26
|
Oh KH, Kim HJ, Kim MH. Non-communicable diseases and risk of tuberculosis in Korea. Int J Tuberc Lung Dis 2018; 20:973-7. [PMID: 27287653 DOI: 10.5588/ijtld.15.0684] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is possible that the increasing burden of non-communicable diseases (NCDs) and their risk factors are an obstacle to the reduction of tuberculosis (TB) incidence in the Republic of Korea. OBJECTIVE To estimate population-attributable fractions (PAF) of NCDs and their risk factors related to TB in Korea. DESIGN The prevalence of diabetes mellitus (DM), current smoking, heavy drinking and undernutrition was estimated from the Korean National Health and Nutrition Examination Survey (KNHANES) conducted in 2013. Estimates of effect for risk factors were obtained from meta-analyses. The PAF was calculated based on these data. RESULTS The PAF of DM, current smoking, heavy drinking and undernutrition was 20.0%, 18.8%, 18.4% and 9.6%, respectively. Current smoking has the highest PAF among men, while undernutrition was the highest among women. Current smoking and heavy drinking were significantly attributed to TB among the younger population, while DM was the most common responsible factor among the older population. Major risk factors such as current smoking and DM were more prevalent in the lower income level population. CONCLUSION NCDs and their risk factors play an important role at the population level in TB epidemics in Korea. Collaborative TB and NCD activities in TB control should therefore be intensified.
Collapse
|
27
|
Flick RJ, Kim MH, Simon K, Munthali A, Hosseinipour MC, Rosenberg NE, Kazembe PN, Mpunga J, Ahmed S. Burden of disease and risk factors for death among children treated for tuberculosis in Malawi. Int J Tuberc Lung Dis 2018; 20:1046-54. [PMID: 27393538 DOI: 10.5588/ijtld.15.0928] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Tuberculosis (TB) is a leading cause of childhood death. Patient-level data on pediatric TB in Malawi that can be used to guide programmatic interventions are limited. OBJECTIVE To describe pediatric TB case burden, disease patterns, treatment outcomes, and risk factors for death and poor outcome. DESIGN We conducted a retrospective cohort study utilizing routine data. Odds ratios (ORs) for factors associated with poor outcome and death were calculated using generalized estimating equations. RESULTS Children represented 8% (371/4642) of TB diagnoses. The median age was 7 years (interquartile range 2.8-11); 32.8% (113/345) were human immunodeficiency virus (HIV) infected. Of these, 54.0% were on antiretroviral therapy (ART) at the time of anti-tuberculosis treatment (ATT) initiation, 21.2% started ART during ATT, and 24.8% had no documented ART. The treatment success rate was 77.3% (11.2% cured, 66.1% completed treatment), with 22.7% experiencing poor outcomes (9.5% died, 13.2% were lost to follow-up). Being on ART at the time of ATT initiation was associated with increased odds of death compared to beginning ART during treatment (adjusted OR 2.75, 95%CI 1.27-5.96). CONCLUSION Children represent a small proportion of diagnosed TB cases and experience poor outcomes. Higher odds of death among children already on ART raises concerns over the management of these children. Further discussion of and research into pediatric-specific strategies is required to improve case finding and outcomes.
Collapse
|
28
|
Aidala C, Akiba Y, Alfred M, Andrieux V, Aoki K, Apadula N, Asano H, Ayuso C, Azmoun B, Babintsev V, Bagoly A, Bandara NS, Barish KN, Bathe S, Bazilevsky A, Beaumier M, Belmont R, Berdnikov A, Berdnikov Y, Blau DS, Boer M, Bok JS, Brooks ML, Bryslawskyj J, Bumazhnov V, Butler C, Campbell S, Canoa Roman V, Cervantes R, Chi CY, Chiu M, Choi IJ, Choi JB, Citron Z, Connors M, Cronin N, Csanád M, Csörgő T, Danley TW, Daugherity MS, David G, DeBlasio K, Dehmelt K, Denisov A, Deshpande A, Desmond EJ, Dion A, Dixit D, Do JH, Drees A, Drees KA, Dumancic M, Durham JM, Durum A, Elder T, Enokizono A, En'yo H, Esumi S, Fadem B, Fan W, Feege N, Fields DE, Finger M, Finger M, Fokin SL, Frantz JE, Franz A, Frawley AD, Fukuda Y, Gal C, Gallus P, Garg P, Ge H, Giordano F, Goto Y, Grau N, Greene SV, Grosse Perdekamp M, Gunji T, Guragain H, Hachiya T, Haggerty JS, Hahn KI, Hamagaki H, Hamilton HF, Han SY, Hanks J, Hasegawa S, Haseler TOS, He X, Hemmick TK, Hill JC, Hill K, Hollis RS, Homma K, Hong B, Hoshino T, Hotvedt N, Huang J, Huang S, Imai K, Imrek J, Inaba M, Iordanova A, Isenhower D, Ito Y, Ivanishchev D, Jacak BV, Jezghani M, Ji Z, Jiang X, Johnson BM, Jorjadze V, Jouan D, Jumper DS, Kang JH, Kapukchyan D, Karthas S, Kawall D, Kazantsev AV, Khachatryan V, Khanzadeev A, Kim C, Kim DJ, Kim EJ, Kim M, Kim MH, Kincses D, Kistenev E, Klatsky J, Kline P, Koblesky T, Kotov D, Kudo S, Kurita K, Kwon Y, Lajoie JG, Lallow EO, Lebedev A, Lee S, Leitch MJ, Leung YH, Lewis NA, Li X, Lim SH, Liu LD, Liu MX, Loggins VR, Lökös S, Lovasz K, Lynch D, Majoros T, Makdisi YI, Makek M, Malaev M, Manko VI, Mannel E, Masuda H, McCumber M, McGaughey PL, McGlinchey D, McKinney C, Mendoza M, Metzger WJ, Mignerey AC, Mihalik DE, Milov A, Mishra