Fatigue in Irritable Bowel Syndrome: A Systematic Review and Meta-analysis of Pooled Frequency and Severity of Fatigue

Claire Jungyoun Han,Gee Su Yang 한국간호과학회 2016 Asian Nursing Research Vol.10 No.1

Purpose: Fatigue is the third most common “extraintestinal” complaint of patients with irritable bowel syndrome (IBS), but it is still poorly understood. This study aimed to review characteristics of IBSassociated fatigue and to examine pooled frequency, severity of fatigue, and correlations of related factors with fatigue in IBS via meta-analyses. Methods: Publications were searched in eight databases from 1995 to 2014. Random effects metaanalyses were applied with standard error, weighted effect size, and correlation-based measure of effect size. Results: Twenty-four studies were included in systematic review. Seventeen studies were used for metaanalyses (2 studies were excluded in the frequency of fatigue analysis due to data unavailability). Using “tiredness” to define fatigue, and Fatigue Impact Scale to assess fatigue were the most frequently used across the studies. Gastrointestinal symptoms, psychological distress, and health-related quality of life were the most common correlates with fatigue. The pooled frequency of fatigue was 54.2% [95% confidence interval (38.5, 69.4)]. Metaregression on the frequency of fatigue showed positive and significant relations with tertiary care settings, female sex, and younger age. There was a negatively moderate relationship between the severity of fatigue and health-related quality of life score (correlation-based measure of effect size: -.378). Conclusions: Fatigue is prevalent among patients with IBS and commonly co-occurs with other symptoms. This is the first study to fully examine fatigue in IBS, which shed light on the comprehensive management of fatigue in this patient group. Future research is warranted to further explore fatiguerelated factors and underlying mechanisms of fatigue in IBS.

Anterior Shoulder Instability with Concomitant Superior Labrum from Anterior to Posterior (SLAP) Lesion Compared to Anterior Instability without SLAP Lesion

Claire Marie C. Durban,Je Kyun Kim,김세훈,Joo Han Oh 대한정형외과학회 2016 Clinics in Orthopedic Surgery Vol.8 No.2

Background: The aims of this study were to investigate the clinical characteristics of patients with combined anterior instability and superior labrum from anterior to posterior (SLAP) lesions, and to analyze the effect of concomitant SLAP repair on surgical outcomes. Methods: We retrospectively reviewed patients who underwent arthroscopic stabilization for anterior shoulder instability between January 2004 and March 2013. A total of 120 patients were available for at least 1-year follow-up. Forty-four patients with reparable concomitant detached SLAP lesions (group I) underwent combined SLAP and anterior stabilization, and 76 patients without SLAP lesions (group II) underwent anterior stabilization alone. Patient characteristics, preoperative and postoperative pain scores, Rowe scores, and shoulder ranges of motion were compared between the 2 groups. Results: Patients in group I had higher incidences of high-energy trauma (p = 0.03), worse preoperative pain visual analogue scale (VAS) (p = 0.02), and Rowe scores (p = 0.04). The postoperative pain VAS and Rowe scores improved equally in both groups without significant differences. Limitation in postoperative range of motion was similar between the groups (all p-value > 0.05). Conclusions: Anterior instability with SLAP lesion may not be related to frequent episodes of dislocation but rather to a highenergy trauma. SLAP fixation with anterior stabilization procedures did not lead to poor functional outcomes if appropriate surgical techniques were followed.

The gene repertoire of Pythium porphyrae (Oomycota) suggests an adapted plant pathogen tackling red algae

Badis, Yacine,Han, Jong Won,Klochkova, Tatyana A.,Gachon, Claire M.M.,Kim, Gwang Hoon The Korean Society of Phycology 2020 ALGAE Vol.35 No.2

Pythium porphyrae is responsible for devastating outbreaks in seaweed farms of Pyropia, the most valuable cultivated seaweed worldwide. While the genus Pythium contains many well studied pathogens, the genome of P. porphyrae has yet to be sequenced. Here we report the first available gene repertoire of P. porphyrae and a preliminary analysis of pathogenicity-related genes. Using ab initio detection strategies, similarity based and manual annotation, we found that the P. porphyrae gene repertoire is similar to classical phytopathogenic Pythium species. This includes the absence of expanded RxLR effector family and the detection of classical pathogenicity-related genes like crinklers, glycoside hydrolases, cellulose-binding elicitor lectin-like proteins and elicitins. We additionally compared this dataset to the proteomes of 8 selected Pythium species. While 34% of the predicted proteome appeared specific to P. porphyrae, we could not attribute specific enzymes to the degradation of red algal biomass. Conversely, we detected several cellulases and a cutinase conserved with plant-pathogenic Pythium species. Together with the recent report of P. porphyrae triggering disease symptoms on several plant species in lab-controlled conditions, our findings add weight to the hypothesis that P. porphyrae is a reformed plant pathogen.

