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Moehler M, Heo J, Lee HC, Tak WY, Chao Y, Paik SW, Yim HJ, Byun KS, Baron A, Ungerechts G, Jonker D, Ruo L, Cho M, Kaubisch A, Wege H, Merle P, Ebert O, Habersetzer F, Blanc JF, Rosmorduc O, Lencioni R, Patt R, Leen AM, Foerster F, Homerin M, Stojkowitz N, Lusky M, Limacher JM, Hennequi M, Gaspar N, McFadden B, De Silva N, Shen D, Pelusio A, Kirn DH, Breitbach CJ, Burke JM. Vaccinia-based oncolytic immunotherapy Pexastimogene Devacirepvec in patients with advanced hepatocellular carcinoma after sorafenib failure: a randomized multicenter Phase IIb trial (TRAVERSE). Oncoimmunology 2019; 8:1615817. [PMID: 31413923 PMCID: PMC6682346 DOI: 10.1080/2162402x.2019.1615817] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [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: 11/27/2018] [Revised: 04/15/2019] [Accepted: 04/19/2019] [Indexed: 02/07/2023] Open
Abstract
Pexastimogene devacirepvec (Pexa-Vec) is a vaccinia virus-based oncolytic immunotherapy designed to preferentially replicate in and destroy tumor cells while stimulating anti-tumor immunity by expressing GM-CSF. An earlier randomized Phase IIa trial in predominantly sorafenib-naïve hepatocellular carcinoma (HCC) demonstrated an overall survival (OS) benefit. This randomized, open-label Phase IIb trial investigated whether Pexa-Vec plus Best Supportive Care (BSC) improved OS over BSC alone in HCC patients who failed sorafenib therapy (TRAVERSE). 129 patients were randomly assigned 2:1 to Pexa-Vec plus BSC vs. BSC alone. Pexa-Vec was given as a single intravenous (IV) infusion followed by up to 5 IT injections. The primary endpoint was OS. Secondary endpoints included overall response rate (RR), time to progression (TTP) and safety. A high drop-out rate in the control arm (63%) confounded assessment of response-based endpoints. Median OS (ITT) for Pexa-Vec plus BSC vs. BSC alone was 4.2 and 4.4 months, respectively (HR, 1.19, 95% CI: 0.78–1.80; p = .428). There was no difference between the two treatment arms in RR or TTP. Pexa-Vec was generally well-tolerated. The most frequent Grade 3 included pyrexia (8%) and hypotension (8%). Induction of immune responses to vaccinia antigens and HCC associated antigens were observed. Despite a tolerable safety profile and induction of T cell responses, Pexa-Vec did not improve OS as second-line therapy after sorafenib failure. The true potential of oncolytic viruses may lie in the treatment of patients with earlier disease stages which should be addressed in future studies. ClinicalTrials.gov: NCT01387555
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Affiliation(s)
- M Moehler
- First Department of Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - J Heo
- College of Medicine, Pusan National University and Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - H C Lee
- Asan Medical Center, University of Ulsan College of Medicine, Ulsan, Republic ofKorea
| | - W Y Tak
- School of Medicine, Kyungpook National University Medical Center, Daegu, Republic of Korea
| | - Y Chao
- Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - S W Paik
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - H J Yim
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan-si, Republic of Korea
| | - K S Byun
- Department of Internal Medicine, Korea UniversityCollege of Medicine, Seoul, Republic of Korea
| | - A Baron
- Department of Medicine, California Pacific Medical Center, San Francisco, CA, USA
| | - G Ungerechts
- Department of Medical Oncology, National Center for Tumor Diseases (NCT) and Heidelberg University Hospital, Heidelberg, Germany
| | - D Jonker
- The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada
| | - L Ruo
- Department of Surgery, Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, Canada
| | - M Cho
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Busan, Republic of Korea
| | - A Kaubisch
- Department of Medicine, Montefiore Medical Center, New York, NY, USA
| | - H Wege
- Department of Medicine, Gastroenterology and Hepatology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - P Merle
- Hepatology Unit, Croix-Rousse Hospital, Lyon, France
| | - O Ebert
- Klinik und Poliklinik für Innere Medizin II, Klinikum rechts der Isar, Technical University, Munich, Germany
| | - F Habersetzer
- Pôle Hépato-Digestif, Hôpitaux Universitaires de Strasbourg, INSERM 1110, IHU de Strasbourg and Université de Strasbourg, Strasbourg, France
| | - J F Blanc
- Hepato-Gastroenterology and Digestive Oncology Department, CHU Bordeaux, Bordeaux, France
| | | | - R Lencioni
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - R Patt
- Rad-MD, New York, NY, USA
| | - A M Leen
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - F Foerster
- First Department of Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - M Homerin
- Medical Affairs, Transgene S.A., Illkirch-Graffenstaden, France
| | - N Stojkowitz
- Clinical Operations, Transgene S.A., 400 Bd Gonthier d'Andernach, Parc d'Innovation, 67405 Illkirch-Graffenstaden, France
| | - M Lusky
- Program Management, Transgene S.A., 400 Bd Gonthier d'Andernach, Parc d'Innovation, 67405 Illkirch-Graffenstaden, France
| | - J M Limacher
- Medical Affairs, Transgene S.A., 400 Bd Gonthier d'Andernach, Parc d'Innovation, 67405 Illkirch-Graffenstaden, France
| | - M Hennequi
- Biostatistics, Transgene S.A., 400 Bd Gonthier d'Andernach, Parc d'Innovation, 67405 Illkirch-Graffenstaden, France
| | - N Gaspar
- Clinical Assays, SillaJen Inc., San Francisco, CA, USA
| | - B McFadden
- Analytical Development and Quality Control, SillaJen Inc., San Francisco, CA, USA
| | - N De Silva
- Clinical, SillaJen Inc., San Francisco, CA, USA
| | - D Shen
- Clinical, SillaJen Inc., San Francisco, CA, USA
| | - A Pelusio
- Clinical, SillaJen Inc., San Francisco, CA, USA
| | - D H Kirn
- SillaJen Inc., San Francisco, CA, USA
| | | | - J M Burke
- Clinical, SillaJen Inc., San Francisco, CA, USA
