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Rao A, Zhang X, Cillo AR, Sussman JH, Sandlesh P, Tarbay AC, Mallela AN, Cardello C, Krueger K, Xu J, Li A, Xu J, Patterson J, Akca E, Angione A, Jaman E, Kim WJ, Allen J, Venketeswaran A, Zinn PO, Parise R, Beumer J, Duensing A, Holland EC, Ferris R, Bagley SJ, Bruno TC, Vignali DAA, Agnihotri S, Amankulor NM. All-trans retinoic acid induces durable tumor immunity in IDH-mutant gliomas by rescuing transcriptional repression of the CRBP1-retinoic acid axis. bioRxiv 2024:2024.04.09.588752. [PMID: 38645178 PMCID: PMC11030316 DOI: 10.1101/2024.04.09.588752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Diffuse gliomas are epigenetically dysregulated, immunologically cold, and fatal tumors characterized by mutations in isocitrate dehydrogenase (IDH). Although IDH mutations yield a uniquely immunosuppressive tumor microenvironment, the regulatory mechanisms that drive the immune landscape of IDH mutant (IDHm) gliomas remain unknown. Here, we reveal that transcriptional repression of retinoic acid (RA) pathway signaling impairs both innate and adaptive immune surveillance in IDHm glioma through epigenetic silencing of retinol binding protein 1 (RBP1) and induces a profound anti-inflammatory landscape marked by loss of inflammatory cell states and infiltration of suppressive myeloid phenotypes. Restorative retinoic acid therapy in murine glioma models promotes clonal CD4 + T cell expansion and induces tumor regression in IDHm, but not IDH wildtype (IDHwt), gliomas. Our findings provide a mechanistic rationale for RA immunotherapy in IDHm glioma and is the basis for an ongoing investigator-initiated, single-center clinical trial investigating all-trans retinoic acid (ATRA) in recurrent IDHm human subjects.
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Zarrin D, Goel K, Kim WJ, Holly LT, Batzdorf U. Chiari Type I Revision Decompressive Surgery Indications and Operative Technique: Experience in a Large Adult Cohort. World Neurosurg 2024:S1878-8750(24)00400-5. [PMID: 38490446 DOI: 10.1016/j.wneu.2024.03.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 03/05/2024] [Accepted: 03/06/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Chiari malformation is characterized by inferior displacement of the cerebellar tonsils through the foramen magnum, frequently resulting in strain related headaches, and motor/sensory dysfunction. Chiari decompression technique varies significantly, possibly contributing to frequent revisions. We reviewed revision Chiari decompressions at our institution to determine the primary indications for revision and outcomes after revision. METHODS We retrospectively reviewed patients who underwent revision of Chiari decompression at our institution from 2005 to 2020. Demographics, indications for revision surgery, operative techniques, imaging findings, and preoperative/postoperative symptoms were collected. χ2 test was performed to determine statistical significance using a P < 0.05. Independent predictors of operative outcomes were identified. RESULTS A total of 46 patients (91% females, mean age 38.8 years) were included for analysis. The median time to revision surgery was 69.1 months (range 0-364 months) with headache (n = 37, 80%) being the most commonly recurring symptom. Large craniectomy (n = 28, 61%) was the most frequent indication for revision surgery. Thirty-two (70%) patients underwent cranioplasty, 20 (43%) required duraplasty, 15 (33%) required arachnoid dissection, and 15 (33%) required tonsillar reduction during revision surgery. Postrevision follow-up (at 8.9 ± 5.2 months average, range 1-18 months), revealed an average reduction in all Chiari-related symptoms relative to symptoms before the revision. CONCLUSIONS The most common indication for revision Chiari decompression was a large craniectomy resulting in cerebellar ptosis. We found that tonsillar reduction paired with modest craniectomy achieved near-complete resolution of symptoms with minimal complications. For patients with recurrent or persistent sequelae of Chiari malformation after decompression, revision may reduce symptom severity.
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Affiliation(s)
- David Zarrin
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Keshav Goel
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Wi Jin Kim
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, USA
| | - Langston T Holly
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, USA
| | - Ulrich Batzdorf
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, USA.
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Peeters SF, Colby GP, Kim WJ, Bae WI, Sparks H, Reitz K, Tateshima S, Jahan R, Szeder V, Nour M, Duckwiler GR, Vinuela F, Martin NA, Wang AC. Arterial Bypass in the Treatment of Complex Middle Cerebral Artery Aneurysms: Lessons Learned from Forty Patients. World Neurosurg 2024; 181:e261-e272. [PMID: 37832639 DOI: 10.1016/j.wneu.2023.10.037] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 10/07/2023] [Indexed: 10/15/2023]
Abstract
OBJECTIVE Complex middle cerebral artery (MCA) aneurysms incorporating parent or branching vessels are often not amenable to standard microsurgical clipping or endovascular embolization treatments. We aim to discuss the treatment of such aneurysms via a combination of surgical revascularization and aneurysm exclusion based on our institutional experience. METHODS Thirty-four patients with complex MCA aneurysms were treated with bypass and aneurysm occlusion, 5 with surgical clipping or wrapping only, and 1 with aneurysm excision and primary reanastomosis. Bypasses included superficial temporal artery (STA)-MCA, double-barrel STA-MCA, occipital artery-MCA, and external carotid artery-MCA. After bypass, aneurysms were treated by surgical clipping, Hunterian ligation, trapping, or coil embolization. RESULTS The average age at diagnosis was 46 years. Of the aneurysms, 67% were large and most involved the MCA bifurcation. Most bypasses performed were STA-MCA bypasses, 12 of which were double-barrel. There were 2 wound-healing complications. All but 2 of the aneurysms treated showed complete occlusion at the last follow-up. There were 3 hemorrhagic complications, 3 graft thromboses, and 4 ischemic insults. The mean follow-up was 73 months. Of patients, 83% reported stable or improved symptoms from presentation and 73% reported a functional status (Glasgow Outcome Scale score 4 or 5) at the latest available follow-up. CONCLUSIONS Cerebral revascularization by bypass followed by aneurysm or parent artery occlusion is an effective treatment option for complex MCA aneurysms that cannot be safely treated by standard microsurgical or endovascular techniques. Double-barrel bypass consisting of 2 STA branches to 2 MCA branches yields adequate flow replacement in most cases.
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Affiliation(s)
- Sophie F Peeters
- Department of Neurosurgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Geoffrey P Colby
- Department of Neurosurgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA; Department of Radiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA; David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Wi Jin Kim
- Department of Neurosurgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Whi Inh Bae
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Hiro Sparks
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Kara Reitz
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Satoshi Tateshima
- Department of Radiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA; David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Reza Jahan
- Department of Radiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA; David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Viktor Szeder
- Department of Radiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA; David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - May Nour
- Department of Radiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA; David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Gary R Duckwiler
- Department of Radiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA; David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Fernando Vinuela
- Department of Radiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA; David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Neil A Martin
- Department of Neurosurgery, Pacific Neuroscience Institute, Santa Monica, California, USA
| | - Anthony C Wang
- Department of Neurosurgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA; David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.
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Peeters SM, Colby GP, Kim WJ, Bae WI, Sparks H, Reitz K, Tateshima S, Jahan R, Szeder V, Nour M, Duckwiler GR, Vinuela F, Martin NA, Wang AC. Proximal Internal Carotid Artery Occlusion and Extracranial-Intracranial Bypass for Treatment of Fusiform and Giant Internal Carotid Artery Aneurysms. World Neurosurg 2023; 180:e494-e505. [PMID: 37774787 DOI: 10.1016/j.wneu.2023.09.097] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 09/22/2023] [Indexed: 10/01/2023]
Abstract
OBJECTIVE To discuss the treatment of intracranial fusiform and giant internal carotid artery (ICA) aneurysms via revascularization based on our institutional experience. METHODS An institutional review board-approved retrospective analysis was performed of patients with unruptured fusiform and giant intracranial ICA aneurysms treated from November 1991 to May 2020. All patients were evaluated for extracranial-intracranial (EC-IC) bypass and ICA occlusion. RESULTS Thirty-eight patients were identified. Initially, patients failing preoperative balloon test occlusion were treated with superficial temporal artery (STA)-middle cerebral artery (MCA) bypass and concurrent proximal ICA ligation. We then treated them with STA-MCA bypass, followed by staged balloon test occlusion, and, if they passed, endovascular ICA coil occlusion. We treat all surgical medically uncomplicated patients with double-barrel STA-MCA bypass and concurrent proximal ICA ligation. The mean length of follow-up was 99 months. Symptom stability or improvement was noted in 85% of patients. Bypass graft patency was 92.1%, and all surviving patients had patent bypasses at their last angiogram. Aneurysm occlusion was complete in 90.9% of patients completing proximal ICA ligation. Three patients experienced ischemic complications and 4 patients experienced hemorrhagic complications. CONCLUSIONS Not all fusiform intracranial ICA aneurysms require intervention, except when life-threatening rupture risk is high or symptomatic management is necessary to preserve function and quality of life. EC-IC bypass can augment the safety of proximal ICA occlusion. The rate of complete aneurysm occlusion with this treatment is 90.9%, and long-term bypass graft-related complications are rare. Perioperative stroke is a major risk, and continued evolution of treatment is required.
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Affiliation(s)
- Sophie M Peeters
- Department of Neurosurgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Geoffrey P Colby
- Department of Neurosurgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA; Department of Radiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA; David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Wi Jin Kim
- Department of Neurosurgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Whi Inh Bae
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Hiro Sparks
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Kara Reitz
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Satoshi Tateshima
- Department of Radiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA; David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Reza Jahan
- Department of Radiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA; David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Viktor Szeder
- Department of Radiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA; David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - May Nour
- Department of Radiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA; David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Gary R Duckwiler
- Department of Radiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA; David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Fernando Vinuela
- Department of Radiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA; David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Neil A Martin
- Pacific Neuroscience Institute, Santa Monica, California, USA
| | - Anthony C Wang
- Department of Neurosurgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA; David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.
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Kim WJ, Samarage HM, Zarrin D, Goel K, Wang AC, Johnson J, Nael K, Colby GP. Endovascular transmural access to carotid artery perivascular tissues: safety assessment of a novel technique. J Neurointerv Surg 2023; 15:1007-1013. [PMID: 36319086 PMCID: PMC10149561 DOI: 10.1136/jnis-2022-019583] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/16/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Recent advances in endovascular devices have allowed access and targeting of perivascular tissues of the peripheral circulation. The perivascular tissues of the cervical and cranial circulations have many important structures of clinical significance, yet the feasibility and safety of such an approach has not been demonstrated. OBJECTIVE To evaluate the safety of a novel endovascular transmural approach to target the perivascular tissues of the common carotid artery in swine. METHODS A micro-infusion device was positioned in the carotid arteries of three Yorkshire pigs (six carotid arteries in total), and each carotid artery was punctured 10 times in the same location to gain access to the perivascular tissues. Digital subtraction angiography was used to evaluate vessel injury or contrast extravasation. MRI and MR angiography were used to evaluate evidence of cerebral ischemia or vessel injury. Post-mortem tissue analysis was performed to assess the level of extravascular hematoma and intravascular dissection. RESULTS None of the tested carotid arteries showed evidence of vessel injury (dissection or perforation) or intravascular thrombosis. MRI performed after repeated puncture was negative for neck hematoma and brain ischemia. Post-mortem tissue analysis of the carotid arteries showed mild adventitial staining with blood, but without associated hematoma and without vessel dissection. CONCLUSION Repeated puncture of the carotid artery to gain access to the perivascular tissues using a novel endovascular transmural approach is safe in a swine model. This represents a novel approach to various tissues in close proximity to the cervical and cranial vasculature.
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Affiliation(s)
- Wi Jin Kim
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Hasitha Milan Samarage
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - David Zarrin
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Keshav Goel
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Anthony C Wang
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Jeremiah Johnson
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Kambiz Nael
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, California, USA
| | - Geoffrey P Colby
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, California, USA
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Kim WJ, Samarage HM, Jafari M, Zarrin D, Goel K, Qi X, Wang AC, Johnson J, Colby GP. Novel endovascular transmural technique for pharmacological block of superior cervical ganglion prevents sympathetic-mediated cerebral vasospasm. J Neurointerv Surg 2023:jnis-2023-020636. [PMID: 37500479 PMCID: PMC10818000 DOI: 10.1136/jnis-2023-020636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 07/12/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Sympathetic-mediated vasoconstriction from the superior cervical ganglion (SCG) is a significant contributor to cerebral vasospasm. Inhibition of the SCG has been shown to improve cerebral blood flow and reverse cerebral vasospasm in swine models. We evaluated the efficacy of a novel minimally invasive endovascular approach to target and pharmacologically inhibit the SCG, using a Micro-Infusion Device for transmural drug delivery. METHODS Eight SCGs in four Yorkshire swine were surgically identified. After confirming appropriate sympathetic-mediated intracranial vasoconstriction response with SCG stimulation, an endovascular Micro-Infusion Device was used for transmural targeting of the SCG and delivery of 1.5-2 mL of 1% lidocaine-contrast mixture to the perivascular space. Digital subtraction angiography was obtained at: (1) baseline; (2) with SCG stimulation; and (3) after lidocaine delivery to the SCG using the Micro-Infusion Device with concurrent SCG stimulation. Vessel diameters were measured and compared. RESULTS Endovascular transmural delivery of lidocaine to the SCG and carotid perivascular tissue using the Micro-Infusion Device successfully inhibited sympathetic-mediated vasoconstriction response. Measured vessel diameters after lidocaine delivery were comparable to baseline despite SCG stimulation. CONCLUSION A novel endovascular technique of transmural delivery of lidocaine to the SCG and carotid artery perivascular tissues successfully inhibits the sympathetic input to the cerebral vasculature and modulates sympathetic-mediated cerebral vasospasm. These results suggest promising steps towards translation to potential clinical use for patients suffering from cerebral vasospasm.
