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Matorras R, Chaudhari VS, Roeder C, Schwarze JE, Bühler K, Hwang K, Chang-Woo C, Iniesta S, D'Hooghe T, Mathur R. Evaluation of costs associated with fertility treatment leading to a live birth after one fresh transfer: A global perspective. Best Pract Res Clin Obstet Gynaecol 2023; 89:102349. [PMID: 37327667 DOI: 10.1016/j.bpobgyn.2023.102349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/27/2023] [Accepted: 05/07/2023] [Indexed: 06/18/2023]
Abstract
Considerable costs are associated with infertility treatment, but little evidence is available on the main drivers of treatment costs. This cost analysis investigated key costs for treatment with assisted reproductive technology (ART) and the proportion of costs attributed to the acquisition of recombinant human follicle-stimulating hormone (r-hFSH) alfa originator for one fresh embryo transfer (ET) leading to a live birth in Spain, Norway, the UK, Germany, Denmark, South Korea, Australia, and New Zealand. The total costs for one ART cycle with a fresh ET leading to a live birth varied between countries (€4108-€12,314). Costs for pregnancy and live birth were the major contributors in European countries, and the costs of oocyte retrieval, monitoring during ovarian stimulation, pregnancy, and live birth were the top contributors in the Asia-Pacific countries, included in this analysis. Acquisition costs for r-hFSH alfa originator contributed to only 5%-17% of the total costs of one ART cycle with one fresh ET leading to a live birth.
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Affiliation(s)
- R Matorras
- Department of Obstetrics and Gynecology, Human Reproduction Unit, Cruces University Hospital, Basque Country University, Bizkaia, Bilbao, Spain; BioCruces Health Research Institute, Spain; Instituto Valenciano de Infertilidad, IVI Bilbao, IVIRMA, Bilbao, Spain
| | - V S Chaudhari
- EMD Serono Research & Development Institute, Inc., Billerica, USA.
| | - C Roeder
- Pharma Value Consulting, Switzerland
| | - J E Schwarze
- Merck Healthcare, Merck KGaA, Darmstadt, Germany
| | - K Bühler
- Scientific Centre for Endometriosis, University Hospitals of Saarland, Saarbrücken, Germany; Department of Gynecology, Jena-University Hospital-Friedrich Schiller University, Jena, Germany
| | - K Hwang
- Cha University, Fertility Centre, Bundang Medical Centre, Seongnam, Gyeonggi-do, South Korea
| | - C Chang-Woo
- Seoul Maria Fertility Hospital, Seoul, South Korea
| | - S Iniesta
- Department of Obstetrics, Gynecology and Reproductive Medicine, La Paz University Hospital, Madrid, Spain; Department of Reproductive Medicine, Ruber Internacional Hospital, Madrid, Spain
| | - T D'Hooghe
- Merck Healthcare, Merck KGaA, Darmstadt, Germany; Department of Development and Regeneration, Laboratory of Endometrium, Endometriosis & Reproductive Medicine, KU Leuven, Leuven, Belgium; Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University Medical School, New Haven, USA
| | - R Mathur
- Department of Reproductive Medicine and Surgery, Manchester Academic Health Sciences Centre, Manchester, UK
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Harakuni SU, Somannavar MS, Ghanchi NK, Ahmed I, Zafar A, Kim J, Tikmani SS, Hwang K, Saleem S, Goudar SS, Dhaded S, Guruprasad G, Yasmin H, Yogeshkumar S, Aceituno A, Silver RM, McClure EM, Goldenberg RL. Pathogens identified in the internal tissues and placentas of stillbirths: results from the prospective, observational PURPOSe study. BJOG 2023. [PMID: 37069731 DOI: 10.1111/1471-0528.17479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 11/18/2022] [Accepted: 12/06/2022] [Indexed: 04/19/2023]
Abstract
OBJECTIVE To examine internal organ tissues and placentas of stillbirths for various pathogens. DESIGN Prospective, observational study. SETTINGS Three study hospitals in India and a large maternity hospital in Pakistan. POPULATION Stillborn infants delivered in a study hospital. METHODS A prospective observational study. MAIN OUTCOME MEASURES Organisms identified by pathogen polymerase chain reaction (PCR) in internal organs and placental tissues of stillbirths. RESULTS Of 2437 stillbirth internal tissues, 8.3% (95% CI 7.2-9.4) were positive. Organisms were most commonly detected in brain (12.3%), cerebrospinal fluid (CSF) (9.5%) and whole blood (8.4%). Ureaplasma urealyticum/parvum was the organism most frequently detected in at least one internal organ (6.4% of stillbirths and 2% of all tissues). Escherichia coli/Shigella was the next most common (4.1% one or more internal organ tissue sample and 1.3% of tissue samples), followed by Staphylococcus aureus in at least one internal organ tissue (1.9% and 0.9% of all tissues). None of the other organisms was found in more than 1.4% of the tissue samples in stillbirths or more than 0.6% of the internal tissues examined. In the placenta tissue, membrane or cord blood combined, 42.8% (95% CI 40.2-45.3) had at least one organism identified, with U. urealyticum/parvum representing the most commonly identified (27.8%). CONCLUSIONS In about 8% of stillbirths, there was evidence of a pathogen in an internal organ. Ureaplasma urealyticum/parvum was the most common organism found in the placenta and in the internal tissues, especially in the fetal brain.
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Affiliation(s)
- S U Harakuni
- KLE Academy of Higher Education and Researchs, J N Medical College, Belagavi, India
| | - M S Somannavar
- KLE Academy of Higher Education and Researchs, J N Medical College, Belagavi, India
| | | | - I Ahmed
- Aga Khan University, Karachi, Pakistan
| | - A Zafar
- Aga Khan University, Karachi, Pakistan
| | - J Kim
- RTI International, Durham, North Carolina, USA
| | | | - K Hwang
- RTI International, Durham, North Carolina, USA
| | - S Saleem
- Aga Khan University, Karachi, Pakistan
- RTI International, Durham, North Carolina, USA
| | - S S Goudar
- KLE Academy of Higher Education and Researchs, J N Medical College, Belagavi, India
| | - S Dhaded
- KLE Academy of Higher Education and Researchs, J N Medical College, Belagavi, India
| | - G Guruprasad
- Bapuji Educational Association's J.J.M. Medical College, Davangere, India
| | - H Yasmin
- Jinnah Postgraduate Medical Centre, Karachi, Pakistan
| | - S Yogeshkumar
- KLE Academy of Higher Education and Researchs, J N Medical College, Belagavi, India
| | - A Aceituno
- RTI International, Durham, North Carolina, USA
| | - R M Silver
- University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - E M McClure
- RTI International, Durham, North Carolina, USA
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Hwang K, Papuga SA. COVID-19 pandemic underscores role of green space in urban carbon dynamics. Sci Total Environ 2023; 859:160249. [PMID: 36402337 PMCID: PMC9671673 DOI: 10.1016/j.scitotenv.2022.160249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/09/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
For Detroit Michigan the arrival of COVID-19 led to intensive measures to prevent further spread of the virus resulting in consequent changes in traffic and energy use. We take advantage of these different emission scenarios to explore CO2 dynamics in a postindustrial city with a declining population and increasing green space. We present atmospheric CO2 concentration and net urban ecosystem exchange of CO2 (NUE) from a typical eddy covariance system and canopy greenness from a field camera on the Wayne State University campus in midtown Detroit. We categorized our study period (January 18, 2020-July 31, 2020) into three subperiods associated with the state-wide shelter-in-place order. Our results support that the city was a net carbon source throughout the period, particularly during the shelter-in-place period, although reduced traffic lowered CO2 concentrations and NUE. However, during the post-order period when traffic was highest, atmospheric CO2 concentrations and NUE were lowest, suggesting that the greening of urban vegetation may have greater carbon mitigation potential than lowering anthropogenic carbon emissions through traffic reductions.
