Publications by authors named "Ji-Ho Lee"

144 Publications

Author Correction: Effects of Aqueous Solubility and Geochemistry on CO Injection for Shale Gas Reservoirs.

Sci Rep 2021 Dec 27;11(1):24521. Epub 2021 Dec 27.

Department of Earth Resources and Environmental Engineering, Hanyang University, Seoul, 04763, Republic of Korea.

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http://dx.doi.org/10.1038/s41598-021-04141-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8712520PMC
December 2021

Comparison of Risk of Pneumonia Caused by Fluticasone Propionate versus Budesonide in Chronic Obstructive Pulmonary Disease: A Nationwide Retrospective Cohort Study.

Int J Chron Obstruct Pulmon Dis 2021 25;16:3229-3237. Epub 2021 Nov 25.

Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.

Introduction: Inhaled corticosteroids (ICSs) play an important role in lowering the risk of acute exacerbation of chronic obstructive pulmonary disease (COPD). However, ICSs are known to increase the risk of pneumonia. Moreover, previous studies have shown that the incidence rate of pneumonia varies depending on the type of ICS. In this study, the risk of pneumonia according to the type of ICS was investigated in a population-based cohort.

Methods: A retrospective cohort study was conducted using claims data of the entire population from the Korean National Health Insurance Service. Patients who were newly diagnosed with COPD and prescribed fluticasone propionate or budesonide were enrolled as study subjects. Cumulative doses of ICSs were classified into categorical variables to analyze the risk of pneumonia within identical ICS doses.

Results: A total of 47,473 subjects were identified and allocated as 14,518 fluticasone propionate and 14,518 budesonide users through 1:1 propensity score matching. Fluticasone propionate users were more likely to develop pneumonia than budesonide users (14.22% vs 10.66%, p<0.0001). The incidence rate per 100,000 person-years was 2,914.77 for fluticasone propionate users and 2,102.90 for budesonide users. The hazard ratio (HR) of pneumonia in fluticasone propionate compared to budesonide was 1.34 (95% CI 1.26-1.43, p<0.0001). The risk of pneumonia for fluticasone propionate compared to budesonide increased with higher ICS cumulative doses: 1.06 (0.93-1.21), 1.41 (1.19-1.66), 1.41 (1.23-1.63), and 1.49 (1.33-1.66) from the lowest to highest quartiles, respectively.

Conclusion: ICS types and doses need to be carefully considered during treatment with ICSs in patients with COPD.
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http://dx.doi.org/10.2147/COPD.S332151DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8629914PMC
November 2021

Epidemiology of adult chronic cough: disease burden, regional issues, and recent findings.

Asia Pac Allergy 2021 Oct 18;11(4):e38. Epub 2021 Oct 18.

Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Chronic cough is a common medical condition that has a significant impact on patients' quality of life. Although it was previously considered a symptom of other disorders, it is now regarded as a pathologic state that is characterized by a deviation from the intrinsic protective functions of the cough reflex, especially in adults. There are several factors that may underlie the cough reflex hypersensitivity and its persistence, such as age, sex, comorbidities, viral infection, exposure to irritants or environmental pollutants, and their interactions may determine the epidemiology of chronic cough in different countries. With a deeper understanding of disease pathophysiology and advanced research methodology, there are more attempts to investigate cough epidemiology using a large cohort of healthcare population data. This is a narrative overview of recent findings on the disease burden, risk factors, Asia-Pacific issues, and longitudinal outcomes in adults with chronic cough. This paper also discusses the approaches utilizing routinely collected data in cough research.
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http://dx.doi.org/10.5415/apallergy.2021.11.e38DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8563099PMC
October 2021

Developing a Diagnostic Bundle for Bronchiectasis in South Korea: A Modified Delphi Consensus Study.

Tuberc Respir Dis (Seoul) 2022 Jan 15;85(1):56-66. Epub 2021 Nov 15.

Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Background: Because the etiologies of bronchiectasis and related diseases vary significantly among different regions and ethnicities, this study aimed to develop a diagnostic bundle for bronchiectasis in South Korea.

Methods: A modified Delphi method was used to develop expert consensus statements on a diagnostic bundle for bronchiectasis in South Korea. Initial statements proposed by a core panel, based on international bronchiectasis guidelines, were discussed in an online meeting and two email surveys by a panel of experts (≥70% agreement).

Results: The study involved 21 expert participants, and 30 statements regarding a diagnostic bundle for bronchiectasis were classified as recommended, conditional, or not recommended. The consensus statements of the expert panel were as follows: A standardized diagnostic bundle is useful in clinical practice; diagnostic tests for specific diseases, including immunodeficiency and allergic bronchopulmonary aspergillosis, are necessary when clinically suspected; initial diagnostic tests, including sputum microbiology and spirometry, are essential in all patients with bronchiectasis, and patients suspected with rare causes such as primary ciliary dyskinesia should be referred to specialized centers.

Conclusion: Based on this Delphi survey, expert consensus statements were generated including specific diagnostic, laboratory, microbiological, and pulmonary function tests required to manage patients with bronchiectasis in South Korea.
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http://dx.doi.org/10.4046/trd.2021.0136DOI Listing
January 2022

Speech-in-Noise Test results of compensation claimants for noise induced hearing loss in Korean male workers: Words-in-Noise Test (WIN) and quick-Hearing-in-Noise Test (HINT).

Ann Occup Environ Med 2021 20;33:e11. Epub 2021 Apr 20.

Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.

Background: Pure-tone audiometry is used as a gold standard for hearing measurement. However, since communication in the work environment occurs in noise, it might be difficult to evaluate the actual communication ability accurately based on pure-tone audiometry only. Therefore, the purpose of this study is to evaluate speech intelligibility in noisy environments by using Speech-in-Noise Tests and to check its relationship with pure-tone audiometry.

Methods: From January 2017 to September 2018, for 362 workers who visited a university hospital for the purpose of compensating for noise-induced hearing loss, several tests were conducted: pure-tone audiometry, speech reception threshold, speech discrimination score, and Speech-in-Noise Tests (Words-in-Noise Test [WIN] and quick-Hearing-in-Noise Test [quick-HINT]). The subjects were classified into serviceable hearing group and non-serviceable hearing group based on 40 dB hearing level (HL) pure-tone average. In both groups, we conducted age-adjusted partial correlation analysis in order to find out the relationship between pure-tone threshold, speech reception threshold, speech discrimination score and WIN and quick-HINT respectively.

Results: In non-serviceable hearing group, all results of partial correlation analysis were statistically significant. However, in serviceable hearing group, there were many results which showed little or no significant relationship between pure-tone threshold and Speech-in-Noise Tests (WIN and quick-HINT).

Conclusions: The relationship between Speech-in-Noise Tests and the pure-tone thresholds were different by the hearing impairment levels; in mild to moderate hearing loss workers, there was little or no relationship; in severe cases, the relationship was significant. It is not enough to predict the speech intelligibility of hearing-impaired persons, especially in mild to moderate level, with pure-tone audiometry only. Therefore, it would be recommended to conduct Speech-in-Noise Test.
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http://dx.doi.org/10.35371/aoem.2021.33.e11DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8144841PMC
April 2021

Depression in public officials during the COVID-19 pandemic in Paraguay: a web-based study.