DK, Mitchell JT, Mitsuka G, Miyasaka S, Mizuno S, Montuenga P, Moon T, Morrison DP, Morrow SIM, Murakami T, Murata J, Nagai K, Nagashima K, Nagashima T, Nagle JL, Nagy MI, Nakagawa I, Nakagomi H, Nakano K, Nattrass C, Niida T, Nouicer R, Novák T, Novitzky N, Novotny R, Nyanin AS, O'Brien E, Ogilvie CA, Orjuela Koop JD, Osborn JD, Oskarsson A, Ottino GJ, Ozawa K, Pantuev V, Papavassiliou V, Park JS, Park S, Pate SF, Patel M, Peng W, Perepelitsa DV, Perera GDN, Peressounko DY, PerezLara CE, Perry J, Petti R, Phipps M, Pinkenburg C, Pisani RP, Pun A, Purschke ML, Radzevich PV, Read KF, Reynolds D, Riabov V, Riabov Y, Richford D, Rinn T, Rolnick SD, Rosati M, Rowan Z, Runchey J, Safonov AS, Sakaguchi T, Sako H, Samsonov V, Sarsour M, Sato K, Sato S, Schaefer B, Schmoll BK, Sedgwick K, Seidl R, Sen A, Seto R, Sexton A, Sharma D, Shein I, Shibata TA, Shigaki K, Shimomura M, Shioya T, Shukla P, Sickles A, Silva CL, Silvermyr D, Singh BK, Singh CP, Singh V, Skoby MJ, Slunečka M, Smith KL, Snowball M, Soltz RA, Sondheim WE, Sorensen SP, Sourikova IV, Stankus PW, Stoll SP, Sugitate T, Sukhanov A, Sumita T, Sun J, Syed S, Sziklai J, Takeda A, Tanida K, Tannenbaum MJ, Tarafdar S, Taranenko A, Tarnai G, Tieulent R, Timilsina A, Todoroki T, Tomášek M, Towell CL, Towell RS, Tserruya I, Ueda Y, Ujvari B, van Hecke HW, Vazquez-Carson S, Velkovska J, Virius M, Vrba V, Vukman N, Wang XR, Wang Z, Watanabe Y, Watanabe YS, Wong CP, Woody CL, Xu C, Xu Q, Xue L, Yalcin S, Yamaguchi YL, Yamamoto H, Yanovich A, Yin P, Yoo JH, Yoon I, Yu H, Yushmanov IE, Zajc WA, Zelenski A, Zharko S, Zou L. Nuclear Dependence of the Transverse-Single-Spin Asymmetry for Forward Neutron Production in Polarized p+A Collisions at sqrt[s_{NN}]=200 GeV. PHYSICAL REVIEW LETTERS 2018; 120:022001. [PMID: 29376675 DOI: 10.1103/physrevlett.120.022001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 09/26/2017] [Indexed: 06/07/2023]
Abstract
During 2015, the Relativistic Heavy Ion Collider (RHIC) provided collisions of transversely polarized protons with Au and Al nuclei for the first time, enabling the exploration of transverse-single-spin asymmetries with heavy nuclei. Large single-spin asymmetries in very forward neutron production have been previously observed in transversely polarized p+p collisions at RHIC, and the existing theoretical framework that was successful in describing the single-spin asymmetry in p+p collisions predicts only a moderate atomic-mass-number (A) dependence. In contrast, the asymmetries observed at RHIC in p+A collisions showed a surprisingly strong A dependence in inclusive forward neutron production. The observed asymmetry in p+Al collisions is much smaller, while the asymmetry in p+Au collisions is a factor of 3 larger in absolute value and of opposite sign. The interplay of different neutron production mechanisms is discussed as a possible explanation of the observed A dependence.
Collapse
|
29
|
Park JE, Kim MH. Happiness and anguish made by the welfare state: work and health of caregivers. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx186.346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
30
|
Kim MH, Cho EJ, Lee JW, Kim EK, Yoo SH, Park CW. A study on setting of the fatigue limit of temporary dental implants. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2017:1962-1965. [PMID: 29060278 DOI: 10.1109/embc.2017.8037234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
A temporary dental implant is a medical device which is temporarily used to support a prosthesis such as an artificial tooth used for restoring patient's masticatory function during implant treatment. It is implanted in the oral cavity to substitute for the role of tooth. Due to the aging and westernization of current Korean society, the number of tooth extraction and implantation procedures is increasing, leading to an increase in the use and development of temporary dental implants. Because an implant performs a masticatory function in place of a tooth, a dynamic load is repeatedly put on the implant. Thus, the fatigue of implants is reported to be the most common causes of the fracture thereof. According to the investigation and analysis of the current domestic and international standards, the standard for fatigue of implant fixtures is not separately specified. Although a test method for measuring the fatigue is suggested in an ISO standard, it is a standard for permanent dental implants. Most of the test standards for Korean manufacturers and importers apply 250 N or more based on the guidance for the safety and performance evaluation of dental implants. Therefore, this study is intended to figure out the fatigue standard which can be applied to temporary dental implants when measuring the fatigue according to the test method suggested in the permanent dental implant standard. The results determined that suitable fatigue standards of temporary dental implants should be provided by each manufacturer rather than applying 250 N. This study will be useful for the establishment of the fatigue standards and fatigue test methods of the manufacturers and importers of temporary dental implants.