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Affiliation(s)
- K Hwang
- Department of Environmental Science and Geology, Wayne State University, Detroit, MI, United States of America.
| | - S A Papuga
- Department of Environmental Science and Geology, Wayne State University, Detroit, MI, United States of America; Department of Hydrology and Atmospheric Sciences, University of Arizona, Tucson, AZ, United States of America
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Apinyankul R, Hui AY, Hwang K, Segovia NA, Amanatullah DF, Huddleston JI, Maloney WJ, Goodman SB. Complications, Implant Survivorships, and Functional Outcomes of Conversion Total Knee Arthroplasty With Prior Hardware. J Arthroplasty 2023; 38:S66-S70.e2. [PMID: 36758842 DOI: 10.1016/j.arth.2023.01.049] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 01/25/2023] [Accepted: 01/31/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND End-stage knee osteoarthritis with retained periarticular hardware is a frequent scenario. Conversion total knee arthroplasty (TKA) leads to excellent outcomes, but poses unique challenges. The evidence supporting retention versus removal of hardware during TKA is controversial. METHODS Patients who underwent TKA with prior hardware between January 2009 and December 2019 were identified. A total of 148 patients underwent TKA with prior hardware. The mean follow-up was 60 months (range, 24-223). Univariate and multivariable analyses were used to study correlations among factors and surgical-related complications, prosthesis failures, and functional outcomes. RESULTS The complication rate was 28 of 148 (18.9%). The use of a quadriceps snips in addition to a medial parapatellar arthrotomy was associated with a higher complication (odds ratio: 20.7, P < .05), implant failures (odds ratio: 13.9, P < .05), and lower the Veterans Rand 12 Mental Score (VR-12 MS) (-14.8, P < .05). Hardware removal versus retention and use of single versus multiple incisions were not associated with complications or prosthesis failures. Removal of all hardware was associated with significantly higher (+7.3, P < .05) VR-12 MS compared to retention of all hardware. CONCLUSIONS TKA with prior hardware was associated with more complications, implant failures, and lower VR-12 MS when a more constrained construct or quadriceps snip was performed. This probably reflects the level of difficulty of the procedure rather than the surgical approach used. Hardware removal or retention was not associated with complications or implant failures; however, removal rather than retention of all prior hardware is associated with increased general health outcomes. LEVEL OF EVIDENCE IV, cohort without control.
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Affiliation(s)
- Rit Apinyankul
- Department of Orthopaedics, Khon Kaen University, Khon Kaen, Thailand
| | - Alexander Y Hui
- Department of Orthopaedic Surgery, Stanford University Medical Center Outpatient Center, Stanford University School of Medicine, Stanford, California
| | - Katherine Hwang
- Department of Orthopaedic Surgery, Stanford University Medical Center Outpatient Center, Stanford University School of Medicine, Stanford, California
| | - Nicole Alexandriadria Segovia
- Department of Orthopaedic Surgery, Stanford University Medical Center Outpatient Center, Stanford University School of Medicine, Stanford, California
| | - Derek F Amanatullah
- Department of Orthopaedic Surgery, Stanford University Medical Center Outpatient Center, Stanford University School of Medicine, Stanford, California
| | - James I Huddleston
- Department of Orthopaedic Surgery, Stanford University Medical Center Outpatient Center, Stanford University School of Medicine, Stanford, California
| | - William J Maloney
- Department of Orthopaedic Surgery, Stanford University Medical Center Outpatient Center, Stanford University School of Medicine, Stanford, California
| | - Stuart B Goodman
- Department of Orthopaedic Surgery, Stanford University Medical Center Outpatient Center, Stanford University School of Medicine, Stanford, California
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Apinyankul R, Hwang K, Segovia NA, Amanatullah DF, Huddleston JI, Maloney WJ, Goodman SB. Isolated Versus Full Component Revision in Total Knee Arthroplasty for Aseptic Loosening. J Arthroplasty 2023; 38:335-340. [PMID: 36099937 DOI: 10.1016/j.arth.2022.09.006] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 09/06/2022] [Accepted: 09/06/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Revision of both femoral and tibial components of a total knee arthroplasty (TKA) for aseptic loosening has favorable outcomes. Revision of only one loose component with retention of others has shorter operative time and lower cost; however, implant survivorship and clinical outcomes of these different operations are unclear. METHODS Between January 2009 and December 2019, a consecutive cohort of revision TKA was reviewed. Univariate and multivariable analyses were used to study correlations among factors and surgical related complications, time to prosthesis failure, and functional outcomes (University of California Los Angeles, Knee Society functional, knee osteoarthritis and outcome score for joint replacement, Veterans RAND 12 (VR-12) physical, and VR-12 mental). RESULTS A total of 238 patients underwent revision TKA for aseptic loosening. The mean follow-up time was 61 months (range 25 to 152). Ten of the 105 patients (9.5%) who underwent full revision (both femoral and tibial components) and 18 of the 133 (13.5%) who underwent isolated revision had subsequent prosthesis failure [Hazard ratio (HR) 0.67, P = .343]. The factor analysis of type of revision (full or isolated revision) did not demonstrate a significant difference between groups in terms of complications, implant failures, and times to failure. Metallosis was related to early time to failure [Hazard ratio 10.11, P < .001] and iliotibial band release was associated with more complications (Odds ratio 9.87, P = .027). Preoperative symptoms of instability were associated with the worst improvement in University of California Los Angeles score. Higher American Society of Anesthesiologists status and higher Charlson Comorbidity Index were related with worse VR-12 physical (-30.5, P = .008) and knee osteoarthritis and outcome score for joint replacement (-4.2, P = .050) scores, respectively. CONCLUSION Isolated and full component revision TKA for aseptic loosening does not differ with respect to prosthesis failures, complications, and clinical results at 5 years. Poor American Society of Anesthesiologists status, increased comorbidities, instability, and a severe bone defect are related to worse functional improvement. LEVEL OF EVIDENCE III, cohort with control.
