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Son J, Lee SH. IgG4-related pericarditis. QJM 2024; 117:300-301. [PMID: 38113430 DOI: 10.1093/qjmed/hcad284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Indexed: 12/21/2023] Open
Affiliation(s)
- J Son
- Division of Cardiology, Department of Internal Medicine, Jeonbuk National University Medical School, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - S H Lee
- Division of Cardiology, Department of Internal Medicine, Jeonbuk National University Medical School, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
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Hutch MR, Son J, Le TT, Hong C, Wang X, Shakeri Hossein Abad Z, Morris M, Gutiérrez-Sacristán A, Klann JG, Spiridou A, Batugo A, Bellazzi R, Benoit V, Bonzel CL, Bryant WA, Chiudinelli L, Cho K, Das P, González González T, Hanauer DA, Henderson DW, Ho YL, Loh NHW, Makoudjou A, Makwana S, Malovini A, Moal B, Mowery DL, Neuraz A, Samayamuthu MJ, Sanz Vidorreta FJ, Schriver ER, Schubert P, Talbert J, Tan ALM, Tan BWL, Tan BWQ, Tibollo V, Tippman P, Verdy G, Yuan W, Avillach P, Gehlenborg N, Omenn GS, Visweswaran S, Cai T, Luo Y, Xia Z. Neurological diagnoses in hospitalized COVID-19 patients associated with adverse outcomes: A multinational cohort study. PLOS Digit Health 2024; 3:e0000484. [PMID: 38620037 PMCID: PMC11018281 DOI: 10.1371/journal.pdig.0000484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 03/06/2024] [Indexed: 04/17/2024]
Abstract
Few studies examining the patient outcomes of concurrent neurological manifestations during acute COVID-19 leveraged multinational cohorts of adults and children or distinguished between central and peripheral nervous system (CNS vs. PNS) involvement. Using a federated multinational network in which local clinicians and informatics experts curated the electronic health records data, we evaluated the risk of prolonged hospitalization and mortality in hospitalized COVID-19 patients from 21 healthcare systems across 7 countries. For adults, we used a federated learning approach whereby we ran Cox proportional hazard models locally at each healthcare system and performed a meta-analysis on the aggregated results to estimate the overall risk of adverse outcomes across our geographically diverse populations. For children, we reported descriptive statistics separately due to their low frequency of neurological involvement and poor outcomes. Among the 106,229 hospitalized COVID-19 patients (104,031 patients ≥18 years; 2,198 patients <18 years, January 2020-October 2021), 15,101 (14%) had at least one CNS diagnosis, while 2,788 (3%) had at least one PNS diagnosis. After controlling for demographics and pre-existing conditions, adults with CNS involvement had longer hospital stay (11 versus 6 days) and greater risk of (Hazard Ratio = 1.78) and faster time to death (12 versus 24 days) than patients with no neurological condition (NNC) during acute COVID-19 hospitalization. Adults with PNS involvement also had longer hospital stay but lower risk of mortality than the NNC group. Although children had a low frequency of neurological involvement during COVID-19 hospitalization, a substantially higher proportion of children with CNS involvement died compared to those with NNC (6% vs 1%). Overall, patients with concurrent CNS manifestation during acute COVID-19 hospitalization faced greater risks for adverse clinical outcomes than patients without any neurological diagnosis. Our global informatics framework using a federated approach (versus a centralized data collection approach) has utility for clinical discovery beyond COVID-19.
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Affiliation(s)
- Meghan R. Hutch
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Jiyeon Son
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Trang T. Le
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Chuan Hong
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, United States of America
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, United States of America
| | - Xuan Wang
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, United States of America
| | - Zahra Shakeri Hossein Abad
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Michele Morris
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Alba Gutiérrez-Sacristán
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Jeffrey G. Klann
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Anastasia Spiridou
- Digital Research, Informatics and Virtual Environments (DRIVE), Great Ormond Street Hospital for Children, London, United Kingdom
| | - Ashley Batugo
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Riccardo Bellazzi
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Vincent Benoit
- IT Department, Innovation & Data, APHP Greater Paris University Hospital, Paris, France
| | - Clara-Lea Bonzel
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - William A. Bryant
- Digital Research, Informatics and Virtual Environments (DRIVE), Great Ormond Street Hospital for Children, London, United Kingdom
| | - Lorenzo Chiudinelli
- UOC Ricerca, Innovazione e Brand reputation, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Kelly Cho
- Population Health and Data Science, VA Boston Healthcare System, Boston Massachusetts, United States of America
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston Massachusetts, United States of America
| | - Priyam Das
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | | | - David A. Hanauer
- Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
| | - Darren W. Henderson
- Center for Clinical and Translational Science, University of Kentucky, Lexington, Kentucky, United States of America
| | - Yuk-Lam Ho
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston Massachusetts, United States of America
| | - Ne Hooi Will Loh
- Department of Anaesthesia, National University Health System, Kent Ridge, Singapore
| | - Adeline Makoudjou
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Simran Makwana
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Alberto Malovini
- Laboratory of Informatics and Systems Engineering for Clinical Research, Istituti Clinici Scientifici Maugeri SpA SB IRCCS, Pavia, Italy
| | - Bertrand Moal
- IAM Unit, Bordeaux University Hospital, Bordeaux, France
| | - Danielle L. Mowery
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Antoine Neuraz
- Department of biomedical informatics, Hôpital Necker-Enfants Malade, Assistance Publique Hôpitaux de Paris (APHP), University of Paris, Paris, France
| | | | - Fernando J. Sanz Vidorreta
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, United States of America
| | - Emily R. Schriver
- Data Analytics Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania, United States of America
| | - Petra Schubert
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston Massachusetts, United States of America
| | - Jeffery Talbert
- Division of Biomedical Informatics, University of Kentucky, Lexington, Kentucky, United States of America
| | - Amelia L. M. Tan
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Byorn W. L. Tan
- Department of Medicine, National University Hospital, Singapore, Kent Ridge, Singapore
| | - Bryce W. Q. Tan
- Department of Medicine, National University Hospital, Singapore, Kent Ridge, Singapore
| | - Valentina Tibollo
- Laboratory of Informatics and Systems Engineering for Clinical Research, Istituti Clinici Scientifici Maugeri SpA SB IRCCS, Pavia, Italy
| | - Patric Tippman
- Institute of Medical Biometry and University of Freiburg, Medical Center, Freiburg, Germany
| | | | - William Yuan
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Paul Avillach
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Nils Gehlenborg
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Gilbert S. Omenn
- Departments of Computational Medicine & Bioinformatics, Internal Medicine, Human Genetics, Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
| | | | - Shyam Visweswaran
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Tianxi Cai
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Yuan Luo
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Zongqi Xia
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
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Levine L, Son J, Yu A, Wesley S, De Jager PL, Moynihan E, Farber RS, Rosser M, Haque H, Riley CS. Inflammatory vaginitis in four B-cell suppressed women with Multiple Sclerosis. Mult Scler Relat Disord 2024; 82:105387. [PMID: 38134606 DOI: 10.1016/j.msard.2023.105387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/04/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023]
Abstract
B-cell depleting therapies are effective in multiple sclerosis (MS) and are widely used (Hauser et al., 2017). Inflammatory vaginitis (IV), characterized by unexplained vaginal symptoms including mucopurulent discharge, pain, irritation, and dyspareunia, has been reported in one MS patient on ocrelizumab (Filikci and Jensen, 2022), and to be present in 3.5 % of women on rituximab for autoimmune diseases (Yockey et al., 2021). We report here four cases of IV in B cell depleted women with MS. B-cell reconstitution was temporally associated with improvement of IV symptoms. Further investigation and vigilance for this potential treatment emergent adverse event affecting sexual and reproductive health of women with MS is needed.
