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Chen TY, Cheng KC, Yang PS, Shrestha LK, Ariga K, Hsu SH. Interaction of vascular endothelial cells with hydrophilic fullerene nanoarchitectured structures in 2D and 3D environments. Sci Technol Adv Mater 2024; 25:2315014. [PMID: 38419801 PMCID: PMC10901190 DOI: 10.1080/14686996.2024.2315014] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 02/01/2024] [Indexed: 03/02/2024]
Abstract
The interaction between diverse nanoarchitectured fullerenes and cells is crucial for biomedical applications. Here, we detailed the preparation of hydrophilic self-assembled fullerenes by the liquid-liquid interfacial precipitation (LLIP) method and hydrophilic coating of the materials as a possible vascularization strategy. The interactions of vascular endothelial cells (ECs) with hydrophilic fullerene nanotubes (FNT-P) and hydrophilic fullerene nanowhiskers (FNW-P) were investigated. The average length and diameter of FNT-P were 16 ± 2 μm and 3.4 ± 0.4 μm (i.e. aspect ratios of 4.6), respectively. The average length and diameter of FNW-P were 65 ± 8 μm and 1.2 ± 0.2 μm (i.e. aspect ratios of 53.9), respectively. For two-dimensional (2D) culture after 7 days, the ECs remained viable and proliferated up to ~ 420% and ~ 400% with FNT-P and FNW-P of 50 μg/mL, respectively. Furthermore, an optimized chitosan-based self-healing hydrogel with a modulus of ~400 Pa was developed and used to incorporate self-assembled fullerenes as in vitro three-dimensional (3D) platforms to investigate the impact of FNT-P and FNW-P on ECs within a 3D environment. The addition of FNW-P or FNT-P (50 μg/mL) in the hydrogel system led to proliferation rates of ECs up to ~323% and ~280%, respectively, after 7 days of culture. The ECs in FNW-P hydrogel displayed an elongated shape with aligned morphology, while those in FNT-P hydrogel exhibited a rounded and clustered distribution. Vascular-related gene expressions of ECs were significantly upregulated through interactions with these fullerenes. Thus, the combined use of different nanoarchitectured self-assembled fullerenes and self-healing hydrogels may offer environmental cues influencing EC development in a 3D biomimetic microenvironment, holding promise for advancing vascularization strategy in tissue engineering.
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Affiliation(s)
- Tsai-Yu Chen
- Institute of Polymer Science and Engineering, National Taiwan University, Taipei, Taiwan, R.O.C
| | - Kun-Chih Cheng
- Institute of Polymer Science and Engineering, National Taiwan University, Taipei, Taiwan, R.O.C
| | - Pei-Syuan Yang
- Institute of Polymer Science and Engineering, National Taiwan University, Taipei, Taiwan, R.O.C
| | - Lok Kumar Shrestha
- Supermolecules Group, Research Center for Materials Nanoarchitectonics (MANA), National Institute for Materials Science (NIMS), Tsukuba, Japan
- Department of Materials Science, Faculty of Pure and Applied Sciences, University of Tsukuba, Tsukuba, Japan
| | - Katsuhiko Ariga
- Supermolecules Group, Research Center for Materials Nanoarchitectonics (MANA), National Institute for Materials Science (NIMS), Tsukuba, Japan
- Graduate School of Frontier Sciences, The University of Tokyo, Kashiwa, Chiba, Japan
| | - Shan-hui Hsu
- Institute of Polymer Science and Engineering, National Taiwan University, Taipei, Taiwan, R.O.C
- Institute of Cellular and System Medicine, National Health Research Institutes, Miaoli, Taiwan, R.O.C
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Yang PS, Kim DH, Jang E, Yu HT, Kim TH, Pak HN, Lee MH, Sung JH, Joung B. Comparative effectiveness of early rhythm control versus rate control for cardiovascular outcomes according to sex in patients with atrial fibrillation. Europace 2022. [DOI: 10.1093/europace/euac053.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ministry of Health & Welfare, Republic of Korea
Background
Rhythm control is associated with better cardiovascular outcomes than usual care among patients recently diagnosed with atrial fibrillation (AF). However, there are limited data on the outcomes of AF ablation according to sex. The purpose of this study was to evaluate gender differences in the effects of early rhythm control compared to rate control on the primary composite outcome of cardiovascular death, ischaemic stroke, hospitalisation for heart failure (HF), or myocardial infarction.
Methods
We conducted a retrospective population-based cohort study including 22635 patients with AF newly treated with rhythm control (antiarrhythmic drugs or ablation) or rate control in 2011-2015 from the Korean National Health Insurance Service database. Propensity overlap weighting was used.
Results
Among patients with early AF treatment (initiated within 1 year since diagnosis), compared with rate control, rhythm control was associated with a similar lower risk of the primary composite outcome both women (weighted incidence rate per 100 person-years: 8.68 in rhythm control vs. 10.3 in rate control; hazard ratio [HR] 0.79, 95% confidence interval [CI] 0.69 to 0.90; P<0.001) and men (weighted incidence rate per 100 person-years: 6.33 in rhythm control vs. 8.32 in rate control; HR 0.77, 95% CI 0.67 to 0.88; P<0.001). However, the effective initiation time for rhythm control therapy was within 6 and 11 months after AF diagnosis in female and male patients, respectively. Moreover, the effective times for other outcomes were different between genders (hospitalization for HF; female within 2 months, male within 9 months/ ischemic stroke; female within 11 months, male immediately).
Conclusions
Early initiation of rhythm control was associated with a lower risk of primary outcome in both genders. However, the effective rhythm control treatment initiation time for primary outcome, stroke and HF-related admission was different in both genders. For rhythm control treatment to be effective, women should start treatment earlier than men.
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Affiliation(s)
- PS Yang
- CHA University, Seongnam, Korea (Republic of)
| | - DH Kim
- Yonsei University College of Medicine, Cardiology, Seoul, Korea (Republic of)
| | - E Jang
- Yonsei University College of Medicine, Cardiology, Seoul, Korea (Republic of)
| | - HT Yu
- Yonsei University College of Medicine, Cardiology, Seoul, Korea (Republic of)
| | - TH Kim
- Yonsei University College of Medicine, Cardiology, Seoul, Korea (Republic of)
| | - HN Pak
- Yonsei University College of Medicine, Cardiology, Seoul, Korea (Republic of)
| | - MH Lee
- Yonsei University College of Medicine, Cardiology, Seoul, Korea (Republic of)
| | - JH Sung
- CHA University, Seongnam, Korea (Republic of)
| | - B Joung
- Yonsei University College of Medicine, Cardiology, Seoul, Korea (Republic of)
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Park JW, Yang PS, Yu HT, Kim TH, Jang ES, Pak HN, Lee MH, Joung BY. The reduction of body mass index and risk of incidence of cardiovascular events in the elderly population. Europace 2021. [DOI: 10.1093/europace/euab116.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Obesity is known to be risk factor for incidence of cardiovascular (CV) events. However, the association between the reduction of body mass index (BMI) and incidence of cardiovascular event is not well established in elderly Asian population.
Methods
From the National Health Insurance Service-Senior (≥60 years) cohort from 2002 to 2013, 13,038 participants over 75 years old without baseline comorbidities (mean age: 78.4 ± 3.2 years 5243 (40.2%) male) were included in this study. We measured the change of BMI from first to second visit for health check-up within mean 23.6 ± 5.8months of follow-up. We categorized the reduction of BMI as five group according to the amount of change in BMI in overall patients (group 1: BMI change <-10%, group 2: -10%≤BMI change<-3%, group 3: -3% ≤ BMI change < 3%, group 4: 3% ≤BMI change < 10%, group 5: 10% ≤BMI change). We investigated the influence of change in BMI on the incidence of new-onset AF, stroke, acute myocardial infarction (MI), and CV mortality
Results
In the overall patients, new-onset AF, stroke, acute MI, and CV death was occurred in the 494 patients (3.5%), 775 patients (5.9%), 16 patients (0.1%), and 458 patients (3.5%) respectively. The Kaplan-Meier curve showed significant cumulative incidence rate of CV death in group 1 (Log rank p < 0.001). The multivariate cox regression after adjusting for compound clinical covariates showed the risk of stroke (HR 1.43, 95% CI [1.09-1.89], p = 0.01) and CV death (HR 2.06, 95% CI [1.49-2.84] were significant higher in the group 1 as compared with group 3. In the high BMI (≥25) group, the risk of AF was significant higher in the group 5 as compared with group 3 (HR 2.38, 95% CI [1.02-5.54], p = 0.04). In contrast, the risk of stroke (HR 1.70, 95% CI [1.07-2.71], p = 0.02) and CV death (HR 3.27, 95% CI [1.66-6.41], p < 0.001) was significant higher in the group 1 than in group 3.
Conclusions
In the elderly Asian population over 75 years old, the reduction of body weight affected worse effect on the incidence of stroke and CV death in overall patient and high BMI (≥25) group. It needs careful consideration to reduce BMI in the elderly Asian population even with high BMI (≥25) for purpose of CV events.
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Affiliation(s)
- JW Park
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - PS Yang
- Bundang CHA General Hospital, Seongnam, Korea (Republic of)
| | - HT Yu
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - TH Kim
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - ES Jang
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - HN Pak
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - MH Lee
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - BY Joung
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
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Romiti GF, Pastori D, Rivera-Caravaca JM, Ding WY, Gue YX, Menichelli D, Gumprecht J, Koziel M, Yang PS, Guo Y, Lip GYH, Proietti M. The Atrial Fibrillation Better Care (ABC) pathway in atrial fibrillation: a systematic review and meta-analysis of 285,000 patients. Europace 2021. [DOI: 10.1093/europace/euab116.290] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
The ‘Atrial Fibrillation Better Care’ (ABC) pathway has been recently proposed as a holistic approach for the comprehensive management of patients with Atrial Fibrillation (AF), standing on three main pillars: ‘A’ Avoid stroke (with Anticoagulants); ‘B’ Better symptom management; ‘C’ Cardiovascular and Comorbidity management. The ABC pathway is now recommended in several clinical guidelines, including the recent European Society of Cardiology (ESC) AF management guidelines. We performed a systematic review of the current evidence for use of the ABC pathway on clinical outcomes.
Methods
We performed a systematic review and meta-analysis according to PRISMA Guidelines. Pubmed and EMBASE were searched for studies reporting the prevalence of ABC pathway adherent management in AF patients, and its impact on clinical outcomes (all-cause death, cardiovascular death, stroke, and major bleeding). Metanalysis of odds ratio (OR) was performed with random-effect models; subgroup analysis and meta-regression were performed to account for heterogeneity; a CHA2DS2-VASc-stratified sensitivity analysis was also performed.
