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Yoon HK, Kim HJ, Kim YJ, Lee H, Kim BR, Oh H, Park HP, Lee HC. Multicentre validation of a machine learning model for predicting respiratory failure after noncardiac surgery. Br J Anaesth 2024:S0007-0912(24)00050-3. [PMID: 38413342 DOI: 10.1016/j.bja.2024.01.030] [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: 06/26/2023] [Revised: 01/01/2024] [Accepted: 01/26/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Postoperative respiratory failure is a serious complication that could benefit from early accurate identification of high-risk patients. We developed and validated a machine learning model to predict postoperative respiratory failure, defined as prolonged (>48 h) mechanical ventilation or reintubation after surgery. METHODS Easily extractable electronic health record (EHR) variables that do not require subjective assessment by clinicians were used. From EHR data of 307,333 noncardiac surgical cases, the model, trained with a gradient boosting algorithm, utilised a derivation cohort of 99,025 cases from Seoul National University Hospital (2013-9). External validation was performed using three separate cohorts A-C from different hospitals comprising 208,308 cases. Model performance was assessed by area under the receiver operating characteristic (AUROC) curve and area under the precision-recall curve (AUPRC), a measure of sensitivity and precision at different thresholds. RESULTS The model included eight variables: serum albumin, age, duration of anaesthesia, serum glucose, prothrombin time, serum creatinine, white blood cell count, and body mass index. Internally, the model achieved an AUROC of 0.912 (95% confidence interval [CI], 0.908-0.915) and AUPRC of 0.113. In external validation cohorts A, B, and C, the model achieved AUROCs of 0.879 (95% CI, 0.876-0.882), 0.872 (95% CI, 0.870-0.874), and 0.931 (95% CI, 0.925-0.936), and AUPRCs of 0.029, 0.083, and 0.124, respectively. CONCLUSIONS Utilising just eight easily extractable variables, this machine learning model demonstrated excellent discrimination in both internal and external validation for predicting postoperative respiratory failure. The model enables personalised risk stratification and facilitates data-driven clinical decision-making.
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Affiliation(s)
- Hyun-Kyu Yoon
- Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Hyun Joo Kim
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Yi-Jun Kim
- Institute of Convergence Medicine, Ewha Womans University Mokdong Hospital, Seoul, South Korea
| | - Hyeonhoon Lee
- Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea
| | - Bo Rim Kim
- Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Hyongmin Oh
- Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Hee-Pyoung Park
- Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Hyung-Chul Lee
- Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea.
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Cho Y, Kim H, Yook G, Yong S, Kim S, Lee N, Kim YJ, Kim JH, Kim TW, Chang MJ, Lee KM, Chang CB, Kang SB, Kim JH. Predisposal of Interferon Regulatory Factor 1 Deficiency to Accumulate DNA Damage and Promote Osteoarthritis Development in Cartilage. Arthritis Rheumatol 2024. [PMID: 38268484 DOI: 10.1002/art.42815] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 01/05/2024] [Accepted: 01/23/2024] [Indexed: 01/26/2024]
Abstract
OBJECTIVE Interferon regulatory factor 1 (IRF1) is a transcriptional regulator conventionally associated with immunomodulation. Recent molecular analyses mapping DNA binding sites of IRF1 have suggested its potential function in DNA repair. However, the physiologic significance of this noncanonical function remains unexplored. Here, we investigated the role of IRF1 in osteoarthritis (OA), a condition marked by senescence and chronic joint inflammation. METHODS OA progression was examined in wild-type and Irf1-/- mice using histologic assessments and microcomputed tomography analysis of whole-joint OA manifestations and behavioral assessments of joint pain. An integrated analysis of assay for transposase-accessible chromatin with sequencing and whole transcriptome data was conducted for the functional assessment of IRF1 in chondrocytes. The role of IRF1 in DNA repair and senescence was investigated by assaying γ-H2AX foci and senescence-associated beta-galactosidase activity. RESULTS Our genome-wide investigation of IRF1 footprinting in chondrocytes revealed its primary occupancies in the promoters of DNA repair genes without noticeable footprint patterns in those of interferon-responsive genes. Chondrocytes lacking IRF1 accumulated irreversible DNA damage under oxidative stress, facilitating their entry into cellular senescence. IRF1 was down-regulated in the cartilage of human and mouse OA. Although IRF1 overexpression did not elicit an inflammatory response in joints or affect OA development, genetic deletion of Irf1 caused enhanced chondrocyte senescence and exacerbated post-traumatic OA in mice. CONCLUSION IRF1 offers DNA damage surveillance in chondrocytes, protecting them from oxidative stress associated with OA risk factors. Our study provides a crucial and cautionary perspective that compromising IRF1 activity renders chondrocytes vulnerable to cellular senescence and promotes OA development.
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Affiliation(s)
- Yongsik Cho
- Institute for Basic Science and Seoul National University, Seoul, South Korea, and Liflex Science, Cheongju, South Korea
| | - Hyeonkyeong Kim
- Institute for Basic Science and Seoul National University, Seoul, South Korea, and Liflex Science, Cheongju, South Korea
| | - Geunho Yook
- Institute for Basic Science and Seoul National University, Seoul, South Korea
| | - Sangmin Yong
- Institute for Basic Science and Seoul National University, Seoul, South Korea
| | - Soy Kim
- Institute for Basic Science and Seoul National University, Seoul, South Korea
| | - Narae Lee
- Institute for Basic Science and Seoul National University, Seoul, South Korea
| | - Yi-Jun Kim
- Ewha Womans University, Seoul, South Korea
| | | | - Tae Woo Kim
- Seoul National University and Boramae Hospital, Seoul, South Korea
| | - Moon Jong Chang
- Seoul National University and Boramae Hospital, Seoul, South Korea
| | - Kyoung Min Lee
- Seoul National University and Boramae Hospital, Seoul, South Korea
| | - Chong Bum Chang
- Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Seung-Baik Kang
- Seoul National University and Boramae Hospital, Seoul, South Korea
| | - Jin-Hong Kim
- Seoul National University and Institute for Basic Science, Seoul, South Korea, and Institute of Green-Bio Science and Technology, Pyeongchang, South Korea
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Suh J, Kim H, Min J, Yeon HJ, Hemberg M, Scimeca L, Wu MR, Kang HG, Kim YJ, Kim JH. Decoupling NAD + metabolic dependency in chondrosarcoma by targeting the SIRT1-HIF-2α axis. Cell Rep Med 2024; 5:101342. [PMID: 38128534 PMCID: PMC10829737 DOI: 10.1016/j.xcrm.2023.101342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 09/13/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023]
Abstract
Chondrosarcomas represent the second most common primary bone malignancy. Despite the vulnerability of chondrosarcoma cells to nicotinamide adenine dinucleotide (NAD+) depletion, targeting the NAD+ synthesis pathway remains challenging due to broad implications in biological processes. Here, we establish SIRT1 as a central mediator reinforcing the dependency of chondrosarcoma cells on NAD+ metabolism via HIF-2α-mediated transcriptional reprogramming. SIRT1 knockdown abolishes aggressive phenotypes of chondrosarcomas in orthotopically transplanted tumors in mice. Chondrosarcoma cells thrive under glucose starvation by accumulating NAD+ and subsequently activating the SIRT1-HIF-2α axis. Decoupling this link via SIRT1 inhibition unleashes apoptosis and suppresses tumor progression in conjunction with chemotherapy. Unsupervised clustering analysis identifies a high-risk chondrosarcoma patient subgroup characterized by the upregulation of NAD+ biosynthesis genes. Finally, SIRT1 inhibition abolishes HIF-2α transcriptional activity and sensitizes chondrosarcoma cells to doxorubicin-induced cytotoxicity, irrespective of underlying pathways to accumulate intracellular NAD+. We provide system-level guidelines to develop therapeutic strategies for chondrosarcomas.
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Affiliation(s)
- Jooyeon Suh
- Center for RNA Research, Institute for Basic Science, Seoul 08826, South Korea; Department of Biological Sciences, College of Natural Sciences, Seoul National University, Seoul 08826, South Korea
| | - Hyeonkyeong Kim
- Center for RNA Research, Institute for Basic Science, Seoul 08826, South Korea; Department of Biological Sciences, College of Natural Sciences, Seoul National University, Seoul 08826, South Korea; Liflex Science, Cheongju 28160, South Korea
| | - Jiyun Min
- Center for RNA Research, Institute for Basic Science, Seoul 08826, South Korea; Department of Biological Sciences, College of Natural Sciences, Seoul National University, Seoul 08826, South Korea
| | - Hyun Ju Yeon
- Center for RNA Research, Institute for Basic Science, Seoul 08826, South Korea; Department of Biological Sciences, College of Natural Sciences, Seoul National University, Seoul 08826, South Korea
| | - Martin Hemberg
- The Gene Lay Institute of Immunology and Inflammation, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02215, USA
| | - Luca Scimeca
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA 02215, USA; Department of Immunology, Harvard Medical School, Boston, MA 02115, USA; Mila, The Quebec AI Institute, Montreal, QC H2S 3H1, Canada
| | - Ming-Ru Wu
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA 02215, USA; Department of Immunology, Harvard Medical School, Boston, MA 02115, USA
| | - Hyun Guy Kang
- Orthopaedic Oncology Clinic, Research Institute and Hospital, National Cancer Center, Goyang 10408, South Korea
| | - Yi-Jun Kim
- Department of Environmental Medicine, College of Medicine, Ewha Womans University, Seoul 07804, South Korea; Department of Radiation Oncology, College of Medicine, Ewha Womans University, Seoul 07804, South Korea; Graduate Program in System Health Science and Engineering, College of Medicine, Ewha Womans University, Seoul 07804, South Korea.
| | - Jin-Hong Kim
- Center for RNA Research, Institute for Basic Science, Seoul 08826, South Korea; Department of Biological Sciences, College of Natural Sciences, Seoul National University, Seoul 08826, South Korea; Bio-MAX Institute, Seoul National University, Seoul 08826, South Korea; Institute of Green-Bio Science and Technology, Seoul National University, Pyeongchang 25354, South Korea; Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul 08826, South Korea.
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Kim YJ, Kang HG, Kim JH. Hunting for the vulnerability in chondrosarcoma by tracing metabolic and genetic links. Cell Rep Med 2024; 5:101385. [PMID: 38232691 PMCID: PMC10829863 DOI: 10.1016/j.xcrm.2023.101385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 12/20/2023] [Indexed: 01/19/2024]
Abstract
In this Backstory, we narrate our journey in establishing a multidisciplinary team for sarcoma research and uncovering vulnerabilities in chondrosarcoma cells associated with their NAD+ dependencies for survival.1 Our findings hold promise for exploitation, yielding a synergistic cytotoxic effect when combined with systemic therapy.
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Affiliation(s)
- Yi-Jun Kim
- Department of Environmental Medicine, College of Medicine, Ewha Womans University, Seoul 07804, South Korea; Department of Radiation Oncology, College of Medicine, Ewha Womans University, Seoul 07804, South Korea
| | - Hyun Guy Kang
- Orthopaedic Oncology Clinic, Research Institute and Hospital, National Cancer Center, Goyang 10408, South Korea
| | - Jin-Hong Kim
- Department of Biological Sciences, College of Natural Sciences, Seoul National University, Seoul 08826, South Korea; Center for RNA Research, Institute for Basic Science, Seoul 08826, South Korea.
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Jeong S, Afroz S, Kang D, Noh J, Suh J, Kim JH, You HJ, Kang HG, Kim YJ, Kim JH. Sarcoma Immunotherapy: Confronting Present Hurdles and Unveiling Upcoming Opportunities. Mol Cells 2023; 46:579-588. [PMID: 37853684 PMCID: PMC10590708 DOI: 10.14348/molcells.2023.0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 10/20/2023] Open
Abstract
Sarcomas are rare and heterogeneous mesenchymal neoplasms originating from the bone or soft tissues, which pose significant treatment challenges. The current standard treatment for sarcomas consists of surgical resection, often combined with chemo- and radiotherapy; however, local recurrence and metastasis remain significant concerns. Although immunotherapy has demonstrated promise in improving long-term survival rates for certain cancers, sarcomas are generally considered to be relatively less immunogenic than other tumors, presenting substantial challenges for effective immunotherapy. In this review, we examine the possible opportunities for sarcoma immunotherapy, noting cancer testis antigens expressed in sarcomas. We then cover the current status of immunotherapies in sarcomas, including progress in cancer vaccines, immune checkpoint inhibitors, and adoptive cellular therapy and their potential in combating these tumors. Furthermore, we discuss the limitations of immunotherapies in sarcomas, including a low tumor mutation burden and immunosuppressive tumor microenvironment, and explore potential strategies to tackle the immunosuppressive barriers in therapeutic interventions, shedding light on the development of effective and personalized treatments for sarcomas. Overall, this review provides a comprehensive overview of the current status and potential of immunotherapies in sarcoma treatment, highlighting the challenges and opportunities for developing effective therapies to improve the outcomes of patients with these rare malignancies.
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Affiliation(s)
- Sehan Jeong
- Center for RNA Research, Institute for Basic Science, Seoul 08826, Korea
- Department of Biological Sciences, College of Natural Sciences, Seoul National University, Seoul 08826, Korea
| | - Sharmin Afroz
- Department of Occupational and Environmental Medicine, Ewha Womans University College of Medicine, Seoul 07985, Korea
| | - Donghyun Kang
- Center for RNA Research, Institute for Basic Science, Seoul 08826, Korea
- Department of Biological Sciences, College of Natural Sciences, Seoul National University, Seoul 08826, Korea
| | - Jeonghwan Noh
- Center for RNA Research, Institute for Basic Science, Seoul 08826, Korea
- Department of Biological Sciences, College of Natural Sciences, Seoul National University, Seoul 08826, Korea
| | - Jooyeon Suh
- Center for RNA Research, Institute for Basic Science, Seoul 08826, Korea
- Department of Biological Sciences, College of Natural Sciences, Seoul National University, Seoul 08826, Korea
| | - June Hyuk Kim
- Orthopaedic Oncology Clinic, Center for Rare Cancer, Research Institute and Hospital, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea
| | - Hye Jin You
- Cancer Microenvironment Branch, Division of Cancer Biology, Research Institute, National Cancer Center, Goyang 10408, Korea
| | - Hyun Guy Kang
- Orthopaedic Oncology Clinic, Center for Rare Cancer, Research Institute and Hospital, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea
| | - Yi-Jun Kim
- Department of Occupational and Environmental Medicine, Ewha Womans University College of Medicine, Seoul 07985, Korea
- Department of Radiation Oncology, Ewha Womans University College of Medicine, Seoul 07985, Korea
| | - Jin-Hong Kim
- Center for RNA Research, Institute for Basic Science, Seoul 08826, Korea
- Department of Biological Sciences, College of Natural Sciences, Seoul National University, Seoul 08826, Korea
- Bio-MAX Institute, Seoul National University, Seoul 08826, Korea
- Institute of Green-Bio Science and Technology, Seoul National University, Pyeongchang 25354, Korea
- Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul 08826, Korea
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Kim JM, Kim E, Song DK, Kim YJ, Lee JH, Ha E. Causal relationship between particulate matter 2.5 and diabetes: two sample Mendelian randomization. Front Public Health 2023; 11:1164647. [PMID: 37637811 PMCID: PMC10450337 DOI: 10.3389/fpubh.2023.1164647] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 07/10/2023] [Indexed: 08/29/2023] Open
Abstract
Backgrounds Many studies have shown particulate matter has emerged as one of the major environmental risk factors for diabetes; however, studies on the causal relationship between particulate matter 2.5 (PM2.5) and diabetes based on genetic approaches are scarce. The study estimated the causal relationship between diabetes and PM2.5 using two sample mendelian randomization (TSMR). Methods We collected genetic data from European ancestry publicly available genome wide association studies (GWAS) summary data through the MR-BASE repository. The IEU GWAS information output PM2.5 from the Single nucleotide polymorphisms (SNPs) GWAS pipeline using pheasant-derived variables (Consortium = MRC-IEU, sample size: 423,796). The annual relationship of PM2.5 (2010) were modeled for each address using a Land Use Regression model developed as part of the European Study of Cohorts for Air Pollution Effects. Diabetes GWAS information (Consortium = MRC-IEU, sample size: 461,578) were used, and the genetic variants were used as the instrumental variables (IVs). We performed three representative Mendelian Randomization (MR) methods: Inverse Variance Weighted regression (IVW), Egger, and weighted median for causal relationship using genetic variants. Furthermore, we used a novel method called MR Mixture to identify outlier SNPs. Results From the IVW method, we revealed the causal relationship between PM2.5 and diabetes (Odds ratio [OR]: 1.041, 95% CI: 1.008-1.076, P = 0.016), and the finding was substantiated by the absence of any directional horizontal pleiotropy through MR-Egger regression (β = 0.016, P = 0.687). From the IVW fixed-effect method (i.e., one of the MR machine learning mixture methods), we excluded outlier SNP (rs1537371) and showed the best predictive model (AUC = 0.72) with a causal relationship between PM2.5 and diabetes (OR: 1.028, 95% CI: 1.006-1.049, P = 0.012). Conclusion We identified the hypothesis that there is a causal relationship between PM2.5 and diabetes in the European population, using MR methods.
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Affiliation(s)
- Joyce Mary Kim
- Graduate Program in System Health Science and Engineering, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
- Department of Environmental Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Eunji Kim
- Graduate Program in System Health Science and Engineering, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
- Department of Environmental Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Do Kyeong Song
- Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Yi-Jun Kim
- Department of Environmental Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Ji Hyen Lee
- Institute of Ewha-SCL for Environmental Health (IESEH), College of Medicine, Ewha Womans University, Seoul, Republic of Korea
- Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Eunhee Ha
- Graduate Program in System Health Science and Engineering, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
- Department of Environmental Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
- Institute of Ewha-SCL for Environmental Health (IESEH), College of Medicine, Ewha Womans University, Seoul, Republic of Korea
- Department of Medical Science, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, Republic of Korea
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Yoon HK, Kim YJ, Lee HS, Seo JH, Kim HS. A randomised controlled trial of the analgesia nociception index for intra-operative remifentanil dose and pain after gynaecological laparotomy. Anaesthesia 2023; 78:988-994. [PMID: 36960477 DOI: 10.1111/anae.16008] [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] [Accepted: 02/25/2023] [Indexed: 03/25/2023]
Abstract
We aimed to investigate the effect of the analgesia nociception index on postoperative pain. We randomly allocated 170 women scheduled for gynaecological laparotomy and analysed results from 159: in 80 women, remifentanil was infused to maintain analgesia nociception indices 50-70; and in 79 women, remifentanil was infused to maintain systolic blood pressure < 120% of baseline values. The primary outcome was the proportion of women with pain scores ≥ 5 (scale 0-10) within 40 min of admission to recovery. The proportion of women with pain scores ≥ 5 was 62/80 (78%) vs. 64/79 (81%), p = 0.73. Mean (SD) doses of fentanyl in recovery were 53.6 (26.9) μg vs. 54.8 (20.8) μg, p = 0.74. Intra-operative remifentanil doses were 0.124 (0.050) μg.kg-1 .min-1 vs. 0.129 (0.044) μg.kg-1 .min-1 , p = 0.55.
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Affiliation(s)
- H-K Yoon
- Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Y J Kim
- Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H S Lee
- Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - J-H Seo
- Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H-S Kim
- Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
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Choi S, Yoo HK, Shin KW, Kim YJ, Yoon HK, Park HP, Oh H. Videolaryngoscopy vs. flexible fibrescopy for tracheal intubation in patients with cervical spine immobilisation: a randomised controlled trial. Anaesthesia 2023; 78:970-978. [PMID: 37145935 DOI: 10.1111/anae.16035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2023] [Indexed: 05/07/2023]
Abstract
In patients with cervical spine immobilisation, tracheal intubation devices other than a direct laryngoscope are frequently used to facilitate tracheal intubation and avoid related complications. In this randomised controlled trial, we compared videolaryngoscopic and fibrescopic tracheal intubation in patients with a cervical collar. Tracheal intubation was performed using either a videolaryngoscope with a non-channelled Macintosh blade (n = 166) or a flexible fibrescope (n = 164) in patients having elective cervical spine surgery whose neck was immobilised with a cervical collar to simulate a difficult airway. The primary outcome was the first attempt success rate of tracheal intubation. Secondary outcomes were the overall success rate of tracheal intubation; time to tracheal intubation; use of additional airway manoeuvres; and incidence and severity of tracheal intubation-related airway complications. First attempt success rate was higher in the videolaryngoscope group than in the fibrescope group (164/166 (98.8%) vs. 149/164 (90.9%), p = 0.003). Tracheal intubation was successful within three attempts in all patients. Median (IQR [range]) time to tracheal intubation was shorter (50.0 (41.0-72.0 [25.0-170.0]) s vs. 81.0 (65.0-107.0 [24.0-178.0]) s, p < 0.001) and additional airway manoeuvres were less frequent (30/166 (18.1%) vs. 91/164 (55.5%), p < 0.001) in the videolaryngoscope group compared with the fibrescope group. The incidence and severity of intubation-related airway complications were not different between the two groups. When performing tracheal intubation in patients with a cervical collar, videolaryngoscopy with a non-channelled Macintosh blade was superior to flexible fibrescopy.
