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1.
Brief Bioinform ; 25(2)2024 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-38349059

RESUMO

Standigm ASK™ revolutionizes healthcare by addressing the critical challenge of identifying pivotal target genes in disease mechanisms-a fundamental aspect of drug development success. Standigm ASK™ integrates a unique combination of a heterogeneous knowledge graph (KG) database and an attention-based neural network model, providing interpretable subgraph evidence. Empowering users through an interactive interface, Standigm ASK™ facilitates the exploration of predicted results. Applying Standigm ASK™ to idiopathic pulmonary fibrosis (IPF), a complex lung disease, we focused on genes (AMFR, MDFIC and NR5A2) identified through KG evidence. In vitro experiments demonstrated their relevance, as TGFß treatment induced gene expression changes associated with epithelial-mesenchymal transition characteristics. Gene knockdown reversed these changes, identifying AMFR, MDFIC and NR5A2 as potential therapeutic targets for IPF. In summary, Standigm ASK™ emerges as an innovative KG and artificial intelligence platform driving insights in drug target discovery, exemplified by the identification and validation of therapeutic targets for IPF.


Assuntos
Inteligência Artificial , Fibrose Pulmonar Idiopática , Humanos , Reconhecimento Automatizado de Padrão , Fibrose Pulmonar Idiopática/tratamento farmacológico , Fibrose Pulmonar Idiopática/genética , Pulmão/metabolismo
2.
BMC Pulm Med ; 23(1): 54, 2023 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-36739401

RESUMO

BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is frequently accompanied by comorbidities, with the management of these comorbidities crucial for clinical outcomes. This study investigated the prevalence, incidence, changes over time, and clinical impact of comorbidities in IPF patients, based on nationwide claims data in South Korea. METHODS: This retrospective cohort study utilised nationwide health claim data in South Korea between 2011 and 2019. Patients with IPF were defined as those with ICD-10 code J84.1 and Rare Intractable Disease code V236 who made at least one claim per year. Patients were classified by sex, age, pirfenidone use and burden of comorbidities, and differences among groups were determined. RESULTS: The yearly prevalence rate of IPF increased from 7.50 to 23.20 per 100,000 people, and the yearly incidence rate increased from 3.56 to 7.91 per 100,000 person-years over time. The most common respiratory comorbidity was chronic obstructive pulmonary disease (37.34%), followed by lung cancer (3.34%), whereas the most common non-respiratory comorbidities were gastro-oesophageal reflux disease (70.83%), dyslipidaemia (62.93%) and hypertension (59.04%). The proportion of some comorbidities differed by sex, age and use of pirfenidone. The proportion of lung cancer was higher in patients treated with pirfenidone, whereas the proportion of anxiety and depression were lower in patients not treated with pirfenidone. Charlson comorbidity index ≥ 4 was associated with increases in hospitalisations and total medical costs. CONCLUSIONS: The yearly prevalence and incidence of IPF and comorbidities in Korea increased over time. These comorbidities affected the use of pirfenidone and medical resources.


Assuntos
Fibrose Pulmonar Idiopática , Neoplasias Pulmonares , Humanos , Estudos de Coortes , Estudos Retrospectivos , Comorbidade , Fibrose Pulmonar Idiopática/tratamento farmacológico , Neoplasias Pulmonares/tratamento farmacológico , Piridonas/uso terapêutico
3.
BMC Pulm Med ; 23(1): 400, 2023 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-37864205

RESUMO

BACKGROUND: Tuberculous effusion varies from lymphocyte-dominant to neutrophilic effusion according to inflammation status. The criteria of adenosine deaminase (ADA) and lymphocyte/neutrophil (L/N) ratio have yet not been evaluated across different disease conditions. METHODS: Patients who conducted pleural fluid analysis from 2009 to 2019 at Asan Medical Center were included. Criteria (ADA of 50 and L/N ratio of 0.75) were evaluated by quantile subgroups according to age, C-reactive protein (CRP), white blood cell (WBC), and lactate dehydrogenase (LD) by the Monte Carlo simulation method to diagnose tuberculosis. The model for the ADA and L/N ratio was evaluated by AUROC. RESULTS: Among the 2,918 reviewed cases, 2034 were included with 229 (11.26%) tuberculosis cases. The mean baseline ADA AUROC was 0.88 across all patients. Increased CRP and WBC showed high proportions of neutrophilic tuberculous effusion, with low sensitivity of approximately 45% and 33% in the fifth WBC and CRP groups, respectively. The AUROC of the models decreased with the increase in WBC and CRP groups (ADA model: 0.69 [the top quantile WBC group], 0.74 [the top quantile CRP group]). The AUROC of the models did not show a trend according to the increase in LD and age. CONCLUSION: Inflammatory status affects the diagnostic metrics for tuberculous effusion due to the progression of tuberculous effusion. Clinicians should consider the low accuracy of tuberculous effusion criteria in high-inflammatory conditions when diagnosing tuberculosis.


