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Namazzi R, Bond C, Conroy AL, Datta D, Tagoola A, Goings MJ, Jang JH, Ware RE, Opoka R, John CC. Hydroxyurea reduces infections in children with sickle cell anemia in Uganda. Blood 2024; 143:1425-1428. [PMID: 38169476 PMCID: PMC11033589 DOI: 10.1182/blood.2023021575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 12/11/2023] [Accepted: 12/16/2023] [Indexed: 01/05/2024] Open
Abstract
ABSTRACT After starting hydroxyurea treatment, Ugandan children with sickle cell anemia had 60% fewer severe or invasive infections, including malaria, bacteremia, respiratory tract infections, and gastroenteritis, than before starting hydroxyurea treatment (incidence rate ratio, 0.40 [95% confidence interval, 0.29-0.54]; P < .001).
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Affiliation(s)
- Ruth Namazzi
- Department of Pediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda
- Global Health Uganda, Kampala, Uganda
| | - Caitlin Bond
- Department of Pediatrics, Ryan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine, Indianapolis, IN
| | - Andrea L. Conroy
- Department of Pediatrics, Ryan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine, Indianapolis, IN
| | - Dibyadyuti Datta
- Department of Pediatrics, Ryan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine, Indianapolis, IN
| | - Abner Tagoola
- Department of Pediatrics, Jinja Regional Referral Hospital, Jinja, Uganda
| | - Michael J. Goings
- Department of Pediatrics, Ryan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine, Indianapolis, IN
| | - Jeong Hoon Jang
- Underwood International College and Department of Applied Statistics, Yonsei University, Seoul, Korea
| | - Russell E. Ware
- Division of Hematology, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | | | - Chandy C. John
- Department of Pediatrics, Ryan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine, Indianapolis, IN
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Yue Y, Jang JH, Manatunga AK. Assessing intra- and inter-method agreement of functional data. Stat Methods Med Res 2024; 33:112-129. [PMID: 38155544 PMCID: PMC11057997 DOI: 10.1177/09622802231219862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2023]
Abstract
Modern medical devices are increasingly producing complex data that could offer deeper insights into physiological mechanisms of underlying diseases. One type of complex data that arises frequently in medical imaging studies is functional data, whose sampling unit is a smooth continuous function. In this work, with the goal of establishing the scientific validity of experiments involving modern medical imaging devices, we focus on the problem of evaluating reliability and reproducibility of multiple functional data that are measured on the same subjects by different methods (i.e. different technologies or raters). Specifically, we develop a series of intraclass correlation coefficient and concordance correlation coefficient indices that can assess intra-method, inter-method, and total (intra + inter) agreement based on multivariate multilevel functional data consisting of replicated functional data measurements produced by each of the different methods. For efficient estimation, the proposed indices are expressed using variance components of a multivariate multilevel functional mixed effect model, which can be smoothly estimated by functional principal component analysis. Extensive simulation studies are performed to assess the finite-sample properties of the estimators. The proposed method is applied to evaluate the reliability and reproducibility of renogram curves produced by a high-tech radionuclide image scan used to non-invasively detect kidney obstruction.
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Affiliation(s)
- Ye Yue
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA
| | - Jeong Hoon Jang
- Quantitative Risk Management, Yonsei University, Incheon, Republic of Korea
| | - Amita K. Manatunga
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA
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Seriramulu VP, Suppiah S, Lee HH, Jang JH, Omar NF, Mohan SN, Ibrahim NSN, Azmi NHM, Buhari I, Ahmad U. Review of MR spectroscopy analysis and artificial intelligence applications for the detection of cerebral inflammation and neurotoxicity in Alzheimer's disease. Med J Malaysia 2024; 79:102-110. [PMID: 38287765] [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: 01/31/2024]
Abstract
INTRODUCTION Magnetic resonance spectroscopy (MRS) has an emerging role as a neuroimaging tool for the detection of biomarkers of Alzheimer's disease (AD). To date, MRS has been established as one of the diagnostic tools for various diseases such as breast cancer and fatty liver, as well as brain tumours. However, its utility in neurodegenerative diseases is still in the experimental stages. The potential role of the modality has not been fully explored, as there is diverse information regarding the aberrations in the brain metabolites caused by normal ageing versus neurodegenerative disorders. MATERIALS AND METHODS A literature search was carried out to gather eligible studies from the following widely sourced electronic databases such as Scopus, PubMed and Google Scholar using the combination of the following keywords: AD, MRS, brain metabolites, deep learning (DL), machine learning (ML) and artificial intelligence (AI); having the aim of taking the readers through the advancements in the usage of MRS analysis and related AI applications for the detection of AD. RESULTS We elaborate on the MRS data acquisition, processing, analysis, and interpretation techniques. Recommendation is made for MRS parameters that can obtain the best quality spectrum for fingerprinting the brain metabolomics composition in AD. Furthermore, we summarise ML and DL techniques that have been utilised to estimate the uncertainty in the machine-predicted metabolite content, as well as streamline the process of displaying results of metabolites derangement that occurs as part of ageing. CONCLUSION MRS has a role as a non-invasive tool for the detection of brain metabolite biomarkers that indicate brain metabolic health, which can be integral in the management of AD.
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Affiliation(s)
- V P Seriramulu
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Radiology, 43400 Serdang, Selangor, Malaysia
| | - S Suppiah
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Radiology, 43400 Serdang, Selangor, Malaysia.
| | - H H Lee
- METLiT Inc., Seoul, Republic of Korea
| | - J H Jang
- METLiT Inc., Seoul, Republic of Korea
| | - N F Omar
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Radiology, 43400 Serdang, Selangor, Malaysia
| | - S N Mohan
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Psychiatry, 43400 Serdang, Selangor, Malaysia
| | - N S N Ibrahim
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Radiology, 43400 Serdang, Selangor, Malaysia
| | - N H M Azmi
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Radiology, 43400 Serdang, Selangor, Malaysia
| | - I Buhari
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Radiology, 43400 Serdang, Selangor, Malaysia
| | - U Ahmad
- Bauchi State University, Faculty of Basic Medical Sciences, Department of Anatomy, Molecular Genetics Informatics, Gadau, Nigeria
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Hammond FM, Zafonte RD, Sherer M, Bell KR, Bogner J, Malec JF, Tang Q, Jang JH. Assessing the benefits and risks of amantadine for irritability and aggression after traumatic brain injury. PM R 2023. [PMID: 38145314 DOI: 10.1002/pmrj.13122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 11/06/2023] [Accepted: 11/29/2023] [Indexed: 12/26/2023]
Abstract
OBJECTIVE To quantify the benefits versus harms of amantadine in the treatment of irritability and aggression following traumatic brain injury. METHODS Secondary outcome data from a randomized controlled multisite trial of amantadine 100 mg twice daily were used to calculate number-needed-to-treat (NNT). Given prior findings of positive clinician-perceived effects and low incidence of adverse events, we hypothesized low number-needed-to-treat for benefit (NNTB; high benefit) and high number-needed-to-treat for harm (NNTH; low risk) based on the clinician ratings, supporting the use of amantadine in clinical practice. Specifically, NNTB values were calculated using number of individuals with improvement on the Clinician Global Impressions-Global Improvement scale (GI). NNTB values were computed using number of individuals with worsening on the GI and experiencing serious and any adverse events. RESULTS Based on clinician ratings, on average for every six patients treated with amantadine rather than placebo, one extra patient would be expected to improve (NNTB = 6.4; 95% confidence interval [CI]: [3.3-76.8]). More participants in the placebo group worsened than in the amantadine group, but the result was not statistically significant (NNTH = -92.4; 95% CI: [NNTB -32.9 to infinity to NNTH -19.2]). The amantadine and placebo groups did not differ on the numbers of adverse events experienced during the trial. CONCLUSION Clinician ratings suggest modest benefit of amantadine 100 mg twice daily with low risk to appropriately selected patients with adequate renal clearance. Thus, amantadine should be considered a treatment option for the experienced brain injury clinician. These data may support treatment decisions when a pharmaceutical agent is being considered to control irritability/aggression.
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Affiliation(s)
- Flora M Hammond
- Department of Physical Medicine & Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Physical Medicine & Rehabilitation, Rehabilitation Hospital of Indiana, Indianapolis, Indiana, USA
- Department of Physical Medicine and Rehabilitation, Carolinas Rehabilitation, Atrium Health, Charlotte, North Carolina, USA
| | - Ross D Zafonte
- Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Brigham and Women's Hospital, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA
| | - Mark Sherer
- Research Department, TIRR Memorial Hermann, Houston, Texas, USA
| | - Kathleen R Bell
- Department of Physical Medicine & Rehabilitation, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jennifer Bogner
- Department of Physical Medicine & Rehabilitation, Ohio State University, Columbus, Ohio, USA
| | - James F Malec
- Department of Physical Medicine & Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Qing Tang
- Department of Physical Medicine & Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jeong Hoon Jang
- Department of Physical Medicine & Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Quantitative Risk Management, Yonsei University, Incheon, South Korea
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Jang JH, Chang C, Manatunga AK, Taylor AT, Long Q. An integrative latent class model of heterogeneous data modalities for diagnosing kidney obstruction. Biostatistics 2023:kxad020. [PMID: 37494883 DOI: 10.1093/biostatistics/kxad020] [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: 10/03/2022] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 07/28/2023] Open
Abstract
Radionuclide imaging plays a critical role in the diagnosis and management of kidney obstruction. However, most practicing radiologists in US hospitals have insufficient time and resources to acquire training and experience needed to interpret radionuclide images, leading to increased diagnostic errors. To tackle this problem, Emory University embarked on a study that aims to develop a computer-assisted diagnostic (CAD) tool for kidney obstruction by mining and analyzing patient data comprised of renogram curves, ordinal expert ratings on the obstruction status, pharmacokinetic variables, and demographic information. The major challenges here are the heterogeneity in data modes and the lack of gold standard for determining kidney obstruction. In this article, we develop a statistically principled CAD tool based on an integrative latent class model that leverages heterogeneous data modalities available for each patient to provide accurate prediction of kidney obstruction. Our integrative model consists of three sub-models (multilevel functional latent factor regression model, probit scalar-on-function regression model, and Gaussian mixture model), each of which is tailored to the specific data mode and depends on the unknown obstruction status (latent class). An efficient MCMC algorithm is developed to train the model and predict kidney obstruction with associated uncertainty. Extensive simulations are conducted to evaluate the performance of the proposed method. An application to an Emory renal study demonstrates the usefulness of our model as a CAD tool for kidney obstruction.
