Publications by authors named "Hye-Jin Kim"

700 Publications

Single-Port Robotic Low Anterior Resection with Lateral Pelvic Node Dissection in Locally Advanced Rectal Cancer.

Dis Colon Rectum 2021 Aug 30. Epub 2021 Aug 30.

Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.

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http://dx.doi.org/10.1097/DCR.0000000000002170DOI Listing
August 2021

Effects of Head and Neck Position on Nasotracheal Tube Intracuff Pressure: A Prospective Observational Study.

J Clin Med 2021 Aug 30;10(17). Epub 2021 Aug 30.

Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.

To prevent endotracheal tube-related barotrauma or leakage, the intracuff pressure should be adjusted to 20-30 cm HO. However, changes in the nasotracheal tube intracuff pressure relative to neck posture are unclear. In this study, we investigated the effect of head and neck positioning on nasotracheal tube intracuff pressure. Fifty adult patients with nasotracheal tubes who were scheduled for surgery under general anesthesia were enrolled. Following intubation, intracuff pressure was measured by connecting the pilot balloon to a device that continuously monitors the intracuff pressure. Subsequently, the intracuff pressure was set to 24.48 cm HO (=18 mmHg) for the neutral position. We recorded the intracuff pressures based on the patients' position during head flexion, extension, and rotation. The initial intracuff pressure was 42.2 cm HO [29.6-73.1] in the neutral position. After pressure adjustment in the neutral position, the intracuff pressure was significantly different from the neutral to flexed ( < 0.001), extended ( = 0.003), or rotated ( < 0.001) positions. Although the median change in intracuff pressure was <3 cm HO when each patient's position was changed, overinflation to >30 cm HO occurred in 12% of patients. Therefore, it is necessary to adjust the intracuff pressure after tracheal intubation and each positional change.
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http://dx.doi.org/10.3390/jcm10173910DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8432023PMC
August 2021

Development of a three-layer consecutive gene delivery system for enhanced bone regeneration.

Biomaterials 2021 Aug 28;277:121104. Epub 2021 Aug 28.

Laboratory of Nano-regenerative Medicine, Department of Biomedical Science, College of Life Science, CHA University, 6F, CHA Bio-Complex, 335 Pangyo-ro, Bundang-gu, Seongnam-si, 134-88, Republic of Korea. Electronic address:

This study developed a three-layer consecutive gene delivery system (T-CGDS) for timely gene delivery into human mesenchymal stem cells (hMSCs). The timing of transcription factor expression is important to effectively induce bone differentiation. Therefore, a three-layered nanocomposite was fabricated using differently sized gold nanoparticles to promote bone regeneration and osteogenic differentiation. The core layer comprised 80 nm gold nanoparticles coupled with ATF4 pDNA. Following coating with heparin-conjugated Pluronic F-127 (HP-F127), 50 nm gold nanoparticles coupled with SP7 pDNA were added to fabricate a bi-layer system. After further coating with HP-F127, 20 nm gold nanoparticles combined with RUNX2 pDNA were added. Consequently, a T-CGDS measuring 350-450 nm was fabricated. Genes were released for more than 8 days, while the size of the T-CGDS decreased over time. When the T-CGDS was applied to hMSCs, the gene in the outer layer (RUNX2) was expressed first, followed by those in the middle (SP7) and core (ATF4) layers. The T-CGDS effectively induced bone differentiation and regeneration in vitro and in vivo. Timely delivery of the ATF4 gene to stem cells via the T-CGDS can greatly assist osteogenic differentiation involved in bone regeneration.
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http://dx.doi.org/10.1016/j.biomaterials.2021.121104DOI Listing
August 2021

Comparative toxicities of BPA, BPS, BPF, and TMBPF in the nematode Caenorhabditis elegans and mammalian fibroblast cells.

Toxicology 2021 Sep 30;461:152924. Epub 2021 Aug 30.

Department of Aging and Geriatric Research, College of Medicine, Institute on Aging, University of Florida, Gainesville, Florida, 32610, USA. Electronic address:

Bisphenol A (BPA) is a chemical compound commonly used in the production of plastics for daily lives and industry. As BPA is well known for its adverse health effects, several alternative materials have been developed. This study comprehensively analyzed the toxicity of BPA and its three substitutes including bisphenol S (BPS), bisphenol F (BPF), and tetramethyl bisphenol F (TMBPF) on aging, healthspan, and mitochondria using an in vivo Caenorhabditis elegans (C. elegans) model animal and cultured mammalian fibroblast cells. C. elegans treated with 1 mM BPA exhibited abnormalities in the four tested parameters related to development and growth, including delayed development, decreased body growth, reduced reproduction, and abnormal tissue morphology. Exposure to the same concentration of each alternative including TMBPF, which has been proposed as a relatively safe BPA alternative, detrimentally affected at least three of these events. Moreover, all bisphenols (except BPS) remarkably shortened the organismal lifespan and increased age-related changes in neurons. Exposure to BPA and BPF resulted in mitochondrial abnormalities, such as reduced oxygen consumption and mitochondrial membrane potential. In contrast, the ATP levels were noticeably higher after treatment with all bisphenols. In mammalian fibroblast cells, exposure to increasing concentrations of all bisphenols (ranging from 50 μM to 500 μM) caused a severe decrease in cell viability in a dose-dependent manner. BPA increased ATP levels and decreased ROS but did not affect mitochondrial permeability transition pores (mPTP). Notably, TMBPF was the only bisphenol that caused a significant increase in mitochondrial ROS and mPTP opening. These results suggest that the potentially harmful physiological effects of BPA alternatives should be considered.
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http://dx.doi.org/10.1016/j.tox.2021.152924DOI Listing
September 2021

Technological advances in electrochemical biosensors for the detection of disease biomarkers.

Biomed Eng Lett 2021 Aug 27:1-26. Epub 2021 Aug 27.

Department of Clinical Pharmacology and Therapeutics, College of Medicine, Kyung Hee University, Kyungheedae-ro 26, Dongdaemun-gu, Seoul, 02447 Republic of Korea.

With an increasing focus on health in contemporary society, interest in the diagnosis, treatment, and prevention of diseases has grown rapidly. Accordingly, the demand for biosensors for the early diagnosis of disease is increasing. However, the measurement range of existing electrochemical sensors is relatively high, which is not suitable for early disease diagnosis, requiring the detection of small amounts of biocomponents. Various attempts have been made to overcome this and amplify the signal, including binding with various labeling molecules, such as DNA, enzymes, nanoparticles, and carbon materials. Efforts are also being made to increase the sensitivity of electrochemical sensors, and the combination of nanomaterials, materials, and biotechnology offers the potential to increase sensitivity in a variety of ways. Recent studies suggest that electrochemical sensors can be a powerful tool in providing comprehensive insights into the targeting and detection of disease-associated biomarkers. Significant advances in nanomaterial and biomolecule approaches for improved sensitivity have resulted in the development of electrochemical biosensors capable of detecting multiple biomarkers in real time in clinically relevant samples. In this review, we have discussed the recent studies on electrochemical sensors for detection of diseases such as diabetes, degenerative diseases, and cancer. Further, we have highlighted new technologies to improve sensitivity using various materials, including DNA, enzymes, nanoparticles, and carbon materials.
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http://dx.doi.org/10.1007/s13534-021-00204-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8396145PMC
August 2021

Experiences of Changes in Eating Habits and Eating Behaviors of Women First Diagnosed with Gestational Diabetes.

