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Saygin D, DiRenzo D, Raaphorst J, de Groot I, Bingham CO, Lundberg IE, Regardt M, Sarver C, de Visser M, Maxwell LJ, Beaton D, Kim JY, Needham M, Alexanderson H, Christopher-Stine L, Mecoli CA, Park JK. Responsiveness and meaningful thresholds of PROMIS pain interference, fatigue, and physical function forms in adults with idiopathic inflammatory myopathies: Report from the OMERACT Myositis Working Group. Semin Arthritis Rheum 2024; 64:152339. [PMID: 38141522 DOI: 10.1016/j.semarthrit.2023.152339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 11/18/2023] [Accepted: 11/28/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND A series of qualitative studies conducted by the OMERACT Myositis Working Group identified pain interference, fatigue, and physical function as highly important life impact domains for adults with idiopathic inflammatory myositis (IIM). In this study, our goal was to assess the responsiveness and minimal important difference of PROMIS pain interference (6a), fatigue (7a), and physical function (8b). METHODS Adults with IIM from USA, Netherlands, Korea, Sweden, and Australia with two "clinical" visits were enrolled in this prospective study. Anchor questions on a Likert scale were collected at baseline, and manual muscle testing (MMT), physician and patient reported global disease activity, and PROMIS instruments were collected at both visits. Responsiveness was assessed with i) ANOVA, ii) paired t-test, effect size and standardized response mean, and iii) Pearson correlation. Minimal important difference (MID), minimal important change (MIC) and minimal detectable change (MDC) values were calculated. RESULTS 114 patients with IIM (median age 60, 60 % female) completed both visits. Changes in PROMIS instruments were significantly different among anchor categories. Patients who reported improvement had a significant improvement in their PROMIS scores with at least medium effect size, while patients who reported worsening and stability did not show a significant change with weak effect size. PROMIS instruments had weak to moderate correlations with MMT, patient and physician global disease activity. MID was approximately 2-3 points for Pain Interference and 3-4 points for Fatigue and Physical Function forms based on the method used. MIC was approximately 4-5 for improvement of all the instruments, while MDC was 1.7-2 points for Pain Interference and Physical Function and 3.2-3.9 for Fatigue. CONCLUSION This study provides evidence towards the responsiveness of the PROMIS instruments in a large international prospective cohort of adults with IIM supporting their use as PROMs in adult myositis.
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Affiliation(s)
- D Saygin
- Division of Rheumatology, Department of Medicine, University of Pittsburgh, Pittsburgh, USA
| | - D DiRenzo
- Division of Rheumatology, Department of Medicine, University of Pennsylvania, Philadelphia, USA
| | - J Raaphorst
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | | | - C O Bingham
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, USA
| | - I E Lundberg
- Division of Rheumatology, Department of Medicine, Solna, Karolinska Institutet, Karolinska University, Stockholm, Sweden
| | - M Regardt
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet and Medical Unit Occupational Therapy and Physical Therapy, Karolinska University Hospital, Stockholm, Sweden
| | | | - M de Visser
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - L J Maxwell
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - D Beaton
- Institute for Work & Health and Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - J Y Kim
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Korea
| | - M Needham
- Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and University of Notre Dame, Perth, Australia
| | - H Alexanderson
- Medical Unit Occupational Therapy and Physical Therapy, Karolinska University Hospital and Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - L Christopher-Stine
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, USA
| | - C A Mecoli
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, USA
| | - J K Park
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Korea.
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Kwon M, Joung CI, Shin H, Lee CC, Song YS, Lee YJ, Kang S, Kim JY, Lee S. Detection of novel drug-adverse drug reaction signals in rheumatoid arthritis and ankylosing spondylitis: analysis of Korean real-world biologics registry data. Sci Rep 2024; 14:2660. [PMID: 38302579 PMCID: PMC10834537 DOI: 10.1038/s41598-024-52822-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 01/24/2024] [Indexed: 02/03/2024] Open
Abstract
This study aimed to detect signals of adverse drug reactions (ADRs) associated with biological disease-modifying antirheumatic drugs (DMARDs) and targeted therapies in rheumatoid arthritis (RA) and ankylosing spondylitis (AS) patients. Utilizing the KOrean College of Rheumatology BIOlogics & Targeted Therapy Registry (KOBIO) data, we calculated relative risks, excluded previously reported drug-ADR pairs, and externally validated remaining pairs using US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) and single centre's electronic health records (EHR) data. Analyzing data from 2279 RA and 1940 AS patients, we identified 35 significant drug-ADR pairs in RA and 26 in AS, previously unreported in drug labels. Among the novel drug-ADR pairs from KOBIO, 15 were also significant in the FAERS data. Additionally, 2 significant drug-laboratory abnormality pairs were found in RA using CDM MetaLAB analysis. Our findings contribute to the identification of 14 novel drug-ADR signals, expanding our understanding of potential adverse effects related to biological DMARDs and targeted therapies in RA and AS. These results emphasize the importance of ongoing pharmacovigilance for patient safety and optimal therapeutic interventions.
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Affiliation(s)
- M Kwon
- Department of Internal Medicine, School of Medicine, Konyang University, Daejeon, South Korea
- Konyang University Myunggok Medical Research Institute, Daejeon, South Korea
- Department of Biomedical Informatics, School of Medicine, Konyang University, Daejeon, South Korea
| | - C I Joung
- Department of Internal Medicine, School of Medicine, Konyang University, Daejeon, South Korea
| | - H Shin
- Healthcare Data Science Centre, Konyang University Hospital, Daejeon, South Korea
| | - C C Lee
- Department of Biomedical Informatics, School of Medicine, Konyang University, Daejeon, South Korea
| | - Y S Song
- Department of Pathology, School of Medicine, Konyang University, Daejeon, South Korea
| | - Y J Lee
- Department of Biomedical Informatics, School of Medicine, Konyang University, Daejeon, South Korea
- Department of Rehabilitation Medicine, School of Medicine, Konyang University, Daejeon, South Korea
| | - S Kang
- Department of Internal Medicine, School of Medicine, Konyang University, Daejeon, South Korea
| | - J Y Kim
- Department of Biomedical Informatics, School of Medicine, Konyang University, Daejeon, South Korea
- Healthcare Data Science Centre, Konyang University Hospital, Daejeon, South Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Konyang University, Daejeon, South Korea
| | - S Lee
- Department of Computer Engineering, Gachon University, (13120) 1342 Seongnamdaero, Sujeong-gu, Seongnam-si, Gyeonggi-do, South Korea.
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Sim AY, Choi DH, Kim JY, Kim ER, Goh AR, Lee YH, Lee JE. SGLT2 and DPP4 inhibitors improve Alzheimer's disease-like pathology and cognitive function through distinct mechanisms in a T2D-AD mouse model. Biomed Pharmacother 2023; 168:115755. [PMID: 37871560 DOI: 10.1016/j.biopha.2023.115755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/17/2023] [Accepted: 10/17/2023] [Indexed: 10/25/2023] Open
Abstract
Alzheimer's disease (AD) and type 2 diabetes mellitus (T2D) share common features, including insulin resistance. Brain insulin resistance has been implicated as a key factor in the pathogenesis of AD. Recent studies have demonstrated that anti-diabetic drugs sodium-glucose cotransporter-2 inhibitor (SGLT2-i) and dipeptidyl peptidase-4 inhibitor (DPP4-i) improve insulin sensitivity and provide neuroprotection. However, the effects of these two inhibitors on the brain metabolism and insulin resistance remain uninvestigated. We developed a T2D-AD mouse model using a high-fat diet (HFD) for 19 weeks along with a single dose of streptozotocin (100 mg/kg, intraperitoneally) at the fourth week of HFD initiation. Subsequently, the animals were treated with SGLT2-i (empagliflozin, 25 mg/kg/day orally [p.o.]) and DPP4-i (sitagliptin, 100 mg/kg/day p.o.) for 7 weeks. Subsequently, behavioral tests were performed, and the expression of insulin signaling, AD-related, and other signaling pathway proteins in the brain were examined. T2D-AD mice not only showed increased blood glucose levels and body weight but also insulin resistance. SGLT2-i and DPP4-i effectively ameliorated insulin sensitivity and reduced body weight in these mice. Furthermore, SGLT2-i and DPP4-i significantly improved hippocampal-dependent learning, memory, and cognitive functions in the T2D-AD mouse model. Interestingly, SGLT2-i and DPP4-i reduced the hyperphosphorylated tau (pTau) levels and amyloid β (Aβ) accumulation and enhanced brain insulin signaling. SGLT2-i reduced pTau accumulation through the angiotensin converting enzyme-2/angiotensin (1-7)/ mitochondrial assembly receptor axis, whereas DPP4-i reduced Aβ accumulation by increasing insulin-degrading enzyme levels. These findings suggest that SGLT2-i and DPP4-i prevent AD-like pathology and cognitive dysfunction in T2D mice potentially through affecting brain insulin signaling via different mechanisms.
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Affiliation(s)
- A Young Sim
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Republic of Korea; Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Da Hyun Choi
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Systems Biology, Glycosylation Network Research Center, Yonsei University, Seoul, Republic of Korea; Interdisciplinary Program of Integrated OMICS for Biomedical Science, Yonsei University, Seoul, Republic of Korea.
| | - Jong Youl Kim
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Eun Ran Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - A-Ra Goh
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Republic of Korea; Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Yong-Ho Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Systems Biology, Glycosylation Network Research Center, Yonsei University, Seoul, Republic of Korea; Interdisciplinary Program of Integrated OMICS for Biomedical Science, Yonsei University, Seoul, Republic of Korea.
| | - Jong Eun Lee
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Republic of Korea; Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Republic of Korea; Brain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Kim JY, Hyun DY, Nam D, Shin HJ, Jung J, Cho SY, Jung K, Hwang D, Lee SW, Kim JY. Proteogenomic Analysis of Human Uterine Cervical Cancer (UCC) Reveals Treatment-Resistant Subtypes of UCC. Int J Radiat Oncol Biol Phys 2023; 117:S22. [PMID: 37784455 DOI: 10.1016/j.ijrobp.2023.06.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Locally advanced uterine cervical cancer (UCC) is treated by radiotherapy with concurrent chemotherapy, but heterogenous treatment responses are frequently observed. To better optimize therapeutic options based on molecular signatures, we performed proteogenomic analysis of UCC. MATERIALS/METHODS UCC tissue and blood samples were collected from patients who underwent primary radiotherapy ± chemotherapy at the National Cancer Center (NCC) in Korea from July 2004 to March 2020. Most samples were obtained via biopsy. Genomic DNA for WES was isolated from frozen biopsy tumor tissues and peripheral blood buffy-coat of patients. Both global proteome and phosphoproteome were analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Whole exome sequencing, RNA sequencing, global proteomics and phosphoproteomics were performed using 253, 337, and 147 cervical cancer samples, respectively. Patient-derived xenograft were established using intratongue implantation using 2 primary cell lines from sub3 and sub5, and flow cytometric analysis was performed. RESULTS Fourteen significantly mutated genes (SMG) were found in our study cohort which include 5 newly identified SMGs. Mutation-phosphorylation analysis revealed association with apoptosis and actin cytoskeleton pathway. Proteogenomic analysis defined 6 molecular subtypes of UCC. Of those, 3 subtypes (i.e., Sub3, Sub5 and Sub6) were associated with treatment-resistant phenotypes. The cell-type deconvolution analysis suggested activated stroma with activation of cancer-associated fibroblast in Sub 3, while Sub5 showed low levels of activated stroma and high levels of myeloid immune cells. FACS analysis of UCC mouse models established from these 2 radio-resistant primary cell lines showed high component of PDGFRA+CAF infiltration in Sub 3, and high level of PVR+CD45+ immune cells mainly composed of polymorphonuclear myeloid-derived suppressor cells (PMN-MDSC) in Sub5. For Sub6, genes and/or protein signatures represented mucin-related processes (e.g., mucin glycosylation/sugar metabolism), which are linked to metastasis-associated Tn antigen production. CONCLUSION The proteogenomic analysis thus suggests potential targets for radiotherapy-resistant subtypes of UCC; secretory factors from activated stroma and cancer-associated fibroblast (Sub3); RHOA signaling, PVR, and PMN-MDSCs (Sub5), and keratin/chondroitin sulfate proteoglycan and Tn antigen production (Sub6). Our study shows the importance of proteogenomic analysis in unveiling the subtype specific molecular pathways of UCC that are beyond reach by genomic data alone. The validity of our molecular pathway and cellular signatures linking these pathways should be further validated through detailed functional experiments and in larger UCC cohorts.