Results
Among 2862 records retrieved from the literature search, 8 studies were included. The pooled prevalence of ABC adherent management was 21% (95% confidence intervals (CI), 13-34%), with a high grade of heterogeneity; in a multivariable meta-regression model, adherence to each criteria of the ABC pathway explained most part of the heterogeneity (R2 = 98.9%). Patients treated according to the ABC pathway showed a lower risk of all-cause death (OR:0.42, 95%CI 0.31-0.56), cardiovascular death (OR:0.37, 95%CI 0.23-0.58), stroke (OR:0.55, 95%CI 0.37-0.82) and major bleeding (OR:0.69, 95%CI 0.51-0.94), with moderate heterogeneity. Meta-regressions showed that the increasing prevalence of diabetes mellitus, coronary artery disease, chronic heart failure and history of stroke were associated with a reduced effectiveness of the ABC pathway for all-cause and cardiovascular death; each comorbidity was able to explain a significant proportion of heterogeneity at univariate meta-regression. Conversely, longer follow-up time was associated with more effectiveness of the ABC pathway for all outcomes. Adherence to ABC pathway was associated with a progressively greater reduction of the all-cause death risk amongst patients with higher CHA2DS2-VASc scores; no difference in ABC pathway effectiveness was found across CHA2DS2-VASc strata for CV death and stroke occurrence.
Conclusions
Adherence to the ABC pathway was suboptimal, being adopted in 1 in every 5 patients. Adherence to the ABC pathway was associated with a reduction in the risk of major adverse outcomes. Our data supports extensive application of the ABC pathway for the management of AF. Abstract Figure.
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Affiliation(s)
- GF Romiti
- Sapienza University of Rome, Rome, Italy
| | - D Pastori
- Sapienza University of Rome, Rome, Italy
| | | | - WY Ding
- University of Liverpool, Liverpool Centre for Cardiovascular Sciences, Liverpool, United Kingdom of Great Britain & Northern Ireland
| | - YX Gue
- University of Liverpool, Liverpool Centre for Cardiovascular Sciences, Liverpool, United Kingdom of Great Britain & Northern Ireland
| | | | - J Gumprecht
- Silesian Center for Heart Diseases (SCHD), Department of Cardiology, Medical University of Silesia, Zabrze, Poland
| | - M Koziel
- Silesian Center for Heart Diseases (SCHD), Department of Cardiology, Medical University of Silesia, Zabrze, Poland
| | - PS Yang
- CHA University, Department of Cardiology, CHA Bundang Medical Center, Seongnam, Korea (Republic of)
| | - Y Guo
- Chinese PLA General Hospital, Medical School of Chinese PLA, Department of Cardiology, Beijing, China
| | - GYH Lip
- University of Liverpool, Liverpool Centre for Cardiovascular Sciences, Liverpool, United Kingdom of Great Britain & Northern Ireland
| | - M Proietti
- University of Milan, Department of Clinical Sciences and Community Health, Milan, Italy
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Yang PS, Byun JH, Sung JH, Joung B. Early mortality and complications associated with catheter ablation of atrial fibrillation: analysis of the entire procedure in Korea from 2007 to 2016. Europace 2021. [DOI: 10.1093/europace/euab116.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
There is limited data regarding the early mortality and adverse outcomes from catheter ablation of atrial fibrillation (AF) in Korea. The aim of this study was to examine the early mortality and frequency of adverse outcomes associated with AF catheter ablation from 2006 to 2016 in Korea.
Methods
From 2006 to 2016 in the Korean National Health Insurance Service database, 11,893 individuals underwent catheter ablation for AF. We investigated the frequency of complications and early mortality associated with AF ablation and comorbidities that led to adverse outcomes after AF ablation.
Results
Out of all 11,893 procedures, early mortality occurred in 38 cases (0.32%). Annual trends in AF procedural complications occurring during index admission for AF ablation decreased from 9.25% in 2006 to 6.49% in 2016 (P for trend = 0.004). The early mortality rate after AF ablation had remained unchanged between 2006 and 2016. After adjustment for age, comorbidities, and medication, procedural complications (adjusted odds ratio[aOR]: 16.1; P < 0.001), age (aOR: 1.25; P = 0.024), history of hemorrhagic stroke (aOR: 4.74; P = 0.019), and less experience with AF ablation of the hospital (aOR: 2.85; P = 0.024) were associated with early mortality. Among procedural complications, atrioesophageal fistula (aOR: 199.8; P < 0.001), access site complications (aOR: 6.08; P = 0.005), complete heart block (aOR: 11.3; P = 0.029), pneumothorax (aOR: 62.0; P < 0.001), and procedure related pneumonia (aOR: 39.0; P < 0.001) were associated with early mortality.
Conclusions
Procedural complications, history of hemorrhagic stroke, and less experience with AF ablation of the hospital were predictors of early mortality. Out of all complications, atrioesophageal fistual, procedure related pneumonia, and in-hospital stroke were related to early mortality. Adequate management of complications may contribute to reducing the number of early mortalty rates following AF ablation. Abstract Figure. Trend of early mortality after ablation
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Affiliation(s)
- PS Yang
- CHA University, Seongnam, Korea (Republic of)
| | - JH Byun
- CHA University, Seongnam, Korea (Republic of)
| | - JH Sung
- CHA University, Seongnam, Korea (Republic of)
| | - B Joung
- Yonsei University College of Medicine, Cardiology, Seoul, Korea (Republic of)
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Yu HT, Yang PS, Jang E, Kim TH, Uhm JS, Kim JY, Pak HN, Lee MH, Joung B, Lip GYH. P4758Label adherence of non-vitamin K antagonist oral anticoagulants and clinical outcomes in patients with atrial fibrillation: A nationwide study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Dose adjustment of non-vitamin K antagonist oral anticoagulants (NOACs) is indicated in some patients with atrial fibrillation (AF), based on selected patient factors or concomitant medications.
Purpose
We assessed the frequency of label adherence of NOAC dosing among AF patients and the associations between off-label NOAC dosing and clinical outcomes in real-world clinical practice.
Methods
We evaluated 53,649 AF patients treated with a NOAC using Korean National Health Insurance Service database during the period from January 2013 to December 2016. NOAC doses were classified as either underdosed or overdosed, consistent with U.S. Food and Drug Administration labeling. Cox proportional hazards regression was performed to investigate the effectiveness and safety outcomes including stroke or systemic embolism, major bleeding, and all-cause mortality.
Results
Overall, 16,757 NOAC-treated patients (31.2%) were underdosed, 4,492 were overdosed (8.4%), and 32,400 (60.4%) were dosed appropriately according to drug labeling. Compared with patients with label adherence, those who were underdosed or overdosed were older (71±8 and 75±7 years of age vs. 70±9 years of age, respectively; p<0.001), more likely female (39% and 53% vs. 38%, respectively; p<0.001), and had higher CHA2DS2-VASc scores (4.6±1.7 and 5.3±1.7 vs. 4.5±1.8, respectively; p<0.001). NOAC overdosing was associated with increased risk for stroke or systemic embolism (5.76 vs. 4.03 events/100 patient-years, p<0.001), major bleeding (4.77 vs. 2.94 events/100 patient-years, p<0.001), and all-cause mortality (5.43 vs. 3.05 events/100 patient-years, p<0.001) compared with label-adherent use.
Figure 1
Conclusion
In routine clinical practice, a significant proportion (almost 2 in 5) of AF patients received NOAC doses inconsistent with drug labeling. NOAC overdosing is associated with increased risk for stroke or systemic embolism, major bleeding, and all-cause mortality in Asian patient with AF.
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Affiliation(s)
- H T Yu
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - P S Yang
- CHA University, Seongnam, Korea (Republic of)
| | - E Jang
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - T H Kim
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - J S Uhm
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - J Y Kim
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - H N Pak
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - M H Lee
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - B Joung
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - G Y H Lip
- University of Liverpool, Liverpool, United Kingdom
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Kim IS, Lee BK, Yang PS, Yu HT, Kim TH, Uhm JS, Pak HN, Lee MH, Kim JY, Joung B. P5660Clinical impact of polycythemia on cardiovascular outcome from the general population: a nationwide cohort study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Although adverse effect of anemia had been reported, effect of polycythemia on cardiovascular outcome from the general population had not been revealed yet.
Methods
We included 451,107 subjects who received national health examinations from the Korean National Health Insurance Service-based National Sample Cohort from 2009–2013. Medical records were screened from January 2002 to investigate the subjects' disease-free baseline period. They were followed until December 2013. We divided male and female subjects into four categories each based on hemoglobin level (normal, moderate to severe and mild anemia, polycythemia) to assess each outcome.
Results
During 1,735,964 person·years, 12,107 major adverse cardiovascular and cerebrovascular events (MACCE), 862 incident acute myocardial infarction (MI), 5,850 incident ischemic stroke, and 2,430 incident atrial fibrillation (AF) were observed. Compared to normal hemoglobin range group, polycythemia group showed higher MACCE (HR=1.23 [1.12–1.35] in male, HR=1.79 [1.20–2.67] in female, each p<0.001), incident MI (HR=1.37 [1.05–1.79] in male, HR=3.46 [1.06–14.00] in female, each p<0.001), incident ischemic stroke (HR=1.27 [1.10–1.46] in male, HR=1.72 [1.02–2.91] in female, each p<0.001), and incident AF (HR=1.46 [1.21–1.74] in male, HR=2.13 [1.03–4.77] in female, each p<0.001). Each outcome was linearly increased with the increase of hemoglobin among subjects with polycythemia (p<0.001), and with the decrease of hemoglobin among subjects with anemia (each p<0.001, U-shaped relationship). These relationship was more profound in obese female younger than 60-year-old.
Conclusion
Not only anemia but also polycythemia were significantly associated with higher rate of MACCE including death, incident MI, ischemic stroke, and AF among the general population.