Collapse
|
31
|
Choi S, Ryoo SB, Park KJ, Kim DS, Song KH, Kim KH, Chung SS, Shin EJ, Cho YB, Oh ST, Kang WK, Kim MH. Autologous adipose tissue-derived stem cells for the treatment of complex perianal fistulas not associated with Crohn's disease: a phase II clinical trial for safety and efficacy. Tech Coloproctol 2017; 21:345-353. [PMID: 28567691 DOI: 10.1007/s10151-017-1630-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 04/16/2017] [Indexed: 12/18/2022]
Abstract
PURPOSE Injection of adipose tissue-derived stem cells (ASCs) is a novel method for the treatment of complex perianal fistulas. We aimed to evaluate the safety and efficacy of ASCs in the treatment of complex anal fistulas not associated with Crohn's disease. METHODS A phase II clinical trial was performed comparing two different doses of ASCs (group 1: 1 × 107 cells/mL and group 2: 2 × 107 cells/mL). Eligible patients were administered an amount of ASCs proportional to the length of the fistula by injection into the submucosal layer surrounding the internal opening and inside of the fistula tract. ASCs at twice the initial concentration were administered if complete closure was not achieved within 8 weeks. The efficacy endpoint was the complete closure of fistulas 8 weeks after injection. Patients demonstrating complete closure at week 8 were subjected to follow-up for 6 months. RESULTS Fifteen patients were injected with ASCs; thirteen completed the study. Complete closure was observed in 69.2% (9/13) of patients at 8 weeks. Three of five patients in group 1, and six of eight in group 2 displayed complete closure; no significant differences were observed between the groups. Six of nine patients who showed complete closure participated in additional follow-up; five (83.3%) showed persistent response at 6 months. No grade 3 or 4 adverse events (AEs) were observed; observed AEs were not related to ASC treatment. CONCLUSION ASCs might be a good option for the treatment of complex perianal fistulas are not healed by conventional operative procedures.
Collapse
|
32
|
Kim MH. Transcortical Endoscopic Surgery for Intraventricular Lesions. J Korean Neurosurg Soc 2017; 60:327-334. [PMID: 28490160 PMCID: PMC5426449 DOI: 10.3340/jkns.2017.0101.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 03/25/2017] [Accepted: 04/24/2017] [Indexed: 11/30/2022] Open
Abstract
To review recent advances in endoscopic techniques for treating intraventricular lesions via transcortical passage. Articles in PubMed published since 2000 were searched using the keywords ‘endoscopy,’ ‘endoscopic,’ and ‘neuroendoscopic.’ Of these articles, those describing intraventricular lesions were reviewed. Suprasellar arachnoid cysts (SACs) can be treated with ventriculo-cystostomy (VC) or ventriculo-cysto-cisternostomy (VCC). VCC showed better results compared to VC. Procedure type, fenestration size, stent placement, and aqueductal patency may affect SAC prognosis. Colloid cysts can be managed using a transforaminal approach (TA) or a transforaminal-transchoroidal approach (TTA). However, TTA may result in better exposure compared to TA. Intraventricular cysticercosis can be cured with an endoscopic procedure alone, but if pericystic inflammation and/or ependymal reaction are seen, third ventriculostomy may be recommended. Tumor biopsies have yielded successful diagnosis rates of up to 100%, but tumor location, total specimen size, endoscope type, and vigorous coagulation on the tumor surface may affect diagnostic accuracy. An ideal indication for tumor excision is a small tumor with friable consistency and little vascularity. Tumor size, composition, and vascularity may influence a complete resection. SACs and intraventricular cysticercosis can be treated successfully using endoscopic procedures. Endoscopic procedures may represent an alternative to surgical options for colloid cyst removal. Solid tumors can be safely biopsied using endoscopic techniques, but endoscopy for tumor resection still results in considerable challenges.
Collapse
|
33
|
Wellman LL, Sutton AM, Kim MH, Koech OK, Fitzpatrick ME, Williams BL, Machida M, Yoon H, Lonart G, Sanford LD. 0136 OPTOGENETIC STIMULATION AND INHIBITION OF THE CENTRAL NUCLEUS OF THE AMYGDALA ALTERS FIRING IN LOCUS COERULEUS NEURONS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
34
|
Daing AT, Kim MH. Feasibility of Reduced Boron Concentration Operation in Pressurized Water Reactor Plants. NUCL TECHNOL 2017. [DOI: 10.13182/nt176-40] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
35
|
Cho DK, Kim MH. Uncertainty Analysis on Fission Molybdenum Production with a Nuclear Fuel Target in a Research Reactor. NUCL TECHNOL 2017. [DOI: 10.13182/nt03-a3432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
36
|
Kim JM, Lee JY, Kim MH. Abstract P5-05-05: The role and regulation mechanism of HOXB5 in human breaset cancer cells. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p5-05-05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
HOX genes are transcription factors that play important roles in body patterning and cell fate specification during normal development. Among of these, HOXB5, is involved in a variety of developmental processes, particularly during the enteric nervous system (ENS) development, and thus, abnormalities in HOXB5 function during embryo stages lead to Hirschsprung's disease. Importantly, many HOX genes, including HOXB5, are expressed not only during embryogenesis but also in adults and are dysregulated in various cancers. In a previous study, we found aberrant overexpression of HOXB5 in breast cancer tissues and cell lines and demonstrated that HOXB5 is important in the regulation of cell proliferation in breast cancer cells. Also, HOXB5 induces invasive potential through epithelial-mesenchymal transition (EMT). The relationship between HOXB5 and phenotypic changes in MCF7 breast cancer cells has been studied, however, HOXB5 functions as a transcription factor and its involvement in signaling pathways remain unclear. In this study, we selected putative downstream target genes of HOXB5, such as interleukin (IL)-6, Snail2 and epidermal growth factor receptor (EGFR) by PCR array analysis. These genes have been reported to be involved in cacner progression, which is characterised by increased growth speed and invasiveness of the tumor cells. Here, we discovered that HOXB5 transcriptionally upregulates the promoter activity of these genes. Chromatin immunoprecipitation (ChIP) analysis to confirm direct binding of HOXB5 to the promoter region is now ongoing. Since we found that HOXB5 induces EGFR protein expression and SRC phosphorylation, we will further investigate signaling pathway components to understand the underlying molecular mechanisms of HOXB5 action in breast cancer.
