[Show abstract][Hide abstract] ABSTRACT: The purpose of this study was to evaluate the predictive role of quantitative metabolic parameters using total lesion glycolysis (TLG) in F-2-fluoro-2-deoxyglucose-positron emission tomography/computed tomography for developing gefitinib resistance in epidermal growth factor receptor (EGFR)-mutant non-small-cell lung cancer (NSCLC) patients treated with first-line gefitinib.
A total of 75 NSCLC patients harboring activating EGFR mutation and receiving first-line gefitinib were analyzed. Whole-body F-2-fluoro-2-deoxyglucose positron emission tomography/computed tomography scans were acquired before first-line gefitinib. The maximal standardized uptake value and TLG of all lesions were calculated. Maximal standardized uptake value and TLG were categorized using the tertile cutoff. Treatment outcomes were compared between groups.
Overall response rate of gefitinib was 69.4%, and median progression-free survival (PFS) of gefitinib was 11.5 months. Overall response rates were similar between low, intermediate, and high TLG groups (68.0% versus 76.0% versus 68.0%, p = 0.274). However, PFS significantly differed by TLG groups, and high TLG was associated with shorter PFS (7.2 months in high TLG; 11.9 months in intermediate TLG; and 24.2 months in low, p < 0.001). Multivariate models adjusted for disease status and response to gefitinib showed that TLG was an independent predictive factor for PFS. TLG was also significantly associated with overall survival (p = 0.005).
TLG can predict PFS and development of gefitinib resistance in EGFR-mutant NSCLC patients treated with first-line gefitinib. Baseline metabolic tumor burdens measured with TLG before first-line gefitinib will be of great help in predicting time to acquired resistance.
Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer 08/2015; 10(8):1189-94. DOI:10.1097/JTO.0000000000000569 · 5.80 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to investigate the clinical performance of whole-body F-FDG PET/Dixon-volume-interpolated breath-hold examination (Dixon-VIBE), T1-weighted, and T2-weighted MRI protocol in patients with colorectal cancer.
A total of 59 patients with colorectal cancer were enrolled in this study. Each patient had one of the following clinical conditions: initial stage before therapy, stage after neoadjuvant therapy, suspicious colorectal liver metastases, and colorectal liver metastases after chemotherapy. Fourteen patients had primary colorectal cancer, whereas 38 patients had a total of 132 hepatic lesions, 53 lesions existed before chemotherapy, and 79 lesions appeared after chemotherapy. The primary stage and metastases images were obtained using our PET/Dixon-VIBE/T1/T2 MRI protocol and were analyzed by 2 nuclear medicine physicians. Diagnostic accuracy was compared with contrast-enhanced MRI images, which were based on surgical pathology results.
The sensitivity of our imaging protocol for primary colorectal cancer was 100% (14/14). T and N stage both showed 92.9% (13/14) accuracy. Of all 132 hepatic lesions, 115 metastatic lesions were analyzed, and 17 benign lesions were excluded (6 were during pretreatment cases, and 11 were during posttreatment cases). In pretreatment metastatic lesions (n = 47), the sensitivities of our protocol and dedicated MRI were 95.7% (45/47) and 100% (47/47), respectively. In posttreatment lesions (n = 68), sensitivities of our protocol and dedicated MRI were 75% (51/68) and 91.2% (62/68), respectively.
Whole-body PET/Dixon-VIBE/T1/T2 MRI protocol is clinically useful for TNM staging and chemonaive hepatic metastasis in colorectal cancer.
Clinical nuclear medicine 05/2015; 40(8). DOI:10.1097/RLU.0000000000000812 · 2.86 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Development of behavior theory–based health promotion programs is encouraged with the paradigm shift from contents to behavior outcomes. This article describes the development process of the diabetes self-management program for older Koreans (DSME-OK) using intervention mapping
(IM) protocol. The IM protocol includes needs assessment, defining goals and objectives, identifying theory and determinants, developing a matrix to form change objectives, selecting strategies and methods, structuring the program, and planning for evaluation and pilot testing. The DSME-OK
adopted seven behavior objectives developed by the American Association of Diabetes Educators as behavioral outcomes. The program applied an information-motivation-behavioral skills model, and interventions were targeted to 3 determinants to change health behaviors. Specific methods were selected
to achieve each objective guided by IM protocol. As the final step, program evaluation was planned including a pilot test. The DSME-OK was structured as the 3 determinants of the IMB model were intervened to achieve behavior objectives in each session. The program has 12 weekly 90-min sessions
tailored for older adults. Using the IM protocol in developing a theory-based self-management program was beneficial in terms of providing a systematic guide to developing theory-based and behavior outcome–focused health education programs.
