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Huh JY, Song YJ, Park G. Rapid and Reliable HLA-B*59:01 Genotyping to Prevent Carbonic Anhydrase Inhibitor-Induced Severe Cutaneous Adverse Reactions. Ann Clin Lab Sci 2024; 54:101-105. [PMID: 38514059] [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] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
OBJECTIVE Carbonic anhydrase inhibitors (CAIs) are intraocular pressure-reducing medications used in ophthalmology. Human leukocyte antigen-B*59:01 (HLA-B*59:01) is strongly associated with CAI-induced severe cutaneous adverse reactions (SCARs). This study aimed to develop and validate a rapid and economical screening method for HLA-B*59:01 to prevent carbonic anhydrase inhibitor-induced SCARs. METHODS Duplex allele-specific polymerase chain reaction (PCR) with an internal control was performed for HLA-B*59:01 genotyping. The accuracy of duplex allele-specific PCR for HLA-B*59:01 genotyping was evaluated in 200 blood samples, using sequence-based typing (SBT) as the reference method. RESULTS In total, 50 HLA-B*59:01-positive and 150 HLA-B*59:01-negative results obtained using duplex allele-specific PCR were in complete agreement with the SBT results. CONCLUSION Duplex allele-specific PCR is a rapid, reliable, and economical assay for screening the HLA-B*59:01 allele.
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Affiliation(s)
- Ji Young Huh
- Department of Laboratory Medicine, CHA Bundang Medical Center, Gyeonggi-do, Korea
| | | | - Geon Park
- Department of Laboratory Medicine, Chosun University College of Medicine, Gwangju, Korea
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2
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Tanaka A, Huh JY, Yamamoto T, Washio K, Ariyoshi K. Bowel obstruction secondary to internal hernia in a hereditary angioedema patient: a case report. Int J Emerg Med 2022; 15:69. [PMID: 36585645 PMCID: PMC9805238 DOI: 10.1186/s12245-022-00475-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/22/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Gastrointestinal attacks are frequent symptoms in patients diagnosed with hereditary angioedema (HAE). Cases of self-limited bowel intussusception and unneeded exploratory laparotomy due to lack of knowledge about HAE have been reported. Furthermore, after the introduction of C1-esterase inhibitor (C1-INH) concentrate, the recommended medication for HAE attacks, treatment has become typically medical in nature. We share a rare case where operative exploration was indicated to resolve a mechanical small bowel obstruction secondary to an HAE attack. CASE REPORT An 80-year-old woman with HAE presented with lower left abdominal pain, vomiting, and nausea. Computed tomography (CT) showed edema of the small bowel and stomach as well as possible signs of mechanical small bowel obstruction. The patient was treated with C1-INH concentrate but showed only mild signs of relief, warranting diagnostic laparoscopy. Intraoperative findings showed internal herniation and strangulation of the small bowel caused by adhesions forming a band. After surgical intervention, no bowel resection was needed. CONCLUSION Although C1-INH concentrate remains the principal treatment for HAE, gastrointestinal attacks may potentially cause surgical emergencies.
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Affiliation(s)
- Atsuhito Tanaka
- grid.410843.a0000 0004 0466 8016Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, Hyogo Prefecture 650-0047 Japan
| | - Ji Young Huh
- grid.410843.a0000 0004 0466 8016Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, Hyogo Prefecture 650-0047 Japan
| | - Takamasa Yamamoto
- grid.416289.00000 0004 1772 3264Kobe City Nishi-Kobe Medical Center, 5-7-1 Kojidai, Nishi-ku, Kobe, Hyogo Prefecture 651-2273 Japan
| | - Ken Washio
- grid.416289.00000 0004 1772 3264Kobe City Nishi-Kobe Medical Center, 5-7-1 Kojidai, Nishi-ku, Kobe, Hyogo Prefecture 651-2273 Japan
| | - Koichi Ariyoshi
- grid.410843.a0000 0004 0466 8016Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, Hyogo Prefecture 650-0047 Japan
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Huh JY, Matsuoka Y, Kinoshita H, Ikenoue T, Yamamoto Y, Ariyoshi K. Premorbid Clinical Frailty Score and 30‐day mortality among older adults in the emergency department. J Am Coll Emerg Physicians Open 2022; 3:e12677. [PMID: 35224550 PMCID: PMC8847731 DOI: 10.1002/emp2.12677] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 01/03/2022] [Accepted: 01/25/2022] [Indexed: 11/27/2022] Open
Abstract
Objectives The association between frailty and short‐term prognosis has not been established in critically ill older adults presenting to the emergency department. We sought to examine the association between premorbid frailty and 30‐day mortality in this patient population. Methods This is a retrospective observational study on older adults aged over 75 who were triaged as Level 1 resuscitation with subsequent admissions to intermediate units or intensive care units (ICUs) in a single critical care center, from January to December 2019. We excluded patients with out‐of‐hospital cardiac arrest or those transferred from other hospitals. Frailty was evaluated by the Clinical Frailty Scale (CFS) from the patients’ chart reviews. The primary outcome was 30‐day mortality, and we examined the association between frailty scored on the CFS and 30‐day mortality using a multivariable logistic regression model with CFS 1–4 as a reference. Results A total of 544 patients, median age: 82 years (interquartile rang 78 to 87), were included in the study. Of these, 29% were in shock and 33% were in respiratory failure. The overall 30‐day mortality was 15.1%. The adjusted risk difference (95% confidence interval [CI]) in mortality for CFS 5, CFS 6, and CFS 7–9 was 6.3% (‐3.4 to 15.9), 11.2% (0.4 to 22.0), and 17.7% (5.3 to 30.1), respectively; and the adjusted risk ratio (95% CI) was 1.45 (0.87 to 2.41), 1.85 (1.13 to 3.03), and 2.44 (1.50 to 3.96), respectively. Conclusion The risk of 30‐day mortality increased as frailty advanced in critically ill older adults. Given this high risk of short‐term outcomes, ED clinicians should consider goals of care conversations carefully to avoid unwanted medical care for these patients.
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Affiliation(s)
- Ji Young Huh
- Department of Emergency Medicine Kobe City Medical Center General Hospital Kyoto University Kyoto Japan
| | - Yoshinori Matsuoka
- Department of Emergency Medicine Kobe City Medical Center General Hospital Kyoto University Kyoto Japan
- Department of Healthcare Epidemiology Graduate School of Medicine and Public Health Kyoto University Kyoto Japan
| | - Hiroki Kinoshita
- Department of Emergency Medicine Kobe City Medical Center General Hospital Kyoto University Kyoto Japan
| | - Tatsuyoshi Ikenoue
- Department of Human Health Science Graduate School of Medicine Kyoto University Kyoto Japan
| | - Yosuke Yamamoto
- Department of Healthcare Epidemiology Graduate School of Medicine and Public Health Kyoto University Kyoto Japan
| | - Koichi Ariyoshi
- Department of Emergency Medicine Kobe City Medical Center General Hospital Kyoto University Kyoto Japan
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Yamanaka S, Morikawa K, Morita H, Huh JY, Yamamura O. Calibration-Free Cuffless Blood Pressure Estimation Based on a Population With a Diverse Range of Age and Blood Pressure. Front Med Technol 2022; 3:695356. [PMID: 35047937 PMCID: PMC8757748 DOI: 10.3389/fmedt.2021.695356] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/30/2021] [Indexed: 11/23/2022] Open
Abstract
This study presents a new blood pressure (BP) estimation algorithm utilizing machine learning (ML). A cuffless device that can measure BP without calibration would be precious for portability, continuous measurement, and comfortability, but unfortunately, it does not currently exist. Conventional BP measurement with a cuff is standard, but this method has various problems like inaccurate BP measurement, poor portability, and painful cuff pressure. To overcome these disadvantages, many researchers have developed cuffless BP estimation devices. However, these devices are not clinically applicable because they require advanced preparation before use, such as calibration, do not follow international standards (81060-1:2007), or have been designed using insufficient data sets. The present study was conducted to combat these issues. We recruited 127 participants and obtained 878 raw datasets. According to international standards, our diverse data set included participants from different age groups with a wide variety of blood pressures. We utilized ML to formulate a BP estimation method that did not require calibration. The present study also conformed to the method required by international standards while calculating the level of error in BP estimation. Two essential methods were applied in this study: (a) grouping the participants into five subsets based on the relationship between the pulse transit time and systolic BP by a support vector machine ensemble with bagging (b) applying the information from the wavelet transformation of the pulse wave and the electrocardiogram to the linear regression BP estimation model for each group. For systolic BP, the standard deviation of error for the proposed BP estimation results with cross-validation was 7.74 mmHg, which was an improvement from 17.05 mmHg, as estimated by the conventional pulse-transit-time-based methods. For diastolic BP, the standard deviation of error was 6.42 mmHg for the proposed BP estimation, which was an improvement from 14.05mmHg. The purpose of the present study was to demonstrate and evaluate the performance of the newly developed BP estimation ML method that meets the international standard for non-invasive sphygmomanometers in a population with a diverse range of age and BP.
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Affiliation(s)
- Syunsuke Yamanaka
- Department of Emergency Medicine, General Internal Medicine, University of Fukui Hospital, Fukui, Japan
| | | | - Hiroshi Morita
- Department of Emergency Medicine, General Internal Medicine, University of Fukui Hospital, Fukui, Japan
| | - Ji Young Huh
- Emergency and Critical Care Center, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Osamu Yamamura
- Second Department of Internal Medicine, University of Fukui Hospital, Fukui, Japan
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Park HJ, Jeon J, Choi J, Kim JY, Kim HS, Huh JY, Goldman SA, Song J. Human iPSC-derived neural precursor cells differentiate into multiple cell types to delay disease progression following transplantation into YAC128 Huntington's disease mouse model. Cell Prolif 2021; 54:e13082. [PMID: 34152047 PMCID: PMC8349664 DOI: 10.1111/cpr.13082] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/06/2021] [Accepted: 05/22/2021] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES To investigate whether human HLA-homozygous induced pluripotent stem cell (iPSC)-derived neural precursor cells (iPSC-NPCs) can provide functional benefits in Huntington's disease (HD), we transplanted them into the YAC128 transgenic HD mouse model. MATERIALS AND METHODS CHAi001-A, an HLA-homozygous iPSC line (A*33:03-B*44:03-DRB1*13:02), was differentiated into neural precursor cells, and then, they were transplanted into 6 months-old YAC128 mice. Various behavioural and histological analyses were performed for five months after transplantation. RESULTS Motor and cognitive functions were significantly improved in transplanted animals. Cells transplanted in the striatum showed multipotential differentiation. Five months after transplantation, the donor cells had differentiated into neurons, oligodendrocytes and astrocytes. Transplantation restored DARPP-32 expression, synaptophysin density, myelin basic protein expression in the corpus callosum and astrocyte function. CONCLUSION Altogether, these results strongly suggest that iPSC-NPCs transplantation induces neuroprotection and functional recovery in a mouse model of HD and should be taken forward for clinical trials in HD patients.
