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Salari K, Lee JS, Ye H, Seymour ZA, Lee KC, Chinnaiyan P, Grills IS. Long-term survival in patients with brain-only metastatic non-small cell lung cancer undergoing upfront intracranial stereotactic radiosurgery and definitive treatment to the thoracic primary site. Radiother Oncol 2024; 196:110262. [PMID: 38556172 DOI: 10.1016/j.radonc.2024.110262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 03/21/2024] [Accepted: 03/24/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND AND PURPOSE To evaluate modern clinical outcomes for patients with brain-only metastatic non-small cell lung cancer (NSCLC) treated with intracranial stereotactic radiosurgery (SRS) with or without definitive treatment of the primary site. MATERIALS AND METHODS Patients with synchronously diagnosed NSCLC and brain-only metastatic disease treated with intracranial SRS at a single institution were retrospectively identified. Patients were stratified based on whether they did (A) or did not (B) receive definitive primary site treatment. Patient characteristics and clinical outcomes were compared. RESULTS From 2008 to 2022, 103 patients were identified, 53 of whom received definitive primary site treatment. Median follow-up was 2.1 y (A) and 0.8 y (B) (p < 0.001). 28 (53 %) patients in Group A received immune checkpoint inhibitor (ICI) therapy versus 19 (38 %) in Group B (p = 0.13) and there were no other statistically significant baseline or treatment characteristic differences between the groups. 5-year local-PFS was 34.5 % (A) versus 0 % (B) (p < 0.001). 5-year regional-PFS was 33.0 % (A) versus 0 % (B) (p < 0.001). 5-year distant body-PFS was 34.0 % (A) versus 0 % (B) (p < 0.001). 5-year CNS-PFS was 14.7 % (A) versus 0 % (B) (p = 0.12). 5-year OS was 40.2 % (A) versus 0 % (B) (p = 0.001). 5-year CSS was 67.6 % (A) versus 0 % (B) (p = 0.002). On multivariable analysis, lack of definitive treatment to the primary site (HR = 2.40), AJCC T3-4 disease (HR = 2.73), and lack of ICI therapy (HR = 2.86) were significant predictors of death. CONCLUSION Definitive treatment to the thoracic primary site in patients with brain-only metastatic NSCLC after intracranial radiosurgery was associated with slower progression of disease and improved survival.
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Affiliation(s)
- K Salari
- Department of Radiation Oncology, Corewell Health East William Beaumont University Hospital, Royal Oak, MI, United States.
| | - J S Lee
- Department of Radiation Oncology, Corewell Health East William Beaumont University Hospital, Royal Oak, MI, United States
| | - H Ye
- Department of Radiation Oncology, Corewell Health East William Beaumont University Hospital, Royal Oak, MI, United States
| | - Z A Seymour
- Department of Radiation Oncology, Corewell Health Dearborn Hospital, Dearborn, MI, United States
| | - K C Lee
- Department of Radiation Oncology, Corewell Health Troy Hospital, Troy, MI, United States
| | - P Chinnaiyan
- Department of Radiation Oncology, Corewell Health East William Beaumont University Hospital, Royal Oak, MI, United States
| | - I S Grills
- Department of Radiation Oncology, Corewell Health East William Beaumont University Hospital, Royal Oak, MI, United States
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Tangen J, Aukrust P, Barrat-Due A, Troseid M, Christoffer Olsen I, Nezvalova-Henriksen K, Kaasine T, Dyrhol-Riise AM, Rygh Holten A, Finbraten AK, Josefsen TA, Lee KC, Haugaa KH, Skulstad H, Edvardsen T. Cardiac function is normal in most patients recovered from COVID-19. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
There are conflicting results regarding impaired cardiac function in patients that have recovered from COVID-19. Cardiovascular magnetic resonance (CMR) studies have revealed a very high frequency of cardiac involvement (78%) and ongoing myocardial inflammation (60%) in patients recently recovered from COVID-19. Findings are advocating further investigation of the long-term myocardial consequences of COVID-19 disease.
Purpose
We aimed to investigate left ventricular (LV) and right ventricular (RV) function by a comprehensive echocardiographic study in patients recovered from COVID-19 infection 3 months after admission to hospital.
Methods
All patients (n=92) had been hospitalized for COVID-19 and were examined with echocardiography three months after hospitalization. They were 59±13 years, and 43% were women. LV function was assessed by ejection fraction (EF) and global longitudinal strain (GLS) and RV function was measured by fractional area change (FAC), tricuspid annular plane systolic excursion (TAPSE) and RV GLS free wall. Tricuspid regurgitation pressure gradient was measured to estimate pulmonary artery pressure.
Results
LV EF was 63±6% and LV GLS was −18.6±2.2%. All patients had normal EF >53%, but 10 showed signs of subtle impaired LV function by LV GLS (≥ −16%). Only two of these did not have hypertension, LV hypertrophy, diabetes or other preexisting diagnosis of heart disease explaining subtle LV dysfunction. All had normal RV FAC (48±7%) and TAPSE (2.3±0.3 cm). We found modestly impaired RV longitudinal function (RV GLS free wall >−25%) in 30% patients, but none had RV GLS worse than −20%. One-third of all patients with reduced RV GLS had signs of elevated pulmonary arterial pressures, which might impact the assessment of RV function.
Conclusions
Traditional echocardiographic parameters showed normal function in all hospitalized COVID-19 patients three months after hospital admittance. Approximately one-third had subtle ventricular dysfunction detected by sensitive echocardiographic methods, but these findings could mostly be explained by systemic or pulmonary hypertension. We cannot, however, exclude that a slight reduction in cardiac function in a minority of our patients was caused by the COVID-19 infection.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): National Clinical Therapy Research in the Specialist Health Services, Norway
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Affiliation(s)
- J Tangen
- Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - P Aukrust
- Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - A Barrat-Due
- Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - M Troseid
- Oslo University Hospital Rikshospitalet, Oslo, Norway
| | | | | | - T Kaasine
- Oslo University Hospital Rikshospitalet, Oslo, Norway
| | | | - A Rygh Holten
- Oslo University Hospital Rikshospitalet, Oslo, Norway
| | | | | | - K C Lee
- Sorlandet hospital, Kristiansand, Norway
| | - K H Haugaa
- Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - H Skulstad
- Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - T Edvardsen
- Oslo University Hospital Rikshospitalet, Oslo, Norway
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Chan JCY, Fung SY, Ching OH, Lee KC, Cheung CW, Ng MY. Painless Asymptomatic Ascending Aortic Dissection with Four-Dimensional Flow Magnetic Resonance Imaging: a Case Report. Hong Kong Journal of Radiology 2021. [DOI: 10.12809/hkjr2117208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- JCY Chan
- Department of Radiology, Queen Mary Hospital, Hong Kong
| | - SY Fung
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - OH Ching
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - KC Lee
- Department of Medicine, Ruttonjee Hospital, Hong Kong
| | - CW Cheung
- Department of Radiology, Queen Mary Hospital, Hong Kong
| | - MY Ng
- Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong
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Juhn JW, Lee KC, Lee TG, Wi HM, Kim YS, Hahn SH, Nam YU. Multi-chord IR-visible two-color interferometer on KSTAR. Rev Sci Instrum 2021; 92:043559. [PMID: 34243393 DOI: 10.1063/5.0043811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/29/2021] [Indexed: 06/13/2023]
Abstract
Major parts of an IR-visible two-color interferometer (TCI) on KSTAR have been upgraded for the multi-chord operation: (1) a diode-pumped-solid-state (DPSS) laser (660 nm) replacing the former HeNe laser (633 nm), (2) vacuum-compatible vibration isolator with titanium retro-reflectors, and (3) full digital phase comparator for multi-chord real-time density signals. The commercial compact DPSS laser suits the multiple chord configuration with its strong beam power (500 mW) and long coherent length (>100 m). Ti retro-reflectors are mounted on vacuum-compatible vibration isolators. The isolators are essential for the visible beams to avoid any fringe skips due to their short wavelength, considering the speed of the mechanical vibration (up to hundreds of μm). Field-programmable-gate-array (FPGA) modules count the entire fringes fast enough with a signal output rate up to 1.25 MHz, solving the fringe skip issues. The FPGA module enables the full digital processing of the phase comparator with a CORDIC algorithm after the sampling rate of 160 MS/s for the 40 MHz intermediate frequency of each beam. The full digital signals are transferred to the main plasma control system in real-time. Stable single-input-single-output operation of the KSTAR density control was demonstrated with the TCI. The real-time density profile control is also promising in the near future, with multiple actuators such as pellets and gas puffings.
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Affiliation(s)
- June-Woo Juhn
- Korea Institute of Fusion Energy, Daejeon 34133, Republic of Korea
| | - K C Lee
- Korea Institute of Fusion Energy, Daejeon 34133, Republic of Korea
| | - T G Lee
- Korea Institute of Fusion Energy, Daejeon 34133, Republic of Korea
| | - H M Wi
- Korea Institute of Fusion Energy, Daejeon 34133, Republic of Korea
| | - Y S Kim
- Korea Institute of Fusion Energy, Daejeon 34133, Republic of Korea
| | - S H Hahn
- Korea Institute of Fusion Energy, Daejeon 34133, Republic of Korea
| | - Y U Nam
- Korea Institute of Fusion Energy, Daejeon 34133, Republic of Korea
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Lee DG, Lee KC, Juhn JW, Lee JS, Ghim YC. The new single crystal dispersion interferometer installed on KSTAR and its first measurement. Rev Sci Instrum 2021; 92:033536. [PMID: 33820011 DOI: 10.1063/5.0043629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 03/03/2021] [Indexed: 06/12/2023]
Abstract
Dispersion interferometers have been used to measure line integrated electron densities from many fusion devices. To optically suppress noise due to mechanical vibrations, a conventional dispersion interferometer typically uses two nonlinear crystals located before and after the plasma along the laser beam path. Due to the long beam path, it can be difficult to overlap the fundamental and second harmonic laser beams for a heterodyne dispersion interferometer and to focus the beams on the second nonlinear crystal located after the plasma, especially when the aperture of the nonlinear crystal is small, i.e., of the order of mm. To overcome such difficulties, a new concept of a heterodyne dispersion interferometer, a single crystal dispersion interferometer (SCDI), is developed and installed on KSTAR with the laser wavelength of 1064 nm. The concept and the optical setup of the KSTAR SCDI are discussed, as well as its first measurement during a shattered pellet injection that produces abrupt and large changes in the electron density. To demonstrate feasibility, the KSTAR SCDI measurements are also compared with those from the existing two-color interferometer.
