Sooyoung Cho

A High-Dimensional, Deep-Sequencing Study of Lung Adenocarcinoma in Female Never-Smokers

Background Deep sequencing techniques provide a remarkable opportunity for comprehensive understanding of tumorigenesis at the molecular level. As omics studies become popular, integrative approaches need to be developed to move from a simple cataloguing of mutations and changes in gene expression to dissecting the molecular nature of carcinogenesis at the systemic level and understanding the complex networks that lead to cancer development. Results Here, we describe a high-throughput, multi-dimensional sequencing study of primary lung adenocarcinoma tumors and adjacent normal tissues of six Korean female never-smoker patients. Our data encompass results from exome-seq, RNA-seq, small RNA-seq, and MeDIP-seq. We identified and validated novel genetic aberrations, including 47 somatic mutations and 19 fusion transcripts. One of the fusions involves the c-RET gene, which was recently reported to form fusion genes that may function as drivers of carcinogenesis in lung cancer patients. We also characterized gene expression profiles, which we integrated with genomic aberrations and gene regulations into functional networks. The most prominent gene network module that emerged indicates that disturbances in G2/M transition and mitotic progression are causally linked to tumorigenesis in these patients. Also, results from the analysis strongly suggest that several novel microRNA-target interactions represent key regulatory elements of the gene network. Conclusions Our study not only provides an overview of the alterations occurring in lung adenocarcinoma at multiple levels from genome to transcriptome and epigenome, but also offers a model for integrative genomics analysis and proposes potential target pathways for the control of lung adenocarcinoma.

miRGator v2.0 : an integrated system for functional investigation of microRNAs

miRGator is an integrated database of microRNA (miRNA)-associated gene expression, target prediction, disease association and genomic annotation, which aims to facilitate functional investigation of miRNAs. The recent version of miRGator v2.0 contains information about (i) human miRNA expression profiles under various experimental conditions, (ii) paired expression profiles of both mRNAs and miRNAs, (iii) gene expression profiles under miRNA-perturbation (e.g. miRNA knockout and overexpression), (iv) known/predicted miRNA targets and (v) miRNA-disease associations. In total, >8000 miRNA expression profiles, ∼300 miRNA-perturbed gene expression profiles and ∼2000 mRNA expression profiles are compiled with manually curated annotations on disease, tissue type and perturbation. By integrating these data sets, a series of novel associations (miRNA–miRNA, miRNA–disease and miRNA–target) is extracted via shared features. For example, differentially expressed genes (DEGs) after miRNA knockout were systematically compared against miRNA targets. Likewise, differentially expressed miRNAs (DEmiRs) were compared with disease-associated miRNAs. Additionally, miRNA expression and disease-phenotype profiles revealed miRNA pairs whose expression was regulated in parallel in various experimental and disease conditions. Complex associations are readily accessible using an interactive network visualization interface. The miRGator v2.0 serves as a reference database to investigate miRNA expression and function (http://miRGator.kobic.re.kr).

Dose-dependency of dexamethasone on the analgesic effect of interscalene block for arthroscopic shoulder surgery using ropivacaine 0.5%: A randomised controlled trial.

BACKGROUND Dexamethasone prolongs the duration of single-shot interscalene brachial plexus block (SISB). However, dose-dependency of dexamethasone as an adjuvant for SISB remains insufficiently understood. OBJECTIVE The objective of this study is to evaluate the effect of different doses of dexamethasone on the duration of SISB using ropivacaine 0.5%. DESIGN A randomised, double-blind controlled trial. SETTING Single university tertiary care centre. PATIENTS One hundred and forty-four patients scheduled for elective arthroscopic shoulder surgery were allocated randomly to one of four groups. INTERVENTIONS Patients received 12u200aml of ropivacaine 0.5% in 0.9% saline (control group), or containing dexamethasone 2.5, 5.0 or 7.5u200amg for SISB. MAIN OUTCOME MEASURES The primary endpoint was the time to the first analgesic request. Pain scores and adverse effects were also assessed up to 48u200ah postoperatively. RESULTS Inclusion of dexamethasone 2.5, 5.0 and 7.5u200amg resulted in significant (Pu200a<u200a0.001) increases in time to the first analgesic request by factors of 1.6, 2.2 and 1.8, respectively. The percentages of patients not requiring analgesics in the first 48u200ah postoperatively with dexamethasone 0.0, 2.5, 5.0 and 7.5u200amg were 3, 22, 39 and 33%, respectively (Pu200a<u200a0.001). There were no significant effects on pain scores or incidences of adverse effects. CONCLUSION Dexamethasone demonstrated significant beneficial dose-dependent effects on duration to the first analgesic request, the number of patients not requiring analgesics and analgesic use in the first 48u200ah after SISB for arthroscopic shoulder surgery. There were no significant effects on pain scores or incidences of adverse effects. TRIAL REGISTRATION the trial was registered with the Clinical Trial Registry of Korea: https://cris.nih.go.kr/cris/index.jsp. Identifier: KCT0001078

