Publications by authors named "So Yeon Lee"

287 Publications

Posterior repair versus no posterior repair for posterior vaginal wall prolapse resolved under simulated apical support at the time of native tissue apical suspension.

Int Urogynecol J 2021 Feb 26. Epub 2021 Feb 26.

Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, South Korea.

Introduction And Hypothesis: The aim of this study was to evaluate the impact of an adjuvant posterior repair (PR) on treatment outcomes of native tissue apical suspension.

Materials And Methods: This retrospective cohort study included 194 women who underwent iliococcygeus or uterosacral ligament suspension with or without PR for Pelvic Organ Prolapse Quantification (POPQ) stage 2-4 posterior vaginal wall prolapse that resolved under simulated preoperative apical support and who completed a 1-year follow-up. The primary outcome was composite surgical failure defined as the presence of vaginal bulge symptoms, descent of the vaginal apex more than one-third of the way into the vaginal canal (apical recurrence), anterior or posterior vaginal wall descent beyond the hymen (anterior or posterior recurrence), or retreatment for prolapse. Secondary outcomes included anatomical outcomes, perioperative outcomes, obstructed defecation, dyspareunia, and adverse events.

Results: One hundred thirty women underwent concomitant PR, and 64 did not. Surgical failure rates were significantly higher in the group not receiving PR than in the group receiving PR (29.7% vs. 12.3%, p < 0.01). Anatomically, anterior and apical recurrence was more common in the group not receiving PR (p < 0.05). Concomitant PR was associated with a longer operating time and more blood loss (p < 0.01). However, there were few adverse events related to PR, and the rates of de novo obstructed defecation and dyspareunia were low in both groups, with no significant difference between the groups.

Conclusion: Concomitant PR at the time of native tissue apical suspension may reduce the recurrence of symptomatic anterior and apical prolapse without significant morbidity.
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http://dx.doi.org/10.1007/s00192-021-04728-8DOI Listing
February 2021

sp. nov., isolated from the gut of the Korean turban shell, .

Int J Syst Evol Microbiol 2021 Feb 22. Epub 2021 Feb 22.

Department of Biology and Department of Life and Nanopharmaceutical Sciences, Kyung Hee University, Seoul 02447, Republic of Korea.

A novel Gram-stain-negative, coccus-shaped, aerobic and motile bacterial strain, designated S12M18, was isolated from the gut of the Korean turban shell, . Phylogenetic analysis based on 16S rRNA gene sequences showed that strain S12M18 belonged to the genus and had the highest 16S rRNA gene sequence similarity twith HDW-19 (98.63 %). The phylogenomic tree congruently verified that strain S12M18 occupies a taxonomic position within the genus . The OrthoANIu value between strain S12M18 and HDW-19 was 87.22 %. The major cellular fatty acid of strain S12M18 was summed feature 8 (C ω7 or C ω6). The major components of the polar lipids were phosphatidylcholine, phosphatidylglycerol and phosphatidylethanolamine. The predominant isoprenoid quinone was Q-10. The DNA G+C content was 57.8 mol%. The polyphasic analyses indicated that strain S12M18 represents a novel species of the genus , for which the name sp. nov. is proposed. The type strain is S12M18 (=KCTC 62742=JCM 33168).
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http://dx.doi.org/10.1099/ijsem.0.004711DOI Listing
February 2021

Different Characteristics of Childhood Asthma Related to Polyhexamethylene Guanidine Hydrochloride (PHMG) Exposure.

Ann Am Thorac Soc 2021 Feb 9. Epub 2021 Feb 9.

Asan Medical Center, Pediatrics, Seoul, Korea (the Republic of).

Rationale: Exposure to humidifier disinfectants (HDs) can increase the risk of asthma but the characteristics of HD-related asthma are currently unclear. Polyhexamethylene guanidine hydrochloride (PHMG)-containing HD was the most commonly used and the most frequently associated with HD-associated lung injury.

Objectives: To investigate the characteristics of PHMG-induced asthma.

Methods: This general population-based birth cohort study utilized data from the Panel Study of Korean Children from 2008 (n = 846). Spirometry, bronchial provocation tests, detailed history recording, and physical examinations were performed on seven-year-old patients (n=362). Exploratory analysis of plasma proteomics was performed.

Results: Compared with healthy control, FEV1 was the lowest in PHMG-exposed asthma group. (z score = -0.806; 95% CI, -1.492 to -0.119) The positive rate of bronchial hyperresponsiveness was lower in children with PHMG-exposed asthma compared to children with asthma without HD exposure (13.3% vs. 47.4%). Long-term exposure to low-intensity PHMG before age three was associated with asthma symptoms. Periostin was higher in asthma without HD exposure compared to the healthy control. The inducible T cell costimulator ligand and hepatocyte growth factor activator were lower in PHMG-exposed asthma compared to asthma without exposure. Hepatocyte growth factor activator a positive correlation with FVC (z-score) in asthma with PHMG exposure (r=0.78, P<0.01).

Conclusions: The asthma associated with low intensity exposure to PHMG is characterized by lower lung function, lower positive rates of bronchial hyperresponsiveness, and varied distributions of plasma proteins. These findings suggest that asthma related to PHMG exposure may constitute a different mechanism of asthma pathophysiology.
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http://dx.doi.org/10.1513/AnnalsATS.202007-807OCDOI Listing
February 2021

TFEB Supports Pancreatic Cancer Growth through the Transcriptional Regulation of Glutaminase.

Cancers (Basel) 2021 Jan 27;13(3). Epub 2021 Jan 27.

Department of Biomedical Sciences, Asan Medical Center, AMIST, University of Ulsan College of Medicine, Seoul 05505, Korea.

