (M. mulatta) macaques revealed that sex effects were apparent for rhesus but not pigtails. Age and seasonal effects were evident for both species. In contrast to previous reports, we found that older animals (over 10 years of age) had improved alopecia scores in comparison to younger adults. This is the first report on alopecia rates in pigtail macaques and the first comparison of alopecia scores in pigtail, cynomolgus, and rhesus macaques housed under similar conditions.
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Affiliation(s)
- R Kroeker
- Washington National Primate Research Center, University of Washington, Seattle, Washington
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16
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Park MT, Kim MJ, Suh Y, Kim RK, Kim H, Lim EJ, Yoo KC, Lee GH, Kim YH, Hwang SG, Yi JM, Lee SJ. Novel signaling axis for ROS generation during K-Ras-induced cellular transformation. Cell Death Differ 2014; 21:1185-97. [PMID: 24632950 DOI: 10.1038/cdd.2014.34] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 02/04/2014] [Accepted: 02/05/2014] [Indexed: 12/13/2022] Open
Abstract
Reactive oxygen species (ROS) are well known to be involved in oncogene-mediated cellular transformation. However, the regulatory mechanisms underlying ROS generation in oncogene-transformed cells are unclear. In the present study, we found that oncogenic K-Ras induces ROS generation through activation of NADPH oxidase 1 (NOX1), which is a critical regulator for the K-Ras-induced cellular transformation. NOX1 was activated by K-Ras-dependent translocation of p47(phox), a subunit of NOX1 to plasma membrane. Of note, PKCδ, when it was activated by PDPK1, directly bound to the SH3-N domain of p47(phox) and catalyzed the phosphorylation on Ser348 and Ser473 residues of p47(phox) C-terminal in a K-Ras-dependent manner, finally leading to its membrane translocation. Notably, oncogenic K-Ras activated all MAPKs (JNK, ERK and p38); however, only p38 was involved in p47(phox)-NOX1-dependent ROS generation and consequent transformation. Importantly, K-Ras-induced activation of p38 led to an activation of PDPK1, which then signals through PKCδ, p47(phox) and NOX1. In agreement with the mechanism, inhibition of p38, PDPK1, PKCδ, p47(phox) or NOX1 effectively blocked K-Ras-induced ROS generation, anchorage-independent colony formation and tumor formation. Taken together, our findings demonstrated that oncogenic K-Ras activates the signaling cascade p38/PDPK1/PKCδ/p47(phox)/NOX1 for ROS generation and consequent malignant cellular transformation.
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Affiliation(s)
- M-T Park
- 1] Laboratory of Molecular Biochemistry, Department of Life Science, Research Institute for Natural Sciences, Hanyang University, Seoul 133-791, Korea [2] Research Center, Dongnam Institute of Radiological and Medical Sciences, Busan, Korea
| | - M-J Kim
- 1] Laboratory of Molecular Biochemistry, Department of Life Science, Research Institute for Natural Sciences, Hanyang University, Seoul 133-791, Korea [2] Low Dose Radiation Research Center, National Radiation Emergency Medical Science, Korea Institute of Radiological and Medical Sciences, Seoul 139-706, Korea
| | - Y Suh
- Laboratory of Molecular Biochemistry, Department of Life Science, Research Institute for Natural Sciences, Hanyang University, Seoul 133-791, Korea
| | - R-K Kim
- Laboratory of Molecular Biochemistry, Department of Life Science, Research Institute for Natural Sciences, Hanyang University, Seoul 133-791, Korea
| | - H Kim
- Laboratory of Molecular Biochemistry, Department of Life Science, Research Institute for Natural Sciences, Hanyang University, Seoul 133-791, Korea
| | - E-J Lim
- Laboratory of Molecular Biochemistry, Department of Life Science, Research Institute for Natural Sciences, Hanyang University, Seoul 133-791, Korea
| | - K-C Yoo
- Laboratory of Molecular Biochemistry, Department of Life Science, Research Institute for Natural Sciences, Hanyang University, Seoul 133-791, Korea
| | - G-H Lee
- Laboratory of Molecular Biochemistry, Department of Life Science, Research Institute for Natural Sciences, Hanyang University, Seoul 133-791, Korea
| | - Y-H Kim
- Laboratory of Molecular Biochemistry, Department of Life Science, Research Institute for Natural Sciences, Hanyang University, Seoul 133-791, Korea
| | - S-G Hwang
- Division of Radiation Cancer Biology, Korea Institute of Radiological and Medical Sciences, Seoul 139-706, Korea
| | - J-M Yi
- Research Center, Dongnam Institute of Radiological and Medical Sciences, Busan, Korea
| | - S-J Lee
- Laboratory of Molecular Biochemistry, Department of Life Science, Research Institute for Natural Sciences, Hanyang University, Seoul 133-791, Korea
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Lee MR, Lee GH, Lee HY, Kim DS, Chung MJ, Lee YC, Kim HR, Chae HJ. BAX inhibitor-1-associated V-ATPase glycosylation enhances collagen degradation in pulmonary fibrosis. Cell Death Dis 2014; 5:e1113. [PMID: 24625972 PMCID: PMC3973240 DOI: 10.1038/cddis.2014.86] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 02/01/2014] [Accepted: 02/06/2014] [Indexed: 12/27/2022]
Abstract
Endoplasmic reticulum (ER) stress is considered one of the pathological mechanisms of idiopathic pulmonary fibrosis (IPF). Therefore, we examined whether an ER stress regulator, Bax inhibitor-1 (BI-1), regulates collagen accumulation, which is both a marker of fibrosis and a pathological mechanism of fibrosis. The presence of BI-1 inhibited the transforming growth factor-β1-induced epithelial-mesenchymal transition of epithelial pulmonary cells and bleomycin-induced pulmonary fibrosis in a mouse model by enhancing collagen degradation, most likely by enhanced activation of the lysosomal V-ATPase through glycosylation. We also found a correlation between post-translational glycosylation of the V-ATPase and its associated chaperone, calnexin, in BI-1-overexpressing cells. BI-1-induced degradation of collagen through lysosomal V-ATPase glycosylation and the involvement of calnexin were confirmed in a bleomycin-induced fibrosis mouse model. These results highlight the regulatory role of BI-1 in IPF and reveal for the first time the role of lysosomal V-ATPase glycosylation in IPF.