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Affiliation(s)
- Libby Levine
- Department of Neurology, Columbia University Irving Medical Center, USA
| | - Jiyeon Son
- Department of Neurology, Columbia University Irving Medical Center, USA
| | - Amy Yu
- Baptist Health South Florida, Marcus Neuroscience Institute, USA
| | - Sarah Wesley
- Department of Neurology, Columbia University Irving Medical Center, USA
| | - Philip L De Jager
- Department of Neurology, Columbia University Irving Medical Center, USA
| | - Erin Moynihan
- Department of Neurology, Columbia University Irving Medical Center, USA
| | | | - Mary Rosser
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, USA
| | - Hoosna Haque
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, USA
| | - Claire S Riley
- Department of Neurology, Columbia University Irving Medical Center, USA.
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Son J, Park H, Yoon E, Kim JI, Choi CH. Development of Novel Focal Irradiation Tool for High-Precision Irradiation Using Clinical Brachytherapy System. Int J Radiat Oncol Biol Phys 2023; 117:e655-e656. [PMID: 37785945 DOI: 10.1016/j.ijrobp.2023.06.2085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Several small animals, including mice, are used to conduct research on state-of-the-art radiation therapy techniques or treatment-related toxicity. However, it is difficult to conduct the focal irradiation to a shallow depth on small animals, because irradiation using LINAC has limitations in energy and field size. The purpose of this paper was to develop a focal irradiation tool for high-precision irradiation and to evaluate beam characteristics. MATERIALS/METHODS We designed the collimator of 1 mm diameter consisting of tungsten material for high-precision irradiation applied to the clinical brachytherapy system and the percent depth dose and horizontal profile were measured. We compared the depth dose and horizontal profile with 4 mm diameter SRS cone for 6 MV in LINAC. We measured the PDD and horizontal profile using EBT3 film for high-precision irradiation of 1 mm diameter using Ir-192 source. In case of 4 mm diameter, the beam was measured using edge detector. In addition, all measurements were compared with the results of planning tool simulation. RESULTS In case of focal irradiation tool, the maximum dose showed at the surface for both measurement and simulation, and 26% and 32% doses at 1 mm depth, respectively. In addition, FWHM at a 1 mm depth showed that high-precision irradiation was possible with measurement and simulation results of 1.86 and 1.28 mm. In case of LINAC, the maximum dose was showed at a depth of 1 cm and 0.8 cm in the measurement and simulation, respectively. Even if the smallest cone is used, the FWHM at a dmax depth was 4.0 mm in both simulation and measurement. CONCLUSION We overcame the limitation for energy and field size through the focal irradiation tool for high-precision irradiation. The focal irradiation tool enables high dose delivery to the shallow depth. In addition, small FWHM reduced dose delivery to the periphery at a specific depth and enabled accurate dose delivery. These results mean that the focal irradiation tool can be useful in small animal experiments that require accurate doses near the shallow depth.
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Affiliation(s)
- J Son
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea, Republic of (South) Korea
| | - H Park
- Department of Radiological Convergence Engineering, Yonsei University, Seoul, Korea, Republic of (South) Korea
| | - E Yoon
- Interdisciplinary Program in Bioengineering, Seoul National University, Seoul, Korea, Republic of (South) Korea
| | - J I Kim
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea, Republic of (South) Korea
| | - C H Choi
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea, Republic of (South) Korea
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Park YI, Choi SH, Hong CS, Cho MS, Son J, Han MC, Kim J, Kim H, Kim DW, Kim JS. A Photograph-Based Visualization and Prediction Framework for Radiation-Induced Dermatitis. Int J Radiat Oncol Biol Phys 2023; 117:e480-e481. [PMID: 37785522 DOI: 10.1016/j.ijrobp.2023.06.1701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) This study aimed to suggest a photograph-based prediction system for acute radiation-induced dermatitis (RID), which can be applied to notify patients about the risk of the development of skin discomfort during radiotherapy. MATERIALS/METHODS The proposed system compared the spatial dose distribution with the RID region using the following methods. Skin photographs of patients were taken using an RGB-depth camera to acquire the shape information of RID. The skin surface data measured from the camera was registered with the shape of the external body contour using an iterative closest point algorithm. Spatial dose distribution of skin was extracted from the external body contour to a depth of 2 mm and projected onto the plane of the skin photograph using a transformation matrix for skin depth data. To compare the spatial distribution of skin dose with the shape of RID, the region of RID in patients' skin was delineated on photographs into three toxicity symptoms referring to the CTCAE criteria grade 1 (skin redness), grade 2 (dry desquamation), and grade 3 (moist desquamation). The degree of overlap between the shape of each RID and skin dose distribution was evaluated using the dice similarity coefficient (DSC). Threshold doses for predicting RID occurrence were estimated by skin isodose lines with the highest DSC. The developed system was validated using data from 19 patients who received volumetric modulated arc therapy for head-neck cancer at a single institution. RESULTS Threshold doses for RID grades 1, 2, and 3 were estimated using 18, 18, and 2 individual RID labels delineated on skin photographs, respectively. Isodose lines with the highest DSC for RID grades 1, 2, and 3 were calculated as 26.0 Gy, 36.5 Gy, and 54.0 Gy, respectively. A strong overlap (average DSC > 0.6) was observed between isodose skin lines and the shape of RID labels in all RID grades. CONCLUSION Assessing the spatial information of skin dose can be helpful in predicting acute RID. The region of RID shows a strong similarity with the skin dose distribution in head-neck patients. Visualization of skin dose on the patient photograph is potent to patient education for preparing the cosmetic discomfort during radiotherapy, which may lead to the improvement of the patient satisfaction in treatment.
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Affiliation(s)
- Y I Park
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea; Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - S H Choi
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea; Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - C S Hong
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea; Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - M S Cho
- Department of Radiation Oncology, Yongin Severance Hospital, Yonsei University College of Medicine, Gyeonggi-do, Korea, Republic of (South) Korea
| | - J Son
- Department of Radiation Oncology, Yongin Severance Hospital, Yonsei University College of Medicine, Gyeonggi-do, Korea, Republic of (South) Korea
| | - M C Han
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea; Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - J Kim
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea; Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - H Kim
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea; Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - D W Kim
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea; Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - J S Kim
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea; Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
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Park YI, Choi SH, Hong CS, Cho MS, Son J, Han MC, Kim J, Kim H, Kim DW, Kim JS. A New Approach to Quantify and Grade Radiation Dermatitis Using Deep-Learning Segmentation in Skin Photographs. Clin Oncol (R Coll Radiol) 2023; 35:e10-e19. [PMID: 35918275 DOI: 10.1016/j.clon.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 06/15/2022] [Accepted: 07/06/2022] [Indexed: 01/04/2023]
Abstract
AIMS Objective evaluation of radiation dermatitis is important for analysing the correlation between the severity of radiation dermatitis and dose distribution in clinical practice and for reliable reporting in clinical trials. We developed a novel radiation dermatitis segmentation system based on convolutional neural networks (CNNs) to consistently evaluate radiation dermatitis. MATERIALS AND METHODS The radiation dermatitis segmentation system is designed to segment the radiation dermatitis occurrence area using skin photographs and skin-dose distribution. A CNN architecture with a dilated convolution layer and skip connection was designed to estimate the radiation dermatitis area. Seventy-three skin photographs obtained from patients undergoing radiotherapy were collected for training and testing. The ground truth of radiation dermatitis segmentation is manually delineated from the skin photograph by an experienced radiation oncologist and medical physicist. We converted the skin photographs to RGB (red-green-blue) and CIELAB (lightness (L∗), red-green (a∗) and blue-yellow (b∗)) colour information and trained the network to segment faint and severe radiation dermatitis using three different input combinations: RGB, RGB + CIELAB (RGBLAB) and RGB + CIELAB + skin-dose distribution (RGBLAB_D). The proposed system was evaluated using the Dice similarity coefficient (DSC), sensitivity, specificity and normalised Matthews correlation coefficient (nMCC). A paired t-test was used to compare the results of different segmentation performances. RESULTS Optimal data composition was observed in the network trained for radiation dermatitis segmentation using skin photographs and skin-dose distribution. The average DSC, sensitivity, specificity and nMCC values of RGBLAB_D were 0.62, 0.61, 0.91 and 0.77, respectively, in faint radiation dermatitis, and 0.69, 0.78, 0.96 and 0.83, respectively, in severe radiation dermatitis. CONCLUSION Our study showed that CNN-based radiation dermatitis segmentation in skin photographs of patients undergoing radiotherapy can describe radiation dermatitis severity and pattern. Our study could aid in objectifying the radiation dermatitis grading and analysing the reliable correlation between dosimetric factors and the morphology of radiation dermatitis.
