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Jo YY, Kim SM, Park CG, Kim JW, Kwak HJ. The Effect of Intermittent Pneumatic Compression on Hemodynamics and Regional Cerebral Oxygen Saturation in Laparoscopic Bariatric Surgery with Mild Hypercapnia in the Steep Reverse Trendelenburg Position. J Pers Med 2024; 14:405. [PMID: 38673032 PMCID: PMC11050837 DOI: 10.3390/jpm14040405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 04/03/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
Obesity negatively affects hemodynamics and cerebral physiology. We investigated the effect of the utilization of an intermittent pneumatic compression (IPC) device on hemodynamics and cerebral physiology in patients undergoing laparoscopic bariatric surgery under general anesthesia with lung-protective ventilation. Sixty-four patients (body mass index > 30 kg/m2) were randomly assigned to groups that received an IPC device (IPC group, n = 32) and did not (control group, n = 32). The mean arterial pressure (MAP), heart rate (HR), need for vasopressors, cerebral oxygen saturation (rSO2), and cerebral desaturation events were recorded. The incidence of intraoperative hypotension was not significantly different between groups (p = 0.153). Changes in MAP and HR over time were similar between groups (p = 0.196 and p = 0.705, respectively). The incidence of intraoperative cerebral desaturation was not significantly different between groups (p = 0.488). Changes in rSO2 over time were similar between the two groups (p = 0.190) during pneumoperitoneum. Applying IPC to patients with obesity in the steep reverse Trendelenburg position may not improve hemodynamic parameters, vasopressor requirements, or rSO2 values during pneumoperitoneum under lung-protective ventilation. During laparoscopic bariatric surgery, IPC alone has limitations in improving hemodynamics and cerebral physiology.
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Affiliation(s)
- Youn Yi Jo
- Department of Anesthesiology and Pain Medicine, College of Medicine, Gil Hospital, Gachon University, Incheon 21565, Republic of Korea; (Y.Y.J.); (C.G.P.); (J.W.K.)
| | - Seong Min Kim
- Department of Surgery, College of Medicine, Gil Hospital, Gachon University, Incheon 21565, Republic of Korea;
| | - Chun Gon Park
- Department of Anesthesiology and Pain Medicine, College of Medicine, Gil Hospital, Gachon University, Incheon 21565, Republic of Korea; (Y.Y.J.); (C.G.P.); (J.W.K.)
| | - Ji Woong Kim
- Department of Anesthesiology and Pain Medicine, College of Medicine, Gil Hospital, Gachon University, Incheon 21565, Republic of Korea; (Y.Y.J.); (C.G.P.); (J.W.K.)
| | - Hyun Jeong Kwak
- Department of Anesthesiology and Pain Medicine, College of Medicine, Gil Hospital, Gachon University, Incheon 21565, Republic of Korea; (Y.Y.J.); (C.G.P.); (J.W.K.)
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Kim HJ, Cho YB, Heo K, Kim JW, Shin HG, Lee EB, Park SM, Park JB, Lee S. Targeting cell surface glucose-regulated protein 94 in gastric cancer with an anti-GRP94 human monoclonal antibody. BMB Rep 2024; 57:188-193. [PMID: 38449302] [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: 10/19/2023] [Indexed: 03/08/2024] Open
Abstract
Gastric cancer (GC), a leading cause of cancer-related mortality, remains a significant challenge despite recent therapeutic advancements. In this study, we explore the potential of targeting cell surface glucose-regulated protein 94 (GRP94) with antibodies as a novel therapeutic approach for GC. Our comprehensive analysis of GRP94 expression across various cancer types, with a specific focus on GC, revealed a substantial overexpression of GRP94, highlighting its potential as a promising target. Through in vitro and in vivo efficacy assessments, as well as toxicological analyses, we found that K101.1, a fully human monoclonal antibody designed to specifically target cell surface GRP94, effectively inhibits GC growth and angiogenesis without causing in vivo toxicity. Furthermore, our findings indicate that K101.1 promotes the internalization and concurrent downregulation of cell surface GRP94 on GC cells. In conclusion, our study suggests that cell surface GRP94 may be a potential therapeutic target in GC, and that antibody-based targeting of cell surface GRP94 may be an effective strategy for inhibiting GRP94-mediated GC growth and angiogenesis. [BMB Reports 2024; 57(4): 188-193].
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Affiliation(s)
- Hyun Jung Kim
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul 02707, Korea
| | - Yea Bin Cho
- Department of Chemistry, Kookmin University, Seoul 02707, Korea
| | - Kyun Heo
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul 02707; Department of Chemistry, Kookmin University, Seoul 02707; Antibody Research Institute, Kookmin University, Seoul 02707, Korea
| | - Ji Woong Kim
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul 02707, Korea
| | - Ha Gyeong Shin
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul 02707, Korea
| | - Eun-Bi Lee
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul 02707, Korea
| | - Seong-Min Park
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea
| | - Jong Bae Park
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea
| | - Sukmook Lee
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul 02707; Department of Chemistry, Kookmin University, Seoul 02707; Antibody Research Institute, Kookmin University, Seoul 02707, Korea
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Schmidgall S, Kim JW, Krieger A. Robots learning to imitate surgeons - challenges and possibilities. Nat Rev Urol 2024:10.1038/s41585-024-00873-z. [PMID: 38514874 DOI: 10.1038/s41585-024-00873-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Affiliation(s)
- Samuel Schmidgall
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, USA.
| | - Ji Woong Kim
- Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Axel Krieger
- Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD, USA
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Choi S, Yang S, Kim JW, Kwon K, Oh SW, Yu E, Han SB, Kang SH, Lee JH, Ha H, Yoo JK, Kim SY, Kim YS, Cho JY, Lee J. Anti-pollutant effect of oleic acid against urban particulate matter is mediated via regulation of AhR- and TRPV1-mediated signaling in vitro. Environ Toxicol 2024. [PMID: 38456238 DOI: 10.1002/tox.24183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 11/11/2023] [Accepted: 02/25/2024] [Indexed: 03/09/2024]
Abstract
Urban Particulate Matter (UPM) induces skin aging and inflammatory responses by regulating skin cells through the transient receptor potential vanilloid 1 (TRPV1). Although oleic acid, an unsaturated free fatty acid (FFA), has some functional activities, its effect on UPM-induced skin damage has not been elucidated. Here, we investigated signaling pathways on how oleic acid is involved in attenuating UPM induced cell damage. UPM treatment increased XRE-promoter luciferase activity and increased translocation of AhR to the nucleus, resulting in the upregulation of CYP1A1 gene. However, oleic acid treatment attenuated the UPM effects on AhR signaling. Furthermore, while UPM induced activation of TRPV1 and MAPKs signaling which activated the downstream molecules NFκB and AP-1, these effects were reduced by cotreatment with oleic acid. UPM-dependent generation of reactive oxygen species (ROS) and reduction of cellular proliferation were also attenuated by the treatment of oleic acid. These data reveal that cell damage induced by UPM treatment occurs through AhR signaling and TRPV1 activation which in turn activates ERK and JNK, ultimately inducing NFκB and AP-1 activation. These effects were reduced by the cotreatment of oleic acid on HaCaT cells. These suggest that oleic acid reduces UPM-induced cell damage through inhibiting both the AhR signaling and activation of TRPV1 and its downstream molecules, leading to a reduction of pro-inflammatory cytokine and recovery of cell proliferation.
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Affiliation(s)
- Seoyoung Choi
- Department of Integrative Biotechnology, Molecular Dermatology Laboratory, College of Biotechnology and Bioengineering, Sungkyunkwan University, Suwon City, Gyunggi Do, Korea
| | - Seyoung Yang
- Department of Integrative Biotechnology, Molecular Dermatology Laboratory, College of Biotechnology and Bioengineering, Sungkyunkwan University, Suwon City, Gyunggi Do, Korea
| | - Ji Woong Kim
- Materials Science Research Institute, LABIO, Inc., Seoul, Korea
| | - Kitae Kwon
- Department of Integrative Biotechnology, Molecular Dermatology Laboratory, College of Biotechnology and Bioengineering, Sungkyunkwan University, Suwon City, Gyunggi Do, Korea
| | - Sae Woong Oh
- Department of Integrative Biotechnology, Molecular Dermatology Laboratory, College of Biotechnology and Bioengineering, Sungkyunkwan University, Suwon City, Gyunggi Do, Korea
| | - Eunbi Yu
- Department of Integrative Biotechnology, Molecular Dermatology Laboratory, College of Biotechnology and Bioengineering, Sungkyunkwan University, Suwon City, Gyunggi Do, Korea
| | - Su Bin Han
- Department of Integrative Biotechnology, Molecular Dermatology Laboratory, College of Biotechnology and Bioengineering, Sungkyunkwan University, Suwon City, Gyunggi Do, Korea
| | - Soo Hyun Kang
- Department of Integrative Biotechnology, Molecular Dermatology Laboratory, College of Biotechnology and Bioengineering, Sungkyunkwan University, Suwon City, Gyunggi Do, Korea
| | - Jung Hyun Lee
- Department of Integrative Biotechnology, Molecular Dermatology Laboratory, College of Biotechnology and Bioengineering, Sungkyunkwan University, Suwon City, Gyunggi Do, Korea
| | - Heejun Ha
- Department of Integrative Biotechnology, Molecular Dermatology Laboratory, College of Biotechnology and Bioengineering, Sungkyunkwan University, Suwon City, Gyunggi Do, Korea
| | - Jeong Kyun Yoo
- Materials Science Research Institute, LABIO, Inc., Seoul, Korea
| | - Su Young Kim
- Materials Science Research Institute, LABIO, Inc., Seoul, Korea
| | - Young Soo Kim
- Materials Science Research Institute, LABIO, Inc., Seoul, Korea
| | - Jae Youl Cho
- Department of Integrative Biotechnology, Molecular Immunology Laboratory, College of Biotechnology and Bioengineering, Sungkyunkwan University, Suwon City, Gyunggi Do, Korea
| | - Jongsung Lee
- Department of Integrative Biotechnology, Molecular Dermatology Laboratory, College of Biotechnology and Bioengineering, Sungkyunkwan University, Suwon City, Gyunggi Do, Korea
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Kim JW, Lee JH, Kim HJ, Heo K, Lee Y, Jang HJ, Lee HY, Park JW, Cho YB, Shin HG, Yang HR, Lee HE, Song JY, Lee S. Empowering SARS-CoV-2 variant neutralization with a bifunctional antibody engineered with tandem heptad repeat 2 peptides. J Med Virol 2024; 96:e29506. [PMID: 38445718 DOI: 10.1002/jmv.29506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/28/2024] [Accepted: 02/23/2024] [Indexed: 03/07/2024]
Abstract
With the global pandemic and the continuous mutations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the need for effective and broadly neutralizing treatments has become increasingly urgent. This study introduces a novel strategy that targets two aspects simultaneously, using bifunctional antibodies to inhibit both the attachment of SARS-CoV-2 to host cell membranes and viral fusion. We developed pioneering IgG4-(HR2)4 bifunctional antibodies by creating immunoglobulin G4-based and phage display-derived human monoclonal antibodies (mAbs) that specifically bind to the SARS-CoV-2 receptor-binding domain, engineered with four heptad repeat 2 (HR2) peptides. Our in vitro experiments demonstrate the superior neutralization efficacy of these engineered antibodies against various SARS-CoV-2 variants, ranging from original SARS-CoV-2 strain to the recently emerged Omicron variants, as well as SARS-CoV, outperforming the parental mAb. Notably, intravenous monotherapy with the bifunctional antibody neutralizes a SARS-CoV-2 variant in a murine model without causing significant toxicity. In summary, this study unveils the significant potential of HR2 peptide-driven bifunctional antibodies as a potent and versatile strategy for mitigating SARS-CoV-2 infections. This approach offers a promising avenue for rapid development and management in the face of the continuously evolving SARS-CoV-2 variants, holding substantial promise for pandemic control.
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Affiliation(s)
- Ji Woong Kim
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul, Republic of Korea
| | - Ji Hyun Lee
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul, Republic of Korea
| | - Hyun Jung Kim
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul, Republic of Korea
| | - Kyun Heo
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul, Republic of Korea
- Department of Chemistry, Kookmin University, Seoul, Republic of Korea
- Antibody Research Institute, Kookmin University, Seoul, Republic of Korea
| | - Yoonwoo Lee
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul, Republic of Korea
| | - Hui Jeong Jang
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul, Republic of Korea
| | - Ho-Young Lee
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul, Republic of Korea
| | - Jun Won Park
- Division of Biomedical Convergence, Kangwon National University, Chuncheon, Republic of Korea
| | - Yea Bin Cho
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul, Republic of Korea
| | - Ha Gyeong Shin
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul, Republic of Korea
| | - Ha Rim Yang
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul, Republic of Korea
| | - Hee Eon Lee
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul, Republic of Korea
| | - Jin Young Song
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul, Republic of Korea
| | - Sukmook Lee
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul, Republic of Korea
- Department of Chemistry, Kookmin University, Seoul, Republic of Korea
- Antibody Research Institute, Kookmin University, Seoul, Republic of Korea
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Cho BJ, Lee WD, Song JS, Yang MA, Kim BS, Yang SY, Jung GM, Kim JW, Cho YK, Cho JW. The efficacy of newly proposed gastric open peroral endoscopic myotomy (GO-POEM) in preventing post-endoscopic submucosal dissection stenosis: A comparison with non-GO-POEM group. Medicine (Baltimore) 2023; 102:e36755. [PMID: 38206733 PMCID: PMC10754599 DOI: 10.1097/md.0000000000036755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/01/2023] [Indexed: 01/13/2024] Open
Abstract
Extensive endoscopic submucosal dissection (ESD) for gastric adenoma or early cancer can lead to post-ESD stenosis. This may cause a decrease in quality of life and an increase in medical issues. Therefore, this study examined the safety and effectiveness of gastric open peroral endoscopic myotomy (GO-POEM) in preventing stenosis following ESD. A retrospective investigation was carried out on 31 patients who underwent gastric ESD for > 75% of the lumen in the antrum or pylorus at the Presbyterian Medical Center in Korea between December 2004 and October 2022. The patients were divided into GO-POEM (n = 11) and non-GO-POEM groups (n = 20). The average age of the 31 patients was 73.23 years, and 18 were male. There were no differences in age, sex, location, gross findings, or procedure time between the 2 groups. In the GO-POEM group, only 1 patient (9 %) developed stenosis, compared to 11 patients (55 %) in the control group (P = .02). Multivariate analysis showed that the GO-POEM group had a significantly lower risk of post-ESD stenosis (P < .05). Stenosis symptoms resolved with a single endoscopic balloon dilatation (EBD) in 1 patient in the GO-POEM group. In contrast, 5 of 11 patients with stenosis in the non-GO-POEM group required a median of 2 EBD sessions (range, 1-8). GO-POEM may be an effective and reliable method for preventing stenosis post extensive gastric ESD. Further investigations are necessary to establish its efficacy and safety.
