[Show abstract][Hide abstract] ABSTRACT: In a prospective randomized controlled study, the efficacy and safety of a continuous ambulatory peritoneal dialysis (CAPD) technique has been evaluated using one icodextrin-containing and two glucose-containing dialysates a day. Eighty incident CAPD patients were randomized to two groups; GLU group continuously using four glucose-containing dialysates (n=39) and ICO group using one icodextrin-containing and two glucose-containing dialysates (n=41). Variables related to residual renal function (RRF), metabolic and fluid control, dialysis adequacy, and dialysate effluent cancer antigen 125 (CA125) and interleukin 6 (IL-6) levels were measured. The GLU group showed a significant decrease in mean renal urea and creatinine clearance (-Δ1.2±2.9 mL/min/1.73 m(2), P=0.027) and urine volume (-Δ363.6±543.0 mL/day, P=0.001) during 12 months, but the ICO group did not (-Δ0.5±2.7 mL/min/1.73 m(2), P=0.266; -Δ108.6±543.3 mL/day, P=0.246). Peritoneal glucose absorption and dialysate calorie load were significantly lower in the ICO group than the GLU group. The dialysate CA125 and IL-6 levels were significantly higher in the ICO group than the GLU group. Dialysis adequacy, β2-microglobulin clearance and blood pressure did not differ between the two groups. The CAPD technique using one icodextrin-containing and two glucose-containing dialysates tends to better preserve RRF and is more biocompatible, with similar dialysis adequacy compared to that using four glucose-containing dialysates in incident CAPD patients. [Clincal Trial Registry, ISRCTN23727549].
Journal of Korean medical science. 09/2014; 29(9):1217-25.
[Show abstract][Hide abstract] ABSTRACT: Here, it is shown that graphene oxide (GO) can be utilized as both a cell-adhesion substrate and a growth factor protein-delivery carrier for the chondrogenic differentiation of adult stem cells. Conventionally, chondrogenic differentiation of stem cells is achieved by culturing cells in pellets and adding the protein transforming growth factor-β3 (TGF-β3), a chondrogenic factor, to the culture medium. However, pellets mainly provide cell-cell interaction and diffusional limitation of TGF-β3 may occur inside the pellet both of these factors may limit the chondrogenic differentiation of stem cells. In this study, GO sheets (size = 0.5–1 μm) were utilized to adsorb fibronectin (FN, a cell-adhesion protein) and TGF-β3 and were then incorporated in pellets of human adipose-derived stem cells (hASCs). The hybrid pellets of hASC-GO enhanced the chondrogenic differentiation of hASCs by adding the cell-FN interaction and supplying TGF-β3 effectively. This method may provide a new platform for stem cell culture for regenerative medicine.
[Show abstract][Hide abstract] ABSTRACT: Over the past decade, stem cell and regenerative medicine has emerged as a very important field in natural sciences and medicine. We have witnessed remarkable progress in this thriving field, as demonstrated by the research articles and reviews in this AFOB Special Issue.
[Show abstract][Hide abstract] ABSTRACT: There is growing concern about unwanted effects associated with the clinical use of recombinant human bone morphogenetic protein-2 (rhBMP-2) at high concentrations, including cyst-like bone formation and excessive fatty marrow formation. We therefore evaluated the induction of mineralized/adipose tissue formation and the bone-healing pattern associated with the controlled release of E. coli-derived rhBMP-2 (ErhBMP-2) by a heparin-conjugated fibrin (HCF) system using ectopic and orthotopic in vivo models, respectively. In the ectopic transplantation model, mineralized tissue formed at the most superficial layer of the transplanted area and on the surfaces of grafted materials, and most of the interstitial space within the transplanted area was filled with excessive adipose tissue specifically at sites that received ErhBMP-2. However, sites that received ErhBMP-2 and HCF showed significantly increased mineralized tissue formation and decreased adipose tissue formation compared to the normal fibrin system with ErhBMP-2. In the orthotopic (calvarial defect) model, controlled release of ErhBMP-2 induced by HCF significantly reduced adipose tissue formation within the defect area compared to the clinically approved absorbable collagen sponge. From these results it can be concluded that the use of a heparin-conjugated fibrin system loaded with ErhBMP-2 may reduce adipose tissue formation and enhance mineralized tissue formation.
