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Lee WY, Marc O'Donnell J, Kuo SY. Effects of preoperative oral care on bacterial colonisation and halitosis in patients undergoing elective surgery: A randomised controlled study. Intensive Crit Care Nurs 2024; 80:103532. [PMID: 37793316 DOI: 10.1016/j.iccn.2023.103532] [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: 06/05/2023] [Revised: 08/12/2023] [Accepted: 08/14/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVES To evaluate the effects of single-dose chlorhexidine oral care on bacterial colonisation and halitosis in patients undergoing elective surgery. RESEARCH METHODOLOGY We conducted a two-arm parallel, single-blinded, randomised controlled trial. The intervention group (n = 102) received preoperative oral care with 0.12% chlorhexidine gluconate, and the control group (n = 105) received standard care. The data of the microbiological cultures between the groups were compared at the time of tracheal intubation, at extubation and 30 min after surgery. The presence of halitosis was measured using a survey questionnaire administered to the anaesthesia nurses assigned to the patients. RESULTS At baseline, no significant differences were found between the intervention and control groups for bacterial colonisation or halitosis. After the intervention, there was no significant difference in microbiological culture, including gram-positive, gram-negative bacilli and cocci results, between the two groups (p > 0.05). The presence of halitosis in the intervention group was significantly lower than in the control group during intubation (p < 0.0001) and at 30 min after surgery (p < 0.02). Regression analysis indicated that receiving oral was protective towards halitosis, while poor oral health was a risk factor. CONCLUSIONS Preoperative oral care using a single dose of chlorhexidine significantly improved the patients' halitosis in the perioperative period, but no significant effect was found on bacterial colonisation. Further studies are needed regarding the safe use of chlorhexidine for oral care. IMPLICATION FOR CLINICAL PRACTICE Oral hygiene using chlorhexidine could be beneficial in improving halitosis for anaesthesia personnel who take care of intubated adult patients undergoing elective surgery with general anaesthesia.
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Affiliation(s)
- Wen-Yi Lee
- Second Degree Bachelor of Science in Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - John Marc O'Donnell
- Department of Nurse Anesthesia, Director, University of Pittsburgh Nurse Anesthesia Program, Senior Associate Director, Winter Institute for Simulation, Education and Research (WISER) VB 360A, 3500 Victoria St., Pittsburgh, PA 15261, United States.
| | - Shu-Yu Kuo
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wuxing Street, Taipei 11031, Taiwan.
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2
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Libourel PA, Lee WY, Achin I, Chung H, Kim J, Massot B, Rattenborg NC. Nesting chinstrap penguins accrue large quantities of sleep through seconds-long microsleeps. Science 2023; 382:1026-1031. [PMID: 38033080 DOI: 10.1126/science.adh0771] [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] [Received: 02/09/2023] [Accepted: 10/05/2023] [Indexed: 12/02/2023]
Abstract
Microsleeps, the seconds-long interruptions of wakefulness by eye closure and sleep-related brain activity, are dangerous when driving and might be too short to provide the restorative functions of sleep. If microsleeps do fulfill sleep functions, then animals faced with a continuous need for vigilance might resort to this sleep strategy. We investigated electroencephalographically defined sleep in wild chinstrap penguins, at sea and while nesting in Antarctica, constantly exposed to an egg predator and aggression from other penguins. The penguins nodded off >10,000 times per day, engaging in bouts of bihemispheric and unihemispheric slow-wave sleep lasting on average only 4 seconds, but resulting in the accumulation of >11 hours of sleep for each hemisphere. The investment in microsleeps by successfully breeding penguins suggests that the benefits of sleep can accrue incrementally.
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Affiliation(s)
- P-A Libourel
- Neuroscience Research Center of Lyon, Bron, France
| | - W Y Lee
- Korea Polar Research Institute, Incheon, Republic of Korea
| | - I Achin
- Neuroscience Research Center of Lyon, Bron, France
| | - H Chung
- Korea Polar Research Institute, Incheon, Republic of Korea
| | - J Kim
- Cheongju Zoo, Cheongju, Republic of Korea
| | - B Massot
- Lyon Institute of Nanotechnology, Villeurbanne, France
| | - N C Rattenborg
- Avian Sleep Group, Max Planck Institute for Biological Intelligence, Seewiesen, Germany
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3
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Chen HHW, Lee WY, Lai YH. Clinical Significance of Arginine Signaling in Patients with Cervical Cancer Receiving Cisplatin Chemoradiation Therapy. Int J Radiat Oncol Biol Phys 2023; 117:e506. [PMID: 37785587 DOI: 10.1016/j.ijrobp.2023.06.1757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Many human malignancies do not produce sustainable amounts of arginine (Arg) because the rate-limiting enzyme, arginosuccinate synthetase 1 (ASS1), in the biosynthesis of Arg has been silenced. We investigated the clinical significance of ASS1 expression on cisplatin chemoradiation therapy for cervical cancer. MATERIALS/METHODS A total of 118 consecutive patients with FIGO stages IB to IVA cervical cancer who had received platinum-based concurrent chemoradiotherapy were identified and their clinical courses were reviewed. Immunohistochemical studies were performed on their formalin-fixed, paraffin-embedded tissues. The prognostic value of ASS1 was investigated by performing univariate and multivariate analyses on factors affecting patient survival. RESULTS Median follow-up for all patients was 5.5 years (range: 1 to 23.5 years). Overexpression of ASS1 was an independent prognostic factor. The 5-year disease-free survival for patients with ASS1-positive tumors was 72.3%, compared with 51.6% for patients with ASS1-negative tumors (P = 0.02). Univariate Cox proportional hazards models showed positive ASS1 immunostaining (hazard ratio [HR]: 0.50, 95% CI: 0.28-0.90), FIGO stage (HR: 0.33, 95% CI: 0.18-0.59) and brachytherapy (HR: 0.22, 95% CI: 0.10-0.48) were significant prognostic factors affecting disease-free survival. In multivariate analyses, positive ASS1 remained an independent significant prognostic factor for DFS (HR = 0.45, 95% CI: 0.25-0.83). CONCLUSION Overexpression of ASS1 is an independent prognostic factor for cervical cancer patients receiving cisplatin concurrent chemoradiotherapy.
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Affiliation(s)
- H H W Chen
- Department of Radiation Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - W Y Lee
- Department of Pathology, Chi Mei Medical Center, Tainan, Taiwan
| | - Y H Lai
- Department of Radiation Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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4
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Yu JR, Wei CH, Lai CJ, Lee WY. Extending the Omega model with momentum and reversal strategies to intraday trading. PLoS One 2023; 18:e0291119. [PMID: 37682858 PMCID: PMC10490999 DOI: 10.1371/journal.pone.0291119] [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: 02/13/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
This study develops the Omega model integrated with momentum and reversal strategies using high-frequency data on the component stocks of the S&P 500 Index and the NASDAQ 100. The Omega model based on the momentum strategy (M_Omega), the reversal strategy (R_Omega), and both strategies (M_R_Omega) are designed to simulate trading over three periods. The portfolio is rebalanced every transaction day to optimize asset allocation by incorporating intraday winners or losers' information and trading cost. The study finds that the proposed models generate positive returns (net of trading costs), in spite of fact that intraday trading frequently erodes profits. The M_Omega and R_Omega models produce a higher return than that of the S&P 500 index or NASDAQ 100 index, considering the intraday trading cost. The performance of the Omega model integrated with the momentum or reversal strategy is more profitable in a volatile market or period. The M_Omega and R_Omega reach the highest final market value from 2020 to 2021, when COVID 19 pandemic emerged. The rebalancing of the momentum or reversal strategy is suitable for the short term but not recommended in the long term for intraday trading as the trading costs become increasingly significant over time.
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Affiliation(s)
- Jing-Rung Yu
- Department of Information Management, National Chi Nan University, Nantou, Taiwan
| | - Chieh-Hui Wei
- Department of Information Management, National Chi Nan University, Nantou, Taiwan
| | - Chi-Ju Lai
- Department of Information Management, National Chi Nan University, Nantou, Taiwan
| | - Wen-Yi Lee
- Department of Information Management, National Taipei University of Business, Taipei, Taiwan
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5
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Mok A, Mui OOY, Tang KP, Lee WY, Ng CF, Wong SH, Wong MCS, Teoh JYC. Public awareness of preventive measures against COVID-19: an infodemiology study. Hong Kong Med J 2023; 29:214-223. [PMID: 37349138 DOI: 10.12809/hkmj219556] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic has led to an increase in global awareness of relevant public health preventive measures. This awareness can be explored using online search trends from major search engines, such as Google Trends. We investigated the relationship between public awareness of preventative measures and progression of the COVID-19 pandemic. METHODS Search data for five queries ('mask', 'hand washing', 'social distancing', 'hand sanitizer', and 'disinfectant') were extracted from Google Trends in the form of relative search volume (RSV). Global incidence data for COVID-19 were obtained from 1 January to 30 June 2020. These data were analysed and illustrated using a global temporal RSV trend diagram, a geographical RSV distribution chart, scatter plots comparing geographical RSV with average number of daily cases, and heat maps comparing temporal trends of RSV with average number of daily cases. RESULTS Global temporal trends revealed multiple increases in RSV, associated with specific COVID-19-related news events. The geographical distribution showed top regions of interest for various preventive measures. For the queries 'mask', 'hand washing', 'hand sanitizer', and 'disinfectant', heat maps demonstrated patterns of early RSV peaks in regions with lower average number of daily cases, when the temporal element was incorporated into the analysis. CONCLUSION Early public awareness of multiple preventive measures was observed in regions with lower average number of daily cases. Our findings indicate optimal public health communication regarding masks, hand washing, hand sanitiser, and disinfectant in the general population during early stages of the COVID-19 pandemic. Early public awareness may facilitate future disease control efforts by public health authorities.
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Affiliation(s)
- A Mok
- SH Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - O O Y Mui
- SH Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - K P Tang
- SH Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - W Y Lee
- SH Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - C F Ng
- SH Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - S H Wong
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - M C S Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Centre for Health Education and Health Promotion, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - J Y C Teoh
- SH Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Office of Global Engagement, The Chinese University of Hong Kong, Hong Kong SAR, China
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6
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Are C, Tyler D, Howe J, Olivares A, Nissan A, Zippel D, Gupta A, Savant D, D'Ugo D, Rubio I, Bargallo-Rocha JE, Martinez-Said H, Takeuchi H, Taketomi A, Oliveira AF, Ribeiro HSC, Cheema MA, Majid HJ, Chen G, Roviello F, Gronchi A, Leon A, Lee WY, Park DJ, Park J, Auer R, Gawad WA, Zaghloul A. Global Forum of Cancer Surgeons: Cancer Surgery During the COVID-19 Pandemic: Impact and Lessons Learned. Ann Surg Oncol 2022; 29:2773-2783. [PMID: 35211857 PMCID: PMC8870071 DOI: 10.1245/s10434-022-11506-3] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/14/2022] [Indexed: 11/18/2022]
Abstract
Background The purpose of this article is to summarize the opinions of the surgical oncology leaders from the Global Forum of Cancer Surgeons (GFCS) about the global impact of COVID-19 pandemic on cancer surgery. Methods A panel session (virtual) was held at the annual Society of Surgical Oncology 2021 International Conference on Surgical Cancer Care to address the impact of COVID-19 on cancer surgery globally. Following the virtual meeting, a questionnaire was sent to all the leaders to gather additional opinions. The input obtained from all the leaders was collated and analyzed to understand how cancer surgeons from across the world adapted in real-time to the impact of COVID-19 pandemic. Results The surgical oncology leaders noted that the COVID-19 pandemic led to severe disruptions in surgical cancer care across all domains of clinical care, education, and research. Several new changes/protocols associated with increased costs were implemented to deliver safe care. Leaders also noted that preexisting disparities in care were exacerbated, and the pandemic had a detrimental effect on well-being and financial status. Conclusions The COVID-19 pandemic has led to severe disruptions in surgical cancer care globally. Leaders of the GFCS opined that new strategies need to be implemented to prepare for any future catastrophic events based on the lessons learned from the current events. The GFCS will embark on developing such a roadmap to ensure that surgical cancer care is preserved in the future regardless of any catastrophic global events.
