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Go SM, Lee B, Ahn C, Jeong SH, Jo NR, Park SM, Lee M, Tran DN, Jung EM, Lee SD, Jeung EB. Initial phase establishment of an in vitro method for developmental neurotoxicity test using Ki-67 in human neural progenitor cells. J Physiol Pharmacol 2023; 74. [PMID: 37453095 DOI: 10.26402/jpp.2023.2.07] [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] [Received: 11/26/2022] [Accepted: 04/30/2023] [Indexed: 07/18/2023]
Abstract
Building a precise alternative neurotoxicological test is of great importance to respond to societal and ethical requirements. In this study, a new developmental neurotoxicity test (DNT) was established with the human neural progenitor cell line. ReNcell CX cells were exposed to neurotoxic chemicals (aphidicolin, hydroxyurea, cytosine arabinoside, 5-fluorouracil, and ochratoxin A) or non-neurotoxic chemicals (sodium gluconate, sodium bicarbonate, penicillin G, and saccharin). Propidium iodide (PI) was used to evaluate cell viability. BrdU and Ki-76 were employed to determine cell proliferation. Based on the cell viability and proliferation, mathematical models were built by linear discriminant analysis. Furthermore, the neurotoxic-considered chemicals inhibited cell cycle progression at the protein level, supporting the biomolecular rationale for the predictive model. Overall, these results show that the new test method can be used to determine the potential developmental neurotoxicants or new drug candidates.
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Affiliation(s)
- S M Go
- Laboratory of Veterinary Biochemistry and Molecular Biology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, Republic of Korea
| | - B Lee
- Laboratory of Veterinary Biochemistry and Molecular Biology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, Republic of Korea
| | - C Ahn
- Laboratory of Veterinary Physiology, College of Veterinary Medicine, Jeju National University, Jeju, 63243, Republic of Korea
| | - S H Jeong
- Laboratory of Veterinary Biochemistry and Molecular Biology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, Republic of Korea
| | - N R Jo
- Department of Information and Statistics, College of Natural Sciences, Chungbuk National University, Cheongju, Chungbuk, 28644, Republic of Korea
| | - S M Park
- Laboratory of Veterinary Biochemistry and Molecular Biology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, Republic of Korea
| | - M Lee
- Laboratory of Veterinary Biochemistry and Molecular Biology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, Republic of Korea
| | - D N Tran
- Laboratory of Veterinary Biochemistry and Molecular Biology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, Republic of Korea
| | - E-M Jung
- Department of Molecular Biology, College of Natural Sciences, Pusan National University, Busan 46241, Republic of Korea
| | - S D Lee
- Department of Information and Statistics, College of Natural Sciences, Chungbuk National University, Cheongju, Chungbuk, 28644, Republic of Korea
| | - E-B Jeung
- Laboratory of Veterinary Biochemistry and Molecular Biology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, Republic of Korea.
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2
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Nelson SW, Hardison RL, Limmer R, Marx J, Taylor BM, James RR, Stewart MJ, Lee SD, Calfee MW, Ryan SP, Howard MW. Efficacy of detergent-based cleaning and wiping against SARS-CoV-2 on high-touch surfaces. Lett Appl Microbiol 2023; 76:7076331. [PMID: 36906280 DOI: 10.1093/lambio/ovad033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 02/15/2023] [Accepted: 03/10/2023] [Indexed: 03/13/2023]
Abstract
Efficacy of cleaning methods against SARS-CoV-2 suspended in either 5% soil load (SARS-soil) or simulated saliva (SARS-SS) was evaluated immediately (hydrated virus, T0) or 2 hours post-contamination (dried virus, T2). Hard water dampened wiping (DW) of surfaces, resulted in 1.77-3.91 log reduction (T0) or 0.93-2.41 log reduction (T2). Incorporating surface pre-wetting by spraying with a detergent solution (D + DW) or hard water (W + DW) just prior to dampened wiping did not unilaterally increase efficacy against infectious SARS-CoV-2, however, the effect was nuanced with respect to surface, viral matrix, and time. Cleaning efficacy on porous surfaces (seat fabric, SF) was low. W + DW on stainless steel (SS) was as effective as D + DW for all conditions except SARS-soil at T2 on SS. DW was the only method that consistently resulted in > 3-log reduction of hydrated (T0) SARS-CoV-2 on SS and ABS plastic. These results suggest that wiping with a hard water dampened wipe can reduce infectious virus on hard non-porous surfaces. Pre-wetting surfaces with surfactants did not significantly increase efficacy for the conditions tested. Surface material, presence or absence of pre-wetting, and time post-contamination affect efficacy of cleaning methods.
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Affiliation(s)
- S W Nelson
- Bioscience Center, Battelle Memorial Institute, Columbus, OH 43201, USA
| | - R L Hardison
- Bioscience Center, Battelle Memorial Institute, Columbus, OH 43201, USA
| | - R Limmer
- Battelle Eastern Science and Technology Center, Aberdeen, MD 21001, USA
| | - J Marx
- Battelle Eastern Science and Technology Center, Aberdeen, MD 21001, USA
| | - B M Taylor
- Battelle Eastern Science and Technology Center, Aberdeen, MD 21001, USA
| | - R R James
- Bioscience Center, Battelle Memorial Institute, Columbus, OH 43201, USA
| | - M J Stewart
- U.S. EPA, Office of Research and Development, Durham, NC 27711, USA
| | - S D Lee
- U.S. EPA, Office of Research and Development, Durham, NC 27711, USA
| | - M W Calfee
- U.S. EPA, Office of Research and Development, Durham, NC 27711, USA
| | - S P Ryan
- U.S. EPA, Office of Research and Development, Durham, NC 27711, USA
| | - M W Howard
- Bioscience Center, Battelle Memorial Institute, Columbus, OH 43201, USA
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3
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Kamp K, Li N, Lachance DM, Saad K, Tolentino E, Yoo L, Heitkemper MM, Clark-Snustad K, Lee SD, Dey N. Interpersonal Variability in Gut Microbial Calprotectin Metabolism. Gastro Hep Adv 2022; 1:853-856. [PMID: 36160305 PMCID: PMC9494624 DOI: 10.1016/j.gastha.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- K Kamp
- Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, Washington
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington
| | - N Li
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington
| | - D M Lachance
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington
| | - K Saad
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington
| | - E Tolentino
- Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, Washington
| | - L Yoo
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington
| | - M M Heitkemper
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington
| | - K Clark-Snustad
- Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, Washington
| | - S D Lee
- Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, Washington
| | - N Dey
- Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, Washington
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington
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Hardison RL, Ryan SP, Limmer RA, Crouse M, Nelson SW, Barriga D, Ghere JM, Stewart MJ, Lee SD, Taylor BM, James RR, Calfee MW, Howard MW. Residual Antimicrobial Coating Efficacy Against SARS-CoV-2. J Appl Microbiol 2022; 132:3375-3386. [PMID: 34981882 DOI: 10.1111/jam.15437] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/30/2021] [Accepted: 12/31/2021] [Indexed: 11/28/2022]
Abstract
AIMS This study evaluated the residual efficacy of commercially available antimicrobial coatings or films against SARS-CoV-2 on nonporous surfaces. METHOD AND RESULTS Products were applied to stainless steel or ABS plastic coupons and dried overnight. Coupons were inoculated with SARS-CoV-2 in the presence of 5% soil load. Recovered infectious SARS-CoV-2 was quantified by TCID50 assay. Tested product efficacies ranged from <1.0 to >3.0 log10 reduction at a 2-hour contact time. The log10 reduction in recovered infectious SARS-CoV-2 ranged from 0.44 to 3 log10 reduction on stainless steel and 0.25 to >1.67 log10 on ABS plastic. The most effective products tested contained varying concentrations (0.5 to 1.3%) of the same active ingredient: 3- (trihydroxysilyl) propyldimethyloctadecyl ammonium chloride. Products formulated with other quaternary ammonium compounds were less effective against SARS-CoV-2 in this test. CONCLUSIONS The residual antimicrobial products tested showed varied effectiveness against SARS-CoV-2 as a function of product tested. Several products were identified as efficacious against SARS-CoV-2 on both stainless steel and ABS plastic surfaces under the conditions evaluated. Differences in observed efficacy may be due to variation in active ingredient formulation; efficacy is, therefore, difficult to predict based upon listed active ingredient and its concentration. SIGNIFICANCE AND IMPACT This study highlights formulation-specific efficacy of several products against SARS-CoV-2 and may inform future development of residual antiviral products for use on nonporous surfaces. The identification of antimicrobial coatings or films showing promise to inactivate SARS-CoV-2 suggests that these products may be worth future testing and consideration.
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Affiliation(s)
- R L Hardison
- Battelle Memorial Institute, Columbus, Ohio, USA
| | - S P Ryan
- USEPA, Research Triangle Park, NC, USA
| | - R A Limmer
- Battelle Eastern Science & Technology Center, Aberdeen, MD, USA
| | - M Crouse
- Battelle Eastern Science & Technology Center, Aberdeen, MD, USA
| | - S W Nelson
- Battelle Memorial Institute, Columbus, Ohio, USA
| | - D Barriga
- Battelle Memorial Institute, Columbus, Ohio, USA
| | - J M Ghere
- Battelle Memorial Institute, Columbus, Ohio, USA
| | | | - S D Lee
- USEPA, Research Triangle Park, NC, USA
| | - B M Taylor
- Battelle Eastern Science & Technology Center, Aberdeen, MD, USA
| | - R R James
- Battelle Memorial Institute, Columbus, Ohio, USA
| | | | - M W Howard
- Battelle Memorial Institute, Columbus, Ohio, USA
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Kang J, Oh YM, Lee JH, Kim EK, Lim SY, Kim WJ, Yoon HI, Kim TH, Park TS, Kim SO, Lee SW, Lee SD, Lee JS. Distinctive patterns of pulmonary function change according to baseline lung volume and diffusing capacity. Int J Tuberc Lung Dis 2021; 24:597-605. [PMID: 32553011 DOI: 10.5588/ijtld.19.0401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING: Multicentre retrospective study in South Korea.OBJECTIVE: To longitudinally evaluate changes in lung volume and diffusing capacity for carbon monoxide (DLCO) with forced expiratory volume in 1 sec (FEV1).DESIGN: A total of 155 patients with chronic obstructive pulmonary disease (COPD), whose pulmonary function parameters were measured annually for 5 years, were selected from a prospective cohort in South Korea. A random coefficients model was used to estimate mean annual FEV1, lung volume parameter and DLCO change rates.RESULTS: Patients were classified into four groups based on baseline DLCO and residual volume/total lung capacity (RV/TLC) measurements. The annual FEV1 decline rate was greater in patients with low DLCO than in those with normal DLCO, with the greatest decline occurring in patients with low DLCO and normal RV/TLC. RV and RV/TLC declined in patients with high RV/TLC, whereas these increased in patients with normal RV/TLC. DLCO decreased longitudinally in all four groups, with the greatest decline occurring in patients with normal DLCO and normal RV/TLC.CONCLUSIONS: Different subgroups of patients with COPD exhibited distinctive pulmonary function change patterns. Baseline DLCO and RV/TLC may be used as physiological markers to predict long-term changes in pulmonary function.
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Affiliation(s)
- J Kang
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - Y-M Oh
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - J-H Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Bundang CHA Hospital, College of Medicine, CHA University, Seongnam
| | - E K Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Bundang CHA Hospital, College of Medicine, CHA University, Seongnam
| | - S Y Lim
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul
| | - W J Kim
- Department of Internal Medicine, College of Medicine, Kangwon National University, Chuncheon
| | - H I Yoon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam
| | - T-H Kim
- Division of Pulmonology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri
| | - T S Park
- Division of Pulmonology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri
| | - S O Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, South Korea
| | - S W Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - S-D Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - J S Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul
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Abstract
OBJECTIVE This retrospective study investigated the nature and severity of venom-induced consumption coagulopathy (VICC) and determined the clotting factors involved in VICC in patients after envenomation by South Korea's snakes. Additionally, we studied the effectiveness of antivenom for the treatment of VICC after envenomation. METHODS Included patients were divided into three groups according to the severity of VICC (no VICC, partial VICC, and complete VICC). Data, including changes in coagulation parameters during hospitalization and clotting factors at presentation, were collected and analyzed. RESULTS One hundred nineteen patients who presented at our emergency department within 3 h after snake envenomation were included. VICC developed in 34 patients (27 patients with partial VICC and 7 patients with complete VICC). Two of 34 patients with VICC required blood transfusions. Five patients with complete VICC had an undetectable fibrinogen concentration at presentation. Three patients with complete VICC had an unmeasurable INR and aPTT within 24 h. The median times of the most extreme values were 10 h for INR, 12 h for aPTT, and 16 h for fibrinogen after presentation in the VICC group. The D-dimer concentration peaked at a median of 63.5 h after presentation. The activities of factors II and X were significantly reduced in the complete VICC group (factor II: 88 (84-99.3)% in the non-VICC group vs. 69 (49.5-83.5)% in the complete VICC group; factor X:94 (83-102) in the non-VICC group vs. 70 (66.5-79.8)% in the complete VICC group), while there was no difference in factor V activity at presentation. The time from bite to first antivenom administration did not correlate with the time course and most extreme concentrations for fibrinogen and D-dimer within the VICC groups. DISCUSSION AND CONCLUSION VICC occurs in approximately one-quarter of snakebite patients in South Korea; however, VICC itself does not appear to lead to clinical deterioration. Fibrinogen is an early diagnostic maker for complete VICC. Clotting factors II and X are involved in VICC. Future investigations should explore the mechanism of VICC from Korean snakebites and the effect of antivenom on VICC.