Assuntos
Derrame Pleural , Tuberculose Pleural , Tuberculose , Humanos , Derrame Pleural/diagnóstico , Tuberculose/diagnóstico , Adenosina Desaminase/metabolismo , Exsudatos e Transudatos/metabolismo , Inflamação , Proteína C-Reativa/análise , L-Lactato Desidrogenase/metabolismo , Tuberculose Pleural/diagnóstico , Sensibilidade e Especificidade
4.
J Korean Med Sci ; 38(3): e16, 2023 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-36647217

RESUMO

BACKGROUND: Although the "unclassifiable type" is categorized as one of the radiologic classifications in Mycobacterium avium complex (MAC) pulmonary disease (PD), there have been few studies of this type thus far. We aimed to investigate the radiologic subtypes and treatment outcome of unclassifiable type MAC-PD. METHODS: Ninety-six patients with unclassifiable type MAC-PD who initiated a macrolide-containing regimen from 2001 to 2020 were identified at a tertiary referral center in South Korea. Among these 96 patients, 1-year culture conversion rate was analyzed for 48 patients who received standard treatment (three-drug oral-antibiotic combination with or without an injectable agent) for ≥ 1 year. RESULTS: The mean age of the 96 patients was 65.4 ± 10.8 years, and 72.9% of them were male. These patients were classified into four major radiologic subtypes; the most common subtype was the focal cavity subtype (n = 31, 32.3%), followed by the focal mass or nodule (n = 23, 24.0%), consolidation upon emphysema (n = 21, 21.9%), and bronchiolitis (n = 21, 21.9%) subtypes. For the 48 patients who received standard treatment for ≥ 1 year, the overall rate of culture conversion at 1-year was 93.8%. All patients in the focal cavity subtype and focal mass or nodule subtype categories achieved 1-year culture conversion. Additionally, 1-year culture conversion rate was 92.9% in consolidation upon emphysema subtype and 75.0% in bronchiolitis subtype. CONCLUSION: Unclassifiable type MAC-PD can be radiologically further categorized into four major radiologic subtypes. The treatment outcome of all of these subtypes seems to be favorable.


Assuntos
Pneumopatias , Infecção por Mycobacterium avium-intracellulare , Enfisema Pulmonar , Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Feminino , Complexo Mycobacterium avium , Infecção por Mycobacterium avium-intracellulare/diagnóstico por imagem , Infecção por Mycobacterium avium-intracellulare/tratamento farmacológico , Pneumopatias/diagnóstico por imagem , Pneumopatias/tratamento farmacológico , Resultado do Tratamento , Antibacterianos/uso terapêutico , Estudos Retrospectivos
5.
Antimicrob Agents Chemother ; 66(2): e0152221, 2022 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-34930036

RESUMO

During the treatment of Mycobacterium avium complex pulmonary disease (MAC-PD), ethambutol or rifampin is often discontinued because of adverse events. This study investigated the treatment outcomes when broader-spectrum fluoroquinolones replace ethambutol or rifampin in MAC-PD treatment based on the radiologic type. From 2006 to 2019, patients who initiated standard treatment and whose treatment duration was ≥1 year were retrospectively identified at a tertiary referral center in South Korea, including 178 patients with cavitary disease (fibrocavitary and cavitary nodular bronchiectatic types) and 256 patients with the noncavitary nodular bronchiectatic (NC-NB) type. We compared the microbiologic cure at 1 year between the patients who maintained the initial regimen and those who replaced ethambutol or rifampin with fluoroquinolones (moxifloxacin or levofloxacin). The overall microbiologic cure rate of the 178 patients with cavitary disease was 71.3%. Among these, the microbiologic cure rates of the 16 patients who substituted fluoroquinolones for ethambutol were lower than those of the 156 patients who maintained three-drug oral antibiotics with aminoglycoside (37.5% versus 74.4%, respectively; P = 0.007), which was statistically significant in multivariate analysis. The outcomes of the six patients receiving fluoroquinolones as an alternative to rifampin were similar to that of those continuing the initial regimen. The microbiologic cure rate of the patients with the NC-NB type receiving daily or intermittent oral three-drug therapy was similar regardless of maintaining the initial therapy or replacing ethambutol or rifampin with fluoroquinolones. In conclusion, in cavitary MAC-PD, replacing ethambutol with fluoroquinolones resulted in inferior patient outcomes.