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Affiliation(s)
- Bong Ju Cho
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Republic of Korea
| | - Won Dong Lee
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Republic of Korea
| | - Jae Sun Song
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Republic of Korea
| | - Min A. Yang
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Republic of Korea
| | - Byung Sun Kim
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Republic of Korea
| | - Sung Yeol Yang
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Republic of Korea
| | - Gum Mo Jung
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Republic of Korea
| | - Ji Woong Kim
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Republic of Korea
| | - Yong Keun Cho
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Republic of Korea
| | - Jin Woong Cho
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Republic of Korea
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Chang H, Kim JW, Jung W, Heo S, Lee SU, Kim T, Hwang SY, Do Shin S, Cha WC. Machine learning pre-hospital real-time cardiac arrest outcome prediction (PReCAP) using time-adaptive cohort model based on the Pan-Asian Resuscitation Outcome Study. Sci Rep 2023; 13:20344. [PMID: 37990066 PMCID: PMC10663550 DOI: 10.1038/s41598-023-45767-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 10/23/2023] [Indexed: 11/23/2023] Open
Abstract
To save time during transport, where resuscitation quality can degrade in a moving ambulance, it would be prudent to continue the resuscitation on scene if there is a high likelihood of ROSC occurring at the scene. We developed the pre-hospital real-time cardiac arrest outcome prediction (PReCAP) model to predict ROSC at the scene using prehospital input variables with time-adaptive cohort. The patient survival at discharge from the emergency department (ED), the 30-day survival rate, and the final Cerebral Performance Category (CPC) were secondary prediction outcomes in this study. The Pan-Asian Resuscitation Outcome Study (PAROS) database, which includes out-of-hospital cardiac arrest (OHCA) patients transferred by emergency medical service in Asia between 2009 and 2018, was utilized for this study. From the variables available in the PAROS database, we selected relevant variables to predict OHCA outcomes. Light gradient-boosting machine (LightGBM) was used to build the PReCAP model. Between 2009 and 2018, 157,654 patients in the PAROS database were enrolled in our study. In terms of prediction of ROSC on scene, the PReCAP had an AUROC score between 0.85 and 0.87. The PReCAP had an AUROC score between 0.91 and 0.93 for predicting survived to discharge from ED, and an AUROC score between 0.80 and 0.86 for predicting the 30-day survival. The PReCAP predicted CPC with an AUROC score ranging from 0.84 to 0.91. The feature importance differed with time in the PReCAP model prediction of ROSC on scene. Using the PAROS database, PReCAP predicted ROSC on scene, survival to discharge from ED, 30-day survival, and CPC for each minute with an AUROC score ranging from 0.8 to 0.93. As this model used a multi-national database, it might be applicable for a variety of environments and populations.
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Affiliation(s)
- Hansol Chang
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 115 Irwon-ro Gangnam-gu, Seoul, 06355, Republic of Korea
- Department of Digital Health, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, 115 Irwon-ro Gangnam-gu, Seoul, 06355, Republic of Korea
| | - Ji Woong Kim
- LG UPLUS, 71, Magokjungang 8-ro, Gangseo-gu, Seoul, 07795, Republic of Korea
| | - Weon Jung
- Smart Health Lab, Research Institute of Future Medicine, Samsung Medical Center, 81 Irwon-ro Gangnam-gu, Seoul, 06351, Korea
| | - Sejin Heo
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 115 Irwon-ro Gangnam-gu, Seoul, 06355, Republic of Korea
| | - Se Uk Lee
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 115 Irwon-ro Gangnam-gu, Seoul, 06355, Republic of Korea
| | - Taerim Kim
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 115 Irwon-ro Gangnam-gu, Seoul, 06355, Republic of Korea
| | - Sung Yeon Hwang
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 115 Irwon-ro Gangnam-gu, Seoul, 06355, Republic of Korea
| | - Sang Do Shin
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea
| | - Won Chul Cha
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 115 Irwon-ro Gangnam-gu, Seoul, 06355, Republic of Korea.
- Department of Digital Health, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, 115 Irwon-ro Gangnam-gu, Seoul, 06355, Republic of Korea.
- Digital Innovation, Samsung Medical Center, 81 Irwon-ro Gangnam-gu, Seoul, 06351, Republic of Korea.
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
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Pyo JH, Lee SY, Lee IJ, Kim SM, Kim JW. Beneficial Role of Multi-Disciplinary Treatment for Anaplastic Thyroid Cancer with Initial Distant Metastasis. Int J Radiat Oncol Biol Phys 2023; 117:e616-e617. [PMID: 37785850 DOI: 10.1016/j.ijrobp.2023.06.1996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Anaplastic thyroid cancer (ATC) is a rare, highly aggressive tumor, with median survival around 5 months. Approximately half of the ATC patients presents with distant metastases at diagnosis, showing even more devastating prognosis, yet no outcome analysis had been reported. In this study, we aim to evaluate the clinical outcome of M1 ATC patients, and to define the group of patients who would benefit from local treatment based on multi-disciplinary approach. MATERIALS/METHODS A total of 133 histology-confirmed ATC patients underwent protocol-based multidisciplinary treatment including surgery and chemoradiotherapy (CRT) between May 2016 and January 2022. Patients received intensity-modulated radiotherapy of 30 fractions concurrently with paclitaxel on days 1, 8 and 15 every 4 weeks, and lenvatinib was added upon progression. After 18 fractions of CRT, interim response analysis using modified RECIST was conducted for adaptive treatment planning. We reviewed 58 patients with distant metastasis at diagnosis (stage IVC). Overall survival (OS) and progression-free survival (PFS) were measured from the day of diagnosis. RESULTS Most common metastatic site was lung (91.4%), followed by bone (31.0%) and brain (5.2%). Lenvatinib was added for 35 patients after any sign of progression. Fourteen patients received upfront surgery (16 debulking and 5 total) followed by adjuvant CRT in 16 patients. Thirty-one patients received upfront CRT with 2 patients receiving total resection after sufficient down-staging. Six (10%) patients could not complete radiotherapy but continued receiving systemic treatment. The median follow-up was 5.9 months. The median and 1-year OS were 6.2 months and 20.5%, and PFS were 3.7 months and 3.5%. Total RT dose over 60 Gy significantly improved median OS (7.5 vs 4.1 months, p = 0.012) and median PFS (4.4 vs 3.0, p = 0.010). Patients with less than 10 initial metastatic tumors showed better median OS (9.1 vs 4.6 months, p = 0.002) but not PFS (5.1 vs 3.6, p = 0.485). At interim analysis, early response (CR, PR and SD) of primary tumor was not associated with survival, while progression of distant metastases showed significantly worse median OS (9.8 vs 4.6 months, p = 0.001). More than 10 metastatic tumors (HR 2.73, 95% CI 1.32-5.66) and stable metastasis at interim analysis (HR 2.39, 95% CI 1.04-5.48) remained as significant factor in the multivariable cox regression analysis. Median OS and PFS of patients with less than 10 metastases showing no progression at interim analysis were 9.1 months, and 5.1 months. CONCLUSION Local treatment combined with chemotherapy for M1 ATC patients showed outcome comparable to those of non-metastatic ATC results. Active local treatment should be considered especially for patients with less than 10 metastases, and patients without distant progression in early response evaluation.
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Affiliation(s)
- J H Pyo
- Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - S Y Lee
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - I J Lee
- Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - S M Kim
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - J W Kim
- Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
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Kim J, Sung J, Yang D, Cho KS, Chung BH, Kim J, Kim JW. Optimal Planning Target Margin for Prostate Radiotherapy Based on Interfractional and Intrafractional Variability Assessment during 1.5T MR-Guided Radiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e401. [PMID: 37785341 DOI: 10.1016/j.ijrobp.2023.06.1534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) MR-guided radiotherapy (MRgRT) provides superior soft-tissue contrast over CT-based image guidance. We collected and analyzed daily pre-treatment (PRE) and real-time motion-monitoring (MM) MR images of patients receiving prostate radiotherapy to assess interfractional and intrafractional variability of prostate using two localization methods: pelvic bony anatomy (bone) and prostate during online adaptive radiotherapy (ART). MATERIALS/METHODS PRE and MM MRIs for the first five fractions of twenty prostate cancer patients who received definitive MRgRT with 1.5T MRI were collected. Using MIM software, rigid registration between PRE MRI and planning CT images based on pelvic bony anatomy and prostate reproduced bone localization and online ART, respectively. To determine interfractional setup margin (SM), prostate was delineated on all PRE MRIs registered after bone and prostate localizations by a radiation oncologist, and centroid values of prostate contours between planning CT and PRE MRIs were compared. To determine interobserver variability, another radiation oncologist, a medical physicist, and a radiotherapist contoured prostate for both localization methods. For internal margin (IM) assessment, we used MM MRIs of the five patients who had all three sets of coronal, sagittal, and axial cine images and determined the maximum contour displacement using in-house MATLAB-based software converting binary image files to 2D cine images with a superimposed grid of 1 mm spacing. RESULTS A total of 100 PRE and 25 MM MRIs were analyzed. Four hundred prostate contours were delineated on MR images registered with planning CT based on both bony anatomy and prostate. After bone localization, SM was 0.57±0.42 mm in left-right (LR), 2.45±1.98 mm in anterior-posterior (AP), and 2.28±2.08 mm in superior-inferior (SI) directions, and IO was 1.06±0.58 mm in LR, 2.32±1.08 mm in AP, and 3.30±1.85 mm in SI directions. After prostate localization, SM was 0.76±0.57 mm in LR, 1.89±1.60 mm in AP, and 2.2±1.79 mm in SI directions, and IO was 1.11±0.55 mm in LR, 2.13±1.07 mm in AP, and 3.53±1.65 mm in SI directions. Average IM was 2.12±0.86 mm, 2.24±1.07 mm, and 2.84±0.88 mm in LR, AP, and SI directions, respectively. CONCLUSION Using daily MRIs from MRgRT, we showed that movements in the SI direction were the largest source of variability in prostate definitive RT. In addition, interobserver variability was a non-negligible source of margin. Optimal PTV margin should also consider internal margin, especially in the SI direction.
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Affiliation(s)
- J Kim
- Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - J Sung
- Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - D Yang
- Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - K S Cho
- Department of Urology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - B H Chung
- Department of Urology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - J Kim
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - J W Kim
- Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
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10
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Kim JW, Kim HJ, Heo K, Lee Y, Jang HJ, Lee HY, Park JW, Cho YB, Lee JH, Shin HG, Yang HR, Choi HL, Shim HB, Lee S. A novel bispecific antibody dual-targeting approach for enhanced neutralization against fast-evolving SARS-CoV-2 variants. Front Immunol 2023; 14:1271508. [PMID: 37822941 PMCID: PMC10562541 DOI: 10.3389/fimmu.2023.1271508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 09/11/2023] [Indexed: 10/13/2023] Open
Abstract
Introduction The emergence of new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants has caused unprecedented health and socioeconomic crises, necessitating the immediate development of highly effective neutralizing antibodies. Despite recent advancements in anti-SARS-CoV-2 receptor-binding domain (RBD)-specific monoclonal antibodies (mAbs) derived from convalescent patient samples, their efficacy against emerging variants has been limited. In this study, we present a novel dual-targeting strategy using bispecific antibodies (bsAbs) that specifically recognize both the SARS-CoV-2 RBD and fusion peptide (FP), crucial domains for viral attachment to the host cell membrane and fusion in SARS-CoV-2 infection. Methods Using phage display technology, we rapidly isolated FP-specific mAbs from an established human recombinant antibody library, identifying K107.1 with a nanomolar affinity for SARS-CoV-2 FP. Furthermore, we generated K203.A, a new bsAb built in immunoglobulin G4-(single-chain variable fragment)2 forms and demonstrating a high manufacturing yield and nanomolar affinity to both the RBD and FP, by fusing K102.1, our previously reported RBD-specific mAb, with K107.1. Results Our comprehensive in vitro functional analyses revealed that the K203.A bsAb significantly outperformed the parental RBD-specific mAb in terms of neutralization efficacy against SARS-CoV-2 variants. Furthermore, intravenous monotherapy with K203.A demonstrated potent in vivo neutralizing activity without significant in vivo toxicity in a mouse model infected with a SARS-CoV-2 variant. Conclusion These findings present a novel bsAb dual-targeting strategy, directed at SARS-CoV-2 RBD and FP, as an effective approach for rapid development and management against continuously evolving SARS-CoV-2 variants.
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Affiliation(s)
- Ji Woong Kim
- Department of Chemistry, Kookmin University, Seoul, Republic of Korea
| | - Hyun Jung Kim
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul, Republic of Korea
| | - Kyun Heo
- Department of Chemistry, Kookmin University, Seoul, Republic of Korea
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul, Republic of Korea
- Antibody Research Institute, Kookmin University, Seoul, Republic of Korea
| | - Yoonwoo Lee
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul, Republic of Korea
| | - Hui Jeong Jang
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul, Republic of Korea
| | - Ho-Young Lee
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul, Republic of Korea
| | - Jun Won Park
- Division of Biomedical Convergence, Kangwon National University, Chuncheon, Republic of Korea
| | - Yea Bin Cho
- Department of Chemistry, Kookmin University, Seoul, Republic of Korea
| | - Ji Hyun Lee
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul, Republic of Korea
| | - Ha Gyeong Shin
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul, Republic of Korea
| | - Ha Rim Yang
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul, Republic of Korea
| | - Hye Lim Choi
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul, Republic of Korea
| | - Hyun Bo Shim
- Department of Life Sciences, Ewha Womans University, Seoul, Republic of Korea
| | - Sukmook Lee
- Department of Chemistry, Kookmin University, Seoul, Republic of Korea
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul, Republic of Korea
- Antibody Research Institute, Kookmin University, Seoul, Republic of Korea
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11
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Shin J, Kim MJ, Quan X, Kim JW, Lee S, Park S, Jeong JY, Yea K. Thrombopoietin receptor agonist antibody for treating chemotherapy-induced thrombocytopenia. BMC Cancer 2023; 23:490. [PMID: 37259024 DOI: 10.1186/s12885-023-10975-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 05/16/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Thrombocytopenia is a common complication in cancer patients undergoing chemotherapy. Chemotherapy-induced thrombocytopenia (CIT) leads to dose reduction and treatment delays, lowering chemotherapy efficacy and survival rate. Thus, rapid recovery and continuous maintenance of platelet count during chemotherapy cycles are crucial in patients with CIT. Thrombopoietin (TPO) and its receptor, myeloid proliferative leukemia (MPL) protein, play a major role in platelet production. Although several MPL agonists have been developed to regulate thrombopoiesis, none have been approved for the management of CIT due to concerns regarding efficacy or safety. Therefore, the development of effective MPL agonists for treating CIT needs to be further expanded. METHODS Anti-MPL antibodies were selected from the human combinatorial antibody phage libraries using phage display. We identified 2R13 as the most active clone among the binding antibodies via cell proliferation assay using BaF3/MPL cells. The effect of 2R13 on megakaryocyte differentiation was evaluated in peripheral blood CD34+ cells by analyzing megakaryocyte-specific differentiation markers (CD41a+ and CD42b+) and DNA ploidy using flow cytometry. The 2R13-induced platelet production was examined in 8- to 10-week-old wild-type BALB/c female mice and a thrombocytopenia mouse model established by intraperitoneal injection of 5-fluorouracil (150 mg/kg). The platelet counts were monitored twice a week over 14 days post-initiation of treatment with a single injection of 2R13, or recombinant human TPO (rhTPO) for seven consecutive days. RESULTS We found that 2R13 specifically interacted with MPL and activated its signaling pathways. 2R13 stimulated megakaryocyte differentiation, evidenced by increasing the proportion of high-ploidy (≥ 8N) megakaryocytes in peripheral blood-CD34+ cells. The platelet count was increased by a single injection of 2R13 for up to 14 days. Injection of 5-fluorouracil considerably reduced the platelet count by day 4, which was recovered by 2R13. The platelets produced by 2R13 sustained a higher count than that achieved using seven consecutive injections of rhTPO. CONCLUSIONS Our findings suggest that 2R13 is a promising therapeutic agent for CIT treatment.