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Affiliation(s)
- Dong-Geun Lee
- Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
| | - K C Lee
- Korea Institute of Fusion Energy, Daejeon 34133, Republic of Korea
| | - J-W Juhn
- Korea Institute of Fusion Energy, Daejeon 34133, Republic of Korea
| | - Jae-Seok Lee
- Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
| | - Y-C Ghim
- Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
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Lee JS, Lee DG, Lee KC, Juhn JW, Ghim YC. Development of a forward model for Bayesian analysis of a single crystal dispersion interferometer. Rev Sci Instrum 2021; 92:033520. [PMID: 33819990 DOI: 10.1063/5.0043632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 02/23/2021] [Indexed: 06/12/2023]
Abstract
The Single Crystal Dispersion Interferometer (SCDI) is a newly developed dispersion interferometer (DI) system installed on KSTAR and has obtained the first data successfully in January 2020. Unlike conventional heterodyne DI systems, which use two nonlinear crystals, only one nonlinear crystal is used to eliminate the difficulty in overlapping the first and second harmonic beams, aligning and focusing the beams to a small aperture of the second nonlinear crystal, and resolving a problem of significant efforts to maintain the beam alignment to the second nonlinear crystal after a long beam transmission. The second nonlinear crystal is replaced by a frequency doubler, a simple electronic component. To infer a line integrated electron density with its associated uncertainty consistent with the measured data, we develop a forward model of the KSTAR SCDI that can be used as a likelihood within a Bayesian-based data analysis routine. The forward model consists of two main parts, which are an optical system and an electronics system, and it takes into account noises by modeling the mechanical vibrations and the electronic noises as Gaussian distributions, while the photon noise is modeled with a Poisson distribution. The developed forward model can be used for designing and improving the SCDI system.
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Affiliation(s)
- Jae-Seok Lee
- Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
| | - Dong-Geun Lee
- Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
| | - K C Lee
- Korea Institute of Fusion Energy, Daejeon 34133, Republic of Korea
| | - J-W Juhn
- Korea Institute of Fusion Energy, Daejeon 34133, Republic of Korea
| | - Y-C Ghim
- Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
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Geleijnse G, Chiang RCJ, Sieswerda M, Schuurman M, Lee KC, van Soest J, Dekker A, Lee WC, Verbeek XAAM. Prognostic factors analysis for oral cavity cancer survival in the Netherlands and Taiwan using a privacy-preserving federated infrastructure. Sci Rep 2020; 10:20526. [PMID: 33239719 PMCID: PMC7688977 DOI: 10.1038/s41598-020-77476-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 11/09/2020] [Indexed: 11/24/2022] Open
Abstract
The difference in incidence of oral cavity cancer (OCC) between Taiwan and the Netherlands is striking. Different risk factors and treatment expertise may result in survival differences between the two countries. However due to regulatory restrictions, patient-level analyses of combined data from the Netherlands and Taiwan are infeasible. We implemented a software infrastructure for federated analyses on data from multiple organisations. We included 41,633 patients with single-tumour OCC between 2004 and 2016, undergoing surgery, from the Taiwan Cancer Registry and Netherlands Cancer Registry. Federated Cox Proportional Hazard was used to analyse associations between patient and tumour characteristics, country, treatment and hospital volume with survival. Five factors showed differential effects on survival of OCC patients in the Netherlands and Taiwan: age at diagnosis, stage, grade, treatment and hospital volume. The risk of death for OCC patients younger than 60 years, with advanced stage, higher grade or receiving adjuvant therapy after surgery was lower in the Netherlands than in Taiwan; but patients older than 70 years, with early stage, lower grade and receiving surgery alone in the Netherlands were at higher risk of death than those in Taiwan. The mortality risk of OCC in Taiwanese patients treated in hospitals with higher hospital volume (≥ 50 surgeries per year) was lower than in Dutch patients. We conducted analyses without exchanging patient-level information, overcoming barriers for sharing privacy sensitive information. The outcomes of patients treated in the Netherlands and Taiwan were slightly different after controlling for other prognostic factors.
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Affiliation(s)
- Gijs Geleijnse
- Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT, Utrecht, The Netherlands.
| | - RuRu Chun-Ju Chiang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University and Taiwan Cancer Registry, Taipei, Taiwan
| | - Melle Sieswerda
- Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT, Utrecht, The Netherlands
| | - Melinda Schuurman
- Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT, Utrecht, The Netherlands
| | - K C Lee
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute (ITRI), Hsinchu, Taiwan
| | - Johan van Soest
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Andre Dekker
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Wen-Chung Lee
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University and Taiwan Cancer Registry, Taipei, Taiwan
| | - Xander A A M Verbeek
- Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT, Utrecht, The Netherlands
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Atwal M, Swan RL, Rowe C, Lee KC, Lee DC, Armstrong L, Cowell IG, Austin CA. Intercalating TOP2 Poisons Attenuate Topoisomerase Action at Higher Concentrations. Mol Pharmacol 2019; 96:475-484. [PMID: 31399497 PMCID: PMC6744389 DOI: 10.1124/mol.119.117259] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 08/02/2019] [Indexed: 12/18/2022] Open
Abstract
Topoisomerase II (TOP2) poisons are effective cytotoxic anticancer agents that stabilize the normally transient TOP2-DNA covalent complexes formed during the enzyme reaction cycle. These drugs include etoposide, mitoxantrone, and the anthracyclines doxorubicin and epirubicin. Anthracyclines also exert cell-killing activity via TOP2-independent mechanisms, including DNA adduct formation, redox activity, and lipid peroxidation. Here, we show that anthracyclines and another intercalating TOP2 poison, mitoxantrone, stabilize TOP2-DNA covalent complexes less efficiently than etoposide, and at higher concentrations they suppress the formation of TOP2-DNA covalent complexes, thus behaving as TOP2 poisons at low concentration and inhibitors at high concentration. We used induced pluripotent stem cell (iPSC)-derived human cardiomyocytes as a model to study anthracycline-induced damage in cardiac cells. Using immunofluorescence, our study is the first to demonstrate the presence of topoisomerase IIβ (TOP2B) as the only TOP2 isoform in iPSC-derived cardiomyocytes. In these cells, etoposide robustly induced TOP2B covalent complexes, but we could not detect doxorubicin-induced TOP2-DNA complexes, and doxorubicin suppressed etoposide-induced TOP2-DNA complexes. In vitro, etoposide-stabilized DNA cleavage was attenuated by doxorubicin, epirubicin, or mitoxantrone. Clinical use of anthracyclines is associated with cardiotoxicity. The observations in this study have potentially important clinical consequences regarding the effectiveness of anticancer treatment regimens when TOP2-targeting drugs are used in combination. These observations suggest that inhibition of TOP2B activity, rather than DNA damage resulting from TOP2 poisoning, may play a role in doxorubicin cardiotoxicity. SIGNIFICANCE STATEMENT: We show that anthracyclines and mitoxantrone act as topoisomerase II (TOP2) poisons at low concentration but attenuate TOP2 activity at higher concentration, both in cells and in in vitro cleavage experiments. Inhibition of type II topoisomerases suppresses the action of other drugs that poison TOP2. Thus, combinations containing anthracyclines or mitoxantrone and etoposide may reduce the activity of etoposide as a TOP2 poison and thus reduce the efficacy of drug combinations.
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Affiliation(s)
- Mandeep Atwal
- Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle upon Tyne, United Kingdom (M.A., R.L.S., C.R., K.C.L., I.G.C., C.A.A.) and Institute of Genetic Medicine, Newcastle University, International Centre for Life, Central Parkway, Newcastle upon Tyne, United Kingdom (D.C.L., L.A.)
| | - Rebecca L Swan
- Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle upon Tyne, United Kingdom (M.A., R.L.S., C.R., K.C.L., I.G.C., C.A.A.) and Institute of Genetic Medicine, Newcastle University, International Centre for Life, Central Parkway, Newcastle upon Tyne, United Kingdom (D.C.L., L.A.)
| | - Chloe Rowe
- Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle upon Tyne, United Kingdom (M.A., R.L.S., C.R., K.C.L., I.G.C., C.A.A.) and Institute of Genetic Medicine, Newcastle University, International Centre for Life, Central Parkway, Newcastle upon Tyne, United Kingdom (D.C.L., L.A.)
| | - Ka C Lee
- Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle upon Tyne, United Kingdom (M.A., R.L.S., C.R., K.C.L., I.G.C., C.A.A.) and Institute of Genetic Medicine, Newcastle University, International Centre for Life, Central Parkway, Newcastle upon Tyne, United Kingdom (D.C.L., L.A.)
| | - David C Lee
- Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle upon Tyne, United Kingdom (M.A., R.L.S., C.R., K.C.L., I.G.C., C.A.A.) and Institute of Genetic Medicine, Newcastle University, International Centre for Life, Central Parkway, Newcastle upon Tyne, United Kingdom (D.C.L., L.A.)
| | - Lyle Armstrong
- Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle upon Tyne, United Kingdom (M.A., R.L.S., C.R., K.C.L., I.G.C., C.A.A.) and Institute of Genetic Medicine, Newcastle University, International Centre for Life, Central Parkway, Newcastle upon Tyne, United Kingdom (D.C.L., L.A.)
| | - Ian G Cowell
- Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle upon Tyne, United Kingdom (M.A., R.L.S., C.R., K.C.L., I.G.C., C.A.A.) and Institute of Genetic Medicine, Newcastle University, International Centre for Life, Central Parkway, Newcastle upon Tyne, United Kingdom (D.C.L., L.A.)
| | - Caroline A Austin
- Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle upon Tyne, United Kingdom (M.A., R.L.S., C.R., K.C.L., I.G.C., C.A.A.) and Institute of Genetic Medicine, Newcastle University, International Centre for Life, Central Parkway, Newcastle upon Tyne, United Kingdom (D.C.L., L.A.)