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Affiliation(s)
- J M Moon
- Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea.,Department of Emergency Medicine, Chonnam National University Hwasun Hospital, Jeollanam-do, Republic of Korea
| | - B J Chun
- Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea.,Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Y S Cho
- Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - J C Kim
- Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Y J Koo
- Department of Agricultural Chemistry, Chonnam National University, Gwangju, Republic of Korea
| | - K H Park
- Department of Emergency Medical Rescue, Nambu University, Gwangju, Republic of Korea.,Department of Medical science, Chonnam National University Graduate School, Gwangju, Republic of Korea
| | - S D Lee
- Department of Emergency Medicine in Trauma Center, Wonkwang University Hospital, Iksan, Republic of Korea
| | - J S Ahn
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Jeollanam-do, Republic of Korea
| | - D K Kim
- Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - S J Ryu
- Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
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Jung YM, Lee SM, Oh S, Lyoo SH, Park CW, Lee SD, Park JS, Jun JK. The concordance rate of non-chromosomal congenital malformations in twins based on zygosity: a retrospective cohort study. BJOG 2020; 128:857-864. [PMID: 32783284 DOI: 10.1111/1471-0528.16463] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine the concordance rate of non-chromosomal congenital malformations in twin pairs based on zygosity. DESIGN Retrospective cohort study. SETTING A tertiary hospital in Korea. POPULATION Twin pairs born at Seoul National University Hospital between 2001 and 2019. METHODS Congenital malformations were diagnosed by postnatal workups of neonates or autopsy in cases of stillborn infants. Zygosity was confirmed by sex, chorionicity and DNA analysis. MAIN OUTCOME MEASURES Concordance rate of congenital malformations in twin pairs based on zygosity. RESULTS In total, 3386 twin pairs were included. The risk of a congenital malformation in the index twin increased significantly if the co-twin had the congenital malformation, and the concordance rate was higher in monozygotic (MZ) than in dizygotic (DZ) twins (37.04 versus 16.77, P < 0.001). An increased risk of a congenital malformation in the presence of the same congenital malformation in the co-twin was observed only for malformations of the nervous system, eye/ear/face/neck, circulatory system, cleft lip/palate, genital organs, urinary system and musculoskeletal system. Significantly higher concordance rates in MZ than in DZ twin pairs were observed only for the nervous system (40.00 versus 0.00, P < 0.001), circulatory system (32.97 versus 19.74, P = 0.021), cleft lip/palate (44.44 versus 0.00, P = 0.017) and urinary system (22.22 versus 0.00, P = 0.004), whereas significant differences were not found for the genital organs or musculoskeletal system. CONCLUSIONS Monozygotic twins had higher concordance rates than DZ twins only in specific organ systems. It may be speculated that nervous system, circulatory system, cleft lip/palate and urinary system are primarily genetically affected. TWEETABLE ABSTRACT Monozygotic twins had higher concordance rates than dizygotic twins only in specific organ systems.
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Affiliation(s)
- Y M Jung
- Department of Obstetrics and Gynaecology, Seoul National University College of Medicine, Seoul, Korea
| | - S M Lee
- Department of Obstetrics and Gynaecology, Seoul National University College of Medicine, Seoul, Korea
| | - S Oh
- Department of Biostatistics, Seoul National University Seoul Metropolitan Government Boramae Medical Centre, Seoul, Korea
| | - S H Lyoo
- Institute of Forensic and Anthropological Science, Medical Research Centre, Seoul National University, Seoul, Korea
| | - C-W Park
- Department of Obstetrics and Gynaecology, Seoul National University College of Medicine, Seoul, Korea.,Institute of Reproductive Medicine and Population, Medical Research Centre, Seoul National University, Seoul, Korea
| | - S D Lee
- Institute of Forensic and Anthropological Science, Medical Research Centre, Seoul National University, Seoul, Korea.,Department of Forensic Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - J S Park
- Department of Obstetrics and Gynaecology, Seoul National University College of Medicine, Seoul, Korea
| | - J K Jun
- Department of Obstetrics and Gynaecology, Seoul National University College of Medicine, Seoul, Korea.,Institute of Reproductive Medicine and Population, Medical Research Centre, Seoul National University, Seoul, Korea
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Moon JM, Koo YJ, Chun BJ, Park KH, Cho YS, Kim JC, Lee SD, Min YR, Park HS. The effect of myocardial injury on the clinical course of snake envenomation in South Korea. Clin Toxicol (Phila) 2020; 59:286-295. [PMID: 32840397 DOI: 10.1080/15563650.2020.1802473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
CONTENT This study investigated the incidence, progression and clinical course of myocardial injury-related snake envenomation in South Korea. In addition, this study evaluated whether antivenom guidelines are appropriate to control envenomation in patients with myocardial injury. METHODS The study included 198 patients who received antivenom after a snakebite, and they were divided into two groups according to evidence of myocardial injury (defined as elevated troponin I or ischemic change on electrocardiogram) at presentation. Data including serial troponin I, echocardiogram/coronary angiogram findings, the clinical course, and treatment were collected and analyzed. RESULTS The incidence of myocardial injury at presentation was 15.2%. The troponin I level was 0.11 (0.07-0.56) ng/ml at presentation and tended to decrease over 24 h. Echocardiograms revealed neither regional wall motion abnormalities nor left ventricular dysfunction in 15 of 17 patients, while two patients showed signs of coronary artery stenosis on echocardiograms and coronary angiograms. However, compared with patients without myocardial injury, patients with myocardial injury had a higher frequency of systemic envenomation complications, including bleeding, respiratory failure, hypotension, acute kidney injury, thrombocytopenia and venom-induced consumption coagulopathy (VICC). The patients with myocardial injury at presentation needed significantly more frequent and larger doses of antivenom than indicated by the initial severity of envenomation. Multivariate analysis showed that myocardial injury was associated with the need for additional antivenom administration after initial administration. DISCUSSION AND CONCLUSION Myocardial injury is not uncommon after snake envenomation in Korea. Although myocardial injury itself seems to be benign, the clinical course of patients with myocardial injury is complicated, and myocardial injury is associated with the need for additional antivenom administration. The optimal use of antivenom to control envenomation in patents with myocardial injury after snake envenomation in South Korea should be established.
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Affiliation(s)
- J M Moon
- Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea.,Department of Emergency Medicine, Chonnam National University Hwasun Hospital, Jeollanam-do, Republic of Korea
| | - Y J Koo
- Department of Agricultural Chemistry, Chonnam National University, Gwangju, Republic of Korea
| | - B J Chun
- Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea.,Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - K H Park
- Department of Emergency Medical Rescue, Nambu University, Gwangju, Republic of Korea.,Department of Medical science, Chonnam National University Graduate School, Gwangju, Republic of Korea
| | - Y S Cho
- Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - J C Kim
- Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - S D Lee
- Department of Emergency Medicine in Trauma Center, Wonkwang University Hospital, Iksan, Republic of Korea
| | - Y R Min
- Department of Medical science, Chonnam National University Graduate School, Gwangju, Republic of Korea
| | - H S Park
- Department of Agricultural Chemistry, Chonnam National University, Gwangju, Republic of Korea
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Lee JH, Park SY, Ahn C, Yoo YM, Kim CW, Kim JE, Jo NR, Kang HY, Jung EM, Kim KS, Choi KC, Lee SD, Jeung EB. Second-phase validation study of an alternative developmental toxicity test using mouse embryonic stem cell-derived embryoid bodies. J Physiol Pharmacol 2020; 71. [PMID: 32633240 DOI: 10.26402/jpp.2020.2.06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 02/28/2020] [Indexed: 11/03/2022]
Abstract
The embryoid body test (EBT) is a developmental toxicity test method that measures the size of embryoid bodies (EBs) and the viability of mouse embryonic stem cells (mESCs) and fibroblasts (3T3 cells). The previous pre-validation study confirmed the high accuracy (above 80%) of EBT using 26 coded test chemicals. This second-phase validation study assessed the inter-laboratory reproducibility (5 chemicals in common) and predictive capacity (10 chemicals in each laboratory) test using the coded test chemicals at three laboratories. For the prediction model, the accuracy is increased when more data is accumulated. Therefore, we updated the prediction model and analyzed the results of the second year with the newly created-prediction model. Statistical analysis of the inter-laboratory reproducibility test results indicated that accuracy, sensitivity, and specificity were 87%, 78%, and 100%, respectively. The results of the statistical analysis of the predictive capacity test showed an accuracy of 80%, sensitivity of 78%, and specificity of 81%. In conclusion, the EBT can accurately classify various embryotoxicants within a short period and with relatively little effort. Therefore, EBT can be used as a good way to test developmental toxicity.
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Affiliation(s)
- J-H Lee
- Laboratory of Veterinary Biochemistry and Molecular Biology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - S Y Park
- Laboratory of Veterinary Biochemistry and Molecular Biology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - C Ahn
- Laboratory of Veterinary Biochemistry and Molecular Biology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - Y-M Yoo
- Laboratory of Veterinary Biochemistry and Molecular Biology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - C-W Kim
- Laboratory of Biochemistry and Immunology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - J-E Kim
- R&D Center for Advanced Pharmaceuticals and Evaluation, Korea Institute of Toxicology, Daejeon, Republic of Korea
| | - N R Jo
- Department of Information and Statistics, College of Natural Sciences, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - H Y Kang
- Laboratory of Veterinary Biochemistry and Molecular Biology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea.,Immunotherapy Convergence Research Center, Korea Research Institute of Bioscience and Biotechnology, Yuseong-gu, Daejeon, Republic of Korea
| | - E-M Jung
- Laboratory of Veterinary Biochemistry and Molecular Biology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - K-S Kim
- R&D Center for Advanced Pharmaceuticals and Evaluation, Korea Institute of Toxicology, Daejeon, Republic of Korea
| | - K-C Choi
- Laboratory of Biochemistry and Immunology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - S D Lee
- Department of Information and Statistics, College of Natural Sciences, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - E-B Jeung
- Laboratory of Veterinary Biochemistry and Molecular Biology, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea.
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10
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Kim WJ, Gupta V, Nishimura M, Makita H, Idolor L, Roa C, Loh LC, Ong CK, Wang JS, Boonsawat W, Gunasekera KD, Madegedara D, Kuo HP, Wang CH, Wang C, Yang T, Lin YX, Ko FWS, Hui DSC, Lan LTT, Vu QTT, Bhome AB, Ng A, Seo JB, Lee BY, Lee JS, Oh YM, Lee SD. Identification of chronic obstructive pulmonary disease subgroups in 13 Asian cities. Int J Tuberc Lung Dis 2019; 22:820-826. [PMID: 29914609 DOI: 10.5588/ijtld.17.0524] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a heterogeneous condition that can differ in its clinical manifestation, structural changes and response to treatment. OBJECTIVE To identify subgroups of COPD with distinct phenotypes, evaluate the distribution of phenotypes in four related regions and calculate the 1-year change in lung function and quality of life according to subgroup. METHODS Using clinical characteristics, we performed factor analysis and hierarchical cluster analysis in a cohort of 1676 COPD patients from 13 Asian cities. We compared the 1-year change in forced expiratory volume in one second (FEV1), modified Medical Research Council dyspnoea scale score, St George's Respiratory Questionnaire (SGRQ) score and exacerbations according to subgroup derived from cluster analysis. RESULTS Factor analysis revealed that body mass index, Charlson comorbidity index, SGRQ total score and FEV1 were principal factors. Using these four factors, cluster analysis identified three distinct subgroups with differing disease severity and symptoms. Among the three subgroups, patients in subgroup 2 (severe disease and more symptoms) had the most frequent exacerbations, most rapid FEV1 decline and greatest decline in SGRQ total score. CONCLUSION Three subgroups with differing severities and symptoms were identified in Asian COPD subjects.