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Affiliation(s)
- J Y Kim
- National Cancer Center, Goyang, Korea, Republic of (South) Korea
| | - D Y Hyun
- School of Biological Sciences, Seoul National University, Seoul, Korea, Republic of (South) Korea
| | - D Nam
- Department of Chemistry and Center for Proteogenome Research, Korea University, Seoul, Korea, Republic of (South) Korea
| | - H J Shin
- Research Institute and Hospital, National Cancer Center, Korea, Goyang, Korea, Republic of (South) Korea
| | - J Jung
- Department of Anatomy and Cell Biology and Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - S Y Cho
- Research Institute and Hospital, National Cancer Center, Korea, Goyang-si, Korea, Republic of (South) Korea
| | - K Jung
- Department of Anatomy and Cell Biology and Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - D Hwang
- School of Biological Sciences, Seoul National University, Seoul, Korea, Republic of (South) Korea
| | - S W Lee
- Department of Chemistry and Center for Proteogenome Research, Korea University, Seoul, Korea, Republic of (South) Korea
| | - J Y Kim
- Research Institute and Hospital, National Cancer Center, Korea, Goyang-si, Korea, Republic of (South) Korea
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Kim JY, Koo B, Lim SY, Cha HH, Kim MJ, Chong YP, Choi SH, Lee SO, Kim YS, Shin Y, Kim SH. A non-invasive, sensitive assay for active TB: combined cell-free DNA detection and FluoroSpot assays. Int J Tuberc Lung Dis 2023; 27:790-792. [PMID: 37749833 PMCID: PMC10519393 DOI: 10.5588/ijtld.23.0180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/18/2023] [Indexed: 09/27/2023] Open
Affiliation(s)
- J Y Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - B Koo
- Department of Biotechnology, Yonsei University, Seoul, Republic of Korea
| | - S Y Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - H H Cha
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - M J Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - Y P Chong
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - S-H Choi
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - S-O Lee
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - Y S Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - Y Shin
- Department of Biotechnology, Yonsei University, Seoul, Republic of Korea
| | - S-H Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul
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Kim JY, Park S, Kim EO, Chang E, Bae S, Kim MJ, Chong YP, Choi SH, Lee SO, Kim YS, Jung J, Kim SH. The seasonality of carbapenemase-producing Enterobacterales in South Korea. J Hosp Infect 2023; 140:87-89. [PMID: 37506769 DOI: 10.1016/j.jhin.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 07/30/2023]
Affiliation(s)
- J Y Kim
- Office for Infection Control, Asan Medical Center, Seoul, Republic of Korea
| | - S Park
- Office for Infection Control, Asan Medical Center, Seoul, Republic of Korea
| | - E O Kim
- Office for Infection Control, Asan Medical Center, Seoul, Republic of Korea
| | - E Chang
- Office for Infection Control, Asan Medical Center, Seoul, Republic of Korea
| | - S Bae
- Departments of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - M J Kim
- Departments of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Y P Chong
- Departments of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - S-H Choi
- Departments of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - S-O Lee
- Departments of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Y S Kim
- Departments of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - J Jung
- Office for Infection Control, Asan Medical Center, Seoul, Republic of Korea; Departments of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - S-H Kim
- Office for Infection Control, Asan Medical Center, Seoul, Republic of Korea; Departments of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Kim J, Sim AY, Barua S, Kim JY, Lee JE. Agmatine-IRF2BP2 interaction induces M2 phenotype of microglia by increasing IRF2-KLF4 signaling. Inflamm Res 2023:10.1007/s00011-023-01741-z. [PMID: 37314519 DOI: 10.1007/s00011-023-01741-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/29/2023] [Accepted: 05/10/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Following central nervous system (CNS) injury, the investigation for neuroinflammation is vital because of its pleiotropic role in both acute injury and long-term recovery. Agmatine (Agm) is well known for its neuroprotective effects and anti-neuroinflammatory properties. However, Agm's mechanism for neuroprotection is still unclear. We screened target proteins that bind to Agm using a protein microarray; the results showed that Agm strongly binds to interferon regulatory factor 2 binding protein (IRF2BP2), which partakes in the inflammatory response. Based on these prior data, we attempted to elucidate the mechanism by which the combination of Agm and IRF2BP2 induces a neuroprotective phenotype of microglia. METHODS To confirm the relationship between Agm and IRF2BP2 in neuroinflammation, we used microglia cell-line (BV2) and treated with lipopolysaccharide from Escherichia coli 0111:B4 (LPS; 20 ng/mL, 24 h) and interleukin (IL)-4 (20 ng/mL, 24 h). Although Agm bound to IRF2BP2, it failed to enhance IRF2BP2 expression in BV2. Therefore, we shifted our focus onto interferon regulatory factor 2 (IRF2), which is a transcription factor and interacts with IRF2BP2. RESULTS IRF2 was highly expressed in BV2 after LPS treatment but not after IL-4 treatment. When Agm bound to IRF2BP2 following Agm treatment, the free IRF2 translocated to the nucleus of BV2. The translocated IRF2 activated the transcription of Kruppel-like factor 4 (KLF4), causing KLF4 to be induced in BV2. The expression of KLF4 increased the CD206-positive cells in BV2. CONCLUSIONS Taken together, unbound IRF2, resulting from the competitive binding of Agm to IRF2BP2, may provide neuroprotection against neuroinflammation via an anti-inflammatory mechanism of microglia involving the expression of KLF4.
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Affiliation(s)
- Jiwon Kim
- Department of Anatomy, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea
- Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - A Young Sim
- Department of Anatomy, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea
- Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sumit Barua
- Department of Anatomy, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea
| | - Jong Youl Kim
- Department of Anatomy, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea.
| | - Jong Eun Lee
- Department of Anatomy, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea.
- Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Republic of Korea.
- Brain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Kosonen R, Chang JY, Lee S, Kim J, Kim JY, Lee JE. APP96-110 Elicits Neuroprotective Effects Following Ischemic Insult in Animal Models. Neurochem Res 2023:10.1007/s11064-023-03928-6. [PMID: 37069416 DOI: 10.1007/s11064-023-03928-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 03/25/2023] [Accepted: 03/31/2023] [Indexed: 04/19/2023]
Abstract
Competitive amyloidogenic pathways play an important role in many neurological diseases such as the onset of various degenerative diseases and ischemic stroke. Overexpression of amyloid precursor protein (APP) and amyloid-beta is modulated via the amyloidogenic pathway, which plays a crucial role in neuroinflammation. During ischemic conditions, the activity of the anti-inflammatory non-amyloidogenic pathway decreases, thus increasing the activity of amyloidogenic pathway. The soluble alpha form of APP (sAPPα), formed via the non-amyloidogenic pathway, exhibits neuroprotective effects against neurological diseases. sAPPα is thought to have a modulatory effect on several cell survival pathways, including its ability to inhibit the phosphoinositide 3-kinases (PI3K) pathway, thereby inhibiting the inflammatory response. The APP derivative, APP96-110, could act as a functional substitute for native sAPPα. Herein, we investigated whether APP96-110 has neuroprotective effects against neuroinflammation and damage following cerebral ischemic stroke. Treatment with diluted APP96-110 (0.005 mg/kg) in mice after 30 min of transient middle cerebral artery occlusion (tMCAO) showed improved motor function and reduced expression of the inflammatory marker CD86. APP96-110 decreased the infarct size and induced an anti-inflammatory response by inhibiting the PI3K pathway. These results suggest that the treatment of APP96-110 is efficacious in reducing neuroinflammation and infarct size in ischemic stroke.
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Affiliation(s)
- Renée Kosonen
- Department of Anatomy, Yonsei University College of Medicine, Seoul, 03722, South Korea
- Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, South Korea
| | - Ji Young Chang
- Department of Anatomy, Yonsei University College of Medicine, Seoul, 03722, South Korea
- Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, South Korea
| | - Seowoo Lee
- Department of Anatomy, Yonsei University College of Medicine, Seoul, 03722, South Korea
- Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, South Korea
| | - Jiwon Kim
- Department of Anatomy, Yonsei University College of Medicine, Seoul, 03722, South Korea
- Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, South Korea
| | - Jong Youl Kim
- Department of Anatomy, Yonsei University College of Medicine, Seoul, 03722, South Korea
| | - Jong Eun Lee
- Department of Anatomy, Yonsei University College of Medicine, Seoul, 03722, South Korea.
- Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, South Korea.
- Brain Research Institute, Yonsei University College of Medicine, Seoul, 03722, South Korea.
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Zhang H, Liu J, Bingham D, Orr A, Kawabori M, Kim JY, Zheng Z, Lam TI, Massa SM, Swanson RA, Yenari MA. Use of Botulinum Toxin for Limb Immobilization for Rehabilitation in Rats with Experimental Stroke. Biomolecules 2023; 13:512. [PMID: 36979446 PMCID: PMC10046338 DOI: 10.3390/biom13030512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 03/15/2023] Open
Abstract
Motor rehabilitation strategies after unilateral stroke suggest that the immobilization of the healthy, unimpaired limb can promote the functional recovery of a paretic limb. In rodents, this has been modeled using casts, harnesses, and other means of restricting the use of the non-paretic forelimb in models of experimental stroke. Here, we evaluated an alternative approach, using botulinum toxin injections to limit the function of the non-paretic forelimb. Adult male rats were subjected to permanent ligation of the left distal middle cerebral artery, resulting in right forelimb paresis. The rats were then subjected to: (1) no treatment; (2) botulinum toxin injections 1 day post stroke; or (3) cast placement 5 days post stroke. Casts were removed after 5 weeks, while the botulinum toxin injection effectively immobilized subjects for approximately the same duration. Rats with bilateral forelimb impairment due to the stroke plus casting or botulinum injections were still able to feed and groom normally. Both immobilization groups showed modest recovery following the stroke compared to those that did not receive immobilization, but the casting approach led to unacceptable levels of animal stress. The botulinum toxin approach to limb immobilization had both advantages and disadvantages over traditional physical limb immobilization. The major advantage was that it was far less stress-inducing to the subject animals and appeared to be well tolerated. A disadvantage was that the paresis took roughly 10 weeks to fully resolve, and any degree of residual paresis could confound the interpretation of the behavioral assessments.
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Affiliation(s)
- Hongxia Zhang
- Department of Neurological Surgery, University of California, San Francisco, CA 94143, USA
- San Francisco Veterans Affairs Medical Center, San Francisco, CA 94121, USA
| | - Jialing Liu
- Department of Neurological Surgery, University of California, San Francisco, CA 94143, USA
- San Francisco Veterans Affairs Medical Center, San Francisco, CA 94121, USA
| | - Deborah Bingham
- Department of Neurological Surgery, University of California, San Francisco, CA 94143, USA
- San Francisco Veterans Affairs Medical Center, San Francisco, CA 94121, USA
| | - Adrienne Orr
- San Francisco Veterans Affairs Medical Center, San Francisco, CA 94121, USA
- Department of Neurology, University of California, San Francisco, CA 94143, USA
| | - Masahito Kawabori
- San Francisco Veterans Affairs Medical Center, San Francisco, CA 94121, USA
- Department of Neurology, University of California, San Francisco, CA 94143, USA
- Department of Neurosurgery, Hokkaido University, Sapporo 060-0808, Japan
| | - Jong Youl Kim
- San Francisco Veterans Affairs Medical Center, San Francisco, CA 94121, USA
- Department of Neurology, University of California, San Francisco, CA 94143, USA
- Department of Anatomy, Yonsei University, Seoul 03722, Republic of Korea
| | - Zhen Zheng
- San Francisco Veterans Affairs Medical Center, San Francisco, CA 94121, USA
- Department of Neurology, University of California, San Francisco, CA 94143, USA
| | - Tina I. Lam
- San Francisco Veterans Affairs Medical Center, San Francisco, CA 94121, USA
- Department of Neurology, University of California, San Francisco, CA 94143, USA
| | - Stephen M. Massa
- San Francisco Veterans Affairs Medical Center, San Francisco, CA 94121, USA
- Department of Neurology, University of California, San Francisco, CA 94143, USA
| | - Raymond A. Swanson
- San Francisco Veterans Affairs Medical Center, San Francisco, CA 94121, USA
- Department of Neurology, University of California, San Francisco, CA 94143, USA
| | - Midori A. Yenari
- San Francisco Veterans Affairs Medical Center, San Francisco, CA 94121, USA
- Department of Neurology, University of California, San Francisco, CA 94143, USA
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Abstract
Therapeutic hypothermia has shown promise as a means to improving neurological outcomes at several neurological conditions. At the clinical level, it has been shown to improve outcomes in comatose survivors of cardiac arrest and in neonatal hypoxic ischemic encephalopathy, but has yet to be convincingly demonstrated in stroke. While numerous preclinical studies have shown benefit in stroke models, translating this to the clinical level has proven challenging. Major obstacles include cooling patients with typical stroke who are awake and breathing spontaneously but often have significant comorbidities. Solutions around these problems include selective brain cooling and cooling to lesser depths or avoiding hyperthermia. This review will cover the mechanisms of protection by therapeutic hypothermia, as well as recent progress made in selective brain cooling and the neuroprotective effects of only slightly lowering brain temperature. Therapeutic hypothermia for stroke has been shown to be feasible, but has yet to be definitively proven effective. There is clearly much work to be undertaken in this area.
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Affiliation(s)
- Je Sung You
- Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Jong Youl Kim
- Department of Anatomy, Yonsei University College of Medicine, Seoul, South Korea
| | - Midori A. Yenari
- Department of Neurology, The San Francisco Veterans Affairs Medical Center, University of California, San Francisco, San Francisco, CA, United States
- *Correspondence: Midori A. Yenari
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11
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Kim DY, Baik SH, Jung C, Kim JY, Han SG, Kim BJ, Kang J, Bae HJ, Kim JH. Predictors and Impact of Sulcal SAH after Mechanical Thrombectomy in Patients with Isolated M2 Occlusion. AJNR Am J Neuroradiol 2022; 43:1292-1298. [PMID: 35902120 PMCID: PMC9451639 DOI: 10.3174/ajnr.a7594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/17/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND PURPOSE Data on SAH after M2 mechanical thrombectomy are limited. We aimed to determine the prevalence of sulcal SAH after mechanical thrombectomy for M2 occlusion, its associated predictors, and the resulting clinical outcome. MATERIALS AND METHODS The study retrospectively reviewed the data of patients with acute ischemic stroke who underwent mechanical thrombectomy for isolated M2 occlusion. The patients were divided into 2 groups according to the presence of sulcal SAH after M2 mechanical thrombectomy. Angiographic and clinical outcomes were compared. Multivariable analysis was performed to identify independent predictors of sulcal SAH and unfavorable outcome (90-day mRS, 3-6). RESULTS Of the 209 enrolled patients, sulcal SAH was observed in 33 (15.8%) patients. The sulcal SAH group showed a higher rate of distal M2 occlusion (69.7% versus 22.7%), a higher of rate of superior division occlusion (63.6% versus 43.8%), and a higher M2 angulation (median, 128° versus 106°) than the non-sulcal SAH group. Of the 33 sulcal SAH cases, 23 (66.7%) were covert without visible intraprocedural contrast extravasation. Distal M2 occlusion (OR, 12.04; 95% CI, 4.56-35.67; P < .001), superior division (OR, 3.83; 95% CI, 1.43-11.26; P = .010), M2 angulation (OR, 1.02; 95% CI, 1.01-1.04; P < .001), and the number of passes (OR, 1.58; 95% CI, 1.22-2.09; P < .001) were independent predictors of sulcal SAH. However, covert sulcal SAH was not associated with an unfavorable outcome (P = .830). CONCLUSIONS After mechanical thrombectomy for M2 occlusion, sulcal SAH was not uncommon and occurred more frequently with distal M2 occlusion, superior division, acute M2 angulation, and multiple thrombectomy passes (≥3). The impact of covert sulcal SAH was mostly benign and was not associated with an unfavorable outcome.
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Affiliation(s)
- D Y Kim
- From the Departments of Radiology (D.Y.K., S.H.B., C.J., J.H.K.)
