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Kang KM, Han JH, Kim KS, Kim EK, Shin Y, Park JH, Kim H, Kim NY, Kim YG, Kim H, Park H, Kim YM, Kee SJ, Kim SJ, Kim HS, Kim YC. Chlorophyll a and novel synthetic derivatives alleviate atopic dermatitis by suppressing Th2 cell differentiation via IL-4 receptor modulation. Clin Immunol 2024; 258:109852. [PMID: 38029848 DOI: 10.1016/j.clim.2023.109852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 10/14/2023] [Accepted: 11/08/2023] [Indexed: 12/01/2023]
Abstract
Atopic dermatitis (AD) treatment has largely relied on non-specific broad immunosuppressants despite their long-term toxicities until the approval of dupilumab, which blocks IL-4 signaling to target Th2 cell responses. Here, we report the discovery of compound 4aa, a novel compound derived from the structure of chlorophyll a, and the efficacy of chlorophyll a to alleviate AD symptoms by oral administration in human AD patients. 4aa downregulated GATA3 and IL-4 in differentiating Th2 cells by potently blocking IL-4 receptor dimerization. In the murine model, oral administration of 4aa reduced the clinical severity of symptoms and scratching behavior by 76% and 72%, respectively. Notably, the elevated serum levels of Th2 cytokines reduced to levels similar to those in the normal group after oral administration of 4aa. Additionally, the toxicological studies showed favorable safety profiles and good tolerance. In conclusion, 4aa may be applied for novel therapeutic developments for patients with AD.
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Affiliation(s)
- Koon Mook Kang
- School of Life Sciences, Gwangju Institute of Science and Technology, 123 Cheomdangwagi-ro, Buk-gu, Gwangju 61005, Republic of Korea
| | - Jung-Hyun Han
- School of Life Sciences, Gwangju Institute of Science and Technology, 123 Cheomdangwagi-ro, Buk-gu, Gwangju 61005, Republic of Korea
| | - Kyeong Seok Kim
- School of Pharmacy, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do 16419, Republic of Korea
| | - Eun Kyung Kim
- Department of Pharmacy, College of Pharmacy and Institute of Pharmaceutical Science and Technology, Hanyang University, 55 Hanyangdaehak-ro, Sangnok-gu, Ansan-si, Gyeonggi-do 15588, Republic of Korea
| | - Youna Shin
- School of Life Sciences, Gwangju Institute of Science and Technology, 123 Cheomdangwagi-ro, Buk-gu, Gwangju 61005, Republic of Korea
| | - Jae Hyeon Park
- School of Pharmacy, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do 16419, Republic of Korea
| | - Hyeon Kim
- R&D Center, Huons co. Ltd., 55 Hanyangdaehak-ro, Sangnok-gu, Ansan-si, Gyeonggi-do 15588, Republic of Korea
| | - Na Yoon Kim
- College of Pharmacy, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan-si, Chungcheongnam-do 31116, Republic of Korea
| | - Yoon Gyoon Kim
- College of Pharmacy, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan-si, Chungcheongnam-do 31116, Republic of Korea
| | - Hyunjun Kim
- R&D Center, Huons co. Ltd., 55 Hanyangdaehak-ro, Sangnok-gu, Ansan-si, Gyeonggi-do 15588, Republic of Korea
| | - Hyunjin Park
- R&D Center, Huons co. Ltd., 55 Hanyangdaehak-ro, Sangnok-gu, Ansan-si, Gyeonggi-do 15588, Republic of Korea
| | - Young-Mi Kim
- Department of Pharmacy, College of Pharmacy and Institute of Pharmaceutical Science and Technology, Hanyang University, 55 Hanyangdaehak-ro, Sangnok-gu, Ansan-si, Gyeonggi-do 15588, Republic of Korea
| | - Seung-Jung Kee
- Department of Laboratory Medicine, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Republic of Korea
| | - Seong-Jin Kim
- Department of Dermatology, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Republic of Korea.
| | - Hyung Sik Kim
- School of Pharmacy, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do 16419, Republic of Korea.
| | - Yong-Chul Kim
- School of Life Sciences, Gwangju Institute of Science and Technology, 123 Cheomdangwagi-ro, Buk-gu, Gwangju 61005, Republic of Korea.
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Kang KM, Jang Y, Lee SS, Jin MS, Jun CD, Kim M, Kim YC. Discovery of antiviral SARS-CoV-2 main protease inhibitors by structure-guided hit-to-lead optimization of carmofur. Eur J Med Chem 2023; 260:115720. [PMID: 37633203 DOI: 10.1016/j.ejmech.2023.115720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/25/2023] [Accepted: 08/10/2023] [Indexed: 08/28/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) main protease (Mpro) has been targeted for the development of anti-SARS-CoV-2 agents against COVID-19 infection because Mpro processes essential viral polyproteins and plays a key role in SARS-CoV-2 replication. In this study, we report the development of novel SARS-CoV-2 Mpro inhibitors derived from carmofur, a previously identified compound that has shown moderate potency as a covalent inhibitor of SARS-CoV-2 Mpro. To employ a structure-guided drug design strategy, a putative intact binding mode of carmofur at catalytic active site of Mpro was initially predicted by docking simulation. Based on the predicted binding mode, a series of carmofur derivatives aiming to occupy the Mpro substrate binding regions were investigated for structure-activity relationship analysis. As a result, an indole-based derivative, speculated to interact with the S4 binding pocket, 21b (IC50 = 1.5 ± 0.1 μM) was discovered. Its structure was further modified and evaluated in silico by combining docking simulation, free energy perturbation calculation and subpocket interaction analysis to optimize the interactions at the S2 and S4 binding pockets. Among the newly designed novel derivatives, 21h and 21i showed the best inhibitory potencies against Mpro with IC50 values of 0.35 and 0.37 μM, respectively. Moreover, their antiviral activities were confirmed with EC50 values of 20-30 μM in the SARS-CoV-2-infected cell-based assay, suggesting that these novel Mpro inhibitors could be applied as potential lead compounds for the development of substantial anti-SARS-CoV-2 agents.
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Affiliation(s)
- Koon Mook Kang
- School of Life Sciences, Gwangju Institute of Science and Technology, 123 Cheomdangwagi-ro, Buk-gu, Gwangju, 61005, Republic of Korea
| | - Yejin Jang
- Infectious Diseases Therapeutic Research Center, Korea Research Institute of Chemical Technology, 141 Gajeong-ro, Yuseong-gu, Daejeon, 34114, Republic of Korea
| | - Sang Soo Lee
- School of Life Sciences, Gwangju Institute of Science and Technology, 123 Cheomdangwagi-ro, Buk-gu, Gwangju, 61005, Republic of Korea
| | - Mi Sun Jin
- School of Life Sciences, Gwangju Institute of Science and Technology, 123 Cheomdangwagi-ro, Buk-gu, Gwangju, 61005, Republic of Korea
| | - Chang-Duk Jun
- School of Life Sciences, Gwangju Institute of Science and Technology, 123 Cheomdangwagi-ro, Buk-gu, Gwangju, 61005, Republic of Korea.
| | - Meehyein Kim
- Infectious Diseases Therapeutic Research Center, Korea Research Institute of Chemical Technology, 141 Gajeong-ro, Yuseong-gu, Daejeon, 34114, Republic of Korea; Graduate School of New Drug Discovery and Development, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon, 34134, Republic of Korea.
| | - Yong-Chul Kim
- School of Life Sciences, Gwangju Institute of Science and Technology, 123 Cheomdangwagi-ro, Buk-gu, Gwangju, 61005, Republic of Korea.