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Affiliation(s)
- Rit Apinyankul
- Department of Orthopaedics, Khon Kaen University, Khon Kaen, Thailand
| | - Katherine Hwang
- Department of Orthopaedic Surgery, Stanford University Medical Center Outpatient Center, Stanford University School of Medicine, Stanford, California
| | - Nicole Alexandriadria Segovia
- Department of Orthopaedic Surgery, Stanford University Medical Center Outpatient Center, Stanford University School of Medicine, Stanford, California
| | - Derek F Amanatullah
- Department of Orthopaedic Surgery, Stanford University Medical Center Outpatient Center, Stanford University School of Medicine, Stanford, California
| | - James I Huddleston
- Department of Orthopaedic Surgery, Stanford University Medical Center Outpatient Center, Stanford University School of Medicine, Stanford, California
| | - William J Maloney
- Department of Orthopaedic Surgery, Stanford University Medical Center Outpatient Center, Stanford University School of Medicine, Stanford, California
| | - Stuart B Goodman
- Department of Orthopaedic Surgery, Stanford University Medical Center Outpatient Center, Stanford University School of Medicine, Stanford, California
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Hardy J, Pollock N, Gingrich T, Sweet P, Ramesh A, Kuong J, Basar A, Jiang H, Hwang K, Vukina J, Jaffe T, Olszewska M, Kurpisz M, Yatsenko AN. Genomic testing for copy number and single nucleotide variants in spermatogenic failure. J Assist Reprod Genet 2022; 39:2103-2114. [PMID: 35849255 PMCID: PMC9474750 DOI: 10.1007/s10815-022-02538-5] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/06/2022] [Indexed: 10/17/2022] Open
Abstract
PURPOSE To identify clinically significant genomic copy number (CNV) and single nucleotide variants (SNV) in males with unexplained spermatogenic failure (SPGF). MATERIALS AND METHODS Peripheral blood DNA from 97/102 study participants diagnosed with oligozoospermia, severe oligozoospermia, or non-obstructive azoospermia (NOA) was analyzed for CNVs via array comparative genomic hybridization (aCGH) and SNVs using whole-exome sequencing (WES). RESULTS Of the 2544 CNVs identified in individuals with SPGF, > 90% were small, ranging from 0.6 to 75 kb. Thirty, clinically relevant genomic aberrations, were detected in 28 patients (~ 29%). These included likely diagnostic CNVs in 3/41 NOA patients (~ 7%): 1 hemizygous, intragenic TEX11 deletion, 1 hemizygous DDX53 full gene deletion, and 1 homozygous, intragenic STK11 deletion. High-level mosaicism for X chromosome disomy (~ 10% 46,XY and ~ 90% 47,XXY) was also identified in 3 of 41 NOA patients who previously tested normal with conventional karyotyping. The remaining 24 CNVs detected were heterozygous, autosomal recessive carrier variants. Follow-up WES analysis confirmed 8 of 27 (30%) CNVs (X chromosome disomy excluded). WES analysis additionally identified 13 significant SNVs and/or indels in 9 patients (~ 9%) including X-linked AR, KAL1, and NR0B1 variants. CONCLUSION Using a combined genome-wide aCGH/WES approach, we identified pathogenic and likely pathogenic SNVs and CNVs in 15 patients (15%) with unexplained SPGF. This value equals the detection rate of conventional testing for aneuploidies and is considerably higher than the prevalence of Y chromosome microdeletions. Our results underscore the importance of comprehensive genomic analysis in emerging diagnostic testing of complex conditions like male infertility.
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Affiliation(s)
- J Hardy
- Department of OBGYN and Reproductive Sciences, Magee-Womens Research Institute, School of Medicine, University of Pittsburgh, 204 Craft Avenue, Pittsburgh, PA, 15213, USA
| | - N Pollock
- Department of OBGYN and Reproductive Sciences, Magee-Womens Research Institute, School of Medicine, University of Pittsburgh, 204 Craft Avenue, Pittsburgh, PA, 15213, USA
| | - T Gingrich
- Department of OBGYN and Reproductive Sciences, Magee-Womens Research Institute, School of Medicine, University of Pittsburgh, 204 Craft Avenue, Pittsburgh, PA, 15213, USA
| | - P Sweet
- Department of OBGYN and Reproductive Sciences, Magee-Womens Research Institute, School of Medicine, University of Pittsburgh, 204 Craft Avenue, Pittsburgh, PA, 15213, USA
| | - A Ramesh
- Department of OBGYN and Reproductive Sciences, Magee-Womens Research Institute, School of Medicine, University of Pittsburgh, 204 Craft Avenue, Pittsburgh, PA, 15213, USA
| | - J Kuong
- Department of OBGYN and Reproductive Sciences, Magee-Womens Research Institute, School of Medicine, University of Pittsburgh, 204 Craft Avenue, Pittsburgh, PA, 15213, USA
| | - A Basar
- Department of OBGYN and Reproductive Sciences, Magee-Womens Research Institute, School of Medicine, University of Pittsburgh, 204 Craft Avenue, Pittsburgh, PA, 15213, USA
| | - H Jiang
- Department of OBGYN and Reproductive Sciences, Magee-Womens Research Institute, School of Medicine, University of Pittsburgh, 204 Craft Avenue, Pittsburgh, PA, 15213, USA
| | - K Hwang
- Department of Urology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - J Vukina
- Department of Urology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - T Jaffe
- Department of Urology, School of Medicine, West Virginia University, Morgantown, WV, USA
| | - M Olszewska
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
| | - M Kurpisz
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
| | - A N Yatsenko
- Department of OBGYN and Reproductive Sciences, Magee-Womens Research Institute, School of Medicine, University of Pittsburgh, 204 Craft Avenue, Pittsburgh, PA, 15213, USA.
- Department of Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States.
- Department of Pathology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States.
