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Byun YH, Won JK, Hong DH, Kang H, Kim JH, Yu MO, Kim MS, Kim YH, Park KJ, Jeong MJ, Hwang K, Kong DS, Park CK, Kang SH. A prospective multicenter assessor blinded pilot study using confocal laser endomicroscopy for intraoperative brain tumor diagnosis. Sci Rep 2024; 14:6784. [PMID: 38514670 PMCID: PMC10957981 DOI: 10.1038/s41598-024-52494-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/19/2024] [Indexed: 03/23/2024] Open
Abstract
In this multi-center, assessor-blinded pilot study, the diagnostic efficacy of cCeLL-Ex vivo, a second-generation confocal laser endomicroscopy (CLE), was compared against the gold standard frozen section analysis for intraoperative brain tumor diagnosis. The study was conducted across three tertiary medical institutions in the Republic of Korea. Biopsy samples from newly diagnosed brain tumor patients were categorized based on location and divided for permanent section analysis, frozen section analysis, and cCeLL-Ex vivo imaging. Of the 74 samples from 55 patients, the majority were from the tumor core (74.3%). cCeLL-Ex vivo exhibited a relatively higher diagnostic accuracy (89.2%) than frozen section analysis (86.5%), with both methods showing a sensitivity of 92.2%. cCeLL-Ex vivo also demonstrated higher specificity (70% vs. 50%), positive predictive value (PPV) (95.2% vs. 92.2%), and negative predictive value (NPV) (58.3% vs. 50%). Furthermore, the time from sample preparation to diagnosis was notably shorter with cCeLL-Ex vivo (13 min 17 s) compared to frozen section analysis (28 min 28 s) (p-value < 0.005). These findings underscore cCeLL-Ex vivo's potential as a supplementary tool for intraoperative brain tumor diagnosis, with future studies anticipated to further validate its clinical utility.
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Affiliation(s)
- Yoon Hwan Byun
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jae-Kyung Won
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Duk Hyun Hong
- Department of Neurosurgery, Korea University Hospital, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
| | - Ho Kang
- Department of Neurosurgery, Seoul National University Bundang Hospital, Gyeonggi-Do, Republic of Korea
| | - Jang Hun Kim
- Department of Neurosurgery, Korea University Hospital, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
| | - Mi Ok Yu
- Department of Neurosurgery, Korea University Hospital, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
| | - Min-Sung Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yong Hwy Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyung-Jae Park
- Department of Neurosurgery, Korea University Hospital, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
| | | | | | - Doo-Sik Kong
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Chul-Kee Park
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Shin-Hyuk Kang
- Department of Neurosurgery, Korea University Hospital, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea.
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Kim JW, Phi JH, Kim SK, Kim YH. Measurement of the intersiphon distance for normal skull base development and estimation of the surgical window for the endoscopic transtuberculum approach in children. J Neurosurg Pediatr 2024:1-8. [PMID: 38364228 DOI: 10.3171/2023.12.peds23426] [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: 09/13/2023] [Accepted: 12/13/2023] [Indexed: 02/18/2024]
Abstract
OBJECTIVE Due to the underdeveloped skull base in children, it is crucial to predict whether a sufficient surgical window for an endoscopic endonasal approach can be achieved. This study aimed to analyze the presumed surgical window through measurement of the intersiphon distance (ISD) and the planum-sella height (PSH) on the basis of age and its correlation with the actual surgical window for the endoscopic transtuberculum approach. METHODS Twenty patients of each age from 3 to 18 years were included as the normal skull base population. ISD and PSH were measured and compared among consecutive ages. Additionally, 42 children with craniopharyngiomas or Rathke's cleft cysts who underwent treatment via the endoscopic transtuberculum approach were included. ISD and PSH were measured on preoperative images and then correlated with the dimensions of the surgical window on postoperative CT scans. The intraoperative endoscopic view was classified as narrow, intermediate, or wide based on operative photographs or videos, and relevant clinical factors were analyzed. RESULTS In the normal skull base population, both ISD and the estimated area of the surgical window increased with age, particularly at 8 and 11 years old. On the other hand, PSH did not show an incremental pattern with age. Among the 42 children who underwent surgery, 24 had craniopharyngioma and 18 had Rathke's cleft cysts. ISD showed the strongest correlation with the actual area of the surgical window [r(40) = 0.69, p < 0.001] rather than with age or PSH. The visual grade of the intraoperative endoscopic view was narrow in 17 patients, intermediate in 21, and wide in 4. Preoperative ISD was 14.58 ± 1.29 mm in the narrow group, 16.13 ± 2.30 mm in the intermediate group, and 18.09 ± 3.43 mm in the wide group (p < 0.01). There were no differences in terms of extent of resection (p = 0.41); however, 2 patients in the narrow group had postoperative complications. CONCLUSIONS Normal skull base development exhibited age-related growth. However, in children with suprasellar lesions, the measurement of the ISD showed a better correlation than age for predicting the surgical window for the endoscopic transtuberculum approach. Children with a small ISD should be approached with caution due to the limited surgical window.
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Affiliation(s)
- Joo Whan Kim
- 1Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; and
| | - Ji Hoon Phi
- 1Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; and
| | - Seung-Ki Kim
- 1Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; and
| | - Yong Hwy Kim
- 2Department of Neurosurgery, Pituitary Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
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Park SS, Kang H, Kim YH, Kim JH. Different tumor growth pattern of clinically nonfunctioning pituitary neuroendocrine tumor according to sex and age: a longitudinal study. J Endocrinol Invest 2024:10.1007/s40618-024-02303-8. [PMID: 38310625 DOI: 10.1007/s40618-024-02303-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/02/2024] [Indexed: 02/06/2024]
Abstract
PURPOSE Asymptomatic patients with clinically non-functional pituitary neuroendocrine tumors (CNF-PitNETs) are usually followed up. However, the natural course of CNF-PitNETs according to sex and age remains unclear. Therefore, this study assessed growth patterns of CNF-PitNETs according to sex and age. METHODS In this longitudinal study, we enrolled 431 consecutive patients with CNF-PitNETs who were treated at Seoul National University Hospital from 1997 to 2021. The patients underwent hormone function testing and visual field testing, and were subsequently followed up with imaging over a median duration of 66 months. RESULTS The median age of the patients was 53.0 years, and 37.1% (n = 160) were men. Men were older and harbored more macroadenomas than women. The annual tumor volume change was higher in men than in women (0.21 vs. 0.04 cm3/year, P < 0.001). The estimated cutoff value of age for significant tumor growth was 51 years. In men, the annual tumor volume change was similar across all age groups. In women, those aged ≤ 50 years showed significantly lower annual tumor volume change than those aged > 50 years (0.01, 0.11, and 0.17 cm3/year, P = 0.001). When comparing sexes within the same age group, the annual tumor volume changes was significantly lower for women than for men, only in patients aged ≤ 50 years (0.01 vs. 0.15 cm3/year, P < 0.001). CONCLUSIONS Among patients with CNF-PitNET, tumor growth was slower in women aged ≤ 50 years than in men and women aged > 50. These findings may guide the customization of surveillance strategies for CNF-PitNETs according to sex and age.
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Affiliation(s)
- S S Park
- Department of Internal Medicine, Seoul National University College of Medicine, 101 Dae-hak ro, Seoul, 03080, Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Pituitary Center, Seoul National University Hospital, Seoul, Korea
| | - H Kang
- Pituitary Center, Seoul National University Hospital, Seoul, Korea
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 101 Dae-hak ro, Seoul, 03080, Korea
| | - Y H Kim
- Pituitary Center, Seoul National University Hospital, Seoul, Korea.
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 101 Dae-hak ro, Seoul, 03080, Korea.
| | - J H Kim
- Department of Internal Medicine, Seoul National University College of Medicine, 101 Dae-hak ro, Seoul, 03080, Korea.
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
- Pituitary Center, Seoul National University Hospital, Seoul, Korea.
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Pak A, Zylstra AB, Baker KL, Casey DT, Dewald E, Divol L, Hohenberger M, Moore AS, Ralph JE, Schlossberg DJ, Tommasini R, Aybar N, Bachmann B, Bionta RM, Fittinghoff D, Gatu Johnson M, Geppert Kleinrath H, Geppert Kleinrath V, Hahn KD, Rubery MS, Landen OL, Moody JD, Aghaian L, Allen A, Baxamusa SH, Bhandarkar SD, Biener J, Birge NW, Braun T, Briggs TM, Choate C, Clark DS, Crippen JW, Danly C, Döppner T, Durocher M, Erickson M, Fehrenbach T, Freeman M, Havre M, Hayes S, Hilsabeck T, Holder JP, Humbird KD, Hurricane OA, Izumi N, Kerr SM, Khan SF, Kim YH, Kong C, Jeet J, Kozioziemski B, Kritcher AL, Lamb KM, Lemos NC, MacGowan BJ, Mackinnon AJ, MacPhee AG, Marley EV, Meaney K, Millot M, Di Nicola JMG, Nikroo A, Nora R, Ratledge M, Ross JS, Shin SJ, Smalyuk VA, Stadermann M, Stoupin S, Suratwala T, Trosseille C, Van Wonterghem B, Weber CR, Wild C, Wilde C, Wooddy PT, Woodworth BN, Young CV. Observations and properties of the first laboratory fusion experiment to exceed a target gain of unity. Phys Rev E 2024; 109:025203. [PMID: 38491694 DOI: 10.1103/physreve.109.025203] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/18/2024] [Indexed: 03/18/2024]
Abstract
An indirect-drive inertial fusion experiment on the National Ignition Facility was driven using 2.05 MJ of laser light at a wavelength of 351 nm and produced 3.1±0.16 MJ of total fusion yield, producing a target gain G=1.5±0.1 exceeding unity for the first time in a laboratory experiment [Phys. Rev. E 109, 025204 (2024)10.1103/PhysRevE.109.025204]. Herein we describe the experimental evidence for the increased drive on the capsule using additional laser energy and control over known degradation mechanisms, which are critical to achieving high performance. Improved fuel compression relative to previous megajoule-yield experiments is observed. Novel signatures of the ignition and burn propagation to high yield can now be studied in the laboratory for the first time.
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Affiliation(s)
- A Pak
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - A B Zylstra
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - K L Baker
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - D T Casey
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - E Dewald
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - L Divol
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - M Hohenberger
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - A S Moore
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - J E Ralph
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - D J Schlossberg
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - R Tommasini
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - N Aybar
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - B Bachmann
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - R M Bionta
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - D Fittinghoff
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - M Gatu Johnson
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - H Geppert Kleinrath
- Los Alamos National Laboratory, Mail Stop F663, Los Alamos, New Mexico 87545, USA
| | - V Geppert Kleinrath
- Los Alamos National Laboratory, Mail Stop F663, Los Alamos, New Mexico 87545, USA
| | - K D Hahn
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - M S Rubery
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - O L Landen
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - J D Moody
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - L Aghaian
- General Atomics, San Diego, California 92186, USA
| | - A Allen
- General Atomics, San Diego, California 92186, USA
| | - S H Baxamusa
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - S D Bhandarkar
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - J Biener
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - N W Birge
- Los Alamos National Laboratory, Mail Stop F663, Los Alamos, New Mexico 87545, USA
| | - T Braun
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - T M Briggs
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - C Choate
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - D S Clark
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - J W Crippen
- General Atomics, San Diego, California 92186, USA
| | - C Danly
- Los Alamos National Laboratory, Mail Stop F663, Los Alamos, New Mexico 87545, USA
| | - T Döppner
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - M Durocher
- Los Alamos National Laboratory, Mail Stop F663, Los Alamos, New Mexico 87545, USA
| | - M Erickson
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | | | - M Freeman
- Los Alamos National Laboratory, Mail Stop F663, Los Alamos, New Mexico 87545, USA
| | - M Havre
- General Atomics, San Diego, California 92186, USA
| | - S Hayes
- General Atomics, San Diego, California 92186, USA
| | - T Hilsabeck
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - J P Holder
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - K D Humbird
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - O A Hurricane
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - N Izumi
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - S M Kerr
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - S F Khan
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - Y H Kim
- Los Alamos National Laboratory, Mail Stop F663, Los Alamos, New Mexico 87545, USA
| | - C Kong
- General Atomics, San Diego, California 92186, USA
| | - J Jeet
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - B Kozioziemski
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - A L Kritcher
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - K M Lamb
- Los Alamos National Laboratory, Mail Stop F663, Los Alamos, New Mexico 87545, USA
| | - N C Lemos
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - B J MacGowan
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - A J Mackinnon
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - A G MacPhee
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - E V Marley
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - K Meaney
- Los Alamos National Laboratory, Mail Stop F663, Los Alamos, New Mexico 87545, USA
| | - M Millot
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - J-M G Di Nicola
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - A Nikroo
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - R Nora
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - M Ratledge
- General Atomics, San Diego, California 92186, USA
| | - J S Ross
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - S J Shin
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - V A Smalyuk
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - M Stadermann
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - S Stoupin
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - T Suratwala
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - C Trosseille
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - B Van Wonterghem
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - C R Weber
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - C Wild
- Diamond Materials GmbH, 79108 Freiburg, Germany
| | - C Wilde
- Los Alamos National Laboratory, Mail Stop F663, Los Alamos, New Mexico 87545, USA
| | - P T Wooddy
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - B N Woodworth
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
| | - C V Young
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551-0808, USA
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Kang H, Park SS, Kim YH, Lim HS, Lee MK, Lee KR, Kim JH, Kim YH. Preoperative Serum Copeptin Can Predict Delayed Hyponatremia after Pituitary Surgery in the Absence of Arginine Vasopressin Deficiency. Endocrinol Metab (Seoul) 2024; 39:164-175. [PMID: 38171208 PMCID: PMC10901654 DOI: 10.3803/enm.2023.1792] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 11/10/2023] [Accepted: 11/21/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGRUOUND Delayed postoperative hyponatremia (DPH) is the most common cause of readmission after pituitary surgery. In this study, we aimed to evaluate the cutoff values of serum copeptin and determine the optimal timing for copeptin measurement for the prediction of the occurrence of DPH in patients who undergo endoscopic transsphenoidal approach (eTSA) surgery and tumor resection. METHODS This was a prospective observational study of 73 patients who underwent eTSA surgery for pituitary or stalk lesions. Copeptin levels were measured before surgery, 1 hour after extubation, and on postoperative days 1, 2, 7, and 90. RESULTS Among 73 patients, 23 patients (31.5%) developed DPH. The baseline ratio of copeptin to serum sodium level showed the highest predictive performance (area under the curve [AUROC], 0.699), and its optimal cutoff to maximize Youden's index was 2.5×10-11, with a sensitivity of 91.3% and negative predictive value of 92.0%. No significant predictors were identified for patients with transient arginine vasopressin (AVP) deficiency. However, for patients without transient AVP deficiency, the copeptin-to-urine osmolarity ratio at baseline demonstrated the highest predictive performance (AUROC, 0.725). An optimal cutoff of 6.5×10-12 maximized Youden's index, with a sensitivity of 92.9% and a negative predictive value of 94.1%. CONCLUSION The occurrence of DPH can be predicted using baseline copeptin and its ratio with serum sodium or urine osmolarity only in patients without transient AVP deficiency after pituitary surgery.
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Affiliation(s)
- Ho Kang
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Seung Shin Park
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yoo Hyung Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hwan Sub Lim
- Department of Laboratory Medicine, Seoul Clinical Laboratories, Yongin, Korea
| | - Mi-Kyeong Lee
- Department of Laboratory Medicine, Seoul Clinical Laboratories, Yongin, Korea
| | - Kyoung-Ryul Lee
- Department of Laboratory Medicine, Seoul Clinical Laboratories, Yongin, Korea
| | - Jung Hee Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Pituitary Center, Seoul National University Hospital, Seoul, Korea
| | - Yong Hwy Kim
- Pituitary Center, Seoul National University Hospital, Seoul, Korea
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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6
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Dho YS, Lee BC, Moon HC, Kim KM, Kang H, Lee EJ, Kim MS, Kim JW, Kim YH, Park SJ, Park CK. Validation of real-time inside-out tracking and depth realization technologies for augmented reality-based neuronavigation. Int J Comput Assist Radiol Surg 2024; 19:15-25. [PMID: 37442869 DOI: 10.1007/s11548-023-02993-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023]
Abstract
PURPOSE Concomitant with the significant advances in computing technology, the utilization of augmented reality-based navigation in clinical applications is being actively researched. In this light, we developed novel object tracking and depth realization technologies to apply augmented reality-based neuronavigation to brain surgery. METHODS We developed real-time inside-out tracking based on visual inertial odometry and a visual inertial simultaneous localization and mapping algorithm. The cube quick response marker and depth data obtained from light detection and ranging sensors are used for continuous tracking. For depth realization, order-independent transparency, clipping, and annotation and measurement functions were developed. In this study, the augmented reality model of a brain tumor patient was applied to its life-size three-dimensional (3D) printed model. RESULTS Using real-time inside-out tracking, we confirmed that the augmented reality model remained consistent with the 3D printed patient model without flutter, regardless of the movement of the visualization device. The coordination accuracy during real-time inside-out tracking was also validated. The average movement error of the X and Y axes was 0.34 ± 0.21 and 0.04 ± 0.08 mm, respectively. Further, the application of order-independent transparency with multilayer alpha blending and filtered alpha compositing improved the perception of overlapping internal brain structures. Clipping, and annotation and measurement functions were also developed to aid depth perception and worked perfectly during real-time coordination. We named this system METAMEDIP navigation. CONCLUSIONS The results validate the efficacy of the real-time inside-out tracking and depth realization technology. With these novel technologies developed for continuous tracking and depth perception in augmented reality environments, we are able to overcome the critical obstacles in the development of clinically applicable augmented reality neuronavigation.
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Affiliation(s)
- Yun-Sik Dho
- Neuro-Oncology Clinic, National Cancer Center, Goyang, Republic of Korea
| | - Byeong Cheol Lee
- Research and Science Division, Research and Development Center, MEDICALIP Co. Ltd., Seoul, Republic of Korea
| | - Hyeong Cheol Moon
- Department of Neurosurgery, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Kyung Min Kim
- Department of Neurosurgery, Inha University Hospital, Inha University College of Medicine, Incheon, Korea
| | - Ho Kang
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea
| | - Eun Jung Lee
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea
| | - Min-Sung Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea
| | - Jin Wook Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea
| | - Yong Hwy Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea
| | - Sang Joon Park
- Research and Science Division, Research and Development Center, MEDICALIP Co. Ltd., Seoul, Republic of Korea.
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea.
| | - Chul-Kee Park
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea.
