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Kim SE, Chun KH, Oh J, Yu HT, Lee CJ, Kim TH, Pak HN, Lee MH, Joung B, Kang SM. Prediction of response to cardiac resynchronization therapy using cardiac magnetic resonance imaging in non-ischemic dilated cardiomyopathy. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1005] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Cardiac resynchronization therapy (CRT) is a well-established therapy for symptomatic heart failure with reduced ejection fraction, but the response is different for individuals. Although many modalities have been conducted to predict CRT response, cardiac magnetic resonance (CMR) to predict CRT response has still insufficient usefulness.
Purpose
We determine whether the parameters including late gadolinium enhancement (LGE) identified in CMR could act as predictors of CRT response.
Methods
We retrospectively investigated 124 patients with non-ischemic dilated cardiomyopathy who underwent CMR before CRT implantation between Jan 2010 and July 2021 in a single center. CRT response was defined as a decrease in left ventricular end-systolic volume (LVESV) >15% on echocardiography after at least 3 months after CRT implantation.
Results
Among the study population (mean age 65.7±11.2 years, mean EF 25±6.5%, 50% of female), 85 (69%) patients were defined as CRT responder. The CRT responders had more left bundle branch block (LBBB) compared with non-responders [79 (92.9%) vs. 23 (59.0%), p<0.001], but there was a no difference of QRS duration (158.7 vs 165.0ms, p=0.054) between two groups. CMR analysis showed that there were no significant differences in the left ventricular (LV) chamber volume and LV ejection fraction between CRT-responder and non-responder. However, the right ventricular (RV) chamber volume was smaller (RV end-diastolic volume index, 86.3 vs 103.5 ml/m2, p=0.039; RV end-systolic volume index, 49.3 vs 68.5 ml/m2, p=0.013) and the RV ejection fraction (RVEF) was higher (46.9 vs 37.6%, p=0.002) in CRT-responders compared with non-responders. The LGE on CMR was more shown in non-responders than in CRT-responders [33 (84.6%) vs 45 (52.9%), p<0.001]. In CMR parameters, RV dysfunction (RVEF <45%) [Odds ratio (OR), 0.21 (0.05–0.93), p=0.045] and LGE [OR, 0.21 (0.05–0.58), p=0.01] were significantly associated with poor CRT response.
Conclusions
The presence of LGE and RV dysfunction on CMR were associated with poor CRT response in patients with non-ischemic dilated cardiomyopathy. Further investigation with CMR for pre-CRT patients is needed to support these results.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S E Kim
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - K H Chun
- NHIS Ilsan Hospital, Cardiology , Goyang , Korea (Republic of)
| | - J Oh
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - H T Yu
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - C J Lee
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - T H Kim
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - H N Pak
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - M H Lee
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - B Joung
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - S M Kang
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
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Park HJ, An WS, Rha SH, Kim SE, Lee SM. Minimal change glomerulonephritis following the second dose of the Moderna COVID-19 vaccine. QJM 2022; 115:490-491. [PMID: 35380707 PMCID: PMC9383619 DOI: 10.1093/qjmed/hcac094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 03/30/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | - S H Rha
- Department of Pathology, College of Medicine, Dong-A University, 26, Daesingongwon-ro, Dongdaesin-dong 3-ga, Seo-gu, Busan 49201, Republic of Korea
| | | | - S M Lee
- Address correspondence to Dr Su Mi Lee, Department of Internal Medicine, College of Medicine, Dong-A University, 26 Daesingongwon-ro, Seo-gu, Busan 49201, Republic of Korea.
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Shin JI, Kim SE, Lee MH, Kim MS, Lee SW, Park S, Shin YH, Yang JW, Song JM, Moon SY, Kim SY, Park Y, Suh DI, Yang JM, Cho SH, Jin HY, Hong SH, Won HH, Kronbichler A, Koyanagi A, Jacob L, Hwang J, Tizaoui K, Lee KH, Kim JH, Yon DK, Smith L. COVID-19 susceptibility and clinical outcomes in autoimmune inflammatory rheumatic diseases (AIRDs): a systematic review and meta-analysis. Eur Rev Med Pharmacol Sci 2022; 26:3760-3770. [PMID: 35647859 DOI: 10.26355/eurrev_202205_28873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This meta-analysis aims to assess the susceptibility to and clinical outcomes of COVID-19 in autoimmune inflammatory rheumatic disease (AIRD) and following AIRD drug use. MATERIALS AND METHODS We included observational and case-controlled studies assessing susceptibility and clinical outcomes of COVID-19 in patients with AIRD as well as the clinical outcomes of COVID-19 with or without use of steroids and conventional synthetic disease-modifying antirheumatic drugs (csDMARDs). RESULTS Meta-analysis including three studies showed that patients with AIRD are not more susceptible to COVID-19 compared to patients without AIRD or the general population (OR: 1.11, 95% CI: 0.58 to 2.14). Incidence of severe outcomes of COVID-19 (OR: 1.34, 95% CI: 0.76 to 2.35) and COVID-19 related death (OR: 1.21, 95% CI: 0.68 to 2.16) also did not show significant difference. The clinical outcomes of COVID-19 among AIRD patients with and without csDMARD or steroid showed that both use of steroid (OR: 1.69, 95% CI: 0.96 to 2.98) or csDMARD (OR: 1.35, 95% CI: 0.63 to 3.08) had no effect on clinical outcomes of COVID-19. CONCLUSIONS AIRD does not increase susceptibility to COVID-19, not affecting the clinical outcome of COVID-19. Similarly, the use of steroids or csDMARDs for AIRD does not worsen the clinical outcome.
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Affiliation(s)
- J I Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Ji SB, Park SY, Bae S, Seo HJ, Kim SE, Lee GM, Wu Z, Liu KH. Comprehensive Investigation of Stereoselective Food Drug Interaction Potential of Resveratrol on Nine P450 and Six UGT Isoforms in Human Liver Microsomes. Pharmaceutics 2021; 13:pharmaceutics13091419. [PMID: 34575495 PMCID: PMC8470274 DOI: 10.3390/pharmaceutics13091419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/29/2021] [Accepted: 09/03/2021] [Indexed: 11/16/2022] Open
Abstract
The stereoselectivity of the food drug inhibition potential of resveratrol on cytochrome P450s and uridine 5'-diphosphoglucuronosyl transferases was investigated in human liver microsomes. Resveratrol enantiomers showed stereoselective inhibition of CYP2C9, CYP3A, and UGT1A1. The inhibitions of CYP1A2, CYP2B6, and CYP2C19 by resveratrol were stereo-nonselective. The estimated Ki values determined for CYP1A2 were 13.8 and 9.2 μM for trans- and cis-resveratrol, respectively. Trans-resveratrol noncompetitively inhibited CYP3A and UGT1A1 activities with Ki values of 23.8 and 27.4 μM, respectively. Trans-resveratrol inhibited CYP1A2, CYP2C19, CYP2E1, and CYP3A in a time-dependent manner with Ki shift values >2.0, while cis-resveratrol time-dependently inhibited CYP2C19 and CYP2E1. The time-dependent inhibition of trans-resveratrol against CYP3A4, CYP2E1, CYP2C19, and CYP1A2 was elucidated using glutathione as a trapping reagent. This information helped the prediction of food drug interaction potentials between resveratrol and co-administered drugs which are mainly metabolized by UGT1A1, CYP1A2, CYP2C19, CYP2E1, and CYP3A.
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Affiliation(s)
- Seung-Bae Ji
- BK21 FOUR KNU Community-Based Intelligent Novel Drug Discovery Education Unit, Daegu 41566, Korea; (S.-B.J.); (S.-Y.P.); (S.B.); (H.-J.S.); (S.-E.K.); (G.-M.L.)
- Research Institute of Pharmaceutical Sciences, College of Pharmacy, Daegu 41566, Korea
| | - So-Young Park
- BK21 FOUR KNU Community-Based Intelligent Novel Drug Discovery Education Unit, Daegu 41566, Korea; (S.-B.J.); (S.-Y.P.); (S.B.); (H.-J.S.); (S.-E.K.); (G.-M.L.)
- Research Institute of Pharmaceutical Sciences, College of Pharmacy, Daegu 41566, Korea
| | - Subin Bae
- BK21 FOUR KNU Community-Based Intelligent Novel Drug Discovery Education Unit, Daegu 41566, Korea; (S.-B.J.); (S.-Y.P.); (S.B.); (H.-J.S.); (S.-E.K.); (G.-M.L.)
- Research Institute of Pharmaceutical Sciences, College of Pharmacy, Daegu 41566, Korea
| | - Hyung-Ju Seo
- BK21 FOUR KNU Community-Based Intelligent Novel Drug Discovery Education Unit, Daegu 41566, Korea; (S.-B.J.); (S.-Y.P.); (S.B.); (H.-J.S.); (S.-E.K.); (G.-M.L.)
- Research Institute of Pharmaceutical Sciences, College of Pharmacy, Daegu 41566, Korea
| | - Sin-Eun Kim
- BK21 FOUR KNU Community-Based Intelligent Novel Drug Discovery Education Unit, Daegu 41566, Korea; (S.-B.J.); (S.-Y.P.); (S.B.); (H.-J.S.); (S.-E.K.); (G.-M.L.)
- Research Institute of Pharmaceutical Sciences, College of Pharmacy, Daegu 41566, Korea
| | - Gyung-Min Lee
- BK21 FOUR KNU Community-Based Intelligent Novel Drug Discovery Education Unit, Daegu 41566, Korea; (S.-B.J.); (S.-Y.P.); (S.B.); (H.-J.S.); (S.-E.K.); (G.-M.L.)
- Research Institute of Pharmaceutical Sciences, College of Pharmacy, Daegu 41566, Korea
| | - Zhexue Wu
- Research Institute of Pharmaceutical Sciences, College of Pharmacy, Daegu 41566, Korea
- Mass Spectrometry Based Convergence Research Institute, Kyungpook National University, Daegu 41566, Korea
- Correspondence: (Z.W.); (K.-H.L.); Tel.: +82-53-950-8567 (Z.W. & K.-H.L.); Fax: +82-53-950-8557 (Z.W. & K.-H.L.)
| | - Kwang-Hyeon Liu
- BK21 FOUR KNU Community-Based Intelligent Novel Drug Discovery Education Unit, Daegu 41566, Korea; (S.-B.J.); (S.-Y.P.); (S.B.); (H.-J.S.); (S.-E.K.); (G.-M.L.)
- Research Institute of Pharmaceutical Sciences, College of Pharmacy, Daegu 41566, Korea
- Mass Spectrometry Based Convergence Research Institute, Kyungpook National University, Daegu 41566, Korea
- Correspondence: (Z.W.); (K.-H.L.); Tel.: +82-53-950-8567 (Z.W. & K.-H.L.); Fax: +82-53-950-8557 (Z.W. & K.-H.L.)
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Kim SE, Ji SB, Kim E, Jeong M, Kim J, Lee GM, Seo HJ, Bae S, Jeong Y, Lee S, Kim S, Lee T, Cho SJ, Liu KH. Nontargeted Metabolomics by High-Resolution Mass Spectrometry to Study the In Vitro Metabolism of a Dual Inverse Agonist of Estrogen-Related Receptors β and γ, DN203368. Pharmaceutics 2021; 13:pharmaceutics13060776. [PMID: 34072800 PMCID: PMC8230175 DOI: 10.3390/pharmaceutics13060776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/21/2021] [Accepted: 05/24/2021] [Indexed: 02/07/2023] Open
Abstract
DN203368 ((E)-3-[1-(4-[4-isopropylpiperazine-1-yl]phenyl) 3-methyl-2-phenylbut-1-en-1-yl] phenol) is a 4-hydroxy tamoxifen analog that is a dual inverse agonist of estrogen-related receptor β/γ (ERRβ/γ). ERRγ is an orphan nuclear receptor that plays an important role in development and homeostasis and holds potential as a novel therapeutic target in metabolic diseases such as diabetes mellitus, obesity, and cancer. ERRβ is also one of the orphan nuclear receptors critical for many biological processes, such as development. We investigated the in vitro metabolism of DN203368 by conventional and metabolomic approaches using high-resolution mass spectrometry. The compound (100 μM) was incubated with rat and human liver microsomes in the presence of NADPH. In the metabolomic approach, the m/z value and retention time information obtained from the sample and heat-inactivated control group were statistically evaluated using principal component analysis and orthogonal partial least-squares discriminant analysis. Significant features responsible for group separation were then identified using tandem mass spectra. Seven metabolites of DN203368 were identified in rat liver microsomes and the metabolic pathways include hydroxylation (M1-3), N-oxidation (M4), N-deisopropylation (M5), N,N-dealkylation (M6), and oxidation and dehydrogenation (M7). Only five metabolites (M2, M3, and M5-M7) were detected in human liver microsomes. In the conventional approach using extracted ion monitoring for values of mass increase or decrease by known metabolic reactions, only five metabolites (M1-M5) were found in rat liver microsomes, whereas three metabolites (M2, M3, and M5) were found in human liver microsomes. This study revealed that nontargeted metabolomics combined with high-resolution mass spectrometry and multivariate analysis could be a more efficient tool for drug metabolite identification than the conventional approach. These results might also be useful for understanding the pharmacokinetics and metabolism of DN203368 in animals and humans.