- Neurology (D.Y.K, J.Y.K, S.-G.H., B.J.K, J.K., H-.J.B), Seoul National University Bundang Hospital, Seongnam, South Korea
| | - S H Baik
- From the Departments of Radiology (D.Y.K., S.H.B., C.J., J.H.K.)
| | - C Jung
- From the Departments of Radiology (D.Y.K., S.H.B., C.J., J.H.K.)
| | - J Y Kim
- Neurology (D.Y.K, J.Y.K, S.-G.H., B.J.K, J.K., H-.J.B), Seoul National University Bundang Hospital, Seongnam, South Korea
| | - S-G Han
- Neurology (D.Y.K, J.Y.K, S.-G.H., B.J.K, J.K., H-.J.B), Seoul National University Bundang Hospital, Seongnam, South Korea
| | - B J Kim
- Neurology (D.Y.K, J.Y.K, S.-G.H., B.J.K, J.K., H-.J.B), Seoul National University Bundang Hospital, Seongnam, South Korea
| | - J Kang
- Neurology (D.Y.K, J.Y.K, S.-G.H., B.J.K, J.K., H-.J.B), Seoul National University Bundang Hospital, Seongnam, South Korea
| | - H-J Bae
- Neurology (D.Y.K, J.Y.K, S.-G.H., B.J.K, J.K., H-.J.B), Seoul National University Bundang Hospital, Seongnam, South Korea
| | - J H Kim
- From the Departments of Radiology (D.Y.K., S.H.B., C.J., J.H.K.)
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12
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Yoo JY, Kwak HJ, Ha EJ, Min SK, Kim JY. Comparison of McGrath videolaryngoscope-assisted insertion versus standard blind technique for flexible laryngeal mask airway insertion in adults. Singapore Med J 2022; 63:342-344. [DOI: 10.11622/smedj.2022080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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13
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Kim JY, Kim J, Huang M, Kosonen R, Lee JE. CCR4 and CCR5 Involvement in Monocyte-Derived Macrophage Migration in Neuroinflammation. Front Immunol 2022; 13:876033. [PMID: 35634277 PMCID: PMC9133420 DOI: 10.3389/fimmu.2022.876033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Abstract
Microglia, resident macrophages in the brain, play major roles in neuroinflammation after an acute many neurological diseases, including stroke. Our recent animal stroke model showed that interleukin (IL)-4 and IL-13 released by microglia are converted into monocyte-derived macrophages. However, the correlation with the migration mechanism of these cells is still unclear. This study aimed to clarify the effect of these cells on their migration and to identify potential targets that influence neuroinflammatory conditions. Inflammatory conditions were induced by lipopolysaccharide (LPS) treatment in in vitro and in vivo models. Cell migration was observed using transwell assay, and target chemokines were screened using the proteome profiler array in the in vitro model. Intravital, IVIS, and CLARITY imaging were used in the in vivo model. After LPS (1 ng/ml) treatment in BV2 (microglia cell line) and J774 (monocyte/macrophage cell line) cells, BV2 migration was approximately two-fold more enhanced compared to J774 migration. Overall, six types of chemokine C-C motif ligands (CCLs) were detected from the BV2 conditioned medium with LPS. These CCLs were related to C-C motif receptor (CCR)4 and CCR5. In the in vivo model, CCR4 and CCR5 antagonist significantly inhibited the migration of monocyte-derived macrophages to brain tissue following LPS (5 µg) treatment. In conclusion, the chemokines released by microglia may influence migration of monocyte-derived macrophages in necroinflammation conditions inducted by microglial activation. CCR4 and CCR5 expressed on monocyte-derived macrophages interacted with these chemokines and induced migration. Therefore, CCR4 and CCR5 may be explored as new therapeutic targets for neuroinflammation.
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Affiliation(s)
- Jong Youl Kim
- Department of Anatomy, Yonsei University College of Medicine, Seoul, South Korea
| | - Jiwon Kim
- Department of Anatomy, Yonsei University College of Medicine, Seoul, South Korea
- Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, South Korea
| | - Meiying Huang
- Department of Anatomy, Yonsei University College of Medicine, Seoul, South Korea
- Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, South Korea
| | - Renée Kosonen
- Department of Anatomy, Yonsei University College of Medicine, Seoul, South Korea
- Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, South Korea
| | - Jong Eun Lee
- Department of Anatomy, Yonsei University College of Medicine, Seoul, South Korea
- Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, South Korea
- Brain Research Institute, Yonsei University College of Medicine, Seoul, South Korea
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14
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Badreddine J, Lee MH, Mishra K, Pope R, Kim JY, Hong SH, Gupta S, Song JM, Shin JI, Ghayda RA. Continuing perioperative estrogen therapy does not increase venous thromboembolic events in transgender patients: a systematic review and meta-analysis. Eur Rev Med Pharmacol Sci 2022; 26:2511-2517. [PMID: 35442466 DOI: 10.26355/eurrev_202204_28488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The aim of this study is to compare the risk of venous thromboembolic events (VTE) between patients suspending and continuing estrogen therapy perioperatively, in male to female gender-affirming surgery (vaginoplasty). MATERIALS AND METHODS The authors conducted a systematic review and meta-analysis of existing research on male to female gender-affirming study, which compared the risk of VTE among the usage of estrogen perioperatively. RESULTS A total of 209 studies were identified as potentially eligible among PubMed, Embase, and Cochrane library databases. Among the studies, 191 studies were excluded due to their abstract inappropriateness. Out of the remaining 18 studies, only 3 articles were eligible and were finally included. Meta-analysis was performed and showed odds ratio of 0.77 (95% CI: 0.04, 14.01). CONCLUSIONS Perioperative estrogen therapy does not increase VTE risk on male to female gender-affirming surgery. Therefore, estrogen therapy may be continued perioperatively in vaginoplasty. More prospective studies are needed.
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Affiliation(s)
- J Badreddine
- Urology Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA.
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15
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Choi MJ, Yang JW, Lee S, Kim JY, Oh JW, Lee J, Stubbs B, Lee KH, Koyanagi A, Hong SH, Ghayda RA, Hwang J, Dragioti E, Jacob L, Carvalho AF, Radua J, Thompson T, Smith L, Fornaro M, Stickley A, Bettac EL, Han YJ, Kronbichler A, Yon DK, Lee SW, Shin JI, Lee E, Solmi M. Suicide associated with COVID-19 infection: an immunological point of view. Eur Rev Med Pharmacol Sci 2021; 25:6397-6407. [PMID: 34730221 DOI: 10.26355/eurrev_202110_27013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Coronavirus disease 2019 (COVID-19) is a pandemic and leading cause of death. Beyond the deaths directly caused by the virus and the suicides related to the psychological response to the dramatic changes as socioeconomic related to the pandemic, there might also be suicides related to the inflammatory responses of the infection. Infection induces inflammation as a cytokine storm, and there is an increasing number of studies that report a relationship between infection and suicide. MATERIALS AND METHODS We searched the World Health Organization status report and the PubMed database for keywords (COVID-19, suicide, infection, inflammation, cytokines), and reviewed five cytokine pathways between suicide and inflammation using two meta-analyses and two observational studies starting from November 31, 2020, focusing on the relationship between suicide and inflammation by infection. First, we discussed existing evidence explaining the relationship between suicidal behaviors and inflammation. Second, we summarized the inflammatory features found in COVID-19 patients. Finally, we highlight the potential for these factors to affect the risk of suicide in COVID-19 patients. RESULTS Patients infected with COVID-19 have high amounts of IL-1β, IFN-γ, IP10, and MCP1, which may lead to Th1 cell response activation. Also, Th2 cytokines (e.g., IL-4 and IL-10) were increased in COVID-19 infection. In COVID-19 patients, neurological conditions, like headache, dizziness, ataxia, seizures, and others have been observed. CONCLUSIONS COVID-19 pandemic can serve as a significant environmental factor contributing directly to increased suicide risk; the role of inflammation by an infection should not be overlooked.
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Affiliation(s)
- M J Choi
- Yonsei University College of Medicine, Seoul, Republic of Korea.
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16
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Jeong DY, Lee J, Kim JY, Lee KH, Li H, Lee JY, Jeong GH, Yoon S, Park EL, Hong SH, Kang JW, Song TJ, Leyhe T, Eisenhut M, Kronbichler A, Smith L, Solmi M, Stubbs B, Koyanagi A, Jacob L, Stickley A, Thompson T, Dragioti E, Oh H, Brunoni AR, Carvalho AF, Kim MS, Yon DK, Lee SW, Yang JM, Ghayda RA, Shin JI, Fusar-Poli P. Empirical assessment of biases in cerebrospinal fluid biomarkers of Alzheimer's disease: an umbrella review and re-analysis of data from meta-analyses. Eur Rev Med Pharmacol Sci 2021; 25:1536-1547. [PMID: 33629323 DOI: 10.26355/eurrev_202102_24862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Alzheimer's disease (AD) is a leading cause of years lived with disability in older age, and several cerebrospinal fluid (CSF) markers have been proposed in individual meta-analyses to be associated with AD but field-wide evaluation and scrutiny of the literature is not available. MATERIALS AND METHODS We performed an umbrella review for the reported associations between CSF biomarkers and AD. Data from available meta-analyses were reanalyzed using both random and fixed effects models. We also estimated between-study heterogeneity, small-study effects, excess significance, and prediction interval. RESULTS A total of 38 meta-analyses on CSF markers from 11 eligible articles were identified and reanalyzed. In 14 (36%) of the meta-analyses, the summary estimate and the results of the largest study showed non-concordant results in terms of statistical significance. Large heterogeneity (I2≥75%) was observed in 73% and small-study effects under Egger's test were shown in 28% of CSF biomarkers. CONCLUSIONS Our results suggest that there is an excess of statistically significant results and significant biases in the literature of CSF biomarkers for AD. Therefore, the results of CSF biomarkers should be interpreted with caution.
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Affiliation(s)
- D Y Jeong
- Yonsei University College of Medicine, Seoul, Republic of Korea.
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17
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Park GR, Kim HS, Kim YT, Chung HJ, Ha SJ, Kim DW, Kang DR, Kim JY, Lee MY, Lee JY. Waist circumference and the risk of lumbar and femur fractures: a nationwide population-based cohort study. Eur Rev Med Pharmacol Sci 2021; 25:1198-1205. [PMID: 33629289 DOI: 10.26355/eurrev_202102_24822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Although obesity is known to have an influence on fracture, the relationship between lumbar and femur fractures and weight or waist circumference is controversial. We investigated the incidence of fracture with regards to waist circumference using the customised database of the Korean National Health Insurance Service (NHIS). Among 8,922,940 adults who participated at least twice in the NHIS National Health Check-up Program in South Korea between 2009 and 2011, 1,556,751 subjects (780,074 men and 776,677 women) were extracted. Over a mean follow-up of 6.5 years, multivariate-adjusted logistic regression analysis demonstrated that higher waist circumference was associated with an increased risk of femur fractures in both males and females. Moreover, the incidence of lumbar fractures was also positively associated with an increased waist circumference in males and females. An increased waist circumference showed a positive linear relationship with the risk of lumbar and femur fractures in both males and females.
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Affiliation(s)
- G R Park
- Department of Internal Medicine, Yonsei Wonju College of Medicine, Wonju, Republic of Korea.
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18
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Sim AY, Barua S, Kim JY, Lee YH, Lee JE. Role of DPP-4 and SGLT2 Inhibitors Connected to Alzheimer Disease in Type 2 Diabetes Mellitus. Front Neurosci 2021; 15:708547. [PMID: 34489627 PMCID: PMC8417940 DOI: 10.3389/fnins.2021.708547] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 07/12/2021] [Indexed: 12/12/2022] Open
Abstract
Alzheimer's disease (AD) is characterized by memory loss and cognitive decline. Additionally, abnormal extracellular amyloid plaques accumulation and nerve damage caused by intracellular neurofibrillary tangles, and tau protein are characteristic of AD. Furthermore, AD is associated with oxidative stress, impaired mitochondrial structure and function, denormalization, and inflammatory responses. Recently, besides the amyloid β hypothesis, another hypothesis linking AD to systemic diseases has been put forth by multiple studies as a probable cause for AD. Particularly, type 2 diabetes mellitus (T2DM) and its features, including hyperinsulinemia, and chronic hyperglycemia with an inflammatory response, have been shown to be closely related to AD through insulin resistance. The brain cannot synthesize or store glucose, but it does require glucose, and the use of glucose in the brain is higher than that in any other organ in the mammalian body. One of the therapeutic drugs for T2DM, dipeptidyl peptidase-4 (DPP-4) inhibitor, suppresses the degradation of incretins, glucagon-like peptides and glucose-dependent insulinotropic peptide. Sodium-glucose cotransporter 2 (SGLT2) inhibitors, recently used in T2DM treatment, have a unique mechanism of action via inhibition of renal glucose reabsorption, and which is different from the mechanisms of previously used medications. This manuscript reviews the pathophysiological relationship between the two diseases, AD and T2DM, and the pharmacological effects of therapeutic T2DM drugs, especially DPP-4 inhibitors, and SGLT2 inhibitors.
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Affiliation(s)
- A Young Sim
- Department of Anatomy, Yonsei University College of Medicine, Seoul, South Korea.,Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Sumit Barua
- Department of Anatomy, Yonsei University College of Medicine, Seoul, South Korea
| | - Jong Youl Kim
- Department of Anatomy, Yonsei University College of Medicine, Seoul, South Korea
| | - Yong-Ho Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Jong Eun Lee
- Department of Anatomy, Yonsei University College of Medicine, Seoul, South Korea.,Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, South Korea.,Brain Research Institute, Yonsei University College of Medicine, Seoul, South Korea
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19
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Baik SH, Jung C, Kim JY, Shin DW, Kim BJ, Kang J, Bae HJ, Kim JH. Local Intra-arterial Thrombolysis during Mechanical Thrombectomy for Refractory Large-Vessel Occlusion: Adjunctive Chemical Enhancer of Thrombectomy. AJNR Am J Neuroradiol 2021; 42:1986-1992. [PMID: 34475193 DOI: 10.3174/ajnr.a7264] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/11/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Data on adjunctive intra-arterial thrombolysis during mechanical thrombectomy for refractory thrombus are sparse. The aim of this study was to evaluate the efficacy and safety of local intra-arterial urokinase as an adjunct to mechanical thrombectomy for refractory large-vessel occlusion. MATERIALS AND METHODS We retrospectively evaluated patients with acute ischemic stroke who underwent mechanical thrombectomy for anterior circulation large-vessel occlusion between January 2016 and December 2019. Patients were divided into 2 groups based on the use of intra-arterial urokinase as an adjunctive therapy during mechanical thrombectomy for refractory thrombus: the urokinase and nonurokinase groups. Herein, refractory thrombus was defined as the target occlusion with minimal reperfusion (TICI 0 or 1) despite >3 attempts with conventional mechanical thrombectomy. The baseline characteristics, procedural outcomes, and clinical outcome were compared between the 2 groups. RESULTS One hundred fourteen cases of refractory thrombus were identified. A total of 45 and 69 patients were in the urokinase and the nonurokinase groups, respectively. The urokinase group compared with the nonurokinase group showed a higher rate of successful reperfusion (82.2% versus 63.8%, P = .034), with lower procedural times (54 versus 69 minutes, P = .137). The rates of good clinical outcome, distal embolism, and symptomatic intracranial hemorrhage were similar between the 2 groups. The use of intra-arterial urokinase (OR = 3.682; 95% CI, 1.156-11.730; P = .027) was an independent predictor of successful reperfusion. CONCLUSIONS The use of local intra-arterial urokinase as an adjunct to mechanical thrombectomy may be an effective and safe method that provides better recanalization than the conventional mechanical thrombectomy for refractory thrombus in patients with embolic large-vessel occlusion.
