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Lee T, Cho Y, Cha KS, Jung J, Cho J, Kim H, Kim D, Hong J, Lee D, Keum M, Kushida CA, Yoon IY, Kim JW. Accuracy of 11 Wearable, Nearable, and Airable Consumer Sleep Trackers: Prospective Multicenter Validation Study. JMIR Mhealth Uhealth 2023; 11:e50983. [PMID: 37917155 PMCID: PMC10654909 DOI: 10.2196/50983] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 07/18/2023] [Revised: 08/08/2023] [Accepted: 09/20/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Consumer sleep trackers (CSTs) have gained significant popularity because they enable individuals to conveniently monitor and analyze their sleep. However, limited studies have comprehensively validated the performance of widely used CSTs. Our study therefore investigated popular CSTs based on various biosignals and algorithms by assessing the agreement with polysomnography. OBJECTIVE This study aimed to validate the accuracy of various types of CSTs through a comparison with in-lab polysomnography. Additionally, by including widely used CSTs and conducting a multicenter study with a large sample size, this study seeks to provide comprehensive insights into the performance and applicability of these CSTs for sleep monitoring in a hospital environment. METHODS The study analyzed 11 commercially available CSTs, including 5 wearables (Google Pixel Watch, Galaxy Watch 5, Fitbit Sense 2, Apple Watch 8, and Oura Ring 3), 3 nearables (Withings Sleep Tracking Mat, Google Nest Hub 2, and Amazon Halo Rise), and 3 airables (SleepRoutine, SleepScore, and Pillow). The 11 CSTs were divided into 2 groups, ensuring maximum inclusion while avoiding interference between the CSTs within each group. Each group (comprising 8 CSTs) was also compared via polysomnography. RESULTS The study enrolled 75 participants from a tertiary hospital and a primary sleep-specialized clinic in Korea. Across the 2 centers, we collected a total of 3890 hours of sleep sessions based on 11 CSTs, along with 543 hours of polysomnography recordings. Each CST sleep recording covered an average of 353 hours. We analyzed a total of 349,114 epochs from the 11 CSTs compared with polysomnography, where epoch-by-epoch agreement in sleep stage classification showed substantial performance variation. More specifically, the highest macro F1 score was 0.69, while the lowest macro F1 score was 0.26. Various sleep trackers exhibited diverse performances across sleep stages, with SleepRoutine excelling in the wake and rapid eye movement stages, and wearables like Google Pixel Watch and Fitbit Sense 2 showing superiority in the deep stage. There was a distinct trend in sleep measure estimation according to the type of device. Wearables showed high proportional bias in sleep efficiency, while nearables exhibited high proportional bias in sleep latency. Subgroup analyses of sleep trackers revealed variations in macro F1 scores based on factors, such as BMI, sleep efficiency, and apnea-hypopnea index, while the differences between male and female subgroups were minimal. CONCLUSIONS Our study showed that among the 11 CSTs examined, specific CSTs showed substantial agreement with polysomnography, indicating their potential application in sleep monitoring, while other CSTs were partially consistent with polysomnography. This study offers insights into the strengths of CSTs within the 3 different classes for individuals interested in wellness who wish to understand and proactively manage their own sleep.
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Affiliation(s)
| | - Younghoon Cho
- Asleep Co., Ltd., Seoul, Republic of Korea
- Clionic Lifecare Clinic, Seoul, Republic of Korea
| | | | | | - Jungim Cho
- Asleep Co., Ltd., Seoul, Republic of Korea
| | | | - Daewoo Kim
- Asleep Co., Ltd., Seoul, Republic of Korea
| | | | | | - Moonsik Keum
- Clionic Lifecare Clinic, Seoul, Republic of Korea
| | - Clete A Kushida
- Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, Redwood City, CA, United States
| | - In-Young Yoon
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Jeong-Whun Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
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Kim H, Seo P, Kim MJ, Huh JI, Sunwoo JS, Cha KS, Jeong E, Kim HJ, Jung KY, Kim KH. Characterization of attentional event-related potential from REM sleep behavior disorder patients based on explainable machine learning. Comput Methods Programs Biomed 2023; 234:107496. [PMID: 36972628 DOI: 10.1016/j.cmpb.2023.107496] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 02/20/2023] [Accepted: 03/17/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND AND OBJECTIVE Idiopathic rapid eye movement sleep behavior disorder (iRBD) is a prodromal stage of neurodegeneration and is associated with cortical dysfunction. The purpose of this study was to investigate the spatiotemporal characteristics of cortical activities underlying impaired visuospatial attention in iRBD patients using an explainable machine-learning approach. METHODS An algorithm based on a convolutional neural network (CNN) was devised to discriminate cortical current source activities of iRBD patients due to single-trial event-related potentials (ERPs), from those of normal controls. The ERPs from 16 iRBD patients and 19 age- and sex-matched normal controls were recorded while the subjects were performing visuospatial attentional task, and converted to two-dimensional images representing current source densities on flattened cortical surface. The CNN classifier was trained based on overall data, and then, a transfer learning approach was applied for the fine-tuning to each patient. RESULTS The trained classifier yielded high classification accuracy. The critical features for the classification were determined by layer-wise relevance propagation, so that the spatiotemporal characteristics of cortical activities that were most relevant to cognitive impairment in iRBD were revealed. CONCLUSIONS These results suggest that the recognized dysfunction in visuospatial attention of iRBD patients originates from neural activity impairment in relevant cortical regions and may contribute to the development of useful iRBD biomarkers based on neural activity.
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Affiliation(s)
- Hyun Kim
- Department of Biomedical Engineering College of Health Science, Yonsei University, 234 Maeji-ri, Heungup-myun, Wonju, Gangwon-do 220-710, South Korea
| | - Pukyeong Seo
- Department of Biomedical Engineering College of Health Science, Yonsei University, 234 Maeji-ri, Heungup-myun, Wonju, Gangwon-do 220-710, South Korea
| | - Min Ju Kim
- Department of Biomedical Engineering College of Health Science, Yonsei University, 234 Maeji-ri, Heungup-myun, Wonju, Gangwon-do 220-710, South Korea
| | - Jun Il Huh
- Department of Biomedical Engineering College of Health Science, Yonsei University, 234 Maeji-ri, Heungup-myun, Wonju, Gangwon-do 220-710, South Korea
| | - Jun-Sang Sunwoo
- Department of Neurology, Kangbuk Samsung Hospital, Seoul, South Korea
| | - Kwang Su Cha
- Department of Neurology Seoul National University Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul 03080, South Korea
| | - El Jeong
- Interdisciplinary Program in Bioengineering College of Engineering, Seoul National University, Seoul, South Korea
| | - Han-Joon Kim
- Department of Neurology Seoul National University Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul 03080, South Korea
| | - Ki-Young Jung
- Department of Neurology Seoul National University Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul 03080, South Korea.
| | - Kyung Hwan Kim
- Department of Biomedical Engineering College of Health Science, Yonsei University, 234 Maeji-ri, Heungup-myun, Wonju, Gangwon-do 220-710, South Korea.
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Byun JI, Shin YY, Seong YA, Yoon SM, Hwang KJ, Jung YJ, Cha KS, Jung KY, Shin WC. Comparative efficacy of prolonged-release melatonin versus clonazepam for isolated rapid eye movement sleep behavior disorder. Sleep Breath 2023; 27:309-318. [PMID: 35141811 DOI: 10.1007/s11325-022-02572-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 10/27/2021] [Revised: 01/09/2022] [Accepted: 01/19/2022] [Indexed: 12/01/2022]
Abstract
PURPOSE Clonazepam and melatonin are recommended as first-line treatments for isolated rapid eye movement (REM) sleep behavior disorder (iRBD). This study aimed to compare their efficacy and safety in REM sleep without atonia (RWA) and RBD-related symptoms. METHODS This prospective, open-label, randomized trial included patients with video-polysomnography-confirmed iRBD. The patients were randomly assigned to receive either clonazepam 0.5 mg or prolonged-release (PR) melatonin 2 mg 30 min before bedtime for 4 weeks. The primary outcome was changes in RWA on follow-up polysomnography (PSG). Secondary endpoints were changes in other PSG parameters, clinical global improvement-impression scale (CGI-I) scores, and sleep questionnaire scores. The safety endpoint was adverse events. RESULTS Of 40 patients with probable RBD considered, 34 were enrolled in the study and randomized. Visual scoring parameters of RWA indices were reduced, and automatic scoring parameters tended to be improved after clonazepam treatment but not after PR melatonin treatment. The proportion of N2 sleep was increased, and N3 and REM sleep were decreased only in the clonazepam group. The clonazepam group tended to answer "much or very much improvement" on the CGI-I more frequently than the PR melatonin group (p = 0.068). Daytime sleepiness and insomnia symptoms were reduced after PR melatonin but not after clonazepam. Depressive symptoms increased after clonazepam. Four of the patients (13.3%) reported mild to moderate adverse events, which were similar between the two groups. CONCLUSION Four weeks of clonazepam, but not PR melatonin, improved RWA. RBD symptom improvement tended to be better after clonazepam than PR melatonin in exchange for increased depressive symptoms and daytime sleepiness. CLINICALTRIALS gov identifier: NCT03255642 (first submitted August 21, 2017).
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Affiliation(s)
- Jung-Ick Byun
- Department of Neurology, Kyung Hee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul, 134-727, Republic of Korea
- Department of Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Yu Yong Shin
- Department of Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Yoon-Ah Seong
- Department of Neurology, Kyung Hee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul, 134-727, Republic of Korea
| | - Seon-Min Yoon
- Department of Neurology, Kyung Hee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul, 134-727, Republic of Korea
| | - Kyoung Jin Hwang
- Department of Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Yu Jin Jung
- Department of Neurology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kwang Su Cha
- Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Ki-Young Jung
- Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Won Chul Shin
- Department of Neurology, Kyung Hee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul, 134-727, Republic of Korea.
- Department of Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea.
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Byun JI, Cha KS, Kim M, Lee WJ, Lee HS, Sunwoo JS, Shin JW, Kim TJ, Jun JS, Kim HJ, Shin WC, Schenck CH, Lee SK, Jung KY. Association of Nucleus Basalis of Meynert Functional Connectivity and Cognition in Idiopathic Rapid-Eye-Movement Sleep Behavior Disorder. J Clin Neurol 2022; 18:562-570. [PMID: 36062774 PMCID: PMC9444555 DOI: 10.3988/jcn.2022.18.5.562] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 10/05/2021] [Revised: 01/10/2022] [Accepted: 01/10/2022] [Indexed: 11/17/2022] Open
Abstract
Background and Purpose Cognitive impairments are common in isolated rapid-eye-movement sleep behavior disorder (iRBD), in which the cholinergic system may play an important role. This study aimed to characterize the cortical cholinergic activity using resting-state functional connectivity (FC) of the nucleus basalis of Meynert (NBM) according to the cognitive status of iRBD patients. Methods In this cross-sectional study, 33 patients with polysomnography-confirmed iRBD and 20 controls underwent neuropsychological evaluations and resting-state functional magnetic resonance imaging. Thirteen of the iRBD patients had mild cognitive impairment (iRBD-MCI), and the others were age-matched patients with normal cognition (iRBD-NC). The seed-to-voxel NBM–cortical FC was compared among the patients with iRBD-MCI, patients with iRBD-NC, and controls. Correlations between average values of significant clusters and cognitive function scores were calculated in the patients with iRBD. Results There were group differences in the FC of the NBM with the left lateral occipital cortex and lingual gyrus (adjusted for age, sex, and education level). The strength of FC was lower in the iRBD-MCI group than in the iRBD-NC and control groups (each post-hoc p<0.001). The average NBM–lateral occipital cortex FC was positively correlated with the memory-domain score in iRBD patients. Conclusions The results obtained in this study support that cortical cholinergic activity is impaired in iRBD patients with MCI. FC between NBM and posterior regions may play a central role in the cognitive function of these patients.
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Affiliation(s)
- Jung-Ick Byun
- Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
| | - Kwang Su Cha
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Minah Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Woo-Jin Lee
- Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Han Sang Lee
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jun-Sang Sunwoo
- Department of Neurology, Kangbuk Samsung Hospital, Seoul, Korea
| | - Jung-Won Shin
- Department of Neurology, CHA University, CHA Bundang Medical Center, Seongnam, Korea
| | - Tae-Joon Kim
- Department of Neurology, Ajou University School of Medicine, Suwon, Korea
| | - Jin-Sun Jun
- Department of Neurology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Han-Joon Kim
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Won Chul Shin
- Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
| | - Carlos H Schenck
- Minnesota Regional Sleep Disorders Center, and Department of Psychiatry, Hennepin County Medical Center and University of Minnesota Medical School, Minneapolis, MN, USA
| | - Sang Kun Lee
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
| | - Ki-Young Jung
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
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Jeong E, Cha KS, Shin HR, Kim EY, Jun JS, Kim TJ, Byun JI, Shin JW, Sunwoo JS, Jung KY. Alerting network alteration in isolated rapid eye movement sleep behavior disorder patients with mild cognitive impairment. Sleep Med 2021; 89:10-18. [PMID: 34864507 DOI: 10.1016/j.sleep.2021.11.002] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/28/2021] [Accepted: 11/03/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Mild cognitive impairment (MCI) was found in 30-50% of the isolated REM sleep behavior disorder (iRBD) patients. Furthermore, it is known that patients with Parkinson's disease have attention network defects. Given that iRBD is known to be the prodromal disease of α-synucleinopathies, our aim was to investigate whether there are attention network dysfunctions in iRBD patients following the presence of MCI. METHODS 14 healthy controls, 48 iRBD patients, 24 with MCI and 24 without MCI, were included in this study. Attention network task (ANT) was used to assess alerting, orienting, and executive control networks. Event-related potentials (ERPs) and behavioral performances were recorded during the ANT. Parietal N1 and P3 components were analyzed to find effects of the three attention networks. RESULTS IRBD patients without MCI showed neuropsychological, behavioral, and ERP results similar to those of healthy controls. On the other hand, iRBD patients with MCI showed a general decline in cognitive domains with no alerting effect (controls, p = 0.043; iRBD-noMCI, p = 0.014; iRBD-MCI, p = 0.130) while preserving orienting and executive control effect. Furthermore, iRBD patients with MCI had impairments in executive function and verbal memory domains, compared to iRBD patients without MCI. CONCLUSIONS Our findings indicate that when cognition is reduced to MCI levels in iRBD patients, the attention network, especially the alerting component, is impaired. The attention network and cognition, on the other hand, can be preserved in iRBD patients due to the compensatory mechanism.