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Affiliation(s)
- Jeong Hoon Jang
- Quantitative Risk Management, Yonsei University, Incheon 21983, South Korea
| | - Changgee Chang
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Amita K Manatunga
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA 30322, USA
| | - Andrew T Taylor
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA 30322, USA
| | - Qi Long
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA 19104, USA
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6
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Namazzi R, Opoka R, Conroy AL, Datta D, Tagoola A, Bond C, Goings MJ, Ryu MS, Cusick SE, Krebs NF, Jang JH, Tu W, Ware RE, John CC. Zinc for infection prevention in children with sickle cell anemia: a randomized double-blind placebo-controlled trial. Blood Adv 2023; 7:3023-3031. [PMID: 36735400 PMCID: PMC10331409 DOI: 10.1182/bloodadvances.2022008539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 01/17/2023] [Accepted: 01/21/2023] [Indexed: 02/04/2023] Open
Abstract
Data from small clinical trials in the United States and India suggest zinc supplementation reduces infection in adolescents and adults with sickle cell anemia (SCA), but no studies of zinc supplementation for infection prevention have been conducted in children with SCA living in Africa. We conducted a randomized double-blind placebo-controlled trial to assess zinc supplementation for prevention of severe or invasive infections in Ugandan children 1.00-4.99 years with SCA. Of 252 enrolled participants, 124 were assigned zinc (10 mg) and 126 assigned placebo once daily for 12 months. The primary outcome was incidence of protocol-defined severe or invasive infections. Infection incidence did not differ between treatment arms (282 vs. 270 severe or invasive infections per 100 person-years, respectively, incidence rate ratio of 1.04 [95% confidence interval (CI), 0.81, 1.32, p=0.78]), adjusting for hydroxyurea treatment. There was also no difference between treatment arms in incidence of serious adverse events or SCA-related events. Children receiving zinc had increased serum levels after 12-months, but at study exit, 41% remained zinc deficient (<65 μg/dL). In post-hoc analysis, occurrence of stroke or death was lower in the zinc treatment arm (adjusted hazard ratio (95% CI), 0.22 (0.05, 1.00); p=0.05). Daily 10 mg zinc supplementation for 12 months did not prevent severe or invasive infections in Ugandan children with SCA, but many supplemented children remained zinc deficient. Optimal zinc dosing and the role of zinc in preventing stroke or death in SCA warrant further investigation. This trial was registered at clinicaltrials.gov as #NCT03528434.
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Affiliation(s)
- Ruth Namazzi
- Department of Pediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda
- Global Health Uganda, Kampala, Uganda
| | - Robert Opoka
- Department of Pediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda
- Global Health Uganda, Kampala, Uganda
| | - Andrea L. Conroy
- Ryan White Center for Pediatric Infectious Diseases and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | - Dibyadyuti Datta
- Ryan White Center for Pediatric Infectious Diseases and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | - Abner Tagoola
- Department of Pediatrics, Jinja Regional Referral Hospital, Jinja, Uganda
| | - Caitlin Bond
- Ryan White Center for Pediatric Infectious Diseases and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | - Michael J. Goings
- Ryan White Center for Pediatric Infectious Diseases and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | - Moon-Suhn Ryu
- Department of Food and Nutrition, Yonsei University, Seoul, Republic of Korea
| | - Sarah E. Cusick
- Department of Pediatrics, University of Minnesota, Minneapolis, MN
| | - Nancy F. Krebs
- Department of Pediatrics, University of Colorado, Aurora, CO
| | - Jeong Hoon Jang
- Underwood International College and Department of Applied Statistics, Yonsei University, Seoul, Republic of Korea
| | - Wanzhu Tu
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN
| | - Russell E. Ware
- Division of Hematology and Global Health Center, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Chandy C. John
- Ryan White Center for Pediatric Infectious Diseases and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
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Jang JH, Manatunga A. Diagnostic evaluation of pharmacokinetic features of functional markers. J Biopharm Stat 2023; 33:307-323. [PMID: 36426623 PMCID: PMC10079622 DOI: 10.1080/10543406.2022.2148163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 10/27/2022] [Indexed: 11/26/2022]
Abstract
The dynamicity of functional (curve) markers from modern clinical studies offers deeper insights into complex disease physiology. A frequent clinical practice is to examine various 'pharmacokinetic features' of functional markers (definite integral, maximum value, time to maximum, etc.) that reflect important physiological underpinnings. For instance, the current diagnostic procedure for kidney obstruction is to examine several pharmacokinetic features of renogram curves characterizing renal function. Motivated by such clinical practices, we develop a statistical framework for evaluating diagnostic accuracy of pharmacokinetic features using area under the receiver operating characteristic curve (AUC). The major challenge is that functional markers are observed at discrete time points with measurement error. To address this challenge, we develop a two-stage non-parametric AUC estimator based on summary functionals providing unified representation of various pharmacokinetic features and study its asymptotic properties. We also propose a sensible adaptation of a semiparametric regression model that can describe heterogeneity of AUC across different subpopulations, while appropriately handling discreteness and noise in observed functional markers. Here, a novel data-driven approach that balances between bias and efficiency of the regression coefficient estimates is introduced. Finally, the framework is applied to rigorously evaluate pharmacokinetic features of renogram curves potentially useful for detecting kidney obstruction.
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Affiliation(s)
- Jeong Hoon Jang
- Underwood International College and Department of Applied Statistics, Yonsei University, Seoul, Republic of Korea
| | - Amita Manatunga
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia, USA
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Moneke I, Ögütür E, Chatterjee S, Haberecker M, Jang JH, Fähndrich S, Senbaklavaci Ö, Faccioli E, Opitz I, Passlick B, Diederichs S, Jungraithmayr W. CD26-inhibition correlates with the absence of chronic lung allograft dysfunction and decreases fibroblast activity in vitro. Br J Surg 2022. [DOI: 10.1093/bjs/znac176.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Objective
Chronic lung allograft dysfunction (CLAD) limits the survival after lung transplantation (Tx). CLAD is characterized by progressive fibrosis of small airways and lung parenchyma. No effective therapy is available that reverses or prevents CLAD. CD26 is a molecule with enzymatic activity also playing a key role in the progression of fibrotic diseases. Here, we analyzed the inhibitory effect of CD26 on fibroblast activity in vitro and the role of CD26-inhibition on allograft rejection in lung transplant patients.
Methods
Profibrogenic mRNA and protein levels were analyzed in vitro on the CD26-expressing fibroblast cell line Wi-38 using RT-qPCR and Western blot. CD26 was inhibited by Vildagliptin. Migration and proliferation activity of activated fibroblasts were analyzed by Incucyte® and Celltiter-Glo®. Characteristics of patients undergoing lung Tx between 2004 and 2021 were reviewed. Lung biopsies were analyzed by immunohistochemistry (IHC) for CD26.
Results
In vitro, the expression of profibrogenic genes (αSMA, FAPα, IGFBP7, Collagen 3 and Fibronectin) was significantly reduced in activated lung fibroblasts by Vildagliptin treatment. Also, migration and proliferation activity were attenuated by Vildagliptin. In 221 patients analyzed, CLAD was absent in 34 patients treated with the CD26-inhibitor Sitagliptin vs. an incidence of 18% in patients without Sitagliptin intake (p=0.02). Five-year survival in patients on Sitagliptin was significantly improved vs. patients without CD26-inhibitor intake (80% vs. 58%, p=0.006). Likewise, the incidence of acute cellular rejection (ACR) was significantly reduced in patients on Sitagliptin (7% vs. 35%, p=0.01). IHC of patient lung biopsies showed expression of CD26 in perifibrotic areas of CLAD lesions. Additional clinical data from University Hospital Zurich and from University Hospital Padua confirmed the finding that Sitagliptin intake correlated with the absence of acute and chronic allograft rejection.
Conclusion
CD26-inhibition attenuates key pro-fibrotic mediators and fibroblast activity in vitro. Impressively, patients on CD26-inhibitor did not show any CLAD. Moreover, ACR was significantly reduced. Gliptins which are in routine clinical use for the treatment of type II diabetes therefore seem to have great potential to be repurposed for a novel clinical application against lung allograft rejection.
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Affiliation(s)
- I Moneke
- Department of Thoracic Surgery, University Medical Center Freiburg , Freiburg, Germany
| | - E Ögütür
- Department of Thoracic Surgery, University Medical Center Freiburg , Freiburg, Germany
| | - S Chatterjee
- Institute for Environmental Medicine, Perelmann School of Medicine, University of Pennsylvania , Philadelphia, USA
| | - M Haberecker
- Institute of Pathology, University Hospital Zurich , Zurich, Switzerland
| | - J H Jang
- Department of Thoracic Surgery, University Hospital Zurich , Zurich, Switzerland
| | - S Fähndrich
- Department of Pneumology, University Medical Center Freiburg , Freiburg, Switzerland
| | - Ö Senbaklavaci
- Department of Thoracic Surgery, University Medical Center Freiburg , Freiburg, Germany
| | - E Faccioli
- Department of Thoracic Surgery, University Hospital of Padua , Padua, Italy
- Department of Thoracic Surgery, University Hospital Zurich , Zurich, Switzerland
| | - I Opitz
- Department of Thoracic Surgery, University Hospital Zurich , Zurich, Switzerland
| | - B Passlick
- Department of Thoracic Surgery, University Medical Center Freiburg , Freiburg, Germany
| | - S Diederichs
- Department of Thoracic Surgery, University Medical Center Freiburg , Freiburg, Germany
- German Cancer Research Center RNA Biology & Cancer, , Heidelberg, Germany
| | - W Jungraithmayr
- Department of Thoracic Surgery, University Medical Center Freiburg , Freiburg, Germany
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Neumann D, Mayfield R, Sander AM, Jang JH, Bhamidipalli SS, Hammond FM. An Examination of Social Inferencing Skills in Males and Females Following Traumatic Brain Injury. Arch Phys Med Rehabil 2021; 103:937-943. [PMID: 34861235 DOI: 10.1016/j.apmr.2021.10.028] [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: 02/15/2021] [Revised: 09/28/2021] [Accepted: 10/25/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study examines sex differences in social inferencing deficits after traumatic brain injury (TBI), and examines the odds of males and females being impaired while controlling for potential confounders. DESIGN Cross-sectional survey. SETTING Outpatient.USA and a University in Canada. PARTICIPANTS One hundred five participants with TBI (60 males, 45 females) and 105 healthy controls (HC; 57 males, 48 females). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The Awareness of Social Inference Test (TASIT), which includes 1) Emotional Evaluation Test (EET), 2) Social Inference-Minimal (SI-M) test, and 3) Social Inference-Enriched (SI-E) test. RESULTS Within the HC sample, males and females performed similarly on all three TASIT subtests. Within the TBI group, males had significantly lower scores than females on EET (P = 0.03), SI-M (P=0.01) and SI-E (P=0.04). Using impairment cutoffs derived from the HC sample, significantly more males with TBI (30%) were impaired on the EET than females(16.7%); impairment was similar between males and females on SI-M and SI-E. When adjusting for executive functioning and education, the odds of being impaired on the EET did not significantly differ for males and females (OR = 0.47; 95% CI: 0.16 - 1.40; P = 0.18). CONCLUSIONS While more males with TBI have emotion perception deficits than females, the difference appears to be driven by education and executive functioning. Research is needed in larger samples with more definitive norms to better understand social inferencing impairments in males and females with TBI, and translation to interpersonal behaviors.