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Affiliation(s)
- S Choi
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H K Yoo
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - K W Shin
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Y J Kim
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H K Yoon
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H P Park
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H Oh
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
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Kim E, Lee W, Lee JY, Kim Y, Lee JH, Hong YC, Park HS, Kim Y, Ha M, Kim YJ, Ha E. The effect of residential greenness during pregnancy on infant neurodevelopment using propensity score weighting: A prospective mother-infant paired cohort study. Sci Total Environ 2023:164888. [PMID: 37321505 DOI: 10.1016/j.scitotenv.2023.164888] [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: 04/07/2023] [Revised: 06/11/2023] [Accepted: 06/12/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND While prior studies have suggested an association between green spaces and infant neurodevelopment, the causal effect of green space exposure during pregnancy has not been fully investigated. This study aimed to identify with causal inference the effect of exposure to residential greenness during pregnancy on infants' mental-psychomotor development and the role of maternal education in modifying this association. METHODS We prospectively collected data of pregnant women and their infants from Mothers and Children Environmental Health cohort study. Based on residential addresses, we compiled information on the percent of green space using different buffer distances (100 m, 300 m, and 500 m) and air pollution (PM2.5). Infant neurodevelopment was measured at 6 months of age using the Korean Bayley Scales of Infant Development II Mental Developmental Index (MDI) and Psychomotor Developmental Index (PDI). Generalized propensity scores (GPSs) were estimated from machine-learning (ML) algorithms. We deduced causal inference through GPS adjustment and weighting approaches. Further analyses confirmed whether the association was altered by maternal academic background. RESULTS A total of 845 mother-infant pairs from the cohort study were included. We found that exposure to green spaces was robustly associated with infants' mental development. For example, an increase in % green space within 300 m increased the MDI by 14.32 (95 % confidence interval [CI], 3.44-25.2) in the weighting approach. Additionally, the association was even more noticeable for mothers with college degrees or above: an increase in % green space within 300 m increased the MDI by 23.69 (95 % CI, 8.53-38.85) and the PDI by 22.45 (95 % CI, 2.58-42.33) in the weighting approach. This association did not appear in mothers without college degrees. CONCLUSION Exposure to green spaces during pregnancy showed a beneficial relationship with infant mental development. Maternal academic background could modify the impact of green space exposure on infant neurodevelopment.
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Affiliation(s)
- Eunji Kim
- Graduate Program in System Health Science and Engineering, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Environmental Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Whanhee Lee
- School of Biomedical Convergence Engineering, College of Information and Biomedical Engineering, Pusan National University, Yangsan, Republic of Korea; Institute of Ewha-SCL for Environmental Health (IESEH), Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Ji-Young Lee
- Department of Occupational and Environmental Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Yeni Kim
- Department of Child and Adolescent Psychiatry, National Center for Mental Health, Seoul, Republic of Korea; Department of Psychiatry, Dongguk University International Hospital, Goyang, Republic of Korea
| | - Ji Hyen Lee
- Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Yun-Chul Hong
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hye-Sook Park
- Department of Preventive Medicine, Ewha Medical Research Center, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Yangho Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Mina Ha
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Yi-Jun Kim
- Department of Environmental Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea.
| | - Eunhee Ha
- Graduate Program in System Health Science and Engineering, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Environmental Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Institute of Ewha-SCL for Environmental Health (IESEH), Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Medical Science, Ewha Womans University College of Medicine and Ewha Medical Research Institute, Seoul, Republic of Korea.
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10
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Galffy G, Lugowska I, Poddubskaya EV, Cho BC, Ahn MJ, Han JY, Su WC, Hauke RJ, Dyar SH, Lee DH, Serwatowski P, Estelles DL, Holden VR, Kim YJ, Vladimirov V, Horvath Z, Ghose A, Goldman A, di Pietro A, Wang J, Murphy DA, Alhadab A, Laskov M. A phase II open-label trial of avelumab plus axitinib in previously treated non-small-cell lung cancer or treatment-naïve, cisplatin-ineligible urothelial cancer. ESMO Open 2023; 8:101173. [PMID: 37141847 DOI: 10.1016/j.esmoop.2023.101173] [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: 06/22/2022] [Revised: 01/17/2023] [Accepted: 02/06/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND We hypothesized that avelumab plus axitinib could improve clinical outcomes in patients with advanced non-small-cell lung cancer (NSCLC) or urothelial carcinoma (UC). PATIENTS AND METHODS We enrolled previously treated patients with advanced or metastatic NSCLC, or untreated, cisplatin-ineligible patients with advanced or metastatic UC. Patients received avelumab 800 mg every 2 weeks (Q2W) and axitinib 5 mg orally two times daily. The primary endpoint was objective response rate (ORR). Immunohistochemistry was used to assess programmed death-ligand 1 (PD-L1) expression (SP263 assay) and the presence of CD8+ T cells (clone C8/144B). Tumor mutational burden (TMB) was assessed by whole-exome sequencing. RESULTS A total of 61 patients were enrolled and treated (NSCLC, n = 41; UC, n = 20); 5 remained on treatment at data cut-off (26 February 2021). The confirmed ORR was 31.7% in the NSCLC cohort and 10.0% in the UC cohort (all partial responses). Antitumor activity was observed irrespective of PD-L1 expression. In exploratory subgroups, ORRs were higher in patients with higher (≥median) CD8+ T cells in the tumor. ORRs were higher in patients with lower TMB (<median) in the NSCLC cohort and higher TMB (≥median) in the UC cohort. Treatment-related adverse events (TRAEs) occurred in 93.4% of patients, including grade ≥3 TRAEs in 55.7%. Avelumab exposures with 800 mg Q2W dosing were similar to those observed with 10 mg/kg Q2W dosing. CONCLUSIONS In previously treated patients with advanced/metastatic NSCLC, ORR appeared to be superior to anti-PD-L1 or anti-programmed cell death protein 1 monotherapy, irrespective of PD-L1 status, whereas in untreated, cisplatin-ineligible patients with advanced/metastatic UC, ORR was lower than expected, potentially limited by small patient numbers. TRIAL REGISTRATION Clinicaltrial.gov NCT03472560; https://clinicaltrials.gov/ct2/show/NCT03472560.
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Affiliation(s)
- G Galffy
- Department of Pulmonology, Pulmonology Hospital Törökbálint, Törökbálint, Hungary.
| | - I Lugowska
- Early Phase Clinical Trials Unit, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland; Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | | | - B C Cho
- Division of Medical Oncology, Yonsei Cancer Center, Severance Hospital, Seoul
| | - M-J Ahn
- Department of Hematology & Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul
| | - J-Y Han
- Center for Lung Cancer, National Cancer Center, Goyang, Republic of Korea
| | - W-C Su
- Division of Hematology and Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - R J Hauke
- Department of Oncology, Nebraska Cancer Specialists, Omaha
| | - S H Dyar
- Department of Hematology & Oncology, Saint Francis Hospital Cancer Center, Greenville, USA
| | - D H Lee
- Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | | | - D L Estelles
- Department of Oncology, Consorcio Hospitalario Provincial de Castellon, Castellon, Spain
| | - V R Holden
- Oncology Hematology Associates, Springfield, USA
| | - Y J Kim
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - V Vladimirov
- GBUZ of Stavropol Territory Pyatigorsk Inter-regional Oncology Dispensary, Pyatigorsk, Stavropol Territory, Russia
| | - Z Horvath
- Bács-Kiskun Megyei Kórház Onkoradiológiai Központ, Kecskemet, Hungary
| | - A Ghose
- Department of Medical Oncology/Hematology, Arizona Oncology Associates, Tempe
| | | | | | | | | | | | - M Laskov
- LLC University Clinic of Headache, Moscow, Russia
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11
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Lee SW, Jung EH, Kim HJ, Min C, Yoo SH, Kim YJ, Rha SY, Yon DK, Kang B. Risk factors for delirium among patients with advanced cancer in palliative care: a multicenter, patient-based registry cohort in South Korea. Eur Rev Med Pharmacol Sci 2023; 27:2068-2076. [PMID: 36930505 DOI: 10.26355/eurrev_202303_31578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE Previous studies have comprehensively investigated the prevalence and various potential risk factors for delirium among patients with advanced cancer admitted to the acute palliative care unit (APCU). Our objective was to evaluate the comprehensive association between delirium and various risk factors among patients with advanced cancer in an acute palliative care setting using a patient-based multicenter registry cohort. PATIENTS AND METHODS We performed a multicenter, patient-based registry cohort study collected in South Korea between January 1, 2019, and December 31, 2020. Delirium was identified using a medical record review based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. RESULTS In total, 2,124 eligible patients with advanced cancer in the APCU met the inclusion criteria. There were 127 out of 2,124 patients (prevalence, 6.0%; 95% CI, 5.0 to 7.1) with delirium during admission. Delirium in patients with advanced cancer was associated with age >70 years (OR, 1.793; 95% CI, 1.246 to 2.581), male sex (OR, 1.675; 95% CI, 1.131 to 2.479), no chemotherapy during hospitalization (OR, 2.019; 95% CI, 1.236 to 3.298), hearing impairment (OR, 3.566; 95% CI, 1.176 to 10.810), underweight (OR, 1.826; 95% CI, 1.067 to 3.124), current use of opioid medication (OR, 1.942; 95% CI, 1.264 to 2.982), previous history of delirium (OR, 12.497; 95% CI, 6.920 to 22.568), and mental illness (OR, 2.333; 95% CI, 1.251 to 4.352). CONCLUSIONS In a large-scale multicenter patient-based registry cohort, delirium was associated with old age, male sex, no chemotherapy during hospitalization, hearing impairment, underweight, current use of opioid medication, and a history of delirium and mental illness. Our findings suggest physicians should pay attention to delirium in patients with advanced cancer admitted to the APCU with the above risk factors.
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Affiliation(s)
- S W Lee
- Palliative Care Center, Division of Medical Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea.
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12
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Kim K, Lee SJ, Seo J, Suh YJ, Cho I, Hong GR, Ha JW, Kim YJ, Shim CY. Assessment of aortic valve area on cardiac computed tomography and doppler echocardiography: differences and clinical significance in symptomatic bicuspid aortic stenosis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Backgrounds
This study aimed to investigate the differences and clinical significance of effective orifice area (EOA) on Doppler echocardiography and geometric orifice area (GOA) on cardiac computed tomography (CT) in bicuspid aortic stenosis (AS).
Methods
One-hundred sixty-three consecutive patients (age 64±10 years, 56.4% men) with symptomatic bicuspid AS who were referred for surgery and underwent both cardiac CT and echocardiography within 3 months were studied. For the aortic valve area, GOACT was measured by multiplanar CT planimetry, and EOAEcho was calculated by continuity equation with Doppler echocardiography. The associations of GOACT and EOAEcho with the patients' symptom scale, biomarkers, and left ventricular (LV) functional variables were comprehensively analyzed.
Results
There was a significant but modest correlation between EOAEcho and GOACT (r=0.604, p<0.001). Both EOAEcho and GOACT revealed significant correlations with mean pressure gradient and peak transaortic velocity and the coefficients were higher in EOAEcho than GOACT. EOAEcho of 1.05 cm2 and GOACT of 1.25 cm2 correspond to the hemodynamic cut-off values for diagnosing severe AS. EOAEcho was well correlated with patients' symptom scale and log NT-pro BNP, but GOACT was not. In addition, EOAEcho showed higher correlation coefficient with estimated LV filling pressure and LV global longitudinal strain than GOACT.
Conclusions
Both EOAEcho and GOACT can be used to evaluate the severity of bicuspid AS, however, the threshold for GOACT for diagnosing severe AS should be applied higher than that for EOAEcho. EOAEcho tends to be more correlated with the patients' symptom degree, biomarkers, and LV functional variables than GOACT.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): The Korean Cardiac Research Foundation
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Affiliation(s)
- K Kim
- Severance Hospital, Cardiology , Seoul , Korea (Republic of)
| | - S J Lee
- Severance Hospital, Radiology , Seoul , Korea (Democratic People's Republic of)
| | - J Seo
- Severance Hospital, Cardiology , Seoul , Korea (Republic of)
| | - Y J Suh
- Severance Hospital, Radiology , Seoul , Korea (Democratic People's Republic of)
| | - I Cho
- Severance Hospital, Cardiology , Seoul , Korea (Republic of)
| | - G R Hong
- Severance Hospital, Cardiology , Seoul , Korea (Republic of)
| | - J W Ha
- Severance Hospital, Cardiology , Seoul , Korea (Republic of)
| | - Y J Kim
- Severance Hospital, Cardiology , Seoul , Korea (Republic of)
| | - C Y Shim
- Severance Hospital, Cardiology , Seoul , Korea (Republic of)
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13
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Lee HJ, Park CS, Lee S, Park JB, Kim HK, Park SJ, Kim YJ, Lee SP. Systemic proinflammatory-profibrotic response in aortic stenosis patients with diabetes and its relationship with myocardial remodeling and clinical outcome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
It is unclear whether and how diabetes mellitus may aggravate myocardial fibrosis and remodeling in the pressure-overloaded heart. We investigated the impact of diabetes on the prognosis of aortic stenosis (AS) patients and its underlying mechanisms using comprehensive noninvasive imaging studies and plasma proteomics.
Methods
Severe AS patients undergoing both echocardiography and cardiovascular magnetic resonance (CMR) (n=253 of which 66 had diabetes) comprised the imaging cohort. The degree of replacement and diffuse interstitial fibrosis by late gadolinium enhancement (LGE) and extracellular volume fraction (ECV) was quantified using CMR. Plasma samples were analyzed with the multiplex proximity extension assay for 92 proteomic biomarkers in a separate biomarker cohort of severe AS patients (n=100 of which 27 had diabetes).
Results
In the imaging cohort, diabetic patients were older (70.4±6.8 vs. 66.7±10.1 years) and had a higher prevalence of ischemic heart disease (28.8% vs. 9.1%), with more advanced ventricular diastolic dysfunction. On CMR, diabetic patients had increased replacement and diffuse interstitial fibrosis (LGE% 0.3 [0.0–1.6] versus 0.0 [0.0–0.5], p=0.009; ECV% 27.9 [25.7–30.1] versus 26.7 [24.9–28.5], p=0.025) (Figure 1).
Plasma proteomics analysis of the biomarker cohort revealed that 9 proteins (E-selectin, interleukin-1 receptor type 1, interleukin-1 receptor type 2, galectin-4, intercellular adhesion molecule 2, integrin beta-2, galectin-3, growth differentiation factor 15, and cathepsin D) are significantly elevated in diabetic AS patients (Figure 2). Pathway over-representation analyses of the plasma proteomics with Gene Ontology terms indicated that pathways related to inflammatory response and extracellular matrix components were enriched, suggesting that diabetes is associated with systemic effects that evoke proinflammatory and profibrotic response to the pressure-overloaded myocardium.
During follow-up (median 6.3 years [IQR 5.2–7.2]) of the imaging cohort, 232 patients received aortic valve replacement (AVR) with 53 unexpected heart failure admissions or death. Diabetes was a significant predictor of heart failure and death, independent of clinical covariates and AVR (hazard ratio 1.88, 95% confidence interval 1.06–3.31, p=0.030).
Conclusion
Plasma proteomic analyses indicate that diabetes potentiates the systemic proinflammatory and profibrotic milieu in AS patients. These systemic biological changes underlie the increase of myocardial fibrosis, diastolic dysfunction, and worse clinical outcomes in severe AS patients with concomitant diabetes.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): National Research Foundation of Korea
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Affiliation(s)
- H J Lee
- Seoul National University Hospital, Internal Medicine , Seoul , Korea (Republic of)
| | - C S Park
- Seoul National University Hospital, Internal Medicine , Seoul , Korea (Republic of)
| | - S Lee
- Asan Medical Center, Internal Medicine , Seoul , Korea (Republic of)
| | - J B Park
- Seoul National University Hospital, Internal Medicine , Seoul , Korea (Republic of)
| | - H K Kim
- Seoul National University Hospital, Internal Medicine , Seoul , Korea (Republic of)
| | - S J Park
- Samsung Medical Center, Cardiovascular Imaging Center , Seoul , Korea (Republic of)
| | - Y J Kim
- Seoul National University Hospital, Internal Medicine , Seoul , Korea (Republic of)
| | - S P Lee
- Seoul National University Hospital, Internal Medicine , Seoul , Korea (Republic of)
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14
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Choi YJ, Kim BS, Rhee TM, Lee HJ, Lee H, Park JB, Lee SP, Han KD, Kim YJ, Hk KIM. Augmented risk of ischemic stroke in hypertrophic cardiomyopathy patients without documented atrial fibrillation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Ischemic stroke is a common complication in patients with hypertrophic cardiomyopathy (HCM) (1). Although atrial fibrillation (AF) is a well-established risk factor for ischemic stroke in HCM, the risk of ischemic stroke in patients with HCM without documented AF is less recognized (1, 2). This study aimed to determine the risk of ischemic stroke and identify its risk factors in patients with HCM without documented AF.
Methods
This nationwide population-based cohort study used the Korean National Health Insurance database. After excluding patients with a prior history of AF, thromboembolic events, cancer, or the use of anticoagulants, we identified 8,328 HCM patients without documented AF and 1:2 propensity score-matched 16,656 non-HCM controls. The clinical outcome was an incident ischemic stroke.
Results
During a mean follow-up of approximately 6 years, ischemic stroke occurred in 328/8,328 (3.9%) patients with HCM and 443/16,656 (2.7%) controls. Among individuals who developed ischemic stroke, the proportion of AF concomitantly detected accounted for 26.5% (87/328) and 5.8% (26/443) in the HCM and control groups, respectively. The overall incidence of ischemic stroke was 0.716/100 person-years in the HCM group, which was significantly higher than that in the control group (0.44/100 person-years) (HR 1.643; 95% CI, 1.424–1.895; P<0.001, Figure 1). The subgroup analysis according to age, sex, and comorbidities (chronic heart failure, hypertension, dyslipidemia, and vascular disease) consistently demonstrated a higher risk of ischemic stroke in the HCM group (P for interaction >0.05). In the HCM group, age ≥65 years (adjusted hazard ratio [HR] 2.741; 95% confidence interval [CI], 2.156–3.486; P<0.001) and chronic heart failure (adjusted HR 1.748; 95% CI, 1.101–2.745; P=0.018) were independent risk factors for ischemic stroke. Overall incidence was 1.360/100 in patients with HCM aged ≥65 and 2.315/100 person-years years in those with chronic heart failure, respectively. Also, compared to controls aged <65 years and without CHF, adjusted HR for ischemic stroke was 4.756 (95% CI 3.807–5.867) in patients with HCM aged ≥65 years and 2.539 (95% CI 1.638–3.936) in those with CHF, respectively (Figure 2).
Conclusions
Patients with HCM without documented AF are at a higher risk of ischemic stroke than the propensity score-matched general population. Age ≥65 years and chronic heart failure are two strong independent risk factors for ischemic stroke in this population.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- Y J Choi
- Korea University Guro Hospital , Seoul , Korea (Democratic People's Republic of)
| | - B S Kim
- The Catholic University of Korea , Seoul , Korea (Republic of)
| | - T M Rhee
- Seoul National University Hospital, Internal medicine , Seoul , Korea (Republic of)
| | - H J Lee
- Seoul National University Hospital, Internal medicine , Seoul , Korea (Republic of)
| | - H Lee
- Seoul National University Hospital, Internal medicine , Seoul , Korea (Republic of)
| | - J B Park
- Seoul National University Hospital, Internal medicine , Seoul , Korea (Republic of)
| | - S P Lee
- Seoul National University Hospital, Internal medicine , Seoul , Korea (Republic of)
| | - K D Han
- The Catholic University of Korea , Seoul , Korea (Republic of)
| | - Y J Kim
- Seoul National University Hospital, Internal medicine , Seoul , Korea (Republic of)
| | - K I M Hk
- Seoul National University Hospital, Internal medicine , Seoul , Korea (Republic of)
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15
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Lee SW, Lee HC, Suh J, Lee KH, Lee H, Seo S, Kim TK, Lee SW, Kim YJ. Multi-center validation of machine learning model for preoperative prediction of postoperative mortality. NPJ Digit Med 2022; 5:91. [PMID: 35821515 PMCID: PMC9276734 DOI: 10.1038/s41746-022-00625-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 02/07/2022] [Accepted: 06/02/2022] [Indexed: 11/09/2022] Open
Abstract
Accurate prediction of postoperative mortality is important for not only successful postoperative patient care but also for information-based shared decision-making with patients and efficient allocation of medical resources. This study aimed to create a machine-learning prediction model for 30-day mortality after a non-cardiac surgery that adapts to the manageable amount of clinical information as input features and is validated against multi-centered rather than single-centered data. Data were collected from 454,404 patients over 18 years of age who underwent non-cardiac surgeries from four independent institutions. We performed a retrospective analysis of the retrieved data. Only 12–18 clinical variables were used for model training. Logistic regression, random forest classifier, extreme gradient boosting (XGBoost), and deep neural network methods were applied to compare the prediction performances. To reduce overfitting and create a robust model, bootstrapping and grid search with tenfold cross-validation were performed. The XGBoost method in Seoul National University Hospital (SNUH) data delivers the best performance in terms of the area under receiver operating characteristic curve (AUROC) (0.9376) and the area under the precision-recall curve (0.1593). The predictive performance was the best when the SNUH model was validated with Ewha Womans University Medical Center data (AUROC, 0.941). Preoperative albumin, prothrombin time, and age were the most important features in the model for each hospital. It is possible to create a robust artificial intelligence prediction model applicable to multiple institutions through a light predictive model using only minimal preoperative information that can be automatically extracted from each hospital.
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Affiliation(s)
- Seung Wook Lee
- School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Hyung-Chul Lee
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jungyo Suh
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kyung Hyun Lee
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Heonyi Lee
- Bioinformatics Collaboration Unit, Department of Biomedical Systems informatics, Yonsei University College of medicine, Seoul, Republic of Korea
| | - Suryang Seo
- Department of Nursing, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Tae Kyong Kim
- Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Sang-Wook Lee
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Yi-Jun Kim
- Institute of Convergence Medicine, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea.