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Affiliation(s)
- El Jeong
- Interdisciplinary Program in Bioengineering, College of Engineering, Seoul National University, Seoul, South Korea
| | - Kwang Su Cha
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Hye-Rim Shin
- Department of Neurology, Dankook University Hospital, Cheonan, South Korea
| | - Eun Young Kim
- Department of Neurology, Chungnam National University Sejong Hospital, Sejong, South Korea
| | - Jin-Sun Jun
- Department of Neurology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Tae-Joon Kim
- Department of Neurology, Ajou University School of Medicine, Suwon, South Korea
| | - Jung-Ick Byun
- Department of Neurology, Kyung Hee University Hospital at Gangdong, Seoul, South Korea
| | - Jung-Won Shin
- Department of Neurology, CHA University, Bundang CHA Medical Center, Seongnam, South Korea
| | - Jun-Sang Sunwoo
- Department of Neurosurgery, Seoul National University Hospital, Seoul, South Korea
| | - Ki-Young Jung
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.
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Sunwoo JS, Cha KS, Byun JI, Jun JS, Kim TJ, Shin JW, Lee ST, Jung KH, Park KI, Chu K, Kim M, Lee SK, Kim HJ, Schenck CH, Jung KY. Nonrapid eye movement sleep electroencephalographic oscillations in idiopathic rapid eye movement sleep behavior disorder: a study of sleep spindles and slow oscillations. Sleep 2021; 44:5896006. [PMID: 32827438 DOI: 10.1093/sleep/zsaa160] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 08/18/2020] [Indexed: 12/29/2022] Open
Abstract
STUDY OBJECTIVES We investigated electroencephalographic (EEG) slow oscillations (SOs), sleep spindles (SSs), and their temporal coordination during nonrapid eye movement (NREM) sleep in patients with idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD). METHODS We analyzed 16 patients with video-polysomnography-confirmed iRBD (age, 65.4 ± 6.6 years; male, 87.5%) and 10 controls (age, 62.3 ± 7.5 years; male, 70%). SSs and SOs were automatically detected during stage N2 and N3. We analyzed their characteristics, including density, frequency, duration, and amplitude. We additionally identified SO-locked spindles and examined their phase distribution and phase locking with the corresponding SO. For inter-group comparisons, we used the independent samples t-test or Wilcoxon rank-sum test, as appropriate. RESULTS The SOs of iRBD patients had significantly lower amplitude, longer duration (p = 0.005 for both), and shallower slope (p < 0.001) than those of controls. The SS power of iRBD patients was significantly lower than that of controls (p = 0.002), although spindle density did not differ significantly. Furthermore, SO-locked spindles of iRBD patients prematurely occurred during the down-to-up-state transition of SOs, whereas those of controls occurred at the up-state peak of SOs (p = 0.009). The phase of SO-locked spindles showed a positive correlation with delayed recall subscores (p = 0.005) but not with tonic or phasic electromyography activity during REM sleep. CONCLUSIONS In this study, we found abnormal EEG oscillations during NREM sleep in patients with iRBD. The impaired temporal coupling between SOs and SSs may reflect early neurodegenerative changes in iRBD.
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Affiliation(s)
- Jun-Sang Sunwoo
- Department of Neurosurgery, Seoul National University Hospital, Seoul, South Korea
| | - Kwang Su Cha
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea
| | - Jung-Ick Byun
- Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Jin-Sun Jun
- Department of Neurology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Tae-Joon Kim
- Department of Neurology, Ajou University School of Medicine, Suwon, South Korea
| | - Jung-Won Shin
- Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Soon-Tae Lee
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea
| | - Keun-Hwa Jung
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea
| | - Kyung-Il Park
- Department of Neurology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea
| | - Kon Chu
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea
| | - Manho Kim
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea.,Protein Metabolism and Dementia Research Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Sang Kun Lee
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea.,Neuroscience Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Han-Joon Kim
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea
| | - Carlos H Schenck
- Minnesota Regional Sleep Disorders Center and Department of Psychiatry, Hennepin County Medical Center, University of Minnesota Medical School, Minneapolis, MN
| | - Ki-Young Jung
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea.,Neuroscience Research Institute, Seoul National University College of Medicine, Seoul, South Korea
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Ahn SJ, Cha KS, Jung KY. Response to Letter to the Editor "Perampanel effects on cognition and quantitative EEG in patients with epilepsy". Epilepsy Behav 2021; 117:107812. [PMID: 33632625 DOI: 10.1016/j.yebeh.2021.107812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 01/12/2021] [Accepted: 01/16/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Seon-Jae Ahn
- Center for Hospital Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kwang Su Cha
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ki-Young Jung
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Cha KS, Sunwoo JS, Byun JI, Kim TJ, Shin JW, Kim KH, Jung KY. Working memory deficits in patients with idiopathic restless legs syndrome are associated with abnormal theta-band neural synchrony. J Sleep Res 2021; 30:e13287. [PMID: 33565234 PMCID: PMC8518982 DOI: 10.1111/jsr.13287] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 01/06/2021] [Accepted: 01/09/2021] [Indexed: 01/01/2023]
Abstract
Cognitive impairment, particularly prefrontal function, has been reported in patients with restless legs syndrome. However, working memory performance in patients with restless legs syndrome remains uncertain. The present study aimed to examine working memory performance in patients with restless legs syndrome by investigating electroencephalography theta-band oscillations within task-relevant brain regions and the synchronization among oscillations during a working memory task. Twelve female idiopathic patients with restless legs syndrome and 12 female healthy controls participated in this study. Nineteen-channel electroencephalography data were recorded while participants performed a Sternberg working memory task. We analysed event-related theta-band activity and interregional theta-band phase synchrony during the memory retrieval phase. The spatial pattern of theta-band phase synchrony was quantified using graph theory measures, including the clustering coefficient, characteristic path length, and small-world propensity. Considerable increases in theta-band activity and theta-band phase synchrony were observed at 600-700 ms in controls and at 650-750 ms in restless legs syndrome subjects after the probe item was presented. During this period, induced theta-band activity showed lower with borderline significance in the restless legs syndrome subjects than in the controls regardless of channel location (F4,88 = 3.92, p = .06). Theta-band phase synchrony between the frontal and posterior regions was significantly reduced in the restless legs syndrome subjects. Inefficiency in both global and local networks in the restless legs syndrome subjects was revealed by the decreased small-world propensity (t22 = 2.26, p = .03). Small-world propensity was negatively correlated with restless legs syndrome severity (r = -.65, p = .02). Our findings suggest that patients with restless legs syndrome have multiple deficits in cognitive processes, including attentional allocation, evaluation of incoming stimuli, and memory manipulation of encoded information during a working memory task. Abnormal local theta-band neural synchrony and global theta-band neural synchrony may underlie the neurophysiological mechanism of the working memory dysfunction associated with restless legs syndrome.
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Affiliation(s)
- Kwang Su Cha
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea
| | - Jun-Sang Sunwoo
- Department of Neurosurgery, Seoul National University Hospital, Seoul, South Korea
| | - Jung-Ick Byun
- Department of Neurology, Kyung Hee University Hospital at Gangdong, Seoul, South Korea
| | - Tae-Joon Kim
- Department of Neurology, Ajou University School of Medicine, Suwon, South Korea
| | - Jung-Won Shin
- Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Kyung Hwan Kim
- Department of Biomedical Engineering, College of Health Science, Yonsei University, Wonju, South Korea
| | - Ki-Young Jung
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea.,Neuroscience Research Institute, Seoul National University College of Medicine, Seoul, South Korea.,Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, South Korea
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Byun JI, Cha KS, Kim M, Lee WJ, Lee HS, Sunwoo JS, Shin JW, Kim TJ, Moon J, Lee ST, Jung KH, Chu K, Kim MH, Kim HJ, Shin WC, Lee SK, Jung KY. Altered insular functional connectivity in isolated REM sleep behavior disorder: a data-driven functional MRI study. Sleep Med 2021; 79:88-93. [PMID: 33485260 DOI: 10.1016/j.sleep.2020.12.038] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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] [Received: 08/24/2020] [Revised: 12/17/2020] [Accepted: 12/29/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Functional connectivity (FC) changes can occur prior to structural changes. This study aimed to evaluate data-driven whole-brain FC associated with isolated rapid eye movement sleep behavior disorder (iRBD) using multivariate pattern analysis (MVPA). METHODS This was a cross-sectional study of 50 polysomnography-confirmed iRBD patients and 20 age- and sex-matched controls. We used MVPA implemented in the connectome-MVPA CONN toolbox to identify data-driven seed regions for post hoc seed-to-voxel connectivity analysis. The association between FC changes and clinical characteristics, including cognition, depression, autonomic function, and daytime sleepiness, was evaluated. RESULTS MVPA revealed one significant cluster located in the left posterior insular cortex. Seed-to-voxel FC analysis using the cluster as a seed showed significantly reduced FC with two clusters located in the precuneus in iRBD patients compared to the controls. The degree of FC was associated with the Montreal Cognitive Assessment-Korean version scores (r = 0.317, p = 0.025). CONCLUSION This study emphasizes the insula as an important neural correlate associated with iRBD that was associated with cognitive function.
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Affiliation(s)
- Jung-Ick Byun
- Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Kwang Su Cha
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Minah Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Woo-Jin Lee
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Han Sang Lee
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Jun-Sang Sunwoo
- Department of Neurosurgery, Seoul National University Hospital, Seoul, South Korea
| | - Jung-Won Shin
- Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Tae-Joon Kim
- Department of Neurology, Ajou University School of Medicine, Suwon, South Korea
| | - Jangsup Moon
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea; Rare Disease Center, Seoul National University Hospital, Seoul, South Korea
| | - Soon-Tae Lee
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Keun-Hwa Jung
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Kon Chu
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Man-Ho Kim
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea; Protein Metabolism and Neuroscience Research Center, College of Medicine, Seoul National University, Seoul, South Korea
| | - Han-Joon Kim
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Won Chul Shin
- Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Sang Kun Lee
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.
| | - Ki-Young Jung
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.
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10
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Byun JI, Cha KS, Jun JE, Kim TJ, Jung KY, Jeong IK, Shin WC. Dynamic changes in nocturnal blood glucose levels are associated with sleep-related features in patients with obstructive sleep apnea. Sci Rep 2020; 10:17877. [PMID: 33087786 PMCID: PMC7578637 DOI: 10.1038/s41598-020-74908-x] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 10/06/2020] [Indexed: 12/12/2022] Open
Abstract
Obstructive sleep apnea (OSA) has a bidirectional relationship with insulin resistance conditions; however, the mechanism remains unclear. This study aimed to compare dynamic nocturnal glucose changes among patients with OSA of varying levels of severity and evaluate temporal changes associated with the cardinal features of OSA (sympathetic hyperactivation, intermittent hypoxemia, and sleep fragmentation) in nondiabetic subjects. Nocturnal glucose was measured with a continuous glucose monitoring device every 5 min during polysomnography (PSG). The OSA features were evaluated using heart rate variability (HRV), minimum saturation, and electroencephalography. Eleven subjects with moderate to severe OSA and 12 subjects with no or mild OSA were evaluated. Those with moderate to severe OSA showed an increasing trend in blood glucose levels after sleep onset, whereas those without or with mild OSA showed a decreasing trend (F = 8.933, p < 0.001). Delta band power also showed different trends during sleep between the two groups (F = 2.991, p = 0.009), and minimum saturation remained lower in the moderate to severe OSA group than in the no or mild OSA group. High degrees of coupling between nocturnal glucose levels and each OSA feature were observed. Altered trends in nocturnal glucose in moderate to severe OSA may reflect glucose intolerance and result in metabolic consequences. Managing the features of sleep-related OSA may have implications for metabolic management in the future.
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Affiliation(s)
- Jung-Ick Byun
- Department of Neurology, Kyung Hee University School of Medicine, Kyung Hee University Hospital At Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul, 134-727, Republic of South Korea
| | - Kwang Su Cha
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of South Korea
| | - Ji Eun Jun
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Kyung Hee University Hospital At Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul, 134-727, Republic of South Korea
| | - Tae-Joon Kim
- Department of Neurology, Ajou University School of Medicine, Suwon, Republic of South Korea
| | - Ki-Young Jung
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of South Korea
| | - In-Kyung Jeong
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Kyung Hee University Hospital At Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul, 134-727, Republic of South Korea.
| | - Won Chul Shin
- Department of Neurology, Kyung Hee University School of Medicine, Kyung Hee University Hospital At Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul, 134-727, Republic of South Korea.
