1
|
Ahn YS, Woo SH, Kim S, Lim JH, An TH, Kim MS. Does the coronoid fracture in terrible triad injury always need to be fixed? BMC Surg 2024; 24:125. [PMID: 38664803 PMCID: PMC11044357 DOI: 10.1186/s12893-024-02394-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 03/20/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND The ideal treatment of terrble triad injuries and whether fixation of coronoid process fractures is needed or not are still debated. Therefore, we aimed to investigate if terrible triad injuries necessitate coronoid fracture fixation and evaluate if non-fixation treatments have similar efficacies and outcomes as fixation-treatments in cases of terrible triad injuries. METHODS From August 2011 to July 2020, 23 patients with acute terrible triad injuries without involvement of the anteromedial facet of the coronoid process were included to evaluate the postoperative clinical and radiological outcomes (minimum follow-up of 20 months). According to the preoperative height loss evaluation of the coronoid process and an intraoperative elbow stability test, seven patients underwent coronoid fracture fixation, and the other eight patients were treated conservatively. The elbow range of motion (ROM), Mayo Elbow Performance Score (MEPS), and modified Broberg-Morrey score were evaluated at the last follow-up. In addition, plain radiographs were reviewed to evaluate joint congruency, fracture union, heterotopic ossification, and the development of arthritic changes. RESULTS At the last follow-up, the mean arcs of flexion-extension and supination-pronation values were 118.2° and 146.8° in the fixation group and 122.5° and 151.3° in the non-fixation group, respectively. The mean MEPSs were 96.4 in the fixation group (excellent, nine cases; good, tow cases) and 96.7 in the non-fixation group (excellent, ten cases; good, two cases). The mean modified Broberg-Morrey scores were 94.0 in the fixation group (excellent, sevev cases; good, four cases) and 94.0 in the non-fixation group (excellent, ten cases; good, tow cases). No statistically significant differences in clinical scores and ROM were identified between the two groups. However, the non-fixation group showed a significantly lower height loss of the coronoid process than the fixation group (36.3% versus 54.5%). CONCLUSIONS There were no significant differences in clinical outcomes between the fixation and non-fixation groups in terrible triad injuries.
Collapse
Affiliation(s)
- Yeong-Seub Ahn
- Department of Orthopaedic Surgery, Chonnam National University Hospital, Chonnam National University College of Medicine, 42 Jebong-ro, Dong-gu, Gwangju, 61469, South Korea
- Department of Orthopaedic Surgery, Good Morning General Hospital, Pyeongtaek, Republic of Korea
| | - Seong-Hwan Woo
- Department of Orthopaedic Surgery, Chonnam National University Hospital, Chonnam National University College of Medicine, 42 Jebong-ro, Dong-gu, Gwangju, 61469, South Korea
| | - Sungmin Kim
- Department of Orthopaedic Surgery, Chonnam National University Hospital, Chonnam National University College of Medicine, 42 Jebong-ro, Dong-gu, Gwangju, 61469, South Korea
| | - Jun-Hyuk Lim
- Department of Orthopaedic Surgery, Chonnam National University Hospital, Chonnam National University College of Medicine, 42 Jebong-ro, Dong-gu, Gwangju, 61469, South Korea
| | - Tae-Hoon An
- Department of Orthopaedic Surgery, Chonnam National University Hospital, Chonnam National University College of Medicine, 42 Jebong-ro, Dong-gu, Gwangju, 61469, South Korea
| | - Myung-Sun Kim
- Department of Orthopaedic Surgery, Chonnam National University Hospital, Chonnam National University College of Medicine, 42 Jebong-ro, Dong-gu, Gwangju, 61469, South Korea.
| |
Collapse
|
2
|
Jeon N, Albogami Y, Jung SY, Bussing R, Winterstein AG. Comparing pregnancy and pregnancy outcome rates between adolescents with and without pre-existing mental disorders. PLoS One 2024; 19:e0296425. [PMID: 38483946 PMCID: PMC10939254 DOI: 10.1371/journal.pone.0296425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 12/13/2023] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND There are limited population-based data on the role of mental disorders in adolescent pregnancy, despite the presence of mental disorders that may affect adolescents' desires and decisions to become pregnant. OBJECTIVE This study aimed to examine the relationship between specific types of mental disorders and pregnancy rates and outcome types among adolescents aged 13-19 years, using single-year age groups. METHODS We conducted a retrospective cohort study using data from the Merative™ MarketScan Research Databases. The study population consisted of females aged 13-19 years with continuous insurance enrollment for three consecutive calendar years between 2005 and 2015. Pregnancy incidence rates were calculated both overall and within the different categories of mental disorders. The presence of mental disorders, identified through diagnosis codes, was classified into 15 categories. Pregnancy and pregnancy outcome types were determined using diagnosis and procedure codes indicating the pregnancy status or outcome. To address potential over- or underestimations of mental disorder-specific pregnancy rates resulting from variations in age distribution across different mental disorder types, we applied age standardization using 2010 U.S. Census data. Finally, multivariable logistic regression models were used to examine the relationships between 15 specific types of mental disorders and pregnancy incidence rates, stratified by age. RESULTS The age-standardized pregnancy rate among adolescents diagnosed with at least one mental disorder was 15.4 per 1,000 person-years, compared to 8.5 per 1,000 person-years among adolescents without a mental disorder diagnosis. Compared to pregnant adolescents without a mental disorder diagnosis, those with a mental disorder diagnosis had a slightly but significantly higher abortion rate (26.7% vs 23.8%, P-value < 0.001). Multivariable logistic regression models showed that substance use-related disorders had the highest odds ratios (ORs) for pregnancy incidence, ranging from 2.4 [95% confidence interval (CI): 2.1-2.7] to 4.5 [95% CI:2.1-9.5] across different age groups. Overall, bipolar disorders (OR range: 1.6 [95% CI:1.4-1.9]- 1.8 [95% CI: 1.7-2.0]), depressive disorders (OR range: 1.4 [95% CI: 1.3-1.5]- 2.7 [95% CI: 2.3-3.1]), alcohol-related disorders (OR range: 1.2 [95% CI: 1.1-1.4]- 14.5 [95% CI: 1.2-178.6]), and attention-deficit/conduct/disruptive behavior disorders (OR range: 1.1 [95% CI: 1.0-1.1]- 1.8 [95% CI: 1.1-3.0]) were also significantly associated with adolescent pregnancy, compared to adolescents without diagnosed mental disorders of the same age. CONCLUSION This study emphasizes the elevated rates of pregnancy and pregnancy ending in abortion among adolescents diagnosed with mental disorders, and identifies the particular mental disorders associated with higher pregnancy rates.
Collapse
Affiliation(s)
- Nakyung Jeon
- Pusan National University College of Pharmacy, Busan, Republic of Korea
- Research Institute for Drug Development, Pusan National University, Busan, Republic of Korea
| | - Yasser Albogami
- Department of Clinical Pharmacy, College of Pharmacy, King Saudi University, Riyadh, Saudi Arabia
| | - Sun-Young Jung
- College of Pharmacy and Department of Global Innovative Drugs, Chung-Ang University, Seoul, Republic of Korea
| | - Regina Bussing
- Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, United States of America
| | - Almut G. Winterstein
- Department of Pharamceutical Outcomes and Policy, Department of Epidemiology, and Center for drug Evaluation and Safety, University of Florida, Gainesville, FL, United States of America
| |
Collapse
|
3
|
Park JW, Kim JT, Lee JS, Kim BJ, Yoo J, Han JH, Kim BJ, Kim CK, Kim JG, Baik SH, Park JM, Kang K, Lee SJ, Park H, Cha JK, Park TH, Lee K, Lee J, Hong KS, Lee BC, Kim DE, Choi JC, Kwon JH, Shin DI, Sohn SI, Lee SH, Ryu WS, Lee J, Bae HJ. Brain Frailty and Outcomes of Acute Minor Ischemic Stroke With Large-Vessel Occlusion. J Clin Neurol 2024; 20:175-185. [PMID: 38171505 PMCID: PMC10921043 DOI: 10.3988/jcn.2023.0181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/30/2023] [Accepted: 07/04/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND AND PURPOSE The influence of imaging features of brain frailty on outcomes were investigated in acute ischemic stroke patients with minor symptoms and large-vessel occlusion (LVO). METHODS This was a retrospective analysis of a prospective, multicenter, nationwide registry of consecutive patients with acute (within 24 h) minor (National Institutes of Health Stroke Scale score=0-5) ischemic stroke with anterior circulation LVO (acute minor LVO). Brain frailty was stratified according to the presence of an advanced white-matter hyperintensity (WMH) (Fazekas grade 2 or 3), silent/old brain infarct, or cerebral microbleeds. The primary outcome was a composite of stroke, myocardial infarction, and all-cause mortality within 1 year. RESULTS In total, 1,067 patients (age=67.2±13.1 years [mean±SD], 61.3% males) were analyzed. The proportions of patients according to the numbers of brain frailty burdens were as follows: no burden in 49.2%, one burden in 30.0%, two burdens in 17.3%, and three burdens in 3.5%. In the Cox proportional-hazards analysis, the presence of more brain frailty burdens was associated with a higher risk of 1-year primary outcomes, but after adjusting for clinically relevant variables there were no significant associations between burdens of brain frailty and 1-year vascular outcomes. For individual components of brain frailty, an advanced WMH was independently associated with an increased risk of 1-year primary outcomes (adjusted hazard ratio [aHR]=1.33, 95% confidence interval [CI]=1.03-1.71) and stroke (aHR=1.32, 95% CI=1.00-1.75). CONCLUSIONS The baseline imaging markers of brain frailty were common in acute minor ischemic stroke patients with LVO. An advanced WMH was the only frailty marker associated with an increased risk of vascular events. Further research is needed into the association between brain frailty and prognosis in patients with acute minor LVO.
Collapse
Affiliation(s)
- Je-Woo Park
- Department of Neurology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Joon-Tae Kim
- Department of Neurology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
| | - Ji Sung Lee
- Clinical Research Center, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Beom Joon Kim
- Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
| | - Joonsang Yoo
- Department of Neurology, Yongin Severance Hospital, Yongin, Korea
| | - Jung Hoon Han
- Department of Neurology, Korea University Guro Hospital, Seoul, Korea
| | - Bum Joon Kim
- Department of Neurology, Asan Medical Center, Seoul, Korea
| | - Chi Kyung Kim
- Department of Neurology, Korea University Guro Hospital, Seoul, Korea
| | - Jae Guk Kim
- Department of Neurology, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
| | - Sung Hyun Baik
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jong-Moo Park
- Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Korea
| | - Kyusik Kang
- Department of Neurology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Soo Joo Lee
- Department of Neurology, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
| | - Hyungjong Park
- Department of Neurology, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Jae-Kwan Cha
- Department of Neurology, Dong-A University Hospital, Busan, Korea
| | - Tai Hwan Park
- Department of Neurology, Seoul Medical Center, Seoul, Korea
| | - Kyungbok Lee
- Department of Neurology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jun Lee
- Department of Neurology, Yeungnam University Medical Center, Daegu, Korea
| | - Keun-Sik Hong
- Department of Neurology, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Byung-Chul Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Dong-Eog Kim
- Department of Neurology, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Jay Chol Choi
- Department of Neurology, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea
| | - Jee-Hyun Kwon
- Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Dong-Ick Shin
- Department of Neurology, Chungbuk National University Hospital, Cheongju, Korea
| | - Sung Il Sohn
- Department of Neurology, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Sang-Hwa Lee
- Department of Neurology, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Wi-Sun Ryu
- Artificial Intelligence Research Center, JLK Inc., Seoul, Korea
| | - Juneyoung Lee
- Department of Biostatistics, Korea University, Seoul, Korea
| | - Hee-Joon Bae
- Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| |
Collapse
|
4
|
Kim J, Lee SJ, Ko B, Lee M, Lee YS, Lee KH. Identification of Atrial Fibrillation With Single-Lead Mobile ECG During Normal Sinus Rhythm Using Deep Learning. J Korean Med Sci 2024; 39:e56. [PMID: 38317452 PMCID: PMC10843976 DOI: 10.3346/jkms.2024.39.e56] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/04/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND The acquisition of single-lead electrocardiogram (ECG) from mobile devices offers a more practical approach to arrhythmia detection. Using artificial intelligence for atrial fibrillation (AF) identification enhances screening efficiency. However, the potential of single-lead ECG for AF identification during normal sinus rhythm (NSR) remains under-explored. This study introduces a method to identify AF using single-lead mobile ECG during NSR. METHODS We employed three deep learning models: recurrent neural network (RNN), long short-term memory (LSTM), and residual neural networks (ResNet50). From a dataset comprising 13,509 ECGs from 6,719 patients, 10,287 NSR ECGs from 5,170 patients were selected. Single-lead mobile ECGs underwent noise filtering and segmentation into 10-second intervals. A random under-sampling was applied to reduce bias from data imbalance. The final analysis involved 31,767 ECG segments, including 15,157 labeled as masked AF and 16,610 as Healthy. RESULTS ResNet50 outperformed the other models, achieving a recall of 79.3%, precision of 65.8%, F1-score of 71.9%, accuracy of 70.5%, and an area under the receiver operating characteristic curve (AUC) of 0.79 in identifying AF from NSR ECGs. Comparative performance scores for RNN and LSTM were 0.75 and 0.74, respectively. In an external validation set, ResNet50 attained an F1-score of 64.1%, recall of 68.9%, precision of 60.0%, accuracy of 63.4%, and AUC of 0.68. CONCLUSION The deep learning model using single-lead mobile ECG during NSR effectively identified AF at risk in future. However, further research is needed to enhance the performance of deep learning models for clinical application.
Collapse
Affiliation(s)
- Jiwoong Kim
- Department of Mathematics and Statistics, Chonnam National University, Gwangju, Korea
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea
| | | | - Bonggyun Ko
- Department of Mathematics and Statistics, Chonnam National University, Gwangju, Korea
- XRAI, Gwangju, Korea
| | - Myungeun Lee
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | | | - Ki Hong Lee
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
| |
Collapse
|
5
|
Kim SG, Lee JY, Jeong WG, Lee JE, Kim YH. Cardiac Magnetic Resonance Imaging Findings and Clinical Features of COVID-19 Vaccine-Associated Myocarditis, Compared With Those of Other Types of Myocarditis. J Korean Med Sci 2024; 39:e42. [PMID: 38288542 PMCID: PMC10825460 DOI: 10.3346/jkms.2024.39.e42] [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: 07/12/2023] [Accepted: 11/20/2023] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND To compare the clinical and cardiac magnetic resonance (CMR) imaging findings of coronavirus disease 2019 (COVID-19) vaccine-associated myocarditis (VAM) with those of other types of myocarditis. METHODS From January 2020 to March 2022, a total of 39 patients diagnosed with myocarditis via CMR according to the Modified Lake Louise criteria were included in the present study. The patients were classified into two groups based on their vaccination status: COVID-19 VAM and other types of myocarditis not associated with COVID-19 vaccination. Clinical outcomes, including the development of clinically significant arrhythmias, sudden cardiac arrest, and death, and CMR imaging features were compared between COVID-19 VAM and other types of myocarditis. RESULTS Of the 39 included patients (mean age, 39 years ± 16.4 [standard deviation]; 23 men), 23 (59%) had COVID-19 VAM and 16 (41%) had other types of myocarditis. The occurrence of clinical adverse events did not differ significantly between the two groups. As per the CMR imaging findings, the presence and dominant pattern of late gadolinium enhancement did not differ significantly between the two groups. The presence of high native T1 or T2 values was not significantly different between the two groups. Although the native T1 and T2 values tended to be lower in COVID-19 VAM than in other types of myocarditis, there were no statistically significant differences between the native T1 and T2 values in the two groups. CONCLUSION The present study demonstrated that the CMR imaging findings and clinical outcomes of COVID-19 VAM did not differ significantly from those of other types of myocarditis during hospitalization.
Collapse
Affiliation(s)
- Sang Gyun Kim
- Department of Radiology, Chonnam National University Hospital, Gwangju, Korea
| | - Jeong Yeop Lee
- Department of Radiology, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Won Gi Jeong
- Department of Radiology, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Jong Eun Lee
- Department of Radiology, Chonnam National University Hospital, Gwangju, Korea
| | - Yun-Hyeon Kim
- Department of Radiology, Chonnam National University Hospital, Gwangju, Korea
- Department of Radiology, Chonnam National University Medical School, Gwangju, Korea.
| |
Collapse
|
6
|
Moon CM, Heo SH, Yoon W, Baek BH, Shin SS, Kim SK, Lee YY. Altered Sexual Response-Related Functional Connectivity and Morphometric Changes Influenced by Sex Hormones across Menopausal Status. J Clin Med 2024; 13:387. [PMID: 38256520 PMCID: PMC10816754 DOI: 10.3390/jcm13020387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 12/29/2023] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Our study retrospectively investigated differential patterns of the functional connectivity (FC) of core brain regions synchronous with morphometric changes associated with sexual dysfunction in menopausal women, and their correlations with sexual hormones. Twenty-three premenopausal women (mean age: 41.52 ± 7.38 years) and 21 menopausal women (mean age: 55.52 ± 2.80 years) underwent sex hormone level measurements with high-resolution T1 and functional magnetic resonance imaging (MRI) during rest, neutral, and sexual arousal conditions. Analysis of covariance adjusted for age was used to compare the FC and gray matter (GM) volume between the two groups. Menopausal women showed lower GM volumes in the superior frontal gyrus (SFG), superior temporal pole, parahippocampal gyrus (PHG), hippocampus (Hip), amygdala (Amg), and cerebellum (Cb) compared to premenopausal women (p < 0.05). In addition, compared to premenopausal women, menopausal women showed decreased FC of seed regions involved in the SFG, frontal eye fields, and Amg, as well as target regions involved in the PHG, Hip, inferior frontal gyrus, Cb, and vermis (p < 0.005). Furthermore, the FC between the right Amg and right Cb and between the left Amg and right Cb during sexual arousal in both groups was positively correlated with total estrogen and estradiol levels, respectively (p < 0.01). The GM volume values in the right Amg and right Cb were positively correlated with total estrogen and estradiol levels (p < 0.05). Our study demonstrated an association between menopause-related differential FC and GM volume variations and fluctuating sex hormones. Our findings highlight that overlapping brain regions with functional alterations and morphometric changes are closely linked with menopausal symptom-related decreases in sexual arousal and hormone levels.
