5 results on '"Song, T-J"'
Search Results
2. Clinical associations and prognostic significance of enlarged perivascular spaces in patients with previous ischaemic stroke or tia: a pooled analysis of individual patient data.
- Author
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Best J.G., Ambler G., Wilson D., Du H., Lee K.-J., Lim J.-S., Teo K.C., Mak H.K.F., Kim Y.D., Song T.-J., Demirelli D.S., Nishihara M., Yoshikawa M., Kubacka M., Zietz A., Al-Shahi Salman R., Jager H.R., Lip G.Y.H., Panos L.D., Goeldlin M.B., Slater L.-A., Karayiannis C., Phan T., Franke M., Abrigo J., Cheng C., Leung T., Chu W., Chappell F., Makin S., Van Dam-Nolen D.H.K., Kooi M.E., Kohler S., Staals J., Bordet R., Dubost F., Wardlaw J., Soo Y., Fluri F., Srikanth V., Jung S., Peters N., Hara H., Yakushiji Y., Orken D.N., Heo J.H., Lau K.K., Bae H.-J., Werring D.J., Best J.G., Ambler G., Wilson D., Du H., Lee K.-J., Lim J.-S., Teo K.C., Mak H.K.F., Kim Y.D., Song T.-J., Demirelli D.S., Nishihara M., Yoshikawa M., Kubacka M., Zietz A., Al-Shahi Salman R., Jager H.R., Lip G.Y.H., Panos L.D., Goeldlin M.B., Slater L.-A., Karayiannis C., Phan T., Franke M., Abrigo J., Cheng C., Leung T., Chu W., Chappell F., Makin S., Van Dam-Nolen D.H.K., Kooi M.E., Kohler S., Staals J., Bordet R., Dubost F., Wardlaw J., Soo Y., Fluri F., Srikanth V., Jung S., Peters N., Hara H., Yakushiji Y., Orken D.N., Heo J.H., Lau K.K., Bae H.-J., and Werring D.J.
- Abstract
Background and aims: Enlarged perivascular spaces are an emerging marker of cerebral small vessel disease (CSVD) and might predict future stroke. However, results from existing studies vary. We aimed to clarify this through a large multicentre analysis. Method(s): We pooled individual patient data from a consortium of prospective observational studies. Participants had recent ischaemic stroke or TIA, underwent baseline MRI, and were followed up for ischaemic stroke and symptomatic intracranial haemorrhage (ICH). Perivascular spaces in the basal ganglia (BGPVS) and centrum semiovale (CSOPVS) were rated using a validated visual scale. We investigated clinical and radiological associations cross-sectionally using multinomial logistic regression, and prospective associations with ischaemic stroke and ICH using Cox regression. Result(s): We included 7,778 participants from 16 studies. Over a median follow-up of 1.47 years, 80 ICH and 424 ischaemic strokes occurred. BGPVS were associated with increasing age, hypertension, hyperlipidaemia, previous ischaemic stroke, previous ICH, lacunes, cerebral microbleeds (CMBs) and white matter hyperintensities. CSOPVS showed similar but weaker associations. Prospectively, after adjusting for potential confounders including CMBs, BGPVS were associated with ischaemic stroke (11-20 BGPVS: HR 1.20, 95% CI 0.93-1.54; 21+ BGPVS: HR 1.50, 95% CI 1.10-2.06; overall p = 0.040), but not ICH. CSOPVS were not associated with either outcome. Conclusion(s): In patients with ischaemic stroke or TIA, increasing BGPVS burden is associated with more severe CSVD and greater ischaemic stroke risk. Neither BGPVS nor CSOPVS were independently associated with future ICH, suggesting that CMBs are a more informative marker for intracranial bleeding risk in this population. (Figure Presented).
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- 2022
3. Cerebral venous thrombosis after ChAdOx1 nCoV-19 vaccination: a systematic review.
- Author
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SONG, T.-J., SHIN, J. I., YON, D. K., LEE, S. W., HWANG, S. Y., HWANG, J., PARK, S. H., LEE, S. B., LEE, M. H., KIM, M. S., KOYANAGI, A., TIZAOUI, K., KIM, J. H., and SMITH, L.