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Affiliation(s)
- S H Baik
- From the Department of Radiology (S.H.B., C.J., D.-W.S., J.H.K.,)
| | - C Jung
- From the Department of Radiology (S.H.B., C.J., D.-W.S., J.H.K.,)
| | - J Y Kim
- Department of Neurology (J.Y.K., B.J.K., J.K., H.-J.B.), Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - D-W Shin
- From the Department of Radiology (S.H.B., C.J., D.-W.S., J.H.K.,)
| | - B J Kim
- Department of Neurology (J.Y.K., B.J.K., J.K., H.-J.B.), Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - J Kang
- Department of Neurology (J.Y.K., B.J.K., J.K., H.-J.B.), Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - H-J Bae
- Department of Neurology (J.Y.K., B.J.K., J.K., H.-J.B.), Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - J H Kim
- From the Department of Radiology (S.H.B., C.J., D.-W.S., J.H.K.,)
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20
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Kim JY, Hwang D, Jang M, Rhee CS, Han DH. Clinical effectiveness of house dust mite immunotherapy in mono- versus poly-sensitised patients with allergic rhinitis: a systematic review and meta-analysis. Rhinology 2021; 59:352-359. [PMID: 34180463 DOI: 10.4193/rhin20.588] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Selecting an appropriate allergen-specific immunotherapy (AIT) regimen for polysensitised allergic rhinitis (AR) patients is challenging for clinicians. Although previous studies showed comparable effectiveness of single-allergen AIT with house dust mite (HDM) extract between monosensitised and polysensitised AR patients, there is no systematic review and meta-analysis demonstrating the comparable effectiveness of HDM AIT. In this meta-analysis, we analysed nine studies to compare the clinical effectiveness of HDM AIT. The primary outcome was nasal symptom score and secondary outcomes were medication and quality of life scores. The changes in nasal symptom score after HDM AIT did not significantly differ between monosensitised and polysensitised patients. The clinical effectiveness of HDM AIT regarding medication and quality of life score was not significantly different between monosensitised and polysensitised patients). In conclusion, single-allergen AIT with HDM extract showed comparable clinical effectiveness between polysensitised and monosensitised patients with AR.
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Affiliation(s)
- J Y Kim
- Department of Otorhinolaryngology "Head and Neck Surgery, Ilsan Hospital, Dongguk University, Goyang, Gyeonggi, Korea 2 Interdisciplinary Program of Medical Informatics, Seoul National University College of Medicine, Seoul, Korea
| | - D Hwang
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - M Jang
- Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Korea
| | - C S Rhee
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul, Korea; Graduate School of Immunology, Seoul National University College of Medicine, Seoul, Korea; Institute of Allergy and Clinical Immunology, and Sensory Organ Research Institute, Seoul National University Biomedical Research Center, Seoul, Korea
| | - D H Han
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul, Korea
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21
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Barua S, Sim AY, Kim JY, Shin I, Lee JE. Maintenance of the Neuroprotective Function of the Amino Group Blocked Fluorescence-Agmatine. Neurochem Res 2021; 46:1933-1940. [PMID: 33914233 PMCID: PMC8254702 DOI: 10.1007/s11064-021-03319-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 02/21/2021] [Accepted: 04/02/2021] [Indexed: 11/23/2022]
Abstract
Agmatine, an endogenous derivative of arginine, has been found to be effective in treating idiopathic pain, convulsion, stress-mediated behavior, and attenuate the withdrawal symptoms of drugs like morphine. In the early stages of ischemic brain injury in animals, exogenous agmatine treatment was found to be neuroprotective. Agmatine is also considered as a putative neurotransmitter and is still an experimental drug. Chemically, agmatine is called agmatine 1-(4-aminobutyl guanidine). Crystallographic study data show that positively-charged guanidine can bind to the protein containing Gly and Asp residues, and the amino group can interact with the complimentary sites of Glu and Ser. In this study, we blocked the amino end of the agmatine by conjugating it with FITC, but the guanidine end was unchanged. We compared the neuroprotective function of the agmatine and agmatine-FITC by treating them in neurons after excitotoxic stimulation. We found that even the amino end blocked neuronal viability in the excitotoxic condition, by NMDA treatment for 1 h, was increased by agmatine-FITC, which was similar to that of agmatine. We also found that the agmatine-FITC treatment reduced the expression of nitric oxide production in NMDA-treated cells. This study suggests that even if the amino end of agmatine is blocked, it can perform its neuroprotective function.
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Affiliation(s)
- Sumit Barua
- Department of Anatomy, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-gu, Seoul, 03722 Korea
| | - A Young Sim
- Department of Anatomy, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-gu, Seoul, 03722 Korea
- BK21 Plus Project for Medical Sciences, Yonsei University College of Medicine, Seoul, 03722 Korea
| | - Jong Youl Kim
- Department of Anatomy, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-gu, Seoul, 03722 Korea
| | - Injae Shin
- Department of Chemistry, Yonsei University, Seoul, 03722 Korea
| | - Jong Eun Lee
- Department of Anatomy, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-gu, Seoul, 03722 Korea
- BK21 Plus Project for Medical Sciences, Yonsei University College of Medicine, Seoul, 03722 Korea
- Brain Research Institute, Yonsei University College of Medicine, Seoul, 03722 Korea
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22
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Hong SN, Kim JK, Kim JA, Cha H, Kim JY, Lim HS, Eun KM, Kim DW. Viral stimulation modulates endotype-related ACE2 expression in eosinophilic chronic rhinosinusitis. Rhinology 2021; 59:460-469. [PMID: 34282808 DOI: 10.4193/rhin21.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Angiotensin-converting enzyme 2 (ACE2), a receptor targeted by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is highly expressed in the nasal mucosa. Chronic rhinosinusitis (CRS) shows diverse endotypes and is aggravated by viral infection. Whether viral stimulation and CRS endotype influence ACE2 expression remains unclear. We investigated the expression of ACE2 and the transmembrane protease, serine 2 (TMPRSS2), which mediate the entry of SARS-CoV-2 into cells, and assessed polyinosinic:polycytidylic acid (poly[I:C])-induced changes based on CRS endotype. METHODOLOGY ACE2 and TMPRSS2 expression was evaluated based on CRS phenotype, endotype, and tissue type. Correlations between ACE2/TMPRSS2 expression and inflammatory mediators in nasal polyps (NP) were examined. Air-liquid interface culture experiments were performed to assess the effects of major cytokines or poly(I:C) stimulation on ACE2/TMPRSS2 expression in primary epithelial cells from healthy nasal mucosa, eosinophilic NP (ENP), and non-eosinophilic NP (NENP). RESULTS In primary nasal epithelial cells, interleukin (IL)-13 decreased ACE2 expression but increased TMPRSS2. Eosinophilic CRS showed lower ACE2 expression than non-eosinophilic CRS, regardless of CRS phenotype. CRS endotype was an independent factor associated with ACE2/TMPRSS2 expression in NP. Serum and tissue eosinophilic marker levels were inversely correlated with ACE2 expression, whereas tissue neutrophilic marker levels and ACE2 expression were positively correlated in NP. ACE2 expression was suppressed in ENP tissues; however, a combination of poly(I:C) and IL-13 induced ACE2/TMPRSS2 upregulation in ENP. CONCLUSIONS ENP tissues have lower ACE2 expression than NENP; however, viral stimulation promotes ACE2/TMPRSS2 upregulation in ENP.
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Affiliation(s)
- S-N Hong
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Republic of Korea.,Sensory Organ Research Institute, Seoul National University Medical Research Center
| | - J K Kim
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Republic of Korea.,Sensory Organ Research Institute, Seoul National University Medical Research Center
| | - J-A Kim
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Republic of Korea.,Sensory Organ Research Institute, Seoul National University Medical Research Center
| | - H Cha
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Republic of Korea.,Sensory Organ Research Institute, Seoul National University Medical Research Center
| | - J Y Kim
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Republic of Korea.,Sensory Organ Research Institute, Seoul National University Medical Research Center
| | - H-S Lim
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Republic of Korea.,Sensory Organ Research Institute, Seoul National University Medical Research Center
| | - K M Eun
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Republic of Korea.,Sensory Organ Research Institute, Seoul National University Medical Research Center
| | - D W Kim
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Republic of Korea.,Sensory Organ Research Institute, Seoul National University Medical Research Center
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23
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Kosonen R, Barua S, Kim JY, Lee JE. Role of agmatine in the application of neural progenitor cell in central nervous system diseases: therapeutic potentials and effects. Anat Cell Biol 2021; 54:143-151. [PMID: 34162764 PMCID: PMC8225474 DOI: 10.5115/acb.21.089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 12/01/2022] Open
Abstract
Agmatine, the primary decarboxylation product of L-arginine, generated from arginine decarboxylase. Since the discovery of agmatine in the mammalian brain in the 1990s, an increasing number of agmatine-mediated effects have been discovered, demonstrating the benefits of agmatine on ischemic strokes, traumatic brain injury and numerous psychological disorders such as depression, anxiety, and stress. Agmatine also has cellular protective effects and contributes to cell proliferation and differentiation in the central nervous system (CNS). Neural progenitor cells are an important component in the recovery and repair of many neurological disorders due to their ability to differentiate into functional adult neurons. Recent data has revealed that agmatine can regulate and increase proliferation and the fate of progenitor cells in the adult hippocampus. This review aims to summarise and discuss the role of agmatine in the CNS; specifically, the effects and relationship between agmatine and neural progenitor cells and how these ideas can be applied to potential therapeutic application.
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Affiliation(s)
- Renée Kosonen
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Korea.,Brain Korea 21 Plus Project for Medical Science, Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Sumit Barua
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Youl Kim
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Eun Lee
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Korea.,Brain Korea 21 Plus Project for Medical Science, Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea
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24
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Abou Ghayda R, Duck-Young Park D, Lee JY, Kim JY, Lee KH, Hong SH, Yang JW, Kim JS, Jeong GH, Kronbichler A, Koyanagi A, Jacob L, Oh H, Li H, Yang JM, Kim MS, Lee SW, Yon DK, Shin JI, Smith L. Body mass index and mortality in patients with cardiovascular disease: an umbrella review of meta-analyses. Eur Rev Med Pharmacol Sci 2021; 25:273-286. [PMID: 33506916 DOI: 10.26355/eurrev_202101_24393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Although many previous meta-analyses of epidemiological studies have demonstrated a relationship between body mass index (BMI) and mortality, inconsistent findings among cardiovascular disease patients have been observed. Thus, we performed an umbrella review to understand the strength of evidence and validity of claimed associations between BMI and mortality in patients with cardiovascular diseases. MATERIALS AND METHODS We comprehensively re-analyzed the data of meta-analyses of observational studies and randomized controlled trials on associations between BMI and mortality among patients with cardiovascular diseases. We also assessed the strength of evidence of the re-analyzed outcomes, which were determined from the criteria including statistical significance of the p-value of random-effects, as well as fixed-effects meta-analyses, small-study effects, between-study heterogeneity, and a 95% prediction interval. RESULTS We ran comprehensive re-analysis of the data from the 21 selected studies, which contained a total of 108 meta-analyses; 23 were graded as convincing evidence and 12 were suggestive, 42 were weak, and 23 were non-significant. CONCLUSIONS Underweight increased mortality in acute coronary syndrome (ACS), heart failure, and after therapeutic intervention for patients with cardiovascular diseases. Overweight, on the other hand decreased mortality in patient's ACS, atrial fibrillation, and heart failure with convincing evidence.
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Affiliation(s)
- R Abou Ghayda
- Urology Institute, University Hospital System, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
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25
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Park S, Lee EJ, Kim JY, Bae YJ, Oh SH. Blood high mobility group box 1 levels are not a suitable biomarker for disease activity or severity in nonsegmental vitiligo. Clin Exp Dermatol 2021; 46:1597-1599. [PMID: 34080225 DOI: 10.1111/ced.14782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 05/20/2021] [Accepted: 06/02/2021] [Indexed: 11/27/2022]
Affiliation(s)
- S Park
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - E J Lee
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - J Y Kim
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Y J Bae
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - S H Oh
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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26
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Park JW, Kwon OS, Shim JM, Yu HT, Kim TH, Uhm JS, Kim JY, Choi JI, Joung BY, Lee MH, Kim YH, Pak HN. Artificial intelligence-predicted poor responders to catheter ablation for atrial fibrillation. Europace 2021. [DOI: 10.1093/europace/euab116.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Although atrial fibrillation (AF) catheter ablation is effective for rhythm control, in some patients it is hard to maintain sinus rhythm in spite of repeated AF catheter ablation (AFCA) procedures and anti-arrhythmic drugs (AADs). We explored the pre-procedural predictors for poor responders to AFCA and tested whether artificial intelligence (AI) assists the prediction of poor responders in the independent cohort by determining the invasive parameters.
Methods
Among 1,214 patients who underwent AFCA and regular rhythm follow-up for 56.2 ± 33.8 months (59 ± 11 years, 73.5% male, 68.6% paroxysmal AF), we differentiated 92 poor responders defined as those with sustained AF despite repeat AFCAs, AADs, or electrical cardioversion. Using the Youden index, we identified advanced LA remodeling with lower LA voltage under 1.109mV. AI model, which was derived from development cohort using medical record, was applied to predict LA voltage <1.109mV in the independent cohort (n = 634, poor responders = 24) using a grad-cam score.
Results
The patients with lower LA voltage under 1.109mV showed significantly poorer rhythm outcomes (Log-rank p < 0.001). We determined invasive parameter LA voltage by using the multiple variables (age, female sex, AF type, CHA2DS2VASc score, LA dimension, E/em, hemoglobin, PR interval) and achieved relatively good prediction power of AI for LA voltage <1.109mV (AUC = 0.734, sensitivity 0.729, specificity 0.643) in the test cohort. In the independent cohort, the AI model showed good discrimination power for poor responders (AUC 0.751, p < 0.001) by estimating LA voltage, which is an invasive variable. The patients with predicted lower LA voltage (grad-cam score <0) showed poorer rhythm outcome after active rhythm control (Log-rank p < 0.001)
Conclusions
The patients with advanced atrial remodeling with low LA voltage, which can be predicted by an AI, showed significantly higher recurrence of AF after AFCA with AADs or cardioversion. AI may assist to select these poor responder patients before the AFCA procedure. Abstract Figure.