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Han DH, Shin JM, An S, Kim JS, Kim DY, Moon S, Kim JS, Cho JS, Kim SW, Kim YH, Roh HJ, Shim WS, Rha KS, Kim SW, Lee SS, Kim DW, Cho KS, Yim HJ, Park SK, Rhee CS. Long-term Breastfeeding in the Prevention of Allergic Rhinitis: Allergic Rhinitis Cohort Study for Kids (ARCO-Kids Study). Clin Exp Otorhinolaryngol 2019; 12:301-307. [PMID: 30992421 PMCID: PMC6635702 DOI: 10.21053/ceo.2018.01781] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 03/11/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES There is a great deal of interest in the possibility that environmental factors may influence the risk of developing allergic rhinitis (AR) in early life. We investigated the simultaneous effects of mode of delivery and duration of breastfeeding on the development of AR in children. METHODS Data from 1,374 children participating in the Allergic Rhinitis Cohort Study for kids (ARCO-kids study) was analyzed. All subjects were divided into AR or non-allergic rhinitis (NAR) groups. Data on environmental factors, mode of delivery and duration of breastfeeding were collected using a questionnaire. RESULTS Compared with short-term breastfeeding (<6 months), long-term breastfeeding (≥12 months) was significantly associated with a lower prevalence of AR (adjusted odds ratio [aOR], 0.54; 95% confidence interval [CI], 0.34 to 0.88). Children in the AR group also had a higher cesarean delivery rate than those in the NAR group (39.1% vs. 32.8%, P=0.05). Regarding the combined effects of mode of delivery and duration of breastfeeding, long-term breastfeeding with a vaginal delivery strongly suppressed the development of AR, compared to short-term breastfeeding with a cesarean delivery (aOR, 0.47; 95% CI, 0.30 to 0.73). CONCLUSION Long-term breastfeeding (≥12 months) and a vaginal delivery are associated with a lower risk of developing childhood AR.
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Affiliation(s)
- Doo Hee Han
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul, Korea
| | - Jae-Min Shin
- Department of Otorhinolaryngology, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Seokyung An
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.,Department of Biomedical Science, Seoul National University Graduate School, Seoul, Korea.,Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Jong Seung Kim
- Department of Otolaryngology-Head and Neck Surgery, Chonbuk National University Medical School, Jeonju, Korea
| | - Dong-Young Kim
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul, Korea
| | - Sungji Moon
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.,Department of Biomedical Science, Seoul National University Graduate School, Seoul, Korea.,Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Jung-Soo Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Joong Saeng Cho
- Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea
| | - Si Whan Kim
- Department of Otolaryngology-Head and Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Young Hyo Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Inha University College of Medicine, Incheon, Korea
| | - Hwan-Jung Roh
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine, Busan, Korea
| | - Woo Sub Shim
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Ki-Sang Rha
- Department of Otolaryngology-Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Korea
| | - Sang-Wook Kim
- Department of Otorhinolaryngology, Gyeongsang National University Hospital, Jinju, Korea.,Institute of Health Sciences, Gyeongsang National University, Jinju, Korea
| | - Seung-Sin Lee
- Department of Otolaryngology-Head and Neck Surgery, Ewha Womans University School of Medicine, Seoul, Korea
| | - Dae Woo Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Kyu-Sup Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine, Busan, Korea
| | - Hyo Jin Yim
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul, Korea
| | - Sue K Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.,Department of Biomedical Science, Seoul National University Graduate School, Seoul, Korea.,Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Chae-Seo Rhee
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul, Korea.,Graduate School of Immunology, Seoul National University College of Medicine, Seoul, Korea.,Institute of Allergy and Clinical Immunology, Seoul National University Biomedical Research Center, Seoul, Korea.,Sensory Organ Research Institute, Seoul National University Biomedical Research Center, Seoul, Korea, Korea
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3
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Yim HJ, Kim IH, Suh SJ, Jung YK, Kim JH, Seo YS, Yeon JE, Kim CW, Kwon SY, Park SH, Lee MS, Um SH, Byun KS. Switching to tenofovir vs continuing entecavir for hepatitis B virus with partial virologic response to entecavir: a randomized controlled trial. J Viral Hepat 2018; 25:1321-1330. [PMID: 29772084 DOI: 10.1111/jvh.12934] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 07/24/2017] [Accepted: 04/16/2018] [Indexed: 12/19/2022]
Abstract
Entecavir 0.5 mg (ETV) is widely used among treatment-naïve chronic hepatitis B (CHB) patients. However, 10%-30% of patients show partial virologic response (PVR) to the drug. If the hepatitis B virus (HBV) continues to replicate, the underlying liver disease may progress. Herein, we compared the efficacy of switching to tenofovir disoproxil fumarate (TDF) with that of continuing ETV in CHB patients with PVR to ETV. This was an open-label randomized controlled trial including CHB patients who had been receiving 0.5 mg of ETV for >12 months, but who still had detectable HBV DNA levels of >60 IU/mL without known resistance to ETV. Sixty patients were enrolled and 45 qualified for the study: Twenty-two patients were randomly assigned into the TDF group and 23 into the ETV group. After 12 months of treatment, the virologic response rate (HBV DNA <20 IU/mL) was significantly higher in the TDF group than in the ETV group, as measured using per-protocol analysis (55% vs 20%; P = .022) and intention-to-treat analysis (50% vs 17.4%; P = .020). The reduction in HBV DNA was greater (-1.13 vs -0.67 log10 IU/mL; P = .024), and the mean HBV DNA level was lower (1.54 vs 2.01 log10 IU/mL; P = .011) in the TDF group than in the ETV group. In conclusion, to achieve optimal response in CHB patients with PVR to ETV, switching to TDF would be a better strategy than continuing ETV. Appropriate modification of therapy would further improve the outcome of chronic HBV infection.
