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Shao RT, Gong EY, Han SS, Chen SM, Yang T, Yang WZ, Wang C. [Proactively embracing the challenges of multimorbidity]. Zhonghua Yi Xue Za Zhi 2024; 104:9-15. [PMID: 38599646 DOI: 10.3760/cma.j.cn12137-20240107-00047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
With rapid socio-economic development and the acceleration of population aging, the average life span of human beings has increased significantly. Individuals suffering from the co-existence of multiple diseases (multimorbidity) have become a new normal in public health and posed severe challenge to human health. Multimorbidity significantly reduces the quality of life, increases disability and mortality risks, complicates disease treatment and care and increases burden of the healthcare system with higher costs. This commentary discusses the definition of multimorbidity and common public misconceptions, then assesses its profound impact on overall public health, socio-economic development and healthcare system. We also proposes the potential strategies to meet the challenges posed by multimorbidity. The main aim is to raise awareness of multimorbidity, advocate proactive responses to improve public health and build a healthy society through the development of prevention and treatment systems and promote precision prevention and treatment for multimorbidity.
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Affiliation(s)
- R T Shao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China State Key Laboratory of Respiratory Health and Multimorbidity, Beijing 100730, China
| | - E Y Gong
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China State Key Laboratory of Respiratory Health and Multimorbidity, Beijing 100730, China
| | - S S Han
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China State Key Laboratory of Respiratory Health and Multimorbidity, Beijing 100730, China Key Laboratory of Pathogen Infection Prevention and Control, Ministry of Education, Peking Union Medical College, Beijing 100730, China
| | - S M Chen
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg 69120, Germany
| | - T Yang
- State Key Laboratory of Respiratory Health and Multimorbidity, Beijing 100730, China Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, China
| | - W Z Yang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - C Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China State Key Laboratory of Respiratory Health and Multimorbidity, Beijing 100730, China Key Laboratory of Pathogen Infection Prevention and Control, Ministry of Education, Peking Union Medical College, Beijing 100730, China Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
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Kim D, Choi HS, Lee D, Kim M, Kim Y, Han SS, Heo Y, Park JH, Park J. A Deep Learning-Based Approach for Prediction of Vancomycin Treatment Monitoring: Retrospective Study Among Patients With Critical Illness. JMIR Form Res 2024; 8:e45202. [PMID: 38152042 PMCID: PMC10960205 DOI: 10.2196/45202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/28/2023] [Accepted: 12/27/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND Vancomycin pharmacokinetics are highly variable in patients with critical illnesses, and clinicians commonly use population pharmacokinetic (PPK) models based on a Bayesian approach to dose. However, these models are population-dependent, may only sometimes meet the needs of individual patients, and are only used by experienced clinicians as a reference for making treatment decisions. To assist real-world clinicians, we developed a deep learning-based decision-making system that predicts vancomycin therapeutic drug monitoring (TDM) levels in patients in intensive care unit. OBJECTIVE This study aimed to establish joint multilayer perceptron (JointMLP), a new deep-learning model for predicting vancomycin TDM levels, and compare its performance with the PPK models, extreme gradient boosting (XGBoost), and TabNet. METHODS We used a 977-case data set split into training and testing groups in a 9:1 ratio. We performed external validation of the model using 1429 cases from Kangwon National University Hospital and 2394 cases from the Medical Information Mart for Intensive Care-IV (MIMIC-IV). In addition, we performed 10-fold cross-validation on the internal training data set and calculated the 95% CIs using the metric. Finally, we evaluated the generalization ability of the JointMLP model using the MIMIC-IV data set. RESULTS Our JointMLP model outperformed other models in predicting vancomycin TDM levels in internal and external data sets. Compared to PPK, the JointMLP model improved predictive power by up to 31% (mean absolute error [MAE] 6.68 vs 5.11) on the internal data set and 81% (MAE 11.87 vs 6.56) on the external data set. In addition, the JointMLP model significantly outperforms XGBoost and TabNet, with a 13% (MAE 5.75 vs 5.11) and 14% (MAE 5.85 vs 5.11) improvement in predictive accuracy on the inner data set, respectively. On both the internal and external data sets, our JointMLP model performed well compared to XGBoost and TabNet, achieving prediction accuracy improvements of 34% and 14%, respectively. Additionally, our JointMLP model showed higher robustness to outlier data than the other models, as evidenced by its higher root mean squared error performance across all data sets. The mean errors and variances of the JointMLP model were close to zero and smaller than those of the PPK model in internal and external data sets. CONCLUSIONS Our JointMLP approach can help optimize treatment outcomes in patients with critical illnesses in an intensive care unit setting, reducing side effects associated with suboptimal vancomycin administration. These include increased risk of bacterial resistance, extended hospital stays, and increased health care costs. In addition, the superior performance of our model compared to existing models highlights its potential to help real-world clinicians.
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Affiliation(s)
- Dohyun Kim
- Department of Research and Development, ZIOVISION Co, Ltd, Chuncheon, Republic of Korea
| | - Hyun-Soo Choi
- Department of Research and Development, ZIOVISION Co, Ltd, Chuncheon, Republic of Korea
- Department of Computer Science and Engineering, Seoul National University of Science and Technology, Seoul, Republic of Korea
| | - DongHoon Lee
- Department of Research and Development, ZIOVISION Co, Ltd, Chuncheon, Republic of Korea
| | - Minkyu Kim
- Department of Research and Development, ZIOVISION Co, Ltd, Chuncheon, Republic of Korea
| | - Yoon Kim
- Department of Research and Development, ZIOVISION Co, Ltd, Chuncheon, Republic of Korea
- Department of Computer Science and Engineering, Kangwon National University, Chuncheon, Republic of Korea
| | - Seon-Sook Han
- Department of Internal Medicine, Kangwon National University, Chuncheon, Republic of Korea
| | - Yeonjeong Heo
- Department of Internal Medicine, Kangwon National University, Chuncheon, Republic of Korea
| | - Ju-Hee Park
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Jinkyeong Park
- Department of Pulmonary, Allergy and Critical Care Medicine, School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
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Park SW, Yeo NY, Kang S, Ha T, Kim TH, Lee D, Kim D, Choi S, Kim M, Lee D, Kim D, Kim WJ, Lee SJ, Heo YJ, Moon DH, Han SS, Kim Y, Choi HS, Oh DK, Lee SY, Park M, Lim CM, Heo J. Early Prediction of Mortality for Septic Patients Visiting Emergency Room Based on Explainable Machine Learning: A Real-World Multicenter Study. J Korean Med Sci 2024; 39:e53. [PMID: 38317451 PMCID: PMC10843974 DOI: 10.3346/jkms.2024.39.e53] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 12/05/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Worldwide, sepsis is the leading cause of death in hospitals. If mortality rates in patients with sepsis can be predicted early, medical resources can be allocated efficiently. We constructed machine learning (ML) models to predict the mortality of patients with sepsis in a hospital emergency department. METHODS This study prospectively collected nationwide data from an ongoing multicenter cohort of patients with sepsis identified in the emergency department. Patients were enrolled from 19 hospitals between September 2019 and December 2020. For acquired data from 3,657 survivors and 1,455 deaths, six ML models (logistic regression, support vector machine, random forest, extreme gradient boosting [XGBoost], light gradient boosting machine, and categorical boosting [CatBoost]) were constructed using fivefold cross-validation to predict mortality. Through these models, 44 clinical variables measured on the day of admission were compared with six sequential organ failure assessment (SOFA) components (PaO2/FIO2 [PF], platelets (PLT), bilirubin, cardiovascular, Glasgow Coma Scale score, and creatinine). The confidence interval (CI) was obtained by performing 10,000 repeated measurements via random sampling of the test dataset. All results were explained and interpreted using Shapley's additive explanations (SHAP). RESULTS Of the 5,112 participants, CatBoost exhibited the highest area under the curve (AUC) of 0.800 (95% CI, 0.756-0.840) using clinical variables. Using the SOFA components for the same patient, XGBoost exhibited the highest AUC of 0.678 (95% CI, 0.626-0.730). As interpreted by SHAP, albumin, lactate, blood urea nitrogen, and international normalization ratio were determined to significantly affect the results. Additionally, PF and PLTs in the SOFA component significantly influenced the prediction results. CONCLUSION Newly established ML-based models achieved good prediction of mortality in patients with sepsis. Using several clinical variables acquired at the baseline can provide more accurate results for early predictions than using SOFA components. Additionally, the impact of each variable was identified.
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Affiliation(s)
- Sang Won Park
- Department of Medical Informatics, School of Medicine, Kangwon National University, Chuncheon, Korea
- Institute of Medical Science, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - Na Young Yeo
- Department of Medical Bigdata Convergence, Kangwon National University, Chuncheon, Korea
| | - Seonguk Kang
- Department of Convergence Security, Kangwon National University, Chuncheon, Korea
| | - Taejun Ha
- Department of Biomedical Research Institute, Kangwon National University Hospital, Chuncheon, Korea
| | - Tae-Hoon Kim
- University-Industry Cooperation Foundation, Kangwon National University, Chuncheon, Korea
| | - DooHee Lee
- Department of Research and Development, ZIOVISION Co. Ltd., Chuncheon, Korea
| | - Dowon Kim
- Department of Research and Development, ZIOVISION Co. Ltd., Chuncheon, Korea
| | - Seheon Choi
- Department of Research and Development, ZIOVISION Co. Ltd., Chuncheon, Korea
| | - Minkyu Kim
- Department of Research and Development, ZIOVISION Co. Ltd., Chuncheon, Korea
| | - DongHoon Lee
- Department of Research and Development, ZIOVISION Co. Ltd., Chuncheon, Korea
| | - DoHyeon Kim
- Department of Research and Development, ZIOVISION Co. Ltd., Chuncheon, Korea
| | - Woo Jin Kim
- Department of Medical Informatics, School of Medicine, Kangwon National University, Chuncheon, Korea
- Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, Korea
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - Seung-Joon Lee
- Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, Korea
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - Yeon-Jeong Heo
- Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, Korea
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - Da Hye Moon
- Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, Korea
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - Seon-Sook Han
- Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, Korea
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - Yoon Kim
- University-Industry Cooperation Foundation, Kangwon National University, Chuncheon, Korea
- Department of Computer Science and Engineering, Kangwon National University, Chuncheon, Korea
| | - Hyun-Soo Choi
- University-Industry Cooperation Foundation, Kangwon National University, Chuncheon, Korea
- Department of Computer Science and Engineering, Seoul National University of Science and Technology, Seoul, Korea
| | - Dong Kyu Oh
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Su Yeon Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - MiHyeon Park
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chae-Man Lim
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jeongwon Heo
- Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, Korea
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea.
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Kim M, Kim TH, Kim D, Lee D, Kim D, Heo J, Kang S, Ha T, Kim J, Moon DH, Heo Y, Kim WJ, Lee SJ, Kim Y, Park SW, Han SS, Choi HS. In-Advance Prediction of Pressure Ulcers via Deep-Learning-Based Robust Missing Value Imputation on Real-Time Intensive Care Variables. J Clin Med 2023; 13:36. [PMID: 38202043 PMCID: PMC10780209 DOI: 10.3390/jcm13010036] [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: 11/07/2023] [Revised: 12/06/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024] Open
Abstract
Pressure ulcers (PUs) are a prevalent skin disease affecting patients with impaired mobility and in high-risk groups. These ulcers increase patients' suffering, medical expenses, and burden on medical staff. This study introduces a clinical decision support system and verifies it for predicting real-time PU occurrences within the intensive care unit (ICU) by using MIMIC-IV and in-house ICU data. We develop various machine learning (ML) and deep learning (DL) models for predicting PU occurrences in real time using the MIMIC-IV and validate using the MIMIC-IV and Kangwon National University Hospital (KNUH) dataset. To address the challenge of missing values in time series, we propose a novel recurrent neural network model, GRU-D++. This model outperformed other experimental models by achieving the area under the receiver operating characteristic curve (AUROC) of 0.945 for the on-time prediction and AUROC of 0.912 for 48h in-advance prediction. Furthermore, in the external validation with the KNUH dataset, the fine-tuned GRU-D++ model demonstrated superior performances, achieving an AUROC of 0.898 for on-time prediction and an AUROC of 0.897 for 48h in-advance prediction. The proposed GRU-D++, designed to consider temporal information and missing values, stands out for its predictive accuracy. Our findings suggest that this model can significantly alleviate the workload of medical staff and prevent the worsening of patient conditions by enabling timely interventions for PUs in the ICU.
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Affiliation(s)
- Minkyu Kim
- Department of Research & Development, Ziovision Co., Ltd., Chuncheon 24341, Republic of Korea; (M.K.); (D.K.); (D.L.); (D.K.)
| | - Tae-Hoon Kim
- Department of Internal Medicine, Kangwon National University, Chuncheon 24341, Republic of Korea; (T.-H.K.); (J.H.); (J.K.); (D.H.M.); (Y.H.); (W.J.K.); (S.-J.L.)
| | - Dowon Kim
- Department of Research & Development, Ziovision Co., Ltd., Chuncheon 24341, Republic of Korea; (M.K.); (D.K.); (D.L.); (D.K.)
| | - Donghoon Lee
- Department of Research & Development, Ziovision Co., Ltd., Chuncheon 24341, Republic of Korea; (M.K.); (D.K.); (D.L.); (D.K.)
| | - Dohyun Kim
- Department of Research & Development, Ziovision Co., Ltd., Chuncheon 24341, Republic of Korea; (M.K.); (D.K.); (D.L.); (D.K.)
| | - Jeongwon Heo
- Department of Internal Medicine, Kangwon National University, Chuncheon 24341, Republic of Korea; (T.-H.K.); (J.H.); (J.K.); (D.H.M.); (Y.H.); (W.J.K.); (S.-J.L.)
| | - Seonguk Kang
- Department of Convergence Security, Kangwon National University, Chuncheon 24341, Republic of Korea;
| | - Taejun Ha
- Biomedical Research Institute, Kangwon National University Hospital, Chuncheon 24289, Republic of Korea;
| | - Jinju Kim
- Department of Internal Medicine, Kangwon National University, Chuncheon 24341, Republic of Korea; (T.-H.K.); (J.H.); (J.K.); (D.H.M.); (Y.H.); (W.J.K.); (S.-J.L.)
| | - Da Hye Moon
- Department of Internal Medicine, Kangwon National University, Chuncheon 24341, Republic of Korea; (T.-H.K.); (J.H.); (J.K.); (D.H.M.); (Y.H.); (W.J.K.); (S.-J.L.)