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11
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Byun JI, Kim HW, Kang H, Cha KS, Sunwoo JS, Shin JW, Moon J, Lee ST, Jung KH, Chu K, Kim M, Shin WC, Lee DS, Schenck CH, Lee SK, Jung KY. Corrigendum to "Altered resting-state thalamo-occipital functional connectivity is associated with cognition in isolated rapid eye movement sleep behavior disorder" [Sleep Med 69 (2020) 198-203]. Sleep Med 2020; 75:547. [PMID: 32451159 DOI: 10.1016/j.sleep.2020.04.023] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Jung-Ick Byun
- Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Hyun-Woo Kim
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Hyejin Kang
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, South Korea; BK21 Plus Global Translational Research on Molecular Medicine and Biopharmaceutical Sciences, Seoul, South Korea
| | - Kwang Su Cha
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Jun-Sang Sunwoo
- Department of Neurosurgery, Seoul National University Hospital, Seoul, South Korea
| | - Jung-Won Shin
- Department of Neurology, CHA University, CHA Bundang Medical Center, Seongnam, South Korea
| | - Jangsup Moon
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea; Rare Disease Center, Seoul National University Hospital, Seoul, South Korea
| | - Soon-Tae Lee
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Keun-Hwa Jung
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Kon Chu
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Manho Kim
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea; Dementia Research Center, Seoul National University, Seoul, South Korea
| | - Won Chul Shin
- Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Dong Soo Lee
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, South Korea; Department of Molecular Medicine and Biopharmaceutical Science, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea
| | - Carlos H Schenck
- Minnesota Regional Sleep Disorders Center, Department of Psychiatry, Hennepin County Medical Center, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Sang Kun Lee
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.
| | - Ki-Young Jung
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.
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12
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Sunwoo JS, Cha KS, Byun JI, Kim TJ, Jun JS, Lim JA, Lee ST, Jung KH, Park KI, Chu K, Kim HJ, Kim M, Lee SK, Kim KH, Schenck CH, Jung KY. Abnormal activation of motor cortical network during phasic REM sleep in idiopathic REM sleep behavior disorder. Sleep 2019; 42:5184577. [PMID: 30445515 DOI: 10.1093/sleep/zsy227] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Indexed: 11/14/2022] Open
Abstract
Study Objectives We investigated electroencephalography (EEG) power spectral density and functional connectivity during phasic and tonic rapid eye movement (REM) sleep, and examined any differences between patients with idiopathic REM sleep behavior disorder (iRBD) and controls. Methods EEG data from 13 people with iRBD (mean age, 66.3 years; men, 84.6%) and 10 controls (mean age, 62.3 years; men, 70%) were analyzed. We selected thirty 3 s miniepochs of both tonic and phasic REM sleep. We estimated relative power for six frequency bands. For functional connectivity analysis, we calculated weighted phase lag index (wPLI) and conducted pairwise comparisons between the two groups. Results EEG power spectral analysis revealed significant interactions between the REM sleep state (phasic vs. tonic) and group at sigma (p = 0.009) and beta (p = 0.002) bands. Sigma- and beta-power decrease during phasic REM sleep was more pronounced and extensive in people with iRBD than in controls. Regarding functional connectivity, there were significant interactions between the REM sleep state and group at alpha (p = 0.029), sigma (p = 0.047), beta (p = 0.015), and gamma (p = 0.046) bands. The average wPLI was significantly higher during phasic REM sleep than during tonic REM sleep, which was observed in people with iRBD but not in controls. The altered functional connections mainly involved the frontal and parietal regions at beta and gamma bands. Conclusions Our findings provide neurophysiological evidence for pathological motor cortex activation during phasic REM sleep which may be associated with generation of dream-enacting behaviors in iRBD.
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Affiliation(s)
- Jun-Sang Sunwoo
- Department of Neurology, Soonchunhyang University College of Medicine, Seoul, South Korea
| | - Kwang Su Cha
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea
| | - Jung-Ick Byun
- Department of Neurology, Kyung Hee University Hospital at Gangdong, Seoul, South Korea
| | - Tae-Joon Kim
- Department of Neurology, National Center for Mental Health, Seoul, South Korea
| | - Jin-Sun Jun
- Department of Neurology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - Jung-Ah Lim
- Department of Neurology, Gangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Soon-Tae Lee
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea.,Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea
| | - Keun-Hwa Jung
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea.,Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea
| | - Kyung-Il Park
- Department of Neurology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea
| | - Kon Chu
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea.,Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea
| | - Han-Joon Kim
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea
| | - Manho Kim
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea.,Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea.,Protein Metabolism Medical Research Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Sang Kun Lee
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea.,Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea.,Neuroscience Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Kyung Hwan Kim
- Department of Biomedical Engineering, College of Health Science, Yonsei University, Wonju, South Korea
| | - Carlos H Schenck
- Minnesota Regional Sleep Disorders Center, and Department of Psychiatry, Hennepin County Medical Center and University of Minnesota Medical School, Minneapolis, MN
| | - Ki-Young Jung
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea.,Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea.,Neuroscience Research Institute, Seoul National University College of Medicine, Seoul, South Korea
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13
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Cha KS, Kim TJ, Jun JS, Byun JI, Sunwoo JS, Shin JW, Kim KH, Lee SK, Jung KY. Impaired slow oscillation, sleep spindle, and slow oscillation-spindle coordination in patients with idiopathic restless legs syndrome. Sleep Med 2019; 66:139-147. [PMID: 31877505 DOI: 10.1016/j.sleep.2019.09.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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] [Received: 07/24/2019] [Revised: 09/10/2019] [Accepted: 09/16/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Thalamocortical abnormalities have been implicated in the pathophysiology of restless legs syndrome (RLS). We hypothesized that sleep spindle and slow oscillation (SO) activity is impaired in RLS, and that this dysfunction may contribute to sleep disturbance in these patients. To address this issue, we characterized sleep spindle and SO activity in RLS. METHODS Fifteen drug-naive, idiopathic RLS patients (13 female and 2 male) and 15 female healthy controls participated in this study. Nineteen-channel electroencephalograms were obtained during polysomnographic (PSG) recordings. An automated sleep spindle and SO detection algorithm was used to detect sleep spindle (12-16 Hz) and SO (<1 Hz) activity. The quantitative characteristics of sleep spindle and SO activity were investigated. RESULTS Compared with the healthy controls, in RLS patients, we observed density and power reduction in sleep spindles. In SOs, density reduction and duration increment were shown in RLS patients. In addition, SO-spindle coordination was deficient in RLS as revealed by reduced SO locked spindle power, dispersed and delayed spindle phase, and decreased SO-spindle coupling. Although sleep spindle power was negatively correlated with wake after sleep onset (WASO) time, SO duration was positively correlated with the arousal index in RLS. CONCLUSIONS Our study suggests that sleep disturbances may be mediated by a combined deficit in spindle and SO activity and SO-spindle coordination. The abnormal SO and spindle activity observed in RLS support the notion that thalamocortical abnormalities underlie this condition and may promote disturbed sleep integrity.
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Affiliation(s)
- Kwang Su Cha
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea
| | - Tae-Joon Kim
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Ajou University School of Medicine, Suwon, South Korea
| | - Jin-Sun Jun
- Department of Neurology, Hallym University College of Medicine, Seoul, South Korea
| | - Jung-Ick Byun
- Department of Neurology, Kyung Hee University Hospital at Gangdong, Seoul, South Korea
| | - Jun-Sang Sunwoo
- Department of Neurosurgery, Seoul National University Hospital, Seoul, South Korea
| | - Jung-Won Shin
- Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Kyung Hwan Kim
- Department of Biomedical Engineering, College of Health Science, Yonsei University, Wonju, South Korea
| | - Sang Kun Lee
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea; Neuroscience Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Ki-Young Jung
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea; Neuroscience Research Institute, Seoul National University College of Medicine, Seoul, South Korea.
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14
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Choe JC, Cha KS, Shin JY, Ahn J, Park JS, Lee HW, Oh JH, Choi JH, Lee HC, Hong TJ. 3334Updated meta-analysis of biodegradable polymer drug-eluting stent versus second-generation durable polymer drug-eluting stent implantations. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0086] [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
Data regarding clinical outcomes of biodegradable polymer drug-eluting stent (BP-DES) versus second-generation durable polymer drug-eluting stent (DP-DES) in patients undergoing percutaneous coronary intervention (PCI) are inconclusive.
Purpose
We aimed to perform a meta-analysis to investigate the clinical outcomes of BP-DES compared with second-generation DP-DES in patients who have undergone PCI.
Methods
We searched PubMed, MEDLINE, EMBASE, and Cochrane databases through January 2019 for randomized controlled trials comparing BP-DES with second-generation DP-DES in patients treated with PCI. All-cause death, cardiac death, myocardial infarction (MI), target vessel revascularization (TVR), target lesion revascularization (TLR), definite/probable stent thrombosis (ST) were compared between the groups. Additionally, a landmark analysis with the landmark set at 1 year and a subgroup analysis according to stent characteristics were performed.
Results
Data from 23 trials including 28802 randomized patients were analyzed. At a median follow up of 3.1 years, no significant differences were found in terms of all-cause death (odds ratio [OR] 1.05, 95% confidence interval [CI] 0.95–1.16), cardiac death (OR 1.01, 95% CI 0.87–1.17), MI (OR 0.92, 95% CI 0.82–1.03), TVR (OR 0.97, 95% CI 0.86–1.11), TLR (OR 0.97, 95% CI 0.85–1.11), and definite/probable ST (OR 0.86, 95% CI 0.70–1.07) between the groups. Landmark analysis showed that there were similar risks in all-cause death (OR 1.04, 95% CI 0.93–1.17), cardiac death (OR 1.11, 95% CI 0.92–1.36), MI (OR 0.94, 95% CI 0.79–1.13), TVR (OR 0.95, 95% CI 0.73–1.23), TLR (OR 1.00, 95% CI 0.80–1.24), and definite/probable ST (OR 0.92, 95% CI 0.67–1.28) between the groups. The similar tendency of any study endpoints between the groups was consistent in the subgroup, including stent platform (stainless steel vs. alloy), the drug coating distribution (abluminal vs. circumferential), the polymer degradation period (<6 months vs. >6 months), or the drug release duration (<6 months vs. >6 months) of BP-DES, or the DAPT duration (≥6 months vs. ≥12 months). However, the uses of BP-DES with sirolimus-eluting (OR 0.84, 95% CI 0.72–0.98) or ultrathin strut (defined as <70μm; OR 0.81, 95% CI 0.68–0.97) were predictive for lower risk of MI.
Clinical outcomes
Conclusions
In our updated meta-analysis, BP-DES implantation was associated with comparable clinical outcomes compared with second-generation DP-DES implantation. However, PCI with ultrathin biodegradable polymer sirolimus-eluting stent could reduce the risk of MI.
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Affiliation(s)
- J C Choe
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - K S Cha
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - J Y Shin
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - J Ahn
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - J S Park
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - H W Lee
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - J H Oh
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - J H Choi
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - H C Lee
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - T J Hong
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
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15
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Kim M, Ahn Y, Jeong MH, Sim DS, Hong YJ, Kim JH, Ahn TH, Seung KB, Kim HS, Gwon HC, Chae SC, Hur SH, Cha KS. P3127Optimal revascularization strategy in non-ST-segment elevation myocardial infarction with multivessel coronary artery disease: staged vs. one-time vs. culprit-only revascularization. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0202] [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: 11/12/2022] Open
Abstract
Abstract
Background/Introduction
Although optimal revascularization strategy in patients with ST-segment elevation myocardial infarction with multivessel coronary artery disease (MVD) was well established, there are few studies which investigated optimal revascularization strategy in non-ST-segment elevation myocardial infarction (NSTEM) with MVD.
Purpose
We investigated 2-year clinical outcomes according to strategy of revascularization in patients with NSTEMI and MVD.
Methods
Between November 2011 and October 2015, a total of 2474 patients with NSTEMI and MVD who underwent successful percutaneous coronary intervention were analyzed from the Korea Acute Myocardial Infarction Registry-National Institute of Health (staged 308, one-time 1043 and culprit-only 1123 patients). We did not include patients with left main disease and cardiogenic shock. Primary endpoint was major adverse cardiac events (MACE: the composite of cardiac death, myocardial infarction [MI] or target-vessel revascularization [TVR]) during 2-year follow-up (median 737 days [interquartile range 705–764]). We also analyzed the of all-cause mortality, stroke and non-TVR.
Results
Baseline characteristics such as age, gender, and prevalence of atherosclerotic risk factors between multivessel revascularization (MVR; staged or one-time revascularization) and CVR were similar. There was also no difference in symptom to balloon time in 2 groups. MACE occurred in 305 patients (12.3%) during 2-year follow-up. MVR could reduce incidence of MACE (10.2% vs. 14.9%; adjusted hazard ratio [HR] 1.50 for CVR, 95% confidence interval [CI] 1.20–1.88, p<0.001), all-cause death (8.4% vs. 12.1%; adjusted HR 1.45 for CVR, 95% CI 1.13–1.87, p=0.003) and non-TVR (1,9% vs. 7.0%; adjusted HR 3.99 for CVR, 95% CI 2.55–6.27, p<0.001). There was no difference in incidence of stroke between MVR and CVR. We also analyzed same analysis between staged and one-time revascularization. Complete revascularization was more achieved in one-time revascularization group compared to staged revascularization group (62.0% vs. 76.1%, p<0.001). In multivariate Cox-regression analysis, staged revascularization was not associated with improved clinical outcomes in terms of MACE (HR 0.74, 95% CI 0.50–1.09, p=0.126), all-cause death (HR 1.07, 95% CI 0.69–1.68, p=0.759), stroke (HR 1.75, 95% CI 0.68–4.52, p=0.245) and non-TVR (HR 2.56, 95% CI 0.75–8.68, p=0.132). Analysis by propensity score matching and inverse probability of treatment weighting did not significantly affect the results.
