Publications by authors named "Se Jin Oh"

89 Publications

A Case Report of Multiple Capillary Hemangioma in a Chronic Myeloid Leukemia Patient Taking Tyrosine Kinase Inhibitors.

Ann Dermatol 2021 Jun 4;33(3):278-280. Epub 2021 May 4.

Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

A capillary hemangioma is a vascular tumor with small capillary sized vascular channel. Multiple capillary hemangioma in relation with drugs have been rarely reported. Here in, we report a case of multiple capillary hemangioma in patient diagnosed with chronic myeloid leukemia who received tyrosine kinase inhibitors (TKIs). Histopathological findings have shown capillary proliferation in the upper dermis, which is consistent with capillary hemangioma. Since TKIs can paradoxically activate the MEK/ERK pathway which is required for angiogenesis, we presumed that the lesions as the cutaneous side effects of TKIs.
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http://dx.doi.org/10.5021/ad.2021.33.3.278DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8137332PMC
June 2021

Effects of Particulate Matter on Healthy Skin: A Comparative Study between High- and Low-Particulate Matter Periods.

Ann Dermatol 2021 Jun 4;33(3):263-270. Epub 2021 May 4.

Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Background: The influence of airborne particulate matter (PM) on skin has primarily been studied in patients with skin diseases such as atopic dermatitis. Recently, the effect of PM on healthy human skin has gained attention.

Objective: To evaluate the relationship between PM concentration and objective skin changes in healthy subjects.

Methods: This prospective study enrolled 25 healthy volunteers without any skin disease. Data regarding daily meteorological parameters and air pollution were collected during a high-PM period and a low-PM period for 14 days. Environmental and lifestyle factors that might influence skin conditions of subjects were also collected during the study period. Biophysical parameters of the skin such as transepidermal water loss (TEWL), hydration, erythema index, and melanin index were measured. Pores, wrinkles, sebum, and skin tone were evaluated using a facial analysis system.

Results: Mean TEWL value during the high-PM period was significantly higher than that during the low-PM period (10.16 g/m/h vs. 5.99 g/m/h; =0.0005). Mean erythema index was significantly higher in the high-PM period than that in the low-PM period (4.3 vs. 3.42; =0.038). For facial analysis system indices, uniformity of skin tone was higher in the low-PM period than that in the high-PM period (<0.0001). In addition, with increasing PM and PM, TEWL also showed increase when other environmental components were constant (regression coefficient [RC]=0.1529, <0.0001 for PM; RC=0.2055, =0.0153 for PM).

Conclusion: Increased PM concentrations may contribute to disturbed barrier function, increased facial erythema, and uneven skin tone even in healthy human skin.
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http://dx.doi.org/10.5021/ad.2021.33.3.263DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8137329PMC
June 2021

Hydroa Vacciniforme-Like Lymphoproliferative Disorder in Korea: Prognostic Implication of Clinical Signs and Whole Blood Epstein-Barr Virus DNA.

Ann Dermatol 2021 Jun 4;33(3):222-227. Epub 2021 May 4.

Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Background: Hydroa vacciniforme-like lymphoproliferative disorder (HVLPD) is rare Epstein-Barr virus (EBV)-associated disease. The classic form of HVLPD is a self-resolving disease, whereas the systemic form can progress to malignant lymphoma, resulting in fatal outcomes. However, the prognostic factors remain unclear.

Objective: This study aimed to evaluate the clinical characteristics of HVLPD and the association between whole blood EBV DNA and clinical outcomes.

Methods: We retrospectively reviewed our 25-year experience involving 11 patients with HVLPD from a single tertiary center in South Korea and evaluated the clinical characteristics of HVLPD and the correlation between whole blood EBV DNA and clinical outcomes.

Results: Of the total 11 patients, 54.5% (6/11) manifested classic HVLPD that resolved with conservative treatment, while 45.5% (5/11) patients had systemic HVLPD, four of whom died of progressive disease or hemophagocytic syndrome. Five patients with systemic HVLPD manifested severe skin lesions such as prominent facial edema, deep ulcers and necrotic skin lesions involving sun-protected areas. Median EBV DNA levels at initial diagnosis were higher in three dead patients than in those alive (2,290 vs. 186.62 copies/µl).

Conclusion: When EBV DNA levels were high, patients showed severe skin lesions and when EBV DNA levels were low, skin lesions tended to improve. Thus, patients with high EBV DNA levels showed an increased risk of severe skin lesions and disease progression.
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http://dx.doi.org/10.5021/ad.2021.33.3.222DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8137328PMC
June 2021

Two Cases of Multiple Epidermolytic Acanthomas Mimicking Verruca Vulgaris.

Ann Dermatol 2020 Dec 11;32(6):512-515. Epub 2020 Nov 11.

Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Epidermolytic acanthoma (EA) is a rare benign tumor, which usually appears as a solitary small papule. However, there are a few case reports of multiple EA, most of which occurs on the genital area. Cases of multiple EA may mimic verruca vulgaris, condyloma accuminatum, seborrheic keratosis, and bowenoid papulosis, and therefore, can be easily misdiagnosed. A 78-year-old male presented with a 2-week history of discrete, small skin-colored papules around the anus. The other case involved a 47-year-old male with a 5-year history of skin-colored papules on the scrotum. Skin biopsy of both cases revealed a well-demarcated papular lesion characterized by compact hyperkeratosis, perinuclear vacuolization, and reticular degeneration in the granular and upper spinous layer with coarse basophilic keratohyalin granules. Epidermal invagination was consistent with a cup-shaped type of EA. Both cases tested negative for human papillomavirus. We report typical cases of multiple EA, which should be considered as the differential diagnosis of small skin-colored papules in the anogenital area, to prevent the misdiagnosis.
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http://dx.doi.org/10.5021/ad.2020.32.6.512DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7875239PMC
December 2020

A Retrospective Clinicopathologic Study of Korean Patients with Cutaneous Peripheral T-Cell Lymphoma Not Otherwise Specified at a Single Tertiary Center.

Ann Dermatol 2020 Aug 30;32(4):337-342. Epub 2020 Jun 30.

Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

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http://dx.doi.org/10.5021/ad.2020.32.4.337DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7992657PMC
August 2020

A Case of Cutaneous Leukocytoclastic Vasculitis Associated with Granulocyte Colony-Stimulating Factor: An Unusual Presentation.

Ann Dermatol 2020 Apr 11;32(2):164-167. Epub 2020 Mar 11.

Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Drug-induced vasculitis is an inflammation of small-sized blood vessel caused by the use of drugs. It accounts for approximately 10% of acute cutaneous vasculitis. Propylthiouracil, hydralazine, and allopurinol have been widely known as causative agents. The most common clinical feature of drug-induced vasculitis is palpable purpura on lower extremities. A 66-year-old Korean female presented with erythematous nodules on upper chest and back. She had been on medication for multiple myeloma. Laboratory results showed neutropenia. After a single injection of filgrastim (recombinant granulocyte colony-stimulating factor), she developed cutaneous lesions with concurrent increase in absolute neutrophil count. A skin biopsy revealed leukocytoclastic vasculitis. After discontinuation of filgrastim injection, her skin lesions disappeared spontaneously.
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http://dx.doi.org/10.5021/ad.2020.32.2.164DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7992539PMC
April 2020

Anti-pollution skincare: Research on effective ways to protect skin from particulate matter.

Dermatol Ther 2021 Jul 28;34(4):e14960. Epub 2021 Apr 28.

Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

While there is increasing interest in anti-pollution care to particulate matter (PM), there has been no research evaluating the efficacy of skin care products in a real-world setting. Our objective was to find effective ways to protect skin from PM. In total, 64 volunteers whose skin was classified as reactive to PM concentration in the previous study were enrolled. Through split-face study, different combinations of skin care products (barrier cream, barrier cream/micellar water, antioxidant, and antioxidant/micellar water) were applied for 4 weeks during the high-PM period. The biophysical properties were measured, and a facial analysis system was used to evaluate skin condition at days 0, 14, and 28. The concentrations of PM and daily events that may affect skin conditions were also recorded. The mean concentration levels of PM and PM from days 0 to 14 were higher in the barrier cream group than in the antioxidant group. For each group, aside from skin tone in the antioxidant/micellar water group, there were no statistically significant differences in skin measurements before and after the application, which reflects no aggravation in skin condition during high-PM periods. Intergroup analysis showed no differences in skin measurements among the four groups from day 0 to day 14, from day 14 to day 28, and from day 0 to 28. For anti-pollution care, maintaining skin barrier function using barrier cream seems to be sufficient in individuals sensitive to PM.
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http://dx.doi.org/10.1111/dth.14960DOI Listing
July 2021

Clinical profile of cutaneous adverse events of immune checkpoint inhibitors in a single tertiary center.

J Dermatol 2021 Jul 20;48(7):979-988. Epub 2021 Apr 20.

Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Programmed death 1 (PD-1)/programmed death ligand 1 (PD-L1) inhibitors have demonstrated their efficacy in the treatment of various malignancies. Despite their benefits, their immunomodulatory activities can cause unpredictable cutaneous adverse events (CAE). This study aimed to identify characteristics of CAE in patients treated with PD-1/PD-L1 inhibitors through the medical records, photographs, and pathology reports. Fifty CAE occurred in 47 (2.75%) of 1711 patients treated with PD-1/PD-L1 inhibitors. Pruritic, psoriasiform, urticarial, and acneiform eruptions were the four most common types. Melanoma patients showed CAE more frequently than other malignancies. Acneiform eruption occurred more often at ages under 60 years. Urticarial eruption appeared earlier, while keratoacanthoma appeared later after immunotherapy. The overall survival times were not significantly different between the two groups with and without CAE by Kaplan-Meier analysis (p = 0.055). Studies on CAE may provide more information to understand these drugs and to help manage the patients.
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http://dx.doi.org/10.1111/1346-8138.15824DOI Listing
July 2021

Role of Ischemic Preconditioning in the Cardioprotective Mechanisms of Monomeric C-Reactive Protein-Deposited Myocardium in a Rat Model.