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Affiliation(s)
- Wi Jin Kim
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Hasitha Milan Samarage
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Matiar Jafari
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - David Zarrin
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Keshav Goel
- University of California Los Angeles, Los Angeles, California, USA
| | - Xin Qi
- School of Medicine, UCLA, Los Angeles, California, USA
| | - Anthony C Wang
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Jeremiah Johnson
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Geoffrey P Colby
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
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Richards H, Alsalek S, Laiwalla A, Attiah M, Harary M, Kim WJ, Hirt D, Rahman SU. Brain and lung metastasis of uterine leiomyosarcoma: illustrative case. J Neurosurg Case Lessons 2023; 5:CASE22557. [PMID: 37158392 PMCID: PMC10550687 DOI: 10.3171/case22557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 03/06/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Uterine leiomyosarcoma is a rare, extremely aggressive tumor with a high rate of metastasis. Five-year survival for individuals with metastatic disease is only 10%-15%. Metastases to the brain are exceptionally rare and are associated with poor survival. OBSERVATIONS The authors report a case of uterine leiomyosarcoma that metastasized to the brain in a 51-year-old woman. A single lesion on magnetic resonance imaging was discovered in the right posterior temporo-occipital region 44 months after resection of the primary uterine tumor. The patient underwent a right occipital craniotomy with gross-total resection of the tumor and is receiving adjuvant stereotactic radiosurgery and chemotherapy with gemcitabine and docetaxel. At 8 months postresection, the patient remains alive and asymptomatic with no sign of recurrence. A literature review of prior reported cases was conducted to analyze patterns of approach to patient treatment and survival. LESSONS The authors found an apparent survival benefit in patients receiving adjuvant radiation therapy.
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Affiliation(s)
- Hunter Richards
- Department of Neurosurgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California; and
| | - Samir Alsalek
- Department of Neurosurgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California; and
| | - Azim Laiwalla
- Department of Neurosurgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California
| | - Mark Attiah
- Department of Neurosurgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California
| | - Maya Harary
- Department of Neurosurgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California
| | - Wi Jin Kim
- Department of Neurosurgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California
| | - Daniel Hirt
- Department of Neurosurgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
| | - Shayan U. Rahman
- Department of Neurosurgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California
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Uy BR, Sun MZ, Muftuoglu Y, Cheng M, Kim WJ, Magaki S, Yoo BY, Salehi B, Beckett JS, Macyszyn L. Upper lumbar spine far lateral disc herniations masquerading as peripheral nerve sheath tumors: illustrative cases. J Neurosurg Case Lessons 2023; 5:CASE22552. [PMID: 37014005 PMCID: PMC10555549 DOI: 10.3171/case22552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/14/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND Migratory disc herniations can mimic neoplasms clinically and on imaging. Far lateral lumbar disc herniations usually compress the exiting nerve root and can be challenging to distinguish from a nerve sheath tumor due to the proximity of the nerve and characteristics on magnetic resonance imaging (MRI). These lesions can occasionally present in the upper lumbar spine region at the L1-2 and L2-3 levels. OBSERVATIONS The authors describe 2 extraforaminal lesions in the far lateral space at the L1-2 and L2-3 levels, respectively. On MRI, both lesions tracked along the corresponding exiting nerve roots with avid postcontrast rim enhancement and edema in the adjacent muscle tissue. Thus, they were initially concerning for peripheral nerve sheath tumors. One patient underwent fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) screening and demonstrated moderate FDG uptake on PET-CT scan. In both cases, intraoperative and postoperative pathology revealed fibrocartilage disc fragments. LESSONS Differential diagnosis for lumbar far lateral lesions that are peripherally enhancing on MRI should include migratory disc herniation, regardless of the level of the disc herniations. Accurate preoperative diagnosis can aid in decision making for management, surgical approach, and resection.
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Samarage HM, Kim WJ, Colby GP. 310 "The "Bright Falx" Sign - Midline Embolic Penetration is Associated With Faster Resolution of CSDH Following MMA Embolization. Neurosurgery 2023. [DOI: 10.1227/neu.0000000000002375_310] [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: 03/18/2023] Open
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Samarage HM, Kim WJ, Zarrin DA, Goel K, Kim W, Bergsneider M, Wang MB, Suh JD, Lee JT, Colby GP, Johnson JN, Peacock WJ, Wang AC. Endoscope-Assisted Pedicled Maxillary Artery to Middle Cerebral Artery Bypass: An Anatomic Feasibility Study. Oper Neurosurg (Hagerstown) 2023; 24:209-220. [PMID: 36637306 DOI: 10.1227/ons.0000000000000492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/31/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Extracranial to intracranial bypass is used to augment and/or replace the intracranial circulation for various pathologies. The superficial temporal artery is the mainstay donor for pedicled bypasses to the anterior circulation but can be limited by its variable size, low native flow rates, and potential scalp complications. Interposition grafts such as the radial artery or greater saphenous vein are alternatives but are sometimes limited by size mismatch, length needed to reach the extracranial circulation, and loss of inherent vascular elasticity. Interposition grafts between the maxillary artery (IMA) and middle cerebral artery (MCA) address these limitations. OBJECTIVE To explore the feasibility of harvesting the IMA through an endoscopic transnasal, transmaxillary approach to perform a direct IMA to MCA bypass. METHODS Combined transcranial and endoscopic endonasal dissections were performed in embalmed human cadavers to harvest the IMAs for intracranial transposition and direct anastomosis to the MCA. Donor and recipient vessel calibers were measured and recorded. RESULTS A total of 8 procedures were performed using the largest and distal-most branches of the IMA (the sphenopalatine branch and the descending palatine branch) as pedicled conduits to second division of middle cerebral artery (M2) recipients. The mean diameter of the IMA donors was 1.89 mm (SD ± 0.42 mm), and the mean diameter of the recipient M2 vessels was 1.90 mm (SD ± 0.46 mm). CONCLUSION Endoscopic harvest of the IMA using a transnasal, transmaxillary approach is a technically feasible option offering an excellent size match to the M2 divisions of the MCA and the advantages of a relatively short, pedicled donor vessel.
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Affiliation(s)
- Hasitha Milan Samarage
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Wi Jin Kim
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - David A Zarrin
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Keshav Goel
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Won Kim
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA.,David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.,Department of Radiation Oncology, University of California Los Angeles, Los Angeles, California, USA
| | - Marvin Bergsneider
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA.,David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.,Department of Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA
| | - Marilene B Wang
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA.,David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.,Department of Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA
| | - Jeffrey D Suh
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.,Department of Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA
| | - Jivianne T Lee
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.,Department of Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA
| | - Geoffrey P Colby
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA.,David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.,Department of Radiology, University of California Los Angeles, Los Angeles, California, USA
| | - Jeremiah N Johnson
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Warwick J Peacock
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA.,David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.,Department of Surgery, University of California Los Angeles, California, USA
| | - Anthony C Wang
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA.,David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
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11
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Hong M, Mozaffari K, Uy B, Kim WJ, Umesh A, Chandla A, Unterberger A, Yang I, Gopen Q. Postoperative Outcomes of Patients with Thin Bone Overlying the Superior Semicircular Canal: A Single Institution's Experience. World Neurosurg 2022; 166:e93-e98. [PMID: 35779752 DOI: 10.1016/j.wneu.2022.06.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Superior semicircular canal dehiscence (SSCD) is defined by a bony defect overlying the superior semicircular canal (SSC) in the middle cranial fossa floor, causing a myriad of vestibular and auditory symptoms. Patients with thin bone without full dehiscence overlying the SSC also present with similar symptoms. There are currently no guidelines for surgical management of patients with thin bone. The authors offer their experience with thin bone patients to characterize their symptomatology and explore whether these patients benefit from surgical intervention typically offered to SSCD patients. METHODS Two hundred fifty-six patients evaluated for SSCD from 2011 to 2019 were reviewed. High-resolution coronal computed tomography scans with 0.6-mm slice thickness of the temporal bones were assessed to determine whether the patient had a true dehiscence or a thin bone covering overlying the SSC. Bone that was ≤0.5 mm was considered to be "thin bone." Parameters of interest included patient demographics as well as preoperative and postoperative symptomatology. A P value < 0.05 was considered statistically significant. RESULTS Forty-eight patients met inclusion criteria of having "thin bone." The mean age was 48.13 ± 12.03 years, and 65.5% of patients were female. Of the preoperative symptoms evaluated, the greatest postoperative symptomatic resolution was noted in hearing loss (92.3%), vertigo (94.4%), and oscillopsia (100%). Dizziness (56.5%) had the lowest symptomatic resolution rate. CONCLUSIONS Surgical management of thin bone patients via middle fossa craniotomy, a similar technique to SSCD repair, provides significant symptomatic resolution. Therefore, surgery should be considered in thin bone patients with debilitating symptoms, albeit not having a true dehiscence.
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Affiliation(s)
- Michelle Hong
- UCLA Department of Head and Neck Surgery, Los Angeles, California, USA
| | | | - Benjamin Uy
- UCLA Department of Neurosurgery, Los Angeles, California, USA
| | - Wi Jin Kim
- UCLA Department of Neurosurgery, Los Angeles, California, USA
| | - Amith Umesh
- UCLA Department of Neurosurgery, Los Angeles, California, USA
| | - Anubhav Chandla
- UCLA Department of Neurosurgery, Los Angeles, California, USA
| | | | - Isaac Yang
- UCLA Department of Head and Neck Surgery, Los Angeles, California, USA; UCLA Department of Neurosurgery, Los Angeles, California, USA; Office of the Patient Experience at UCLA, Los Angeles, California, USA; UCLA Department of Radiation Oncology, Los Angeles, California, USA; UCLA Jonsson Comprehensive Cancer Center, Los Angeles, California, USA; Los Angeles Biomedical Research Institute (LA BioMed) at Harbor-UCLA Medical Center, Torrance, California, USA.
| | - Quinton Gopen
- UCLA Department of Head and Neck Surgery, Los Angeles, California, USA; UCLA Department of Radiation Oncology, Los Angeles, California, USA; UCLA Jonsson Comprehensive Cancer Center, Los Angeles, California, USA
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12
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Kim WJ, Samarage HM, Zarrin D, Goel K, Chan C, Qi X, Wang A, Shivkumar K, Ardell J, Colby GP. Superior cervical ganglion stimulation results in potent cerebral vasoconstriction in swine. J Vasc Interv Neurol 2022; 13:35-41. [PMID: 36447624 PMCID: PMC9703949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Sympathetic activity from the superior cervical ganglion (SCG) has been shown to cause cerebral hypoperfusion in swine, similar to that seen with clinical cerebral vasospasm. Although the mechanism of such perfusion deficit has been speculated to be from pathologic cerebral vasoconstriction, the extent of sympathetic contribution to vasoconstriction has not been wellestablished. OBJECTIVE We aimed to demonstrate that SCG stimulation in swine leads to significant cerebral vasoconstriction on digital subtraction angiography (DSA). Additionally, we aimed to show that inhibition of SCG can mitigate the effects of sympathetic-mediated cerebral vasoconstriction. METHODS Five SCGs were surgically identified in Yorkshire swine and were electrically stimulated to achieve sympathetic activation. DSA was performed to measure and compare changes in cerebral vessel diameter. Syngo iFlow was also used to quantify changes in contrast flow through the cerebral and neck vessels. RESULTS SCG stimulation resulted in 35-45% narrowing of the ipsilateral ascending pharyngeal, anterior middle cerebral and anterior cerebral arteries. SCG stimulation also decreased contrast flow through ipsilateral ascending pharyngeal, internal carotid and anterior cerebral arteries as seen on iFLow. These effects were prevented with prior SCG blockade. Minimal vessel caliber changes were seen in the posterior cerebral, posterior middle cerebral and internal carotid arteries with SCG stimulation. CONCLUSION SCG stimulation results in significant luminal narrowing and reduction in flow through various intracranial arteries in swine. The results of sympathetic hyperactivity from the SCG closely models cerebral vasoconstriction seen in human cerebral vasospasm. SCG inhibition is a potential promising therapeutic approach to treating cerebral vasospasm.
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Affiliation(s)
- Wi Jin Kim
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Hasitha Milan Samarage
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - David Zarrin
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Keshav Goel
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Christopher Chan
- Cardiac Arrhythmia Center, Department of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Xin Qi
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Anthony Wang
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Kalyanam Shivkumar
- Cardiac Arrhythmia Center, Department of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Jeffrey Ardell
- Cardiac Arrhythmia Center, Department of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Geoffrey P. Colby
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
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13
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Samarage HM, Kim WJ, Zarrin D, Goel K, Chin-Hsiu Wang A, Johnson J, Kaneko N, Nour M, Szeder V, Tateshima S, Jahan R, Duckwiler G, Colby GP. The "Bright Falx" Sign-Midline Embolic Penetration Is Associated With Faster Resolution of Chronic Subdural Hematoma After Middle Meningeal Artery Embolization: A Case Series. Neurosurgery 2022; 91:389-398. [PMID: 35551167 DOI: 10.1227/neu.0000000000002038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 04/03/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Chronic subdural hematomas (CSDHs) are common in the elderly population and patients taking antiplatelet/anticoagulation medications. Middle meningeal artery (MMA) embolization has become an adjunctive treatment to observation and surgery. Despite many embolization techniques, best practices for optimal CSDH resolution remain unknown. OBJECTIVE To report a retrospective case series of MMA embolization for CSDHs regarding rate of hematoma improvement and the significance of distal embolic penetration into the falx. METHODS Retrospective chart review was performed on all patients who underwent MMA embolization for CSDHs between January 2017 and June 2021. Patient demographics, clinical presentation, anticoagulant use, and radiographic features were collected. Pre-embolization and postembolization computed tomography scans were analyzed for volumetric changes and assessed for midline penetration of embolic material in the falx. RESULTS MMA embolization was performed in 37 patients and 53 hemispheres. Older patients took longer to obtain complete resolution of CSDHs (r = 0.47, P = .03). Patients with larger pre-embolization (r = 0.57, P = .007) and postembolization (r = 0.56, P = .008) CSDH volumes took longer to completely resolve. Patients who had n-butyl cyanoacrylate embolization with midline penetration, as evidenced by the "bright falx" sign, had faster improvement rates than those who did not (5.64 cm3/d vs 1.2 cm3/d, P = .02). CONCLUSION Distal penetration of embolic material, particularly n-butyl cyanoacrylate, into the falx may lead to more rapid improvement of CSDH.