Research and Theory for Nursing Practice 05/2015; 29(2):94-112. DOI:10.1891/1541-6522.214.171.124
[Show abstract][Hide abstract] ABSTRACT: This paper presents the control of an ionic polymer metal composite (IPMC) strip, which is an electro-active polymer actuator. IPMC can produce mechanical bending motion in response to an electrical excitation. Although IPMC has many beneficial properties, such as low power consumption, large deformation, and bi-directional actuation, it is very challenging to control because of its time-varying and nonlinear properties. Time-delay control (TDC) was applied to an IPMC strip in order to obtain a robust and precise tracking performance. The TDC scheme has shown good tracking performance with exceptional robustness in many other applications, in addition to having a simple and efficient structure and design process. A first-order filter was applied to the control input to reduce the sensor noise. An anti-windup scheme was also used because of its inherent integral effect. The simulation and experimental results of an IPMC strip controlled by TDC showed good performance in the steady state and transient responses. Furthermore, the control output responses tracked the desired model even when the IPMC parameters varied in repetitive experiments. In addition, it was shown through Nyquist analysis that the stability of the IPMC strip controlled by TDC is always maintained with the time-varying parameters. These results demonstrate that the TDC law applied to a time-varying and nonlinear IPMC provides robustness in performance and stability, while yielding precise transient and steady state tracking performance.
[Show abstract][Hide abstract] ABSTRACT: This study was conducted to examine the prevalence of successful aging and factors influencing successful aging.
This was a secondary analysis study. Data were analyzed from 10,462 elderly people who participated in the 2011 National Elderly Survey. According to the use of community senior facilities, participants were divided into 4 groups: those who used senior centers (group A, n=580), village senior clubs (group B, n=3,240), both of the 2 facilities (group C, n=339), and neither of the 2 facilities (group D, n=6,303). Cross-tabulation and logistic regression were performed.
The prevalence of successful aging was highest in group C (20.94%) and lowest in group D (10.41%). The physical & mental function and active engagement domains were highest in group C, while they were lowest in group D. The disease & risk factors domain were highest in group A, while lowest in group B. An educational level of middleschool or higher and income level in the third or higher quintile were significant factors for predicting successful aging in all groups.
These results provide a basis for designing prevention and management programs as interventions to increase the prevalence of successful aging in Korean older adults.
Journal of Korean Academy of Nursing 04/2015; 45(2):231-9. DOI:10.4040/jkan.2015.45.2.231 · 0.36 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Sasang typology is a widely used personalized traditional medicine in clinical diagnosis and treatment in Korea. The aim of this study was to examine the personality construct of the Sasang Personality Questionnaire (SPQ) to replicate the previous findings in the adolescent sample.
[Show abstract][Hide abstract] ABSTRACT: The purpose of the present study is to investigate the relationship between dopaminergic neuron destruction and 5-HT system changes in a hemiparkinsonian rat model. We performed PET imaging studies with trans-[18F]Mefway in a hemiparkinsonian model of unilateral 6-hydroxydopamine (6-OHDA) rats. Region-of-interests (ROIs) were drawn in the hippocampus (HP) and cerebellum (CB). HP uptake, the ratios of specific binding to non-specific binding in the HP, and non-displaceable binding potential (BPND) in the HP were compared between 6-OHDA and control rats. As a result, unilateral 6-OHDA-lesioned rats exhibited significant bilateral reduction of HP uptake and trans-[18F]Mefway BPND compared to the intact control group. Therefore, the results demonstrate that destruction of the dopaminergic system causes the reduction of the serotonergic system.
[Show abstract][Hide abstract] ABSTRACT: Purpose: To identify the gadoxetic acid-enhanced MR and the 18 F-fludeoxyglucose (FDG) PET/CT findings associated with microvascular invasion (MVI) of hepa-tocellular carcinoma (HCC) in patients who are under-going liver transplantation (LT). Methods: Fifty-one patients with 78 HCCs underwent LT. Preoperative MRI and 18 F-FDG PET/CT findings were retrospectively analyzed and the association of the imaging findings with MVI was assessed. Results: Univariate analysis revealed that hypointensity seen on T1WI (OR = 4.329, p = 0.011), peritumoral enhancement (OR = 7.000, p = 0.008), inhomogeneity on arterial phase (OR = 4.321, p = 0.011), delayed phase (OR = 4.519, p = 0.009) or hepatobiliary phase (OR = 3.564, p = 0.032), and the large tumor size (>5 cm) (OR = 12.091, p = 0.001) showed statistically significant associations with MVI. The ratio of tumor maximum standardized uptake value (SUV) to normal liver mean SUV (T SUVmax /L SUVmean) (2.05 ± 1.43 vs. 1.08 ± 0.37) revealed significantly higher value in the MVI-positive group. Multivariate analysis revealed that peritumoral enhancement and a T SUVmax /L SUVmean of 1.2 or greater had a statistically significant association with MVI, with odds ratios of 10.648 (p = 0.016) and 14.218 (p = 0.001), respectively. Conclusions: Preoperative imaging findings such as peritumoral enhancement seen on gadoxetic acid-enhanced MR and a T SUVmax /L SUVmean of 1.2 or more on 18 F-FDG PET/CT, may suggest the presence of MVI in HCC patients.
