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Lee KH, Choi GH, Yun J, Choi J, Goh MJ, Sinn DH, Jin YJ, Kim MA, Yu SJ, Jang S, Lee SK, Jang JW, Lee JS, Kim DY, Cho YY, Kim HJ, Kim S, Kim JH, Kim N, Kim KM. Machine learning-based clinical decision support system for treatment recommendation and overall survival prediction of hepatocellular carcinoma: a multi-center study. NPJ Digit Med 2024; 7:2. [PMID: 38182886 PMCID: PMC10770025 DOI: 10.1038/s41746-023-00976-8] [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: 03/31/2023] [Accepted: 11/29/2023] [Indexed: 01/07/2024] Open
Abstract
The treatment decisions for patients with hepatocellular carcinoma are determined by a wide range of factors, and there is a significant difference between the recommendations of widely used staging systems and the actual initial treatment choices. Herein, we propose a machine learning-based clinical decision support system suitable for use in multi-center settings. We collected data from nine institutions in South Korea for training and validation datasets. The internal and external datasets included 935 and 1750 patients, respectively. We developed a model with 20 clinical variables consisting of two stages: the first stage which recommends initial treatment using an ensemble voting machine, and the second stage, which predicts post-treatment survival using a random survival forest algorithm. We derived the first and second treatment options from the results with the highest and the second-highest probabilities given by the ensemble model and predicted their post-treatment survival. When only the first treatment option was accepted, the mean accuracy of treatment recommendation in the internal and external datasets was 67.27% and 55.34%, respectively. The accuracy increased to 87.27% and 86.06%, respectively, when the second option was included as the correct answer. Harrell's C index, integrated time-dependent AUC curve, and integrated Brier score of survival prediction in the internal and external datasets were 0.8381 and 0.7767, 91.89 and 86.48, 0.12, and 0.14, respectively. The proposed system can assist physicians by providing data-driven predictions for reference from other larger institutions or other physicians within the same institution when making treatment decisions.
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Affiliation(s)
- Kyung Hwa Lee
- Department of Radiation Oncology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Gwang Hyeon Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University, Seongnam, Republic of Korea
| | - Jihye Yun
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jonggi Choi
- Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Myung Ji Goh
- Department of Internal Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Dong Hyun Sinn
- Department of Internal Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Young Joo Jin
- Department of Internal Medicine, Inha University Hospital, Incheon, Republic of Korea
| | - Minseok Albert Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University, Seoul, Republic of Korea
| | - Su Jong Yu
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University, Seoul, Republic of Korea
| | - Sangmi Jang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University, Seongnam, Republic of Korea
- Department of Internal Medicine, Inha University Hospital, Incheon, Republic of Korea
| | - Soon Kyu Lee
- Department of Internal Medicine, Seoul St. Mary's Hospital, Seoul, Republic of Korea
- Department of Internal Medicine, Incheon St. Mary's Hospital, Incheon, Republic of Korea
| | - Jeong Won Jang
- Department of Internal Medicine, Seoul St. Mary's Hospital, Seoul, Republic of Korea
| | - Jae Seung Lee
- Department of Internal Medicine, Seoul Severance Hospital, Seoul, Republic of Korea
| | - Do Young Kim
- Department of Internal Medicine, Seoul Severance Hospital, Seoul, Republic of Korea
| | - Young Youn Cho
- Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Hyung Joon Kim
- Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Sehwa Kim
- Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Bundang Jesaeng General Hospital, Seongnam, Republic of Korea
| | - Ji Hoon Kim
- Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Namkug Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
- Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Kang Mo Kim
- Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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Shin YC, Cho EJ, Na HY, Cho JY, Han HS, Lee YJ, Kim H, Jang S, Choi GH, Jang ES, Kim JW, Jeong SH. Hepatic hemangioma: proportion and predictor of surgical treatment with emphasis on its growth rate. Korean J Intern Med 2023; 38:818-830. [PMID: 37939665 PMCID: PMC10636540 DOI: 10.3904/kjim.2023.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/16/2023] [Accepted: 06/09/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND/AIMS There are limited studies on the management of hepatic hemangiomas (HHs). We investigated the proportion and predictors of surgical resection and analyzed HH growth rates in addition to associated factors. METHODS A retrospective case-control study of patients treated in 2 centers was conducted. Thirty-six patients who underwent surgical resection were assigned to the case group. Patients who did not undergo surgical treatment were randomly sigselected at a 1:10 ratio and assigned to the control group (n = 360). Baseline characteristics, clinical course and surgical outcomes were analyzed. RESULTS The proportion of surgically treated HH patients was 0.3% (36 per 11,049). The longest diameter at diagnosis (mean ± standard deviation) was 7.7 ± 5.2 cm in the case group and 2.4 ± 1.8 cm in the control group (p < 0.001). In the multivariate analysis, the presence of more than 2 HHs (odds ratio [OR] 7.64, 95% confidence interval [CI] 1.40-41.72) and a growth rate of more than 4.8%/year (OR 30.73, 95% CI 4.86-194.51) were independently associated with surgical treatment. Symptom development during follow-up was related to HH size > 10 cm (OR 10.50, 95% CI 1.06-103.77, p = 0.04). The subgroup analysis showed substantial growth in 41.3% with an overall mean annual growth rate of 0.14 cm. CONCLUSION Approximately one in 300 patients with an HH underwent surgical treatment. Multiple HHs and a growth rate of more than 4.8%/year were indications for surgical treatment. Nearly half of the HHs showed growing pattern in our study.
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Affiliation(s)
- Young Cheol Shin
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam,
Korea
| | - Eun Ju Cho
- Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul,
Korea
| | - Hee Young Na
- Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam,
Korea
| | - Jai Young Cho
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam,
Korea
| | - Ho-Seong Han
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam,
Korea
| | - Yoon Jin Lee
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam,
Korea
| | - Haeryoung Kim
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul,
Korea
| | - Sangmi Jang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam,
Korea
| | - Gwang Hyeon Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam,
Korea
| | - Eun Sun Jang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam,
Korea
| | - Jin-Wook Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam,
Korea
| | - Sook-Hyang Jeong
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam,
Korea
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Zhang X, Olesinski EA, Duong Q, Truong MT, Lee S, Jang S, Mak KS, Parekh A, Hirsch AE. Development and Assessment of a Multi-Purpose Knowledge-Based Planning Model (RapidPlan) for Prostate Radiation. Int J Radiat Oncol Biol Phys 2023; 117:e497. [PMID: 37785565 DOI: 10.1016/j.ijrobp.2023.06.1737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) RapidPlan (RP) is a knowledge-based planning (KBP) tool to improve plan quality, planning speed, and reduce inter-patient plan variability. For small to medium institutions, it is difficult to find sufficient patient numbers to configure a reliable KBP-RP model. This study aimed to build a multi-purpose KBP-RP model for prostate cancers. MATERIALS/METHODS A total of 124 prostate plans from 2018-2022 at our institution were selected to configure the initial RP model. After model training, outliers were removed. 77 patients were used for the final RP model. Three fine-tuned RP sub-models with different optimized constraints corresponding to prostate bed, prostate + seminal vesicles (SV), and prostate boost plans were generated. RP models were validated by comparing plan quality with the original manually optimized plans (MP). 54 independent plans were selected to validate the RP models. Validation included: dose to 99% and 2% of PTV (D99%, D2%), PTV conformity index (CI); for organs at risk (OARs), volume receiving >70Gy and >60Gy (V70Gy, V60Gy) to bladder and rectum, maximum dose (Dmax) to femur heads (FHs) and small bowel. Statistical t-test analysis was performed with a significance of p<0.05. RESULTS A total of 48/54 model-based plans were clinically approved after single RP optimization. 6/54 failed plans were prostate bed plans and were deemed acceptable after additional minor constraint adjustments. For PTV, D99%, D2%, and CI were comparable (p>0.05) to MP. Bladder and rectum V70Gy were comparable (p>0.05), and V60Gy were significantly lower to MP (p<0.05), with an average Dmean of 23.21±14.58Gy and 16.41±10.63Gy vs 26.36±16.89Gy and 18.24±12.81Gy for RP and MP. RP significantly reduced Dmax to FHs and small bowel (p<0.05), with average Dmax of 34.95±6.06Gy and 35.62±18.99Gy vs 36.81±7.05Gy and 38.14±17.81Gy, respectively. CONCLUSION Multi-purpose prostate RP model was configured and approved plans were generated after single optimization. Prostate RP plans had equivalent PTV coverage with better or comparable OAR constraints.