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Kim S, Bae H, Chu J, Cho H, Choi S, Hwang K, Jo Y, Kim S. 907P A real-time histologic evaluation of gastric cancer tissue by using confocal laser endomicroscopic system. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1033] [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: 11/01/2022] Open
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Sung M, Choi HJ, Lee MH, Lee JY, Kim HB, Ahn YM, Kim JK, Kim HY, Jung SS, Kim M, Kang EK, Yang EA, Lee SJ, Park Y, Seo JH, Lee E, Yang ES, Park KS, Shin M, Chung HL, Jang YY, Choi BS, Kim H, Jung JA, Yu ST, Roh EJ, Lee ES, Kim JT, Kim BS, Hwang YH, Sol IS, Yang HJ, Han MY, Yew HY, Cho HM, Kim HY, Hn YH, Im DH, Hwang K, Yoo J, Jung SO, Jeon YH, Shim JY, Chung EH. Regional and annual patterns in respiratory virus co-infection etiologies and antibiotic prescriptions for pediatric mycoplasma pneumoniae pneumonia. Eur Rev Med Pharmacol Sci 2022; 26:5844-5856. [PMID: 36066160 DOI: 10.26355/eurrev_202208_29524] [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: 06/15/2023]
Abstract
OBJECTIVE Mycoplasma pneumoniae (M. pneumoniae) pneumonia is the second-most common cause of community-acquired pneumonia (CAP). This study aimed at investigating into the prevalence of macrolide-resistant M. pneumoniae (MRMP) with respiratory virus co-infection and the antibiotic prescriptions in children with CAP in four provinces in Korea, and to assess the variations in the findings across regions and throughout the year. PATIENTS AND METHODS This prospective study was conducted in 29 hospitals in Korea between July 2018 and June 2020. Among the enrolled 1,063 children with CAP, all 451 patients with M. pneumoniae underwent PCR assays of M. pneumoniae and respiratory viruses, and the presence of point mutations of residues 2063 and 2064 was evaluated. RESULTS Gwangju-Honam (88.6%) showed the highest prevalence of MRMP pneumonia, while Daejeon-Chungcheong (71.3%) showed the lowest, although the differences in prevalence were not significant (p=0.074). Co-infection of M. pneumoniae pneumonia and respiratory virus was observed in 206 patients (45.4%), and rhinovirus co-infection (101 children; 22.2%) was the most frequent. The prevalence of MRMP pneumonia with respiratory virus co-infection and the antibiotic prescriptions differed significantly among the four provinces (p < 0.05). The monthly rate of MRMP pneumonia cases among all cases of M. pneumoniae pneumonia and tetracycline or quinolone prescriptions did not differ significantly among the four regions (trend p > 0.05) during the study period. CONCLUSIONS The prevalence of M. pneumoniae pneumonia with virus co-infection and antibiotic prescriptions could differ according to region, although the MRMP pneumonia rate showed no difference within Korea.
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Affiliation(s)
- M Sung
- Department of Pediatrics, Soonchunhyang University Gumi Hospital, Gumi, Republic of Korea.
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Lee H, Kang M, Hwang K, Kim C, Kim Y, Suh K, Choi B, Kim I, Jang B. MO-0726 Volumetric change in gray matter after radiotherapy in glioma patients detected with MRI. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02424-0] [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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10
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Goldenberg RL, Saleem S, Goudar SS, Silver RM, Tikmani SS, Guruprasad G, Dhaded SM, Yasmin H, Bano K, Somannavar MS, Yogeshkumar S, Hwang K, Aceituno A, Parlberg L, McClure EM. Preventable stillbirths in India and Pakistan: a prospective, observational study. BJOG 2021; 128:1762-1773. [PMID: 34173998 DOI: 10.1111/1471-0528.16820] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2021] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Stillbirths occur 10-20 times more frequently in low-income settings compared with high-income settings. We created a methodology to define the proportion of stillbirths that are potentially preventable in low-income settings and applied it to stillbirths in sites in India and Pakistan. DESIGN Prospective observational study. SETTING Three maternity hospitals in Davangere, India and a large public hospital in Karachi, Pakistan. POPULATION All cases of stillbirth at ≥20 weeks of gestation occurring from July 2018 to February 2020 were screened for participation; 872 stillbirths were included in this analysis. METHODS We prospectively defined the conditions and gestational ages that defined the stillbirth cases considered potentially preventable. Informed consent was sought from the parent(s) once the stillbirth was identified, either before or soon after delivery. All information available, including obstetric and medical history, clinical course, fetal heart sounds on admission, the presence of maceration as well as examination of the stillbirth after delivery, histology, and polymerase chain reaction for infectious pathogens of the placenta and various fetal tissues, was used to assess whether a stillbirth was potentially preventable. MAIN OUTCOME MEASURES Whether a stillbirth was determined to be potentially preventable and the criteria for assignment to those categories. RESULTS Of 984 enrolled, 872 stillbirths at ≥20 weeks of gestation met the inclusion criteria and were included; of these, 55.5% were deemed to be potentially preventable. Of the 649 stillbirths at ≥28 weeks of gestation and ≥1000 g birthweight, 73.5% were considered potentially preventable. The most common conditions associated with a potentially preventable stillbirth at ≥28 weeks of gestation and ≥1000 g birthweight were small for gestational age (SGA) (52.8%), maternal hypertension (50.2%), antepartum haemorrhage (31.4%) and death that occurred after hospital admission (15.7%). CONCLUSIONS Most stillbirths in these sites were deemed preventable and were often associated with maternal hypertension, antepartum haemorrhage, SGA and intrapartum demise. TWEETABLE ABSTRACT Most stillbirths are preventable by better care for women with hypertension, growth restriction and antepartum haemorrhage.
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Affiliation(s)
| | - S Saleem
- Aga Khan University, Karachi, Pakistan
| | - S S Goudar
- KLE Academy of Higher Education and Research's JN Medical College, Belagavi, India
| | - R M Silver
- University of Utah, Salt Lake City, UT, USA
| | | | | | - S M Dhaded
- KLE Academy of Higher Education and Research's JN Medical College, Belagavi, India
| | - H Yasmin
- Jinnah Postgraduate Medical Centre, Karachi, Pakistan
| | - K Bano
- Jinnah Postgraduate Medical Centre, Karachi, Pakistan
| | - M S Somannavar
- KLE Academy of Higher Education and Research's JN Medical College, Belagavi, India
| | - S Yogeshkumar
- KLE Academy of Higher Education and Research's JN Medical College, Belagavi, India
| | - K Hwang
- RTI International, Durham, NC, USA
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Lim SB, Tsai CJ, Yu Y, Greer P, Fuangrod T, Hwang K, Fontenla S, Coffman F, Lee N, Lovelock DM. Investigation of a Novel Decision Support Metric for Head and Neck Adaptive Radiation Therapy Using a Real-Time In Vivo Portal Dosimetry System. Technol Cancer Res Treat 2020; 18:1533033819873629. [PMID: 31551011 PMCID: PMC6763934 DOI: 10.1177/1533033819873629] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
In adaptive radiation therapy of head and neck cancer, any significant anatomical changes observed are used to adapt the treatment plan to maintain target coverage without elevating the risk of xerostomia. However, the additional resources required for adaptive radiation therapy pose a challenge for broad-based implementation. It is hypothesized that a change in transit fluence is associated with volumetric change in the vicinity of the target and therefore can be used as a decision support metric for adaptive radiation therapy. This was evaluated by comparing the fluence with volumetric changes in 12 patients. Transit fluence was measured by an in vivo portal dosimetry system. Weekly cone beam computed tomography was used to determine volume change in the rectangular region of interest from condyloid process to C6. The integrated transit fluence through the region of interest on the day of the cone beam computed tomography scan was calculated with the first treatment as the baseline. The correlation between fluence change and volume change was determined. A logistic regression model was also used to associate the 5% region of interest volume reduction replanning trigger point and the fluence change. The model was assessed by a chi-square test. The area under the receiver-operating characteristic curve was also determined. A total of 46 pairs of measurements were obtained. The correlation between fluence and volumetric changes was found to be -0.776 (P value <.001). The negative correlation is attributed to the increase in the photon fluence transport resulting from the volume reduction. The chi-square of the logistic regression was found to be 17.4 (P value <.001). The area under the receiver-operating characteristic curve was found to be 0.88. Results indicate the change in transit fluence, which can be measured without consuming clinical resources or requiring additional time in the treatment room, can be used as a decision support metric for adaptive therapy.