J Chest Surg 2021 Feb;54(1):9-16

Department of Thoracic and Cardiovascular Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.

Background: The deposition of monomeric C-reactive protein (mCRP) in the myocardium aggravates ischemia-reperfusion injury (IRI) and myocardial infarction. Ischemic preconditioning (IPC) is known to protect the myocardium against IRI.

Methods: We evaluated the effects of IPC on myocardium upon which mCRP had been deposited due to IRI in a rat model. Myocardial IRI was induced via ligation of the coronary artery. Direct IPC was applied prior to IRI using multiple short direct occlusions of the coronary artery. CRP was infused intravenously after IRI. The study included sham (n=3), IRI-only (n=5), IRI+CRP (n=9), and IPC+IRI+CRP (n=6) groups. The infarcted area and the area at risk were assessed using Evans blue and 2,3,5-triphenyltetrazolium staining. Additionally, mCRP immunostaining and interleukin-6 (IL-6) mRNA reverse transcription-polymerase chain reaction were performed.

Results: In the IRI+CRP group, the infarcted area and the area of mCRP deposition were greater, and the level of IL-6 mRNA expression was higher, than in the IRI-only group. However, in the IPC+IRI+CRP group relative to the IRI+CRP group, the relative areas of infarction (20% vs. 34%, respectively; p=0.079) and mCRP myocardial deposition (21% vs. 44%, respectively; p=0.026) were lower and IL-6 mRNA expression was higher (fold change: 407 vs. 326, respectively; p=0.376), although the difference in IL-6 mRNA expression was not statistically significant.

Conclusion: IPC was associated with significantly decreased deposition of mCRP and with increased expression of IL-6 in myocardium damaged by IRI. The net cardioprotective effect of decreased mCRP deposition and increased IL-6 levels should be clarified in a further study.
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http://dx.doi.org/10.5090/kjtcs.20.096DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7946522PMC
February 2021

Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019: Expert Recommendations from The Korean Society for Thoracic and Cardiovascular Surgery.

J Chest Surg 2021 Feb;54(1):2-8

Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.

Since the first reported case of coronavirus disease 2019 (COVID-19) in December 2019, the numbers of confirmed cases and deaths have continued to increase exponentially despite multi-factorial efforts. Although various attempts have been made to improve the level of evidence for extracorporeal membrane oxygenation (ECMO) treatment over the past 10 years, most experts still hesitate to take an active position on whether to apply ECMO in COVID-19 patients. Several ECMO management guidelines have been published recently, but they reflect some important differences from the Korean medical system and aspects of real-world medical practice in Korea. We aimed to find evidence on the efficacy of ECMO for COVID-19 patients by reviewing the published literature and to propose expert recommendations by analyzing the Korean COVID-19 ECMO registry data.
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http://dx.doi.org/10.5090/kjtcs.21.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7946520PMC
February 2021

Duration of Oral Antibiotics Administration for Cetuximab-Induced Acneiform Eruption.

Dermatology 2021 10;237(3):457-463. Epub 2020 Dec 10.

Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Background: Acneiform eruption is the most common cutaneous adverse event associated with cetuximab. As it can affect quality of life and adversely affect chemotherapy schedule, additional medical care is required.

Objectives: To investigate the adherence to and the duration of antibiotic administration to treat cetuximab-induced acneiform eruption.

Methods: Medical data of patients who were referred to the Department of Dermatology were reviewed from January 2013 to June 2018. Dermatologists assessed the severity of acneiform eruption and prescribed tetracycline-class antibiotics according to the severity every 2 or 4 weeks. We investigated the duration and amount of oral antibiotic administration and analyzed the factors that may affect the control of acneiform eruption statistically.

Results: A total of 207 of 267 patients referred to the Department of Dermatology showed acneiform eruption; 124 patients were treated with minocycline, 34 patients with doxycycline, 27 patients with both, and 22 patients with topical agents. The mean duration of oral antibiotic medication was 82.7 days. A statistical analysis of the factors that prolonged the use of antibiotics for more than 90 days showed that male and younger age were risk factors. Shorter time interval from starting cetuximab to starting antibiotics was associated with longer duration of antibiotic use, statistically.

Conclusions: Cetuximab-induced acneiform eruption can be well controlled with tetracycline-class antibiotics in about 3 months. It can last longer in male and younger patients. The sooner and the more severe it appears, the longer it can last.
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http://dx.doi.org/10.1159/000511623DOI Listing
December 2020

Effect of photobiomodulation therapy on radiodermatitis in a mouse model: an experimental animal study.