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Affiliation(s)
- JW Park
- Yonsei University Health system, Seoul, Korea (Republic of)
| | - OS Kwon
- Yonsei University Health system, Seoul, Korea (Republic of)
| | - JM Shim
- Korea University, Cardiovascular Center, Seoul, Korea (Republic of)
| | - HT Yu
- Yonsei University Health system, Seoul, Korea (Republic of)
| | - TH Kim
- Yonsei University Health system, Seoul, Korea (Republic of)
| | - JS Uhm
- Yonsei University Health system, Seoul, Korea (Republic of)
| | - JY Kim
- Yonsei University Health system, Seoul, Korea (Republic of)
| | - JI Choi
- Korea University, Cardiovascular Center, Seoul, Korea (Republic of)
| | - BY Joung
- Yonsei University Health system, Seoul, Korea (Republic of)
| | - MH Lee
- Yonsei University Health system, Seoul, Korea (Republic of)
| | - YH Kim
- Korea University, Cardiovascular Center, Seoul, Korea (Republic of)
| | - HN Pak
- Yonsei University Health system, Seoul, Korea (Republic of)
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27
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Seo J, An ES, Park T, Hwang SY, Kim GY, Song K, Noh WS, Kim JY, Choi GS, Choi M, Oh E, Watanabe K, Taniguchi T, Park JH, Jo YJ, Yeom HW, Choi SY, Shim JH, Kim JS. Tunable high-temperature itinerant antiferromagnetism in a van der Waals magnet. Nat Commun 2021; 12:2844. [PMID: 33990589 PMCID: PMC8121823 DOI: 10.1038/s41467-021-23122-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 04/13/2021] [Indexed: 11/29/2022] Open
Abstract
Discovery of two dimensional (2D) magnets, showing intrinsic ferromagnetic (FM) or antiferromagnetic (AFM) orders, has accelerated development of novel 2D spintronics, in which all the key components are made of van der Waals (vdW) materials and their heterostructures. High-performing and energy-efficient spin functionalities have been proposed, often relying on current-driven manipulation and detection of the spin states. In this regard, metallic vdW magnets are expected to have several advantages over the widely-studied insulating counterparts, but have not been much explored due to the lack of suitable materials. Here, we report tunable itinerant ferro- and antiferromagnetism in Co-doped Fe4GeTe2 utilizing the vdW interlayer coupling, extremely sensitive to the material composition. This leads to high TN antiferromagnetism of TN ~ 226 K in a bulk and ~210 K in 8 nm-thick nanoflakes, together with tunable magnetic anisotropy. The resulting spin configurations and orientations are sensitively controlled by doping, magnetic field, and thickness, which are effectively read out by electrical conduction. These findings manifest strong merits of metallic vdW magnets as an active component of vdW spintronic applications. Metallic van der Waals magnets have considerable technological promise, due to their ability to be strongly coupled with electronic currents and integrated in two dimensional heterostructures. Here, Seo et al. demonstrate highly tunable itinerant antiferromagnetism in a van der Waals magnet.
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Affiliation(s)
- Junho Seo
- Center for Artificial Low Dimensional Electronic Systems, Institute for Basic Science (IBS), Pohang, Korea.,Department of Physics, Pohang University of Science and Technology (POSTECH), Pohang, Korea
| | - Eun Su An
- Center for Artificial Low Dimensional Electronic Systems, Institute for Basic Science (IBS), Pohang, Korea.,Department of Physics, Pohang University of Science and Technology (POSTECH), Pohang, Korea
| | - Taesu Park
- Department of Chemistry, Pohang University of Science and Technology (POSTECH), Pohang, Korea
| | - Soo-Yoon Hwang
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), Pohang, Korea
| | - Gi-Yeop Kim
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), Pohang, Korea
| | - Kyung Song
- Materials Modeling and Characterization Department, KIMS, Changwon, Korea
| | - Woo-Suk Noh
- MPPC-CPM, Max Planck POSTECH/Korea Research Initiative, Pohang, Korea
| | - J Y Kim
- Center for Artificial Low Dimensional Electronic Systems, Institute for Basic Science (IBS), Pohang, Korea
| | - Gyu Seung Choi
- Center for Artificial Low Dimensional Electronic Systems, Institute for Basic Science (IBS), Pohang, Korea.,Department of Physics, Pohang University of Science and Technology (POSTECH), Pohang, Korea
| | - Minhyuk Choi
- Center for Artificial Low Dimensional Electronic Systems, Institute for Basic Science (IBS), Pohang, Korea.,Department of Physics, Pohang University of Science and Technology (POSTECH), Pohang, Korea
| | - Eunseok Oh
- Center for Artificial Low Dimensional Electronic Systems, Institute for Basic Science (IBS), Pohang, Korea.,Department of Physics, Pohang University of Science and Technology (POSTECH), Pohang, Korea
| | - Kenji Watanabe
- Research Center for Functional Materials, National Institute for Materials Science, Tsukuba, Japan
| | - Takashi Taniguchi
- International Center for Materials Nanoarchitectonics, National Institute for Materials Science, Tsukuba, Japan
| | - J -H Park
- Department of Physics, Pohang University of Science and Technology (POSTECH), Pohang, Korea.,MPPC-CPM, Max Planck POSTECH/Korea Research Initiative, Pohang, Korea
| | - Youn Jung Jo
- Department of Physics, Kyungpook National University, Daegu, Korea
| | - Han Woong Yeom
- Center for Artificial Low Dimensional Electronic Systems, Institute for Basic Science (IBS), Pohang, Korea.,Department of Physics, Pohang University of Science and Technology (POSTECH), Pohang, Korea
| | - Si-Young Choi
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), Pohang, Korea.
| | - Ji Hoon Shim
- Department of Physics, Pohang University of Science and Technology (POSTECH), Pohang, Korea. .,Department of Chemistry, Pohang University of Science and Technology (POSTECH), Pohang, Korea.
| | - Jun Sung Kim
- Center for Artificial Low Dimensional Electronic Systems, Institute for Basic Science (IBS), Pohang, Korea. .,Department of Physics, Pohang University of Science and Technology (POSTECH), Pohang, Korea.
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28
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Kim JY, Kim JH, Park J, Beom JH, Chung SP, You JS, Lee JE. Targeted Temperature Management at 36 °C Shows Therapeutic Effectiveness via Alteration of Microglial Activation and Polarization After Ischemic Stroke. Transl Stroke Res 2021; 13:132-141. [PMID: 33893993 DOI: 10.1007/s12975-021-00910-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 02/03/2021] [Accepted: 04/12/2021] [Indexed: 02/02/2023]
Abstract
Ischemic injury leads to cell death and inflammatory responses after stroke. Microglia especially play a crucial role in this brain inflammation. Targeted temperature management (TTM) at 33 °C has shown neuroprotective effects against many acute ischemic injuries. However, it has also shown some adverse effects in preclinical studies. Therefore, we explored the neuroprotective effect of TTM at 36 °C in the ischemic brain. To confirm the neuroprotective effects of hypothermia, mice were subjected to a permanent stroke and then treated with one of the TTM paradigms at 33 and 36 °C. For comparison of TTM at 33 and 36 °C, we examined neuronal cell death and inflammatory response, including activation and polarization of microglia in the ischemic brain. TTM at 33 and 36 °C showed neuroprotective effects in comparison with normal body temperature (NT) at 37.5 °C. Mice under TTM at 33 and 36 °C showed ~ 45-50% fewer TUNEL-positive cells than those under NT. In IVIS spectrum CT, the activation of microglia/macrophage in CX3CR1GFP mice reduced after TTM at 33 and 36 °C in comparison with that after NT on day 7 after ischemic stroke. The number of Tmem119-positive cells under TTM at 33 and 36 °C was ~ 45-50% lower than that in mice under NT. TTM at 33 and 36 °C also increased the ratio of CD206-/CD86-positive cells than the ratio of CD86-/CD206-positive cells by ~ 1.2-fold. Thus, TTM at 33 and 36 °C could equivalently decrease the expression of certain cytokines after ischemic stroke. Our study suggested that TTM at 33 or 36 °C produces equivalent neuroprotective effects by attenuating cell death and by altering microglial activation and polarization. Therefore, TTM at 36 °C can be considered for its safety and effectiveness in ischemic stroke.
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Affiliation(s)
- Jong Youl Kim
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ju Hee Kim
- Department of Emergency Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Joohyun Park
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jin Ho Beom
- Department of Emergency Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Sung Phil Chung
- Department of Emergency Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Je Sung You
- Department of Emergency Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea.
| | - Jong Eun Lee
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Republic of Korea. .,BK21 PLUS Project for Medical Science, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Medical School Building Room # 146, Seoul, 03722, Republic of Korea. .,Brain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
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29
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Park JH, Jung J, Kim JY, Hong MJ, Kim EO, Jo KW, Shim TS, Kim SH. Airborne precautions based on Xpert ® MTB/RIF results for patients with presumptive TB. Int J Tuberc Lung Dis 2021; 25:244-246. [PMID: 33688817 DOI: 10.5588/ijtld.20.0584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- J H Park
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea, Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - J Jung
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea, Office for Infection Control, Republic of Korea
| | - J Y Kim
- Office for Infection Control, Republic of Korea
| | - M J Hong
- Office for Infection Control, Republic of Korea
| | - E O Kim
- Office for Infection Control, Republic of Korea
| | - K-W Jo
- Department of Pulmonology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - T S Shim
- Department of Pulmonology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - S-H Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea, Office for Infection Control, Republic of Korea
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30
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Chung H, Park CH, Kim YJ, Kim JY, Min PK, Yoon YW, Lee KA, Lee BK, Hong BK, Kim TH, Rim SJ, Kwon HM, Choi EY. Myocardial extracellular space expansion is related to burden of premature ventricular contractions in patients with hypertrophic cardiomyopathy without non-sustained ventricular tachycardia. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Current guidelines suggest the presence of non-sustained ventricular tachycardia (NSVT) as a risk factor of sudden cardiac death in patients with hypertrophic cardiomyopathy (HCM). However, high burden of premature ventricular contraction (PVC) may reflect myocardial fibrosis although the absence of NSVT.
Purpose
We investigated the association between PVC burden and myocardial extracellular space expansion in HCM patients without NSVT.
Methods
Of the 212 patients prospectively enrolled to the HCM registry of genetics, 84 patients were evaluated with both cardiac magnetic resonance and 24hr holter. Among them, 71 patients (58 males, mean age: 71 ± 13 years) have not been diagnosed with NSVT.
Results
Patients with NSVT (n = 13) showed more impaired LA functional indices and higher myocardial fibrosis burden compared with patients without NSVT (n = 71). Among patients who have not been diagnosed with NSVT, patients with late gadolinium enhancement (LGE, n = 46) had a higher total beats (109 ± 332 vs. 7 ± 13 beats per a day, p = 0.003) and burden (0.114 ± 0.225 vs. 0.008 ± 0.014 %, p = 0.003) of PVC during 24-hour compared with patients without LGE (n = 25). %LGE was correlated with total beats of PVC (r = 0.358, p = 0.002) and PVC burden (r = 0.377, p = 0.001). ECV also correlated with total beats of PVC (r = 0.387, p = 0.001) and PVC burden (r = 0.401, p = 0.001). The optimal cutoff value for PVC number was 45 (37.0% of sensitivity and 100% of specificity) with 0.733 of the area under the ROC curve (p < 0.001). Pathogenic or likely pathogenic sarcomere mutation was higher in NSVT group than no NSVT group (p < 0.05), and had a higher tendency in higher PVC burden group (0.05 < p < 0.1) than lower PVC burden group.
Conclusions
Total beats and burden of PVC are significantly related to increase in myocardial fibrosis in HCM patients without NSVT.
Abstract Figure. Mechanism of ventricular arrhythmia
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Affiliation(s)
- H Chung
- Kyung Hee Medical Center, Seoul, Korea (Republic of)
| | - CH Park
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - YJ Kim
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - JY Kim
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - PK Min
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - YW Yoon
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - KA Lee
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - BK Lee
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - BK Hong
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - TH Kim
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - SJ Rim
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - HM Kwon
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - EY Choi
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
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Park J, Kim JY, Kim YR, Huang M, Chang JY, Sim AY, Jung H, Lee WT, Hyun YM, Lee JE. Reparative System Arising from CCR2(+) Monocyte Conversion Attenuates Neuroinflammation Following Ischemic Stroke. Transl Stroke Res 2021; 12:879-893. [PMID: 33409730 PMCID: PMC8421302 DOI: 10.1007/s12975-020-00878-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 10/20/2020] [Accepted: 11/16/2020] [Indexed: 01/22/2023]
Abstract
Monocytes recruitment from the blood to inflamed tissues following ischemic stroke is an important immune response to wound healing and tissue repair. Mouse monocytes can be endogenously divided into two distinct populations: pro-inflammatory or classical monocytes that express CCR2highCX3CR1low and circulate in blood, and anti-inflammatory or non-classical monocytes that express CCR2lowCX3CR1high and patrol locally. In this study of transgenic mice with functional CX3CR1GFP/+ or CX3CR1GFP/+-CCR2RFP/+, we found that CCR2highCX3CR1low monocytes recruited to the injured brain were cytokine-dependently converted into CCR2lowCX3CR1high macrophages, especially under the influence of IL-4 and IL-13, thereby attenuating the neuroinflammation following sterile ischemic stroke. The overall data suggest that (1) the regulation of monocyte-switching is one of the ultimate reparative strategies in ischemic stroke, and (2) the adaptation of monocytes in a locally inflamed milieu is vital to alleviating the effects of ischemic stroke through innate immunity.
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Affiliation(s)
- Joohyun Park
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Republic of Korea.,Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jong Youl Kim
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yu Rim Kim
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Republic of Korea.,Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Meiying Huang
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Republic of Korea.,Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ji Young Chang
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Republic of Korea.,Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - A Young Sim
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Republic of Korea.,Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hosung Jung
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Republic of Korea.,Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Won Taek Lee
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young-Min Hyun
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Republic of Korea. .,Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Jong Eun Lee
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Republic of Korea. .,Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea. .,Brain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Park J, Chang JY, Kim JY, Lee JE. Corrigendum: Monocyte Transmodulation: The Next Novel Therapeutic Approach in Overcoming Ischemic Stroke? Front Neurol 2020; 11:620560. [PMID: 33329374 PMCID: PMC7729162 DOI: 10.3389/fneur.2020.620560] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 11/03/2020] [Indexed: 11/13/2022] Open
Abstract
[This corrects the article DOI: 10.3389/fneur.2020.578003.].