Assuntos
Pneumopatias , Infecção por Mycobacterium avium-intracellulare , Antibacterianos/uso terapêutico , Quimioterapia Combinada , Etambutol/uso terapêutico , Fluoroquinolonas/uso terapêutico , Humanos , Pneumopatias/tratamento farmacológico , Pneumopatias/microbiologia , Complexo Mycobacterium avium , Infecção por Mycobacterium avium-intracellulare/tratamento farmacológico , Infecção por Mycobacterium avium-intracellulare/microbiologia , Estudos Retrospectivos , Rifampina
6.
BMC Infect Dis ; 22(1): 600, 2022 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-35799129

RESUMO

BACKGROUND: Very few studies have compared the effects and side effects of vancomycin and teicoplanin in patients with methicillin-resistant Staphylococcus aureus pneumonia. This study aimed to compare the efficacy and safety of vancomycin and teicoplanin in patients with methicillin-resistant Staphylococcus aureus pneumonia. METHODS: This study examined 116 patients with methicillin-resistant Staphylococcus aureus pneumonia who met the inclusion criteria and were treated with either vancomycin (n = 54) or teicoplanin (n = 62). The primary (i.e., clinical failure during treatment) and secondary outcomes (i.e., mortality rates, discontinuation of study drugs due to treatment failure, side effects, and clinical cure) were evaluated. RESULTS: The vancomycin group presented lower clinical failure rates (25.9% vs. 61.3%, p < 0.001), discontinuation due to treatment failure (22.2% vs. 41.9%, p = 0.024), and mortality rates (3.7% vs 19.4%, p = 0.010). The Cox proportional hazard model revealed that teicoplanin was a significant clinical failure predictor compared with vancomycin (adjusted odds ratio, 2.198; 95% confidence interval 1.163-4.154). The rates of drug change due to side effects were higher in the vancomycin group than in the teicoplanin group (24.1% vs. 1.6%, p < 0.001). CONCLUSIONS: Vancomycin presented favorable treatment outcomes and more side effects compared with teicoplanin, which suggests that clinicians would need to consider the efficacy and potential side effects of these drugs before prescription.


Assuntos
Staphylococcus aureus Resistente à Meticilina , Pneumonia Estafilocócica , Infecções Estafilocócicas , Antibacterianos/efeitos adversos , Humanos , Testes de Sensibilidade Microbiana , Pneumonia Estafilocócica/tratamento farmacológico , Infecções Estafilocócicas/tratamento farmacológico , Teicoplanina/efeitos adversos , Vancomicina/efeitos adversos
7.
Neurol Sci ; 43(11): 6425-6431, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35939134

RESUMO

PURPOSE: To identify the retina-structural and visual-functional alterations in the patients with aquaporin-4 (AQP4)-IgG-positive neuromyelitis optica spectrum disorder (NMOSD), myelin oligodendrocyte glycoprotein-associated disease (MOGAD), and multiple sclerosis (MS) patients, all of whom had demyelinating transverse myelitis (TM) without optic neuritis (ON). METHODS: In this retrospective cross-sectional study, we reviewed the medical records of 97 patients, including 23 with AQP4-ON, 13 with AQP4-TM, 32 with MOG-ON, 3 with MOG-TM, 13 with MS-ON, and 13 with MS-TM. We measured the thickness of the retinal nerve fiber layer (RNFL) and the ganglion cell layer-inner plexiform layer (GCIPL) using optical coherence tomography to evaluate structural changes and compared these parameters with those of an age-matched healthy control. Functional outcomes were measured as visual acuity and mean deviation in visual field test. RESULTS: Mean RNFL and GCIPL thicknesses in all of the patients with TM were lower relative to the healthy control, while visual function was well preserved. Among the TM patients, RNFL thickness did not vary significantly among the groups, whereas GCIPL thickness in AQP4-TM and MS-TM was significantly lower than that in MOG-TM. All three TM groups showed significant mean RNFL reduction compared with the healthy control, whereas mean GCIPL thinning was evident only in AQP4-TM and MS-TM, not in MOG-TM. CONCLUSION: Patients with demyelinating TM incur retina-microstructural damage that varies by specific disease entity. Damage is distinct in AQP4-IgG-positive NMOSD and MS, but it is not so severe as to cause functional damage.