Lasers Med Sci 2021 Jun 2;36(4):843-853. Epub 2020 Sep 2.

Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.

This study aimed to evaluate the effect of photobiomodulation (PBM) for prevention of radiodermatitis in an irradiated mouse model and compare the efficacy of PBM using 633- or 830-nm wavelengths. Irradiated mice were randomly distributed into three groups: A (633 nm), B (830 nm), and C (without PBM). On post-irradiation days 7 and 21, we compared acute damage and recovery in treated skin samples to non-irradiated skin using H&E, Masson's trichrome, anti-CD45 and PCNA immunohistochemistry, and a TUNEL assay. Grade 3 radiodermatitis was evident only in group C. Compared with that in group C, the skin in groups A and B had significantly less epidermal hyperplasia, inflammatory cell infiltration, and thinner dermis on day 7 and less inflammatory cell infiltration, fewer apoptotic cells, and thinner dermis on day 21. However, there was no significant difference between groups A and B. This study indicates PBM could prevent severe radiodermatitis by reducing epidermal and dermal damage, inflammation, and apoptosis. There was no difference in PBM efficacy between the 633- and 830-nm wavelengths.
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http://dx.doi.org/10.1007/s10103-020-03123-xDOI Listing
June 2021

What Drives Task Performance During Animal Fluency in People With Alzheimer's Disease?

Front Psychol 2020 21;11:1485. Epub 2020 Jul 21.

Department of Communication Disorders, EWHA Womans University, Seoul, South Korea.

Background: Animal fluency is a widely used task to assess people with Alzheimer's disease (AD) and other neurological disorders. The mechanisms that drive performance in this task are argued to rely on language and executive functions. However, there is little information regarding what specific aspects of these cognitive processes drive performance on this task.

Objective: To understand which aspects of language (i.e., semantics, phonological output lexicon, phonological assembly) and executive function (i.e., mental set shifting; information updating and monitoring; inhibition of possible responses) are involved in the performance of animal fluency in people with AD.

Methods: Animal fluency data from 58 people with probable AD from the DementiaBank Pittsburgh Corpus were analyzed. Number of clusters and switches were measured and nine word properties (e.g., frequency, familiarity) for each of the correct words (i.e., each word counting toward the total score, disregarding non-animals and repetitions) were determined. Random forests were used to understand which variables predicted the total number of correct words, and conditional inference trees were used to search for interactions between the variables. Finally, Wilcoxon tests were implemented to cross-validate the results, by comparing the performance of participants with scores below the norm in animal fluency against participants with scores within the norm based on a large normative sample.

Results: Switches and age of acquisition emerged as the most important variables to predict total number of correct words in animal fluency in people with AD. Cross-validating the results, people with AD whose animal fluency scores fell below the norm produced fewer switches and words with lower age of acquisition than people with AD with scores in the normal range.

Conclusion: The results indicate that people with AD rely on executive functioning (information updating and monitoring) and language (phonological output lexicon, not necessarily semantics) to produce words on animal fluency.
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http://dx.doi.org/10.3389/fpsyg.2020.01485DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7388773PMC
July 2020

Veno-arterial extracorporeal membrane oxygenation may be useful in critically ill COVID-19 patients with suspected cardiac injury.

Acute Crit Care 2020 Aug 10;35(3):223-225. Epub 2020 Aug 10.

Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.

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http://dx.doi.org/10.4266/acc.2020.00262DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7483018PMC
August 2020

LC3B upregulation by NANOG promotes immune resistance and stem-like property through hyperactivation of EGFR signaling in immune-refractory tumor cells.

Autophagy 2020 Aug 14:1-20. Epub 2020 Aug 14.

Department of Biochemistry & Molecular Biology, Department of Biomedical Science, Korea University College of Medicine, Seoul, South Korea.

Immune selection drives tumor cells to acquire refractory phenotypes. We previously demonstrated that cytotoxic T lymphocyte (CTL)-mediated immune pressure enriches NANOG tumor cells with stem-like and immune-refractory properties that make them resistant to CTLs. Here, we report that the emergence of refractory phenotypes is highly associated with an aberrant macroautophagic/autophagic state of the NANOG tumor cells and that the autophagic phenotype arises through transcriptional induction of by NANOG. Furthermore, we found that upregulation of LC3B expression contributes to an increase in EGF secretion. The subsequent hyperactivation of EGFR-AKT signaling rendered NANOG tumor cells resistant to CTL killing. The NANOG-LC3B-p-EGFR axis was preserved across various types of human cancer and correlated negatively with the overall survival of cervical cancer patients. Inhibition of LC3B in immune-refractory tumor models rendered tumors susceptible to adoptive T-cell transfer, as well as PDCD1/PD-1 blockade, and led to successful, long-term control of the disease. Thus, our findings demonstrate a novel link among immune-resistance, stem-like phenotypes, and LC3B-mediated autophagic secretion in immune-refractory tumor cells, and implicate the LC3B-p-EGFR axis as a central molecular target for controlling NANOG immune-refractory cancer.