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Affiliation(s)
| | - D Tyler
- Society of Surgical Oncology, Rosemont, IL, USA
| | - J Howe
- Society of Surgical Oncology, Rosemont, IL, USA
| | - A Olivares
- Society of Surgical Oncology, Rosemont, IL, USA
| | - A Nissan
- Israeli Society of Surgical Oncology, Tel Aviv, Israel
| | - D Zippel
- Israeli Society of Surgical Oncology, Tel Aviv, Israel
| | - A Gupta
- Indian Association of Surgical Oncology, Uttar Pradesh, Varanasi, India
| | - D Savant
- Indian Association of Surgical Oncology, Uttar Pradesh, Varanasi, India
| | - D D'Ugo
- European Society of Surgical Oncology, Brussels, Belgium
| | - I Rubio
- European Society of Surgical Oncology, Brussels, Belgium
| | | | | | - H Takeuchi
- Japanese Society of Gastroenterological Surgery, Tokyo, Japan
| | - A Taketomi
- Japanese Society of Gastroenterological Surgery, Tokyo, Japan
| | - A F Oliveira
- Brazilian Society of Surgical Oncology, Rio de Janeiro, Brazil
| | | | - M A Cheema
- Pakistan Society of Surgical Oncology, Lahore, Pakistan
| | - H J Majid
- Pakistan Society of Surgical Oncology, Lahore, Pakistan
| | - G Chen
- Chinese Society of Clinical Oncology, Beijing, China
| | - F Roviello
- Italian Society of Surgical Oncology, Milan, Italy
| | - A Gronchi
- Italian Society of Surgical Oncology, Milan, Italy
| | - A Leon
- Pontifical Catholic University of Chile, Santiago, Chile
| | - W Y Lee
- Korean Society of Surgical Oncology, Seoul, Korea
| | - D J Park
- Korean Society of Surgical Oncology, Seoul, Korea
| | - J Park
- Canadian Society of Surgical Oncology, Ottawa, ON, Canada
| | - R Auer
- Canadian Society of Surgical Oncology, Ottawa, ON, Canada
| | - W A Gawad
- Egyptian Society of Surgical Oncology, Cairo, Egypt
| | - A Zaghloul
- Egyptian Society of Surgical Oncology, Cairo, Egypt
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7
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Moore MJ, Zhong M, Hansen J, Gartner H, Grant C, Huang M, Harris FM, Tu N, Bowerman NA, Edelmann KH, Barry T, Herbin O, Tay CS, DiLillo DJ, Decker CE, Levenkova N, Shevchuk J, Dhanik A, Meagher KA, Karr A, Roos J, Lee WY, Suh D, Eckersdorff M, Meagher TC, Koss M, Esau L, Sleeman MA, Babb R, Chen G, Kyratsous CA, Poueymirou WT, McWhirter JR, Voronina VA, Guo C, Gurer C, Yancopoulos GD, Murphy AJ, Macdonald LE. Humanization of T cell-mediated immunity in mice. Sci Immunol 2021; 6:eabj4026. [PMID: 34919442 DOI: 10.1126/sciimmunol.abj4026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
[Figure: see text].
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Affiliation(s)
- Michael J Moore
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - Maggie Zhong
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - Johanna Hansen
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - Hans Gartner
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - Craig Grant
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - Mei Huang
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - Faith M Harris
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - Naxin Tu
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - Natalie A Bowerman
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - Kurt H Edelmann
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - Thomas Barry
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - Olivier Herbin
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - Chin-Siean Tay
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - David J DiLillo
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - Corinne E Decker
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - Natasha Levenkova
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - James Shevchuk
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - Ankur Dhanik
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - Karoline A Meagher
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - Amanda Karr
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - Jan Roos
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - Wen-Yi Lee
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - David Suh
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - Mark Eckersdorff
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - T Craig Meagher
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - Matthew Koss
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - Lakeisha Esau
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - Matthew A Sleeman
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - Robert Babb
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - Gang Chen
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | | | | | - John R McWhirter
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - Vera A Voronina
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - Chunguang Guo
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - Cagan Gurer
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | | | - Andrew J Murphy
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
| | - Lynn E Macdonald
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA
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8
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Lee WY, Mok A, Chung JPW. Potential effects of COVID-19 on reproductive systems and fertility; assisted reproductive technology guidelines and considerations: a review. Hong Kong Med J 2021; 27:118-126. [PMID: 33853972 DOI: 10.12809/hkmj209078] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) employs the angiotensin-converting enzyme 2 (ACE2) receptor in the renin-angiotensin system for viral entry. The ACE2 receptor is present in both female and male reproductive systems, and reports of multi-organ involvement have led to uncertainty regarding its effects on the reproductive system and fertility. We review the existing literature regarding the function of ACE2 and the renin-angiotensin system in the female and male reproductive systems to postulate the possible implications of SARS-CoV-2 regarding fertility. Because of the presence of ACE2 in the ovaries, SARS-CoV-2 infection may disrupt ovarian function and hence oocyte quality. Higher expression of ACE2 in the endometrium with age and during the secretory phase raises concern about increased susceptibility to infection during periods of high ACE2 expression. The possibility of vertical transmission and the presence of ACE2 in the placenta and during pregnancy are also discussed. The presence of SARS-CoV-2 RNA in semen is controversial, but impaired semen quality has been found in men with moderate coronavirus disease 2019 infection. Evidence of orchitis and hormonal changes seen in male coronavirus disease 2019 infection may lead to infertility. The implications of these effects on assisted reproductive technology (ART) outcomes are also explored. The ART guidelines from different fertility societies for the management of patients treated with ART are provided. The importance of prioritising 'time-sensitive' patients for ART, counselling patients about the uncertainty and risks of ART, and pregnancy during the pandemic is discussed. Recommendations are also provided for infection control and safe regulation of ART centres and laboratories.
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Affiliation(s)
- W Y Lee
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - A Mok
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - J P W Chung
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong
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9
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Zindel J, Peiseler M, Hossain M, Deppermann C, Lee WY, Haenni B, Zuber B, Deniset JF, Surewaard BGJ, Candinas D, Kubes P. Primordial GATA6 macrophages function as extravascular platelets in sterile injury. Science 2021; 371:371/6533/eabe0595. [PMID: 33674464 DOI: 10.1126/science.abe0595] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 01/08/2021] [Indexed: 12/14/2022]
Abstract
Most multicellular organisms have a major body cavity that harbors immune cells. In primordial species such as purple sea urchins, these cells perform phagocytic functions but are also crucial in repairing injuries. In mammals, the peritoneal cavity contains large numbers of resident GATA6+ macrophages, which may function similarly. However, it is unclear how cavity macrophages suspended in the fluid phase (peritoneal fluid) identify and migrate toward injuries. In this study, we used intravital microscopy to show that cavity macrophages in fluid rapidly form thrombus-like structures in response to injury by means of primordial scavenger receptor cysteine-rich domains. Aggregates of cavity macrophages physically sealed injuries and promoted rapid repair of focal lesions. In iatrogenic surgical situations, these cavity macrophages formed extensive aggregates that promoted the growth of intra-abdominal scar tissue known as peritoneal adhesions.
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Affiliation(s)
- J Zindel
- Department of Pharmacology and Physiology, University of Calgary, Calgary, Alberta, Canada.,Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Visceral Surgery and Medicine, Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - M Peiseler
- Department of Pharmacology and Physiology, University of Calgary, Calgary, Alberta, Canada.,Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - M Hossain
- Department of Pharmacology and Physiology, University of Calgary, Calgary, Alberta, Canada.,Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - C Deppermann
- Department of Pharmacology and Physiology, University of Calgary, Calgary, Alberta, Canada.,Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - W Y Lee
- Department of Pharmacology and Physiology, University of Calgary, Calgary, Alberta, Canada.,Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - B Haenni
- Institute of Anatomy, University of Bern, Bern, Switzerland
| | - B Zuber
- Institute of Anatomy, University of Bern, Bern, Switzerland
| | - J F Deniset
- Department of Pharmacology and Physiology, University of Calgary, Calgary, Alberta, Canada.,Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada
| | - B G J Surewaard
- Department of Pharmacology and Physiology, University of Calgary, Calgary, Alberta, Canada.,Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - D Candinas
- Department of Visceral Surgery and Medicine, Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - P Kubes
- Department of Pharmacology and Physiology, University of Calgary, Calgary, Alberta, Canada. .,Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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10
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Tsai WC, Lee WY, Huang MS, Lee WH. Different effects on right ventricular function in different etiology of secondary tricuspid regurgitation. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ministry of Science and Technology, Excutive Yuan, Taiwan
Background
Tricuspid regurgitation (TR) is traditionally classified as primary or secondary TR. The effects of TR on right ventricular (RV) function were not consistent. We hypothesized that secondary TR is not a unique group, sophisticated sub-grouping can be useful for studying effects of TR on RV function.
Methods
207 consecutive patients identified as significant TR (moderate and severe) by echocardiography were recruited. Standard measurements for right heart were done according to guideline. Lateral tricuspid annulus systolic tissue velocity (S’) and RV fractional area change (FAC) were used for RV function. We classified these patients into primary TR and 6 subgroups of secondary TR according to a new systemic approach.
Results
Mean age of subjects was 71.2 ± 14.7 years, and there were 84 (40.6%) male. There were 29 (14%) primary TR. Secondary TR was further classified into 6 groups included 18 (8.7%) pacemaker related, 81 (39.1 %) left heart diseases, 6 (2.9%) congenital heart diseases, 3 (1.4%) RV myopathy, 27 (13.0%) pulmonary hypertension, and 43 (20.8%) idiopathic TR. Among 4 major groups (congenital heart disease and RV myopathy were not included in analysis due to low numbers) of secondary TR, S’ was significant higher in idiopathic TR and RV FAC were higher in pacemaker related and idiopathic TR. RV dysfunction was defined as FAC < 35%. RV dysfunction presented mostly in pulmonary hypertension related TR and leastly in idiopathic TR (59.3% vs. 14%, p <0.001). Multivariate analysis using idiopathic TR as reference and controlled TR maximal velocity, RV end-diastolic area, right atrial area, and severity of TR, left heart disease related TR had higher risk of RV dysfunction (OR 4.178, 95% CI 1.490-11.703, p = 0.007).
Conclusions
Effects of TR on RV function were different among different subgroups of secondary TR. Left heart disease related TR had highest risk for RV dysfunction. Secondary TR should not be regarded as a single disease.
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Affiliation(s)
- WC Tsai
- National Cheng Kung University Hospital, Tainan, Taiwan
| | - WY Lee
- National Cheng Kung University Hospital, Tainan, Taiwan
| | - MS Huang
- National Cheng Kung University Hospital, Tainan, Taiwan
| | - WH Lee
- National Cheng Kung University Hospital, Tainan, Taiwan
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Hansen J, Baum A, Pascal KE, Russo V, Giordano S, Wloga E, Fulton BO, Yan Y, Koon K, Patel K, Chung KM, Hermann A, Ullman E, Cruz J, Rafique A, Huang T, Fairhurst J, Libertiny C, Malbec M, Lee WY, Welsh R, Farr G, Pennington S, Deshpande D, Cheng J, Watty A, Bouffard P, Babb R, Levenkova N, Chen C, Zhang B, Romero Hernandez A, Saotome K, Zhou Y, Franklin M, Sivapalasingam S, Lye DC, Weston S, Logue J, Haupt R, Frieman M, Chen G, Olson W, Murphy AJ, Stahl N, Yancopoulos GD, Kyratsous CA. Studies in humanized mice and convalescent humans yield a SARS-CoV-2 antibody cocktail. Science 2020; 369:1010-1014. [PMID: 32540901 PMCID: PMC7299284 DOI: 10.1126/science.abd0827] [Citation(s) in RCA: 909] [Impact Index Per Article: 227.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 06/11/2020] [Indexed: 12/18/2022]
Abstract
There is an urgent focus on antibodies that target the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral spike and prevent the virus from entering host cells. Hansen et al. generated a large panel of antibodies against the spike protein from humanized mice and recovered patients. From this panel, they identified several neutralizing antibodies, including pairs that do not compete for binding to the receptor binding domain. Baum et al. focused in on four of these antibodies. All four are effective against known spike variants. However, by growing a pseudovirus that expresses the spike in the presence of individual antibodies, the authors were able to select for spike mutants resistant to that antibody. In contrast, escape mutants are not selected when pseudovirus is grown in the presence of pairs of antibodies that either do not compete or only partially compete for binding to the RBD. Such a pair might be used in a therapeutic antibody cocktail. Science, this issue p. 1010, p. 1014 Neutralizing antibodies have become an important tool in treating infectious diseases. Recently, two separate approaches yielded successful antibody treatments for Ebola—one from genetically humanized mice and the other from a human survivor. Here, we describe parallel efforts using both humanized mice and convalescent patients to generate antibodies against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein, which yielded a large collection of fully human antibodies that were characterized for binding, neutralization, and three-dimensional structure. On the basis of these criteria, we selected pairs of highly potent individual antibodies that simultaneously bind the receptor binding domain of the spike protein, thereby providing ideal partners for a therapeutic antibody cocktail that aims to decrease the potential for virus escape mutants that might arise in response to selective pressure from a single-antibody treatment.