Assuntos
Esclerose Múltipla , Mielite Transversa , Neuromielite Óptica , Neurite Óptica , Humanos , Mielite Transversa/diagnóstico por imagem , Estudos Retrospectivos , Estudos Transversais , Autoanticorpos , Aquaporina 4 , Glicoproteína Mielina-Oligodendrócito , Neuromielite Óptica/diagnóstico por imagem , Neurite Óptica/diagnóstico por imagem , Retina/diagnóstico por imagem , Esclerose Múltipla/complicações , Esclerose Múltipla/diagnóstico por imagem , Imunoglobulina G
8.
J Infect Chemother ; 28(8): 1112-1118, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35400550

RESUMO

BACKGROUND: We aimed to investigate treatment outcomes according to the presence or absence of cavitary lesions in patients with the interstitial lung disease (ILD) subtype of unclassifiable type Mycobacterium avium complex (MAC) pulmonary disease (PD). METHODS: Study subjects were enrolled at a tertiary referral center in South Korea from 2001 to 2020. Among patients with MAC-PD who had ILD as an underlying disease, 38 patients who were diagnosed with the ILD subtype of unclassifiable MAC-PD and who received treatment for ≥1 year were selected for this study. Treatment outcomes in terms of microbiological cure at 1 year were retrospectively analyzed for these patients. RESULTS: The mean age of the patients was 64.4 ± 12.9 years, and 63.2% were male. The presence of cavitary lesions was noted in 68.4% (26/38) patients. A usual interstitial pneumonia pattern was the predominant type of ILD, which was identified in 26 (68.4%) patients. The overall 1-year microbiological cure rate of the 38 patients was 65.8% (25/38). Of the 26 patients with cavitary lesions, microbiological cure at 1 year was achieved in 14 patients (53.8%), which is significantly lower than that in patients without cavitary lesions (91.7%, 11/12, p = 0.030). CONCLUSIONS: A clear difference in treatment outcomes was noted in the ILD subtype of MAC-PD according to the presence or absence of cavitary lesions.


Assuntos
Doenças Pulmonares Intersticiais , Infecção por Mycobacterium avium-intracellulare , Idoso , Feminino , Humanos , Doenças Pulmonares Intersticiais/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Complexo Mycobacterium avium , Infecção por Mycobacterium avium-intracellulare/microbiologia , Estudos Retrospectivos , Resultado do Tratamento
9.
BMC Pulm Med ; 22(1): 175, 2022 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-35501757

RESUMO

BACKGROUND: Although pulmonary rehabilitation is helpful for patients following lung cancer surgery, rehabilitation is not widely available, due in part to a lack of medical resources. Recent developments in digital health care have overcome the space limitations associated with in-person health care. This study will evaluate and compare the efficacy of three different smartphone healthcare systems in patients with lung cancer. METHODS: This single center randomized controlled study is designed to evaluate the efficacy of digital healthcare applications for lung cancer patients after thoracoscopic lung resection. A total of 320 patients will be enrolled and randomized 1:1:1:1 into four different groups, with one group each using the smartphone applications NOOM, Walkon, and Efilcare and the fourth being the control group without intervention. Questionnaires will be administered to patients at baseline and after 3, 6, and 12 months. The primary endpoint will be the score on the EuroQol five-dimension index. Secondary endpoints will include other questionnaires about quality of life and dyspnea. DISCUSSION: This prospective randomized controlled study may allow assessments and comparisons of the efficacy of various smartphone applications in patients who undergo lung cancer surgery. This process may enable the introduction of healthcare interventions that maintain quality of life in patients with lung cancer. Trial registration CRIS, KCT0005447. Registered 06 October 2020, https://cris.nih.go.kr/cris/search/detailSearch.do/19346.


Assuntos
Neoplasias Pulmonares , Qualidade de Vida , Atenção à Saúde , Humanos , Neoplasias Pulmonares/cirurgia , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto , Smartphone
10.
BMC Med Inform Decis Mak ; 22(1): 229, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-36050674