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Affiliation(s)
- Hasitha Milan Samarage
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Wi Jin Kim
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - David Zarrin
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Keshav Goel
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Anthony Chin-Hsiu Wang
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Jeremiah Johnson
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Naoki Kaneko
- Department of Interventional Neuroradiology, University of California Los Angeles, Los Angeles, California, USA
| | - May Nour
- Department of Interventional Neuroradiology, University of California Los Angeles, Los Angeles, California, USA
| | - Viktor Szeder
- Department of Interventional Neuroradiology, University of California Los Angeles, Los Angeles, California, USA
| | - Satoshi Tateshima
- Department of Interventional Neuroradiology, University of California Los Angeles, Los Angeles, California, USA
| | - Reza Jahan
- Department of Interventional Neuroradiology, University of California Los Angeles, Los Angeles, California, USA
| | - Gary Duckwiler
- Department of Interventional Neuroradiology, University of California Los Angeles, Los Angeles, California, USA
| | - Geoffrey Philip Colby
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA.,Department of Interventional Neuroradiology, University of California Los Angeles, Los Angeles, California, USA
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14
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Kim WJ, Dacey M, Samarage HM, Zarrin D, Goel K, Chan C, Qi X, Wang A, Shivkumar K, Ardell J, Colby G. Sympathetic nervous system hyperactivity results in potent cerebral hypoperfusion in swine. Auton Neurosci 2022; 241:102987. [DOI: 10.1016/j.autneu.2022.102987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 04/14/2022] [Accepted: 05/04/2022] [Indexed: 11/28/2022]
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15
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Zhang X, Kim WJ, Rao AV, Jaman E, Deibert CP, Sandlesh P, Krueger K, Allen JC, Amankulor NM. In vivo efficacy of decitabine as a natural killer cell-mediated immunotherapy against isocitrate dehydrogenase mutant gliomas. Neurosurg Focus 2022; 52:E3. [PMID: 35104792 DOI: 10.3171/2021.11.focus21489] [Citation(s) in RCA: 2] [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] [Received: 08/17/2021] [Accepted: 11/17/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Isocitrate dehydrogenase (IDH) mutations are found in more than 80% of low-grade gliomas and in the majority of secondary glioblastomas. IDH mutation (IDHmut) leads to aberrant production of an oncogenic metabolite that promotes epigenetic dysregulation by inducing hypermethylation to suppress transcription of various tumor suppressor genes. Hypermethylation in IDHmut gliomas leads to transcriptional repression of NKG2D ligands, especially UL16-binding protein (ULBP)-1 and ULBP-3, and subsequent evasion of natural killer (NK) cell-mediated lysis. The demethylating agent 5-aza-2'deoxycytodine (decitabine [DAC]) is a DNA methyltransferase 1 inhibitor that prevents hypermethylation and is capable of restoring NKG2D ligand expression in IDHmut gliomas to resensitize them to NK cells. Given its capacity for sustained epigenetic reprogramming, the authors hypothesized that DCA would be an effective immunotherapeutic agent in treating IDHmut gliomas in an NK cell-dependent manner by upregulating epigenetically repressed activating NKG2D ligands in IDHmut tumors. In this study, the authors sought to use a glioma stem cell, preclinical animal model to determine the efficacy of DAC in IDHmut and IDH wild-type (IDHwt) tumors, and to characterize whether the activity of DAC in gliomas is dependent on NK cell function. METHODS Xenograft models of IDHwt and IDHmut gliomas were established in athymic-nude mice. When tumors were grossly visible and palpable, mice were treated with either DCA or dimethylsulfoxide intraperitoneally every 7 days. Tumor sizes were measured every 2 to 3 days. After the animals were euthanized, xenografts were harvested and analyzed for the following: tumor expression of NKG2D ligands, tumor susceptibility to human and murine NK cells, immunohistochemistry for NK infiltration, and tumor-infiltrating lymphocyte characterization. RESULTS DAC significantly inhibited the growth of IDHmut xenografts in the athymic nude mice. This effect was abrogated with NK cell depletion. Ex vivo analysis of tumor cells from harvested xenografts confirmed that DAC increased NKG2D ligand ULBP-1 and ULBP-3 expressions, and enhanced susceptibility to lysis of both human and murine IDHmut glial cells with corresponding NK cells. Immunohistochemical analysis of the xenografts indicated that DCA-treated IDHmut gliomas had a greater level of NK infiltration into the tumor compared with the negative control. Finally, DCA radically altered the tumor-infiltrating lymphocyte landscape of IDHmut glioma xenografts by increasing NK cells, dendritic cells, and M1 macrophages, while decreasing suppressive monocyte infiltration. CONCLUSIONS DCA displayed novel immunotherapeutic functions in IDHmut gliomas. This effect was critically dependent on NK cells. Additionally, DCA significantly altered the tumor immune landscape in IDHmut gliomas from suppressive to proinflammatory.
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Affiliation(s)
- Xiaoran Zhang
- 1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh
| | - Wi Jin Kim
- 2Department of Neurological Surgery, University of California, Los Angeles, California
| | - Aparna V Rao
- 1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh
| | - Emade Jaman
- 3University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; and
| | | | - Poorva Sandlesh
- 1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh
| | - Katharine Krueger
- 1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh
| | - Jordan C Allen
- 1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh
| | - Nduka M Amankulor
- 1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh
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16
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Kang J, Oh YM, Lee JH, Kim EK, Lim SY, Kim WJ, Yoon HI, Kim TH, Park TS, Kim SO, Lee SW, Lee SD, Lee JS. Distinctive patterns of pulmonary function change according to baseline lung volume and diffusing capacity. Int J Tuberc Lung Dis 2021; 24:597-605. [PMID: 32553011 DOI: 10.5588/ijtld.19.0401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING: Multicentre retrospective study in South Korea.OBJECTIVE: To longitudinally evaluate changes in lung volume and diffusing capacity for carbon monoxide (DLCO) with forced expiratory volume in 1 sec (FEV1).DESIGN: A total of 155 patients with chronic obstructive pulmonary disease (COPD), whose pulmonary function parameters were measured annually for 5 years, were selected from a prospective cohort in South Korea. A random coefficients model was used to estimate mean annual FEV1, lung volume parameter and DLCO change rates.RESULTS: Patients were classified into four groups based on baseline DLCO and residual volume/total lung capacity (RV/TLC) measurements. The annual FEV1 decline rate was greater in patients with low DLCO than in those with normal DLCO, with the greatest decline occurring in patients with low DLCO and normal RV/TLC. RV and RV/TLC declined in patients with high RV/TLC, whereas these increased in patients with normal RV/TLC. DLCO decreased longitudinally in all four groups, with the greatest decline occurring in patients with normal DLCO and normal RV/TLC.CONCLUSIONS: Different subgroups of patients with COPD exhibited distinctive pulmonary function change patterns. Baseline DLCO and RV/TLC may be used as physiological markers to predict long-term changes in pulmonary function.
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Affiliation(s)
- J Kang
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - Y-M Oh
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - J-H Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Bundang CHA Hospital, College of Medicine, CHA University, Seongnam
| | - E K Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Bundang CHA Hospital, College of Medicine, CHA University, Seongnam
| | - S Y Lim
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul
| | - W J Kim
- Department of Internal Medicine, College of Medicine, Kangwon National University, Chuncheon
| | - H I Yoon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam
| | - T-H Kim
- Division of Pulmonology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri
| | - T S Park
- Division of Pulmonology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri
| | - S O Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, South Korea
| | - S W Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - S-D Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - J S Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul
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17
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Abstract
Patients with cleidocranial dysplasia (CCD) caused by mutations in RUNX2 have severe dental anomalies, including delayed or absent eruption of permanent teeth. This requires painful and expensive surgical/orthodontic intervention because of the absence of medicine for this condition. Here, we demonstrate that nicotinamide, a vitamin B3 and class III histone deacetylase inhibitor, significantly improves delayed tooth eruption in Runx2+/- mice, a well-known CCD animal model, through the restoration of decreased osteoclastogenesis. We also found that Csf1 mRNA and protein levels were significantly reduced in Runx2+/- osteoblasts as compared with wild type whereas RANKL and OPG levels had no significant difference between wild type and Runx2+/- osteoblasts. The nicotinamide-induced restoration of osteoclastogenesis of bone marrow-derived macrophages in Runx2+/- mice was due to the increased expression of RUNX2 and CSF1 and increased RANKL/OPG ratio. RUNX2 directly regulated Csf1 mRNA expression via binding to the promoter region of the Csf1 gene. In addition, nicotinamide enhanced the RUNX2 protein level and transacting activity posttranslationally with Sirt2 inhibition. Taken together, our study shows the potential and underlying molecular mechanism of nicotinamide for the treatment of delayed tooth eruption by using the Runx2+/- murine model, suggesting nicotinamide as a candidate therapeutic drug for dental abnormalities in patients with CCD.
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Affiliation(s)
- H Yoon
- Department of Molecular Genetics and Pharmacology, School of Dentistry and Dental Research Institute, BK21 Program, Seoul National University, Seoul, Republic of Korea
| | - H J Kim
- Department of Molecular Genetics and Pharmacology, School of Dentistry and Dental Research Institute, BK21 Program, Seoul National University, Seoul, Republic of Korea
| | - H R Shin
- Department of Molecular Genetics and Pharmacology, School of Dentistry and Dental Research Institute, BK21 Program, Seoul National University, Seoul, Republic of Korea
| | - B S Kim
- Department of Molecular Genetics and Pharmacology, School of Dentistry and Dental Research Institute, BK21 Program, Seoul National University, Seoul, Republic of Korea
| | - W J Kim
- Department of Molecular Genetics and Pharmacology, School of Dentistry and Dental Research Institute, BK21 Program, Seoul National University, Seoul, Republic of Korea
| | - Y D Cho
- Department of Periodontology, School of Dentistry and Dental Research Institute, BK21 Program, Seoul National University, Seoul, Republic of Korea
| | - H M Ryoo
- Department of Molecular Genetics and Pharmacology, School of Dentistry and Dental Research Institute, BK21 Program, Seoul National University, Seoul, Republic of Korea
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18
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Newall AT, Leong RNF, Nazareno A, Muscatello DJ, Wood JG, Kim WJ. Delay-adjusted age- and sex-specific case fatality rates for COVID-19 in South Korea: Evolution in the estimated risk of mortality throughout the epidemic. Int J Infect Dis 2020; 101:306-311. [PMID: 33011281 PMCID: PMC7529598 DOI: 10.1016/j.ijid.2020.09.1478] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/27/2020] [Accepted: 09/29/2020] [Indexed: 12/24/2022] Open
Abstract
Objectives The aim of this study was to estimate delay-adjusted case fatality rates (CFRs) for COVID-19 in South Korea, and evaluate how these estimates have evolved over time throughout the epidemic. Methods Public data from the Korea Centers for Disease Control and Prevention (KCDC) were used to estimate age- and sex-specific CFRs for COVID-19 in South Korea up to June 12, 2020. We applied statistical methods previously developed to adjust for the delay between diagnosis and death, and presented both delay-adjusted and crude (unadjusted) CFRs throughout the epidemic. Results The overall estimated delay-adjusted CFR was 2.39% (3.05% for males and 1.92% for females). Within each age strata where deaths were reported, males were found to have significantly higher CFRs than females. The estimated CFRs increased substantially from age 60 years in males and from 70 years in females. Both the delay-adjusted and crude CFRs were found to have evolved substantially, particularly early in the epidemic, converging only from mid-April 2020. Conclusions The CFRs for South Korea provide an estimate of mortality risk in a setting where case ascertainment is likely to be more complete. The evolution in CFRs throughout the epidemic highlights the need for caution when interpreting CFRs calculated at a given time point.
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Affiliation(s)
- A T Newall
- School of Public Health and Community Medicine, University of NSW, Sydney, NSW, Australia.
| | - R N F Leong
- School of Public Health and Community Medicine, University of NSW, Sydney, NSW, Australia.
| | - A Nazareno
- School of Public Health and Community Medicine, University of NSW, Sydney, NSW, Australia.
| | - D J Muscatello
- School of Public Health and Community Medicine, University of NSW, Sydney, NSW, Australia.
| | - J G Wood
- School of Public Health and Community Medicine, University of NSW, Sydney, NSW, Australia.
| | - W J Kim
- Department of Infectious Diseases, Guro Hospital, Korea University College of Medicine, Seoul, South Korea.
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19
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Baharvahdat H, Ooi YC, Kim WJ, Mowla A, Coon AL, Colby GP. Updates in the management of cranial dural arteriovenous fistula. Stroke Vasc Neurol 2019; 5:50-58. [PMID: 32411408 PMCID: PMC7213517 DOI: 10.1136/svn-2019-000269] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 10/23/2019] [Accepted: 11/11/2019] [Indexed: 11/21/2022] Open
Abstract
Dural arteriovenous fistula (dAVF) accounts for approximately 10% of all intracranial vascular malformations. While they can be benign lesions, the presence of retrograde venous drainage and cortical venous reflux makes the natural course of these lesions aggressive high risk of haemorrhage, neurological injury and mortality. Endovascular treatment is often the first line of treatment for dAVF. Both transarterial and transvenous approaches are used to cure dAVF. The selection of treatment approach depends on the angioarchitecture of the dAVF, the location, the direction of venous flow. Surgery and, to a lesser extent, stereotactic radiosurgery are used when endovascular approaches are impossible or unsuccessful.