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Chung H, Seo H, Choi SH, Park CK, Kim TM, Park SH, Won JK, Lee JH, Lee ST, Lee JY, Hwang I, Kang KM, Yun TJ. Cluster Analysis of DSC MRI, Dynamic Contrast-Enhanced MRI, and DWI Parameters Associated with Prognosis in Patients with Glioblastoma after Removal of the Contrast-Enhancing Component: A Preliminary Study. AJNR Am J Neuroradiol 2022; 43:1559-1566. [PMID: 36175084 PMCID: PMC9731243 DOI: 10.3174/ajnr.a7655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 08/21/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND PURPOSE No report has been published on the use of DSC MR imaging, DCE MR imaging, and DWI parameters in combination to create a prognostic prediction model in glioblastoma patients. The aim of this study was to develop a machine learning-based model to find preoperative multiparametric MR imaging parameters associated with prognosis in patients with glioblastoma. Normalized CBV, volume transfer constant, and ADC of the nonenhancing T2 high-signal-intensity lesions were evaluated using K-means clustering. MATERIALS AND METHODS A total of 142 patients with glioblastoma who underwent preoperative MR imaging and total resection were included in this retrospective study. From the normalized CBV, volume transfer constant, and ADC maps, the parametric data were sorted using the K-means clustering method. Patients were divided into training and test sets (ratio, 1:1), and the optimal number of clusters was determined using receiver operating characteristic analysis. Kaplan-Meier survival analysis and log-rank tests were performed to identify potential parametric predictors. A multivariate Cox proportional hazard model was conducted to adjust for clinical predictors. RESULTS The nonenhancing T2 high-signal-intensity lesions were divided into 6 clusters. The cluster (class 4) with the relatively low normalized CBV and volume transfer constant value and the lowest ADC values was most associated with predicting glioblastoma prognosis. The optimal cutoff of the class 4 volume fraction of nonenhancing T2 high-signal-intensity lesions predicting 1-year progression-free survival was 9.70%, below which the cutoff was associated with longer progression-free survival. Two Kaplan-Meier curves based on the cutoff value showed a statistically significant difference (P = .037). When we adjusted for all clinical predictors, the cluster with the relatively low normalized CBV and volume transfer constant values and the lowest ADC value was an independent prognostic marker (hazard ratio, 3.04; P = .048). The multivariate Cox proportional hazard model showed a concordance index of 0.699 for progression-free survival. CONCLUSIONS Our model showed that nonenhancing T2 high-signal-intensity lesions with the relatively low normalized CBV, low volume transfer constant values, and the lowest ADC values could serve as useful prognostic imaging markers for predicting survival outcomes in patients with glioblastoma.
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Affiliation(s)
- H Chung
- From the Seoul National University College of Medicine (H.C., H.S.), Seoul, Korea
| | - H Seo
- From the Seoul National University College of Medicine (H.C., H.S.), Seoul, Korea
| | - S H Choi
- Department of Radiology (S.H.C., J.Y.L., I.H., K.M.K., T.J.Y.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Center for Nanoparticle Research (S.H.C.), Institute for Basic Science, Seoul, Korea
- School of Chemical and Biological Engineering (S.H.C.), Seoul National University, Seoul, Korea
| | - C-K Park
- Department of Neurosurgery (C.-K.P.), Internal Medicine
| | - T M Kim
- Cancer Research Institute (T.M.K.)
| | - S-H Park
- Departments of Pathology (S.-H.P., J.K.W.), Radiation Oncology
| | - J K Won
- Departments of Pathology (S.-H.P., J.K.W.), Radiation Oncology
| | - J H Lee
- Cancer Research Institute (J.H.L.)
| | - S-T Lee
- Neurology (S.-T.L.), Seoul National University Hospital, Seoul, Korea
| | - J Y Lee
- Department of Radiology (S.H.C., J.Y.L., I.H., K.M.K., T.J.Y.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - I Hwang
- Department of Radiology (S.H.C., J.Y.L., I.H., K.M.K., T.J.Y.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - K M Kang
- Department of Radiology (S.H.C., J.Y.L., I.H., K.M.K., T.J.Y.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - T J Yun
- Department of Radiology (S.H.C., J.Y.L., I.H., K.M.K., T.J.Y.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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Bae J, Mook Kang K, Kim YC. Discovery of 5-methyl-1H-benzo[d]imidazole derivatives as novel P2X3 Receptor antagonists. Bioorg Med Chem Lett 2022; 72:128820. [PMID: 35644300 DOI: 10.1016/j.bmcl.2022.128820] [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: 04/04/2022] [Revised: 05/17/2022] [Accepted: 05/22/2022] [Indexed: 11/02/2022]
Abstract
Drug discovery programs targeting P2X3 receptors (P2X3R), an extracellular adenosine 5'-triphosphate (ATP) gated cation channel family, have been actively investigated for several CNS-related diseases. The current unmet need in the field of P2X3R targeted drugs is to avoid a side effect, the loss of taste, that could be reduced by increase of the P2X3R selectivity vs P2X2/3R. In this study, 5-methyl-1H-benzo[d]imidazole derivatives were designed and synthesized from the analysis of key pharmacophores of current antagonists. In the structure-activity relationship study, the most potent compounds 17a-b was discovered as potent P2X3R antagonists with IC50 values of 145 and 206 nM, and selectivity index of 60 and 41, respectively. In addition, 17a-b showed the not-competitive antagonism, but poor binding score in the docking study at the known allosteric binding site of Gefapixant binding site, indicating that another allosteric binding site might be existing for the novel P2X3R antagonists.
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Affiliation(s)
- Jinsu Bae
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology (GIST) 61005, Republic of Korea
| | - Koon Mook Kang
- School of Life Sciences, Gwangju Institute of Science and Technology (GIST) 61005, Republic of Korea
| | - Yong-Chul Kim
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology (GIST) 61005, Republic of Korea; School of Life Sciences, Gwangju Institute of Science and Technology (GIST) 61005, Republic of Korea.
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Kang KM, Muralidharan K, Knowlton H, Hassan KIA, Yekula A, Misra M, Swearingen B, Jones PS. Utility of bilateral inferior petrosal sinus sampling for diagnosis and lateralization of Cushing's disease in the pediatric population: case series and review of the literature. J Endocrinol Invest 2022; 45:617-627. [PMID: 34655038 DOI: 10.1007/s40618-021-01680-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 09/16/2021] [Indexed: 12/01/2022]
Abstract
OBJECTS Cushing's disease (CD) is the most common cause of ACTH-dependent hypercortisolism in children age ≥ 7. The utility of bilateral inferior petrosal sinus sampling (BIPSS), an important test in adults, is less defined in children. We present a case series of children with ACTH-dependent hypercortisolemia and review the literature to assess the utility of BIPSS in the diagnosis and localization of CD. METHODS We performed an IRB-approved chart review of patients aged ≤ 18 with ACTH-dependent hypercortisolism at MGH between 2000 and 2019 and collected clinical, laboratory, radiographic, BIPSS, surgical, and outcomes data. RESULTS In our cohort (n = 21), BIPSS had a sensitivity of 93% and specificity of 100% for diagnosis of CD. Compared to surgery, successful BIPSS correctly predicted adenoma laterality in 69% of cases vs. 70% by MRI. Among patients with lesions ≥ 4 mm (n = 9), BIPSS correctly lateralized in 50% vs. 100% by MRI. In patients with subtle lesions (< 4 mm, n = 7), BIPSS correctly lateralized in 80% vs. 71% by MRI. In patients (n = 4) with CD and negative MRIs, BIPSS correctly lateralized in 75% cases. Surgical cure was achieved in 90% of patients and 95% of patients had long-term disease control. CONCLUSIONS In our cohort (n = 21; n = 20 CD, n = 1 ectopic ACTH secretion), BIPSS was sensitive and specific for the diagnosis of CD. Compared to MRI, BIPSS was not additionally helpful for lateralization in patients with lesions ≥ 4 mm on MRI. BIPSS was helpful in guiding surgical exploration and achieving immediate postoperative remission among patients with subtle and negative MRI findings.