BMC Public Health 2021 10 11;21(1):1835. Epub 2021 Oct 11.

Yonsei Global Health Center, Wonju, Republic of Korea.

Background: According to the World Health Organization, the coronavirus disease 2019 (COVID-19) pandemic has created situations that have a negative effect on people and threaten their mental health. Paraguay announced the Estado de Emergencia Sanitaria (Presidential Decree No. 3456) on March 16, 2020, which was followed by the imposition of a 24-h restriction on movement order on March 21. Self-quarantine at home may have been the most effective method of preventing the spread of infectious diseases; however, with the global pandemic becoming more prolonged and the consequent lengthening of the 24-h self-quarantine period, it is highly probable that both physical and psychological problems will arise.

Methods: In this study, a web-based cross-sectional method was used to analyze the factors influencing COVID-19-induced depressive feelings in Paraguayan public officials.

Results: Public officials reported a high level of depressive symptoms with a high level of apprehension in early stage of COVID-19. In addition, this study identified that when the self-quarantine period increased, levels of depressive feelings also increased. Since self-quarantine is characterized by the requirement that individuals endure an undetermined period within a confined area, it may have caused stress and anxiety, as well as the consequent experience of depressive feelings.

Conclusions: Paraguayan government should develop a program for the delivery of mental health care and services to public officials in COVID-19 Pandemic period. Moreover, a program is required for people facing deteriorating mental health due to social isolation and loneliness caused by social distancing during the prolonged period of self-quarantine. Finally, mental health care programs should be organized in a community-focused way by utilizing online systems to enhance the effectiveness of mental health recovery.
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http://dx.doi.org/10.1186/s12889-021-11860-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8503714PMC
October 2021

Prevalence of depression and its associated factors in bronchiectasis: findings from KMBARC registry.

BMC Pulm Med 2021 Sep 27;21(1):306. Epub 2021 Sep 27.

Department of Internal Medicine, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju, 26426, Korea.

Background: With the emergence of bronchiectasis as a common respiratory disease, epidemiological data have accumulated. However, the prevalence and impact of psychological comorbidities were not sufficiently evaluated. The present study examined the prevalence of depression and its associated factors in patients with bronchiectasis.

Methods: This study involved a multicenter cohort of bronchiectasis patients recruited from 33 pulmonary specialist hospitals. The baseline characteristics and bronchiectasis-related factors at enrollment were analyzed. Depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-9).

Results: Of the 810 patients enrolled in the study, 168 (20.7%) patients had relevant depression (PHQ-9 score ≥ 10), and only 20 (11.9%) patients had a diagnosis of depression. Significant differences were noted in the depressive symptoms with disease severity, which was assessed using the Bronchiectasis Severity Index and E-FACED (all p < 0.001). Depressive symptoms inversely correlated with quality-of-life (r = - 0.704, p < 0.001) and positively correlated with fatigue severity score (r = 0.712, p < 0.001). Multivariate analysis showed that depression was significantly associated with the modified Medical Research Council dyspnea scale ≥ 2 (OR 2.960, 95% CI 1.907-4.588, p =  < 0.001) and high number of exacerbations (≥ 3) in the previous year (OR 1.596, 95% CI 1.012-2.482, p = 0.041).

Conclusions: Depression is common, but its association with bronchiectasis was underrecognized. It negatively affected quality-of-life and presented with fatigue symptoms. Among the bronchiectasis-related factors, dyspnea and exacerbation were closely associated with depression. Therefore, active screening for depression is necessary to optimize the treatment of bronchiectasis.

Trial Registration: The study was registered at Clinical Research Information Service (CRiS), Republic of Korea (KCT0003088). The date of registration was June 19th, 2018.
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http://dx.doi.org/10.1186/s12890-021-01675-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8475377PMC
September 2021

Efficacy of non-sedating H1-receptor antihistamines in adults and adolescents with chronic cough: A systematic review.

World Allergy Organ J 2021 Aug 21;14(8):100568. Epub 2021 Jul 21.

Department of Allergy and Clinical Immunology, Airway Sensation and Cough Research Laboratory, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.

Background: Nasal symptoms frequently coexist in patients with chronic cough, and non-sedating H1-receptor antihistamines (nsH1RAs) are often prescribed for cough management in several countries. However, recommendations on the use of nsH1RAs vary among chronic cough guidelines. This study aimed to examine the efficacy of nsH1RAs over placebos in adolescents or adults with chronic cough or allergic respiratory conditions that may present as chronic cough.

Methods: Electronic databases were searched for studies published until November 2020. Randomized placebo-controlled trials of nsH1RAs reporting cough endpoints in adolescents or adults with chronic cough or cough-associated allergic respiratory conditions (allergic rhinitis, allergic asthma, or atopic cough) were included.

Results: A total of 10 placebo-controlled trials were identified. Three studies (one study each involving allergic rhinitis, allergic rhinitis with comorbid asthma, and atopic cough) described baseline and post-treatment cough scores, and all reported significant improvements in subjective cough scores; however, the magnitude of improvement was greater in the 2 studies of patients with atopic cough (relative improvement in cough frequency score: -36.6 ± 8.4%) or seasonal allergic rhinitis-associated cough (cough frequency score: -44.0 ± 7.3% and cough intensity score: -65.7 ± 8.3%) than in the 1 study of allergic rhinitis patients with comorbid asthma (-4.0 ± 1.3%). Meanwhile, the other 7 trials found conflicting results but lacked information on the baseline cough score and did not use validated cough measurement tools; thus, their clinical relevance could not be determined.

Conclusion: Despite the widespread use of nsH1RAs in patients with chronic cough, only a few clinical trials examining their benefits on cough outcomes have been conducted. There may be a subgroup of patients, particularly those with seasonal allergic rhinitis-associated cough or atopic cough, whose cough may improve with nsH1RA treatment. However, adequately powered trials with validated cough measurement tools are warranted to confirm the role of nsH1RAs in the management of patients with allergic phenotypes of chronic cough.
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http://dx.doi.org/10.1016/j.waojou.2021.100568DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8322120PMC
August 2021

Pathogenesis and genetic characteristics of a novel reassortant low pathogenic avian influenza A(H7N6) virus isolated in Cambodia in 2019.

Transbound Emerg Dis 2021 Nov 13;68(6):3180-3186. Epub 2021 Aug 13.

Avian Influenza Research & Diagnostic Division, Animal and Plant Quarantine Agency, Gimcheon, Republic of Korea.