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Lee KC, Bamford A, Gardiner F, Agovino A, Ter Horst B, Bishop J, Sitch A, Grover L, Logan A, Moiemen NS. Investigating the intra- and inter-rater reliability of a panel of subjective and objective burn scar measurement tools. Burns 2019; 45:1311-1324. [PMID: 31327551 PMCID: PMC6731390 DOI: 10.1016/j.burns.2019.02.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 01/13/2019] [Accepted: 02/07/2019] [Indexed: 01/03/2023]
Abstract
Subjective scar measures have poor reliability unless repeated by more than one assessor. Objective scar measures have been demonstrated to have good to excellent reliability. Physical symptoms of scars such as pain and itch were found to be more important to patients compared to surface, area and colour although this finding was not sustained when corrected for multiple comparisons.
Background Research into the treatment of hypertrophic burn scar is hampered by the variability and subjectivity of existing outcome measures. This study aims to measure the inter- and intra-rater reliability of a panel of subjective and objective burn scar measurement tools. Methods Three independent assessors evaluated 55 scar and normal skin sites using subjective (modified Vancouver Scar Scale [mVSS] & Patient and Observer Scar Assessment Scale [POSAS]) and objective tools. The intra-class correlation coefficient was utilised to measure reliability (acceptable when >0.70). Patient satisfaction with the different tools and scar parameter importance were assessed via questionnaires. Results The inter-rater reliabilities of the mVSS and POSAS were below the acceptable limit. For erythema and pigmentation, all of the Scanoskin and DSM II measures (except the b* value) had acceptable to excellent intra and inter-rater reliability. The Dermascan ultrasound (dermal thickness, intensity) had excellent intra- and inter-rater reliability (>0.90). The Cutometer R0 (firmness) had acceptable reliability but not R2 (gross elasticity). All objective measurement tools had good overall satisfaction scores. Patients rated scar related pain and itch as more important compared to appearance although this finding was not sustained when corrected for multiple comparisons. Conclusion The objective scar measures demonstrated acceptable to excellent intra- and inter-rater reliability and performed better than the subjective scar scales.
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Affiliation(s)
- K C Lee
- Scar Free Foundation Centre for Burns Research, University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK
| | - A Bamford
- University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK
| | - F Gardiner
- University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK
| | - A Agovino
- Scar Free Foundation Centre for Burns Research, University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK
| | - B Ter Horst
- Scar Free Foundation Centre for Burns Research, University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK
| | - J Bishop
- Birmingham Clinical Trials Unit (BCTU), Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - A Sitch
- Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - L Grover
- School of Chemical Engineering, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - A Logan
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - N S Moiemen
- Scar Free Foundation Centre for Burns Research, University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK.
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Kim H, Park W, Choi DH, Ahn SJ, Kim SS, Kim ES, Lee JH, Lee KC, Kim JH, Lee HS, Kim JH, Kim MY, Park HJ, Kim K, Song SH, Kwon J, Lee IJ, Kim TH, Kim TG, Chang AR, Cho O, Jeong BK, Ha B, Lee J, Ki Y. Abstract OT2-04-02: A phase 3 study of post-lumpectomy radiotherapy to whole breast + regional lymph nodes vs whole breast alone for patients with pN1 breast cancer treated with taxane-based chemotherapy (KROG 1701): Trial in progress. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-ot2-04-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
In patients with early stage breast cancer, regional nodal irradiation (RNI) is added to whole breast irradiation (WBI) in order to control microscopic regional disease and to prevent systemic spread of cancer. According to recent randomized trials (MA.20 and EORTC 22922-10925), prophylactic RNI was associated with improvement in disease-free survival (DFS) in the patients with high-risk node negative or pN1 breast cancer. However, systemic agents now known to improve loco-regional control, such as taxane or endocrine therapy, were prescribed to a small percentage of patients in the studies. The benefit of RNI found in the previous studies might be attributed to incorporation of less effective systemic treatments. The impact of prophylactic RNI in pN1 breast cancer should be evaluated in the patients receiving modern systemic treatment. The current study was conducted to compare the effect of post-lumpectomy WBI vs WBI plus RNI on DFS in pN1 breast cancer patients who received adjuvant taxane-based chemotherapy.
Methods
This study is a multicenter, phase 3, randomized controlled non-inferiority trial (NCT03269981). Eligibility criteria are ≥ 20 years female; pathologically proven invasive carcinoma of the breast; one to three positive axillary lymph nodes (pN1) in pathologic specimen; receiving breast-conserving surgery followed by taxane-based chemotherapy; having adjuvant endocrine therapy or anti-HER2 treatment according to molecular subtype of tumor. Patients are randomly assigned in a 1:1 ratio to receive WBI or WBI plus RNI. Patient randomization was stratified by molecular subtype of tumor (i.e. luminal A/luminal B/luminal HER2/HER2-enriched/triple-negative) and methods of axillary management (i.e. sentinel lymph node biopsy/axillary lymph node dissection). The primary outcome is DFS. The secondary outcomes include DFS according to molecular subtype, treatment-related toxicity, and patient's quality of life per EORTC QLQ-C30 and QLQ-BR23. Patients will be followed for survival and disease recurrence for seven years. A total of 1,926 patients are planned to be enrolled, with recruitment initiated in April 2017. As of June 2018, a total of 236 patients were enrolled.
Acknowledgement
This study was supported by a grant from the National R&D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea (grant number: HA17C0043010018).
Citation Format: Kim H, Park W, Choi DH, Ahn SJ, Kim SS, Kim ES, Lee JH, Lee KC, Kim JH, Lee H-S, Kim JH, Kim MY, Park HJ, Kim K, Song SH, Kwon J, Lee IJ, Kim TH, Kim TG, Chang AR, Cho O, Jeong BK, Ha B, Lee J, Ki Y. A phase 3 study of post-lumpectomy radiotherapy to whole breast + regional lymph nodes vs whole breast alone for patients with pN1 breast cancer treated with taxane-based chemotherapy (KROG 1701): Trial in progress [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT2-04-02.
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Affiliation(s)
- H Kim
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - W Park
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - DH Choi
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - SJ Ahn
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - SS Kim
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - ES Kim
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - JH Lee
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - KC Lee
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - JH Kim
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - H-S Lee
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - JH Kim
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - MY Kim
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - HJ Park
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - K Kim
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - SH Song
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - J Kwon
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - IJ Lee
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - TH Kim
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - TG Kim
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - AR Chang
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - O Cho
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - BK Jeong
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - B Ha
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - J Lee
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - Y Ki
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
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Mak CM, Mok NS, Shum HC, Siu WK, Chong YK, Lee HHC, Fong NC, Tong SF, Lee KW, Ching CK, Chen SPL, Cheung WL, Tso CB, Poon WM, Lau CL, Lo YK, Tsui PT, Shum SF, Lee KC. Sudden arrhythmia death syndrome in young victims: a five-year retrospective review and two-year prospective molecular autopsy study by next-generation sequencing and clinical evaluation of their first-degree relatives. Hong Kong Med J 2019; 25:21-9. [PMID: 30670673 DOI: 10.12809/hkmj187256] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE Sudden arrhythmia death syndrome (SADS) accounts for about 30% of causes of sudden cardiac death (SCD) in young people. In Hong Kong, there are scarce data on SADS and a lack of experience in molecular autopsy. We aimed to investigate the value of molecular autopsy techniques for detecting SADS in an East Asian population. METHODS This was a two-part study. First, we conducted a retrospective 5-year review of autopsies performed in public mortuaries on young SCD victims. Second, we conducted a prospective 2-year study combining conventional autopsy investigations, molecular autopsy, and cardiac evaluation of the first-degree relatives of SCD victims. A panel of 35 genes implicated in SADS was analysed by next-generation sequencing. RESULTS There were 289 SCD victims included in the 5-year review. Coronary artery disease was the major cause of death (35%); 40% were structural heart diseases and 25% were unexplained. These unexplained cases could include SADS-related conditions. In the 2-year prospective study, 21 SCD victims were examined: 10% had arrhythmogenic right ventricular cardiomyopathy, 5% had hypertrophic cardiomyopathy, and 85% had negative autopsy. Genetic analysis showed 29% with positive heterozygous genetic variants; six variants were novel. One third of victims had history of syncope, and 14% had family history of SCD. More than half of the 11 first-degree relatives who underwent genetic testing carried related genetic variants, and 10% had SADS-related clinical features. CONCLUSION This pilot feasibility study shows the value of incorporating cardiac evaluation of surviving relatives and next-generation sequencing molecular autopsy into conventional forensic investigations in diagnosing young SCD victims in East Asian populations. The interpretation of genetic variants in the context of SCD is complicated and we recommend its analysis and reporting by qualified pathologists.