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7
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Yang JY, Byun YH, Kim MS, Kim JH, Park CK, Kim YH, Kang H. Factors Limiting Complete Resection in the Subarachnoid Space in Endoscopic Surgery for Giant Pituitary Adenoma. World Neurosurg 2024; 181:e222-e233. [PMID: 37821027 DOI: 10.1016/j.wneu.2023.10.018] [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: 09/19/2023] [Accepted: 10/04/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVES Giant pituitary adenomas (>4 cm, GPAs) have presented great challenges to surgeons because the residual tumor in the subarachnoid space can cause hemorrhage or vessel injury following apoplexy. This study aimed to investigate the factors limiting surgical success in endoscopic skull base surgery (ESS) for GPAs. METHODS ESS was performed on 67 consecutive patients with GPAs from 2010 to 2020. We retrospectively analyzed the clinical and radiologic features and surgical outcomes. Correlations between the tumor characteristics and extent of resection were statistically presented with odds ratios (ORs). RESULTS Preoperative visual and hormonal impairments were present in 59 (88.1%) and 55 patients (82.1%), respectively. Gross total resection (GTR) was achieved in 58.2% of patients, and the tumor remained on the lateral side of the subarachnoid space or the cavernous sinus when complete resection failed. The tumor volume, maximal diameter, multilobulated shape, cavernous sinus invasion, posterior fossa extension, and extent of suprasellar lateral extension of tumors were significantly correlated with incomplete resection. In tumors with subarachnoid lateral extension, greater distances from the medial wall of the proximal cavernous internal carotid artery to the most lateral tumor significantly increased the risk of incomplete resection for the suprasellar lateral portion of the tumor, with an OR of 1.21. CONCLUSIONS Considerable surgical planning in ESS for GPAs is crucial for complete resection and patient safety. We elucidated that lateral extension of tumors in the subarachnoid space hindered the surgical success of the suprasellar portion of the tumor.
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Affiliation(s)
- Jung Yeop Yang
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yoon Hwan Byun
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Min-Sung Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jung Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Pituitary Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Chul-Kee Park
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yong Hwy Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea; Pituitary Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Ho Kang
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea.
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8
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Zanon I, Clément E, Goasduff A, Menéndez J, Miyagi T, Assié M, Ciemała M, Flavigny F, Lemasson A, Matta A, Ramos D, Rejmund M, Achouri L, Ackermann D, Barrientos D, Beaumel D, Benzoni G, Boston AJ, Boston HC, Bottoni S, Bracco A, Brugnara D, de France G, de Sereville N, Delaunay F, Desesquelles P, Didierjean F, Domingo-Prato C, Dudouet J, Eberth J, Fernández D, Fougères C, Gadea A, Galtarossa F, Girard-Alcindor V, Gonzales V, Gottardo A, Hammache F, Harkness-Brennan LJ, Hess H, Judson DS, Jungclaus A, Kaşkaş A, Kim YH, Kuşoğlu A, Labiche M, Leblond S, Lenain C, Lenzi SM, Leoni S, Li H, Ljungvall J, Lois-Fuentes J, Lopez-Martens A, Maj A, Menegazzo R, Mengoni D, Michelagnoli C, Million B, Napoli DR, Nyberg J, Pasqualato G, Podolyak Z, Pullia A, Quintana B, Recchia F, Regueira-Castro D, Reiter P, Rezynkina K, Rojo JS, Salsac MD, Sanchis E, Şenyiğit M, Siciliano M, Sohler D, Stezowski O, Theisen C, Utepov A, Valiente-Dobón JJ, Verney D, Zielinska M. High-Precision Spectroscopy of ^{20}O Benchmarking Ab Initio Calculations in Light Nuclei. Phys Rev Lett 2023; 131:262501. [PMID: 38215380 DOI: 10.1103/physrevlett.131.262501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/18/2023] [Accepted: 11/21/2023] [Indexed: 01/14/2024]
Abstract
The excited states of unstable ^{20}O were investigated via γ-ray spectroscopy following the ^{19}O(d,p)^{20}O reaction at 8 AMeV. By exploiting the Doppler shift attenuation method, the lifetimes of the 2_{2}^{+} and 3_{1}^{+} states were firmly established. From the γ-ray branching and E2/M1 mixing ratios for transitions deexciting the 2_{2}^{+} and 3_{1}^{+} states, the B(E2) and B(M1) were determined. Various chiral effective field theory Hamiltonians, describing the nuclear properties beyond ground states, along with a standard USDB interaction, were compared with the experimentally obtained data. Such a comparison for a large set of γ-ray transition probabilities with the valence space in medium similarity renormalization group ab initio calculations was performed for the first time in a nucleus far from stability. It was shown that the ab initio approaches using chiral effective field theory forces are challenged by detailed high-precision spectroscopic properties of nuclei. The reduced transition probabilities were found to be a very constraining test of the performance of the ab initio models.
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Affiliation(s)
- I Zanon
- INFN Laboratori Nazionali di Legnaro, Legnaro, Italy
- Dipartimento di Fisica e Scienze della Terra, Università di Ferrara, Ferrara, Italy
| | - E Clément
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DRF-CNRS/IN2P3, Caen, France
| | - A Goasduff
- INFN Laboratori Nazionali di Legnaro, Legnaro, Italy
| | - J Menéndez
- Department of Quantum Physics and Astrophysics and Institute of Cosmos Sciences, University of Barcelona, Spain
| | - T Miyagi
- Department of Physics, Technische Universität Darmstadt, Darmstadt, Germany
- ExtreMe Matter Institute, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
- Max-Planck-Institut für Kernphysik, Heidelberg, Germany
| | - M Assié
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | | | - F Flavigny
- Université de Caen Normandie, ENSICAEN, CNRS/IN2P3, LPC Caen UMR6534, F-14000 Caen, France
| | - A Lemasson
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DRF-CNRS/IN2P3, Caen, France
| | - A Matta
- Université de Caen Normandie, ENSICAEN, CNRS/IN2P3, LPC Caen UMR6534, F-14000 Caen, France
| | - D Ramos
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DRF-CNRS/IN2P3, Caen, France
| | - M Rejmund
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DRF-CNRS/IN2P3, Caen, France
| | - L Achouri
- Université de Caen Normandie, ENSICAEN, CNRS/IN2P3, LPC Caen UMR6534, F-14000 Caen, France
| | - D Ackermann
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DRF-CNRS/IN2P3, Caen, France
| | | | - D Beaumel
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - G Benzoni
- INFN Sezione di Milano, I-20133 Milano, Italy
| | - A J Boston
- Oliver Lodge Laboratory, The University of Liverpool, Liverpool, United Kingdom
| | - H C Boston
- Oliver Lodge Laboratory, The University of Liverpool, Liverpool, United Kingdom
| | - S Bottoni
- INFN Sezione di Milano, I-20133 Milano, Italy
- Dipartimento di Fisica, Università di Milano, Milano, Italy
| | - A Bracco
- INFN Sezione di Milano, I-20133 Milano, Italy
- Dipartimento di Fisica, Università di Milano, Milano, Italy
| | - D Brugnara
- INFN Laboratori Nazionali di Legnaro, Legnaro, Italy
- Dipartimento di Fisica, Università di Padova, Padova, Italy
| | - G de France
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DRF-CNRS/IN2P3, Caen, France
| | - N de Sereville
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - F Delaunay
- Université de Caen Normandie, ENSICAEN, CNRS/IN2P3, LPC Caen UMR6534, F-14000 Caen, France
| | - P Desesquelles
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - F Didierjean
- Université de Strasbourg, IPHC, Strasbourg, France
| | - C Domingo-Prato
- Instituto de Fisica Corpuscolar, CSIC-Universidad de Valencia, E-46071 Valencia, Spain
| | - J Dudouet
- Université de Lyon, Université Lyon-1, CNRS/IN2P3, UMR5822, IP2I, F-69622 Villeurbanne Cedex, France
| | - J Eberth
- Institut für Kernphysik, Universität zu Köln, Zülpicher Strasse 77, D-50937 Köln, Germany
| | - D Fernández
- IGFAE and Department de Física de Partículas, Universidade of Santiago de Compostela, Santiago de Compostela, Spain
| | - C Fougères
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DRF-CNRS/IN2P3, Caen, France
| | - A Gadea
- Instituto de Fisica Corpuscolar, CSIC-Universidad de Valencia, E-46071 Valencia, Spain
| | - F Galtarossa
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - V Girard-Alcindor
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DRF-CNRS/IN2P3, Caen, France
| | - V Gonzales
- Departamento de Ingeniería Electrónica, Universitat de Valencia, Burjassot, Valencia, Spain
| | - A Gottardo
- INFN Laboratori Nazionali di Legnaro, Legnaro, Italy
| | - F Hammache
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | | | - H Hess
- Institut für Kernphysik, Universität zu Köln, Zülpicher Strasse 77, D-50937 Köln, Germany
| | - D S Judson
- Oliver Lodge Laboratory, The University of Liverpool, Liverpool, United Kingdom
| | - A Jungclaus
- Instituto de Estructura de la Materia, CSIC, Madrid, E-28006 Madrid, Spain
| | - A Kaşkaş
- Department of Physics, Faculty of Science, Ankara University, 06100 Besevler - Ankara, Turkey
| | - Y H Kim
- Institue Laue-Langevin, Grenoble, France
| | - A Kuşoğlu
- Department of Physics, Faculty of Science, Istanbul University, Vezneciler/Fatih, Istanbul, Turkey
| | - M Labiche
- STFC Daresbury Laboratory, Daresbury, Warrington, WA4 4AD, United Kingdom
| | - S Leblond
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DRF-CNRS/IN2P3, Caen, France
| | - C Lenain
- Université de Caen Normandie, ENSICAEN, CNRS/IN2P3, LPC Caen UMR6534, F-14000 Caen, France
| | - S M Lenzi
- INFN, Sezione di Padova, I-35131 Padova, Italy
| | - S Leoni
- INFN Sezione di Milano, I-20133 Milano, Italy
| | - H Li
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DRF-CNRS/IN2P3, Caen, France
| | - J Ljungvall
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - J Lois-Fuentes
- IGFAE and Department de Física de Partículas, Universidade of Santiago de Compostela, Santiago de Compostela, Spain
| | - A Lopez-Martens
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - A Maj
- The Henryk Niewodniczański Institute of Nuclear Physics, Polish Academy of Sciences, 31-342 Kraków, Poland
| | - R Menegazzo
- INFN, Sezione di Padova, I-35131 Padova, Italy
| | - D Mengoni
- Dipartimento di Fisica, Università di Padova, Padova, Italy
- INFN, Sezione di Padova, I-35131 Padova, Italy
| | - C Michelagnoli
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DRF-CNRS/IN2P3, Caen, France
- Institue Laue-Langevin, Grenoble, France
| | - B Million
- INFN Sezione di Milano, I-20133 Milano, Italy
| | - D R Napoli
- INFN Laboratori Nazionali di Legnaro, Legnaro, Italy
| | - J Nyberg
- Department of Physics and Astronomy, Uppsala University, SE-75120 Uppsala, Sweden
| | - G Pasqualato
- Dipartimento di Fisica, Università di Padova, Padova, Italy
- INFN, Sezione di Padova, I-35131 Padova, Italy
| | - Zs Podolyak
- Department of Physics, University of Surrey, Guildford, GU2 7XH, United Kingdom
| | - A Pullia
- INFN Sezione di Milano, I-20133 Milano, Italy
| | - B Quintana
- Laboratorio de Radiaciones Ionizantes, Departamento de Física Fundamental, Universidad de Salamanca, E-37008 Salamanca, Spain
| | - F Recchia
- Dipartimento di Fisica, Università di Padova, Padova, Italy
- INFN, Sezione di Padova, I-35131 Padova, Italy
| | - D Regueira-Castro
- IGFAE and Department de Física de Partículas, Universidade of Santiago de Compostela, Santiago de Compostela, Spain
| | - P Reiter
- Institut für Kernphysik, Universität zu Köln, Zülpicher Strasse 77, D-50937 Köln, Germany
| | - K Rezynkina
- Université de Strasbourg, CNRS, IPHC UMR 7178, F-67000 Strasbourg, France
| | - J S Rojo
- Department of Physics, University of York, York, United Kingdom
| | - M D Salsac
- Irfu, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - E Sanchis
- Departamento de Ingeniería Electrónica, Universitat de Valencia, Burjassot, Valencia, Spain
| | - M Şenyiğit
- Department of Physics, Faculty of Science, Ankara University, 06100 Besevler - Ankara, Turkey
| | - M Siciliano
- Irfu, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
- Physics Division, Argonne National Laboratory, Lemont, Illinois 60439, USA
| | - D Sohler
- Institute for Nuclear Research, Atomki, 4001 Debrecen, Hungary
| | - O Stezowski
- Université de Lyon, Université Lyon-1, CNRS/IN2P3, UMR5822, IP2I, F-69622 Villeurbanne Cedex, France
| | - Ch Theisen
- Irfu, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A Utepov
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DRF-CNRS/IN2P3, Caen, France
- Université de Caen Normandie, ENSICAEN, CNRS/IN2P3, LPC Caen UMR6534, F-14000 Caen, France
| | | | - D Verney
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - M Zielinska
- Irfu, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
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9
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Lee JS, Kim YH, Koh EJ, Phi JH, Lee JY, Kim KH, Wang KC, Cheon JE, Park SH, Lee YA, Shin CH, Kim SK. Surgical indication of pediatric Rathke's cleft cyst based on a 20-year retrospective cohort. J Neurosurg Pediatr 2023; 32:729-738. [PMID: 37657098 DOI: 10.3171/2023.7.peds23181] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/11/2023] [Indexed: 09/03/2023]
Abstract
OBJECTIVE Rathke's cleft cyst (RCC) is the most commonly encountered pituitary incidentaloma in children. Because RCC is not frequently diagnosed in children, there are few reports on pediatric RCCs. The natural course of the disease and appropriate treatments are still obscure. The present study aimed to elucidate the natural history and surgical indications of RCCs in children. METHODS The authors retrospectively reviewed the clinical presentations, imaging features, ophthalmological evaluations, endocrine evaluations, and surgical outcomes of pediatric RCCs at a single institution from January 2000 to October 2022. Clinical outcomes between the surgery and observation groups were compared. RESULTS Among 93 patients, there were 41 patients in the surgery group and 52 patients in the observation group. The mean age at diagnosis was 10.9 years, and the mean follow-up period was 5.6 years. Headache fully or partially improved after surgery (86.2%), but the rate of improvement was not different from that of the observation group (70.0%). Ophthalmological abnormalities were effectively improved by surgical treatment (93.3%). Both the improvement and deterioration rates of endocrine abnormalities were significantly higher in the surgery group (p = 0.026 and p < 0.001, respectively), but the deterioration rate (43.9%) was higher than the improvement rate (14.6%). In the surgery group, the recurrence rate was 17.1% and the reoperation rate was 4.9%. Compared with total cyst wall resection, cyst fenestration with partial wall resection was associated with a higher recurrence rate (26.9%, p = 0.035) but a lower rate of endocrine abnormalities (30.8%, p = 0.049). CONCLUSIONS Pediatric RCCs of ≥ 10 mm in size were analyzed. Ophthalmological abnormalities are the major surgical indications for pediatric RCCs. Headache and partial endocrine abnormalities may be improved with surgery, but they are not absolute indications for surgery. Cyst fenestration with partial wall resection via an endoscopic endonasal approach is the most recommended surgical method. Follow-up is essential to monitor for the occurrence of visual field defects and the recurrence of cysts.
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Affiliation(s)
- Jong Seok Lee
- 1Division of Pediatric Neurosurgery, Pediatric Clinical Neuroscience Center, Seoul National University Children's Hospital, Seoul
- 2Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul
| | - Yong Hwy Kim
- 2Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul
| | - Eun Jung Koh
- 1Division of Pediatric Neurosurgery, Pediatric Clinical Neuroscience Center, Seoul National University Children's Hospital, Seoul
- 2Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul
| | - Ji Hoon Phi
- 1Division of Pediatric Neurosurgery, Pediatric Clinical Neuroscience Center, Seoul National University Children's Hospital, Seoul
- 3Neuroscience Research Institute, Seoul National University Medical Research Center, Seoul National University College of Medicine, Seoul
- 3Neuroscience Research Institute, Seoul National University Medical Research Center, Seoul National University College of Medicine, Seoul
| | - Ji Yeoun Lee
- 1Division of Pediatric Neurosurgery, Pediatric Clinical Neuroscience Center, Seoul National University Children's Hospital, Seoul
- 2Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul
- 4Department of Anatomy and Cell Biology, Neural Development and Anomaly Laboratory, Seoul National University College of Medicine, Seoul
| | - Kyung Hyun Kim
- 1Division of Pediatric Neurosurgery, Pediatric Clinical Neuroscience Center, Seoul National University Children's Hospital, Seoul
- 2Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul
| | - Kyu-Chang Wang
- 5Neuro-Oncology Clinic, Center for Rare Cancers, National Cancer Center, Goyang
| | - Jung-Eun Cheon
- 6Division of Pediatric Radiology, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul
| | | | - Young Ah Lee
- 8Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Choong Ho Shin
- 8Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Seung-Ki Kim
- 1Division of Pediatric Neurosurgery, Pediatric Clinical Neuroscience Center, Seoul National University Children's Hospital, Seoul
- 3Neuroscience Research Institute, Seoul National University Medical Research Center, Seoul National University College of Medicine, Seoul
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10
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Adhikari G, Carlin N, Choi JJ, Choi S, Ezeribe AC, França LE, Ha C, Hahn IS, Hollick SJ, Jeon EJ, Jo JH, Joo HW, Kang WG, Kauer M, Kim BH, Kim HJ, Kim J, Kim KW, Kim SH, Kim SK, Kim WK, Kim YD, Kim YH, Ko YJ, Lee DH, Lee EK, Lee H, Lee HS, Lee HY, Lee IS, Lee J, Lee JY, Lee MH, Lee SH, Lee SM, Lee YJ, Leonard DS, Luan NT, Manzato BB, Maruyama RH, Neal RJ, Nikkel JA, Olsen SL, Park BJ, Park HK, Park HS, Park KS, Park SD, Pitta RLC, Prihtiadi H, Ra SJ, Rott C, Shin KA, Cavalcante DFFS, Scarff A, Spooner NJC, Thompson WG, Yang L, Yu GH. Search for Boosted Dark Matter in COSINE-100. Phys Rev Lett 2023; 131:201802. [PMID: 38039466 DOI: 10.1103/physrevlett.131.201802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 10/30/2023] [Indexed: 12/03/2023]
Abstract
We search for energetic electron recoil signals induced by boosted dark matter (BDM) from the galactic center using the COSINE-100 array of NaI(Tl) crystal detectors at the Yangyang Underground Laboratory. The signal would be an excess of events with energies above 4 MeV over the well-understood background. Because no excess of events are observed in a 97.7 kg·yr exposure, we set limits on BDM interactions under a variety of hypotheses. Notably, we explored the dark photon parameter space, leading to competitive limits compared to direct dark photon search experiments, particularly for dark photon masses below 4 MeV and considering the invisible decay mode. Furthermore, by comparing our results with a previous BDM search conducted by the Super-Kamionkande experiment, we found that the COSINE-100 detector has advantages in searching for low-mass dark matter. This analysis demonstrates the potential of the COSINE-100 detector to search for MeV electron recoil signals produced by the dark sector particle interactions.