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Affiliation(s)
- S B Lim
- Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Health Informatics, Rutgers University, Newark, NJ, USA
| | - C J Tsai
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Y Yu
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - P Greer
- Calvary Mater Newcastle Hospital, Newcastle, Australia
| | - T Fuangrod
- HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, BKK, Thailand
| | - K Hwang
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - S Fontenla
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - F Coffman
- Department of Health Informatics, Rutgers University, Newark, NJ, USA
| | - N Lee
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - D M Lovelock
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
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12
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Hwang K, Kim Y, Kim C, Han J. P14.104 The outcomes of conservatively observed asymptomatic nonfunctioning pituitary adenomas with optic nerve compression. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
We investigated the natural history of asymptomatic nonfunctioning pituitary adenomas (NFPAs) abutting on optic nerve.
MATERIAL AND METHODS
Eighty-three patients with asymptomatic NFPAs with documented optic nerve compression on magnetic resonance imaging (MRI) at the time of detection between 2000 and 2016 were included in this study. Patients were evaluated with a hormone test, visual acuity test, visual field test and MRI at the time of diagnosis, and then, yearly, without any treatment (including surgery and radiation).
RESULTS
The mean age was 57.7±13.6 (range, 15 - 81) years. The mean follow-up duration was 66.6±39.0 (range, 12 - 184) months. Tumor volume growth ≥ 20% was observed in 64 (77.1%) patients. Ten (12.2%) patients experienced any kind of hormonal dysfunction, and gonadotropin deficiency was the most common type of hormonal deficiency [n=9 (10.8%)]. Visual deterioration quantified by Visual Impairment Scale was seen 27 (32.5%) patients. There was no statistically significant factor for tumor growth or visual aggravation. Fourteen (16.9%) patients eventually underwent tumor resection. From multivariate analysis, the significant predictors for eventual surgical intervention were cavernous sinus invasion (OR=20.95; 95% CI, 2.754–159.3; p=0.003) and last follow-up visual field defect score (OR=1.170; 95% CI, 1.049–1.305; p=0.005). All patients who underwent surgery did not experience any neurologic or endocrinological deficits postoperatively.
CONCLUSION
The clinical outcomes of conservatively observed NFPAs with optic nerve compression can be acceptable. The decision for surgical intervention should be made by balancing the risk and benefits.
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Affiliation(s)
- K Hwang
- Seoul National University Bundang hospital, Seongnam-si, Korea, Republic of
| | - Y Kim
- Seoul National University hospital, Seoul, Korea, Republic of
| | - C Kim
- Seoul National University Bundang hospital, Seongnam-si, Korea, Republic of
| | - J Han
- Seoul National University Bundang hospital, Seongnam-si, Korea, Republic of
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13
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Lim S, Tsai C, Greer P, Fuangrod T, Hwang K, Fontenla S, Gohel S, Coffman F, Lee N, Lovelock D. The Use of Transit Fluence as a Decision Support Metric for Head and Neck Adaptive Radiation Therapy. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.351] [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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14
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Abdel MP, Akgün D, George A, Akinola B, Alencar P, Amanatullah DF, Babazadeh S, Borens O, Vicente Cabral RM, Cichos KH, Deirmengian C, de Steiger R, Ghanem E, Radtke Gonçalves JR, Goodman S, Hamlin B, Hwang K, Klatt BA, Lee GC, Manrique J, Moon AS, Ogedegbe F, Salib CG, Tian S, Winkler T. Erratum to "Hip and Knee Section, Diagnosis, Pathogen Isolation, Culture: Proceedings of International Consensus on Orthopedic Infections" [The Journal of Arthroplasty 34 (2019) S361-S367]. J Arthroplasty 2019; 34:1863. [PMID: 31155458 DOI: 10.1016/j.arth.2019.05.014] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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15
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Zainul-Abidin S, Amanatullah DF, Anderson MB, Austin M, Barretto JM, Battenberg A, Bedard NA, Bell K, Blevins K, Callaghan JJ, Cao L, Certain L, Chang Y, Chen JP, Cizmic Z, Coward J, DeMik DE, Diaz-Borjon E, Enayatollahi MA, Feng JE, Fernando N, Gililland JM, Goodman S, Goodman S, Greenky M, Hwang K, Iorio R, Karas V, Khan R, Kheir M, Klement MR, Kunutsor SK, Limas R, Morales Maldonado RA, Manrique J, Matar WY, Mokete L, Nung N, Pelt CE, Pietrzak JRT, Premkumar A, Rondon A, Sanchez M, Novaes de Santana C, Sheth N, Singh J, Springer BD, Tay KS, Varin D, Wellman S, Wu L, Xu C, Yates AJ. General Assembly, Prevention, Host Related General: Proceedings of International Consensus on Orthopedic Infections. J Arthroplasty 2019; 34:S13-S35. [PMID: 30360983 DOI: 10.1016/j.arth.2018.09.050] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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16
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Abdel MP, Akgün D, Akin G, Akinola B, Alencar P, Amanatullah DF, Babazadeh S, Borens O, Vicente Cabral RM, Cichos KH, Deirmengian C, de Steiger R, Ghanem E, Radtke Gonçalves JR, Goodman S, Hamlin B, Hwang K, Klatt BA, Lee GC, Manrique J, Moon AS, Ogedegbe F, Salib CG, Tian S, Winkler T. Hip and Knee Section, Diagnosis, Pathogen Isolation, Culture: Proceedings of International Consensus on Orthopedic Infections. J Arthroplasty 2019; 34:S361-S367. [PMID: 30343972 DOI: 10.1016/j.arth.2018.09.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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17
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Lim S, Tsai C, Yu Y, Greer P, Fuangrod T, Hwang K, Fontenla S, Lee N, Lovelock D. The Investigation of a Decision Support Metric for Head and Neck Adaptive Radiation Therapy using a Real-Time In Vivo Portal Dosimetry System. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1505] [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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18
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Affiliation(s)
- K. Hwang
- Division of Plant and Soil Sciences, West Virginia University, Morgantown, West Virginia 26506
| | - D. A. Stelzig
- Division of Plant and Soil Sciences, West Virginia University, Morgantown, West Virginia 26506
| | - H. L. Barnett
- Division of Plant and Soil Sciences, West Virginia University, Morgantown, West Virginia 26506
| | - P. P. Roller
- Laboratory of Carcinogen Metabolism and Office of the Scientific Coordinator for Environmental Cancer, National Cancer Institute, NIH, Bethesda, Maryland 20205
| | - M. I. Kelsey
- Laboratory of Carcinogen Metabolism and Office of the Scientific Coordinator for Environmental Cancer, National Cancer Institute, NIH, Bethesda, Maryland 20205
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19
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Choi Y, Chung Y, Kim J, Hong M, Chae S, Hwang K, Yoon S. Association between polycystic ovary syndrome and the polymorphisms of aryl hydrocarbon receptor repressor, glutathione-s-transferase T1, and glutathione-S-transferase M1 genes. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.357] [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: 11/27/2022]
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20
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Bianchi E, Stermer A, Boekelheide K, Sigman M, Hall SJ, Reyes G, Dere E, Hwang K. High-quality human and rat spermatozoal RNA isolation for functional genomic studies. Andrology 2018; 6:374-383. [PMID: 29470852 DOI: 10.1111/andr.12471] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 12/11/2017] [Accepted: 01/04/2018] [Indexed: 12/30/2022]