Journal of Biomedical Materials Research Part A 04/2014; · 2.83 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This study aimed at evaluating the clinical severity and treatment outcomes of Clostridium difficile infections (CDI) and identifying predictors associated with mortality in patients with malignancy.
A retrospective study was conducted in a teaching hospital from January 2004 to June 2013. The subjects included adult patients (aged ≥18 years) receiving treatment for malignancy whose conditions were complicated by CDI. Clinical severity was determined using the guidelines from the Society for Healthcare Epidemiology of America and the Infectious Diseases Society of America (SHEA/IDSA). Multivariate logistic regression analysis was performed to identify predictors independently associated with CDI-related mortality.
Of the 5,594 patients treated for malignancy at the Division of Hematology/Oncology during the study period, 61 (1.1 %) had CDI complications. CDI-related mortality was 19.7 % (12/61). Twenty-seven (44.3 %) patients were diagnosed with neutropenia (ANC ≤500/mm(3)) at initial CDI presentation. Forty-one patients (67.2 %) received antimicrobial therapy for CDI. Based on the SHEA/IDSA guidelines, only 12 patients (19.7 %) presented with severe CDI, but 25 (61.0 %) patients experienced treatment failure. Multiple logistic regression modeling showed neutropenia to be an independent risk factor for CDI-related mortality (odds ratio, 5.17; 95 % confidence interval, 1.24-21.59).
This study tracked poor CDI treatment outcomes in patients with malignancy and identified neutropenia as a previously unrecognized risk factor of CDI-related mortality. Alternative definitions of severe CDI that include neutropenia might be necessary to more accurately determine clinical severity.
Supportive Care in Cancer 03/2014; · 2.09 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: We conducted a prospective multicenter study identifying the role of bortezomib in patients with relapsed or refractory plasma cell myeloma (PCM) in bone resorption and formation via bone turnover markers. A total of 104 patients received at least 1 cycle of bortezomib. Most of them had advanced disease (n = 89). Among them, 75 patients completed 4 cycles of treatment. Most of the patients (81.7%) were treated in combination with steroid. After the 4th cycle treatment, 47 of 75 patients achieved CR, nCR, VGPR, and PR (64.4%), while 26 patients achieved less than PR (35.6%). The proportion of patients who achieved ≥ PR increased as patients received more treatment cycles, reaching 90% after the 8th cycle. DKK-1 levels decreased significantly posttreatment. Bone formation markers (bALP and OC) and osteoclast regulator such as sRANKL also decreased significantly. These findings were observed primarily in patients who received steroid and who had a longer disease duration. While sRANKL demonstrated significant reduction posttreatment, osteoprotegerin (OPG) level did not significantly change posttreatment, resulting in a decreased sRANKL/OPG ratio (P = 0.037). In conclusion, our clinical data suggest that treatment with bortezomib and steroid may rearrange the metabolic balance between osteoblast and osteoclast activities in PCM.
BioMed Research International 01/2014; 2014:245247. · 2.71 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: We assessed the success rate of empirical antifungal therapy with itraconazole and evaluated risk factors for predicting the failure of empirical antifungal therapy. A multicenter, prospective, observational study was performed in patients with hematological malignancies who had neutropenic fever and received empirical antifungal therapy with itraconazole at 22 centers. A total of 391 patients who had abnormal findings on chest imaging tests (31.0%) or a positive result of enzyme immunoassay for serum galactomannan (17.6%) showed a 56.5% overall success rate. Positive galactomannan tests before the initiation of the empirical antifungal therapy (P=0.026, hazard ratio [HR], 2.28; 95% confidence interval [CI], 1.10-4.69) and abnormal findings on the chest imaging tests before initiation of the empirical antifungal therapy (P=0.022, HR, 2.03; 95% CI, 1.11-3.71) were significantly associated with poor outcomes for the empirical antifungal therapy. Eight patients (2.0%) had premature discontinuation of itraconazole therapy due to toxicity. It is suggested that positive galactomannan tests and abnormal findings on the chest imaging tests at the time of initiation of the empirical antifungal therapy are risk factors for predicting the failure of the empirical antifungal therapy with itraconazole. (Clinical Trial Registration on National Cancer Institute website, NCT01060462).
