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1. Comparison of factors influencing the decision to withdraw life-sustaining treatment in intensive care unit patients after implementation of the Life-Sustaining Treatment Act in Korea

Author: Claire Junga Kim, Kyung Sook Hong, Sooyoung Cho, and Jin Park
Subjects: cancer, death, healthcare cost, intensive care unit, palliative care, terminal care, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Background The decision to discontinue intensive care unit (ICU) treatment during the end-of-life stage has recently become a significant concern in Korea, with an observed increase in life-sustaining treatment (LST) withdrawal. There is a growing demand for evidence-based support for patients, families, and clinicians in making LST decisions. This study aimed to identify factors influencing LST decisions in ICU inpatients and to analyze their impact on healthcare utilization. Methods We retrospectively reviewed medical records of ICU patients with neurological disorders, infectious disorders, or cancer who were treated at a single university hospital between January 1, 2019 and July 7, 2021. Factors influencing the decision to withdraw LST were compared between those who withdrew LST and those who did not. Results Among 54,699 hospital admissions, LST was withdrawn in 550 cases (1%). Cancer was the most common diagnosis, followed by pneumonia and cerebral infarction. Among ICU inpatients, LST was withdrawn from 215 (withdrawal group). The withdrawal group was older (78 vs. 75 years, P=0.002), had longer total hospital stays (16 vs. 11 days, P
Published: 2024
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2. Integrating ensemble and machine learning models for early prediction of pneumonia mortality using laboratory tests

Author: Seung Min Baik, Kyung Sook Hong, Jae-Myeong Lee, and Dong Jin Park
Subjects: Artificial intelligence, Laboratory test, Pneumonia, Mortality, Prediction, Science (General), Q1-390, Social sciences (General), H1-99
Abstract: Background: The recent use of artificial intelligence (AI) in medical research is noteworthy. However, most research has focused on medical imaging. Although the importance of laboratory tests in the clinical field is acknowledged by clinicians, they are undervalued in medical AI research. Our study aims to develop an early prediction AI model for pneumonia mortality, primarily using laboratory test results. Materials and methods: We developed a mortality prediction model using initial laboratory results and basic clinical information of patients with pneumonia. Several machine learning (ML) models and a deep learning method—multilayer perceptron (MLP)—were selected for model development. The area under the receiver operating characteristic curve (AUROC) and F1-score were optimized to improve model performance. In addition, an ensemble model was developed by blending several models to improve the prediction performance. We used 80,940 data instances for model development. Results: Among the ML models, XGBoost exhibited the best performance (AUROC = 0.8989, accuracy = 0.88, F1-score = 0.80). MLP achieved an AUROC of 0.8498, accuracy of 0.86, and F1-score of 0.75. The performance of the ensemble model was the best among the developed models, with an AUROC of 0.9006, accuracy of 0.90, and F1-score of 0.81. Several laboratory tests were conducted to identify risk factors that affect pneumonia mortality using the ''Feature importance'' technique and SHapley Additive exPlanations. We identified several laboratory results, including systolic blood pressure, serum glucose level, age, aspartate aminotransferase-to-alanine aminotransferase ratio, and monocyte-to-lymphocyte ratio, as significant predictors of mortality in patients with pneumonia. Conclusions: Our study demonstrates that the ensemble model, incorporating XGBoost, CatBoost, and LGBM techniques, outperforms individual ML and deep learning models in predicting pneumonia mortality. Our findings emphasize the importance of integrating AI techniques to leverage laboratory test data effectively, offering a promising direction for advancing AI applications in medical research and clinical decision-making.
Published: 2024
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3. Deep learning approach for early prediction of COVID-19 mortality using chest X-ray and electronic health records

Author: Seung Min Baik, Kyung Sook Hong, and Dong Jin Park
Subjects: COVID-19, Deep learning, Prediction model, Chest X-ray, Electronic health record, Computer applications to medicine. Medical informatics, R858-859.7, Biology (General), QH301-705.5
Abstract: Abstract Background An artificial-intelligence (AI) model for predicting the prognosis or mortality of coronavirus disease 2019 (COVID-19) patients will allow efficient allocation of limited medical resources. We developed an early mortality prediction ensemble model for COVID-19 using AI models with initial chest X-ray and electronic health record (EHR) data. Results We used convolutional neural network (CNN) models (Inception-ResNet-V2 and EfficientNet) for chest X-ray analysis and multilayer perceptron (MLP), Extreme Gradient Boosting (XGBoost), and random forest (RF) models for EHR data analysis. The Gradient-weighted Class Activation Mapping and Shapley Additive Explanations (SHAP) methods were used to determine the effects of these features on COVID-19. We developed an ensemble model (Area under the receiver operating characteristic curve of 0.8698) using a soft voting method with weight differences for CNN, XGBoost, MLP, and RF models. To resolve the data imbalance, we conducted F1-score optimization by adjusting the cutoff values to optimize the model performance (F1 score of 0.77). Conclusions Our study is meaningful in that we developed an early mortality prediction model using only the initial chest X-ray and EHR data of COVID-19 patients. Early prediction of the clinical courses of patients is helpful for not only treatment but also bed management. Our results confirmed the performance improvement of the ensemble model achieved by combining AI models. Through the SHAP method, laboratory tests that indicate the factors affecting COVID-19 mortality were discovered, highlighting the importance of these tests in managing COVID-19 patients.
Published: 2023
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4. Validation of presepsin measurement for mortality prediction of sepsis: a preliminary study

Author: Seung Min Baik, Jin Park, Tae Yoon Kim, Se Hong Choi, and Kyung Sook Hong
Subjects: biomarkers, mortality, presepsin, sepsis, septic shock, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Background Sepsis and septic shock remain the leading causes of death in critically ill patients worldwide. Various biomarkers are available to determine the prognosis and therapeutic effects of sepsis. In this study, we investigated the effectiveness of presepsin as a sepsis biomarker. Methods Patients admitted to the intensive care unit with major or minor diagnosis of sepsis were categorized into survival and non-survival groups. The white blood cell count and serum C-reactive protein, procalcitonin, and presepsin levels were measured in all patients. Results The study included 40 patients (survival group, 32; non-survival group, 8; mortality rate, 20%). The maximum serum presepsin levels measured during intensive care unit admission were significantly higher in the non-survival group ((median [interquartile range]: 4,205.5 pg/ml [1,155.8–10,094.0] vs. 741.5 pg/ml [520.0–1,317.5], P
Published: 2022
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5. Efficacy of a rehabilitation program using minor muscles in colorectal cancer patients with chemotherapy-induced neuropathy: preliminary study

Author: Kyung Sook Hong, Soon Sup Chung, Kwang Ho Kim, and Ryung-Ah Lee
Subjects: peripheral neuropathy, pain, rehabilitation, chemotherapy, colorectal neoplasms, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282, Surgery, RD1-811
Abstract: Purpose Chemotherapy-induced peripheral neuropathy (CIPN) is one of the common reasons that colorectal cancer patients cannot maintain their routine chemotherapy schedules. Some medications are used for pain relief; however, the effect of medication is disappointing. We carried out this study to confirm that a rehabilitation program using minor muscles might provide a valuable aid in symptom relief of CIPN. Methods Eleven colorectal cancer patients participated in the basic craftwork program which encouraged the use of the minor muscles of the hands to make and decorate the handicrafts and it was held for 2 hours once a week, for a total of four times. There were no limitations in the stage of cancer or types of chemotherapy to participate the program. Questionnaires were obtained from participants before and after the basic handicrafts program. Results Of the 11 patients (3 men, 8 women; mean age, 53.0±11.2 years), six received 5-fluorouracil (5-FU) chemotherapy, four received FOLFOX4 (combination of 5-FU, leucovorin, and oxaliplatin) chemotherapy, and one received 5-FU, FOLFOX4, and FOLFIRI (combination of 5-FU, leucovorin, and irinotecan) chemotherapy sequentially. Patients attended the program a mean of 3.8±0.4 times. Common symptoms of CIPN were “throbbing pain,” “aching pain,” and “numbness.” The mean score of the questionnaires between pre- and post-program was 34.1±31.7 points and 24.4±21.5 points each, and it was significantly decreased (P=0.040). Conclusion Patients often suffered from CIPN symptoms like throbbing or aching pain and numbness during their adjuvant chemotherapy. A rehabilitation program using minor muscles for CIPN is expected to be effective.
Published: 2022
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6. Excellence of the closed intensive care unit system in critically ill surgical patients

Author: Seung Min Baik, Na Rae Yang, Tae Yoon Kim, and Kyung Sook Hong
Subjects: Medicine, Science
Abstract: Background Despite reports that the closed intensive care unit (ICU) system improves clinical outcomes, it has not been widely applied for various reasons. This study aimed to propose a better ICU system for critically ill patients by comparing the experience of open surgical ICU (OSICU) and closed surgical ICU (CSICU) systems in the same institution. Methods and findings Our institution converted the ICU system from “open” to “closed” in February 2020, and enrolled patients were classified into the OSICU and CSICU groups at that time from March 2019 to February 2022. A total of 751 patients were categorized into the OSICU (n = 191) and CSICU (n = 560) groups. The mean age of the patients was 67 years in the OSICU group and 72 years in the CSICU group (p < 0.05). The acute physiology and chronic health evaluation II score was 21.8 ± 7.65 in the CSICU group, which was higher than the score 17.4 ± 7.97 in the OSICU group (p < 0.05). The sequential organ failure assessment scores were 2.0 ± 2.29 in the OSICU group and 4.1 ± 3.06 in the CSICU group (p < 0.05). After correction for bias by logistic regression analysis for all-cause mortality, the odds ratio in the CSICU group was 0.089 (95% confidence interval [CI]: 0.014–0.568, p < 0.05). Conclusions Despite considering the various factors of increased patient severity, a CSICU system is more beneficial for critically ill patients. Therefore, we propose that the CSICU system be applied worldwide.
Published: 2023

7. Optimal duration of the apnea test for determining brain death: Benefit of the short-term apnea test.

Author: Seung Min Baik, Jin Park, Tae Yoon Kim, and Kyung Sook Hong
Subjects: Medicine, Science
Abstract: BackgroundThe criteria for brain death determination have not been unified globally, and there is no global consensus on the apnea test, which is essential for determining brain death. Since the apnea test is associated with many complications, we aimed to determine an optimal duration of the apnea test.MethodsWe analyzed the results of the apnea test performed for brain death determination between August 2013 and February 2021 at a single institution in South Korea. Elevations in the partial pressure of carbon dioxide and mean arterial blood pressure fluctuations over time in the apnea test were recorded.ResultsIn the 1st and 2nd tests, the mean partial pressure of carbon dioxide increased by more than 20 mmHg at 3 min after the apnea test compared to before the test (P < 0.05). At 4 min in the 1st test and 5 min in the 2nd test, the partial pressure of carbon dioxide exceeded 60 mmHg (P < 0.05). The fluctuation in the mean arterial blood pressure observed for 5 min during the apnea test was not significant. There was no significant fluctuation in the mean arterial blood pressure over time in the apnea test between patients with normal chest radiography findings and those with abnormal chest radiography findings (P = 0.888).ConclusionsOur study proposes that a short-term apnea test protocol is valid for the preservation of organs for donation.
Published: 2022
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8. Posterior Reversible Encephalopathy Syndrome after Hypovolemic Shock Which Is Required Differential Diagnosis with Delirium in the Intensive Care Unit

Author: Seo In Lee, Gyeong Seon Choi, Jin Park, Young-Joo Lee, and Kyung Sook Hong
Subjects: Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Published: 2018
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9. Epidermal growth factor-mediated Rab25 pathway regulates integrin β1 trafficking in colon cancer

Author: Kyung Sook Hong, Eun-Young Jeon, Soon Sup Chung, Kwang Ho Kim, and Ryung-Ah Lee
Subjects: Colonic neoplasms, Receptor trafficking, Endocytosis, Shedding, Integrins, Epidermal growth factor, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282, Cytology, QH573-671
Abstract: Abstract Background Integrins play a critical role in carcinogenesis. Integrin β1 localization is regulated by the guanosine-5′-triphosphate hydrolase Rab25 and integrin β1 levels are elevated in the serum of colon cancer patients; thus, the present study examined the effects of epidermal growth factor (EGF) and Rab25 on integrin β1 localization in colon cancer cells. Methods HCT116 human colon cancer cells were treated with increasing concentrations of EGF, and cell proliferation and protein expression were monitored by MTT and western blot analyses, respectively. Cell fractionation was performed to determine integrin β1 localization in the membrane and cytosol. Integrin β1 extracellular shedding was monitored by enzyme-linked immunosorbent assays (ELISAs) with culture supernatants from stimulated cells. HCT116 cells were transfected with Rab25-specific siRNA to determine the significance of Rab25 in integrin β1 trafficking in the presence of EGF. Results Total integrin β1 expression increased in response to EGF and subsequently decreased at 24 h post-stimulation. A similar decrease was observed in purified membrane fractions, whereas no changes were observed in cytosolic levels. ELISAs using media from stimulated cell cultures demonstrated increased integrin β1 levels corresponding to the decrease observed in membrane fractions, suggesting that EGF induces integrin receptor shedding. EGF stimulation in Rab25-knockdown cells resulted in integrin β1 accumulation in the membrane, suggesting that Rab25 promotes integrin endocytosis. Conclusions Integrin β1 is shed from colon cancer cells in response to EGF stimulation in a Rab25-dependent manner. These results further the present understanding of the role of integrin β1 in colon cancer progression.
Published: 2018
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10. Acute Cholecystitis as a Cause of Fever in Aneurysmal Subarachnoid Hemorrhage

Author: Na Rae Yang, Kyung Sook Hong, and Eui Kyo Seo
Subjects: cholecystectomy, cholecystitis, intensive care units, prognosis, retrospective studies, subarachnoid hemorrhage, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Background Fever is a very common complication that has been related to poor outcomes after aneurysmal subarachnoid hemorrhage (aSAH). The incidence of acalculous cholecystitis is reportedly 0.5%–5% in critically ill patients, and cerebrovascular disease is a risk factor for acute cholecystitis (AC). However, abdominal evaluations are not typically performed for febrile patients who have recently undergone aSAH surgeries. In this study, we discuss our experiences with febrile aSAH patients who were eventually diagnosed with AC. Methods We retrospectively reviewed 192 consecutive patients who underwent aSAH from January 2009 to December 2012. We evaluated their characteristics, vital signs, laboratory findings, radiologic images, and pathological data from hospitalization. We defined fever as a body temperature of >38.3°C, according to the Society of Critical Care Medicine guidelines. We categorized the causes of fever and compared them between patients with and without AC. Results Of the 192 enrolled patients, two had a history of cholecystectomy, and eight (4.2%) were eventually diagnosed with AC. Among them, six patients had undergone laparoscopic cholecystectomy. In their pathological findings, two patients showed findings consistent with coexistent chronic cholecystitis, and two showed necrotic changes to the gall bladder. Patients with AC tended to have higher white blood cell counts, aspartame aminotransferase levels, and C-reactive protein levels than patients with fevers from other causes. Predictors of AC in the aSAH group were diabetes mellitus (odds ratio [OR], 8.758; P = 0.033) and the initial consecutive fasting time (OR, 1.325; P = 0.024). Conclusions AC may cause fever in patients with aSAH. When patients with aSAH have a fever, diabetes mellitus and a long fasting time, AC should be suspected. A high degree of suspicion and a thorough abdominal examination of febrile aSAH patients allow for prompt diagnosis and treatment of this condition. Additionally, physicians should attempt to decrease the fasting time in aSAH patients.
Published: 2017
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11. Experiences Using Airway Pressure Release Ventilation for Pneumonia with Severe Hypercapnia or Postoperative Pulmonary Edema

Author: Kyung Sook Hong and Young-Joo Lee
Subjects: Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Published: 2017
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12. The Role of Glutathione Reductase in Influenza Infection