Transcription factor EB (TFEB) is a master regulator of lysosomal function and autophagy. In addition, TFEB has various physiological roles such as nutrient sensing, cellular stress responses, and immune responses. However, the precise roles of TFEB in pancreatic cancer growth remain unclear. Here, we show that pancreatic cancer cells exhibit a significantly elevated TFEB expression compared with normal tissue samples and that the genetic inhibition of TFEB results in a significant inhibition in both glutamine and mitochondrial metabolism, which in turn suppresses the PDAC growth both in vitro and in vivo. High basal levels of autophagy are critical for pancreatic cancer growth. The TFEB knockdown had no significant effect on the autophagic flux under normal conditions but interestingly caused a profound reduction in glutaminase (GLS) transcription, leading to an inhibition of glutamine metabolism. We observed that the direct binding of TFEB to the GLS and TFEB gene promotors regulates the transcription of GLS. We also found that the glutamate supplementation leads to a significant recovery of the PDAC growth that had been reduced by a TFEB knockdown. Taken together, our current data demonstrate that TFEB supports the PDAC cell growth by regulating glutaminase-mediated glutamine metabolism.
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http://dx.doi.org/10.3390/cancers13030483DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7865852PMC
January 2021

Molecular basis of IRGB10 oligomerization and membrane association for pathogen membrane disruption.

Commun Biol 2021 Jan 19;4(1):92. Epub 2021 Jan 19.

College of Pharmacy, Chung-Ang University, Seoul, 06974, Republic of Korea.

Immunity-related GTPase B10 (IRGB10) belongs to the interferon (IFN)-inducible GTPases, a family of proteins critical to host defense. It is induced by IFNs after pathogen infection, and plays a role in liberating pathogenic ligands for the activation of the inflammasome by directly disrupting the pathogen membrane. Although IRGB10 has been intensively studied owing to its functional importance in the cell-autonomous immune response, the molecular mechanism of IRGB10-mediated microbial membrane disruption is still unclear. In this study, we report the structure of mouse IRGB10. Our structural study showed that IRGB10 bound to GDP forms an inactive head-to-head dimer. Further structural analysis and comparisons indicated that IRGB10 might change its conformation to activate its membrane-binding and disruptive functions. Based on this observation, we propose a model of the working mechanism of IRGB10 during pathogen membrane disruption.
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http://dx.doi.org/10.1038/s42003-020-01640-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7815755PMC
January 2021

Interaction of the TLR4 rs1927911 polymorphism with house dust mite sensitization in allergic rhinitis with its prognosis.

Asian Pac J Allergy Immunol 2021 Jan 2. Epub 2021 Jan 2.

Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Background: Sensitization to the house dust mite (HDM) plays important roles in the development of allergic rhinitis (AR). Toll-like receptor 4 (TLR4) is a key initiator of the innate immune system upon exposure to environmental factors.

Objective: The present study investigated the independent and interaction effects of HDM sensitization and TLR4 rs1927911 polymorphism on AR and its prognosis in children.

Methods: This study included 2,929 children (mean age, 7.8 yrs) from the Children's HEalth and Environmental Research study (CHEER), a prospective study with a 2-year-interval for 4 years. An ISAAC questionnaire was used with skin prick tests in all subjects. TaqMan genotyping was performed for TLR4 (rs1927911) polymorphism in 1,024 children.

Results: HDM sensitization increased risk of current AR (aOR, 2.50; 95% CI, 1.41-4.41; P for interaction = 0.005), current asthma at follow-up (aOR, 4.63; 95% CI, 2.41-8.88; P for interaction < 0.001) and allergic march (aOR, 2.57; 95% CI, 1.06-6.22; P for interaction = 0.002) by interacting with genotypes of TLR4 (rs1927911). HDM sensitization increased risk of persistence (aOR, 4.17; 95% CI, 1.77-9.83) and new diagnosis of AR (aOR, 2.48; 95% CI, 1.10-5.61), new sensitization to inhalant allergens (aOR, 10.67; 95% CI, 5.83-19.54), and new development of bronchial hyper-responsiveness (aOR, 5.29; 95% CI, 2.29-12.21) in children with CC genotype of TLR4 rs1927911.

Conclusions: HDM sensitization affects AR and its prognosis by interacting with TLR4 rs1957911 polymorphism. The preventive and therapeutic strategies for AR in children need to be targeted in accordance with genetic susceptibility with HDM sensitization.
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http://dx.doi.org/10.12932/AP-170820-0943DOI Listing
January 2021

sp. nov., isolated from the intestine of the dark diving beetle, .

Int J Syst Evol Microbiol 2021 Jan 8;71(1). Epub 2020 Dec 8.

Department of Biology and Department of Life and Nanopharmaceutical Sciences, Kyung Hee University, Seoul 02447, Republic of Korea.

A polyphasic taxonomic approach was used to characterize a novel bacterium, designated as strain HDW20, isolated from the intestine of the dark diving beetle . The isolate was Gram-stain-positive, facultatively anaerobic, non-motile, coccus-shaped, and formed pale orange colonies. Phylogenetic analysis based on 16S rRNA gene sequences and genome sequences showed that the isolate belonged to the genus in the phylum and was closely related to SST-39, JCM 17540, and NSG39, with the highest 16S rRNA gene sequence similarity of 98.5 % and a highest average nucleotide identity (ANI) value of 80.6 %. The major cellular fatty acids were C9 and anteiso-C. The main respiratory quinone was MK-9 (H). The major polar lipid components were phosphatidylglycerol and diphosphatidylglycerol. The genomic DNA G+C content was 69.0 %. The isolate contains ʟʟ-diaminopimelic acid, ʟ-alanine, and ʟ-lysine as amino acid components, and ribose, glucose, and galactose as sugar components of the cell wall peptidoglycan. The results of phylogenetic, phenotypic, chemotaxonomic, and genotypic analyses suggested that strain HDW20 represents a novel species within the genus . We propose the name sp. nov. The type strain is HDW20 (=KACC 21348=KCTC 49324=JCM 33674).
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http://dx.doi.org/10.1099/ijsem.0.004588DOI Listing
January 2021

The crystal structure of mouse IRG1 suggests that cis-aconitate decarboxylase has an open and closed conformation.

PLoS One 2020 1;15(12):e0242383. Epub 2020 Dec 1.

College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea.

Protein Data Bank Accession Codes: Coordinate and structural factors were deposited with the Protein Data Bank under PDB ID: 7BR9.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0242383PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7707506PMC
January 2021

Characteristics of Exposure to Chloromethylisothiazolinone (CMIT) and Methylisothiazolinone (MIT) among Humidifier Disinfectant-Associated Lung Injury (HDLI) Patients in South Korea.

Molecules 2020 Nov 12;25(22). Epub 2020 Nov 12.

