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Cho SH, Nho WY, Lee DE, Ahn JY, Kim JW, Lim KH, Ryoo HW, Kim JK. Impact of COVID-19 pandemic on interhospital transfer of patients with major trauma in Korea: a retrospective cohort study. BMC Emerg Med 2024; 24:53. [PMID: 38570762 PMCID: PMC10988904 DOI: 10.1186/s12873-024-00963-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 03/08/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Interhospital transfer (IHT) is necessary for providing ultimate care in the current emergency care system, particularly for patients with severe trauma. However, studies on IHT during the pandemic were limited. Furthermore, evidence on the effects of the coronavirus disease 2019 (COVID-19) pandemic on IHT among patients with major trauma was lacking. METHOD This retrospective cohort study was conducted in an urban trauma center (TC) of a tertiary academic affiliated hospital in Daegu, Korea. The COVID-19 period was defined as from February 1, 2020 to January 31, 2021, whereas the pre-COVID-19 period was defined as the same duration of preceding span. Clinical data collected in each period were compared. We hypothesized that the COVID-19 pandemic negatively impacted IHT. RESULTS A total of 2,100 individual patients were included for analysis. During the pandemic, the total number of IHTs decreased from 1,317 to 783 (- 40.5%). Patients were younger (median age, 63 [45-77] vs. 61[44-74] years, p = 0.038), and occupational injury was significantly higher during the pandemic (11.6% vs. 15.7%, p = 0.025). The trauma team activation (TTA) ratio was higher during the pandemic both on major trauma (57.3% vs. 69.6%, p = 0.006) and the total patient cohort (22.2% vs. 30.5%, p < 0.001). In the COVID-19 period, duration from incidence to the TC was longer (218 [158-480] vs. 263[180-674] minutes, p = 0.021), and secondary transfer was lower (2.5% vs. 0.0%, p = 0.025). CONCLUSION We observed that the total number of IHTs to the TC was reduced during the COVID-19 pandemic. Overall, TTA was more frequent, particularly among patients with major trauma. Patients with severe injury experienced longer duration from incident to the TC and lesser secondary transfer from the TC during the COVID-19 pandemic.
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Affiliation(s)
- Sung Hoon Cho
- Trauma Center, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
- Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Woo Young Nho
- Trauma Center, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
| | - Dong Eun Lee
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Jae Yun Ahn
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Joon-Woo Kim
- Trauma Center, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
- Department of Orthopaedic Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Kyoung Hoon Lim
- Trauma Center, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
- Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Hyun Wook Ryoo
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Jong Kun Kim
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
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Lee MO, Lee JH, Cho SH, Kim CE. Anesthesia for a Patient with Undiagnosed Myotonic Dystrophy. Niger J Clin Pract 2024; 27:541-544. [PMID: 38679780 DOI: 10.4103/njcp.njcp_553_23] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 02/26/2024] [Indexed: 05/01/2024]
Abstract
ABSTRACT Myotonic dystrophy (DM) is an autosomal dominant genetic disorder characterized by progressively worsening loss of muscle mass and weakness. Anesthesiologists face challenges in managing these patients due to risks such as prolonged intubation and delayed recovery associated with anesthesia in such conditions. We report a case of a 40-year-old male patient undergoing open total gastrectomy under general anesthesia. After the surgery, we administered sugammadex to reverse neuromuscular blockade and confirmed the patient's spontaneous breathing. We then proceeded to extubate the patient. However, the patient experienced complications such as apnea, desaturation, and mental changes. The patient was re-intubated and transferred to the intensive care unit for ventilator support. He was diagnosed with DM by genetic test later. Poor preoperative assessment or undiagnosed DM in surgical patients can lead to severe complications. Thus, it is important to carefully check preoperative laboratory results, patient history, and physical findings.
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Affiliation(s)
- M O Lee
- Department of Anesthesia and Pain Medicine Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
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Brookens SK, Cho SH, Paik Y, Meyer K, Raybuck AL, Park C, Greenwood DL, Rathmell JC, Boothby MR. Plasma Cell Differentiation, Antibody Quality, and Initial Germinal Center B Cell Population Depend on Glucose Influx Rate. J Immunol 2024; 212:43-56. [PMID: 37955416 PMCID: PMC10841396 DOI: 10.4049/jimmunol.2200756] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 10/19/2023] [Indexed: 11/14/2023]
Abstract
Serum Ab concentrations, selection for higher affinity BCRs, and generation of higher Ab affinities are important elements of immune response optimization and functions of germinal center (GC) reactions. B cell proliferation requires nutrients to support the anabolism inherent in clonal expansion. Glucose usage by mouse GC B cells has been reported to contribute little to their energy needs, with questions raised as to whether glucose uptake or glycolysis increases in GC B cells compared with their naive precursors. Indeed, metabolism can be highly flexible, such that supply shortage along one pathway may be compensated by increased flux on others. We now show that reduction of the glucose transporter GLUT1 in mice after establishment of a preimmune B cell repertoire, even after initiation of the GC B cell gene expression program, decreased initial GC B cell population numbers, affinity maturation, and plasma cell outputs. Glucose oxidation was heightened in GC B cells, but this hexose flowed more into the pentose phosphate pathway, whose activity was important in controlling reactive oxygen species (ROS) and Ab-secreting cell production. In modeling how glucose usage by B cells promotes the Ab response, the control of ROS appeared insufficient. Surprisingly, the combination of galactose, which mitigated ROS, with provision of mannose, an efficient precursor to glycosylation, supported robust production of and normal Ab secretion by Ab-secreting cells under glucose-free conditions. Collectively, the findings indicate that GCs depend on normal glucose influx, especially in plasma cell production, but reveal an unexpected metabolic flexibility in hexose requirements.
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Affiliation(s)
- Shawna K. Brookens
- Department of Pathology-Microbiology-Immunology, Vanderbilt University Medical Center, Nashville, TN 37232
- Cancer Biology Program, Vanderbilt University
- Center for Cellular Immunotherapies, University of Pennsylvania, Philadelphia, PA 19104
| | - Sung Hoon Cho
- Department of Pathology-Microbiology-Immunology, Vanderbilt University Medical Center, Nashville, TN 37232
- Vanderbilt Center for Immunobiology
- Vanderbilt Institute for Infection, Inflammation, & Immunology
| | - Yeeun Paik
- Department of Pathology-Microbiology-Immunology, Vanderbilt University Medical Center, Nashville, TN 37232
| | - Kaylor Meyer
- Department of Pathology-Microbiology-Immunology, Vanderbilt University Medical Center, Nashville, TN 37232
| | - Ariel L. Raybuck
- Department of Pathology-Microbiology-Immunology, Vanderbilt University Medical Center, Nashville, TN 37232
| | - Chloe Park
- Department of Pathology-Microbiology-Immunology, Vanderbilt University Medical Center, Nashville, TN 37232
| | - Dalton L. Greenwood
- Department of Pathology-Microbiology-Immunology, Vanderbilt University Medical Center, Nashville, TN 37232
| | - Jeffrey C. Rathmell
- Department of Pathology-Microbiology-Immunology, Vanderbilt University Medical Center, Nashville, TN 37232
- Cancer Biology Program, Vanderbilt University
- Vanderbilt Center for Immunobiology
- Vanderbilt Institute for Infection, Inflammation, & Immunology
| | - Mark R. Boothby
- Department of Pathology-Microbiology-Immunology, Vanderbilt University Medical Center, Nashville, TN 37232
- Cancer Biology Program, Vanderbilt University
- Vanderbilt Center for Immunobiology
- Vanderbilt Institute for Infection, Inflammation, & Immunology
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Lee SE, Amin N, Mannent LP, Bachert C, Gross G, Cho SH, Praestgaard A, Siddiqui S, Nash S, Kamat S, Khan AH, Jacob Nara JA. The relationship of sinus opacification, olfaction and dupilumab efficacy in patients with CRSwNP. Rhinology 2023; 61:531-540. [PMID: 37453138 DOI: 10.4193/rhin22.220] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
BACKGROUND Loss of sense of smell is one of the most burdensome symptoms of chronic rhinosinusitis with nasal polyps (CRSwNP) but its relationship to sinus disease on imaging is unclear. Dupilumab improves sense of smell and radiographic severity of sinus disease in patients with CRSwNP. We investigated the relationship of sinus opacification severity and loci to olfactory impairment and dupilumab efficacy in patients with CRSwNP from the SINUS-24/SINUS-52 (NCT02912468/NCT02898454) studies. METHODS Sinus opacification was evaluated using the Lund-Mackay computed tomography (LMK-CT) score and sense of smell using patient-reported loss of smell (LoS) score, University of Pennsylvania Smell Identification Test (UPSIT) score and the 22-item Sino-Nasal Outcome Test (SNOT-22) smell/taste item. RESULTS At baseline, 95% of patients (688/724) had impaired sense of smell and opacification was extensive across all sinuses. Greater olfactory impairment was associated with greater opacification, especially in the ethmoid, sphenoid and frontal sinuses. At Week 24, reductions in LMK-CT total score and ethmoid and sphenoid sinus scores with dupilumab were weakly correlated with improvements in sense of smell assessed by LoS, UPSIT and SNOT-22 smell/taste item. More dupilumab than placebo patients achieved clinically meaningful improvement in LMK-CT total score at Week 24 and Week 52. CONCLUSION Radiographic disease severity on imaging was associated with smell outcomes in this cohort. Opacification of the ethmoid, sphenoid and frontal sinuses was associated with severe smell loss. These data suggest that dupilumab effects on smell may be partly mediated through reduced sinus inflammation.
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Affiliation(s)
- S E Lee
- Division of Otolaryngology - Head and Neck Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - N Amin
- Clinical Sciences Global Development, Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
| | - L P Mannent
- Global Clinical Development, Sanofi, Chilly-Mazarin, France
| | - C Bachert
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital of Münster, Münster, Germany, and International Airway Research Center, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China, and Upper Airways Research Laboratory and Department of Otorhinolaryngology, Ghent University, Ghent, Belgium
| | - G Gross
- Department of Internal Medicine, University of Texas Southwestern Medical School, Dallas, TX, USA
| | - S H Cho
- Division of Allergy-Immunology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - A Praestgaard
- Department of Biostatistics, Sanofi, Cambridge, MA, USA
| | - S Siddiqui
- Medical Affairs, Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
| | - S Nash
- Medical Affairs, Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
| | - S Kamat
- Medical Affairs, Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
| | - A H Khan
- Global Medical Affairs, Sanofi, Chilly-Mazarin, France
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Brookens SK, Cho SH, Paik Y, Meyer K, Raybuck AL, Park C, Greenwood DL, Rathmell JC, Boothby MR. Plasma cell differentiation, antibody quality, and initial germinal center B cell population depend on glucose influx rate. bioRxiv 2023:2023.09.13.557599. [PMID: 37745429 PMCID: PMC10515901 DOI: 10.1101/2023.09.13.557599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Antibody secretion into sera, selection for higher affinity BCR, and the generation of higher Ab affinities are important elements of immune response optimization, and a core function of germinal center reactions. B cell proliferation requires nutrients to support the anabolism inherent in clonal expansion. Glucose usage by GC B cells has been reported to contribute little to their energy needs, with questions raised as to whether or not glucose uptake or glycolysis increases in GC B cells compared to their naïve precursors. Indeed, metabolism can be highly flexible, such that supply shortage along one pathway may be compensated by increased flux on others. We now show that elimination of the glucose transporter GLUT1 after establishment of a pre-immune B cell repertoire, even after initiation of the GC B cell gene expression program, decreased initial GC B cell population numbers, affinity maturation, and PC outputs. Glucose oxidation was heightened in GC B cells, but this hexose flowed more into the pentose phosphate pathway (PPP), whose activity was important in controlling reactive oxygen (ROS) and ASC production. In modeling how glucose usage by B cells promotes the Ab response, the control of ROS appeared insufficient. Surprisingly, the combination of galactose, which mitigated ROS, with provision of mannose - an efficient precursor to glycosylation - supported robust production of and normal Ab secretion by ASC under glucose-free conditions. Collectively, the findings indicate that GC depend on normal glucose influx, especially in PC production, but reveal an unexpected metabolic flexibility in hexose requirements. KEY POINTS Glucose influx is critical for GC homeostasis, affinity maturation and the generation of Ab-secreting cells.Plasma cell development uses the Pentose Phosphate Pathway, and hexose sugars maintain redox homeostasis.PCs can develop and achieve robust Ab secretion in the absence of glucose using a combination of hexose alternatives.
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Jo S, Lee SH, Jo HR, Weon S, Jeon C, Park MK, Kim TH, Cho SH. Eosinophil-derived TGFβ1 controls the new bone formation in chronic rhinosinusitis with nasal polyps. Rhinology 2023; 61:338-347. [PMID: 37083114 DOI: 10.4193/rhin22.439] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
BACKGROUND Chronic rhinosinusitis with nasal polyps (CRSwNP) is characterized by chronic eosinophilic inflammation and new bone formation (NBF). These processes may be associated with each other in the pathogenesis and influence the severity and prognosis of the disease. However, it is still unclear how eosinophilic inflammation is involved in the NBF. METHODOLOGY Sinus bone cells were isolated from ethmoid bone tissues of patients with CRSwNP and controls. Transforming growth factor beta 1 (TGFβ1) and alkaline phosphatase (ALP) expression in sinus bone cells was determined using quantitative RT-PCR, immunoblotting, and immunohistochemistry. The co-localization of TGFβ1 with eosinophils was assessed by immunofluorescence staining. Sinus bone cells were co-cultured with eosinophils (Eol-1 cell line), which were differentiated with butyrate, to measure the osteoblast differentiation activity of sinus bone cells. RESULTS TGFβ1 expression was increased in sinus bone tissues and correlated with CT scores in CRSwNP. TGFβ1 was also increased in the submucosa of CRSwNP and co-localized predominantly with eosinophils compared with neutrophils Differentiated Eol-1 cells-derived TGFβ1 increased ALP expression in sinus bone cells. Treatment with a TGFβ inhibitor attenuated TGFβ1-induced ALP expression and staining in sinus bone cells of CRSwNP, leading to loss of bone formation. CONCLUSIONS Eosinophil-derived TGFβ1 was enriched in the submucosa of CRSwNP, which induced ALP expression in sinus bone cells and NBF. Therefore, eosinophil-derived TGFβ1 may mediate aberrant bone remodeling in CRSwNP.
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Affiliation(s)
- S Jo
- Hanyang University Institute for Rheumatology Research (HYIRR), Hanyang University, Seoul, Republic of Korea
| | - S H Lee
- Hanyang University Institute for Rheumatology Research (HYIRR), Hanyang University, Seoul, Republic of Korea
| | - H-R Jo
- Hanyang University Institute for Rheumatology Research (HYIRR), Hanyang University, Seoul, Republic of Korea
| | - S Weon
- Hanyang University Institute for Rheumatology Research (HYIRR), Hanyang University, Seoul, Republic of Korea
| | - C Jeon
- Hanyang University Institute for Rheumatology Research (HYIRR), Hanyang University, Seoul, Republic of Korea
| | - M K Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - T-H Kim
- Hanyang University Institute for Rheumatology Research (HYIRR), Hanyang University, Seoul, Republic of Korea; Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Republic of Korea
| | - S H Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Republic of Korea
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Thirunavukkarasu S, Ahmed M, Rosa BA, Boothby M, Cho SH, Rangel-Moreno J, Mbandi SK, Schreiber V, Gupta A, Zuniga J, Mitreva M, Kaushal D, Scriba TJ, Khader SA. Poly(ADP-ribose) polymerase 9 mediates early protection against Mycobacterium tuberculosis infection by regulating type I IFN production. J Clin Invest 2023; 133:e158630. [PMID: 37200107 PMCID: PMC10266794 DOI: 10.1172/jci158630] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/19/2023] [Indexed: 05/20/2023] Open
Abstract
The ADP ribosyltransferases (PARPs 1-17) regulate diverse cellular processes, including DNA damage repair. PARPs are classified on the basis of their ability to catalyze poly-ADP-ribosylation (PARylation) or mono-ADP-ribosylation (MARylation). Although PARP9 mRNA expression is significantly increased in progressive tuberculosis (TB) in humans, its participation in host immunity to TB is unknown. Here, we show that PARP9 mRNA encoding the MARylating PARP9 enzyme was upregulated during TB in humans and mice and provide evidence of a critical modulatory role for PARP9 in DNA damage, cyclic GMP-AMP synthase (cGAS) expression, and type I IFN production during TB. Thus, Parp9-deficient mice were susceptible to Mycobacterium tuberculosis infection and exhibited increased TB disease, cGAS and 2'3'-cyclic GMP-AMP (cGAMP) expression, and type I IFN production, along with upregulation of complement and coagulation pathways. Enhanced M. tuberculosis susceptibility is type I IFN dependent, as blockade of IFN α receptor (IFNAR) signaling reversed the enhanced susceptibility of Parp9-/- mice. Thus, in sharp contrast to PARP9 enhancement of type I IFN production in viral infections, this member of the MAR family plays a protective role by limiting type I IFN responses during TB.
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Affiliation(s)
| | | | - Bruce A. Rosa
- McDonnell Genome Institute, and
- Division of Infectious Diseases, Department of Internal Medicine, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Mark Boothby
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Sung Hoon Cho
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Javier Rangel-Moreno
- Department of Medicine, Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center, Rochester, New York, USA
| | - Stanley K. Mbandi
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Valérie Schreiber
- Biotechnology and Cell Signaling, CNRS UMR7242, Institut de Génétique et de Biologie Moléculaire et Cellulaire, CNRS UMR7104, INSERM U1258, Université de Strasbourg, Illkirch, France
| | | | - Joaquin Zuniga
- Laboratory of Immunobiology and Genetics, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City, Mexico
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Mexico City, Mexico
| | - Makedonka Mitreva
- McDonnell Genome Institute, and
- Division of Infectious Diseases, Department of Internal Medicine, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Deepak Kaushal
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, Texas, USA
| | - Thomas J. Scriba
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa
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Kim E, Cho HH, Cho SH, Park B, Hong J, Shin KM, Hwang MJ, You SK, Lee SM. Accelerated Synthetic MRI with Deep Learning-Based Reconstruction for Pediatric Neuroimaging. AJNR Am J Neuroradiol 2022; 43:1653-1659. [PMID: 36175085 PMCID: PMC9731246 DOI: 10.3174/ajnr.a7664] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/31/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND PURPOSE Synthetic MR imaging is a time-efficient technique. However, its rather long scan time can be challenging for children. This study aimed to evaluate the clinical feasibility of accelerated synthetic MR imaging with deep learning-based reconstruction in pediatric neuroimaging and to investigate the impact of deep learning-based reconstruction on image quality and quantitative values in synthetic MR imaging. MATERIALS AND METHODS This study included 47 children 2.3-14.7 years of age who underwent both standard and accelerated synthetic MR imaging at 3T. The accelerated synthetic MR imaging was reconstructed using a deep learning pipeline. The image quality, lesion detectability, tissue values, and brain volumetry were compared among accelerated deep learning and accelerated and standard synthetic data sets. RESULTS The use of deep learning-based reconstruction in the accelerated synthetic scans significantly improved image quality for all contrast weightings (P < .001), resulting in image quality comparable with or superior to that of standard scans. There was no significant difference in lesion detectability between the accelerated deep learning and standard scans (P > .05). The tissue values and brain tissue volumes obtained with accelerated deep learning and the other 2 scans showed excellent agreement and a strong linear relationship (all, R 2 > 0.9). The difference in quantitative values of accelerated scans versus accelerated deep learning scans was very small (tissue values, <0.5%; volumetry, -1.46%-0.83%). CONCLUSIONS The use of deep learning-based reconstruction in synthetic MR imaging can reduce scan time by 42% while maintaining image quality and lesion detectability and providing consistent quantitative values. The accelerated deep learning synthetic MR imaging can replace standard synthetic MR imaging in both contrast-weighted and quantitative imaging.
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Affiliation(s)
- E Kim
- From the Departments of Medical and Biological Engineering (E.K.)
