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Lee D, Lee JH, Kwak YH, Suh D, Kwon H, Kim DK, Jung JH, Park JW, Lee HN, Kim JH. The Barriers to Recognizing and Reporting Child Physical Abuse by Emergency Physicians and Associated Factors. Pediatr Emerg Care 2024:00006565-990000000-00419. [PMID: 38498930 DOI: 10.1097/pec.0000000000003146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
BACKGROUND Although the reporting rate of child abuse is increasing every year, the child abuse detection rate is 3.81% as of 2019 in Korea, which is significantly lower than that of developed countries for child rights. OBJECTIVE We investigated the associated factors with barriers that emergency physicians face in recognizing and reporting cases of child abuse. METHODS From May to July 2022, 240 emergency physicians working in the 15 emergency department were asked to participate in the survey via email. The questionnaire included the respondent's basic information, treatment experience for child abuse, reasons for reporting or not reporting, and opinions on measures to increase the reporting rate. We conducted a logistic regression analysis to discern the factors contributing to underreporting. RESULTS Seventy-one individuals were included in the analysis, after excluding those who had never encountered suspected cases of child abuse. A multivariable logistic regression was performed with the above variables, and although it was not statistically significant, there was a tendency for workers to report well when working at a pediatric emergency department (odds ratio [95% confidence interval], 3.97 [0.98-16.09]). The primary reason for reporting suspected abuse was the pattern of damage suspected of abuse. The first reason for not reporting suspected abuse was because they were not sure it was child abuse. Respondents answered that to report better, a quick and appropriate response from the police and confidentiality of the reporter were needed. CONCLUSIONS Physicians in pediatric emergency departments demonstrated a tendency for more proactive reporting suspected cases of child abuse.
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Affiliation(s)
- Dongwoo Lee
- From the Department of Emergency Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, Republic of Korea
| | | | | | - Dongbum Suh
- From the Department of Emergency Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Hyuksool Kwon
- From the Department of Emergency Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Do Kyun Kim
- Department of Emergency Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jin Hee Jung
- Department of Emergency Medicine, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
| | - Joong Wan Park
- Department of Emergency Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ha Ni Lee
- Department of Emergency Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jin Hee Kim
- Department of Emergency Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
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Kim JH, Jung JY, Lee S, Hwang S, Park JW, Lee EJ, Lee HN, Kim DK, Kwak YH. Ideal chest compression site for cardiopulmonary resuscitation in fontan circulation patients with dextrocardia. BMC Cardiovasc Disord 2024; 24:22. [PMID: 38172727 PMCID: PMC10765782 DOI: 10.1186/s12872-023-03691-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 12/24/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND We aimed to identify the ideal chest compression site for cardiopulmonary resuscitation (CPR) in patients with a single ventricle with dextrocardia corrected by Fontan surgery. METHODS The most recent stored chest computed tomography images of all patients with a single ventricle who underwent Fontan surgery were retrospectively analysed. We reported that the ideal chest compression site is the largest part of the compressed single ventricle. To identify the ideal chest compression site, we measured the distance from the midline of the sternum to the point of the maximum sagittal area of the single ventricle as a deviation and calculated the area fraction of the compressed structures. RESULTS 58 patients (67.2% male) were analysed. The mean right deviation from the midline of the sternum to the ideal compression site was similar to the mean sternum width (32.85 ± 15.61 vs. 31.05 ± 6.75 mm). When chest compression was performed at the ideal site, the area fraction of the single ventricle significantly increased by 7%, which was greater than that of conventional compression (0.15 ± 0.10 vs. 0.22 ± 0.11, P < 0.05). CONCLUSIONS When performing CPR on a patient with Fontan circulation with dextrocardia, right-sided chest compression may be better than the conventional location.
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Affiliation(s)
- Jin Hee Kim
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jae Yun Jung
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
| | - Sangyun Lee
- Department of Paediatrics, Seoul National University Children's Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Soyun Hwang
- Department of Paediatrics, Severance Hospital, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea
| | - Joong Wan Park
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Eui Jun Lee
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Ha Ni Lee
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Do Kyun Kim
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Young Ho Kwak
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
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Lee HN, Park JW, Jung JY, Kim DK, Kwak YH, Hwang S, Lee EJ, Kim JH, Jue JH. Unpowered scooter injuries in children and risk factors for traumatic brain injuries: An 8-year cross-sectional study using a national registry in South Korea. Injury 2024; 55:111197. [PMID: 38007295 DOI: 10.1016/j.injury.2023.111197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 10/22/2023] [Accepted: 11/10/2023] [Indexed: 11/27/2023]
Abstract
INTRODUCTION Head trauma accounts for a large proportion of unpowered scooter injuries in children. Traumatic brain injury (TBI) is the leading cause of considerable mortality and morbidity in children, who are the main users of unpowered scooters. The aim of this study was to explore the characteristics of unpowered scooter injuries in children and to identify predictors of the occurrence of TBI. METHODS A multicentre observational retrospective study was conducted using the Emergency Department-based Injury In-depth Surveillance (EDIIS) database in South Korea. Children aged 2 to 18 years old with unpowered scooter injuries between 2011 and 2018 were eligible for inclusion in this study, and the primary outcome was TBI defined based on the International Classification of Diseases, 10th Revision (ICD-10) code. RESULTS The annual rate of unpowered scooter injuries per 1,000 injured patients increased throughout the study period from 1.4 in 2011 to 16.4 in 2018 (P for trend < 0.001). Of the 3,892 children who had unpowered scooter injuries, 353 (9.2 %) had TBI. Children were at a higher risk of unpowered scooter TBI if they were aged between 2 and 5 years (adjusted odds ratio [aOR]: 1.37; 95 % confidence interval (CI): 1.09-1.73), were male (aOR: 1.45; 95 % CI: 1.14-1.86), were injured either on sidewalks (aOR: 1.80; 95 % CI: 1.20-2.70) or on driveways (aOR: 2.31; 95 % CI: 1.41-3.79), and experienced a fall (aOR: 1.98; 95 % CI: 1.15-3.43). Additionally, children injured after a blunt force were at a lower risk of TBI (aOR: 0.28; 95 % CI: 0.15-0.53). CONCLUSION Unpowered scooter injuries in children are increasing in South Korea. It is essential for younger children riding unpowered scooters to wear helmets and for caregivers to actively supervise their children to prevent TBI.
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Affiliation(s)
- Ha Ni Lee
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Disaster Medicine Research Center, Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Emergency Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Joong Wan Park
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Disaster Medicine Research Center, Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Emergency Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
| | - Jae Yun Jung
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Disaster Medicine Research Center, Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Do Kyun Kim
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Disaster Medicine Research Center, Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Young Ho Kwak
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Disaster Medicine Research Center, Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Emergency Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Soyun Hwang
- Department of Pediatrics, Severance Children's Hospital, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Eui Jun Lee
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Jin Hee Kim
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Jie Hee Jue
- Department of Pediatrics, Kyungpook National University Chilgok Hospital, 807 Hoguk-ro, Buk-gu, Daegu 41404, Republic of Korea
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Choi D, Park JW, Kwak YH, Kim DK, Jung JY, Lee JH, Jung JH, Suh D, Lee HN, Lee EJ, Kim JH. Comparison of age-adjusted shock indices as predictors of injury severity in paediatric trauma patients immediately after emergency department triage: A report from the Korean multicentre registry. Injury 2024; 55:111108. [PMID: 37858444 DOI: 10.1016/j.injury.2023.111108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/26/2023] [Accepted: 10/05/2023] [Indexed: 10/21/2023]
Abstract
INTRODUCTION Shock index paediatric-adjusted (SIPA) was presented for early prediction of mortality and trauma team activation in paediatric trauma patients. However, the derived cut-offs of normal vital signs were based on old references. We established alternative SIPAs based on the other commonly used references and compared their predictive values. METHODS We performed a retrospective review of all paediatric trauma patients aged 1-15 years in the Emergency Department (ED)-based Injury In-depth Surveillance (EDIIS) database from January 1, 2011 to December 31, 2019. A total of 4 types of SIPA values were obtained based on the references as follows: uSIPA based on the Nelson textbook of paediatrics 21st ed., SIATLS based on the ATLS 10th guideline, SIPALS based on the PALS 2020 guideline, and SIPA. In each SIPA group, the cut-off was established by dividing the group into 4 subgroups: toddler (age 1-3), preschooler (age 4-6), schooler (age 7-12), and teenager (age 13-15). We performed an ROC analysis and calculated the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) to compare the predicted values of each SIPA in mortality, ICU admission, and emergent surgery or intervention. RESULTS A total of 332,271 patients were included. The proportion of patients with an elevated shock index was 14.9 % (n = 49,347) in SIPA, 22.8 % (n = 75,850) in uSIPA, 0.3 % (n = 1058) in SIATLS, and 4.3 % (n = 14,168) in SIPALS. For mortality, uSIPA achieved the highest sensitivity (57.0 %; 95 % confidence interval 56.9 %-57.2 %) compared to SIPA (49.4 %, 95 % CI 49.2 %-49.5 %), SIATLS (25.5 %, 95 % CI 25.4 %-25.7 %), and SIPALS (43.8 %, 95 % CI 43.7 %-44.0 %), but there were no significant differences in the negative predictive value (NPV) or area under the curve (AUC). The positive predictive value (PPV) was highest in SIATLS (5.7 %, 95 % CI 5.6 %-5.8 %) compared to SIPA (0.2 %, 95 % CI 0.2 %-0.3 %), uSIPA (0.2 %, 95 % CI 0.2 %-0.2 %), and SIPALS (0.7 %, 95 % CI 0.7 %-0.8 %). The same findings were presented in ICU admission and emergent operation or intervention. CONCLUSION The ATLS-based shock index achieved the highest PPV and specificity compared to SIPA, uSIPA, and SIPALS for adverse outcomes in paediatric trauma.
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Affiliation(s)
- Dongmuk Choi
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Joong Wan Park
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea; Disaster Medicine Research Center, Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea; Department of Emergency Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
| | - Young Ho Kwak
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea; Disaster Medicine Research Center, Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea; Department of Emergency Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Do Kyun Kim
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea; Disaster Medicine Research Center, Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jae Yun Jung
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea; Disaster Medicine Research Center, Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jin Hee Lee
- Disaster Medicine Research Center, Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea; Department of Emergency Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea; Department of Emergency Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro, Bundang-gu, Seong-Nam, 13620, Republic of Korea
| | - Jin Hee Jung
- Disaster Medicine Research Center, Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea; Department of Emergency Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, Republic of Korea
| | - Dongbum Suh
- Disaster Medicine Research Center, Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea; Department of Emergency Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro, Bundang-gu, Seong-Nam, 13620, Republic of Korea
| | - Ha Ni Lee
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea; Disaster Medicine Research Center, Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea; Department of Emergency Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Eui Jun Lee
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jin Hee Kim
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
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Hwang S, Chung HJ, Park JW, Lee EJ, Lee HN, Kim JH, Jue JH, Choi YH, Jung JY. Factors contributing to uncertainty in paediatric abdominal ultrasound reports in the paediatric emergency department. BMC Emerg Med 2023; 23:120. [PMID: 37817121 PMCID: PMC10566031 DOI: 10.1186/s12873-023-00892-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 10/04/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Abdominal pain, which is a common cause of children presenting to the paediatric emergency department (PED), is often evaluated by ultrasonography (US). However, uncertainty in US reports may necessitate additional imaging. OBJECTIVE In this study, we evaluated factors contributing to uncertainty in paediatric abdominal US reports in the PED. MATERIALS AND METHODS This retrospective cohort study included children younger than 18 years of age who underwent abdominal US in the PED of the study hospital between January 2017 and December 2019. After exclusion, the researchers manually reviewed and classified all US reports as 'certain' or 'uncertain'. Univariate and multivariate logistic regression analyses were performed to identify the factors contributing to uncertain reports. RESULTS In total, 1006 patients were included in the final analysis., 796 patients were tagged as having certain reports, and 210 as having uncertain reports. Children with uncertain reports had a significantly higher rate of undergoing an additional computed tomography (CT) scan (31.0% vs. 2.5%, p < 0.001) and a longer PED median length of stay (321.0 (Interquartile range (IQR); 211.3-441.5) minutes vs. 284.5 (IQR; 191.8-439.5) minutes, p = 0.042). After logistic regression, US performed by a radiology resident (odds ratio, 5.01; 95% confidence interval, 3.63-7.15) was the most significant factor contributing to uncertainty in paediatric abdominal US reports followed by obesity and age. CONCLUSION Several factors contribute to uncertainty in paediatric abdominal US reports. Uncertain radiological reports increase the likelihood of additional CT scans. Measures to improve the clarity of radiological reports must be considered to improve the quality of care for children visiting the PED.