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Affiliation(s)
- K M Kang
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
- University of California San Diego, San Diego, CA, USA.
| | - K Muralidharan
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - H Knowlton
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - K I A Hassan
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - A Yekula
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - M Misra
- Division of Pediatric Endocrinology, Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - B Swearingen
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - P S Jones
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA
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Choi HJ, Choi SH, You SH, Yoo RE, Kang KM, Yun TJ, Kim JH, Sohn CH, Park CK, Park SH. MGMT Promoter Methylation Status in Initial and Recurrent Glioblastoma: Correlation Study with DWI and DSC PWI Features. AJNR Am J Neuroradiol 2021; 42:853-860. [PMID: 33632732 DOI: 10.3174/ajnr.a7004] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 11/16/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation status in primary and recurrent glioblastoma may change during treatment. The purpose of this study was to correlate MGMT promoter methylation status changes with DWI and DSC PWI features in patients with recurrent glioblastoma after standard treatment. MATERIALS AND METHODS Between January 2008 and November 2016, forty patients with histologically confirmed recurrent glioblastoma were enrolled. Patients were divided into 3 groups according to the MGMT promoter methylation status for the initial and recurrent tumors: 2 groups whose MGMT promoter methylation status remained, group methylated (n = 13) or group unmethylated (n = 18), and 1 group whose MGMT promoter methylation status changed from methylated to unmethylated (n = 9). Normalized ADC and normalized relative CBV values were obtained from both the enhancing and nonenhancing regions, from which histogram parameters were calculated. The ANOVA and the Kruskal-Wallis test followed by post hoc tests were performed to compare histogram parameters among the 3 groups. The t test and Mann-Whitney U test were used to compare parameters between group methylated and group methylated to unmethylated. Receiver operating characteristic curve analysis was used to measure the predictive performance of the normalized relative CBV values between the 2 groups. RESULTS Group methylated to unmethylated showed significantly higher means and 90th and 95th percentiles of the cumulative normalized relative CBV values of the nonenhancing region of the initial tumor than group methylated and group unmethylated (all P < .05). The mean normalized relative CBV value of the nonenhancing region of the initial tumor was the best predictor of methylation status change (P < .001), with a sensitivity of 77.78% and specificity of 92.31% at a cutoff value of 2.594. CONCLUSIONS MGMT promoter methylation status might change in recurrent glioblastoma after standard treatment. The normalized relative CBV values of the nonenhancing region at the first preoperative MR imaging were higher in the MGMT promoter methylation change group from methylation to unmethylation in recurrent glioblastoma.
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Affiliation(s)
- H J Choi
- From the Department of Radiology (H.J.C.), Cha Bundang Medical Center, Cha University, Seongnam, Korea
| | - S H Choi
- Department of Radiology (S.H.C., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University Hospital, Seoul, Korea
| | - S-H You
- Department of Radiology (S.-H.Y.), Korea University Hospital, Seoul, Korea
| | - R-E Yoo
- Department of Radiology (S.H.C., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University Hospital, Seoul, Korea
| | - K M Kang
- Department of Radiology (S.H.C., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University Hospital, Seoul, Korea
| | - T J Yun
- Department of Radiology (S.H.C., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University Hospital, Seoul, Korea
| | - J-H Kim
- Department of Radiology (S.H.C., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University Hospital, Seoul, Korea
| | - C-H Sohn
- Department of Radiology (S.H.C., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University Hospital, Seoul, Korea
| | - C-K Park
- Department of Neurosurgery (C.-K.P.), Seoul National University Hospital, Seoul, Korea
| | - S-H Park
- Department of Pathology (S.-H.P.), Seoul National University Hospital, Seoul, Korea
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Hwang I, Choi SH, Park CK, Kim TM, Park SH, Won JK, Kim IH, Lee ST, Yoo RE, Kang KM, Yun TJ, Kim JH, Sohn CH. Dynamic Contrast-Enhanced MR Imaging of Nonenhancing T2 High-Signal-Intensity Lesions in Baseline and Posttreatment Glioblastoma: Temporal Change and Prognostic Value. AJNR Am J Neuroradiol 2019; 41:49-56. [PMID: 31806595 DOI: 10.3174/ajnr.a6323] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 10/02/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The prognostic value of dynamic contrast-enhanced MR imaging on nonenhancing T2 high-signal-intensity lesions in patients with glioblastoma has not been thoroughly elucidated to date. We evaluated the temporal change and prognostic value for progression-free survival of dynamic contrast-enhanced MR imaging-derived pharmacokinetic parameters on nonenhancing T2 high-signal-intensity lesions in patients with glioblastoma before and after standard treatment, including gross total surgical resection. MATERIALS AND METHODS This retrospective study included 33 patients who were newly diagnosed with glioblastoma and treated with gross total surgical resection followed by concurrent chemoradiation therapy and adjuvant chemotherapy with temozolomide in a single institution. All patients underwent dynamic contrast-enhanced MR imaging before surgery as a baseline and after completion of maximal surgical resection and concurrent chemoradiation therapy. On the whole nonenhancing T2 high-signal-intensity lesion, dynamic contrast-enhanced MR imaging-derived pharmacokinetic parameters (volume transfer constant [K trans], volume of extravascular extracellular space [v e], and blood plasma volume [vp ]) were calculated. The Cox proportional hazards regression model analysis was performed to determine the histogram features or percentage changes of pharmacokinetic parameters related to progression-free survival. RESULTS Baseline median K trans, baseline first quartile K trans, and posttreatment median K trans were significant independent variables, as determined by univariate analysis (P < .05). By multivariate Cox regression analysis including methylation status of O6-methylguanine-DNA methyltransferase, baseline median K trans was determined to be the significant independent variable and was negatively related to progression-free survival (hazard ratio = 1.48, P = .003). CONCLUSIONS Baseline median K trans from nonenhancing T2 high-signal-intensity lesions could be a potential prognostic imaging biomarker in patients undergoing gross total surgical resection followed by standard therapy for glioblastoma.