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Affiliation(s)
- M-R Lee
- Department of Pharmacology and Institute of Cardiovascular Research, Medical School, Chonbuk National University, Jeonju, Chonbuk, Republic of Korea
| | - G-H Lee
- Department of Pharmacology and Institute of Cardiovascular Research, Medical School, Chonbuk National University, Jeonju, Chonbuk, Republic of Korea
| | - H-Y Lee
- Department of Pharmacology and Institute of Cardiovascular Research, Medical School, Chonbuk National University, Jeonju, Chonbuk, Republic of Korea
| | - D-S Kim
- Department of Pharmacology and Institute of Cardiovascular Research, Medical School, Chonbuk National University, Jeonju, Chonbuk, Republic of Korea
| | - M J Chung
- Department of Pathology, Chonbuk National University Medical School, Jeonju, Chonbuk, Republic of Korea
| | - Y C Lee
- Department of Internal Medicine, Chonbuk National University, Medical School, Jeonju, Chonbuk, Republic of Korea
| | - H-R Kim
- Department of Dental Pharmacology, School of Dentistry, Wonkwang University, Iksan, Chonbuk, Republic of Korea
| | - H-J Chae
- Department of Pharmacology and Institute of Cardiovascular Research, Medical School, Chonbuk National University, Jeonju, Chonbuk, Republic of Korea
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Bernardo D, Mann ER, Al-Hassi HO, English NR, Man R, Lee GH, Ronde E, Landy J, Peake STC, Hart AL, Knight SC. Lost therapeutic potential of monocyte-derived dendritic cells through lost tissue homing: stable restoration of gut specificity with retinoic acid. Clin Exp Immunol 2013; 174:109-19. [PMID: 23607934 PMCID: PMC3784218 DOI: 10.1111/cei.12118] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2013] [Indexed: 01/09/2023] Open
Abstract
Human monocyte-derived dendritic cells (DC) (MoDC) are utilized for immunotherapy. However, in-vitro immunological effects are often not mirrored in vivo. We studied the tissue-homing potential of MoDC. Circulating monocytes and DC expressed different tissue-homing markers and, during in-vitro development of MoDC, homing marker expression was lost resulting in a 'homeless' phenotype. Retinoic acid (RA) induced gut-homing markers (β7 and CCR9) and a regulatory phenotype and function [decreased human leucocyte antigen D-related (HLA-DR) and increased ILT3 and fluorescein isothiocyanate (FITC-dextran uptake) in MoDC]. RA-MoDC were less stimulatory and primed conditioned T cells with a gut-homing profile (β7(+)CLA(-)). Unlike the normal intestinal microenvironment, that from inflamed colon of ulcerative colitis (UC) patients did not induce regulatory properties in MoDC. However, RA-MoDC maintained their regulatory gut-specific properties even in the presence of UC microenvironment. Therefore, MoDC may be ineffectual for immunotherapy because they lack tissue-homing and tissue-imprinting specificity. However, MoDC rehabilitation with gut-homing potential by RA could be useful in promoting immunotherapy in pathologies such as UC.
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Affiliation(s)
- D Bernardo
- Antigen Presentation Research Group, Imperial College London, Northwick Park & St Mark's Campus, UK
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Iguchi M, Osanai M, Hayashi Y, Koentgen F, Lee GH. The error-prone DNA polymerase ι provides quantitative resistance to lung tumorigenesis and mutagenesis in mice. Oncogene 2013; 33:3612-7. [DOI: 10.1038/onc.2013.331] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 05/19/2013] [Accepted: 06/25/2013] [Indexed: 12/24/2022]
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Jung JH, Choi KD, Ahn JY, Lee JH, Jung HY, Choi KS, Lee GH, Song HJ, Kim DH, Kim MY, Bae SE, Kim JH. Endoscopic submucosal dissection for sessile, nonampullary duodenal adenomas. Endoscopy 2013; 45:133-5. [PMID: 23364841 DOI: 10.1055/s-0032-1326178] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Although endoscopic submucosal dissection (ESD) is increasingly utilized to treat early neoplasms of the gastrointestinal tract, its use for duodenal neoplasms is limited by the thin wall and narrow lumen of the duodenum. We have reviewed cases where ESD was used to treat sessile, nonampullary duodenal neoplasms. To do this, we retrospectively reviewed the medical records of patients treated with ESD for adenomas of the duodenum from January 2001 to December 2010, assessing the curative outcomes and complication rates. A total of 14 cases were reviewed. Mean patient age was 56.4 years. The mean size of tumors and mean size of the specimens were 17.1 mm and 26.4 mm, respectively. The en bloc resection rate with ESD was 78.6%, and the complete (R0) resection rate was 85.7%. No patient in the study experienced major bleeding. However, second-look endoscopy revealed minor bleeding requiring endoscopic homeostasis in one case (7.1%). Perforations were observed in five cases (35.7%). Two of the five patients with perforation underwent surgery. The ESD methods yielded acceptable curative resection rates for duodenal adenomas, although ESD was associated with a higher rate of perforation. Therefore, duodenal ESD should be performed with care and only in selected patients to avoid serious complications.
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Affiliation(s)
- J H Jung
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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Hartono JL, Aung MO, Dan YY, Gowans M, Lim K, Lee YM, Lee GH, Low HC, Tan PS, Thwin MA, Soon C, Chiu LL, Khoo MJ, Koay E, Lim SG. Resolution of adefovir-related nephrotoxicity by adefovir dose-reduction in patients with chronic hepatitis B. Aliment Pharmacol Ther 2013; 37:710-9. [PMID: 23432107 DOI: 10.1111/apt.12251] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Revised: 10/08/2012] [Accepted: 01/27/2013] [Indexed: 12/17/2022]
Abstract
BACKGROUND Chronic hepatitis B patients (CHB) treated with adefovir were followed up to evaluate nephrotoxicity and its outcome. AIM To assess the incidence of renal dysfunction during adefovir therapy in Asian patients and factors associated with it, and evaluate strategies to improve adefovir-related renal dysfunction and their impact on viral suppression. METHODS Chronic hepatitis B clinic patients from a tertiary hospital on adefovir treatment, with their clinical and laboratory parameters were extracted from the hospital electronic clinical database in an observational study design. Patients were excluded if they had liver/renal transplant, baseline renal impairment or were on dialysis. Adefovir-related renal dysfunction was defined as adefovir-related abnormal serum creatinine (ARASC) > 125 μmol/L (males), >90 μmol/L (females); adefovir-related abnormal GFR <60 mL/min; and adefovir-related increased serum creatinine >0.5 mg/dL, without other known causes of nephrotoxicity. RESULTS A total of 271/383 adefovir-treated patients were suitable for analysis and 33(12%) patients developed abnormal serum creatinine. Cumulative increase in proportion of patients with ARASC was 33.8% and GFR ≤60 mL/min was 38.3% by 6 years, while serum creatinine increase ≥0.5 mg/dL was 21.48% by 5 years. Using multivariate analysis, the only independent baseline predictor of ARASC was GFR ≤76.1 mL/min. Patients who had ARASC had similar levels of viral suppression to those who did not have ARASC. Those who had ARASC either continued adefovir (24%), switched therapy (24%) or had adefovir dose reduction (52%). ARASC resolved and GFR normalised in almost all patients after either switching therapy or reducing adefovir dose, with no difference between the two strategies (P = 0.737). Those with adefovir dose reduction had no significant increase in HBV DNA (P = 0.170). CONCLUSIONS Adefovir-related renal dysfunction occurred in a significant number of adefovir-treated patients, but reduction of the dose led to renal improvement without compromising treatment efficacy.