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Affiliation(s)
- X Zhang
- Department of Radiation Oncology, Boston University School of Medicine, Boston, MA
| | | | - Q Duong
- Boston Medical Center, Boston, MA
| | - M T Truong
- Department of Radiation Oncology, Boston University School of Medicine, Boston, MA
| | - S Lee
- Department of Radiation Oncology, Boston University School of Medicine, Boston, MA
| | - S Jang
- Department of Radiation Oncology, Boston University School of Medicine, Boston, MA
| | - K S Mak
- Department of Radiation Oncology, Boston University School of Medicine, Boston, MA
| | - A Parekh
- Department of Radiation Oncology, Boston University School of Medicine, Boston, MA
| | - A E Hirsch
- Department of Radiation Oncology, Boston University School of Medicine, Boston, MA
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Jang S, Jin YJ, Lee JW, Kwon D, Yu JH. Risk factors associated with late hepatocellular carcinoma detection in patients undergoing regular surveillance. Medicine (Baltimore) 2023; 102:e34637. [PMID: 37565915 PMCID: PMC10419803 DOI: 10.1097/md.0000000000034637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 07/17/2023] [Indexed: 08/12/2023] Open
Abstract
Hepatocellular carcinoma (HCC) has a very poor prognosis with a 5-year survival rate of < 20%; hence, early diagnosis is crucial. Despite regular checkups for high-risk groups of HCC, there are a few cases in which it is discovered as a late-stage HCC. Therefore, this study aimed to investigate the characteristics of patients with delayed HCC detection during regular surveillance. Between January 2010 and December 2020, we analyzed patients with newly diagnosed HCCs who underwent HCC surveillance by ultrasound or computed tomography scan at least twice and were followed up for more than 1 year for hepatitis B, hepatitis C, and chronic liver disease. The mean age of 223 HCC patients was 70 years, of which 152 were male, accounting for 68.1%. Among them, 196 patients (87%) were diagnosed with Barcelona clinic liver cancer stage 0 or A, while 27 (13%) were diagnosed with Barcelona clinic liver cancer stages B and C. When classified according to the TNM criteria, 154 patients (69%) were in stage I, and 69 (31%) were in stage II or higher. Multivariate analysis was performed to identify the risk factors for patients diagnosed with late-stage HCC. The Child-Turcotte-Pugh (CTP) score was identified as a highly significant factor (P = .002, HR 1.547, 95% CI 1.177-2.032), whereas the presence of cirrhosis, body mass index, and sex had no significant effect. We found that in patients with chronic liver disease who were screened regularly, those with higher CTP scores were more likely to be diagnosed with HCC in the late-stages. Therefore, although the presence of cirrhosis is also important for HCC surveillance, careful attention is needed in patients with high CTP scores.
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Affiliation(s)
- Sangmi Jang
- Digestive Disease Center, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, South Korea
| | - Young-Joo Jin
- Digestive Disease Center, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, South Korea
| | - Jin-Woo Lee
- Digestive Disease Center, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, South Korea
| | - Dam Kwon
- Digestive Disease Center, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, South Korea
| | - Jung Hwan Yu
- Digestive Disease Center, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, South Korea
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Kim M, Park D, Kim D, Lee M, Jeon D, Jang S, Kim J, Kim E, Yoon K, Lim S, Lee K, Choi S. Discovery of an allosteric small molecule inhibitor that can potently target SHP2 in vitro and in vivo. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00894-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Kim CH, Choi GH, Na HY, Yoon CJ, Cho JY, Jang S, Kim JH, Jang ES, Kim JW, Jeong SH. Hepatocellular carcinoma with Budd-Chiari syndrome due to membranous obstruction of the inferior vena cava with long-term follow-up: a case report. J Liver Cancer 2022; 22:194-201. [PMID: 37383405 PMCID: PMC10035742 DOI: 10.17998/jlc.2022.08.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/14/2022] [Accepted: 08/29/2022] [Indexed: 06/30/2023]
Abstract
Membranous obstruction of the inferior vena cava (MOVC) is a rare subset of Budd-Chiari syndrome (BCS) with a subacute onset that is often complicated by cirrhosis and hepatocellular carcinoma (HCC). Here we report a case of recurrent HCC in a patient with cirrhosis and BCS that was treated with several episodes of transarterial chemoembolization followed by surgical tumorectomy, whereas the MOVC was successfully treated with balloon angioplasty followed by endovascular stenting. The patient was followed up for 9.9 years without anticoagulation and experienced no stent thrombosis. After the tumorectomy, the patient was HCC-free for 4.4 years of follow-up.