[Show abstract][Hide abstract] ABSTRACT: Our study aimed to assess the longitudinal association of frequency of contact with non-cohabitating adult children and risk of depression in the elderly. Elderly aged ≥60 years were included from Living Profiles of Older People Survey (LPOPS) in Korea. The baseline assessment, Wave 1, was conducted in 2008, and follow-up assessment, Wave 2, was conducted in 2011. We included participants who completed both waves and excluded those who met the following criteria: no adult children, living with adult children, cognitive impairment at either waves, and depression at baseline (n = 4398). We defined infrequent contact as <1 time per month face-to-face contact or <1 time per week phone contact and classified participants into four groups based on contact method and frequency. Depression was measured using the 15-item geriatric depression scales (SGDS-K). In multivariable logistic regression analysis, infrequent face-to-face and phone contact group had adjusted odds ratio (OR) of 1.86 (95% CI, 1.44–2.42) when compared with frequent face-to-face and phone contact group. Frequent face-to-face contact with infrequent phone contact group and infrequent face-to-face contact with frequent phone contact group had adjusted OR of 1.49 (95% CI, 1.12–1.98) and 1.44 (95% CI, 1.15–1.80), respectively, when compared with frequent face-to-face and phone contact group. These results propose that the risk of subsequent depression in elderly is associated with frequency of contact with non-cohabitating adult children. Moreover, the efficacy of face-to-face contact and that of phone contact were similar, while the group lacking both types of contact demonstrated the highest risk of depression.
Archives of Gerontology and Geriatrics 09/2014; 60(1). DOI:10.1016/j.archger.2014.09.007 · 1.53 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: House dust mite (HDM) is a primary allergen in allergic rhinitis (AR) and asthma. Neutrophil apoptosis is associated with allergic diseases and innate immunity to infection. The present study examined how HDM affects constitutive neutrophil apoptosis in normal and AR subjects. Total IgE increased in AR subjects when compared to normal subjects, and patients with AR were HDM-specific IgE positive (+), which is specific IgE to Dermatophagoides pteronissinus and Dermatophagoides farinae. In normal and AR subjects, neutrophil apoptosis was inhibited by extract of Dermatophagoides pteronissinus (DP), but not by extract of Dermatophagoides farina (DF). Aprotinin (serine protease inhibitor) and E64 (cysteine protease inhibitor) have no effect on neutrophil apoptosis due to DP. The anti-apoptotic effect of DP was blocked by TLR4i, an inhibitor of TLR4, rottlerin, an inhibitor of PKCδ, PD98059, an inhibitor of ERK, and BAY-11-7085, an inhibitor of NF-κB. DP induced PKCδ, ERK, and NF-κB activation in a time-dependent manner. DP inhibited the cleavage of procaspase 3 and procaspase 9. The expression of IL-6, IL-8, TNF-α, G-CSF, GM-CSF, and CCL2 increased in the supernatant collected from the normal and AR neutrophils after DP treatment and the supernatant inhibited the apoptosis of normal and AR neutrophils. In summary, DP has anti-apoptotic effects on neutrophils of normal and AR subjects through the TLR4/PKCδ/ERK/NF-κB pathway, and this finding may contribute to solution of the pathogenic mechanism of allergic diseases triggered by DP.
PLoS ONE 09/2014; 9(9):e105814. DOI:10.1371/journal.pone.0105814 · 3.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Our study aimed to examine the relationship between perceived sleep quality and depression using Pittsburgh Sleep Quality Index (PSQI) and Cole's model to materialize the concept of perceived sleep quality in the non-cognitively impaired elderly. Older adults aged 60+ were recruited from the baseline study of Suwon Project between 2009 and 2011 (n = 2,040). Perceived sleep quality was measured using the Korean version of the Pittsburgh Sleep Quality Index (PSQI-K), and depression was accessed using the Korean version of the Geriatric Depression Scale-Short Form (SGDS-K). We excluded the cognitively impaired elderly using the Korean version-Mini Mental Status Examination (K-MMSE) score less than or equal to 17. In multivariable adjusted logistic regression related to PSQI-K components, poor perceived sleep quality, including poor subjective sleep quality (Odds ratio (OR) = 1.27, 95% confidence interval (CI) = 1.01-1.61), longer sleep latency (OR = 1.32, 95% CI = 1.13-1.55) and the frequent use of sleeping medication (OR = 1.30, 95% CI = 1.10-1.53) were significantly associated with depression after adjusting for age, sex, education, living status, current smoking and current alcohol drinking, the number of comorbidity and Beck Anxiety Inventory (BAI). PSQI-K global score also had greater odds of reporting depression (OR = 1.12, 95% CI = 1.07-1.16). These results suggested that poor perceived sleep quality was associated with a greater level of depression in the elderly.