The first human case of zoonotic A(H7N4) avian influenza virus (AIV) infection was reported in early 2018 in China. Two months after this case, novel A(H7N4) viruses phylogenetically related to the Jiangsu isolate emerged in ducks from live bird markets in Cambodia. During active surveillance in Cambodia, a novel A(H7N6) reassortant of the zoonotic low pathogenic AIV (LPAIV) A(H7N4) was detected in domestic ducks at a slaughterhouse. Complete genome sequencing and phylogenetic analysis showed that the novel A(H7N6) AIV is a reassortant, in which four gene segments originated from Cambodia A(H7N4) viruses and four gene segments originated from LPAIVs in Eurasia. Animal infection experiments revealed that chickens transmitted the A(H7N6) virus via low-level direct contacts, but ducks did not. Although avian-origin A(H7Nx) LPAIVs do not contain the critical mammalian-adaptive substitution (E627K) in PB2, the lethality and morbidity of the A(H7N6) virus in BALB/c mice were similar to those of A(H7N9) viruses, suggesting potential for interspecies transmission. Our study reports the emergence of a new reassortant of zoonotic A(H7N4) AIVs with novel viral characteristics and emphasizes the need for ongoing surveillance of avian-origin A(H7Nx) viruses.
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http://dx.doi.org/10.1111/tbed.14256DOI Listing
November 2021

Association between Osteoporotic Vertebral Compression Fractures and Age, Bone Mineral Density, and European Quality of Life-5 Dimensions in Korean Postmenopausal Women: A Nationwide Cross-sectional Observational Study.

Clin Orthop Surg 2021 Jun 17;13(2):207-215. Epub 2021 Mar 17.

Department of Orthopedic Surgery, SMG-SNU Boramae Medical Center, Seoul, Korea.

Backgroud: The purpose of this study was to investigate the characteristics of osteoporotic vertebral compression fractures (OVCFs) in Korean postmenopausal women and the association between OVCFs and clinical factors such as age, bone mineral density (BMD), and quality of life.

Methods: According to the population distribution in four regions in Korea, 1,281 postmenopausal female patients were recruited from nationwide orthopedic outpatient clinics. Radiologic, asymptomatic, and within 3 months of OVCF groups were analyzed based on age, fracture location, and prevalence according to BMD. In addition, BMD, T-score, body mass index, and European Quality of Life-5 Dimensions (EQ-5D) were investigated in the three groups, and the differences between groups were compared and analyzed.

Results: The prevalence of radiologic OVCFs at the T11-L1 was 3.7 times higher in the 70s group (44.0%) than in the 50s group (11.9%). Femur and total hip BMD were significantly lower in patients with thoracolumbar junction fractures than in patients with L2-5 fractures, whereas no difference was observed in lumbar spine BMD. Of the three OVCF groups, the within 3 months of OVCF group had the lowest lumbar spine T-score of -2.445. The asymptomatic OVCF group also showed significantly lower lumbar spine T-score than did the group without radiologic OVCFs ( < 0.001). The EQ-5D showed a significant decrease in the radiologic OVCF group ( < 0.001) and within 3 months of OVCF group ( < 0.001).

Conclusions: The prevalence of OVCFs in the thoracolumbar junction rapidly increases with old age and low BMD in Korean postmenopausal women. Femur and total hip BMD are more predictive of thoracolumbar junction fractures than lumbar spine BMD. Patients with radiologic OVCFs had a significantly lower quality of life than no OVCF group. Therefore, this study shows it is important to treat and prevent osteoporosis before an OVCF occurs.
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http://dx.doi.org/10.4055/cios20209DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8173246PMC
June 2021

Performance of Modified Early Warning Score (MEWS) for Predicting In-Hospital Mortality in Traumatic Brain Injury Patients.

J Clin Med 2021 Apr 28;10(9). Epub 2021 Apr 28.

Department of Emergency Medicine, Chonnam National University Medical School, 160 Baekseo-ro, Dong-gu, Gwangju 61469, Korea.

The present study aimed to analyze and compare the prognostic performances of the Revised Trauma Score (RTS), Injury Severity Score (ISS), Shock Index (SI), and Modified Early Warning Score (MEWS) for in-hospital mortality in patients with traumatic brain injury (TBI). This retrospective observational study included severe trauma patients with TBI who visited the emergency department between January 2018 and December 2020. TBI was considered when the Abbreviated Injury Scale was 3 or higher. The primary outcome was in-hospital mortality. In total, 1108 patients were included, and the in-hospital mortality was 183 patients (16.3% of the cohort). Receiver operating characteristic curve analyses were performed for the ISS, RTS, SI, and MEWS with respect to the prediction of in-hospital mortality. The area under the curves (AUCs) of the ISS, RTS, SI, and MEWS were 0.638 (95% confidence interval (CI), 0.603-0.672), 0.742 (95% CI, 0.709-0.772), 0.524 (95% CI, 0.489-0.560), and 0.799 (95% CI, 0.769-0.827), respectively. The AUC of MEWS was significantly different from the AUCs of ISS, RTS, and SI. In multivariate analysis, age (odds ratio (OR), 1.012; 95% CI, 1.000-1.023), the ISS (OR, 1.040; 95% CI, 1.013-1.069), the Glasgow Coma Scale (GCS) score (OR, 0.793; 95% CI, 0.761-0.826), and body temperature (BT) (OR, 0.465; 95% CI, 0.329-0.655) were independently associated with in-hospital mortality after adjustment for confounders. In the present study, the MEWS showed fair performance for predicting in-hospital mortality in patients with TBI. The GCS score and BT seemed to have a significant role in the discrimination ability of the MEWS. The MEWS may be a useful tool for predicting in-hospital mortality in patients with TBI.
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http://dx.doi.org/10.3390/jcm10091915DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8124302PMC
April 2021

Leucine-sensing mechanism of leucyl-tRNA synthetase 1 for mTORC1 activation.

Cell Rep 2021 04;35(4):109031

Medicinal Bioconvergence Research Center, Institute for Artificial Intelligence and Biomedical Research, College of Pharmacy & College of Medicine, Gangnam Severance Hospital, Yonsei University, Incheon 21983, Republic of Korea. Electronic address:

Leucyl-tRNA synthetase 1 (LARS1) mediates activation of leucine-dependent mechanistic target of rapamycin complex 1 (mTORC1) as well as ligation of leucine to its cognate tRNAs, yet its mechanism of leucine sensing is poorly understood. Here we describe leucine binding-induced conformational changes of LARS1. We determine different crystal structures of LARS1 complexed with leucine, ATP, and a reaction intermediate analog, leucyl-sulfamoyl-adenylate (Leu-AMS), and find two distinct functional states of LARS1 for mTORC1 activation. Upon leucine binding to the synthetic site, H251 and R517 in the connective polypeptide and FPYPY in the catalytic domain change the hydrogen bond network, leading to conformational change in the C-terminal domain, correlating with RagD association. Leucine binding to LARS1 is increased in the presence of ATP, further augmenting leucine-dependent interaction of LARS1 and RagD. Thus, this work unveils the structural basis for leucine-dependent long-range communication between the catalytic and RagD-binding domains of LARS1 for mTORC1 activation.
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http://dx.doi.org/10.1016/j.celrep.2021.109031DOI Listing
April 2021

Multiple Reassortants of H5N8 Clade 2.3.4.4b Highly Pathogenic Avian Influenza Viruses Detected in South Korea during the Winter of 2020-2021.