- Abstract
OBJECTIVE: To perform a systematic review of case reports or case series regarding thrombosis with thrombocytopenia syndrome (TTS) and cerebral venous thrombosis (CVT) related to ChAdOx1 nCoV-19 vaccination to address the clinical features, laboratory findings, treatment modalities, and prognosis related with CVT. SUBJECTS AND METHODS: We included 64 TTS patients from 19 articles, 6 case series and 13 case reports, in which thrombosis occurred after the first dose of ChAdOx1 nCoV-19 vaccination published up to 30 June 2021 in Embase, ePubs, Medline/PubMed, Scopus, and Web of Science databases. RESULTS: Of the 64 TTS patients, 38 (59.3%) had CVT. Patients with CVT were younger (median 36.5 vs. 52.5 years, p<0.001), had lower fibrinogen levels (130 vs. 245 mg/dL, p=0.008), had more frequent history of intracerebral hemorrhage (ICH), and had higher mortality rate (48.6% vs. 19.2%, p=0.020) than that of patients without CVT. In multivariable analysis, the possibility of presence of CVT was higher in younger age groups [odd ratio (OR): 0.91, 95% confidence interval (CI): (0.86-0.97, p<0.001)] and those with accompanying intracerebral hemorrhage (ICH) (OR: 13.60, 95% CI (1.28-144.12, p=0.045). CONCLUSIONS: Our study demonstrated that CVT related to ChAdOx1 nCoV-19 vaccination was associated with younger age, low levels of fibrinogen, presence of ICH and more frequent mortality compared to those of non-CVT. If TTS occurs after ChAdOx1 nCoV-19 vaccination, the presence of CVT in patients with young age or ICH should be considered. [ABSTRACT FROM AUTHOR]
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- 2023
4. [Expert consensus on late stage of critical care management].
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Tang B, Chen WJ, Jiang LD, Zhu SH, Song B, Chao YG, Song TJ, He W, Liu Y, Zhang HM, Chai WZ, Yin MG, Zhu R, Liu LX, Wu J, Ding X, Shang XL, Duan J, Xu QH, Zhang H, Wang XM, Huang QB, Gong RC, Li ZZ, Lu MS, and Wang XT
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- Humans, Consensus, Intensive Care Units, Pain drug therapy, Analgesics therapeutic use, Critical Illness, Critical Care methods, Delirium therapy
- Abstract
We wished to establish an expert consensus on late stage of critical care (CC) management. The panel comprised 13 experts in CC medicine. Each statement was assessed based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) principle. Then, the Delphi method was adopted by 17 experts to reassess the following 28 statements. (1) ESCAPE has evolved from a strategy of delirium management to a strategy of late stage of CC management. (2) The new version of ESCAPE is a strategy for optimizing treatment and comprehensive care of critically ill patients (CIPs) after the rescue period, including early mobilization, early rehabilitation, nutritional support, sleep management, mental assessment, cognitive-function training, emotional support, and optimizing sedation and analgesia. (3) Disease assessment to determine the starting point of early mobilization, early rehabilitation, and early enteral nutrition. (4) Early mobilization has synergistic effects upon the recovery of organ function. (5) Early functional exercise and rehabilitation are important means to promote CIP recovery, and gives them a sense of future prospects. (6) Timely start of enteral nutrition is conducive to early mobilization and early rehabilitation. (7) The spontaneous breathing test should be started as soon as possible, and a weaning plan should be selected step-by-step. (8) The waking process of CIPs should be realized in a planned and purposeful way. (9) Establishment of a sleep-wake rhythm is the key to sleep management in post-CC management. (10) The spontaneous awakening trial, spontaneous breathing trial, and sleep management should be carried out together. (11) The depth of sedation should be adjusted dynamically in the late stage of CC period. (12) Standardized sedation assessment is the premise of rational sedation. (13) Appropriate sedative drugs should be selected according to the objectives of sedation and drug characteristics. (14) A goal-directed minimization strategy for sedation should be implemented. (15) The principle of analgesia must be mastered first. (16) Subjective assessment is preferred for analgesia assessment. (17) Opioid-based analgesic strategies should be selected step-by-step according to the characteristics of different drugs. (18) There must be rational use of non-opioid analgesics and non-drug-based analgesic measures. (19) Pay attention to evaluation of the psychological status of CIPs. (20) Cognitive function in CIPs cannot be ignored. (21) Delirium management should be based on non-drug-based measures and rational use of drugs. (22) Reset treatment can be considered for severe delirium. (23) Psychological assessment should be conducted as early as possible to screen-out high-risk groups with post-traumatic stress disorder. (24) Emotional support, flexible visiting, and environment management are important components of humanistic management in the intensive care unit (ICU). (25) Emotional support from medical teams and families should be promoted through"ICU diaries"and other forms. (26) Environmental management should be carried out by enriching environmental content, limiting environmental interference, and optimizing the environmental atmosphere. (27) Reasonable promotion of flexible visitation should be done on the basis of prevention of nosocomial infection. (28) ESCAPE is an excellent project for late stage of CC management.