Collapse
Affiliation(s)
- Chung Man Moon
- Research Institute of Medical Sciences, Chonnam National University, 264 Seoyang-ro, Hwasun-eup, Hwasun-gun 58128, Jeollanam-do, Republic of Korea
| | - Suk Hee Heo
- Department of Radiology, Chonnam National University Hwasun Hospital, 322 Seoyang-ro, Hwasun-eup, Hwasun-gun 58128, Jeollanam-do, Republic of Korea
- Department of Radiology, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
| | - Woong Yoon
- Department of Radiology, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
- Department of Radiology, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
| | - Byung Hyun Baek
- Department of Radiology, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
- Department of Radiology, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
| | - Sang Soo Shin
- Department of Radiology, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
- Department of Radiology, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
| | - Seul Kee Kim
- Department of Radiology, Chonnam National University Hwasun Hospital, 322 Seoyang-ro, Hwasun-eup, Hwasun-gun 58128, Jeollanam-do, Republic of Korea
- Department of Radiology, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
| | - Yun Young Lee
- Department of Radiology, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
| |
Collapse
|
7
|
Choi HW, Jung Y, Kim UJ, Lee SC, Kwon JH, Kim H, Kim S, Lee Y, Shim HJ, Cho SH, Chung IJ, Hwang EC, Kang SJ, Bae WK, Kee SJ. Comparative Study on the Immunogenicity of COVID-19 mRNA Vaccines in Patients Receiving Adjuvant and Palliative Chemotherapy. Chonnam Med J 2024; 60:69-77. [PMID: 38304127 PMCID: PMC10828089 DOI: 10.4068/cmj.2024.60.1.69] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 02/03/2024] Open
Abstract
This study was conducted to investigate potential differences in vaccine efficacy between patients undergoing palliative chemotherapy and receiving adjuvant chemotherapy. Additionally, the study proved the influence of vaccination timing on vaccine efficacy during active chemotherapy. Anti-receptor-binding domain (RBD) IgG binding antibody assays and surrogate neutralizing antibody assays were performed after BNT162b2 or mRNA-1273 vaccination in 45 solid cancer patients (23 adjuvant and 22 palliative chemotherapy) and in 24 healthy controls before vaccination (baseline), at every two to four weeks after the first (post-dose 1) and the second vaccination (post-dose 2). The levels of anti-RBD IgG and neutralizing antibodies increased significantly from baseline through post-dose 1 to post-dose 2 in all three groups. At the post-dose 1, the anti-RBD IgG and neutralizing antibody levels were significantly lower in cancer patients than in healthy controls. However, by post-dose 2, the seropositivity of anti-RBD IgG and neutralizing antibodies uniformly reached 100% across all groups, with no significant disparity in antibody levels among the three groups. Moreover, the antibody titers were not significantly different between patients with a vaccine and chemotherapy interval of more than 14 days or those with less than 14 days. This study demonstrated that after second doses of mRNA COVID-19 vaccines, humoral immune responses in patients receiving chemotherapy were comparable to those of healthy controls, regardless of whether the purpose of the anti-cancer treatment was palliative or adjuvant. Furthermore, the timing of vaccination did not affect the level of humoral immunity after the second vaccination.
Collapse
Affiliation(s)
- Hyun-Woo Choi
- Department of Laboratory Medicine, Chonnam National University Medical School and Hospital, Gwangju, Korea
| | - Younggon Jung
- Division of Infectious Disease, Department of Internal Medicine, St. Carollo General Hospital, Suncheon, Korea
| | - Uh Jin Kim
- Department of Internal Medicine, Chonnam National University Medical School, Hwasun, Korea
| | - Sang-Cheol Lee
- Division of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University Hospital Cheonan, Cheonan, Korea
| | - Jung Hye Kwon
- Division of Hemato-Oncology, Department of Internal Medicine, Chungnam National University Sejong Hospital, Sejong, Korea
- Division of Hematology and Oncology, Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Hyeonjong Kim
- Department of Internal Medicine, Chonnam National University Medical School, Hwasun, Korea
| | - Sarah Kim
- Department of Internal Medicine, Chonnam National University Medical School, Hwasun, Korea
| | - Yoonjung Lee
- Department of Internal Medicine, Chonnam National University Medical School, Hwasun, Korea
| | - Hyun-Jung Shim
- Department of Internal Medicine, Chonnam National University Medical School, Hwasun, Korea
| | - Sang-Hee Cho
- Department of Internal Medicine, Chonnam National University Medical School, Hwasun, Korea
| | - Ik-Joo Chung
- Department of Internal Medicine, Chonnam National University Medical School, Hwasun, Korea
| | - Eu Chang Hwang
- Department of Urology, Chonnam National University Medical School, Hwasun, Korea
| | - Seung Ji Kang
- Department of Internal Medicine, Chonnam National University Medical School, Hwasun, Korea
| | - Woo Kyun Bae
- Department of Internal Medicine, Chonnam National University Medical School, Hwasun, Korea
| | - Seung-Jung Kee
- Department of Laboratory Medicine, Chonnam National University Medical School and Hospital, Gwangju, Korea
| |
Collapse
|
8
|
Park JH, Quang LT, Yoon W, Baek BH, Park I, Kim SK. Predicting Histologic Grade of Meningiomas Using a Combined Model of Radiomic and Clinical Imaging Features from Preoperative MRI. Biomedicines 2023; 11:3268. [PMID: 38137489 PMCID: PMC10741678 DOI: 10.3390/biomedicines11123268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/04/2023] [Accepted: 12/09/2023] [Indexed: 12/24/2023] Open
Abstract
Meningiomas are common primary brain tumors, and their accurate preoperative grading is crucial for treatment planning. This study aimed to evaluate the value of radiomics and clinical imaging features in predicting the histologic grade of meningiomas from preoperative MRI. We retrospectively reviewed patients with intracranial meningiomas from two hospitals. Preoperative MRIs were analyzed for tumor and edema volumes, enhancement patterns, margins, and tumor-brain interfaces. Radiomics features were extracted, and machine learning models were employed to predict meningioma grades. A total of 212 patients were included. In the training group (Hospital 1), significant differences were observed between low-grade and high-grade meningiomas in terms of tumor volume (p = 0.012), edema volume (p = 0.004), enhancement (p = 0.001), margin (p < 0.001), and tumor-brain interface (p < 0.001). Five radiomics features were selected for model development. The prediction model for radiomics features demonstrated an average validation accuracy of 0.74, while the model for clinical imaging features showed an average validation accuracy of 0.69. When applied to external test data (Hospital 2), the radiomics model achieved an area under the receiver operating characteristics curve (AUC) of 0.72 and accuracy of 0.69, while the clinical imaging model achieved an AUC of 0.82 and accuracy of 0.81. An improved performance was obtained from the model constructed by combining radiomics and clinical imaging features. In the combined model, the AUC and accuracy for meningioma grading were 0.86 and 0.73, respectively. In conclusion, this study demonstrates the potential value of radiomics and clinical imaging features in predicting the histologic grade of meningiomas. The combination of both radiomics and clinical imaging features achieved the highest AUC among the models. Therefore, the combined model of radiomics and clinical imaging features may offer a more effective tool for predicting clinical outcomes in meningioma patients.
Collapse
Affiliation(s)
- Jae Hyun Park
- Department of Radiology, Chonnam National University Hospital, Gwangju 61469, Republic of Korea; (J.H.P.); (W.Y.)
| | - Le Thanh Quang
- Department of Artificial Intelligence Convergence, Chonnam National University, Gwangju 61469, Republic of Korea;
| | - Woong Yoon
- Department of Radiology, Chonnam National University Hospital, Gwangju 61469, Republic of Korea; (J.H.P.); (W.Y.)
- Department of Radiology, Chonnam National University Medical School, Gwangju 61469, Republic of Korea
| | - Byung Hyun Baek
- Department of Radiology, Chonnam National University Hospital, Gwangju 61469, Republic of Korea; (J.H.P.); (W.Y.)
- Department of Radiology, Chonnam National University Medical School, Gwangju 61469, Republic of Korea
| | - Ilwoo Park
- Department of Radiology, Chonnam National University Hospital, Gwangju 61469, Republic of Korea; (J.H.P.); (W.Y.)
- Department of Artificial Intelligence Convergence, Chonnam National University, Gwangju 61469, Republic of Korea;
- Department of Radiology, Chonnam National University Medical School, Gwangju 61469, Republic of Korea
- Department of Data Science, Chonnam National University, Gwangju 61186, Republic of Korea
| | - Seul Kee Kim
- Department of Radiology, Chonnam National University Medical School, Gwangju 61469, Republic of Korea
- Department of Radiology, Chonnam National University Hwasun Hospital, Hwasun-gun 58128, Republic of Korea
| |
Collapse
|
9
|
Won EJ, Kim HJ, Lee YJ, Kim MJ, Lee HI, Jang HH, Kim SH, Kang JH, Park KJ, Shim SC, Jo S, Kim TH, Kim TJ. CCL20 inhibition for treating inflammation in ankylosing spondylitis. Rheumatology (Oxford) 2023; 62:4000-4005. [PMID: 37279731 DOI: 10.1093/rheumatology/kead268] [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: 04/06/2023] [Revised: 05/23/2023] [Accepted: 05/26/2023] [Indexed: 06/08/2023] Open
Abstract
OBJECTIVES Th17 cells are known to play a significant role in AS. C-C motif chemokine ligand 20 (CCL20) binds to C-C chemokine receptor 6 (CCR6) on Th17 cells, promoting their migration to inflammation sites. The aim of this research is to examine the effectiveness of CCL20 inhibition in treating inflammation in AS. METHODS Mononuclear cells from peripheral blood (PBMC) and SF (SFMC) were collected from healthy individuals and AS. Flow cytometry was used to analyse cells producing inflammatory cytokines. CCL20 levels were determined using ELISA. The impact of CCL20 on Th17 cell migration was verified using a Trans-well migration assay. The in vivo efficacy of CCL20 inhibition was evaluated using an SKG mouse model. RESULTS The presence of Th17 cells and CCL20 expressing cells was higher in SFMCs from AS patients compared with their PBMCs. The CCL20 level in AS SF was significantly higher than in OA patients. The percentage of Th17 cells in PBMCs from AS patients increased when exposed to CCL20, whereas the percentage of Th17 cells in SFMCs from AS patients decreased when treated with CCL20 inhibitor. The migration of Th17 cells was found to be influenced by CCL20, and this effect was counteracted by the CCL20 inhibitor. In the SKG mouse model, the use of CCL20 inhibitor significantly reduced joint inflammation. CONCLUSION This research validates the critical role of CCL20 in AS and suggests that targeting CCL20 inhibition could serve as a novel therapeutic approach for AS treatment.
Collapse
Affiliation(s)
- Eun Jeong Won
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hui-Ju Kim
- Department of Biomedical Sciences, Graduate School of Chonnam National University, Gwangju, Republic of Korea
| | - Yu Jeong Lee
- Department of Biomedical Sciences, Graduate School of Chonnam National University, Gwangju, Republic of Korea
| | - Moon-Ju Kim
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Hae-In Lee
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Hyun Hee Jang
- Department of Biomedical Sciences, Graduate School of Chonnam National University, Gwangju, Republic of Korea
| | - Seong Hoon Kim
- Department of Biomedical Sciences, Graduate School of Chonnam National University, Gwangju, Republic of Korea
| | - Ji-Hyoun Kang
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Ki-Jeong Park
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Seung Cheol Shim
- Division of Rheumatology, Daejeon Rheumatoid & Degenerative Arthritis Center, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Sungsin Jo
- Hanyang University Institute for Rheumatology Research (HYIRR), Seoul, Republic of Korea
| | - Tae-Hwan Kim
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Republic of Korea
| | - Tae-Jong Kim
- Department of Biomedical Sciences, Graduate School of Chonnam National University, Gwangju, Republic of Korea
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| |
Collapse
|
10
|
Shin HJ, Yoon JY, Na YO, Lee JK, Kho BG, Kim TO, Kim YI, Lim SC, Jeong SH, Kwon YS. Major adverse cardiovascular events and hyperuricemia during tuberculosis treatment. PLoS One 2023; 18:e0294490. [PMID: 37972037 PMCID: PMC10653473 DOI: 10.1371/journal.pone.0294490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 10/31/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Hyperuricemia is common during tuberculosis (TB) treatment, especially in association with pyrazinamide (PZA). This study investigated the relationship between major adverse cardiovascular events (MACEs) and hyperuricemia during TB treatment. METHODS We conducted a single-center retrospective cohort study. From January 2010 through June 2017, we assessed all consecutive TB patients at Chonnam National University Hospital in South Korea. Hyperuricemia was defined as serum uric acid levels exceeding 7.0 mg/dL (men) and 6.0 mg/dL (women). RESULTS Of the 1,143 patients included, PZA was administered to 1,081 (94.6%), and hyperuricemia was detected in 941 (82.3%). Eight patients experienced MACEs. Multivariate analysis using logistic regression indicated that prior ischemic heart disease was associated with MACE development (OR,14.087; 95% CI,3.304-60.061; P < 0.000), while hyperuricemia was not (OR, 1.505; 95% CI, 0.184-12.299; P = 0.703). For patients without drug-resistant TB, the absence of hyperuricemia was associated with higher mortality (OR, 2.609; 95% CI, 1.066-6.389; P = 0.036), whereas hyperuricemia was associated with less worse outcomes (OR,0.316; 95% CI,0.173-0.576; P < 0.000). CONCLUSIONS Although most patients treated with PZA developed hyperuricemia, it was not associated with MACE development. Hyperuricemia during TB treatment was associated with better outcomes, possibly due to consistent adherence to TB treatment.
Collapse
Affiliation(s)
- Hong-Joon Shin
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
- Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Joon-Young Yoon
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Young-Ok Na
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Jae-Kyeong Lee
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Bo Gun Kho
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Tae-Ok Kim
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
- Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Yu-Il Kim
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
- Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sung-Chul Lim
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
- Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sae-Hee Jeong
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Yong-Soo Kwon
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
- Chonnam National University Medical School, Gwangju, Republic of Korea
| |
Collapse
|
11
|
Cho SG, Park KS, Kim J, Moon JB, Song HC, Kang TW, Yu SH. Tc-99m DMSA SPECT for Follow-Up of Non-Operative Treatments in Renal Injuries: A Prospective Single-Center Study. Korean J Radiol 2023; 24:1017-1027. [PMID: 37724588 PMCID: PMC10550745 DOI: 10.3348/kjr.2023.0149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/09/2023] [Accepted: 07/17/2023] [Indexed: 09/21/2023] Open
Abstract
OBJECTIVE The assessment of cortical integrity following renal injuries with planar Tc-99m dimercaptosuccinic acid (DMSA) scintigraphy depends on measuring relatively decreased cortical uptake (i.e., split renal function [SRF]). We analyzed the additive values of the volumetric and quantitative analyses of the residual cortical integrity using single-photon emission computed tomography (SPECT) compared to the planar scintigraphy. MATERIALS AND METHODS This prospective study included 47 patients (male:female, 32:15; age, 47 ± 22 years) who had non-operatively managed renal injuries and underwent DMSA planar and SPECT imaging 3-6 months after the index injury. In addition to planar SRF, SPECT SRF, cortical volume, and absolute cortical uptake were measured for the injured kidney and both kidneys together. The correlations of planar SRF with SPECT SRF and those of SRF with volumetric/quantitative parameters obtained with SPECT were analyzed. The association of SPECT parameters with renal function, grades of renal injuries, and the risk of renal failure was also analyzed. RESULTS SPECT SRF was significantly lower than planar SRF, with particularly higher biases in severe renal injuries. Planar and SPECT SRF (dichotomized with a cutoff of 45%) showed 19%-36% of discrepancies with volumetric and quantitative DMSA indices (when dichotomized as either high or low). Absolute cortical uptake of the injured kidney best correlated with glomerular filtration rate (GFR) at follow-up (ρ = 0.687, P < 0.001) with significant stepwise decreases by GFR strata (90 and 60 mL/min/1.73 m²). Total renal cortical uptake was significantly lower in patients with moderate-to-high risk of renal failure than those with low risk. However, SRF did not reflect GFR decrease below 60 mL/min/1.73 m² or the risk of renal failure, regardless of planar or SPECT (count- or volume-based SRF) imaging. CONCLUSION Quantitative measurements of renal cortical integrity assessed with DMSA SPECT can provide more clinically relevant and comprehensive information than planar imaging or SRF alone.