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Affiliation(s)
- Y I Park
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, South Korea; Medical Physics and Biomedical Engineering Lab (MPBEL), Yonsei University College of Medicine, Seoul, South Korea
| | - S H Choi
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, South Korea; Department of Radiation Oncology, Yongin Severance Hospital, Yongin, South Korea
| | - C-S Hong
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, South Korea.
| | - M-S Cho
- Department of Radiation Oncology, Yongin Severance Hospital, Yongin, South Korea
| | - J Son
- Department of Radiation Oncology, Yongin Severance Hospital, Yongin, South Korea
| | - M C Han
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, South Korea
| | - J Kim
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, South Korea
| | - H Kim
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, South Korea
| | - D W Kim
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, South Korea
| | - J S Kim
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, South Korea; Medical Physics and Biomedical Engineering Lab (MPBEL), Yonsei University College of Medicine, Seoul, South Korea.
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Jung S, Kim B, Lee S, Chang W, Park J, Choi C, Son J, Lee J, Wu H, Kim J, Kim J. Geometric and Dosimetric Evaluation of Using a Novel Tongue Positioning Device to Reduce Tongue Motions during Radiation Therapy for Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Kang B, Lee J, Xue L, Son J, Wu H, Kim H, Kang H. Prediction of Delayed Lymphopenia at the Time of Consolidation Immunotherapy After Chemoradiotherapy in Locally Advanced Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Le TT, Gutiérrez-Sacristán A, Son J, Hong C, South AM, Beaulieu-Jones BK, Loh NHW, Luo Y, Morris M, Ngiam KY, Patel LP, Samayamuthu MJ, Schriver E, Tan ALM, Moore J, Cai T, Omenn GS, Avillach P, Kohane IS, Visweswaran S, Mowery DL, Xia Z. Multinational characterization of neurological phenotypes in patients hospitalized with COVID-19. Sci Rep 2021; 11:20238. [PMID: 34642371 PMCID: PMC8510999 DOI: 10.1038/s41598-021-99481-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 09/23/2021] [Indexed: 01/08/2023] Open
Abstract
Neurological complications worsen outcomes in COVID-19. To define the prevalence of neurological conditions among hospitalized patients with a positive SARS-CoV-2 reverse transcription polymerase chain reaction test in geographically diverse multinational populations during early pandemic, we used electronic health records (EHR) from 338 participating hospitals across 6 countries and 3 continents (January-September 2020) for a cross-sectional analysis. We assessed the frequency of International Classification of Disease code of neurological conditions by countries, healthcare systems, time before and after admission for COVID-19 and COVID-19 severity. Among 35,177 hospitalized patients with SARS-CoV-2 infection, there was an increase in the proportion with disorders of consciousness (5.8%, 95% confidence interval [CI] 3.7-7.8%, pFDR < 0.001) and unspecified disorders of the brain (8.1%, 5.7-10.5%, pFDR < 0.001) when compared to the pre-admission proportion. During hospitalization, the relative risk of disorders of consciousness (22%, 19-25%), cerebrovascular diseases (24%, 13-35%), nontraumatic intracranial hemorrhage (34%, 20-50%), encephalitis and/or myelitis (37%, 17-60%) and myopathy (72%, 67-77%) were higher for patients with severe COVID-19 when compared to those who never experienced severe COVID-19. Leveraging a multinational network to capture standardized EHR data, we highlighted the increased prevalence of central and peripheral neurological phenotypes in patients hospitalized with COVID-19, particularly among those with severe disease.
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Affiliation(s)
- Trang T Le
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | | | - Jiyeon Son
- Department of Neurology, University of Pittsburgh, Biomedical Science Tower 3, Suite 7014, 3501 5th Avenue, Pittsburgh, PA, 15260, USA
| | - Chuan Hong
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Andrew M South
- Department of Pediatrics, Wake Forest School of Medicine, Winston Salem, NC, USA
| | | | - Ne Hooi Will Loh
- Department of Critical Care, National University Health Systems, Singapore, Singapore
| | - Yuan Luo
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Michele Morris
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kee Yuan Ngiam
- Department of Surgery, National University Health Systems, Singapore, Singapore
| | - Lav P Patel
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | | | - Emily Schriver
- Data Analytics Center, University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Amelia L M Tan
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Jason Moore
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Tianxi Cai
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Gilbert S Omenn
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Paul Avillach
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Isaac S Kohane
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Shyam Visweswaran
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Danielle L Mowery
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Zongqi Xia
- Department of Neurology, University of Pittsburgh, Biomedical Science Tower 3, Suite 7014, 3501 5th Avenue, Pittsburgh, PA, 15260, USA.
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Rocha M, Desai S, Son J, Tonetti DA, Jovin T, Jadhav AP. Clinical characteristics of fast and slow progressors of infarct growth in anterior circulation large vessel occlusion stroke. J Cereb Blood Flow Metab 2021; 41:271678X211015068. [PMID: 34139885 PMCID: PMC8221763 DOI: 10.1177/0271678x211015068] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 11/16/2022]
Abstract
Fast and slow progressor phenotypes of infarct growth due to anterior circulation large vessel occlusion (ACLVO) remain poorly understood. We aimed to define clinical predictors of fast and slow progressors in a retrospective study of patients with ACLVO who underwent baseline advanced imaging within 24 hours of stroke onset. Fast progressors (ischemic core > 70 ml, < 6 hours after onset) and slow progressors (ischemic core ≤ 30 ml, 6 to 24 hours after onset) were identified amongst 185 patients. Clinical and laboratory variables were tested for association with fast or slow progressor status. In the early epoch, no significant differences were found between fast progressors and controls. In the delayed epoch, slow progressors had a median NIHSS of 14 versus 20 (p < 0.01) and MCA occlusion in 80% versus 63% (p < 0.05) relative to controls. In multivariate analyses, NIHSS (OR 0.83, 95% CI 0.73-0.95), hyperlipidemia (OR 4.24, 95% CI 1.01 - 19.3) and hemoglobin concentration (OR 0.75, 95% CI 0.57 - 0.99) were independently associated with slow progressor status. This study indicates that lower initial stroke symptom severity, a history of hyperlipidemia and mild anemia are associated with individual tolerance to ACLVO stroke.