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Affiliation(s)
- Dawn Neumann
- Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, IN; Rehabilitation Hospital of Indiana, Indianapolis, IN.
| | - Ryan Mayfield
- Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, IN
| | - Angelle M Sander
- Division of Clinical Neuropsychology and Rehabilitation Psychology, H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine and Harris Health System, Houston, TX; Brain Injury Research Center, TIRR Memorial Hermann, Houston, TX
| | - Jeong Hoon Jang
- Department of Biostatistics and Health Data Science, Indiana University of Medicine, Indianapolis, IN
| | - Surya Sruthi Bhamidipalli
- Department of Biostatistics and Health Data Science, Indiana University of Medicine, Indianapolis, IN
| | - Flora M Hammond
- Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, IN; Rehabilitation Hospital of Indiana, Indianapolis, IN
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10
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Hammond FM, Zafonte RD, Tang Q, Jang JH. Carbamazepine for Irritability and Aggression after Traumatic Brain Injury: A Randomized, Placebo-Controlled Study. J Neurotrauma 2021; 38:2238-2246. [PMID: 33563104 DOI: 10.1089/neu.2020.7530] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
This study tested the hypothesis that carbamazepine (CBZ) reduces irritability/aggression among individuals >6 months post-traumatic brain injury (TBI). Seventy individuals were enrolled in a parallel-group, randomized, double-blind, placebo-controlled, forced-titration trial of CBZ (n = 35) versus placebo (n = 35). Participants were randomly assigned to receive CBZ or placebo 42 days with outcome assessed at baseline and Day 42. Dose was titrated up to 400 mg CBZ or placebo equivalent two times daily. Symptoms of irritability and aggression were measured using the Neuropsychiatric Inventory Irritability (NPI-I) and Aggression (NPI-A) domains as a composite measure (NPI-I/A). Global impression of change was recorded from participant, observer, and study clinician. The CBZ group did not differ significantly from the placebo group (p = 0.60 and 0.59 for NPI-I/A observer and participant ratings, respectively). High placebo effects were observed with minimal clinically important difference in observer NPI-I/A 57% in CBZ group and 77% in placebo group (p = 0.09). Findings were similar for participant ratings. Eighteen of 35 had therapeutic CBZ level ≥4. Therapeutic sample analysis revealed similar high placebo response and non-significant differences except clinician ratings favoring CBZ. Non-serious adverse events occurred more frequently in the CBZ group with greater nervous system effects. CBZ up to 400 mg two times daily was not superior to placebo at reducing irritability/aggression according observers and participants. Large placebo effects may have masked the detection of differences. Clinician rating metrics suggest benefit, and thus, CBZ should remain a treatment option for the experienced brain injury clinician. Data are provided that may aid treatment decisions.
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Affiliation(s)
- Flora M Hammond
- Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Physical Medicine and Rehabilitation, Carolinas Rehabilitation, Atrium Health, Charlotte, North Carolina, USA
- Rehabilitation Hospital of Indiana, Indianapolis, Indiana, USA
| | - Ross D Zafonte
- Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Brigham and Women's Hospital, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA
| | - Qing Tang
- Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jeong Hoon Jang
- Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana, USA
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11
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O'Sullivan MJ, Jang JH, Panariti A, Bedrat A, Ijpma G, Lemos B, Park JA, Lauzon AM, Martin JG. Airway Epithelial Cells Drive Airway Smooth Muscle Cell Phenotype Switching to the Proliferative and Pro-inflammatory Phenotype. Front Physiol 2021; 12:687654. [PMID: 34295265 PMCID: PMC8290262 DOI: 10.3389/fphys.2021.687654] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/03/2021] [Indexed: 12/13/2022] Open
Abstract
The increased mass of airway smooth muscle (ASM) in the airways of asthmatic patients may contribute to the pathology of this disease by increasing the capacity for airway narrowing. Evidence for the airway epithelium as a participant in ASM remodeling is accruing. To investigate mechanisms by which airway epithelial cells induce ASM cell (ASMC) proliferation, we have employed a co-culture model to explore markers of ASMC proliferative phenotype. Co-culture with epithelial cells led to incorporation of bromodeoxyuridine into ASMCs, indicating augmented proliferation and an associated increase in mRNA of the pro-proliferative co-transcription factor Elk1. Although the mitogen heparin-binding epidermal growth factor (HB-EGF) was augmented in the co-culture supernatant, the ASMC epidermal growth factor receptor (EGFR), an effector of HB-EGF induced proliferation, did not mediate epithelial-induced proliferation. The co-culture increased the expression of ASMC mRNA for the pro-inflammatory cytokines IL-6 and IL-8 as well as the pro-proliferative microRNA miR-210. The transcriptional repressor Max-binding protein (Mnt), a putative target of miR-210, was transcriptionally repressed in co-cultured ASMCs. Together, these data indicate that the airway epithelium-induced proliferative phenotype of ASMCs is not driven by EGFR signaling, but rather may be dependent on miR210 targeting of tumor suppressor Mnt.
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Affiliation(s)
- M J O'Sullivan
- Meakins-Christie Laboratories, McGill University Health Centre, Montreal, QC, Canada.,T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
| | - J H Jang
- Meakins-Christie Laboratories, McGill University Health Centre, Montreal, QC, Canada
| | - A Panariti
- Meakins-Christie Laboratories, McGill University Health Centre, Montreal, QC, Canada
| | - A Bedrat
- T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
| | - G Ijpma
- Meakins-Christie Laboratories, McGill University Health Centre, Montreal, QC, Canada
| | - B Lemos
- T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
| | - J A Park
- T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
| | - A M Lauzon
- Meakins-Christie Laboratories, McGill University Health Centre, Montreal, QC, Canada
| | - J G Martin
- Meakins-Christie Laboratories, McGill University Health Centre, Montreal, QC, Canada
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12
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Jang JH. Principal component analysis of hybrid functional and vector data. Stat Med 2021; 40:5152-5173. [PMID: 34160848 DOI: 10.1002/sim.9117] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 04/09/2021] [Accepted: 06/10/2021] [Indexed: 11/07/2022]
Abstract
We propose a practical principal component analysis (PCA) framework that provides a nonparametric means of simultaneously reducing the dimensions of and modeling functional and vector (multivariate) data. We first introduce a Hilbert space that combines functional and vector objects as a single hybrid object. The framework, termed a PCA of hybrid functional and vector data (HFV-PCA), is then based on the eigen-decomposition of a covariance operator that captures simultaneous variations of functional and vector data in the new space. This approach leads to interpretable principal components that have the same structure as each observation and a single set of scores that serves well as a low-dimensional proxy for hybrid functional and vector data. To support practical application of HFV-PCA, the explicit relationship between the hybrid PC decomposition and the functional and vector PC decompositions is established, leading to a simple and robust estimation scheme where components of HFV-PCA are calculated using the components estimated from the existing functional and classical PCA methods. This estimation strategy allows flexible incorporation of sparse and irregular functional data as well as multivariate functional data. We derive the consistency results and asymptotic convergence rates for the proposed estimators. We demonstrate the efficacy of the method through simulations and analysis of renal imaging data.
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Affiliation(s)
- Jeong Hoon Jang
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana, USA
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13
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Jang JH, Manatunga AK, Chang C, Long Q. A Bayesian multiple imputation approach to bivariate functional data with missing components. Stat Med 2021; 40:4772-4793. [PMID: 34102703 PMCID: PMC9125166 DOI: 10.1002/sim.9093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 04/06/2021] [Accepted: 05/26/2021] [Indexed: 11/08/2022]
Abstract
Existing missing data methods for functional data mainly focus on reconstructing missing measurements along a single function-a univariate functional data setting. Motivated by a renal study, we focus on a bivariate functional data setting, where each sampling unit is a collection of two distinct component functions, one of which may be missing. Specifically, we propose a Bayesian multiple imputation approach based on a bivariate functional latent factor model that exploits the joint changing patterns of the component functions to allow accurate and stable imputation of one component given the other. We further extend the framework to address multilevel bivariate functional data with missing components by modeling and exploiting inter-component and intra-subject correlations. We develop a Gibbs sampling algorithm that simultaneously generates multiple imputations of missing component functions and posterior samples of model parameters. For multilevel bivariate functional data, a partially collapsed Gibbs sampler is implemented to improve computational efficiency. Our simulation study demonstrates that our methods outperform other competing methods for imputing missing components of bivariate functional data under various designs and missingness rates. The motivating renal study aims to investigate the distribution and pharmacokinetic properties of baseline and post-furosemide renogram curves that provide further insights into the underlying mechanism of renal obstruction, with post-furosemide renogram curves missing for some subjects. We apply the proposed methods to impute missing post-furosemide renogram curves and obtain more refined insights.
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Affiliation(s)
- Jeong Hoon Jang
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Amita K Manatunga
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Changgee Chang
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Qi Long
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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14
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Bosslet GT, Pollak M, Jang JH, Roll R, Sperling M, Khan B. The effect of in-person primary and secondary school instruction on county-level SARS-CoV-2 spread in Indiana. Clin Infect Dis 2021; 74:17-23. [PMID: 33846706 PMCID: PMC8083360 DOI: 10.1093/cid/ciab306] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Indexed: 11/17/2022] Open
Abstract
Objective To determine the county-level effect of in-person primary and secondary school reopening on daily cases of SARS-CoV-2 in Indiana. Methods This is a county-level population-based study using a panel data regression analysis of the proportion of in-person learning to evaluate an association with community-wide daily new SARS-CoV-2 cases. The study period was July 12-October 6, 2020. We included 73 out of 92 (79.3%) Indiana counties in the analysis, accounting for 85.7% of school corporations and 90.6% of student enrollment statewide. The primary exposure was the proportion of students returning to in-person instruction. The primary outcome was the daily new SARS-CoV-2 cases per 100,000 residents at the county level. Results There is a statistically significant relationship between the proportion of students attending K-12 schools in-person and the county level daily cases of SARS-CoV-2 28 days later. For all ages, the coefficient of interest (β) is estimated at 3.36 (95% CI: 1.91—4.81; p < 0.001). This coefficient represents the effect of a change the proportion of students attending in-person on new daily cases 28 days later. For example, a 10 percentage point increase in K-12 students attending school in-person is associated with a daily increase in SARS-CoV-2 cases in the county equal to 0.336 cases/100,000 residents of all ages. Conclusion In-person primary and secondary school is associated with a statistically significant but proportionally small increase in the spread of SARS-CoV-2 cases.