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Affiliation(s)
- G Adhikari
- Department of Physics and Wright Laboratory, Yale University, New Haven, Connecticut 06520, USA
| | - N Carlin
- Physics Institute, University of São Paulo, 05508-090, São Paulo, Brazil
| | - J J Choi
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Republic of Korea
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - S Choi
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Republic of Korea
| | - A C Ezeribe
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - L E França
- Physics Institute, University of São Paulo, 05508-090, São Paulo, Brazil
| | - C Ha
- Department of Physics, Chung-Ang University, Seoul 06973, Republic of Korea
| | - I S Hahn
- Department of Science Education, Ewha Womans University, Seoul 03760, Republic of Korea
- Center for Exotic Nuclear Studies, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- IBS School, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
| | - S J Hollick
- Department of Physics and Wright Laboratory, Yale University, New Haven, Connecticut 06520, USA
| | - E J Jeon
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - J H Jo
- Department of Physics and Wright Laboratory, Yale University, New Haven, Connecticut 06520, USA
| | - H W Joo
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Republic of Korea
| | - W G Kang
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - M Kauer
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - B H Kim
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - H J Kim
- Department of Physics, Kyungpook National University, Daegu 41566, Republic of Korea
| | - J Kim
- Department of Physics, Chung-Ang University, Seoul 06973, Republic of Korea
| | - K W Kim
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - S H Kim
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - S K Kim
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Republic of Korea
| | - W K Kim
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- IBS School, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
| | - Y D Kim
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- IBS School, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
- Department of Physics, Sejong University, Seoul 05006, Republic of Korea
| | - Y H Kim
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- IBS School, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
- Korea Research Institute of Standards and Science, Daejeon 34113, Republic of Korea
| | - Y J Ko
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - D H Lee
- Department of Physics, Kyungpook National University, Daegu 41566, Republic of Korea
| | - E K Lee
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - H Lee
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- IBS School, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
| | - H S Lee
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- IBS School, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
| | - H Y Lee
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - I S Lee
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - J Lee
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - J Y Lee
- Department of Physics, Kyungpook National University, Daegu 41566, Republic of Korea
| | - M H Lee
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- IBS School, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
| | - S H Lee
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- IBS School, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
| | - S M Lee
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Republic of Korea
| | - Y J Lee
- Department of Physics, Chung-Ang University, Seoul 06973, Republic of Korea
| | - D S Leonard
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - N T Luan
- Department of Physics, Kyungpook National University, Daegu 41566, Republic of Korea
| | - B B Manzato
- Physics Institute, University of São Paulo, 05508-090, São Paulo, Brazil
| | - R H Maruyama
- Department of Physics and Wright Laboratory, Yale University, New Haven, Connecticut 06520, USA
| | - R J Neal
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - J A Nikkel
- Department of Physics and Wright Laboratory, Yale University, New Haven, Connecticut 06520, USA
| | - S L Olsen
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - B J Park
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- IBS School, University of Science and Technology (UST), Daejeon 34113, Republic of Korea
| | - H K Park
- Department of Accelerator Science, Korea University, Sejong 30019, Republic of Korea
| | - H S Park
- Korea Research Institute of Standards and Science, Daejeon 34113, Republic of Korea
| | - K S Park
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - S D Park
- Department of Physics, Kyungpook National University, Daegu 41566, Republic of Korea
| | - R L C Pitta
- Physics Institute, University of São Paulo, 05508-090, São Paulo, Brazil
| | - H Prihtiadi
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - S J Ra
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - C Rott
- Department of Physics, Sungkyunkwan University, Suwon 16419, Republic of Korea
- Department of Physics and Astronomy, University of Utah, Salt Lake City, Utah 84112, USA
| | - K A Shin
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - D F F S Cavalcante
- Physics Institute, University of São Paulo, 05508-090, São Paulo, Brazil
| | - A Scarff
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - N J C Spooner
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - W G Thompson
- Department of Physics and Wright Laboratory, Yale University, New Haven, Connecticut 06520, USA
| | - L Yang
- Department of Physics, University of California San Diego, La Jolla, California 92093, USA
| | - G H Yu
- Center for Underground Physics, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
- Department of Physics, Sungkyunkwan University, Suwon 16419, Republic of Korea
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11
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Kim YH, Kim YC. Development of metastatic lung adenocarcinoma in a twenty-year-old skin graft site on the scalp: A case report. Indian J Dermatol Venereol Leprol 2023; 0:1-2. [PMID: 38031680 DOI: 10.25259/ijdvl_518_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 09/17/2023] [Indexed: 12/01/2023]
Affiliation(s)
- Y H Kim
- Department of Dermatology, Ajou University Hospital, World Cup-ro, Suwon, Korea
| | - Y C Kim
- Department of Dermatology, Ajou University Hospital, World Cup-ro, Suwon, Korea
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Park TH, Kim SK, Phi JH, Park CK, Kim YH, Paek SH, Lee CH, Park SH, Koh EJ. Survival and Malignant Transformation of Pineal Parenchymal Tumors: A 30-Year Retrospective Analysis in a Single-Institution. Brain Tumor Res Treat 2023; 11:254-265. [PMID: 37953449 PMCID: PMC10641322 DOI: 10.14791/btrt.2023.0033] [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: 08/09/2023] [Revised: 09/08/2023] [Accepted: 09/08/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND This study aims to elucidate clinical features, therapeutic strategies, and prognosis of pineal parenchymal tumors (PPT) by analyzing a 30-year dataset of a single institution. METHODS We reviewed data from 43 patients diagnosed with PPT at Seoul National University Hospital between 1990 and 2020. We performed survival analyses and assessed prognostic factors. RESULTS The cohort included 10 patients with pineocytoma (PC), 13 with pineal parenchymal tumor of intermediate differentiation (PPTID), and 20 with pineoblastoma (PB). Most patients presented with hydrocephalus at diagnosis. Most patients underwent an endoscopic third ventriculostomy and biopsy, with some undergoing additional resection after diagnosis confirmation. Radiotherapy was administered with a high prevalence of gamma knife radiosurgery for PC and PPTID, and craniospinal irradiation for PB. Chemotherapy was essential in the treatment of grade 3 PPTID and PB. The 5-year progression-free survival rates for PC, grade 2 PPTID, grade 3 PPTID, and PB were 100%, 83.3%, 0%, and 40%, respectively, and the 5-year overall survival rates were 100%, 100%, 40%, and 55%, respectively. High-grade tumor histology was associated with lower survival rates. Significant prognostic factors varied among tumor types, with World Health Organization (WHO) grade and leptomeningeal seeding (LMS) for PPTID, and the extent of resection and LMS for PB. Three patients experienced malignant transformations. CONCLUSION This study underscores the prognostic significance of WHO grades in PPT. It is necessary to provide specific treatment according to tumor grade. Grade 3 PPTID showed a poor prognosis. Potential LMS and malignant transformations necessitate aggressive multimodal treatment and close-interval screening.
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Affiliation(s)
- Tae-Hwan Park
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Seung-Ki Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul, Korea
- Neuroscience Research Institute, Seoul National University Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Hoon Phi
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul, Korea
- Neuroscience Research Institute, Seoul National University Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
| | - Chul-Kee Park
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yong Hwy Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sun Ha Paek
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Chang-Hyun Lee
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sung-Hye Park
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Eun Jung Koh
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul, Korea
- Center of Hospital Medicine, Seoul National University Hospital, Seoul, Korea.
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13
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Kim YH, Phi JH, Kim SK, Wang KC. Endoscopic biopsy of pineal tumors: two burr hole trans-foramen of Monro approach and endonasal trans-tuber cinereum approach. Childs Nerv Syst 2023; 39:2367-2375. [PMID: 36112201 DOI: 10.1007/s00381-022-05654-w] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 08/16/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION The pineal region is a challenging area for neurosurgeons due to its innate anatomical features, such as its deep location, surrounding large draining veins, and adjacent critical neural structures. DISCUSSION There is a high proportion of malignant tumors in the pineal gland, especially in children, and they are frequently accompanied by obstructive hydrocephalus. These cases require that surgical procedures can make a pathological diagnosis to guide further treatment strategies and immediately resolve increased intracranial pressure. Simultaneous endoscopic third ventriculostomy and biopsy have been regarded as the first-line surgical intervention before establishing a definite treatment plan. However, it is not always successful because various factors affect the surgical procedures, such as the location and extent of the tumor, degree of ventriculomegaly, location and size of the massa intermedia, and size of the foramen of Monro. CONCLUSION Here, we briefly reviewed the points to be considered in endoscopic biopsy of pineal tumors and introduced an alternative surgical procedure, the endoscopic endonasal trans-tuber cinereum approach, to surmount the anatomical hurdles.
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Affiliation(s)
- Yong Hwy Kim
- Pituitary Center, Department of Neurosurgery, Seoul National University of College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Ji Hoon Phi
- Division of Pediatric Neurosurgery, Department of Neurosurgery, Seoul National University of College of Medicine, Seoul National University Children's Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Seung-Ki Kim
- Division of Pediatric Neurosurgery, Department of Neurosurgery, Seoul National University of College of Medicine, Seoul National University Children's Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
| | - Kyu-Chang Wang
- Neuro-Oncology Clinic, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, Kyounggi-do, 10408, Republic of Korea.
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14
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Ree J, Ko KC, Kim YH, Shin HK. Excitation of NH Stretching Modes in Aromatic Molecules: o-Toluidine and α-Methylbenzylamine. J Phys Chem B 2023; 127:7276-7282. [PMID: 37566790 DOI: 10.1021/acs.jpcb.3c03968] [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: 08/13/2023]
Abstract
Selectively excited o-toluidine and α-methylbenzylamine have been studied with quasi-classical trajectory procedures to determine the extent and timescales of intramolecular energy flow. The initial excitation is in the stretching mode of the para-CH bond, and its flow is initiated by interaction with an argon atom. Energy flow to the NH stretching mode is the dominant relaxation pathway, and its effectiveness is enhanced strongly by the methyl-NH interaction. Energy flow characteristics in both molecules are similar, but the flow is more effective in o-toluidine than in α-methylbenzylamine because the methyl group bonded to the benzene ring exerts stronger perturbation on the energy-flow pathway than the group bonded to the side chain. The relaxation of the initially excited CH completes on a timescale of several picoseconds, but the main part of energy flow to the NH occurs on a subpicosecond scale. In o-toluidine, carbon-carbon overtone modes lead to ring-CC bonds gaining and transporting more energy than high-frequency CH bonds, but they all gain far less energy than the NH stretching mode.
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Affiliation(s)
- J Ree
- Department of Chemistry Education, Chonnam National University, Gwangju 61186, Korea
| | - K C Ko
- Department of Chemistry Education, Chonnam National University, Gwangju 61186, Korea
| | - Y H Kim
- Department of Chemistry, Inha University, Incheon 22212, Korea
| | - H K Shin
- Department of Chemistry, University of Nevada, Reno, Nevada 89557, United States
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15
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Kim KM, Byun YH, Kang H, Kim MS, Kim JW, Kim YH, Park CK, Dho YS. Changes of resection goal after using 3D printing brain tumor model for presurgical planning. World Neurosurg 2023:S1878-8750(23)00776-3. [PMID: 37302706 DOI: 10.1016/j.wneu.2023.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/04/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND Conventional 2D MRI-based neuronavigation systems can improve the maximal safe resection in brain tumor surgery but can be unintuitive. A 3D-printed brain tumor model allows for a more intuitive and stereoscopic understanding of brain tumors and adjacent neurovascular structures. This study aimed to identify the clinical efficacy of a 3D-printed brain tumor model in presurgical planning by focusing on differences in the extent of resection (EOR). MATERIALS AND METHODS Thirty-two neurosurgeons (14 faculty members, 11 fellows, 7 residents) randomly selected the two 3D-printed brain tumor models from the 10 manufactured models and performed presurgical planning following a standardized questionnaire. To compare the 2D MRI-based planning results with the 3D-printed model-based planning results, we analyzed the changing patterns and characteristics of the EOR. RESULTS Of 64 randomly generated cases, the resection goal changed in 12 cases (18.8%). When the tumor was located intra-axially, the surgical posture required a prone position, and when the neurosurgeon was dexterous in surgery, there was a higher rate of EOR changes. 3D-printed models 2, 4, and 10, which all represented tumors in the posterior of the brain, had high rates of changing EOR. CONCLUSIONS A 3D-printed brain tumor model could be utilized in presurgical planning to effectively determine the EOR.
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Affiliation(s)
- Kyung-Min Kim
- Department of Neurosurgery, Inha University Hospital, Inha University College of Medicine, Incheon, Korea
| | - Yoon Hwan Byun
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Ho Kang
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Min-Sung Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jin-Wook Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yong Hwy Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Chul-Kee Park
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yun-Sik Dho
- Neuro-oncology Clinic, National Cancer Center, Goyang, Korea.
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Kim YH, Park MR, Kim SY, Kim MY, Kim KW, Sohn MH. Respiratory microbiome profiles are associated with distinct inflammatory phenotype and lung function in children with asthma. J Investig Allergol Clin Immunol 2023:0. [PMID: 37260034 DOI: 10.18176/jiaci.0918] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Respiratory microbiome studies have fostered our understanding of various phenotypes and endotypes of heterogeneous asthma. However, the relationship between the respiratory microbiome and clinical phenotypes in children with asthma remains unclear. We aimed to identify microbiome-driven clusters reflecting the clinical features of asthma and their dominant microbiotas in children with asthma. METHODS Induced sputum was collected from children with asthma, and microbiome profiles were generated via sequencing of the V3-V4 region of the 16S rRNA gene. Cluster analysis was performed using the partitioning around medoid clustering method. The dominant microbiota in each cluster was determined using the Linear Discriminant Effect Size analysis. Each cluster was analyzed for association among the dominant microbiota, clinical phenotype, and inflammatory cytokine. RESULTS Eighty-three children diagnosed with asthma were evaluated. Among four clusters reflecting the clinical characteristics of asthma, cluster 1, dominated by Haemophilus and Neisseria, demonstrated lower post-bronchodilator (BD) forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) than that in the other clusters and more mixed granulocytic asthma. Neisseria negatively correlated with pre-BD and post-BD FEV1/FVC. Haemophilus and Neisseria positively correlated with programmed death-ligand (PD-L)1. CONCLUSION To our knowledge, this study is the first to analyze the relationship between an unbiased microbiome-driven cluster and clinical phenotype in children with asthma. The cluster dominated by Haemophilus and Neisseria showed fixed airflow obstruction and mixed granulocytic asthma, which correlated with PD-L1 levels. Thus, microbiome-driven unbiased clustering can help identify new asthma phenotypes related to endotypes in childhood asthma.
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Affiliation(s)
- Y H Kim
- Department of Pediatrics, Gangnam Severance Hospital, Seoul
- Institute of Allergy, Severance Biomedical Science Institute, Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul
| | - M R Park
- Department of Pediatrics, Gangnam Severance Hospital, Seoul
- Institute of Allergy, Severance Biomedical Science Institute, Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul
| | - S Y Kim
- Institute of Allergy, Severance Biomedical Science Institute, Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul
- Department of Pediatrics, Severance Hospital, Seoul
| | - M Y Kim
- Institute of Allergy, Severance Biomedical Science Institute, Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul
- Department of Pediatrics, Yongin Severance Hospital, Yongin, Korea
| | - K W Kim
- Institute of Allergy, Severance Biomedical Science Institute, Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul
- Department of Pediatrics, Severance Hospital, Seoul
| | - M H Sohn
- Institute of Allergy, Severance Biomedical Science Institute, Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul
- Department of Pediatrics, Severance Hospital, Seoul
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17
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Choi SK, Chung HS, Ko HS, Gen Y, Kim SM, Shin JE, Kil KC, Kim YH, Wie JH, Jo YS. Hemorrhagic morbidity in nulliparous patients with placenta previa without placenta accrete spectrum disorders. Niger J Clin Pract 2023; 26:432-437. [PMID: 37203107 DOI: 10.4103/njcp.njcp_456_22] [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] [Indexed: 05/20/2023]
Abstract
Background Placental adhesion spectrum (PAS) is a disease in which the trophoblast invades the myometrium, and is a well-known high-risk condition associated with placental previa. Aim The morbidity of nulliparous women with placenta previa without PAS disorders is unknown. Patients and Methods The data from nulliparous women who underwent cesarean delivery were collected retrospectively. The women were dichotomized into malpresentation (MP) and placenta previa groups. The placenta previa group was categorized into previa (PS) and low-lying (LL) groups. When the placenta covers the internal cervical os, it is called placenta previa, when the placenta is near the cervical os, it is called the low-lying placenta. Their maternal hemorrhagic morbidity and neonatal outcomes were analyzed and adjusted using multivariate analysis based on univariate analysis. Results A total of 1269 women were enrolled: 781 women in the MP group and 488 women in the PP-LL group. Regarding packed red blood cell transfusion, PP and LL had adjusted odds ratio (aOR) of 14.7 (95% confidence interval (CI): 6.6 - 32.5), and 11.3 (95% CI: 4.9 - 26) during admission, and 51.2 (95% CI: 22.1 - 122.7) and 10.3 (95% CI: 3.9 - 26.6) during operation, respectively. For intensive care unit admission, PS and LL had aOR of 15.9 (95% CI: 6.5 - 39.1) and 3.5 (95% CI: 1.1 - 10.9), respectively. No women had cesarean hysterectomy, major surgical complications, or maternal death. Conclusion Despite placenta previa without PAS disorders, maternal hemorrhagic morbidity was significantly increased. Thus, our results highlight the need for resources for those women with evidence of placenta previa including a low-lying placenta, even if those women do not meet PAS disorder criteria. In addition, placenta previa without PAS disorder was not associated with critical maternal complications.
