Publications by authors named "Seung Kim"

3,913 Publications

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Management of Patients with Metastatic Castration-Sensitive Prostate Cancer in the Real-World Setting in the United States.

J Urol 2021 Jul 23:101097JU0000000000002121. Epub 2021 Jul 23.

Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California.

Purpose: This study provides a contemporary assessment of the treatment patterns, healthcare resource utilization (HRU), and costs among metastatic castration-sensitive prostate cancer (mCSPC) patients in the US.

Methods: Adults with mCSPC were selected from Optum's de-identified Clinformatics® Data Mart Database (Commercial insurance/Medicare Advantage [COM/MA]; 01/01/2014-07/31/2019) or Medicare Fee-for-Service (FFS; 01/01/2014-12/31/2017). The index date was the first metastatic disease diagnosis date on/after the first prostate cancer diagnosis (without prior evidence of castration resistance). Patients were observed for 12 months pre-index (baseline) through their mCSPC period (from index until castration resistance or follow-up end). First-line (1L) mCSPC therapy was assessed during the mCSPC period; all-cause HRU and health plan-paid costs per-patient-per-year (PPPY) were measured during baseline and mCSPC periods.

Results: Among 6,517 COM/MA and 13,324 Medicare-FFS mCSPC patients over ∼10 months (median mCSPC period), 38% and 48% remained untreated/deferred treatment, and 45% and 46% received 1L androgen deprivation therapy (ADT) monotherapy, respectively. 1L abiraterone acetate and docetaxel were used among 7% and 6% of COM/MA and 1% and 2% of Medicare-FFS patients, respectively. HRU increased from baseline to mCSPC period, resulting in increased health plan-paid costs from $21,201 to $108,767 in COM/MA and from $16,819 to $69,639 PPPY in Medicare-FFS.

Conclusions: This study highlights the limited use of newer therapies that improve survival in men with mCSPC in the US. HRU and costs increased substantially after onset of metastasis. Given the emergence of newer effective mCSPC therapies, further evaluation of future real-world mCSPC treatment patterns and outcomes is warranted.
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http://dx.doi.org/10.1097/JU.0000000000002121DOI Listing
July 2021

Prognostic Impact of Sarcopenia and Radiotherapy in Patients With Advanced Gastric Cancer Treated With Anti-PD-1 Antibody.

Front Immunol 2021 8;12:701668. Epub 2021 Jul 8.

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

Background: We explored the combined effects of sarcopenia (SAR) and radiotherapy (RT) on outcomes in patients with advanced gastric cancer (AGC) treated with immune-checkpoint blockade (ICB).

Methods: Among 185 patients with AGC treated with ICB, we defined SAR as skeletal muscle index <49 cm2/m2 for men and <31 cm2/m2 for women; 93 patients met criteria. We defined high neutrophil-to-lymphocyte ratio (hNLR) as NLR≥3. Palliative RT was performed in 37 patients (20%) before ICB.

Results: We frequently observed hNLR in patients with SAR (53% 35%, p = 0.02). The median overall survival (OS) for the entire cohort was 5 months. Stratification by risk factors of SAR or hNLR revealed a significant difference in median OS (0 [N = 60] 1 [N = 76] 2 [N = 49]: 7.6 6.4 2.2 months, p < 0.001). Patients with microsatellite instability-high (MSI-H, N = 19) or Epstein-Barr virus (EBV)-positive tumors (N = 13) showed favorable outcomes compared to those with microsatellite stable (MSS, N = 142) tumors (median OS, not reached 16.8 3.8 months, respectively). The benefit of RT was evident in patients with both SAR and hNLR (median OS, 3.1 1.3 months, p = 0.02) and MSS/EBV-negative tumor (median OS, 6.5 3.5 months, p = 0.03), but outcomes after RT in MSI-H tumor were not significantly different. In multivariable analysis, SAR/hNLR, molecular subtypes, and a history of RT were associated with OS (all p < 0.05).

Conclusions: We demonstrated the negative predictive value of SAR/hNLR on outcomes after ICB for AGC, and the history of RT could overcome the negative impact of SAR/hNLR and the MSS/EBV-negative subtype.
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http://dx.doi.org/10.3389/fimmu.2021.701668DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8298191PMC
July 2021

Restoration of Motion Blurred Image by Modified DeblurGAN for Enhancing the Accuracies of Finger-Vein Recognition.

Sensors (Basel) 2021 Jul 6;21(14). Epub 2021 Jul 6.

Division of Electronics and Electrical Engineering, Dongguk University, 30 Pildong-ro 1-gil, Jung-gu, Seoul 04620, Korea.

Among many available biometrics identification methods, finger-vein recognition has an advantage that is difficult to counterfeit, as finger veins are located under the skin, and high user convenience as a non-invasive image capturing device is used for recognition. However, blurring can occur when acquiring finger-vein images, and such blur can be mainly categorized into three types. First, skin scattering blur due to light scattering in the skin layer; second, optical blur occurs due to lens focus mismatching; and third, motion blur exists due to finger movements. Blurred images generated in these kinds of blur can significantly reduce finger-vein recognition performance. Therefore, restoration of blurred finger-vein images is necessary. Most of the previous studies have addressed the restoration method of skin scattering blurred images and some of the studies have addressed the restoration method of optically blurred images. However, there has been no research on restoration methods of motion blurred finger-vein images that can occur in actual environments. To address this problem, this study proposes a new method for improving the finger-vein recognition performance by restoring motion blurred finger-vein images using a modified deblur generative adversarial network (modified DeblurGAN). Based on an experiment conducted using two open databases, the Shandong University homologous multi-modal traits (SDUMLA-HMT) finger-vein database and Hong Kong Polytechnic University finger-image database version 1, the proposed method demonstrates outstanding performance that is better than those obtained using state-of-the-art methods.
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http://dx.doi.org/10.3390/s21144635DOI Listing
July 2021

Sustained Inflation During Chest Compression: A New Technique of Pediatric Cardiopulmonary Resuscitation That Improves Recovery and Survival in a Pediatric Porcine Model.

J Am Heart Assoc 2021 Jul 21:e019136. Epub 2021 Jul 21.

Neonatal Research Unit, Centre for the Studies of Asphyxia and Resuscitation Royal Alexandra Hospital Edmonton Alberta Canada.

