Clinical Practice Guideline for Cardiac Rehabilitation in Korea

Chul Kim,성지동,Jong Hwa Lee,Won-Seok Kim,Goo Joo Lee,Sungju Jee,Il-Young Jung,Ueon Woo Rah,Byung Ok Kim,Kyoung Hyo Choi,Bum Sun Kwon,유승돈,Heui Je Bang,Hyung-ik Shin,Yong Wook Kim,Heeyoune Jung,Eung Ju Ki 대한흉부외과학회 2019 Journal of Chest Surgery (J Chest Surg) Vol.52 No.4

Background: Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. Methods: This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors—primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. Results: CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Conclusion: Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.

Generation of a Human Monoclonal Antibody to Cross-Reactive Material 197 (CRM₁₉₇) and Development of a Sandwich ELISA for CRM₁₉₇ Conjugate Vaccines

( Dain Kim ),( Hyeseon Yoon ),( Sangkyu Kim ),( Jimin Wi ),( Heesu Chae ),( Gyunghee Jo ),( Jun-yeol Yoon ),( Heeyoun Kim ),( Chankyu Lee ),( Se-ho Kim ),( Hyo Jeong Hong ) 한국미생물 · 생명공학회 2018 Journal of microbiology and biotechnology Vol.28 No.12

Cross-reactive material 197 (CRM₁₉₇) is a non-toxic mutant of diphtheria toxin containing a single amino acid substitution of glycine 52 with glutamic acid. CRM₁₉₇ has been used as a carrier protein for poorly immunogenic polysaccharide antigens to improve immune responses. In this study, to develop a sandwich ELISA that can detect CRM₁₉₇ and CRM₁₉₇ conjugate vaccines, we generated a human anti-CRM₁₉₇ monoclonal antibody (mAb) 3F9 using a phage-displayed human synthetic Fab library and produced mouse anti-CRM197 polyclonal antibody. The affinity (K_D) of 3F9 for CRM₁₉₇ was 3.55 nM, based on Bio-Layer interferometry, and it bound specifically to the B fragment of CRM₁₉₇. The sandwich ELISA was carried out using 3F9 as a capture antibody and the mouse polyclonal antibody as a detection antibody. The detection limit of the sandwich ELISA was <1 ng/ml CRM₁₉₇. In addition, the 3F9 antibody bound to the CRM₁₉₇-polysaccharide conjugates tested in a dose-dependent manner. This ELISA system will be useful for the quantification and characterization of CRM₁₉₇ and CRM₁₉₇ conjugate vaccines. To our knowledge, this study is the first to generate a human monoclonal antibody against CRM197 and to develop a sandwich ELISA for CRM₁₉₇ conjugate vaccines.

High-dose rate γ-irradiation leads to the change of body and organ weights, hematological parameters, frequency of micronuclei in ICR mice

HEEYOUN SHIM,BYULNIM HWANG,YUN-MI BAEK,JEONG-IN KIM,SEO KON KANG,BYOUNG-IL LEE,HEE SUN KIM 한국실험동물학회 2016 한국실험동물학회 학술발표대회 논문집 Vol.2016 No.08

Direct Monitoring of Fucosylated Glycopeptides of Alpha-Fetoprotein in Human Serum for Early Hepatocellular Carcinoma by Liquid Chromatography-Tandem Mass Spectrometry with Immunoprecipitation

Kim, Kwang Hoe,Lee, Soo-Youn,Hwang, Heeyoun,Lee, Ju Yeon,Ji, Eun Sun,An, Hyun Joo,Kim, Jin Young,Yoo, Jong Shin Wiley (John WileySons) 2018 PROTEOMICS CLINICAL APPLICATIONS Vol.12 No.6

Heteronuclear NMR studies on 44 kDa dimer, syndesmos

Kim, Heeyoun,Lee, Inhwan,Han, Jeongmin,Cheong, Hae-kap,Kim, Eunhee,Lee, Weontae Korean Magnetic Resonance Society 2015 Journal of the Korean Magnetic Resonance Society Vol.19 No.2

Syndesmos, which is co-localized with syndecan-4 cytoplasmic domain ($Syn4^{cyto}$) in focal contacts, interacts with various cell adhesion adaptor proteins including $Syn4^{cyto}$ to control cell signaling. Syndesmos consists of 211 amino acids and it exists as a dimer (44kDa) in solution. Recently, we have determined the structure of syndesmos by x-ray crystallography, however, dynamics related to syndecan binding still remain elusive. In this report, we performed NMR experiments to acquire biochemical and structural information of syndesmos. Based on a series of three-dimensional triple resonance experiments on a $^{13}C/^{15}N/^2H$ labeled protein, NMR spectra were obtained with well dispersed and homogeneous NMR data. We present the sequence specific backbone assignment of syndesmos and assigned NMR data with combination structural information can be directly used for the studies on interaction with $Syn4^{cyto}$ and other binding molecules.