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Affiliation(s)
- I Hwang
- From the Department of Radiology (I.H., S.H.C., R.-E.Y., K.M.K., T.J.Y., J.-H.K., C.-H.S.), Center for Nanoparticle Research
| | - S H Choi
- From the Department of Radiology (I.H., S.H.C., R.-E.Y., K.M.K., T.J.Y., J.-H.K., C.-H.S.), Center for Nanoparticle Research .,Institute for Basic Science, and School of Chemical and Biological Engineering (S.H.C.)
| | - C-K Park
- Department of Neurosurgery and Biomedical Research Institute (P.C.-K.)
| | - T M Kim
- Department of Internal Medicine and Cancer Research Institute (T.M.K.)
| | - S-H Park
- Department of Pathology (S.-H.P., J.K.W.)
| | - J K Won
- Department of Pathology (S.-H.P., J.K.W.)
| | - I H Kim
- Department of Radiation Oncology and Cancer Research Institute (I.H.K.)
| | - S-T Lee
- Department of Neurology (S.-T.L.), Seoul National University Hospital, Seoul, Korea
| | - R-E Yoo
- From the Department of Radiology (I.H., S.H.C., R.-E.Y., K.M.K., T.J.Y., J.-H.K., C.-H.S.), Center for Nanoparticle Research
| | - K M Kang
- From the Department of Radiology (I.H., S.H.C., R.-E.Y., K.M.K., T.J.Y., J.-H.K., C.-H.S.), Center for Nanoparticle Research
| | - T J Yun
- From the Department of Radiology (I.H., S.H.C., R.-E.Y., K.M.K., T.J.Y., J.-H.K., C.-H.S.), Center for Nanoparticle Research
| | - J-H Kim
- From the Department of Radiology (I.H., S.H.C., R.-E.Y., K.M.K., T.J.Y., J.-H.K., C.-H.S.), Center for Nanoparticle Research
| | - C-H Sohn
- From the Department of Radiology (I.H., S.H.C., R.-E.Y., K.M.K., T.J.Y., J.-H.K., C.-H.S.), Center for Nanoparticle Research
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Oh J, Choi SH, Lee E, Shin DJ, Jo SW, Yoo RE, Kang KM, Yun TJ, Kim JH, Sohn CH. Application of 3D Fast Spin-Echo T1 Black-Blood Imaging in the Diagnosis and Prognostic Prediction of Patients with Leptomeningeal Carcinomatosis. AJNR Am J Neuroradiol 2018; 39:1453-1459. [PMID: 30002052 DOI: 10.3174/ajnr.a5721] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 02/18/2018] [Accepted: 05/23/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND PURPOSE Contrast-enhanced 3D fast spin-echo T1 black-blood imaging selectively suppresses the signal of blood flow and could provide a higher contrast-to-noise ratio compared with contrast-enhanced 3D ultrafast gradient recalled echo (contrast-enhanced gradient recalled echo) and 2D spin-echo T1WI (contrast-enhanced spin-echo). The purpose of our study was to evaluate whether black-blood imaging can improve the diagnostic accuracy for leptomeningeal carcinomatosis compared with contrast-enhanced gradient recalled-echo and contrast-enhanced spin-echo and, furthermore, to determine whether the grade of leptomeningeal carcinomatosis evaluated on black-blood imaging is a significant predictor of progression-free survival. MATERIALS AND METHODS Leptomeningeal carcinomatosis (n = 78) and healthy (n = 31) groups were enrolled. Contrast-enhanced gradient recalled-echo, contrast-enhanced spin-echo, and black-blood imaging were separately reviewed, and a diagnostic rating (positive, indeterminate, or negative) and grading of leptomeningeal carcinomatosis were assigned. The diagnostic accuracies of the 3 imaging sequences were compared in terms of leptomeningeal carcinomatosis detection. The Kaplan-Meier and the Cox proportional hazards model analyses were performed to determine the relationship between the leptomeningeal carcinomatosis grade evaluated on black-blood imaging and progression-free survival. RESULTS Black-blood imaging showed a significantly higher sensitivity (97.43%) than contrast-enhanced gradient recalled-echo (64.1%) and contrast-enhanced spin-echo (66.67%) (P < .05). In terms of specificities, we did not find any significant differences among contrast-enhanced gradient recalled-echo (90.32%), contrast-enhanced spin-echo (90.32%), and black-blood imaging (96.77%) (P > .05). A Cox proportional hazards model identified the time to metastasis, Karnofsky Performance Scale status, and a combination of the leptomeningeal carcinomatosis grade with a linear pattern as independent predictors of progression-free survival (P < .05). CONCLUSIONS Black-blood imaging can improve the diagnostic accuracy and predict progression-free survival in patients with leptomeningeal carcinomatosis.
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Affiliation(s)
- J Oh
- From the Department of Radiology (J.O., S.H.C., E.L., D.J.S., S.W.J., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University Hospital, Seoul, Korea
- Department of Radiology (J.O., S.H.C., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University College of Medicine, Seoul, Korea
| | - S H Choi
- From the Department of Radiology (J.O., S.H.C., E.L., D.J.S., S.W.J., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University Hospital, Seoul, Korea
- Department of Radiology (J.O., S.H.C., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University College of Medicine, Seoul, Korea
- Institute of Radiation Medicine (S.H.C.), Seoul National University Medical Research Center, Seoul, Korea
- Center for Nanoparticle Research (S.H.C.), Institute for Basic Science, Seoul, Republic of Korea
| | - E Lee
- From the Department of Radiology (J.O., S.H.C., E.L., D.J.S., S.W.J., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University Hospital, Seoul, Korea
| | - D J Shin
- From the Department of Radiology (J.O., S.H.C., E.L., D.J.S., S.W.J., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University Hospital, Seoul, Korea
| | - S W Jo
- From the Department of Radiology (J.O., S.H.C., E.L., D.J.S., S.W.J., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University Hospital, Seoul, Korea
| | - R-E Yoo
- From the Department of Radiology (J.O., S.H.C., E.L., D.J.S., S.W.J., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University Hospital, Seoul, Korea
- Department of Radiology (J.O., S.H.C., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University College of Medicine, Seoul, Korea
| | - K M Kang
- From the Department of Radiology (J.O., S.H.C., E.L., D.J.S., S.W.J., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University Hospital, Seoul, Korea
- Department of Radiology (J.O., S.H.C., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University College of Medicine, Seoul, Korea
| | - T J Yun
- From the Department of Radiology (J.O., S.H.C., E.L., D.J.S., S.W.J., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University Hospital, Seoul, Korea
- Department of Radiology (J.O., S.H.C., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University College of Medicine, Seoul, Korea
| | - J-H Kim
- From the Department of Radiology (J.O., S.H.C., E.L., D.J.S., S.W.J., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University Hospital, Seoul, Korea
- Department of Radiology (J.O., S.H.C., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University College of Medicine, Seoul, Korea
| | - C-H Sohn
- From the Department of Radiology (J.O., S.H.C., E.L., D.J.S., S.W.J., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University Hospital, Seoul, Korea
- Department of Radiology (J.O., S.H.C., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University College of Medicine, Seoul, Korea
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Chae S, Kang KM, Kim HJ, Kang E, Park SY, Kim JH, Kim SH, Kim SW, Kim EK. Neutrophil-lymphocyte ratio predicts response to chemotherapy in triple-negative breast cancer. ACTA ACUST UNITED AC 2018; 25:e113-e119. [PMID: 29719435 DOI: 10.3747/co.25.3888] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background The neutrophil-lymphocyte ratio (nlr) has been reported to correlate with patient outcome in several cancers, including breast cancer. We evaluated whether the nlr can be a predictive factor for pathologic complete response (pcr) after neoadjuvant chemotherapy (nac) in patients with triple-negative breast cancer (tnbc). Methods We analyzed the correlation between response to nac and various factors, including the nlr, in 87 patients with tnbc who underwent nac. In addition, we analyzed the association between the nlr and recurrence-free survival (rfs) in patients with tnbc. Results Of the 87 patients, 25 (28.7%) achieved a pcr. A high Ki-67 index and a low nlr were significantly associated with pcr. The pcr rate was higher in patients having a high Ki-67 index (≥15%) than in those having a low Ki-67 index (35.7% vs. 0%, p = 0.002) and higher in patients having a low nlr (≤1.7) than in those having a high nlr (42.1% vs. 18.4%, p = 0.018). In multiple logistic analysis, a low nlr remained the only predictive factor for pcr (odds ratio: 4.274; p = 0.008). In the survival analysis, the rfs was significantly higher in the low nlr group than in the high nlr group (5-year rfs rate: 83.7% vs. 66.9%; log-rank p = 0.016). Conclusions Our findings that the nlr is a predictor of pcr to nac and also a prognosticator of recurrence suggest an association between response to chemotherapy and inflammation in patients with tnbc. The pretreatment nlr can be a useful predictive and prognostic marker in patients with tnbc scheduled for nac.