- Korea Radioisotope Center for Pharmaceuticals (E.K.), Korea Institute of Radiological and Medical Sciences, Seoul, South Korea
| | - H-H Cho
- Department of Radiology and Medical Research Institute (H.-H.C.), College of Medicine, Ewha Womans University, Seoul, South Korea
| | - S H Cho
- Radiology (S.H.C., B.P., J.H., K.M.S., S.M.L.), School of Medicine, Kyungpook National University, Daegu, South Korea
- Department of Radiology (S.H.C., B.P., J.H., K.M.S., S.M.L.), Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - B Park
- Radiology (S.H.C., B.P., J.H., K.M.S., S.M.L.), School of Medicine, Kyungpook National University, Daegu, South Korea
- Department of Radiology (S.H.C., B.P., J.H., K.M.S., S.M.L.), Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - J Hong
- Radiology (S.H.C., B.P., J.H., K.M.S., S.M.L.), School of Medicine, Kyungpook National University, Daegu, South Korea
- Department of Radiology (S.H.C., B.P., J.H., K.M.S., S.M.L.), Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - K M Shin
- Radiology (S.H.C., B.P., J.H., K.M.S., S.M.L.), School of Medicine, Kyungpook National University, Daegu, South Korea
- Department of Radiology (S.H.C., B.P., J.H., K.M.S., S.M.L.), Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - M J Hwang
- GE Healthcare Korea (M.J.H.), Seoul, South Korea
| | - S K You
- Department of Radiology (S.K.Y.), Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, South Korea
| | - S M Lee
- Radiology (S.H.C., B.P., J.H., K.M.S., S.M.L.), School of Medicine, Kyungpook National University, Daegu, South Korea
- Department of Radiology (S.H.C., B.P., J.H., K.M.S., S.M.L.), Kyungpook National University Chilgok Hospital, Daegu, South Korea
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Cho SH, Lim KH. Laparoscopic repair of colonoscopy-induced adult Bochdalek hernia: Case report. Int J Surg Case Rep 2022; 99:107591. [PMID: 36108379 PMCID: PMC9568726 DOI: 10.1016/j.ijscr.2022.107591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/30/2022] [Accepted: 08/30/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction Bochdalek hernias are congenital diaphragmatic malformations caused by a failure to close the pleuroperitoneal cavity in the posterolateral area. Bochdalek hernias are very rare in adult, with congenital diaphragmatic defects being even rarer. Presentation of case A 35-year-old man presented to our emergency room with epigastric pain after colonoscopy. The patient had no history of trauma. Plain chest X-ray revealed bowel gas patterns and haziness in the left lower lung field. Abdominal computed tomography revealed a left diaphragmatic defect in the posterolateral area, with herniation of the omentum and colon. The patient successfully underwent laparoscopic herniorrhaphy. Discussion The diaphragm comprises fibrous tissue and muscle. Therefore, direct damage by a colonoscope is almost impossible. Normal chest X-ray as a part of a health screening was performed 9 days prior to admission, and the size of the diaphragmatic defect could be covered by the spleen; therefore, the patient was considered hernia-free for over 30 years. Conclusion We report a rare case of delayed Bochdalek hernia that may have been induced by the difficult insertion of a colonoscopy. Although rare, this disorder should be recognized, examined and treated appropriately to avoid complications. Bochdalek hernia found in adult is very rare. The small size of the diaphragm defect appears to have been blocked by the spleen. Herniation of colon was induced by the difficult insertion of a colonoscopy.
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Abstract
Patients with trauma may develop thrombocytopenia. We encountered cases wherein patients experienced symptoms resembling thrombotic microangiopathies (TMAs) following severe trauma. As the condition of these patients did not meet the diagnostic criteria of thrombotic thrombocytopenic purpura and there was no mention of trauma among the several causes of TMAs, it was termed as "trauma-induced thrombotic microangiopathy-like syndrome" (t-TMAS). In this study, we aimed to analyze the risk factors that may affect the incidence of t-TMAS in patients with severe trauma. This retrospective study was conducted in the trauma intensive care unit at the Kyungpook National University Hospital between January 2018 and December 2019. The medical records of 1164 of the 1392 enrolled participants were analyzed. To assess the risk factors of t-TMAS, we analyzed age, sex, mechanism of trauma, abbreviated injury scale (AIS) score, injury severity score (ISS), hematological examination, and red blood cell volume transfused in 24 hours. Among the 1164 patients, 20 (1.7%) were diagnosed with t-TMAS. The univariate analysis revealed higher age, ISS, and myoglobin, lactate, creatine kinase-myocardial band (on admission), creatine phosphokinase, lactate dehydrogenase (LDH), and lactate (day 2) levels in the t-TMAS group than in the non-t-TMAS group. The red blood cell volume transfused in 24 hours was higher in the t-TMAS group than in the non-t-TMAS group. t-TMAS was more common in patients with injuries in the chest, abdomen, and pelvis (AIS score ≥3) than in those with head injuries (AIS score ≥3) alone. The higher the sum of AIS scores of the chest, abdomen, and pelvis injuries, the higher the incidence of t-TMAS. Multivariate analysis revealed age, ISS, and LDH level (day 2) to be independent predictors of t-TMAS. Trauma surgeons should consider the possibility of t-TMAS if thrombocytopenia persists without any evidence of bleeding, particularly among older patients with multiple severe torso injuries who have high LDH levels on day 2. Early diagnosis and treatment of t-TMAS could improve patients' prognosis.
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Affiliation(s)
- Kyoung Hoon Lim
- Department of Surgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, South Korea
- *Correspondence: Kyoung Hoon Lim, Department of Surgery, Kyungpook National University Hospital, 130, Dongduk-ro, Jung-gu, Daegu, 41944, South Korea (e-mail: )
| | - Jinyoung Park
- Department of Surgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Sung Hoon Cho
- Department of Surgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, South Korea
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Eddie AM, Chen KW, Schenkel LB, Swinger KK, Molina JR, Kunii K, Raybuck AL, Keilhack H, Gibson-Corley KN, Niepel M, Peebles RS, Boothby MR, Cho SH. Selective Pharmaceutical Inhibition of PARP14 Mitigates Allergen-Induced IgE and Mucus Overproduction in a Mouse Model of Pulmonary Allergic Response. Immunohorizons 2022; 6:432-446. [PMID: 35817532 PMCID: PMC10182383 DOI: 10.4049/immunohorizons.2100107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 06/16/2022] [Indexed: 11/19/2022] Open
Abstract
The type 2 cytokines IL-4 and IL-13, which share use of an IL-4 receptor α-chain and its nuclear induction of the transcription factor STAT6, are crucial in elicitation and maintenance of allergic conditions including asthma. STAT6 binds poly(ADP-ribose) polymerase (PARP)14, an ADP-ribosyl monotransferase. Elimination of PARP14 by gene targeting led to attenuation of OVA-specific allergic lung inflammation. However, PARP14 has multiple functional domains apart from the portion that catalyzes ADP-ribosylation, and it is not clear whether inhibition of the catalytic function has any biological consequence. Using BALB/c mice sensitized to the allergen Alternaria alternata, we show that peroral administration of RBN012759, a highly selective inhibitor of ADP-ribosylation by PARP14 with negligible impact on other members of the PARP gene family, achieved biologically active plasma concentrations and altered several responses to the Ag. Specifically, the pharmaceutical compound decreased mucus after allergen challenge, blunted the induced increases in circulating IgE, and prevented suppression of IgG2a. We conclude that PARP14 catalytic activity can contribute to pathogenesis in allergic or atopic processes and propose that other biological endpoints dependent on ADP-ribosylation by PARP14 can be targeted using selective inhibition.
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Affiliation(s)
- Alex M Eddie
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center and School of Medicine, Nashville TN
| | - Kevin W Chen
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center and School of Medicine, Nashville TN
| | | | | | | | | | - Ariel L Raybuck
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center and School of Medicine, Nashville TN
| | | | - Katherine N Gibson-Corley
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center and School of Medicine, Nashville TN
| | | | - R Stokes Peebles
- Department of Medicine, Vanderbilt University Medical Center and School of Medicine, Nashville TN; and.,Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville Campus, Nashville TN
| | - Mark R Boothby
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center and School of Medicine, Nashville TN;
| | - Sung Hoon Cho
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center and School of Medicine, Nashville TN
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Kouli O, Murray V, Bhatia S, Cambridge WA, Kawka M, Shafi S, Knight SR, Kamarajah SK, McLean KA, Glasbey JC, Khaw RA, Ahmed W, Akhbari M, Baker D, Borakati A, Mills E, Thavayogan R, Yasin I, Raubenheimer K, Ridley W, Sarrami M, Zhang G, Egoroff N, Pockney P, Richards T, Bhangu A, Creagh-Brown B, Edwards M, Harrison EM, Lee M, Nepogodiev D, Pinkney T, Pearse R, Smart N, Vohra R, Sohrabi C, Jamieson A, Nguyen M, Rahman A, English C, Tincknell L, Kakodkar P, Kwek I, Punjabi N, Burns J, Varghese S, Erotocritou M, McGuckin S, Vayalapra S, Dominguez E, Moneim J, Salehi M, Tan HL, Yoong A, Zhu L, Seale B, Nowinka Z, Patel N, Chrisp B, Harris J, Maleyko I, Muneeb F, Gough M, James CE, Skan O, Chowdhury A, Rebuffa N, Khan H, Down B, Fatimah Hussain Q, Adams M, Bailey A, Cullen G, Fu YXJ, McClement B, Taylor A, Aitken S, Bachelet B, Brousse de Gersigny J, Chang C, Khehra B, Lahoud N, Lee Solano M, Louca M, Rozenbroek P, Rozitis E, Agbinya N, Anderson E, Arwi G, Barry I, Batchelor C, Chong T, Choo LY, Clark L, Daniels M, Goh J, Handa A, Hanna J, Huynh L, Jeon A, Kanbour A, Lee A, Lee J, Lee T, Leigh J, Ly D, McGregor F, Moss J, Nejatian M, O'Loughlin E, Ramos I, Sanchez B, Shrivathsa A, Sincari A, Sobhi S, Swart R, Trimboli J, Wignall P, Bourke E, Chong A, Clayton S, Dawson A, Hardy E, Iqbal R, Le L, Mao S, Marinelli I, Metcalfe H, Panicker D, R HH, Ridgway S, Tan HH, Thong S, Van M, Woon S, Woon-Shoo-Tong XS, Yu S, Ali K, Chee J, Chiu C, Chow YW, Duller A, Nagappan P, Ng S, Selvanathan M, Sheridan C, Temple M, Do JE, Dudi-Venkata NN, Humphries E, Li L, Mansour LT, Massy-Westropp C, Fang B, Farbood K, Hong H, Huang Y, Joan M, Koh C, Liu YHA, Mahajan T, Muller E, Park R, Tanudisastro M, Wu JJG, Chopra P, Giang S, Radcliffe S, Thach P, Wallace D, Wilkes A, Chinta SH, Li J, Phan J, Rahman F, Segaran A, Shannon J, Zhang M, Adams N, Bonte A, Choudhry A, Colterjohn N, Croyle JA, Donohue J, Feighery A, Keane A, McNamara D, Munir K, Roche D, Sabnani R, Seligman D, Sharma S, Stickney Z, Suchy H, Tan R, Yordi S, Ahmed I, Aranha M, El Sabawy D, Garwood P, Harnett M, Holohan R, Howard R, Kayyal Y, Krakoski N, Lupo M, McGilberry W, Nepon H, Scoleri Y, Urbina C, Ahmad Fuad MF, Ahmed O, Jaswantlal D, Kelly E, Khan MHT, Naidu D, Neo WX, O'Neill R, Sugrue M, Abbas JD, Abdul-Fattah S, Azlan A, Barry K, Idris NS, Kaka N, Mc Dermott D, Mohammad Nasir MN, Mozo M, Rehal A, Shaikh Yousef M, Wong RH, Curran E, Gardner M, Hogan A, Julka R, Lasser G, Ní Chorráin N, Ting J, Browne R, George S, Janjua Z, Leung Shing V, Megally M, Murphy S, Ravenscroft L, Vedadi A, Vyas V, Bryan A, Sheikh A, Ubhi J, Vannelli K, Vawda A, Adeusi L, Doherty C, Fitzgerald C, Gallagher H, Gill P, Hamza H, Hogan M, Kelly S, Larry J, Lynch P, Mazeni NA, O'Connell R, O'Loghlin R, Singh K, Abbas Syed R, Ali A, Alkandari B, Arnold A, Arora E, Azam R, Breathnach C, Cheema J, Compton M, Curran S, Elliott JA, Jayasamraj O, Mohammed N, Noone A, Pal A, Pandey S, Quinn P, Sheridan R, Siew L, Tan EP, Tio SW, Toh VTR, Walsh M, Yap C, Yassa J, Young T, Agarwal N, Almoosawy SA, Bowen K, Bruce D, Connachan R, Cook A, Daniell A, Elliott M, Fung HKF, Irving A, Laurie S, Lee YJ, Lim ZX, Maddineni S, McClenaghan RE, Muthuganesan V, Ravichandran P, Roberts N, Shaji S, Solt S, Toshney E, Arnold C, Baker O, Belais F, Bojanic C, Byrne M, Chau CYC, De Soysa S, Eldridge M, Fairey M, Fearnhead N, Guéroult A, Ho JSY, Joshi K, Kadiyala N, Khalid S, Khan F, Kumar K, Lewis E, Magee J, Manetta-Jones D, Mann S, McKeown L, Mitrofan C, Mohamed T, Monnickendam A, Ng AYKC, Ortu A, Patel M, Pope T, Pressling S, Purohit K, Saji S, Shah Foridi J, Shah R, Siddiqui SS, Surman K, Utukuri M, Varghese A, Williams CYK, Yang JJ, Billson E, Cheah E, Holmes P, Hussain S, Murdock D, Nicholls A, Patel P, Ramana G, Saleki M, Spence H, Thomas D, Yu C, Abousamra M, Brown C, Conti I, Donnelly A, Durand M, French N, Goan R, O'Kane E, Rubinchik P, Gardiner H, Kempf B, Lai YL, Matthews H, Minford E, Rafferty C, Reid C, Sheridan N, Al Bahri T, Bhoombla N, Rao BM, Titu L, Chatha S, Field C, Gandhi T, Gulati R, Jha R, Jones Sam MT, Karim S, Patel R, Saunders M, Sharma K, Abid S, Heath E, Kurup D, Patel A, Ali M, Cresswell B, Felstead D, Jennings K, Kaluarachchi T, Lazzereschi L, Mayson H, Miah JE, Reinders B, Rosser A, Thomas C, Williams H, Al-Hamid Z, Alsadoun L, Chlubek M, Fernando P, Gaunt E, Gercek Y, Maniar R, Ma R, Matson M, Moore S, Morris A, Nagappan PG, Ratnayake M, Rockall L, Shallcross O, Sinha A, Tan KE, Virdee S, Wenlock R, Donnelly HA, Ghazal R, Hughes I, Liu X, McFadden M, Misbert E, Mogey P, O'Hara A, Peace C, Rainey C, Raja P, Salem M, Salmon J, Tan CH, Alves D, Bahl S, Baker C, Coulthurst J, Koysombat K, Linn T, Rai P, Sharma A, Shergill A, Ahmed M, Ahmed S, Belk LH, Choudhry H, Cummings D, Dixon Y, Dobinson C, Edwards J, Flint J, Franco Da Silva C, Gallie R, Gardener M, Glover T, Greasley M, Hatab A, Howells R, Hussey T, Khan A, Mann A, Morrison H, Ng A, Osmond R, Padmakumar N, Pervaiz F, Prince R, Qureshi A, Sawhney R, Sigurdson B, Stephenson L, Vora K, Zacken A, Cope P, Di Traglia R, Ferarrio I, Hackett N, Healicon R, Horseman L, Lam LI, Meerdink M, Menham D, Murphy R, Nimmo I, Ramaesh A, Rees J, Soame R, Dilaver N, Adebambo D, Brown E, Burt J, Foster K, Kaliyappan L, Knight P, Politis A, Richardson E, Townsend J, Abdi M, Ball M, Easby S, Gill N, Ho E, Iqbal H, Matthews M, Nubi S, Nwokocha JO, Okafor I, Perry G, Sinartio B, Vanukuru N, Walkley D, Welch T, Yates J, Yeshitila N, Bryans K, Campbell B, Gray C, Keys R, Macartney M, Chamberlain G, Khatri A, Kucheria A, Lee STP, Reese G, Roy choudhury J, Tan WYR, Teh JJ, Ting A, Kazi S, Kontovounisios C, Vutipongsatorn K, Amarnath T, Balasubramanian N, Bassett E, Gurung P, Lim J, Panjikkaran A, Sanalla A, Alkoot M, Bacigalupo V, Eardley N, Horton M, Hurry A, Isti C, Maskell P, Nursiah K, Punn G, Salih H, Epanomeritakis E, Foulkes A, Henderson R, Johnston E, McCullough H, McLarnon M, Morrison E, Cheung A, Cho SH, Eriksson F, Hedges J, Low Z, May C, Musto L, Nagi S, Nur S, Salau E, Shabbir S, Thomas MC, Uthayanan L, Vig S, Zaheer M, Zeng G, Ashcroft-Quinn S, Brown R, Hayes J, McConville R, French R, Gilliam A, Sheetal S, Shehzad MU, Bani W, Christie I, Franklyn J, Khan M, Russell J, Smolarek S, Varadarassou R, Ahmed SK, Narayanaswamy S, Sealy J, Shah M, Dodhia V, Manukyan A, O'Hare R, Orbell J, Chung I, Forenc K, Gupta A, Agarwal A, Al Dabbagh A, Bennewith R, Bottomley J, Chu TSM, Chu YYA, Doherty W, Evans B, Hainsworth P, Hosfield T, Li CH, McCullagh I, Mehta A, Thaker A, Thompson B, Virdi A, Walker H, Wilkins E, Dixon C, Hassan MR, Lotca N, Tong KS, Batchelor-Parry H, Chaudhari S, Harris T, Hooper J, Johnson C, Mulvihill C, Nayler J, Olutobi O, Piramanayagam B, Stones K, Sussman M, Weaver C, Alam F, Al Rawi M, Andrew F, Arrayeh A, Azizan N, Hassan A, Iqbal Z, John I, Jones M, Kalake O, Keast M, Nicholas J, Patil A, Powell K, Roberts P, Sabri A, Segue AK, Shah A, Shaik Mohamed SA, Shehadeh A, Shenoy S, Tong A, Upcott M, Vijayasingam D, Anarfi S, Dauncey J, Devindaran A, Havalda P, Komninos G, Mwendwa E, Norman C, Richards J, Urquhart A, Allan J, Cahya E, Hunt H, McWhirter C, Norton R, Roxburgh C, Tan JY, Ali Butt S, Hansdot S, Haq I, Mootien A, Sanchez I, Vainas T, Deliyannis E, Tan M, Vipond M, Chittoor