Viruses 2021 03 16;13(3). Epub 2021 Mar 16.

Avian Influenza Research & Diagnostic Division, Animal and Plant Quarantine Agency, 177 Hyeoksin 8-ro, Gimcheon-si 39660, Gyeongsangbuk-do, Korea.

During October 2020-January 2021, we isolated a total of 67 highly pathogenic avian influenza (HPAI) H5N8 viruses from wild birds and outbreaks in poultry in South Korea. We sequenced the isolates and performed phylogenetic analysis of complete genome sequences to determine the origin, evolution, and spread patterns of these viruses. Phylogenetic analysis of the hemagglutinin (HA) gene showed that all the isolates belong to H5 clade 2.3.4.4 subgroup B (2.3.4.4b) and form two distinct genetic clusters, G1 and G2. The cluster G1 was closely related to the 2.3.4.4b H5N8 HPAI viruses detected in Europe in early 2020, while the cluster G2 had a close genetic relationship with the 2.3.4.4b H5N8 viruses that circulated in Europe in late 2020. A total of seven distinct genotypes were identified, including five novel reassortants carrying internal genes of low pathogenic avian influenza viruses. Our Bayesian discrete trait phylodynamic analysis between host types suggests that the viruses initially disseminated from migratory waterfowl to domestic duck farms in South Korea. Subsequently, domestic duck farms most likely contributed to the transmission of HPAI viruses to chicken and minor poultry farms, highlighting the need for enhanced, high levels of biosecurity measures at domestic duck farms to effectively prevent the introduction and spread of HPAI.
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http://dx.doi.org/10.3390/v13030490DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8001867PMC
March 2021

Association between airflow limitation and prognosis in patients with chronic pulmonary aspergillosis.

J Thorac Dis 2021 Feb;13(2):681-688

Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.

Background: Previous studies have shown that reduced levels of lung function, characterized by forced expiratory volume in 1 second (FEV), are associated with higher respiratory events and mortality in general population and some chronic lung diseases. Chronic pulmonary aspergillosis (CPA) is a destructive, fatal lung disease caused by infection in non-immunocompromised patients with suboptimal pulmonary function. However, there is limited information on the status and features of CPA according to FEV.

Methods: We performed a retrospective observational study to investigate the FEV and airflow limitation in patients with CPA between March 2017 and February 2019 at a tertiary hospital in South Korea.

Results: Of the 144 CPA patients, 104 underwent spirometry, demonstrating median forced vital capacity (FVC) and FEV of 2.35 L (68%) and 1.43 L (62%), respectively. Among them, 56 patients had airflow limitation on PFT, with median FVC, and FEV of 2.47 L (73%) and 1.11 L (47%), respectively. Low body mass index (BMI) (20.1 22.1 kg/m; P=0.011), breathlessness (60% 20%; P=0.002), and bilateral pulmonary lesions (33.3% 4%; P=0.006) were more common in patients with moderate to very severe airflow limitation than in those with normal to mild airflow limitation.

Conclusions: Moderate to very severe airflow limitation was observed in 43.3% of patients with CPA. Additionally, low BMI, breathlessness, and bilateral pulmonary lesions contributing to poor prognosis were more common in patients with moderate to very severe airflow limitation than in those with normal to mild airflow limitation. Our findings suggest that airflow limitation can be associated with the prognosis of CPA. Further investigations are needed to demonstrate the clinical significance of this association.
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http://dx.doi.org/10.21037/jtd-20-1815DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7947530PMC
February 2021

Insights into the structure of mature streptavidin C1 from reveal the self-binding of the extension C-terminal peptide to biotin-binding sites.

IUCrJ 2021 Mar 11;8(Pt 2):168-177. Epub 2021 Jan 11.

Department of Biotechnology, School of Life Sciences and Biotechnology for BK21 PLUS, Institute of Life Science and Natural Resources, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul 02841, South Korea.

The members of the avidin protein family are well known for their high affinity towards d-biotin and their structural stability. These properties make avidins a valuable tool for various biotechnological applications. In the present study, two avidin-like biotin-binding proteins (named streptavidin C1 and C2) from were newly identified while exploring antifungal proteins against f. sp. . Streptavidin C1 reveals a low correlation (a sequence identity of approximately 64%) with all known streptavidins, whereas streptavidin C2 shares a sequence identity of approximately 94% with other streptavidins. Here, the crystal structures of streptavidin C1 in the mature form and in complex with biotin at 2.1 and 2.5 Å resolution, respectively, were assessed. The overall structures present similar tetrameric features with symmetry to other (strept)avidin structures. Interestingly, the long C-terminal region comprises a short α-helix (C-Lid; residues 169-179) and an extension C-terminal peptide (ECP; residues 180-191) which stretches into the biotin-binding sites of the same monomer. This ECP sequence (-VTSANPPAS-) is a newly defined biotin-binding site, which reduces the ability to bind to (strept)avidin family proteins. The novel streptavidin C1 could help in the development of an engineered tetrameric streptavidin with reduced biotin-binding capacity as well as other biomaterial tools.
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http://dx.doi.org/10.1107/S2052252520015675DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7924230PMC
March 2021

Coexisting Spine Lesions on Whole Spine T2 Sagittal MRI in Evaluating Spinal Degenerative Disease.

J Korean Med Sci 2021 Feb 22;36(7):e48. Epub 2021 Feb 22.

Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.

Background: Studies have reported on the usefulness of whole spine magnetic resonance imaging (MRI) in evaluating specific diseases such as spinal tuberculosis, spinal trauma, spondyloarthropathies, and multiple myeloma. In studies concerning degenerative spinal disease, sample sizes were small and some did not provide information on how symptomatic coexisting lesions were treated. We evaluated the types and prevalence of coexisting spine lesions found on whole spine T2 sagittal screening performed at the time of routine cervical and lumbar spine MRI and evaluated the efficacy of such screening in degenerative diseases of the cervical and lumbar spine.

Methods: We reviewed 1,757 and 2,266 consecutive cases where whole spine T2 sagittal screening had been performed with routine cervical and lumbar spine MRI, respectively, in patients with cervical and lumbar spinal degenerative diseases. Coexisting spine lesions were documented and statistical analysis was performed to investigate significant differences according to sex, age, and initial diagnosis. Electronic medical records were reviewed to determine whether additional interventions were necessary following such findings.

Results: We reviewed 1,252 and 1,689 consecutive cases of routine cervical and lumbar spine MRI respectively, with whole spine T2 sagittal screening. Of the 1,252, 419 (33.5%) patients with cervical spinal degenerative disease had coexisting lesions in the thoracolumbar spine. Patients with ligament ossification disease of the cervical spine showed a higher prevalence of coexisting spine lesions. Sixty of the 419 (14.3%) patients with coexisting spine lesions warranted additional intervention or surgical treatment. Four hundred and eighty-one of 1,689 (28.5%) patients with lumbar degenerative disease had coexisting spine lesions in the cervicothoracic spine. Forty-eight of the 481 (10.0%) patients with coexisting spine lesions warranted additional intervention. In both patient groups, older patients showed a significantly higher prevalence of coexisting spine lesions than younger patients.