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Affiliation(s)
| | | | | | | | | | - J H Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; and
| | - S H Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; and
| | - S W Kim
- Department of Surgery, Daerim St. Mary's Hospital, Seoul, Republic of Korea
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Nam JG, Kang KM, Choi SH, Lim WH, Yoo RE, Kim JH, Yun TJ, Sohn CH. Comparison between the Prebolus T1 Measurement and the Fixed T1 Value in Dynamic Contrast-Enhanced MR Imaging for the Differentiation of True Progression from Pseudoprogression in Glioblastoma Treated with Concurrent Radiation Therapy and Temozolomide Chemotherapy. AJNR Am J Neuroradiol 2017; 38:2243-2250. [PMID: 29074633 DOI: 10.3174/ajnr.a5417] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 07/24/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE Glioblastoma is the most common primary brain malignancy and differentiation of true progression from pseudoprogression is clinically important. Our purpose was to compare the diagnostic performance of dynamic contrast-enhanced pharmacokinetic parameters using the fixed T1 and measured T1 on differentiating true from pseudoprogression of glioblastoma after chemoradiation with temozolomide. MATERIALS AND METHODS This retrospective study included 37 patients with histopathologically confirmed glioblastoma with new enhancing lesions after temozolomide chemoradiation defined as true progression (n = 15) or pseudoprogression (n = 22). Dynamic contrast-enhanced pharmacokinetic parameters, including the volume transfer constant, the rate transfer constant, the blood plasma volume per unit volume, and the extravascular extracellular space per unit volume, were calculated by using both the fixed T1 of 1000 ms and measured T1 by using the multiple flip-angle method. Intra- and interobserver reproducibility was assessed by using the intraclass correlation coefficient. Dynamic contrast-enhanced pharmacokinetic parameters were compared between the 2 groups by using univariate and multivariate analysis. The diagnostic performance was evaluated by receiver operating characteristic analysis and leave-one-out cross validation. RESULTS The intraclass correlation coefficients of all the parameters from both T1 values were fair to excellent (0.689-0.999). The volume transfer constant and rate transfer constant from the fixed T1 were significantly higher in patients with true progression (P = .048 and .010, respectively). Multivariate analysis revealed that the rate transfer constant from the fixed T1 was the only independent variable (OR, 1.77 × 105) and showed substantial diagnostic power on receiver operating characteristic analysis (area under the curve, 0.752; P = .002). The sensitivity and specificity on leave-one-out cross validation were 73.3% (11/15) and 59.1% (13/20), respectively. CONCLUSIONS The dynamic contrast-enhanced parameter of rate transfer constant from the fixed T1 acted as a preferable marker to differentiate true progression from pseudoprogression.
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Affiliation(s)
- J G Nam
- From the Department of Radiology (J.G.N., K.M.K., S.H.C., W.H.L., R.-E.Y., J.-H.K., T.J.Y., C.-H.S.), Seoul National University Hospital, Seoul, Korea
| | - K M Kang
- From the Department of Radiology (J.G.N., K.M.K., S.H.C., W.H.L., R.-E.Y., J.-H.K., T.J.Y., C.-H.S.), Seoul National University Hospital, Seoul, Korea
| | - S H Choi
- From the Department of Radiology (J.G.N., K.M.K., S.H.C., W.H.L., R.-E.Y., J.-H.K., T.J.Y., C.-H.S.), Seoul National University Hospital, Seoul, Korea
- Center for Nanoparticle Research, Institute for Basic Science (S.H.C., C.-H.S.)
- School of Chemical and Biological Engineering (S.H.C.), Seoul National University, Seoul, Korea
| | - W H Lim
- From the Department of Radiology (J.G.N., K.M.K., S.H.C., W.H.L., R.-E.Y., J.-H.K., T.J.Y., C.-H.S.), Seoul National University Hospital, Seoul, Korea
| | - R-E Yoo
- From the Department of Radiology (J.G.N., K.M.K., S.H.C., W.H.L., R.-E.Y., J.-H.K., T.J.Y., C.-H.S.), Seoul National University Hospital, Seoul, Korea
| | - J-H Kim
- From the Department of Radiology (J.G.N., K.M.K., S.H.C., W.H.L., R.-E.Y., J.-H.K., T.J.Y., C.-H.S.), Seoul National University Hospital, Seoul, Korea
| | - T J Yun
- From the Department of Radiology (J.G.N., K.M.K., S.H.C., W.H.L., R.-E.Y., J.-H.K., T.J.Y., C.-H.S.), Seoul National University Hospital, Seoul, Korea
| | - C-H Sohn
- From the Department of Radiology (J.G.N., K.M.K., S.H.C., W.H.L., R.-E.Y., J.-H.K., T.J.Y., C.-H.S.), Seoul National University Hospital, Seoul, Korea
- Center for Nanoparticle Research, Institute for Basic Science (S.H.C., C.-H.S.)
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Choi HJ, Sohn CH, You SH, Yoo RE, Kang KM, Yun TJ, Choi SH, Kim JH, Cho WS, Kim JE. Can Arterial Spin-Labeling with Multiple Postlabeling Delays Predict Cerebrovascular Reserve? AJNR Am J Neuroradiol 2017; 39:84-90. [PMID: 29146719 DOI: 10.3174/ajnr.a5439] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 09/04/2017] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND PURPOSE The effect of delayed transit time is the main source of error in the quantitative measurement of CBF in arterial spin-labeling. In the present study, we evaluated the usefulness of the transit time-corrected CBF and arterial transit time delay from multiple postlabeling delays arterial spin-labeling compared with basal/acetazolamide stress technetium Tc99m-hexamethylpropylene amineoxime (Tc99m-HMPAO) SPECT in predicting impairment in the cerebrovascular reserve. MATERIALS AND METHODS Transit time-corrected CBF maps and arterial transit time maps were acquired in 30 consecutive patients with unilateral ICA or MCA steno-occlusive disease (severe stenosis or occlusion). Internal carotid artery territory-based ROIs were applied to both perfusion maps. Additionally, impairment in the cerebrovascular reserve was evaluated according to both qualitative and quantitative analyses of the ROIs on basal/acetazolamide stress Tc99m-HMPAO SPECT using a previously described method. The area under the receiver operating characteristic curve was used to evaluate the diagnostic accuracy of arterial spin-labeling in depicting impairment of the cerebrovascular reserve. The correlation between arterial spin-labeling and cerebrovascular reserve was evaluated. RESULTS The affected hemisphere had a decreased transit time-corrected CBF and increased arterial transit time compared with the corresponding values of the contralateral normal hemisphere, which were statistically significant (P < .001). The percentage change of transit time-corrected CBF and the percentage change of arterial transit time were independently differentiating variables (P < .001) for predicting cerebrovascular reserve impairment. The correlation coefficient between the arterial transit time and cerebrovascular reserve index ratio was -0.511. CONCLUSIONS Our results demonstrate that the transit time-corrected CBF and arterial transit time based on arterial spin-labeling perfusion MR imaging can predict cerebrovascular reserve impairment.
