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Bernard L, Kwon JS, Simpson AN, Ferguson SE, Sinasac S, Pina A, Reade CJ. The levonorgestrel intrauterine system for prevention of endometrial cancer in women with obesity: A cost-effectiveness study. Gynecol Oncol 2021; 161:367-373. [PMID: 33648747 DOI: 10.1016/j.ygyno.2021.02.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 02/12/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To estimate the cost-effectiveness of the levonorgestrel intrauterine system (LNG-IUS) as an endometrial cancer prevention strategy in women with obesity. METHODS A Markov decision-analytic model was used to compare 5 strategies in women with a body mass index of 30 or greater: 1) Usual care 2) LNG-IUS for 5 years 3) LNG-IUS for 7 years 4) LNG-IUS for 5 years, replaced once for a total of 10 years 5) LNG-IUS for 7 years, replaced once for a total of 14 years. Obesity was presumed to be associated with a 3-fold relative risk of endometrial cancer incidence and a 2.65-fold disease-specific mortality. The LNG-IUS was assumed to confer a 50% reduction in cancer incidence over the period of the LNG-IUS insertion. Outcomes were incremental cost-effectiveness ratios, calculated in 2019 Canadian dollars (CAD) per year of life saved. One-way and two-way sensitivity analyses were performed. RESULTS The LNG-IUS strategy was considered cost-effective if the cost of the intervention is less than $66,400 CAD ($50,000 US dollars) per year of life saved. The strategy becomes cost-effective if the LNG-IUS is inserted at age 57 (strategy #2), at age 52 for strategy #3, at age 51 for strategy #4 and at age 45 for strategy #5, when compared to usual care. The results are stable to variations in cost but sensitive to the estimated risk reduction of the LNG-IUS and the impact of obesity on endometrial cancer incidence and disease-specific mortality. CONCLUSION The LNG-IUS is a cost-effective method of endometrial cancer prevention in women with obesity.
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Affiliation(s)
- L Bernard
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada.
| | - J S Kwon
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
| | - A N Simpson
- Department of Obstetrics & Gynecology, University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital/Unity Health Toronto, Toronto, Ontario, Canada
| | - S E Ferguson
- Department of Obstetrics & Gynecology, University of Toronto, Toronto, Ontario, Canada; Division of Gynecologic Oncology, Princess Margaret Cancer Centre/Sinai Health Systems, Toronto, Ontario, Canada
| | - S Sinasac
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada
| | - A Pina
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Université de Montréal, Montréal, Québec, Canada
| | - C J Reade
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
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2
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de Lange NM, Ezendam NPM, Kwon JS, Vandenput I, Mirchandani D, Amant F, van der Putten LJM, Pijnenborg JMA. Neoadjuvant chemotherapy followed by surgery for advanced-stage endometrial cancer. ACTA ACUST UNITED AC 2019; 26:e226-e232. [PMID: 31043831 DOI: 10.3747/co.26.4655] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Data showing the value of neoadjuvant chemotherapy (nact) followed by interval debulking surgery (ids) in the management of advanced-stage serous endometrial carcinoma (eca) are limited; the aim of the present study was to expand the knowledge about that treatment strategy in patients with advanced eca, including endometrioid eca. Methods Data were collected retrospectively from all patients with advanced-stage eca treated with nact between 2005 and 2014 at 3 oncology referral centres. Primary outcomes were the radiologic response to nact and achievement of optimal or complete ids. Secondary outcomes were recurrence rate and progression-free and overall survival. Results Of 102 eca cases included, a complete radiologic response was achieved in only 4 cases, with a partial response being achieved in 72% (64% of endometrioid cases, 80% of serous cases). Complete ids was achieved in 62% of the endometrioid cases and in 56% of the serous eca cases, with optimal ids achieved in 31% and 28% of those cases respectively. Survival rates were calculated for all patients with complete and optimal ids; recurrence was observed in 56% and 67% of the cases respectively, and progression-free survival was 18 months and 13 months respectively. Median survival duration was 24 months for endometrioid eca and 28 months for serous eca. Conclusions For patients with advanced eca who are not suitable for primary debulking, nact followed by ids can be considered regardless of histologic subtype. The treatment options for this group of patients are limited and have to be explored.
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Affiliation(s)
- N M de Lange
- Formerly: Department of Obstetrics and Gynaecology, Catharina Hospital Eindhoven, Eindhoven, Netherlands; Currently: Department of Obstetrics and Gynaecology, University Medical Centre Groningen, Groningen, Netherlands
| | - N P M Ezendam
- Tilburg University and Comprehensive Cancer Centre, Tilburg, Netherlands
| | - J S Kwon
- Department of Obstetrics and Gynaecology, BC Cancer, University of British Columbia, Vancouver, BC
| | - I Vandenput
- Department of Obstetrics and Gynaecology, AZ Turnhout, Turnhout, Belgium
| | - D Mirchandani
- Department of Oncology, BC Cancer-Sindi Ahluwalia Hawkins Centre for the Southern Interior, Kelowna, BC
| | - F Amant
- Department of Obstetrics and Gynaecology, University Hospital Leuven, Leuven, Belgium.,Centre for Gynaecologic Oncology, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - L J M van der Putten
- Formerly: Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, Netherlands; Currently: Department of Obstetrics and Gynaecology, Jeroen Bosch Hospital, Hertogenbosch, Netherlands
| | - J M A Pijnenborg
- Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, Netherlands.,Radboud Institute for Health Sciences, Nijmegen, Netherlands
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3
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Kelly S, Jahanshad N, Zalesky A, Kochunov P, Agartz I, Alloza C, Andreassen OA, Arango C, Banaj N, Bouix S, Bousman CA, Brouwer RM, Bruggemann J, Bustillo J, Cahn W, Calhoun V, Cannon D, Carr V, Catts S, Chen J, Chen JX, Chen X, Chiapponi C, Cho KK, Ciullo V, Corvin AS, Crespo-Facorro B, Cropley V, De Rossi P, Diaz-Caneja CM, Dickie EW, Ehrlich S, Fan FM, Faskowitz J, Fatouros-Bergman H, Flyckt L, Ford JM, Fouche JP, Fukunaga M, Gill M, Glahn DC, Gollub R, Goudzwaard ED, Guo H, Gur RE, Gur RC, Gurholt TP, Hashimoto R, Hatton SN, Henskens FA, Hibar DP, Hickie IB, Hong LE, Horacek J, Howells FM, Hulshoff Pol HE, Hyde CL, Isaev D, Jablensky A, Jansen PR, Janssen J, Jönsson EG, Jung LA, Kahn RS, Kikinis Z, Liu K, Klauser P, Knöchel C, Kubicki M, Lagopoulos J, Langen C, Lawrie S, Lenroot RK, Lim KO, Lopez-Jaramillo C, Lyall A, Magnotta V, Mandl RCW, Mathalon DH, McCarley RW, McCarthy-Jones S, McDonald C, McEwen S, McIntosh A, Melicher T, Mesholam-Gately RI, Michie PT, Mowry B, Mueller BA, Newell DT, O'Donnell P, Oertel-Knöchel V, Oestreich L, Paciga SA, Pantelis C, Pasternak O, Pearlson G, Pellicano GR, Pereira A, Pineda Zapata J, Piras F, Potkin SG, Preda A, Rasser PE, Roalf DR, Roiz R, Roos A, Rotenberg D, Satterthwaite TD, Savadjiev P, Schall U, Scott RJ, Seal ML, Seidman LJ, Shannon Weickert C, Whelan CD, Shenton ME, Kwon JS, Spalletta G, Spaniel F, Sprooten E, Stäblein M, Stein DJ, Sundram S, Tan Y, Tan S, Tang S, Temmingh HS, Westlye LT, Tønnesen S, Tordesillas-Gutierrez D, Doan NT, Vaidya J, van Haren NEM, Vargas CD, Vecchio D, Velakoulis D, Voineskos A, Voyvodic JQ, Wang Z, Wan P, Wei D, Weickert TW, Whalley H, White T, Whitford TJ, Wojcik JD, Xiang H, Xie Z, Yamamori H, Yang F, Yao N, Zhang G, Zhao J, van Erp TGM, Turner J, Thompson PM, Donohoe G. Widespread white matter microstructural differences in schizophrenia across 4322 individuals: results from the ENIGMA Schizophrenia DTI Working Group. Mol Psychiatry 2018; 23:1261-1269. [PMID: 29038599 PMCID: PMC5984078 DOI: 10.1038/mp.2017.170] [Citation(s) in RCA: 412] [Impact Index Per Article: 68.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 05/02/2017] [Accepted: 06/07/2017] [Indexed: 12/15/2022]
Abstract
The regional distribution of white matter (WM) abnormalities in schizophrenia remains poorly understood, and reported disease effects on the brain vary widely between studies. In an effort to identify commonalities across studies, we perform what we believe is the first ever large-scale coordinated study of WM microstructural differences in schizophrenia. Our analysis consisted of 2359 healthy controls and 1963 schizophrenia patients from 29 independent international studies; we harmonized the processing and statistical analyses of diffusion tensor imaging (DTI) data across sites and meta-analyzed effects across studies. Significant reductions in fractional anisotropy (FA) in schizophrenia patients were widespread, and detected in 20 of 25 regions of interest within a WM skeleton representing all major WM fasciculi. Effect sizes varied by region, peaking at (d=0.42) for the entire WM skeleton, driven more by peripheral areas as opposed to the core WM where regions of interest were defined. The anterior corona radiata (d=0.40) and corpus callosum (d=0.39), specifically its body (d=0.39) and genu (d=0.37), showed greatest effects. Significant decreases, to lesser degrees, were observed in almost all regions analyzed. Larger effect sizes were observed for FA than diffusivity measures; significantly higher mean and radial diffusivity was observed for schizophrenia patients compared with controls. No significant effects of age at onset of schizophrenia or medication dosage were detected. As the largest coordinated analysis of WM differences in a psychiatric disorder to date, the present study provides a robust profile of widespread WM abnormalities in schizophrenia patients worldwide. Interactive three-dimensional visualization of the results is available at www.enigma-viewer.org.