RESUMO

BACKGROUND: Extracting metastatic information from previous radiologic-text reports is important, however, laborious annotations have limited the usability of these texts. We developed a deep-learning model for extracting primary lung cancer sites and metastatic lymph nodes and distant metastasis information from PET-CT reports for determining lung cancer stages. METHODS: PET-CT reports, fully written in English, were acquired from two cohorts of patients with lung cancer who were diagnosed at a tertiary hospital between January 2004 and March 2020. One cohort of 20,466 PET-CT reports was used for training and the validation set, and the other cohort of 4190 PET-CT reports was used for an additional-test set. A pre-processing model (Lung Cancer Spell Checker) was applied to correct the typographical errors, and pseudo-labelling was used for training the model. The deep-learning model was constructed using the Convolutional-Recurrent Neural Network. The performance metrics for the prediction model were accuracy, precision, sensitivity, micro-AUROC, and AUPRC. RESULTS: For the extraction of primary lung cancer location, the model showed a micro-AUROC of 0.913 and 0.946 in the validation set and the additional-test set, respectively. For metastatic lymph nodes, the model showed a sensitivity of 0.827 and a specificity of 0.960. In predicting distant metastasis, the model showed a micro-AUROC of 0.944 and 0.950 in the validation and the additional-test set, respectively. CONCLUSION: Our deep-learning method could be used for extracting lung cancer stage information from PET-CT reports and may facilitate lung cancer studies by alleviating laborious annotation by clinicians.


Assuntos
Aprendizado Profundo , Neoplasias Pulmonares , Humanos , Pulmão , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Processamento de Linguagem Natural , Estadiamento de Neoplasias , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos
11.
Int J Mol Sci ; 23(19)2022 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-36233134

RESUMO

Zinc is a fundamental trace element essential for numerous biological processes, and zinc homeostasis is regulated by the Zrt-/Irt-like protein (ZIP) and zinc transporter (ZnT) families. ZnT7 is mainly localized in the Golgi apparatus and endoplasmic reticulum (ER) and transports zinc into these organelles. Although previous studies have reported the role of zinc in animal physiology, little is known about the importance of zinc in the Golgi apparatus and ER in animal development and neurodegenerative diseases. In this study, we demonstrated that ZnT86D, a Drosophila ortholog of ZnT7, plays a pivotal role in the neurodevelopment and pathogenesis of Alzheimer disease (AD). When ZnT86D was silenced in neurons, the embryo-to-adult survival rate, locomotor activity, and lifespan were dramatically reduced. The toxic phenotypes were accompanied by abnormal neurogenesis and neuronal cell death. Furthermore, knockdown of ZnT86D in the neurons of a Drosophila AD model increased apoptosis and exacerbated neurodegeneration without significant changes in the deposition of amyloid beta plaques and susceptibility to oxidative stress. Taken together, our results suggest that an appropriate distribution of zinc in the Golgi apparatus and ER is important for neuronal development and neuroprotection and that ZnT7 is a potential protective factor against AD.


Assuntos
Doença de Alzheimer , Proteínas de Transporte de Cátions , Oligoelementos , Doença de Alzheimer/genética , Peptídeos beta-Amiloides/metabolismo , Animais , Proteínas de Transporte de Cátions/genética , Proteínas de Transporte de Cátions/metabolismo , Drosophila/metabolismo , Drosophila melanogaster/genética , Drosophila melanogaster/metabolismo , Oligoelementos/metabolismo , Zinco/metabolismo
12.
Environ Monit Assess ; 194(4): 268, 2022 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-35266055

RESUMO

The simultaneous determination of 8 polychlorinated biphenyls (PCBs), 23 organic chlorine pesticides (OCPs), and 35 polycyclic aromatic hydrocarbons (PAHs) in black-tailed gull eggs was described using ultrasound-assisted extraction and gas chromatography-tandem mass spectrometry (GC-MS/MS). The ranges of the lower limits of detection for PCBs, OCPs, and PAHs were 0.006-0.029, 0.01-0.10, and 0.01-0.20 µg kg-1, respectively. The intraday precision was in the range of 0.650-12.9% and the intraday accuracy was in the range of 86.6-113%. When the proposed method was used to analyze the target compounds in gull eggs collected from six sites in the Republic of Korea, the analytical results demonstrated concentration ranges of 113.32-394.07 µg kg-1 for total PCBs, 422.92-1082.09 µg kg-1 for total OCPs, and 134.50-231.27 µg kg-1 for total PAHs in the samples. The PCA results for PAHs and OCPs were well differentiated by sampling site, whereas those for PCBs differed little by sampling site. There were more pyrogenic PAHs in the West Sea and the South Sea with many industrial areas than in the East Sea with few industrial areas. Differences in the OCP patterns of samples from the West Sea close to China were considered to be related to the use of DDT in China until recently. PCBs were accumulated in the samples regardless of region, so there was no significant difference in the PCB patterns between the samples obtained from the three Seas.