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Affiliation(s)
- Hyun Jung Park
- Department of Biomedical Science, CHA Stem Cell Institute, CHA University, Seongnam-si, Korea
| | - Juhyun Jeon
- Department of Biomedical Science, CHA Stem Cell Institute, CHA University, Seongnam-si, Korea
| | - Jiwoo Choi
- Department of Biomedical Science, CHA Stem Cell Institute, CHA University, Seongnam-si, Korea
| | - Ji Yeon Kim
- Department of Biomedical Science, CHA Stem Cell Institute, CHA University, Seongnam-si, Korea
| | - Hyun Sook Kim
- Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam-si, Korea
| | - Ji Young Huh
- Department of Laboratory Medicine, CHA Bundang Medical Center, CHA University, Seongnam-si, Korea
| | - Steven A Goldman
- Center for Translational Neuromedicine, University of Rochester Medical Center, Rochester, NY, USA.,Center for Translational Neuromedicine, University of Copenhagen Faculty of Health and Medical Science, Copenhagen N, Denmark
| | - Jihwan Song
- Department of Biomedical Science, CHA Stem Cell Institute, CHA University, Seongnam-si, Korea.,iPS Bio, Inc., 3F, 16 Daewangpangyo-ro 712 Beon-gil, Seongnam-si, Korea
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Ito Y, Goto T, Huh JY, Yamamura O, Hamano T, Kikuta KI, Hayashi H. Development of a Scoring System to Predict Prolonged Post-Stroke Dysphagia Remaining at Discharge from a Subacute Care Hospital to the Home. J Stroke Cerebrovasc Dis 2021; 30:105804. [PMID: 33906072 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105804] [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: 11/16/2020] [Revised: 02/24/2021] [Accepted: 03/29/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Prolonged dysphagia is an important stroke-related complication that imposes a substantial burden on patients and families. However, simple scoring tool to predict prolonged dysphagia is not existing. MATERIALS AND METHODS This retrospective cohort study used data from April 2010 to March 2016. Adult patients with first-ever stroke were included. The outcome was swallowing function at discharge from the subacute care hospital to the patient's home. We collected the following factors obtained at discharge from the University of Fukui Hospital: age, sex, type of stroke, comorbidities, smoking status, alcohol use, denture use, functional dependency in daily living before admission, National Institutes of Health Stroke Scale score (NIHSS) at admission, and Functional Independence Measure(FIM). Data were divided into a training set (70%) and test set (30%). Lasso and logistic regression were used for feature selection, a scoring system was then developed, and its prediction performance evaluated. RESULTS This study enrolled 462 patients with acute stroke. Using lasso and logistic regression, three variables (functional dependency before admission, Functional Independence Measure [FIM]-cognitive and FIM-motor scores at transfer) remained statistically significant predictors of prolonged dysphagia. Risk scores were categorized as low risk (0-2), moderate risk (3-4), and high risk (5-7), with dysphagia rates of 0%-1%, 13%-29%, and 50%-100%, respectively. A newly developed score ≥3 was the optimal cutoff for identifying patients with the potential risk of prolonged dysphagia (C-statistics, 0.92 in the test set). CONCLUSION The developed scoring system is simple and has a high performance in predicting prolonged dysphagia after acute stroke.
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Affiliation(s)
- Yukiko Ito
- Department of Family and Emergency Medicine, University of Fukui Hospital, Fukui, Japan.
| | - Tadahiro Goto
- TXP Medical Co. Ltd., Tokyo, Japan; Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Ji Young Huh
- Department of Emergency Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Osamu Yamamura
- Department of Community Medicine, Faculty of Medical Science,University of Fukui, Fukui, Japan
| | - Tadanori Hamano
- Department of Neurology, University of Fukui Hospital, Fukui, Japan
| | - Ken-Ichiro Kikuta
- Department of Neurosurgery, University of Fukui Hospital, Fukui, Japan
| | - Hiroyuki Hayashi
- Department of Family and Emergency Medicine, University of Fukui Hospital, Fukui, Japan
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Maezawa T, Yanai M, Huh JY, Ariyoshi K. Effectiveness and safety of small-bore tube thoracostomy (≤20 Fr) for chest trauma patients: A retrospective observational study. Am J Emerg Med 2020; 38:2658-2660. [PMID: 33039219 DOI: 10.1016/j.ajem.2020.09.028] [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: 07/15/2020] [Revised: 08/31/2020] [Accepted: 09/11/2020] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Tube thoracostomy is an important treatment for traumatic hemothorax and pneumothorax. The optimal tube diameter remains unclear. To reduce invasiveness, we use small-bore chest tubes (≤20 Fr) for all trauma patients for whom tube thoracostomy is indicated in our emergency department (ED). The aim of this study was to investigate the effectiveness and safety of small-bore tube thoracostomy for traumatic hemothorax or pneumothorax. METHOD We conducted a retrospective observational study at a single emergency medical center. This study included adult patients (≥18 years old) who had undergone tube thoracostomy for chest trauma in the ED during the 5 years from October 2013 to September 2018. We used 20 Fr chest tubes or 8 Fr pigtail catheters. The examined outcome was tube-related complications, such as tube obstruction, retained hemothorax, and unresolved pneumothorax. RESULTS A total of 107 tube thoracostomies were performed in 102 patients. The mean Injury Severity Score of these patients was 17.8 (±9.6), and the mean duration of the tube placement period was 3.9 days (±1.8). Eight patients developed tube-related complications (7.8%) (retained hemothorax: 4 patients (3.9%), unresolved pneumothorax: 4 patients (3.9%)). None of these cases were caused by tube obstruction. Although the drainage itself was effective, they underwent definitive invasive interventions to stop bleeding or air leak. CONCLUSION Our study showed that the use of small-bore (≤20 Fr) chest tubes to treat traumatic hemothorax/pneumothorax achieved the purposes of tube thoracostomy. It might be possible to safely manage chest trauma with small-bore chest tubes.
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Affiliation(s)
- Toshinori Maezawa
- Department of Emergency Medicine, Kobe City Medical Center General Hospital, Japan.
| | - Machi Yanai
- Department of Emergency Medicine, Kobe City Medical Center General Hospital, Japan
| | - Ji Young Huh
- Department of Emergency Medicine, Kobe City Medical Center General Hospital, Japan
| | - Koichi Ariyoshi
- Department of Emergency Medicine, Kobe City Medical Center General Hospital, Japan
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Noh JE, Oh SH, Lee S, Lee S, Kim YH, Park HJ, Ju JH, Kim HS, Huh JY, Song J. Intracerebral transplantation of HLA-homozygous human iPSC-derived neural precursors ameliorates the behavioural and pathological deficits in a rodent model of ischaemic stroke. Cell Prolif 2020; 53:e12884. [PMID: 32713053 PMCID: PMC7507302 DOI: 10.1111/cpr.12884] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/30/2020] [Accepted: 07/02/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES Human-induced pluripotent stem cells (hiPSCs) are a promising cell source for treating ischaemic stroke. Although autologous hiPSCs provide the advantage of avoiding immune rejection, their practical limitations, such as substantial amount of time and costs to generate individual iPSC lines, have hampered their widespread application in clinical settings. In this study, we investigated the therapeutic potential of neural precursor cells derived from human HLA-homozygous induced pluripotent stem cells (hiPSC-NPCs) following intracerebral transplantation into a rodent model of middle cerebral artery occlusion (MCAo). MATERIALS AND METHODS We differentiated a GMP-grade HLA-homozygous hiPSC line (CMC-hiPSC-004) into neural precursor cells for transplantation into rats at the subacute stage of ischaemic stroke (ie at 7 days after the induction of MCAo). To investigate functional recovery, the transplanted animals were subjected to five behavioural tests, namely the rotarod, stepping, mNSS, staircase and apomorphine-induced rotation tests, for up to 12 weeks, followed by histological analyses. RESULTS We observed that the hiPSC-NPC transplantation produced significant behavioural improvements. At 12 weeks post-transplantation, a high proportion of transplanted cells survived and had differentiated into MAP2+ mature neurons, GABAergic neurons and DARPP32+ medium spiny neurons. The transplanted cells formed neuronal connections with striatal neurons in the host brain. In addition, hiPSC-NPC transplantation gave rise to enhanced endogenous repair processes, including decreases of post-stroke neuroinflammation and glial scar formation and an increase of proliferating endogenous neural stem cells in the subventricular zone as well as the perilesional capillary networks. CONCLUSIONS These results strongly suggest that HLA-homozygous hiPSC-NPCs may be useful for treating ischaemic stroke patients.