Background Chest compression (CC) during sustained inflations (CC+SI) compared with CC with asynchronized ventilation (CCaV) during cardiopulmonary resuscitation in asphyxiated pediatric piglets will reduce time to return of spontaneous circulation (ROSC). Methods and Results Piglets (20-23 days of age, weighing 6.2-10.2 kg) were anesthetized, intubated, instrumented, and exposed to asphyxia. Cardiac arrest was defined as mean arterial blood pressure <25 mm Hg with bradycardia. After cardiac arrest, piglets were randomized to CC+SI (n=12) or CCaV (n=12) or sham (n=8). Sham-operated animals had no asphyxia. Heart rate, arterial blood pressure, carotid blood flow, cerebral oxygenation, and respiratory parameters were continuously recorded. There were no differences in baseline parameters or the duration and degree of asphyxiation. Median (interquartile range) Time to ROSC was 248 (41-346) seconds compared with 720 (167-720) seconds in the CC+SI group and CCaV group, respectively (=0.0292). There was a 100% higher rate of ROSC in the CC+SI group versus CCaV group, with 10 (83%) versus 5 (42%) achieving ROSC (=0.089), respectively. Piglets in the CC+SI and CCaV groups received intravenous epinephrine boluses to achieve ROSC (8/12 versus 10/12 =0.639). There was a significantly higher minute ventilation in the CC+SI group, which was secondary to a 5-fold increase in the number of inflations per minute and a 1.5-fold increase in tidal volume. Conclusions CC+SI reduced time to ROSC and improved survival compared with using CCaV. CC+SI allowed passive ventilation of the lung while providing chest compressions. This technique warrants further studies to examine the potential to improve outcomes in pediatric patients with cardiac arrest. Registration URL: https://www.preclinicaltrials.eu; Unique identifier: PCTE0000152.
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http://dx.doi.org/10.1161/JAHA.120.019136DOI Listing
July 2021

Arthroscopic cystectomy for Baker's cysts with and without one-way valve lesions: incidence of one-way valve lesion, associated pathologies, and clinical outcomes.

Arch Orthop Trauma Surg 2021 Jul 20. Epub 2021 Jul 20.

Department of Orthopaedic Surgery, Korea University Ansan Hospital, Gyeonggi-do, Republic of Korea.

Introduction: A one-way valve lesion plays an important role in the formation of Baker's cysts and serves as an important landmark for accessing these cysts during arthroscopic surgery. This study aimed to investigate the incidence of one-way valve lesions and their effect on clinical outcomes in patients who underwent arthroscopic cystectomy for Baker's cysts.

Materials And Methods: Patients who underwent arthroscopic cystectomy for Baker's cysts between June 2005 and November 2017 were retrospectively reviewed. Patient demographic characteristics, radiologic/arthroscopic findings (presence of one-way valve lesions, concurrent chondral and meniscal lesions, and cyst wall thickness), and clinical outcomes (clinical recurrence rate, Lysholm score, and complications) at the 2-year follow-up were evaluated. Subgroup analysis was performed to compare clinical outcomes between patients with and without one-way valve lesions.

Results: Thirty patients (mean age, 57.4 ± 9.4 years) were included in this study. One-way valve lesions were surgically documented in 11 patients (36.7%). Ten patients (33.3%) had chondral lesions with an International Cartilage Repair Society grade ≥ 3, and 23 patients (76.7%) had concurrent chondral and meniscal lesions. At the 2-year follow-up, none of the patients had experienced clinical recurrence; the mean Lysholm score was 76.3 ± 17.5 (48-100). Three patients reported persistent pain, while two reported numbness or paresthesia. Subgroup analysis showed no significant differences in clinical recurrence rates, Lysholm scores, and complication rates between the groups.

Conclusions: The incidence of one-way valve lesions during arthroscopic cystectomy for Baker's cysts was lower than that previously reported. Arthroscopic cystectomy showed good clinical results in patients with and without these lesions.
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http://dx.doi.org/10.1007/s00402-021-04076-8DOI Listing
July 2021

Evaluation of nutritional status using bioelectrical impedance analysis in patients with inflammatory bowel disease.

Intest Res 2021 Jul 20. Epub 2021 Jul 20.

Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.

Background/aims: Nutritional status influences quality of life among patients with inflammatory bowel disease (IBD), although there is no clear method to evaluate nutritional status in this setting. Therefore, this study examined whether bioelectrical impedance analysis (BIA) could be used to evaluate the nutritional status of patients with IBD.

Methods: We retrospectively analyzed data from 139 Korean patients with IBD who were treated between November 2018 and November 2019. Patients were categorized as having active or inactive IBD based on the Harvey-Bradshaw index (a score of ≥5 indicates active Crohn's disease) and the partial Mayo scoring index (a score of ≥2 indicates active ulcerative colitis). BIA results and serum nutritional markers were analyzed according to disease activity.

Results: The mean patient age was 45.11±17.71 years. The study included 47 patients with ulcerative colitis and 92 patients with Crohn's disease. Relative to the group with active disease (n=72), the group with inactive disease (n=67) had significantly higher values for hemoglobin (P<0.001), total protein (P<0.001), and albumin (P<0.001). Furthermore, the group with inactive disease had higher BIA values for body moisture (P=0.047), muscle mass (P=0.046), skeletal muscle mass (P=0.042), body mass index (P=0.027), and mineral content (P=0.034). Moreover, the serum nutritional markers were positively correlated with the BIA results.

Conclusions: Nutritional markers evaluated using BIA were correlated with serum nutritional markers and inversely correlated with disease activity. Therefore, we suggest that BIA may be a useful tool that can help existing nutritional tests monitor the nutritional status of IBD patients.
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http://dx.doi.org/10.5217/ir.2021.00022DOI Listing
July 2021

RNA-sequencing identification and validation of genes differentially expressed in high-risk adenoma, advanced colorectal cancer, and normal controls.

Funct Integr Genomics 2021 Jul 17;21(3-4):513-521. Epub 2021 Jul 17.

Department of Pathology, College of Medicine, Korea University, Seoul, Republic of Korea.

Distinct gene expression patterns that occur during the adenoma-carcinoma sequence need to be determined to analyze the underlying mechanism in each step of colorectal cancer progression. Elucidation of biomarkers for colorectal polyps that harbor malignancy potential is important for prevention of colorectal cancer. Here, we use RNA sequencing to determine gene expression profile in patients with high-risk adenoma treated with endoscopic submucosal dissection by comparing with gene expression in patients with advanced colorectal cancer and normal controls. We collected 70 samples, which consisted of 27 colorectal polyps, 24 cancer tissues, and 19 normal colorectal mucosa. RNA sequencing was performed on an Illumina platform to select differentially expressed genes (DEGs) between colorectal polyps and cancer, polyps and controls, and cancer and normal controls. The Kyoto Gene and Genome Encyclopedia (KEGG) and gene ontology (GO) analysis, gene-concept network, GSEA, and a decision tree were used to evaluate the DEGs. We selected the most highly expressed genes in high-risk polyps and validated their expression using real-time PCR and immunohistochemistry. Compared to patients with colorectal cancer, 82 upregulated and 24 downregulated genes were detected in high-risk adenoma. In comparison with normal controls, 33 upregulated and 79 downregulated genes were found in high-risk adenoma. In total, six genes were retrieved as the highest and second highest expressed in advanced polyps and cancers among the three groups. Among the six genes, ANAX3 and CD44 expression in real-time PCR for validation was in good accordance with RNA sequencing. We identified differential expression of mRNAs among high-risk adenoma, advanced colorectal cancer, and normal controls, including that of CD44 and ANXA3, suggesting that this cluster of genes as a marker of high-risk colorectal adenoma.
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http://dx.doi.org/10.1007/s10142-021-00795-8DOI Listing
July 2021

sp. nov., isolated from soil.