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Affiliation(s)
- Joohyun Park
- Department of Anatomy, Yonsei University College of Medicine, Seoul, South Korea.,Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Ji Young Chang
- Department of Anatomy, Yonsei University College of Medicine, Seoul, South Korea.,Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Jong Youl Kim
- Department of Anatomy, Yonsei University College of Medicine, Seoul, South Korea
| | - Jong Eun Lee
- Department of Anatomy, Yonsei University College of Medicine, Seoul, South Korea.,Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, South Korea.,Brain Research Institute, Yonsei University College of Medicine, Seoul, South Korea
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Ohn J, Hur K, Cho Y, Park J, Kim JY, Lee SJ, Park H, Mun JH. Developing a predictive model for distinguishing invasive nail unit melanoma from nail unit melanoma in situ. J Eur Acad Dermatol Venereol 2020; 35:906-911. [PMID: 33205521 DOI: 10.1111/jdv.17036] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 10/21/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Clinical information that distinguishes invasive nail unit melanoma from nail unit melanoma in situ before surgery would aid physicians in the decision-making process and estimating prognosis. However, limited information is available on the detailed demographic and dermoscopic features of invasive nail unit melanoma and nail unit melanoma in situ for differential diagnosis. OBJECTIVE This study aimed to investigate the demographic data and dermoscopic features of invasive nail unit melanoma and nail unit melanoma in situ and establish a predictive model for differentiating these two forms of nail unit melanoma. METHODS A retrospective observational study of ninety-seven patients diagnosed with nail unit melanoma (59 in situ and 38 invasive cases) in four healthcare centres in South Korea (three tertiary referral hospitals and one second referral hospital) from March 2014 to December 2019. RESULTS A multivariable analysis revealed that ulcer (odds ratio = 21.6, confidence interval = 2.1-219.8, P = 0.009), total melanonychia (odds ratio = 17.6, confidence interval = 3.0-104.0, P = 0.002), nail plate destruction (odds ratio = 10.9, confidence interval = 2.0-59.4, P = 0.006) and polychromia (odds ratio = 5.3, confidence interval = 1.36-20.57, P = 0.016) were distinctive dermoscopic features of invasive nail unit melanoma. A predictive model with scores ranging from 0 to 6 points demonstrated a reliable diagnostic value (C-statistic = 0.902) in differentiating invasive nail unit melanoma from nail unit melanoma in situ. CONCLUSIONS Invasive nail unit melanoma and nail unit melanoma in situ have different dermoscopic features. A predictive model based on morphologic dermoscopic features could aid in differentiating invasive nail unit melanoma from nail unit melanoma in situ.
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Affiliation(s)
- J Ohn
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea.,Institute of Human-Environment Interface Biology, Seoul National University, Seoul, Korea
| | - K Hur
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea.,Institute of Human-Environment Interface Biology, Seoul National University, Seoul, Korea
| | - Y Cho
- Department of Mathematical Sciences, College of Science, The University of Texas at El Paso, El Paso, TX, USA
| | - J Park
- Department of Dermatology, Jeonbuk National University Medical School, Jeonju, Korea
| | - J Y Kim
- Department of Dermatology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea
| | - S-J Lee
- Department of Dermatology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea
| | - H Park
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea.,Institute of Human-Environment Interface Biology, Seoul National University, Seoul, Korea.,Department of Dermatology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center (SMG-SNU), Seoul, Korea
| | - J-H Mun
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea.,Institute of Human-Environment Interface Biology, Seoul National University, Seoul, Korea
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Choi JH, Jang HI, Jang JS, Jeon SH, Joo KK, Ju K, Jung DE, Kim JG, Kim JH, Kim JY, Kim SB, Kim SY, Kim W, Kwon E, Lee DH, Lee HG, Lim IT, Moon DH, Pac MY, Seo H, Seo JW, Shin CD, Yang BS, Yoo J, Yoon SG, Yeo IS, Yu I. Search for Sub-eV Sterile Neutrinos at RENO. Phys Rev Lett 2020; 125:191801. [PMID: 33216576 DOI: 10.1103/physrevlett.125.191801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 10/08/2020] [Accepted: 10/09/2020] [Indexed: 06/11/2023]
Abstract
We report a search result for a light sterile neutrino oscillation with roughly 2200 live days of data in the RENO experiment. The search is performed by electron antineutrino (ν[over ¯]_{e}) disappearance taking place between six 2.8 GW_{th} reactors and two identical detectors located at 294 m (near) and 1383 m (far) from the center of the reactor array. A spectral comparison between near and far detectors can explore reactor ν[over ¯]_{e} oscillations to a light sterile neutrino. An observed spectral difference is found to be consistent with that of the three-flavor oscillation model. This yields limits on sin^{2}2θ_{14} in the 10^{-4}≲|Δm_{41}^{2}|≲0.5 eV^{2} region, free from reactor ν[over ¯]_{e} flux and spectrum uncertainties. The RENO result provides the most stringent limits on sterile neutrino mixing at |Δm_{41}^{2}|≲0.002 eV^{2} using the ν[over ¯]_{e} disappearance channel.
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Affiliation(s)
- J H Choi
- Institute for High Energy Physics, Dongshin University, Naju 58245, Korea
| | - H I Jang
- Department of Fire Safety, Seoyeong University, Gwangju 61268, Korea
| | - J S Jang
- GIST College, Gwangju Institute of Science and Technology, Gwangju 61005, Korea
| | - S H Jeon
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - K K Joo
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - K Ju
- Department of Physics, KAIST, Daejeon 34141, Korea
| | - D E Jung
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - J G Kim
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - J H Kim
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - J Y Kim
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - S B Kim
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - S Y Kim
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - W Kim
- Department of Physics, Kyungpook National University, Daegu 41566, Korea
| | - E Kwon
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - D H Lee
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - H G Lee
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - I T Lim
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - D H Moon
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - M Y Pac
- Institute for High Energy Physics, Dongshin University, Naju 58245, Korea
| | - H Seo
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - J W Seo
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - C D Shin
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - B S Yang
- Institute for Basic Science, Daejeon 34047, Korea
| | - J Yoo
- Department of Physics, KAIST, Daejeon 34141, Korea
- Institute for Basic Science, Daejeon 34047, Korea
| | - S G Yoon
- Department of Physics, KAIST, Daejeon 34141, Korea
| | - I S Yeo
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - I Yu
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
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Park JE, Kim JY, Kim HS, Shim WH. Comparison of Dynamic Contrast-Enhancement Parameters between Gadobutrol and Gadoterate Meglumine in Posttreatment Glioma: A Prospective Intraindividual Study. AJNR Am J Neuroradiol 2020; 41:2041-2048. [PMID: 33060100 DOI: 10.3174/ajnr.a6792] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 07/22/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND PURPOSE Differences in molecular properties between one-molar and half-molar gadolinium-based contrast agents are thought to affect parameters obtained from dynamic contrast-enhanced imaging. The aim of our study was to investigate differences in dynamic contrast-enhanced parameters between one-molar nonionic gadobutrol and half-molar ionic gadoterate meglumine in patients with posttreatment glioma. MATERIALS AND METHODS This prospective study enrolled 32 patients who underwent 2 20-minute dynamic contrast-enhanced examinations, one with gadobutrol and one with gadoterate meglumine. The model-free parameter of area under the signal intensity curve from 30 to 1100 seconds and the Tofts model-based pharmacokinetic parameters were calculated and compared intraindividually using paired t tests. Patients were further divided into progression (n = 12) and stable (n = 20) groups, which were compared using Student t tests. RESULTS Gadobutrol and gadoterate meglumine did not show any significant differences in the area under the signal intensity curve or pharmacokinetic parameters of K trans, Ve, Vp, or Kep (all P > .05). Gadobutrol showed a significantly higher mean wash-in rate (0.83 ± 0.64 versus 0.29 ± 0.63, P = .013) and a significantly lower mean washout rate (0.001 ± 0.0001 versus 0.002 ± 0.002, P = .02) than gadoterate meglumine. Trends toward higher area under the curve, K trans, Ve, Vp, wash-in, and washout rates and lower Kep were observed in the progression group in comparison with the treatment-related-change group, regardless of the contrast agent used. CONCLUSIONS Model-free and pharmacokinetic parameters did not show any significant differences between the 2 gadolinium-based contrast agents, except for a higher wash-in rate with gadobutrol and a higher washout rate with gadoterate meglumine, supporting the interchangeable use of gadolinium-based contrast agents for dynamic contrast-enhanced imaging in patients with posttreatment glioma.
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Affiliation(s)
- J E Park
- From the Department of Radiology and Research Institute of Radiology (J.E.P., H.S.K., W.H.S.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - J Y Kim
- Department of Radiology (J.Y.K.), Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H S Kim
- From the Department of Radiology and Research Institute of Radiology (J.E.P., H.S.K., W.H.S.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - W H Shim
- From the Department of Radiology and Research Institute of Radiology (J.E.P., H.S.K., W.H.S.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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Park J, Chang JY, Kim JY, Lee JE. Monocyte Transmodulation: The Next Novel Therapeutic Approach in Overcoming Ischemic Stroke? Front Neurol 2020; 11:578003. [PMID: 33193029 PMCID: PMC7642685 DOI: 10.3389/fneur.2020.578003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/22/2020] [Indexed: 12/13/2022] Open
Abstract
The immune response following neuroinflammation is a vital element of ischemic stroke pathophysiology. After the onset of ischemic stroke, a specialized vasculature system that effectively protects central nervous system tissues from the invasion of blood cells and other macromolecules is broken down within minutes, thereby triggering the inflammation cascade, including the infiltration of peripheral blood leukocytes. In this series of processes, blood-derived monocytes have a significant effect on the outcome of ischemic stroke through neuroinflammatory responses. As neuroinflammation is a necessary and pivotal component of the reparative process after ischemic stroke, understanding the role of infiltrating monocytes in the modulation of inflammatory responses may offer a great opportunity to explore new therapies for ischemic stroke. In this review, we discuss and highlight the function and involvement of monocytes in the brain after ischemic injury, as well as their impact on tissue damage and repair.
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Affiliation(s)
- Joohyun Park
- Department of Anatomy, Yonsei University College of Medicine, Seoul, South Korea.,Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Ji Young Chang
- Department of Anatomy, Yonsei University College of Medicine, Seoul, South Korea.,Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Jong Youl Kim
- Department of Anatomy, Yonsei University College of Medicine, Seoul, South Korea
| | - Jong Eun Lee
- Department of Anatomy, Yonsei University College of Medicine, Seoul, South Korea.,Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, South Korea.,Brain Research Institute, Yonsei University College of Medicine, Seoul, South Korea
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Kim JY, Barua S, Jeong YJ, Lee JE. Adiponectin: The Potential Regulator and Therapeutic Target of Obesity and Alzheimer's Disease. Int J Mol Sci 2020; 21:ijms21176419. [PMID: 32899357 PMCID: PMC7504582 DOI: 10.3390/ijms21176419] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/28/2020] [Accepted: 08/28/2020] [Indexed: 02/08/2023] Open
Abstract
Animal and human mechanistic studies have consistently shown an association between obesity and Alzheimer’s disease (AD). AD, a degenerative brain disease, is the most common cause of dementia and is characterized by the presence of extracellular amyloid beta (Aβ) plaques and intracellular neurofibrillary tangles disposition. Some studies have recently demonstrated that Aβ and tau cannot fully explain the pathophysiological development of AD and that metabolic disease factors, such as insulin, adiponectin, and antioxidants, are important for the sporadic onset of nongenetic AD. Obesity prevention and treatment can be an efficacious and safe approach to AD prevention. Adiponectin is a benign adipokine that sensitizes the insulin receptor signaling pathway and suppresses inflammation. It has been shown to be inversely correlated with adipose tissue dysfunction and may enhance the risk of AD because a range of neuroprotection adiponectin mechanisms is related to AD pathology alleviation. In this study, we summarize the recent progress that addresses the beneficial effects and potential mechanisms of adiponectin in AD. Furthermore, we review recent studies on the diverse medications of adiponectin that could possibly be related to AD treatment, with a focus on their association with adiponectin. A better understanding of the neuroprotection roles of adiponectin will help clarify the precise underlying mechanism of AD development and progression.
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Affiliation(s)
- Jong Youl Kim
- Department of Anatomy, Yonsei University College of Medicine, Seoul 120-752, Korea; (J.Y.K.); (S.B.); (Y.J.J.)
| | - Sumit Barua
- Department of Anatomy, Yonsei University College of Medicine, Seoul 120-752, Korea; (J.Y.K.); (S.B.); (Y.J.J.)
| | - Ye Jun Jeong
- Department of Anatomy, Yonsei University College of Medicine, Seoul 120-752, Korea; (J.Y.K.); (S.B.); (Y.J.J.)
| | - Jong Eun Lee
- Department of Anatomy, Yonsei University College of Medicine, Seoul 120-752, Korea; (J.Y.K.); (S.B.); (Y.J.J.)
- BK21 Plus Project for Medical Sciences, and Brain Research Institute, Yonsei University College of Medicine, Seoul 120-752, Korea
- Correspondence: ; Tel.: +82-2-2228-1646 (ext. 1659); Fax: +82-2-365-0700
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Kim JY, Barua S, Huang MY, Park J, Yenari MA, Lee JE. Heat Shock Protein 70 (HSP70) Induction: Chaperonotherapy for Neuroprotection after Brain Injury. Cells 2020; 9:cells9092020. [PMID: 32887360 PMCID: PMC7563654 DOI: 10.3390/cells9092020] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/24/2020] [Accepted: 08/26/2020] [Indexed: 12/27/2022] Open
Abstract
The 70 kDa heat shock protein (HSP70) is a stress-inducible protein that has been shown to protect the brain from various nervous system injuries. It allows cells to withstand potentially lethal insults through its chaperone functions. Its chaperone properties can assist in protein folding and prevent protein aggregation following several of these insults. Although its neuroprotective properties have been largely attributed to its chaperone functions, HSP70 may interact directly with proteins involved in cell death and inflammatory pathways following injury. Through the use of mutant animal models, gene transfer, or heat stress, a number of studies have now reported positive outcomes of HSP70 induction. However, these approaches are not practical for clinical translation. Thus, pharmaceutical compounds that can induce HSP70, mostly by inhibiting HSP90, have been investigated as potential therapies to mitigate neurological disease and lead to neuroprotection. This review summarizes the neuroprotective mechanisms of HSP70 and discusses potential ways in which this endogenous therapeutic molecule could be practically induced by pharmacological means to ultimately improve neurological outcomes in acute neurological disease.