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Affiliation(s)
- Johanna Hansen
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY 10591, USA
| | - Alina Baum
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY 10591, USA
| | | | - Vincenzo Russo
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY 10591, USA
| | | | - Elzbieta Wloga
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY 10591, USA
| | | | - Ying Yan
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY 10591, USA
| | - Katrina Koon
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY 10591, USA
| | - Krunal Patel
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY 10591, USA
| | | | - Aynur Hermann
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY 10591, USA
| | - Erica Ullman
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY 10591, USA
| | - Jonathan Cruz
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY 10591, USA
| | | | - Tammy Huang
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY 10591, USA
| | | | | | - Marine Malbec
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY 10591, USA
| | - Wen-Yi Lee
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY 10591, USA
| | - Richard Welsh
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY 10591, USA
| | - Glen Farr
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY 10591, USA
| | | | | | - Jemmie Cheng
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY 10591, USA
| | - Anke Watty
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY 10591, USA
| | | | - Robert Babb
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY 10591, USA
| | | | - Calvin Chen
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY 10591, USA
| | - Bojie Zhang
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY 10591, USA
| | | | - Kei Saotome
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY 10591, USA
| | - Yi Zhou
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY 10591, USA
| | | | | | - David Chien Lye
- National Centre for Infectious Diseases, Tan Tock Seng Hospital, Yong Loo Lin School of Medicine, Lee Kong Chian School of Medicine, 16 Jalan Tan Tock Seng, Singapore 308442, Singapore
| | - Stuart Weston
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - James Logue
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Robert Haupt
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Matthew Frieman
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Gang Chen
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY 10591, USA
| | - William Olson
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY 10591, USA
| | | | - Neil Stahl
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY 10591, USA
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Lee WY, Kuo SY. [Anesthetic Care of Patient With Heroin Addiction: A Case Report]. Hu Li Za Zhi 2018; 65:100-108. [PMID: 29564862 DOI: 10.6224/jn.201804_65(2).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] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The use of illegal drugs in Taiwan is on the rise. Drug addicts often have complex physical, psychological, and social problems. In addition, they often avoid disclosing their illicit drug use by deceit, concealment, or under-reporting. Building and maintaining relationships of trust with drug-addict patients has become a critical issue in achieving better care quality. In this case report, we report on an anesthesia care process for a heroin addict who was admitted for open reduction and internal fixation surgery for the femur and patella fractures after a car accident. During the six-hour perioperative care period, starting from 11pm on November 30th to 5am on December 1st, 2015, the patient was not willing to disclose his illicit drug use before the surgery. However, the nurse anesthetist noticed signs and symptoms of drug use. The nurse empathized with the patient's worries, provided him with a safe communication environment, and gained trust from the patient in a timely manner, which then enabled the patient to fully disclose his illicit drug use with the nurse anesthetist. The anesthesia-care strategy was then modified according to client's condition. The nurse anesthetist played an important role of bridging communications between the patient and medical care staffs and of modifying the care strategies in a timely manner. During the care period, the blood-borne disease contamination was successfully prevented, the client received uneventful pain management, there was a lack of withdrawal symptoms, and the staffs and patient safety was maintained. The literature on the anesthetic care of heroin patients undergoing surgery is relatively limited in Taiwan. The findings in the current case report add information on providing anesthetic care to patients with drug addiction. Publishing additional case reports, research, and clinical recommendations is essential for improving care quality for this vulnerable population.
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Affiliation(s)
- Wen-Yi Lee
- MSN, RN, Department of Anesthesiology, National Taiwan University Hospital, Yun-Lin Branch, Taiwan, ROC
| | - Shu-Yu Kuo
- PhD, RN, Associate Professor, School of Nursing, College of Nursing, Taipei Medical University, Taiwan, ROC.
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Hamdan H, Jaumally BA, Chan T, Munn L, Khawaja IS, Bernardo EJ, Lee WY, Khan S, Carter GS. 1108 REM Sleep Motor Dysregulation in Narcolepsy. Sleep 2018. [DOI: 10.1093/sleep/zsy063.1107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- H Hamdan
- Departments of Neurology, Otolaryngology, Psychiatry, and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - B A Jaumally
- Departments of Neurology, Otolaryngology, Psychiatry, and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - T Chan
- Departments of Neurology, Otolaryngology, Psychiatry, and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - L Munn
- Departments of Neurology, Otolaryngology, Psychiatry, and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - I S Khawaja
- Departments of Neurology, Otolaryngology, Psychiatry, and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - E J Bernardo
- Departments of Neurology, Otolaryngology, Psychiatry, and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - W Y Lee
- Departments of Neurology, Otolaryngology, Psychiatry, and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - S Khan
- Departments of Neurology, Otolaryngology, Psychiatry, and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - G S Carter
- Departments of Neurology, Otolaryngology, Psychiatry, and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
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Hamdan H, Jaumally BA, Chan T, Munn L, Khawaja IS, Bernardo EJ, Lee WY, Carter GS, Khan S. 1109 Hypoglossal Nerve Stimulation for Treatment of Patient with Severe Obstructive Sleep Apnea (OSA) Complicated by Severe Bruxism. Sleep 2018. [DOI: 10.1093/sleep/zsy063.1108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- H Hamdan
- Departments of Neurology, Otolaryngology, Psychiatry, and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - B A Jaumally
- Departments of Neurology, Otolaryngology, Psychiatry, and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - T Chan
- Departments of Neurology, Otolaryngology, Psychiatry, and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - L Munn
- Departments of Neurology, Otolaryngology, Psychiatry, and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - I S Khawaja
- Departments of Neurology, Otolaryngology, Psychiatry, and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - E J Bernardo
- Departments of Neurology, Otolaryngology, Psychiatry, and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - W Y Lee
- Departments of Neurology, Otolaryngology, Psychiatry, and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - G S Carter
- Departments of Neurology, Otolaryngology, Psychiatry, and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - S Khan
- Departments of Neurology, Otolaryngology, Psychiatry, and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
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Kim WG, Lee WY, Mi Kim J, Moon HJ. Tissue-Engineered Acellularized Valve Xenografts: A Comparative Animal Study between Plain Acellularized Xenografts and Autologous Endothelial Cell Seeded Acellularized Xenografts. Int J Artif Organs 2018; 27:501-8. [PMID: 15293356 DOI: 10.1177/039139880402700609] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Acellularized valve xenografts are considered a promising way of overcoming the inherent limitations of current prosthetic valves. The aim of this study was to compare the biological responses of an autologous endothelial cell seeded acellularized xenograft (AAX) and a plain acellularized xenograft (PAX) implanted in the pulmonary valve leaflet in the same animal. Methods Endothelial cells were isolated and cultured from the jugular vein of goats. Porcine valve leaflets were acellularized with Nacl-SDS, and for AAX, leaflets were then seeded with autologous endothelial cells. A PAX and an AAX were implanted as double pulmonary valve leaflet replacement in the same animal in a goat model (n=6). After sacrifice, the implanted valve leaflet tissues were retrieved and analyzed visually and under a light microscope. Results and Conclusions Six animals were sacrificed as scheduled during the short-term (6 and 24 hours), mid-term (1 week and 1 month) and long-term (3 and 6 months). Gross and ultrasonographic examinations revealed good valve function with no thrombosis but with slight thickening. Microscopic analysis of the leaflets showed abundant cellular ingrowth into the acellularized leaflets over time. The role of endothelial cell seeding remains controversial. This animal experiment demonstrates the practical feasibility of using acellularized valve xenografts.
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Affiliation(s)
- W G Kim
- Department of Thoracic and Cardiovascular Surgery and Heart Research Institute, Seoul National University College of Medicine, Seoul, Korea.
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16
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Lee WY. Antibiotic Prescribing for Patients with Upper Respiratory Tract Infections by Emergency Physicians in a Singapore Tertiary Hospital. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490790501200207] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective Despite the paucity of supporting evidence, the use of antibiotics in the management of upper respiratory tract infections (URTI) remains a persistent and worrying trend worldwide. This survey study set out to examine the antibiotic prescribing profile of emergency physicians for patients diagnosed with URTI at a local tertiary hospital. Methods Patients seeking treatment for URTI at the emergency department in the year 2001 were identified by their ICD-9 code. The electronic medical records of a random sample of these patients were reviewed. Patients with the following documented findings were excluded: (a) a duration of more than 7 days between disease onset and date of consultation, (b) prior antibiotic usage or medical consultation, (c) presentation of purulent sputum and/or purulent nasal discharge, and (d) existing medical conditions requiring antibiotic treatment/prophylaxis. Chi-square and multivariate analyses were performed to assess the association of patient-related factors with antibiotic prescribing. Results Of a random sample of 488 cases of URTI, inappropriate antibiotic prescribing was observed in 24% of cases (95% CI 20%, 28%). Significant associations were observed between antibiotic prescribing and month of consultation, patients' temperature and symptom of rhinorrhoea. Conclusion A substantial proportion of emergency department patients with URTI received antibiotics despite the lack of evidence supporting the drugs' effectiveness. Appropriate interventions to promote evidence-based prescribing amongst emergency physicians are required to reduce the extent of inappropriate antibiotic prescribing as well as to ensure the longevity of antibiotic effectiveness.
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Abstract
Study Objectives The object of this study is to audit the care of ankle sprain of different severity and the functional limitations at two weeks and six weeks post injury of patients presenting to the Emergency Department of my hospital. Methods Over a three month period, all patients presenting with acute ankle sprain were recruited at triage (index visit). Exclusion criteria were ankle injuries more than twenty-four hours old or had already received radiological evidence of fractures. A self-administered questionnaire was used to determine the severity and treatment. At second and at sixth week post index visit, three telephone interview attempts were made respectively to ask for the functional limitations and recovery using a standard questionnaire. Results One hundred and thirty-nine candidates were recruited. Of these, 35.3% had mild, 19.6% had moderate and 15.2% had severe ankle sprain. Those with moderately severe ankle sprain have the least medical leave days. Only 48% were given more than 3 days of medical leave compared to 71% (mild group) and 76% (severe group). The treatment is otherwise similar across the three groups. Eighty-one patients (58%) and 70 patients (50%) were captured in the 2nd and 6th week telephone interviews respectively. Those patients with moderate severity fared worse with higher overall percentages in functional limitations and secondary consultations. This was more obvious in the 6th week telephone interview. Conclusion Patients with moderate severity ankle sprain fared worse compared with patients with severe or mild ankle sprain over a six-week recovery period. This may be due to insufficient rest days given to this group of patients at initial presentation.