Conclusion: Considering the minimal extra time and cost in performing whole spine screening, its application to routine spine MRI can be considered in evaluating cervical and lumbar spinal degenerative diseases.
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http://dx.doi.org/10.3346/jkms.2021.36.e48DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7900531PMC
February 2021

Patterns of injury mechanism observed in terrible triad.

J Shoulder Elbow Surg 2021 Sep 3;30(9):e583-e593. Epub 2021 Feb 3.

Department of Orthopaedic Surgery, Upper Extremity and Microsurgery Center, Pohang Semyeong Christianity Hospital, Pohang, Republic of Korea.

Introduction: The purpose of this study was to classify the injury mechanism of terrible triad (TT) and suggest a treatment method according to the mechanism.

Materials And Methods: Forty TTs with magnetic resonance imaging (MRI) scans and 3-dimensional computed tomography (3D CT) were enrolled. 3D CT scans of coronoid fractures were used for classifying into O'Driscoll type representing injury mechanisms and measuring sizes. In MRI scans, lateral collateral ligament complex (LCLC) injuries were classified into distraction (D) type caused by varus force and stripping (S) type caused by forearm external rotation force. Using these findings, possible injury mechanisms were speculated and classified into groups. Characteristic soft tissue injury patterns of collateral ligaments and overlying muscles, direction of dislocation in simple radiographs, and the amount of involvement of radial head fracture were investigated. Ulnar- and radial-side instabilities of soft tissues were newly defined and investigated.

Results: There were 29 (73%) cases by posterolateral external rotation (PLER), 5 (13%) cases by posteromedial external rotation (PMER), and 6 (14%) cases by posteromedial internal rotation (PMIR). Simple radiographs showed all posterolateral dislocations in PLER TT compared to posteromedial or pure posterior dislocations in PMER or PMIR TT. Regarding LCLC and overlying extensor muscle, they were all completely torn with D type in all PLER compared to D type in PMER or PMIR. The ulnar collateral ligament was spared in 5 (17%) cases among 29 PLER in contrast to complete rupture in all PMER and PMIR. In PLER, PMER, and PMIR, involvement ratios of radial head fracture were 82% (range, 27%-100%), 61% (range, 25%-100%), and 61% (range, 25%-100%), respectively, and sizes of coronoid fractures were 7 mm (range, 1-14 mm), 6 mm (range, 2-11 mm), and 10 mm (range, 2-16 mm), respectively. In PLER, PMER, and PMIR, percentages of ulnar-side instabilities were 17%, 20%, and 17%, respectively, and those of radial-side instabilities were 59%, 60%, and 83%, respectively.

Conclusions: TT is caused by at least 3 mechanisms (PLER, PMER, and PMIR) with characteristic soft tissue injuries and fracture patterns. PLER is the main mechanism of injury. It is always observed in the form of posterolateral dislocation on simple radiographs compared with pure posterior or posteromedial dislocation of PMER or PMIR. It should be managed individually based on injury mechanisms presenting different instability patterns.
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http://dx.doi.org/10.1016/j.jse.2020.12.015DOI Listing
September 2021

Association between human papillomavirus vaccination and serious adverse events in South Korean adolescent girls: nationwide cohort study.

BMJ 2021 01 29;372:m4931. Epub 2021 Jan 29.

School of Pharmacy, Sungkyunkwan University, 2066, Seobu-ro, Jangan-gu, Suwon, Gyeonggi-do, South Korea

Objective: To evaluate the association between human papillomavirus (HPV) vaccination and serious adverse events in adolescent girls in South Korea.

Design: Cohort study.

Setting: A large linked database created by linking the Korea Immunization Registry Information System and the National Health Information Database, between January 2017 and December 2019.

Participants: 441 399 girls aged 11-14 years who had been vaccinated in 2017: 382 020 had been vaccinated against HPV and 59 379 had not been vaccinated against HPV.

Main Outcome Measures: Outcomes were 33 serious adverse events, including endocrine, gastrointestinal, cardiovascular, musculoskeletal, haematological, dermatological, and neurological diseases. A cohort design was used for the primary analysis and a self-controlled risk interval design for the secondary analysis; both analyses used a risk period of one year after HPV vaccination for each outcome. Incidence rate and adjusted rate ratios were estimated using Poisson regression in the primary analysis, comparing the HPV vaccinated group with the HPV unvaccinated group, and adjusted relative risks were estimated using conditional logistic regression in the secondary analysis.

Results: Among the 33 predefined serious adverse events, no associations were found with HPV vaccination in the cohort analysis, including Hashimoto's thyroiditis (incidence rate per 100 000 person years: 52.7 36.3 for the vaccinated and unvaccinated groups; adjusted rate ratio 1.24, 95% confidence interval 0.78 to 1.94) and rheumatoid arthritis (incidence rate per 100 000 person years: 168.1 145.4 for the vaccinated and unvaccinated groups; 0.99, 0.79 to 1.25), with the exception of an increased risk observed for migraine (incidence rate per 100 000 person years: 1235.0 920.9 for the vaccinated and unvaccinated groups; 1.11, 1.02 to 1.22). Secondary analysis using self-controlled risk intervals confirmed no associations between HPV vaccination and serious adverse events, including migraine (adjusted relative risk 0.67, 95% confidence interval 0.58 to 0.78). Results were robust to varying follow-up periods and for vaccine subtypes.

Conclusions: In this nationwide cohort study, with more than 500 000 doses of HPV vaccines, no evidence was found to support an association between HPV vaccination and serious adverse events using both cohort analysis and self-controlled risk interval analysis. Inconsistent findings for migraine should be interpreted with caution considering its pathophysiology and the population of interest.
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http://dx.doi.org/10.1136/bmj.m4931DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030229PMC
January 2021

Safety and Utility of Rush Immunotherapy with Aqueous Allergen Extracts for Treatment of Respiratory Allergies.

J Korean Med Sci 2021 Jan 18;36(3):e18. Epub 2021 Jan 18.

Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.

Background: Generally, allergen immunotherapy must be administered for three to five years. Meanwhile, rush immunotherapy (RIT) shortens the required duration for the build-up phase, thereby improving the therapy's convenience compared with conventional immunotherapy (CIT). However, RIT is often performed with modified allergens. Therefore, this study aimed to investigate the safety and utility of RIT with aqueous allergens.

Methods: Medical records of 98 patients sensitized with at least one inhalant allergen who had received subcutaneous immunotherapy for allergic rhinitis with or without asthma were retrospectively reviewed. All patients were classified into three groups: depot-RIT (n = 25), receiving RIT with depot allergen; aqueous-RIT (n = 48), receiving RIT with aqueous allergen; and aqueous-CIT (n = 25), receiving CIT with aqueous allergen. Patients who had received immunotherapy targeting only house dust mites were excluded.