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16
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Aaltonen T, Amerio S, Amidei D, Anastassov A, Annovi A, Antos J, Apollinari G, Appel JA, Arisawa T, Artikov A, Asaadi J, Ashmanskas W, Auerbach B, Aurisano A, Azfar F, Badgett W, Bae T, Barbaro-Galtieri A, Barnes VE, Barnett BA, Barria P, Bartos P, Bauce M, Bedeschi F, Behari S, Bellettini G, Bellinger J, Benjamin D, Beretvas A, Bhatti A, Bland KR, Blumenfeld B, Bocci A, Bodek A, Bortoletto D, Boudreau J, Boveia A, Brigliadori L, Bromberg C, Brucken E, Budagov J, Budd HS, Burkett K, Busetto G, Bussey P, Butti P, Buzatu A, Calamba A, Camarda S, Campanelli M, Carls B, Carlsmith D, Carosi R, Carrillo S, Casal B, Casarsa M, Castro A, Catastini P, Cauz D, Cavaliere V, Cerri A, Cerrito L, Chen YC, Chertok M, Chiarelli G, Chlachidze G, Cho K, Chokheli D, Clark A, Clarke C, Convery ME, Conway J, Corbo M, Cordelli M, Cox CA, Cox DJ, Cremonesi M, Cruz D, Cuevas J, Culbertson R, d'Ascenzo N, Datta M, de Barbaro P, Demortier L, Deninno M, D'Errico M, Devoto F, Di Canto A, Di Ruzza B, Dittmann JR, Donati S, D'Onofrio M, Dorigo M, Driutti A, Ebina K, Edgar R, Elagin A, Erbacher R, Errede S, Esham B, Farrington S, Fernández Ramos JP, Field R, Flanagan G, Forrest R, Franklin M, Freeman JC, Frisch H, Funakoshi Y, Galloni C, Garfinkel AF, Garosi P, Gerberich H, Gerchtein E, Giagu S, Giakoumopoulou V, Gibson K, Ginsburg CM, Giokaris N, Giromini P, Glagolev V, Glenzinski D, Gold M, Goldin D, Golossanov A, Gomez G, Gomez-Ceballos G, Goncharov M, González López O, Gorelov I, Goshaw AT, Goulianos K, Gramellini E, Grosso-Pilcher C, Guimaraes da Costa J, Hahn SR, Han JY, Happacher F, Hara K, Hare M, Harr RF, Harrington-Taber T, Hatakeyama K, Hays C, Heinrich J, Herndon M, Hocker A, Hong Z, Hopkins W, Hou S, Hughes RE, Husemann U, Hussein M, Huston J, Introzzi G, Iori M, Ivanov A, James E, Jang D, Jayatilaka B, Jeon EJ, Jindariani S, Jones M, Joo KK, Jun SY, Junk TR, Kambeitz M, Kamon T, Karchin PE, Kasmi A, Kato Y, Ketchum W, Keung J, Kilminster B, Kim DH, Kim HS, Kim JE, Kim MJ, Kim SH, Kim SB, Kim YJ, Kim YK, Kimura N, Kirby M, Kondo K, Kong DJ, Konigsberg J, Kotwal AV, Kreps M, Kroll J, Kruse M, Kuhr T, Kurata M, Laasanen AT, Lammel S, Lancaster M, Lannon K, Latino G, Lee HS, Lee JS, Leo S, Leone S, Lewis JD, Limosani A, Lipeles E, Lister A, Liu Q, Liu T, Lockwitz S, Loginov A, Lucchesi D, Lucà A, Lueck J, Lujan P, Lukens P, Lungu G, Lys J, Lysak R, Madrak R, Maestro P, Malik S, Manca G, Manousakis-Katsikakis A, Marchese L, Margaroli F, Marino P, Matera K, Mattson ME, Mazzacane A, Mazzanti P, McNulty R, Mehta A, Mehtala P, Menzione A, Mesropian C, Miao T, Michielin E, Mietlicki D, Mitra A, Miyake H, Moed S, Moggi N, Moon CS, Moore R, Morello MJ, Mukherjee A, Muller T, Murat P, Mussini M, Nachtman J, Nagai Y, Naganoma J, Nakano I, Napier A, Nett J, Nigmanov T, Nodulman L, Noh SY, Norniella O, Oakes L, Oh SH, Oh YD, Okusawa T, Orava R, Ortolan L, Pagliarone C, Palencia E, Palni P, Papadimitriou V, Parker W, Pauletta G, Paulini M, Paus C, Phillips TJ, Piacentino G, Pianori E, Pilot J, Pitts K, Plager C, Pondrom L, Poprocki S, Potamianos K, Pranko A, Prokoshin F, Ptohos F, Punzi G, Redondo Fernández I, Renton P, Rescigno M, Rimondi F, Ristori L, Robson A, Rodriguez T, Rolli S, Ronzani M, Roser R, Rosner JL, Ruffini F, Ruiz A, Russ J, Rusu V, Sakumoto WK, Sakurai Y, Santi L, Sato K, Saveliev V, Savoy-Navarro A, Schlabach P, Schmidt EE, Schwarz T, Scodellaro L, Scuri F, Seidel S, Seiya Y, Semenov A, Sforza F, Shalhout SZ, Shears T, Shepard PF, Shimojima M, Shochet M, Shreyber-Tecker I, Simonenko A, Sliwa K, Smith JR, Snider FD, Song H, Sorin V, St Denis R, Stancari M, Stentz D, Strologas J, Sudo Y, Sukhanov A, Suslov I, Takemasa K, Takeuchi Y, Tang J, Tecchio M, Teng PK, Thom J, Thomson E, Thukral V, Toback D, Tokar S, Tollefson K, Tomura T, Torre S, Torretta D, Totaro P, Trovato M, Ukegawa F, Uozumi S, Vázquez F, Velev G, Vellidis K, Vernieri C, Vidal M, Vilar R, Vizán J, Vogel M, Volpi G, Wagner P, Wallny R, Wang SM, Waters D, Wester WC, Whiteson D, Wicklund AB, Wilbur S, Williams HH, Wilson JS, Wilson P, Winer BL, Wittich P, Wolbers S, Wolfmeister H, Wright T, Wu X, Wu Z, Yamamoto K, Yamato D, Yang T, Yang UK, Yang YC, Yao WM, Yeh GP, Yi K, Yoh J, Yorita K, Yoshida T, Yu GB, Yu I, Zanetti AM, Zeng Y, Zhou C, Zucchelli S. High-precision measurement of the W boson mass with the CDF II detector. Science 2022; 376:170-176. [PMID: 35389814 DOI: 10.1126/science.abk1781] [Citation(s) in RCA: 77] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The mass of the W boson, a mediator of the weak force between elementary particles, is tightly constrained by the symmetries of the standard model of particle physics. The Higgs boson was the last missing component of the model. After observation of the Higgs boson, a measurement of the W boson mass provides a stringent test of the model. We measure the W boson mass, MW, using data corresponding to 8.8 inverse femtobarns of integrated luminosity collected in proton-antiproton collisions at a 1.96 tera-electron volt center-of-mass energy with the CDF II detector at the Fermilab Tevatron collider. A sample of approximately 4 million W boson candidates is used to obtain [Formula: see text], the precision of which exceeds that of all previous measurements combined (stat, statistical uncertainty; syst, systematic uncertainty; MeV, mega-electron volts; c, speed of light in a vacuum). This measurement is in significant tension with the standard model expectation.
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Affiliation(s)
| | - T Aaltonen
- Division of High Energy Physics, Department of Physics, University of Helsinki, FIN-00014, Helsinki, Finland.,Helsinki Institute of Physics, FIN-00014, Helsinki, Finland
| | - S Amerio
- Istituto Nazionale di Fisica Nucleare, Sezione di Padova, I-35131 Padova, Italy.,University of Padova, I-35131 Padova, Italy
| | - D Amidei
- University of Michigan, Ann Arbor, MI 48109, USA
| | - A Anastassov
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - A Annovi
- Laboratori Nazionali di Frascati, Istituto Nazionale di Fisica Nucleare, I-00044 Frascati, Italy
| | - J Antos
- Comenius University, 842 48 Bratislava, Slovakia.,Institute of Experimental Physics, 040 01 Kosice, Slovakia
| | - G Apollinari
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - J A Appel
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | | | - A Artikov
- Joint Institute for Nuclear Research, Dubna RU-141980, Russia
| | - J Asaadi
- Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, TX 77843, USA
| | - W Ashmanskas
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - B Auerbach
- Argonne National Laboratory, Argonne, IL 60439, USA
| | - A Aurisano
- Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, TX 77843, USA
| | - F Azfar
- University of Oxford, Oxford OX1 3RH, UK
| | - W Badgett
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - T Bae
- Center for High Energy Physics, Kyungpook National University, Daegu 702-701, Korea.,Seoul National University, Seoul 151-742, Korea.,Sungkyunkwan University, Suwon 440-746, Korea.,Korea Institute of Science and Technology Information, Daejeon 305-806, Korea.,Chonnam National University, Gwangju 500-757, Korea.,Chonbuk National University, Jeonju 561-756, Korea.,Ewha Womans University, Seoul 120-750, Korea
| | - A Barbaro-Galtieri
- Ernest Orlando Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - V E Barnes
- Purdue University, West Lafayette, IN 47907, USA
| | - B A Barnett
- The Johns Hopkins University, Baltimore, MD 21218, USA
| | - P Barria
- Istituto Nazionale di Fisica Nucleare Pisa, I-56127 Pisa, Italy.,University of Siena, I-53100 Siena, Italy
| | - P Bartos
- Comenius University, 842 48 Bratislava, Slovakia.,Institute of Experimental Physics, 040 01 Kosice, Slovakia
| | - M Bauce
- Istituto Nazionale di Fisica Nucleare, Sezione di Padova, I-35131 Padova, Italy.,University of Padova, I-35131 Padova, Italy
| | - F Bedeschi
- Istituto Nazionale di Fisica Nucleare Pisa, I-56127 Pisa, Italy
| | - S Behari
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - G Bellettini
- Istituto Nazionale di Fisica Nucleare Pisa, I-56127 Pisa, Italy.,University of Pisa, I-56126 Pisa, Italy
| | - J Bellinger
- University of Wisconsin-Madison, Madison, WI 53706, USA
| | | | - A Beretvas
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - A Bhatti
- The Rockefeller University, New York, NY 10065, USA
| | - K R Bland
- Baylor University, Waco, TX 76798, USA
| | - B Blumenfeld
- The Johns Hopkins University, Baltimore, MD 21218, USA
| | - A Bocci
- Duke University, Durham, NC 27708, USA
| | - A Bodek
- University of Rochester, Rochester, NY 14627, USA
| | - D Bortoletto
- Purdue University, West Lafayette, IN 47907, USA
| | - J Boudreau
- University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - A Boveia
- Enrico Fermi Institute, University of Chicago, Chicago, IL 60637, USA
| | - L Brigliadori
- Istituto Nazionale di Fisica Nucleare Bologna, I-40127 Bologna, Italy.,University of Bologna, I-40127 Bologna, Italy
| | - C Bromberg
- Michigan State University, East Lansing, MI 48824, USA
| | - E Brucken
- Division of High Energy Physics, Department of Physics, University of Helsinki, FIN-00014, Helsinki, Finland.,Helsinki Institute of Physics, FIN-00014, Helsinki, Finland
| | - J Budagov
- Joint Institute for Nuclear Research, Dubna RU-141980, Russia
| | - H S Budd
- University of Rochester, Rochester, NY 14627, USA
| | - K Burkett
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - G Busetto
- Istituto Nazionale di Fisica Nucleare, Sezione di Padova, I-35131 Padova, Italy.,University of Padova, I-35131 Padova, Italy
| | - P Bussey
- Glasgow University, Glasgow G12 8QQ, UK
| | - P Butti
- Istituto Nazionale di Fisica Nucleare Pisa, I-56127 Pisa, Italy.,University of Pisa, I-56126 Pisa, Italy
| | - A Buzatu
- Glasgow University, Glasgow G12 8QQ, UK
| | - A Calamba
- Carnegie Mellon University, Pittsburgh, PA 15213, USA
| | - S Camarda
- Institut de Fisica d'Altes Energies, ICREA, Universitat Autonoma de Barcelona, E-08193 Bellaterra (Barcelona), Spain
| | | | - B Carls
- University of Illinois, Urbana, IL 61801, USA
| | - D Carlsmith
- University of Wisconsin-Madison, Madison, WI 53706, USA
| | - R Carosi
- Istituto Nazionale di Fisica Nucleare Pisa, I-56127 Pisa, Italy
| | - S Carrillo
- University of Florida, Gainesville, FL 32611, USA
| | - B Casal
- Instituto de Fisica de Cantabria, CSIC-University of Cantabria, 39005 Santander, Spain
| | - M Casarsa
- Istituto Nazionale di Fisica Nucleare Trieste, I-34127 Trieste, Italy
| | - A Castro
- Istituto Nazionale di Fisica Nucleare Bologna, I-40127 Bologna, Italy.,University of Bologna, I-40127 Bologna, Italy
| | - P Catastini
- Harvard University, Cambridge, MA 02138, USA
| | - D Cauz
- Istituto Nazionale di Fisica Nucleare Trieste, I-34127 Trieste, Italy.,Gruppo Collegato di Udine, I-33100 Udine, Italy.,University of Udine, I-33100 Udine, Italy
| | - V Cavaliere
- University of Illinois, Urbana, IL 61801, USA
| | - A Cerri
- Ernest Orlando Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - L Cerrito
- University College London, London WC1E 6BT, UK
| | - Y C Chen
- Institute of Physics, Academia Sinica, Taipei, Taiwan 11529, Republic of China
| | - M Chertok
- University of California, Davis, Davis, CA 95616, USA
| | - G Chiarelli
- Istituto Nazionale di Fisica Nucleare Pisa, I-56127 Pisa, Italy
| | - G Chlachidze
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - K Cho
- Center for High Energy Physics, Kyungpook National University, Daegu 702-701, Korea.,Seoul National University, Seoul 151-742, Korea.,Sungkyunkwan University, Suwon 440-746, Korea.,Korea Institute of Science and Technology Information, Daejeon 305-806, Korea.,Chonnam National University, Gwangju 500-757, Korea.,Chonbuk National University, Jeonju 561-756, Korea.,Ewha Womans University, Seoul 120-750, Korea
| | - D Chokheli
- Joint Institute for Nuclear Research, Dubna RU-141980, Russia
| | - A Clark
- University of Geneva, CH-1211 Geneva 4, Switzerland
| | - C Clarke
- Wayne State University, Detroit, MI 48201, USA
| | - M E Convery
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - J Conway
- University of California, Davis, Davis, CA 95616, USA
| | - M Corbo
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - M Cordelli
- Laboratori Nazionali di Frascati, Istituto Nazionale di Fisica Nucleare, I-00044 Frascati, Italy
| | - C A Cox
- University of California, Davis, Davis, CA 95616, USA
| | - D J Cox
- University of California, Davis, Davis, CA 95616, USA
| | - M Cremonesi
- Istituto Nazionale di Fisica Nucleare Pisa, I-56127 Pisa, Italy
| | - D Cruz
- Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, TX 77843, USA
| | - J Cuevas
- Instituto de Fisica de Cantabria, CSIC-University of Cantabria, 39005 Santander, Spain
| | - R Culbertson
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - N d'Ascenzo
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - M Datta
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - P de Barbaro
- University of Rochester, Rochester, NY 14627, USA
| | - L Demortier
- The Rockefeller University, New York, NY 10065, USA
| | - M Deninno
- Istituto Nazionale di Fisica Nucleare Bologna, I-40127 Bologna, Italy
| | - M D'Errico
- Istituto Nazionale di Fisica Nucleare, Sezione di Padova, I-35131 Padova, Italy.,University of Padova, I-35131 Padova, Italy
| | - F Devoto
- Division of High Energy Physics, Department of Physics, University of Helsinki, FIN-00014, Helsinki, Finland.,Helsinki Institute of Physics, FIN-00014, Helsinki, Finland
| | - A Di Canto
- Istituto Nazionale di Fisica Nucleare Pisa, I-56127 Pisa, Italy.,University of Pisa, I-56126 Pisa, Italy
| | - B Di Ruzza
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | | | - S Donati
- Istituto Nazionale di Fisica Nucleare Pisa, I-56127 Pisa, Italy.,University of Pisa, I-56126 Pisa, Italy
| | - M D'Onofrio
- University of Liverpool, Liverpool L69 7ZE, UK
| | - M Dorigo
- Istituto Nazionale di Fisica Nucleare Trieste, I-34127 Trieste, Italy.,University of Trieste, I-34127 Trieste, Italy
| | - A Driutti
- Istituto Nazionale di Fisica Nucleare Trieste, I-34127 Trieste, Italy.,Gruppo Collegato di Udine, I-33100 Udine, Italy.,University of Udine, I-33100 Udine, Italy
| | - K Ebina
- Waseda University, Tokyo 169, Japan
| | - R Edgar
- University of Michigan, Ann Arbor, MI 48109, USA
| | - A Elagin
- Enrico Fermi Institute, University of Chicago, Chicago, IL 60637, USA
| | - R Erbacher
- University of California, Davis, Davis, CA 95616, USA
| | - S Errede
- University of Illinois, Urbana, IL 61801, USA
| | - B Esham
- University of Illinois, Urbana, IL 61801, USA
| | | | - J P Fernández Ramos
- Centro de Investigaciones Energeticas Medioambientales y Tecnologicas, E-28040 Madrid, Spain
| | - R Field
- University of Florida, Gainesville, FL 32611, USA
| | - G Flanagan
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - R Forrest
- University of California, Davis, Davis, CA 95616, USA
| | - M Franklin
- Harvard University, Cambridge, MA 02138, USA
| | - J C Freeman
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - H Frisch
- Enrico Fermi Institute, University of Chicago, Chicago, IL 60637, USA
| | | | - C Galloni
- Istituto Nazionale di Fisica Nucleare Pisa, I-56127 Pisa, Italy.,University of Pisa, I-56126 Pisa, Italy
| | | | - P Garosi
- Istituto Nazionale di Fisica Nucleare Pisa, I-56127 Pisa, Italy.,University of Siena, I-53100 Siena, Italy
| | - H Gerberich
- University of Illinois, Urbana, IL 61801, USA
| | - E Gerchtein
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - S Giagu
- Istituto Nazionale di Fisica Nucleare, Sezione di Roma 1, I-00185 Roma, Italy
| | - V Giakoumopoulou
- National and Kapodistrian University of Athens, 157 71 Athens, Greece
| | - K Gibson
- University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - C M Ginsburg
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - N Giokaris
- National and Kapodistrian University of Athens, 157 71 Athens, Greece
| | - P Giromini
- Laboratori Nazionali di Frascati, Istituto Nazionale di Fisica Nucleare, I-00044 Frascati, Italy
| | - V Glagolev
- Joint Institute for Nuclear Research, Dubna RU-141980, Russia
| | - D Glenzinski
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - M Gold
- University of New Mexico, Albuquerque, NM 87131, USA
| | - D Goldin
- Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, TX 77843, USA
| | - A Golossanov
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - G Gomez
- Instituto de Fisica de Cantabria, CSIC-University of Cantabria, 39005 Santander, Spain
| | | | - M Goncharov
- Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - O González López
- Centro de Investigaciones Energeticas Medioambientales y Tecnologicas, E-28040 Madrid, Spain
| | - I Gorelov
- University of New Mexico, Albuquerque, NM 87131, USA
| | | | - K Goulianos
- The Rockefeller University, New York, NY 10065, USA
| | - E Gramellini
- Istituto Nazionale di Fisica Nucleare Bologna, I-40127 Bologna, Italy
| | - C Grosso-Pilcher
- Enrico Fermi Institute, University of Chicago, Chicago, IL 60637, USA
| | | | - S R Hahn
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - J Y Han
- University of Rochester, Rochester, NY 14627, USA
| | - F Happacher
- Laboratori Nazionali di Frascati, Istituto Nazionale di Fisica Nucleare, I-00044 Frascati, Italy
| | - K Hara
- University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - M Hare
- Tufts University, Medford, MA 02155, USA
| | - R F Harr
- Wayne State University, Detroit, MI 48201, USA
| | | | | | - C Hays
- University of Oxford, Oxford OX1 3RH, UK
| | - J Heinrich
- University of Pennsylvania, Philadelphia, PA 19104, USA
| | - M Herndon
- University of Wisconsin-Madison, Madison, WI 53706, USA
| | - A Hocker
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - Z Hong
- Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, TX 77843, USA
| | - W Hopkins
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - S Hou
- Institute of Physics, Academia Sinica, Taipei, Taiwan 11529, Republic of China
| | - R E Hughes
- The Ohio State University, Columbus, OH 43210, USA
| | - U Husemann
- Yale University, New Haven, CT 06520, USA
| | - M Hussein
- Michigan State University, East Lansing, MI 48824, USA
| | - J Huston
- Michigan State University, East Lansing, MI 48824, USA
| | - G Introzzi
- Istituto Nazionale di Fisica Nucleare Pisa, I-56127 Pisa, Italy.,Istituto Nazionale di Fisica Nucleare Pavia, I-27100 Pavia, Italy.,University of Pavia, I-27100 Pavia, Italy
| | - M Iori
- Istituto Nazionale di Fisica Nucleare, Sezione di Roma 1, I-00185 Roma, Italy.,Sapienza Università di Roma, I-00185 Roma, Italy
| | - A Ivanov
- University of California, Davis, Davis, CA 95616, USA
| | - E James
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - D Jang
- Carnegie Mellon University, Pittsburgh, PA 15213, USA
| | - B Jayatilaka
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - E J Jeon
- Center for High Energy Physics, Kyungpook National University, Daegu 702-701, Korea.,Seoul National University, Seoul 151-742, Korea.,Sungkyunkwan University, Suwon 440-746, Korea.,Korea Institute of Science and Technology Information, Daejeon 305-806, Korea.,Chonnam National University, Gwangju 500-757, Korea.,Chonbuk National University, Jeonju 561-756, Korea.,Ewha Womans University, Seoul 120-750, Korea
| | - S Jindariani
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - M Jones
- Purdue University, West Lafayette, IN 47907, USA
| | - K K Joo
- Center for High Energy Physics, Kyungpook National University, Daegu 702-701, Korea.,Seoul National University, Seoul 151-742, Korea.,Sungkyunkwan University, Suwon 440-746, Korea.,Korea Institute of Science and Technology Information, Daejeon 305-806, Korea.,Chonnam National University, Gwangju 500-757, Korea.,Chonbuk National University, Jeonju 561-756, Korea.,Ewha Womans University, Seoul 120-750, Korea
| | - S Y Jun
- Carnegie Mellon University, Pittsburgh, PA 15213, USA
| | - T R Junk
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - M Kambeitz
- Institut für Experimentelle Kernphysik, Karlsruhe Institute of Technology, D-76131 Karlsruhe, Germany
| | - T Kamon
- Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, TX 77843, USA.,Center for High Energy Physics, Kyungpook National University, Daegu 702-701, Korea.,Seoul National University, Seoul 151-742, Korea.,Sungkyunkwan University, Suwon 440-746, Korea.,Korea Institute of Science and Technology Information, Daejeon 305-806, Korea.,Chonnam National University, Gwangju 500-757, Korea.,Chonbuk National University, Jeonju 561-756, Korea.,Ewha Womans University, Seoul 120-750, Korea
| | - P E Karchin
- Wayne State University, Detroit, MI 48201, USA
| | - A Kasmi
- Baylor University, Waco, TX 76798, USA
| | - Y Kato
- Osaka City University, Osaka 558-8585, Japan
| | - W Ketchum
- Enrico Fermi Institute, University of Chicago, Chicago, IL 60637, USA
| | - J Keung
- University of Pennsylvania, Philadelphia, PA 19104, USA
| | - B Kilminster
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - D H Kim
- Center for High Energy Physics, Kyungpook National University, Daegu 702-701, Korea.,Seoul National University, Seoul 151-742, Korea.,Sungkyunkwan University, Suwon 440-746, Korea.,Korea Institute of Science and Technology Information, Daejeon 305-806, Korea.,Chonnam National University, Gwangju 500-757, Korea.,Chonbuk National University, Jeonju 561-756, Korea.,Ewha Womans University, Seoul 120-750, Korea
| | - H S Kim
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - J E Kim
- Center for High Energy Physics, Kyungpook National University, Daegu 702-701, Korea.,Seoul National University, Seoul 151-742, Korea.,Sungkyunkwan University, Suwon 440-746, Korea.,Korea Institute of Science and Technology Information, Daejeon 305-806, Korea.,Chonnam National University, Gwangju 500-757, Korea.,Chonbuk National University, Jeonju 561-756, Korea.,Ewha Womans University, Seoul 120-750, Korea
| | - M J Kim
- Laboratori Nazionali di Frascati, Istituto Nazionale di Fisica Nucleare, I-00044 Frascati, Italy
| | - S H Kim
- University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - S B Kim
- Center for High Energy Physics, Kyungpook National University, Daegu 702-701, Korea.,Seoul National University, Seoul 151-742, Korea.,Sungkyunkwan University, Suwon 440-746, Korea.,Korea Institute of Science and Technology Information, Daejeon 305-806, Korea.,Chonnam National University, Gwangju 500-757, Korea.,Chonbuk National University, Jeonju 561-756, Korea.,Ewha Womans University, Seoul 120-750, Korea
| | - Y J Kim
- Center for High Energy Physics, Kyungpook National University, Daegu 702-701, Korea.,Seoul National University, Seoul 151-742, Korea.,Sungkyunkwan University, Suwon 440-746, Korea.,Korea Institute of Science and Technology Information, Daejeon 305-806, Korea.,Chonnam National University, Gwangju 500-757, Korea.,Chonbuk National University, Jeonju 561-756, Korea.,Ewha Womans University, Seoul 120-750, Korea