Biochemical and NMR Characterization of MTH1880 Mutant Proteins for Folding-Unfolding Studies

Heeyoun Kim,Sooyoung Ryu,윤지혜,김석만,장익수,이원태 대한화학회 2010 Bulletin of the Korean Chemical Society Vol.31 No.12

MTH1880 is a hypothetical protein derived from Methanobacterium thermoautotrophicum, thermophilic methanogen. The solution structure determined by NMR spectroscopy showed that it has a novel α+β-fold with a highly acidic ligand binding pocket. Since MTH1880 maintains its ultra-stable structural characteristics at both high temperature and pressure, it has been considered as an excellent model for studying protein folding. To initiate the structural and folding study of MTH1880 in proving its unusual stability, we performed the site directed mutagenesis and biochemical analysis of MTH1880 mutants. Data from circular dichroism and NMR spectroscopy suggest that the point mutations perturbed the structural stability of protein even though the secondary structure is retained. This study will provide the useful information in understanding the role of participating residues during folding-unfolding process and our result will be used in designing further folding experiments for hyper-thermopile proteins like MTH1880.

Site specific characterization of N- and O-Glycosylation in etanercept by TMT-labeling and LC-MS/MS

Hyejin Kim,Heeyoun Hwang,Yeji Jeong,Sangwoo Park,Hyun Joo An,Jin Young Kim,Jong Shin Yoo 한국당과학회 2022 한국당과학회 학술대회 Vol.2022 No.07

Improved methods are required for glyco-characterization of biopharmaceuticals and comparison between their corresponding biologics and biosimilar, where they have multiple glycosylation sites such as Etanercept of a fusion protein. In order to enhance sensitivity of discovery and minimize the sample loss, the combination of a TMT labeling method and fractionation using high flow HPLC has contributed to detect low amount of peptide in data dependent mode of LC-MS/MS. Here, we report a new method combined with TMT labeling, fractionation using ZIC-HILIC HPLC, LC-MS/MS using HCD triggered CID/EThcD, and computational software for identification of site-specific N- and O-glycopeptide and comparison of their corresponding biologics and biosimilar. Of three different Etanercept, such as Enbrel (biologics), Etoloce and Eucept biosimilars), a total of 115 N- and O- glycopeptides were identified and quantified using TMT-11plex labeling including triplicates and 22 ZIC-HILIC fractionation in three and 15 of N- and O- glycosylation sites, respectively. Two O-glycopeptides in different O-glycosylation site and seven core 2 type of O-glycopeptides were first reported. In particular, three kinds of O-glycopeptides with NeuGC which could be a foreign agent of immune response. In depth of quantification, our strategy shows site-specific similarity is quite not similar between biologics and biosimilar.

Identification and quantification by GlycoProteome analyzer (IQ-GPA) in web service

Nahye Kim,Jung Hun Ju,Hyejin Kim,Jin Young Kim,Jong Shin Yoo,Heeyoun Hwang 한국당과학회 2022 한국당과학회 학술대회 Vol.2022 No.07

We have developed an Identification and Quantification by GlycoProteome Analyzer (IQ-GPA) for high throughput analysis of N- and O-glycoproteome. Herein, we introduce the web version of IQ-GPA for a database search and algorithmic suite with tandem mass spectrometry of HCD/CID/ETD (EThcD) in a shotgun experiment. We have designed to easily handle high-throughput glycoproteomic data with graphical user interfaces, and users can instantly access to a range of Glycan Database Builder as well as N and O-GPA modules using Microsoft Azure cloud platforms. With spectra files and the glycopeptide database of interest, the modules identify and quantify intact N- and O-linked glycopeptides in the complex samples, which requires the following steps: 1) DB Builder Module generates a GPA database using the detailed parameters after select working directory. 2) Analysis Module requires a spectrum file and a GPA-Database to analyze N- and O- glycopeptides with user specific parameters. 3) GPA Report Module shows the results and statistical charts on the website. In addition, IQ-GPA contains a module for the classification of N-glycopeptides as core- and outer-fucosylated types using the artificial intelligence ( https://www.iqgpa.org ).