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Affiliation(s)
- I.-S Kim
- Yonsei University, Department of Internal Medicine, Cardiology Division, Seoul, Korea (Republic of)
| | - B K Lee
- Gangnam Severance Hospital, Cardiology Division, Seoul, Korea (Republic of)
| | - P S Yang
- Bundang CHA General Hospital, Cardiology Division, Seongnam, Korea (Republic of)
| | - H T Yu
- Yonsei University, Department of Internal Medicine, Cardiology Division, Seoul, Korea (Republic of)
| | - T H Kim
- Yonsei University, Department of Internal Medicine, Cardiology Division, Seoul, Korea (Republic of)
| | - J S Uhm
- Yonsei University, Department of Internal Medicine, Cardiology Division, Seoul, Korea (Republic of)
| | - H N Pak
- Yonsei University, Department of Internal Medicine, Cardiology Division, Seoul, Korea (Republic of)
| | - M H Lee
- Yonsei University, Department of Internal Medicine, Cardiology Division, Seoul, Korea (Republic of)
| | - J Y Kim
- Gangnam Severance Hospital, Cardiology Division, Seoul, Korea (Republic of)
| | - B Joung
- Yonsei University, Department of Internal Medicine, Cardiology Division, Seoul, Korea (Republic of)
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Kim D, Yang PS, Jang E, Yu HT, Kim TH, Uhm JS, Kim JY, Sung JH, Pak HN, Lee MH, Lip GYH, Joung B. 208Effect of hypertension duration and systolic blood pressure on dementia in patients with atrial fibrillation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is associated with a higher risk for cognitive impairment and dementia, with or without a history of clinical stroke. There are a paucity of data on the associations of hypertension duration and blood pressure (BP) level with risk of dementia in patients with AF.
Purpose
We examined associations of duration of hypertension and secondly, systolic blood pressure (SBP) levels with incidence of dementia among patients with AF.
Methods
We enrolled a total 196,388 patients aged ≥50 years who were newly diagnosed as AF and undergoing hypertension treatment from the Korean National Health Insurance Service database (2005–2016). Starting from AF diagnosis, participants were followed up until the date of dementia, death, or December 31, 2016. To incorporate the effect of BP level and hypertension duration changes over time on dementia incidence, we constructed time-updated multivariable Cox models in which BP levels and hypertension duration were updated at each participants' regular national health examination visits (at 0–7 years of follow-up). Similarly, age, BP medications, and health-related behaviors were included as time-varying covariates in these models.
Results
During 1,016,744 person-years of follow-up, there were 32,692 dementia events. A cubic spline curve using continuous hypertension duration measures suggested a linear association between increase of hypertension duration and dementia risk. One-year increase of hypertension duration increased the adjusted risk of dementia with a hazard ratio (HR) of 1.17 [95% confidence interval (CI) 1.13–1.22]. In patients with hypertension duration <6 years, SBP of ≥140 mmHg was significantly associated with higher dementia risk, compared to SBP of <130 mmHg (in patients with hypertension duration <3 years: adjusted HR 1.08, 95% CI 1.01–1.16; and in those with 3 ≤ hypertension duration <6 years: adjusted HR 1.13, 95% CI 1.07–1.20), whereas no significant association between SBP and dementia risk in those with hypertension duration ≥6 years.
SBP and dementia in different duration
Conclusion
In patients with AF, the increase of hypertension duration was strongly associated with increased risk of dementia. Uncontrolled SBP was also associated with higher dementia risk. But, this effect of SBP might be attenuated in patients with longer hypertension duration. These findings suggest more emphasis needed on BP control in AF patients with earlier phase of hypertension (duration <6 years).
Acknowledgement/Funding
The Korean Ministry of Education, Science and Technology (NRF-2017R1A2B3003303) and the Korean Ministry of Health & Welfare (HI16C0058, HI15C1200)
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Affiliation(s)
- D Kim
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - P S Yang
- CHA University, Seongnam, Korea (Republic of)
| | - E Jang
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - H T Yu
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - T H Kim
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - J S Uhm
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - J Y Kim
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - J H Sung
- CHA University, Seongnam, Korea (Republic of)
| | - H N Pak
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - M H Lee
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - G Y H Lip
- University of Liverpool, Liverpool, United Kingdom
| | - B Joung
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
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Kim IS, Yang PS, Yu HT, Kim TH, Uhm JS, Pak HN, Lee MH, Kim JY, Joung B. P5710Clinical applications of machine learning for prediction of incident atrial fibrillation from the general population: a nationwide cohort study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0651] [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: 11/15/2022] Open
Abstract
Abstract
Background
To evaluate the ability of machine learning algorithms to predict incident atrial fibrillation (AF) from the general population using health examination items.
Methods
We included 483,343 subjects who received national health examinations from the Korean National Health Insurance Service-based National Sample Cohort (NHIS-NSC). We trained deep neural network model (DNN) of a deep learning system and decision tree model (DT) of a machine learning system using clinical variables and health examination items (including age, sex, body mass index, history of heart failure, hypertension or diabetes, baseline creatinine, and smoking and alcohol intake habits) to predict incident AF using a training dataset of 341,771 subjects constructed from the NHIS-NSC database. The DNN and DT were validated using an independent test dataset of 141,572 remaining subjects. C-indices of DNN and DT for prediction of incident AF were compared with that of conventional logistic regression model.
Results
During 1,874,789 person·years (mean±standard-deviation age 47.7±14.4 years, 49.6% male), 3,282 subjects with incident AF were observed. In the validation dataset, 1,139 subjects with incident AF were observed. The c-indices of the DNN and DT for incident AF prediction were 0.828 [0.819–0.836] and 0.835 [0.825–0.844], and were significantly higher (p<0.01) than conventional logistic regression model (c-index=0.789 [0.784–0.794]).
Conclusions
Application of machine learning using simple clinical variables and health examination items was helpful to predict incident AF in the general population. Prospective study is warranted to construct an individualized precision medicine.
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Affiliation(s)
- I.-S Kim
- Yonsei University, Department of Internal Medicine, Cardiology Division, Seoul, Korea (Republic of)
| | - P S Yang
- Bundang CHA General Hospital, Cardiology Division, Seongnam, Korea (Republic of)
| | - H T Yu
- Yonsei University, Department of Internal Medicine, Cardiology Division, Seoul, Korea (Republic of)
| | - T H Kim
- Yonsei University, Department of Internal Medicine, Cardiology Division, Seoul, Korea (Republic of)
| | - J S Uhm
- Yonsei University, Department of Internal Medicine, Cardiology Division, Seoul, Korea (Republic of)
| | - H N Pak
- Yonsei University, Department of Internal Medicine, Cardiology Division, Seoul, Korea (Republic of)
| | - M H Lee
- Yonsei University, Department of Internal Medicine, Cardiology Division, Seoul, Korea (Republic of)
| | - J Y Kim
- Gangnam Severance Hospital, Cardiology Division, Seoul, Korea (Republic of)
| | - B Joung
- Yonsei University, Department of Internal Medicine, Cardiology Division, Seoul, Korea (Republic of)
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10
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Kim D, Yang PS, Jang E, Yu HT, Kim TH, Uhm JS, Kim JY, Sung JH, Pak HN, Lee MH, Lip GYH, Joung B. 64Risk of dementia in patients treated with non-vitamin k antagonist oral anticoagulant or warfarin for nonvalvular atrial fibrillation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0010] [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
Evidence is accumulating that use of oral anticoagulants (OACs) decreases the risk of dementia in patients with atrial fibrillation (AF), but it is unclear if there is a difference between non-vitamin K antagonist oral anticoagulants (NOACs) and warfarin in protecting against dementia.
Purpose
To compare the risk of dementia between patients taking either NOAC or warfarin using a nationwide cohort data covering the entire Korean population.
Methods
Using the Korean national health insurance service database, 68,984 new OAC users with non-valvular AF aged ≥50 years and no prior diagnosis of dementia were identified during the period of 2013–2016 (39,687 NOAC users and 29,297 warfarin users). Starting from OAC initiation, participants were followed up until the date of dementia, death, or December 31, 2016. We compared the rates of dementia in 1:1 propensity score-matched cohorts of NOAC (n=18,925) and warfarin users (n=18,925).
Results
During the 52,259 person-years of follow-up, there were 2,750 dementia events. Use of NOAC was associated with significant lower risk of dementia [hazard ratio (HR) 0.75, 95% confidence interval (CI) 0.69–0.81], compared with warfarin. The risk reduction was prominent for vascular dementia (HR 0.60, 95% CI 0.52–0.71), whereas there was no significant difference in the risk of Alzheimer dementia (HR 0.92, 95% CI 0.83–1.02). Restricting the analyses to patients with no stroke diagnosis prior to OAC initiation (primary prevention) showed no significant difference between NOAC and warfarin in any types of dementia, but in the subgroup with prior stroke (secondary prevention), NOAC significantly reduced the risk of overall (HR 0.70, 95% CI 0.63–0.78) and vascular dementia (HR 0.59, 95% CI 0.49–0.69).
Subgroup analysis according to stroke Hx Patient N Overall dementia Alzheimer dementia Vascular dementia HR (95% CI) P for interaction HR (95% CI) P for interaction HR (95% CI) P for interaction Total 37,850 0.75 (0.69–0.81) 0.92 (0.83–1.02) 0.60 (0.52–0.71) Without prior stroke 24,773 0.90 (0.78–1.05) 0.948 0.98 (0.83–1.15) 0.235 0.85 (0.56–1.28) 0.863 With prior stroke 13,077 0.70 (0.63–0.78) 0.90 (0.79–1.03) 0.59 (0.49–0.69) CI, confidence interval; HR, hazard ratio.
KM curves of dementia incidence
Conclusion
In this propensity-weighted nationwide cohort of non-valvular AF patients, NOAC was associated with reduced risk of dementia, compared with warfarin. This association was the most pronounced for vascular dementia in patients with prior stroke.
Acknowledgement/Funding
The Korean Ministry of Education, Science and Technology (NRF-2017R1A2B3003303) and the Korean Ministry of Health & Welfare (HI16C0058, HI15C1200)
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Affiliation(s)
- D Kim
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - P S Yang
- CHA University, Seongnam, Korea (Republic of)
| | - E Jang
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - H T Yu
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - T H Kim
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - J S Uhm
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - J Y Kim
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - J H Sung
- CHA University, Seongnam, Korea (Republic of)
| | - H N Pak
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - M H Lee
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - G Y H Lip
- University of Liverpool, Liverpool, United Kingdom
| | - B Joung
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea (Republic of)
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11
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Joung B, Yang PS, Sung JH, Jang ES, Yu HT, Kim TH, Pak HN, Lee MH. P345Catheter ablation for atrial fibrillation is associated with lower incidence of stroke, major bleeding and death: data from Korean health registries. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0179] [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
Compared with antiarrhythmic drug therapy, catheter ablation of AF reduces the number of AF episodes, prolongs the time in sinus rhythm, and improves quality of life. However, it is still unclear if catheter ablation for atrial fibrillation (AF) affects the prognosis or merely is a symptomatic treatment. Our objective was to compare long-term outcome regarding stroke, major bleeding and death in AF patients with and without ablation, and in relation to long-term exposure to anticoagulants.