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Affiliation(s)
- S K Choi
- Department of Obstetrics and Gynaecology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - H S Chung
- Department of Anaesthesiology and Pain Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - H S Ko
- Department of Obstetrics and Gynaecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Y Gen
- Department of Obstetrics and Gynaecology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - S M Kim
- Department of Obstetrics and Gynaecology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - J E Shin
- Department of Obstetrics and Gynaecology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - K C Kil
- Department of Obstetrics and Gynaecology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Y H Kim
- Department of Obstetrics and Gynaecology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - J H Wie
- Department of Obstetrics and Gynaecology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Y S Jo
- Department of Obstetrics and Gynaecology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Kang H, Witanto JN, Pratama K, Lee D, Choi KS, Choi SH, Kim KM, Kim MS, Kim JW, Kim YH, Park SJ, Park CK. Fully Automated MRI Segmentation and Volumetric Measurement of Intracranial Meningioma Using Deep Learning. J Magn Reson Imaging 2023; 57:871-881. [PMID: 35775971 DOI: 10.1002/jmri.28332] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [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: 04/27/2022] [Revised: 06/16/2022] [Accepted: 06/16/2022] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Accurate and rapid measurement of the MRI volume of meningiomas is essential in clinical practice to determine the growth rate of the tumor. Imperfect automation and disappointing performance for small meningiomas of previous automated volumetric tools limit their use in routine clinical practice. PURPOSE To develop and validate a computational model for fully automated meningioma segmentation and volume measurement on contrast-enhanced MRI scans using deep learning. STUDY TYPE Retrospective. POPULATION A total of 659 intracranial meningioma patients (median age, 59.0 years; interquartile range: 53.0-66.0 years) including 554 women and 105 men. FIELD STRENGTH/SEQUENCE The 1.0 T, 1.5 T, and 3.0 T; three-dimensional, T1 -weighted gradient-echo imaging with contrast enhancement. ASSESSMENT The tumors were manually segmented by two neurosurgeons, H.K. and C.-K.P., with 10 and 26 years of clinical experience, respectively, for use as the ground truth. Deep learning models based on U-Net and nnU-Net were trained using 459 subjects and tested for 100 patients from a single institution (internal validation set [IVS]) and 100 patients from other 24 institutions (external validation set [EVS]), respectively. The performance of each model was evaluated with the Sørensen-Dice similarity coefficient (DSC) compared with the ground truth. STATISTICAL TESTS According to the normality of the data distribution verified by the Shapiro-Wilk test, variables with three or more categories were compared by the Kruskal-Wallis test with Dunn's post hoc analysis. RESULTS A two-dimensional (2D) nnU-Net showed the highest median DSCs of 0.922 and 0.893 for the IVS and EVS, respectively. The nnU-Nets achieved superior performance in meningioma segmentation than the U-Nets. The DSCs of the 2D nnU-Net for small meningiomas less than 1 cm3 were 0.769 and 0.780 with the IVS and EVS, respectively. DATA CONCLUSION A fully automated and accurate volumetric measurement tool for meningioma with clinically applicable performance for small meningioma using nnU-Net was developed. EVIDENCE LEVEL 3 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Ho Kang
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | | | - Kevin Pratama
- Research and Science Division, Research and Development Center, MEDICALIP Co. Ltd, Seoul, Korea
| | - Doohee Lee
- Research and Science Division, Research and Development Center, MEDICALIP Co. Ltd, Seoul, Korea
| | - Kyu Sung Choi
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Seung Hong Choi
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung-Min Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Min-Sung Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jin Wook Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yong Hwy Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Joon Park
- Research and Science Division, Research and Development Center, MEDICALIP Co. Ltd, Seoul, Korea.,Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Chul-Kee Park
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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Park SS, Kim YH, Kang H, Ahn CH, Byun DJ, Choi MH, Kim JH. Serum and hair steroid profiles in patients with nonfunctioning pituitary adenoma undergoing surgery: A prospective observational study. J Steroid Biochem Mol Biol 2023; 230:106276. [PMID: 36858289 DOI: 10.1016/j.jsbmb.2023.106276] [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: 01/08/2023] [Revised: 02/23/2023] [Accepted: 02/26/2023] [Indexed: 03/02/2023]
Abstract
Patients who undergo transsphenoidal surgery (TSS) experience perioperative hormonal changes, but there are few studies on the perioperative changes of serum and hair steroid profiles. This study investigated the perioperative changes in steroid metabolic signatures in patients with nonfunctioning pituitary adenoma (NFPA) who underwent transsphenoidal surgery (TSS). A total of 55 participants who underwent TSS for NFPA at a single center between July 2017 and October 2018 were enrolled. Fifteen serum steroids and their metabolic ratios were profiled using gas chromatography-mass spectrometry (GC-MS) before and 1 day, 1 week, and 3 months after TSS. Five steroids from hair samples collected 1 day and 3 months after TSS were also quantitatively compared. Serum cortisol and its A-ring reductive metabolites, as well as 6β-hydroxycortisol, increased dramatically 1 day after TSS and then gradually decreased. Seven serum steroids, including adrenal androgens and mineralocorticoids, and hair cortisone levels were significantly lower in patients with preoperative adrenocorticotropic hormone (ACTH) deficiency (N = 7) than in those without ACTH deficiency (N = 48). Serum levels of dehydroepiandrosterone (DHEA) levels 1 week after TSS predicted ACTH deficiency 3 months after TSS, with 100 % sensitivity and 86 % specificity. A significant positive correlation between the preoperative serum and hair DHEA levels (r = 0.356, P = 0.008) was observed. These findings suggest that the levels of DHEA in both the serum and hair could be an early marker of ACTH deficiency after TSS. In addition, hair cortisone may be a useful preoperative indicator of chronic ACTH deficiency.
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Affiliation(s)
- Seung Shin Park
- Department of Internal Medicine, Seoul National University College of Medicine, Republic of Korea; Department of Internal Medicine, Seoul National University Hospital, Republic of Korea
| | - Yong Hwy Kim
- Pituitary Center, Seoul National University Hospital, Republic of Korea; Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Republic of Korea
| | - Ho Kang
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Republic of Korea
| | - Chang Ho Ahn
- Department of Internal Medicine, Seoul National University College of Medicine, Republic of Korea; Department of Internal Medicine, Seoul National University Bundang Hospital, Republic of Korea
| | - Dong Jun Byun
- Center for Advanced Biomolecular Recognition, Korea Institute of Science and Technology, Republic of Korea
| | - Man Ho Choi
- Center for Advanced Biomolecular Recognition, Korea Institute of Science and Technology, Republic of Korea.
| | - Jung Hee Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Republic of Korea; Department of Internal Medicine, Seoul National University Hospital, Republic of Korea,; Pituitary Center, Seoul National University Hospital, Republic of Korea.
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20
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Lee M, Park MJ, Lee KH, Kim JH, Choi HJ, Kim YH. Obesity mechanism after hypothalamic damage: Cohort analysis of neuroimaging, psychological, cognitive, and clinical phenotyping data. Front Endocrinol (Lausanne) 2023; 14:1114409. [PMID: 37056667 PMCID: PMC10086156 DOI: 10.3389/fendo.2023.1114409] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/01/2023] [Indexed: 03/30/2023] Open
Abstract
OBJECTIVE The hypothalamus regulates energy homeostasis, and its damage results in severe obesity. We aimed to investigate the multifaceted characteristics of hypothalamic obesity. METHODS We performed multidimensional analyses of brain structure/function and psychological and behavioral phenotypes in 29 patients with hypothalamic damage (HD) (craniopharyngioma) and 31 controls (non-functional pituitary adenoma). Patients underwent structural and functional magnetic resonance imaging and completed self-reports and cognitive tasks. RESULTS Patients with HD showed significantly higher postoperative weight gain than controls. The HD group also showed significant hypothalamic damage and lower neural activation in the left caudate nucleus in response to food images. The HD group had significantly higher food inattention, lower satiety, and higher restrained eating behavior. Within the HD group, higher restrained eating behavior was significantly associated with lower activation in the bilateral fusiform gyrus. CONCLUSION These results suggest that hypothalamic damage contributes to weight gain by altering the brain response, attention, satiety, and eating behaviors. The present study proposes novel neuro-psycho-behavioral mechanisms targeted for patients with hypothalamic obesity.
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Affiliation(s)
- Miwoo Lee
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Min-Jung Park
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyung Hwa Lee
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jung Hee Kim
- Pituitary Center, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyung Jin Choi
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
- *Correspondence: Yong Hwy Kim, ; Hyung Jin Choi,
| | - Yong Hwy Kim
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Republic of Korea
- Pituitary Center, Seoul National University College of Medicine, Seoul, Republic of Korea
- *Correspondence: Yong Hwy Kim, ; Hyung Jin Choi,
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21
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Jang HN, Kang H, Kim YH, Lim HS, Lee MK, Lee KR, Kim YH, Kim JH. Serum copeptin levels at day two after pituitary surgery and ratio to baseline predict postoperative central diabetes insipidus. Pituitary 2022; 25:1004-1014. [PMID: 36322283 DOI: 10.1007/s11102-022-01278-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/23/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE Central diabetes insipidus is a complication that may occur after pituitary surgery and has been difficult to predict. This study aimed to identify the cutoff levels of serum copeptin and its optimal timing for predicting the occurrence of central diabetes insipidus in patients who underwent transsphenoidal surgery. METHODS This was a prospective observational study of patients who underwent transsphenoidal surgery for pituitary gland or stalk lesions. Copeptin levels were measured before surgery, 1 h after extubation, and on postoperative days 1, 2, 7, and 90. RESULTS Among 73 patients, 14 (19.2%) and 13 (17.8%) patients developed transient and permanent central diabetes insipidus, respectively. There was no significant difference in copeptin levels before surgery and 1 h after extubation; copeptin levels on postoperative days 1, 2, 7, and 90 were significantly lower in patients with permanent central diabetes insipidus than in those without central diabetes insipidus. Copeptin measurement on postoperative day 2 exhibited the highest performance for predicting permanent central diabetes insipidus among postoperative days 1, 2, and 7 (area under the curve [95% confidence interval] = 0.754 [0.632-0.876]). Serum copeptin level at postoperative day 2(< 3.1 pmol/L) showed a sensitivity of 92.3% and a negative predictive value of 97.1%. The ratio of copeptin at postoperative day 2 to baseline (< 0.94) presented a sensitivity of 84.6% and a negative predictive value of 94.9%. The copeptin levels > 3.4 and 7.5 pmol/L at postoperative day 2 and 7 may have ruled out the occurrence of CDI with a negative predictive value of 100%. CONCLUSION The copeptin level at postoperative day 2 and its ratio to baseline can predict the occurrence of permanent central diabetes insipidus after pituitary surgery.
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Affiliation(s)
- Han Na Jang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080, Seoul, Republic of Korea
| | - Ho Kang
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080, Seoul, Republic of Korea
| | - Yoo Hyung Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080, Seoul, Republic of Korea
| | - Hwan Sub Lim
- Department of Laboratory Medicine, Seoul Clinical Laboratories, 25F, Heungdeok IT Valley, 13 Heungdeok1-ro, Giheung-gu, 16954, Yongin, Gyeonggi-do, Republic of Korea
| | - Mi-Kyeong Lee
- Department of Laboratory Medicine, Seoul Clinical Laboratories, 25F, Heungdeok IT Valley, 13 Heungdeok1-ro, Giheung-gu, 16954, Yongin, Gyeonggi-do, Republic of Korea
| | - Kyoung-Ryul Lee
- Department of Laboratory Medicine, Seoul Clinical Laboratories, 25F, Heungdeok IT Valley, 13 Heungdeok1-ro, Giheung-gu, 16954, Yongin, Gyeonggi-do, Republic of Korea
| | - Yong Hwy Kim
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080, Seoul, Republic of Korea.
- Pituitary Center, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080, Seoul, Republic of Korea.
| | - Jung Hee Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080, Seoul, Republic of Korea.
- Pituitary Center, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080, Seoul, Republic of Korea.
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22
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Kong DS, Kim YH, Lee WJ, Kim YH, Hong CK. Indications and outcomes of endoscopic transorbital surgery for trigeminal schwannoma based on tumor classification: a multicenter study with 50 cases. J Neurosurg 2022:1-9. [PMID: 36681991 DOI: 10.3171/2022.9.jns22779] [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: 04/03/2022] [Accepted: 09/09/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Trigeminal schwannoma is a rare CNS tumor and involves the multicompartmental skull base. Recently, the endoscopic transorbital approach (ETOA) has emerged as a technique for minimally invasive surgery. The objective of this study was to evaluate the optimal indications and clinical outcomes of the ETOA for trigeminal schwannomas based on their tumor classification. METHODS Between September 2016 and February 2022, the ETOA was performed in 50 patients with trigeminal schwannoma at four tertiary hospitals. There were 15 men and 35 women in the study, with a mean age of 46.9 years. All tumors were classified as type A (predominantly involving the middle cranial fossa), type B (predominantly involving the posterior cranial fossa), type C (dumbbell-shaped tumors involving the middle and posterior fossa), or type D (involvement of the extracranial compartment). Type D tumors were also subclassified by ophthalmic division (D1), maxillary division (D2), and mandibular division (D3). Clinical outcome was analyzed, including extent of resection and surgical morbidities. RESULTS In this study, overall gross-total resection (GTR) was performed in 35 (70.0%) of 50 patients and near-total resection (NTR) in 9 patients (18.0%). The mean follow-up period was 21.9 (range 1-61.7) months. There was no tumor regrowth or recurrence during the follow-up period. Based on the classification, there were 17 type A tumors, 20 type C, and 13 type D. There were no type B tumors. Of the 13 type D tumors, 7 were D1, 1 D2, and 5 D3. For type A tumors, GTR or NTR was achieved using an ETOA in 16 (94.1%) of 17 patients. Eighteen (90.0%) of 20 patients with type C tumors attained GTR or NTR. Ten (76.9%) of 13 patients with type D tumors underwent GTR. Statistical analysis showed that there was no significant difference in the extent of resection among the tumor subtypes. Surgical complications included transient partial ptosis (n = 4), permanent ptosis (n = 1), transient diplopia (n = 7), permanent diplopia (n = 1), corneal keratopathy (n = 7), difficulties in mastication (n = 5), and neuralgic pain or paresthesia (n = 14). There were no postoperative CSF leaks or enophthalmos during follow-up. CONCLUSIONS This study showed that trigeminal schwannomas can be effectively treated with a minimally invasive ETOA in all tumor types, except those predominantly involving the posterior fossa (type B). For the extracranial compartments, D2 or D3 tumor types often require an ETOA combined with the endoscopic endonasal approach, while D1 tumor types can be treated using an ETOA alone.
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Affiliation(s)
- Doo-Sik Kong
- 1Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University
| | - Yong Hwy Kim
- 2Department of Neurosurgery, Seoul National University Hospital, Seoul National University; and
| | - Won-Jae Lee
- 1Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University
| | - Young-Hoon Kim
- 3Department of Neurosurgery, Asan Medical Center, Ulsan University of Ulsan College of Medicine, Seoul, Korea
| | - Chang-Ki Hong
- 3Department of Neurosurgery, Asan Medical Center, Ulsan University of Ulsan College of Medicine, Seoul, Korea
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23
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Seo SM, Kim SJ, Kwon O, Brilakis ES, Yoon YH, Lee KS, Kim TO, Lee PH, Kang SJ, Kim YH, Lee CW, Park SW, Lee SW. Intravascular ultrasound-guided optimization for chronic total occlusion-percutaneous coronary intervention with multiple drug-eluting stents. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2071] [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
Multiple stenting in the chronic total occlusion (CTO) lesions is frequently required, however associated with poorer clinical outcomes. It is demonstrated that intravascular ultrasound (IVUS)-guided CTO-percutaneous coronary intervention (PCI) is related to a lower risk of adverse clinical events.
Purpose
We aimed to evaluate the clinical impact of stent optimization under IVUS guidance for multiple stenting, comparing with single stenting.
Methods
A total of 916 patients receiving drug-eluting stent (DES) under IVUS guidance were classified into two groups (stent optimization and non-optimization) according to optimization criteria (an absolute expansion criteria; minimal stent area ≥4.9 mm2 and a relative expansion criteria; 80% of mean reference lumen area). Of total population, 314 patients (34.3%) were treated with single stent and 575 patients (62.7%) were treated with multiple stents, respectively. Ischemic-driven target-lesion revascularization (TLR)/reocclusion was evaluated.
Results
Under IVUS guidance, 316 patients (34.5%) met IVUS criteria for stent optimization The achieving rates were 53% in the single stent group and 24% in the multiple stents group, respectively, (p<0.001). During a median of 4.7 years, the multiple stent group showed a significantly higher TLR/reocclusion rate, compared with the single stent group (12.8% vs. 5.2%, adjusted hazard ratio [HR] 2.51, 95% confidence interval [CI] 1.20–5.25, p=0.01). (Figure 1) Meeting both the absolute and relative expansion criteria was associated with a significantly low rate of TLR/reocclusion rate (12.5% vs. 5.2%, adjusted HR 0.34, 95% CI: 0.15–0.79, p=0.01). Under IVUS-guidance, there was no significant difference between multiple stenting and single stenting in case of achieving the optimization criteria (6.5% vs. 4.2%, p=0.11), whereas non-optimization group in the patients with multiple stenting showed a significantly higher rate of TLR/reocclusion, compared with IVUS-optimization group in the patients with single stenting (14.5% vs. 4.2%, p=0.002). (Figure 2)
Conclusions
In CTO-PCI with DES, multiple stenting significantly increased the risk of TLR/reocclusion. IVUS-guided optimization for multiple stenting showed a comparable long-term risk of TLR/reocclusion to single stenting with IVUS optimization. Hence, achieving IVUS expansion criteria may help to reduce the risk of TLR/reocclusion in CTO-PCI with multiple DES overlapping.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S M Seo
- Eunpyeoung St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - S J Kim
- Eunpyeoung St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - O Kwon
- Eunpyeoung St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - E S Brilakis
- Minneapolis Heart Institute Foundation , Minneapolis , United States of America
| | - Y H Yoon
- Sejong Chungnam National University Hospital , Sejong , Korea (Republic of)
| | - K S Lee
- Daejeon St. Mary's Hospital , Daejeon , Korea (Republic of)
| | - T O Kim
- Asan Medical Center , Seoul , Korea (Republic of)
| | - P H Lee
- Asan Medical Center , Seoul , Korea (Republic of)
| | - S J Kang
- Asan Medical Center , Seoul , Korea (Republic of)
| | - Y H Kim
- Asan Medical Center , Seoul , Korea (Republic of)
| | - C W Lee
- Asan Medical Center , Seoul , Korea (Republic of)
| | - S W Park
- Asan Medical Center , Seoul , Korea (Republic of)
| | - S W Lee
- Asan Medical Center , Seoul , Korea (Republic of)
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24
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Jeong J, Choi JI, Kim YG, Choi YY, Min KJ, Roh SY, Shim JM, Kim JS, Kim YH. Late ventricular potential for risk prediction of sudden cardiac death risk: a valuable tool or an unnecessary step? Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.399] [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/Introduction
Signal-averaged electrocardiography (SA-ECG) is a high-resolution electrocardiography that can detect late ventricular potential, which known to be a noninvasive tool for risk stratification of sudden cardiac death (SCD) by predicting reentrant ventricular tachyarrhythmia. There is a paucity of data with SA-ECG on SCD survivors without structural heart disease, whereas majority of previous studies had been focused on post myocardial infarction survivors.