Division of Environmental Science and Ecological Engineering, Korea University, Seoul 02841, Korea.

This study aimed to quantify both chloromethylisothiazolinone (CMIT) and methylisothiazolinone (MIT) dissolved in different product brands and to characterize the exposure to these chemicals among humidifier disinfectant-associated lung injury (HDLI) patients. Both CMIT and MIT dissolved in different humidifier disinfectant (HD) products were quantified using gas chromatography-mass spectrometry. The inhalation level of CMIT and MIT was estimated based on HD-associated factors as reported by HDLI patients. A total of eleven HD products marketed until the end of 2011 were found to contain CMIT and/or MIT. The level of combined CMIT and/or MIT dissolved in these HD products ranged from 12 to 353 ppm. The level varied among HD products and the year of manufacture. The average inhalation levels were estimated to be 7.5, 4.1, and 3.2 μg/m for the definite, probable, and possible groups, respectively. If probable and possible groups were collapsed together, the inhalation level of the collapsed group was significantly different from that of the definite group ( < 0.001). All HDLI patients responded as having used HD not only while sleeping, but also as having a humidifier treated with HD within close proximity every day in insufficiently ventilated spaces. These HD use characteristics of patients may be directly/indirectly linked to the HDLI development.
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http://dx.doi.org/10.3390/molecules25225284DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7697974PMC
November 2020

Gut linoleic acid is associated with the severity of atopic dermatitis and sensitization to egg white/milk in infants.

Pediatr Allergy Immunol 2021 Feb 27;32(2):382-385. Epub 2020 Oct 27.

Department of Pediatrics, Childhood Asthma and Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

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http://dx.doi.org/10.1111/pai.13393DOI Listing
February 2021

A high-resolution (1.2 Å) crystal structure of the anti-CRISPR protein AcrIF9.

FEBS Open Bio 2020 Dec 5;10(12):2532-2540. Epub 2020 Nov 5.

Department of Global Innovative Drugs, Graduate School of Chung-Ang University, Seoul, Korea.

Prokaryotic adaptive immunity by CRISPR-Cas systems, which confer resistance to foreign genetic elements, has been used by bacteria to combat viruses. To cope, viruses evolved multiple anti-CRISPR proteins, which can inhibit system function through various mechanisms. Although the structures and mechanisms of several anti-CRISPR proteins have been elucidated, those of the AcrIF9 family have not yet been identified. To understand the molecular basis underlying AcrIF9 anti-CRISPR function, we determined the 1.2 Å crystal structure of AcrIF9. Structural and biochemical studies showed that AcrIF9 exists in monomeric form in solution and can directly interact with DNA using a positively charged cleft. Based on analysis of the structure, we suggest part of the anti-CRISPR molecular mechanism by AcrIF9.
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http://dx.doi.org/10.1002/2211-5463.12986DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7714069PMC
December 2020

A 1.3 Å high-resolution crystal structure of an anti-CRISPR protein, AcrI E2.

Biochem Biophys Res Commun 2020 Dec 25;533(4):751-757. Epub 2020 Sep 25.

Department of Global Innovative Drugs, Graduate School of Chung-Ang University, Seoul, 06974, Republic of Korea; College of Pharmacy, Chung-Ang University, Seoul, 06974, Republic of Korea. Electronic address:

As a result of bacterial infection with viruses, bacteria have developed CRISPR-Cas as an adaptive immune system, which allows them to destroy the viral genetic material introduced via infection. However, viruses have also evolved to develop multiple anti-CRISPR proteins, which are capable of inactivating the CRISPR-Cas adaptive immune system to combat bacteria. In this study, we aimed to elucidate the molecular mechanisms associated with anti-CRISPR proteins by determining a high-resolution crystal structure (1.3 Å) of Type I-E anti-CRISPR protein called AcrIE2. Our structural analysis revealed that AcrIE2 was composed of unique folds comprising five antiparallel β-sheets (β1∼β5) surrounding one α-helix (α1) in the order, ββαβββ. Structural comparison of AcrIE2 with a structural homolog called AcrIF9 showed that AcrIE2 contained a long and flexible β4-β5 connecting loop and a distinct surface feature. These results indicated that the inhibitory mechanism of AcrIE2 might be different from that of AcrIF9. This unique structure of AcrIE2 indicates its special mode of CRISPR-Cas inhibitory activity. Therefore, this study helps us understand the diversity in the inhibitory mechanisms of Acr family.
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http://dx.doi.org/10.1016/j.bbrc.2020.09.067DOI Listing
December 2020

Prenatal PM exposure and vitamin D-associated early persistent atopic dermatitis via placental methylation.

Ann Allergy Asthma Immunol 2020 12 21;125(6):665-673.e1. Epub 2020 Sep 21.

Department of Pediatrics, Childhood Asthma Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. Electronic address:

Background: The effects of prenatal particulate matter with an aerodynamic diameter ranging from 0.1 μm to 2.5 μm (PM) and vitamin D on atopic dermatitis (AD) phenotypes have not been evaluated. DNA methylation and cord blood (CB) vitamin D could represent a plausible link between prenatal PM exposure and AD in an offspring.

Objective: To determine the critical windows of prenatal PM exposure on the AD phenotypes, if vitamin D modulated these effects, and if placental DNA methylation mediated these effects on AD in offspring.

Methods: Mother-child pairs were enrolled from the birth cohort of the Cohort for Childhood Origin of Asthma and allergic diseases (COCOA) study. PM was estimated by land-use regression models, and CB vitamin D was measured by chemiluminescence immunoassay. AD was identified by the parental report of a physician's diagnosis. We defined the following 4 AD phenotypes according to onset age (by the age of 2 years) and persistence (by the age of 3 years): early-onset transient and persistent, late onset, and never. Logistic regression analysis and Bayesian distributed lag interaction model were used. DNA methylation microarray was analyzed using an Infinium Human Methylation EPIC BeadChip (Illumina, San Diego, California) in placenta.

Results: PM exposure during the first trimester of pregnancy, especially during 6 to 7 weeks of gestation, was associated with early-onset persistent AD. This effect increased in children with low CB vitamin D, especially in those with PM exposure during 3 to 7 weeks of gestation. AHRR (cg16371648), DPP10 (cg19211931), and HLADRB1 (cg10632894) were hypomethylated in children with AD with high PM and low CB vitamin D.