- Department of Pulmonology, Kangwon National University Hospital, Chuncheon 24289, Republic of Korea
| | - Yeonjeong Heo
- Department of Internal Medicine, Kangwon National University, Chuncheon 24341, Republic of Korea; (T.-H.K.); (J.H.); (J.K.); (D.H.M.); (Y.H.); (W.J.K.); (S.-J.L.)
- Department of Pulmonology, Kangwon National University Hospital, Chuncheon 24289, Republic of Korea
| | - Woo Jin Kim
- Department of Internal Medicine, Kangwon National University, Chuncheon 24341, Republic of Korea; (T.-H.K.); (J.H.); (J.K.); (D.H.M.); (Y.H.); (W.J.K.); (S.-J.L.)
| | - Seung-Joon Lee
- Department of Internal Medicine, Kangwon National University, Chuncheon 24341, Republic of Korea; (T.-H.K.); (J.H.); (J.K.); (D.H.M.); (Y.H.); (W.J.K.); (S.-J.L.)
| | - Yoon Kim
- Department of Computer Science and Engineering, Kangwon National University, Chuncheon 24341, Republic of Korea;
| | - Sang Won Park
- Department of Medical Informatics, School of Medicine, Kangwon National University, Chuncheon 24341, Republic of Korea;
- Institute of Medical Science, School of Medicine, Kangwon National University, Chuncheon 24341, Republic of Korea
| | - Seon-Sook Han
- Department of Internal Medicine, Kangwon National University, Chuncheon 24341, Republic of Korea; (T.-H.K.); (J.H.); (J.K.); (D.H.M.); (Y.H.); (W.J.K.); (S.-J.L.)
| | - Hyun-Soo Choi
- Department of Computer Science and Engineering, Seoul National University of Science and Technology, Seoul 01811, Republic of Korea
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Jo HS, Kim WJ, Park Y, Hwang YS, Han SS, Heo YJ, Moon D, Kim SK, Lee CY. Study Protocol for a Hospital-to-Home Transitional Care for Older Adults Hospitalized with Chronic Obstructive Pulmonary Disease in South Korea: A Randomized Controlled Trial. Int J Environ Res Public Health 2023; 20:6507. [PMID: 37569047 PMCID: PMC10418954 DOI: 10.3390/ijerph20156507] [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] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/18/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is a progressive respiratory condition characterized by persistent inflammation in the airways, resulting in narrowing and obstruction of the air passages. The development of COPD is primarily attributed to long-term exposure to irritants, such as cigarette smoke and environmental pollutants. Among individuals hospitalized for exacerbations of COPD, approximately one in five is readmitted within 30 days of discharge or encounters immediate post-discharge complications, highlighting a lack of adequate preparedness for self-management. To address this inadequate preparedness, transitional care services (TCS) have emerged as a promising approach. Therefore, this study primarily aims to present a detailed protocol for a multi-site, single-blind, randomized, controlled trial (RCT) aimed at enhancing self-management competency and overall quality of life for patients with COPD through the provision of TCS, facilitated by a proficient Clinical Research Coordinator. The RCT intervention commenced in September 2022 and is set to conclude in December 2024, with a total of 362 COPD patients anticipated to be enrolled in the study. The intervention program encompasses various components, including an initial assessment during hospitalization, comprehensive self-management education, facilitation of social welfare connections, post-discharge home visits, and regular telephone monitoring. Furthermore, follow-up evaluations are conducted at both one month and three months after discharge to assess the effectiveness of the intervention in terms of preventing re-hospitalization, reducing acute exacerbations, and enhancing disease awareness among participants. The results of this study are expected to provide a basis for the development of TCS fee payment policies for future health insurance.
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Affiliation(s)
- Heui-Sug Jo
- Department of Health Policy and Management, School of Medicine, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon-si 24341, Republic of Korea; (H.-S.J.)
| | - Woo-Jin Kim
- Department of Internal Medicine, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon-si 24341, Republic of Korea;
| | - Yukyung Park
- Department of Preventive Medicine, Kangwon National University Hospital, 156, Baengnyeong-ro, Chuncheon-si 24289, Republic of Korea;
| | - Yu-Seong Hwang
- Department of Health Policy and Management, School of Medicine, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon-si 24341, Republic of Korea; (H.-S.J.)
| | - Seon-Sook Han
- Department of Internal Medicine, Kangwon National University Hospital, 156, Baengnyeong-ro, Chuncheon-si 24289, Republic of Korea; (S.-S.H.); (Y.-J.H.); (D.M.)
| | - Yeon-Jeong Heo
- Department of Internal Medicine, Kangwon National University Hospital, 156, Baengnyeong-ro, Chuncheon-si 24289, Republic of Korea; (S.-S.H.); (Y.-J.H.); (D.M.)
| | - Dahye Moon
- Department of Internal Medicine, Kangwon National University Hospital, 156, Baengnyeong-ro, Chuncheon-si 24289, Republic of Korea; (S.-S.H.); (Y.-J.H.); (D.M.)
| | - Su-Kyoung Kim
- Department of Health Policy and Management, School of Medicine, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon-si 24341, Republic of Korea; (H.-S.J.)
| | - Chang-Youl Lee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, 77, Sakju-ro, Chuncheon-si 24253, Republic of Korea
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Xue KK, Chen JL, Wei YR, Chen Y, Han SS, Wang CH, Zhang Y, Song XQ, Cheng JL. [Abnormal changes of static and dynamic functional connectivity of dopaminergic midbrain in patients with first-episode schizophrenia and their correlations with clinical symptoms]. Zhonghua Yi Xue Za Zhi 2023; 103:1623-1630. [PMID: 37248062 DOI: 10.3760/cma.j.cn112137-20221118-02428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Objective: To investigate the abnormal changes of static functional connectivity (sFC) and dynamic functional connectivity (dFC) in the dopaminergic midbrain (ventral dorsal tegmental area and bilateral substantia nigra compacta, VTA/SNc) in patients with first-episode schizophrenia(SCH), and their correlation with the Positive and Negative Symptom Scale (PANSS). Methods: The data of 198 first-episode untreated schizophrenia patients and 199 healthy controls (HC) matched by age, sex and years of education who were admitted to the First Affiliated Hospital of Zhengzhou University from January 2019 to May 2022 were prospectively collected. All subjects underwent high resolution structural MRI and resting state functional magnetic resonance imaging (rs-fMRI) scanning. The dopaminergic midbrain (VTA/SNc) was defined as three regions of interest (ROI). The sFC and dFC analyses with VTA/SNc as seeds were performed to produce a whole-brain diagram initially, which subsequently were compared between schizophrenia group and HC group. Finally, the correlation analysis of sFC and dFC values with the PANSS scores were performed, including the positive scale score, negative scale score, general psychopathology scale score, total score and symptom scores. Results: There were 86 males and 112 females in SCH group, and aged (23±9) years. Meanwhile, there were 95 males and 104 females in HC group, and aged (22±5) years. In the SCH group, the positive (P), the negative (N) and the general psychopathology (G) scale scores and the total score (T) of the PANSS scale was 20±7, 21±7, 41±11 and 82±22, respectively. Compared with the HC group, the VTA showed decreased sFC with four clusters including cerebellar vermis 7/9, left putamen, right thalamus and left middle cingulate gyrus in the schizophrenia group (peak center, t=-4.35, -4.81, -4.35 and -4.65; voxel P<0.005; cluster P<0.05), the right SNc showed decreased sFC with four clusters including left cerebellar hemisphere 4/5/8, right putamen, right medial orbitofrontal gyrus and the left putamen in the schizophrenia group (peak center, t=-4.91, -5.15, -4.77 and -5.21; voxel P<0.005; cluster P<0.05), and the left SNc showed decreased sFC with four clusters including the left putamen, right putamen, right medial orbitofrontal gyrus and left middle cingulate gyrus in the schizophrenia group (peak center, t=-5.82, -4.83 and -4.65; voxel P<0.005; cluster P<0.05). Compared with the HC group, the VTA showed decreased dFC with the right inferior parietal gyrus, right angular gyrus and right superior parietal gyrus in schizophrenia group (t=-4.17). In the schizophrenia group, the sFC value of cluster 2 (left putamen) with VTA as seed and cluster 4 (left putamen) with right SNc as seed were positively correlated with the positive scale scores in PANSS (r=0.141, 0.169, both P<0.05). The sFC and dFC values of significant regions were also correlated with hallucination, delusion, suspicion, hostility, communication disorder, passivity/indifference, lack of communication, stereotyped thinking, depression, non-cooperation, lack of judgment and insight, impulse control disorder, active social avoidance (all P<0.05). Conclusion: The static and dynamic functional connectivity (stability) of VTA/SNc to cerebellum, thalamus, striatum, prefrontal lobe and cingulate gyrus in first-episode schizophrenia patients were decreased, which were closely related to the positive and negative symptoms of schizophrenia.
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Affiliation(s)
- K K Xue
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - J L Chen
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Y R Wei
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Y Chen
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - S S Han
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - C H Wang
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Y Zhang
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - X Q Song
- Department of Psychiatry, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - J L Cheng
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
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Kim JY, Jung JH, Lee SJ, Han SS, Hong SH. Glyoxalase 1 as a Therapeutic Target in Cancer and Cancer Stem Cells. Mol Cells 2022; 45:869-876. [PMID: 36172978 PMCID: PMC9794553 DOI: 10.14348/molcells.2022.0109] [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] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 07/29/2022] [Accepted: 08/01/2022] [Indexed: 01/11/2023] Open
Abstract
Methylglyoxal (MG) is a dicarbonyl compound formed in cells mainly by the spontaneous degradation of the triose phosphate intermediates of glycolysis. MG is a powerful precursor of advanced glycation end products, which lead to strong dicarbonyl and oxidative stress. Although divergent functions of MG have been observed depending on its concentration, MG is considered to be a potential anti-tumor factor due to its cytotoxic effects within the oncologic domain. MG detoxification is carried out by the glyoxalase system. Glyoxalase 1 (Glo1), the ubiquitous glutathione-dependent enzyme responsible for MG degradation, is considered to be a tumor promoting factor due to it catalyzing the removal of cytotoxic MG. Indeed, various cancer types exhibit increased expression and activity of Glo1 that closely correlate with tumor cell growth and metastasis. Furthermore, mounting evidence suggests that Glo1 contributes to cancer stem cell survival. In this review, we discuss the role of Glo1 in the malignant progression of cancer and its possible use as a promising therapeutic target for tumor therapy. We also summarize therapeutic outcomes of Glo1 inhibitors as prospective treatments for the prevention of cancer.
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Affiliation(s)
- Ji-Young Kim
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon 24341, Korea
| | - Ji-Hye Jung
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon 24341, Korea
| | - Seung-Joon Lee
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon 24341, Korea
| | - Seon-Sook Han
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon 24341, Korea
| | - Seok-Ho Hong
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon 24341, Korea
- Institute of Medical Science, School of Medicine, Kangwon National University, Chuncheon 24341, Korea
- KW-Bio Co., Ltd., Wonju 26487, Korea
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8
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Abstract
BACKGROUND Lung cancer is the leading cause of cancer-related deaths worldwide. Copy number variation (CNV) in several genetic regions correlate with cancer susceptibility. Hence, this study evaluated the association between CNV and non-small cell lung cancer (NSCLC) in the peripheral blood. METHODS Blood samples of 150 patients with NSCLC and 150 normal controls were obtained from a bioresource center (Seoul, Korea). Through an epigenome-wide analysis using the MethylationEPIC BeadChip method, we extracted CNVs by using an SVS8 software-supplied multivariate method. We compared CNV frequencies between the NSCLC and controls, and then performed stratification analyses according to smoking status. RESULTS We acquired 979 CNVs, with 582 and 967 copy-number gains and losses, respectively. We identified five nominally significant associations (ACOT1, NAA60, GSDMD, HLA-DPA1, and SLC35B3 genes). Among the current smokers, the NSCLC group had more CNV losses and gains at the GSDMD gene in chromosome 8 (P=0.02) and at the ACOT1 gene in chromosome 14 (P=0.03) than the control group. It also had more CNV losses at the NAA60 gene in chromosome 16 (P=0.03) among non-smokers. In the NSCLC group, current smokers had more CNV gains and losses at the ACOT1 gene in chromosome 14 (P=0.003) and at HLA-DPA1 gene in chromosome 6 (P=0.02), respectively, than non-smokers. CONCLUSION Five nominally significant associations were found between the NSCLC and CNVs. CNVs are associated with the mechanism of lung cancer development. However, the role of CNVs in lung cancer development needs further investigation.