Int J Environ Res Public Health 2021 08 19;18(16). Epub 2021 Aug 19.

College of Nursing, Chung-Ang University, 84 Dongjak-gu, Heukseok-ro, Seoul 06974, Korea.

As gestational diabetes, which is increasing steadily around the world, can cause complications in the mother and fetus, it is essential to change eating habits and eating behavior to prevent this. According to the 2020 American Diabetes Association recommendations, the food plan should be designed for the adequate calorie intake to achieve glycemic goals and consequently promote maternal and fetal health. Thus, the following study has used the qualitative theme analysis method to assess what it means for 28 South Korean women, who were diagnosed with gestational diabetes for the first time, to change their eating habits and behaviors. As a result, themes were derived related to reflection on daily life, formation of new relationships in the same group, efforts that must be made, rediscovery of couples, and lifestyles reborn as new roles. Based on the results of the study, it is shown that the study participants recovered the peace in their mental state after the crisis of gestational diabetes to pursue relaxation and ultimately higher quality of life by following the plan to fulfill healthy achievements, such as changing their eating habits and behaviors. Therefore, future research and support measures to help the healthy behaviors should be sought by comprehensively exploring the effects of women's experiences in changing their eating habits and behaviors.
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http://dx.doi.org/10.3390/ijerph18168774DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8394878PMC
August 2021

Cinnamomum verum-derived O-methoxycinnamaldehyde prevents lipopolysaccharide-induced depressive-like behavior in mice via NFAT mRNA stability in T lymphocytes.

Phytomedicine 2021 Oct 8;91:153703. Epub 2021 Aug 8.

KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea. Electronic address:

Background: Depressive-like behaviors are related to inflammatory immune activation. Cinnamomum verum (CV) has anti-inflammatory effects, but the molecular mechanisms underlying the antidepressant effects after immunological activation still remain elusive.

Purpose: The aim of the present study was to investigate the effect of CV in improving depressive-like behavior and explore its underlying mechanism in T lymphocytes.

Methods: Mice were randomly divided into Control, LPS, LPS plus fluoxetine, LPS plus CV, and LPS plus MCA groups. Behavior was evaluated using forced swimming test (FST) and tail suspension test (TST). The experimental group mice were exposed to LPS to induce depressive-like behavior. Cell viability was measured upon treating splenic T lymphocytes and Jurkat T cells with CV. Cytokine activity was measured using ELISA and RT-qPCR. The components of CV were analyzed by HPLC. NFAT expression was evaluated by western blotting, immunofluorescence, and luciferase assay. To verify the half-life of NFAT mRNA, Jurkat cells were treated with actinomycin D for 1.5, 3, and 4.5 h.

Results: CV effectively prevents inflammation-induced depressive-like behaviors. CV dose-dependently decreased protein and mRNA levels of TNFα and IL-2. Inhibition of TNFα and IL-2 production involves an MCA-mediated decrease in NFAT mRNA level, rather than inhibition of nuclear translocation. This mechanism was independent of NFAT transcription inducer p38 MAPK; it can be attributed to the promotion of NFAT mRNA decay.

Conclusion: Overall, MCA might be an alternative or adjuvant to existing NFAT-targeting immunosuppressants for clinical prophylaxis or therapy in the context of inflammation-induced depressive disorder or other T-cell-associated inflammatory disorders.
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http://dx.doi.org/10.1016/j.phymed.2021.153703DOI Listing
October 2021

Disparities in infant mortality from all-infectious, vaccine-preventable, and non-vaccine preventable diseases in relation to parental education.

Vaccine 2021 Sep 20;39(39):5658-5665. Epub 2021 Aug 20.

Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Republic of Korea; Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea. Electronic address:

Background: The burden of infectious diseases in infants is substantial. Parental education has been considered as a critical factor for predicting infant mortality. However, even though some studies have been done about relationship between infectious disease and parent's education level, no researches have been conducted specifically about vaccine-preventable and non-vaccine-preventable disease mortality by parent's educational level.

Purpose: This study aimed to compare infant mortality rates from all-infectious diseases, vaccine-preventable and non-vaccine-preventable diseases by mother's and father's education levels.

Methods: We used 2017 US Linked Birth and Infant Death Data from National Center for Health Statistics, which included 3,153,574 live births and 13,870 deaths. To identify the association between each mother's and father's education level and all-infectious disease, vaccine-preventable disease, and non-vaccine-preventable disease infant mortality, logistic regression analyses were conducted by using educational level 1 as the reference. All-infectious diseases, vaccine-preventable and non-vaccine-preventable diseases were identified by vaccination recommendation of 2017 CDC guideline. Education levels were classified into four groups: level 1, through 12th grade with no diploma; Level 2, high school graduate or GED completed; Level 3, some college credit but no degree or associate degree; and Level 4, bachelor's degree, master's degree, doctorate or professional degree.

Results: Higher parents' education level was appreciably associated with lower infant mortality from all-cause, all-infectious diseases, vaccine-preventable diseases, and non-vaccine-preventable diseases. Moreover, each mother's and father's education level was correlated to infant mortality due to vaccine-preventable diseases on the whole education level, while all-infectious disease and non-vaccine-preventable disease mortality is related with parent's education level only if their education level is fairly high. In other words, the adjusted odds for vaccine-preventable disease mortality were significantly lower than that for all-infectious and non-vaccine-preventable disease mortality at education level 2 and 3 and still smaller at education level 4.

Conclusion: These finding implies that each mother's and father's higher education level was associated with lower infant mortality rate from all-infectious diseases, vaccine-preventable diseases, and non-vaccine-preventable diseases. Furthermore, each level of mother's and father's education was more likely to be related to infant mortality by vaccine-preventable diseases than that of infant mortality by all-infectious diseases, and non-vaccine-preventable diseases.
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http://dx.doi.org/10.1016/j.vaccine.2021.08.009DOI Listing
September 2021

Associations of creatinine/cystatin C ratio and postoperative pulmonary complications in elderly patients undergoing off-pump coronary artery bypass surgery: a retrospective study.

Sci Rep 2021 Aug 19;11(1):16881. Epub 2021 Aug 19.

Department of Anaesthesiology and Pain Medicine, Anaesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, 03722, South Korea.