Author: Kyung Sook Hong, Kassandra Pagan, William Whalen, Rebecca Harris, Jianjun Yang, Heather Stout-Delgado, and Soo Jung Cho
Subjects: Male, Pulmonary and Respiratory Medicine, Mice, Inbred BALB C, Clinical Biochemistry, Lung Injury, Cell Biology, Glutathione, Antioxidants, Mice, Glutathione Reductase, Influenza A Virus, H1N1 Subtype, Orthomyxoviridae Infections, Influenza, Human, Animals, Humans, RNA, Female, Lung, Molecular Biology, Original Research
Abstract: Influenza infection induces lung epithelial cell injury via programmed cell death. Glutathione, a potent antioxidant, has been reported to be associated with influenza infection. We hypothesized that lung epithelial cell death during influenza infection is regulated by glutathione metabolism. Eight-week-old male and female BALB/c mice were infected with influenza (PR8: A/PR/8/34 [H1N1]) via intranasal instillation. Metabolomic analyses were performed on whole lung lysate after influenza infection. Foriin vitro/ianalysis, Beas-2B cells were infected with influenza. RNA was extracted, and QuantiTect Primer Assay was used to assess gene expression. Glutathione concentrations were assessed by colorimetric assay. Influenza infection resulted in increased inflammation and epithelial cell injury in our murine model, leading to increased morbidity and mortality. In both ouriin vivo/iandiin vitro/imodels, influenza infection was found to induce apoptosis and necroptosis. Influenza infection led to decreased glutathione metabolism and reduced glutathione reductase activity in lung epithelial cells. Genetic inhibition of glutathione reductase suppressed apoptosis and necroptosis of lung epithelial cells. Pharmacologic inhibition of glutathione reductase reduced airway inflammation, lung injury, and cell death in our murine influenza model. Our results demonstrate that glutathione reductase activity is suppressed during influenza. Glutathione reductase inhibition prevents epithelial cell death and morbidity in our murine influenza model. Our results suggest that glutathione reductase-dependent glutathione metabolism may play an important role in the host response to viral infection by regulating lung epithelial cell death.
Published: 2022
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13. Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Author: Tài, Pham, Leo, Heunk, Giacomo, Bellani, Fabiana, Madotto, Irene, Aragao, Gaëtan, Beduneau, Ewan C, Goligher, Giacomo, Grasselli, Jon Henrik, Laake, Jordi, Mancebo, Oscar, Peñuela, Lise, Piquilloud, Antonio, Pesenti, Hannah, Wunsch, Frank, van Haren, Laurent, Brochard, John G, Laffey, Abrough, Fekri, P Acharya, Subhash, Amin, Pravin, Arabi, Yaseen, Aragao, Irene, Bauer, Philippe, Beduneau, Gaëtan, Beitler, Jeremy, Berkius, Johan, Bugedo, Guillermo, Camporota, Luigi, Cerny, Vladimir, Cho, Young-Jae, Clarkson, Kevin, Estenssoro, Elisa, Goligher, Ewan, Grasselli, Giacomo, Gritsan, Alexey, Mohammadreza Hashemian, Seyed, Hermans, Greet, M Heunks, Leo, Jovanovic, Bojan, Kurahashi, Kiyoyasu, Henrik Laake, Jon, Matamis, Dimitrio, Moerer, Onnen, Molnar, Zsolt, Ozyilmaz, Ezgi, Panka, Bernardo, Papali, Alfred, Peñuelas, Óscar, Perbet, Sébastien, Piquilloud, Lise, Qiu, Haibo, Abdel Razek, Assem, Rittayamai, Nuttapol, Roldan, Rollin, Serpa Neto, Ary, Szuldrzynski, Konstanty, Talmor, Daniel, Tomescu, Dana, Van Haren, Frank, Villagomez, Asisclo, Ali Zeggwagh, Amine, Abe, Toshikazu, Aboshady, Abdelrhman, Acampo-de Jong, Melanie, Acharya, Subhash, Adderley, Jane, Adiguzel, Nalan, Kumar Agrawal, Vijay, Aguilar, Gerardo, Aguirre, Gaston, Aguirre-Bermeo, Hernan, Ahlström, Björn, Akbas, Türkay, Akker, Mustafa, Al Sadeh, Ghamdan, Alamri, Sultan, Algaba, Angela, Ali, Muneeb, Aliberti, Anna, Manuel Allegue, Jose, Alvarez, Diana, Amador, Joaquin, H Andersen, Finn, Ansari, Sharique, Apichatbutr, Yutthana, Apostolopoulou, Olympia, Arellano, Daniel, Arica, Mestanza, Arikan, Huseyin, Arinaga, Koichi, Arnal, Jean-Michel, Asano, Kengo, Asín-Corrochano, Marta, Milagrito Avalos Cabrera, Jesu, Avila Fuentes, Silvia, Aydemir, Semih, Aygencel, Gulbin, Azevedo, Luciano, Bacakoglu, Feza, Badie, Julio, Baedorf Kassis, Elia, Bai, Gabriela, Balaraj, Govindan, Ballico, Bruno, Banner-Goodspeed, Valerie, Banwarie, Preveen, Barbieri, Rosella, Baronia, Arvind, Barrett, Jonathan, Barrot, Loïc, Emilio Barrueco-Francioni, Jesu, Barry, Jeffrey, Bawangade, Harshal, Beavis, Sarah, Beck, Eduardo, Beehre, Nina, Belenguer Muncharaz, Alberto, Bellani, Giacomo, Belliato, Mirko, Bellissima, Agrippino, Beltramelli, Rodrigo, Ben Souissi, Asma, Benitez-Cano, Adela, Benlamin, Mohamed, Benslama, Abdellatif, Bento, Lui, Benvenuti, Daniela, Bernabe, Laura, Bersten, Andrew, Berta, Giacomo, Bertini, Pietro, Bertram-Ralph, Elliot, Besbes, Mohamed, Roberto Bettini, Lisandro, Beuret, Pascal, Bewley, Jeremy, Bezzi, Marco, Bhakhtiani, Lakshay, Bhandary, Rakesh, Bhowmick, Kaushik, Bihari, Shailesh, Bissett, Bernie, Blythe, David, Bocher, Simon, Boedjawan, Narain, M Bojanowski, Christine, Boni, Elisa, Boraso, Sabrina, Borelli, Massimo, Borello, Silvina, Borislavova, Margarita, J Bosma, Karen, Bottiroli, Maurizio, Boyd, Owen, Bozbay, Suha, Briva, Arturo, Brochard, Laurent, Bruel, Cédric, Bruni, Andrea, Buehner, Ulrike, Bulpa, Pierre, Burt, Karen, Buscot, Mathieu, Buttera, Stefania, Cabrera, Jorge, Caccese, Roberta, Caironi, Pietro, Canchos Gutierrez, Ivan, Canedo, Nancy, Cani, Alma, Cappellini, Iacopo, Carazo, Jesu, Pablo Cardonnet, Lui, Carpio, David, Carriedo, Demetrio, Carrillo, Ramón, Carvalho, João, Caser, Eliana, Castelli, Antonio, Castillo Quintero, Manuel, Castro, Heloisa, Catorze, Nuno, Cengiz, Melike, Cereijo, Enrique, Ceunen, Helga, Chaintoutis, Christo, Chang, Youjin, Chaparro, Gustavogcha, Chapman, Carmel, Chau, Simon, Eugenia Chavez, Cecilia, Chelazzi, Cosimo, Chelly, Jonathan, Chemouni, Frank, Chen, Kai, Chena, Ariel, Chiarandini, Paolo, Chilton, Phil, Chiumello, Davide, Chou-Lie, Yvette, Chudeau, Nicola, Cinel, Ismail, Cinnella, Gilda, Clark, Michele, Clark, Thoma, Clementi, Stefano, Coaguila, Lui, Jaspe Codecido, Alexi, Collins, Amy, Colombo, Riccardo, Conde, Juan, Consales, Guglielmo, Cook, Tim, Coppadoro, Andrea, Cornejo, Rodrigo, Cortegiani, Andrea, Coxo, Cristina, Neville Cracchiolo, Andrea, Crespo Ramirez, Mónica, Crova, Philippe, Cruz, José, Cubattoli, Lucia, Çukurova, Zafer, Curto, Francesco, Czempik, Piotr, D'Andrea, Rocco, da Silva Ramos, Fernando, Dangers, Laurence, Danguy des Déserts, Marc, Danin, Pierre-Eric, Dantas, Fabianne, Daubin, Cédric, Dawei, Wu, de Haro, Candelaria, de Jesus Montelongo, Felipe, De Mendoza, Diego, de Pablo, Raúl, De Pascale, Gennaro, De Rosa, Silvia, Decavèle, Maxen, Declercq, Pierre-Loui, Deicas, Alberto, Del Carmen Campos Moreno, María, Dellamonica, Jean, Delmas, Benjamin, Demirkiran, Oktay, Demirkiran, Hilmi, Dendane, Tarek, di Mussi, Rossella, Diakaki, Chrysi, Diaz, Anatilde, Diaz, Willy, Dikmen, Yalim, Dimoula, Aikaterini, Doble, Patricia, Doha, Nagwa, Domingos, Guilherme, Dres, Martin, Dries, David, Duggal, Abhijit, Duke, Graeme, Dunts, Pavel, Dybwik, Knut, Dykyy, Maksym, Eckert, Philippe, Efe, Serdar, Elatrous, Souheil, Elay, Gülseren, S Elmaryul, Abubaker, Elsaadany, Mohamed, Elsayed, Hany, Elsayed, Samar, Emery, Malo, Ena, Sébastien, Eng, Kevin, A Englert, Joshua, Erdogan, Elif, Ergin Ozcan, Perihan, Eroglu, Ege, Escobar, Miguel, Esen, Figen, Esen Tekeli, Arzu, Esquivel, Alejandro, Esquivel Gallegos, Helbert, Ezzouine, Hanane, Facchini, Alberto, Faheem, Mohammad, Fanelli, Vito, Fernanda Farina, Maria, Fartoukh, Muriel, Fehrle, Lutz, Feng, Feng, Feng, Yufeng, Fernandez, Irene, Fernandez, Borja, Lorena Fernandez-Rodriguez, Maria, Ferrando, Carlo, João Ferreira da Silva, Maria, Ferreruela, Mireia, Ferrier, Janet, Jesús Flamm Zamorano, Matia, Flood, Laura, Floris, Leda, Fluckiger, Martin, Forteza, Catalina, Fortunato, Antonella, Frans, Eric, Frattari, Antonella, Fredes, Sebastian, Frenzel, Tim, Fumagalli, Roberto, Andres Furche, Mariano, Fusari, Maurizio, Fysh, Edward, Luis Galeas-Lopez, Juan, Galerneau, Louis-Marie, Garcia, Analía, Fernanda Garcia, María, Garcia, Elisabet, Garcia Olivares, Pablo, Garlicki, Jaroslaw, Garnero, Aude, Garofalo, Eugenio, Gautam, Prabha, Gazenkampf, Andrey, Gelinotte, Stéphanie, Gelormini, Domenico, Ghrenassia, Etienne, Giacomucci, Angelo, Giannoni, Robert, Gigante, Andrea, Glober, Nancy, Gnesin, Paolo, Gollo, Yari, Gomaa, Dina, Gomero Paredes, Rosita, Gomes, Rui, Alejandro Gomez, Raúl, Gomez, Oscar, Gomez, Aroa, Gondim, Louise, Gonzalez, Manuel, Gonzalez, Isabel, Gonzalez-Castro, Alejandro, Gordillo Romero, Orlando, Gordo, Federico, Gouin, Philippe, Graf Santos, Jerónimo, Grainne, Rooney, Grando, Matilde, Granov Grabovica, Sanja, Grasso, Salvatore, Grasso, Rinaldo, Grimmer, Lisa, Grissom, Colin, Gu, Qing, Guan, Xiang-Dong, Guarracino, Fabio, Guasch, Neu, Guatteri, Luca, Gueret, Renaud, Guérin, Claude, Guerot, Emmanuel, Guitard, Pierre-Gilda, Gül, Fethi, Gumus, Ayca, Gurjar, Mohan, Gutierrez, Patricia, Hachimi, Abdelhamid, Hadzibegovic, Adi, Hagan, Samantha, Hammel, Clare, Han Song, Joo, Hanlon, Gabrielle, Heines, Serge, Henriksson, Johanna, Herbrecht, Jean-Etienne, Omar Heredia Orbegoso, Gabriel, Hermon, Andrew, Hernandez, Rosana, Hernandez, Carmen, Herrera, Lui, Herrera-Gutierrez, Manuel, Heunks, Leo, Hidalgo, Juan, Hill, Dianne, Holmquist, Dagmar, Homez, Marcela, Hongtao, Xia, Hormis, Anil, Horner, Daniel, Carmen Hornos, M, Hou, Meihong, House, Stacy, Housni, Brahim, Hugill, Keith, Humphreys, Sally, Humbert, Loui, Hunter, Stephanie, Hwa Young, Lee, Iezzi, Nicola, Ilutovich, Santiago, Inal, Volkan, Innes, Richard, Ioannides, Panagioti, Antonio Iotti, Giorgio, Ippolito, Mariachiara, Irie, Hiromasa, Iriyama, Hiroki, Itagaki, Taiga, Izura, Javier, Izza, Santiago, Jabeen, Rakhshanda, Jamaati, Hamidreza, Jamadarkhana, Sunil, Jamoussi, Amira, Jankowski, Milosz, Alberto Jaramillo, Lui, Jeon, Kyeongman, Jeong Lee, Seok, Jeswani, Deepak, Jha, Simant, Jiang, Liangyan, Jing, Chen, Jochmans, Sébastien, Anders Johnstad, Bror, Jongmin, Lee, Joret, Aurélie, Junhasavasdikul, Detajin, Teresa Jurado, Maria, Kam, Elisa, Kamohara, Hidenobu, Kane, Caroline, Kara, Iskender, Karakurt, Sait, Karnjanarachata, Cherdkiat, Kataoka, Jun, Katayama, Shinshu, Kaushik, Shuchi, Kelebek Girgin, Nermin, Kerr, Kathryn, Kerslake, Ian, Khairnar, Prakash, Khalid, Abidi, Khan, Akram, K Khanna, Ashish, Khorasanee, Reza, Kienhorst, Dieneke, Kirakli, Cenk, Knafelj, Rihard, Kol Kol, Mark, Kongpolprom, Napplika, Kopitko, Csaba, Korkmaz Ekren, Pervin, Kubisz-Pudelko, Agnieszka, Kulcsar, Zoltan, Kumasawa, Junji, Kuriyama, Akira, Kutchak, Fernanda, Labarca, Eduardo, Labat, Françoise, Laborda, César, Alberto Laca Barrera, Manuel, Lagache, Laurie, Landaverde Lopez, Antonio, Lanspa, Michael, Lascari, Valeria, Le Meur, Matthieu, Hwan Lee, Su, Ju Lee, Young, Lee, Jinwoo, Lee, Won-Yeon, Lee, Jarone, Legernaes, Terje, Leiner, Tamaa, Lemiale, Virginie, Leonor, Tiago, M Lepper, Philipp, Li, Dahuan, Li, Hongbin, Li, Oleg, Raquel Lima, Ana, Lind, Dan, Litton, Edward, Liu, Ning, Liu, Ling, Liu, Jialin, Llitjos, Jean-Françoi, Llorente, Beatriz, Lopez, Rodolfo, Elizabeth Lopez, Claudia, Lopez Nava, Claudia, Lovazzano, Pablo, Lu, Min, Lucchese, Francesca, Lugano, Manuela, Lugo Goytia, Gustavo, Luo, Hua, Lynch, Ceri, Macheda, Sebastiano, Hugo Madrigal Robles, Victor, Maurizio Maggiore, Salvatore, Magret Iglesias, Mònica, Malaga, Peter, Mallapura Maheswarappa, Harish, Malpartida, Guillermo, Malyarchikov, Andrey, Mansson, Helena, Manzano, Anaid, Marey, Ismael, Marin, Nathalie, Del Carmen Marin, Maria, Markman, Eliana, Martin, Felix, Martin, Alex, Martin Dal Gesso, Cristina, Martinez, Felipe, Martínez-Fidalgo, Conchita, Martin-Loeches, Ignacio, Mas, Arantxa, Masaaki, Sakuraya, Maseda, Emilio, Massa, Eleni, Mattsson, Anna, Maugeri, Jessica, Mccredie, Victoria, Mccullough, Jame, Mcguinness, Shay, Mckown, Andrew, Medve, László, Mei, Chengqing, Mellado Artigas, Ricard, Mendes, Vitor, Khalaf Ebraheim Mervat, Mohamed, Michaux, Isabelle, Mikhaeil, Michael, Milagros, Olga, Milet, Igor, Teresa Millan, Maria, Minwei, Zhang, Mirabella, Lucia, Mishra, Sanghamitra, Mistraletti, Giovanni, Mochizuki, Katsunori, Moghal, Arif, Mojoli, Francesco, Molin, Alexandre, Montiel, Raquel, Montini, Luca, Monza, Gianmario, Mora Aznar, Maria, Morakul, Sunthiti, Morales, Maria, Moreno Torres, Daniel, Rolando Morocho Tutillo, Diego, Motherway, Catherine, Mouhssine, Doumiri, Mouloudi, Eleni, Muñoz, Tapia, Munoz de Cabo, Carlo, Mustafa, Mohamed, Muthuchellappan, Radhakrishnan, Muthukrishnan, Muraleekrishnan, Muttini, Stefano, Nagata, Isao, Nahar, Dick, Nakanishi, Misuzu, Nakayama, Izumi, Antonio Namendys-Silva, Silvio, Nanchal, Rahul, Nandakumar, Sivakumar, Nasi, Alessandra, Nasir, Kamal, Navalesi, Paolo, Naz Aslam, Tayyba, Nga Phan, Thuy, Nichol, Alistair, Niiyama, Shuhei, Nikolakopoulou, Sofia, Nikolic, Elena, Nitta, Kenichi, Noc, Marko, Nonas, Stephanie, Nseir, Saad, Nur Soyturk, Ayse, Obata, Yukako, Oeckler, Richard, Oguchi, Moe, Ohshimo, Shinichiro, Oikonomou, Marina, Ojados, Agueda, Teresa Oliveira, Maria, Oliveira Filho, Wilson, Oliveri, Carlo, Olmos, Aitor, Omura, Kazuya, Cristina Orlandi, Maria, Orsenigo, Francesca, Ortiz-Ruiz De Gordoa, Laura, Ota, Kei, Ovalle Olmos, Rainier, Öveges, Nándo, Oziemski, Peter, Ozkan Kuscu, Ozlem, Özyilmaz, Ezgi, Pachas Alvarado, Fernando, Pagella, Gonzalo, Palaniswamy, Vijayanand, Luis Palazon Sanchez, Eugenio, Palmese, Salvatore, Pan, Guojun, Pan, Wensen, Papanikolaou, Metaxia, Papavasilopoulou, Theonymfi, Parekh, Ameet, Parke, Rachael, J Parrilla, Francisco, Parrilla, Dácil, Pasha, Taha, Pasin, Laura, Patão, Lui, Patel, Mayur, Patel, Grisma, Kumar Pati, Basanta, Patil, Jayaprakash, Pattnaik, Saroj, Paul, Daniel, Pavesi, Maurizio, Alejandra Pavlotsky, Vanesa, Paz, Graciela, Paz, Enrique, Pecci, Elisabetta, Pellegrini, Carlo, Gabriela Peña Padilla, Andrea, Perchiazzi, Gaetano, Pereira, Tiago, Pereira, Vera, Perez, Manuel, Perez Calvo, Cesar, Perez Cheng, Meisy, Perez Maita, Ronald, Pérez-Araos, Rodrigo, Perez-Teran, Purificación, Perez-Torres, David, Perkins, Gavin, Persona, Paolo, Petnak, Tananchai, Petrova, Marina, Pham, Tai, Philippart, Françoi, Picetti, Edoardo, Pierucci, Elisabetta, Piervincenzi, Edoardo, Pinciroli, Riccardo, Pintado, Maria-Consuelo, Piraino, Thoma, Piras, Stephanie, Piras, Claudio, Pirompanich, Pattarin, Pisani, Luigi, Platas, Enrique, Plotnikow, Gustavo, Porras, Willy, Porta, Virginia, Portilla, Mariana, Portugal, José, Povoa, Pedro, Prat, Gwenael, Pratto, Romina, Preda, Gabriel, Prieto, Isidro, Prol-Silva, Estefania, Pugh, Richard, Qi, Yupeng, Qian, Chuanyun, Qin, Tiehe, Qu, Hongping, Quintana, Teobaldo, Quispe Sierra, Rosari, Quispe Soto, Rocio, Rabbani, Raihan, Rabee, Mohamed, Rabie, Ahmed, Augusta Rahe Pereira, Maria, Rai, Ashish, Raj Ashok, Sundar, Rajab, Mostafa, Ramdhani, Navin, Ramey, Elizabeth, Ranieri, Marco, Rathod, Darshana, Ray, Banambar, Mahmud Redwanul Huq, Shihan, Regli, Adrian, Reina, Rosa, Resano Sarmiento, Natalia, Reynaud, Faustine, Rialp, Gemma, Ricart, Pilar, Rice, Todd, Richardson, Angu, Rieder, Marcelo, Rinket, Martin, Rios, Fernando, Risso Vazquez, Alejandro, Riva, Ivano, Rivette, Monaly, Roca, Oriol, Roche-Campo, Ferran, Rodriguez, Covadonga, 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Mandy, Tamasato, Tamasato, Tang, Zhanhong, Tangsujaritvijit, Viratch, Taniguchi, Leandro, Taniguchi, Daisuke, Tarantino, Fabio, Teerapuncharoen, Krittika, Temprano, Susana, Terragni, Pierpaolo, Terzi, Nicola, Thakur, Anand, Theerawit, Pongdhep, W Thille, Arnaud, Thomas, Matt, Thungtitigul, Poungrat, Thyrault, Martial, Tilouch, Nejla, Timenetsky, Karina, Tirapu, Juna, Todeschini, Manuel, Tomas, Roser, Tomaszewski, Christian, Tonetti, Tommaso, Tonnelier, Alexandre, Trinder, John, Trongtrakul, Konlawij, Truwit, Jonathon, Tsuei, Betty, Tulaimat, Aiman, Turan, Sema, Turkoglu, Melda, Tyagi, Sanjeev, Ubeda, Alejandro, Vagginelli, Federica, Florencia Valenti, María, Vallverdu, Imma, Van Axel, Alisha, van den Hul, Ingrid, van der Hoeven, Han, Van