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Affiliation(s)
- J L Hartono
- Department of Gastroenterology and Hepatology, National University of Singapore, Singapore
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Ahn JY, Jung HY, Choi JY, Kim MY, Lee JH, Choi KS, Kim DH, Choi KD, Song HJ, Lee GH, Kim JH, Park YS. Natural course of noncurative endoscopic resection of differentiated early gastric cancer. Endoscopy 2012. [PMID: 23188661 DOI: 10.1055/s-0032-1325676] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND STUDY AIMS Following noncurative endoscopic resection of early gastric cancer (EGC), the patient should be observed when the underlying disease is severe, the patient is elderly, or the patient refuses further treatment. The aim of this study was to analyze the clinical outcomes of patients with differentiated EGC who underwent noncurative endoscopic resection without additional treatment. PATIENTS AND METHODS Included patients underwent noncurative endoscopic resection for differentiated EGC without additional treatment at the Asan Medical Center between July 1994 and January 2009. Clinical and oncological outcomes were analyzed. RESULTS A total of 159 patients were included in the analysis. The median follow-up period was 33 months (interquartile range [IQR] 22 - 52 months). In total, 40 patients died (25.2 %) - 3 due to stomach cancer, 34 due to other causes, and 3 from unknown causes; the median survival time after endoscopic treatment for these patients was 27.5 months (IQR 13.8 - 48.3 months). Multivariate analysis showed that the rates of underlying disease (P < 0.001) and lymphovascular invasion (P = 0.005) were higher among the 40 patients who died than among the 119 survivors. The overall 3- and 5-year survival rates were 82.9 % and 77.1 %, respectively; the rates of the patients with lymphovascular invasion were 61.9 % and 42.4 %, respectively, and the rates of patients without lymphovascular invasion were 86.1 % and 81.8 %, respectively (P < 0.001). CONCLUSIONS Additional treatment provides fewer benefits to patients who do not have long life expectancies. Additional surgery can be considered for patients with lymphovascular invasion because of its high mortality rate; however, the benefits and risks of surgery should be considered carefully.
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Affiliation(s)
- J Y Ahn
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, South Korea
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Khan T, Lee GH, Alvand A, Mahaluxmivala JS. Spontaneous bilateral compartment syndrome of the legs: A case report and review of the literature. Int J Surg Case Rep 2012; 3:209-11. [PMID: 22466112 DOI: 10.1016/j.ijscr.2012.02.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Revised: 01/26/2012] [Accepted: 02/03/2012] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Bilateral acute compartment syndrome of the legs is a rare presentation requiring emergent surgical intervention. PRESENTATION OF CASE We report the case of 41-year-old woman who presented with acute bilateral compartment syndrome of the legs, complicated by rhabdomyolysis and acute renal failure. DISCUSSION There are very few previously reported cases of bilateral compartment syndrome of the legs. In the present case, despite any clear causative factor, we suggest that the aetiology is related to inadvertent posture during sleep. CONCLUSION The diagnosis of acute bilateral compartment syndrome of the legs requires a high index of suspicion, particularly in the absence of obvious aetiology. A successful outcome can be achieved with early diagnosis, prompt surgical intervention and a multidisciplinary approach.
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Affiliation(s)
- T Khan
- Princess Alexandra Hospital, Harlow, Essex, UK
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Phillips CJC, Izmirli S, Aldavood SJ, Alonso M, Choe BI, Hanlon A, Handziska A, Illmann G, Keeling L, Kennedy M, Lee GH, Lund V, Mejdell C, Pelagic VR, Rehn T. Students' attitudes to animal welfare and rights in Europe and Asia. Anim Welf 2012. [DOI: 10.7120/096272812799129466] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Kevin M, Ong WL, Lee GH, Ho GW. Formation of hybrid structures: copper oxide nanocrystals templated on ultralong copper nanowires for open network sensing at room temperature. Nanotechnology 2011; 22:235701. [PMID: 21474867 DOI: 10.1088/0957-4484/22/23/235701] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A facile large-scale synthesis approach for producing intrinsically p-type nanowires with uniform coverage of nanocrystals to form a highly interconnected porous nanowire network is of great demand for p-type sensing. Here, we have demonstrated synthesis of a very high aspect ratio (10(2)-10(5)) open network of interconnected hybrid nanocrystals-nanowire copper and copper oxide nanomaterials. The copper nanowire scaffold is employed to realize a porous and highly interconnected network of hybrid metal-metal oxide nanocrystal-nanowire structures. The structural and composition tunability of the hybrid nanomaterials is demonstrated. The hybrid copper-copper oxide nanowires exhibit enhanced gas/light sensing properties without any operating temperature. This may be attributed to enhanced medium diffusion due to the porous network of highly interconnected nanocrystal-nanowire structures.
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Affiliation(s)
- M Kevin
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore
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Kim JJ, Choi YM, Hwang SS, Yoon SH, Lee GH, Chae SJ, Hwang KR, Moon SY. Association of the interferon-γ gene (CA)n repeat polymorphism with endometriosis. BJOG 2011; 118:1061-6. [PMID: 21477169 DOI: 10.1111/j.1471-0528.2011.02963.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To investigate whether the interferon-γ (IFN-γ) gene (CA)(n) repeat polymorphism is associated with susceptibility to endometriosis. DESIGN Case-control study. SETTING University Department of Obstetrics and Gynaecology. POPULATION Women with (n = 622) and without (n = 442) endometriosis. METHODS Genotyping was performed by fluorescent polymerase chain reaction (PCR) and gene-scan analysis. MAIN OUTCOME MEASURES Genotype distribution and allele frequency of the dinucleotide (CA)(n) repeat polymorphism in the IFN-γ gene. RESULTS Seven alleles (12-18 repeats) of the IFN-γ gene (CA)(n) repeat polymorphism were found. In both patients with endometriosis and controls the most common allele was composed of 13 repeats, followed by an allele of 15 repeats, and then by an allele of 12 repeats. Patients with endometriosis had a significantly higher incidence of genotypes with alleles composed of fewer repeats (12-13 repeats), compared with the controls (92.0 versus 84.4%, respectively, P < 001). CONCLUSIONS Our results suggest that the (CA)(n) repeat polymorphism in the IFN-γ gene may be associated with a risk of endometriosis in the South Korean population.