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Affiliation(s)
- Choong Hee Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Gwang Hyeon Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Hee Young Na
- Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Chang Jin Yoon
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jai Young Cho
- Department of General Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Sangmi Jang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Ji Hye Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Eun Sun Jang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jin-Wook Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Sook-Hyang Jeong
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Yoon H, Jeong J, Lee H, Jang S. More than a single effect by a single point mutation: molecular dynamics simulation of NPC1. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322094086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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Choi WJ, Kim GA, Park J, Jang S, Jung WJ, Shim JJ, Park Y, Choi GH, Kim JW, Jeong SH, Jang ES. Incidence and Pattern of Aminotransferase Elevation During Anti-Hypertensive Therapy With Angiotensin-II Receptor Blockers. J Korean Med Sci 2022; 37:e255. [PMID: 35996932 PMCID: PMC9424746 DOI: 10.3346/jkms.2022.37.e255] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/11/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Angiotensin type II receptor blockers (ARBs) are the most widely used anti-hypertensive drugs. This study aimed to elucidate the likelihood and pattern of ARB-induced liver injury in a hospital-based cohort. METHODS Data of patients receiving fimasartan (n = 5,543), candesartan (n = 6,406), valsartan (n = 6,040), and losartan (n = 9,126) were retrieved from the clinical data warehouse of two tertiary hospitals. Patients with alanine aminotransferase (ALT) levels > 5 times the upper normal limit were assessed according to the Roussel Uclaf Causality Assessment Method (RUCAM). RESULTS A total of 27,115 patients were enrolled, including 14,630 (54.0%) men, with a mean age of 64.6 years (standard deviation, 13.6). During 31,717 person-years of ARB therapy, serum ALT levels > 120 IU/L were found in 558 (2.1%) person-years, and levels > 200 IU/L were found in 155 (0.6%) person-years. The incidence of ALT elevation > 120 IU/L per 106 cumulative defined daily doses was 6.6, 3.6, 3.9, and 4.0 in the fimasartan, candesartan, valsartan, and losartan groups, respectively (P = 0.002). An ALT level > 200 IU/L with RUCAM score ≥ 6 was found in 20 patients, suggesting probable drug-induced liver injury for 11 (0.2%) patients receiving fimasartan, five (0.1%) receiving candesartan, four (0.1%) receiving valsartan, and none receiving losartan (P < 0.001). CONCLUSION Approximately 2% of patients receiving ARB therapy had significant ALT elevation (4.24/106 cumulative defined daily doses [cDDDs]), which was associated with probable ARB-related liver injury in 0.07% of patients (0.15/106 cDDDs). Elevation of ALT was more commonly associated with fimasartan than the other ARBs. Clinicians should be aware of the possibility of ARB-related ALT elevation in patients with unexplained chronic abnormal ALT.
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Affiliation(s)
- Won Joon Choi
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Gi-Ae Kim
- Department of Internal Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Jaewon Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sangmi Jang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Woo Jin Jung
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jae-Jun Shim
- Department of Internal Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Yewan Park
- Department of Internal Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Gwang Hyeon Choi
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jin-Wook Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sook-Hyang Jeong
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Eun Sun Jang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
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Park M, Jang S, Chung J, Kim K, Kwon O, Jo S. 702 Inhibition of class I HDACs preserves hair follicle inductivity in postnatal dermal cells. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Jang S, Choi GH, Chang W, Jang ES, Kim JW, Jeong SH. Elevated alpha-fetoprotein in asymptomatic adults: Clinical features, outcome, and association with body composition. PLoS One 2022; 17:e0271407. [PMID: 35862314 PMCID: PMC9302731 DOI: 10.1371/journal.pone.0271407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 06/29/2022] [Indexed: 11/22/2022] Open
Abstract
Background and aim Apparently healthy individuals with elevated serum alpha-fetoprotein (AFP) levels (>7 ng/mL) for unknown causes visit clinics. We investigated their clinical characteristics, outcomes, and relationship with body fat deposition and muscle mass. Methods The case group included asymptomatic 137 individuals with “elevated AFP level” (R772) diagnostic code from 2009 to 2018 in a tertiary hospital. The control group enrolled 274 age- and sex-matched patients with <5 cm hepatic hemangiomas. Hepatic, visceral, and psoas muscle adiposity and psoas muscle index (PMI) were measured in the subgroups of 45 cases and 90 controls with pre-contrast computed tomography (CT) images. Results The case group (mean age 47.5 years, male 35.8%) showed higher AFP levels (10.3 vs 2.5 ng/mL, p<0.001) and total bilirubin (0.8 vs 0.7 mg/dL, p<0.001), but a lower body mass index (22.2 vs 23.3 kg/m2, p = 0.011) and alanine aminotransferase levels (17.0 vs 19.0 IU/L, p = 0.047) than the controls. During 13 months of median follow-up, there was no cancer or liver disease development. The AFP levels were stable. In the subgroups with CT images, cases showed a lower proportion of hepatic steatosis (4.4% vs 18.9%, p = 0.023), higher psoas muscle attenuation (48.2 vs 43.8 Hounsfield units, p<0.001) and higher PMI (5.7 vs 4.2 cm2/m2, p<0.001) than the controls. Conclusion Elevated AFP levels in asymptomatic individuals may play a role in expressing a protective phenotype against hepatic steatosis, myosteatosis, and sarcopenia. AFP levels in patients with elevated AFP were stable during follow-up without liver injury or cancer development. Interaction between AFP expression and steatosis warrants further study.
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Affiliation(s)
- Sangmi Jang
- Department of Internal Medicine Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Gwang Hyeon Choi
- Department of Internal Medicine Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Won Chang
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Eun Sun Jang
- Department of Internal Medicine Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jin-Wook Kim
- Department of Internal Medicine Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Sook-Hyang Jeong
- Department of Internal Medicine Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
- * E-mail:
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Ko Y, Oh K, Kim C, Park G, Kang S, Jang S. W111 Assessment of synergistic effect of various antimicrobial combinations on extensively drug-resistant (XDR) acinetobacter baumannii clinical isolates. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Aurisano N, Huang L, Jang S, Chiu W, Judson R, Jolliet O, Fantke P. Broadening the chemical coverage to derive human toxicity dose-response factors for non-cancer endpoints. Toxicol Lett 2021. [DOI: 10.1016/s0378-4274(21)00799-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Shenderov E, Mallesara G, Wysocki P, Xu W, Ramlau R, Weickhardt A, Zolnierek J, Spira A, Joshua A, Powderly J, Antonarakis E, Jang S, Aragon-Ching J, Shen J, Paller C, Vogelzang N, Leu K, Cortés J, Bohac C, Lugowska I. 620P MGC018, an anti-B7-H3 antibody-drug conjugate (ADC), in patients with advanced solid tumors: Preliminary results of phase I cohort expansion. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1133] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Sekine R, Hirata M, Ikezoe R, Jang S, Kubota Y, Kayano H, Sugata K, Aizawa T, Noguchi D, Kim D, Sugimoto Y, Matsuura R, Yamazaki H, Ichimura M, Yoshikawa M, Kohagura J, Nakashima Y, Ezumi N, Sakamoto M. Measurement of axial phase difference of density fluctuations owing to spontaneously excited waves by using microwave reflectometer on GAMMA 10/PDX. Rev Sci Instrum 2021; 92:053506. [PMID: 34243319 DOI: 10.1063/5.0043821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 04/14/2021] [Indexed: 06/13/2023]
Abstract
In the GAMMA 10/PDX tandem mirror, plasma with strong ion-temperature anisotropy is produced by using the ion cyclotron range of frequency waves. This anisotropy of ion temperature causes several Alfvén-Ion-Cyclotron (AIC) waves to spontaneously excite in the frequency range just below the ion cyclotron frequency. In addition, difference-frequency (DF) waves are excited in the radial inner region of the plasma by wave-wave coupling among the AIC waves. The radial density profiles were measured at multi-axial positions using a frequency-modulation reflectometer with an axial array of microwave antennas, and an axial variation of the density was found to be significant. In addition, a relative phase difference of the DF wave between axially separated two points was first obtained by finely choosing the probing frequency of the reflectometers with a maximum coherence used as a measure, indicating that the DF wave is a propagating wave, while the pump AIC waves are standing waves in the axial region of measurement.