Der Meer, Nardo, Vanhoof, Marc, Vargas-Ordoñez, Mónica, Vaschetto, Rosanna, Vascotto, Ettore, Vatsik, Maria, Vaz, Ana, Vazquez-Sanchez, Antonia, Ventura, Sara, Wytze Vermeijden, Jan, Vidal, Anxela, Vieira, Jocyelle, Vilela Costa Pinto, Bruno, 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Maseda, Eleni Massa, Anna Mattsson, Jessica Maugeri, Victoria McCredie, James McCullough, Shay McGuinness, Andrew McKown, László Medve, Chengqing Mei, Ricard Mellado Artigas, Vitor Mendes, Mohamed Khalaf Ebraheim Mervat, Isabelle Michaux, Michael Mikhaeil, Olga Milagros, Igor Milet, Maria Teresa Millan, Zhang Minwei, Lucia Mirabella, Sanghamitra Mishra, Giovanni Mistraletti, Katsunori Mochizuki, Arif Moghal, Francesco Mojoli, Alexandre Molin, Raquel Montiel, Luca Montini (ORCID:0000-0003-4602-5134), Gianmario Monza, Maria Mora Aznar, Sunthiti Morakul, Maria Morales, Daniel Moreno Torres, Diego Rolando Morocho Tutillo, Catherine Motherway, Doumiri Mouhssine, Eleni Mouloudi, Tapia Muñoz, Carlos Munoz de Cabo, Mohamed Mustafa, Radhakrishnan Muthuchellappan, Muraleekrishnan Muthukrishnan, Stefano Muttini, Isao Nagata, Dick Nahar, Misuzu Nakanishi, Izumi Nakayama, Silvio Antonio Namendys-Silva, Rahul Nanchal, Sivakumar Nandakumar, Alessandra Nasi, Kamal Nasir, Paolo Navalesi, Tayyba Naz 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Carlos Pellegrini, Andrea Gabriela Peña Padilla, Gaetano Perchiazzi, Tiago Pereira, Vera Pereira, Manuel Perez, Cesar Perez Calvo, Meisy Perez Cheng, Ronald Perez Maita, Rodrigo Pérez-Araos, Purificación Perez-Teran, David Perez-Torres, Gavin Perkins, Paolo Persona, Tananchai Petnak, Marina Petrova, Tai Pham, François Philippart, Edoardo Picetti, Elisabetta Pierucci, Edoardo Piervincenzi, Riccardo Pinciroli, Maria-Consuelo Pintado, Thomas Piraino, Stephanie Piras, Claudio Piras, Pattarin Pirompanich, Luigi Pisani, Enrique Platas, Gustavo Plotnikow, Willy Porras, Virginia Porta, Mariana Portilla, José Portugal, Pedro Povoa, Gwenael Prat, Romina Pratto, Gabriel Preda, Isidro Prieto, Estefania Prol-Silva, Richard Pugh, Yupeng Qi, Chuanyun Qian, Tiehe Qin, Hongping Qu, Teobaldo Quintana, Rosari Quispe Sierra, Rocio Quispe Soto, Raihan Rabbani, Mohamed Rabee, Ahmed Rabie, Maria Augusta Rahe Pereira, Ashish Rai, Sundar Raj Ashok, Mostafa Rajab, Navin Ramdhani, Elizabeth Ramey, Marco 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Saravanabavan, Sema Sari, Agnes Sarkany, Bertrand Sauneuf, Monica Savioli, Hilal Sazak, Riccardo Scano, Francis Schneider, Frédérique Schortgen, Marcus J Schultz, Gabriele Leonie Schwarz, Faruk Seçkin Yücesoy, Andrew Seely, Frederik Seiler, Yasemin Seker Tekdos, Kim Seok Chan, Luca Serano, Wojciech Serednicki, Mariano Setten, Asim Shah, Bhagyesh Shah, You Shang, Pradeep Shanmugasundaram, Konstantin Shapovalov, Eman Shebl, Takuya Shiga, Nobuaki Shime, Phil Shin, Jack Short, Chen Shuhua, Sughrat Siddiqui, Juan Ignacio Silesky Jimenez, Daniel Silva, Betania Silva Sales, Koen Simons, Brit Ågot Sjøbø, David Slessor, Jakub Smiechowicz, Nathan Smischney, Paul Smith, Tim Smith, Mark Smith, Sarah Snape, Lindi Snyman, Filiep Soetens, Kyung Sook Hong, Miguel Ángel Sosa Medellin, Giovanna Soto, Xavier Souloy, Elsa Sousa, Stefania Sovatzis, Didem Sozutek, Savino Spadaro, Marco Spagnoli, Martin Spångfors, Nick Spittle, Mike Spivey, Andrew Stapleton, Branislava Stefanovic, Lorraine Stephenson, Elizabeth Stevenson, Kristian Strand, Maria Teresa Strano, Slavenka Straus, Chenliang Sun, Rongqing Sun, Venkat Sundaram, Tai SunPark, Elisabeth Surlemont, Yuda Sutherasan, Zsuzsanna Szabo, Christopher Tainter, Akihiro Takaba, Mandy Tallott, Tamasato Tamasato, Zhanhong Tang, Viratch Tangsujaritvijit, Leandro Taniguchi, Daisuke Taniguchi, Fabio Tarantino, Krittika Teerapuncharoen, Susana Temprano, Pierpaolo Terragni, Nicolas Terzi, Anand Thakur, Pongdhep Theerawit, Arnaud W Thille, Matt Thomas, Poungrat Thungtitigul, Martial Thyrault, Nejla Tilouch, Karina Timenetsky, Juna Tirapu, Manuel Todeschini, Roser Tomas, Christian Tomaszewski, Tommaso Tonetti, Alexandre Tonnelier, John Trinder, Konlawij Trongtrakul, Jonathon Truwit, Betty Tsuei, Aiman Tulaimat, Sema Turan, Melda Turkoglu, Sanjeev Tyagi, Alejandro Ubeda, Federica Vagginelli, María Florencia Valenti, Imma Vallverdu, Alisha Van Axel, Ingrid van den Hul, Hans van der Hoeven, Nardo Van Der Meer, Marc Vanhoof, Mónica 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Shinichiro, Oikonomou, Marina, Ojados, Agueda, Teresa Oliveira, Maria, Oliveira Filho, Wilson, Oliveri, Carlo, Olmos, Aitor, Omura, Kazuya, Cristina Orlandi, Maria, Orsenigo, Francesca, Ortiz-Ruiz De Gordoa, Laura, Ota, Kei, Ovalle Olmos, Rainier, Öveges, Nándo, Oziemski, Peter, Ozkan Kuscu, Ozlem, Özyilmaz, Ezgi, Pachas Alvarado, Fernando, Pagella, Gonzalo, Palaniswamy, Vijayanand, Luis Palazon Sanchez, Eugenio, Palmese, Salvatore, Pan, Guojun, Pan, Wensen, Papanikolaou, Metaxia, Papavasilopoulou, Theonymfi, Parekh, Ameet, Parke, Rachael, J Parrilla, Francisco, Parrilla, Dácil, Pasha, Taha, Pasin, Laura, Patão, Lui, Patel, Mayur, Patel, Grisma, Kumar Pati, Basanta, Patil, Jayaprakash, Pattnaik, Saroj, Paul, Daniel, Pavesi, Maurizio, Alejandra Pavlotsky, Vanesa, Paz, Graciela, Paz, Enrique, Pecci, Elisabetta, Pellegrini, Carlo, Gabriela Peña Padilla, Andrea, Perchiazzi, Gaetano, Pereira, Tiago, Pereira, Vera, Perez, Manuel, Perez Calvo, Cesar, Perez Cheng, Meisy, Perez Maita, 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Glober, Paolo Gnesin, Yari Gollo, Dina Gomaa, Rosita Gomero Paredes, Rui Gomes, Raúl Alejandro Gomez, Oscar Gomez, Aroa Gomez, Louise Gondim, Manuel Gonzalez, Isabel Gonzalez, Alejandro Gonzalez-Castro, Orlando Gordillo Romero, Federico Gordo, Philippe Gouin, Jerónimo Graf Santos, Rooney Grainne, Matilde Grando, Sanja Granov Grabovica, Salvatore Grasso, Rinaldo Grasso, Lisa Grimmer, Colin Grissom, Qing Gu, Xiang-Dong Guan, Fabio Guarracino, Neus Guasch, Luca Guatteri, Renaud Gueret, Claude Guérin, Emmanuel Guerot, Pierre-Gildas Guitard, Fethi Gül, Ayca Gumus, Mohan Gurjar, Patricia Gutierrez, Abdelhamid Hachimi, Adi Hadzibegovic, Samantha Hagan, Clare Hammel, Joo Han Song, Gabrielle Hanlon, Serge Heines, Johanna Henriksson, Jean-Etienne Herbrecht, Gabriel Omar Heredia Orbegoso, Andrew Hermon, Rosana Hernandez, Carmen Hernandez, Luis Herrera, Manuel Herrera-Gutierrez, Leo Heunks, Juan Hidalgo, Dianne Hill, Dagmar Holmquist, Marcela Homez, Xia Hongtao, Anil Hormis, Daniel Horner, M Carmen Hornos, Meihong Hou, Stacy House, Brahim Housni, Keith Hugill, Sally Humphreys, Louis Humbert, Stephanie Hunter, Lee Hwa Young, Nicolas Iezzi, Santiago Ilutovich, Volkan Inal, Richard Innes, Panagiotis Ioannides, Giorgio Antonio Iotti, Mariachiara Ippolito, Hiromasa Irie, Hiroki Iriyama, Taiga Itagaki, Javier Izura, Santiago Izza, Rakhshanda Jabeen, Hamidreza Jamaati, Sunil Jamadarkhana, Amira Jamoussi, Milosz Jankowski, Luis Alberto Jaramillo, Kyeongman Jeon, Seok Jeong Lee, Deepak Jeswani, Simant Jha, Liangyan Jiang, Chen Jing, Sébastien Jochmans, Bror Anders Johnstad, Lee Jongmin, Aurélie Joret, Detajin Junhasavasdikul, Maria Teresa Jurado, Elisa Kam, Hidenobu Kamohara, Caroline Kane, Iskender Kara, Sait Karakurt, Cherdkiat Karnjanarachata, Jun Kataoka, Shinshu Katayama, Shuchi Kaushik, Nermin Kelebek Girgin, Kathryn Kerr, Ian Kerslake, Prakash Khairnar, Abidi Khalid, Akram Khan, Ashish K Khanna, Reza Khorasanee, Dieneke Kienhorst, Cenk Kirakli, Rihard Knafelj, Mark Kol Kol, Napplika Kongpolprom, Csaba Kopitko, Pervin Korkmaz Ekren, Agnieszka Kubisz-Pudelko, Zoltan Kulcsar, Junji Kumasawa, Akira Kuriyama, Fernanda Kutchak, Eduardo Labarca, Françoise Labat, César Laborda, Manuel Alberto Laca Barrera, Laurie Lagache, Antonio Landaverde Lopez, Michael Lanspa, Valeria Lascari, Matthieu Le Meur, Su Hwan Lee, Young Ju Lee, Jinwoo Lee, Won-Yeon Lee, Jarone Lee, Terje Legernaes, Tamaas Leiner, Virginie Lemiale, Tiago Leonor, Philipp M Lepper, Dahuan Li, Hongbin Li, Oleg Li, Ana Raquel Lima, Dan Lind, Edward Litton, Ning Liu, Ling Liu, Jialin Liu, Jean-François Llitjos, Beatriz Llorente, Rodolfo Lopez, Claudia Elizabeth Lopez, Claudia Lopez Nava, Pablo Lovazzano, Min Lu, Francesca Lucchese, Manuela Lugano, Gustavo Lugo Goytia, Hua Luo, Ceri Lynch, Sebastiano Macheda, Victor Hugo Madrigal Robles, Salvatore Maurizio Maggiore, Mònica Magret Iglesias, Peter Malaga, Harish Mallapura Maheswarappa, Guillermo Malpartida, Andrey Malyarchikov, Helena Mansson, Anaid Manzano, Ismael Marey, Nathalie Marin, Maria Del Carmen Marin, Eliana Markman, Felix Martin, Alex Martin, Cristina Martin Dal Gesso, Felipe Martinez, Conchita Martínez-Fidalgo, Ignacio Martin-Loeches, Arantxa Mas, Sakuraya Masaaki, Emilio Maseda, Eleni Massa, Anna Mattsson, Jessica Maugeri, Victoria McCredie, James McCullough, Shay McGuinness, Andrew McKown, László Medve, Chengqing Mei, Ricard Mellado Artigas, Vitor Mendes, Mohamed Khalaf Ebraheim Mervat, Isabelle Michaux, Michael Mikhaeil, Olga Milagros, Igor Milet, Maria Teresa Millan, Zhang Minwei, Lucia Mirabella, Sanghamitra Mishra, Giovanni Mistraletti, Katsunori Mochizuki, Arif Moghal, Francesco Mojoli, Alexandre Molin, Raquel Montiel, Luca Montini (ORCID:0000-0003-4602-5134), Gianmario Monza, Maria Mora Aznar, Sunthiti Morakul, Maria Morales, Daniel Moreno Torres, Diego Rolando Morocho Tutillo, Catherine Motherway, Doumiri Mouhssine, Eleni Mouloudi, Tapia Muñoz, Carlos Munoz de Cabo, Mohamed Mustafa, Radhakrishnan Muthuchellappan, Muraleekrishnan Muthukrishnan, Stefano Muttini, Isao Nagata, Dick Nahar, Misuzu Nakanishi, Izumi Nakayama, Silvio Antonio Namendys-Silva, Rahul Nanchal, Sivakumar Nandakumar, Alessandra Nasi, Kamal Nasir, Paolo Navalesi, Tayyba Naz Aslam, Thuy Nga Phan, Alistair Nichol, Shuhei Niiyama, Sofia Nikolakopoulou, Elena Nikolic, Kenichi Nitta, Marko Noc, Stephanie Nonas, Saad Nseir, Ayse Nur Soyturk, Yukako Obata, Richard Oeckler, Moe Oguchi, Shinichiro Ohshimo, Marina Oikonomou, Agueda Ojados, Maria Teresa Oliveira, Wilson Oliveira Filho, Carlo Oliveri, Aitor Olmos, Kazuya Omura, Maria Cristina Orlandi, Francesca Orsenigo, Laura Ortiz-Ruiz De Gordoa, Kei Ota, Rainier Ovalle Olmos, Nándo Öveges, Peter Oziemski, Ozlem Ozkan Kuscu, Ezgi Özyilmaz, Fernando Pachas Alvarado, Gonzalo Pagella, Vijayanand Palaniswamy, Eugenio Luis Palazon Sanchez, Salvatore Palmese, Guojun Pan, Wensen Pan, Metaxia Papanikolaou, Theonymfi Papavasilopoulou, Ameet Parekh, Rachael Parke, Francisco J Parrilla, Dácil Parrilla, Taha Pasha, Laura Pasin, Luis Patão, Mayur Patel, Grisma Patel, Basanta Kumar Pati, Jayaprakash Patil, Saroj Pattnaik, Daniel Paul, Maurizio Pavesi, Vanesa Alejandra Pavlotsky, Graciela Paz, Enrique Paz, Elisabetta Pecci, Carlos Pellegrini, Andrea Gabriela Peña Padilla, Gaetano Perchiazzi, Tiago Pereira, Vera Pereira, Manuel Perez, Cesar Perez Calvo, Meisy Perez Cheng, Ronald Perez Maita, Rodrigo Pérez-Araos, Purificación Perez-Teran, David Perez-Torres, Gavin Perkins, Paolo Persona, Tananchai Petnak, Marina Petrova, Tai Pham, François Philippart, Edoardo Picetti, Elisabetta Pierucci, Edoardo Piervincenzi, Riccardo Pinciroli, Maria-Consuelo Pintado, Thomas Piraino, Stephanie Piras, Claudio Piras, Pattarin Pirompanich, Luigi Pisani, Enrique Platas, Gustavo Plotnikow, Willy Porras, Virginia Porta, Mariana Portilla, José Portugal, Pedro Povoa, Gwenael Prat, Romina Pratto, Gabriel Preda, Isidro Prieto, Estefania Prol-Silva, Richard Pugh, Yupeng Qi, Chuanyun Qian, Tiehe Qin, Hongping Qu, Teobaldo Quintana, Rosari Quispe Sierra, Rocio Quispe Soto, Raihan Rabbani, Mohamed Rabee, Ahmed Rabie, Maria Augusta Rahe Pereira, Ashish Rai, Sundar Raj Ashok, Mostafa Rajab, Navin Ramdhani, Elizabeth Ramey, Marco Ranieri, Darshana Rathod, Banambar Ray, Shihan Mahmud Redwanul Huq, Adrian Regli, Rosa Reina, Natalia Resano Sarmiento, Faustine Reynaud, Gemma Rialp, Pilar Ricart, Todd Rice, Angus Richardson, Marcelo Rieder, Martin Rinket, Fernando Rios, Alejandro Risso Vazquez, Ivano Riva, Monaly Rivette, Oriol Roca, Ferran Roche-Campo, Covadonga Rodriguez, Gabriel Rodriguez, Daniel Rodriguez Gonzalez, Xandra Yanina Rodriguez Tucto, Angela Rogers, María Elena Romano, Linda Rørtveit, Alastair Rose, Damien Roux, Anahita Rouze, Paolo Nahuel Rubatto Birri, Wang Ruilan, Aldana Ruiz Robledo, Antonio Luis Ruiz-Aguilar, Tomohito Sadahiro, Ignacio Saez, Judith Sagardia, Rajnish Saha, Rohit Saha, Narongkorn Saiphoklang, Shigeki Saito, Maie Salem, Gabriele Sales, Patricia Salgado, Srinivas Samavedam, Mhamed Sami Mebazaa, Line Samuelsson, Nandyelly San Juan Roman, Patricia Sanchez, Jesus Sanchez-Ballesteros, Yazcitk Sandoval, Emanuele Sani, Martin Santos, Carla Santos, Masamitsu Sanui, Lakshmikanthcharan Saravanabavan, Sema Sari, Agnes Sarkany, Bertrand Sauneuf, Monica Savioli, Hilal Sazak, Riccardo Scano, Francis Schneider, Frédérique Schortgen, Marcus J Schultz, Gabriele Leonie Schwarz, Faruk Seçkin Yücesoy, Andrew Seely, Frederik Seiler, Yasemin Seker Tekdos, Kim Seok Chan, Luca Serano, Wojciech Serednicki, Mariano Setten, Asim Shah, Bhagyesh Shah, You Shang, Pradeep Shanmugasundaram, Konstantin Shapovalov, Eman Shebl, Takuya Shiga, Nobuaki Shime, Phil Shin, Jack Short, Chen Shuhua, Sughrat Siddiqui, Juan Ignacio Silesky Jimenez, Daniel Silva, Betania Silva Sales, Koen Simons, Brit Ågot Sjøbø, David Slessor, Jakub Smiechowicz, Nathan Smischney, Paul Smith, Tim Smith, Mark Smith, Sarah Snape, Lindi Snyman, Filiep Soetens, Kyung Sook Hong, Miguel Ángel Sosa Medellin, Giovanna Soto, Xavier Souloy, Elsa Sousa, Stefania Sovatzis, Didem Sozutek, Savino Spadaro, Marco Spagnoli, Martin Spångfors, Nick Spittle, Mike Spivey, Andrew Stapleton, Branislava Stefanovic, Lorraine Stephenson, Elizabeth Stevenson, Kristian Strand, Maria Teresa Strano, Slavenka Straus, Chenliang Sun, Rongqing Sun, Venkat Sundaram, Tai SunPark, Elisabeth Surlemont, Yuda Sutherasan, Zsuzsanna Szabo, Christopher Tainter, Akihiro Takaba, Mandy Tallott, Tamasato Tamasato, Zhanhong Tang, Viratch Tangsujaritvijit, Leandro Taniguchi, Daisuke Taniguchi, Fabio Tarantino, Krittika Teerapuncharoen, Susana Temprano, Pierpaolo Terragni, Nicolas Terzi, Anand Thakur, Pongdhep Theerawit, Arnaud W Thille, Matt Thomas, Poungrat Thungtitigul, Martial Thyrault, Nejla Tilouch, Karina Timenetsky, Juna Tirapu, Manuel Todeschini, Roser Tomas, Christian Tomaszewski, Tommaso Tonetti, Alexandre Tonnelier, John Trinder, Konlawij Trongtrakul, Jonathon Truwit, Betty Tsuei, Aiman Tulaimat, Sema Turan, Melda Turkoglu, Sanjeev Tyagi, Alejandro Ubeda, Federica Vagginelli, María Florencia Valenti, Imma Vallverdu, Alisha Van Axel, Ingrid van den Hul, Hans van der Hoeven, Nardo Van Der Meer, Marc Vanhoof, Mónica Vargas-Ordoñez, Rosanna Vaschetto, Ettore Vascotto, Maria Vatsik, Ana Vaz, Antonia Vazquez-Sanchez, Sara Ventura, Jan Wytze Vermeijden, Anxela Vidal, Jocyelle Vieira, Bruno Vilela Costa Pinto, Ana Villagra, Cristina Villegas Succar, Ole Georg Vinorum, Giovanni Vitale, Ramesh Vj, Ana Vochin, Guillaume Voiriot, Carlo Alberto Volta, Magnus von Seth, Maazouzi Wajdi, Don Walsh, Shouhong Wang, Gabriel Wardi, Nils Christian Ween-Velken, Bi-Lin Wei, Dolf Weller, Deborah Welsh, Ingeborg Welters, Michael Wert, Simon Whiteley, Elizabeth Wilby, Erin Williams, Karen Williams, Antoinette Wilson, Jadwiga Wojtas, Jin Won Huh, David Wrathall, Christopher Wright, Jian-Feng Wu, Guo Xi, Zheng-Jiang Xing, Hongyang Xu, Kotaro Yamamoto, Jie Yan, Julio Yáñez, Xiaobo Yang, Elliot Yates, Ozlem Yazicioglu Mocin, Zhenglong Ye, Fatma Yildirim, Norifumi Yoshida, Hector Higo Leon Yoshido, Bo Young Lee, Rongguo Yu, Gong Yu, Tao Yu, Boyun Yuan, Nadwipa Yuangtrakul, Tetsuya Yumoto, Xie Yun, Graciela Zakalik, Ahmad Zaki, Begoña Zalba-Etayo, Massimo Zambon, Bin Zang, Gianluca Zani, Jonathan Zarka, Simone Maria Zerbi, Avsar Zerman, Harald Zetterquist, Jiuzhi Zhang, Hongwen Zhang, Wei Zhang, Guoxiu Zhang, Weixin Zhang, Hongsheng Zhao, Jia Zheng, Bin Zhu, and Ronald Zumaran
Abstract: Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0-4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 d
Published: 2023