Citation Format: Kim JM, Lee J-Y, Kim MH. The role and regulation mechanism of HOXB5 in human breaset cancer cells [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-05-05.
Collapse
|
37
|
Lan R, Loiko P, Mateos X, Wang Y, Li J, Pan Y, Choi SY, Kim MH, Rotermund F, Yasukevich A, Yumashev K, Griebner U, Petrov V. Passive Q-switching of microchip lasers based on Ho:YAG ceramics. APPLIED OPTICS 2016; 55:4877-4887. [PMID: 27409113 DOI: 10.1364/ao.55.004877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A Ho:YAG ceramic microchip laser pumped by a Tm fiber laser at 1910 nm is passively Q-switched by single- and multi-layer graphene, single-walled carbon nanotubes (SWCNTs), and Cr2+:ZnSe saturable absorbers (SAs). Employing SWCNTs, this laser generated an average power of 810 mW at 2090 nm with a slope efficiency of 68% and continuous wave to Q-switching conversion efficiency of 70%. The shortest pulse duration was 85 ns at a repetition rate of 165 kHz, and the pulse energy reached 4.9 μJ. The laser performance and pulse stability were superior compared to graphene SAs even for a different number of graphene layers (n=1 to 4). A model for the description of the Ho:YAG laser Q-switched by carbon nanostructures is presented. This modeling allowed us to estimate the saturation intensity for multi-layered graphene and SWCNT SAs to be 1.2±0.2 and 7±1 MW/cm2, respectively. When using Cr2+:ZnSe, the Ho:YAG microchip laser generated 11 ns/25 μJ pulses at a repetition rate of 14.8 kHz.
Collapse
|
38
|
Kim MH, Im YJ, Kil HK, Han SW, Joe YE, Lee JH. Impact of caudal block on postoperative complications in children undergoing tubularised incised plate urethroplasty for hypospadias repair: a retrospective cohort study. Anaesthesia 2016; 71:773-8. [PMID: 27156500 DOI: 10.1111/anae.13463] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2016] [Indexed: 11/26/2022]
Abstract
This study aimed to assess the association between caudal block and postoperative complications after tubularised incised plate urethroplasty. The medical records of 388 paediatric patients who underwent urethroplasty at a tertiary medical centre were analysed retrospectively. Among the 342 patients included, 216 patients received a caudal block and 72 (21.1%) patients suffered surgical complications. The number of patients having surgical complications was significantly greater among patients who received a caudal block than among patients who did not receive a caudal block (53 (24.5%) versus 19 (15.1%), respectively, p = 0.04). Based on multivariate logistic regression analysis, duration of surgery, caudal block and hypospadias types were independent risk factors for the surgical complications. Patients with caudal block had an odds ratio of 2.1 (95% CI, 1.14-3.81, p = 0.018) for the development of postoperative complications compared with patients without caudal block. This analysis demonstrates that caudal block is associated with surgical complications after tubularised incised plate urethroplasty.
Collapse
|
39
|
Choi SK, Kim MH, Choe LJ, Eo J, Bang HS. Prediction of the Flight Times of Hydrochara affinis and Sternolophus rufipes in Paddy Fields Based on RCP 8.5 Scenario. ACTA ACUST UNITED AC 2016. [DOI: 10.5532/kjafm.2016.18.1.16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
40
|
Yoon JH, Kim MH, Chung H, Choi EY, Min PK, Yoon YW, Lee BK, Hong BK, Rim SJ, Kwon HM, Kim JY. Echo-Doppler-derived indexes of ventricular stiffness and ventriculo-arterial interaction as predictors of new-onset atrial fibrillation in patients with heart failure. Cardiovasc Ultrasound 2016; 14:7. [PMID: 26846527 PMCID: PMC4743395 DOI: 10.1186/s12947-016-0050-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 01/29/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Atrial fibrillation (AF) is common in patients with heart failure (HF) and worsens their prognosis. Vulnerability to changes in loading is an important factor in the development of AF and is strongly influenced by ventricular stiffness and ventriculo-arterial interaction. The aim of this study was to investigate predictors of AF development in patients with HF. METHODS We studied 349 patients with stable HF. The following parameters of ventricular stiffness and ventriculo-arterial interaction were derived from echo-Doppler measurements: left ventricular (LV) diastolic elastance (Ed), effective arterial elastance (Ea), LV end-systolic elastance (Ees) and ventricular-vascular coupling index (VVI). RESULTS AF occurred in 57 (16.3%) patients over a median follow up of 30.3 months. Echo-Doppler-derived parameters of ventricular stiffness and ventriculo-arterial interaction were closely associated with HF severity. Ed was independently associated with AF after adjustment for age, hypertension, diabetes mellitus, and left atrial volume index (hazard ratio [HR] 5.49, p = 0.018). Ea and VVI were also associated with new-onset AF (HR 1.66, p = 0.027, and HR 1.06, p = 0.001, respectively). CONCLUSIONS Echo-Doppler indexes of ventricular stiffness are closely associated with HF severity. LV diastolic elastance (Ed) is the strongest predictor of new-onset AF in HF patients.