Abstract
Sperm RNA is a sensitive monitoring endpoint for male reproductive toxicants, and a potential biomarker to assess male infertility and sperm quality. However, isolation of sperm RNA is a challenging procedure due to the heterogeneous population of cells present in the ejaculate, the low yield of RNA per spermatozoon, and the absence of 18S and 28S ribosomal RNA subunits. The unique biology of spermatozoa has created some uncertainty in the field about RNA isolation methods, indicating the need for rigorous quality control checks to ensure reproducibility of data generated from sperm RNA. Therefore, we developed a reliable and effective protocol for RNA isolation from rat and human spermatozoa that delivers highly purified and intact RNA, verified using RNA-specific electrophoretic chips and molecular biology approaches such as RT-PCR and Western blot analysis. The sperm RNA isolation technique was optimized using rat spermatozoa and then adapted to human spermatozoa. Three steps in the sperm isolation procedure, epididymal fluid collection, sperm purification, and spermatozoon RNA extraction, were evaluated and assessed. The sperm RNA extraction methodology consists of collection of rat epididymal fluid with repeated needle punctures of the epididymis, somatic cell elimination using detergent-based somatic cell lysis buffer (SCLB) and the use of RNA isolation Kit. Rat sperm heads are more resistant to disruption than human spermatozoa, necessitating the addition of mechanical lysis with microbeads and heat in the rat protocol, whereas the human sperm protocol only required lysis buffer. In conclusion, this methodology results in reliable and consistent isolation of high-quality sperm RNA. Using this technique will aid in translation of data collected from animal models, and reproducibility of clinical assessment of male factor fertility using RNA molecular biomarkers.
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Affiliation(s)
- E Bianchi
- Division of Urology, Rhode Island Hospital, Providence, RI, USA.,Department of Pathology and Laboratory Medicine, Brown University, Providence, RI, USA
| | - A Stermer
- Department of Pathology and Laboratory Medicine, Brown University, Providence, RI, USA
| | - K Boekelheide
- Department of Pathology and Laboratory Medicine, Brown University, Providence, RI, USA
| | - M Sigman
- Division of Urology, Rhode Island Hospital, Providence, RI, USA.,Department of Pathology and Laboratory Medicine, Brown University, Providence, RI, USA
| | - S J Hall
- Department of Pathology and Laboratory Medicine, Brown University, Providence, RI, USA
| | - G Reyes
- Department of Pathology and Laboratory Medicine, Brown University, Providence, RI, USA
| | - E Dere
- Division of Urology, Rhode Island Hospital, Providence, RI, USA.,Department of Pathology and Laboratory Medicine, Brown University, Providence, RI, USA
| | - K Hwang
- Division of Urology, Rhode Island Hospital, Providence, RI, USA.,Department of Pathology and Laboratory Medicine, Brown University, Providence, RI, USA
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21
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Nehmeh S, Fox J, Schwartz J, Ballangrud A, Schoder H, Strauss H, Yu A, Gupta D, Hwang K, Powell S, Humm J, Ho A. A Pilot Study of Cardiac 13 N-Ammonia PET Imaging to Assess Early Cardiotoxicity Following Multibeam Intensity-Modulated Radiation Therapy for Breast Cancer. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.633] [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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22
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Kim C, Hwang K. P08.28 The combination therapy with temozolomide and DWMA-003TS for glioblastoma in vitro and invivo experiments. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.218] [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: 11/14/2022] Open
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23
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Hwang K, Joo J, Kim Y, Kim C, Han J. P12.09 Postoperatively delayed-onset seizure outcome in patients with primary supratentorial meningioma resection. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.367] [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: 11/14/2022] Open
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24
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Bianchi E, Boekelheide K, Sigman M, Hall S, Hwang K. Molecular mechanisms behind ghrelin-mediated prevention of post-surgical adhesions. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.037] [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: 11/24/2022]
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25
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Heo J, Hwang K, Moon Y, Kim J, Lee J, Tak T, Choi J. Sub-acute oral toxicity study of soybean [Glycine max (L.) Merr.] whole plant extract in rats. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.06.1725] [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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26
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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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27
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Price R, Knight R, Hwang K, Bayram E, Glide-Hurst C. TU-AB-BRA-05: Optimization of a Novel Large Field of View Distortion Phantom for MR-Only Treatment Planning. Med Phys 2016. [DOI: 10.1118/1.4957415] [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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28
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Hwang K, Meier J, Yung J, Stafford R. TU-H-206-07: Assessment of Geometric Distortion in EPI with a SPAMM Tagged Acquisition. Med Phys 2016. [DOI: 10.1118/1.4957652] [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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29
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Aina-Mumuney A, Hwang K, Sunwoo N, Burd I, Blakemore K. The Impact of Maternal Body Mass Index and Gestational Age on the Detection of Uterine Contractions by Tocodynamometry: A Retrospective Study. Reprod Sci 2016; 23:638-43. [PMID: 26499394 PMCID: PMC5933158 DOI: 10.1177/1933719115611754] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To examine the impact of maternal body mass index (BMI) and gestational age (GA) on uterine contraction detection by tocodynamometry. METHODS Gravidas with preterm labor (PTL) complaints who were evaluated by tocodynamometry, discharged from Labor and Delivery triage, and subsequently readmitted for preterm delivery were studied. Forty-six patients in whom contractions were detected (group 1) were compared to 49 women in whom contractions were not detected (group 2) with respect to BMI and GA at both evaluation and delivery. Multivariable logistic regression was used to adjust for confounders. RESULTS Group 2 had a higher mean BMI (31.7 vs 26.1, P < .001), were more likely to be obese (57.1% vs 19.6%, P < .001), and were more likely to have been evaluated in the mid-trimester (36.7% vs 17.4%, P = .04) compared to group 1. Independent risk factors for the inability of the tocodynamometer to detect contractions were obesity (odds ratio [OR] 0.18, 95% confidence interval [CI] 0.07-0.46) and evaluation in the mid-trimester (OR 0.33, 95% CI 0.13-0.84). CONCLUSION Our study provides evidence that the effectiveness of tocodynamometry diminishes with increasing maternal BMI. Efficacy of tocodynamometry is also decreased at earlier GA, most pronounced below 25 weeks. To evaluate women with PTL symptoms in the mid-trimester or symptomatic obese women at any GA, a modality other than tocodynamometry could be valuable to more accurately assess uterine activity.