Satish NN, Dattani A, De Carvalho L, Gaston-Grubb M, Karunanithy L, Lowe B, Pace C, Raju K, Roope J, Taylor C, Youssef H, Munro T, Thorn C, Wong KHF, Yunus A, Chawla S, Datta A, Dinesh AA, Field D, Georgi T, Gwozdz A, Hamstead E, Howard N, Isleyen N, Jackson N, Kingdon J, Sagoo KS, Schizas A, Yin L, Aung E, Aung YY, Franklin S, Han SM, Kim WC, Martin Segura A, Rossi M, Ross T, Tirimanna R, Wang B, Zakieh O, Ben-Arzi H, Flach A, Jackson E, Magers S, Olu abara C, Rogers E, Sugden K, Tan H, Veliah S, Walton U, Asif A, Bharwada Y, Bowley D, Broekhuizen A, Cooper L, Evans N, Girdlestone H, Ling C, Mann H, Mehmood N, Mulvenna CL, Rainer N, Trout I, Gujjuri R, Jeyaraman D, Leong E, Singh D, Smith E, Anderton J, Barabas M, Goyal S, Howard D, Joshi A, Mitchell D, Weatherby T, Badminton R, Bird R, Burtle D, Choi NY, Devalia K, Farr E, Fischer F, Fish J, Gunn F, Jacobs D, Johnston P, Kalakoutas A, Lau E, Loo YNAF, Louden H, Makariou N, Mohammadi K, Nayab Y, Ruhomaun S, Ryliskyte R, Saeed M, Shinde P, Sudul M, Theodoropoulou K, Valadao-Spoorenberg J, Vlachou F, Arshad SR, Janmohamed AM, Noor M, Oyerinde O, Saha A, Syed Y, Watkinson W, Ahmadi H, Akintunde A, Alsaady A, Bradley J, Brothwood D, Burton M, Higgs M, Hoyle C, Katsura C, Lathan R, Louani A, Mandalia R, Prihartadi AS, Qaddoura B, Sandland-Taylor L, Thadani S, Thompson A, Walshaw J, Teo S, Ali S, Bawa JH, Fox S, Gargan K, Haider SA, Hanna N, Hatoum A, Khan Z, Krzak AM, Li T, Pitt J, Tan GJS, Ullah Z, Wilson E, Cleaver J, Colman J, Copeland L, Coulson A, Davis P, Faisal H, Hassan F, Hughes JT, Jabr Y, Mahmoud Ali F, Nahaboo Solim ZN, Sangheli A, Shaya S, Thompson R, Cornwall H, De Andres Crespo M, Fay E, Findlay J, Groves E, Jones O, Killen A, Millo J, Thomas S, Ward J, Wilkins M, Zaki F, Zilber E, Bhavra K, Bilolikar A, Charalambous M, Elawad A, Eleni A, Fawdon R, Gibbins A, Livingstone D, Mala D, Oke SE, Padmakumar D, Patsalides MA, Payne D, Ralphs C, Roney A, Sardar N, Stefanova K, Surti F, Timms R, Tosney G, Bannister J, Clement NS, Cullimore V, Kamal F, Lendor J, McKay J, Mcswiggan J, Minhas N, Seneviratne K, Simeen S, Valverde J, Watson N, Bloom I, Dinh TH, Hirniak J, Joseph R, Kansagra M, Lai CKN, Melamed N, Patel J, Randev J, Sedighi T, Shurovi B, Sodhi J, Vadgama N, Abdulla S, Adabavazeh B, Champion A, Chennupati R, Chu K, Devi S, Haji A, Schulz J, Testa F, Davies P, Gurung B, Howell S, Modi P, Pervaiz A, Zahid M, Abdolrazaghi S, Abi Aoun R, Anjum Z, Bawa G, Bhardwaj R, Brown S, Enver M, Gill D, Gopikrishna D, Gurung D, Kanwal A, Kaushal P, Khanna A, Lovell E, McEvoy C, Mirza M, Nabeel S, Naseem S, Pandya K, Perkins R, Pulakal R, Ray M, Reay C, Reilly S, Round A, Seehra J, Shakeel NM, Singh B, Vijay Sukhnani M, Brown L, Desai B, Elzanati H, Godhaniya J, Kavanagh E, Kent J, Kishor A, Liu A, Norwood M, Shaari N, Wood C, Wood M, Brown A, Chellapuri A, Ferriman A, Ghosh I, Kulkarni N, Noton T, Pinto A, Rajesh S, Varghese B, Wenban C, Aly R, Barciela C, Brookes T, Corrin E, Goldsworthy M, Mohamed Azhar MS, Moore J, Nakhuda S, Ng D, Pillay S, Port S, Abdullah M, Akinyemi J, Islam S, Kale A, Lewis A, Manjunath T, McCabe H, Misra S, Stubley T, Tam JP, Waraich N, Chaora T, Ford C, Osinkolu I, Pong G, Rai J, Risquet R, Ainsworth J, Ayandokun P, Barham E, Barrett G, Barry J, Bisson E, Bridges I, Burke D, Cann J, Cloney M, Coates S, Cripps P, Davies C, Francis N, Green S, Handley G, Hathaway D, Hurt L, Jenkins S, Johnston C, Khadka A, McGee U, Morris D, Murray R, Norbury C, Pierrepont Z, Richards C, Ross O, Ruddy A, Salmon C, Shield M, Soanes K, Spencer N, Taverner S, Williams C, Wills-Wood W, Woodward S, Chow J, Fan J, Guest O, Hunter I, Moon WY, Arthur-Quarm S, Edwards P, Hamlyn V, McEneaney L, N D G, Pranoy S, Ting M, Abada S, Alawattegama LH, Ashok A, Carey C, Gogna A, Haglund C, Hurley P, Leelo N, Liu B, Mannan F, Paramjothy K, Ramlogan K, Raymond-Hayling O, Shanmugarajah A, Solichan D, Wilkinson B, Ahmad NA, Allan D, Amin A, Bakina C, Burns F, Cameron F, Campbell A, Cavanagh S, Chan SMZ, Chapman S, Chong V, Edelsten E, Ekpete O, El Sheikh M, Ghose R, Hassane A, Henderson C, Hilton-Christie S, Husain M, Hussain H, Javid Z, Johnson-Ogbuneke J, Johnston A, Khalil M, Leung TCC, Makin I, Muralidharan V, Naeem M, Patil P, Ravichandran S, Saraeva D, Shankey-Smith W, Sharma N, Swan R, Waudby-West R, Wilkinson A, Wright K, Balasubramanian A, Bhatti S, Chalkley M, Chou WK, Dixon M, Evans L, Fisher K, Gandhi P, Ho S, Lau YB, Lowe S, Meechan C, Murali N, Musonda C, Njoku P, Ochieng L, Pervez MU, Seebah K, Shaikh I, Sikder MA, Vanker R, Alom J, Bajaj V, Coleman O, Finch G, Goss J, Jenkins C, Kontothanassis A, Liew MS, Ng K, Outram M, Shakeel MM, Tawn J, Zuhairy S, Chapple K, Cinnamond A, Coleman S, George HA, Goulder L, Hare N, Hawksley J, Kret A, Luesley A, Mecia L, Porter H, Puddy E, Richardson G, Sohail B, Srikaran V, Tadross D, Tobin J, Tokidis E, Young L, Ashdown T, Bratsos S, Koomson A, Kufuor A, Lim MQ, Shah S, Thorne EPC, Warusavitarne J, Xu S, Abigail S, Ahmed A, Ahmed J, Akmal A, Al-Khafaji M, Amini B, Arshad M, Bogie E, Brazkiewicz M, Carroll M, Chandegra A, Cirelli C, Deng A, Fairclough S, Fung YJ, Gornell C, Green RL, Green SV, Gulamhussein AHM, Isaac AG, Jan R, Jegatheeswaran L, Knee M, Kotecha J, Kotecha S, Maxwell-Armstrong C, McIntyre C, Mendis N, Naing TKP, Oberman J, Ong ZX, Ramalingam A, Saeed Adam A, Tan LL, Towell S, Yadav J, Anandampillai R, Chung S, Hounat A, Ibrahim B, Jeyakumar G, Khalil A, Khan UA, Nair G, Owusu-Ayim M, Wilson M, Kanani A, Kilkelly B, Ogunmwonyi I, Ong L, Samra B, Schomerus L, Shea J, Turner O, Yang Y, Amin M, Blott N, Clark A, Feather A, Forrest M, Hague S, Hamilton K, Higginbotham G, Hope E, Karimian S, Loveday K, Malik H, McKenna O, Noor A, Onsiong C, Patel B, Radcliffe N, Shah P, Tye L, Verma K, Walford R, Yusufi U, Zachariah M, Casey A, Doré C, Fludder V, Fortescue L, Kalapu SS, Karel E, Khera G, Smith C, Appleton B, Ashaye A, Boggon E, Evans A, Faris Mahmood H, Hinchcliffe Z, Marei O, Silva I, Spooner C, Thomas G, Timlin M, Wellington J, Yao SL, Abdelrazek M, Abdelrazik Y, Bee F, Joseph A, Mounce A, Parry G, Vignarajah N, Biddles D, Creissen A, Kolhe S, K T, Lea A, Ledda V, O'Loughlin P, Scanlon J, Shetty N, Weller C, Abdalla M, Adeoye A, Bhatti M, Chadda KR, Chu J, Elhakim H, Foster-Davies H, Rabie M, Tailor B, Webb S, Abdelrahim ASA, Choo SY, Jiwa A, Mangam S, Murray S, Shandramohan A, Aghanenu O, Budd W, Hayre J, Khanom S, Liew ZY, McKinney R, Moody N, Muhammad-Kamal H, Odogwu J, Patel D, Roy C, Sattar Z, Shahrokhi N, Sinha I, Thomson E, Wonga L, Bain J, Khan J, Ricardo D, Bevis R, Cherry C, Darkwa S, Drew W, Griffiths E, Konda N, Madani D, Mak JKC, Meda B, Odunukwe U, Preest G, Raheel F, Rajaseharan A, Ramgopal A, Risbrooke C, Selvaratnam K, Sethunath G, Tabassum R, Taylor J, Thakker A, Wijesingha N, Wybrew R, Yasin T, Ahmed Osman A, Alfadhel S, Carberry E, Chen JY, Drake I, Glen P, Jayasuriya N, Kawar L, Myatt R, Sinan LOH, Siu SSY, Tjen V, Adeboyejo O, Bacon H, Barnes R, Birnie C, D'Cunha Kamath A, Hughes E, Middleton S, Owen R, Schofield E, Short C, Smith R, Wang H, Willett M, Zimmerman M, Balfour J, Chadwick T, Coombe-Jones M, Do Le HP, Faulkner G, Hobson K, Shehata Z, Beattie M, Chmielewski G, Chong C, Donnelly B, Drusch B, Ellis J, Farrelly C, Feyi-Waboso J, Hibell I, Hoade L, Ho C, Jones H, Kodiatt B, Lidder P, Ni Cheallaigh L, Norman R, Patabendi I, Penfold H, Playfair M, Pomeroy S, Ralph C, Rottenburg H, Sebastian J, Sheehan M, Stanley V, Welchman J, Ajdarpasic D, Antypas A, Azouaghe O, Basi S, Bettoli G, Bhattarai S, Bommireddy L, Bourne K, Budding J, Cookey-Bresi R, Cummins T, Davies G, Fabelurin C, Gwilliam R, Hanley J, Hird A, Kruczynska A, Langhorne B, Lund J, Lutchman I, McGuinness R, Neary M, Pampapathi S, Pang E, Podbicanin S, Rai N, Redhouse White G, Sujith J, Thomas P, Walker I, Winterton R, Anderson P, Barrington M, Bhadra K, Clark G, Fowler G, Gibson C, Hudson S, Kaminskaite V, Lawday S, Longshaw A, MacKrill E, McLachlan F, Murdeshwar A, Nieuwoudt R, Parker P, Randall R, Rawlins E, Reeves SA, Rye D, Sirkis T, Sykes B, Ventress N, Wosinska N, Akram B, Burton L, Coombs A, Long R, Magowan D, Ong C, Sethi M, Williams G, Chan C, Chan LH, Fernando D, Gaba F, Khor Z, Les JW, Mak R, Moin S, Ng Kee Kwong KC, Paterson-Brown S, Tew YY, Bardon A, Burrell K, Coldwell C, Costa I, Dexter E, Hardy A, Khojani M, Mazurek J, Raymond T, Reddy V, Reynolds J, Soma A, Agiotakis S, Alsusa H, Desai N, Peristerakis I, Adcock A, Ayub H, Bennett T, Bibi F, Brenac S, Chapman T, Clarke G, Clark F, Galvin C, Gwyn-Jones A, Henry-Blake C, Kerner S, Kiandee M, Lovett A, Pilecka A, Ravindran R, Siddique H, Sikand T, Treadwell K, Akmal K, Apata A, Barton O, Broad G, Darling H, Dhuga Y, Emms L, Habib S, Jain R, Jeater J, Kan CYP, Kathiravelupillai A, Khatkar H, Kirmani S, Kulasabanathan K, Lacey H, Lal K, Manafa C, Mansoor M, McDonald S, Mittal A, Mustoe S, Nottrodt L, Oliver P, Papapetrou I, Pattinson F, Raja M, Reyhani H, Shahmiri A, Small O, Soni U, Aguirrezabala Armbruster B, Bunni J, Hakim MA, Hawkins-Hooker L, Howell KA, Hullait R, Jaskowska A, Ottewell L, Thomas-Jones I, Vasudev A, Clements B, Fenton J, Gill M, Haider S, Lim AJM, Maguire H, McMullan J, Nicoletti J, Samuel S, Unais MA, White N, Yao PC, Yow L, Boyle C, Brady R, Cheekoty P, Cheong J, Chew SJHL, Chow R, Ganewatta Kankanamge D, Mamer L, Mohammed B, Ng Chieng Hin J, Renji Chungath R, Royston A, Sharrad E, Sinclair R, Tingle S, Treherne K, Wyatt F, Maniarasu VS, Moug S, Appanna T, Bucknall T, Hussain F, Owen A, Parry M, Parry R, Sagua N, Spofforth K, Yuen ECT, Bosley N, Hardie W, Moore T, Regas C, Abdel-Khaleq S, Ali N, Bashiti H, Buxton-Hopley R, Constantinides M, D'Afflitto M, Deshpande A, Duque Golding J, Frisira E, Germani Batacchi M, Gomaa A, Hay D, Hutchison R, Iakovou A, Iakovou D, Ismail E, Jefferson S, Jones L, Khouli Y, Knowles C, Mason J, McCaughan R, Moffatt J, Morawala A, Nadir H, Neyroud F, Nikookam Y, Parmar A, Pinto L, Ramamoorthy R, Richards E, Thomson S, Trainer C, Valetopoulou A, Vassiliou A, Wantman A, Wilde S, Dickinson M, Rockall T, Senn D, Wcislo K, Zalmay P, Adelekan K, Allen K, Bajaj M, Gatumbu P, Hang S, Hashmi Y, Kaur T, Kawesha A, Kisiel A, Woodmass M, Adelowo T, Ahari D, Alhwaishel K, Atherton R, Clayton B, Cockroft A, Curtis Lopez C, Hilton M, Ismail N, Kouadria M, Lee L, MacConnachie A, Monks F, Mungroo S, Nikoletopoulou C, Pearce L, Sara X, Shahid A, Suresh G, Wilcha R, Atiyah A, Davies E, Dermanis A, Gibbons H, Hyde A, Lawson A, Lee C, Leung-Tack M, Li Saw Hee J, Mostafa O, Nair D, Pattani N, Plumbley-Jones J, Pufal K, Ramesh P, Sanghera J, Saram S, Scadding S, See S, Stringer H, Torrance A, Vardon H, Wyn-Griffiths F, Brew A, Kaur G, Soni D, Tickle A, Akbar Z, Appleyard T, Figg K, Jayawardena P, Johnson A, Kamran Siddiqui Z, Lacy-Colson J, Oatham R, Rowlands B, Sludden E, Turnbull C, Allin D, Ansar Z, Azeez Z, Dale VH, Garg J, Horner A, Jones S, Knight S, McGregor C, McKenna J, McLelland T, Packham-Smith A, Rowsell K, Spector-Hill I, Adeniken E, Baker J, Bartlett M, Chikomba L, Connell B, Deekonda P, Dhar M, Elmansouri A, Gamage K, Goodhew R, Hanna P, Knight J, Luca A, Maasoumi N, Mahamoud F, Manji S, Marwaha PK, Mason F, Oluboyede A, Pigott L, Razaq AM, Richardson M, Saddaoui I, Wijeyendram P, Yau S, Atkins W, Liang K, Miles N, Praveen B, Ashai S, Braganza J, Common J, Cundy A, Davies R, Guthrie J, Handa I, Iqbal M, Ismail R, Jones C, Jones I, Lee KS, Levene A, Okocha M, Olivier J, Smith A, Subramaniam E, Tandle S, Wang A, Watson A, Wilson C, Chan XHF, Khoo E, Montgomery C, Norris M, Pugalenthi PP, Common T, Cook E, Mistry H, Shinmar HS, Agarwal G, Bandyopadhyay S, Brazier B, Carroll L, Goede A, Harbourne A, Lakhani A, Lami M, Larwood J, Martin J, Merchant J, Pattenden S, Pradhan A, Raafat N, Rothwell E, Shammoon Y, Sudarshan R, Vickers E, Wingfield L, Ashworth I, Azizi S, Bhate R, Chowdhury T, Christou A, Davies L, Dwaraknath M, Farah Y, Garner J, Gureviciute E, Hart E, Jain A, Javid S, Kankam HK, Kaur Toor P, Kaz R, Kermali M, Khan I, Mattson A, McManus A, Murphy M, Nair K, Ngemoh D, Norton E, Olabiran A, Parry L, Payne T, Pillai K, Price S, Punjabi K, Raghunathan A, Ramwell A, Raza M, Ritehnia J, Simpson G, Smith W, Sodeinde S, Studd L, Subramaniam M, Thomas J, Towey S, Tsang E, Tuteja D, Vasani J, Vio M, Badran A, Adams J, Anthony Wilkinson J, Asvandi S, Austin T, Bald A, Bix E, Carrick M, Chander B, Chowdhury S, Cooper Drake B, Crosbie S, D Portela S, Francis D, Gallagher C, Gillespie R, Gravett H, Gupta P, Ilyas C, James G, Johny J, Jones A, Kinder F, MacLeod C, Macrow C, Maqsood-Shah A, Mather J, McCann L, McMahon R, Mitham E, Mohamed M, Munton E, Nightingale K, O'Neill K, Onyemuchara I, Senior R, Shanahan A, Sherlock J, Spyridoulias A, Stavrou C, Stokes D, Tamang R, Taylor E, Trafford C, Uden C, Waddington C, Yassin D, Zaman M, Bangi S, Cheng T, Chew D, Hussain N, Imani-Masouleh S, Mahasivam G, McKnight G, Ng HL, Ota HC, Pasha T, Ravindran W, Shah K, Vishnu K S, Zaman S, Carr W, Cope S, Eagles EJ, Howarth-Maddison M, Li CY, Reed J, Ridge A, Stubbs T, Teasdaled D, Umar R, Worthington J, Dhebri A, Kalenderov R, Alattas A, Arain Z, Bhudia R, Chia D, Daniel S, Dar T, Garland H, Girish M, Hampson A, Kyriacou H, Lehovsky K, Mullins W, Omorphos N, Vasdev N, Venkatesh A, Waldock W, Bhandari A, Brown G, Choa G, Eichenauer CE, Ezennia K, Kidwai Z, Lloyd-Thomas A, Macaskill Stewart A, Massardi C, Sinclair E, Skajaa N, Smith M, Tan I, Afsheen N, Anuar A, Azam Z, Bhatia P, Davies-kelly N, Dickinson S, Elkawafi M, Ganapathy M, Gupta S, Khoury EG, Licudi D, Mehta V, Neequaye S, Nita G, Tay VL, Zhao S, Botsa E, Cuthbert H, Elliott J, Furlepa M, Lehmann J, Mangtani A, Narayan A, Nazarian S, Parmar C, Shah D, Shaw C, Zhao Z, Beck C, Caldwell S, Clements JM, French B, Kenny R, Kirk S, Lindsay J, McClung A, McLaughlin N, Watson S, Whiteside E, Alyacoubi S, Arumugam V, Beg R, Dawas K, Garg S, Lloyd ER, Mahfouz Y, Manobharath N, Moonesinghe R, Morka N, Patel K, Prashar J, Yip S, Adeeko ES, Ajekigbe F, Bhat A, Evans C, Farrugia A, Gurung C, Long T, Malik B, Manirajan S, Newport D, Rayer J, Ridha A, Ross E, Saran T, Sinker A, Waruingi D, Allen R, Al Sadek Y, Alves do Canto Brum H, Asharaf H, Ashman M, Balakumar V, Barrington J, Baskaran R, Berry A, Bhachoo H, Bilal A, Boaden L, Chia WL, Covell G, Crook D, Dadnam F, Davis L, De Berker H, Doyle C, Fox C, Gruffydd-Davies M, Hafouda Y, Hill A, Hubbard E, Hunter A, Inpadhas V, Jamshaid M, Jandu G, Jeyanthi M, Jones T, Kantor C, Kwak SY, Malik N, Matt R, McNulty P, Miles C, Mohomed A, Myat P, Niharika J, Nixon A, O'Reilly D, Parmar K, Pengelly S, Price L, Ramsden M, Turnor R, Wales E, Waring H, Wu M, Yang T, Ye TTS, Zander A, Zeicu C, Bellam S, Francombe J, Kawamoto N, Rahman MR, Sathyanarayana A, Tang HT, Cheung J, Hollingshead J, Page V, Sugarman J, Wong E, Chiong J, Fung E, Kan SY, Kiang J, Kok J, Krahelski O, Liew MY, Lyell B, Sharif Z, Speake D, Alim L, Amakye NY, Chandrasekaran J, Chandratreya N, Drake J, Owoso T, Thu YM, Abou El Ela Bourquin B, Alberts J, Chapman D, Rehnnuma N, Ainsworth K, Carpenter H, Emmanuel T, Fisher T, Gabrel M, Guan Z, Hollows S, Hotouras A, Ip Fung Chun N, Jaffer S, Kallikas G, Kennedy N, Lewinsohn B, Liu FY, Mohammed S, Rutherfurd A, Situ T, Stammer A, Taylor F, Thin N, Urgesi E, Zhang N, Ahmad MA, Bishop A, Bowes A, Dixit A, Glasson R, Hatta S, Hatt K, Larcombe S, Preece J, Riordan E, Fegredo D, Haq MZ, Li C, McCann G, Stewart D, Baraza W, Bhullar D, Burt G, Coyle J, Deans J, Devine A, Hird R, Ikotun O, Manchip G, Ross C, Storey L, Tan WWL, Tse C, Warner C, Whitehead M, Wu F, Court EL, Crisp E, Huttman M, Mayes F, Robertson H, Rosen H, Sandberg C, Smith H, Al Bakry M, Ashwell W, Bajaj S, Bandyopadhyay D, Browlee O, Burway S, Chand CP, Elsayeh K, Elsharkawi A, Evans E, Ferrin S, Fort-Schaale A, Iacob M, I K, Impelliziere Licastro G, Mankoo AS, Olaniyan T, Otun J, Pereira R, Reddy R, Saeed D, Simmonds O, Singhal G, Tron K, Wickstone C, Williams R, Bradshaw E, De Kock Jewell V, Houlden C, Knight C, Metezai H, Mirza-Davies A, Seymour Z, Spink D, Wischhusen S. Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study. Lancet Digit Health 2022; 4:e520-e531. [PMID: 35750401 DOI: 10.1016/s2589-7500(22)00069-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. METHODS We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). FINDINGS In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]). INTERPRETATION In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. FUNDING British Journal of Surgery Society.