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Affiliation(s)
- Gabriel T Bosslet
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Micah Pollak
- School of Business and Economics, Indiana University Northwest, Gary, IN, United States
| | - Jeong Hoon Jang
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Rebekah Roll
- Indiana University School of Medicine, Indianapolis, IN, United States
| | - Mark Sperling
- School of Education, Indiana University Northwest, Gary, IN, United States
| | - Babar Khan
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States.,Regenstrief Institute, Indianapolis, IN, United States
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15
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Son JW, Choi SH, Jang JH, Koh JT, Oh WM, Hwang YC, Lee BN. Irisin promotes odontogenic differentiation and angiogenic potential in human dental pulp cells. Int Endod J 2020; 54:399-412. [PMID: 33089893 DOI: 10.1111/iej.13435] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 10/19/2020] [Accepted: 10/19/2020] [Indexed: 12/31/2022]
Abstract
AIM To determine whether irisin, a newly discovered myokine that links exercise-induced and metabolic homeostasis, is able to promote odontogenic differentiation and angiogenesis in human dental pulp cells (HDPCs). METHODOLOGY Cell viability in the presence of irisin was measured. Real-time PCR and Western blot analysis were performed to evaluate the expression levels of irisin, odontogenic and angiogenic markers. The involvement of mitogen-activated protein kinase (MAPK) and the protein kinase B (Akt) signalling pathway was evaluated by Western blot. To evaluate mineralization nodule formation, alkaline phosphatase (ALP) staining and alizarin red S staining were performed. Scratch wound assays were performed to evaluate the effects of irisin on cell migration. The data were analysed using one-way analysis of variance (anova) followed by Tukey post hoc test and Student's t-test. Statistical significance was considered at P < 0.05. RESULTS Irisin significantly promoted odontogenic differentiation as evidenced by formation of mineralized nodules, induction of ALP activity and upregulation of odontogenic and angiogenic markers (P < 0.05). Scratch wound assays revealed that irisin significantly increased migration of HDPCs (P < 0.05). Phosphorylation of both MAPK and Akt was increased by irisin. MAPK and Akt inhibitors inhibited mineralization, cell migration and the increased expression of odontogenic and angiogenic markers. CONCLUSIONS Irisin promoted odontogenic differentiation and mineralization and has the potential for angiogenesis through activation of the MAPK and Akt signalling pathways in HDPCs.
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Affiliation(s)
- J W Son
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - S H Choi
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - J H Jang
- Department of Conservative Dentistry, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - J T Koh
- Department of Pharmacology and Dental Therapeutics, Hard-tissue Biointerface Research Center, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - W M Oh
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - Y C Hwang
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - B N Lee
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
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16
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Neumann D, Mayfield R, Sander A, Hammond F, Bhamidipalli S, Jang JH. Does Social Inferencing Differ in Men and Women after TBI? Arch Phys Med Rehabil 2020. [DOI: 10.1016/j.apmr.2020.09.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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17
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Neumann D, Sander A, Bhamidipalli S, Jang JH, Hammond F. Sex Differences in Aggression, Anxiety, and Depression After TBI. Arch Phys Med Rehabil 2020. [DOI: 10.1016/j.apmr.2020.09.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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18
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Abstract
BACKGROUND AND PURPOSE Previous data suggest patient demographics and clinical presentation are primary predictors of motor recovery poststroke, with minimal contributions of physical interventions. Other studies indicate consistent associations between the amount and intensity of stepping practice with locomotor outcomes. The goal of this study was to determine the relative contributions of these combined variables to locomotor outcomes poststroke across a range of patient demographics and baseline function. METHODS Data were pooled from 3 separate trials evaluating the efficacy of high-intensity training, low-intensity training, and conventional interventions. Demographics, clinical characteristics, and training activities from 144 participants >1-month poststroke were included in stepwise regression analyses to determine their relative contributions to locomotor outcomes. Subsequent latent profile analyses evaluated differences in classes of participants based on their responses to interventions. RESULTS Stepwise regressions indicate primary contributions of stepping activity on locomotor outcomes, with additional influences of age, duration poststroke, and baseline function. Latent profile analyses revealed 2 main classes of outcomes, with the largest gains in those who received high-intensity training and achieved the greatest amounts of stepping practice. Regression and latent profile analyses of only high-intensity training participants indicated age, baseline function, and training activities were primary determinants of locomotor gains. Participants with the smallest gains were older (≈60 years), presented with slower gait speeds (<0.40 m/s), and performed 600 to 1000 less steps/session. CONCLUSIONS Regression and cluster analyses reveal primary contributions of training interventions on mobility outcomes in patients >1-month poststroke. Age, duration poststroke, and baseline impairments were secondary predictors. Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02507466 and NCT01789853.
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Affiliation(s)
- T. George Hornby
- Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis IN
- Rehabilitation Hospital of Indiana, Indianapolis, IN
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Christopher E. Henderson
- Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis IN
- Rehabilitation Hospital of Indiana, Indianapolis, IN
| | - Carey L. Holleran
- Division of Physical Therapy, Department of Neurology, Washington University School of Medicine, St. Louis, MO
| | - Linda Lovell
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL
- Shirley Ryan Ability Lab, Chicago, IL
| | - Elliot J. Roth
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL
- Shirley Ryan Ability Lab, Chicago, IL
| | - Jeong Hoon Jang
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN
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19
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Aldrete S, Jang JH, Easley KA, Okulicz J, Dai T, Chen YN, Pino M, Agan BK, Maves RC, Paiardini M, Marconi VC. CD4 rate of increase is preferred to CD4 threshold for predicting outcomes among virologically suppressed HIV-infected adults on antiretroviral therapy. PLoS One 2020; 15:e0227124. [PMID: 31905222 PMCID: PMC6944336 DOI: 10.1371/journal.pone.0227124] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 12/12/2019] [Indexed: 11/30/2022] Open
Abstract
Objectives Immune non-responders (INR) have poor CD4 recovery and are associated with increased risk of serious events despite antiretroviral therapy (ART). A clinically relevant definition for INR is lacking. Methods We conducted a retrospective analysis of three large cohorts: Infectious Disease Clinic at the Atlanta Veterans Affairs Medical Center, the US Military HIV Natural History Study and Infectious Disease Program of the Grady Health System in Atlanta, Georgia. Two-stage modeling and joint model (JM) approaches were used to evaluate the association between CD4 (or CD4/CD8 ratio) slope within two years since ART initiation and a composite endpoint (AIDS, serious non-AIDS events and death) after two years of ART. We compared the predictive capacity of four CD4 count metrics (estimated CD4 slope, estimated CD4/CD8 ratio slope during two years following ART initiation and CD4 at 1 and 2 years following ART initiation) using Cox regression models. Results We included 2,422 patients. Mean CD4 slope (±standard error) during two years of ART was 102 ± 2 cells/μl/year (95% confidence interval: 98–106 cells/μl/year), this increase was uniform among the three cohorts (p = 0.80). There were 267 composite events after two years on ART. Using the JM approach, a CD4 slope ≥100 cells/μL/year or CD4/CD8 ratio slope >0.1 higher rate per year were associated with lower composite endpoint rates (adjusted hazard ratio [HR] = 0.80, p = 0.04 and HR = 0.75 p<0.01, respectively). All four CD4 metrics showed modest predictive capacity. Conclusions Using a complex JM approach, CD4 slope and CD4/CD8 ratio slope the first two years after ART initiation were associated with lower rates of the composite outcome. Moreover, the uniformity observed in the mean CD4 slope regardless of the cohort suggests a common CD4 response pattern independent of age or CD4 nadir. Given the consistency observed with CD4 slope, availability and ease of interpretation, this study provides strong rationale for using CD4 gains <100 cells/μl/year to identify patients at risk for adverse events.
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Affiliation(s)
- Sol Aldrete
- Division of Infectious Diseases, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
- * E-mail:
| | - Jeong Hoon Jang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Kirk A. Easley
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Jason Okulicz
- Division of Internal Medicine and Infectious Disease Service, San Antonio Military Medical Center, San Antonio, Texas, United States of America
| | - Tian Dai
- Amgen Inc, Thousands Oaks, California, United States of America
| | - Yi No Chen
- Department of Epidemiology, Emory University, Atlanta, Georgia, United States of America
| | - Maria Pino
- Division of Microbiology and Immunology, Yerkes Non-Human Primates Research Center and Emory Vaccine Center, Atlanta, Georgia, United States of America
| | - Brian K. Agan
- Department of Preventive Medicine and Biostatistics, Infectious Diseases Clinical Research Program, Uniformed Services University of the Health Sciences and Henry M. Jackson Foundation for the Advancement of Military Medicine, Rockville, Maryland, United States of America
| | - Ryan C. Maves
- Division of Infectious Diseases, Naval Medical Center San Diego, San Diego, California, United States of America
| | - Mirko Paiardini
- Division of Microbiology and Immunology, Yerkes Non-Human Primates Research Center and Emory Vaccine Center, Atlanta, Georgia, United States of America
| | - Vincent C. Marconi
- Division of Microbiology and Immunology, Yerkes Non-Human Primates Research Center and Emory Vaccine Center, Atlanta, Georgia, United States of America
- Division of Infectious Diseases, School of Medicine, Emory University, Atlanta, Georgia, United States of America
- Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- Atlanta Veterans Affairs Medical Center, Decatur, Georgia, United States of America
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20
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Chang C, Jang JH, Manatunga A, Taylor AT, Long Q. A Bayesian Latent Class Model to Predict Kidney Obstruction in the Absence of Gold Standard. J Am Stat Assoc 2020; 115:1645-1663. [PMID: 34113054 DOI: 10.1080/01621459.2019.1689983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Kidney obstruction, if untreated in a timely manner, can lead to irreversible loss of renal function. A widely used technology for evaluations of kidneys with suspected obstruction is diuresis renography. However, it is generally very challenging for radiologists who typically interpret renography data in practice to build high level of competency due to the low volume of renography studies and insufficient training. Another challenge is that there is currently no gold standard for detection of kidney obstruction. Seeking to develop a computer-aided diagnostic (CAD) tool that can assist practicing radiologists to reduce errors in the interpretation of kidney obstruction, a recent study collected data from diuresis renography, interpretations on the renography data from highly experienced nuclear medicine experts as well as clinical data. To achieve the objective, we develop a statistical model that can be used as a CAD tool for assisting radiologists in kidney interpretation. We use a Bayesian latent class modeling approach for predicting kidney obstruction through the integrative analysis of time-series renogram data, expert ratings, and clinical variables. A nonparametric Bayesian latent factor regression approach is adopted for modeling renogram curves in which the coefficients of the basis functions are parameterized via the factor loadings dependent on the latent disease status and the extended latent factors that can also adjust for clinical variables. A hierarchical probit model is used for expert ratings, allowing for training with rating data from multiple experts while predicting with at most one expert, which makes the proposed model operable in practice. An efficient MCMC algorithm is developed to train the model and predict kidney obstruction with associated uncertainty. We demonstrate the superiority of the proposed method over several existing methods through extensive simulations. Analysis of the renal study also lends support to the usefulness of our model as a CAD tool to assist less experienced radiologists in the field.
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Affiliation(s)
- Changgee Chang
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania
| | - Jeong Hoon Jang
- Department of Biostatistics and Bioinformatics, Emory University
| | - Amita Manatunga
- Department of Biostatistics and Bioinformatics, Emory University
| | - Andrew T Taylor
- Department of Radiology and Imaging Sciences, Emory University
| | - Qi Long
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania
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21
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Jang JH, Peng L, Manatunga AK. Assessing alignment between functional markers and ordinal outcomes based on broad sense agreement. Biometrics 2019; 75:1367-1379. [PMID: 30998261 DOI: 10.1111/biom.13063] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 03/08/2019] [Accepted: 03/18/2019] [Indexed: 11/27/2022]
Abstract
Functional markers and their quantitative features (eg, maximum value, time to maximum, area under the curve [AUC], etc) are increasingly being used in clinical studies to diagnose diseases. It is thus of interest to assess the diagnostic utility of functional markers by assessing alignment between their quantitative features and an ordinal gold standard test that reflects the severity of disease. The concept of broad sense agreement (BSA) has recently been introduced for studying the relationship between continuous and ordinal measurements, and provides a promising tool to address such a question. Our strategy is to adopt a general class of summary functionals (SFs), each of which flexibly captures a different quantitative feature of a functional marker, and study its alignment according to an ordinal outcome via BSA. We further illustrate the proposed framework using three special classes of SFs (AUC-type, magnitude-specific, and time-specific) that are widely used in clinical settings. The proposed BSA estimator is proven to be consistent and asymptotically normal given a consistent estimator for the SF. We further provide an inferential framework for comparing a pair of candidate SFs in terms of their importance on the ordinal outcome. Our simulation results demonstrate satisfactory finite-sample performance of the proposed framework. We demonstrate the application of our methods using a renal study.