Conclusions
MVR reduced 2-year adverse cardiac events in patients with NSTEMI and MVD compared to CVR. However, staged revascularization was not superior to one-time revascularization for reducing MACE among NSTEMI patients with MVD who received MVR.
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Affiliation(s)
- M Kim
- Chonnam National University Hospital, Gwangju, Korea (Republic of)
| | - Y Ahn
- Chonnam National University Hospital, Gwangju, Korea (Republic of)
| | - M H Jeong
- Chonnam National University Hospital, Gwangju, Korea (Republic of)
| | - D S Sim
- Chonnam National University Hospital, Gwangju, Korea (Republic of)
| | - Y J Hong
- Chonnam National University Hospital, Gwangju, Korea (Republic of)
| | - J H Kim
- Chonnam National University Hospital, Gwangju, Korea (Republic of)
| | - T H Ahn
- Gil Hospital, Incheon, Korea (Republic of)
| | - K B Seung
- Seoul St. Mary's Hospital, Seoul, Korea (Republic of)
| | - H S Kim
- Seoul National University Hospital, Seoul, Korea (Republic of)
| | - H C Gwon
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - S C Chae
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - S H Hur
- Keimyung University Hospital Dongsan Medical Center, Daegu, Korea (Republic of)
| | - K S Cha
- Pusan National University Hospital, Pusan, Korea (Republic of)
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16
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Choe JC, Cha KS, Shin JY, Ahn J, Park JS, Lee HW, Oh JH, Choi JH, Lee HC, Hong TJ. P2799Long-term outcomes after percutaneous coronary intervention with biodegradable polymer drug-eluting stent versus second-generation durable polymer drug-eluting stent: evidence from a meta-analysis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1112] [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
The true benefit of biodegradable polymer drug-eluting stent (BP-DES) over second-generation durable polymer drug-eluting stent (DP-DES) expected to be represented during late period of follow-up after percutaneous coronary intervention (PCI), but prior meta-analysis only evaluated short-term outcomes.
Purpose
We aimed to compare the long-term clinical outcomes after PCI with BP-DES versus second-generation DP-DES by a meta-analysis of randomized controlled trials.
Methods
Randomized controlled trials comparing BP-DES with second-generation DP-DES implantations were searched through PubMed, MEDLINE, EMBASE, and Cochrane databases. All-cause death, cardiac death, myocardial infarction (MI), target vessel revascularization (TVR), target lesion revascularization (TLR), and definite/probable stent thrombosis (ST) were compared between the groups. In addition, a landmark analysis with the landmark set at 1-year and a subgroup analysis based on stent characteristics were performed.
Results
Fifteen trials that included a total of 21311 randomized patients with at least 2 years follow-up were analyzed. At a median follow-up of 4.2 years, no significant differences in the risks of all-cause death (odds ratio [OR] 1.03, 95% confidence interval [CI] 0.94–1.14), cardiac death (OR 1.03, 95% CI 0.88–1.20), MI (OR 0.90, 95% CI 0.79–1.01), TVR (OR 0.96, 95% CI 0.82–1.12), TLR (OR 0.97, 95% CI 0.85–1.11), and definite/probable ST (OR 0.84, 95% CI 0.67–1.05) were found between the groups. In the 1-year landmark analysis, the rates of all-cause death (OR 1.04, 95% CI 0.93–1.17), cardiac death (OR 1.11, 95% CI 0.92–1.36), MI (OR 0.94, 95% CI 0.79–1.13), TVR (OR 0.95, 95% CI 0.73–1.23), TLR (OR 1.00, 95% CI 0.80–1.24), and definite/probable ST (OR 0.94, 95% CI 0.67–1.31) were similar between the groups. There were comparable rates of any study endpoints between the groups regardless of stent platform (stainless steel vs. alloy), the polymer degradation period (<6 months vs. >6 months) or the drug release duration (<6 months vs. >6 months) of BP-DES, or the DAPT duration (≥6 months vs. ≥12 months). However, the use of BP-DES with sirolimus eluting (OR 0.82, 95% CI 0.70–0.97), circumferential drug distribution (OR 0.79, 95% CI 0.65–0.96), thin strut (defined as <100μm; OR 0.83, 95% CI 0.70–0.97), or ultrathin strut (defined as <70μm; OR 0.78, 95% CI 0.64–0.94) were associated with lower rates of MI than did second-generation DP-DES. Moreover, BP-DES with circumferential drug distribution (OR 0.82, 95% CI 0.69–0.98) was predictive for reduced rates of TVR.
Clinical outcomes
Conclusions
In this meta-analysis, long-term clinical outcomes were equivalent between BP-DES and second-generation DP-DES implantations. However, among BP-DESs, the improved risks of MI in those with sirolimus eluting, circumferential drug distribution, thin strut, or ultrathin strut and decreased rates of TVR in those with circumferential drug distribution were noted.
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Affiliation(s)
- J C Choe
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - K S Cha
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - J Y Shin
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - J Ahn
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - J S Park
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - H W Lee
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - J H Oh
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - J H Choi
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - H C Lee
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
| | - T J Hong
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea (Republic of)
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Her S, Cha KS, Choi JW, Kim H, Byun JI, Sunwoo JS, Kim TJ, Lim JA, Jung KY, Kim KH. Impaired visuospatial attention revealed by theta- and beta-band cortical activities in idiopathic REM sleep behavior disorder patients. Clin Neurophysiol 2019; 130:1962-1970. [PMID: 31476702 DOI: 10.1016/j.clinph.2019.07.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 04/09/2019] [Revised: 07/04/2019] [Accepted: 07/26/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Idiopathic REM sleep behavior disorder (iRBD) patients are susceptible to cognitive deficits, especially attention dysfunction. The objective of this study is to elucidate the neural mechanism of the dysfunction in attention known as 'inhibition of return' (IOR) in iRBD patients based on an analysis of oscillatory cortical activity during a selective attention task. METHODS Event-related potentials (ERPs) were recorded from iRBD patients and normal control subjects while performing a Posner task. The differences in N1 ERP and theta- and beta-bands event-related spectral perturbations (ERSPs) between valid and invalid stimuli were compared between groups. RESULTS The N1 amplitude was significantly higher for the invalid stimuli in controls, while the valid-invalid difference was not significant in iRBD patients. The valid-invalid differences in ERSPs were prominent in controls at ∼100-400 ms for the theta-band and ∼200-400 ms for the beta-band, and the valid-invalid differences in ERSPs were not significant in the iRBD patients. CONCLUSION The results demonstrated that valid-invalid differences in neural activity were absent in iRBD patients, and these neural findings were in accord with the behavioral results. SIGNIFICANCE Our findings imply impairment in sensory-perceptual processing mediated by attentional control and response inhibition in early-stage iRBD before clinical neurodegeneration.
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Affiliation(s)
- Seongjin Her
- Department of Biomedical Engineering, College of Health Science, Yonsei University, Wonju, South Korea
| | - Kwang Su Cha
- Department of Biomedical Engineering, College of Health Science, Yonsei University, Wonju, South Korea; Department of Neurology, Seoul National University Hospital, Neuroscience Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Jeong Woo Choi
- Department of Biomedical Engineering, College of Health Science, Yonsei University, Wonju, South Korea; Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Hyun Kim
- Department of Biomedical Engineering, College of Health Science, Yonsei University, Wonju, South Korea
| | - Jung-Ick Byun
- Department of Neurology, Kyung Hee University Hospital at Gangdong, Seoul, South Korea
| | - Jun-Sang Sunwoo
- Department of Neurosurgery, Seoul National University Hospital, Seoul, South Korea
| | - Tae-Joon Kim
- Department of Neurology, Ajou University School of Medicine, Ajou University Medical Center, Suwon, South Korea
| | - Jung-Ah Lim
- Department of Neurology, Chamjoeun Hospital, Gwangju, South Korea
| | - Ki-Young Jung
- Department of Neurology, Seoul National University Hospital, Neuroscience Research Institute, Seoul National University College of Medicine, Seoul, South Korea.
| | - Kyung Hwan Kim
- Department of Biomedical Engineering, College of Health Science, Yonsei University, Wonju, South Korea.
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Yeo D, Kim H, Her S, Choi JW, Cha KS, Kim KH. Spatiotemporal Analysis of Event-related Current Density Reveals Dissociable Effects of Arousal and Valence on Emotional Picture Processing. J Korean Med Sci 2019; 34:e146. [PMID: 31124325 PMCID: PMC6535406 DOI: 10.3346/jkms.2019.34.e146] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 04/22/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The processing of emotional visual stimulation involves the processing of emotional and visuoperceptual information. It is not completely revealed how the valence and arousal affect these two aspects. The objective was to investigate the effects of valence and arousal on spatiotemporal characteristics of cortical information processing using distributed source imaging of event-related current density (ERCD). METHODS Electroencephalograms (64 channels) were recorded from 19 healthy men while presenting affective pictures. Distributed source localization analysis was adopted to obtain the spatiotemporal pattern of ERCD on cortical surface in response to emotional visual stimulation. A nonparametric cluster-based permutation test was used to find meaningful time and space without prior knowledge. RESULTS Significant changes of ERCD in 400-800 ms among positive, negative, and neutral emotional conditions were found in left posterior cingulate cortex (PCC) and right inferior temporal cortex (ITC). In the PCC, the stimuli with higher arousal levels showed more negative ERCD than neutral stimuli. In the ITC, the ERCD for negative stimuli was significantly more negative than those of positive and neutral ones. CONCLUSION Arousal and valence had strong influence on memory encoding and visual analysis at late period. The location and time showing significant change in neural activity according to arousal and valence would provide valuable information for understanding the changes of cortical function by neuropsychiatric disorders.
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Affiliation(s)
- Donghoon Yeo
- Department of Biomedical Engineering, College of Health Science, Yonsei University, Wonju, Korea
| | - Hyun Kim
- Department of Biomedical Engineering, College of Health Science, Yonsei University, Wonju, Korea
| | - Seongjin Her
- Department of Biomedical Engineering, College of Health Science, Yonsei University, Wonju, Korea
| | - Jeong Woo Choi
- Department of Biomedical Engineering, College of Health Science, Yonsei University, Wonju, Korea
- Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Kwang Su Cha
- Department of Biomedical Engineering, College of Health Science, Yonsei University, Wonju, Korea
- Department of Neurology, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung Hwan Kim
- Department of Biomedical Engineering, College of Health Science, Yonsei University, Wonju, Korea.
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Cha KS, Chang HY, Shin YW, Kim HW, Jung KY. 0646 Abnormal Event-related Electroencephalograms In Patients With Rapid-eye Movement (REM) Sleep Behavior Disorder (RBD) During Involuntary Visuospatial Attention Task: A Possible Progression Marker In Neurodegenerative Disease. Sleep 2019. [DOI: 10.1093/sleep/zsz067.644] [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: 11/14/2022] Open
Affiliation(s)
- Kwang Su Cha
- Seoul National University Hospital, Seoul, Korea, Republic of
| | - Hye-Yeon Chang
- Seoul National University Hospital, Seoul, Korea, Republic of
| | - Yong-Won Shin
- Seoul National University Hospital, Seoul, Korea, Republic of
| | - Hyun Woo Kim
- Seoul National University Hospital, Seoul, Korea, Republic of
| | - Ki-Young Jung
- Seoul National University Hospital, Seoul, Korea, Republic of
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20
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Sim DS, Jeong MH, Kim HS, Gwon HC, Seung KB, Rha SW, Chae SC, Kim CJ, Cha KS, Park JS, Yoon JH, Chae JK, Joo SJ, Choi DJ, Hur SH. P4610Utility of GRACE and ACUITY-HORIZONS risk scores to guide dual antiplatelet therapy in patients with acute myocardial infarction undergoing drug-eluting stenting. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4610] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D S Sim
- Chonnam National University Hospital, Gwangju, Korea Republic of
| | - M H Jeong
- Chonnam National University Hospital, Gwangju, Korea Republic of
| | - H S Kim
- Seoul National University Hospital, Seoul, Korea Republic of
| | - H C Gwon
- Samsung Medical Center, Seoul, Korea Republic of
| | - K B Seung
- The Catholic University of Korea, Seoul, Korea Republic of
| | - S W Rha
- Korea University Guro Hospital, Seoul, Korea Republic of
| | - S C Chae
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - C J Kim
- Kyunghee University, Seoul, Korea Republic of
| | - K S Cha
- Pusan National University Hospital, Pusan, Korea Republic of
| | - J S Park
- Yeungnam University Hospital, Daegu, Korea Republic of
| | - J H Yoon
- Wonju Medical College, Wonju, Korea Republic of
| | - J K Chae
- Chonbuk National University Hospital, Jeonju, Korea Republic of
| | - S J Joo
- Jeju National University Hospital, Jeju, Korea Republic of
| | - D J Choi
- Seoul National University Bundang Hospital, Seongnam, Korea Republic of
| | - S H Hur
- Keimyung University Hospital Dongsan Medical Center, Daegu, Korea Republic of
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Choe JC, Cha KS, Shin JY, Lee SH, Ahn J, Park JS, Lee HW, Oh JH, Choi JH, Lee HC, Hong TJ, Jeong MH. 1466Prognosis of biodegradable polymer drug-eluting stents versus second-generation durable polymer drug-eluting stents in acute myocardial infarction patients following percutaneous coronary intervention. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.1466] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J C Choe
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea Republic of
| | - K S Cha
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea Republic of
| | - J Y Shin
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea Republic of
| | - S H Lee
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea Republic of
| | - J Ahn
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea Republic of
| | - J S Park
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea Republic of
| | - H W Lee
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea Republic of
| | - J H Oh
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea Republic of
| | - J H Choi
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea Republic of
| | - H C Lee
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea Republic of
| | - T J Hong
- Pusan National University Hospital, Department of Cardiology, Pusan, Korea Republic of
| | - M H Jeong
- Chonnam National University Hospital, Department of Cardiology, Gwangju, Korea Republic of
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Sunwoo JS, Lee S, Kim JH, Lim JA, Kim TJ, Byun JI, Jeong MH, Cha KS, Choi JW, Kim KH, Lee ST, Jung KH, Park KI, Chu K, Kim M, Lee SK, Jung KY. Altered Functional Connectivity in Idiopathic Rapid Eye Movement Sleep Behavior Disorder: A Resting-State EEG Study. Sleep 2018; 40:3738526. [PMID: 28431177 DOI: 10.1093/sleep/zsx058] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [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: 04/12/2017] [Indexed: 11/13/2022] Open
Abstract
Study Objectives Idiopathic rapid eye movement sleep behavior disorder (iRBD) is considered as a prodromal stage of synucleinopathy. Although loss of functional connectivity is implicated in neurodegenerative diseases, network characteristics of electroencephalography (EEG) in iRBD are unknown. Therefore, we evaluated resting-state EEG functional connectivity to identify the brain network changes in patients with iRBD. Methods We prospectively enrolled 20 patients with polysomnography-confirmed iRBD and 16 controls. Four patients with mild cognitive impairment were excluded from the analysis after cognitive function tests. EEG was recorded during relaxed wakefulness. We computed the weighted phase lag index as a measure of functional connectivity from EEG recordings. Results All patients with iRBD (mean age 64.3 years; men, 68.8%) had no overt manifestations of neurodegenerative diseases such as Parkinsonism or dementia. The mean duration from symptom onset was 4.8 years. Overall connectivity strength did not differ between the two groups in all frequency bands. However, comparisons of each functional connection with the nonparametric permutation test demonstrated iRBD had decreased delta-band functional connectivity in the frontal regions. There were no significantly increased functional connections in all frequencies. The altered connections had a significant correlation with RBD questionnaire scores. Notably, delta-band weighted phase lag index between left frontal and central regions was correlated with verbal fluency performance (r = 0.486, p = .007). Conclusions Resting-state brain network of iRBD was characterized by a loss of delta-band functional connectivity. Therefore, functional networks in iRBD are altered at the early phase of disease.