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Affiliation(s)
- H J Yim
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea
| | - I H Kim
- Department of Internal Medicine, Chonbuk National University Hospital, Jeonju, South Korea
| | - S J Suh
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea
| | - Y K Jung
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea.,Department of Internal Medicine, Gachon University Gil Hospital, Incheon, South Korea
| | - J H Kim
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, South Korea
| | - Y S Seo
- Department of Internal Medicine, Korea University Anam Hospital, Seoul, South Korea
| | - J E Yeon
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, South Korea
| | - C W Kim
- Department of Internal Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - S Y Kwon
- Department of Internal Medicine, Konkuk University Hospital, Seoul, South Korea
| | - S H Park
- Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, South Korea
| | - M S Lee
- Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, South Korea
| | - S H Um
- Department of Internal Medicine, Korea University Anam Hospital, Seoul, South Korea
| | - K S Byun
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, South Korea
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4
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Lee HA, Cho EY, Kim TH, Lee Y, Suh SJ, Jung YK, Kim JH, An H, Seo YS, Kim DS, Yim HJ, Yeon JE, Byun KS, Um SH. Risk Factors for Dropout From the Liver Transplant Waiting List of Hepatocellular Carcinoma Patients Under Locoregional Treatment. Transplant Proc 2018; 50:3521-3526. [PMID: 30577230 DOI: 10.1016/j.transproceed.2018.08.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Accepted: 08/29/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND In new organ allocation policy, patients with hepatocellular carcinoma (HCC) experience a 6-month delay in being granted Model for End-Stage Liver Disease exception points. However, it may not be fair for patients at risk of early progression of HCC. METHODS All patients who were diagnosed as United Network for Organ Sharing (UNOS) stage 1 or 2 of HCC between January 2004 and December 2012 were included. Patients who received surgical resection or liver transplant (LT) as a primary treatment and who did not receive any treatment for HCC were excluded. Patients with baseline Model for End-Stage Liver Disease score ≥22 were also excluded because they have a higher chance of receiving LT. Patients who developed extrahepatic progression within 1 year were considered as high-risk for early recurrence after LT. RESULTS A total of 586 patients were included. Mean (SD) age was 59.9 (10.3) years and 409 patients (69.8%) were men. The cumulative incidence of estimated dropout was 8.9% at 6 months; size of the maximum nodule (≥3 cm) and nonachievement of complete response were independent factors. Extrahepatic progression developed in 16 patients (2.7%) within 1 year; size of the maximum nodule (4 cm) and alpha-fetoprotein level (>100 ng/mL) were independent predictors. CONCLUSIONS The estimated dropout rate from the waiting list within 6 months was 8.9%. Advantage points might be needed for patients with maximum nodule size ≥3 cm or those with noncomplete response. However, in patients with maximum nodule size ≥4 cm or alpha-fetoprotein level >100 ng/mL, caution is needed.
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Affiliation(s)
- H A Lee
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - E Y Cho
- Department of Biostatistics, Korea University College of Medicine, Seoul, Korea
| | - T H Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Y Lee
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - S J Suh
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Y K Jung
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - J H Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - H An
- Department of Biostatistics, Korea University College of Medicine, Seoul, Korea
| | - Y S Seo
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
| | - D-S Kim
- Department of Surgery, Korea University College of Medicine, Seoul, Korea
| | - H J Yim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
| | - J E Yeon
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - K S Byun
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - S H Um
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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5
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Ahn SH, Lim YS, Lee KS, Paik SW, Lee YJ, Jeong SH, Kim JH, Yoon SK, Yim HJ, Tak WY, Han SY, Yang JC, Mo H, Mathias A, Han L, Knox SJ, Brainard DM, Kim YJ, Byun KS, Kim YS, Heo J, Han KH. A phase 3b study of sofosbuvir plus ribavirin in treatment-naive and treatment-experienced Korean patients chronically infected with genotype 2 hepatitis C virus. J Viral Hepat 2016; 23:358-65. [PMID: 26864153 DOI: 10.1111/jvh.12499] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 11/05/2015] [Indexed: 01/04/2023]
Abstract
In Korea, patients with chronic hepatitis C virus (HCV) infection are typically treated with pegylated interferon-alpha plus ribavirin, but interferons are contraindicated in many patients and are often poorly tolerated, particularly by the elderly and those with advanced liver disease. No interferon-free treatment regimens are approved in Korea. Sofosbuvir is an oral nucleotide analog inhibitor of the HCV nonstructural 5B RNA polymerase. It is approved in the USA, European Union and Japan for treating a number of HCV genotypes, including genotype 2. Genotype 2 has a seroprevalence of 38-46% in Korea. This single-arm, phase 3b study (NCT02021643) examined the efficacy and safety of sofosbuvir plus ribavirin (12-week duration) in chronic genotype 2 HCV-infected treatment-naive and treatment-experienced Korean patients with and without cirrhosis. The proportion of patients with sustained virologic response 12 weeks after treatment discontinuation (SVR12) was 97% (125/129), with 96% (101/105) of treatment-naive and 100% (24/24) of treatment-experienced patients achieving SVR12. Two patients experienced virologic failure (n = 1, on-treatment failure; n = 1, relapse). No patient discontinued study treatment due to an adverse event (AE). The most common treatment-emergent AEs were headache (18%, 23/129) and pruritus (15%, 19/129). Few patients had grade 3 AEs (5%, 6/129) or grade 3 laboratory abnormalities (12%, 15/129). No grade 4 AE was reported. These data suggest that 12 weeks of treatment with the all-oral, interferon-free regimen of sofosbuvir plus ribavirin is effective and well tolerated in Korean patients with chronic genotype 2 HCV infection.