Abbreviations: ACTB: actin beta; ATG7: autophagy related 7; BafA1: bafilomycin A; CASP3: caspase 3; CFSE: carboxyfluorescein succinimidyl ester; ChIP: chromatin immunoprecipitation; CI: confidence interval; CIN: cervical intraepithelial neoplasia; CSC: cancer stem cell; CTL: cytotoxic T lymphocyte; EGF: epidermal growth factor; EGFR: epidermal growth factor receptor; FIGO: International Federation of Gynecology and Obstetrics; GFP: green fluorescent protein; GZMB: granzyme B; HG-CIN: high-grade CIN; IHC: immunohistochemistry; LG-CIN: low-grade CIN; LN: lymph node; MAP1LC3B/LC3B: microtubule associated protein 1 light chain 3 beta; MCL1: myeloid cell leukemia sequence 1; MLANA/MART-1: melanoma antigen recognized by T cells 1; MUT: mutant; NANOG: Nanog homeobox; PDCD1/PD-1: programmed cell death 1; PMEL/gp100: premelanosome protein; RTK: receptor tyrosine kinase; TMA: tissue microarray; WT: wild type.
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http://dx.doi.org/10.1080/15548627.2020.1805214DOI Listing
August 2020

Regulation of mRNA export through API5 and nuclear FGF2 interaction.

Nucleic Acids Res 2020 06;48(11):6340-6352

Research Institute, National Cancer Center, Goyang-si, Gyeonggi 10408, Republic of Korea.

API5 (APoptosis Inhibitor 5) and nuclear FGF2 (Fibroblast Growth Factor 2) are upregulated in various human cancers and are correlated with poor prognosis. Although their physical interaction has been identified, the function related to the resulting complex is unknown. Here, we determined the crystal structure of the API5-FGF2 complex and identified critical residues driving the protein interaction. These findings provided a structural basis for the nuclear localization of the FGF2 isoform lacking a canonical nuclear localization signal and identified a cryptic nuclear localization sequence in FGF2. The interaction between API5 and FGF2 was important for mRNA nuclear export through both the TREX and eIF4E/LRPPRC mRNA export complexes, thus regulating the export of bulk mRNA and specific mRNAs containing eIF4E sensitivity elements, such as c-MYC and cyclin D1. These data show the newly identified molecular function of API5 and nuclear FGF2, and provide a clue to understanding the dynamic regulation of mRNA export.
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http://dx.doi.org/10.1093/nar/gkaa335DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7293033PMC
June 2020

Pulse wave velocity is a new predictor of acute kidney injury development after off-pump coronary artery bypass grafting.

PLoS One 2020 30;15(4):e0232377. Epub 2020 Apr 30.

Department of Thoracic and Cardiovascular Surgery, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea.

Background: Brachial-ankle pulse wave velocity (baPWV) is the simple, non-invasive, gold-standard method for assessing arterial stiffness. However, baPWV has been shown to be associated with renal dyfunction, with a few reports demonstrating an association between baPWV and postoperative acute kidney injury (AKI) among surgical patients.

Methods: We retrospectively analyzed preoperative baPWV data that were prospectively collected from 164 patients who underwent off-pump coronary artery bypass grafting (CABG) between April 2013 and July 2019 (mean age: 66.2 ± 10.3 years, 29.3% females). Primarily, baPWV was investigated as an independent predictor of postoperative AKI development; secondarily, the patients were divided into high and low PWV groups according to the optimal baPWV cut-off value. Postoperative complications, mortality, and mid-term survival were compared between the two groups.

Results: AKI developed in 30 patients (18.3%). Univariate analysis showed that AKI was significantly associated with baPWV (20.2±7.3 vs. 16.2±2.8 m/s, p < 0.001), age, preoperative serum creatinine, and EuroSCORE. Multivariable logistic regression analysis revealed baPWV as independently associated with postoperative AKI even after adjustment for preoperative creatinine, old age (> 75 years), hypertension, diabetes under insulin therapy, and EuroSCORE. Moreover, area under the curve (AUC) analysis indicated that PWV can predict AKI better than preoperative creatinine levels (AUC, 0.781 [95% confidence interval, 0.688-0.874] vs. 0.680 [0.568-0.792]). The group-dividing baPWV cut-off value for AKI was 19 m/s. There were no 30-day mortality. The in-hospital mortality rates in the high and the low PWV groups were 2.2% (n = 1) and 0.8% (n = 1), respectively (p = 0.484). Midterm survival rates were not different between the two groups, but the rate of composite neurologic complication composed of stroke and delirium, was higher, and rate of mechanical ventilatory support was longer, in the high PWV group.