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Affiliation(s)
- S Kelly
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA,Harvard Medical School, Boston, MA, USA,Imaging Genetics Center, Keck School of Medicine, University of Southern California, Marina del Rey, CA 90292, USA. E-mail:
| | - N Jahanshad
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - A Zalesky
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - P Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - I Agartz
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden,Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - C Alloza
- University of Edinburgh, Edinburgh, UK
| | | | - C Arango
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - N Banaj
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - S Bouix
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - C A Bousman
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, VIC, Australia,Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia,Department of General Practice, The University of Melbourne, Parkville, VIC, Australia,Swinburne University of Technology, Melbourne, VIC, Australia
| | - R M Brouwer
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - J Bruggemann
- Neuroscience Research Australia and School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - J Bustillo
- University of New Mexico, Albuquerque, NM, USA
| | - W Cahn
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - V Calhoun
- The Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM, USA,The Mind Research Network, Albuquerque, NM, USA
| | - D Cannon
- Centre for Neuroimaging and Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, National University of Ireland Galway, Galway, Ireland
| | - V Carr
- Neuroscience Research Australia and School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - S Catts
- Discipline of Psychiatry, School of Medicine, University of Queensland, Herston, QLD, Australia
| | - J Chen
- Department of Computer Science and Engineering, The Ohio State University, Columbus, OH, USA
| | - J-x Chen
- Beijing Huilongguan Hospital, Beijing, China
| | - X Chen
- Worldwide Research and Development, Pfizer, Cambridge, MA, USA
| | | | - Kl K Cho
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - V Ciullo
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - A S Corvin
- Department of Psychiatry and Neuropsychiatric Genetics Research Group, Institute of Molecular Medicine, Trinity College Dublin, Dublin, Ireland
| | - B Crespo-Facorro
- University Hospital Marqués de Valdecilla, IDIVAL, Department of Medicine and Psychiatry, School of Medicine, University of Cantabria, Santander, Spain,CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Santander, Spain
| | - V Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - P De Rossi
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy,Department NESMOS, Faculty of Medicine and Psychology, University ‘Sapienza’ of Rome, Rome, Italy,Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - C M Diaz-Caneja
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - E W Dickie
- Center for Addiction and Mental Health, Toronto, ON, Canada
| | - S Ehrlich
- Division of Psychological and Social Medicine and Developmental Neurosciences, Technische Universität Dresden, Faculty of Medicine, University Hospital C.G. Carus, Dresden, Germany
| | - F-m Fan
- Beijing Huilongguan Hospital, Beijing, China
| | - J Faskowitz
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - H Fatouros-Bergman
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - L Flyckt
- University of New South Wales, School of Psychiatry, Sydney, NSW, Australia,The University of Queensland, Queensland Brain Institute and Centre for Advanced Imaging, Brisbane, QLD, Australia
| | - J M Ford
- University of California, VAMC, San Francisco, CA, USA
| | - J-P Fouche
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - M Fukunaga
- Division of Cerebral Integration, National Institute for Physiological Sciences, Aichi, Japan
| | - M Gill
- Department of Psychiatry and Neuropsychiatric Genetics Research Group, Institute of Molecular Medicine, Trinity College Dublin, Dublin, Ireland
| | - D C Glahn
- Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital and Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - R Gollub
- Harvard Medical School, Boston, MA, USA,Departments of Psychiatry and Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - E D Goudzwaard
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA
| | - H Guo
- Zhumadian Psychiatry Hospital, Henan Province, China
| | - R E Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - R C Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - T P Gurholt
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - R Hashimoto
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Osaka, Japan,Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - S N Hatton
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - F A Henskens
- School of Electrical Engineering and Computer Science, University of Newcastle, Callaghan, NSW, Australia,Health Behaviour Research Group, University of Newcastle, Callaghan, NSW, Australia,Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - D P Hibar
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - I B Hickie
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - L E Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - J Horacek
- National Institute of Mental Health, Klecany, Czech Republic,Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - F M Howells
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - H E Hulshoff Pol
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - C L Hyde
- Worldwide Research and Development, Pfizer, Cambridge, MA, USA
| | - D Isaev
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - A Jablensky
- University of Western Australia, Perth, WA, Australia
| | - P R Jansen
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | - J Janssen
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain,Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - E G Jönsson
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - L A Jung
- Laboratory for Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - R S Kahn
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Z Kikinis
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - K Liu
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - P Klauser
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, VIC, Australia,Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences and Monash Biomedical Imaging, Monash University, Clayton, VIC, Australia,Department of Psychiatry, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - C Knöchel
- Laboratory for Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - M Kubicki
- Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - J Lagopoulos
- Sunshine Coast Mind and Neuroscience Institute, University of the Sunshine Coast QLD, Australia, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - C Langen
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | - S Lawrie
- University of Edinburgh, Edinburgh, UK
| | - R K Lenroot
- Neuroscience Research Australia and School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - K O Lim
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - C Lopez-Jaramillo
- Research Group in Psychiatry (GIPSI), Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Mood Disorder Program, Hospital Universitario San Vicente Fundación, Medellín, Colombia
| | - A Lyall
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - R C W Mandl
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - D H Mathalon
- University of California, VAMC, San Francisco, CA, USA
| | | | - S McCarthy-Jones
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - C McDonald
- Centre for Neuroimaging and Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, National University of Ireland Galway, Galway, Ireland
| | - S McEwen
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - T Melicher
- Third Faculty of Medicine, Charles University, Prague, Czech Republic,The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - R I Mesholam-Gately
- Harvard Medical School and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess, Medical Center, Boston, MA, USA
| | - P T Michie
- Hunter Medical Research Institute, Newcastle, NSW, Australia,The University of Newcastle, Newcastle, NSW, Australia,Schizophrenia Research Institute, Sydney, NSW, Australia
| | - B Mowry
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia and Queensland Centre for Mental Health Research, Brisbane and Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - B A Mueller
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - D T Newell
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - P O'Donnell
- Worldwide Research and Development, Pfizer, Cambridge, MA, USA
| | - V Oertel-Knöchel
- Laboratory for Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - L Oestreich
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia and Queensland Centre for Mental Health Research, Brisbane and Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - S A Paciga
- Worldwide Research and Development, Pfizer, Cambridge, MA, USA
| | - C Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, VIC, Australia,Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia,Schizophrenia Research Institute, Sydney, NSW, Australia,Centre for Neural Engineering (CfNE), Department of Electrical and Electronic Engineering, University of Melbourne, Parkville, VIC, Australia
| | - O Pasternak
- Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - G Pearlson
- Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital and Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - G R Pellicano
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - A Pereira
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | | | - F Piras
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy,School of Biomedical Sciences, Faculty of Health, the University of Newcastle, Callaghan, NSW, Australia
| | - S G Potkin
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA
| | - A Preda
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA
| | - P E Rasser
- Hunter Medical Research Institute, Newcastle, NSW, Australia,Priority Centre for Brain and Mental Health Research, The University of Newcastle, Newcastle, NSW, Australia
| | - D R Roalf
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - R Roiz
- University Hospital Marqués de Valdecilla, IDIVAL, Department of Medicine and Psychiatry, School of Medicine, University of Cantabria, Santander, Spain,CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Santander, Spain
| | - A Roos
- SU/UCT MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - D Rotenberg
- Center for Addiction and Mental Health, Toronto, ON, Canada
| | - T D Satterthwaite
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - P Savadjiev
- Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - U Schall
- Hunter Medical Research Institute, Newcastle, NSW, Australia,Priority Centre for Brain and Mental Health Research, The University of Newcastle, Newcastle, NSW, Australia
| | - R J Scott
- Hunter Medical Research Institute, Newcastle, NSW, Australia,School of Biomedical Sciences, Faculty of Health, the University of Newcastle, Callaghan, NSW, Australia
| | - M L Seal
- Murdoch Childrens Research Institute, The Royal Children’s Hospital, Parkville, VIC, Australia
| | - L J Seidman
- Harvard Medical School, Boston, MA, USA,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA,Harvard Medical School and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess, Medical Center, Boston, MA, USA
| | - C Shannon Weickert
- Schizophrenia Research Institute, Sydney, NSW, Australia,Neuroscience Research Australia, Sydney, NSW, Australia,School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - C D Whelan
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - M E Shenton
- Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA,VA Boston Healthcare System, Boston, MA, USA
| | - J S Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - G Spalletta
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy,Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - F Spaniel
- National Institute of Mental Health, Klecany, Czech Republic,Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - E Sprooten
- Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital and Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - M Stäblein
- Laboratory for Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - D J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa,Department of Psychiatry and MRC Unit on Anxiety and Stress Disorders, University of Cape Town, Cape Town, South Africa
| | - S Sundram
- Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia,Department of Psychiatry, School of Clinical Sciences, Monash University and Monash Health, Clayton, VIC, Australia
| | - Y Tan
- Beijing Huilongguan Hospital, Beijing, China
| | - S Tan
- Beijing Huilongguan Hospital, Beijing, China
| | - S Tang
- Chongqing Three Gorges Central Hospital, Chongqing, China
| | - H S Temmingh
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - L T Westlye
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Psychology, University of Oslo, Oslo, Norway
| | - S Tønnesen
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - D Tordesillas-Gutierrez
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Santander, Spain,Neuroimaging Unit, Technological Facilities, Valdecilla Biomedical Research Institute IDIVAL, Santander, Spain
| | - N T Doan
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - J Vaidya
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - N E M van Haren
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - C D Vargas
- Research Group in Psychiatry (GIPSI), Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - D Vecchio
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - D Velakoulis
- Neuropsychiatry Unit, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - A Voineskos
- Kimel Family Translational Imaging-Genetics Research Laboratory, Campbell Family Mental Health Research Institute, CAMH Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - J Q Voyvodic
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Z Wang
- Beijing Huilongguan Hospital, Beijing, China
| | - P Wan
- Zhumadian Psychiatry Hospital, Henan Province, China
| | - D Wei
- Luoyang Fifth People's Hospital, Henan Province, China
| | - T W Weickert
- Schizophrenia Research Institute, Sydney, NSW, Australia,Neuroscience Research Australia, Sydney, NSW, Australia,School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - H Whalley
- University of Edinburgh, Edinburgh, UK
| | - T White
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | - T J Whitford
- University of New South Wales, School of Psychiatry, Sydney, NSW, Australia
| | - J D Wojcik
- Harvard Medical School and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess, Medical Center, Boston, MA, USA
| | - H Xiang
- Chongqing Three Gorges Central Hospital, Chongqing, China
| | - Z Xie
- Worldwide Research and Development, Pfizer, Cambridge, MA, USA
| | - H Yamamori
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - F Yang
- Beijing Huilongguan Hospital, Beijing, China
| | - N Yao
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - G Zhang
- Department of Computer Science and Electrical Engineering, University of Maryland, Baltimore, MD, USA
| | - J Zhao
- Centre for Neuroimaging and Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, National University of Ireland Galway, Galway, Ireland,School of Psychology, Shaanxi Normal University and Key Laboratory for Behavior and Cognitive Neuroscience of Shaanxi Province, Xi’an, Shaanxi, China
| | - T G M van Erp
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA
| | - J Turner
- Psychology Department & Neuroscience Institute, Georgia State University, Atlanta, GA, USA
| | - P M Thompson
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - G Donohoe
- Centre for Neuroimaging and Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, National University of Ireland Galway, Galway, Ireland
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4
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Scott SA, van der Zanden C, Cai E, McGahan CE, Kwon JS. Prognostic significance of peritoneal cytology in low-intermediate risk endometrial cancer. Gynecol Oncol 2017; 145:262-268. [PMID: 28359690 DOI: 10.1016/j.ygyno.2017.03.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [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: 12/21/2016] [Revised: 03/11/2017] [Accepted: 03/15/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVES There is uncertainty surrounding the prognostic value and clinical utility of peritoneal cytology in endometrial cancer. Our primary objective was to determine if positive cytology is associated with disease-free and overall survival in women treated surgically for endometrial cancer, specifically those with low or intermediate risk disease. METHODS This was a retrospective population-based cohort study of British Columbia Cancer Registry patients who underwent surgery with peritoneal washings for endometrioid-type endometrial cancer from 2003 to 2009. Low risk was defined as Stage IA grade 1 or 2, and intermediate risk defined as Stage IA grade 3, or Stage IB grade 1 or 2 tumours. Five-year overall and disease free-survival were assessed using Kaplan-Meier estimation. Potential covariates including peritoneal cytology, grade, depth of myometrial invasion, LVSI, age, and adjuvant therapy were evaluated in a multivariable Cox proportional hazards model. RESULTS There were 849 patients, of whom 370 (43.6%) and 298 (35.1%) had low- and intermediate-risk disease, respectively. Overall, forty-nine (5.8%) patients had positive cytology, including 6 and 9 with low- and intermediate-risk respectively (2.2% within low and intermediate risk combined). Positive peritoneal cytology was not significantly associated with disease-free (HR 3.17, 95% CI 0.91-11.03) or overall survival (HR 1.33, 95% CI 0.47-3.76) in low and intermediate risk patients. Only age and extensive LVSI were associated with lower overall survival (HR 1.10, 95% CI 1.08-1.13, and HR 2.39, 95% CI 1.02-5.61, respectively). CONCLUSIONS Positive peritoneal cytology was not associated with disease-free and overall survival in women with low and intermediate risk endometrial cancer.
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Affiliation(s)
| | | | - E Cai
- Cancer Surveillance & Outcomes, BC Cancer Agency, Canada
| | - C E McGahan
- Cancer Surveillance & Outcomes, BC Cancer Agency, Canada; Surgical Oncology Network, BC Cancer Agency, Canada
| | - J S Kwon
- BC Cancer Agency, Canada; University of British Columbia, Canada
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5
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Han HJ, Jung WH, Yun JY, Park JW, Cho KK, Hur JW, Shin NY, Lee TY, Kwon JS. Disruption of effective connectivity from the dorsolateral prefrontal cortex to the orbitofrontal cortex by negative emotional distraction in obsessive-compulsive disorder. Psychol Med 2016; 46:921-932. [PMID: 26619965 DOI: 10.1017/s0033291715002391] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) has been associated with abnormal cognitive and emotional functions and these dysfunctions may be dependent on the disruption of dynamic interactions within neuronal circuits associated with emotion regulation. Although several studies have shown the aberrant cognitive-affective processing in OCD patients, little is known about how to characterize effective connectivity of the disrupted neural interactions. In the present study, we applied effective connectivity analysis using dynamic causal modeling to explore the disturbed neural interactions in OCD patients. METHOD A total of 20 patients and 21 matched healthy controls performed a delayed-response working memory task under emotional or non-emotional distraction while undergoing functional magnetic resonance imaging. RESULTS During the delay interval under negative emotional distraction, both groups showed similar patterns of activations in the amygdala. However, under negative emotional distraction, the dorsolateral prefrontal cortex (DLPFC) and the orbitofrontal cortex (OFC) exhibited significant differences between groups. Bayesian model averaging indicated that the connection from the DLPFC to the OFC was negatively modulated by negative emotional distraction in patients, when compared with healthy controls (p < 0.05, Bonferroni-corrected). CONCLUSIONS Exaggerated recruitment of the DLPFC may induce the reduction of top-down prefrontal control input over the OFC, leading to abnormal cortico-cortical interaction. This disrupted cortico-cortical interaction under negative emotional distraction may be responsible for dysfunctions of cognitive and emotional processing in OCD patients and may be a component of the pathophysiology associated with OCD.