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Affiliation(s)
- Jeong-Eun Noh
- Department of Biomedical Science, CHA Stem Cell Institute, CHA University, Seongnam-si, Korea
| | - Seung-Hun Oh
- Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam-si, Korea
| | - Suji Lee
- Department of Biomedical Science, CHA Stem Cell Institute, CHA University, Seongnam-si, Korea
| | - Soohyeon Lee
- Department of Biomedical Science, CHA Stem Cell Institute, CHA University, Seongnam-si, Korea
| | - Young Hoon Kim
- Department of Biomedical Science, CHA Stem Cell Institute, CHA University, Seongnam-si, Korea
| | - Hyun Jung Park
- Department of Biomedical Science, CHA Stem Cell Institute, CHA University, Seongnam-si, Korea
| | - Ji Hyeon Ju
- Department of Internal Medicine, Seoul St. Mary's Hospital, Institute of Medical Science, The Catholic University of Korea, Seoul, Korea
| | - Hyun Sook Kim
- Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam-si, Korea
| | - Ji Young Huh
- Department of Laboratory Medicine, CHA Bundang Medical Center, CHA University, Seongnam-si, Korea
| | - Jihwan Song
- Department of Biomedical Science, CHA Stem Cell Institute, CHA University, Seongnam-si, Korea.,iPS Bio, Inc., Seongnam-si, Korea
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Oh J, Oh D, Lee SJ, Kim JO, Kim NK, Chong SY, Huh JY, Baker RI. Prognostic utility of ADAMTS13 activity for the atypical hemolytic uremic syndrome (aHUS) and comparison of complement serology between aHUS and thrombotic thrombocytopenic purpura. Blood Res 2019; 54:218-228. [PMID: 31730685 PMCID: PMC6779945 DOI: 10.5045/br.2019.54.3.218] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 06/10/2019] [Revised: 08/09/2019] [Accepted: 08/12/2019] [Indexed: 12/13/2022] Open
Abstract
Background Atypical hemolytic uremic syndrome (aHUS) involves dysregulation of the complement system, but whether this also occurs in thrombotic thrombocytopenic purpura (TTP) remains unclear. Although these conditions are difficult to differentiate clinically, TTP can be distinguished by low (<10%) ADAMTS13 activity. The aim was to identify the differences in complement activation products between TTP and aHUS and investigate ADAMTS13 activity as a prognostic factor in aHUS. Methods We analyzed patients with thrombotic microangiopathy diagnosed as TTP (N=48) or aHUS (N=50), selected from a Korean registry (N=551). Complement activation products in the plasma samples collected from the patients prior to treatment and in 40 healthy controls were measured by ELISA. Results The levels of generalized (C3a), alternate (factor Bb), and terminal (C5a and C5b-9) markers were significantly higher (all P<0.01) in the patients than in the healthy controls. Only the factor Bb levels significantly differed (P=0.008) between the two disease groups. In aHUS patients, high normal ADAMTS13 activity (≥77%) was associated with improved treatment response (OR, 6.769; 95% CI, 1.605-28.542; P=0.005), remission (OR, 6.000; 95% CI, 1.693-21.262; P=0.004), exacerbation (OR, 0.242; 95% CI, 0.064-0.916; P=0.031), and disease-associated mortality rates (OR, 0.155; 95% CI, 0.029-0.813; P=0.017). Conclusion These data suggest that complement biomarkers, except factor Bb, are similarly activated in TTP and aHUS patients, and ADAMTS13 activity can predict the treatment response and outcome in aHUS patients.
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Affiliation(s)
- Jisu Oh
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Doyeun Oh
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Seon Ju Lee
- Institute for Clinical Research, School of Medicine CHA University, Seongnam, Korea
| | - Jeong Oh Kim
- Institute for Clinical Research, School of Medicine CHA University, Seongnam, Korea
| | - Nam Keun Kim
- Institute for Clinical Research, School of Medicine CHA University, Seongnam, Korea
| | - So Young Chong
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Ji Young Huh
- Department Laboratory Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Ross I Baker
- Western Australian Centre for Thrombosis and Haemostasis, Murdoch University, Perth, Australia
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10
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Lee S, Huh JY, Turner DM, Lee S, Robinson J, Stein JE, Shim SH, Hong CP, Kang MS, Nakagawa M, Kaneko S, Nakanishi M, Rao MS, Kurtz A, Stacey GN, Marsh SGE, Turner ML, Song J. Repurposing the Cord Blood Bank for Haplobanking of HLA-Homozygous iPSCs and Their Usefulness to Multiple Populations. Stem Cells 2018; 36:1552-1566. [PMID: 30004605 DOI: 10.1002/stem.2865] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 06/17/2018] [Accepted: 05/02/2018] [Indexed: 01/26/2023]
Abstract
Although autologous induced pluripotent stem cells (iPSCs) can potentially be useful for treating patients without immune rejection, in reality it will be extremely expensive and labor-intensive to make iPSCs to realize personalized medicine. An alternative approach is to make use of human leukocyte antigen (HLA) haplotype homozygous donors to provide HLA matched iPSC products to significant numbers of patients. To establish a haplobank of iPSCs, we repurposed the cord blood bank by screening ∼4,200 high resolution HLA typed cord blood samples, and selected those homozygous for the 10 most frequent HLA-A,-B,-DRB1 haplotypes in the Korean population. Following the generation of 10 iPSC lines, we conducted a comprehensive characterization, including morphology, expression of pluripotent markers and cell surface antigens, three-germ layer formation, vector clearance, mycoplasma/microbiological/viral contamination, endotoxin, and short tandem repeat (STR) assays. Various genomic analyses using microarray and comparative genomic hybridization (aCGH)-based single nucleotide polymorphism (SNP) and copy number variation (CNV) were also conducted. These 10 HLA-homozygous iPSC lines match 41.07% of the Korean population. Comparative analysis of HLA population data shows that they are also of use in other Asian populations, such as Japan, with some limited utility in ethnically diverse populations, such as the UK. Taken together, the generation of the 10 most frequent Korean HLA-homozygous iPSC lines serves as a useful pointer for the development of optimal methods for iPSC generation and quality control and indicates the benefits and limitations of collaborative HLA driven selection of donors for future stocking of worldwide iPSC haplobanks. Stem Cells 2018;36:1552-1566.
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Affiliation(s)
- Suji Lee
- Department of Biomedical Science, CHA Stem Cell Institute, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Ji Young Huh
- Department of Laboratory Medicine, CHA Bundang Medical Center, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - David M Turner
- Histocompatibility and Immunogenetics Laboratory, Royal Infirmary of Edinburgh, Edinburgh, UK
- Advanced Therapeutics, Scottish National Blood Transfusion Service, Edinburgh, UK
| | - Soohyeon Lee
- Department of Biomedical Science, CHA Stem Cell Institute, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - James Robinson
- HLA Informatics Group, Anthony Nolan Research Institute, Royal Free Campus, London, UK
- UCL Cancer Institute, University College London, London, UK
| | - Jeremy E Stein
- HLA Informatics Group, Anthony Nolan Research Institute, Royal Free Campus, London, UK
| | - Sung Han Shim
- Department of Biomedical Science, CHA Stem Cell Institute, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Chang Pyo Hong
- Bioinformatics Team, Theragen Etex Bio Institute, Suwon-si, Gyeonggi-do, Republic of Korea
| | - Myung Seo Kang
- Department of Laboratory Medicine, CHA Bundang Medical Center, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Masato Nakagawa
- Center for iPS Cell Research and Application, Kyoto University, Kyoto, Japan
| | - Shin Kaneko
- Center for iPS Cell Research and Application, Kyoto University, Kyoto, Japan
| | - Mahito Nakanishi
- Biotechnology Research Institute for Drug Discovery, National Institute of Advanced Industrial Science and Technology, Ibaraki, Japan
| | - Mahendra S Rao
- New York Stem Cell Foundation Research Institute, New York, New York, USA
| | - Andreas Kurtz
- Berlin-Brandenburg Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Glyn N Stacey
- International Stem Cell Banking Initiative, Hertfordshire, UK
| | - Steven G E Marsh
- HLA Informatics Group, Anthony Nolan Research Institute, Royal Free Campus, London, UK
- UCL Cancer Institute, University College London, London, UK
| | - Marc L Turner
- Advanced Therapeutics, Scottish National Blood Transfusion Service, Edinburgh, UK
- Global Alliance for iPSC Therapies, The Jack Copland Centre, Edinburgh, UK
| | - Jihwan Song
- Department of Biomedical Science, CHA Stem Cell Institute, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea
- Global Alliance for iPSC Therapies, The Jack Copland Centre, Edinburgh, UK
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11
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Moon Y, Kim MH, Kim HR, Ahn JY, Huh J, Huh JY, Han JH, Park JS, Cho SR. The 2016 WHO versus 2008 WHO Criteria for the Diagnosis of Chronic Myelomonocytic Leukemia. Ann Lab Med 2018; 38:481-483. [PMID: 29797820 PMCID: PMC5973924 DOI: 10.3343/alm.2018.38.5.481] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 10/29/2017] [Revised: 12/12/2017] [Accepted: 04/27/2018] [Indexed: 11/19/2022] Open
Abstract
The 2016 WHO diagnostic criteria for chronic myelomonocytic leukemia (CMML) require both absolute and relative monocytosis (≥1×109/L and ≥10% of white blood cell counts) in peripheral blood. Moreover, myeloproliferative neoplasm (MPN) features in bone marrow and/or MPN-associated mutations tend to support MPN with monocytosis rather than CMML. We assessed the impact of the 2016 WHO criteria on CMML diagnosis, compared with the 2008 WHO criteria, through a retrospective review of the medical records of 38 CMML patients diagnosed according to the 2008 WHO classification. Application of the 2016 WHO criteria resulted in the exclusion of three (8%) patients who did not fulfill the relative monocytosis criterion and eight (21%) patients with an MPN-associated mutation. These 11 patients formed the 2016 WHO others group; the remaining 27 formed the 2016 WHO CMML group. The significant difference in the platelet count and monocyte percentage between the two groups indicated that the 2016 WHO criteria lead to a more homogenous and improved definition of CMML compared with the 2008 WHO criteria, which may have led to over-diagnosis of CMML. More widespread use of molecular tests and more sophisticated clinical and morphological evaluations are necessary to diagnose CMML accurately.
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Affiliation(s)
- Yeonsook Moon
- Department of Laboratory Medicine, Inha University School of Medicine, Incheon, Korea
| | - Mi Hyang Kim
- Department of Laboratory Medicine, Kosin University College of Medicine, Busan, Korea
| | - Hye Ryoun Kim
- Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jeong Yeal Ahn
- Department of Laboratory Medicine, Gachon University Gil Hospital, Incheon, Korea
| | - Jungwon Huh
- Department of Laboratory Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Ji Young Huh
- Department of Laboratory Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Jae Ho Han
- Department of Pathology, Ajou University School of Medicine, Suwon, Korea
| | - Joon Seong Park
- Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea
| | - Sung Ran Cho
- Department of Laboratory Medicine, Ajou University School of Medicine, Suwon, Korea.