Methods
We identified all 800,084 patients with a diagnosis of AF from 2006 to 2015 in the Korean national health insurance service database. During a 10-year period, 10,979 AF ablations were performed among 9,768 individuals. Propensity scores for the likelihood of AF ablation were obtained by logistic regression. Propensity score (PS) matching was used to construct two cohorts of equal size (n=9,768) with similar characteristics in 16 dimensions.
Results
Patients who had undergone catheter ablation were younger (57.2 vs. 65.6 years, P<0.001) and healthier (mean CHA2DS2-VASc scores 2.5±1.7 vs. 3.6±2.1, P<0.001) than other patients with AF. Mean follow-up was 5.5±3.1 years. After propensity score matching, in the ablated group, 472 patients suffered ischemic stroke/systemic embolism (SE) compared with 1,682 in the matched non-ablated (annual rates 2.92 vs. 1.10%, P<0.001). Major bleeding occurred in 439 and 1,219 patients in ablated and non-ablated (annual rates 2.07 vs. 1.01%, P<0.001). A total of 306 ablated and 1,439 non-ablated patients died (annual rates 2.31 vs. 0.69%, P<0.001). After multivariable adjustments, catheter ablation was associated with lower risk of ischemic stroke [hazard ratio (HR) 0.51, 95% confidence interval (CI) 0.38–0.67), lower risk of major bleeding (HR 0.65, 95% CI 0.57–0.75) and with lower mortality risk (HR 0.39, 95% CI 0.34–0.46). The reduction of stroke/SE and mortality was observed after AF ablation regardless thromboembolic risk. Major bleeding was reduced only among patients with CHA2DS2-VASc score ≥2 (HR 0.70, 95% CI 0.59–0.84).
Conclusion
We found a strong association between ablation and survival. Ablation may be associated with lower incidence of ischemic stroke and major bleeding in patients with AF. The reduction of stroke/SE and mortality was observed regardless thromboembolic risk after AF ablation. But the risk of major bleeding was reduced only in patients with high thromboembolic risk factors.
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Affiliation(s)
- B Joung
- Yonsei University, Seoul, Korea (Republic of)
| | - P S Yang
- CHA University, Cardiology, Seongnam, Korea (Republic of)
| | - J H Sung
- CHA University, Cardiology, Seongnam, Korea (Republic of)
| | - E S Jang
- Yonsei University, Seoul, Korea (Republic of)
| | - H T Yu
- Yonsei University, Seoul, Korea (Republic of)
| | - T H Kim
- Yonsei University, Seoul, Korea (Republic of)
| | - H N Pak
- Yonsei University, Seoul, Korea (Republic of)
| | - M H Lee
- Yonsei University, Seoul, Korea (Republic of)
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12
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Yang PS, Sung JH, Jang E, Yu HT, Kim TH, Uhm JS, Kim JY, Pak HN, Lee MH, Joung B. P1027The risk of dementia and catheter ablation for atrial fibrillation: a nationwide cohort study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0618] [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
Atrial fibrillation (AF) is associated with all forms of dementia, including Alzheimer's disease. Catheter ablation of AF reduces the number of AF episodes, prolongs the time in sinus rhythm, and improves quality of life. However, it is still unclear if catheter ablation for AF improve cognitive function and prevent dementia. Our objective was to compare long-term outcome regarding dementia and type of dementia in AF patients with and without ablation, and about long-term exposure to anticoagulants.
Methods
We identified all 801,701 patients with a diagnosis of AF from 2006 to 2015 in the Korean national health insurance service database. During ten years, 10,979 AF ablations were performed among 9,768 individuals. Propensity scores for the likelihood of AF ablation were obtained by logistic regression. Propensity score (PS) matching was used to construct two cohorts of equal size (n=9,768) with similar characteristics in 16 dimensions.
Results
Patients who had undergone catheter ablation were younger (57.2 vs. 65.6 years, P<0.001) and healthier (mean CHA2DS2-VASc scores 2.5±1.7 vs. 3.6±2.1, p<0.001) than other patients with AF. Mean follow-up was 5.5±3.1 years. After propensity score matching, in the ablated group, 184 patients suffered dementia compared with 650 in the matched non-ablated (annual rates 0.42 vs. 1.08%, P<0.001). While a total of 134 ablated and 379 non-ablated patients had Alzheimer disease (annual rates 0.31 vs. 0.62%, p<0.001), 40 ablated and 191 non-ablated patients had vascular disease (annual rates 0.09 vs. 0.31%, p<0.001). After multivariable adjustments, catheter ablation was associated with lower risk of dementia (hazard ratio [HR] 0.46, 95% confidence interval [CI] 0.37–0.58), lower risk of Alzheimer disease (HR 0.61, 95% CI 0.46–0.79) and lower risk of vascular dementia (HR 0.27, 95% CI 0.19–0.38). Although the reduction of dementia and Alzheimer disease was observed after AF ablation regardless of thromboembolic risk, vascular dementia was reduced only among patients with CHA2DS2-VASc score ≥2 (HR 0.29, 95% CI 0.20–0.42).
The risk of dementia, RFCA vs. no-RFCA Type Propensity score matched ablation group vs. no ablation group adjusted HR (95% CI) P-value Overall dementia 0.46 (0.37–0.58) <0.001 Alzheimer dementia 0.61 (0.46–0.79) <0.001 Vascular dementia 0.27 (0.19–0.38) <0.001
Conclusion
Ablation may be associated with a lower incidence of dementia and both type of dementia in patients with AF. This finding appears more pronounced in patients with high thromboembolic risk factors.
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Affiliation(s)
- P S Yang
- CHA University, Seongnam, Korea (Republic of)
| | - J H Sung
- CHA University, Seongnam, Korea (Republic of)
| | - E Jang
- Yonsei University Health System, cardiology, Seoul, Korea (Republic of)
| | - H T Yu
- Yonsei University Health System, cardiology, Seoul, Korea (Republic of)
| | - T H Kim
- Yonsei University Health System, cardiology, Seoul, Korea (Republic of)
| | - J S Uhm
- Yonsei University Health System, cardiology, Seoul, Korea (Republic of)
| | - J Y Kim
- Yonsei University Health System, cardiology, Seoul, Korea (Republic of)
| | - H N Pak
- Yonsei University Health System, cardiology, Seoul, Korea (Republic of)
| | - M H Lee
- Yonsei University Health System, cardiology, Seoul, Korea (Republic of)
| | - B Joung
- Yonsei University Health System, cardiology, Seoul, Korea (Republic of)
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13
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Kim D, Yang PS, Jang E, Yu HT, Kim TH, Uhm JS, Kim JY, Pak HN, Lee MH, Joung B, Lip G. P4795Dabigatran in real-world asian patients with atrial fibrillation with low body weight: nationwide cohort data covering the entire korean population. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4795] [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: 11/14/2022] Open
Affiliation(s)
- D Kim
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - P S Yang
- Bundang CHA General Hospital, Seongnam, Korea Republic of
| | - E Jang
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - H T Yu
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - T H Kim
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - J S Uhm
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - J Y Kim
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - H N Pak
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - M H Lee
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - B Joung
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - G Lip
- University of Birmingham, Institute of Cardiovascular Sciences, Birmingham, United Kingdom
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14
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Baek YS, Yang PS, Kim TH, Uhm JS, Pak HN, Lee MH, Kwan J, Joung BY, Kim DH. P4791Different obesity paradox of ischemic stroke without and with atrial fibrillation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4791] [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: 11/14/2022] Open
Affiliation(s)
- Y S Baek
- Inha University Hospital, cardiology, Incheon, Korea Republic of
| | - P S Yang
- Yonsei University College of Medicine, Seoul, Korea Republic of
| | - T H Kim
- Yonsei University College of Medicine, Seoul, Korea Republic of
| | - J S Uhm
- Yonsei University College of Medicine, Seoul, Korea Republic of
| | - H N Pak
- Yonsei University College of Medicine, Seoul, Korea Republic of
| | - M H Lee
- Yonsei University College of Medicine, Seoul, Korea Republic of
| | - J Kwan
- Inha University Hospital, cardiology, Incheon, Korea Republic of
| | - B Y Joung
- Yonsei University College of Medicine, Seoul, Korea Republic of
| | - D H Kim
- Yonsei University College of Medicine, Seoul, Korea Republic of
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15
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Kim IS, Yang PS, Kim TH, Uhm JS, Pak HN, Lee MH, Joung B. P2515Particulate matter air pollution and mortality in a general healthy population: a nationwide cohort study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2515] [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: 11/14/2022] Open
Affiliation(s)
- I.-S Kim
- Yonsei University, Department of Internal Medicine, Cardiology Division, Seoul, Korea Republic of
| | - P S Yang
- Yonsei University, Department of Internal Medicine, Cardiology Division, Seoul, Korea Republic of
| | - T H Kim
- Yonsei University, Department of Internal Medicine, Cardiology Division, Seoul, Korea Republic of
| | - J S Uhm
- Yonsei University, Department of Internal Medicine, Cardiology Division, Seoul, Korea Republic of
| | - H N Pak
- Yonsei University, Department of Internal Medicine, Cardiology Division, Seoul, Korea Republic of
| | - M H Lee
- Yonsei University, Department of Internal Medicine, Cardiology Division, Seoul, Korea Republic of
| | - B Joung
- Yonsei University, Department of Internal Medicine, Cardiology Division, Seoul, Korea Republic of
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16
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Kim D, Yang PS, Kim TH, Jang E, Yu HT, Uhm JS, Kim JY, Pak HN, Lee MH, Joung B, Lip G. 2181What is the ideal blood pressure threshold and target for the management of high blood pressure in patients with atrial fibrillation? Nationwide cohort data covering the entire korean population. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.2181] [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: 11/14/2022] Open
Affiliation(s)
- D Kim
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - P S Yang
- Bundang CHA General Hospital, Seongnam, Korea Republic of
| | - T H Kim
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - E Jang
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - H T Yu
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - J S Uhm
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - J Y Kim
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - H N Pak
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - M H Lee
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - B Joung
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - G Lip
- University of Birmingham, Institute of Cardiovascular Sciences, Birmingham, United Kingdom
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17
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Kim IS, Yang PS, Kim TH, Uhm JS, Pak HN, Lee MH, Joung B. 113Particulate matter air pollution and incident atrial fibrillation in a general healthy population: a nationwide cohort study. Europace 2018. [DOI: 10.1093/europace/euy015.035] [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: 11/13/2022] Open