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Affiliation(s)
- Jun-Sang Sunwoo
- Department of Neurology, Soonchunhyang University College of Medicine, Seoul, South Korea
| | - Sanghun Lee
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea.,Department of Mathematical Sciences, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - Jung-Hoon Kim
- Weldon School of Biomedical Engineering, College of Engineering, Purdue University, West Lafayette, IN
| | - Jung-Ah Lim
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea.,Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea.,Department of Neurology, National Center for Mental Health, An affiliate of the Ministry for Health & Welfare, Seoul, South Korea
| | - Tae-Joon Kim
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea.,Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea
| | - Jung-Ick Byun
- Department of Neurology, Kyung Hee University Hospital at Gangdong, Seoul, South Korea
| | - Min Hee Jeong
- Department of Biomedical Engineering, College of Health Science, Yonsei University, Wonju, South Korea
| | - Kwang Su Cha
- Department of Biomedical Engineering, College of Health Science, Yonsei University, Wonju, South Korea
| | - Jeong Woo Choi
- Department of Biomedical Engineering, College of Health Science, Yonsei University, Wonju, South Korea
| | - Kyung Hwan Kim
- Department of Biomedical Engineering, College of Health Science, Yonsei University, Wonju, South Korea
| | - Soon-Tae Lee
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea.,Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea
| | - Keun-Hwa Jung
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea.,Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea
| | - Kyung-Il Park
- Department of Neurology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea
| | - Kon Chu
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea.,Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea
| | - Manho Kim
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea.,Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea.,Protein Metabolism Medical Research Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Sang Kun Lee
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea.,Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea.,Neuroscience Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Ki-Young Jung
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea.,Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea.,Neuroscience Research Institute, Seoul National University College of Medicine, Seoul, South Korea
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Abstract
The purpose of this study was to compare the electroencephalographic (EEG) patterns and reaction times (RTs) of muscle activation between concentric and eccentric biceps brachii contractions under the RT paradigm and to evaluate how the EEG patterns and RTs changed with practice. Sixteen subjects performed 3 sets of 30 repetitions of submaximal voluntary concentric and eccentric biceps contractions. RT, event-related desynchronization (ERD) patterns of mu rhythm onset, and ERD amplitudes were selectively analyzed. Mental demand decreased as familiarity with the motor action increased due to practice regardless of contraction type. However, the 2 types of muscle contractions still have differences in brain activity regardless of decreased mental demand: eccentric contractions require earlier preparation than concentric contractions.
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Affiliation(s)
- Joo-Hee Park
- a Department of Physical Therapy , Graduate School, Yonsei University , Wonju , Republic of Korea
| | - Heon-Seock Cynn
- b Department of Physical Therapy , College of Health Science, Yonsei University , Wonju , Republic of Korea
| | - Kwang Su Cha
- c Department of Biomedical Engineering , College of Health Science, Yonsei University , Wonju , Republic of Korea
| | - Kyung Hwan Kim
- c Department of Biomedical Engineering , College of Health Science, Yonsei University , Wonju , Republic of Korea
| | - Hye-Seon Jeon
- b Department of Physical Therapy , College of Health Science, Yonsei University , Wonju , Republic of Korea
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Cha KS, Choi JW, Jung KY, Kim KH. Frontal dysfunction in patients with restless legs syndrome performing a visual oddball task: an event-related potential source imaging study. Sleep Med 2017; 36:48-54. [DOI: 10.1016/j.sleep.2017.04.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 04/03/2017] [Accepted: 04/22/2017] [Indexed: 01/18/2023]
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Choi JW, Jeong MH, Her SJ, Lee BU, Cha KS, Jung KY, Kim KH. Abnormal Sleep Delta Rhythm and Interregional Phase Synchrony in Patients with Restless Legs Syndrome and Their Reversal by Dopamine Agonist Treatment. J Clin Neurol 2017; 13:340-350. [PMID: 28831786 PMCID: PMC5653621 DOI: 10.3988/jcn.2017.13.4.340] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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: 03/20/2017] [Revised: 05/13/2017] [Accepted: 05/15/2017] [Indexed: 02/05/2023] Open
Abstract
Background and Purpose The purpose of this study was to characterize abnormal cortical activity during sleep in restless legs syndrome (RLS) patients and to determine the effects of treatment with a dopamine agonist. Based on whole-brain electroencephalograms, we attempted to verify alterations in the functional network as well as the spectral power of neural activities during sleep in RLS patients and to determine whether the changes are reversed by treatment with pramipexole. Methods Twelve drug-naïve RLS patients participated in the study. Overnight polysomnography was performed before and after treatment: the first recording was made immediately prior to administering the first dose of pramipexole, and the second recording was made 12–16 weeks after commencing pramipexole administration. Sixteen age-matched healthy participants served as a control group. The spectral power and interregional phase synchrony were analyzed in 30-s epochs. The functional characteristics of the cortical network were quantified using graph-theory measures. Results The delta-band power was significantly increased and the small-world network characteristics in the delta band were disrupted in RLS patients compared to the healthy controls. These abnormalities were successfully treated by dopaminergic medication. The delta-band power was significantly correlated with the RLS severity score in the RLS patients prior to treatment. Conclusions Our findings suggest that the spectral and functional network characteristics of neural activities during sleep become abnormal in RLS patients, and these abnormalities can be successfully treated by a dopamine agonist.
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Affiliation(s)
- Jeong Woo Choi
- Department of Biomedical Engineering, College of Health Science, Yonsei University, Wonju, Korea
| | - Min Hee Jeong
- Department of Biomedical Engineering, College of Health Science, Yonsei University, Wonju, Korea
| | - Seong Jin Her
- Department of Biomedical Engineering, College of Health Science, Yonsei University, Wonju, Korea
| | - Byeong Uk Lee
- Department of Neurology, Seoul National University College of Medicine, Seoul, Korea
| | - Kwang Su Cha
- Department of Biomedical Engineering, College of Health Science, Yonsei University, Wonju, Korea
| | - Ki Young Jung
- Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
| | - Kyung Hwan Kim
- Department of Biomedical Engineering, College of Health Science, Yonsei University, Wonju, Korea.
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Gowran A, Kulikova T, Lewis FC, Foldes G, Fuentes L, Viiri LE, Spinelli V, Costa A, Perbellini F, Sid-Otmane C, Bax NAM, Pekkanen-Mattila M, Schiano C, Chaloupka A, Forini F, Sarkozy M, De Jager SCA, Vajen T, Glezeva N, Lee HW, Golovkin A, Kucera T, Musikhina NA, Korzhenkov NP, Santuchi MDEC, Munteanu D, Garcia RG, Ang R, Usui S, Kamilova U, Jumeau C, Aberg M, Kostina DA, Brandt MM, Muntean D, Lindner D, Sadaba R, Bacova B, Nikolov A, Sedmera D, Ryabov V, Neto FP, Lynch M, Portero V, Kui P, Howarth FC, Gualdoni A, Prorok J, Diolaiuti L, Vostarek F, Wagner M, Abela MA, Nebert C, Xiang W, Kloza M, Maslenko A, Grechanyk M, Bhattachariya A, Morawietz H, Babaeva AR, Martinez Sanchez SM, Krychtiuk KA, Starodubova J, Fiorelli S, Rinne P, Ozkaramanli Gur D, Hofbauer T, Starodubova J, Stellos K, Pinon P, Tsoref O, Thaler B, Fraga-Silva RA, Fuijkschot WW, Shaaban MNS, Matthaeus C, Deluyker D, Scardigli M, Zahradnikova A, Dominguez A, Kondrat'eva D, Sosorburam T, Murarikova M, Duerr GD, Griecsova L, Portnichenko VI, Smolina N, Duicu OANAM, Elder JM, Zaglia T, Lorenzon A, Ruperez C, Woudstra L, Suffee N, De Lucia C, Tsoref O, Russell-Hallinan A, Menendez-Montes I, Kapelko VI, Emmens RW, Hetman O, Van Der Laarse WJ, Goncharov S, Adao R, Huisamen B, Sirenko O, Kamilova U, Nassiri I, Tserendavaa SUMIYA, Yushko K, Baldan Martin M, Falcone C, Vigorelli V, Nigro P, Pompilio G, Stepanova O, Valikhov M, Samko A, Masenko V, Tereschenko S, Teoh T, Domenjo-Vila E, Theologou T, Field M, Awad W, Yasin M, Nadal-Ginard B, Ellison-Hughes GM, Hellen N, Vittay O, Harding SE, Gomez-Cid L, Fernandez-Santos ME, Suarez-Sancho S, Plasencia V, Climent A, Sanz-Ruiz R, Hedhammar M, Atienza F, Fernandez-Aviles F, Kiamehr M, Oittinen M, Viiri KM, Kaikkonen M, Aalto-Setala K, Diolaiuti L, Laurino A, Sartiani L, Vona A, Zanardelli M, Cerbai E, Failli P, Hortigon-Vinagre MP, Van Der Heyden M, Burton FL, Smith GL, Watson S, Scigliano M, Tkach S, Alayoubi S, Harding SE, Terracciano CM, Ly HQ, Mauretti A, Van Marion MH, Van Turnhout MC, Van Der Schaft DWJ, Sahlgren CM, Goumans MJ, Bouten CVC, Vuorenpaa H, Penttinen K, Sarkanen R, Ylikomi T, Heinonen T, Aalto-Setala K, Grimaldi V, Aprile M, Esposito R, Maiello C, Soricelli A, Colantuoni V, Costa V, Ciccodicola A, Napoli C, Rowe GC, Johnson K, Arany ZP, Del Monte F, D'aurizio R, Kusmic C, Nicolini G, Baumgart M, Groth M, Ucciferri N, Iervasi G, Pitto L, Pipicz M, Gaspar R, Siska A, Foldesi I, Kiss K, Bencsik P, Thum T, Batkai S, Csont T, Haan JJ, Bosch L, Brans MAD, Van De Weg SM, Deddens JC, Lee SJ, Sluijter JPG, Pasterkamp G, Werner I, Projahn D, Staudt M, Curaj A, Soenmez TT, Simsekyilmaz S, Hackeng TM, Von Hundelshausen P, Koenen RR, Weber C, Liehn EA, Santos-Martinez M, Medina C, Watson C, Mcdonald K, Gilmer J, Ledwidge M, Song SH, Lee MY, Park MH, Choi JC, Ahn JH, Park JS, Oh JH, Choi JH, Lee HC, Cha KS, Hong TJ, Kudryavtsev I, Serebryakova M, Malashicheva A, Shishkova A, Zhiduleva E, Moiseeva O, Durisova M, Blaha M, Melenovsky V, Pirk J, Kautzner J, Petelina TI, Gapon LI, Gorbatenko EA, Potolinskaya YV, Arkhipova EV, Solodenkova KS, Osadchuk MA, Dutra MF, Oliveira FCB, Silva MM, Passos-Silva DG, Goncalves R, Santos RAS, Da Silva RF, Gavrilescu CM, Paraschiv CM, Manea P, Strat LC, Gomez JMG, Merino D, Hurle MA, Nistal JF, Aires A, Cortajarena AL, Villar AV, Abramowitz J, Birnbaumer L, Gourine AV, Tinker A, Takamura M, Takashima S, Inoue O, Misu H, Takamura T, Kaneko S, Alieva TOHIRA, Mougenot N, Dufilho M, Hatem S, Siegbahn A, Kostina AS, Uspensky VE, Moiseeva OM, Kostareva AA, Malashicheva AB, Van Dijk CGM, Chrifi I, Verhaar MC, Duncker DJ, Cheng C, Sturza A, Petrus A, Duicu O, Kiss L, Danila M, Baczko I, Jost N, Gotzhein F, Schon J, Schwarzl M, Hinrichs S, Blankenberg S, Volker U, Hammer E, Westermann D, Martinez-Martinez E, Arrieta V, Fernandez-Celis A, Jimenez-Alfaro L, Melero A, Alvarez-Asiain V, Cachofeiro V, Lopez-Andres N, Tribulova N, Wallukat G, Knezl V, Radosinska J, Barancik M, Tsinlikov I, Tsinlikova I, Nicoloff G, Blazhev A, Pesevski Z, Kvasilova A, Stopkova T, Eckhardt A, Buffinton CM, Nanka O, Kercheva M, Suslova T, Gusakova A, Ryabova T, Markov V, Karpov R, Seemann H, Alcantara TC, Santuchi MDEC, Fonseca SG, Da Silva RF, Barallobre-Barreiro J, Oklu R, Fava M, Baig F, Yin X, Albadawi H, Jahangiri M, Stoughton J, Mayr M, Podliesna SP, Veerman CCV, Verkerk AOV, Klerk MK, Lodder EML, Mengarelli IM, Bezzina CRB, Remme CAR, Takacs H, Polyak A, Morvay N, Lepran I, Tiszlavicz L, Nagy N, Ordog B, Farkas A, Forster T, Varro A, Farkas AS, Jayaprakash P, Parekh K, Ferdous Z, Oz M, Dobrzynski H, Adrian TE, Landi S, Bonzanni M, D'souza A, Boyett M, Bucchi A, Baruscotti M, Difrancesco D, Barbuti A, Kui P, Takacs H, Oravecz K, Hezso T, Polyak A, Levijoki J, Pollesello P, Koskelainen T, Otsomaa L, Farkas AS, Papp JGY, Varro A, Toth A, Acsai K, Dini L, Mazzoni L, Sartiani