| | - Y K Kim
- Enrico Fermi Institute, University of Chicago, Chicago, IL 60637, USA
| | - N Kimura
- Waseda University, Tokyo 169, Japan
| | - M Kirby
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - K Kondo
- Waseda University, Tokyo 169, Japan
| | - D J Kong
- Center for High Energy Physics, Kyungpook National University, Daegu 702-701, Korea.,Seoul National University, Seoul 151-742, Korea.,Sungkyunkwan University, Suwon 440-746, Korea.,Korea Institute of Science and Technology Information, Daejeon 305-806, Korea.,Chonnam National University, Gwangju 500-757, Korea.,Chonbuk National University, Jeonju 561-756, Korea.,Ewha Womans University, Seoul 120-750, Korea
| | - J Konigsberg
- University of Florida, Gainesville, FL 32611, USA
| | | | - M Kreps
- Institut für Experimentelle Kernphysik, Karlsruhe Institute of Technology, D-76131 Karlsruhe, Germany
| | - J Kroll
- University of Pennsylvania, Philadelphia, PA 19104, USA
| | - M Kruse
- Duke University, Durham, NC 27708, USA
| | - T Kuhr
- Institut für Experimentelle Kernphysik, Karlsruhe Institute of Technology, D-76131 Karlsruhe, Germany
| | - M Kurata
- University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - A T Laasanen
- Purdue University, West Lafayette, IN 47907, USA
| | - S Lammel
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - M Lancaster
- University College London, London WC1E 6BT, UK
| | - K Lannon
- The Ohio State University, Columbus, OH 43210, USA
| | - G Latino
- Istituto Nazionale di Fisica Nucleare Pisa, I-56127 Pisa, Italy.,University of Siena, I-53100 Siena, Italy
| | - H S Lee
- Center for High Energy Physics, Kyungpook National University, Daegu 702-701, Korea.,Seoul National University, Seoul 151-742, Korea.,Sungkyunkwan University, Suwon 440-746, Korea.,Korea Institute of Science and Technology Information, Daejeon 305-806, Korea.,Chonnam National University, Gwangju 500-757, Korea.,Chonbuk National University, Jeonju 561-756, Korea.,Ewha Womans University, Seoul 120-750, Korea
| | - J S Lee
- Center for High Energy Physics, Kyungpook National University, Daegu 702-701, Korea.,Seoul National University, Seoul 151-742, Korea.,Sungkyunkwan University, Suwon 440-746, Korea.,Korea Institute of Science and Technology Information, Daejeon 305-806, Korea.,Chonnam National University, Gwangju 500-757, Korea.,Chonbuk National University, Jeonju 561-756, Korea.,Ewha Womans University, Seoul 120-750, Korea
| | - S Leo
- University of Illinois, Urbana, IL 61801, USA
| | - S Leone
- Istituto Nazionale di Fisica Nucleare Pisa, I-56127 Pisa, Italy
| | - J D Lewis
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | | | - E Lipeles
- University of Pennsylvania, Philadelphia, PA 19104, USA
| | - A Lister
- University of Geneva, CH-1211 Geneva 4, Switzerland
| | - Q Liu
- Purdue University, West Lafayette, IN 47907, USA
| | - T Liu
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - S Lockwitz
- Yale University, New Haven, CT 06520, USA
| | - A Loginov
- Yale University, New Haven, CT 06520, USA
| | - D Lucchesi
- Istituto Nazionale di Fisica Nucleare, Sezione di Padova, I-35131 Padova, Italy.,University of Padova, I-35131 Padova, Italy
| | - A Lucà
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA.,Laboratori Nazionali di Frascati, Istituto Nazionale di Fisica Nucleare, I-00044 Frascati, Italy
| | - J Lueck
- Institut für Experimentelle Kernphysik, Karlsruhe Institute of Technology, D-76131 Karlsruhe, Germany
| | - P Lujan
- Ernest Orlando Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - P Lukens
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - G Lungu
- The Rockefeller University, New York, NY 10065, USA
| | - J Lys
- Ernest Orlando Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - R Lysak
- Comenius University, 842 48 Bratislava, Slovakia.,Institute of Experimental Physics, 040 01 Kosice, Slovakia
| | - R Madrak
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - P Maestro
- Istituto Nazionale di Fisica Nucleare Pisa, I-56127 Pisa, Italy.,University of Siena, I-53100 Siena, Italy
| | - S Malik
- The Rockefeller University, New York, NY 10065, USA
| | - G Manca
- University of Liverpool, Liverpool L69 7ZE, UK
| | | | - L Marchese
- Istituto Nazionale di Fisica Nucleare Bologna, I-40127 Bologna, Italy
| | - F Margaroli
- Istituto Nazionale di Fisica Nucleare, Sezione di Roma 1, I-00185 Roma, Italy
| | - P Marino
- Istituto Nazionale di Fisica Nucleare Pisa, I-56127 Pisa, Italy.,Scuola Normale Superiore, I-56126 Pisa, Italy
| | - K Matera
- University of Illinois, Urbana, IL 61801, USA
| | - M E Mattson
- Wayne State University, Detroit, MI 48201, USA
| | - A Mazzacane
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - P Mazzanti
- Istituto Nazionale di Fisica Nucleare Bologna, I-40127 Bologna, Italy
| | - R McNulty
- University of Liverpool, Liverpool L69 7ZE, UK
| | - A Mehta
- University of Liverpool, Liverpool L69 7ZE, UK
| | - P Mehtala
- Division of High Energy Physics, Department of Physics, University of Helsinki, FIN-00014, Helsinki, Finland.,Helsinki Institute of Physics, FIN-00014, Helsinki, Finland
| | - A Menzione
- Istituto Nazionale di Fisica Nucleare Pisa, I-56127 Pisa, Italy
| | - C Mesropian
- The Rockefeller University, New York, NY 10065, USA
| | - T Miao
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - E Michielin
- Istituto Nazionale di Fisica Nucleare, Sezione di Padova, I-35131 Padova, Italy.,University of Padova, I-35131 Padova, Italy
| | - D Mietlicki
- University of Michigan, Ann Arbor, MI 48109, USA
| | - A Mitra
- Institute of Physics, Academia Sinica, Taipei, Taiwan 11529, Republic of China
| | - H Miyake
- University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - S Moed
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - N Moggi
- Istituto Nazionale di Fisica Nucleare Bologna, I-40127 Bologna, Italy
| | - C S Moon
- Center for High Energy Physics, Kyungpook National University, Daegu 702-701, Korea.,Seoul National University, Seoul 151-742, Korea.,Sungkyunkwan University, Suwon 440-746, Korea.,Korea Institute of Science and Technology Information, Daejeon 305-806, Korea.,Chonnam National University, Gwangju 500-757, Korea.,Chonbuk National University, Jeonju 561-756, Korea.,Ewha Womans University, Seoul 120-750, Korea
| | - R Moore
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - M J Morello
- Istituto Nazionale di Fisica Nucleare Pisa, I-56127 Pisa, Italy.,Scuola Normale Superiore, I-56126 Pisa, Italy
| | - A Mukherjee
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - Th Muller
- Institut für Experimentelle Kernphysik, Karlsruhe Institute of Technology, D-76131 Karlsruhe, Germany
| | - P Murat
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - M Mussini
- Istituto Nazionale di Fisica Nucleare Bologna, I-40127 Bologna, Italy.,University of Bologna, I-40127 Bologna, Italy
| | - J Nachtman
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - Y Nagai
- University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | | | - I Nakano
- Okayama University, Okayama 700-8530, Japan
| | - A Napier
- Tufts University, Medford, MA 02155, USA
| | - J Nett
- Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, TX 77843, USA
| | - T Nigmanov
- University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - L Nodulman
- Argonne National Laboratory, Argonne, IL 60439, USA
| | - S Y Noh
- Center for High Energy Physics, Kyungpook National University, Daegu 702-701, Korea.,Seoul National University, Seoul 151-742, Korea.,Sungkyunkwan University, Suwon 440-746, Korea.,Korea Institute of Science and Technology Information, Daejeon 305-806, Korea.,Chonnam National University, Gwangju 500-757, Korea.,Chonbuk National University, Jeonju 561-756, Korea.,Ewha Womans University, Seoul 120-750, Korea
| | - O Norniella
- University of Illinois, Urbana, IL 61801, USA
| | - L Oakes
- University of Oxford, Oxford OX1 3RH, UK
| | - S H Oh
- Duke University, Durham, NC 27708, USA
| | - Y D Oh
- Center for High Energy Physics, Kyungpook National University, Daegu 702-701, Korea.,Seoul National University, Seoul 151-742, Korea.,Sungkyunkwan University, Suwon 440-746, Korea.,Korea Institute of Science and Technology Information, Daejeon 305-806, Korea.,Chonnam National University, Gwangju 500-757, Korea.,Chonbuk National University, Jeonju 561-756, Korea.,Ewha Womans University, Seoul 120-750, Korea
| | - T Okusawa
- Osaka City University, Osaka 558-8585, Japan
| | - R Orava
- Division of High Energy Physics, Department of Physics, University of Helsinki, FIN-00014, Helsinki, Finland.,Helsinki Institute of Physics, FIN-00014, Helsinki, Finland
| | - L Ortolan
- Institut de Fisica d'Altes Energies, ICREA, Universitat Autonoma de Barcelona, E-08193 Bellaterra (Barcelona), Spain
| | - C Pagliarone
- Istituto Nazionale di Fisica Nucleare Trieste, I-34127 Trieste, Italy
| | - E Palencia
- Instituto de Fisica de Cantabria, CSIC-University of Cantabria, 39005 Santander, Spain
| | - P Palni
- University of New Mexico, Albuquerque, NM 87131, USA
| | - V Papadimitriou
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - W Parker
- University of Wisconsin-Madison, Madison, WI 53706, USA
| | - G Pauletta
- Istituto Nazionale di Fisica Nucleare Trieste, I-34127 Trieste, Italy.,Gruppo Collegato di Udine, I-33100 Udine, Italy.,University of Udine, I-33100 Udine, Italy
| | - M Paulini
- Carnegie Mellon University, Pittsburgh, PA 15213, USA
| | - C Paus
- Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | | | - G Piacentino
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - E Pianori
- University of Pennsylvania, Philadelphia, PA 19104, USA
| | - J Pilot
- University of California, Davis, Davis, CA 95616, USA
| | - K Pitts
- University of Illinois, Urbana, IL 61801, USA
| | - C Plager
- University of California, Los Angeles, Los Angeles, CA 90024, USA
| | - L Pondrom
- University of Wisconsin-Madison, Madison, WI 53706, USA
| | - S Poprocki
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - K Potamianos
- Ernest Orlando Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - A Pranko
- Ernest Orlando Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - F Prokoshin
- Joint Institute for Nuclear Research, Dubna RU-141980, Russia
| | - F Ptohos
- Laboratori Nazionali di Frascati, Istituto Nazionale di Fisica Nucleare, I-00044 Frascati, Italy
| | - G Punzi
- Istituto Nazionale di Fisica Nucleare Pisa, I-56127 Pisa, Italy.,University of Pisa, I-56126 Pisa, Italy
| | - I Redondo Fernández
- Centro de Investigaciones Energeticas Medioambientales y Tecnologicas, E-28040 Madrid, Spain
| | - P Renton
- University of Oxford, Oxford OX1 3RH, UK
| | - M Rescigno
- Istituto Nazionale di Fisica Nucleare, Sezione di Roma 1, I-00185 Roma, Italy
| | - F Rimondi
- Istituto Nazionale di Fisica Nucleare Bologna, I-40127 Bologna, Italy
| | - L Ristori
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA.,Istituto Nazionale di Fisica Nucleare Pisa, I-56127 Pisa, Italy
| | - A Robson
- Glasgow University, Glasgow G12 8QQ, UK
| | - T Rodriguez
- University of Pennsylvania, Philadelphia, PA 19104, USA
| | - S Rolli
- Tufts University, Medford, MA 02155, USA
| | - M Ronzani
- Istituto Nazionale di Fisica Nucleare Pisa, I-56127 Pisa, Italy.,University of Pisa, I-56126 Pisa, Italy
| | - R Roser
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - J L Rosner
- Enrico Fermi Institute, University of Chicago, Chicago, IL 60637, USA
| | - F Ruffini
- Istituto Nazionale di Fisica Nucleare Pisa, I-56127 Pisa, Italy.,University of Siena, I-53100 Siena, Italy
| | - A Ruiz
- Instituto de Fisica de Cantabria, CSIC-University of Cantabria, 39005 Santander, Spain
| | - J Russ
- Carnegie Mellon University, Pittsburgh, PA 15213, USA
| | - V Rusu
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - W K Sakumoto
- University of Rochester, Rochester, NY 14627, USA
| | | | - L Santi
- Istituto Nazionale di Fisica Nucleare Trieste, I-34127 Trieste, Italy.,Gruppo Collegato di Udine, I-33100 Udine, Italy.,University of Udine, I-33100 Udine, Italy
| | - K Sato
- University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - V Saveliev
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - A Savoy-Navarro
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - P Schlabach
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - E E Schmidt
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - T Schwarz
- University of Michigan, Ann Arbor, MI 48109, USA
| | - L Scodellaro
- Instituto de Fisica de Cantabria, CSIC-University of Cantabria, 39005 Santander, Spain
| | - F Scuri
- Istituto Nazionale di Fisica Nucleare Pisa, I-56127 Pisa, Italy
| | - S Seidel
- University of New Mexico, Albuquerque, NM 87131, USA
| | - Y Seiya
- Osaka City University, Osaka 558-8585, Japan
| | - A Semenov
- Joint Institute for Nuclear Research, Dubna RU-141980, Russia
| | - F Sforza
- Istituto Nazionale di Fisica Nucleare Pisa, I-56127 Pisa, Italy.,University of Pisa, I-56126 Pisa, Italy
| | - S Z Shalhout
- University of California, Davis, Davis, CA 95616, USA
| | - T Shears
- University of Liverpool, Liverpool L69 7ZE, UK
| | - P F Shepard
- University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - M Shimojima
- University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - M Shochet
- Enrico Fermi Institute, University of Chicago, Chicago, IL 60637, USA
| | - I Shreyber-Tecker
- Institution for Theoretical and Experimental Physics, ITEP, Moscow 117259, Russia
| | - A Simonenko
- Joint Institute for Nuclear Research, Dubna RU-141980, Russia
| | - K Sliwa
- Tufts University, Medford, MA 02155, USA
| | - J R Smith
- University of California, Davis, Davis, CA 95616, USA
| | - F D Snider
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - H Song
- University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - V Sorin
- Institut de Fisica d'Altes Energies, ICREA, Universitat Autonoma de Barcelona, E-08193 Bellaterra (Barcelona), Spain
| | | | - M Stancari
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - D Stentz
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - J Strologas
- University of New Mexico, Albuquerque, NM 87131, USA
| | - Y Sudo
- University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - A Sukhanov
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - I Suslov
- Joint Institute for Nuclear Research, Dubna RU-141980, Russia
| | - K Takemasa
- University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - Y Takeuchi
- University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - J Tang
- Enrico Fermi Institute, University of Chicago, Chicago, IL 60637, USA
| | - M Tecchio
- University of Michigan, Ann Arbor, MI 48109, USA
| | - P K Teng
- Institute of Physics, Academia Sinica, Taipei, Taiwan 11529, Republic of China
| | - J Thom
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - E Thomson
- University of Pennsylvania, Philadelphia, PA 19104, USA
| | - V Thukral
- Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, TX 77843, USA
| | - D Toback
- Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, TX 77843, USA
| | - S Tokar
- Comenius University, 842 48 Bratislava, Slovakia.,Institute of Experimental Physics, 040 01 Kosice, Slovakia
| | - K Tollefson
- Michigan State University, East Lansing, MI 48824, USA
| | - T Tomura
- University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - S Torre
- Laboratori Nazionali di Frascati, Istituto Nazionale di Fisica Nucleare, I-00044 Frascati, Italy
| | - D Torretta
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - P Totaro
- Istituto Nazionale di Fisica Nucleare, Sezione di Padova, I-35131 Padova, Italy
| | - M Trovato
- Istituto Nazionale di Fisica Nucleare Pisa, I-56127 Pisa, Italy.,Scuola Normale Superiore, I-56126 Pisa, Italy
| | - F Ukegawa
- University of Tsukuba, Tsukuba, Ibaraki 305, Japan
| | - S Uozumi
- Center for High Energy Physics, Kyungpook National University, Daegu 702-701, Korea.,Seoul National University, Seoul 151-742, Korea.,Sungkyunkwan University, Suwon 440-746, Korea.,Korea Institute of Science and Technology Information, Daejeon 305-806, Korea.,Chonnam National University, Gwangju 500-757, Korea.,Chonbuk National University, Jeonju 561-756, Korea.,Ewha Womans University, Seoul 120-750, Korea
| | - F Vázquez
- University of Florida, Gainesville, FL 32611, USA
| | - G Velev
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - K Vellidis
- National and Kapodistrian University of Athens, 157 71 Athens, Greece
| | - C Vernieri
- Istituto Nazionale di Fisica Nucleare Pisa, I-56127 Pisa, Italy.,Scuola Normale Superiore, I-56126 Pisa, Italy
| | - M Vidal
- Purdue University, West Lafayette, IN 47907, USA
| | - R Vilar
- Instituto de Fisica de Cantabria, CSIC-University of Cantabria, 39005 Santander, Spain
| | - J Vizán
- Instituto de Fisica de Cantabria, CSIC-University of Cantabria, 39005 Santander, Spain
| | - M Vogel
- University of New Mexico, Albuquerque, NM 87131, USA
| | - G Volpi
- Laboratori Nazionali di Frascati, Istituto Nazionale di Fisica Nucleare, I-00044 Frascati, Italy
| | - P Wagner
- University of Pennsylvania, Philadelphia, PA 19104, USA
| | - R Wallny
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - S M Wang
- Institute of Physics, Academia Sinica, Taipei, Taiwan 11529, Republic of China
| | - D Waters
- University College London, London WC1E 6BT, UK
| | - W C Wester
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - D Whiteson
- University of Pennsylvania, Philadelphia, PA 19104, USA
| | - A B Wicklund
- Argonne National Laboratory, Argonne, IL 60439, USA
| | - S Wilbur
- University of California, Davis, Davis, CA 95616, USA
| | - H H Williams
- University of Pennsylvania, Philadelphia, PA 19104, USA
| | - J S Wilson
- University of Michigan, Ann Arbor, MI 48109, USA
| | - P Wilson
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - B L Winer
- The Ohio State University, Columbus, OH 43210, USA
| | - P Wittich
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - S Wolbers
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | | | - T Wright
- University of Michigan, Ann Arbor, MI 48109, USA
| | - X Wu
- University of Geneva, CH-1211 Geneva 4, Switzerland
| | - Z Wu
- Baylor University, Waco, TX 76798, USA
| | - K Yamamoto
- Osaka City University, Osaka 558-8585, Japan
| | - D Yamato
- Osaka City University, Osaka 558-8585, Japan
| | - T Yang
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - U K Yang
- Center for High Energy Physics, Kyungpook National University, Daegu 702-701, Korea.,Seoul National University, Seoul 151-742, Korea.,Sungkyunkwan University, Suwon 440-746, Korea.,Korea Institute of Science and Technology Information, Daejeon 305-806, Korea.,Chonnam National University, Gwangju 500-757, Korea.,Chonbuk National University, Jeonju 561-756, Korea.,Ewha Womans University, Seoul 120-750, Korea
| | - Y C Yang
- Center for High Energy Physics, Kyungpook National University, Daegu 702-701, Korea.,Seoul National University, Seoul 151-742, Korea.,Sungkyunkwan University, Suwon 440-746, Korea.,Korea Institute of Science and Technology Information, Daejeon 305-806, Korea.,Chonnam National University, Gwangju 500-757, Korea.,Chonbuk National University, Jeonju 561-756, Korea.,Ewha Womans University, Seoul 120-750, Korea
| | - W-M Yao
- Ernest Orlando Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - G P Yeh
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - K Yi
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - J Yoh
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - K Yorita
- Waseda University, Tokyo 169, Japan
| | - T Yoshida
- Osaka City University, Osaka 558-8585, Japan
| | - G B Yu
- Center for High Energy Physics, Kyungpook National University, Daegu 702-701, Korea.,Seoul National University, Seoul 151-742, Korea.,Sungkyunkwan University, Suwon 440-746, Korea.,Korea Institute of Science and Technology Information, Daejeon 305-806, Korea.,Chonnam National University, Gwangju 500-757, Korea.,Chonbuk National University, Jeonju 561-756, Korea.,Ewha Womans University, Seoul 120-750, Korea
| | - I Yu
- Center for High Energy Physics, Kyungpook National University, Daegu 702-701, Korea.,Seoul National University, Seoul 151-742, Korea.,Sungkyunkwan University, Suwon 440-746, Korea.,Korea Institute of Science and Technology Information, Daejeon 305-806, Korea.,Chonnam National University, Gwangju 500-757, Korea.,Chonbuk National University, Jeonju 561-756, Korea.,Ewha Womans University, Seoul 120-750, Korea
| | - A M Zanetti
- Istituto Nazionale di Fisica Nucleare Trieste, I-34127 Trieste, Italy
| | - Y Zeng
- Duke University, Durham, NC 27708, USA
| | - C Zhou
- Duke University, Durham, NC 27708, USA
| | - S Zucchelli
- Istituto Nazionale di Fisica Nucleare Bologna, I-40127 Bologna, Italy.,University of Bologna, I-40127 Bologna, Italy
| |
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17
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Lee KH, Lee H, Park JH, Kim YJ, Lee Y. ANNO: A General Annotation Tool for Bilingual Clinical Note Information Extraction. Healthc Inform Res 2022; 28:89-94. [PMID: 35172094 PMCID: PMC8850170 DOI: 10.4258/hir.2022.28.1.89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 01/05/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives: This study was conducted to develop a generalizable annotation tool for bilingual complex clinical text annotation, which led to the design and development of a clinical text annotation tool, ANNO.Methods: We designed ANNO to enable human annotators to support the annotation of information in clinical documents efficiently and accurately. First, annotations for different classes (word or phrase types) can be tagged according to the type of word using the dictionary function. In addition, it is possible to evaluate and reconcile differences by comparing annotation results between human annotators. Moreover, if the regular expression set for each class is updated during annotation, it is automatically reflected in the new document. The regular expression set created by human annotators is designed such that a word tagged once is automatically labeled in new documents.Results: Because ANNO is a Docker-based web application, users can use it freely without being subjected to dependency issues. Human annotators can share their annotation markups as regular expression sets with a dictionary structure, and they can cross-check their annotated corpora with each other. The dictionary-based regular expression sharing function, cross-check function for each annotator, and standardized input (Microsoft Excel) and output (extensible markup language [XML]) formats are the main features of ANNO.Conclusions: With the growing need for massively annotated clinical data to support the development of machine learning models, we expect ANNO to be helpful to many researchers.