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Affiliation(s)
- Jong Youl Kim
- Department of Anatomy, Yonsei University College of Medicine, Seoul 03722, Korea; (J.Y.K.); (S.B.); (M.Y.H.); (J.P.)
| | - Sumit Barua
- Department of Anatomy, Yonsei University College of Medicine, Seoul 03722, Korea; (J.Y.K.); (S.B.); (M.Y.H.); (J.P.)
| | - Mei Ying Huang
- Department of Anatomy, Yonsei University College of Medicine, Seoul 03722, Korea; (J.Y.K.); (S.B.); (M.Y.H.); (J.P.)
- BK21 Plus Project for Medical Science and Brain Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea
| | - Joohyun Park
- Department of Anatomy, Yonsei University College of Medicine, Seoul 03722, Korea; (J.Y.K.); (S.B.); (M.Y.H.); (J.P.)
- BK21 Plus Project for Medical Science and Brain Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea
| | - Midori A. Yenari
- Department of Neurology, University of California, San Francisco & the San Francisco Veterans Affairs Medical Center, Neurology (127) VAMC 4150 Clement St., San Francisco, CA 94121, USA
- Correspondence: (M.A.Y.); (J.E.L.); Tel.: +1-415-750-2011 (M.A.Y.); +82-2-2228-1646 (ext. 1659) (J.E.L.); Fax: +1-415-750-2273 (M.A.Y.); +82-2-365-0700 (J.E.L.)
| | - Jong Eun Lee
- Department of Anatomy, Yonsei University College of Medicine, Seoul 03722, Korea; (J.Y.K.); (S.B.); (M.Y.H.); (J.P.)
- BK21 Plus Project for Medical Science and Brain Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea
- Correspondence: (M.A.Y.); (J.E.L.); Tel.: +1-415-750-2011 (M.A.Y.); +82-2-2228-1646 (ext. 1659) (J.E.L.); Fax: +1-415-750-2273 (M.A.Y.); +82-2-365-0700 (J.E.L.)
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Kim JY, Choi H, Park JH, Jung HD, Jung YS. Effects of anti-resorptive drugs on implant survival and peri-implantitis in patients with existing osseointegrated dental implants: a retrospective cohort study. Osteoporos Int 2020; 31:1749-1758. [PMID: 32367226 DOI: 10.1007/s00198-019-05257-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 12/03/2019] [Indexed: 02/07/2023]
Abstract
UNLABELLED The effect of anti-resorptive drug (ARD) usage among patients with successful dental implant osseointegration is controversial. This study showed an increased risk of implant failure in ARD users. Risk factors included pre-existing marginal bone loss, overdenture, diabetes, and a short interval between implant placement and ARD administration. INTRODUCTION This retrospective study aimed to determine whether anti-resorptive drug (ARD) usage increased risk of implant failure among patients with successful implant osseointegration. Additionally, the study investigated risk factors that affected implant survival rate in ARD users. METHODS Eighty ARD users with 344 implants who had more than 12 months of follow-up from the initiation of ARD treatment during the period between 2008 and 2017 were included, along with 80 non-ARD users from the same period. The primary outcome was dental implant survival. Kaplan-Meier survival curves and Cox proportional hazard models were used for survival analysis. RESULTS Average follow-up was 85.3 months. Implant survival rates were 89.83% in ARD users and 96.03% in non-ARD users. In the univariate Cox proportional hazard model, risk of implant failure was significantly higher in patients with pre-existing marginal bone loss (MBL), diabetes, and concurrent bone augmentation. However, risk of implant failure was significantly lower when the interval between implant placement and ARD administration was < 36 months. Compared with overdenture, single crown and fixed splinted users had lower risk of implant failure. In multivariate analysis, variables including pre-existing MBL, diabetes, < 36-month interval between implant placement and ARD treatment, and usage of fixed splinted prosthesis were significantly associated with increased risk of implant failure. CONCLUSIONS ARD administration after implant osseointegration was correlated with a reduced implant survival rate. Pre-existing MBL, diabetes, type of final prosthesis, and the interval between implant placement and initiation of ARD administration influenced risk of implant failure.
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Affiliation(s)
- J Y Kim
- Department of Oral & Maxillofacial Surgery, Oral Science Research Center, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - H Choi
- Department of Oral & Maxillofacial Surgery, Oral Science Research Center, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - J H Park
- Department of Oral & Maxillofacial Surgery, Oral Science Research Center, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - H D Jung
- Department of Oral & Maxillofacial Surgery, Oral Science Research Center, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Y S Jung
- Department of Oral & Maxillofacial Surgery, Oral Science Research Center, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.
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Sohng C, Han MH, Park D, Park KD, Jang YH, Lee WJ, Lee SJ, Kim JY. Clinical features of subungual melanoma according to the extent of Hutchinson's nail sign: a retrospective single-centre study. J Eur Acad Dermatol Venereol 2020; 35:380-386. [PMID: 32562580 DOI: 10.1111/jdv.16762] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 05/27/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Hutchinson's nail sign (HS) is among the diagnostic criteria for subungual melanoma (SUM). However, there is minimal evidence supporting the overall clinical significance of HS in SUM. OBJECTIVES To identify clinicopathological features of SUM according to the extent of HS. METHODS Retrospective cohort study was performed with consecutive SUM patients at a single centre from January 2006 to December 2017. The extent of HS was defined by the number of affected nail folds (range 0-4). Comparison groups were organized as follows: patients with HS (affecting ≥1 nail folds) vs. without HS; patients with HS affecting ≥2 nail folds vs. HS affecting <2 nail folds; patients with HS affecting ≥3 nail folds vs. HS affecting <3 nail folds. Clinicopathological characteristics of SUM were compared between the groups. RESULTS Sixty-one SUM patients were included. Forty-six (75.4%) exhibited HS; 22 (47.8%) on a toe and 24 (52.2%) on a finger. In multivariate analysis, nail destruction [hazard ratio (HR), 10.00; 95% confidence interval (CI), 2.61-38.30; P = 0.001] was significantly associated with the presence of HS and amputation was significantly associated with HS affecting ≥2 nail folds (HR, 4.75; 95% CI, 1.36-16.61; P = 0.015). High T stage (HR, 1.85; 95% CI, 1.20-2.85; P = 0.005, Fig. 2) was significantly associated with HS appearing in ≥3 nail folds. CONCLUSION Besides its value of detecting SUM, HS provides useful clinical information. The number of nail folds exhibiting HS could be a useful clinical clue for planning therapeutic strategies for SUM.
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Affiliation(s)
- C Sohng
- Department of Dermatology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - M H Han
- Department of Pathology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - D Park
- Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - K D Park
- Department of Dermatology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - Y H Jang
- Department of Dermatology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - W J Lee
- Department of Dermatology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - S J Lee
- Department of Dermatology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - J Y Kim
- Department of Dermatology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
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Abstract
SETTING: In Korea, the price of a pack of cigarettes increased 80% from US$2.2 to US$4 in 2015. The smoking rate decreased in 2015. However, it rebounded in the following year.OBJECTIVE: To evaluate the characteristics associated with this rebound in smoking rate following the price increase.DESIGN: We analysed the KNHANES (Korean National Health and Nutrition Examination Survey) data of 44 015 participants to evaluate current smoking rate and the proportion of smokers planning to quit within 6 months from 2010 to 2016. We also performed focused analysis of 18 303 participants between 2014 and 2016 KNHANES to determine the current smoking rate according to their demographic and socio-economic characteristics.RESULTS: Individuals who were older, female, unemployed, had a low household income or a shorter total smoking period, or smoked less per day were more likely to stop or reduce smoking after the price increase. The current smoking rate increased to 18.8% in 2016 from 17.7% in 2015; this difference was significant in men, those in the lower-middle quartile of household income, those with a middle-school or college education, and those who were employed.CONCLUSION: The rebound in smoking after the price increase was significantly related to the individual's sex, income, education and employment status.
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Affiliation(s)
- J W Jung
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - J Y Kim
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
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Jung JW, Yoon SW, Lee GE, Shin HG, Kim H, Shin JW, Park IW, Choi BW, Kim JY. Poor nutritional intake is a dominant factor for weight loss in chronic obstructive pulmonary disease. Int J Tuberc Lung Dis 2020; 23:631-637. [PMID: 31097074 DOI: 10.5588/ijtld.18.0456] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
<sec id="st1"> <title>SETTING</title> Increase in energy expenditure and/or decrease in nutritional intake leads to low body mass index (BMI). The balance between energy expenditure and nutritional intake has rarely been evaluated in a large population of patients with chronic obstructive pulmonary disease (COPD). </sec> <sec id="st2"> <title>OBJECTIVE</title> To evaluate BMI, nutritional intake and physical activity and the association of these factors with the severity of airflow obstruction in COPD patients. </sec> <sec id="st3"> <title>DESIGN</title> We analysed the Korean National Health and Nutrition Examination Survey (KNHANES) data set from 2012 to 2015. </sec> <sec id="st4"> <title>RESULTS</title> Among the 9682 individuals (1601 with COPD and 8081 without COPD) recruited, BMI was lower in COPD patients than in non-COPD participants (males, 23.86 ± 2.76 vs. 24.28 ± 2.80, P < 0.001; females, 23.63 ± 2.94 vs. 23.98 ± 3.10, P < 0.05). As the stage of COPD advanced, BMI, intake of nutrients (food, water and carbohydrates) and total energy levels declined in COPD patients. Total time spent walking in the preceding week decreased with advancing COPD stage in male patients with COPD. COPD severity was an important risk factor for the limitation of physical activity due to respiratory problems (OR 3.92, 95%CI 2.77∼5.34, P < 0.001). </sec> <sec id="st5"> <title>CONCLUSION</title> Patients with COPD had a low nutritional intake with little physical activity, which worsened with advancing COPD stage. In late-stage COPD, impaired nutritional intake outweighed the decrease in physical activity, resulting in weight loss. </sec>.
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Affiliation(s)
- J-W Jung
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - S W Yoon
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - G-E Lee
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - H-G Shin
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - H Kim
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - J W Shin
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - I W Park
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - B W Choi
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - J Y Kim
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
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Heo W, Jin N, Park MS, Kim HY, Yoon SM, Lee J, Kim JY. STIM1 knock-down decreases the affinity of obinutuzumab for CD20 by altering CD20 localization to Triton-soluble membrane. Clin Exp Immunol 2020; 200:260-271. [PMID: 32056202 DOI: 10.1111/cei.13427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2020] [Indexed: 01/16/2023] Open
Abstract
Obinutuzumab is thought to exert its effects through its high antibody-dependent cellular cytotoxicity (ADCC) via glyco-engineering of the Fc region. In addition, obinutuzumab causes direct binding-induced cell death (DCD) only by specifically binding to its target CD20, a Ca2+ channel. However, the specific features of CD20 related to obinutuzumab binding-induction of cell death are not clearly understood. In this study, we evaluated the relationship between the Ca2+ channel features of CD20 as a store-operated Ca2+ channel (SOC) and obinutuzumab binding-induced cell death. Ca2+ channel function and biochemical analysis revealed that CD20 is an Orai1- and stromal interaction molecule (STIM1)-dependent Ca2+ pore. However, binding of obinutuzumab on CD20 did not have any effect on Ca2+ influx activity of CD20; the direct cell death rate mediated by obinutuzumab binding was almost equivalent with or without the extracellular Ca2+ condition. Given the apparent interaction between STIM1 and CD20, we observed Triton-X solubilized obinutuzumab-bound CD20 accompanied by STIM1. Subsequently, obinutuzumab binding and cell death were decreased by STIM1 knock-down in Ramos B cells. Thus, STIM1 directly contributes to cell death by increasing the affinity of cells for obinutuzumab by transferring CD20 to the Triton-soluble membrane region.
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Affiliation(s)
- W Heo
- Department of Pharmacology and Brain, Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - N Jin
- Department of Pharmacology and Brain, Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - M S Park
- Department of Pharmacology and Brain, Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - H-Y Kim
- Department of Pharmacology and Brain, Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - S M Yoon
- College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon, Korea
| | - J Lee
- College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon, Korea
| | - J Y Kim
- Department of Pharmacology and Brain, Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
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Kurisu K, Kim JY, You J, Yenari MA. Therapeutic Hypothermia and Neuroprotection in Acute Neurological Disease. Curr Med Chem 2019; 26:5430-5455. [PMID: 31057103 DOI: 10.2174/0929867326666190506124836] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 12/24/2018] [Accepted: 04/11/2019] [Indexed: 01/07/2023]
Abstract
Therapeutic hypothermia has consistently been shown to be a robust neuroprotectant in many labs studying different models of neurological disease. Although this therapy has shown great promise, there are still challenges at the clinical level that limit the ability to apply this routinely to each pathological condition. In order to overcome issues involved in hypothermia therapy, understanding of this attractive therapy is needed. We review methodological concerns surrounding therapeutic hypothermia, introduce the current status of therapeutic cooling in various acute brain insults, and review the literature surrounding the many underlying molecular mechanisms of hypothermic neuroprotection. Because recent work has shown that body temperature can be safely lowered using pharmacological approaches, this method may be an especially attractive option for many clinical applications. Since hypothermia can affect multiple aspects of brain pathophysiology, therapeutic hypothermia could also be considered a neuroprotection model in basic research, which would be used to identify potential therapeutic targets. We discuss how research in this area carries the potential to improve outcome from various acute neurological disorders.
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Affiliation(s)
- Kota Kurisu
- Department of Neurology, University of California, San Francisco and Veterans Affairs Medical Center, San Francisco, California 94121, United States
| | - Jong Youl Kim
- Department of Neurology, University of California, San Francisco and Veterans Affairs Medical Center, San Francisco, California 94121, United States.,Departments of Anatomy, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jesung You
- Department of Neurology, University of California, San Francisco and Veterans Affairs Medical Center, San Francisco, California 94121, United States.,Emergency Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Midori A Yenari
- Department of Neurology, University of California, San Francisco and Veterans Affairs Medical Center, San Francisco, California 94121, United States
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Yu HT, Yang PS, Jang E, Kim TH, Uhm JS, Kim JY, Pak HN, Lee MH, Joung B, Lip GYH. P4758Label adherence of non-vitamin K antagonist oral anticoagulants and clinical outcomes in patients with atrial fibrillation: A nationwide study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Dose adjustment of non-vitamin K antagonist oral anticoagulants (NOACs) is indicated in some patients with atrial fibrillation (AF), based on selected patient factors or concomitant medications.
Purpose
We assessed the frequency of label adherence of NOAC dosing among AF patients and the associations between off-label NOAC dosing and clinical outcomes in real-world clinical practice.
Methods
We evaluated 53,649 AF patients treated with a NOAC using Korean National Health Insurance Service database during the period from January 2013 to December 2016. NOAC doses were classified as either underdosed or overdosed, consistent with U.S. Food and Drug Administration labeling. Cox proportional hazards regression was performed to investigate the effectiveness and safety outcomes including stroke or systemic embolism, major bleeding, and all-cause mortality.