Affiliation(s)
- I S Kim
- Yonsei University , Department of Internal Medicine, Cardiology Division, Seoul, Korea Republic of
| | - P S Yang
- Yonsei University , Department of Internal Medicine, Cardiology Division, Seoul, Korea Republic of
| | - T H Kim
- Yonsei University , Department of Internal Medicine, Cardiology Division, Seoul, Korea Republic of
| | - J S Uhm
- Yonsei University , Department of Internal Medicine, Cardiology Division, Seoul, Korea Republic of
| | - H N Pak
- Yonsei University , Department of Internal Medicine, Cardiology Division, Seoul, Korea Republic of
| | - M H Lee
- Yonsei University , Department of Internal Medicine, Cardiology Division, Seoul, Korea Republic of
| | - B Joung
- Yonsei University , Department of Internal Medicine, Cardiology Division, Seoul, Korea Republic of
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18
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Kim D, Yang PS, Jang E, Yu HT, Kim TH, Uhm JS, Kim JY, Sung JH, Pak HN, Lee MH, Joung B, Lip GYH. P1195Current and future incidence and prevalence of atrial fibrillation in korea. Europace 2018. [DOI: 10.1093/europace/euy015.677] [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: 11/12/2022] Open
Affiliation(s)
- D Kim
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - P S Yang
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - E Jang
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - H T Yu
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - T H Kim
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - J S Uhm
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - J Y Kim
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - J H Sung
- Bundang CHA General Hospital, Seongnam, Korea Republic of
| | - H N Pak
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - M H Lee
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - B Joung
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - GYH Lip
- University of Birmingham, Institute of Cardiovascular Sciences, Birmingham, United Kingdom
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19
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Yang PS, Kim TH, Uhm JS, Joung B, Kim MH, Pak HN. P1185Serum uric acid concentration and risk of atrial fibrillation: a Mendelian randomization analysis in Asian population. Europace 2018. [DOI: 10.1093/europace/euy015.669] [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: 11/12/2022] Open
Affiliation(s)
- P S Yang
- Yonsei University Health System, cardiology, Seoul, Korea Republic of
| | - T H Kim
- Yonsei University Health System, cardiology, Seoul, Korea Republic of
| | - J S Uhm
- Yonsei University Health System, cardiology, Seoul, Korea Republic of
| | - B Joung
- Yonsei University Health System, cardiology, Seoul, Korea Republic of
| | - M H Kim
- Yonsei University Health System, cardiology, Seoul, Korea Republic of
| | - H N Pak
- Yonsei University Health System, cardiology, Seoul, Korea Republic of
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20
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Yu HT, Yang PS, Kim TH, Uhm JS, Kim JY, Joung B, Lee MH, Pak HN. 524Poor rhythm outcome of catheter ablation for early onset atrial fibrillation in women: mechanistic insight. Europace 2018. [DOI: 10.1093/europace/euy015.291] [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)
- H T Yu
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea Republic of
| | - P S Yang
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea Republic of
| | - T H Kim
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea Republic of
| | - J S Uhm
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea Republic of
| | - J Y Kim
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea Republic of
| | - B Joung
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea Republic of
| | - M H Lee
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea Republic of
| | - H N Pak
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea Republic of
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21
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Kim D, Yang PS, Jang E, Yu HT, Kim TH, Uhm JS, Kim JY, Pak HN, Lee MH, Sung JH, Joung B, Lip GYH. P1196Increasing trends in hospital-care burden of atrial fibrillation in korea, 2006 through 2015: implications for healthcare planning. Europace 2018. [DOI: 10.1093/europace/euy015.678] [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)
- D Kim
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - P S Yang
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - E Jang
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - H T Yu
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - T H Kim
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - J S Uhm
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - J Y Kim
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - H N Pak
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - M H Lee
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - J H Sung
- Bundang CHA General Hospital, Seongnam, Korea Republic of
| | - B Joung
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - GYH Lip
- University of Birmingham, Institute of Cardiovascular Sciences, Birmingham, United Kingdom
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Yu HT, Yang PS, Hwang J, Ryu S, Jang E, Kim TH, Uhm JS, Sung JH, Kim JY, Pak HN, Lee MH, Joung B, Lip GYH. P378Influence of reimbursement of non-vitamin K antagonist oral anticoagulants on overall prescription rates of oral anticoagulation: A nationwide study using the Korean National Health Insurance Data. Europace 2018. [DOI: 10.1093/europace/euy015.189] [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: 11/13/2022] Open
Affiliation(s)
- H T Yu
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea Republic of
| | - P S Yang
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea Republic of
| | - J Hwang
- Daegu University, Department of Computer Science and Statistics, Gyeongsan, Korea Republic of
| | - S Ryu
- Daegu University, Department of Computer Science and Statistics, Gyeongsan, Korea Republic of
| | - E Jang
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea Republic of
| | - T H Kim
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea Republic of
| | - J S Uhm
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea Republic of
| | - J H Sung
- CHA University, Seongnam, Korea Republic of
| | - J Y Kim
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea Republic of
| | - H N Pak
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea Republic of
| | - M H Lee
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea Republic of
| | - B Joung
- Yonsei University College of Medicine, Division of Cardiology, Seoul, Korea Republic of
| | - GYH Lip
- University of Birmingham, Institute of Cardiovascular Sciences, Birmingham, United Kingdom
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Lim YM, Yang PS, Jang ES, Yu HT, Kim TH, Uhm JS, Sung JH, Kim JY, Pak HN, Lee MH, Joung B, Lip GYH. 1009Body mass index variability and long-term risk of new-onset atrial fibrillation in the general population: a korean nationwide cohort study. Europace 2018. [DOI: 10.1093/europace/euy015.558] [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: 11/13/2022] Open
Affiliation(s)
- Y M Lim
- SAM medical center, Anyang, Korea Republic of
| | - P S Yang
- Yonsei Cardiovascular Center, Seoul, Korea Republic of
| | - E S Jang
- Yonsei Cardiovascular Center, Seoul, Korea Republic of
| | - H T Yu
- Yonsei Cardiovascular Center, Seoul, Korea Republic of
| | - T H Kim
- Yonsei Cardiovascular Center, Seoul, Korea Republic of
| | - J S Uhm
- Yonsei Cardiovascular Center, Seoul, Korea Republic of
| | - J H Sung
- CHA University, Seongnam, Korea Republic of
| | - J Y Kim
- Yonsei Cardiovascular Center, Seoul, Korea Republic of
| | - H N Pak
- Yonsei Cardiovascular Center, Seoul, Korea Republic of
| | - M H Lee
- Yonsei Cardiovascular Center, Seoul, Korea Republic of
| | - B Joung
- Yonsei Cardiovascular Center, Seoul, Korea Republic of
| | - GYH Lip
- University of Birmingham, Birmingham, United Kingdom
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Yang PS, Yeh CH, Chao YK. Boerhaave's Syndrome Secondary to Migration of Gastrostomy Tube. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791302000615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Percutaneous endoscopic gastrostomy is a safe procedure for providing nutrition. Complications associated with tube migration such as duodenal obstruction or pancreatitis have been reported. For the first time, we reported a rare complication of gastrostomy tube migration manifested by Boerhaave's syndrome. (Hong Kong j.emerg.med. 2013;20:400-401)
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Affiliation(s)
- PS Yang
- Chang Gung Memorial Hospital, Department of Surgery, Linkou, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - CH Yeh
- Chang Gung Memorial Hospital, Division of Thoracic and Cardiovascular Surgery, Keelung, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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25
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Wang LM, Zhao N, Zhang J, Sun QF, Yang CZ, Yang PS. Tumor necrosis factor-alpha inhibits osteogenic differentiation of pre-osteoblasts by downregulation of EphB4 signaling via activated nuclear factor-kappaB signaling pathway. J Periodontal Res 2017; 53:66-72. [PMID: 28857167 DOI: 10.1111/jre.12488] [Citation(s) in RCA: 23] [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] [Subscribe] [Scholar Register] [Accepted: 07/01/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND OBJECTIVE The majority of experiments show that tumor necrosis factor-alpha (TNF-α) inhibits osteogenic differentiation of mesenchymal stem cells and pre-osteoblasts by activated nuclear factor-kappaB (NF-κB) signaling. However, the underlying mechanisms by which NF-κB signaling inhibits osteogenic differentiation are not fully understood. The aim of the present study was to investigate whether EphB4 signaling inhibition mediates the effects of TNF-α-activated NF-κB signaling on osteogenic differentiation of pre-osteoblasts. MATERIAL AND METHODS Murine MC3T3-E1 pre-osteoblasts were treated with 10 ng/mL of TNF-α. NF-κB inhibitor, pyrrolidine dithiocarbamate, was used to achieve NF-κB signaling inhibition. EphB4 signaling was activated using ephrinB2-fc. The mRNA expressions of runt related transcription factor 2 (Runx2), bone sialoprotein (BSP) and EphB4 were determined using reverse transcription-polymerase chain reaction. The protein levels of Runx2, BSP, Col Ia1, osteopontin, EphB4, p-NF-κB p65 and NF-κB p65 were evaluated using western blot assays. Alkaline phosphatase (ALP) activity in MC3T3-E1 cells was evaluated by ALP activity kit, and mineral nodule formation was evaluated by Alizarin Red S staining. RESULTS TNF-α inhibited EphB4 expression, while it suppressed Runx2, BSP expression from gene and protein levels as well as ALP activity and mineral nodule formation in MC3T3-E1 cells. Activation of EphB4 signaling by ephrinB2-fc promoted osteogenic differentiation of MC3T3-E1 cells, whereas TNF-α impaired the osteogenic differentiation enhanced by ephrinB2-fc. Pyrrolidine dithiocarbamate blocked the activation of NF-κB signaling induced by TNF-α, while it prevented the downregulation of Runx2, BSP and EphB4, induced by TNF-α. CONCLUSION TNF-α inhibits osteogenic differentiation of pre-osteoblasts by downregulation of EphB4 signaling via activated NF-κB signaling pathway.