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Affiliation(s)
- Sin-Eun Kim
- BK21 FOUR KNU Community-Based Intelligent Novel Drug Discovery Education Unit, College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Korea; (S.-E.K.); (S.-B.J.); (E.K.); (G.-M.L.); (H.-J.S.); (S.B.); (Y.J.); (S.L.); (T.L.)
| | - Seung-Bae Ji
- BK21 FOUR KNU Community-Based Intelligent Novel Drug Discovery Education Unit, College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Korea; (S.-E.K.); (S.-B.J.); (E.K.); (G.-M.L.); (H.-J.S.); (S.B.); (Y.J.); (S.L.); (T.L.)
| | - Euihyeon Kim
- BK21 FOUR KNU Community-Based Intelligent Novel Drug Discovery Education Unit, College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Korea; (S.-E.K.); (S.-B.J.); (E.K.); (G.-M.L.); (H.-J.S.); (S.B.); (Y.J.); (S.L.); (T.L.)
| | - Minseon Jeong
- New Drug Development Center, Daegu-Gyeongbuk Medical Innovation Foundation, Daegu 41061, Korea; (M.J.); (J.K.)
| | - Jina Kim
- New Drug Development Center, Daegu-Gyeongbuk Medical Innovation Foundation, Daegu 41061, Korea; (M.J.); (J.K.)
| | - Gyung-Min Lee
- BK21 FOUR KNU Community-Based Intelligent Novel Drug Discovery Education Unit, College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Korea; (S.-E.K.); (S.-B.J.); (E.K.); (G.-M.L.); (H.-J.S.); (S.B.); (Y.J.); (S.L.); (T.L.)
| | - Hyung-Ju Seo
- BK21 FOUR KNU Community-Based Intelligent Novel Drug Discovery Education Unit, College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Korea; (S.-E.K.); (S.-B.J.); (E.K.); (G.-M.L.); (H.-J.S.); (S.B.); (Y.J.); (S.L.); (T.L.)
| | - Subin Bae
- BK21 FOUR KNU Community-Based Intelligent Novel Drug Discovery Education Unit, College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Korea; (S.-E.K.); (S.-B.J.); (E.K.); (G.-M.L.); (H.-J.S.); (S.B.); (Y.J.); (S.L.); (T.L.)
| | - Yeojin Jeong
- BK21 FOUR KNU Community-Based Intelligent Novel Drug Discovery Education Unit, College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Korea; (S.-E.K.); (S.-B.J.); (E.K.); (G.-M.L.); (H.-J.S.); (S.B.); (Y.J.); (S.L.); (T.L.)
| | - Sangkyu Lee
- BK21 FOUR KNU Community-Based Intelligent Novel Drug Discovery Education Unit, College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Korea; (S.-E.K.); (S.-B.J.); (E.K.); (G.-M.L.); (H.-J.S.); (S.B.); (Y.J.); (S.L.); (T.L.)
- Mass Spectrometry Based Convergence Research Institute, Kyungpook National University, Daegu 41566, Korea;
| | - Sunghwan Kim
- Mass Spectrometry Based Convergence Research Institute, Kyungpook National University, Daegu 41566, Korea;
- Department of Chemistry, Kyungpook National University, Daegu 41566, Korea
| | - Taeho Lee
- BK21 FOUR KNU Community-Based Intelligent Novel Drug Discovery Education Unit, College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Korea; (S.-E.K.); (S.-B.J.); (E.K.); (G.-M.L.); (H.-J.S.); (S.B.); (Y.J.); (S.L.); (T.L.)
| | - Sung Jin Cho
- Convergence Research Center for Diagnosis, Treatment and Care System of Dementia, Korea Institute of Science and Technology, Seoul 02792, Korea
- Correspondence: (S.J.C.); (K.-H.L.); Tel.: +82-2-958-5137 (S.-J.C.); +82-53-950-8567 (K.-H.L.); Fax: +82-2-958-5137 (S.J.C.); +82-53-950-8557 (K.-H.L.)
| | - Kwang-Hyeon Liu
- BK21 FOUR KNU Community-Based Intelligent Novel Drug Discovery Education Unit, College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Korea; (S.-E.K.); (S.-B.J.); (E.K.); (G.-M.L.); (H.-J.S.); (S.B.); (Y.J.); (S.L.); (T.L.)
- Mass Spectrometry Based Convergence Research Institute, Kyungpook National University, Daegu 41566, Korea;
- Correspondence: (S.J.C.); (K.-H.L.); Tel.: +82-2-958-5137 (S.-J.C.); +82-53-950-8567 (K.-H.L.); Fax: +82-2-958-5137 (S.J.C.); +82-53-950-8557 (K.-H.L.)
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Seo HJ, Ji SB, Kim SE, Lee GM, Park SY, Wu Z, Jang DS, Liu KH. Inhibitory Effects of Schisandra Lignans on Cytochrome P450s and Uridine 5'-Diphospho-Glucuronosyl Transferases in Human Liver Microsomes. Pharmaceutics 2021; 13:pharmaceutics13030371. [PMID: 33802239 PMCID: PMC8000448 DOI: 10.3390/pharmaceutics13030371] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 02/26/2021] [Accepted: 03/02/2021] [Indexed: 01/21/2023] Open
Abstract
Schisandra chinensis has been widely used as a traditional herbal medicine to treat chronic coughs, fatigue, night sweats, and insomnia. Numerous bioactive components including lignans have been identified in this plant. Lignans with a dibenzocyclooctadiene moiety have been known to possess anti-cancer, anti-inflammatory, and hepatoprotective activity. Fragmentary studies have reported the ability of some lignans to modulate some cytochrome P450 (P450) enzymes. Herein, we investigated the drug interaction potential of six dibenzocyclooctadiene lignans (schisandrin, gomisin A, B, C, and N, and wuweizisu C) on nine P450 enzymes (CYP1A2, 2A6, 2B6, 2C8, 2C9, 2C19, 2D6, 2E1, and 3A) and six uridine 5'-diphosphoglucuronosyl transferase (UGT) enzymes (UGT1A1, 1A3, 1A4, 1A6, 1A9, and 2B7) using human liver microsomes. We found that lignans with one or two methylenedioxyphenyl groups inhibited CYP2B6, CYP2C8, CYP2C9, CYP2C19, and CYP2E1 activities in a time- and concentration-dependent like their CYP3A inhibition. In comparison, these lignans do not induce time-dependent inhibition of CYP1A2, CYP2A6, and CYP2D6. The time-dependent inhibition of gomisin A against CYP2C8, CYP2C19, and CYP3A4 was also elucidated using glutathione as a trapping reagent of reactive carbene metabolites given that gomisin A strongly inhibits these P450 enzymes in a time-dependent manner. A glutathione conjugate of gomisin A was generated in reactions with human recombinant CYP2C8, CYP2C19, and CYP3A4. This suggests that the time-dependent inhibition of gomisin A against CYP2C8, CYP2C9, and CYP3A4 is due to the production of carbene reactive metabolite. Six of the lignans we tested inhibited the activities of six UGT to a limited extent (IC50 > 15 μM). This information may aid the prediction of possible drug interactions between Schisandra lignans and any co-administered drugs which are mainly metabolized by P450s.
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Affiliation(s)
- Hyung-Ju Seo
- BK21 FOUR Community-Based Intelligent Novel Drug Discovery Education Unit, College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Korea; (H.-J.S.); (S.-B.J.); (S.-E.K.); (G.-M.L.); (S.-Y.P.)
| | - Seung-Bae Ji
- BK21 FOUR Community-Based Intelligent Novel Drug Discovery Education Unit, College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Korea; (H.-J.S.); (S.-B.J.); (S.-E.K.); (G.-M.L.); (S.-Y.P.)
| | - Sin-Eun Kim
- BK21 FOUR Community-Based Intelligent Novel Drug Discovery Education Unit, College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Korea; (H.-J.S.); (S.-B.J.); (S.-E.K.); (G.-M.L.); (S.-Y.P.)
| | - Gyung-Min Lee
- BK21 FOUR Community-Based Intelligent Novel Drug Discovery Education Unit, College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Korea; (H.-J.S.); (S.-B.J.); (S.-E.K.); (G.-M.L.); (S.-Y.P.)
| | - So-Young Park
- BK21 FOUR Community-Based Intelligent Novel Drug Discovery Education Unit, College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Korea; (H.-J.S.); (S.-B.J.); (S.-E.K.); (G.-M.L.); (S.-Y.P.)
| | - Zhexue Wu
- Mass Spectrometry Based Convergence Research Institute and Department of Chemistry, Kyungpook National University, Daegu 41566, Korea;
| | - Dae Sik Jang
- Department of Life and Nanopharmaceutical Sciences, Kyung Hee University, Seoul 02447, Korea
- Correspondence: (D.S.J.); (K.-H.L.); Tel.: +82-2-961-0719 (D.S.J.); +82-53-950-8567 (K.-H.L.)
| | - Kwang-Hyeon Liu
- BK21 FOUR Community-Based Intelligent Novel Drug Discovery Education Unit, College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Korea; (H.-J.S.); (S.-B.J.); (S.-E.K.); (G.-M.L.); (S.-Y.P.)
- Mass Spectrometry Based Convergence Research Institute and Department of Chemistry, Kyungpook National University, Daegu 41566, Korea;
- Correspondence: (D.S.J.); (K.-H.L.); Tel.: +82-2-961-0719 (D.S.J.); +82-53-950-8567 (K.-H.L.)
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Seok JK, Hong EH, Yang G, Lee HE, Kim SE, Liu KH, Kang HC, Cho YY, Lee HS, Lee JY. Oxidized Phospholipids in Tumor Microenvironment Stimulate Tumor Metastasis via Regulation of Autophagy. Cells 2021; 10:cells10030558. [PMID: 33806593 PMCID: PMC8001732 DOI: 10.3390/cells10030558] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 02/21/2021] [Accepted: 02/25/2021] [Indexed: 12/16/2022] Open
Abstract
Oxidized phospholipids are well known to play physiological and pathological roles in regulating cellular homeostasis and disease progression. However, their role in cancer metastasis has not been entirely understood. In this study, effects of oxidized phosphatidylcholines such as 1-palmitoyl-2-(5-oxovaleroyl)-sn-glycero-3-phosphocholine (POVPC) on epithelial-mesenchymal transition (EMT) and autophagy were determined in cancer cells by immunoblotting and confocal analysis. Metastasis was analyzed by a scratch wound assay and a transwell migration/invasion assay. The concentrations of POVPC and 1-palmitoyl-2-glutaroyl-sn-glycero-phosphocholine (PGPC) in tumor tissues obtained from patients were measured by LC-MS/MS analysis. POVPC induced EMT, resulting in increase of migration and invasion of human hepatocellular carcinoma cells (HepG2) and human breast cancer cells (MCF7). POVPC induced autophagic flux through AMPK-mTOR pathway. Pharmacological inhibition or siRNA knockdown of autophagy decreased migration and invasion of POVPC-treated HepG2 and MCF7 cells. POVPC and PGPC levels were greatly increased at stage II of patient-derived intrahepatic cholangiocarcinoma tissues. PGPC levels were higher in malignant breast tumor tissues than in adjacent nontumor tissues. The results show that oxidized phosphatidylcholines increase metastatic potential of cancer cells by promoting EMT, mediated through autophagy. These suggest the positive regulatory role of oxidized phospholipids accumulated in tumor microenvironment in the regulation of tumorigenesis and metastasis.
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Affiliation(s)
- Jin Kyung Seok
- BK21 PLUS Team, College of Pharmacy, The Catholic University of Korea, Bucheon 14662, Korea; (J.K.S.); (E.-H.H.); (G.Y.); (H.E.L.); (H.C.K.); (Y.-Y.C.); (H.S.L.)
| | - Eun-Hee Hong
- BK21 PLUS Team, College of Pharmacy, The Catholic University of Korea, Bucheon 14662, Korea; (J.K.S.); (E.-H.H.); (G.Y.); (H.E.L.); (H.C.K.); (Y.-Y.C.); (H.S.L.)