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Affiliation(s)
- H J Choi
- From the Department of Radiology (H.J.C.), CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - C-H Sohn
- Departments of Radiology (C.-H.S., R.-E.Y., K.M.K., T.J.Y., S.H.C., J.-H.K.)
| | - S-H You
- Department of Radiology (S.-H.Y.), Korea University Hospital, Seoul, Korea
| | - R-E Yoo
- Departments of Radiology (C.-H.S., R.-E.Y., K.M.K., T.J.Y., S.H.C., J.-H.K.)
| | - K M Kang
- Departments of Radiology (C.-H.S., R.-E.Y., K.M.K., T.J.Y., S.H.C., J.-H.K.)
| | - T J Yun
- Departments of Radiology (C.-H.S., R.-E.Y., K.M.K., T.J.Y., S.H.C., J.-H.K.)
| | - S H Choi
- Departments of Radiology (C.-H.S., R.-E.Y., K.M.K., T.J.Y., S.H.C., J.-H.K.)
| | - J-H Kim
- Departments of Radiology (C.-H.S., R.-E.Y., K.M.K., T.J.Y., S.H.C., J.-H.K.)
| | - W-S Cho
- Neurosurgery (W.-S.C., J.E.K.), Seoul National University Hospital, Seoul, Korea
| | - J E Kim
- Neurosurgery (W.-S.C., J.E.K.), Seoul National University Hospital, Seoul, Korea
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Kang KM, Sohn CH, You SH, Nam JG, Choi SH, Yun TJ, Yoo RE, Kim JH. Added Value of Arterial Spin-Labeling MR Imaging for the Differentiation of Cerebellar Hemangioblastoma from Metastasis. AJNR Am J Neuroradiol 2017; 38:2052-2058. [PMID: 28912280 PMCID: PMC7963584 DOI: 10.3174/ajnr.a5363] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 06/30/2017] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND PURPOSE In adults with only cerebellar masses, hemangioblastoma and metastasis are the 2 most important differential diagnoses. Our aim was to investigate the added value of arterial spin-labeling MR imaging for differentiating hemangioblastoma from metastasis in patients with only cerebellar masses. MATERIALS AND METHODS This retrospective study included a homogeneous cohort comprising patients with only cerebellar masses, including 16 hemangioblastomas and 14 metastases. All patients underwent enhanced MR imaging, including arterial spin-labeling. First, the presence or absence of a hyperperfused mass was determined. Next, in the hyperperfused mass, relative tumor blood flow (mean blood flow in the tumor divided by blood flow measured in normal-appearing cerebellar tissue) and the size ratio (size in the arterial spin-labeling images divided by size in the postcontrast T1WI) were measured. To validate the arterial spin-labeling findings, 2 observers independently evaluated the conventional MR images and the combined set of arterial spin-labeling images. RESULTS All patients with hemangioblastomas and half of the patients with metastases presented with a hyperperfused mass (P < .001). The size ratio and relative tumor blood flow were significantly larger for hemangioblastomas than for metastases (P < .001 and P = .039, respectively). The size ratio revealed excellent diagnostic power (area under the curve = 0.991), and the relative tumor blood flow demonstrated moderate diagnostic power (area under the curve = 0.777). The diagnostic accuracy of both observers was significantly improved after the addition of arterial spin-labeling; the area under the curve improved from 0.574 to 0.969 (P < .001) for observer 2 and from 0.683 to 1 (P < .001) for observer 2. CONCLUSIONS Arterial spin-labeling imaging can aid in distinguishing hemangioblastoma from metastasis in patients with only cerebellar masses.
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Affiliation(s)
- K M Kang
- From the Department of Radiology (K.M.K., C.-H.S., J.G.N., S.H.C., T.J.Y., R.-E.Y., J.-h.K.), Seoul National University Hospital, Seoul, Korea
| | - C-H Sohn
- From the Department of Radiology (K.M.K., C.-H.S., J.G.N., S.H.C., T.J.Y., R.-E.Y., J.-h.K.), Seoul National University Hospital, Seoul, Korea
- Department of Radiology (C.-H.S., S.H.C.), Seoul National University College of Medicine, Seoul, Korea
| | - S-H You
- Department of Radiology (S.-H.Y.), Korea University Hospital, Seoul, Korea
| | - J G Nam
- From the Department of Radiology (K.M.K., C.-H.S., J.G.N., S.H.C., T.J.Y., R.-E.Y., J.-h.K.), Seoul National University Hospital, Seoul, Korea
| | - S H Choi
- From the Department of Radiology (K.M.K., C.-H.S., J.G.N., S.H.C., T.J.Y., R.-E.Y., J.-h.K.), Seoul National University Hospital, Seoul, Korea
- Department of Radiology (C.-H.S., S.H.C.), Seoul National University College of Medicine, Seoul, Korea
| | - T J Yun
- From the Department of Radiology (K.M.K., C.-H.S., J.G.N., S.H.C., T.J.Y., R.-E.Y., J.-h.K.), Seoul National University Hospital, Seoul, Korea
| | - R-E Yoo
- From the Department of Radiology (K.M.K., C.-H.S., J.G.N., S.H.C., T.J.Y., R.-E.Y., J.-h.K.), Seoul National University Hospital, Seoul, Korea
| | - J-H Kim
- From the Department of Radiology (K.M.K., C.-H.S., J.G.N., S.H.C., T.J.Y., R.-E.Y., J.-h.K.), Seoul National University Hospital, Seoul, Korea
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Jung YH, Kim YO, Lin H, Cho JH, Park JH, Lee SD, Bae J, Kang KM, Kim YG, Pae AN, Ko H, Park CS, Yoon MH, Kim YC. Discovery of Potent Antiallodynic Agents for Neuropathic Pain Targeting P2X3 Receptors. ACS Chem Neurosci 2017; 8:1465-1478. [PMID: 28323403 DOI: 10.1021/acschemneuro.6b00401] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Antagonism of the P2X3 receptor is one of the potential therapeutic strategies for the management of neuropathic pain because P2X3 receptors are predominantly localized on small to medium diameter C- and Aδ-fiber primary afferent neurons, which are related to the pain-sensing system. In this study, 5-hydroxy pyridine derivatives were designed, synthesized, and evaluated for their in vitro biological activities by two-electrode voltage clamp assay at hP2X3 receptors. Among the novel hP2X3 receptor antagonists, intrathecal treatment of compound 29 showed parallel efficacy with pregabalin (calcium channel modulator) and higher efficacy than AF353 (P2X3 receptor antagonist) in the evaluation of its antiallodynic effects in spinal nerve ligation rats. However, because compound 29 was inactive by intraperitoneal administration in neuropathic pain animal models due to low cell permeability, the corresponding methyl ester analogue, 28, which could be converted to compound 29 in vivo, was investigated as a prodrug concept. Intravenous injection of compound 28 resulted in potent antiallodynic effects, with ED50 values of 2.62 and 2.93 mg/kg in spinal nerve ligation and chemotherapy-induced peripheral neuropathy rats, respectively, indicating that new drug development targeting the P2X3 receptor could be promising for neuropathic pain, a disease with high unmet medical needs.