Archives of Gerontology and Geriatrics 09/2014; 59(2). DOI:10.1016/j.archger.2014.04.007 · 1.53 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background
The purpose of present study was to examine biological and psychological characteristics of people according to the Sasang typology, which is popular in Korea. We evaluated the Sasang Personality Questionnaire (SPQ) as a measure of temperament, and Body Mass Index (BMI) as a measure of the somatic properties of each Sasang type.
Subjects were 2506 (877 males, 1629 females) outpatients between the ages of 20 through 70 who requested traditional medical assessment and treatment in Korea. The structural validity of the SPQ was examined and its correlation with BMI was analyzed. The SPQ and BMI measures of each Sasang type across age and gender were presented and their differences were analyzed with Analysis of Variance.
Confirmatory factor analysis and path analysis identified an acceptable three-factor structure of the SPQ measuring differences in individual’s behavior, emotion, and cognition. SPQ scores (29.71 ± 1.00, 28.29 ± 0.19 and 26.14 ± 0.22) and BMI scores (22.92 ± 0.09, 25.56 ± 0.10 and 21.44 ± 0.10) were significantly (p < 0.001) different among So-Yang, Tae-Eum and So-Eum Sasang types, respectively.
The results showed that the SPQ and BMI is a reliable measure for quantifying the biopsychological characteristics of each types, and useful for guiding personalized and type-specific treatment with medical herbs and acupuncture.
BMC Complementary and Alternative Medicine 08/2014; 14(1):315. DOI:10.1186/1472-6882-14-315 · 1.88 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Purpose
The new modality of an integrated positron emission tomography/magnetic resonance imaging (PET/MRI) has recently been introduced but not validated. Our objective was to evaluate clinical performance of 18F-fluoro-2-deoxyglucose (18F-FDG) PET/MRI in patients with head and neck cancer.
This retrospective study was conducted between January 2013 and February 2013. Ten patients (eight men, two women; mean age, 61.4 ± 13.4 years) with histologically proven head and neck tumors were enrolled. Whole-body PET/MRI and regional positron emission tomography (PET) with dedicated MRI were sequentially obtained. Maximum standardized uptake value (SUVmax), SUVmean, metabolic tumor volume, total lesion glycolysis and contrast enhancement were analyzed. A total of ten whole-body positron emission tomography (PET), ten regional positron emission tomography (PET), ten dedicated MRI and ten regional PET/gadolinium-enhanced T1-weighted (Gd)-MRI images were analyzed for initial staging. Two nuclear medicine physicians analyzed positron emission tomography (PET) and PET/MRI with a consensus. One radiologist analyzed dedicated MRI. The primary lesions and number of metastatic lymph nodes analyzed from each image were compared.
Eight patients were diagnosed with head and neck cancer (one tongue cancer, four tonsillar cancers, one nasopharyngeal cancer and two hypopharyngeal cancers) by histological diagnosis. Two benign tumors (pleomorphic adenoma and Warthin tumor) were diagnosed with surgical operation. Whole-body positron emission tomography (PET) and regional positron emission tomography (PET) attenuated by MRI showed good image quality for the lesion detection. Whole-body positron emission tomography (PET) and regional positron emission tomography (PET) detected ten primary sites and compensated for a missed lesion on dedicated MRI. A discordant number of suspicious lymph node metastases was noted according to the different images; 22, 16, 39 and 40 in the whole-body positron emission tomography (PET) only, dedicated MR, regional positron emission tomography (PET) only and regional PET/Gd-MRI, respectively. There was no distant metastasis based on analysis of whole-body positron emission tomography (PET) and whole-body PET/Dixon-volume interpolated breathhold examination (VIBE) MRI. Regional PET/Gd-MRI combined with whole-body PET/MRI modified staging in three patients. Lesions of primary tumor and suspicious metastasis were well detected on both value of SUVmax and visual analysis. The regional PET/Gd-MRI combined with whole-body PET/MRI showed convenient clinical staging performance compared with positron emission tomography (PET) and MRI alone.
In this preliminary study, PET attenuated by MRI showed good image quality to detect lesions. And whole-body PET/MRI as a single modality was feasible for staging in a clinical setting. Whole-body positron emission tomography (PET), regional positron emission tomography (PET), dedicated MRI and regional PET/Gd-MRI showed discordant results in lesion detection. These discordant results might be synergistic effect for accurate staging.