- Korea Hydro & Nuclear Power (KHNP) Central Research Institute, Daejeon 34101, Korea
| | - Gabsik Yang
- BK21 PLUS Team, College of Pharmacy, The Catholic University of Korea, Bucheon 14662, Korea; (J.K.S.); (E.-H.H.); (G.Y.); (H.E.L.); (H.C.K.); (Y.-Y.C.); (H.S.L.)
- Immunotherapy Research Lab, Department of Pharmacology, College of Korean Medicine, Woosuk University, Jeonju 54986, Korea
| | - Hye Eun Lee
- BK21 PLUS Team, College of Pharmacy, The Catholic University of Korea, Bucheon 14662, Korea; (J.K.S.); (E.-H.H.); (G.Y.); (H.E.L.); (H.C.K.); (Y.-Y.C.); (H.S.L.)
| | - Sin-Eun Kim
- BK21 Plus KNU Multi-Omics Based Creative Drug Research Team, College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Korea; (S.-E.K.); (K.-H.L.)
| | - Kwang-Hyeon Liu
- BK21 Plus KNU Multi-Omics Based Creative Drug Research Team, College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Korea; (S.-E.K.); (K.-H.L.)
| | - Han Chang Kang
- BK21 PLUS Team, College of Pharmacy, The Catholic University of Korea, Bucheon 14662, Korea; (J.K.S.); (E.-H.H.); (G.Y.); (H.E.L.); (H.C.K.); (Y.-Y.C.); (H.S.L.)
| | - Yong-Yeon Cho
- BK21 PLUS Team, College of Pharmacy, The Catholic University of Korea, Bucheon 14662, Korea; (J.K.S.); (E.-H.H.); (G.Y.); (H.E.L.); (H.C.K.); (Y.-Y.C.); (H.S.L.)
| | - Hye Suk Lee
- BK21 PLUS Team, College of Pharmacy, The Catholic University of Korea, Bucheon 14662, Korea; (J.K.S.); (E.-H.H.); (G.Y.); (H.E.L.); (H.C.K.); (Y.-Y.C.); (H.S.L.)
| | - Joo Young Lee
- BK21 PLUS Team, College of Pharmacy, The Catholic University of Korea, Bucheon 14662, Korea; (J.K.S.); (E.-H.H.); (G.Y.); (H.E.L.); (H.C.K.); (Y.-Y.C.); (H.S.L.)
- Correspondence: ; Tel./Fax: +82-2-2164-4095
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Lee KH, Kim JS, Hong SH, Seong D, Choi YR, Ahn YT, Kim KS, Kim SE, Lee S, Sim W, Kim D, Jun B, Yang JW, Yon DK, Lee SW, Kim MS, Dragioti E, Li H, Jacob L, Koyanagi A, Abou Ghayda R, Shin JI, Smith L. Risk factors of COVID-19 mortality: a systematic review of current literature and lessons from recent retracted articles. Eur Rev Med Pharmacol Sci 2020; 24:13089-13097. [PMID: 33378062 DOI: 10.26355/eurrev_202012_24216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Recently, two influential articles that reported the association of (hydroxy)chloroquine or angiotensin converting enzyme (ACE) inhibitors and coronavirus disease 2019 (COVID-19) mortality were retracted due to significant methodological issues. Therefore, we aimed to analyze the same clinical issues through an improved research method and to find out the differences from the retracted papers. We systematically reviewed pre-existing literature, and compared the results with those of the retracted papers to gain a novel insight. MATERIALS AND METHODS We extracted common risk factors identified in two retracted papers, and conducted relevant publication search until June 26, 2020 in PubMed. Then, we analyzed the risk factors for COVID-19 mortality and compared them to those of the retracted papers. RESULTS Our systematic review demonstrated that most demographic and clinical risk factors for COVID-19 mortality were similar to those of the retracted papers. However, while the retracted paper indicated that both (hydroxy)chloroquine monotherapy and combination therapy with macrolide were associated with higher risk of mortality, our study showed that only combination therapy of hydroxychloroquine and macrolide was associated with higher risk of mortality (odds ratio 2.33; 95% confidence interval 1.63-3.34). In addition, our study demonstrated that use of ACE inhibitors or angiotensin receptor blockers (ARBs) was associated with reduced risk of mortality (0.77; 0.65-0.91). CONCLUSIONS When analyzing the same clinical issues with the two retracted papers through a systematic review of randomized controlled trials and relevant cohort studies, we found out that (hydroxy)chloroquine monotherapy was not associated with higher risk of mortality, and that the use of ACE inhibitors or ARBs was associated with reduced risk of mortality in COVID-19 patients.
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Affiliation(s)
- K H Lee
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea.
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9
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Peterson LC, Kim SE. Minimally invasive fixation of a lateral tibial plateau fracture in a dog. J Small Anim Pract 2020; 62:161. [PMID: 33150589 DOI: 10.1111/jsap.13210] [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] [Received: 05/12/2020] [Revised: 07/02/2020] [Accepted: 07/06/2020] [Indexed: 11/29/2022]
Affiliation(s)
- L C Peterson
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, 32608, USA
| | - S E Kim
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, 32608, USA
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Park DG, Seo WW, Kim SE, Lee JH, Han KR, Oh DJ. P1478 Evaluation of reversibility of alcoholic cardiomyopathy using doubaimine stress echocardiography. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.903] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Alcoholic cardiomyopathy (CM) is known as a reversible CM. Appropriate medications with cessation of alcohol may lead to full recovery of chamber size and contractility. But there is not much information about morphologic and hemodynamic changes over the course of treatment, and predictors of reversibility. We experienced the patient with alcoholic CM who was admitted with heart failure and recovered over 1 year and 5 months. He consumed daily 180g alcohol for 6 months before admission. On initial echocardiography, left atrial (LA) dimension, left ventricular (LV) systolic dimension (SD) and diastolic dimension (DD), inferior vena cava (IVC) size, and ejection fraction (EF) were 50 mm, 69 mm, 78 mm, 27 mm and 22%, respectively. Doppler examination revealed a restrictive pattern in tansmitral flow, and a systolic peak velocity/diastolic peak velocity (S/D) ratio of less than 1 in pulmonary vein flow (PVF). Pressure gradient through tricuspid regurgitation was 29 mmHg. Coronary angiogram confirmed no significant stenosis. Within 1 week after medications, LVEF increased mainly by decrease of enlarged LVSD which might be partly caused by volume overload, evidenced by respiratory variation of transmitral flow. On 8th day, we performed dobutamine stress echocardiography (DSE) to evaluate reversibility because LVEF slightly decreased despite decrease of LVDD. During dobutamine infusion, both LVDD and LVSD decreased along with increase of LVEF according to dose escalation. From 1 to 2 months, LVEF slightly increased with decrease of LVDD and LVSD. Afterwards, LVEF was normalized mainly with decrease of LVSD, and LVEF was completely normalized at 1 year and 5 month after initiation of treatment. Initial increase of LVEF might reflect decrease of LVSD by relief of volume overload rather than improving LV contractility. Based on this observation of serial change of chambers and LVEF, we speculate that increased LV wall tension, which is induced by increase of preload as a compensating mechanism for increasing stroke volume, might aggravate LVEF in later stage of heart failure with reduced EF. The sequence of normalization in chamber size was IVC, and then LA, and then LVDD. Transmitral flow as an indicator of diastolic dysfunction changed from restrictive (transiently existed only for 1 week) to abnormal relaxation pattern (no change since that time). PVF pattern showed S/D ratio < 1 until 1 week, and then triphasic pattern at 1 month, finally biphasic pattern at 8 month after initiation of medications. We observed a serial change of echocardiographic findings in patient with alcoholic CM, which might provide an insightful information to understand reverse of LV or LA remodeling associated with hemodynamic parameters, and DSE might be helpful to evaluate reversibility of LV systolic function and convince patients who are reluctant to medications.
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Affiliation(s)
- D G Park
- Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea (Republic of)
| | - W W Seo
- Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea (Republic of)
| | - S E Kim
- Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea (Republic of)
| | - J H Lee
- Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea (Republic of)
| | - K R Han
- Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea (Republic of)
| | - D J Oh
- Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea (Republic of)
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11
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Au Yong JA, Lewis DD, Evans RB, Kim SE, Pozzi A. Retrospective evaluation of the efficacy of minimally invasive, fluoroscopic-assisted reduction and stabilisation of unicondylar humeral fractures. Aust Vet J 2018; 96:302-307. [DOI: 10.1111/avj.12723] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 03/08/2018] [Accepted: 04/30/2018] [Indexed: 11/30/2022]
Affiliation(s)
- JA Au Yong
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, 2015 SW 16th Ave; University of Florida; Gainesville FL 32608 USA
| | - DD Lewis
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, 2015 SW 16th Ave; University of Florida; Gainesville FL 32608 USA
| | - RB Evans
- Department of Orthopedic Surgery, School of Medicine, University of Missouri; Columbia, MO USA
| | - SE Kim
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, 2015 SW 16th Ave; University of Florida; Gainesville FL 32608 USA
| | - A Pozzi
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, 2015 SW 16th Ave; University of Florida; Gainesville FL 32608 USA
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Son YK, Kwon H, Lee HW, Jeong EG, Lee SM, Kim SE, Park Y, An WS. Modification of Erythrocyte Membrane Fatty Acid Contents After Kidney Transplantation: A Prospective Study. Transplant Proc 2018; 50:1332-1335. [PMID: 29880354 DOI: 10.1016/j.transproceed.2018.01.057] [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: 11/17/2017] [Accepted: 01/23/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Modifications of erythrocyte membrane fatty acid (FA) contents may affect cellular function or transmembrane receptors. One cross-sectional study has shown that kidney transplant (KTP) recipients have lower erythrocyte membrane oleic acid content than dialysis patients do. Therefore, we prospectively tested whether erythrocyte membrane contents of FA including oleic acid change after KTP. METHODS We recruited 23 KTP recipients (September 2011 through May 2014). Blood samples were obtained immediately before KTP and 6 months after. Erythrocyte membrane FA contents were measured by gas chromatography. RESULTS Mean age of the enrolled KTP recipients was 45.3 ± 10.9 years, and men represented 66.7% of the cases. ABO-incompatible KTPs constituted 14.3% and cadaver donors 42.9% of the cases. Steroids, mycophenolate mofetil, and tacrolimus were used as immunosuppressive treatment. There was no significant difference in dietary consumption between time points before and 6 months after KTP. Total cholesterol and low-density lipoprotein cholesterol levels were significantly higher at 6 months after KTP as compared with baseline. Erythrocyte membrane contents of polyunsaturated FA, ω-3 FA, ω-6 FA, and the ω-3 index were significantly higher, but erythrocyte membrane contents of total saturated FAs, total monounsaturated FAs, including oleic acid, total trans-FA, palmitoleic acid, and the ω-6-to-ω-3 ratio were significantly lower at 6 months after KTP. CONCLUSIONS Erythrocyte membrane FA contents significantly changed toward a more favorable cardiovascular profile after KTP. These changes in erythrocyte membrane FA contents may be related to improved renal function because of the absence of significant dietary changes.
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Affiliation(s)
- Y K Son
- Department of Internal Medicine, Dong-A University, Busan, Korea
| | - H Kwon
- Department of Internal Medicine, BHS Hanseo Hospital, Busan, Korea
| | - H W Lee
- Department of Internal Medicine, Dong-A University, Busan, Korea
| | - E G Jeong
- Department of Internal Medicine, Dong-A University, Busan, Korea
| | - S M Lee
- Department of Internal Medicine, Dong-A University, Busan, Korea
| | - S E Kim
- Department of Internal Medicine, Dong-A University, Busan, Korea
| | - Y Park
- Department of Food and Nutrition, Hanyang University, Seoul, Korea
| | - W S An
- Department of Internal Medicine, Dong-A University, Busan, Korea.