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Lim KK, Kwan YH, Tan CS, Low LL, Chua AP, Lee WY, Pang L, Tay HY, Chan SY, Ostbye T. The association between distance to public amenities and cardiovascular risk factors among lower income Singaporeans. Prev Med Rep 2017; 8:116-121. [PMID: 29021948 PMCID: PMC5633842 DOI: 10.1016/j.pmedr.2017.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 08/21/2017] [Accepted: 09/09/2017] [Indexed: 01/05/2023] Open
Abstract
Existing evidence on the association between built environment and cardiovascular disease (CVD) risk factors focused on the general population, which may not generalize to higher risk subgroups such as those with lower socio-economic status (SES). We examined the associations between distance to 5 public amenities from residential housing (public polyclinic, subsidized private clinic, healthier eatery, public park and train station) and 12 CVD risk factors (physical inactivity, medical histories and unhealthy dietary habits) among a study sample of low income Singaporeans aged ≥ 40 years (N = 1972). Using data from the Singapore Heart Foundation Health Mapping Exercise 2013–2015, we performed a series of logistic mixed effect regressions, accounting for clustering of respondents in residential blocks and multiple comparisons. Each regression analysis used the minimum distance (in km) between residential housing and each public amenity as an independent continuous variable and a single risk factor as the dependent variable, controlling for demographic characteristics. Increased distance (geographical inaccessibility) to a train station was significantly associated with lower odds of participation in sports whereas greater distance to a subsidized private clinic was associated with lower odds of having high cholesterol diagnosed. Increasing distance to park was positively associated with higher odds of less vegetable and fruits consumption, deep fried food and fast food consumption in the preceding week/month, high BMI at screening and history of diabetes, albeit not achieving statistical significance. Our findings highlighted potential effects of health-promoting amenities on CVD risk factors in urban low-income setting, suggesting gaps for further investigations. We examined associations between access to 5 amenities and 12 CVD risk factors. Only 2/60 associations were statistically significant. Poorer access to train station was associated with lower odds of sports. Poorer access to primary care was associated with lower high cholesterol diagnosis.
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Affiliation(s)
- K K Lim
- Health Systems & Services Research, Duke NUS Medical School, Republic of Singapore
| | - Y H Kwan
- Health Systems & Services Research, Duke NUS Medical School, Republic of Singapore
| | - C S Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Republic of Singapore
| | - L L Low
- Department of Family Medicine & Continuing Care, Singapore General Hospital, Republic of Singapore
| | - A P Chua
- Department of Medicine, Ng Teng Fong General Hospital, 1 Jurong East Street 21, 609606, Republic of Singapore
| | - W Y Lee
- Saw Swee Hock School of Public Health, National University of Singapore, Republic of Singapore.,Department of Medical Informatics, Jurong Health Services, 1 Jurong East Street 21, 609606, Republic of Singapore
| | - L Pang
- Saw Swee Hock School of Public Health, National University of Singapore, Republic of Singapore
| | - H Y Tay
- Singapore Heart Foundation, 9 Bishan Place #07-01 Junction 8 (Office Tower), 579837, Republic of Singapore
| | - S Y Chan
- Department of Pharmacy, Faculty of Science, National University of Singapore, Block S4A, Level 3, 18 Science Drive 4, 117543, Republic of Singapore
| | - T Ostbye
- Health Systems & Services Research, Duke NUS Medical School, Republic of Singapore
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Koh KC, Islam M, Chan WK, Lee WY, Ho YW, Alsagoff SAH, Yusof RA. Missed opportunities for earlier HIV-testing in patients with HIV infection referred to a tertiary hospital, a cross-sectional study. Med J Malaysia 2017; 72:209-214. [PMID: 28889131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION In Malaysia, the prevalence of missed opportunities for HIV-testing is unknown. Missed opportunities have been linked to late diagnosis of HIV and poorer outcome for patients. We describe missed opportunities for earlier HIV-testing in newly-HIV-diagnosed patients. METHODS Cross sectional study. Adult patients diagnosed with HIV infection and had at least one medical encounter in a primary healthcare setting during three years prior to diagnosis were included. We collected data on sociodemographic characteristics, patient characteristics at diagnosis, HIV-related conditions and whether they were subjected to risk assessment and offered HIV testing during the three years prior to HIV diagnosis. RESULTS 65 newly HIV-diagnosed patients (male: 92.3%; Malays: 52.4%; single: 66.7%; heterosexual: 41%; homosexual 24.6%; CD4 <350 at diagnosis: 63%). 93.8% were unaware of their HIV status at diagnosis. Up to 56.9% had presented with HIV-related conditions at a primary healthcare facility during the three years prior to diagnosis. Slightly more than half were had risk assessment done and only 33.8% were offered HIV-testing. CONCLUSIONS Missed opportunities for HIV-testing was unacceptably high with insufficient risk assessment and offering of HIV-testing. Risk assessment must be promoted and primary care physicians must be trained to recognize HIV-related conditions that will prompt them to offer HIVtesting.
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Affiliation(s)
- K C Koh
- International Medical University, Department of Medicine, Seremban, Negeri Sembilan, Malaysia.
| | - M Islam
- International Medical University, Department of Medicine, Seremban, Negeri Sembilan, Malaysia
| | - W K Chan
- International Medical University, Department of Medicine, Seremban, Negeri Sembilan, Malaysia
| | - W Y Lee
- International Medical University, Department of Medicine, Seremban, Negeri Sembilan, Malaysia
| | - Y W Ho
- International Medical University, Department of Medicine, Seremban, Negeri Sembilan, Malaysia
| | - S A H Alsagoff
- International Medical University, Department of Medicine, Seremban, Negeri Sembilan, Malaysia
| | - R A Yusof
- Hospital Tuanku Ja'afar, Department of Medicine, Seremban, Negeri Sembilan, Malaysia
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Chong SM, Wong WK, Lee WY, Tan ZB, Tay YH, Teo XH, Chee LD, Fernandez CJ. Streptococcus agalactiae outbreaks in cultured golden pomfret, Trachinotus blochii (Lacépède), in Singapore. J Fish Dis 2017; 40:971-974. [PMID: 28000924 DOI: 10.1111/jfd.12570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 09/19/2016] [Accepted: 09/20/2016] [Indexed: 06/06/2023]
Affiliation(s)
- S M Chong
- Aquatic Animal Health Laboratory, Animal Health Laboratory, Laboratories Group, Animal & Plant Health Centre, The Agri-Food & Veterinary Authority of Singapore (AVA), Singapore City, Singapore
| | - W K Wong
- Bacteriology Laboratory, Animal Health Laboratory, Laboratories Group, Animal & Plant Health Centre, The Agri-Food & Veterinary Authority of Singapore (AVA), Singapore City, Singapore
| | - W Y Lee
- Bacteriology Laboratory, Animal Health Laboratory, Laboratories Group, Animal & Plant Health Centre, The Agri-Food & Veterinary Authority of Singapore (AVA), Singapore City, Singapore
| | - Z B Tan
- Bacteriology Laboratory, Animal Health Laboratory, Laboratories Group, Animal & Plant Health Centre, The Agri-Food & Veterinary Authority of Singapore (AVA), Singapore City, Singapore
| | - Y H Tay
- Bacteriology Laboratory, Animal Health Laboratory, Laboratories Group, Animal & Plant Health Centre, The Agri-Food & Veterinary Authority of Singapore (AVA), Singapore City, Singapore
| | - X H Teo
- Aquatic Animal Health Laboratory, Animal Health Laboratory, Laboratories Group, Animal & Plant Health Centre, The Agri-Food & Veterinary Authority of Singapore (AVA), Singapore City, Singapore
| | - L D Chee
- Aquatic Animal Health Laboratory, Animal Health Laboratory, Laboratories Group, Animal & Plant Health Centre, The Agri-Food & Veterinary Authority of Singapore (AVA), Singapore City, Singapore
| | - C J Fernandez
- Aquatic Animal Health Laboratory, Animal Health Laboratory, Laboratories Group, Animal & Plant Health Centre, The Agri-Food & Veterinary Authority of Singapore (AVA), Singapore City, Singapore
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Huang JC, Huang WT, Chu PT, Lee WY, Pai HP, Chuang CC, Wu YW. Applying a Markov chain for the stock pricing of a novel forecasting model. COMMUN STAT-THEOR M 2017. [DOI: 10.1080/03610926.2015.1083108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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22
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Lee WY, Park MH, Kim KW, Song H, Kim KB, Lee CS, Kim NK, Park JK, Yang BC, Oh KB, Im GS, Chung HJ. Identification of lactoferrin and glutamate receptor-interacting protein 1 in bovine cervical mucus: A putative marker for oestrous detection. Reprod Domest Anim 2016; 52:16-23. [DOI: 10.1111/rda.12744] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 07/01/2016] [Indexed: 11/28/2022]
Affiliation(s)
- WY Lee
- Department of Food Bioscience; College of Biomedical & Health Science; Konkuk University; Chung-ju Korea
| | - MH Park
- Department of Biomedical Chemistry; College of Biomedical & Health Science; Konkuk University; Chung-ju Korea
- Doosan Venture Digm 924; Dongan-gu Anyang Korea
| | - KW Kim
- Animal Biotechnology Division; National Institute of Animal Science; Wanju-gun Korea
| | - H Song
- Department of Animal Biotechnology; Konkuk University; Gwangjin-gu Seoul Korea
| | - KB Kim
- Korea Institute for Animal Products Quality Evaluation; Gunpo Korea
| | - CS Lee
- Department of Biomedical Chemistry; College of Biomedical & Health Science; Konkuk University; Chung-ju Korea
| | - NK Kim
- Experiment Research Institute; National Agricultural Products Quality Management Service (NAQS); Gimcheon Gyeongbuk Korea
| | - JK Park
- Department of Swine & Poultry Science; Korea National College of Agriculture and Fisheries; Jeonju Korea
| | - BC Yang
- Institute of Hanwoo; National institute of animal Science; Pyeongchang Korea
| | - KB Oh
- Animal Biotechnology Division; National Institute of Animal Science; Wanju-gun Korea
| | - GS Im
- Animal Biotechnology Division; National Institute of Animal Science; Wanju-gun Korea
| | - HJ Chung
- Animal Biotechnology Division; National Institute of Animal Science; Wanju-gun Korea
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Toro-Vélez AF, Madera-Parra CA, Peña-Varón MR, Lee WY, Bezares-Cruz JC, Walker WS, Cárdenas-Henao H, Quesada-Calderón S, García-Hernández H, Lens PNL. BPA and NP removal from municipal wastewater by tropical horizontal subsurface constructed wetlands. Sci Total Environ 2016; 542:93-101. [PMID: 26519570 DOI: 10.1016/j.scitotenv.2015.09.154] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 09/29/2015] [Accepted: 09/30/2015] [Indexed: 06/05/2023]
Abstract
It has been recognized that numerous synthetic compounds like Bisphenol A (BPA) and nonylphenols (NP) are present in effluents from wastewater treatment plants (WWTP) at levels of parts per billion (μg L(-1)) or even parts per trillion (ng L(-1)) with a high potential to cause endocrine disruption in the aquatic environment. Constructed wetlands (CW) are a cost-effective wastewater treatment alternative with promising performance to treat these afore mentioned compounds. This research was aimed to evaluate the efficacy of CW treatment of WWTP effluent for mitigating the effects endocrine disrupting compounds (EDCs). This research goal was accomplished by (1) quantifying the removal of BPA and NP in CWs; (2) isolating CW fungal strains and testing for laccase production; and (3) performing endocrine disruption (reproduction) bioassays using the fruit fly Drosophila melanogaster. Three pilot scale horizontal subsurface flow constructed wetlands (HSSF-CW) were operated for eight weeks: one planted with Phragmites australis; one planted with Heliconia psitacorum; and one unplanted. The Heliconia CW showed a removal efficiency of 73.3(± 19%) and 62.8(± 20.1%) for BPA and NP, respectively; while the Phragmites CW demonstrated a similar removal for BPA (70.2 ± 27%) and lower removal efficiency for NP 52.1(± 37.1%).The unplanted CW achieved 62.2 (± 33%) removal for BPA and 25.3(± 37%) removal for NP. Four of the eleven fungal strains isolated from the Heliconia-CW showed the capacity to produce laccase. Even though complete removal of EDCs was not achieved by the CWs, the bioassay confirmed a significant improvement (p < 0.05) in fly viability for all CWs, with Heliconia sp. being the most effective at mitigating adverse effects on first and second generational reproduction. This study showed that a CW planted with a native Heliconia sp. CW demonstrated a higher removal of endocrine disrupting compounds and better mitigation of reproductive disruption in the bioassay.