L, Cerbai E, Mugelli A, Svatunkova J, Sedmera D, Deffge C, Baer C, Weinert S, Braun-Dullaeus RC, Herold J, Cassar AC, Zahra GZ, Pllaha EP, Dingli PD, Montefort SM, Xuereb RGX, Aschacher T, Messner B, Eichmair E, Mohl W, Reglin B, Rong W, Nitzsche B, Maibier M, Guimaraes P, Ruggeri A, Secomb TW, Pries AR, Baranowska-Kuczko M, Karpinska O, Kusaczuk M, Malinowska B, Kozlowska H, Demikhova N, Vynnychenko L, Prykhodko O, Grechanyk N, Kuryata A, Cottrill KA, Du L, Bjorck HM, Maleki S, Franco-Cereceda A, Chan SY, Eriksson P, Giebe S, Cockcroft N, Hewitt K, Brux M, Brunssen C, Tarasov AA, Davidov SI, Reznikova EA, Tapia Abellan A, Angosto Bazarra D, Pelegrin Vivancos P, Montoro Garcia S, Kastl SP, Pongratz T, Goliasch G, Gaspar L, Maurer G, Huber K, Dostal E, Pfaffenberger S, Oravec S, Wojta J, Speidl WS, Osipova I, Sopotova I, Eligini S, Cosentino N, Marenzi G, Tremoli E, Rami M, Ring L, Steffens S, Gur O, Gurkan S, Mangold A, Scherz T, Panzenboeck A, Staier N, Heidari H, Mueller J, Lang IM, Osipova I, Sopotova I, Gatsiou A, Stamatelopoulos K, Perisic L, John D, Lunella FF, Eriksson P, Hedin U, Zeiher A, Dimmeler S, Nunez L, Moure R, Marron-Linares G, Flores X, Aldama G, Salgado J, Calvino R, Tomas M, Bou G, Vazquez N, Hermida-Prieto M, Vazquez-Rodriguez JM, Amit U, Landa N, Kain D, Tyomkin D, David A, Leor J, Hohensinner PJ, Baumgartner J, Krychtiuk KA, Maurer G, Huber K, Baik N, Miles LA, Wojta J, Seeman H, Montecucco F, Da Silva AR, Costa-Fraga FP, Anguenot L, Mach FP, Santos RAS, Stergiopulos N, Da Silva RF, Kupreishvili K, Vonk ABA, Smulders YM, Van Hinsbergh VWM, Stooker W, Niessen HWM, Krijnen PAJ, Ashmawy MM, Salama MA, Elamrosy MZ, Juettner R, Rathjen FG, Bito V, Crocini C, Ferrantini C, Gabbrielli T, Silvestri L, Coppini R, Tesi C, Cerbai E, Poggesi C, Pavone FS, Sacconi L, Mackova K, Zahradnik I, Zahradnikova A, Diaz I, Sanchez De Rojas De Pedro E, Hmadcha K, Calderon Sanchez E, Benitah JP, Gomez AM, Smani T, Ordonez A, Afanasiev SA, Egorova MV, Popov SV, Wu Qing P, Cheng X, Carnicka S, Pancza D, Jasova M, Kancirova I, Ferko M, Ravingerova T, Wu S, Schneider M, Marggraf V, Verfuerth L, Frede S, Boehm O, Dewald O, Baumgarten G, Kim SC, Farkasova V, Gablovsky I, Bernatova I, Ravingerova T, Nosar V, Portnychenko A, Drevytska T, Mankovska I, Gogvadze V, Sejersen T, Kostareva A, Sturza A, Wolf A, Privistirescu A, Danila M, Muntean D, O ' Gara P, Sanchez-Alonso JL, Harding SE, Lyon AR, Prando V, Pianca N, Lo Verso F, Milan G, Pesce P, Sandri M, Mongillo M, Beffagna G, Poloni G, Dazzo E, Sabatelli P, Doliana R, Polishchuk R, Carnevale D, Lembo G, Bonaldo P, Braghetta P, Rampazzo A, Cairo M, Giralt M, Villarroya F, Planavila A, Biesbroek PS, Emmens RWE, Juffermans LJM, Van Der Wall AC, Van Rossum AC, Niessen JWM, Krijnen PAJ, Moor Morris T, Dilanian G, Farahmand P, Puceat M, Hatem S, Gambino G, Petraglia L, Elia A, Komici K, Femminella GD, D'amico ML, Pagano G, Cannavo A, Liccardo D, Koch WJ, Nolano M, Leosco D, Ferrara N, Rengo G, Amit U, Landa N, Kain D, Leor J, Neary R, Shiels L, Watson C, Baugh J, Palacios B, Escobar B, Alonso AV, Guzman G, Ruiz-Cabello J, Jimenez-Borreguero LJ, Martin-Puig S, Lakomkin VL, Lukoshkova EV, Abramov AA, Gramovich VV, Vyborov ON, Ermishkin VV, Undrovinas NA, Shirinsky VP, Smilde BJ, Woudstra L, Fong Hing G, Wouters D, Zeerleder S, Murk JL, Van Ham SM, Heymans S, Juffermans LJM, Van Rossum AC, Niessen JWM, Krijnen PAJ, Krakhmalova O, Van Groen D, Bogaards SJP, Schalij I, Portnichenko GV, Tumanovska LV, Goshovska YV, Lapikova-Bryhinska TU, Nagibin VS, Dosenko VE, Mendes-Ferreira P, Maia-Rocha C, Santos-Ribeiro D, Potus F, Breuils-Bonnet S, Provencher S, Bonnet S, Rademaker M, Leite-Moreira AF, Bras-Silva C, Lopes J, Kuryata O, Lusynets T, Alikulov I, Nourddine M, Azzouzi L, Habbal R, Tserendavaa SUMIYA, Enkhtaivan ODKHUU, Enkhtaivan ODKHUU, Shagdar ZORIGO, Shagdar ZORIGO, Malchinkhuu MUNKHZ, Malchinkhuu MUNLHZ, Koval S, Starchenko T, Mourino-Alvarez L, Gonzalez-Calero L, Sastre-Oliva T, Lopez JA, Vazquez J, Alvarez-Llamas G, Ruilope LUISM, De La Cuesta F, Barderas MG, Bozzini S, D'angelo A, Pelissero G. Poster session 3Cell growth, differentiation and stem cells - Heart511The role of the endocannabinoid system in modelling muscular dystrophy cardiac disease with induced pluripotent stem cells.512An emerging role of T lymphocytes in cardiac regenerative processes in heart failure due to dilated cardiomyopathy513Canonical wnt signaling reverses the ‘aged/senescent’ human endogenous cardiac stem cell phenotype514Hippo signalling modulates survival of human induced pluripotent stem cell-derived cardiomyocytes515Biocompatibility of mesenchymal stem cells with a spider silk matrix and its potential use as scaffold for cardiac tissue regeneration516A snapshot of genome-wide transcription in human induced pluripotent stem cell-derived hepatocyte-like cells (iPSC-HLCs)517Can NOS/sGC/cGK1 pathway trigger the differentiation and maturation of mouse embryonic stem cells (ESCs)?518Introduction of external Ik1 to human-induced pluripotent stem cell-derived cardiomyocytes via Ik1-expressing HEK293519Cell therapy of the heart studied using adult myocardial slices in vitro520Enhancement of the paracrine potential of human adipose derived stem cells when cultured as spheroid bodies521Mechanosensitivity of cardiomyocyte progenitor cells: the strain response in 2D and 3D environments522The effect of the vascular-like network on the maturation of the human induced pluripotent stem cell derived cardiomyocytes.Transcriptional control and RNA species - Heart525Gene expression regulation in heart failure: from pathobiology to bioinformatics526Human transcriptome in idiopathic dilated cardiomyopathy - a novel high throughput screening527A high-throghput approach unveils putative miRNA-mediated mitochondria-targeted cardioprotective circuits activated by T3 in the post ischemia reperfusion setting528The effect of uraemia on the expression of miR-212/132 and the calcineurin pathway in the rat heartCytokines and cellular inflammation - Heart531Lack of growth differentiation factor 15 aggravates adverse cardiac remodeling upon pressure-overload in mice532Blocking heteromerization of platelet chemokines ccl5 and cxcl4 reduces inflammation and preserves heart function after myocardial infarction533Is there an association between low-dose aspirin use and clinical outcome in HFPEF? Implications of modulating monocyte function and inflammatory mediator release534N-terminal truncated intracellular matrix metalloproteinase-2 expression in diabetic heart.535Expression of CD39 and CD73 on peripheral T-cell subsets in calcific aortic stenosis536Mast cells in the atrial myocardium of patients with atrial fibrillation: a comparison with patients in sinus rhythm539Characteristics of the inflammatory response in patients with coronary artery disease and arterial hypertension540Pro-inflammatory cytokines as cardiovascular events predictors in rheumatoid arthritis and asymptomatic atherosclerosis541Characterization of FVB/N murinic bone marrow-derived macrophage polarization into M1 and M2 phenotypes542The biological expression and thoracic anterior pain syndromeSignal transduction - Heart545The association of heat shock protein 90 and TGFbeta receptor I is involved in collagen production during cardiac remodelling in aortic-banded mice546Loss of the inhibitory GalphaO protein in the rostral ventrolateral medulla of the brainstem leads to abnormalities in cardiovascular reflexes and altered ventricular excitablitiy547Selenoprotein P regulates pressure overload-induced cardiac remodeling548Study of adenylyl cyclase activity in erythrocyte membranes in patients with chronic heart failure549Direct thrombin inhibitors inhibit atrial myocardium hypertrophy in a rat model of heart failure and atrial remodeling550Tissue factor / FVIIa transactivates the IGF-1R by a Src-dependent phosphorylation of caveolin-1551Notch signaling is differently altered in endothelial and smooth muscle cells of ascending aortic aneurysm patients552Frizzled 5 expression is essential for endothelial proliferation and migration553Modulation of vascular function and ROS production by novel synthetic benzopyran analogues in diabetes mellitusExtracellular matrix and fibrosis - Heart556Cardiac fibroblasts as inflammatory supporter cells trigger cardiac inflammation in heart failure557A role for galectin-3 in calcific aortic valve stenosis558Omega-3 polyunsaturated fatty acids- can they decrease risk for ventricular fibrillation?559Serum levels of elastin derived peptides and circulating elastin-antielastin immune complexes in sera of patients with coronary artery disease560Endocardial fibroelastosis is secondary to hemodynamic alterations in the chick model of hypoplastic left heart syndrome561Dynamics of serum levels of matrix metalloproteinases in primary anterior STEMI patients564Deletion of the alpha-7 nicotinic acetylcholine receptor changes the vascular remodeling induced by transverse aortic constriction in mice.565Extracellular matrix remodelling in response to venous hypertension: proteomics of human varicose veinsIon channels, ion exchangers and cellular electrophysiology - Heart568Microtubule-associated protein RP/EB family member 1 modulates sodium channel trafficking and cardiac conduction569Investigation of electrophysiological abnormalities in a rabbit athlete's heart model570Upregulation of expression of multiple genes in the atrioventricular node of streptozotocin-induced diabetic rat571miR-1 as a regulator of sinoatrial rhythm in endurance training adaptation572Selective sodium-calcium exchanger inhibition reduces myocardial dysfunction associated with hypokalaemia and ventricular fibrillation573Effect of racemic and levo-methadone on action potential of human ventricular cardiomyocytes574Acute temperature effects on the chick embryonic heart functionVasculogenesis, angiogenesis and arteriogenesis577Clinical improvement and enhanced collateral vessel growth after monocyte transplantation in mice578The role of HIF-1 alpha, VEGF and obstructive sleep apnoea in the development of coronary collateral circulation579Initiating cardiac repair with a trans-coronary sinus catheter intervention in an ischemia/reperfusion porcine animal model580Early adaptation of pre-existing collaterals after acute arteriolar and venular microocclusion: an in vivo study in chick chorioallantoic membraneEndothelium583EDH-type responses to the activator of potassium KCa2.3 and KCa3.1 channels SKA-31 in the small mesenteric artery from spontaneously hypertensive rats584The peculiarities of endothelial dysfunction in patients with chronic renocardial syndrome585Endothelial dysfunction, atherosclerosis of the carotid arteries and level of leptin in patient with coronary heart disease in combination with hepatic steatosis depend from body mass index.586Role of non-coding RNAs in thoracic aortic aneurysm associated with bicuspid aortic valve587Cigarette smoke extract abrogates atheroprotective effects of high laminar flow on endothelial function588The prognostic value of anti-connective tissue antibodies in coronary heart disease and asymptomatic atherosclerosis589Novel potential properties of bioactive peptides from spanish dry-cured ham on the endothelium.Lipids592Intermediate density lipoprotein is associated with monocyte subset distribution in patients with stable atherosclerosis593The characteristics of dyslipidemia in rheumatoid arthritisAtherosclerosis596Macrophages differentiated in vitro are heterogeneous: morphological and functional profile in patients with coronary artery disease597Palmitoylethanolamide promotes anti-inflammatory phenotype of macrophages and attenuates plaque formation in ApoE-/- mice598Amiodarone versus esmolol in the perioperative period: an in vitro study of coronary artery bypass grafts599BMPRII signaling of fibrocytes, a mesenchymal progenitor cell population, is increased in STEMI and dyslipidemia600The characteristics of atherogenesis and systemic inflammation in rheumatoid arthritis601Role of adenosine-to-inosine RNA editing in human atherosclerosis602Presence of bacterial DNA in thrombus aspirates of patients with myocardial infarction603Novel E-selectin binding polymers reduce atherosclerotic lesions in ApoE(-/-) mice604Differential expression of the plasminogen receptor Plg-RKT in monocyte and macrophage subsets - possible functional consequences in atherogenesis605Apelin-13 treatment enhances the stability of atherosclerotic plaques606Mast cells are increased in the media of coronary lesions