Journal of Korean medical science 01/2014; 29(1):61-8. · 0.84 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: There are limited data about characteristics of hypertension subtypes in Asian hypertensive patients and their impacts on treatment of hypertension. This prospective, multi-center, observational study evaluated 2,439 hypertensive patients. (≥ 60 years) Inadequately controlled and drug-naïve patients were categorized into three hypertension subtypes (isolated systolic hypertension [ISH], combined systolic/diastolic hypertension [SDH], and isolated diastolic hypertension [IDH]) and proportions of each hypertension subtype were evaluated. After six-month strict treatments, we compared the characteristics of patients who did not achieve target BP with those who did. In overall population, ISH was the most common subtype (53.2%, 1297/2439). However, in drug-naïve patients, SDH was predominant hypertension subtype (59.6%, 260/436). Notably, the proportion of ISH was substantially lower than previously known data. Predictors associated with failure of reaching target BP were old age (>70 years), hypertension awareness, and baseline systolic BP (≥160 mm Hg) for total patients. In drug naïve patients, hypertension awareness, ISH, and microalbuminuria were associated with treatment failure. These findings might have an impact on the evaluations and antihypertensive treatments of elderly Korean patients.
Journal of the American Society of Hypertension (JASH) 01/2014;
[Show abstract][Hide abstract] ABSTRACT: Total body irradiation (TBI) has traditionally been used in the conditioning regimen for allogenetic hematopoietic stem cell transplantation (alloHCT) from an unrelated donor (u-HCT). However, patients are increasingly receiving a fludarabine-based conditioning regimen without TBI, as it seemed less toxic than TBI. We need to know the clinical results of non-TBI u-HCT treatments. We retrospectively investigated the clinical outcomes of allogenetic hematopoietic cell transplantation (alloHCT) from an unrelated donor without TBI (non-TBI u-HCT) and compared the clinical outcomes of fludarabine-based (FLU group) and cyclophosphamide-ATG (Cy-ATG group) conditioning regimens. Sixty-one patients received the non-TBI conditioning regimen for u-HCT (32 in the FLU group and 29 in the Cy-ATG group). The cumulative incidence of neutrophil engraftment at 30 days, platelet > 20 K/μL at 30 days, acute graft-versus host disease (aGvHD) at 100 days, and chronic GvHD (cGvHD) at 2 years were 87.01%, 65.57%, 35.20%, and 26.64%, respectively. However, transplantation outcomes and overall survival rates did not differ between the FLU and Cy-ATG groups. Only infused CD34+ cells >3 × 106/kg was identified as a favorable factor for survival in the multivariate analysis. In conclusion, non-TBI u-HCT was feasible and there was no difference between the FLU and Cy-ATG groups in terms of transplantation outcomes.
[Show abstract][Hide abstract] ABSTRACT: Special vehicles called transporters are used to deliver heavy blocks from one plant to another in shipyards. Because of the limitation on the number of transporters, the scheduling of transporters is important for maintaining the overall production schedule of the blocks. This paper considers a scheduling problem of block transportation under a delivery restriction to determine when and by which transporter each block is delivered from its source plant to its destination plant. The objective of the problem is to minimize the penalty times that can cause delays in the overall block production schedule. A mathematical model for the optimal solution is derived, and two meta-heuristic algorithms based on a genetic algorithm (GA) and a self-evolution algorithm (SEA) are proposed. The performance of the algorithms is evaluated with several randomly generated experimental examples.
Expert Systems with Applications 01/2014; 41(6):2851–2858. · 1.85 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Transfusional iron overload and its consequences are challenges in chronically transfused patients with myelodysplastic syndromes (MDSs) or aplastic anemia (AA).
This was a prospective, multicenter, open-label study to investigate the efficacy of deferasirox (DFX) by serial measurement of serum ferritin (S-ferritin) level, liver iron concentration (LIC) level using relaxation rates magnetic resonance imaging, and other laboratory variables in patients with MDS or AA.
A total of 96 patients showing S-ferritin level of at least 1000 ng/mL received daily DFX for up to 1 year. At the end of the study, S-ferritin level was significantly decreased in MDS (p = 0.02366) and AA (p = 0.0009). LIC level was also significantly reduced by more than 6.7 mg Fe/g dry weight from baseline. Hemoglobin level and platelet counts were significantly increased from baseline (p = 0.002 and p = 0.025, respectively) for patients showing significant anemia or thrombocytopenia. Elevated alanine aminotransferase was also significantly decreased from baseline.