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Affiliation(s)
- W J Kim
- Department of Internal Medicine, Kangwon National University, Chuncheon, Korea
| | - V Gupta
- Department of Internal Medicine, Kangwon National University, Chuncheon, Korea, Adesh Institute of Medical Sciences and Research, Bathinda, India
| | - M Nishimura
- Division of Respiratory Medicine, Department of Internal Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - H Makita
- Division of Respiratory Medicine, Department of Internal Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - L Idolor
- Section of Respiratory Services and Physical Therapy and Rehabilitation Lung Center of the Philippines, Quezon City
| | - C Roa
- College of Medicine and Philippine General Hospital, University of the Philippines, Manila, The Philippines
| | - L-C Loh
- Department of Medicine, Penang Medical College, Penang, Malaysia
| | - C-K Ong
- Department of Medicine, Penang Medical College, Penang, Malaysia
| | - J-S Wang
- Taipei Medical University, Taipei, Taiwan
| | - W Boonsawat
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - K D Gunasekera
- Central Chest Clinic, National Hospital of Sri Lanka, Colombo
| | - D Madegedara
- Respiratory Disease Treatment Unit, Teaching Hospital Kandy, Kandy, Sri Lanka
| | - H-P Kuo
- Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - C-H Wang
- Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - C Wang
- Department of Respiratory and Critical Care Medicine, Beijing China-Japan Friendship Hospital, Beijing
| | - T Yang
- Department of Respiratory and Critical Care Medicine, Beijing China-Japan Friendship Hospital, Beijing
| | - Y-X Lin
- Beijing Institute of Respiratory Medicine, Department of Respiratory and Critical Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing
| | - F W S Ko
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - D S C Hui
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - L T T Lan
- Respiratory Care Center, University Medical Center, Ho Chi Minh City, Viet Nam
| | - Q T T Vu
- Respiratory Care Center, University Medical Center, Ho Chi Minh City, Viet Nam
| | - A B Bhome
- Indian Coalition of Obstructive Lung Diseases Network, Pune, Maharashtra, India
| | - A Ng
- Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore
| | - J B Seo
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - B Y Lee
- Division of Allergy and Respiratory Diseases, Soon Chun Hyang University Hospital, Seoul
| | - J S Lee
- Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Y-M Oh
- Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - S-D Lee
- Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Abstract
This study investigated whether hyperthermia within the first 24 h after presentation was associated with long-term neurological outcomes after acute carbon monoxide (CO) poisoning. This retrospective study included 200 patients with acute severe CO poisoning. Hyperthermia (≥ 37.5°C) developed during the first 24 h after presentation in 55 (27.5%) patients, and poor long-term neurological sequelae assessed at 23 months after acute CO poisoning developed in 19.5% of the patients. The incidence of poor long-term neurological outcomes was significantly higher in the hyperthermia group than in the normothermia group. Patients with poor long-term neurological outcomes had higher maximum temperatures than patients with good outcomes. No significant difference was found in the time of hyperthermia onset within the first day according to the neurological outcomes. Hyperthermia (adjusted odds ratio (aOR) 5.009 (95% confidence interval (CI) 1.556-16.126)) and maximum temperature (aOR 2.581 (95% CI 1.098-6.063)) within the first 24 h after presentation to the emergency department were independently associated with poor long-term neurological outcomes. Body temperature measurements, which are easily and noninvasively recorded at the bedside in any facility, help to predict the risk for poor long-term neurological outcomes. This study carefully emphasizes fastidious control of pyrexia, particularly during the early period after acute CO poisoning.
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Affiliation(s)
- J M Moon
- 1 Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - B J Chun
- 1 Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - S D Lee
- 1 Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - M H Shin
- 2 Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, South Korea
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Colombel JF, Sloan S, Gasink C, Gao L, Jacobstein D, Lee SD, Targan S. A147 RESPONSE AND REMISSION AFTER 16 WEEKS OF USTEKINUMAB– AN ALL PATIENTS ANALYSIS FROM THE UNITI CROHN’S STUDIES. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy009.147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J F Colombel
- School Of Medicine, Mount Sinai Medical Center, New York, NY
| | - S Sloan
- Janssen Scientific Affairs, LLC, Horsham, PA
| | - C Gasink
- Janssen Scientific Affairs, LLC, Horsham, PA
| | - L Gao
- Janssen Scientific Affairs, LLC, Horsham, PA
| | - D Jacobstein
- Janssen Research & Development, LLC, Spring House, PA
| | - S D Lee
- University of Washington Medical Center, Seattle, WA
| | - S Targan
- Cedars-Sinai Medical Center, Los Angeles, CA
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13
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Moon JM, Chun BJ, Lee SD, Jung EJ. Serum neuron-specific enolase levels at presentation and long-term neurological sequelae after acute charcoal burning-induced carbon monoxide poisoning. Clin Toxicol (Phila) 2017; 56:751-758. [PMID: 29239210 DOI: 10.1080/15563650.2017.1415347] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 12/12/2022]
Abstract
OBJECTIVE This study aimed to investigate whether clinical parameters and serum neuron-specific enolase (NSE) levels measured at emergency department (ED) presentation help stratify the risk of acute or delayed persistent severe neurological sequelae after acute carbon monoxide (CO) poisoning induced by charcoal burning. METHODS This retrospective study included 236 patients who suffered from CO poisoning. Demographic information, serum NSE levels measured in the ED, treatment, clinical course, and long-term neurological outcomes were recorded. RESULTS The median serum NSE level at presentation was 15.5 (10.9-22.7) ng/mL. No differences were observed in the duration of CO exposure; the initial Glasgow Coma Scale (GCS) score; the levels of arterial HCO3-, white blood cells (WBCs), C-reactive protein (CRP) or troponin I; or the frequency of abnormal diffusion-weighted imaging finding at presentation among the groups with different serum NSE levels at presentation. The incidences of acute and delayed persistent neurologic sequelae assessed at 22.3 months after acute charcoal CO poisoning were 5.1% and 8.5%, respectively. No difference in the NSE level was observed between patients stratified according to long-term neurological status. According to the multinomial logistic regression analysis, age, serum CRP levels and the initial GCS score were risk factors for the two types of persistent severe neurological sequelae, whereas troponin I levels were associated only with the acute persistent severe neurological sequelae. However, the adjusted NSE level was not a risk factor for any persistent neurological sequelae. CONCLUSIONS Serum NSE levels at presentation were not correlated with the risk of acute or delayed persistent neurological sequelae. Further studies with blood sampling at optimal time points and serial measurements should be conducted. Age, initial GCS score, and CRP levels may be risk factors for persistent severe neurological sequelae.
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Affiliation(s)
- J M Moon
- a Department of Emergency Medicine , Chonnam National University Medical School , Gwangju , South Korea
| | - B J Chun
- a Department of Emergency Medicine , Chonnam National University Medical School , Gwangju , South Korea
| | - S D Lee
- a Department of Emergency Medicine , Chonnam National University Medical School , Gwangju , South Korea
| | - E J Jung
- a Department of Emergency Medicine , Chonnam National University Medical School , Gwangju , South Korea
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14
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Moon JM, Chun BJ, Lee SD. In-hospital outcomes and delayed neurologic sequelae of seizure-related endosulfan poisoning. Seizure 2017; 51:43-49. [PMID: 28787683 DOI: 10.1016/j.seizure.2017.07.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Revised: 05/22/2017] [Accepted: 07/19/2017] [Indexed: 11/18/2022] Open
Abstract
PURPOSE This study investigated the predictive factors for progression from seizure-related endosulfan poisoning to status epilepticus (SE) and refractory SE (RSE). This study also investigated delayed neurologic sequelae in seizure-related endosulfan poisoning. METHODS This retrospective, observational case series consisted of 73 patients who developed at least one seizure after endosulfan ingestion. RESULTS The progression rates from seizure-related endosulfan poisoning to SE and from SE-related endosulfan poisoning to RSE were 78.1% and 54.4%, respectively. The SE and RSE fatality rates were 19.2% and 41.9%, respectively. No patients reported the development of delayed neurological sequelae at least six months after discharge. Glasgow coma scale (GCS) score were identified as an independent factor for progression from seizure-related endosulfan poisoning to SE and from SE-related endosulfan poisoning to RSE. Lorazepam administration was independently associated with preventing progression from SE-related endosulfan poisoning to RSE. CONCLUSION Seizure-related endosulfan poisoning had higher progression rates to SE and RSE and higher fatality rates than other drug-induced seizures. However, delayed neurologic sequelae after discharge were not demonstrated. Due to the high progression rates from seizure-related endosulfan poisoning to SE and RSE and the absence of an established treatment for SE-related endosulfan poisoning, physicians should aggressively treat patients who experience a seizure after endosulfan poisoning and who present with decreased GCS score. Lorazepam should be considered a first-line anti-epileptic drug for controlling seizures in patients with endosulfan poisoning.
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Affiliation(s)
- J M Moon
- Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - B J Chun
- Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, South Korea.
| | - S D Lee
- Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, South Korea
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15
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Park HM, Han SS, Lee EC, Lee SD, Yoon HM, Eom BW, Kim SH, Ryu KW, Park SJ, Kim YW, Park B. Randomized clinical trial of preoperative skin antisepsis with chlorhexidine gluconate or povidone–iodine. Br J Surg 2016; 104:e145-e150. [DOI: 10.1002/bjs.10395] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 07/04/2016] [Accepted: 09/06/2016] [Indexed: 11/11/2022]
Abstract
Abstract
Background
Skin antiseptic agents are used to prevent surgical-site infection (SSI); few trials have reported the superiority of any specific agent in clean-contaminated abdominal surgery. This RCT was designed to compare the effectiveness of chlorhexidine gluconate and povidone–iodine.
Methods
Consecutive patients who underwent clean-contaminated upper gastrointestinal or hepatobiliary–pancreatic open surgery between 2011 and 2014 were assigned randomly to either chlorhexidine gluconate or povidone–iodine. The primary endpoint was the occurrence of SSI within 30 days of surgery. Secondary endpoints included causative organisms and risk factors for SSI.
Results
A total of 534 patients were randomized; 31 (5·8 per cent) developed an SSI. There was no difference in the overall SSI rate in the chlorhexidine gluconate and povidone–iodine groups: 15 of 267 (5·6 per cent) and 16 of 267 (6·0 per cent) respectively (P = 0·853). The most common causative organism was Enterococcus faecalis. In subgroup analysis, biliary–pancreatic surgery had a higher SSI rate (26 of 127, 20·5 per cent) than upper gastrointestinal (2 of 204, 1·0 per cent) and hepatic (3 of 203, 1·5 per cent) resection. Both age (60 years and over) and type of incision were associated with the risk of SSI.
Conclusion
No difference was detected between chlorhexidine gluconate and povidone–iodine antiseptics for prevention of SSI. Registration number: NCT01495117 (http://www.clinicaltrials.gov).
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Affiliation(s)
- H M Park
- Centre for Liver Cancer, National Cancer Centre, South Korea
| | - S-S Han
- Centre for Liver Cancer, National Cancer Centre, South Korea
| | - E C Lee
- Centre for Liver Cancer, National Cancer Centre, South Korea
| | - S D Lee
- Centre for Liver Cancer, National Cancer Centre, South Korea
| | - H M Yoon
- Centre for Gastric Cancer, National Cancer Centre, South Korea
| | - B W Eom
- Centre for Gastric Cancer, National Cancer Centre, South Korea
| | - S H Kim
- Centre for Liver Cancer, National Cancer Centre, South Korea
| | - K W Ryu
- Centre for Gastric Cancer, National Cancer Centre, South Korea
| | - S-J Park
- Centre for Liver Cancer, National Cancer Centre, South Korea
| | - Y W Kim
- Centre for Gastric Cancer, National Cancer Centre, South Korea
| | - B Park
- Biometric Research Branch, Research Institute and Hospital, National Cancer Centre, South Korea
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16
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Abstract
Chronic obstructive lung disease (COPD) primarily affects men; however, its epidemiology has been changing because more women have become smokers. Recently, investigators found that although women and men were exposed to the same amount of smoke fume, women tended to have more severe disease and higher mortality rate. They also complain of more dyspnoea and may experience more severe exacerbations than men. This led to the question of whether sex has an impact on COPD course and whether women have a higher susceptibility to smoke fumes than men. That may be explained by multiple complex factors highlighting the relationship between sex, epidemiology, method of diagnostics and the clinical course of the disease. In this review, sex differences in epidemiology, clinical presentation, exacerbation, co-morbidities and treatment are covered.