in patients with myocardial infarction and favor atherosclerotic plaque instability607Association of neutrophil to lymphocyte ratio with presence of isolated coronary artery ectasiaCalcium fluxes and excitation-contraction coupling610The coxsackie- and adenovirus receptor (CAR) regulates calcium homeostasis in the developing heart611HMW-AGEs application acutely reduces ICaL in adult cardiomyocytes612Measuring electrical conductibility of cardiac T-tubular systems613Postnatal development of cardiac excitation-contraction coupling in rats614Role of altered Ca2+ homeostasis during adverse cardiac remodeling after ischemia/reperfusion615Experimental study of sarcoplasmic reticulum dysfunction and energetic metabolism in failing myocardium associated with diabetes mellitusHibernation, stunning and preconditioning618Volatile anesthetic preconditioning attenuates ischemic-reperfusion injury in type II diabetic patients undergoing on-pump heart surgery619The effect of early and delayed phase of remote ischemic preconditioning on ischemia-reperfusion injury in the isolated hearts of healthy and diabetic rats620Post-conditioning with 1668-thioate leads to attenuation of the inflammatory response and remodeling with less fibrosis and better left ventricular function in a murine model of myocardial infarction621Maturation-related changes in response to ischemia-reperfusion injury and in effects of classical ischemic preconditioning and remote preconditioningMitochondria and energetics624Phase changes in myocardial mitochondrial respiration caused by hypoxic preconditioning or periodic hypoxic training625Desmin mutations depress mitochondrial metabolism626Methylene blue modulates mitochondrial function and monoamine oxidases-related ROS production in diabetic rat hearts627Doxorubicin modulates the real-time oxygen consumption rate of freshly isolated adult rat and human ventricular cardiomyocytesCardiomyopathies and fibrosis630Effects of genetic or pharmacologic inhibition of the ubiquitin/proteasome system on myocardial proteostasis and cardiac function631Suppression of Wnt signalling in a desmoglein-2 transgenic mouse model for arrhythmogenic cardiomyopathy632Cold-induced cardiac hypertrophy is reversed after thermo-neutral deacclimatization633CD45 is a sensitive marker to diagnose lymphocytic myocarditis in endomyocardial biopsies of living patients and in autopsies634Atrial epicardial adipose tissue derives from epicardial progenitors635Caloric restriction ameliorates cardiac function, sympathetic cardiac innervation and beta-adrenergic receptor signaling in an experimental model of post-ischemic heart failure636High fat diet improves cardiac remodelling and function after extensive myocardial infarction in mice637Epigenetic therapy reduces cardiac hypertrophy in murine models of heart failure638Imbalance of the VHL/HIF signaling in WT1+ Epicardial Progenitors results in coronary vascular defects, fibrosis and cardiac hypertrophy639Diastolic dysfunction is the first stage of the developing heart failure640Colchicine aggravates coxsackievirus B3 infection in miceArterial and pulmonary hypertension642Osteopontin as a marker of pulmonary hypertension in patients with coronary heart disease combined with chronic obstructive pulmonary disease643Myocardial dynamic stiffness is increased in experimental pulmonary hypertension partly due to incomplete relaxation644Hypotensive effect of quercetin is possibly mediated by down-regulation of immunotroteasome subunits in aorta of spontaneously hypertensive rats645Urocortin-2 improves right ventricular function and attenuates experimental pulmonary arterial hypertension646A preclinical evaluation of the anti-hypertensive properties of an aqueous extract of Agathosma (Buchu)Biomarkers648The adiponectin level in hypertensive females with rheumatoid arthritis and its relationship with subclinical atherosclerosis649Markers for identification of renal dysfunction in the patients with chronic heart failure650cardio-hepatic syndromes in chronic heart failure: North Africa profile651To study other biomarkers that assess during myocardial infarction652Interconnections of apelin levels with parameters of lipid metabolism in hypertension patients653Plasma proteomics in hypertension: prediction and follow-up of albuminuria during chronic renin-angiotensin system suppression654Soluble RAGE levels in plasma of patients with cerebrovascular events. Cardiovasc Res 2016. [DOI: 10.1093/cvr/cvw150] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Choi JW, Cha KS, Choi JD, Jung KY, Kim KH. Difficulty-related changes in inter-regional neural synchrony are dissociated between target and non-target processing. Brain Res 2015; 1603:114-23. [PMID: 25636271 DOI: 10.1016/j.brainres.2015.01.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 07/15/2014] [Revised: 01/05/2015] [Accepted: 01/17/2015] [Indexed: 10/24/2022]
Abstract
The major purpose of this study was to explore the changes in the local/global gamma-band neural synchronies during target/non-target processing due to task difficulty under an auditory three-stimulus oddball paradigm. Multichannel event-related potentials (ERPs) were recorded from fifteen healthy participants during the oddball task. In addition to the conventional ERP analysis, we investigated the modulations in gamma-band activity (GBA) and inter-regional gamma-band phase synchrony (GBPS) for infrequent target and non-target processing due to task difficulty. The most notable finding was that the difficulty-related changes in inter-regional GBPS (33-35 Hz) at P300 epoch (350-600 ms) completely differed for target and non-target processing. As task difficulty increased, the GBPS significantly reduced for target processing but increased for non-target processing. This result contrasts with the local neural synchrony in gamma-bands, which was not affected by task difficulty. Another major finding was that the spatial patterns of functional connectivity were dissociated for target and non-target processing with regard to the difficult task. The spatial pattern for target processing was compatible with the top-down attention network, whereas that for the non-target corresponded to the bottom-up attention network. Overall, we found that the inter-regional gamma-band neural synchronies during target/non-target processing change significantly with task difficulty and that this change is dissociated between target and non-target processing. Our results indicate that large-scale neural synchrony is more relevant for the difference in information processing between target and non-target stimuli.
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Affiliation(s)
- Jeong Woo Choi
- Department of Biomedical Engineering, College of Health Science, Yonsei University, 234 Maeji-ri, Heungup-myun, Wonju, Gangwon-do 220-710, South Korea
| | - Kwang Su Cha
- Department of Biomedical Engineering, College of Health Science, Yonsei University, 234 Maeji-ri, Heungup-myun, Wonju, Gangwon-do 220-710, South Korea
| | - Jong Doo Choi
- Department of Biomedical Engineering, College of Health Science, Yonsei University, 234 Maeji-ri, Heungup-myun, Wonju, Gangwon-do 220-710, South Korea
| | - Ki-Young Jung
- Department of Neurology, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul 110-744, South Korea
| | - Kyung Hwan Kim
- Department of Biomedical Engineering, College of Health Science, Yonsei University, 234 Maeji-ri, Heungup-myun, Wonju, Gangwon-do 220-710, South Korea.
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Kim KE, Woo KS, Goh RY, Quan ML, Cha KS, Kim MH, Han JY. Comparison of laboratory detection methods of aspirin resistance in coronary artery disease patients. Int J Lab Hematol 2008; 32:50-5. [PMID: 19016915 DOI: 10.1111/j.1751-553x.2008.01119.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Aspirin reduces the prevalence of nonfatal myocardial infarction, stroke, and death by 25.0% in high risk group of patients with cardiovascular disease. Previous studies have estimated that about 5.5-56.8% of the population are aspirin resistant. The mechanisms of aspirin resistance (AR) have not been fully understood. We compared the detection methods for AR using traditional platelet aggregometry and VerifyNow system. One hundred and seventy-two coronary artery disease patients who had taken aspirin only or combinations with aspirin and clopidogrel for over 7 days were included. Of the 55 patients with aspirin only, aggregometer detected six AR (10.9%) and VerifyNow identified 10 AR (18.2%) cases. Among 117 patients with combined therapy, none (0.0%) and 10 (8.5%) of AR were detected by aggregometer and VerifyNow, respectively. There were six (3.4%) patients of AR defined by both methods and they all received aspirin monotherapy. Although the correlation between the aggregometry and VerifyNow was low, with defined criteria both methods gave 91.9% agreement to find AR. VerifyNow showed a higher sensitivity to detect AR. Further studies are required to biologically define AR and to alter therapy based on platelet function tests.
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Affiliation(s)
- K E Kim
- Department of Laboratory Medicine, Dong-A University College of Medicine, Busan, Korea
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Hwang SH, Lee WJ, Lim JW, Jung KY, Cha KS, Rho BS. Chip- and board-level optical interconnections using rigid flexible optical electrical printed circuit boards. Opt Express 2008; 16:8077-8083. [PMID: 18545520 DOI: 10.1364/oe.16.008077] [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] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
A new optical interconnection scheme based on a rigid flexible optical electrical printed circuit board (RFOE-PCB) is suggested. The easily installed RFOE-PCB can be universally applied for both chip- and board-level optical interconnections. This letter describes the detailed fabrication process, optical properties, and heat-resisting property of the RFOE-PCB. The fabricated RFOE-PCB was also successfully demonstrated with a 2.5-Gb/s data transmission through a 45 degrees-ended optical waveguide embedded in the RFOE-PCB.
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Affiliation(s)
- S H Hwang
- Integrated Optical Module Laboratory, Korea Photonics Technology Institute, Gwangju 500-460, Korea
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Cha KS, Kim MH, Hung JS, Woo JS, Kim YD, Kim JS. Nonselective left internal mammary artery angiography during right transradial coronary angiography: a simple, rapid, and safe technique. Angiology 2001; 52:773-9. [PMID: 11716330 DOI: 10.1177/000331970105201107] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Internal mammary artery angiography is increasingly required, but the technique for left internal mammary artery (LIMA) angiography during right transradial coronary angiography is not well established. The authors investigated the feasibility and safety of a new, simple, and rapid nonselective technique. Following right transradial coronary angiography, LIMA angiography was performed using a 5 French (Fr) Judkins JL-3.5 catheter in 110 patients. The catheter, placed in the ascending aorta with its natural curve, was withdrawn slowly while being rotated clockwise to engage its tip in the proximal left subclavian artery. Contrast material was injected while sphygmomanometer cuff inflation was applied to the left upper arm. In the last 50 patients, the angiography was performed twice randomly with and without the cuff inflation. In 108 patients (98%), the catheter was successfully engaged in the subclavian artery in a mean of 11 +/- 8 seconds (range, 3-136) from the time when it was withdrawn from the ascending aorta, and nonselective LIMA angiography was successfully performed. The image quality of the angiograms was satisfactory in 103 (95%) of the 108 patients. In the last 50 patients, the image quality of the angiograms was determined satisfactory in 48 (96%) and 45 (90%) patients, with and without the cuff inflation, respectively. The difference was statistically not significant. There were no complications, including arterial dissection and thromboembolism. In conclusion, nonselective LIMA angiography can be readily and safely performed during right transradial coronary angiography using a 5 Fr Judkins JL-3.5 catheter.
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Affiliation(s)
- K S Cha
- Department of Internal Medicine and Cardiovascular Surgery, Dong-A University Hospital, Pusan, South Korea.