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Affiliation(s)
- R Sekine
- Plasma Research Center, University of Tsukuba, Tsukuba 305-8577, Japan
| | - M Hirata
- Plasma Research Center, University of Tsukuba, Tsukuba 305-8577, Japan
| | - R Ikezoe
- Research Institute for Applied Mechanics, Kyushu University, Kasuga 816-8580, Japan
| | - S Jang
- Plasma Research Center, University of Tsukuba, Tsukuba 305-8577, Japan
| | - Y Kubota
- Plasma Research Center, University of Tsukuba, Tsukuba 305-8577, Japan
| | - H Kayano
- Plasma Research Center, University of Tsukuba, Tsukuba 305-8577, Japan
| | - K Sugata
- Plasma Research Center, University of Tsukuba, Tsukuba 305-8577, Japan
| | - T Aizawa
- Plasma Research Center, University of Tsukuba, Tsukuba 305-8577, Japan
| | - D Noguchi
- Plasma Research Center, University of Tsukuba, Tsukuba 305-8577, Japan
| | - D Kim
- Plasma Research Center, University of Tsukuba, Tsukuba 305-8577, Japan
| | - Y Sugimoto
- Plasma Research Center, University of Tsukuba, Tsukuba 305-8577, Japan
| | - R Matsuura
- Plasma Research Center, University of Tsukuba, Tsukuba 305-8577, Japan
| | - H Yamazaki
- Plasma Research Center, University of Tsukuba, Tsukuba 305-8577, Japan
| | - M Ichimura
- Plasma Research Center, University of Tsukuba, Tsukuba 305-8577, Japan
| | - M Yoshikawa
- Plasma Research Center, University of Tsukuba, Tsukuba 305-8577, Japan
| | - J Kohagura
- Plasma Research Center, University of Tsukuba, Tsukuba 305-8577, Japan
| | - Y Nakashima
- Plasma Research Center, University of Tsukuba, Tsukuba 305-8577, Japan
| | - N Ezumi
- Plasma Research Center, University of Tsukuba, Tsukuba 305-8577, Japan
| | - M Sakamoto
- Plasma Research Center, University of Tsukuba, Tsukuba 305-8577, Japan
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Guenter R, Aweda T, Carmona Matos DM, Jang S, Whitt J, Cheng YQ, Liu XM, Chen H, Lapi SE, Jaskula-Sztul R. Corrigendum to: Overexpression of somatostatin receptor type 2 in neuroendocrine tumors for improved Ga68-DOTATATE imaging and treatment [Surgery. 2020 Jan;167(1):189-196. doi: 10.1016/j.surg.2019.05.092. Epub 2019 Oct 16.PMID: 31629542]. Surgery 2021; 170:351. [PMID: 33875251 PMCID: PMC10166185 DOI: 10.1016/j.surg.2021.03.028] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- R Guenter
- Department of Surgery, University of Alabama at Birmingham School of Medicine, Birmingham, AL
| | - T Aweda
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL
| | - D M Carmona Matos
- Department of Surgery, University of Alabama at Birmingham School of Medicine, Birmingham, AL; San Juan Bautista School of Medicine, Caguas, PR
| | - S Jang
- Department of Surgery, University of Alabama at Birmingham School of Medicine, Birmingham, AL
| | - J Whitt
- Department of Surgery, University of Alabama at Birmingham School of Medicine, Birmingham, AL
| | - Y Q Cheng
- Department of Pharmaceutical Sciences, University of North Texas Health Science Center, Fort Worth, TX
| | - X M Liu
- Department of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, AL
| | - H Chen
- Department of Surgery, University of Alabama at Birmingham School of Medicine, Birmingham, AL
| | - S E Lapi
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL
| | - R Jaskula-Sztul
- Department of Surgery, University of Alabama at Birmingham School of Medicine, Birmingham, AL.
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Jung HS, Jang S, Chung HY, Park SY, Kim HY, Ha YC, Lee YK, Nho JH. Incidence of subsequent osteoporotic fractures after distal radius fractures and mortality of the subsequent distal radius fractures: a retrospective analysis of claims data of the Korea National Health Insurance Service. Osteoporos Int 2021; 32:293-299. [PMID: 32876712 DOI: 10.1007/s00198-020-05609-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 08/25/2020] [Indexed: 10/23/2022]
Abstract
UNLABELLED A better understanding of the features of subsequent fractures after distal radius fracture (DRF) is important for the prevention of further osteoporotic fractures. This study found that the cumulative incidence of subsequent osteoporotic fractures in South Korea increased over time and that the mortality rates of subsequent DRFs were lower than those of first-time DRFs. INTRODUCTION We examined the incidence of osteoporotic fractures following distal radius fractures (DRFs) and the mortality rate after subsequent DRFs using claims data from the Korea National Health Insurance (KNHI) Service. METHODS We identified records for 41,417 patients with first-time DRFs in 2012. The occurrence of osteoporotic fractures of the spine, hip, wrist, and humerus at least 6 months after the index DRF was tracked through 2016. All fractures were identified by specific diagnosis and procedure codes. One-year mortality rates and standardized mortality ratios (SMRs) for initial and subsequent DRFs were calculated for all patients. RESULTS The 4-year cumulative incidence of all subsequent osteoporotic fractures was 14.74% (6105/41,417; 9.47% in men, 15.9% in women). The number of associated subsequent fractures was 2850 for the spine (46.68%), 2271 for the wrist (37.2%), 708 for the hip (11.6%), and 276 for the humerus (4.52%). The cumulative mortality rate 1 year after the first-time and subsequent DRF was 1.47% and 0.71%, respectively, and the overall SMR was 1.48 (95% CI: 1.37-1.61) and 0.71 (95% CI: 0.42-1.21), respectively. CONCLUSION The cumulative incidence of osteoporotic fractures following DRFs increased over the study period and was higher among women. The cumulative mortality rates and SMRs of subsequent DRFs were lower than those of first-time DRFs at the 1-year follow-up. Given the increasing incidence rate of DRFs, the incidence of subsequent osteoporotic fractures may also increase.
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Affiliation(s)
- H-S Jung
- Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - S Jang
- College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, Republic of Korea
| | - H-Y Chung
- Department of Endocrinology and Metabolism, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - S Y Park
- Department of Endocrinology and Metabolism, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - H-Y Kim
- Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea
| | - Y-C Ha
- Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Y-K Lee
- Department of Orthopaedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - J-H Nho
- Department of Orthopaedic Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, 59, Daesagwan-ro, Yongsan-gu, Seoul, 04401, Republic of Korea.