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Affiliation(s)
- Yeonjeong Heo
- Department of Internal Medicine, Kangwon National University, Kangwon National University Hospital, Chuncheon, Korea
| | - Jeongwon Heo
- Department of Internal Medicine, Kangwon National University, Kangwon National University Hospital, Chuncheon, Korea
- Department of Internal Medicine and Environmental Health Center, Kangwon National University, Kangwon National University Hospital, Chuncheon, Korea
| | - Seon-Sook Han
- Department of Internal Medicine, Kangwon National University, Kangwon National University Hospital, Chuncheon, Korea
- Department of Internal Medicine and Environmental Health Center, Kangwon National University, Kangwon National University Hospital, Chuncheon, Korea
| | - Woo Jin Kim
- Department of Internal Medicine, Kangwon National University, Kangwon National University Hospital, Chuncheon, Korea
- Department of Internal Medicine and Environmental Health Center, Kangwon National University, Kangwon National University Hospital, Chuncheon, Korea
| | - Hyun Sub Cheong
- Department of Genetic Epidemiology, SNP Genetics, Inc., Sogang University, Mapo-gu, Seoul, Republic of Korea
| | - Yoonki Hong
- Department of Internal Medicine, Kangwon National University, Kangwon National University Hospital, Chuncheon, Korea
- Department of Internal Medicine and Environmental Health Center, Kangwon National University, Kangwon National University Hospital, Chuncheon, Korea
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9
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Muñoz-López C, Ramírez-Cornejo C, Marchetti MA, Han SS, Del Barrio-Díaz P, Jaque A, Uribe P, Majerson D, Curi M, Del Puerto C, Reyes-Baraona F, Meza-Romero R, Parra-Cares J, Araneda-Ortega P, Guzmán M, Millán-Apablaza R, Nuñez-Mora M, Liopyris K, Vera-Kellet C, Navarrete-Dechent C. Performance of a deep neural network in teledermatology: a single-centre prospective diagnostic study. J Eur Acad Dermatol Venereol 2020; 35:546-553. [PMID: 33037709 DOI: 10.1111/jdv.16979] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 09/22/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND The use of artificial intelligence (AI) algorithms for the diagnosis of skin diseases has shown promise in experimental settings but has not been yet tested in real-life conditions. OBJECTIVE To assess the diagnostic performance and potential clinical utility of a 174-multiclass AI algorithm in a real-life telemedicine setting. METHODS Prospective, diagnostic accuracy study including consecutive patients who submitted images for teledermatology evaluation. The treating dermatologist chose a single image to upload to a web application during teleconsultation. A follow-up reader study including nine healthcare providers (3 dermatologists, 3 dermatology residents and 3 general practitioners) was performed. RESULTS A total of 340 cases from 281 patients met study inclusion criteria. The mean (SD) age of patients was 33.7 (17.5) years; 63% (n = 177) were female. Exposure to the AI algorithm results was considered useful in 11.8% of visits (n = 40) and the teledermatologist correctly modified the real-time diagnosis in 0.6% (n = 2) of cases. The overall top-1 accuracy of the algorithm (41.2%) was lower than that of the dermatologists (60.1%), residents (57.8%) and general practitioners (49.3%) (all comparisons P < 0.05, in the reader study). When the analysis was limited to the diagnoses on which the algorithm had been explicitly trained, the balanced top-1 accuracy of the algorithm (47.6%) was comparable to the dermatologists (49.7%) and residents (47.7%) but superior to the general practitioners (39.7%; P = 0.049). Algorithm performance was associated with patient skin type and image quality. CONCLUSIONS A 174-disease class AI algorithm appears to be a promising tool in the triage and evaluation of lesions with patient-taken photographs via telemedicine.
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Affiliation(s)
- C Muñoz-López
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - C Ramírez-Cornejo
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - M A Marchetti
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - S S Han
- Dermatology Clinic, Seoul, Korea
| | - P Del Barrio-Díaz
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - A Jaque
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - P Uribe
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.,Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - D Majerson
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - M Curi
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - C Del Puerto
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - F Reyes-Baraona
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - R Meza-Romero
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - J Parra-Cares
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - P Araneda-Ortega
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - M Guzmán
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - R Millán-Apablaza
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - M Nuñez-Mora
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - K Liopyris
- Department of Dermatology, University of Athens, Andreas Syggros Hospital of Skin and Venereal Diseases, Athens, Greece
| | - C Vera-Kellet
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - C Navarrete-Dechent
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.,Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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Abstract
Background Various studies have investigated the association between pulmonary tuberculosis (TB) and lung cancer However, how the relationship between TB and lung cancer may differ by age is not yet clear. This study investigated how risk for lung cancer after pulmonary TB may differ by age. Methods This study used the National Health Insurance Service–National Sample Cohort in South Korea. We compared 3,776 pulmonary TB patients with 18,880 controls matched for sex and age during the period from 2003 to 2013. We analyzed the incidence of lung cancer after diagnosis of active pulmonary TB. A multivariate Cox proportional hazard model was used to calculate the adjusted hazard ratio (HR) of lung cancer after adjusting for sex, age, house income, and smoking status. Results Among 3,776 pulmonary TB patients, 86 had lung cancer diagnoses, whereas there were 108 lung cancer patients among 18,880 controls. The incidence rate ratio in the pulmonary TB group was 12.26 within 1 year and 3.33 at 1–3.9 years after TB infection, compared to the control group. There was increased risk for lung cancer in pulmonary TB patients compared to controls (HR, 4.18; 95% CI, 3.15–5.56). Compared to patients <50 years of age, the risks for lung cancer were HR 9.85, 7.1, 3.32, and 2.57 in patients aged 50–59, 60–69, and ≥70 years, respectively. Conclusions Pulmonary TB is a risk factor for lung cancer. Patients with pulmonary TB should be monitored for subsequent development of lung cancer, particularly in younger patients.
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Affiliation(s)
- Soo Jeong An
- Department of Benefits Strategy, National Health Insurance Service, Wonju, Republic of Korea
| | - Young-Ju Kim
- Department of Statistics, Kangwon National University, Chuncheon, Republic of Korea
| | - Seon-Sook Han
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, Republic of Korea.,Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, Republic of Korea
| | - Jeongwon Heo
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, Republic of Korea.,Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, Republic of Korea
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11
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Kim JE, Kim YC, Min SL, Lee H, Ha J, Chin HJ, Kim YS, Han SS. Transplant outcomes in kidney recipients with lupus nephritis, and systematic review. Lupus 2020; 29:248-255. [DOI: 10.1177/0961203320902524] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background Despite improved survival of patients with lupus nephritis (LN), some require kidney transplantation because of progression to end-stage renal disease (ESRD). However, the transplant outcomes of these patients and other recipients have not been thoroughly compared. Methods In total, 1848 Korean kidney recipients who underwent transplantation from 1998 to 2017 at two tertiary referral centers were evaluated retrospectively. Among them, 28 recipients with LN, and 50 control recipients matched by age, sex, and donor type, were compared with respect to graft and patient survival. We pooled our data with 17 previous cohort studies in which the graft survival of recipients with LN was described in detail. Results During the median follow-up period of 9.5 years (maximum 21 years), graft failure (GF) occurred in 10.7% and 16.0% of LN and control recipients, respectively. No differences were found in the rates of GF and death-censored graft failure or patient survival between the two groups. The risks of acute T cell-mediated and antibody-mediated rejection were also similar between the two groups. The pooled analysis showed similar 1- and 5-year graft survival rates between LN and control recipients. Conclusions Kidney transplantation is an acceptable option in patients with concurrent LN and ESRD.
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Affiliation(s)
- J E Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Y C Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - S-l Min
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - H Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - J Ha
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - H J Chin
- Department of Internal Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Korea
| | - Y S Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - S S Han
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
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12
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Bak SH, Kwon SO, Han SS, Kim WJ. Computed tomography-derived area and density of pectoralis muscle associated disease severity and longitudinal changes in chronic obstructive pulmonary disease: a case control study. Respir Res 2019; 20:226. [PMID: 31638996 PMCID: PMC6805427 DOI: 10.1186/s12931-019-1191-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 09/20/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Muscle wasting is associated with prognosis in patients with chronic obstructive pulmonary disease (COPD). The cross-sectional area of skeletal muscles on computed tomography (CT) could serve as a method to evaluate body composition. The present study aimed to determine the ability of CT-derived pectoralis muscle area (PMA) and pectoralis muscle density (PMD) to determine the severity of COPD and change in longitudinal pulmonary function in patients with COPD. METHODS A total of 293 participants were enrolled in this study, a whom 222 had undergone at least two spirometry measurements within 3 years after baseline data acquisition. PMA and PMD were measured from a single axial slice of chest CT above the aortic arch at baseline. The emphysema index and bronchial wall thickness were quantitatively assessed in all scans. The generalized linear model was used to determine the correlation between PMA and PMD measurements and pulmonary function. RESULTS PMA and PMD were significantly associated with baseline lung function and the severity of emphysema (P < 0.05). Patients with the lowest PMA and PMD exhibited significantly more severe airflow obstruction (β = - 0.06; 95% confidence interval: - 0.09 to - 0.03]. PMA was statistically associated with COPD assessment test (CAT) score (P = 0.033). However, PMD did not exhibit statistically significant correlation with either CAT scores or modified Medical Research Council scores (P > 0.05). Furthermore, neither PMA nor PMD were associated with changes in forced expiratory volume in 1 s over a 3-year periods. CONCLUSIONS CT-derived features of the pectoralis muscle may be helpful in predicting disease severity in patients with COPD, but are not necessarily associated with longitudinal changes in lung function.
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Affiliation(s)
- So Hyeon Bak
- Department of Radiology, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Republic of Korea
| | - Sung Ok Kwon
- Biomedical Research Institute, Kangwon National University Hospital, Chuncheon, Republic of Korea
| | - Seon-Sook Han
- Department of Internal Medicine and Environmental Health Center, School of Medicine, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon, Gangwon-do, 24341, Republic of Korea
| | - Woo Jin Kim
- Department of Internal Medicine and Environmental Health Center, School of Medicine, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon, Gangwon-do, 24341, Republic of Korea.
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13
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Heo J, Heo Y, Hong Y, Han SS, Cheong HS, Kim WJ. Difference of Copy number variation in the blood between patients with lung cancer and control. Lung Cancer 2019. [DOI: 10.1183/13993003.congress-2019.pa3659] [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: 11/05/2022]
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14
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Hong Y, Kim Y, Lee JJ, Lee MG, Lee CY, Kim Y, Heo J, Han SS, Lee SJ, Kim WJ, Hong JY. Levels of vitamin D-associated cytokines distinguish between active and latent tuberculosis following a tuberculosis outbreak. BMC Infect Dis 2019; 19:151. [PMID: 30760247 PMCID: PMC6375131 DOI: 10.1186/s12879-019-3798-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 02/08/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Vitamin D levels are associated with the extent of mycobactericidal activity. Interleukin (IL)-15 and IL-32 play roles in the vitamin D-mediated tuberculosis (TB) defense mechanism. Vitamin D induces IL-1β, which plays an important role in terms of resistance to TB. We evaluated whether the levels of vitamin D-related cytokines distinguished between those with active TB and latent TB infection (LTBI). METHODS In total, 50 TB-infected patients (25 with active TB and 25 with LTBI following a TB outbreak in a high school) were enrolled. Plasma 25-hydroxyvitamin D (25[OH]D), IL-15, IL-32, and IL-1β levels were measured via enzyme-linked immunosorbent assays. Mycobacterium tuberculosis-specific antigen-induced and unstimulated cytokine levels were measured in the supernatants of the QuantiFERON TB Gold-In-Tube (QFT-GIT) assay. RESULTS Plasma 25(OH)D and plasma IL-15 levels were lower in patients with active TB than in LTBI subjects (25(OH)D: 16.64 ng/mL vs. 21.6 ng/mL, P = 0.031; IL-15: 148.9 pg/mL vs. 189.8 pg/mL, P = 0.013). Plasma 25(OH)D levels correlated with the plasma levels of IL-15 and IL-1β in TB-infected patients. In addition, the plasma 25(OH)D levels correlated positively with the level of unstimulated IL-15 (IL-15nil) and negatively with that of TB antigen-stimulated IL-32 (IL-32TB) in QFT-GIT supernatants. Although the IL-15nil and IL-15TB levels were higher in LTBI subjects than patients with active TB, the IL-32nil and IL-32TB levels were higher in the latter patients. A combination of the IL-15nil and IL-32TB levels accurately predicted 91.3% of active TB patients and latent subjects, with an area under the curve of 0.964. CONCLUSIONS Our preliminary data showed that the levels of the vitamin D-related cytokines IL-15 and IL-32 differed between active TB patients and LTBI subjects. This result might be used as a basic data for developing biomarkers distinguishing between active TB and LTBI.