This study shows that DFX is effective in reducing S-ferritin and LIC level in transfusional iron overload patients with MDS or AA and is well tolerated. In addition, positive effects in hematologic and hepatic function can be expected with DFX. Iron chelation treatment should be considered in transfused patients with MDS and AA when transfusion-related iron overload is documented.
[Show abstract][Hide abstract] ABSTRACT: The increased use of bypass surgery in the treatment of ischemic cerebrovascular diseases requires a better understanding of the superficial temporal artery (STA) anatomy. This study is to describe the gross anatomy of STA in adult Korean population with respect to cranial surgery and to provide basic anatomic data for bypass surgery.
The study evaluated retrospectively 35 patients who visited the neurosurgery department at a single institution. For each patient, both the left and right STA (70 vessels) were evaluated by a 3-dimensional computed tomographic angiogramfor diameter and anatomic relationships to external landmarks.
Of 70 STAs, 69 had a bifurcation. Among these, 57 (82.6%) were above the superior margin of the zygomatic arch. The STA bifurcation was 53.2 ± 5.9 mm posterior to the keyhole, 9.5 ± 5.3 mm anterior to the posterior margin of condylar process of the mandible, and 21.7 ± 15.8 mm superior to the superior margin of the zygomatic arch. The inner diameter of the STA was 1.8 ± 0.5 mm at the superior margin of the zygomatic arch, and 1.4 ± 0.4 mm and 1.4 ± 0.5 mm for frontal and parietal branches, respectively. The 75.7% of frontal and 66.7% of parietal branches were suitable for microvascular anastomosis.
This present study demonstrated the STA in Korean adults, which may benefit the clinician in dealing with the surgical procedures related to this STA.
Journal of cerebrovascular and endovascular neurosurgery. 09/2013; 15(3):145-51.
[Show abstract][Hide abstract] ABSTRACT: We retrospectively investigated the incidence, risk factors, and outcomes of SOS (sinusoidal obstruction syndrome; previously veno-occlusive disease [VOD]) after allogeneic hematopoietic stem cell transplantation (alloHSCT) in aplastic anemia. Two hundred and sixty patients were included in the analysis. SOS developed in 7.3% (n=19/260) of patients. Classical Cy (200mg/m(2))-ATG was the most common conditioning regimen (84.2%) in the SOS group. The SOS mortality rate was 4/19 (21.1%). Univariate analyses revealed that Cy 200mg/m(2) conditioning (p=0.035), classical Cy-ATG conditioning (p=0.007), and horse ATG conditioning (p<0.001) were significant risk factors for developing SOS. Multivariate analysis revealed that only horse ATG conditioning was a poor prognostic factor (HR=3.484; 95% CI 1.226-9.904; p=0.002). Rabbit ATG (HR 12.719; 95% CI 2.332-69.373; p=0.003) and weight gain>10% (HR 35.655; 95% CI 2.208-575.805; p=0.012) were risk factors in the overall SOS group. Both rabbit ATG conditioning and weight gain of more than 10% were associated with poor overall survival with a median of 1.2 months (5Y survival rate, any risk factor vs. none: 74.6% vs. 0.0%; p<0.001; Fig. 2) in the SOS group. In conclusion, SOS is a relatively rare (7.3%) but highly fatal (21.1%) acute complication of alloHSCT in AA, and the horse ATG conditioning regimen was a significant risk factor for developing SOS.
[Show abstract][Hide abstract] ABSTRACT: In this paper, the integration of two emerging classes of scheduling problems, the class of scheduling problems with time-dependent deterioration and the class of scheduling problems with rate-modifying activities, are addressed. The scheduling problems have been studied independently. However, the integration of these classes is motivated by human operators of tasks who have fatigue while carrying out the operation of a series of tasks. This situation is also applicable to machines that experience performance degradation over time due to mal-position or mal-alignment of jobs, abrasion of tools, and scraps of operations, etc. It requires maintenance in order to sustain acceptable production rates. We consider the single machine scheduling problem with time-dependent deterioration and multiple RMAs. A mathematical model for an optimal solution to minimize the makespan is derived and genetic algorithms are proposed. The performance of the genetic algorithms is evaluated using randomly generated examples.