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12
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Huh JY, Han OJ, Park G. Rapid, Reliable, and Inexpensive HLA-B*58:01 Detection Method Using DNA Binding Dye-based Duplex Allele-specific Melting Curve Analysis. Ann Clin Lab Sci 2018; 48:296-300. [PMID: 29970431] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Allopurinol is the most commonly used drug for the treatment of gout and also one of the most common causes of severe cutaneous adverse reactions (SCARs). Human leukocyte antigen-B*58:01 (HLA-B*58:01) is strongly associated with allopurinol-induced SCARs. The aim of the present study was to develop and validate a rapid and economic screening method for HLA-B*58:01. METHODS The accuracy of duplex allele-specific melting curve analysis using DNA-binding dye for HLA-B*58:01 was evaluated in 150 blood samples with sequence-based typing (SBT) as the reference method. RESULTS Fifty HLA-B*58:01-positive and 100 negative results obtained by duplex allele-specific melting curve analysis were completely in agreement with the SBT results. CONCLUSION Duplex allele-specific melting curve analysis is a rapid, reliable and inexpensive assay that is appropriate for screening for the HLA-B*58:01 allele.
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Affiliation(s)
- Ji Young Huh
- Department of Laboratory Medicine, CHA Bundang Medical Center, Gyeonggi-do, CHA University, Korea
| | - Ok Jin Han
- Department of Laboratory Medicine, CHA Bundang Medical Center, Gyeonggi-do, CHA University, Korea
| | - Geon Park
- Department of Laboratory Medicine, Chosun University College of Medicine, Gwangju, Korea
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13
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Miyata J, Huh JY, Ito Y, Kobuchi T, Kusukawa K, Hayashi H. Can we truly rely on the urinary antigen test for the diagnosis? Legionella case report. J Gen Fam Med 2017; 18:139-143. [PMID: 29264010 PMCID: PMC5689406 DOI: 10.1002/jgf2.16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 10/30/2016] [Accepted: 06/27/2016] [Indexed: 11/07/2022] Open
Abstract
It is critical to diagnose and treat Legionella pneumonia (LP) immediately after infection because of the associated high mortality. The urine antigen test (UAT) is often used for the diagnosis of LP; however, it cannot detect the serogroups of all Legionella species. A detained medical history and several clinical findings such as liver enzyme elevation and hyponatremia are useful in diagnosis. Some specific types of Legionella are found in compost. Herein, we report a case of LP in which the patient's medical history and several clinical findings were useful for diagnosis.
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Affiliation(s)
- Jun Miyata
- Division of Family Medicine University of Fukui Hospital Fukui Japan
| | - Ji Young Huh
- Department of Family Medicine Adventist Medical Center Okinawa Japan
| | - Yukiko Ito
- Division of Family Medicine University of Fukui Hospital Fukui Japan
| | - Taketsune Kobuchi
- Division of Family Medicine University of Fukui Hospital Fukui Japan
| | - Kazuko Kusukawa
- Division of Family Medicine University of Fukui Hospital Fukui Japan
| | - Hiroyuki Hayashi
- Division of Family Medicine University of Fukui Hospital Fukui Japan
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14
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Yamanaka S, Huh JY, Nishiyama K, Hayashi H. The optimal number of personnel for good quality of chest compressions: A prospective randomized parallel manikin trial. PLoS One 2017; 12:e0189412. [PMID: 29267300 PMCID: PMC5739419 DOI: 10.1371/journal.pone.0189412] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 11/25/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Long durational chest compression (CC) deteriorates cardiopulmonary resuscitation (CPR) quality. The appropriate number of CC personnel for minimizing rescuer's fatigue is mostly unknown. OBJECTIVE We determined the optimal number of personnel needed for 30-min CPR in a rescue-team. METHODS We conducted a randomized, manikin trial on healthcare providers. We divided them into Groups A to D according to the assigned different rest period to each group between the 2 min CCs. Groups A, B, C, and D performed CCs at 2, 4, 6, and 8 min rest period. All participants performed CCs for 30 min with a different rest period; participants allocated to Groups A, B, C, and D performed, eight, five, four, and three cycles, respectively. We compared a quality change of CCs among these groups to investigate how the assigned rest period affects the maintenance of CC quality during the 30-min CPR. RESULTS This study involved 143 participants (male 58 [41%]; mean age, 24 years,) for the evaluation. As participants had less rest periods, the quality of their CCs such as sufficient depth ratio declined over 30-min CPR. A significant decrease in the sufficient CC depth ratio was observed in the second to the last cycle as compared to the first cycle. (median changes; A: -4%, B: -3%, C: 0%, and D: 0% p < 0.01). CONCLUSIONS A 6 min rest period after 2 min CC is vital in order to sustain the quality of CC during a 30-min CPR cycle. At least four personnel may be needed to reduce rescuer's fatigue for a 30-min CPR cycle when the team consists of men and women.
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Affiliation(s)
- Syunsuke Yamanaka
- Department of Emergency Medicine, University of Fukui Hospital, Fukui, Japan
- * E-mail:
| | - Ji Young Huh
- Department of Family Medicine, Adventist Medical Center, Okinawa, Japan
| | - Kei Nishiyama
- Department of Trauma and Critical Care Center, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Hiroyuki Hayashi
- Department of Family Medicine, Family Medicine, University of Fukui Hospital, Fukui, Japan
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15
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Kim KM, Han OJ, Kang MS, Huh JY. HLA-A*02:687, a novel allele identified by sequence-based typing in cord blood from a Korean woman. HLA 2017; 90:246-247. [PMID: 28686327 DOI: 10.1111/tan.13088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Revised: 06/28/2017] [Accepted: 06/28/2017] [Indexed: 11/29/2022]
Abstract
A*02:687 showed one nucleotide difference with A*02:01:01:01 resulting in an amino acid change.
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Affiliation(s)
- K M Kim
- Department of Laboratory Medicine, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - O J Han
- Department of Laboratory Medicine, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - M S Kang
- Department of Laboratory Medicine, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - J Y Huh
- Department of Laboratory Medicine, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
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16
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Hirai J, Sakanashi D, Huh JY, Suematsu H, Hagihara M, Kato H, Yamagishi Y, Fujita J, Mikamo H. The first human clinical case of chronic osteomyelitis caused by Clostridium hydrogeniformans. Anaerobe 2017; 45:138-141. [PMID: 28232120 DOI: 10.1016/j.anaerobe.2017.02.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Revised: 02/09/2017] [Accepted: 02/15/2017] [Indexed: 12/19/2022]
Abstract
We present the first case report of osteomyelitis due to Clostridium hydrogeniformans in a previously healthy 18-year-old male. He was admitted to our hospital because of an open contaminated fracture of the right arm after being blown into a drain in a motorbike accident. He underwent surgical debridement and treatment course of cefazolin. Although he responded well to these initial treatments, subcutaneous abscess and ulnar osteomyelitis developed 1 month after discharge. Second debridement was performed and specimens were collected from both the abscess and bone tissues. Only anaerobic culture showed a gas-producing Gam-positive rod. Conventional methods and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry could not accurately identify this organism. However, 16S rRNA gene sequence analysis determined the isolate as C. hydrogeniformans with 99.79% homology. The patient recovered after 90 days of antibiotic treatment, and had no evidence of recurrence. Anaerobic bacteria are more common as causative pathogens in osteomyelitis related to traumatic wounds and Clostridium spp. are particularly associated with open fractures, which is consistent with our case. Although the epidemiology and clinical characteristics of C. hydrogeniformans infection is poorly understood because of the limitations of currently available conventional methods of identification, clinicians need to consider this organism as a causative pathogen in a patient with osteomyelitis in traumatic wounds, especially contaminated by sewer water.
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MESH Headings
- Adolescent
- Bacteriological Techniques
- Clostridium/classification
- Clostridium/genetics
- Clostridium/isolation & purification
- Clostridium Infections/diagnosis
- Clostridium Infections/pathology
- Cluster Analysis
- DNA, Bacterial/chemistry
- DNA, Bacterial/genetics
- DNA, Ribosomal/chemistry
- DNA, Ribosomal/genetics
- Fractures, Bone/complications
- Humans
- Male
- Osteomyelitis/diagnosis
- Osteomyelitis/pathology
- Phylogeny
- RNA, Ribosomal, 16S/genetics
- Sequence Analysis, DNA
- Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
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Affiliation(s)
- Jun Hirai
- Department of Infectious Diseases, Respiratory, and Digestive Medicine, Control and Prevention of Infectious Diseases, Faculty of Medicine, University of the Ryukyus, 207, Aza-Uehara, Nakagami, Okinawa 903-0215, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1, Yazako-karimata, Nagakute, Aichi 480-1195, Japan; Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 1-1, Yazako-karimata, Nagakute, Aichi 480-1195, Japan.
| | - Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1, Yazako-karimata, Nagakute, Aichi 480-1195, Japan
| | - Ji Young Huh
- Department of Family Medicine, Adventist Medical Center, Okinawa, Japan, 868 Kochi, Nishihara city, Okinawa 903-0201, Japan
| | - Hiroyuki Suematsu
- Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1, Yazako-karimata, Nagakute, Aichi 480-1195, Japan
| | - Mao Hagihara
- Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1, Yazako-karimata, Nagakute, Aichi 480-1195, Japan
| | - Hideo Kato
- Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1, Yazako-karimata, Nagakute, Aichi 480-1195, Japan
| | - Yuka Yamagishi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1, Yazako-karimata, Nagakute, Aichi 480-1195, Japan; Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 1-1, Yazako-karimata, Nagakute, Aichi 480-1195, Japan
| | - Jiro Fujita
- Department of Infectious Diseases, Respiratory, and Digestive Medicine, Control and Prevention of Infectious Diseases, Faculty of Medicine, University of the Ryukyus, 207, Aza-Uehara, Nakagami, Okinawa 903-0215, Japan
| | - Hiroshige Mikamo
- Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1, Yazako-karimata, Nagakute, Aichi 480-1195, Japan; Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 1-1, Yazako-karimata, Nagakute, Aichi 480-1195, Japan
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17
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Cho HJ, Kim JO, Huh JY, Park Y, Kim MG, Oh D. A case of atypical hemolytic uremic syndrome associated with the c.1273C>T mutation in the complement C3 gene. Blood Res 2016; 51:210-213. [PMID: 27722136 PMCID: PMC5054257 DOI: 10.5045/br.2016.51.3.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 08/21/2015] [Accepted: 09/10/2015] [Indexed: 11/19/2022] Open
Affiliation(s)
- Hye Jeong Cho
- Department of Internal Medicine, School of Medicine, CHA University, Seongnam, Korea
| | - Jung O Kim
- Institute for Clinical Research, Korea University College of Medicine, Seoul, Korea
| | - Ji Young Huh
- Laboratory Medicine, School of Medicine, CHA University, Seongnam, Korea
| | - Yong Park
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Myung-Gyu Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Doyeun Oh
- Department of Internal Medicine, School of Medicine, CHA University, Seongnam, Korea
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18
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Huh JY, Lee WG, Jin HY. Molecular Characterization of Vancomycin-Resistant Enterococci from Clinical and Surveillance Specimens. Infect Control Hosp Epidemiol 2016; 27:1076-80. [PMID: 17006815 DOI: 10.1086/507961] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2005] [Accepted: 11/03/2005] [Indexed: 11/03/2022]
Abstract
Objective:To compare the molecular characteristics of infection-derived (ID) isolates and intestinal colonization–derived (ICD) isolates of vancomycin-resistant enterococci (VRE) recovered from hospitalized patients.Design.A 12-month prospective cohort study.Setting.A 1,000-bed teaching facility.Methods.From January through December 2004, a total of 30 pairs ofvanA-containing enterococcal isolates were collected from patients admitted to a teaching hospital in South Korea. Each pair comprised an ID and an ICD VRE isolate from the same patient. All VRE isolates were investigated on the basis ofSmaI-restricted pulsed-field gel electrophoresis (PFGE) pattern, Tn1546type, and presence of theespgene, including A and C repeat number variation.Results.Members of 19 pairs (63%) of VRE isolates were genetically indistinguishable from each other. The 11 patients for whom the molecular characteristics of the ID isolates differed from those of the ICD isolates had longer durations of hospitalization and intensive care unit (ICU) stay, compared with the other 19 patients.Conclusions.These findings suggest the longer durations of hospitalization and ICU stay may be possible risk factors for colonization with multiple clones of VRE.
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Affiliation(s)
- Ji Young Huh
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea
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19
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Liu X, Huh JY, Gong H, Chamberland JP, Brinkoetter MT, Hamnvik OPR, Mantzoros CS. Lack of mature lymphocytes results in obese but metabolically healthy mice when fed a high-fat diet. Int J Obes (Lond) 2015; 39:1548-57. [PMID: 25994806 DOI: 10.1038/ijo.2015.93] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 01/11/2015] [Accepted: 01/17/2015] [Indexed: 01/18/2023]
Abstract
BACKGROUND/OBJECTIVES Obesity is characterized by chronic inflammation and immune dysregulation, as well as insulin resistance, but the link between obesity and adaptive immunity remains to be fully studied. METHODS To elucidate the role of adaptive immunity on body composition, glucose homeostasis and inflammation, recombination-activating gene 1 knockout (Rag1-/-) mice, without mature T-lymphocytes or B-lymphocytes, were maintained on a low- or high-fat diet (LFD and HFD, respectively) for 11 weeks. RESULTS Rag1-/- mice fed HFD gained significantly more weight and had increased body fat compared with wild type. Downregulation of energy expenditure as well as brown fat uncoupling protein UCP-1 and UCP-3 gene expression were noticed in HFD-fed Rag1-/- mice compared with LFD. HFD mice had significantly decreased energy intake compared with LFD mice, consistent with decreased agouti-related protein and increased pro-opiomelanocortin gene expression levels in the hypothalamus. Moreover, compared with wild type, Rag1-/- mice had lower interleukin (IL)-4 levels, a cytokine recently found to induce browning in white adipocytes, and higher IL-12 levels in HFD-fed Rag1-/- mice. Despite that HFD Rag1-/- mice were more obese, they had similar glucose, insulin and adiponectin levels, while leptin was marginally increased. CONCLUSIONS Mice with deficiency in adaptive immunity are obese, partly owing to decreased energy expenditure, but are metabolically normal, suggesting that mature lymphocytes have necessary roles in the development of obesity-related metabolic dysregulation.
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Affiliation(s)
- X Liu
- Division of Endocrinology, Diabetes and Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - J Y Huh
- Division of Endocrinology, Diabetes and Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - H Gong
- Division of Endocrinology, Diabetes and Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - J P Chamberland
- Division of Endocrinology, Diabetes and Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.,Section of Endocrinology, Boston VA Healthcare System, Harvard Medical School, Boston, MA, USA
| | - M T Brinkoetter
- Division of Endocrinology, Diabetes and Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - O-P R Hamnvik
- Section of Endocrinology, Boston VA Healthcare System, Harvard Medical School, Boston, MA, USA
| | - C S Mantzoros
- Division of Endocrinology, Diabetes and Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.,Section of Endocrinology, Boston VA Healthcare System, Harvard Medical School, Boston, MA, USA
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20
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Kim KM, Huh JY, Hong SS, Kang MS. Assessment of cell viability, early apoptosis, and hematopoietic potential in umbilical cord blood units after storage. Transfusion 2015; 55:2017-22. [DOI: 10.1111/trf.13120] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 02/05/2015] [Accepted: 02/10/2015] [Indexed: 01/23/2023]
Affiliation(s)
- Kyeong Mi Kim
- Department of Laboratory Medicine; CHA Bundang Medical Center, CHA University
| | - Ji Young Huh
- Department of Laboratory Medicine; CHA Bundang Medical Center, CHA University
| | - Sang Sook Hong
- Department of Laboratory Medicine; CHA Bundang Medical Center, CHA University
| | - Myung Seo Kang
- Department of Laboratory Medicine; CHA Bundang Medical Center, CHA University
- CHA Medical Center Cord Blood Bank; Gyeonggi-do Korea
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21
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Huh JY, Ross GW, Chen R, Abbott RD, Bell C, Willcox B, Launer L, Petrovitch H, Kaya B, Masaki K. Total and differential white blood cell counts in late life predict 8-year incident stroke: the Honolulu Heart Program. J Am Geriatr Soc 2015; 63:439-46. [PMID: 25739422 DOI: 10.1111/jgs.13298] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To study the association between total and differential white blood cell (WBC) count and incident stroke in an older Asian population. DESIGN Prospective population-based study with 8 years of follow-up. SETTING The Honolulu Heart Program, Oahu, Hawaii. PARTICIPANTS Japanese-American men aged 71 to 93 who were free of stroke and had baseline WBC counts measured in 1991-93 (N=3,342). MEASUREMENTS Participants were divided into quartiles of total and differential WBC count for analysis and were followed for incident stroke (thromboembolic and hemorrhagic (hemorrhagic)) for 8 years using data from a comprehensive hospital surveillance system. RESULTS Age-adjusted incident stroke rates increased significantly with increasing WBC quartile (Q1, 7.68; Q2, 9.04; Q3, 9.26; Q4, 14.10 per 1,000 person-years of follow-up, P=.001). Hazard ratios (HRs) for stroke for each quartile of total and differential WBC count were obtained using Cox regression analysis, with the lowest quartile as the reference group. After full adjustment, including age; cardiovascular risk factors; fibrinogen; prevalent coronary heart disease, cancer, or chronic obstructive pulmonary disease, and nonsteroidal anti-inflammatory drug use, HRs were 1.62 (95% confidence interval (CI)=1.04-2.52, P=.03) in the highest quartile of total WBC and 2.19 (95% CI=1.41-3.39, P<.001) in the highest quartile of neutrophil counts. Significant associations were also seen for thromboembolic but not for hemorrhagic strokes. No significant associations were found between lymphocyte or monocyte counts and incident stroke or subtypes. CONCLUSION In elderly Japanese-American men, higher total WBC and neutrophil counts were independent predictors of overall stroke, as well as thromboembolic stroke.
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Affiliation(s)
- Ji Young Huh
- Department of Geriatric Medicine, The John A. Hartford Foundation Center of Excellence in Geriatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
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22
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Song EY, Huh JY, Kim SY, Kim TG, Oh S, Yoon JH, Roh EY, Park MH, Kang MS, Shin S. Estimation of size of cord blood inventory based on high-resolution typing of HLAs. Bone Marrow Transplant 2014; 49:977-9. [PMID: 24777194 DOI: 10.1038/bmt.2014.76] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Revised: 02/05/2014] [Accepted: 03/04/2014] [Indexed: 11/09/2022]
Abstract
Methods for estimating the cord blood (CB) inventory size required vary according to the ethnic diversity of the HLA, degree of HLA matching and HLA-typing resolution. We estimated the CB inventory size required using 7190 stored CB units (CBU) and 2450 patients who were awaiting or underwent allogeneic hematopoietic stem cell transplantation. With high-resolution typing of HLA-A, B and DRB1, 94.6% of Korean patients could find CBUs in 100 000 CBUs with a 5/6 match, and 95.7% could find CBUs in 5000 CBUs with a 4/6 match. With low-resolution typing of HLA-A and B and high-resolution typing of leukocyte antigen-DRB1, 95% of patients could find CBUs in 50 000 CBUs with a 5/6 match, and 96.7% could find CBUs in 3000 CBUs with a 4/6 match. With additional high-resolution typing for HLA-A and B, which could improve transplantation outcome, the size of the CB inventory would need to increase twofold for Koreans.