Collapse
|
41
|
Jais B, Rebours V, Malleo G, Salvia R, Fontana M, Maggino L, Bassi C, Manfredi R, Moran R, Lennon AM, Zaheer A, Wolfgang C, Hruban R, Marchegiani G, Fernández Del Castillo C, Brugge W, Ha Y, Kim MH, Oh D, Hirai I, Kimura W, Jang JY, Kim SW, Jung W, Kang H, Song SY, Kang CM, Lee WJ, Crippa S, Falconi M, Gomatos I, Neoptolemos J, Milanetto AC, Sperti C, Ricci C, Casadei R, Bissolati M, Balzano G, Frigerio I, Girelli R, Delhaye M, Bernier B, Wang H, Jang KT, Song DH, Huggett MT, Oppong KW, Pererva L, Kopchak KV, Del Chiaro M, Segersvard R, Lee LS, Conwell D, Osvaldt A, Campos V, Aguero Garcete G, Napoleon B, Matsumoto I, Shinzeki M, Bolado F, Fernandez JMU, Keane MG, Pereira SP, Acuna IA, Vaquero EC, Angiolini MR, Zerbi A, Tang J, Leong RW, Faccinetto A, Morana G, Petrone MC, Arcidiacono PG, Moon JH, Choi HJ, Gill RS, Pavey D, Ouaïssi M, Sastre B, Spandre M, De Angelis CG, Rios-Vives MA, Concepcion-Martin M, Ikeura T, Okazaki K, Frulloni L, Messina O, Lévy P. Serous cystic neoplasm of the pancreas: a multinational study of 2622 patients under the auspices of the International Association of Pancreatology and European Pancreatic Club (European Study Group on Cystic Tumors of the Pancreas). Gut 2016; 65:305-12. [PMID: 26045140 DOI: 10.1136/gutjnl-2015-309638] [Citation(s) in RCA: 173] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Accepted: 05/11/2015] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Serous cystic neoplasm (SCN) is a cystic neoplasm of the pancreas whose natural history is poorly known. The purpose of the study was to attempt to describe the natural history of SCN, including the specific mortality. DESIGN Retrospective multinational study including SCN diagnosed between 1990 and 2014. RESULTS 2622 patients were included. Seventy-four per cent were women, and median age at diagnosis was 58 years (16-99). Patients presented with non-specific abdominal pain (27%), pancreaticobiliary symptoms (9%), diabetes mellitus (5%), other symptoms (4%) and/or were asymptomatic (61%). Fifty-two per cent of patients were operated on during the first year after diagnosis (median size: 40 mm (2-200)), 9% had resection beyond 1 year of follow-up (3 years (1-20), size at diagnosis: 25 mm (4-140)) and 39% had no surgery (3.6 years (1-23), 25.5 mm (1-200)). Surgical indications were (not exclusive) uncertain diagnosis (60%), symptoms (23%), size increase (12%), large size (6%) and adjacent organ compression (5%). In patients followed beyond 1 year (n=1271), size increased in 37% (growth rate: 4 mm/year), was stable in 57% and decreased in 6%. Three serous cystadenocarcinomas were recorded. Postoperative mortality was 0.6% (n=10), and SCN's related mortality was 0.1% (n=1). CONCLUSIONS After a 3-year follow-up, clinical relevant symptoms occurred in a very small proportion of patients and size slowly increased in less than half. Surgical treatment should be proposed only for diagnosis remaining uncertain after complete workup, significant and related symptoms or exceptionally when exists concern with malignancy. This study supports an initial conservative management in the majority of patients with SCN. TRIAL REGISTRATION NUMBER IRB 00006477.