Postoperative analgesic effects of ultrasound-guided transversus abdominis plane block for open appendectomy

Purpose Transversus abdominis plane (TAP) block is a newly developed and effective peripheral block involving the nerves of the anterior abdominal wall for lower abdominal surgery. We evaluated the postoperative analgesic efficacy of ultrasound-guided TAP block using 20 mL of 0.5% levobupivacaine in patients undergoing open appendectomy. Methods Forty-four patients undergoing appendectomy were assigned either to undergo a right sided-TAP block (group I, n = 22), or to receive standard care (group II, n = 22). All patients received standard anesthetics, and the TAP block group received ultrasound-guided right side TAP block using 20 mL of 0.5% levobupivacaine after induction of anesthesia. All patients received acetaminophen, and nonsteroidal anti-inflammatory drug as required during the 48 postoperative hours. Each patients was assessed for time to first rescue analgesia, verbal numerical rating pain scores (VNRS), number of rescue analgesic demands, nausea, vomiting, pruritus, and drowsiness by a blinded investigator at 0, 1, 3, 6, 12, 24 and 48 hours postoperatively. Results The TAP block group with levobupivacaine compared to the control group reduced VNRS significantly up to 12 hours postoperatively. There were no significant differences in time to first analgesia, number of rescue analgesics demands, nausea, vomiting, pruritus and drowsiness between the groups. There were no complications attributable to the TAP block. Conclusion Ultrasound-guided TAP block using 20 mL of 0.5% levobupivacaine provided effective postoperative analgesia during the 12 postoperative hours after an open appendectomy.

Double-injection perivascular ultrasound-guided axillary brachial plexus block according to needle positioning: 12 versus 6 o'clock position of the axillary artery

Background We conducted prospective, randomized, observer-blinded trial to compare two double-injection perivascular (PV) ultrasound-guided techniques of axillary brachial plexus block (BPB). Methods American Society of Anesthesiologists physical status I-II, 50 patients undergoing surgery of the forearm, wrist or hand were randomly allocated to two groups. For PV12 group, injection was carried out at the 12 oclock position using 24 ml of 2% lidocaine. Patients of PV6 group got their injection of 24 ml of 2% lidocaine at direction of 6 oclock of axillary artery. For all 2 groups, the musculocutaneous nerve was identified and 5 ml of 2% lidocaine was deposited around the nerve. The performance time and the onset time were recorded. The induction time (sum of performance and onset time), the success rate of the block, the need rate of rescue block, and incidence of adverse events was compared. Results The success rate was same (84%) in two groups. The performance time, onset time, and induction time showed no differences between two groups. There were no differences in vessel puncture, paresthesia, and numbness. Conclusions Double-injection perivascular ultrasound-guided axillary BPB can be performed at 12 oclock or 6 oclock position of axillary artery, and performer may choose needle targeting position by considering surgery site. Thus perivascular double-injection technique may be an alternative method for axillary BPB and useful in case of difficult block.

Comparison of Ultrasound-Guided Axillary Brachial Plexus Block Techniques: Perineural Injection versus Single or Double Perivascular Infiltration

Purpose We compared three methods of ultrasound-guided axillary brachial plexus block, which were single, and double perivascular (PV) infiltration techniques, and a perineural (PN) injection technique. Materials and Methods 78 patients of American Society of Anesthesiologists physical status I-II undergoing surgery of the forearm, wrist, or hand were randomly allocated to three groups. 2% lidocaine with epinephrine 5 µg/mL was used. The PN group (n=26) received injections at the median, ulnar, and radial nerve with 8 mL for each nerve. The PV1 group (n=26) received a single injection of 24 mL at 12-oclock position of the axillary artery. The PV2 group (n=26) received two injections of 12 mL each at 12-oclock and 6-oclock position. For all groups, musculocutaneous nerve was blocked separately. Results The PN group (391.2±171.6 sec) had the longest anesthetic procedure duration than PV1 (192.8±59.0 sec) and PV2 (211.4±58.6 sec). There were no differences in onset time. The average induction time was longer in PN group (673.4±149.6 sec) than PV1 (557.6±194.9 sec) and PV2 (561.5±129.8 sec). There were no differences in the success rate (89.7% vs. 86.2% vs. 89.7%). Conclusion The PV injection technique consisting of a single injection in 12-oclock position above the axillary artery in addition to a musculocutaneous nerve block is equally effective and less time consuming than the PN technique. Therefore, the PV technique is an alternative method that may be used in busy clinics or for difficult cases.