Conclusion: Higher PM during the first trimester of pregnancy and low CB vitamin D affected early-onset persistent AD, and the most sensitive window was 6 to 7 weeks of gestation. Placental DNA methylation mediated this effect.
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http://dx.doi.org/10.1016/j.anai.2020.09.008DOI Listing
December 2020

Evaluation of the InnoTyper21® system for the applications into trace and degraded DNA in the Korean population.

Int J Legal Med 2020 Nov 14;134(6):2053-2059. Epub 2020 Sep 14.

Department of Forensic Sciences, Graduate School of Sungkyunkwan University, Suwon, Republic of Korea.

The InnoTyper 21® Human Identification kit consists of amelogenin and 20 bi-allelic Alus, retrotransposon markers existing abundantly in human genome. The InnoTyper 21® kit produces shorter amplicons (60-125 bp) than conventional short tandem repeat (STR) genotyping kit, then it is effective on the analysis of challengeable forensic samples including insufficient or highly degraded DNAs. Also, as the genotyping with InnoTyper21® kit is compatible with PCR and capillary electrophoresis, it is easy to incorporate into the workflow in forensic laboratories. In the internal validation of InnoTyper21® kit on sensitivity, degradation, and mixture studies for the evaluation in this study, we acquired full profiles on analyzing small concentration DNA (as low as 25 pg) and highly degraded DNA (up to 105 degradation index value). Through the Korean population study, forensic statistical parameters were investigated and a specific variant of T insertion in NBC51 was confirmed in six samples. Comparison of Korean population with five populations or 1000 Genomes Project data show Korean specific substructure. It is expected that the InnoTyper 21® kit will be used into the actual forensic cases, utilizing the population study investigated through this research.
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http://dx.doi.org/10.1007/s00414-020-02429-3DOI Listing
November 2020

sp. nov., isolated from the faeces of the oriental stork, .

Int J Syst Evol Microbiol 2020 Oct 4;70(10):5439-5444. Epub 2020 Sep 4.

Department of Life and Nanopharmaceutical Sciences and Department of Biology, Kyung Hee University, Seoul 130-701, Republic of Korea.

A novel Gram-stain-positive, non-motile, non-spore-forming, coccobacillus-shaped, strictly aerobic bacterium, designated strain H23T48, was isolated from the faecal sample of an oriental stork collected from the Seoul Grand Park Zoo in Seoul, Republic of Korea. Optimal growth of strain H23T48 was observed at 30-37 °C, pH 8 and with 3 % (w/v) NaCl. 16S rRNA gene sequence-based phylogenetic analysis revealed that strain H23T48 was closely related to the genus , with 97.0 and 96.7 % sequence similarities to EBR4-1-2 and H5, respectively. Strain H23T48 possessed MK-9(H) as the major menaquinone and C (42.4 %), C9 (31.3 %) and C (17.7 %) as the major cellular fatty acids. The polar lipids included phosphatidylglycerol, two unidentified lipids, six unidentified phospholipids and two unidentified glycophospholipids. The amino acid composition of the cell-wall peptidoglycan was l-alanine, l-lysine, d-glutamic acid, l-aspartic acid and glycine. The genomic G+C content of strain H23T48 is 59.5 mol% and the average nucleotide identity value between H23T48 and KCT C33148 (=EBR4-1-2) is 75.5 %. Based on the obtained data, strain H23T48 represents a novel species of the genus , for which the name sp. nov. is proposed. The type strain is H23T48 (=KCTC 49253=JCM 33282).
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http://dx.doi.org/10.1099/ijsem.0.004435DOI Listing
October 2020

A multicenter anaphylaxis registry in Korea: Clinical characteristics and acute treatment details from infants to older adults.

World Allergy Organ J 2020 Aug 11;13(8):100449. Epub 2020 Aug 11.

Department of Pediatrics, Ajou University School of Medicine, Suwon, South Korea.

Background: Although the prevalence of anaphylaxis is increasing worldwide, the large-scale studies in Asia evaluating anaphylaxis in all age groups are limited. We aimed to collect more precise and standardized data on anaphylaxis in Korea using the first multicenter web-based registry.

Methods: Twenty-two departments from 16 hospitals participated from November 2016 to December 2018. A web-based case report form, designed by allergy specialists, was used to collect anaphylaxis data.

Results: Within the 2-year period, 558 anaphylaxis cases were registered. The age of registered patients ranged from 2 months to 84 years, and 60% were aged <18 years. In children and adolescents, foods (84.8%) were the most common cause of anaphylaxis, followed by drugs (7.2%); in adults, drugs (58.3%) were the most common cause, followed by foods (28.3%) and insect venom (8.1%). The onset time was ≤10 min in 37.6% of patients. Among the 351 cases registered via the emergency department (ED) of participating hospitals, epinephrine was administered to 63.8% of patients. Among those receiving epinephrine in the ED, 13.8% required 2 or more epinephrine shots. Severe anaphylaxis accounted for 23.5% cases (38.1% in adults; 13.7% in children); patients with drug and insect venom-induced anaphylaxis had higher rates of severe anaphylaxis.

Conclusion: This multicenter registry provides data on anaphylaxis for all age groups for the first time in Asia. The major causes and severity of anaphylaxis were remarkably different according to age group, and the acute treatment features of anaphylaxis in the EDs were examined in detail.
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http://dx.doi.org/10.1016/j.waojou.2020.100449DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7426446PMC
August 2020

Prognosis Prediction in Initially Diagnosed Multiple Myeloma Patients Using Intravoxel Incoherent Motion-Diffusion Weighted Imaging and Multiecho Dixon Imaging.

J Magn Reson Imaging 2021 Feb 19;53(2):491-501. Epub 2020 Aug 19.

Department of Hematology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Background: Multiparametric MRI provides complementary information for the diagnosis and management of multiple myeloma (MM).

Purpose: To evaluate the association of prognostic factors of MM and parameters derived from intravoxel-incoherent motion diffusion-weighted imaging (IVIM-DWI) and multiecho (ME) Dixon.

Study Type: Retrospective.