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Lee YK, Haam JH, Suh E, Cho SH, Kim YS. A Case-Control Study on the Changes in Natural Killer Cell Activity following Administration of Polyvalent Mechanical Bacterial Lysate in Korean Adults with Recurrent Respiratory Tract Infection. J Clin Med 2022; 11:jcm11113014. [PMID: 35683402 PMCID: PMC9181696 DOI: 10.3390/jcm11113014] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/18/2022] [Accepted: 05/24/2022] [Indexed: 02/01/2023] Open
Abstract
Polyvalent mechanical bacterial lysate (PMBL) is used for the treatment and prevention of recurrent respiratory tract infections. Although PMBL is an immunostimulant, it remains unknown whether treatment with PMBL influences natural killer cell activity (NKA). Hence, this case-control study compared the changes in IFN-γ levels (surrogate index for NKA) following PMBL treatment or time passing between the PMBL-treated group and controls. The treatment group included adults who had a PMBL prescription for three months against recurrent respiratory tract infection from an outpatient clinic, while the control group had healthy adults visiting the health promotion center for periodic health check-ups. The control group (N = 506) showed no change in IFN-γ levels, while the treatment group (N = 301) showed a significant increase in mean from 462.8 to 749.3 pg/mL after PMBL treatment. In the subgroup with IFN-γ <500 pg/mL, IFN-γ levels significantly increased in both groups. However, the change in the treatment group (287 ± 822 pg/mL) was greater than that in the control group (58 ± 809 pg/mL), and the interaction between the visit and case/control was significant (p = 0.030) in a generalized estimating equation model. In conclusion, NKA increased in the subjects with recurrent respiratory tract infections with PMBL treatment.
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Affiliation(s)
- Yun Kyong Lee
- Chaum Life Center, CHA University, Seoul 06062, Korea; (Y.K.L.); (J.-H.H.); (E.S.)
| | - Ji-Hee Haam
- Chaum Life Center, CHA University, Seoul 06062, Korea; (Y.K.L.); (J.-H.H.); (E.S.)
| | - Eunkyung Suh
- Chaum Life Center, CHA University, Seoul 06062, Korea; (Y.K.L.); (J.-H.H.); (E.S.)
| | | | - Young-Sang Kim
- Department of Family Medicine, CHA Bundang Medical Center, CHA University, Seongnam 13496, Korea
- Correspondence:
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Cho SH, Lee SY, Cha JG, Hong J, Lee S, Lim KH. Portal vein embolization in intrahepatic portal vein injury after blunt trauma: a case report. J Trauma Inj 2022. [DOI: 10.20408/jti.2022.0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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15
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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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Boothby MR, Brookens SK, Raybuck AL, Cho SH. Supplying the trip to antibody production-nutrients, signaling, and the programming of cellular metabolism in the mature B lineage. Cell Mol Immunol 2022; 19:352-369. [PMID: 34782762 PMCID: PMC8591438 DOI: 10.1038/s41423-021-00782-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 09/16/2021] [Indexed: 12/26/2022] Open
Abstract
The COVID pandemic has refreshed and expanded recognition of the vital role that sustained antibody (Ab) secretion plays in our immune defenses against microbes and of the importance of vaccines that elicit Ab protection against infection. With this backdrop, it is especially timely to review aspects of the molecular programming that govern how the cells that secrete Abs arise, persist, and meet the challenge of secreting vast amounts of these glycoproteins. Whereas plasmablasts and plasma cells (PCs) are the primary sources of secreted Abs, the process leading to the existence of these cell types starts with naive B lymphocytes that proliferate and differentiate toward several potential fates. At each step, cells reside in specific microenvironments in which they not only receive signals from cytokines and other cell surface receptors but also draw on the interstitium for nutrients. Nutrients in turn influence flux through intermediary metabolism and sensor enzymes that regulate gene transcription, translation, and metabolism. This review will focus on nutrient supply and how sensor mechanisms influence distinct cellular stages that lead to PCs and their adaptations as factories dedicated to Ab secretion. Salient findings of this group and others, sometimes exhibiting differences, will be summarized with regard to the journey to a distinctive metabolic program in PCs.
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Affiliation(s)
- Mark R Boothby
- Department of Pathology, Microbiology & Immunology, Molecular Pathogenesis Division, Vanderbilt University Medical Center, Nashville, TN, 37232, USA.
- Department of Medicine, Rheumatology & Immunology Division, Vanderbilt University Medical Center, Nashville, TN, 37232, USA.
- Cancer Biology Program, Vanderbilt University, Nashville, TN, 37232, USA.
- Vanderbilt Institute of Infection, Inflammation, and Immunology, Nashville, TN, 37232, USA.
| | - Shawna K Brookens
- Department of Pathology, Microbiology & Immunology, Molecular Pathogenesis Division, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
- Cancer Biology Program, Vanderbilt University, Nashville, TN, 37232, USA
| | - Ariel L Raybuck
- Department of Pathology, Microbiology & Immunology, Molecular Pathogenesis Division, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - Sung Hoon Cho
- Department of Pathology, Microbiology & Immunology, Molecular Pathogenesis Division, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
- Vanderbilt Institute of Infection, Inflammation, and Immunology, Nashville, TN, 37232, USA
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Abstract
Extrahepatic biliary tract and gallbladder injuries following blunt abdominal trauma are uncommon. Traumatic cystic duct transection is even rarer, which has frequently caused missed diagnosis and delayed treatment. An 18-year-old female patient with no past medical history was transferred to the Trauma Center of Kyungpook National University Hospital after falling from a height of approximately 20 meters. She became hemodynamically stable after initial resuscitation, and initial contrast-enhanced abdominal computed tomography (CT) showed right kidney traumatic infarction and multiple intrahepatic contusions with minimal fluid collection but no extravasation of the contrast. She was admitted to the intensive care unit. On the second day of hospitalization, her abdomen became distended, with follow-up CT showing a large collection of intra-abdominal fluid. Laparoscopic exploration was then performed, which revealed devascularization of the gallbladder with complete transection of the cystic duct and artery. Laparoscopic cholecystectomy was performed, as well as primary closure of the cystic duct orifice on the common bile duct using a 4-0 Prolene suture. After surgery, no clinical evidence of biliary leakage or common bile duct stricture was observed.
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Desrosiers M, Mannent LP, Amin N, Canonica GW, Hellings PW, Gevaert P, Mullol J, Lee SE, Fujieda S, Han JK, Hopkins C, Fokkens W, Jankowski R, Cho SH, Mao X, Zhang M, Rice MS, Khan AH, Kamat S, Patel N, Graham NMH, Ruddy M, Bachert C. Dupilumab reduces systemic corticosteroid use and sinonasal surgery rate in CRSwNP. Rhinology 2021; 59:301-311. [PMID: 33847325 DOI: 10.4193/rhin20.415] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Chronic rhinosinusitis with nasal polyps (CRSwNP) is a type 2 inflammatory disease with a high symptom burden and poor quality of life. Treatment options include recurrent surgeries and/or frequent systemic corticosteroids (SCS). Dupilumab, a fully human monoclonal antibody, blocks the shared receptor component for interleukin-4 and interleukin-13, key drivers of type 2-mediated inflammation. We report results of pooled analyses from 2 randomised, double-blind, placebo-controlled phase 3 studies (SINUS 24 [NCT02912468]; SINUS-52 [NCT02898454]) to evaluate dupilumab effect versus placebo in adults with CRSwNP with/without SCS use and sinonasal surgery. METHODOLOGY SINUS-24 patients were randomised 1:1 to subcutaneous dupilumab 300 mg (n=143) or placebo (n=133) every 2 weeks (q2w) for 24 weeks. SINUS-52 patients were randomised 1:1:1 to 52 weeks of subcutaneous dupilumab 300 mg q2w (n=150), 24 weeks q2w followed by 28 weeks of dupilumab 300 mg every 4 weeks (n=145) or 52 weeks of placebo q2w (n=153). RESULTS Dupilumab reduced the number of patients undergoing sinonasal surgery (82.6%), the need for in-study SCS use (73.9%), and SCS courses (75.3%). Significant improvements were observed with dupilumab vs placebo regardless of prior sinonasal surgery or SCS use in nasal polyp, nasal congestion, Lund-MacKay, and Sinonasal Outcome Test (22-items) scores, and the University of Pennsylvania Smell Identification Test. CONCLUSIONS Dupilumab demonstrated significant improvements in disease signs and symptoms and reduced the need for sino-nasal surgery and SCS use versus placebo in patients with severe CRSwNP, regardless of SCS use in the previous 2 years, or prior sinonasal surgery.
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Affiliation(s)
- M Desrosiers
- Centre de recherche du Centre hospitalier de l’Universite de Montreal (CRCHUM), Montreal, QC, Canada
| | | | - N Amin
- Regeneron Pharmaceuticals, Inc. Tarrytown, NY, USA
| | - G W Canonica
- Regeneron Pharmaceuticals, Inc. Tarrytown, NY, USA
| | | | | | - J Mullol
- Hospital Clinic, IDIBAPS, Universitat de Barcelona, CIBERES, Barcelona, Catalonia, Spain
| | - S E Lee
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | - J K Han
- Eastern Virginia Medical School, Norfolk, VA, USA
| | - C Hopkins
- Guy's and St Thomas' Hospitals, London, UK
| | - W Fokkens
- Academic Medical Center, Amsterdam, Netherlands
| | - R Jankowski
- University Hospital of Nancy, University of Lorraine, Nancy, France
| | - S H Cho
- University of South Florida, Tampa, FL, USA
| | - X Mao
- Sanofi, Bridgewater, NJ, USA
| | - M Zhang
- Sanofi, Bridgewater, NJ, USA
| | | | | | - S Kamat
- Regeneron Pharmaceuticals, Inc. Tarrytown, NY, USA
| | - N Patel
- Sanofi, Bridgewater, NJ, USA
| | - N M H Graham
- Regeneron Pharmaceuticals, Inc. Tarrytown, NY, USA
| | - M Ruddy
- Regeneron Pharmaceuticals, Inc. Tarrytown, NY, USA
| | - C Bachert
- Ghent University, Ghent, Belgium; Karolinska Institutet, Stockholm, Sweden; Sun Yat-sen University, First Affiliated Hospital, Guangzhou, China
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19
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Boothby MR, Raybuck A, Cho SH, Stengel KR, Haase VH, Hiebert S, Li J. Over-Generalizing About GC (Hypoxia): Pitfalls of Limiting Breadth of Experimental Systems and Analyses in Framing Informatics Conclusions. Front Immunol 2021; 12:664249. [PMID: 34040610 PMCID: PMC8141812 DOI: 10.3389/fimmu.2021.664249] [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] [Accepted: 04/14/2021] [Indexed: 11/18/2022] Open
Abstract
Accumulating evidence suggests that many immune responses are influenced by local nutrient concentrations in addition to the programming of intermediary metabolism within immune cells. Humoral immunity and germinal centers (GC) are settings in which these factors are under active investigation. Hypoxia is an example of how a particular nutrient is distributed in lymphoid follicles during an antibody response, and how oxygen sensors may impact the qualities of antibody output after immunization. Using exclusively a bio-informatic analysis of mRNA levels in GC and other B cells, recent work challenged the concept that there is any hypoxia or that it has any influence. To explore this proposition, we performed new analyses of published genomics data, explored potential sources of disparity, and elucidated aspects of the apparently conflicting conclusions. Specifically, replicability and variance among data sets derived from different naïve as well as GC B cells were considered. The results highlight broader issues that merit consideration, especially at a time of heightened focus on scientific reports in the realm of immunity and antibody responses. Based on these analyses, a standard is proposed under which the relationship of new data sets should be compared to prior “fingerprints” of cell types and reported transparently to referees and readers. In light of independent evidence of diversity within and among GC elicited by protein immunization, avoidance of overly broad conclusions about germinal centers in general when experimental systems are subject to substantial constraints imposed by technical features also is warranted.
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Affiliation(s)
- Mark R Boothby
- Department of Pathology, Microbiology & Immunology, Molecular Pathogenesis Division, Vanderbilt University Medical Center and School of Medicine, Nashville, TN, United States
| | - Ariel Raybuck
- Department of Pathology, Microbiology & Immunology, Molecular Pathogenesis Division, Vanderbilt University Medical Center and School of Medicine, Nashville, TN, United States
| | - Sung Hoon Cho
- Department of Pathology, Microbiology & Immunology, Molecular Pathogenesis Division, Vanderbilt University Medical Center and School of Medicine, Nashville, TN, United States
| | - Kristy R Stengel
- Department of Biochemistry, Vanderbilt University School of Medicine, Nashville TN, United States
| | - Volker H Haase
- Department of Medicine, Nephrology Division, Vanderbilt University Medical Center and School of Medicine, Nashville, TN, United States
| | - Scott Hiebert
- Department of Biochemistry, Vanderbilt University School of Medicine, Nashville TN, United States
| | - Jingxin Li
- Medical Scientist Training Program, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
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20
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Edwards DN, Ngwa VM, Raybuck AL, Wang S, Hwang Y, Kim LC, Cho SH, Paik Y, Wang Q, Zhang S, Manning HC, Rathmell JC, Cook RS, Boothby MR, Chen J. Selective glutamine metabolism inhibition in tumor cells improves antitumor T lymphocyte activity in triple-negative breast cancer. J Clin Invest 2021; 131:140100. [PMID: 33320840 PMCID: PMC7880417 DOI: 10.1172/jci140100] [Citation(s) in RCA: 140] [Impact Index Per Article: 46.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 12/10/2020] [Indexed: 12/27/2022] Open
Abstract
Rapidly proliferating tumor and immune cells need metabolic programs that support energy and biomass production. The amino acid glutamine is consumed by effector T cells and glutamine-addicted triple-negative breast cancer (TNBC) cells, suggesting that a metabolic competition for glutamine may exist within the tumor microenvironment, potentially serving as a therapeutic intervention strategy. Here, we report that there is an inverse correlation between glutamine metabolic genes and markers of T cell-mediated cytotoxicity in human basal-like breast cancer (BLBC) patient data sets, with increased glutamine metabolism and decreased T cell cytotoxicity associated with poor survival. We found that tumor cell-specific loss of glutaminase (GLS), a key enzyme for glutamine metabolism, improved antitumor T cell activation in both a spontaneous mouse TNBC model and orthotopic grafts. The glutamine transporter inhibitor V-9302 selectively blocked glutamine uptake by TNBC cells but not CD8+ T cells, driving synthesis of glutathione, a major cellular antioxidant, to improve CD8+ T cell effector function. We propose a "glutamine steal" scenario, in which cancer cells deprive tumor-infiltrating lymphocytes of needed glutamine, thus impairing antitumor immune responses. Therefore, tumor-selective targeting of glutamine metabolism may be a promising therapeutic strategy in TNBC.
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Affiliation(s)
- Deanna N. Edwards
- Division of Rheumatology and Immunology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Verra M. Ngwa
- Program in Cancer Biology, Vanderbilt University, Nashville, Tennessee, USA
| | - Ariel L. Raybuck
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Shan Wang
- Division of Rheumatology and Immunology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Yoonha Hwang
- Division of Rheumatology and Immunology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Laura C. Kim
- Program in Cancer Biology, Vanderbilt University, Nashville, Tennessee, USA
| | - Sung Hoon Cho
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Yeeun Paik
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Qingfei Wang
- Department of Biological Sciences, College of Science, University of Notre Dame, Notre Dame, Indiana, USA
- Mike and Josie Harper Cancer Research Institute, University of Notre Dame, South Bend, Indiana, USA
| | - Siyuan Zhang
- Department of Biological Sciences, College of Science, University of Notre Dame, Notre Dame, Indiana, USA
- Mike and Josie Harper Cancer Research Institute, University of Notre Dame, South Bend, Indiana, USA
| | - H. Charles Manning
- Department of Chemistry
- Center for Molecular Probes
- Vanderbilt Institute for Imaging Sciences
- Department of Radiology and Radiological Sciences
- Vanderbilt-Ingram Cancer Center
| | - Jeffrey C. Rathmell
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Vanderbilt-Ingram Cancer Center
- Vanderbilt Institute for Infection, Immunology and Inflammation, and
| | - Rebecca S. Cook
- Program in Cancer Biology, Vanderbilt University, Nashville, Tennessee, USA
- Vanderbilt-Ingram Cancer Center
- Department of Cell and Developmental Biology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Mark R. Boothby
- Division of Rheumatology and Immunology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Program in Cancer Biology, Vanderbilt University, Nashville, Tennessee, USA
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Vanderbilt Institute for Infection, Immunology and Inflammation, and
| | - Jin Chen
- Division of Rheumatology and Immunology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Program in Cancer Biology, Vanderbilt University, Nashville, Tennessee, USA
- Vanderbilt-Ingram Cancer Center
- Vanderbilt Institute for Infection, Immunology and Inflammation, and
- Department of Cell and Developmental Biology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, Tennessee, USA
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21
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Cho SH, Han YS, Han JR, Kwon HJ, Choi SH, Kim HT, Han MH, Chun JM. Synchronous gallbladder metastasis of renal cell carcinoma presenting as a gallbladder polyp: A case report. Medicine (Baltimore) 2021; 100:e24037. [PMID: 33546003 PMCID: PMC7837895 DOI: 10.1097/md.0000000000024037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 12/04/2020] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Gallbladder polyps are common in the general population, but gallbladder metastasis of renal cell carcinoma (RCC) is very rare. In a patient with RCC diagnosed with a small gallbladder polyp that does not meet the traditional size criteria, the surgeon faces a dilemma of whether cholecystectomy should be performed given the possibility of metastasis. PATIENT CONCERNS A 55-year-old man who had received a left nephrectomy for RCC presented with a gallbladder polyp that was noted at the time of the nephrectomy. Imaging showed the maximum diameter of the polyp had increased from 5 mm to 24 mm in the 40 months after the initial diagnosis. DIAGNOSIS Pathological and immunohistology findings confirmed the gallbladder polyp as a metastasis of clear-cell RCC. INTERVENTIONS : We performed a laparoscopic cholecystectomy. OUTCOMES Even though the synchronous solitary gallbladder metastasis was left untreated and a cholecystectomy was not performed over the 40 months, no metastasis occurred in other sites. The patient is free from disease 10 months after the cholecystectomy. LESSONS Solitary gallbladder metastasis of RCC may have more favorable outcomes than typical metastases. Although gallbladder metastasis of RCC occur rarely, it can occur, and any changes in gallbladder polyps in RCC patients should be managed under a strong suspicion of metastasis.