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Affiliation(s)
- Humain Baharvahdat
- Neurosurgery, Ronald Reagan UCLA Medical Center, Los Angeles, California, USA
| | - Yinn Cher Ooi
- Neurointerventional Radiology, UCLA, Los Angeles, California, USA
| | - Wi Jin Kim
- Neurosurgery, Ronald Reagan UCLA Medical Center, Los Angeles, California, USA
| | - Ashkan Mowla
- Neurointerventional Radiology, UCLA, Los Angeles, California, USA
| | | | - Geoffrey P Colby
- Neurosurgery, Ronald Reagan UCLA Medical Center, Los Angeles, California, USA
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20
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Jeong HT, Kim WJ. Comparison of Hot Deformation Behavior Characteristics Between As-Cast and Extruded Al-Zn-Mg-Cu (7075) Aluminum Alloys with a Similar Grain Size. Materials (Basel) 2019; 12:ma12233807. [PMID: 31756980 PMCID: PMC6926894 DOI: 10.3390/ma12233807] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 11/14/2019] [Accepted: 11/18/2019] [Indexed: 11/26/2022]
Abstract
The hot compressive behavior and processing maps of as-cast and extruded 7075 aluminum alloys with a similar grain size (320–350 μm) were studied and compared, which allows us to directly observe the effect of segregated phases in the as-cast microstructure on the deformation behavior and hot workability of 7075 alloys. In the as-cast alloy, the compound phases segregated along the interdendritic interfaces within the interiors of original grains provided the additional sites for continuous dynamic recrystallization via the particle stimulation nucleation mechanism. As a result, the as-cast alloy exhibited higher fractions of recrystallized grains and smaller grain sizes than the extruded alloy after compression. The stress exponent values of the as-cast alloy were smaller than those of the extruded alloy. In the processing maps, the domain associated with high power dissipation efficiencies (≥35%) occurred in a wider temperature range in the as-cast alloy compared to the extruded alloy. The segregated phases that remained undissolved in the as-cast alloy after compressive deformation could be effectively eliminated during the solid solution treatment (753 K for 2 h) for T6 aging applied after hot compression. The current results suggest the possibility and advantage of omitting the extrusion step when preparing 7xxx aluminum forging or extrusion feedstocks for hot working. The proposed method can be applied to other precipitation hardenable aluminum alloys.
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Affiliation(s)
- H T Jeong
- Department of Materials Science and Engineering, Hongik University, Mapo-gu, Sangsu-dong 72-1, Seoul 121-791, Korea
| | - W J Kim
- Department of Materials Science and Engineering, Hongik University, Mapo-gu, Sangsu-dong 72-1, Seoul 121-791, Korea
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21
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Abstract
Visual signs and symptoms are a common manifestation of pituitary adenomas from compression or ischemia of the optic nerves and optic chiasm. Although bitemporal hemianopsia is a classic presenting visual field deficit, additional visual disturbances can result from these tumors. After endoscopic endonasal pituitary surgery, most patients have improvement in visual symptoms. Preoperative factors including retinal nerve fiber layer thickness, severity of preoperative deficit, duration of visual symptoms, tumor size, extent of resection, and patient age serve as possible predictors of postoperative visual outcomes.
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Affiliation(s)
- Benjamin Uy
- Department of Neurosurgery, University California Los Angeles, 300 Stein Plaza Driveway #420, Los Angeles, CA 90095, USA
| | - Bayard Wilson
- Department of Neurosurgery, University California Los Angeles, 300 Stein Plaza Driveway #420, Los Angeles, CA 90095, USA
| | - Wi Jin Kim
- Department of Neurosurgery, University California Los Angeles, 300 Stein Plaza Driveway #420, Los Angeles, CA 90095, USA
| | - Giyarpuram Prashant
- Department of Neurosurgery, University California Los Angeles, 300 Stein Plaza Driveway #420, Los Angeles, CA 90095, USA
| | - Marvin Bergsneider
- Department of Neurosurgery, University California Los Angeles, 300 Stein Plaza Driveway #420, Los Angeles, CA 90095, USA.
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22
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Kim WJ, Zhang X, Agarwal N, Gross BA, Safonova A, Jankowitz BT, Friedlander RM. Utility of surveillance imaging for spontaneous intracerebral hemorrhage. J Clin Neurosci 2019; 69:132-138. [PMID: 31427239 DOI: 10.1016/j.jocn.2019.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 08/04/2019] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Management of spontaneous intracerebral hemorrhage involves reversal of coagulopathy, neurological examinations and repeated imaging. Repeated imaging is employed to identify patients prior to neurological deterioration, however, there is no data to support this practice. As such, we strive to identify the utility of surveillance imaging as well as the risks factors that are associated with higher likelihood of developing a clinically significant hematoma progression. METHODS A retrospective chart analysis of 200 consecutive patients was performed on patients with non-traumatic intracerebral hemorrhage. Patients with non-parenchymal hemorrhage, vascular malformations, patients that required surgical intervention based on the initial scan/neurological exam, and trauma were excluded. Patient demographics, blood pressure, presence of a new neurological deficit, progression of hematoma, surgical intervention and mortality were gathered from the chart. RESULTS Hematoma progression of greater than 5 mL was seen in 24 patients (12%) on repeat imaging. Large initial hematoma volume, early time from symptom onset to initial imaging, and new neurological deterioration between scans were significantly associated with significant hematoma progression. Of the 24 patients with hematoma progression greater 5 mL, five patients did not develop neurological deterioration. None of these patients required intervention. CONCLUSION Routine imaging in patients with spontaneous intracerebral hemorrhages does not alter clinical management. Rather, careful neurologic monitoring may be safe and more clinically useful in these patients.
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Affiliation(s)
- Wi Jin Kim
- Department of Neurological Surgery, University of Pittsburgh Medical Center, 200 Lothrop Street Suite B400, Pittsburgh, PA 15213, United States
| | - Xiaoran Zhang
- Department of Neurological Surgery, University of Pittsburgh Medical Center, 200 Lothrop Street Suite B400, Pittsburgh, PA 15213, United States
| | - Nitin Agarwal
- Department of Neurological Surgery, University of Pittsburgh Medical Center, 200 Lothrop Street Suite B400, Pittsburgh, PA 15213, United States
| | - Bradley A Gross
- Department of Neurological Surgery, University of Pittsburgh Medical Center, 200 Lothrop Street Suite B400, Pittsburgh, PA 15213, United States
| | - Aleksandra Safonova
- Department of Neurological Surgery, University of Pittsburgh Medical Center, 200 Lothrop Street Suite B400, Pittsburgh, PA 15213, United States
| | - Brian T Jankowitz
- Department of Neurological Surgery, University of Pittsburgh Medical Center, 200 Lothrop Street Suite B400, Pittsburgh, PA 15213, United States
| | - Robert M Friedlander
- Department of Neurological Surgery, University of Pittsburgh Medical Center, 200 Lothrop Street Suite B400, Pittsburgh, PA 15213, United States.
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Kim WJ, Gupta V, Nishimura M, Makita H, Idolor L, Roa C, Loh LC, Ong CK, Wang JS, Boonsawat W, Gunasekera KD, Madegedara D, Kuo HP, Wang CH, Wang C, Yang T, Lin YX, Ko FWS, Hui DSC, Lan LTT, Vu QTT, Bhome AB, Ng A, Seo JB, Lee BY, Lee JS, Oh YM, Lee SD. Identification of chronic obstructive pulmonary disease subgroups in 13 Asian cities. Int J Tuberc Lung Dis 2019; 22:820-826. [PMID: 29914609 DOI: 10.5588/ijtld.17.0524] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a heterogeneous condition that can differ in its clinical manifestation, structural changes and response to treatment. OBJECTIVE To identify subgroups of COPD with distinct phenotypes, evaluate the distribution of phenotypes in four related regions and calculate the 1-year change in lung function and quality of life according to subgroup. METHODS Using clinical characteristics, we performed factor analysis and hierarchical cluster analysis in a cohort of 1676 COPD patients from 13 Asian cities. We compared the 1-year change in forced expiratory volume in one second (FEV1), modified Medical Research Council dyspnoea scale score, St George's Respiratory Questionnaire (SGRQ) score and exacerbations according to subgroup derived from cluster analysis. RESULTS Factor analysis revealed that body mass index, Charlson comorbidity index, SGRQ total score and FEV1 were principal factors. Using these four factors, cluster analysis identified three distinct subgroups with differing disease severity and symptoms. Among the three subgroups, patients in subgroup 2 (severe disease and more symptoms) had the most frequent exacerbations, most rapid FEV1 decline and greatest decline in SGRQ total score. CONCLUSION Three subgroups with differing severities and symptoms were identified in Asian COPD subjects.
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Affiliation(s)
- W J Kim
- Department of Internal Medicine, Kangwon National University, Chuncheon, Korea
| | - V Gupta
- Department of Internal Medicine, Kangwon National University, Chuncheon, Korea, Adesh Institute of Medical Sciences and Research, Bathinda, India
| | - M Nishimura
- Division of Respiratory Medicine, Department of Internal Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - H Makita
- Division of Respiratory Medicine, Department of Internal Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - L Idolor
- Section of Respiratory Services and Physical Therapy and Rehabilitation Lung Center of the Philippines, Quezon City
| | - C Roa
- College of Medicine and Philippine General Hospital, University of the Philippines, Manila, The Philippines
| | - L-C Loh
- Department of Medicine, Penang Medical College, Penang, Malaysia
| | - C-K Ong
- Department of Medicine, Penang Medical College, Penang, Malaysia
| | - J-S Wang
- Taipei Medical University, Taipei, Taiwan
| | - W Boonsawat
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - K D Gunasekera
- Central Chest Clinic, National Hospital of Sri Lanka, Colombo
| | - D Madegedara
- Respiratory Disease Treatment Unit, Teaching Hospital Kandy, Kandy, Sri Lanka
| | - H-P Kuo
- Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - C-H Wang
- Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - C Wang
- Department of Respiratory and Critical Care Medicine, Beijing China-Japan Friendship Hospital, Beijing
| | - T Yang
- Department of Respiratory and Critical Care Medicine, Beijing China-Japan Friendship Hospital, Beijing
| | - Y-X Lin
- Beijing Institute of Respiratory Medicine, Department of Respiratory and Critical Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing
| | - F W S Ko
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - D S C Hui
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - L T T Lan
- Respiratory Care Center, University Medical Center, Ho Chi Minh City, Viet Nam
| | - Q T T Vu
- Respiratory Care Center, University Medical Center, Ho Chi Minh City, Viet Nam
| | - A B Bhome
- Indian Coalition of Obstructive Lung Diseases Network, Pune, Maharashtra, India
| | - A Ng
- Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore
| | - J B Seo
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - B Y Lee
- Division of Allergy and Respiratory Diseases, Soon Chun Hyang University Hospital, Seoul
| | - J S Lee
- Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Y-M Oh
- Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - S-D Lee
- Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Shin HR, Bae HS, Kim BS, Yoon HI, Cho YD, Kim WJ, Choi KY, Lee YS, Woo KM, Baek JH, Ryoo HM. PIN1 is a new therapeutic target of craniosynostosis. Hum Mol Genet 2019; 27:3827-3839. [PMID: 30007339 PMCID: PMC6216213 DOI: 10.1093/hmg/ddy252] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 07/05/2018] [Indexed: 01/14/2023] Open
Abstract
Gain-of-function mutations in fibroblast growth factor receptors (FGFRs) cause congenital skeletal anomalies, including craniosynostosis (CS), which is characterized by the premature closure of craniofacial sutures. Apert syndrome (AS) is one of the severest forms of CS, and the only treatment is surgical expansion of prematurely fused sutures in infants. Previously, we demonstrated that the prolyl isomerase peptidyl-prolyl cis-trans isomerase interacting 1 (PIN1) plays a critical role in mediating FGFR signaling and that Pin1+/- mice exhibit delayed closure of cranial sutures. In this study, using both genetic and pharmacological approaches, we tested whether PIN1 modulation could be used as a therapeutic regimen against AS. In the genetic approach, we crossbred Fgfr2S252W/+, a mouse model of AS, and Pin1+/- mice. Downregulation of Pin1 gene dosage attenuated premature cranial suture closure and other phenotypes of AS in Fgfr2S252W/+ mutant mice. In the pharmacological approach, we intraperitoneally administered juglone, a PIN1 enzyme inhibitor, to pregnant Fgfr2S252W/+ mutant mice and found that this treatment successfully interrupted fetal development of AS phenotypes. Primary cultured osteoblasts from Fgfr2S252W/+ mutant mice expressed high levels of FGFR2 downstream target genes, but this phenotype was attenuated by PIN1 inhibition. Post-translational stabilization and activation of Runt-related transcription factor 2 (RUNX2) in Fgfr2S252W/+ osteoblasts were also attenuated by PIN1 inhibition. Based on these observations, we conclude that PIN1 enzyme activity is important for FGFR2-induced RUNX2 activation and craniofacial suture morphogenesis. Moreover, these findings highlight that juglone or other PIN1 inhibitors represent viable alternatives to surgical intervention for treatment of CS and other hyperostotic diseases.
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Affiliation(s)
- H R Shin
- BK21 Program, Department of Molecular Genetics and Dental Pharmacology and Therapeutics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - H S Bae
- BK21 Program, Department of Molecular Genetics and Dental Pharmacology and Therapeutics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - B S Kim
- BK21 Program, Department of Molecular Genetics and Dental Pharmacology and Therapeutics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - H I Yoon
- BK21 Program, Department of Molecular Genetics and Dental Pharmacology and Therapeutics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Y D Cho
- BK21 Program, Department of Molecular Genetics and Dental Pharmacology and Therapeutics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea.,Department of Periodontology, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - W J Kim
- BK21 Program, Department of Molecular Genetics and Dental Pharmacology and Therapeutics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - K Y Choi
- Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Y S Lee
- BK21 Program, Department of Molecular Genetics and Dental Pharmacology and Therapeutics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - K M Woo
- BK21 Program, Department of Molecular Genetics and Dental Pharmacology and Therapeutics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - J H Baek
- BK21 Program, Department of Molecular Genetics and Dental Pharmacology and Therapeutics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - H M Ryoo
- BK21 Program, Department of Molecular Genetics and Dental Pharmacology and Therapeutics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
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Kim WJ, Newman WC, Amankulor NM. Phase I/II Trial of Combination of Temozolomide Chemotherapy and Immunotherapy With Fusions of Dendritic and Glioma Cells in Patients With Glioblastoma. Neurosurgery 2018; 81:N11. [PMID: 28873996 DOI: 10.1093/neuros/nyx263] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Wi Jin Kim
- Department of Neurological Surgery University of Pittsburgh Medical Center Pittsburgh, Pennsylvania
| | - W Christopher Newman
- Department of Neurological Surgery University of Pittsburgh Medical Center Pittsburgh, Pennsylvania
| | - Nduka M Amankulor
- Department of Neurological Surgery University of Pittsburgh Medical Center Pittsburgh, Pennsylvania
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Park SH, Kim WJ, Kang DH. Effect of relative humidity on inactivation of foodborne pathogens using chlorine dioxide gas and its residues on tomatoes. Lett Appl Microbiol 2018; 67:154-160. [PMID: 29719930 DOI: 10.1111/lam.13002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 03/27/2018] [Accepted: 04/22/2018] [Indexed: 11/26/2022]
Abstract
The effect of relative humidity (RH) on the antimicrobial efficacy of chlorine dioxide (ClO2 ) gas against foodborne pathogens on tomatoes was evaluated. Also, levels of ClO2 residues on tomatoes after exposure to ClO2 gas under different RH conditions were measured to determine the quantity of solubilized ClO2 gas on tomato surfaces. Escherichia coli O157:H7, Salmonella Typhimurium and Listeria monocytogenes were inoculated on tomatoes and exposed to ClO2 gas (5, 10, 20 and 30 ppmv) under different RH conditions (50, 70 and 90%). As ClO2 gas concentration and treatment time increased, significant differences (P < 0·05) were observed between inactivation levels under different RH conditions. Exposure to 30 ppmv of ClO2 gas (50% RH) for 20 min resulted in 1·22-1·52 log reductions of the three foodborne pathogens. Levels of the three foodborne pathogens were reduced to below the detection limit (0·48 log CFU per cm2 ) within 15 min when exposed to 30 ppmv of ClO2 gas at 70% RH and within 10 min at 90% RH. At a given ClO2 gas concentration, ClO2 residues on tomatoes significantly (P < 0·05) increased with increasing RH, and there were close correlations between log reductions of pathogens and ClO2 residues on tomatoes. SIGNIFICANCE AND IMPACT OF THE STUDY This study reported on the correlation between the amount of ClO2 residues on produce surfaces and the level of inactivation of pathogens after ClO2 gas treatment. Variations in RH have great effect on the solubilization of ClO2 gas on tomato surfaces considering that ClO2 residues on tomatoes increased with increasing RH. Also, the amount of ClO2 residues on tomatoes is positively correlated with the level of inactivation of pathogens. The results of this study provide insights for predicting inactivation patterns of foodborne pathogens by ClO2 gas for practical application by the fresh produce industry.