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Affiliation(s)
- C M Mak
- Department of Pathology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - N S Mok
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - H C Shum
- Forensic Pathology Service, Department of Health, Hong Kong
| | - W K Siu
- Department of Pathology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - Y K Chong
- Department of Pathology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - H H C Lee
- Department of Pathology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - N C Fong
- Department of Paediatrics, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - S F Tong
- Department of Pathology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - K W Lee
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - C K Ching
- Department of Pathology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - S P L Chen
- Department of Pathology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - W L Cheung
- Department of Pathology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - C B Tso
- Forensic Pathology Service, Department of Health, Hong Kong
| | - W M Poon
- Forensic Pathology Service, Department of Health, Hong Kong
| | - C L Lau
- Forensic Pathology Service, Department of Health, Hong Kong
| | - Y K Lo
- Forensic Pathology Service, Department of Health, Hong Kong
| | - P T Tsui
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - S F Shum
- Forensic Pathology Service, Department of Health, Hong Kong
| | - K C Lee
- Department of Pathology, Princess Margaret Hospital, Kwai Chung, Hong Kong
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Ho KM, Ismail H, Lee KC, Branch R. Use of Intrathecal Neostigmine as an Adjunct to Other Spinal Medications in Perioperative and Peripartum Analgesia: A Meta-analysis. Anaesth Intensive Care 2019; 33:41-53. [PMID: 15957690 DOI: 10.1177/0310057x0503300107] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Intrathecal neostigmine has been used as an adjunct to intrathecal local anaesthetic or opioid to prolong regional analgesia and improve haemodynamic stability, with variable results. This meta-analysis aims to evaluate the effectiveness and side-effects of intrathecal neostigmine in the perioperative and peripartum settings. The literature search was based on Cochrane Controlled Trials Register, EMBASE and MEDLINE (from 1966 to 14 November 2003) databases. Volunteer and animal studies were excluded. We identified 26 studies and 19 were considered suitable for detailed data extraction. Intrathecal neostigmine increased the incidence of nausea and vomiting (OR 5.0, 95% CI: 3.4 to 7.3; P<0.00001), bradycardia requiring intravenous atropine (OR 2.7, 95% CI: 1.4 to 5.4; P=0.005), and anxiety, agitation, or restlessness (OR 10.3, 95% CI: 3.7 to 28.9; P=0.00001). It improved the overall 24 hour VAS score (–1.4 VAS pain score, 95% CI: -1.7 to -1.2, P<0.00001), delayed the time of first request for rescue analgesia (168 min, 95% CI: 125 to 211; P<0.00001), and reduced the total number of rescue injections of nonsteroidal anti-inflammatory drug within the first 24 hours (-0.8, 95% CI: -1.1 to -0.4; P=0.00001). It did not affect the duration of motor blockade (3.5 min, 95% CI: -1.5 to 8.6; P=0.17) or the total amount of ephedrine required (-0.4 mg, 95% CI: -1.5 to 0.7; P=0.5). Adding intrathecal neostigmine to other spinal medications improves perioperative and peripartum analgesia marginally when compared with placebo. It is associated with significant side-effects and the disadvantages outweigh the minor improvement in analgesia achieved.
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Affiliation(s)
- K M Ho
- Department of Anaesthesia and Intensive Care, North Shore Hospital, Auckland, New Zealand
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Nam YU, Juhn JW, Lee KC, Wi HM. Fringe jump compensation techniques for the time-averaging zero-crossing phase measurement in the KSTAR millimeter-wave interferometer. Rev Sci Instrum 2018; 89:10B111. [PMID: 30399651 DOI: 10.1063/1.5035140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 06/13/2018] [Indexed: 06/08/2023]
Abstract
A fringe jump compensation algorithm has been developed for a phase measurement that measures the phase within a single fringe. The algorithm is extremely useful in the case of the time-averaging zero-crossing phase detector on noisy environments. When the noise level on the measurements is not sufficiently suppressed, the signals near the fringe jump show a negative slope instead of a sharp drop. The slope brings an ambiguity over the compensation process. An algorithm with an additional channel that measures the phase of a half fringe shift has been applied in the millimeter-wave interferometer on the Korea Superconducting Tokamak Advanced Research device. These techniques removed the ambiguity in most cases. The algorithm can provide a most simple, robust, and cost-effective solution for the phase measurement system in various fields.
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Affiliation(s)
- Y U Nam
- National Fusion Research Institute, Daejeon 305-333, South Korea
| | - J W Juhn
- National Fusion Research Institute, Daejeon 305-333, South Korea
| | - K C Lee
- National Fusion Research Institute, Daejeon 305-333, South Korea
| | - H M Wi
- National Fusion Research Institute, Daejeon 305-333, South Korea
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14
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Austin CA, Lee KC, Swan RL, Khazeem MM, Manville CM, Cridland P, Treumann A, Porter A, Morris NJ, Cowell IG. TOP2B: The First Thirty Years. Int J Mol Sci 2018; 19:ijms19092765. [PMID: 30223465 PMCID: PMC6163646 DOI: 10.3390/ijms19092765] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 09/07/2018] [Accepted: 09/11/2018] [Indexed: 12/19/2022] Open
Abstract
Type II DNA topoisomerases (EC 5.99.1.3) are enzymes that catalyse topological changes in DNA in an ATP dependent manner. Strand passage reactions involve passing one double stranded DNA duplex (transported helix) through a transient enzyme-bridged break in another (gated helix). This activity is required for a range of cellular processes including transcription. Vertebrates have two isoforms: topoisomerase IIα and β. Topoisomerase IIβ was first reported in 1987. Here we review the research on DNA topoisomerase IIβ over the 30 years since its discovery.
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Affiliation(s)
- Caroline A Austin
- Institute for Cell and Molecular Biosciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
| | - Ka C Lee
- Institute for Cell and Molecular Biosciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
| | - Rebecca L Swan
- Institute for Cell and Molecular Biosciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
| | - Mushtaq M Khazeem
- Institute for Cell and Molecular Biosciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
| | - Catriona M Manville
- Institute for Cell and Molecular Biosciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
| | - Peter Cridland
- Institute for Cell and Molecular Biosciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
| | - Achim Treumann
- NUPPA, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
| | - Andrew Porter
- NUPPA, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
| | - Nick J Morris
- School of Biomedical Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
| | - Ian G Cowell
- Institute for Cell and Molecular Biosciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
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Mak CM, Law EC, Lee HH, Siu WK, Chow KM, Au Yeung SK, Ngan HY, Tse NK, Kwong NS, Chan GC, Lee KW, Chan WP, Wong SF, Tang MH, Kan AS, Hui AP, So PL, Shek CC, Lee RS, Wong KY, Yau EK, Poon KH, Siu S, Poon GW, Kwok AM, Ng JW, Yim VC, Ma GG, Chu CH, Tong TY, Chong YK, Chen SP, Ching CK, Chan AO, Tam S, Lau RL, Ng WF, Lee KC, Chan AY, Lam CW. The first pilot study of expanded newborn screening for inborn errors of metabolism and survey of related knowledge and opinions of health care professionals in Hong Kong. Hong Kong Med J 2018; 24:226-237. [PMID: 29888706 DOI: 10.12809/hkmj176939] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Newborn screening is important for early diagnosis and effective treatment of inborn errors of metabolism (IEM). In response to a 2008 coroners' report of a 14-year-old boy who died of an undiagnosed IEM, the OPathPaed service model was proposed. In the present study, we investigated the feasibility of the OPathPaed model for delivering expanded newborn screening in Hong Kong. In addition, health care professionals were surveyed on their knowledge and opinions of newborn screening for IEM. METHODS The present prospective study involving three regional hospitals was conducted in phases, from 1 October 2012 to 31 August 2014. The 10 steps of the OPathPaed model were evaluated: parental education, consent, sampling, sample dispatch, dried blood spot preparation and testing, reporting, recall and counselling, confirmation test, treatment and monitoring, and cost-benefit analysis. A fully automated online extraction system for dried blood spot analysis was also evaluated. A questionnaire was distributed to 430 health care professionals by convenience sampling. RESULTS In total, 2440 neonates were recruited for newborn screening; no true-positive cases were found. Completed questionnaires were received from 210 respondents. Health care professionals supported implementation of an expanded newborn screening for IEM. In addition, there is a substantial need of more education for health care professionals. The majority of respondents supported implementing the expanded newborn screening for IEM immediately or within 3 years. CONCLUSION The feasibility of OPathPaed model has been confirmed. It is significant and timely that when this pilot study was completed, a government-led initiative to study the feasibility of newborn screening for IEM in the public health care system on a larger scale was announced in the Hong Kong Special Administrative Region Chief Executive Policy Address of 2015.