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Affiliation(s)
- H J Han
- Department of Brain and Cognitive Sciences,College of Natural Sciences,Seoul National University,Seoul,South Korea
| | - W H Jung
- Medical Research Center,Seoul National University Hospital,Seoul,South Korea
| | - J-Y Yun
- Medical Research Center,Seoul National University Hospital,Seoul,South Korea
| | - J W Park
- Department of Psychiatry,Seoul National University College of Medicine,Seoul,South Korea
| | - K K Cho
- Department of Brain and Cognitive Sciences,College of Natural Sciences,Seoul National University,Seoul,South Korea
| | - J-W Hur
- Department of Brain and Cognitive Sciences,College of Natural Sciences,Seoul National University,Seoul,South Korea
| | - N Y Shin
- Medical Research Center,Seoul National University Hospital,Seoul,South Korea
| | - T Y Lee
- Medical Research Center,Seoul National University Hospital,Seoul,South Korea
| | - J S Kwon
- Department of Brain and Cognitive Sciences,College of Natural Sciences,Seoul National University,Seoul,South Korea
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Kwon JS, Han J, Kim TW, Oh JH, Kwon HH, Jung JT, Kwon JG, Kim EY, Kim HG. Changes in causative pathogens of acute cholangitis and their antimicrobial susceptibility over a period of 6 years. Korean J Gastroenterol 2016; 63:299-307. [PMID: 24870302 DOI: 10.4166/kjg.2014.63.5.299] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND/AIMS We evaluated changes of causative pathogen in acute cholangitis and their antimicrobial susceptibility over six years and differences between community-acquired and hospital-acquired acute cholangitis at our institution. METHODS Medical records of 1,596 patients with acute cholangitis and biliary drainage between August 2006 and August 2012 were reviewed retrospectively. Cases were divided according to time: period 1 (August 2006-December 2008, n=645, 40.4%), period 2 (January 2009-August 2012, n=951, 59.6%). Cases were divided according to community-acquired cholangitis (n=1,397, 87.5%) and hospital-acquired cholangitis (n=199, 12.5%). Causative pathogens and antimicrobial susceptibility were investigated in each group. RESULTS Causative pathogen was isolated from bile culture in 1,520 out of 1,596 cases (95.2%). The three most frequently isolated Gram-negative bacteria were extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (n=485, 30.4%), E. coli (n=237, 13.2%), and Citrobacter freundii (n=110, 6.9%). Between periods 1 and 2, prevalence of ESBL-producing E. coli and Klebsiella pneumoniae did not show significant change (36.7% vs. 32.1%, p=0.073; 6.6% vs. 6.2%, p=0.732). C. freundii showed a significant increase from period 1 to period 2 (1.7% vs. 13.2%, p=0.000). In both time periods, imipenem was the antimicrobial agent showing the highest rate of susceptibility (93.3% vs. 93.9%, p=0.783). Higher prevalence of ESBL-producing E. coli and C. freundii was observed in the hospital-acquired cholangitis group (52.1% vs. 31.2%, p=0.000; 15.9% vs. 7.3%, p=0.001). CONCLUSIONS The most common causative pathogen of acute cholangitis was ESBL-producing E. coli. Prevalence of C. freundii increased over the time period. Imipenem should be reserved as an alternative for resistant pathogens.
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Affiliation(s)
- Jeong Seok Kwon
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Duryugongwon-ro 17-gil, Nam-gu, Daegu 705-718, Korea
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7
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Kim E, Howes OD, Park JW, Kim SN, Shin SA, Kim BH, Turkheimer FE, Lee YS, Kwon JS. Altered serotonin transporter binding potential in patients with obsessive-compulsive disorder under escitalopram treatment: [11C]DASB PET study. Psychol Med 2016; 46:357-366. [PMID: 26423910 DOI: 10.1017/s0033291715001865] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a chronic, relapsing mental illness. Selective serotonin reuptake inhibitors block serotonin transporters (SERTs) and are the mainstay of treatment for OCD. SERT abnormalities are reported in drug-free patients with OCD, but it is not known what happens to SERT levels during treatment. This is important as alterations in SERT levels in patients under treatment could underlie poor response, or relapse during or after treatment. The aim of the present study was first to validate a novel approach to measuring SERT levels in people taking treatment and then to investigate SERT binding potential (BP) using [11C]DASB PET in patients with OCD currently treated with escitalopram in comparison with healthy controls. METHOD Twelve patients and age- and sex-matched healthy controls were enrolled. The patients and healthy controls underwent serial PET scans after administration of escitalopram and blood samples for drug concentrations were collected simultaneously with the scans. Drug-free BPs were obtained by using an inhibitory E max model we developed previously. RESULTS The inhibitory E max model was able to accurately predict drug-free SERT BP in people taking drug treatment. The drug-free BP in patients with OCD currently treated with escitalopram was significantly different from those in healthy volunteers [Cohen's d = 0.03 (caudate), 1.16 (putamen), 1.46 (thalamus), -5.67 (dorsal raphe nucleus)]. CONCLUSIONS This result extends previous findings showing SERT abnormalities in drug-free patients with OCD by indicating that altered SERT availability is seen in OCD despite treatment. This could account for poor response and the high risk of relapse in OCD.
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Affiliation(s)
- E Kim
- Department of Neuropsychiatry,Seoul National University Bundang Hospital,Gyeonggi-do,Korea
| | - O D Howes
- Psychiatric Imaging,Medical Research Council Clinical Sciences Centre,Imperial College London,Hammersmith Hospital Campus,London,UK
| | - J W Park
- Department of Psychiatry,Seoul National University College of Medicine,Seoul,Korea
| | - S N Kim
- Department of Psychiatry,Seoul National University College of Medicine,Seoul,Korea
| | - S A Shin
- Department of Biomedical Sciences,Seoul National University,Seoul,Korea
| | - B-H Kim
- Department of Clinical Pharmacology and Therapeutics,Kyung Hee University College of Medicine and Hospital,Seoul,Korea
| | - F E Turkheimer
- King's College London, Institute of Psychiatry,London,UK
| | - Y-S Lee
- Department of Nuclear Medicine,Seoul National University College of Medicine,Seoul,Korea
| | - J S Kwon
- Department of Psychiatry,Seoul National University College of Medicine,Seoul,Korea
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Son KL, Choi JS, Lee J, Park SM, Lim JA, Lee JY, Kim SN, Oh S, Kim DJ, Kwon JS. Neurophysiological features of Internet gaming disorder and alcohol use disorder: a resting-state EEG study. Transl Psychiatry 2015; 5:e628. [PMID: 26327686 PMCID: PMC5068800 DOI: 10.1038/tp.2015.124] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 06/22/2015] [Accepted: 07/11/2015] [Indexed: 01/27/2023] Open
Abstract
Despite that Internet gaming disorder (IGD) shares clinical, neuropsychological and personality characteristics with alcohol use disorder (AUD), little is known about the resting-state quantitative electroencephalography (QEEG) patterns associated with IGD and AUD. Therefore, this study compared the QEEG patterns in patients with IGD with those in patients with AUD to identify unique neurophysiological characteristics that can be used as biomarkers of IGD. A total of 76 subjects (34 with IGD, 17 with AUD and 25 healthy controls) participated in this study. Resting-state, eyes-closed QEEGs were recorded, and the absolute and relative power of brains were analyzed. The generalized estimating equation showed that the IGD group had lower absolute beta power than AUD (estimate = 5.319, P < 0.01) and the healthy control group (estimate = 2.612, P = 0.01). The AUD group showed higher absolute delta power than IGD (estimate = 7.516, P < 0.01) and the healthy control group (estimate = 7.179, P < 0.01). We found no significant correlations between the severity of IGD and QEEG activities in patients with IGD. The current findings suggest that lower absolute beta power can be used as a potential trait marker of IGD. Higher absolute power in the delta band may be a susceptibility marker for AUD. This study clarifies the unique characteristics of IGD as a behavioral addiction, which is distinct from AUD, by providing neurophysiological evidence.
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Affiliation(s)
- K-L Son
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - J-S Choi
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - J Lee
- Department of Psychiatry, Gangnam Eulji Hospital, Eulji University, Seoul, Republic of Korea
| | - S M Park
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
| | - J-A Lim
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
| | - J Y Lee
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
| | - S N Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - S Oh
- Department of Biostatistics, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
| | - D J Kim
- Department of Psychiatry, Seoul St Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - J S Kwon
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea
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Talhouk A, McConechy MK, Leung S, Li-Chang HH, Kwon JS, Melnyk N, Yang W, Senz J, Boyd N, Karnezis AN, Huntsman DG, Gilks CB, McAlpine JN. A clinically applicable molecular-based classification for endometrial cancers. Br J Cancer 2015; 113:299-310. [PMID: 26172027 PMCID: PMC4506381 DOI: 10.1038/bjc.2015.190] [Citation(s) in RCA: 529] [Impact Index Per Article: 58.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 04/14/2015] [Accepted: 04/29/2015] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Classification of endometrial carcinomas (ECs) by morphologic features is inconsistent, and yields limited prognostic and predictive information. A new system for classification based on the molecular categories identified in The Cancer Genome Atlas is proposed. METHODS Genomic data from the Cancer Genome Atlas (TCGA) support classification of endometrial carcinomas into four prognostically significant subgroups; we used the TCGA data set to develop surrogate assays that could replicate the TCGA classification, but without the need for the labor-intensive and cost-prohibitive genomic methodology. Combinations of the most relevant assays were carried forward and tested on a new independent cohort of 152 endometrial carcinoma cases, and molecular vs clinical risk group stratification was compared. RESULTS Replication of TCGA survival curves was achieved with statistical significance using multiple different molecular classification models (16 total tested). Internal validation supported carrying forward a classifier based on the following components: mismatch repair protein immunohistochemistry, POLE mutational analysis and p53 immunohistochemistry as a surrogate for 'copy-number' status. The proposed molecular classifier was associated with clinical outcomes, as was stage, grade, lymph-vascular space invasion, nodal involvement and adjuvant treatment. In multivariable analysis both molecular classification and clinical risk groups were associated with outcomes, but differed greatly in composition of cases within each category, with half of POLE and mismatch repair loss subgroups residing within the clinically defined 'high-risk' group. Combining the molecular classifier with clinicopathologic features or risk groups provided the highest C-index for discrimination of outcome survival curves. CONCLUSIONS Molecular classification of ECs can be achieved using clinically applicable methods on formalin-fixed paraffin-embedded samples, and provides independent prognostic information beyond established risk factors. This pragmatic molecular classification tool has potential to be used routinely in guiding treatment for individuals with endometrial carcinoma and in stratifying cases in future clinical trials.