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Affiliation(s)
- Soyun Hwang
- Department of Pediatrics, Yonsei School of Medicine, Severance Children's Hospital, Seoul, Republic of Korea
| | - Hyun Jung Chung
- Department of Pediatrics, Konkuk University Hospital, Seoul, Republic of Korea
| | - Joong Wan Park
- Department of Emergency Medicine, Seoul National University Hospital, 101, Daehak-Ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Eui Jun Lee
- Department of Emergency Medicine, Seoul National University Hospital, 101, Daehak-Ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Ha Ni Lee
- Department of Emergency Medicine, Seoul National University Hospital, 101, Daehak-Ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jin Hee Kim
- Department of Emergency Medicine, Seoul National University Hospital, 101, Daehak-Ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jie Hee Jue
- Department of Emergency Medicine, Seoul National University Hospital, 101, Daehak-Ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Young Hun Choi
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jae Yun Jung
- Department of Emergency Medicine, Seoul National University Hospital, 101, Daehak-Ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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Miao H, Zhang TT, Li HX, Fabbris G, Said AH, Tartaglia R, Yilmaz T, Vescovo E, Yin JX, Murakami S, Feng XL, Jiang K, Wu XL, Wang AF, Okamoto S, Wang YL, Lee HN. Signature of spin-phonon coupling driven charge density wave in a kagome magnet. Nat Commun 2023; 14:6183. [PMID: 37793998 PMCID: PMC10550957 DOI: 10.1038/s41467-023-41957-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 09/21/2023] [Indexed: 10/06/2023] Open
Abstract
The intertwining between spin, charge, and lattice degrees of freedom can give rise to unusual macroscopic quantum states, including high-temperature superconductivity and quantum anomalous Hall effects. Recently, a charge density wave (CDW) has been observed in the kagome antiferromagnet FeGe, indicative of possible intertwining physics. An outstanding question is that whether magnetic correlation is fundamental for the spontaneous spatial symmetry breaking orders. Here, utilizing elastic and high-resolution inelastic x-ray scattering, we observe a c-axis superlattice vector that coexists with the 2[Formula: see text]2[Formula: see text]1 CDW vectors in the kagome plane. Most interestingly, between the magnetic and CDW transition temperatures, the phonon dynamical structure factor shows a giant phonon-energy hardening and a substantial phonon linewidth broadening near the c-axis wavevectors, both signaling the spin-phonon coupling. By first principles and model calculations, we show that both the static spin polarization and dynamic spin excitations intertwine with the phonon to drive the spatial symmetry breaking in FeGe.
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Affiliation(s)
- H Miao
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN, USA.
| | - T T Zhang
- Department of Physics, Tokyo Institute of Technology, Okayama, Meguro-ku, Tokyo, Japan
| | - H X Li
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN, USA
- Advanced Materials Thrust, The Hong Kong University of Science and Technology (Guangzhou), Guangzhou, China
| | - G Fabbris
- Advanced Photon Source, Argonne National Laboratory, Argonne, IL, USA
| | - A H Said
- Advanced Photon Source, Argonne National Laboratory, Argonne, IL, USA
| | - R Tartaglia
- Advanced Photon Source, Argonne National Laboratory, Argonne, IL, USA
- "Gleb Wataghin" Institute of Physics, University of Campinas, Campinas, São Paulo, Brazil
| | - T Yilmaz
- National Synchrotron Light Source II, Brookhaven National Laboratory, Upton, New York, USA
| | - E Vescovo
- National Synchrotron Light Source II, Brookhaven National Laboratory, Upton, New York, USA
| | - J-X Yin
- Laboratory for Quantum Emergence, Department of Physics, Southern University of Science and Technology, Shenzhen, China
| | - S Murakami
- Department of Physics, Tokyo Institute of Technology, Okayama, Meguro-ku, Tokyo, Japan
| | - X L Feng
- Beijing National Laboratory for Condensed Matter Physics, and Institute of Physics, Chinese Academy of Sciences, Beijing, China
| | - K Jiang
- Beijing National Laboratory for Condensed Matter Physics, and Institute of Physics, Chinese Academy of Sciences, Beijing, China
| | - X L Wu
- Low Temperature Physics Laboratory, College of Physics and Center of Quantum Materials and Devices, Chongqing University, Chongqing, China
| | - A F Wang
- Low Temperature Physics Laboratory, College of Physics and Center of Quantum Materials and Devices, Chongqing University, Chongqing, China.
| | - S Okamoto
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN, USA.
| | - Y L Wang
- School of Emerging Technology, University of Science and Technology of China, Hefei, Anhui, China.
| | - H N Lee
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN, USA
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Jung JH, Hwang S, Jung JY, Park JW, Lee EJ, Lee HN, Kim JH, Kim DK, Kwak YH. Brain natriuretic peptide as a clinical screening tool for the diagnosis of Kawasaki disease. Medicine (Baltimore) 2023; 102:e34319. [PMID: 37478221 PMCID: PMC10662796 DOI: 10.1097/md.0000000000034319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 06/22/2023] [Indexed: 07/23/2023] Open
Abstract
N-terminal pro-brain natriuretic peptide (NT-proBNP) has been studied as a diagnostic screening tool for Kawasaki disease (KD). However, brain natriuretic peptide (BNP) has been less studied while has less variability among age groups. We aimed to find out if BNP can be used as a diagnostic screening tool for KD in Korea. This was a retrospective cohort study performed in a single pediatric emergency department. Patients younger than 19 years of age who presented with fever and underwent BNP examination for suspected KD was included. The primary outcome was the diagnostic performance of BNP for KD, and the secondary outcome was the diagnostic performance of BNP for coronary artery aneurysm (CAA). We also derived a scoring system for predicting KD and CAA. Of the 778 patients who were finally included, 400 were not diagnosed with KD and 378 were diagnosed with KD. The odds ratio of BNP at the cutoff of 30 pg/mL for KD was 7.80 (95% CI, 5.67-10.73) in the univariate analysis and 3.62 (95% CI, 2.33-5.88) in the multivariable analysis. The odds ratio of BNP at the cutoff of 270 pg/mL for CAA was 3.67 (95% CI, 2.18-6.19) in the univariate analysis and 2.37 (95% CI, 1.16-8.74) in the multivariable analysis. The AUC of KD and CAA were 0.884 and 0.726, respectively, which was the highest AUCs among all variables. Additionally, we proposed a scoring system for KD and CAA. It is important to clinically suspect KD and CAA in children with high BNP levels.
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Affiliation(s)
- Jae Ho Jung
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Soyun Hwang
- Department of Pediatrics, Severance Children’s Hospital, Seoul, Republic of Korea
| | - Jae Yun Jung
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Joong Wan Park
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Eui Jun Lee
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Ha Ni Lee
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jin Hee Kim
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Do Kyun Kim
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Young Ho Kwak
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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Zhong Y, Li S, Liu H, Dong Y, Aido K, Arai Y, Li H, Zhang W, Shi Y, Wang Z, Shin S, Lee HN, Miao H, Kondo T, Okazaki K. Testing electron-phonon coupling for the superconductivity in kagome metal CsV 3Sb 5. Nat Commun 2023; 14:1945. [PMID: 37029104 PMCID: PMC10082024 DOI: 10.1038/s41467-023-37605-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 03/23/2023] [Indexed: 04/09/2023] Open
Abstract
In crystalline materials, electron-phonon coupling (EPC) is a ubiquitous many-body interaction that drives conventional Bardeen-Cooper-Schrieffer superconductivity. Recently, in a new kagome metal CsV3Sb5, superconductivity that possibly intertwines with time-reversal and spatial symmetry-breaking orders is observed. Density functional theory calculations predicted weak EPC strength, λ, supporting an unconventional pairing mechanism in CsV3Sb5. However, experimental determination of λ is still missing, hindering a microscopic understanding of the intertwined ground state of CsV3Sb5. Here, using 7-eV laser-based angle-resolved photoemission spectroscopy and Eliashberg function analysis, we determine an intermediate λ=0.45-0.6 at T = 6 K for both Sb 5p and V 3d electronic bands, which can support a conventional superconducting transition temperature on the same magnitude of experimental value in CsV3Sb5. Remarkably, the EPC on the V 3d-band enhances to λ~0.75 as the superconducting transition temperature elevated to 4.4 K in Cs(V0.93Nb0.07)3Sb5. Our results provide an important clue to understand the pairing mechanism in the kagome superconductor CsV3Sb5.
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Affiliation(s)
- Yigui Zhong
- Institute for Solid State Physics, The University of Tokyo, Kashiwa, Chiba, 277-8581, Japan
| | - Shaozhi Li
- Material Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN, 37831, USA
| | - Hongxiong Liu
- Beijing National Laboratory for Condensed Matter Physics and Institute of Physics, Chinese Academy of Sciences, 100190, Beijing, China
| | - Yuyang Dong
- Institute for Solid State Physics, The University of Tokyo, Kashiwa, Chiba, 277-8581, Japan
| | - Kohei Aido
- Institute for Solid State Physics, The University of Tokyo, Kashiwa, Chiba, 277-8581, Japan
| | - Yosuke Arai
- Institute for Solid State Physics, The University of Tokyo, Kashiwa, Chiba, 277-8581, Japan
| | - Haoxiang Li
- Material Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN, 37831, USA
- Advanced Materials Thrust, The Hong Kong University of Science and Technology (Guangzhou), 511453, Guangzhou, Guangdong, China
| | - Weilu Zhang
- Institute for Solid State Physics, The University of Tokyo, Kashiwa, Chiba, 277-8581, Japan
- Department of Engineering and Applied Sciences, Sophia University, Tokyo, 102-8554, Japan
| | - Youguo Shi
- Beijing National Laboratory for Condensed Matter Physics and Institute of Physics, Chinese Academy of Sciences, 100190, Beijing, China
| | - Ziqiang Wang
- Department of Physics, Boston College, Chestnut Hill, MA, 02467, USA
| | - Shik Shin
- Institute for Solid State Physics, The University of Tokyo, Kashiwa, Chiba, 277-8581, Japan
- Office of University Professor, The University of Tokyo, Kashiwa, Chiba, 277-8581, Japan
| | - H N Lee
- Material Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN, 37831, USA
| | - H Miao
- Material Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN, 37831, USA.
| | - Takeshi Kondo
- Institute for Solid State Physics, The University of Tokyo, Kashiwa, Chiba, 277-8581, Japan.
- Trans-scale Quantum Science Institute, The University of Tokyo, Bunkyo, Tokyo, 113-0033, Japan.
| | - Kozo Okazaki
- Institute for Solid State Physics, The University of Tokyo, Kashiwa, Chiba, 277-8581, Japan.
- Trans-scale Quantum Science Institute, The University of Tokyo, Bunkyo, Tokyo, 113-0033, Japan.
- Material Innovation Research Center, The University of Tokyo, Kashiwa, Chiba, 277-8561, Japan.