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Affiliation(s)
- A F Toro-Vélez
- Grupo de Saneamiento Ambiental, Instituto Cinara, Universidad del Valle, Cali, Calle 13 No. 100-00, Colombia.
| | - C A Madera-Parra
- Escuela EIDENAR-Facultad de Ingeniería, Universidad del Valle, Cali, Calle 13 No. 100-00, Colombia.
| | - M R Peña-Varón
- Grupo de Saneamiento Ambiental, Instituto Cinara, Universidad del Valle, Cali, Calle 13 No. 100-00, Colombia
| | - W Y Lee
- Department of Chemistry, University of Texas at El Paso, 500 W. University Ave., El Paso, TX 79968-0513, USA.
| | - J C Bezares-Cruz
- Department of Civil Engineering, University of Texas at El Paso, 500 W. University Ave., El Paso, TX 79968-0513, USA.
| | - W S Walker
- Department of Civil Engineering, University of Texas at El Paso, 500 W. University Ave., El Paso, TX 79968-0513, USA.
| | - H Cárdenas-Henao
- Grupo de Estudio en Genética, Departamento de Biología, Universidad del Valle, Cali, Calle 13 No. 100-00, Colombia.
| | - S Quesada-Calderón
- Instituto de las Ciencias Ambientales y Evolutivas, Universidad Austral de Chile, Valdivia 5090000, Chile.
| | - H García-Hernández
- UNESCO-IHE Institute for Water Education, Westvest 7, 2611 AX Delft, The Netherlands.
| | - P N L Lens
- UNESCO-IHE Institute for Water Education, Westvest 7, 2611 AX Delft, The Netherlands.
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24
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Lee SJ, Jung YR, Lee MK, Kim SH, Yong SJ, Lee WY. Impact of initial management on respiratory complications in emergency department patients requiring mechanical ventilation. Intensive Care Med Exp 2015. [PMCID: PMC4797919 DOI: 10.1186/2197-425x-3-s1-a670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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25
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Zhang W, Gu Y, Hao Y, Sun Q, Konior K, Wang H, Zilberberg J, Lee WY. Well plate-based perfusion culture device for tissue and tumor microenvironment replication. Lab Chip 2015; 15:2854-2863. [PMID: 26021852 PMCID: PMC4470735 DOI: 10.1039/c5lc00341e] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
There are significant challenges in developing in vitro human tissue and tumor models that can be used to support new drug development and evaluate personalized therapeutics. The challenges include: (1) working with primary cells which are often difficult to maintain ex vivo, (2) mimicking native microenvironments from which primary cells are harvested, and (3) the lack of culture devices that can support these microenvironments to evaluate drug responses in a high-throughput manner. Here we report a versatile well plate-based perfusion culture device that was designed, fabricated and used to: (1) ascertain the role of perfusion in facilitating the expansion of human multiple myeloma cells and evaluate drug response of the cells, (2) preserve the physiological phenotype of primary murine osteocytes by reconstructing the 3D cellular network of osteocytes, and (3) circulate primary murine T cells through a layer of primary murine intestine epithelial cells to recapitulate the interaction of the immune cells with the epithelial cells. Through these diverse case studies, we demonstrate the device's design features to support: (1) the convenient and spatiotemporal placement of cells and biomaterials into the culture wells of the device; (2) the replication of tissues and tumor microenvironments using perfusion, stromal cells, and/or biomaterials; (3) the circulation of non-adherent cells through the culture chambers; and (4) conventional tissue and cell characterization by plate reading, histology, and flow cytometry. Future challenges are identified and discussed from the perspective of manufacturing the device and making its operation for routine and wide use.
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Affiliation(s)
- W Zhang
- Department of Chemical Engineering and Materials Science, Stevens Institute of Technology, 1 Castle Point on Hudson, Hoboken, NJ, 07030, USA
| | - Y Gu
- Department of Chemical Engineering and Materials Science, Stevens Institute of Technology, 1 Castle Point on Hudson, Hoboken, NJ, 07030, USA
| | - Y Hao
- Department of Chemical Engineering and Materials Science, Stevens Institute of Technology, 1 Castle Point on Hudson, Hoboken, NJ, 07030, USA
| | - Q Sun
- Department of Chemical Engineering and Materials Science, Stevens Institute of Technology, 1 Castle Point on Hudson, Hoboken, NJ, 07030, USA
| | - K Konior
- Department of Chemical Engineering and Materials Science, Stevens Institute of Technology, 1 Castle Point on Hudson, Hoboken, NJ, 07030, USA
| | - H Wang
- Department of Chemistry, Chemical Biology, and Biomedical Engineering, Stevens Institute of Technology, Hoboken, NJ, 07030, USA
| | - J Zilberberg
- Research Department, Hackensack University Medical Center, 40 Prospect Ave, Hackensack, NJ, 07601, USA
- John Theurer Cancer Center, Hackensack University Medical Center
| | - W Y Lee
- Department of Chemical Engineering and Materials Science, Stevens Institute of Technology, 1 Castle Point on Hudson, Hoboken, NJ, 07030, USA
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Lee WY, Weng CH, Hsu YP, Lin PC. [The Perioperative Management of Pain in Patients Who Are Addicted to Heroin]. Hu Li Za Zhi 2015; 62:72-7. [PMID: 26073959 DOI: 10.6224/jn.62.3.72] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Heroin addicts admitted to the hospital for surgery should be treated as high-risk patients because these patients face a significantly higher risk of experiencing severe drug withdrawal symptoms and of pain management complications during hospitalization. The lack of proper pain management often suffered by heroin addicts during hospitalization has been attributed to care providers' insufficient knowledge regarding opioid medications and their addicting effects as well as fears that opioid medications may cause addiction symptoms to reemerge. The objective of this article is to illustrate the pain management process across the entire hospitalization period for heroin-addicted patients undergoing surgical procedures. This process includes management of the heroin-related physical and psychological reactions from surgery, of the mechanism of pain induced specifically from surgery, and of the heroin addiction during the surgical procedure and subsequent clinical management and nursing care. It is hoped that this article assists healthcare providers to better understand the need for the proper pain management and care of heroin-addicted surgical patients over the entire period of hospitalization and thus the enhancement of the overall quality and safety of patient care management procedures.
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Affiliation(s)
- Wen-Yi Lee
- Department of Anesthesiology, National Taiwan University Hospital, Yun-Lin Branch, Taiwan, ROC
| | - Chia-Hsing Weng
- Department of Anesthesiology, National Taiwan University Hospital, Yun-Lin Branch, Taiwan, ROC
| | - Yu-Ping Hsu
- Department of Anesthesiology, China Medical University Beigang Hospital, Taiwan, ROC
| | - Pao-Chen Lin
- Department of Nursing, National Tainan Junior College of Nursing, Taiwan, ROC.
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Lo CS, Yang CY, Ko JH, Lee WY, Shih IH, Lin YC. Hyperimmunoglobulin E syndrome presenting as eosinophilic pustular folliculitis: a case report. Int J Dermatol 2015; 54:211-4. [DOI: 10.1111/ijd.12005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 11/30/2022]
Affiliation(s)
- Chi-Shou Lo
- Department of Dermatology; Chang Gung Memorial Hospital; Keelung Taiwan
- Chang Gung University College of Medicine; Taoyuan Taiwan
| | - Chin-Yi Yang
- Chang Gung University College of Medicine; Taoyuan Taiwan
- Department of Dermatology; Chang Gung Memorial Hospital; Taipei Taiwan
| | - Jui-Hung Ko
- Chang Gung University College of Medicine; Taoyuan Taiwan
- Department of Dermatology; Chang Gung Memorial Hospital; Taipei Taiwan
| | - Wen-Yi Lee
- Chang Gung University College of Medicine; Taoyuan Taiwan
- Department of Pediatrics; Chang Gung Memorial Hospital; Taipei Taiwan
| | - I-Hsin Shih
- Chang Gung University College of Medicine; Taoyuan Taiwan
- Department of Dermatology; Chang Gung Memorial Hospital; Taipei Taiwan
| | - Yi-Chen Lin
- Chang Gung University College of Medicine; Taoyuan Taiwan
- Department of Dentistry; Chang Gung Memorial Hospital; Taipei Taiwan
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28
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Kim TG, Park W, Choi DH, Kim SH, Kim HC, Lee WY, Park JO, Park YS. The adequacy of the distal resection margin after preoperative chemoradiotherapy for rectal cancer. Colorectal Dis 2014; 16:O257-63. [PMID: 24422744 DOI: 10.1111/codi.12554] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 10/20/2013] [Indexed: 02/08/2023]
Abstract
AIM The study aimed to determine the adequacy of the distal margin in patients having preoperative chemoradiotherapy (CRT) followed by restorative surgery for rectal cancer. METHOD A total of 368 patients with locally advanced rectal cancer treated for cure at our institution between July 1999 and March 2009 were included in the study. All underwent preoperative CRT and sphincter-sparing surgery. The distal margin and other factors were examined for their effect on recurrence and survival. The median duration of follow-up was 48 months. RESULTS The length of distal margin ranged from 0 to 9.0 cm (median 1.5 cm). The pelvic control and disease-free survival rates at 5 years for patients with a margin of ≤ 3 mm were no different from those in whom it was > 3 mm (P = 0.6 and 0.8). The 5-year pelvic control rates between the ≤ 3 mm and > 3 mm groups were 66.7 and 86.2% in patients with a ypT3-4 tumour (P = 0.049) and 70.0 and 89.1% in patients who showed no response to CRT (P = 0.039). CONCLUSION The results suggest that a distal margin of < 3 mm in the surgical specimen after preoperative CRT is associated with a lower rate of pelvic tumour control at 5 years in patients with Stage ypT3-4 tumours or in those who do not respond to CRT.
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Affiliation(s)
- T G Kim
- Department of Radiation Oncology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
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29
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Poon DMC, Kam M, Leung CM, Chau R, Wong S, Lee WY, Wong KCW, Yu B, Chan A. Dosimetric advantages and superior treatment delivery efficiency of RapidArc over conventional intensity-modulated radiotherapy in high-risk prostate cancer involving seminal vesicles and pelvic nodes. Clin Oncol (R Coll Radiol) 2013; 25:706-12. [PMID: 23954261 DOI: 10.1016/j.clon.2013.07.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Revised: 06/06/2013] [Accepted: 06/10/2013] [Indexed: 11/27/2022]
Abstract
AIMS To compare the dosimetry and treatment delivery efficiency of RapidArc with conventional intensity-modulated radiotherapy (IMRT) in the treatment of high-risk prostate cancer. MATERIALS AND METHODS Fifteen patients with high-risk localised prostate cancer were studied. Sequential treatment was used. The initial planning target volume (PTV-L) included the prostate, seminal vesicles and pelvic lymphatics, whereas the prostate boost PTV (PTV-P) included the prostate and seminal vesicles only. The total prescription dose was 76 Gy (44 Gy to PTV-L, 32 Gy to PTV-P; 2 Gy/fraction). Two separate planning techniques were generated for each patient: seven static-field IMRT versus two-arc RapidArc. Dose-volume parameters for the organs at risk, conformity index and homogeneity index for the PTVs, the calculated monitor units and treatment delivery time for both techniques were compared. RESULTS RapidArc gave more conformal plans than IMRT for both PTVs. RapidArc gave a higher homogeneity index to the PTV-P and a similar homogeneity index to the PTV-L. The two techniques gave similar dosimetric results for the rectum, bladder and femoral heads. The mean dose (Dmean) and the maximum dose (Dmax) of the bowel space were reduced by 3.06 and 2.83%, respectively, with RapidArc. The V20 Gy, V30 Gy and V40 Gy for healthy tissues were reduced by 7.77, 14.25 and 17.55%, respectively, with RapidArc. The calculated treatment delivery time and monitor units were reduced by 74.09%/60.93% and 68.32%/48.06% for the PTV-L/PTV-P, respectively, with RapidArc. CONCLUSION RapidArc is better than conventional IMRT in terms of dosimetry and delivery efficiency for high-risk prostate cancer.