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Affiliation(s)
- S H Park
- Department of Food and Animal Biotechnology, Center for Food and Bioconvergence, Research Institute for Agriculture and Life Sciences, Seoul National University, Seoul, Korea.,Department of Agricultural Biotechnology, Center for Food and Bioconvergence, Research Institute for Agriculture and Life Sciences, Seoul National University, Seoul, Korea
| | - W J Kim
- Department of Food and Animal Biotechnology, Center for Food and Bioconvergence, Research Institute for Agriculture and Life Sciences, Seoul National University, Seoul, Korea.,Department of Agricultural Biotechnology, Center for Food and Bioconvergence, Research Institute for Agriculture and Life Sciences, Seoul National University, Seoul, Korea
| | - D H Kang
- Department of Food and Animal Biotechnology, Center for Food and Bioconvergence, Research Institute for Agriculture and Life Sciences, Seoul National University, Seoul, Korea.,Department of Agricultural Biotechnology, Center for Food and Bioconvergence, Research Institute for Agriculture and Life Sciences, Seoul National University, Seoul, Korea
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27
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Kim WJ, Zenonos G, McDowell MM, Gardner PA, Engh JA. Cardioversion-Responsive Ventriculoatrial Shunt Malfunction Precipitated by Atrial Fibrillation. World Neurosurg 2018; 114:348-351. [PMID: 29551718 DOI: 10.1016/j.wneu.2018.03.071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 03/06/2018] [Accepted: 03/09/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND Ventriculoatrial shunts are common alternatives for patients who cannot tolerate ventriculoperitoneal shunts. The majority of ventriculoatrial shunt malfunctions are related to mechanical problems. We report an interesting case of ventriculoatrial shunt malfunction due to elevated central venous pressure from new-onset atrial fibrillation. METHODS After the patient was confirmed to have ventriculomegaly, he was taken to the operating room for exploration of his ventriculoatrial shunt; there were no obstructions. Subsequently, the patient was cardioverted to normal sinus rhythm for his new onset atrial fibrillation. RESULTS The clinical syndrome and ventriculomegaly both resolved after the patient's atrial fibrillation was corrected with chemical cardioversion. CONCLUSIONS The cause of this patient's VA shunt malfunction was likely associated with his new onset atrial fibrillation.
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Affiliation(s)
- Wi Jin Kim
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA; University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Georgios Zenonos
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Michael M McDowell
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Paul A Gardner
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Johnathan A Engh
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
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28
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Kim WJ, Kang H, Yang SY, Shin HY, Baek CW, Jung YH, Woo YC, In JY. Effective Dose of Remifentanil for Control of Haemodynamic Response to Insertion of the Streamlined Liner of the Pharyngeal Airway. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791302000404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective To determine the dose of remifentanil needed to achieve successful insertion of the Streamlined Liner of the Pharyngeal Airway (SLIPA™) without the development of hypertension in 95% of the patients. Design Randomised controlled trial. Setting operating theatre of a university hospital Methods A total of 100 ASA I or II patients requiring SLIPA insertion were randomly assigned to receive normal saline (Group C) or one of the four different doses (0.5 µg/kg [Group R0.5], 1.0 µg/kg [Group R1], 1.5 µg/kg [Group R1.5] or 2.0 µg/kg [Group R2]) of remifentanil. Arterial blood pressure and heart rate were recorded at preanesthetic baseline, preinserton, and every one minute during the initial 3 minutes period after insertion. Results A Probit model of remifentanil concentration was predictive of successful insertion of SLIPA without the development of hypertension. The ED95 of remifentanil needed to suppress haemodynamic response from SLIPA insertion was 1.39 µg/kg (95% confidence interval, 1.06-2.61 µg/kg). Conclusions A single administration of remifentanil can effectively suppress haemodynamic changes due to the insertion of SLIPA.
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Affiliation(s)
| | | | | | | | | | | | | | - JY In
- Dongguk University College of Medicine, Department of Anesthesiology and Pain Medicine, Ilsan Hospital, 814, Siksa-dong, Ilsan-gu, Goyang 411-773, Korea
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29
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Kong JS, Jeong CY, Shim MJ, Kim WJ, Yeo SW, Park SN. Comparative study of new autologous material, bone-cartilage composite graft, for ossiculoplasty with Polycel ® and Titanium. Clin Otolaryngol 2017; 43:434-439. [PMID: 28944619 DOI: 10.1111/coa.12987] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Ossiculoplasty is a surgical procedure that recreates sound transmission of the middle ear in conductive hearing loss. Various materials have been used for ossicular reconstruction, but the most ideal material for ossiculoplasty remains controversial. The purpose of this study was to introduce a novel method of autologous ossiculoplasty, bone-cartilage composite graft (BCCG) and to compare its surgical results with different types of ossiculoplastic prostheses. STUDY DESIGN A retrospective study was performed in a tertiary referral centre. METHODS Data of 275 patients who received ossiculoplasty using the three different materials of BCCG, Polycel® and titanium were analysed according to type of ossiculoplasty: partial or total ossicular replacement prosthesis (PORP or TORP). Hearing results, complication rates and clinical parameters including age, sex, past history, preoperative diagnosis and surgery type were compared among different groups. RESULTS Ossiculoplasty with BCCG showed satisfactory hearing outcomes and the lowest complication rate among the three different materials. In particular, its extrusion rate was 0%. CONCLUSION We propose that the BCCG technique is a useful alternative method for ossiculoplasty, with proper patient selection.
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Affiliation(s)
- J S Kong
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - C Y Jeong
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - M J Shim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - W J Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - S W Yeo
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - S N Park
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Newman WC, Kim WJ, Amankulor NM. BRCA1-Regulated RRM2 Expression Protects Glioblastoma Cells from Endogenous Replication Stress and Promotes Tumorigenicity. Neurosurgery 2017; 80:N34. [PMID: 28586489 DOI: 10.1093/neuros/nyx106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- W Christopher Newman
- Department of Neurological Surgery University of Pittsburgh Medical Center Pittsburgh, Pennsylvania
| | - Wi Jin Kim
- University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania
| | - Nduka M Amankulor
- Department of Neurological Surgery University of Pittsburgh Medical Center Pittsburgh, Pennsylvania
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Kim S, Kim H, Kim WJ, Lee SJ, Hong Y, Lee HY, Lim MN, Han SS. Mortality and predictors in pulmonary tuberculosis with respiratory failure requiring mechanical ventilation. Int J Tuberc Lung Dis 2017; 20:524-9. [PMID: 26970163 DOI: 10.5588/ijtld.15.0690] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To analyse the predictors and mortality rate among patients receiving mechanical ventilation (MV) for respiratory failure due to pulmonary tuberculosis (TB). DESIGN We retrospectively compared patients who required MV for TB with patients who required MV for community-acquired pneumonia (CAP). RESULTS In-hospital mortality was significantly different between the two groups: 95.1% in TB vs. 62.7% in CAP (P < 0.001 using the χ(2) test). TB patients had a higher 30-day mortality (P = 0.040 using log-rank test), although the median sequential organ failure assessment (SOFA) (7.0 vs. 6.0, P = 0.842) and mean Acute Physiology and Chronic Health Evaluation (APACHE) II scores (20.0 ± 6.7 vs. 21.2 ± 6.7, P = 0.379) for TB and CAP patients were not different. TB patients were more likely to have increased lung lesion intrusions (OR 1.307, 95%CI 1.042-1.641, P = 0.021), and reduced albumin (OR 0.073, 95%CI 0.016-0.335, P = 0.001), C-reactive protein (OR 0.324, 95%CI 0.146-0.716, P = 0.005) and CURB-65 score (confusion, uraemia, respiratory rate, blood pressure and age ⩾65 years) (OR 0.916, 95%CI 0.844-0.995, P = 0.037). CONCLUSIONS TB patients showed identical SOFA and APACHE II scores, but higher mortality than CAP patients. The higher mortality was not related to severity, but suggested an association with the extent of destructive lung lesions.
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Affiliation(s)
- S Kim
- Department of Internal Medicine, Seoul Medical Center, Seoul, Korea
| | - H Kim
- Department of Internal Medicine, Seoul Medical Center, Seoul, Korea
| | - W J Kim
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - S-J Lee
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - Y Hong
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - H-Y Lee
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - M-N Lim
- Environmental Health Center, Kangwon National University Hospital, Chuncheon, Korea
| | - S-S Han
- Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea
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Peppler WT, Kim WJ, Ethans K, Cowley KC. Precision of dual-energy X-ray absorptiometry of the knee and heel: methodology and implications for research to reduce bone mineral loss after spinal cord injury. Spinal Cord 2016; 55:483-488. [PMID: 27995940 DOI: 10.1038/sc.2016.170] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 10/21/2016] [Accepted: 10/29/2016] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Methodological validation of dual-energy x-ray absorptiometry (DXA)-based measures of leg bone mineral density (BMD) based on the guidelines of the International Society for Clinical Densitometry. OBJECTIVES The primary objective of this study was to determine the precision of BMD estimates at the knee and heel using the manufacturer provided DXA acquisition algorithm. The secondary objective was to determine the smallest change in DXA-based measurement of BMD that should be surpassed (least significant change (LSC)) before suggesting that a biological change has occurred in the distal femur, proximal tibia and calcaneus. SETTING Academic Research Centre, Canada. METHODS Ten people with motor-complete SCI of at least 2 years duration and 10 people from the general population volunteered to have four DXA-based measurements taken of their femur, tibia and calcaneus. BMDs for seven regions of interest (RIs) were calculated, as were short-term precision (root-mean-square (RMS) standard deviation (g cm-2), RMS-coefficient of variation (RMS-CV, %)) and LSC. RESULTS Overall, RMS-CV values were similar between SCI (3.63-10.20%, mean=5.3%) and able-bodied (1.85-5.73%, mean=4%) cohorts, despite lower absolute BMD values at each RIs in those with SCI (35%, heel to 54%, knee; P<0.0001). Precision was highest at the calcaneus and lowest at the femur. Except at the femur, RMS-CV values were under 6%. CONCLUSIONS For DXA-based estimates of BMD at the distal femur, proximal tibia and calcaneus, these precision values suggest that LSC values >10% are needed to detect differences between treated and untreated groups in studies aimed at reducing bone mineral loss after SCI.
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Affiliation(s)
- W T Peppler
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada
| | - W J Kim
- Faculty of Science, University of Manitoba, Winnipeg, MB, Canada
| | - K Ethans
- Section of Physical Medicine and Rehabilitation, Department of Medicine and Rehabilitation, Department of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - K C Cowley
- Department of Physiology and Pathophysiology, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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Kim WJ, Ji Y, Choi G, Kang YM, Yang S, Moon BC. Molecular identification and phylogenetic analysis of important medicinal plant species in genus Paeonia based on rDNA-ITS, matK, and rbcL DNA barcode sequences. Genet Mol Res 2016; 15:gmr8472. [PMID: 27525917 DOI: 10.4238/gmr.15038472] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
This study was performed to identify and analyze the phylogenetic relationship among four herbaceous species of the genus Paeonia, P. lactiflora, P. japonica, P. veitchii, and P. suffruticosa, using DNA barcodes. These four species, which are commonly used in traditional medicine as Paeoniae Radix and Moutan Radicis Cortex, are pharmaceutically defined in different ways in the national pharmacopoeias in Korea, Japan, and China. To authenticate the different species used in these medicines, we evaluated rDNA-internal transcribed spacers (ITS), matK and rbcL regions, which provide information capable of effectively distinguishing each species from one another. Seventeen samples were collected from different geographic regions in Korea and China, and DNA barcode regions were amplified using universal primers. Comparative analyses of these DNA barcode sequences revealed species-specific nucleotide sequences capable of discriminating the four Paeonia species. Among the entire sequences of three barcodes, marker nucleotides were identified at three positions in P. lactiflora, eleven in P. japonica, five in P. veitchii, and 25 in P. suffruticosa. Phylogenetic analyses also revealed four distinct clusters showing homogeneous clades with high resolution at the species level. The results demonstrate that the analysis of these three DNA barcode sequences is a reliable method for identifying the four Paeonia species and can be used to authenticate Paeoniae Radix and Moutan Radicis Cortex at the species level. Furthermore, based on the assessment of amplicon sizes, inter/intra-specific distances, marker nucleotides, and phylogenetic analysis, rDNA-ITS was the most suitable DNA barcode for identification of these species.