Int J Syst Evol Microbiol 2021 Jul;71(7)

Department of Microbiology and Molecular Biology, College of Bioscience and Biotechnology, Chungnam National University, 99, Daehak-ro, Yuseong-gu, Daejeon 34134, Republic of Korea.

A Gram-stain-negative, oxidase-positive, catalase-positive, aerobic, orange-pigmented, rod-shaped and non-motile bacterium designated strain MMS17-SY002 was isolated from island soil. The isolate grew at 20-37 °C (optimum, 30 °C), at pH 6.0-9.5 (optimum, pH 7) and in the presence of 0.5-4.0 % (w/v) NaCl (optimum, 2.0 %). Phylogenetic analysis based on 16S rRNA gene sequences revealed that strain MMS17-SY002 was mostly related to the genus of the family and had highest sequence similarity of 96.82 % to A6B8 and EM44, but formed a distinct phylogenetic line within the genus. Chemotaxonomic analyses showed that menaquinone 6 was the predominant isoprenoid quinone, the major fatty acids were iso-C G and iso-C, and the diagnostic polar lipid was phosphatidylethanolamine. The genomic DNA G+C content was 42.4 mol%. Strain MMS17-SY002 could be distinguished from related species by the combination of trypsin, α-chymotrypsin, acid phosphatase, naphthol-AS-BI-phosphohydrolase, α-galactosidase, β-galactosidase and β-glucosidase activities. The orthologous average nucleotide identity between the genomes of strain MMS17-SY002 and and that between the strain and A6B8 were 73.26 and 73.33%, respectively, thus confirming the separation of the strain from related species at species level. Based on the phenotypic, phylogenetic, chemotaxonomic and genomic characterization, MMS17-SY002 should be recognized as a novel species of the genus , for which the name sp. nov. is proposed. The type strain is MMS17-SY002 (=KCTC 62790=JCM 32370).
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http://dx.doi.org/10.1099/ijsem.0.004887DOI Listing
July 2021

Quantitative MRI Assessment of Pancreatic Steatosis Using Proton Density Fat Fraction in Pediatric Obesity.

Korean J Radiol 2021 Jul 14. Epub 2021 Jul 14.

Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea.

Objective: To assess the feasibility of quantitatively assessing pancreatic steatosis using magnetic resonance imaging (MRI) and its correlation with obesity and metabolic risk factors in pediatric patients.

Materials And Methods: Pediatric patients (≤ 18 years) who underwent liver fat quantification MRI between January 2016 and June 2019 were retrospectively included and divided into the obesity and control groups. Pancreatic proton density fat fraction (P-PDFF) was measured as the average value for three circular regions of interest (ROIs) drawn in the pancreatic head, body, and tail. Age, weight, laboratory results, and mean liver MRI values including liver PDFF (L-PDFF), stiffness on MR elastography, and T2 values were assessed for their correlation with P-PDFF using linear regression analysis. The associations between P-PDFF and metabolic risk factors, including obesity, hypertension, diabetes mellitus (DM), and dyslipidemia, were assessed using logistic regression analysis.

Results: A total of 172 patients (male:female = 125:47; mean ± standard deviation [SD], 13.2 ± 3.1 years) were included. The mean P-PDFF was significantly higher in the obesity group than in the control group (mean ± SD, 4.2 ± 2.5% vs. 3.4 ± 2.4%; = 0.037). L-PDFF and liver stiffness values showed no significant correlation with P-PDFF ( = 0.235 and = 0.567, respectively). P-PDFF was significantly associated with obesity (odds ratio 1.146, 95% confidence interval 1.006-1.307, = 0.041), but there was no significant association with hypertension, DM, and dyslipidemia.

Conclusion: MRI can be used to quantitatively measure pancreatic steatosis in children. P-PDFF is significantly associated with obesity in pediatric patients.
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http://dx.doi.org/10.3348/kjr.2020.1343DOI Listing
July 2021

Controlled attenuation parameter value and the risk of hepatocellular carcinoma in chronic hepatitis B patients under antiviral therapy.

Hepatol Int 2021 Jul 14. Epub 2021 Jul 14.

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

Background: Controlled attenuation parameter (CAP) can evaluate hepatic steatosis in patients with chronic hepatitis B (CHB). However, prognostic implications of CAP value remain unclear. We evaluated the association between CAP and the risk of hepatocellular carcinoma (HCC) in patients with CHB under antiviral therapy and maintained virologic response.

Methods: A total of 1823 CHB patients who were taking nucleos(t)ide analogue and showing suppressed hepatitis B virus replication were analyzed. The primary outcome was incident HCC during follow-up. Patients were grouped into those with and without advanced chronic liver disease (ACLD) (liver stiffness measurement cutoff: 10 kPa), and those with and without hepatic steatosis (CAP cutoff: 222 dB/m).

Results: During 6.4 years of follow-up, 127 patients (7.0%) newly developed HCC. Among patients with ACLD (n = 382), the cumulative HCC incidence rate was lower for those with CAP ≥ 222 (11.0% at 5 years) than those with CAP < 222 (24.0% at 5 years, p = 0.002), and was an independent factor associated with HCC. When CAP value was further stratified, the cumulative HCC incidence rate decreased in dose-dependent manner according to an increase in CAP value (24.0%, 13.9%, 12.8% and 6.0% at 5 years for those with CAP < 222, 222-246, 247-273 and ≥ 274, respectively). Among patients without ACLD (n = 1441), there was no significance difference in HCC risk according to CAP value (HCC incidence rate: 3.3% and 4.0% at 5 years for those with CAP < 222 and CAP ≥ 222, p = 0.20).