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Affiliation(s)
| | | | | | | | | | | | - Man-Hoon Han
- Department of Pathology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
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22
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Wollenberg A, Blauvelt A, Guttman-Yassky E, Worm M, Lynde C, Lacour JP, Spelman L, Katoh N, Saeki H, Poulin Y, Lesiak A, Kircik L, Cho SH, Herranz P, Cork MJ, Peris K, Steffensen LA, Bang B, Kuznetsova A, Jensen TN, Østerdal ML, Simpson EL. Tralokinumab for moderate-to-severe atopic dermatitis: results from two 52-week, randomized, double-blind, multicentre, placebo-controlled phase III trials (ECZTRA 1 and ECZTRA 2). Br J Dermatol 2020; 184:437-449. [PMID: 33000465 PMCID: PMC7986411 DOI: 10.1111/bjd.19574] [Citation(s) in RCA: 239] [Impact Index Per Article: 59.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2020] [Indexed: 12/14/2022]
Abstract
Background Tralokinumab, a fully human monoclonal antibody, specifically neutralizes interleukin‐13, a key cytokine driving peripheral inflammation in atopic dermatitis (AD). In phase II studies, tralokinumab combined with topical corticosteroids provided early and sustained improvements in AD signs and symptoms. Objectives To evaluate the efficacy and safety of tralokinumab monotherapy in adults with moderate‐to‐severe AD who had an inadequate response to topical treatments. Methods In two 52‐week, randomized, double‐blind, placebo‐controlled, phase III trials, ECZTRA 1 and ECZTRA 2, adults with moderate‐to‐severe AD were randomized (3 : 1) to subcutaneous tralokinumab 300 mg every 2 weeks (Q2W) or placebo. Primary endpoints were Investigator’s Global Assessment (IGA) score of 0 or 1 at week 16 and ≥ 75% improvement in Eczema Area and Severity Index (EASI 75) at week 16. Patients achieving an IGA score of 0 or 1 and/or EASI 75 with tralokinumab at week 16 were rerandomized to tralokinumab Q2W or every 4 weeks or placebo, for 36 weeks. The trials were registered with ClinicalTrials.gov: NCT03131648 and NCT03160885. Results At week 16, more patients who received tralokinumab vs. placebo achieved an IGA score of 0 or 1: 15·8% vs. 7·1% in ECZTRA 1 [difference 8·6%, 95% confidence interval (CI) 4·1–13·1; P = 0·002] and 22·2% vs. 10·9% in ECZTRA 2 (11·1%, 95% CI 5·8–16·4; P < 0·001) and EASI 75: 25·0% vs. 12·7% (12·1%, 95% CI 6·5–17·7; P < 0·001) and 33·2% vs. 11·4% (21·6%, 95% CI 15·8–27·3; P < 0·001). Early improvements in pruritus, sleep interference, Dermatology Life Quality Index, SCORing Atopic Dermatitis and Patient‐Oriented Eczema Measure were observed from the first postbaseline measurements. The majority of week 16 tralokinumab responders maintained response at week 52 with continued tralokinumab treatment without any rescue medication (including topical corticosteroids). Adverse events were reported in 76·4% and 61·5% of patients receiving tralokinumab in ECZTRA 1 and ECZTRA 2, respectively, and in 77·0% and 66·0% of patients receiving placebo in ECZTRA 1 and ECZTRA 2, respectively, in the 16‐week initial period. Conclusions Tralokinumab monotherapy was superior to placebo at 16 weeks of treatment and was well tolerated up to 52 weeks of treatment. What is already known about this topic?Atopic dermatitis (AD) is a chronic interleukin (IL)‐13‐mediated disease. There is a need for safe and effective long‐term treatment options for AD. Tralokinumab is a fully human monoclonal antibody that binds specifically to IL‐13 with high affinity, thereby preventing receptor interaction and subsequent downstream signalling. Tralokinumab combined with topical corticosteroids showed early and sustained efficacy and safety in a 12‐week, phase IIb trial in moderate‐to‐severe AD.
What does this study add?These are the first pivotal phase III trials demonstrating that by specifically targeting IL‐13 alone, patients can achieve significant improvements in AD signs and symptoms and quality of life, and maintain these improvements over time without the requirement for topical corticosteroids. These trials provide evidence that tralokinumab offers a long‐term, well‐tolerated treatment option for patients with moderate‐to‐severe AD.
Linked Comment: Morra and Drucker. Br J Dermatol 2021; 184:386–387. Plain language summary available online
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Affiliation(s)
- A Wollenberg
- Department of Dermatology and Allergy, Ludwig Maximilian University of Munich, Munich, Germany
| | - A Blauvelt
- Oregon Medical Research Center, Portland, OR, USA
| | - E Guttman-Yassky
- Department of Dermatology and the Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - M Worm
- Division of Allergy and Immunology, Department of Dermatology, Venereology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - C Lynde
- Lynde Dermatology, Probity Medical Research, Markham, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - J-P Lacour
- Department of Dermatology, University Hospital of Nice, Nice, France
| | - L Spelman
- Veracity Clinical Research, Brisbane, QLD, Australia.,Probity Medical Research, Woolloongabba, QLD, Australia
| | - N Katoh
- Department of Dermatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - H Saeki
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | - Y Poulin
- Laval University and Centre Dermatologique du Québec Métropolitain and Centre de Recherche Dermatologique du Québec Métropolitain, Québec, QC, Canada
| | - A Lesiak
- Department of Dermatology and Pediatric and Oncologic Dermatology, Medical University of Łódź, Łódź, Poland
| | - L Kircik
- Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Indiana University Medical Center, Indianapolis, IN, USA
| | - S H Cho
- Department of Dermatology, The Catholic University of Korea, Seoul, South Korea
| | - P Herranz
- Department of Dermatology, Hospital Universitario La Paz, Madrid, Spain
| | - M J Cork
- Sheffield Dermatology Research, Department of Infection, Immunity, and Cardiovascular Disease, The University of Sheffield and Sheffield Teaching Hospitals NIHR Clinical Research Facility, Sheffield, UK
| | - K Peris
- Dermatology, Catholic University and Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | | | - B Bang
- LEO Pharma A/S, Ballerup, Denmark
| | | | | | | | - E L Simpson
- Department of Dermatology, Oregon Health & Science University, Portland, OR, USA
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23
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Brookens SK, Cho SH, Basso PJ, Boothby MR. AMPKα1 in B Cells Dampens Primary Antibody Responses yet Promotes Mitochondrial Homeostasis and Persistence of B Cell Memory. J Immunol 2020; 205:3011-3022. [PMID: 33148712 PMCID: PMC7686102 DOI: 10.4049/jimmunol.1901474] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 10/01/2020] [Indexed: 12/29/2022]
Abstract
Emerging evidence indicates that metabolic programs regulate B cell activation and Ab responses. However, the metabolic mediators that support the durability of the memory B cell and long-lived plasma cell populations are not fully elucidated. Adenosine monophosphate-activated protein kinase (AMPK) is an evolutionary conserved serine/threonine kinase that integrates cellular energy status and nutrient availability to intracellular signaling and metabolic pathways. In this study, we use genetic mouse models to show that loss of ΑMPKα1 in B cells led to a weakened recall Ab response associated with a decline in the population of memory-phenotype B cells. AMPKα1-deficient memory B lymphocytes exhibited aberrant mitochondrial activity, decreased mitophagy, and increased lipid peroxidation. Moreover, loss of AMPKα1 in B lymphoblasts was associated with decreased mitochondrial spare respiratory capacity. Of note, AMPKα1 in B cells was dispensable for stability of the bone marrow-resident, long-lived plasma cell population, yet absence of this kinase led to increased rates of Ig production and elevated serum Ab concentrations elicited by primary immunization. Collectively, our findings fit a model in which AMPKα1 in B cells supports recall function of the memory B cell compartment by promoting mitochondrial homeostasis and longevity but restrains rates of Ig production.
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Affiliation(s)
- Shawna K Brookens
- Department of Cancer Biology, Vanderbilt University, Nashville, TN 37232
| | - Sung Hoon Cho
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232; and
| | - Paulo J Basso
- Department of Immunology, University of São Paulo, São Paulo 05508-000, Brazil
| | - Mark R Boothby
- Department of Cancer Biology, Vanderbilt University, Nashville, TN 37232;
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232; and
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24
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Wang S, Raybuck A, Shiuan E, Cho SH, Wang Q, Brantley-Sieders DM, Edwards D, Allaman MM, Nathan J, Wilson KT, DeNardo D, Zhang S, Cook R, Boothby M, Chen J. Selective inhibition of mTORC1 in tumor vessels increases antitumor immunity. JCI Insight 2020; 5:139237. [PMID: 32759497 PMCID: PMC7455083 DOI: 10.1172/jci.insight.139237] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 07/01/2020] [Indexed: 02/06/2023] Open
Abstract
A tumor blood vessel is a key regulator of tissue perfusion, immune cell trafficking, cancer metastasis, and therapeutic responsiveness. mTORC1 is a signaling node downstream of multiple angiogenic factors in the endothelium. However, mTORC1 inhibitors have limited efficacy in most solid tumors, in part due to inhibition of immune function at high doses used in oncology patients and compensatory PI3K signaling triggered by mTORC1 inhibition in tumor cells. Here we show that low-dose RAD001/everolimus, an mTORC1 inhibitor, selectively targets mTORC1 signaling in endothelial cells (ECs) without affecting tumor cells or immune cells, resulting in tumor vessel normalization and increased antitumor immunity. Notably, this phenotype was recapitulated upon targeted inducible gene ablation of the mTORC1 component Raptor in tumor ECs (RaptorECKO). Tumors grown in RaptorECKO mice displayed a robust increase in tumor-infiltrating lymphocytes due to GM-CSF-mediated activation of CD103+ dendritic cells and displayed decreased tumor growth and metastasis. GM-CSF neutralization restored tumor growth and metastasis, as did T cell depletion. Importantly, analyses of human tumor data sets support our animal studies. Collectively, these findings demonstrate that endothelial mTORC1 is an actionable target for tumor vessel normalization, which could be leveraged to enhance antitumor immune therapies.
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Affiliation(s)
- Shan Wang
- Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, Tennessee, USA.,Division of Rheumatology and Immunology and
| | - Ariel Raybuck
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Eileen Shiuan
- Program in Cancer Biology, School of Medicine, Vanderbilt University, Nashville, Tennessee, USA
| | - Sung Hoon Cho
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Qingfei Wang
- Department of Biological Sciences, Harper Cancer Research Institute, University of Notre Dame, South Bend, Indiana, USA
| | | | | | - Margaret M Allaman
- Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - James Nathan
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Keith T Wilson
- Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, Tennessee, USA.,Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Program in Cancer Biology, School of Medicine, Vanderbilt University, Nashville, Tennessee, USA.,Vanderbilt-Ingram Cancer Center and.,Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - David DeNardo
- Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Siyuan Zhang
- Department of Biological Sciences, Harper Cancer Research Institute, University of Notre Dame, South Bend, Indiana, USA
| | - Rebecca Cook
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Cell and Developmental Biology, School of Medicine, Vanderbilt University, Nashville, Tennessee, USA
| | - Mark Boothby
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Program in Cancer Biology, School of Medicine, Vanderbilt University, Nashville, Tennessee, USA.,Vanderbilt-Ingram Cancer Center and
| | - Jin Chen
- Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, Tennessee, USA.,Division of Rheumatology and Immunology and.,Program in Cancer Biology, School of Medicine, Vanderbilt University, Nashville, Tennessee, USA.,Vanderbilt-Ingram Cancer Center and.,Department of Cell and Developmental Biology, School of Medicine, Vanderbilt University, Nashville, Tennessee, USA
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25
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de Souza PC, Fernandes GFS, Marino LB, Ribeiro CM, Silva PBD, Chorilli M, Silva CSP, Resende FA, Solcia MC, de Grandis RA, Costa CAS, Cho SH, Wang Y, Franzblau SG, Dos Santos JL, Pavan FR. Furoxan derivatives demonstrated in vivo efficacy by reducing Mycobacterium tuberculosis to undetectable levels in a mouse model of infection. Biomed Pharmacother 2020; 130:110592. [PMID: 32763822 DOI: 10.1016/j.biopha.2020.110592] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES The most recent survey conducted by the World Health Organization described Tuberculosis (TB) as one of the top 10 causes of death and the leading cause of death from a single infectious agent. The increasing number of TB-resistant cases has contributed to this scenario. In light of this, new strategies to control and treat the disease are necessary. Our research group has previously described furoxan derivatives as promising scaffolds to be explored as new antitubercular drugs. RESULTS Two of these furoxan derivatives, (14b) and (14c), demonstrated a high selectivity against Mycobacterium tuberculosis. The compounds (14b) and (14c) were also active against a latent M. tuberculosis strain, with MIC90 values of 6.67 μM and 9.84 μM, respectively; they were also active against monoresistant strains (MIC90 values ranging from 0.61 to 20.42 μM) and clinical MDR strains (MIC90 values ranging from 3.09 to 42.95 μM). Time-kill experiments with compound (14c) showed early bactericidal effects that were superior to those of the first- and second-line anti-tuberculosis drugs currently used in therapy. The safety of compounds (14b) and (14c) was demonstrated by the Ames test because these molecules were not mutagenic under the tested conditions. Finally, we confirmed the safety, and high efficacy of compounds (14b) and (14c), which reduced M. tuberculosis to undetectable levels in a mouse aerosol model of infection. CONCLUSION Altogether, we have identified two advanced lead compounds, (14b) and (14c), as novel promising candidates for the treatment of TB infection.
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Affiliation(s)
- P C de Souza
- São Paulo State University (UNESP), School of Pharmaceutical Sciences, Tuberculosis Research Laboratory, Araraquara, São Paulo, 14800-903, Brazil
| | - G F S Fernandes
- São Paulo State University (UNESP), School of Pharmaceutical Sciences, Department of Drugs and Medicines, Araraquara, São Paulo, 14800-903, Brazil
| | - L B Marino
- São Paulo State University (UNESP), School of Pharmaceutical Sciences, Tuberculosis Research Laboratory, Araraquara, São Paulo, 14800-903, Brazil
| | - C M Ribeiro
- São Paulo State University (UNESP), School of Pharmaceutical Sciences, Tuberculosis Research Laboratory, Araraquara, São Paulo, 14800-903, Brazil
| | - P B da Silva
- São Paulo State University (UNESP), School of Pharmaceutical Sciences, Department of Drugs and Medicines, Araraquara, São Paulo, 14800-903, Brazil
| | - M Chorilli
- São Paulo State University (UNESP), School of Pharmaceutical Sciences, Department of Drugs and Medicines, Araraquara, São Paulo, 14800-903, Brazil
| | - C S P Silva
- São Paulo State University (UNESP), School of Pharmaceutical Sciences, Tuberculosis Research Laboratory, Araraquara, São Paulo, 14800-903, Brazil
| | - F A Resende
- Department of Biological Sciences and Health, UNIARA - University of Araraquara, Araraquara, São Paulo, 14801-340, Brazil
| | - M C Solcia
- São Paulo State University (UNESP), School of Pharmaceutical Sciences, Tuberculosis Research Laboratory, Araraquara, São Paulo, 14800-903, Brazil
| | - R A de Grandis
- São Paulo State University (UNESP), School of Pharmaceutical Sciences, Tuberculosis Research Laboratory, Araraquara, São Paulo, 14800-903, Brazil; Department of Biological Sciences and Health, UNIARA - University of Araraquara, Araraquara, São Paulo, 14801-340, Brazil
| | - C A S Costa
- São Paulo State University (UNESP), School of Odontology, Department of Physiology and Pathology, Araraquara, São Paulo, 14801-903, Brazil
| | - S H Cho
- Institute of Tuberculosis Research, UIC - University of Illinois at Chicago, Chicago, Illinois, 60612-7231, USA
| | - Y Wang
- Institute of Tuberculosis Research, UIC - University of Illinois at Chicago, Chicago, Illinois, 60612-7231, USA
| | - S G Franzblau
- Institute of Tuberculosis Research, UIC - University of Illinois at Chicago, Chicago, Illinois, 60612-7231, USA
| | - J L Dos Santos
- São Paulo State University (UNESP), School of Pharmaceutical Sciences, Department of Drugs and Medicines, Araraquara, São Paulo, 14800-903, Brazil
| | - F R Pavan
- São Paulo State University (UNESP), School of Pharmaceutical Sciences, Tuberculosis Research Laboratory, Araraquara, São Paulo, 14800-903, Brazil.
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26
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Jones MA, Cho SH, Patterson NH, Van de Plas R, Spraggins JM, Boothby MR, Caprioli RM. Discovering New Lipidomic Features Using Cell Type Specific Fluorophore Expression to Provide Spatial and Biological Specificity in a Multimodal Workflow with MALDI Imaging Mass Spectrometry. Anal Chem 2020; 92:7079-7086. [PMID: 32298091 PMCID: PMC7456589 DOI: 10.1021/acs.analchem.0c00446] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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] [Indexed: 12/29/2022]
Abstract
Identifying the spatial distributions of biomolecules in tissue is crucial for understanding integrated function. Imaging mass spectrometry (IMS) allows simultaneous mapping of thousands of biosynthetic products such as lipids but has needed a means of identifying specific cell-types or functional states to correlate with molecular localization. We report, here, advances starting from identity marking with a genetically encoded fluorophore. The fluorescence emission data were integrated with IMS data through multimodal image processing with advanced registration techniques and data-driven image fusion. In an unbiased analysis of spleens, this integrated technology enabled identification of ether lipid species preferentially enriched in germinal centers. We propose that this use of genetic marking for microanatomical regions of interest can be paired with molecular information from IMS for any tissue, cell-type, or activity state for which fluorescence is driven by a gene-tracking allele and ultimately with outputs of other means of spatial mapping.
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Affiliation(s)
- Marissa A Jones
- Department of Chemistry, Vanderbilt University, 7330 Stevenson Center, Station B 351822, Nashville, Tennessee 37235, United States
- Mass Spectrometry Research Center and Department of Biochemistry, Vanderbilt University Medical Center, 465 21st Avenue South, MRB III Suite 9160, Nashville, Tennessee 37232, United States
| | - Sung Hoon Cho
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, 1161 21st Avenue South, MCN AA-4214B, MCN A-5301, Nashville, Tennessee 37232, United States
| | - Nathan Heath Patterson
- Mass Spectrometry Research Center and Department of Biochemistry, Vanderbilt University Medical Center, 465 21st Avenue South, MRB III Suite 9160, Nashville, Tennessee 37232, United States
- Department of Biochemistry, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - Raf Van de Plas
- Mass Spectrometry Research Center and Department of Biochemistry, Vanderbilt University Medical Center, 465 21st Avenue South, MRB III Suite 9160, Nashville, Tennessee 37232, United States
- Department of Biochemistry, Vanderbilt University, Nashville, Tennessee 37232, United States
- Delft Center for Systems and Control (DCSC), Delft University of Technology, 2628 CD Delft, The Netherlands
| | - Jeffrey M Spraggins
- Mass Spectrometry Research Center and Department of Biochemistry, Vanderbilt University Medical Center, 465 21st Avenue South, MRB III Suite 9160, Nashville, Tennessee 37232, United States
- Department of Biochemistry, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - Mark R Boothby
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, 1161 21st Avenue South, MCN AA-4214B, MCN A-5301, Nashville, Tennessee 37232, United States
- Department of Medicine, Vanderbilt University, Nashville, Tennessee 37232, United States
- Department of Cancer Biology, Vanderbilt University, Nashville, Tennessee 37232, United States
- Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, Tennessee 37232, United States
- Pharmacology, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - Richard M Caprioli
- Department of Chemistry, Vanderbilt University, 7330 Stevenson Center, Station B 351822, Nashville, Tennessee 37235, United States
- Mass Spectrometry Research Center and Department of Biochemistry, Vanderbilt University Medical Center, 465 21st Avenue South, MRB III Suite 9160, Nashville, Tennessee 37232, United States
- Department of Biochemistry, Vanderbilt University, Nashville, Tennessee 37232, United States
- Department of Medicine, Vanderbilt University, Nashville, Tennessee 37232, United States
- Pharmacology, Vanderbilt University, Nashville, Tennessee 37232, United States
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27
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Cho SH, Jones M, Spraggins J, Caprioli RM, Boothby MR. Identification of germinal center-specific lipid species. The Journal of Immunology 2020. [DOI: 10.4049/jimmunol.204.supp.151.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Germinal centers (GCs) are microanatomic structures that B cells proliferate, are selected for affinity maturation, undergo antibody (Ab) class-switch recombination and differentiate into Ab-secreting plasma cells and memory B cells. Nutrient availability, metabolic reprogramming process, and spatial localizations of biomolecules can impact on GC response and quality of humoral immune response. By using matrix-assisted laser desorption/ionization-imaging mass spectrometry (MALDI-IMS), we identified that the ether lipid species are preferentially enriched in germinal centers, and the perturbation of ether lipid synthesis attenuatedGC response and antigen-specific Ab production. These results suggest that molecular programing of GC lymphocytes is tied to increased ether lipid synthesis and that these species are functionally important in humoral immunity.