Purpose
This study assessed the clinical utility of SA-ECG as a risk stratification modality for lethal arrhythmic event in patients at risk of SCD without definite structural heart disease.
Methods
Total 629 patients who experienced or had potential risk of SCD were studied with SA-ECG. Among them, 48 patients who were found to have significant structural heart disease were excluded, except arrhythmogenic right ventricular cardiomyopathy. Major arrhythmic event (MAE) was defined as composite of all-cause death, aborted SCD, and sustained VT during any time either before visit of clinic or during follow up period. Syncope and non-sustained VT was defined as non-major arrhythmic event. SA-ECG was defined positive when fulfilling three or more criterion: (1) unfiltered QRS duration ≥114ms, (2) filtered QRS duration ≥114ms, (3) duration of terminal QRS <40uV exceeding 40ms, and (4) root mean square voltage in the terminal 40ms of ≤20ms.
Results
Among total 581 patients, 145 patients with positive SA-ECG showed higher incidence of MAE compared to patients with negative SA-ECG (21.4% vs. 6.7%, OR 3.816 [95% CI 2.208–6.597], p<0.001, Table). As the number of positive SA-ECG criteria increases, incidence of MAE tended to increase sequentially, which was markedly noted from 2 positive to 3 positive criteria (10.7% to 20.8%, p<0.001, Figure). In particular, patient with inherited arrhythmia showed higher rate of positive late potential compared to those with non-inherited arrhythmia (51.0% vs. 19.3%, p<0.001).
Conclusion
This study showed that at least 3 out of 4 diagnostic criteria in SA-ECG can independently predict lethal arrhythmic events and the positive late potential was associated with lethal arrhythmic event that leads to SCD, suggesting risk prediction for SCD using SA-ECG in patients even without structural heart disease including inherited arrhythmias.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J Jeong
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - J I Choi
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - Y G Kim
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - Y Y Choi
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - K J Min
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - S Y Roh
- Korea University Guro Hospital , Seoul , Korea (Democratic People's Republic of)
| | - J M Shim
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - J S Kim
- Korea University Ansan Hospital , Ansan , Korea (Democratic People's Republic of)
| | - Y H Kim
- Korea University Anam Hospital , Seoul , Korea (Republic of)
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25
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Jeong J, Choi JI, Kim YG, Choi YY, Min KJ, Roh SY, Shim JM, Kim JS, Kim YH. Clinical role of genetic testing for overlapping between Brugada syndrome and arrhythmogenic right ventricular cardiomyopathy. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.367] [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/Introduction
Brugada syndrome (BrS) and arrhythmogenic right ventricular cardiomyopathy (ARVC) are inherited arrhythmias that may predispose to sudden cardiac arrest. Although its pathogenetic mechanisms differ, overlapping features between BrS and ARVC have been demonstrated previously. However, it remains to be determined whether genetic testing for ARVC-related gene is needed in patients with BrS.
Purpose
This study is aimed to analyze genetic profiles of BrS patients using next generation sequencing (NGS) based multigene panel including ARVC related genes.
Methods
Patients who were confirmed as BrS or clinically suspected as BrS with type 2 or 3 Brugada pattern electrocardiography were studied. Genetic testing using NGS panels (Illumina Inc., San Diego, CA, USA) included 30 genetic variants associated with inherited arrhythmia and genetic cardiomyopathy.
Results
Among the total 119 patients from BrS registry, 63 patients were confirmed as BrS and 56 patients were clinically suspected as BrS without fulfilling diagnostic criteria. One-hundred-fourteen patients (95.8%) were male, and mean age of onset was 43.6 year-old. Genetic variants were identified in 25 of 42 patients who received genetic testing. Six out of 25 patients (24.0%) showed ARVC-related genotypes (2 PKP2, 1 DSG2, 1 TMEM43, 1 JUP, and 1 DSP) (Figure 1 and Table 1). None of the patients showed structural or electrocardiographic features that fulfill diagnostic criteria of ARVC. It is notable that ARVC-related genotypes were mostly frequently accounted for BrS patients, following SCN5A and SCN10A.
Conclusion
In the clinic setting, ARVC-related genetic variants were identified in significant proportion of BrS patients, supporting that genetic testing of ARVC-overlapping is needed. This study suggests that follow-up including imaging study should be considered in BrS patients with ARVC-related genotypes to monitor disease progression as ARVC.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J Jeong
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - J I Choi
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - Y G Kim
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - Y Y Choi
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - K J Min
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - S Y Roh
- Korea University Guro Hospital , Seoul , Korea (Democratic People's Republic of)
| | - J M Shim
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - J S Kim
- Korea University Ansan Hospital , Ansan , Korea (Democratic People's Republic of)
| | - Y H Kim
- Korea University Anam Hospital , Seoul , Korea (Republic of)
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26
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Kim B, Jang HN, Chae KS, Shin HS, Kim YH, Kim SJ, Seong MW, Kim JH. A Novel Missense PRKAR1A Variant Causes Carney Complex. Endocrinol Metab (Seoul) 2022; 37:810-815. [PMID: 36193716 PMCID: PMC9633213 DOI: 10.3803/enm.2022.1544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 08/26/2022] [Indexed: 12/30/2022] Open
Abstract
The Carney complex (CNC) is an autosomal dominant disorder characterized by endocrine and nonendocrine tumors. Loss-of-function variants of protein kinase A regulatory subunit 1 alpha (PRKAR1A) are common causes of CNC. Here, we present the case of a patient with CNC with a novel PRKAR1A missense variant. A 21-year-old woman was diagnosed with CNC secondary to acromegaly and adrenal Cushing syndrome. Genetic analysis revealed a novel missense heterozygous variant of PRKAR1A (c.176A>T). Her relatives, suspected of having CNC, also carried the same variant. RNA analysis revealed that this variant led to nonsense-mediated mRNA decay. In vitro functional analysis of the variant confirmed its role in increasing protein kinase A activity and cyclic adenosine monophosphate levels. This study broadens our understanding of the genetic spectrum of CNC. We suggest that PRKAR1A genetic testing and counseling be recommended for patients with CNC and their families.
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Affiliation(s)
- Boram Kim
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Han Na Jang
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung Shil Chae
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Ho Seop Shin
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yong Hwy Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Pituitary Center, Seoul National University Hospital, Seoul, Korea
| | - Su Jin Kim
- Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Moon-Woo Seong
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
- Corresponding authors: Moon-Woo Seong. Department of Laboratory Medicine, Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea Tel: +82-2-2072-4180, Fax: +82-2-747-0359, E-mail:
| | - Jung Hee Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Pituitary Center, Seoul National University Hospital, Seoul, Korea
- Corresponding authors: Moon-Woo Seong. Department of Laboratory Medicine, Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea Tel: +82-2-2072-4180, Fax: +82-2-747-0359, E-mail:
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27
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Pérez-Vidal RM, Gadea A, Domingo-Pardo C, Gargano A, Valiente-Dobón JJ, Clément E, Lemasson A, Coraggio L, Siciliano M, Szilner S, Bast M, Braunroth T, Collado J, Corina A, Dewald A, Doncel M, Dudouet J, de France G, Fransen C, González V, Hüyük T, Jacquot B, John PR, Jungclaus A, Kim YH, Korichi A, Labiche M, Lenzi S, Li H, Ljungvall J, López-Martens A, Mengoni D, Michelagnoli C, Müller-Gatermann C, Napoli DR, Navin A, Quintana B, Ramos D, Rejmund M, Sanchis E, Simpson J, Stezowski O, Wilmsen D, Zielińska M, Boston AJ, Barrientos D, Bednarczyk P, Benzoni G, Birkenbach B, Boston HC, Bracco A, Cederwall B, Cullen DM, Didierjean F, Eberth J, Gottardo A, Goupil J, Harkness-Brennan LJ, Hess H, Judson DS, Kaşkaş A, Korten W, Leoni S, Menegazzo R, Million B, Nyberg J, Podolyak Z, Pullia A, Ralet D, Recchia F, Reiter P, Rezynkina K, Salsac MD, Şenyiğit M, Sohler D, Theisen C, Verney D. Evidence of Partial Seniority Conservation in the πg_{9/2} Shell for the N=50 Isotones. Phys Rev Lett 2022; 129:112501. [PMID: 36154392 DOI: 10.1103/physrevlett.129.112501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 02/08/2022] [Accepted: 07/29/2022] [Indexed: 06/16/2023]
Abstract
The reduced transition probabilities for the 4_{1}^{+}→2_{1}^{+} and 2_{1}^{+}→0_{1}^{+} transitions in ^{92}Mo and ^{94}Ru and for the 4_{1}^{+}→2_{1}^{+} and 6_{1}^{+}→4_{1}^{+} transitions in ^{90}Zr have been determined in this experiment making use of a multinucleon transfer reaction. These results have been interpreted on the basis of realistic shell-model calculations in the f_{5/2}, p_{3/2}, p_{1/2}, and g_{9/2} proton valence space. Only the combination of extensive lifetime information and large scale shell-model calculations allowed the extent of the seniority conservation in the N=50 g_{9/2} orbital to be understood. The conclusion is that seniority is largely conserved in the first πg_{9/2} orbital.
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Affiliation(s)
- R M Pérez-Vidal
- Instituto de Física Corpuscular, CSIC-Universidad de Valencia, Valencia E-46980, Spain
- INFN Laboratori Nazionali di Legnaro, I-35020 Legnaro, Italy
| | - A Gadea
- Instituto de Física Corpuscular, CSIC-Universidad de Valencia, Valencia E-46980, Spain
| | - C Domingo-Pardo
- Instituto de Física Corpuscular, CSIC-Universidad de Valencia, Valencia E-46980, Spain
| | - A Gargano
- INFN Complesso Universitario di Monte S. Angelo, Via Cintia, I-80126 Napoli, Italy
| | | | - E Clément
- Grand Accélérateur National d'Ions Lourds, CEA/DRF-CNRS/IN2P3, F-14076 Caen cedex 5, France
| | - A Lemasson
- Grand Accélérateur National d'Ions Lourds, CEA/DRF-CNRS/IN2P3, F-14076 Caen cedex 5, France
| | - L Coraggio
- INFN Complesso Universitario di Monte S. Angelo, Via Cintia, I-80126 Napoli, Italy
- Dipartimento di Matematica e Fisica, Università degli Studi della Campania "Luigi Vanvitelli", viale Abramo Lincoln 5, I-81100 Caserta, Italy
| | - M Siciliano
- Physics Division, Argonne National Laboratory, Lemont, 60439 Illinois, USA
| | - S Szilner
- Ruder Bošković Institute, 10000 Zagreb, Croatia
| | - M Bast
- Institut für Kernphysik, Universität zu Köln, D-50937 Köln, Germany
| | - T Braunroth
- Institut für Kernphysik, Universität zu Köln, D-50937 Köln, Germany
| | - J Collado
- Departamento de Ingeniería Electrónica, Universitat de Valencia, Burjassot, E-46100 Valencia, Spain
| | - A Corina
- Department of Chemistry, Simon Fraser University, Burnaby, British Columbia BC V5A 1S6, Canada
| | - A Dewald
- Institut für Kernphysik, Universität zu Köln, D-50937 Köln, Germany
| | - M Doncel
- Department of Physics, Stockholm University, SE-106 91 Stockholm, Sweden
| | - J Dudouet
- Université Lyon, Université Claude Bernard Lyon 1, CNRS/IN2P3, IP2I Lyon, F-69622 Villeurbanne, France
| | - G de France
- Grand Accélérateur National d'Ions Lourds, CEA/DRF-CNRS/IN2P3, F-14076 Caen cedex 5, France
| | - C Fransen
- Institut für Kernphysik, Universität zu Köln, D-50937 Köln, Germany
| | - V González
- Departamento de Ingeniería Electrónica, Universitat de Valencia, Burjassot, E-46100 Valencia, Spain
| | - T Hüyük
- Instituto de Física Corpuscular, CSIC-Universidad de Valencia, Valencia E-46980, Spain
- Instituto de Estructura de la Materia, CSIC, Madrid, E-28006 Madrid, Spain
| | - B Jacquot
- Grand Accélérateur National d'Ions Lourds, CEA/DRF-CNRS/IN2P3, F-14076 Caen cedex 5, France
| | - P R John
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - A Jungclaus
- Instituto de Estructura de la Materia, CSIC, Madrid, E-28006 Madrid, Spain
| | - Y H Kim
- Grand Accélérateur National d'Ions Lourds, CEA/DRF-CNRS/IN2P3, F-14076 Caen cedex 5, France
- Institut Laue-Langevin, 71 Avenue des Martyrs, 38042 Grenoble, France
| | - A Korichi
- IJCLab Orsay, IN2P3-CNRS, Université Paris-Saclay and Université Paris-Sud, 91405 Orsay, France
| | - M Labiche
- STFC Daresbury Laboratory, Daresbury, Warrington WA4 4AD, United Kingdom
| | - S Lenzi
- Dipartimento di Fisica e Astronomia dell'Università di Padova, I-35131 Padova, Italy
- INFN Sezione di Padova, I-35131 Padova, Italy
| | - H Li
- Grand Accélérateur National d'Ions Lourds, CEA/DRF-CNRS/IN2P3, F-14076 Caen cedex 5, France
| | - J Ljungvall
- IJCLab Orsay, IN2P3-CNRS, Université Paris-Saclay and Université Paris-Sud, 91405 Orsay, France
| | - A López-Martens
- IJCLab Orsay, IN2P3-CNRS, Université Paris-Saclay and Université Paris-Sud, 91405 Orsay, France
| | - D Mengoni
- Dipartimento di Fisica e Astronomia dell'Università di Padova, I-35131 Padova, Italy
- INFN Sezione di Padova, I-35131 Padova, Italy
| | - C Michelagnoli
- Grand Accélérateur National d'Ions Lourds, CEA/DRF-CNRS/IN2P3, F-14076 Caen cedex 5, France
- Institut Laue-Langevin, 71 Avenue des Martyrs, 38042 Grenoble, France
| | - C Müller-Gatermann
- Physics Division, Argonne National Laboratory, Lemont, 60439 Illinois, USA
- Institut für Kernphysik, Universität zu Köln, D-50937 Köln, Germany
| | - D R Napoli
- INFN Laboratori Nazionali di Legnaro, I-35020 Legnaro, Italy
| | - A Navin
- Grand Accélérateur National d'Ions Lourds, CEA/DRF-CNRS/IN2P3, F-14076 Caen cedex 5, France
| | - B Quintana
- Laboratorio de Radiaciones Ionizantes, Universidad de Salamanca, E-37008 Salamanca, Spain
| | - D Ramos
- Grand Accélérateur National d'Ions Lourds, CEA/DRF-CNRS/IN2P3, F-14076 Caen cedex 5, France
| | - M Rejmund
- Grand Accélérateur National d'Ions Lourds, CEA/DRF-CNRS/IN2P3, F-14076 Caen cedex 5, France
| | - E Sanchis
- Departamento de Ingeniería Electrónica, Universitat de Valencia, Burjassot, E-46100 Valencia, Spain
| | - J Simpson
- STFC Daresbury Laboratory, Daresbury, Warrington WA4 4AD, United Kingdom
| | - O Stezowski
- Université Lyon, Université Claude Bernard Lyon 1, CNRS/IN2P3, IP2I Lyon, F-69622 Villeurbanne, France
| | - D Wilmsen
- Grand Accélérateur National d'Ions Lourds, CEA/DRF-CNRS/IN2P3, F-14076 Caen cedex 5, France
| | - M Zielińska
- Irfu, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A J Boston
- Oliver Lodge Laboratory, The University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | | | - P Bednarczyk
- The Henryk Niewodniczański Institute of Nuclear Physics, Polish Academy of Sciences, ul. Radzikowskiego 152, 31-342 Kraków, Poland
| | - G Benzoni
- INFN Sezione di Milano, I-20133 Milano, Italy
| | - B Birkenbach
- Institut für Kernphysik, Universität zu Köln, D-50937 Köln, Germany
| | - H C Boston
- Oliver Lodge Laboratory, The University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - A Bracco
- INFN Sezione di Milano, I-20133 Milano, Italy
- Dipartimento di Fisica, Università di Milano, I-20133 Milano, Italy
| | - B Cederwall
- Department of Physics, KTH Royal Institute of Technology, SE-10691 Stockholm, Sweden
| | - D M Cullen
- Nuclear Physics Group, Schuster Laboratory, University of Manchester, Manchester M13 9PL, United Kingdom
| | - F Didierjean
- Université de Strasbourg, CNRS, IPHC UMR 7178, F-67000 Strasbourg, France
| | - J Eberth
- Institut für Kernphysik, Universität zu Köln, D-50937 Köln, Germany
| | - A Gottardo
- INFN Laboratori Nazionali di Legnaro, I-35020 Legnaro, Italy
| | - J Goupil
- Grand Accélérateur National d'Ions Lourds, CEA/DRF-CNRS/IN2P3, F-14076 Caen cedex 5, France
| | - L J Harkness-Brennan
- Oliver Lodge Laboratory, The University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - H Hess
- Institut für Kernphysik, Universität zu Köln, D-50937 Köln, Germany
| | - D S Judson
- Oliver Lodge Laboratory, The University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - A Kaşkaş
- Department of Physics, Ankara University, 06100 Besevler-Ankara, Turkey
| | - W Korten
- Irfu, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - S Leoni
- INFN Sezione di Milano, I-20133 Milano, Italy
- Dipartimento di Fisica, Università di Milano, I-20133 Milano, Italy
| | - R Menegazzo
- INFN Sezione di Padova, I-35131 Padova, Italy
| | - B Million
- INFN Sezione di Milano, I-20133 Milano, Italy
| | - J Nyberg
- Department of Physics and Astronomy, Uppsala University, SE-75120 Uppsala, Sweden
| | - Zs Podolyak
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - A Pullia
- INFN Sezione di Milano, I-20133 Milano, Italy
- Dipartimento di Fisica, Università di Milano, I-20133 Milano, Italy
| | - D Ralet
- Grand Accélérateur National d'Ions Lourds, CEA/DRF-CNRS/IN2P3, F-14076 Caen cedex 5, France
| | - F Recchia
- Dipartimento di Fisica e Astronomia dell'Università di Padova, I-35131 Padova, Italy
- INFN Sezione di Padova, I-35131 Padova, Italy
| | - P Reiter
- Institut für Kernphysik, Universität zu Köln, D-50937 Köln, Germany
| | - K Rezynkina
- INFN Sezione di Padova, I-35131 Padova, Italy
- Université de Strasbourg, CNRS, IPHC UMR 7178, F-67000 Strasbourg, France
| | - M D Salsac
- Irfu, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - M Şenyiğit
- Department of Physics, Ankara University, 06100 Besevler-Ankara, Turkey
| | - D Sohler
- Institute for Nuclear Research, Atomki, 4001 Debrecen, P.O. Box 51, Hungary
| | - Ch Theisen
- Irfu, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - D Verney
- IJCLab Orsay, IN2P3-CNRS, Université Paris-Saclay and Université Paris-Sud, 91405 Orsay, France
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Bagot M, Muller M, Kim YH, Ortiz-Romero PL, Zinzani PL, Beylot-Barry M, Dalle S, Jacobsen E, Combalia A, Huen A, Mehta-Shah N, Khodadoust MS, Viotti J, Paiva C, Porcu P. Lacutamab in patients with advanced mycosis fungoides according to KIR3DL2 expression: stage 1 results from the TELLOMAK phase 2 trial. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00590-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Lee WJ, Kim YH, Hong SD, Rho TH, Kim YH, Dho YS, Hong CK, Kong DS. Development of 3-dimensional printed simulation surgical training models for endoscopic endonasal and transorbital surgery. Front Oncol 2022; 12:966051. [PMID: 35992880 PMCID: PMC9389537 DOI: 10.3389/fonc.2022.966051] [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: 06/10/2022] [Accepted: 07/11/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundEndoscopic skull base surgery (ESBS) is complex, requiring methodical and unremitting surgical training. Herein, we describe the development and evaluation of a novel three-dimensional (3D) printed simulation model for ESBS. We further validate the efficacy of this model as educational support in neurosurgical training.MethodsA patient-specific 3D printed simulation model using living human imaging data was established and evaluated in a task-based hands-on dissection program. Endoscopic endonasal and transorbital procedures were simulated on the model by neurosurgeons and otorhinolaryngology surgeons of varying experience. All procedures were recorded using a high-definition camera coupled with digital video recorder system. The participants were asked to complete a post-procedure questionnaire to validate the efficacy of the model.ResultsFourteen experts and 22 trainees participated in simulations, and the 32 participants completed the post-procedure survey. The anatomical realism was scored as 4.0/5.0. The participants rated the model as helpful in hand-eye coordination training (4.7/5.0) and improving surgical skills (4.6/5.0) for ESBS. All participants believed that the model was useful as educational support for trainees (4.7 [ ± 0.5]). However, the color (3.6/5.0) and soft tissue feedback parameters (2.8/5) scored low.ConclusionThis study shows that high-resolution 3D printed skull base models for ESBS can be generated with high anatomical accuracy and acceptable haptic feedback. The simulation program of ESBS using this model may be supplemental or provide an alternative training platform to cadaveric dissection.