Sarcopenia along with nutritional status are associated with postoperative pulmonary complications in various surgical fields. Recently, the creatinine/cystatin C ratio and CONtrolling NUTritional status score were introduced as biochemical indicators for sarcopenia and malnutrition, respectively. We aimed to investigate the associations among these indicators and postoperative pulmonary complications in elderly patients undergoing off-pump coronary artery bypass surgery. We reviewed the medical records of 605 elderly patients (aged ≥ 65 years) who underwent off-pump coronary artery bypass surgery from January 2010 to December 2019. Postoperative pulmonary complications (pneumonia, prolonged ventilation [> 24 h], and reintubation during post-surgical hospitalisation) occurred in 80 patients. A 10-unit increase of creatinine/cystatin C ratio was associated with a reduced risk of postoperative pulmonary complications (odds ratio: 0.80, 95% confidence interval: 0.69-0.92, P = 0.001); the optimal cut-off values for predicting postoperative pulmonary complications was 89.5. Multivariable logistic regression analysis revealed that age, congestive heart failure, and creatinine/cystatin C ratio < 89.5 (odds ratio 2.36, 95% confidence interval 1.28-4.37) were independently associated with the occurrence of postoperative pulmonary complications, whereas CONtrolling NUTritional status score was not. A low creatinine/cystatin C ratio was associated with an increased risk of developing postoperative pulmonary complications after off-pump coronary artery bypass surgery.
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http://dx.doi.org/10.1038/s41598-021-96442-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8376894PMC
August 2021

Shikimate metabolic pathway engineering in .

J Microbiol Biotechnol 2021 Aug 6;31(10). Epub 2021 Aug 6.

Department of Biological Sciences and Bioengineering, Inha University, Incheon 22212, Korea.

Shikimate is a key high-demand metabolite for synthesizing valuable antiviral drugs, such as the anti-influenza drug, oseltamivir (Tamiflu®). Microbial-based strategies for shikimate production have been developed to overcome the unstable and expensive supply of shikimate derived from traditional plant extraction processes. In this study, a microbial cell factory using was designed to overproduce shikimate in a fed-batch culture system. First, the shikimate kinase gene () responsible for converting shikimate to the next step was disrupted to facilitate the accumulation of shikimate. Several genes encoding the shikimate bypass route, such as dehydroshikimate dehydratase (QsuB), pyruvate kinase (Pyk1), and quinate/shikimate dehydrogenase (QsuD), were disrupted sequentially. An artificial operon containing several shikimate pathway genes, including , and were overexpressed to maximize the glucose uptake and intermediate flux. The rationally designed shikimate-overproducing strain grown in an optimized medium produced approximately 37.3 g/L of shikimate in 7-L fed-batch fermentation. Overall, rational cell factory design and culture process optimization for the microbial-based production of shikimate will play a key role in complementing traditional plant-derived shikimate production processes.
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http://dx.doi.org/10.4014/jmb.2106.06009DOI Listing
August 2021

Comparison of the effect of electromyogram activity during emergence on anesthetic depth monitoring between phase lag entropy and bispectral index: a prospective observational study.

Ann Palliat Med 2021 Jul 14. Epub 2021 Jul 14.

Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.

Background: The bispectral index (BIS) is the most widely used algorithm for measuring anesthetic depth. The BIS has been demonstrated as inaccurate when neuromuscular blocking drugs (NMBDs) are used. Compared with BIS, phase lag entropy (PLE), which measures the anesthetic depth based on a 4-channel EEG signal, is less affected by EMG. The purpose of this study was to compare the effect of EMG activity during emergence on anesthetic depth monitoring between PLE and BIS.

Methods: Twenty five consecutive patients with physical status I-II of American Society of Anesthesiologists undergoing general anesthesia (age range, 20-60 years). The anesthesiologist attached the sensors of BIS and PLEM 100 on the patient's forehead. NMB reversal was performed by intravenously injecting sugammadex after confirmation of shallow NMB (TOF count 1-4) under neuromuscular monitoring. The BIS and PLE scores were recorded with neuromuscular monitoring at 1-min intervals for 5 min after administration of sugammadex.

Results: The BIS and BIS-EMG measured at 1 min after sugammadex injection were significantly higher at 1 min [51.650 (46.100, 62.225) (P<0.001); 28.500 (27.800, 31.075) (P=0.003)] than at 0 min. However, there was no between-time point difference in the PLE score and PLE-EMG (P=0.0843, P=0.329).

Conclusions: In general anesthesia using propofol-remifentanil, the BIS at 1 min after sugammadex reversal during emergence appears to be more affected by EMG activity than the PLE score. Therefore, immediately after sugammadex administration (within 1 min), it may be clinically useful to evaluate the consciousness status through the PLE score.
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http://dx.doi.org/10.21037/apm-21-847DOI Listing
July 2021

Hydrogel-based hybridization chain reaction (HCR) for detection of urinary exosomal miRNAs as a diagnostic tool of prostate cancer.

Biosens Bioelectron 2021 Nov 16;192:113504. Epub 2021 Jul 16.

Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul, 02792, South Korea; Division of Bio-Medical Science & Technology, KIST School, Korea University of Science and Technology (UST), Seoul, 02792, South Korea; KU-KIST Graduate School of Converging Science and Technology, Korea University, Seoul, 02841, South Korea. Electronic address:

Although urinary exosomal microRNAs (miRNAs) have recently emerged as potential biomarkers, clinical applications are still limited due to their low concentration in small volumes of clinical samples. Therefore, the development of a non-invasive, specific diagnostic tool, along with profiling exosomal miRNA markers from urine, remains a significant challenge. Here, we present hydrogel-based hybridization chain reaction (HCR) for multiplex signal amplification to detect urinary exosomal miRNAs from human clinical samples. We succeeded in identifying small amounts (~amol) of exosomal miRNAs from 600 μL of urine with up to ~35-fold amplification and enhanced detection limits by over an order of magnitude for two miRNA biomarker candidates, hsa-miR-6090 and hsa-miR-3665. Furthermore, we proposed ratiometric analysis without requiring normalization to a reference miRNA and validated the clinical diagnostic potential toward differentiating prostate cancer patients from healthy controls. Our hydrogel-based HCR could serve as a new diagnostic platform for a non-invasive liquid biopsy before burdensome tissue biopsy of various diseases, including prostate cancer screening, complementing the PSA test.
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http://dx.doi.org/10.1016/j.bios.2021.113504DOI Listing
November 2021

Successful lung transplantation from a donor who had recovered from SARS-CoV-2 pneumonia.

Ann Thorac Surg 2021 Jul 20. Epub 2021 Jul 20.

Division of Allergy, Pulmonary and Critical care medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea; Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea. Electronic address:

During the present COVID-19 pandemic, transplantation of donor lungs with a history of COVID-19 infection is a critical issue. Donor-derived virus infection and graft dysfunction are possible after transplantation. However, use of such lungs could save the lives of patients requiring emergency transplantation. We successfully transplanted lungs from a brain-dead donor who had recovered from SARS-CoV-2 into a severe respiratory failure patient supported with ECMO who needed an emergency transplant. At the 3-month follow-up, our patient showed no evidence of COVID-19 transmission or graft dysfunction.
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http://dx.doi.org/10.1016/j.athoracsur.2021.06.045DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8290075PMC
July 2021

Predictors of difficult intubation when using a videolaryngoscope with an intermediate-angled blade during the first attempt: a prospective observational study.

J Clin Monit Comput 2021 Jul 12. Epub 2021 Jul 12.

Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Anesthesia and Pain Research Institute, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.