Collapse
|
42
|
Martins VL, Caley MP, Moore K, Szentpetery Z, Marsh ST, Murrell DF, Kim MH, Avari M, McGrath JA, Cerio R, Kivisaari A, Kähäri VM, Hodivala-Dilke K, Brennan CH, Chen M, Marshall JF, O'Toole EA. Suppression of TGFβ and Angiogenesis by Type VII Collagen in Cutaneous SCC. J Natl Cancer Inst 2016; 108:djv293. [PMID: 26476432 DOI: 10.1093/jnci/djv293] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 09/22/2015] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Individuals with severe generalized recessive dystrophic epidermolysis bullosa (RDEB), an inherited blistering disorder caused by mutations in the COL7A1 gene, develop unexplained aggressive squamous cell carcinomas (SCC). Here we report that loss of type VII collagen (Col7) in SCC results in increased TGFβ signaling and angiogenesis in vitro and in vivo. METHODS Stable knockdown (KD) of Col7 was established using shRNA, and cells were used in a mouse xenograft model. Angiogenesis was assessed by immunohistochemistry, endothelial tube-forming assays, and proteome arrays. Mouse and zebrafish models were used to examine the effect of recombinant Col7 on angiogenesis. Findings were confirmed in anonymized, archival human tissue: RDEB SCC tumors, non-EB SCC tumors, RDEB skin, normal skin; and two human RDEB SCC cell lines. The TGFβ pathway was examined using immunoblotting, immunohistochemistry, biochemical inhibition, and siRNA. All statistical tests were two-sided. RESULTS Increased numbers of cross-cut blood vessels were observed in Col7 KD compared with control xenografts (n = 4 to 7 per group) and in RDEB tumors (n = 21) compared with sporadic SCC (n = 24, P < .001). Recombinant human Col7 reversed the increased SCC angiogenesis in Col7 KD xenografts in vivo (n = 7 per group, P = .04). Blocking the interaction between α2β1 integrin and Col7 increased TGFB1 mRNA expression 1.8-fold and p-Smad2 levels two-fold. Increased TGFβ signaling and VEGF expression were observed in Col7 KD xenografts (n = 4) compared with control (n = 4) and RDEB tumors (TGFβ markers, n = 6; VEGF, n = 17) compared with sporadic SCC (TGFβ markers, n = 6; VEGF, n = 21). Inhibition of TGFβ receptor signaling using siRNA resulted in decreased endothelial cell tube formation (n = 9 per group, mean tubes per well siC = 63.6, SD = 17.1; mean tubes per well siTβRII = 29.7, SD = 6.1, P = .02). CONCLUSIONS Type VII collagen suppresses TGFβ signaling and angiogenesis in cutaneous SCC. Patients with RDEB SCC may benefit from anti-angiogenic therapy.
Collapse
|
43
|
Yamamoto TO, Agnello M, Akazawa Y, Amano N, Aoki K, Botta E, Chiga N, Ekawa H, Evtoukhovitch P, Feliciello A, Fujita M, Gogami T, Hasegawa S, Hayakawa SH, Hayakawa T, Honda R, Hosomi K, Hwang SH, Ichige N, Ichikawa Y, Ikeda M, Imai K, Ishimoto S, Kanatsuki S, Kim MH, Kim SH, Kinbara S, Koike T, Lee JY, Marcello S, Miwa K, Moon T, Nagae T, Nagao S, Nakada Y, Nakagawa M, Ogura Y, Sakaguchi A, Sako H, Sasaki Y, Sato S, Shiozaki T, Shirotori K, Sugimura H, Suto S, Suzuki S, Takahashi T, Tamura H, Tanabe K, Tanida K, Tsamalaidze Z, Ukai M, Yamamoto Y, Yang SB. Observation of Spin-Dependent Charge Symmetry Breaking in ΛN Interaction: Gamma-Ray Spectroscopy of _{Λ}^{4}He. PHYSICAL REVIEW LETTERS 2015; 115:222501. [PMID: 26650298 DOI: 10.1103/physrevlett.115.222501] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Indexed: 06/05/2023]
Abstract
The energy spacing between the spin-doublet bound state of _{Λ}^{4}He(1^{+},0^{+}) was determined to be 1406±2±2 keV, by measuring γ rays for the 1^{+}→0^{+} transition with a high efficiency germanium detector array in coincidence with the ^{4}He(K^{-},π^{-})_{Λ}^{4}He reaction at J-PARC. In comparison to the corresponding energy spacing in the mirror hypernucleus _{Λ}^{4}H, the present result clearly indicates the existence of charge symmetry breaking (CSB) in ΛN interaction. By combining the energy spacings with the known ground-state binding energies, it is also found that the CSB effect is large in the 0^{+} ground state but is vanishingly small in the 1^{+} excited state, demonstrating that the ΛN CSB interaction has spin dependence.
Collapse
|
44
|
Jeon YK, Shin MJ, Kim MH, Mok JH, Kim SS, Kim BH, Kim SJ, Kim YK, Chang JH, Shin YB, Kim IJ. Low pulmonary function is related with a high risk of sarcopenia in community-dwelling older adults: the Korea National Health and Nutrition Examination Survey (KNHANES) 2008-2011. Osteoporos Int 2015; 26:2423-9. [PMID: 25956284 DOI: 10.1007/s00198-015-3152-8] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 04/26/2015] [Indexed: 01/06/2023]
Abstract
UNLABELLED Sarcopenia is the age-related reduction of skeletal muscle mass in older individuals. Respiratory muscle strength may be related to skeletal muscle mass and, thus, the present study attempted to estimate the risk of sarcopenia relative to decreased pulmonary function. The present findings demonstrated that low pulmonary function was associated with low muscle mass in community-dwelling older adults. INTRODUCTION Lean body mass is related to pulmonary function in patients with chronic obstructive pulmonary disease (COPD). However, the relationship between muscle mass and pulmonary function in healthy older adults has yet to be clarified. Thus, the present study investigated the association of pulmonary function with muscle mass in an older community-dwelling Korean population. METHODS This study included 463 disease-free subjects over 65 years of age who underwent anthropometric measurements, laboratory tests, spirometry, and the estimation of appendicular skeletal muscle (ASM) mass in the 2008-2011 Korea National Health and Nutrition Examination Survey (KNHANES). Low muscle mass was defined as the value of ASM divided by height squared (ASM/height(2)) that was less than two standard deviations (SD) below the sex-specific mean of the young reference group. RESULTS Forced expiratory volume in 1 s (FEV1[L]) and forced vital capacity (FVC[L]) were positively correlated with ASM/height(2) in males (p < 0.001 and p = 0.001, respectively) but not in females (p = 0.360 and p = 0.779, respectively). A univariate logistic regression analysis revealed that males with low FEV1 or FVC were more likely to have low muscle mass (odds ratio [OR] = 3.11, 95% confidence interval [CI] 1.62-5.99 for FEV1; OR = 1.99, 95% CI 1.13-3.53 for FVC); similar results were found for females, but the significance was lower (OR = 11.37, 95% CI 0.97-132.91 for FEV1; OR = 7.31, 95% CI 1.25-42.74 for FVC). After adjusting for age, smoking, and moderate physical activity, a low FEV1 value was associated with low muscle mass in both males (OR = 2.90, 95% CI 1.50-5.63) and females (OR = 9.15, 95% CI 1.53-54.77). CONCLUSIONS Using nationally representative data from the 2008-2011 KNHANES, low pulmonary function was found to be associated with low muscle mass in community-dwelling older Korean adults.