14. Low dose administration of mature silkworm powder induces gastric mucosal defense factors in ethanol-induced gastric injury rat model

Author: Da-Young Lee, Moon-Young Song, Kyung-Sook Hong, Sun-Mi Yun, Young-Min Han, and Eun-Hee Kim
Subjects: Applied Microbiology and Biotechnology, Food Science, Biotechnology
Published: 2023
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15. Supplementary Table 3 from Prevention of Colitis-Associated Colorectal Cancer with 8-Hydroxydeoxyguanosine

Author: Myung-Hee Chung, Ki-Baik Hahm, Ki-Seok Choi, Young-Min Han, Kyung Sook Hong, Hua Hong, Eun-Hee Kim, and Chan Young Ock
Abstract: PDF file - 108K
Published: 2023
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16. Supplementary Figure 1 from Prevention of Colitis-Associated Colorectal Cancer with 8-Hydroxydeoxyguanosine

Author: Myung-Hee Chung, Ki-Baik Hahm, Ki-Seok Choi, Young-Min Han, Kyung Sook Hong, Hua Hong, Eun-Hee Kim, and Chan Young Ock
Abstract: PDF file - 257K
Published: 2023
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17. Application and utility of boosting machine learning model based on laboratory test in the differential diagnosis of non-COVID-19 pneumonia and COVID-19

Author: Seung Min Baik, Kyung Sook Hong, and Dong Jin Park
Subjects: Clinical Biochemistry, General Medicine
Published: 2023
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18. Development of Machine-Learning Model to Predict COVID-19 Mortality: Application of Ensemble Model and Regarding Feature Impacts