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Affiliation(s)
- Won-Jae Lee
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Yong Hwy Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University School of Medicine, Seoul, South Korea
| | - Sang-Duk Hong
- Department of Otorhinolaryngology—Head & Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Tae-Hoon Rho
- Department of Neurosurgery, Ajou University Hospital, Ajou University School of Medicine, Suwon, South Korea
| | - Young Hoon Kim
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Yun-Sik Dho
- Department of Neurosurgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, South Korea
| | - Chang-Ki Hong
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Doo-Sik Kong
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- *Correspondence: Doo-Sik Kong, /
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Byun YH, Kang H, Kim YH. Advances in Pituitary Surgery. Endocrinol Metab (Seoul) 2022; 37:608-616. [PMID: 35982611 PMCID: PMC9449102 DOI: 10.3803/enm.2022.1546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 08/01/2022] [Indexed: 11/11/2022] Open
Abstract
Pituitary surgery has advanced considerably in recent years with the exploration and development of various endoscopic approaches and techniques. Different endoscopic skull base approaches are being applied to access sellar tumors in different locations. Moreover, extracapsular dissection and cavernous sinus exploration have enabled gross total resection of sellar tumors where it could not have been achieved in the past. Techniques for skull base reconstruction have also progressed, allowing surgeons to remove larger and more complicated tumors than before. This review article discusses different endoscopic skull base approaches, surgical techniques for removing pituitary adenomas, and reconstruction methods for repairing postoperative low-flow and high-flow cerebrospinal fluid leakage.
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Affiliation(s)
- Yoon Hwan Byun
- Pituitary Center, Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Ho Kang
- Pituitary Center, Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yong Hwy Kim
- Pituitary Center, Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Corresponding author: Yong Hwy Kim. Pituitary Center, Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea Tel: +82-2-2072-4062, Fax: +82-2-744-8459, E-mail:
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Kim H, Kim K, Kim YH. Associations between mental illness and cancer: a systematic review and meta-analysis of observational studies. Eur Rev Med Pharmacol Sci 2022; 26:4997-5007. [PMID: 35916796 DOI: 10.26355/eurrev_202207_29286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Considering the impact of mental illness and cancer on the society, the relationship between the two diseases should be assessed. This study aimed at determining the association between mental illness and cancer. MATERIALS AND METHODS The Embase and Medline databases were searched on October 21, 2020. Cohort, case-control, and cross-sectional studies were eligible for study inclusion. The Newcastle-Ottawa scale was used to qualitatively assess the risk of bias. Funnel plots were drawn to evaluate the risks of bias across the included studies. RESULTS We included 58 studies from 16 countries, incorporating approximately 30 national databases and 25 million individuals. Patients with psychiatric disorders did not show an increased risk of developing cancer. However, patients with cancer had a significantly increased risk of developing mental illness. The survival rates of patients with mental illness according to cancer occurrence and patients with cancer according to mental illness occurrence were significantly decreased. CONCLUSIONS Clinicians should conduct early screening to ensure that appropriate interventions for mental illness are administered in patients with cancer. Due to the high incidence of death in patients with mental illnesses due to unnatural causes, such as suicide, homicide, and accidents, clinicians should be aware of the importance of the treatment and management of these patients.
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Affiliation(s)
- H Kim
- Department of Laboratory Medicine, Pusan National University Hospital, Busan, Republic of Korea.
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Choi S, Kim YJ, Oh H, Kim N, Kim YH, Park HP. Sevoflurane anesthesia rather than propofol anesthesia is associated with 3-month postoperative hypocortisolism in patients undergoing endoscopic transsphenoidal surgery for non-functional pituitary adenoma with preoperative normal hypothalamic-pituitary-adrenal axis. Acta Neurochir (Wien) 2022; 164:2083-2094. [PMID: 35641648 DOI: 10.1007/s00701-022-05260-4] [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: 02/15/2022] [Accepted: 05/17/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE The effects of anesthetic technique on intermediate-term postoperative adrenocorticotropic hormone (ACTH) functional outcomes have not been fully determined in non-functioning pituitary adenoma (NFPA) patients. Postoperative hypocortisolism is potentially life-threatening and requires steroid replacement after pituitary surgery. The present study determined whether sevoflurane anesthesia was predictive of 3-month postoperative hypocortisolism in NFPA patients with preoperative normal hypothalamic-pituitary-adrenal (HPA) axis. METHODS Demographics, preoperative pituitary hormone status, intraoperative data, and tumor characteristics were retrospectively collected from 429 NFPA patients, who had preoperative normal HPA axis and underwent endoscopic transsphenoidal surgery. Patients were divided into two groups based on intraoperative anesthetic technique: sevoflurane-based inhalation anesthesia group (n = 74) and propofol-based intravenous anesthesia group (n = 355). After propensity score matching, 73 patients were selected in each group and the incidence of 3-month postoperative hypocortisolism (primary outcome measure) was compared between the two groups. RESULTS The incidence of 3-month postoperative hypocortisolism was higher in the sevoflurane anesthesia group than the propofol anesthesia group before (n = 20[27.0%] vs. n = 49[13.8%], P = 0.008) and after (n = 20 [27.4%] vs. n = 5 [6.8%], P = 0.002) propensity score matching, respectively. Sevoflurane anesthetic use (odds ratio [95% CI] 5.37[1.80-15.98], P = 0.003) and postoperative steroid administration (2.89 [1.06-7.92], P = 0.039) were predictors of 3-month postoperative hypocortisolism. CONCLUSION In patients with preoperative normal HPA axis undergoing endoscopic transsphenoidal surgery for NFPA, sevoflurane anesthesia and postoperative steroid administration were associated with the development of 3-month postoperative hypocortisolism. A large-scale prospective study is needed to confirm the negative association between sevoflurane anesthesia and postoperative ACTH functional outcome.
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Affiliation(s)
- Seungeun Choi
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Yoon Jung Kim
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Hyongmin Oh
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Nayoung Kim
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Yong Hwy Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Hee-Pyoung Park
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.
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Yang J, Kim YH, Phi JH, Kim SK, Wang KC. Complications of Endoscopic Skull Base Surgery for Sellar and Parasellar Tumors in Pediatric Population; Neurosurgical Perspectives. Front Oncol 2022; 12:769576. [PMID: 35692769 PMCID: PMC9186047 DOI: 10.3389/fonc.2022.769576] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 04/20/2022] [Indexed: 11/13/2022] Open
Abstract
Background Advances in surgical techniques based on in-depth anatomical knowledge of the skull base have broadened the indications for endoscopic skull base surgery (ESS) with the advantage of wide and direct surgical exposure while minimizing invasiveness. However, the low incidence of the indicated diseases and narrow surgical corridors in children have limited the popularization of ESS. In addition, surgical complications and preventive interventions are not yet well known. Therefore, we retrospectively investigated the complications and prevention methods of ESS in children with a comprehensive review. Methods We retrospectively analyzed the medical records of pediatric patients who underwent ESS for sellar and parasellar tumors at Seoul National University Children's Hospital from July 2010 to December 2020. Visual and endocrine status, extent of resection, complications, and recurrences were investigated depending on the pathology of the tumor. In addition, a comprehensive literature review regarding the complications of pediatric ESS was performed. Results A total of 98 patients were enrolled. The median age of the patients was 12 years, and 52 patients were male. Preoperative visual disturbance was found in 53 patients, anterior pituitary function deficit in 69, and diabetes insipidus in 32. Gross total resection was attempted in 67 patients and achieved in 62 (93%). Biopsy and cyst fenestration were the goals of surgery in 26 patients, and all were achieved as planned. Regarding outcomes, visual disturbance worsened in two patients (2%), endocrine status was aggravated in 34 (35%) patients, and new-onset diabetes insipidus occurred in 27 (41%) patients. The overall surgical complication rate (other than aggravation of visual or endocrine status) was 17%. Postoperative meningitis (12%) was the most common complication, followed by cerebrospinal fluid leakage (2%), vasospasm, hemorrhage and infarction. By pathological diagnosis, craniopharyngioma had the highest complication rate of 29%. All but one patient with postoperative hemorrhage showed no permanent deficits. Conclusion ESS in children is feasible and relatively safe. More attention and different postoperative management protocols are required in children to avoid complications, especially in craniopharyngiomas. However, the complications can be mostly managed conservatively without permanent neurologic deficits.
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Affiliation(s)
- Jeyul Yang
- Neuro-Oncology Clinic, National Cancer Center, Goyang, South Korea
| | - Yong Hwy Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Ji Hoon Phi
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
- Division of Pediatric Neurosurgery, Seoul National University Children’s Hospital, Seoul, South Korea
| | - Seung-Ki Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
- Division of Pediatric Neurosurgery, Seoul National University Children’s Hospital, Seoul, South Korea
| | - Kyu-Chang Wang
- Neuro-Oncology Clinic, National Cancer Center, Goyang, South Korea
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Moon HC, Park SJ, Kim YD, Kim KM, Kang H, Lee EJ, Kim MS, Kim JW, Kim YH, Park CK, Kim YG, Dho YS. Navigation of frameless fixation for gamma knife radiosurgery using fixed augmented reality. Sci Rep 2022; 12:4486. [PMID: 35296720 PMCID: PMC8927150 DOI: 10.1038/s41598-022-08390-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 03/07/2022] [Indexed: 11/25/2022] Open
Abstract
Augmented reality (AR) offers a new medical treatment approach. We aimed to evaluate frameless (mask) fixation navigation using a 3D-printed patient model with fixed-AR technology for gamma knife radiosurgery (GKRS). Fixed-AR navigation was developed using the inside-out method with visual inertial odometry algorithms, and the flexible Quick Response marker was created for object-feature recognition. Virtual 3D-patient models for AR-rendering were created via 3D-scanning utilizing TrueDepth and cone-beam computed tomography (CBCT) to generate a new GammaKnife Icon™ model. A 3D-printed patient model included fiducial markers, and virtual 3D-patient models were used to validate registration accuracy. Registration accuracy between initial frameless fixation and re-fixation navigated fixed-AR was validated through visualization and quantitative method. The quantitative method was validated through set-up errors, fiducial marker coordinates, and high-definition motion management (HDMM) values. A 3D-printed model and virtual models were correctly overlapped under frameless fixation. Virtual models from both 3D-scanning and CBCT were enough to tolerate the navigated frameless re-fixation. Although the CBCT virtual model consistently delivered more accurate results, 3D-scanning was sufficient. Frameless re-fixation accuracy navigated in virtual models had mean set-up errors within 1 mm and 1.5° in all axes. Mean fiducial marker differences from coordinates in virtual models were within 2.5 mm in all axes, and mean 3D errors were within 3 mm. Mean HDMM difference values in virtual models were within 1.5 mm of initial HDMM values. The variability from navigation fixed-AR is enough to consider repositioning frameless fixation without CBCT scanning for treating patients fractionated with large multiple metastases lesions (> 3 cm) who have difficulty enduring long beam-on time. This system could be applied to novel GKRS navigation for frameless fixation with reduced preparation time.
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Affiliation(s)
- Hyeong Cheol Moon
- Department of Neurosurgery, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | | | | | - Kyung Min Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ho Kang
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Eun Jung Lee
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Min-Sung Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jin Wook Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yong Hwy Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Chul-Kee Park
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Young Gyu Kim
- Department of Neurosurgery, Chungbuk National University Hospital, Cheongju, Republic of Korea.,Department of Neurosurgery, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Yun-Sik Dho
- Department of Neurosurgery, Chungbuk National University Hospital, Cheongju, Republic of Korea. .,Department of Neurosurgery, Chungbuk National University College of Medicine, Cheongju, Republic of Korea.
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Chang WI, Kim IH, Choi SH, Kim TM, Lee ST, Won JK, Park SH, Kim MS, Kim JW, Kim YH, Park CK, Lee JH. Risk Stratification to Define the Role of Radiotherapy for Benign and Atypical Meningioma: A Recursive Partitioning Analysis. Neurosurgery 2022; 90:619-626. [PMID: 35262528 DOI: 10.1227/neu.0000000000001904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 11/07/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The role of adjuvant radiotherapy (RT) for benign or atypical meningioma is controversial. OBJECTIVE To identify prognostic factors and a subgroup that could be potentially indicated for adjuvant RT. METHODS A total of 336 patients with benign and 157 patients with atypical meningioma underwent surgical resection between January 2015 and December 2019. We retrospectively analyzed 407 patients who did not receive adjuvant RT to stratify risk groups for recurrence. A recursive partitioning analysis (RPA) with the prognostic factors for their failure-free survival (FFS) divided the patients into risk groups. RESULTS The 3-year FFS with surgical resection only was 76.5%. Identified prognostic factors for FFS were skull base location, tumor size, brain invasion, a Ki-67 proliferation index of ≥5%, and subtotal resection. The RPA-classified patients were divided into 4 risk groups: very low, low, intermediate, and high, and their 3-year FFS were 98.9%, 78.5%, 59.8%, and 34.2%, respectively. Intermediate-risk and high-risk groups comprise the patients with meningioma of sizes ≥2 cm after subtotal resection or meningioma of sizes >3 cm, located in the skull base or with brain invasion, respectively. After combining with patients treated with adjuvant RT, no FFS benefit was found in the very low-risk and low-risk groups after adjuvant RT, whereas significantly improved FFS was found in the intermediate-risk and high-risk groups (P < .05). CONCLUSION The RPA classification revealed a subgroup of patients who could be potentially indicated for adjuvant RT even after gross total resection or for whom adjuvant RT could be deferred.
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Affiliation(s)
- Won Ick Chang
- Department of Radiation Oncology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Il-Han Kim
- Department of Radiation Oncology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Seung Hong Choi
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Tae Min Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Soon-Tae Lee
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jae Kyung Won
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sung-Hye Park
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Min-Sung Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jin Wook Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yong Hwy Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Chul-Kee Park
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Joo Ho Lee
- Department of Radiation Oncology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
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Kang KM, Choi EJ, Jung W, Lee J, Choi SH, Kim YH. Diffusion Tensor Imaging and Neurite Orientation Dispersion and Density Imaging Assessment of Optic Pathway Function in Patients With Anterior Visual Pathway Compression. J Neuroophthalmol 2022; 42:e192-e202. [PMID: 34270520 DOI: 10.1097/wno.0000000000001309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND In patients with sellar or parasellar tumors, it is crucial to evaluate visual field impairment in the preoperative stage and to predict visual field improvement after the surgery. The purpose of this study was to investigate the associations of diffusion tensor imaging (DTI) and neurite orientation dispersion and density imaging (NODDI) parameters in the optic radiations with preoperative and postoperative visual field impairment. METHODS This prospective study included 81 participants with sellar or parasellar tumors. Multishell diffusion imaging and a visual field impairment score (VFIS) were acquired before and after the surgery. The multishell diffusion-weighted imaging was acquired to measure the neurite density and neurite orientation dispersion, as well as the diffusivity. DTI parameters were fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity, and radial diffusivity (RD). NODDI provided intracellular volume fraction (Vic), the orientation dispersion index, and isotropic volume fraction (Viso). The associations of DTI and NODDI parameters in the optic radiations with VFIS were investigated, adjusting for age, tumor height, and symptom duration. RESULTS Among 162 optic radiations, 117 were functionally impaired in the preoperative stage. FA and Vic had significant negative correlations, whereas MD and RD had significant positive correlations with the VFIS (all P < 0.001). In the preoperative stage, lower FA (P = 0.001; odds ratio = 0.750) and Vic (P = 0.003; OR = 0.827) and higher MD (P = 0.007; OR = 1.244) and RD (P < 0.001; OR = 1.361) were significantly associated with the presence of visual field impairment. For the degree of postoperative improvement, preoperative lower Vic (P = 0.034; OR = 0.910) and higher MD (P = 0.037; OR = 1.103) and RD (P = 0.047; OR = 1.090) were significantly associated with more postoperative improvement. CONCLUSIONS DTI and NODDI parameters in the optic radiations were correlated with VFIS and associated with preoperative visual field impairments and postoperative improvement. It may help in predicting visual field improvement after the surgery in patients with sellar or parasellar tumors.