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Affiliation(s)
- Jiwon Shin
- Department of New Biology, Daegu Gyeongbuk Institute of Science and Technology (DGIST), Daegu, 42988, Republic of Korea
| | - Min-Jung Kim
- Department of Biochemistry, Kosin University College of Medicine, Busan, 49267, Republic of Korea
| | - Xingguo Quan
- Department of Microbiology and Immunology, Inje University College of Medicine, Busan, 47392, Republic of Korea
| | - Ji Woong Kim
- Department of Biochemistry, Kookmin University, Seoul, 02707, Republic of Korea
| | - Sukmook Lee
- Department of Biochemistry, Kookmin University, Seoul, 02707, Republic of Korea
| | - SaeGwang Park
- Department of Microbiology and Immunology, Inje University College of Medicine, Busan, 47392, Republic of Korea.
| | - Jee-Yeong Jeong
- Department of Biochemistry, Kosin University College of Medicine, Busan, 49267, Republic of Korea.
| | - Kyungmoo Yea
- Department of New Biology, Daegu Gyeongbuk Institute of Science and Technology (DGIST), Daegu, 42988, Republic of Korea.
- New Biology Research Center, DGIST, Daegu, 43024, Republic of Korea.
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12
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Zhang P, Kim JW, Gehlbach P, Iordachita I, Kobilarov M. Autonomous Needle Navigation in Retinal Microsurgery: Evaluation in ex vivo Porcine Eyes. IEEE Int Conf Robot Autom 2023; 2023:4661-4667. [PMID: 38107423 PMCID: PMC10723823 DOI: 10.1109/icra48891.2023.10161151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Important challenges in retinal microsurgery include prolonged operating time, inadequate force feedback, and poor depth perception due to a constrained top-down view of the surgery. The introduction of robot-assisted technology could potentially deal with such challenges and improve the surgeon's performance. Motivated by such challenges, this work develops a strategy for autonomous needle navigation in retinal microsurgery aiming to achieve precise manipulation, reduced end-to-end surgery time, and enhanced safety. This is accomplished through real-time geometry estimation and chance-constrained Model Predictive Control (MPC) resulting in high positional accuracy while keeping scleral forces within a safe level. The robotic system is validated using both open-sky and intact (with lens and partial vitreous removal) ex vivo porcine eyes. The experimental results demonstrate that the generation of safe control trajectories is robust to small motions associated with head drift. The mean navigation time and scleral force for MPC navigation experiments are 7.208 s and 11.97 mN, which can be considered efficient and well within acceptable safe limits. The resulting mean errors along lateral directions of the retina are below 0.06 mm, which is below the typical hand tremor amplitude in retinal microsurgery.
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Affiliation(s)
- Peiyao Zhang
- Department of Mechanical Engineering and the Laboratory for Computational Sensing and Robotics (LCSR), Johns Hopkins University, Baltimore, MD 21211, USA
| | - Ji Woong Kim
- Department of Mechanical Engineering and the Laboratory for Computational Sensing and Robotics (LCSR), Johns Hopkins University, Baltimore, MD 21211, USA
| | - Peter Gehlbach
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD 21211, USA
| | - Iulian Iordachita
- Department of Mechanical Engineering and the Laboratory for Computational Sensing and Robotics (LCSR), Johns Hopkins University, Baltimore, MD 21211, USA
| | - Marin Kobilarov
- Department of Mechanical Engineering and the Laboratory for Computational Sensing and Robotics (LCSR), Johns Hopkins University, Baltimore, MD 21211, USA
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13
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Choi HL, Yang HR, Shin HG, Hwang K, Kim JW, Lee JH, Ryu T, Jung Y, Lee S. Generation and Next-Generation Sequencing-Based Characterization of a Large Human Combinatorial Antibody Library. Int J Mol Sci 2023; 24:ijms24066011. [PMID: 36983085 PMCID: PMC10057307 DOI: 10.3390/ijms24066011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/04/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
Antibody phage display is a key technology for the discovery and development of target-specific monoclonal antibodies (mAbs) for use in research, diagnostics, and therapy. The construction of a high-quality antibody library, with larger and more diverse antibody repertoires, is essential for the successful development of phage display-derived mAbs. In this study, a large human combinatorial single-chain variable fragment library (1.5 × 1011 colonies) was constructed from Epstein-Barr virus-infected human peripheral blood mononuclear cells stimulated with a combination of two of the activators of human B cells, the Toll-like receptor 7/8 agonist R848 and interleukin-2. Next-generation sequencing analysis with approximately 1.9 × 106 and 2.7 × 106 full-length sequences of heavy chain variable (VH) and κ light chain variable (Vκ) domains, respectively, revealed that the library consists of unique VH (approximately 94%) and Vκ (approximately 91%) sequences with greater diversity than germline sequences. Lastly, multiple unique mAbs with high affinity and broad cross-species reactivity could be isolated from the library against two therapeutically relevant target antigens, validating the library quality. These findings suggest that the novel antibody library we have developed may be useful for the rapid development of target-specific phage display-derived recombinant human mAbs for use in therapeutic and diagnostic applications.
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Affiliation(s)
- Hye Lim Choi
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul 02707, Republic of Korea
| | - Ha Rim Yang
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul 02707, Republic of Korea
| | - Ha Gyeong Shin
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul 02707, Republic of Korea
| | - Kyusang Hwang
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul 02707, Republic of Korea
| | - Ji Woong Kim
- Department of Chemistry, Kookmin University, Seoul 02707, Republic of Korea
| | - Ji Hyun Lee
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul 02707, Republic of Korea
| | - Taehoon Ryu
- ATG Lifetech Inc., Seoul 08507, Republic of Korea
| | - Yushin Jung
- ATG Lifetech Inc., Seoul 08507, Republic of Korea
| | - Sukmook Lee
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul 02707, Republic of Korea
- Department of Applied Chemistry, Kookmin University, Seoul 02707, Republic of Korea
- Antibody Research Institute, Kookmin University, Seoul 02707, Republic of Korea
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14
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Kim JW, Heo K, Kim HJ, Yoo Y, Cho HS, Jang HJ, Lee HY, Ko IY, Woo JR, Cho YB, Lee JH, Yang HR, Shin HG, Choi HL, Hwang K, Kim S, Kim H, Chun K, Lee S. Novel bispecific human antibody platform specifically targeting a fully open spike conformation potently neutralizes multiple SARS-CoV-2 variants. Antiviral Res 2023; 212:105576. [PMID: 36870394 PMCID: PMC9979629 DOI: 10.1016/j.antiviral.2023.105576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/15/2023] [Accepted: 03/01/2023] [Indexed: 03/06/2023]
Abstract
Rapid emergence of new variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has prompted an urgent need for the development of broadly applicable and potently neutralizing antibody platform against the SARS-CoV-2, which can be used for combatting the coronavirus disease 2019 (COVID-19). In this study, based on a noncompeting pair of phage display-derived human monoclonal antibodies (mAbs) specific to the receptor-binding domain (RBD) of SARS-CoV-2 isolated from human synthetic antibody library, we generated K202.B, a novel engineered bispecific antibody with an immunoglobulin G4-single-chain variable fragment design, with sub- or low nanomolar antigen-binding avidity. Compared with the parental mAbs or mAb cocktail, the K202.B antibody showed superior neutralizing potential against a variety of SARS-CoV-2 variants in vitro. Furthermore, structural analysis of bispecific antibody-antigen complexes using cryo-electron microscopy revealed the mode of action of K202.B complexed with a fully open three-RBD-up conformation of SARS-CoV-2 trimeric spike proteins by simultaneously interconnecting two independent epitopes of the SARS-CoV-2 RBD via inter-protomer interactions. Intravenous monotherapy using K202.B exhibited potent neutralizing activity in SARS-CoV-2 wild-type- and B.1.617.2 variant-infected mouse models, without significant toxicity in vivo. The results indicate that this novel approach of development of immunoglobulin G4-based bispecific antibody from an established human recombinant antibody library is likely to be an effective strategy for the rapid development of bispecific antibodies, and timely management against fast-evolving SARS-CoV-2 variants.
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Affiliation(s)
- Ji Woong Kim
- Department of Biochemistry, Kookmin University, Seoul, 02707, Republic of Korea
| | - Kyun Heo
- Department of Biochemistry, Kookmin University, Seoul, 02707, Republic of Korea; Department of Biopharmaceutical Chemistry, Kookmin University, Seoul, 02707, Republic of Korea; Antibody Research Institute, Kookmin University, Seoul, 02707, Republic of Korea
| | - Hyun Jung Kim
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul, 02707, Republic of Korea
| | - Youngki Yoo
- Department of Systems Biology, Yonsei University, Seoul, 03722, Republic of Korea
| | - Hyun-Soo Cho
- Department of Systems Biology, Yonsei University, Seoul, 03722, Republic of Korea
| | - Hui Jeong Jang
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul, 13620, Republic of Korea
| | - Ho-Young Lee
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul, 13620, Republic of Korea
| | - In Young Ko
- New Drug Development Center, KBIOHealth, Cheongju, 28160, Republic of Korea
| | - Ju Rang Woo
- New Drug Development Center, KBIOHealth, Cheongju, 28160, Republic of Korea
| | - Yea Bin Cho
- Department of Biochemistry, Kookmin University, Seoul, 02707, Republic of Korea
| | - Ji Hyun Lee
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul, 02707, Republic of Korea
| | - Ha Rim Yang
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul, 02707, Republic of Korea
| | - Ha Gyeong Shin
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul, 02707, Republic of Korea
| | - Hye Lim Choi
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul, 02707, Republic of Korea
| | - Kyusang Hwang
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul, 02707, Republic of Korea
| | - Sokho Kim
- Research Center, KNOTUS Co. Ltd., Incheon, 22014, Republic of Korea
| | - Hanseong Kim
- Baobab AiBIO, POSCO Green Building, Yonsei University, Incheon, 21983, Republic of Korea
| | - Kwangrok Chun
- R&D Center, Binex, Incheon, 21999, Republic of Korea
| | - Sukmook Lee
- Department of Biochemistry, Kookmin University, Seoul, 02707, Republic of Korea; Department of Biopharmaceutical Chemistry, Kookmin University, Seoul, 02707, Republic of Korea; Antibody Research Institute, Kookmin University, Seoul, 02707, Republic of Korea.
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15
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Kim JW, Cho AH, Shin HG, Jang SH, Cho SY, Lee YR, Lee S. Development and Characterization of Phage Display-Derived Monoclonal Antibodies to the S2 Domain of Spike Proteins of Wild-Type SARS-CoV-2 and Multiple Variants. Viruses 2023; 15:174. [PMID: 36680213 PMCID: PMC9862430 DOI: 10.3390/v15010174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/07/2022] [Accepted: 12/23/2022] [Indexed: 01/11/2023] Open
Abstract
The rapid emergence of new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants has resulted in the ongoing global coronavirus disease 2019 (COVID-19) pandemic. Thus, the rapid development of a platform to detect a broad range of SARS-CoV-2 variants is essential for successful COVID-19 management. In this study, four SARS-CoV-2 spike protein-specific single-chain variable fragments (scFvs) were isolated from a synthetic antibody library using phage display technology. Following the conversion of these scFvs into monoclonal antibodies (mAbs) (K104.1-K104.4) and production and purification of the mAbs, the antibody pair (K104.1 and K104.2) that exhibited the highest binding affinity (K104.1 and K104.2, 1.3 nM and 1.9 nM) was selected. Biochemical analyses revealed that this antibody pair specifically bound to different sites on the S2 subunit of the spike protein. Furthermore, we developed a highly sensitive sandwich immunoassay using this antibody pair that accurately and quantitatively detected the spike proteins of wild-type SARS-CoV-2 and multiple variants, including Alpha, Beta, Gamma, Delta, Kappa, and Omicron, in the picomolar range. Conclusively, the novel phage display-derived mAbs we have developed may be useful for the rapid and efficient detection of the fast-evolving SARS-CoV-2.
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Affiliation(s)
- Ji Woong Kim
- Department of Applied Chemistry, Kookmin University, Seoul 02707, Republic of Korea
| | - Ah Hyun Cho
- Biopharmaceutical Chemistry Major, School of Applied Chemistry, Kookmin University, Seoul 02707, Republic of Korea
| | - Ha Gyeong Shin
- Biopharmaceutical Chemistry Major, School of Applied Chemistry, Kookmin University, Seoul 02707, Republic of Korea
| | - Sung Hoon Jang
- Department of Applied Chemistry, Kookmin University, Seoul 02707, Republic of Korea
| | - Su Yeon Cho
- Biopharmaceutical Chemistry Major, School of Applied Chemistry, Kookmin University, Seoul 02707, Republic of Korea
| | - Ye Rim Lee
- Biopharmaceutical Chemistry Major, School of Applied Chemistry, Kookmin University, Seoul 02707, Republic of Korea
| | - Sukmook Lee
- Department of Applied Chemistry, Kookmin University, Seoul 02707, Republic of Korea
- Biopharmaceutical Chemistry Major, School of Applied Chemistry, Kookmin University, Seoul 02707, Republic of Korea
- Antibody Research Institute, Kookmin University, Seoul 02707, Republic of Korea
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16
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Kim JW, Min SW, Lee J, Shin HG, Choi HL, Yang HR, Lee JH, Cho YB, Shim H, Lee S. Development and Characterization of Phage-Display-Derived Novel Human Monoclonal Antibodies against the Receptor Binding Domain of SARS-CoV-2. Biomedicines 2022; 10:biomedicines10123274. [PMID: 36552031 PMCID: PMC9775448 DOI: 10.3390/biomedicines10123274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has resulted in an ongoing global pandemic crisis, caused by the life-threatening illness coronavirus disease 2019 (COVID-19). Thus, the rapid development of monoclonal antibodies (mAbs) to cope with COVID-19 is urgently necessary. In this study, we used phage display to develop four human mAbs specific to the receptor-binding domain (RBD) of SARS-CoV-2. Our intensive in vitro functional analyses demonstrated that K102.1, an anti-SARS-CoV-2 RBD-specific mAb, exerted potent neutralizing activity against pseudoviral and live viral infection and the interaction between SARS-CoV-2 RBD and human angiotensin-converting enzyme 2. Monotherapy with K102.1 also revealed the therapeutic potential against SARS-CoV-2 infection in vivo. Further, this study developed a sandwich enzyme-linked immunosorbent assay with a non-competing mAb pair, K102.1 and K102.2, that accurately detected the RBDs of SARS-CoV-2 wild-type and variants with high sensitivity in the picomolar range. These findings suggest that the phage-display-based mAb selection from an established antibody library may be an effective strategy for the rapid development of mAbs against the constantly evolving SARS-CoV-2.