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Kim M, Lee JH, Kwak YH, Kim HK, Kwon H, Suh D, Kim DK, Lee HN, Kim JH, Jue JH, Hwang S. Delta Neutrophil Index Does Not Differentiate Bacterial Infection without Bacteremia from Viral Infection in Pediatric Febrile Patients. Children (Basel) 2023; 10:children10010161. [PMID: 36670711 PMCID: PMC9857165 DOI: 10.3390/children10010161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/03/2023] [Accepted: 01/10/2023] [Indexed: 01/17/2023]
Abstract
Introduction: We sought to determine whether the delta neutrophil index (DNI), a marker that is reported to be used to predict the diagnosis, prognosis, and disease severity of bacteremia and sepsis, is useful in differentiating bacterial infection without bacteremia (BIWB) from viral infections (VI) in pediatric febrile patients in the emergency department (ED). Method: We conducted a retrospective analysis of febrile patients’ medical records from the pediatric ED of the teaching hospital. The patients with BIWB and those with VI were identified with a review of medical records. The primary outcome was the diagnostic performance of DNI in differentiating BIWB from VI. The secondary outcome was a comparison of the diagnostic performances of DNI, CRP, WBC, and neutrophil count between the two groups. Results: A total of 151 (26.3%) patients were in the BIWB group, and 423 (73.7%) were in the VI group. There was no significant difference in DNI between the two groups (3.51 ± 6.90 vs. 3.07 ± 5.82, mean ± SD, BIWB vs. VI). However, CRP levels were significantly higher in the BIWB group than in the VI group (4.56 ± 5.45 vs. 1.39 ± 2.12, mean ± SD, BIWB vs. VI, p < 0.05). The AUROCs of DNI, WBC count, neutrophil levels, RDW, and CRP levels were 0.5016, 0.5531, 0.5631, 0.5131, and 0.7389, respectively, and only CRP levels were helpful in differentiating BIWB from VI. Conclusion: In the absence of bacteremia, DNI would not be helpful in differentiating BIWB from VI in pediatric febrile patients.
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Affiliation(s)
- Maro Kim
- Department of Emergency Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul 13620, Republic of Korea
| | - Jin Hee Lee
- Department of Emergency Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul 13620, Republic of Korea
- Disaster Medicine Research Center, Seoul National University Medical Research Center, Seoul 03080, Republic of Korea
- Correspondence: ; Tel.: +82-31-787-7586
| | - Young Ho Kwak
- Disaster Medicine Research Center, Seoul National University Medical Research Center, Seoul 03080, Republic of Korea
- Department of Emergency Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Hyun Kyung Kim
- Department of Laboratory Medicine, Cancer Research Institute, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Hyuksool Kwon
- Department of Emergency Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul 13620, Republic of Korea
| | - Dongbum Suh
- Department of Emergency Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul 13620, Republic of Korea
| | - Do Kyun Kim
- Department of Emergency Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Ha Ni Lee
- Department of Emergency Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Jin Hee Kim
- Department of Emergency Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Jie Hee Jue
- Department of Emergency Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Soyun Hwang
- Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
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Lee HN, Park JW, Hwang S, Jung JY, Kim DK, Kwak YH, Lee EJ. Effect of a Virtual Reality Environment Using a Domed Ceiling Screen on Procedural Pain During Intravenous Placement in Young Children: A Randomized Clinical Trial. JAMA Pediatr 2023; 177:25-31. [PMID: 36409508 PMCID: PMC9679961 DOI: 10.1001/jamapediatrics.2022.4426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 08/24/2022] [Indexed: 11/23/2022]
Abstract
Importance Distraction using virtual reality (VR) has been found to provide a clinically significant reduction in the experience of pain during various painful procedures. Commercially available VR systems usually require the user to wear a head-mounted display helmet, which can be challenging for young children, and whether VR can reduce pain during intravenous (IV) placement in young children is currently unknown. Objective To determine whether a VR environment using a novel domed ceiling screen reduces distress among children over the course of IV placement compared with standard care in a pediatric emergency department. Design, Setting, and Participants This randomized clinical trial was conducted from June 3, 2020, to February 8, 2021, at an urban tertiary academic children's hospital. Included were children aged 6 months to 4 years undergoing IV placement in the pediatric emergency department. Intervention Children in the intervention group lay on a bed to experience a VR animation using a domed ceiling screen during the IV placement procedure, which was performed as usual. Children in the control group also lay on a bed during the procedure but did not view a VR animation. Main Outcomes and Measures The primary outcome was pain scores measured using the Face, Legs, Activity, Cry, and Consolability (FLACC) scale at 4 time points during IV placement: immediately after the child lay down on the bed (T1), the moment the tourniquet was applied (T2), the moment a sterile alcohol swab was applied (T3), and the moment the needle penetrated the skin (T4). Results Of the 88 children included in the final analysis, 44 received VR distraction (median [IQR] age, 24.0 [14.5-44.0] months; 27 boys [61.4%]), and 44 received standard care (median [IQR] age, 23.0 [15.0-40.0] months; 26 boys [59.1%]). The median [IQR] FLACC scores at T4 were 6.0 (1.8-7.5) in the intervention group and 7.0 (5.5-7.8) in the control group. The ordinal logistic regression model showed that children in the VR intervention group vs the control group had a lower probability of higher FLACC scores (odds ratio, 0.53; 95% CI, 0.28-0.99; P = .046). Conclusions and Relevance The findings of this trial indicate that displaying VR using a domed ceiling screen may be an effective distraction method that reduces distress in young children undergoing IV placement. Trial Registration isrctn.org Identifier: KCT0005122.
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Affiliation(s)
- Ha Ni Lee
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea
| | - Joong Wan Park
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea
| | - Soyun Hwang
- Department of Pediatrics, Severance Children’s Hospital, Seoul, Korea
| | - Jae Yun Jung
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea
| | - Do Kyun Kim
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea
| | - Young Ho Kwak
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea
| | - Eui Jun Lee
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea
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11
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Lee HN, Hwang S, Jung JY, Park JW, Kim DK, Kwak YH. Tablet personal computer distraction during intravenous placement for young children in the pediatric emergency department: A pilot study. Pediatr Int 2022; 64:e15150. [PMID: 35510723 DOI: 10.1111/ped.15150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 01/16/2022] [Accepted: 01/21/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Intravenous (IV) placement is a common procedure experienced by children visiting the pediatric emergency department (PED). However, uncontrolled anxiety and pain cause children to interfere with the procedure. In this pilot study, we sought to evaluate the effectiveness of tablet personal computers as a distraction method during IV placement. METHODS This is a single-center pilot study conducted at a tertiary teaching hospital. Children visiting the PED were eligible if they were aged 3-5 years and required IV placement during the PED visit. After written consent was obtained from the guardian, the child was randomly assigned to a control group or an intervention group. For the intervention group, an animated video was played via tablet PC during IV placement. For both groups, children's anxiety, heart rate, and pain scale scores (the Face, Legs, Activity, Cry, Consolability and Evaluation Enfant Douleur) and guardian satisfaction were recorded. RESULTS 22 children were eligible for the final analysis. There was no significant difference in the pain scale scores between the two groups, with the exception of the degree of pain relief after the procedure measured using Evaluation Enfant Douleur (intervention group: 6.0, interquartile range (IQR): 4.2-6.8, and control group; 3.0, IQR: 2.0-3.8, P = 0.011) and Face, Legs, Activity, Cry, Consolability (intervention group: 4.0, IQR: 4.0-4.2 and control group; 3.0, IQR: 1.5-3.5, P = 0.043). CONCLUSION In this pilot study, distraction using tablet personal computers may have reduced children's distress during the recovery phase after venipuncture. Further study with a larger sample size and different methods of distraction is essential.
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Affiliation(s)
- Ha Ni Lee
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seodaemun-gu, Korea
| | - Soyun Hwang
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seodaemun-gu, Korea
| | - Jae Yun Jung
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seodaemun-gu, Korea
| | - Joong Wan Park
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seodaemun-gu, Korea
| | - Do Kyun Kim
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seodaemun-gu, Korea
| | - Young Ho Kwak
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seodaemun-gu, Korea
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12
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Lee HN, Subrayan V. I think I have double vision? Or not? Internuclear Ophthalmoplegia following right lacunar infarct. Med J Malaysia 2021; 76:950-952. [PMID: 34806694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Internuclear Ophthalmoplegia (INO) is an inability of the ipsilateral adduction with a contralateral horizontal abducting saccade on attempted gaze to the contra-lesion side. Injury to the medial longitudinal fasciculus (MLF) will obstruct the signalling pathway between the ipsilateral abducens nucleus and the contralateral medial rectus muscle. Infarction accounts for 38% of INO cases with mostly being unilateral (87%), followed by demyelination (34%), which mostly being bilateral (73%). Lacunar infarct is the most common ischemic stroke. INO can be easily missed due to its subtle presentation with no complaints from the patients. A full cranial nerves assessment, includes the extraocular muscles movement, is important. Ischemic and demyelinating INO typically recover. We present here of a case of INO following right lacunar infarct in a 72-year-old Malay woman. She had hypertensive crisis due to missed medications. Her blood pressure was well controlled throughout the hospital admission and finally she was discharged home with continuation of care at her primary facility.
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Affiliation(s)
- H N Lee
- Sultanah Fatimah Specialist Hopsital, Johor, Malaysia.
| | - V Subrayan
- University Malaya Medical Center, Kuala Lumpur, Malaysia
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13
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Lee HN, Bae W, Park JW, Jung JY, Hwang S, Kim DK, Kwak YH. Virtual reality environment using a dome screen for procedural pain in young children during intravenous placement: A pilot randomized controlled trial. PLoS One 2021; 16:e0256489. [PMID: 34464411 PMCID: PMC8407539 DOI: 10.1371/journal.pone.0256489] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 08/03/2021] [Indexed: 12/05/2022] Open
Abstract
We assessed the feasibility and potential efficacy of a virtual reality (VR) environment using a dome screen as a distraction method in young children during intravenous (IV) placement in the pediatric emergency department. This randomized controlled pilot study enrolled children aged 2 to 6 years who underwent IV placement into either the intervention group or the control group. Children in the intervention group experienced VR using a dome screen during IV placement. The child’s pain intensity was measured using the Face, Legs, Activity, Cry, and Consolability (FLACC) scale at four time points of IV placement: immediately after arrival to the blood collection room (base); immediately after the child laid down on the bed (preparation); when the tourniquet was applied (tourniquet); and the moment at which the needle penetrated the skin (venipuncture). The guardian’s satisfaction and rating of the child’s distress were assessed using a 5-point Likert-type questionnaire. We recruited 19 children (9 in the intervention group and 10 in the control group). Five children in the control group were excluded from the analysis because of missing video recordings (n = 3), failed first attempt at IV placement (n = 1), and the child’s refusal to lie on the bed during the procedure (n = 1). No side effects of VR were reported during the study period. Although the average FLACC scale score at each time point (preparation, tourniquet, venipuncture) was lower in the intervention group than the control group, the difference was not statistically significant (2.3, interquartile range [IQR]: 2.0–3.0; vs. 3.3, IQR: 2.7–6.7, P = 0.255). There were no statistically significant differences between the groups in the guardian’s satisfaction and anxiety or his/her rating of the child’s pain and anxiety. The guardians and emergency medical technicians reported satisfaction with the use of VR with a dome screen and considered it a useful distraction during the procedure. VR using a dome screen is a feasible distraction method for young children during IV placement. A larger clinical trial with further development of the VR environment and study process is required to adequately evaluate the efficacy of VR using a dome screen.