Assuntos
Charadriiformes , Hidrocarbonetos Clorados , Praguicidas , Bifenilos Policlorados , Hidrocarbonetos Policíclicos Aromáticos , Animais , Cloro/análise , Monitoramento Ambiental , Cromatografia Gasosa-Espectrometria de Massas , Hidrocarbonetos Clorados/análise , Praguicidas/análise , Bifenilos Policlorados/análise , Hidrocarbonetos Policíclicos Aromáticos/análise , Espectrometria de Massas em Tandem
13.
Neurol Sci ; 42(12): 5213-5218, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33825117

RESUMO

Pupil palsy has been a frequent finding in Miller Fisher syndrome (MFS), but its clinical characteristics have not been clearly defined. The basis for differential diagnosis with other diseases with pupil palsy has also remained vague. We report cases of four MFS patients with bilateral pupil palsy and specify pupil characteristics of light-near dissociation (LND), cholinergic super-sensitivity, vermiform movements, and prognosis. We conducted a literature review to compare with our cases and investigate common findings of pupil palsy in MFS patients. We suggest that the acute generalized pupil palsy without vermiform movements can serve as a key finding for the diagnosis of pupil palsy associated with MFS. However, the presence of LND and cholinergic super-sensitivity was not distinctive clinical findings in MFS patients who had pupil palsy and did not prove useful for differential diagnosis. The prognosis of pupil palsy in MFS patients was good in our 4 cases and the literature review.


Assuntos
Síndrome de Miller Fisher , Diagnóstico Diferencial , Humanos , Síndrome de Miller Fisher/complicações , Síndrome de Miller Fisher/diagnóstico , Paralisia , Prognóstico , Pupila
14.
Respiration ; 98(3): 203-211, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31096241

RESUMO

BACKGROUND: Standard therapy for cancer-associated venous thromboembolism (VTE) is low-molecular-weight heparin. The use of direct oral anticoagulants for cancer-associated VTE has increased; however, their efficacy and safety in lung cancer patients remain unclear. OBJECTIVES: We examined the efficacy and safety of rivaroxaban compared with dalteparin for cancer-associated VTE in patients with primary lung cancer. METHODS: A single-center retrospective study of 204 patients with primary lung cancer who were prescribed rivaroxaban (n = 131) or dalteparin (n = 73) for VTE was performed. The primary endpoint was a composite event including recurrence and major or clinically relevant nonmajor bleeding. Secondary endpoints included the incidence of recurrence, major and clinically relevant nonmajor bleeding, all-cause mortality, and bleeding or pulmonary embolism-related mortality. RESULTS: The composite event occurred in 38 (29.0) and 12 (16.4%) patients in the rivaroxaban and dalteparin (p = 0.045) groups, respectively. The multivariate Cox proportional hazards model for age, Eastern Cooperative Oncology Group performance score, and bleeding risk factors revealed the rivaroxaban group showed a 1.176-fold composite event risk without statistical significance (0.595-2.324, p = 0.641). There was no statistically significant intergroup difference for the incidence of VTE recurrence (5.3% in the rivaroxaban group versus 2.7% in the dalteparin group, p = 0.495) and major or clinically relevant nonmajor bleeding (23.7% in the rivaroxaban group versus 13.7% in the dalteparin group, p = 0.089). There was no significant difference in the all-cause mortality rate (hazard ratio 0.864, 95% CI 0.624-1.196, p = 0.337). CONCLUSIONS: There was no difference in the safety and efficacy profile of rivaroxaban compared with dalteparin. Therefore, rivaroxaban may be a valuable treatment option for lung cancer-associated VTE.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/complicações , Dalteparina/uso terapêutico , Inibidores do Fator Xa/uso terapêutico , Neoplasias Pulmonares/complicações , Embolia Pulmonar/tratamento farmacológico , Rivaroxabana/uso terapêutico , Trombose Venosa/tratamento farmacológico , Idoso , Anticoagulantes/uso terapêutico , Carcinoma de Células Grandes/complicações , Causas de Morte , Duração da Terapia , Feminino , Hemorragia Gastrointestinal/induzido quimicamente , Hemorragia/induzido quimicamente , Humanos , Hemorragias Intracranianas/induzido quimicamente , Masculino , Pessoa de Meia-Idade , Mortalidade , Modelos de Riscos Proporcionais , Embolia Pulmonar/complicações , Recidiva , Doenças Respiratórias , Estudos Retrospectivos , Carcinoma de Pequenas Células do Pulmão/complicações , Tromboembolia Venosa/complicações , Tromboembolia Venosa/tratamento farmacológico , Trombose Venosa/complicações
15.
J Korean Med Sci ; 34(21): e160, 2019 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-31144482