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Affiliation(s)
- Jeong Hoon Jang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Limin Peng
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Amita K Manatunga
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia
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22
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Oh S, Jang JH, Kim HJ, Seo NS, Byun SH, Kim SW, Kim DS. Long-term Follow-up of Complicated Crown Fracture With Fragment Reattachment: Two Case Reports. Oper Dent 2019; 44:574-580. [PMID: 30702408 DOI: 10.2341/18-201-t] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Two cases of complicated crown fracture of the maxillary incisors were restored using the fragment reattachment technique. Root canal treatment was performed, and the fractured fragment was bonded to the tooth structure using a dentin adhesive system and a flowable composite resin, followed by the insertion of a fiber post using dual-cured resin cement. Reattached fragments have shown reliable prognosis without inflammatory signs around bonded junctions after long-term follow-up.
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23
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Jang JH, Manatunga AK, Taylor AT, Long Q. Overall indices for assessing agreement among multiple raters. Stat Med 2018; 37:4200-4215. [PMID: 30062738 DOI: 10.1002/sim.7912] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 05/31/2018] [Accepted: 06/25/2018] [Indexed: 11/09/2022]
Abstract
The need to assess agreement exists in various clinical studies where quantifying inter-rater reliability is of great importance. Use of unscaled agreement indices, such as total deviation index and coverage probability (CP), is recommended for two main reasons: (i) they are intuitive in a sense that interpretations are tied to the original measurement unit; (ii) practitioners can readily determine whether the agreement is satisfactory by directly comparing the value of the index to a prespecified tolerable CP or absolute difference. However, the unscaled indices were only defined in the context of comparing two raters or multiple raters that assume homogeneity of variances across raters. In this paper, we introduce a set of overall indices based on the root mean square of pairwise differences that are unscaled and can be used to evaluate agreement among multiple raters that often exhibit heterogeneous measurement processes in practice. Furthermore, we propose another overall agreement index based on the root mean square of pairwise differences that is scaled and extends the concept of the recently proposed relative area under CP curve in the presence of multiple raters. We present the definitions of overall indices and propose inference procedures in which bootstrap methods are used for the estimation of standard errors. We assess the performance of the proposed approach and demonstrate its superiority over the existing methods when raters exhibit heterogeneous measurement processes using simulation studies. Finally, we demonstrate the application of our methods using a renal study.
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Affiliation(s)
- Jeong Hoon Jang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Amita K Manatunga
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Andrew T Taylor
- Department of Radiology and Imaging Sciences, School of Medicine, Emory University, Atlanta, Georgia
| | - Qi Long
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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Jang JH, Wu YN, Kim SJ, Zhang YH. P927Neuronal nitric oxide synthase-beta in the myofilament and maintains sarcomere structure in cardiomyocyte. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p927] [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: 11/13/2022] Open
Affiliation(s)
- J H Jang
- Seoul National University, Seoul, Korea Republic of
| | - Y N Wu
- Seoul National University, Seoul, Korea Republic of
| | - S J Kim
- Seoul National University, Seoul, Korea Republic of
| | - Y H Zhang
- Seoul National University, Seoul, Korea Republic of
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Jang JH, Moon J, Ha HY, Lee TH, Suh DW. Quantum-mechanical analysis of effect of alloying elements on ε-martensite start temperature of steels. Sci Rep 2017; 7:17860. [PMID: 29259306 PMCID: PMC5736593 DOI: 10.1038/s41598-017-18230-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 08/25/2017] [Accepted: 12/07/2017] [Indexed: 12/01/2022] Open
Abstract
With regard to the transformation mechanism of austenitic high manganese steel, the prediction of the ε-martensite start temperature is a critical consideration in alloy design. Evaluation of the ε-martensite start temperature makes it possible to predict the microstructure and to understand the phase transformation occurring during deformation. Here we use the quantum mechanical calculation of random alloys to understand the physics for ε-martensitic transformation in steels. We could find the linear relationship between the measured ε-martensite start temperatures and the crystal structure stability for various compositions. We also could estimate the effect of several alloying elements. It is expected that the effect of decreasing the temperatures for the same amount of alloying elements addition will be larger moving farther from Group VIII. By creating a free-energy model that reflects the temperature effect, we were able to calculate the average driving force required for the ε-martensitic transformations.
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Affiliation(s)
- J H Jang
- Ferrous Alloy Department, Korea Institute of Materials Science, Changwon, 51508, Republic of Korea.
| | - J Moon
- Ferrous Alloy Department, Korea Institute of Materials Science, Changwon, 51508, Republic of Korea
| | - H-Y Ha
- Ferrous Alloy Department, Korea Institute of Materials Science, Changwon, 51508, Republic of Korea
| | - T-H Lee
- Ferrous Alloy Department, Korea Institute of Materials Science, Changwon, 51508, Republic of Korea
| | - D-W Suh
- Graduate Institute of Ferrous Technology, POSTECH, Pohang, 37673, Republic of Korea
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Shin WC, Moon NH, Jang JH, Park KY, Suh KT. Anterolateral femoral bowing and loss of thigh muscle are associated with occurrence of atypical femoral fracture: Effect of failed tension band mechanism in mid-thigh. J Orthop Sci 2017; 22:99-104. [PMID: 27720510 DOI: 10.1016/j.jos.2016.09.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 05/07/2016] [Revised: 08/23/2016] [Accepted: 09/10/2016] [Indexed: 02/09/2023]
Abstract
BACKGROUND The purpose of this study was to characterize anterolateral bowing of the femur using X-rays and muscular atrophy in the mid-thigh using computed tomography (CT) in patients with atypical femoral fractures (AFFs). We then compared the results with those of an intertrochanteric fracture to understand whether these measures act as causative factors of AFFs. METHODS From January 2009 to December 2015, 37 patients with complete AFF and 12 patients with incomplete AFF were enrolled in this study. Lateral femoral bowing, anterior femoral bowing, cross-sectional area (CSA), and attenuation coefficient of thigh muscles in the AFF group are measured and compare with those in the intertrochanteric fracture group. RESULTS Lateral and anterior femoral bowing in the AFF group were significantly higher than those in the intertrochanteric fracture group. The level of fracture was found to be significantly associated with lateral and anterior femoral bowing (r = 0.569, r2 = 0.324, p < 0.001; r = -0.530, r2 = 0.281, p < 0.001, respectively). Total CSA and CSA of anterior and medial compartments were significantly lower in the AFF group (p < 0.05). The attenuation coefficient of the total thigh muscle and all three compartments in the AFF group were significantly lower than those in the intertrochanteric fracture group (p < 0.05). CONCLUSIONS This study demonstrated that anterolateral femoral bowing and loss of thigh muscle were highly associated with the occurrence of AFFs.
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Affiliation(s)
- W C Shin
- Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea
| | - N H Moon
- Department of Orthopaedic Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Hospital, South Korea.
| | - J H Jang
- Department of Orthopaedic Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Hospital, South Korea
| | - K Y Park
- Department of Orthopaedic Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Hospital, South Korea
| | - K T Suh
- Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea
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Lee MH, Jang JH, Min HJ, Jang HI, Nah JH, Lyu CJ, Han KS, Won JH, Lee YH, Chong SY, Mun YC, Lee WS, Kim SJ, Kim I. Predictors of general discomfort, limitations in activities of daily living and intention of a second donation in unrelated hematopoietic stem cell donation. Bone Marrow Transplant 2016; 52:258-263. [PMID: 27819689 DOI: 10.1038/bmt.2016.260] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 08/22/2016] [Accepted: 08/24/2016] [Indexed: 11/09/2022]
Abstract
We performed a retrospective study of 1868 consecutive unrelated donors to predict the risk factors related to general discomfort, limitations in activities of daily living (ADLs) and intention of a second donation in hematopoietic stem cell (HSC) donation. General discomfort and limitations in ADLs were assessed by numerical measurement (scores of 0-10) and donor's intention of a second donation by yes or no reply. The post-donation questionnaires were completed within 48 h after HSC collection and at 1 week, 4 weeks, and 4 months thereafter. Predictors of general discomfort included female sex (P<0.0001), bone marrow (BM) collection (P<0.0001) or PBSC collection through a central line (CL; P=0.0349), 2-day collection (P=0.0150) and negative or undetermined intention of a second donation on day 1 (P<0.0001). Predictors of limitations in ADLs included age group of 30-39 years (P=0.0046), female sex (P<0.0001), BM collection (P<0.0001) or PBSC collection through a CL (P<0.0001) and negative or undetermined intention of a second donation on day 1 (P<0.0001). The only predictor of positive intention of a second donation was male sex (P=0.0007). Age, sex and collection method and period should be considered risk factors when unrelated HSC donation is performed.
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Affiliation(s)
- M H Lee
- Division of Hematology-Oncology, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, South Korea
| | - J H Jang
- Korea Marrow Donor Program, Seoul, South Korea
| | - H J Min
- Clinical Research Institute, Konkuk University Medical Center, Seoul, South Korea
| | - H I Jang
- Korea Marrow Donor Program, Seoul, South Korea
| | - J H Nah
- Korea Marrow Donor Program, Seoul, South Korea
| | - C J Lyu
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - K-S Han
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - J H Won
- Department of Hematology-Oncology, Soon Chun Hyang University Hospital, Seoul, South Korea
| | - Y-H Lee
- Department of Pediatrics, Hanyang University Medical Center, Hanyang University College of Medicine, Seoul, South Korea
| | - S Y Chong
- Department of Internal Medicine, Bundang Cha Hospital, Seongnam, South Korea
| | - Y C Mun
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, South Korea
| | - W S Lee
- Department of Hematology and Oncology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - S J Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - I Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
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Jang JH, Janker F, Arni S, Yamada Y, De Meester I, Weder W, Jungraithmayr W. CD26/DPP4-inhibition suppresses lung cancer growth via increased NK cell and macrophage recruitment. Zentralbl Chir 2016. [DOI: 10.1055/s-0036-1587531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Yamada Y, Laube I, Jang JH, Maeyashiki T, Bonvini J, Inci I, Beck Schimmer B, Weder W, Jungraithmayr W. Sevoflurane preconditioning attenuates lung injury after mouse lung transplantation. Zentralbl Chir 2016. [DOI: 10.1055/s-0036-1587544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Jung YH, Jang JH, Kang H, Choi WS, Choi YK, Song WC, Song BS, Lee JH, Hong B. Properties of Dye-Sensitized Solar Cells Using Carbon Nanowall Counter Electrodes. J Nanosci Nanotechnol 2016; 16:5302-5304. [PMID: 27483920 DOI: 10.1166/jnn.2016.12215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This research investigates plasma-treated and metal-coated carbon nanowalls (CNWs) for use as counter electrodes of dye-sensitized solar cells (DSSCs). The CNWs were synthesized on a fluorine-tin-oxide (FTO) glass substrate using the microwave plasma-enhanced chemical vapor deposition (PECVD) system with methane (CH4) gas. The post-plasma treatment was performed on the CNWs with hydrogen (H2) plasma using PECVD, and the CNWs were sputter-coated with metal films using the RF magnetron sputtering system with a four-inch tungsten (W) target. Then the post-plasma-treated and metal-coated CNWs were used as counter electrodes for the fabrication of the DSSCs. Field-emission scanning electron microscopy (FE-SEM) was performed to obtain cross-sectional and planar images of the grown CNWs. The energy conversion efficiencies of the DSSCs manufactured using the post-plasma-treated and metal-layer-coated CNWs as the counter electrodes were measured.