Collapse
Affiliation(s)
- Sang-Geon Cho
- Department of Nuclear Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ki Seong Park
- Department of Nuclear Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jahae Kim
- Department of Nuclear Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jang Bae Moon
- Department of Nuclear Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ho-Chun Song
- Department of Nuclear Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Taek Won Kang
- Department of Urology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Seong Hyeon Yu
- Department of Urology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea.
| |
Collapse
|
12
|
Kim CS, Oh TR, Suh SH, Choi HS, Bae EH, Ma SK, Kim B, Han K, Kim SW. Underweight status and development of end-stage kidney disease: A nationwide population-based study. J Cachexia Sarcopenia Muscle 2023; 14:2184-2195. [PMID: 37503821 PMCID: PMC10570067 DOI: 10.1002/jcsm.13297] [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: 09/30/2022] [Revised: 01/24/2023] [Accepted: 06/16/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Underweight status increases the risk of cardiovascular disease and mortality in the general population. However, whether underweight status is associated with an increased risk of developing end-stage kidney disease is unknown. METHODS A total of 9 845 420 participants aged ≥20 years who underwent health checkups were identified from the Korean National Health Insurance Service database and analysed. Individuals with underweight (body mass index [BMI] < 18.5 kg/m2 ) and obesity (BMI ≥ 25 kg/m2 ) were categorized according to the World Health Organization recommendations for Asian populations. RESULTS During a mean follow-up period of 9.2 ± 1.1 years, 26 406 participants were diagnosed with end-stage kidney disease. After fully adjusting for other potential predictors, the moderate to severe underweight group (<17 kg/m2 ) had a significantly higher risk of end-stage kidney disease than that of the reference (normal) weight group (adjusted hazard ratio, 1.563; 95% confidence interval, 1.337-1.828), and competing risk analysis to address the competing risk of death also showed the similar results (adjusted hazard ratio, 1.228; 95% confidence interval, 1.042-1.448). Compared with that of the reference BMI group (24-25 kg/m2 ), the adjusted hazard ratios for end-stage kidney disease increased as the BMI decreased by 1 kg/m2 . In the sensitivity analysis, sustained underweight status or progression to underweight status over two repeated health checkups, when compared with normal weight status, had a higher hazard ratio for end-stage kidney disease. CONCLUSIONS Underweight status is associated with an increased risk of end-stage kidney disease, and this association gradually strengthens as BMI decreases.
Collapse
Affiliation(s)
- Chang Seong Kim
- Department of Internal MedicineChonnam National University Medical SchoolGwangjuSouth Korea
- Department of Internal MedicineChonnam National University HospitalGwangjuSouth Korea
| | - Tae Ryom Oh
- Department of Internal MedicineChonnam National University Medical SchoolGwangjuSouth Korea
- Department of Internal MedicineChonnam National University HospitalGwangjuSouth Korea
| | - Sang Heon Suh
- Department of Internal MedicineChonnam National University Medical SchoolGwangjuSouth Korea
- Department of Internal MedicineChonnam National University HospitalGwangjuSouth Korea
| | - Hong Sang Choi
- Department of Internal MedicineChonnam National University Medical SchoolGwangjuSouth Korea
- Department of Internal MedicineChonnam National University HospitalGwangjuSouth Korea
| | - Eun Hui Bae
- Department of Internal MedicineChonnam National University Medical SchoolGwangjuSouth Korea
- Department of Internal MedicineChonnam National University HospitalGwangjuSouth Korea
| | - Seong Kwon Ma
- Department of Internal MedicineChonnam National University Medical SchoolGwangjuSouth Korea
- Department of Internal MedicineChonnam National University HospitalGwangjuSouth Korea
| | - Bongseong Kim
- Department of Statistics and Actuarial ScienceSoongsil UniversitySeoulSouth Korea
| | - Kyung‐Do Han
- Department of Statistics and Actuarial ScienceSoongsil UniversitySeoulSouth Korea
| | - Soo Wan Kim
- Department of Internal MedicineChonnam National University Medical SchoolGwangjuSouth Korea
- Department of Internal MedicineChonnam National University HospitalGwangjuSouth Korea
| |
Collapse
|
13
|
Kim DH, Jung YW, Jin BC, Oh HH, Song HY, Kim SJ, Myung DS, Kim SW, Lee J, Seo GS, Joo YE, Kim HS. Effectiveness and Safety of Endoscopic Submucosal Dissection for Colorectal Neoplasm in Patients with High Charlson Comorbidity Index Score: A HASID Multicenter Study. J Clin Med 2023; 12:6255. [PMID: 37834899 PMCID: PMC10573342 DOI: 10.3390/jcm12196255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/07/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
Endoscopic submucosal dissection (ESD) is an effective method for removing early colorectal lesions. However, research on the safety and efficacy of ESD in patients with various underlying conditions remains limited. This study retrospectively examined ESD outcomes in colorectal neoplasm patients from five tertiary medical centers. The Charlson Comorbidity Index (CCI) and age-adjusted CCI (ACCI) were analyzed, and the differences in complete resection and complication rates were analyzed. The CCI, ACCI, and complication rates tended to gradually increase proportionally, and the complication resection rate increased from CCI 2 to ACCI 4 as the starting point, followed by a decreasing trend. Of these, 140 patients (9.7%) had a CCI score of 3 or higher. The high CCI group was older (70.6% vs. 64.7%, p < 0.01) and had a higher proportion of men (70.7% vs. 58.7%, p < 0.01) than the low CCI group. The high CCI group had a higher incidence of cancer than the low CCI group (77.9% vs. 65.2%, p < 0.01). The en bloc resection rate (90.0% vs. 89.3%, p = 0.79) and complete resection rate (75.7% vs. 81.2%, p = 0.12) were not significantly different between the two groups. Colorectal ESD can be safely and effectively performed in patients with various underlying medical conditions.
Collapse
Affiliation(s)
- Dong-Hyun Kim
- Department of Internal Medicine, Medical School, Chonnam National University, Gwangju 61469, Republic of Korea; (D.-H.K.); (Y.-W.J.); (H.-H.O.); (Y.-E.J.)
| | - Yong-Wook Jung
- Department of Internal Medicine, Medical School, Chonnam National University, Gwangju 61469, Republic of Korea; (D.-H.K.); (Y.-W.J.); (H.-H.O.); (Y.-E.J.)
| | - Byung-Chul Jin
- Department of Internal Medicine, Medical School, Jeonbuk National University, Jeonju 54907, Republic of Korea; (B.-C.J.); (S.-W.K.)
| | - Hyung-Hoon Oh
- Department of Internal Medicine, Medical School, Chonnam National University, Gwangju 61469, Republic of Korea; (D.-H.K.); (Y.-W.J.); (H.-H.O.); (Y.-E.J.)
| | - Hyo-Yeop Song
- Department of Internal Medicine, Digestive Diseases Research Institute, School of Medicine, Wonkwang University, Iksan 54538, Republic of Korea; (H.-Y.S.); (G.-S.S.)
| | - Seong-Jung Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju 61452, Republic of Korea; (S.-J.K.); (J.L.)
| | - Dae-Seong Myung
- Department of Internal Medicine, Medical School, Chonnam National University, Gwangju 61469, Republic of Korea; (D.-H.K.); (Y.-W.J.); (H.-H.O.); (Y.-E.J.)
| | - Sang-Wook Kim
- Department of Internal Medicine, Medical School, Jeonbuk National University, Jeonju 54907, Republic of Korea; (B.-C.J.); (S.-W.K.)
| | - Jun Lee
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju 61452, Republic of Korea; (S.-J.K.); (J.L.)
| | - Geom-Seog Seo
- Department of Internal Medicine, Digestive Diseases Research Institute, School of Medicine, Wonkwang University, Iksan 54538, Republic of Korea; (H.-Y.S.); (G.-S.S.)
| | - Young-Eun Joo
- Department of Internal Medicine, Medical School, Chonnam National University, Gwangju 61469, Republic of Korea; (D.-H.K.); (Y.-W.J.); (H.-H.O.); (Y.-E.J.)
| | - Hyun-Soo Kim
- Department of Internal Medicine, Medical School, Chonnam National University, Gwangju 61469, Republic of Korea; (D.-H.K.); (Y.-W.J.); (H.-H.O.); (Y.-E.J.)
| |
Collapse
|
14
|
Choi J, Gang S, Ramalingam M, Hwang J, Jeong H, Yoo J, Cho HH, Kim BC, Jang G, Jeong HS, Jang S. BML-281 promotes neuronal differentiation by modulating Wnt/Ca 2+ and Wnt/PCP signaling pathway. Mol Cell Biochem 2023:10.1007/s11010-023-04857-2. [PMID: 37768498 DOI: 10.1007/s11010-023-04857-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023]
Abstract
Histone deacetylase (HDAC) inhibitors promote differentiation through post-translational modifications of histones. BML-281, an HDAC6 inhibitor, has been known to prevent tumors, acute dextran sodium sulfate-associated colitis, and lung injury. However, the neurogenic differentiation effect of BML-281 is poorly understood. In this study, we investigated the effect of BML-281 on neuroblastoma SH-SY5Y cell differentiation into mature neurons by immunocytochemistry (ICC), reverse transcriptase PCR (RT-PCR), quantitative PCR (qPCR), and western blotting analysis. We found that the cells treated with BML-281 showed neurite outgrowth and morphological changes into mature neurons under a microscope. It was confirmed that the gene expression of neuronal markers (NEFL, MAP2, Tuj1, NEFH, and NEFM) was increased with certain concentrations of BML-281. Similarly, the protein expression of neuronal markers (NeuN, Synaptophysin, Tuj1, and NFH) was upregulated with BML-281 compared to untreated cells. Following treatment with BML-281, the expression of Wnt5α increased, and downstream pathways were activated. Interestingly, both Wnt/Ca2+ and Wnt/PCP pathways activated and regulated PKC, Cdc42, RhoA, Rac1/2/3, and p-JNK. Therefore, BML-281 induces the differentiation of SH-SY5Y cells into mature neurons by activating the non-canonical Wnt signaling pathway. From these results, we concluded that BML-281 might be a novel drug to differentiation into neuronal cells through the regulation of Wnt signaling pathway to reduce the neuronal cell death.
Collapse
Affiliation(s)
- Jiyun Choi
- Department of Physiology, Chonnam National University Medical School, Jellanamdo, 58128, Republic of Korea
| | - Seoyeon Gang
- Department of Physiology, Chonnam National University Medical School, Jellanamdo, 58128, Republic of Korea
- Department of Pre-Medical Science, Chonnam National University Medical School, Jellanamdo, 58128, Republic of Korea
| | - Mahesh Ramalingam
- Department of Physiology, Chonnam National University Medical School, Jellanamdo, 58128, Republic of Korea
| | - Jinsu Hwang
- Department of Physiology, Chonnam National University Medical School, Jellanamdo, 58128, Republic of Korea
| | - Haewon Jeong
- Department of Physiology, Chonnam National University Medical School, Jellanamdo, 58128, Republic of Korea
| | - Jin Yoo
- Department of Physiological Education, Chonnam National University, Gwangju, 61186, Republic of Korea
| | - Hyong-Ho Cho
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, 61469, Republic of Korea
| | - Byeong C Kim
- Department of Neurology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, 61469, Republic of Korea
| | - Geupil Jang
- School of Biological Sciences and Technology, Chonnam National University, Gwangju, 61186, Republic of Korea
| | - Han-Seong Jeong
- Department of Physiology, Chonnam National University Medical School, Jellanamdo, 58128, Republic of Korea.
| | - Sujeong Jang
- Department of Physiology, Chonnam National University Medical School, Jellanamdo, 58128, Republic of Korea.
| |
Collapse
|
15
|
Hwang J, Jang S, Kim C, Lee S, Jeong HS. Role of Stem Cell-Derived Exosomes and microRNAs in Spinal Cord Injury. Int J Mol Sci 2023; 24:13849. [PMID: 37762150 PMCID: PMC10530823 DOI: 10.3390/ijms241813849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 08/30/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
Neurological disorders represent a global health problem. Current pharmacological treatments often lead to short-term symptomatic relief but have dose-dependent side effects, such as inducing orthostatic arterial hypotension due to the blockade of alpha receptors, cardiotoxic effects due to impaired repolarization, and atrioventricular block and tachycardia, including ventricular fibrillation. These challenges have driven the medical community to seek effective treatments for this serious global health threat. Mesenchymal stem cells (MSCs) are pluripotent cells with anti-inflammatory, anti-apoptotic, and immunomodulatory properties, providing a promising alternative due to their ability to differentiate, favorable culture conditions, in vitro manipulation ability, and robust properties. Although MSCs themselves rarely differentiate into neurons at the site of injury after transplantation in vivo, paracrine factors secreted by MSCs can create environmental conditions for cell-to-cell communication and have shown therapeutic effects. Recent studies have shown that the pleiotropic effects of MSCs, particularly their immunomodulatory potential, can be attributed primarily to these paracrine factors. Exosomes derived from MSCs are known to play an important role in these effects. Many studies have evaluated the potential of exosome-based therapies for the treatment of various neurological diseases. In addition to exosomes, various miRNAs derived from MSCs have been identified to regulate genes and alleviate neuropathological changes in neurodegenerative diseases. This review explores the burgeoning field of exosome-based therapies, focusing on the effects of MSC-derived exosomes and exosomal miRNAs, and summarizes recent findings that shed light on the potential of exosomes in the treatment of neurological disorders. The insights gained from this review may pave the way for innovative and effective treatments for these complex conditions. Furthermore, we suggest the therapeutic effects of exosomes and exosomal miRNAs from MSCs, which have a rescue potential in spinal cord injury via diverse signaling pathways.
Collapse
Affiliation(s)
- Jinsu Hwang
- Department of Physiology, Chonnam National University Medical School, Hwasun 58128, Republic of Korea; (J.H.); (S.J.)
| | - Sujeong Jang
- Department of Physiology, Chonnam National University Medical School, Hwasun 58128, Republic of Korea; (J.H.); (S.J.)
| | - Choonghyo Kim
- Department of Neurosurgery, Kangwon National University School of Medicine, Chuncheon 24341, Republic of Korea;
| | - Sungjoon Lee
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea;
| | - Han-Seong Jeong
- Department of Physiology, Chonnam National University Medical School, Hwasun 58128, Republic of Korea; (J.H.); (S.J.)
| |
Collapse
|
16
|
Kim JM, Nam TS, Choi SM, Kim BC, Lee SH. Clinical value of vestibulo-ocular reflex in the differentiation of spinocerebellar ataxias. Sci Rep 2023; 13:14783. [PMID: 37679515 PMCID: PMC10485070 DOI: 10.1038/s41598-023-41924-6] [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: 06/20/2023] [Accepted: 09/04/2023] [Indexed: 09/09/2023] Open
Abstract
The diagnosis of spinocerebellar ataxia (SCA) currently depends upon genetic testing. Although genetic testing for SCA is highly specific, clinical parameters for the differentiation of SCAs are still insufficient. We aimed to assess the vestibulo-ocular reflex (VOR) parameters of various SCA subtypes to determine whether they have substantial value in differential diagnosis. We consecutively enrolled 33 genetically confirmed SCA patients (SCA2 = 8, SCA3 = 6, SCA6 = 10, SCA7 = 9). Normative data were obtained from 36 age- and gender-matched healthy controls. Quantitative indicators of VOR were measured using video head impulse test (HIT) and combined ocular motor dysfunctions were investigated using video-oculography. Compared with the control group, the VOR gains in SCA2 were relatively spared, but were markedly decreased for all six canals in SCA3. The VOR gains for the posterior canals (PCs) were significantly decreased in SCA6, and for both vertical canals were decreased in SCA7. The VOR gains for the horizontal canals in SCA3 were negatively correlated with disease severity (R = -0.900, p = 0.037). Abnormal catch-up saccades were common in SCA3 and SCA6, rare in SCA7 and absent in SCA2. Spontaneous, headshaking-induced, and positional nystagmus were only documented in SCA6. SCA3 and SCA6 commonly showed horizontal gaze-evoked nystagmus, but SCA2 and SCA7 had characteristic saccadic slowing without gaze-evoked nystagmus. VOR impairments are common in SCAs, but their patterns vary depending on subtype. In addition to ocular motor characteristics, distinctive VOR performance for each subtype using video HIT may aid the differential diagnosis of the SCA genotypes.