Clinical Practice Guideline for Cardiac Rehabilitation in Korea

Chul Kim,성지동,Jong Hwa Lee,김원석,Goo Joo Lee,Sungju Jee,Il-Young Jung,Ueon Woo Rah,Byung Ok Kim,Kyoung Hyo Choi,Bum Sun Kwon,Seung Don Yoo,Heui Je Bang,Hyung-Ik Shin,김용욱,Heeyoune Jung,Eung Ju Kim,Jung Hw 대한재활의학회 2019 Annals of Rehabilitation Medicine Vol.43 No.3

Objective Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and three additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. Methods This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors—primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and two general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, three rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. Principal Conclusions CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.

병원 학대피해아동보호팀의 아동학대 사망사건 개입경험 연구

김경희(Kim, Gyeong-Hui),이희연(Lee, Heeyoun),정익중(Chung, Ick-Joong),김지혜(Kim, Ji-Hye),김세원(Kim, Sewon) 한국사회복지학회 2013 한국사회복지학 Vol.65 No.4

이 연구는 아동학대 예방과 개입의 큰 축을 담당하는 병원 학대피해아동보호팀의 아동학대 사망사건 개입경험을 탐색할 목적으로 수행되었다. 이를 위하여 전국적으로 등록된 62개 병원 학대피해아동보호팀과 접촉하였고, 최종적으로 아동학대 사망사건을 경험한 5개 병원 학대피해아동보호팀 구성원들 (의료사회복지사와 의사)과의 인터뷰를 통해 자료를 수집하였다. 수집된 자료를 질적연구방법을 사용하여 분석한 결과, 팀의 개입에도 불구하고, 학대 피해 아동이 매우 위중한 상태에서 병원에 도착했거나, 보호자의 거짓말이나 치료 거부로 인한 치료적 대응의 지연 때문에, 아동의 사망 진행을 막기 어려웠던 것으로 나타났다. 그럼에도 학대피해아동보호팀의 의심과 개입을 통해 사망 원인이 학대임을 밝혀낸 것은 팀 활동의 의미 있는 성과로 간주되었다. 이 과정에서 신고의무자 역할에 대한 인식 부족과 부담은 의료진의 적극적인 개입을 막는 장애물이며, 개입을 지속하기 위해서는 학대 인과관계 규명에 필요한 증거자료의 확보가 중요하다는 점이 확인되었다. 이러한 연구 결과를 토대로 학대 상황에 대한 조기 발견과 증거 확보 조치, 사망 원인 규명을 위한 실천적 및 정책적 방안에 대해 제언하였다. The aim of this study was to explore the work experiences of hospital-based child protection team staffs who had intervened the child abuse cases resulting in death. In order to gather the relevant data, all 62 child protection teams registered nationwide were contacted and 5 teams which had actually experienced at least one child abuse deaths were found. The staffs (hospital social workers and doctors) who belonged to these teams were intensively interviewed, and the interviewed materials were thoroughly analyzed by qualitative research methodology. The result showed that treatment delay was the most important obstacle to prevent unnecessary deaths of the victims. Some abused victims were sent to the hospital only after their physical condition had so gravely deteriorated. In other cases, custodians’ bland denial or refusal to treatment made impossible the timely intervention to save the child lives. Nevertheless, child protection team staffs’ reasonable suspicion and active intervention could sometimes uncover the hidden truth that child abuse was the actual cause of death. These incidents were regarded as a team’s meaningful accomplishments by team members. Meanwhile, lack of awareness and excessive burden about the role and re sponsibility of mandated reporter precluded medical staffs’ active involvement. Also, substantiating the abuse suspicion by securing positive evidences was found to be a facilitatory factor for the rapid public intervention. On the basis of these results, several practice and policy implications were discussed to improve the early detection process, securing evidence and uncovering the actual cause of death in child abuse deaths.