Conclusions: Among CHB patients under antiviral therapy showing suppressed HBV replication, low CAP value predicted higher risk for HCC among ACLD patients, indicating that CAP value has a prognostic implication in this population.
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http://dx.doi.org/10.1007/s12072-021-10205-7DOI Listing
July 2021

Sequential treatment of afatinib and osimertinib or other regimens in patients with advanced non-small-cell lung cancer harboring EGFR mutations: Results from a real-world study in South Korea.

Cancer Med 2021 Jul 13. Epub 2021 Jul 13.

Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.

Objectives: The optimal sequence for the administration of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) for treating non-small cell lung cancer (NSCLC) is still unclear. This study aimed to evaluate the efficacy of sequential afatinib and osimertinib treatment in patients with NSCLC harboring EGFR mutations.

Materials And Methods: Electronic records of patients with EGFR-mutated NSCLC, who were administered afatinib and osimertinib (group A) or other chemotherapy (group B) between October 2014 and 2019, across 16 hospitals in South Korea were reviewed. The primary outcome, time on treatment (TOT), secondary outcome, and overall survival (OS) were estimated using the Kaplan-Meier method and log-rank test. Multivariate analyses were performed using the Cox proportional hazards model.

Results: Of the 737 patients who received frontline afatinib treatment, 324 with complete records were selected (group A: 126, group B: 198). All patients in group A were T790M positive after afatinib, while patients in group B were all negative or unknown. The median TOT was 35.4 months (95% confidence interval [CI]: 27.7-45.6) in group A and 20.8 months (95% CI: 19.4-24.0) in group B. The median TOT with afatinib was 13.0 months (95% CI: 12.0-13.9) overall and 15.7 months (95% CI: 13.9-17.3) in group A. The 2- and 3-year survival rates were 86.0 and 69.3% in group A and 75.9 and 55.3% in group B, respectively.

Conclusion: Sequential afatinib and osimertinib treatment resulted in better survival rates than treatment with afatinib followed by other chemotherapies.
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http://dx.doi.org/10.1002/cam4.4127DOI Listing
July 2021

Understanding Patient Experience in Biliary Tract Cancer: A Qualitative Patient Interview Study.

Oncol Ther 2021 Jul 10. Epub 2021 Jul 10.

AstraZeneca, Gaithersburg, MD, USA.

Introduction: Patients living with biliary tract cancer (BTC) experience a decline in health-related quality of life (HRQoL). This study aimed to obtain a comprehensive understanding of the patient experience of BTC-related signs/symptoms and the impacts of these on daily functioning and HRQoL.

Methods: Patients with BTC participated in qualitative semi-structured concept elicitation interviews. Signs/symptoms and impacts of BTC were initially explored by targeted literature searches and interviews with five clinicians. Patient interviews were transcribed and coded using qualitative research software. Concept saturation was assessed over five interview waves. A sign/symptom or impact was defined as "salient" if mentioned by ≥ 50% of patients, with a mean disturbance rating of ≥ 5 (0-10 scale). A conceptual model of the patient experience of BTC-related signs/symptoms and impacts was produced.

Results: Twenty-three patients from the USA (78% women; median age: 54 years), diagnosed as having early (n = 3), locally advanced (n = 11) or metastatic (n = 9) disease, were interviewed. Sixty-six signs/symptoms and 12 impacts were identified. Of these, 46 signs/symptoms and 8 impacts were not identified from the targeted literature or clinician interviews. Concept saturation was reached by the fourth of five interview waves. Fourteen disease-related signs/symptoms (including fatigue/lack of energy, abdominal pain, lack of appetite, insomnia and diarrhoea) and three impacts (physical, emotional and cognitive impacts) were deemed "salient". The conceptual model included 50 signs/symptoms and 12 impacts.

Conclusion: Patients with BTC reported a range of signs/symptoms and impacts that negatively affect daily functioning and HRQoL.
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http://dx.doi.org/10.1007/s40487-021-00159-zDOI Listing
July 2021

Cardiovascular Risk Is Elevated in Lean Subjects with Nonalcoholic Fatty Liver Disease.

Gut Liver 2021 Jul 12. Epub 2021 Jul 12.

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

Background/aims: Nonalcoholic fatty liver disease (NAFLD) and obesity are independently associated with an increased risk for atherosclerotic cardiovascular disease (ASCVD), the leading cause of mortality in patients with NAFLD. Many NAFLD patients are lean, but their ASCVD risk compared to obese subjects with NAFLD is unclear.

Methods: Data from the 2008 to 2011 Korea National Health and Nutrition Examination Surveys database were analyzed (n=4,786). NAFLD was defined as a comprehensive NAFLD score ≥40 or a liver fat score ≥-0.640. ASCVD risk was evaluated using the American College of Cardiology/ American Heart Association guidelines.

Results: The frequency of subjects without NAFLD, with obese NAFLD, and with lean NAFLD was 62.4% (n=2,987), 26.6% (n=1,274), and 11.0% (n=525), respectively. Subjects with lean NAFLD had a significantly higher ASCVD score and prevalence of a high ASCVD risk (mean 15.6±14.0, 51.6%) than those with obese NAFLD and without NAFLD (mean 11.2±11.4, 39.8%; mean 7.9±10.9, 25.5%; all p<0.001). Subjects with lean NAFLD and significant liver fibrosis showed a significantly higher odds ratio for a high risk for ASCVD than those with obese NAFLD with or without significant liver fibrosis (odds ratio, 2.60 vs 1.93; p=0.023).

Conclusions: Subjects with lean NAFLD had a significantly higher ASCVD score and prevalence of high risk for ASCVD than those with obese NAFLD. Similarly, lean subjects with significant liver fibrosis had a higher probability of ASCVD than obese subjects in the subpopulation with NAFLD.
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http://dx.doi.org/10.5009/gnl210084DOI Listing
July 2021

Real-world effectiveness of post-trastuzumab emtansine treatment in patients with HER2-positive, unresectable and/or metastatic breast cancer: a retrospective observational study (KBCSG-TR 1917).

BMC Cancer 2021 Jul 9;21(1):795. Epub 2021 Jul 9.

Department of Surgery, Breast Oncology, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan.

Background: Trastuzumab emtansine (T-DM1) is a second-line standard therapy for patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer. Evidence regarding post-T-DM1 treatments is currently lacking. We evaluated the effectiveness of post-T-DM1 drug therapy in patients with HER2-positive, unresectable and/or metastatic breast cancer.

Methods: In this multicenter, retrospective, observational study, real-world clinical data of female patients with HER2-positive breast cancer who had a history of T-DM1 treatment were consecutively collected from five sites in Japan. We investigated the effectiveness of post-T-DM1 therapy by evaluating the real-world progression-free survival (rwPFS), time to treatment failure (TTF), overall survival (OS), objective response rate (ORR), and clinical benefit rate (CBR). Tumor response was assessed by investigators according to Response Evaluation Criteria in Solid Tumors (RECIST version 1.1) guidelines. Subgroup and exploratory analyses according to background factors were also undertaken.