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Affiliation(s)
- A Talhouk
- Department of Pathology and Laboratory Medicine, University of British Columbia and BC Cancer Agency, 509-2660 Oak Street, Vancouver, British Columbia, Canada V6H 3Z6
| | - M K McConechy
- Department of Pathology and Laboratory Medicine, University of British Columbia and BC Cancer Agency, 509-2660 Oak Street, Vancouver, British Columbia, Canada V6H 3Z6
| | - S Leung
- Genetic Pathology Evaluation Centre, Department of Pathology and Laboratory Medicine, University of British Columbia, 509-2660 Oak Street, Vancouver, British Columbia, Canada V6H 3Z6
| | - H H Li-Chang
- 1] Department of Pathology and Laboratory Medicine, University of British Columbia and BC Cancer Agency, 509-2660 Oak Street, Vancouver, British Columbia, Canada V6H 3Z6 [2] Department of Laboratory Services, Royal Victoria Regional Health Centre, 201 Georgian Drive, Barrie, Ontario, Canada L4M 6M2
| | - J S Kwon
- Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University of British Columbia, 2775 Laurel St. 6th Floor, Vancouver, British Columbia, Canada V5Z 1M9
| | - N Melnyk
- Department of Pathology and Laboratory Medicine, University of British Columbia and BC Cancer Agency, 509-2660 Oak Street, Vancouver, British Columbia, Canada V6H 3Z6
| | - W Yang
- Department of Pathology and Laboratory Medicine, University of British Columbia and BC Cancer Agency, 509-2660 Oak Street, Vancouver, British Columbia, Canada V6H 3Z6
| | - J Senz
- Department of Pathology and Laboratory Medicine, University of British Columbia and BC Cancer Agency, 509-2660 Oak Street, Vancouver, British Columbia, Canada V6H 3Z6
| | - N Boyd
- Department of Pathology and Laboratory Medicine, University of British Columbia and BC Cancer Agency, 509-2660 Oak Street, Vancouver, British Columbia, Canada V6H 3Z6
| | - A N Karnezis
- Department of Pathology and Laboratory Medicine, University of British Columbia and BC Cancer Agency, 509-2660 Oak Street, Vancouver, British Columbia, Canada V6H 3Z6
| | - D G Huntsman
- Department of Pathology and Laboratory Medicine, University of British Columbia and BC Cancer Agency, 509-2660 Oak Street, Vancouver, British Columbia, Canada V6H 3Z6
| | - C B Gilks
- Department of Pathology and Laboratory Medicine, University of British Columbia and BC Cancer Agency, 509-2660 Oak Street, Vancouver, British Columbia, Canada V6H 3Z6
| | - J N McAlpine
- Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University of British Columbia, 2775 Laurel St. 6th Floor, Vancouver, British Columbia, Canada V5Z 1M9
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Abstract
BACKGROUND Substantial empirical evidence has indicated impairment in the cognitive functioning of patients with obsessive-compulsive disorder (OCD) despite inconsistencies. Although several confounding factors have been investigated to explain the conflicting results, the findings remain mixed. This study aimed to investigate cognitive dysfunction in patients with OCD using a meta-analytic approach. METHOD The PubMed database was searched between 1980 and October 2012, and reference lists of review papers were examined. A total of 221 studies were identified, of which 88 studies met inclusion criteria. Neuropsychological performance and demographic and clinical variables were extracted from each study. RESULTS Patients with OCD were significantly impaired in tasks that measured visuospatial memory, executive function, verbal memory and verbal fluency, whereas auditory attention was preserved in these individuals. The largest effect size was found in the ability to recall complex visual stimuli. Overall effect estimates were in the small to medium ranges for executive function, verbal memory and verbal fluency. The effects of potentially confounding factors including educational level, symptom severity, medication status and co-morbid disorders were not significant. CONCLUSIONS Patients with OCD appear to have wide-ranging cognitive deficits, although their impairment is not so large in general. The different test forms and methods of testing may have influenced the performance of patients with OCD, indicating the need to select carefully the test forms and methods of testing used in future research. The effects of various confounding variables on cognitive functioning need to be investigated further and to be controlled before a definite conclusion can be made.
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Affiliation(s)
- N Y Shin
- Interdisciplinary Cognitive Science Program, Seoul National University, Seoul, South Korea
| | - T Y Lee
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | - E Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | - J S Kwon
- Interdisciplinary Cognitive Science Program, Seoul National University, Seoul, South Korea
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Kang WS, Kwon JS, Kim HB, Jeong HY, Kang HJ, Jeong MH, Cho JG, Park JC, Kim YS, Ahn Y. A macrophage-specific synthetic promoter for therapeutic application of adiponectin. Gene Ther 2014; 21:353-62. [PMID: 24500526 PMCID: PMC3975813 DOI: 10.1038/gt.2014.3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [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: 07/04/2013] [Revised: 11/19/2013] [Accepted: 12/16/2013] [Indexed: 11/09/2022]
Abstract
Foam cell formation from macrophage is a major cause of atherosclerosis. An efficient macrophage-specific promoter is required for the targeting to macrophages. In this study, we develop a macrophage-specific synthetic promoter for the therapeutic application of adiponectin (APN), an antiatherogenic gene. Synthetic promoter-146 (SP146), registered on the NCBI website (http://www.ncbi.nlm.nih.gov/nuccore/DQ107383), was tested for promoter activities in two non-macrophage cell lines (293 T, HeLa) and a macrophage cell line (RAW264.7, bone marrow-derived macrophages). To enforce macrophage specificity, partial elements of p47(phox) including the PU.1 site with various lengths (-C1, -C2 and -C3) were inserted next to the synthetic promoters. SP146-C1 showed the highest specificity and efficacy in RAW264.7 cells and was selected for development of an APN-carrying macrophage-specific promoter. Green fluorescent protein (GFP)- or APN-expressing lentivirus under SP146-C1 (Lenti-SP-GFP or Lenti-SP-APN, respectively) showed the highest expression efficacy in RAW264.7 cells compared with the non-macrophage cell lines. APN overexpression in RAW264.7 cells successfully inhibited intracellular lipid accumulation, and atherosclerotic lesions and lipid accumulation were significantly reduced by Lenti-SP-APN in ApoE-/- atherosclerosis mice. In conclusion, the synthetic promoter SP146-C1, combined with a p47(phox) promoter element, was successfully developed to target macrophage, and macrophage-specific introduction of APN under SP146-C1 was shown to ameliorate the atherosclerotic pathology.
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Affiliation(s)
- W S Kang
- 1] Research Laboratory of Cardiovascular Regeneration, Chonnam National University Hospital, Gwangju, Korea [2] Center of Molecular Medicine, Graduate School, Chonnam National University, Gwangju, Korea
| | - J S Kwon
- 1] Research Laboratory of Cardiovascular Regeneration, Chonnam National University Hospital, Gwangju, Korea [2] Heart Research Center, Chonnam National University Hospital, Gwangju, Korea
| | - H B Kim
- Research Laboratory of Cardiovascular Regeneration, Chonnam National University Hospital, Gwangju, Korea
| | - H-Y Jeong
- Research Laboratory of Cardiovascular Regeneration, Chonnam National University Hospital, Gwangju, Korea
| | - H J Kang
- Research Laboratory of Cardiovascular Regeneration, Chonnam National University Hospital, Gwangju, Korea
| | - M H Jeong
- 1] Heart Research Center, Chonnam National University Hospital, Gwangju, Korea [2] Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - J G Cho
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - J C Park
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Y S Kim
- 1] Research Laboratory of Cardiovascular Regeneration, Chonnam National University Hospital, Gwangju, Korea [2] Heart Research Center, Chonnam National University Hospital, Gwangju, Korea
| | - Y Ahn
- 1] Research Laboratory of Cardiovascular Regeneration, Chonnam National University Hospital, Gwangju, Korea [2] Heart Research Center, Chonnam National University Hospital, Gwangju, Korea [3] Department of Cardiology, Chonnam National University Hospital, Gwangju, 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 JS, Kwon JS, Won DP, Lee JH, Lee KE, Lee SY, Hong EK. Study of macrophage activation and structural characteristics of purified polysaccharide from the fruiting body of Cordyceps militaris. J Microbiol Biotechnol 2010; 20:1053-60. [PMID: 20668397 DOI: 10.4014/jmb.0910.10022] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Cordyceps militaris, an entomophathogenic fungus belonging to the class Ascomycetes, has been reported to have beneficial biological activities such as hypoglycemic, anti-inflammatory, anti-tumor, anti-metastatic, hypolipidemic, immunomodulatory, and antioxidant effect. In this study, the crude water-soluble polysaccharides CMP, which was obtained from the fruiting body of C. militaris by hot water extraction and ethanol precipitation, was fractionated by DEAE cellulose and Sepharose CL-6B column chromatography. This process resulted in three polysaccharide fractions, termed CMP Fr I, CMP Fr II, and CMP Fr III. Of these fractions, CMP Fr II, with an average molecular weight of 127 kDa, was able to upregulate effectively the phenotypic functions of macrophages such as NO production and cytokine expression. The chemical property of the stimulatory polysaccharide, CMP Fr II, was determined based on monosaccharide composition, which consisted of glucose (56.4 %), galactose (26.4 %), and mannose (17.2%). Its structural characteristics were investigated by a combination of chemical and instrumental analyses, including methylation, reductive cleavage, acetylation, Fourier transform infrared spectroscopy (FT-IR), and gas chromatography-mass spectrometry (GC-MS). Results indicated that CMP Fr II consisted of the (1-->4) or (1-->2) linked glucopyranosyl or galactopyranosyl residue with a (1-->2) or (1-->6) linked mannopyranosyl, glucopyranosyl or galactopyranosyl residue as a side chain. The configuration of the beta-linkage and random coil conformation of CMP Fr II were confirmed using a Fungi Fluor kit and Congo Red reagent, respectively.
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Affiliation(s)
- Jong Seok Lee
- Department of Bioengineering and Technology, Kangwon National University, Chuncheon, Korea
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Paek MR, Lee YJ, Yoon H, Kang HM, Kim MC, Choi JG, Jeong OM, Kwon JS, Moon OK, Lee SJ, Kwon JH. Survival rate of H5N1 highly pathogenic avian influenza viruses at different temperatures. Poult Sci 2010; 89:1647-50. [PMID: 20634520 DOI: 10.3382/ps.2010-00800] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The survival rate of Korean H5N1 highly pathogenic avian influenza (HPAI) viruses was investigated at different temperatures under the laboratory conditions. The estimated survival days for a starting viral concentration of 10(6.5) 50% egg infectious dose/0.1 mL were 930, 1,042, and 3,213 d at 4 degrees C; 226, 232, and 293 d at 20 degrees C; and 51, 55, and 58 d at 30 degrees C for A/chicken/Korea/ES/03, A/chicken/Korea/IS/06, and A/chicken/Korea/Gimje/08 (Gimje/08) viruses, respectively. The stability of the Gimje/08 virus was statistically significant compared with the other 2 viruses except for the data between Gimje/08 and A/chicken/Korea/IS/06 virus at 30 degrees C. This result indicated that the survival rate of 3 Korean HPAI viruses is different at various temperatures, which might have partially influenced the large scale of HPAI outbreak in Korea in 2008.
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Affiliation(s)
- M R Paek
- Avian Disease Division, National Veterinary Research and Quarantine Service, Anyang, Gyeonggi, 430-757, South Korea
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Lee JS, Kwon JS, Yun JS, Pahk JW, Shin WC, Lee SY, Hong EK. Structural characterization of immunostimulating polysaccharide from cultured mycelia of Cordyceps militaris. Carbohydr Polym 2010. [DOI: 10.1016/j.carbpol.2010.01.017] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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16
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Nguyen YTC, Kim HK, Kwon JS, Kim YS, Yoon TR, Ahn Y, Jeong MH, Park IK. Efficient transfer of reporter gene-loaded nanoparticles to bone marrow stromal cells (D1) by reverse transfection. J Nanosci Nanotechnol 2010; 10:3170-3174. [PMID: 20358915 DOI: 10.1166/jnn.2010.2236] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Nucleic acids can be complexed with cationic polymer to form DNA nanoparticles (polyplex) which are then immobilized on the surface coated extracellular matrix protein (ECM), the process termed as reverse transfection. ECM-containing proteins provide a surface for cell attachment and sustain the release of polyplexes from their surface, thereby inducing transgene expression for prolonged period of time. Consequently, long-term expression of the desired protein can be achieved with the smaller amount of required DNA, as compared to bolus delivery. First of all, we investigated the different ECM components as a coating material and the range of optimal coating density in different ECM was examined for enhanced transfection to neighboring cells. Reporter genes such as luciferase (luc) and enhanced green fluorescent protein (eGFP) were initially used to quantitate transfection efficiencies from polyplex from the coated ECMs of Collagen type I (Col I), fetal bovine serum protein (FBS), bovine serum albumin (BSA). DNA was complexed with positively charged polyethyleneimine (PEI) at N/P ratio 9. Our initial work exhibited that, in the case of both NIH/3T3 cell line and bone marrow stromal (D1) cell line, Col I facilitated the greatest cell adhesion compared to the other coating proteins and 0.5 microg/cm2 of Col I coating density resulted in highest transfection efficiency. On the other hand, comparison of reverse delivery system with atelocollagen-I have shown that reverse delivery system to yield ten times higher transfection efficiency than atelocollagen-PEI/DNA delivery system and one hundred times higher than atelocollagen-naked plasmid delivery system. Moreover, the amount of DNA used for reverse delivery system was much lower than the other systems. This methodology would be applied to induce cellular differentiation in 3-dimensional scaffold after coating scaffolds with genes inducing the differentiation in the nanoparticle formulation. Our final goal is to search for the optimal conditions for the differentiation of stem cells to specific cell types.