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Affiliation(s)
- Sung Hoon Cho
- 1Pathology, Microbiology & Immunology; Vanderbilt University Medical Center, Nashville, TN
| | | | | | | | - Mark Robin Boothby
- 1Pathology, Microbiology & Immunology; Vanderbilt University Medical Center, Nashville, TN
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McLetchie S, Cho SH, Basso P, Boothby MR. AMPKα1 in B cells promotes memory B cell longevity and mitochondrial homeostasis while dampening antibody synthesis. The Journal of Immunology 2020. [DOI: 10.4049/jimmunol.204.supp.71.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Emerging evidence indicates that metabolic programs regulate B cell activation and antibody responses. However, the metabolic mediators that support the durability of the memory B cell and long-lived plasma cell populations are not fully elucidated. Adenosine monophosphate-activated protein kinase (AMPK) is an evolutionary conserved serine/threonine kinase that integrates cellular energy status and nutrient availability to intracellular signaling and metabolic pathways. Here, we use genetic mouse models to show that B cell restricted loss of the catalytic subunit, AMPKα1, leads to a defect in the long-term survival of the memory B cell population. AMPKα1-deficient memory B lymphocytes exhibited aberrant mitochondrial activity including impaired mitophagy and decreased mitochondrial spare respiratory capacity. In contrast, AMPKα1 was dispensable for the stability of the bone marrow-resident long-lived plasma cell population yet its absence led to increased rates of Ig synthesis and elevated serum antibody concentrations elicited by immunization. Collectively, our findings fit a model in which AMPKα1 supports longevity in the memory B cell compartment by promoting mitochondrial homeostasis but restrains rates of immunoglobulin production by plasma cells.
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Zheng L, Cho SH, Kang CW, Lee KW, Kim KE, An BK. Effects of β-mannanase on Egg Production Performance, Egg Quality, Intestinal Microbiota, Viscosity, and Ammonia Concentration in Laying Hens. Braz J Poult Sci 2020. [DOI: 10.1590/1806-9061-2019-1180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- L Zheng
- Konkuk University, Republic of Korea
| | - SH Cho
- Konkuk University, Republic of Korea
| | - CW Kang
- Konkuk University, Republic of Korea
| | - KW Lee
- Konkuk University, Republic of Korea
| | - KE Kim
- Nonghyup Feed, Republic of Korea
| | - BK An
- Konkuk University, Republic of Korea
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Raybuck AL, Lee K, Cho SH, Li J, Thomas JW, Boothby MR. mTORC1 as a cell-intrinsic rheostat that shapes development, preimmune repertoire, and function of B lymphocytes. FASEB J 2019; 33:13202-13215. [PMID: 31533002 PMCID: PMC6894075 DOI: 10.1096/fj.201900069r] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 08/19/2019] [Indexed: 11/11/2022]
Abstract
Ample evidence indicates that nutrient concentrations in extracellular milieux affect signaling mediated by environmental sensor proteins. For instance, the mechanistic target of rapamycin (mTOR) is reduced during protein malnutrition and is known to be modulated by concentrations of several amino acids when in a multiprotein signaling complex that contains regulatory-associated protein of mTOR. We hypothesized that a partial decrease in mTOR complex 1 (mTORC1) activity intrinsic to B-lineage cells would perturb lymphocyte development or function, or both. We show that a cell-intrinsic decrease in mTORC1 activity impacted developmental progression, antigen receptor repertoire, and function along the B lineage. Thus, preimmune repertoires of B-lineage cells were altered in the marrow and periphery in a genetic model of regulatory-associated protein of mTOR haplo-insufficiency. An additional role for mTORC1 was revealed when a B-cell antigen receptor transgene was found to circumvent the abnormal B-cell development: haploinsufficient B cells were profoundly impaired in responses to antigen in vivo. Collectively, our findings indicate that mTORC1 serves as a rheostat that shapes differentiation along the B lineage, the preimmune repertoire, and antigen-driven selection of mature B cells. The findings also reveal a range in the impact of this nutrient sensor on activity-response relationships for distinct endpoints.-Raybuck, A. L., Lee, K., Cho, S. H., Li, J., Thomas, J. W., Boothby, M. R. mTORC1 as a cell-intrinsic rheostat that shapes development, preimmune repertoire, and function of B lymphocytes.
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Affiliation(s)
- Ariel L. Raybuck
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Keunwook Lee
- Department of Biomedical Science, Hallym University, Chuncheon, Gangwon-do, South Korea
| | - Sung Hoon Cho
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Vanderbilt Institute for Infection, Immunology, and Inflammation (VI4), Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jingxin Li
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - James W. Thomas
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Mark R. Boothby
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Vanderbilt Institute for Infection, Immunology, and Inflammation (VI4), Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Cancer Biology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Cho SH, Khang YH, June KJ, Lee JY, Cho HJ, Kim YM. Postpartum women’s experience of abuse in childhood, postnatal depression, and thoughts of self-harm. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Postnatal depression threatens the health of both mothers and babies. To improve maternal and child health in Seoul, South Korea, a nurse home visitation program for pregnant women and new mothers and babies has been implemented since 2013.
Methods
Cross-sectional data collected from 9,124 mothers while they were visiting a public health center for prenatal services or a nurse was visiting their home within 6 weeks after birth between 2014 and 2018 were analyzed. Mothers were asked whether they had experienced physical, emotional, or sexual abuse in their childhood. Postnatal depression and thoughts of self-harm were measured using the Edinburgh Postnatal Depression Scale (EPDS). Postnatal depression was defined as a total EPDS score of 13 or higher; thoughts of self-harm were defined as a response of “yes, quite often,” “sometimes,” or “hardly ever” to the corresponding item, excluding the response of “never".
Results
Overall, 3.2% of mothers had experienced child abuse; 8.1% experienced postnatal depression and 5.4% reported thoughts of self-harm. Postnatal depression was more common in mothers who had experienced child abuse than among those who had not (24.2% vs. 7.6%). A similar pattern was found for thoughts of self-harm (21.1% vs. 4.9%, respectively). When controlling for mothers’ age, economic status, history of receiving treatment for mental health problems, and other factors, having experienced child abuse was associated with a 2.73-fold increase in the odds of postnatal depression (odds ratio, 2.02-3.70) and a 3.58-fold increase in the odds of thoughts of self-harm (odds ratio, 2.58-4.96).
Conclusions
Mothers should be screened for having experienced child abuse when providing public health perinatal care to improve mothers’ mental health and parenting practices and to promote their children’s growth and development.
Key messages
Child abuse may have a lifelong negative effect on victims, and the effect extends to the next generation’s health and development. Public health policy and interventions to prevent child abuse are needed to tackle health inequality beginning in early childhood.
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Affiliation(s)
- S H Cho
- College of Nursing, Seoul National University, Seoul, South Korea
| | - Y H Khang
- College of Medicine, Seoul National University, Seoul, South Korea
| | - K J June
- Department of Nursing, Soonchunhyang University, Cheonan, South Korea
| | - J Y Lee
- College of Nursing, Kangwon National University, Chuncheon, South Korea
| | - H J Cho
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, South Korea
| | - Y M Kim
- College of Medicine, Dong-A University, Busan, South Korea
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Cho SH, Raybuck A, Kemboi E, Haase V, Boothby MR. Hypoxia-Inducible Factors (HIF) in CD4+ T cells promote metabolism, switch cytokine secretion, and T cell help in humoral immunity. The Journal of Immunology 2019. [DOI: 10.4049/jimmunol.202.supp.186.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
T cell help in humoral immunity includes interactions of B cells with activated extrafollicular CD4+ and follicular T helper (Tfh) cells. Each can promote antibody responses but Tfh cells play critical roles during germinal center (GC) reactions. After re-stimulation of their antigen receptor (TCR) by B cells, helper T cells act on B cells via CD40 ligand and secreted cytokines that guide immunoglobulin class switching. Recent work showed that hypoxia is a normal feature of most GC, raising questions about molecular mechanisms governing the relationship between hypoxia and T cell help to antibody response. Hypoxia-inducible factors (HIF) are prominent among mechanisms that mediate cellular responses to limited oxygen but also are induced by lymphocyte activation. We now show that loss of HIF-1a and HIF-2a in CD4+ T cells compromised essential functions in help during antibody responses. HIF-1a depletion from CD4 T cells reduced frequencies of antigen-specific GC B cells, Tfh cells, and overall antigen-specific Ab. Compound deficiency of HIF-1a and HIF-2a intensified humoral defects after hapten-carrier immunization. Further, HIF promoted CD40L expression while restraining the FoxP3-positive CD4+ cells in the CCR5+ follicular regulatory (Tfr) population. Glycolysis increases T helper cytokine expression, and HIF was essential for stimulation of glycolysis in T helper cells via TCR or cytokine stimulation, as well as their production of cytokines that direct antibody class switching. Indeed, interferon-g elaboration by HIF-deficient in vivo-generated Tfh cells was impaired. Collectively, the results indicate that HIF transcription factors are vital components of the mechanisms of follicular help during humoral responses.
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Kim HJ, Noh WC, Nam SJ, Park BW, Lee ES, Im SA, Jung YS, Yoon JH, Kang SS, Park KH, Lee SJ, Jung J, Lee MH, Cho SH, Kim SY, Kim HA, Han SH, Han W, Hur MH, Ahn SH. Abstract P4-14-04: Time course changes in serum FSH, estradiol, and menstruation restoration in premenopausal patients with breast cancer taking adjuvant tamoxifen after completing chemotherapy: A report from the ASTRRA study. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-14-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND
Assessment of restoration of ovarian function after chemotherapy is critical with respect to the initiation of different types of endocrine treatment in young high risk breast cancer patients
METHODS
In total, 1289 women who remained premenopausal or resumed premenopausal status after chemotherapy were randomized to receive 5 years of tamoxifen or 5 years of tamoxifen plus 2 years of ovarian suppression. The patients who did not resume menstruation were followed up for 2 years with tamoxifen treatment after finishing chemotherapy. Prospectively collected consecutive post-chemotherapy hormone and menstruation data were available for 705 breast cancer patients who enrolled tamoxifen-only treatment group or did not resume menstruation during follow up. This analysis evaluated the proportion of patients with pre-menopausal FSH levels (<30 mIU/ml), E2 levels (340 pg/ml), and menstruation at any time point during treatment with tamoxifen.
RESULTS
During 5 years of tamoxifen treatment after chemotherapy for premenopausal breast cancer patients, 62% of patients resumed menstruation. Menstruation returned in 92% of patients under 35 years old but only in 31% of patients over 45 years old. Ovarian function, defined by serum FSH and E2 levels, resumed in 94% and 65% of patients, respectively, over 5 years. Most patients achieved ovarian function restoration during the first 2 years after chemotherapy, with 47.1% resuming menstruation and 86.2% and 50.3% achieving pre-menopausal FSH and E2 levels, respectively, in the first 2 years. Clinical factors related to menstruation restoration were younger age (HR = 6.38, 95% CI 1.33-3.47), 6 month hormone profile after chemotherapy (FSH<30: HR=1.67, 95% CI 1.28-2.17; E2 >40: HR=2.96, 95% CI 2.25-3.89), and anthracycline without taxane chemotherapy (HR=1.63, 95% CI 1.25-2.13).
CONCLUSIONS
During 5 years of tamoxifen treatment after chemotherapy, half of patients experienced menstruation restoration, including most very young patients under 35 years. The majority of patients experienced menstruation restoration in the first 2 years of tamoxifen treatment.
Citation Format: Kim HJ, Noh WC, Nam SJ, Park B-w, Lee ES, Im SA, Jung YS, Yoon JH, Kang SS, Park KH, Lee S-J, Jung J, Lee MH, Cho SH, Kim SY, Kim H-A, Han S-H, Han W, Hur MH, Ahn SH. Time course changes in serum FSH, estradiol, and menstruation restoration in premenopausal patients with breast cancer taking adjuvant tamoxifen after completing chemotherapy: A report from the ASTRRA study [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-14-04.
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Affiliation(s)
- HJ Kim
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - WC Noh
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - SJ Nam
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - B-w Park
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - ES Lee
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - SA Im
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - YS Jung
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - JH Yoon
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - SS Kang
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - KH Park
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - S-J Lee
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - J Jung
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - MH Lee
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - SH Cho
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - SY Kim
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - H-A Kim
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - S-H Han
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - W Han
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - MH Hur
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - SH Ahn
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
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34
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Lee SY, Kang DY, Kim JY, Yoon SH, Choi YH, Lee W, Cho SH, Kang HR. Incidence and Risk Factors of Immediate Hypersensitivity Reactions Associated With Low-Osmolar Iodinated Contrast Media: A Longitudinal Study Based on a Real-Time Monitoring System. J Investig Allergol Clin Immunol 2019; 29:444-450. [PMID: 30676320 DOI: 10.18176/jiaci.0374] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES We investigated the incidence of immediate hypersensitivity reaction (HSR) caused by different types of low-osmolar contrast media (LOCM) and cumulative exposure to LOCM. METHODS This cohort study included all consecutive patients who underwent LOCM-enhanced computed tomography from 2012 through 2014. We assessed 5 LOCM (iobitridol, iohexol, iomeprol, iopamidol, and iopromide). All patients were monitored for adverse events, and new symptoms and signs were recorded in real time using the Contrast Safety Monitoring and Management System (CoSM2oS). RESULTS The overall incidence of immediate HSR to LOCM was 0.97% (2004 events resulting from 205 726 exposures). Incidence differed significantly depending on whether the patient had a previous history of HSR to LOCM (0.80% in patients with no history and 16.99% in patients with a positive history of HSR to LOCM, P=.001). The incidence of HSR to individual LOCM ranged from 0.72% (iohexol) to 1.34% (iomeprol), although there were no significant differences across the 5 LOCM. A longitudinal analysis demonstrated that the incidence of HSR increased gradually with more frequent previous exposure to LOCM (HR=2.006 [95%CI, 1.517-2.653], P<.001). However, this cumulative increase in risk was observed in patients who had experienced HSR to LOCM, but not in those who had not. CONCLUSION The incidence of HSR did not differ significantly across the 5 LOCM assessed in the study. Repeated exposure to LOCM did not increase the risk of HSR among patients who had never experienced HSR to LOCM.
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Affiliation(s)
- S Y Lee
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea.,Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - D Y Kang
- Drug Safety Monitoring Center, Seoul National University Hospital, Seoul, Korea
| | - J Y Kim
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - S H Yoon
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Y H Choi
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - W Lee
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - S H Cho
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea.,Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.,Drug Safety Monitoring Center, Seoul National University Hospital, Seoul, Korea
| | - H R Kang
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea.,Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.,Drug Safety Monitoring Center, Seoul National University Hospital, Seoul, Korea
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35
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Song Y, Cho SH, Lee DW, Sheen JJ, Shin JH, Suh DC. Osseous versus Nonosseous Spinal Epidural Arteriovenous Fistulas: Experiences of 13 Patients. AJNR Am J Neuroradiol 2018; 40:129-134. [PMID: 30523143 DOI: 10.3174/ajnr.a5904] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 10/12/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND PURPOSE Spinal epidural arteriovenous fistulas are rare vascular malformations. We present 13 patients with spinal epidural arteriovenous fistulas, noting the various presenting symptom patterns, imaging findings related to bone involvement, and outcomes. MATERIALS AND METHODS Among 111 patients with spinal vascular malformations in the institutional data base from 1993 to 2017, thirteen patients (11.7%) had spinal epidural arteriovenous fistulas. We evaluated presenting symptoms and imaging findings, including bone involvement and mode of treatment. To assess the treatment outcome, we compared initial and follow-up clinical status using the modified Aminoff and Logue Scale of Disability and the modified Rankin Scale. RESULTS The presenting symptoms were lower back pain (n = 2), radiculopathy (n = 5), and myelopathy (n = 7). There is overlap of symptoms in 1 patient (No. 11). Distribution of spinal epidural arteriovenous fistulas was cervical (n = 3), thoracic (n = 2), lumbar (n = 6), and sacral (n = 2). Intradural venous reflux was identified in 7 patients with congestive venous myelopathy. The fistulas were successfully treated in all patients who underwent treatment (endovascular embolization, n = 10; operation, n = 1) except 2 patients who refused treatment due to tolerable symptoms. Transarterial glue (n = 7) was used in nonosseous types; and transvenous coils (n = 3), in osseous type. After 19 months of median follow-up, the patients showed symptom improvement after treatment. CONCLUSIONS Although presenting symptoms were diverse, myelopathy caused by intradural venous reflux was the main target of treatment. Endovascular treatment was considered via an arterial approach in nonosseous types and via a venous approach in osseous types.
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Affiliation(s)
- Y Song
- From the Departments of Radiology and Research Institute of Radiology (Y.S., D.W.L., J.J.S., J.H.S., D.C.S.), University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - S H Cho
- Department of Neurosurgery (S.H.C.), Ulsan University College of Medicine, Asan Hospital, Gang-reung, Republic of Korea
| | - D W Lee
- From the Departments of Radiology and Research Institute of Radiology (Y.S., D.W.L., J.J.S., J.H.S., D.C.S.), University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - J J Sheen
- From the Departments of Radiology and Research Institute of Radiology (Y.S., D.W.L., J.J.S., J.H.S., D.C.S.), University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - J H Shin
- From the Departments of Radiology and Research Institute of Radiology (Y.S., D.W.L., J.J.S., J.H.S., D.C.S.), University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - D C Suh
- From the Departments of Radiology and Research Institute of Radiology (Y.S., D.W.L., J.J.S., J.H.S., D.C.S.), University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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36
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Schuemann J, McNamara AL, Warmenhoven JW, Henthorn NT, Kirkby KJ, Merchant MJ, Ingram S, Paganetti H, Held KD, Ramos-Mendez J, Faddegon B, Perl J, Goodhead DT, Plante I, Rabus H, Nettelbeck H, Friedland W, Kundrát P, Ottolenghi A, Baiocco G, Barbieri S, Dingfelder M, Incerti S, Villagrasa C, Bueno M, Bernal MA, Guatelli S, Sakata D, Brown JMC, Francis Z, Kyriakou I, Lampe N, Ballarini F, Carante MP, Davídková M, Štěpán V, Jia X, Cucinotta FA, Schulte R, Stewart RD, Carlson DJ, Galer S, Kuncic Z, Lacombe S, Milligan J, Cho SH, Sawakuchi G, Inaniwa T, Sato T, Li W, Solov'yov AV, Surdutovich E, Durante M, Prise KM, McMahon SJ. A New Standard DNA Damage (SDD) Data Format. Radiat Res 2018; 191:76-92. [PMID: 30407901 DOI: 10.1667/rr15209.1] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Our understanding of radiation-induced cellular damage has greatly improved over the past few decades. Despite this progress, there are still many obstacles to fully understand how radiation interacts with biologically relevant cellular components, such as DNA, to cause observable end points such as cell killing. Damage in DNA is identified as a major route of cell killing. One hurdle when modeling biological effects is the difficulty in directly comparing results generated by members of different research groups. Multiple Monte Carlo codes have been developed to simulate damage induction at the DNA scale, while at the same time various groups have developed models that describe DNA repair processes with varying levels of detail. These repair models are intrinsically linked to the damage model employed in their development, making it difficult to disentangle systematic effects in either part of the modeling chain. These modeling chains typically consist of track-structure Monte Carlo simulations of the physical interactions creating direct damages to DNA, followed by simulations of the production and initial reactions of chemical species causing so-called "indirect" damages. After the induction of DNA damage, DNA repair models combine the simulated damage patterns with biological models to determine the biological consequences of the damage. To date, the effect of the environment, such as molecular oxygen (normoxic vs. hypoxic), has been poorly considered. We propose a new standard DNA damage (SDD) data format to unify the interface between the simulation of damage induction in DNA and the biological modeling of DNA repair processes, and introduce the effect of the environment (molecular oxygen or other compounds) as a flexible parameter. Such a standard greatly facilitates inter-model comparisons, providing an ideal environment to tease out model assumptions and identify persistent, underlying mechanisms. Through inter-model comparisons, this unified standard has the potential to greatly advance our understanding of the underlying mechanisms of radiation-induced DNA damage and the resulting observable biological effects when radiation parameters and/or environmental conditions change.