Results: The proportions of patients presenting with a systemic reaction to depot-RIT, aqueous-RIT, or aqueous-CIT were 80.0%, 85.4%, and 48.0%, respectively ( = 0.002). The proportions of patients experiencing severe systemic reaction were 4.0%, 16.7%, and 8.0% in depot-RIT, aqueous-RIT and aqueous-CIT, respectively ( = 0.223). The proportions of depot-RIT and aqueous-RIT patients presenting with systemic reaction or severe systemic reaction did not differ significantly ( = 0.553 and = 0.118, respectively). Significantly fewer depot-RIT (1.0 ± 0.2) and aqueous-RIT patients (2.0 ± 1.3) required outpatient clinical visits during the build-up phase, compared to those administered aqueous-CIT (13.6 ± 1.9; < 0.001). Moreover, the build-up phase decreased to 17.4 ± 1.8 days in depot-RIT and 23.7 ± 10.9 days in aqueous-RIT, compared to 92.0 ± 12.5 days in aqueous-CIT ( < 0.001).

Conclusion: RIT with aqueous allergen reduced the build-up phase duration and frequency of hospital visits, with acceptable safety levels. RIT with aqueous allergen may, therefore, be suitable for broad application to patients with respiratory allergies.
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http://dx.doi.org/10.3346/jkms.2021.36.e18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7813580PMC
January 2021

Risk of Pneumonia Associated with Inhaled Corticosteroid in Patients with Chronic Obstructive Pulmonary Disease: A Korean Population-Based Study.

Int J Chron Obstruct Pulmon Dis 2020 29;15:3397-3406. Epub 2020 Dec 29.

Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.

Introduction: Inhaled corticosteroids (ICSs) are recommended for patients with frequent exacerbation of chronic obstructive pulmonary disease (COPD). However, accumulating evidence has indicated the risk of pneumonia from the use of ICS. This study aimed to investigate the association between ICS and pneumonia in the real-world clinical setting.

Methods: A retrospective cohort study was performed using nationwide population data from the Korea National Health Insurance Service. Subjects who had a new diagnosis of COPD and who received inhaled bronchodilators without a diagnosis of pneumonia before the initiation of bronchodilators were identified. Subjects were followed up until their first diagnosis of pneumonia. The risk of pneumonia in ICS users was compared to that in non-ICS users.

Results: A total of 87,594 subjects were identified and 1:1 matched to 22,161 ICS users and non-ICS users. More ICS users were diagnosed with pneumonia compared to non-ICS users (33.73% versus 24.51%, <0.0001). The incidence rate per 100,000 person-years was 8904.98 for ICS users and 6206.79 for non-ICS users. The hazard ratio (HR) of pneumonia for ICS users was 1.62 (95% CI 1.54-1.70). The HR of subjects prescribed with the lowest ICS cumulative dose was 1.35 (1.27-1.43). The HR increased to 1.51 (1.42-1.60), 1.96 (1.85-2.09), and 2.03 (1.89-2.18) as the cumulative dose increased. Pneumonia was strongly associated with fluticasone propionate (1.79 (1.70-1.89)) and fluticasone furoate (1.80 (1.61-2.01)) use, compared to the use of other types of ICS.

Conclusion: ICS increases the risk of pneumonia in patients with COPD. Hence, ICS should be carefully prescribed in patients with risk factors for pneumonia while considering the cumulative doses and subtypes of ICS.
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http://dx.doi.org/10.2147/COPD.S286149DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7778438PMC
June 2021

Analysis of personal and national factors that influence depression in individuals during the COVID-19 pandemic: a web-based cross-sectional survey.

Global Health 2021 01 5;17(1). Epub 2021 Jan 5.

Yonsei Global Health Center, Yonsei University, Wonju, Republic of Korea.

Background: The World Health Organization (WHO) declared coronavirus disease (COVID-19) a pandemic on March 11, 2020. Previous studies of infectious diseases showed that infectious diseases not only cause physical damage to infected individuals but also damage to the mental health of the public. Therefore this study aims to analyze the factors that affected depression in the public during the COVID-19 pandemic to provide evidence for COVID-19-related mental health policies and to emphasize the need to prepare for mental health issues related to potential infectious disease outbreaks in the future.

Results: This study performed the following statistical analyses to analyze the factors that influence depression in the public during the COVID-19 pandemic. First, to confirm the level of depression in the public in each country, the participants' depression was plotted on a Boxplot graph for analysis. Second, to confirm personal and national factors that influence depression in individuals, a multi-level analysis was conducted. As a result, the median Patient Health Questionnaire-9 (PHQ-9) score for all participants was 6. The median was higher than the overall median for the Philippines, Indonesia, and Paraguay, suggesting a higher level of depression. In personal variables, depression was higher in females than in males, and higher in participants who had experienced discrimination due to COVID-19 than those who had not. In contrast, depression was lower in older participants, those with good subjective health, and those who practiced personal hygiene for prevention. In national variables, depression was higher when the Government Response Stringency Index score was higher, when life expectancy was higher, and when social capital was higher. In contrast, depression was lower when literacy rates were higher.

Conclusions: Our study reveals that depression was higher in participants living in countries with higher stringency index scores than in participants living in other countries. Maintaining a high level of vigilance for safety cannot be criticized. However, in the current situation, where coexisting with COVID-19 has become inevitable, inflexible and stringent policies not only increase depression in the public, but may also decrease resilience to COVID-19 and compromise preparations for coexistence with COVID-19. Accordingly, when establishing policies such as social distancing and quarantine, each country should consider the context of their own country.
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http://dx.doi.org/10.1186/s12992-020-00650-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7783293PMC
January 2021

Identification, quantification, and prioritization of new emerging pollutants in domestic and industrial effluents, Korea: Application of LC-HRMS based suspect and non-target screening.

J Hazard Mater 2021 01 22;402:123706. Epub 2020 Aug 22.

Graduate School of FEED of Eco-Friendly Offshore Structure, Changwon National University, Changwon, Gyeongsangnamdo, 51140, Republic of Korea; School of Civil, Environmental and Chemical Engineering, Changwon National University, Changwon, Gyeongsangnamdo, 51140, Republic of Korea. Electronic address:

The present study was designed to identify recently (or rarely) recognized or unreported substances (RRS or URS) contained in the effluents from water treatment plants in two industrialized urban areas, Gumi and Daegu, in Korea. In addition to 30 initial targets, 72 substances were identified through suspect and non-target screening (SNTS). Among them were 4 RRSs and 22 URSs, respectively. The quantitative analyses were applied to 35 pharmaceuticals, 15 pesticides, 13 poly-/perfluorinated alkyl substances (PFASs), 2 organophosphate flame retardants (OPFRs), 2 corrosion inhibitors, and 3 metabolites. The highest average concentration was observed for benzotriazole, followed by those for niflumic acid, and metformin. Effluents from Gumi mainly contained benzotriazole and metformin whereas niflumic acid and tramadol were the major components in effluents from Daegu. According to a scoring system based on risk relevant parameters, higher priorities were given to telmisartan, PFOA, and cimetidine. Yet, priorities for some substances were area specific (e.g., benzotriazole from Gumi, PFASs from Daegu), reflecting differences in industry profiles and populations. Many of the RRSs and URSs were recognized as potential hazards. The new identifications and evaluations should be taken into consideration for constant monitoring and management, as do the previously recognized contaminants.
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http://dx.doi.org/10.1016/j.jhazmat.2020.123706DOI Listing
January 2021

Differences in Rupture Patterns and Associated Lesions Related to Traumatic Distal Triceps Tendon Rupture Between Outstretched Hand and Direct Injuries.

