Publications by authors named "Frances Eun-Hyung Lee"

7 Publications

  • Page 1 of 1

Immediate reactions following the first dose of the SARS-CoV2 mRNA vaccines do not preclude second dose administration.

Clin Infect Dis 2021 May 14. Epub 2021 May 14.

Division of Pulmonary, Allergy and Critical Care, Emory University School of Medicine, Atlanta, Georgia, U.S.A.

Addressing COVID19 vaccine hesitancy and minimizing potential vaccine contraindications are critical to combat the ongoing pandemic. We describe a practical approach to immediate adverse events after the first dose of the SARS-CoV2 mRNA vaccines, focusing on allergic reactions with respect to their diagnosis and management.
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http://dx.doi.org/10.1093/cid/ciab448DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8194535PMC
May 2021

A Bioinformatic Approach to Utilize a Patient's Antibody-Secreting Cells against to Detect Challenging Musculoskeletal Infections.

Immunohorizons 2020 06 22;4(6):339-351. Epub 2020 Jun 22.

Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, NY 14642;

Noninvasive diagnostics for musculoskeletal infections (MSKI) remain challenging. Abs from newly activated, pathogen-specific plasmablasts in human blood, which emerge during an ongoing infection, can be used for diagnosing and tracking treatment response in diabetic foot infections. Using multianalyte immunoassays on medium enriched for newly synthesized Abs (MENSA) from Ab-secreting cells, we assessed anti- IgG responses in 101 MSKI patients (63 culture-confirmed , 38 -negative) and 52 healthy controls. MENSA IgG levels were assessed for their ability to identify the presence and type of MSKI using machine learning and multivariate receiver operating characteristic curves. Eleven -infected patients were presented with prosthetic joint infections, 15 with fracture-related infections, 5 with native joint septic arthritis, 15 with diabetic foot infections, and 17 with suspected orthopedic infections in the soft tissue. Anti- MENSA IgG levels in patients with non- infections and healthy controls were 4-fold (*** = 0.0002) and 8-fold (**** < 0.0001) lower, respectively, compared with those with culture-confirmed infections. Comparison of MENSA IgG responses among culture-positive patients revealed Ags predictive of active MSKI (IsdB, SCIN, Gmd) and Ags predictive of MSKI type (IsdB, IsdH, Amd, Hla). When combined, IsdB, IsdH, Gmd, Amd, SCIN, and Hla were highly discriminatory of MSKI (area under the ROC curve = 0.89 [95% confidence interval 0.82-0.93, < 0.01]). Collectively, these results demonstrate the feasibility of a bioinformatic approach to use a patient's active immune proteome against to diagnose challenging MSKI.
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http://dx.doi.org/10.4049/immunohorizons.2000024DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7737182PMC
June 2020

The impact of belatacept on third-party HLA alloantibodies in highly sensitized kidney transplant recipients.

Am J Transplant 2020 02 8;20(2):573-581. Epub 2019 Oct 8.

Department of Pathology, Emory University School of Medicine, Atlanta, Georgia.

Recent evidence suggests that belatacept reduces the durability of preexisting antibodies to class I and class II human leukocyte antigens (HLAs). In this case series of 163 highly sensitized kidney transplant candidates whose calculated panel-reactive antibody (cPRA) activity was ≥98% to 100%, the impact of belatacept on preexisting HLA antibodies was assessed. Of the 163 candidates, 72 underwent transplantation between December 4, 2014 and April 15, 2017; 60 of these transplanted patients remained on belatacept consecutively for at least 6 months. We observed a decrease in the breadth and/or strength of HLA class I antibodies as assessed by FlowPRA in belatacept-treated patients compared to controls who did not receive belatacept. Specifically, significant HLA antibody reduction was evident for class I (P < .0009). Posttransplant belatacept-treated patients also had a clinically significant reduction in their cPRA compared to controls (P < .01). Collectively, these findings suggest belatacept can reduce HLA class I antibodies in a significant proportion of highly sensitized recipients and could be an option to improve pretransplant compatibility with organ donors.
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http://dx.doi.org/10.1111/ajt.15585DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6984982PMC
February 2020

Epidemiology and risk factors for asthma.