Conclusion: Brachial-ankle pulse wave velocity was an independent predictor of postoperative AKI following off-pump CABG, and high baPWVs may affect the composite neurologic outcome and the duration of mechanical ventilatory support.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0232377PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7192459PMC
July 2020

Far Beyond Cancer Immunotherapy: Reversion of Multi-Malignant Phenotypes of Immunotherapeutic-Resistant Cancer by Targeting the NANOG Signaling Axis.

Immune Netw 2020 Feb 20;20(1):e7. Epub 2020 Jan 20.

Department of Biochemistry & Molecular Biology, Korea University College of Medicine, Seoul 02841, Korea.

Cancer immunotherapy, in the form of vaccination, adoptive cellular transfer, or immune checkpoint inhibitors, has emerged as a promising practice within the field of oncology. However, despite the developing field's potential to revolutionize cancer treatment, the presence of immunotherapeutic-resistant tumor cells in many patients present a challenge and limitation to these immunotherapies. These cells not only indicate immunotherapeutic resistance, but also show multi-modal resistance to conventional therapies, abnormal metabolism, stemness, and metastasis. How can immunotherapeutic-resistant tumor cells render multi-malignant phenotypes? We reasoned that the immune-refractory phenotype could be associated with multi-malignant phenotypes and that these phenotypes are linked together by a factor that acts as the master regulator. In this review, we discussed the role of the embryonic transcription factor NANOG as a crucial master regulator we named "common factor" in multi-malignant phenotypes and presented strategies to overcome multi-malignancy in immunotherapeutic-resistant cancer by restraining the NANOG-mediated multi-malignant signaling axis. Strategies that blunt the NANOG axis could improve the clinical management of therapy-refractory cancer.
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http://dx.doi.org/10.4110/in.2020.20.e7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7049583PMC
February 2020

An Atypical Extraintestinal Manifestation in a Child with Ulcerative Colitis: Cutaneous Leukocytoclastic Vasculitis.

Ann Dermatol 2020 Feb 27;32(1):90-91. Epub 2019 Dec 27.

Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

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http://dx.doi.org/10.5021/ad.2020.32.1.90DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7992630PMC
February 2020

HSP90A inhibition promotes anti-tumor immunity by reversing multi-modal resistance and stem-like property of immune-refractory tumors.

Nat Commun 2020 Jan 28;11(1):562. Epub 2020 Jan 28.

Department of Biochemistry & Molecular Biology, Korea University College of Medicine, Seoul, Korea.

Cancer immunotherapy has emerged as a promising cancer treatment. However, the presence of immune-refractory tumor cells limits its clinical success by blocking amplification of anti-tumor immunity. Previously, we found that immune selection by immunotherapy drives the evolution of tumors toward multi-modal resistant and stem-like phenotypes via transcription induction of AKT co-activator TCL1A by NANOG. Here, we report a crucial role of HSP90A at the crossroads between NANOG-TCL1A axis and multi-aggressive properties of immune-edited tumor cells by identifying HSP90AA1 as a NANOG transcriptional target. Furthermore, we demonstrate that HSP90A potentiates AKT activation through TCL1A-stabilization, thereby contributing to the multi-aggressive properties in NANOG tumor cells. Importantly, HSP90 inhibition sensitized immune-refractory tumor to adoptive T cell transfer as well as PD-1 blockade, and re-invigorated the immune cycle of tumor-reactive T cells. Our findings implicate that the HSP90A-TCL1A-AKT pathway ignited by NANOG is a central molecular axis and a potential target for immune-refractory tumor.
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http://dx.doi.org/10.1038/s41467-019-14259-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6987099PMC
January 2020

Repigmentation of Eyebrow Leukotrichia in Segmental Vitiligo Treated with Suction Blister Epidermal Grafting Following Hair Plucking.

Ann Dermatol 2019 Dec 31;31(6):687-689. Epub 2019 Oct 31.

Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

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http://dx.doi.org/10.5021/ad.2019.31.6.687DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7992606PMC
December 2019

Association of Plasma Marker of Oxidized Lipid with Histologic Plaque Instability in Patients with Peripheral Artery Disease.

Ann Vasc Surg 2020 Jul 9;66:554-565. Epub 2019 Nov 9.

Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.

Background: The association between oxidized low-density lipoprotein (OxLDL) and plaque instability in coronary and carotid artery disease is well established. However, the association between OxLDL and the histologic changes of plaque in peripheral artery disease has not been clearly elucidated. This study aims to investigate the association between plasma OxLDL and histologic plaque instability in patients with peripheral artery disease.

Methods: Prospectively obtained plaques from 48 patients who underwent endovascular atherectomy (n = 20), surgical endarterectomy (n = 9), or bypass surgery (n = 19) for treatment of atherosclerotic femoropopliteal artery disease were evaluated for histologic fibrosis, sclerosis, calcification, necrosis, cholesterol cleft, and foamy macrophages using hematoxylin and eosin, oil red O, and immunohistochemical staining. Unstable plaques were defined as plaques that were positive for foamy macrophages and with lipid content of more than 10% of the total plaque area. Plasma OxLDL levels were measured using an enzyme-linked immunosorbent assay (Mercodia AB, Uppsala, Sweden).