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Abstract
The traditional techniques involving an oblique tunnel or triangular wedge resection to approach a central or mixed-type physeal bar are hindered by poor visualisation of the bar. This may be overcome by a complete transverse osteotomy at the metaphysis near the growth plate or a direct vertical approach to the bar. Ilizarov external fixation using small wires allows firm fixation of the short physis-bearing fragment, and can also correct an associated angular deformity and permit limb lengthening. We accurately approached and successfully excised ten central- or mixed-type bars; six in the distal femur, two in the proximal tibia and two in the distal tibia, without damaging the uninvolved physis, and corrected the associated angular deformity and leg-length discrepancy. Callus formation was slightly delayed because of periosteal elevation and stretching during resection of the bar. The resultant resection of the bar was satisfactory in seven patients and fair in three as assessed using a by a modified Williamson-Staheli classification.
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Affiliation(s)
- H T Kim
- Pusan National University, 1Ga-10, Ami-Dong, Seo-Gu Busan, 602-739, Korea
| | - K P Lim
- Pusan National University, 1Ga-10, Ami-Dong, Seo-Gu Busan, 602-739, Korea
| | - J H Jang
- Pusan National University, 1Ga-10, Ami-Dong, Seo-Gu Busan, 602-739, Korea
| | - T Y Ahn
- Pusan National University, 1Ga-10, Ami-Dong, Seo-Gu Busan, 602-739, Korea
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Lee SK, Ahn KJ, Jang JH, Choi HS, Jung SL, Kim BS. Artefacts at a glance: differentiating features of artefactual stenosis from true stenosis at the genu of the petrous internal carotid artery on TOF MRA. Clin Radiol 2015; 71:e72-8. [PMID: 26652609 DOI: 10.1016/j.crad.2015.10.023] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 10/05/2015] [Accepted: 10/20/2015] [Indexed: 10/22/2022]
Abstract
AIM To investigate the distinguishing features of artefactual stenosis from true stenosis at the genu of the petrous internal carotid artery (ICA) on time of flight (TOF) magnetic resonance angiography (MRA). MATERIALS AND METHODS Both TOF MRA and digital subtraction angiography (DSA) were performed in 65 patients with 74 vessels who demonstrated artefactual stenosis in 43 patients with 50 vessels and true stenosis in 22 patients with 24 vessels. The following findings of the signal loss were compared between the two groups: (1) margin, (2) darkness, (3) the presence of bilaterality, (4) the presence of tandem arterial stenosis, (5) the location of the epicentre, and (6) length. RESULTS In five out of the six evaluated items, statistically significant differences were present between the two groups (p<0.00 in all five items). Artefactual stenosis more frequently showed signal loss with ill-defined margins (47/50), less darkness compared to the background darkness (46/50), the absence of tandem arterial stenosis (35/50), epicentre at the genu (34/50), and shorter length (2.57 ± 0.68 mm). No significant difference was noted in the presence of bilaterality of signal loss between the two groups (p=0.706). CONCLUSION Several MRA features can be useful for suggesting artefactual stenosis rather than true stenosis at the genu of the petrous ICA on TOF MRA.
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Affiliation(s)
- S K Lee
- Department of Radiology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, South Korea
| | - K J Ahn
- Department of Radiology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, South Korea.
| | - J H Jang
- Department of Radiology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, South Korea
| | - H S Choi
- Department of Radiology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, South Korea
| | - S L Jung
- Department of Radiology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, South Korea
| | - B S Kim
- Department of Radiology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, South Korea
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Abstract
Soft tissue reconstruction is needed to maintain the maximum length of the fingers in fingertip injury. The purpose of this study was to present an anterograde pedicle advancement flap technique, for the treatment of fingertip injuries, which involved a modification to the anterograde advancement flap by the dissection of the digital nerve and artery with a pedicle to advance the flap. This technique was used in 12 fingers in patients who had undergone soft tissue reconstruction of fingertip injuries between January 2012 and October 2013. The sizes of the flaps ranged from 8 × 7 mm to 14 × 10 mm. The mean length of advancement was 9.7 mm (range 7-13). The mean value of the static two-point discrimination test of the healed flaps was 5.1 mm (range 4-6) and the flaps survived in all the 12 cases. The modified anterograde pedicle advancement flap provides a reliable coverage of sensate soft tissue without bone shortening in fingertip injuries.Level II.
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Affiliation(s)
- S H Lee
- Department of Orthopaedic Surgery, Medical Research Institute, Pusan National University Hospital, Pusan, Republic of Korea
| | - J H Jang
- Department of Orthopaedic Surgery, Medical Research Institute, Pusan National University Hospital, Pusan, Republic of Korea
| | - J I Kim
- Department of Orthopaedic Surgery, Medical Research Institute, Pusan National University Hospital, Pusan, Republic of Korea
| | - S J Cheon
- Department of Orthopaedic Surgery, Medical Research Institute, Pusan National University Hospital, Pusan, Republic of Korea
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Park S, Jung CW, Jang JH, Kim SJ, Kim WS, Kim K. Incidence of infection according to intravenous immunoglobulin use in autologous hematopoietic stem cell transplant recipients with multiple myeloma. Transpl Infect Dis 2015. [PMID: 26201517 DOI: 10.1111/tid.12424] [Citation(s) in RCA: 18] [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] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Although intravenous immunoglobulin (IVIG) is not routinely recommended, many centers still use IVIG during the post-hematopoietic stem cell transplant (HSCT) period. METHOD A total of 162 multiple myeloma (MM) patients who underwent autologous (auto-) HSCT between January 2008 and June 2013 were retrospectively reviewed. Primary objective was determination of the impact of IVIG on post-transplant infection, and secondary objectives included identification of overall incidence of infection, type of infection, and risk factors for infection after auto-HSCT in MM patients. RESULTS After auto-HSCT, 53 of 162 patients (32.7%) experienced 104 infectious events. Upper respiratory infection was most common (n = 31, 29.8%) and pneumonia (n = 27, 26.0%) and herpes zoster (n = 15, 14.4%) came next. Among the identifiable organisms causing respiratory infection, influenza virus (n = 10) and Pneumococcus (n = 9) were predominant. Incidence of infection was not statistically different according to IVIG use (34.8% in IVIG (-) vs. 31.3% in IVIG (+), P = 0.631). Incidence of infection requiring hospitalization and multiple episodes of infection showed no difference between the groups (P = 0.147, P = 0.156). In a Cox proportional hazard model, none of the factors including age, gender, type of disease, stage, tandem (vs. single) transplantation,and IVIG was prognostic for infectious event after auto-HSCT (P = 0.955, hazard ratio 0.980 with 95% confidence interval 0.481-1.997 for IVIG). CONCLUSION In auto-HSCT recipients with MM, incidence of post-transplant infection was not different according to prophylactic IVIG use.
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Affiliation(s)
- S Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - C W Jung
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J H Jang
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S J Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - W S Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - K Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Yoon YA, Kim JS, Yoon CE, Jang JH, Kang ES. A new HLA-A*30 allele, A*30:81, identified by sequence-based typing. ACTA ACUST UNITED AC 2014; 84:582-3. [PMID: 25302674 DOI: 10.1111/tan.12435] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 07/21/2014] [Accepted: 08/05/2014] [Indexed: 11/29/2022]
Abstract
The new allele, HLA-A*30:81, differs from A*30:01:01 by one nucleotide substitution at codon 272 (CTG→ATG).
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Affiliation(s)
- Y A Yoon
- Division of Chronic Disease Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea
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Hwang LR, Cha S, Jong JE, Jang JH, Seo T. Acetylation changes at lysine 5 of histone H4 associated with lytic gene promoters during reactivation of Kaposi's sarcoma-associated herpesvirus. Acta Virol 2014; 58:282-6. [PMID: 25283865 DOI: 10.4149/av_2014_03_282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Kaposi's sarcoma-associated herpesvirus (KSHV) is a pathogenic agent of Kaposi's sarcoma, primary effusion lymphoma and multicentric Castleman's disease in humans. Similarly to other gammaherpesviruses such as Epstein-Barr virus (EBV) and herpesvirus saimiri (HVS), KSHV displays two alternative life cycles, latent and lytic one. The transactivation from latency to the lytic phase is the result of transcriptional changes in the KSHV genome caused by the replication and transcriptional activator (RTA). During KSHV reactivation, epigenetic modifications of histone protein on the viral genome occur, which regulate the transcriptional activation of a number of lytic genes. The reactivation of EBV from latency to lytic cycle, induced by an immediate-early Zta protein, was shown to be accompanied by acetylation of specific lysines in histone H4. Accordingly, we hypothesized that the RTA-induced transactivation of KSHV could also be accompanied by histone acetylation. To validate this hypothesis, we assayed alterations of acetyl-histone H4-lysine 5 (acH4K5) during the RTA-mediated KSHV reactivation. While the modified histone protein in a total cell lysate was not distinguished between control and RTA-expressed cells, upregulated acH4K5 was detected on several lytic gene promoter regions during KSHV reactivation. Our results clearly indicate that this epigenetic change is related to transcription of genes expressed in the lytic cycle of KSHV.
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Kim JH, Park CH, Perez RA, Lee HY, Jang JH, Lee HH, Wall IB, Shi S, Kim HW. Advanced biomatrix designs for regenerative therapy of periodontal tissues. J Dent Res 2014; 93:1203-11. [PMID: 25139364 DOI: 10.1177/0022034514540682] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Periodontitis is an inflammatory disease that causes loss of the tooth-supporting apparatus, including periodontal ligament, cementum, and alveolar bone. A broad range of treatment options is currently available to restore the structure and function of the periodontal tissues. A regenerative approach, among others, is now considered the most promising paradigm for this purpose, harnessing the unique properties of stem cells. How to make full use of the body's innate regenerative capacity is thus a key issue. While stem cells and bioactive factors are essential components in the regenerative processes, matrices play pivotal roles in recapitulating stem cell functions and potentiating therapeutic actions of bioactive molecules. Moreover, the positions of appropriate bioactive matrices relative to the injury site may stimulate the innate regenerative stem cell populations, removing the need to deliver cells that have been manipulated outside of the body. In this topical review, we update views on advanced designs of biomatrices-including mimicking of the native extracellular matrix, providing mechanical stimulation, activating cell-driven matrices, and delivering bioactive factors in a controllable manner-which are ultimately useful for the regenerative therapy of periodontal tissues.