Results: Of the 205 patients who received T-DM1 treatment between 1 January 2014 and 31 December 2018, 128 were included in this study. Among the 128 patients analyzed, 105 (82%) patients received anti-HER2 therapy and 23 (18%) patients received regimens without anti-HER2 therapy. Median (95% confidence interval [CI]) rwPFS, TTF, and OS were 5.7 (4.8-6.9) months, 5.6 (4.6-6.4) months, and 22.8 (18.2-32.4) months, respectively. CBR and ORR (95% CI) were 48% (38.8-56.7) and 23% (15.1-31.4), respectively. Cox-regression analysis showed that an ECOG PS score of 0, a HER2 immunohistochemistry score of 3+, recurrent type, ≥12 month duration of T-DM1 therapy, and anti-HER2 therapy were independent variables for rwPFS. An exploratory subgroup analysis of regimens after T-DM1 showed that those with anti-HER2 therapy had a median rwPFS of 6.3 and those without anti-HER2 therapy had a median rwPFS of 4.8 months.

Conclusions: In the real-world setting in Japan, several post-T-DM1 regimens for patients with unresectable and/or metastatic HER2-positive breast cancer, including continuation of anti-HER2 therapy, showed some effectiveness; however, this effectiveness was insufficient. Novel therapeutic options are still needed for further improvement of PFS and OS in later treatment settings.

Trial Registration: UMIN000038296 ; registered on 15 October 2019.
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http://dx.doi.org/10.1186/s12885-021-08504-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8268506PMC
July 2021

Randomised clinical trial: comparison of tegoprazan and placebo in non-erosive reflux disease.

Aliment Pharmacol Ther 2021 Jul 6. Epub 2021 Jul 6.

Seoul, South Korea.

Background: Tegoprazan is a novel, fast- and long-acting potassium-competitive acid blocker that suppresses gastric acid secretion, which could benefit patients with non-erosive reflux disease (NERD), a type of gastroesophageal reflux disease.

Aim: To evaluate the efficacy and safety profiles of tegoprazan compared with those of a placebo in Korean patients with NERD.

Methods: In this phase 3, double-blind, placebo-controlled, multicentre study, 324 Korean patients with NERD were randomised into three treatment groups: tegoprazan 50 mg, tegoprazan 100 mg and placebo. These drugs were provided once daily for 4 weeks. The primary endpoint was the proportion of patients with complete resolution of major symptoms (both heartburn and regurgitation) for the last 7 days of the 4-week treatment period. Other outcomes related to efficacy, safety and tolerability were also evaluated.

Results: Among all, 42.5% (45/106), 48.5% (48/99) and 24.2% (24/99) of patients showed complete resolution of major symptoms at week 4 after receiving tegoprazan 50 mg, tegoprazan 100 mg, and placebo, respectively. Both doses of tegoprazan showed superior efficacy than the placebo (P = 0.0058 and P = 0.0004, respectively). The complete resolution rates of heartburn and proportions of heartburn-free days (as other efficacy outcomes) were significantly higher in both tegoprazan groups than in the placebo group (P < 0.05 for all). No significant difference in the incidence of treatment-emergent adverse events were noted.

Conclusions: Tegoprazan 50 and 100 mg showed superior therapeutic efficacy compared with the placebo, as well as a favourable safety profile in patients with NERD. Registration number: ClinicalTrials.gov identifier NCT02556021.
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http://dx.doi.org/10.1111/apt.16477DOI Listing
July 2021

Streptococcus equi-derived extracellular vesicles as a vaccine candidate against Streptococcus equi infection.

Vet Microbiol 2021 Aug 25;259:109165. Epub 2021 Jun 25.

Research Center for Bioconvergence Analysis, Korea Basic Science Institute (KBSI), Ochang, 28119, Republic of Korea; Center for Convergent Research of Emerging Virus Infection, Korea Research Institute of Chemical Technology (KRICT), Daejeon, 34114, Republic of Korea; Bio-Analytical Science, University of Science and Technology, Daejeon 34113, Republic of Korea. Electronic address:

Streptococcus equi subspecies equi is a pathogenic bacterium that causes strangles, a highly contagious respiratory infection in horses and other equines. The limitations of current vaccines against S. equi infection warrants the development of an affordable, safe, and effective vaccine. Because gram-positive extracellular vesicles (EVs) transport various immunogenic antigens, they are attractive vaccine candidates. Here, we purified the EVs of S. equi ATCC 39506 and evaluated them as a vaccine candidate against S. equi infection in mice. As an initial step, comparative proteomic analysis was performed to characterize the functional features of the EVs. Reverse vaccinology and knowledge-based annotations were then used to screen potential vaccine candidates (PVCs) for S. equi ATCC 39506. Finally, 32 PVCs were found to be enriched in the EV fraction, suggesting the usefulness of this fraction as a vaccine. Importantly, a significantly higher survival rate after S. equi infection was detected in mice immunized with S. equi-derived EVs via the intraperitoneal route than in mice immunized with heat-killed bacteria. Of note, immunoprecipitation-mass spectrometry results validated various immunogenic antigens within the EV proteome. In conclusion, our results suggest that S. equi-derived EVs can serve as a vaccine candidate against S. equi infection.
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http://dx.doi.org/10.1016/j.vetmic.2021.109165DOI Listing
August 2021

Effect of different driver power amplitudes on liver stiffness measurement in pediatric liver MR elastography.

Abdom Radiol (NY) 2021 Jul 3. Epub 2021 Jul 3.

Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea.

Purpose: To assess how different driver power amplitudes affect the measurement of liver stiffness in pediatric liver magnetic resonance elastography (MRE).

Methods: From January 2018 to May 2018, pediatric patients (≤ 18 years) who underwent liver MRE with 20% and 56% driver power amplitudes were included in this retrospective study. Region-of-interests (ROIs) were drawn on four stiffness maps to include the largest area of the liver parenchyma. Intraclass correlation coefficients (ICCs) were used to assess agreements for the area, mean, maximum, minimum and standard deviation of liver stiffness between the driver power amplitudes.