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Cornelissen L, Kim SE, Lee JM, Brown EN, Purdon PL, Berde CB. Electroencephalographic markers of brain development during sevoflurane anaesthesia in children up to 3 years old. Br J Anaesth 2018; 120:1274-1286. [PMID: 29793594 PMCID: PMC6617966 DOI: 10.1016/j.bja.2018.01.037] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [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: 08/03/2017] [Revised: 01/30/2018] [Accepted: 01/30/2018] [Indexed: 12/14/2022] Open
Abstract
Background General anaesthetics generate spatially defined brain oscillations in the EEG that relate fundamentally to neural-circuit architecture. Few studies detailing the neural-circuit activity of general anaesthesia in children have been described. The study aim was to identify age-related changes in EEG characteristics that mirror different stages of early human brain development during sevoflurane anaesthesia. Methods Multichannel EEG recordings were performed in 91 children aged 0–3 yr undergoing elective surgery. We mapped spatial power and coherence over the frontal, parietal, temporal, and occipital cortices during maintenance anaesthesia. Results During sevoflurane exposure: (i) slow–delta (0.1–4 Hz) oscillations were present in all ages, (ii) theta (4–8 Hz) and alpha (8–12 Hz) oscillations emerge by ∼4 months, (iii) alpha oscillations increased in power from 4 to 10 months, (iv) frontal alpha-oscillation predominance emerged at ∼6 months, (v) frontal slow oscillations were coherent from birth until 6 months, and (vi) frontal alpha oscillations became coherent ∼10 months and persisted in older ages. Conclusions Key developmental milestones in the maturation of the thalamo-cortical circuitry likely generate changes in EEG patterns in infants undergoing sevoflurane general anaesthesia. Characterisation of anaesthesia-induced EEG oscillations in children demonstrates the importance of developing age-dependent strategies to monitor properly the brain states of children receiving general anaesthesia. These data have the potential to guide future studies investigating neurodevelopmental pathologies involving altered excitatory–inhibitory balance, such as epilepsy or Rett syndrome.
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Affiliation(s)
- L Cornelissen
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Anaesthesia, Harvard Medical School, Boston, MA, USA.
| | - S E Kim
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - J M Lee
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - E N Brown
- Department of Anaesthesia, Harvard Medical School, Boston, MA, USA; Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA; Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - P L Purdon
- Department of Anaesthesia, Harvard Medical School, Boston, MA, USA; Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - C B Berde
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Anaesthesia, Harvard Medical School, Boston, MA, USA
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14
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Hong JY, Kim CW, Noh H, Lee DH, Kim SE, Lee SJ. The Effect of Animation-Assisted Informed Consent Using Tablet Personal Computer for Contrast-Enhanced Computed-Tomography in Emergency Department. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791201900404] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction Informed consent is essential patient's right even in overcrowded emergency department (ED). We compared the effect of animation-assisted informed consent using tablet PC with the standard informed consent for contrast-enhanced computed-tomography (CT) in ED. Methods We included 150 patients scheduled to undergo contrast-enhanced CT in ED from November 2010 through January 2011. Participants were randomised to either animation-assisted information (AAI) (n=75) or standard verbal information (SVI) group (n=75). AAI was provided by tablet personal computer (PC); and SVI by clinicians. All participants completed 10-point scale questionnaires after the CT scan. The questionnaires included two main categories – understanding and satisfaction of informed consent. Results Participants in the AAI group had a better understanding of purpose (8.95±1.48 vs. 8.32±1.88, p=0.026) and methods (8.93±1.43 vs. 8.37±1.83, p=0.048) of CT scans compared to participants in the SVI group. Every score in satisfaction categories was significantly higher in the AAI group. In the SVI group, relatively low-educated participants had a lower score in understanding when compared with university-educated participants (7.53±2.28 vs. 8.52±1.40, p=0.029). Regardless of education level, understanding score was high in the AAI group (8.73±1.27 vs. 8.57±1.50, p=0.71). Conclusions Participants receiving animation assisted informed consent with tablet PC shows a higher degree of understanding and satisfaction compared with patients receiving standard verbal informed consent. Particularly in patients with lower education, animation-assisted informed consent may be better for understanding of contrast-enhanced CT.
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Affiliation(s)
- JY Hong
- Chung-Ang University College of Medicine, Department of Emergency Medicine, Chung-Ang University Medical Center, Heukseok-dong, Dongjak-gu, Seoul, 156-755, Korea
| | - CW Kim
- Chung-Ang University College of Medicine, Department of Emergency Medicine, Chung-Ang University Medical Center, Heukseok-dong, Dongjak-gu, Seoul, 156-755, Korea
| | | | - DH Lee
- Chung-Ang University College of Medicine, Department of Emergency Medicine, Chung-Ang University Medical Center, Heukseok-dong, Dongjak-gu, Seoul, 156-755, Korea
| | - SE Kim
- Chung-Ang University College of Medicine, Department of Emergency Medicine, Chung-Ang University Medical Center, Heukseok-dong, Dongjak-gu, Seoul, 156-755, Korea
| | - SJ Lee
- Chung-Ang University College of Medicine, Department of Emergency Medicine, Chung-Ang University Medical Center, Heukseok-dong, Dongjak-gu, Seoul, 156-755, Korea
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Abstract
Background Escalator-related injuries have been considered uncommon and most likely to occur in children. In this study, we described the epidemiology of these injuries with focus on the aged population in order to determine whether escalators are safe for the aged, and to obtain information to help in preventing escalator-related injuries. Methods A prospective survey was taken to identify the number and nature of these injuries from May 2004 to December 2008. We enrolled patients who had sustained escalator-related injuries. A standard list of questions and answers were recorded by the emergency physician. A total of 104 questionnaires were completed during the study period. Results The average patient age was 59.2±24.0 years (range 1-94). There were 64 (61.5%) females. Only 11 (10.6%) were younger than 15 years old, and 59 (56.7%) were aged 65 or above; 35 (59.3%) of the aged people were injured while standing on the escalator. However, out of the 45 patients younger than age 65, 22 (48.9%) were injured from walking on a moving escalator. Head injury was the commonest site of injury overall and all were due to fall or slipping down. Conclusions Escalator-related injuries are not as rare as previously believed and the aged population 65 years old or above is the highest risk group. In particular, walking on a moving escalator was the main cause of injury in people under age 65. Therefore, primary prevention strategies are needed to prevent users from walking on escalators, especially young people, and educate aged people the safe utilization of escalators to prevent slip and fall injuries.
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Abstract
Cases of deep venous thrombosis (DVT) and pulmonary thromboembolism (PTE) related to the isolated risk factor of uterine myoma are very rare. In a setting of emergency department (ED), it is unlikely that uterine myoma would be suspected as the primary cause of symptoms in a patient with thromboembolism. We presented a 44-year-old woman who visited the ED for DVT presenting with right lower leg swelling with an underlying cause of a huge uterine myoma. Various aetiologies, including obstetric and gynaecological causes (especially uterine myoma), should be considered in female patients visiting the ED with suspected DVT or PTE.
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Oh JH, Kim CW, Kim SE, Lee DH. Does the Bed Frame Deflection Occur along with Mattress Deflection during In-Hospital Cardiopulmonary Resuscitation? an Experiment Using Mechanical Devices. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791602300205] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives When we perform chest compression on a patient on a bed, the mattress and bed frame can be depressed together with the patient's chest. This study was conducted to assess whether bed frame deflection occurred during chest compressions. Methods We designed a firm bed (“bed like the ground,” BLG) to assess the bed frame deflection in the Stryker Trauma Stretcher (STS) and the ER stretcher cart (ER-SC). The STS included a soft mattress and the ER-SC a hard mattress. We performed 50 continuous chest compressions on the Resusci Anne Skill Reporter with CPRmeter in each experiment. The experiments were done in four settings. Test 1 included the BLG; test 2 included a mattress and backboard on each bed; test 3 included the mattress of each bed and a backboard on the BLG; and test 4 included the mattress of each bed on the BLG. We calculated the mattress and bed frame deflections using the gaps of compression depths between the values measured by Resusci Anne and CPRmeter. Results The mattress deflections of the STS and ER-SC mattress were determined to be 11.2 and 0.67 mm, respectively. The bed frame deflection for the STS and ER-SC were 0.95 and 5.17 mm, respectively. Conclusion The study confirms that bed frame deflection will occur when we perform chest compressions on the manikin lying on a bed. Additionally, the bed frame deflections differ depending on the type of bed. (Hong Kong j.emerg.med. 2016;23:35-41)
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Kim SE, Lee SJ, Noh H, Lee DH, Kim CW. Is There Any Difference in Cardiopulmonary Resuscitation Performance According to Different Instructional Models of Cardiopulmonary Resuscitation Education for Junior and Senior High School Students? HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791101800602] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective This study aims to determine whether or not cardiopulmonary resuscitation (CPR) skills differ according to different instructional models for CPR education and training for junior and senior high school students. Methods This was a prospective and randomised study including 519 junior and senior high school students. After the lecture on CPR, students practiced the skill on the manikin. Group 1 used model 1 and Group 2 used model 2 for practical training and practical skills and CPR performance quality were evaluated. Results Data from skill tests were analysed in 229 students in group 1 and 210 students in group 2. The total score of sequence skill tests was 17.8±2.0 points. During 2 cycles, no chest elevation was observed in 33.3% and was significantly lower in group 1. There were no significant differences in the frequency of proper ventilation and in ventilation volume between the 2 groups. Excessive ventilation was more frequently observed in group 1 and insufficient ventilation was observed more frequently in group 2. The percentage of the frequency of a proper chest compression rate was 80.5±31.2% and there were no significant differences in proper and insufficient depths, mean rate and recoil of the chest in chest compression between the 2 groups. Conclusions There were differences in CPR skills according to different CPR training manikins. Therefore, certain conditions seem to be considered in selection of instructional models for CPR psychomotor skills. (Hong Kong j.emerg.med. 2011;18:375-382)
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Affiliation(s)
- SE Kim
- Myongji Hospital, Department of Emergency Medicine, Seoul, Korea; Noh Hyun, MD
| | - SJ Lee
- Myongji Hospital, Department of Emergency Medicine, Seoul, Korea; Noh Hyun, MD
| | - H Noh
- Myongji Hospital, Department of Emergency Medicine, Seoul, Korea; Noh Hyun, MD
| | - DH Lee
- Myongji Hospital, Department of Emergency Medicine, Seoul, Korea; Noh Hyun, MD
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Abstract
Pneumomediastinum is an uncommon radiographic finding resulting from various causes, such as trauma, infection and unknown causes. The pneumomediastinum due to minor trauma is rarely reported and treatment and diagnostic process is not established. We report on a 20-year-old female patient who initially presented with neck pain and dyspnoea following manual strangulation. Her chest X-ray and computed tomography (CT) of neck imaging showed subcutaneous emphysema and extensive pneumomediastinum, but pneumothorax was not shown. She was transferred to the thoracic surgery and admitted to the general ward. The patient's condition improved and she was discharged on the sixth hospital day. In conclusion, patients with pneumomediastinum following a minor strangulation injury can be observed alone without invasive testing or repeated imaging. CT scans are of great value for safe observation in determined patients and for the further evaluation of pneumomediastinum.
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Affiliation(s)
| | | | | | - JH Hong
- Chung-Ang University Hosiptal, Department of Thoracic and Cardiovascular Surgery, College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul, Korea
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Yao K, Uedo N, Muto M, Ishikawa H, Cardona HJ, Filho ECC, Pittayanon R, Olano C, Yao F, Parra-Blanco A, Ho SH, Avendano AG, Piscoya A, Fedorov E, Bialek AP, Mitrakov A, Caro L, Gonen C, Dolwani S, Farca A, Cuaresma LF, Bonilla JJ, Kasetsermwiriya W, Ragunath K, Kim SE, Marini M, Li H, Cimmino DG, Piskorz MM, Iacopini F, So JB, Yamazaki K, Kim GH, Ang TL, Milhomem-Cardoso DM, Waldbaum CA, Carvajal WAP, Hayward CM, Singh R, Banerjee R, Anagnostopoulos GK, Takahashi Y. Development of an E-learning System for the Endoscopic Diagnosis of Early Gastric Cancer: An International Multicenter Randomized Controlled Trial. EBioMedicine 2016; 9:140-147. [PMID: 27333048 PMCID: PMC4972485 DOI: 10.1016/j.ebiom.2016.05.016] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [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: 02/04/2016] [Revised: 05/15/2016] [Accepted: 05/16/2016] [Indexed: 01/06/2023] Open
Abstract
Background In many countries, gastric cancer is not diagnosed until an advanced stage. An Internet-based e-learning system to improve the ability of endoscopists to diagnose gastric cancer at an early stage was developed and was evaluated for its effectiveness. Methods The study was designed as a randomized controlled trial. After receiving a pre-test, participants were randomly allocated to either an e-learning or non-e-learning group. Only those in the e-learning group gained access to the e-learning system. Two months after the pre-test, both groups received a post-test. The primary endpoint was the difference between the two groups regarding the rate of improvement of their test results. Findings 515 endoscopists from 35 countries were assessed for eligibility, and 332 were enrolled in the study, with 166 allocated to each group. Of these, 151 participants in the e-learning group and 144 in the non-e-learning group were included in the analysis. The mean improvement rate (standard deviation) in the e-learning and non-e-learning groups was 1·24 (0·26) and 1·00 (0·16), respectively (P < 0·001). Interpretation This global study clearly demonstrated the efficacy of an e-learning system to expand knowledge and provide invaluable experience regarding the endoscopic detection of early gastric cancer (R000012039). This report establishes that an e-learning system on the Internet can improve the diagnostic ability of endoscopists. Countless endoscopists worldwide can access the system to learn how to make an endoscopic diagnosis of early gastric cancer. The e-learning system could be modified to provide education regarding endoscopic diagnosis in other organs.