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Affiliation(s)
- Kye Hwa Lee
- Department of Information Medicine, Asan Medical Center, Seoul, Korea
| | - Hyunsung Lee
- Research & Development Team, iKooB, Seoul, Korea
| | - Jin-Hyeok Park
- Department of IT Convergence Engineering, Gachon University, Seongnam, Korea
| | - Yi-Jun Kim
- Institute of Convergence Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Youngho Lee
- Department of IT Convergence Engineering, Gachon University, Seongnam, Korea
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18
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Kim YJ. Diagnostic Accuracy of Unenhanced Abbreviated Diffusion-Weighted Magnetic Resonance Imaging Versus Postcontrast Abbreviated Breast Magnetic Resonance Imaging for Breast Cancer. Hong Kong Journal of Radiology 2022. [DOI: 10.12809/hkjr2117203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- YJ Kim
- Department of Radiology, Konyang University Hospital, Republic of Korea
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19
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Kim YJ, Jee Y, Park S, Ha EH, Jo I, Lee HW, Song MS. Mortality Risk within 14 Days after Coronavirus Disease 2019 Diagnosis in Dementia Patients: A Nationwide Analysis. Dement Geriatr Cogn Disord 2021; 50:425-436. [PMID: 34856552 PMCID: PMC8805064 DOI: 10.1159/000519466] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 09/04/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The study evaluated the increased mortality risk within 14 days of coronavirus disease 2019 (COVID-19) diagnosis in dementia patients. METHODS This retrospective study was conducted from February to April 2020 using the COVID-19 patients' database from the Korea Disease Control and Prevention Agency. The risk factors for early death within 14 days were determined using generalized logistic regression performed in a stepwise manner. Dementia patients diagnosed with COVID-19 were used for the study. The propensity score-matched cohort was included as controls. The differences in mortality within 14 days after COVID-19 diagnosis between the dementia patients and controls were evaluated. RESULTS We enrolled 5,349 COVID-19 patients from the database; 224 had dementia as comorbidity. The mortality rate within 14 days after COVID-19 diagnosis in dementia patients and the controls was 23.7% versus 1.7%, respectively, before propensity score matching (PSM) (p < 0.001), and 23.7% versus 9.2% after PSM (p < 0.001). The hazard ratio (HR) for mortality within 14 days in COVID-19 patients with dementia was significant even after PSM (HR 5.104, 95% confidence interval 2.889-5.673, p < 0.001). The survival curve of dementia patients was steeply inclined within 14 days after COVID-19 diagnosis, resulting in 70.7% of all deaths in dementia patients. CONCLUSIONS COVID-19 patients with dementia had a higher risk of early death within 14 days. Thus, prompt intervention is necessary for dementia patients after COVID-19 diagnosis.
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Affiliation(s)
- Yi-Jun Kim
- Institute of Convergence Medicine, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea
| | - Yongho Jee
- Advanced Biomedical Research Institute, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea
| | - Sholhui Park
- Department of Laboratory Medicine, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea
| | - Eun-Hee Ha
- Department of Occupational and Environmental Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea
- System Health Science & Engineering, Ewha Womans University, Seoul, Republic of Korea
| | - Inho Jo
- System Health Science & Engineering, Ewha Womans University, Seoul, Republic of Korea
- Department of Molecular Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Hyang Woon Lee
- System Health Science & Engineering, Ewha Womans University, Seoul, Republic of Korea
- Departments of Neurology, Medical Science, and Computational Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Myung Seon Song
- Department of Psychiatry, Keyo Hospital, Uiwang, Republic of Korea
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20
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Lee JJ, Kang HY, Lee WI, Cho SY, Kim YJ, Lee HJ. Efflux pump gene expression study using RNA-seq in multidrug-resistant TB. Int J Tuberc Lung Dis 2021; 25:974-981. [PMID: 34886926 DOI: 10.5588/ijtld.21.0117] [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: 11/10/2022] Open
Abstract
BACKGROUND: The mechanism underlying kanamycin (KM) resistance in Mycobacterium tuberculosis is not well understood, although efflux pump proteins are thought to play a role. This study used RNA-seq data to investigate changes in the expression levels of efflux pump genes following exposure to KM.METHODS: RNA expression of efflux pump and regulatory genes following exposure to different concentrations of KM (minimum inhibitory concentration MIC 25 and MIC50) in rrs wild-type strain and rrs A1401G mutated strain were compared with the control group.RESULTS: The selected strains had differential RNA expression patterns. Among the 71 putative efflux pump and regulatory genes, 46 had significant fold changes, and 12 genes (Rv0842, Rv1146, Rv1258c, Rv1473, Rv1686c, Rv1687c, Rv1877, Rv2038c, Rv3065, Rv3197a, Rv3728 and Rv3789) that were overexpressed following exposure to KM were thought to contribute to drug resistance. Rv3197A (whiB7) showed a distinct fold change based on the concentration of KM.CONCLUSION: The significant changes in the expression of the efflux pump and regulatory genes following exposure to KM may provide insights into the identification of a new resistance mechanism.
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Affiliation(s)
- J J Lee
- Department of Laboratory Medicine, Graduate School, Kyung Hee University, Seoul, Korea, Department of Laboratory Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea
| | - H Y Kang
- Department of Laboratory Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea
| | - W-I Lee
- Department of Laboratory Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - S Y Cho
- Department of Laboratory Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea
| | - Y J Kim
- Department of Laboratory Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea
| | - H J Lee
- Korean National Tuberculosis Association, Seoul, Korea
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21
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Park S, Kim YJ, Huh HJ, Chung HS, Lee M, Park YM, Mun YC, Seong CM, Huh J. Comprehensive DNA repair gene expression analysis and its prognostic significance in acute myeloid leukemia. Hematology 2021; 26:904-913. [PMID: 34789078 DOI: 10.1080/16078454.2021.1997196] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Deficiency in DNA damage response (DDR) pathway and accumulation of DNA damage increases mutation rates resulting in genomic instability and eventually increases the risk of cancer. The aim of our study was to investigate expressions of DNA repair genes as new prognostic biomarkers in acute myeloid leukemia (AML). METHODS We utilized The Cancer Genome Atlas AML project (TCGA-LAML cohort, 15 acute promyelocytic leukemia (APL) and 155 non-APL AML) for the expression data of DNA repair genes. For validation, clinical samples (Ewha study group, 9 APL and 72 non-APL AML patients) were analyzed for the expression of 22 DNA repair genes using a custom RT2 Profiler PCR Array. RESULTS APL patients presented significantly lower expression of DNA repair genes than non-APL AML patients in both study groups. Among non-APL AML patients, high expression levels of PARP1, XRCC1, and RAD51 were associated with poor overall survival (OS) probability in both study groups. Furthermore, Cox regression analysis showed that increased expression levels of PARP1, XRCC1, RAD51, BRCA1 and MRE11A could be independent risk factors for OS in the Ewha study group. Among non-APL patients of the Ewha study group, the OS probability of DDR-overexpressed group with at least one gene or more showing Z score greater than 1.5 was poorer than that of DDR non-overexpressed group. CONCLUSION In the current study, the DNA repair gene expression profile of APL patients was different from that of non-APL AML patients. Overexpression of DNA repair genes could be a poor prognostic biomarker in non-APL AML.
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Affiliation(s)
- Sholhui Park
- Department of Laboratory Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Yi-Jun Kim
- Institute of Convergence Medicine, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea
| | - Hee Jin Huh
- Department of Laboratory Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Hae-Sun Chung
- Department of Laboratory Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Miae Lee
- Department of Laboratory Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Young Mi Park
- Department of Molecular Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Yeung Chul Mun
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Chu-Myong Seong
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Jungwon Huh
- Department of Laboratory Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
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22
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Cho Y, Kim HS, Kang D, Kim H, Lee N, Yun J, Kim YJ, Lee KM, Kim JH, Kim HR, Hwang YI, Jo CH, Kim JH. CTRP3 exacerbates tendinopathy by dysregulating tendon stem cell differentiation and altering extracellular matrix composition. Sci Adv 2021; 7:eabg6069. [PMID: 34797714 PMCID: PMC8604415 DOI: 10.1126/sciadv.abg6069] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 10/01/2021] [Indexed: 05/31/2023]
Abstract
Tendinopathy, the most common disorder affecting tendons, is characterized by chronic disorganization of the tendon matrix, which leads to tendon tear and rupture. The goal was to identify a rational molecular target whose blockade can serve as a potential therapeutic intervention for tendinopathy. We identified C1q/TNF-related protein-3 (CTRP3) as a markedly up-regulated cytokine in human and rodent tendinopathy. Overexpression of CTRP3 enhanced the progression of tendinopathy by accumulating cartilaginous proteoglycans and degenerating collagenous fibers in the mouse tendon, whereas CTRP3 knockdown suppressed the tendinopathy pathogenesis. Functional blockade of CTRP3 using a neutralizing antibody ameliorated overuse-induced tendinopathy of the Achilles and rotator cuff tendons. Mechanistically, CTRP3 elicited a transcriptomic pattern that stimulates abnormal differentiation of tendon stem/progenitor cells and ectopic chondrification as an effect linked to activation of Akt signaling. Collectively, we reveal an essential role for CTRP3 in tendinopathy and propose a potential therapeutic strategy for the treatment of tendinopathy.
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Affiliation(s)
- Yongsik Cho
- Center for RNA Research, Institute for Basic Science, 08826 Seoul, South Korea
- Department of Biological Sciences, College of Natural Sciences, Seoul National University, 08826 Seoul, South Korea
| | - Hyeon-Seop Kim
- Center for RNA Research, Institute for Basic Science, 08826 Seoul, South Korea
- Department of Biological Sciences, College of Natural Sciences, Seoul National University, 08826 Seoul, South Korea
| | - Donghyun Kang
- Center for RNA Research, Institute for Basic Science, 08826 Seoul, South Korea
- Department of Biological Sciences, College of Natural Sciences, Seoul National University, 08826 Seoul, South Korea
| | - Hyeonkyeong Kim
- Center for RNA Research, Institute for Basic Science, 08826 Seoul, South Korea
- Department of Biological Sciences, College of Natural Sciences, Seoul National University, 08826 Seoul, South Korea
| | - Narae Lee
- Center for RNA Research, Institute for Basic Science, 08826 Seoul, South Korea
- Department of Biological Sciences, College of Natural Sciences, Seoul National University, 08826 Seoul, South Korea
| | - Jihye Yun
- Department of Biological Sciences, College of Natural Sciences, Seoul National University, 08826 Seoul, South Korea
- School of Medicine, CHA University, 13496 Seongnam, South Korea
| | - Yi-Jun Kim
- Institute of Convergence Medicine, Ewha Womans University Mokdong Hospital, 07985 Seoul, South Korea
| | - Kyoung Min Lee
- Foot and Ankle Division, Department of Orthopedic Surgery, Seoul National University Bundang Hospital, 13620 Seongnam, South Korea
| | - Jin-Hee Kim
- Department of Anatomy and Cell Biology, Seoul National University College of Medicine, 03080 Seoul, South Korea
| | - Hang-Rae Kim
- Department of Anatomy and Cell Biology, Seoul National University College of Medicine, 03080 Seoul, South Korea
| | - Young-il Hwang
- Department of Anatomy and Cell Biology, Seoul National University College of Medicine, 03080 Seoul, South Korea
| | - Chris Hyunchul Jo
- Department of Orthopedic Surgery, Seoul Metropolitan Government–Seoul National University (SMG-SNU) Boramae Medical Center, Seoul National University College of Medicine, 07061 Seoul, South Korea
| | - Jin-Hong Kim
- Center for RNA Research, Institute for Basic Science, 08826 Seoul, South Korea
- Department of Biological Sciences, College of Natural Sciences, Seoul National University, 08826 Seoul, South Korea
- Interdisciplinary Program in Bioinformatics, Seoul National University, 08826 Seoul, South Korea
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23
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Kim YJ, Kim K, Seo SY, Yu J, Kim IH, Kim HJ, Park CK, Lee KH, Choi J, Song MS, Kim JH. Time-sequential change in immune-related gene expression after irradiation in glioblastoma: next-generation sequencing analysis. Anim Cells Syst (Seoul) 2021; 25:245-254. [PMID: 34408813 PMCID: PMC8366673 DOI: 10.1080/19768354.2021.1954550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The time-sequential change in immune-related gene expression of the glioblastoma cell line after irradiation was evaluated to speculate the effect of combined immunotherapy with radiotherapy. The U373 MG glioblastoma cell line was irradiated with 6 Gy single dose. Next-generation sequencing (NGS) transcriptome data was generated before irradiation (control), and at 6, 24, and 48 h post-irradiation. Immune-related pathways were analyzed at each time period. The same analyses were also performed for A549 lung cancer and U87 MG glioblastoma cell lines. Western blotting confirmed the programmed death-ligand 1 (PD-L1) expression levels over time. In the U373 MG cell line, neutrophil-mediated immunity, type I interferon signaling, antigen cross-presentation to T cell, and interferon-γ signals began to increase significantly at 24 h and were upregulated until 48 h after irradiation. The results were similar to those of the A549 and U87 MG cell lines. Without T cell infiltration, PD-L1 did not increase even with upregulated interferon-γ signaling in cancer cells. In conclusions, in the glioblastoma cell line, immune-related signals were significantly upregulated at 24 and 48 h after irradiation. Therefore, the time interval between daily radiotherapy might not be enough to expect full immune responses by combined immune checkpoint inhibitors and newly infiltrating immune cells after irradiation.
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Affiliation(s)
- Yi-Jun Kim
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea.,Institute of Convergence Medicine, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea
| | - Kwangsoo Kim
- Transdisciplinary Department of Medicine & Advanced Technology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Soo Yeon Seo
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Juyeon Yu
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Il Han Kim
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.,Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea
| | - Hak Jae Kim
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Chul-Kee Park
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kye Hwa Lee
- Department of Information Medicine, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Junjeong Choi
- Yonsei Institute of Pharmaceutical Sciences, College of Pharmacy, Yonsei University, Incheon, Republic of Korea
| | - Myung Seon Song
- Department of Psychiatry, Keyo Hospital, Uiwang, Republic of Korea
| | - Jin Ho Kim
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea
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24
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Cho MJ, Kim YJ, Kim MJ, Kim YS, Park E, Choi KH, Kang JY, Kim HO, Koong MK, Kim YS, Yoon TK, Ko JJ, Lee JH. P–205 Epothilone D as an actin cytoskeleton stabilizer improved mitochondria bioenergenesis and blastocyst formation of mouse preimplantation embryo. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.204] [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: 11/14/2022] Open
Abstract
Abstract
Study question
What is primary factor of bioenergetics product activity between microtubule instability and the functional activity of mitochondria in embryo?
Summary answer
The actin cytoskeleton instability is presumably the primary cause for the bioenergenesis of mitochondrial function to the preimplantation embryo development.
What is known already
Mitochondria are cellular organelles dynamically moving and morphological changes. It provides for homeostatic energy to the cell. The dynamic property of the mitochondria is associated with the microtubule network in the cell. However, the stability of the microtubule was clearly identified for preimplantation embryo development.
Study design, size, duration
This study is designed to assess the ATP productivity of the mitochondria, and specifically to observe what its primary factor is in terms of providing microtubule stability in mammalian cells. Additionally, we investigated the relationship between blastocyst formation and actin cytoskeleton stabilization by EpD with 2-cell mice.
Participants/materials, setting, methods
We prepared the microtubule stability regulation model with the HEK293 cell line by using the microtubule stabilizer as an Epothilone D (EpD). Then we analyzed the metabolic activity of the cells through oxidative phosphorylation (OXP) ratios analysis. Also, we performed confocal live imaging to observe mitochondria morphology depending on the cells’ microtubule. Next, we treated EpD to 2-cell culture media for the analysis of blastocyst development ratios.
Main results and the role of chance
EpD significantly increased fusion form. Also, EpD enhance bioenergy ratios like OXP in the mitochondria and functional activity related marker, like mTOR compared with the control. These results suggest that microtubule stabilization enhances mitochondrial metabolism by increasing oxygen consumption. Also, EpD in 2-cell culture media led to a significant increase in the speed of development and 50% higher hatched out blastocyst formation ratios compared to the control group.
Limitations, reasons for caution
This study had limited animal experiments. For the next study, we are planning with an aim to improve the quality and development ratios of human embryos by EpD.
Wider implications of the findings: Microtubule stabilizer has a possibility to recover the mitochondria’s functional activity in the preimplantation embryo development. Mitochondrial functional activity along the actin cytoskeleton may play a pivotal role in determining the embryo quality and development ratios for archive pregnancy.
Trial registration number
non-clinical trials
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Affiliation(s)
- M J Cho
- CHA University, Biomedical Sciences, Seoul, Korea- South
| | - Y J Kim
- CHA Medical Group, Reproductive and Molecular Medicine, Seoul, Korea- South
| | - M J Kim
- CHA Fertility Center Seoul Station, Clinic, Seoul, Korea- South
| | - Y S Kim
- CHA Fertility Center Seoul Station, Clinic, Seoul, Korea- South
| | - E Park
- CHA Fertility Center Seoul Station, Embryology lab, Seoul, Korea- South
| | - K H Choi
- CHA Fertility Center Seoul Station, Embryology lab, Seoul, Korea- South
| | - J Y Kang
- CHA Fertility Center Seoul Station, Embryology lab, Seoul, Korea- South
| | - H O Kim
- CHA Fertility Center Seoul Station, Clinic, Seoul, Korea- South
| | - M K Koong
- CHA Fertility Center Seoul Station, Clinic, Seoul, Korea- South
| | - Y S Kim
- CHA Fertility Center Seoul Station, Clinic, Seoul, Korea- South
| | - T K Yoon
- CHA Fertility Center Seoul Station, Clinic, Seoul, Korea- South
| | - J J Ko
- CHA University, Biomedical Sciences, Seoul, Korea- South
| | - J H Lee
- CHA fertility seoul center seoul sequare 3floor, Reproductive and Molecular Medicine., Seoul, Korea- South
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25
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Choi KH, Kim YJ, Kang KY, Park EA, Kim YS, Kim MJ, Kim HO, Koong MK, Kim YS, Yoon TK, Ko JJ, Lee JH. P–657 Prostaglandin D2 is correlated with follicles development and a reliable marker of ovarian reserve of poor ovarian responder patients. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.656] [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: 11/14/2022] Open
Abstract
Abstract
Study question
Is the prostaglandin D2 (PGD2) associated with growing follicles and ovarian reserve of poor ovarian responders?