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Affiliation(s)
- A Aina-Mumuney
- Division of Maternal Fetal Medicine, Department of Gynecology/Obstetrics, Johns Hopkins University School of Medicine Baltimore, MD, USA
| | - K Hwang
- Department of Biomedical Engineering, Johns Hopkins University Baltimore, MD, USA
| | - N Sunwoo
- Department of Biomedical Engineering, Johns Hopkins University Baltimore, MD, USA
| | - I Burd
- Division of Maternal Fetal Medicine, Department of Gynecology/Obstetrics, Johns Hopkins University School of Medicine Baltimore, MD, USA
| | - K Blakemore
- Division of Maternal Fetal Medicine, Department of Gynecology/Obstetrics, Johns Hopkins University School of Medicine Baltimore, MD, USA
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30
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Dere E, Huse S, Hwang K, Sigman M, Boekelheide K. Intra- and inter-individual differences in human sperm DNA methylation. Andrology 2016; 4:832-42. [PMID: 27089098 DOI: 10.1111/andr.12170] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 01/06/2016] [Accepted: 01/13/2016] [Indexed: 12/20/2022]
Abstract
There is growing evidence that sperm DNA methylation is important in maintaining proper sperm health and function. Previous studies have associated sperm DNA methylation levels with sperm quality and function, however, little is known regarding the intra- and inter-individual variability in sperm methylation levels. This study characterizes this variation. Sperm epigenetic differences between successive semen samples from 12 patients were examined to identify the intra- and inter-individual differences globally across the genome, and in specifically defined genomic regions using the Illumina Infinium HumanMethylation450 BeadChips. Methylation analysis identified a bimodal distribution in the methylation levels that were non-uniformly distributed across the different genomic regions. The methylation levels were highly correlated in both the intra- and inter-individual comparisons. The intra-individual methylation levels were more highly correlated than the inter-individual comparison both globally and across the defined genomic regions, demonstrating that sperm DNA methylation levels are relatively stable between semen sample collections.
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Affiliation(s)
- E Dere
- Division of Urology, Rhode Island Hospital, Providence, RI, USA.,Department of Pathology and Laboratory Medicine, Brown University, Providence, RI, USA
| | - S Huse
- Department of Pathology and Laboratory Medicine, Brown University, Providence, RI, USA
| | - K Hwang
- Division of Urology, Rhode Island Hospital, Providence, RI, USA.,The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - M Sigman
- Division of Urology, Rhode Island Hospital, Providence, RI, USA.,The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - K Boekelheide
- Department of Pathology and Laboratory Medicine, Brown University, Providence, RI, USA
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31
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Rotker K, Vigneswaran H, Omil-Lima D, Baird G, Sigman M, Hwang K. Efficacy of standardized nursing fertility counseling on sperm banking rates in cancer patients. Fertil Steril 2015. [DOI: 10.1016/j.fertnstert.2015.07.276] [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: 11/24/2022]
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32
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Bianchi E, Sigman M, Boekelheide K, Hall S, Hwang K. Ghrelin administration ameliorates adhesion formation in a mouse surgical model. Fertil Steril 2015. [DOI: 10.1016/j.fertnstert.2015.07.540] [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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33
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Wang J, Yang J, Hwang K, Wen Z, Court L, Ibbott G. SU-E-J-227: Evaluation of Residual Geometric Distortion in MRI for Treatment Planning. Med Phys 2015. [DOI: 10.1118/1.4924313] [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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34
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Wang J, Hwang K, Fuller C, Mohamed A, Ding Y, Frank S, Hazle J, Zhou J. SU-E-J-225: CEST Imaging in Head and Neck Cancer Patients. Med Phys 2015. [DOI: 10.1118/1.4924311] [Citation(s) in RCA: 2] [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: 11/07/2022] Open
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35
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Hwang K, Bianchi E, Sigman M, Lamb D, Boekelheide K. Special research presentation: defining the role of ghrelin in wound healing and the inflammatory response in the post-operative setting. Fertil Steril 2014. [DOI: 10.1016/j.fertnstert.2014.07.013] [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: 11/27/2022]
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36
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Kim M, Ham O, Lee S, Choi E, Lee C, Park J, Lee J, Seo H, Seung M, Choi E, Min P, Hwang K, Kwon H. Microrna-365 inhibits the proliferation of vascular smooth muscle cells by targeting cyclin d1. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.359] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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37
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Stefan W, Hwang K, Hazle J, Stafford R. SU-E-I-32: Improving Vessel Delineation in Brain Using Susceptibility Weighted MRI and Group Sparse Reconstruction. Med Phys 2014. [DOI: 10.1118/1.4887980] [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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38
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Hwang K, Illerstam F, Torfeh T, Maier J, Shave S, Hoang M. SU-E-J-146: Spatial Accuracy QA of An MR System. Med Phys 2014. [DOI: 10.1118/1.4888199] [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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39
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Ai H, Hwang K, Pan T. MO-G-17A-03: MR-Based Cortical Bone Segmentation for PET Attenuation Correction with a Non-UTE 3D Fast GRE Sequence. Med Phys 2014. [DOI: 10.1118/1.4889205] [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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40
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Jun JH, Hwang K, Kim SK, Oh HB, Cho MC, Lee KJ. Estimation of the 6-digit level allele and haplotype frequencies of HLA-A, -B, and -C in Koreans using ambiguity-solving DNA typing. ACTA ACUST UNITED AC 2014; 84:277-84. [PMID: 24851935 DOI: 10.1111/tan.12368] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 03/31/2014] [Accepted: 04/15/2014] [Indexed: 01/20/2023]
Abstract
Because Korean society is fast becoming multi-ethnic, the determination of ambiguous human leukocyte antigen (HLA) types using HLA allele frequencies is becoming less applicable. In this study, we focused on the development of new technical methods to directly resolve the ambiguities arising from HLA genotyping. One hundred and fifty unrelated healthy Korean adults were included in this study. All alleles from each HLA locus were first divided into 2-4 groups, with each group amplified in a single PCR tube (multi-group-specific amplification, MGSA). To resolve phase ambiguities, some allele groups were also amplified separately in small group-specific amplification (SGSA) tubes. In order to then resolve incomplete sequence ambiguities, primers for MGSA and SGSA were initially designed to cover additional exons. If needed, a heterozygous ambiguity resolving primer (HARP) or sequence specific primer (SSP) was also used. When MGSA and SGSA methods were applied, the rate of phase ambiguity was greatly reduced to an average of 6% (1.3% in HLA-A, 15.7% in -B, and 2.0% in -C). Additional HARP and SSP methods could resolve all the phase ambiguities. Using our proposed method, we also detected three alleles that have not been previously reported in Korea, C*04:82, C*07:18, and C*08:22, and report 6-digit level HLA allele and haplotype frequencies among Koreans. In conclusion, the use of MGSA/SGSA for the initial amplification step is a cost-effective method facilitating timely and accurate reporting, given the continuing increase in the ethnic diversity of the Korean population. The MGSA described here can be applicable to various populations and thus could be shared by the majority of HLA typing laboratories. However, efforts to solve HLA ambiguity should continue, because SGSA, HARPs and SSPs would be specific to a particular population.