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Affiliation(s)
- L M Wang
- Department of Stomatology, Qilu Hospital, and Institute of Stomatology, Shandong University, Jinan, Shandong, China.,Department of Periodontology, School of Stomatology, Shandong University, Jinan, Shandong, China.,Shandong provincial key laboratory of oral tissue regeneration, Jinan, Shandong, China
| | - N Zhao
- Dezhou keen Stomatology Hospital, Dezhou, Shandong, China
| | - J Zhang
- Department of Endodontics, School of Stomatology, Shandong University, Jinan, Shandong, China
| | - Q F Sun
- Department of Periodontology, School of Stomatology, Shandong University, Jinan, Shandong, China
| | - C Z Yang
- Department of Oral & Maxillofacial Surgery, Qilu Hospital, and Institute of Stomatology, Shandong University, Jinan, Shandong, China
| | - P S Yang
- Department of Periodontology, School of Stomatology, Shandong University, Jinan, Shandong, China.,Shandong provincial key laboratory of oral tissue regeneration, Jinan, Shandong, China
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Abstract
Background As an adjunctive treatment of chronic periodontitis, it seems that the application of periocline or the other antimicrobials is effective against periodontopathogens. In this study, nanoliposomes were investigated as carriers of minocycline hydrochloride and the inhibition effects of minocycline hydrochloride nanoliposomes on the proliferation and lipopolysaccharide (LPS)-stimulated production of tumor necrosis factor-α (TNF-α) of macrophages were elucidated. Methods After stimulation with 10 μg/mL LPS, murine macrophages (ANA-1) were treated with 10, 20, 40, 50 and 70 μg/mL 2% minocycline hydrochloride nanoliposomes, minocycline hydrochloride solution, and periocline for 6, 12, 24, 48 and 60 hours, respectively. A tetrazolium (MTT) assay was used to evaluate macrophages cell proliferation rate and the levels of TNF-α mRNA were measured by SYBR Green Real Time PCR. Results Ten to 70 μg/mL 2% minocycline hydrochloride nanoliposomes, minocycline hydrochloride solution, and periocline showed dose- and time-dependent inhibition of ANA-1 proliferation. Minocycline hydrochloride nanoliposomes showed dose- and ratio-dependent inhibition of LPS-stimulated TNF-α secretion of ANA-1. The inhibition effect of 10 μg/mL minocycline hydrochloride nanoliposomes was significantly better than that of two positive control groups, and equated to that of 60 or 70 μg/mL periocline. The expression of TNF-α mRNA in experimental group continued to reduce linearly with time. Conclusion All three preparations of minocycline hydrochloride showed dose- and time-dependent inhibition of proliferation of ANA-1. Minocycline hydrochloride nanoliposomes have stronger and longer inhibition effect on LPS-stimulated TNF-α secretion of macrophages cell than minocycline hydrochloride solution and periocline.
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Affiliation(s)
- D Liu
- Shandong Provincial Key Laboratory of Oral Biomedicine, College of Stomatology, Shandong University, Shandong Province, People's Republic of China
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Yan SG, Zhang J, Tu QS, Ye JH, Luo E, Schuler M, Kim MS, Griffin T, Zhao J, Duan XJ, Cochran DJ, Murray D, Yang PS, Chen J. Enhanced osseointegration of titanium implant through the local delivery of transcription factor SATB2. Biomaterials 2011; 32:8676-83. [PMID: 21862122 DOI: 10.1016/j.biomaterials.2011.07.072] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Accepted: 07/25/2011] [Indexed: 10/17/2022]
Abstract
Titanium implants are widely used in dentistry and orthopedic surgery. Nevertheless, bone regeneration around the implant is a relatively slow process, after placement. This study assessed whether SATB2 can enhance osseointegration of a titanium implant. To determine the effect of SATB2 in implant integration, two different viruses encoding SATB2 (PBABE-Satb2 virus or RCAS-Satb2 virus) were locally administered to the bone defect prior to titanium implant placement in our established transgenic TVA mice. Seven and 21 days post implantation, the femurs were isolated for quantitative real-time RT-PCR, H&E staining, immunohistochemical (IHC) staining, and microcomputed tomography (microCT) analysis. Quantitative real-time RT-PCR results demonstrated that the in vivo overexpression of SATB2 enhanced expression levels of potent osteogenic transcription factors and bone matrix proteins. We also found that 21 days after implantation, there were no significant differences in the expression levels of SATB2, Osx, Runx2, COLI, OC, and BSP between the RCAS-Satb2 group and the RCAS group. Histological analysis showed that SATB2 overexpression significantly enhanced new bone formation and bone-to-implant contact after implantation. IHC staining analysis revealed that forced expression of SATB2 increased the number of BSP-positive cells surrounding the implant. MicroCT analysis demonstrated that in vivo overexpression of SATB2 significantly increased the density of the newly formed bone surrounding the implant. These results conclude that in vivo overexpression of SATB2 significantly accelerates osseointegration of titanium implants and SATB2 can serve as a potent molecule in promoting tissue regeneration.
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Affiliation(s)
- S G Yan
- Division of Oral Biology, Department of General Dentistry, Tufts University School of Dental Medicine, 1 Kneeland Street, Boston, MA 02111, USA.
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Glenzer SH, MacGowan BJ, Meezan NB, Adams PA, Alfonso JB, Alger ET, Alherz Z, Alvarez LF, Alvarez SS, Amick PV, Andersson KS, Andrews SD, Antonini GJ, Arnold PA, Atkinson DP, Auyang L, Azevedo SG, Balaoing BNM, Baltz JA, Barbosa F, Bardsley GW, Barker DA, Barnes AI, Baron A, Beeler RG, Beeman BV, Belk LR, Bell JC, Bell PM, Berger RL, Bergonia MA, Bernardez LJ, Berzins LV, Bettenhausen RC, Bezerides L, Bhandarkar SD, Bishop CL, Bond EJ, Bopp DR, Borgman JA, Bower JR, Bowers GA, Bowers MW, Boyle DT, Bradley DK, Bragg JL, Braucht J, Brinkerhoff DL, Browning DF, Brunton GK, Burkhart SC, Burns SR, Burns KE, Burr B, Burrows LM, Butlin RK, Cahayag NJ, Callahan DA, Cardinale PS, Carey RW, Carlson JW, Casey AD, Castro C, Celeste JR, Chakicherla AY, Chambers FW, Chan C, Chandrasekaran H, Chang C, Chapman RF, Charron K, Chen Y, Christensen MJ, Churby AJ, Clancy TJ, Cline BD, Clowdus LC, Cocherell DG, Coffield FE, Cohen SJ, Costa RL, Cox JR, Curnow GM, Dailey MJ, Danforth PM, Darbee R, Datte PS, Davis JA, Deis GA, Demaret RD, Dewald EL, Di Nicola P, Di Nicola JM, Divol L, Dixit S, Dobson DB, Doppner T, Driscoll JD, Dugorepec J, Duncan JJ, Dupuy PC, Dzenitis EG, Eckart MJ, Edson SL, Edwards GJ, Edwards MJ, Edwards OD, Edwards PW, Ellefson JC, Ellerbee CH, Erbert GV, Estes CM, Fabyan WJ, Fallejo RN, Fedorov M, Felker B, Fink JT, Finney MD, Finnie LF, Fischer MJ, Fisher JM, Fishler BT, Florio JW, Forsman A, Foxworthy CB, Franks RM, Frazier T, Frieder G, Fung T, Gawinski GN, Gibson CR, Giraldez E, Glenn SM, Golick BP, Gonzales H, Gonzales SA, Gonzalez MJ, Griffin KL, Grippen J, Gross SM, Gschweng PH, Gururangan G, Gu K, Haan SW, Hahn SR, Haid BJ, Hamblen JE, Hammel BA, Hamza AV, Hardy DL, Hart DR, Hartley RG, Haynam CA, Heestand GM, Hermann MR, Hermes GL, Hey DS, Hibbard RL, Hicks DG, Hinkel DE, Hipple DL, Hitchcock JD, Hodtwalker DL, Holder JP, Hollis JD, Holtmeier GM, Huber SR, Huey AW, Hulsey DN, Hunter SL, Huppler TR, Hutton MS, Izumi N, Jackson JL, Jackson MA, Jancaitis KS, Jedlovec DR, Johnson B, Johnson MC, Johnson T, Johnston MP, Jones OS, Kalantar DH, Kamperschroer JH, Kauffman RL, Keating GA, Kegelmeyer LM, Kenitzer SL, Kimbrough JR, King K, Kirkwood RK, Klingmann JL, Knittel KM, Kohut TR, Koka KG, Kramer SW, Krammen JE, Krauter KG, Krauter GW, Krieger EK, Kroll JJ, La Fortune KN, Lagin LJ, Lakamsani VK, Landen OL, Lane SW, Langdon AB, Langer SH, Lao N, Larson DW, Latray D, Lau GT, Le Pape S, Lechleiter BL, Lee Y, Lee TL, Li J, Liebman JA, Lindl JD, Locke SF, Loey HK, London RA, Lopez FJ, Lord DM, Lowe-Webb RR, Lown JG, Ludwigsen AP, Lum NW, Lyons RR, Ma T, MacKinnon AJ, Magat MD, Maloy DT, Malsbury TN, Markham G, Marquez RM, Marsh AA, Marshall CD, Marshall SR, Maslennikov IL, Mathisen DG, Mauger GJ, Mauvais MY, McBride JA, McCarville T, McCloud JB, McGrew A, McHale B, MacPhee AG, Meeker JF, Merill JS, Mertens EP, Michel PA, Miller MG, Mills T, Milovich JL, Miramontes R, Montesanti RC, Montoya MM, Moody J, Moody JD, Moreno KA, Morris J, Morriston KM, Nelson JR, Neto M, Neumann JD, Ng E, Ngo QM, Olejniczak BL, Olson RE, Orsi NL, Owens MW, Padilla EH, Pannell TM, Parham TG, Patterson RW, Pavel G, Prasad RR, Pendlton D, Penko FA, Pepmeier BL, Petersen DE, Phillips TW, Pigg D, Piston KW, Pletcher KD, Powell CL, Radousky HB, Raimondi BS, Ralph JE, Rampke RL, Reed RK, Reid WA, Rekow VV, Reynolds JL, Rhodes JJ, Richardson MJ, Rinnert RJ, Riordan BP, Rivenes AS, Rivera AT, Roberts CJ, Robinson JA, Robinson RB, Robison SR, Rodriguez OR, Rogers SP, Rosen MD, Ross GF, Runkel M, Runtal AS, Sacks RA, Sailors SF, Salmon JT, Salmonson JD, Saunders RL, Schaffer JR, Schindler TM, Schmitt MJ, Schneider MB, Segraves KS, Shaw MJ, Sheldrick ME, Shelton RT, Shiflett MK, Shiromizu SJ, Shor M, Silva LL, Silva SA, Skulina KM, Smauley DA, Smith BE, Smith LK, Solomon AL, Sommer S, Soto JG, Spafford NI, Speck DE, Springer PT, Stadermann M, Stanley F, Stone TG, Stout EA, Stratton PL, Strausser RJ, Suter LJ, Sweet W, Swisher MF, Tappero JD, Tassano JB, Taylor JS, Tekle EA, Thai C, Thomas CA, Thomas A, Throop AL, Tietbohl GL, Tillman JM, Town RPJ, Townsend SL, Tribbey KL, Trummer D, Truong J, Vaher J, Valadez M, Van Arsdall P, Van Prooyen AJ, Vergel de Dios EO, Vergino MD, Vernon SP, Vickers JL, Villanueva GT, Vitalich MA, Vonhof SA, Wade FE, Wallace RJ, Warren CT, Warrick AL, Watkins J, Weaver S, Wegner PJ, Weingart MA, Wen J, White KS, Whitman PK, Widmann K, Widmayer CC, Wilhelmsen K, Williams EA, Williams WH, Willis L, Wilson EF, Wilson BA, Witte MC, Work K, Yang PS, Young BK, Youngblood KP, Zacharias RA, Zaleski T, Zapata PG, Zhang H, Zielinski JS, Kline JL, Kyrala GA, Niemann C, Kilkenny JD, Nikroo A, Van Wonterghem BM, Atherton LJ, Moses EI. Demonstration of ignition radiation temperatures in indirect-drive inertial confinement fusion hohlraums. Phys Rev Lett 2011; 106:085004. [PMID: 21405580 DOI: 10.1103/physrevlett.106.085004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Indexed: 05/30/2023]
Abstract
We demonstrate the hohlraum radiation temperature and symmetry required for ignition-scale inertial confinement fusion capsule implosions. Cryogenic gas-filled hohlraums with 2.2 mm-diameter capsules are heated with unprecedented laser energies of 1.2 MJ delivered by 192 ultraviolet laser beams on the National Ignition Facility. Laser backscatter measurements show that these hohlraums absorb 87% to 91% of the incident laser power resulting in peak radiation temperatures of T(RAD)=300 eV and a symmetric implosion to a 100 μm diameter hot core.