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Affiliation(s)
- W J Kim
- K-herb Research Center, Korea Institute of Oriental Medicine, Yuseong-daero, Yuseong-gu, Daejeon, Republic of Korea
| | - Y Ji
- K-herb Research Center, Korea Institute of Oriental Medicine, Yuseong-daero, Yuseong-gu, Daejeon, Republic of Korea
| | - G Choi
- K-herb Research Center, Korea Institute of Oriental Medicine, Yuseong-daero, Yuseong-gu, Daejeon, Republic of Korea
| | - Y M Kang
- K-herb Research Center, Korea Institute of Oriental Medicine, Yuseong-daero, Yuseong-gu, Daejeon, Republic of Korea
| | - S Yang
- K-herb Research Center, Korea Institute of Oriental Medicine, Yuseong-daero, Yuseong-gu, Daejeon, Republic of Korea
| | - B C Moon
- K-herb Research Center, Korea Institute of Oriental Medicine, Yuseong-daero, Yuseong-gu, Daejeon, Republic of Korea
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Kang WH, Hwang S, Song GW, Jung DH, Kim KH, Park GC, Ha TY, Ahn CS, Moon DB, Yoon YI, Shin MH, Kim WJ, Kim SH, Lee SG. Donor Safety and Recipient Liver Function After Right-Lobe Liver Transplantation From Living Donors With Gilbert Syndrome. Transplant Proc 2016; 47:2827-30. [PMID: 26707296 DOI: 10.1016/j.transproceed.2015.10.050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 10/28/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND Donor safety is the most important aspect in living-donor liver transplantation (LDLT). Gilbert syndrome is an autosomal recessive condition that is a common cause of isolated unconjugated hyperbilirubinemia, and its prevalence is not negligibly low in the general population. This study intended to assess donor safety and recipient liver function after LDLT with the use of right liver grafts from living donors with Gilbert syndrome. METHODS Among 2,140 right liver transplantations performed from January 2002 to December 20113 at our institution, we identified 12 living donors (0.6%) who showed a preoperative serum total bilirubin level of ≥2 mg/dL. These donors were clinically diagnosed with Gilbert syndrome. The clinical outcomes of these donors and their recipients were analyzed retrospectively. RESULTS The mean donor age was 24.6 ± 7.1 years, and 11 donors were male. All subjects met the preoperative evaluation conditions for right liver donation except for the level of unconjugated hyperbilirubinemia. The mean serum total bilirubin level of the donors was 2.23 ± 0.20 mg/dL before and 1.79 ± 0.61 mg/dL 1 year after right liver donation. The preoperative donor direct bilirubin level was 0.43 ± 0.19 mg/dL. The preoperative indocyanine green retention rate at 15 minutes was 8.2 ± 2.8%. All donors and recipients recovered uneventfully and were alive at the time of writing. The recipient serum total bilirubin level was 1.29 ± 0.47 mg/dL 1 year after LDLT. CONCLUSIONS We suggest that LDLT with living donors with Gilbert syndrome can be safely performed, but that a meticulous preoperative evaluation is vital to maximize donor safety.
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Affiliation(s)
- W H Kang
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - S Hwang
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | - G W Song
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - D H Jung
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - K H Kim
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - G C Park
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - T Y Ha
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - C S Ahn
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - D B Moon
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Y I Yoon
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - M H Shin
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - W J Kim
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - S H Kim
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - S G Lee
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Zhang X, Rao A, Sette P, Deibert C, Pomerantz A, Kim WJ, Kohanbash G, Chang Y, Park Y, Engh J, Choi J, Chan T, Okada H, Lotze M, Grandi P, Amankulor N. IDH mutant gliomas escape natural killer cell immune surveillance by downregulation of NKG2D ligand expression. Neuro Oncol 2016; 18:1402-12. [PMID: 27116977 DOI: 10.1093/neuonc/now061] [Citation(s) in RCA: 113] [Impact Index Per Article: 14.1] [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: 10/12/2015] [Accepted: 03/20/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Diffuse gliomas are poorly immunogenic, fatal brain tumors. The basis for insufficient antitumor immunity in diffuse gliomas is unknown. Gain-of-function mutations in isocitrate dehydrogenases (IDH1 and IDH2) promote diffuse glioma formation through epigenetic reprogramming of a number of genes, including immune-related genes. Here, we identify epigenetic dysregulation of natural killer (NK) cell ligand genes as significant contributors to immune escape in glioma. METHODS We analyzed the database of The Cancer Genome Atlas for immune gene expression patterns in IDH mutant or wild-type gliomas and identified differentially expressed immune genes. NKG2D ligand expression levels and NK cell-mediated lysis were measured in IDH mutant and wild-type patient-derived glioma stem cells and genetically engineered astrocytes. Finally, we assessed the impact of hypomethylating agent 5-aza-2'deoxycytodine (decitabine) as a potential NK cell sensitizing agent in IDH mutant cells. RESULTS IDH mutant glioma stemlike cell lines exhibited significantly lower expression of NKG2D ligands compared with IDH wild-type cells. Consistent with these findings, IDH mutant glioma cells and astrocytes are resistant to NK cell-mediated lysis. Decitabine increases NKG2D ligand expression and restores NK-mediated lysis of IDH mutant cells in an NKG2D-dependent manner. CONCLUSIONS IDH mutant glioma cells acquire resistance to NK cells through epigenetic silencing of NKG2D ligands ULBP1 and ULBP3. Decitabine-mediated hypomethylation restores ULBP1 and ULBP3 expression in IDH mutant glioma cells and may provide a clinically useful method to sensitize IDH mutant gliomas to NK cell-mediated immune surveillance in patients with IDH mutated diffuse gliomas.
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Affiliation(s)
- Xiaoran Zhang
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (X.Z., W.J.K.); Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (A.P., A.R., C.D., P.S., Y.C., J.E., P.G., N.A.); Department of Neurological Surgery, University of California San Francisco, San Francisco, California (G.K., H.O.); Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania (Y.P.); Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (J.C); Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (T.C); Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (M.L.); Department of Biological Sciences, Carnegie Mellon University, Pittsburgh, Pennsylvania (A.P.)
| | - Aparana Rao
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (X.Z., W.J.K.); Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (A.P., A.R., C.D., P.S., Y.C., J.E., P.G., N.A.); Department of Neurological Surgery, University of California San Francisco, San Francisco, California (G.K., H.O.); Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania (Y.P.); Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (J.C); Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (T.C); Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (M.L.); Department of Biological Sciences, Carnegie Mellon University, Pittsburgh, Pennsylvania (A.P.)
| | - Paola Sette
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (X.Z., W.J.K.); Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (A.P., A.R., C.D., P.S., Y.C., J.E., P.G., N.A.); Department of Neurological Surgery, University of California San Francisco, San Francisco, California (G.K., H.O.); Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania (Y.P.); Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (J.C); Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (T.C); Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (M.L.); Department of Biological Sciences, Carnegie Mellon University, Pittsburgh, Pennsylvania (A.P.)
| | - Christopher Deibert
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (X.Z., W.J.K.); Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (A.P., A.R., C.D., P.S., Y.C., J.E., P.G., N.A.); Department of Neurological Surgery, University of California San Francisco, San Francisco, California (G.K., H.O.); Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania (Y.P.); Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (J.C); Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (T.C); Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (M.L.); Department of Biological Sciences, Carnegie Mellon University, Pittsburgh, Pennsylvania (A.P.)
| | - Alexander Pomerantz
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (X.Z., W.J.K.); Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (A.P., A.R., C.D., P.S., Y.C., J.E., P.G., N.A.); Department of Neurological Surgery, University of California San Francisco, San Francisco, California (G.K., H.O.); Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania (Y.P.); Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (J.C); Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (T.C); Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (M.L.); Department of Biological Sciences, Carnegie Mellon University, Pittsburgh, Pennsylvania (A.P.)
| | - Wi Jin Kim
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (X.Z., W.J.K.); Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (A.P., A.R., C.D., P.S., Y.C., J.E., P.G., N.A.); Department of Neurological Surgery, University of California San Francisco, San Francisco, California (G.K., H.O.); Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania (Y.P.); Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (J.C); Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (T.C); Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (M.L.); Department of Biological Sciences, Carnegie Mellon University, Pittsburgh, Pennsylvania (A.P.)
| | - Gary Kohanbash
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (X.Z., W.J.K.); Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (A.P., A.R., C.D., P.S., Y.C., J.E., P.G., N.A.); Department of Neurological Surgery, University of California San Francisco, San Francisco, California (G.K., H.O.); Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania (Y.P.); Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (J.C); Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (T.C); Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (M.L.); Department of Biological Sciences, Carnegie Mellon University, Pittsburgh, Pennsylvania (A.P.)
| | - Yigang Chang
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (X.Z., W.J.K.); Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (A.P., A.R., C.D., P.S., Y.C., J.E., P.G., N.A.); Department of Neurological Surgery, University of California San Francisco, San Francisco, California (G.K., H.O.); Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania (Y.P.); Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (J.C); Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (T.C); Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (M.L.); Department of Biological Sciences, Carnegie Mellon University, Pittsburgh, Pennsylvania (A.P.)
| | - Yongseok Park
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (X.Z., W.J.K.); Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (A.P., A.R., C.D., P.S., Y.C., J.E., P.G., N.A.); Department of Neurological Surgery, University of California San Francisco, San Francisco, California (G.K., H.O.); Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania (Y.P.); Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (J.C); Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (T.C); Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (M.L.); Department of Biological Sciences, Carnegie Mellon University, Pittsburgh, Pennsylvania (A.P.)
| | - Johnathan Engh
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (X.Z., W.J.K.); Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (A.P., A.R., C.D., P.S., Y.C., J.E., P.G., N.A.); Department of Neurological Surgery, University of California San Francisco, San Francisco, California (G.K., H.O.); Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania (Y.P.); Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (J.C); Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (T.C); Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (M.L.); Department of Biological Sciences, Carnegie Mellon University, Pittsburgh, Pennsylvania (A.P.)
| | - Jaehyuk Choi
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (X.Z., W.J.K.); Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (A.P., A.R., C.D., P.S., Y.C., J.E., P.G., N.A.); Department of Neurological Surgery, University of California San Francisco, San Francisco, California (G.K., H.O.); Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania (Y.P.); Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (J.C); Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (T.C); Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (M.L.); Department of Biological Sciences, Carnegie Mellon University, Pittsburgh, Pennsylvania (A.P.)
| | - Timothy Chan
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (X.Z., W.J.K.); Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (A.P., A.R., C.D., P.S., Y.C., J.E., P.G., N.A.); Department of Neurological Surgery, University of California San Francisco, San Francisco, California (G.K., H.O.); Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania (Y.P.); Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (J.C); Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (T.C); Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (M.L.); Department of Biological Sciences, Carnegie Mellon University, Pittsburgh, Pennsylvania (A.P.)
| | - Hideho Okada
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (X.Z., W.J.K.); Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (A.P., A.R., C.D., P.S., Y.C., J.E., P.G., N.A.); Department of Neurological Surgery, University of California San Francisco, San Francisco, California (G.K., H.O.); Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania (Y.P.); Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (J.C); Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (T.C); Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (M.L.); Department of Biological Sciences, Carnegie Mellon University, Pittsburgh, Pennsylvania (A.P.)
| | - Michael Lotze
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (X.Z., W.J.K.); Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (A.P., A.R., C.D., P.S., Y.C., J.E., P.G., N.A.); Department of Neurological Surgery, University of California San Francisco, San Francisco, California (G.K., H.O.); Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania (Y.P.); Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (J.C); Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (T.C); Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (M.L.); Department of Biological Sciences, Carnegie Mellon University, Pittsburgh, Pennsylvania (A.P.)
| | - Paola Grandi
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (X.Z., W.J.K.); Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (A.P., A.R., C.D., P.S., Y.C., J.E., P.G., N.A.); Department of Neurological Surgery, University of California San Francisco, San Francisco, California (G.K., H.O.); Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania (Y.P.); Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (J.C); Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (T.C); Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (M.L.); Department of Biological Sciences, Carnegie Mellon University, Pittsburgh, Pennsylvania (A.P.)
| | - Nduka Amankulor
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (X.Z., W.J.K.); Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (A.P., A.R., C.D., P.S., Y.C., J.E., P.G., N.A.); Department of Neurological Surgery, University of California San Francisco, San Francisco, California (G.K., H.O.); Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania (Y.P.); Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (J.C); Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (T.C); Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (M.L.); Department of Biological Sciences, Carnegie Mellon University, Pittsburgh, Pennsylvania (A.P.)
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Jung JY, Woo SM, Kim WJ, Lee BN, Nör JE, Min KS, Choi CH, Koh JT, Lee KJ, Hwang YC. Simvastatin inhibits the expression of inflammatory cytokines and cell adhesion molecules induced by LPS in human dental pulp cells. Int Endod J 2016; 50:377-386. [PMID: 27003335 DOI: 10.1111/iej.12635] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 03/17/2016] [Indexed: 11/30/2022]
Abstract
AIM To investigate the effect of simvastatin on lipopolysaccharide (LPS)-stimulated inflammatory cytokines, cell adhesion molecules and nuclear factor-κB (NF-κB) transcription factors in human dental pulp cells (HDPCs). METHODOLOGY The effect of LPS and simvastatin on human dental pulp cell (HDPCs) viability was measured using a 3-[4, 5-dimethylthiazol-2-yl]-2, 5 diphenyltetrazolium bromide (MTT) assay. The expression of inflammatory cytokines and cell adhesion molecules was evaluated by reverse-transcription polymerase chain reaction (RT-PCR), enzyme-linked immunosorbent assay (ELISA) and Western blot analysis. NF-κB transcription factors were evaluated by Western blot analysis. Statistical analysis was performed with analysis of variance (anova). RESULTS The viability of cells exposed to different concentrations of E. coli LPS, P. gingivalis LPS and simvastatin was not significantly different compared with that of control cells (P > 0.05). LPS significantly increased interleukin (IL)-1β (P < 0.05) and IL-6 mRNA expression (P < 0.05) and vascular cell adhesion molecule-1 (VCAM-1) (P < 0.05) and intercellular adhesion molecule-1 (ICAM-1) protein expression (P < 0.05) in HDPCs. Treatment with simvastatin significantly attenuated LPS-stimulated production of IL-1β, IL-6, VCAM-1 and ICAM-1 (P < 0.05). Treatment with simvastatin decreased LPS-induced expression of p65 and phosphorylation of IκB and also significantly decreased the phosphorylation of p65 and IκB in the cytoplasm and the level of p65 in the nucleus (P < 0.05). CONCLUSIONS Simvastatin has a suppressing effect on LPS-induced inflammatory cytokine, cell adhesion molecules and NF-κB transcription factors in HDPCs. Therefore, simvastatin might be a useful candidate as a pulp-capping agent in vital pulp therapy.