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Affiliation(s)
- Nurdan Kokturk
- a Department of Pulmonary Medicine , School of Medicine, Gazi University , Ankara , Turkey
| | - Hatice Kilic
- b Clinic of Chest Diseases , Ankara Ataturk Training and Research Hospital , Ankara , Turkey
| | - Ayse Baha
- c Department of Pulmonary Medicine , School of Medicine, Ufuk University , Ankara , Turkey
| | - S D Lee
- d Department of Pulmonary and Critical Care Medicine , Asan Medical Center, University of Ulsan College of Medicine , Seoul , Korea
| | - Paul W Jones
- e Department of Pulmonology, Clinical Science Center , St George University School of Medicine , London , UK
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17
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Kim SH, Lee SD, Kim YK, Park SJ. Impact of Intra-Abdominal Adhesion on Living Donor Right Hepatectomy. Am J Transplant 2016; 16:1788-94. [PMID: 26613370 DOI: 10.1111/ajt.13636] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 10/26/2015] [Accepted: 11/14/2015] [Indexed: 01/25/2023]
Abstract
The impact of intra-abdominal adhesion (IAA) on living donor right hepatectomy (LDRH) remains to be clarified. The purpose of this study was to compare both the donor and recipient outcomes of right lobe living donor liver transplantation according to IAA detected intraoperatively. LDRH donors were identified through a prospectively maintained database at the authors' institution between March 2008 and February 2014. IAA was graded according to Beck et al (Dis Colon Rectum 2000; 43: 1749-1753). LDRH donors with IAA (group A) were matched 1:3 to those without IAA (group B) based on age, gender, and BMI. Perioperative data, complications by the Clavien classification, and the outcomes with at least 12 months follow-up were compared. Thirty-two (7.6%) of a total of 420 LDRH donors had IAA around the liver. Nineteen donors had previous abdominal surgery. LDRH was successfully completed under upper midline laparotomy in all donors. Compared with group B, group A had a longer operative time (270 vs. 172 min; p < 0.001), a higher wound complication rate (28.1% vs. 4.2%; p = 0.009), and a longer postoperative stay (10 vs. 7 days; p = 0.009). All donors recovered completely to their previous activities. The 1-year graft and recipient survivals of recipients were comparable between two groups. These findings support the feasibility and safety of LDRH in patients with IAA.
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Affiliation(s)
- S H Kim
- Center for Liver Cancer, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea
| | - S D Lee
- Center for Liver Cancer, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Y K Kim
- Center for Liver Cancer, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea
| | - S-J Park
- Center for Liver Cancer, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea
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18
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Kim MA, Noh CS, Chang YJ, Hong YK, Lee JS, Lee SW, Lee SD, Oh YM. Asthma and COPD overlap syndrome is associated with increased risk of hospitalisation. Int J Tuberc Lung Dis 2016; 19:864-9. [PMID: 26056115 DOI: 10.5588/ijtld.14.0327] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is associated with poor prognosis and a high health care burden. The incidence of asthma and COPD overlap syndrome is increasing, and contributes to a high financial burden and poor prognosis. OBJECTIVE To investigate clinical features of the overlap syndrome among Asian patients and to analyse its impact on hospitalisation due to respiratory problems or death compared to COPD alone. DESIGN We performed a retrospective cohort analysis of 2933 COPD patients presenting at the Asan Medical Center from 1 January 2000 to 31 December 2009. Kaplan-Meier and Cox proportional hazard models were used to analyse the significance of clinical parameters, including age, sex, smoking history, body mass index (BMI), severity of airflow limitation, airway obstruction reversibility and overlap syndrome with hospitalisation due to respiratory problems or death. RESULTS Overlap syndrome patients were older, included smaller proportions of males and of smokers and had lower forced expiratory volume in 1 s (FEV1) (% predicted). Shorter hospitalisation-free and survival periods were noted among overlap syndrome patients. Overlap syndrome was significantly associated with risk of hospitalisation due to respiratory problems after adjusting for age, smoking history, BMI, FEV1 (% predicted) and changes in FEV1 (P < 0.001). CONCLUSION Asthma and COPD overlap syndrome is associated with a higher risk of hospitalisation due to respiratory problems than COPD alone.
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Affiliation(s)
- M-A Kim
- Department of Allergy and Clinical Immunology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - C S Noh
- Department of Internal Medicine, Seoul Seonam Hospital, Ewha Womans University Medical Center, Seoul, Republic of Korea
| | - Y-J Chang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Y-K Hong
- Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, Republic of Korea
| | - J S Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - S W Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - S-D Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Y-M Oh
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Kim GW, Joo HJ, Park TS, Lee JS, Lee SW, Jung YJ, Lee SD, Oh YM. Vertebral compression fractures may increase mortality in male patients with chronic obstructive pulmonary disease. Int J Tuberc Lung Dis 2016; 19:603-9. [PMID: 25868031 DOI: 10.5588/ijtld.14.0754] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Vertebral compression fracture (VCF) is frequent in chronic obstructive pulmonary disease (COPD) patients. However, little is known about whether VCF affects mortality in COPD patients. OBJECTIVE To investigate whether VCFs might increase death in COPD patients. METHODS In this retrospective cohort study, we enrolled 254 COPD patients with a recent history of hospitalisation due to respiratory problems. Patients were assessed for VCF using quantitative morphometric analyses of lateral chest radiographs; 211 patients received follow-up examinations for 2 years. RESULTS Of the 211 COPD patients analysed, 60 (28.4%) had VCF at enrolment. During the follow-up period, 33/60 (55.0%) patients with and 46/151 patients (30.5%) without VCF died (P = 0.003, log-rank test). Cox proportional hazard analysis revealed that VCF is an independent risk factor for death after adjusting for age, sex, body mass index, smoking, dyspnoea scale, forced expiratory volume in 1 sec (FEV1) and comorbidities (hazard ratio for VCF = 1.79, 95%CI 1.11-2.89, P = 0.02). CONCLUSION VCF might be an independent risk factor for death in male COPD patients.
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Affiliation(s)
- G-W Kim
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - H-J Joo
- Department of Pulmonary and Critical Care Medicine, Cheongju St Mary's Hospital, Cheonju, Seoul, Korea
| | - T S Park
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J S Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - S W Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Y J Jung
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - S-D Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Y-M Oh
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Affiliation(s)
- L-C Loh
- From the Department of Medicine, Penang Medical College, Penang, Malaysia and
| | - Y-M Oh
- Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan Collage of Medicine, Seoul, Korea
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21
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Feagan BG, Sandborn WJ, D'Haens G, Lee SD, Allez M, Fedorak RN, Seidler U, Vermeire S, Lawrance IC, Maroney AC, Jurgensen CH, Heath A, Chang DJ. Randomised clinical trial: vercirnon, an oral CCR9 antagonist, vs. placebo as induction therapy in active Crohn's disease. Aliment Pharmacol Ther 2015; 42:1170-81. [PMID: 26400458 DOI: 10.1111/apt.13398] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 06/16/2015] [Accepted: 08/18/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Many patients with active Crohn's disease do not adequately respond to therapies, highlighting the need for new treatments. AIMS To conduct a randomised, double-blind, placebo-controlled phase 3 study to assess the efficacy and safety of vercirnon, an oral inhibitor of CC chemokine receptor-9, for the treatment of patients with moderately-to-severely active Crohn's disease. METHODS Patients with a Crohn's Disease Activity Index (CDAI) of 220-450, plus evidence of active disease (endoscopically confirmed or elevation of both C-reactive protein and faecal calprotectin), who had failed corticosteroid or immunosuppressant therapy were enrolled. Patients were equally randomised to receive placebo, vercirnon 500 mg once daily or vercirnon 500 mg twice daily. The primary endpoint was clinical response, defined as a 100-point decrease in CDAI from baseline to week 12. RESULTS Six hundred and eight patients were randomised. Patient characteristics and baseline demographics were similar among the groups. The proportions of patients achieving a clinical response were 25.1%, 27.6% and 27.2% for placebo, once daily and twice daily respectively; treatment differences were not significant (2.5%; 95% confidence interval, CI -6.1% to 11.0%, P = 0.546 for once daily vs. placebo, and 2.1%; 95% CI -6.5% to 10.7%, P = 0.648 for twice daily vs. placebo). Adverse events were reported in 69.8%, 73.3% and 78.1% with serious adverse events in 8.9%, 5.9%, and 6.0% of patients in the placebo, once-daily and twice-daily groups, respectively. CONCLUSIONS We did not demonstrate efficacy of vercirnon as an induction therapy in patients with moderately-to-severely active Crohn's disease; its effect in maintenance therapy was not addressed.
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Affiliation(s)
- B G Feagan
- Robarts Clinical Trials Inc, Robarts Research Institute, Western University, London, ON, Canada
| | - W J Sandborn
- Division of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - G D'Haens
- Department of Gastroenterology, Academic Medical Centre, Amsterdam, The Netherlands
| | - S D Lee
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - M Allez
- Department of Gastroenterology, Hopital Saint-Louis, APHP, Université Paris Diderot, Paris, France
| | - R N Fedorak
- Division of Gastroenterology, University of Alberta, Edmonton, AB, Canada
| | - U Seidler
- Department of Gastroenterology, Hannover Medical School, Hannover, Germany
| | - S Vermeire
- Department of Gastroenterology, University Hospitals Leuven, Leuven, Belgium
| | - I C Lawrance
- School of Medicine and Pharmacology, University of Western Australia, Harry Perkins Institute for Medical Research, Fiona Stanley Hospital, Murdoch, WA, Australia.,Centre for inflammatory Bowel Diseases, Saint John of God Hospital, Subiaco, WA, Australia
| | - A C Maroney
- GlaxoSmithKline, King of Prussia, PA, Research Triangle Park, NC, Philadelphia, PA, USA
| | - C H Jurgensen
- GlaxoSmithKline, King of Prussia, PA, Research Triangle Park, NC, Philadelphia, PA, USA
| | - A Heath
- GlaxoSmithKline, King of Prussia, PA, Research Triangle Park, NC, Philadelphia, PA, USA
| | - D J Chang
- GlaxoSmithKline, King of Prussia, PA, Research Triangle Park, NC, Philadelphia, PA, USA
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Sandborn WJ, Melmed GY, McGovern DPB, Loftus EV, Choi JM, Cho JH, Abraham B, Gutierrez A, Lichtenstein G, Lee SD, Randall CW, Schwartz DA, Regueiro M, Siegel CA, Spearman M, Kosutic G, Pierre-Louis B, Coarse J, Schreiber S. Clinical and demographic characteristics predictive of treatment outcomes for certolizumab pegol in moderate to severe Crohn's disease: analyses from the 7-year PRECiSE 3 study. Aliment Pharmacol Ther 2015; 42:330-42. [PMID: 26031921 DOI: 10.1111/apt.13251] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 03/30/2015] [Accepted: 04/28/2015] [Indexed: 12/24/2022]
Abstract
BACKGROUND Clinical factors were previously identified as predictors of short-term treatment efficacy in Crohn's disease (CD). The PRECiSE 3 (P3) 7-year trial provides an opportunity to study predictors of short- and long-term clinical remission among CD patients treated with certolizumab pegol (CZP). AIM To identify factors that influence long-term remission of CD with CZP treatment. METHODS Patients who had completed placebo-controlled studies (PRECiSE 1/PRECiSE 2, P1/P2) enrolled in P3 and received open-label CZP 400 mg every 4 weeks up to 7 years. Baseline predictors included, but were not limited to, smoking status, disease duration, prior inflammatory bowel disease (IBD) surgery, Harvey-Bradshaw Index (HBI), albumin, haematocrit and CZP exposure; association with time to initial remission (HBI ≤4) was tested for patients who received CZP in P1/P2; time to loss of remission/frequency of maintenance of remission was also tested. Univariate analyses and multivariate Cox or logistic regression models were used. RESULTS Predictors for initial remission (N = 377) included age, haematocrit, prior IBD surgery and entry HBI (P < 0.05 for all). Predictors for loss of remission (N = 437) included HBI, serum albumin concentration, haematocrit, smoking status and exposure. Predictors of maintenance of remission (N = 437) included haematocrit, IBD surgery, HBI, disease duration, serum albumin concentration and exposure. Significant predictors were confirmed with stepwise multivariate regression models. CONCLUSIONS These analyses identified several influential parameters for short-and long-term remission of Crohn's disease with certolizumab pegol treatment. The data yield valuable hypotheses regarding factors that influence certolizumab pegol treatment. More investigation is needed. (ClinicalTrials.gov identifier NCT00552058).
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Affiliation(s)
- W J Sandborn
- University of California San Diego School of Medicine, La Jolla, CA, USA
| | - G Y Melmed
- The Widjaja Foundation Inflammatory Bowel and Immunology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - D P B McGovern
- The Widjaja Foundation Inflammatory Bowel and Immunology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | - J M Choi
- UCLA Center for Inflammatory Bowel Diseases, Los Angeles, CA, USA
| | - J H Cho
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - A Gutierrez
- Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - G Lichtenstein
- Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
| | - S D Lee
- University of Washington School of Medicine, Seattle, WA, USA
| | - C W Randall
- Gastroenterology Research of America, San Antonio, TX, USA
| | - D A Schwartz
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - M Regueiro
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - C A Siegel
- Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | | | | | | | | | - S Schreiber
- Christian-Albrechts University at Kiel, Kiel, Germany
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Kim SH, Kim YK, Lee SD, Park SJ. Successful living donor liver transplantation between septuagenarians. Am J Transplant 2015; 15:274-7. [PMID: 25331693 DOI: 10.1111/ajt.13020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [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: 05/22/2014] [Revised: 07/21/2014] [Accepted: 08/07/2014] [Indexed: 01/25/2023]
Abstract
We report a case of a 76-year-old female who underwent living donor right hepatectomy for her 75-year-old husband with recurrent hepatocellular carcinoma. With her voluntary decision, full medical and psychiatric assessment was performed. The operative time was 130 min in the donor and 399 min in the recipient. Both the donor and recipient had an uneventful recovery and were discharged on days 7 and 10, respectively with normal liver function. The couple has had no complication so far and is currently doing well in good health 26 months after living donor liver transplantation.