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Affiliation(s)
- Ji Woong Kim
- Department of Chemistry, Kookmin University, Seoul 02707, Republic of Korea
| | - Sung Won Min
- Research Center, SG Medical, Seoul 05548, Republic of Korea
| | - Jichul Lee
- Research Center, SG Medical, Seoul 05548, Republic of Korea
| | - Ha Gyeong Shin
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul 02707, Republic of Korea
| | - Hye Lim Choi
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul 02707, Republic of Korea
| | - Ha Rim Yang
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul 02707, Republic of Korea
| | - Ji Hyun Lee
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul 02707, Republic of Korea
| | - Yea Bin Cho
- Department of Chemistry, Kookmin University, Seoul 02707, Republic of Korea
| | - Hyunbo Shim
- Department of Life Sciences, Ewha Womans University, Seoul 03760, Republic of Korea
| | - Sukmook Lee
- Department of Chemistry, Kookmin University, Seoul 02707, Republic of Korea
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul 02707, Republic of Korea
- Biopharmaceutical Chemistry Major, School of Applied Chemistry, Kookmin University, Seoul 02707, Republic of Korea
- Antibody Research Institute, Kookmin University, Seoul 02707, Republic of Korea
- Correspondence:
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17
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Mach K, Wei S, Kim JW, Martin-Gomez A, Zhang P, Kang JU, Nasseri MA, Gehlbach P, Navab N, Iordachita I. OCT-guided Robotic Subretinal Needle Injections: A Deep Learning-Based Registration Approach. Proceedings (IEEE Int Conf Bioinformatics Biomed) 2022; 2022:781-786. [PMID: 37396671 PMCID: PMC10312384 DOI: 10.1109/bibm55620.2022.9995143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Subretinal injection (SI) is an ophthalmic surgical procedure that allows for the direct injection of therapeutic substances into the subretinal space to treat vitreoretinal disorders. Although this treatment has grown in popularity, various factors contribute to its difficulty. These include the retina's fragile, nonregenerative tissue, as well as hand tremor and poor visual depth perception. In this context, the usage of robotic devices may reduce hand tremors and facilitate gradual and controlled SI. For the robot to successfully move to the target area, it needs to understand the spatial relationship between the attached needle and the tissue. The development of optical coherence tomography (OCT) imaging has resulted in a substantial advancement in visualizing retinal structures at micron resolution. This paper introduces a novel foundation for an OCT-guided robotic steering framework that enables a surgeon to plan and select targets within the OCT volume. At the same time, the robot automatically executes the trajectories necessary to achieve the selected targets. Our contribution consists of a novel combination of existing methods, creating an intraoperative OCT-Robot registration pipeline. We combined straightforward affine transformation computations with robot kinematics and a deep neural network-determined tool-tip location in OCT. We evaluate our framework's capability in a cadaveric pig eye open-sky procedure and using an aluminum target board. Targeting the subretinal space of the pig eye produced encouraging results with a mean Euclidean error of 23.8μm.
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Affiliation(s)
- Kristina Mach
- Laboratory for Computational Sensing and Robotics, Johns Hopkins University, Baltimore, USA
| | - Shuwen Wei
- Laboratory for Computational Sensing and Robotics, Johns Hopkins University, Baltimore, USA
| | - Ji Woong Kim
- Laboratory for Computational Sensing and Robotics, Johns Hopkins University, Baltimore, USA
| | - Alejandro Martin-Gomez
- Laboratory for Computational Sensing and Robotics, Johns Hopkins University, Baltimore, USA
| | - Peiyao Zhang
- Laboratory for Computational Sensing and Robotics, Johns Hopkins University, Baltimore, USA
| | - Jin U Kang
- Laboratory for Computational Sensing and Robotics, Johns Hopkins University, Baltimore, USA
| | - M Ali Nasseri
- Augenklinik und Poliklinik, Klinikum rechts der Isar der Technische Universität, Munich, Germany
| | - Peter Gehlbach
- Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, USA
| | - Nassir Navab
- Laboratory for Computational Sensing and Robotics, Johns Hopkins University, Baltimore, USA
- Chair for Computer Aided Medical Procedures, Technical University of Munich, Germany
| | - Iulian Iordachita
- Laboratory for Computational Sensing and Robotics, Johns Hopkins University, Baltimore, USA
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18
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Song JS, Kim BS, Yang MA, Lee YJ, Jung GM, Kim JW, Cho JW. Underestimation of endoscopic size in large gastric epithelial neoplasms. Clin Endosc 2022; 55:760-766. [PMID: 36464825 PMCID: PMC9726444 DOI: 10.5946/ce.2021.269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 02/09/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND/AIMS Endoscopic submucosal dissection (ESD) is an effective method for resecting gastric adenomas and adenocarcinomas. A significant discrepancy was observed between endoscopic and pathological sizes in samples obtained from patients undergoing ESD. This study elucidates the factors affecting size discrepancy after formalin fixation. METHODS The records of 64 patients with 69 lesions were analyzed, including 50 adenomas and 19 adenocarcinomas. Data on location, gross shape, histology, and size after fixation in formalin were collected. RESULTS The mean size of the resected specimen appeared to decrease after formalin fixation (37.5 mm prefixation vs. 35.8 mm postfixation, p<0.05). The mean long axis diameter of the lesions was 20.3±7.9 mm prefixation and 13.4±7.9 mm postfixation. Size differences in lesions smaller than 20 mm were significantly greater than those in lesions larger than 20 mm (7.6±5.6 mm vs. 2.5±5.8 mm, p<0.01). In multivariate analysis, a tumor size of ≥20 mm was found to be an independent factor affecting size postformalin fixation (p<0.05). CONCLUSION The endoscopic size of lesions before ESD may be underestimated in tumors larger than 20 mm in size. Therefore, increased attention must be paid during ESD to avoid instances of incomplete resection.
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Affiliation(s)
- Jae Sun Song
- Division of Gastroenterology, Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Byung Sun Kim
- Division of Gastroenterology, Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Min A Yang
- Division of Gastroenterology, Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Young Jae Lee
- Division of Gastroenterology, Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Gum Mo Jung
- Division of Gastroenterology, Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Ji Woong Kim
- Division of Gastroenterology, Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Jin Woong Cho
- Division of Gastroenterology, Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea,Correspondence: Jin Woong Cho Division of Gastroenterology, Department of Internal Medicine, Presbyterian Medical Center, 365 Seowon-ro, Wansan-gu, Jeonju 54987, Korea E-mail:
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19
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Frenel JS, Kim JW, Aryal N, Asher R, Berton D, Vidal L, Pautier P, Ledermann JA, Penson RT, Oza AM, Korach J, Huzarski T, Pignata S, Colombo N, Park-Simon TW, Tamura K, Sonke GS, Freimund AE, Lee CK, Pujade-Lauraine E. Efficacy of subsequent chemotherapy for patients with BRCA1/2-mutated recurrent epithelial ovarian cancer progressing on olaparib versus placebo maintenance: post-hoc analyses of the SOLO2/ENGOT Ov-21 trial. Ann Oncol 2022; 33:1021-1028. [PMID: 35772665 DOI: 10.1016/j.annonc.2022.06.011] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 06/16/2022] [Accepted: 06/20/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND In the SOLO2 trial (ENGOT Ov-21; NCT01874353), maintenance olaparib in patients with platinum-sensitive relapsed ovarian cancer (PSROC) and BRCA mutation significantly improved progression-free survival (PFS) and prolonged overall survival (OS). Following disease progression on olaparib, efficacy of subsequent chemotherapy remains unknown. PATIENTS AND METHODS We conducted a post-hoc hypothesis-generating analysis of SOLO2 data to determine the efficacy of different chemotherapy regimens following RECIST disease progression in patients who received olaparib or placebo. We evaluated time to second progression (TTSP) calculated from the date of RECIST progression to the next progression/death. RESULTS The study population comprised 147 patients who received chemotherapy as their first subsequent treatment after RECIST progression. Of these, 69 (47%) and 78 (53%) were originally randomized to placebo and olaparib arms, respectively. In the placebo-treated cohort, 27/69 and 42/69 received non-platinum and platinum-based chemotherapy, respectively, compared with 24/78 and 54/78, respectively, in the olaparib-treated cohort. Among patients treated with chemotherapy (N = 147), TTSP was significantly longer in the placebo than in the olaparib arm: 12.1 versus 6.9 months [hazard ratio (HR) 2.17, 95% confidence interval (CI) 1.47-3.19]. Similar result was obtained on multivariable analysis adjusting for prognostic factors at RECIST progression (HR 2.13, 95% CI 1.41-3.22). Among patients treated with platinum-based chemotherapy (n = 96), TTSP was significantly longer in the placebo arm: 14.3 versus 7.0 months (HR 2.89, 95% CI 1.73-4.82). Conversely, among patients treated with non-platinum-based chemotherapy (n = 51), the TTSP was comparable in the placebo and olaparib arms: 8.3 versus 6.0 months (HR 1.58, 95% CI 0.86-2.90). CONCLUSIONS Following progression from maintenance olaparib in the recurrent setting, the efficacy of platinum-based subsequent chemotherapy seems to be reduced in BRCA1/2-mutated patients with PSROC compared to patients not previously receiving poly (ADP-ribose) polymerase inhibitors (PARPi). The optimal strategy for patients who relapse after PARPi is an area of ongoing research.
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Affiliation(s)
- J S Frenel
- Institut de Cancerologie de l'Ouest, GINECO, GINEGEPS, Centre René Gauducheau, Saint-Herblain, France.
| | - J W Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - N Aryal
- NHMRC CTC Centre, University of Sydney, Camperdown, Sydney, Australia
| | - R Asher
- NHMRC CTC Centre, University of Sydney, Camperdown, Sydney, Australia
| | - D Berton
- Institut de Cancerologie de l'Ouest, GINECO, GINEGEPS, Centre René Gauducheau, Saint-Herblain, France
| | - L Vidal
- GEICO & H Clínic de Barcelona, Barcelona, Spain
| | - P Pautier
- GINECO & Gustave Roussy Cancer Center, Villejuif, France
| | | | - R T Penson
- Massachusetts General Hospital, Boston, USA
| | - A M Oza
- Princess Margaret Cancer Centre, Toronto, Canada
| | - J Korach
- ISGO & Chaim Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - T Huzarski
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - S Pignata
- MITO & Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale Napoli, Naples, Italy
| | - N Colombo
- MaNGO & European Institute of Oncology IRCCS and University of Milan-Bicocca, Milano, Italy
| | - T W Park-Simon
- AGO & Medical School, Department of Gynecologic Oncology, Hannover, Hannover, Germany
| | - K Tamura
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - G S Sonke
- DGOG & Netherlands Cancer Institute, Amsterdam, Netherlands
| | - A E Freimund
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | - C K Lee
- NHMRC CTC Centre, University of Sydney, Camperdown, Sydney, Australia
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20
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Kim BS, Yang SY, Lee WD, Song JS, Yang MA, Jung GM, Cho JW, Kim JW. Endoscopic Ultrasonography-guided Gastrojejunostomy for Patients with Gastric Outlet Obstruction and Pyloric Metal Stent Dysfunction. Korean J Gastroenterol 2022; 79:260-264. [PMID: 35746840 DOI: 10.4166/kjg.2022.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/03/2022] [Accepted: 04/19/2022] [Indexed: 06/15/2023]
Abstract
A 52-year-old woman with a gastric outlet obstruction (GOO) caused by pyloric cancer underwent pyloric endoscopic self-expandable metal stent (SEMS) insertion. She presented with abdominal distension 40 days later. The SEMS was dysfunctional, and endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ) was performed using an endoscopic nasobiliary drainage tube. A 16 mm×31 mm Niti-S ™ HOT SPAXUS™ (TaeWoong Medical, Gimpo, Korea) was inserted successfully between the stomach and the adjacent jejunum. After the procedure, the patient had a good oral intake for more than seven months. GOO is a mechanical obstructive condition caused by various benign and malignant conditions. Traditionally, surgical GJ and SEMS insertion have been used to treat GOOs. EUS-GJ is a feasible treatment option for patients with GOO and a pyloric metal stent dysfunction.
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Affiliation(s)
- Byung Sun Kim
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Sung Yeol Yang
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Won Dong Lee
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Jae Sun Song
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Min A Yang
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Gum Mo Jung
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Jin Woong Cho
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Ji Woong Kim
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
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21
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Cho YB, Kim JW, Heo K, Kim HJ, Yun S, Lee HS, Shin HG, Shim H, Yu H, Kim YH, Lee S. An internalizing antibody targeting of cell surface GRP94 effectively suppresses tumor angiogenesis of colorectal cancer. Biomed Pharmacother 2022; 150:113051. [PMID: 35658213 DOI: 10.1016/j.biopha.2022.113051] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 11/16/2022] Open
Abstract
Colorectal cancer (CRC) is one of the life-threatening malignancies worldwide. Thus, novel potential therapeutic targets and therapeutics for the treatment of CRC need to be identified to improve the clinical outcomes of patients with CRC. In this study, we found that glucose-regulated protein 94 (GRP94) is overexpressed in CRC tissues, and its high expression is correlated with increased microvessel density. Next, through phage display technology and consecutive in vitro functional isolations, we generated a novel human monoclonal antibody that specifically targets cell surface GRP94 and shows superior internalizing activity comparable to trastuzumab. We found that this antibody specifically inhibits endothelial cell tube formation and simultaneously promotes the downregulation of GRP94 expression on the endothelial cell surface. Finally, we demonstrated that this antibody effectively suppresses tumor growth and angiogenesis of HCT116 human CRC cells without causing severe toxicity in vivo. Collectively, these findings suggest that cell surface GRP94 is a novel potential anti-angiogenic target in CRC and that antibody targeting of GRP94 on the endothelial cell surface is an effective strategy to suppress CRC tumor angiogenesis.
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Affiliation(s)
- Yea Bin Cho
- Department of Chemistry, Kookmin University, Seoul 02707, Republic of Korea
| | - Ji Woong Kim
- Department of Chemistry, Kookmin University, Seoul 02707, Republic of Korea
| | - Kyun Heo
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul 02707, Republic of Korea; Biopharmaceutical Chemistry Major, School of Applied Chemistry, Kookmin University, Seoul 02707, Republic of Korea; Antibody Research Institute, Kookmin University, Seoul 02707, Republic of Korea
| | - Hyun Jung Kim
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul 02707, Republic of Korea; Biopharmaceutical Chemistry Major, School of Applied Chemistry, Kookmin University, Seoul 02707, Republic of Korea
| | - Sumi Yun
- Samkwang Medical Laboratories, Department of Diagnostic Pathology, Seoul 06742, Republic of Korea
| | - Hye Seung Lee
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Ha Gyeong Shin
- Department of Biopharmaceutical Chemistry, Kookmin University, Seoul 02707, Republic of Korea
| | - Hyunbo Shim
- Department of Life Science, Ewha Womans University, Seoul 03760, Republic of Korea
| | - Hanjin Yu
- HauulBio, Chuncheon, Gangwon 24398, Republic of Korea
| | - Yun-Hee Kim
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Republic of Korea; Division of Convergence Technology, Research Institute of National Cancer Center, Goyang 10408, Republic of Korea
| | - Sukmook Lee
- Department of Chemistry, Kookmin University, Seoul 02707, Republic of Korea; Department of Biopharmaceutical Chemistry, Kookmin University, Seoul 02707, Republic of Korea; Biopharmaceutical Chemistry Major, School of Applied Chemistry, Kookmin University, Seoul 02707, Republic of Korea; Antibody Research Institute, Kookmin University, Seoul 02707, Republic of Korea.