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Affiliation(s)
- D M C Poon
- Department of Clinical Oncology, State Key Laboratory in Oncology in South China, Sir YK Pao Centre for Cancer, Hong Kong Cancer Institute and Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
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Wang L, Yeung JHK, Hu T, Lee WY, Lu L, Zhang L, Shen J, Chan RLY, Wu WKK, Cho CH. Dihydrotanshinone induces p53-independent but ROS-dependent apoptosis in colon cancer cells. Life Sci 2013; 93:344-51. [PMID: 23871989 DOI: 10.1016/j.lfs.2013.07.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 06/26/2013] [Accepted: 07/06/2013] [Indexed: 12/16/2022]
Abstract
AIMS The therapeutic potential of various tanshinones was examined and compared for their anti-cancer activities on colon cancer cells. The role of ROS generation in the pro-apoptotic activity of dihydrotanshinone (DHTS) was further studied. MAIN METHODS Cell viability was determined by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Apoptosis and poly-ADP-ribose-polymerase (PARP) cleavage were respectively measured by flow cytometer and Western blot. Changes of mitochondrial membrane potential (MMP), mitochondrial ROS (mitoROS) and total ROS were determined by confocal system under an inverted microscope. KEY FINDINGS Among the different tanshinones examined, DHTS produced the most potent anti-cancer effect. DHTS induced a selective cytotoxicity and apoptosis in both HCT116 p53(-/-) and HCT116 p53(+/+) colon cancer cells. A time- and concentration-dependent PARP cleavage further confirmed the apoptotic activity. In this regard, it was found DHTS provoked mitochondrial dysfunction in the early stage by decreasing MMP and mitoROS levels. This was followed by a time-dependent increase in intracellular ROS generation. Pretreatment with N-acetyl-l-cysteine (NAC) or catalase-PEG, the free radical scavengers, reduced apoptotic cell death. From these findings, it seems that leakage of ROS from mitochondria into cytosol by DHTS represents the major contributory factor leading to cell death in colon cancer cells. SIGNIFICANCE We report for the first time that DHTS induces apoptosis in colon cancer cells through a p53-independent pathway. Disturbance of ROS generation at the oxidative phosphorylation (OXPHOS) complex in mitochondria followed by the decrease of MMP and increase of intracellular ROS accumulation are suggested to be involved in the pro-apoptotic activity of DHTS.
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Affiliation(s)
- L Wang
- Faculty of Medicine, School of Biomedical Sciences, The Chinese University of Hong Kong, China
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31
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Lee KH, Lee WY, Kim JH, Yoon MJ, Kim NH, Kim JH, Uhm SJ, Kim DH, Chung HJ, Song H. Characterization of GFRα-1-Positive and GFRα-1-Negative Spermatogonia in Neonatal Pig Testis. Reprod Domest Anim 2013; 48:954-60. [DOI: 10.1111/rda.12193] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2012] [Accepted: 05/08/2013] [Indexed: 12/21/2022]
Affiliation(s)
- KH Lee
- Department of Animal and Food Bioscience; College of Biomedical and Health Science; Konkuk University; Chung-ju Korea Korea
| | - WY Lee
- Department of Animal and Food Bioscience; College of Biomedical and Health Science; Konkuk University; Chung-ju Korea Korea
| | - JH Kim
- Major in Animal Biotechnology; College of Animal Biotechnology; Konkuk University; Seoul Korea
| | - MJ Yoon
- Division of Animal Science and Biotechnology; Kyungpook National University; Sang-ju Korea
| | - NH Kim
- Department of Animal Science; College of Agriculture; Chungbuk National University; Choung-ju Korea
| | - JH Kim
- CHA Stem Cell Institute; Graduate School of Life Science and Biotechnology; Pochon CHA University; Seoul Korea
| | - SJ Uhm
- Department of Animal Science & Biotechnology; Sangji Youngseo College; Wonju Korea
| | - DH Kim
- Animal Biotechnology Division; National Institute of Animal Science; RDA; Suwon Korea
| | - HJ Chung
- Animal Biotechnology Division; National Institute of Animal Science; RDA; Suwon Korea
| | - H Song
- Department of Animal and Food Bioscience; College of Biomedical and Health Science; Konkuk University; Chung-ju Korea Korea
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Rhee EJ, Lee WY, Min KW, Shivane VK, Sosale AR, Jang HC, Chung CH, Nam-Goong IS, Kim JA, Kim SW. Efficacy and safety of the dipeptidyl peptidase-4 inhibitor gemigliptin compared with sitagliptin added to ongoing metformin therapy in patients with type 2 diabetes inadequately controlled with metformin alone. Diabetes Obes Metab 2013; 15:523-30. [PMID: 23320436 DOI: 10.1111/dom.12060] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2012] [Revised: 12/21/2012] [Accepted: 12/21/2012] [Indexed: 11/28/2022]
Abstract
AIMS This study was designed to assess the efficacy and safety of a dipeptidyl peptidase-4 inhibitor, gemigliptin versus sitagliptin added to metformin in patients with type 2 diabetes. METHODS We conducted a double-blind, randomized, active-controlled trial in 425 Asian patients with inadequately controlled type 2 diabetes being treated with metformin alone. Eligible patients were randomized into three groups: 50 mg gemigliptin qd, 25 mg gemigliptin bid or sitagliptin 100 mg qd added to ongoing metformin treatment for 24 weeks. Haemoglobin A1c (HbA1c) and fasting plasma glucose (FPG) were measured periodically, and oral glucose tolerance tests were performed at baseline and 24 weeks after starting the treatment regimen. RESULTS Twenty-four weeks later, adding gemigliptin (50 mg/day) to ongoing metformin therapy significantly improved glycaemic control. Reduction in HbA1c caused by 50 mg gemigliptin qd (-0.77% ± 0.8) was non-inferior to that caused by 100 mg sitagliptin qd (-0.8% ± 0.85). Proportion of patients achieving HbA1c <7% while taking 25 mg gemigliptin bid (50%) or 50 mg gemigliptin qd (54.07%) was comparable to the results with 100 mg sitagliptin qd (48.87%). There were significant decreases in FPG, postprandial glucose and AUC0-2 h glucose, as well as increases in GLP-1 and β cell sensitivity to glucose (supported by homeostasis model assessment of β-cell function, postprandial 2-h c-peptide and insulinogenic index) in patients receiving gemigliptin treatment with their metformin therapy. There was no increased risk of adverse effects with this dose of gemigliptin compared with sitagliptin 100 mg qd. CONCLUSIONS Addition of gemigliptin 50 mg daily to metformin was shown to be efficacious, well tolerated and non-inferior to sitagliptin in patients with type 2 diabetes mellitus.
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Affiliation(s)
- E J Rhee
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Koh KC, Lee WY, Eh ZW, Nor Julaika I, Tee PS, Azizon O, Thilageswary M. Efavirenz does not cause false-positive urine cannabis test in HIV-infected patients on Highly Active Anti-Retroviral Therapy. Med J Malaysia 2013; 68:249-252. [PMID: 23749016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Efavirenz is a non-nucleoside reverse transcriptase inhibitor used in combination with other drugs for the treatment of patients with HIV infection. Efavirenz has been reported to cause a positive urine cannabis test reaction which may create problems between HIV-infected patients on Efavirenz and law enforcement agencies. Doctors are at loss whether to issue documents certifying the potential false positive urine cannabis test with Efavirenz to patients. We investigated if the urine of HIV-infected patients on Efavirenz caused a positive urine cannabis test using the AxSYM Cannabinoids Assay®. Urine samples from 51 eligible patients on Efavirenz were tested for cannabis. All tested negative except for one who had used cannabis the day before. Efavirenz does not cause false positive urine cannabis test with the AxSYM Cannabinoids Assay®. Certification documents from doctors are therefore unnecessary.
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Affiliation(s)
- K C Koh
- International Medical University, Internal Medicine, Clinical School, Jalan Rasah, Seremban, Negeri Sembilan 70400, Malaysia.
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Lee KH, Park HJ, Seo HG, Kim JH, Lim GS, Lee WY, Kim NH, Kim JH, Lee JH, Jung HS, Sung SH, Song H. Immune modulation effect of porcine placenta extracts in weaned the pig. J Anim Sci 2013; 91:2405-13. [PMID: 23463569 DOI: 10.2527/jas.2012-5208] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In a previous study, we established a collection of appropriate porcine placental extracts using PBS at 80°C (PE-PBS80) as a food supplement to increase immune activities in a mice model. In this study, piglets were treated with 0.1%, 0.3%, and 0.5% PE-PBS80 for 3 wk after weaning. Experiments were performed at 2 separate farms using 2 different pig varieties. Composition of white blood cells, lymphocyte activation, and cytokine concentrations were analyzed to assess the immune modulation effect. In Exp. 1, the number of white blood cells increased significantly in the PE-PBS80 treatment and T- and B-cell activation increased as well (P < 0.01). Interestingly, piglets in all treatments in Exp. 2 were naturally infected by a rotavirus at the third day of the experiment but recovered after d 10. Increased lymphocyte activation was observed in the PE-PBS80 treatment (P < 0.01) regardless of viral infection. Additionally, unlike in Exp. 1, the percentage of granulocytes and concentrations of interferon-γ, IL-1β, and IgG increased in the PE-PBS80 treatment (P < 0.01) and were more active in the 0.3% PE-PBS80 treatment compared with the control and the other treatment. In conclusion, 0.3% PE-PBS80 treatment modulated immune activities in antigen-infected piglets. Therefore, the PE-PBS80 pig placental extract, particularly the 0.3% supplement to the normal diet, could be useful as an alternative feed supplement to modulate immune activity during the early piglet period.
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Affiliation(s)
- K H Lee
- Department of Animal and Food Bioscience, College of Natural Science, Konkuk University, Chung-ju 380-701, Korea.
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Lee WY, Chai SY, Lee KH, Park HJ, Kim JH, Kim B, Kim NH, Jeon HS, Kim IC, Choi HS, Song H. Identification of the DDAH2 Protein in Pig Reproductive Tract Mucus: A Putative Oestrus Detection Marker. Reprod Domest Anim 2013; 48:e13-6. [DOI: 10.1111/j.1439-0531.2012.02122.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Liew NC, Chang YH, Choi G, Chu PH, Gao X, Gibbs H, Ho CO, Ibrahim H, Kim TK, Kritpracha B, Lee LH, Lee L, Lee WY, Li YJ, Nicolaides AN, Oh D, Pratama D, Ramakrishnan N, Robless PA, Villarama-Alemany G, Wong R. Asian venous thromboembolism guidelines: prevention of venous thromboembolism. INT ANGIOL 2012; 31:501-516. [PMID: 23222928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Venous thromboembolism (VTE) prophylaxis is under-utilized in Asia because of the misconception that its incidence is lower in Asians as compared to the Caucasians. The available data on VTE in Asia is limited due to the lack of well-designed multicenter randomized controlled trials as well as non-standardized research designs, making data comparison difficult. Emerging data indicates that the VTE incidence is not low in Asia, and is comparable to that reported in the Western literature in some instances. There is also a trend towards increasing incidence of VTE, as demonstrated by a number of hospital-based studies in Asia. This could be attributed to lifestyle changes, ageing population, increasing awareness of VTE and wider availability of Duplex ultrasound. The risk of VTE in hospitalized patients remain the same in Asians and Caucasians, even though there may be factors that are inherent to patients in Asia that influence the slight variation in incidence. The utilization rate of VTE prophylaxis remains suboptimal in Asia. The Asian Venous Thrombosis Forum (AVTF) comprises participants from various countries such as China, Hong Kong, India, Indonesia, Korea, Malaysia, Philippines, Singapore, Taiwan, Thailand and experts from Australia and Europe. The forum evaluated the available data on VTE from the Asian region and formulated guidelines tailored to meet the needs of the region. We recommend that serious considerations are given to VTE prophylaxis especially in the at-risk group and a formal hospital policy be established to facilitate the implementation. On admission to the hospital, we recommend assessing the patients for both VTE and bleeding risk. We recommend mechanical prophylaxis for patients at increased risk of bleeding and utilizing it as an adjunctive measure in combination with pharmacological prophylaxis in patients with high risk of VTE. For patients undergoing general or gynecological surgery and with moderate risk for VTE, we recommend prophylaxis with one of the following: low dose unfractionated heparin (LDUH), low molecular weight heparin (LMWH), fondaparinux or intermittent pneumatic compression (IPC). For the same group of patients at high risk of VTE, we recommend pharmacological or combination of pharmacological and mechanical prophylaxis. For patients undergoing major orthopedic surgeries like total hip replacement, total knee replacement and proximal hip fracture surgery, we recommend using one of the following: LMWH, fondaparinux, rivaroxaban, apixaban, edoxaban, dabigatran, warfarin or aspirin with IPC. For patients admitted to the hospital with acute medical illness and has moderate risk of VTE, we recommend prophylaxis with LDUH, LMWH or Fondaparinux. For the same group at high risk of VTE, we recommend combination of pharmacological and mechanical prophylaxis.