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Affiliation(s)
- J J Kim
- Department of Obstetrics and Gynaecology, Seoul National University College of Medicine, Seoul, South Korea
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Ahn JY, Choi KD, Choi JY, Kim MY, Lee JH, Choi KS, Kim DH, Song HJ, Lee GH, Jung HY, Kim JH. Transnasal endoscope-assisted endoscopic submucosal dissection for gastric adenoma and early gastric cancer in the pyloric area: a case series. Endoscopy 2011; 43:233-5. [PMID: 21165828 DOI: 10.1055/s-0030-1256037] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Endoscopic submucosal dissection (ESD) is an important therapeutic option for gastric adenoma and early gastric cancer (EGC). However, ESD is technically difficult when lesions are located in the pyloric area. Our aim was to introduce the transnasal endoscope-assisted ESD method, which provides for excellent cutting-line visualization through control of submucosal traction. A total of eight patients with gastric adenoma or EGC located in the pyloric area were consecutively enrolled. A primary operating endoscope was used to perform marking, incision, submucosal dissection, and hemostasis, while a thinner, transnasal endoscope operated by a second endoscopist was used to retract connective submucosal tissue to provide cutting-line visualization using V-shaped grasping forceps. En bloc resection was achieved in all eight cases, as was complete resection. The median longest lesion diameter was 19 mm (range: 12-25 mm), and the median procedure time was 37.5 minutes (range: 29-59 minutes). There were no incidents of significant bleeding or perforation. Transnasal endoscope-assisted ESD was useful for treating gastric neoplasms in the pyloric area. The procedure was relatively easy and safe, provided excellent visualization through tissue retraction, and allowed for complete en bloc resection.
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Affiliation(s)
- J Y Ahn
- Division of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Lee GH, Hwang KY, Jang JE, Jin YW, Lee SY, Jung JE. Characteristics of color optical shutter with dye-doped polymer network liquid crystal. Opt Lett 2011; 36:754-756. [PMID: 21368972 DOI: 10.1364/ol.36.000754] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The optical properties and the theoretical prediction of color optical shutter with dye-doped polymer network liquid crystal (PNLC) were investigated. The view-angle dependence of reflectance according to the bias conditions showed distinctive characteristics, which could be explained from the effects of dye absorption and path length. It was also shown that the thickness dependence of reflectance was strongly influenced by the light-scattering coefficient. Our experimental results matched up well with the theoretical prediction based on the light scattering of liquid crystals in polymer network and the absorption of dichroic dye. This work indicates potential to improve the optical device using dye-doped liquid crystal-polymer composite.
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Affiliation(s)
- G H Lee
- Material and Device Research Center, Samsung Advanced Institute of Technology, Yongin-si, South Korea
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Ito K, Lee GH, Suemasu T. Epitaxial growth of ferromagnetic Fe4N thin films on SrTiO3(001) substrates by molecular beam epitaxy. ACTA ACUST UNITED AC 2011. [DOI: 10.1088/1742-6596/266/1/012091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Kim H, Kim CY, Kim DW, Lee IS, Lee GH, Park JC, Lee SJ, Lee KY. Wear performance of self-mating contact pairs of TiN and TiAlN coatings on orthopedic grade Ti-6Al-4V. Biomed Mater 2010; 5:044108. [PMID: 20683130 DOI: 10.1088/1748-6041/5/4/044108] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Both titanium nitride (TiN) and titanium aluminum nitride (TiAlN) have shown great wear resistance potential in metallic medical devices as protective, hard thin film coatings. In the present study, the effects of TiN and TiAlN coating layers on the wear performance of Ti-6Al-4V were compared and analyzed. TiN and TiAlN coatings with a thickness of 3 microm were deposited by a cathodic vacuum arc ion plating technique on the surface of Ti-6Al-4V. Wear tests were conducted by using a pin-on-disk-type tribotester with a point contact self-mating pair in a linear reciprocal motion. A sliding distance of 20 mm per cycle at 1 Hz was used under a load of 15 N under ambient conditions with no lubricant. The wear resistance of TiN and TiAlN coatings is superior to that of uncoated Ti-6Al-4V at the early stage of sliding contact. Until a measurable amount of wear was detected, the number of sliding cycles of the TiAlN coating pair was longer than TiN. After the first detection of wear from the coating layers, the rate of wear of the TiN coating pairs was significantly higher than that of TiAlN (p < 0.05), and it was close to that of the uncoated pairs. In conclusion, the TiAlN coating is superior to TiN from the viewpoint of wear resistance under the test conditions used in this study.
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Affiliation(s)
- H Kim
- Department of Mechanical Engineering, Bioengineering Research Center, Sejong University, Seoul 143-747, Korea
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Abstract
A nanowire growth model assisted by polymer reconstruction was discovered and used to achieve the direct synthesis of amorphous silicon oxide nanowires (SiONWs) on polyethylene terephthalate (PET) substrates at low growth temperatures (no more than 150 degrees C) using plasma-enhanced chemical vapor deposition (PECVD). The reconstructed polymers were generated from the scission and recombination of polymer chains on the surface of PET substrates under active Ar:O(2) plasma in the PECVD process. The highly ordered nanowire arrays exhibited an excellent geometrical configuration that is comparable to that of SiONWs grown on Si substrates at temperatures higher than 1000 degrees C by using conventional vapor deposition methods with various metal catalysts. A promising optical property-strong photoluminescence in the violet-blue spectral range at room temperature-was detected in the nanowires. This might lead to breakthroughs in the fabrication of electronic and optical nanoscale devices on flexible polymer substrates.
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Affiliation(s)
- J Yun
- Materials Processing Division, Korean Institute of Materials Science, 531 Changwondaero, Changwon, Gyeongnam 641-831, Republic of Korea.
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Abstract
A leiomyoma is a benign mesenchymal neoplasm that usually develops where smooth muscle is present. In this report, we present a rare case of perianal leiomyoma. The external anal sphincter was stretched over the surface of the leiomyoma and the internal anal sphincter was intact on surgery. It was confirmed as a deep soft-tissue leiomyoma on pathology. We describe the ultrasonographic and MRI findings of a rare case of perianal leiomyoma, together with differential diagnoses.
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Affiliation(s)
- H J Kim
- Department of Radiology, Kyung Hee University Medical Center, Dongdaemun-Gu, Seoul, Korea.