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Affiliation(s)
- Ha Ni Lee
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Woori Bae
- Department of Emergency Medicine, Seoul St. Mary Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Joong Wan Park
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- * E-mail:
| | - Jae Yun Jung
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Soyun Hwang
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Do Kyun Kim
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Young Ho Kwak
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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Lee HN, Jung JY, Hwang S, Park JW, Kim D, Kwak YH, Lee BJ, Lee EJ. Role of the urinary N-acetyl-beta-D-glucosaminidase/creatinine (NAG/Cr) ratio in discriminating between true and false pyuria in sterile urine bag specimens. J Pediatr Urol 2021; 17:442.e1-442.e7. [PMID: 34092512 DOI: 10.1016/j.jpurol.2021.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 04/12/2021] [Accepted: 05/01/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Urethral catheterization (CATH) and suprapubic aspiration (SA) are reliable methods of collecting urine for the diagnosis of urinary tract infections (UTIs), but both are invasive and difficult. Therefore, urine collection through a sterile urine bag (SUB) is commonly used for UTI screening. However, when pyuria is found in SUB specimens, it is difficult to interpret whether this result is true or false. OBJECTIVE We aimed to determine the diagnostic performance of the urinary NAG/Cr ratio in detecting true pyuria in SUB specimens for children with suspected UTIs. STUDY DESIGN This retrospective study included children 2-24 months of age presenting to the pediatric emergency department (PED) and in whom urinary NAG and creatinine levels were measured and a urine culture was performed between January 1, 2018, and December 31, 2019. Children with the presence of pyuria in SUB specimens were categorized into true or false pyuria groups depending on whether pyuria was present in CATH specimens. The diagnostic performance of the urinary NAG/Cr ratio in detecting true pyuria was identified using receiver operating characteristic (ROC) curve analysis. The optimal cutoff was calculated based on ROC curve analysis. Sensitivity, specificity, and positive and negative likelihood ratios were assessed for optimal cutoff values. RESULTS Among 606 children with measured urinary NAG levels, 144 children with pyuria in SUB specimens were included in the analyses. Pyuria was consistently present in the CATH specimens of 67 (46.5%) children and absent in those of 77 (44.5%) children. The urinary NAG/Cr ratio was significantly higher in the true pyuria group than in the false pyuria group (21.5 IU/g; 95% confidence interval [CI]: 12.3-35.6; vs 9.6 IU/g; 95% CI: 6.7-16.1, P < 0.001). The area under the ROC curve (AUC) for the urinary NAG/Cr ratio was 0.776 (95% CI: 0.700-0.851). The optimal cutoff of 18.85 IU/g corresponded to the best combination of sensitivity (58.2, 95% CI: 46.4-70.0) and specificity (83.3, 95% CI: 74.7-91.6), with positive and negative likelihood ratios of 3.49 (95% CI: 2.04-5.97) and 0.50 (95% CI: 0.37-0.68), respectively. CONCLUSION The urinary NAG/Cr ratio may be a potential indicator discriminating true pyuria from false pyuria in SUB specimens in the PED. However, large prospective studies are required to implement the NAG/Cr ratio in clinical practice.
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Affiliation(s)
- Ha Ni Lee
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jae Yun Jung
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
| | - Soyun Hwang
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Joong Wan Park
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - DoKyun Kim
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Young Ho Kwak
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Bong Jin Lee
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Eui Jun Lee
- Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
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15
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Li H, Zhang TT, Said A, Fabbris G, Mazzone DG, Yan JQ, Mandrus D, Halász GB, Okamoto S, Murakami S, Dean MPM, Lee HN, Miao H. Giant phonon anomalies in the proximate Kitaev quantum spin liquid α-RuCl 3. Nat Commun 2021; 12:3513. [PMID: 34112804 PMCID: PMC8192767 DOI: 10.1038/s41467-021-23826-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 04/30/2021] [Indexed: 11/18/2022] Open
Abstract
The Kitaev quantum spin liquid epitomizes an entangled topological state, for which two flavors of fractionalized low-energy excitations are predicted: the itinerant Majorana fermion and the Z2 gauge flux. It was proposed recently that fingerprints of fractional excitations are encoded in the phonon spectra of Kitaev quantum spin liquids through a novel fractional-excitation-phonon coupling. Here, we detect anomalous phonon effects in α-RuCl3 using inelastic X-ray scattering with meV resolution. At high temperature, we discover interlaced optical phonons intercepting a transverse acoustic phonon between 3 and 7 meV. Upon decreasing temperature, the optical phonons display a large intensity enhancement near the Kitaev energy, JK~8 meV, that coincides with a giant acoustic phonon softening near the Z2 gauge flux energy scale. These phonon anomalies signify the coupling of phonon and Kitaev magnetic excitations in α-RuCl3 and demonstrates a proof-of-principle method to detect anomalous excitations in topological quantum materials.
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Affiliation(s)
- Haoxiang Li
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - T T Zhang
- Department of Physics, Tokyo Institute of Technology, Okayama, Meguro-ku, Tokyo, Japan
- Tokodai Institute for Element Strategy, Tokyo Institute of Technology, Nagatsuta, Midori-ku, Yokohama, Kanagawa, Japan
| | - A Said
- Advanced Photon Source, Argonne National Laboratory, Argonne, IL, USA
| | - G Fabbris
- Advanced Photon Source, Argonne National Laboratory, Argonne, IL, USA
| | - D G Mazzone
- Condensed Matter Physics and Materials Science Department, Brookhaven National Laboratory, Upton, NY, USA
- Laboratory for Neutron Scattering and Imaging, Paul Scherrer Institut, Villigen, Switzerland
| | - J Q Yan
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - D Mandrus
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN, USA
- Department of Materials Science and Engineering, the University of Tennessee at Knoxville, Knoxville, TN, USA
| | - Gábor B Halász
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - S Okamoto
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - S Murakami
- Department of Physics, Tokyo Institute of Technology, Okayama, Meguro-ku, Tokyo, Japan
- Tokodai Institute for Element Strategy, Tokyo Institute of Technology, Nagatsuta, Midori-ku, Yokohama, Kanagawa, Japan
| | - M P M Dean
- Condensed Matter Physics and Materials Science Department, Brookhaven National Laboratory, Upton, NY, USA
| | - H N Lee
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - H Miao
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN, USA.
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Lee HN, Kwak YH, Jung JY, Lee SU, Park JW, Kim DK. Are parents' statements reliable for diagnosis of serious bacterial infection among children with fever without an apparent source?: A retrospective study. Medicine (Baltimore) 2019; 98:e17530. [PMID: 31626114 PMCID: PMC6824753 DOI: 10.1097/md.0000000000017530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Serious bacterial infection (SBI) is a major cause of morbidity and mortality in children. Distinguishing SBI from self-limiting viral infections is a very important task in the emergency department (ED), especially in the children with fever without source (FWS). The aim of this study was to analyze whether parents' statements about clinical manifestations, which were categorized according to grades, are related to the actual diagnosis of SBI in children with FWS.Retrospective analysis was conducted using prospectively acquired cohort data for all febrile children in the pediatric ED of Seoul National University Hospital from August 2016 to August 2017. The association of clinical manifestations and SBI was the main outcome of this study. The SBIs included diagnoses such as bacteremia, bacterial meningitis, urinary tract infection, and pneumonia. Clinical manifestations including activity, urination, and feeding were categorized into 3 or 4 grades according to the parents' statements. The linear-by-linear association test was used to examine linear associations between the severity of clinical manifestations and SBI. Receiver operating characteristic curves for clinical manifestations were constructed for patients with SBI. Area under the curve (AUC) statistics and 95% confidence intervals (CIs) were obtained to evaluate the predictive performance of clinical manifestations.There was no linear association between SBI and non-SBI when compared by severity of the clinical manifestations, such as duration of fever (P = .299), activity (P = .781), feeding (P = .161), and urination (P = .834). The AUC was 0.54 (95% CI 0.41-0.67) for duration of fever, 0.52 for activity (95% CI 0.40-0.64), 0.42 for feeding (95% CI 0.32-0.53), and 0.51 for urination (95% CI 0.39-0.62).There was no evidence that the test performance of the clinical manifestations is valid for predicting SBIs, even considering the severity of manifestations. For optimal evaluation of the children with FWS, more comprehensive approach including laboratory tests, are needed.
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Affiliation(s)
- Ha Ni Lee
- Department of Emergency Medicine, Seoul National University Hospital, Jongno-gu
| | - Young Ho Kwak
- Department of Emergency Medicine, Seoul National University Hospital, Jongno-gu
| | - Jae Yun Jung
- Department of Emergency Medicine, Seoul National University Hospital, Jongno-gu
| | - Se Uk Lee
- Department of Emergency Medicine, Seoul National University Hospital, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Dongjak-gu, Seoul, Republic of Korea
| | - Joong Wan Park
- Department of Emergency Medicine, Seoul National University Hospital, Jongno-gu
| | - Do Kyun Kim
- Department of Emergency Medicine, Seoul National University Hospital, Jongno-gu
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Park IY, Kim MR, Lee HN, Gen Y, Kim MJ. Risk factors for Korean women to develop an isthmocele after a cesarean section. BMC Pregnancy Childbirth 2018; 18:162. [PMID: 29764452 PMCID: PMC5952596 DOI: 10.1186/s12884-018-1821-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 05/02/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The increase in number of cesarean section (CS) operations has resulted in an increase in cases of isthmocele development. The objective of this study is to determine the risk factors for isthmocele development after CS. METHODS Isthmocele measurements were taken for 404 women with a history of at least one low transverse CS. The following potential risk factors were investigated: patient's age at CS, cause of CS, weeks of gestation at CS, premature rupture of membrane (PROM), phase of labor, type suture (single/double layer), operation time, uterine flexion (anteversion/retroversion), and blood transfusion during operation. A transvaginal ultrasound was carried out to examine the isthmocele in the uterus after CS, including the shape of the isthmocele, residual myometrial thickness, depth and width of isthmocele, cervical thickness, location of the isthmocele, and clinical characteristics. RESULTS In our study population, the isthmocele had a prevalence of 73.8%. Most isthmocele had a triangular (65.4%) or semicircular shape (10.4%). The presence of an isthmocele was significantly associated with repeat CS, premature rupture of membrane (PROM), short operation time, and extent of cervix dilatation at CS. The risk of isthmocele was low in women who had placenta previa totalis (PPT), twin, a long operation time, or a transfusion during the operation. CONCLUSIONS In our study, isthmocele development was significantly associated with repeat CS, PROM, a short operation time, and the extent of cervix dilatation at CS. Therefore, PROM prevention and a more careful uterine closure are needed to reduce the risk of developing an isthmocele after CS.
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Affiliation(s)
- I Y Park
- Department of Obstetrics and Gynecology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - M R Kim
- Department of Obstetrics and Gynecology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - H N Lee
- Department of Obstetrics and Gynecology, College of Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea, 327 Sosa-ro, Bucheon, Gyeonggi-do, 14647, Republic of Korea
| | - Y Gen
- Department of Obstetrics and Gynecology, College of Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea, 327 Sosa-ro, Bucheon, Gyeonggi-do, 14647, Republic of Korea
| | - M J Kim
- Department of Obstetrics and Gynecology, College of Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea, 327 Sosa-ro, Bucheon, Gyeonggi-do, 14647, Republic of Korea.
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18
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Lee JH, Choi WS, Jeen H, Lee HJ, Seo JH, Nam J, Yeom MS, Lee HN. Strongly Coupled Magnetic and Electronic Transitions in Multivalent Strontium Cobaltites. Sci Rep 2017; 7:16066. [PMID: 29167490 PMCID: PMC5700177 DOI: 10.1038/s41598-017-16246-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 05/19/2017] [Accepted: 10/13/2017] [Indexed: 12/21/2022] Open
Abstract
The topotactic phase transition in SrCoOx (x = 2.5–3.0) makes it possible to reversibly transit between the two distinct phases, i.e. the brownmillerite SrCoO2.5 that is a room-temperature antiferromagnetic insulator (AFM-I) and the perovskite SrCoO3 that is a ferromagnetic metal (FM-M), owing to their multiple valence states. For the intermediate x values, the two distinct phases are expected to strongly compete with each other. With oxidation of SrCoO2.5, however, it has been conjectured that the magnetic transition is decoupled to the electronic phase transition, i.e., the AFM-to-FM transition occurs before the insulator-to-metal transition (IMT), which is still controversial. Here, we bridge the gap between the two-phase transitions by density-functional theory calculations combined with optical spectroscopy. We confirm that the IMT actually occurs concomitantly with the FM transition near the oxygen content x = 2.75. Strong charge-spin coupling drives the concurrent IMT and AFM-to-FM transition, which fosters the near room-T magnetic transition characteristic. Ultimately, our study demonstrates that SrCoOx is an intriguingly rare candidate for inducing coupled magnetic and electronic transition via fast and reversible redox reactions.