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Affiliation(s)
- Y T C Nguyen
- Department of Biomedical Sciences, Chonnam National University Medical School, The Brain Korea 21 Project, Centre for Biomedical Human Resources at Chonnam National University, Gwangju 501-746, South Korea
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Kwon JS, Lee JS, Shin WC, Lee KE, Hong EK. Optimization of culture conditions and medium components for the production of mycelial biomass and exo-polysaccharides with Cordyceps militaris in liquid culture. BIOTECHNOL BIOPROC E 2010. [DOI: 10.1007/s12257-009-0024-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kim SH, Jeon S, Kang DH, Kwon JS, Kim SI, Lee JM. Anatomical correlation between the caudate and cortical area based on the thickness in the healthy control. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)70220-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Lee JY, Gu BM, Kim LS, Youn JH, Lee JH, Yoo SY, Kang DH, Kim SJ, Choi CH, Kwon JS. Working Memory and Word Processing in Illiterate Subjects: An FMRI Study. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)71096-1] [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: 10/20/2022] Open
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Kwon JS, Kim ST, Jeon YM, Choi JH. Effect of botulinum toxin type A injection into human masseter muscle on stimulated parotid saliva flow rate. Int J Oral Maxillofac Surg 2009; 38:316-20. [PMID: 19231136 DOI: 10.1016/j.ijom.2009.01.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2007] [Revised: 11/02/2008] [Accepted: 01/16/2009] [Indexed: 11/28/2022]
Abstract
Botulinum toxin type A (BTX-A) injection into the masseter muscles is used to treat masseteric hypertrophy. No serious side effects of BTX-A have been reported, but patients sometimes complain of xerostomia. The aim of this study was to evaluate the effect of injecting BTX-A into the masseter for the treatment of masseteric hypertrophy on the flow of saliva from the parotid gland. 34 volunteers enrolled in this study. A total of 25 units of BTX-A was injected into each side bilaterally at two points at the center of the lower third of the masseter muscle. Saliva was collected from the parotid gland over a period of 10 min to determine the flow rate for 18 weeks after injection. The flow rate was calculated by dividing the amount in milliliters by the collection time in minutes. There were no significant changes in the stimulated parotid saliva flow at 4, 8, 12 or 18 weeks compared with the baseline. Within this limited study, it can be concluded that BTX-A injection into the masseter does not cause any significant decrease in the production of saliva from the parotid gland.
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Affiliation(s)
- J S Kwon
- TMJ and Orofacial Pain Clinic, Department of Oral Diagnosis & Oral Medicine, College of Dentistry, Yonsei University, Seoul, Korea
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21
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Lee KJ, Lee JS, Kim SJ, Correll CU, Wee H, Yoo SY, Jeong JM, Lee DS, Lee SI, Kwon JS. Loss of asymmetry in D2 receptors of putamen in unaffected family members at increased genetic risk for schizophrenia. Acta Psychiatr Scand 2008; 118:200-8. [PMID: 18699953 DOI: 10.1111/j.1600-0447.2008.01223.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Dopamine dysregulation has been implicated in the pathophysiology of schizophrenia. The present study was performed to examine whether unaffected relatives at high genetic risk of schizophrenia have dopamine dysregulation in comparison with healthy controls. METHOD Eleven unaffected relatives from families with two or more first- or second-degree relatives with schizophrenia (n = 9) or with a monozygotic schizophrenic twin (n = 2) and 11 age- and sex-matched controls were examined using positron emission tomography (PET) with [(11)C] raclopride. Subjects also underwent extensive neuropsychological testing. RESULTS Subjects with high genetic risk showed a loss of asymmetry of D(2) receptors in the putamen in comparison with healthy controls. In addition, they showed significantly poorer performance on neuropsychological tests than controls. CONCLUSION Our results suggest that dopamine dysregulation and neuropsychological dysfunction may be present in subjects at high genetic risk of schizophrenia. However, further studies are required to confirm these findings.
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Affiliation(s)
- K J Lee
- Neuroscience Institute, Seoul National University Medical Research Center, Seoul, South Korea
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22
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Kwon JS, Abrams J, Sugimoto A, Carey MS. Is adjuvant therapy necessary for Stage IA and IB uterine papillary serous carcinoma and clear cell carcinoma after surgical staging? Int J Gynecol Cancer 2008; 18:820-4. [PMID: 17892450 DOI: 10.1111/j.1525-1438.2007.01082.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Adjuvant therapy of early-stage uterine papillary serous carcinoma (UPSC) and clear cell carcinoma (CCC) is controversial. We conducted a prospective cohort study to evaluate outcomes of patients with early-stage UPSC or CCC who were followed without adjuvant therapy after complete surgical staging. From 2000 to 2006, we evaluated all consecutive patients with stage IA/IB UPSC or CCC who had surgical staging by a gynecological oncologist at the London Health Sciences Centre, Canada. Follow-up consisted of history and physical examination every 3 months for 2 years, then every 6 months for the next 3 years. Primary outcome measure was 2-year disease-free survival. There were 22 evaluable patients. Mean patient age was 63.4 years. Median number of pelvic and para-aortic lymph nodes resected was 15 (range 2-39) and 4 (range 0-12), respectively. Thirteen had UPSC, seven had CCC, and two had both UPSC and CCC. Nine had stage IA and 13 had stage IB disease. Median follow-up was 25 months (range 6-72). Only one patient has recurred (stage IB UPSC, isolated vault recurrence 10 months after surgery), but she is well 9 months after receiving pelvic radiotherapy and vault brachytherapy. Two-year disease-free survival was 95%. These results suggest that adjuvant therapy may not be necessary for stage IA and IB UPSC and CCC after surgical staging. Further prospective evaluation of different adjuvant therapy practices is required for early-stage UPSC and CCC, which may be useful in the design of future clinical trials.
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MESH Headings
- Adenocarcinoma, Clear Cell/mortality
- Adenocarcinoma, Clear Cell/pathology
- Adenocarcinoma, Clear Cell/radiotherapy
- Adenocarcinoma, Clear Cell/surgery
- Adult
- Aged
- Aged, 80 and over
- Cohort Studies
- Cystadenocarcinoma, Papillary/mortality
- Cystadenocarcinoma, Papillary/pathology
- Cystadenocarcinoma, Papillary/radiotherapy
- Cystadenocarcinoma, Papillary/surgery
- Cystadenocarcinoma, Serous/mortality
- Cystadenocarcinoma, Serous/pathology
- Cystadenocarcinoma, Serous/radiotherapy
- Cystadenocarcinoma, Serous/surgery
- Female
- Follow-Up Studies
- Humans
- Lymph Node Excision
- Lymphatic Metastasis
- Middle Aged
- Neoplasm Staging/methods
- Radiotherapy, Adjuvant/methods
- Recurrence
- Survival Analysis
- Uterine Neoplasms/mortality
- Uterine Neoplasms/pathology
- Uterine Neoplasms/radiotherapy
- Uterine Neoplasms/surgery
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Affiliation(s)
- J S Kwon
- Department of Gynecologic Oncology, MD Anderson Cancer Center, Houston, Texas 77230-1439, USA.
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Kwon JS, Lenehan J, Carey M, Ainsworth P. Prolonged survival among women with BRCA germline mutations and advanced endometrial cancer: a case series. Int J Gynecol Cancer 2008; 18:546-9. [PMID: 17645508 DOI: 10.1111/j.1525-1438.2007.01030.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
It is unclear if BRCA mutation carriers diagnosed with advanced endometrial cancer have a better prognosis compared to sporadic cases. From a population database of BRCA1 and 2 mutation carriers in Southwestern Ontario, Canada, we identified three women with advanced-stage endometrial cancer. They were 57, 59, and 64 years of age, and of English/Scottish, Ashkenazi Jewish, and English heritage, respectively. They had different mutations in BRCA1 (Q1240X:C3837T; 68_69delAG; 1961delA). One had a sarcomatoid carcinoma and two had uterine papillary serous carcinoma. All had stage IVB disease, with surgery followed by adjuvant chemotherapy and/or radiotherapy. Follow-up has ranged from 3.3 to 14.6 years. They are still alive and well with no evidence of recurrent disease. This observation raises the question as to whether BRCA mutations may be associated with a better prognosis in patients with advanced endometrial cancer
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Affiliation(s)
- J S Kwon
- Department of Gynecologic Oncology, MD Anderson Cancer Center, Houston, Texas, USA.
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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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Rho MH, Kim DW, Kim SS, Sung YS, Kwon JS, Lee SW. Tuberculous otomastoiditis on high-resolution temporal bone CT: comparison with nontuberculous otomastoiditis with and without cholesteatoma. AJNR Am J Neuroradiol 2007; 28:493-6. [PMID: 17353320 PMCID: PMC7977825] [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] [Received: 02/07/2006] [Accepted: 05/15/2006] [Indexed: 05/14/2023]
Abstract
BACKGROUND AND PURPOSE Our purpose was to evaluate the differential findings of tuberculous otomastoiditis (TOM) and nontuberculous chronic otomastoiditis with or without middle ear cholesteatoma on high-resolution CT of the temporal bone. MATERIALS AND METHODS We reviewed 19 cases of TOM, 30 cases of chronic otomastoiditis (COM), and 30 cases of COM with cholesteatoma (CHOM), all of which had been confirmed by pathologic examination after surgery or middle ear mucosal biopsy. Two neuroradiologists analyzed the findings of temporal bone CT. RESULTS The soft tissue attenuation in the entire middle ear cavity, preservation of the mastoid air cells without sclerotic change, and soft tissue extension to the external auditory canal (EAC) or mucosal thickening of the bony EAC, had statistical significance (chi(2) test, P < .05) between the TOM group and the COM group and between the TOM group and the CHOM group. Erosion of the ossicles and scutum was statistically significant (chi(2) test, P < .05) between the TOM group and the CHOM group. CONCLUSION Findings of soft tissue in the entire middle ear cavity, preservation of mastoid air cells without sclerotic change, soft tissue extension, or mucosal thickening of the EAC with intact scutum seemed to be helpful in differentiating TOM from COM and CHOM.
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Affiliation(s)
- M H Rho
- Department of Radiology, Masan Samsung Hospital, Sungkyunkwan University School of Medicine, Masan, Korea.
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Kwon JS, Carey MS, Cook EF, Qiu F, Paszat L. Patterns of practice and outcomes in intermediate- and high-risk stage I and II endometrial cancer: a population-based study. Int J Gynecol Cancer 2007; 17:433-40. [PMID: 17309565 DOI: 10.1111/j.1525-1438.2007.00812.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
To evaluate patterns of practice and outcomes in intermediate- and high-risk stage I and II endometrial cancer in the province of Ontario, Canada. This was a retrospective population-based study of women diagnosed with stage I and II endometrial cancer in Ontario from 1996 to 2000. After excluding low-risk (stages IA and IB, grades 1 and 2) and nonendometrioid histologies, the population was stratified into two risk groups: intermediate risk (stages IA and IB, grade 3; stages IC and IIA, grades 1 and 2; stage IIA, grade 3 if <50% myometrial invasion) and high risk (stage IC, grade 3; stage IIA, grade 3 if >50% myometrial invasion, and all stage IIB). Patterns of practice were assessed in each risk group, including use of surgical staging and adjuvant pelvic radiotherapy (APRT). Cox proportional hazards models determined effects of prognostic factors on 5-year overall survival (OS), including age, income, comorbidities, lymphvascular space invasion (LVSI), surgical staging, and APRT. There were 995 women in this study: 748 intermediate risk (75.2%) and 247 high risk (24.8%). Only 69 (9.2%) and 40 (16.2%) women underwent surgical staging in the intermediate- and high-risk groups, respectively. Surgical staging did not reduce rates of APRT. Determinants of survival included age >60 and comorbidities in the intermediate-risk group, and age >60, income, and LVSI in the high-risk group. In this population-based study, there were variable patterns of practice for intermediate- and high-risk stage I and II endometrial cancer. Surgical staging and APRT did not affect OS
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Affiliation(s)
- J S Kwon
- Division of Gynecologic Oncology, University of Western Ontario, London, Ontario, Canada.