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Huang SW, Jeng HT, Lin JY, Chang WJ, Chen JM, Lee GH, Berger H, Yang HD, Liang KS. Electronic structure of pyrochlore Cd(2)Re(2)O(7). J Phys Condens Matter 2009; 21:195602. [PMID: 21825493 DOI: 10.1088/0953-8984/21/19/195602] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Detailed band structure calculations have been performed for Cd(2)Re(2)O(7) in high-, middle- and low-temperature (T) phases. The calculations are based on the observed lattice structures from x-ray diffraction measurements. The spin-orbit interaction is incorporated self-consistently in both the generalized gradient approximation (GGA) and the GGA plus Hubbard U (GGA+U) approaches. It is found that the on-site U has negligible effects on the Re 5d band structures; therefore both the GGA and GGA+U Re 5d band energies agree well with the observed O K-edge x-ray absorption spectroscopy (XAS) spectrum, whereas the Cd 4d band energy observed from photoemission spectroscopy can only be correctly reproduced by GGA+U calculations, indicating the relatively itinerant Re 5d and localized Cd 4d electrons. On the other hand, the spin-orbit coupling gives rise to nontrivial spin and orbital magnetic moments for the middle- T phase. Most unexpectedly, we found that the low- T phase exhibits quasi-two-dimensional Fermi surfaces. The calculated carrier numbers for the three phases are, at least qualitatively, consistent with the measured Hall coefficient.
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Affiliation(s)
- Shih-Wen Huang
- National Synchrotron Radiation Research Center, Hsinchu 300, Taiwan. Department of Electrophysics, National Chiao Tung University, Hsinchu 300, Taiwan
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Abstract
The fruit of Lycii fructus has been used as a tonic medicine and a long-term healthy food without side effect in Asia. An increase in the demand for natural healthy food, L. fructus has been thought as a source of healthy foods. For its value adding, its character impact aromas were isolated by using direct solvent extraction with vacuum transfer and identified by using gas chromatography olfactometry (GC-O) and GC-mass spectrometry (GC-MS). Thirty-three odor compounds were sniffed at GC-O, each trial equipped with DB-5MS and HP-WAX capillary column. The most contributing odor compounds in L. fructus were (E)-2-heptenal (green, mushroomy), 1-heptanol (planty, oily), hexanal (planty), 3-octanol (mushroomy, planty), 1-octen-3-ol (mushroomy), and 2-methyl-2-butenoic acid (pungent, planty), which might be produced by enzymatic oxidation and/or oxidation of lipids and carotenes, resulting in undesirable aromas.
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Affiliation(s)
- G H Lee
- School of Food Biotechnology and Nutrition, Woo-Song Univ., Jayang-Dong, Dong-Gu, Dae-Jeon, 300-718, Korea
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Tan HH, Lee GH, Thia KTJ, Ng HS, Chow WC, Lui HF. Minimal hepatic encephalopathy runs a fluctuating course: results from a three-year prospective cohort follow-up study. Singapore Med J 2009; 50:255-260. [PMID: 19352567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Minimal hepatic encephalopathy (mHE) has been reported in up to 84 percent of cirrhotics. The natural history of mHE has not been well-described. We designed a three-year prospective cohort study to determine the prevalence and natural history of mHE among cirrhotic patients. METHODS The patient cohort comprising 62 consecutive outpatients with cirrhosis were assessed at baseline and followed-up with a repeat assessment three years later. The assessments include: (1) Neuropsychometric analysis (digit-symbol substitution test, block-design test, number-connection test A); (2) Clinical, biochemical assessment; and (3) Quality of life (QOL) assessment (abbreviated sickness impact profile). RESULTS Baseline characteristics were: age 52.9 +/- 11.0 years; Child's A:B:C was 46:14:2. mHE was detected in 33.9 percent of the cohort. Older age, a higher Child-Pugh score and female gender were independently associated with mHE. mHE was associated with a poorer QOL. Follow-up assessment three years later showed that seven patients had died, while six were lost to follow-up; these patients had significantly higher baseline Child's scores. Of the remaining patients, 36/49 (73 percent) agreed to a repeat evaluation. In this group, none had mHE. QOL remained impaired despite the resolution of mHE. CONCLUSION It has been shown for the first time that mHE can revert to a normal state in a significant proportion of patients with well-compensated cirrhosis.
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Affiliation(s)
- H H Tan
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Outram Road, Singapore 169608.
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Chung JW, Lee GH, Choi KS, Kim DH, Jung KW, Song HJ, Choi KD, Jung HY, Kim JH, Yook JH, Kim BS, Jang SJ. Unchanging trend of esophagogastric junction adenocarcinoma in Korea: experience at a single institution based on Siewert's classification. Dis Esophagus 2009; 22:676-81. [PMID: 19222529 DOI: 10.1111/j.1442-2050.2009.00946.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The incidence of adenocarcinoma of the esophagogastric junction (AEG) has been increasing in Western countries. It is unclear, however, whether similar changes are occurring in Asia. We therefore investigated the incidence of AEG in Korea, and assessed the clinical characteristics of three types of AEG based on Siewert's classification. We retrospectively reviewed the medical records of 16 811 patients diagnosed with esophageal squamous cell carcinoma (ESC, n= 1450) or gastric noncardiac adenocarcinoma (GNCA, n= 14 751) between 1992 and 2006. The patients were divided into three 5-year cohorts (cohort A [1992-1996], n= 2734, cohort B [1997-2001], n= 5727, and cohort C [2002-2006], n= 8350), and the ratios of AEG (n= 610) to non-AEG (ESC and GNCA) in each cohort were compared. Using Siewert's classification, the tumors were categorized into one of three types, and patient demographic features and 5-year survival rates were compared. The ratio of AEG to non-AEG cases did not change over time (0.037, 0.034, and 0.039 for cohorts A, B, and C, respectively; P= 0.40). Of the 610 patients with AEG, 23 (3.7%) had type 1 tumors, 47 (7.7%) had type 2, and 540 (88.5%) had type 3. The 5-year survival rate of patients with type 1 AEG was much lower (4.8 +/- 4.7%) than that of those with type 2 (47.9 +/- 7.8%) and type 3 (47.4 +/- 2.5%) tumors. Unlike in Western countries, the ratio of AEG to non-AEG cases has not increased over time in Korea. Type 1 AEG was rarer and associated with a more unfavorable prognosis in Korea than in Western countries.