Collapse
Affiliation(s)
- Jae-Myung Kim
- Department of Neurology, Chonnam National University Hospital, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju, 61469, Korea
| | - Tai-Seung Nam
- Department of Neurology, Chonnam National University Hospital, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju, 61469, Korea
| | - Seong-Min Choi
- Department of Neurology, Chonnam National University Hospital, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju, 61469, Korea
| | - Byeong C Kim
- Department of Neurology, Chonnam National University Hospital, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju, 61469, Korea
| | - Seung-Han Lee
- Department of Neurology, Chonnam National University Hospital, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju, 61469, Korea.
| |
Collapse
|
17
|
Kim J, Song SH, Oh TR, Suh SH, Choi HS, Kim CS, Ma SK, Kim SW, Bae EH. Prognostic role of the neutrophil-to-lymphocyte ratio in patients with chronic kidney disease. Korean J Intern Med 2023; 38:725-733. [PMID: 37586809 PMCID: PMC10493449 DOI: 10.3904/kjim.2023.171] [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: 04/14/2023] [Revised: 06/05/2023] [Accepted: 06/12/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND/AIMS The neutrophil-to-lymphocyte ratio (NLR) has a prognostic value in cardiovascular disease, infection, inflammatory disease, and several malignancies. Therefore, the NLR has a possible predictive value in patients with chronic kidney disease (CKD), but this predictive value has not been validated. Here, we aimed to investigate the possibility of NLR as a predictor of CKD progression. METHODS This retrospective observational study included 141 patients with non-dialysis CKD. The participants were divided into terciles (T1, T2, and T3) according to NLR. The primary outcome was defined as a composite kidney event, which included a decline in the estimated glomerular filtration rate (eGFR) of at least 50% or initiation of renal replacement therapy during the follow-up period. RESULTS The mean follow-up duration was 5.45 ± 2.11 years. The mean NLRs were 1.35 ± 0.05 in T1 (n = 47), 2.16 ± 0.04 in T2 (n = 47), and 4.29 ± 0.73 in T3 (n = 47). The group with the highest NLR (T3) had higher baseline CKD and serum creatinine and lower eGFR levels than the group with the lowest NLR (T1). The cumulative incidence rate of composite kidney events was significantly higher in T3 compared with T1 (p < 0.001, log-rank test). Cox regression analysis revealed that high NLR was associated with the risk of composite kidney events (adjusted hazard ratio, 3.33; 95% confidence interval, 1.43-7.76). CONCLUSION A higher NLR reflects the more advanced stage of CKD and suggests a role for NLR as a biomarker for predicting CKD progression.
Collapse
Affiliation(s)
- Jin Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Su Hyun Song
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Tae Ryom Oh
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Sang Heon Suh
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Hong Sang Choi
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Chang Seong Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Seong Kwon Ma
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Soo Wan Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Eun Hui Bae
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| |
Collapse
|
18
|
Lee KH, Park HW. Low-dose non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation. Korean J Intern Med 2023; 38:583-594. [PMID: 37680096 PMCID: PMC10493442 DOI: 10.3904/kjim.2023.035] [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: 01/24/2023] [Revised: 06/14/2023] [Accepted: 08/03/2023] [Indexed: 09/09/2023] Open
Abstract
In the last decade, non-vitamin K antagonist oral anticoagulants (NOACs), a new generation of OACs, were introduced to prevent thromboembolism in patients with atrial fibrillation. Although vitamin K-dependent anticoagulants have long been used as OACs, their inherent disadvantage of considerable bleeding complications has limited their use. NOACs demonstrate similar or superior clinical outcomes to those of warfarin. Although strict dose reduction criteria are recommended for NOACs, low-dose NOACs are frequently utilized, especially in Asian patients. Low-dose NOACs have shown clinical outcomes similar to those of warfarin in randomized controlled trials (RCTs) and real-world studies. However, off-label low-dose NOACs have shown inconsistent results compared with standard-dose NOACs and warfarin. Therefore, strict dose reduction criteria for NOACs should be followed until RCTs confirm the issues associated with NOAC underdosing.
Collapse
Affiliation(s)
- Ki Hong Lee
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea
- Department of Cardiovascular Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Hyung Wook Park
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea
- Department of Cardiovascular Medicine, Chonnam National University Medical School, Gwangju, Korea
| |
Collapse
|
19
|
Kim MS, Ahn YS, Lee SH, Jeong HJ, Kim YK, Oh JH. Can convertible metal-backed glenoid components replace cemented polyethylene glenoid components in anatomical total shoulder arthroplasty? BMC Surg 2023; 23:193. [PMID: 37407984 DOI: 10.1186/s12893-023-02092-6] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 06/25/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Anatomical total shoulder arthroplasty (aTSA) has been used to manage degenerative diseases such as primary osteoarthritis. An increase in the use of this procedure has led to several developments in humeral and glenoid components to improve patient outcomes. This study aimed to compare clinical and radiological outcomes of the newly-introduced convertible metal-backed glenoid components with cemented polyethylene glenoid components in aTSA, and to determine whether the new component would be comparable to a conventional one for reducing the burden of future revision or conversion surgeries. METHODS Medical records of fifty patients who underwent aTSA with at least two years of follow-up were retrospectively reviewed. Eighteen patients received convertible metal-backed glenoid components with vitamin E1-coated liner (MB group), while thirty-two patients received conventional cemented polyethylene glenoid components (PE group). Pre- and postoperative clinical and radiological outcomes (acromion-greater tuberosity angle [AGA] and humeral lateral offset [LO]) at final follow-up were assessed. Radiolucent lines (RLLs) and loosening around the humeral and glenoid components were also evaluated. RESULTS Clinical outcomes improved after surgery in both groups (all p < 0.001). The arc of rotation measured by AGA improved postoperatively in both groups (all p < 0.001), and AGA and LO were not different according to the type of glenoid components (all p > 0.05). Overall complication rates including RLLs of PE and MB groups were 43.8% (14/32) and 16.7% (3/18), respectively (p = 0.031). Although the PE group had more RLLs than did the MB group (p < 0.05), related symptoms and/or glenoid implant loosening were not observed in both groups. Subscapularis failure occurred in two patients in the PE group and in one in the MB group. CONCLUSION The convertible metal-backed glenoid implant with vitamin E1-coated liner may be a good alternative for considering the potential for an easier conversion to reverse total shoulder arthroplasty.
Collapse
Affiliation(s)
- Myung-Sun Kim
- Department of Orthopaedic Surgery, Chonnam National University College of Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Yeong-Seub Ahn
- Department of Orthopaedic Surgery, Chonnam National University College of Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
- Department of Orthopaedic Surgery, Good Morning General Hospital, Pyeongtaek, Republic of Korea
| | - Sun-Ho Lee
- Department of Orthopaedic Surgery, Chonnam National University College of Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Hyeon Jang Jeong
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Young Kyu Kim
- Department of Orthopaedic Surgery, Daejin Medical Center Bundang Jesaeng General Hospital, Seongnam, Republic of Korea
| | - Joo Han Oh
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
| |
Collapse
|
20
|
Jung MH, Ihm SH. Obesity-related hypertension and chronic kidney disease: from evaluation to management. Kidney Res Clin Pract 2023; 42:431-444. [PMID: 37551125 PMCID: PMC10407638 DOI: 10.23876/j.krcp.23.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/14/2023] [Accepted: 06/15/2023] [Indexed: 08/09/2023] Open
Abstract
With the recent obesity pandemic, obesity-related hypertension and its complications (e.g., heart failure, coronary disease, and chronic kidney disease [CKD]) are gaining attention in clinical and research fields. Obesity-related hypertension frequently precedes the onset of CKD and aggravates its progression. In this review, we discuss the role of visceral fat in the pathophysiology of obesity-related hypertension and the potential therapeutic strategies for its prevention and management. Various factors, including the sympathetic nervous system, renin-angiotensin-aldosterone system, and inflammatory pathways, are intricately involved in the pathogenesis of obesity-related hypertension. These factors individually and jointly contribute to the development of hypertension (usually sodium-sensitive or resistant hypertension) and, ultimately, to the progression of CKD. From a clinical standpoint, a decline in renal function in advanced CKD further makes blood pressure control challenging since only a few options are available for blood pressure-lowering medications. Proactive lifestyle modification, pharmacological treatment for obesity, and bariatric surgery can be considered for obesity control and management. Furthermore, intensive blood pressure control is required to prevent and halt the development and progression of CKD.
Collapse
Grants
- 2011E3300300, 2012E3301100, 2013E3301600, 2013E3301601, 2013E3301602, 2016E3300200, 2016E330 0201, 2016E3300202,2019E320100, 2019E320101, 2019 E320102, 2022-11-007 Korea Disease Control and Prevention Agency
- NRF-2019R1A2C2086276 National Research Foundation of Korea
- BCRI22042, BCRI22079 Chonnam National University Hospital Biomedical Research Institute
Collapse
Affiliation(s)
- Mi-Hyang Jung
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sang-Hyun Ihm
- Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Division of Cardiology, Department of Internal Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| |
Collapse
|
21
|
Sung MS, Kim SY, Eom GH, Park SW. High VEGF Concentrations Accelerate Human Trabecular Meshwork Fibrosis in a TAZ-Dependent Manner. Int J Mol Sci 2023; 24:ijms24119625. [PMID: 37298577 DOI: 10.3390/ijms24119625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 05/31/2023] [Accepted: 05/31/2023] [Indexed: 06/12/2023] Open
Abstract
We aimed to investigate the effects of different concentrations of vascular endothelial growth factor (VEGF) on the extracellular matrix (ECM) and fibrotic proteins in human trabecular meshwork (TM) cells. We also explored how the Yes-associated protein (YAP)/transcriptional co-activator with PDZ-binding motif (TAZ) signaling pathway modulates VEGF-induced fibrosis. We determined cross-linked actin network (CLAN) formation using TM cells. Changes in fibrotic and ECM protein expression were determined. High VEGF concentrations (10 and 30 ng/mL) increased TAZ and decreased p-TAZ/TAZ expression in TM cells. Western blotting and real-time PCR revealed no YAP expression changes. Fibrotic and ECM protein expression decreased at low VEGF concentrations (1 and 10 ρg/mL) and significantly increased at high VEGF concentrations (10 and 30 ng/mL). CLAN formation increased in TM cells treated with high VEGF concentrations. Moreover, TAZ inhibition by verteporfin (1 μM) rescued TM cells from high-VEGF-concentration-induced fibrosis. Low VEGF concentrations reduced fibrotic changes, whereas high VEGF concentrations accelerated fibrosis and CLAN formations in TM cells in a TAZ-dependent manner. These findings reflect the dose-dependent influences of VEGF on TM cells. Moreover, TAZ inhibition might be a therapeutic target for VEGF-induced TM dysfunction.
Collapse
Affiliation(s)
- Mi Sun Sung
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju 61469, Republic of Korea
| | - So Young Kim
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju 61469, Republic of Korea
| | - Gwang Hyeon Eom
- Department of Pharmacology, Chonnam National University Medical School, Hwasun 58128, Republic of Korea
| | - Sang Woo Park
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju 61469, Republic of Korea
| |
Collapse
|
22
|
Park KJ, Jin HM, Cho YN, Yoon JH, Kee SJ, Kim HS, Park YW. Altered Frequency, Activation, and Clinical Relevance of Circulating Innate and Innate-Like Lymphocytes in Patients With Alcoholic Liver Cirrhosis. Immune Netw 2023; 23:e22. [PMID: 37416928 PMCID: PMC10320422 DOI: 10.4110/in.2023.23.e22] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/22/2023] [Accepted: 03/25/2023] [Indexed: 07/08/2023] Open
Abstract
Alcoholic liver cirrhosis (ALC) is caused by chronic alcohol overconsumption and might be linked to dysregulated immune responses in the gut-liver axis. However, there is a lack of comprehensive research on levels and functions of innate lymphocytes including mucosal-associated invariant T (MAIT) cells, NKT cells, and NK (NK) cells in ALC patients. Thus, the aim of this study was to examine the levels and function of these cells, evaluate their clinical relevance, and explore their immunologic roles in the pathogenesis of ALC. Peripheral blood samples from ALC patients (n = 31) and healthy controls (HCs, n = 31) were collected. MAIT cells, NKT cells, NK cells, cytokines, CD69, PD-1, and lymphocyte-activation gene 3 (LAG-3) levels were measured by flow cytometry. Percentages and numbers of circulating MAIT cells, NKT cells, and NK cells were significantly reduced in ALC patients than in HCs. MAIT cell exhibited increased production of IL-17 and expression levels of CD69, PD-1, and LAG-3. NKT cells displayed decreased production of IFN-γ and IL-4. NK cells showed elevated CD69 expression. Absolute MAIT cell levels were positively correlated with lymphocyte count but negatively correlated with C-reactive protein. In addition, NKT cell levels were negatively correlated with hemoglobin levels. Furthermore, log-transformed absolute MAIT cell levels were negatively correlated with the Age, Bilirubin, INR, and Creatinine score. This study demonstrates that circulating MAIT cells, NKT cells, and NK cells are numerically deficient in ALC patients, and the degree of cytokine production and activation status also changed. Besides, some of their deficiencies are related to several clinical parameters. These findings provide important information about immune responses of ALC patients.
Collapse
Affiliation(s)
- Ki-Jeong Park
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Hye-Mi Jin
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Young-Nan Cho
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Jae Hyun Yoon
- Department of Gastroenterology and Hepatology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Seung-Jung Kee
- Department of Laboratory Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Hyo-Sin Kim
- Department of Surgery, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Yong-Wook Park
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| |
Collapse
|
23
|
Akanda MR, Ahn EJ, Kim YJ, Salam SMA, Noh MG, Lee TK, Kim SS, Lee KH, Moon KS. Analysis of stromal PDGFR-β and α-SMA expression and their clinical relevance in brain metastases of breast cancer patients. BMC Cancer 2023; 23:468. [PMID: 37217880 DOI: 10.1186/s12885-023-10957-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 05/13/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Breast cancer brain metastasis (BCBM) is a growing therapeutic challenge and clinical concern. Stromal cancer-associated fibroblasts (CAFs) are crucial factors in the modulation of tumorigeneses and metastases. Herein, we investigated the relationship between the expression of stromal CAF markers in metastatic sites, platelet-derived growth factor receptor-beta (PDGFR-β), and alpha-smooth muscle actin (α-SMA) and the clinical and prognostic variables in BCBM patients. METHODS Immunohistochemistry (IHC) of the stromal expression of PDGFR-β and α-SMA was performed on 50 cases of surgically resected BCBM. The expression of the CAF markers was analyzed in the context of clinico-pathological characteristics. RESULTS Expression of PDGFR-β and α-SMA was lower in the triple-negative (TN) subtype than in other molecular subtypes (p = 0.073 and p = 0.016, respectively). And their expressions were related to a specific pattern of CAF distribution (PDGFR-β, p = 0.009; α-SMA, p = 0.043) and BM solidity (p = 0.009 and p = 0.002, respectively). High PDGFR-β expression was significantly related to longer recurrence-free survival (RFS) (p = 0.011). TN molecular subtype and PDGFR-β expression were independent prognostic factors of recurrence-free survival (p = 0.029 and p = 0.030, respectively) and TN molecular subtype was an independent prognostic factor of overall survival (p < 0.001). CONCLUSIONS Expression of PDGFR-β in the stroma of BM was associated with RFS in BCBM patients, and the clinical implication was uniquely linked to the low expression of PDGFR-β and α-SMA in the aggressive form of the TN subtype.
Collapse
Affiliation(s)
- Md Rashedunnabi Akanda
- Department of Pathology, Chonnam National University Research Institute of Medical Science, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro, Hwasun-eup, Hwasun-gun, 58128, Jeollanam-do, South Korea
- Department of Pharmacology and Toxicology, Sylhet Agricultural University, Sylhet, Bangladesh
| | - Eun-Jung Ahn
- Department of Neurosurgery, Chonnam National University Research Institute of Medical Science, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro, Hwasun-eup, Hwasun-gun, 58128, Jeollanam-do, South Korea
| | - Yeong Jin Kim
- Department of Neurosurgery, Chonnam National University Research Institute of Medical Science, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro, Hwasun-eup, Hwasun-gun, 58128, Jeollanam-do, South Korea
| | - S M Abdus Salam
- Department of Pathology, Chonnam National University Research Institute of Medical Science, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro, Hwasun-eup, Hwasun-gun, 58128, Jeollanam-do, South Korea
| | - Myung-Giun Noh
- Department of Pathology, Chonnam National University Research Institute of Medical Science, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro, Hwasun-eup, Hwasun-gun, 58128, Jeollanam-do, South Korea
| | - Tae-Kyu Lee
- Department of Neurosurgery, Chonnam National University Research Institute of Medical Science, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro, Hwasun-eup, Hwasun-gun, 58128, Jeollanam-do, South Korea
| | - Sung Sun Kim
- Department of Pathology, Chonnam National University Research Institute of Medical Science, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro, Hwasun-eup, Hwasun-gun, 58128, Jeollanam-do, South Korea
| | - Kyung-Hwa Lee
- Department of Pathology, Chonnam National University Research Institute of Medical Science, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro, Hwasun-eup, Hwasun-gun, 58128, Jeollanam-do, South Korea.