The curvature of a videolaryngoscope blade has been diversified from the standard macintosh-type to the hyperacute-angle-type, resulting in different performances. We aimed to determine the intubation success rate and identify predictors of difficult intubation when using an intermediate-angled videolaryngoscope in the first attempt of intubation under routine anaesthesia settings. We enrolled 808 patients between 19 and 79 years of age, scheduled for elective surgeries under general anaesthesia with orotracheal intubation from July 2017 to November 2018; patients who were candidates for awake intubation were excluded. We obtained patient demographic data and performed airway evaluation before induction of anaesthesia for elective surgeries. We used the UEScope for tracheal intubation with a hockey stick-shaped malleable stylet. The intubation time was defined as the total duration from the entry of the blade into the oropharynx to the detection of first end-tidal carbon dioxide capnogram; this duration was recorded along with the number of intubation attempts. Difficult intubation was defined as either > 60 s duration for tracheal intubation, or > 1 intubation attempt. The use of the UEScope demonstrated a 99.4% success rate for intubation; however, increased difficulties were observed in patients who were male, obese, had a short thyromental distance, limited mouth opening, and high upper-lip-bite test class. Despite the high intubation success rate using an intermediate-angled videolaryngoscope, we recommend preparing backup plans, considering the increased difficulty in patients with certain preoperative features.Clinical trial number and registry URL: Clinical Trials.gov Identifier: NCT03215823 (Date of registration: 12 July).
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http://dx.doi.org/10.1007/s10877-021-00742-9DOI Listing
July 2021

Clinical Impact of Postoperative Vitamin D Deficiency on the Recurrence of Colon Cancer After Curative Surgical Resection.

Anticancer Res 2021 Jul;41(7):3683-3688

Department of Oncology/Hematology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Kyungpook National University Cancer Research Institute, Daegu, Republic of Korea;

Background/aim: There are no clinically significant cutoff values of serum vitamin D levels and time points to predict the prognosis of colon cancer, particularly in patients who underwent curative surgical resection.

Patients And Methods: We retrospectively analyzed serum vitamin D levels in 795 patients with stages I to III colon cancer who underwent curative surgical resection.

Results: Patients with vitamin D levels below 12 ng/ml at one year after surgical resection demonstrated a significantly reduced disease-free survival (DFS) than those who did not have vitamin D deficiency (p=0.01). In the multivariate analysis, an age of 70 years or older [hazard ratio (HR)=1.992; p=0.001], pathologic stage (HR=3.739; p<0.001), and vitamin D deficiency (less than 12 ng/ml) at one year after surgery (HR=0.563; p=0.020) were factors unfavorably influencing DFS.

Conclusion: In patients with stages I to III of colon cancer, vitamin D deficiency at one year after surgical resection was associated with increased disease relapse.
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http://dx.doi.org/10.21873/anticanres.15159DOI Listing
July 2021

Mediating Effects of Empathy on Competence of Korean Nursing Students.

Iran J Public Health 2021 Apr;50(4):737-746

College of Nursing, The Catholic University of Korea, Seoul, Republic of Korea.

Background: Empathic communication is important for nurses to establish therapeutic relationships with patients and to improve the quality of care. Thus, empathy is essential for nursing students who will be future nurses. The aim of this study was to examine the mediating role of empathy in the influence of communication competence on interpersonal competence of nursing students.

Methods: This study was conducted at the Catholic University of Korea. Participants were 218 nursing students who completed a survey questionnaire on general characteristics, Interpersonal Reactivity Index, Primary Communication Inventory, and Interpersonal Competence Questionnaire from Feb. 20 to Feb. 21, 2014. Data were analyzed using simple and multiple regression analyses. Mediation analysis was performed according to the Baron and Kenny method and Sobel test.

Results: A three-step regression analysis was performed to verify the mediating role of empathy in the relationship between communication competence and interpersonal competence. Results confirmed that communication competence significantly influenced interpersonal competence, showing that empathy had a partial mediating role (Z=2.40, =.016).

Conclusion: Communication competence improved interpersonal competence through mediation by empathy in nursing students. Result of this study suggested that nursing schools should implement communication education that can strengthen empathy in order to boost nursing students' interpersonal competence.
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http://dx.doi.org/10.18502/ijph.v50i4.5998DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8219634PMC
April 2021

Lutein and zeaxanthin reduce A2E and iso-A2E levels and improve visual performance in Abca4/Bco2 double knockout mice.

Exp Eye Res 2021 Jun 20;209:108680. Epub 2021 Jun 20.

Department of Ophthalmology and Visual Science, John A. Moran Eye Center, University of Utah, School of Medicine, Salt Lake City, UT, USA. Electronic address:

Accumulation of bisretinoids such as A2E and its isomer iso-A2E is thought to mediate blue light-induced oxidative damage associated with age-related macular degeneration (AMD) and autosomal recessive Stargardt disease (STGD1). We hypothesize that increasing dietary intake of the macular carotenoids lutein and zeaxanthin in individuals at risk of AMD and STGD1 can inhibit the formation of bisretinoids A2E and iso-A2E, which can potentially ameliorate macular degenerative diseases. To study the beneficial effect of macular carotenoids in a retinal degenerative diseases model, we used ATP-binding cassette, sub-family A member 4 (Abca4)/β,β-carotene-9',10'-oxygenase 2 (Bco2) double knockout (KO) mice that accumulate elevated levels of A2E and iso-A2E in the retinal pigment epithelium (RPE) and macular carotenoids in the retina. Abca4/Bco2 and Abca4 mice were fed a lutein-supplemented chow, zeaxanthin-supplemented chow or placebo chow (~2.6 mg of carotenoid/mouse/day) for three months. Visual function and electroretinography (ERG) were measured after one month and three months of carotenoid supplementation. The lutein and zeaxanthin supplemented Abca4/Bco2 mice had significantly lower levels of RPE/choroid A2E and iso-A2E compared to control mice fed with placebo chow and improved visual performance. Carotenoid supplementation in Abca4 mice minimally raised retinal carotenoid levels and did not show much difference in bisretinoid levels or visual function compared to the control diet group. There was a statistically significant inverse correlation between carotenoid levels in the retina and A2E and iso-A2E levels in the RPE/choroid. Supplementation with retinal carotenoids, especially zeaxanthin, effectively inhibits bisretinoid formation in a mouse model of STGD1 genetically enhanced to accumulate carotenoids in the retina. These results provide further impetus to pursue oral carotenoids as therapeutic interventions for STGD1 and AMD.
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http://dx.doi.org/10.1016/j.exer.2021.108680DOI Listing
June 2021

Comparative analysis of the gut microbiota of mice fed a diet supplemented with raw and cooked beef loin powder.

Sci Rep 2021 Jun 1;11(1):11489. Epub 2021 Jun 1.

Department of Applied Animal Science, College of Animal Life Science, Kangwon National University, Chuncheon, 24341, Korea.