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Affiliation(s)
- Marcelo Rocha
- Department of Neurology , University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Shashvat Desai
- Department of Neurology , University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Jiyeon Son
- Department of Neurology , University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Daniel A Tonetti
- Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Tudor Jovin
- Cooper University Hospital Neurological Institute, Camden, NJ, USA
| | - Ashutosh P Jadhav
- Department of Neurology , University of Pittsburgh Medical Center, Pittsburgh, PA, USA
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA
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Le TT, Gutiérrez-Sacristán A, Son J, Hong C, South AM, Beaulieu-Jones BK, Loh NHW, Luo Y, Morris M, Ngiam KY, Patel LP, Samayamuthu MJ, Schriver E, Tan AL, Moore J, Cai T, Omenn GS, Avillach P, Kohane IS, Visweswaran S, Mowery DL, Xia Z. Multinational Prevalence of Neurological Phenotypes in Patients Hospitalized with COVID-19. medRxiv 2021. [PMID: 33655281 PMCID: PMC7924306 DOI: 10.1101/2021.01.27.21249817] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE: Neurological complications can worsen outcomes in COVID-19. We defined the prevalence of a wide range of neurological conditions among patients hospitalized with COVID-19 in geographically diverse multinational populations. METHODS: Using electronic health record (EHR) data from 348 participating hospitals across 6 countries and 3 continents between January and September 2020, we performed a cross-sectional study of hospitalized adult and pediatric patients with a positive SARS-CoV-2 reverse transcription polymerase chain reaction test, both with and without severe COVID-19. We assessed the frequency of each disease category and 3-character International Classification of Disease (ICD) code of neurological diseases by countries, sites, time before and after admission for COVID-19, and COVID-19 severity. RESULTS: Among the 35,177 hospitalized patients with SARS-CoV-2 infection, there was increased prevalence of disorders of consciousness (5.8%, 95% confidence interval [CI]: 3.7%−7.8%, pFDR<.001) and unspecified disorders of the brain (8.1%, 95%CI: 5.7%−10.5%, pFDR<.001), compared to pre-admission prevalence. During hospitalization, patients who experienced severe COVID-19 status had 22% (95%CI: 19%−25%) increase in the relative risk (RR) of disorders of consciousness, 24% (95%CI: 13%−35%) increase in other cerebrovascular diseases, 34% (95%CI: 20%−50%) increase in nontraumatic intracranial hemorrhage, 37% (95%CI: 17%−60%) increase in encephalitis and/or myelitis, and 72% (95%CI: 67%−77%) increase in myopathy compared to those who never experienced severe disease. INTERPRETATION: Using an international network and common EHR data elements, we highlight an increase in the prevalence of central and peripheral neurological phenotypes in patients hospitalized with SARS-CoV-2 infection, particularly among those with severe disease.
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Affiliation(s)
- Trang T Le
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | | | - Jiyeon Son
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Chuan Hong
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Andrew M South
- Department of Pediatrics, Wake Forest School of Medicine, Winston Salem, NC, USA
| | | | - Ne Hooi Will Loh
- Department of Critical Care, National University Health Systems, Singapore
| | - Yuan Luo
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Michele Morris
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kee Yuan Ngiam
- Department of Surgery, National University Health Systems, Singapore
| | - Lav P Patel
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | | | - Emily Schriver
- Data Analytics Center, University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Amelia Lm Tan
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Jason Moore
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Tianxi Cai
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Gilbert S Omenn
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Paul Avillach
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Isaac S Kohane
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | | | - Shyam Visweswaran
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Danielle L Mowery
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Zongqi Xia
- Department of Neurology, University of Pittsburgh, PA, USA
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12
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Son J, Tran T, Yao M, Michener C. Factors associated with successful same-day discharge in patients undergoing minimally invasive hysterectomy for endometrial cancer and atypical complex hyperplasia. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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13
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AlHilli M, Son J, Carr C, Yao M, Michener C, Rose P. Mismatch repair deficiency is predictive of improved response to radiation therapy in patients with advanced or recurrent endometrial cancer. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Son J, Carr C, Chambers LM, Michener C, Meng Y, Yen T, Beavis A, Stone R, Wethington S, Burkett W, Richardson D, Staley AS, Ahn S, Gehrig P, Torres D, Dowdy S, Sullivan M, Modesitt S, Watson C, Secord A, Veade A, Havrilesky L, Loreen A, Griffin K, Jackson A, Fader AN, Ricci S. Adjuvant treatment in high intermediate risk early stage endometrial cancer. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2019.11.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Chen X, Grimm J, Baker B, Son J, Siu C, Redmond K, Bettegowda C, Lim M, Kleinberg L. Fractionated Stereotactic Radiosurgery for Brainstem Metastasis and Brainstem Tolerance. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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16
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Son J, Carr C, Radeva M, Priyadarshini A, Marquard J, AlHilli M. Molecular and pathologic features of endometrial cancer in young patients. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.03.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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17
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Son J, Carr C, Yao M, Radeva M, Priyadarshini A, Marquard J, AlHilli M. Characterization of endometrial cancer in young patients diagnosed under the age of 40 years. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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18
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Yen T, Beavis A, Stone R, Wethington S, Carr C, Son J, Chambers LM, Ricci S, Burkett W, Richardson D, Staley A, Ahn S, Gehrig P, Torres D, Dowdy S, Sullivan M, Modesitt S, Watson C, Secord A, Veade A, Havrilesky L, Loreen A, Griffin K, Jackson A, Fader A. Early-stage endometrial cancer with lymphovascular space invasion: Chemotherapy improves progression free survival and reduces distant metastases. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Cho S, Son J, Kim H, Jeong J, Lee S, Lim Y, Lee S, Yoon M, Shin D. The Development of New Dosimetry System using an Optic-Disk Radiation Sensor for Pencil Beam Scanning Mode. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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20
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Peng L, Chen L, Han P, Baker B, Shen C, Gui C, Sheikh K, Ames H, Kirschbaum T, Silvestri F, Son J, Robinson A, Huang E, Grimm J, Redmond K, Lim M, Lee J, Kleinberg L. Concurrent Immunotherapy Usage and Asymmetric Growth May Distinguish True Progression from Treatment Effect in Growing Brain Metastases after Stereotactic Radiosurgery. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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21
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Gordon AC, Gillespie C, Son J, Polhill T, Leibman S, Smith GS. Long-term outcomes of laparoscopic large hiatus hernia repair with nonabsorbable mesh. Dis Esophagus 2018; 31:4850447. [PMID: 29444215 DOI: 10.1093/dote/dox156] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 08/07/2017] [Accepted: 12/06/2017] [Indexed: 12/11/2022]
Abstract
The use of mesh to augment suture repair of large hiatus hernias remains controversial. Repair with mesh may help reduce the recurrence rate of primary repair, but concerns about the potential for serious complications, such as mesh erosion or stricturing, continue to limit its use. We aim to evaluate the long-term outcome of primary hiatus hernia repair with lightweight polypropylene mesh (TiMesh) specifically looking at rates of clinical recurrence, dysphagia, and mesh-related complications. From a prospectively maintained database, 50 consecutive patients who underwent elective primary laparoscopic hiatal hernia repair with TiMesh between January 2005 and December 2007 were identified. Case notes and postoperative endoscopy reports were reviewed. Clinical outcomes were evaluated using a structured questionnaire, including a validated dysphagia score. Of the 50 patients identified, 36 (72%) were contactable for follow-up. At a median follow-up of 9 years, the majority of patients (97%) regarded their surgery as successful. Twelve patients (33%) reported a recurrence of their symptoms, but only 4 (11%) reported that their symptoms were as severe as prior to the surgery. There was no significant difference between pre- and postoperative dysphagia scores. Postoperative endoscopy reports were available for 32 patients at a median time point of 4 years postoperatively, none of which revealed any mesh-related complications. One patient had undergone a revision procedure for a recurrent hernia at another institution. In this series, primary repair of large hiatus hernia with nonabsorbable mesh was not associated with any adverse effects over time. Patient satisfaction with symptomatic outcome remained high in the long term.