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Lim KS, Kwon JS, Jang IJ, Jeong JM, Lee JS, Kim HW, Kang WJ, Kim JR, Cho JY, Kim E, Yoo SY, Shin SG, Yu KS. Modeling of Brain D2 Receptor Occupancy-Plasma Concentration Relationships with a Novel Antipsychotic, YKP1358, Using Serial PET Scans in Healthy Volunteers. Clin Pharmacol Ther 2007; 81:252-8. [PMID: 17259948 DOI: 10.1038/sj.clpt.6100049] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
YKP1358 is a novel serotonin (5-HT(2A)) and dopamine (D(2)) antagonist that, in preclinical studies, fits the general profile of an atypical antipsychotic. We conducted a D(2) receptor occupancy study with YKP1358 in healthy volunteers using positron emission tomography (PET) to measure the D(2) receptor occupancy of YKP1358 and to characterize its relationship to plasma drug concentrations. A single oral dose, parallel group, dose-escalation (100, 200, and 250 mg) study was performed in 10 healthy male volunteers with the PET radiotracer [(11)C]raclopride. The D(2) receptor occupancy of striatum was measured pre-dose, and at 2, 5, and 10 h after YKP1358 administration. Serial blood samples were taken for measurement of plasma YKP1358 concentrations. D(2) receptor occupancy by YKP1358 increased to 53-83% at 2 h, and then decreased afterwards, ranging from 40-64% at 5 h to 20-51% at 10 h. The YKP1358 dose-plasma concentration relationship exhibited extensive variability, but there was a good relationship between plasma concentrations and D(2) receptor occupancy that was well predicted by a sigmoid E(max) model using nonlinear mixed effects modeling. To our knowledge, this is the first study in which the relationship between plasma concentration and the biomarker of D(2) receptor occupancy was modeled using nonlinear mixed effects modeling. It is anticipated that these results will be useful in estimating for subsequent studies the initial doses of YKP1358 required to achieve a therapeutically effective range of D(2) receptor occupancy.
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Affiliation(s)
- K S Lim
- Department of Pharmacology and Clinical Pharmacology Unit, Seoul National University College of Medicine and Hospital, Seoul, Korea
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Rho MH, Kim DW, Kwon JS, Lee SW, Sung YS, Song YK, Kim MG, Kim SG. OK-432 sclerotherapy of plunging ranula in 21 patients: it can be a substitute for surgery. AJNR Am J Neuroradiol 2006; 27:1090-5. [PMID: 16687549 PMCID: PMC7975734] [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: 05/09/2023]
Abstract
BACKGROUND AND PURPOSE Although first-choice therapy for the ranula is surgery, this choice presents technical difficulties and frequent recurrences because of insufficient surgery. We evaluated the efficacy of OK-432 sclerosis of the plunging ranula as a substitute for surgery. METHODS Twenty-one patients with plunging ranula were treated with intralesional injection of OK-432. The liquid content of the ranula was aspirated as much as possible, after which OK-432 solution was injected in the same volumes as that drawn out. Patients were followed on sonography or CT. RESULTS Seven (33.3%) patients with plunging ranulas showed total shrinkage and resolution, and 4 (19%) patients showed near-total shrinkage (more than 90% of the volume). Four (19%) patients revealed marked shrinkage (more than 70% of the volume), and 3 (14.3%) patients showed partial shrinkage (less than 70% of the volume). Three (14.3%) patients showed recurrence after total shrinkage 1 month after injection. The overall recurrence rate after each injection was 47% (16 of 34 injections in 21 patients), but the recurrence rate after the last sclerotherapy was only 14%. There were no serious side effects except for fever lasting 2-3 days (12 patients) and swelling (10 patients) for 3-5 days. Mild odynophagia for 1-2 days was also noted in 7 patients, and there was 1 severe case of odynophagia. CONCLUSION OK-432 sclerotherapy of plunging ranula is a safe and potentially curative procedure that may be used as a primary treatment for plunging ranula before considering surgery.
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Affiliation(s)
- M H Rho
- Department of Radiology, Masan Samsung Hospital, Sungkunkwan University School of Medicine, Masan, Korea
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Shin YW, Kwon JS, Kim JJ, Kang DH, Youn T, Kang KW, Kang E, Lee DS, Lee MC. Altered neural circuit for working memory before and after symptom provocation in patients with obsessive-compulsive disorder. Acta Psychiatr Scand 2006; 113:420-9. [PMID: 16603033 DOI: 10.1111/j.1600-0447.2005.00709.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The authors compared the neural circuits recruited for working memory (WM) in obsessive-compulsive disorder (OCD) patients both at a neutral state and at a symptom provoked state. METHOD Twelve OCD patients, and 12 age-, and sex-matched healthy subjects underwent [(15)O]H(2)O positron emission tomography (PET) scanning, while performing WM task. In the patients, the tasks were performed both in the neutral and in the symptom provoked states. RESULTS In the OCD patients, the right caudate and the right superior parietal cortex (rSPC) displayed activations for WM at the neutral state, while the right cingulate cortex and rSPC displayed activations for WM at the symptom provoked state. Path analysis revealed that the activity of the caudate and orbitofrontal cortex was altered according to the interaction between WM and symptom provocation. CONCLUSION The interaction between symptom provocation and WM occurring in the fronto-striatal system may hold the key to the neurobiology of OCD.
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Affiliation(s)
- Y-W Shin
- Department of Psychiatry, Seoul National University College of Medicine and Institute for Neuroscience, SNU-MRC, Seoul, South Korea
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Lee SH, Jeong JS, Ha HS, No MJ, Hong JJ, Kwon JS, Lee KH, Han DJ, Lee SG. Decision-Related Factors and Attitudes Toward Donation in Living Related Liver Transplantation: Ten-Year Experience. Transplant Proc 2005; 37:1081-4. [PMID: 15848629 DOI: 10.1016/j.transproceed.2005.01.032] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Living related liver transplantation (LRLT) has been performed since 1994 in Korea; more than 600 donors have contributed to our successful LRLT program for 10 years. Although the decision to donate is difficult and the donors need a formal psychosocial assessment, no system has been available to us for the assessment. This survey was performed as a presurveillance for the development of a psychosocial assessment protocol. METHODS A survey questionnaire included 31 questions on general and medical characteristics, factors, and processes related to the decision for donation. Donors of partial livers at least 6 months ago during the period from December 1994 to August 2003 and whose address could be confirmed by telephone were enrolled in the study. RESULTS A questionnaire was sent by mail to 441 contactable donors of whom 209 (47.4%) responded. Male-to-female ratio was 2:1 and mean age was 32.8 years (range: 16 to 60 years). The number of spousal donors was 120 (57.4%) and 164 (78.5%) donors were employed at the time of donation. Protestants, Buddhists, and Catholics were 29.2%, 19.1%, and 14.8%, respectively. Parents were the most common recipients (33.0%), followed by siblings (17.2%), extended family members (17.2%), and children (15.8%); one hundred eighty nine (90.4%) donors had decided by themselves, the major reason for donation in 192 (91.9%) donors was "to save the lives of family members and relatives." The first person who suggested donation was the donor (64.1%), followed by family members (23.9%) or the attending physicians (8.6%). Although 70.8% of donors answered that they were not hesitant to donate at the time of decision, 44.5% were uneasy at the possibility of being unable to sustain a normal life after donation, at their lack of knowledge on organ donation, and about the pain and fear of surgery. Family members and relatives (53.3%), medical personnel (46.7%), and previous donors (35.4%) were the preferable counselors compared to transplantation institutions and clergymen. The large majority (80.8%) of donors would encourage others to donate. CONCLUSIONS Although the decision to donate was made by the donors themselves in most cases and they appeared firm and determined about their decision, a significant number of donors felt uneasy about possible complications of organ donation and effects on their lives after donation. A precise and formal psychosocial assessment protocol is needed to support and secure their decision before and after donation.
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Affiliation(s)
- S H Lee
- Transplantation Team and Departments of Clinical Nursing and General Surgery, University of Ulsan Asan Medical Center, Seoul, Korea
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Abstract
This study was conducted to investigate the deficits of organizational strategy and visual memory in obsessive-compulsive disorder (OCD). Thirty OCD patients and 30 healthy controls aged 20-35 years participated. The Maudsley Obsessive-Compulsive Inventory, Beck Anxiety Inventory, Wechsler Adult Intelligence Scale, and Rey-Osterrieth Complex Figure (ROCF) test were administered to participants. The authors scored ROCF performances using the Boston Qualitative Scoring System. The OCD patients showed poorer planning ability and higher fragmentation than did healthy controls when copying the ROCF, and they showed even poorer performances in the immediate and delayed recall conditions. The authors found that the Organization score in the copy condition mediated the difference between the OCD group and the healthy group in immediate recall. The direct effect of diagnosis (OCD or healthy) on the immediate recall condition of the ROCF was also significant. This study indicates that people with OCD have poor memory function and organizational deficits.
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Affiliation(s)
- M S Shin
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
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Jo C, Yook HS, Lee MS, Kim JH, Song HP, Kwon JS, Byun MW. Irradiation effects on embryotoxicity and oxidative properties of gossypol dissolved in methanol. Food Chem Toxicol 2003; 41:1329-36. [PMID: 12909266 DOI: 10.1016/s0278-6915(03)00125-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Gossypol dissolved in methanol (0.25 and 0.5 mg/ml) was gamma-irradiated at 0, 5, 10, and 20 kGy. The gossypol content was significantly reduced by irradiation in a dose-dependent manner. Ames test performed with nonirradiated and irradiated gossypol solutions was negative at the level of 0.1, 0.5, 1, 10, 50, and 100 microg gossypol/plate. At the gossypol concentration of 2.5 microg/ml, the blastocysts formation rate of mice embryo were decreased by a factor of two as compared with the control, but irradiation at 20 kGy increased the blastocysts formation, resulting in no difference from the control. Addition of gossypol to oil emulsion system or oil showed a prooxidative effect of lipids at the beginning stage by increasing 2-thiobarbituric acid reactive substances (TBARS) and peroxide value but irradiation of the gossypol solution decreased the oxidative changes significantly as compared with the nonirradiated one. Results indicated that irradiation decreased the gossypol concentration dissolved in methanol, resulting in a reduction of embryotoxicity in mice.
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Affiliation(s)
- C Jo
- Team for Radiation Food Science and Biotechnology, Korea Atomic Energy Research Institute, Yuseong, 305-600 Daejeon, South Korea
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Kim JS, Lee JM, Kim JJ, Choe BY, Oh CH, Nam SH, Kwon JS, Kim SI. Non-linear registration for brain images by maximising feature and intensity similarities with a Bayesian framework. Med Biol Eng Comput 2003; 41:473-80. [PMID: 12892372 DOI: 10.1007/bf02348092] [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] [Indexed: 11/30/2022]
Abstract
The objective of this work was to provide a new, precise registration of the cortical mantle with a non-linear transformation. Image registration is broadly classified into two types, using intensity similarity and feature similarity. Whereas the former approach has merit in global brain matching, the latter provides a fast registration centred on a region of interest. The hybrid registration proposed in this paper was achieved using a Bayesian framework, which consisted of a likelihood model including intensity similarity and a prior model including feature information and a smoothing constraint. In this approach, each voxel was spatially transformed, so that the distance between corresponding features was shortened and also so that the intensity correlation was maximised. The result of the hybrid method clearly showed a good match of global brain (r = 0.930) by including intensity similarity. Moreover, this method compensated for the approximated sulcus of the feature-based method with intensity information, so that the geometric shape and thickness of the sulcus at the feature-defined region was likely to be registered. The accuracy in the feature-defined area was improved by 33.4% and 7.5% compared with feature-based and intensity-based methods, respectively.
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Affiliation(s)
- J S Kim
- Department of Biomedical Engineering, Hanyang University, Korea
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Kwon JS, Shin YW, Kim CW, Kim YI, Youn T, Han MH, Chang KH, Kim JJ. Similarity and disparity of obsessive-compulsive disorder and schizophrenia in MR volumetric abnormalities of the hippocampus-amygdala complex. J Neurol Neurosurg Psychiatry 2003; 74:962-4. [PMID: 12810792 PMCID: PMC1738533 DOI: 10.1136/jnnp.74.7.962] [Citation(s) in RCA: 90] [Impact Index Per Article: 4.3] [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: 11/04/2022]
Abstract
OBJECTIVES Given that obsessive-compulsive disorder (OCD) and schizophrenia may share clinical symptoms as well as functional brain abnormalities, this study was designed to clarify common and different morphological abnormalities in OCD and schizophrenia. METHODS Volumes of the hippocampus, the amygdala, and the thalamus were measured in three age and sex matched groups of 22 patients with OCD, 22 patients with schizophrenia, and 22 normal subjects using three dimensional magnetic resonance imaging. Volume tracing was performed manually on serial coronal slices with the references of sagittal or axial planes using internal landmarks. RESULTS Hippocampal volume was bilaterally reduced in both OCD and schizophrenic patients versus the normal controls. Left amygdala volume was significantly enlarged in patients with OCD but not in patients with schizophrenia versus the normal controls. The thalamus did not show any volumetric group differences. CONCLUSIONS Non-specific hippocampal reduction in both the OCD and schizophrenic groups is likely to link to a clinical overlap between the two illnesses, whereas the left amygdala enlargement observed only in the OCD patients seems to be suggestive of a unique role for the amygdala in the pathophysiology of OCD.