We used 16S ribosomal RNA sequencing to evaluate changes in the gut microbiota of mice fed a diet supplemented with either raw or cooked beef loin powder for 9 weeks. Male BALB/c mice (n = 60) were randomly allocated to five groups: mice fed AIN-93G chow (CON), chow containing 5% (5RB) and 10% (10RB) raw beef loin powder, and chow containing 5% (5CB) and 10% (10CB) cooked beef loin powder. Dietary supplementation with both RB and CB increased the relative abundance of Clostridiales compared to the CON diet (p < 0.05). Mice fed 10RB showed a significantly higher relative abundance of Firmicutes (p = 0.018) and Lactobacillus (p = 0.001) than CON mice, and the ratio of Firmicutes/Bacteroidetes showed an increasing trend in the 10RB mice (p > 0.05). Mice fed 10CB showed a higher abundance of Peptostreptococcaceae and a lower abundance of Desulfovibrionaceae compared with the CON mice (p < 0.05). Genes for glycan biosynthesis, which result in short-chain fatty acid synthesis, were enriched in the CB mice compared to the RB mice, which was correlated to a high abundance of Bacteroides. Overall, dietary RB and CB changed the gut microbiota of mice (p < 0.05).
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http://dx.doi.org/10.1038/s41598-021-90461-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8169908PMC
June 2021

Prediction of endotracheal tube size using a printed three-dimensional airway model in pediatric patients with congenital heart disease: a prospective, single-center, single-group study.

Korean J Anesthesiol 2021 08 31;74(4):333-341. Epub 2021 May 31.

Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine and Medical Research Institute, Yangsan, Korea.

Background: To determine the correct size of endotracheal tubes (ETTs) for endotracheal intubation of pediatric patients, new methods have been investigated. Although the three-dimensional (3D) printing technology has been successful in the field of surgery, there are not many studies in the field of anesthesia. The purpose of this study was to evaluate the accuracy of a 3D airway model for prediction of the correct ETT size, and compare the results with a conventional age-based formula in pediatric patients.

Methods: Thirty-five pediatric patients under six years of age who were scheduled for congenital heart surgery were enrolled. In the pre-anesthetic period, the patient's computed tomography (CT) images were converted to Standard Triangle Language (STL) files using the 3D conversion program. A Fused Deposition Modelling (FDM) type 3D printer was used to print 3D airway models from the sub-glottis to the upper carina. ETT size was selected by inserting various sized cuffed-ETTs to a printed 3D airway model.

Results: The 3D method selected the correct ETT size in 21 out of 35 pediatric patients (60%), whereas the age-based formula selected the correct ETT size in 9 patients (26%).

Conclusions: Prediction of the correct size of ETTs using a printed 3D airway model demonstrated better results than the age-based formula. This suggests that the selection of ETT size using a printed 3D airway model may be feasible for helping minimize re-intubation attempts and complications in patients with congenital heart disease and/or those with an abnormal range of growth and development.
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http://dx.doi.org/10.4097/kja.21114DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8342841PMC
August 2021

Effects of Gochujang (Korean Red Pepper Paste) Marinade on Polycyclic Aromatic Hydrocarbon Formation in Charcoal-Grilled Pork Belly.

Food Sci Anim Resour 2021 May 1;41(3):481-496. Epub 2021 May 1.

Department of Applied Animal Science, Kangwon National University, Chuncheon 24341, Korea.

Charcoal-grilling is a popular cooking method but causes the formation of polycyclic aromatic hydrocarbons (PAHs), which can be harmful to human health. Gochujang marinade is commonly used for flavoring meats during charcoal-grilling. However, the effects of this marinade on PAHs formation during charcoal-grilling are unclear. Here, we evaluated the effects of Gochujang marinade on the formation of 16 PAHs and inhibition rate of major PAHs (benzo[a]anthracene, benzo[b]fluoranthene, and benzo[a]pyrene) in charcoal-grilled pork belly. Pork belly without marinade (PBW) and marinated with Gochujang (PBG) were stored for 10 days at 9°C under vacuum conditions and then charcoal-grilled to different doneness (internal temperatures of 71°C and 81°C). Among 16 PAHs evaluated in this study, 14 PAHs were detected in charcoal-grilled pork belly, regardless of doneness. PAH formation in charcoal-grilled pork belly was higher at an internal temperature of 81°C than at 71°C (p<0.05). Initially, PBG showed reduced total PAH formation and lower percentages of three major PAHs compared with PBW. Storage increased the inhibitory effects of PBG on the 16 PAHs, and the maximum reduction in total 16 PAHs (63.06%) was observed with moderate cooking (71°C) on day 10 (p<0.05). Moreover, marinade and doneness showed a high interaction with regard to PAH contents in charcoal-grilled pork belly (p<0.05-p<0.0001). Therefore, our findings suggested that marinating pork belly with Gochujang and grilling at 71°C could reduce the formation of 16 PAHs in charcoal-grilled pork belly.
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http://dx.doi.org/10.5851/kosfa.2021.e12DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8112319PMC
May 2021

Prognostic Value of Venous Invasion Detected by Elastin Stain May Surpass Lymph Node Status in Colon Cancer.

Dis Colon Rectum 2021 Aug;64(8):955-963

Department of Pathology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.

Background: Venous invasion is a poor prognostic factor in colon cancer but is often underreported with significant variability.

Objectives: We aimed to determine the impact of an elastin stain on venous invasion detection in colon cancer and evaluate the value of venous invasion in predicting disease recurrence in combination with lymph node status and other prognostic factors.

Design: This is a retrospective analysis of a prospectively collected database.

Setting: This study was conducted at a tertiary cancer center.

Patients: A total of 418 patients who underwent curative resection for stage I to III colon cancer and routinely adopted an elastin stain were evaluated.

Main Outcome Measures: Venous invasion detection rate after adopting elastin stain, prognostic factors influencing disease recurrences by multivariate Cox regression models, and survival were measured. The zones of lymph node metastasis were defined as LNZ1, LNZ2, and LNZ3, corresponding to metastases in the pericolic, intermediate, and apical nodes.

Results: Venous invasion detection rate increased from 11.3% to 35.4% compared with the previous period in which only hematoxylin and eosin stain was performed. Cox regression analysis showed venous invasion (HR, 3.856; 95% CI, 1.249-11.910; p = 0.019) and lymph node metastases (HR, 3.156; 95% CI, 1.094-9.108; p = 0.034) in all stages and LNZ 2, 3 (HR, 2.649; 95% CI, 1.244-5.640; p = 0.012) in stage III to be significantly associated with poor disease-free survival. When stratifying all patients by these 3 factors, patients with stage III [LNZ1/venous invasion (-)] had disease-free survival comparable with stage I, but significantly better disease-free survival than those with stage II [venous invasion (+)] (p = 0.018). Patients with stage II [venous invasion (+)] had better disease-free survival by using adjuvant chemotherapy (p < 0.001).

Limitations: This study was limited by its retrospective design.

Conclusion: Elastin stain contributed to a considerable increase in venous invasion detection. Venous invasion can be a powerful predictor of poor disease-free survival beyond lymph node metastases when limited to the pericolic area and is useful for deciding the use of adjuvant chemotherapy in stage II colon cancer. See Video Abstract at http://links.lww.com/DCR/B573.