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Affiliation(s)
- A C Gordon
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - C Gillespie
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - J Son
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - T Polhill
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - S Leibman
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - G S Smith
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia
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22
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Kang KT, Son J, Suh DS, Kwon SK, Kwon OR, Koh YG. Patient-specific medial unicompartmental knee arthroplasty has a greater protective effect on articular cartilage in the lateral compartment: A Finite Element Analysis. Bone Joint Res 2018; 7:20-27. [PMID: 29305427 PMCID: PMC5805830 DOI: 10.1302/2046-3758.71.bjr-2017-0115.r2] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Patient-specific (PS) implantation surgical technology has been introduced in recent years and a gradual increase in the associated number of surgical cases has been observed. PS technology uses a patient's own geometry in designing a medical device to provide minimal bone resection with improvement in the prosthetic bone coverage. However, whether PS unicompartmental knee arthroplasty (UKA) provides a better biomechanical effect than standard off-the-shelf prostheses for UKA has not yet been determined, and still remains controversial in both biomechanical and clinical fields. Therefore, the aim of this study was to compare the biomechanical effect between PS and standard off-the-shelf prostheses for UKA. METHODS The contact stresses on the polyethylene (PE) insert, articular cartilage and lateral meniscus were evaluated in PS and standard off-the-shelf prostheses for UKA using a validated finite element model. Gait cycle loading was applied to evaluate the biomechanical effect in the PS and standard UKAs. RESULTS The contact stresses on the PE insert were similar for both the PS and standard UKAs. Compared with the standard UKA, the PS UKA did not show any biomechanical effect on the medial PE insert. However, the contact stresses on the articular cartilage and the meniscus in the lateral compartment following the PS UKA exhibited closer values to the healthy knee joint compared with the standard UKA. CONCLUSION The PS UKA provided mechanics closer to those of the normal knee joint. The decreased contact stress on the opposite compartment may reduce the overall risk of progressive osteoarthritis.Cite this article: K-T. Kang, J. Son, D-S. Suh, S. K. Kwon, O-R. Kwon, Y-G. Koh. Patient-specific medial unicompartmental knee arthroplasty has a greater protective effect on articular cartilage in the lateral compartment: A Finite Element Analysis. Bone Joint Res 2018;7:20-27. DOI: 10.1302/2046-3758.71.BJR-2017-0115.R2.
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Affiliation(s)
- K-T. Kang
- Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea
| | - J. Son
- Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea
| | - D-S. Suh
- Department of Orthopaedic Surgery, Joint Reconstruction Center, Yonsei Sarang Hospital, 10 Hyoryeong-ro, Seocho-gu, Seoul 06698, South Korea
| | - S. K. Kwon
- Department of Orthopaedic Surgery, Joint Reconstruction Center, Yonsei Sarang Hospital, 10 Hyoryeong-ro, Seocho-gu, Seoul 06698, South Korea
| | - O-R. Kwon
- Department of Orthopaedic Surgery, Joint Reconstruction Center, Yonsei Sarang Hospital, 10 Hyoryeong-ro, Seocho-gu, Seoul 06698, South Korea
| | - Y-G. Koh
- Department of Orthopaedic Surgery, Joint Reconstruction Center, Yonsei Sarang Hospital, 10 Hyoryeong-ro, Seocho-gu, Seoul 06698, South Korea
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23
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Kang KT, Koh YG, Son J, Kwon OR, Lee JS, Kwon SK. A computational simulation study to determine the biomechanical influence of posterior condylar offset and tibial slope in cruciate retaining total knee arthroplasty. Bone Joint Res 2018; 7:69-78. [PMID: 29330345 PMCID: PMC5805829 DOI: 10.1302/2046-3758.71.bjr-2017-0143.r1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objectives Posterior condylar offset (PCO) and posterior tibial slope (PTS) are critical factors in total knee arthroplasty (TKA). A computational simulation was performed to evaluate the biomechanical effect of PCO and PTS on cruciate retaining TKA. Methods We generated a subject-specific computational model followed by the development of ± 1 mm, ± 2 mm and ± 3 mm PCO models in the posterior direction, and -3°, 0°, 3° and 6° PTS models with each of the PCO models. Using a validated finite element (FE) model, we investigated the influence of the changes in PCO and PTS on the contact stress in the patellar button and the forces on the posterior cruciate ligament (PCL), patellar tendon and quadriceps muscles under the deep knee-bend loading conditions. Results Contact stress on the patellar button increased and decreased as PCO translated to the anterior and posterior directions, respectively. In addition, contact stress on the patellar button decreased as PTS increased. These trends were consistent in the FE models with altered PCO. Higher quadriceps muscle and patellar tendon force are required as PCO translated in the anterior direction with an equivalent flexion angle. However, as PTS increased, quadriceps muscle and patellar tendon force reduced in each PCO condition. The forces exerted on the PCL increased as PCO translated to the posterior direction and decreased as PTS increased. Conclusion The change in PCO alternatively provided positive and negative biomechanical effects, but it led to a reduction in a negative biomechanical effect as PTS increased. Cite this article: K-T. Kang, Y-G. Koh, J. Son, O-R. Kwon, J-S. Lee, S. K. Kwon. A computational simulation study to determine the biomechanical influence of posterior condylar offset and tibial slope in cruciate retaining total knee arthroplasty. Bone Joint Res 2018;7:69–78. DOI: 10.1302/2046-3758.71.BJR-2017-0143.R1.
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Affiliation(s)
- K-T Kang
- Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea
| | - Y-G Koh
- Joint Reconstruction Center, Department of Orthopaedic Surgery, Yonsei Sarang Hospital, 10 Hyoryeong-ro, Seocho-gu, Seoul 06698, South Korea
| | - J Son
- Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea
| | - O-R Kwon
- Joint Reconstruction Center, Department of Orthopaedic Surgery, Yonsei Sarang Hospital, 10 Hyoryeong-ro, Seocho-gu, Seoul 06698, South Korea
| | - J-S Lee
- Joint Reconstruction Center, Department of Orthopaedic Surgery, Yonsei Sarang Hospital, 10 Hyoryeong-ro, Seocho-gu, Seoul 06698, South Korea
| | - S K Kwon
- Joint Reconstruction Center, Department of Orthopaedic Surgery, Yonsei Sarang Hospital, 10 Hyoryeong-ro, Seocho-gu, Seoul 06698, South Korea
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Sandilands LJ, Kyung W, Kim SY, Son J, Kwon J, Kang TD, Yoshida Y, Moon SJ, Kim C, Noh TW. Spin-Orbit Coupling and Interband Transitions in the Optical Conductivity of Sr_{2}RhO_{4}. Phys Rev Lett 2017; 119:267402. [PMID: 29328701 DOI: 10.1103/physrevlett.119.267402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Indexed: 06/07/2023]
Abstract
The prototypical correlated metal Sr_{2}RhO_{4} was studied using optical and photoemission spectroscopy. At low energies and temperatures, the optical data reveal a complex, multicomponent response that on the surface points to an unconventional metallic state in this material. Via a comparison with photoemission, the anomalous optical response may be attributed to an unexpectedly strong interband transition near 180 meV between spin-orbit coupled bands that are nearly parallel along ΓX. This spin-orbit coupling effect is shown to occur in a number of related metallic ruthenates and explains the previously puzzling optical properties reported for these materials.