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Affiliation(s)
- J-W Chung
- Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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Kuroda N, Hes O, Michal M, Nemcova J, Gal V, Yamaguchi T, Kawada T, Imamura Y, Hayashi Y, Lee GH. Mucinous tubular and spindle cell carcinoma with Fuhrman nuclear grade 3: a histological, immunohistochemical, ultrastructural and FISH study. Histol Histopathol 2008; 23:1517-23. [PMID: 18830937 DOI: 10.14670/hh-23.1517] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Mucinous tubular and spindle cell carcinoma (MTSCC) of the kidney generally shows low nuclear grade. MTSCC with high nuclear grade is relatively rare. In this article, we report two cases of MTSCC with Fuhrman grade 3. One case occurred in a 57-year-old Japanese female and the second case in a 49-year-old Caucasian female. Histologically, the tumors were composed of neoplastic cells with cuboidal or columnar and spindle morphology, and Fuhrman nuclear grade 3. The myxoid stroma was also observed. This stroma was positive for Alcian blue stain. Immunohistochemically, neoplastic cells of both cases were positive for AMACR, but negative for CD10 and RCC Ma. Ultrastructurally, tumorous cells of one case contained numerous mitochondria. In FISH analysis, many neoplastic cells of both cases demonstrated monosomy of chromosomes 15 and 22 and disomy of chromosomes 7 and 17. One of the two patients died of respiratory failure due to pleuritis carcinomatosa 48 months postoperatively. Finally, the pathologist should recognize that high grade MTSCC exists despite its rare frequency. FISH analysis may be helpful in establishing the diagnosis of this entity. Furthermore, we present the first report of a patient with MTSCC dying of distant metastasis.
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Affiliation(s)
- N Kuroda
- Department of Diagnostic Pathology, Kochi Red Cross Hospital, Kochi, Japan.
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Lee HJ, Lee GH, Nah S, Lee KH, Yang H, Kim YM, Chun W, Hong S, Kim S. Association of TIMP-4 gene polymorphism with the risk of osteoarthritis in the Korean population. Rheumatol Int 2008; 28:845-50. [PMID: 18301898 DOI: 10.1007/s00296-008-0545-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [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: 08/12/2007] [Accepted: 02/11/2008] [Indexed: 01/29/2023]
Abstract
Due to an imbalance in the MMP:TIMP ratio determined a tissue damage in arthritis, it is hypothesized that polymorphic variations of the TIMP genes are associated with regulation of the MMP:TIMP balance. To test this hypothesis, the presence of single nucleotide polymorphisms (SNPs) located in the human TIMP-2 and TIMP-4 genes was confirmed in the Korean RA and OA patients. We performed a case-control study comprising 109 unrelated Korean OA patients, 177 unrelated Korean RA patients and 175 healthy subjects. There were statistically significant differences in the genotype distribution and allele frequencies of the C/T polymorphism of TIMP-4 gene between OA and control groups (P = 0.0002 and P = 0.001, respectively). However, no significant association between TIMP-2 polymorphisms and OA was observed. Also, no difference was observed when allele or genotype frequencies of both TIMP-2 and TIMP-4 gene polymorphisms were compared between RA and controls. We demonstrated that the C/T polymorphism which is located on the 3'-untranslational regions of the TIMP-4 gene might be associated with susceptibility to OA patients.
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Affiliation(s)
- H J Lee
- Department of Pharmacology, College of Medicine, Kangwon National University, Hyoja, Chuncheon, 200-701, Republic of Korea
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Hong HS, Ha HK, Won HJ, Byun JH, Shin YM, Kim AY, Kim PN, Lee MG, Lee GH, Kim MJ. Gastric schwannomas: radiological features with endoscopic and pathological correlation. Clin Radiol 2008; 63:536-42. [PMID: 18374717 DOI: 10.1016/j.crad.2007.05.026] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2006] [Revised: 05/17/2007] [Accepted: 05/31/2007] [Indexed: 02/08/2023]
Abstract
AIM To describe the radiological, endoscopic, and pathological findings of gastric schwannomas in 16 patients. MATERIALS AND METHODS The radiological, endoscopic, and pathological findings of 16 surgically proven cases of gastric schwannoma were retrospectively reviewed. All patients underwent computed tomography (CT) and four patients were evaluated with upper gastrointestinal series. Two radiologists reviewed the CT and upper gastrointestinal series images by consensus with regard to tumour size, contour, margin, and growth pattern, the presence or absence of ulcer, cystic change, and the CT enhancement pattern. Endoscopy was performed in eight of these 16 patients. Six patients underwent endoscopic ultrasonography. Pathological specimens were obtained from and reviewed in all 16 patients. Immunohistochemistry was performed for c-kit, CD34, smooth muscle actin, and S-100 protein. RESULTS On radiographic examination, gastric schwannomas appeared as submucosal tumours with the CT features of well-demarcated, homogeneous, and uncommonly ulcerated masses. Endoscopy with endoscopic ultrasonography demonstrated homogeneous, submucosal masses contiguous with the muscularis propria in all six examined cases. On pathological examination, gastric schwannomas appeared as well-circumscribed and homogeneous tumours in the muscularis propria and consisted microscopically of interlacing bundles of spindle cells. Strong positivity for S-100 protein was demonstrated in all 16 cases on immunohistochemistry. CONCLUSION Gastric schwannomas appear as submucosal tumours of the stomach and have well-demarcated and homogeneous features on CT, endoscopic ultrasonography, and gross pathology. Immunohistochemistry consistently reveals positivity for S-100 protein in the tumours.
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Affiliation(s)
- H S Hong
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seodaemoon-gu, Seoul, Korea
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Huang GTJ, Lee HW, Lee HS, Lee GH, Huh SY, Choi GW, Park SH. Localization of substance P-induced upregulated interleukin-8 expression in human dental pulp explants. Int Endod J 2007; 41:100-7. [PMID: 18005045 DOI: 10.1111/j.1365-2591.2007.01318.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To localize ex vivo expression of interleukin-8 (IL-8) induced by substance P (SP) in human dental pulps. METHODOLOGY Intact caries-free, freshly extracted third molars (n = 20) were collected from patients (15-25 years old). The teeth were split and pulpal tissue was obtained and stored in Dulbecco's modified Eagle medium. Human dental pulp tissue explants were stimulated with SP. Expression of IL-8 in pulp explants was detected and localized by immunohistochemistry. RESULTS Moderated IL-8 immunoreactivities were detected mainly in the cell-rich zone in pulp tissues 12 h after tumour necrosis factor alpha (TNF-alpha) stimulation (positive controls), whereas only weak IL-8 expression was observed in tissues stimulated with SP at the same time interval. These data did not differ from those in negative controls. Increased IL-8 expression in pulp explants after 24 h of SP stimulation was noted compared with negative controls and located in fibroblast-like cells, blood vessel-associated cells and extracellular matrix in the central zone and cell-rich zone of pulp explants. Tissues stimulated with TNF-alpha for 24 h (positive controls) revealed weak IL-8 immunoreactivities with altered cell morphology. CONCLUSIONS Substance P induces IL-8 expression and was located in fibroblast-like pulp cells, blood vessel-associated cells and extracellular matrix of human dental explants. These data support the hypothesis that neuropeptide (SP) coordinates the modulation of pulpal inflammation via up-regulating chemokine IL-8.