This is the first report to demonstrate how an e-learning system based on the Internet can improve the diagnostic ability of gastrointestinal endoscopists worldwide. There is no limit to the number of endoscopists who can access the system and benefit from this opportunity to learn how to make an endoscopic diagnosis of early gastric cancer. This e-learning system could be modified to provide education regarding endoscopic diagnosis in other organs such as the large intestine and the esophagus, as well as the stomach. It may contribute to human welfare and health by reducing the mortality from gastrointestinal cancer.
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Affiliation(s)
- K Yao
- Fukuoka University Chikushi Hospital, Chikushino, Japan.
| | - N Uedo
- Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - M Muto
- Kyoto University, Kyoto, Japan
| | - H Ishikawa
- Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | | | - R Pittayanon
- King Chulalongkorn Memorial Hospital, The Thai Red Cross and Chulalongkorn University, Bangkok, Thailand
| | - C Olano
- Universidad de la República, Montevideo, Uruguay
| | - F Yao
- Peking Union Medical College Hospital, Beijing, China
| | - A Parra-Blanco
- School of Medicine, Pontificia Universidad Catolica De Chile, Santiago, Chile
| | - S H Ho
- University of Malaya, Kuala Lumpur, Malaysia
| | - A G Avendano
- Hospital Rafael Angel Calderon Guardia, CCSS, San Jose, Costa Rica
| | - A Piscoya
- Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - E Fedorov
- Russia National Medical University, Moscow University Hospital, N31, Moscow, Russian Federation
| | - A P Bialek
- Pomeranian Medical University, Szczecin, Poland
| | - A Mitrakov
- Nizhniy Novgorod Cancer Hospital, Nizhniy Novgorod, Russian Federation
| | - L Caro
- GEDyt Gastroenterologia diagnostica y tratamiento Inst afiliafa a la UBA Buenos Aires, Argentina
| | - C Gonen
- Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - S Dolwani
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - A Farca
- The American British Cowdray Medical Center. Mexico City, Mexico
| | - L F Cuaresma
- Hospital Nacional Adolfo Guevara Velasco, Cusco, Peru
| | - J J Bonilla
- i-gastro/Hospital Central de la Fuerza Aerea del Peru, Lima, Peru
| | - W Kasetsermwiriya
- Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | - K Ragunath
- NIHR Nottingham Digestive Disease Biomedical Research Unit, Queens Medical Centre, Nottingham University Hospital, Nottingham, United Kingdom
| | - S E Kim
- Kosin University College of Medicine, Busan, Republic of Korea
| | - M Marini
- Gastroenterology and Operative Endoscopy Unit, Siena University Hospital, Siena, Italy
| | - H Li
- Sichuan Provincial People's Hospital, Sichuan, Academy of Medical Sciences, Chengdu, China
| | | | - M M Piskorz
- Hospital de Clinicas Jose de San Martin, Buenos Aires, Argentina
| | - F Iacopini
- Ospedale S. Giuseppe, ASL Roma 6, Albano L, Rome, Italy
| | - J B So
- National University of Singapore, Singapore, Singapore
| | - K Yamazaki
- University of Sao Paulo, Sao Paulo, Brazil
| | - G H Kim
- Pusan National University School of Medicine, Busan, Republic of Korea
| | - T L Ang
- Changi General Hospital, Singapore, Singapore
| | | | - C A Waldbaum
- Hospital de Clinicas Jose de San Martin, Buenos Aires, Argentina
| | | | - C M Hayward
- Derriford Hospital, Plymouth, United Kingdom
| | - R Singh
- Lyell McEwin Hospital & University of Adelaide, Adelaide, Australia
| | - R Banerjee
- Asian Institute of Gastroenterology, Hyderabad, India
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Park HS, Kim E, Moon BS, Lim NH, Lee BC, Kim SE. In Vivo Tissue Pharmacokinetics of Carbon-11-Labeled Clozapine in Healthy Volunteers: A Positron Emission Tomography Study. CPT Pharmacometrics Syst Pharmacol 2015. [PMID: 26225256 PMCID: PMC4452936 DOI: 10.1002/psp4.38] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
We investigated clozapine (CLZ) tissue pharmacokinetics in vivo by using carbon-11-labeled CLZ (11C-CLZ) and positron emission tomography (PET). Eight healthy volunteers underwent 11C-CLZ studies wherein computed tomography image acquisition was followed by PET scans (whole-body, four; brain, four). After bolus intravenous 11C-CLZ injection, PET images were acquired at various timepoints for 2–3 hours. Tissue 11C-CLZ signals were plotted over time, and pharmacokinetic parameters were determined. High 11C-CLZ radioactivity was detected in the liver and brain, implying CLZ hepatic metabolism and efficient blood–brain barrier penetration. The urinary and hepatobiliary tracts were involved in 11C-CLZ excretion. Moderate to high radioactivity was observed in the dopaminergic and serotonergic receptor-rich brain regions, indicating CLZ binding to multiple receptor types. To our knowledge, this is the first study to report the determination of 11C-CLZ tissue pharmacokinetics in humans. PET using radiolabeled drugs can provide valuable information that could complement plasma pharmacokinetic data.
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Affiliation(s)
- H S Park
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital Seongnam, South Korea ; Smart Humanity Convergence Center, Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University Seoul, South Korea ; Advanced Institutes of Convergence Technology Suwon, South Korea
| | - E Kim
- Department of Neuropsychiatry, Seoul National University College of Medicine, Seoul National University Bundang Hospital Seongnam, South Korea
| | - B S Moon
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital Seongnam, South Korea
| | - N H Lim
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital Seongnam, South Korea
| | - B C Lee
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital Seongnam, South Korea ; Advanced Institutes of Convergence Technology Suwon, South Korea
| | - S E Kim
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital Seongnam, South Korea ; Smart Humanity Convergence Center, Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University Seoul, South Korea ; Advanced Institutes of Convergence Technology Suwon, South Korea
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Roach RC, Dvorkin D, Julian CG, Gronewold J, Bourdillon N, Bucher J, Elliott JE, Evero O, Fan JL, Jameson‐Van Houten S, Kayser B, Kern JP, Kim SE, Laurie SS, Lovering AT, Ryan B, Wachsmuth NB, Subudhi AW. Transcriptomic and Epigenomic Reponses During Human Adaptation to High‐Altitude Hypoxia. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.1051.5] [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: 11/11/2022]
Affiliation(s)
- RC Roach
- Altitude Research Center U Colorado AMCUnited States
| | - D Dvorkin
- Altitude Research Center U Colorado AMCUnited States
| | - C G Julian
- Altitude Research Center U Colorado AMCUnited States
| | - J Gronewold
- Altitude Research Center U Colorado AMCUnited States
| | | | - J Bucher
- Dept HumanPhysiol U OregonUnited States
| | | | - O Evero
- Altitude Research Center U Colorado AMCUnited States
| | - JL Fan
- Inst Sports Sci ULausanneSwitzerland
| | | | - B Kayser
- Inst Sports Sci ULausanneSwitzerland
| | - JP Kern
- Dept HumanPhysiol U OregonUnited States
| | - SE Kim
- Dept HumanPhysiol U OregonUnited States
| | - SS Laurie
- Dept HumanPhysiol U OregonUnited States
| | | | - B Ryan
- Dept IntegrPhysiol U Colorado BoulderUnited States
| | | | - A W Subudhi
- Altitude Research Center U Colorado AMCUnited States
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Florey O, Kim SE, Overholtzer M. Entosis: Cell-in-Cell Formation that Kills Through Entotic Cell Death. Curr Mol Med 2015; 15:861-6. [PMID: 26511711 DOI: 10.2174/1566524015666151026100042] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Revised: 09/29/2015] [Accepted: 10/19/2015] [Indexed: 11/22/2022]
Abstract
Entosis is a cell-in-cell formation mechanism that targets viable cells for uptake in epithelial cell cultures and human tumors. Entotic cells control their own engulfment, by invading into their hosts in a Rho-GTPase and actomyosin-dependent manner. Although entotic cells are internalized while alive, most eventually undergo a non-apoptotic form of cell death, called entotic cell death, that is executed non-cell-autonomously by autophagy proteins and lysosomes. Here we review the current understanding of entosis and entotic cell death and discuss the potential roles of this process in cancer.
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Affiliation(s)
| | | | - M Overholtzer
- Cell Biology Program, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
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Choi YJ, Park MI, Park SJ, Moon W, Kim SE, Kwon HJ, Kim JH, Jeon WS. The effect of water bolus temperature on esophageal motor function as measured by high-resolution manometry. Neurogastroenterol Motil 2014; 26:1628-34. [PMID: 25307526 DOI: 10.1111/nmo.12441] [Citation(s) in RCA: 12] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 08/19/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND Ingestion of cold fluids may induce pain in patients with esophageal motility disorders. Hot fluids, on the other hand, may help to relieve pain. We studied changes in esophageal motility as a variable of water bolus temperature using high-resolution manometry (HRM) in healthy human. METHODS Thirty-two healthy subjects were recruited at Kosin University Hospital. HRM was performed in a sitting position, with room temperature (RT, 25 °C), hot (45 °C), and cold (2 °C) water swallowed in that order. This exam included single swallowing (10 swallows of 5 mL water, 30 s intervals) and multiple water swallows (MWS; 100 mL water within 30 s). KEY RESULTS In the single swallowing, hot water caused a decrease in lower esophageal sphincter (LES) residual pressure (5.87 ± 4.20 mmHg vs 7.45 ± 4.17 mmHg (RT), p = 0.001) and duration of esophageal body (EB) contraction (3.01 ± 0.80 s vs 3.15 ± 1.16 s (RT), p = 0.009). Cold water caused an increase in the duration of EB contraction (3.52 ± 0.87 s vs 3.15 ± 1.16 s (RT), p = 0.001) and a decrease in contractile front velocity (CFV) (4.43 ± 1.50 cm/s vs 4.90 ± 2.53 cm/s (RT), p = 0.007). Similarly, in the MWS, hot water caused a decrease in the duration of EB contraction (12.95 ± 5.02 s vs 16.33 ± 5.94 s (RT), p = 0.024) and an increase in the amplitude of EB contraction (114.27 ± 83.36 mmHg vs 82.70 ± 46.77 mmHg (RT), p = 0.007). Cold water caused an increase in the duration of EB contraction (27.38 ± 2.89 s vs 16.33 ± 5.94 s (RT), p = 0.03) and a decrease in the amplitude of EB contraction (51.68 ± 33.94 mmHg vs 82.70 ± 46.77 mmHg (RT), p = 0.001). CONCLUSIONS & INFERENCES This study showed changes in esophageal motility to be dependent on water temperature. Especially, MWS showed clear changes in esophageal motility at different temperatures of water.
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Affiliation(s)
- Y J Choi
- Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea
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Choi YJ, Park MI, Park SJ, Moon W, Kim SE, Yoo CH, Kwon HJ. Relationship between multiple water swallows and gastroesophageal reflux in patients with normal esophageal motility. Dis Esophagus 2014; 28:520-3. [PMID: 24898795 DOI: 10.1111/dote.12232] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Multiple water swallows (MWS) stimulates neural inhibition, resulting in abolition of contractions in the esophageal body and complete lower esophageal sphincter relaxation, which is followed by peristalsis and the lower esophageal sphincter contraction. We assessed the relationship between MWS and gastroesophageal reflux in patients with esophageal symptoms and with normal findings by high-resolution manometry (HRM). We retrospectively reviewed the clinical records of patients who underwent HRM and a 24-hour ambulatory impedance-pH study. Correlation between the findings of the impedance-pH study and abnormal MWS responses without motility disorders was evaluated. Independent t-tests were used for statistical analysis. Of 28 patients, 20 (71%) had abnormal MWS responses: four (20%) had abnormal responses during MWS, six (30%) had abnormal responses after MWS, and 10 (50%) had abnormal responses both during and after MWS. Total acid exposure times were significantly longer in patients with abnormal MWS responses than in patients with normal MWS responses. In particular, upright acid exposure time and all reflux percent times were significantly longer in patients with abnormal MWS responses. However, bolus clearance time and longest reflux episode were not different between the two groups. Abnormal MWS responses predicted increased acid exposure times in patients with normal findings of HRM by the Chicago classification.