Population: In all, 78 MM patients.

Field Strength/sequences: T -weighted turbo spin-echo sequences (TSE), IVIM-DWI, ME 3D gradient echo sequence with multistep adaptive fitting at 3T.

Assessment: The region of interest (ROI) on the vertebral body was independently measured on four parametric maps (D , D and perfusion fraction [f], and proton-density fat-fraction [Ff] maps) by two readers. All patients were categorized into three groups based on the International Staging System (ISS).

Statistical Tests: Three groups were compared using analysis of variance (ANOVA) and post-hoc tests with Bonferroni correction. Logistic regression analysis was performed to predict the advancement of disease (early vs. advanced). Principal component analysis (PCA) was used to find the deterministic parameters.

Results: D and Ff were significantly different among ISS-1 (n = 38), ISS-2 (n = 22), and ISS-3 (n = 18) groups in both readers: 0.36, 0.41, and 0.58 × 10 mm /s for D (P < 0.05), and 46%, 30%, and 15% for Ff (P < 0.05) in reader 1; 0.34, 0.41, and 0.58 × 10 mm /s for D (P < 0.05), 43%, 27%, and 13.2% for Ff (P < 0.05) in reader 2, respectively. D between ISS-3 and the other groups was significantly different in one reader only: 2.03, 2.29, and 2.85 × 10 mm /s (P < 0.05). There was no significant difference in f among the groups in both readers. Logistic regression by stepwise selection indicated Ff as the single most significant factor for differentiating early and advanced stages of MM with an accuracy of 76% and area under the curve (AUC) of 0.83 (P < 0.05). PCA revealed Ff, and D as the deterministic parameters, with a cumulative proportion of 0.84.

Data Conclusion: D and Ff are associated with the prognostic factor of MM. Level of Evidence 3 Technical Efficacy Stage 5. J. MAGN. RESON. IMAGING 2021;53:491-501.
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http://dx.doi.org/10.1002/jmri.27321DOI Listing
February 2021

Ultrasound evaluation of postsurgical shoulder after rotator cuff repair: comparison of clinical results.

Acta Radiol 2020 Aug 16:284185120948494. Epub 2020 Aug 16.

Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Background: The relationship between the imaging parameters on postoperative ultrasound (US) other than repaired tendon integrity with clinical outcome such as postoperative residual pain has not been well defined.

Purpose: To investigate whether the repaired tendon thickness and subdeltoid fluid collection after rotator cuff repair are correlated with early postoperative clinical outcome.

Material And Methods: This retrospective study included 54 patients who underwent repair of the arthroscopic rotator cuff either by suture-bridge or single-row technique and postoperative US. We assessed the relationship between the sonographic parameters, including repaired supraspinatus tendon thickness and subdeltoid fluid collection, with the clinical outcome represented by the Korean Shoulder Scoring system (KSS) score using correlation coefficients (R). Also, the subgroup analysis was done to assess the differences by surgical technique and patients' age.

Results: There was a significant inverse relationship between the amount of subdeltoid fluid collection and degree of self-assessed pain improvement of the patients ( < 0.05), although every KSS category showed statistically insignificant tendency of inverse relationship with the fluid thickness. However, there was no statistically significant relationship between the thickness of repaired supraspinatus tendon and KSS scores. In patients aged >60 years, a statistically significant inverse relationship between thickness of subdeltoid fluid collection and difference value of the KSS scores in category of function was observed with both interpreters ( = 0.015 and  = 0.04, respectively).

Conclusion: Subdeltoid fluid collection measured on US after repair of the arthroscopic rotator cuff in the early postoperative period has significant association with the patients' subjective clinical outcome.
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http://dx.doi.org/10.1177/0284185120948494DOI Listing
August 2020

Quercitrin, the Main Compound in , Mitigates Skin Lesions in a Mouse Model of 2,4-Dinitrochlorobenzene-Induced Contact Hypersensitivity.

Evid Based Complement Alternat Med 2020 9;2020:4307161. Epub 2020 Jul 9.

College of Pharmacy, Pusan National University, Busan 46241, Republic of Korea.

Hapten-induced contact hypersensitivity (CHS) is widely utilized to induce immune activation in animal models of allergic contact dermatitis. Our previous findings suggested that the 95% EtOH extract of (L.) C. A. Mey. has antiallergic and anti-inflammatory effects in DNCB-treated CHS SKH-1 hairless mice. The aim of this study was to evaluate the protective effects of compounds isolated from the EtOAc fraction of in RBL-2H3 cells and 2,4-dinitrochlorobenzene- (DNCB-) induced CHS mice. Of eight compounds in , that is, umbelliferone, daphnoretin, wikstrocoumarin, (+)-syringaresinol, tricin, (+)-lariciresinol, -guaiacylglycerol--coniferyl ether, and quercitrin, quercitrin exhibited the most antiallergic activity against antigen-induced -hexosaminidase release and IL-4 mRNA expression, which are markers of degranulation in RBL-2H3 cells. After a 7-sensitizing period, 14 days of DNCB treatment with or without topical pimecrolimus (1%) or quercitrin (0.5%) treatment, quercitrin was found to suppress DNCB-induced increases in serum IL-4 and IgE concentrations and transepidermal water loss. These results indicate that quercitrin has therapeutic potential for treatment of allergies and allergy-related contact dermatitis.
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http://dx.doi.org/10.1155/2020/4307161DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7368186PMC
July 2020

Enzymatic reaction mechanism of cis-aconitate decarboxylase based on the crystal structure of IRG1 from Bacillus subtilis.

Sci Rep 2020 07 9;10(1):11305. Epub 2020 Jul 9.

College of Pharmacy, Chung-Ang University, Seoul, 06974, Republic of Korea.