RESUMO

BACKGROUND: Low-molecular-weight heparin (LMWH) is the standard treatment for venous thromboembolism (VTE) in patients with active cancer. However, use of factor Xa inhibitors, such as rivaroxaban, is increasing on the basis of limited clinical evidence. The present single-center study compared the incidence of bleeding and other treatment outcomes in gastrointestinal and pancreatobiliary cancer (GI tract cancer) patients administered rivaroxaban or LMWH for the treatment of VTE. METHODS: Retrospective data from 281 GI tract cancer patients who were treated for VTE with rivaroxaban (n = 78) or LMWH (n = 203) between 1 January 2012 and 31 December 2016, were analyzed. Primary end-point was the incidence of major and clinically relevant bleeding. Secondary outcomes included the incidence of recurrent VTE and mortality. RESULTS: Clinically relevant bleeding occurred in 19 patients (24.4%) in the rivaroxaban group and 31 (15.3%) in the LMWH group (P = 0.074). No inter-group difference was observed for rate of VTE recurrence (3.8% with rivaroxaban vs. 3.9% with LMWH; P > 0.999) or incidence of major bleeding (5.1% with rivaroxaban vs. 8.9% with LMWH; P = 0.296). Multivariate Cox proportional hazards analysis for age, cancer type, metastasis, history of chemotherapy or recent surgery, and Eastern Cooperative Oncology Group performance status revealed a 1.904-fold higher risk of bleeding with rivaroxaban than LMWH (1.031-3.516; P = 0.040). No significant inter-group difference was found in terms of hazard ratio for all-cause mortality. CONCLUSION: Compared to LMWH, rivaroxaban was associated with a higher incidence of clinically relevant bleeding in GI tract cancer patients presenting with VTE.


Assuntos
Anticoagulantes/uso terapêutico , Inibidores do Fator Xa/uso terapêutico , Heparina de Baixo Peso Molecular/uso terapêutico , Neoplasias Pancreáticas/patologia , Rivaroxabana/uso terapêutico , Neoplasias Gástricas/patologia , Tromboembolia Venosa/tratamento farmacológico , Anticoagulantes/efeitos adversos , Sistema Biliar/patologia , Inibidores do Fator Xa/efeitos adversos , Feminino , Trato Gastrointestinal/patologia , Hemorragia/induzido quimicamente , Heparina de Baixo Peso Molecular/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Estudos Retrospectivos , Rivaroxabana/efeitos adversos , Tromboembolia Venosa/complicações
16.
Biol Pharm Bull ; 41(4): 470-477, 2018 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-29398668

RESUMO

The Nardostachys jatamansi DC (NJ) root has been used as a sedative or analgesic to treat neurological symptoms and pain in traditional Korean medicine. Here, we investigate the potential effects of NJ on Alzheimer's disease (AD) and reveal the molecular mechanism through which NJ exerts its effects. The neuroprotective effect of the NJ root ethanol extract against ß amyloid (Aß) toxicity was examined in vitro using a cell culture system and in vivo using a Drosophila AD model. The NJ extract and chlorogenic acid, a major component of NJ, inhibited Aß-induced cell death in SH-SY5Y cells. Moreover, the NJ extract rescued the neurological phenotypes of the Aß42-expressing flies (decreased survival and pupariation rate and a locomotor defect) and suppressed Aß42-induced cell death in the brain. We also found that NJ extract intake reduced glial cell number, reactive oxygen species level, extracellular-signal-regulated kinase (ERK) phosphorylation, and nitric oxide level in Aß42-expressing flies, without affecting Aß accumulation. These data suggest that the neuroprotective activity of NJ might be associated with its antioxidant and anti-inflammatory properties, as well as its inhibitory action against ERK signaling; thus, NJ is a promising medicinal plant for the development of AD treatment.


Assuntos
Doença de Alzheimer/tratamento farmacológico , Encéfalo/efeitos dos fármacos , Nardostachys/química , Neurônios/efeitos dos fármacos , Fármacos Neuroprotetores/uso terapêutico , Extratos Vegetais/uso terapêutico , Raízes de Plantas/química , Doença de Alzheimer/metabolismo , Doença de Alzheimer/patologia , Peptídeos beta-Amiloides/antagonistas & inibidores , Peptídeos beta-Amiloides/genética , Peptídeos beta-Amiloides/metabolismo , Animais , Animais Geneticamente Modificados , Encéfalo/metabolismo , Encéfalo/patologia , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Células Cultivadas , Drosophila/genética , Drosophila/crescimento & desenvolvimento , Etnofarmacologia , Humanos , Larva/efeitos dos fármacos , Larva/metabolismo , Medicina Tradicional Coreana , Proteínas do Tecido Nervoso , Neurônios/metabolismo , Neurônios/patologia , Fármacos Neuroprotetores/farmacologia , Fragmentos de Peptídeos/antagonistas & inibidores , Fragmentos de Peptídeos/genética , Fragmentos de Peptídeos/metabolismo , Fitoterapia , Extratos Vegetais/farmacologia , República da Coreia , Análise de Sobrevida
18.
Sensors (Basel) ; 18(10)2018 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-30241384