Results
Overall, 16,757 NOAC-treated patients (31.2%) were underdosed, 4,492 were overdosed (8.4%), and 32,400 (60.4%) were dosed appropriately according to drug labeling. Compared with patients with label adherence, those who were underdosed or overdosed were older (71±8 and 75±7 years of age vs. 70±9 years of age, respectively; p<0.001), more likely female (39% and 53% vs. 38%, respectively; p<0.001), and had higher CHA2DS2-VASc scores (4.6±1.7 and 5.3±1.7 vs. 4.5±1.8, respectively; p<0.001). NOAC overdosing was associated with increased risk for stroke or systemic embolism (5.76 vs. 4.03 events/100 patient-years, p<0.001), major bleeding (4.77 vs. 2.94 events/100 patient-years, p<0.001), and all-cause mortality (5.43 vs. 3.05 events/100 patient-years, p<0.001) compared with label-adherent use.
Figure 1
Conclusion
In routine clinical practice, a significant proportion (almost 2 in 5) of AF patients received NOAC doses inconsistent with drug labeling. NOAC overdosing is associated with increased risk for stroke or systemic embolism, major bleeding, and all-cause mortality in Asian patient with AF.
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Affiliation(s)
- H T Yu
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - P S Yang
- CHA University, Seongnam, Korea (Republic of)
| | - E Jang
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - T H Kim
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - J S Uhm
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - J Y Kim
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - H N Pak
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - M H Lee
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - B Joung
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - G Y H Lip
- University of Liverpool, Liverpool, United Kingdom
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Yoo BS, Ahn MS, Lee SJ, Son JW, Kim JY, Park SW. P783Guideline-directed therapy at discharge is important in patients with heart failure and atrial fibrillation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
There are limited and conflicting data regarding the prognostic implication of guideline-directed therapy, especially in heart failure (HF) patients with atrial fibrillation (AF). Thus, this study evaluated the relationship between guideline adherence to recommended therapy at discharge and relevant 60-day clinical outcomes in acute HF patients with AF having reduced ejection fraction (HFrEF) or preserved ejection fraction (HFpEF).
Methods and results
Of 5,625 acute HF patients in the Korean Acute Heart Failure Registry, 2,071 with documented AF (HFrEF, n=986; HFpEF, n=1,085) were separately analysed. A guideline adherence score was calculated for the prescription of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, β-blockers, mineralocorticoid receptor antagonists, and anticoagulants. In HFrEF patients with AF, there was significant trend of increase in mortality (p for trend <0.001) and composite endpoint (p for trend = 0.002) according to guideline adherence. Poor adherence was associated with a significantly high risk of mortality (hazard ratio [HR], 4.75; 95% confidence interval [95% CI], 1.77–12.74) and composite endpoint (HR, 2.36; 95% CI, 1.33–4.18). In HFpEF patients with AF, there was a significant increasing trend for rehospitalization (p for trend = 0.04) and composite endpoint (p for trend = 0.03). However, the beneficial effect of good guideline adherence was statistically non-significant for all clinical outcomes
Conclusion
Better adherence to guidelines was associated with a better 60-day prognosis in both HFrEF and HFpEF patients with AF. However, the beneficial effect of guideline adherence was more pronounced in HFrEF patients with AF.
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Affiliation(s)
- B S Yoo
- Wonju College of Medicine, Yonsei University, Division of Cardiology, Department of Internal Medicin, Wonju, Korea (Republic of)
| | - M S Ahn
- Wonju College of Medicine, Yonsei University, Division of Cardiology, Department of Internal Medicin, Wonju, Korea (Republic of)
| | - S J Lee
- Wonju College of Medicine, Yonsei University, Division of Cardiology, Department of Internal Medicin, Wonju, Korea (Republic of)
| | - J W Son
- Wonju College of Medicine, Yonsei University, Division of Cardiology, Department of Internal Medicin, Wonju, Korea (Republic of)
| | - J Y Kim
- Wonju College of Medicine, Yonsei University, Division of Cardiology, Department of Internal Medicin, Wonju, Korea (Republic of)
| | - S W Park
- Wonju College of Medicine, Yonsei University, Division of Cardiology, Department of Internal Medicin, Wonju, Korea (Republic of)
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Kurisu K, Zheng Z, Kim JY, Shi J, Kanoke A, Liu J, Hsieh CL, Yenari MA. Triggering receptor expressed on myeloid cells-2 expression in the brain is required for maximal phagocytic activity and improved neurological outcomes following experimental stroke. J Cereb Blood Flow Metab 2019; 39:1906-1918. [PMID: 30523715 PMCID: PMC6775587 DOI: 10.1177/0271678x18817282] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Triggering receptor expressed on myeloid cells-2 (TREM2) is an innate immune receptor that promotes phagocytosis by myeloid cells such as microglia and macrophages. We previously showed that TREM2 deficiency worsened outcomes from experimental stroke and impeded phagocytosis. However, myeloid cells participating in stroke pathology include both brain resident microglia and circulating macrophages. We now clarify whether TREM2 on brain microglia or circulating macrophages contribute to its beneficial role in ischemic stroke by generating bone marrow (BM) chimeric mice. BM chimera mice from TREM2 knockout (KO) or wild type (Wt) mice were used as donor and recipient mice. Mice were subjected to experimental stroke, and neurological function and infarct volume were assessed. Mice with intact TREM2 in brain microglia showed better neurological recovery and reduced infarct volumes, compared with mice lacking microglial TREM2. Myeloid cell activation and numbers of phagocytes were decreased in mice lacking brain TREM2, compared with mice with intact brain TREM2. These results suggest that TREM2 expression is important for post-stroke recovery, and that TREM2 expression on brain resident microglia is more essential to this recovery, than that of circulating macrophages. These findings might suggest a new therapeutic target for cerebrovascular diseases.
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Affiliation(s)
- Kota Kurisu
- Department of Neurology, University of California, San Francisco and the San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Zhen Zheng
- Department of Neurology, University of California, San Francisco and the San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Jong Youl Kim
- Department of Neurology, University of California, San Francisco and the San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Jian Shi
- Department of Neurology, University of California, San Francisco and the San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Atsushi Kanoke
- Department of Neurosurgery, University of California, San Francisco and the San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Jialing Liu
- Department of Neurosurgery, University of California, San Francisco and the San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Christine L Hsieh
- Department of Medicine, University of California, San Francisco and the San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Midori A Yenari
- Department of Neurology, University of California, San Francisco and the San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
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Kim IS, Lee BK, Yang PS, Yu HT, Kim TH, Uhm JS, Pak HN, Lee MH, Kim JY, Joung B. P5660Clinical impact of polycythemia on cardiovascular outcome from the general population: a nationwide cohort study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Although adverse effect of anemia had been reported, effect of polycythemia on cardiovascular outcome from the general population had not been revealed yet.
Methods
We included 451,107 subjects who received national health examinations from the Korean National Health Insurance Service-based National Sample Cohort from 2009–2013. Medical records were screened from January 2002 to investigate the subjects' disease-free baseline period. They were followed until December 2013. We divided male and female subjects into four categories each based on hemoglobin level (normal, moderate to severe and mild anemia, polycythemia) to assess each outcome.
Results
During 1,735,964 person·years, 12,107 major adverse cardiovascular and cerebrovascular events (MACCE), 862 incident acute myocardial infarction (MI), 5,850 incident ischemic stroke, and 2,430 incident atrial fibrillation (AF) were observed. Compared to normal hemoglobin range group, polycythemia group showed higher MACCE (HR=1.23 [1.12–1.35] in male, HR=1.79 [1.20–2.67] in female, each p<0.001), incident MI (HR=1.37 [1.05–1.79] in male, HR=3.46 [1.06–14.00] in female, each p<0.001), incident ischemic stroke (HR=1.27 [1.10–1.46] in male, HR=1.72 [1.02–2.91] in female, each p<0.001), and incident AF (HR=1.46 [1.21–1.74] in male, HR=2.13 [1.03–4.77] in female, each p<0.001). Each outcome was linearly increased with the increase of hemoglobin among subjects with polycythemia (p<0.001), and with the decrease of hemoglobin among subjects with anemia (each p<0.001, U-shaped relationship). These relationship was more profound in obese female younger than 60-year-old.
Conclusion
Not only anemia but also polycythemia were significantly associated with higher rate of MACCE including death, incident MI, ischemic stroke, and AF among the general population.
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Affiliation(s)
- I.-S Kim
- Yonsei University, Department of Internal Medicine, Cardiology Division, Seoul, Korea (Republic of)
| | - B K Lee
- Gangnam Severance Hospital, Cardiology Division, Seoul, Korea (Republic of)
| | - P S Yang
- Bundang CHA General Hospital, Cardiology Division, Seongnam, Korea (Republic of)
| | - H T Yu
- Yonsei University, Department of Internal Medicine, Cardiology Division, Seoul, Korea (Republic of)
| | - T H Kim
- Yonsei University, Department of Internal Medicine, Cardiology Division, Seoul, Korea (Republic of)
| | - J S Uhm
- Yonsei University, Department of Internal Medicine, Cardiology Division, Seoul, Korea (Republic of)
| | - H N Pak
- Yonsei University, Department of Internal Medicine, Cardiology Division, Seoul, Korea (Republic of)
| | - M H Lee
- Yonsei University, Department of Internal Medicine, Cardiology Division, Seoul, Korea (Republic of)
| | - J Y Kim
- Gangnam Severance Hospital, Cardiology Division, Seoul, Korea (Republic of)
| | - B Joung
- Yonsei University, Department of Internal Medicine, Cardiology Division, Seoul, Korea (Republic of)
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Uhm JS, Jin MN, Kim IS, Bae HJ, Yu HT, Kim TH, Kim JY, Joung B, Pak HN, Lee MH. P1875Nonspecific intraventricular conduction delay is associated with future occurrence of atrial fibrillation in patients with structurally normal heart and sinus rhythm. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
This study aimed to elucidate long-term prognosis of nonspecific intraventricular conduction delay (NIVCD) in patients with structurally normal heart.
Methods
We included 107,838 patients (age, 52.1±15.5 years; men, 46.8%) who underwent electrocardiography in outpatient clinics or medical checkup (model 1). NIVCD was defined as QRS duration ≥110 ms and incompatibility with bundle branch block. The patients with structurally normal heart and sinus rhythm were assigned to the NIVCD group and normal QRS group according to propensity score with matching variables of age, sex, hypertension, and diabetes (model 2), and additional PR interval (model 3). Baseline characteristics, electrocardiographic parameters, and clinical outcomes were compared in model 1, 2, and 3, respectively.
Results
In model 1, the frequencies of male and preexisting atrial fibrillation (AF) were significantly higher in the NIVCD group than in the normal QRS group. In model 2, sinus rate and PR interval were significantly slower and longer in the NIVCD group than in the normal QRS group. In model 3, cumulative incidence of AF was significantly higher in the NIVCD group than in the normal QRS group during follow-up of 8.8±2.9 years (Figure). NIVCD significantly increased risk of AF (hazard ratio, 2.571; 95% confidence interval, 1.074–6.156; p=0.034). NIVCD did not significantly increase risk of sick sinus syndrome, complete atrioventricular block, and heart failure.
Atrial fibrillation-free survival
Conclusions
NIVCD is associated with slow sinus rate and prolonged PR interval. NIVCD is an independent risk factor of AF in patients with structurally normal heart.
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Affiliation(s)
- J S Uhm
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - M N Jin
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - I S Kim
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - H J Bae
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - H T Yu
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - T H Kim
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - J Y Kim
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - B Joung
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - H N Pak
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - M H Lee
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
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Kim D, Yang PS, Jang E, Yu HT, Kim TH, Uhm JS, Kim JY, Sung JH, Pak HN, Lee MH, Lip GYH, Joung B. 208Effect of hypertension duration and systolic blood pressure on dementia in patients with atrial fibrillation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is associated with a higher risk for cognitive impairment and dementia, with or without a history of clinical stroke. There are a paucity of data on the associations of hypertension duration and blood pressure (BP) level with risk of dementia in patients with AF.
Purpose
We examined associations of duration of hypertension and secondly, systolic blood pressure (SBP) levels with incidence of dementia among patients with AF.
Methods
We enrolled a total 196,388 patients aged ≥50 years who were newly diagnosed as AF and undergoing hypertension treatment from the Korean National Health Insurance Service database (2005–2016). Starting from AF diagnosis, participants were followed up until the date of dementia, death, or December 31, 2016. To incorporate the effect of BP level and hypertension duration changes over time on dementia incidence, we constructed time-updated multivariable Cox models in which BP levels and hypertension duration were updated at each participants' regular national health examination visits (at 0–7 years of follow-up). Similarly, age, BP medications, and health-related behaviors were included as time-varying covariates in these models.
Results
During 1,016,744 person-years of follow-up, there were 32,692 dementia events. A cubic spline curve using continuous hypertension duration measures suggested a linear association between increase of hypertension duration and dementia risk. One-year increase of hypertension duration increased the adjusted risk of dementia with a hazard ratio (HR) of 1.17 [95% confidence interval (CI) 1.13–1.22]. In patients with hypertension duration <6 years, SBP of ≥140 mmHg was significantly associated with higher dementia risk, compared to SBP of <130 mmHg (in patients with hypertension duration <3 years: adjusted HR 1.08, 95% CI 1.01–1.16; and in those with 3 ≤ hypertension duration <6 years: adjusted HR 1.13, 95% CI 1.07–1.20), whereas no significant association between SBP and dementia risk in those with hypertension duration ≥6 years.
SBP and dementia in different duration
Conclusion
In patients with AF, the increase of hypertension duration was strongly associated with increased risk of dementia. Uncontrolled SBP was also associated with higher dementia risk. But, this effect of SBP might be attenuated in patients with longer hypertension duration. These findings suggest more emphasis needed on BP control in AF patients with earlier phase of hypertension (duration <6 years).
Acknowledgement/Funding
The Korean Ministry of Education, Science and Technology (NRF-2017R1A2B3003303) and the Korean Ministry of Health & Welfare (HI16C0058, HI15C1200)
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Affiliation(s)
- D Kim
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - P S Yang
- CHA University, Seongnam, Korea (Republic of)
| | - E Jang
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - H T Yu
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - T H Kim
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - J S Uhm
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - J Y Kim
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - J H Sung
- CHA University, Seongnam, Korea (Republic of)
| | - H N Pak
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - M H Lee
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - G Y H Lip
- University of Liverpool, Liverpool, United Kingdom
| | - B Joung
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
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