Author: Seung-Min Baik, Miae Lee, Kyung-Sook Hong, and Dong-Jin Park
Subjects: COVID-19, mortality, artificial intelligence, ensemble model, Clinical Biochemistry
Abstract: This study was designed to develop machine-learning models to predict COVID-19 mortality and identify its key features based on clinical characteristics and laboratory tests. For this, deep-learning (DL) and machine-learning (ML) models were developed using receiver operating characteristic (ROC) area under the curve (AUC) and F1 score optimization of 87 parameters. Of the two, the DL model exhibited better performance (AUC 0.8721, accuracy 0.84, and F1 score 0.76). However, we also blended DL with ML, and the ensemble model performed the best (AUC 0.8811, accuracy 0.85, and F1 score 0.77). The DL model is generally unable to extract feature importance; however, we succeeded by using the Shapley Additive exPlanations method for each model. This study demonstrated both the applicability of DL and ML models for classifying COVID-19 mortality using hospital-structured data and that the ensemble model had the best predictive ability.
Published: 2022
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19. Decision-making regarding withdrawal of life-sustaining treatment and the role of intensivists in the intensive care unit: a single-center study

Author: Young Joo Lee, Kyung Sook Hong, Jin Park, and Seo In Lee
Subjects: Ethics, withholding treatment, medicine.medical_specialty, Withholding Treatment, business.industry, intensive care units, Medical record, resuscitation orders, Treatment withdrawal, euthanasia, Critical Care and Intensive Care Medicine, Critical Care Nursing, Single Center, Intensive care unit, law.invention, terminal care, Life sustaining treatment, law, Intensive care, Emergency medicine, medicine, University medical, Original Article, business
Abstract: BACKGROUND This study examined the experience of withholding or withdrawing life-sustaining treatment in patients hospitalized in the intensive care units (ICUs) of a tertiary care center. It also considers the role that intensivists play in the decision-making process regarding the withdrawal of life-sustaining treatment. METHODS We retrospectively analyzed the medical records of 227 patients who decided to withhold or withdraw life-sustaining treatment while hospitalized at Ewha Womans University Medical Center Mokdong between April 9 and December 31, 2018. RESULTS The 227 hospitalized patients included in the analysis withheld or withdrew from life-sustaining treatment. The department in which life-sustaining treatment was withheld or withdrawn most frequently was hemato-oncology (26.4%). Among these patients, the most common diagnosis was gastrointestinal tract cancer (29.1%). A majority of patients (64.3%) chose not to receive any life-sustaining treatment. Of the 80 patients in the ICU, intensivists participated in the decision to withhold or withdraw life-sustaining treatment in 34 cases. There were higher proportions of treatment withdrawal and ICU-to-ward transfers among the cases in whom intensivists participated in decision making compared to those cases in whom intensivists did not participate (50.0% vs. 4.3% and 52.9% vs. 19.6%, respectively). CONCLUSIONS Through their participation in end-of-life discussions, intensivists can help patients' families to make decisions about withholding or withdrawing life-sustaining treatment and possibly avoiding futile treatments for these patients.
Published: 2020

20. Optimal Duration of the Apnea Test for Determining Brain Death: Benefit of the Short-Term Apnea Test

Author: Seung Min Baik, Kyung Sook Hong, Tae Yoon Kim, Jin Park, and Jung Hwa Lee
Subjects: medicine.medical_specialty, Duration (music), business.industry, Internal medicine, medicine, Cardiology, Apnea test, business, Term (time)
Abstract: Background: The criteria for brain death determination have not been unified globally, and there is no global consensus on the apnea test, which is essential for determining brain death. Since the apnea test is associated with many complications, we aimed to determine an optimal duration of the apnea test.Methods: We analyzed the results of the apnea test performed for brain death determination between August 2013 and February 2021 at a single institution in South Korea. Elevations in the partial pressure of carbon dioxide and mean arterial blood pressure fluctuations over time in the apnea test were recorded.Results: In the 1st and 2nd tests, the mean partial pressure of carbon dioxide increased by more than 20 mmHg at 3 min after the apnea test compared to before the test (P < 0.05). At 4 min in the 1st test and 5 min in the 2nd test, the partial pressure of carbon dioxide exceeded 60 mmHg (P < 0.05). The fluctuation in the mean arterial blood pressure observed for 5 min during the apnea test was not significant. There was no significant fluctuation in the mean arterial blood pressure over time in the apnea test between patients with normal chest radiography findings and those with abnormal chest radiography findings (P = 0.888).Conclusion: Our study proposes that a short-term apnea test protocol is valid for the preservation of organs for donation.
Published: 2021
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21. 1000: WHICH SURGICAL INTENSIVE CARE UNIT SYSTEM IS BENEFICIAL FOR CRITICALLY ILL PATIENTS, CLOSED OR OPEN?

Author: Kyung Sook Hong, Seung Min Baik, and Tae Yoon Kim
Subjects: Critical Care and Intensive Care Medicine
Published: 2022
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22. The Future Direction of the Organ Donation System After Legislation of the Life-Sustaining Treatment Decision Act

Author: Kyung Sook Hong, Jung Hwa Lee, Jin Park, Seung Min Baik, and Tae Yoon Kim
Subjects: Male, Brain Death, medicine.medical_specialty, Tissue and Organ Procurement, MEDLINE, Transplants, Legislation, Tissue Donation, Republic of Korea, medicine, Humans, Organ donation, Aged, Retrospective Studies, Original Paper, Transplantation, Withholding Treatment, business.industry, Medical record, Organ Transplantation, General Medicine, Tissue Donors, Death, Family medicine, Donation, Female, business
Abstract: BACKGROUND The transplant community is seeking ways to encourage organ donation after cardiac arrest to solve the problem of the insufficiency of organs available for the increasing number of people awaiting transplantation. This study aimed to determine whether the life-sustaining treatment (LST) decision system, implemented in Korea on February 4, 2018, can address the shortage of organ donations. MATERIAL AND METHODS We retrospectively analyzed the medical records of the 442 patients who had filled out forms for the LST decision at Ewha Womans University Mokdong Hospital from April 2018 to December 2019, and classified the eligibility of organ and tissue donation according to the Korean Organ Donation Agency criteria. RESULTS We included 442 patients in this study. Among them, 238 (53.8%) were men, and 204 (46.2%) were women. The average age of the patients was 71.8 years (the youngest and oldest were aged 23 years and 103 years, respectively). Of these, 110 patients (24.9%) decided on their own to discontinue LST, whereas 332 (75.1%) decided to discontinue with their family's consent. This study demonstrated that 50% of patients who were not brain-dead and discontinued LST were eligible for organ donation. However, the patients and caregivers were not aware of this option because the current law does not allow the discussion of such donations. CONCLUSIONS A discussion regarding donation after circulatory death is recommended to solve the problem of insufficient organ donation.
Published: 2021
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23. High concentrated probiotics improve inflammatory bowel diseases better than commercial concentration of probiotics

Author: Napapan Kangwan, Kyung-Sook Hong, Ki-Seok Choi, Hua Hong, Ki Baik Hahm, Young-Min Han, Eun-Hee Kim, and Young Chae Cho
Subjects: Pharmacology, 0303 health sciences, medicine.medical_specialty, 030309 nutrition & dietetics, business.industry, medicine.medical_treatment, 010401 analytical chemistry, Inflammatory Bowel Diseases, medicine.disease, 01 natural sciences, Inflammatory bowel disease, Gastroenterology, 0104 chemical sciences, 03 medical and health sciences, Cytokine, Intestinal homeostasis, Intestinal inflammation, Internal medicine, Immunology, medicine, Asian country, Tumor necrosis factor alpha, Colitis, business, Food Science
Abstract: The incidence of inflammatory bowel diseases has increased during recent decades in Korea as well as Asian countries. Probiotics have been clinically administered to improve intestinal inflammation in inflammatory bowel disease (ffiD). In this study, we identified that higher concentrations of probiotics called ”Amanlac” probiotics protected intestinal tissues with the regulation of cytokine production and the improvement of intestinal injury of mice with dextran sodium sulfate (DSS)-induced colitis much better than commercial probiotics. ”Amanlac” probiotics significantly ameliorated gross and pathological scores of colitis caused by DSS in a concentration-dependent manner based on the following mechanisms; inflammatory markers such as IL-Ift, TNF a and COX-2, as well as MMPs and ICAMI were significantly lower in colon tissues of probiotics-treated mice following DSS treatment compared with DSS-treated control mice, but the overall efficacy of ”Amanlac” probiotics was significantly improved than conventional concentration of probiotics. In conclusion, the administration of higher concentrated probiotics helps to successfully maintain intestinal homeostasis, while also improving intestinal inflammation.
Published: 2020
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24. Hepatoprotective Effects of Steamed and Freeze-Dried Mature Silkworm Larval Powder against Ethanol-Induced Fatty Liver Disease in Rats

Author: Jong-Gon Son, Sang-Deok Ji, Eun-Hee Kim, Sun-Mi Yun, Moon-Young Song, Da-Young Lee, and Kyung-Sook Hong
Subjects: Alcoholic liver disease, medicine.medical_specialty, Health (social science), Normal diet, steamed and freeze-dried mature silkworm larval powder, Plant Science, sprague-dawley rats, lcsh:Chemical technology, Health Professions (miscellaneous), Microbiology, Article, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Internal medicine, medicine, lcsh:TP1-1185, alcoholic fatty liver, lipogenesis, fatty acid oxidation, 030304 developmental biology, chemistry.chemical_classification, 0303 health sciences, biology, Triglyceride, Chemistry, Fatty liver, Fatty acid, medicine.disease, Endocrinology, Alanine transaminase, Lipogenesis, biology.protein, 030211 gastroenterology & hepatology, Alcoholic fatty liver, ethanol, Food Science
Abstract: Silkworm, Bombyx mori, contains high amounts of beneficial nutrients, including amino acids, proteins, essential minerals, and omega-3 fatty acids. We have previously reported a technique for producing steamed and freeze-dried mature silkworm larval powder (SMSP), which makes it easier to digest mature silkworm. In this study, we investigated the preventive effects of SMSP on alcoholic fatty liver disease and elucidated its mechanism of action. Male Sprague-Dawley rats treated with SMSP (50 mg/kg) or normal diet (AIN-76A) were administered 25% ethanol (3 g/kg body weight) by oral gavage for 4 weeks. SMSP administration for 4 weeks significantly decreased hepatic fat accumulation in ethanol-treated rats by modulating lipogenesis and fatty acid oxidation-related molecules such as sirtuin 1, AMP-activated protein kinase, and acetyl-CoA carboxylase 1. Moreover, SMSP administration significantly diminished the levels of triglyceride in liver tissues by as much as 35%, as well as lowering the serum levels of triglyceride, gamma glutamyl transpeptidase, alanine transaminase, and aspartate aminotransferase in ethanol-treated rats. SMSP supplementation also decreased the pro-inflammatory tumor necrosis factor-alpha and interleukin 1 beta levels and cytochrome P450 2E1 generating oxidative stress. These results suggest that SMSP administration may be possible for the prevention of alcoholic liver disease.
Published: 2020

25. A Single-Center Experience with an Intensivist-Led Brain-Dead Donor Management Program

Author: Jin Park, Young Joo Lee, Kyung Sook Hong, and Na Rae Yang
Subjects: Adult, Male, 0301 basic medicine, Brain Death, medicine.medical_specialty, Resuscitation, Tissue and Organ Procurement, Critical Care, medicine.medical_treatment, Intensivist, Single Center, Organ transplantation, 03 medical and health sciences, Intensive care, Republic of Korea, medicine, Humans, Renal replacement therapy, Organ donation, Aged, Retrospective Studies, Original Paper, Transplantation, 030102 biochemistry & molecular biology, business.industry, Medical record, Intensive Care, Organ Transplantation, General Medicine, Middle Aged, Emergency medicine, Tissue and Organ Harvesting, Female, business
Abstract: BACKGROUND The aim of this study is to report our experience of brain-dead donor management by a dedicated intensivist who had wide experience in treatment of hemodynamically unstable patient and to suggest a role for intensivists in organ donation. MATERIAL AND METHODS The management of brain-dead donors was performed by experienced intensivists. The hospital medical records and data from the Korean Network of Organ Sharing from August 2013 to December 2016 were reviewed retrospectively. RESULTS Fifty-four brain death patients (3.2% of KONOS nationwide data) donated organs in our institution during 41 months. Dedicated intensivists managed deceased patients for the whole duration (2.81±1.21 days) of management, not only with conservative therapies like fluid resuscitation, vasopressor, or hormonal replacement, but also with pulmonary artery catheter insertion for cardiac output monitoring (n=47, 87.0%) and continuous renal replacement therapy (n=22, 40.7%). The number of donors increased each year. The mean number of retrieved organs in each deceased donor was 3.98±1.55, more than the national average (3.26) and comparable to the higher level among the recent worldwide data. The number of donations by organ was: 23 hearts (4.9% of nationwide data), 17 lungs (7.5% of nationwide data), 102 kidneys (3.3% of nationwide data), 47 livers (3.1% of nationwide data), 6 pancreases (2.9% of nationwide data), 1 pancreatic duct (11.1% of nationwide data), and 1 small intestine (12.5% of nationwide data). CONCLUSIONS Management by dedicated intensivists will improve not only the number of actual organ donors, but also the number of harvested organs.
Published: 2018
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26. Posterior Reversible Encephalopathy Syndrome after Hypovolemic Shock Which Is Required Differential Diagnosis with Delirium in the Intensive Care Unit

Author: Jin Park, Seo In Lee, Kyung Sook Hong, Gyeong Seon Choi, and Young Joo Lee
Subjects: business.industry, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Posterior reversible encephalopathy syndrome, lcsh:RC86-88.9, Critical Care and Intensive Care Medicine, Critical Care Nursing, medicine.disease, Intensive care unit, law.invention, Neurology, law, Shock (circulatory), Anesthesia, medicine, Delirium, medicine.symptom, Differential diagnosis, business, Letter to the Editor
Published: 2018

27. Silkworm (Bombyx mori) powder supplementation alleviates alcoholic fatty liver disease in rats

Author: Kyung-Sook Hong, Eun-Hee Kim, Jong-Gon Son, Sun-Mi Yun, Sang-Deok Ji, Jae-Min Cho, and Da-Young Lee
Subjects: 0301 basic medicine, medicine.medical_specialty, Hepatic steatosis, AMP-activated kinase, Medicine (miscellaneous), 03 medical and health sciences, chemistry.chemical_compound, Internal medicine, medicine, TX341-641, chemistry.chemical_classification, Nutrition and Dietetics, 030102 biochemistry & molecular biology, Ethanol, Chemistry, Nutrition. Foods and food supply, Fatty liver, fungi, Fatty acid, Lipid metabolism, medicine.disease, Malondialdehyde, 030104 developmental biology, Endocrinology, Fatty acid oxidation, Lipogenesis, Alcoholic fatty liver, Mature silkworm powder, Steatosis, Hepatic fibrosis, Food Science
Abstract: Chronic alcohol consumption causes hepatic injury including fatty liver and fibrosis. Global interests in edible insects as future food source have been increased. We have previously demonstrated a new technology to make hard mature silkworm, Bombyx mori, into edible form, steamed and freeze-dried mature silkworm larval powder (SMSP). Here, we assessed the protective effects of SMSP on ethanol-induced hepatic steatosis and lipid metabolism in rats. SMSP supplementation for 4 weeks significantly attenuated ethanol-induced fat accumulation and LDL/HDL ratio by modulating lipogenesis and fatty acid oxidation-related gene expression such as SIRT1, AMPK, and ACC. SMSP administration also inhibited hepatic fibrosis by decreasing the levels of pro-collagen1 and α-SMA. Moreover, SMSP supplementation effectively restored total antioxidant levels and significantly reduced the levels of hepatic malondialdehyde and TNF-α. Our findings suggest that SMSP supplementation may be the promising strategy for the prevention or treatment of chronic alcoholic fatty liver disease.
Published: 2018