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Affiliation(s)
- J H Lee
- School of Energy and Chemical Engineering, Ulsan National Institute of Science & Technology (UNIST), Ulsan, 44919, Republic of Korea.
| | - Woo Seok Choi
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN, 37831, USA.,Department of Physics, Sungkyunkwan University, Suwon, 440-746, Korea
| | - H Jeen
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN, 37831, USA.,Department of Physics, Pusan National University, Busan, 46241, Korea
| | - H-J Lee
- School of Energy and Chemical Engineering, Ulsan National Institute of Science & Technology (UNIST), Ulsan, 44919, Republic of Korea
| | - J H Seo
- School of Energy and Chemical Engineering, Ulsan National Institute of Science & Technology (UNIST), Ulsan, 44919, Republic of Korea
| | - J Nam
- School of Energy and Chemical Engineering, Ulsan National Institute of Science & Technology (UNIST), Ulsan, 44919, Republic of Korea
| | - M S Yeom
- Department of Applied Research and Network R&D, Center for Computational Science and Engineering, Division of National Supercomputing R&D, Korea Institute of Science and Technology Information (KISTI), 245 Daehak-ro, Daejeon, 34141, Republic of Korea.
| | - H N Lee
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN, 37831, USA.
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Yoon SB, Lee IS, Lee HN, Kim E, Kim W, Lee HH, Lee BI, Choi MG, Jung SE, Choi BO, Park GS, Cho SG. Role of follow-up endoscopic examination in treatment response assessment for patients with gastric diffuse large B cell lymphoma. Scand J Gastroenterol 2016; 51:1111-7. [PMID: 27175513 DOI: 10.1080/00365521.2016.1177854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE According to lymphoma guidelines, gastric diffuse large B cell lymphoma (DLBCL) patients should undergo regular computed tomography (CT) and/or positron emission tomography (PET) examinations to assess treatment response. Endoscopic examinations are not indicated in the guidelines. The aim of this study was to investigate the utility of endoscopic examinations during and after treatment for DLBCL. METHODS We reviewed the patients diagnosed with gastric DLBCL at Seoul St. Mary's Hospital. All patients underwent endoscopy and radiologic examinations at every follow-up appointment. Radiologic response was defined according to World Health Organization criteria and endoscopic response was determined based on the Groupe d'Etude des Lymphomes de l'Adult grading system that is widely used in post-treatment evaluation of gastric MALT lymphoma. RESULTS Forty-five patients were analyzed. Within a median follow-up period of 34 months, 35 patients achieved both radiologic and endoscopic complete remission (CR). The median times to endoscopic and radiologic CR were not significantly different (21 versus 16 weeks, p = 0.118). However, in 25 patients with stage I disease, endoscopic CR [median (range), 20 (11-36)] was achieved later than radiologic CR [median (range), 13 (8-36)] (p = 0.027). Among 40 patients who achieved radiologic CR, 35 patients who also achieved endoscopic CR maintained remission during the follow-up. Two of the five patients who achieved radiologic CR without endoscopic CR experienced recurrence. CONCLUSIONS In gastric DLBCL patients, endoscopic response does not always correlate with radiologic response and might predict disease recurrence. We suggest that follow-up endoscopic examination with biopsy should be performed in addition to radiologic examination.
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Affiliation(s)
- Seung Bae Yoon
- a Department of Gastroenterology, College of Medicine , The Catholic University of Korea , Seoul , South Korea
| | - In Seok Lee
- a Department of Gastroenterology, College of Medicine , The Catholic University of Korea , Seoul , South Korea
| | - Ha Ni Lee
- a Department of Gastroenterology, College of Medicine , The Catholic University of Korea , Seoul , South Korea
| | - Eunyoung Kim
- a Department of Gastroenterology, College of Medicine , The Catholic University of Korea , Seoul , South Korea
| | - Woohyeon Kim
- a Department of Gastroenterology, College of Medicine , The Catholic University of Korea , Seoul , South Korea
| | - Han Hee Lee
- a Department of Gastroenterology, College of Medicine , The Catholic University of Korea , Seoul , South Korea
| | - Bo-In Lee
- a Department of Gastroenterology, College of Medicine , The Catholic University of Korea , Seoul , South Korea
| | - Myung-Gyu Choi
- a Department of Gastroenterology, College of Medicine , The Catholic University of Korea , Seoul , South Korea
| | - Seung Eun Jung
- b Department of Radiology, College of Medicine , The Catholic University of Korea , Seoul , South Korea
| | - Byung Ock Choi
- c Department of Radiation Oncology, College of Medicine , The Catholic University of Korea , Seoul , South Korea
| | - Gyeong Sin Park
- d Department of Hospital Pathology, College of Medicine , The Catholic University of Korea , Seoul , South Korea
| | - Seok-Goo Cho
- e Department of Hematology, College of Medicine , The Catholic University of Korea , Seoul , South Korea
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Halvorsen EC, Hamilton MJ, Young A, Wadsworth BJ, LePard NE, Lee HN, Firmino N, Collier JL, Bennewith KL. Maraviroc decreases CCL8-mediated migration of CCR5(+) regulatory T cells and reduces metastatic tumor growth in the lungs. Oncoimmunology 2016; 5:e1150398. [PMID: 27471618 DOI: 10.1080/2162402x.2016.1150398] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 01/21/2016] [Accepted: 01/31/2016] [Indexed: 02/08/2023] Open
Abstract
Regulatory T cells (Tregs) play a crucial physiological role in the regulation of immune homeostasis, although recent data suggest Tregs can contribute to primary tumor growth by suppressing antitumor immune responses. Tregs may also influence the development of tumor metastases, although there is a paucity of information regarding the phenotype and function of Tregs in metastatic target organs. Herein, we demonstrate that orthotopically implanted metastatic mammary tumors induce significant Treg accumulation in the lungs, which is a site of mammary tumor metastasis. Tregs in the primary tumor and metastatic lungs express high levels of C-C chemokine receptor type 5 (CCR5) relative to Tregs in the mammary fat pad and lungs of tumor-free mice, and Tregs in the metastatic lungs are enriched for CCR5 expression in comparison to other immune cell populations. We also identify that C-C chemokine ligand 8 (CCL8), an endogenous ligand of CCR5, is produced by F4/80(+) macrophages in the lungs of mice with metastatic primary tumors. Migration of Tregs toward CCL8 ex vivo is reduced in the presence of the CCR5 inhibitor Maraviroc. Importantly, treatment of mice with Maraviroc (MVC) reduces the level of CCR5(+) Tregs and metastatic tumor burden in the lungs. This work provides evidence of a CCL8/CCR5 signaling axis driving Treg recruitment to the lungs of mice bearing metastatic primary tumors, representing a potential therapeutic target to decrease Treg accumulation and metastatic tumor growth.
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Affiliation(s)
- E C Halvorsen
- Integrative Oncology Department, British Columbia Cancer Agency, Vancouver, BC, Canada; Interdisciplinary Oncology Program, University of British Columbia, Vancouver, BC, Canada
| | - M J Hamilton
- Integrative Oncology Department, British Columbia Cancer Agency , Vancouver, BC, Canada
| | - A Young
- Integrative Oncology Department, British Columbia Cancer Agency, Vancouver, BC, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - B J Wadsworth
- Integrative Oncology Department, British Columbia Cancer Agency, Vancouver, BC, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - N E LePard
- Integrative Oncology Department, British Columbia Cancer Agency , Vancouver, BC, Canada
| | - H N Lee
- Integrative Oncology Department, British Columbia Cancer Agency , Vancouver, BC, Canada
| | - N Firmino
- Integrative Oncology Department, British Columbia Cancer Agency, Vancouver, BC, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - J L Collier
- Integrative Oncology Department, British Columbia Cancer Agency, Vancouver, BC, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - K L Bennewith
- Integrative Oncology Department, British Columbia Cancer Agency, Vancouver, BC, Canada; Interdisciplinary Oncology Program, University of British Columbia, Vancouver, BC, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
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21
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Liu ZQ, Li L, Gai Z, Clarkson JD, Hsu SL, Wong AT, Fan LS, Lin MW, Rouleau CM, Ward TZ, Lee HN, Sefat AS, Christen HM, Ramesh R. Full Electroresistance Modulation in a Mixed-Phase Metallic Alloy. Phys Rev Lett 2016; 116:097203. [PMID: 26991197 DOI: 10.1103/physrevlett.116.097203] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Indexed: 06/05/2023]
Abstract
We report a giant, ∼22%, electroresistance modulation for a metallic alloy above room temperature. It is achieved by a small electric field of 2 kV/cm via piezoelectric strain-mediated magnetoelectric coupling and the resulting magnetic phase transition in epitaxial FeRh/BaTiO_{3} heterostructures. This work presents detailed experimental evidence for an isothermal magnetic phase transition driven by tetragonality modulation in FeRh thin films, which is in contrast to the large volume expansion in the conventional temperature-driven magnetic phase transition in FeRh. Moreover, all the experimental results in this work illustrate FeRh as a mixed-phase model system well similar to phase-separated colossal magnetoresistance systems with phase instability therein.
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Affiliation(s)
- Z Q Liu
- Center for Nanophase Materials Sciences, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
- Department of Materials Science and Engineering, University of California, Berkeley, California 94720, USA
| | - L Li
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - Z Gai
- Center for Nanophase Materials Sciences, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - J D Clarkson
- Department of Materials Science and Engineering, University of California, Berkeley, California 94720, USA
| | - S L Hsu
- Department of Materials Science and Engineering, University of California, Berkeley, California 94720, USA
| | - A T Wong
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
- Materials Science and Engineering, University of Tennessee, Knoxville, Tennessee 37996, USA
| | - L S Fan
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - M-W Lin
- Center for Nanophase Materials Sciences, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - C M Rouleau
- Center for Nanophase Materials Sciences, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - T Z Ward
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - H N Lee
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - A S Sefat
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - H M Christen
- Center for Nanophase Materials Sciences, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - R Ramesh
- Department of Materials Science and Engineering, University of California, Berkeley, California 94720, USA
- Department of Physics, University of California, Berkeley, California 94720, USA
- Materials Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
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22
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Choi JI, Lee HJ, Shin YJ, Lim HW, Lee HN. Rapid enlargement of endometrial stromal sarcoma after uterine fibroid embolization for presumed adenomyosis: a case report and literature review. EUR J GYNAECOL ONCOL 2016; 37:876-881. [PMID: 29943942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Uterine sarcomas have rarely been diagnosed after uterine artery embolization. It remains unclear whether the diagnostic work-up is required prior to such embolization to prevent a missed diagnosis of sarcomas and a delay in providing definitive treatment. Because of the rarity and heterogeneity of endometrial stromal neoplasms, little is known about their epidemiology, pathogenesis, and molecular pathology. The authors report a case of low-grade endometrial stromal sarcoma (ESS) diagnosed after uterine fibroid embolization. Although they performed laparoscopic biopsy of the rapidly growing uterine mass, they could not detect the ESS. Although rare, ESS should be considered in the differential diagnosis of uterine fibroid enlargement. It is essential to assess the risk of malignancy by taking into account the patient's clinical symptoms, results of the physical exam, and imaging findings prior to uterine artery embolization. Pathologic diagnosis should include an adequate biopsy sample and the use of molecular genetic testing.