Results: Of the 48 patients, 26 (54%) had unstable plaques. The unstable plaque group was younger, had fewer angiographic total occlusions, less calcification, and more CD68-positive and LOX-1-positive cells than the stable plaque group. Plasma OxLDL levels were significantly higher in the unstable plaque group than in the stable plaque group (57.4 ± 13.9 vs. 47.2 ± 13.6 U/L, P = 0.014). Multivariate analysis revealed that plasma OxLDL level, smoking, angiographic nontotal occlusion, and statin nonuse were independent predictors of unstable plaque.

Conclusions: Among patients with peripheral artery disease, the histologic instability of femoropopliteal plaque was independently associated with high plasma OxLDL, smoking, nontotal occlusion, and statin nonuse. Further large-scale studies are necessary to evaluate the role of noninvasive OxLDL measurement for predicting plaque instability and future adverse vascular event.
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http://dx.doi.org/10.1016/j.avsg.2019.11.004DOI Listing
July 2020

Twenty-Year Experience With Off-Pump Coronary Artery Bypass Grafting and Early Postoperative Angiography.

Ann Thorac Surg 2020 04 6;109(4):1112-1119. Epub 2019 Sep 6.

Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea.

Background: We have performed off-pump coronary artery bypass grafting and also performed early postoperative angiography to assess anastomosis accuracy and patency in most of our patients requiring surgical revascularization.

Methods: Of 3083 patients who underwent isolated coronary artery bypass grafting between 1998 and 2017, 2919 patients (94.7%) underwent off-pump coronary artery bypass grafting. Conduits for distal anastomoses were left internal thoracic artery (n = 2764), right internal thoracic artery (n = 866), right gastroepiploic artery (n = 997), radial artery (n = 16), and saphenous vein (n = 1505). Since the introduction of transit-time flow measurement in 2000, we revised abnormal grafts intraoperatively. Early (≤7 days) angiography was performed in 2820 patients (96.6%) at 1.5 ± 1.2 postoperative days, and surgical intervention was performed based on angiographic findings.

Results: Operative mortality was 1.1% (32 of 2919). Average number of distal anastomoses was 3.2 ± 1.0. Intraoperative flowmetry-guided revision for distal anastomosis failures was performed in 109 of 8585 distal anastomoses (1.3%). Angiography showed an overall patency of 98.2% (8836 of 9001): 99.0% (5484 of 5540) for arterial and 96.9% (3352 of 3461) for venous conduits (P < .001). Patency of venous conduits was 87.2% (231 of 265) for free grafts and 97.7% (3121 of 3196) for composite grafts (P = .001). After the introduction of transit-time flow measurement, patency of arterial conduits became significantly higher (97.2% vs 99.2%; P = .038); however, patency of free venous conduits was not significantly improved (86.0% vs 91.4%; P = .181). Early re-intervention according to angiographic findings was performed in 76 patients (2.7%). Reevaluation of graft patency before discharge in 31 who underwent revision of distal anastomoses showed improved patency (65.1% [56 of 86] vs 95.3% [82 of 86]; P < .001).

Conclusions: Intraoperative flowmetry and revision of abnormal grafts improved early arterial graft patency, and reoperation based on early angiographic findings may further improve graft patency at the time of discharge.
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http://dx.doi.org/10.1016/j.athoracsur.2019.07.053DOI Listing
April 2020

Clustering and Switching Patterns in Semantic Fluency and Their Relationship to Working Memory in Mild Cognitive Impairment.

Dement Neurocogn Disord 2019 Jun 24;18(2):47-61. Epub 2019 Jun 24.

Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea.

Background And Purpose: Semantic verbal fluency test is a neuropsychological assessment that can sensitively detect neuropathological changes. Considering its multifactorial features tapping various cognitive domains such as semantic memory, executive function, and working memory, it is necessary to examine verbal fluency performance in association with underlying cognitive functions. The objective of the current study was to investigate semantic fluency patterns of people with mild cognitive impairment (MCI) based on clustering and switching and their relationship with working memory.

Methods: Twenty-six individuals with MCI and 23 normal elderly adults participated in this study. A semantic verbal fluency test (animal version) was administered and the performance was analyzed using the following measures: number of correct words, cluster size, and number of switches. Scores of digit forward (DF) and backward span tasks were employed as working memory measures.

Results: Analyses of variance revealed significant group differences in the numbers of correct words and switches. Multivariate logistic regression and receiver-operating characteristic analyses showed that the number of switches more sensitively distinguished MCI existence than the number of correct words. Stepwise linear regression analysis showed that DF task and age significantly predicted the number of correct words while only the DF task significantly predicted the number of switches.