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Affiliation(s)
- S H Kim
- National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea
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Lee SD, Lee BJ, Park JJ, Kim JS, Bak YT. Education and imaging. Gastrointestinal: Impacted gastric balloon in small bowel. J Gastroenterol Hepatol 2015; 30:1. [PMID: 25536457 DOI: 10.1111/jgh.12825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- S D Lee
- Division of Gastroenterology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
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Jung YJ, Lee JY, Jo KW, Yoo B, Lee CK, Kim YG, Yang SK, Byeon JS, Kim KJ, Ye BD, Lee KH, Lee SD, Kim WS, Kim DS, Shim TS. The 'either test positive' strategy for latent tuberculous infection before anti-tumour necrosis factor treatment. Int J Tuberc Lung Dis 2014; 18:428-34. [PMID: 24670697 DOI: 10.5588/ijtld.13.0644] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING A ttertiary referral centre in South Korea. OBJECTIVES The 'either test positive' strategy, incorporating both the tuberculin skin test (TST) and the T-SPOT(®).TB(T-SPOT) assay, was evaluated as a novel method for diagnosing latent tuberculous infection (LTBI) before treatment with anti-tumour necrosis factor (TNF) in patients with immune-mediated inflammatory diseases. DESIGN From June 2008 to April 2012, 430 patients received anti-TNF treatment at our institution. TST and T-SPOT were performed simultaneously at baseline. LTBI was defined as a positive TST or a positive T-SPOT result. RESULTS The positivity rates for the TST and T-SPOT assays were respectively 19.1% (82/430) and 44.2% (190/430), yielding an LTBI-positive rate of 48.6% (209/430). LTBI treatment was initiated in 46.0% (198/430) of patients and was completed by 89.4% (177/198). During follow-up (median 884 days), 0.9% (4/430) of the patients developed active tuberculosis (TB). All four TB patients were TST-negative at baseline, although two received LTBI treatment based on the baseline positive T-SPOT assay results. CONCLUSIONS The either test positive strategy is a valid method for diagnosing LTBI before anti-TNF treatment, although it is not clear whether it is superior to other strategies.
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Affiliation(s)
- Y J Jung
- Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - J Y Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungju Hospital, School of Medicine, Konkuk University, Seoul, South Korea
| | - K-W Jo
- Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - B Yoo
- Department of Rheumatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - C-K Lee
- Department of Rheumatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Y-G Kim
- Department of Rheumatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - S-K Yang
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - J-S Byeon
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - K-J Kim
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - B D Ye
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - K-H Lee
- Okjeong Middle School, Seoul, South Korea
| | - S-D Lee
- Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - W S Kim
- Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - D S Kim
- Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - T S Shim
- Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
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Sandborn WJ, Lee SD, Randall C, Gutierrez A, Schwartz DA, Ambarkhane S, Kayhan C, Pierre-Louis B, Schreiber S, Lichtenstein GR. Long-term safety and efficacy of certolizumab pegol in the treatment of Crohn's disease: 7-year results from the PRECiSE 3 study. Aliment Pharmacol Ther 2014; 40:903-16. [PMID: 25146586 DOI: 10.1111/apt.12930] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 05/28/2014] [Accepted: 07/31/2014] [Indexed: 01/20/2023]
Abstract
BACKGROUND The efficacy and safety of certolizumab pegol (CZP) in moderate-to-severe Crohn's disease were demonstrated in two 26-week double-blind studies (PRECiSE 1 & 2). AIM To report the safety and efficacy outcomes of long-term, CZP therapy from PRECiSE 3, in which patients received treatment up to 7 years treatment. METHODS Patients completing PRECiSE 1 or 2 were eligible to enter PRECiSE 3 in which they received CZP 400 mg, open-label, every 4 weeks (without additional induction therapy) for up to 7 years, for up to 91 doses from study start. Safety (adverse events, including infections and malignancies) and efficacy (Harvey-Bradshaw Index, faecal calprotectin, C-reactive protein) were prospectively monitored. Remission was analysed using observed cases, last observation carried forward imputation and nonresponder imputation. RESULTS A total of 595 patients entered the study; 117 (20%) completed 7 years. Discontinuation rates were 29.2%, 13.6%, 16.1%, 7.9%, 5.0%, 4.5% and 3.9% (years 1-7 respectively). During 1920 patient-years of exposure to CZP, no new safety signals were observed. Incidence rates (new cases/100 patient-years) for serious infections and malignant neoplasms were 4.37 and 1.06 respectively. No lymphoproliferative malignancies were reported. Clinical remission rates were ≥68% at each year (observed cases); rates by last observation carried forward and nonresponder imputation were 58% and 45% at year 1, 56% and 26% at year 3 and 55% and 13% at year 7 respectively. CONCLUSION Certolizumab pegol was well tolerated in the long-term treatment of Crohn's disease, with sustained remission in some patients continuing in the study for up to 7 years. ClinicalTrials.gov identifier NCT00552058.
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Affiliation(s)
- W J Sandborn
- Division of Gastroenterology, University of California San Diego School of Medicine, La Jolla, CA, USA
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Kwon JH, Kang DW, Lee SD, Kim J. First Report of Sclerotium Rot Caused by Sclerotium rolfsii on Yacón in South Korea. Plant Dis 2014; 98:1443. [PMID: 30703993 DOI: 10.1094/pdis-06-14-0616-pdn] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Yacón, or ground apple (Smallanthus sonchifolius), is a perennial plant grown in the northern and central Andes from Colombia to northern Argentina for its crisp, sweet, and tuberous roots. In 2012, yacóns cultivated in the research field of the Gyeongsangnam-do Agriculture and Extension Services, Jinju, South Korea, suddenly died. The characteristic symptoms consisted of rotting, wilting, and blighting. Initial symptoms included water-soaked lesions on lower stem tissue near the soil line. Infected plants gradually withered, and white mycelial mats and sclerotia appeared on the surface of roots and stems at the soil line. The sclerotia were collected and disinfested by immersion in 1% sodium hypochlorite solution for 30 s and in sterilized distilled water for 1 min. Then, the sclerotia were placed on potato dextrose agar (PDA) and incubated at 30°C. Numerous globoid sclerotia were formed on PDA after 18 days of growth. The sclerotia (1 to 3 mm in diameter) were white at first and then gradually turned dark brown. Aerial mycelia usually formed many narrow hyphal strands 4 to 9 μm wide. The white mycelium formed a typical clamp connection after 5 days of growth. To fulfill Koch's postulates, 50-day-old healthy seedlings were transplanted individually into pots (10 × 10 × 9 cm) containing autoclaved soil. After 7 days, five seedlings were inoculated with colonized agar discs (6 mm in diameter) directly on the base of the plant, and five yacón seedlings were inoculated similarly with PDA discs as the control treatment. The inoculated and non-inoculated plants were incubated in a humid growth chamber at 28°C for 24 h and then maintained in a greenhouse. Eight days after inoculation, the yacón seedlings inoculated with the fungus died, whereas those treated with PDA discs were symptomless. The fungus was re-isolated from the artificially inoculated plants. To confirm the identity of the causal fungus, the complete internal transcribed spacer (ITS) rDNA region of the fungus was amplified using the primers ITS1 (5'-TCCGTAGGTGAACCTGCGG-3') and ITS4 (5'-TCCTCCGCTTATTGATATGC-3') (2), and the PCR amplicons were cloned into the pGEM-T Easy vector. The resulting plasmid (pOR119) was sequenced in both directions with the primers M13F and M13R. The resulting 684 bp of ITS rDNA sequence was deposited in GenBank (Accession No. KJ944395). A DNA analysis revealed that it was 100% identical to Sclerotium rolfsii (HM355751). Cultures of S. rolfsii have been deposited with the Korean Agricultural Culture Collection (KACC 47750), National Academy of Agricultural Science, Suwon, South Korea. On the basis of symptoms, fungal colonies, the ITS sequence, and pathogenicity to the host, this fungus was identified as S. rolfsii Saccardo (1). This is the first report of sclerotium rot on yacón caused by S. rolfsii in South Korea. References: (1) J. E. M. Mordue. CMI Descriptions of Pathogenic Fungi and Bacteria, No. 410, 1974. (2) T. J. White et al. Page 315 in: PCR Protocols: A Guide to Methods and Applications. M. A. Innis et al., eds. Academic Press, San Diego, 1990.
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Affiliation(s)
- J-H Kwon
- Gyeongsangnam-do Agricultural Research and Extension, Jinju 660-360, South Korea
| | - D-W Kang
- Gyeongsangnam-do Agricultural Research and Extension, Jinju 660-360, South Korea
| | - S-D Lee
- Gyeongsangnam-do Agricultural Research and Extension, Jinju 660-360, South Korea
| | - J Kim
- Institute of Agriculture and Life Sciences, Gyeongsang National University, Jinju 660-701, South Korea. This work was supported by the Rural Development Administration fund PJ009192
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Jo KW, Lee SD, Kim WS, Kim DS, Shim TS. Treatment outcomes and moxifloxacin susceptibility in ofloxacin-resistant multidrug-resistant tuberculosis. Int J Tuberc Lung Dis 2014; 18:39-43. [PMID: 24365550 DOI: 10.5588/ijtld.13.0307] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING A tertiary referral centre in Seoul, South Korea. OBJECTIVE To investigate the effect of moxifloxacin (MFX) susceptibility and later-generation fluoroquinolone (FQ) use on the treatment outcomes of ofloxacin (OFX) resistant multidrug-resistant tuberculosis (MDR-TB). DESIGN Of 223 patients diagnosed with MDR-TB between January 2006 and December 2012, 70 (31.4%) patients with OFX-resistant MDR-TB were enrolled in this retrospective cohort study. Their treatment outcomes were analysed. RESULTS The mean age (standard deviation) of the 70 patients was 40.6 (12.9) years; 43 (61.4%) were male and 26 (37.1%) had extensively drug-resistant TB. Of the 70 patients, 22 (31.4%) had MFX-susceptible TB, while the remaining 48 (68.6%) were MFX-resistant. The MFX-susceptible and -resistant groups were comparable in terms of baseline characteristics (including age, sex and radiological severity), and respectively 90.9% (20/22) and 70.8% (34/48) were treated with later-generation FQ-containing regimens (P = 0.074; mainly MFX [40/54, 74.1%]). Treatment success was achieved in 72.7% (16/22) of the MFX-susceptible patients and in 41.7% (20/48) of the MFX-resistant patients (P = 0.021). Treatment failure was significantly higher in the MFX-resistant group (41.7% [20/48] vs. 9.1% [2/22]; P = 0.006). CONCLUSION Patients with OFX-resistant MDR-TB had significantly better treatment outcomes when susceptible to MFX. This probably reflects the effect of later-generation FQ treatment.
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Affiliation(s)
- K-W Jo
- Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - S-D Lee
- Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - W S Kim
- Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - D S Kim
- Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - T S Shim
- Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
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Park JC, Kim SC, Lee SD, Jang HC, Kim NK, Lee SH, Jung HJ, Kim IC, Seong HH, Choi BH. Effects of Dietary Fat Types on Growth Performance, Pork Quality, and Gene Expression in Growing-finishing Pigs. Asian-Australas J Anim Sci 2014; 25:1759-67. [PMID: 25049542 PMCID: PMC4094162 DOI: 10.5713/ajas.2012.12416] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Revised: 09/16/2012] [Accepted: 09/04/2012] [Indexed: 11/27/2022]
Abstract
This study was performed to determine the effects of dietary fat sources, i.e., beef tallow, soybean oil, olive oil and coconut oil (each 3% in feed), on the growth performance, meat quality and gene expression in growing-finishing pigs. A total of 72 crossbred pigs (Landrace×Large White×Duroc) were used at 71±1 kg body weight (about 130 d of age) in 24 pens (320×150 cm) in a confined pig house (three pigs per pen) with six replicate pens per treatment. The growing diet was given for periods of 14±3 d and the finishing diet was given for periods of 28±3 d. The fat type had no significant effect either on growth performance or on chemical composition or on meat quality in growing-finishing pigs. Dietary fat type affected fatty acid composition, with higher levels of unsaturated fatty acids (UFAs) and monounsaturated fatty acids (MUFAs) in the olive oil group. Microarray analysis in the Longissimus dorsi identified 6 genes, related to insulin signaling pathway, that were differentially expressed among the different feed groups. Real time-PCR was conducted on the six genes in the longissimus dorsi muscle (LM). In particular, the genes encoding the protein kinase, cAMP-dependent, regulatory, type II, alpha (PRKAR2A) and the catalytic subunit of protein phosphatase 1, beta isoform (PPP1CB) showed the highest expression level in the olive oil group (respectively, p<0.05, p<0.001). The results of this study indicate that the type of dietary fat affects fatty acid composition and insulin signaling-related gene expression in the LM of pigs.