- BioMedical Sciences Graduate Program (BMSGP), Chonnam National University, Hwasun, Jeollanam-do, South Korea.
| | - Kyung-Sub Moon
- Department of Neurosurgery, Chonnam National University Research Institute of Medical Science, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro, Hwasun-eup, Hwasun-gun, 58128, Jeollanam-do, South Korea.
| |
Collapse
|
24
|
Suh SH, Oh TR, Choi HS, Kim CS, Bae EH, Ma SK, Oh KH, Hyun YY, Sung S, Kim SW. Urinary Phosphorus Excretion and Cardiovascular Outcomes in Patients with Pre-Dialysis Chronic Kidney Disease: The KNOW-CKD Study. Nutrients 2023; 15:nu15102267. [PMID: 37242150 DOI: 10.3390/nu15102267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/08/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
The relationship between 24-h urinary phosphorus excretion (24 h UPE) and cardiovascular disease in patients with pre-dialysis chronic kidney disease (CKD) has rarely been studied, despite the fact that the relationship between serum phosphorus level and the risk of a cardiovascular event is well established. A total of 1701 patients with pre-dialysis CKD were finally included for the analyses and were divided into tertiles by 24 h UPE (first tertile (T1, 349.557 (mean) ± 88.413 (standard deviation)), second tertile (T2, 557.530 ± 50.738), and third tertile (T3, 851.695 ± 171.593). The study outcome was a six-point major adverse cardiac event (MACE). The median follow-up duration was 7.992 years. Kaplan-Meier curve analysis visualized that the cumulative incidences of a six-point MACE (p = 0.029) significantly differed from 24 h UPE levels, as the incidence rate of the study outcomes was highest in T1 and lowest in T3. Cox proportional hazard models unveiled that, compared to T1, the risk of a six-point MACE was significantly decreased in T3 (adjusted hazard ratio (HR) 0.376, 95% confidence interval (CI) 0.207 to 0.683). The restricted cubic spline curve analysis visualized an inverted S-shaped association between 24 h UPE level and the risk of a six-point MACE, indicating a significantly increased risk of a six-point MACE in patients with a low 24 h UPE level. In conclusion, low 24 h UPE is associated with adverse cardiovascular outcomes in patients with CKD. Our finding emphasizes that low 24 h UPE should not be a reliable marker for dietary restriction of phosphorus that essentially leads to better outcomes in patients with CKD.
Collapse
Grants
- 2011E3300300, 2012E3301100, 2013E3301600, 2013E3301601, 2013E3301602, 2016E3300200, 2016E3300201, 2016E3300202, 2019E320100, 2019E320101, 2019E320102 and 2022-11-007 the Research Program funded by the Korea Disease Control and Prevention Agency
- NRF-2019R1A2C2086276 the National Research Foundation of Korea (NRF) funded by the Korea government (MSIT)
- BCRI22079, BCRI22042 Chonnam National University Hospital Biomedical Research Institute
Collapse
Affiliation(s)
- Sang Heon Suh
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju 61469, Republic of Korea
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju 61469, Republic of Korea
| | - Tae Ryom Oh
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju 61469, Republic of Korea
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju 61469, Republic of Korea
| | - Hong Sang Choi
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju 61469, Republic of Korea
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju 61469, Republic of Korea
| | - Chang Seong Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju 61469, Republic of Korea
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju 61469, Republic of Korea
| | - Eun Hui Bae
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju 61469, Republic of Korea
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju 61469, Republic of Korea
| | - Seong Kwon Ma
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju 61469, Republic of Korea
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju 61469, Republic of Korea
| | - Kook-Hwan Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Young Youl Hyun
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea
| | - Suah Sung
- Department of Internal Medicine, Eulji Medical Center, Eulji University, Seoul 01830, Republic of Korea
| | - Soo Wan Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju 61469, Republic of Korea
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju 61469, Republic of Korea
| |
Collapse
|
25
|
Choi J, Hwang J, Ramalingam M, Jeong HS, Jang S. Effects of HDAC inhibitors on neuroblastoma SH-SY5Y cell differentiation into mature neurons via the Wnt signaling pathway. BMC Neurosci 2023; 24:28. [PMID: 37127577 PMCID: PMC10152798 DOI: 10.1186/s12868-023-00798-0] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 04/19/2023] [Indexed: 05/03/2023] Open
Abstract
Histone deacetylase (HDAC) inhibitors affect cell homeostasis, gene expression, and cell cycle progression and promote cell terminal differentiation or apoptosis. However, the effect of HDAC inhibition on SH-SY5Y cells, which are neuroblastoma cells capable of differentiating into neurons under specific conditions, such as in the presence of retinoic acid (RA), is unknown. In this study, we hypothesized that HDAC inhibitors induced the neuronal differentiation of SH-SY5Y cells. To test this hypothesis, we used phase contrast microscopy, immunocytochemistry (ICC), qPCR, and western blotting analysis. MS-275 and valproic acid (VPA), two HDAC inhibitors, were selected to evaluate neuronal differentiation. It was confirmed that cells treated with MS-275 or VPA differentiated into mature neurons, which were distinguished by bipolar or multipolar morphologies with elongated branches. In addition, the mRNA expression of neuronal markers (Tuj1 and NEFH) and the oligodendrocyte marker (CNP) was significantly increased with MS-275 or VPA treatment compared to that with RA treatment. In addition, the protein expression of the other neuronal markers, Tuj1 and NeuN, was highly increased with HDAC inhibitor treatments compared to that with RA treatment. Furthermore, we confirmed that noncanonical Wnt signaling was upregulated by HDAC inhibitors via MAPK signaling and the Wnt/JNK pathway. Therefore, both MS-275 and VPA promoted the differentiation of SH-SY5Y cells into mature neurons via the Wnt signaling pathway.
Collapse
Affiliation(s)
- Jiyun Choi
- Department of Physiology, Chonnam National University Medical School, Hwasun-gun, Jellanamdo, 58128, Republic of Korea
| | - Jinsu Hwang
- Department of Physiology, Chonnam National University Medical School, Hwasun-gun, Jellanamdo, 58128, Republic of Korea
| | - Mahesh Ramalingam
- Department of Physiology, Chonnam National University Medical School, Hwasun-gun, Jellanamdo, 58128, Republic of Korea
| | - Han-Seong Jeong
- Department of Physiology, Chonnam National University Medical School, Hwasun-gun, Jellanamdo, 58128, Republic of Korea.
| | - Sujeong Jang
- Department of Physiology, Chonnam National University Medical School, Hwasun-gun, Jellanamdo, 58128, Republic of Korea.
| |
Collapse
|
26
|
Park JS, Cho KH, Hong YJ, Kim MC, Sim DS, Kim JH, Ahn Y, Jeong MH. Baseline Lipoprotein(a) Levels and Long-Term Cardiovascular Outcomes After Acute Myocardial Infarction. J Korean Med Sci 2023; 38:e102. [PMID: 37012687 PMCID: PMC10070047 DOI: 10.3346/jkms.2023.38.e102] [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: 08/03/2022] [Accepted: 12/27/2022] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Lipoprotein(a) is a known independent risk factor for atherosclerotic cardiovascular disease. However, the prognostic impact of the baseline lipoprotein(a) levels on long-term clinical outcomes among patients with acute myocardial infarction remain unclear. METHODS We analyzed 1,908 patients with acute myocardial infarction from November 2011 to October 2015 from a single center in Korea. They were divided into 3 groups according to their baseline lipoprotein(a) levels: groups I (< 30 mg/dL, n = 1,388), II (30-49 mg/dL, n = 263), and III (≥50 mg/dL, n = 257). Three-point major adverse cardiovascular events (a composite of nonfatal myocardial infarction, nonfatal stroke, and cardiac death) at 3 years were compared among the 3 groups. RESULTS The patients were followed for 1094.0 (interquartile range, 1,033.8-1,095.0) days, during which a total of 326 (17.1%) three-point major adverse cardiovascular events occurred. Group III had higher rates of three-point major adverse cardiovascular events compared with Group I (23.0% vs. 15.7%; log-rank P = 0.009). In the subgroup analysis, group III had higher rates of three-point major adverse cardiovascular events compared with group I in patients with non-ST-segment elevation myocardial infarction (27.0% vs. 17.1%; log-rank P = 0.006), but not in patients with ST-segment elevation myocardial infarction (14.4% vs. 13.3%; log-rank P = 0.597). However, in multivariable Cox time-to-event models, baseline lipoprotein(a) levels were not associated with an increased incidence of three-point major adverse cardiovascular events, regardless of the type of acute myocardial infarction. Sensitivity analyses in diverse subgroups showed similar findings to those of the main analysis. CONCLUSION Baseline lipoprotein(a) levels in Korean patients with acute myocardial infarction were not independently associated with increased major adverse cardiovascular events at 3 years.
Collapse
Affiliation(s)
- Joon Sung Park
- Department of Cardiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Kyung Hoon Cho
- Department of Cardiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Young Joon Hong
- Department of Cardiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
| | - Min Chul Kim
- Department of Cardiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Doo Sun Sim
- Department of Cardiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Ju Han Kim
- Department of Cardiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Youngkeun Ahn
- Department of Cardiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Myung Ho Jeong
- Department of Cardiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| |
Collapse
|
27
|
Park KS, Moon JB, Cho SG, Kim J, Song HC. Applying Pix2pix to Translate Hyperemia in Blood Pool Image into Corresponding Increased Bone Uptake in Delayed Image in Three-Phase Bone Scintigraphy. Nucl Med Mol Imaging 2023; 57:103-109. [PMID: 36998587 PMCID: PMC10043061 DOI: 10.1007/s13139-022-00786-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 11/24/2022] [Accepted: 12/15/2022] [Indexed: 01/04/2023] Open
Abstract
Purpose Delayed images may not be acquired due to severe pain, drowsiness, or worsening vital signs while waiting after blood pool imaging in three-phase bone scintigraphy. If the hyperemia in the blood pool image contains information from which increased uptake on the delayed images can be inferred, the generative adversarial network (GAN) can generate the increased uptake from the hyperemia. We attempted to apply pix2pix, a type of conditional GAN, to transform hyperemia into increased bone uptake. Methods We enrolled 1464 patients who underwent three-phase bone scintigraphy for inflammatory arthritis, osteomyelitis, complex regional pain syndrome (CRPS), cellulitis, and recent bone injury. Blood pool images were acquired 10 min after intravenous injection of Tc-99 m hydroxymethylene diphosphonate, and delayed bone images were obtained after 3 h. The model was based on the open-source code of the pix2pix model with perceptual loss. Increased uptake in the delayed images generated by the model was evaluated using lesion-based analysis by a nuclear radiologist in areas consistent with hyperemia in the blood pool images. Results The model showed sensitivities of 77.8% and 87.5% for inflammatory arthritis and CRPS, respectively. In osteomyelitis and cellulitis, their sensitivities of about 44% were observed. However, in cases of recent bone injury, the sensitivity was only 6.3% in areas consistent with focal hyperemia. Conclusion The model based on pix2pix generated increased uptake in delayed images matching the hyperemia in the blood pool image in inflammatory arthritis and CRPS.
Collapse
Affiliation(s)
- Ki Seong Park
- Department of Nuclear Medicine, Chonnam National University Hospital, 42 Jaebong-Ro, Dong-Gu, Gwangju, 61469 Republic of Korea
| | - Jang Bae Moon
- Department of Nuclear Medicine, Chonnam National University Hospital, 42 Jaebong-Ro, Dong-Gu, Gwangju, 61469 Republic of Korea
| | - Sang-Geon Cho
- Department of Nuclear Medicine, Chonnam National University Hospital, 42 Jaebong-Ro, Dong-Gu, Gwangju, 61469 Republic of Korea
| | - Jahae Kim
- Department of Nuclear Medicine, Chonnam National University Hospital, 42 Jaebong-Ro, Dong-Gu, Gwangju, 61469 Republic of Korea
- Department of Nuclear Medicine, Chonnam National University Medical School, 160 Baekseo-ro, Dong-Gu, Gwangju, 61469 Republic of Korea
- Department of Artificial Intelligence Convergence, Chonnam National University, Gwangju, Republic of Korea
| | - Ho-Chun Song
- Department of Nuclear Medicine, Chonnam National University Hospital, 42 Jaebong-Ro, Dong-Gu, Gwangju, 61469 Republic of Korea
- Department of Nuclear Medicine, Chonnam National University Medical School, 160 Baekseo-ro, Dong-Gu, Gwangju, 61469 Republic of Korea
| |
Collapse
|
28
|
Suh SH, Oh TR, Choi HS, Kim CS, Bae EH, Ma SK, Oh KH, Yoo TH, Chae DW, Kim SW. Association between urinary chloride excretion and progression of coronary artery calcification in patients with nondialysis chronic kidney disease: results from the KNOW-CKD study. Kidney Res Clin Pract 2023; 42:251-261. [PMID: 36908202 PMCID: PMC10085721 DOI: 10.23876/j.krcp.22.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 05/05/2022] [Accepted: 05/19/2022] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Urine chloride has recently been suggested as a biomarker of renal tubule function in patients with nondialysis chronic kidney disease (CKD), as low urinary chloride concentration is associated with an increased risk of CKD progression. We investigate the association between urinary chloride excretion and the progression of coronary artery calcification (CAC). METHODS A total of 1,065 patients with nondialysis CKD were divided into tertiles by spot urine chloride-to-creatinine ratios. The 1st, 2nd, and 3rd tertiles were defined as low, moderate, and high urinary chloride excretion, respectively. The study outcome was CAC progression, which was defined as an increase in coronary artery calcium score of more than 200 Agatston units during the 4-year follow-up period. RESULTS Compared to moderate urinary chloride excretion, high urinary chloride excretion was associated with decreased risk of CAC progression (adjusted odds ratio, 0.379; 95% confidence interval, 0.190-0.757), whereas low urinary chloride excretion was not associated with risk of CAC progression. Restricted cubic spine depicted an inverted J-shaped curve, with a significant reduction in the risk of CAC progression in subjects with high spot urine chloride-to-creatinine ratios. CONCLUSION High urinary chloride excretion is associated with decreased risk of CAC progression in patients with nondialysis CKD.
Collapse
Affiliation(s)
- Sang Heon Suh
- Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Tae Ryom Oh
- Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Hong Sang Choi
- Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Chang Seong Kim
- Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Eun Hui Bae
- Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Seong Kwon Ma
- Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Kook-Hwan Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Tae-Hyun Yoo
- Department of Internal Medicine and Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dong-Wan Chae
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Soo Wan Kim
- Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - on behalf of the Korean Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD) Investigators
- Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Internal Medicine and Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| |
Collapse
|
29
|
Sung CM, Kim HC, Kim J, Kim JG, Lim SC, Shin MH, Nam K, Lee J, Vena D, White DP, Yang HC, Wellman A. Patients with Epiglottic Collapse Are Less Adherent to Autotitrating Positive Airway Pressure Therapy for Obstructive Sleep Apnea. Ann Am Thorac Soc 2022; 19:1907-1912. [PMID: 35969148 PMCID: PMC9667810 DOI: 10.1513/annalsats.202202-118oc] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 07/03/2022] [Indexed: 12/30/2022] Open
Abstract
Rationale: The anatomic orientation of the epiglottis is such that it points in the opposite direction to inspiratory flow, thereby potentially making positive airway pressure (PAP) treatment challenging in patients with epiglottic collapse. However, no previous studies have analyzed PAP adherence in these patients. Objectives: This study aimed to analyze adherence to autotitrating PAP (APAP) treatment in patients with epiglottic collapse. Methods: We performed an age- and sex-matched case-control study. On the basis of their overnight level-I polysomnogram, patients were prescribed APAP in a tertiary hospital between July 2018 and March 2019. The site of airway collapse was diagnosed with drug-induced sleep endoscopy. Demographic factors, sleep questionnaire, polysomnography, and APAP usage statistics were analyzed. Results: Eighteen patients with epiglottic collapse (epi-group) and 36 without epiglottic collapse (control group) were analyzed. We found that 22.8% of patients in the epi-group terminated APAP within 2 weeks, whereas only 2.8% of patients in the control group terminated APAP within 2 weeks (P = 0.048). The percentage of days with usage over 4 hours was significantly lower in the epi-group (64.6% vs. 75.6%; P = 0.008). In addition, the adherence failure rate was 66.7% in the epi-group and 33.3% in the control group (P = 0.039). Patients with epiglottic collapse were also found to have lower body mass index, which is an unfavorable predictor of APAP adherence. Conclusions: This study suggests that patients with epiglottic collapse have a higher APAP adherence failure rate than patients without epiglottic collapse. Thus, patients with epiglottic collapse should be followed closely during treatment, and alternative therapies should probably be considered for these patients.