Collapse
|
45
|
Khosroshahi A, Wallace ZS, Crowe JL, Akamizu T, Azumi A, Carruthers MN, Chari ST, Della-Torre E, Frulloni L, Goto H, Hart PA, Kamisawa T, Kawa S, Kawano M, Kim MH, Kodama Y, Kubota K, Lerch MM, Löhr M, Masaki Y, Matsui S, Mimori T, Nakamura S, Nakazawa T, Ohara H, Okazaki K, Ryu JH, Saeki T, Schleinitz N, Shimatsu A, Shimosegawa T, Takahashi H, Takahira M, Tanaka A, Topazian M, Umehara H, Webster GJ, Witzig TE, Yamamoto M, Zhang W, Chiba T, Stone JH. International Consensus Guidance Statement on the Management and Treatment of IgG4-Related Disease. Arthritis Rheumatol 2015; 67:1688-99. [PMID: 25809420 DOI: 10.1002/art.39132] [Citation(s) in RCA: 600] [Impact Index Per Article: 66.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 03/19/2015] [Indexed: 02/06/2023]
|
46
|
Son DJ, Hwang SY, Kim MH, Park UK, Kim BS. Anti-Diabetic and Hepato-Renal Protective Effects of Ziyuglycoside II Methyl Ester in Type 2 Diabetic Mice. Nutrients 2015. [PMID: 26198246 PMCID: PMC4517009 DOI: 10.3390/nu7075232] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Type 2 diabetes is a metabolic disorder caused by abnormal carbohydrate metabolism, and closely associated with abnormal lipid metabolism and hepato-renal dysfunction. This study investigated the anti-diabetic and hepato-renal protective properties of ziyuglycoside I (ZG01) derivative on type 2 diabetes. ZG01 was isolated from roots of Sanguisorba officinalis and chemically modified by deglycosylation and esterification to obtained ziyuglycoside II methyl ester (ZG02-ME). Here, we showed that ZG02-ME has stronger anti-diabetic activity than the original compound (ZG01) through decreasing blood glucose, glycated hemoglobin (HbA1c), and insulin levels in a mouse model of type 2 diabetes (db/db mice). We further found that ZG02-ME treatment effectively ameliorated serum insulin, leptin and C-peptide levels, which are key metabolic hormones, in db/db mice. In addition, we showed that elevated basal blood lipid levels were decreased by ZG02-ME treatment in db/db mice. Furthermore, treatment of ZG02-ME significantly decreased serum AST, ALT, BUN, creatinine, and liver lipid peroxidation in db/db mice. These results demonstrated that compared to ZG01, chemically modified ZG02-ME possess improved anti-diabetic properties, and has hepato-renal protective activities in type 2 diabetes.
Collapse
|
47
|
Kim MH, Ham O, Lee SY, Choi E, Lee CY, Park JH, Lee J, Seo HH, Seung M, Choi E, Min PK, Hwang KC. MicroRNA-365 inhibits the proliferation of vascular smooth muscle cells by targeting cyclin D1. J Cell Biochem 2015; 115:1752-61. [PMID: 24819721 DOI: 10.1002/jcb.24841] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Accepted: 05/08/2014] [Indexed: 02/02/2023]
Abstract
Abnormal proliferation of vascular smooth muscle cells (VSMCs) is a common feature of disease progression in atherosclerosis. Cell proliferation is regulated by cell cycle regulatory proteins. MicroRNAs (miR) have been reported to act as important gene regulators and play essential roles in the proliferation and migration of VSMCs in a cardiovascular disease. However, the roles and mechanisms of miRs in VSMCs and neointimal formation are far from being fully understood. In this study, cell cycle-specific cyclin D1 was found to be a potential target of miR-365 by direct binding. Through an in vitro experiment, we showed that exogenous miR-365 overexpression reduced VSMC proliferation and proliferating cell nuclear antigen (PCNA) expression, while miR-365 was observed to block G1/S transition in platelet-derived growth factor-bb (PDGF-bb)-induced VSMCs. In addition, the proliferation of VSMCs by various stimuli, including PDGF-bb, angiotensin II (Ang II), and serum, led to the downregulation of miR-365 expression levels. The expression of miR-365 was confirmed in balloon-injured carotid arteries. Taken together, our results suggest an anti-proliferative role for miR-365 in VSMC proliferation, at least partly via modulating the expression of cyclin D1. Therefore, miR-365 may influence neointimal formation in atherosclerosis patients.