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Lee DW, Lee HN. Hysteroscopic Vaginal Septum Resection in Adolescent Girl With Herlyn-Werner-Wunderlich Syndrome. J Minim Invasive Gynecol 2015; 22:S191. [DOI: 10.1016/j.jmig.2015.08.698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sung HH, Han DH, Kim TH, Lee YS, Lee HN, Seo JT, Choo MS, Lee KS. Interventions do not enhance medication persistence and compliance in patients with overactive bladder: a 24 weeks, randomised, open-label, multi-center trial. Int J Clin Pract 2015. [PMID: 26215431 DOI: 10.1111/ijcp.12705] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES Anticholinergics are currently the mainstay for the management of overactive bladder (OAB). However, low drug adherence has been noted with these medications. The aim of this study was to determine whether a health education intervention (HEI) could improve drug persistence with anticholinergics in OAB patients. METHODS We enrolled 682 OAB patients who were randomly distributed into either the HEI plus fesoterodine (HEI) group or the fesoterodine alone (control) group. The HEI consists of four education sections: understanding OAB disease, dietary control, bladder training and understanding anticholinergics. The primary end-point was the difference in drug persistence between the HEI and control groups at 24 weeks. Persistence was defined as a gap ≤ 30 days between successive prescription pills. RESULTS Among the 682 patients, 210 (30.8%) completed 24 weeks of study. Persistence of the HEI group at 6 months was not statistically higher than that of the control group (40.4% vs. 34.9%, p = 0.181). Compliance at 6 months was also similar between the two groups (38.5% vs. 32.5%, p = 0.128). Using OAB symptom score questionnaire, the efficacy of the two groups was not different at each follow-up (p > 0.05). The global response was similar between the two groups. However, the HEI group was more satisfied with treatment than the control group (p = 0.034). The most common reason for discontinuation was satisfaction with the treatment so that they did not need to follow-up, followed by inadequate efficacy in both groups. Adverse events were reported in 12.3% of patients. CONCLUSIONS The health education intervention was not effective to increase drug persistence in OAB patients on anticholinergics.
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Affiliation(s)
- H H Sung
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Korea
| | - D H Han
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Korea
| | - T H Kim
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Korea
| | - Y-S Lee
- Department of Urology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - H N Lee
- Department of Urology, Seoul Seonam Hospital, Ewha Womans University, Seoul, Korea
| | - J T Seo
- Department of Urology, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - M-S Choo
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - K-S Lee
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Korea
- Department of Medical Device Management & Research, SAIHST, Sungkyunkwan University, Seoul, 06351, Korea
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25
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Lee HN, Lee KS, Kim JC, Chung BH, Kim CS, Lee JG, Kim DK, Park CH, Park JK, Hong SJ. Rate and associated factors of solifenacin add-on after tamsulosin monotherapy in men with voiding and storage lower urinary tract symptoms. Int J Clin Pract 2015; 69:444-53. [PMID: 25363606 DOI: 10.1111/ijcp.12581] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 09/29/2014] [Indexed: 11/27/2022] Open
Abstract
AIM To explore the rate of add-on therapy with solifenacin in men with voiding and storage lower urinary tract symptoms (LUTS) after tamsulosin monotherapy and to explore predictive factors for starting solifenacin add-on therapy. METHODS Men aged ≥ 45 years with IPSS ≥ 12 and symptoms of OAB (OAB-V8 ≥ 8, micturition ≥ 8/24 h, urgency ≥ 2/24 h) were enrolled to receive tamsulosin 0.2 mg once daily. After 4 weeks, men with residual symptoms of OAB and reported 'dissatisfied' or 'a little satisfied' were received solifenacin 5 mg in combination with tamsulosin monotherapy. Subjects completed an IPSS, a Quality of life (QoL) index, OAB V8, and an International Consultation of Incontinence Questionnaire (ICIQ)-Male LUTS, and patient perception of bladder condition (PPBC) at baseline and week 4. RESULTS Of a total of 305 patients, 254 patients completed 4 weeks of tamsulosin treatment. For 176 patients, solifenacin was added (69.3%). Significant predictive factors of solifenacin add-on therapy included long LUTS duration, high IPSS, number of micturitions per 24 h, more urgency episodes, high urgency severity score in a voiding diary and high OAB V8 score. Based on multivariable analysis, potential predictive factors of solifenacin add-on therapy included long LUTS duration (OR = 1.008, 95% CI: 1.001-1.014), high serum PSA (OR = 1.543, 95% CI: 1.136-2.095) and small prostate size (OR = 0.970, 95% CI: 0.947-0.994) (p < 0.05). IPSS, daytime micturitions and urgency episodes, OAB V8 scores, ICIQ and PPBC were improved after tamsulosin monotherapy. CONCLUSIONS Two thirds of men with voiding and storage LUTS needed to add anticholinergics after 4 weeks of tamsulosin monotherapy. Patients with longer lasting symptoms and storage symptoms with small prostate volume may require the anticholinergic add-on.
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Affiliation(s)
- H N Lee
- Department of Urology, Seoul Seonam Hospital, Ewha Womans University, Seoul, Korea
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Lee HN, Mahajan MK, Das S, Sachdeva J, Tiwana MS. Early hematological effects of chemo-radiation therapy in cancer patients and their pattern of recovery - A prospective single institution study. Gulf J Oncolog 2015; 1:43-51. [PMID: 25682452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2014] [Indexed: 06/04/2023]
Abstract
UNLABELLED The purpose of this prospective study is to understand the early hematological effects of chemo-radiation therapy in cancer patients, their pattern of recovery and to ascertain their prognostic value. METHODS 255 diagnosed cancer patients planned for definitive treatment with radiation therapy alone or with chemotherapy were included in this two year prospective study. A complete blood count was done at baseline, weekly during the course of therapy and thereafter, monthly for a period of 6 months. For the purpose of grading clinical toxicity, the Common Toxicity Criteria, CTCAE v2.0 was used while RECIST criteria was used to define the tumor response rates. This study was statistically analyzed using SPSS software. RESULTS 255 patients were included in the study wherein head and neck cancers comprised the major patient population (28.6%) followed by cervix (18.8%) and breast (15.7%). Out of these, 37% in head-and-neck cancer subgroup, and 58.3% in cervix had anemia at start of treatment. 92.2% cases with chemoradiation developed anemia during treatment, while with radiation alone it was 95.5%. This was statistically significant in patients with cancer uterine cervix (p 〈 0.01). At the end of treatment 65% patients with normal hemoglobin had complete responses (CR), while 58.3% with mild anemia and 33.3% with moderate anemia had CR (p=0.1). CONCLUSIONS Severe anemia during treatment is a poor prognostic indicator and is usually a sign of advanced disease. Leucopenia and thrombocytopenia occur more commonly during chemoradiotherapy as against radiotherapy alone, but improves with supportive management.
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Affiliation(s)
- H N Lee
- Dept. of Radiotherapy, Christian Medical College and Hospital, Ludhiana, Punjab 141 008, India
| | - M K Mahajan
- Dept. of Radiotherapy, Christian Medical College and Hospital, Ludhiana, Punjab 141 008, India
| | - S Das
- Dept. of Pathology, Christian Medical College and Hospital, Ludhiana, Punjab 141 008, India
| | - J Sachdeva
- Dept. of Radiotherapy, Christian Medical College and Hospital, Ludhiana, Punjab 141 008, India
| | - M S Tiwana
- Dept. of Radiotherapy, Christian Medical College and Hospital, Ludhiana, Punjab 141 008, India
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Lee HN, Tiwana MS, Saini M, Verma SK, Saini M, Jain N, Gupta M, Chauhan N. Superior vena cava obstruction (SVCO) in patients with advanced non small cell lung cancer (NSCLC). Gulf J Oncolog 2014; 1:56-62. [PMID: 24610289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2013] [Indexed: 06/03/2023]
Abstract
INTRODUCTION To report on prognostic and treatment factors influencing the response of SVCO and related survival outcomes in advanced non small cell lung cancer. MATERIAL AND METHODS From November 2008 through December 2011, 18 consecutively diagnosed NSCLC patients with SVCO were included in this study. The patient, tumor and treatment related factors were analyzed. Median overall survival (OS), Kaplan -Meier survival plots, T-test, Cox Proportional Hazards models were generated by multiple covariates (MVA) and analyzed on SPSS software (version 19.0; SPSS, Inc., Chicago, IL). RESULTS Thirteen patients (72%) had presented with SVCO before the pathological diagnosis of underlying lung malignancy, while 5 (28%) progressed to SVCO after initiating treatment with chemotherapy. Twelve (68%) patients achieved subjective relief from the obstruction at the completion of palliative radiation therapy. Treating oncologists preferred 4 Gy per fraction in 11 (62%), while the median biologically equivalent dose delivered was 28 Gy. Six (33%) patients received chemotherapy during the course of treatment. Median OS of the entire cohort was 3±1.85mths and 1-year survival rate of 7%. Univariate analysis confirmed that SVCO patients with good performance score (p=0.02), and partial response to chemotherapy (p= 0.001) have superior OS. However, Cox regression modeling for MVA demonstrated only good performance SVCO patients (p = 0.05) have a better OS. CONCLUSION RT effectively relieves SVCO but overall poor survival associated in our clinical scenario needs to be improved with multimodality approach. Adjuvant chemotherapy is to be considered after initial radiation therapy in good performance patients. KEYWORDS superior vena cava obstruction (SVCO), radiation therapy, chemotherapy, non small cell lung cancer (NSCLC), BED (biologically equivalent dose).
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Affiliation(s)
- H N Lee
- Lee Hsueh Ni, Assistant Professor, Radiation Oncology, STM Cancer Research Institute, Himalayan Institute Hospital Trust, Swami Ram Nagar, Jolly Grant, Dehradun, India 248140. Office Tel. +91 135 2471127. Fax +91 135 2471190.
| | - M S Tiwana
- Surgical Oncology,STM Cancer Research Institute, Himalayan Institute Hospital Trust, Swami Ram Nagar, Jolly Grant, Dehradun, India
| | - M Saini
- Radiodiagnosis, STM Cancer Research Institute, Himalayan Institute Hospital Trust, Swami Ram Nagar, Jolly Grant, Dehradun, India
| | - S K Verma
- Medical Oncology, STM Cancer Research Institute, Himalayan Institute Hospital Trust, Swami Ram Nagar, Jolly Grant, Dehradun, India
| | - M Saini
- Radiodiagnosis, STM Cancer Research Institute, Himalayan Institute Hospital Trust, Swami Ram Nagar, Jolly Grant, Dehradun, India
| | - N Jain
- Surgical Oncology, STM Cancer Research Institute, Himalayan Institute Hospital Trust, Swami Ram Nagar, Jolly Grant, Dehradun, India
| | - M Gupta
- Surgical Oncology, STM Cancer Research Institute, Himalayan Institute Hospital Trust, Swami Ram Nagar, Jolly Grant, Dehradun, India
| | - N Chauhan
- Pathology, STM Cancer Research Institute, Himalayan Institute Hospital Trust, Swami Ram Nagar, Jolly Grant, Dehradun, India
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Jeen H, Choi WS, Freeland JW, Ohta H, Jung CU, Lee HN. Topotactic phase transformation of the brownmillerite SrCoO2.5 to the perovskite SrCoO3- δ. Adv Mater 2013; 25:3651-3656. [PMID: 23852832 DOI: 10.1002/adma.201300531] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Indexed: 06/02/2023]
Abstract
Pulsed laser epitaxy of brownmillerite SrCoO2.5 thin films and their phase transformation to the perovskite SrCoO3-δ are investigated. While the direct growth of the fully oxidized perovskite films is found to be an arduous task, filling some of oxygen vacancies into SrCoO2.5 by topotactic oxidation accompanies systematic evolution of electronic, magnetic, and thermoelectric properties, useful for many information and energy technologies.
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Affiliation(s)
- H Jeen
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA
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Park J, Cho BG, Kim KD, Koo J, Jang H, Ko KT, Park JH, Lee KB, Kim JY, Lee DR, Burns CA, Seo SSA, Lee HN. Oxygen-vacancy-induced orbital reconstruction of Ti ions at the interface of LaAlO3/SrTiO3 heterostructures: a resonant soft-X-ray scattering study. Phys Rev Lett 2013; 110:017401. [PMID: 23383835 DOI: 10.1103/physrevlett.110.017401] [Citation(s) in RCA: 9] [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] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Indexed: 06/01/2023]
Abstract
Resonant soft-x-ray scattering measurements have been performed to investigate interface electronic structures of (LaAlO(3)/SrTiO(3)) superlattices. Resonant scattering intensities at superlattice reflections show clear evidence of degeneracy lifting in t(2g) states of interface Ti ions. Polarization dependence of intensities indicates the energy of d(xy) states is lower by ~1 eV than two other t(2g) states. The energy splitting is insensitive to epitaxial strain. The orbital reconstruction is induced by oxygen vacancies and confined to the interface within two unit cells, indicating charge compensation at the polar interfaces.