Conclusions: Decrement in semantic verbal fluency in MCI seems to be associated with impaired switching abilities. Working memory capacity might serve as the underlying cognitive factor related to decreased verbal fluency in MCI.
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http://dx.doi.org/10.12779/dnd.2019.18.2.47DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6609534PMC
June 2019

A Case of Nivolumab-Induced Lichen Planus.

Ann Dermatol 2019 Jun 1;31(3):345-347. Epub 2019 May 1.

Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

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http://dx.doi.org/10.5021/ad.2019.31.3.345DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7992723PMC
June 2019

High serum CRP influences myocardial miRNA profiles in ischemia-reperfusion injury of rat heart.

PLoS One 2019 7;14(5):e0216610. Epub 2019 May 7.

Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea.

Objective: Prognosis of myocardial infarction tends to be worse when serum C-reactive protein (CRP) level is high. miRNAs are also known to be involved in different pathogeneses of heart diseases such as myocardial infarction. However, how CRP is involved in myocardial infarction has not been fully elucidated. We hypothesized that serum CRP changes the miRNA profile during ischemia-reperfusion injury (IRI) of the myocardium. To confirm this hypothesis, we performed global miRNA expression profiling of myocardium using IRI and CRP infusion rat model.

Methods: After ligation of the coronary artery of rat hearts, human serum CRP was intravenously injected, and reperfusion was performed (I/R+CRP group, n = 6). Control group consisted of the sham group (n = 3), IV CRP infusion group (CRP only, n = 3), and the I/R-only group (I/R only, n = 5). We evaluated 423 miRNA expression in non-ischemic areas and areas at risk (AAR) of each group using NanoString nCounter miRNA expression assay.

Results: MiR-124 was downregulated in non-ischemic myocardium in CRP-only group. In AAR, 7 miRNAs were commonly upregulated in both I/R-only and I/R+CRP groups. And additional 6 miRNAs were upregulated in the I/R+CRP group (miR-33, miR-409-3p, miR-384-3p, miR-3562, miR-101a, and miR-340-5p). Similarly, in the non-ischemic areas, 6 miRNAs were commonly upregulated in both I/R-only and I/R+CRP groups, and additional 5 miRNAs changed in the I/R+CRP group (upregulation of miR-3559-5p, miR-499, and miR-21 and downregulation of miR-500 and miR-532-3p).

Conclusion: We showed that when serum CRP level is high, IRI results in multiple miRNA profile changes not only in ischemic areas but also in non-ischemic myocardium. Our results may provide a strong basis for studying the role of CRP and miRNAs in ischemic heart disease.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0216610PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6504103PMC
January 2020

The concept of nail matrix onychodermis (onychomatricodermis) in the nail unit: Histology and elastin immunohistochemistry.

J Cutan Pathol 2019 Jul 25;46(7):490-497. Epub 2019 Apr 25.

Dermpath Diagnostics New York, Port Chester, New York.

Backgrounds: We previously demonstrated the presence of onychodermis below nail matrix and nail bed. Because nail matrix is a producer of nail plate, we hypothesized that onychodermis below nail matrix could be the nail counterpart of follicular dermal papilla. In this study, we sought to further characterize histologic, histochemical, and immunohistochemical features of nail matrix onychodermis.

Methods And Results: Hematoxylin and eosin slides of 10 polydactyly nail units and 10 nail matrix biopsies from children and adults were reviewed. In polydactyly nail units, the onychodermis beneath nail matrix was characterized by onychofibroblasts showing abundant cytoplasm, and this area was slightly separated from the undersurface of the nail matrix. Nail matrix biopsy specimens also showed similar histology in the nail matrix onychodermis. Alcian blue stain demonstrated mucin deposition in onychofibroblasts within the nail matrix onychodermis. Immunohistochemically, elastin was rarely expressed in the nail matrix onychodermis while it was strongly expressed in the dermis of other areas of polydactyly nail units. Elastin was not expressed in follicular dermal papilla of terminal hair follicles of the scalp.

Conclusion: Our findings demonstrate the presence and localization of nail matrix onychodermis (onychomatricodermis). Our study also demonstrates similar elastin expression patterns in the onychomatricodermis and follicular dermal papilla.
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http://dx.doi.org/10.1111/cup.13460DOI Listing
July 2019

Cutaneous extranodal natural killer/T-cell lymphoma: Clinical implications of whole blood Epstein-Barr virus DNA.

J Am Acad Dermatol 2019 07 28;81(1):241-243. Epub 2018 Nov 28.

Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Electronic address:

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http://dx.doi.org/10.1016/j.jaad.2018.11.031DOI Listing
July 2019

A Case of Mycosis Fungoides Occurring after Primary Gamma-Delta T-Cell Lymphoma.

Ann Dermatol 2018 Oct 28;30(5):635-637. Epub 2018 Aug 28.

Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

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http://dx.doi.org/10.5021/ad.2018.30.5.635DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7992478PMC
October 2018
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