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Perry BI, Upthegrove R, Crawford O, Jang S, Lau E, McGill I, Carver E, Jones PB, Khandaker GM. Cardiometabolic risk prediction algorithms for young people with psychosis: a systematic review and exploratory analysis. Acta Psychiatr Scand 2020; 142:215-232. [PMID: 32654119 DOI: 10.1111/acps.13212] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 07/06/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Cardiometabolic risk prediction algorithms are common in clinical practice. Young people with psychosis are at high risk for developing cardiometabolic disorders. We aimed to examine whether existing cardiometabolic risk prediction algorithms are suitable for young people with psychosis. METHODS We conducted a systematic review and narrative synthesis of studies reporting the development and validation of cardiometabolic risk prediction algorithms for general or psychiatric populations. Furthermore, we used data from 505 participants with or at risk of psychosis at age 18 years in the ALSPAC birth cohort, to explore the performance of three algorithms (QDiabetes, QRISK3 and PRIMROSE) highlighted as potentially suitable. We repeated analyses after artificially increasing participant age to the mean age of the original algorithm studies to examine the impact of age on predictive performance. RESULTS We screened 7820 results, including 110 studies. All algorithms were developed in relatively older participants, and most were at high risk of bias. Three studies (QDiabetes, QRISK3 and PRIMROSE) featured psychiatric predictors. Age was more strongly weighted than other risk factors in each algorithm. In our exploratory analysis, calibration plots for all three algorithms implied a consistent systematic underprediction of cardiometabolic risk in the younger sample. After increasing participant age, calibration plots were markedly improved. CONCLUSION Existing cardiometabolic risk prediction algorithms cannot be recommended for young people with or at risk of psychosis. Existing algorithms may underpredict risk in young people, even in the face of other high-risk features. Recalibration of existing algorithms or a new tailored algorithm for the population is required.
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Affiliation(s)
- B I Perry
- Department of Psychiatry, University of Cambridge, Cambridge, UK.,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - R Upthegrove
- Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - O Crawford
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - S Jang
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - E Lau
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - I McGill
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - E Carver
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - P B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK.,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - G M Khandaker
- Department of Psychiatry, University of Cambridge, Cambridge, UK.,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
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18
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Jang S, Cho G, Choi S, Jung Y, Han J, Kim E. 744 A study of skin-age analysis method using five parameters and skin characteristics of subjects using First Care Activation Serum for long-term period. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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19
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Jang S, Suto Y, Liu J, Liu Q, Zuo Y, Duy PN, Miura T, Abe Y, Hamasaki K, Suzuki K, Kodama S. CORRIGENDUM TO: CAPABILITIES OF THE ARADOS-WG03 REGIONAL NETWORK FOR LARGE-SCALE RADIOLOGICAL AND NUCLEAR EMERGENCY SITUATIONS IN ASIA. Radiat Prot Dosimetry 2020; 188:270. [PMID: 32459335 DOI: 10.1093/rpd/ncaa079] [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] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 01/13/2020] [Accepted: 02/19/2020] [Indexed: 06/11/2023]
Affiliation(s)
- S Jang
- Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, South Korea
| | - Y Suto
- National Institute of Radiological Sciences (NIRS), National Institute for Quantum and Radiological Science and Technology (QST), Chiba, Japan
| | - J Liu
- National Institute of Radiation Protection (NIRP), China CDC, Beijing, China
| | - Q Liu
- National Institute of Radiation Protection (NIRP), China CDC, Beijing, China
| | - Y Zuo
- China Institute of Radiation Protection (CIRP), China National Nuclear Corporation (CNNC), Taiyuen, China
| | - P N Duy
- Nuclear Research Institute (NRI), Viet Nam Atomic Energy Commission, VINATOM, Dalat, Viet Nam
| | - T Miura
- Hirosaki University, Hirosaki, Japan
| | - Y Abe
- Fukushima Medical University, Fukushima, Japan
| | - K Hamasaki
- Radiation Effects Research Foundation (RERF), Hiroshima, Japan
| | - K Suzuki
- agasaki University, Nagasaki, Japan
| | - S Kodama
- Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, South Korea
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20
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Jang S, Suto Y, Liu J, Liu Q, Zuo Y, Duy PN, Miura T, Abe Y, Hamasaki K, Suzuki K, Kodama S. CAPABILITIES OF THE ARADOS-WG03 REGIONAL NETWORK FOR LARGE-SCALE RADIOLOGICAL AND NUCLEAR EMERGENCY SITUATIONS IN ASIA. Radiat Prot Dosimetry 2019; 186:139-142. [PMID: 30576530 DOI: 10.1093/rpd/ncy279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 11/27/2018] [Accepted: 12/02/2018] [Indexed: 06/09/2023]
Abstract
In 2015, the Asian Radiation Dosimetry Group established a regional network of biological dosimetry laboratories known as the ARADOS-WG03 (Working Group 03; Biological Dosimetry). A survey was conducted in 2017 to evaluate the capabilities and capacities of the participating laboratories for emergency preparedness and responses in large-scale nuclear and/or radiological incidents. The results of this survey were identified and assessed. The data provide important information on the current state of emergency cytogenetic biological dosimetry capabilities in the Asian region.
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Affiliation(s)
- S Jang
- Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, South Korea
| | - Y Suto
- National Institute of Radiological Sciences (NIRS), National Institute for Quantum and Radiological Science and Technology (QST), Chiba, Japan
| | - J Liu
- National Institute of Radiation Protection (NIRP), China CDC, Beijing, China
| | - Q Liu
- National Institute of Radiation Protection (NIRP), China CDC, Beijing, China
| | - Y Zuo
- China Institute of Radiation Protection (CIRP), China National Nuclear Corporation (CNNC), Taiyuen, China
| | - P N Duy
- Nuclear Research Institute (NRI), Viet Nam Atomic Energy Commission, VINATOM, Dalat, Viet Nam
| | - T Miura
- Hirosaki University, Hirosaki, Japan
| | - Y Abe
- Fukushima Medical University, Fukushima, Japan
| | - K Hamasaki
- Radiation Effects Research Foundation (RERF), Hiroshima, Japan
| | - K Suzuki
- Nagasaki University, Nagasaki, Japan
| | - S Kodama
- Osaka Prefacture University, Osaka, Japan
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21
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Tawbi H, Forsyth P, Hodi F, Lao C, Moschos S, Hamid O, Atkins M, Lewis K, Thomas R, Glaspy J, Jang S, Algazi A, Khushalani N, Postow M, Pavlick A, Ernstoff M, Reardon D, Balogh A, Rizzo J, Margolin K. Efficacité et tolérance de l’association du nivolumab (NIVO) et de l’ipilimumab (IPI) chez des patients atteints d’un mélanome et présentant des métastases cérébrales symptomatiques. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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22
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Backhaus I, Kawachi I, Ramirez A, Jang S, Khoo S, Al-Shamli A, Po-Hsiu L, Begotaraj E, Fischer F, Torre GL. Social capital and students’ health: results of the splash study. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Universities around the world are challenged with rising rates of mental health problems among their students. Cumulative evidence demonstrated that aspects of the social environment, including social capital, play an important role in mental health. This study aimed to determine the prevalence of depressive symptoms among university students from across the globe and to investigate whether social capital was associated with depressive symptoms in university students.