Itaconate, which is formed by decarboxylation of cis-aconitate-an intermediate metabolite in the tricarboxylic acid cycle-has been used as a building block in polymer synthesis and is an important chemical in several biomedical and industrial applications. Itaconate is an immunometabolite with antibacterial, antiviral, immunoregulatory, and tumor-promoting activities. Recent focus has been on the role of itaconate in the field of immunology, with immune-responsive gene 1 (IRG1) being identified as the cis-aconitate decarboxylase responsible for itaconate production. We solved the structure of IRG1 from Bacillus subtilis (bsIRG1) and showed that IRG1 adopts either a closed or an open conformation; bsIRG1 was in the open form. A1 and A2 loops around the active site are flexible and can control the formation of the open and closed forms of IRG1. An in silico docking simulation showed that only the open form of IRG1 can accommodate the substrate. The most energetically favorable position of cis-aconitate in the active site of bsIRG1 involved the localization of C2 and C5 of cis-aconitate into the H102 region and H151 region of bsIRG1, respectively. Based on the structural study of bsIRG1, compared with IDS epimerase, and in silico docking simulation, we proposed two tentative enzymatic reaction mechanisms of IRG1, a two-base model and a one-base model.
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http://dx.doi.org/10.1038/s41598-020-68419-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7347537PMC
July 2020

Quantile regression analysis of the socioeconomic inequalities in air pollution and birth weight.

Environ Int 2020 09 23;142:105875. Epub 2020 Jun 23.

Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea. Electronic address:

Background: An association between maternal exposure to air pollution and the birth weight distribution has been reported, but the extent to which this relationship varies according to socioeconomic status (SES) is unknown. This study examined the relationship using the data from a Korean birth cohort.

Methods: Data for singleton births in Seoul from 2007 to 2017 (n = 1739) were analyzed. Maternal exposures to particulate matter with an aerodynamic diameter <10 µm (PM) and <2.5 µm (PM), as well as to nitrogen dioxide (NO) and ozone (O) for each trimester and the entire pregnancy were estimated using residential address, gestational age, and the birth date. The associations between the interquartile range (IQR) increases in pollutant concentrations and the changes in birth weight were examined using linear regression and quantile regression models. The socioeconomic disparities in the associations were investigated using a derived SES variable based on the composite of parental education and occupation. This SES variable was then interacted with the air pollutant.

Results: In the gestational age-adjusted models, particulate air pollutants (PM and PM) and O were associated with birth weight decreases for the lower birth weight percentiles. For example, the decrease in mean birthweight per IQR increase in PM during second trimester was -21.1 g (95% confidence interval (CI) = -41.8, -0.4), whereas the quantile-specific associations were: 10th percentile -27.0 g (95% CI = -46.6, -7.3); 50th percentile -22.2 g (95% CI = -39.6, -4.8); and 90th percentile -22.9 g (95% CI = -45.5, -0.2). Particulate air pollutants and O showed a pattern of socioeconomic inequalities; the reduced birth weight was of greater magnitude for children from a low SES group.

Conclusions: Negative associations between particulate air pollutants and O and birth weight were consistently greater at the lower quantiles of the birth weight distribution, especially in lower SES group.
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http://dx.doi.org/10.1016/j.envint.2020.105875DOI Listing
September 2020

Vegetable dietary pattern may protect mild and persistent allergic rhinitis phenotype depending on genetic risk in school children.

Pediatr Allergy Immunol 2020 11 9;31(8):920-929. Epub 2020 Jul 9.

Department of Pediatrics, Childhood Asthma Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Background: The effect of diet on allergic rhinitis (AR), its severity in children, and whether it modifies AR depending on genetic susceptibility are unknown. We investigated the association between dietary patterns and AR in school children and the influence of diet on AR according to a genetic risk score (GRS).

Methods: Totally, 435 7-year-old school children were recruited from the Panel Study on Korean Children. We used dietary patterns (vegetable, sugar, and meat) and dietary inflammatory index (DII) as dietary parameters. AR and its severity were defined by questionnaires about treatment in the previous 12 months and the Allergic Rhinitis and its Impact on Asthma (ARIA) guideline, respectively. A GRS was calculated using 6 single nucleotide polymorphisms for allergic diseases.

Results: A vegetable diet containing a lot of anti-inflammatory nutrients and higher vitamin D level in blood were negatively correlated, while DII was positively correlated with triglyceride level and triglyceride/HDL cholesterol. Vegetable diet (aOR, 95% CI = 0.73, 0.58-0.94) and DII (1.13, 1.01-1.28) were associated with AR risk. In particular, a high-vegetable diet resulted in a lower risk of mild and persistent AR (aOR, 95% CI = 0.24, 0.10-0.56) while a high DII represented a higher risk (2.33, 1.06-5.10). The protective effect of vegetable diet on AR appeared only among children with a lower GRS (adjusted P = .018).

Conclusions: A vegetable dietary pattern characterized by high intake of anti-inflammatory nutrients and higher vitamin D level in blood might be associated with a lower risk of mild and persistent AR. This beneficial effect is modified by a genetic factor.
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http://dx.doi.org/10.1111/pai.13308DOI Listing
November 2020

TNF-α (rs1800629) polymorphism modifies the effect of sensitization to house dust mite on asthma and bronchial hyperresponsiveness in children.

Exp Mol Pathol 2020 08 20;115:104467. Epub 2020 May 20.

Department of Pediatrics, Childhood Asthma Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. Electronic address:

Asthma is a complex disease, with various genetic and environmental factors implicated in its development. Sensitization to the house dust mite (HDM) is closely linked with the development of respiratory allergies, including asthma. However, some children sensitized to HDM do not complain of any symptoms of respiratory allergies, even though HDM is correlated with an increased risk for developing asthma, suggesting the involvement of other factors. Tumor necrosis factor (TNF)-α is associated with the pathophysiologies of asthma in combination with its genetic polymorphism. The aim of the present study was to elucidate the associations between sensitization to HDM, polymorphism of TNF-α rs1800629, and asthma/bronchial hyperresponsiveness (BHR). Our results revealed that sensitization to HDM is associated with asthma diagnosis in lifetime, current asthma, and BHR in Korean children. Furthermore, the genetic polymorphism of TNF-a rs1800629 was found to modify and interact with these associations. This study suggests that prevention strategies for childhood asthma need to be targeted according to genetic susceptibility.
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http://dx.doi.org/10.1016/j.yexmp.2020.104467DOI Listing
August 2020

Prenatal maternal anxiety promotes atopic dermatitis in offspring via placental DNA methylation changes.

Asian Pac J Allergy Immunol 2020 May 17. Epub 2020 May 17.