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22
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Lee WD, Song JS, Kim BS, Yang MA, Lee YJ, Jung GM, Kim JW, Cho YK, Cho JW. Safety and efficacy of prophylactic gastric open peroral endoscopic myotomy for prevention of post-ESD stenosis: A case series (with video). J Dig Dis 2022; 23:220-227. [PMID: 35373499 DOI: 10.1111/1751-2980.13094] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/14/2022] [Accepted: 03/31/2022] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Endoscopic resection of over 3/4 of the lumen of the antrum or pylorus is a known risk factor for post-endoscopic submucosal dissection (ESD) stenosis. Local or systemic steroids may reduce the risk of stenosis, but their overall role in stenosis prevention remains controversial. We aimed to evaluate the efficacy and safety of prophylactic gastric open peroral endoscopic myotomy (GO-POEM) in preventing post-ESD stenosis. METHODS Ten patients who underwent GO-POEM during or immediately after ESD in the Presbyterian Medical Center between June 2017 and November 2020 were included. All patients underwent excision of over 3/4 of the lumen of the antrum or pylorus. GO-POEM was performed without submucosal tunneling. RESULTS Well-differentiated tubular adenocarcinoma, tubulovillous adenoma with high-grade dysplasia, and tubular adenoma with low-grade dysplasia were diagnosed in three, one, and six patients, respectively. GO-POEM was performed successfully in all the 10 patients. Stenosis could not be evaluated in one patient, whereas one of the remaining nine patients developed post-ESD stenosis. GO-POEM decreased the risk of post-ESD stenosis in the other eight patients. Two patients presented with intraprocedural bleeding, both of whom were managed endoscopically successfully. CONCLUSIONS Prophylactic GO-POEM may be a novel, effective and safe treatment modality for preventing post-ESD stenosis in the stomach. Well-designed, multicenter studies with large sample sizes are needed to confirm our results.
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Affiliation(s)
- Won Dong Lee
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, South Korea
| | - Jae Sun Song
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, South Korea
| | - Byung Sun Kim
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, South Korea
| | - Min A Yang
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, South Korea
| | - Young Jae Lee
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, South Korea
| | - Gum Mo Jung
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, South Korea
| | - Ji Woong Kim
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, South Korea
| | - Yong Keun Cho
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, South Korea
| | - Jin Woong Cho
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, South Korea
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23
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Kim JW, Vella C, Parvez W, Verma R, Majid M, Woltmann G, Pareek M, Bennett J, Agrawal S, Sudhir R, Ahyow L, Tufail M, Haldar P. Impact of COVID-19 on the diagnosis and management of lung cancer and TB. Int J Tuberc Lung Dis 2022; 26:372-374. [PMID: 35351244 DOI: 10.5588/ijtld.22.0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- J W Kim
- Department of Respiratory Sciences, University of Leicester, Leicester, Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester
| | - C Vella
- Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester
| | - W Parvez
- Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester
| | - R Verma
- Department of Respiratory Sciences, University of Leicester, Leicester, Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester
| | - M Majid
- Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester
| | - G Woltmann
- Department of Respiratory Sciences, University of Leicester, Leicester, Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester
| | - M Pareek
- Department of Respiratory Sciences, University of Leicester, Leicester
| | - J Bennett
- Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester
| | - S Agrawal
- Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester
| | - R Sudhir
- Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester
| | - L Ahyow
- UK Health Security Agency, London, UK
| | - M Tufail
- Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester
| | - P Haldar
- Department of Respiratory Sciences, University of Leicester, Leicester, Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester
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24
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Kim JW, Woo SB, Song JI, Kwon HK. An observational study of hydrodynamic impact on water mass transport due to tidal power generation. Sci Total Environ 2022; 807:151013. [PMID: 34662618 DOI: 10.1016/j.scitotenv.2021.151013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/08/2021] [Accepted: 10/11/2021] [Indexed: 06/13/2023]
Abstract
The world's largest Sihwa Tidal Power Plant (TPP), located on the west coast of Korea, was built in 2011 for the purpose of improving water quality and producing renewable energy. After several years of actual operation, most of the original purpose was achieved, but unexpected coastal environmental changes such as tidal flat damage and sediment accumulation also occurred. In this study, in order to understand the causes of these environmental changes, field observations were conducted near TPP, and spatial and temporal variability of flow structure and water exchange process were investigated. Three-dimensional velocity data were collected along the closed line surrounding the outside of the TPP for 11 h during spring tide and analyzed according to two discharge phases: power generation phase (PGP) and drainage phase (DP). The results show that the depth-averaged maximum current velocity was more than three times greater at DP than at PGP. Jet-like flow during DP caused very high horizontal shear, whereas vertical shear was relatively weak, indicating that the horizontal and vertical flow structures were very different. The most notable result is that the mass transport patterns between PGP and DP are significantly different, i.e., during PGP, mass transport is dominated on the left side of the TPP, whereas during DP, it occurs at the front of the TPP. This means that there is a strong spatiotemporal asymmetry between the inflow from the downstream (outside of the TPP) during PGP and the outflow from the upstream (inside of the TPP) during DP. These asymmetric processes can have a significant impact on the material exchange and sediment transport near the TPP. Since observational studies on TPP are extremely rare, this study is expected to contribute to future TPP related research, such as numerical modeling.
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Affiliation(s)
- J W Kim
- Department of Ocean Sciences, Inha University, Incheon 22212, Republic of Korea
| | - S-B Woo
- Department of Ocean Sciences, Inha University, Incheon 22212, Republic of Korea.
| | - J I Song
- Department of Ocean Sciences, Inha University, Incheon 22212, Republic of Korea
| | - H-K Kwon
- Korea Water Resources Corporation, Ansan 15637, Republic of Korea
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Abstract
OBJECTIVES The present study aimed to investigate the incidence of and risk factors for postoperative pneumonia and aspiration pneumonia after hip fracture surgery. DESIGN Retrospective cohort study from 2005 to 2021. SETTING Asan Medical Center in Seoul, Republic of Korea. PARTICIPANTS A total 1,208 patients aged ≥ 65 years who underwent hip fracture surgery. MEASUREMENTS Postoperative pneumonia was defined as cases with new infiltration on chest x-ray or chest computed tomography (CT) after surgery or confirmed by a pulmonologist's consultation and diagnosis. Aspiration pneumonia was defined as: 1) radiologic findings of hospital-acquired pneumonia on chest radiographs or CT, medical record of aspiration pneumonia confirmed by a pulmonologist's consultation, and history of vomiting or aspiration, or 2) gravity-dependent opacity on chest CT when the history of vomiting or aspiration is ambiguous. Patient demographics, past medical history, pre-injury Koval score, Charlson Comorbidity Index (CCI), blood test results, length of hospital stay, and in-hospital mortality were evaluated. A comparison analysis and binary logistic regression were performed to identify the incidence and risk factors for postoperative pneumonia and aspiration pneumonia. RESULTS Postoperative pneumonia was diagnosed in 47 patients (3.9%), including 20 with aspiration pneumonia (1.7%). In the multivariate analysis, postoperative delirium (odds ratio [OR], 3.42; P < 0.001), American Society of Anesthesiologists (ASA) scores ≥ 3 (OR, 2.11; P = 0.021), and CCI (OR, 1.21; P = 0.013) were significant risk factors for postoperative pneumonia. Male sex (OR, 3.01; P = 0.017), postoperative delirium (OR, 3.16; P = 0.014), and preoperative serum albumin levels < 3.5 g/dL (OR, 7.00; P = 0.010) were significant risk factors for aspiration pneumonia. CONCLUSION ASA classification ≥ 3, higher CCI, and postoperative delirium were the risk factors for postoperative pneumonia. Male sex, postoperative delirium, and lower preoperative serum albumin level were the risk factors for aspiration pneumonia. Thus, physicians should pay attention to patients with the risk factors.
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Affiliation(s)
- J Ahn
- Ji Wan Kim, Department of Orthopedic Surgery, University of Ulsan, College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea, Phone: +82-2-3010-3530, Fax: +82-2-2045-4542, Email address: , ORCID: 0000-0002-3524-8706
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Kim JW, Lee S. Current status and perspectives on CAR-T therapy. FRONT BIOSCI-LANDMRK 2021; 26:1393-1395. [PMID: 34994154 DOI: 10.52586/5033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 11/26/2021] [Accepted: 11/26/2021] [Indexed: 11/09/2022]
Affiliation(s)
- Ji Woong Kim
- Biopharmaceutical Chemistry Major, School of Applied Chemistry, Kookmin University, 02707 Seoul, Republic of Korea
| | - Sukmook Lee
- Biopharmaceutical Chemistry Major, School of Applied Chemistry, Kookmin University, 02707 Seoul, Republic of Korea
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Jeong SY, Hwang KT, Oh CW, Kim JW, Sohn OJ, Kim JW, Cho YH, Park KC. Infographic: Mid-term outcomes after the surgical treatment of atypical femoral fractures : minimum three-year follow-up. Bone Joint J 2021; 103-B:1646-1647. [PMID: 34719273 DOI: 10.1302/0301-620x.103b11.bjj-2021-1428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- S-Y Jeong
- Department of Orthopaedic Surgery, Hanyang University Guri Hospital, Guri, South Korea
| | - K-T Hwang
- Hanyang University College of Medicine, Seoul, South Korea
| | - C-W Oh
- Department of Orthopedic Surgery, Kyungpook National University Hospital, Daegu, South Korea
| | - J-W Kim
- Department of Orthopedic Surgery, Kyungpook National University Hospital, Daegu, South Korea
| | - O J Sohn
- Yeungnam University, Gyeongsan, South Korea
| | - J W Kim
- Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Y-H Cho
- Daegu Fatima Hospital, Daegu, South Korea
| | - K C Park
- Department of Orthopaedic Surgery, Hanyang University Guri Hospital, Guri, South Korea
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Kim MJ, Kim JW, Kim MS, Choi SY, Na JI. Generalized erythema multiforme-like skin rash following the first dose of COVID-19 vaccine (Pfizer-BioNTech). J Eur Acad Dermatol Venereol 2021; 36:e98-e100. [PMID: 34661942 PMCID: PMC8656619 DOI: 10.1111/jdv.17757] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 10/13/2021] [Indexed: 12/18/2022]
Affiliation(s)
- M J Kim
- Department of Dermatology, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Korea
| | - J W Kim
- Department of Dermatology, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Korea
| | - M S Kim
- Department of Dermatology, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Korea
| | - S Y Choi
- Department of Dermatology, Ilsan Paik Hospital, Inje University, 170, Juhwa-ro, Ilsanseo-gu, Goyang-si, Gyeonggi-do, Korea
| | - J I Na
- Department of Dermatology, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Korea
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29
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Yang BR, Cha SH, Lee KE, Kim JW, Lee J, Shin KH. Effect of dipeptidyl peptidase IV inhibitors, thiazolidinedione, and sulfonylurea on osteoporosis in patients with type 2 diabetes: population-based cohort study. Osteoporos Int 2021; 32:1705-1712. [PMID: 33594487 DOI: 10.1007/s00198-020-05801-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 12/15/2020] [Indexed: 12/01/2022]
Abstract
UNLABELLED The population-based cohort study used the Korean National Health Insurance claims database to evaluate the effect of anti-diabetic drugs on osteoporosis. The use of DPP-IV inhibitors does not increase the risk of osteoporosis compared with the use of sulfonylureas in patients with type 2 diabetes mellitus, while a weak association was found between thiazolidinediones and increased risk of osteoporosis. PURPOSE The current study aimed to evaluate the effect of dipeptidyl peptidase IV inhibitors (DPP-IVi), thiazolidinedione (TZD), and sulfonylurea (SU) on osteoporosis in patients with type 2 diabetes. METHODS A population-based cohort study was conducted in the Republic of Korea using the Korean National Health Insurance claims database. Data from 2012 to 2017 for patients of 50-99 years of age who were prescribed DPP-IVi, TZD, or SU during 2013-2015 were extracted from the database. Based on pre-defined criteria, a total of 381,404 patients were analyzed after inverse probability of treatment weighting. The association between the study drugs and osteoporosis was estimated using Cox proportional hazards models. Data of 220,166 patients who were prescribed DPP-IVi, 18,630 who were prescribed TZD, and 142,608 patients who were prescribed SU were set. RESULTS In the multivariate-adjusted analysis, the hazard ratio (HR) of osteoporosis in the DPP-IVi group was not significantly different from that of the SU group (HR: 0.97; 95% confidence interval (CI) 0.94-1.00), whereas the HR of osteoporosis in the TZD group was higher (HR: 1.13; 95% CI 1.06-1.20). In the subgroup analysis, the HRs of osteoporosis were higher with pioglitazone (HR: 1.14; 95% CI 1.06-1.23) in the TZD group and with glibenclamides (HR: 1.39; 95% CI 1.09-1.77) in the SU group, whereas drugs with lower HR in the DPP-IVi group were saxagliptin (HR: 0.93; 95% CI 0.87-0.99) and sitagliptin (HR: 0.93; 95% CI 0.89-0.97). CONCLUSION DPP-IV inhibitors do not increase the risk of osteoporosis compared with sulfonylureas in patients with type 2 diabetes mellitus, while a weak association was found between thiazolidinediones and increased risk of osteoporosis.
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Affiliation(s)
- B R Yang
- College of Pharmacy, Chungnam National University, Daejeon, Republic of Korea
| | - S H Cha
- Department of Statistics, College of Natural Sciences, Kyungpook National University, Daegu, Republic of Korea
| | - K E Lee
- Department of Statistics, College of Natural Sciences, Kyungpook National University, Daegu, Republic of Korea
| | - J W Kim
- Department of Family Medicine, Daegu Health College Hospital, Daegu, Republic of Korea
| | - J Lee
- College of Pharmacy, Research Institute of Pharmaceutical Sciences, Kyungpook National University, 80 Daehak-ro, Buk-gu, Daegu, 41566, Republic of Korea
| | - K-H Shin
- College of Pharmacy, Research Institute of Pharmaceutical Sciences, Kyungpook National University, 80 Daehak-ro, Buk-gu, Daegu, 41566, Republic of Korea.
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Yang JH, Cho SI, Kim DH, Yoon JY, Moon J, Kim JW, Choi S, Suh DH. Pilot study of fractional microneedling radiofrequency for hidradenitis suppurativa assessed by clinical response and histology. Clin Exp Dermatol 2021; 47:335-342. [PMID: 34431555 DOI: 10.1111/ced.14905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a devastating chronic inflammatory skin disease with frequent recurrences. Various systemic treatments and procedures have been used but the efficacy of fractional microneedling radiofrequency (FMR) has not been reported. AIM To evaluate the clinical and histological efficacy of FMR in the treatment of HS lesions. METHODS An 8-week, prospective, split-body, unblinded study was conducted, which enrolled 10 adult patients with mild to moderate HS to receive 3 sessions of FMR treatment biweekly. HS severity was assessed using the number and type of lesions, HS Physician Global Assessment (HS-PGA) and the modified Sartorius score (mSS). Skin biopsies were performed on participants to assess change in inflammation before and after FMR. RESULTS Severity of HS was significantly reduced on the FMR-treated side of the body, but not on the control side. Inflammatory HS lesions were significantly reduced after 4 weeks, while HS-PGA and mSS were significantly decreased after 6 weeks. Immunohistochemistry staining showed decreased expression of inflammatory markers including neutrophil elastases, interleukin (IL)-8 and IL-17, tumour necrosis factor-α, transforming growth factor-β1 and matrix metalloproteinases. CONCLUSION FMR may be a viable treatment option for mild to moderate HS.