Summary answer
PGD2 is correlated with ovarian stimulation activity and follicle growth. Especially, poor ovarian responders show a significant decrease in the level of follicular fluid.
What is known already
Prostaglandins (PGs) are involved in the female reproductive process, mainly ovulation, fertilization, and implantation.
Study design, size, duration
We investigated the PGD2 level in the follicular fluid of poor ovarian responders. The collection of human follicular fluid was approved by the Institutional Research and Ethical Committees of CHA University (approval number: 1044308–201611-BR–027–04) from January to December 2019. Follicular fluid was collected from patients with normal ovarian response and patients with POR.
Participants/materials, setting, methods
We studied whether prostaglandin has related to POR in the clinical key factor by measuring human follicular fluid. Follicular fluid was collected from patients with normal ovarian response and patients with POR. The concentration of PGD2 in follicular fluid was determined with ELISA kits following the manufacturer’s protocol.
Main results and the role of chance
We analyzed the level of PGD2 in the follicular fluid of patients with normal ovarian response and patients with POR using an ELISA. The PGD2 concentration was significantly lower in the follicular fluid of patients with POR than in the follicular fluid of young and old patients with normal ovarian response.
Limitations, reasons for caution
This study has an identification of biomarker of the clinical samples as POR criteria patients. Therefore, further investigations aimed at specific recovery of low PGD2 metabolic activity in the CCs during control ovarian stimulation.
Wider implications of the findings: Until now there is no specific biomarker of POR. AMH is just an ovary reserve marker for an indication of ovary function. PGD2 is one of the metabolites in steroid metabolism in the ovary. Therefore, we can find some cure through further study for improved PGD2 production to POR patients.
Trial registration number
none
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Affiliation(s)
- K H Choi
- CHA Fertility Center Seoul Station, Embryology Lab, Seoul, Korea- South
| | - Y J Kim
- CHA Medical Group, Advanced Research Division of Reproductive Medicine, Seoul, Korea- South
| | - K Y Kang
- CHA Fertility Center Seoul Station, Embryology Lab, Seoul, Korea- South
| | - E A Park
- CHA Fertility Center Seoul Station, Embryology Lab, Seoul, Korea- South
| | - Y S Kim
- CHA Fertility Center Seoul Station, IVF clinic, Seoul, Korea- South
| | - M J Kim
- CHA Fertility Center Seoul Station, IVF clinic, Seoul, Korea- South
| | - H O Kim
- CHA Fertility Center Seoul Station, IVF clinic, Seoul, Korea- South
| | - M K Koong
- CHA Fertility Center Seoul Station, IVF clinic, Seoul, Korea- South
| | - Y S Kim
- CHA Fertility Center Seoul Station, IVF clinic, Seoul, Korea- South
| | - T K Yoon
- CHA Fertility Center Seoul Station, IVF clinic, Seoul, Korea- South
| | - J J Ko
- CHA University, Biomedical Science, Pocheon-si, Korea- South
| | - J H Lee
- CHA Fertility Center Seoul Station, Embryology Lab, Seoul, Korea- South
- CHA University, Biomedical Science, Pocheon-si, Korea- South
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26
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Kim YJ, Choi KH, Kang KY, Park EA, Kim YS, Kim MJ, Kim HO, Koong MK, Kim YS, Yoon TK, Ko JJ, Lee JH. P–658 Lovastatin promotes the expression of LDL receptor and enhances E2 production in the cumulus cells. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.657] [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: 11/15/2022] Open
Abstract
Abstract
Study question
Lovastatin enhanced E2 productive ratios in the cumulus cells through promoted expression of Low-density lipoprotein receptor (LDLR).
Summary answer
Lovastatin up-regulated gene expression of LDLR in the CCs. And the high expression of LDLR promoted E2 productive ratios from CCs.
What is known already
We already reported that the up-regulation of LDLR correlated with clinical pregnancy. Therefore, we found lovastatin as an up-regulator of LDLR expression of clinical pregnancy.
Study design, size, duration
This is an expended study of LDLR to enhance steroidogenesis regarding the effect of lovastatin in the CCs. The collection of human cumulus cells was approved by the Institutional Research and Ethical Committees of CHA University (approval number: 1044308–201611-BR–027–04) from January to December 2019. The CCs were collected from 12 patients with normal ovarian response after oocyte denudation for ICSI.
Participants/materials, setting, methods
We studied whether lovastatin has up-regulated LDLR expression in human CCs. Cumulus cells were collected from patients with young (∼ 36) and old aged patients (37 ∼). After culturing human CCs, they were treated lovastatin for one day. The concentration of E2 in culture medium was measured using Chemiluminescence immunoassay. The mRNA isolated from CCs was analyzed gene expression level through real time-PCR.
Main results and the role of chance
The concentration of E2 was significantly increased in the culture medium treated with lovastatin. The CCs treated with lovastatin increased the expression of LDLR and StAR which are components of the steroidogenesis pathway.
Limitations, reasons for caution
We have found that the role of lovastatin promotes the E2 production by increasing the ldlr gene of CCs. Therefore, further investigations aimed at lovastatin effect on human oocytes embryo whether enhanced quality of oocytes or not.
Wider implications of the findings: Previous data show that high activation of LDLR and StAR was associated with embryo quality and clinical pregnancy in infertile women. Our data suggest that lovastatin is stimulated LDLR expression to enhanced pregnancy ratios of IVF patients.
Trial registration number
none
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Affiliation(s)
- Y J Kim
- CHA Medical Group, Advanced Research Division of Reproductive Medicine, Seoul, Korea- South
| | - K H Choi
- CHA Fertility Center Seoul Station, Embryology Lab, Seoul, Korea- South
| | - K Y Kang
- CHA Fertility Center Seoul Station, Embryology Lab, Seoul, Korea- South
| | - E A Park
- CHA Fertility Center Seoul Station, Embryology Lab, Seoul, Korea- South
| | - Y S Kim
- CHA Fertility Center Seoul Station, IVF clinic, Seoul, Korea- South
| | - M J Kim
- CHA Fertility Center Seoul Station, IVF clinic, Seoul, Korea- South
| | - H O Kim
- CHA Fertility Center Seoul Station, IVF clinic, Seoul, Korea- South
| | - M K Koong
- CHA Fertility Center Seoul Station, IVF clinic, Seoul, Korea- South
| | - Y S Kim
- CHA Fertility Center Seoul Station, IVF clinic, Seoul, Korea- South
| | - T K Yoon
- CHA Fertility Center Seoul Station, IVF clinic, Seoul, Korea- South
| | - J J Ko
- CHA University, Biomedical Science, Pocheon-si, Korea- South
| | - J H Lee
- CHA Fertility Center Seoul Station, Embryology Lab, Seoul, Korea- South
- CHA University, Biomedical Science, Pocheon-si, Korea- South
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27
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Kim YJ, Ma S, Yoon HK, Lee HC, Park HP, Oh H. Supraclavicular versus infraclavicular approach for ultrasound-guided right subclavian venous catheterisation: a randomised controlled non-inferiority trial. Anaesthesia 2021; 77:59-65. [PMID: 34231204 DOI: 10.1111/anae.15525] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2021] [Indexed: 11/30/2022]
Abstract
Infraclavicular and supraclavicular approaches are used for subclavian venous catheterisation. We hypothesised that the supraclavicular approach is non-inferior to the infraclavicular approach in terms of safety during ultrasound-guided right subclavian venous catheterisation. We randomly allocated 401 neurosurgical patients undergoing ultrasound-guided right subclavian venous catheterisation into supraclavicular (n = 200) and infraclavicular (n = 201) groups. We assessed catheterisation-related complications (primary outcome measure) including catheter misplacement and mechanical complications (arterial puncture, haematoma formation, pneumothorax and haemothorax). We also recorded catheterisation success rates and time required for venous puncture and catheterisation. The number (proportion) of patients with catheterisation-related complications was six (3.0%) in the supraclavicular group and 27 (13.4%) in the infraclavicular group, mean difference (95%CI) -10.4% (-15.7 to -5.1%), p < 0.001, with a significant difference also seen for catheter misplacement. Except for a shorter time (median (IQR [range]) required for venous puncture in the supraclavicular group, being 9 (6-20 [2-138]) vs. 13 (8-20 [3-99]) s, the incidence of mechanical complications and other catheterisation characteristics were similar between the two groups. We recommend the supraclavicular approach for ultrasound-guided right subclavian venous catheterisation.
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Affiliation(s)
- Y J Kim
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - S Ma
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - H K Yoon
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - H C Lee
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - H P Park
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - H Oh
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
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Estee J, Lynch WG, Tsang CY, Barney J, Jhang G, Tsang MB, Wang R, Kaneko M, Lee JW, Isobe T, Kurata-Nishimura M, Murakami T, Ahn DS, Atar L, Aumann T, Baba H, Boretzky K, Brzychczyk J, Cerizza G, Chiga N, Fukuda N, Gasparic I, Hong B, Horvat A, Ieki K, Inabe N, Kim YJ, Kobayashi T, Kondo Y, Lasko P, Lee HS, Leifels Y, Łukasik J, Manfredi J, McIntosh AB, Morfouace P, Nakamura T, Nakatsuka N, Nishimura S, Otsu H, Pawłowski P, Pelczar K, Rossi D, Sakurai H, Santamaria C, Sato H, Scheit H, Shane R, Shimizu Y, Simon H, Snoch A, Sochocka A, Sumikama T, Suzuki H, Suzuki D, Takeda H, Tangwancharoen S, Toernqvist H, Togano Y, Xiao ZG, Yennello SJ, Zhang Y, Cozma MD. Probing the Symmetry Energy with the Spectral Pion Ratio. Phys Rev Lett 2021; 126:162701. [PMID: 33961456 DOI: 10.1103/physrevlett.126.162701] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/08/2021] [Accepted: 03/22/2021] [Indexed: 06/12/2023]
Abstract
Many neutron star properties, such as the proton fraction, reflect the symmetry energy contributions to the equation of state that dominate when neutron and proton densities differ strongly. To constrain these contributions at suprasaturation densities, we measure the spectra of charged pions produced by colliding rare isotope tin (Sn) beams with isotopically enriched Sn targets. Using ratios of the charged pion spectra measured at high transverse momenta, we deduce the slope of the symmetry energy to be 42<L<117 MeV. This value is slightly lower but consistent with the L values deduced from a recent measurement of the neutron skin thickness of ^{208}Pb.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - M D Cozma
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- IFIN-HH, Reactorului 30, 077125 Măgurele-Bucharest, Romania
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29
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Abstract
Since the introduction of menopausal hormone therapy (MHT) in the 1940s, randomized clinical trials and observational studies have been performed to determine the benefits and risks of MHT. However, MHT therapeutic impact remains under debate as multiple factors including genetic biomarkers and medical history contribute to inter-individual variations in neurodegenerative diseases. Herein, we review the characteristics of women who participated in clinical studies and methodological approaches for study analyses to assess the critical variables influencing an association between MHT and risk of neurodegenerative diseases. Outcomes of the review indicated that: (1) observational studies assessed outcomes of MHT in symptomatic women whereas MHT clinical trials were conducted in asymptomatic postmenopausal women not treated for menopausal symptoms, (2) in asymptomatic postmenopausal women, late MHT intervention was of no benefit, (3) different MHT treatments and regimens between observational studies and clinical trials may impact outcomes, and (4) observational studies may provide greater predictive validity for long-term neurological health outcomes as MHT was introduced in symptomatic women and administered over a long period of time. Going forward, achieving precision hormone therapy will require a priori identification of symptomatic women appropriate for MHT and the type and dose of MHT appropriate for their genetic profile and health risks.
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Affiliation(s)
- Y J Kim
- Center for Innovation in Brain Science, University of Arizona, Tucson, AZ, USA
| | - R D Brinton
- Center for Innovation in Brain Science, University of Arizona, Tucson, AZ, USA.,Department of Pharmacology, College of Medicine, University of Arizona, Tucson, AZ, USA.,Department of Neurology, College of Medicine, University of Arizona, Tucson, AZ, USA
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30
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Chung H, Park CH, Kim YJ, Kim JY, Min PK, Yoon YW, Lee KA, Lee BK, Hong BK, Kim TH, Rim SJ, Kwon HM, Choi EY. Myocardial extracellular space expansion is related to burden of premature ventricular contractions in patients with hypertrophic cardiomyopathy without non-sustained ventricular tachycardia. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Current guidelines suggest the presence of non-sustained ventricular tachycardia (NSVT) as a risk factor of sudden cardiac death in patients with hypertrophic cardiomyopathy (HCM). However, high burden of premature ventricular contraction (PVC) may reflect myocardial fibrosis although the absence of NSVT.
Purpose
We investigated the association between PVC burden and myocardial extracellular space expansion in HCM patients without NSVT.
Methods
Of the 212 patients prospectively enrolled to the HCM registry of genetics, 84 patients were evaluated with both cardiac magnetic resonance and 24hr holter. Among them, 71 patients (58 males, mean age: 71 ± 13 years) have not been diagnosed with NSVT.
Results
Patients with NSVT (n = 13) showed more impaired LA functional indices and higher myocardial fibrosis burden compared with patients without NSVT (n = 71). Among patients who have not been diagnosed with NSVT, patients with late gadolinium enhancement (LGE, n = 46) had a higher total beats (109 ± 332 vs. 7 ± 13 beats per a day, p = 0.003) and burden (0.114 ± 0.225 vs. 0.008 ± 0.014 %, p = 0.003) of PVC during 24-hour compared with patients without LGE (n = 25). %LGE was correlated with total beats of PVC (r = 0.358, p = 0.002) and PVC burden (r = 0.377, p = 0.001). ECV also correlated with total beats of PVC (r = 0.387, p = 0.001) and PVC burden (r = 0.401, p = 0.001). The optimal cutoff value for PVC number was 45 (37.0% of sensitivity and 100% of specificity) with 0.733 of the area under the ROC curve (p < 0.001). Pathogenic or likely pathogenic sarcomere mutation was higher in NSVT group than no NSVT group (p < 0.05), and had a higher tendency in higher PVC burden group (0.05 < p < 0.1) than lower PVC burden group.
Conclusions
Total beats and burden of PVC are significantly related to increase in myocardial fibrosis in HCM patients without NSVT.
Abstract Figure. Mechanism of ventricular arrhythmia
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Affiliation(s)
- H Chung
- Kyung Hee Medical Center, Seoul, Korea (Republic of)
| | - CH Park
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - YJ Kim
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - JY Kim
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - PK Min
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - YW Yoon
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - KA Lee
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - BK Lee
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - BK Hong
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - TH Kim
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - SJ Rim
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - HM Kwon
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - EY Choi
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
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Esterhuizen M, Behnam Sani S, Wang L, Kim YJ, Pflugmacher S. Mycoremediation of acetaminophen: Culture parameter optimization to improve efficacy. Chemosphere 2021; 263:128117. [PMID: 33297110 DOI: 10.1016/j.chemosphere.2020.128117] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/06/2020] [Accepted: 08/21/2020] [Indexed: 06/12/2023]
Abstract
Untreated pharmaceutical pollution and their possibly toxic metabolites, resulting from overloaded wastewater treatment processes, end up in aquatic environments and are hazardous to the ecosystem homeostasis. Biological wastewater remediation could supplement traditional methods and overcome the release of these biologically active compounds in the environment. Mycoremediation is especially promising due to the unspecific nature of fungi to decompose compounds through exoenzymes and the uptake of compounds as nutrients. In the present study, we improved on the previous advances made using the fungus Mucor hiemalis to remediate one of the most commonly occurring pharmaceuticals, acetaminophen (APAP), at higher concentrations. The limitation of nitrogen, adjustment of pH, and comparison to, as well as co-cultivation with the white-rot fungus Phanerochaete chrysosporium, were tested. Nitrogen limitation did not significantly improve the APAP remediation efficiency of M. hiemalis. Maintaining the pH of the media improved the remediation restraint of 24 h previously observed. The APAP remediation efficiency of P. chrysosporium was far superior to that of M. hiemalis, and co-cultivation of the two resulted in a decreased remediation efficiency compared to P. chrysosporium in single.
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Affiliation(s)
- M Esterhuizen
- University of Helsinki, Ecosystems and Environmental Research Programme, Faculty of Biological and Environmental Sciences, Niemenkatu 73, 15140, Lahti, Finland; Korea Institute of Science and Technology Europe (KIST), Joint Laboratory of Applied Ecotoxicology, Campus 7.1, 66123, Saarbrücken, Germany; University of Helsinki, Helsinki Institute of Sustainability Science (HELSUS), Fabianinkatu 33, 00014, Helsinki, Finland.
| | - S Behnam Sani
- Technische Universität Berlin, Ecotoxicological Impact Research and Ecotoxicology, Ernst-Reuter-Platz 1, 10587, Berlin, Germany
| | - L Wang
- Technische Universität Berlin, Ecotoxicological Impact Research and Ecotoxicology, Ernst-Reuter-Platz 1, 10587, Berlin, Germany
| | - Y J Kim
- Korea Institute of Science and Technology Europe (KIST), Joint Laboratory of Applied Ecotoxicology, Campus 7.1, 66123, Saarbrücken, Germany
| | - S Pflugmacher
- University of Helsinki, Ecosystems and Environmental Research Programme, Faculty of Biological and Environmental Sciences, Niemenkatu 73, 15140, Lahti, Finland; Korea Institute of Science and Technology Europe (KIST), Joint Laboratory of Applied Ecotoxicology, Campus 7.1, 66123, Saarbrücken, Germany; University of Helsinki, Helsinki Institute of Sustainability Science (HELSUS), Fabianinkatu 33, 00014, Helsinki, Finland
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32
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M Hassan N, Kim YJ. A FEASIBILITY TEST FOR QUICK RADON RISK ASSESSMENT BY MEASURING AN IN SITU RADIATION DOSE RATE. Radiat Prot Dosimetry 2020; 192:482-490. [PMID: 33598703 DOI: 10.1093/rpd/ncab004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 11/02/2020] [Accepted: 01/01/2021] [Indexed: 06/12/2023]
Abstract
Radon concentration was estimated using an accumulation chamber equipped with AlphaGUARD radon monitor. It varies from 12.6 ± 1.20 to 363 ± 19.3 Bq m-3 with a mean value of 180 ± 11.2 Bq m-3. A good correlation between radium content and radon concentrations was obtained of R = 0.754, which suggests that radium is the main reason of releasing radon to the atmosphere. Radon emanation coefficient and exhalation rate were also calculated. Furthermore, the radiation dose rate was measured with a high-pressure ionization chamber detector. The radiation dose rate was strongly correlated with the radon concentration and exhalation rate of R = 0.85 and 0.63. The obtained results support our idea that the radiation dose rate can be a good indicator to the radon level in the atmosphere. In addition, the dependence of radon concentration on the water content was discussed.
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Affiliation(s)
- Nabil M Hassan
- Department of Physics, Faculty of Science, University of Zagazig, PO Box 44519, Zagazig, Egypt
- Department of Physics, Faculty of Science, University of Bahrain, PO Box 32038, Zallaq, Kingdom of Bahrain
| | - Y J Kim
- NORM Safety Center, Korea Institute of Nuclear Safety, Yuseong, Daejeon 34142, Republic of Korea
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33
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Lee KH, Goh J, Kim YJ, Kim K. Identification of synthetic chemosensitivity genes paired with BRAF for BRAF/MAPK inhibitors. Sci Rep 2020; 10:20001. [PMID: 33203961 PMCID: PMC7672081 DOI: 10.1038/s41598-020-76909-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 10/07/2020] [Indexed: 01/02/2023] Open
Abstract
Molecular-targeted approaches are important for personalised cancer treatment, which requires knowledge regarding drug target specificity. Here, we used the synthetic lethality concept to identify candidate gene pairs with synergistic effects on drug responses. A synergistic chemo-sensitivity response was identified if a drug had a significantly lower half-maximal inhibitory concentration (IC50) in cell lines with a pair of mutated genes compared with those in other cell lines (wild-type or one mutated gene). Among significantly damaging mutations in the Genomics of Drug Sensitivity in Cancer database, we found 580 candidate synergistic chemo-sensitivity interaction sets for 456 genes and 54 commercial drugs. Clustering analyses according to drug/gene and drug/tissue interactions showed that BRAF/MAPK inhibitors clustered together; 11 partner genes for BRAF were identified. The combined effects of these partners on IC50 values were significant for both drug-specific and drug-combined comparisons. Survival analysis using The Cancer Genome Atlas data showed that patients who had mutated gene pairs in synergistic interaction sets had longer overall survival compared with that in patients with other mutation profiles. Overall, this analysis demonstrated that synergistic drug-responsive gene pairs could be successfully used as predictive markers of drug sensitivity and patient survival, offering new targets for personalised medicine.