Monitored anesthesia care for great saphenous vein stripping surgery with target controlled infusion of propofol and remifentanil: a prospective study

Background The aim of this study was to determine the appropriate target concentrations at the effect site of propofol and remifentanil when deep sedation was achieved by monitored anesthesia care (MAC) anesthesia and related respiratory depression during vein stripping surgery for varicose veins. Methods In total, 51 adult patients who were scheduled for varicose vein stripping surgery were sedated with propofol and remifentanil during the surgery, after administration of midazolam. Target concentrations at the effect site of the two drugs were changed based on the patients status. Respiratory support was applied in the order of oxygen supply, chin lift, and assisted mask ventilation. Target concentrations at the effect site of propofol and remifentanil, the need for respiratory support, and a six-point rating scale satisfaction score were the outcome measurements. Results Only one patient did not require oxygen, eight patients needed oxygen alone, 22 patients required use of the chin lift technique, and 20 patients were assisted with mask ventilation. There was no significant difference in the target concentration of propofol or remifentanil between the patients who required mask ventilation and those who did not. Fifty of the 51 patients reported a satisfaction score of 6. Conclusions Although MAC using low target concentrations of propofol and remifentanil during vein stripping surgery was satisfactory to patients, close observation regarding the need for respiratory assistance was necessary.

gsGator: an integrated web platform for cross-species gene set analysis

BackgroundGene set analysis (GSA) is useful in deducing biological significance of gene lists using a priori defined gene sets such as gene ontology (GO) or pathways. Phenotypic annotation is sparse for human genes, but is far more abundant for other model organisms such as mouse, fly, and worm. Often, GSA needs to be done highly interactively by combining or modifying gene lists or inspecting gene-gene interactions in a molecular network.DescriptionWe developed gsGator, a web-based platform for functional interpretation of gene sets with useful features such as cross-species GSA, simultaneous analysis of multiple gene sets, and a fully integrated network viewer for visualizing both GSA results and molecular networks. An extensive set of gene annotation information is amassed including GO & pathways, genomic annotations, protein-protein interaction, transcription factor-target (TF-target), miRNA targeting, and phenotype information for various model organisms. By combining the functionalities of Set Creator, Set Operator and Network Navigator, user can perform highly flexible and interactive GSA by creating a new gene list by any combination of existing gene sets (intersection, union and difference) or expanding genes interactively along the molecular networks such as protein-protein interaction and TF-target. We also demonstrate the utility of our interactive and cross-species GSA implemented in gsGator by several usage examples for interpreting genome-wide association study (GWAS) results. gsGator is freely available at http://gsGator.ewha.ac.kr.ConclusionsInteractive and cross-species GSA in gsGator greatly extends the scope and utility of GSA, leading to novel insights via conserved functional gene modules across different species.

Analysis of Electrical Properties for Optimal Operating Conditions of Mono-crystalline Si Solar Cell

This paper was investigated the electrical properties for optimal operating conditions of monocrystalline silicon solar cell. The output of electricity for monocrystalline solar cell was investigated according to the distances between solar cell and halogen lamp and to the resistances by the variable resistor.

Ultrasound-guided bilateral rectus sheath block reduces early postoperative pain after laparoscopic gynecologic surgery: a randomized study

PurposeRectus sheath block (RSB) is an anterior abdominal wall block that reduces postoperative pain associated with midline incisions. This study aims to investigate the effect of ultrasound-guided bilateral RSB (US-BRSB) on postoperative pain and analgesic consumption in patients undergoing laparoscopic gynecologic surgery.MethodsSixty patients who underwent laparoscopic gynecologic surgery were allocated to RSB (nxa0=xa030) or control (nxa0=xa030) group. A bilateral US-BRSB procedure (30xa0ml of 0.25% ropivacaine) was performed after induction of general anesthesia in the RSB group. The control group proceeded the surgery without sham block. All patients received fentanyl-based intravenous patient-controlled analgesia and rescue analgesics upon demand. Pain was scored by a blinded observer using a verbal numerical rating scale (VNRS) at rest while coughing at 0, 1, 6, 12, 24, and 48xa0h after postanesthesia care unit (PACU) admission. The primary outcome was the total number of rescue analgesics used in the 48-h postoperative period.ResultsAt 0xa0h, VNRS were lower in the RSB group than in the control, both at rest (median VNRS 4.5 vs. 5, pxa0=xa00.02) and while coughing (median VNRS 6 vs. 7, pxa0=xa00.004). At 6xa0h, VNRS scores were lower in the RSB group than in the control while coughing (median VNRS 3 vs. 5, pxa0=xa00.01). Fentanyl use as rescue analgesics in the PACU was significantly lower in the RSB group than in the control (27.7xa0±xa032.1 vs. 53.3xa0±xa033.7xa0µg, respectively; pxa0=xa00.004). At 48xa0h postoperatively, the total number of rescue analgesics administered were significantly fewer in the RSB group than in the control (2.5xa0±xa02.5 vs. 3.9xa0±xa02.6, respectively; pxa0=xa00.04).ConclusionUS-BRSB reduces the immediate postoperative pain and opioid consumption during the early postoperative period.ClinicalTrials.gov identifierNCT02476799, https://clinicaltrials.gov/ct2/show/NCT02476799.