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Affiliation(s)
- J H Yang
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea.,Acne, Rosacea, Seborrheic Dermatitis and Hidradenitis Suppurativa Research Laboratory, Seoul National University Hospital, Seoul, South Korea
| | - S I Cho
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea
| | - D H Kim
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea
| | - J Y Yoon
- Acne, Rosacea, Seborrheic Dermatitis and Hidradenitis Suppurativa Research Laboratory, Seoul National University Hospital, Seoul, South Korea
| | - J Moon
- Reone Skin Clinic, Seoul, South Korea
| | - J W Kim
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea
| | - S Choi
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea
| | - D H Suh
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea.,Acne, Rosacea, Seborrheic Dermatitis and Hidradenitis Suppurativa Research Laboratory, Seoul National University Hospital, Seoul, South Korea
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Jung IJ, Choi EJ, Lee BG, Kim JW. Population-based, three-dimensional analysis of age- and sex-related femur shaft geometry differences. Osteoporos Int 2021; 32:1631-1638. [PMID: 33501569 DOI: 10.1007/s00198-021-05841-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 01/11/2021] [Indexed: 10/22/2022]
Abstract
UNLABELLED This study deals with differences of femoral geometric focus on the bowing and width. Analysis using three-dimensional skeletonization showed increase of femoral bowing and femur width over life (more in women), and widening of the medullary canal only in women after 50 years old, not in men. INTRODUCTION The changes in femur geometry that occur with aging and lead to fragility or insufficiency fracture remain unclear. The role of the lower limb geometry, including the femur and femoral bowing, has become a point of discussion, especially in atypical femur fracture. This study aimed to analyze femur shaft geometry using three-dimensional skeletonization. METHODS We acquired computed tomography images of both femurs obtained. A total of 1400 age- and sex-stratified participants were enrolled and were divided into subgroups according to age (by decade) and sex. The computed tomography images were used to produce 3-dimensional samplings of anatomical elements of the human femur using reconstruction and parametrization from these datasets. The process of skeletonization was conducted to obtain compact representation of the femur. With the skeletonization, we were able to compare all parameters according to age and sex. RESULTS The femur length was 424.4 ± 28.6 mm and was longer in men (P < 0.001). The minimum diameter of the medullary canal was 8.9 ± 2.0 mm. The radius of curvature (ROC) was 906.9 ± 193.3 mm. Men had a larger femur length, femur outer diameter, and the narrowest medullary diameter (P < 0.001, respectively). Women had significantly smaller ROC (P < 0.001). ROC decreased by 19.4% in men and 23.6% in women between the ages of 20 to 89 years. Femur width increased over life by 11.4% in men and 24.5% in women. Between the ages of 50 and 89 years, the medullary canal appears to have increased by 32.7% in women. CONCLUSION This geometry analysis demonstrated that femoral bowing and femoral width increased related to aging, and that the medullary canal widened after the age of 50 years in women. This cross-sectional study revealed important age- and sex-related differences in femur shaft geometry that occur with aging.
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Affiliation(s)
- I J Jung
- University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - E J Choi
- Department of Orthopaedics, Asan Medical Center, Seoul, Republic of Korea
| | - B G Lee
- Division of Computer Engineering, Dongseo University, Busan, Republic of Korea
| | - J W Kim
- Department of Orthopaedics, Asan Medical Center, Seoul, Republic of Korea.
- Department of Orthopedic Surgery, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
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Kim HJ, Cho H, Park M, Kim JW, Ahn SJ, Lyoo CH, Suh SH, Ryu YH. MRI-Visible Perivascular Spaces in the Centrum Semiovale Are Associated with Brain Amyloid Deposition in Patients with Alzheimer Disease-Related Cognitive Impairment. AJNR Am J Neuroradiol 2021; 42:1231-1238. [PMID: 33985952 DOI: 10.3174/ajnr.a7155] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 01/21/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The association of perivascular spaces in the centrum semiovale with amyloid accumulation among patients with Alzheimer disease-related cognitive impairment is unknown. We evaluated this association in patients with Alzheimer disease-related cognitive impairment and β-amyloid deposition, assessed with [18F] florbetaben PET/CT. MATERIALS AND METHODS MR imaging and [18F] florbetaben PET/CT images of 144 patients with Alzheimer disease-related cognitive impairment were retrospectively evaluated. MR imaging-visible perivascular spaces were rated on a 4-point visual scale: a score of ≥3 or <3 indicated a high or low degree of MR imaging-visible perivascular spaces, respectively. Amyloid deposition was evaluated using the brain β-amyloid plaque load scoring system. RESULTS Compared with patients negative for β-amyloid, those positive for it were older and more likely to have lower cognitive function, a diagnosis of Alzheimer disease, white matter hyperintensity, the Apolipoprotein E ε4 allele, and a high degree of MR imaging-visible perivascular spaces in the centrum semiovale. Multivariable analysis, adjusted for age and Apolipoprotein E status, revealed that a high degree of MR imaging-visible perivascular spaces in the centrum semiovale was independently associated with β-amyloid positivity (odds ratio, 2.307; 95% CI, 1.036-5.136; P = .041). CONCLUSIONS A high degree of MR imaging-visible perivascular spaces in the centrum semiovale independently predicted β-amyloid positivity in patients with Alzheimer disease-related cognitive impairment. Thus, MR imaging-visible perivascular spaces in the centrum semiovale are associated with amyloid pathology of the brain and could be an indirect imaging marker of amyloid burden in patients with Alzheimer disease-related cognitive impairment.
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Affiliation(s)
- H J Kim
- From the Department of Nuclear Medicine (H.J.K., Y.H.R.)
- Department of Nuclear Medicine (H.J.K.), Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, South Korea
| | | | - M Park
- Radiology (M.P., J.W.K., S.J.A., S.H.S.), Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - J W Kim
- Radiology (M.P., J.W.K., S.J.A., S.H.S.), Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - S J Ahn
- Radiology (M.P., J.W.K., S.J.A., S.H.S.), Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | | | - S H Suh
- Radiology (M.P., J.W.K., S.J.A., S.H.S.), Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Y H Ryu
- From the Department of Nuclear Medicine (H.J.K., Y.H.R.)
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Lee WD, Song JS, Kim BS, Yang MA, Lee YJ, Jung GM, Cho YK, Cho JW, Kim JW. [Cannulation of the Portal Vein during Endoscopic Retrograde Cholangiopancreatography in a Patient with Choledocholithiasis]. Korean J Gastroenterol 2021; 77:253-257. [PMID: 34035204 DOI: 10.4166/kjg.2021.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 11/03/2022]
Abstract
Cannulation of the portal vein is a rare complication of ERCP. This paper reports a case of portal vein catheterization during ERCP in a patient with choledocholithiasis. A 62-year-old man was admitted to the Presbyterian Medical Center with right upper quadrant pain and jaundice. ERCP was performed under the suspicion of obstructive jaundice caused by a radiolucent stone. Bile duct cannulation using a pull-type papillotome was attempted, but it failed. After needle-knife fistulotomy, wire-guided cannulation was performed successfully, and 10 mL contrast was injected. On the other hand, the fluoroscopy image showed that the contrast medium disappeared very quickly. Pure blood was collected when the catheter was aspirated to identify the bile reflux, indicating possible cannulation of the portal vein. The procedure was terminated immediately and abdominal computed tomography showed air in the portal vein. One day after, a follow-up CT scan showed no air in the portal vein. The patient underwent repeated ERCP, and the common bile duct was cannulated. In most cases, isolated portal vein cannulation does not result in severe morbidity. However, it is important to aware of this rare complication so that no further invasive procedure is performed on the patient.
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Affiliation(s)
- Won Dong Lee
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Jae Sun Song
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Byung Sun Kim
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Min A Yang
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Young Jae Lee
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Gum Mo Jung
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Yong Keun Cho
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Jin Woong Cho
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Ji Woong Kim
- Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
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Kim JW, Cho YB, Lee S. Correction: Kim et al. Cell Surface GRP94 as a Novel Emerging Therapeutic Target for Monoclonal Antibody Cancer Therapy. Cells 2021, 10, 670. Cells 2021; 10:cells10051198. [PMID: 34069315 PMCID: PMC8153583 DOI: 10.3390/cells10051198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 05/06/2021] [Indexed: 11/16/2022] Open
Abstract
In Section 4.1.3 of the published paper, the authors made an incorrect and unsupported statement regarding PU-H71 and a Samus-sponsored Phase 1 clinical trial [...].
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Kim JW, Cho YB, Lee S. Cell Surface GRP94 as a Novel Emerging Therapeutic Target for Monoclonal Antibody Cancer Therapy. Cells 2021; 10:cells10030670. [PMID: 33802964 PMCID: PMC8002708 DOI: 10.3390/cells10030670] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/11/2021] [Accepted: 03/14/2021] [Indexed: 12/15/2022] Open
Abstract
Glucose-regulated protein 94 (GRP94) is an endoplasmic reticulum (ER)-resident member of the heat shock protein 90 (HSP90) family. In physiological conditions, it plays a vital role in regulating biological functions, including chaperoning cellular proteins in the ER lumen, maintaining calcium homeostasis, and modulating immune system function. Recently, several reports have shown the functional role and clinical relevance of GRP94 overexpression in the progression and metastasis of several cancers. Therefore, the current review highlights GRP94’s physiological and pathophysiological roles in normal and cancer cells. Additionally, the unmet medical needs of small chemical inhibitors and the current development status of monoclonal antibodies specifically targeting GRP94 will be discussed to emphasize the importance of cell surface GRP94 as an emerging therapeutic target in monoclonal antibody therapy for cancer.
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Kim JW, Ha J, Kim T, Yoon H, Hwang SY, Jo IJ, Shin TG, Sim MS, Kim K, Cha WC. Developing a time-adaptive prediction model for out-of-hospital cardiac arrest: Results from a nationwide cohort study in Korea (Preprint). J Med Internet Res 2021; 23:e28361. [PMID: 36260382 PMCID: PMC8406108 DOI: 10.2196/28361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/12/2021] [Accepted: 05/31/2021] [Indexed: 11/13/2022] Open
Abstract
Background Out-of-hospital cardiac arrest (OHCA) is a serious public health issue, and predicting the prognosis of OHCA patients can assist clinicians in making decisions about the treatment of patients, use of hospital resources, or termination of resuscitation. Objective This study aimed to develop a time-adaptive conditional prediction model (TACOM) to predict clinical outcomes every minute. Methods We performed a retrospective observational study using data from the Korea OHCA Registry in South Korea. In this study, we excluded patients with trauma, those who experienced return of spontaneous circulation before arriving in the emergency department (ED), and those who did not receive cardiopulmonary resuscitation (CPR) in the ED. We selected patients who received CPR in the ED. To develop the time-adaptive prediction model, we organized the training data set as ongoing CPR patients by the minute. A total of 49,669 patients were divided into 39,602 subjects for training and 10,067 subjects for validation. We compared random forest, LightGBM, and artificial neural networks as the prediction model methods. Model performance was quantified using the prediction probability of the model, area under the receiver operating characteristic curve (AUROC), and area under the precision recall curve. Results Among the three algorithms, LightGBM showed the best performance. From 0 to 30 min, the AUROC of the TACOM for predicting good neurological outcomes ranged from 0.910 (95% CI 0.910-0.911) to 0.869 (95% CI 0.865-0.871), whereas that for survival to hospital discharge ranged from 0.800 (95% CI 0.797-0.800) to 0.734 (95% CI 0.736-0.740). The prediction probability of the TACOM showed similar flow with cohort data based on a comparison with the conventional model’s prediction probability. Conclusions The TACOM predicted the clinical outcome of OHCA patients per minute. This model for predicting patient outcomes by the minute can assist clinicians in making rational decisions for OHCA patients.
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Affiliation(s)
- Ji Woong Kim
- Department of Digital Health, Samsung Advanced Institute for Health Science & Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Juhyung Ha
- Department of Computer Science, Indiana University, Bloomington, IN, United States
| | - Taerim Kim
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hee Yoon
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sung Yeon Hwang
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ik Joon Jo
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Tae Gun Shin
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Min Seob Sim
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyunga Kim
- Department of Digital Health, Samsung Advanced Institute for Health Science & Technology, Sungkyunkwan University, Seoul, Republic of Korea
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Won Chul Cha
- Department of Digital Health, Samsung Advanced Institute for Health Science & Technology, Sungkyunkwan University, Seoul, Republic of Korea
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Health Information and Strategy Center, Samsung Medical Center, Seoul, Republic of Korea
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Park HS, Kang B, Chon HJ, Im HS, Lee CK, Kim I, Kang MJ, Hwang JE, Bae WK, Cheon J, Park JO, Hong JY, Kang JH, Kim JH, Lim SH, Kim JW, Kim JW, Yoo C, Choi HJ. Liposomal irinotecan plus fluorouracil/leucovorin versus FOLFIRINOX as the second-line chemotherapy for patients with metastatic pancreatic cancer: a multicenter retrospective study of the Korean Cancer Study Group (KCSG). ESMO Open 2021; 6:100049. [PMID: 33578192 PMCID: PMC7878976 DOI: 10.1016/j.esmoop.2021.100049] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/31/2020] [Accepted: 01/03/2021] [Indexed: 12/16/2022] Open
Abstract
Background There is no clear consensus on the recommended second-line treatment for patients with metastatic pancreatic cancer who have disease progression following gemcitabine-based therapy. We retrospectively evaluated the clinical outcomes of liposomal irinotecan (nal-IRI) plus fluorouracil/leucovorin (FL) and FOLFIRINOX (fluorouracil, leucovorin, irinotecan, and oxaliplatin) in patients who had failed on the first-line gemcitabine-based therapy. Patients and methods From January 2015 to August 2019, 378 patients with MPC who had received nal-IRI/FL (n = 104) or FOLFIRINOX (n = 274) as second-line treatment across 11 institutions were included in this retrospective study. Results There were no significant differences in baseline characteristics between groups, except age and first-line regimens. With a median follow-up of 6 months, the median progression-free survival (PFS) was 3.7 months with nal-IRI/FL versus 4.6 months with FOLFIRINOX (P = 0.44). Median overall survival (OS) was 7.7 months with nal-IRI/FL versus 9.7 months with FOLFRINOX (P = 0.13). There was no significant difference in PFS and OS between the two regimens in the univariate and multivariate analyses. The subgroup analysis revealed that younger age (<70 years) was associated with better OS with FOLFIRINOX. In contrast, older age (≥70 years) was associated with better survival outcomes with nal-IRI/FL. Adverse events were manageable with both regimens; however, the incidence of grade 3 or higher neutropenia and peripheral neuropathy was higher in patients treated with FOLFIRINOX than with nal-IRI/FL. Conclusions Second-line nal-IRI/FL and FOLFIRINOX showed similar effectiveness outcomes after progression following first-line gemcitabine-based therapy. Age could be the determining factor for choosing the appropriate second-line therapy. This multicenter retrospective study investigated nal-IRI/FL and FOLFIRINOX outcomes after gemcitabine-based therapy. We found no significant differences in outcome between nal-IRI/FL and FOLFIRINOX treatment. Both regimens were well tolerated; however, neutropenia and peripheral neuropathy were more frequent with FOLFIRINOX. Age (cut-off, 70 years) showed differential efficacy between chemotherapy regimens.