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Affiliation(s)
- Kye Hwa Lee
- Department of Biomedical Informatics, Asan Medical Center, Seoul, 05505, South Korea.
| | - Jinmin Goh
- Biomedical Research Institute, Seoul National University Hospital, Seoul, 03080, South Korea.,Department of Chemical Engineering, Pohang University of Science and Technology (POSTECH), Pohang, 37673, South Korea
| | - Yi-Jun Kim
- Institute of Convergence Medicine, Ewha Womans University Mokdong Hospital, Seoul, 07985, South Korea
| | - Kwangsoo Kim
- Transdisciplinary Department of Medicine & Advanced Technology, Seoul National University Hospital, Seoul, 03080, South Korea.
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34
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Kim YJ, Jeong WJ, Bae YJ, Kim H, Choi BS, Jung YH, Baik SH, Sunwoo L, Kim JH. MRI-Based Assessment of the Pharyngeal Constrictor Muscle as a Predictor of Surgical Margin after Transoral Robotic Surgery in HPV-Positive Tonsillar Cancer. AJNR Am J Neuroradiol 2020; 41:2320-2326. [PMID: 33060104 DOI: 10.3174/ajnr.a6806] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 07/29/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Transoral robotic surgery is an emerging strategy for treating human papillomavirus-positive cancers, but the role of MR imaging in predicting the surgical outcome has not been established. We aimed to identify preoperative MR imaging characteristics that predispose the outcome of transoral robotic surgery toward an insecure (positive or close) surgical margin in human papillomavirus-positive tonsillar squamous cell carcinoma. MATERIALS AND METHODS Between December 2012 and May 2019, sixty-nine patients underwent transoral robotic surgery at our institution. Among these, 29 who were diagnosed with human papillomavirus-positive tonsillar squamous cell carcinoma, did not receive neoadjuvant treatment, underwent preoperative 3T MR imaging, and had postoperative pathologic reports and were included in this retrospective study. Two neuroradiologists evaluated the preoperative MR imaging scans to determine the tumor spread through the pharyngeal constrictor muscle using a 5-point scale: 1, normal constrictor; 2, bulging constrictor; 3, thinning constrictor; 4, obscured constrictor; and 5, tumor protrusion into the parapharyngeal fat. The risk of an insecure surgical margin (involved or <1 mm) according to the MR imaging scores was predicted using logistic regression with the Firth correction. RESULTS The interobserver agreement for the MR imaging scores was excellent (κ = 0.955, P < .001). A score of ≥4 could predict an insecure margin with 87.5% sensitivity and 92.3% specificity (area under the curve = 0.899) and was the only significant factor associated with an insecure margin in the multivariable analysis (OR, 6.59; 95% CI, 3.11-22.28; P < .001). CONCLUSIONS The pre-transoral robotic surgery MR imaging scoring system for the pharyngeal constrictor muscle is a promising predictor of the surgical margin in human papillomavirus-positive tonsillar squamous cell carcinoma.
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Affiliation(s)
- Y J Kim
- From the Department of Radiology (Y.J.K., Y.J.B., B.S.C., S.H.B., L.S., J.H.K.)
| | - W-J Jeong
- Otolaryngology-Head and Neck Surgery (W.-J.J., Y.H.J.)
| | - Y J Bae
- From the Department of Radiology (Y.J.K., Y.J.B., B.S.C., S.H.B., L.S., J.H.K.)
| | - H Kim
- Pathology (H.K.), Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - B S Choi
- From the Department of Radiology (Y.J.K., Y.J.B., B.S.C., S.H.B., L.S., J.H.K.)
| | - Y H Jung
- Otolaryngology-Head and Neck Surgery (W.-J.J., Y.H.J.)
| | - S H Baik
- From the Department of Radiology (Y.J.K., Y.J.B., B.S.C., S.H.B., L.S., J.H.K.)
| | - L Sunwoo
- From the Department of Radiology (Y.J.K., Y.J.B., B.S.C., S.H.B., L.S., J.H.K.)
| | - J H Kim
- From the Department of Radiology (Y.J.K., Y.J.B., B.S.C., S.H.B., L.S., J.H.K.)
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Papagiannopoulos P, Ganti A, Kim YJ, Raad RA, Kuan EC, Losavio P, Tajudeen BA, Batra PS. Impact of COVID-19 Pandemic on Ambulatory and Operating Room Rhinology Practice in the US. Am J Rhinol Allergy 2020; 35:441-448. [PMID: 33019817 DOI: 10.1177/1945892420961962] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The pandemic caused by the novel coronavirus virus has altered all facets of clinical practice in the United States. The goal of this study is to better understand the impact of COVID-19 on rhinologic ambulatory and operative practice. METHODS A 27-item survey to assess these objectives was created and approved by the Division of Rhinology faculty at Rush University Medical Center in April 2020. The survey was then distributed to rhinologists in a web based format via www.surveymonkey.com from April 10 through April 23, 2020. RESULTS A total of 277 U.S based rhinologists responded to the survey (23.04%). The most common practice types were single specialty private (44.9%) and academic (24.6%). 90.2% practice in a state under a shelter in place order. Comparing pre-COVID baseline to during-COVID, there was statistically significant reduction in the number of patients of seen daily in clinic (p < 0.001). The number of nasal endoscopies in the office and surgical procedures fell dramatically. Overall, 5 respondent rhinologists have been infected with COVID-19 and 27 have been furloughed. CONCLUSION COVID-19 has drastically affected rhinologic practice. There is a dramatic reduction of in person care in the office setting and surgical management of sinonasal and skull base disease. Enhanced PPE is being used in only half of potentially aerosolizing procedures which represents an area of further education. Novel approaches such as use of virtual encounters and point of care testing should be considered as options to facilitate care.
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Affiliation(s)
- P Papagiannopoulos
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois
| | - A Ganti
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois
| | - Y J Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois
| | - R A Raad
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois
| | - E C Kuan
- Department of Otorhinolaryngology - Head and Neck Surgery, University of California Irvine, Irvine, California
| | - P Losavio
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois
| | - B A Tajudeen
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois
| | - P S Batra
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois
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Kim YJ, Kim K, Lee KH, Kim J, Jung W. Immune expression signatures as candidate prognostic biomarkers of age and gender survival differences in cutaneous melanoma. Sci Rep 2020; 10:12322. [PMID: 32703987 PMCID: PMC7378165 DOI: 10.1038/s41598-020-69082-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 05/12/2020] [Indexed: 12/24/2022] Open
Abstract
This study aims to investigate the difference of gene expression and its prognostic significance in younger women with melanoma. Significantly upregulated genes in tumors compared to normal skin tissues were extracted. Among these genes, genes that significantly affected survival according to expression level were selected, and pathway annotation was performed. The patient proportion with high/low expression of the most significant pathways was analyzed in each age (< 50, 50-59, ≥ 60) and gender group. Survival was analyzed according to age, gender, and pathways. The most significant pathways that were upregulated in tumor tissues and also had impacts on survival were programmed cell death protein [PD]-1, interferon-γ, and interferon-α/β pathways. In women, the immune signaling rate in patients was higher than men and decreased with age (63.5%, 53.8%, and 47.6%). In men, the decreasing tendency was minimal (47.6%, 50.0%, and 41.6%). In patients aged < 60 years, women had a favorable survival rate than men (p = 0.055). Except for patients with high immune signaling, no survival difference was observed between genders (p = 0.6). In conclusion, younger female melanoma patients had high immune signaling than older women and men. This immune signaling improved survival of the younger female patients.
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Affiliation(s)
- Yi-Jun Kim
- Department of Radiation Oncology, Ewha Womans University College of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, Republic of Korea
- Institute of Convergence Medicine, Ewha Womans University Mokdong Hospital, Seoul, 07985, Republic of Korea
| | - Kyubo Kim
- Department of Radiation Oncology, Ewha Womans University College of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, Republic of Korea.
| | - Kye Hwa Lee
- Biomedical Informatics Department, Asan Medical Center, Seoul, 05505, Republic of Korea
| | - Jiyoung Kim
- Department of Radiation Oncology, Ewha Womans University College of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, Republic of Korea
| | - Wonguen Jung
- Department of Radiation Oncology, Ewha Womans University College of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, Republic of Korea
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Choi SJ, Kwak DW, Kil K, Kim SC, Kwon JY, Kim YH, Na S, Bae JG, Cha HH, Shim JY, Oh KY, Lee KA, Kim SM, Cho IA, Lee SM, Cho GJ, Jo YS, Choi GY, Choi SK, Hur SE, Hwang HS, Kim YJ. Vaginal compared with intramuscular progestogen for preventing preterm birth in high-risk pregnant women (VICTORIA study): a multicentre, open-label randomised trial and meta-analysis. BJOG 2020; 127:1646-1654. [PMID: 32536019 DOI: 10.1111/1471-0528.16365] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare the efficacy of two types of progestogen therapy for preventing preterm birth (PTB) and to review the relevant literature. DESIGN A multicentre, randomised, open-label, equivalence trial and a meta-analysis. SETTING Tertiary referral hospitals in South Korea. POPULATION Pregnant women with a history of spontaneous PTB or short cervical length (<25 mm). METHODS Eligible women were screened and randomised at 16-22 weeks of gestation to receive either 200 mg of vaginal micronised progesterone daily (vaginal group) or an intramuscular injection of 250 mg 17α-hydroxyprogesterone caproate weekly (IM group). Stratified randomisation was carried out according to participating centres and indications for progestogen therapy. This trial was registered at ClinicalTrials.gov (NCT02304237). MAIN OUTCOME MEASURE Preterm birth (PTB) before 37 weeks of gestation. RESULTS A total of 266 women were randomly assigned and a total of 247 women (119 and 128 women in the vaginal and IM groups, respectively) were available for the intention-to-treat analysis. Risks of PTB before 37 weeks of gestation did not significantly differ between the two groups (22.7 versus 25.8%, P = 0.571). The difference in PTB risk between the two groups was 3.1% (95% CI -7.6 to 13.8%), which was within the equivalence margin of 15%. The meta-analysis results showed no significant differences in the risk of PTB between the vaginal and IM progestogen treatments. CONCLUSION Compared with vaginal progesterone, treatment with intramuscular progestin might increase the risk of PTB before 37 weeks of gestation by as much as 13.8%, or reduce the risk by as much as 7.6%, in women with a history of spontaneous PTB or with short cervical length. TWEETABLE ABSTRACT Vaginal and intramuscular progestogen showed equivalent efficacy for preventing preterm birth before 37 weeks of gestation.
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Affiliation(s)
- S-J Choi
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - D W Kwak
- Ajou University School of Medicine, Suwon, Korea
| | - K Kil
- Yeouido St Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - S-C Kim
- Pusan National University College of Medicine, Pusan, Korea
| | - J-Y Kwon
- Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Y H Kim
- Chonnam National University Medical School, Gwangju, Korea
| | - S Na
- Kangwon National University Hospital, School of Medicine Kangwon National University, Chuncheon, Korea
| | - J-G Bae
- Keimyung University School of Medicine, Daegu, Korea
| | - H-H Cha
- Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - J-Y Shim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - K Y Oh
- School of Medicine, Eulji University, Daejeon, Korea
| | - K A Lee
- Kyung Hee University School of Medicine, Seoul, Korea
| | - S M Kim
- Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - I A Cho
- Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - S M Lee
- Seoul National University College of Medicine, Seoul, Korea
| | - G J Cho
- Korea University College of Medicine, Seoul, Korea
| | - Y S Jo
- St Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - G Y Choi
- Soonchunhyang University Seoul Hospital, College of Medicine, Soonchunhyang University, Seoul, Korea
| | - S K Choi
- College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - S E Hur
- Konyang University Hospital, Daejeon, Korea
| | - H S Hwang
- Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
| | - Y J Kim
- College of Medicine, Ewha Womans University, Seoul, Korea
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Abstract
The purpose of this study was to develop a diagnostic tool to automatically detect temporomandibular joint osteoarthritis (TMJOA) from cone beam computed tomography (CBCT) images with artificial intelligence. CBCT images of patients diagnosed with temporomandibular disorder were included for image preparation. Single-shot detection, an object detection model, was trained with 3,514 sagittal CBCT images of the temporomandibular joint that showed signs of osseous changes in the mandibular condyle. The region of interest (condylar head) was defined and classified into 2 categories-indeterminate for TMJOA and TMJOA-according to image analysis criteria for the diagnosis of temporomandibular disorder. The model was tested with 2 sets of 300 images in total. The average accuracy, precision, recall, and F1 score over the 2 test sets were 0.86, 0.85, 0.84, and 0.84, respectively. Automated detection of TMJOA from sagittal CBCT images is possible by using a deep neural networks model. It may be used to support clinicians with diagnosis and decision making for treatments of TMJOA.
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Affiliation(s)
- K S Lee
- College of Medicine, Korea University, Seoul, Republic of Korea
| | - H J Kwak
- College of Medicine, Korea University, Seoul, Republic of Korea
| | - J M Oh
- College of Medicine, Korea University, Seoul, Republic of Korea
| | - N Jha
- Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Y J Kim
- Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - W Kim
- Seoul National University, Seoul, Republic of Korea
| | - U B Baik
- Ewha Womans University, Seoul, Republic of Korea
| | - J J Ryu
- College of Medicine, Korea University, Seoul, Republic of Korea
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Lee SY, Yeom SS, Kim CH, Kim YJ, Kim HR. A new aortoiliac calcification scoring system to predict grade C anastomotic leak following rectal cancer surgery. Tech Coloproctol 2020; 24:843-849. [PMID: 32468245 DOI: 10.1007/s10151-020-02246-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 05/19/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Aortoiliac calcification may be a surrogate marker of decreased visceral perfusion causing anastomotic leak (AL). The aim of this study was to evaluate the predictive role of aortoiliac calcification for AL after rectal cancer surgery. METHODS We enrolled patients with primary rectal cancer who had restorative resection at our institution between January 2013 and December 2015. An aortoiliac calcification score was calculated as the sum of calcification scores at the infrarenal aorta (0: no, 1: ≤ 3 cm, 2: > 3 cm) and the common iliac arteries (0: no, 1: unilateral, 2: bilateral). AL was classified into three grades: grade A, requiring no intervention; grade B, requiring therapeutic intervention without re-laparotomy; and grade C, requiring re-laparotomy. Clinicopathological characteristics were analyzed to identify risk factors for AL. RESULTS There were 583 patients. Three-hundred forty-five (59.2%) had an aortoiliac calcification score ≥ 3, and 37 (6.3%) patients experienced AL, in 30 cases (5.1%) grade C AL. Patients with an aortoiliac calcification score ≥ 3 had a higher incidence of grade C AL (6.7% vs. 2.9%, p = 0.045). Multivariate logistic regression analysis revealed that an aortoiliac calcification score ≥ 3 was an independent risk factor for grade C AL (odds ratio = 2.669, 95% confidence interval 1.066-6.686, p = 0.036). CONCLUSIONS Aortoiliac calcification may be considered a risk factor for grade C AL after rectal cancer surgery.
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Affiliation(s)
- S Y Lee
- Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro Hwasun-eup, Hwasun-gun, Jeonnam, 58128, South Korea
| | - S-S Yeom
- Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro Hwasun-eup, Hwasun-gun, Jeonnam, 58128, South Korea
| | - C H Kim
- Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro Hwasun-eup, Hwasun-gun, Jeonnam, 58128, South Korea
| | - Y J Kim
- Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro Hwasun-eup, Hwasun-gun, Jeonnam, 58128, South Korea
| | - H R Kim
- Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro Hwasun-eup, Hwasun-gun, Jeonnam, 58128, South Korea.
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Abstract
We evaluated changes in incidence, relative survival (RS), and conditional survival (CS) of head and neck squamous cell carcinoma (HNSCC), focusing on oral tongue squamous cell carcinoma (OTSCC). Data of 74 680 HNSCC patients from 1976 to 2015 were obtained from the Surveillance, Epidemiology, and End Results database. Five anatomical sites and their subsites were analyzed. Annual percent change (APC) of incidence was calculated. RS and CS were compared across the four decades. Adjusted hazard ratios (aHRs) of RS were evaluated using multivariate regression. OTSCC incidence decreased from 1976 (APC = −0.76, P < 0.05) but has increased since 1999 (APC = 2.36, P < 0.05). During 2006–2015, the 5-year CS exceeded 90% only for OTSCC and oropharyngeal squamous cell carcinoma (OPSCC). RS improved in OTSCC (aHR = 0.697, 95% confidence interval [CI] 0.642–0.757, P < 0.001) and OPSCC (aHR = 0.669, 95% CI 0.633–0.706, P < 0.001) during the last two decades. For both OTSCC and OPSCC, improved survival was observed regardless of treatment. Incidence and survival remained unchanged for nasopharyngeal, hypopharyngeal, and laryngeal cancers during this period. In conclusion, OTSCC incidence has been increasing since the 2000s, with improving prognosis irrespective of treatment. Given its similarity to OPSCC, OTSCC may represent an emerging HNSCC, warranting further research and clinical recognition.
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Affiliation(s)
- Yi-Jun Kim
- Institute of Convergence Medicine, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea.,Department of Radiation Oncology, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Jin Ho Kim
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Kim YJ, Jeong YJ, Kim SH, Kim YJ, Lee SY, Kim TY, Choi MS, Ahn JH. Preparedness for COVID-19 infection prevention in Korea: a single-centre experience. J Hosp Infect 2020; 105:370-372. [PMID: 32302723 PMCID: PMC7194524 DOI: 10.1016/j.jhin.2020.04.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 04/09/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Y J Kim
- Division of Infectious Disease, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea; Infection Control Team, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea.
| | - Y J Jeong
- Division of Infectious Disease, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea; Infection Control Team, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea
| | - S H Kim
- Division of Infectious Disease, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea; Infection Control Team, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea
| | - Y J Kim
- Infection Control Team, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea
| | - S Y Lee
- Infection Control Team, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea
| | - T Y Kim
- Infection Control Team, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea
| | - M S Choi
- Infection Control Team, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea
| | - J H Ahn
- Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea; Division of Pulmonology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Kim JH, Kim I, Kang CK, Jun KI, Yoo SH, Chun JY, Jung J, Kim YJ, Kim DY, Jo HB, Kim DY, Koh Y, Shin DY, Hong J, Kim NJ, Yoon SS, Kim TS, Park WB, Oh MD. Enhanced antimicrobial stewardship based on rapid phenotypic antimicrobial susceptibility testing for bacteraemia in patients with haematological malignancies: a randomized controlled trial. Clin Microbiol Infect 2020; 27:69-75. [PMID: 32272171 DOI: 10.1016/j.cmi.2020.03.038] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 01/27/2020] [Revised: 03/30/2020] [Accepted: 03/31/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Recently, rapid phenotypic antimicrobial susceptibility testing (AST) based on microscopic imaging analysis has been developed. The aim of this study was to determine whether implementation of antimicrobial stewardship programmes (ASP) based on rapid phenotypic AST can increase the proportion of patients with haematological malignancies who receive optimal targeted antibiotics during early periods of bacteraemia. METHODS This randomized controlled trial enrolled patients with haematological malignancies and at least one positive blood culture. Patients were randomly assigned 1:1 to conventional (n = 60) or rapid phenotypic (n = 56) AST. The primary outcome was the proportion of patients receiving optimal targeted antibiotics 72 hr after blood collection for culture. RESULTS The percentage receiving optimal targeted antibiotics at 72 hr was significantly higher in the rapid phenotypic AST group (45/56, 80.4%) than in conventional AST group (34/60, 56.7%) (relative risk (RR) 1.42, 95% confidence interval (CI) 1.09-1.83). The percentage receiving unnecessary broad-spectrum antibiotics at 72 hr was significantly lower (7/26, 12.5% vs 18/60, 30.0%; RR 0.42, 95% CI 0.19-0.92) and the mean time to optimal targeted antibiotic treatment was significantly shorter (38.1, standard deviation (SD) 38.2 vs 72.8, SD 93.0 hr; p < 0.001) in the rapid phenotypic AST group. The mean time from blood collection to the AST result was significantly shorter in the rapid phenotypic AST group (48.3, SD 17.6 vs 83.1, SD 22.2 hr). DISCUSSION ASP based on rapid phenotypic AST can rapidly optimize antibiotic treatment for bacteraemia in patients with haematological malignancy. Rapid phenotypic AST can improve antimicrobial stewardship in immunocompromised patients.
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Affiliation(s)
- J-H Kim
- Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea
| | - I Kim
- Division of Haematology-Oncology, Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea
| | - C K Kang
- Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea
| | - K-I Jun
- Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea
| | - S H Yoo
- Division of Haematology-Oncology, Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea
| | - J Y Chun
- Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea
| | - J Jung
- Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea
| | - Y J Kim
- Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea
| | - D Y Kim
- Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea
| | - H B Jo
- Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea
| | - D Y Kim
- Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea
| | - Y Koh
- Division of Haematology-Oncology, Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea
| | - D-Y Shin
- Division of Haematology-Oncology, Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea
| | - J Hong
- Division of Haematology-Oncology, Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea
| | - N J Kim
- Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea
| | - S-S Yoon
- Division of Haematology-Oncology, Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea
| | - T S Kim
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - W B Park
- Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea.
| | - M-D Oh
- Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea
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Kim YJ, Lee S, Jung J, Jung H, In S, Chang J, Chang D, Fahie M. Atlantoaxial bands in small breed dogs: influence of external pressure by the endotracheal tube tie. J Small Anim Pract 2020; 61:163-169. [PMID: 31960442 DOI: 10.1111/jsap.13094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 10/30/2019] [Accepted: 11/01/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To determine the prevalence of dorsal cervical spinal compression in a population of dogs susceptible to caudal occipital dysplasia. To determine whether endotracheal tube ties iatrogenically alter the dorsal compression ratio in the atlantoaxial region. MATERIALS AND METHODS Prospective, randomised, controlled, cross-over, blinded cohort study of dogs weighing <15 kg and presenting for neurologic signs localised to the cervical region. In mid-sagittal T2-weighted MR images, dorsal cervical compression and cerebellar compression were evaluated. Dorsal cervical compression ratios were calculated and compared to determine the effect of the endotracheal tube tie on the atlantoaxial region depending on whether dogs were in extended or flexed neck position. RESULTS Prevalence of dorsal cervical spinal compression consistent with an atlantoaxial band was 32/44 (73%) dogs without tie pressure and 37/44 (84%) dogs with tie pressure. Significantly higher compression ratios were found with tie placement over the craniocervical region. Dorsal compression ratios of dogs with cerebellar compression were significantly greater than those without it. CLINICAL SIGNIFICANCE The location of the endotracheal tube tie can influence interpretation of MR images of the craniocervical region of small breed dogs. These breeds more often had greater dorsal cervical spinal compression with tie pressure, especially when they had cerebellar compression.