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Affiliation(s)
- Luke J Sandilands
- Center for Correlated Electron Systems, Institute for Basic Science, Seoul 08826, Republic of Korea
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Republic of Korea
- Measurement Science and Standards, National Research Council Canada, Ottawa, Ottawa K1A 0R6 Canada
| | - Wonshik Kyung
- Center for Correlated Electron Systems, Institute for Basic Science, Seoul 08826, Republic of Korea
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Republic of Korea
| | - So Yeun Kim
- Center for Correlated Electron Systems, Institute for Basic Science, Seoul 08826, Republic of Korea
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Republic of Korea
| | - J Son
- Center for Correlated Electron Systems, Institute for Basic Science, Seoul 08826, Republic of Korea
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Republic of Korea
| | - J Kwon
- Center for Correlated Electron Systems, Institute for Basic Science, Seoul 08826, Republic of Korea
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Republic of Korea
| | - T D Kang
- Center for Correlated Electron Systems, Institute for Basic Science, Seoul 08826, Republic of Korea
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Republic of Korea
| | - Y Yoshida
- National Institute of Advanced Industrial Science and Technology, Tsukuba 305-8568, Japan
| | - S J Moon
- Department of Physics, Hanyang University, Seoul 04763, Republic of Korea
| | - C Kim
- Center for Correlated Electron Systems, Institute for Basic Science, Seoul 08826, Republic of Korea
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Republic of Korea
| | - Tae Won Noh
- Center for Correlated Electron Systems, Institute for Basic Science, Seoul 08826, Republic of Korea
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Republic of Korea
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Cho J, Kim Y, Ahn H, I H, Son J. P3.16-006 Impact of Limited Resection or Omitted Adjuvant Therapy in Patients with Pathologic Stage II and III Non-Small-Cell Lung Cancer. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Cho J, Kim Y, Ahn H, I H, Son J. P1.16-001 Characteristics of Resected Lung Cancer in Patients Aged Under 60: A Single–Center Experience. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Lee J, Rho J, Son J, Choi C. P3.02-088 Enhanced Glycolysis Is Critical for Maintaining Inactivation of JNK and Stability of EGFR Leading to the Survival of EGFR-Mutant Lung Cancer Cells. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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28
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Suh DS, Kang KT, Son J, Kwon OR, Baek C, Koh YG. Computational study on the effect of malalignment of the tibial component on the biomechanics of total knee arthroplasty: A Finite Element Analysis. Bone Joint Res 2017; 6:623-630. [PMID: 29162607 PMCID: PMC5717075 DOI: 10.1302/2046-3758.611.bjr-2016-0088.r2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Accepted: 07/03/2017] [Indexed: 11/10/2022] Open
Abstract
Objectives Malalignment of the tibial component could influence the long-term survival of a total knee arthroplasty (TKA). The object of this study was to investigate the biomechanical effect of varus and valgus malalignment on the tibial component under stance-phase gait cycle loading conditions. Methods Validated finite element models for varus and valgus malalignment by 3° and 5° were developed to evaluate the effect of malalignment on the tibial component in TKA. Maximum contact stress and contact area on a polyethylene insert, maximum contact stress on patellar button and the collateral ligament force were investigated. Results There was greater total contact stress in the varus alignment than in the valgus, with more marked difference on the medial side. An increase in ligament force was clearly demonstrated, especially in the valgus alignment and force exerted on the medial collateral ligament also increased. Conclusion These results highlight the importance of accurate surgical reconstruction of the coronal tibial alignment of the knee joint. Varus and valgus alignments will influence wear and ligament stability, respectively in TKA. Cite this article: D-S. Suh, K-T. Kang, J. Son, O-R. Kwon, C. Baek, Y-G. Koh. Computational study on the effect of malalignment of the tibial component on the biomechanics of total knee arthroplasty: A Finite Element Analysis. Bone Joint Res 2017;6:623–630. DOI: 10.1302/2046-3758.611.BJR-2016-0088.R2.
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Affiliation(s)
- D-S Suh
- Department of Orthopaedic Surgery, Joint Reconstruction Center, Yonsei Sarang Hospital, 10 Hyoryeongro, Seocho-gu, Seoul, 06698, Republic of Korea
| | - K-T Kang
- Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - J Son
- Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - O-R Kwon
- Department of Orthopaedic Surgery, Joint Reconstruction Center, Yonsei Sarang Hospital, 10 Hyoryeongro, Seocho-gu, Seoul, 06698, Republic of Korea
| | - C Baek
- Department of Orthopaedic Surgery, Joint Reconstruction Center, Yonsei Sarang Hospital, 10 Hyoryeongro, Seocho-gu, Seoul, 06698, Republic of Korea
| | - Y-G Koh
- Department of Orthopaedic Surgery, Joint Reconstruction Center, Yonsei Sarang Hospital, 10 Hyoryeongro, Seocho-gu, Seoul, 06698, Republic of Korea
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Cho J, Kim Y, Ahn H, I H, Son J. P2.16-011 Unsuspectedly Detected Isolated Fibrinogen Deficiency in a Patient with Lung Adenocarcinoma after Surgery. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Park M, Seo H, Kim B, Son J, Liu K, Park B, Kim M, Hong S. 123 The fatty-acid chain length of ceramides is negatively affected by chronic UV exposure. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kim H, Choi Y, Son J, Cho Y, Chung B, Park C. 142 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) regulates the expression of AhR-related factors(AhR, ARNT, CYP1A1), and cytokines in peripheral blood mononuclear cells and changes in differentiation of CD4+ T cells from healthy subjects, patients with atopic dermatitis and psoriasis. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Koh YG, Son J, Kwon SK, Kim HJ, Kwon OR, Kang KT. Preservation of kinematics with posterior cruciate-, bicruciate- and patient-specific bicruciate-retaining prostheses in total knee arthroplasty by using computational simulation with normal knee model. Bone Joint Res 2017; 6:557-565. [PMID: 28947604 PMCID: PMC5631000 DOI: 10.1302/2046-3758.69.bjr-2016-0250.r1] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 06/30/2017] [Indexed: 12/11/2022] Open
Abstract
Objectives Preservation of both anterior and posterior cruciate ligaments in total knee arthroplasty (TKA) can lead to near-normal post-operative joint mechanics and improved knee function. We hypothesised that a patient-specific bicruciate-retaining prosthesis preserves near-normal kinematics better than standard off-the-shelf posterior cruciate-retaining and bicruciate-retaining prostheses in TKA. Methods We developed the validated models to evaluate the post-operative kinematics in patient-specific bicruciate-retaining, standard off-the-shelf bicruciate-retaining and posterior cruciate-retaining TKA under gait and deep knee bend loading conditions using numerical simulation. Results Tibial posterior translation and internal rotation in patient-specific bicruciate-retaining prostheses preserved near-normal kinematics better than other standard off-the-shelf prostheses under gait loading conditions. Differences from normal kinematics were minimised for femoral rollback and internal-external rotation in patient-specific bicruciate-retaining, followed by standard off-the-shelf bicruciate-retaining and posterior cruciate-retaining TKA under deep knee bend loading conditions. Moreover, the standard off-the-shelf posterior cruciate-retaining TKA in this study showed the most abnormal performance in kinematics under gait and deep knee bend loading conditions, whereas patient-specific bicruciate-retaining TKA led to near-normal kinematics. Conclusion This study showed that restoration of the normal geometry of the knee joint in patient-specific bicruciate-retaining TKA and preservation of the anterior cruciate ligament can lead to improvement in kinematics compared with the standard off-the-shelf posterior cruciate-retaining and bicruciate-retaining TKA. Cite this article: Y-G. Koh, J. Son, S-K. Kwon, H-J. Kim, O-R. Kwon, K-T. Kang. Preservation of kinematics with posterior cruciate-, bicruciate- and patient-specific bicruciate-retaining prostheses in total knee arthroplasty by using computational simulation with normal knee model. Bone Joint Res 2017;6:557–565. DOI: 10.1302/2046-3758.69.BJR-2016-0250.R1.