Direct Reprogramming of Human Dermal Fibroblasts Into Endothelial Cells Using ER71/ETV2

Lee, Sangho,Park, Changwon,Han, Ji Woong,Kim, Ju Young,Cho, Kyuwon,Kim, Eun Jae,Kim, Sangsung,Lee, Shin-Jeong,Oh, Se Yeong,Tanaka, Yoshiaki,Park, In-Hyun,An, Hyo Jae,Shin, Claire Min,Sharma, Shraya,Yo Grune & Stratton 2017 Circulation research Vol.120 No.5

<P>Conclusions: This study for the first time demonstrates that ER71/ETV2 alone can directly reprogram human postnatal cells to functional, mature ECs after an intervening transgene-free period. These rECs could be valuable for cell therapy, personalized disease investigation, and exploration of the reprogramming process.</P>

Echocardiography Core Laboratory Validation of a Novel Vendor-Independent Web-Based Software for the Assessment of Left Ventricular Global Longitudinal Strain

Ernest Spitzer,Benjamin Camacho,Blaz Mrevlje,Hans-Jelle Brandendburg,Claire B. Ren 한국심초음파학회 2023 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.31 No.3

BACKGROUND: Global longitudinal strain (GLS) is an accurate and reproducible parameter of left ventricular (LV) systolic function which has shown meaningful prognostic value. Fast, user-friendly, and accurate tools are required for its widespread implementation. We aim to compare a novel web-based tool with two established algorithms for strain analysis and test its reproducibility. METHODS: Thirty echocardiographic datasets with focused LV acquisitions were analyzed using three different semi-automated endocardial GLS algorithms by two readers. Analyses were repeated by one reader for the purpose of intra-observer variability. CAAS Qardia (Pie Medical Imaging) was compared with 2DCPA and AutoLV (TomTec). RESULTS: Mean GLS values were −15.0 ± 3.5% from Qardia, −15.3 ± 4.0% from 2DCPA, and −15.2 ± 3.8% from AutoLV. Mean GLS between Qardia and 2DCPA were not statistically different (p = 0.359), with a bias of −0.3%, limits of agreement (LOA) of 3.7%, and an intra-class correlation coefficient (ICC) of 0.88. Mean GLS between Qardia and AutoLV were not statistically different (p = 0.637), with a bias of −0.2%, LOA of 3.4%, and an ICC of 0.89. The coefficient of variation (CV) for intra-observer variability was 4.4% for Qardia, 8.4% 2DCPA, and 7.7% AutoLV. The CV for inter-observer variability was 4.5%, 8.1%, and 8.0%, respectively. CONCLUSIONS: In echocardiographic datasets of good image quality analyzed at an independent core laboratory using a standardized annotation method, a novel web-based tool for GLS analysis showed consistent results when compared with two algorithms of an established platform. Moreover, inter- and intra-observer reproducibility results were excellent.

기존 교육과정에서의 성과바탕 의학교육 이론 적용

홍영선,한재진,김정아,최희정,윤주천,정혜경,김한수 이화여자대학교 의과학연구소 2017 EMJ (Ewha medical journal) Vol.40 No.1

Objectives: This paper aims to describe an outcome-based curriculum development process at a medical school that has difficulty in advancement from the higher stage outcomes to the individual lesson outcomes, and to propose a way to implement it practically. Methods: We reviewed the objectives, strategies and previous products of the school’s taskforce activities and suggested the principle of bidirectional approaches of outcome based curriculum development. Results: The developing strategy identified such as firstly, the evaluation of present curriculum and then, the review of the outcomes developed previously with considering the nation-wide environmental change in medical education. Then, we selected one example course which was focused the resources of the school to, and finally the product of the example course was propagated to the other courses with central monitoring. Conclusion: Bidirectional model of ‘Top-down’ plus ‘Bottom-up’ approaches could be an efficient way to develop the outcome-based curriculum in a medical school, which has difficulties to advance the developing process due to various reasons including limited resources.

Direct Regulation of TLR5 Expression by Caveolin-1

Lim, Jae Sung,Nguyen, Kim Cuc Thi,Han, Jung Min,Jang, Ik-Soon,Fabian, Claire,Cho, Kyung A Korean Society for Molecular and Cellular Biology 2015 Molecules and cells Vol.38 No.12

Toll-like receptor 5 (TLR5) is a specific receptor for microbial flagellin and is one of the most well-known receptors in the TLR family. We reported previously that TLR5 signaling is well maintained during aging and that caveolin-1 may be involved in TLR5 signaling in aged macrophages through direct interactions. Therefore, it is important to clarify whether caveolin-1/TLR5 interactions affect TLR5 expression during aging. To assess the effect of caveolin-1 on TLR5, we analyzed TLR5 expression in senescent fibroblasts and aged tissues expressing high levels of caveolin-1. As expected, TLR5 mRNA and protein expression was well maintained in senescent fibroblasts and aged tissues, whereas TLR4 mRNA and protein were diminished in those cells and tissues. To determine the mechanism of caveolin-1-dependent TLR5 expression, we examined TLR5 expression in caveolin-1 deficient mice. Interestingly, TLR5 mRNA and protein levels were decreased dramatically in tissues from caveolin-1 knockout mice. Moreover, overexpressed caveolin-1 in vitro enhanced TLR5 mRNA through the MAPK pathway and prolonged TLR5 protein half-life through direct interaction. These results suggest that caveolin-1 may play a crucial role in maintaining of TLR5 by regulating transcription systems and increasing protein half-life.