Collapse
Affiliation(s)
- Chung Man Sung
- Department of Otolaryngology-Head and Neck Surgery and Department of Anatomy, Chonnam National University Medical School, Gwangju, South Korea
- Chonnam National University Hospital, Gwangju, South Korea
| | - Hong Chan Kim
- Department of Otolaryngology-Head and Neck Surgery and Department of Anatomy, Chonnam National University Medical School, Gwangju, South Korea
- Chonnam National University Hospital, Gwangju, South Korea
| | - Jisun Kim
- Department of Otolaryngology-Head and Neck Surgery and Department of Anatomy, Chonnam National University Medical School, Gwangju, South Korea
- Chonnam National University Hospital, Gwangju, South Korea
| | - Jae Gu Kim
- Department of Otolaryngology-Head and Neck Surgery and Department of Anatomy, Chonnam National University Medical School, Gwangju, South Korea
- Chonnam National University Hospital, Gwangju, South Korea
| | - Sang Chul Lim
- Department of Otolaryngology-Head and Neck Surgery and Department of Anatomy, Chonnam National University Medical School, Gwangju, South Korea
- Chonnam National University Hospital, Gwangju, South Korea
| | | | - Kwangil Nam
- Department of Anatomy, Chonnam National University Medical School, Hwasun, South Korea
| | - Jongho Lee
- School of Mechanical Engineering, Gwangju Institute of Science and Technology (GIST), Gwangju, South Korea; and
| | - Daniel Vena
- Division of Sleep and Circadian Disorders, Department of Medicine and Neurology, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - David P. White
- Division of Sleep and Circadian Disorders, Department of Medicine and Neurology, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Hyung Chae Yang
- Department of Otolaryngology-Head and Neck Surgery and Department of Anatomy, Chonnam National University Medical School, Gwangju, South Korea
- Chonnam National University Hospital, Gwangju, South Korea
- Division of Sleep and Circadian Disorders, Department of Medicine and Neurology, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Andrew Wellman
- Division of Sleep and Circadian Disorders, Department of Medicine and Neurology, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
30
|
Heo WY, Jung YH, Lee HY, Jeung KW, Lee BK, Youn CS, Choi SP, Park KN, Min YI. External validation of cardiac arrest-specific prognostication scores developed for early prognosis estimation after out-of-hospital cardiac arrest in a Korean multicenter cohort. PLoS One 2022; 17:e0265275. [PMID: 35363794 PMCID: PMC8975166 DOI: 10.1371/journal.pone.0265275] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/25/2022] [Indexed: 12/23/2022] Open
Abstract
We evaluated the performance of cardiac arrest-specific prognostication scores developed for outcome prediction in the early hours after out-of-hospital cardiac arrest (OHCA) in predicting long-term outcomes using independent data. The following scores were calculated for 1,163 OHCA patients who were treated with targeted temperature management (TTM) at 21 hospitals in South Korea: OHCA, cardiac arrest hospital prognosis (CAHP), C-GRApH (named on the basis of its variables), TTM risk, 5-R, NULL-PLEASE (named on the basis of its variables), Serbian quality of life long-term (SR-QOLl), cardiac arrest survival, revised post-cardiac arrest syndrome for therapeutic hypothermia (rCAST), Polish hypothermia registry (PHR) risk, and PROgnostication using LOGistic regression model for Unselected adult cardiac arrest patients in the Early stages (PROLOGUE) scores and prediction score by Aschauer et al. Their accuracies in predicting poor outcome at 6 months after OHCA were determined using the area under the receiver operating characteristic curve (AUC) and calibration belt. In the complete-case analyses, the PROLOGUE score showed the highest AUC (0.923; 95% confidence interval [CI], 0.904–0.941), whereas the SR-QOLl score had the lowest AUC (0.749; 95% CI, 0.711–0.786). The discrimination performances were similar in the analyses after multiple imputation. The PROLOGUE, TTM risk, CAHP, NULL-PLEASE, 5-R, and cardiac arrest survival scores were well calibrated. The rCAST and PHR risk scores showed acceptable overall calibration, although they showed miscalibration under the 80% CI level at extreme prediction values. The OHCA score, C-GRApH score, prediction score by Aschauer et al., and SR-QOLl score showed significant miscalibration in both complete-case (P = 0.026, 0.013, 0.005, and < 0.001, respectively) and multiple-imputation analyses (P = 0.007, 0.018, < 0.001, and < 0.001, respectively). In conclusion, the discrimination performances of the prognostication scores were all acceptable, but some showed significant miscalibration.
Collapse
Affiliation(s)
- Wan Young Heo
- Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Yong Hun Jung
- Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
- Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Hyoung Youn Lee
- Trauma Center, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Kyung Woon Jeung
- Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
- Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
- * E-mail:
| | - Byung Kook Lee
- Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
- Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Chun Song Youn
- Department of Emergency Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seung Pill Choi
- Department of Emergency Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyu Nam Park
- Department of Emergency Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yong Il Min
- Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
- Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | | |
Collapse
|
31
|
Mathew AP, Uthaman S, Bae EH, Lee JY, Park IK. Vimentin Targeted Nano-gene Carrier for Treatment of Renal Diseases. J Korean Med Sci 2021; 36:e333. [PMID: 34931497 PMCID: PMC8688343 DOI: 10.3346/jkms.2021.36.e333] [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: 08/30/2021] [Accepted: 10/21/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is a global health problem, and there is no permanent treatment for reversing kidney failure; thus, early diagnosis and effective treatment are required. Gene therapy has outstanding potential; however, the lack of safe gene delivery vectors, a reasonable transfection rate, and kidney targeting ability limit its application. Nanoparticles can offer innovative ways to diagnose and treat kidney diseases as they facilitate targetability and therapeutic efficacy. METHODS Herein, we developed a proximal renal tubule-targeting gene delivery system based on alternative copolymer (PS) of sorbitol and polyethyleneimine (PEI), modified with vimentin-specific chitobionic acid (CA), producing PS-conjugated CA (PSC) for targeting toward vimentin-expressing cells in the kidneys. In vitro studies were used to determine cell viability, transfection efficiency, serum influence, and specific uptake in the human proximal renal tubular epithelial cell line (HK-2). Finally, the targeting efficiency of the prepared PSC gene carriers was checked in a murine model of Alport syndrome. RESULTS Our results suggested that the prepared polyplex showed low cytotoxicity, enhanced transfection efficiency, specific uptake toward HK-2 cells, and excellent targeting efficiency toward the kidneys. CONCLUSION Collectively, from these results it can be inferred that the PSC can be further evaluated as a potential gene carrier for the kidney-targeted delivery of therapeutic genes for treating diseases.
Collapse
Affiliation(s)
- Ansuja Pulickal Mathew
- Department of Biomedical Sciences, Chonnam National University Medical School, Gwangju, Korea
- BioMedical Sciences Graduate Program (BMSGP), Chonnam National University, Hwasun, Korea
| | - Saji Uthaman
- Department of Polymer Science and Engineering, Chungnam National University, Daejeon, Korea
| | - Eun Hui Bae
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Jae Young Lee
- School of Materials Science and Engineering, Gwangju Institute of Science and Engineering, Gwangju, Korea
| | - In-Kyu Park
- Department of Biomedical Sciences, Chonnam National University Medical School, Gwangju, Korea
- BioMedical Sciences Graduate Program (BMSGP), Chonnam National University, Hwasun, Korea.
| |
Collapse
|
32
|
Cho KH, Jeong MH, Park DS, Kim M, Kim J, Park JK, Han X, Hyun DY, Kim MC, Sim DS, Hong YJ, Kim JH, Ahn Y. Preclinical Evaluation of a Novel Polymer-free Everolimus-eluting Stent in a Mid-term Porcine Coronary Restenosis Model. J Korean Med Sci 2021; 36:e259. [PMID: 34664799 PMCID: PMC8524232 DOI: 10.3346/jkms.2021.36.e259] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 08/22/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Titanium dioxide films exhibit good biocompatibility and may be effective as drug-binding matrices for drug-eluting stents. We conducted a mid-term evaluation of a novel polymer-free everolimus-eluting stent using nitrogen-doped titanium dioxide film deposition (TIGEREVOLUTION®) in comparison with a commercial durable polymer everolimus-eluting stent (XIENCE Alpine®) in a porcine coronary restenosis model. METHODS Twenty-eight coronary arteries from 14 mini-pigs were randomly allocated to TIGEREVOLUTION® stent and XIENCE Alpine® stent groups. The stents were implanted in the coronary artery at a 1.1-1.2:1 stent-to-artery ratio. Eleven stented coronary arteries in each group were finally analyzed using coronary angiography, optical coherence tomography, and histopathologic evaluation 6 months after stenting. RESULTS Quantitative coronary analysis showed no significant differences in the pre-procedural, post-procedural, and 6-month lumen diameters between the groups. In the volumetric analysis of optical coherence tomography at 6 months, no significant differences were observed in stent volume, lumen volume, and percent area stenosis between the groups. There were no significant differences in injury score, inflammation score, or fibrin score between the groups, although the fibrin score was zero in the TIGEREVOLUTION® stent group (0 vs. 0.07 ± 0.11, P = 0.180). CONCLUSION Preclinical evaluation, including optical coherence tomographic findings 6 months after stenting, demonstrated that the TIGEREVOLUTION® stent exhibited efficacy and safety comparable with the XIENCE Alpine® stent, supporting the need for further clinical studies on the TIGEREVOLUTION® stent.
Collapse
Affiliation(s)
- Kyung Hoon Cho
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Myung Ho Jeong
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
- Department of Cardiology, Chonnam National University Medical School, Hwasun, Korea.
| | - Dae Sung Park
- Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea
| | - Moonki Kim
- Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea
| | - JungHa Kim
- Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea
| | | | - Xiongyi Han
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Dae Young Hyun
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Min Chul Kim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
- Department of Cardiology, Chonnam National University Medical School, Hwasun, Korea
| | - Doo Sun Sim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
- Department of Cardiology, Chonnam National University Medical School, Hwasun, Korea
| | - Young Joon Hong
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
- Department of Cardiology, Chonnam National University Medical School, Hwasun, Korea
| | - Ju Han Kim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
- Department of Cardiology, Chonnam National University Medical School, Hwasun, Korea
| | - Youngkeun Ahn
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
- Department of Cardiology, Chonnam National University Medical School, Hwasun, Korea
| |
Collapse
|
33
|
Shin HJ, Chang JS, Kim MS, Koh BG, Park HY, Kim TO, Park CK, Oh IJ, Kim YI, Lim SC, Kim YC, Koh YI, Kwon YS. Hypersensitivity reactions to multiple anti-tuberculosis drugs. PLoS One 2021; 16:e0246291. [PMID: 33539388 PMCID: PMC7861523 DOI: 10.1371/journal.pone.0246291] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 01/16/2021] [Indexed: 12/18/2022] Open
Abstract
Objective This study aimed to evaluate hypersensitivity reactions to anti-tuberculosis (TB) drugs. Methods We retrospectively compared the clinical manifestations and treatment outcomes of single and multiple drug hypersensitivity reactions (DHRs). Results Twenty-eight patients were diagnosed with anti-TB DHRs using oral drug provocation tests. Of these 28 patients, 17 patients (60.7%) had DHRs to a single drug and 11 (39.3%) had multiple DHRs. The median age of patients was 57.5 years (interquartile range [IQR], 39.2–73.2). Of the total patients, 18 patients (64.3%) were men. The median number of anti-TB drugs causing multiple DHRs was 2.0 (IQR 2.0–3.0). Rifampin was the most common drug that caused DHRs in both the single and multiple DHR groups (n = 8 [47.1%] and n = 9 [52.9%], respectively). The treatment success rate was lower in the multiple DHR group than in the single DHR group; however, the difference was not statistically significant (81.8% vs. 94.1%; P = 0.543). Conclusions Multiple anti-TB DHRs were common in all patients who experienced DHRs, and rifampin was the most common causative drug. The treatment outcomes appeared to be poorer in patients with multiple DHRs than in those with single DHRs.
Collapse
Affiliation(s)
- Hong-Joon Shin
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea
| | - Jin-Sun Chang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea
| | - Min-Suk Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea
| | - Bo-Gun Koh
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea
| | - Ha-Young Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea
| | - Tae-Ok Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea
| | - Chul-Kyu Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea
| | - In-Jae Oh
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea
| | - Yu-Il Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea
| | - Sung-Chul Lim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea
| | - Young-Chul Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea
| | - Young-Il Koh
- Division of Allergy, Asthma, and Clinical Immunology, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea
| | - Yong-Soo Kwon
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea
- * E-mail:
| |
Collapse
|
34
|
Zhai Y, Han JJ, Jung S, Kook MS, Park HJ, Oh HK. Changes in the temporomandibular joint clicking and pain disorders after orthognathic surgery: Comparison of orthodontics-first approach and surgery-first approach. PLoS One 2020; 15:e0238494. [PMID: 32886686 PMCID: PMC7473545 DOI: 10.1371/journal.pone.0238494] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/18/2020] [Indexed: 11/19/2022] Open
Abstract
The purposes of this study were to investigate the influence of the orthodontics-first approach (OFA) and surgery-first approach (SFA) on changes in the signs and symptoms of temporomandibular joint disorders (TMDs) and to compare pre- and postoperative orthodontic treatment duration and total treatment duration between the two approaches. This retrospective study recruited 182 adult patients with malocclusions treated with OFA and SFA and recorded variables such as age, gender, skeletal classification, and signs and symptoms of TMD (clicking and pain disorders) before the start of the surgical-orthodontic treatment and after surgery. Changes in the signs and symptoms of TMD and treatment duration were evaluated within each approach and compared between two approaches. A binary logistic regression was performed to assess the influence of the variables on the postoperative signs and symptoms of TMD. There were no significant postoperative changes in temporomandibular joint (TMJ) pain for OFA and SFA, whereas a significant reduction was found in TMJ clicking after surgery for both approaches. According to binary logistic regression, the type of surgical-orthodontic treatment (OFA or SFA) was not a significant risk factor for postoperative TMJ clicking and pain, and the risk of postoperative TMJ clicking and pain was significant only when TMJ clicking (OR = 10.774, p < 0.001) and pain (OR = 26.876, p = 0.008) existed before the start of the entire treatment, respectively. With regard to the treatment duration, SFA (21.1 ± 10.3 months) exhibited significantly shorter total treatment duration than OFA (34.4 ± 11.9 months) (p < 0.001). The results of this study suggest that surgical-orthodontic treatment using SFA can be a feasible option of treatment for dentofacial deformities based on the equivalent effect on TMD and shorter overall treatment period compared to conventional surgical-orthodontic treatment using OFA.
Collapse
Affiliation(s)
- Ying Zhai
- Graduate Dental School, Chonnam National University, Gwangju, Republic of Korea
| | - Jeong Joon Han
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Republic of Korea
- Hard-tissue Biointerface Research Center, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - Seunggon Jung
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Republic of Korea
| | - Min-Suk Kook
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Republic of Korea
| | - Hong-Ju Park
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Republic of Korea
| | - Hee-Kyun Oh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Republic of Korea
| |
Collapse
|
35
|
Cho SH, Choi SM, Kim BC, Song WY, Kim HS, Lee KH. An Autopsy-Proven Case of Limbic-Predominant Age-Related TDP-43 Encephalopathy. Yonsei Med J 2020; 61:731-735. [PMID: 32734738 PMCID: PMC7393298 DOI: 10.3349/ymj.2020.61.8.731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/25/2020] [Accepted: 06/16/2020] [Indexed: 11/27/2022] Open
Abstract
Limbic-predominant age-related TDP-43 encephalopathy (LATE) is a recently established neurodegenerative disease entity. LATE neuropathological change (LATE-NC) is characterized by a TDP-43 proteinopathy that mainly involves the amygdala and medial temporal structures, with or without hippocampal sclerosis. LATE-NC is typically observed in individuals aged 80 years or older and manifests clinically as amnestic memory decline. Herein, we report a case of LATE diagnosed by brain autopsy in an 82-year-old male who had an 11-year history of memory impairment. Pathological examination revealed high Alzheimer disease neuropathological changes, as well as amygdala-predominant Lewy body pathology. In addition, immunohistochemistry for TDP-43 revealed neuronal and glial cytoplasmic inclusions in the dentate gyrus of the hippocampus, amygdala, and inferior temporal cortex. Increasing awareness of the newly defined entity LATE will enhance our understanding of the neurodegenerative processes that occur in the oldest individuals.
Collapse
Affiliation(s)
- Soo Hyun Cho
- Department of Neurology, Chonnam National University Medical School and Hospital, Gwangju, Korea
| | - Seong Min Choi
- Department of Neurology, Chonnam National University Medical School and Hospital, Gwangju, Korea
- Chonnam National University Hospital Brain Bank, Gwangju, Korea
| | - Byeong C Kim
- Department of Neurology, Chonnam National University Medical School and Hospital, Gwangju, Korea
- Chonnam National University Hospital Brain Bank, Gwangju, Korea
| | - Won Young Song
- Chonnam National University Hospital Brain Bank, Gwangju, Korea
| | - Hyung Seok Kim
- Chonnam National University Hospital Brain Bank, Gwangju, Korea
- Department of Forensic Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Kyung Hwa Lee
- Chonnam National University Hospital Brain Bank, Gwangju, Korea
- Department of Pathology, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Korea.
| |
Collapse
|
36
|
Jung S, Oh HK, Kim MS, Lee KY, Park H, Kook MS. Effect of Gellan Gum/Tuna Skin Film in Guided Bone Regeneration in Artificial Bone Defect in Rabbit Calvaria. Materials (Basel) 2020; 13:E1318. [PMID: 32183273 PMCID: PMC7142440 DOI: 10.3390/ma13061318] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/05/2020] [Accepted: 03/10/2020] [Indexed: 11/17/2022]
Abstract
It is necessary to prevent the invasion of soft tissue into bone defects for successful outcomes in guided bone regeneration (GBR). For this reason, many materials are used as protective barriers to bone defects. In this study, a gellan gum/tuna skin gelatin (GEL/TSG) film was prepared, and its effectiveness in bone regeneration was evaluated. The film exhibited average cell viability in vitro. Experimental bone defects were prepared in rabbit calvaria, and a bone graft procedure with beta-tricalcium phosphate was done. The film was used as a membrane of GBR and compared with results using a commercial collagen membrane. Grafted material did not show dispersion outside of bone defects and the film did not collapse into the bone defect. New bone formation was comparable to that using the collagen membrane. These results suggest that the GEL/TSG film could be used as a membrane for GBR.