28. Gastroprotective effect of mature silkworm, Bombyx mori against ethanol-induced gastric mucosal injuries in rats

Author: Kyung-Sook Hong, Jong-Gon Son, Sun-Mi Yun, Sang-Deok Ji, Jae-Min Cho, Da-Young Lee, and Eun-Hee Kim
Subjects: 0301 basic medicine, medicine.medical_specialty, Normal diet, Medicine (miscellaneous), Pharmacology, 03 medical and health sciences, chemistry.chemical_compound, Anti-oxidation, 0302 clinical medicine, Immune system, Bombyx mori, Anti-inflammation, medicine, Gastric mucosa, TX341-641, Secretion, Nutrition and Dietetics, Ethanol, biology, Nutrition. Foods and food supply, business.industry, Gastric ulcer, fungi, biology.organism_classification, Mucus, digestive system diseases, Surgery, 030104 developmental biology, medicine.anatomical_structure, chemistry, 030220 oncology & carcinogenesis, Mature silkworm powder, Gastritis, medicine.symptom, business, Food Science
Abstract: Gastric ulcer is a clinical condition characterized by ulceration of the surface of the gastric mucosa. Alcohol consumption has been identified as a major cause of gastric ulceration. The silkworm, Bombyx mori, produces diverse functional materials including silk proteins. Here, we evaluated whether Steamed and freeze-dried Mature Silkworm larval Powder (SMSP) can prevent ethanol-induced gastric injury in rats. Sprague-Dawley rats pretreated with SMSP (0.1 or 1 g/kg body weight) or normal diet (AIN-76A) were subjected to intragastric administration of absolute ethanol (3 g/kg body weight, 3 h). Pretreatment with SMSP significantly prevented ethanol-induced gastric mucosal ulceration and hemorrhagic injury, by which improved the total antioxidant capacity and mucus secretion and suppressed the pro-inflammatory responses through inhibiting the recruitment of immune cells. SMSP exerted protective effects in ethanol-induced gastritis via the regulation of anti-oxidative and pro-inflammatory signaling pathway, suggesting SMSP could be anticipating remedy for the treatment of ethanol-induced gastric injury.
Published: 2017
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29. Acute Cholecystitis as a Cause of Fever in Aneurysmal Subarachnoid Hemorrhage

Author: Kyung Sook Hong, Na Rae Yang, and Eui Kyo Seo
Subjects: medicine.medical_specialty, Subarachnoid hemorrhage, intensive care units, subarachnoid hemorrhage, medicine.medical_treatment, cholecystectomy, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, cholecystitis, Internal medicine, medicine, 030212 general & internal medicine, Risk factor, business.industry, General surgery, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Retrospective cohort study, Odds ratio, lcsh:RC86-88.9, medicine.disease, retrospective studies, Abdominal examination, Cholecystitis, Cholecystectomy, Original Article, prognosis, Complication, business
Abstract: Background: Fever is a very common complication that has been related to poor outcomes after aneurysmal subarachnoid hemorrhage (aSAH). The incidence of acalculous cholecystitis is reportedly 0.5%-5% in critically ill patients, and cerebrovascular disease is a risk factor for acute cholecystitis (AC). However, abdominal evaluations are not typically performed for febrile patients who have recently undergone aSAH surgeries. In this study, we discuss our experiences with febrile aSAH patients who were eventually diagnosed with AC. Methods: We retrospectively reviewed 192 consecutive patients who underwent aSAH from January 2009 to December 2012. We evaluated their characteristics, vital signs, laboratory findings, radiologic images, and pathological data from hospitalization. We defined fever as a body temperature of >38.3°C, according to the Society of Critical Care Medicine guidelines. We categorized the causes of fever and compared them between patients with and without AC. Results: Of the 192 enrolled patients, two had a history of cholecystectomy, and eight (4.2%) were eventually diagnosed with AC. Among them, six patients had undergone laparoscopic cholecystectomy. In their pathological findings, two patients showed findings consistent with coexistent chronic cholecystitis, and two showed necrotic changes to the gall bladder. Patients with AC tended to have higher white blood cell counts, aspartame aminotransferase levels, and C-reactive protein levels than patients with fevers from other causes. Predictors of AC in the aSAH group were diabetes mellitus (odds ratio [OR], 8.758; P = 0.033) and the initial consecutive fasting time (OR, 1.325; P = 0.024). Conclusions: AC may cause fever in patients with aSAH. When patients with aSAH have a fever, diabetes mellitus and a long fasting time, AC should be suspected. A high degree of suspicion and a thorough abdominal examination of febrile aSAH patients allow for prompt diagnosis and treatment of this condition. Additionally, physicians should attempt to decrease the fasting time in aSAH patients.
Published: 2017

30. GLUT1-dependent glycolysis regulates exacerbation of fibrosis via AIM2 inflammasome activation

Author: Kyung Sook Hong, Ha Seon Yun, Heather W. Stout-Delgado, Jong Seok Moon, Kiichi Nikahira, Soo Jung Cho, Augustine M.K. Choi, Rebecca Harris, and Hua-Rong Huang
Subjects: Pulmonary and Respiratory Medicine, Exacerbation, Inflammasomes, Bleomycin, medicine.disease_cause, Interstitial Lung Disease, Pneumococcal Infections, Microbiology, Pathogenesis, 03 medical and health sciences, chemistry.chemical_compound, AIM2, Idiopathic pulmonary fibrosis, Gene Knockout Techniques, Mice, 0302 clinical medicine, Fibrosis, Streptococcus pneumoniae, medicine, pneumonia, Animals, Humans, Lung, 030304 developmental biology, 0303 health sciences, Glucose Transporter Type 1, business.industry, Microbiota, Inflammasome, respiratory system, interstitial fibrosis, medicine.disease, Idiopathic Pulmonary Fibrosis, respiratory tract diseases, 3. Good health, carbohydrates (lipids), Disease Models, Animal, 030228 respiratory system, chemistry, Disease Progression, business, Glycolysis, medicine.drug
Abstract: BackgroundIdiopathic pulmonary fibrosis (IPF) is a rapidly progressive, fatal lung disease that affects older adults. One of the detrimental natural histories of IPF is acute exacerbation of IPF (AE-IPF), of which bacterial infection is reported to play an important role. However, the mechanism by which bacterial infection modulates the fibrotic response remains unclear.ObjectivesAltered glucose metabolism has been implicated in the pathogenesis of fibrotic lung diseases. We have previously demonstrated that glucose transporter 1 (GLUT1)-dependent glycolysis regulates fibrogenesis in a murine fibrosis model. To expand on these findings, we hypothesised that GLUT1-dependent glycolysis regulates acute exacerbation of lung fibrogenesis during bacterial infection via AIM2 inflammasome activation.ResultsIn our current study, using a murine model of Streptococcus pneumoniae (S. pneumoniae) infection, we investigated the potential role of GLUT1 on mediating fibrotic responses to an acute exacerbation during bleomycin-induced fibrosis. The results of our current study illustrate that GLUT1 deficiency ameliorates S. pneumoniae-mediated exacerbation of lung fibrosis (wild type (WT)/phosphate buffered saline (PBS), n=3; WT/S. pneumoniae, n=3; WT/Bleomycin, n=5 ; WT/Bleomycin+S. pneumoniae, n=7; LysM-Cre-Glut1fl/f/PBS, n=3; LysM-Cre-Glut1fl/fl/S. pneumoniae, n=3; LysM-Cre-Glut1fl/fl/Bleomycin, n=6; LysM-Cre-Glut1fl/fl/Bleomycin+S. pneumoniae, n=9, p=0.041). Further, the AIM2 inflammasome, a multiprotein complex essential for sensing cytosolic bacterial DNA as a danger signal, is an important regulator of this GLUT1-mediated fibrosis and genetic deficiency of AIM2 reduced bleomycin-induced fibrosis after S. pneumoniae infection (WT/PBS, n=6; WT/Bleomycin+S. pneumoniae, n=15; Aim2−/−/PBS, n=6, Aim2−/−/Bleomycin+S. pneumoniae, n=11, p=0.034). GLUT1 deficiency reduced expression and function of the AIM2 inflammasome, and AIM2-deficient mice showed substantial reduction of lung fibrosis after S. pneumoniae infection.ConclusionOur results demonstrate that GLUT1-dependent glycolysis promotes exacerbation of lung fibrogenesis during S. pneumoniae infection via AIM2 inflammasome activation.
Published: 2019

31. Transforming Growth Factor Beta Regulates Epithelial Cell Death During Influenza Infection

Author: Kyung Sook Hong, R. Harris, Augustine M.K. Choi, H. Stout-Delgado, Soo Jung Cho, and Ha Seon Yun
Subjects: medicine.anatomical_structure, medicine, biology.protein, Transforming growth factor beta, Biology, Epithelium, Cell biology
Published: 2019
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32. An Analysis of the Respiratory Subscore of the Sequential Organ Failure Assessment (SOFA) Scoring System in the Weill Cornell-Critical Care Database for Advanced Research (WC-CEDAR)

Author: Ilias I. Siempos, Joseph Kabariti, S. Flores, Thomas R. Campion, Clara Oromendia, John Harrington, Kyung Sook Hong, E. Finkelzstein, Augustine M.K. Choi, Elizabeth Sanchez, and Edward J. Schenck
Subjects: medicine.medical_specialty, Scoring system, business.industry, Sequential organ failure assessment, Emergency medicine, Medicine, business
Published: 2019
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33. The Future Direction of the Organ Donation System After Legislation of the Life-Sustaining Treatment Decision Act.

Author: Seung Min Baik, Jin Park, Tae Yoon Kim, Jung Hwa Lee, and Kyung Sook Hong
Published: 2021
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34. A Comparative Analysis of the Respiratory Subscore of the Sequential Organ Failure Assessment Scoring System.

Author: Schenck, Edward J., Hoffman, Katherine L., Oromendia, Clara, Sanchez, Elizabeth, Finkelsztein, Eli J., Kyung Sook Hong, Kabariti, Joseph, Torres, Lisa K., Harrington, John S., Siempos, Ilias I., Choi, Augustine M. K., Campion Jr., Thomas R., Hoffman, Katherine, Hong, Kyung Sook, and Campion, Thomas R Jr
Abstract: Rationale: The Sequential Organ Failure Assessment (SOFA) tool is a commonly used measure of illness severity. Calculation of the respiratory subscore of SOFA is frequently limited by missing arterial oxygen pressure (PaO2) data. Although missing PaO2 data are commonly replaced with normal values, the performance of different methods of substituting PaO2 for SOFA calculation is unclear. Objectives: The study objective was to compare the performance of different substitution strategies for missing PaO2 data for SOFA score calculation. Methods: This retrospective cohort study was performed using the Weill Cornell Critical Care Database for Advanced Research from a tertiary care hospital in the United States. All adult patients admitted to an intensive care unit (ICU) from 2011 to 2019 with an available respiratory SOFA score were included. We analyzed the availability of the PaO2/fraction of inspired oxygen (FiO2) ratio on the first day of ICU admission. In those without a PaO2/FiO2 ratio available, the ratio of oxygen saturation as measured by pulse oximetry to FiO2 was used to calculate a respiratory SOFA subscore according to four methods (linear substitution [Rice], nonlinear substitution [Severinghaus], modified respiratory SOFA, and multiple imputation by chained equations [MICE]) as well as the missing-as-normal technique. We then compared how well the different total SOFA scores discriminated in-hospital mortality. We performed several subgroup and sensitivity analyses. Results: We identified 35,260 unique visits, of which 9,172 included predominant respiratory failure. PaO2 data were available for 14,939 (47%). The area under the receiver operating characteristic curve for each substitution technique for discriminating in-hospital mortality was higher than that for the missing-as-normal technique (0.78 [0.77-0.79]) in all analyses (modified, 0.80 [0.79-0.81]; Rice, 0.80 [0.79-0.81]; Severinghaus, 0.80 [0.79-0.81]; and MICE, 0.80 [0.79-0.81]) (P < 0.01). Each substitution method had a higher accuracy for discriminating in-hospital mortality (MICE, 0.67; Rice, 0.67; modified, 0.66; and Severinghaus, 0.66) than the missing-as-normal technique. Model calibration for in-hospital mortality was less precise for the missing-as-normal technique than for the other substitution techniques at the lower range of SOFA and among the subgroups. Conclusions: Using physiologic and statistical substitution methods improved the total SOFA score's ability to discriminate mortality compared with the missing-as-normal technique. Treating missing data as normal may result in underreporting the severity of illness compared with using substitution. The simplicity of a direct oxygen saturation as measured by pulse oximetry/FiO2 ratio-modified SOFA technique makes it an attractive choice for electronic health record-based research. This knowledge can inform comparisons of severity of illness across studies that used different techniques. [ABSTRACT FROM AUTHOR]
Published: 2021
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35. Protective Effect of Silkworm (Bombyx mori) Powder against Diethylnitrosamine-induced Hepatotoxicity in Mice

Author: Kyung-Sook Hong, Kee-Young Kim, Jae-Min Cho, Da-Young Lee, Eun-Hee Kim, and Sang-Deok Ji
Subjects: chemistry.chemical_classification, C57BL/6, Necrosis, biology, Cancer, Pharmacology, biology.organism_classification, medicine.disease, digestive system diseases, Nitric oxide synthase, Enzyme, chemistry, Biochemistry, Bombyx mori, Hepatocellular carcinoma, medicine, biology.protein, Alkaline phosphatase, medicine.symptom, Food Science
Abstract: Hepatocellular carcinoma (HCC) is a representative inflammation-associated cancer and known to be the most frequent tumor. However, the preventive agents for hepatocarcinogenesis are unsatisfactorily identified. We investigated the protective effect of steamed and freeze-dried mature silkworm larval powder (SMSP) on diethylnitrosamine (DEN)-induced hepatotoxicity in mice and compared the effect of three silkworm varieties: white-jade, golden-silk, and light-green strains. The mice were fed with diet containing 0.1, 1, and 10 g/kg of three types of SMSP for two weeks while DEN (100 mg/kg, i.p.) was injected 18 h before the end of this experiment. Liver toxicity was determined as serum indicator, histopathological examination, and expression of inflammatory enzyme. Pretreatment with SMSP reduced necrotic and histopathological changes induced by DEN in the liver. The measurement of serum biochemical indicators showed that pretreatment with SMSP also decreased DEN-induced hepatotoxicity, the levels of alkaline phosphatase (ALP), alanine aminotransferase (ALT), and aspartate aminotransferase (AST). In addition, SMSP inhibited the expressions of inflammatory enzymes, cyclooxygenase-2 and inducible nitric oxide synthase. White-jade SMSP showed the most effective hepatoprotective results against hepatotoxicity among the three silkworm strains used in this study. SMSP may have a protective effect against acute liver injury by inhibiting necrosis and inflammatory response in DEN-treated mice.
Published: 2016
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36. Essential Role of Indoleamine 2, 3‐dioxygenase 1 ( IDO1 ) in Metabolic Programming of Innate Immune Responses in Aged Lung during Influenza

Author: Heather W. Stout-Delgado, Jianjun Yang, Soo Jung Cho, Rebecca Harris, and Kyung Sook Hong
Subjects: Lung, medicine.anatomical_structure, Innate immune system, Immunology, Genetics, medicine, Biology, Indoleamine 2,3-dioxygenase, Molecular Biology, Biochemistry, Biotechnology
Published: 2020
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37. Epidermal growth factor-mediated Rab25 pathway regulates integrin β1 trafficking in colon cancer