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Affiliation(s)
- J C Park
- Division of Animal Genomics & Bioinformatics, National Institute of Animal Science, Rural Development Administration, Chuksan gil 77, Kwonsun-gu, Suwon, Korea
| | - S C Kim
- Division of Animal Genomics & Bioinformatics, National Institute of Animal Science, Rural Development Administration, Chuksan gil 77, Kwonsun-gu, Suwon, Korea
| | - S D Lee
- Division of Animal Genomics & Bioinformatics, National Institute of Animal Science, Rural Development Administration, Chuksan gil 77, Kwonsun-gu, Suwon, Korea
| | - H C Jang
- Division of Animal Genomics & Bioinformatics, National Institute of Animal Science, Rural Development Administration, Chuksan gil 77, Kwonsun-gu, Suwon, Korea
| | - N K Kim
- Division of Animal Genomics & Bioinformatics, National Institute of Animal Science, Rural Development Administration, Chuksan gil 77, Kwonsun-gu, Suwon, Korea
| | - S H Lee
- Division of Animal Genomics & Bioinformatics, National Institute of Animal Science, Rural Development Administration, Chuksan gil 77, Kwonsun-gu, Suwon, Korea
| | - H J Jung
- Division of Animal Genomics & Bioinformatics, National Institute of Animal Science, Rural Development Administration, Chuksan gil 77, Kwonsun-gu, Suwon, Korea
| | - I C Kim
- Division of Animal Genomics & Bioinformatics, National Institute of Animal Science, Rural Development Administration, Chuksan gil 77, Kwonsun-gu, Suwon, Korea
| | - H H Seong
- Division of Animal Genomics & Bioinformatics, National Institute of Animal Science, Rural Development Administration, Chuksan gil 77, Kwonsun-gu, Suwon, Korea
| | - B H Choi
- Division of Animal Genomics & Bioinformatics, National Institute of Animal Science, Rural Development Administration, Chuksan gil 77, Kwonsun-gu, Suwon, Korea
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Kim YK, Kim SH, Lee SD, Park SJ. Clinical outcomes and risk factors of hepatitis B virus recurrence in patients who received prophylaxis with entecavir and hepatitis B immunoglobulin following liver transplantation. Transplant Proc 2014; 45:3052-6. [PMID: 24157034 DOI: 10.1016/j.transproceed.2013.08.065] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Although entecavir (ETV) and hepatitis B immunoglobulin (HBIG) have widely been used for prophylaxis of hepatitis B virus (HBV) recurrence following liver transplantation (OLT), there have been few studies about clinical outcomes and risk factors of HBV recurrence. MATERIALS AND METHODS This study retrospectively assessed clinical outcomes and identified risk factors of post-transplant HBV recurrence in 154 patients who received prophylaxis with both ETV and HBIG after OLT. RESULTS The median follow-up duration was 28.0 months (range, 1.0-57.8). Post-transplant HBV recurrence occurred in 5 patients (3.2%) without any ETV-resistant mutants. The overall rates of HBV recurrence at 1, 2, and 4 years were 0.6%, 1.6%, and 6.2%, respectively. We found that recurrent hepatocellular carcinoma (HCC) was an independent risk factor of HBV recurrence (hazard ratio = 13.5, 95% confidence interval, 2.4-74.4; P = .006). CONCLUSIONS Prophylaxis with a combination of ETV and HBIG resulted in a low HBV recurrence rate following OLT without any emergence of ETV-resistant mutants. Recurrent HCC was an independent risk factor of HBV recurrence in patients who received prophylaxis with both ETV and HBIG for prophylaxis following OLT.
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Affiliation(s)
- Y-K Kim
- Center for Liver Cancer, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea
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Maslova K, Stepina I, Konoplev A, Popov V, Gusarov A, Pankratov F, Lee SD, Il'icheva N. Fate and transport of radiocesium, radiostrontium and radiocobalt on urban building materials. J Environ Radioact 2013; 125:74-80. [PMID: 23399030 DOI: 10.1016/j.jenvrad.2013.01.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 01/19/2013] [Indexed: 06/01/2023]
Abstract
Kinetics of (137)Cs, (60)Co and (85)Sr sorption on powdered building materials in aqueous suspensions at 20 °C for interaction times of 1, 7, 14 and 28 days were studied. The (137)Cs distribution coefficient (Kd) values for all building materials except limestone practically did not change during 28 days of sorption. The Kd ((85)Sr) was several orders of magnitude lower than for (60)Co. The highest values were observed for asphalt and granite. An effective method to study the radionuclide distribution in depth of building materials using layer-by-layer sanding was developed. Using the developed method, the (137)Cs, (60)Co and (85)Sr distribution with depth of selected building materials at different air humidity, time and temperature was studied. Relative humidity (RH) was found to influence significantly the (85)Sr depth distribution in the case of granite (unlike (137)Cs and (60)Co). While (85)Sr penetrated to 0.5 mm in depth of granite at RH 30%, at RH 87% the depth of (85)Sr penetration to granite reached up to 7 mm.
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Affiliation(s)
- K Maslova
- RPA "Typhoon", Centre for Environmental Chemistry, Pobedy St. 4, Obninsk, Kaluga Region 249038, Russia
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Lee SD, Shyu WC, Cheng IS, Kuo CH, Chan YS, Lin YM, Tasi CY, Tsai CH, Ho TJ, Huang CY. Effects of exercise training on cardiac apoptosis in obese rats. Nutr Metab Cardiovasc Dis 2013; 23:566-573. [PMID: 22402061 DOI: 10.1016/j.numecd.2011.11.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Revised: 10/10/2011] [Accepted: 11/02/2011] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND AIM The purpose of this study was to evaluate the effects of exercise training on cardiac apoptotic pathways in obesity. METHODS AND RESULTS Sixteen lean Zucker rats (LZR) and sixteen obese Zucker rats (OZR) of 5-6 months of age as well as the other sixteen obese rats were subjected to treadmill running exercise for 1 h everyday for 3 months (OZR-EX). After exercise training or sedentary status of the rats, the excised hearts from the three groups were measured by heart weight index, H&E staining, TUNEL assays and Western blotting. Cardiac TUNEL-positive apoptotic cells, the protein levels of TNF alpha, Fas ligand, Fas receptors, Fas-associated death domain (FADD), Bad, Bax, activated caspase 8, activated caspase 9, and activated caspase 3 were higher in OZR than those in LZR. The protein levels of TNF alpha, Fas ligand, Fas receptors, FADD, activated caspase 8, and activated caspase 3 (Fas pathway) and the protein levels of Bad, Bax, Bax-to-Bcl2 ratio, activated caspase 9, and activated caspase 3 (mitochondria pathway) were lower in OZR-EX than those in OZR. CONCLUSION Cardiac Fas-dependent and mitochondria-dependent apoptotic pathways become more activated in obesity. Exercise training can prevent obesity-activated cardiac Fas-dependent and mitochondria-dependent apoptotic pathways. Our findings demonstrate a new therapeutic effect of exercise training to prevent delirious cardiac Fas-mediated and mitochondria-mediated apoptosis in obesity.
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Affiliation(s)
- S-D Lee
- Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung, Taiwan
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Rhee CK, Yoo KH, Lee JH, Park MJ, Kim WJ, Park YB, Hwang YI, Kim YS, Jung JY, Moon JY, Rhee YK, Park HK, Lim JH, Park HY, Lee SW, Kim YH, Lee SH, Yoon HK, Kim JW, Kim JS, Kim YK, Oh YM, Lee SD, Kim HJ. Clinical characteristics of patients with tuberculosis-destroyed lung. Int J Tuberc Lung Dis 2013; 17:67-75. [PMID: 23232006 DOI: 10.5588/ijtld.12.0351] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Multicentre study. OBJECTIVE To define the clinical characteristics of patients with tuberculosis (TB) destroyed lung due to past TB. DESIGN We reviewed patients with TB-destroyed lung between May 2005 and June 2011. RESULTS A total of 595 patients from 21 hospitals were enrolled. The mean age was 65.63 ± 0.47 (mean ± standard error); 60.5% were male. The mean number of lobes involved was 2.59 ± 0.05. Pleural thickening was observed in 54.1% of the patients. Mean forced vital capacity (FVC), forced expiratory volume in 1 s (FEV(1)), FEV(1)/FVC, bronchodilator response and number of exacerbations per year were respectively 2.06 ± 0.03 l (61.26% ± 0.79), 1.16 ± 0.02 l (49.05% ± 0.84), 58.03% ± 0.70, 5.70% ± 0.34, and 0.40 ± 0.04. The number of lobes involved was significantly correlated with FVC and FEV(1), and with the number of exacerbations per year. Use of long-acting muscarinic antagonists or long-acting beta-2 agonists plus inhaled corticosteroids resulted in bronchodilatory effects. Multivariable regression analysis showed that age, initial FEV(1) (%) and number of exacerbations during follow-up were independent factors affecting change in FEV(1). CONCLUSION Decreased lung function with exacerbation, and progressive decline of FEV(1) were observed in patients with TB-destroyed lung.
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Affiliation(s)
- C K Rhee
- Department of Internal Medicine, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Korea
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Lyu J, Kim MN, Song JW, Choi CM, Oh YM, Lee SD, Kim WS, Kim DS, Shim TS. GenoType® MTBDRplus assay detection of drug-resistant tuberculosis in routine practice in Korea. Int J Tuberc Lung Dis 2013; 17:120-4. [PMID: 23232012 DOI: 10.5588/ijtld.12.0197] [Citation(s) in RCA: 22] [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] [Indexed: 11/10/2022] Open
Abstract
SETTING Korea is an intermediate-burden country with high rates of tuberculosis (TB) drug resistance. OBJECTIVE To evaluate the performance of the GenoType® MTBDRplus (MTBDR) assay in diagnosing drug-resistant TB in routine practice in Korea. DESIGN The MTBDR assay was performed on 428 samples, and the results were retrospectively compared with the results of conventional drug susceptibility testing (DST). The interval between treatment and diagnosis of drug resistance was also compared. RESULTS The sensitivity, specificity and positive and negative predictive values of the MTBDR assay were respectively 96.6%, 98.9%, 93.4% and 99.5% for the detection of rifampicin (RMP) resistance; 93.8%, 98.3%, 92.7% and 98.6% for isoniazid (INH) resistance; and 91.1%, 99.2%, 99.4% and 98.7% for multidrug-resistant TB (MDR-TB). The median interval between the start of anti-tuberculosis chemotherapy and the reporting of results was 88.9 days for conventional DST and 19.8 days for MTBDR using clinical specimens. CONCLUSION The specificity of the MTBDR assay in detecting MDR-TB was very high, although the sensitivity in detecting INH resistance and MDR-TB was not optimal (<95%). Although the turnaround time in detecting drug resistance was dramatically reduced with MTBDR compared to conventional DST, more effort is needed to shorten the turnaround time.
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Affiliation(s)
- J Lyu
- Department of Pulmonary and Critical Care Medicine, Inje University Haeundae Paik Hospital, Haeundae-gu, Busan, South Korea
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Wu WC, Wu CY, Wang YJ, Hung HH, Yang HI, Kao WY, Su CW, Wu JC, Chan WL, Lin HC, Lee FY, Lee SD. Updated thresholds for serum alanine aminotransferase level in a large-scale population study composed of 34 346 subjects. Aliment Pharmacol Ther 2012; 36:560-8. [PMID: 22817613 DOI: 10.1111/j.1365-2036.2012.05224.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2012] [Revised: 06/29/2012] [Accepted: 07/02/2012] [Indexed: 12/15/2022]
Abstract
BACKGROUND The sensitivity of current upper limit of normal (ULN) of serum alanine aminotransferase (ALT) levels for detecting chronic liver disease has been challenged recently. AIM To identify modulating factors for serum ALT levels and to refine its ULN threshold. METHODS We enrolled 34 346 consecutive subjects who completed the health check-up at Taipei Veterans General Hospital from 2002 to 2009. ULN was set for healthy ALT level to the 95th percentile of the reference healthy population. RESULTS A group of 21 282 subjects were used as a training set to define an ULN with the highest sensitivity; afterwards, this ULN was validated in another set of 13 064 subjects. A reference healthy population was selected from the training set after excluding subjects with any abnormalities in independent risk factors associated with elevated serum ALT level (>40 IU/L) by multivariate analysis like body mass index, waist circumference, glucose, cholesterol, high-density lipoprotein-cholesterol, triglyceride, hepatitis B virus surface antigen, anti-hepatitis C virus antibody and fatty liver. The new ULN of serum ALT level defined as the 95% percentile in the healthy population were 21 IU/L and 17 IU/L for men and women respectively. These cut-off values had the highest Youden's index and areas under the corresponding receiver operating curves among four widely applied thresholds in both the training and validation sets. CONCLUSIONS The suggested threshold of upper limit of normal provides better discrimination between healthy and unhealthy status. Viral hepatitis, metabolic syndrome and fatty liver are the major risk factors of elevated serum alanine aminotransferase levels.