Results: 128 MRE stiffness maps from 16 patients (M:F = 10:6, median 12.5 years old) were included. On MRE, median ROI areas of liver were 83.1 cm (range, 46.9-144.1 cm) and 63.0 cm (range, 5.4-123.4 cm) for the driver power amplitudes of 20% and 56%, respectively. Median liver stiffness values were 2.3 kPa (range, 1.7-8.0 kPa) and 2.8 kPa (range, 1.7-8.5 kPa). Maximum and minimum liver stiffness values were 5.3 kPa and 1.0 kPa for 20% and 7.8 kPa and 1.1 kPa for 56%. Standard deviation was 0.6 kPa for 20% and 1.0 kPa for 56%. ICC values between the two power amplitudes were 0.33-0.51 for the ROI area and the maximum, minimum and standard deviation values of liver stiffness. The ICC value for liver stiffness was 0.857 (95% confidence interval, 0.760-0.915).

Conclusion: Liver stiffness with two driver power amplitudes on MRE showed good reliability in pediatric patients. Driver power amplitudes need to be optimized according to the pediatric liver size.
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http://dx.doi.org/10.1007/s00261-021-03197-3DOI Listing
July 2021

Axillary response according to neoadjuvant single or dual human epidermal growth factor receptor 2 (HER2) blockade in clinically node-positive, HER2-positive breast cancer.

Int J Cancer 2021 Jul 2. Epub 2021 Jul 2.

Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.

Incorporating dual human epidermal growth factor receptor 2 (HER2) blockade into neoadjuvant systemic therapy (NST) led to higher response in patients with HER2-positive breast cancer. However, axillary response to treatment regimens, including single or dual HER2 blockade, in patients with clinically node-positive breast cancer remains uncertain. Our study aimed to examine the pathologic axillary response according to the type of NST, that is, single or dual HER2 blockade. In our study, 546 patients with clinically node-positive, HER2-positive breast cancer who received NST followed by axillary surgery were retrospectively selected and divided into three groups: chemotherapy alone, chemotherapy + trastuzumab and chemotherapy + trastuzumab with pertuzumab. The primary outcome was the axillary pathologic complete response (pCR). Among 471 patients undergoing axillary lymph node dissection, the axillary pCR rates were 43.5%, 74.5% and 68.8% in patients who received chemotherapy alone, chemotherapy + trastuzumab and chemotherapy + trastuzumab with pertuzumab, respectively. There was no difference in axillary pCR rates between patients who received single or dual HER2 blockade (P = .379). Among patients receiving chemotherapy + trastuzumab, patients without breast pCR had the greatest risk for residual axillary metastases (relative risk, 9.8; 95% confidence interval, 3.2-14.9; P < .0001). In conclusion, adding trastuzumab to chemotherapy increased the axillary pCR rate in patients with clinically node-positive, HER2-positive breast cancer; furthermore, dual HER2-blockade with trastuzumab and pertuzumab did not elevate the axillary response compared with trastuzumab alone. Breast pCR could be a strong predictor for axillary pCR in clinically node-positive patients treated with HER2-targeting therapy.
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http://dx.doi.org/10.1002/ijc.33726DOI Listing
July 2021

Cytotoxicity, metabolic enzyme inhibitory, and anti-inflammatory effect of Lentinula edodes fermented using probiotic lactobacteria.

J Food Biochem 2021 Jul 1:e13838. Epub 2021 Jul 1.

Department of Food Science and Biotechnology, Gwangju University, Gwangju, Republic of Korea.

We found that the fermented Lentinula edodes (FLE) products exhibited various differences in terms of proximate composition, free sugar, and amino acid. In particular, there were higher levels of ergosterol, and ergothioneine in FLE-Pediococcus pentosaceus (PP) and -Lactobacillus acidophilus (LA) than in the L. edodes (LE) products. The survival rates of lactic acid bacteria (LAB) strains on artificial gastric juice, artificial bile, or heat (50-60°C) were observed to vary from 60%-66%, 60%-66%, to 42%-79%, respectively. The FLE products up to 300 μg/ml had no cytotoxicity on RAW264.7, AGS, and RBL-2H3 cells, but inhibited the activities of α-amylase, α-glucosidase, and pancreatic lipase, as well as the production of nitrite, IL-1β, IL-4, TNF-α, and prostaglandin E2 (PGE2) from lipopolysaccharide (LPS)-induced inflammatory response. Our findings suggest that FLE products have metabolic enzyme inhibitory and anti-inflammatory effects. PRACTICAL APPLICATIONS: Fermentation plays a critical role in improving the functional and nutritional properties of food. In addition, lactobacteria are the main microorganisms involved in the fermentation of food known to have a variety of biological activities. Therefore, the utilization of lactobacteria for research and development of mushroom food materials can be used as a key strategy to improve the biological activity characteristics of mushroom food materials and to increase their active ingredient content. The present results show that FLE products had promising inhibitory efficacies against the activities of obesity-related metabolic enzymes and LPS-induced inflammatory response. These suggest that FLE products have the potential to be developed as functional probiotic dietary supplements or food products.
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http://dx.doi.org/10.1111/jfbc.13838DOI Listing
July 2021

Vascular cell-specific roles of mineralocorticoid receptors in pulmonary hypertension.

Pulm Circ 2021 Jul-Sep;11(3):20458940211025240. Epub 2021 Jun 18.

Pulmonary, Critical Care and Sleep Division, Tufts Medical Center, Boston, MA, USA.

Abnormalities that characterize pulmonary arterial hypertension include impairment in the structure and function of pulmonary vascular endothelial and smooth muscle cells. Aldosterone levels are elevated in human pulmonary arterial hypertension and in experimental pulmonary hypertension, while inhibition of the aldosterone-binding mineralocorticoid receptor attenuates pulmonary hypertension in multiple animal models. We explored the role of mineralocorticoid receptor in endothelial and smooth muscle cells in using cell-specific mineralocorticoid receptor knockout mice exposed to sugen/hypoxia-induced pulmonary hypertension. Treatment with the mineralocorticoid receptor inhibitor spironolactone significantly reduced right ventricular systolic pressure. However, this is not reproduced by selective mineralocorticoid receptor deletion in smooth muscle cells or endothelial cells. Similarly, spironolactone attenuated the increase in right ventricular cardiomyocyte area independent of vascular mineralocorticoid receptor with no effect on right ventricular weight or interstitial fibrosis. Right ventricular perivascular fibrosis was significantly decreased by spironolactone and this was reproduced by specific deletion of mineralocorticoid receptor from endothelial cells. Endothelial cell-mineralocorticoid receptor deletion attenuated the sugen/hypoxia-induced increase in the leukocyte-adhesion molecule, E-selectin, and collagen IIIA1 in the right ventricle. Spironolactone also significantly reduced pulmonary arteriolar muscularization, independent of endothelial cell-mineralocorticoid receptor or smooth muscle cell-mineralocorticoid receptor. Finally, the degree of pulmonary perivascular inflammation was attenuated by mineralocorticoid receptor antagonism and was fully reproduced by smooth muscle cell-specific mineralocorticoid receptor deletion. These studies demonstrate that in the sugen/hypoxia pulmonary hypertension model, systemic-mineralocorticoid receptor blockade significantly attenuates the disease and that mineralocorticoid receptor has cell-specific effects, with endothelial cell-mineralocorticoid receptor contributing to right ventricular perivascular fibrosis and smooth muscle cell-mineralocorticoid receptor participating in pulmonary vascular inflammation. As mineralocorticoid receptor antagonists are being investigated to treat pulmonary arterial hypertension, these findings support novel mechanisms and potential mineralocorticoid receptor targets that mediate therapeutic benefits in patients.
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http://dx.doi.org/10.1177/20458940211025240DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8216367PMC
June 2021

Enhancement of Photodetective Properties on Multilayered MoS Thin Film Transistors via Self-Assembled Poly-L-Lysine Treatment and Their Potential Application in Optical Sensors.