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Affiliation(s)
- J S Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
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Kang DH, Kwon JS, Kim JJ, Youn T, Park HJ, Kim MS, Lee DS, Lee MC. Brain glucose metabolic changes associated with neuropsychological improvements after 4 months of treatment in patients with obsessive-compulsive disorder. Acta Psychiatr Scand 2003; 107:291-7. [PMID: 12662252 DOI: 10.1034/j.1600-0447.2003.00070.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The study was designed to elucidate regional brain metabolic changes according to a treatment and their relationship with neuropsychological performance changes in obsessive-compulsive disorder (OCD). METHOD Cerebral glucose metabolic rates were repeatedly measured before and after treatment in 10 patients with OCD using [18F]-2-fluoro-deoxyglucose positron emission tomography (PET). They were compared on a voxel-basis, and the correlations were counted between the regional metabolic changes and the degree to improvement on the neuropsychological assessments. RESULTS After treatment, the patients showed significant (P < 0.005, two-tailed) regional metabolic changes in multiple brain areas involving frontal-subcortical circuits and parietal-cerebellar networks. Especially, the metabolic changes of the putamen, the cerebellum, and the hippocampus were significantly correlated with the improvement of the immediate- and delayed-recall scores of the Rey-Osterrieth Complex Figure Test (RCFT). CONCLUSION These results suggest a possibility that metabolic changes of frontal-subcortical and parietal-cerebellar circuit changes may underlie cognitive improvements in patients with OCD.
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Affiliation(s)
- D-H Kang
- Department of Psychiatry, Seoul National University Hospital, Seoul, Korea
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Lyoo IK, Yoon T, Kang DH, Kwon JS. Patterns of changes in temperament and character inventory scales in subjects with obsessive-compulsive disorder following a 4-month treatment. Acta Psychiatr Scand 2003; 107:298-304. [PMID: 12662253 DOI: 10.1034/j.1600-0447.2003.00054.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The purpose of this study was to assess changes in the temperament and character patterns in subjects with obsessive-compulsive disorder (OCD) following the treatment for obsessive/compulsive and accompanying depressive symptoms. METHOD Study subjects were 35 patients who met the DSM-IV criteria for OCD. All subjects were assessed with the Temperament and Character Inventory (TCI), the Yale-Brown Obsessive-Compulsive Scale, the Beck Depression Inventory, and the Beck Anxiety Inventory before and after a 4-month treatment. RESULTS Harm Avoidance (HA) scores in OCD subjects before treatment significantly decreased after treatment. However, the Self-Directedness scores, which were significantly lower than healthy comparison subjects before treatment, did not change. In addition, Reward Dependence scores in OCD subjects, which were not significantly different from healthy comparison subjects before treatment, significantly increased after treatment. CONCLUSION The TCI pattern of untreated OCD subjects (high HA and low Self-Directedness, relative to healthy comparison subjects) and the decrease of HA scores and no change in Self-Directedness scores following a successful treatment suggest that temperaments are more amenable to treatment than characters.
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Affiliation(s)
- I K Lyoo
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
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Abstract
This study investigated the cognitive and cerebral function of adolescents with conduct problems by neuropsychological battery (STIM) and event-related potential (ERP). Eighteen adolescents with conduct disorder, and 18 age-matched normal subjects were included. Such cognitive functions as attention, memory, executive function and problem solving were evaluated using subtests of STIM. ERP was measured using an auditory oddball paradigm. The conduct group showed a significantly lower hit rate on the Wisconsin Card Sorting Test (WCST) than the control group. In addition, the conduct group showed reduced P300 amplitude at Fz and Cz, and prolonged P300 latency at Fz, and there was a significant correlation between P300 amplitude and Stroop test performance. These results indicate that adolescents with conduct problems have impairments of executive function and inhibition, and that these impairments are associated with frontal dysfunction.
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Affiliation(s)
- M S Kim
- Department of Psychiatry, Seoul National University Medical College, Neuroscience Institute, Seoul National University, Korea
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Kim JJ, Lee MC, Kim J, Kim IY, Kim SI, Han MH, Chang KH, Kwon JS. Grey matter abnormalities in obsessive-compulsive disorder: statistical parametric mapping of segmented magnetic resonance images. Br J Psychiatry 2001; 179:330-4. [PMID: 11581113 DOI: 10.1192/bjp.179.4.330] [Citation(s) in RCA: 167] [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: 11/23/2022]
Abstract
BACKGROUND Although a number of functional imaging studies are in agreement in suggesting orbitofrontal and subcortical hyperfunction in the pathophysiology of obsessive-compulsive disorder (OCD), the structural findings have been contradictory. AIMS To investigate grey matter abnormalities in patients with OCD by employing a novel voxel-based analysis of magnetic resonance images. METHOD Statistical parametric mapping was utilised to compare segmented grey matter images from 25 patients with OCD with those from 25 matched controls. RESULTS Increased regional grey matter density was found in multiple cortical areas, including the left orbitofrontal cortex, and in subcortical areas, including the thalamus. On the other hand, regions of reduction were confined to posterior parts of the brain, such as the left cuneus and the left cerebellum. CONCLUSIONS Increased grey matter density of frontal-subcortical circuits, consonant with the hypermetabolic findings from functional imaging studies, seems to exist in patients with OCD, and cerebellar dysfunction may be involved in the pathophysiology of OCD.
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Affiliation(s)
- J J Kim
- BK Life Sciences, Seoul National University, 28 Yongon-dong, Chongno-gu, Seoul, Korea 110-744
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Kwon JS, Elit L, Mazurka J, Moens F, Schmuck ML. Weekly intravenous methotrexate with folinic acid for nonmetastatic gestational trophoblastic neoplasia. Gynecol Oncol 2001; 82:367-70. [PMID: 11531296 DOI: 10.1006/gyno.2001.6271] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The objective of this study was to determine the complete response rate to weekly intravenous methotrexate at 100 mg/m(2) with folinic acid for patients with nonmetastatic gestational trophoblastic neoplasia. METHODS From 1988 to 1999, 22 women with nonmetastatic gestational trophoblastic neoplasia were treated with weekly intravenous methotrexate with folinic acid at the Hamilton Regional Cancer Centre. Complete response was defined as the attainment of a serum beta-hCG level <5 IU/L for 3 consecutive weeks. Toxicity was graded according to the National Cancer Institute of Canada-Clinical Trials Group criteria for chemotherapy toxicity. RESULTS There were 10 women who achieved complete response with weekly intravenous methotrexate alone (45.5%). Of the 12 who did not achieve complete response with methotrexate, 10 received actinomycin D and 2 received EMA as second-line chemotherapy. Patients successfully treated with methotrexate required a median of 6.5 cycles (including 2 cycles for consolidation) to achieve complete response. The only significant prognostic factor for failure with methotrexate was pretreatment beta-hCG (P = 0.01). CONCLUSIONS Only a select group of patients with low pretreatment beta-hCG titers would be expected to achieve complete response with this regimen. Large randomized studies are required to determine the optimal treatment for nonmetastatic gestational trophoblastic neoplasia.
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Affiliation(s)
- J S Kwon
- Division of Gynecologic Oncology, University of Toronto, Toronto, Canada
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Abstract
BACKGROUND The purpose of this study was to assess the temperament and character patterns of obsessive-compulsive disorder (OCD) patients and to investigate the relationship between patterns of temperament and character and the severity of obsessive-compulsive symptoms. METHOD The subjects were 40 patients who met DSM-IV criteria for OCD and 40 age-, sex-, and IQ-matched healthy controls. All subjects completed Cloninger's Temperament and Character Inventory. Other instruments included the Yale-Brown Obsessive Compulsive Scale, the Beck Depression Inventory, and the Beck Anxiety Inventory. RESULTS OCD patients showed significantly higher scores of harm avoidance and lower scores of novelty seeking and self-directedness compared with healthy comparison subjects. In addition, the high harm avoidance and low self-directedness scores are correlated with a greater severity of obsessive-compulsive symptoms in OCD subjects (multiple regression analysis, beta = 0.39, t = 2.54, df = 34, p = .016; beta = -0.41, t = 2.46, df = 34, p = .019, respectively). CONCLUSION OCD patients had distinct patterns of temperament and character compared with healthy comparison subjects. In addition, these patterns are specifically related to the severity of obsessive-compulsive symptoms.
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Affiliation(s)
- I K Lyoo
- Department of Psychiatry, Seoul National University Medical College, Neuroscience Institute, South Korea
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Kim M, Kim J, Kwon JS. The effect of immediate and delayed word repetition on event-related potential in a continuous recognition task. Brain Res Cogn Brain Res 2001; 11:387-96. [PMID: 11339988 DOI: 10.1016/s0926-6410(01)00011-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The dissociation of immediate and delayed word repetition was studied using a continuous recognition memory task and event-related potential (ERP). Among 240 stimulus words, 40 words were not repeated, 100 were immediately repeated and 100 were repeated after 5 intervening words. Words presented only once during the experiment were referred to as new words. Subjects responded faster and more accurately to words repeated immediately than to new words and to words repeated after a delay. In terms of ERP results, immediate repetition was associated with large P300 amplitude, early P300 latency and the absence of N400, while delayed repetition was associated with small P300 amplitude, late P300 latency and the presence of N400. N400 was elicited only to new words and to those repeated after intervening words. The general morphology of the waveforms was similar for two repetition conditions until around 310 ms after the onset of stimulus. These results indicate that distinct neural systems subserve the immediate and delayed repetition effect, and that the difference between the two emerges around 310 ms poststimulus. Immediate and delayed word repetition are considered in terms of template matching and memory searching, and are possibly mediated by the parietal and left medial temporal lobes, respectively.
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Affiliation(s)
- M Kim
- Department of Psychiatry, Seoul National University College of Medicine and Institute for Neuroscience, SNU-MRC, 28 Yeongon-dong, Chongno-gu, 110-744, Seoul, South Korea
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Abstract
OBJECTIVE To compare the efficacy of oral with vaginal misoprostol for induction of labour at term. DESIGN Randomised trial. SETTING Tertiary Care hospital. PARTICIPANTS One hundred and sixty-seven women requiring induction of labour. METHODS The women were randomised to receive 50 microg of misoprostol orally or vaginally every 6 h until the cervix was favourable for amniotomy, spontaneous rupture of membranes, or active labour occurred. Sample size was calculated with a two-tailed alpha of 0.05 and a power of 95% to detect a 5 h difference in induction-to-delivery time. Student's t test was used for comparison of normally distributed continuous variables and the Mann-Whitney U test was used for non-Gaussian distributed continuous variables. Fisher' s exact and chi2 tests were used for comparison of categorical variables. The main outcome measure was induction to delivery time. RESULTS The median induction to delivery time was significantly shorter with vaginal misoprostol (15.7 h range 4.3-55.7), compared with oral misoprostol (23.0 h range 3.2-141.7, P = 0.0013). The median number of doses was also significantly less in the vaginal misoprostol group, 1 (range 1-3), compared with the oral group, 2 (range 1-8), (P < 0.0001). The significant differences in outcome held true when nulliparous and multiparous women were analysed separately. There were no differences between the two routes of administration with respect to rates of hyperstimulation or neonatal asphyxia. There were more caesarean sections in the vaginal misoprostol group, but the difference was not statistically significant. CONCLUSIONS Compared with oral misoprostol, vaginal misoprostol for induction of labour at term results in a shorter induction-to-delivery time, with fewer doses required per patient. Vaginal misoprostol may be associated with higher rates of caesarean section than oral misoprostol.
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Affiliation(s)
- J S Kwon
- Department of Obstetrics and Gynaecology, Queen's University, Kingston General Hospital, Ontario, Canada
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Kwon JS, Kim YM, Chang CG, Park BJ, Kim L, Yoon DJ, Han WS, Lee HJ, Lyoo IK. Three-year follow-up of women with the sole diagnosis of depressive personality disorder: subsequent development of dysthymia and major depression. Am J Psychiatry 2000; 157:1966-72. [PMID: 11097962 DOI: 10.1176/appi.ajp.157.12.1966] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors sought to determine whether subjects with the sole diagnosis of depressive personality disorder are at higher risk for developing dysthymia and major depression than are healthy comparison subjects. METHOD Eighty-five women with depressive personality disorder who had no comorbid axis I or axis II disorders and 85 age-matched healthy comparison women were initially recruited and reinterviewed 3 years later to evaluate the cumulative incidence rate of dysthymia and major depression. RESULTS At the 3-year follow-up assessment, the women with depressive personality disorder had a significantly greater odds ratio for developing dysthymia than did the healthy comparison women. The difference in odds ratios for the development of major depression between women with and without depressive personality disorder did not reach statistical significance. CONCLUSIONS The present study, the first to determine the subsequent development of dysthymia and major depression in subjects with the sole diagnosis of depressive personality disorder, found that subjects with depressive personality disorder had a greater risk of developing dysthymia than did healthy comparison subjects at 3-year follow-up. Findings of the current study also suggest that depressive personality disorder may mediate the effects of a family history of axis I unipolar mood disorders.