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Affiliation(s)
- Yoonki Hong
- Department of Internal Medicine, Kangwon National University Hospital, School of Medicine,Kangwon National University, Chuncheon, Republic of Korea
| | - Youngmi Kim
- Institute of New frontier Research, Hallym University College of Medicine, Chuncheon, South Korea
| | - Jae Jun Lee
- Institute of New frontier Research, Hallym University College of Medicine, Chuncheon, South Korea
| | - Myung Goo Lee
- Lung Research Institute of Hallym University College of Medicine, Chuncheon, Gangwon-do Republic of Korea
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Hallym University Medical Center, 77, Sakju-ro, Chuncheon-si, Gangwon-do 200-704 Republic of Korea
| | - Chang Youl Lee
- Lung Research Institute of Hallym University College of Medicine, Chuncheon, Gangwon-do Republic of Korea
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Hallym University Medical Center, 77, Sakju-ro, Chuncheon-si, Gangwon-do 200-704 Republic of Korea
| | - Youlim Kim
- Lung Research Institute of Hallym University College of Medicine, Chuncheon, Gangwon-do Republic of Korea
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Hallym University Medical Center, 77, Sakju-ro, Chuncheon-si, Gangwon-do 200-704 Republic of Korea
| | - Jeongwon Heo
- Department of Internal Medicine, Kangwon National University Hospital, School of Medicine,Kangwon National University, Chuncheon, Republic of Korea
| | - Seon-Sook Han
- Department of Internal Medicine, Kangwon National University Hospital, School of Medicine,Kangwon National University, Chuncheon, Republic of Korea
| | - Seung-Joon Lee
- Department of Internal Medicine, Kangwon National University Hospital, School of Medicine,Kangwon National University, Chuncheon, Republic of Korea
| | - Woo Jin Kim
- Department of Internal Medicine, Kangwon National University Hospital, School of Medicine,Kangwon National University, Chuncheon, Republic of Korea
| | - Ji Young Hong
- Lung Research Institute of Hallym University College of Medicine, Chuncheon, Gangwon-do Republic of Korea
- Institute of New frontier Research, Hallym University College of Medicine, Chuncheon, South Korea
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Hallym University Medical Center, 77, Sakju-ro, Chuncheon-si, Gangwon-do 200-704 Republic of Korea
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Lee CM, Heo J, Han SS, Moon KW, Lee SH, Kim YJ, Lee SJ, Kwon JW. Inhaled Corticosteroid-Related Tuberculosis in the Real World Among Patients with Asthma and COPD: A 10-Year Nationwide Population-Based Study. J Allergy Clin Immunol Pract 2018; 7:1197-1206.e3. [PMID: 30339858 DOI: 10.1016/j.jaip.2018.10.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 09/28/2018] [Accepted: 10/01/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND There have been concerns about the risk of inhaled corticosteroid (ICS)-related tuberculosis (TB) development. OBJECTIVE We investigated the occurrence of TB among ICS users according to underlying respiratory diseases and type of ICS. METHODS A 12-year population cohort comprising approximately 1 million subjects collected from the Korean claims database were used. Adult ICS users (budesonide or fluticasone) were enrolled. The temporal relationship between TB development and the last ICS prescription before TB development was evaluated. A nested case-control study was performed with 1:4 matching for age, sex, and the initiation date of the ICS. RESULTS There were 17,991 ICS users, and 175 developed TB during the study period. Approximately 80% (140/175) of patients who developed TB were diagnosed within 3 years after the last ICS prescription. In the nested case-control study, the occurrence of TB was not related to the type of ICS, but was related to a higher annual admission rate and a higher comorbidity score. The risk of TB was higher in patients with chronic obstructive pulmonary disease (COPD) than in those with asthma (odds ratio: 2.31; CI 95%: 1.39-3.38; P = .0011) after adjusting for covariates. The subgroup analysis revealed no difference between budesonide and fluticasone with respect to the risk of developing TB in patients with asthma, COPD, or asthma-COPD overlap syndrome. CONCLUSION An increased risk of TB development may persist for 3 years after stopping the ICS and the risk is higher in patients with COPD regardless of the type of ICS used.
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Affiliation(s)
- Chang-Min Lee
- Department of Statistics, Kangwon National University, Chuncheon, Gangwon, Republic of Korea
| | - Jeongwon Heo
- Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, Gangwon, Republic of Korea
| | - Seon-Sook Han
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Gangwon, Republic of Korea
| | - Ki Won Moon
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Gangwon, Republic of Korea
| | - Seung-Hwan Lee
- Department of Neurology, Kangwon National University School of Medicine, Chuncheon, Gangwon, Republic of Korea
| | - Young-Ju Kim
- Department of Statistics, Kangwon National University, Chuncheon, Gangwon, Republic of Korea
| | - Seung-Joon Lee
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Gangwon, Republic of Korea.
| | - Jae-Woo Kwon
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Gangwon, Republic of Korea; Division of Allergy and Clinical Immunology, Kangwon National University School of Medicine, Chuncheon, Gangwon, Republic of Korea.
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16
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Heo J, Hong Y, Han SS, Kim WJ, Kwon JW, Moon KW, Jeong JH, Kim YJ, Lee SH, Lee SJ. Changes in the Characteristics and Long-term Mortality Rates of Intensive Care Unit Patients from 2003 to 2010: A Nationwide Population-Based Cohort Study Performed in the Republic of Korea. Acute Crit Care 2018; 33:135-145. [PMID: 31723877 PMCID: PMC6786693 DOI: 10.4266/acc.2018.00164] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/24/2018] [Accepted: 08/21/2018] [Indexed: 01/21/2023] Open
Abstract
Background There are few studies on intensive care unit (ICU) patients in the Republic of Korea. We analyzed the characteristics and mortality changes of all ICU patients over the last 8 years. Methods This study used the cohort of the National Health Insurance Corporation, which provides medical care to all residents of the Republic of Korea. The cohort consists of patients aged 20 years or older between 2003 and 2010 with a history of ICU admission. We analyzed changes in sex, age, household income, number of hospital beds, emergency admissions, and reasons for admission using the Cochran-Armitage trend test. The adjusted hazard ratios (HRs) of mortality according to these variables and year of admission were calculated by Cox proportional hazards regression. Results The proportion of patients aged ≥70 years increased over that period, as did their average age (by 3.6 years). During the 8-year study period, the 3-year mortality rate was 32.91%-35.83%. The overall mortality was higher in males and older patients, in those with a lower household income and higher Charlson Comorbidity Index (CCI) score, those admitted to a hospital with a smaller number of beds, and those admitted via the emergency room. There was no significant change in crude mortality rate over the 8-year study period; however, the adjusted HR showed a decreasing trend. Conclusions Patients admitted to the ICU were older and had higher CCI score. Nevertheless, there was a temporal trend toward a decrease in the HR of long-term mortality.
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Affiliation(s)
- Jeongwon Heo
- Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, Korea
| | - Yoonki Hong
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Seon-Sook Han
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Woo Jin Kim
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Jae-Woo Kwon
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.,Division of Allergy and Clinical Immunology, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Ki Won Moon
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Jae Hoon Jeong
- Department of Statistics, Kangwon National University, Chuncheon, Korea
| | - Young-Ju Kim
- Department of Statistics, Kangwon National University, Chuncheon, Korea
| | - Seung-Hwan Lee
- Department of Neurology, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Seung-Joon Lee
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
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17
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Moon HG, Kim SJ, Jeong JJ, Han SS, Jarjour NN, Lee H, Abboud-Werner SL, Chung S, Choi HS, Natarajan V, Ackerman SJ, Christman JW, Park GY. Airway Epithelial Cell-Derived Colony Stimulating Factor-1 Promotes Allergen Sensitization. Immunity 2018; 49:275-287.e5. [PMID: 30054206 DOI: 10.1016/j.immuni.2018.06.009] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 04/25/2018] [Accepted: 06/21/2018] [Indexed: 10/28/2022]
Abstract
Airway epithelial cells (AECs) secrete innate immune cytokines that regulate adaptive immune effector cells. In allergen-sensitized humans and mice, the airway and alveolar microenvironment is enriched with colony stimulating factor-1 (CSF1) in response to allergen exposure. In this study we found that AEC-derived CSF1 had a critical role in the production of allergen reactive-IgE production. Furthermore, spatiotemporally secreted CSF1 regulated the recruitment of alveolar dendritic cells (DCs) and enhanced the migration of conventional DC2s (cDC2s) to the draining lymph node in an interferon regulatory factor 4 (IRF4)-dependent manner. CSF1 selectively upregulated the expression of the chemokine receptor CCR7 on the CSF1R+ cDC2, but not the cDC1, population in response to allergen stimuli. Our data describe the functional specification of CSF1-dependent DC subsets that link the innate and adaptive immune responses in T helper 2 (Th2) cell-mediated allergic lung inflammation.
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Affiliation(s)
- Hyung-Geun Moon
- Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Seung-Jae Kim
- Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Jong Jin Jeong
- Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Seon-Sook Han
- Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Nizar N Jarjour
- Allergy, Pulmonary, and Critical Care Division, Department of Medicine, University of Wisconsin, Madison, WI, USA
| | - Hyun Lee
- Center for Biomolecular Sciences, and Department of Medicinal Chemistry & Pharmacognosy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA
| | - Sherry L Abboud-Werner
- Department of Pathology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Sangwoon Chung
- Section of Pulmonary, Critical Care, and Sleep Medicine, the Ohio State University, Davis Heart and Lung Research Center, Columbus, OH, USA
| | - Hak Soo Choi
- Gordon Center for Medical Imaging, Division of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, Boston, MA, USA
| | - Viswanathan Natarajan
- Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA; Department of Pharmacology, University of Illinois at Chicago, Chicago, IL, USA
| | - Steven J Ackerman
- Department of Biochemistry and Molecular Genetics, and Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - John W Christman
- Section of Pulmonary, Critical Care, and Sleep Medicine, the Ohio State University, Davis Heart and Lung Research Center, Columbus, OH, USA
| | - Gye Young Park
- Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA.
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18
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Kim DJ, Kim WJ, Lim M, Hong Y, Lee SJ, Hong SH, Heo J, Lee HY, Han SS. Plasma CRABP2 as a Novel Biomarker in Patients with Non-Small Cell Lung Cancer. J Korean Med Sci 2018; 33:e178. [PMID: 29930489 PMCID: PMC6010740 DOI: 10.3346/jkms.2018.33.e178] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 04/20/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Lung cancer is the most common cause of cancer-related mortality worldwide. We previously reported the identification of a new genetic marker, cellular retinoic acid binding protein 2 (CRABP2), in lung cancer tissues. The aim of this study was to assess plasma levels of CRABP2 from patients with non-small cell lung cancer (NSCLC). METHODS Blood samples that were collected from 122 patients with NSCLC between September 2009 and September 2013 were selected for the analysis, along with samples from age- (± 5 years), sex-, and cigarette smoking history (± 10 pack-years [PY])-matched controls from the Korea Biobank Network. The control specimens were from patients who were without malignancies or pulmonary diseases. We measured plasma levels of CRABP2 using commercially available enzyme-linked immunosorbent assay kits. RESULTS The mean age of the NSCLC patients was 71.8 ± 8.9 years, and the median cigarette smoking history was 32 PY (range, 0-150 PY). Plasma CRABP2 levels were significantly higher in patients with NSCLC than in the matched controls (37.63 ± 28.71 ng/mL vs. 24.09 ± 21.09 ng/mL, P < 0.001). Higher plasma CRABP2 levels were also correlated with lower survival rates in NSCLC patients (P = 0.014). CONCLUSION Plasma CRABP2 levels might be a novel diagnostic and prognostic marker in NSCLC.
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Affiliation(s)
- Do Jun Kim
- Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, Korea
| | - Woo Jin Kim
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Myoungnam Lim
- Data Analytics Center, Kangwon National University, Chuncheon, Korea
| | - Yoonki Hong
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Seung-Joon Lee
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Seok-Ho Hong
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Jeongwon Heo
- Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, Korea
| | - Hui-Young Lee
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Seon-Sook Han
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
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19
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Kim S, Lim MN, Hong Y, Han SS, Lee SJ, Kim WJ. A cluster analysis of chronic obstructive pulmonary disease in dusty areas cohort identified three subgroups. BMC Pulm Med 2017; 17:209. [PMID: 29246211 PMCID: PMC5732468 DOI: 10.1186/s12890-017-0553-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 12/06/2017] [Indexed: 11/16/2022] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease with variable clinical manifestations, structural changes, and treatment responses. In a cohort study, we performed a baseline cluster analysis to identify the subgroups of COPD and to assess the clinical outcomes of each subgroup during a 1-year follow-up. Methods We analyzed dusty areas cohort comprising 272 patients with COPD. The main factors with the highest loading in 15 variables were selected using principal component analysis (PCA) at baseline. The COPD patients were classified by hierarchical cluster analysis using clinical, physiological, and imaging data based on PCA-transformed data. The clinical parameters and outcomes during the 1-year follow-up were evaluated among the subgroups. Results PCA revealed that six independent components accounted for 77.3% of variance. Three distinct subgroups were identified through the cluster analysis. Subgroup 1 included younger subjects with fewer symptoms and mild airflow obstruction, and they had fewer exacerbations during the 1-year follow-up. Subgroup 2 comprised subjects with additional symptoms and moderate airflow obstruction, and they most frequently experienced exacerbations requiring hospitalization during the 1-year follow-up. Subgroup 3 included subjects with additional symptoms and mild airflow obstruction; this group had more female patients and a modest frequency of exacerbations requiring hospitalization. Conclusions Cluster analysis using the baseline data of a COPD cohort identified three distinct subgroups with different clinical parameters and outcomes. These findings suggest that the identified subgroups represent clinically meaningful subtypes of COPD. Electronic supplementary material The online version of this article (10.1186/s12890-017-0553-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Suhyun Kim
- Department of Internal Medicine, Seoul Medical Center, Seoul, Korea
| | - Myoung-Nam Lim
- Kangwon National University Data Analytics Center, Chuncheon, Korea
| | - Yoonki Hong
- Department of Internal Medicine and Environmental Health Center, Kangwon National University, Chuncheon, Korea
| | - Seon-Sook Han
- Department of Internal Medicine and Environmental Health Center, Kangwon National University, Chuncheon, Korea
| | - Seung-Joon Lee
- Department of Internal Medicine and Environmental Health Center, Kangwon National University, Chuncheon, Korea
| | - Woo Jin Kim
- Department of Internal Medicine and Environmental Health Center, Kangwon National University, Chuncheon, Korea.