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Affiliation(s)
- S H Ahn
- Yonsei University College of Medicine, Seoul-Korea, South Korea
| | - Y S Lim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul-Korea, South Korea
| | - K S Lee
- Gangnam Severance Hospital, Yonsei University Health System, Seoul-Korea, South Korea
| | - S W Paik
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul-Korea, South Korea
| | - Y J Lee
- Pusan Paik Hospital, Inje University, Busan-Korea, South Korea
| | - S H Jeong
- Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-Korea, South Korea
| | - J H Kim
- Gachon University Gil Hospital, Incheon-Korea, South Korea
| | - S K Yoon
- Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul-Korea, South Korea
| | - H J Yim
- Korea University Ansan Hospital, Ansan-si, Gyeonggi-do-Korea, South Korea
| | - W Y Tak
- Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, South Korea
| | - S Y Han
- Dong-A University Medical Center, Busan-Korea, South Korea
| | - J C Yang
- Gilead Sciences Inc., Foster City, CA, USA
| | - H Mo
- Gilead Sciences Inc., Foster City, CA, USA
| | - A Mathias
- Gilead Sciences Inc., Foster City, CA, USA
| | - L Han
- Gilead Sciences Inc., Foster City, CA, USA
| | - S J Knox
- Gilead Sciences Inc., Foster City, CA, USA
| | | | - Y J Kim
- Seoul National University Hospital, Seoul National University College of Medicine and Liver Research Institute, Seoul, Korea
| | - K S Byun
- Korea University Guro Hospital, Seoul-Korea, South Korea
| | - Y S Kim
- Soonchunhyang University Bucheon Hospital, Bucheon-Korea, South Korea
| | - J Heo
- Pusan National University and Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - K H Han
- Yonsei University College of Medicine, Seoul-Korea, South Korea
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6
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Yang DS, Yoon WS, Lee JA, Lee NK, Lee S, Kim CY, Yim HJ, Lee SH, Chung HH, Cha SH. The effectiveness of gadolinium MRI to improve target delineation for radiotherapy in hepatocellular carcinoma: a comparative study of rigid image registration techniques. Phys Med 2014; 30:676-81. [PMID: 24870246 DOI: 10.1016/j.ejmp.2014.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 04/14/2014] [Accepted: 05/06/2014] [Indexed: 11/29/2022] Open
Abstract
To achieve consistent target delineation in radiotherapy for hepatocellular carcinoma (HCC), image registration between simulation CT and diagnostic MRI was explored. Twenty patients with advanced HCC were included. The median interval between MRI and CT was 11 days. CT was obtained with shallow free breathing and MRI at exhale phase. On each CT and MRI, the liver and the gross target volume (GTV) were drawn. A rigid image registration was taken according to point information of vascular bifurcation (Method[A]) and pixel information of volume of interest only including the periphery of the liver (Method[B]) and manually drawn liver (Method[C]). In nine cases with an indefinite GTV on CT, a virtual sphere was generated at the epicenter of the GTV. The GTV from CT (VGTV[CT]) and MRI (VGTV[MR]) and the expanded GTV from MRI (V+GTV[MR]) considering geometrical registration error were defined. The underestimation (uncovered V[CT] by V[MR]) and the overestimation (excessive V[MR] by V[CT]) were calculated. Through a paired T-test, the difference between image registration techniques was analyzed. For method[A], the underestimation rates of VGTV[MR] and V+GTV[MR] were 16.4 ± 8.9% and 3.2 ± 3.7%, and the overestimation rates were 16.6 ± 8.7% and 28.4 ± 10.3%, respectively. For VGTV[MR] and V+GTV[MR], the underestimation rates and overestimation rates of method[A] were better than method[C]. The underestimation rates and overestimation rates of the VGTV[MR] were better in method[B] than method[C]. By image registration and additional margin, about 97% of HCC could be covered. Method[A] or method[B] could be recommended according to physician preference.