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Affiliation(s)
- J Park
- Department of Physics, Pohang University of Science and Technology, Pohang 790-784, Korea
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Park CK, Lee SJ, Cho HJ, Lee KS, Kim SJ, Cho GM, Lee HN. Multiple Cancers in a Patient with Systemic Sclerosis and Aggravated Interstitial Lung Disease by Chemotherapy. Tuberc Respir Dis (Seoul) 2013; 75:111-5. [PMID: 24101935 PMCID: PMC3790022 DOI: 10.4046/trd.2013.75.3.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 10/26/2012] [Accepted: 05/28/2013] [Indexed: 11/24/2022] Open
Affiliation(s)
- Chan Kwon Park
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Seok Jong Lee
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hyung Jun Cho
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Kyeong Soo Lee
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Sung Jun Kim
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Gu Min Cho
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Ha Ni Lee
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
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Kim YM, Kong S, Kim SJ, Kim H, Lee KE, Lee SJ, Lee HN, Cho MJ, Lee JW, Lee DG. A Case of Disseminated Candidiasis and Subsequent Breakthrough Pulmonary Mucormycosis after Consolidation Chemotherapy for Acute Myeloid Leukemia. Infect Chemother 2012. [DOI: 10.3947/ic.2012.44.6.544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Young Min Kim
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sieun Kong
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Soo Jeong Kim
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Haneul Kim
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyoung Eun Lee
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seok Jong Lee
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ha Ni Lee
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Min Jung Cho
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung Woo Lee
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong-Gun Lee
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Lee S, Lee HN, Yang H, Kang J, Kim N, Sin Y, Lee S. A Case of Septic Arthritis of the Knee Joint due to Group D Non-typhoidal Salmonella. Infect Chemother 2012. [DOI: 10.3947/ic.2012.44.4.303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- SuHyun Lee
- Department of Internal Medicine College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ha Ni Lee
- Department of Internal Medicine College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - HeaKyung Yang
- Department of Internal Medicine College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - JuHyun Kang
- Department of Internal Medicine College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - NaYoung Kim
- Department of Internal Medicine College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - YunMi Sin
- Department of Internal Medicine College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - SangRok Lee
- Department of Internal Medicine, Cheongju St. Mary's Hospital, Cheongju, Korea
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Lee HN, Lee MA, Kim SW, Lim Y, Lee H, Lee HM, Won HS, Chun SH. [A case of severe bevacizumab-induced ischemic pancolitis, treated with conservative management]. Korean J Gastroenterol 2011; 58:42-6. [PMID: 21778803 DOI: 10.4166/kjg.2011.58.1.42] [Citation(s) in RCA: 1] [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: 11/03/2022]
Abstract
Bevacizumab (Avastin(Ⓡ)) is a monoclonal antibody against the vascular endothelial growth factor (VEGF) receptor that increases the overall survival rate when added to standard chemotherapy regimens in patients with metastatic colorectal cancer. The known toxicities of bevacizumab are hypertension, proteinuria, wound healing complications, arterial thrombosis, bleeding, and gastrointestinal complications. Especially ischemic colitis can rapidly develop into bowel perforation, so an emergency operation often is needed. Recently, a 65-year-old male patient developed ischemic pancolitis after FOLFOX (85 mg/m(2) Oxaliplatin, d1; 200 mg/m(2) Leucovorin, d1; 400 mg/m(2) 5-FU iv bolus, d1-2; and 600 mg/m(2) 5-FU, d1-2, every two wk) and Bevacizumab combination chemotherapy was administered. However, he recovered after early conservative care without surgery. We report this case with a review of literature.
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Affiliation(s)
- Ha Ni Lee
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Tiwana MS, Uppal B, Sachdeva J, Talole SD, Mahajan MK, Koshy G, Lee HN. Whole saliva physico-biochemical changes and quality of life in head and neck cancer patients following conventional radiation therapy: A prospective longitudinal study. Indian J Cancer 2011; 48:289-95. [DOI: 10.4103/0019-509x.84918] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ha JE, Jeung IC, Lee YS, Lee HN, Park EK. Clinical analysis of borderline ovarian tumors. EUR J GYNAECOL ONCOL 2011; 32:69-72. [PMID: 21446329] [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: 05/30/2023]
Abstract
PURPOSE The goal of this study was to evaluate the incidence and clinical features of borderline ovarian tumors (BOTS). METHODS We retrospectively performed chart reviews of 22 patients with BOTS who were diagnosed and treated in the university medical center from 1998 to 2009 inclusively. RESULTS BOTS among ovarian pathology in our hospital were detected in 22 patients (1.79%). The mean age was 50 years, range (20-90). Post surgical FIGO staging was Stage I = 86.4%, and Stage II = 13.6%. The most common histologic subtype was mucinous (59%). Five patients (22.7%) had a unilocular cyst at ultrasonography. Conservative surgery was performed in 31.8%. One patient of them had normal spontaneous delivery after term pregnancy. Two patients had a recurrence. One patient with recurrent disease underwent transformation to invasive cancer and died 35 months after the initial diagnosis. CONCLUSION Clinicians should warn patients about the early relapse of BOTS and these patients may need careful follow-up due to the possibility of recurrences.
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Affiliation(s)
- J E Ha
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Korea
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Kim JO, Baek JM, Jeung C, Park EK, Lee HN, Lee YS. A case of primary ovarian adenomyoma mimicking ovarian malignancy. EUR J GYNAECOL ONCOL 2011; 32:103-106. [PMID: 21446338] [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: 05/30/2023]
Abstract
Adenomyoma is a benign tumor composed of smooth muscle and benign endometrium. These tumors typically originate within the uterus. An extrauterine adenomyoma is an extremely rare entity. After an extensive literature search, only four cases of primary ovarian adenomyoma appear to have thus far been reported. Here, we report a case of ovarian adenomyoma in a 39-year-old woman mimicking malignant neoplasma of the ovary, along with a brief literature review.
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Affiliation(s)
- J O Kim
- Department of Pathology, The Catholic University of Korea, Korea
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Yu JH, Kim NY, Lee HM, Lee HN, Ahn HJ, Kim SW, Choi KY. [A case of pseudomembranous colitis in a juvenile rheumatoid arthritis patient taking methotrexate]. Korean J Gastroenterol 2010; 56:387-90. [PMID: 21173564 DOI: 10.4166/kjg.2010.56.6.387] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Pseudomembranous colitis is mainly caused by antibiotics and Clostridium difficile infection. But conditions such as gastrointestinal surgery, antacid medication, anti-neoplastic agent or immunosuppressive agent which influences the normal flora of colon can induce colitis without the administration of any antibiotics. We experienced a 13 year-old male who was taking low-dose methotrexate for juvenile rheumatoid arthritis complained diarrhea and abdominal pain for 3 weeks. Sigmoidoscopic findings revealed diffuse patch yellowish pseudomembranes on the rectum. Histologic finding was compatible to pseudomembranous colitis. His symptom was improved after stop taking methotrexate and the administration of metronidazole. If a patient treated with immunosuppressive agents or antineoplastic agents complains diarrhea, fever or abdominal pain and has not improved with conservative care, pseudomembranous colitis should be taken into account as a differential diagnosis and prompt treatment is required for better prognosis.
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Affiliation(s)
- Ji Han Yu
- Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Ciaschini PM, Straus SE, Dolovich LR, Goeree RA, Leung KM, Woods CR, Zimmerman GM, Majumdar SR, Spadafora S, Fera LA, Lee HN. Community-based intervention to optimise falls risk management: a randomised controlled trial. Age Ageing 2009; 38:724-30. [PMID: 19767629 DOI: 10.1093/ageing/afp176] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [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: 11/14/2022] Open
Abstract
BACKGROUND falls are the leading causes of accidental death and fragility fractures in older adults. Interventions that assess and reduce falls risk are underutilised. OBJECTIVE to evaluate the impact of a multifaceted community-based programme aimed at optimising evidence-based management of patients at risk for fall-related fractures. DESIGN this was a randomised trial performed from 2003 to 2006. SETTING community-based intervention in Ontario, Canada. PARTICIPANTS eligible patients were community-dwelling, aged > or =55 years and identified to be at risk for fall-related fractures. A total of 201 patients were allocated to the intervention group or to usual care. INTERVENTION components of the intervention included assessment of falls risk, functional status and home environment, and patient education. MEASUREMENTS primary outcome was the implementation of appropriate falls risk assessment at 6 months. Secondary outcomes included falls and fractures at 6 and 12 months. RESULTS the mean age of participants was 72 years, and 41% had fallen with injury in the previous year. Compared to usual care, the intervention increased the number of referrals made to physiotherapy [21% (21/101) vs 6.0% (6/100); relative risk (RR) 3.47, 95% confidence interval (CI) 1.46-8.22] and occupational therapy [15% (15/101) vs 0%; RR 30.7, 95% CI 1.86 to >500]. At 12 months, the number of falls in the intervention group was greater than in the usual care group [23% (23/101) vs 11% (11/100); RR 2.07, 95% CI 1.07-4.02]. CONCLUSIONS compared to usual care, a multi-faceted intervention increased referrals to physiotherapy and occupational therapy but did not reduce risk of falls. Similar falls reduction interventions cannot be recommended based on the results of this study.
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Affiliation(s)
- P M Ciaschini
- Algoma District Medical Group, Sault Ste. Marie, Canada
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Jo JY, Yang SM, Kim TH, Lee HN, Yoon JG, Park S, Jo Y, Jung MH, Noh TW. Nonlinear dynamics of domain-wall propagation in epitaxial ferroelectric thin films. Phys Rev Lett 2009; 102:045701. [PMID: 19257442 DOI: 10.1103/physrevlett.102.045701] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2008] [Revised: 11/28/2008] [Indexed: 05/27/2023]
Abstract
We investigated the ferroelectric domain-wall propagation in epitaxial Pb(Zr,Ti)O3 thin film over a wide temperature range (3-300 K). We measured the domain-wall velocity under various electric fields and found that the velocity data is strongly nonlinear with electric fields, especially at low temperature. We found that, as one of surface growth issues, our domain-wall velocity data from ferroelectric epitaxial film could be classified into the creep, depinning, and flow regimes due to competition between disorder and elasticity. The measured values of velocity and dynamical exponents indicate that the ferroelectric domain walls in the epitaxial films are fractal and pinned by a disorder-induced local field.
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Affiliation(s)
- J Y Jo
- Department of Physics and Astronomy, Seoul National University, Seoul 151-747, Korea
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Ciaschini PM, Straus SE, Dolovich LR, Goeree RA, Leung KM, Woods CR, Zimmerman GM, Majumdar SR, Spadafora S, Fera LA, Lee HN. Community-based randomised controlled trial evaluating falls and osteoporosis risk management strategies. Trials 2008; 9:62. [PMID: 18983670 PMCID: PMC2612651 DOI: 10.1186/1745-6215-9-62] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2008] [Accepted: 11/04/2008] [Indexed: 01/06/2023] Open
Abstract
Background Osteoporosis-related fractures are a significant public health concern. Interventions that increase detection and treatment of osteoporosis, as well as prevention of fractures and falls, are substantially underutilized. This paper outlines the protocol for a pragmatic randomised trial of a multifaceted community-based care program aimed at optimizing the evidence-based management of falls and fractures in patients at risk. Design 6-month randomised controlled study. Methods This population-based study was completed in the Algoma District of Ontario, Canada a geographically vast area with Sault Ste Marie (population 78 000) as its main city. Eligible patients were allocated to an immediate intervention protocol (IP) group, or a delayed intervention protocol (DP) group. The DP group received usual care for 6 months and then was crossed over to receive the interventions. Components of the intervention were directed at the physicians and their patients and included patient-specific recommendations for osteoporosis therapy as outlined by the clinical practice guidelines developed by Osteoporosis Canada, and falls risk assessment and treatment. Two primary outcomes were measured including implementation of appropriate osteoporosis and falls risk management. Secondary outcomes included quality of life and the number of falls, fractures, and hospital admissions over a twelve-month period. The patient is the unit of allocation and analysis. Analyses will be performed on an intention to treat basis. Discussion This paper outlines the protocol for a pragmatic randomised trial of a multi-faceted, community-based intervention to optimize the implementation of evidence based management for patients at risk for falls and osteoporosis. Trial Registration This trial has been registered with clinicaltrials.gov (ID: NCT00465387)
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Affiliation(s)
- P M Ciaschini
- Algoma District Medical Group, Sault Ste. Marie, Canada.