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Affiliation(s)
- Koung Mi Kang
- Department of Radiology (KMK, SHC), Seoul National University Hospital, Jongno-gu, Republic of Korea ; Department of Electrical and Computer Engineering (E-JC), Laboratory for Imaging Science and Technology, Seoul National University, Gwanak-gu, Republic of Korea ; AIRS Medical (WJ), Seoul, Republic of Korea; Department of Electrical and Computer Engineering (JL), Laboratory for Imaging Science and Technology, INMC, IOER, Seoul National University, Gwanak-gu, Republic of Korea and Department of Neurosurgery (YHK), Seoul National University Hospital, Jongno-gu, Republic of Korea
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Hong AR, Kim JH, Park SS, Kong SH, Choi HJ, Kim YH, Shin CS. Determinants of Short-Term Weight Gain Following Surgical Treatment for Craniopharyngioma in Adults. J Korean Neurosurg Soc 2022; 65:439-448. [PMID: 35184516 PMCID: PMC9082123 DOI: 10.3340/jkns.2021.0067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 08/12/2021] [Indexed: 11/27/2022] Open
Abstract
Objective Craniopharyngiomas (CPs) are associated with hypothalamic damage that causes hypothalamic obesity, however, the mechanisms underlying CP-related postoperative weight gain remain debatable. This study aimed to elucidate whether the major determinant of postoperative weight gain in patients with CP is hypothalamic injury or steroid replacement therapy.
Methods We included 48 adult patients with CP (age ≥18 years) who underwent transsphenoidal surgery between 2010 and 2018 in a single tertiary center, and whose body weight was measured pre- and postoperatively (<120 days after the surgery). We recruited 144 age- and body mass index-matched patients with non-functioning pituitary adenoma (NFPA) as controls.
Results Patients with CP experienced greater postoperative weight gain than patients with NFPA (3.0±5.1 vs. 0.1±3.6 kg, p<0.001). The prevalence of postoperative steroid use was significantly higher in patients with CP than in those with NFPA (89.6% vs. 34.0%, p<0.001). Steroid replacement therapy and CP were associated with postoperative weight gain after adjusting for covariates in overall patients (p=0.032 and 0.007, respectively). In subgroup analysis with postoperative steroid users, weight gain was significantly greater in patients with CP (n=43, 0.96±0.25 kg/month) than in patients with NFPA (n=49, 0.26±0.23 kg/month) even after adjusting for the daily steroid dose (p=0.048).
Conclusion Patients with CP experience greater postoperative weight gain than those with NFPA. Hypothalamic damage itself as well as steroid replacement may contribute to the postoperative weight gain in patients with CP.
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Abstract
PURPOSE The indications for and the optimal biopsy approach in pituitary stalk-hypothalamic (PsH) lesions are controversial. Biopsies through an endoscopic endonasal approach (EEA) for PsH lesions have often been considered to cause the infundibulo-tuberal syndrome. The purpose of this study was to analyze the surgical and endocrinological safety of EEA biopsies for PsH lesions. METHODS A total of 39 consecutive patients who underwent an EEA biopsy between June 2011 and August 2020 in a single institute were retrospectively analyzed. The ophthalmological and endocrinological outcomes were assessed before and after surgery. RESULTS PsH lesions were confirmed to be diverse pathological diagnoses, ranging from lymphocytic hypophysitis to diffuse midline glioma, and the most common pathologic diagnosis was a germinoma (18 patients, 46.2%). No patients developed visual deterioration after the biopsy. In patients without preoperative panhypopituitarism, 13 out of 28 patients (46.4%) developed new anterior pituitary hormonal deficiencies after the biopsy. When the tissue was collected from the stalk, the endocrinological deterioration rate was 100% (6 of 6 patients), while the rate was 31.8% (7 of 22 patients) when tissue could be harvested from an extra-stalk lesion. The rate of newly developed permanent diabetes insipidus after surgery was 40.9% (9 of 22 patients). The median surgery time was 125 min, and there was no postoperative CSF leakage or infections noted. CONCLUSIONS An EEA biopsy for PsH lesions is a safe and efficient surgical method unless the tissue is collected from the stalk.
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Affiliation(s)
- Ho Kang
- Department of Neurosurgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Kyung-Min Kim
- Department of Neurosurgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Min-Sung Kim
- Department of Neurosurgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jung Hee Kim
- Devision of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Department of Neurosurgery, Pituitary Center, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Chul-Kee Park
- Department of Neurosurgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Yong Hwy Kim
- Department of Neurosurgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
- Department of Neurosurgery, Pituitary Center, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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Kim MS, Chun SW, Dho YS, Seo Y, Lee JH, Won JK, Kim JW, Park CK, Park SH, Kim YH. Histopathological predictors of progression-free survival in atypical meningioma: a single-center retrospective cohort and meta-analysis. Brain Tumor Pathol 2022; 39:99-110. [PMID: 35031884 DOI: 10.1007/s10014-021-00419-w] [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: 09/08/2021] [Accepted: 11/22/2021] [Indexed: 11/02/2022]
Abstract
To determine the prognostic significance of histopathological features included in the diagnostic criteria of atypical meningioma for progression-free survival (PFS). We performed a retrospective cohort study and meta-analysis. Brain invasion, mitotic index, spontaneous necrosis, sheeting, prominent nucleoli, high cellularity, and small cells were the histopathological features of interest. The data from 25 studies involving 3590 patients including our cohort (n = 262) were included. The pooled HR of mitotic index at a cutoff value of 4 showed no statical significance in the gross analysis (pooled HR, 1.09; 95% CI 0.61-1.96; p = 0.7699). Furthermore, it failed to prognosticate PFS in other pooled analyses. For brain invasion, no consistent association with the progression was found in each pooled analysis according to the included studies. Among the remaining five atypical features, spontaneous necrosis, sheeting, and prominent nucleoli showed a significant correlation with PFS in the gross analysis. In the analysis that pooled the HRs from the multivariate analyses, only spontaneous necrosis had significant association with PFS. The available evidence supports that the current cutoff value of mitotic index for diagnosing atypical meningioma might be improper to have prognostic value. The prognostic significance of brain invasion also needs further evaluation.
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Affiliation(s)
- Min-Sung Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Se-Woong Chun
- Department of Rehabilitation Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea
| | - Yun-Sik Dho
- Department of Neurosurgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Youngbeom Seo
- Department of Neurosurgery, Yeungnam University Hospital, Yeungnam University College of Medicine, Daegu, Korea
| | - Joo Ho Lee
- Department of Radiation Oncology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Kyung Won
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jin Wook Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Chul-Kee Park
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Sung-Hye Park
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yong Hwy Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.
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Jang HN, Kim YH, Kim JH. Diabetes Mellitus Predicts Weight Gain After Surgery in Patients With Acromegaly. Front Endocrinol (Lausanne) 2022; 13:854931. [PMID: 35355553 PMCID: PMC8959539 DOI: 10.3389/fendo.2022.854931] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 02/09/2022] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE Metabolic complications are common in patients with acromegaly. However, this occasionally does not improve post-surgery and may be related to postoperative weight gain. We aimed to investigate the postoperative weight change and factors associated with postoperative weight gain in patients with acromegaly. DESIGN AND METHODS Overall, 113 consecutive patients with body weight records pre- and 3-6 months post-surgery between October 2009 and March 2021 were enrolled. Patients were divided into three groups: weight loss (weight decrease ≥3%), stable, and weight gain (weight increase ≥3%). Hormone status, metabolic comorbidities, and anthropometric parameters were compared between the groups. RESULTS Among 113 patients, 29 (25.7%) and 26 (23.0%) patients lost and gained weight, respectively, post-surgery. There were no significant differences in baseline characteristics, including age at diagnosis, sex, body mass index, and growth hormone levels among the three groups. The prevalence of diabetes mellitus at diagnosis was significantly higher in the weight gain group than in the other groups. Patients with diabetes (n=22) had a 5.2-fold higher risk of postoperative weight gain than those with normal glucose tolerance (n=37) (P=0.006). In the diabetes mellitus group, the percentage lean mass decreased (-4.5 [-6.6-2.0]%, P=0.002), and the percentage fat mass significantly increased post-surgery (18.0 [4.6-36.6]%, P=0.003), whereas the normal glucose tolerance group did not show body composition changes post-surgery. CONCLUSION In patients with acromegaly, 23% experienced ≥3% weight gain post-surgery. Diabetes mellitus at diagnosis is a significant predictor of weight and fat gain post-surgery.
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Affiliation(s)
- Han Na Jang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Yong Hwy Kim
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
- Pituitary Center, Seoul National University Hospital, Seoul, South Korea
| | - Jung Hee Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
- Pituitary Center, Seoul National University Hospital, Seoul, South Korea
- *Correspondence: Jung Hee Kim, ;
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Park JH, Yoon JE, Kim YH, Kim Y, Park TJ, Kang HY. The potential skin lightening candidate, senolytic drug ABT263, for photoageing pigmentation. Br J Dermatol 2021; 186:740-742. [PMID: 34773647 DOI: 10.1111/bjd.20893] [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: 10/10/2021] [Revised: 11/09/2021] [Accepted: 11/09/2021] [Indexed: 11/28/2022]
Abstract
Senescent cells accumulate in several tissues during ageing, including the skin, and contribute to the functional decline of the skin via the senescence-associated secretory phenotypes (SASPs) 1 . Due to the potential negative effects of SASPs during the ageing process, drugs that selectively target senescent cells or SASPs represent an important therapeutic strategy to delay skin ageing. The selective induction of cell death specifically to kill senescent cells using drugs, referred to as senolytics, is a main approach to achieve this strategy 2 .
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Affiliation(s)
- J H Park
- Department of Biochemistry and Molecular Biology, Ajou University School of Medicine, Suwon, Korea.,Institution of Inflamm-aging translational research center, Ajou University School of Medicine, Suwon, Korea
| | - J E Yoon
- Department of Biochemistry and Molecular Biology, Ajou University School of Medicine, Suwon, Korea.,Institution of Inflamm-aging translational research center, Ajou University School of Medicine, Suwon, Korea
| | - Y H Kim
- Department of Dermatology, Ajou University School of Medicine, Suwon, Korea
| | - Y Kim
- Institution of Inflamm-aging translational research center, Ajou University School of Medicine, Suwon, Korea.,Department of Dermatology, Ajou University School of Medicine, Suwon, Korea
| | - T J Park
- Department of Biochemistry and Molecular Biology, Ajou University School of Medicine, Suwon, Korea.,Institution of Inflamm-aging translational research center, Ajou University School of Medicine, Suwon, Korea
| | - H Y Kang
- Institution of Inflamm-aging translational research center, Ajou University School of Medicine, Suwon, Korea.,Department of Dermatology, Ajou University School of Medicine, Suwon, Korea
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Kim JH, Kim H, Dan K, Kim SI, Park SH, Han D, Kim YH. In-depth proteomic profiling captures subtype-specific features of craniopharyngiomas. Sci Rep 2021; 11:21206. [PMID: 34707096 PMCID: PMC8551227 DOI: 10.1038/s41598-021-00483-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 10/12/2021] [Indexed: 11/09/2022] Open
Abstract
Craniopharyngiomas are rare epithelial tumors derived from pituitary gland embryonic tissue. This epithelial tumor can be categorized as an adamantinomatous craniopharyngioma (ACP) or papillary craniopharyngioma (PCP) subtype with histopathological and genetic differences. Genomic and transcriptomic profiles of craniopharyngiomas have been investigated; however, the proteomic profile has yet to be elucidated and added to these profiles. Recent improvements in high-throughput quantitative proteomic approaches have introduced new opportunities for a better understanding of these diseases and the efficient discovery of biomarkers. We aimed to confirm subtype-associated proteomic changes between ACP and PCP specimens. We performed a system-level proteomic study using an integrated approach that combines mass spectrometry-based quantitative proteomic, statistical, and bioinformatics analyses. The bioinformatics analysis showed that differentially expressed proteins between ACP and PCP were significantly involved in mitochondrial organization, fatty acid metabolic processes, exocytosis, the inflammatory response, the cell cycle, RNA splicing, cell migration, and neuron development. Furthermore, using network analysis, we identified hub proteins that were positively correlated with ACP and PCP phenotypes. Our findings improve our understanding of the pathogenesis of craniopharyngiomas and provide novel insights that may ultimately translate to the development of craniopharyngioma subtype-specific therapeutics.
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Affiliation(s)
- Jung Hee Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.,Pituitary Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyeyoon Kim
- Proteomics Core Facility, Biomedical Research Institute, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.,Department of Pathology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kisoon Dan
- Proteomics Core Facility, Biomedical Research Institute, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Seong-Ik Kim
- Department of Pathology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sung-Hye Park
- Department of Pathology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Dohyun Han
- Proteomics Core Facility, Biomedical Research Institute, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. .,Transdisciplinary Department of Medicine & Advanced Technology, Seoul National University Hospital, Seoul, Republic of Korea.
| | - Yong Hwy Kim
- Pituitary Center, Seoul National University Hospital, Seoul, Republic of Korea. .,Department of Neurosurgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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Lee EJ, Lee JY, Kim JW, Phi JH, Kim YH, Kim SK, Chung HT, Wang KC, Kim DG. Dosimetric parameters associated with the long-term oncological outcomes of Gamma Knife surgery for sellar and parasellar tumors in pediatric patients. J Neurosurg Pediatr 2021:1-9. [PMID: 34678777 DOI: 10.3171/2021.7.peds21312] [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: 06/12/2021] [Accepted: 07/22/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The authors aimed to investigate the dosimetric parameter and the minimally required dose associated with long-term control of sellar and parasellar tumors after Gamma Knife surgery (GKS) in children. METHODS A retrospective analysis was performed on pediatric patients younger than 19 years of age who were diagnosed with sellar and parasellar tumors and received GKS at the authors' institution from 1998 to 2019. Cox proportional hazards regression analyses were used to investigate the dosimetric parameters associated with treatment outcome. The Kaplan-Meier method was used to analyze tumor control rates after GKS. RESULTS Overall, 37 patients with 40 sellar and parasellar tumors, including 22 craniopharyngiomas and 12 pituitary adenomas, had a mean follow-up of 85.8 months. The gross target volume was 0.05 cm3 to 15.28 cm3, and the mean marginal dose was 15.8 Gy (range 9.6-30.0 Gy). Ten patients experienced treatment failure at a mean of 28.0 ± 26.7 months. The actuarial 5- and 10-year tumor control rates were 79.0% and 69.8%, respectively. D98% was an independent predictive factor of tumor control (HR 0.846 [95% CI 0.749-0.956], p = 0.007), with a cutoff value of 11.5 Gy for the entire cohort and 10 Gy for the craniopharyngioma group. Visual deterioration occurred in 2 patients with the maximum point dose of 10.1 Gy and 10.6 Gy to the optic apparatus. CONCLUSIONS In pediatric patients, D98% was a reliable index of the minimum required dose for long-term control of sellar and parasellar tumors after GKS. The optimal D98% value for each tumor diagnosis needs to be elucidated in the future.
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Affiliation(s)
- Eun Jung Lee
- 1Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul
| | - Ji Yeoun Lee
- 1Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul.,2Division of Pediatric Neurosurgery, Department of Neurosurgery, Seoul National University Children's Hospital, Seoul.,3Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul
| | - Jin-Wook Kim
- 1Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul
| | - Ji Hoon Phi
- 1Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul.,2Division of Pediatric Neurosurgery, Department of Neurosurgery, Seoul National University Children's Hospital, Seoul
| | - Yong Hwy Kim
- 1Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul.,4Pituitary Center, Seoul National University Hospital, Seoul; and
| | - Seung-Ki Kim
- 1Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul.,2Division of Pediatric Neurosurgery, Department of Neurosurgery, Seoul National University Children's Hospital, Seoul
| | - Hyun-Tai Chung
- 1Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul
| | - Kyu-Chang Wang
- 5Neuro-oncology Clinic, National Cancer Center, Goyang, Republic of Korea
| | - Dong Gyu Kim
- 1Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul
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Cho SG, Kim YH, Park HJ, Park KS, Kim JH, Ahn SJ, Bom HS. Prediction of radiation-related cardiotoxicity using F-18 FDG PET in non-small-cell lung cancer. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2844] [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
Radiation-related cardiotoxicity has been refocused nowadays as the follow-up was increased amomg the patients with advanced lung cancer. The early recognition of the occult cardiotoxicity enables the early intervention preventing clinically significant cardiac events or worsening of severity.
Purpose
We aim to search whether the F-18 fluorodeoxyglucose positron emission tomography (FDG PET) performed immediately after radiotherapy could predict the late cardiac events.
Methods
We retrospectively enrolled 133 patients with locally advanced, unresectable stage III NSCLC who underwent F-18 fluorodeoxyglucose positron emission tomography (FDG PET) immediately after CCRT for the response evaluation and survived at least for 6 months. Heart was recontoured according to the RTOG 0617 secondary analysis atlas for the dose volume analysis. Standardized uptake values (SUV) of the left ventricular myocardium were measured on FDG PET images. The patients were regularly followed up for the disease progression and complications. The primary end-point was the cardiac events grade ≥2 based on the Common Terminology Criteria for Adverse Events (version 5.0).
Results
FDG PET was performed at median interval of 11 days after CCRT. Fourty-two patients experienced cardiotoxicity during a median follow-up of 47 months (range, 12 – 123 months). In univariable analysis, mean heart dose, maximum SUV of the left ventricle (LV SUVmax), white blood cell count, and diabetes were associated with the risk of cardiotoxicity. In multivariable analysis, only higher mean heart dose (>11.1 Gy, hazard ratio 3.930 [95% confidence interval 1.933–7.988]; p=0.0002) and higher LV SUVmax (>12.84, 2.189 [1.162–4.124]; p=0.0152) were independently associated with increased risk of cardiotoxicity. In subgroup analyses, LV SUVmax remained predictive of cardiotoxicity among those with higher mean heart dose, but not among those with lower mean heart dose.