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Affiliation(s)
- D S Yang
- Department of Radiation Oncology, Guro Hospital, College of Medicine, Korea University, Seoul, Republic of Korea
| | - W S Yoon
- Department of Radiation Oncology, Ansan Hospital, College of Medicine, Korea University, Ansan, Republic of Korea.
| | - J A Lee
- Department of Radiation Oncology, Guro Hospital, College of Medicine, Korea University, Seoul, Republic of Korea
| | - N K Lee
- Department of Radiation Oncology, Anam Hospital, College of Medicine, Korea University, Seoul, Republic of Korea
| | - S Lee
- Department of Radiation Oncology, Anam Hospital, College of Medicine, Korea University, Seoul, Republic of Korea
| | - C Y Kim
- Department of Radiation Oncology, Anam Hospital, College of Medicine, Korea University, Seoul, Republic of Korea
| | - H J Yim
- Department of Internal Medicine, Ansan Hospital, College of Medicine, Korea University, Ansan, Republic of Korea
| | - S H Lee
- Department of Radiology, Ansan Hospital, College of Medicine, Korea University, Ansan, Republic of Korea
| | - H H Chung
- Department of Radiology, Ansan Hospital, College of Medicine, Korea University, Ansan, Republic of Korea
| | - S H Cha
- Department of Radiology, Ansan Hospital, College of Medicine, Korea University, Ansan, Republic of Korea
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7
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Affiliation(s)
- S Y Kim
- Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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8
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Affiliation(s)
- H J Noh
- Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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9
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Yun MH, Seo YS, Kang HS, Lee KG, Kim JH, An H, Yim HJ, Keum B, Jeen YT, Lee HS, Chun HJ, Um SH, Kim CD, Ryu HS. The effect of the respiratory cycle on liver stiffness values as measured by transient elastography. J Viral Hepat 2011; 18:631-6. [PMID: 21029256 DOI: 10.1111/j.1365-2893.2010.01376.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The findings of several studies suggest that liver stiffness values can be affected by the degree of intrahepatic congestion respiration influence intrahepatic blood volume and may affect liver stiffness. We evaluated the influence of respiration on liver stiffness. Transient elastography (TE) was performed at the end of inspiration and at the end of expiration in patients with chronic liver disease. The median values obtained during the inspiration set and during the expiration set were defined as inspiratory and expiratory liver stiffness, respectively. A total of 123 patients with chronic liver disease were enrolled (mean age 49years; 64.2% men). Liver cirrhosis coexisted in 29 patients (23.6%). Expiratory liver stiffness was significantly higher than inspiratory liver stiffness (8.7 vs 7.9kPa, P=0.001), while the expiratory interquartile range/median ratio (IQR ratio) did not differ from the inspiratory IQR ratio. Expiratory liver stiffness was significantly higher than inspiratory liver stiffness in 49 (39.8%) patients (HE group), expiratory liver stiffness was significantly lower than inspiratory stiffness in 15 (12.2%) patients, and there was no difference in 59 (48.0%) patients. Liver cirrhosis was more frequent in those who had a lower liver stiffness reading in expiration, and only the absence of liver cirrhosis was significantly associated with a higher reading in expiration in multivariate analysis. In conclusion, liver stiffness was significantly elevated during expiration especially in patients without liver cirrhosis. The effect of respiration should be kept in mind during TE readings.
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Affiliation(s)
- M H Yun
- Departments of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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10
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Kim JH, Yim HJ, Jung ES, Jung YK, Kim JH, Seo YS, Yeon JE, Lee HS, Um SH, Byun KS. Virologic and biochemical responses to clevudine in patients with chronic HBV infection-associated cirrhosis: data at week 48. J Viral Hepat 2011; 18:287-93. [PMID: 20367793 DOI: 10.1111/j.1365-2893.2010.01304.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Clevudine shows high rates of virologic and biochemical responses in patients with chronic hepatitis B. However, the efficacy and safety of clevudine in patients with cirrhosis are unknown. The aims of this study were to evaluate the safety and to assess the virologic and the biochemical responses to clevudine in patients with cirrhosis with chronic hepatitis B virus (HBV) infection. We reviewed data from treatment-naïve patients with chronic hepatitis B with and without cirrhosis who started clevudine between April 2007 and March 2008 (n = 52, hepatitis B without cirrhosis n = 21 and chronic hepatitis B with cirrhosis n = 31) at Korea University Ansan/Guro Hospital. All of the patients were treated for more than 48 weeks. The mean age was older in the patients with cirrhosis. Baseline HBV DNA levels were 6.9 and 7.78 log copies/mL (P = 0.042), and alanine aminotransferase (ALT) levels were 104.9 and 147.4 IU/L (P = 0.204), for those with and without cirrhosis, respectively. Virologic response (HBV DNA <1000 copies/mL) (87.1%vs 71.4%, P = 0.24) and biochemical response (83.9%vs 80.9%, P = 0.99) at week 48 were not significantly different between the two groups. Early virologic response at week 12 was even higher in the patients with cirrhosis (61.3%vs 28.6%, P = 0.026). Neither ALT flare nor newly onset hepatic decompensation was found in the patients with cirrhosis, whereas ALT flare was transiently observed in 14.3% of the chronic hepatitis group. In conclusion, although clevudine may produce a transient elevation of ALT during the early treatment period, such findings were not observed in patients with cirrhosis and the virologic and biochemical responses of the groups were comparable.