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Affiliation(s)
- E Y Song
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - J Y Huh
- CHA Bundang Medical Center, Department of Laboratory Medicine, CHA University, Seongnam, Korea
| | - S Y Kim
- Catholic Hematopoietic Stem Cell Bank, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - T G Kim
- Catholic Hematopoietic Stem Cell Bank, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - S Oh
- Department of Biostatistics, Boramae Hospital, Seoul, Korea
| | - J H Yoon
- 1] Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea [2] Department of Laboratory Medicine, Boramae Hospital, Seoul, Korea [3] Seoul Metropolitan Government Public Cord Blood Bank (Allcord), Seoul, Korea
| | - E Y Roh
- 1] Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea [2] Department of Laboratory Medicine, Boramae Hospital, Seoul, Korea [3] Seoul Metropolitan Government Public Cord Blood Bank (Allcord), Seoul, Korea
| | - M H Park
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - M S Kang
- 1] CHA Bundang Medical Center, Department of Laboratory Medicine, CHA University, Seongnam, Korea [2] CHA Medical Center Cord Blood Bank, Seongnam, Korea
| | - S Shin
- 1] Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea [2] Department of Laboratory Medicine, Boramae Hospital, Seoul, Korea [3] Seoul Metropolitan Government Public Cord Blood Bank (Allcord), Seoul, Korea
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Huh JY, Kwon MJ, Seo KY, Kim MK, Chae KY, Kim SH, Ki CS, Yoon MS, Kim DH. Novel nonsense GNAS mutation in a 14-month-old boy with plate-like osteoma cutis and medulloblastoma. J Dermatol 2014; 41:319-21. [PMID: 24517547 DOI: 10.1111/1346-8138.12284] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Accepted: 08/09/2013] [Indexed: 11/26/2022]
Abstract
Plate-like osteoma cutis (PLOC) is a dermatological disorder characterized by superficial ossification and rarely occurs without any underlying tissue abnormalities or pre-existing calcification. The hereditary form of PLOC is mainly due to inactivating mutation in the GNAS gene. Inactivating mutation of the GNAS gene is associated with several diseases, which commonly manifest heterotopic ossification and hormonal resistance; however, the development of malignant neoplasm has never been reported. Herein, we report a case of a patient with a novel nonsense mutation in the GNAS gene, who presented with concurrent PLOC and medulloblastoma.
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Affiliation(s)
- Ji Young Huh
- Department of Laboratory Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
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24
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Affiliation(s)
- Kyeong Mi Kim
- Department of Laboratory Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Ji Young Huh
- Department of Laboratory Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Myung Seo Kang
- Department of Laboratory Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Sang Hee Jung
- Department of Obstetrics & Gynecology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
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25
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Oh J, Lim Y, Jang MJ, Huh JY, Shima M, Oh D. Characterization of anti-factor VIII antibody in a patient with acquired hemophilia A. Blood Res 2013; 48:58-62. [PMID: 23589798 PMCID: PMC3624998 DOI: 10.5045/br.2013.48.1.58] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [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: 01/08/2012] [Revised: 06/23/2012] [Accepted: 02/04/2013] [Indexed: 01/23/2023] Open
Abstract
Acquired hemophilia A (AHA) is a bleeding disorder caused by the development of an auto-antibody against endogenous factor VIII (FVIII). In this study, the epitope of the autoantibody was identified in a 67-year-old female patient with AHA. A prolonged activated partial thromboplastin time (77.4 s) that failed to correct in an incubation mixing test (68.2 s), a decreased FVIII activity, and a high FVIII inhibitor (14.6 Bethesda units/mL) were observed. Enzyme-linked immunosorbent assay demonstrated that the antibody belonged to the immunoglobulin G4 subclass. An immunoblotting assay revealed the light chain (A3/C1/C2 domain) of FVIII as the binding region of the antibody. The bleeding experienced by our patient resulted from the interference of FVIII binding to both FIX by anti-A3 antibodies and phospholipids and von Willebrand factor by anti-C2 antibodies. To the best of our knowledge, this is the first study in Korea characterizing an autoantibody in the context of AHA.
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Affiliation(s)
- Jisu Oh
- Department of Internal Medicine, CHA University School of Medicine, Seongnam, Korea
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26
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Kim H, Hyeon S, Kim H, Yang Y, Huh JY, Park DR, Lee H, Seo DH, Kim HS, Lee SY, Jeong W. Dynein Light Chain LC8 Inhibits Osteoclast Differentiation and Prevents Bone Loss in Mice. J I 2013; 190:1312-8. [DOI: 10.4049/jimmunol.1202525] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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27
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Jin SM, Jang MJ, Huh JY, Park MH, Song EY, Oh D. A case of transfusion-related acute lung injury induced by anti-human leukocyte antigen antibodies in acute leukemia. Korean J Hematol 2012; 47:302-6. [PMID: 23320011 PMCID: PMC3538804 DOI: 10.5045/kjh.2012.47.4.302] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Revised: 06/17/2012] [Accepted: 10/09/2012] [Indexed: 11/30/2022]
Abstract
Transfusion-related acute lung injury (TRALI) is a noncardiogenic pulmonary edema that occurs during or within 6 hours after transfusion. Risk factors for TRALI, which is relatively common in critically ill patients, include recent surgery, hematologic malignancy, and sepsis. Here, we report a case of TRALI induced by anti-human leukocyte antigen (anti-HLA) class II antibodies (HLA-DR) occurring after transfusion of platelet concentrates in a patient with acute leukemia. Although most patients with TRALI show improvement within 48-96 hours, our patient's condition rapidly worsened, and he did not respond to supportive treatment. TRALI is a relatively common and serious adverse transfusion reaction that requires prompt diagnosis and management.
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Affiliation(s)
- Sun Mi Jin
- Department of Internal Medicine, CHA University School of Medicine, Seongnam, Korea
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28
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Hong SS, Kim K, Huh JY, Jung B, Kang MS, Hong SG. Multiplex PCR for rapid detection of genes encoding class A carbapenemases. Ann Lab Med 2012; 32:359-61. [PMID: 22950072 PMCID: PMC3427824 DOI: 10.3343/alm.2012.32.5.359] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Revised: 05/21/2012] [Accepted: 07/09/2012] [Indexed: 12/18/2022] Open
Abstract
In recent years, there have been increasing reports of KPC-producing Klebsiella pneumoniae in Korea. The modified Hodge test can be used as a phenotypic screening test for class A carbapenamase (CAC)-producing clinical isolates; however, it does not distinguish between carbapenemase types. The confirmation of type of CAC is important to ensure optimal therapy and to prevent transmission. This study applied a novel multiplex PCR assay to detect and differentiate CAC genes in a single reaction. Four primer pairs were designed to amplify fragments encoding 4 CAC families (SME, IMI/NMC-A, KPC, and GES). The multiplex PCR detected all genes tested for 4 CAC families that could be differentiated by fragment size according to gene type. This multiplex PCR offers a simple and useful approach for detecting and distinguishing CAC genes in carbapenem-resistant strains that are metallo-β-lactamase nonproducers.
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Affiliation(s)
- Sang Sook Hong
- Department of Laboratory Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
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29
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Lee SG, Park TS, Yang JJ, Oh SH, Cho EH, Lee S, Oh D, Huh JY, Marschalek R, Meyer C. Molecular identification of a new splicing variant of the MLL - MLLT11 fusion transcript in an adult with acute myeloid leukemia and t(1;11)(q21;q23). Acta Haematol 2012; 128:131-8. [PMID: 22854283 DOI: 10.1159/000338258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Accepted: 03/13/2012] [Indexed: 02/02/2023]
Abstract
More than 70 different mixed lineage leukemia (MLL) rearrangements involving 11q23 have been molecularly characterized in acute leukemia. Among these, the MLLT11 gene is highly unique as MLL fusion partner because the entire open reading frame is usually fused in-frame to the N-terminal portion of the MLL gene. By using molecular genetic methods, we identified the chromosomal fusion site within MLL exon 10 sequences which were fused to the MLLT11 intron 1 sequences. This unusual break site results in the creation of two in-frame MLL-MLLT11 fusion transcripts in this acute myeloid leukemia patient with t(1;11)(q21;q23). One fusion transcript represents a normal splice product, while the other contains intronic sequences and a cryptic splice event in order to generate an intact fusion transcript. We also reviewed all published articles which have reported t(1;11)(q21;q23) in myeloid or lymphoid neoplasm and attempted to summarize these published data. Of interest, pediatric patients displayed a significant larger portion of unique balanced translocations (n = 40), while complex karyotypes were less often identified (n = 12). Vice versa, in adult leukemia patients, complex karyotypes (n = 5) were more frequent than unique balanced translocations (n = 2).
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Affiliation(s)
- Sang-Guk Lee
- Department of Laboratory Medicine, Armed Forces Capital Hospital, Seongnam, Korea
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30
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Kim KM, Sung HY, Jung B, Kang MS, Huh JY. HLA-B*40:179, a novel allele identified by sequence-based typing in cord blood from a Korean woman. ACTA ACUST UNITED AC 2012; 80:194-5. [PMID: 22607317 DOI: 10.1111/j.1399-0039.2012.01894.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The novel allele B*40:179 showed one nucleotide difference with B*40:01:01 in exon 4.
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Affiliation(s)
- K M Kim
- Department of Laboratory Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Gyeonggi-do, Korea
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31
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Abstract
In this report, we describe a Korean patient with May-Hegglin anomaly from a mutation of the MYH9 gene. The proband was a 21-year-old man with thrombocytopenia. He did not have a bleeding tendency. His neutrophil count was normal at 7490/mm³; however, the neutrophils contained abnormal basophilic inclusions in their cytoplasm. The platelet count was decreased at 15,000/mm³ with giant platelets. Coagulation test results were not remarkable. Direct sequencing of MYH9 revealed that he was heterozygous for a mutation in exon 1, which was a 97T>A substitution mutation affecting codon 33, substituting tryptophan with arginine (Trp33Arg). Family study showed that both of his parents had normal phenotype and genotypes, indicating a de novo occurrence of the mutation in the proband.