El Valor Pronstico De La Invasin Venosa Detectada Por La Tincin De Elastina Puede Superar El Estado De Los Ganglios Linfticos En El Cncer De Colon: ANTECEDENTES:Invasión venosa (IV) es un factor de mal pronóstico en el cáncer de colon, que frecuentemente no se informa con una variabilidad significativa.OBJETIVOS:Nuestro objetivo fue determinar el impacto de tinción de elastina en la detección de IV en el cáncer de colon y evaluar el valor de IV en la predicción de la recurrencia de la enfermedad en combinación con el estado de los ganglios linfáticos y otros factores pronósticos.DISEÑO:Este es un análisis retrospectivo de una base de datos recopilada prospectivamente.ENTORNO CLINICO:Este estudio se realizó en un centro oncológico de referencia de tercer nivel.PACIENTES:Se valoraron un total de 418 pacientes sometidos a resección curativa por cáncer de colon en estadio I-III utilizando de manera rutinaria una tinción de elastina.PRINCIPALES MEDIDAS DE VALORACION:Se midieron la tasa de detección de IV después de adoptar la tinción de elastina, los factores de pronóstico que influyen en las recurrencias de la enfermedad mediante modelos de regresión de Cox multivariados y la supervivencia. La zona de metástasis ganglionares se definió como, LNZ1, LNZ2 y LNZ3, correspondientes a las metástasis en los ganglios pericólicos, intermedios y apicales, respectivamente.RESULTADOS:La tasa de detección de IV aumentó de 11,3% a 35,4% en comparación con el período anterior en el que solo se realizó tinción con hematoxilina y eosina. El análisis de regresión de Cox mostró VI (razón de riesgo, 3.856; intervalo de confianza [IC] del 95%, 1.249-11.910, p = 0.019) y metástasis en los ganglios linfáticos (razón de riesgo, 3.156; IC del 95%, 1.094-9.108, p = 0.034) en todos los estadios y LNZ 2, 3 (cociente de riesgo, 2.649; IC del 95%, 1.244-5.640, p = 0.012) en el estadio III se asociaron significativamente con una pobre supervivencia libre de enfermedad. Al estratificar a todos los pacientes según estos tres factores, los pacientes con estadio III [LNZ1 / VI (-)] tuvieron una sobrevivencia sin enfermedad (SSE) comparable con el estadio I, pero una supervivencia libre de enfermedad significativamente mejor que aquellos con estadio II [VI (+)] (p = 0,018). Pacientes en estadío II [VI (+)] tuvieron una mejor supervivencia sin enfermedad mediante el uso de quimioterapia adyuvante (p <0,001).LIMITACIONES:Estudio limitado por su diseño retrospectivo.CONCLUSIÓN:La tinción de elastina contribuyó a un aumento considerable en la detección de IV. IV puede ser un poderoso predictor de supervivencia sin enfermedad deficiente más allá de las metástasis de los ganglios linfáticos cuando se limita al área pericólica y es útil para decidir el uso de quimioterapia adyuvante en el cáncer de colon en estadío II. Consulte Video Resumen en http://links.lww.com/DCR/B573. (Traducción-Dr. Adrian Ortega).
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http://dx.doi.org/10.1097/DCR.0000000000001968DOI Listing
August 2021

Abuse Potential of Synthetic Cannabinoids: AM-1248, CB-13, and PB-22.

Biomol Ther (Seoul) 2021 Jul;29(4):384-391

Department of Pharmacology, School of Pharmacy, Sungkyunkwan University, Suwon 16419, Republic of Korea.

Currently, the expanding recreational use of synthetic cannabinoids (SCBs) threatens public health. SCBs produce psychoactive effects similar to those of tetrahydrocannabinol, the main component of cannabis, and additionally induce unexpected pharmacological side effects. SCBs are falsely advertised as legal and safe, but in reality, SCB abuse has been reported to cause acute intoxication and addictive disorders. However, because of the lack of scientific evidence to elucidate their dangerous pharmacological effects, SCBs are weakly regulated and continue to circulate in illegal drug markets. In the present study, the intravenous self-administration (IVSA) paradigm was used to evaluate the abuse potential of three SCBs (AM-1248, CB-13, and PB-22) in rats. All three SCBs maintained IVSA with a large number of infusions and active lever presses, demonstrating their reinforcing effects. The increase of active lever presses was particularly significant during the early IVSA sessions, indicating the reinforcementenhancing effects of the SCBs (AM-1248 and CB-13). The number of inactive lever presses was significantly higher in the SCB groups (AM-1248 and CB-13) than that in the vehicle group, indicating their impulsive effects. In summary, these results demonstrated that SCBs have distinct pharmacological properties and abuse potential.
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http://dx.doi.org/10.4062/biomolther.2020.212DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8255142PMC
July 2021

The Effect of Tranexamic Acid Administration on Early Endothelial Damage Following Posterior Lumbar Fusion Surgery.

J Clin Med 2021 Apr 1;10(7). Epub 2021 Apr 1.

Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul 03722, Korea.

Tranexamic acid (TXA) protects against endothelial glycocalyx injury in vitro. We aimed to evaluate whether TXA could protect against endothelial glycocalyx degradation in patients undergoing posterior lumbar fusion surgery. Patients aged 30-80 years were enrolled. The TXA group was administered a loading dose of 10 mg/kg, followed by a 1 mg/kg/h infusion. Serum syndecan-1 and heparan sulfate concentrations, which are biomarkers of glycocalyx degradation, were measured at preoperative baseline (T0), immediately post-surgery (T1), and 2 h post-surgery (T2). Postoperative complications were assessed, including hypotension, desaturation, and acute kidney injury. Among the 121 patients who completed the study, 60 received TXA. There were no significant differences in the marker concentrations at each time point. However, the postoperative increase in syndecan-1 levels from baseline was significantly attenuated in the TXA group compared with the control group (median (interquartile range); T1 vs. T0: -1.6 (-5.3-2.6) vs. 2.2 (-0.7-4.8), = 0.001; T2 vs. T0: 0.0 (-3.3-5.5) vs. 3.6 (-0.1-9.3), = 0.013). Postoperative complications were significantly associated with the magnitude of the change in syndecan-1 levels (for T2 vs. T0: odds ratio: 1.08, 95% confidence interval: 1.02-1.14, = 0.006). TXA administration was associated with reduced syndecan-1 shedding in patients undergoing posterior lumbar fusion surgery.
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http://dx.doi.org/10.3390/jcm10071415DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8037070PMC
April 2021

The impact of pretransplant hepatic encephalopathy, model for end-stage liver disease (MELD) scale on long-term survival following deceased donor liver transplantation: a retrospective study.

Ann Palliat Med 2021 May 19;10(5):5171-5180. Epub 2021 Apr 19.

Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.

Background: Liver transplantation (LT) has the incidence of 30-day mortality about 5-10%, Jo et al. reported that 30-day mortality and 1-year mortality for DDLT were 30%, and 39% respectively. It is not easy to create a model for predicting post-transplantation outcomes based on pretransplant variables. MELD does not take into account individual complications such as hepatic encephalopathy (HE), and research has shown that the greater the severity of pretransplant HE, the lower the survival rate after LT; the importance of monitoring for HE is therefore emphasized.

Methods: The medical records of adult patients who underwent deceased donor LT (DDLT) were retrospectively reviewed for analysis of the effect of HE on the long-term survival rate of post-transplant for more than 1 year.