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20
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Ahn EJ, Kang H, Choi GJ, Yang SY, Shin HY, Baek CW, Jung YH, Woo YC, Han SS. Streamlined Liner of the Pharynx Airway: Randomised Comparison of Size Selection Strategies with Regard to Patient Height versus Thyroid Cartilage Width. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791502200507] [Citation(s) in RCA: 4] [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: 12/14/2022] Open
Abstract
Introduction Streamlined Liner of the Pharynx Airway (SLIPA) is a disposable supraglottic airway. There are two strategies to select the size of SLIPA: by height and width of thyroid cartilage. This study compared the utility of the two strategies in selecting the optimal size. Methods One hundred forty-two patients were randomly divided into two groups with size selection by height (H) and the maximal width of the thyroid cartilage (T). The SLIPA size was selected by height in group H, and by the width of thyroid cartilage in group T. After inserting SLIPA, the investigator made note of the oropharyngeal leakage pressure (OLP) and the degree of insertion difficulty. We set the OLP as a primary outcome. In cases of an OLP <15 cmH2O, the investigator manipulated the apparatus to try to reposition it. If air still leaked, another attempt was made using a SLIPA one size larger until an OLP >15 cmH2O was achieved in up to three attempts. After insertion, the investigator measured the inspiratory and expiratory tidal volume. Post-operatively, the presence of blood or regurgitated fluid on the device was evaluated. Results OLP for group T was higher than that of group H (p=0.009). The need for manipulation and the leak fraction was higher in group H than in group T (p=0.008 and 0.034, respectively). The degree of insertion difficulty, number of trials and incidence of blood and regurgitated fluid on the device were similar between the two groups. Conclusions Both the width and height of thyroid cartilage can be used for selecting the optimal SLIPA size. (Hong Kong j.emerg.med. 2015;22:303-311)
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Affiliation(s)
| | | | | | | | | | | | | | | | - SS Han
- Chung-Ang University, College of Medicine, Department of Obstetrics and Gynecology, Seoul, Korea
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21
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Kim J, Song H, Heo HR, Kim JW, Kim HR, Hong Y, Yang SR, Han SS, Lee SJ, Kim WJ, Hong SH. Cadmium-induced ER stress and inflammation are mediated through C/EBP-DDIT3 signaling in human bronchial epithelial cells. Exp Mol Med 2017; 49:e372. [PMID: 28860664 PMCID: PMC5628270 DOI: 10.1038/emm.2017.125] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 03/28/2017] [Accepted: 03/29/2017] [Indexed: 02/07/2023] Open
Abstract
Cadmium (Cd), a major component of cigarette smoke, disrupts the normal functions of airway cells and can lead to the development of various pulmonary diseases such as chronic obstructive pulmonary disease (COPD). However, the molecular mechanisms involved in Cd-induced pulmonary diseases are poorly understood. Here, we identified a cluster of genes that are altered in response to Cd exposure in human bronchial epithelial cells (BEAS-2B) and demonstrated that Cd-induced ER stress and inflammation are mediated via CCAAT-enhancer-binding proteins (C/EBP)-DNA-damaged-inducible transcript 3 (DDIT3) signaling in BEAS-2B cells. Cd treatment led to marked upregulation and downregulation of genes associated with the cell cycle, apoptosis, oxidative stress and inflammation as well as various signal transduction pathways. Gene set enrichment analysis revealed that Cd treatment stimulated the C/EBP signaling pathway and induced transcriptional activation of its downstream target genes, including DDIT3. Suppression of DDIT3 expression using specific small interfering RNA effectively alleviated Cd-induced ER stress and inflammatory responses in both BEAS-2B and normal primary normal human bronchial epithelial cells. Taken together, these data suggest that C/EBP signaling may have a pivotal role in the early induction of ER stress and inflammatory responses by Cd exposure and could be a molecular target for Cd-induced pulmonary disease.
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Affiliation(s)
- Jeeyoung Kim
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, South Korea.,Environmental Health Center, Kangwon National University Hospital, Chuncheon, South Korea
| | - Haengseok Song
- Department of Biomedical Science, College of Life Science, CHA University, Seongnam, South Korea
| | - Hye-Ryeon Heo
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, South Korea.,Environmental Health Center, Kangwon National University Hospital, Chuncheon, South Korea
| | - Jung Woon Kim
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, South Korea.,Environmental Health Center, Kangwon National University Hospital, Chuncheon, South Korea
| | - Hye-Ryun Kim
- Department of Biomedical Science, College of Life Science, CHA University, Seongnam, South Korea
| | - Yoonki Hong
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, South Korea.,Environmental Health Center, Kangwon National University Hospital, Chuncheon, South Korea
| | - Se-Ran Yang
- Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kangwon National University, Chuncheon, South Korea
| | - Seon-Sook Han
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, South Korea.,Environmental Health Center, Kangwon National University Hospital, Chuncheon, South Korea
| | - Seung-Joon Lee
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, South Korea.,Environmental Health Center, Kangwon National University Hospital, Chuncheon, South Korea
| | - Woo Jin Kim
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, South Korea.,Environmental Health Center, Kangwon National University Hospital, Chuncheon, South Korea
| | - Seok-Ho Hong
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, South Korea.,Environmental Health Center, Kangwon National University Hospital, Chuncheon, South Korea
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Jeong JH, Kim J, Kim J, Heo HR, Jeong JS, Ryu YJ, Hong Y, Han SS, Hong SH, Lee SJ, Kim WJ. ACN9 Regulates the Inflammatory Responses in Human Bronchial Epithelial Cells. Tuberc Respir Dis (Seoul) 2017; 80:247-254. [PMID: 28747957 PMCID: PMC5526951 DOI: 10.4046/trd.2017.80.3.247] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 05/02/2017] [Accepted: 05/04/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Airway epithelial cells are the first line of defense, against pathogens and environmental pollutants, in the lungs. Cellular stress by cadmium (Cd), resulting in airway inflammation, is assumed to be directly involved in tissue injury, linked to the development of lung cancer, and chronic obstructive pulmonary disease (COPD). We had earlier shown that ACN9 (chromosome 7q21), is a potential candidate gene for COPD, and identified significant interaction with smoking, based on genetic studies. However, the role of ACN9 in the inflammatory response, in the airway cells, has not yet been reported. METHODS We first checked the anatomical distribution of ACN9 in lung tissues, using mRNA in situ hybridization, and immunohistochemistry. Gene expression profiling in bronchial epithelial cells (BEAS-2B), was performed, after silencing ACN9. We further tested the roles of ACN9, in the intracellular mechanism, leading to Cd-induced production, of proinflammatory cytokines in BEAS-2B. RESULTS ACN9 was localized in lymphoid, and epithelial cells, of human lung tissues. ACN9 silencing, led to differential expression of 216 genes. Pathways of sensory perception to chemical stimuli, and cell surface receptor-linked signal transduction, were significantly enriched. ACN9 silencing, further increased the expression of proinflammatory cytokines, in BEAS-2B after Cd exposure. CONCLUSION Our findings suggest, that ACN9 may have a role, in the inflammatory response in the airway.
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Affiliation(s)
- Jae Hoon Jeong
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Jeeyoung Kim
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.,Environmental Health Center, Kangwon National University Hospital, Chuncheon, Korea
| | - Jeongwoon Kim
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.,Environmental Health Center, Kangwon National University Hospital, Chuncheon, Korea
| | - Hye-Ryeon Heo
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.,Environmental Health Center, Kangwon National University Hospital, Chuncheon, Korea
| | - Jin Seon Jeong
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Young-Joon Ryu
- Department of Pathology, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Yoonki Hong
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.,Environmental Health Center, Kangwon National University Hospital, Chuncheon, Korea
| | - Seon-Sook Han
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.,Environmental Health Center, Kangwon National University Hospital, Chuncheon, Korea
| | - Seok-Ho Hong
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.,Environmental Health Center, Kangwon National University Hospital, Chuncheon, Korea
| | - Seung-Joon Lee
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.,Environmental Health Center, Kangwon National University Hospital, Chuncheon, Korea
| | - Woo Jin Kim
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.,Environmental Health Center, Kangwon National University Hospital, Chuncheon, Korea
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Ji W, Lim MN, Bak SH, Hong SH, Han SS, Lee SJ, Kim WJ, Hong Y. Differences in chronic obstructive pulmonary disease phenotypes between non-smokers and smokers. Clin Respir J 2016; 12:666-673. [PMID: 27805311 DOI: 10.1111/crj.12577] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 10/05/2016] [Accepted: 10/25/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND OBJECTIVES Although tobacco smoking is a major risk factor for chronic obstructive pulmonary disease (COPD), more than one-fourth of COPD patients are non-smokers. In this cross-sectional study, the differences in COPD phenotypes between non-smokers and smokers in male subjects were investigated and were focused on structural lung changes using a quantitative assessment of computed tomography (CT) images. METHODS They divided male participants with COPD, from a Korean cohort near a cement plant, into non-smokers and smokers by a cutoff of a 5 pack-year smoking history. Clinical characteristics, including age, body mass index (BMI), spirometry results, history of biomass smoke exposure, and CT measurements, were compared between the two groups. Emphysema index (EI) and mean wall area percentage (MWA %) were used to evaluate the structural lung changes on volumetric CT scans. RESULTS The non-smoker group (n = 49) had younger patients and had a greater BMI than the smoker group (n = 113) (P < .05). Spirometry results, including post-bronchodilator forced expiratory volume in 1 s, were comparable between the two groups. More smokers had emphysema than non-smokers (EI 10.0 vs. 6.5, P < .001), but after accounting the potential confounders in model analysis, the difference was borderline significance (P = .051). In the subgroup of biomass smoke-exposed subjects, MWA% was significantly greater in smokers than in non-smokers (MWA 69.1 vs. 65.3, P = .03), while EI was not statistically different (EI 7.1 vs. 10.4, P = .52). CONCLUSIONS Non-smoker males with COPD were younger and had a greater BMI than the smokers. Tobacco smoke exposure seemed to be associated with an emphysema-predominant phenotype, while biomass smoke exposure exhibited a significant interaction with tobacco smoking in an airway-predominant phenotype.
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Affiliation(s)
- Wonjun Ji
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, Korea
| | - Myoung Nam Lim
- Department of Respiratory Center, Kangwon National University Hospital, 156, Baengyeong-ro, Chuncheon-si, Gangwon-do, Korea
| | - So Hyeon Bak
- Department of Radiology, Kangwon National University Hospital, 156, Baengyeong-ro, Chuncheon-si, Gangwon-do, Korea
| | - Seok-Ho Hong
- Department of Internal Medicine and Environmental Health Center, Kangwon National University Hospital, 156, Baengyeong-ro, Chuncheon-si, Gangwon-do, Korea
| | - Seon-Sook Han
- Department of Internal Medicine and Environmental Health Center, Kangwon National University Hospital, 156, Baengyeong-ro, Chuncheon-si, Gangwon-do, Korea
| | - Seung-Joon Lee
- Department of Internal Medicine and Environmental Health Center, Kangwon National University Hospital, 156, Baengyeong-ro, Chuncheon-si, Gangwon-do, Korea
| | - Woo Jin Kim
- Department of Internal Medicine and Environmental Health Center, Kangwon National University Hospital, 156, Baengyeong-ro, Chuncheon-si, Gangwon-do, Korea
| | - Yoonki Hong
- Department of Internal Medicine and Environmental Health Center, Kangwon National University Hospital, 156, Baengyeong-ro, Chuncheon-si, Gangwon-do, Korea
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Kim S, Han SS. In reply. Int J Tuberc Lung Dis 2016; 20:1417-1418. [DOI: 10.5588/ijtld.16.0460-2] [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: 11/10/2022] Open
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25
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Hahm CR, Lim MN, Kim HY, Hong SH, Han SS, Lee SJ, Kim WJ, Hong Y. Implications of the pulmonary artery to ascending aortic ratio in patients with relatively mild chronic obstructive pulmonary disease. J Thorac Dis 2016; 8:1524-31. [PMID: 27499939 DOI: 10.21037/jtd.2016.05.79] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 11/06/2022]
Abstract
BACKGROUND Identifying markers for predicting the course and outcome of chronic obstructive pulmonary disease (COPD) remains important. The relative pulmonary artery enlargement to aorta ratio (PA-A ratio), which is measured using computed tomography (CT), is a reported predictor for COPD exacerbation and mortality. However, little is known about the implications of the PA-A ratio in patients with mild COPD. METHODS We investigated the utility of the PA-A ratio as a biomarker in patients with relatively mild COPD. A total of 131 patients with mild to moderate COPD [post-bronchodilator forced expiratory volume in 1 sec (FEV1)/forced vital capacity (FVC) 61.6±6.4, mean post-bronchodilator FEV1 83%±17.8% of predicted value] were selected from a Korean COPD cohort (from 2012 until the end of 2014) and analyzed retrospectively. We determined the correlation between the PA-A ratio and clinical parameters using a linear regression model. RESULTS The COPD assessment test (P=0.04), FEV1 (P=0.03), and a history of exacerbation in the last year (P=0.03) were significant factors in the univariate linear regression analysis. Post-bronchodilator FEV1 was most significantly associated with the PA-A ratio in the multivariate analysis (P=0.01). CONCLUSIONS The PA-A ratio evaluated by CT imaging was independently correlated with a representative pulmonary function factor (FEV1) in patients with relatively mild COPD. The results suggest that the PA-A ratio may be an important biomarker for clinical outcome in patients with mild COPD.