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Affiliation(s)
- N C Liew
- Department of Surgery, University Putra Malaysia, General Hospital, Kuala Lumpur, Malaysia.
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Park SU, Min YW, Shin JU, Choi JH, Kim YH, Kim JJ, Cho YB, Kim HC, Yun SH, Lee WY, Chun HK, Chang DK. Endoscopic submucosal dissection or transanal endoscopic microsurgery for nonpolypoid rectal high grade dysplasia and submucosa-invading rectal cancer. Endoscopy 2012; 44:1031-6. [PMID: 23012217 DOI: 10.1055/s-0032-1310015] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND STUDY AIMS Transanal endoscopic microsurgery (TEM) has been shown to be highly effective for early rectal cancer, and endoscopic submucosal dissection (ESD) has been introduced to treat noninvasive colorectal neoplasia. The aim of this study was to compare the outcomes of ESD and TEM for superficial early rectal cancer. PATIENTS AND METHODS We retrospectively analyzed 63 patients with nonpolypoid rectal high grade dysplasia or submucosa-invading cancer who were treated with ESD or TEM, and compared clinical outcomes and safety between the treatment groups. RESULTS 30 patients underwent ESD and 33 underwent TEM. For ESD compared with TEM, en bloc resection rates were 96.7% vs. 100% (P = 0.476) and R0 resection rates were 96.7 % vs. 97.0 % (P = 1.000). There were no cases of local recurrence or distant metastasis in either group. Antibiotics were required in 11 patients (36.7%) in the ESD group and 33 (100%) in the TEM group (P < 0.001). There was no difference in net procedure time although ESD was associated with shorter total procedure time and hospital stay than TEM, with mean (standard deviation [SD]) 84.0 (51.2) vs. 116.4 (58.5) min (P = 0.0023), and 3.6 (1.2) vs. 6.6 (3.5) days (P < 0.001), respectively. There were no significant differences in complications between the two groups. CONCLUSIONS Both ESD and TEM are effective and oncologically safe for treating nonpolypoid rectal high grade dysplasia and submucosa-invading cancers. ESD has the additional advantages of minimal invasiveness and avoidance of anesthesia. Therefore, ESD could be recommended as a treatment option for superficial early rectal cancers.
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Affiliation(s)
- S U Park
- Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Chen XN, Gu YX, Lee JH, Lee WY, Wang HJ. Multifunctional surfaces with biomimetic nanofibres and drug-eluting micro-patterns for infection control and bone tissue formation. Eur Cell Mater 2012; 24:237-48. [PMID: 23007909 DOI: 10.22203/ecm.v024a17] [Citation(s) in RCA: 18] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
For long-term orthopaedic implants, the creation of a surface that is repulsive to bacteria while adhesive to tissue cells represents a promising strategy to control infection. To obtain such multifunctional surfaces, two possible approaches were explored to incorporate a model antibiotic, rifampicin (Rf), into the osteogenic polycaprolactone (PCL)/chitosan (CHS) biomimetic nanofibre meshes by (1) blending Rf into the electrospinning solutions and then electrospinning into nanofibres (i.e., Rf-incorporating fibres), or (2) depositing Rf-containing poly(D,L-lactic-co-glycolic) acid (PLGA) micro-patterns onto the PCL/chitosan nanofibre meshes via ink-jet printing (i.e., Rf-eluting micro-pattern/fibre). Rapid release of Rf from both meshes was measured even though a relatively slower release rate was obtained from the Rf-eluting micro-pattern ones. Antibacterial assay with Staphylococcus epidermidis showed that both mesh surfaces could effectively kill bacteria and prevent biofilm formation. However, only Rf-eluting micro-pattern meshes favoured the attachment, spreading and metabolic activity of preosteoblasts in the cell culture study. Furthermore, the Rf-eluting micro-pattern meshes could better support the osteogenic differentiation of preosteoblasts by up-regulating the gene expression of bone markers (type I collagen and alkaline phosphatase). Clearly, compared to Rf-incorporating nanofibre meshes, Rf-eluting micro-patterns could effectively prevent biofilm formation without sacrificing the osteogenic properties of PCL/chitosan nanofibre surfaces. This finding provides an innovative avenue to design multifunctional surfaces for enhancing bone tissue formation while controlling infection.
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Affiliation(s)
- X N Chen
- Department of Chemistry, Chemical Biology and Biomedical Engineering, Stevens Institute of Technology, Hoboken, NJ 07030, USA
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Kim JH, Kim SJ, Lee WY, Cheon YH, Lee SS, Ju A, K M, Kim DJ. The Effects of Alcohol Abstinence on BDNF, Ghrelin, and Leptin Secretions in Alcohol-Dependent Patients with Glucose Intolerance. Alcohol Clin Exp Res 2012; 37 Suppl 1:E52-8. [DOI: 10.1111/j.1530-0277.2012.01921.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Accepted: 07/02/2012] [Indexed: 01/15/2023]
Affiliation(s)
- JH Kim
- Department of Biomedical Science; The Catholic University of Korea College of Medicine; Seoul; South Korea
| | - SJ Kim
- Department of Psychiatry; Seoul St Mary's Hospital; College of Medicine; The Catholic University of Korea; Seoul; South Korea
| | - WY Lee
- Division of Endocrinology and Metabolism; Department of Internal Medicine; Kangbuk Samsung Hospital; Sungkyunkwan University School of Medicine; Seoul; South Korea
| | - YH Cheon
- Department of Psychiatry; Incheon Chamsarang Hospital; Seojin Medical Research Institute; Incheon; South Korea
| | - SS Lee
- Division of Endocrinology and Metabolism; Department of Internal Medicine; Bucheon St Mary's Hospital; The Catholic University of Korea College of Medicine; Bucheon; South Korea
| | - A Ju
- Department of Biomedical Science; The Catholic University of Korea College of Medicine; Seoul; South Korea
| | - Min K
- Department of Psychiatry; Seoul St Mary's Hospital; College of Medicine; The Catholic University of Korea; Seoul; South Korea
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Abstract
Virus evolution should be monitored because frequent reassortment, which contributes to virus diversity, creates the potential for more severe infections. Several severe respiratory virus infections that have emerged during the past decade originated in animals, including bats. In Indonesia, exposure to bats has been associated with increased risk of acquiring orthoreovirus infection. Although orthoreovirus infections are mild and self-limiting, we explored their potential for evolution into a more virulent form. We used conventional virus culture, electron microscopy, and molecular sequencing to isolate and identify orthoreoviruses from 3 patients in whom respiratory tract infection developed after travel to Indonesia. Virus characterization by plaque-reduction neutralization testing showed antigenic similarity, but sequencing of the small segment genes suggested virus reassortment, which could lead to increased virulence. Bats as a reservoir might contribute to virus evolution and genetic diversity, giving orthoreoviruses the potential to become more virulent. Evolution of this virus should be closely monitored so that prevention and control measures can be taken should it become more virulent.
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Affiliation(s)
- Ann H Wong
- Centre for Health Protection, Hong Kong SpecialAdministrative Region, People’s Republic of China.
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Kim WJ, Park CY, Park SE, Rhee EJ, Lee WY, Oh KW, Park SW, Kim SW, Park HS, Kim YJ, Song SJ, Ahn HY. Serum 1,5-anhydroglucitol is associated with diabetic retinopathy in Type 2 diabetes. Diabet Med 2012; 29:1184-90. [PMID: 22332964 DOI: 10.1111/j.1464-5491.2012.03613.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS To determine whether there is a relationship between 1,5-anhydroglucitol (1,5-AG), a marker of postprandial hyperglycaemia and glycaemic variability, and the presence of diabetic retinopathy and albuminuria in patients with Type 2 diabetes. METHODS Five hundred and sixty-seven patients with Type 2 diabetes (serum creatinine < 133 μmol/l), who were enrolled in the Seoul Metro-City Diabetes Prevention Program (SMC-DPP), were cross-sectionally assessed by multivariate logistic regression analysis. RESULTS After controlling for age, sex, binary HbA(1c) levels, duration of diabetes, triglyceride, systolic blood pressure, smoking status, history of hypertension and dyslipidaemia, and the use of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker medication, the odds ratios (95% CI) of diabetic retinopathy were 2.86 (1.12-7.25) for the first (lowest) quartile of 1,5-anhydroglucitol, 2.87 (1.25-6.61) for the second quartile and 0.88 (0.35-2.22) for the third quartile compared with the fourth quartile (P for trend = 0.010). Conversely, the associations between 1,5-anhydroglucitol and clinical albuminuria were non-significant after adjustment. Subjects with low 1,5-anhydroglucitol (< 10.0 μg/ml) were more likely to experience diabetic retinopathy than those with high 1,5-anhydroglucitol (≥ 10.0 μg/ml) under moderate glucose control (HbA(1c) < 8%, 64 mmol/mol) and there were no significant differences in the prevalence of diabetic retinopathy between the subgroup with HbA(1c) < 8% (64 mmol/mol) and low 1,5-anhydroglucitol and the subgroup with HbA(1c) ≥ 8% (64 mmol/mol). CONCLUSIONS 1,5-Anhydroglucitol levels show close associations with diabetic retinopathy, especially among patients under moderate glucose control, but not with albuminuria. These results suggest that 1,5-anhydroglucitol might be a complementary marker for targeting higher risk group.
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Affiliation(s)
- W J Kim
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Lee WY, Lin PC, Weng CH, Lin YL, Tsai WL. [A project to reduce the incidence of facial pressure ulcers caused by prolonged surgery with prone positioning]. Hu Li Za Zhi 2012; 59:70-78. [PMID: 22661034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND & PROBLEMS We observed in our institute a 13.6% incidence of prolonged surgery (>4 hours) induced facial pressure ulcers that required prone positioning. Causes identified included: (1) customized silicon face pillows used were not suited for every patient; (2) our institute lacked a standard operating procedure for prone positioning; (3) our institute lacked a postoperative evaluation and audit procedure for facial pressure ulcers. PURPOSE We designed a strategy to reduce post-prolonged surgery facial pressure ulcer incidence requiring prone positioning by 50% (i.e., from 13.6% to 6.8%). RESOLUTIONS We implemented the following: (1) Created a new water pillow to relieve facial pressure; (2) Implemented continuing education pressure ulcer prevention and evaluation; (3) Established protocols on standard care for prone-position patients and proper facial pressure ulcer identification; (4) Established a face pressure ulcers accident reporting mechanism; and (5) Established an audit mechanism facial pressure ulcer cases. RESULTS After implementing the resolution measures, 116 patients underwent prolonged surgery in a prone position (mean operating time: 298 mins). None suffered from facial pressure ulcers. The measures effectively reduced the incidence of facial pressure ulcers from 13.6% to 0.0%. CONCLUSIONS The project used a water pillow to relieve facial pressure and educated staff to recognize and evaluate pressure ulcers. These measures were demonstrated effective in reducing the incidence of facial pressure ulcers caused by prolonged prone positioning.