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Affiliation(s)
- Moon Ju Jang
- Department of Internal Medicine, School of Medicine, CHA University, Seongnam, Korea
| | - Hyun-Jeong Park
- Department of Internal Medicine, School of Medicine, CHA University, Seongnam, Korea
| | - So Young Chong
- Department of Internal Medicine, School of Medicine, CHA University, Seongnam, Korea
| | - Ji Young Huh
- Department of Laboratory Medicine, School of Medicine, CHA University, Seongnam, Korea
| | - In-Ho Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Ja-Hyun Jang
- Department of Laboratory Medicine & Genetics, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee-Jin Kim
- Department of Laboratory Medicine & Genetics, Sungkyunkwan University School of Medicine, Seoul, Korea
- Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Doyeun Oh
- Department of Internal Medicine, School of Medicine, CHA University, Seongnam, Korea
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32
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Cho SY, Park TS, Oh SH, Cho EH, Oh D, Huh JY, Marschalek R, Meyer C. Genomic analysis of a four-way t(4;11;22;10) associated with MLL-AF4 in an adult acute lymphoblastic leukemia. Ann Hematol 2011; 91:977-9. [PMID: 22086294 DOI: 10.1007/s00277-011-1364-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Accepted: 10/26/2011] [Indexed: 01/12/2023]
MESH Headings
- Adult
- Base Sequence
- Chromosomes, Human, Pair 10/genetics
- Chromosomes, Human, Pair 11/genetics
- Chromosomes, Human, Pair 22/genetics
- Chromosomes, Human, Pair 4/genetics
- Cytogenetic Analysis
- Genome, Human
- Humans
- Male
- Molecular Sequence Data
- Myeloid-Lymphoid Leukemia Protein/genetics
- Oncogene Proteins, Fusion/genetics
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics
- Translocation, Genetic
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33
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Huh JY, Yi DY, Hwang SG, Choi JJ, Kang MS. Characterization of antiphospholipid antibodies in chronic hepatitis B infection. Korean J Hematol 2011; 46:36-40. [PMID: 21461302 PMCID: PMC3065625 DOI: 10.5045/kjh.2011.46.1.36] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2010] [Revised: 02/13/2011] [Accepted: 02/15/2011] [Indexed: 11/17/2022]
Abstract
BACKGROUND Many infections are associated with antiphospholipid antibodies (aPLs). The purpose of this study was to investigate the prevalence, persistence, clinical significance, and characteristics of aPLs in hepatitis B virus (HBV)-infected patients. METHODS This study included 143 patients with HBV infection and 32 healthy individuals as controls. The presence of anticardiolipin antibodies (aCL Ab), anti-β(2)-glycoprotein I antibodies (β(2)GPI Ab), and lupus anticoagulant (LA) was assessed. RESULTS The total prevalence of aPLs in HBV-infected patients was 12.6% (18 of 143). Of these 18 patients, 15 had low to medium titers of aCL Ab (10 with IgM, 4 with IgG, and 1 with both isotypes). β(2)GPI Ab and LA were detected in 3 (2.1%) and 2 (1.4%) patients with HBV infection, respectively. In follow-up specimens from 14 patients with elevated levels of aCL Ab or β(2)GPI Ab, 10 (71.4%) showed the persistent presence of aPLs. No clinical manifestations related to aPLs were identified. CONCLUSION In HBV-infected patients, the most frequently detected antiphospholipid antibodies were IgM aCL Ab, which have a weak association with the clinical manifestations of APS. Unlike the transient presence reported for other infection-associated aPLs, most aPLs were persistently detected over a 12-week period in patients with HBV infection.
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Affiliation(s)
- Ji Young Huh
- Department of Laboratory Medicine, CHA Bundang Medical Center, Seongnam, Korea
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34
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Ree PH, Hahn WB, Chang SW, Jung SH, Kang JH, Cha DH, Kang MS, Huh JY. Early detection of preeclampsia using inhibin a and other second-trimester serum markers. Fetal Diagn Ther 2011; 29:280-6. [PMID: 21252475 DOI: 10.1159/000322742] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2010] [Accepted: 11/11/2010] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The purpose of this study was to determine whether second-trimester maternal serum markers including inhibin A are useful for the detection of preeclampsia. METHODS Between January 2005 and March 2009, we analyzed the data of 4,764 subjects who underwent second-trimester multiple-marker screening for Down syndrome. Serum samples were assayed at 15+0 to 20+6 weeks for maternal serum alpha-fetoprotein (MSAFP), human chorionic gonadotrophin (hCG), unconjugated estriol (uE(3)) and inhibin A. We reviewed all medical records retrospectively, and assessed the relationships of several markers with preeclampsia using logistic regression analysis. RESULTS The study sample included 41 patients who developed preeclampsia and a control group consisting of the other 4,723 healthy subjects treated between January 2005 and March 2009. There were no significant differences in gestational ages at blood sampling, maternal weights, gravidity and parity between the two groups. However, the mean ages, Apgar scores, gestational age at delivery and neonatal weights were significantly different between the study group and the control group. The levels of markers in the study group were significantly increased compared to the control group, 1.76 ± 2.68 for inhibin A, 1.18 ± 0.69 for MSAFP, and 1.62 ± 1.18 for hCG, but uE(3) did not differ significantly between the two groups. The AUC of inhibin A was 0.715, but the AUC of a three-marker combination model (0.800) was even better. A mid-trimester inhibin A concentration of 1.5 MoM or greater had a sensitivity of 60% and a false-positive rate of 16% for the prediction of preeclampsia. Inhibin A was the best predictor of preeclampsia. Three other markers were reliable predictive markers of preeclampsia. CONCLUSIONS Inhibin A and other second-trimester serum markers may be useful for early detection of preeclampsia. Inhibin A was in fact the most important predictable marker among the markers we surveyed. The results of this study support those of previous studies, and provide quantified data elucidating the occurrence of preeclampsia.
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Affiliation(s)
- Park Hea Ree
- Department of Obstetrics and Gynecology, Bundang CHA General Hospital, Sungnam, Republic of Korea
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35
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Lee SG, Park TS, Cho SY, Lim G, Park GJ, Oh SH, Cho EH, Chong SY, Huh JY. T-cell acute lymphoblastic leukemia associated with complex karyotype and SET-NUP214 rearrangement: a case study and review of the literature. Ann Clin Lab Sci 2011; 41:267-272. [PMID: 22075511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
SET-NUP214 rearrangements have been rarely reported in T-cell acute lymphoblastic leukemia (T-ALL), acute undifferentiated leukemia, and acute myeloid leukemia, and most documented cases have been associated with normal karyotypes in conventional cytogenetic analyses. Here, we describe a novel case of T-ALL associated with a mediastinal mass and a SET-NUP214 rearrangement, which was masked by a complex karyotype at the time of initial diagnosis. Using multiplex reverse transcriptase-polymerase chain reaction analysis, we detected a cryptic SET-NUP214 rearrangement in our patient. As only 11 cases (including the present study) of T-ALL with SET-NUP214 rearrangement have been reported, the clinical features and treatment outcomes have not been fully determined. Further studies are necessary to evaluate the incidence of SET-NUP214 rearrangement in T-ALL patients and the treatment responses as well as prognosis of these patients.
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Affiliation(s)
- Sang-Guk Lee
- Department of Laboratory Medicine, Armed Forces Capital Hospital, Seongnam, Korea
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36
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Huh JY, Park G, Jang SJ, Moon DS, Park YJ. A rapid long PCR-direct sequencing analysis for ABO genotyping. Ann Clin Lab Sci 2011; 41:340-345. [PMID: 22166503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
ABO is the most clinically important blood group system in transfusion and transplantation medicine. The popular ABO genotyping methods, such as the sequencing of exons 6 and 7 and sequence-specific primer (SSP)-PCR, often lead to ambiguous typing results. Long PCR-sequencing method was designed to analyze two regulatory regions (promoter and CBF/NF-Y enhancer regions) and all genomic sequences (except for intron 1) of the ABO gene. Using rapid DNA polymerase with high-fidelity, we amplified 6.3 kb and 7.3 kb for sequencing of enhancer-exon 1 and exons 2-7, respectively. ABO genotyping was performed using this technique in the peripheral blood of three unrelated families. The time requirements of the PCR amplification and purification processes were about 2.0 hours and 15 minutes, respectively. Five different ABO alleles (ABO A102, ABO A105, ABO O01, ABO O02, and ABO B101) with allele-specific CBF/NF-Y minisatellite repeats from three families were analyzed. All genotyping results agreed with serologic findings and results expected by Mendelian inheritance. Compared to conventional PCR-direct sequencing for ABO genotyping, this method proves simple and fast for the analysis of ABO genotypes. Therefore, it might be valuable in clinical transfusion or forensic applications.
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Affiliation(s)
- Ji Young Huh
- Department of Laboratory Medicine, CHA Bundang Medical Center, Gyeonggi-do, South Korea
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37
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Huh JY, Chung S, Oh D, Kang MS, Eom HS, Cho EH, Han MH, Kong SY. Clathrin assembly lymphoid myeloid leukemia-AF10-positive acute leukemias: a report of 2 cases with a review of the literature. Korean J Lab Med 2010; 30:117-21. [PMID: 20445327 DOI: 10.3343/kjlm.2010.30.2.117] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The translocation t(10;11)(p13;q14q21) has been found to be recurrent in acute lymphoblastic and myeloid leukemias, and results in the fusion of the clathrin assembly lymphoid myeloid leukemia (CALM) gene with the AF10 gene; these genes are present on chromosomes 11 and 10, respectively. Because the CALM-AF10 rearrangement is a rare chromosomal abnormality, it is not included in routine molecular tests for acute leukemia. Here, we describe the cases of 2 patients with the CALM-AF10 fusion gene. The first patient (case 1) was diagnosed with T-cell ALL, and the second patient (case 2) was diagnosed with AML. Both patient samples showed expression of the homeobox A gene cluster and the histone methyltransferase hDOT1L, which suggests that they mediate leukemic transformation in CALM-AF10-positive and mixed-lineage leukemia-AF10-positive leukemias. Both patients achieved complete remission after induction chemotherapy. The first patient (case 1) relapsed after double-unit cord blood transplantation; there was no evidence of relapse in the second patient (case 2) after allogenic peripheral blood stem cell transplantation. Since CALM-AF10- positive leukemias have been shown to have poor prognosis with conventional therapy, molecular tests for CALM-AF10 rearrangement would be necessary to detect minimal residual disease during follow-up.