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Affiliation(s)
- Y J Kim
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, California, 91766, USA
| | - S Lee
- Section of Medical imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, 28644, South Korea
| | - J Jung
- Section of Medical imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, 28644, South Korea
| | - H Jung
- Section of Medical imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, 28644, South Korea
| | - S In
- Section of Medical imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, 28644, South Korea
| | - J Chang
- Section of Medical imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, 28644, South Korea
| | - D Chang
- Section of Medical imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, 28644, South Korea
| | - M Fahie
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, California, 91766, USA
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Amano M, Izumi C, Kim YJ, Park SJ, Park SW, Tanaka H, Hozumi T, Ling LH, Yu CM, Fukuda S, Otsuji Y, Song JK, Sohn DW. P914 Changes of echocardiographic parameters in primary mitral regurgitation and determinants of symptom: an assessment from the Asian valve registry data. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
[Background]Clinicians often have a difficulty in determining the presence of mitral regurgitation (MR)-relatedsymptoms because of subjectivity.However, there are few actual measurement data for echocardiographic left ventricular (LV) and left atrial (LA) size related to the severity of MR and the relationship between MR-related symptoms and these echocardiographic parameters.
[Purpose] The purpose of this study was to clarify actual values for echocardiographic parameters related to severity of MR and determinant factors of MR-related symptoms.
[Methods] Among patients enrolled in the Asian Valve Registry, we investigated 778 consecutive patients with primary MR showing sinus rhythm. Symptoms were determined by NYHA (≤ II or ≥ III).
[Results]MR severity was mild in 106, moderate in 285, and severe in 387 patients. LA volume index, LV end-diastolic diameter, and LV mass index increased with increasing MR grade [LA volume index: 47.9 (mild), 56.2 (moderate), and 64.9 ml/m2(severe) (p < 0.001), LV end-diastolic diameter: 51.2, 54.5, 58.1 mm (p < 0.001), and LV mass index: 101, 109, 123 g/m2(p < 0.001)]. Regarding moderate and severe MR, 70 patients (10.4%) were symptomatic. Table shows multivariable analysis for being symptomatic in moderate and severe MR patients. LV mass index (p = 0.040), ejection fraction (p < 0.001), female gender (p = 0.004), and heart rate (p = 0.007) were independent factors for MR-related symptoms.
[Conclusions] LV and LA parameters on echocardiography worsened as MR severity progressed. Larger LV mass index and lower ejection fraction were independent determinant factors for MR-related symptoms. We should also pay attention to LV hypertrophy in patients with primary MR.
Determinant factors for mitral regurgita Model 1 Model 2 OR (95% CI) P-value OR (95% CI) P-value Age, per 1-y increment 1.03 (1.00-1.05) 0.035 1.02 (0.99-1.05) 0.053 Sex (female) 2.23 (1.20-4.16) 0.011 2.28 (1.31-3.98) 0.004 Hear rate, per 1 bpm increment 1.03 (1.00-1.05) 0.025 1.03 (1.01-1.05) 0.007 LVDs index, per 1 mm increment 0.99 (0.90-1.09) 0.90 EF, per 1% increment 0.95 (0.92-0.99) 0.019 0.96 (0.93-0.98) <0.001 LV mass index, per 10 g/m2increment 1.12 (1.01-1.25) 0.033 1.09 (1.005-1.18) 0.040 LA volume index, per 10 mL/m2increment 0.96 (0.90-1.03) 0.23 E wave, per 1cm/s increment 1.81 (0.70-4.66) 0.23 TR pressure gradient >40 mmHg 2.11 (0.97-4.57) 0.057 Hypertention 1.40 (0.75-2.63) 0.29
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Affiliation(s)
- M Amano
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - C Izumi
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - Y J Kim
- Seoul National University Hospital, Cardiology, Seoul, Korea (Republic of)
| | - S J Park
- Samsung Medical Center, Cardiology, Seoul, Korea (Republic of)
| | - S W Park
- Samsung Medical Center, Cardiology, Seoul, Korea (Republic of)
| | - H Tanaka
- Kobe University, Cardiovascular Medicine, Kobe, Japan
| | - T Hozumi
- Wakayama Medical University, Cardiovascular Medicine, Wakayama, Japan
| | - L H Ling
- National Heart Centre Singapore, Singapore, Singapore
| | - C M Yu
- The University of Hong Kong, Medicine and Therapeutics, Hong Kong, Hong Kong
| | - S Fukuda
- University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Y Otsuji
- University of Occupational and Environmental Health, Kitakyushu, Japan
| | - J K Song
- Asan Medical Center, Seoul, Korea (Republic of)
| | - D W Sohn
- Seoul National University Hospital, Cardiology, Seoul, Korea (Republic of)
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Moon I, Lee SP, Kim MK, Park JB, Kim HK, Kim YJ, Sohn DW. P1274 Early surgery versus watchful waiting in patients with moderate aortic stenosis and left ventricular systolic dysfunction. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Aortic stenosis (AS) induces significant pressure overload to the left ventricle (LV) and its burden may increase if there is concomitant LV systolic dysfunction. Severe AS with LV systolic dysfunction is a class I indication for aortic valve replacement (AVR) irrespective of symptoms, however, this recommendation is not well established in those with moderate AS and LV systolic dysfunction. In this study, we sought to investigate the clinical impact of surgical AVR among patients with moderate AS and LV systolic dysfunction.
Methods
From 2001 to 2017, we retrospectively but consecutively identified patients with moderate AS and LV systolic dysfunction from a single tertiary hospital. Moderate AS was defined as aortic valve area between 1.0 and 1.5cm2 and LV systolic dysfunction as LV ejection fraction less than 50%. The primary outcome was all-cause death and we additionally analyzed cardiac death as a secondary endpoint. The outcomes were compared between those who underwent early surgical AVR at the stage of moderate AS versus those who were followed without AVR at the outpatient clinic.
Results
Among a total of 257 patients with moderate AS and concomitant LV systolic dysfunction (70.0 ± 11.3 years, 63.4% of male), 34 patients received early AVR. Patients in the AVR group was younger than the observation group (64.2 ± 8.1 vs. 70.9 ± 11.5, respectively), and had a lower prevalence of hypertension and chronic kidney disease. During a mean of 3-year follow up, 112 patients (47.5%) died and the overall death rate was 15.367 per 100 person-year (PY). The AVR group showed a significantly lower rate of all-cause death than the observation group (5.241PY vs. 18.160PY, p-value = 0.002). After multivariable Cox proportional hazard regression adjusting for age, sex, comorbidities and laboratory data, early AVR at the stage of moderate AS significantly reduced the risk of all-cause death (hazard ratio [HR] 0.340, 95% confidence interval [CI] 0.117 - 0.985, p-value = 0.047). However, there was no risk reduction of cardiac death (HR 0.578 95% CI 0.150 - 2.231, p-value = 0.426).
Conclusions
In patients with moderate AS and LV systolic dysfunction, AVR reduces the risk of all-cause death. A prospective design study is warranted to confirm our findings in the near future.
Abstract P1274 Figure. Kaplan-Meier curves for deaths
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Affiliation(s)
- I Moon
- Seoul National University Hospital, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - S P Lee
- Seoul National University Hospital, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - M K Kim
- Seoul National University Hospital, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - J B Park
- Seoul National University Hospital, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - H K Kim
- Seoul National University Hospital, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - Y J Kim
- Seoul National University Hospital, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - D W Sohn
- Seoul National University Hospital, Department of Internal Medicine, Seoul, Korea (Republic of)
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Kim HM, Kim HK, Lee JH, Park EA, Park JB, Lee SP, Kim YJ, Sohn DW, Lee YB, Kim YJ, Yoon JH. P1603 Changes of cardiac function in cirrhotic patients after liver transplantation. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.1021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
This study was supported by the grant of CJ healthcare 2016 research fund.
Background
Liver cirrhosis (LC) has been known to affect cardiovascular performance. Limited study have evaluated the alteration of myocardial function in patients with LC after liver transplantation (LT).
Purpose
The aim of study was to evaluate changes of cardiac function in patients with cirrhosis following LT using conventional and speckle-tracking echocardiography and late gadolinium enhancement (LGE) of cardiac magnetic resonance (MR).
Methods
Thirty-five patients with cirrhosis (mean age, 57.1 ± 9.0; male, 75%) who were listed for LT were prospectively enrolled. Patients underwent conventional, speckle-tracking echocardiography, and cardiac MR imaging with LGE. Echocardiography and cardiac MR were performed at pre and 1 year after LT. Cirrhotic patients were compared with normal control (n = 20, mean age, 65.0 ± 14.8; men, 11(55%)) and echocardiographic and cardiac MR data were compared pre and post LT.
Results
Conventional and speckle-tracking echocardiography and Cardiac MR imaging demonstrated hyperdynamic left ventricular (LV) function in patients with cirrhosis (LV ejection fraction (EF) with cardiac MR 67.8 ± 7.0% in LC vs. 63.4 ± 6.4% in control, P = 0.028; global longitudinal strain (GLS) -24.3 ± 2.6% in LC vs. -18.6 ± 2.2% in control, P < 0.001). There were no LGE in patients with cirrhosis and no significant differences in LV size, LV wall thickness, LV mass index, and diastolic function between cirrhotic patients and control group (all P > 0.1). Corrected QT interval (QTc) in electrocardiogram was prolonged in LC patients (P < 0.001). One-year after LT, LV end-diastolic diameter and LV end-diastolic volume significantly decreased (P = 0.016 and 0.022, respectively). Although LVEF showed no significant changes 1 year post-LT (P = 0.362), LV-GLS (from -24.7 ± 1.8% to -20.8 ± 3.4%, P < 0.001) significantly decreased. QTc interval also decreased 1 year after LT (from 470.4 ± 29.6msec to 428.2 ± 31.6msec, P = 0.001).
Conclusions
The present study demonstrated that cirrhotic patients showed hyperdynamic circulation and prolonged QTc interval compared with normal controls. After 1 year LT, LV size reduced and augmented LV function was normalized. Given that no LGE in cardiac MR and normalized GLS and QTc after LT, cardiac dysfunction in LC patients could be reversed by LT.
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Affiliation(s)
- H M Kim
- Mediplex Sejong Hospital, Incheon, Korea (Republic of)
| | - H K Kim
- Seoul National University Hospital, Cardiology, Seoul, Korea (Republic of)
| | - J H Lee
- Seoul National University Hospital, Gastroenterology, Seoul, Korea (Republic of)
| | - E A Park
- Seoul National University Hospital, Radiology, Seoul, Korea (Republic of)
| | - J B Park
- Seoul National University Hospital, Cardiology, Seoul, Korea (Republic of)
| | - S P Lee
- Seoul National University Hospital, Cardiology, Seoul, Korea (Republic of)
| | - Y J Kim
- Seoul National University Hospital, Cardiology, Seoul, Korea (Republic of)
| | - D W Sohn
- Seoul National University Hospital, Cardiology, Seoul, Korea (Republic of)
| | - Y B Lee
- Seoul National University Hospital, Gastroenterology, Seoul, Korea (Republic of)
| | - Y J Kim
- Seoul National University Hospital, Gastroenterology, Seoul, Korea (Republic of)
| | - J H Yoon
- Seoul National University Hospital, Gastroenterology, Seoul, Korea (Republic of)
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Hwang I, Lee JM, Park JB, Yoon YE, Lee SP, Kim HK, Kim YJ, Cho GY, Park SJ, Kim KH, Hong GR. P1368 Effect of angiotensin receptor blocker in patients with moderate or severe aortic stenosis: a randomized controlled trial. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
This study was supported by grants from Boryung Pharmacy Research Fund.
Background/Introduction: Pathophysiology of aortic stenosis (AS) and several previous studies suggested the potential role of angiotensin receptor blocker (ARB) in patients with AS.
Purpose
We aimed to investigate the effects of Fimasartan, an ARB, on exercise capacity and progression of AS in patients with moderate to severe AS.
Methods
We conducted a prospective, randomized, double-blind, placebo-controlled trial in 32 normotensive or controlled-hypertensive patients with moderate or severe AS. Study participants were randomized to Fimasartan 30 mg to 60 mg daily (n = 14) or placebo (n = 18) for 1 year, and underwent cardiopulmonary exercise test, 6-minute walk test, and echocardiography at 0, 6, and 12 months, with follow-up data available in 29 subjects.
Results
Significant reductions in blood pressures were observed in the Fimasartan group but not in the placebo group. Two of the 14 patients in the Fimasartan group withdrew the study due to mild symptoms probably related with the decreased blood pressure, and one patient decline the study protocol. After the 12-month treatment, the peak oxygen consumption (VO2; the primary outcome) in the Fimasartan group was significantly decreased (from 28.3 ± 5.9 to 25.4 ± 3.8 mL/min/kg, P = 0.021) but not in the placebo group (P for interaction = 0.046) (Figure 1A). The severity of AS showed a gradual progression in both groups, without inter-group differences (mean transaortic pressure; Fimasartan group, +4.0 ± 3.8 mmHg/year; placebo group, +5.3 ± 6.2 mmHg/year; P for interaction = 0.429) (Figure 1B). Parameters of left ventricular systolic and diastolic function did not change in both groups.
Conclusions
The use of ARB impaired exercise capacity in patients with moderate or severe AS, and did not prevent the progression of AS. However, due to the small number of participants, further studies are required to confirm these findings.
Abstract P1368 Figure.
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Affiliation(s)
- I Hwang
- Seoul National University Bundang Hospital, Seongnam, Korea (Republic of)
| | - J M Lee
- Samsung Medical Center, Cardiovascular Center, Seoul, Korea (Republic of)
| | - J B Park
- Seoul National University Hospital, Seoul, Korea (Republic of)
| | - Y E Yoon
- Seoul National University Bundang Hospital, Seongnam, Korea (Republic of)
| | - S P Lee
- Seoul National University Hospital, Seoul, Korea (Republic of)
| | - H K Kim
- Seoul National University Hospital, Seoul, Korea (Republic of)
| | - Y J Kim
- Seoul National University Hospital, Seoul, Korea (Republic of)
| | - G Y Cho
- Seoul National University Bundang Hospital, Seongnam, Korea (Republic of)
| | - S J Park
- Samsung Medical Center, Cardiovascular Center, Seoul, Korea (Republic of)
| | - K H Kim
- Chonnam National University Hospital, Gwangju, Korea (Republic of)
| | - G R Hong
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
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Oh J, Hong YJ, Ha J, Chun KH, Kim H, Lee CJ, Kim YJ, Choi BW, Kang SM. P3555Lower native T1, extracellular volume and T2 on cardiac magnetic resonance imaging is related to more left ventricular reverse remodeling in nonischemic dilated cardiomyopathy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Guideline-directed medical therapy can induce left ventricular reverse remodeling (LVRR) in nonischemic dilated cardiomyopathy (NIDCM). Some predictors for LVRR have been reported but, there were few studies about the relationship between cardiac magnetic resonance imaging (CMR) parameters and LVRR in NIDCM on optimal GDMT.
Methods
We retrospectively analyzed echocardiogram and CMR data of newly diagnosed 142 NIDCM patients (age: 57±16 years old, 71.8% male) in a single center from Jan 2012 to Dec 2017. NIDCM was defined as left ventricular ejection fraction (LVEF) <45% and the ischemic etiology was excluded by CMR, coronary angiography or coronary CT or SPECT scan. LVRR was defined as improvement in LVEF ≥10% during follow-up period (median 403 days).
Results
Baseline LVEF and LV end diastolic dimension (LVEDD) were 27±8% and 64±8 mm. There were 87 patients (61.3%) of LVRR in our cohort. In LVRR group, native T1 value was significantly lower (1326±66 for LVRR vs 1369±72ms, p<0.001), extracellular volume (ECV) was significantly lower (28.3±3.6 for LVRR vs 32.4±4.4%, p<0.001), and T2 value was significantly lower (49.6±4.6 for LVRR vs 52.1±5.4ms, p=0.004) compared with non-LVRR group. ECV was an independent predictor for LVRR after adjusting current LVRR predictors such as age, sex, LVEF, LVEDD, systolic blood pressure, heart rate and QRS duration (Odd ratio 0.706, 95% confidence interval 0.616–0.809, p<0.001).
Conclusion
Lower native T1, ECV and T2 on CMR is related to higher incidence of LVRR in NIDCM. Further larger prospective study should be warranted to confirm the relationship between CMR parameters and LVRR in NIDCM.
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Affiliation(s)
- J Oh
- Yonsei University College of Medicine, Cardiology Division, Seoul, Korea (Republic of)
| | - Y J Hong
- Yonsei University College of Medicine, Radiology, Seoul, Korea (Republic of)
| | - J Ha
- Yonsei University College of Medicine, Cardiology Division, Seoul, Korea (Republic of)
| | - K H Chun
- Yonsei University College of Medicine, Cardiology Division, Seoul, Korea (Republic of)
| | - H Kim
- Yonsei University College of Medicine, Cardiology Division, Seoul, Korea (Republic of)
| | - C J Lee
- Yonsei University College of Medicine, Cardiology Division, Seoul, Korea (Republic of)
| | - Y J Kim
- Yonsei University College of Medicine, Radiology, Seoul, Korea (Republic of)
| | - B W Choi
- Yonsei University College of Medicine, Radiology, Seoul, Korea (Republic of)
| | - S M Kang
- Yonsei University College of Medicine, Cardiology Division, Seoul, Korea (Republic of)
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Jeon SH, Chie EK, Kim YJ, Lee KH, Lee HS, Kim MJ, Im SA, Kim JI, Kim TY. Targeted next-generation DNA sequencing identifies Notch signaling pathway mutation as a predictor of radiation response. Int J Radiat Biol 2019; 95:1640-1647. [PMID: 31525117 DOI: 10.1080/09553002.2019.1665212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Purpose: Identifying the association between somatic mutations and the radiation response of tumor is essential for understanding the mechanisms and practicing personalized radiotherapy. The present study aimed to discover specific genes or pathways that are associated with radiation response using targeted next-generation DNA sequencing.Material and methods: Fifty-five patients with various solid tumors whose specimen were sequenced using institutional panel which includes 148 cancer-related genes and received radiotherapy for a measurable tumor were analyzed. Patients with irradiated tumors in complete or partial remission for more than 6 months were defined as responders. Association between mutations including pathogenic single nucleotide variants and insertions/deletions in the 148 genes and 39 molecular pathways and radiation response was investigated.Results: Analyzing 17 responders and 38 non-responders, biologically effective dose (BED), but not concurrent chemotherapy, was associated with radiation response. No single gene correlated with radiation response. Mutations in Notch signaling pathway were associated with radiosensitivity after correction for multiple comparison (adjusted p = .094). When BED and Notch signaling pathway mutation were tested with logistic regression, both variables were associated with radiation response.Conclusions: Our results suggest that somatic mutations in Notch signaling pathway may be related to sensitivity to radiation, although these results should be validated in a larger and more homogeneous cohort.
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Affiliation(s)
- Seung Hyuck Jeon
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea
| | - Eui Kyu Chie
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.,Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Yi-Jun Kim
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung-Hun Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hyun-Seob Lee
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Min Jung Kim
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea
| | - Seock-Ah Im
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jong-Il Kim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea
| | - Tae-You Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.,Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea
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Kim SW, Kim MA, Chang Y, Lee HY, Yoon JS, Lee YB, Cho EJ, Lee JH, Yu SJ, Yoon JH, Park KJ, Kim YJ. Prognosis of surgical hernia repair in cirrhotic patients with refractory ascites. Hernia 2019; 24:481-488. [PMID: 31512088 DOI: 10.1007/s10029-019-02043-2] [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: 04/28/2019] [Accepted: 08/27/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Abdominal wall hernias are common in patients with ascites. Elective surgical repair is recommended for the treatment of abdominal wall hernias. However, surgical hernia repair in cirrhotic patients with refractory ascites is controversial. In this study, we aimed to evaluate the outcomes of elective surgical hernia repair in patients with liver cirrhosis with and without refractory ascites. METHOD From January 2005 to June 2018, we retrospectively reviewed the records of consecutive patients with liver cirrhosis who underwent a surgical hernia repair. RESULTS This study included 107 patients; 31 patients (29.0%) had refractory ascites. Preoperatively, cirrhotic patients with refractory ascites had a higher median model for end-stage liver disease (MELD) score (13.0 vs 11.0, P = 0.001) than those without refractory ascites. The 30-day mortality rate (3.2% vs 0%, P = 0.64) and the risk of recurrence (hazard ratio 0.410; 95% CI 0.050-3.220; P = 0.39) did not differ significantly between cirrhotic patients with refractory ascites and cirrhotic patients without refractory ascites. Among cirrhotic patients with refractory ascites, albumin (P = 0.23), bilirubin (P = 0.37), creatinine (P = 0.97), and sodium levels (P = 0.35) did not change significantly after surgery. CONCLUSION In advanced liver cirrhosis patients with refractory ascites, hernias can be safely treated with elective surgical repair. Mortality rate within 30 days did not differ by the presence or absence of refractory ascites. Elective hernia repair might be beneficial for treatment of abdominal wall hernia in cirrhotic patients with refractory ascites.
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Affiliation(s)
- S W Kim
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - M A Kim
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Y Chang
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - H Y Lee
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea.,Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, South Korea
| | - J S Yoon
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea.,Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Y B Lee
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - E J Cho
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - J-H Lee
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - S J Yu
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - J-H Yoon
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - K J Park
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Y J Kim
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea. .,Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
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