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Affiliation(s)
- J H Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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11
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Koo JS, Park SM, Yim HJ, Um JW, Lee HS, Lee SW, Choi JH. Ileorectal anastomotic obstruction treated with a dual endoscopic transillumination technique. Endoscopy 2010; 41 Suppl 2:E259. [PMID: 19851960 DOI: 10.1055/s-0029-1215220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- J S Koo
- Division of Gastroenterology, Department of Internal Medicine, Korea University School of Medicine, Seoul, Korea
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12
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Kim M, Ajimura S, Aoki K, Banu A, Bhang H, Fukuda T, Hashimoto O, Hwang JI, Kameoka S, Kang BH, Kim E, Kim JH, Maruta T, Miura Y, Miyake Y, Nagae T, Nakamura M, Nakamura SN, Noumi H, Okada S, Okayasu Y, Outa H, Park H, Saha PK, Sato Y, Sekimoto M, Takahashi T, Tamura H, Tanida K, Toyoda A, Tshoo K, Tsukada K, Watanabe T, Yim HJ. Three-body nonmesonic weak decay of the (Lambda)12C hypernucleus. Phys Rev Lett 2009; 103:182502. [PMID: 19905801 DOI: 10.1103/physrevlett.103.182502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2009] [Indexed: 05/28/2023]
Abstract
We have measured the branching ratio of the three-body process in the nonmesonic weak decay of Lambda12C to be 0.29+/-0.13. This result was obtained by reproducing the nucleon and the nucleon pair yields introducing a measured final state interaction. At the same time, we have determined the absolute decay widths, Gamma(n) and Gamma(p), along with Gamma2N, whose relative ratio has been a long-standing puzzle. Including the three-body process, we have successfully reproduced the nucleon energy distribution, the coincidence two-nucleon angular correlation, and the momentum sum distribution simultaneously.
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Affiliation(s)
- M Kim
- Department of Physics and Astronomy, Seoul National University, Seoul, 151-747, Korea
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13
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Jung SW, Lee SW, Hyun JJ, Kim DI, Koo JS, Yim HJ, Park JJ, Lee HS, Chun HJ, Um SH, Choi JH, Kim CD, Ryu HS. Efficacy of Helicobacter pylori eradication therapy in chronic liver disease. Dig Liver Dis 2009; 41:134-40. [PMID: 18436489 DOI: 10.1016/j.dld.2008.03.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2007] [Revised: 03/03/2008] [Accepted: 03/03/2008] [Indexed: 12/11/2022]
Abstract
BACKGROUND/AIMS Peptic ulcers occur more commonly in patients with liver cirrhosis (LC). Helicobacter pylori is recognized as the most important etiology in the pathogenesis of peptic ulcers. We investigated the efficacy of proton pump inhibitor (PPI)-based triple therapy in patients with chronic liver disease and peptic ulcer. PATIENTS AND METHODS One hundred sixty-three patients with LC or chronic hepatitis (CH) with a peptic ulcer and proven H. pylori infection were included. The combination of PPI, amoxicillin (1.0 g), and clarithromycin (500 mg), each given twice daily, was administered for 1 or 2 weeks. The eradication of H. pylori was determined by the rapid urease test, histology, or the 13C-urea breath test at least 4 weeks after completing the treatment. RESULTS The eradication rate of H. pylori was similar between the LC and CH groups; 82.6% and 88.1%, respectively. In addition, there were no significant differences in eradication rates between the patients with Child-Pugh class A and Child-Pugh class B/C disease. The side effects in each group were generally mild. Only the serum ALT levels showed a significant correlation with the success of H. pylori eradication in both the LC and CH groups. CONCLUSION The PPI-based triple therapy achieves high eradication rates for H. pylori infection, in patients with chronic liver disease, without significant side effects.
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Affiliation(s)
- S W Jung
- Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Ansan Hospital, 516 Gojan-dong, Danwon-gu, Ansan-si, Gyeonggi-do 425-707, South Korea
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14
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Kang BH, Bhang H, Kim EH, Kim JH, Kim MJ, Yim HJ, Ajimura S, Miyake Y, Aoki K, Nagae T, Noumi H, Outa H, Saha PK, Sato Y, Sekimoto M, Toyoda A, Banu A, Fukuda T, Hashimoto O, Kameoka S, Miura Y, Nakamura SN, Okayasu Y, Takahashi T, Tamura H, Tsukada K, Watanabe T, Hwang JI, Maruta T, Nakamura M, Okada S, Park H, Tanida K. Exclusive measurement of the nonmesonic weak decay of the lambda(5)He hypernucleus. Phys Rev Lett 2006; 96:062301. [PMID: 16605985 DOI: 10.1103/physrevlett.96.062301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2005] [Indexed: 05/08/2023]
Abstract
We performed a coincidence measurement of two nucleons emitted from the nonmesonic weak decay of lambda(5)He formed via the 6Li(pi+, K+) reaction. The energies of the two nucleons and the pair number distributions in the opening angle between them were measured. In both np and nn pairs, we observed a clean back-to-back correlation coming from the two-body weak reactions of lambda p --> np and lambda n --> nn, respectively. The ratio of the nucleon pair numbers was N(nn)/N(np) = 0.45 +/- 0.11(stat) +/- 0.03(syst) in the kinematic region of cos theta(NN) < -0.8. Since each decay mode was exclusively detected, the measured ratio should be close to the ratio of gamma(lambda p --> np)/gamma(lambda n --> nn). The ratio is consistent with recent theoretical calculations based on the heavy meson and/or direct-quark exchange picture.