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Affiliation(s)
- J Y Jung
- Department of Physiology, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - S M Woo
- Department of Physiology, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - W J Kim
- Department of Physiology, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea.,Research Center for Biomineralization Disorders, Chonnam National University, Gwangju, Korea
| | - B N Lee
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - J E Nör
- Angiogenesis Research Laboratory, Department of Cariology, Restorative Sciences, Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - K S Min
- Department of Conservative Dentistry, School of Dentistry, Chonbuk National University, Jeonju, Korea
| | - C H Choi
- Department of Preventive and Public Health Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - J T Koh
- Research Center for Biomineralization Disorders, Chonnam National University, Gwangju, Korea
| | - K J Lee
- Department of Convergence Medicine, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Y C Hwang
- Research Center for Biomineralization Disorders, Chonnam National University, Gwangju, Korea.,Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
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Moon BC, Kim WJ, Ji Y, Lee YM, Kang YM, Choi G. Molecular identification of the traditional herbal medicines, Arisaematis Rhizoma and Pinelliae Tuber, and common adulterants via universal DNA barcode sequences. Genet Mol Res 2016; 15:gmr7064. [PMID: 26909979 DOI: 10.4238/gmr.15017064] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Methods to identify Pinelliae Tuber and Arisaematis Rhizoma are required because of frequent reciprocal substitution between these two herbal medicines and the existence of several closely related plant materials. As a result of the morphological similarity of dried tubers, correct discrimination of authentic herbal medicines is difficult by conventional methods. Therefore, we analyzed DNA barcode sequences to identify each herbal medicine and the common adulterants at a species level. To verify the identity of these herbal medicines, we collected five authentic species (Pinellia ternata for Pinelliae Tuber, and Arisaema amurense, A. amurense var. serratum, A. erubescens, and A. heterophyllum for Arisaematis Rhizoma) and six common adulterant plant species. Maturase K (matK) and ribulose-1,5-bisphosphate carboxylase/oxygenase large subunit (rbcL) genes were then amplified using universal primers. In comparative analyses of two DNA barcode sequences, we obtained 45 species-specific nucleotides sufficient to identify each species (except A. erubescens with matK) and 28 marker nucleotides for each species (except P. pedatisecta with rbcL). Sequence differences at corresponding positions of the two combined DNA barcodes provided genetic marker nucleotides that could be used to identify specimens of the correct species among the analyzed medicinal plants. Furthermore, we generated a phylogenetic tree showing nine distinct groups depending on the species. These results can be used to authenticate Pinelliae Tuber and Arisaematis Rhizoma from their adulterants and to identify each species. Thus, comparative analyses of plant DNA barcode sequences identified useful genetic markers for the authentication of Pinelliae Tuber and Arisaematis Rhizoma from several adulterant herbal materials.
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Affiliation(s)
- B C Moon
- K-herb Research Center, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - W J Kim
- K-herb Research Center, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Y Ji
- K-herb Research Center, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Y M Lee
- K-herb Research Center, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Y M Kang
- K-herb Research Center, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - G Choi
- K-herb Research Center, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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Han SS, Kim S, Lee SJ, Kim WJ, Hong Y, Lee HY. Clinical characteristics and prognostic factors in patients with pulmonary tuberculosis as a primary cause of respiratory failure admitted to intensive care units. Intensive Care Med Exp 2015. [PMCID: PMC4797566 DOI: 10.1186/2197-425x-3-s1-a383] [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: 11/10/2022] Open
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Choi HY, Kim WJ. Effect of thermal treatment on the bio-corrosion and mechanical properties of ultrafine-grained ZK60 magnesium alloy. J Mech Behav Biomed Mater 2015; 51:291-301. [PMID: 26275491 DOI: 10.1016/j.jmbbm.2015.07.019] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 07/17/2015] [Accepted: 07/18/2015] [Indexed: 11/17/2022]
Affiliation(s)
- H Y Choi
- Department of Materials Science and Engineering, Hongik University, Mapo-gu, Sangsu-dong 72-1, Seoul 121-791, South Korea
| | - W J Kim
- Department of Materials Science and Engineering, Hongik University, Mapo-gu, Sangsu-dong 72-1, Seoul 121-791, South Korea.
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Kim WJ, Lee E, Kim KR, Namkoong K, Park ES, Rha DW. Progress of PTSD symptoms following birth: a prospective study in mothers of high-risk infants. J Perinatol 2015; 35:575-9. [PMID: 25856762 DOI: 10.1038/jp.2015.9] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 01/03/2015] [Accepted: 01/20/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To understand how postpartum posttraumatic stress disorder (PTSD) symptoms in mothers of high-risk infants progress and identify what factors predict postpartum PTSD. STUDY DESIGN We prospectively obtained self-reported psychological data from neonatal intensive care unit discharged infants' mothers (NICU mothers) at the infants' corrected ages of 1 (T0), 3 (T1) and 12 months (T2) and mothers of healthy infants (controls). Maternal sociodemographic and infant-related factors were also investigated. RESULT PTSD was present in 25 and 9% of NICU mothers and controls, respectively. We identified four PTSD patterns: none, persistent, delayed and recovered. The postpartum PTSD course was associated with trait anxiety. Whether the infant was the first child who predicted PTSD at year 1 (adjusted odds ratio=7.62, 95% confidence interval=1.07 to 54.52). CONCLUSION Mothers of high-risk infants can develop early or late PTSD, and its course can be influenced by factors besides medical status. We therefore recommend regular screenings of postpartum PTSD.
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Affiliation(s)
- W J Kim
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - E Lee
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - K R Kim
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - K Namkoong
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - E S Park
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - D-w Rha
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, South Korea
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Kim JY, Kim SS, Jang HJ, Oh MY, Lee DH, Eom DW, Kang KS, Kim SN, Kwan HC, Ham JY, Kim WJ, Jang DS, Han DJ. 5,7-dihydroxy-3,4,6-trimethoxyflavone attenuates ischemic damage and apoptosis in mouse islets. Transplant Proc 2015; 47:1073-8. [PMID: 26036523 DOI: 10.1016/j.transproceed.2014.12.049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 12/30/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND The transplantation of isolated pancreatic islets is a promising treatment for diabetes. 5,7-dihydroxy-3,4,6-trimethoxyflavone (Eupatilin), a pharmacologically active flavone derived from the Artemisia plant species, has been reported to have antioxidant and anti-inflammatory activities. This study examines the hypothesis that preoperative eupatilin treatment can attenuate ischemic damage and apoptosis before islet transplantation. METHODS Islets isolated from Balb/c mice were randomly divided into 2 groups, and cultured in medium supplemented with or without eupatilin. In vitro islet viability and function were assessed. After treatment with a cytokine cocktail consisting of tumor necrosis factor (TNF)-α, interferon (INF)-γ, and interleukin (IL)-1β, islet cell viability, function, and apoptotic status were determined. The glutathione (GSH) and nitrous oxide (NO) levels were also measured. Proteins related to apoptosis were analyzed using Western blotting. RESULTS There was no difference in cell viability between the 2 groups. Islets cultured in the medium supplemented with eupatilin showed 1.4-fold higher glucose-induced insulin secretion than the islets cultured in the medium without eupatilin. After treatment with a cytokine cocktail, glucose-induced insulin release and the total insulin content of the islets were significantly improved in eupatilin-pretreated islets compared with islets not treated with eupatilin. Apoptosis was significantly decreased, and GSH levels were elevated in the eupatilin-pretreated group. Cytokine-only treated islets produced significantly higher levels of NO, iNOS, and caspase-3 than islets pretreated with eupatilin before cytokine treatment. CONCLUSIONS These results suggest that preoperative eupatilin administration enhances islet function before transplantation and attenuates the cytokine-induced damage associated with NO production and apoptosis.
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Affiliation(s)
- J Y Kim
- Department of Internal Medicine, Ulsan University College of Medicine, Gangneung Asan Hospital, South Korea
| | - S S Kim
- Department of Anesthesia and Pain, Ulsan University College of Medicine, Gangneung Asan Hospital, South Korea
| | - H J Jang
- Department of Surgery, Ulsan University College of Medicine, Gangneung Asan Hospital, South Korea.
| | - M Y Oh
- Department of Surgery, Ulsan University College of Medicine, Gangneung Asan Hospital, South Korea
| | - D H Lee
- Department of Surgery, Ulsan University College of Medicine, Gangneung Asan Hospital, South Korea
| | - D W Eom
- Department of Pathology, Ulsan University College of Medicine, Gangneung Asan Hospital, South Korea
| | - K S Kang
- College of Korean Medicine, Gachon University, Seongnam, South Korea
| | - S N Kim
- Natural Medicine Center, Korea Institute of Science and Technology (KIST), Gangneung, South Korea
| | - H C Kwan
- Natural Medicine Center, Korea Institute of Science and Technology (KIST), Gangneung, South Korea
| | - J Y Ham
- Natural Medicine Center, Korea Institute of Science and Technology (KIST), Gangneung, South Korea
| | - W J Kim
- Department of Internal Medicine, Ulsan University College of Medicine, Gangneung Asan Hospital, South Korea
| | - D S Jang
- Department of Pharmaceutical Science, College of Pharmacy, Kyung Hee University, Seoul, South Korea
| | - D J Han
- Asan Medical Center, Seoul, South Korea
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Ha YS, Yu J, Patel N, Hassanzadeh Salmasi A, Parihar J, Kwon TG, Kim WJ, Kim IY. Pathologic findings in patients who underwent robot-assisted radical prostatectomy following active surveillance: a prospective study in a single center. MINERVA UROL NEFROL 2015; 67:1-9. [PMID: 25664959] [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: 06/04/2023]
Abstract
AIM Active surveillance is the recommended treatment of option for men with very low-risk prostate cancer. In this study, the clinicopathological results of patients who were initially treated with active surveillance and subsequently underwent robot-assisted radical prostatectomy during follow-up are described. METHODS A prospective cohort of 106 men enrolled in active surveillance was reviewed. Pathologic specimens for patients who ultimately underwent robot-assisted radical prostatectomy for progression or personal preference were analyzed. RESULTS After exclusion of 14 patients who were lost to follow-up or with incomplete data collection, 92 men were included in the present analyses. Median follow-up was 27.6 months (range 3.3 to 193.1). Twenty-nine patients underwent robot-assisted radical prostatectomy. Progression occurred in 32 patients (34.8%), of which 23 men elected to undergo surgery. Robot-assisted radical prostatectomy was performed in 6 additional patients who chose definitive intervention due to anxiety. Pathologic analyses revealed organ-confined disease in 24 patients (82.8%), and Gleason score was ≥ 7 in nine (31%). Fourteen (48.3%) specimens were identified as having an advanced disease (Gleason score ≥ 7 and/or T3). In comparison to the patients with low-risk disease post-operatively (Gleason score <7 and T2), patients with advanced disease had significantly higher PSA density level and lower prostate volume. CONCLUSION In this prospective active surveillance cohort, the progression rate was 34.8% over the follow-up period of 27.6 months. In specimens of patients who underwent robot-assisted radical prostatectomy, 48.3% displayed advanced pathologic features. Therefore we recommend that patients considering active surveillance should be counseled on risk of advanced disease as a possible hazard.
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Affiliation(s)
- Y S Ha
- Section of Urologic Oncology Rutgers Cancer Institute of New Jersey Rutgers, The State University of New Jersey New Brunswick, NJ USA -
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Chu M, Cho SJ, Kim WJ, Kim JM. EHMTI-0075. Is insomnia associated with migraineurs attributable to anxiety and depression? J Headache Pain 2014. [PMCID: PMC4180186 DOI: 10.1186/1129-2377-15-s1-d10] [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: 11/29/2022] Open
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Kim WJ, Shin EH, Kong HJ, Kim HS, Kim BS, Nam BH, Kim YO, Kim CH, Jung H, An CM. Characterization of novel microsatellite markers derived from Korean rose bitterling (Rhodeus uyekii) genomic library. Genet Mol Res 2014; 13:8147-52. [PMID: 25299199 DOI: 10.4238/2014.october.7.9] [Citation(s) in RCA: 8] [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: 11/03/2022]
Abstract
Korean rose bitterling (Rhodeus uyekii) is a freshwater fish endemic to Korea. Natural populations of this species have experienced severe declines as a result of habitat fragmentation and water pollution. To conserve and restore R. uyekii, the genetic diversity of this species needs to be assessed at the population level. Eighteen novel polymorphic microsatellite loci for R. uyekii were developed using an enriched partial genomic library. Polymorphisms at these loci were studied in 150 individuals collected from three populations. The number of alleles at each locus ranged from 3 to 47 (mean = 17.1). Within the populations, the observed heterozygosity ranged from 0.032 to 1.000, expected heterozygosity from 0.082 to 0.967, and polymorphism information content from 0.078 to 0.950. Six loci showed significant deviation from Hardy-Weinberg equilibrium after Bonferroni's correction, and no significant linkage disequilibrium was detected between most locus pairs, except in three cases. These highly informative microsatellite markers should be useful for genetic population structure analyses of R. uyekii.