Expert Systems with Applications 06/2013; 40(8):3036–3043. · 1.85 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This paper proposes a procedure to obtain monotone estimates of both the
local and the tail false discovery rates that arise in large-scale multiple
testing. The proposed monotonization is asymptotically optimal for controlling
the false discovery rate and also has many attractive finite-sample properties.
[Show abstract][Hide abstract] ABSTRACT: The chemokine receptor CCR3 is expressed in prominent allergic inflammatory cells, including eosinophils, mast cells, and Th2 cells. We previously identified a functional GATA element within exon 1 of the CCR3 gene that is responsible for GATA-1-mediated CCR3 transcription. Because allergic inflammatory cells exhibit distinct expression patterns of different GATA factors, we investigated whether different GATA factors dictate CCR3 transcription in a cell type-specific manner. GATA-2 was expressed in EoL-1 eosinophilic cells, GATA-1 and GATA-2 were expressed in HMC-1 mast cells, and GATA-3 was preferentially expressed in Jurkat cells. Unlike a wild-type CCR3 reporter, reporters lacking the functional GATA element were not active in any of the three cell types, implying the involvement of different GATA factors in CCR3 transcription. RNA interference assays showed that small interfering RNAs specific for different GATA factors reduced CCR3 reporter activity in a cell type-specific fashion. Consistent with these findings, chromatin immunoprecipitation and EMSA analyses demonstrated cell type-specific binding of GATA factors to the functional GATA site. More importantly, specific inhibition of the CCR3 reporter activity by different GATA small interfering RNAs was well preserved in respective cell types differentiated from cord blood; in particular, GATA-3 was entirely responsible for reporter activity in Th2 cells and replaced the role predominantly played by GATA-1 and GATA-2. These results highlight a mechanistic role of GATA factors in which cell type-specific expression is the primary determinant of transcription of the CCR3 gene in major allergic inflammatory cells.
The Journal of Immunology 05/2013; · 5.52 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: We consider the single machine scheduling problem with a rate-modifying activity and time-dependent deterioration after the activity. The class of scheduling problems with rate-modifying activities and the class of scheduling problems with time-dependent processing times have been studied independently. However, the integration of these classes is motivated by human operators of tasks who has fatigue while carrying out the operation of a series of tasks. This situation is also applicable to machines that experience performance degradation over time due to mal-position or mal-alignment of jobs, abrasion of tools, and scraps of operations, etc. In this study, the integration of the two classes of scheduling problems is considered. We present a mathematical model to determine job-sequence and a position of a rate-modifying activity for the integration problem. Since the model is difficult to solve as the size of real problem being very large, we propose genetic algorithms. The performance of the algorithms are compared with optimal solutions with various problems.
[Show abstract][Hide abstract] ABSTRACT: In a supply chain, cross docking is one of the most innovative systems for improving the operational performance at distribution centers. By utilizing this cross docking system, products are delivered to the distribution center via inbound trucks and immediately sorted out. Then, products are shipped to customers via outbound trucks and thus, no inventory remains at the distribution center. In this paper, we consider the scheduling problem of inbound and outbound trucks at distribution centers. The aim is to maximize the number of products that are able to ship within a given working horizon at these centers. In this paper, a mathematical model for an optimal solution is derived and intelligent genetic algorithms are proposed. The performances of the genetic algorithms are evaluated using several randomly generated examples.
Expert Systems with Applications 12/2012; 39(17):12975–12983. · 1.85 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Pseudomembranous necrotizing bronchial aspergillosis (PNBA) is a rare form of invasive aspergillosis with a very poor prognosis. The symptoms are non-specific, and the necrotizing plugs cause airway obstruction. Atelectasis and respiratory failure can be the initial manifestations. Recently, we treated an immunocompromised patient with PNBA, who presented with a sudden onset of atelectasis and acute respiratory failure. There were no preceding signs except for a mild cough and one febrile episode. Bronchoscopy revealed PNBA, and Aspergillus nidulans was cultured from the bronchial wash.
The Korean Journal of Internal Medicine 12/2012; 27(4):463-6.