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Affiliation(s)
- Cho Rom Hahm
- Department of School of Medicine, Kangwon National University, Chuncheon, Korea
| | - Myoung Nam Lim
- Department of Respiratory Center, Kangwon National University Hospital, Chuncheon, Korea
| | - Hee Yeong Kim
- Department of Radiology, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea
| | - Seok-Ho Hong
- Stem Cell Institute, Kangwon National University, Chuncheon, Korea
| | - Seon-Sook Han
- Department of Internal Medicine and Environmental Health Center, Kangwon National University Hospital, Chuncheon, Korea
| | - Seung-Joon Lee
- Department of Internal Medicine and Environmental Health Center, Kangwon National University Hospital, Chuncheon, Korea
| | - Woo Jin Kim
- Department of Internal Medicine and Environmental Health Center, Kangwon National University Hospital, Chuncheon, Korea
| | - Yoonki Hong
- Department of Internal Medicine and Environmental Health Center, Kangwon National University Hospital, Chuncheon, Korea
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Abstract
BACKGROUND There is growing evidence about sex-related phenotypes of COPD. However, the sex differences in COPD mainly result from smokers. This study evaluated the sex differences in nonsmoking patients with COPD, focusing on structural changes in the lungs in airway diseases and emphysema. METHODS Ninety-seven nonsmoking patients, defined as having <1 pack-year of lifetime cigarette smoking, diagnosed with COPD were selected from a Korean COPD cohort. Emphysema extent and mean wall area percentage (WA%) on computed tomography were compared between the male and female groups. RESULTS The 97 patients with COPD included 62 females and 35 males. Emphysema index was significantly lower (3.5±4.2 vs 6.2±5.7, P<0.01) and mean WA% on computed tomography was significantly higher (71.8%±5% vs 69.4%±5%, P<0.01) in females than in males, after adjusting for age, body mass index, history of biomass exposure, and postbronchodilator forced expiratory volume in 1 second (% of predicted). CONCLUSION WA% was higher and emphysema extent was lower in nonsmoking females with COPD than in nonsmoking males with COPD. These findings suggest that males may be predisposed to an emphysema phenotype and females may be predisposed to an airway phenotype of COPD.
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Affiliation(s)
- Yoonki Hong
- Department of Internal Medicine, Environmental Health Center, Kangwon National University Hospital, Chuncheon, South Korea
| | - Wonjun Ji
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Soojeong An
- Department of Statistics, Kangwon National University, Chuncheon, South Korea
| | - Seon-Sook Han
- Department of Internal Medicine, Environmental Health Center, Kangwon National University Hospital, Chuncheon, South Korea
| | - Seung-Joon Lee
- Department of Internal Medicine, Environmental Health Center, Kangwon National University Hospital, Chuncheon, South Korea
| | - Woo Jin Kim
- Department of Internal Medicine, Environmental Health Center, Kangwon National University Hospital, Chuncheon, South Korea
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Han SS, Lee WH, Hong Y, Kim WJ, Yang J, Lim MN, Lee SJ, Kwon JW. Comparison of serum biomarkers between patients with asthma and with chronic obstructive pulmonary disease. J Asthma 2016; 53:583-8. [PMID: 27104648 DOI: 10.3109/02770903.2015.1056347] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE Asthma and chronic obstructive pulmonary disease (COPD) have distinct pathophysiological mechanisms but sometimes share similar clinical manifestations. Distinguishing between these diseases is important. This study compared the profiles of serum biomarkers between patients with asthma and those with COPD. METHODS Serum levels of the chitinase like protein YKL-40, periostin, interleukin (IL)-18, and chemokine (C--C motif) ligand 18 (CCL18) were measured in asthma patients (n = 20), COPD patients (n = 16), and normal controls (n = 20). RESULTS Serum levels of YKL-40 were higher in COPD patients [median (range), 55 (17-565) versus 208 (74-922) ng/mL, p < 0.0001], but no differences were observed between asthma and COPD patients after adjusting for age and forced expiratory volume in 1 s (FEV1). No differences in serum levels of periostin, IL-18, or CCL18 were observed between the patient groups. Total IgE and airway hypersensitivity were negatively correlated (r = -0.485, p = 0.007). CCL18 levels were related to patients' age in asthmatic patients (r = -0.562, p = 0.010). Serum levels of CCL18 and IL-18 were positively correlated in patients with COPD (r = 0.696, p = 0.003). CONCLUSIONS No differences in the serum profiles of periostin, IL-18, or CCL18 were observed between patients with asthma and those with COPD. Serum levels of YKL-40 were not different between asthma and COPD patients after adjusting for age and FEV1. There were negative correlation between CCL18 and age in patients with asthma and positive correlation between IL-18 and CCL18 in patients with COPD.
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Affiliation(s)
- Seon-Sook Han
- a Department of Internal Medicine , Kangwon National University College of Medicine , Chuncheon , Korea.,b Environmental Health Center , Kangwon National University Hospital , Chuncheon , Korea
| | - Won Ho Lee
- a Department of Internal Medicine , Kangwon National University College of Medicine , Chuncheon , Korea
| | - Yoonki Hong
- a Department of Internal Medicine , Kangwon National University College of Medicine , Chuncheon , Korea.,b Environmental Health Center , Kangwon National University Hospital , Chuncheon , Korea
| | - Woo Jin Kim
- a Department of Internal Medicine , Kangwon National University College of Medicine , Chuncheon , Korea.,b Environmental Health Center , Kangwon National University Hospital , Chuncheon , Korea
| | - JeongHee Yang
- c Department of Family Medicine , Kangwon National University School of Medicine , Chuncheon , Korea
| | - Myoung Nam Lim
- d Regional Center for Respiratory Diseases , Kangwon National University Hospital , Chuncheon , Korea
| | - Seung-Joon Lee
- a Department of Internal Medicine , Kangwon National University College of Medicine , Chuncheon , Korea.,b Environmental Health Center , Kangwon National University Hospital , Chuncheon , Korea
| | - Jae-Woo Kwon
- a Department of Internal Medicine , Kangwon National University College of Medicine , Chuncheon , Korea.,b Environmental Health Center , Kangwon National University Hospital , Chuncheon , Korea.,e Department of Allergy and Clinical Immunology , Kangwon National University Hospital , Chuncheon , Korea
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Han SS, Kim HJ, Lee SJ, Kim WJ, Hong Y, Lee HY, Song SY, Jung HH, Ahn HS, Ahn IM, Baek H. Effects of Renal Replacement Therapy in Patients Receiving Extracorporeal Membrane Oxygenation: A Meta-Analysis. Ann Thorac Surg 2015; 100:1485-95. [PMID: 26341602 DOI: 10.1016/j.athoracsur.2015.06.018] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 05/29/2015] [Accepted: 06/01/2015] [Indexed: 11/26/2022]
Abstract
The use of renal replacement therapy (RRT) in patients receiving extracorporeal membrane oxygenation (ECMO) is increasing, but the effect of RRT on ECMO is controversial. We performed a meta-analysis to determine whether RRT is related to higher mortality in patients receiving ECMO. We searched MEDLINE, EMBASE, the Cochrane Library, and KoreaMed and found 43 observational studies with 21,624 patients receiving ECMO and then compared inpatient mortality rates of patients receiving ECMO both with and without RRT. The risk ratio (RR) of mortality between patients receiving RRT and those not receiving RRT tended to decrease as the mortality of the group not receiving RRT increased. Among patients with RRT use rates of 30% and higher, the overall mortality rates for all patients receiving ECMO tended to decrease. We found that the increase in the RR for RRT tended to be greater the longer the initiation of RRT was delayed. We suggest that in patients receiving ECMO who have high RRT use rates, RRT may decrease mortality rates.
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Affiliation(s)
- Seon-Sook Han
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Kangwon National University, Chuncheon-si, Kangwon-do, Republic of Korea; Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon-si, Kangwon-do, Republic of Korea
| | - Hyun Jung Kim
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Seung Joon Lee
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Kangwon National University, Chuncheon-si, Kangwon-do, Republic of Korea; Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon-si, Kangwon-do, Republic of Korea
| | - Woo Jin Kim
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Kangwon National University, Chuncheon-si, Kangwon-do, Republic of Korea; Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon-si, Kangwon-do, Republic of Korea
| | - Youngi Hong
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Kangwon National University, Chuncheon-si, Kangwon-do, Republic of Korea; Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon-si, Kangwon-do, Republic of Korea
| | - Hui-Young Lee
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon-si, Kangwon-do, Republic of Korea
| | - Seo-Young Song
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon-si, Kangwon-do, Republic of Korea
| | - Hae Hyuk Jung
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon-si, Kangwon-do, Republic of Korea; Division of Nephrology, School of Medicine, Kangwon National University, Chuncheon-si, Kangwon-do, Republic of Korea
| | - Hyeong Sik Ahn
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Il Min Ahn
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea; Department of Literary Arts, Brown University, Providence, Rhode Island
| | - Hyunjeong Baek
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon-si, Kangwon-do, Republic of Korea; Division of Nephrology, School of Medicine, Kangwon National University, Chuncheon-si, Kangwon-do, Republic of Korea.
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Lee HY, Han SS, Rhee H, Park JH, Lee JS, Oh YM, Choi SS, Shin SH, Kim WJ. Differential expression of microRNAs and their target genes in non-small-cell lung cancer. Mol Med Rep 2014; 11:2034-40. [PMID: 25376560 DOI: 10.3892/mmr.2014.2890] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 09/09/2014] [Indexed: 11/06/2022] Open
Abstract
MicroRNAs (miRNAs) are single‑stranded RNA species that constitute a class of non‑coding RNAs, and are emerging as key regulators of gene expression. Since each miRNA is capable of regulating multiple genes, miRNAs are attractive markers for studies of coordinated gene expression. In this study, we investigated miRNA expression profiling using a massively parallel sequencing technique to compare non‑small‑cell lung cancer (NSCLC) tissue and normal lung tissue. Lung cancer tissue and normal lung tissue were obtained from nine NSCLC patients. RNA isolated from these samples was processed using RNA sequencing (RNA Seq) and the HiSeq 2000 system. Differentially expressed miRNAs and mRNAs were analyzed using a t‑test. We selected target pairs that showed a negative correlation among significantly differentially expressed miRNAs and their putative target mRNAs using miRBase Targets. The differences in the expression levels of 222 miRNAs and 1,597 genes were statistically significant, as indicated by an absolute fold change ≥1.5 and P<0.05. miR‑577, miR‑301b, miR‑944, miR‑891a and miR‑615‑3p were generally upregulated, and miR‑338‑3p was generally downregulated. miRNA‑mRNA target pair analysis revealed that 49 miRNAs had 696 target mRNAs. There were significantly differentially expressed miRNAs and mRNAs between lung cancer and normal tissue. Further investigation of miRNAs and their target genes is warranted to better understand NSCLC.
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Affiliation(s)
- Hui-Young Lee
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon-si, Gangwon-do 200-722, Republic of Korea
| | - Seon-Sook Han
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon-si, Gangwon-do 200-722, Republic of Korea
| | - Hwanseok Rhee
- Macrogen Bioinformatics Center, Macrogen, Seoul 153-023, Republic of Korea
| | - Jung Hoon Park
- Macrogen Bioinformatics Center, Macrogen, Seoul 153-023, Republic of Korea
| | - Jae Seung Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Republic of Korea
| | - Yeon-Mok Oh
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Republic of Korea
| | - Sun Shim Choi
- Department of Medical Biotechnology, College of Biomedical Science and Institute of Bioscience and Biotechnology, Kangwon National University, Chuncheon-si, Gangwon-do 200-701, Republic of Korea
| | - Seung-Ho Shin
- Department of Medical Biotechnology, College of Biomedical Science and Institute of Bioscience and Biotechnology, Kangwon National University, Chuncheon-si, Gangwon-do 200-701, Republic of Korea
| | - Woo Jin Kim
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon-si, Gangwon-do 200-722, Republic of Korea
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Chon SB, Kim TS, Oh WS, Lee SJ, Han SS, Kim WJ. Pulmonary tuberculosis among patients hospitalised with community-acquired pneumonia in a tuberculosis-prevalent area. Int J Tuberc Lung Dis 2014; 18:761-2. [PMID: 24200280 DOI: 10.5588/ijtld.13.0183] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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 suburban teaching hospital in a tuberculosis (TB) prevalent area. OBJECTIVES To evaluate the proportion of pulmonary TB among patients hospitalised with suspected community-acquired pneumonia (CAP), and to develop a diagnostic index for identifying TB among these patients. DESIGN TB cases confirmed using 1) sputum culture, or 2) both sputum acid-fast bacilli smear and polymerase chain reaction for Mycobacterium tuberculosis, were compared with non-tuberculous CAP by demographic, clinical, laboratory and radiographic information. Using multiple logistic regression analysis, risk factors for TB were identified. A diagnostic index was developed by summing up their simplified regression coefficients. Its performance was checked using c-statistic. RESULTS TB was the second leading cause of CAP (37/528, 7.0%). Risk factors were initial symptoms >7 days, serum albumin <3.5 g/dl, cavitary/nodular infiltrates and upper lobe involvement (1 point for each). The c-statistic of the index was 0.856 (95%CI 0.789-0.923), and for bootstrapping samples of 1000 repetitions it was 0.856 (95%CI 0.791-0.921). For scores ≥2, sensitivity and specificity were respectively 81.1% and 75.8%. CONCLUSION TB is one of the leading causes of CAP in TB-prevalent areas. Our diagnostic index may help clinicians identify TB immediately from CAP and initiate appropriate isolation and optimal treatment.