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Affiliation(s)
- Young-Hwan Jung
- School of Life Sciences, Gwangju Institute of Science and Technology (GIST), Gwangju 500-712, Republic of Korea
| | | | | | - Joong-Heui Cho
- New Drug Development Center
(NDDC), Daegu-Gyeongbuk Medical Innovation Foundation (DGMIF), 80
Cheombok-ro, Dong-gu, Daegu 41061, Republic of Korea
| | - Jin-Hee Park
- New Drug Development Center
(NDDC), Daegu-Gyeongbuk Medical Innovation Foundation (DGMIF), 80
Cheombok-ro, Dong-gu, Daegu 41061, Republic of Korea
| | - So-Deok Lee
- School of Life Sciences, Gwangju Institute of Science and Technology (GIST), Gwangju 500-712, Republic of Korea
| | - Jinsu Bae
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology (GIST), Gwangju 500-712, Republic of Korea
| | - Koon Mook Kang
- School of Life Sciences, Gwangju Institute of Science and Technology (GIST), Gwangju 500-712, Republic of Korea
| | - Yoon-Gyoon Kim
- College of Pharmacy, Dankook University, Cheonan 330-714, Republic of Korea
| | - Ae Nim Pae
- Convergence Research Center for Diagnosis, Treatment
and Care System of Dementia, Korea Institute of Science and Technology, PO Box 131, Cheongryang, Seoul 130-650, Republic of Korea
| | - Hyojin Ko
- School of Life Sciences, Gwangju Institute of Science and Technology (GIST), Gwangju 500-712, Republic of Korea
| | - Chul-Seung Park
- School of Life Sciences, Gwangju Institute of Science and Technology (GIST), Gwangju 500-712, Republic of Korea
| | | | - Yong-Chul Kim
- School of Life Sciences, Gwangju Institute of Science and Technology (GIST), Gwangju 500-712, Republic of Korea
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology (GIST), Gwangju 500-712, Republic of Korea
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Hwang I, Sohn CH, Kang KM, Jeon BS, Kim HJ, Choi SH, Yun TJ, Kim JH. Differentiation of Parkinsonism-Predominant Multiple System Atrophy from Idiopathic Parkinson Disease Using 3T Susceptibility-Weighted MR Imaging, Focusing on Putaminal Change and Lesion Asymmetry. AJNR Am J Neuroradiol 2015; 36:2227-34. [PMID: 26338919 DOI: 10.3174/ajnr.a4442] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 04/23/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Asymmetric presentation of clinical feature in parkinsonism is common, but correlatable radiologic feature is not clearly defined. Our aim was to evaluate 3T susceptibility-weighted imaging findings for differentiating parkinsonism-predominant multiple system atrophy from idiopathic Parkinson disease, focusing on putaminal changes and lesion asymmetry. MATERIALS AND METHODS This retrospective cohort study included 27 patients with parkinsonism-predominant multiple system atrophy and 50 patients with idiopathic Parkinson disease diagnosed clinically. Twenty-seven age-matched subjects without evidence of movement disorders who underwent SWI were included as the control group. A consensus was reached by 2 radiologists who visually assessed SWI for the presence of putaminal atrophy and marked signal hypointensity on each side of the posterolateral putamen. We also quantitatively measured putaminal width and phase-shift values. RESULTS The mean disease duration was 4.7 years for the patients with parkinsonism-predominant multiple system atrophy and 7.8 years for the patients with idiopathic Parkinson disease. In the patients with parkinsonism-predominant multiple system atrophy, putaminal atrophy was frequently observed (14/27, 51.9%) and was most commonly found in the unilateral putamen (13/14). Marked signal hypointensity was observed in 12 patients with parkinsonism-predominant multiple system atrophy (44.4%). No patients with idiopathic Parkinson disease or healthy controls showed putaminal atrophy or marked signal hypointensity. Quantitatively measured putaminal width, phase-shift values, and the ratio of mean phase-shift values for the dominant and nondominant sides were significantly different between the parkinsonism-predominant multiple system atrophy group and the idiopathic Parkinson disease and healthy control groups (P < .001). CONCLUSIONS 3T SWI can visualize putaminal atrophy and marked signal hypointensity in patients with parkinsonism-predominant multiple system atrophy with high specificity. Furthermore, it clearly demonstrates the dominant side of putaminal changes, which correlate with the contralateral symptomatic side of patients.
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Affiliation(s)
- I Hwang
- From the Departments of Radiology (I.H., C.-H.S., K.M.K, S.H.C., T.J.Y., J.-h.K.)
| | - C-H Sohn
- From the Departments of Radiology (I.H., C.-H.S., K.M.K, S.H.C., T.J.Y., J.-h.K.) Department of Radiology (C.-H.S.), Seoul National University College of Medicine, Seoul, Korea Institute of Radiation Medicine (C.-H.S.), Seoul National University Medical Research Center, Seoul, Korea.
| | - K M Kang
- From the Departments of Radiology (I.H., C.-H.S., K.M.K, S.H.C., T.J.Y., J.-h.K.)
| | - B S Jeon
- Neurology (B.S.J., H.-J.K.), Seoul National University Hospital, Seoul, Korea
| | - H-J Kim
- Neurology (B.S.J., H.-J.K.), Seoul National University Hospital, Seoul, Korea
| | - S H Choi
- From the Departments of Radiology (I.H., C.-H.S., K.M.K, S.H.C., T.J.Y., J.-h.K.)
| | - T J Yun
- From the Departments of Radiology (I.H., C.-H.S., K.M.K, S.H.C., T.J.Y., J.-h.K.)
| | - J-H Kim
- From the Departments of Radiology (I.H., C.-H.S., K.M.K, S.H.C., T.J.Y., J.-h.K.)