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Kim MH, Cha KS, Kim HJ, Kim JS. Bilateral selective internal mammary artery angiography via right radial approach: clinical experience with newly designed Yumiko catheter. Catheter Cardiovasc Interv 2001; 54:19-24. [PMID: 11553943 DOI: 10.1002/ccd.1232] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The radial artery has been increasingly used as a primary access site for coronary angiography and intervention. But the technique for internal mammary artery (IMA) visualization via the right radial artery has not been well described. Therefore, the study was conducted to investigate the feasibility, safety, and adequacy of selective bilateral IMA angiography via the right radial artery using the recently developed Yumiko catheter. From November 1999 to October 2000, both IMA angiographies were undertaken immediately following the diagnostic coronary angiogram taken from right transradial approach in 114 patients. IMA angiography was successfully obtained in 99% (113/114) patients. For left IMA angiography, 73 (64%), 28 (25%), and 12 (11%) imagings were obtained in a selective, a semiselective, and a nonselective way, respectively. After initial periods of 33 left-IMA-only imaging, right IMA angiography was obtained in 81 patients (phase 2). Selective right IMA imaging was done in 73 (90%), semiselective in 6, and nonselective in 2 patients. The reasons for failure of selective or semiselective visualization were severe vascular tortuosity, far distal anatomical origin of left IMA and ulcerative plaque, or acutely angled left subclavian artery. The feasibility and safety of selective and semiselective bilateral IMA angiography were demonstrated using a 5 Fr Yumiko catheter from the right radial approach. Cathet Cardiovasc Intervent 2001;54:19-24.
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Affiliation(s)
- M H Kim
- Section of Cardiology, Dong-A Medical College, Seo-Gu, Pusan, South Korea.
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Cha KS, Kim MH, Kim YD, Kim JS. Combined right transradial coronary angiography and selective carotid angiography: safety and feasibility in unselected patients. Catheter Cardiovasc Interv 2001; 53:380-5. [PMID: 11458419 DOI: 10.1002/ccd.1186] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We evaluated the safety and feasibility of ad hoc carotid angiography following the right transradial coronary angiography. Selective carotid angiography was performed subsequent to coronary angiography in 213 consecutive patients. A 5 Fr Simmons catheter was reformed in descending or ascending aorta, then, withdrawn and rotated to cannulate the left and right carotid artery. Both carotid angiography was performed selectively in 211 (99%) patients. In two patients with severely tortuous subclavian artery, selective cannulation of the left carotid artery failed. There was no thromboembolism or arterial dissection. After the learning phase of 50 patients, the time to reform the catheter in aorta and to cannulate the left and right carotid artery was 50 +/- 77, 66 +/- 68, and 58 +/- 57 sec, respectively. Total procedural time was 195 +/- 145 sec. In conclusion, ad hoc carotid angiography can be performed reliably and safely following the right transradial coronary angiography. It might be useful for evaluation of an isolated or associated carotid artery stenosis. Cathet Cardiovasc Intervent 2001;53:380-385.
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Affiliation(s)
- K S Cha
- Department of Internal Medicine, Dong-A University Hospital, 3 Ga 1 Dongdaesindong Seogu, Pusan 602-715, South Korea.
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Kim MH, Cha KS, Kim JS. Retrieval of dislodged and disfigured transradially delivered coronary stent: report on a case using forcep and antegrade brachial sheath insertion. Catheter Cardiovasc Interv 2001; 52:489-91. [PMID: 11285606 DOI: 10.1002/ccd.1109] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We report a case of dislodged and damaged stent during transradial coronary procedure using 6 Fr device, which was successfully retrieved by using a forcep and 8 Fr antegrade brachial sheath. The disfigured and bulky stent can be removed, after their retrieval from the coronary circulation, using a forcep inserted through an 8 Fr brachial artery sheath if the radial artery is deemed too small to accommodate larger sheath.
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Affiliation(s)
- M H Kim
- Section of Cardiology, Dong-A Medical College, Pusan, South Korea.
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Kim MH, Cha KS, Kim HJ, Kim SG, Kim JS. Primary stenting for acute myocardial infarction via the transradial approach: a safe and useful alternative to the transfemoral approach. J Invasive Cardiol 2000; 12:292-6. [PMID: 10859712] [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: 02/16/2023]
Abstract
BACKGROUND Primary stenting in acute myocardial infarction (AMI) has been demonstrated to reduce recurrent ischemic events. However, transradial stenting in AMI has not been well established. Therefore, we sought to investigate the feasibility and utility of transradial coronary stenting in patients with AMI. METHODS From April 1998 to April 1999, 56 patients (43 male; mean age of 57 years) who arrived within 6 hours of pain onset with culprit vessel size > 2.5 mm constituted this study. The transradial approach (Group 1) was used in 30 patients with hemodynamically stable and palpable right radial pulse. The transfemoral approach (Group 2) was used for vascular access in the remainder of patients (26) who might have required a second vascular access site for intraaortic balloon pumping (in cardiogenic shock) and/or a transvenous temporary pacemaker. RESULTS Overall success rate was achieved in 54 of 56 patients (96%). The success rate was 90% (27/30) in Group 1 and 96% (25/26) in Group 2. The cannulation time (from patient arrival at the catheterization room to the time of arterial cannulation) and the total procedure time (from patient arrival at the catheterization room to the completion of the procedure) were not significantly different between Group 1 and Group 2 (9.2+/-5.3 versus 8.9+/-5. 8 minutes, p>0.05; 53.7+/-19.4 versus 57.5 +/-26.8 minutes, p>0.05, respectively). In the Group 1 patients, there was no forearm ischemia or loss of radial pulse during the 30-day follow-up period. CONCLUSION Primary coronary stenting for acute myocardial infarction via the transradial approach is a safe and feasible alternative to the conventional transfemoral approach, and is especially useful for hemodynamically stable patients who do not require a second vascular access site.
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Affiliation(s)
- M H Kim
- Section of Cardiology, Dong-A Medical College, 3Eth 1 Dongdaeshin-Dong, Seo-Gu, Pusan, South Korea, 602Eth 103. kmh60@damc. dauhosp.or.kr
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Abstract
We report a rare case of stenotic double-orifice mitral valve of incomplete bridge type in a 40-year-old male. The fibrous bridge tissue between the leaflets was successfully split with a 24-mm Inoue balloon catheter using the stepwise dilation technique. Cathet. Cardiovasc. Intervent. 49:200-203, 2000.
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Affiliation(s)
- M H Kim
- Section of Cardiology, Dong-A Medical College, Pusan, South Korea.
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Park HM, Eo YW, Cha KS, Kim YM, Lee KB. Determination of free acetaldehyde in total blood for investigating the effect of aspartate on metabolism of alcohol in mice. J Chromatogr B Biomed Sci Appl 1998; 719:217-21. [PMID: 9869383 DOI: 10.1016/s0378-4347(98)00389-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
To explore the effect of sodium L-aspartate monohydrate (aspartate) as a NAD+ regenerating agent for acetaldehyde in alcohol metabolism, a simple HPLC method has been developed for the measurement of free acetaldehyde in total mice blood digested with alcohol and aspartate. The blood samples were collected in EDTA Vacutainer tubes, and treated with 2,4-dinitrophenylhydrazine (DNP hydrazine) reagent in total blood. Acetaldehyde DNP hydrazone was extracted from total blood and analyzed by HPLC using an Ultrasphere ODS column. The compounds were separated using acetonitrile-water (50:50, v/v) as mobile phase and detected at 356 nm. The detection limit for acetaldehyde DNP hydrazone was 0.1 ppm. A blank determination was carried out for each analysis and subtracted from the results. The amount of acetaldehyde in blood has been determined as a function of time lapse after sole alcohol administration and aspartate ingestion followed by alcohol administration, respectively. This comparative analysis demonstrates that the ingestion of aspartate before the administration of alcohol dramatically decreases the aldehyde level in blood, and aspartate may be utilized as a prospective antagonist for acceleration of ethanol metabolism and prevention of acetaldehyde toxicity.
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Affiliation(s)
- H M Park
- Advanced Analysis Center, Korea Institute of Science and Technology, Cheongryangri, Seoul, South Korea
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Cho JG, Jeong YH, Cho IJ, Ahn YG, Cha KS, Seo JP, Park JH, Jeong MH, Park JC, Kang JC. Atrial fibrillation in patients with permanent VVI pacemakers: risk factors for atrial fibrillation. Korean J Intern Med 1997; 12:34-8. [PMID: 9159035 PMCID: PMC4531969 DOI: 10.3904/kjim.1997.12.1.34] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES Atrial fibrillation (AF) does not only deteriorate the cardiac function and increases the thromboembolic risk but also triggers rapid and irregular ventricular rhythm in patients with atrial synchronous pacing. However, the risk factors for the development of AF in patients with pacemakers are not clearly determined yet. The present study was designed to determine the risk factors for AF in patients with VVI pacemakers. METHODS This study included 80 patients (41 sick sinus syndrome, 39 AV block) who were followed for more than 6 months or developed AF regardless of the duration of follow-up after implantation of VVI pacemakers. Patients were divided into two groups according to whether or not AF developed during follow-up (mean: 25.7 +/- 2.5 months): group A developed AF and group B did not. The underlying arrhythmias, cardiovascular risk factors, left atrial size, characteristics of P wave were compared between the two groups. RESULTS The mean age of the patients was 58.9 +/- 11.4 years and 28 (35%) were male. AF developed in 13 (16.3%) of 80 patients with VVI pacemakers. Sick sinus syndrome (SSS) as an underlying arrhythmia was significantly more frequent in group A than group B (84.6% vs. 44.8%, p < 0.01). P wave width was greater in group A (127.6 +/- 24.8 ms) than in group B (110.7 +/- 17 ms) (p < 0.05). There was, however, no significant difference in cardiovascular risk factors, left atrial size, P wave axis and amplitude between the two groups. CONCLUSION These results suggest that sinus node dysfunction and intra-atrial conduction delay may be the risk factors for AF in patients with VVI pacemakers. Further studies are needed to determine how sick sinus syndrome and intra-atrial conduction delay increase the risk for AF in patients with VVI pacemakers.
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Affiliation(s)
- J G Cho
- Department of Internal Medicine, Chonnam University Hospital, Kwangju, Korea
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Cho JY, Kim SJ, Cha KY, Kay CW, Kim MI, Cha KS. Interrupted circular suture: bleeding control during cesarean delivery in placenta previa accreta. Obstet Gynecol 1991; 78:876-9. [PMID: 1923215] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Rapid accumulation of blood from the placental separation site during cesarean delivery for placenta previa obscures the surgical field and quickly leads to deterioration of the patient's vital signs. We used the following technique in eight cases of intractable bleeding among 49 cesareans for placenta previa. Following failure to control the bleeding by suture at the placental separation site via the lower segment cesarean incision, the vessels were ligated using interrupted 2-3-cm sutures at 1-cm intervals in a circle around the bleeding area on the serosal surface of the uterus. The sutures were placed as deeply as possible in order to reach the endometrium. This led to a marked decrease in bleeding and allowed the small vessels to be easily identified and ligated. The amount of blood transfused and the operation time were gradually reduced as we became adept in the use of this procedure. Our experience suggests that this technique could reduce the use of hysterectomy in cesarean for placenta previa.
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Affiliation(s)
- J Y Cho
- Department of Obstetrics and Gynecology, Cha Women's Hospital, Seoul, Korea
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Abstract
A case is presented of an amnionic rupture sequence which led to massive fetal ventral herniation and lordoscoliosis. Characteristic ultrasonographic findings of an omphalocele, fetal attachment to the placenta, and the absence of free-floating umbilical cord were observed.
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Affiliation(s)
- S A Jun
- Department of Radiology, Cha Women's Hospital of Seoul, Korea
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Lee DI, Shin JA, Moon CH, Lee JY, Cha KS, Shin YW, Shin YK. Evaluation of the Efficacy and Tolerability of Isradipine in the Treatment of Mild to Moderate Hypertension. Korean Circ J 1991. [DOI: 10.4070/kcj.1991.21.4.757] [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: 11/11/2022] Open
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Abstract
The authors present an unusual vascular anomaly of the placenta. The placenta was very large, weighing 1,490 g. On the fetal surface, numerous dilated and tortuous vessels were observed on and under the chorionic membrane, of which three branches arose from a vein that was connected to the umbilical vein. One of them had a 5 x 2.5 cm aneurysmal dilatation, where three secondary branches arose. These venous channels were dilated and tortuous. The longest secondary branch was 133 cm in length and 1.2 cm in mean diameter and led into the placenta. Multiple, severely coiled or straight small branches arising from these vessels were also observed as vascular tangles. Some of these smaller vessels also led into the placenta. All abnormal vessels were veins. The umbilical cord was also normal except for a membranous insertion, and the placenta was unremarkable except for its large size.
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Affiliation(s)
- G K Lee
- Department of Pathology, Seoul National University Children's Hospital, Korea
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Abstract
Recently, we developed the "window operation" as a more effective way to treat Bartholin gland cysts and abscesses. The window operation was used to treat 25 Bartholin cysts and 22 Bartholin abscesses during a 3-year period from October 1, 1986 to September 30, 1989. Under local anesthesia, a small piece of skin including the cyst wall was excised in an oval shape, and suturing was performed along the excised margin. Postoperative antibiotics were given in cases of acute inflammation. A new mucocutaneous junction was observed at the 4-week postoperative checkup. No complications or recurrences have been observed during the study period. The window operation can be an alternative method of treatment for Bartholin gland cysts or abscesses.
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Affiliation(s)
- J Y Cho
- Department of Obstetrics and Gynecology, Cha Women's Hospital of Seoul, Korea
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Lee JY, Lee DI, Shin JA, Cha KS, Lee MK, Hu JY, Shin YW, Shin YK. Clinical Effects of Isosorbide 5-Mononitrate(Elantan®) on Angina Pectoris. Korean Circ J 1990. [DOI: 10.4070/kcj.1990.20.4.815] [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: 11/11/2022] Open
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