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Affiliation(s)
- Y-G Koh
- Joint Reconstruction Center, Department of Orthopaedic Surgery, Yonsei Sarang Hospital, 10 Hyoryeong-ro, Seocho-gu, Seoul 06698, South Korea
| | - J Son
- Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - S-K Kwon
- Joint Reconstruction Center, Department of Orthopaedic Surgery, Yonsei Sarang Hospital, 10 Hyoryeong-ro, Seocho-gu, Seoul 06698, South Korea
| | - H-J Kim
- Spine Center and Department of Orthopaedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beongil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, South Korea
| | - O-R Kwon
- Joint Reconstruction Center, Department of Orthopaedic Surgery, Yonsei Sarang Hospital, 10 Hyoryeong-ro, Seocho-gu, Seoul 06698, South Korea
| | - K-T Kang
- Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
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Uchibe K, Son J, Larmour C, Pacifici M, Enomoto-Iwamoto M, Iwamoto M. Genetic and pharmacological inhibition of retinoic acid receptor γ function promotes endochondral bone formation. J Orthop Res 2017; 35:1096-1105. [PMID: 27325507 PMCID: PMC6900928 DOI: 10.1002/jor.23347] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Accepted: 06/14/2016] [Indexed: 02/04/2023]
Abstract
The nuclear retinoic acid receptors (RARs) play key roles in skeletal development and endochondral ossification. Previously, we showed that RARγ regulates chondrogenesis and that pharmacological activation of RARγ blocked heterotopic ossification (HO), pathology in which endochondral bone forms in soft tissues. Thus, we reasoned that pharmacological inhibition of RARγ should enhance endochondral ossification, leading to a potential therapeutic strategy for bone deficiencies. We created surgical bone defects in wild type and RARγ-null mice and monitored bone healing. Fibrous, cartilaginous, and osseous tissues formed in both groups by day 7, but more cartilaginous tissue formed in mutants within and around the defects compared to controls. Next, we implanted a mixture of Matrigel and rhBMP2 subdermally to induce ectopic endochondral ossification. Administration of RARγ antagonists significantly stimulated ectopic bone formation in wild type but not in RARγ-null mice. The antagonist-induced increases in bone formation were preceded by increases in cartilage formation and were accompanied by higher levels of phosphorylated Smad1/5/8 (pSmad1/5/8) compared to vehicle-treated control. Higher pSmad1/5/8 levels were also observed in cartilaginous tissues forming in healing bone defects in RARγ-null mice, and increases in pSmad1/5/8 levels and Id1-luc activity were observed in RARγ antagonist-treated chondrogenic cells in culture. Our data show that genetic or pharmacological interference with RARγ stimulates endochondral bone formation and does so at least in part by stimulating canonical BMP signaling. This pharmacologic strategy could represent a new tool to enhance endochondral bone formation in the setting of various orthopedic surgical interventions and other skeletal deficiencies. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1096-1105, 2017.
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Affiliation(s)
- Kenta Uchibe
- Translational Research Program in Pediatric Orthopaedics, Division of Orthopaedic Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Oral Morphology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Jiyeon Son
- Translational Research Program in Pediatric Orthopaedics, Division of Orthopaedic Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Colleen Larmour
- Translational Research Program in Pediatric Orthopaedics, Division of Orthopaedic Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Maurizio Pacifici
- Translational Research Program in Pediatric Orthopaedics, Division of Orthopaedic Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Motomi Enomoto-Iwamoto
- Translational Research Program in Pediatric Orthopaedics, Division of Orthopaedic Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Masahiro Iwamoto
- Translational Research Program in Pediatric Orthopaedics, Division of Orthopaedic Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA
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Kang KT, Koh YG, Jung M, Nam JH, Son J, Lee YH, Kim SJ, Kim SH. The effects of posterior cruciate ligament deficiency on posterolateral corner structures under gait- and squat-loading conditions: A computational knee model. Bone Joint Res 2017; 6:31-42. [PMID: 28077395 PMCID: PMC5301905 DOI: 10.1302/2046-3758.61.bjr-2016-0184.r1] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 11/06/2016] [Indexed: 01/12/2023] Open
Abstract
Objectives The aim of the current study was to analyse the effects of posterior cruciate ligament (PCL) deficiency on forces of the posterolateral corner structure and on tibiofemoral (TF) and patellofemoral (PF) contact force under dynamic-loading conditions. Methods A subject-specific knee model was validated using a passive flexion experiment, electromyography data, muscle activation, and previous experimental studies. The simulation was performed on the musculoskeletal models with and without PCL deficiency using a novel force-dependent kinematics method under gait- and squat-loading conditions, followed by probabilistic analysis for material uncertain to be considered. Results Comparison of predicted passive flexion, posterior drawer kinematics and muscle activation with experimental measurements showed good agreement. Forces of the posterolateral corner structure, and TF and PF contact forces increased with PCL deficiency under gait- and squat-loading conditions. The rate of increase in PF contact force was the greatest during the squat-loading condition. The TF contact forces increased on both medial and lateral compartments during gait-loading conditions. However, during the squat-loading condition, the medial TF contact force tended to increase, while the lateral TF contact forces decreased. The posterolateral corner structure, which showed the greatest increase in force with deficiency of PCL under both gait- and squat-loading conditions, was the popliteus tendon (PT). Conclusion PCL deficiency is a factor affecting the variability of force on the PT in dynamic-loading conditions, and it could lead to degeneration of the PF joint. Cite this article: K-T. Kang, Y-G. Koh, M. Jung, J-H. Nam, J. Son, Y.H. Lee, S-J. Kim, S-H. Kim. The effects of posterior cruciate ligament deficiency on posterolateral corner structures under gait- and squat-loading conditions: A computational knee model. Bone Joint Res 2017;6:31–42. DOI: 10.1302/2046-3758.61.BJR-2016-0184.R1.
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Affiliation(s)
- K-T Kang
- Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Y-G Koh
- Joint Reconstruction Center, Department of Orthopaedic Surgery, Yonsei Sarang Hospital, 10 Hyoryeong-ro, Seocho-gu, Seoul, 06698, South Korea
| | - M Jung
- AnyBody Technology A/S, 10 Niels Jernes Vej, Aalborg, 9220, Denmark
| | - J-H Nam
- Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - J Son
- Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Y H Lee
- Department of Radiology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - S-J Kim
- Joint Reconstruction Center, Department of Orthopaedic Surgery, Yonsei Sarang Hospital, 10 Hyoryeong-ro, Seocho-gu, Seoul, 06698, South Korea
| | - S-H Kim
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, South Korea
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Kang KT, Koh YG, Son J, Kwon OR, Baek C, Jung SH, Park KK. Measuring the effect of femoral malrotation on knee joint biomechanics for total knee arthroplasty using computational simulation. Bone Joint Res 2016; 5:552-559. [PMID: 28094763 PMCID: PMC5131092 DOI: 10.1302/2046-3758.511.bjr-2016-0107.r1] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 09/05/2016] [Indexed: 11/18/2022] Open
Abstract
Objectives Malrotation of the femoral component can result in post-operative complications in total knee arthroplasty (TKA), including patellar maltracking. Therefore, we used computational simulation to investigate the influence of femoral malrotation on contact stresses on the polyethylene (PE) insert and on the patellar button as well as on the forces on the collateral ligaments. Materials and Methods Validated finite element (FE) models, for internal and external malrotations from 0° to 10° with regard to the neutral position, were developed to evaluate the effect of malrotation on the femoral component in TKA. Femoral malrotation in TKA on the knee joint was simulated in walking stance-phase gait and squat loading conditions. Results Contact stress on the medial side of the PE insert increased with internal femoral malrotation and decreased with external femoral malrotation in both stance-phase gait and squat loading conditions. There was an opposite trend in the lateral side of the PE insert case. Contact stress on the patellar button increased with internal femoral malrotation and decreased with external femoral malrotation in both stance-phase gait and squat loading conditions. In particular, contact stress on the patellar button increased by 98% with internal malrotation of 10° in the squat loading condition. The force on the medial collateral ligament (MCL) and the lateral collateral ligament (LCL) increased with internal and external femoral malrotations, respectively. Conclusions These findings provide support for orthopaedic surgeons to determine a more accurate femoral component alignment in order to reduce post-operative PE problems. Cite this article: K-T. Kang, Y-G. Koh, J. Son, O-R. Kwon, C. Baek, S. H. Jung, K. K. Park. Measuring the effect of femoral malrotation on knee joint biomechanics for total knee arthroplasty using computational simulation. Bone Joint Res 2016;5:552–559. DOI: 10.1302/2046-3758.511.BJR-2016-0107.R1.