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Affiliation(s)
- J Schuemann
- a Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - A L McNamara
- a Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - J W Warmenhoven
- b Division of Cancer Sciences, The University of Manchester, Manchester, United Kingdom
| | - N T Henthorn
- b Division of Cancer Sciences, The University of Manchester, Manchester, United Kingdom
| | - K J Kirkby
- b Division of Cancer Sciences, The University of Manchester, Manchester, United Kingdom
| | - M J Merchant
- b Division of Cancer Sciences, The University of Manchester, Manchester, United Kingdom
| | - S Ingram
- b Division of Cancer Sciences, The University of Manchester, Manchester, United Kingdom
| | - H Paganetti
- a Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - K D Held
- a Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - J Ramos-Mendez
- c Department of Radiation Oncology, University of California San Francisco, San Francisco, California
| | - B Faddegon
- c Department of Radiation Oncology, University of California San Francisco, San Francisco, California
| | - J Perl
- d SLAC National Accelerator Laboratory, Menlo Park, California
| | - D T Goodhead
- e Medical Research Council, Harwell, United Kingdom
| | | | - H Rabus
- g Physikalisch-Technische Bundesanstalt (PTB), Braunschweig, Germany.,h Task Group 6.2 "Computational Micro- and Nanodosimetry", European Radiation Dosimetry Group e.V., Neuherberg, Germany
| | - H Nettelbeck
- g Physikalisch-Technische Bundesanstalt (PTB), Braunschweig, Germany.,h Task Group 6.2 "Computational Micro- and Nanodosimetry", European Radiation Dosimetry Group e.V., Neuherberg, Germany
| | - W Friedland
- h Task Group 6.2 "Computational Micro- and Nanodosimetry", European Radiation Dosimetry Group e.V., Neuherberg, Germany.,i Institute of Radiation Protection, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - P Kundrát
- i Institute of Radiation Protection, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - A Ottolenghi
- j Physics Department, University of Pavia, Pavia, Italy
| | - G Baiocco
- h Task Group 6.2 "Computational Micro- and Nanodosimetry", European Radiation Dosimetry Group e.V., Neuherberg, Germany.,j Physics Department, University of Pavia, Pavia, Italy
| | - S Barbieri
- h Task Group 6.2 "Computational Micro- and Nanodosimetry", European Radiation Dosimetry Group e.V., Neuherberg, Germany.,j Physics Department, University of Pavia, Pavia, Italy
| | - M Dingfelder
- k Department of Physics, East Carolina University, Greenville, North Carolina
| | - S Incerti
- l CNRS, IN2P3, CENBG, UMR 5797, F-33170 Gradignan, France.,m University of Bordeaux, CENBG, UMR 5797, F-33170 Gradignan, France
| | - C Villagrasa
- h Task Group 6.2 "Computational Micro- and Nanodosimetry", European Radiation Dosimetry Group e.V., Neuherberg, Germany.,n Institut de Radioprotection et Sûreté Nucléaire, F-92262 Fontenay aux Roses Cedex, France
| | - M Bueno
- n Institut de Radioprotection et Sûreté Nucléaire, F-92262 Fontenay aux Roses Cedex, France
| | - M A Bernal
- o Applied Physics Department, Gleb Wataghin Institute of Physics, State University of Campinas, Campinas, SP, Brazil
| | - S Guatelli
- p Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW, Australia
| | - D Sakata
- p Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW, Australia
| | - J M C Brown
- q Department of Radiation Science and Technology, Delft University of Technology, Delft, The Netherlands
| | - Z Francis
- r Department of Physics, Faculty of Science, Saint Joseph University, Beirut, Lebanon
| | - I Kyriakou
- s Medical Physics Laboratory, University of Ioannina Medical School, Ioannina, Greece
| | - N Lampe
- l CNRS, IN2P3, CENBG, UMR 5797, F-33170 Gradignan, France
| | - F Ballarini
- j Physics Department, University of Pavia, Pavia, Italy.,t Italian National Institute of Nuclear Physics, Section of Pavia, I-27100 Pavia, Italy
| | - M P Carante
- j Physics Department, University of Pavia, Pavia, Italy.,t Italian National Institute of Nuclear Physics, Section of Pavia, I-27100 Pavia, Italy
| | - M Davídková
- u Department of Radiation Dosimetry, Nuclear Physics Institute of the CAS, Řež, Czech Republic
| | - V Štěpán
- u Department of Radiation Dosimetry, Nuclear Physics Institute of the CAS, Řež, Czech Republic
| | - X Jia
- v Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - F A Cucinotta
- w Health Physics and Diagnostic Sciences, University of Nevada Las Vegas, Las Vegas, Nevada
| | - R Schulte
- x Division of Biomedical Engineering Sciences, School of Medicine, Loma Linda University, Loma Linda, California
| | - R D Stewart
- y Department of Radiation Oncology, University of Washington, Seattle, Washington
| | - D J Carlson
- z Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut
| | - S Galer
- aa Medical Radiation Science Group, National Physical Laboratory, Teddington, United Kingdom
| | - Z Kuncic
- bb School of Physics, University of Sydney, Sydney, NSW, Australia
| | - S Lacombe
- cc Institut des Sciences Moléculaires d'Orsay (UMR 8214) University Paris-Sud, CNRS, University Paris-Saclay, 91405 Orsay Cedex, France
| | | | - S H Cho
- ee Department of Radiation Physics and Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - G Sawakuchi
- ee Department of Radiation Physics and Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - T Inaniwa
- ff Department of Accelerator and Medical Physics, National Institute of Radiological Sciences, Chiba, Japan
| | - T Sato
- gg Japan Atomic Energy Agency, Nuclear Science and Engineering Center, Tokai 319-1196, Japan
| | - W Li
- i Institute of Radiation Protection, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.,hh Task Group 7.7 "Internal Micro- and Nanodosimetry", European Radiation Dosimetry Group e.V., Neuherberg, Germany
| | - A V Solov'yov
- ii MBN Research Center, 60438 Frankfurt am Main, Germany
| | - E Surdutovich
- jj Department of Physics, Oakland University, Rochester, Michigan
| | - M Durante
- kk GSI Helmholtzzentrum für Schwerionenforschung, Biophysics Department, Darmstadt, Germany
| | - K M Prise
- ll Centre for Cancer Research and Cell Biology, Queens University Belfast, Belfast, United Kingdom
| | - S J McMahon
- ll Centre for Cancer Research and Cell Biology, Queens University Belfast, Belfast, United Kingdom
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37
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Yoo SH, Kwon JH, Nam SW, Kim HY, Kim CW, You CR, Choi SW, Cho SH, Han JY, Song DS, Chang UI, Yang JM, Lee HL, Lee SW, Han NI, Kim SH, Song MJ, Hwang S, Sung PS, Jang JW, Bae SH, Choi JY, Yoon SK. Early development of de novo hepatocellular carcinoma after direct-acting agent therapy: Comparison with pegylated interferon-based therapy in chronic hepatitis C patients. J Viral Hepat 2018; 25:1189-1196. [PMID: 29660199 DOI: 10.1111/jvh.12918] [Citation(s) in RCA: 7] [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: 01/03/2018] [Accepted: 03/26/2018] [Indexed: 01/18/2023]
Abstract
Patients with chronic hepatitis C who achieve a sustained viral response after pegylated interferon therapy have a reduced risk of hepatocellular carcinoma, but the risk after treatment with direct-acting antivirals is unclear. We compared the rates of early development of hepatocellular carcinoma after direct-acting antivirals and after pegylated interferon therapy. We retrospectively analysed 785 patients with chronic hepatitis C who had no history of hepatocellular carcinoma (211 treated with pegylated interferon, 574 with direct-acting antivirals) and were followed up for at least 24 weeks after antiviral treatment. De novo hepatocellular carcinoma developed in 6 of 574 patients receiving direct-acting antivirals and in 1 of 211 patients receiving pegylated interferon. The cumulative incidence of early hepatocellular carcinoma development did not differ between the treatment groups either for the whole cohort (1.05% vs 0.47%, P = .298) or for those patients with Child-Pugh Class A cirrhosis (3.73% vs 2.94%, P = .827). Multivariate analysis indicated that alpha-fetoprotein level >9.5 ng/mL at the time of end-of-treatment response was the only independent risk factor for early development of hepatocellular carcinoma in all patients (P < .0001, hazard ratio 176.174, 95% confidence interval 10.768-2882.473) and in patients treated with direct-acting agents (P < .0001, hazard ratio 128.402, 95% confidence interval 8.417-1958.680). In conclusion, the rate of early development of hepatocellular carcinoma did not differ between patients treated with pegylated interferon and those treated with direct-acting antivirals and was associated with the serum alpha-fetoprotein level at the time of end-of-treatment response.
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Affiliation(s)
- S H Yoo
- Department of Internal Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Incehon, Korea.,Catholic University Liver Research Center, The Catholic University of Korea, Seoul, Korea
| | - J H Kwon
- Department of Internal Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Incehon, Korea.,Catholic University Liver Research Center, The Catholic University of Korea, Seoul, Korea
| | - S W Nam
- Department of Internal Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Incehon, Korea.,Catholic University Liver Research Center, The Catholic University of Korea, Seoul, Korea
| | - H Y Kim
- Catholic University Liver Research Center, The Catholic University of Korea, Seoul, Korea.,Department of Internal Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea
| | - C W Kim
- Catholic University Liver Research Center, The Catholic University of Korea, Seoul, Korea.,Department of Internal Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea
| | - C R You
- Catholic University Liver Research Center, The Catholic University of Korea, Seoul, Korea.,Department of Internal Medicine, St. Paul's Hospital, The Catholic University of Korea, Seoul, Korea
| | - S W Choi
- Catholic University Liver Research Center, The Catholic University of Korea, Seoul, Korea.,Department of Internal Medicine, St. Paul's Hospital, The Catholic University of Korea, Seoul, Korea
| | - S H Cho
- Catholic University Liver Research Center, The Catholic University of Korea, Seoul, Korea.,Department of Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - J-Y Han
- Catholic University Liver Research Center, The Catholic University of Korea, Seoul, Korea.,Department of Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - D S Song
- Catholic University Liver Research Center, The Catholic University of Korea, Seoul, Korea.,Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea
| | - U I Chang
- Catholic University Liver Research Center, The Catholic University of Korea, Seoul, Korea.,Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea
| | - J M Yang
- Catholic University Liver Research Center, The Catholic University of Korea, Seoul, Korea.,Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea
| | - H L Lee
- Catholic University Liver Research Center, The Catholic University of Korea, Seoul, Korea.,Department of Internal Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea, Bucheon, Korea
| | - S W Lee
- Catholic University Liver Research Center, The Catholic University of Korea, Seoul, Korea.,Department of Internal Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea, Bucheon, Korea
| | - N I Han
- Catholic University Liver Research Center, The Catholic University of Korea, Seoul, Korea.,Department of Internal Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea, Bucheon, Korea
| | - S-H Kim
- Catholic University Liver Research Center, The Catholic University of Korea, Seoul, Korea.,Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Korea
| | - M J Song
- Catholic University Liver Research Center, The Catholic University of Korea, Seoul, Korea.,Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Korea
| | - S Hwang
- Catholic University Liver Research Center, The Catholic University of Korea, Seoul, Korea.,Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - P S Sung
- Catholic University Liver Research Center, The Catholic University of Korea, Seoul, Korea.,Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - J W Jang
- Catholic University Liver Research Center, The Catholic University of Korea, Seoul, Korea.,Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - S H Bae
- Catholic University Liver Research Center, The Catholic University of Korea, Seoul, Korea.,Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - J Y Choi
- Catholic University Liver Research Center, The Catholic University of Korea, Seoul, Korea.,Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - S K Yoon
- Catholic University Liver Research Center, The Catholic University of Korea, Seoul, Korea.,Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
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Lim YH, Choi YW, Park JY, Lee YG, Choi JW, Park HK, Cho SH, Cho SH. P4423Non-contact heart beat monitoring using impulse-radio ultra-wide band radar technology. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Y.-H Lim
- Hanyang University, Seoul, Korea Republic of
| | - Y W Choi
- Hanyang University, Seoul, Korea Republic of
| | - J Y Park
- Hanyang University, Seoul, Korea Republic of
| | - Y G Lee
- Hanyang University, Seoul, Korea Republic of
| | - J W Choi
- Hanyang University, Seoul, Korea Republic of
| | - H K Park
- Hanyang University, Seoul, Korea Republic of
| | - S.-H Cho
- Hanyang University, Seoul, Korea Republic of
| | - S H Cho
- Hanyang University, Seoul, Korea Republic of
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Cho SH, Raybuck A, Kemboi E, Boothby MR. Hypoxia-Inducible Factors regulate metabolism and germinal center response. The Journal of Immunology 2018. [DOI: 10.4049/jimmunol.200.supp.48.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Germinal centers (GCs) are micronantomic structures that B cells proliferate, are selected for affinity maturation, undergo antibody (Ab) class-switch recombination and differentiate into Ab-secreting plasma cells and memory B cells. Both cell-autonomous and extrinsic metabolic reprogramming have emerged as modulators of T cellmediated immunity. We have shown that GC light zone (LZ) are hypoxic, and the low oxygen tension or persistent stabilization of Hypoxia-Inducible Factor (HIF)-1a and 2a alters B cell physiology and function. Depletion of HIF-1a and HIF-2a in CD4 T cells caused deficiencies of the antibody response due to HIF functions in both B lineage cells and the follicular CD4 subset. Among CD4 T cells, HIF restrained the FoxP3-positive T follicular regulatory (TFR) population while promoting CD40L expression. In the B lineage, HIF promoted humoral responses both through their capacity to promote effective proliferation and via enhancement of plasma cell differentiation. Collectively, these results provide evidence that HIF transcription factors regulate humoral responses via vital functions of B and Tfh cells. We propose that restriction of oxygen in lymphoid structure and organs, which can be altered in pathophysiological status, modulates humoral immune response and memory.
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Affiliation(s)
- Sung Hoon Cho
- 1Department of Pathology, Microbiology & Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Ariel Raybuck
- 1Department of Pathology, Microbiology & Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Edna Kemboi
- 1Department of Pathology, Microbiology & Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Mark R. Boothby
- 1Department of Pathology, Microbiology & Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
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Kim S, Lee CH, Jin KN, Cho SH, Kang HR. Severe Asthma Phenotypes Classified by Site of Airway Involvement and Remodeling via Chest CT Scan. J Investig Allergol Clin Immunol 2018; 28:312-320. [PMID: 29667580 DOI: 10.18176/jiaci.0265] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES This study aimed to establish a system that can classify severe asthma on the basis of airway remodeling patterns visualizedusing computed tomography (CT) images and to evaluate the clinical characteristics of individual image-based subtypes. METHODS Chest CT images from severe asthma patients were retrospectively evaluated to classify phenotypes by site of airway involvement and remodeling. The association between radiologic subtypes and clinical characteristics was assessed. RESULTS Of 91 patients with severe asthma, 74 (81.3%) exhibited abnormal radiologic findings, including bronchial wall thickening (BT), mucus plugging (MP), and bronchiectasis (BE). The severity of BT and the extent of MP were independently associated with peripheral blood eosinophil count (P=.012, r2=0.112) and sputum eosinophil count (P=.022, r2=0.090), respectively. The large-to-medium airway remodeling type, which showed diffuse BT combined with MP and BE, accounted for 44% of patients and revealed higher peripheral blood eosinophil counts than other types. In the small airway remodeling type, which accounted for 6.6% of patients, we observed a higher rate of fixed airflow obstruction, along with a predominance of males and smokers and more frequent use of controller medication than other phenotypes. In 26% of patients with severe asthma, no prominent airway remodeling was observed (near-normal type); the near-normal type required oral corticosteroids less frequently than the large-to-medium airway and small airway remodeling types. CONCLUSIONS Depending on the site of airway involvement and remodeling pattern, 3 different structural types can be distinguished in chest CT findings from patients with severe asthma. Remodeling in large-to-medium sized airways revealed an association with systemic eosinophilic inflammation in patients with severe asthma.
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Affiliation(s)
- S Kim
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea
| | - C H Lee
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - K N Jin
- Department of Radiology, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - S H Cho
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul National University College of Medicine, Seoul, Korea.,Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - H R Kang
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul National University College of Medicine, Seoul, Korea.,Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
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Raybuck AL, Cho SH, Li J, Rogers MC, Lee K, Williams CL, Shlomchik M, Thomas JW, Chen J, Williams JV, Boothby MR. B Cell-Intrinsic mTORC1 Promotes Germinal Center-Defining Transcription Factor Gene Expression, Somatic Hypermutation, and Memory B Cell Generation in Humoral Immunity. J Immunol 2018. [PMID: 29531165 DOI: 10.4049/jimmunol.1701321] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
B lymphocytes migrate among varied microenvironmental niches during diversification, selection, and conversion to memory or Ab-secreting plasma cells. Aspects of the nutrient milieu differ within these lymphoid microenvironments and can influence signaling molecules such as the mechanistic target of rapamycin (mTOR). However, much remains to be elucidated as to the B cell-intrinsic functions of nutrient-sensing signal transducers that modulate B cell differentiation or Ab affinity. We now show that the amino acid-sensing mTOR complex 1 (mTORC1) is vital for induction of Bcl6-a key transcriptional regulator of the germinal center (GC) fate-in activated B lymphocytes. Accordingly, disruption of mTORC1 after B cell development and activation led to reduced populations of Ag-specific memory B cells as well as plasma cells and GC B cells. In addition, induction of the germ line transcript that guides activation-induced deaminase in selection of the IgG1 H chain region during class switching required mTORC1. Expression of the somatic mutator activation-induced deaminase was reduced by a lack of mTORC1 in B cells, whereas point mutation frequencies in Ag-specific GC-phenotype B cells were only halved. These effects culminated in a B cell-intrinsic defect that impacted an antiviral Ab response and drastically impaired generation of high-affinity IgG1. Collectively, these data establish that mTORC1 governs critical B cell-intrinsic mechanisms essential for establishment of GC differentiation and effective Ab production.