Collapse
Affiliation(s)
- Seunggon Jung
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University, Gwangju 61186, Korea; (S.J.); (H.-K.O.); (H.P.)
| | - Hee-Kyun Oh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University, Gwangju 61186, Korea; (S.J.); (H.-K.O.); (H.P.)
| | - Myung-Sun Kim
- Department of Orthopaedics, School of Medicine, Chonnam National University, Gwangju 61469, Korea;
| | - Ki-Young Lee
- School of Chemical Engineering and Biocosmos Co., Chonnam National University, Gwangju 61186, Korea;
| | - Hongju Park
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University, Gwangju 61186, Korea; (S.J.); (H.-K.O.); (H.P.)
| | - Min-Suk Kook
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University, Gwangju 61186, Korea; (S.J.); (H.-K.O.); (H.P.)
| |
Collapse
|
37
|
Kim HY, Choi CK, Kweon SS, Lee YH, Nam HS, Park KS, Ryu SY, Choi SW, Shin MH. Effect Modification of Acetaldehyde Dehydrogenase 2 rs671 Polymorphism on the Association between Alcohol Intake and Blood Pressure: the Dong-gu Study. J Korean Med Sci 2020; 35:e14. [PMID: 32141245 PMCID: PMC7061145 DOI: 10.3346/jkms.2020.35.e14] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 01/06/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Elevated blood pressure is a major preventable cause of cardiovascular diseases. Alcohol consumption is a well-known risk factor of elevated blood pressure. The aldehyde dehydrogenase 2 (ALDH2) polymorphism is common in Eastern Asians, and inactive ALDH2 genotypes are associated with both avoiding alcohol consumption and aldehyde accumulation. Therefore, this study assessed the associations between alcohol consumption and hypertension and blood pressure according to the ALDH2 genotypes. METHODS This study consists of 8,526 participants in the Dong-gu Study. Multivariate logistic regression was used to calculate the odds ratio (OR) according to alcohol consumption after stratifying by gender and ALDH2 genotypes. Multivariate linear regression was performed to estimate the systolic blood pressure (SBP) and diastolic blood pressure (DBP) according to the amount of alcohol consumed. RESULTS In men, alcohol consumption was positively associated with both SBP and DBP in active ALDH2 carriers, but not in inactive ALDH2 carriers. In active ALDH2 carriers, compared to non-drinkers, the OR of hypertension was 1.16 (95% confidence interval [CI], 0.91-1.49) for < 1 drink/day, and 1.44 (95% CI, 1.15-1.80) for ≥ 1 drink/day in men. With each 1 drink/day increase, SBP and DBP increased by 3 and 1 mmHg in men, respectively. There was no significant association between ALDH2 genotypes and hypertension and blood pressure in women. CONCLUSION ALDH2 genotype modified the association between alcohol consumption and blood pressure in men. There was a positive relationship between alcohol consumption and blood pressure in active ALDH2 carriers, but no significant relationship in inactive ALDH2 carriers.
Collapse
Affiliation(s)
- Hye Yeon Kim
- Gwangju-Jeonnam Regional Cardiocerebrovascular Center, Chonnam National University Hospital, Gwangju, Korea
| | - Chang Kyun Choi
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Sun Seog Kweon
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Young Hoon Lee
- Department of Preventive Medicine, Institute of Wonkwang Medical Science, Wonkwang University College of Medicine, Iksan, Korea
| | - Hae Sung Nam
- Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Kyeong Soo Park
- Cardiocerebrovascular Center, Mokpo Jung-Ang Hospital, Mokpo, Korea
| | - So Yeon Ryu
- Department of Preventive Medicine, Chosun University College of Medicine, Gwangju, Korea
| | - Seong Woo Choi
- Department of Preventive Medicine, Chosun University College of Medicine, Gwangju, Korea
| | - Min Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea.
| |
Collapse
|
38
|
Choi CK, Kweon SS, Lee YH, Nam HS, Park KS, Ryu SY, Choi SW, Kim HY, Shin MH. The Association between the Apolipoprotein E Gene Polymorphism and All-cause Mortality in the Korean Population. J Korean Med Sci 2019; 34:e269. [PMID: 31625294 PMCID: PMC6801224 DOI: 10.3346/jkms.2019.34.e269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 07/11/2019] [Accepted: 09/03/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Apolipoprotein E (APOE) gene polymorphism is associated with neurodegenerative and cardiovascular diseases. Although the effects of the gene differ by ethnic group, few studies have examined Asians. Therefore, the association between APOE polymorphism and mortality in Koreans was evaluated in this study. METHODS This study population included participants from the Dong-gu and Namwon Studies. APOE genotypes were categorized as E2 (E2/E2 and E2/E3), E3 (E3/E3), and E4 (E3/E4 and E4/E4). Multivariate Cox proportional hazard models were constructed using the E3 allele as a reference. RESULTS In the model adjusting for study site, age, gender, and lifestyle, the hazard ratio (HR) of mortality for those with the E4 allele was 1.08 (95% confidence interval [CI], 0.97-1.20), while that for those with the E2 allele was 0.84 (95% CI, 0.74-0.96). After adjusting for blood lipids to evaluate their mediating effects, the HRs of mortality for those with E4 and E2 alleles were 1.08 (95% CI, 0.97-1.20) and 0.80 (95% CI, 0.70-0.92), respectively. These associations were more evident in younger groups, with HRs of 0.70 (95% CI, 0.52-0.92) for the E2 allele and 1.25 (95% CI, 1.03-1.53) for the E4 allele. CONCLUSION In two large population-based cohort studies, the E2 allele was associated with a lower risk of mortality compared with the E3 allele, whereas the E4 genotype was not associated with mortality in Koreans.
Collapse
Affiliation(s)
- Chang Kyun Choi
- Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, Korea
| | - Sun Seog Kweon
- Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, Korea
| | - Young Hoon Lee
- Department of Preventive Medicine, Institute of Wonkwang Medical Science, Wonkwang University College of Medicine, Iksan, Korea
| | - Hae Sung Nam
- Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Kyeong Soo Park
- Cardiocerebrovascular Center, Mokpo Jung-Ang Hospital, Mokpo, Korea
| | - So Yeon Ryu
- Department of Preventive Medicine, Chosun University College of Medicine, Gwangju, Korea
| | - Seong Woo Choi
- Department of Preventive Medicine, Chosun University College of Medicine, Gwangju, Korea
| | - Hye Yeon Kim
- Gwangju-Jeonnam Regional Cardiocerebrovascular Center, Chonnam National University Hospital, Gwangju, Korea
| | - Min Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, Korea.
| |
Collapse
|
39
|
Abstract
BACKGROUND C-reactive protein (CRP) is an acute-phase protein whose level increases in response to tissue injury, infection, or other inflammation. It is used in clinical and forensic settings. Point-of-care (POC) testing has recently become available, and it is considered to be useful during postmortem examinations. However, laboratory testing of postmortem blood samples is difficult due to hemolysis and postmortem clotting. METHODS The utility of POC testing for CRP during postmortem examination was evaluated using cardiac blood from the inferior vena cava. The whole blood sample was immediately tested using the POC instrument. Subsequently, the same sample was processed to obtain the serum, which was tested using common laboratory instruments. RESULTS The postmortem POC test had a high positive predictive value and specificity, and the results strongly correlated with the laboratory test results. CONCLUSION POC CRP testing is valid in postmortem examination and can be used in forensic medicine (postmortem inspection and autopsy).
Collapse
Affiliation(s)
- Joo Young Na
- Biomedical Research Institute, Chonnam National University Hospital, Gwangju, Korea
| | - Jong Tae Park
- Department of Forensic Medicine, Chonnam National University Medical School, Gwangju, Korea,
- Department of Pathology, Chonnam National University Hospital, Gwangju, Korea.
| |
Collapse
|
40
|
Yoon JH, Kim HJ, Jun CH, Cho SB, Jung Y, Choi SK. Various Treatment Modalities in Hepatic Hydrothorax: What Is Safe and Effective? Yonsei Med J 2019; 60:944-951. [PMID: 31538429 PMCID: PMC6753336 DOI: 10.3349/ymj.2019.60.10.944] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 06/26/2019] [Revised: 08/14/2019] [Accepted: 08/19/2019] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Hepatic hydrothorax is a complication of decompensated liver cirrhosis that is difficult and complex to manage. Data concerning the optimal treatment method, other than liver transplantation, are limited. This study aimed to compare the clinical features and outcomes of patients treated with various modalities, while focusing on surgical management and pigtail drainage. MATERIALS AND METHODS Forty-one patients diagnosed with refractory hepatic hydrothorax between January 2013 and December 2017 were enrolled. RESULTS The mean Child-Turcotte-Pugh and model for end stage liver disease scores of the enrolled patients were 10.1 and 19.7, respectively. The patients underwent four modalities: serial thoracentesis (n=11, 26.8%), pigtail drainage (n=16, 39.0%), surgery (n=10, 24.4%), and liver transplantation (n=4, 9.8%); 12-month mortality rate/median survival duration was 18.2%/868 days, 87.5%/79 days, 70%/179 days, and 0%/601.5 days, respectively. Regarding the management of refractory hepatic hydrothorax, surgery group required less frequent needle puncture (23.5 times in pigtail group vs. 9.3 times in surgery group), had a lower occurrence of hepatorenal syndrome (50% vs. 30%), and had a non-inferior cumulative overall survival (402.1 days vs. 221.7 days) compared to pigtail group. On multivariate analysis for poor survival, body mass index <19 kg/m², refractory hepatic hydrothorax not managed with liver transplantation, Child-Turcotte-Pugh score >10, and history of severe encephalopathy (grade >2) were associated with poor survival. CONCLUSION Serial thoracentesis may be recommended for management of hepatic hydrothorax and surgical management can be a useful option in patients with refractory hepatic hydrothorax, alternative to pigtail drainage.
Collapse
Affiliation(s)
- Jae Hyun Yoon
- Department of Gastroenterology and Hepatology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Hee Joon Kim
- Department of Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Chung Hwan Jun
- Department of Gastroenterology and Hepatology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Sung Bum Cho
- Department of Gastroenterology and Hepatology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Yochun Jung
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
| | - Sung Kyu Choi
- Department of Gastroenterology and Hepatology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
| |
Collapse
|
41
|
Lee DH, Lee KM, Lee SM, Lee BK, Cho YS, Choi G, Yun SW. Performance of Three Scoring Systems in Predicting Massive Transfusion in Patients with Unstable Upper Gastrointestinal Hemorrhage. Yonsei Med J 2019; 60:368-374. [PMID: 30900423 PMCID: PMC6433562 DOI: 10.3349/ymj.2019.60.4.368] [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: 11/14/2018] [Revised: 01/29/2019] [Accepted: 02/20/2019] [Indexed: 11/27/2022] Open
Abstract
PURPOSE After trauma and surgery, upper gastrointestinal bleeding (UGIB) is the most common condition that can require massive transfusion (MT). The present study aimed to analyze and compare the prognostic performance of the Glasgow-Blatchford (GB), pre-endoscopy Rockall (PER), and modified early warning (MEW) scores for predicting MT in patients with unstable UGIB. MATERIALS AND METHODS This retrospective observational study included patients with UGIB from March 2016 to February 2018. Receiver operating characteristics analysis was performed to examine the prognostic performance of the GB, PER, and MEW scoring systems. Logistic regression analysis was used to identify independent risk factors for MT, after adjusting for relevant covariates. The primary outcome was MT. RESULTS Of the 484 included patients with unstable UGIB, 19 (3.9%) received an MT. The areas under the curves (AUCs) of the GB, PER, and MEW scores for MT were 0.577 [95% confidence interval (CI), 0.531-0.621], 0.570 (95% CI, 0.525-0.615), and 0.767 (95% CI, 0.727-0.804), respectively. The AUC of the MEW score was significantly different from those of the GB and PER scores. In multivariate analysis, MEW score was independently associated with MT in patients with unstable UGIB (odds ratio, 1.495; 95% CI, 1.100-2.033; p=0.010). CONCLUSION In unstable UGIB patients, MEW score had the best prognostic performance for MT among three scoring systems.
Collapse
Affiliation(s)
- Dong Hun Lee
- Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Kyeung Mi Lee
- Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Sung Min Lee
- Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Korea.
| | - Byung Kook Lee
- Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Yong Soo Cho
- Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Goeun Choi
- Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Seong Woo Yun
- Department of Emergency Medical Technology, Namseoul University, Cheonan, Korea
| |
Collapse
|
42
|
Abstract
Coronary artery disease, especially acute myocardial infarction (AMI), is a leading cause of death in the Asia-Pacific region. The Korea Acute Myocardial Infarction Registry (KAMIR) is the first nationwide, prospective, multicenter registry of Korean patients with AMI. Since the KAMIR first began in November 2005, more than 70,000 patients have been enrolled, and 230 papers have been published (as of October 2018). Moreover, published data from the KAMIR have revealed different characteristics from those of Western AMI registries regarding risk factors, interventional strategies, and clinical outcomes. As a result, the KAMIR study has improved the outcomes of percutaneous coronary intervention and reduced mortality. We propose the use of the KAMIR score in the prediction of 1-year mortality. Using data from the KAMIR, we provide an overview of the current status of AMI in Korea, including trends in demographic characteristics, risk factors, medications, treatment strategies, and clinical outcomes.
Collapse
Affiliation(s)
- Yongcheol Kim
- Departemt of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Youngkeun Ahn
- Departemt of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Myeong Chan Cho
- Department of Cardiology, Chungbuk National University Hospital, Cheongju, Korea
| | - Chong Jin Kim
- Department of Cardiology, Kyung Hee University Hospital, Seoul, Korea
| | - Young Jo Kim
- Department of Cardiology, Yeungnam University Medical Center, Daegu, Korea
| | - Myung Ho Jeong
- Departemt of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| |
Collapse
|
43
|
An BC, Choi YD, Oh IJ, Kim JH, Park JI, Lee SW. GPx3-mediated redox signaling arrests the cell cycle and acts as a tumor suppressor in lung cancer cell lines. PLoS One 2018; 13:e0204170. [PMID: 30260967 PMCID: PMC6160013 DOI: 10.1371/journal.pone.0204170] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 09/03/2018] [Indexed: 12/15/2022] Open
Abstract
Glutathione peroxidase 3 (GPx3), a major scavenger of reactive oxygen species (ROS) in plasma, acts as a redox signal modulator. However, the mechanism underlying GPx3-mediated suppression of cancer cell growth is unclear. The aim of this study was to identify these mechanisms with respect to lung cancer. To enhance the redox modulating properties of GPx3, lung cancer cells were subjected to serum starvation for 12 h, resulting in ROS generation in the absence of oxidant treatment. We then investigated whether suppression of tumorigenesis under conditions of oxidative stress was dependent on GPx3. The results showed that GPx3 effectively suppressed proliferation, migration, and invasion of lung cancer cells under oxidative stress. In addition, GPx3 expression led to a significant reduction in ROS production by cancer cells and induced G2/M phase arrest. We also found that inactivation of cyclin B1 significantly suppressed by nuclear factor-κB(NF-κB) inactivation in lung cancer cells was dependent on GPx3 expression. To further elucidate the mechanism(s) underlying GPx3-medited suppression of tumor proliferation, we next examined the effect of GPx3-mediated redox signaling on the ROS-MKP3-extracellular signal-regulated kinase (Erk)-NF-κB-cyclin B1 pathway and found that GPx3 strongly suppressed activation of the Erk-NF-κB-cyclin B1 signaling cascade by protecting MKP3 (an Erk-specific phosphatase) from the effects of ROS. Thus, this study demonstrates for the first time that the GPx3 suppresses proliferation of lung cancer cells by modulating redox-mediated signals.
Collapse
Affiliation(s)
- Byung Chull An
- Department of Anatomy, Chonnam National University Medical School, Hwasun-eup, Hwasun-gun, Jeollanam-do, Korea
| | - Yoo-Duk Choi
- Department of Pathology, Chonnam National University Hospital, Dong-gu, Gwangju, Korea
| | - In-Jae Oh
- Department of Lung and Esophageal Cancer Clinic, Chonnam National University Hwasun Hospital, Hwasun-eup, Hwasun-gun, Jeollanam-do, Korea
| | - Ju Han Kim
- Department of Internal Medicine, Chonnam National University Hospital, Dong-gu, Gwangju, Korea
| | - Jae-Il Park
- Animal Facility of Aging Science, Korea Basic Science Institute, Buk-gu, Gwangju, Korea
| | - Seung-won Lee
- Department of Anatomy, Chonnam National University Medical School, Hwasun-eup, Hwasun-gun, Jeollanam-do, Korea
- * E-mail:
| |
Collapse
|
44
|
Nam TS, Levy M, Kim SH, Kang KW, Kim BJ, Lee SH. Is Corticospinal Tract Degeneration Caused by Sjögren Syndrome? J Clin Neurol 2018; 14:259-260. [PMID: 29629535 PMCID: PMC5897216 DOI: 10.3988/jcn.2018.14.2.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 01/24/2018] [Accepted: 01/25/2018] [Indexed: 11/17/2022] Open
Affiliation(s)
- Tai Seung Nam
- Department of Neurology, Chonnam National University Medical School, Gwangju, Korea
- Department of Neurology, Chonnam National University Hospital, Gwangju, Korea.
| | - Michael Levy
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA.
| | - Sang Hoon Kim
- Department of Neurology, Chonnam National University Hospital, Gwangju, Korea
| | - Kyung Wook Kang
- Department of Neurology, Chonnam National University Hospital, Gwangju, Korea
| | - Byoung Joon Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seung Han Lee
- Department of Neurology, Chonnam National University Medical School, Gwangju, Korea
- Department of Neurology, Chonnam National University Hospital, Gwangju, Korea
| |
Collapse
|
45
|
Wen L, Shin MH, Kang JH, Yim YR, Kim JE, Lee JW, Lee KE, Park DJ, Kim TJ, Kweon SS, Lee YH, Yun YW, Lee SS. Association between grip strength and hand and knee radiographic osteoarthritis in Korean adults: Data from the Dong-gu study. PLoS One 2017; 12:e0185343. [PMID: 29190722 PMCID: PMC5708816 DOI: 10.1371/journal.pone.0185343] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 11/12/2017] [Indexed: 11/25/2022] Open
Abstract
Objectives We assessed whether grip strength was related to various types of radiographic damage in Korean adults with osteoarthritis (OA). Methods Data from 2,251 subjects enrolled in the Dong-gu study, who had no hand joint pain, were analyzed to investigate the relationship between grip strength and OA. Hand grip strength was measured using a hand-held dynamometer, and radiographs of the hand and knee were scored according to a semi-quantitative grading system. Multiple linear regressions were used to explore associations between grip strength and radiographic features of OA. Results Grip strength in men and women was negatively related to hand (both p < 0.001) and knee (men, p < 0.001; women, p = 0.010) OA after adjusting for confounders. Hand (men, p < 0.001; women, p = 0.001) and knee (both p < 0.001) joint space narrowing (JSN) showed the strongest associations with low grip strength, regardless of gender. Moreover, the severity of hand osteophytes in women (p = 0.001), and subchondral cysts (men, p < 0.001) was correlated with low grip strength in both genders. Conclusions Among subjects without hand joint pain, low grip strength was associated significantly with hand and knee radiographic OA, regardless of gender. Among all types of OA radiographic damage, low grip strength showed the strongest association with JSN.