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Affiliation(s)
- K-T Kang
- Department of Mechanical Engineering, Yonsei University, Seoul, Republic of Korea
| | - Y-G Koh
- Joint Reconstruction Center, Department of Orthopaedic Surgery, Yonsei Sarang Hospital, Seoul, Republic of Korea
| | - J Son
- Department of Mechanical Engineering, Yonsei University, Seoul, Republic of Korea
| | - O-R Kwon
- Joint Reconstruction Center, Department of Orthopaedic Surgery, Yonsei Sarang Hospital, Seoul, Republic of Korea
| | - C Baek
- Department of Mechanical and Control Engineering, The Cyber University of Korea, Seoul, Republic of Korea
| | - S H Jung
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - K K Park
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
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Jo S, Yan Y, Son J, Hong S, Lee J. The Effect of Fast Time Manipulation on Memory with Emotional Stimuli. Personality and Individual Differences 2016. [DOI: 10.1016/j.paid.2016.05.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Swarer K, Son J, Ganocy S, Singh S, Resnick K. Does Presentation to Medical Care Differ Between African-American And Caucasian Women With High-Grade Epithelial Ovarian Cancer? Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.08.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Park S, Son J, Park S, Choi H, Hong K. THE IMPACT OF INTERARM BLOOD PRESSURE DIFFERENCES TO CORONARY INTERVENTION IN PATIENTS WITH CORONARY ARTERY DISEASE. Can J Cardiol 2016. [DOI: 10.1016/j.cjca.2016.07.447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Shin D, Son J, Kim M, Yoon M, Lee S, Lim Y, Park J, Lee S, Park S. Development of Real-Time Monitoring System for Proton Pencil Beam Spot Position Using Fiber-Optic Cerenkov Radiation Sensor Array. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.2157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Chung B, Byun Y, Son J, Cho Y, Kim H, Cho H, Park C. 227 Effect of different cooking methods on histamine levels in selected foods. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Son J, Chung B, Cho Y, Byun Y, Yang Y, Cho H, Kim H, Park C. 222 Effects of itraconazole and tacrolimus on Aryl hydrocarbon receptor and NADPH quinine oxidoreductase 1. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Accili D, Talchai SC, Kim-Muller JY, Cinti F, Ishida E, Ordelheide AM, Kuo T, Fan J, Son J. When β-cells fail: lessons from dedifferentiation. Diabetes Obes Metab 2016; 18 Suppl 1:117-22. [PMID: 27615140 PMCID: PMC5021187 DOI: 10.1111/dom.12723] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Accepted: 05/03/2016] [Indexed: 12/14/2022]
Abstract
Diabetes is caused by a combination of impaired responsiveness to insulin and reduced production of insulin by the pancreas. Until recently, the decline of insulin production had been ascribed to β-cell death. But recent research has shown that β-cells do not die in diabetes, but undergo a silencing process, termed "dedifferentiation." The main implication of this discovery is that β-cells can be revived by appropriate treatments. We have shown that mitochondrial abnormalities are a key step in the progression of β-cell dysfunction towards dedifferentiation. In normal β-cells, mitochondria generate energy required to sustain insulin production and its finely timed release in response to the body's nutritional status. A normal β-cell can adapt its mitochondrial fuel source based on substrate availability, a concept known as "metabolic flexibility." This capability is the first casualty in the progress of β-cell failure. β-Cells lose the ability to select the right fuel for mitochondrial energy production. Mitochondria become overloaded, and accumulate by-products derived from incomplete fuel utilization. Energy production stalls, and insulin production drops, setting the stage for dedifferentiation. The ultimate goal of these investigations is to explore novel treatment paradigms that will benefit people with diabetes.
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Affiliation(s)
- D Accili
- Department of Medicine and Berrie Diabetes Center, Columbia University, New York, New York.
| | - S C Talchai
- Department of Medicine and Berrie Diabetes Center, Columbia University, New York, New York
| | - J Y Kim-Muller
- Department of Medicine and Berrie Diabetes Center, Columbia University, New York, New York
| | - F Cinti
- Department of Medicine and Berrie Diabetes Center, Columbia University, New York, New York
| | - E Ishida
- Department of Medicine and Berrie Diabetes Center, Columbia University, New York, New York
| | - A M Ordelheide
- Department of Medicine and Berrie Diabetes Center, Columbia University, New York, New York
| | - T Kuo
- Department of Medicine and Berrie Diabetes Center, Columbia University, New York, New York
| | - J Fan
- Department of Medicine and Berrie Diabetes Center, Columbia University, New York, New York
| | - J Son
- Department of Medicine and Berrie Diabetes Center, Columbia University, New York, New York
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Lah J, Son J, Kim G, Shin D. SU-G-TeP2-15: Feasibility Study of Fiber-Optic Cerenkov Radiation Sensors for in Vivo Measurement: Dosimetric Characterization and Clinical Application in Proton Beams. Med Phys 2016. [DOI: 10.1118/1.4957050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Ma J, Son J, Arun B, Hazle J, Hwang K, Wang K, Bayram E, Madewell J, Yang W, Dogan B. SU-F-I-16: Short Breast MRI with High-Resolution T2-Weighted and Dynamic Contrast Enhanced T1-Weighted Images. Med Phys 2016. [DOI: 10.1118/1.4955844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Perera D, Son J. MO-FG-CAMPUS-IeP3-03: Optimal Parameters to Determine the Apparent Diffusion Coefficient in Diffusion Weighted Imaging Via Simulation. Med Phys 2016. [DOI: 10.1118/1.4957373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Son J, Kim M, Yoon M, Shin D. SU-F-T-174: Patient-Specific Point Dose Measurement Using Fiber Optic Radiation Sensor Using Cerenkov Radiation for Proton Therapeutic Beam. Med Phys 2016. [DOI: 10.1118/1.4956311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Park K, Han JY, Kim DW, Bazhenova L, Ou SH, Pang YK, Hin H, Juan O, Son J, Jänne P. 190TiP: ELUXA 1: Phase II study of BI 1482694 (HM61713) in patients (pts) with T790M-positive non-small cell lung cancer (NSCLC) after treatment with an epidermal growth factor receptor tyrosine kinase inhibitor (EGFR TKI). J Thorac Oncol 2016. [DOI: 10.1016/s1556-0864(16)30299-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Jånne P, Son J, Voccia I, Uttenreuther-Fischer M, Park K. 476TiP Phase II study of BI1482694 in patients (pts) with T790M-positive non-small cell lung cancer (NSCLC) after treatment with an epidermal growth factor receptor tyrosine kinase inhibitor (EGFR TKI). Ann Oncol 2015. [DOI: 10.1093/annonc/mdv532.60] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Son J, Sung I, Cho Y, Kim D, Kim Y. Low level laser irradiation has synergistic effect of melatonin on osteoblast differentiation and mineralization of MC3T3-E1 cells under hypoxic conditions. Int J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.ijom.2015.08.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Son J, Kim M, Hwang U, Park J, Lim Y, Lee S, Park S, Yoon M, Shin D. SU-E-T-159: Characteristics of Fiber-Optic Radiation Sensor for Proton Therapeutic Beam. Med Phys 2015. [DOI: 10.1118/1.4924521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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