Results: Presence of HE is not statistically associated to patient survival (P=0.062), but the hazard ratio is 1.954 (95% CI, 0.968, 3.943). In addition, the severe HE group significantly decreased survival compared to the non-HE group, and the cumulative 1- and 3-year overall survival rates were 80.9% and 78.7%, respectively, in non HE group, and 65.7% and 56.1%, respectively, in severe HE group (P=0.031).

Conclusions: Severe HE is a factor influencing the long-term survival over 3 years in the patients who underwent DDLT. Although prospective validation should be conducted to determine the prognostic value of HE severity, efforts could be made to reduce the severity of HE before DDLT, and consider severity of HE rather than MELD score in DDLT allocation.
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http://dx.doi.org/10.21037/apm-21-21DOI Listing
May 2021

Anterior neck soft tissue measurements on computed tomography to predict difficult laryngoscopy: a retrospective study.

Sci Rep 2021 Apr 19;11(1):8438. Epub 2021 Apr 19.

Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.

Predicting difficult laryngoscopy is an essential component of the airway management. We aimed to evaluate the use of anterior neck soft tissue measurements on computed tomography for predicting difficult laryngoscopy and to present a clear measurement protocol. In this retrospective study, 281 adult patients whose tracheas were intubated using a direct laryngoscope for thyroidectomy were enrolled. On computed tomography, the distances from the midpoint of the thyrohyoid membrane to the closest concave point of the vallecular (membrane-to-vallecula distance; dMV), and to the most distant point of the epiglottis (membrane-to-epiglottis distance; dME) were measured, respectively. The extended distances straight to the skin anterior from the dMV and dME were called the skin-to-vallecula distance (dSV) and skin-to-epiglottis distance (dSE), respectively. Difficult laryngoscopy was defined by a Cormack-Lehane grade of > 2. Difficult laryngoscopy occurred in 40 (14%) cases. Among four indices, the dMV showed the highest prediction ability for difficult laryngoscopy with an area under the receiver operating characteristic curve of 0.884 (95% confidence interval 0.841-0.919, P < 0.001). The optimal dMV cut-off value for predicting difficult laryngoscopy was 2.33 cm (sensitivity 75.0%; specificity 93.8%). The current study provides novel evidence that increased dMV is a potential predictive indicator of difficult laryngoscopy.
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http://dx.doi.org/10.1038/s41598-021-88076-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8055648PMC
April 2021

Differences between proximal and distal M1 occlusions after mechanical thrombectomy.

J Clin Neurosci 2021 May 26;87:1-7. Epub 2021 Feb 26.

Department of Neurosurgery, Inje University Haeundae Paik Hospital, Busan, Republic of Korea. Electronic address:

Purpose: Whether M1 occlusions proximal (pM1) and distal (dM1) to the lenticulostriate perforators result in different clinical outcomes after mechanical thrombectomy (MT) is unknown. We retrospectively compared the clinical outcomes and baseline characteristics of patients with these two types of occlusions.

Methods: From March 2010 to May 2019, we performed MT for 141 M1 occlusions, including pM1 occlusions (n = 58) and dM1 occlusions (n = 83).

Results: Good clinical outcomes (modified Rankin Scale score 0 to 2) were achieved in 28 out of 58 (48.3%) patients with pM1 occlusions and 46 out of 83 (55.4%) patients with dM1 occlusions without significance (p = 0.493). Cardioembolic occlusions represented 19 out of 58 (32.6%) pM1 occlusions and 53 out of 83 (63.9%) dM1 occlusions, and atherosclerotic occlusions represented 37 out of 58 (63.8%) pM1 occlusions and 27 out of 83 (32.5%) dM1 occlusions, with significance (p = 0.001). Rescue treatments, such as balloon angioplasty or stenting, were needed more for pM1 occlusions than dM1 occlusions (21 out of 58 (36.2%) vs. 8 out of 83 (9.8%), p < 0.001). The multivariable logistic regression analysis demonstrated that the need for rescue treatment was associated with pM1 occlusions (adjusted odds ratio; 3.804, 95% confidence interval; 1.306-11.082, p = 0.014).

Conclusions: In our series, pM1 and dM1 occlusions did not significantly differ in good clinical outcomes. Our study also showed that pM1 occlusions were more strongly associated with atherosclerotic occlusions, while dM1 occlusions were more strongly associated with cardioembolic occlusions, and rescue treatments were needed more often for pM1 occlusions than dM1 occlusions.
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http://dx.doi.org/10.1016/j.jocn.2021.01.053DOI Listing
May 2021

A vicious cycle of bisretinoid formation and oxidation relevant to recessive Stargardt disease.

J Biol Chem 2021 Jan-Jun;296:100259. Epub 2021 Jan 7.

Department of Ophthalmology, Columbia University Medical Center, New York, New York, USA; Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York, USA. Electronic address:

The ability of iron to transfer electrons enables the contribution of this metal to a variety of cellular activities even as the redox properties of iron are also responsible for the generation of hydroxyl radicals (OH), the most destructive of the reactive oxygen species. We previously showed that iron can promote the oxidation of bisretinoid by generating highly reactive hydroxyl radical (OH). Now we report that preservation of iron regulation in the retina is not sufficient to prevent iron-induced bisretinoid oxidative degradation when blood iron levels are elevated in liver-specific hepcidin knockout mice. We obtained evidence for the perpetuation of Fenton reactions in the presence of the bisretinoid A2E and visible light. On the other hand, iron chelation by deferiprone was not associated with changes in postbleaching recovery of 11-cis-retinal or dark-adapted ERG b-wave amplitudes indicating that the activity of Rpe65, a rate-determining visual cycle protein that carries an iron-binding domain, is not affected. Notably, iron levels were elevated in the neural retina and retinal pigment epithelial (RPE) cells of Abca4 mice. Consistent with higher iron content, ferritin-L immunostaining was elevated in RPE of a patient diagnosed with ABCA4-associated disease and in RPE and photoreceptor cells of Abca4 mice. In neural retina of the mutant mice, reduced Tfrc mRNA was also an indicator of retinal iron overload. Thus iron chelation may defend retina when bisretinoid toxicity is implicated in disease processes.
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http://dx.doi.org/10.1016/j.jbc.2021.100259DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7948646PMC
August 2021

Robot Surgery Shows Similar Long-term Oncologic Outcomes as Laparoscopic Surgery for Mid/Lower Rectal Cancer but Is Beneficial to ypT3/4 After Preoperative Chemoradiation.

Dis Colon Rectum 2021 07;64(7):812-821

Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, Department of Surgery, School of Medicine, Kyungpook National University, Daegu, South Korea.

Background: The long-term oncologic efficacy of robotic surgery for patients with rectal cancer is unknown.

Objective: The aim of the study was to investigate survival outcomes of robotic total mesorectal excision for mid/low rectal cancer compared with those of laparoscopic surgery.

Design: We performed a single-center retrospective analysis.

Setting: The data of a tertiary academic institution was reviewed.

Patients: A total of 705 patients underwent laparoscopic (n = 415) or robotic (n = 118) low anterior resection for stage I to III mid/low rectal cancer. A total of 118 patients in each group were selected from the original data set by using propensity score matching.