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Affiliation(s)
- J S Kwon
- Department of Psychiatry, Seoul National University Hospital and College of Medicine, South Korea
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Chang J, Kim IO, Ahn JS, Kwon JS, Jeon SH, Kim SH. The CNS midline cells coordinate proper cell cycle progression and identity determination of the Drosophila ventral neuroectoderm. Dev Biol 2000; 227:307-23. [PMID: 11071757 DOI: 10.1006/dbio.2000.9905] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The CNS midline cells, specified by the single-minded (sim) gene, are required for the proper patterning of the ventral CNS and epidermis, which are derived from the Drosophila ventral neuroectoderm. Defects in the sim mutant are characterized by the loss of the gene expression, which is required for the proper formation of the ventral neurons and epidermis, and by a decrease in the spacing of longitudinal and commissural axon tracks. Molecular and cellular mechanisms for these defects were analyzed to elucidate the precise role of the CNS midline cells in proper patterning of the ventral neuroectoderm during embryonic neurogenesis. These analyses showed that the ventral neuroectoderm in the sim mutant fails to carry out its proper formation and characteristic cell division cycle. This resulted in the loss of the dividing neuroectodermal cells that are located ventral to the CNS midline. The CNS midline cells are also required for the cell cycle-independent expression of the neural and epidermal markers. This indicates that the CNS midline cells are essential for the establishment and maintenance of the ventral epidermal and neuronal cell lineage by cell-cell interaction. On the other hand, the CNS midline cells do not cause extensive cell death in the ventral neuroectoderm. This study indicates that the CNS midline cells play important roles in the coordination of the proper cell cycle progression and the correct identity determination of the adjacent ventral neuroectoderm along the dorsoventral axis.
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Affiliation(s)
- J Chang
- Department of Chemistry, Konkuk University, Seoul, 143-701, Korea
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Ju WK, Choi SH, Kwon JS, Kwon OJ, Lee MY, Oh SJ, Moon JL, Chun MH. Expression of brain/kidney protein in Müller cells of rat retina following transient ischemia. Neurosci Lett 2000; 293:53-6. [PMID: 11065136 DOI: 10.1016/s0304-3940(00)01492-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We have investigated the expression and cellular localization of brain/kidney (B/K) protein in the rat retina following transient ischemia. In the normal retina, strong B/K immunoreactivity was localized to some ganglion cells. In addition, a few radial Muller cell processes showed B/K immunoreactivity. Following ischemia and reperfusion, most B/K-labeled ganglion cells were lost, whereas between 1 day and 2 weeks post-lesion B/K immunoreactivity appeared in many more Muller cell processes with increasing intensity. Quantitative evaluation by immunoblotting confirmed that B/K expression then decreased progressively, to 35% of control values at four weeks post-lesion. Our findings suggest that Muller cells are involved in the pathophysiology of retinal ischemia through the expression of B/K following transient ischemia.
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Affiliation(s)
- W K Ju
- Department of Anatomy, College of Medicine, The Catholic University of Korea, Socho-gu, Seoul
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Abstract
BACKGROUND Cardiovascular side effects of clozapine are not uncommon, but few systematic studies of these effects have been performed. In this study, we reviewed data on the electrocardiographic (ECG) abnormalities in patients treated with clozapine. METHOD Sixty-one patients treated with clozapine were selected from the Seoul National University Hospital Treatment-Resistant Schizophrenia Clinic. A retrospective chart review was conducted to identify ECG abnormalities and cardiovascular side effects. RESULTS The prevalence of ECG abnormalities in patients who had been using antipsychotics other than clozapine was 13.6% at baseline, which increased significantly to 31.1% after commencement of clozapine treatment. Among the 53 patients without baseline ECG abnormalities, 13 showed new-onset ECG abnormalities after using clozapine. Normal ECG under previous antipsychotic medication reduced the risk of new-onset ECG abnormalities, whereas increased age was found to increase the risk. The occurrence of orthostatic hypotension or tachycardia was not related to the development of ECG abnormalities. Most of the newly developed abnormalities had little clinical significance, and they tended to occur during the initial phase of treatment. In 10 patients, ECGs normalized despite the continued use of clozapine. Clozapine increased corrected QT interval (QTc) in a dose-dependent fashion; however, the clinical significance of this observation is uncertain. Pathologic prolongation of QTc was found to be rare. CONCLUSION Although a substantial portion of patients treated with clozapine developed ECG abnormalities, most of the abnormalities were benign and did not hinder further treatment.
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Affiliation(s)
- U G Kang
- Department of Psychiatry, Seoul National University College of Medicine, Korea
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47
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Kwon JS, O'Donnell BF, Wallenstein GV, Greene RW, Hirayasu Y, Nestor PG, Hasselmo ME, Potts GF, Shenton ME, McCarley RW. Gamma frequency-range abnormalities to auditory stimulation in schizophrenia. Arch Gen Psychiatry 1999; 56:1001-5. [PMID: 10565499 PMCID: PMC2863027 DOI: 10.1001/archpsyc.56.11.1001] [Citation(s) in RCA: 464] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Basic science studies at the neuronal systems level have indicated that gamma-range (30-50 Hz) neural synchronization may be a key mechanism of information processing in neural networks, reflecting integration of various features of an object. Furthermore, gamma-range synchronization is thought to depend on the glutamatergically mediated interplay between excitatory projection neurons and inhibitory neurons utilizing gamma-aminobutyric acid (GABA), which postmortem studies suggest may be abnormal in schizophrenia. We therefore tested whether auditory neural networks in patients with schizophrenia could support gamma-range synchronization. METHODS Synchronization of the electroencephalogram (EEG) to different rates (20-40 Hz) of auditory stimulation was recorded from 15 patients with schizophrenia and 15 sex-, age-, and handedness-matched control subjects. The EEG power at each stimulation frequency was compared between groups. The time course of the phase relationship between each stimulus and EEG peak was also evaluated for gamma-range (40 Hz) stimulation. RESULTS Schizophrenic patients showed reduced EEG power at 40 Hz, but not at lower frequencies of stimulation. In addition, schizophrenic patients showed delayed onset of phase synchronization and delayed desynchronization to the click train. CONCLUSIONS These data provide new information on selective deficits in early-stage sensory processing in schizophrenia, a failure to support the entrainment of intrinsic gamma-frequency oscillators. The reduced EEG power at 40 Hz in schizophrenic patients may reflect a dysfunction of the recurrent inhibitory drive on auditory neural networks.
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Affiliation(s)
- J S Kwon
- Department of Psychiatry, Laboratory of Neuroscience, Harvard Medical School, Brockton Veterans Affairs Medical Center, MA 02401, USA
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48
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Hirayasu Y, Shenton ME, Salisbury DF, Kwon JS, Wible CG, Fischer IA, Yurgelun-Todd D, Zarate C, Kikinis R, Jolesz FA, McCarley RW. Subgenual cingulate cortex volume in first-episode psychosis. Am J Psychiatry 1999; 156:1091-3. [PMID: 10401458 PMCID: PMC2845843 DOI: 10.1176/ajp.156.7.1091] [Citation(s) in RCA: 72] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Gray matter volume and glucose utilization have been reported to be reduced in the left subgenual cingulate of subjects with familial bipolar or unipolar depression. It is unclear whether these findings are secondary to recurrent illness or are part of a familial/genetic syndrome. The authors' goal was to clarify these findings. METHOD Volumetric analyses were performed by using magnetic resonance imaging in 41 patients experiencing their first episode of affective disorder or schizophrenia and in 20 normal comparison subjects. RESULTS The left subgenual cingulate volume of the patients with affective disorder who had a family history of affective disorder was smaller than that of patients with affective disorder with no family history of the illness and the normal comparison subjects. Patients with schizophrenia did not differ from comparison subjects in left subgenual cingulate volume. CONCLUSIONS Left subgenual cingulate abnormalities are present at first hospitalization for psychotic affective disorder in patients who have a family history of affective disorder.
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Affiliation(s)
- Y Hirayasu
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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49
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Lee DY, Lee KU, Kwon JS, Jang IJ, Cho MJ, Shin SG, Woo JI. Pharmacokinetic-pharmacodynamic modeling of risperidone effects on electroencephalography in healthy volunteers. Psychopharmacology (Berl) 1999; 144:272-8. [PMID: 10435394 DOI: 10.1007/s002130051003] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [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: 11/24/2022]
Abstract
RATIONALE CNS-active drugs produce specific electroencephalographic changes and the concentration-effect relationship of antipsychotics may be elucidated by adopting electroencephalography (EEG) as an effect measurement tool. OBJECTIVE The purpose of the present study was to determine the concentration-effect relationship of risperidone by assessing the EEG effect after oral administrations of single dose risperidone in healthy young males. METHODS Nine healthy male volunteers received a 1 mg single oral dose of risperidone according to a placebo controlled crossover design. Plasma levels of risperidone and its active metabolite 9-hydroxyrisperidone were measured by radioimmunoassay. Quantitative EEG parameters were obtained for each of four frequency bands through spectral EEG analysis. The difference in the absolute power in the delta frequency band for the F3 lead between risperidone and placebo was used as a drug effect parameter. For pharmacokinetic-pharmacodynamic modeling, the hypothetical effect compartment kinetically linked to plasma by a first-order process was postulated. All curve fittings were done with the non-linear curve-fitting program NONLIN. RESULTS Our results showed that absolute powers in delta and theta frequency bands were higher for risperidone administration than for placebo at all EEG leads, and the maximum effects were detected at about 3 h after administration of the drug. The hysteresis loop was observed in the plot of plasma concentration of risperidone or sum of risperidone and 9-hydroxyrisperidone (Cp) versus EEG effect for each subject. A linear model adequately described the relationship between the effect compartment concentrations (Ce) and EEG effects, and the two limbs of hysteresis in the Cp-effect plot were collapsed in the Ce-effect plot for risperidone or risperidone plus 9-hydroxyrisperidone. CONCLUSION The increases of absolute power for delta and theta frequency bands of EEG were induced by single oral administration of risperidone. The linear PK-PD model fit well with the relationship between effect compartment concentrations (Ce) and EEG effects of risperidone.
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Affiliation(s)
- D Y Lee
- Department of Psychiatry, Seoul National University College of Medicine & Institute for Neuroscience, Korea
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50
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Kim DE, Yoon HK, Ko GY, Kwon JS, Song HY, Sung KB. Hepatic falciform artery: is prophylactic embolization needed before short-term hepatic arterial chemoinfusion? AJR Am J Roentgenol 1999; 172:1597-9. [PMID: 10350296 DOI: 10.2214/ajr.172.6.10350296] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE The purpose of this study was to assess the need for prophylactic embolization of the hepatic falciform artery (HFA) to prevent supraumbilical skin rash before short-term hepatic arterial chemoinfusion with or without subsequent embolization. MATERIALS AND METHODS Transcatheter arterial chemoinfusions or chemoembolizations were performed on 127 consecutive patients with hepatocellular carcinoma between August 1997 and September 1997. Hepatic angiography findings regarding the anatomic variations of the hepatic artery and the presence and origin of the HFA were analyzed. The patients were followed up for 35-143 days (mean, 78 days). The incidence of supraumbilical skin rash was assessed for two groups of patients, those with an HFA and those without. We also evaluated other factors that seemed closely related to the presence of an HFA. RESULTS An HFA was identified in 16 (13%) of 127 patients. Each HFA originated either in the left hepatic artery (n = 14) or the middle hepatic artery (n = 2). In the 16 patients with an HFA, serum bilirubin levels were significantly higher than in patients without one (p < .05), whereas serum albumin levels and prothrombin times were significantly lower (p < .05) and more prolonged (p = .02) than in patients without one. Portal venous collateral vessels were more frequently seen in patients with an HFA (50%) than in those without one (31%), but the frequency was not significant (p = .157). However, supraumbilical skin rash was not seen in any patient. CONCLUSION We found no need for prophylactic embolization of the HFA to prevent supraumbilical skin rash before short-term hepatic arterial chemoinfusion with or without subsequent embolization.
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Affiliation(s)
- D E Kim
- Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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