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Affiliation(s)
- Ariel L Raybuck
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232
| | - Sung Hoon Cho
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232
| | - Jingxin Li
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232
| | - Meredith C Rogers
- Division of Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 27232.,Department of Immunology, University of Pittsburgh Medical Center, Pittsburgh, PA 15261
| | - Keunwook Lee
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232
| | - Christopher L Williams
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232
| | - Mark Shlomchik
- Department of Immunology, University of Pittsburgh Medical Center, Pittsburgh, PA 15261
| | - James W Thomas
- Division of Rheumatology and Immunology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 27232
| | - Jin Chen
- Division of Rheumatology and Immunology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 27232.,Medical and Research Services, Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN 37212.,Program in Cancer Biology, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232; and.,Department of Cell and Developmental Biology, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232
| | - John V Williams
- Division of Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 27232.,Department of Immunology, University of Pittsburgh Medical Center, Pittsburgh, PA 15261
| | - Mark R Boothby
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232; .,Medical and Research Services, Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN 37212.,Program in Cancer Biology, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232; and
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Bhuiyan MSA, Kim HJ, Lee DH, Lee SH, Cho SH, Yang BS, Kim SD, Lee SH. Genetic parameters of carcass and meat quality traits in different muscles (longissimus dorsi and semimembranosus) of Hanwoo (Korean cattle). J Anim Sci 2018; 95:3359-3369. [PMID: 28805895 DOI: 10.2527/jas.2017.1493] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We estimated heritability () and genetic and phenotypic correlations for carcass and meat quality traits of longissimus dorsi (LD) and semimembranosus (SM) muscles in 30-mo-old Hanwoo steers. Variance and covariance components were estimated using REML procedures under univariate and bivariate models. The mean carcass weight (CWT), eye muscle area (EMA), back fat thickness (BFT), and marbling score (MS) were 428.20 ± 46.30 kg, 87.38 ± 8.54 cm2, 13.00 ± 5.14 mm, and 5.21 ± 1.56, respectively. The mean CIE reflectance of meat lightness (L*), redness (a*), and yellowness (b*) were 40.01 ± 2.73, 22.37 ± 2.18, and 10.35 ± 1.46, respectively, in LD muscles and 36.33 ± 2.44, 22.91 ± 2.43, and 10.25 ± 1.65, respectively, in SM muscles. The mean Warner-Bratzler shear force (WBSF), intramuscular fat content (IMF), water-holding capacity (WHC), and protein and ash content in LD and SM muscles were 3.84 ± 0.96 and 6.52 ± 1.21 kg, 15.91 ± 4.39 and 5.10 ± 1.94%, 62.07 ± 3.38 and 71.61 ± 2.06%, 20.01 ± 1.39 and 21.34 ± 0.89%, and 0.80 ± 0.10 and 0.93 ± 0.07, respectively. The estimates of CWT, EMA, BFT, and MS were 0.51 ± 0.13, 0.45 ± 0.13, 0.29 ± 0.09, and 0.22 ± 0.08, respectively. The estimates were moderate for meat quality traits and were 0.37 ± 0.12, 0.40 ± 0.12, 0.33 ± 0.10, 0.33 ± 0.10, 0.30 ± 0.11, and 0.24 ± 0.09 for L*, WBSF, IMF, WHC, and protein and ash content, respectively, in LD muscle; estimates from SM muscle were comparatively low (0.08 ± 0.06 to 0.25 ± 0.09). Estimates of for a* and b* were also low (0.08 ± 0.06 to 0.13 ± 0.07). Carcass weight had a moderate, positive genetic correlation with EMA (0.60 ± 0.13) and a weak correlation with MS and BFT. The genetic correlations among the 3 colorimeter variants were strong and positive within and between muscles. Intramuscular fat content had moderate to strong and negative genetic correlations with WBSF (-0.49 ± 0.18), WHC (-0.99 ± 0.01), and protein (-0.93 ± 0.04) and ash content (-0.98 ± 0.06) in LD muscle, whereas the associations were less pronounced in SM muscle. In general, CWT and EMA had low genetic and phenotypic correlations with meat quality traits, which suggests that the traits are independent and have distinct genetic contributions in each muscle. Conversely, with few exceptions, meat quality traits had genetic and phenotypic correlations with MS and BFT. In conclusion, the estimated genetic parameters for carcass and meat quality traits could be used for genetic evaluation and breeding programs in Korean Hanwoo cattle populations.
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Kwon J, Rha HK, Park HK, Chough CK, Joo WI, Cho SH, Gu W, Moon W, Han J. Proper Management of Posttraumatic Tension Pneumocephalus. Korean J Neurotrauma 2017; 13:158-161. [PMID: 29201853 PMCID: PMC5702754 DOI: 10.13004/kjnt.2017.13.2.158] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 10/13/2017] [Accepted: 10/13/2017] [Indexed: 11/15/2022] Open
Abstract
Pneumocephalus is commonly seen after craniofacial injury. The pathogenesis of pneumocephalus has been debated as to whether it was caused by ball valve effect or combined episodic increased pressure within the nasopharynx on coughing. Discontinuous exchange of air and cerebrospinal fluid due to “inverted bottle” effect is assumed to be the cause of it. Delayed tension pneumocephalus is not common, but it requires an active management in order to prevent serious complication. We represent a clinical case of a 57-year-old male patient who fell down from 3 m height, complicated by tension pneumocephalus on 5 months after trauma. We recommend a surgical intervention, but the patient did not want that so we observe the patient. The patient was underwent seizure and meningitis after 7 months after trauma, he came on emergency room on stupor mentality. Tension pneumocephalus may result in a neurologic disturbance due to continued air entrainment and it significantly the likelihood of intracranial infection caused by continued open channel. Tension pneumocephalus threat a life, so need a neurosurgical emergency surgical intervention.
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Affiliation(s)
- Jinwon Kwon
- Department of Neurosurgery, Yeouido St. Mary's Hospital, The Catholic University College of Medicine, Seoul, Korea
| | - Hyoung Kyun Rha
- Department of Neurosurgery, Yeouido St. Mary's Hospital, The Catholic University College of Medicine, Seoul, Korea
| | - Hae Kwan Park
- Department of Neurosurgery, Yeouido St. Mary's Hospital, The Catholic University College of Medicine, Seoul, Korea
| | - Chung Kee Chough
- Department of Neurosurgery, Yeouido St. Mary's Hospital, The Catholic University College of Medicine, Seoul, Korea
| | - Won Il Joo
- Department of Neurosurgery, Yeouido St. Mary's Hospital, The Catholic University College of Medicine, Seoul, Korea
| | - Sung Hoon Cho
- Department of Neurosurgery, Yeouido St. Mary's Hospital, The Catholic University College of Medicine, Seoul, Korea
| | - Wonmo Gu
- Department of Neurosurgery, Yeouido St. Mary's Hospital, The Catholic University College of Medicine, Seoul, Korea
| | - Wonjun Moon
- Department of Neurosurgery, Yeouido St. Mary's Hospital, The Catholic University College of Medicine, Seoul, Korea
| | - Jaesung Han
- Department of Neurosurgery, Yeouido St. Mary's Hospital, The Catholic University College of Medicine, Seoul, Korea
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Sherenian MG, Cho SH, Levin A, Min JY, Oh SS, Hu D, Galanter J, Sen S, Huntsman S, Eng C, Rodriguez-Santana JR, Serebrisky D, Avila PC, Kalhan R, Smith LJ, Borrell LN, Seibold MA, Keoki Williams L, Burchard EG, Kumar R. PAI-1 gain-of-function genotype, factors increasing PAI-1 levels, and airway obstruction: The GALA II Cohort. Clin Exp Allergy 2017; 47:1150-1158. [PMID: 28543872 DOI: 10.1111/cea.12958] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 03/27/2017] [Accepted: 04/27/2017] [Indexed: 01/05/2023]
Abstract
BACKGROUND PAI-1 gain-of-function variants promote airway fibrosis and are associated with asthma and with worse lung function in subjects with asthma. OBJECTIVE We sought to determine whether the association of a gain-of-function polymorphism in plasminogen activator inhibitor-1 (PAI-1) with airway obstruction is modified by asthma status, and whether any genotype effect persists after accounting for common exposures that increase PAI-1 level. METHODS We studied 2070 Latino children (8-21y) with genotypic and pulmonary function data from the GALA II cohort. We estimated the relationship of the PAI-1 risk allele with FEV1/FVC by multivariate linear regression, stratified by asthma status. We examined the association of the polymorphism with asthma and airway obstruction within asthmatics via multivariate logistic regression. We replicated associations in the SAPPHIRE cohort of African Americans (n=1056). Secondary analysis included the effect of the at-risk polymorphism on postbronchodilator lung function. RESULTS There was an interaction between asthma status and the PAI-1 polymorphism on FEV1 /FVC (P=.03). The gain-of-function variants, genotypes (AA/AG), were associated with lower FEV1 /FVC in subjects with asthma (β=-1.25, CI: -2.14,-0.35, P=.006), but not in controls. Subjects with asthma and the AA/AG genotypes had a 5% decrease in FEV1 /FVC (P<.001). In asthmatics, the risk genotype (AA/AG) was associated with a 39% increase in risk of clinically relevant airway obstruction (OR=1.39, CI: 1.01, 1.92, P=.04). These associations persisted after exclusion of factors that increase PAI-1 including tobacco exposure and obesity. CONCLUSIONS AND CLINICAL RELEVANCE The decrease in the FEV1 /FVC ratio associated with the risk genotype was modified by asthma status. The genotype increased the odds of airway obstruction by 75% within asthmatics only. As exposures known to increase PAI-1 levels did not mitigate this association, PAI-1 may contribute to airway obstruction in the context of chronic asthmatic airway inflammation.
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Affiliation(s)
- M G Sherenian
- Division of Allergy-Immunology, Department of Pediatrics, Northwestern University, Chicago, IL, USA.,The Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - S H Cho
- Division of Allergy-Immunology, Department of Medicine, Northwestern University, Chicago, IL, USA.,Division of Allergy-Immunology, Department of Internal Medicine, University of South Florida, Tampa, FL, USA
| | - A Levin
- Department of Public Health Science, Henry Ford Health System, Detroit, MI, USA
| | - J-Y Min
- Department of Otolaryngology, Northwestern University, Chicago, IL, USA
| | - S S Oh
- Department of Medicine, University of California, San Francisco, CA, USA
| | - D Hu
- Department of Medicine, University of California, San Francisco, CA, USA
| | - J Galanter
- Department of Medicine, University of California, San Francisco, CA, USA
| | - S Sen
- Division of Biostatistics, Department of Preventive Medicine, UTHSC, Memphis, TN, USA
| | - S Huntsman
- Department of Medicine, University of California, San Francisco, CA, USA
| | - C Eng
- Department of Medicine, University of California, San Francisco, CA, USA
| | | | - D Serebrisky
- Pediatric Pulmonary Division, Jacobi Medical Center, Bronx, NY, USA
| | - P C Avila
- Division of Allergy-Immunology, Department of Medicine, Northwestern University, Chicago, IL, USA
| | - R Kalhan
- Division of Pulmonary Medicine, Department of Medicine, Northwestern University, Chicago, IL, USA
| | - L J Smith
- Division of Pulmonary Medicine, Department of Medicine, Northwestern University, Chicago, IL, USA
| | - L N Borrell
- Department of Health Sciences, Lehman College, CUNY, New York, NY, USA
| | - M A Seibold
- Center for Genes, Environment and Health, National Jewish Health, Denver, CO, USA
| | - L Keoki Williams
- Department of Internal Medicine, Henry Ford Health System, Detroit, MI, USA.,Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, USA
| | - E G Burchard
- Department of Medicine, University of California, San Francisco, CA, USA
| | - R Kumar
- Division of Allergy-Immunology, Department of Pediatrics, Northwestern University, Chicago, IL, USA.,The Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
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McLetchie S, Raybuck A, Cho SH, Lin J, Boothby MR. mTORC1 in B cells regulates antibody responses and promotes mitochondrial and metabolic fitness. The Journal of Immunology 2017. [DOI: 10.4049/jimmunol.198.supp.195.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
B lymphocytes migrate among different micro-anatomic sites for diversification, selection, and eventual differentiation into antibody-secreting plasma cells. Emerging evidence supports the premise that aspects of the nutrient milieu vary within lymphoid micro-environments. However, the role of B cell-intrinsic metabolic programs in regulating B cell differentiation and antibody response quality remain unclear. We now show that the amino acid-sensing mTOR complex 1 (mTORC1) is essential for induction of Bcl6 and IRF4, key transcriptional regulators of germinal center and plasma cell fates. mTORC1 also enhances B cell proliferation upon exposure to antigen, increases the rate of somatic hyper-mutation, and is essential for generating high-affinity class switched antibodies. We also find that AMP-activated kinase (AMPK), an intracellular energy sensor, promotes plasma cell differentiation and antibody production. Collectively, these findings suggest mechanisms by which mTORC1 activity is critical for the germinal center reaction and producing class-switched, high-affinity antibodies, and indicate that AMPK can regulate the development and functional properties of terminally differentiated plasma cells.
Supported by NIH R01 AI113292, HL106812, and NCI T32CA009592-29
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Cho SH, Ariel R, Wei M, Haase V, Boothby M. Class-biased regulation of humoral immunity and mTORC1 inhibition by physiological hypoxia. The Journal of Immunology 2016. [DOI: 10.4049/jimmunol.196.supp.57.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
B lymphocytes activated by cognate antigen (Ag) proliferate, are selected for affinity maturation, undergo antibody (Ab) class switching dependent on the cytosine deaminase AID, and yield major forms of memory via germinal center (GC) reactions. Although metabolic programming has emerged as a means of mediating or initiating changes in immunity, nothing is known as to the metabolic landscape in lymphoid organs. Here we show that B lymphocytes in GC are hypoxic, and that low oxygen alters B cell Ab response as well as metabolic programming. In addition to increased B cell death, restricted oxygen concentrations impaired Ab class switching by reducing expression of AID and suppressing the pro-inflammatory IgG2c Ab isotype. Prolyl hydroxyl dioxygenases (PHD) and von Hippel-Lindau (VHL) are central to regulation of hypoxia-induced factors (HIF) in hypoxic responses. B cell-intrinsic deficiency of VHL attenuated Ag-specific IgG2c, and decreased levels of Ag-specific GC, early memory B cells, and Ab responses. Hypoxia and VHL deficiency each also inhibited activity of mTORC1 in a manner dependent on HIF proteins. Genetic limitation of mTORC1 in B cells reduced their clonal expansion, AID expression, and IgG2c Ab responses. Collectively, these results provide evidence that GC reactions are sites of physiologic hypoxia that in turn regulates vital functions of B cells through interruption of program that maintains mTORC1 activity. We propose that this restriction of oxygen regulates the balance of fate choices made by GC B cells, and that pathophysiological states that alter oxygen homeostasis may moderate the pro-inflammatory component of humoral immunity.
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Affiliation(s)
| | | | - Mei Wei
- 1Vanderbilt Univ. Sch. of Med
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Cho SH, Chun JM, Kwon HJ, Han YS, Kim SG, Hwang YJ. Outcomes and recurrence pattern after non-anatomic liver resection for solitary hepatocellular carcinomas. Korean J Hepatobiliary Pancreat Surg 2016; 20:1-7. [PMID: 26925143 PMCID: PMC4767267 DOI: 10.14701/kjhbps.2016.20.1.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 09/26/2015] [Accepted: 09/30/2015] [Indexed: 12/11/2022]
Abstract
Backgrounds/Aims Anatomic resection (AR) is preferred for eradicating portal tributaries in patients with hepatocellular carcinoma (HCC). However, the extent of resection is influenced by underlying liver disease and tumor location. We compared the surgical outcomes and recurrence pattern between non-anatomic resection (NR) and AR. Methods From March 2009 to February 2012, 184 patients underwent surgical resection for HCC. Among these, 79 patients who were primarily treated for a single tumor without rupture or macroscopic vascular invasion were enrolled. The patients were divided into 2 groups based on the extent of resection: AR (n=31) or NR (n=48). We compared the clinical characteristics, overall survival, disease-free survival, pattern of recurrence, and biochemical liver functions during the perioperative period between the two groups. Results The extent of resection had no significant effect on overall or disease-free survival rates. The overall 1- and 3-year survival rates were 97% and 82% in the AR group, and 96% and 89% in the NR group, respectively (p=0.49). In addition, the respective 1- and 3-year disease-free survival rates for the AR and NR groups were 84% and 63%, and 85% and 65%, respectively (p=0.94). On the other hand, the presence of hepatic cirrhosis and a tumor size of >5 cm were significant risk factors for recurrence according to multivariate analysis (p<0.001 and p=0.003, respectively). The frequency of early recurrence, the first site of recurrence, and the pattern of intrahepatic recurrence were similar between the 2 groups (p=0.419, p=0.210, and p=0.734, respectively); in addition, the frequency of marginal recurrence did not differ between the 2 groups (1 patient in the AR group and 2 in the NR group). The NR group showed better postoperative liver function than the AR group. Conclusions Non-anatomic liver resection can be a safe and efficient treatment for patients with a solitary HCC without rupture or gross vascular invasion.
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Affiliation(s)
- Sung Hoon Cho
- Department of Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jae Min Chun
- Department of Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Hyung Jun Kwon
- Department of Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Young Seok Han
- Department of Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Sang Geol Kim
- Department of Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Yoon Jin Hwang
- Department of Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
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Cho SH, Hwang DK, Um W, Son DH, Oh K. Sludge Reduction by H2O2 Oxidation with Fe/MgO Catalyst. Water Environ Res 2015; 87:675-682. [PMID: 26237682 DOI: 10.2175/106143015x14338845156704] [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: 06/04/2023]
Abstract
This study aimed to determine whether catalytic pretreatment can be used as a method to reduce the amount of wastewater sludge. In this study, H2O2 oxidation in the presence of a heterogeneous Fe/MgO catalyst was added to the pretreatment step. Initially a laboratory-scale test showed a TCOD (total chemical oxygen demand) was reduced 27.4% during catalytic oxidation compared to 2.1% in a catalyst-free option. Catalytic pretreatment was then evaluated in a bench-scale flow-loop test. Two bench systems were composed of identical serial processes that included anaerobic digestion, aerobic digestion, and coagulating sedimentation. The only difference between the two processes was whether catalytic pretreatment of sediment sludge was used or not. Results showed that catalyst-free oxidation TCOD gradually increased from 4200 to 7800 mg/L while catalytic oxidation maintained TCOD values at 4200 ± 200 mg/L. In addition, catalytic pretreatment reduced total nitrogen from 46.9 to 41.0 mg/L and phosphate from 3.1 to 2.3 mg/L.
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Affiliation(s)
- Sung Hoon Cho
- Catalytic Oxidation System, B01 HANA Officetel, 216-21, 1 ga-Hangangro, Youngsan-Gu, Seoul 140-011, Republic of Korea
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Abstract
Components of the complement system act directly on T cells to alter conventional and regulatory T cell subsets. In this issue of Immunity, Kolev, Dimeloe, Le Friec et al. (2015) provide evidence of a mechanism by which the complement stimulates sustained mTORC1 activation and regulates cellular metabolism.
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Affiliation(s)
- Mark R Boothby
- Program in Immunology, Microbiology & Immunology, Vanderbilt University, Nashville, TN 37232-2363, USA; Department of Medicine, Microbiology & Immunology, Vanderbilt University, Nashville, TN 37232-2363, USA; Department of Pathology, Microbiology & Immunology, Vanderbilt University, Nashville, TN 37232-2363, USA.
| | - Ariel L Raybuck
- Department of Pathology, Microbiology & Immunology, Vanderbilt University, Nashville, TN 37232-2363, USA
| | - Sung Hoon Cho
- Program in Immunology, Microbiology & Immunology, Vanderbilt University, Nashville, TN 37232-2363, USA; Department of Pathology, Microbiology & Immunology, Vanderbilt University, Nashville, TN 37232-2363, USA
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Cho SH, Lim JY, Kim SN, Hong S, Chung HW, So Y, Kim WY, Lee SJ. The prognostic significance of pretreatment [18F]FDG-PET/CT imaging in patients with uterine cervical cancer: preliminary results. EUR J GYNAECOL ONCOL 2015; 36:30-35. [PMID: 25872331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
PURPOSE OF INVESTIGATION To evaluate the prognostic significance of positron emission tomography/computed tomography (PET/CT) in patients diagnosed with cervical cancer. MATERIALS AND METHODS Patients with cervical cancer in FIGO Stages IB1 to IVB were imaged with PET/CT prior to treatment during one of the staging work-ups. The patients were observed for a median of 31.4 months (range, six to 89 months) after the initial treatment. The standardized uptake value (SUV) max of the primary cervical tumor mass was compared with the prognostic factors. RESULTs: A total of 81 patients who were primarily treated with radical hysterectomy (RH, n = 45) or concurrent chemoradiation (CCRT, n = 36) were analyzed. Multivariate analysis indicated that larger tumor size (> 4 cm, OR 8.694, 95% CI, 1.638-46.146), deep stromal invasion (≥ 1 cm, OR 7.249, 95% CI, 1.141-46.039) by the primary tumor, and pathologically confirmed pelvic lymph node involvement (positive, OR 14.586, 95% CI, 2.072-102.674) were significantly associated with recurrence after treatment. However, pretreatment SUVmax was not a significant independent predictor of disease recurrence (OR 1.058, 95% CI, 0.255-4.398). CONCLUSION [18F]Fluorodeoxyglucose (FDG) uptake by the primary tumor showed a significant association with several risk factors that have been identified as treatment predictors. However, a high pretreatment SUVmax was not predictive of recurrence in uter- ine cervical cancer patients.
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