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Affiliation(s)
- H S Park
- Division of Medical Oncology, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Korea
| | - B Kang
- Medical Oncology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - H J Chon
- Medical Oncology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - H-S Im
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - C-K Lee
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - I Kim
- Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - M J Kang
- Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - J E Hwang
- Division of Hematology-Oncology, Department of Internal Medicine, Chonnam National University Medical School and Hwasun Hospital, Gwangju, Korea
| | - W K Bae
- Division of Hematology-Oncology, Department of Internal Medicine, Chonnam National University Medical School and Hwasun Hospital, Gwangju, Korea
| | - J Cheon
- Department of Hematology and Oncology, Ulsan University Hospital, Ulsan University College of Medicine, Ulsan, Korea
| | - J O Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea
| | - J Y Hong
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea
| | - J H Kang
- Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Korea
| | - J H Kim
- Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Korea
| | - S H Lim
- Division of Hematology-Oncology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - J W Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - J-W Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - C Yoo
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | - H J Choi
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.
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Kim JW, Zhang P, Gehlbach P, Iordachita I, Kobilarov M. Towards Autonomous Eye Surgery by Combining Deep Imitation Learning with Optimal Control. Proc Mach Learn Res 2021; 155:2347-2358. [PMID: 34712957 PMCID: PMC8549631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
During retinal microsurgery, precise manipulation of the delicate retinal tissue is required for positive surgical outcome. However, accurate manipulation and navigation of surgical tools remain difficult due to a constrained workspace and the top-down view during the surgery, which limits the surgeon's ability to estimate depth. To alleviate such difficulty, we propose to automate the tool-navigation task by learning to predict relative goal position on the retinal surface from the current tool-tip position. Given an estimated target on the retina, we generate an optimal trajectory leading to the predicted goal while imposing safety-related physical constraints aimed to minimize tissue damage. As an extended task, we generate goal predictions to various points across the retina to localize eye geometry and further generate safe trajectories within the estimated confines. Through experiments in both simulation and with several eye phantoms, we demonstrate that our framework can permit navigation to various points on the retina within 0.089mm and 0.118mm in xy error which is less than the human's surgeon mean tremor at the tool-tip of 0.180mm. All safety constraints were fulfilled and the algorithm was robust to previously unseen eyes as well as unseen objects in the scene. Live video demonstration is available here: https://youtu.be/n5j5jCCelXk.
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Affiliation(s)
- Ji Woong Kim
- Department of Mechanical Engineering, Johns Hopkins University
| | - Peiyao Zhang
- Department of Mechanical Engineering, Johns Hopkins University
| | - Peter Gehlbach
- Wilmer Eye Institute, Johns Hopkins University School of Medicine
| | | | - Marin Kobilarov
- Department of Mechanical Engineering, Johns Hopkins University
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Alhazemi AA, Park S, Shin JH, Cho YC, Kim Y, Lee J, Kim PH, Kim JW, Chu HH. Safety and efficacy of transarterial embolisation for treatment of dorsal pancreatic artery haemorrhage. Clin Radiol 2020; 76:314.e9-314.e15. [PMID: 33334554 DOI: 10.1016/j.crad.2020.11.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 11/12/2020] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the safety and efficacy of transarterial embolisation (TAE) of dorsal pancreatic artery (DPA) haemorrhage. MATERIALS AND METHODS Nineteen consecutive patients (M:F = 16:3, mean age 59.6 years) who underwent TAE of DPA in three tertiary medical centres between January 2001 to January 2020 were reviewed retrospectively. Angiographic features and the technical and clinical outcomes of TAE were analysed. RESULTS The clinical presentations were a bloody drain from the Jackson-Pratt drainage tube (n=8), melaena (n=7), abdominal pain (n=4), and haematochezia (n=3). Angiographic findings included pseudoaneurysm (n=14), contrast media extravasation (n=4), or abrupt cut-off of the arterial branch (n=1). The NBCA (N-butyl-cyanoacrylate; n=4), microcoils (n=4), and a combination of these agents (n=7) were used as embolic agents. The most common origin of the DPA in the present study cohort was the splenic artery (n=7), followed by the coeliac trunk (n=4), common hepatic artery (n=4), and superior mesenteric artery (n=4). Technical and clinical success rates were 100% and 84.2% (16/19), respectively. Of the three clinically unsuccessful cases, two patients were revealed to have newly developed bleeding from another artery. The other patient expired 1 day after the TAE procedure due to a progression of hepatic failure. In one patient, an asymptomatic non-target embolisation occurred in the right posterior tibial artery as a procedure-related complication. No major complications were observed. CONCLUSION TAE is safe and effective for the management of bleeding from the DPA. It is important to be aware of the DPA as a potential bleeding source, including the relevant clinical characteristics.
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Affiliation(s)
- A A Alhazemi
- Department of Radiology, King Fahd Central Hospital, Jazan 45196, Saudi Arabia
| | - S Park
- Department of Radiology, Gil Medical Centre, Gachon University College of Medicine, Incheon, Republic of Korea
| | - J H Shin
- Department of Radiology and Research Institute of Radiology, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Y C Cho
- Department of Radiology and Research Institute of Radiology, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Y Kim
- Department of Radiology Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - J Lee
- Department of Radiology Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - P H Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - J W Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - H H Chu
- Department of Radiology and Research Institute of Radiology, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea
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40
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Islam MJ, Kim JW, Begum MK, Sohel MAT, Lim YS. Physiological and Biochemical Changes in Sugar Beet Seedlings to Confer Stress Adaptability under Drought Condition. Plants (Basel) 2020; 9:E1511. [PMID: 33171867 PMCID: PMC7695173 DOI: 10.3390/plants9111511] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 12/12/2022]
Abstract
The present study was conducted to examine the adaptability of 11 sugar beet cultivars grown under drought stress in the controlled glasshouse. The treatment was initiated on 30-day-old sugar beet plants where drought stress was made withholding water supply for consecutive 10 days while control was done with providing water as per requirement. It was observed that drought stress expressively reduced plant growth, photosynthetic pigments, and photosynthetic quantum yield in all the cultivars but comparative better results were observed in S1 (MAXIMELLA), S2 (HELENIKA), S6 (RECODDINA), S8 (SV2347), and S11 (BSRI Sugarbeet 2) cultivars. Besides, osmolytes like proline, glycine betaine, total soluble carbohydrate, total soluble sugar, total polyphenol, total flavonoid, and DPPH free radical scavenging activity were remarkably increased under drought condition in MAXIMELLA, HELENIKA, TERRANOVA, GREGOIA, SV2348, and BSRI Sugar beet 2 cultivars. In contrast, activities of enzymes like superoxide dismutase (SOD), catalase (CAT), and peroxidase (POD) were significantly decreased in all, while the cultivars SV2347, BSRI Sugar beet 1 and BSRI Sugar beet 2 were found with increased ascorbate peroxidase (APX) activity under drought condition. In parallel, polyphenol oxidase (PPO) was increased in all cultivars except HELENIKA. Overall, the cultivars HELENIKA, RECODDINA, GREGOIA, SV2347, SV2348, BSRI Sugar beet 1, and BSRI Sugar beet 2 were found best fitted to the given drought condition. These findings would help further for the improvement of stress adaptive sugar beet cultivars development in the breeding program for drought-prone regions.
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Affiliation(s)
- Md. Jahirul Islam
- Department of Bio-Health Convergence, Kangwon National University, Chuncheon 24341, Korea; (M.J.I.); (J.W.K.)
- Physiology and Sugar Chemistry Division, Bangladesh Sugarcrop Research Institute, Ishurdi 6620, Pabna, Bangladesh;
| | - Ji Woong Kim
- Department of Bio-Health Convergence, Kangwon National University, Chuncheon 24341, Korea; (M.J.I.); (J.W.K.)
| | - Mst. Kohinoor Begum
- Physiology and Sugar Chemistry Division, Bangladesh Sugarcrop Research Institute, Ishurdi 6620, Pabna, Bangladesh;
| | - Md. Abu Taher Sohel
- Agronomy and Farming System Division, Bangladesh Sugarcrop Research Institute, Ishurdi 6620, Pabna, Bangladesh;
| | - Young-Seok Lim
- Department of Bio-Health Convergence, Kangwon National University, Chuncheon 24341, Korea; (M.J.I.); (J.W.K.)
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41
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Han HJ, Kim JW, Jeong JH. Intramedullary pneumorrhachis following a cervical epidural steroid injection. Neurochirurgie 2020; 67:189-192. [PMID: 33049286 DOI: 10.1016/j.neuchi.2020.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 06/29/2020] [Accepted: 08/27/2020] [Indexed: 10/23/2022]
Abstract
Pneumorrhachis (PR) is a rare radiological condition characterized by the presence of intraspinal air. PR is commonly classified as spontaneous (nontraumatic), traumatic, or iatrogenic, and iatrogenic PR is the most common and often occurs secondary to invasive procedures such as epidural anesthesia, lumbar puncture, or spinal surgery. PR is usually asymptomatic, but it can produce symptoms associated with its underlying pathology. Here, we report a rare case of intramedullary cervical PR following a cervical epidural steroid injection (ESI) and include pertinent discussion.
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Affiliation(s)
- H J Han
- Department of Neurosurgery, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine, Dongdae-ro 87, 38067 Gyeongju, Republic of Korea.
| | - J W Kim
- Department of Neurosurgery, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine, Dongdae-ro 87, 38067 Gyeongju, Republic of Korea.
| | - J H Jeong
- Department of Neurosurgery, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine, Dongdae-ro 87, 38067 Gyeongju, Republic of Korea.
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Abstract
Autosomal dominant hypocalcified amelogenesis imperfecta (ADHCAI; OMIM #130900) is a genetic disorder exhibiting severe hardness defects and reduced fracture toughness of dental enamel. While the condition is nonsyndromic, it can be associated with other craniofacial anomalies, such as malocclusions and delayed or failed tooth eruption. Truncation mutations in FAM83H (OMIM *611927) are hitherto the sole cause of ADHCAI. With human genetic studies, Fam83h knockout and mutation-knock-in mouse models indicated that FAM83H does not serve a critical physiologic function during enamel formation and suggested a neomorphic mutation mechanism causing ADHCAI. The function of FAM83H remains obscure. FAM83H has been shown to interact with various isoforms of casein kinase 1 (CK1) and keratins and to mediate organization of keratin cytoskeletons and desmosomes. By considering FAM83H a scaffold protein to anchor CK1s, further molecular characterization of the protein could gain insight into its functions. In this study, we characterized 9 kindreds with ADHCAI and identified 3 novel FAM83H truncation mutations: p.His437*, p.Gln459*, and p.Glu610*. Some affected individuals exhibited hypoplastic phenotypes, in addition to the characteristic hypocalcification enamel defects, which have never been well documented. Failed eruption of canines or second molars in affected persons was observed in 4 of the families. The p.Glu610* mutation was located in a gap area (amino acids 470 to 625) within the zone of previously reported pathogenic variants (amino acids 287 to 694). In vitro pull-down studies with overexpressed FAM83H proteins in HEK293 cells demonstrated an interaction between FAM83H and SEC16A, a protein component of the COP II complex at endoplasmic reticulum exit sites. The interaction was mediated by the middle part (amino acids 287 to 657) of mouse FAM83H protein. Results of this study significantly extended the phenotypic and genotypic spectrums of FAM83H-associated ADHCAI and suggested a role for FAM83H in endoplasmic reticulum-to-Golgi vesicle trafficking and protein secretion (dbGaP phs001491.v1.p1).
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Affiliation(s)
- S K Wang
- Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA.,Department of Dentistry, School of Dentistry, National Taiwan University, Jhongjheng District, Taipei City, Taiwan
| | - H Zhang
- Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - C Y Hu
- Department of Prosthodontics, National Taiwan University Hospital, Jhongjheng District, Taipei City, Taiwan
| | - J F Liu
- Division of Pediatric Dentistry, Department of Stomatology, Taichung Veterans General Hospital, Xitun District, Taichung City, Taiwan
| | - S Chadha
- Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - J W Kim
- Department of Pediatric Dentistry and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea.,Department of Molecular Genetics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - J P Simmer
- Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - J C C Hu
- Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
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43
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Wenger DS, Triplette M, Shahrir S, Akgun KM, Wongtrakool C, Brown ST, Kim JW, Soo Hoo GW, Rodriguez-Barradas MC, Huang L, Feemster LC, Zifodya J, Crothers K. Associations of marijuana with markers of chronic lung disease in people living with HIV. HIV Med 2020; 22:92-101. [PMID: 33022830 DOI: 10.1111/hiv.12966] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/21/2020] [Accepted: 08/26/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVES The relationship between marijuana use and markers of chronic lung disease in people living with HIV (PLWH) is poorly understood. METHODS We performed a cross-sectional analysis of the Examinations of HIV-Associated Lung Emphysema (EXHALE) study, including 162 HIV-positive patients and 138 participants without HIV. We modelled marijuana exposure as: (i) current daily or weekly marijuana smoking vs. monthly or less often; or (ii) cumulative marijuana smoking (joint-years). Linear and logistic regression estimated associations between marijuana exposure and markers of lung disease, adjusted for tobacco smoking and other factors. RESULTS In PLWH, current daily or weekly marijuana use was associated with a larger forced vital capacity (FVC), larger total lung capacity and increased odds of radiographic emphysema compared with marijuana non-smokers in adjusted models; these associations were not statistically significant in participants without HIV. Marijuana joint-years were associated with higher forced expiratory volume in 1 s and FVC in PLWH but not with emphysema. CONCLUSIONS In PLWH, marijuana smoking was associated with higher lung volumes and potentially with radiographic emphysema. No consistently negative associations were observed between marijuana and measures of chronic lung health.
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Affiliation(s)
- D S Wenger
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA, USA
| | - M Triplette
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA, USA.,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - S Shahrir
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA, USA
| | - K M Akgun
- Department of Internal Medicine, Veterans Affairs (VA) Connecticut Healthcare System and Yale University School of Medicine, New Haven, CT, USA
| | - C Wongtrakool
- Atlanta VA Medical Center and Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - S T Brown
- Department of Medicine, James J. Peters VA Medical Center, Bronx, NY, USA.,Department of Medicine, Icahn School of Medicine at Mt. Sinai, New York, NY, USA
| | - J W Kim
- Department of Medicine, James J. Peters VA Medical Center, Bronx, NY, USA
| | - G W Soo Hoo
- VA Greater Los Angeles Healthcare System and Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - M C Rodriguez-Barradas
- Michael E. DeBakey VA Medical Center and Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - L Huang
- Center for AIDS Research, University of California at San Francisco, San Francisco, CA, USA
| | - L C Feemster
- VA Puget Sound Healthcare System, University of Washington, Seattle, WA, USA
| | - J Zifodya
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA, USA
| | - K Crothers
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA, USA.,VA Puget Sound Healthcare System, University of Washington, Seattle, WA, USA
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44
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Park JS, Kim TH, Oh YJ, Park EJ, Kim JW, Jeong H. Investigation of photodarkening in tandem-pumped Yb-doped fibers. Opt Express 2020; 28:27316-27323. [PMID: 32988028 DOI: 10.1364/oe.400094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 08/25/2020] [Indexed: 06/11/2023]
Abstract
Investigation of photodarkening (PD) in Yb-doped fibers tandem-pumped at 1018 nm is reported. For a homemade Yb-doped aluminosilicate double-clad fiber (YADF), the transmitted power of a 633 nm probe beam is reduced by 2.4% over 2 hours for the tandem pumping configuration at 1018 nm, which is significantly smaller than 33.3% for a laser diode (LD) pumping at 976 nm. A tandem-pumped Yb fiber amplifier also shows a much smaller decrease in the amplified output power over time than a LD-pumped Yb fiber amplifier. Based on fluorescence spectra of the YADF, we can not only associate PD of the YADF to intrinsic oxygen deficiency centers or Tm3+ impurities but also confirm the impact of the excited Yb3+ ion density on PD. The benefits of the tandem pumping in a high-power Yb fiber laser system will be discussed.