Main Outcome Measures: The main outcomes were 5-year disease-free survival, distant recurrence, and local recurrence.

Results: The 2 groups were balanced in terms of basic characteristics, perioperative treatment, and pathological stage. The 5-year disease-free survival rate was 80.5% in the laparoscopic group and 87.6% in the robotic group (p = 0.118). The 5-year distant recurrence rate and local recurrence rate were 19.0% and 4.2% in the laparoscopic group and 10.0% and 3.7% in the robotic group (p = 0.048 and p = 0.846). In a subgroup of patients who received preoperative chemoradiation and had ypT3/4 tumors, the 5-year distant recurrence and local recurrence rates were 44.8% and 5.0% in the laparoscopic group and 9.8% and 9.8% in the robotic group (p = 0.014 and p = 0.597).

Limitations: The retrospective nature of the study, potential selection bias with distinct demographics between the groups, and relatively small number of cases are limitations.

Conclusions: Robotic surgery for mid/low rectal cancer shows similar long-term oncologic outcomes with laparoscopic surgery but is beneficial to a certain group of patients with advanced rectal cancer with poor response to neoadjuvant chemoradiation. Additional studies are required to confirm our results. See Video Abstract at http://links.lww.com/DCR/B546.

La Ciruga Robtica Muestra Resultados Oncolgicos A Largo Plazo Similares A La Ciruga Laparoscpica En Casos De Cncer De Recto Medio / Bajo, Pero Es Ventajosa En Casos Ypt Postquimioradioterapia Preoperatoria: ANTECEDENTES:Se desconoce la eficacia oncológica a largo plazo de la cirugía robótica en pacientes con cáncer de recto.OBJETIVO:La finalidad de nuestro estudio fue el investigar los resultados de supervivencia de la escisión mesorrectal total robótica en casos de cáncer de recto medio / bajo en comparación con los de la cirugía laparoscópica.DISEÑO:Realizamos un análisis retrospectivo mono-céntrico.AJUSTE:Se revisaron los datos de una institución académica terciaria.PACIENTES:705 pacientes fueron sometidos a resección anterior baja laparoscópica (n = 415) o robótica (n = 118) para cáncer de recto medio / bajo en estadio I-III. Se seleccionó un total de 118 pacientes en cada grupo del conjunto de datos original utilizando el emparejamiento por puntuación de propensión.RESULTADOS PRINCIPALES:Éstos fueron, la supervivencia libre de enfermedad a 5 años, la recurrencia a distancia y la recurrencia local.RESULTADOS:Los dos grupos estaban equilibrados en cuanto a características básicas, tratamiento péri-operatorio y estadío patológico. La tasa de sobrevida libre de enfermedad a 5 años fue del 80,5% en el grupo laparoscópico y del 87,6% en el grupo robótico (p = 0,118). La tasa de recurrencia a distancia a 5 años y la tasa de recurrencia local fueron 19,0% y 4,2% en el grupo laparoscópico y 10,0% y 3,7% en el grupo robótico, respectivamente (p = 0,048 y p= 0,846). En el subgrupo de pacientes que recibieron quimio-radioterapia pré-operatoria y tenían tumores ypT3-4, las tasas de recidiva a distancia a 5 años y recidiva local fueron 44,8% y 5,0% en el grupo laparoscópico y 9,8% y 9,8% en el grupo robótico, respectivamente (p = 0.014 y p = 0.597).LIMITACIONES:La naturaleza retrospectiva del estudio, el posible sesgo en la selección con datos demográficos distintos entre los grupos y un número relativamente pequeño de casos son limitaciones importantes.CONCLUSIONES:La cirugía robótica para el cáncer de recto medio / bajo muestra resultados oncológicos a largo plazo similares con la cirugía laparoscópica, pero es mas beneficiosa en ciertos grupos de cáncer de recto avanzado con mala respuesta a la quimio-radioterapia neoadyuvante. Se requieren más estudios para confirmar nuestros resultados. Consulte Video Resumen en http://links.lww.com/DCR/B546.).
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http://dx.doi.org/10.1097/DCR.0000000000001978DOI Listing
July 2021

Genetic and clinical spectrums in Korean Charcot-Marie-Tooth disease patients with myelin protein zero mutations.

Mol Genet Genomic Med 2021 Jun 6;9(6):e1678. Epub 2021 Apr 6.

Department of Biological Sciences, Kongju National University, Gongju, Korea.

Background: Charcot-Marie-Tooth disease (CMT) is the most common disorder of inherited peripheral neuropathies characterized by distal muscle weakness and sensory loss. CMT is usually classified into three types, demyelinating, axonal, and intermediate neuropathies. Mutations in myelin protein zero (MPZ) gene which encodes a transmembrane protein of the Schwann cells as a major component of peripheral myelin have been reported to cause various type of CMT.

Methods: This study screened MPZ mutations in Korean CMT patients (1,121 families) by whole exome sequencing and targeted sequencing.

Results: We identified 22 pathogenic or likely pathogenic MPZ mutations in 36 families as the underlying cause of the CMT1B, CMTDID, or CMT2I subtypes. Among them, five mutations were novel. The frequency of CMT patients with the MPZ mutations was similar or slightly lower compared to other ethnic groups.

Conclusions: We showed that the median onset ages and clinical phenotypes varied by subtypes: the most severe in the CMT1B group, and the mildest in the CMT2I group. This study also observed a clear correlation that earlier onsets cause more severe symptoms. We believe that this study will provide useful reference data for genetic and clinical information on CMT patients with MPZ mutations in Korea.
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http://dx.doi.org/10.1002/mgg3.1678DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8222852PMC
June 2021

Non-Polio Enteroviruses from Acute Flaccid Paralysis Surveillance in Korea, 2012-2019.

Viruses 2021 03 5;13(3). Epub 2021 Mar 5.

Division of Viral Diseases, Korea Disease Control and Prevention Agency, Cheongju 28159, Korea.

The risk of polio importation and re-emergence persists since epidemic polio still occurs in some countries, and the resurgence of polio occurring almost 20 years after polio eradication was declared in Asia has been reported. We analyzed the results of acute flaccid paralysis (AFP) surveillance in Korea to assess the quality of AFP surveillance and understand the etiology of non-polio enterovirus (NPEV)-associated central nervous system diseases in a polio-free area. We investigated 637 AFP patients under 15 years of age whose cases were confirmed during 2012-2019 by virus isolation, real-time reverse transcription polymerase chain reaction, and VP1 gene sequencing. Among the 637 AFP cases, NPEV was detected in 213 (33.4%) patients, with the majority observed in EV-A71, with 54.9% of NPEV positives. EV-A71 has been shown to play a role as a major causative agent in most neurological diseases except for Guillain-Barré syndrome (GBS), acute disseminated encephalomyelitis (ADEM), and meningitis. This study provides information on the AFP surveillance situation in Korea and highlights the polio eradication stage in the monitoring and characterization of NPEV against the outbreak of neurological infectious diseases such as polio.
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http://dx.doi.org/10.3390/v13030411DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8001888PMC
March 2021
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