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Affiliation(s)
- G T-J Huang
- Division of Endodontics, College of Dental Surgery, Dental School, University of Maryland, Baltimore, MD, USA
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Yamamoto M, Maeda H, Hirose N, Radhakrishnan G, Katare RG, Hayashi Y, Rao P, Lee GH, Yamaguchi T, Sasaguri S. Bilirubin oxidation provoked by nitric oxide radicals predicts the progression of acute cardiac allograft rejection. Am J Transplant 2007; 7:1897-906. [PMID: 17578506 DOI: 10.1111/j.1600-6143.2007.01868.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Bilirubin, a strong intrinsic antioxidant, quenches free radicals produced under inflammatory conditions. The oxidized bilirubin metabolites, i.e. biopyrrins, are immediately excreted into urine and can indicate the intensity of oxidation in vivo. Our preliminary studies suggested the involvement of reactive nitrogen species (RNS) in generation of biopyrrins. However, little is known about biological significance of bilirubin oxidation by RNS. Here, we analyzed the correlation between bilirubin oxidation and nitric oxide (NO) radicals during rat acute cardiac allograft rejection. In allograft recipients, urinary biopyrrins steeply increased on day 3 prior to the increase in myocardial tissue damage marker, serum troponin-T. In contrast, no significant changes in urinary biopyrrins were evident in recipients of isografts or cyclosporine-A treated allografts. Urinary nitrotyrosine, a marker of oxidation by NO radicals also increased on day 3, while administration of a NO synthase inhibitor, N(G)-monomethyl-L-arginine apparently diminished the elevation of urinary biopyrrins as well as nitrotyrosine. Immunohistochemistry revealed enhanced local expression of heme oxygenase-1, biopyrrins and nitrotyrosine in allografts in accordance with the cellular infiltrates, suggesting that changes in urinary biopyrrins reflect the bilirubin oxidation in grafts undergoing rejection. These results indicate that locally evoked bilirubin oxidation by NO radicals can predict the progression of rejection.
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Affiliation(s)
- M Yamamoto
- Department of Surgery II, Faculty of Medicine, Kochi University, Nankoku, Kochi, 783-8505 Japan
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Han IH, Lee IS, Song JH, Lee MH, Park JC, Lee GH, Sun XD, Chung SM. Characterization of a silver-incorporated calcium phosphate film by RBS and its antimicrobial effects. Biomed Mater 2007; 2:S91-4. [DOI: 10.1088/1748-6041/2/3/s01] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Kuroda N, Mizobuchi M, Shimamura Y, Taniguchi Y, Daibata M, Miyoshi I, Ichimura T, Beppu H, Ohara M, Hirouchi T, Mizuno K, Lee GH. An Asian variant of intravascular lymphoma: unique clinical and pathological manifestation in the gallbladder. APMIS 2007; 115:371-5. [PMID: 17504306 DOI: 10.1111/j.1600-0463.2007.apm_578.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We here present a rare case of intravascular lymphoma (IVL) in a Japanese man. 4 months after cholecystectomy due to cholecystitis, a diagnosis of intravascular lymphoma (IVL) was strongly suspected. Lymphoma cells were diffusely observed in the bone marrow parenchyma, but were absent in the vascular spaces. The patient died of respiratory failure and at autopsy a small number of lymphoma cells in the extravascular parenchyma of the adrenal gland and bone marrow were seen. Serial sections of the surgically resected gallbladder retrospectively confirmed the diagnosis of IVL. In addition, congestion and edema were observed in the connective tissue layer. It is possible that edema or ischemia in the gallbladder wall or at other anatomic sites due to the circulation disturbance induced by the intravascular obstruction of lymphoma cells may have caused the initial symptoms. In conclusion, clinicians and pathologists should keep in mind that the gallbladder may be initially involved in IVL.
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Affiliation(s)
- N Kuroda
- Department of Pathology and Laboratory Medicine, Kochi Red Cross Hospital, Kochi, Japan.
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Kuroda N, Inoue Y, Taguchi T, Tominaga A, Hes O, Michal M, Hayashi Y, Hiroi M, Shuin T, Lee GH. Renal leiomyoma: an immunohistochemical, ultrastructural and comparative genomic hybridization study. Histol Histopathol 2007; 22:883-8. [PMID: 17503345 DOI: 10.14670/hh-22.883] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Renal leiomyoma is a rare neoplasm. We report such a case in a 57-year-old Japanese woman who was found to have a mass in the left kidney. The histological examination disclosed the proliferation of spindle cells showing a benign appearance. Entrapped tubular cells were observed in the peripheral area of the tumor. The immunohistochemical examination of spindle neoplastic cells showed a positive reaction for alpha smooth muscle actin, h-caldesmon, l-caldesmon, calponin, muscle actin, myosin and desmin. Additionally, the ultrastructural examination of the tumor showed membrane caveolae and myofilaments in the cytoplasm. This tumor was considered to show a differentiation into smooth muscle cells. The comparative genomic hybridization of the tumor detected the combined losses of chromosomes 4, 6, 12 and 14 which has not been previously described in renal tumors. Finally, the immunohistochemical panel of smooth muscle markers and ultrastructural and genetic study may be useful in diagnosing renal leiomyoma.
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Affiliation(s)
- N Kuroda
- Department of Pathology and Laboratory Medicine, Kochi Red Cross Hospital, Kochi, Japan.
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Kuroda N, Mizobuchi M, Shimamura Y, Daibata M, Miyoshi I, Ohara M, Hirouchi T, Mizuno K, Lee GH. Bridging necrosis and reticulin bridging fibrosis induced by intrahepatic involvement of acute biphenotypic leukemia. APMIS 2007; 114:908-11. [PMID: 17207092 DOI: 10.1111/j.1600-0463.2006.apm_540.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A 47-year-old Japanese woman was diagnosed as having acute biphenotypic leukemia with association of t(9;22)(q34;q11). Cholestatic liver dysfunction arose, and she died of cachexia and intracranial hemorrhage. Autopsy showed unusual hepatic fibrosis. In the liver, bridging infiltration, bridging necrosis and bridging fibrosis by leukemic cells were seen. It seemed that the degree of fibrosis was associated with the number of aggregates of infiltrating leukemic cells. The fibrotic foci were predominantly composed of reticulin and collagen fibers, and distortion of the lobules was observed. Immunohistochemically, dense bundles of alpha-smooth muscle actin (ASMA)-positive stromal cells, namely activated hepatic stellate cells (HSCs), were observed in the immature fibrotic foci as well as along the sinusoids densely infiltrated by leukemic cells. No cells positive for TGF-beta1 or PDGF-BB were identified. In conclusion, extensive intrahepatic involvement by neoplastic cells in adult acute biphenotypic leukemia may cause the unusual "disorganized" hepatic fibrosis.