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Affiliation(s)
- C M Mak
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - E Cy Law
- Department of Pathology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong.,Division of Clinical Biochemistry, Queen Mary Hospital, Pokfulam, Hong Kong
| | - H Hc Lee
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - W K Siu
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - K M Chow
- Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - S Kc Au Yeung
- Department of Obstetrics and Gynaecology, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - H Ys Ngan
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, Pokfulam, Hong Kong
| | - N Kc Tse
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - N S Kwong
- Department of Paediatrics and Adolescent Medicine, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - G Cf Chan
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Pokfulam, Hong Kong
| | - K W Lee
- Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - W P Chan
- Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - S F Wong
- Department of Obstetrics and Gynaecology, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - M Hy Tang
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, Pokfulam, Hong Kong
| | - A Sy Kan
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, Pokfulam, Hong Kong
| | - A Pw Hui
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, Pokfulam, Hong Kong
| | - P L So
- Department of Obstetrics and Gynaecology, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - C C Shek
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - R Sy Lee
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - K Y Wong
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Pokfulam, Hong Kong
| | - E Kc Yau
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - K H Poon
- Department of Paediatrics and Adolescent Medicine, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - S Siu
- Department of Paediatrics and Adolescent Medicine, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - G Wk Poon
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Pokfulam, Hong Kong
| | - A Mk Kwok
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Pokfulam, Hong Kong
| | - J Wy Ng
- Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - V Cs Yim
- Department of Obstetrics and Gynaecology, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - G Gy Ma
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, Pokfulam, Hong Kong
| | - C H Chu
- Department of Pathology, United Christian Hospital, Kwun Tong, Hong Kong
| | - T Y Tong
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - Y K Chong
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - S Pl Chen
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - C K Ching
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - A Ok Chan
- Division of Clinical Biochemistry, Queen Mary Hospital, Pokfulam, Hong Kong
| | - S Tam
- Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - R Lk Lau
- Department of Pathology, Yan Chai Hospital, Tsuen Wan, Hong Kong
| | - W F Ng
- Department of Pathology, Yan Chai Hospital, Tsuen Wan, Hong Kong
| | - K C Lee
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - A Yw Chan
- Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - C W Lam
- Department of Pathology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
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Korgavkar K, Weinstock MA, Lee KC. Evaluation of photoaging scales in an elderly male population. J Eur Acad Dermatol Venereol 2017; 31:e489-e490. [PMID: 28500658 DOI: 10.1111/jdv.14330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- K Korgavkar
- Department of Dermatology, Brown University, Providence, RI, USA
| | - M A Weinstock
- Department of Dermatology, Brown University, Providence, RI, USA.,Dermatoepidemiology Unit, VA Medical Center, Providence, RI, USA
| | - K C Lee
- Department of Dermatology, Brown University, Providence, RI, USA
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Abstract
The 2015 KSTAR experimental campaign was the first year of routine measurement with a far infrared interferometer (FIRI) utilizing 118.87 μm CH3OH lasers at maximum 200 mW CW beam power. By using rtEFIT reconstruction, the path lengths of interferometers can be calculated and so the line-averaged electron densities n¯e from the FIRI and a millimeter-wave interferometer were in excellent agreement. In this way, the number of successfully diagnosed discharges is counted: 1003 shots or 83.7% of sustained discharges, defined as shots of plasma current IP ≥ 0.3 MA with pulse lengths tf ≥ 2.0 s, have good-quality FIRI data within a few fringe jump errors. In addition, real-time H-mode density feedback control based on the FIRI was also successfully achieved with supersonic molecular beam injection as an actuator. Both constant density and controlled linear increment with a ramp-up rate of 1.0 × 1019 m-3 s-1 were achieved.
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Affiliation(s)
- June-Woo Juhn
- National Fusion Research Institute, Daejeon, South Korea
| | - K C Lee
- National Fusion Research Institute, Daejeon, South Korea
| | - H M Wi
- National Fusion Research Institute, Daejeon, South Korea
| | - Y S Kim
- National Fusion Research Institute, Daejeon, South Korea
| | - Y U Nam
- National Fusion Research Institute, Daejeon, South Korea
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18
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Lee KW, Lee KC, Kim GH, Kim JH, Yeon JS, Cho SB, Chang BJ, Kim SK. EFFECTS OF DIETARY FERMENTED GARLIC ON THE GROWTH PERFORMANCE, RELATIVE ORGAN WEIGHTS, INTESTINAL MORPHOLOGY, CECAL MICROFLORA AND SERUM CHARACTERISTICS OF BROILER CHICKENS. Rev Bras Cienc Avic 2016. [DOI: 10.1590/1806-9061-2016-0242] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- KW Lee
- Konkuk University, Republic of Korea
| | - KC Lee
- Konkuk University, Republic of Korea
| | - GH Kim
- Konkuk University, Republic of Korea
| | - JH Kim
- Konkuk University, Republic of Korea
| | - JS Yeon
- Konkuk University, Republic of Korea
| | - SB Cho
- Konkuk University, Republic of Korea
| | - BJ Chang
- College of Veterinary Medicine, Republic of Korea
| | - SK Kim
- Konkuk University, Republic of Korea
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Shariff JA, Lee KC, Leyton A, Abdalal S. Neonatal mortality and topical application of chlorhexidine on umbilical cord stump: a meta-analysis of randomized control trials. Public Health 2016; 139:27-35. [PMID: 27311991 DOI: 10.1016/j.puhe.2016.05.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 05/08/2016] [Accepted: 05/11/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To examine the efficacy of topical chlorhexidine as an intervention on neonatal umbilical cord stumps and its association with neonatal mortality and omphalitis. STUDY DESIGN Meta-analysis of randomized controlled trials (RCTs). METHOD PubMed, EMBASE, CINAHL, IMSEAR, Google Scholar, Cochrane Central Register of Controlled Trials, Cochrane Pregnancy and Childbirth Group's Trials Register and Clinicaltrials.gov were screened until September 1, 2015 to identify RCTs that met the inclusion criteria. Pooled relative risks (RR) with 95% confidence intervals (CI) were calculated. RESULTS Five RCTs, conducted in Italy, Bangladesh, Nepal, Pakistan and India with a total of 55,008 participants were identified. Analysis revealed a significant reduction in the incidence of neonatal mortality among the intervention group as compared to the control group (pooled RR = 0.8; 95% CI: 0.6-1.0; P = 0.04; random effects model, I2 = 58%; χ2 = 9.5; P = 0.05). Additionally, decreased incidence in omphalitis was seen in the intervention group as compared to the control group (pooled RR = 0.4; 95% CI: 0.3-0.7; P < 0.001; random effects model, I2 = 50%; χ2 = 8.0; P = 0.09). CONCLUSIONS Application of chlorhexidine to newborn umbilical cord stumps, significantly reduce the incidences of both neonatal mortality and omphalitis. However, high-quality trials from different regions and obstetric settings may help form more conclusive judgement on universal application of topical chlorhexidine.
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Affiliation(s)
- J A Shariff
- Section of Population Oral Health, Columbia University, College of Dental Medicine, 630W, 168st, 17th floor, suite 306, New York, NY 10032, USA.
| | - K C Lee
- Columbia University, College of Dental Medicine, 630W, 168st, 8th Floor, New York, NY 10032, USA.
| | - A Leyton
- Department of Global Health Systems and Development, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, 22nd Floor, New Orleans, LA 70112, USA.
| | - S Abdalal
- Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112, USA.
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Lee KC, Bramley RL, Cowell IG, Jackson GH, Austin CA. Proteasomal inhibition potentiates drugs targeting DNA topoisomerase II. Biochem Pharmacol 2016; 103:29-39. [PMID: 26794000 PMCID: PMC5071433 DOI: 10.1016/j.bcp.2015.12.015] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 12/22/2015] [Indexed: 01/15/2023]
Abstract
The reaction mechanism of DNA topoisomerase II (TOP2) involves a covalent double-strand break intermediate in which the enzyme is coupled to DNA via a 5′-phosphotyrosyl bond. This normally transient enzyme-bridged break is stabilised by drugs such as mitoxantrone, mAMSA, etoposide, doxorubicin, epirubicin and idarubicin, which are referred to as TOP2 poisons. Removal of topoisomerase II by the proteasome is involved in the repair of these lesions. In K562 cells, inhibiting the proteasome with MG132 significantly potentiated the growth inhibition by these six drugs that target topoisomerase II, and the highest level of potentiation was observed with mitoxantrone. Mitoxantrone also showed the greatest potentiation by MG132 in three Nalm 6 cell lines with differing levels of TOP2A or TOP2B. Mitoxantrone was also potentiated by the clinically used proteasome inhibitor PS341 (Velcade). We have also shown that proteasome inhibition with MG132 in K562 cells reduces the rate of removal of mitoxantrone or etoposide stabilised topoisomerase complexes from DNA, suggesting a possible mechanism for the potentiation of topoisomerase II drugs by proteasomal inhibition.
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Affiliation(s)
- Ka C Lee
- Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom
| | - Rebecca L Bramley
- Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom
| | - Ian G Cowell
- Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom
| | - Graham H Jackson
- Institute for Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom
| | - Caroline A Austin
- Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom.
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Abstract
The TOP2 poison etoposide has been implicated in the generation of secondary malignancies during cancer treatment. Structural similarities between TOP2 isoforms challenge the rational design of isoform-specific poisons to further delineate these processes. Herein, we describe the synthesis and biological evaluation of a focused library of etoposide analogues, with the identification of two novel small molecules exhibiting TOP2B-dependent toxicity. Our findings pave the way toward studying isoform-specific cellular processes by means of small molecule intervention.
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Affiliation(s)
- Angelica Mariani
- †Centre de Recherche de Gif, Institut de Chimie des Substances Naturelles du CNRS, Avenue de la Terrasse, 91198 Gif-sur-Yvette, France
| | - Alexandra Bartoli
- †Centre de Recherche de Gif, Institut de Chimie des Substances Naturelles du CNRS, Avenue de la Terrasse, 91198 Gif-sur-Yvette, France
| | - Mandeep Atwal
- ‡Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom
| | - Ka C Lee
- ‡Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom
| | - Caroline A Austin
- ‡Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom
| | - Raphaël Rodriguez
- †Centre de Recherche de Gif, Institut de Chimie des Substances Naturelles du CNRS, Avenue de la Terrasse, 91198 Gif-sur-Yvette, France.,§Organic Synthesis and Cell Biology Group, Institut Curie Research Center, 26 rue d'Ulm, 75248 Paris Cedex 05, France
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22
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Lee KC, Chang ATY, Law ALY, Chan LK, Cheung HYS, Ng WT. Five-year Treatment Outcomes for Stage II to III Rectal Cancer in a Single Cancer Institution. Hong Kong J Radiol 2014. [DOI: 10.12809/hkjr1414235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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23
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Cheng HF, Tang WYM, Lee KC. Diffuse xanthomatous eruption. Hong Kong Med J 2014; 20:350.e3-4. [PMID: 25104014 DOI: 10.12809/hkmj134046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- H F Cheng
- DERM 1 Skin Specialists Centre, Room 1102, Champion Building, 301-309 Nathan Road, Kowloon, Hong Kong
| | - William Y M Tang
- DERM 1 Skin Specialists Centre, Room 1102, Champion Building, 301-309 Nathan Road, Kowloon, Hong Kong
| | - K C Lee
- DERM 1 Skin Specialists Centre, Room 1102, Champion Building, 301-309 Nathan Road, Kowloon, Hong Kong
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Yang HS, Chen IC, Lee YT, Lee KC, Chuang YC, Chang CY, Wei J. Cardiac transplantation and concomitant coronary artery bypass grafting: our experiences in 11 cases. Transplant Proc 2014; 46:900-2. [PMID: 24767376 DOI: 10.1016/j.transproceed.2013.11.127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 11/07/2013] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The shortage of donor hearts for transplantation could be alleviated by including the hearts of older donors. Previous literature revealed similar early and medium-term survival outcomes compared with those of younger donors. This study presents our experience with patients who underwent orthotopic heart transplantation and concomitant coronary artery bypass grafting at our institution. METHODS We present our experience with 11 patients with end-stage cardiomyopathy (8 men and 3 women) undergoing orthotopic heart transplantation and concomitant coronary artery bypass grafting from September 2002 to November 2011 at our institute. RESULTS All 11 donor organs would otherwise have been rejected, depriving potential recipients of organ transplantation. Two patients received concurrent 2-coronary-artery bypass, and the other 9 patients received concurrent single-coronary-artery bypass during orthotopic heart transplantation. All patients had an uneventful postoperative course, with follow-up completed 3 to 128 months after cardiac transplantation and concomitant coronary artery bypass grafting surgery. CONCLUSIONS Our experiences suggest that donor hearts requiring coronary artery bypass grafting, which form a small but significant donor subgroup, can be used effectively and safely when matched to the recipients' age and medical condition.