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Affiliation(s)
- Wen-Yi Lee
- Department of Nursing, National Taiwan University Hospital, Republic of China
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Poon DMC, Leung CM, Chu CM, Lee WY, Lee L, Kam MK, Leung SF, Yu KH, Chan ATC. The impact of image-guided radiotherapy (IGRT) for prostate cancer (PC) on radiotherapy (RT)-related acute toxicities and prostate-specific antigen (PSA) kinetics. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.e15110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e15110 Background: IGRT for PC could potentially improve the therapeutic ratio by enhancing accuracy of delivery of radiation to the prostate gland. Our aim is to compare the treatment outcomes in terms of RT-related acute toxicities and PSA kinetics of PC patients (pts) undergoing radical intensity-modulated radiotherapy (IMRT) with or without image-guidance. Methods: A cohort of 21 consecutive pts treated by IGRT (I) from January 2010, when the IGRT system was introduced in our institution, was compared with an immediately precedent cohort of 21 pts receiving IMRT without image-guidance (Non-I). The prescription dose (76Gy in 38 fractions) and the treatment margins were the same between the 2 groups (gps). In the I gp, daily online verification and correction of treatment position was performed with reference to image registration of the daily pre-treatment on-board imaging with the corresponding digitally reconstructed radiographs, based on three-dimensional matching of three intra-prostatic fiducial markers. Androgen deprivation therapy was not used in both gps. Acute toxicities were scored weekly during the course of RT according to the Common Terminology Criteria for Adverse Events Version 4.02. The pre- and the post-RT PSA within 6 months after completion of RT were obtained. The PSA halving time (PSAHT) was calculated by first order kinetics. Results: There was no statistically significant difference regarding the baseline clinical characteristics (age, PSA at diagnosis, Gleason score, T staging) between the gps. No grade 3 or 4 acute genitourinary (GU) or gastrointestinal (GI) toxicities was encountered in either gps. Acute grade 1 or 2 GI toxicities were significantly less frequent in the I gp (23.8% vs 81.0%, p=0.001), and their median duration of such toxicity were also significantly shorter (0.33 week vs 1.38 week, p=0.004).The frequencies of acute grade 1 or 2 GU toxicities were comparable between both gps (66.6% vs 81.0%, p=0.45).The I gp had a shorter median PSAHT than the non-I gp (3.36 week vs 5.49 week, p=0.09). Conclusions: IGRT is effective in reducing acute GI toxicities in treatment of PC, and may have more favorable PSA kinetics.
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Affiliation(s)
- Darren M. C. Poon
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - CM Leung
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - CM Chu
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - WY Lee
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Louis Lee
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Michael K. Kam
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Sing Fai Leung
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Kwok Hung Yu
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Anthony T. C. Chan
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
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Yoon WT, Lee WY, Lee ST, Ahn JY, Ki CS, Cho JW. Atypical hereditary spastic paraplegia with thin corpus callosum in a Korean patient with a novel SPG11 mutation. Eur J Neurol 2012; 19:e7-8. [PMID: 22175763 DOI: 10.1111/j.1468-1331.2011.03569.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Lee WY, Hsieh CC, Hsu JW, Datta A, Lin YC, Huang JH, Lee TY. Zirconium and hafnium amide, alkoxide, and pyrrolyl complexes manifesting with pyrrolyl-linked N-donor ligands: Syntheses, characterization, and ring opening polymerization of ε-caprolactone. J Organomet Chem 2011. [DOI: 10.1016/j.jorganchem.2011.09.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hwang ST, Cho YK, Yun JW, Park JH, Kim HJ, Park DI, Sohn CI, Jeon WK, Kim BI, Rhee EJ, Oh KW, Lee WY, Jin W. Impact of non-alcoholic fatty liver disease on microalbuminuria in patients with prediabetes and diabetes. Intern Med J 2011; 40:437-42. [PMID: 19460054 DOI: 10.1111/j.1445-5994.2009.01979.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND It is unknown whether microalbuminuria is associated with non-alcoholic fatty liver disease (NAFLD) among patients with prediabetes and type 2 diabetes mellitus (DM). This study investigated the association of NAFLD with microalbuminuria among patients with prediabetes and diabetes. METHODS We evaluated 1361 subjects who had an abnormal oral glucose tolerance test (OGTT) on routine screening. All participants were divided into two groups, prediabetes and newly diagnosed type 2 DM, and the association of NAFLD with metabolic parameters on microalbuminuria was analysed. RESULTS The patients with NAFLD had higher prevalence rates of microalbuminuria (6.3% vs 19%; P = 0.001 in prediabetes, 4.5% vs 32.6%; P < 0.001 in diabetes) and also had a greater albumin-to-creatinine ratio (14.6 +/- 52.0 microg/mg Cr vs 27.7 +/- 63.9 microg/mg Cr; P = 0.051 in prediabetes, 11.4 +/- 21.4 microg/mg Cr vs 44.7 +/- 76.4 microg/mg Cr; P < 0.001 in diabetes) than those without NAFLD. The logistic regression analysis showed that NAFLD was associated with increased rates of microalbuminuria (odds ratio 3.66; 95%confidence interval (CI) 1.31-10.20, P = 0.013 in prediabetes, odds ratio 5.47;95% CI 1.01-29.61, P = 0.048 in diabetes), independently of age, sex, body mass index, waist circumference, liver enzymes, lipid profiles, HbA1c, insulin resistance as estimated by homeostasis model assessment, hypertension,smoking status and the metabolic syndrome. CONCLUSIONS The results of our study revealed a strong relationship between microalbuminuria and NAFLD in the patients with prediabetes and newly diagnosed diabetes. Further studies are required to confirm whether NAFLD is a predictor of the development of microalbuminuria in patients with prediabetes and diabetes.
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Affiliation(s)
- S T Hwang
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul 110-746, Korea
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Rajesh H, Lee WY, Fook-Chong S, Yu SL. Ovarian hyperstimulation syndrome: an analysis of patient characteristics in the Asian population. Singapore Med J 2011; 52:168-174. [PMID: 21451925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
INTRODUCTION We aimed to identify the variables associated with ovarian hyperstimulation in Asian patients and compare them with western standards. METHODS This is a retrospective case record analysis of 79 patients with ovarian hyperstimulation at a tertiary restructured hospital. RESULTS Gonadotropin doses resulting in hyperstimulation did not vary between long and antagonist cycles in women less than 35 years with polycystic ovaries (PCO). Mean oestradiol levels at hyperstimulation were not different between PCO and non-PCO patients in a long cycle. Hyperstimulation was mostly due to higher starting doses. Total follicle counts of more than 20 on Day 5-7 after stimulation may be predictive of subsequent hyperstimulation. Hyperstimulation tended to be more severe in lean PCO patients, and prophylactic albumin helped to reduce its severity. CONCLUSION Gonadotropin doses at stimulation should start at 150 iu or less in women below 35 years of age, with a step up of 37.5 iu, as necessary. Transfer should be abandoned in the presence of high oestradiol levels (more than 5,000 pg/ml), when the total number of intermediate and large follicle count exceeds 30 on the day of oocyte retrieval, or when more than 19 eggs are retrieved. Variables in the Asian population appear to be similar to those in the western population.
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Affiliation(s)
- H Rajesh
- Department of Obstetrics and Gynaecology, Singapore General Hospital, Outram Road, Singapore 169608.
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Mak GC, Choy PWW, Lee WY, Wong AH, Ng KC, Lim W. Sero-immunity and serologic response to pandemic influenza A (H1N1) 2009 virus in Hong Kong. J Med Virol 2011; 82:1809-15. [PMID: 20872705 DOI: 10.1002/jmv.21895] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
To study the serologic response to the new pandemic influenza A (H1N1) 2009 virus in Hong Kong, the level of immunity was measured before and after the occurrence of the outbreak, and the titer of antibody to the pandemic influenza A (H1N1) 2009 virus in serum samples of laboratory confirmed cases. The presence of pre-outbreak pandemic influenza A (H1N1) 2009 virus antibodies in 37% of individuals older than >65 years suggested previous exposures to heterologous virus strains may have elicited cross-reacting antibody. Following large outbreaks of pandemic influenza A 2009 virus that peaked in September 2009, there is a change in immunity level in various age groups consistent with the attack rates among population in Hong Kong. Among individuals with mild clinical presentation, the antibody response to pandemic influenza A (H1N1) 2009 virus was stronger in those individuals aged ≤ 24 years but took more time to reach a titer of 40 when compared with those aged >24 years; however, the antibody level declined slower among individuals aged ≤ 24 years. Regardless of age, the antibody response rose rapidly and reached much higher titer among individuals with severe clinical presentation. Further study is required to collect additional data on antibody persistence and determine how much protection is conferred by previous exposure to seasonal influenza A (H1N1) viruses.
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Affiliation(s)
- Gannon C Mak
- Virology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, Kowloon, Hong Kong
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Woo GKS, Wong AH, Lee WY, Lau CS, Cheng PKC, Leung PCK, Lim WWL. Comparison of laboratory diagnostic methods for measles infection and identification of measles virus genotypes in Hong Kong. J Med Virol 2010; 82:1773-81. [PMID: 20827776 DOI: 10.1002/jmv.21888] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The sensitivities of IgM detection, virus isolation, and RT-PCR for the diagnosis of measles infection were assessed using samples collected from confirmed measles cases from 2006 to 2009. The optimal timing of specimen collection and the preferred specimen type(s) for these tests were also determined. IgM detection showed highest sensitivity when serum samples were collected >or=5 days after rash onset. Virus isolation gave the highest sensitivity when samples were collected <or=3 days after rash onset, with nasopharyngeal aspirate being the best specimen type, followed by urine and throat/combined throat and nasal swab. The highest RT-PCR positive rate (81.0%) was obtained with serum samples collected <or=3 days after rash onset. RT-PCR positive rate of 100% was observed with throat/combined throat and nasal swab, urine and nasopharyngeal aspirate collected <or=16, 4-16, and 4-7 days after rash onset, respectively. The genotype of each measles case was confirmed by sequencing. It was shown that the predominant measles viruses detected in Hong Kong during 2006-2009 belonged to genotype H1 (subtype a) and these strains were related closely to those detected in China.
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Affiliation(s)
- Gibson K S Woo
- Virology Division, Department of Health, Public Health Laboratory Services Branch, Centre for Health Protection, Hong Kong SAR, China
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Rhee EJ, Lee WY, Yoon KH, Yoo SJ, Lee IK, Baik SH, Kim YK, Lee MK, Park KS, Park JY, Cha BS, Lee HW, Min KW, Bae HY, Kim MJ, Kim JA, Kim DK, Kim SW. A multicenter, randomized, placebo-controlled, double-blind phase II trial evaluating the optimal dose, efficacy and safety of LC 15-0444 in patients with type 2 diabetes. Diabetes Obes Metab 2010; 12:1113-9. [PMID: 20977584 DOI: 10.1111/j.1463-1326.2010.01303.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM The objective of this study was to evaluate the optimal dose, efficacy and safety of a novel dipeptidyl peptidase-4 (DPP-IV) inhibitor, LC15-0444, in Korean subjects with type 2 diabetes mellitus treated by diet and exercise. METHODS This study was a double-blind, randomized, multicenter and parallel-group, dose-range finding study. We enrolled 145 patients (91 men and 54 women) with a median age of 53 years and a median body mass index of 25.1 kg/m(2) . The median baseline fasting plasma glucose (FPG) was 8.1 mmol/l, the median HbA1c was 7.9% and the median time since the diagnosis of diabetes was 3 years. After 2 weeks of an exercise/diet programme followed by 2 weeks of a placebo period, the subjects were randomized to one of the four following groups for a 12-week active treatment period: placebo and 50, 100 or 200 mg of LC15-0444. RESULTS All three doses of LC15-0444 significantly reduced the HbA1c from baseline compared to the placebo group (-0.06 vs. -0.98, -0.74 and -0.78% in the placebo and 50, 100 and 200 mg groups, respectively), without a significant difference between the doses. Subjects with a higher baseline HbA1c (≥8.5%) had a greater reduction in HbA1c. Insulin secretory function, as assessed using homeostasis model assessment-beta cell, C-peptide and the insulinogenic index, improved significantly with LC15-0444 treatment. Insulin sensitivity, as assessed using homeostasis model assessment-insulin resistance, also improved significantly after 12 weeks of treatment. The 50 and 200 mg groups had significantly reduced total cholesterol and low-density lipoprotein cholesterol levels at 12 weeks compared to the placebo group. No dosage of LC15-0444 affected weight or waist circumference. The incidences of adverse events were similar in all study subjects. CONCLUSIONS LC15-0444 monotherapy (50 mg for 12 weeks) improved the HbA1c, FPG level, oral glucose tolerance test results, β-cell function and insulin sensitivity measures, and was well tolerated in Korean subjects with type 2 diabetes.
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Affiliation(s)
- E J Rhee
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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