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15
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Kang KM, Sohn CH, Kim BS, Kim YI, Choi SH, Yun TJ, Kim JH, Park SW, Cheon GJ, Han MH. Correlation of Asymmetry Indices Measured by Arterial Spin-Labeling MR Imaging and SPECT in Patients with Crossed Cerebellar Diaschisis. AJNR Am J Neuroradiol 2015; 36:1662-8. [PMID: 26228883 DOI: 10.3174/ajnr.a4366] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 02/20/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Crossed cerebellar diaschisis, not only a secondary result of supratentorial infarction but also an indicator of clinical outcomes, has frequently been reported on PET and SPECT but has been rarely described with arterial spin-labeling MR imaging. The purpose of this study was to determine the ability of arterial spin-labeling MR imaging to evaluate crossed cerebellar diaschisis compared with that of SPECT. To our knowledge, this is the first study to validate arterial spin-labeling in crossed cerebellar diaschisis by using SPECT as a reference standard. MATERIALS AND METHODS This study included 16 patients in whom crossed cerebellar diaschisis was shown on SPECT and 10 control subjects in whom crossed cerebellar diaschisis was not shown on SPECT. During the qualitative analysis, asymmetric cerebellar perfusion on arterial spin-labeling was divided into 1 of the following 3 grades by 2 blinded observers: the affected cerebellum was isointense compared with the unaffected cerebellum (grade I), it was slightly hypointense (grade II), or it was markedly hypointense (grade III). In the quantitative analysis, asymmetry indices were calculated by using SPECT and arterial spin-labeling images. For statistical analysis, κ statistics, the interobserver correlation coefficient, the independent t test, Pearson correlation, and linear regression analysis were used. RESULTS Almost all the diagnoses of crossed cerebellar diaschisis on SPECT were noted on arterial spin-labeling in both qualitative and quantitative analyses with good interobserver agreement (κ = 0.961; interobserver correlation coefficient, 0.806). The mean asymmetry index of arterial spin-labeling (26.06 ± 9.00) was significantly larger than that for SPECT (15.28 ± 5.34; P < .001). There was a significant positive correlation between the asymmetry indices obtained for SPECT and those for arterial spin-labeling (r = 0.77 [95% CI, 0.443-0.916]; P < .001). The relationship of asymmetry indices between SPECT and arterial spin-labeling (x, y) was calculated as y = 6.2131 + 1.2986x (R(2) = 0.592; P < .001). CONCLUSIONS Arterial spin-labeling can be a noninvasive alternative to SPECT for evaluating crossed cerebellar diaschisis.
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Affiliation(s)
- K M Kang
- From the Departments of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., M.H.H.) Department of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., S.-W.P., M.H.H.), Seoul National University College of Medicine, Seoul, Republic of Korea
| | - C-H Sohn
- From the Departments of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., M.H.H.) Department of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., S.-W.P., M.H.H.), Seoul National University College of Medicine, Seoul, Republic of Korea Institute of Radiation Medicine (C.-H.S., S.H.C., M.H.H.), Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - B S Kim
- From the Departments of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., M.H.H.) Department of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., S.-W.P., M.H.H.), Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Y I Kim
- Nuclear Medicine (Y.I.K., G.J.C.), Seoul National University Hospital, Seoul, Republic of Korea
| | - S H Choi
- From the Departments of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., M.H.H.) Department of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., S.-W.P., M.H.H.), Seoul National University College of Medicine, Seoul, Republic of Korea Institute of Radiation Medicine (C.-H.S., S.H.C., M.H.H.), Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - T J Yun
- From the Departments of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., M.H.H.) Department of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., S.-W.P., M.H.H.), Seoul National University College of Medicine, Seoul, Republic of Korea
| | - J-h Kim
- From the Departments of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., M.H.H.) Department of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., S.-W.P., M.H.H.), Seoul National University College of Medicine, Seoul, Republic of Korea
| | - S-W Park
- Department of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., S.-W.P., M.H.H.), Seoul National University College of Medicine, Seoul, Republic of Korea Department of Radiology (S.-W.P.), Seoul National University Boramae Hospital, Seoul, Republic of Korea
| | - G J Cheon
- Nuclear Medicine (Y.I.K., G.J.C.), Seoul National University Hospital, Seoul, Republic of Korea
| | - M H Han
- From the Departments of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., M.H.H.) Department of Radiology (K.M.K., C.-H.S., B.S.K., S.H.C., T.J.Y., J.-h.K., S.-W.P., M.H.H.), Seoul National University College of Medicine, Seoul, Republic of Korea Institute of Radiation Medicine (C.-H.S., S.H.C., M.H.H.), Seoul National University Medical Research Center, Seoul, Republic of Korea
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16
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Kang KM, Yun TJ, Yoon BW, Jeon BS, Choi SH, Kim JH, Kim JE, Sohn CH, Han MH. Clinical utility of arterial spin-labeling as a confirmatory test for suspected brain death. AJNR Am J Neuroradiol 2015; 36:909-14. [PMID: 25572951 DOI: 10.3174/ajnr.a4209] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 11/11/2014] [Indexed: 01/03/2023]
Abstract
Diagnosis of brain death is made on the basis of 3 essential findings: coma, absence of brain stem reflexes, and apnea. Although confirmatory tests are not mandatory in most situations, additional testing may be necessary to declare brain death in patients in whom results of specific components of clinical testing cannot be reliably evaluated. Recently, arterial spin-labeling has been incorporated as part of MR imaging to evaluate cerebral perfusion. Advantages of arterial spin-labeling include being completely noninvasive and providing information about absolute CBF. We retrospectively reviewed arterial spin-labeling findings according to the following modified criteria based on previously established confirmatory tests to determine brain death: 1) extremely decreased perfusion in the whole brain, 2) bright vessel signal intensity around the entry of the carotid artery to the skull, 3) patent external carotid circulation, and 4) "hollow skull sign" in a series of 5 patients. Arterial spin-labeling findings satisfied the criteria for brain death in all patients. Arterial spin-labeling imaging has the potential to be a completely noninvasive confirmatory test to provide additional information to assist in the diagnosis of brain death.
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Affiliation(s)
- K M Kang
- From the Institute of Radiation Medicine (K.M.K., T.J.Y., S.H.C., J.-h.K., C.-H.S., M.H.H.), Seoul National University Medical Research Center, Seoul, Republic of Korea Departments of Radiology (K.M.K., T.J.Y., S.H.C., J.-h.K., C.-H.S., M.H.H.)
| | - T J Yun
- From the Institute of Radiation Medicine (K.M.K., T.J.Y., S.H.C., J.-h.K., C.-H.S., M.H.H.), Seoul National University Medical Research Center, Seoul, Republic of Korea Departments of Radiology (K.M.K., T.J.Y., S.H.C., J.-h.K., C.-H.S., M.H.H.)
| | - B-W Yoon
- Neurology (B.-W.Y., B.S.J.) Clinical Research Center for Stroke (B.-W.Y., B.S.J.), Clinical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - B S Jeon
- Neurology (B.-W.Y., B.S.J.) Clinical Research Center for Stroke (B.-W.Y., B.S.J.), Clinical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - S H Choi
- From the Institute of Radiation Medicine (K.M.K., T.J.Y., S.H.C., J.-h.K., C.-H.S., M.H.H.), Seoul National University Medical Research Center, Seoul, Republic of Korea Departments of Radiology (K.M.K., T.J.Y., S.H.C., J.-h.K., C.-H.S., M.H.H.)
| | - J-H Kim
- From the Institute of Radiation Medicine (K.M.K., T.J.Y., S.H.C., J.-h.K., C.-H.S., M.H.H.), Seoul National University Medical Research Center, Seoul, Republic of Korea Departments of Radiology (K.M.K., T.J.Y., S.H.C., J.-h.K., C.-H.S., M.H.H.)
| | | | - C-H Sohn
- From the Institute of Radiation Medicine (K.M.K., T.J.Y., S.H.C., J.-h.K., C.-H.S., M.H.H.), Seoul National University Medical Research Center, Seoul, Republic of Korea Departments of Radiology (K.M.K., T.J.Y., S.H.C., J.-h.K., C.-H.S., M.H.H.)
| | - M H Han
- From the Institute of Radiation Medicine (K.M.K., T.J.Y., S.H.C., J.-h.K., C.-H.S., M.H.H.), Seoul National University Medical Research Center, Seoul, Republic of Korea Departments of Radiology (K.M.K., T.J.Y., S.H.C., J.-h.K., C.-H.S., M.H.H.)
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