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Affiliation(s)
- J H Kim
- Department of Nanobiomedical Science & BK21 PLUS NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan 330-714, Republic of Korea Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan 330-714, Republic of Korea
| | - C H Park
- Department of Nanobiomedical Science & BK21 PLUS NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan 330-714, Republic of Korea Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan 330-714, Republic of Korea
| | - R A Perez
- Department of Nanobiomedical Science & BK21 PLUS NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan 330-714, Republic of Korea Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan 330-714, Republic of Korea
| | - H Y Lee
- Department of Nanobiomedical Science & BK21 PLUS NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan 330-714, Republic of Korea Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan 330-714, Republic of Korea
| | - J H Jang
- Department of Biochemistry, Inha University School of Medicine, Incheon 400-712, Republic of Korea
| | - H H Lee
- Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan 330-714, Republic of Korea Department of Biomaterials Science, College of Dentistry, Dankook University, Cheonan 330-714, Republic of Korea
| | - I B Wall
- Department of Nanobiomedical Science & BK21 PLUS NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan 330-714, Republic of Korea Department of Biochemical Engineering, University College London, Torrington Place, London WC1E 7JE, United Kingdom
| | - S Shi
- Department of Nanobiomedical Science & BK21 PLUS NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan 330-714, Republic of Korea Center for Craniofacial Molecular Biology, Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - H W Kim
- Department of Nanobiomedical Science & BK21 PLUS NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan 330-714, Republic of Korea Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan 330-714, Republic of Korea Department of Biomaterials Science, College of Dentistry, Dankook University, Cheonan 330-714, Republic of Korea
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Lee SW, Jang JH, Kim BJ. Dysphagia could be the first presenting symptom of telbivudine-induced myopathy. Intern Med J 2014; 43:1048-9. [PMID: 24004397 DOI: 10.1111/imj.12237] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Accepted: 05/22/2013] [Indexed: 12/13/2022]
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Jang JH, Lee J, Kim JH, Lee YH, Ju YC, Lee JS. Isolation and identification of RANKL-induced osteoclast differentiation inhibitor from Pleurotus citrinopileatus. MYCOSCIENCE 2013. [DOI: 10.1016/j.myc.2012.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Kang W, Kim S, Lee S, Jeon E, Lee Y, Yun YR, Suh CK, Kim HW, Jang JH. Characterization and optimization of vascular endothelial growth factor(165) (rhVEGF(165)) expression in Escherichia coli. Protein Expr Purif 2012; 87:55-60. [PMID: 23108225 DOI: 10.1016/j.pep.2012.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Revised: 09/27/2012] [Accepted: 10/18/2012] [Indexed: 11/29/2022]
Abstract
Vascular endothelial growth factors(165) (VEGF(165)) is the most potent and widely used pro-angiogenic factor. Here we determined optimal culture condition of recombinant human VEGF(165) (rhVEGF(165)) in Escherichia coli (E. coli). rhVEGF(165) expression was the highest in 0.25% of L-arabinose induction concentration, at 20 °C induction temperature, and for 5 h induction time under the control of araBAD promoter using pBADHisA vector. In biological activity test, rhVEGF(165) significantly increased the proliferative activity of CPAE cells (p<0.001) and upregulated the expressions of endothelial cell growth-related genes, such as platelet endothelial cell adhesion molecule (PECAM-1), endothelial-specific receptor tyrosine kinase (TEK), kinase insert domain protein receptor (KDR), and tyrosine kinase with immunoglobulin-like and EGF-like domains 1 (TIE1) in calf pulmonary artery endothelial (CPAE) cells.
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Affiliation(s)
- W Kang
- Department of Biochemistry, Inha University School of Medicine, Incheon 400-712, Republic of Korea
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Jung WH, Kang DH, Han JY, Jang JH, Gu BM, Choi JS, Jung MH, Choi CH, Kwon JS. Aberrant ventral striatal responses during incentive processing in unmedicated patients with obsessive-compulsive disorder. Acta Psychiatr Scand 2011; 123:376-86. [PMID: 21175552 DOI: 10.1111/j.1600-0447.2010.01659.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Obsessive-compulsive disorder (OCD) is characterized by the dysfunction of control and reward mechanisms. However, only few neuroimaging studies of OCD have examined the reward processing. We examined the neural responses during incentive processing in OCD. METHOD Twenty unmedicated patients with OCD and 20 age-, sex-, and IQ-matched healthy controls underwent functional magnetic resonance imaging while performing a modified monetary incentive delay task. RESULTS Compared with controls, patients with OCD showed increased ventral striatal activation in the no-loss minus loss outcome contrast and a significant positive correlation between the ventral striatal activation and compulsion symptom severity. In addition, patients with OCD showed increased activations in the frontostriatal regions in the gain minus no-gain outcomes contrast. During loss anticipation, patients with OCD showed less activations in the lateral prefrontal and inferior parietal cortices. However, during gain anticipation, patients with OCD and healthy controls did not differ in the ventral striatal activation. CONCLUSION These findings provide neural evidence for altered incentive processing in unmedicated patients with OCD, suggesting an elevated sensitivity to negatively affect stimuli as well as dysfunction of the ventral striatum.
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Affiliation(s)
- W H Jung
- Clinical Cognitive Neuroscience Center, Neuroscience Institute, SNU-MRC, Seoul, South Korea
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Lee SH, Cheuh H, Yoo KH, Kim YJ, Sung KW, Koo HH, Kim DH, Kim SJ, Kim K, Jang JH, Jung CW. Hematopoietic stem cell transplantation from a related donor infected with influenza H1N1 2009. Transpl Infect Dis 2011; 13:548-50. [PMID: 21348910 DOI: 10.1111/j.1399-3062.2011.00616.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Cho DH, Jang JH, Lee SK, Choi MY, Koo MY, Hur SM, Bae SY, Kim SM, Choe JH, Lee JE, Kim JH, Kim JS, Nam SJ, Yang JH. Abstract P3-10-25: The Prognosis of Metaplastic Breast Cancer Patients Compare to Triple-Negative Breast Cancer Patients. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p3-10-25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Metaplastic breeast cancer (MBC) is a rare, heterogenous cancer characterized by admixture of adenocarcinoma with metaplastic elements, low hormone receptor expression and poor outcome. This study was planned to assess the clinicopathological chacteristics and immunohistochemical findings of MBC compared to invasive ductal carcinoma (IDC) including the triple-negative subtype (TN-IDC). Material and Methods: We retrospectively reviewed the medical records of 47 MBC and 1,346 IDC patients. Two hundred eighteen TN-IDC patients were included in the 1,346 IDC patients. Between 2005 and 2009, these patients were undergone surgical treatment at the Samsung Medical Center. Patients were reviewed clinicopathologic factors, immunohistochemistry of biologic factors such as ER, PR, HER-2, p53, Ki67, cytokeratine (CK) 5/6, epidermal growth factor receptor (EGFR), and treatment modalities (type of operation, use of chemotherapy, radiotherapy and hormone therapy). Result: The MBC patients presented with a larger tumor size (>T1, 66.0% vs. 44.3.%, P = 0.008), lower lymph node involvement (N0, 73.3% vs. 55.6%, P = 0.03), higher histologic (HG) and nuclear grade (NG) (HG3, 70.0% vs. 41.5%, P = 0.001; NG3,82.6% vs. 46.9%, P < 0.001), fewer estrogen receptor (ER), progesterone receptor (PR) and HER2 positivity (ER+, 4.3% vs. 69.2%, P < 0.001; PR+, 6.4% vs. 63.5%, P < 0.001; HER2+, 0% vs. 27.6%, P < 0.001), higher p53, CK5/6 and EGFR expression (p53+, 63.8% vs.38.8%, P < 0.001; CK5/6+, 71.9% vs.21.5%, P < 0.001; EGFR+, 93.9% vs.21.6%, P <0.001) and more TN subtypes (93.6% vs. 16.2%, P < 0.001) compared to the IDC group. There was no significant difference in clinicopathological characteristics with MBC and TN-IDC except EGFR over expression (EGFR+, 93.9% vs.69.0%, P = 0.017). In follow-up duration (median 30 months, range 2-56 months), seven (14.9%) MBC patients and 98 (7.2%) IDC patients recurred. The 3-year disease-free survival (DFS) rate was 78.1% in the MBC group and 91.1% in IDC group (P <0.001). The 3-year DFS rate was not significantly difference between MBC group and TN-IDC group (78.1% vs. 84.9%, P = 0.114). However, in patients with lymph node metastasis who underwent adjuvant chemotherapy, the 3-year DFS rate was 44.4% in MBC group and 72.5% in TN-IDC group (P = 0.025).
Discussion: In our result, MBC show poorer clinical outcome than IDC. It is not shown significant difference between MBC and TN-IDC. However, MBC patients with nodal metastasis have poorer prognosis than TN-IDC patients with metastasis despite adjuvant chemotherapy.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-10-25.
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Affiliation(s)
- DH Cho
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - JH Jang
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - SK Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - M-Y Choi
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - MY Koo
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - SM Hur
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - SY Bae
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - SM Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - J-H Choe
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - JE Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - J-H Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - JS Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - SJ Nam
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - J-H Yang
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Hong IS, Park BS, Jang JH, Kwon HJ, Cho YS, Hwang YS. Design and construction of a compact microwave proton source for a proton linac. Rev Sci Instrum 2010; 81:02A314. [PMID: 20192335 DOI: 10.1063/1.3271170] [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] [Indexed: 05/28/2023]
Abstract
A 100 MeV, 20 mA proton linear accelerator is being developed by the Proton Engineering Frontier Project at the Korea Atomic Energy Research Institute. 20 MeV acceleration system using radio frequency quadrupole and drift tube linac was already developed and has been tested. To operate this acceleration system with a long time, more reliable proton source is needed. A compact microwave proton source was proposed and has been designed and constructed as a prototype ion source for the 100 MeV proton linear accelerator. The design of microwave power injection system is based on the microwave proton injector at LANL and CEA. The wave power from a 2.45 GHz, 2 kW magnetron source is introduced into a compact plasma chamber with 7 cm diameter and 5 cm length through a standard tapered, double-ridged waveguide (WRD250) and a quartz window. The microwave power supply is installed on high voltage platform. Axial magnetic fields up to 1 kG can be provided with a water-cooled solenoid coil. A single-hole three electrode extraction system is designed for an extraction current up to 30 mA at a 50 kV extraction voltage. The design and initial operations of the proton source are presented.
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Affiliation(s)
- I S Hong
- Proton Engineering Frontier Project, Korea Atomic Energy Research Institute, Daejeon 305-353, Republic of Korea.