Nanomaterials (Basel) 2021 Jun 17;11(6). Epub 2021 Jun 17.

Department of Electronic Engineering, Incheon National University, Incheon 22012, Korea.

Photodetectors and display backplane transistors based on molybdenum disulfide (MoS) have been regarded as promising topics. However, most studies have focused on the improvement in the performances of the MoS photodetector itself or emerging applications. In this study, to suggest a better insight into the photodetector performances of MoS thin film transistors (TFTs), as photosensors for possible integrated system, we performed a comparative study on the photoresponse of MoS and hydrogenated amorphous silicon (a-Si:H) TFTs. As a result, in the various wavelengths and optical power ranges, MoS TFTs exhibit 2~4 orders larger photo responsivities and detectivities. The overall quantitative comparison of photoresponse in single device and inverters confirms a much better performance by the MoS photodetectors. Furthermore, as a strategy to improve the field effect mobility and photoresponse of the MoS TFTs, molecular doping via poly-L-lysine (PLL) treatment was applied to the MoS TFTs. Transfer and output characteristics of the MoS TFTs clearly show improved photocurrent generation under a wide range of illuminations (740~365 nm). These results provide useful insights for considering MoS as a next-generation photodetector in flat panel displays and makes it more attractive due to the fact of its potential as a high-performance photodetector enabled by a novel doping technique.
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http://dx.doi.org/10.3390/nano11061586DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8234691PMC
June 2021

Development of a Multidisciplinary Aerodigestive Program: An Institutional Experience.

Children (Basel) 2021 Jun 23;8(7). Epub 2021 Jun 23.

Department of Pediatrics, Severance Hospital, Institute of Allergy, Institute for Immunology and Immunological Diseases, Severance Biomedical Science Institute, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul 03722, Korea.

We share our experience on the implementation of a multidisciplinary aerodigestive program comprising an aerodigestive team (ADT) so as to evaluate its feasibility. We performed a retrospective chart review of the patients discussed at the monthly ADT meetings and analyzed the data. A total of 98 children were referred to the ADT during the study period. The number of cases increased steadily from 3.5 cases per month in 2019 to 8.5 cases per month in 2020. The median age of patients was 34.5 months, and 55% were male. Among the chronic comorbidities, neurologic disease was the most common (85%), followed by respiratory (36%) and cardiac (13%) disorders. The common reasons for consultation were suspected aspiration (56%), respiratory difficulty (44%), drooling/stertor (30%), regurgitation/vomiting (18%), and feeding/swallowing difficulty (17%). Following discussions, 58 patients received active interventions, including fundoplication, gastrostomy, laryngomicrosurgery, tracheostomy, and primary dilatation of the airway. According to the questionnaire of the caregiver, the majority agreed that the main symptoms and quality of life of patients had improved (88%), reducing the burden on caregivers (77%). Aerodigestive programs may provide comprehensive and multidisciplinary management for children with complex airway and digestive tract disorders.
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http://dx.doi.org/10.3390/children8070535DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8307318PMC
June 2021

Four new epigean spiders of the genus Cybaeus (Araneae: Cybaeidae) from South Korea.

Zootaxa 2021 May 5;4966(4):458468. Epub 2021 May 5.

Life and Environment Research Institute, Konkuk University, Seoul 05029, Republic of Korea.

The males of four new species of Cybaeus L. Koch, 1868 (Cybaeus yeongwolensis sp. nov., Cybaeus culter sp. nov., Cybaeus vanimaculatus sp. nov., and Cybaeus pseudoauriculatus sp. nov.) are described from leaf litter habitats in South Korea. We provide diagnoses, detailed descriptions, a key to the males of Korean Cybaeus species, and a distribution map for these new species. They appear to be endemic to South Korea and were collected from mixed forests in hilly and mountainous terrain.
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http://dx.doi.org/10.11646/zootaxa.4966.4.4DOI Listing
May 2021

Risk assessment of hepatocellular carcinoma and liver-related events using ultrasonography and transient elastography in patients with chronic hepatitis B.

J Viral Hepat 2021 Jun 29. Epub 2021 Jun 29.

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

Cirrhosis has prognostic value. We investigated whether the combined use of ultrasonography (US) and transient elastography (TE) to diagnose cirrhosis is beneficial for the risk assessment of hepatocellular carcinoma (HCC) and liver-related events in patients with chronic hepatitis B (CHB). 9,300 patients with CHB who underwent US and TE in two institutions between 2006 and 2018 were enrolled. TE value ≥13 kPa was set to indicate cirrhosis. Patients were divided into four groups: US(+)TE(+) (cirrhosis by US and TE), US(+)TE(-) (cirrhosis by US, but not by TE), US(-)TE(+) (cirrhosis by TE, but not by US), and US(-)TE(-) (non-cirrhosis by US and TE).The patients were predominantly male (n=5,474, 58.9%) with a mean age of 47.5 years. The proportions of patients with cirrhosis diagnosed by US and TE were 17.2% (n=1,595) and 13.2% (n=1,225), respectively. The proportion of patients with discordant results in diagnosing cirrhosis by US and TE was 18.7% (n=1,740). During follow-up (median: 60.0 months), HCC and LRE developed in 481 (5.2%) and 759 (8.2%) patients, respectively. The cumulative incidence rates of HCC and liver-related events were highest in the US(+)TE(+) group, intermediate-high in the US(-)TE(+) group, intermediate-low in the US(+)TE(-) group, and the lowest in the US(-)TE(-) group (overall P<0.001). Cirrhosis assessed using US and TE was a major predictor of HCC and liver-related events development in patients with CHB. Cirrhosis assessed using TE was better in predicting HCC or liver-related events than using US, when cirrhosis diagnosis was discordant by US and TE.
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http://dx.doi.org/10.1111/jvh.13560DOI Listing
June 2021

Hereditary Frontotemporal Dementia Linked to the Pathogenic p.L266V Variant of the MAPT Gene in Korea.