Author: Kwang Ho Kim, Ryung-Ah Lee, Soon Sup Chung, Eun-Young Jeon, and Kyung Sook Hong
Subjects: 0301 basic medicine, Receptor trafficking, Integrins, Cancer Research, Colonic neoplasms, Integrin, medicine.disease_cause, Endocytosis, Target therapy, lcsh:RC254-282, 03 medical and health sciences, Rab25, Epidermal growth factor, Genetics, medicine, Epidermal growth factor receptor, lcsh:QH573-671, Shedding, biology, lcsh:Cytology, Cell growth, Chemistry, Transfection, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Cell biology, 030104 developmental biology, Oncology, Cell culture, biology.protein, Primary Research, Carcinogenesis
Abstract: Background Integrins play a critical role in carcinogenesis. Integrin β1 localization is regulated by the guanosine-5′-triphosphate hydrolase Rab25 and integrin β1 levels are elevated in the serum of colon cancer patients; thus, the present study examined the effects of epidermal growth factor (EGF) and Rab25 on integrin β1 localization in colon cancer cells. Methods HCT116 human colon cancer cells were treated with increasing concentrations of EGF, and cell proliferation and protein expression were monitored by MTT and western blot analyses, respectively. Cell fractionation was performed to determine integrin β1 localization in the membrane and cytosol. Integrin β1 extracellular shedding was monitored by enzyme-linked immunosorbent assays (ELISAs) with culture supernatants from stimulated cells. HCT116 cells were transfected with Rab25-specific siRNA to determine the significance of Rab25 in integrin β1 trafficking in the presence of EGF. Results Total integrin β1 expression increased in response to EGF and subsequently decreased at 24 h post-stimulation. A similar decrease was observed in purified membrane fractions, whereas no changes were observed in cytosolic levels. ELISAs using media from stimulated cell cultures demonstrated increased integrin β1 levels corresponding to the decrease observed in membrane fractions, suggesting that EGF induces integrin receptor shedding. EGF stimulation in Rab25-knockdown cells resulted in integrin β1 accumulation in the membrane, suggesting that Rab25 promotes integrin endocytosis. Conclusions Integrin β1 is shed from colon cancer cells in response to EGF stimulation in a Rab25-dependent manner. These results further the present understanding of the role of integrin β1 in colon cancer progression.
Published: 2018
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38. Preventive effect of anti-VacA egg yolk immunoglobulin (IgY) on Helicobacter pylori-infected mice

Author: H M Arif Ullah, Eun-Joo Lee, Kyung Sook Hong, Myung-Jin Chung, Jin-Kyu Park, Yong Deuk Kim, Mi-Ran Ki, Ahmed K. Elfadl, and Kyu-Shik Jeong
Subjects: 0301 basic medicine, food.ingredient, Administration, Oral, Immunoglobulins, Microbiology, Helicobacter Infections, 03 medical and health sciences, food, Blood serum, Immune system, Bacterial Proteins, Oral administration, Yolk, medicine, Animals, General Veterinary, General Immunology and Microbiology, biology, Helicobacter pylori, Stomach, Public Health, Environmental and Occupational Health, bacterial infections and mycoses, biology.organism_classification, Antibodies, Bacterial, digestive system diseases, Mice, Inbred C57BL, Disease Models, Animal, 030104 developmental biology, Infectious Diseases, medicine.anatomical_structure, Treatment Outcome, biology.protein, bacteria, Molecular Medicine, Immunoglobulin Y, Female, Antibody
Abstract: Helicobacter pylori, a gram-negative bacterium, is the causative agent of gastric disorders and gastric cancer in the human stomach. Vacuolating cytotoxin A (VacA) is among the multi-effect protein toxins released by H. pylori that enables its persistence in the human stomach.To evaluate the effect of anti-VacA egg yolk immunoglobulin (anti-VacA IgY) on H. pylori infection, a highly specific anti-VacA IgY was produced from egg yolks of hens immunized with a mixture of two purified recombinant VacAs. Female C57BL/6 mice were supplemented anti-VacA IgY daily with drinking water for 2 weeks before and 4 weeks after H. pylori ATCC 43504 inoculation. Anti-VacA IgY recognized both native and denatured structures of VacA by enzyme-linked immunosorbent assay and immunoblotting analyses, respectively.Oral administration of anti-VacA IgYs significantly (p .05) reduced the serum levels of anti-H. pylori antibodies compared to those in the H. pylori-infected, untreated group. The reduction in the immune response was accompanied by a significant (p .05) decrease in eosinophilic infiltration of the stomach in anti-VacA IgY treated group compared to other groups. Concomitantly, H. pylori-induced histological changes and H. pylori antigen-positivity in gastric tissues were decreased significantly (p .05) in anti-VacA IgY treated group similar to the control group.Oral administration of anti-VacA IgY is correlated with a protective effect against H. pylori colonization and induced histological changes in gastric tissues. Our experimental study has proved that it is expected to be a new drug candidate of Hp infection by further study.
Published: 2017

39. Prognostic factors and treatment outcomes for patients with Fournier's gangrene: a retrospective study

Author: Kyung Sook, Hong, Hee Jung, Yi, Ryung-Ah, Lee, Kwang Ho, Kim, and Soon Sup, Chung
Subjects: Adult, Aged, 80 and over, Male, Wound Healing, Soft Tissue Infections, Original Articles, Middle Aged, Perineum, Prognosis, Combined Modality Therapy, Treatment Outcome, Debridement, Humans, Wounds and Injuries, Female, Fournier Gangrene, Negative-Pressure Wound Therapy, Aged, Retrospective Studies
Abstract: Fournier's gangrene is a gas‐forming, necrotising soft tissue infection affecting the perineum. It spreads rapidly along the deep fascial planes and is associated with a high mortality rate. With a growing elderly population with comorbidities, the frequency of severe cases of Fournier's gangrene is expected to increase. We retrospectively reviewed 20 patients diagnosed with Fournier's gangrene at our institution from 2003 to 2014 and analysed data. Thirteen patients had diabetes mellitus, two had been diagnosed with liver cirrhosis, and four were chronic alcoholics. Of 15 patients admitted to an intensive care unit, 11 underwent colostomy, and 4 required skin grafts for wound healing. The wide wounds of two patients were healed using vacuum‐assisted closure (VAC (®)) dressing without additional surgery. The mortality rate was 25%, and the patients whose Fournier's gangrene severity index (FGSI) score was higher than 9 points or whose blood urea nitrogen (BUN) level was higher than 50 mg/dl had a poor prognosis. In order to treat Fournier's gangrene, aggressive surgical treatment, including wide debridement and stoma creation, should be considered as soon as possible to improve survival rates. Additionally, VAC dressing is helpful in healing the wide debridement wound without additional reconstructive surgery.
Published: 2017

40. Reliability of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in the Nodal Staging of Colorectal Cancer Patients

Author: Kwang Ho Kim, Soon Sup Chung, Nara Moon, Kyung Sook Hong, Hee Jung Yi, and Ryung-Ah Lee
Subjects: medicine.medical_specialty, Positron emission tomography, Colorectal cancer, Nodal staging, Colorectal neoplasms, Metastasis, Fluorodeoxyglucose positron emission tomography, Carcinoembryonic antigen, parasitic diseases, medicine, Lymph node, biology, medicine.diagnostic_test, business.industry, Gastroenterology, medicine.disease, medicine.anatomical_structure, biology.protein, Surgery, Original Article, Lymph, Radiology, business
Abstract: Purpose Lymph-node metastasis is considered as critical prognostic factor in colorectal cancer. A preoperative evaluation of lymph-node metastasis can also help to determine the range of distant lymph node dissection. However, the reliability of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in the detection of lymph-node metastasis is not fully known. Methods The medical records of 433 patients diagnosed with colorectal cancer were reviewed retrospectively. FDG-PET/CT and CT were performed on all patients. Lymph nodes were classified into regional and distant lymph nodes according to the American Joint Committee on Cancer (AJCC) Cancer Staging Manual, 7th edition. Results The patients included 231 males (53.3%) and 202 females (46.7%), with a mean age of 64.7 ± 19.0 years. For regional lymph nodes, the sensitivity of FDG-PET/CT was lower than that of CT (57.1% vs. 73.5%, P < 0.001). For distant lymph nodes, the sensitivity of FDG-PET/CT was higher than that of CT (64.7% vs. 52.9%, P = 0.012). The sensitivity of FDG-PET/CT for regional lymph nodes was higher in patients with larger primary tumors. The positivity of lymph-node metastasis for FDG-PET/CT was affected by carcinoembryonic antigen levels, tumor location, and cancer stage for regional lymph nodes and by age and cancer stage for distant lymph nodes (P < 0.05). Conclusion The sensitivity of FDG-PET/CT for regional lymph-node metastasis was not superior to that of CT. However, FDG-PET/CT provides helpful information for determining surgical plan especially in high risk patients group.
Published: 2014

41. Proposed safe apnea test using positive end-expiratory pressure valve and short-term blood gas analysis

Author: Kyung Sook Hong, Jin Park, and Young-Joo Lee
Subjects: Resuscitator, business.industry, Apnea, General Medicine, Overweight, respiratory tract diseases, Hypoxemia, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, Anesthesia, medicine, Apnea test, Observational study, 030212 general & internal medicine, medicine.symptom, business, Body mass index, Positive end-expiratory pressure, circulatory and respiratory physiology
Abstract: The apnea test is an essential examination for the determination of brain death; however, hypotension, hypoxemia, and other complications during the apnea test can affect the stability of brain-dead patients, as well as organ function for recipients. Therefore, it is necessary to establish standard guidelines for apnea testing.The modified apnea test (MAT) comprises delivery of 100% oxygen through the endotracheal tube connected to manual resuscitator (Ambu bag) with the positive end-expiratory pressure (PEEP) valve after disconnection of the mechanical ventilator for maintenance of PEEP. Forty-nine instances of the conventional apnea test (CAT) were performed in 25 brain-dead patients; 77 instances of the MAT were performed in 39 brain-dead patients.The mean duration of the apnea test was 3.5 ± 1.4 minutes in the CAT group and 3.0 ± 1.2 minutes in the MAT group. There were no significant changes in PaCO2, PaO2, or pH between the CAT and MAT groups (P = .341, .593, and .503, respectively). In overweight patients (body mass index ≥ 23 kg/m), MAT prevented dramatic reductions in PaO2 and SaO2 (P
Published: 2019
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42. Decision-making regarding withdrawal of lifesustaining treatment and the role of intensivists in the intensive care unit: a single-center study.

Author: Seo In Lee, Kyung Sook Hong, Jin Park, and Young-Joo Lee
Subjects: *INTENSIVE care units, *PATIENTS' families, *INTENSIVE care patients, *CURRICULUM, *ACADEMIC medical centers
Abstract: Background: This study examined the experience of withholding or withdrawing life-sustaining treatment in patients hospitalized in the intensive care units (ICUs) of a tertiary care center. It also considers the role that intensivists play in the decision-making process regarding the withdrawal of life-sustaining treatment. Methods: We retrospectively analyzed the medical records of 227 patients who decided to withhold or withdraw life-sustaining treatment while hospitalized at Ewha Womans University Medical Center Mokdong between April 9 and December 31, 2018. Results: The 227 hospitalized patients included in the analysis withheld or withdrew from life-sustaining treatment. The department in which life-sustaining treatment was withheld or withdrawn most frequently was hemato-oncology (26.4%). Among these patients, the most common diagnosis was gastrointestinal tract cancer (29.1%). A majority of patients (64.3%) chose not to receive any life-sustaining treatment. Of the 80 patients in the ICU, intensivists participated in the decision to withhold or withdraw life-sustaining treatment in 34 cases. There were higher proportions of treatment withdrawal and ICU-to-ward transfers among the cases in whom intensivists participated in decision making compared to those cases in whom intensivists did not participate (50.0% vs. 4.3% and 52.9% vs. 19.6%, respectively). Conclusions: Through their participation in end-of-life discussions, intensivists can help patients' families to make decisions about withholding or withdrawing life-sustaining treatment and possibly avoiding futile treatments for these patients. [ABSTRACT FROM AUTHOR]
Published: 2020
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43. GLUT1-dependent glycolysis regulates exacerbation of fibrosis via AIM2 inflammasome activation.

Author: Soo Jung Cho, Jong-Seok Moon, Kiichi Nikahira, Ha Seon Yun, Harris, Rebecca, Kyung Sook Hong, Huarong Huang, Choi, Augustine M. K., Stout-Delgado, Heather, Cho, Soo Jung, Moon, Jong-Seok, Nikahira, Kiichi, Yun, Ha Seon, Hong, Kyung Sook, and Huang, Huarong
Subjects: WARBURG Effect (Oncology), PULMONARY fibrosis, FIBROSIS, GLYCOLYSIS, BACTERIAL DNA, PATHOLOGY, PROTEIN metabolism, ANIMAL experimentation, BIOLOGICAL models, BLEOMYCIN, CARRIER proteins, COMPARATIVE studies, GENETIC techniques, LUNGS, RESEARCH methodology, MEDICAL cooperation, MICE, PROTEINS, RESEARCH, STREPTOCOCCUS pneumoniae, EVALUATION research, DISEASE progression, IDIOPATHIC pulmonary fibrosis, DISEASE complications
Abstract: Background: Idiopathic pulmonary fibrosis (IPF) is a rapidly progressive, fatal lung disease that affects older adults. One of the detrimental natural histories of IPF is acute exacerbation of IPF (AE-IPF), of which bacterial infection is reported to play an important role. However, the mechanism by which bacterial infection modulates the fibrotic response remains unclear.Objectives: Altered glucose metabolism has been implicated in the pathogenesis of fibrotic lung diseases. We have previously demonstrated that glucose transporter 1 (GLUT1)-dependent glycolysis regulates fibrogenesis in a murine fibrosis model. To expand on these findings, we hypothesised that GLUT1-dependent glycolysis regulates acute exacerbation of lung fibrogenesis during bacterial infection via AIM2 inflammasome activation.Results: In our current study, using a murine model of Streptococcus pneumoniae (S. pneumoniae) infection, we investigated the potential role of GLUT1 on mediating fibrotic responses to an acute exacerbation during bleomycin-induced fibrosis. The results of our current study illustrate that GLUT1 deficiency ameliorates S. pneumoniae-mediated exacerbation of lung fibrosis (wild type (WT)/phosphate buffered saline (PBS), n=3; WT/S. pneumoniae, n=3; WT/Bleomycin, n=5 ; WT/Bleomycin+S. pneumoniae, n=7; LysM-Cre-Glut1fl/f /PBS, n=3; LysM-Cre-Glut1fl/fl /S. pneumoniae, n=3; LysM-Cre-Glut1fl/fl /Bleomycin, n=6; LysM-Cre-Glut1fl/fl /Bleomycin+S. pneumoniae, n=9, p=0.041). Further, the AIM2 inflammasome, a multiprotein complex essential for sensing cytosolic bacterial DNA as a danger signal, is an important regulator of this GLUT1-mediated fibrosis and genetic deficiency of AIM2 reduced bleomycin-induced fibrosis after S. pneumoniae infection (WT/PBS, n=6; WT/Bleomycin+S. pneumoniae, n=15; Aim2-/-/PBS, n=6, Aim2-/-/Bleomycin+S. pneumoniae, n=11, p=0.034). GLUT1 deficiency reduced expression and function of the AIM2 inflammasome, and AIM2-deficient mice showed substantial reduction of lung fibrosis after S. pneumoniae infection.Conclusion: Our results demonstrate that GLUT1-dependent glycolysis promotes exacerbation of lung fibrogenesis during S. pneumoniae infection via AIM2 inflammasome activation. [ABSTRACT FROM AUTHOR]
Published: 2020
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44. A comparison of transumbilical single-port laparoscopic appendectomy and conventional three-port laparoscopic appendectomy: from the diagnosis to the hospital cost