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Affiliation(s)
- H S Yang
- Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan, R.O.C
| | - I C Chen
- Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan, R.O.C
| | - Y T Lee
- Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan, R.O.C
| | - K C Lee
- Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan, R.O.C
| | - Y C Chuang
- Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan, R.O.C
| | - C Y Chang
- Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan, R.O.C
| | - J Wei
- Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan, R.O.C.
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Affiliation(s)
- K C Lee
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, RI, USA
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Meakin LB, Salonen LK, Baines SJ, Brockman DJ, Gregory SP, Halfacree ZJ, Lipscomb VJ, Lee KC. Prevalence, outcome and risk factors for postoperative pyothorax in 232 dogs undergoing thoracic surgery. J Small Anim Pract 2013; 54:313-7. [PMID: 23581608 PMCID: PMC3708104 DOI: 10.1111/jsap.12064] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objective To determine the prevalence, outcome and risk factors for postoperative pyothorax in dogs undergoing thoracic surgery. Methods Case records were reviewed retrospectively to identify dogs with post thoracic surgery pyothorax, defined as septic neutrophilic inflammation within the pleural space based on cytology and/or a positive bacterial culture of pleural fluid. Those identified were reviewed for potential risk factors for postoperative pyothorax based on biological plausibility and previously published data. These potential risk factors were explored by multivariable logistic regression. Results Of 232 dogs undergoing thoracic surgery, 15 (6·5%) dogs developed pyothorax. Bacteria cultured included methicillin-resistant Staphylococcus aureus and multi-resistant Escherichia coli. Of these dogs, six died, four were euthanased and five were treated successfully. A diagnosis of idiopathic chylothorax [Odds Ratio (OR)=12·5, 95% Confidence Interval (CI)=2·7-58·5, P=0·001], preoperative intrathoracic biopsy (OR=14·3, 95% CI=1·7-118·7, P=0·014) and preoperative thoracocentesis (OR=11·2, 95% CI=1·6-78·2, P=0·015) were identified as independent risk factors for development of postoperative pyothorax. Clinical Significance Idiopathic chylothorax, intrathoracic biopsy and prior thoracocentesis are independent risk factors for postoperative pyothorax, which was associated with a 67% mortality rate.
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Affiliation(s)
- L B Meakin
- School of Veterinary Sciences, University of Bristol, Langford, Bristol BS40 5DU
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Kwak HJ, Chae YJ, Lee KC, Kim JY. Target-controlled infusion of remifentanil for laryngeal mask airway insertion during sevoflurane induction in adults. J Int Med Res 2013; 40:1476-82. [PMID: 22971499 DOI: 10.1177/147323001204000426] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE This randomized, double-blind study investigated the suitable target effect-site concentration of remifentanil for laryngeal mask airway (LMA) insertion during inhalation induction with sevoflurane. METHODS Patients aged 18 - 60 years were randomly assigned to one of three groups receiving infusions of normal saline (control group), or infusions with target effect-site remifentanil concentrations of either 1 ng/ml (R1 group) or 2 ng/ml (R2 group), 1 min after the induction of anaesthesia with sevoflurane. LMA insertion was attempted 2 min after induction. Insertion conditions were graded using a six-variable, three-point scale (excellent, intermediate or poor). RESULTS A total of 102 patients were included. The proportion of patients ranked as excellent for the LMA insertion was significantly higher in groups R1 and R2 compared with the control group. The incidence of apnoea was significantly more frequent in the R2 group than in the control or R1 groups. CONCLUSIONS Compared with 1 ng/ml remifentanil or normal saline, target-controlled infusion of 2 ng/ml remifentanil significantly improved the LMA insertion conditions during sevoflurane inhalational induction, although apnoeic episodes were more frequently observed.
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Affiliation(s)
- H J Kwak
- Department of Anaesthesiology and Pain Medicine, Gachon University of Science and Medicine, Gil Medical Centre, Incheon, Republic of Korea
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Reim KF, Nunn J, Jin XM, Michelberger PS, Champion TFM, England DG, Lee KC, Kolthammer WS, Langford NK, Walmsley IA. Multipulse addressing of a Raman quantum memory: configurable beam splitting and efficient readout. Phys Rev Lett 2012; 108:263602. [PMID: 23004977 DOI: 10.1103/physrevlett.108.263602] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Indexed: 06/01/2023]
Abstract
Quantum memories are vital to the scalability of photonic quantum information processing (PQIP), since the storage of photons enables repeat-until-success strategies. On the other hand, the key element of all PQIP architectures is the beam splitter, which allows us to coherently couple optical modes. Here, we show how to combine these crucial functionalities by addressing a Raman quantum memory with multiple control pulses. The result is a coherent optical storage device with an extremely large time bandwidth product, that functions as an array of dynamically configurable beam splitters, and that can be read out with arbitrarily high efficiency. Networks of such devices would allow fully scalable PQIP, with applications in quantum computation, long distance quantum communications and quantum metrology.
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Affiliation(s)
- K F Reim
- Clarendon Laboratory, University of Oxford, Parks Road, Oxford OX1 3PU, United Kingdom.
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Reim KF, Michelberger P, Lee KC, Nunn J, Langford NK, Walmsley IA. Single-photon-level quantum memory at room temperature. Phys Rev Lett 2011; 107:053603. [PMID: 21867069 DOI: 10.1103/physrevlett.107.053603] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2010] [Indexed: 05/31/2023]
Abstract
Room-temperature, easy-to-operate quantum memories are essential building blocks for future long distance quantum information networks operating on an intercontinental scale, because devices like quantum repeaters, based on quantum memories, will have to be deployed in potentially remote, inaccessible locations. Here we demonstrate controllable, broadband and efficient storage and retrieval of weak coherent light pulses at the single-photon level in warm atomic cesium vapor using the robust far off-resonant Raman memory scheme. We show that the unconditional noise floor of this technically simple quantum memory is low enough to operate in the quantum regime, even in a room-temperature environment.
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Affiliation(s)
- K F Reim
- Clarendon Laboratory, University of Oxford, Oxford, United Kingdom.
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Ren Y, Kaye SM, Mazzucato E, Guttenfelder W, Bell RE, Domier CW, LeBlanc BP, Lee KC, Luhmann NC, Smith DR, Yuh H. Density gradient stabilization of electron temperature gradient driven turbulence in a spherical tokamak. Phys Rev Lett 2011; 106:165005. [PMID: 21599377 DOI: 10.1103/physrevlett.106.165005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2010] [Indexed: 05/30/2023]
Abstract
In this Letter we report the first clear experimental observation of density gradient stabilization of electron temperature gradient driven turbulence in a fusion plasma. It is observed that longer wavelength modes, k(⊥)ρ(s) ≲ 10, are most stabilized by density gradient, and the stabilization is accompanied by about a factor of 2 decrease in the plasma effective thermal diffusivity.
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Affiliation(s)
- Y Ren
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08543, USA
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Abstract
In contrast to the usual slow disease progression in myofibrillar myopathies, patients with Bag3opathy often have a rapidly progressive and more severe phenotype with a worse prognosis. We describe a Chinese patient, born to non-consanguineous parents, who first presented at age 6 with clumsy walking and difficult climbing staircase. With a history of restrictive lung disease previously diagnosed as asthma, she progressed rapidly with proximal myopathy, rigid spine and bilateral tightening of the Achilles tendons requiring surgical elongation. Hypertrophic cardiomyopathy with restrictive physiology was shown by echocardiogram. Moreover, prolonged QT interval was also noted in the patient. Family history was unremarkable yet her father was incidentally found to have prolonged QT interval. Mutation analysis with genomic DNA of the proband showed heterozygous de novo known mutation c.626C>T (p.Pro209Leu) and a germline variation c.772C>T (p.Arg258Trp) in BAG3. Her father was found to be a carrier of c.772C>T. Muscle biopsy findings were suggestive of myofibrillar myopathy on light microscopy and ultrastructural studies. To our knowledge, this is the first Chinese case of Bag3opathy so far reported.