Collapse
|
48
|
Kim BH, Park SJ, Jin HM, Kim JY, Son SW, Kim MH, Koo CM, Shin J, Kim JU, Kim SO. Anomalous rapid defect annihilation in self-assembled nanopatterns by defect melting. NANO LETTERS 2015; 15:1190-1196. [PMID: 25590438 DOI: 10.1021/nl5042935] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Molecular self-assembly commonly suffers from dense structural defect formation. Spontaneous defect annihilation in block copolymer (BCP) self-assembly is particularly retarded due to significant energy barrier for polymer chain diffusion and structural reorganization. Here we present localized defect melting induced by blending short neutral random copolymer chain as an unusual method to promote the defect annihilation in BCP self-assembled nanopatterns. Chemically neutral short random copolymer chains blended with BCPs are specifically localized and induce local disordered states at structural defect sites in the self-assembled nanopatterns. Such localized "defect melting" relieves the energy penalty for polymer diffusion and morphology reorganization such that spontaneous defect annihilation by mutual coupling is anomalously accelerated upon thermal annealing. Interestingly, neutral random copolymer chain blending also causes morphology-healing self-assembly behavior that can generate large-area highly ordered 10 nm scale nanopattern even upon poorly defined defective prepatterns. Underlying mechanisms of the unusual experimental findings are thoroughly investigated by three-dimensional self-consistent field theory calculation.
Collapse
|
49
|
Kim SY, Kim HJ, Park SY, Lee DE, Kim KS, Park SY, Kim MH, Kwak DW, Ryu HM. Quantification of the placental epigenetic signature of the SERPINB5 gene in maternal plasma of pregnancies complicated by small for gestational age. Placenta 2015; 36:131-7. [PMID: 25553975 DOI: 10.1016/j.placenta.2014.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 08/20/2014] [Accepted: 09/11/2014] [Indexed: 11/28/2022]
Abstract
INTRODUCTION To investigate the association between pregnancies with small for gestational age (SGA) neonates and the concentration of cell-free fetal DNA or cell-free total DNA in maternal plasma during the first and second trimesters using tissue-specific epigenetic characteristics of the SERPINB5 gene. METHODS A nested case-control study was conducted with maternal plasma collected at 11 to 26 gestational weeks from 51 women with SGA neonates and 102 controls. We performed a real-time quantitative methylation-specific PCR to quantify concentrations of unmethylated-SERPINB5 (U-SERPINB5) as a cell-free fetal DNA marker and methylated-SERPINB5 (M-SERPINB5) as a cell-free total DNA marker. RESULTS A positive correlation was observed between U-SERPINB5 and M-SERPINB5 concentrations in both control (r = 0.363, p < 0.001) and SGA groups (r = 0.548, p < 0.001). Moreover, the concentration of U-SERPINB5 or M-SERPINB5 was significantly positive correlated with gestational age at sampling in both controls (U-SERPINB5: r = 0.397, p < 0.001; M-SERPINB5: r = 0.275, p = 0.005) and SGA (U-SERPINB5: r = 0.274, p = 0.052; M-SERPINB5: r = 0.439, p = 0.001). However, the concentration of U-SERPINB5 or M-SERPINB5 was not correlated with birthweight. At 11-14 weeks, U-SERPINB5 and M-SERPINB5 concentrations in SGA did not differ significantly from those of controls. There were also no statistically significant differences in the concentrations of U-SERPINB5 and M-SERPINB5 between SGA and controls at 15-26 weeks of gestation. DISCUSSION Our findings suggest that U-SERPINB5 and M-SERPINB5 concentrations in maternal plasma during early pregnancy are not associated with pregnancies who delivered SGA neonates.
Collapse
|
50
|
Chung H, Kwon HM, Kim JY, Yoon YW, Rhee J, Choi EY, Min PK, Hong BK, Rim SJ, Yoon JH, Lee SJ, Park JK, Kim MH, Jo M, Yang JH, Lee BK. Lipoprotein-associated phospholipase A₂ is related to plaque stability and is a potential biomarker for acute coronary syndrome. Yonsei Med J 2014; 55:1507-15. [PMID: 25323886 PMCID: PMC4205689 DOI: 10.3349/ymj.2014.55.6.1507] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
PURPOSE Plasma lipoprotein-associated phospholipase A₂ (Lp-PLA₂) binds to low-density lipoprotein. The levels of Lp-PLA₂ reflect the plaque burden, and are upregulated in acute coronary syndrome (ACS). We investigated the diagnostic value of Lp-PLA2 levels and found that it might be a potential biomarker for ACS. MATERIALS AND METHODS We classified 226 study participants into three groups: patients without significant stenosis (control group), patients with significant stenosis with stable angina (SA group), and patients with ACS (ACS group). RESULTS Lp-PLA₂ and high-sensitivity C-reactive protein (hs-CRP) levels were significantly greater in the ACS group than in the SA group (p=0.044 and p=0.029, respectively). Multivariate logistic regression analysis revealed that Lp-PLA₂ levels are significantly associated with ACS (odds ratio=1.047, p=0.013). The addition of Lp-PLA₂ to the ACS model significantly increased the global χ² value over traditional risk factors (28.14 to 35.602, p=0.006). The area under the receiver operating characteristic curve for Lp-PLA₂ was 0.624 (p=0.004). The addition of Lp-PLA₂ level to serum hs-CRP concentration yielded an integrated discrimination improvement of 0.0368 (p=0.0093, standard error: 0.0142) and improved the ability to diagnose ACS. CONCLUSION Lp-PLA₂ levels are related to plaque stability and might be a diagnostic biomarker for ACS.
Collapse
|