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- 2023
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5. Tumor immune-gene expression profiles and peripheral immune phenotypes associated with clinical outcomes of locally advanced pancreatic cancer following FOLFIRINOX.
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Hyung J, Lee H, Jin H, Lee S, Lee HJ, Gong G, Song TJ, Lee SS, Hwang DW, Kim SC, Jeong JH, Ryoo BY, Kim K, and Yoo C
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- Fluorouracil pharmacology, Fluorouracil therapeutic use, Humans, Irinotecan pharmacology, Irinotecan therapeutic use, Leucovorin pharmacology, Leucovorin therapeutic use, Oxaliplatin pharmacology, Oxaliplatin therapeutic use, Phenotype, Transcriptome, Tumor Microenvironment, Antineoplastic Combined Chemotherapy Protocols adverse effects, Pancreatic Neoplasms drug therapy, Pancreatic Neoplasms genetics, Pancreatic Neoplasms pathology
- Abstract
Background: A comprehensive analysis of peripheral immune cell phenotypes and tumor immune-gene expression profiles in locally advanced pancreatic cancer patients treated with neoadjuvant chemotherapy in a phase II clinical trial was carried out., Methods: Patients were treated with neoadjuvant modified folinic acid, fluorouracil, irinotecan hydrochloride, oxaliplatin (mFOLFIRINOX) followed by surgery and adjuvant gemcitabine at the Asan Medical Center. Correlations between survival outcomes and baseline peripheral immune cells and their changes during preoperative chemotherapy were analyzed. Patients who had surgery were divided into two groups according to achievement of disease-free survival >10 months (achieved versus failed). Differential expression and pathway analysis of immune-related genes were carried out using the Nanostring platform, and immune cells within the tumor microenvironment were compared by immunohistochemistry., Results: Forty-four patients were treated in the phase II clinical trial. Higher baseline CD14+CD11c+HLA-DR+ monocytes (P = 0.044) and lower Foxp3+CD4+ T cells (P = 0.02) were associated with poor progression-free survival of neoadjuvant mFOLFIRINOX. During the preoperative chemotherapy, PD-1 T cells significantly decreased (P = 0.0110). Differential expression and pathway analysis of immune-genes from the resected tumor after neoadjuvant treatment revealed transforming growth factor-β pathway enrichment and higher expression of MARCO (adjusted P < 0.05) associated with early recurrence. Enrichment of the Th1 pathway and higher peritumoral CD8+ T cells (P = 0.0103) were associated with durable disease-free survival from surgery (>10 months) following neoadjuvant mFOLFIRINOX., Conclusions: Our results identify potential immune biomarkers for locally advanced pancreatic cancer and provide insights into pancreatic cancer immunity., Competing Interests: Disclosure The authors have declared no conflicts of interest. Ethics approval and consent to participate All procedures in studies involving human participants were carried out in accordance with the ethical standards of the Institutional Review Board of Asan Medical Center, and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards (IRB approval number 2016-0010)., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2022
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