Methods
A cross-sectional study was conducted in Albania, Brazil, Germany, Italy, Malaysia Oman, South Korea, Switzerland, Taiwan and the USA in 2018/2019. Data were obtained through self-administered questionnaire, including questions on sociodemographic characteristics and depressive symptoms. The BDI-S was used to assess the presence of depressive symptoms. Multilevel analyses were conducted to assess the relationship between social capital and depressive, adjusting for individual covariates (e.g. perceived stress and health behaviours) and country-level characteristics (e.g. democracy type).
Results
A total 3894 students participated. Out of all participants almost 47% presented clinically relevant depressive symptoms. The prevalence of depressive symptoms was highest among students identifying as other than male or female (48.7%), among students with low socioeconomic status (59.5%) and among students with low levels of cognitive (65.3%) and behavioural social capital (57.0%). Even after adjustment in multilevel logistic regression analyses, depressive symptoms remained significantly associated with low levels of cognitive social capital (OR = 1.49, 95% CI: 1.06 to 2.10) and low level of behavioural social capital (OR = 1.36, 95% CI: 1.08 to 1.71).
Conclusions
Social capital may play an important role in mental health problems in the university setting. The study identified significant opportunities for future research and health promotion strategies among students.
Key messages
Key factors associated with depressive symptoms among university students were low levels of behavioural and cognitive social capital. Health promotion programs targeting young persons with depressive symptoms should include effective components of social epidemiology such as social capital.
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Affiliation(s)
- I Backhaus
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, USA
| | - I Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, USA
| | - A Ramirez
- Center for Epidemiology Research, Federal University of Pelotas, Pelotas, Brazil
| | - S Jang
- Red Cross College of Nursing, Chung-Ang University, Seoul, South Korea
| | - S Khoo
- Sports Centre, University of Malaya, Kuala Lumpur, Malaysia
| | - A Al-Shamli
- Physical Education Department, Sohar University, Sohar, Oman
| | - L Po-Hsiu
- Graduate Institute of Sports,Leisure,Hostipality Management, National Taiwan Normal University, Taipei, Taiwan
| | - E Begotaraj
- Department of Clinical Psychology, Sapienza University, Rome, Italy
| | - F Fischer
- Faculty of Health Sciences, Bielefeld University, Bielefeld, Germany
| | - G La Torre
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
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23
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Jang SH, Lim JS, Jang S, Lee M, Chi SG. XAF1 assembles a destructive complex to induce BRCA1-mediated apoptosis via suppressing ERa and switching estrogen function. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz238.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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24
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Ishida K, Ohara N, Ercan A, Jang S, Trinh T, Kavvas ML, Carr K, Anderson ML. Impacts of climate change on snow accumulation and melting processes over mountainous regions in Northern California during the 21st century. Sci Total Environ 2019; 685:104-115. [PMID: 31174110 DOI: 10.1016/j.scitotenv.2019.05.255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 05/16/2019] [Accepted: 05/17/2019] [Indexed: 06/09/2023]
Abstract
A point-location-based analysis of future climate change impacts on snow accumulation and melting processes was conducted over three study watersheds in Northern California during a 90-year future period by means of snow regime projections. The snow regime projections were obtained by means of a physically-based snow model with dynamically downscaled future climate projections. Then, atmospheric and snow-related variables, and their interrelations during the 21st century were investigated to reveal future climate change impacts on snow accumulation and melting processes. The analysis shows large reductions in snow water equivalent (SWE), snowfall to precipitation (S/P) ratio, and snowmelt through the 21st century. Timing of the peak of the SWE and snowmelt will also change in the future. Meanwhile, the analysis in this study shows that air temperature rise will affect, but will not dominate the future change in snowmelt over the study watersheds. This result implies the importance of considering atmospheric variables other than air temperature, such as precipitation, shortwave radiation, relative humidity, and wind speed even if these variables will not clearly change during the 21st century.
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Affiliation(s)
- K Ishida
- Faculty of Advanced Science and Technology, Kumamoto University, 2-39-1 Kurokami, Kumamoto 860-8555, Japan.
| | - N Ohara
- Civil and Architectural Engineering, University of Wyoming, Laramie, WY 82071, USA.
| | - A Ercan
- J.Amorocho Hydraulics Laboratory, Department of Civil and Environmental Engineering, University of California, Davis, One Shields Avenue, Davis, CA 95616, USA.
| | - S Jang
- Korea Institute of Water and Environment, Korea Water Resources Corporation, Daejeon 305-730, South Korea.
| | - T Trinh
- Hydrologic Research Laboratory, Department of Civil and Environmental Engineering, University of California, Davis, One Shields Avenue, Davis, CA 95616, USA.
| | - M L Kavvas
- J.Amorocho Hydraulics Laboratory, Department of Civil and Environmental Engineering, University of California, Davis, One Shields Avenue, Davis, CA 95616, USA; Hydrologic Research Laboratory, Department of Civil and Environmental Engineering, University of California, Davis, One Shields Avenue, Davis, CA 95616, USA.
| | - K Carr
- J.Amorocho Hydraulics Laboratory, Department of Civil and Environmental Engineering, University of California, Davis, One Shields Avenue, Davis, CA 95616, USA.
| | - M L Anderson
- California Department of Water Resources, Division of Flood Management, 3310 El Camino Ave Rm 200, Sacramento, CA 95821, USA.
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25
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Jang S, Lee KW, Magdalene T, Ahn J, Lee MG, Chi SG. XAF1 and ZNF313 complex stimulates ER stress-induced apoptosis via direct GRP78 inhibition. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz238.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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26
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Kim E, Jeon H, Choi S, Kim S, Lee J, Choi H, Keum B, Chun H, Lee H, Kim C, Jang S. Endoscopic submucosal dissection using an detachable robotic assitive device in a live porcine model. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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27
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Kim B, Jang S, Lee YJ, Park N, Cho YU, Park CJ. The rivaroxaban-adjusted normalized ratio: use of the prothrombin time to monitor the therapeutic effect of rivaroxaban. Br J Biomed Sci 2019; 76:122-128. [DOI: 10.1080/09674845.2019.1605648] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- B Kim
- Department of Laboratory Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea (South Korea)
| | - S Jang
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea (South Korea)
- Asan Clinical Research Center, Seoul, Republic of Korea (South Korea)
| | - YJ Lee
- Asan Clinical Research Center, Seoul, Republic of Korea (South Korea)
| | - N Park
- Asan Clinical Research Center, Seoul, Republic of Korea (South Korea)
| | - YU Cho
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea (South Korea)
| | - CJ Park
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea (South Korea)
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28
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Kulka U, Wojcik A, Di Giorgio M, Wilkins R, Suto Y, Jang S, Quing-Jie L, Jiaxiang L, Ainsbury E, Woda C, Roy L, Li C, Lloyd D, Carr Z. BIODOSIMETRY AND BIODOSIMETRY NETWORKS FOR MANAGING RADIATION EMERGENCY. Radiat Prot Dosimetry 2018; 182:128-138. [PMID: 30423161 DOI: 10.1093/rpd/ncy137] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Indexed: 06/09/2023]
Abstract
Biological dosimetry enables individual dose reconstruction in the case of unclear or inconsistent radiation exposure situations, especially when a direct measurement of ionizing radiation is not or is no longer possible. To be prepared for large-scale radiological incidents, networking between well-trained laboratories has been identified as a useful approach for provision of the fast and trustworthy dose assessments needed in such circumstances. To this end, various biodosimetry laboratories worldwide have joined forces and set up regional and/or nationwide networks either on a formal or informal basis. Many of these laboratories are also a part of global networks such as those organized by World Health Organization, International Atomic Energy Agency or Global Health Security Initiative. In the present report, biodosimetry networks from different parts of the world are presented, and the partners, activities and cooperation actions are detailed. Moreover, guidance for situational application of tools used for individual dosimetry is given.