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Affiliation(s)
- Ji Young Huh
- Department of Laboratory Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
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38
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Hobbie EK, Simien DO, Fagan JA, Huh JY, Chung JY, Hudson SD, Obrzut J, Douglas JF, Stafford CM. Wrinkling and strain softening in single-wall carbon nanotube membranes. Phys Rev Lett 2010; 104:125505. [PMID: 20366547 DOI: 10.1103/physrevlett.104.125505] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2009] [Indexed: 05/29/2023]
Abstract
The nonlinear elasticity of thin supported membranes assembled from length purified single-wall carbon nanotubes is analyzed through the wrinkling instability that develops under uniaxial compression. In contrast with thin polymer films, pristine nanotube membranes exhibit strong softening under finite strain associated with bond slip and network fracture. We model the response as a shift in percolation threshold generated by strain-induced nanotube alignment in accordance with theoretical predictions.
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Affiliation(s)
- E K Hobbie
- Department of Physics, Department of Coatings and Polymeric Materials, North Dakota State University, Fargo, North Dakota 58108, USA.
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39
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Kim H, Choi HK, Shin JH, Kim KH, Huh JY, Lee SA, Ko CY, Kim HS, Shin HI, Lee HJ, Jeong D, Kim N, Choi Y, Lee SY. Selective inhibition of RANK blocks osteoclast maturation and function and prevents bone loss in mice. J Clin Invest 2009; 119:813-25. [PMID: 19258703 DOI: 10.1172/jci36809] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2008] [Accepted: 01/13/2009] [Indexed: 12/14/2022] Open
Abstract
Regulation of the formation and function of bone-resorbing osteoclasts (OCs) is a key to understanding the pathogenesis of skeletal disorders. Gene-targeting studies have shown that the RANK signaling pathway plays a critical role in OC differentiation and function. Although pharmaceutical blockade of RANK may be a viable strategy for preventing bone destruction, RANK is implicated in multiple biological processes. Recently, a cytoplasmic motif of RANK was identified that may be specifically involved in OC differentiation. Here, we developed a cell-permeable inhibitor termed the RANK receptor inhibitor (RRI), which targets this motif. The RRI peptide blocked RANKL-induced OC formation from murine bone marrow-derived macrophages. Furthermore, RRI inhibited the resorptive function of OCs and induced OC apoptosis. Treatment with the peptide impaired downstream signaling of RANK linked to Vav3, Rac1, and Cdc42 and resulted in disruptions of the actin cytoskeleton in differentiated OCs. In addition, RRI blocked inflammation-induced bone destruction and protected against ovariectomy-induced bone loss in mice. These data may be useful in the development of selective therapeutic agents for the treatment of osteoporosis and other bone diseases.
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Affiliation(s)
- Hyunsoo Kim
- Division of Life and Pharmaceutical Sciences, Center for Cell Signaling and Drug Discovery Research, Department of Life Science, College of Natural Sciences, Ewha Womans University, Seoul, Republic of Korea
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40
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Affiliation(s)
- Wookeun Lee
- Department of Laboratory Medicine, School of Medicine, CHA University, Gyeonggi-do, Korea
| | - Dae Young Yi
- Department of Laboratory Medicine, School of Medicine, CHA University, Gyeonggi-do, Korea
| | - Bochan Jung
- Department of Laboratory Medicine, School of Medicine, CHA University, Gyeonggi-do, Korea
| | - Ji Young Huh
- Department of Laboratory Medicine, School of Medicine, CHA University, Gyeonggi-do, Korea
| | - Myung Seo Kang
- Department of Laboratory Medicine, School of Medicine, CHA University, Gyeonggi-do, Korea
| | - Seong Geun Hong
- Department of Laboratory Medicine, School of Medicine, CHA University, Gyeonggi-do, Korea
| | - Sung Kwan Hong
- Department of Internal Medicine, School of Medicine, CHA University, Gyeonggi-do, Korea
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41
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Huh JY, Lee WG, Lee K, Shin WS, Yoo JH. Distribution of insertion sequences associated with Tn1546-like elements among Enterococcus faecium isolates from patients in Korea. J Clin Microbiol 2004; 42:1897-902. [PMID: 15131146 PMCID: PMC404624 DOI: 10.1128/jcm.42.5.1897-1902.2004] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The vanA gene cluster is carried as a part of Tn1546-like elements. The genetic diversity in Tn1546-like elements has been documented previously. The differences described thus far have included the integration of insertion sequence (IS) elements IS1216V, IS1251, IS1476, and IS1542. Among these, IS1216V has been reported to be widespread in VanA enterococci of diverse geographic areas, whereas IS1542 and IS1476 have been reported only in the United Kingdom and Canada, respectively. We investigated the distribution of ISs among 20 vanA-containing Enterococcus faecium isolates from human patients in nine different university hospitals in Korea. Pulsed-field gel electrophoresis (PFGE) was performed to identify the clonality of the isolates. Moreover, PCR amplification of the internal regions of Tn1546 was performed for structural analysis of the van gene, and both DNA strands of the PCR amplicons were directly sequenced by the dideoxy termination method. The PFGE patterns revealed a high degree of clonal diversity. Structural analyses of the van gene detected IS1542 and IS1216V in the genomes of all 20 isolates, whereas it did not detect IS1476 or IS1251 in the genomes of any of the isolates. In addition, IS19 was detected in the vanS-vanH intergenic region of one isolate. These data indicate that identification of the IS within a vanA gene cluster could be a useful tool in epidemiological investigations. In addition, the distribution of ISs associated with Tn1546-like elements among the Korean isolates is therefore similar to that among European vancomycin-resistant enterococci.
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Affiliation(s)
- Ji Young Huh
- Department of Laboratory Medicine, Ajou University School of Medicine, Suwon, Korea
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42
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Lee WG, Huh JY, Cho SR, Lim YA. Reduction in glycopeptide resistance in vancomycin-resistant enterococci as a result of vanA cluster rearrangements. Antimicrob Agents Chemother 2004; 48:1379-81. [PMID: 15047548 PMCID: PMC375328 DOI: 10.1128/aac.48.4.1379-1381.2004] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The molecular characterization of five clinical isolates of vanA-containing vancomycin-resistant enterococci with altered resistance to glycopeptides was examined. One strain represented an IS1216V insertion accompanied by partial deletion of the reading frame of vanX following a transposition event. The other four strains represented IS1216V within the vanX-vanY intergenic region associated with deletion of vanY or vanZ.
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Affiliation(s)
- Wee Gyo Lee
- Department of Laboratory Medicine, Ajou University School of Medicine, Suwon, South Korea.
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43
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Cho SR, Huh JY, Hyun BH. Erythrophagocytosis by myeloid cells in a patient with myeloproliferative disorder. Yonsei Med J 2003; 44:928-30. [PMID: 14584114 DOI: 10.3349/ymj.2003.44.5.928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
This report documents a case of myeloid erythrophagocytosis in a patient with myeloproliferative disorder. The patient had pancytopenia and his marrow was hyperplastic with erythrophagocytosis by myeloid cells of various stages, including myeloblasts. He was diagnosed to have a prefibrotic stage of chronic idiopathic myelofibrosis. The erythrophagocytosis by myeloid cells persisted even after 2 months of treatment for the primary disorder.
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Affiliation(s)
- Sung Ran Cho
- Department of Laboratory Medicine, Ajou University School of Medicine, Ajou University Hospital, Suwon, Korea.
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44
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Choi BH, Huh JY, Yoo JH. Computed tomographic findings of the fractured mandibular condyle after open reduction. Int J Oral Maxillofac Surg 2003; 32:469-73. [PMID: 14759103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
The purpose of this study was to evaluate the long-term radiological results obtained with open reduction and fixation of unilateral mandibular condyle fractures in 10 patients. CT images taken at the end of the follow-up period (average of 22 months, range 7 to 33 months), were traced and digitized, and the position and morphology of the fractured condylar process was statistically compared with those of the contralateral non-fractured condylar process in the coronal, transverse and sagittal planes. Little difference was observed in the position or morphology of the condylar process in the operated and non-fractured joints. This study shows that it is possible to anatomically reduce fractured condyles, and thereby to avoid postoperative disadvantageous joint changes.
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Affiliation(s)
- B H Choi
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University (Brain Korea 21 Project for Medical Sciences), Wonju, Kangwon-Do, South Korea.
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45
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Oh MJ, Choi JH, Kim IH, Lee YH, Huh JY, Park YK, Lee KW, Chough SY, Joo KS, Ku BS, Saw HS. Detection of epidermal growth factor receptor in the serum of patients with cervical carcinoma. Clin Cancer Res 2000; 6:4760-3. [PMID: 11156231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Epidermal growth factor receptor (EGFR) is overexpressed in a variety of malignancies, including breast, lung, gastric, and cervical carcinoma. Its overexpression has been associated with disease progression or poor prognosis in patients with cervical carcinoma. In the present study, the levels of EGFR were determined in serum from 38 patients with cervical carcinoma [invasive or recurrent carcinoma (n = 26) and carcinoma in situ (CIS; n = 12)] and 38 healthy female controls using ELISA. The mean serum level for EGFR in patients with invasive or recurrent carcinoma (165 +/- 60 fmol/ml) was significantly elevated (P < 0.0001) compared with that of healthy controls (66 +/- 17 fmol/ml) and also higher (P = 0.015) than that of patients with CIS (126 +/- 25 fmol/ml). In addition, there was a significant difference in the mean serum levels of EGFR between patients with CIS and healthy controls (P < 0.0001). Thirty-five patients (92%) with cervical carcinoma [invasive or recurrent (n = 24) and CIS (n = 11)] had elevated serum, EGFR levels above the cutoff value of 100 fmol/ml (defined as 2 SD above the mean of the controls). In conclusion, the serum EGFR level was elevated in a significant proportion of patients with cervical carcinoma, and it demonstrated an increasing tendency according to disease progression from normal tissue through CIS to invasive cervical carcinoma. Therefore, it may have a potential usefulness as a biological marker of cervical carcinoma.
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Affiliation(s)
- M J Oh
- Department of Obstetrics and Gynecology, Korea University College of of Medicine, Seoul, Korea (Republic)
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