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Affiliation(s)
- S H Glenzer
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
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Kim HJ, Lee HJ, Yang JH, Yeo IS, Yi JS, Lee IW, Lee SB, Ryu SY, Kim JK, Yang PS. The influence of carotid artery catheterization technique on the incidence of thromboembolism during carotid artery stenting. AJNR Am J Neuroradiol 2010; 31:1732-6. [PMID: 20595362 DOI: 10.3174/ajnr.a2141] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Thromboembolic events related to CAS continue to be the main limitation to the widespread use of this technique as a first-line treatment for carotid occlusive disease. Our aim was to evaluate thromboembolism during CAS using DWI for catheterization techniques of the carotid artery. MATERIALS AND METHODS Thirty-two consecutive patients with symptomatic carotid stenosis underwent CAS involving 1 of 2 carotid artery catheterization techniques: One used a 7F or 8F catheter (group 1, n = 16) and the other used a coaxial system in which a 7F or 8F catheter was used in conjunction with a 4F or 5F catheter (group 2, n = 16). DWI was performed before and after CAS. Clinical variables, the number and location of NES on DWI after CAS, were compared between the 2 groups. RESULTS NES on DWI occurred in 53% of all patients. The incidence of NES was significantly higher in patients 65 years of age and older versus those younger than 65 years of age (P = .013). All NESs were asymptomatic, and their rate of occurrence did not differ significantly between groups 1 and 2. The incidence of NES in the other territories that were outside that of the treated carotid artery (P = .004) and the incidence of multiple NESs (P = .04) were significantly higher in group 1. CONCLUSIONS NES in the other territories mainly arises from the atherosclerotic aortic arch and arch vessels during the manipulation of endoluminal devices. The carotid artery catheterization technique using the coaxial system with a 7F or 8F catheter in conjunction with a 4F or 5F catheter reduced the incidence of NES in the other territories.
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Affiliation(s)
- H J Kim
- Departments of Radiology, Daejeon St. Mary’s Hospital, Medical School, The Catholic University of Korea, 520-2 Daeheung-Dong, Jung-Gu, Daejeon, Korea
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Li S, Tu Q, Zhang J, Stein G, Lian J, Yang PS, Chen J. Systemically transplanted bone marrow stromal cells contributing to bone tissue regeneration. J Cell Physiol 2008; 215:204-9. [PMID: 17960569 DOI: 10.1002/jcp.21302] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Bone marrow stromal cells (BMSCs) are a rich source of osteogenic progenitor cells. A fundamental question is whether systemically transplanted BMSCs participate in bone regeneration. Luciferase and GFP double-labeled BMSCs were transplanted into irradiated mice. Five weeks after transplantation, artificial bone wounds were created in the mandibles and calvaria of the recipients. Animals were sacrificed at weeks 2, 4, and 6 after surgery and the expressions of luciferase and GFP were determined using Xenogen IVIS Imaging System, immunohistochemical staining and RT-PCR. The results demonstrated that transplanted BMSCs can be detected in wound sites as early as 2 weeks and lasted the whole experimental period. Luciferase expression peaked at 2 weeks after surgery and decreased thereafter, exhibiting a similar expression pattern as that of BSP, while GFP expression was relatively stable during the experimental period. In conclusion, BMSCs can migrate to bone wound sites and participate in bone regeneration in orocraniofacial region.
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Affiliation(s)
- S Li
- Division of Oral Biology, Department of General Dentistry, Tufts University School of Dental Medicine, Boston, Massachusetts 02111, USA
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Tsung JSH, Yang PS. Hepatoid carcinoma of the ovary: characteristics of its immunoreactivity. A case report. EUR J GYNAECOL ONCOL 2004; 25:745-8. [PMID: 15597858] [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: 05/01/2023]
Abstract
Alpha-fetoprotein producing tumors other than hepatoma and germ cell tumors have been widely reported, especially in carcinoma with hepatoid differentiation (hepatoid carcinoma). Hepatoid carcinoma has mostly been found in the stomach, but also occurs in many other organs. A rare case of hepatoid carcinoma of the ovary is presented. A 57-year-old Taiwanese woman was admitted because of lower abdominal pain. Magnetic resonance imaging showed a 10 cm right adnexal mass. She underwent a total hysterectomy and bilateral salpingo-oophorectomy with omentectomy. A right ovarian mass measuring 13 x 9 x 8 cm was found. Microscopic examination showed characteristic features for hepatoid carcinoma. Immunohistochemical staining was performed on the tumor using a panel of eight markers (AFP, p-CEA, CD10, Hep Par 1, thyroid transcription factor-1, CK7, CK19 and CK20). This study contradicts the theory that hepatoid carcinoma derives from the surface epithelium of the ovary. Hepatoid carcinoma of the ovary commonly contains a population of clear cells, which may lead to the misdiagnosis of yolk sac tumor or clear cell adenocarcinoma that may arise in many anatomic sites. Histologically, it is also difficult to distinguish hepatoid carcinoma from hepatoid yolk sac tumor. In such cases, demonstration of CD 10, Hep Par 1, membraneous patterns of p-CEA and CK7 would be invaluable for characterizing the tumor as hepatoid carcinoma. More studies are needed to confirm this observation.
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Affiliation(s)
- J S H Tsung
- Department of Pathology and Laboratory Medicine, Sun-Yat Sen Cancer Center and Institute of Pharmacy, School of Medicine, National Yang-Ming University Taipei, Taiwan
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Kim EA, Johkoh T, Lee KS, Han J, Fujimoto K, Sadohara J, Yang PS, Kozuka T, Honda O, Kim S. Quantification of ground-glass opacity on high-resolution CT of small peripheral adenocarcinoma of the lung: pathologic and prognostic implications. AJR Am J Roentgenol 2001; 177:1417-22. [PMID: 11717098 DOI: 10.2214/ajr.177.6.1771417] [Citation(s) in RCA: 84] [Impact Index Per Article: 3.7] [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: 01/15/2023]
Abstract
OBJECTIVE The purpose of our study was to correlate the high-resolution CT findings of small peripheral adenocarcinoma of the lung with underlying histopathology and to evaluate the prognostic implications of the CT findings. MATERIALS AND METHODS The high-resolution CT findings of small peripheral adenocarcinoma of the lung in 224 patients were analyzed by two independent observers for location, size, marginal characteristics, and extent of ground-glass opacity and necrosis. The pathologic specimens were reviewed by an experienced lung pathologist. RESULTS One hundred and thirty-two patients had bronchioloalveolar carcinoma and 92 had adenocarcinoma. The extent of ground-glass opacity was greater in bronchioloalveolar carcinomas (mean +/- SD, 29% +/- 31.6%) than in other adenocarcinomas (8% +/- 13.3%) (p < 0.001). The extent of ground-glass opacity was significantly greater in patients without recurrence (p = 0.020) and those without nodal (p = 0.017) or distant (p = 0.007) metastases than in patients with nodal or distant metastases or in whom the carcinoma had recurred. CONCLUSION The extent of ground-glass opacity in a nodule is greater in bronchioloalveolar carcinomas than in other adenocarcinomas. Greater extent of ground-glass opacity also correlates with improved prognosis.
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Affiliation(s)
- E A Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea
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Affiliation(s)
- T S Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea
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Abstract
The purpose of this study was to describe the CT findings of focal organizing pneumonia and to compare the findings with pathology. CT findings of histologically proven focal organizing pneumonias in 26 consecutive patients were analyzed. In 17 patients who had undergone surgical resections, the findings were correlated with pathology. Focal organizing pneumonias appeared as a nodule (n= 13) or a mass (n=13), ranging from 9 mm to 66 mm in diameter. Ground-glass opacity was seen in 6/13 (46%) nodules and 6.5/13 (50%) masses (k=.48) with an extent ranging from 5% to 75% (mean, 16%). In 4/26 (15%) patients, the extent was more than 50% of the lesion. They showed smooth (n=4), lobulated (n=8), spiculated (n=1), or lobulated and spiculated margin (n=13). On correlative analysis, nodule or mass on CT consisted histologically of intraalveolar exudate or microabscess, chronic inflammatory cell infiltration, fibrotic nodules, and polypoid granulation tissue in the alveolar or bronchiolar spaces. Ground-glass opacity consisted of interstitial fibrosis and chronic inflammatory cell infiltration and intraalveolar polypoid granulation tissue. Focal organizing pneumonia may simulate a lung cancer with variable appearances on CT and the findings reflect underlying histopathology of the disease.
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Affiliation(s)
- P S Yang
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Wang XL, Yang PS, Yu Y, Sun SZ. [Clinical evaluation of pulpotomy in the treatment of deciduous teeth with deep dentine caries]. Shanghai Kou Qiang Yi Xue 2001; 10:199-200, 242. [PMID: 14993988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
OBJECTIVE To study the curative effect of pulpotomy in the treatment of deciduous teeth with deep caries. METHODS 45 deciduous molars with deep caries from 3 8 years old children were selected at random. Pulpotomy was performed on these treated teeth. Clinical examination and X-ray films for the treated teeth were taken to follow up all the teeth at 6 months, one year and two years respectively after treatment. RESULTS At one year after treatment, 45 cases were followed up, the rate of success in clinical examination and in X-ray photographs both were 100%. While at two years after treatment, 42 cases were followed up and 3 cases were lost, the rate of success in clinical examination was 95% and the rate of success in X-ray photographs was 88%. The reasons of the failure were internal absorption and pulpitis followed by fracture and exfoliation of the obturators in the treated teeth. CONCLUSION Pulpotomy in deciduous teeth with deep caries was a reliable and effective method. It is necessary to follow up the treated teeth by X-ray at regular intervals after treatment.