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45
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Zang Y, Song JH, Oh SH, Kim JW, Lee MN, Piao X, Yang JW, Kim OS, Kim TS, Kim SH, Koh JT. Targeting NLRP3 Inflammasome Reduces Age-Related Experimental Alveolar Bone Loss. J Dent Res 2020; 99:1287-1295. [PMID: 32531176 DOI: 10.1177/0022034520933533] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The cause of chronic inflammatory periodontitis, which leads to the destruction of periodontal ligament and alveolar bone, is multifactorial. An increasing number of studies have shown the clinical significance of NLRP3-mediated low-grade inflammation in degenerative disorders, but its causal linkage to age-related periodontitis has not yet been elucidated. In this study, we investigated the involvement of the NLRP3 inflammasome and the therapeutic potential of NLRP3 inhibition in age-related alveolar bone loss by using in vivo and in vitro models. The poor quality of alveolar bones in aged mice was correlated with caspase-1 activation by macrophages and elevated levels of IL-1β, which are mainly regulated by the NLRP3 inflammasome, in periodontal ligament and serum, respectively. Aged mice lacking Nlrp3 showed better bone mass than age-matched wild-type mice via a way that affects bone resorption rather than bone formation. In line with this finding, treatment with MCC950, a potent inhibitor of the NLRP3 inflammasome, significantly suppressed alveolar bone loss with reduced caspase-1 activation in aged mice but not in young mice. In addition, our in vitro studies showed that the addition of IL-1β encourages RANKL-induced osteoclastogenesis from bone marrow-derived macrophages and that treatment with MCC950 significantly suppresses osteoclastic differentiation directly, irrelevant to the inhibition of IL-1β production. Our results suggest that the NLRP3 inflammasome is a critical mediator in age-related alveolar bone loss and that targeting the NLRP3 inflammasome could be a novel option for controlling periodontal degenerative changes with age.
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Affiliation(s)
- Y Zang
- Department of Pharmacology and Dental Therapeutics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea.,Hard-tissue Biointerface Research Center, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - J H Song
- Department of Pharmacology and Dental Therapeutics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea.,Hard-tissue Biointerface Research Center, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - S H Oh
- Department of Pharmacology and Dental Therapeutics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea.,Hard-tissue Biointerface Research Center, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - J W Kim
- Department of Pharmacology and Dental Therapeutics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea.,Hard-tissue Biointerface Research Center, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - M N Lee
- Department of Pharmacology and Dental Therapeutics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea.,Hard-tissue Biointerface Research Center, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - X Piao
- Department of Pharmacology and Dental Therapeutics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea.,Hard-tissue Biointerface Research Center, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - J W Yang
- Department of Pharmacology and Dental Therapeutics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea.,Hard-tissue Biointerface Research Center, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - O S Kim
- Hard-tissue Biointerface Research Center, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea.,Department of Periodontology, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - T S Kim
- Department of Life Sciences, College of Life Sciences and Biotechnology, Korea University, Seoul, Republic of Korea
| | - S H Kim
- Hard-tissue Biointerface Research Center, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea.,Department of Oral Anatomy, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - J T Koh
- Department of Pharmacology and Dental Therapeutics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea.,Hard-tissue Biointerface Research Center, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
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Kim CH, Kim JW. Letter to the editor about the article "Different surgical outcomes in a patient with bilateral atypical femoral fracture related to bisphosphonate use with or without teriparatide treatment". Osteoporos Int 2020; 31:1177. [PMID: 32144475 DOI: 10.1007/s00198-020-05354-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 02/17/2020] [Indexed: 10/24/2022]
Affiliation(s)
- C-H Kim
- Department of Orthopedic Surgery, Gachon University Gil Medical Center, 21, Namdong-daero 774 beon-gil, Namdong-gu, Incheon, 21565, Republic of Korea
| | - J W Kim
- Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan, College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
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47
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Kim JW, He C, Urias M, Gehlbach P, Hager GD, Iordachita I, Kobilarov M. Autonomously Navigating a Surgical Tool Inside the Eye by Learning from Demonstration. IEEE Int Conf Robot Autom 2020; 2020. [PMID: 34621556 DOI: 10.1109/icra40945.2020.9196537] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A fundamental challenge in retinal surgery is safely navigating a surgical tool to a desired goal position on the retinal surface while avoiding damage to surrounding tissues, a procedure that typically requires tens-of-microns accuracy. In practice, the surgeon relies on depth-estimation skills to localize the tool-tip with respect to the retina in order to perform the tool-navigation task, which can be prone to human error. To alleviate such uncertainty, prior work has introduced ways to assist the surgeon by estimating the tool-tip distance to the retina and providing haptic or auditory feedback. However, automating the tool-navigation task itself remains unsolved and largely unexplored. Such a capability, if reliably automated, could serve as a building block to streamline complex procedures and reduce the chance for tissue damage. Towards this end, we propose to automate the tool-navigation task by learning to mimic expert demonstrations of the task. Specifically, a deep network is trained to imitate expert trajectories toward various locations on the retina based on recorded visual servoing to a given goal specified by the user. The proposed autonomous navigation system is evaluated in simulation and in physical experiments using a silicone eye phantom. We show that the network can reliably navigate a needle surgical tool to various desired locations within 137 μm accuracy in physical experiments and 94 μm in simulation on average, and generalizes well to unseen situations such as in the presence of auxiliary surgical tools, variable eye backgrounds, and brightness conditions.
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Affiliation(s)
- Ji Woong Kim
- Laboratory for Computing + Sensing (LCSR) dept. at the Johns Hopkins University, Baltimore, MD 21218 USA
| | - Changyan He
- Laboratory for Computing + Sensing (LCSR) dept. at the Johns Hopkins University, Baltimore, MD 21218 USA
| | - Muller Urias
- Wilmer Eye Institute at the Johns Hopkins Hospital, Baltimore, MD 21287 USA
| | - Peter Gehlbach
- Wilmer Eye Institute at the Johns Hopkins Hospital, Baltimore, MD 21287 USA
| | - Gregory D Hager
- Computer Science dept. at the Johns Hopkins University, Baltimore, MD 21218 USA
| | - Iulian Iordachita
- Laboratory for Computing + Sensing (LCSR) dept. at the Johns Hopkins University, Baltimore, MD 21218 USA
| | - Marin Kobilarov
- Laboratory for Computing + Sensing (LCSR) dept. at the Johns Hopkins University, Baltimore, MD 21218 USA
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48
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Urias MG, Patel N, He C, Ebrahimi A, Kim JW, Iordachita I, Gehlbach PL. Artificial intelligence, robotics and eye surgery: are we overfitted? Int J Retina Vitreous 2019; 5:52. [PMID: 31890281 PMCID: PMC6912992 DOI: 10.1186/s40942-019-0202-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 11/25/2019] [Indexed: 11/10/2022] Open
Abstract
Eye surgery, specifically retinal micro-surgery involves sensory and motor skill that approaches human boundaries and physiological limits for steadiness, accuracy, and the ability to detect the small forces involved. Despite assumptions as to the benefit of robots in surgery and also despite great development effort, numerous challenges to the full development and adoption of robotic assistance in surgical ophthalmology, remain. Historically, the first in-human-robot-assisted retinal surgery occurred nearly 30 years after the first experimental papers on the subject. Similarly, artificial intelligence emerged decades ago and it is only now being more fully realized in ophthalmology. The delay between conception and application has in part been due to the necessary technological advances required to implement new processing strategies. Chief among these has been the better matched processing power of specialty graphics processing units for machine learning. Transcending the classic concept of robots performing repetitive tasks, artificial intelligence and machine learning are related concepts that has proven their abilities to design concepts and solve problems. The implication of such abilities being that future machines may further intrude on the domain of heretofore "human-reserved" tasks. Although the potential of artificial intelligence/machine learning is profound, present marketing promises and hype exceeds its stage of development, analogous to the seventieth century mathematical "boom" with algebra. Nevertheless robotic systems augmented by machine learning may eventually improve robot-assisted retinal surgery and could potentially transform the discipline. This commentary analyzes advances in retinal robotic surgery, its current drawbacks and limitations, and the potential role of artificial intelligence in robotic retinal surgery.
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Affiliation(s)
- Müller G. Urias
- Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD 21287 USA
- Federal University of Sao Paulo, São Paulo, 04023-062 Brazil
| | - Niravkumar Patel
- Laboratory for Computational Sensing and Robotics, Johns Hopkins University, Baltimore, MD 21218 USA
| | - Changyan He
- Laboratory for Computational Sensing and Robotics, Johns Hopkins University, Baltimore, MD 21218 USA
- School of Mechanical Engineering and Automation at, Beihang University, Beijing, 100191 China
| | - Ali Ebrahimi
- Laboratory for Computational Sensing and Robotics, Johns Hopkins University, Baltimore, MD 21218 USA
| | - Ji Woong Kim
- Laboratory for Computational Sensing and Robotics, Johns Hopkins University, Baltimore, MD 21218 USA
| | - Iulian Iordachita
- Laboratory for Computational Sensing and Robotics, Johns Hopkins University, Baltimore, MD 21218 USA
| | - Peter L. Gehlbach
- Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD 21287 USA
- Whiting School of Engineering, Johns Hopkins University, Baltimore, MD 21218 USA
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49
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Park S, Jeong B, Shin JH, Kim JH, Kim JW, Gwon DI, Ko GY, Chen CS. Interventional treatment of arterial injury during blind central venous catheterisation in the upper thorax: experience from two centres. Clin Radiol 2019; 75:158.e1-158.e7. [PMID: 31711638 DOI: 10.1016/j.crad.2019.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 10/03/2019] [Indexed: 12/01/2022]
Abstract
AIM To evaluate the safety and clinical efficacy of interventional treatment for arterial injury during blind, central venous catheterisation in the upper thorax at two tertiary medical centres. MATERIALS AND METHODS Eighteen consecutive patients (37-81 years; M:F=8:10) who underwent interventional treatment for the arterial injuries that occurred during central venous catheterisation without any imaging guidance between November 2007 and December 2018 were included. Clinical data, angiographic findings, detailed interventional procedures, and technical and clinical outcomes were analysed retrospectively. RESULTS Arterial injury sites were the subclavian artery/branches (n=12), axillary artery/branches (n=2), and common carotid artery (n=4). The target vein was not correlated with the corresponding artery/branches in eight patients (44.4%); internal jugular vein to subclavian artery branches. Angiographic findings were pseudoaneurysm (66.7%, 12/18), contrast medium extravasation (22.2%, 4/18), or both (11.1%, n=2). A stent graft was inserted for the main trunk injuries in nine patients, with (n=2) or without (n=7) prior arterial branch embolisation to prevent potential endoleak, while embolisation for the arterial branch injuries was performed in nine patients. Direct percutaneous access with thrombin injection to the pseudoaneurysm or residual arteriovenous fistula was utilised in two. The technical and clinical success rate was 94.4% (17/18) each. There were no procedure-related complications. In one patient without immediate clinical success, there was a persistent pseudoaneurysm after stent graft placement, which was treated with in-stent balloon dilation. CONCLUSION Interventional treatment serves as a safe and effective treatment modality for inadvertent arterial injury related to blind, central venous access catheterisation in the upper thorax.
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Affiliation(s)
- S Park
- Department of Radiology, Gachon University Gil Medical Centre, 21, Namdong-daero 774beon-gil, Namdong-gu, Incheon, South Korea
| | - B Jeong
- Department of Radiology and Research Institute of Radiology, Asan Medical Centre, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea
| | - J H Shin
- Department of Radiology and Research Institute of Radiology, Asan Medical Centre, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea.
| | - J H Kim
- Department of Radiology, Gachon University Gil Medical Centre, 21, Namdong-daero 774beon-gil, Namdong-gu, Incheon, South Korea
| | - J W Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Centre, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea
| | - D I Gwon
- Department of Radiology and Research Institute of Radiology, Asan Medical Centre, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea
| | - G-Y Ko
- Department of Radiology and Research Institute of Radiology, Asan Medical Centre, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea
| | - C S Chen
- Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University, 1 Jianshe E Rd, Erqi Qu, Zhengzhou Shi, Henan Sheng, PR China
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Jeoung MH, Kim TK, Kim JW, Cho YB, Na HJ, Yoo BC, Shim H, Song DK, Heo K, Lee S. Antibody-Based Targeting of Cell Surface GRP94 Specifically Inhibits Cetuximab-Resistant Colorectal Cancer Growth. Biomolecules 2019; 9:biom9110681. [PMID: 31683810 PMCID: PMC6920916 DOI: 10.3390/biom9110681] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 10/21/2019] [Accepted: 10/27/2019] [Indexed: 12/19/2022] Open
Abstract
Colorectal cancer (CRC) is one of the leading causes of cancer death worldwide. Cetuximab, a human/mouse chimeric monoclonal antibody, is effective in a limited number of CRC patients because of cetuximab resistance. This study aimed to identify novel therapeutic targets in cetuximab-resistant CRC in order to improve clinical outcomes. Through phage display technology, we isolated a fully human antibody strongly binding to the cetuximab-resistant HCT116 cell surface and identified the target antigen as glucose-regulated protein 94 (GRP94) using proteomic analysis. Short interfering RNA-mediated GRP94 knockdown showed that GRP94 plays a key role in HCT116 cell growth. In vitro functional studies revealed that the GRP94-blocking antibody we developed strongly inhibits the growth of various cetuximab-resistant CRC cell lines. We also demonstrated that GRP94 immunoglobulin G monotherapy significantly reduces HCT116 cell growth more potently compared to cetuximab, without severe toxicity in vivo. Therefore, cell surface GRP94 might be a potential novel therapeutic target in cetuximab-resistant CRC, and antibody-based targeting of GRP94 might be an effective strategy to suppress GRP94-expressing cetuximab-resistant CRC.
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Affiliation(s)
- Mee Hyun Jeoung
- Scripps Korea Antibody Institute, Chuncheon, Gangwon 24341, Korea.
| | - Taek-Keun Kim
- Scripps Korea Antibody Institute, Chuncheon, Gangwon 24341, Korea.
| | - Ji Woong Kim
- Biopharmaceutical Chemistry Major, School of Applied Chemistry, Kookmin University, Seoul 02707, Korea.
| | - Yea Bin Cho
- Biopharmaceutical Chemistry Major, School of Applied Chemistry, Kookmin University, Seoul 02707, Korea.
| | - Hee Jun Na
- Scripps Korea Antibody Institute, Chuncheon, Gangwon 24341, Korea.
| | - Byong Chul Yoo
- Research Institute, National Cancer Center, Goyang, Gyeonggi 10408, Korea.
| | - Hyunbo Shim
- Department of Bioinspired Science and Life Science, Ewha Womans University, Seoul 03760, Korea.
| | - Dong-Keun Song
- Department of Pharmacology, College of Medicine, Hallym University, Chuncheon, Gangwon 24252, Korea.
| | - Kyun Heo
- Biopharmaceutical Chemistry Major, School of Applied Chemistry, Kookmin University, Seoul 02707, Korea.
| | - Sukmook Lee
- Biopharmaceutical Chemistry Major, School of Applied Chemistry, Kookmin University, Seoul 02707, Korea.
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