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45
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Kim HJ, Chung DH, Kim MJ, Jang JH, Kim YW, Han SK, Shim YS, Yim JJ. Decreased phosphorylation of STAT-1, STAT-4 and cytokine release in MDR-TB patients with primary resistance. Int J Tuberc Lung Dis 2008; 12:1071-1076. [PMID: 18713507] [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: 05/26/2023] Open
Abstract
SETTING We recently showed that treatment failure rate was higher among multidrug-resistant tuberculosis (MDR-TB) patients without a previous history of tuberculosis (TB) treatment, or so-called 'primary resistance'. OBJECTIVE To investigate the phosphorylation levels of signal transducers and activators of transcription-1 (STAT-1) and STAT-4 and the subsequent cytokine release as a possible cause of a poor prognosis in MDR-TB patients with primary resistance. DESIGN Ten patients with successfully treated pulmonary TB without resistance, 12 MDR-TB patients with acquired resistance and 10 MDR-TB patients with primary resistance were enrolled. After 24 h stimulation of peripheral blood mononuclear cells (PBMC) with interferon-gamma (IFN-gamma), interleukin-12 (IL-12), purified protein derivative (PPD), or lysate of Mycobacterium tuberculosis, flow cytometric analysis of intracellular pSTAT-1 and pSTAT-4 were performed and secretion of IFN-gamma, IL-12p40 and tumour necrosis factor-alpha (TNF-alpha) was measured in culture supernatant. RESULTS The mean fluorescent intensities of pSTAT-1 and pSTAT-4 in PBMC of MDR-TB patients with primary resistance decreased on stimulation of IFN-gamma, PPD or lysate of M. tuberculosis when compared with patients with acquired resistance. In addition, secretion of IFN-gamma, IL-12p40 and TNF-alpha in these patients decreased on various stimuli. CONCLUSION Decreased phosphorylation of STAT-1, STAT-4, and of subsequent cytokine release, might be associated with a poor prognosis in MDR-TB patients with primary resistance.
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MESH Headings
- Adolescent
- Adult
- Cytokines/metabolism
- Enzyme-Linked Immunosorbent Assay
- Female
- Flow Cytometry
- Humans
- Leukocytes, Mononuclear/chemistry
- Leukocytes, Mononuclear/immunology
- Male
- Middle Aged
- Mycobacterium tuberculosis/immunology
- Phosphorylation
- STAT1 Transcription Factor/metabolism
- STAT4 Transcription Factor/metabolism
- Tuberculosis, Multidrug-Resistant/blood
- Tuberculosis, Multidrug-Resistant/drug therapy
- Tuberculosis, Multidrug-Resistant/immunology
- Tuberculosis, Multidrug-Resistant/metabolism
- Tuberculosis, Pulmonary/drug therapy
- Tuberculosis, Pulmonary/immunology
- Tuberculosis, Pulmonary/metabolism
- Tuberculosis, Pulmonary/microbiology
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Affiliation(s)
- H J Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
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Georgiev P, Jochum W, Heinrich S, Jang JH, Nocito A, Dahm F, Clavien PA. Characterization of time-related changes after experimental bile duct ligation. Br J Surg 2008; 95:646-56. [PMID: 18196571 DOI: 10.1002/bjs.6050] [Citation(s) in RCA: 165] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Although bile duct ligation (BDL) in mice is used to study cholestasis, a detailed description of this animal model is lacking. The aim of this study was to define specific phases of acute and chronic injury and repair in the different cellular compartments of the liver. METHODS C57BL/6 mice underwent BDL or sham laparotomy, and serum and liver tissue were analysed between 8 h and 6 weeks later. RESULTS Biliary infarcts and alanine aminotransferase levels revealed acute hepatocellular injury peaking at days 2-3, paralleled by enhanced transcription of pro-proliferative mediators and followed by a distinct peak of hepatocellular proliferation at day 5. Cholangiocellular proliferation occurred in large bile ducts on days 2-3 and in small bile ducts on day 5. Neutrophil infiltration occurred within 8 h, with neutrophils remaining the predominant immune cell type until day 3. Acute injury was followed by continuous tissue repair, lymphocyte and Kupffer cell infiltration, and accumulation of collagen during the second week. Thereafter, the number of alpha-smooth muscle actin-positive cells and the expression of transforming growth factor beta1, tissue inhibitor of metalloproteinases 1 and procollagen (I) decreased, and liver fibrosis stabilized. CONCLUSION BDL elicits dynamic changes in mouse liver. The chronological dissection and quantification of these events identified specific phases of acute and chronic cholestatic liver injury.
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Affiliation(s)
- P Georgiev
- Swiss Hepato-Pancreato-Biliary Centre, Department of Visceral and Transplant Surgery, University Hospital of Zurich, Zurich, Switzerland
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47
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Yoo SY, Jang JH, Shin YW, Kim DJ, Park HJ, Moon WJ, Chung EC, Lee JM, Kim IY, Kim SI, Kwon JS. White matter abnormalities in drug-naïve patients with obsessive-compulsive disorder: a diffusion tensor study before and after citalopram treatment. Acta Psychiatr Scand 2007; 116:211-9. [PMID: 17655563 DOI: 10.1111/j.1600-0447.2007.01046.x] [Citation(s) in RCA: 124] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim was to investigate the white matter abnormalities of drug-naïve patients with obsessive-compulsive disorder (OCD) using diffusion tensor-imaging and the white matter changes in the patients after pharmacotherapy. METHOD Thirteen drug-naïve OCD patients and 13 age- and sex-matched healthy comparison subjects were examined using diffusion tensor-imaging and structural magnetic resonance imaging. Measurements were made in OCD patients before and after 12 weeks of citalopram treatment. RESULTS Compared with controls, the drug-naïve OCD patients showed significant increases in fractional anisotropy (FA) in the corpus callosum, the internal capsule and white matter in the area superolateral to the right caudate. The increases in FA were mostly no longer observed in patients after 12 weeks of treatment compared with controls. CONCLUSION Our findings suggest that white matter alterations are associated with the pathophysiology of OCD, and the abnormalities may be partly reversible with pharmacotherapy.
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Affiliation(s)
- S Y Yoo
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
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48
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Jung KW, Yoon CG, Jang JH, Jeon JH. Characteristics of indicator microorganisms in paddy rice plots after reclaimed water irrigation. Water Sci Technol 2007; 55:267-73. [PMID: 17305149 DOI: 10.2166/wst.2007.020] [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: 05/14/2023]
Abstract
A study was performed to examine the effects of reclaimed-water irrigation on microorganism concentration in the ponded-water of paddy rice plots. Several treatments were used and each one was triplicated to evaluate the change of indicator microorganisms (total coliforms (TC), faecal coliforms (FC), and E. coli) concentrations in 2003 and 2004 growing seasons. Their concentrations increased significantly after irrigation, but decreased by approximately 45% in 24 h. It implies that agricultural activities such as ploughing and fertilising need to be practiced one or two days after irrigation, considering health risks. Treatments with UV-disinfected water irrigation, demonstrated significantly lower concentrations than others, including control plots where natural water was irrigated. The monitoring result from actual paddy rice fields and experimental paddy plots showed that concentrations of indicator microorganisms ranged from 10(2) to 10(5) MPN/100 mL. The field scale water reuse research project is in progress and national guidelines for reclaimed-water irrigation are under preparation in Korea. A comprehensive assessment of existing agricultural practices and a thorough monitoring in the fields as well as treatment plots are recommended to make national guidelines more representative.
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Affiliation(s)
- K W Jung
- Department of Environmental Science, Konkuk University, #1 Hwayang-dong, Gwangjin-gu, Seoul, Korea.
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49
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Ham JH, Yoon CG, Jung KW, Jang JH. Integrated modelling under uncertainty in watershed-level assessment and management. Water Sci Technol 2007; 56:31-39. [PMID: 17978430 DOI: 10.2166/wst.2007.594] [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: 05/25/2023]
Abstract
Uncertainty in water quality model predictions is inevitably high due to natural stochasticity, model uncertainty, and parameter uncertainty. An integrated modelling system (modified-BASINS) under uncertainty is described and demonstrated for use in receiving-water quality prediction and watershed management. A Monte Carlo simulation was used to investigate the effect of various uncertainty types on output prediction. Without pollution control measures in the watershed, the concentrations of total nitrogen (T-N) and total phosphorus (T-P) in the Hwaong Reservoir, considering three uncertainty types, would be less than about 4.4 and 0.23 mg L(-1), respectively, in 2012, with 90% confidence. The effects of two watershed management practices, wastewater treatment plants (WWTP) and constructed wetlands (WETLAND), were evaluated. The combined scenario (WWTP + WETLAND) was the most effective at improving reservoir water quality, bringing concentrations of T-N and T-P in the Hwaong Reservoir to less than 3.4 and 0.14 mg L(-1), 24 and 41% improvements, respectively, with 90% confidence. Overall, the Monte Carlo simulation in the integrated modelling system was practical for estimating uncertainty and reliable in water quality prediction. The approach described here may allow decisions to be made based on the probability and level of risk, and its application is recommended.
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Affiliation(s)
- J H Ham
- School of Civil and Environmental Engineering, Cornell University, Ithaca, NY, USA.
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50
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Abd El-Aty AM, Goudah A, Mouneir SM, Sunwoo YE, Jang JH, Shin JG, Shim JH, Shimoda M. Acute-phase response alters the disposition kinetics of cefepime following intravenous administration to rabbits. Vet Res Commun 2006; 31:67-75. [PMID: 17186405 DOI: 10.1007/s11259-006-3405-2] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2005] [Indexed: 11/24/2022]
Abstract
The effect of experimentally induced fever on the pharmacokinetics of cefepime administered intravenously at a dose of 75 mg/kg bw was studied in six healthy rabbits. The study was conducted in two consecutive phases, separated by a washout period of 2 weeks. Infection was induced by the intravenous inoculation of 5 x 10(8) cfu of Escherichia coli 24 h before the pharmacokinetic investigation was carried out. Serial blood samples for cefepime concentration determination were obtained for 48 h following drug administration. The concentrations of cefepime in the plasma were determined by a quantitative microbiological assay using an agar-gel diffusion method employing Bacillus subtilis ATCC 6633 as the test organism, with a level of detectability of approximately 0.10 microg/ml. Cefepime plasma concentrations versus time were evaluated by non-compartmental methods using WinNonLin. Cefepime was well tolerated and no serious adverse events were observed. Rectal temperature increased 1 degree C 24 h post injection in infected animals. Highly significant differences in the blood plasma concentrations of cefepime were observed between febrile and healthy animals at all the sampling times. This could explain the greater area under the plasma level-time curve of the drug in febrile compared with healthy animals. The results from pharmacokinetic calculations showed that both the distribution volume at steady state (V (dss)) and body clearance (CL(tot)) were affected in febrile as compared to healthy animals. The mean values of V (dss) and CL(tot) of cefepime in healthy rabbits were 1.168 L/kg and 0.303 L/kg/h, respectively. As compared with healthy animals, the mean estimates of V (dss) (0.917 L/kg) and CL(tot) (0.205 L/kg per h) of cefepime were significantly lower, whereas t (1/2lambda), MRT and AUMC were significantly higher in febrile rabbits. It is concluded that, although experimental infection had an effect on the disposition kinetics of cefepime in healthy and febrile rabbits, this was not sufficiently pronounced to require alteration of the dosage during disease.
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Affiliation(s)
- A M Abd El-Aty
- Department of Pharmacology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt.
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