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Affiliation(s)
- W J Kim
- Biotechnology Research Division, National Fisheries Research and Development Institute, Busan, Republic of Korea
| | - E H Shin
- Biotechnology Research Division, National Fisheries Research and Development Institute, Busan, Republic of Korea
| | - H J Kong
- Biotechnology Research Division, National Fisheries Research and Development Institute, Busan, Republic of Korea
| | - H S Kim
- Biotechnology Research Division, National Fisheries Research and Development Institute, Busan, Republic of Korea
| | - B S Kim
- Biotechnology Research Division, National Fisheries Research and Development Institute, Busan, Republic of Korea
| | - B H Nam
- Biotechnology Research Division, National Fisheries Research and Development Institute, Busan, Republic of Korea
| | - Y O Kim
- Biotechnology Research Division, National Fisheries Research and Development Institute, Busan, Republic of Korea
| | - C H Kim
- Central Regional Inland Fisheries Research, National Fisheries Research and Development Institute, Gyeonggi-do, Republic of Korea
| | - H Jung
- Biotechnology Research Division, National Fisheries Research and Development Institute, Busan, Republic of Korea
| | - C M An
- Biotechnology Research Division, National Fisheries Research and Development Institute, Busan, Republic of Korea
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Kang JH, Ko HM, Moon JS, Yoo HI, Jung JY, Kim MS, Koh JT, Kim WJ, Kim SH. Osteoprotegerin expressed by osteoclasts: an autoregulator of osteoclastogenesis. J Dent Res 2014; 93:1116-23. [PMID: 25256714 DOI: 10.1177/0022034514552677] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Osteoprotegerin (OPG) is secreted by stromal and osteoblastic lineage cells and inhibits osteoclastogenesis by preventing the interaction of receptor activator of nuclear factor-κB ligand (RANKL) with receptor activator of nuclear factor-κB (RANK). In this study, the expression of OPG in osteoclasts themselves and its biological functions during osteoclastogenesis were investigated for the first time. OPG expression in vivo in the developing rat maxilla was examined by immunofluorescence analysis. OPG expression in osteoclasts during in vitro osteoclastogenesis was determined by reverse-transcription polymerase chain-reaction (RT-PCR), Western blot, and immunofluorescence staining. We determined the function of OPG produced by osteoclasts during osteoclastogenesis by silencing the OPG gene. The effects of OPG on bone-resorbing activity and apoptosis of mature osteoclasts were examined by the assay of resorptive pit formation on calcium-phosphate-coated plate and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) staining, respectively. In the immunofluorescence findings, strong immunoreactivities were unexpectedly seen in multinucleated tartrate-resistant acid phosphatase (TRAP)-positive osteoclasts around the growing and erupting tooth germs in the rat alveolar bone. In vitro, OPG expression was significantly increased during the differentiation of osteoclasts from mouse bone-marrow-derived cells treated with a combination of macrophage colony-stimulating factor (M-CSF) and RANKL. Interestingly, it was found that OPG small interfering (si)RNA treatment during osteoclastogenesis enhanced the sizes of osteoclasts, but attenuated their bone-resorbing activity. Also, the increased chromosomal DNA fragmentation and caspase-3 activity in the late phase of osteoclastogenesis were found to be decreased by treatment with OPG siRNA. Furthermore, effects of OPG siRNA treatment on osteoclastogenesis and bone-resorbing activity were recovered by the treatment of exogenous OPG. These results suggest that OPG, expressed by the osteoclasts themselves, may play an auto-regulatory role in the late phase of osteoclastogenesis through the induction of apoptosis.
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Affiliation(s)
- J H Kang
- Dental Science Research Institute, School of Dentistry, Chonnam National University, Gwangju, Korea
| | - H M Ko
- Department of Microbiology, College of Medicine, Seonam University, Namwon, Korea
| | - J S Moon
- Dental Science Research Institute, School of Dentistry, Chonnam National University, Gwangju, Korea
| | - H I Yoo
- Dental Science Research Institute, School of Dentistry, Chonnam National University, Gwangju, Korea
| | - J Y Jung
- Dental Science Research Institute, School of Dentistry, Chonnam National University, Gwangju, Korea
| | - M S Kim
- Dental Science Research Institute, School of Dentistry, Chonnam National University, Gwangju, Korea
| | - J T Koh
- Dental Science Research Institute, School of Dentistry, Chonnam National University, Gwangju, Korea
| | - W J Kim
- Dental Science Research Institute, School of Dentistry, Chonnam National University, Gwangju, Korea
| | - S H Kim
- Dental Science Research Institute, School of Dentistry, Chonnam National University, Gwangju, Korea
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Kang DH, Kim KL, Kim YG, Park YJ, Kim WJ, Kim SH, Lee HG. Investigation of thermal and electrical stabilities of a GdBCO coil using grease as an insulation material for practical superconducting applications. Rev Sci Instrum 2014; 85:094701. [PMID: 25273748 DOI: 10.1063/1.4894202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This paper presents the effects of thermal grease on the electrical and thermal characteristics of GdBCO pancake coils, observed through charge-discharge, sudden discharge, over-current, and thermal quench testing. In charge-discharge and sudden discharge tests, a coil using thermal grease as an insulation material demonstrated faster charging/discharging rates compared to a coil without turn-to-turn insulation. In the case of over-current tests, the coil using thermal grease exhibited the highest electrical stability. Furthermore, thermal quench testing showed the coil employing thermal grease to possess superior thermal characteristics, with rapid cooling and low temperature rise. Overall, the use of thermal grease as an insulation material may be a potential solution to the problems observed with the existing insulation materials, possessing fast charging/discharging rates with superior thermal and electrical stabilities.
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Affiliation(s)
- D H Kang
- Department of Materials Science and Engineering, Korea University, Anam-dong 5 ga, Seongbuk-gu, Seoul 136-713, South Korea
| | - K L Kim
- Department of Materials Science and Engineering, Korea University, Anam-dong 5 ga, Seongbuk-gu, Seoul 136-713, South Korea
| | - Y G Kim
- Department of Materials Science and Engineering, Korea University, Anam-dong 5 ga, Seongbuk-gu, Seoul 136-713, South Korea
| | - Y J Park
- Department of Materials Science and Engineering, Korea University, Anam-dong 5 ga, Seongbuk-gu, Seoul 136-713, South Korea
| | - W J Kim
- Department of Electrical Engineering, Gyeongsang National University and ERI, 501 Jinju-daero, Jinju 660-701, South Korea
| | - S H Kim
- Department of Electrical Engineering, Gyeongsang National University and ERI, 501 Jinju-daero, Jinju 660-701, South Korea
| | - H G Lee
- Department of Materials Science and Engineering, Korea University, Anam-dong 5 ga, Seongbuk-gu, Seoul 136-713, South Korea
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Chon SB, Kim TS, Oh WS, Lee SJ, Han SS, Kim WJ. Pulmonary tuberculosis among patients hospitalised with community-acquired pneumonia in a tuberculosis-prevalent area. Int J Tuberc Lung Dis 2014; 18:761-2. [PMID: 24200280 DOI: 10.5588/ijtld.13.0183] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING A suburban teaching hospital in a tuberculosis (TB) prevalent area. OBJECTIVES To evaluate the proportion of pulmonary TB among patients hospitalised with suspected community-acquired pneumonia (CAP), and to develop a diagnostic index for identifying TB among these patients. DESIGN TB cases confirmed using 1) sputum culture, or 2) both sputum acid-fast bacilli smear and polymerase chain reaction for Mycobacterium tuberculosis, were compared with non-tuberculous CAP by demographic, clinical, laboratory and radiographic information. Using multiple logistic regression analysis, risk factors for TB were identified. A diagnostic index was developed by summing up their simplified regression coefficients. Its performance was checked using c-statistic. RESULTS TB was the second leading cause of CAP (37/528, 7.0%). Risk factors were initial symptoms >7 days, serum albumin <3.5 g/dl, cavitary/nodular infiltrates and upper lobe involvement (1 point for each). The c-statistic of the index was 0.856 (95%CI 0.789-0.923), and for bootstrapping samples of 1000 repetitions it was 0.856 (95%CI 0.791-0.921). For scores ≥2, sensitivity and specificity were respectively 81.1% and 75.8%. CONCLUSION TB is one of the leading causes of CAP in TB-prevalent areas. Our diagnostic index may help clinicians identify TB immediately from CAP and initiate appropriate isolation and optimal treatment.
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Affiliation(s)
- S-B Chon
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea
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Jeon YK, Shin MJ, Kim WJ, Kim SS, Kim BH, Kim SJ, Kim YK, Shin YB, Kim IJ. The relationship between pulmonary function and bone mineral density in healthy nonsmoking women: the Korean National Health and Nutrition Examination Survey (KNHANES) 2010. Osteoporos Int 2014; 25:1571-6. [PMID: 24577346 DOI: 10.1007/s00198-014-2627-3] [Citation(s) in RCA: 10] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 01/20/2014] [Indexed: 10/25/2022]
Abstract
UNLABELLED The aim of this study was to examine the association between pulmonary function and bone mineral density (BMD) in subjects who had never smoked. Pulmonary function was associated with BMD in premenopausal, but not postmenopausal, women. INTRODUCTION It has been reported that low bone mass is common in patients with pulmonary disorders such as chronic obstructive pulmonary disease. However, in healthy nonsmoking women, the relationship between bone mass and pulmonary function has yet to be clarified. The object of this study was to determine whether pulmonary function is related to BMD in healthy nonsmoking women based on menopausal status. METHODS This study was a cross-sectional study based on data obtained from the Korean National Health and Nutrition Examination Survey (KNHANES), a nationwide representative survey conducted by the Korean Ministry of Health and Welfare in 2010. This study included 456 subjects who had never smoked and analyzed data concerning pulmonary function and BMD. RESULTS Functional vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were correlated with BMD at lumbar spine, femur neck (FN), and total hip in premenopausal women (p = 0.030, p = 0.003, p = 0.019, respectively, for FVC; p = 0.015, p = 0.006, p = 0.059, respectively, for FEV1). However, FVC and FEV1 were only correlated with BMD at FN in postmenopausal women (p = 0.003 for FVC; p = 0.006 for FEV1). Body mass index (BMI), FVC, and FEV1 were significantly related with BMD at FN, even after adjusting for age and other confounding factors (β = 0.334, p < 0.001; β = 0.145, p = 0.017; and β = 0.129, p = 0.037, respectively) in premenopausal women. However, only age and BMI were correlated with BMD at FN (β = -0.268, p = 0.001 and β = 0.384, p > 0.001) in postmenopausal women after adjusting for confounding factors. CONCLUSIONS Pulmonary function, including FVC and FEV1 are associated with BMD at FN in healthy nonsmoking premenopausal women but not in postmenopausal women.
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Affiliation(s)
- Y K Jeon
- Division of Endocrinology, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
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Lee TH, Lee JS, Park JW, Cho SJ, Hong SJ, Jeon SR, Kim WJ, Kim HG, Cho JY, Kim JO. High-resolution impedance manometry facilitates assessment of pharyngeal residue and oropharyngeal dysphagic mechanisms. Dis Esophagus 2014; 27:220-9. [PMID: 23855892 DOI: 10.1111/dote.12101] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The utility of high-resolution impedance manometry (HRIM) for evaluating oropharyngeal dysphagia (OPD) has been investigated. These approaches are limited because of the sophisticated methodology. A method of transforming HRIM into a simple and useful diagnostic tool for evaluating OPD is needed. A videofluoroscopic swallowing study (VFSS) and HRIM were performed by independent blinded examiners in 26 consecutive healthy volunteers (12 men; median age, 56.5 years) and 10 OPD patients (five men; median age, 59.5 years). Upper esophageal sphincter (UES) relaxation parameters were measured using a standard HRIM protocol. Peristalsis and bolus transit of the pharyngoesophageal (PE) segment were assessed using an HRIM-modified protocol in which the catheter was pulled back 10 cm. PE bolus transits were evaluated with an impedance contour pattern (linear vs. stasis) method. A significant difference was observed between the manometric measures of healthy volunteers and OPD patients for only the duration of pharyngeal contraction (0.49 ± 0.19 vs. 0.76 ± 0.33 s, P = 0.04). The percentage agreement and kappa value for detecting pharyngeal residue between the VFSS and the impedance analysis were 100% and 1.00, respectively. HRIM allowed for comprehensive assessment of abnormal pharyngeal components that caused pharyngeal residue on VFSS in two patients; reduced base of the tongue versus weak pharyngeal contraction in one, and reduced relaxation of the UES versus reduced laryngeal elevation in the remaining patient. Our findings demonstrated that HRIM using a simple methodology (i.e., pull-back of the catheter) detected pharyngeal residue through a simple analysis of the impedance contour pattern (linear vs. stasis). Furthermore, HRIM facilitated a comprehensive assessment of OPD mechanisms and recognition of subtle abnormalities not yet visible to the naked eye on VFSS.
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Affiliation(s)
- T H Lee
- Institute for Digestive Research, College of Medicine, Soonchunhyang University, Seoul, Republic of Korea
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Kim WT, Kim J, Yan C, Jeong P, Choi SY, Lee OJ, Chae YB, Yun SJ, Lee SC, Kim WJ. S100A9 and EGFR gene signatures predict disease progression in muscle invasive bladder cancer patients after chemotherapy. Ann Oncol 2014; 25:974-9. [PMID: 24631944 DOI: 10.1093/annonc/mdu037] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In our previous gene expression profile analysis, IL1B, S100A8, S100A9, and EGFR were shown to be important mediators of muscle invasive bladder cancer (MIBC) progression. The aim of the present study was to investigate the ability of these gene signatures to predict disease progression after chemotherapy in patients with locally recurrent or metastatic MIBC. PATIENTS AND METHODS Patients with locally advanced MIBC who received chemotherapy were enrolled. The expression signatures of four genes were measured and carried out further functional analysis to confirm our findings. RESULTS Two of the four genes, S100A9 and EGFR, were determined to significantly influence disease progression (P = 0.023, 0.045, respectively). Based on a receiver operating characteristic curve, a cut-off value for disease progression was determined. Patients with the good-prognostic signature group had a significantly longer time to progression and cancer-specific survival time than those with the poor-prognostic signature group (P < 0.001, 0.042, respectively). In the multivariate Cox regression analysis, gene signature was the only factor that significantly influenced disease progression [hazard ratio: 4.726, confidence interval: 1.623-13.763, P = 0.004]. In immunohistochemical analysis, S100A9 and EGFR positivity were associated with disease progression after chemotherapy. Protein expression of S100A9/EGFR showed modest correlation with gene expression of S100A9/EGFR (r = 0.395, P = 0.014 and r = 0.453, P = 0.004). Our functional analysis provided the evidence demonstrating that expression of S100A9 and EGFR closely associated chemoresistance, and that inhibition of S100A9 and EGFR may sensitize bladder tumor cells to the cisplatin-based chemotherapy. CONCLUSIONS The S100A9/EGFR level is a novel prognostic marker to predict the chemoresponsiveness of patients with locally recurrent or metastatic MIBC.
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Affiliation(s)
- W T Kim
- Department of Urology, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea
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