Author: Seung Min Baik, Kyung Sook Hong, and Yong Il Kim
Subjects: Laparoscopic surgery, medicine.medical_specialty, business.industry, Visual analogue scale, Medical record, medicine.medical_treatment, Single incision, Complicated appendicitis, Hospital cost, Single surgeon, Surgery, Port (medical), Laparoscopic appendectomy, medicine, Operative time, Original Article, business
Abstract: Purpose: Recently many cases of appendectomy have been conducted by singleincision laparoscopic technique. The aim of this study is to figure out the benefits of transumbilical single-port laparoscopic appendectomy (TULA) compared with conventional three-port laparoscopic appendectomy (CTLA). Methods: From 2010 to 2012, 89 patients who were diagnosed as acute appendicitis and then underwent laparoscopic appendectomy a single surgeon were enrolled in this study and with their medical records were reviewed retrospectively. Cases of complicated appendicitis confirmed on imaging tools and patients over 3 points on the American Society of Anesthesia score were excluded. Results: Among the total of 89 patients, there were 51 patients in the TULA group and 38 patients in the CTLA group. The visual analogue scale (VAS) of postoperative day (POD) #1 was higher in the TULA group than in the CTLA group (P = 0.048). The operative time and other variables had no statistical significances (P > 0.05). Conclusion: Despite the insufficiency of instruments and the difficulty of handling, TULA was not worse in operative time, VAS after POD #2, and the total operative cost than CTLA. And, if there are no disadvantages of TULA, TULA may be suitable in substituting three-port laparoscopic surgery and could be considered as one field of natural orifice transluminal endoscopic surgery with the improvement and development of the instruments and revised studies.
Published: 2013

45. A novel approach for stress-induced gastritis based on paradoxical anti-oxidative and anti-inflammatory action of exogenous 8-hydroxydeoxyguanosine

Author: Yun Soo Kim, Ju Hyun Kim, Kyung Sook Hong, Ki Baik Hahm, Ki-Seok Choi, Chan Young Ock, and Myung-Hee Chung
Subjects: Male, Transcription, Genetic, GTP', Anti-Inflammatory Agents, IκB kinase, Pharmacology, medicine.disease_cause, Biochemistry, Antioxidants, Cell Line, Rats, Sprague-Dawley, Mice, chemistry.chemical_compound, Stress, Physiological, medicine, Animals, Humans, chemistry.chemical_classification, Reactive oxygen species, Chemistry, Kinase, Deoxyguanosine, NF-κB, Rats, Specific Pathogen-Free Organisms, Endothelial stem cell, 8-Hydroxy-2'-Deoxyguanosine, NAD(P)H oxidase, Gastritis, Reactive Oxygen Species, Oxidative stress
Abstract: Reactive oxygen species (ROS) attack guanine bases in DNA and form 8-hydroxydeoxyguanosine (8-OHdG), which has been regarded simply as an oxidative mutagenic by-product. On the other hand, our previous report showed paradoxically ROS attenuating action of generated 8-OHdG. In the current study, both in vitro and in vivo experiments were executed in order to document anti-oxidative and anti-inflammatory actions of 8-OHdG in cell model and to elucidate the therapeutic efficacy against water immersion restraint stress (WIRS)-induced gastritis animal model. Electron spin resonance measurements showed that 8-OHdG at >5μg/ml completely scavenged OH(-) radicals, which was further confirmed by checking 2'-7'-dichlorodihydrofluorescein diacetate (DCFDA) spectroscopy. On molecular assay, 8-OHdG antagonized the action of GTP on Rac, a small GTP binding protein, without affecting Rac-guanosine exchange factor (GEF) or phosphoinositide 3-kinases (PI3K) activity. In Raw264.7 cells, 8-OHdG was found to be associated with marked attenuations of NOX1, NOXO1, and NOXA1 accompanied with the decreased expressions of LPS-induced inflammatory mediators including COX-2, iNOS, IL-1β, and IL-6. Similarly, 8-OHdG attenuated hypoxia-induced angiogenesis and platelet endothelial cell adhesion molecule-1 (PECAM-1), COX-2, iNOS, IL-8, and VEGF expressions in HUVEC cells. At transcriptional level, 8-OHdG inhibited the nuclear translocation of NF-κB, inhibitory κB kinase (IKK) β kinase activation, and decreased phospho-IκBα levels. 8-OHdG efficiently ameliorated WIRS-induced gastric mucosal injury as evidenced with improvement of gross lesion index and attenuation of engaging mediators. Taken together, exogenous 8-OHdG can be a functional molecule regulating oxidative stress-induced gastritis through either antagonizing Rac-GTP binding or blocking the signals responsible for gastric inflammatory cascade.
Published: 2011
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46. The Protective Effect of ENA Actimineral Resource A on CCl4-Induced Liver Injury in Rats

Author: Hoon Ji, Moon-Jung Goo, Hae Young Chung, Jung-Youn Han, Da-Hee Jeong, Il-Hwa Hong, Won-Il Jeong, Kyung-Sook Hong, Ok-Kyung Hwang, Mi-Ran Ki, Ji Min Kim, Sun Hee Do, Jin-Kyu Park, Kyu-Shik Jeong, and Sung-Yong Hwa
Subjects: Antioxidant, medicine.medical_treatment, Biology, Peroxiredoxin 1, Pharmacology, medicine.disease_cause, Applied Microbiology and Biotechnology, Antioxidants, Mass Spectrometry, Lipid peroxidation, chemistry.chemical_compound, medicine, Animals, Electrophoresis, Gel, Two-Dimensional, Carbon Tetrachloride, Glutathione Transferase, Liver injury, chemistry.chemical_classification, Minerals, Reactive oxygen species, Kelch-Like ECH-Associated Protein 1, Intracellular Signaling Peptides and Proteins, Proteins, Cytochrome P-450 CYP2E1, Peroxiredoxins, Glutathione, Catalase, medicine.disease, Immunohistochemistry, Rats, Oxidative Stress, chemistry, Biochemistry, Enzyme Induction, biology.protein, Lipid Peroxidation, Plant Preparations, Chemical and Drug Induced Liver Injury, Reactive Oxygen Species, Oxidative stress
Abstract: ENA Actimineral Resource A (ENA-A) is alkaline water that is composed of refined edible cuttlefish bone and two different species of seaweed, Phymatolithon calcareum and Lithothamnion corallioides. In the present study, ENA-A was investigated as an antioxidant to protect against CCl(4)-induced oxidative stress and hepatotoxicity in rats. Liver injury was induced by either subacute or chronic CCl(4) administration, and the rats had free access to tap water mixed with 0% (control group) or 10% (v/v) ENA-A for 5 or 8 weeks. The results of histological examination and measurement of antioxidant activity showed that the reactive oxygen species production, lipid peroxidation, induction of CYP2E1 were decreased and the antioxidant activity, including glutathione and catalase production, was increased in the ENA-A groups as compared with the control group. On 2-DE gel analysis of the proteomes, 13 differentially expressed proteins were obtained in the ENA-A groups as compared with the control group. Antioxidant proteins, including glutathione S-transferase, kelch-like ECH-associated protein 1, and peroxiredoxin 1, were increased with hepatocyte nuclear factor 3-beta and serum albumin precursor, and kininogen precursor decreased more in the ENA-A groups than compared to the control group. In conclusion, our results suggest that ENA-A does indeed have some protective capabilities against CCl(4)-induced liver injury through its antioxidant function.
Published: 2010
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47. Efficacy of Korean Red Ginseng Supplementation on Eradication Rate and Gastric Volatile Sulfur Compound Levels after Helicobacter pylori Eradication Therapy

Author: Chan Young Ock, Ji Young Park, So Jung Lee, Ki Baik Hahm, Jun-Won Chung, Yoon Jae Kim, Ki Seok Choi, and Kyung Sook Hong
Subjects: Breath test, medicine.medical_specialty, Traditional medicine, medicine.diagnostic_test, biology, medicine.drug_class, business.industry, Proton-pump inhibitor, macromolecular substances, Amoxicillin, Helicobacter pylori, biology.organism_classification, Biochemistry, Genetics and Molecular Biology (miscellaneous), Gastroenterology, Halimeter, Regimen, Ginseng, Complementary and alternative medicine, Internal medicine, Clarithromycin, medicine, business, Biotechnology, medicine.drug
Abstract: This clinical study was performed to evaluate whether supplementation of proton pump inhibitor (PPI)-based triple therapy with Korean red ginseng can enhance Helicobacter pylori (H. pylori) eradication and reduce levels of halitosis-associated volatile sulfur compounds (VSCs) in the stomach. Seventy-six patients were randomized into an eradication regimen-only group (n=45) or an eradication regimen plus 10 weeks of Korean red ginseng supplementation group (n=31). The eradication regimen consisted of PPI b.i.d., clarithromycin 500 ㎎ b.i.d., and amoxicillin 1 g b.i.d.. for seven days. Korean red ginseng supplementation commenced on the last day of the eradication regimen. ¹³C-urea breath test and halimeter measurements were performed prior to protocol repetition. By intention-to-treat analysis, the H. pylori eradication rate in the Korean red ginseng group (77.4%, 24 of 31) was higher than that in the control group (45.0%, 26 of 45). However, by per protocol analysis, the eradication rate in the Korean red ginseng group was significantly higher than that in the control group (92.3%, 24/26 vs. 69.4%, 26/38; p＜0.05). H. pylori infection was significantly associated with increased VSC levels. However, VSC levels decreased significantly in the Korean red ginseng group (p＜0.05). In conclusion, supplementation of triple therapy with Korean red ginseng increased the H. pylori eradication rate and led to significant reductions in VSC levels, suggesting the usefulness of this substance in combating H. pylori infection.
Published: 2010
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48. Multiple perianal infundibular follicular cysts in a dog

Author: Jin-Kyu Park, Kyung-Sook Hong, Mi-Ran Ki, Il-Hwa Hong, Ae-Ri Ji, Kyu-Shik Jeong, and Sun Hee Do
Subjects: Pathology, medicine.medical_specialty, General Veterinary, Follicular Cyst, business.industry, Sequela, Histology, Anus, medicine.disease, Perianal region, Surgery, medicine.anatomical_structure, Skin tissue, Cocker spaniel, Anal sacculitis, medicine, business
Abstract: This case report describes a 7-year-old male cocker spaniel dog with multiple perianal infundibular follicular cysts. Clinically the dog had moderate anal sacculitis, peri-anal pruritus causing it to 'scoot' and lick the area. On examination of the perianal area, there were over 100 firm, well circumscribed papules, ranged from 0.2 to 0.5 cm in diameter with a central pore, and were found in the perianal region. Alopecia was present in the perianal region. The skin tissue in the perianal region resected surgically was submitted for histological examination. Microscopically, the tissue revealed multiple dilated cysts filled with keratins and the papules corresponded to infundibular follicular cysts. The affected dog showed moderate anal sacculitis. Anal sacculitis commonly causes repeated scooting or licking the area around the anus. Therefore, the multiple follicular cysts in the present case appear to be primarily a sequela to chronic external trauma to the perianal area, probably in response to anal sacculitis. To the best of the authors' knowledge, the present report is the first documented case of multiple perianal infundibular follicular cysts in a dog.
Published: 2010
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49. Beneficial Effect of Korea Red Ginseng on Halitosis; Attenuation of H2

Author: Kyung-Sook Hong, So Jung Lee, Jeong-Sang Lee, Yoon Jae Kim, Ki-Seok Choi, Jeong-Gon Kim, and Ki Baik Hahm
Subjects: MAPK/ERK pathway, biology, Traditional medicine, business.industry, Moesin, Chronic gastritis, Inflammation, Pharmacology, medicine.disease, Biochemistry, Genetics and Molecular Biology (miscellaneous), Cystathionine beta synthase, Proinflammatory cytokine, Ginseng, Ezrin, Complementary and alternative medicine, medicine, biology.protein, medicine.symptom, business, Biotechnology
Abstract: Halitosis is a generally accepted marker of diseases in the oral cavity and of systemic and gastrointestinal disorders. Based on these authors’ previous findings (that (1) there is a close association between H. pylori infection and halitosis; (2) Korea red ginseng may suppress the colonization of H. pylori, fight H. pylori-induced cytotoxicity, and impose significant anti-inflammatory actions in patients with chronic gastritis; and (3) H. pylori infection is linked with the generation of significant levels of volatile sulfur compounds (VSCs), and the levels of VSCs correlate significantly with H. pylori-associated mucosal damages), in the current study, the authors documented the molecular mechanisms of Korea red ginseng’s efficacy in ameliorating halitosis. When the RAW 264.7 cells were treated with the H₂S releasing compound NaHS, the mRNA expression of cystathionine γ-lyase (CSE), IL-6, COX-2, and iNOS were more significantly induced compared with the vehicle-treated group. The cytoskeletal components of ezrin’s and moesin’s mRNA expressions were elevated by NaHS treatment accompanied by the activation of MAPK, p38, and ERK. Korea red ginseng pretreatment reduced both the NaHS-induced CSE expression and the proinflammatory genes (e.g., IL-6, COX-2, and iNOS) in a concentration-dependent manner. The ERM expression and the phosphorylation of p38 were also significantly reduced by Korea-red-ginseng pretreatment. Overall, Korea red ginseng pretreatment imposed significant anti-inflammatory effects through the downregulation of the NaHS-triggered proinflammatory gene expression, CSE, and ERM mRNA expression. Korea red ginseng could thus be said to be a key remedy of halitosis and to be effective in relieving gastric inflammation.
Published: 2009
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50. Helicobacter pylori promotes hepatic fibrosis in the animal model

Author: Kyung Sook Hong, Hai Jie Yang, Il Hwa Hong, Sun Hee Do, Ok Kyung Hwang, Dong Wei Yuan, Hye Rim Lee, Jung Youn Han, Jin-Kyu Park, Kyu-Shik Jeong, Moon Jung Goo, Ronald D. Cohn, Dong-Hwan Kim, and Mi Ran Ki
Subjects: Cirrhosis, Spirillaceae, CCL4, Liver Cirrhosis, Experimental, medicine.disease_cause, Helicobacter Infections, Pathology and Forensic Medicine, Rats, Sprague-Dawley, Mice, Antigen, RNA, Ribosomal, 16S, medicine, Animals, Aspartate Aminotransferases, Carbon Tetrachloride, Molecular Biology, Helicobacter pylori, biology, Calcium-Binding Proteins, Intracellular Signaling Peptides and Proteins, Alanine Transaminase, Gene Expression Regulation, Bacterial, Cell Biology, bacterial infections and mycoses, medicine.disease, biology.organism_classification, Rats, Mice, Inbred C57BL, Apoptosis, Immunology, Disease Progression, Hepatic fibrosis, Biomarkers, Oxidative stress
Abstract: Helicobacter pylori infection has been reported to be very common in patients with chronic liver diseases, including cirrhosis. To elucidate the pathological effect of H. pylori infection on the progression of hepatic fibrosis, C57BL/6 mice and Sprague-Dawley rats were orally inoculated with H. pylori, and hepatic fibrosis was induced with carbon tetrachloride (CCl(4)) administration. We observed the histopathological changes and the presence of H. pylori genes by PCR in the liver. Significant increase in the fibrotic score as well as in serum alanine aminotransferase and aspartate aminotransferase levels was shown in the CCl(4)+H. pylori group compared with that in the CCl(4)-treated group. Compared with the CCl(4)-treated group, alpha-smooth muscle actin and transforming growth factor-beta1 were enhanced; however, senescence marker protein-30, a multifunctional protein protecting hepatocytes against oxidative stress and apoptosis, was suppressed in the CCl(4)+H. pylori group. The 16S rRNA (400 bp) was demonstrated by PCR for H. pylori genes from genomic DNA extracted from the liver, and H. pylori-infected mice showed 93.8% (15 of 16) seropositivity by contrast with seronegativity in all H. pylori-noninfected mice. In addition, immunohistochemical study against H. pylori showed positive antigen fragments in the liver of the infected groups. Consequently, our data suggest that H. pylori infection could be an important contributing infectious factor to the development of liver cirrhosis.
Published: 2009
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