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Affiliation(s)
- Y J Choi
- Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea
| | - M I Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea
| | - S J Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea
| | - W Moon
- Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea
| | - S E Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea
| | - C H Yoo
- Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea
| | - H J Kwon
- Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea
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Kim SE, Lewis DD. Corrective osteotomy for procurvatum deformity caused by distal femoral physeal fracture malunion stabilised with String-of-Pearls locking plates: results in two dogs and a review of the literature. Aust Vet J 2014; 92:75-80. [DOI: 10.1111/avj.12149] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2013] [Indexed: 11/29/2022]
Affiliation(s)
- SE Kim
- Department of Small Animal Clinical Sciences; College of Veterinary Medicine; University of Florida; Gainesville FL 32610 USA
| | - DD Lewis
- Department of Small Animal Clinical Sciences; College of Veterinary Medicine; University of Florida; Gainesville FL 32610 USA
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Cha JM, Lim KS, Lee SH, Joo YE, Hong SP, Kim TI, Kim HG, Park DI, Kim SE, Yang DH, Shin JE. Clinical outcomes and risk factors of post-polypectomy coagulation syndrome: a multicenter, retrospective, case-control study. Endoscopy 2013; 45:202-7. [PMID: 23381948 DOI: 10.1055/s-0032-1326104] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [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] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND STUDY AIMS Post-polypectomy coagulation syndrome (PPCS) is a well known complication of colonoscopic polypectomy. However, no previous studies have reported on the clinical outcomes or risk factors of PPCS. The aim of the current study was to analyze the clinical outcomes and risk factors of PPCS developing after a colonoscopic polypectomy. PATIENTS AND METHODS Data for all patients who underwent colonoscopic polypectomies and required hospitalization in nine university hospitals were analyzed retrospectively. The incidence, clinicopathological characteristics, and clinical outcomes of PPCS cases were examined. Additionally, patients who developed PPCS were compared with controls who were matched by age and sex, in order to assess for possible risk factors. RESULTS The rate of PPCS that required hospitalization after colonoscopic polypectomy was 0.7/1000. All patients with PPCS were treated medically without the need for surgical interventions. The median durations of therapeutic fasting, hospitalization, and antibiotic use were 3 days, 5.5 days, and 7 days, respectively. The rates of major PPCS and mortality were 2.9 % and 0 %, respectively. On multivariate analysis, hypertension (OR = 3.023, 95 %CI 1.034 - 8.832), large lesion size (OR = 2.855, 95 %CI 1.027 - 7.937), and non-polypoid configuration (OR = 3.332, 95 %CI 1.029 - 10.791) were found to be independent risk factors related to the development of PPCS. CONCLUSIONS In this study, the rates of major PPCS and mortality were only 2.9 % and 0 %, respectively. Hypertension, large lesion size, and non-polypoid configuration of the lesion were independently associated with PPCS. Therefore, patients may be reassured by the excellent prognosis of PPCS, while endoscopists should be especially careful when performing colonoscopic polypectomies in patients with hypertension or large and non-polypoid lesions.
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Affiliation(s)
- J M Cha
- Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul 134-727, Korea
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Coggeshall JD, Reese DJ, Kim SE, Pozzi A. Arthroscopic-guided ulnar distraction for the correction of elbow incongruency in four dogs. J Small Anim Pract 2013; 55:46-51. [PMID: 24032426 DOI: 10.1111/jsap.12126] [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] [Accepted: 06/26/2013] [Indexed: 11/29/2022]
Abstract
Four skeletally immature, small breed dogs (five elbows) with elbow incongruency were evaluated for forelimb lameness. Findings on clinical examination included pain, effusion and decreased range of motion of the affected elbow. Radiography, computed tomography and arthroscopy demonstrated elbow incongruency in all dogs. Fragmented medial coronoid process was diagnosed arthroscopically in three dogs (four elbows). Arthroscopic subtotal coronoidectomy was performed in all cases of fragmented medial coronoid process. Incongruency was corrected with acute ulnar lengthening under arthroscopic visualisation. The ulna was stabilised with a plate following correction. In two elbows an ostectomy of the anconeal process was performed to prevent impingement against the olecranon fossa. All dogs demonstrated improvement in lameness scores and client-scored visual analogue scale scores. Postoperative computed tomography showed significant improvement in elbow incongruency in all dogs. Arthroscopic-guided ulnar lengthening may be considered as a valid treatment in severe cases of elbow incongruency.
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Affiliation(s)
- J D Coggeshall
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, 32610, USA
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Abstract
A Pekingese dog was presented for evaluation of head trauma with ventral head and neck swelling, puncture wounds, palpable mandibular fractures, and loss of menace, severe miosis, and loss of palpebral reflex of the right eye. Computed tomography confirmed multiple mandibular and zygomatic fractures, a right ear canal avulsion, and a complete right tympanic bulla fracture with ventral displacement. The tympanic bulla fracture was managed conservatively. Topical lubrication and antibiotic ointment was prescribed for the right eye. A subtotal hemimandibulectomy was performed to address the mandibular fractures. A temporary oesophagostomy feeding tube was placed. No short-term complications developed as a result of the fractured bulla and avulsed ear canal being left in situ, and no complications were reported 18 months after the injury. To the authors' knowledge this is the first report of a traumatic tympanic bulla fracture in the dog.
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Affiliation(s)
- J A Rubin
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, 32610-0126, USA
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Song SH, Kim SE, Agashe MV, Lee H, Refai MA, Park YE, Choi HJ, Park JH, Song HR. Growth disturbance after lengthening of the lower limb and quantitative assessment of physeal closure in skeletally immature patients with achondroplasia. ACTA ACUST UNITED AC 2012; 94:556-63. [PMID: 22434475 DOI: 10.1302/0301-620x.94b4.28375] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This study evaluated the effect of limb lengthening on longitudinal growth in patients with achondroplasia. Growth of the lower extremity was assessed retrospectively by serial radiographs in 35 skeletally immature patients with achondroplasia who underwent bilateral limb lengthening (Group 1), and in 12 skeletally immature patients with achondroplasia who did not (Group 2). In Group 1, 23 patients underwent only tibial lengthening (Group 1a) and 12 patients underwent tibial and femoral lengthening sequentially (Group 1b). The mean lengthening in the tibia was 9.2 cm (59.5%) in Group 1a, and 9.0 cm (58.2%) in the tibia and 10.2 cm (54.3%) in the femur in Group 1b. The mean follow-up was 9.3 years (8.6 to 10.3). The final mean total length of lower extremity in Group 1a was 526.6 mm (501.3 to 552.9) at the time of skeletal maturity and 610.1 mm (577.6 to 638.6) in Group 1b, compared with 457.0 mm (411.7 to 502.3) in Group 2. However, the mean actual length, representing the length solely grown from the physis without the length of distraction, showed that there was a significant disturbance of growth after limb lengthening. In Group 1a, a mean decrease of 22.4 mm (21.3 to 23.1) (4.9%) was observed in the actual limb length when compared with Group 2, and a greater mean decrease of 38.9 mm (37.2 to 40.8) (8.5%) was observed in Group 1b when compared with Group 2 at skeletal maturity. In Group 1, the mean actual limb length was 16.5 mm (15.8 to 17.2) (3.6%) shorter in Group 1b when compared with Group 1a at the time of skeletal maturity. Premature physeal closure was seen mostly in the proximal tibia and the distal femur with relative preservation of proximal femur and distal tibia. We suggest that significant disturbance of growth can occur after extensive limb lengthening in patients with achondroplasia, and therefore, this should be included in pre-operative counselling of these patients and their parents.
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Affiliation(s)
- S H Song
- Korea University Medical Center, Guro Hospital, Institute for Rare Diseases and Department of Orthopaedic Surgery, 80 Guro-dong, Guro-gu, Seoul 152-703, Korea
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Choate CJ, Lewis DD, Kim SE, Sereda CW. Use of hinged circular fixator constructs for the correction of crural deformities in three dogs. Aust Vet J 2012; 90:256-63. [DOI: 10.1111/j.1751-0813.2012.00931.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Affiliation(s)
- C Aitken-Palmer
- Department of Small Animal Clinical Sciences, University of Florida, College of Veterinary Medicine, 2015 SW 16th Avenue, Gainesville, FL 32610-0126, USA.
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Kim KW, Jhoo JH, Lee SB, Lee SD, Kim TH, Kim SE, Kim YK, Yoon IY. Increased striatal dopamine transporter density in moderately severe old restless legs syndrome patients. Eur J Neurol 2012; 19:1213-8. [PMID: 22435397 DOI: 10.1111/j.1468-1331.2012.03705.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Dopamine dysregulation in restless legs syndrome (RLS) may be varied by the severity of RLS, which could contribute to the conflicting results from previous functional neuroimaging studies on the central dopaminergic neurotransmission of RLS. The aim of this study was to observe whether reduced striatal dopaminergic neurotransmission is associated with moderate to moderately severe RLS. METHODS Thirteen elderly patients with RLS and 12 normal elderly controls were enrolled in the study. All the subjects were dopaminergic-drug naïve and twelve patients with RLS had the severity of moderate to moderately severe degree based on the International Restless Legs Syndrome Study Group (IRLSSG) Severity Scale. We compared dopamine transporter density (DAT) availability and D2 receptor density in the striatum between patients with RLS and controls using [(123)I]2β-carbomethoxy-3β-(4-iodophenyl)tropane single-photon emission computed tomography (SPECT) and [(123)I]iodobenzamide SPECT. RESULTS Dopamine transporter density of patients with RLS was increased in the caudate (P = 0.037), posterior putamen (P = 0.041), and entire striatum (P = 0.046) compared with that of normal controls. DAT density was higher in the anterior putamen of patients with RLS than controls, although statistically not significant (P = 0.079). There was no difference in the D2 receptor density between patients with RLS and normal controls in the whole striatum or any of subregions. CONCLUSIONS Dysregulation rather than simple upregulation or downregulation of central dopaminergic neurotransmission may underlie the pathogenesis of RLS, and decreased dopaminergic neurotransmission may cause moderate to moderately severe RLS in the elderly.
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Affiliation(s)
- K W Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggi, Korea
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An WS, Lee SM, Son YK, Kim SE, Kim KH, Han JY, Bae HR, Park Y. Effect of omega-3 fatty acids on the modification of erythrocyte membrane fatty acid content including oleic acid in peritoneal dialysis patients. Prostaglandins Leukot Essent Fatty Acids 2012; 86:29-34. [PMID: 22071008 DOI: 10.1016/j.plefa.2011.10.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2011] [Revised: 10/21/2011] [Accepted: 10/22/2011] [Indexed: 11/25/2022]
Abstract
Erythrocyte membrane fatty acids (FA), such as oleic acid, are related to acute coronary syndrome. There is no report about the effect of omega-3 FA on oleic acid in peritoneal dialysis (PD) patients. We hypothesized that omega-3 FA can modify erythrocyte membrane FA, including oleic acid, in PD patients. In a double-blind, randomized, placebo-controlled study, 18 patients who were treated with PD for at least 6 months were randomized to treatment for 12 weeks with omega-3 FA or placebo. Erythrocyte membrane FA content was measured by gas chromatography at baseline and after 12 weeks. The erythrocyte membrane content of eicosapentaenoic acid and docosahexaenoic acid was significantly increased and saturated FA and oleic acid were significantly decreased in the omega-3 FA supplementation group after 12 weeks compared to baseline. In conclusion, erythrocyte membrane FA content, including oleic acid, was significantly modified by omega-3 FA supplementation for 12 weeks in PD patients.
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Affiliation(s)
- W S An
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Republic of Korea.