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Affiliation(s)
- U Kulka
- Bundesamt für Strahlenschutz, Salzgitter, Germany
| | - A Wojcik
- Stockholm University, Centre for Radiation Protection Research, Stockholm, Sweden
| | - M Di Giorgio
- Autoridad Regulatoria Nuclear, C1429BNP CABA, Buenos Aires, Argentina
| | - R Wilkins
- Health Canada, Radiation Protection Bureau, Ottawa, Canada
| | - Y Suto
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - S Jang
- Korea Institute of Radiological & Medical Sciences, Seoul, Korea
| | - L Quing-Jie
- National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, Beijing, China
| | - L Jiaxiang
- National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, Beijing, China
| | - E Ainsbury
- Public Health England, Centre for Radiation Chemical and Environmental Hazards, Chilton, UK
| | - C Woda
- HelmholtzZentrum München, Institute of Radiation Protection, Oberschleissheim, Germany
| | - L Roy
- Institut de Radioprotection et de Surete Nucleaire, Fontenay-aux-Roses, France
| | - C Li
- Health Canada, Radiation Protection Bureau, Ottawa, Canada
| | - D Lloyd
- Public Health England, Centre for Radiation Chemical and Environmental Hazards, Chilton, UK
| | - Z Carr
- World Health Organization, Department of Public Health, Environmental and Social Determinants of Health, Geneva-27, Switzerland
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29
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Hwang M, Jang S, Lalonde R, Heron D, Huq S. Normal Brain Dose and Treatment Efficiency of Coplanar-Only IMRT/VMAT plans for Glioblastoma Multiforme using a Novel Ring Gantry Linac Delivery System. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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30
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Schub M, Dohopolski M, Horne Z, Burton S, Christie N, Jang S, Heron D. Lung Stereotactic Body Radiation Therapy: Is There a Difference in Outcome Based on Respiratory Gating? Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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31
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Jang S, Rosenberg S, Hullett C, Bradley K, Kimple R. Beyond Charting Outcomes in the Radiation Oncology Match: Analysis of Self-reported Applicant Data. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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32
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Lee J, Jang S, Cho S. THE LONG-TERM EFFECT OF DEPRESSIVE SYMPTOMS ON ALL-CAUSE MORTALITY IN THE ELDERLY. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1905] [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: 11/13/2022] Open
Affiliation(s)
- J Lee
- Graduate School of Public Administration, Seoul National University
| | - S Jang
- Red Cross College of Nursing, Chung-Ang Univerisity
| | - S Cho
- Graduate School of Public Health, Seoul National University
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33
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Kim R, Cordero-Gallardo F, Burnett O, McNamaro M, Weber T, Zarzour J, Bae S, Jang S, Barrett O, McDonald A. Incidence of Mesorectal Node Metastasis in Locally Advanced Cervical Cancer: Its Therapeutic Implications. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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34
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Jethwa K, Jang S, Olivier K, Park S, Merrell K, Martenson J, Neben-Wittich M, Roberts K, Arnett A, Hubbard J, Whitaker T, Harmsen W, Waltman L, Kipp B, Grothey A, Haddock M, Hallemeier C. Metastasis-Directed Stereotactic Body Radiation Therapy for Oligometastatic Colorectal Cancer: A Single Institution Experience. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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35
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Teo P, Li F, Rhoades D, Shen Z, Jang S, Lalonde R, Heron D, Huq S, Ling D. Dosimetric Performance of a New Ring-Gantry Linear Accelerator for IMRT and VMAT Prostate Plans. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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36
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Jang S, Teo P, Heron D, Huq M. Could the Jawless Flattening-Filter-Free Double-Mlc Layer Machine Reduce Low-Dose Regions Compared to Conventional Linear Accelerator for Large-Field Pelvic and Abdominal IMRT/VMAT Cases? Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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37
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Ribas A, Mehmi I, Medina T, Lao C, Kummar S, Amin A, Deva S, Salama A, Tueting T, Milhem M, Hoimes C, Daniels G, Shaheen M, Jang S, Barve M, Powell A, Chandra S, Schmidt E, Janssen R, Long G. Phase Ib/II study of the combination of SD-101 and pembrolizumab in patients with advanced melanoma who had progressive disease on or after prior anti-PD-1 therapy. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy289.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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38
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Freeman M, Gupte-Singh K, You M, Le T, Ritchings C, Rao S, Jang S. Assessment of real-world effectiveness of first-line (1L) nivolumab (NIVO) plus ipilimumab (IPI) or NIVO monotherapy for advanced melanoma: A retrospective cohort study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy289.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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39
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Jang S, Jeen Y, Choi S, Lee J, Kim S, Lee J, Choi H, Kim E, Keum B, Lee H, Chun H, Kim C. Comparing efficacy of 1-L Peg-Asc with prucalopride versus 2-L Peg-Asc for bowel preparation. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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40
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Jang S, Jo A, Kook K. Isolation of adipose stromal vascular fraction and adipose derived stem cells from defferent donor age, sites and sex using 5 year data. Cytotherapy 2018. [DOI: 10.1016/j.jcyt.2018.02.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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41
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Jang S, Kim S, Han J, Kim J, Kim E. 470 A study of skin characteristics according to humidity during sleep. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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42
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Sarvepalli S, Garg SK, Sarvepalli SS, Parikh MP, Wadhwa V, Jang S, Thota PN, Sanaka MR. Inpatient burden of esophageal cancer and analysis of factors affecting in-hospital mortality and length of stay. Dis Esophagus 2018; 31:4956135. [PMID: 29617798 PMCID: PMC7055505 DOI: 10.1093/dote/doy022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 02/16/2018] [Indexed: 12/11/2022]
Abstract
Esophageal cancer (EC) continues to be a major source of morbidity and mortality in the United States. However, there has been a relative dearth of research into hospital utilization in patients with EC. This study examines temporal trends in hospital admissions, length of stay (LOS), mortality, and costs associated with EC. In addition, we also analyzed factors associated with inpatient mortality and LOS. We interrogated National Inpatient Sample (NIS), a large registry of inpatient data, to retrieve information about various demographic and factors associated with hospital stay in patients who were admitted for EC between the years 1998 and 2013 in the United States. After examining trends over time, multivariate analysis was performed to identify factors associated with LOS and mortality. During 1998-2013, 538,776 hospital stays with principal diagnosis of EC were reviewed. Number of hospital stays and inpatient charges increased by 397 per year (±67.8; P < 0.0001) and $3,033 per patient per year (±135; <0.0001) respectively. Mortality and LOS decreased by 0.23% per year (±0.03; P < 0.0001) and 0.07 days per year (±0.006; P < 0.0001) respectively. Multiple factors associated with LOS and mortality were outlined. Despite overall increase in hospital utilization with respect to number of admissions and inpatient charges, inpatient mortality and LOS associated with EC declined. Factors associated with inpatient mortality and LOS may help drive clinical decision-making and influence healthcare or hospital policy.