Conclusion
Early FDG PET after CCRT for NSCLC could predict the late cardiac events, especially in patients with high dose cardiac irradiation.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): This work was supported by a grant of the Basic Science Research Program through the National Research Foundation funded by the Ministry of Education, Republic of Korea (Principal Investigator: Sang-Geon Cho)
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Affiliation(s)
- S G Cho
- Chonnam National University Hospital, Nuclear Medicine, Gwangju, Korea (Republic of)
| | - Y H Kim
- Chonnam National University Hwasun Hospital, Radiation Oncology, Hwasun, Korea (Republic of)
| | - H J Park
- Chonnam National University Hwasun Hospital, Cardiololgy, Hwasun, Korea (Republic of)
| | - K S Park
- Chonnam National University Hospital, Nuclear Medicine, Gwangju, Korea (Republic of)
| | - J H Kim
- Chonnam National University Hospital, Nuclear Medicine, Gwangju, Korea (Republic of)
| | - S J Ahn
- Chonnam National University Hwasun Hospital, Radiation Oncology, Hwasun, Korea (Republic of)
| | - H S Bom
- Chonnam National University Hwasun Hospital, Nuclear Medicine, Hwasun, Korea (Republic of)
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Lotay G, Gillespie SA, Williams M, Rauscher T, Alcorta M, Amthor AM, Andreoiu CA, Baal D, Ball GC, Bhattacharjee SS, Behnamian H, Bildstein V, Burbadge C, Catford WN, Doherty DT, Esker NE, Garcia FH, Garnsworthy AB, Hackman G, Hallam S, Hudson KA, Jazrawi S, Kasanda E, Kennington ARL, Kim YH, Lennarz A, Lubna RS, Natzke CR, Nishimura N, Olaizola B, Paxman C, Psaltis A, Svensson CE, Williams J, Wallis B, Yates D, Walter D, Davids B. First Direct Measurement of an Astrophysical p-Process Reaction Cross Section Using a Radioactive Ion Beam. Phys Rev Lett 2021; 127:112701. [PMID: 34558922 DOI: 10.1103/physrevlett.127.112701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/19/2021] [Accepted: 08/11/2021] [Indexed: 06/13/2023]
Abstract
We have performed the first direct measurement of the ^{83}Rb(p,γ) radiative capture reaction cross section in inverse kinematics using a radioactive beam of ^{83}Rb at incident energies of 2.4 and 2.7A MeV. The measured cross section at an effective relative kinetic energy of E_{cm}=2.393 MeV, which lies within the relevant energy window for core collapse supernovae, is smaller than the prediction of statistical model calculations. This leads to the abundance of ^{84}Sr produced in the astrophysical p process being higher than previously calculated. Moreover, the discrepancy of the present data with theoretical predictions indicates that further experimental investigation of p-process reactions involving unstable projectiles is clearly warranted.
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Affiliation(s)
- G Lotay
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - S A Gillespie
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - M Williams
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics, University of York, Heslington, York YO10 5DD, United Kingdom
| | - T Rauscher
- Department of Physics, University of Basel, Klingelbergstrasse 82, CH-4056 Basel, Switzerland
- Centre for Astrophysics Research, University of Hertfordshire, Hatfield AL10 9AB, United Kingdom
| | - M Alcorta
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - A M Amthor
- Department of Physics and Astronomy, Bucknell University, Lewisburg, Pennsylvania 17837, USA
| | - C A Andreoiu
- Department of Chemistry, Simon Fraser University, Burnaby, British Columbia V5A 1S6, Canada
| | - D Baal
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - G C Ball
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - S S Bhattacharjee
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - H Behnamian
- Department of Physics, University of Guelph, Guelph, Ontario N1G 2W1, Canada
| | - V Bildstein
- Department of Physics, University of Guelph, Guelph, Ontario N1G 2W1, Canada
| | - C Burbadge
- Department of Physics, University of Guelph, Guelph, Ontario N1G 2W1, Canada
| | - W N Catford
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - D T Doherty
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - N E Esker
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - F H Garcia
- Department of Chemistry, Simon Fraser University, Burnaby, British Columbia V5A 1S6, Canada
| | - A B Garnsworthy
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - G Hackman
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - S Hallam
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - K A Hudson
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics, Simon Fraser University, Burnaby, British Columbia V5A 1S6, Canada
| | - S Jazrawi
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - E Kasanda
- Department of Physics, University of Guelph, Guelph, Ontario N1G 2W1, Canada
| | - A R L Kennington
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - Y H Kim
- Department of Nuclear Engineering, Hanyang University, Seoul 04763, Republic of Korea
| | - A Lennarz
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - R S Lubna
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - C R Natzke
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics, Colorado School of Mines, Golden, Colorado 80401, USA
| | - N Nishimura
- Astrophysical Big Bang Laboratory, CPR, RIKEN, Wako, Saitama 351-0198, Japan
| | - B Olaizola
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - C Paxman
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - A Psaltis
- Department of Physics and Astronomy, McMaster University, Hamilton, Ontario L8S 4L8, Canada
| | - C E Svensson
- Department of Physics, University of Guelph, Guelph, Ontario N1G 2W1, Canada
| | - J Williams
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - B Wallis
- Department of Physics, University of York, Heslington, York YO10 5DD, United Kingdom
| | - D Yates
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics and Astronomy, University of British Columbia, Vancouver BC V6T 1Z4, Canada
| | - D Walter
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - B Davids
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics, Simon Fraser University, Burnaby, British Columbia V5A 1S6, Canada
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Martin WK, Padilla S, Kim YH, Hunter DL, Hays MD, DeMarini DM, Hazari MS, Gilmour MI, Farraj AK. Zebrafish irritant responses to wildland fire-related biomass smoke are influenced by fuel type, combustion phase, and byproduct chemistry. J Toxicol Environ Health A 2021; 84:674-688. [PMID: 34006202 PMCID: PMC8237130 DOI: 10.1080/15287394.2021.1925608] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Human exposure to wildfire-derived particulate matter (PM) is linked to adverse health outcomes; however, little is known regarding the influence of biomass fuel type and burn conditions on toxicity. The aim of this study was to assess the irritant potential of extractable organic material (EOM) of biomass smoke condensates from five fuels (eucalyptus, pine, pine needle, peat, or red oak), representing various fire-prone regions of the USA, burned at two temperatures each [flaming (approximately 640°C) or (smoldering approximately 500°C)] using a locomotor assay in zebrafish (Danio rerio) larvae. It was postulated that locomotor responses, as measures of irritant effects, might be dependent upon fuel type and burn conditions and that these differences relate to combustion byproduct chemistry. To test this, locomotor activity was tracked for 60 min in 6-day-old zebrafish larvae (25-32/group) immediately after exposure to 0.4% dimethyl sulfoxide (DMSO) vehicle or EOM from the biomass smoke condensates (0.3-30 µg EOM/ml; half-log intervals). All EOM samples produced concentration-dependent irritant responses. Linear regression analysis to derive rank-order potency indicated that on a µg PM basis, flaming pine and eucalyptus were the most irritating. In contrast, on an emission-factor basis, which normalizes responses to the amount of PM produced/kg of fuel burned, smoldering smoke condensates induced greater irritant responses (>100-fold) than flaming smoke condensates, with smoldering pine being the most potent. Importantly, irritant responses significantly correlated with polycyclic aromatic hydrocarbon (PAH) content, but not with organic carbon or methoxyphenols. Data indicate that fuel type and burn condition influence the quantity and chemical composition of PM as well as toxicity.
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Affiliation(s)
- W Kyle Martin
- Curriculum in Toxicology and Environmental Medicine, UNC-Chapel Hill, USA
| | - S Padilla
- Biomolecular and Computational Toxicology Division, Us Epa, Rtp, NC, US
| | - Y H Kim
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina, Chapel Hill, NC, US
| | - D L Hunter
- Biomolecular and Computational Toxicology Division, Us Epa, Rtp, NC, US
| | - M D Hays
- Air Methods & Characterization Division, Us Epa, Rtp, NC, US
| | - D M DeMarini
- Biomolecular and Computational Toxicology Division, Us Epa, Rtp, NC, US
| | - M S Hazari
- Public Health and Integrated Toxicology Division, Us Epa, Rtp, NC, US
| | - M I Gilmour
- Public Health and Integrated Toxicology Division, Us Epa, Rtp, NC, US
| | - A K Farraj
- Public Health and Integrated Toxicology Division, Us Epa, Rtp, NC, US
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Dho YS, Park SJ, Choi H, Kim Y, Moon HC, Kim KM, Kang H, Lee EJ, Kim MS, Kim JW, Kim YH, Kim YG, Park CK. Development of an inside-out augmented reality technique for neurosurgical navigation. Neurosurg Focus 2021; 51:E21. [PMID: 34333463 DOI: 10.3171/2021.5.focus21184] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 03/26/2021] [Accepted: 05/25/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE With the advancement of 3D modeling techniques and visualization devices, augmented reality (AR)-based navigation (AR navigation) is being developed actively. The authors developed a pilot model of their newly developed inside-out tracking AR navigation system. METHODS The inside-out AR navigation technique was developed based on the visual inertial odometry (VIO) algorithm. The Quick Response (QR) marker was created and used for the image feature-detection algorithm. Inside-out AR navigation works through the steps of visualization device recognition, marker recognition, AR implementation, and registration within the running environment. A virtual 3D patient model for AR rendering and a 3D-printed patient model for validating registration accuracy were created. Inside-out tracking was used for the registration. The registration accuracy was validated by using intuitive, visualization, and quantitative methods for identifying coordinates by matching errors. Fine-tuning and opacity-adjustment functions were developed. RESULTS ARKit-based inside-out AR navigation was developed. The fiducial marker of the AR model and those of the 3D-printed patient model were correctly overlapped at all locations without errors. The tumor and anatomical structures of AR navigation and the tumors and structures placed in the intracranial space of the 3D-printed patient model precisely overlapped. The registration accuracy was quantified using coordinates, and the average moving errors of the x-axis and y-axis were 0.52 ± 0.35 and 0.05 ± 0.16 mm, respectively. The gradients from the x-axis and y-axis were 0.35° and 1.02°, respectively. Application of the fine-tuning and opacity-adjustment functions was proven by the videos. CONCLUSIONS The authors developed a novel inside-out tracking-based AR navigation system and validated its registration accuracy. This technical system could be applied in the novel navigation system for patient-specific neurosurgery.
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Affiliation(s)
- Yun-Sik Dho
- 1Department of Neurosurgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | | | - Haneul Choi
- 2MEDICALIP Co. Ltd., Seoul, Republic of Korea; and
| | | | - Hyeong Cheol Moon
- 1Department of Neurosurgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Kyung Min Kim
- 3Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ho Kang
- 3Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Eun Jung Lee
- 3Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Min-Sung Kim
- 3Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jin Wook Kim
- 3Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yong Hwy Kim
- 3Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Young Gyu Kim
- 1Department of Neurosurgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Chul-Kee Park
- 3Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
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Seo Y, Kim YH, Kim JH, Kong DS, Dho YS, Kang H, Kim KM, Kim JW, Park CK. Outcomes of the endoscopic endonasal approach for tumors in the third ventricle or invading the third ventricle. J Clin Neurosci 2021; 90:302-310. [PMID: 34275567 DOI: 10.1016/j.jocn.2021.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 05/27/2021] [Accepted: 06/12/2021] [Indexed: 10/21/2022]
Abstract
We aimed to retrospectively analyze the surgical and clinical outcomes of the endoscopic endonasal approach (EEA) for tumors in the third ventricle or invading the third ventricle. In total, 82 patients who had undergone surgical treatment using the EEA for tumors involving the third ventricle were enrolled in this study. This cohort study comprised 46 male and 36 female patients. The median age was 37 years (range, 5-76), and the median follow-up duration was 56.5 months (range, 6-117). Seventy-six patients had craniopharyngiomas, and 6 had gangliocytomas, gangliogliomas, astrocytomas, diffuse midline gliomas and lymphomas. Gross total removal was performed in 71 (86.5%) of the 82 patients, subtotal tumor removal in 7 patients and partial removal or biopsy in 4 patients. The pituitary stalk was preserved in 20 cases. Visual function improved in 40 (81.6%) of 49 patients. Endocrine function worsened in 41 (50%) of 82 patients. Hypothalamic function improved in 16 (72.7%) of 22 cases. Postoperative obesity occurred in 3 (20.0%) of 15 children and 11 (23.9%) of 46 adult patients. The postoperative cerebrospinal fluid leakage rate was 3.6%. Postoperative meningitis occurred in 18 (21.9%) cases. Permanent diabetes insipidus was identified in 73 (89.0%) of 82 patients. Tumor recurrence was observed in 10 patients (12%). The EEA appears to be a safe and effective treatment modality for tumors in the third ventricle or involving the third ventricle. However, more cases and long-term follow-up outcomes are required to confirm the clinical efficacy of the EEA.
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Affiliation(s)
- Youngbeom Seo
- Department of Neurosurgery, Yeungnam University Hospital, Daegu, Republic of Korea
| | - Yong Hwy Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea.
| | - Jung Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Doo-Sik Kong
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yun-Sik Dho
- Department of Neurosurgery, Chungbuk National University, College of Medicine, Cheongju, Republic of Korea
| | - Ho Kang
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kyung-Min Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jin Wook Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Chul-Kee Park
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea
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Tsauo J, Noh SY, Shin JH, Gwon DI, Han K, Lee JM, Jeon UB, Kim YH. Retrograde transvenous obliteration for the prevention of variceal rebleeding in patients with hepatocellular carcinoma: a multicentre retrospective study. Clin Radiol 2021; 76:681-687. [PMID: 34140137 DOI: 10.1016/j.crad.2021.05.011] [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: 12/23/2020] [Accepted: 05/14/2021] [Indexed: 12/14/2022]
Abstract
AIM To evaluate the effectiveness and safety of retrograde transvenous obliteration (RTO) for the prevention of variceal rebleeding variceal rebleeding in patients with hepatocellular carcinoma (HCC). MATERIALS AND METHODS This multicentre retrospective study enrolled 79 patients with HCC who underwent RTO for the prevention of variceal rebleeding. Successful occlusion of the gastrorenal shunt and obliteration of the gastric varices were achieved in 74 patients, with a technical success rate of 93.7%. Of the remaining 74 patients (mean age, 64.9±10.3 years; 56 men), 66 (90.4%) had gastroesophageal varices and seven (9.6%) had isolated gastric varices. Thirty-two patients (43.8%) underwent balloon-occluded RTO, 40 patients (54.8%) underwent plug-assisted RTO, and one patient (1.4%) underwent coil-assisted RTO. No patients had major procedural complications. RESULTS Rebleeding occurred in seven patients (9.6%) during the follow-up period. The 6-week and 1-year actuarial probabilities of patients remaining free of rebleeding were 90.8±3.6% and 88.6±4.1%, respectively. The median survival was 12.6 (95% confidence interval [CI] 8-17.3) months. The 6-week, 1-year, and 3-year actuarial probabilities of survival were 83.2±4.4%, 51.1±6.6%, and 32.7±7%, respectively. New or worsening ascites and oesophageal varices occurred in 12 (16.4%) and 13 patients (17.8%), respectively, during the follow-up period. Overt hepatic encephalopathy occurred in one patient (1.4%) during the follow-up period. The Child-Pugh score remained comparable to that at baseline at 1 and 3 months. CONCLUSION RTO was effective and safe in preventing variceal rebleeding in patients with HCC.
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Affiliation(s)
- J Tsauo
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - S Y Noh
- Department of Radiology, Kyung Hee University Seoul Hospital, Seoul, South Korea
| | - J H Shin
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
| | - D I Gwon
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - K Han
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - J M Lee
- Department of Radiology, Soonchunhyang University Hospital, Bucheon, South Korea
| | - U B Jeon
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Y H Kim
- Department of Radiology, Daegu Catholic University Medical Center, Daegu, South Korea
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Oh H, Cheun H, Kim YJ, Yoon HK, Kang H, Lee HC, Park HP, Kim JH, Kim YH. Cephalocaudal tumor diameter is a predictor of diabetes insipidus after endoscopic transsphenoidal surgery for non-functioning pituitary adenoma. Pituitary 2021; 24:303-311. [PMID: 33191457 DOI: 10.1007/s11102-020-01108-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/04/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE Diabetes insipidus (DI) develops commonly after endoscopic transsphenoidal surgery (ETS). We retrospectively investigated the incidence, onset, duration and predictors of DI after ETS in patients with non-functioning pituitary adenoma (NFPA). METHODS A total of 168 patients who underwent ETS to remove NFPAs were included. Various perioperative data on demographics, comorbidities, previous treatments, perioperative hormone deficiencies, tumor characteristics, surgery, anesthesia, intraoperative fluid balance, perioperative laboratory findings, postoperative complications, readmission and hospital length of stay were collected and analyzed. Patients were diagnosed with DI and treated with desmopressin when they showed urine output > 5 mL/kg/hr with a serum sodium concentration > 145 mmol/L or an increase ≥ 3 mmol/L in serum sodium concentration between two consecutive tests after surgery. DI was considered permanent when desmopressin was prescribed for > 6 months after surgery. RESULTS Seventy-seven (45.8%) patients experienced postoperative DI and 10 (6.0%) patients suffered from permanent DI. The median onset of DI and the median duration of transient DI were postoperative day 1 and 5 days, respectively. In multivariable logistic regression analysis, cephalocaudal tumor diameter (odds ratio [95% confidence interval] 2.59 [1.05-6.36], P = 0.038) was related to postoperative DI. In receiver operating characteristic analysis, its area under the curve was 0.68 (95% confidence interval 0.59-0.76, P < 0.001). Its optimal cutoff value that maximized the sum of sensitivity and specificity for postoperative DI was 2.7 cm. CONCLUSIONS Postoperative DI was observed in 45.8% of patients undergoing ETS to remove NFPAs. A large cephalocaudal tumor diameter was predictive of postoperative DI in such patients.
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Affiliation(s)
- Hyongmin Oh
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Hyeon Cheun
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Yoon Jung Kim
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Hyun-Kyu Yoon
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Ho Kang
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Hyung-Chul Lee
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Hee-Pyoung Park
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Jung Hee Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, 03080, Korea
- Pituitary Center, Seoul National University Hospital, Seoul, 03080, Korea
| | - Yong Hwy Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Korea.
- Pituitary Center, Seoul National University Hospital, Seoul, 03080, Korea.
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