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Hong JH, Song SH, Kim SE, Lee JK, Lee NW, Lee KW. Diffuse intraabdominal fibrosis and inflammation mimicking peritoneal carcinomatosis recurred after surgery for borderline ovarian tumor misdiagnosed by 18F-fluorodeoxyglucose-positron emission tomography. EUR J GYNAECOL ONCOL 2011; 32:231-233. [PMID: 21614927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) adds to conventional imaging in the detection and staging of peritoneal carcinomatosis. CASE REPORT Herein we report a 27-year-old woman with multiple intraperitoneal masses detected by 18F-FDG-PET, suggesting peritoneal carcinomatosis. She had undergone laparoscopic unilateral oophorectomy for a left ovarian mucinous borderline tumor approximately five years before. Based on imaging and intraoperative findings, multiple intraabdominal masses strongly suggested peritoneal recurrence from a previous ovarian borderline tumor, but it finally proved to be inflammation and fibrosis on histopathologic examination. CONCLUSION Although 18F-FDG-PET is well known to be a highly sensitive imaging tool for identification of peritoneal carcinomatosis, FDG uptake is not tumor-specific. Therefore, the possibility of a false-positive diagnosis due to benign conditions, such as inflammation, should always be taken into consideration.
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Affiliation(s)
- J H Hong
- Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Hwang JY, Kim SY, Lee SH, Kim GS, Go MJ, Kim SE, Kim HC, Shin HD, Park BL, Kim TH, Hong JM, Park EK, Kim HL, Lee JY, Koh JM. Association of TWIST1 gene polymorphisms with bone mineral density in postmenopausal women. Osteoporos Int 2010; 21:757-64. [PMID: 19597909 DOI: 10.1007/s00198-009-1009-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2009] [Accepted: 06/12/2009] [Indexed: 12/23/2022]
Abstract
UNLABELLED A novel polymorphism (+1871A>G) in the 3' flanking region and haplotypes were significantly associated with reduced osteoporosis risk and enhanced bone mineral density (BMD). These results suggest that TWIST1 may be a useful genetic marker for osteoporosis. Our results provide preliminary evidence supporting an association of TWIST1 with osteoporosis in postmenopausal women. INTRODUCTION TWIST1, a basic helix-loop-helix (bHLH) transcription factor, has been implicated in cell lineage determination and differentiation. METHODS To address the genetic variations in the TWIST1 gene associated with osteoporosis, we investigated the potential involvement of three TWIST1 single-nucleotide polymorphisms (SNPs) in osteoporosis in 729 postmenopausal women. BMD was measured using dual-energy X-ray absorptiometry. RESULTS A novel polymorphism in the 3' flanking region (+1871A>G) was significantly associated with osteoporosis risk (p = 0.007-0.008) and also in multiple comparison (p = 0.02). Consistent with these results, haplotype analysis showed that Block1_ht2 had protective effects in the dominant and additive model (p = 0.006-0.007). Specifically, the +1871A>G polymorphism was overdominantly associated with higher BMD values of the femoral neck (p = 0.039). CONCLUSION These results suggest that TWIST1 may be a useful genetic marker for osteoporosis and may have a role on bone metabolism in humans. Our results provide preliminary evidence supporting an association of TWIST1 with osteoporosis in postmenopausal women.
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Affiliation(s)
- J-Y Hwang
- The Center for Genome Science, National Institute of Health, Seoul, Republic of Korea
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Kim TH, Zollinger L, Shi XF, Kim SE, Rose J, Patel AA, Jeong EK. Quantification of diffusivities of the human cervical spinal cord using a 2D single-shot interleaved multisection inner volume diffusion-weighted echo-planar imaging technique. AJNR Am J Neuroradiol 2010; 31:682-7. [PMID: 20019109 DOI: 10.3174/ajnr.a1881] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND PURPOSE DTI is a highly sensitive technique, which can detect pathology not otherwise noted with conventional imaging methods. This paper provides the atlas of reliable normative in vivo DTI parameters in the cervical spinal cord and its potential applications toward quantifying pathology. MATERIALS AND METHODS In our study, we created a reference of normal diffusivities of the cervical spinal cord by using a 2D ss-IMIV-DWEPI technique from 14 healthy volunteers and compared parameters with those in 8 patients with CSM. The 2D ss-IMIV-DWEPI technique was applied in each subject to acquire diffusion-weighted images. FA, lambda( parallel), and lambda( perpendicular) were calculated. A reference of normal DTI indices from 12 regions of interest was created and compared with DTI indices of 8 patients. RESULTS A map of reference diffusivity values was obtained from healthy controls. We found statistically significant differences in diffusivities between healthy volunteers and patients with CSM with different severities of disease, by using FA, lambda( parallel), and lambda( perpendicular) values. CONCLUSIONS DTI using 2D ss-IMIV-DWPEI is sensitive to spinal cord pathology. This technique can be used to detect and quantify the degree of pathology within the cervical spinal cord from multiple disease states.
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Affiliation(s)
- T H Kim
- Department of Radiology, Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, 84108-1218, USA
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Jhoo JH, Yoon IY, Kim YK, Chung S, Kim JM, Lee SB, Kim TH, Moon SH, Kim SE, Kim KW. Availability of brain serotonin transporters in patients with restless legs syndrome. Neurology 2010; 74:513-8. [PMID: 20142619 DOI: 10.1212/wnl.0b013e3181cef824] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Selective serotonin reuptake inhibitors have been associated with the risk of restless legs syndrome (RLS), suggesting that dysregulation of serotonergic neurotransmission may provoke or exacerbate RLS. METHODS We compared the availability of serotonin transporter (SERT) between 16 drug-naïve patients with RLS and 16 healthy controls. SERT was measured in the pons and medulla via [(123)I]-2beta-carbomethoxy-3beta-(4-iodophenyl) tropane (beta-CIT) SPECT. A ratio of specific to nonspecific brain uptake (V(3)'') was used for all comparisons. RLS was diagnosed according to the criteria proposed by the National Institute of Health, and its severity was measured using the International RLS Study Group (IRLSSG) Severity Scale. RESULTS The availability of SERT was similar in the RLS group and the control group with regards to the pons (1.24 +/- 0.31 vs 1.24 +/- 0.25, p > 0.1) and the medulla (0.99 +/- 0.25 vs 1.00 +/- 0.23, p > 0.1). However, IRLSSG Severity Scale scores increased with decrease of SERT availability in both the pons (beta = -0.50, t = -3.19, p = 0.009) and the medulla (beta = -0.42, t = -2.44, p = 0.03). CONCLUSIONS Although serotonin transporter (SERT) availability in pons and medulla was similar in the restless legs syndrome (RLS) group and the control group, the severity of RLS symptoms increased as the availability of SERT decreased. These data partially support the hypothesis that an increase of serotonergic neurotransmission in the brainstem may exacerbate RLS, possibly via dual modulations on striatal dopaminergic neurotransmission and on the activities of spinal motor and sensory neurons.
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Affiliation(s)
- J H Jhoo
- Department of Psychiatry, Kangwon National University School of Medicine, Kangwon, Korea
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Hong KS, Kang DW, Bae HJ, Kim YK, Han MK, Park JM, Rha JH, Lee YS, Koo JS, Cho YJ, Kwon SU, Kim SE, Park SH. Effect of cilnidipine vs losartan on cerebral blood flow in hypertensive patients with a history of ischemic stroke: a randomized controlled trial. Acta Neurol Scand 2010; 121:51-7. [PMID: 19925528 DOI: 10.1111/j.1600-0404.2009.01299.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this study was to compare the effects of antihypertensive agents on cerebral blood flow (CBF) in hypertensive patients with previous ischemic stroke. MATERIALS AND METHODS In this double-blind, multi-center, non-inferiority trial, 196 patients were randomized to cilnidipine 10-20 mg or losartan 50-100 mg once daily for 4 weeks. Baseline and follow-up CBF as measured by single photon emission computed tomography were obtained in 167. The primary endpoint was the global CBF change. The secondary endpoints were the CBF change in the hemisphere ipsilateral to the index stroke, non-impairment of global CBF and blood pressure (BP) reduction. RESULTS Global CBF increased significantly in the cilnidipine arm (9.0 +/- 29.6%, P = 0.0071) and the losartan arm (11.4 +/- 31.4%, P = 0.0012), and these changes were not different between the two groups (P = 0.607). However, the estimated difference in percentage global CBF change between the two groups was -2.43% (97.5% CI, -13.06% to 8.21%), which crossed the predetermined non-inferiority margin of -8.6%. Ipsilesional hemispheric CBF change, non-impairment of global CBF and BP reduction were similar in the two groups. CONCLUSIONS This trial failed to prove the non-inferiority of cilnidipine to losartan regarding global CBF change. Both the treatments, however, increase the global CBF despite BP lowering.
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Affiliation(s)
- K-S Hong
- Department of Neurology, Clinical Research Center, Ilsan Paik Hospital, Inje University, Goyang, Korea
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Kim YK, Yoon IY, Kim JM, Jeong SH, Kim KW, Shin YK, Kim BS, Kim SE. The implication of nigrostriatal dopaminergic degeneration in the pathogenesis of REM sleep behavior disorder. Eur J Neurol 2009; 17:487-92. [PMID: 19968708 DOI: 10.1111/j.1468-1331.2009.02854.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE The pathogenesis of rapid eye movement (REM) sleep behavior disorder (RBD) is not clear despite its frequent association with Parkinson's disease (PD). We investigated whether the nigrostriatal dopaminergic system is involved in the development of idiopathic RBD. METHODS Fourteen patients with RBD, 14 patients with PD and 12 normal controls were included in the study. The diagnosis of RBD was confirmed on polysomnography. All the participants performed single-photon emission computed tomography imaging 3 h after injection of [(123)I]FP-CIT. During REM sleep of the RBD patients, each 30-s epoch was rated as 'tonic' when there was at least 50% of tonically maintained chin electromyography (EMG) activity in the epoch. Phasic EMG activities were calculated as the percentage of 3-s mini-epoch containing phasic EMG events (leg and chin, separately). RESULTS The RBD patients showed a trend of lower binding in the striatum than the normal controls (P = 0.07), and the significance was revealed in the putamen (P = 0.02). However, in 11 individual cases of the 14 RBD patients, the dopamine transporter (DAT) densities in the putamen still remained within the normal range. In the RBD patients, there was no correlation between EMG activities and DAT densities. CONCLUSIONS Nigrostriatal dopaminergic degeneration could be a part of the pathogenesis of RBD, but not essential for the development of RBD. The lack of correlation between RBD severity and DAT densities suggests that another pathogenic process not related to nigrostriatal dopaminergic transmission may be implicated in RBD.
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Affiliation(s)
- Y K Kim
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Bundang-gu, Seongnam, Korea
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Kim JY, Kim SY, Kim JM, Kim YK, Yoon KY, Kim JY, Lee BC, Kim JS, Paek SH, Park SS, Kim SE, Jeon BS. Spinocerebellar ataxia type 17 mutation as a causative and susceptibility gene in parkinsonism. Neurology 2009; 72:1385-9. [PMID: 19380697 DOI: 10.1212/wnl.0b013e3181a18876] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate the role of spinocerebellar ataxia type 17 (SCA17) in the development of parkinsonism. METHOD We screened 1,155 parkinsonian patients (931 with Parkinson disease and 224 with multiple system atrophy) and 400 normal subjects for SCA17. 99mTc-TRODAT-1 SPECT was used to evaluate the striatal dopamine transporter (DAT) status. RESULTS Trinucleotide expansion in the SCA17 gene was found in 10 parkinsonian patients (8 with Parkinson disease, 2 with multiple system atrophy) using 42 repeats as an upper normal limit. The repeat sizes in the patients ranged from 43 to 46, which are considered to be low-range expansions. All patients had interrupted sequences. Three probands and three asymptomatic carriers underwent 99mTc-TRODAT-1 SPECT. Striatal DAT binding was markedly reduced in all probands and mildly decreased in one asymptomatic carrier. Among the 400 normal control subjects, there was one individual with an expansion of 44 repeats, another with 43 repeats, and two with 42 repeats. Striatal DAT binding was decreased not only in the control subjects with 44 or 43 repeats, but in ones with 42 repeats, suggesting that an expansion as low as 42 repeats might constitute a susceptibility gene for parkinsonism. CONCLUSIONS Low-range expansion of the SCA17 gene is not a rare genetic cause of parkinsonism without ataxia in our population. Reduced penetrance or variable expressivity in low-range expansion might be an explanation for the blurred cutoff point for normal expansion in SCA17.