Respir Med 2019 03 31;149:16-22. Epub 2019 Jan 31.

Division of Pulmonary, Allergy, Critical Care & Sleep Medicine, Emory University, USA.

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http://dx.doi.org/10.1016/j.rmed.2019.01.014DOI Listing
March 2019

A Vision-Based Respiration Monitoring System for Passive Airway Resistance Estimation.

IEEE Trans Biomed Eng 2016 09 4;63(9):1904-1913. Epub 2015 Dec 4.

Objective: Airway resistance is the mechanical cause of most of the symptoms in obstructive pulmonary disease, and can be considered as the primary measure of disease severity. A low-cost and noninvasive method to measure the airway resistance that does not require patient effort could be of great benefit in evaluating the severity of lung diseases, especially in patient population that are unable to use spirometry, such as young children.

Methods: The Vision-Based Passive Airway Resistance Estimation (VB-PARE) technology is a passive method to measure airway resistance noninvasively. The airway resistance is estimated from: 1) airflow extracted from processing depth data captured by a Microsoft Kinect, and 2) Pulsus Paradoxus extracted from a pulse oximeter (SpO ).

Results: To verify the validity and accuracy of the VB-PARE, two phases of experiment were conducted. In Phase I, spontaneous breathing data was collected from 14 healthy participants with externally induced airway obstruction, and the accuracy of 76.2±13.8% was achieved in predicting three levels of obstruction severity. In Phase II, VB-PARE outputs were compared with the clinical results from 14 patients. VB-PARE estimated the tidal volume with an average error of 0.07±0.06 liter. Also, patients with airway obstruction were detected with 80% accuracy.

Conclusion: Using the information extracted from Kinect and SpO , here, we present a quantitative method to measure the severity of airway obstruction without requiring active patient involvement.

Significance: The proposed VB-PARE system contributes to the state-of-art respiration monitoring methods by expanding the idea of passive and noninvasive airway resistance measurement.
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http://dx.doi.org/10.1109/TBME.2015.2505732DOI Listing
September 2016

Viral shedding and immune responses to respiratory syncytial virus infection in older adults.

J Infect Dis 2013 May 4;207(9):1424-32. Epub 2013 Feb 4.

Department of Medicine, University of Rochester School of Medicine and Dentistry, New York, USA.

Background: Comprehensive analyses of host, viral, and immune factors associated with severe respiratory syncytial virus (RSV) infection in adults have not been performed.

Methods: Adults with RSV infection identified in both outpatient and inpatient settings were evaluated. Upper and lower respiratory tract virus load, duration of virus shedding, select mucosal chemokine and cytokine levels, humoral and mucosal immunoglobulin responses, and systemic T-cell responses were measured.

Results: A total of 111 RSV-infected adults (61 outpatients and 50 hospitalized patients) were evaluated. Hospitalized subjects shed virus in nasal secretions at higher titers and for longer durations than less ill outpatients, had greater mucosal interleukin 6 (IL-6) levels throughout infection, and had higher macrophage inflammatory protein 1α (MIP-1α) levels early in infection. Persons >64 years old and those with more severe disease had a higher frequency of activated T cells in the blood than younger, less ill subjects at infection. Multivariate analysis found that the presence of underlying medical conditions, female sex, increased mucosal IL-6 level, and longer duration of virus shedding were associated with severe disease. Older age and increased nasal MIP-1α levels were of borderline statistical significance.

Conclusions: Multiple factors, but not older age, are independently associated with severe RSV infection in adults. The presence of underlying medical conditions had the greatest influence on disease severity.
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http://dx.doi.org/10.1093/infdis/jit038DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3610422PMC
May 2013