A Delta Neutrophil Index for the Prediction of Contrast-Induced Nephropathy in Patients With St-Elevation Myocardial Infarction Followed By Percutaneous Coronary Intervention

Kong, Taeyoung,Park, Yoo Seok,Lee, Hye Sun,Kim, Sinae,Han, Sehee,Eun, Claire H.,Lee, Jong Wook,You, Je Sung,Chung, Hyun Soo,Park, Incheol,Chung, Sung Phil Ovid Technologies (Wolters Kluwer) - Lippincott Wi 2018 Shock Vol.49 No.3

Tryptophan Metabolites in Irritable Bowel Syndrome: An Overnight Time-Course Study

Robert L Burr,Haiwei Gu,Kevin Cain,Danijel Djukovic,Xinyu Zhang,Claire Han,Nini Callan,Daniel Raftery,,Margaret Heitkemper 대한소화기 기능성질환∙운동학회 2019 Journal of Neurogastroenterology and Motility (JNM Vol.25 No.4

Background/Aims Patients with irritable bowel syndrome (IBS) often report poor sleep quality. Whether poor sleep is associated with tryptophan (Trp) metabolites is unknown. We compared serum Trp metabolites in women with IBS and healthy controls (HCs) using targeted liquid chromatography mass spectrometry (LC-MS)-based profiling. In IBS only, we explored whether Trp metabolites are associated with IBS symptoms and subjective and objective sleep indices, serum cortisol, plasma adrenocorticotropic hormone (ACTH), and cortisol/ACTH levels. Methods Blood samples were obtained every 80 minutes in 21 HCs and 38 IBS subjects following an anticipation-of-public-speaking stressor during a sleep laboratory protocol. Subjects completed symptom diaries for 28 days. Adjacent values of metabolites were averaged to represent 4 time-periods: awake, early sleep, mid-sleep, and mid-to-late sleep. Thirteen of 20 targeted Trp metabolites were identified. Results Ten of 13 Trp metabolites decreased across the night, while nicotinamide increased in both groups. A MANOVA omnibus test performed after principal component analysis showed a significant difference in these 13 principal component (P = 0.014) between groups. Compared to HCs, nicotinamide levels were higher and indole-3-lactic acid levels lower in the IBS group. Melatonin and indole-3-acetic acid levels were associated with several subjective/objective sleep measures; decreased stool consistency/frequency and abdominal pain were positively associated with melatonin and serotonin in the IBS group. The kynurenine and kynurenic acid were associated with ACTH (positively) and cortisol/ACTH (negatively). Conclusions Nighttime Trp metabolites may provide clues to poor sleep and stress with IBS. Further study of the mechanism of metabolite action is warranted.

Flagellin-dependent TLR5/caveolin-1 as a promising immune activator in immunosenescence

Lim, Jae Sung,Nguyen, Kim Cuc Thi,Nguyen, Chung Truong,Jang, Ik-Soon,Han, Jung Min,Fabian, Claire,Lee, Shee Eun,Rhee, Joon Haeng,Cho, Kyung A BLACKWELL PUBLISHING 2015 AGING CELL Vol.14 No.5

<P>The age-associated decline of immune responses causes high susceptibility to infections and reduced vaccine efficacy in the elderly. However, the mechanisms underlying age-related deficits are unclear. Here, we found that the expression and signaling of flagellin (FlaB)-dependent Toll-like receptor 5 (TLR5), unlike the other TLRs, were well maintained in old macrophages, similar to young macrophages. The expression and activation of TLR5/MyD88, but not TLR4, were sensitively regulated by the upregulation of caveolin-1 in old macrophages through direct interaction. This interaction was also confirmed using macrophages from caveolin-1 or MyD88 knockout mice. Because TLR5 and caveolin-1 were well expressed in major old tissues including lung, skin, intestine, and spleen, we analyzed in vivo immune responses via a vaccine platform with FlaB as a mucosal adjuvant for the pneumococcal surface protein A (PspA) against <I>Streptococcus pneumoniae</I> infection in young and aged mice. The FlaB-PspA fusion protein induced a significantly higher level of PspA-specific IgG and IgA responses and demonstrated a high protective efficacy against a lethal challenge with live <I>S. pneumoniae</I> in aged mice. These results suggest that caveolin-1/TLR5 signaling plays a key role in age-associated innate immune responses and that FlaB-PspA stimulation of TLR5 may be a new strategy for a mucosal vaccine adjuvant against pneumococcal infection in the elderly.</P>