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Affiliation(s)
- H C Lee
- Department of Pathology, Princess Margaret Hospital, Hong Kong, China
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Tsai WC, Domier CW, Lee KC, Luhmann NC, Kaita R, Park HK. NSTX far infrared tangential interferometer/polarimeter electronics upgrade. Rev Sci Instrum 2010; 81:10D526. [PMID: 21033881 DOI: 10.1063/1.3485103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
New electronics for the multichannel far infrared tangential interferometer/polarimeter system employed on the National Spherical Torus Experiment (NSTX) have greatly extended its capability to monitor high frequency density fluctuations. Such measurements are essential in understanding transport physics issues in NSTX as well as for the coming ITER device. The electronics, which were previously limited to ∼250 kHz, have been upgraded with a video bandwidth that extends to 4 MHz when operating as an interferometry-only configuration, and to ∼500 kHz when operating as a simultaneous interferometer/polarimeter system. Experimental details and test results of the new electronics are presented.
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Affiliation(s)
- W C Tsai
- Department of Electrical and Computer Engineering, University of California, Davis, California 95616, USA
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Kim J, Lee KC, Kaita R, Phillips CK, Domier CW, Valeo E, Luhmann NC, Bonoli PT, Park H. Use of the Far Infrared Tangential Interferometer/Polarimeter diagnostic for the study of rf driven plasma waves on NSTX. Rev Sci Instrum 2010; 81:10D527. [PMID: 21033882 DOI: 10.1063/1.3499506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
A rf detection system for waves in the 30 MHz range has been constructed for the Far Infrared Tangential Interferometer/Polarimeter on National Spherical Torus Experiment (NSTX). It is aimed at monitoring high frequency density fluctuations driven by 30 MHz high harmonic fast wave fields. The levels of density fluctuations at various radial chords and antenna phase angles can be estimated using the electric field calculated by TORIC code and linearized continuity equation for the electron density. In this paper, the experimental arrangement for the detection of rf signal and preliminary results of simulation will be discussed.
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Affiliation(s)
- J Kim
- Department of Physics, POSTECH, Pohang, Gyeongbuk 790-784, Korea.
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Juhn JW, Lee KC, Hwang YS, Domier CW, Luhmann NC, Leblanc BP, Mueller D, Gates DA, Kaita R. Fringe-jump corrected far infrared tangential interferometer/polarimeter for a real-time density feedback control system of NSTX plasmas. Rev Sci Instrum 2010; 81:10D540. [PMID: 21033892 DOI: 10.1063/1.3492381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The far infrared tangential interferometer/polarimeter (FIReTIP) of the National Spherical Torus Experiment (NSTX) has been set up to provide reliable electron density signals for a real-time density feedback control system. This work consists of two main parts: suppression of the fringe jumps that have been prohibiting the plasma density from use in the direct feedback to actuators and the conceptual design of a density feedback control system including the FIReTIP, control hardware, and software that takes advantage of the NSTX plasma control system (PCS). By investigating numerous shot data after July 2009 when the new electronics were installed, fringe jumps in the FIReTIP are well characterized, and consequently the suppressing algorithms are working properly as shown in comparisons with the Thomson scattering diagnostic. This approach is also applicable to signals taken at a 5 kHz sampling rate, which is a fundamental constraint imposed by the digitizers providing inputs to the PCS. The fringe jump correction algorithm, as well as safety and feedback modules, will be included as submodules either in the gas injection system category or a new category of density in the PCS.
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Affiliation(s)
- J-W Juhn
- Department of Nuclear Engineering, Seoul National University, Seoul 151-744, Korea.
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Maingi R, Bell RE, Canik JM, Gerhardt SP, Kaye SM, Leblanc BP, Osborne TH, Bell MG, Fredrickson ED, Lee KC, Menard JE, Park JK, Sabbagh SA. Triggered confinement enhancement and pedestal expansion in high-confinement-mode discharges in the national spherical torus experiment. Phys Rev Lett 2010; 105:135004. [PMID: 21230781 DOI: 10.1103/physrevlett.105.135004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2010] [Indexed: 05/30/2023]
Abstract
We report observation of a new high performance regime in discharges in the National Spherical Torus Experiment, where the H mode edge "pedestal" temperature doubles and the energy confinement increases by 50%. The spontaneous transition is triggered by a large edge-localized mode, either natural or externally triggered by 3D fields. The transport barrier grows inward from the edge, with a doubling of both the pedestal pressure width and the spatial extent of steep radial electric field shear. The dynamics suggest that 3D fields could be applied to reduce edge transport in fusion devices.
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Affiliation(s)
- R Maingi
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
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Shrimali RK, Correa PD, Lee KC, Lai CNB, Kakumanu SA, Cowie F. Adjuvant radiotherapy with 50 Gy after limb-sparing surgery for soft-tissue sarcoma--West of Scotland experience. Clin Oncol (R Coll Radiol) 2010; 22:322-3. [PMID: 20303718 DOI: 10.1016/j.clon.2010.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2009] [Revised: 02/10/2010] [Accepted: 02/23/2010] [Indexed: 10/19/2022]
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Lee KC, Ouwehand I, Giannini AL, Thomas NS, Dibb NJ, Bijlmakers MJ. Lck is a key target of imatinib and dasatinib in T-cell activation. Leukemia 2010; 24:896-900. [PMID: 20147973 DOI: 10.1038/leu.2010.11] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Kang JSL, Cherian A, Gan SH, Lee TH, Lee KC, Chee CBE, Doherty TM, Wang YT, Seah GT. Strong purified protein derivative responses are associated with poor mycobacterium inhibition in latent TB. Eur Respir J 2009; 36:348-54. [PMID: 19996195 DOI: 10.1183/09031936.00063209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The tuberculin skin test (TST) using purified protein derivative (PPD) of Mycobacterium tuberculosis is traditionally used to diagnose latent tuberculosis (TB) infection (LTBI). However, LTBI diagnosis by peripheral blood mononuclear cell (PBMC) interferon (IFN)-gamma responses to M. tuberculosis-specific antigens, early secreted antigenic target 6 kDa (ESAT-6) and culture filtrate protein (CFP)-10 has greater specificity. We investigated the difference in antimycobacterium cellular immunity in TB contacts who were strong TST reactors but nonresponsive to the ESAT-6/CFP-10 assay compared with those with concordant results. Healthy TB contacts were tested using the above two assays and mycobacterium survival was measured after co-culture of infected macrophages with their PBMCs. Whether PPD reactivity was tested by TST or by PBMC-specific IFN-gamma responses, strongly PPD-reactive TB contacts without ESAT-6/CFP-10 responsiveness showed significantly better mycobacterium inhibition activity than ESAT-6/CFP-10-responsive TB contacts with the same PPD reactivity. In the former group, stronger PPD reactivity was associated with improved mycobacterium killing, whereas ESAT-6/CFP-10 responders showed the opposite result. PPD-reactive ESAT-6/CFP-10-nonresponsive TB contacts in our population may have had protective immunity related to prior mycobacterium exposure. ESAT-6/CFP10-responsive TB contacts are more likely to have LTBI and, in this group, strong PPD reactivity may paradoxically be associated with poor mycobactericidal activity.
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Affiliation(s)
- J S L Kang
- Dept of Microbiology and Immunology Programme, Yong Loo Lin School of Medicine, National University of Singapore, MD4, 5 Science Drive 2, Singapore 117597, Singapore
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Chiu TW, Lee KC, Lam TH, Lau MC. Effects of fear-avoidance beliefs on Chinese patients with neck pain. Hong Kong Med J 2009; 15 Suppl 6:9-12. [PMID: 19801709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Affiliation(s)
- T W Chiu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China.
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Cheung CY, Chan AOK, Chan YH, Lee KC, Chan GPT, Lau GTC, Shek CC, Chau KF, Li CS. A rare cause of nephrotic syndrome: lipoprotein glomerulopathy. Hong Kong Med J 2009; 15:57-60. [PMID: 19197098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
Lipoprotein glomerulopathy is a rare kidney disease in which lipoprotein thrombi are seen in the glomerular capillaries. Most of these patients are found in Japan and East Asian countries. The presenting symptoms include proteinuria, an abnormal plasma lipoprotein profile that resembles type III hyperlipoproteinaemia, and a marked increase in serum apolipoprotein E concentration. Previous studies have suggested that lipoprotein glomerulopathy might be related to APOE gene mutation. No effective therapeutic regimen has been established for lipoprotein glomerulopathy. We report the first case of biopsy-proven lipoprotein glomerulopathy in Hong Kong in a patient who presented with nephrotic syndrome and dyslipidaemia. DNA analysis revealed apolipoprotein E Kyoto together with a novel apolipoprotein E mutation, apolipoprotein E (Asp230Tyr) Hong Kong. There was significant improvement in the clinical parameters and resolution of symptoms after the introduction of statins. Further studies will be needed to clarify the role of apolipoprotein E Hong Kong and its interaction with apolipoprotein E Kyoto in the pathogenesis of lipoprotein glomerulopathy.
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Affiliation(s)
- C Y Cheung
- Department of Medicine, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong.
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Nunn J, Reim K, Lee KC, Lorenz VO, Sussman BJ, Walmsley IA, Jaksch D. Multimode memories in atomic ensembles. Phys Rev Lett 2008; 101:260502. [PMID: 19113761 DOI: 10.1103/physrevlett.101.260502] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2008] [Indexed: 05/27/2023]
Abstract
The ability to store multiple optical modes in a quantum memory allows for increased efficiency of quantum communication and computation. Here we compute the multimode capacity of a variety of quantum memory protocols based on light storage in ensembles of atoms. We find that adding a controlled inhomogeneous broadening improves this capacity significantly.
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Affiliation(s)
- J Nunn
- Clarendon Laboratory, Oxford University, Parks Road, Oxford OX1 3PU, United Kingdom.