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Affiliation(s)
- S-B Chon
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea
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Han SS, Kim WJ, Hong Y, Hong SH, Lee SJ, Ryu DR, Lee W, Cho YH, Lee S, Ryu YJ, Won JY, Rhee H, Park JH, Jang SJ, Lee JS, Choi CM, Lee JC, Lee SD, Oh YM. RNA sequencing identifies novel markers of non-small cell lung cancer. Lung Cancer 2014; 84:229-35. [PMID: 24751108 DOI: 10.1016/j.lungcan.2014.03.018] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 01/29/2014] [Accepted: 03/17/2014] [Indexed: 12/24/2022]
Abstract
INTRODUCTION The development of reliable gene expression profiling technology increasingly impacts our understanding of lung cancer biology. Here, we used RNA sequencing (RNA-Seq) to compare the transcriptomes of non-small cell lung cancer (NSCLC) and normal lung tissues and to investigate expression in lung cancer tissues. METHODS We enrolled 88 male patients (mean age, 61.2 years) with NSCLC. RNA-Seq was performed on 88 pairs of NSCLC tumor tissue and non-tumor tissue from 54 patients with adenocarcinoma and 34 patients with squamous cell carcinoma. Immunohistochemistry was performed to validate differential candidate gene expression in a different NSCLC group. RESULTS RNA-Seq produced 25.41 × 10(6) (± 8.90 × 10(6)) reads in NSCLC tissues and 24.70×10(6) (± 4.70 × 10(6)) reads in normal lung tissues [mean (± standard deviation)]. Among the genes expressed in both tissues, 335 were upregulated and 728 were downregulated ≥ 2-fold (p < 0.001). Four upregulated genes - CBX3, GJB2, CRABP2, and DSP - not previously reported in lung cancer were studied further. Their altered expression was verified by immunohistochemistry in a different set of NSCLC tissues (n = 154). CBX3 was positive in 90.3% (139 cases) of the samples; GJB2, in 22.7% (35 cases); CRABP2, in 72.1% (111 cases); and DSP, in 17.5% (27 cases). The positive rate of CRABP2 was higher in adenocarcinoma than squamous cell carcinoma (p < 0.01). CONCLUSIONS CBX3 and CRABP2 expression was markedly increased in lung cancer tissues and especially CRABP2 may be promising candidate genes in lung adenocarcinoma.
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Affiliation(s)
- Seon-Sook Han
- Department of Internal Medicine, School of Medicine, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon-si, Kangwon-do 200-701, Republic of Korea
| | - Woo Jin Kim
- Department of Internal Medicine, School of Medicine, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon-si, Kangwon-do 200-701, Republic of Korea
| | - Yoonki Hong
- Department of Internal Medicine, School of Medicine, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon-si, Kangwon-do 200-701, Republic of Korea
| | - Seok-Ho Hong
- Department of Internal Medicine, School of Medicine, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon-si, Kangwon-do 200-701, Republic of Korea
| | - Seung-Joon Lee
- Department of Internal Medicine, School of Medicine, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon-si, Kangwon-do 200-701, Republic of Korea
| | - Dong Ryeol Ryu
- Department of Internal Medicine, School of Medicine, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon-si, Kangwon-do 200-701, Republic of Korea
| | - Wonho Lee
- Department of Internal Medicine, School of Medicine, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon-si, Kangwon-do 200-701, Republic of Korea
| | - Yo Han Cho
- Department of Internal Medicine, School of Medicine, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon-si, Kangwon-do 200-701, Republic of Korea
| | - Seungkoo Lee
- Department of Anatomic Pathology, School of Medicine, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon-si, Kangwon-do 200-701, Republic of Korea
| | - Young-Joon Ryu
- Department of Pathology, School of Medicine, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon-si, Kangwon-do 200-701, Republic of Korea
| | - Jun Yeon Won
- Department of Otolaryngology, School of Medicine, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon-si, Kangwon-do 200-701, Republic of Korea
| | - Hwanseok Rhee
- Macrogen Bioinformatics Center, Macrogen, Seoul 153-781, Republic of Korea
| | - Jung Hoon Park
- Macrogen Bioinformatics Center, Macrogen, Seoul 153-781, Republic of Korea
| | - Se Jin Jang
- Department of Pathology and Asan Center for Cancer Genome Discovery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea
| | - Jae Seung Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea; Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea
| | - Chang-Min Choi
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea
| | - Jae Cheol Lee
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea
| | - Sang Do Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea; Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea
| | - Yeon-Mok Oh
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea; Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea.
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Lee W, Ryu DR, Han SS, Ryu SW, Cho BR, Kwon H, Kim BR. Very early onset of amiodarone-induced pulmonary toxicity. Korean Circ J 2013; 43:699-701. [PMID: 24255655 PMCID: PMC3831017 DOI: 10.4070/kcj.2013.43.10.699] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 05/09/2013] [Accepted: 05/29/2013] [Indexed: 11/29/2022] Open
Abstract
Amiodarone is a widely used antiarrhythmic agent. Among its various adverse effects, amiodarone-induced pulmonary toxicity (APT) is the most life threatening complication, which has been described mostly in patients who have been in treatment with high accumulative doses for a long duration of time. However, amiodarone therapy in short-term duration induced APT was rarely reported. We describe a case of a 54-year-old man who is presented with symptoms of APT after a few days of therapy for post-myocardial infarction ventricular tachycardia. For early diagnosis and successful treatment, awareness and high suspicion of this rare type of early onset APT is crucial in patients with amiodarone therapy.
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Affiliation(s)
- Wonho Lee
- Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, Korea
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Han SS, Lee SJ, Kim WJ, Ryu DR, Won JY, Park S, Cheon MJ. Plasma osteopontin is a useful diagnostic biomarker for advanced non-small cell lung cancer. Tuberc Respir Dis (Seoul) 2013; 75:104-10. [PMID: 24101934 PMCID: PMC3790021 DOI: 10.4046/trd.2013.75.3.104] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Revised: 05/10/2013] [Accepted: 05/31/2013] [Indexed: 01/01/2023] Open
Abstract
Background Osteopontin (OPN) and carbonic anhydrase IX (CAIX), which are expressed on the surface of tumor cells, are associated with hypoxia during tumor development and progression. However, the roles of these proteins in the plasma of patients with non-small cell lung cancer (NSCLC) are poorly understood. Herein, we hypothesized that plasma OPN and CAIX levels could be used as diagnostic and prognostic tumor markers in patients with NSCLC. Methods Fifty-three patients with NSCLC and 50 healthy control subjects were enrolled. We selected controls without malignancy and matched them with NSCLC patient cases according to age and gender. Blood samples were collected at the time of diagnosis; the plasma levels of OPN and CAIX were measured by enzyme-linked immunosorbent assays. Results The plasma levels of OPN in the patients with NSCLC were significantly elevated as compared to those in the controls (p=0.016). However, there was no difference in the plasma level of CAIX between the NSCLC patients and controls. NSCLC patients with a distant metastasis had a remarkable increase in plasma OPN compared with patients without metastasis (p=0.026), but no such correlation was found for CAIX. There was no difference in overall survival rates according to the plasma level of OPN between the two groups (by Kaplan-Meier survival analysis). Conclusion Plasma OPN levels were elevated in patients with NSCLC as compared with the controls, with greater elevation of OPN levels in the advanced stages of disease. Therefore, plasma OPN may have utility as a diagnostic, but not prognostic, biomarker of advanced NSCLC.
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Affiliation(s)
- Seon-Sook Han
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
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Lee HA, Kim HR, Lee YJ, Lee SJ, Kim WJ, Han SS, Yang SR, Woo HM, Na S, Song H, Hong SH. Immunolocalisation and oestrogen regulation of small proline-rich protein 2a protein in the mouse uterus. Reprod Fertil Dev 2013; 26:682-9. [PMID: 23735658 DOI: 10.1071/rd12408] [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] [Received: 12/24/2012] [Accepted: 04/21/2013] [Indexed: 11/23/2022] Open
Abstract
Small proline-rich protein 2a (Sprr2a) is one of the structural components of the cornified keratinocyte cell envelope that contributes to form a protective barrier in the skin against dehydration and environmental stress. Interestingly, Sprr2a mRNA is detected in the mouse uterus and is regulated by 17β-oestradiol (E2). In the present study, we investigated the effects of E2 and oestrogenic compounds on the regulation and localisation of Sprr2a protein in the mouse uterus. Immunohistochemical staining revealed that Sprr2a protein is detected only in the adult uterus, and not in the ovary, oviduct or testis. We also demonstrated that Sprr2a protein is tightly regulated by E2 in the mouse uterus and exclusively detected in luminal and glandular epithelial cells. Furthermore, Sprr2a is dose-dependently induced by oestrogenic compounds such as bisphenol A and 4-tert-octylphenol. Collectively, our studies suggest that Sprr2a protein may have a unique function in physiological events in the mouse uterus and can be used as an indicator to detect compounds with oestrogenic activity in the mouse uterus.
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Affiliation(s)
- Hyang-Ah Lee
- Department of Obstertics and Gynecology, School of Medicine, Kangwon National University, Chuncheon 200-701, South Korea
| | - Hye-Ryun Kim
- Department of Biomedical Science, CHA University, Seoul 135-081, South Korea
| | - Young Jin Lee
- Center for Biomedical Engineering and Technology and Department of Anatomy and Neurobiology, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Seung-Joon Lee
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon 200-701, South Korea
| | - Woo Jin Kim
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon 200-701, South Korea
| | - Seon-Sook Han
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon 200-701, South Korea
| | - Se-Ran Yang
- Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kangwon National University, Chuncheon 200-701, South Korea
| | - Heung-Myong Woo
- College of Veterinary Medicine, Kangwon National Univeristy, Chuncheon 200-701, South Korea
| | - Sunghun Na
- Department of Obstertics and Gynecology, School of Medicine, Kangwon National University, Chuncheon 200-701, South Korea
| | - Haengseok Song
- Department of Biomedical Science, CHA University, Seoul 135-081, South Korea
| | - Seok-Ho Hong
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon 200-701, South Korea
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Kim KH, Song SY, Lim KH, Han SS, Kim SH, Cho JH, Park CW, Lee S, Lee HY. Interstitial Pneumonitis after Treatment with Pemetrexed for Non-small Cell Lung Cancer. Cancer Res Treat 2013; 45:74-7. [PMID: 23613674 PMCID: PMC3629367 DOI: 10.4143/crt.2013.45.1.74] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Accepted: 08/03/2011] [Indexed: 11/21/2022] Open
Abstract
Pemetrexed is approved as a first-line treatment for advanced non-squamous non-small cell lung cancer (NSCLC) with cisplatin and as a single agent for second-line treatment or for patients who show no disease progression after four cycles of platinum-based doublet induction chemotherapy as maintenance therapy. Pemetrexed has a modest toxicity profile and has not traditionally been regarded as a cause of interstitial pneumonitis. Here, we report on a rare case of pemetrexed-induced pneumonitis in a patient with NSCLC.
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Affiliation(s)
- Kyeong-Hyun Kim
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea
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Kwon JW, Han YJ, Oh MK, Lee CR, Han SS, Lee SJ, Kim WJ. An Analysis of Asthma Exacerbations and Weather Conditions in Chuncheon. J Allergy Clin Immunol 2013. [DOI: 10.1016/j.jaci.2012.12.1238] [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: 10/27/2022]
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Guo L, Han SS, Liu X, Cheng Y, Xu ZZ, Fan J, Chen J, Chen SG, Becker W, Blaga CI, DiChiara AD, Sistrunk E, Agostini P, DiMauro LF. Scaling of the low-energy structure in above-threshold ionization in the tunneling regime: theory and experiment. Phys Rev Lett 2013; 110:013001. [PMID: 23383786 DOI: 10.1103/physrevlett.110.013001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Indexed: 06/01/2023]
Abstract
A calculation of the second-order (rescattering) term in the S-matrix expansion of above-threshold ionization is presented for the case when the binding potential is the unscreened Coulomb potential. Technical problems related to the divergence of the Coulomb scattering amplitude are avoided in the theory by considering the depletion of the atomic ground state due to the applied laser field, which is well defined and does not require the introduction of a screening constant. We focus on the low-energy structure, which was observed in recent experiments with a midinfrared wavelength laser field. Both the spectra and, in particular, the observed scaling versus the Keldysh parameter and the ponderomotive energy are reproduced. The theory provides evidence that the origin of the structure lies in the long-range Coulomb interaction.
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Affiliation(s)
- L Guo
- Key Laboratory for Quantum Optics and Center for Cold Atom Physics, Shanghai Institute of Optics and Fine Mechanics, Chinese Academy of Sciences, Shanghai 201800, China
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Abstract
OBJECTIVE To assess the effect of Ginkgo biloba and clonazepam, a γ-aminobutyric acid (GABA)-receptor agonist, upon tinnitus. METHODS This was an open-label, randomised, crossover study. 27 men and 11 women (aged 16-80 (mean 58)) with tinnitus for more than 2 months were enrolled. Participants were randomised to either clonazepam or G biloba for the first 3 weeks. For the next 2 weeks of washout no medication was taken. For the final 3 weeks, subjects were given the other drug. The initial dose of clonazepam and G biloba was one tablet daily (clonazepam 0.5 mg; G biloba 40 mg). Subjects were instructed to increase the dose by one tablet every 3 days to a maximum of four tablets daily until they perceived a satisfactory decrease in tinnitus loudness or intolerable side effects. Tinnitus was assessed with pitch and loudness matching, tinnitus handicap inventory, and visual analogue scales of loudness, duration and annoyance. RESULTS Comparing before and after each drug, clonazepam significantly improved tinnitus loudness (74% of subjects), duration (63%), annoyance (79%), and tinnitus handicap inventory score (61%), whereas the G biloba showed no significant differences on any of these measures. CONCLUSION Clonazepam is effective in treating tinnitus; G biloba is ineffective.