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Affiliation(s)
- W-C Wu
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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Kao WY, Hwang CY, Chang YT, Su CW, Hou MC, Lin HC, Lee FY, Lee SD, Wu JC. Cancer risk in patients with pyogenic liver abscess: a nationwide cohort study. Aliment Pharmacol Ther 2012; 36:467-76. [PMID: 22779737 DOI: 10.1111/j.1365-2036.2012.05212.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2012] [Revised: 04/04/2012] [Accepted: 06/20/2012] [Indexed: 12/12/2022]
Abstract
BACKGROUND There has been no large-scale population-based study on the relationship between pyogenic liver abscesses (PLA) and subsequent cancer risk. AIM To estimate all cancer risk following a diagnosis of PLA. METHODS Based on Taiwan's National Health Insurance Research Database, 1257 patients with PLA without prior cancers in the period 1996-2008 were identified and followed-up. The standard incidence ratio (SIR) of each cancer was calculated as the number of observed cancer cases arising among the PLA patients divided by the expected case number of cancer cases according to the national cancer rates. RESULTS Of the 1257 PLA patients identified, 598 (47.6%) had diabetes mellitus. After a median (±s.d.) follow-up of 3.33 ± 3.45 years, 186 were diagnosed with cancers, including 56 liver cancer, 22 biliary tract cancer and 40 colorectal cancer patients. Patients with PLA had a higher risk of all cancers (SIR, 3.83; 95% CI, 3.30-4.42), liver cancer (SIR, 7.87; 95% CI, 5.94-10.21), biliary tract cancer (SIR, 34.58; 95% CI, 21.67-52.36) and colorectal cancer (SIR, 5.27; 95% CI, 3.76-7.18). The highest SIRs of all cancers, liver cancer, biliary tract cancer and colorectal cancer occurred within 90 days of follow-up (360.82; 95% CI, 278.46-459.91, 257.28; 95% CI, 186.17-346.56, 1153.38; 95% CI 694.08-1801.24, and 52.63; 95% CI 25.2-96.8 respectively). CONCLUSIONS Pyogenic liver abscesses may herald the onset of cancer, especially hepato-biliary and colon cancer. Further surveys should be conducted for the detection of occult cancers in such patients.
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Affiliation(s)
- W-Y Kao
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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Ryu KW, Lee SD. Authors' reply: Prognostic significance of peritoneal washing cytology in patients with gastric cancer ( Br J Surg 2012; 99: 397–403). Br J Surg 2012. [DOI: 10.1002/bjs.8856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- K W Ryu
- Gastric Cancer Branch, Nation Cancer Centre, Seoul, Korea
| | - S D Lee
- Gastric Cancer Branch, Nation Cancer Centre, Seoul, Korea
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Abstract
BACKGROUND The clinical significance of an isolated reduction in forced expiratory volume in 1 second (FEV(1); i.e., low FEV(1), but normal forced vital capacity [FVC] and FEV(1)/FVC) has not been established. OBJECTIVE To examine the clinical features of subjects with an isolated FEV(1) reduction. METHODS Clinical, spirometry and radiological data were retrospectively collected from 15,192 subjects attending a medical check-up at the Health Promotion Center of the Asan Medical Center, Korea. Predicted spirometry values were calculated from the Korean reference equations, and the lower limit of normal was set at the 5th percentile. Subjects were divided into four groups: isolated FEV(1) reduction, normal (normal FVC, FEV(1) and FEV(1)/FVC), obstructive (low FEV(1)/FVC) and restrictive (low FVC and normal FEV(1)/FVC). The groups were compared in terms of clinical characteristics. RESULTS Of the 15,192 subjects, 323 (2.1%) had an isolated FEV(1) reduction, 10,591 (69.7%) were normal, 951 obstructive (6.3%) and 3327 (22.0%) restrictive. The isolated FEV(1) reduction group had a higher proportion of subjects with smoking history (63.2% vs. 45.7%), radiology abnormalities (15.5% vs. 4.3%) and history of respiratory disease (8.4% vs. 3.0%) than the normal group (all P < 0.001). CONCLUSION An isolated FEV(1) reduction suggests abnormal spirometry, and further study is needed to evaluate whether these cases belong to the obstructive or restrictive group.
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Affiliation(s)
- Y J Jung
- Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Lee SD, Kim TH, Kim DY, Baek JY, Kim SY, Chang HJ, Park SC, Park JW, Oh JH, Jung KH. Lymph node ratio is an independent prognostic factor in patients with rectal cancer treated with preoperative chemoradiotherapy and curative resection. Eur J Surg Oncol 2012; 38:478-83. [PMID: 22465588 DOI: 10.1016/j.ejso.2012.03.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Revised: 02/26/2012] [Accepted: 03/05/2012] [Indexed: 01/04/2023] Open
Abstract
PURPOSE To evaluate the prognostic effect of lymph node ratio (LNR) in patients with locally advanced rectal cancer who were treated with curative resection after preoperative chemoradiotherapy (CRT). METHODS Between October 2001 and December 2007, 519 patients who had undergone curative resection of primary rectal cancer after preoperative CRT were enrolled. Of these, 154 patients were positive for lymph node (LN) metastasis and were divided into three groups according to the LNR (≤ 0.15 [n=80], 0.16-0.3 [n=44], >0.3 [n=30]) to evaluate the prognostic effect on overall survival (OS) and disease-free survival (DFS). RESULTS LNR (≤ 0.15, 0.16-0.3, and >0.3) was significantly associated with 5-year OS (90.3%, 75.1%, and 45.1%; p<0.001) and DFS (66.7%, 55.8%, and 21.9%; p<0.001) rates. In a multivariate analysis, LNR (≤ 0.15, 0.16-0.3, and >0.3) was a significant independent prognostic factor for OS (hazard ratios [HRs], 1, 3.609, and 8.197; p<0.001) and DFS (HRs, 1, 1.699, and 3.960; p<0.001). LNR had a prognostic impact on OS and DFS in patients with <12 harvested LNs, as well as in those with ≥ 12 harvested LNs (p<0.05). CONCLUSION LNR was a significant independent prognostic predictor for OS and DFS in patients with locally advanced rectal cancer who were treated with curative resection after preoperative CRT.
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Affiliation(s)
- S D Lee
- Center for Colorectal Cancer, National Cancer Center, Goyang, Republic of Korea
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Kim KW, Jhoo JH, Lee SB, Lee SD, Kim TH, Kim SE, Kim YK, Yoon IY. Increased striatal dopamine transporter density in moderately severe old restless legs syndrome patients. Eur J Neurol 2012; 19:1213-8. [PMID: 22435397 DOI: 10.1111/j.1468-1331.2012.03705.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Dopamine dysregulation in restless legs syndrome (RLS) may be varied by the severity of RLS, which could contribute to the conflicting results from previous functional neuroimaging studies on the central dopaminergic neurotransmission of RLS. The aim of this study was to observe whether reduced striatal dopaminergic neurotransmission is associated with moderate to moderately severe RLS. METHODS Thirteen elderly patients with RLS and 12 normal elderly controls were enrolled in the study. All the subjects were dopaminergic-drug naïve and twelve patients with RLS had the severity of moderate to moderately severe degree based on the International Restless Legs Syndrome Study Group (IRLSSG) Severity Scale. We compared dopamine transporter density (DAT) availability and D2 receptor density in the striatum between patients with RLS and controls using [(123)I]2β-carbomethoxy-3β-(4-iodophenyl)tropane single-photon emission computed tomography (SPECT) and [(123)I]iodobenzamide SPECT. RESULTS Dopamine transporter density of patients with RLS was increased in the caudate (P = 0.037), posterior putamen (P = 0.041), and entire striatum (P = 0.046) compared with that of normal controls. DAT density was higher in the anterior putamen of patients with RLS than controls, although statistically not significant (P = 0.079). There was no difference in the D2 receptor density between patients with RLS and normal controls in the whole striatum or any of subregions. CONCLUSIONS Dysregulation rather than simple upregulation or downregulation of central dopaminergic neurotransmission may underlie the pathogenesis of RLS, and decreased dopaminergic neurotransmission may cause moderate to moderately severe RLS in the elderly.
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Affiliation(s)
- K W Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggi, Korea
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Jung JY, Kang YA, Park MS, Oh YM, Park EC, Kim HR, Lee SD, Kim SK, Chang J, Kim YS. Chronic obstructive lung disease-related health care utilisation in Korean adults with obstructive lung disease. Int J Tuberc Lung Dis 2012; 15:824-9. [PMID: 21575306 DOI: 10.5588/ijtld.10.0432] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The numbers of nationwide epidemiological surveys about chronic obstructive pulmonary disease (COPD) prevalence and prospective cohort studies for health care utilisation are limited. We investigated COPD-related health care utilisation in adults with obstructive lung disease in the second Korean National Health and Nutritional Survey (KNHANES II) in 2001 using Korean national medical insurance claim data. METHODS Among people aged >40 years, obstructive lung disease (OLD) is defined according to Global Initiative for Chronic Obstructive Lung Disease criteria. Data from a total of 1942 subjects were linked with Korean national medical insurance claims data, and we investigated their COPD-related out-patient visits from 2002 to 2005. RESULTS Among the 1942 subjects, 256 (13.2%) had airflow obstruction. COPD-related out-patient visits were reported for 8.2% of patients without airway obstruction, 18.1% of those with mild airway obstruction, and 33.9% of those with moderate to very severe airway obstruction. Multivariate analysis revealed that previous COPD diagnosis by a physician (OR 2.54; P = 0.02) and lower socio-economic status (OR 0.45; P = 0.02) were independent predictors of COPD-related out-patient visits in subjects with OLD. CONCLUSIONS Of the subjects with airway obstruction, those with poor financial status utilised COPD-related health care services less frequently, and those previously diagnosed as having COPD by a physician utilised the services more frequently.
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Affiliation(s)
- J Y Jung
- Department of Internal Medicine and Institute of Chest Diseases, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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Lee JH, Oh YM, Seo JB, Lee YK, Kim WJ, Sheen SS, Kim TH, Lee JH, Kim EK, Lee JS, Huh JW, Lim SY, Yoon HI, Shin TR, Lee SM, Lee SY, Lee SD. Pulmonary artery pressure in chronic obstructive pulmonary disease without resting hypoxaemia. Int J Tuberc Lung Dis 2012; 15:830-7. [PMID: 21575307 DOI: 10.5588/ijtld.10.0598] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) can lead to pulmonary hypertension and cor pulmonale, which are predictors of mortality. OBJECTIVE To identify predictors of increased pulmonary artery pressure (PAP) in COPD patients without resting hypoxaemia, and to characterise COPD patients with increased PAP. DESIGN A study of 117 COPD patients from the Korean Obstructive Lung Disease (KOLD) cohort who had measurable tricuspid regurgitant flow under transthoracic Doppler echocardiography and no resting hypoxaemia. RESULTS The mean patient age was 67 years. Mean forced expiratory volume in 1 second (FEV(1)) was 47% predicted, mean haemoglobin (Hb) concentration was 145 g/l and mean systolic PAP (sPAP) was 33 mmHg. Multiple linear regression analysis showed that Hb was the only factor independently associated with sPAP (beta = -1.752, P = 0.005). Cluster analysis using FEV(1)% predicted, sPAP and Hb concentration as variables indicated three patient clusters: Cluster 1 (n = 36; mean FEV(1) 44% predicted, mean sPAP 39 mmHg, mean Hb 132 g/l), Cluster 2 (n = 45; FEV(1) 35% predicted, sPAP 31 mmHg, Hb 154 g/l), and Cluster 3 (n = 36; FEV(1) 65% predicted, sPAP 29 mmHg, Hb 148 g/l). CONCLUSION Elevated PAP was linked to low haemoglobin levels in COPD without resting hypoxaemia.
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Affiliation(s)
- J H Lee
- Department of Internal Medicine, Ewha Womans University School of Medicine, Ewha Medical Research Institute, Seoul, Republic of Korea
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Kim HT, Song YK, Lee SD, Park Y, Kim CK. Relative bioavailability of two 5-mg montelukast sodium chewable tablets: a single dose, randomized, open-label, 2-period crossover comparison in healthy korean adult male volunteers. ACTA ACUST UNITED AC 2012; 62:123-7. [PMID: 22407900 DOI: 10.1055/s-0031-1298004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Montelukast sodium, cysteinyl leukotriene receptor 1 specific antagonist, has been marketed in Korea for the treatment of bronchial asthma and allergic rhinitis. The aim of this study was to compare the pharmacokinetics and relative bioavailability of a test and reference formulation of montelukast 5-mg chewable tablets in healthy Korean male volunteers to meet KFDA regulatory criteria for marketing of the new generic formulation. This study was designed as a single-dose, 2-treatment, and 2-period crossover trial with 32 healthy volunteers. Each subject was randomly assigned to receive the test (Dong-Kook Montelukast Sodium Chewable Tablet 5 mg®) or reference (Singulair Chewable Tablet 5 mg®) formulation. The tablet was chewed 20 times, and then swallowed with 240 mL of water. Plasma concentrations of montelukast up to 24 h after the dose were determined using a validated UPLC-MS/MS method, and the bioequivalence between the 2 formulations was assessed by statistical analysis of mean ratios of log-transformed AUC0-24 h and Cmax. No period or sequence effects were detected. The AUC0-24 h was 1 835 ng·h/mL for the test formulation, and 1 930 ng·h/mL for the reference formulation. The respective values of AUC0-∞ were 1 917 and 2 015 ng·h/mL. The Cmax of the test and reference products (247 and 283 ng/mL, respectively) reached at 2.25 and 2.72 h, respectively. Then, they gradually decreased with the mean terminal t1/2 of 5.25 and 5.30 h for the test and reference products, respectively. The 90% CIs for the ratio of log-transformed AUC0-24 h and Cmax for the test and reference formulations were 0.92-0.99 and 0.83-0.91, respectively. No adverse events were reported in this study. This single dose study found that the test and reference products met the regulatory criteria for bioequivalence in these fasting healthy Korean male volunteers.