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Affiliation(s)
- S Sarvepalli
- Department of Hospital Medicine, Medicine Institute,Address correspondence to: Shashank Sarvepalli, Department of Hospital Medicine, M75 9500 Euclid Ave, Cleveland, OH 44195, USA.
| | - S K Garg
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - S S Sarvepalli
- College of Liberal Arts and Science, Wayne State University, Detroit, Michigan
| | - M P Parikh
- Department of Hospital Medicine, Medicine Institute
| | - V Wadhwa
- Department of Gastroenterology and Hepatology, Digestive Diseases and Surgery Institute, Cleveland Clinic, Weston, Florida, USA
| | - S Jang
- Department of Gastroenterology and Hepatology, Digestive Diseases and Surgery Institute, Cleveland Clinic, Cleveland, Ohio
| | - P N Thota
- Department of Gastroenterology and Hepatology, Digestive Diseases and Surgery Institute, Cleveland Clinic, Cleveland, Ohio
| | - M R Sanaka
- Department of Gastroenterology and Hepatology, Digestive Diseases and Surgery Institute, Cleveland Clinic, Cleveland, Ohio
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43
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Cho YU, You E, Jang S, Park CJ. Validation of reflex testing rules and establishment of a new workflow for body fluid cell analysis using a Sysmex XN-550 automatic hematology analyzer. Int J Lab Hematol 2018; 40:258-267. [DOI: 10.1111/ijlh.12774] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 10/17/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Y.-U. Cho
- Department of Laboratory Medicine; University of Ulsan College of Medicine and Asan Medical Center; Seoul Korea
| | - E. You
- Department of Laboratory Medicine; University of Ulsan College of Medicine and Asan Medical Center; Seoul Korea
| | - S. Jang
- Department of Laboratory Medicine; University of Ulsan College of Medicine and Asan Medical Center; Seoul Korea
| | - C.-J. Park
- Department of Laboratory Medicine; University of Ulsan College of Medicine and Asan Medical Center; Seoul Korea
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44
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Tsai FC, Ghorbani S, Greenwald BD, Jang S, Dumot JA, McKinley MJ, Shaheen NJ, Habr F, Wolfsen HC, Abrams JA, Lightdale CJ, Nishioka NS, Johnston MH, Zfass A, Coyle WJ. Safety and efficacy of endoscopic spray cryotherapy for esophageal cancer. Dis Esophagus 2017; 30:1-7. [PMID: 28881903 DOI: 10.1093/dote/dox087] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Accepted: 06/03/2017] [Indexed: 12/11/2022]
Abstract
Although surgery is traditionally the standard of care for esophageal cancer, esophagectomy carries significant morbidity. Alternative endoscopic therapies are needed for patients who are not candidates for conventional treatment. The objective of this study is to assess the safety, efficacy, and tolerability of spray cryotherapy of esophageal adenocarcinoma. This study includes patients with esophageal adenocarcinoma who had failed or were not candidates for conventional therapy enrolled retrospectively and prospectively in an open-label registry and patients in a retrospective cohort from 11 academic and community practices. Endoscopic spray cryotherapy was performed until biopsy proven local tumor eradication or until treatment was halted due to progression of disease, patient withdrawal or comorbidities. Eighty-eight patients with esophageal adenocarcinoma (median age 76, 80.7% male, mean length 5.1 cm) underwent 359 treatments (mean 4.4 per patient). Tumor stages included 39 with T1a, 25 with T1b, 9 with unspecified T1, and 15 with T2. Eighty-six patients completed treatment with complete response of intraluminal disease in 55.8%, including complete response in 76.3% for T1a, 45.8% for T1b, 66.2% for all T1, and 6.7% for T2. Mean follow-up was 18.4 months. There were no deaths or perforations related to spray cryotherapy. Strictures developed in 12 of 88 patients (13.6%) but were present before spray cryotherapy in 3 of 12. This study suggests that endoscopic spray cryotherapy is a safe, well-tolerated, and effective treatment option for early esophageal adenocarcinoma.
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Affiliation(s)
- F C Tsai
- Scripps Clinic, La Jolla, California
| | | | - B D Greenwald
- University of Maryland School of Medicine and Greenebaum Cancer Center, Baltimore, Maryland
| | - S Jang
- Cleveland Clinic, Cleveland, Ohio
| | | | - M J McKinley
- North Shore LIJ Health System and ProHEALTHcare Associates, Syosset & Lake Success, New York
| | - N J Shaheen
- University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - F Habr
- Alpert School of Medicine of Brown University, Providence, Rhode Island
| | - H C Wolfsen
- Mayo Clinic Jacksonville, Jacksonville, Florida
| | - J A Abrams
- Columbia University Medical Center, New York, New York
| | - C J Lightdale
- Columbia University Medical Center, New York, New York
| | - N S Nishioka
- Massachusetts General Hospital, Boston, Massachusetts
| | - M H Johnston
- Lancaster Gastroenterology, Inc., Lancaster, Pennsylvania
| | - A Zfass
- Virginia Commonwealth University, Richmond, Virginia, USA
| | - W J Coyle
- Scripps Clinic, La Jolla, California
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45
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Choi J, Kim E, Jang S, Lee H. 062 The body skin texture changes with age in Korean women. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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46
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Cordero F, Burnett O, McNamara M, Weber T, Zarzour J, Jang S, Barrett O, Kim R. Incidence of Mesorectal Nodal Metastasis in Vaginal and Cervical Cancer: Its Clinical Implication. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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47
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Balagamwala E, Berriochoa C, Leyrer C, Reddy C, Stephans K, Raja S, Raymond D, Murthy S, Bhatt A, Jang S, Sanaka M, Videtic G. T1N0 Esophageal Cancer: A Patterns of Care and Survival Analysis. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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48
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49
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Affiliation(s)
- J. Lee
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea (the Republic of),
| | - S. Jang
- Red Cross College of Nursing, Chung-Ang University, Seoul, Korea (the Republic of)
| | - S. Cho
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea (the Republic of),
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50
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Jang S, Jo A, Yoon W, Kook K. Stromal vascular fraction and adipose derived stem cells from chronic disease and obese patients can affect stem cell therapy. Cytotherapy 2017. [DOI: 10.1016/j.jcyt.2017.02.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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