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Affiliation(s)
- N Kuroda
- Department of Pathology and Laboratory Medicine, Kochi Red Cross Hospital, Kochi City, Kochi, Japan.
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Kim KJ, Lee GH. Acute abdominal pain caused by a prolapsed duodenal polyp that resolved when the polyp broke off spontaneously. Endoscopy 2007; 39 Suppl 1:E92-3. [PMID: 17440868 DOI: 10.1055/s-2007-966455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- K J Kim
- Department of Gastroenterology, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, South Korea.
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Park JY, Kim KA, Park PW, Lee OJ, Kim JS, Lee GH, Ha MC, Park JH, O MJ, Ryu JH. Comparative pharmacokinetic and pharmacodynamic characteristics of amlodipine besylate and amlodipine nicotinate in healthy subjects. Int J Clin Pharmacol Ther 2006; 44:641-7. [PMID: 17190374 DOI: 10.5414/cpp44641] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND AND AIM Amlodipine, a dihydropyridine calcium antagonist, is prescribed for the management of angina and hypertension, and is sold as amlodipine besylate. However, a new salt formulation, amlodipine nicotinate, has recently been developed. Here, we evaluated the comparative pharmacokinetic and pharmacodynamic characteristics of the nicotinate and besylate forms of amlodipine. SUBJECTS AND METHODS A randomized, 2-way crossover study was conducted in 18 healthy male volunteers to compare the pharmacokinetics and pharmacodynamics of these two forms, i.e. amlodipine nicotinate (test) and amlodipine besylate (reference), after administration of a single dose of 5 mg of each drug and a washout period between doses of 4 weeks. Blood samples for the pharmacokinetic analysis of amlodipine were obtained over the 144-hour period after administration. Systolic and diastolic blood pressures and pulse rates were recorded immediately prior to each blood sampling. RESULTS All participants completed both treatment periods, and no serious adverse events occurred during the study period. After administering a single dose of each formulation, mean AUC0-infinity and Cmax values were 190.91+/-60.49 ng x h/ml and 3.87+/-1.04 ng/ml for the test formulation and 203.15+/-52.05 ng x h/ml and 4.01+/-0.60 ng/ml for the reference formulation, respectively. The 90% confidence intervals of test/reference mean ratios for AUC0- infinity and Cmax fell within the predetermined equivalence range of 80 - 125%. Pharmacodynamic profiles including systolic and diastolic blood pressures and pulse rates exhibited no significant differences between the two formulations. CONCLUSION The two amlodipine formulations showed similar pharmacokinetic and pharmacodynamic characteristics and the new amlodipine formulation, amlodipine nicotinate, was found to be equivalent for pharmacokinetics to the currently available amlodipine besylate with respect to the rate and extent of amlodipine absorption.
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Affiliation(s)
- J Y Park
- Department of Clinical Pharmacology and Toxicology, Anam Hospital, Korea University College of Medicine, Seoul.
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Lee YJ, Yang SK, Byeon JS, Myung SJ, Chang HS, Hong SS, Kim KJ, Lee GH, Jung HY, Hong WS, Kim JH, Min YI, Chang SJ, Yu CS. Analysis of colonoscopic findings in the differential diagnosis between intestinal tuberculosis and Crohn's disease. Endoscopy 2006; 38:592-7. [PMID: 16673312 DOI: 10.1055/s-2006-924996] [Citation(s) in RCA: 149] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND STUDY AIMS Intestinal tuberculosis and Crohn's disease are chronic inflammatory bowel disorders that are difficult to differentiate from one another. This study aimed to evaluate the diagnostic value of various colonoscopic findings in the differential diagnosis between intestinal tuberculosis and Crohn's disease. PATIENTS AND METHODS Colonoscopic findings on initial work-up were prospectively recorded in patients with an initial diagnosis of either intestinal tuberculosis or Crohn's disease. These findings were analyzed after a final diagnosis of intestinal tuberculosis (n = 44) or Crohn's disease (n = 44) had been made after follow-up. RESULTS Four parameters (anorectal lesions, longitudinal ulcers, aphthous ulcers, and cobblestone appearance) were significantly more common in patients with Crohn's disease than in patients with intestinal tuberculosis. Four other parameters (involvement of fewer than four segments, a patulous ileocecal valve, transverse ulcers, and scars or pseudopolyps) were observed more frequently in patients with intestinal tuberculosis than in patients with Crohn's disease. We hypothesized that a diagnosis of Crohn's disease could be made when the number of parameters characteristic of Crohn's disease was higher than the number of parameters characteristic of intestinal tuberculosis, and vice versa. Making these assumptions, we calculated that the diagnosis of either intestinal tuberculosis or Crohn's disease would have been made made correctly in 77 of our 88 patients (87.5 %), incorrectly in seven patients (8.0 %), and would not have been made in four patients (4.5 %). CONCLUSIONS A systematic analysis of colonoscopic findings is very useful in the differential diagnosis between intestinal tuberculosis and Crohn's disease.
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Affiliation(s)
- Y J Lee
- Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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Abstract
Many recombinant proteins are often over-expressed in host cells, such as Escherichia coli, and are found as insoluble and inactive protein aggregates known as inclusion bodies (IBs). Recently, a novel process for IB extraction and solubilisation, based on chemical extraction, has been reported. While this method has the potential to radically intensify traditional IB processing, the process economics of the new technique have yet to be reported. This study focuses on the evaluation of process economics for several IB processing schemes based on chemical extraction and/or traditional techniques. Simulations and economic analysis were conducted at various processing conditions using granulocyte macrophage-colony stimulating factor, expressed as IBs in E. coli, as a model protein. In most cases, IB processing schemes based on chemical extraction having a shorter downstream cascade demonstrated a competitive economic edge over the conventional route, validating the new process as an economically more viable alternative for IB processing.
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Affiliation(s)
- G H Lee
- Department of Chemical and Biomolecular Engineering, National University of Singapore, 10 Kent Ridge Crescent, 117576, Singapore, Singapore
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