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Affiliation(s)
- Seon-Sook Han
- Department of Internal Medicine, Kangwon National University, School of Medicine, Chuncheon, Republic of Korea
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Ryu JH, Han SS, Choi WJ, Kim H, Lee SC, Do SH, Son YK. Ultrasonographic investigation of the effect of positive end-expiratory pressure on the cross-sectional area of the femoral vein. Int J Cardiovasc Imaging 2012; 29:295-9. [PMID: 22772474 DOI: 10.1007/s10554-012-0089-2] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Accepted: 06/20/2012] [Indexed: 10/28/2022]
Abstract
Femoral veins are commonly used as a relatively safe alternative route for central venous cannulation. Several maneuvers are used to increase the cross-sectional area of the vein. In this study, we assessed the effect of positive end-expiratory pressure (PEEP) on the cross-sectional area (CSA) of femoral veins, using ultrasound in adult patients under positive pressure ventilation. All patients received a standardized induction of general anesthesia and intravenous fluid administration. Using ultrasound, the cross-sectional areas of both femoral veins were measured in 57 adult patients in the supine position without PEEP (control) and in the supine position with PEEP of 10 cm H(2)O. Mean arterial pressure and heart rate were recorded before and after the application of PEEP at 10 cm H(2)O. The application of 10 cm H(2)O PEEP significantly increased the CSA of the right femoral vein by 47.6 % and the left femoral vein by 48.4 % (each P < 0.001). Mean arterial pressure decreased by 2.6 mmHg (95 % CI 1.3-3.9; P < 0.001), whereas no significant change in heart rate was observed (P = 0.861). The CSA of the femoral vein is augmented with the application of 10 cm H(2)O PEEP in adult patients undergoing positive pressure ventilation.
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Affiliation(s)
- J H Ryu
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
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Lee KH, Cho SJ, Ryu SM, Park SM, Yie KS, Han SS. Fluid-filled Giant Bulla Treated with Percutaneous Drainage and Talc Sclerotherapy: A Modified Brompton Technique. Korean J Thorac Cardiovasc Surg 2012; 45:134-7. [PMID: 22500287 PMCID: PMC3322186 DOI: 10.5090/kjtcs.2012.45.2.134] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [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: 08/26/2011] [Revised: 09/23/2011] [Accepted: 10/16/2011] [Indexed: 11/26/2022]
Abstract
A 75-year-old man who was diagnosed as having a fluid-filled giant bulla was treated with a modified Brompton technique due to his poor performance status. Percutaneous drainage, suction, and talc sclerotherapy through a Foley catheter can be good treatment options for patients with conditions that are too poor to allow surgical intervention, especially if there is adhesion between a giant bulla and parietal pleura. Talc can also be used safely when mixed with normal saline as a sclerosant.
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Affiliation(s)
- Kyung-Hak Lee
- Department of Thoracic and Cardiovascular Surgery, Kangwon National University Hospital, Kangwon National University School of Medicine, Korea
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41
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Cho SY, Han SS, Park SJ, Kim YK, Kim SH, Woo SM, Lee WJ, Kim TH, Hong EK. T-category reflects the histopathologic characteristics of gallbladder cancer. Eur J Surg Oncol 2012; 38:537-42. [PMID: 22284345 DOI: 10.1016/j.ejso.2012.01.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Revised: 10/11/2011] [Accepted: 01/09/2012] [Indexed: 02/06/2023] Open
Abstract
AIMS Gallbladder (GB) cancer is a relatively uncommon gastrointestinal malignancy and is known to often result in unfavorable outcomes. Recent advances in aggressive surgical resection have improved the overall survival rate of patients with GB cancer. We aimed to evaluate the outcomes and prognostic factors of GB cancer following a surgical resection with curative intent. METHODS Between March 2001 and March 2009, 89 patients with GB cancer underwent surgical resection with curative intent at the National Cancer Center of Korea. We then conducted a retrospective analysis of clinicopathologic data. RESULTS Nineteen patients underwent simple cholecystectomy and 70 patients underwent extended cholecystectomy. Tumor-free resection margins were obtained in 84 cases. The 1-, 3- and 5-year disease-specific survival rates in the 89 patients were 85.8%, 68.0% and 64.1%, respectively. By multivariate analysis, only the T-category was significant (p < 0.001). The T-category showed a close correlation with all of the other histopathologic factors which were significant in univariate analysis. CONCLUSION The T-category of GB cancer represents not only the depth of the primary tumor but also the aggressiveness of its histopathologic nature.
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Affiliation(s)
- S Y Cho
- Center for Liver Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410 769, Republic of Korea
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42
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Lim KR, Kang MH, Kim TS, Moon KW, Ryu DR, Lee HY, Han SS. A Case of Multi-Organ Macronodular Tuberculosis. Tuberc Respir Dis (Seoul) 2012. [DOI: 10.4046/trd.2012.72.1.88] [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: 11/24/2022] Open
Affiliation(s)
- Kyoung Ree Lim
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Myung Ho Kang
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Tae-Suk Kim
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Ki-Won Moon
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Dong Ryeol Ryu
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Hui Young Lee
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Seon-Sook Han
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
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43
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Kim SH, Kim KH, Kim TS, Han SS, Moon KW. A Case of a Patient with Dermatomyositis Who Developed a Diffuse Alveolar Hemorrhage. J Rheum Dis 2011. [DOI: 10.4078/jrd.2011.18.2.125] [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: 11/22/2022]
Affiliation(s)
- Se-Hyun Kim
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - Kyung-Hyun Kim
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - Tae-Suk Kim
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - Seon-Sook Han
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - Ki-Won Moon
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea
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44
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Han SS, Kim SH, Kim WJ, Lee SJ, Ryu SW, Cheon MJ. Diagnostic Role of C-reactive Protein, Procalcitonin and Lipopolysaccharide-Binding Protein in Discriminating Bacterial-Community Acquired Pneumonia from 2009 H1N1 Influenza A Infection. Tuberc Respir Dis (Seoul) 2011. [DOI: 10.4046/trd.2011.70.6.490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Seon-Sook Han
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Se-Hyun Kim
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Woo Jin Kim
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Seung-Joon Lee
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Sook-Won Ryu
- Department of Laboratory Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Myeong Ju Cheon
- Clinical Research Institute of Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea
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45
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Kim KH, Kim SH, Heo JW, Lee SH, Han SS, Lee SJ, Kim WJ. A Case of Massive Empyema Caused by Streptococcus constellatusand Anaerobic Bacteria for Mental Retardation. Tuberc Respir Dis (Seoul) 2011. [DOI: 10.4046/trd.2011.71.6.476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Kyeong-Hyun Kim
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National Univsersity School of Medicine, Chuncheon, Korea
| | - Se-Hyun Kim
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National Univsersity School of Medicine, Chuncheon, Korea
| | - Jeong-Won Heo
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National Univsersity School of Medicine, Chuncheon, Korea
| | - Sang-Hoon Lee
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National Univsersity School of Medicine, Chuncheon, Korea
| | - Seon-Sook Han
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National Univsersity School of Medicine, Chuncheon, Korea
| | - Seoung-Joon Lee
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National Univsersity School of Medicine, Chuncheon, Korea
| | - Woo Jin Kim
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National Univsersity School of Medicine, Chuncheon, Korea
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46
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Han SS, Kim SS, Hong HP, Lee SY, Lee SJ, Lee BK. Massive paradoxical air embolism in brain occurring after central venous catheterization: a case report. J Korean Med Sci 2010; 25:1536-8. [PMID: 20890441 PMCID: PMC2946670 DOI: 10.3346/jkms.2010.25.10.1536] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [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: 10/23/2009] [Accepted: 01/19/2010] [Indexed: 12/03/2022] Open
Abstract
Cerebral air embolism is a rare but fatal complication of central venous catheterization. Here, we report a case of paradoxical cerebral air embolism associated with central venous catheterization. An 85-yr-old man underwent right internal jugular vein catheterization, and became obtunded. Brain MR imaging and CT revealed acute infarction with multiple air bubbles on the side of catheter insertion. The possibility of cerebral air embolism should be considered in patients developing neurological impairment after central venous catheterization, and efforts should be made to limit cerebral damage.
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Affiliation(s)
- Seon-Sook Han
- Department of Internal Medicine, Kangwon National University, School of Medicine, Chuncheon, Korea
| | - Sam Soo Kim
- Neuroscience Research Institute, Kangwon National University, School of Medicine, Chuncheon, Korea
| | - Hyun Pyo Hong
- Neuroscience Research Institute, Kangwon National University, School of Medicine, Chuncheon, Korea
| | - Seo-Young Lee
- Neuroscience Research Institute, Kangwon National University, School of Medicine, Chuncheon, Korea
| | - Seung-Joon Lee
- Department of Internal Medicine, Kangwon National University, School of Medicine, Chuncheon, Korea
| | - Bong-Ki Lee
- Department of Internal Medicine, Kangwon National University, School of Medicine, Chuncheon, Korea
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47
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Han SS, Lee SC, Ro YJ, Min SW, Huh J. Warming the epidural injectate improves first sacral segment block: a randomised double-blind study. Anaesth Intensive Care 2010; 38:690-4. [PMID: 20715733 DOI: 10.1177/0310057x1003800412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study investigated the effect of local anaesthetic temperature on block of the first sacral segment. Twenty-four patients undergoing lumbar epidural anaesthesia at L2-3 or L3-4 were randomly divided in double-blind fashion into two groups to receive 22 ml of lignocaine 2% with adrenaline 1:200,000, sodium bicarbonate and fentanyl, at either 21 degrees C (cold group) or 37 degrees C (warm group). The sensory block was assessed by loss of sensation to pinprick and the pain threshold after repeated electrical stimulation at L2, S1 and S3 dermatomes. Motor block was evaluated using the modified Bromage scale. Patient characteristics were comparable between the groups. Onset of block at the first sacral segment (S1) was faster in the warm group than in the cold (10 vs. 17.5 minutes, P < 0.001). The pain threshold at S1 was significantly higher in the warm group. We concluded that epidural lignocaine 2% with adrenaline 1:200,000, sodium bicarbonate and fentanyl injected at 370C hastens SI block within 10 minutes of administration.
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Affiliation(s)
- S S Han
- Department of Anesthesiology and Pain Medicine, Seoul National University Boramae Metropolitan Hospital, Seoul, South Korea
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Ann Pollack D, Han SS. Recurrent intracranial hemorrhage in an adult with moyamoya vasculopathy and a basilar artery aneurysm. J Stroke Cerebrovasc Dis 2010; 4:267-70. [PMID: 26486250 DOI: 10.1016/s1052-3057(10)80105-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Moyamoya disease is an unusual disorder of the cerebral vasculature, characterized by internal carotid artery occlusions and formation of a collateral network of the intracranial vessels, which resembles a "puff of smoke" ("moyamoya" in Japanese) on cerebral angiography. This condition has a higher-than-usual association with intracranial aneurysms. We present a case of recurrent intracranial hemorrhage in an adult with moyamoya-like vasculopathy and a basilar tip aneurysm.
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Affiliation(s)
- D Ann Pollack
- From the Department of Neurology, Pennsylvania Hospital, Philadelphia, PA, U.S.A
| | - S S Han
- The Department of Radiology, Pennsylvania Hospital, Philadelphia, PA, U.S.A
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Han SS, Yim JJ, Yoo CG, Kim YW, Han SK, Shim YS, Lee SM. Clinical characteristics and risk factors for nosocomial candidemia in medical intensive care units: experience in a single hospital in Korea for 6.6 years. J Korean Med Sci 2010; 25:671-6. [PMID: 20436700 PMCID: PMC2858823 DOI: 10.3346/jkms.2010.25.5.671] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [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: 04/21/2009] [Accepted: 09/28/2009] [Indexed: 01/06/2023] Open
Abstract
The aim of this study was to determine candidemia incidence among patients in a medical intensive-care unit (MICU) and the associated mortality rate and to identify risk factors associated with candidemia. We retrospectively performed a 1:3 matched case-control study of MICU patients with candidemia. Controls were matched for sex, age, and Acute Physiology and Chronic Health Evaluation (APACHE) II score. Candidemia incidence was 9.1 per 1,000 admissions. The most common pathogen was Candida albicans. Crude mortality was 96% among candidemia patients and 52% among controls (P<0.001). Mortality differed significantly between the groups according to Kaplan-Meier survival analysis (P=0.024). Multivariate analysis identified the following independent risk factors for candidemia: central venous catheterization (odds ratio [OR] = 3.2, 95% confidence interval [CI]=1.2-9.0), previous steroid therapy (OR=4.7, 95% CI=1.8-12.1), blood transfusion during the same admission period (OR=6.3, 95% CI=2.4-16.7), and hepatic failure upon MICU admission (OR=6.9, 95% CI=1.7-28.4). In conclusion, we identify an additional independent risk factor for candidemia, the presence of hepatic failure on MICU admission. Therefore, increased awareness of risk factors, including hepatic failure, is necessary for the management of candidemia.
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Affiliation(s)
- Seon-Sook Han
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Jae-Joon Yim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Chul-Gyu Yoo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Young Whan Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Sung Koo Han
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Young-Soo Shim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Sang-Min Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea
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50
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Guo L, Lu RH, Han SS. Molecular dynamics simulation of disorder-induced heating in ultracold neutral plasma. Phys Rev E Stat Nonlin Soft Matter Phys 2010; 81:046406. [PMID: 20481846 DOI: 10.1103/physreve.81.046406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Indexed: 05/29/2023]
Abstract
Disorder-induced heating (DIH) is one of the main reasons reducing the coupling strength in ultracold plasma. We propose applying an optical lattice as periodic confinement before the ultracold atomic cloud is ionized to eliminate its effect. We demonstrate a numerical simulation for the dynamics of the ultracold plasmas using classical molecular dynamics method with open boundary. DIH is reproduced in the simulation with the random Gaussian initial distribution and is absent in the results with the ordered lattice initial distribution. We further find that the collisional heating from electrons is important for ultracold plasmas with chosen spatial correlations in the optical lattice. Carefully preparing the initial condition (e.g., the ion density, initial electron temperature, and so on), collisional heating for the ions would be significantly reduced and eventually negligible. This allows a much stronger coupling in ultracold plasma to be realized.
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Affiliation(s)
- L Guo
- Key Laboratory for Quantum Optics and Center for Cold Atom Physics, Shanghai Institute of Optics and Fine Mechanics, Chinese Academy of Sciences, Shanghai 201800, China
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