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Youn YS, Jeon JE, Chae SY, Lee S, Lee KC. PEGylation improves the hypoglycaemic efficacy of intranasally administered glucagon-like peptide-1 in type 2 diabetic db/db mice. Diabetes Obes Metab 2008; 10:343-6. [PMID: 18034839 DOI: 10.1111/j.1463-1326.2007.00823.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS PEGylation - covalent modification of therapeutic peptides with polyethylene glycol (PEG) - is viewed as an effective way of prolonging the short lifetime of glucagon-like peptide-1 (GLP-1). In this study, we investigated the hypoglycaemic efficacies of PEGylated GLP-1s administered intranasally in type 2 diabetic db/db mice. METHODS Three types of site-specific (Lys(34)) PEGylated GLP-1 analogues (PEG molecular weight: 1, 2 or 5 kDa) were synthesized. Their metabolic stabilities were evaluated in nasal mucosa enzyme pools. Oral glucose tolerance test was conducted 30, 60 and 120 min after intranasally administering these analogues in type 2 diabetic db/db mice. RESULTS PEGylated GLP-1 analogues were found to have significantly longer half-lives than native GLP-1 in nasal mucosa enzymes (2.4-fold to 11.0-fold, p < 0.005). Non-PEGylated GLP-1 at 100 nmol/kg was not found to have marked efficacy irrespective of nasal administration time [total hypoglycaemic degree (HD(total)) values 2.8-17.3%]. On the contrary, PEGylated GLP-1s (100 nmol/kg) showed obvious efficacies with maximum HD(total) values of >51.8 +/- 5.8% (p < 0.005 vs. GLP-1). CONCLUSION This study highlights the pharmacological potential of intranasally administered PEGylated GLP-1s in terms of stabilizing postprandial hyperglycaemia in type 2 diabetic patients.
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Affiliation(s)
- Y S Youn
- College of Pharmacy, Pusan National University, Busan, South Korea
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Kim JY, Kwak YL, Lee KC, Chang YJ, Kwak HJ. The optimal bolus dose of alfentanil for tracheal intubation during sevoflurane induction without neuromuscular blockade in day-case anaesthesia. Acta Anaesthesiol Scand 2008; 52:106-10. [PMID: 17976223 DOI: 10.1111/j.1399-6576.2007.01477.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The purpose of this study was to determine the optimal bolus dose of alfentanil required to provide successful intubating conditions following inhalation induction of anaesthesia using 5% sevoflurane and 60% nitrous oxide without neuromuscular blockade in adult day-case anaesthesia. METHODS Twenty-four adults, aged 18-60 years, undergoing general anaesthesia for short ambulatory surgery were enroled into the study. After vital capacity induction, with sevoflurane 5% and 60% nitrous oxide in oxygen, pre-determined dose of alfentanil was injected over 30 s. The dose of alfentanil was determined by modified Dixon's up-and-down method (2 microg/kg as a step size). Ninety seconds after the end of bolus administration of alfentanil, the trachea was intubated. Systolic blood pressure, heart rate and SpO2 were recorded at anaesthetic induction, before, 1 min and 3 min after intubation. RESULTS The bolus dose of alfentanil for successful tracheal intubation was 10.7+/-2.1 microg/kg in 50% of patients during inhalation induction. From probit analysis, 50% effective dose (ED(50)) and ED(95) values (95% confidence limits) of alfentanil were 10.7 microg/kg (8.0-12.9 microg/kg) and 14.9 microg/kg (12.9-31.1 microg/kg), respectively. CONCLUSIONS Using the modified Dixon's up-and-down method, the bolus dose of alfentanil for successful tracheal intubation was 10.7+/-2.1 microg/kg in 50% of adult patients during inhalation induction using 5% sevoflurane and 60% nitrous oxide in oxygen without neuromuscular blocking agent in day-case anaesthesia.
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Affiliation(s)
- J Y Kim
- Department of Anaesthesiology and Pain Medicine, Gachon University of Medicine and Science, Gil Medical Center, Incheon, Korea
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Cheung RKH, Leung KK, Lee KC, Chow TC. Sequential non-traumatic femoral shaft fractures in a patient on long-term alendronate. Hong Kong Med J 2007; 13:485-489. [PMID: 18057440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
Fractures associated with osteoporosis are common among elderly people and postmenopausal women. Bisphosphonate is an effective anti-resorptive drug commonly used for the prevention and treatment of osteoporosis. There are, however, concerns about potential side-effects during long-term treatment with alendronate. We report a case where an 82-year-old woman who had been taking alendronate for 10 years presented with two episodes of non-traumatic femoral shaft fracture. An iliac bone biopsy showed severely suppressed bone turnover, suggestive of adynamic bone disease. We suspect the bone turnover suppression was related to the prolonged use of alendronate.
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Affiliation(s)
- Ralph K H Cheung
- Department of Orthopaedics and Traumatology, Caritas Medical Centre, Shamshuipo, Hong Kong
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Lee KC. Gyrocenter shift of low-temperature plasmas and the retrograde motion of cathode spots in arc discharges. Phys Rev Lett 2007; 99:065003. [PMID: 17930837 DOI: 10.1103/physrevlett.99.065003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2007] [Indexed: 05/25/2023]
Abstract
The gyrocenter shift phenomenon explained the mechanism of radial electric field formation at the high confinement mode transition in fusion devices. This Letter reports that the theory of gyrocenter shift is also applicable to low temperature high collisional plasmas such as arc discharges by the generalization of the theory resulting from a short mean free path compared with the gyroradius. The retrograde motion of cathode spots in the arc discharge is investigated through a model with the expanded formula of gyrocenter shift. It is found that a reversed electric field is formed in front of the cathode spots when they are under a magnetic field, and this reversed electric field generates a rotation of cathode spots opposite to the Amperian direction. The ion drift velocity profiles calculated from the model are in agreement with the experimental results as functions of magnetic flux density and gas pressure.
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Affiliation(s)
- K C Lee
- Department of Applied Science, University of California, Davis, California 95616, USA
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Cain WS, Jalowayski AA, Schmidt R, Kleinman M, Magruder K, Lee KC, Culver BD. Chemesthetic responses to airborne mineral dusts: boric acid compared to alkaline materials. Int Arch Occup Environ Health 2007; 81:337-45. [PMID: 17609973 DOI: 10.1007/s00420-007-0218-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2005] [Accepted: 06/06/2007] [Indexed: 11/25/2022]
Abstract
OBJECTIVES (1) To assess the relation between occupationally relevant exposures to dust of boric acid and magnitude of feel in the eye, nose, and throat during activity (pedaling) equal to light industrial work. (2) To compare feel from the dust of boric acid with that of the alkaline dusts calcium oxide and sodium tetraborate pentahydrate (sodium borate). (3) To chart how magnitude of feel changes with time in exposures up to 3/4 h. METHODS Twelve subjects, six males and six females, participated in duplicate sessions of exposure to 2.5, 5, and 10 mg m(-3) of boric acid, 10 mg m(-3) of sodium borate, 2.5 mg m(-3) of calcium oxide presented as calcium oxide alone or diluted with hydrated calcium sulfate, and 0 mg m(-3) (blank). Exposures occurred in a plastic dome suspended over the head and closed around the neck with rubber dam. Measurements pre- and post-exposure included nasal secretion and nasal resistance. Measurements during exposure included rated magnitude of feel in the eye, nose, and throat, and respiration (Respitrace System). Six concentrations of carbon dioxide ranging from just below detectable to sharply stinging gave subjects references for their ratings. RESULTS In general, feel increased for periods up to half an hour, then either declined or held at a plateau. Each material had a temporal signature. The nose led with the highest feel, followed by the throat, then the eyes. This hierarchy proved weakest for boric acid; at one level of exposure, magnitude in the throat overtook that in the nose. Accompanying measures implied that change of feel with time occurred neither because of an increase in dilution of the dissolved dusts in newly secreted mucus nor an increase of consequence in nasal resistance. Most likely, sensory adaptation determined the change. Boric acid of 10 mg m(-3) fell slightly and insignificantly below 10 mg m(-3) sodium borate in feel. Boric acid, though, showed a relatively flat dose-response relationship, i.e., a change in level caused little change in feel. CONCLUSIONS The time-constant for feel from dusts lies on the order of tens of minutes. A flat concentration-response function for boric acid and a notable response from the throat suggests that perceived dryness, not mediated by acidity but perhaps by osmotic pressure, may account for the feel evoked at levels of exposure at or below 10 mg m(-3). More acidic dusts that could actually change nasal pH may trigger sensations differently.
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Affiliation(s)
- William S Cain
- Chemosensory Perception Laboratory, Department of Surgery (Otolaryngology), University of California, San Diego, La Jolla, CA 92093-0957, USA.
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Yu JTHT, Chong LY, Lee KC. A recalcitrant case of cicatricial pemphigoid. Hong Kong Med J 2007; 13:157-60. [PMID: 17406047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023] Open
Abstract
A 57-year-old woman presented with a 1-year history of blisters and erosions on her oral mucosa with bilateral conjunctivitis and symblephara formation. A diagnosis of cicatricial pemphigoid was made based on the clinical features and immunohistological findings. A multidisciplinary team managed her with different topical and systemic immunosuppressive agents but she finally succumbed due to multi-organ failure secondary to sepsis.
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Affiliation(s)
- John T H T Yu
- Yau Ma Tei Dermatology Clinic, Social Hygiene Service, 143 Battery Street, Hong Kong.
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Abstract
Patient safety in transplantation depends on accurate testing, transcription and transmission of the ABO types of the donor and recipient. Similar to 'near-miss' transfusion labeling errors, three cases of mislabeled ABO types on deceased donor kidney containers were recognized through a pretransplant verification process. Six steps to confirming the organ and ABO identification were developed to ensure safety of the patient and prevent liability for the transplant team and facility. In each case, rapid recognition and documentation of the error source, on site confirmation of the ABO type of the accompanying blood specimen, and full disclosure to the patient and family permitted safe transplantation and avoided the need to pursue a more conservative course that would have required discarding the organs. We advocate following these measures in determining whether to persevere with transplantation of a mislabeled organ.
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Affiliation(s)
- A L Friedman
- Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA.
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