Department of Pediatrics, Childhood Asthma Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Background: Maternal anxiety during pregnancy has been previously reported to be associated with atopic dermatitis (AD) in offspring. The potential mechanism is not yet proven but epigenetic change may be suggested.

Objective: We examined whether maternal anxiety during pregnancy may alter placental DNA methylation, then develop AD in the offspring.

Methods: We evaluated maternal anxiety at 36 weeks of gestation by self-reported questionnaires, the State-Trait Anxiety Inventory-Trait subscale (STAI-T), in the Cohort for Childhood Origin of Asthma and Allergic Diseases (COCOA) study. AD was diagnosed at 6 months of age by pediatric allergists. We stratified the subjects into four groups according to the STAI score of mothers and diagnosis of AD in children. Placental genome-wide methylation microarray was analyzed using Infinium 450K BeadChip and selected genes were validated by pyrosequencing.

Results: From microarray, several differential methylation sites were identified in AD and healthy subjects and in total subjects, regarding to the STAI scores. Among differential methylation sites in microarray, six sites were selected for pyrosequencing. And site of matrix metalloproteinases 27 (MMP27) among 6 sites showed decreased methylation in AD infants with high STAI mothers compared to healthy infants with low STAI mothers.

Conclusions: Epigenetic change in placenta can be a suggesting mechanism for the development of AD in offspring at 6 months of age associated with maternal anxiety during pregnancy and MMP27 may be a candidate gene.
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http://dx.doi.org/10.12932/AP-221119-0699DOI Listing
May 2020

Usefulness of Optical Coherence Tomography Angiography in the Differential Diagnosis Between Superior Segmental Optic Hypoplasia and Normal-tension Glaucoma.

J Glaucoma 2020 08;29(8):718-722

Department of Ophthalmology, Nune Eye Hospital, Seoul, Republic of Korea.

Purpose: The differential diagnosis of superior segmental optic hypoplasia (SSOH) and normal-tension glaucoma (NTG) is an issue in the ophthalmologic field. To date, several modalities have been developed to solve this issue; however, no standard methods have been established. Recently, optical coherence tomography angiography (OCTA) has been introduced to better evaluate the volumetric angiography images. Therefore, in this study, we investigated the usefulness of OCTA in differentiating between SSOH and NTG.

Materials And Methods: In this retrospective study, we included 26 patients with SSOH who had definite visual field defects and 40 patients with NTG who had only inferior visual field defects. Age, sex, intraocular pressure, refractive error, retinal nerve fiber layer thickness, and visual field defects were compared between the groups. In addition, we analyzed and compared the peripapillary vessel density (VD) measured on OCTA between the groups. The area under the receiver operating characteristic curves were obtained for each parameter.

Results: On Cirrus HD-OCT, the retinal nerve fiber layer in patients with SSOH was thinner in the superonasal segment and thicker in the superotemporal segment compared with patients with NTG. In the analysis of OCTA, the peripapillary VD of the superonasal segment was significantly lower in the SSOH group than in the NTG group, while it was significantly higher in the superotemporal segment in the SSOH group than in the NTG group. The optimal superonasal-to-superotemporal ratio cutoff was 0.8828, with a sensitivity of 95% and specificity of 92.3%, for the diagnosis of SSOH (area under the receiver operating characteristic curve=0.962).

Conclusions: Our findings suggest that the superonasal-to-superotemporal VD ratio measured on OCTA may be used to distinguish between SSOH and NTG. However, further large-scale studies are required to verify our findings.
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http://dx.doi.org/10.1097/IJG.0000000000001530DOI Listing
August 2020

sp. nov., isolated from the faeces of an Oriental stork.

Int J Syst Evol Microbiol 2020 May;70(5):3247-3254

Department of Biology and Department of Life and Nanopharmaceutical Sciences, Kyung Hee University, Seoul 02447, Republic of Korea.

A novel, Gram-stain-positive, non-spore-forming, facultatively anaerobic bacterium, designated strain H21T32, was isolated from the faeces of an Oriental stork, . Cells formed cocci grouped in pairs, tetrads or conglomerates, and colonies on solid medium were pale yellow. Strain H21T32 belonged to the genus , family , order and class . The 16S rRNA gene sequences of the strain showed 97.06-97.34, 96.17-96.31 and 95.93-96.07 % similarity to the type strains of , and , respectively. The strain grew at 10-37 °C (optimum temperature: 30 °C), with 0-7 % (w/v) NaCl (optimum salinity: 0.5 %) and at pH 7-9 (optimum pH: 8). The main cellular fatty acids were C9, C9 and C. The major polar lipids were diphosphatidylglycerol and phosphatidylglycerol. Respiratory quinones were not detected. Sugar components of the peptidoglycan were rhamnose, ribose and glucose. Amino acid components of the cell wall were l-alanine, d-glucose, l-lysine, glycine and aspartic acid. The DNA G+C content of the strain was 37.1 mol%. Average nucleotide identity between strain H21T32 and CECT 9157 was 77.02 %, confirming that strain H21T32 represents a novel species of the genus , for which the name sp. nov. is proposed. The type strain is H21T32 (=KCTC 33991=JCM 33222).
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http://dx.doi.org/10.1099/ijsem.0.004163DOI Listing
May 2020

Association of IL13 genetic polymorphisms with atopic dermatitis: Fine mapping and haplotype analysis.

Ann Allergy Asthma Immunol 2020 09 1;125(3):287-293. Epub 2020 May 1.

Department of Pediatrics, Childhood Asthma Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. Electronic address:

Background: Although previous studies had reported an important role of interleukin 13 (IL13) and its genetic polymorphisms in atopic dermatitis (AD), many of these previous reports focused on the missense variant rs20541 (Gln144Arg) without fine mapping of the gene region.

Objective: To analyze the potential associations of other IL13 variants and their haplotypes with AD and assess total serum immunoglobulin E (IgE) levels.

Methods: We performed fine mapping of single-nucleotide polymorphisms (SNPs) within the IL13 gene in a pilot study of 495 children with AD and 444 healthy controls. Then, we conducted a replication study of 757 children with AD and 1620 healthy controls to evaluate the association between the rs20541 variant of IL13 and AD.