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Affiliation(s)
- B H Kang
- Department of Physics, Seoul National University, Seoul 151-742, Korea
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15
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Saha PK, Fukuda T, Imoto W, Ahn JK, Ajimura S, Aoki K, Bhang HC, Fujioka H, Hotchi H, Hwang JI, Itabashi T, Kang BH, Kim HD, Kim MJ, Kishimoto T, Krutenkova A, Maruta T, Miura Y, Miwa K, Nagae T, Noumi H, Outa H, Ohtaki T, Sakaguchi A, Sato Y, Sekimoto M, Shimizu Y, Tamura H, Tanida K, Toyoda A, Ukai M, Yim HJ. Production of the neutron-rich hypernucleus 10LambdaLi in the (pi-,K+) double charge-exchange reaction. Phys Rev Lett 2005; 94:052502. [PMID: 15783631 DOI: 10.1103/physrevlett.94.052502] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2004] [Indexed: 05/24/2023]
Abstract
In order to produce a neutron-rich Lambda hypernucleus for the first time, we carried out an experiment by utilizing the (pi-,K+) double charge-exchange reaction on a 10B target. We observed the production of a 10LambdaLi hypernucleus. The cross section for the Lambda bound region was found to be 11.3+/-1.9 nb/sr with the 1.2 GeV/c incident momentum, which is compared with the 10LambdaB hypernucleus production cross section, 7.8+/-0.3 microb/sr, in the (pi+,K+) reaction with a 1.05 GeV/c incident momentum beam.
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Affiliation(s)
- P K Saha
- Osaka Electro-Communication University, Neyagawa, Osaka 572-8530, Japan
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16
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Yim HJ, Gonzales RA. Ethanol-induced increases in dopamine extracellular concentration in rat nucleus accumbens are accounted for by increased release and not uptake inhibition. Alcohol 2000; 22:107-15. [PMID: 11113625 DOI: 10.1016/s0741-8329(00)00121-x] [Citation(s) in RCA: 128] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
We performed a quantitative microdialysis study to determine whether the increase in dialysate dopamine from the nucleus accumbens caused by intraperitoneal administration of ethanol (1 g/kg) was due to enhanced dopamine release or inhibition of dopamine uptake. The Lönnroth method (no net flux), adapted for transient conditions, was used to follow the time course of true extracellular dopamine concentrations in the nucleus accumbens simultaneously with the in vivo recovery of dopamine across the microdialysis probe. Separate groups of rats were perfused with artificial cerebral spinal fluid containing 0, 4, 8, or 12 nM dopamine for the entire experiment. Samples were taken every 10 min. Each rat received a saline or an ethanol injection. The concentration of dopamine gained by or lost from the probe was plotted as a function of the concentration of dopamine perfused into the probe for each time point. Linear regression was used to determine the slope of the line (in vivo recovery) and the x-intercept (point of no net flux) for each plot. The in vivo recovery did not significantly change over time for the saline- or the ethanol-injected rats. However, the point of no net flux (true extracellular concentration of dopamine) significantly increased after the ethanol injection from 9.4+/-0.4 nM (mean of six basal samples) to 13.2+/-1.8 nM, at the maximum, but did not change after the saline injection. On the basis of these results, it is suggested that the primary mechanism by which ethanol increases dialysate dopamine levels in the nucleus accumbens after intraperitoneal administration is by increasing dopamine release from the terminals, rather than by inhibiting the dopamine transporter.
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Affiliation(s)
- H J Yim
- Department of Pharmacology, College of Pharmacy, University of Texas at Austin, 78712, USA
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Yim HJ, Robinson DL, White ML, Jaworski JN, Randall PK, Lancaster FE, Gonzales RA. Dissociation between the time course of ethanol and extracellular dopamine concentrations in the nucleus accumbens after a single intraperitoneal injection. Alcohol Clin Exp Res 2000; 24:781-8. [PMID: 10888065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
BACKGROUND Dopamine release in the nucleus accumbens has been linked to the reinforcing effects of ethanol, but the time course or relationship of this response to ethanol concentrations in the brain has not been studied. METHODS Various doses of ethanol (0-2.0 g/kg) were administered intraperitoneally to male Sprague Dawley rats, and dopamine and ethanol were simultaneously analyzed in dialysate samples from the nucleus accumbens. A separate study to compare the ethanol-induced dopamine response in male and female rats was carried out by using a 1 g/kg intraperitoneal dose of ethanol. RESULTS In male rats, 1 and 2 g/kg ethanol significantly increased dialysate dopamine by 40% over basal, whereas 0.25 and 0.5 g/kg ethanol produced a nonsignificant 20% increase. Dialysate ethanol concentrations exhibited a curvilinear decline after reaching peak levels for the lower doses but showed a linear decrease after 1 and 2 g/kg. There was a dissociation between the time courses of extracellular dopamine and ethanol after 1 and 2 g/kg ethanol treatment. The dopamine response returned to basal within 90 min, whereas the ethanol concentrations remained elevated. In a separate study that compared male and female rats, the ratio of the dopamine response over basal to the dialysate ethanol concentrations was significantly decreased at 60 min after an injection of 1 g/kg. However, there were no differences between males and females. CONCLUSIONS The dissociation between dopamine and ethanol levels may reflect the development of acute tolerance to ethanol-induced dopamine release in the nucleus accumbens within the time course of a single acute injection. Given the strong links between dopamine and ethanol reinforcement, our findings may be relevant for understanding the time course of ethanol's reinforcing effects in vivo.