Clin Orthop Relat Res 2021 Apr;479(4):781-789

J. H. Lee, K. B. Ahn, K. C. Kim, I. H. Rhyou, Department of Orthopedic Surgery, Upper Extremity and Microsurgery Center, SM Christianity Hospital, Pohang, South Korea.

Background: Traumatic distal triceps tendon rupture results in substantial disability in the absence of an appropriate diagnosis and treatment. To the best of our knowledge, differences in the degree of injury according to the injury mechanisms and associated lesions are not well known.

Questions/purposes: In this study, we asked: (1) What differences are seen in triceps tear patterns between indirect injuries (fall on an outstretched hand) and direct injuries? (2) What are the associated elbow and soft tissue injuries seen in indirect and direct triceps ruptures?

Methods: Between 2006 and 2017, one center treated 73 elbows of 72 patients for distal triceps tendon rupture. Of those, 70% (51 of 73 elbows) was excluded from this study; 8% (6 of 73) were related to systemic diseases, 59% (43 of 73) sustained open injuries, and 3% (2 of 73) were related to local steroid injections. We retrospectively collected data on traumatic distal triceps tendon rupture in 30% (22 of 73) of elbows at a single trauma center during a 10-year period. A fall on an outstretched hand was the cause of injury in 15 patients and direct blow by object or contusion were the cause in seven. MRI and surgery were performed in all patients. Traumatic distal triceps tendon rupture was classified by the Giannicola method, which is classified according to the depth and degree of the lesion based on MRI and surgical findings. Associated fractures and bone contusions on MRI were characterized. Ligament injuries on MRI was divided into partial and complete rupture. Agreement between the MRI and intraoperative findings for the presence of a traumatic distal triceps tendon rupture was perfect, and the Giannicola classification of traumatic distal triceps tendon rupture was good (kappa = 0.713).

Results: In the indirect injury group (fall on an outstretched hand), 15 of 15 patients had injuries that involved only the tendinous portion of the distal triceps, but these injuries were not full-thickness tears, whereas in the direct injury group, three of seven patients had a full-thickness rupture (odds ratio [OR] 1.75 [95% CI 0.92 to 3.32]; p = 0.02). The direct injury group had no associated ligamentous injuries while 14 of 15 patients with indirect injuries had ligamentous injuries (OR 0.13 [95% CI 0.02 to 0.78]; p < 0.001; associated injuries in the indirect group: anterior medial collateral ligament [14 of 15], posterior medial collateral ligament [7 of 15], and lateral collateral ligament complex [2 of 15]). Similarly, one of seven patients in the direct injury group had a bone injury (capitellar contusion), whereas 15 of 15 patients with indirect ruptures had associated fractures or bone contusions (OR 16.0 [95% CI 2.4 to 106.7]; p < 0.001).

Conclusion: A fall on an outstretched hand may result in an injury mostly to the lateral and long head of distal triceps tendon and an intact medial head tendon; however, direct injuries can involve full-thickness ruptures. Although a traumatic distal triceps tendon rupture occurs after a fall on an outstretched hand, radial neck, capitellar, and medial collateral ligament injury can occur because of valgus load and remnant extensor mechanisms. Based on our finding, the clinician encountering a distal triceps tendon rupture due to a fall on an outstretched hand should be aware of the possibility of remaining elbow extensor mechanism by intact medial head tendon portion, and associated injuries, which may induce latent complications.

Level Of Evidence: Level III, prognostic study.
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http://dx.doi.org/10.1097/CORR.0000000000001550DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8083823PMC
April 2021

COVID-19 screening center models in South Korea.

J Public Health Policy 2021 Mar 21;42(1):15-26. Epub 2020 Oct 21.

Yonsei Global Health Center, Yonsei University, Wonju, Republic of Korea.

In a recent report, the British Broadcasting Company (BBC) introduced South Korea's measures to manage COVID-19 as role model for the world. Screening centers serve as frontiers for preventing community transmission of infectious diseases. COVID-19 screening centers in Korea operate 24 h a day, always open for individuals with suspected COVID-19 symptoms. South Korea concentrated COVID-19 screening centers around cities with high population density. Advanced screening centers (models C, D, and E) proved more effective and efficient in the prevention of COVID-19 than the traditional screening centers (models A and B). Particularly, screening centers at Incheon Airport in South Korea prevent transmission through imported cases effectively. It will be important elsewhere, as in South Korea, to establish an infectious disease delivery system that can lead to 'Test-Treat-Track' using an adequate model of screening centers.
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http://dx.doi.org/10.1057/s41271-020-00258-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576111PMC
March 2021

Rapid harvesting of stem cell sheets by thermoresponsive bulk poly(-isopropylacrylamide) (PNIPAAm) nanotopography.

Biomater Sci 2020 Sep;8(19):5260-5270

Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Pohang, 37673, Korea.

To date, cell sheet engineering-based technologies have actualized diverse scaffold-free bio-products to revitalize unintentionally damaged tissues/organs, including cardiomyopathy, corneal defects, and periodontal damage. Although substantial interest is now centered on the practical utilization of these bio-products for patients, the long harvest period of stem cells- or other primary cell-sheets has become a huge hurdle. Here, we dramatically reduce the total harvest period of a cell sheet (from cell layer formation to cell sheet detachment) composed of human bone marrow mesenchymal stem cells (hBMSCs) down to 2 d with the help of bulk thermoresponsive poly(N-isopropylacrylamide) (PNIPAAm) substrate nanotopography, which is not achievable via the previous grafting methods using PNIPAAm. We directly replicated an isotropic 400 nm-nanopore-array pattern on a bulk PNIPAAm substrate through UV polymerization of highly concentrated NIPAAm monomers, which was achieved using a remarkably increased Young's modulus of bulk PNIPAAm that was 1500 times higher than conventional PNIPAAm. The rapid harvesting of the hBMSC sheet on the bulk PNIPAAm substrate nanotopography was not only based on the accelerated formation and maturation of the hBMSC layer, but also the easy detachment of the hBMSC sheet induced by the abrupt change in the surface roughness of the substrate below the lower critical solution temperature (LCST) owing to the enlarged surface area of the substrate. Our findings may contribute to reverse presumptions about the limitations regarding the grafting methods for the cell sheet harvest and could broaden the practical utilization of cell sheets for patients in the near future.
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http://dx.doi.org/10.1039/d0bm01338bDOI Listing
September 2020

Prediction of the anterior shoulder pain source by detecting indirect signs for partial articular subscapularis tendon tears through conventional magnetic resonance imaging.