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Affiliation(s)
- H T Kim
- Department of Medicine/Gastroenterology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, Republic of Korea
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Harper JW, Welch MP, Sinanan MN, Wahbeh GT, Lee SD. Co-morbid diabetes in patients with Crohn's disease predicts a greater need for surgical intervention. Aliment Pharmacol Ther 2012; 35:126-32. [PMID: 22074268 DOI: 10.1111/j.1365-2036.2011.04915.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND The prevalence of diabetes is increasing rapidly. Given its pro-inflammatory nature, comorbid diabetes may affect the course of Crohn's disease (CD). AIM To determine whether comorbid diabetes influences the natural history of CD. METHODS We compared a cohort with CD and comorbid diabetes to a nondiabetic control population and calculated the period prevalence of surgical intervention over a 5-year period. Unadjusted and adjusted odds-ratios were calculated regarding the need for surgical intervention using univariate and multivariate logistic regression. RESULTS A total of 240 patients were identified, 16 of whom were diabetics (6.7%). The period prevalence of CD-specific surgery in the diabetic cases was 75.0% and in the nondiabetic controls, 31.7%. The diabetic patients were more obese than the controls (44% vs. 10%; P < 0.0001) and older than the controls (47.4 years vs. 38.6; P < 0.01). There was no difference in the frequency of biologic therapy use, immunomodulator use, smoking, perianal disease, ileal involvement or corticosteroid use between the diabetics and controls. Univariate analysis revealed that diabetes (OR 6.46 [95% CI 2.01-20.8]), smoking (OR 2.46 [95% CI 1.24-4.90]), ileal disease (OR 2.21 [95% CI 1.15-4.24]) and obesity (OR 2.22 [95% CI 1.04-4.77]) were risk factors for needing surgery. After adjustment for covariates, the OR for surgical intervention in diabetics was 5.4 (95% CI 1.65-17.64). CONCLUSION Co-morbid diabetes in patients with Crohn's disease predicts a greater need for surgical intervention.
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Affiliation(s)
- J W Harper
- Department of Medicine, University of Washington, Seattle, WA, USA.
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Kao WY, Chiou YY, Hung HH, Su CW, Chou YH, Wu JC, Huo TI, Huang YH, Wu WC, Lin HC, Lee SD. Serum alpha-fetoprotein response can predict prognosis in hepatocellular carcinoma patients undergoing radiofrequency ablation therapy. Clin Radiol 2011; 67:429-36. [PMID: 22153231 DOI: 10.1016/j.crad.2011.10.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Revised: 09/11/2011] [Accepted: 10/25/2011] [Indexed: 12/21/2022]
Abstract
AIMS To evaluate the clinical inference of serum alpha-fetoprotein (AFP) response in hepatocellular carcinoma (HCC) patients undergoing percutaneous radiofrequency ablation (RFA). MATERIALS AND METHODS Three hundred and thirteen previously untreated HCC patients were enrolled in the study. The optimal AFP response was defined as >20% decrease from baseline after 1 month of RFA for those with a baseline AFP level of ≥100 ng/ml. The impact of AFP response on prognosis was analysed and prognostic factors were assessed. RESULTS After a median follow-up of 26.7 ± 19.1 months, 49 patients died and 264 patients were alive. The cumulative 5 year survival rates were 75.3 and 57.4% in patients with an initial AFP of <100 ng/ml and ≥100 ng/ml, respectively (p = 0.003). In the 58 patients with a baseline AFP of ≥100 ng/ml and initial completed tumour necrosis after RFA, the cumulative 5 year survival rates were 62.4 and 25.7% in optimal and non-optimal AFP responders, respectively (p = 0.001). By multivariate analysis, the prothrombin time international normalized ratio >1.1 (p = 0.009), non-optimal AFP response (p = 0.023), and creatinine >1.5 mg/dl (p = 0.021) were independent risk factors predictive of poor overall survival. Besides, the cumulative 5 year recurrence rates were 83.4 and 100% in optimal and non-optimal AFP responders, respectively (p < 0.001). Multivariate analysis demonstrated platelet count ≤10(5)/mm(3) (p = 0.048), tumour size >2 cm (p = 0.027), and non-optimal AFP response (p < 0.001) were independent risk factors associated with tumour recurrence after RFA. CONCLUSIONS Serum AFP response may be a useful marker for predicting prognosis in HCC patients undergoing RFA.
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Affiliation(s)
- W-Y Kao
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taiwan
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Ra SW, Lyu J, Choi CM, Oh YM, Lee SD, Kim WS, Kim DS, Shim TS. Distinguishing tuberculosis from Mycobacterium avium complex disease using an interferon-gamma release assay. Int J Tuberc Lung Dis 2011; 15:635-40. [PMID: 21756514 DOI: 10.5588/ijtld.10.0485] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING The QuantiFERON-TB Gold (QFT-G) test can be used to distinguish between tuberculosis (TB) and non-tuberculous mycobacterial disease, but a high background TB infection rate may pose a problem. Although the QuantiFERON-TB (QFT) test, the first-generation QFT-G test, employs a non-specific PPD antigen, avium sensitin is also used as a stimulating antigen. OBJECTIVE To evaluate the utility of these two interferon gamma release assays (IGRAs), QFT-G and QFT, and the tuberculin skin test (TST), to differentiate TB from Mycobacterium avium complex (MAC) disease in an intermediate TB burden country. METHODS We compared the diagnostic performance of these three tests in 38 prospectively enrolled patients with TB and 40 with MAC lung disease. RESULTS The TST yielded positive results in 70.6% of TB and 47.5% of MAC patients; the proportions were respectively 89.5% and 34.3% for QFT-G and 86.8% and 35.3% for QFT. The three tests were of similar accuracy, sensitivity and specificity in diagnosing TB. CONCLUSION Our findings indicate that the TST and IGRAs could not discriminate between active TB and MAC disease or latent TB infection in a TB-endemic area.
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Affiliation(s)
- S W Ra
- Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea
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Lee JS, Huh JW, Chae EJ, Seo JB, Ra SW, Lee JH, Kim EK, Lee YK, Kim TH, Kim WJ, Lee JH, Lee SM, Lee S, Lim SY, Shin TR, Yoon HI, Sheen SS, Oh YM, Lee SD. Different therapeutic responses in chronic obstructive pulmonary disease subgroups. Int J Tuberc Lung Dis 2011; 15:1104-10. [PMID: 21740676 DOI: 10.5588/ijtld.10.0553] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Eleven referring hospitals in South Korea. OBJECTIVE To compare therapeutic responses in chronic obstructive pulmonary disease (COPD) subgroups, classified by diffusing capacity of the lung for carbon monoxide (DL(CO)) and lung volume. DESIGN A total of 130 stable male COPD patients were classified into four subgroups according to baseline DL(CO) and residual volume/total lung capacity (RV/TLC) ratio. We compared therapeutic responses to short acting β(2)-agonist (SABA) and 3-month combined inhalation of long-acting β(2)-agonist (LABA) and corticosteroid among patients with these subgroups. RESULTS Among the 130 COPD patients, 41 (31.5%) had normal DL(CO) and RV/TLC, 28 (21.5%) low DL(CO) and normal RV/TLC, 31 (23.8%) normal DL(CO) and high RV/TLC, and 30 (23.1%) low DL(CO) and high RV/TLC. The normal DL(CO)/high RV/TLC subgroup showed a significantly larger flow response (changes in forced expiratory volume in 1 s) to salbutamol than the normal DL(CO)/RV/TLC subgroups, and a larger volume response (changes in forced vital capacity) than the two normal RV/TLC subgroups. The normal DL(CO)/high RV/TLC subgroup also showed significantly larger flow and volume response to 3-month combined inhalation of LABA and corticosteroid than the two normal RV/TLC subgroups. CONCLUSION COPD subgroups classified by DL(CO) and RV/TLC may have different pulmonary function responses to pharmacological treatment.
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Affiliation(s)
- J S Lee
- Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Seoul, South Korea
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Luo JC, Huang KW, Leu HB, Chen LC, Hou MC, Li CP, Lu CL, Lin HC, Lee FY, Lee SD. Randomised clinical trial: rabeprazole plus aspirin is not inferior to rabeprazole plus clopidogrel for the healing of aspirin-related peptic ulcer. Aliment Pharmacol Ther 2011; 34:519-25. [PMID: 21726257 DOI: 10.1111/j.1365-2036.2011.04760.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Clopidogrel does not inhibit prostaglandin synthesis. As a result, clopidogrel's incidence of peptic ulcer disease (PUD) and ulcer bleeding is lower than aspirin's. AIM To compare the healing rate in aspirin-related dyspeptic ulcer patients who were given proton pump inhibitor (PPI) plus aspirin or PPI plus clopidogrel. METHODS Patients with aspirin-related nonbleeding symptomatic ulcers were randomised to receive rabeprazole (20 mg/day) plus aspirin (100 mg/day) or rabeprazole (20 mg/day) plus clopidogrel (75 mg/day) for 12 weeks. The primary endpoint was the successful treatment of PUD as characterised by intention-to-treat at the end of therapy. RESULTS Two hundred and eighteen patients (109 in the aspirin group and 109 in the clopidogrel group) were enrolled. There were no statistical demographic differences between the group that received aspirin and the group that received clopidogrel. The PUD treatment success rate was also statistically equal between the clopidogrel and aspirin groups (86.2% vs. 90.0%, P = 0.531). Neither group experienced ulcer-related bleeding. Multivariate logistic regression analysis showed that large ulcer size (>10 mm) (OR: 6.29, 95% CI: 2.58-15.37) and past history of PUD (OR: 3.69, 95% CI: 1.24-10.97) were important predictors of unsuccessful therapy for aspirin-related PUD. CONCLUSIONS Rabeprazole plus aspirin is not inferior to rabeprazole plus clopidogrel in treating aspirin-related symptomatic PUD. Large ulcer size (>10 mm) and past history of PUD are important predictors of unsuccessful therapy (NCT 01037491).
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Affiliation(s)
- J-C Luo
- Division of Gastroenterology, Taipei Veterans General Hospital, Taiwan.
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Affiliation(s)
- P-H Chen
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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Lim J, Lyu J, Choi CM, Oh YM, Lee SD, Kim WS, Kim DS, Lee H, Shim TS. Non-tuberculous mycobacterial diseases presenting as solitary pulmonary nodules. Int J Tuberc Lung Dis 2010; 14:1635-1640. [PMID: 21144251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
SETTING South Korea, 2005-2007. BACKGROUND Non-tuberculous mycobacterial diseases presenting as solitary pulmonary nodules (NTM-SPN) are rare and may be misdiagnosed as tuberculoma. DESIGN Eleven NTM-SPN patients were enrolled retrospectively and compared with two groups each of 33 patients with upper lobe cavitary (UC) and nodular bronchiectatic (NB) type NTM diseases, respectively. RESULTS The patients' median age was 52 years. Compared with UC-type disease, NTM-SPN patients showed female (n = 9) and never smoker (n = 8) predominance and fewer comorbidities (n = 0; P < 0.05 for each). Mycobacterium avium (n = 9) was predominant in NTM-SPN patients, followed by M. intracellulare (n = 2), whereas M. intracellulare was most frequently isolated from patients with both UC- and NB-type NTM (P < 0.05). The nodules were a median of 2.3 cm in diameter (range 1.6-6.3 cm) and were distributed evenly in all lobes. In all patients, percutaneous needle aspiration/biopsy was performed with a median 71 days of diagnostic delay. Ten patients successfully completed treatment, and one showed spontaneous reduction of nodule size without treatment. Reverse blot hybridisation assays of six DNA samples identified four subjects with M.avium-intracellulare complex (MAC), in line with conventional test data. CONCLUSION NTM-SPN was caused exclusively by MAC. Although clinical outcome was favourable, confirmatory diagnosis was delayed. Molecular methods are needed for early diagnosis of NTM-SPN.
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Affiliation(s)
- J Lim
- Division of Pulmonary & Critical Care Medicine, Gangneung Asan Hospital, Gangneung, Korea
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