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Affiliation(s)
- H J Yim
- Division of Pharmacology and Toxicology, College of Pharmacy, University of Texas at Austin, 78712, USA
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Gonzales RA, McNabb J, Yim HJ, Ripley T, Bungay PM. Quantitative microdialysis of ethanol in rat striatum. Alcohol Clin Exp Res 1998; 22:858-67. [PMID: 9660313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
We have applied a steady-state theory of microdialysis to characterize the diffusion of ethanol through a microdialysis membrane and through rat striatum. Quantitative characterization required measurement of in vitro and in vivo extraction fractions for ethanol and determination of the clearance of ethanol from brain tissue during steady-state perfusion through a microdialysis probe. Extraction fraction of ethanol was determined in vitro by perfusing a known concentration of ethanol through probes immersed in water at 37 degrees C with stirring. The in vitro extraction fraction yielded a probe permeability value of 0.046 +/- 0.004 cm/min that is comparable with an estimate from published measurements for similar dialysis membranes. The in vivo extraction fraction was determined for probes placed in the striatum. Clearance of ethanol and a brain slice concentration profile of ethanol were determined by measurement of the amount of ethanol remaining in the brain tissue during steady-state perfusion of the probe. Steady state was achieved within 10 min after beginning the ethanol perfusion in vivo, and the extraction fraction was not altered by sedation of the rat with pentobarbital. The tissue concentration profile was symmetrical around the probe track, and ethanol was detected 1 mm from the probe. The experimental clearance rate constant value obtained for ethanol (2.0 +/- 0.3 min(-1)) was higher than that expected for removal solely by loss to the blood. The tissue diffusivity for ethanol, Dt, derived from the experimental measurements was 1.2 +/- 0.2 x 10(-5) cm2/sec. This value is greater than expected for interstitial diffusion, suggesting a substantial contribution by transcellular diffusion of ethanol as well. The predicted tissue concentration profile had a higher peak value and did not extend into the tissue (0.5 mm) as much as the experimental profile (1 mm), although there was reasonable agreement between experiment and theory. Our quantitative characterization of the microdialysis behavior of ethanol in brain provides a framework for interpretation of brain microdialysis experiments using ethanol by supplying, inter alia, a means for estimating the ethanol concentration achieved in the tissue volume being sampled by the probe.
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Affiliation(s)
- R A Gonzales
- Institute for Neuroscience, Neuropharmacology Program, University of Texas, Austin 78712, USA
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Yim HJ, Schallert T, Randall PK, Gonzales RA. Comparison of local and systemic ethanol effects on extracellular dopamine concentration in rat nucleus accumbens by microdialysis. Alcohol Clin Exp Res 1998; 22:367-74. [PMID: 9581642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
To determine the site of action of systemic ethanol on dopaminergic function in the nucleus accumbens, we compared the effect of intraperitoneal (i.p.) and local administration of ethanol on interstitial dopamine concentration using microdialysis in freely moving rats. The i.p. administration of 1 g/kg of ethanol significantly increased the dialysate dopamine (DA) concentrations (approximately 40% above basal), compared with saline treatment. The concentration-time profile of DA and ethanol in dialysates was similar after two ethanol injections 4 hr apart. Local perfusion with several ethanol concentrations showed that 510 and 860 mM of ethanol caused a significant concentration-related increase in extracellular DA concentrations in the nucleus accumbens (510 mM, 28% increase; 860 mM, 62% increase). However, lower ethanol concentrations, 170 mM or below, failed to change basal DA concentrations. Stimulation with high potassium (50 mM) in artificial cerebrospinal fluid preceding local ethanol treatment increased dialysate DA concentrations to 523 +/- 83% of basal levels, confirming that the DA terminals were responsive to pharmacological manipulation. Basal DA levels in dialysates were approximately 70% calcium-dependent when tested at the end of the local perfusion experiments. Stereological examination of the nucleus accumbens revealed probe-induced damage, but did not detect additional damage by local perfusion of ethanol. When ethanol concentrations in the DA sampling area around the probe are taken into account in both systemic and local administration experiments, this study suggests that concentrations of ethanol associated with moderate intoxication do not directly affect the function of DA terminals in the nucleus accumbens. Therefore, the systemic effects of ethanol on nucleus accumbens DAergic function is more likely due to an interaction with sites other than the nucleus accumbens.
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Affiliation(s)
- H J Yim
- Department of Pharmacology, University of Texas, Austin 78712, USA
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Abstract
The concentration-related effects of ethanol on extracellular dopamine (DA) in rat striatum were studied by direct perfusion through microdialysis probes in freely moving rats. Two sets of three ethanol concentrations were separately tested using a Latin square experimental design. Potassium stimulation with high potassium (50 mM) in artificial CSF (ACSF) preceding ethanol treatment confirmed the neuronal function of dopaminergic cells by increasing DA concentrations to 200-1,500% of basal levels. The perfusion with calcium-free ACSF applied at the end of each experiment confirmed the calcium dependency of the basal levels of extracellular DA by decreasing basal DA levels by 70%. The striatal volume measurement to examine the possible brain damage by direct ethanol perfusion suggested that ethanol did not increase the damage caused by the probe implantation at any ethanol concentration tested in this study. The 30-min direct perfusion of 510 and 860 mM ethanol resulted in a significant concentration-related stimulatory effect on the extracellular DA concentration in rat striatum (510 mM, 29% increase, p < 0.05; 860 mM, 66% increase, p < 0.05). However, there was no significant effect of ethanol at low concentrations, < or = 170 mM. Considering the effective ethanol concentration in tissue areas in which DA is sampled, the data suggest that concentrations of ethanol associated with moderate intoxication do not directly affect the extracellular concentration of DA in the striatum. Therefore, the systemic effects of ethanol on striatal DA found in previous studies may be caused by the interaction with sites other than the striatum.
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Affiliation(s)
- H J Yim
- Department of Pharmacology, University of Texas, Austin 78712, USA
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