Results: In the pilot study, the rs20541 and rs1295685 SNPs in the 3'-untranslated region of IL13 had significant associations with AD (P < .001 and .01, respectively). In addition, 2 haplotypes (BL2_ht1 and BL2_ht2), which harbored the significant rs20541 and rs1295685 SNPs, had an association with AD (minimum P = .006). BL2_ht1 and BL2_ht2 had nominal signals associated with the total serum IgE levels (P < .05) but not with the severity of AD (P > .05). In the replication study, rs20541 was associated with the total serum IgE levels but not with the severity of AD.

Conclusion: An additional IL13 gene SNP, rs1295685, has a strong linkage disequilibrium with rs20541, and its haplotypes are associated with AD and the total serum IgE levels.
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http://dx.doi.org/10.1016/j.anai.2020.04.023DOI Listing
September 2020

Inter-observer reliability and clinical validity of the MRI grading system for cervical central stenosis based on sagittal T2-weighted image.

Eur J Radiol 2020 Jun 8;127:108987. Epub 2020 Apr 8.

Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Purpose: The aim was to evaluate the inter-observer reliability of the Kang system among radiologists, residents, and clinicians and examine the correlation between radiologic and clinical findings.

Methods: A total of 133 patients (M:F = 44:89, mean age 56 years) who underwent MRI of the cervical spine at our hospital were included. Two radiologists, two trainees, and two clinicians measured Central cervical spinal stenosis (CCSS) grade at the narrowest point according to the grading system suggested by Kang et al. A different clinician (a neurosurgeon) assessed the associated neurologic manifestations. Kappa statistics were used to analyze the inter-reader agreement among the radiologists, trainees, and clinicians. The clinical correlation (R) between grade and positive clinical manifestations (PCMs) was assessed using nonparametric correlation analysis (Spearman's correlation).

Results: We found almost perfect agreement between trainees (k value = 0.890) and between radiologists (k value = 0.912) and substantial agreement between clinicians (k value = 0.691). Clinical correlations for all six readers suggested moderate correlation with R values ranging from 0.380 to 0.566. There was moderate correlation between grade and clinical manifestation within each group (R = 0.562-0.669).

Conclusion: The Kang MRI grading system of CCSS based on mid-sagittal MRI provides objective, reliable, and reproducible assessment regardless of field proficiency of the reader although the reproducibility of the clinician is slightly lower than radiologist and trainee of the radiology department. There was moderate correlation between image interpretation and clinical findings irrespective of the reader's main field of research.
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http://dx.doi.org/10.1016/j.ejrad.2020.108987DOI Listing
June 2020

Effects of chloromethylisothiazolinone/methylisothiazolinone (CMIT/MIT) on Th2/Th17-related immune modulation in an atopic dermatitis mouse model.

Sci Rep 2020 03 5;10(1):4099. Epub 2020 Mar 5.

Department of Pediatrics, Childhood Asthma Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Exposure to chloromethylisothiazolinone/methylisothiazolinone (CMIT/MIT) has been associated with allergic contact dermatitis and occupational asthma. Despite this association however, no study has investigated the effects of CMIT/MIT exposure on the development of atopic dermatitis (AD). This study was conducted to investigate the influence of epicutaneous exposure to CMIT/MIT on AD in a mouse model and the underlying biological mechanisms. BALB/C mice were exposed to CMIT/MIT for 3 weeks and AD was developed using ovalbumin (OVA) epidermal sensitization. CMIT/MIT epicutaneous exposure in normal mice significantly enhanced AD-like phenotypes (e.g., transepidermal water loss, clinical score, total serum immunoglobulin E level and infiltration of inflammatory cells). In addition, CMIT/MIT exposure significantly augmented the mRNA expression level of T helper (Th) 2-related cytokines (thymic stromal lymphopoietin, interleukin (IL)-6 and IL-13), Th2 chemokine (chemokine (C-C motif) ligand 17) and the population of CD4IL-4 cells in the skin. Moreover, mice exposed to CMIT/MIT in the OVA challenge had greater AD-like phenotypes, higher IL-4 and IL-17A skin mRNA expression levels, and a larger population of CD4IL-4- and IL-17A-producing cells in the skin-draining lymph nodes. Our current findings in a mouse model thus suggest that CMIT/MIT exposure may cause AD symptoms through the dysregulation of Th2/Th17-related immune responses.
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http://dx.doi.org/10.1038/s41598-020-60966-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7058054PMC
March 2020

Anterior repair versus no anterior repair for anterior vaginal wall prolapse resolved under simulated apical support at the time of uterosacral ligament suspension.

Int Urogynecol J 2020 10 11;31(10):2043-2049. Epub 2020 Feb 11.

Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, South Korea.

Introduction And Hypothesis: The aim of this study was to compare treatment outcomes 1 year after uterosacral ligament suspension (USLS) with or without concomitant anterior repair (AR) for anterior vaginal wall prolapse resolved under simulated apical support.

Methods: This retrospective cohort study included 179 women who underwent USLS with or without concomitant AR for Pelvic Organ Prolapse Quantification (POPQ) stage 2-4 anterior vaginal wall prolapse resolved under simulated apical support, and who completed a 1-year follow-up. The primary outcome was composite surgical failure defined as anterior anatomical recurrence (point Ba>0), symptomatic recurrence (presence of vaginal bulge symptoms), or retreatment for prolapse. Secondary outcomes included changes in POPQ values and Urogenital Distress Inventory-6 (UDI-6) scores, perioperative outcomes, and complications.

Results: Eighty-six women underwent concomitant AR, and 93 did not. The group receiving AR had more advanced anterior and apical prolapse. Surgical failure rates were significantly higher in the group not receiving AR than in the group receiving AR (21.5% vs 7.0%, p < 0.01). However, there were no differences in the mean point Ba and C values and UDI-6 scores through 12 months postoperatively between the two groups. Operating times were longer, and adverse events, such as immediate postoperative urinary retention and minor wound complications, were more frequent in the group receiving AR (p < 0.05).

Conclusions: Concomitant AR at the time of USLS seems to reduce the recurrence of anterior vaginal wall prolapse without significant morbidity. Considering the small difference in anatomical outcomes, a longer follow-up period will be required to confirm this.
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http://dx.doi.org/10.1007/s00192-020-04229-0DOI Listing
October 2020