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Affiliation(s)
- J-H Jun
- Life Science Institute of Biowithus, Seoul, South Korea
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Abstract
BACKGROUND Revision total hip arthroplasty (THA) in patients with juvenile idiopathic arthritis (JIA) is challenging as a result of the patient's young age, systemic disease, multiple affected joints, small proportions, and bone loss. The intermediate- to long-term results of these surgeries remain unknown. QUESTIONS/PURPOSES The purpose of this study is to determine the (1) functional outcomes; (2) surgical complications; and (3) frequency of reoperation or revision after revision THA for JIA. METHODS We reviewed the records of all patients from one center who underwent revision THA for JIA who had a minimum of 5 years of followup (mean, 9 years; range, 5-19 years). This resulted in a series of 24 revision THAs in 15 patients. All patients were Charnley Class C. Age at revision averaged 35 years (range, 21-53 years). The 20 acetabular and 12 femoral revision components included 15 cementless cups, five reconstruction/roof rings with a cemented cup, and four cemented and eight cementless femoral stems. RESULTS The Harris hip scores improved from 54 (range, 34-85) to 77 (range, 37-100) (p < 0.001). Complications included two proximal femoral fractures associated with severe osteolysis and one sciatic nerve palsy in a patient with severe acetabular deficiency. A total of seven hips (29%) required reoperation or revision surgery, including three for infection (one early and two late) and four for mechanical loosening. CONCLUSIONS Revision THA in JIA is very challenging owing to patients' small proportions and compromised bone stock. The intraoperative and early complication rates are relatively high. Prognosis for long-term survivorship is guarded; limiting factors include periprosthetic osteolysis associated with older implants that used conventional polyethylene and cemented stems.
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Affiliation(s)
- Stuart B. Goodman
- Department of Orthopaedic Surgery, Stanford University Medical Center Outpatient Center, 450 Broadway Street, M/C 6342, Redwood City, CA 94063 USA
| | - Katherine Hwang
- Department of Orthopaedic Surgery, Stanford University Medical Center Outpatient Center, 450 Broadway Street, M/C 6342, Redwood City, CA 94063 USA
| | - Susanna Imrie
- Department of Orthopaedic Surgery, Stanford University Medical Center Outpatient Center, 450 Broadway Street, M/C 6342, Redwood City, CA 94063 USA
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Oh J, Choi J, Suh J, Liu H, Hwang K, Chung I, Lee S, Kang J, Park H, Jung W, Jo S, Gweon H, Lee Y, Lee W, Kim J, Han S, Hong G, Lee J, Lee B, Yeo C, Kim H, Seo E, Reynaud P, Goff J, Tan H, Tao J. Preliminary design of the ITER AC/DC converters supplied by the Korean Domestic Agency. Fusion Engineering and Design 2013. [DOI: 10.1016/j.fusengdes.2013.01.099] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Novak G, Osztroluczki A, Hwang K, Shave S, Chandler A, Fidrich M. Development of a Semiautomated Contouring Toolkit for Pelvic Organs on an MR Image Series. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1888] [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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Hwang K, Stefan W, Stafford R. SU-E-J-60: In Vivo Management of Suspectibility-Induced Distortions for Intracranial MRI Guided Therapies at 3 Tesla. Med Phys 2013. [DOI: 10.1118/1.4814272] [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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Pinnaduwage D, Sudhyadhom A, Descovich M, Hwang K, Novak G, Chen J, Pouliot J. SU-D-WAB-02: MRI-Based Treatment Planning in Brain Radiation Therapy: Validation of An Atlas-Based Pseudo-CT Generation Method. Med Phys 2013. [DOI: 10.1118/1.4814026] [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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McLellan JS, Gorman J, Bonsignori M, Hwang K, Liao H, Rerks-Ngarm S, Nitayaphan S, Michael NL, Kim JH, Haynes BF, Kwong PD. V1/V2-directed antibodies elicited in RV144 vaccinees bind to a structurally polymorphic site. Retrovirology 2012. [PMCID: PMC3441966 DOI: 10.1186/1742-4690-9-s2-p107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Pollara J, Bonsignori M, Moody M, Alam M, Liao H, Hwang K, Pickeral J, Kappes J, Ochsenbauer C, Soderberg K, Gurley TC, Kozink DM, Marshall DJ, Whitesides JF, Montefiori D, Robinson JE, Kaewkungwal J, Nitayaphan S, Pitisuttithum P, Rerks-Ngarm S, Kim J, Michael N, Tomaras G, Haynes BF, Ferrari G. Vaccine-induced ADCC-mediating antibodies target unique and overlapping envelope epitopes. Retrovirology 2012. [PMCID: PMC3441773 DOI: 10.1186/1742-4690-9-s2-o39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Liao L, Bonsignori M, Hwang K, Moody AM, Park R, Crawford S, Chen H, Jeffries TL, Cooper M, Lu X, De R, Karasavvas N, Rerks-Ngarm S, Nitayaphan S, Kaewkungwal J, Tovanabutra S, Pitisuttithum P, Tartaglia J, Sinangil F, Kim J, Michael NL, Tomaras GD, Yang Z, Dai K, Pancera M, Nabel GJ, Mascola JR, Kwong PD, Pinter A, Zolla-Pazner S, Alam MS, Haynes BF. Design of an HIV Env antigen that binds with high affinity to antibodies against linear, conformational and broadly neutralizing epitopes within V1/V2. Retrovirology 2012. [PMCID: PMC3441578 DOI: 10.1186/1742-4690-9-s2-o31] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Morris P, Hwang K, Hara R, Rapelje C, Mitchell L. Cell cycle kinetics, nuclear receptor and gene expression in human endometrial cells: differential regulation by progestin and selective progesterone receptor modulator. Fertil Steril 2012. [DOI: 10.1016/j.fertnstert.2012.07.024] [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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Thomas A, Mancino A, Elnathan H, Fesi J, Hwang K, Gilmore R. Children's cortical responses to optic flow patterns show differential tuning by pattern type, speed, scalp location and age group. J Vis 2012. [DOI: 10.1167/12.9.243] [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: 11/24/2022] Open
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