Collapse
Affiliation(s)
- Lihui Wen
- Department of Rheumatology, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea
- Department of Biomedical Sciences, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ji-Hyoun Kang
- Department of Rheumatology, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea
| | - Yi-Rang Yim
- Department of Rheumatology, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea
| | - Ji-Eun Kim
- Department of Rheumatology, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea
| | - Jeong-Won Lee
- Department of Rheumatology, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea
| | - Kyung-Eun Lee
- Department of Rheumatology, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea
| | - Dong-Jin Park
- Department of Rheumatology, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea
| | - Tae-Jong Kim
- Department of Rheumatology, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea
| | - Sun-Seog Kweon
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
- Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea
| | - Young-Hoon Lee
- Department of Preventive Medicine & Institute of Wonkwang Medical Science, Wonkwang University College of Medicine, Iksan, Republic of Korea
| | - Yong-Woon Yun
- Department of Preventive Medicine, Bitgoeul Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Shin-Seok Lee
- Department of Rheumatology, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea
- Department of Biomedical Sciences, Chonnam National University Medical School, Gwangju, Republic of Korea
- * E-mail:
| |
Collapse
|
46
|
Oh SH, Kim JW, Kim Y, Lee MN, Kook MS, Choi EY, Im SY, Koh JT. The extracellular matrix protein Edil3 stimulates osteoblast differentiation through the integrin α5β1/ERK/Runx2 pathway. PLoS One 2017; 12:e0188749. [PMID: 29182679 PMCID: PMC5705136 DOI: 10.1371/journal.pone.0188749] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 11/12/2017] [Indexed: 02/07/2023] Open
Abstract
Epidermal growth factor-like repeats and discoidin I-like domain 3 (Edil3) is an extracellular matrix protein containing an Arg-Gly-Asp (RGD) motif that binds integrin. Recently, Edil3 has been implicated in various biological processes, including angiogenesis and cellular differentiation. It can inhibit inflammatory bone destruction. The objective of this study was to explore the role of Edil3 in osteoblast differentiation and its underlying molecular mechanisms. In wild-type mice, high expression levels of Edil3 mRNA were observed in isolated calvaria and tibia/femur bones. Immunohistochemical analysis showed that Edil3 protein was localized along periosteum and calcified regions surrounding bone tissues. When murine calvaria-derived MC3T3-E1 cells were cultured in osteogenic medium containing 50 μg/ml ascorbic acid and 5 mM β-glycerophosphate, Edil3 mRNA and protein expression levels were increased. Treatment with Edil3 protein in growth media increased expression levels of alkaline phosphatase and osteocalcin gene and phosphorylation level of extracellular signal-regulated kinase (ERK). Edil3 treatment with osteogenic medium induced mineralization. Treatment with a neutralizing antibody against α5β1 and MEK inhibitor U0126 inhibited Edil3-enhanced osteogenic marker gene expression and mineral deposition. Edil3 increased protein expression levels of transcription factor runt-related transcription factor2 (Runx2). Edil3-induced Runx2 protein expression was suppressed by pretreatment with U0126. Taken together, these results suggest that Edil3 may stimulate osteoblast differentiation and matrix mineralization by increasing expression of Runx2 through α5β1 integrin /ERK pathway.
Collapse
Affiliation(s)
- Sin-Hye Oh
- Department of Pharmacology and Dental Therapeutics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
- Department of Biological Sciences, College of Natural Sciences, Chonnam National University, Gwangju, Republic of Korea
| | - Jung-Woo Kim
- Department of Pharmacology and Dental Therapeutics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - Yuri Kim
- Department of Pharmacology and Dental Therapeutics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - Mi Nam Lee
- Department of Pharmacology and Dental Therapeutics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - Min-Suk Kook
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - Eun Young Choi
- Department of Biomedical Sciences, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Suhn-Young Im
- Department of Biological Sciences, College of Natural Sciences, Chonnam National University, Gwangju, Republic of Korea
| | - Jeong-Tae Koh
- Department of Pharmacology and Dental Therapeutics, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
- * E-mail:
| |
Collapse
|
47
|
Kim MC, Kim YS, Kang WS, Lee KH, Cho M, Hong MH, Lim KS, Jeong MH, Ahn Y. Intramyocardial Injection of Stem Cells in Pig Myocardial Infarction Model: The First Trial in Korea. J Korean Med Sci 2017; 32:1708-1712. [PMID: 28875618 PMCID: PMC5592188 DOI: 10.3346/jkms.2017.32.10.1708] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 03/19/2017] [Accepted: 07/01/2017] [Indexed: 11/20/2022] Open
Abstract
Although cell therapy is emerged for cardiac repair, its efficacy is modest by intracoronary infusion. Therefore, we established the intramyocardial delivery technique using a left ventricular (LV) mapping system (NOGA® XP) using 18 pigs. After adipose tissue-derived mesenchymal stem cells (ATSCs) were delivered intramyocardially to porcine infarcted heart, LV ejection fraction (EF) was increased, and LV chamber size was decreased. We proved the therapeutic effect of intramyocardial injection of ATSC through a LV mapping system in the porcine model for the first time in Korea. The adoption of this technique may accelerate the translation into a clinical application in the near future.
Collapse
Affiliation(s)
- Min Chul Kim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Yong Sook Kim
- Biomedical Research Institute, Chonnam National University Hospital, Gwangju, Korea
- Cell Regeneration Research Center, Chonnam National University Hospital, Gwangju, Korea
| | - Wan Seok Kang
- Biomedical Research Institute, Chonnam National University Hospital, Gwangju, Korea
| | - Ki Hong Lee
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Meeyoung Cho
- Cell Regeneration Research Center, Chonnam National University Hospital, Gwangju, Korea
| | - Moon Hwa Hong
- Cell Regeneration Research Center, Chonnam National University Hospital, Gwangju, Korea
| | - Kyung Seob Lim
- Biomedical Research Institute, Chonnam National University Hospital, Gwangju, Korea
| | - Myung Ho Jeong
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Youngkeun Ahn
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
- Biomedical Research Institute, Chonnam National University Hospital, Gwangju, Korea.
| |
Collapse
|
48
|
Shin J, Song SY, Ahn HS, An BC, Choi YD, Yang EG, Na KJ, Lee ST, Park JI, Kim SY, Lee C, Lee SW. Integrative analysis for the discovery of lung cancer serological markers and validation by MRM-MS. PLoS One 2017; 12:e0183896. [PMID: 28837649 PMCID: PMC5570484 DOI: 10.1371/journal.pone.0183896] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 08/14/2017] [Indexed: 12/18/2022] Open
Abstract
Non-small-cell lung cancer (NSCLC) constitutes approximately 80% of all diagnosed lung cancers, and diagnostic markers detectable in the plasma/serum of NSCLC patients are greatly needed. In this study, we established a pipeline for the discovery of markers using 9 transcriptome datasets from publicly available databases and profiling of six lung cancer cell secretomes. Thirty-one out of 312 proteins that overlapped between two-fold differentially expressed genes and identified cell secretome proteins were detected in the pooled plasma of lung cancer patients. To quantify the candidates in the serum of NSCLC patients, multiple-reaction-monitoring mass spectrometry (MRM-MS) was performed for five candidate biomarkers. Finally, two potential biomarkers (BCHE and GPx3; AUC = 0.713 and 0.673, respectively) and one two-marker panel generated by logistic regression (BCHE/GPx3; AUC = 0.773) were identified. A validation test was performed by ELISA to evaluate the reproducibility of GPx3 and BCHE expression in an independent set of samples (BCHE and GPx3; AUC = 0.630 and 0.759, respectively, BCHE/GPx3 panel; AUC = 0.788). Collectively, these results demonstrate the feasibility of using our pipeline for marker discovery and our MRM-MS platform for verifying potential biomarkers of human diseases.
Collapse
Affiliation(s)
- Jihye Shin
- Center for Theragnosis, Korea Institute of Science and Technology, Seongbuk-gu, Seoul, Korea
- Department of Biochemistry, College of Life Science and Biotechnology, Yonsei University, Seodaemun-gu, Seoul, Korea
| | - Sang-Yun Song
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hwasun Hospital, Hwasun-gun, Jeollanam-do, Korea
| | - Hee-Sung Ahn
- Center for Theragnosis, Korea Institute of Science and Technology, Seongbuk-gu, Seoul, Korea
- KIST School, Korea University of Science and Technology, Daejeon, Korea
| | - Byung Chull An
- Department of Anatomy, Chonnam National University Medical School, Hwasun-gun, Jeollanam-do, Korea
| | - Yoo-Duk Choi
- Department of Pathology, Chonnam National University Hospital, Dong-gu, Gwangju, Korea
| | - Eun Gyeong Yang
- Center for Theragnosis, Korea Institute of Science and Technology, Seongbuk-gu, Seoul, Korea
| | - Kook-Joo Na
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hwasun Hospital, Hwasun-gun, Jeollanam-do, Korea
| | - Seung-Taek Lee
- Department of Biochemistry, College of Life Science and Biotechnology, Yonsei University, Seodaemun-gu, Seoul, Korea
| | - Jae-Il Park
- Animal Facility of Aging Science, Korea Basic Science Institute, Buk-gu, Gwangju, Korea
| | - Seon-Young Kim
- Personalized Genomic Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, Korea
- Department of Functional Genomics, University of Science and Technology, Daejeon, Korea
| | - Cheolju Lee
- Center for Theragnosis, Korea Institute of Science and Technology, Seongbuk-gu, Seoul, Korea
- KIST School, Korea University of Science and Technology, Daejeon, Korea
- * E-mail: (SL); (CL)
| | - Seung-won Lee
- Department of Anatomy, Chonnam National University Medical School, Hwasun-gun, Jeollanam-do, Korea
- * E-mail: (SL); (CL)
| |
Collapse
|
49
|
Lee JW, Lee KE, Park DJ, Kim SH, Nah SS, Lee JH, Kim SK, Lee YA, Hong SJ, Kim HS, Lee HS, Kim HA, Joung CI, Kim SH, Lee SS. Determinants of quality of life in patients with fibromyalgia: A structural equation modeling approach. PLoS One 2017; 12:e0171186. [PMID: 28158289 PMCID: PMC5291376 DOI: 10.1371/journal.pone.0171186] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 01/17/2017] [Indexed: 11/24/2022] Open
Abstract
Objective Health-related quality of life (HRQOL) in patients with fibromyalgia (FM) is lower than in patients with other chronic diseases and the general population. Although various factors affect HRQOL, no study has examined a structural equation model of HRQOL as an outcome variable in FM patients. The present study assessed relationships among physical function, social factors, psychological factors, and HRQOL, and the effects of these variables on HRQOL in a hypothesized model using structural equation modeling (SEM). Methods HRQOL was measured using SF-36, and the Fibromyalgia Impact Questionnaire (FIQ) was used to assess physical dysfunction. Social and psychological statuses were assessed using the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), the Arthritis Self-Efficacy Scale (ASES), and the Social Support Scale. SEM analysis was used to test the structural relationships of the model using the AMOS software. Results Of the 336 patients, 301 (89.6%) were women with an average age of 47.9±10.9 years. The SEM results supported the hypothesized structural model (χ2 = 2.336, df = 3, p = 0.506). The final model showed that Physical Component Summary (PCS) was directly related to self-efficacy and inversely related to FIQ, and that Mental Component Summary (MCS) was inversely related to FIQ, BDI, and STAI. Conclusions In our model of FM patients, HRQOL was affected by physical, social, and psychological variables. In these patients, higher levels of physical function and self-efficacy can improve the PCS of HRQOL, while physical function, depression, and anxiety negatively affect the MCS of HRQOL.
Collapse
Affiliation(s)
- Jeong-Won Lee
- Division of Rheumatology, Department of Internal Medicine, Chonnam National University Hospital & Medical School, Gwangju, Korea
| | - Kyung-Eun Lee
- Division of Rheumatology, Department of Internal Medicine, Chonnam National University Hospital & Medical School, Gwangju, Korea
| | - Dong-Jin Park
- Division of Rheumatology, Department of Internal Medicine, Chonnam National University Hospital & Medical School, Gwangju, Korea
| | - Seong-Ho Kim
- Division of Rheumatology, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Seong-Su Nah
- Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University, College of Medicine, Cheonan, Korea
| | - Ji Hyun Lee
- Division of Rheumatology, Department of Internal Medicine, Maryknoll Medical Center, Busan, Korea
| | - Seong-Kyu Kim
- Division of Rheumatology, Department of Internal Medicine, Catholic University of Daegu, School of Medicine, Daegu, Korea
| | - Yeon-Ah Lee
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Seung-Jae Hong
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Hyun-Sook Kim
- Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Hye-Soon Lee
- Division of Rheumatology, Department of Internal Medicine, Hanyang University College of Medicine and the Hospital for Rheumatic Diseases, Seoul, Korea
| | - Hyoun Ah Kim
- Division of Rheumatology, Department of Internal Medicine, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea
| | - Chung-Il Joung
- Division of Rheumatology, Department of Internal Medicine, Konyang University Medical School, Daejeon, Korea
| | - Sang-Hyon Kim
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Keimyung University, Daegu, Korea
| | - Shin-Seok Lee
- Division of Rheumatology, Department of Internal Medicine, Chonnam National University Hospital & Medical School, Gwangju, Korea
- * E-mail:
| |
Collapse
|
50
|
Kang SJ, Jin HM, Won EJ, Cho YN, Jung HJ, Kwon YS, Kee HJ, Ju JK, Kim JC, Kim UJ, Jang HC, Jung SI, Kee SJ, Park YW. Activation, Impaired Tumor Necrosis Factor-α Production, and Deficiency of Circulating Mucosal-Associated Invariant T Cells in Patients with Scrub Typhus. PLoS Negl Trop Dis 2016; 10:e0004832. [PMID: 27463223 PMCID: PMC4963088 DOI: 10.1371/journal.pntd.0004832] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 06/17/2016] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Mucosal-associated invariant T (MAIT) cells contribute to protection against certain microorganism infections. However, little is known about the role of MAIT cells in Orientia tsutsugamushi infection. Hence, the aims of this study were to examine the level and function of MAIT cells in patients with scrub typhus and to evaluate the clinical relevance of MAIT cell levels. METHODOLOGY/PRINCIPAL FINDINGS Thirty-eight patients with scrub typhus and 53 health control subjects were enrolled in the study. The patients were further divided into subgroups according to disease severity. MAIT cell level and function in the peripheral blood were measured by flow cytometry. Circulating MAIT cell levels were found to be significantly reduced in scrub typhus patients. MAIT cell deficiency reflects a variety of clinical conditions. In particular, MAT cell levels reflect disease severity. MAIT cells in scrub typhus patients displayed impaired tumor necrosis factor (TNF)-α production, which was restored during the remission phase. In addition, the impaired production of TNF-α by MAIT cells was associated with elevated CD69 expression. CONCLUSIONS This study shows that circulating MAIT cells are activated, numerically deficient, and functionally impaired in TNF-α production in patients with scrub typhus. These abnormalities possibly contribute to immune system dysregulation in scrub typhus infection.
Collapse
Affiliation(s)
- Seung-Ji Kang
- Department of Infectious Diseases, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Hye-Mi Jin
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Eun Jeong Won
- Department of Laboratory Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Young-Nan Cho
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Hyun-Ju Jung
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Yong-Soo Kwon
- Department of Pulmonary and Critical Care Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Hae Jin Kee
- Heart Research Center, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Jae Kyun Ju
- Department of Surgery, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Jung-Chul Kim
- Department of Surgery, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Uh Jin Kim
- Department of Infectious Diseases, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Hee-Chang Jang
- Department of Infectious Diseases, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Sook-In Jung
- Department of Infectious Diseases, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Seung-Jung Kee
- Department of Laboratory Medicine, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Yong-Wook Park
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| |
Collapse
|