J Clin Neurol 2021 Jul;17(3):478-480

Department of Neurology, College of Medicine, Hanyang University, Seoul, Korea.

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http://dx.doi.org/10.3988/jcn.2021.17.3.478DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8242314PMC
July 2021

Evaluating an In-House Cell-Based Assay for Detecting Antibodies Against Muscle-Specific Tyrosine Kinase in Myasthenia Gravis.

J Clin Neurol 2021 Jul;17(3):400-408

Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.

Background And Purpose: Detecting antibodies against muscle-specific tyrosine kinase (MuSK Abs) is essential for diagnosing myasthenia gravis (MG). We applied an in-house cell-based assay (CBA) to detect MuSK Abs.

Methods: A stable cell line was generated using a lentiviral vector, which allowed the expression of MuSK tagged with green fluorescent protein in human embryonic kidney 293 (HEK293) cells. Serum and anti-human IgG antibody conjugated with red fluorescence were added. The presence of MuSK Abs was determined based on the fluorescence intensity and their colocalization in fluorescence microscopy. Totals of 218 serum samples collected from 177 patients with MG, 31 with other neuromuscular diseases, and 10 healthy controls were analyzed. The CBA results were compared with those of a radioimmunoprecipitation assay (RIPA) and an enzyme-linked immunosorbent assay (ELISA).

Results: The MuSK-HEK293 cell line stably expressed MuSK protein. The CBA detected MuSK Abs in 34 (19.2%) of 177 samples obtained from patients with MG and in none of the participants having other neuromuscular diseases or in the healthy controls. The clinical characteristics of the patients with MuSK MG determined based on the CBA were strongly correlated with known clinical features of MuSK MG. There was an almost perfect agreement between the results of the CBA and those of the RIPA (Cohen's kappa=0.880, <0.001) and ELISA (Cohen's kappa=0.982, <0.001).

Conclusions: The results of the in-house CBA showed excellent agreement with both the RIPA and ELISA. Our in-house CBA can be considered a reliable method for detecting MuSK Abs.
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http://dx.doi.org/10.3988/jcn.2021.17.3.400DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8242307PMC
July 2021

Clinical Outcomes of Neoadjuvant Chemotherapy in Colorectal Cancer Patients With Synchronous Resectable Liver Metastasis: A Propensity Score Matching Analysis.

Ann Coloproctol 2021 Jun 29. Epub 2021 Jun 29.

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

Purpose: The survival benefit of neoadjuvant chemotherapy (NAC) prior to surgical resection in colorectal cancer with liver metastases (CRCLM) patients remains controversial. The aim of this study was to compare overall outcome of CRCLM patients who underwent NAC followed by surgical resection versus surgical treatment first.

Methods: We retrospectively analyzed 429 patients with stage IV colorectal cancer with synchronous liver metastases who underwent simultaneous liver resection between January 2008 and December 2016. Using propensity score matching, overall outcome between 60 patients who underwent NAC before surgical treatment and 60 patients who underwent surgical treatment first was compared.

Results: Before propensity score matching, metastatic cancer tended to involve a larger number of liver segments and the primary tumor size was bigger in the NAC group than in the primary resection group, so that a larger percentage of patients in the NAC group underwent major hepatectomy (P<0.001). After propensity score matching, demographic features and pathologic outcomes showed no significant differences between the 2 groups. In addition, there was no significant difference in short-term recovery outcomes such as postoperative morbidity (P=0.603) and oncologic outcome, including 3-year overall survival rate (P=0.285) and disease-free survival rate (P=0.730), between the 2 groups.

Conclusion: NAC prior to surgical treatment in CRCLM is considered a safe treatment that does not increase postoperative morbidity, and its impact on oncologic outcome was not inferior.
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http://dx.doi.org/10.3393/ac.2020.00710.0101DOI Listing
June 2021

Predictability of early changes in derived neutrophil-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in patients with advanced non-small cell lung cancer treated with immune checkpoint inhibitors.

J Thorac Dis 2021 May;13(5):2824-2832

Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Background: As association between systemic inflammation and disease progression has been suggested, early changes in neutrophil-to-lymphocyte ratio (NLR) and derived NLR (dNLR) may have accurate predictability for prognosis in non-small cell lung cancer (NSCLC) treated with ICI therapy.

Methods: Complete blood count (CBC) was measured immediately before the first and second cycles of ICI therapy in patients with advanced NSCLC. Differences in NLR and dNLR were measured. When the increase in NLR was ≥1, the patient was classified into the increased NLR group. Similarly, when the increase in dNLR was ≥1, the patient was classified into the increased dNLR group; otherwise, they were classified into the non-increased NLR or dNLR group.

Results: A total of 89 patients was selected for evaluation. Median progression-free survival (PFS) was significantly shorter in the increased NLR group than in the non-increased NLR group (2.6 9.5 months, P<0.001). The increased dNLR group showed significantly shorter median PFS than the non-increased dNLR group (4.2 9.2 months, P=0.001). Association with PFS was analyzed using the Cox regression model. In model 1, increase ≥1 in NLR showed significant association (HR =3.085, 95% CI, 1.657-5.742, P<0.001). In model 2, increase ≥1 in dNLR showed significant association (HR =2.826, 95% CI, 1.436-5.561, P=0.003).

Conclusions: Early changes in dNLR were shown to have prognostic value in patients undergoing immunotherapy. It can be an accurate and a comprehensive biomarker for predicting ICI response.
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http://dx.doi.org/10.21037/jtd-20-3416DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8182547PMC
May 2021

Entecavir versus tenofovir in patients with chronic hepatitis B: Enemies or partners in the prevention of hepatocellular carcinoma.

Clin Mol Hepatol 2021 Jul 23;27(3):402-412. Epub 2021 Jun 23.

Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seou, Korea.

Over the past several decades, entecavir (ETV) and tenofovir disoproxil fumarate (TDF) have remained the first-line antiviral agents in several international guidelines. These two antiviral agents have shown similar short to intermediateterm efficacy, including virologic, biochemical, serologic, and histologic responses. However, huge controversies regarding the antiviral efficacy of ETV and TDF in preventing the development of hepatocellular carcinoma (HCC) still exist. In this review, we summarized recent studies that compared the treatment efficacy of ETV and TDF in terms of HCC development.
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http://dx.doi.org/10.3350/cmh.2021.0179DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8273642PMC
July 2021
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