RESUMO

In this paper, we present the fabrication of an efficient thin film temperature sensor utilizing chemical vapor deposited carbon nanotube (CNT) film as the sensing element on Si substrates, with diamond-like carbon (DLC):Ni as a catalyst in assisting CNT growth. The fabricated sensor showed good electrical response with change in temperature. Relative linear change in resistance of 18.4% for an increase in temperature from 22 °C to 200 °C was achieved. Various characterizing techniques, such as scanning electron microscopy (SEM) and Raman spectroscopy, were used to characterize the films. In an effort to study device performance, van der Pauw and Hall measurements were carried out to study the dependence of resistance on temperature and magnetic fields. Temperature coefficient of resistance of the sensor was calculated as 1.03 × 10-3/°C. All implications arising from the study are presented. The results establish the aptness of the as-grown CNT film to be used as an active sensing material in thin film temperature sensors.

19.
Biochem Biophys Res Commun ; 484(3): 702-709, 2017 03 11.
Artigo em Inglês | MEDLINE | ID: mdl-28161642

RESUMO

Oogenesis in Drosophila involves very dynamic cellular changes such as cell migration and polarity formation inside an ovary during short period. Previous studies identified a number of membrane-bound receptors directly receiving certain types of extracellular inputs as well as intracellular signalings to be involved in the regulation of these dynamic cellular changes. However, yet our understanding on exactly how these receptor-mediated extracellular inputs lead to dynamic cellular changes remains largely unclear. Here, we identified Drosophila tensin encoded by blistery (by) as a novel regulator of cell migration and planar polarity formation and characterized the genetic interaction between tensin and integrin during oogenesis. Eggs from by mutant showed decreased hatching rate and morphological abnormality, a round-shape, compared to the wild-type eggs. Further analyses revealed that obvious cellular defects such as defective border cell migration and planar polarity formation might be primarily associated with the decreased hatching rate and the round-shape phenotype of by mutant eggs, respectively. Moreover, by mutation also induced marked defects in F-actin organization closely associated with both cell migration and planar polarity formation during oogenesis of Drosophila. Notably, all these defective phenotypes observed in by mutant eggs became much severer by reduced level of integrin, indicative of a close functional association between integrin and tensin during oogenesis. Collectively, our findings suggest that tensin acts as a crucial regulator of dynamic cellular changes during oogenesis by bridging integrin-dependent extracellular signals to intracellular cytoskeletal organization.


Assuntos
Actinas/metabolismo , Drosophila/embriologia , Drosophila/fisiologia , Integrinas/metabolismo , Oogênese/fisiologia , Tensinas/metabolismo , Animais , Movimento Celular/fisiologia , Polaridade Celular/fisiologia , Células Cultivadas , Drosophila/citologia , Proteínas de Drosophila , Líquido Extracelular/metabolismo , Regulação da Expressão Gênica no Desenvolvimento/fisiologia
20.
Int J Mol Sci ; 18(7)2017 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-28665350

RESUMO

Methylation of several lysine residues of histones is a crucial mechanism for relatively long-term regulation of genomic activity. Recent molecular biological studies have demonstrated that the function of histone methylation is more diverse and complex than previously thought. Moreover, studies using newly available genomics techniques, such as exome sequencing, have identified an increasing number of histone lysine methylation-related genes as intellectual disability-associated genes, which highlights the importance of accurate control of histone methylation during neurogenesis. However, given the functional diversity and complexity of histone methylation within the cell, the study of the molecular basis of histone methylation-related neurodevelopmental disorders is currently still in its infancy. Here, we review the latest studies that revealed the pathological implications of alterations in histone methylation status in the context of various neurodevelopmental disorders and propose possible therapeutic application of epigenetic compounds regulating histone methylation status for the treatment of these diseases.


Assuntos
Histonas/metabolismo , Lisina/metabolismo , Transtornos do Neurodesenvolvimento/genética , Transtornos do Neurodesenvolvimento/metabolismo , Animais , Epigênese Genética/genética , Humanos , Metilação , Processamento de Proteína Pós-Traducional
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