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Affiliation(s)
- J-Y Kim
- Department of Neurology, Neuroscience Research Institute, Korea
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Kim SE, Yun HS, Hyun YT, Shin JW, Song JJ. Nano-hydroxyapatite/poly ϵ-caprolactone composite 3D scaffolds for mastoid obliteration. ACTA ACUST UNITED AC 2009. [DOI: 10.1088/1742-6596/165/1/012083] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Abstract
BACKGROUND Fisher syndrome (FS) is characterised by a triad of ophthalmoplegia, ataxia and areflexia. The lesion sites responsible for ataxia and ophthalmoplegia in FS require further exploration. The aim of this study was to determine the involvement of the central nervous system in FS using (18)F-fluorodeoxyglucose-positron emission tomography (FDG-PET). METHODS Cerebral glucose metabolism in 10 patients with FS was compared with that of 60 age and sex matched normal controls using PET. For individual analyses, 15 age and sex matched controls were selected from the control group. Patients also underwent MRI of the brain and measurement of serum anti-GQ1b antibody. RESULTS Group analyses revealed increased metabolism in the cerebellar vermis and hemispheres, pontine tegmentum, midbrain tectum, left thalamus and right inferior frontal cortex (p<0.001, uncorrected). In contrast, the visual association cortices (Brodmann areas 18 and 19) showed decreased metabolism bilaterally. Individual analyses disclosed hypermetabolism in the cerebellar vermis or hemispheres (n = 7), inferior frontal cortex (n = 5) and brainstem (n = 4, p<0.005, uncorrected). A negative correlation between the cerebellar hypermetabolism and the interval from symptom onset to PET (r = -0.745, p = 0.013) was also found. Hypermetabolism was normalised on follow-up PET with an improvement in ophthalmoplegia and ataxia in one patient. CONCLUSIONS These findings indicate involvement of the central nervous system in FS, and the hypermetabolism in the cerebellum and brainstem suggests an antibody associated acute inflammatory process as a mechanism of this autoimmune disorder.
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Affiliation(s)
- Y K Kim
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
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Wei J, Heo SJ, Kim DH, Kim SE, Hyun YT, Shin JW. Comparison of physical, chemical and cellular responses to nano- and micro-sized calcium silicate/poly(epsilon-caprolactone) bioactive composites. J R Soc Interface 2008; 5:617-30. [PMID: 17999948 DOI: 10.1098/rsif.2007.1267] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
In this study, we fabricated nano-sized calcium silicate/poly(epsilon-caprolactone) composite (n-CPC) and micro-sized calcium silicate/poly(epsilon-caprolactone) composite (m-CPC). The composition, mechanical properties, hydrophilicity and degradability of both n-CPC and m-CPC were determined, and in vitro bioactivity was evaluated by investigating apatite forming on their surfaces in simulated body fluid (SBF). In addition, cell responses to the two kinds of composites were comparably investigated. The results indicated that n-CPC has superior hydrophilicity, compressive strength and elastic modulus properties compared with m-CPC. Both n-CPC and m-CPC exhibited good in vitro bioactivity, with different morphologies of apatite formation on their surfaces. The apatite layer on n-CPC was more homogeneous and compact than on m-CPC, due to the elevated levels of calcium and silicon concentrations in SBF from n-CPC throughout the 14-day soaking period. Significantly higher levels of attachment and proliferation of MG63 cells were observed on n-CPC than on m-CPC, and significantly higher levels of alkaline phosphatase activity were observed in human mesenchymal stem cells (hMSCs) on n-CPC than on m-CPC after 7 days. Scanning electron microscopy observations revealed that hMSCs were in intimate contact with both n-CPC and m-CPC surfaces, and significantly cell adhesion, spread and growth were observed on n-CPC and m-CPC. These results indicated that both n-CPC and m-CPC have the ability to support cell attachment, growth, proliferation and differentiation, and also yield good bioactivity and biocompatibility.
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Affiliation(s)
- Jie Wei
- Team of BK21, First project team, Department of Biomedical Engineering, Inje University, Gimhae, Gyeongnam 621-749, Republic of Korea
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Abstract
No study adopted the statistical parametric mapping (SPM) analyses of (18)F-fluorodeoxy glucose (FDG) PET in a large number of patients with oculopalatal tremor (OPT). To determine regional cerebral glucose metabolism in patients with OPT, nine patients with OPT underwent FDG-PET of the brain. Their glucose metabolism was compared with that of 50 normal controls (NC) by using SPM analyses. Three patients had bilateral and six showed unilateral pseudohypertrophic degeneration of the inferior olivary nucleus (ION) on MRI. Compared with NC, OPT patients did not show any metabolic derangement in the anterolateral medulla where the pseudohypertrophic ION locates. Instead, six patients with unilateral ION changes had hypometabolism in ipsilesional pontine tegmentum and hypermetabolism in contralesional thalamus. Their metabolic changes did not depend on the lateralization of ION changes. Our study failed to present any metabolic evidence for the role of ION in the generation of OPT. In part, the failure might originate from the different pathomechanism between OPT and pure palatal tremor or sensitivity/specificity issues of PET and SPM analyses. But, our results suggest that impaired cell groups of the paramedian tract and thalamic tremor cells may contribute to the generation of OPT.
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Affiliation(s)
- S Y Moon
- Department of Neurology, Seoul National University College of Medicine, Seoul, Korea
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Abstract
To determine the frequency and aetiology of acute symptomatic seizures in central nervous system (CNS) infections and to assess the clinical factors predicting the occurrence of the seizures, we retrospectively reviewed the medical records of patients diagnosed with CNS infections from 2000 to 2005. One hundred and forty-seven patients were included in the study. The clinical variables between those with and without acute symptomatic seizures were compared. Of the 147 patients, 23% (34/147) had acute symptomatic seizures. A significant relation between clinical variables and the occurrence of acute symptomatic seizures was found: encephalitis as the aetiology of the CNS infection, Glasgow Coma Scale (GCS) < or =12, and neurological deficits. By multiple logistic regression analysis, age of onset >42 years, encephalitis, and GCS < or =12 were found to be independently significant clinical variables for predicting the occurrence of acute symptomatic seizures. Encephalitis and GCS < or =12 are significant clinical variables for predicting the occurrence of acute symptomatic seizures in CNS infection, suggesting that patients with a greater extent of parenchymal damage are more vulnerable to acute symptomatic seizures.
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Affiliation(s)
- M A Kim
- Department of Neurology, Inje University, Busan Paik Hospital, Busan, Korea
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Abstract
Agminated lentiginosis is an unusual pigmentary disorder, characterized by numerous lentigines grouped within an area of normal skin. The pigmented macules are often in a segmental distribution within a sharp demarcation at the midline. We encountered a 28-year-old woman with an unusual combination of multiple café-au-lait macules and diffuse numerous lentigines involving the right cheek and ipsilateral upper thorax with sharp demarcation at the midline. The multiple lentigines extended bilaterally over the back in a peppered distribution. There were 21 café-au-lait macules on both arms, and the trunk and buttocks; however, there were no Lisch nodules, neurofibromas, or any other clinical manifestations for neurofibromatosis. Histopathology of a macule revealed the features of lentigo.
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Affiliation(s)
- J H Lee
- Department of Dermatology, Eulji Medical Centre, Eulji University, Seoul, Korea
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Ahn TB, Kim SY, Kim JY, Park SS, Lee DS, Min HJ, Kim YK, Kim SE, Kim JM, Kim HJ, Cho J, Jeon BS. alpha-Synuclein gene duplication is present in sporadic Parkinson disease. Neurology 2007; 70:43-9. [PMID: 17625105 DOI: 10.1212/01.wnl.0000271080.53272.c7] [Citation(s) in RCA: 170] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE alpha-Synuclein gene (SNCA) multiplication was found in familial Parkinson disease (PD). We examined SNCA multiplication in patients with familial and sporadic PD and multiple system atrophy (MSA). METHODS We screened 1,106 patients with parkinsonism (PD = 906, MSA = 200) for SNCA multiplication by multiplex PCR. Fluorescent in situ hybridization was done to confirm the multiplication. [(123)I]N-omega-Fluoropropyl-2 beta-carbomethoxy-3beta-(4-iodophenyl)-tropane ([(123)I]FP-CIT) SPECT was done in the patients with SNCA multiplication and their family members. RESULTS Three patients were identified as having SNCA duplication. One patient had a positive family history, and two patients were sporadic. Each patient had asymptomatic carriers in their families. The familial case had early onset parkinsonism with rapidly progressive course, cognitive impairment, and dysautonomia. Sporadic cases were more typical of PD. [(123)I]FP-CIT SPECT was abnormal in the patients and normal in the asymptomatic carriers. CONCLUSION SNCA multiplication is present in sporadic Parkinson disease (PD) and needs to be screened. Low penetrance, clinical heterogeneity, and normal dopamine transporter imaging in asymptomatic carriers may suggest the presence of other genetic modifiers or environmental triggers that play a role in the pathogenesis of PD due to SNCA duplication.
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Affiliation(s)
- T-B Ahn
- Department of Neurology, Kyung Hee University College of Medicine, Korea
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Shim JH, Kim SE, Woo DH, Kim SK, Oh CH, McKay R, Kim JH. Directed differentiation of human embryonic stem cells towards a pancreatic cell fate. Diabetologia 2007; 50:1228-38. [PMID: 17457565 DOI: 10.1007/s00125-007-0634-z] [Citation(s) in RCA: 168] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2006] [Accepted: 01/15/2007] [Indexed: 12/13/2022]
Abstract
AIMS/HYPOTHESIS The relative lack of successful pancreatic differentiation of human embryonic stem cells (hESCs) may suggest that directed differentiation of hESCs into definitive endoderm and subsequent commitment towards a pancreatic fate are not readily achieved. The aim of this study was to investigate whether sequential exposure of hESCs to epigenetic signals that mimic in vivo pancreatic development can efficiently generate pancreatic endodermal cells, and whether these cells can be further matured and reverse hyperglycaemia upon transplantation. MATERIALS AND METHODS The hESCs were sequentially treated with serum, activin and retinoic acid (RA) during embryoid body formation. The patterns of gene expression and protein production associated with embryonic germ layers and pancreatic endoderm were analysed by RT-PCR and immunostaining. The developmental competence and function of hESC-derived PDX1-positive cells were evaluated after in vivo transplantation. RESULTS Sequential treatment with serum, activin and RA highly upregulated the expression of the genes encoding forkhead box protein A2 (FOXA2), SRY-box containing gene 17 (SOX17), pancreatic and duodenal homeobox 1 (PDX1) and homeobox HB9 (HLXB9). The population of pancreatic endodermal cells that produced PDX1 was significantly increased at the expense of ectodermal differentiation, and a subset of the PDX1-positive cells also produced FOXA2, caudal-type homeobox transcription factor 2 (CDX2), and nestin (NES). After transplantation, the PDX1-positive cells further differentiated into mature cell types producing insulin and glucagon, resulting in amelioration of hyperglycaemia and weight loss in streptozotocin-treated diabetic mice. CONCLUSIONS/INTERPRETATION Our strategy allows the progressive differentiation of hESCs into pancreatic endoderm capable of generating mature pancreatic cell types that function in vivo. These findings may establish the basis of further investigations for the purification of transplantable islet progenitors derived from hESCs.
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Affiliation(s)
- J H Shim
- Division of Biotechnology, College of Life Sciences and Biotechnology, Korea University, West Building/Room 304, Science Campus, 1 Anam-dong 5-ga, Sungbuk-goo, Seoul 136-713, Republic of Korea
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Kim SE, Yamada H, Tsuno H. Ozonation parameter for removal of oestrogenicity from secondary effluent without by-products. Water Sci Technol 2007; 55:233-40. [PMID: 17305145 DOI: 10.2166/wst.2007.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
The purposes of this study are to investigate ozonation characteristics, to evaluate oestrogenicity and to confirm behaviours of by-products during ozonation of secondary effluent. For the ozonation of secondary effluent, TOC was decreased only 10% when 4 (mgO3/mgC) of ozone consumption per initial TOC. However, UV254 and SUVA was decreased approximately 65% until ozone consumption of 2 (mgO3/mgC). Ozonation was also shown to be very effective for decrease of oestrogenicity in secondary effluent. Bromate ion started to form obviously when the ozone consumption per initial TOC exceeded 2 (mgO3/mgC) and increased while the time of ozonation became longer. From these results, ozone consumption per initial TOC was shown to be an appropriate operation parameter to reduce SUVA effectively and E2 equivalent concentration to less than 0.1 nM without significant formation of bromate ion, and its value was determined to be 2 (mgO3/mgC) in ozonation of secondary effluent.
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Affiliation(s)
- S E Kim
- Department of Civil and Environmental Engineering, Korea Advanced Institute of Science and Technology, 373-1, Guseong-dong, Yuseong-gu, Daejeon, 305-701, Republic of Korea.
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