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Wolbarst AB, Griggs J, Lee HN, Ren T, Hudson T, White JD, Zhu C. Comparison of environmental radiation monitoring programs in China and the United States. Health Phys 2008; 94:501-511. [PMID: 18469583 DOI: 10.1097/01.hp.0000305823.17036.b3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The monitoring of environmental radiation has been carried out across the United States by the U.S. Environmental Protection Agency's RadNet (formerly the Environmental Radiation Ambient Monitoring System, ERAMS) and the Global Network Program (GNP) of the Environmental Measurements Laboratory (EML), and in the People's Republic of China (PRC) by their National Radioactivity Contamination Monitoring System (NRCMS). It is expected that an awareness of the similarities and differences in the structure and operation of these programs will prove helpful to both countries and perhaps others as they continue to develop their monitoring capabilities.
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Affiliation(s)
- Anthony B Wolbarst
- College of Health Sciences and College of Medicine, University of Kentucky, Lexington, KY 40536, USA.
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Seo SSA, Choi WS, Lee HN, Yu L, Kim KW, Bernhard C, Noh TW. Optical study of the free-carrier response of LaTiO3/SrTiO3 superlattices. Phys Rev Lett 2007; 99:266801. [PMID: 18233598 DOI: 10.1103/physrevlett.99.266801] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2007] [Indexed: 05/25/2023]
Abstract
We used infrared spectroscopic ellipsometry to investigate the electronic properties of LaTiO_{3}/SrTiO_{3} superlattices (SLs). Our results indicated that, independent of the SL periodicity and individual layer thickness, the SLs exhibited a Drude metallic response with sheet carrier density per interface approximately 3x10;{14} cm;{-2}. This is probably due to the leakage of d electrons at interfaces from the Mott insulator LaTiO3 to the band insulator SrTiO3. We observed a carrier relaxation time approximately 35 fs and mobility approximately 35 cm;{2} V-1 s;{-1} at 10 K, and an unusual temperature dependence of carrier density that was attributed to the dielectric screening of quantum paraelectric SrTiO3.
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Affiliation(s)
- S S A Seo
- ReCOE & FPRD, Department of Physics and Astronomy, Seoul National University, Seoul 151-747, Korea
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Choi YW, Bae SM, Kim YW, Lee HN, Kim YW, Park TC, Ro DY, Shin JC, Shin SJ, Seo JS, Ahn WS. Gene expression profiles in squamous cell cervical carcinoma using array-based comparative genomic hybridization analysis. Int J Gynecol Cancer 2007; 17:687-96. [PMID: 17504382 DOI: 10.1111/j.1525-1438.2007.00834.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Our aim was to identify novel genomic regions of interest and provide highly dynamic range information on correlation between squamous cell cervical carcinoma and its related gene expression patterns by a genome-wide array-based comparative genomic hybridization (array-CGH). We analyzed 15 cases of cervical cancer from KangNam St Mary's Hospital of the Catholic University of Korea. Microdissection assay was performed to obtain DNA samples from paraffin-embedded cervical tissues of cancer as well as of the adjacent normal tissues. The bacterial artificial chromosome (BAC) array used in this study consisted of 1440 human BACs and the space among the clones was 2.08 Mb. All the 15 cases of cervical cancer showed the differential changes of the cervical cancer-associated genetic alterations. The analysis limit of average gains and losses was 53%. A significant positive correlation was found in 8q24.3, 1p36.32, 3q27.1, 7p21.1, 11q13.1, and 3p14.2 changes through the cervical carcinogenesis. The regions of high level of gain were 1p36.33-1p36.32, 8q24.3, 16p13.3, 1p36.33, 3q27.1, and 7p21.1. And the regions of homozygous loss were 2q12.1, 22q11.21, 3p14.2, 6q24.3, 7p15.2, and 11q25. In the high level of gain regions, GSDMDC1, RECQL4, TP73, ABCF3, ALG3, HDAC9, ESRRA, and RPS6KA4 were significantly correlated with cervical cancer. The genes encoded by frequently lost clones were PTPRG, GRM7, ZDHHC3, EXOSC7, LRP1B, and NR3C2. Therefore, array-CGH analyses showed that specific genomic alterations were maintained in cervical cancer that were critical to the malignant phenotype and may give a chance to find out possible target genes present in the gained or lost clones.
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Affiliation(s)
- Y-W Choi
- Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Choi YW, Kim YW, Bae SM, Kwak SY, Chun HJ, Tong SY, Lee HN, Shin JC, Kim KT, Kim YJ, Ahn WS. Identification of differentially expressed genes using annealing control primer-based GeneFishing in human squamous cell cervical carcinoma. Clin Oncol (R Coll Radiol) 2007; 19:308-18. [PMID: 17399965 DOI: 10.1016/j.clon.2007.02.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [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: 09/07/2005] [Revised: 12/01/2006] [Accepted: 02/13/2007] [Indexed: 01/14/2023]
Abstract
AIMS To compare different gene expression patterns between squamous cell cervical carcinoma (SCC) and normal cervical tissue in Korean women and to identify those genes that are specifically or predominantly expressed in SCC by employing annealing control primer (ACP)-based GeneFishing polymerase chain reaction (PCR). MATERIALS AND METHODS Cervical cancer specimens were obtained from patients enrolled at the Department of Obstetrics and Gynecology, Kang Nam St. Mary's Hospital, Catholic University of Korea. We used a common reference that was mixed with an equal amount of RNA extracted from patients without cervical cancer. The profiles of expressed genes were compared between the SCC and normal cervix identified using GeneFishing differentially expressed gene kits, screened by a BLAST search, and confirmed by semi-quantitative reverse transcription-PCR (RT-PCR). RESULTS Almost 100 differentially expressed genes were identified in the control and SCC samples. Using 60 arbitrary ACPs, 50 differentially expressed genes were identified, and 30 up-regulated and 20 down-regulated expressed genes were sequenced. Among 50 clones selected by ACP-based GeneFishing PCR, six genes with different expression patterns were determined and confirmed by semi-quantitative RT-PCR. The functional roles of two up-regulated genes, fibrillarin and calgranulin A, and one down-regulated gene, clusterin, were previously identified. However, the functional roles of two up-regulated genes and one down-regulated gene were not identified. CONCLUSION We identified distinctive gene expression profiles in Korean women with SCC using ACP-based GeneFishing PCR.
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Affiliation(s)
- Y-W Choi
- Department of Anesthesiology, Catholic University of Korea, Seoul, Republic of Korea
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Kalinin SV, Jesse S, Rodriguez BJ, Shin J, Baddorf AP, Lee HN, Borisevich A, Pennycook SJ. Spatial resolution, information limit, and contrast transfer in piezoresponse force microscopy. Nanotechnology 2006; 17:3400-11. [PMID: 19661582 DOI: 10.1088/0957-4484/17/14/010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Scanning probe-based ferroelectric domain imaging and patterning has attracted broad attention for use in the characterization of ferroelectric materials, ultrahigh density data storage, and nanofabrication. The viability of these applications is limited by the minimal domain size that can be fabricated and reliably detected by scanning probe microscopy. Here, the contrast transfer mechanism in piezoresponse force microscopy (PFM) of ferroelectric materials is analysed in detail. A consistent definition of resolution is developed both for the writing and the imaging processes, and the concept of an information limit in PFM is established. Experimental determination of the object transfer function and the subsequent reconstruction of an 'ideal image' is demonstrated. This contrast transfer theory provides a quantitative basis for image interpretation and allows for the comparison of different instruments in PFM. It is shown that experimentally observed domain sizes can be limited by the resolution of the scanning probe microscope to the order of tens of nanometres even though smaller domains, of the order of several nanometres, can be created.
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Lee HN, Park TS, Lee SY, Huh Y. Spatial filters based on independent component analysis for magnetic noise reduction in the magnetocardiogram. Med Biol Eng Comput 2004; 42:532-4. [PMID: 15320463 DOI: 10.1007/bf02350995] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A spatial filter design method to reduce magnetic noise in the magnetocardiogram (MCG) is introduced. Based on the facts that external magnetic noise appearing on multichannel MCG sensors is independent of the cardiac signals and that there is strong spatial correlation among the channels, the independent component analysis (ICA) method was applied to extract the noise components from the measured MCG signals. After extraction of the noise components in a given time period using ICA, a spatial filter was made to reduce the noise components in subsequently acquired MCG signals. In experimental studies of nine healthy volunteers, the spatial filters improved the signal-to-noise ratio of the MCG signals by about 500% on average. This spatial filtering method can be used for measurements of MCG signals in a magnetically noisy environment.
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Affiliation(s)
- H N Lee
- Graduate School of East-West Medical Science, Kyung Hee University, Korea
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Affiliation(s)
- H N Lee
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Abstract
Cutaneous endometriosis is characterized by the presence of extrauterine endometrial tissue in or under the skin. We report a case of cutaneous endometriosis in postmenopausal woman who was receiving hormonal replacement.
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Affiliation(s)
- S W Choi
- Department of Dermatology, The Catholic University of Korea, Seoul, Korea
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Lee HN, Cook DJ, Sarabia A, Hatala R, McCallum A, King D, Guyatt GH, Dobranowski J, Powers P. Inadequacy of intravenous heparin therapy in the initial management of venous thromboembolism. J Gen Intern Med 1995; 10:342-5. [PMID: 7562125 DOI: 10.1007/bf02599954] [Citation(s) in RCA: 5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
To determine the adequacy of initial anticoagulation by intravenous heparin for patients who have deep venous thrombosis (DVT), and the factors that influence delayed anticoagulation, independent, duplicate chart review of 63 consecutive patients who had venography-proven DVT was conducted. Adequate heparinization (AH) was defined as an activated partial thromboplastin time (PTT) of more than 1.5 times the normal laboratory control. The proportions of patients achieving AH within 24 hours and 48 hours of initial heparin bolus were 46% and 62%, respectively. Patients who weighed more were less likely to achieve AH (p < 0.05), while patients receiving care from the thromboembolism service were more likely to achieve AH (p < 0.05). Low initial infusion rate was strongly but not significantly predictive of inadequate anticoagulation (p = 0.06). The mean heparin bolus and initial infusion rates were significantly lower than those suggested in the literature (p < 0.01). The AH rates were comparable to historical controls but suboptimal compared with the rates of 66% at 24 hours and 81% at 48 hours reported in association with heparin nomogram use (p < 0.05). A heparin nomogram is likely to achieve consistently higher rates of adequate heparinization.
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Affiliation(s)
- H N Lee
- Department of Medicine, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
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Abstract
We investigated changes in two gonadotropin releasing hormone (GnRH)-containing neuronal populations during juvenile development in the African teleost, Haplochromis burtoni. Juveniles were sampled at weekly intervals and GnRHir neurons were identified through immunocytochemistry (ICC), then counted and measured on computer-captured video images. Soma size of GnRH neurons in the preoptic area (POA), which regulate gonadotropin release from the pituitary, is socially modulated in adults. Here we show that in juveniles the soma size of these neurons increases as a linear function of body weight. Terminal nerve (TN) GnRHir neurons, in contrast, are not involved in pituitary regulation and their soma size is not socially modulated in adults. In juveniles, soma size of these neurons is a quadratic function of body size and the covariance of soma size and body size is much less than in the POA GnRHir neurons. In both populations, GnRHir neuronal number covaries with body size or age only in the earliest juvenile stages. Analysis of the development of these two distinct GnRHir neuronal populations provides insight into their functional differentiation in adults.
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Affiliation(s)
- R C Francis
- Department of Psychology, Stanford University, CA 94305-2130
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