Knee Surg Sports Traumatol Arthrosc 2021 Jul 8;29(7):2297-2304. Epub 2020 Sep 8.

Department of Orthopedic Surgery, Pohang Semyeong Christianity Hospital, 351, Poscodaero, NamKu, Pohang, Gyungbuk, South Korea.

Purpose: To evaluate the diagnostic efficacy of indirect signs for proximal articular-positioned, partial (< 50%), subscapularis tendon tears (facet 1 tears) via conventional magnetic resonance imaging (MRI).

Methods: A retrospective study was conducted on 67 patients of Yoo's type 1 or 2A tears. Forty-five arthroscopic subacromial decompression and acromioclavicular resection cases served as controls. Indirect signs indicating a facet 1 tear included small defects, superior subscapularis recess (SSR), long head of the biceps (LHBT) configurations, bone edema or cyst formation on lesser tuberosity (LTBEC), and fatty infiltration of subscapularis muscle. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were checked.

Results: SSR was the most sensitive sign (90%). The sensitivities and NPV of LHBT configurations and LTBEC were low (sensitivity: 42.9% and 17.9%, NPV: 56.4% and 44.4%, respectively). The specificities of all indirect signs were relatively high (> 90%). The Chi-squared test and multinomial logistic regression confirmed the significance of small defects, SSRs, and fatty infiltrations for facet 1 tears (p ≤ 0.014). The combined sensitivity and specificity were up to 97.7% and 92.3%, respectively, in the presence of either a small defect or an SSR.

Conclusions: Conventional MRI alone can detect facet 1 tears through indirect signs (small defects, SSR, and fatty infiltrations of the subscapularis muscle), predicting unspecified anterior shoulder pain due to concealed biceps instability, and facilitating preoperative diagnosis for a facet 1 tear.

Level Of Evidence: III.
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http://dx.doi.org/10.1007/s00167-020-06259-zDOI Listing
July 2021

A variety of bacterial aetiologies in the lower respiratory tract at patients with endobronchial tuberculosis.

PLoS One 2020 25;15(6):e0234558. Epub 2020 Jun 25.

Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.

Recently, our understanding of the elusive bacterial communities in the lower respiratory tract and their role in chronic lung disease has increased significantly. However, little is known about the respiratory microorganisms in patients with endobronchial tuberculosis (EBTB), which is a chronic inflammatory disease characterized by destruction of the tracheobronchial tree due to Mycobacterium tuberculosis (MTB) infection. We retrospectively reviewed data for histopathologically and microbiologically confirmed EBTB patients diagnosed at a tertiary referral hospital in South Korea between January 2013 and January 2019. Bacterial cultures were performed on bronchial washing from these patients at the time of EBTB diagnosis. A total of 216 patients with EBTB were included in the study. The median age was 73 years and 142 (65.7%) patients were female. Bacteria were detected in 42 (19.4%) patients. Additionally, bacterial co-infection was present in 6 (2.8%) patients. Apart from MTB, the most common microorganisms identified were Staphylococcus aureus (n = 14, 33.3%) followed by Klebsiella species (n = 12, 28.6%; 10 Klebsiella pneumoniae, 2 Klebsiella oxytoca), Streptococcus species (n = 5, 11.9%), Enterobacter species (n = 4, 9.5%), and Pseudomonas aeruginosa (n = 3, 7.1%). A variety of microorganisms were isolated from the bronchial washing indicating that changes in microorganism composition occur in the airways of patients with EBTB. Further studies are needed to investigate the clinical significance of this finding.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0234558PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7316277PMC
August 2020

The relationship between trends in COVID-19 prevalence and traffic levels in South Korea.

Int J Infect Dis 2020 Jul 14;96:399-407. Epub 2020 May 14.

Department of Health Administration, College of Health Science, Yonsei University, Wonju, Gangwon-do, Republic of Korea. Electronic address:

Objective: The World Health Organization (WHO) declared a COVID-19 pandemic on March 12, 2020. Several studies have indicated that densely populated urban environments and the heavy dependence on traffic could increase the potential spread of COVID-19. This study investigated the association between changes in traffic volume and the spread of COVID-19 in South Korea.

Methods: This study analyzed the daily national traffic and traffic trend for 3 months from January 1, 2020. Traffic data were measured using 6307 vehicle detection system (VDS). This study analyzed the difference in traffic levels between 2019 and 2020. Non-linear regression was performed to analyze the change in traffic trend in 2020. The relationship between traffic and confirmed COVID-19 cases was analyzed using single linear regression.

Results: The mean daily nationwide level of traffic for the first 3 months of 2020 was 143 655 563 vehicles, which was 9.7% lower than the same period in 2019 (159 044 566 vehicles). All regions showed a decreasing trend in traffic in February, which shifted to an increasing trend from March. In Incheon there was a positive, but insignificant, linear relationship between increasing numbers of newly confirmed cases and increasing traffic (β = 43 146; p = 0.056).

Conclusions: Numbers of newly confirmed COVID-19 patients have been decreasing since March, while the traffic has been increasing. The fact that traffic is increasing indicates greater contact between people, which in turn increases the risk of further COVID-19 spread. Therefore, the government will need to devise suitable policies, such as total social distancing.
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http://dx.doi.org/10.1016/j.ijid.2020.05.031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7224658PMC
July 2020

Polysomnographic phenotype as a risk factor for cardiovascular diseases in patients with obstructive sleep apnea syndrome: a retrospective cohort study.

J Thorac Dis 2020 Mar;12(3):907-915

Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea.

Background: Obstructive sleep apnea syndrome (OSAS) is associated with the development of cardiovascular diseases caused by hypoxemia during sleeping. We classified OSAS phenotypes based on polysomnographic findings and aimed to evaluate that the unique phenotypes would be differentially associated with risk of cardiovascular disease.

Methods: This retrospective and observational study assessed adult patients who underwent polysomnography at the Wonju Severance Christian Hospital from November 2008 to February 2018. The OSAS phenotypes were classified as apnea-predominant, hypopnea-predominant, and respiratory effort-related arousal (RERA)-predominant based on the polysomnography results. The polysomnographic data were collected and analysed, and clinical features such as medical history and comorbidities were assessed by a review of the electronic medical records.

Results: A total of 860 adult patients were classified as apnea-predominant (n=220), hypopnea-predominant (n=119), or RERA-predominant (n=275). The hypopnea-predominant group had significantly higher rates of hyperlipidaemia (P<0.001), heart failure (15.5%, P<0.001), and coronary artery disease (20.9%, P=0.005) than the other groups. After classifying the patients according to severity of the hypopnea index, logistic regression analyses adjusted for age, sex, and smoking history revealed that the hypopnea index increased the risk for coronary artery disease and heart failure.

Conclusions: The hypopnea-predominant group would be a specific phenotype that has a differential association with the risks for coronary artery disease and heart failure.
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http://dx.doi.org/10.21037/jtd.2019.12.66DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7138968PMC
March 2020
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