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Affiliation(s)
- X L Wang
- Department of Oral Medicine, Affiliated Stomatological Hospital, Shandong University, Shandong 250012, China
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Abstract
Various surgical procedures are performed for benign and malignant esophageal lesions. These procedures include transthoracic esophageal resection through a right or left thoracotomy and transhiatal blunt esophageal resection (esophagectomy) without thoracotomy. The whole stomach, colon, gastric tube, jejunum, and free revascularized grafts may be used as substitutes for the resected esophagus. Bypass procedures including substernal stomach bypass surgery and substernal or subcutaneous colon bypass surgery are performed for tracheoesophageal fistula, previous esophagectomy without reconstruction, or obstruction due to lye ingestion. The mortality rate for esophageal resection depends on the stage of the tumor, the patient's condition, and the surgeon's skill and is quite low when the procedure is performed by a highly skilled surgeon. The most frequent sources of morbidity related to esophageal surgery include pneumothorax, pleural effusion, pneumonia, and respiratory failure. Mediastinitis and sepsis due to disruption at an anastomosis site cause serious postoperative morbidity and mortality; therefore, thoracic anastomotic leaks require aggressive surgical treatment. Familiarity with these surgical options, the resultant anatomic changes associated with each option, and the expected findings at postoperative imaging is essential for evaluating the effectiveness of surgical procedures and for the early detection and management of surgery-related complications.
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Affiliation(s)
- S H Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea
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Song AM, Yang PS, Sun QF, Ge SH. [The effect on angiogenesis in guided tissue regeneration procedure using expanded polytetrafluoroethyene membranes in dogs]. Shanghai Kou Qiang Yi Xue 2001; 10:236-9. [PMID: 14994003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
OBJECTIVE To observe the effect on angiogenesis in guided tissue regeneration procedures in which the barrier membranes were designed to be left for different time. METHODS Periodontal defects were created on buccal side of mesial root of mandibular third and fourth premolar in dogs. An experimental polytetrafluoroethyene (ePTFE) membrane was adapted to leave in place for 2, 3, 4 and 8 weeks,respectively. In the control defects(right mandibular second premolar), no membrane was used. At the end of 8 weeks,all the animals were perfused with a combined solution of carbon black ink and 10% formalin solution and killed. 500 microm thick specimens were processed. Descriptive histology was carried out,evaluating angiogenesis in area of new supraalveolar and gingival flaps. RESULTS Histologic analysis demonstrated that new vascular meshworks were built between the gingival flap and new connective tissue in the wound in 2-week,3-week and 4-week groups.However, in 8-week group, the number of supraalveolar blood vessels were fewer than that in other groups.But vascular rebuilt in gingival flap in 8-week group had come to normal. CONCLUSION The existance of nonresorbable membrane could affect the rebuilt of supraalveolar vascular meshwork, but it had no significant effect on the blood circulation in gingival flap. The revascularization between gingival flap and the new connective tissue was not significantly influenced after the membranes were removed from 2 to 4 weeks' placement.
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Affiliation(s)
- A M Song
- Faculty of Stomatology, Shandong University, Shandong 250012, China.
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Chia-Hsien Cheng J, Chuang VP, Cheng SH, Lin YM, Cheng TI, Yang PS, Jian JJ, You DL, Horng CF, Huang AT. Unresectable hepatocellular carcinoma treated with radiotherapy and/or chemoembolization. Int J Cancer 2001; 96:243-52. [PMID: 11474499 DOI: 10.1002/ijc.1022] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.2] [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: 12/17/2022]
Abstract
The purpose of our study was to evaluate the outcome, patterns of failure, and toxicity for patients with unresectable hepatocellular carcinoma (HCC) treated with radiotherapy, transcatheter arterial chemoembolization (TACE), or combined TACE and radiotherapy. Forty-two patients with unresectable HCC were treated with combined radiotherapy and TACE (TACE+RT group, 17 patients), radiotherapy alone (RT group, 9 patients), or with TACE alone (TACE group, 16 patients). Mean dose of radiation was 46.9 +/- 5.8 Gy in a daily fraction of 1.8 to 2 Gy, directed only to the cancer-involved areas of the liver. TACE was performed with a combination of Lipiodol, doxorubicin, cisplatin, and mitomycin C, followed by Gelfoam or Ivalon embolization. Tumor size was smaller in the TACE group (mean: 5.4 cm) compared with the TACE+RT group (8.6 cm) and the RT group (13.1 cm) (P = 0.0003). The median follow-up was 24 months in the TACE+RT group, 28 months in the RT group, and 23 months in the TACE group. Survival was significantly worse for patients treated with radiotherapy alone due to the selection bias of patients with more advanced disease and compromised condition in this group. In contrast, the TACE+RT and TACE groups had comparable survival (two-year rates: TACE+RT 58%, TACE 56%, P = 0.69). The local control rate for the treated tumors was similar in the TACE+RT and TACE groups (P = 0.11). The intrahepatic recurrence outside the treated tumors was common and similar between these two groups (P = 0.48). The extrahepatic progression-free survival was significantly shorter for patients in the TACE+RT group than in the TACE group (two-year rates: TACE+RT 36%, TACE 100%, P = 0.002). Seven patients died from complications of treatment. Local radiotherapy may be added to treat patients with unresectable HCC, and the control of progression of the treated tumors was promising even in patients with large hepatic tumors. Survival of patients with combined TACE and radiotherapy was similar to that with TACE as the only treatment, while a significant portion of the patients treated with radiotherapy developed extrahepatic metastasis.
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Affiliation(s)
- J Chia-Hsien Cheng
- Department of Radiation Oncology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan.
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Zhang SJ, Liang YH, Yang PS. [Effects of basic fibroblast growth factor on growth of human periodontal ligament cells]. Shanghai Kou Qiang Yi Xue 2001; 10:135-7. [PMID: 14994039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
OBJECTIVE To evaluate the biological effects of basic fibroblast growth factor (bFGF) on proliferation and DNA synthesis of periodontal ligament cells(PDLC). METHODS PDLC was isolated from periodontal ligament explants. The effects of bFGF on PDLC were assayed by MTT and 3(H)-TdR incorporation studies. The results were expressed as A value and CPM. Analysis of variance was used. RESULTS bFGF could enhance the proliferation and DNA synthesis of PDLC in a dose dependent manner. No inhibition was observed within 1000ng/ml bFGF concentration. The concentration of half maximal effect was 100ng/ml. CONCLUSION The results suggest that bFGF may play an important role in the regeneration of periodontal tissue.
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Affiliation(s)
- S J Zhang
- Department of Stomatology, Shandong Medical University, Shandong 250012, China.
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40
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Ge SH, Yang PS. [Effects of bFGF on biological characteristics of cells derived from periodontium]. Shanghai Kou Qiang Yi Xue 2001; 10:24-6, 48. [PMID: 14994072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
OBJECTIVE To observe effects of basic fibroblast growth factor on the biological characteristics of cultured human gingival,periodontal ligament fibroblasts and human alveolar bone cells, such as proliferation, alkaline phosphatase activity, protein synthesis and the formation of mineralized nodules. METHODS Using cell culture technique, MTT colorimetric assay, ALP activity assay, Commasie brilliant blue staining and Dahl McGec-Russell's alizarin red stain for calcium. RESULTS bFGF enhanced the proliferative responses of the three types of cells. In contrast, bFGF inhabited the induction of alkaline phosphatase activity, protein synthesis and the mineralized nodule formation by PDLF and ABC. CONCLUSION bFGF can enhance cell proliferation while inhibit cytodifferentiation, thus accelerating periodontal regeneration.
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Affiliation(s)
- S H Ge
- Hospital of Stomatology attached to Shangdong Medical University, Shandong 250012, China
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Cheng JC, Chen CM, Liu MC, Tsou MH, Yang PS, Cheng SH. Locoregional recurrence in patients with one to three positive axillary nodes after mastectomy without adjuvant radiotherapy. J Formos Med Assoc 2000; 99:759-65. [PMID: 11061070] [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: 02/18/2023] Open
Abstract
PURPOSE To retrospectively assess the risk of locoregional recurrence (LRR) and analyze the prognostic factors of this pattern of failure in patients with breast cancer and one to three positive axillary lymph nodes treated with modified radical mastectomy (MRM) without adjuvant radiotherapy. METHODS From April 1991 through December 1997, 649 patients received a diagnosis of invasive breast cancer, and 545 were treated with MRM. Eighty-one of these patients who were found to have one to three positive axillary nodes and had a minimum follow-up of 2 years were included in this study. None of the 81 patients received adjuvant radiation therapy after mastectomy; 43 patients received adjuvant chemotherapy; and 60 patients received adjuvant hormone therapy. The median duration of follow-up was 39 months. RESULTS Thirteen patients had LRR during follow-up, all within 2 years after mastectomy. The 3-year LRR rate was 14%. The 3-year rates of distant metastasis for patients with and without LRR were 48% and 14% (p = 0.03), respectively. The 3-year survival rates for patients with and without LRR were 73% and 87% (p = 0.01), respectively. In univariate analysis, age (p = 0.01), estrogen receptor (ER) status (p = 0.02), and the addition of hormone therapy (p < 0.001) were significant risk factors for LRR; in multivariate analysis, negative ER status (p = 0.02) was the only statistically significant risk factor. The 3-year LRR rates for ER-negative patients and those with positive or unknown ER status were 31% and 11%, respectively. CONCLUSIONS LRR after mastectomy is a substantial clinical problem, despite the use of adjuvant chemotherapy and/or hormone therapy. Further randomized trials of postmastectomy radiotherapy for patients with one to three positive axillary nodes and specific risk factors are urgently needed to determine its potential benefit in locoregional control and survival, especially for young and ER-negative patients.
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Affiliation(s)
- J C Cheng
- Department of Radiation Oncology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan
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Cheng JC, Chuang VP, Cheng SH, Huang AT, Lin YM, Cheng TI, Yang PS, You DL, Jian JJ, Tsai SY, Sung JL, Horng CF. Local radiotherapy with or without transcatheter arterial chemoembolization for patients with unresectable hepatocellular carcinoma. Int J Radiat Oncol Biol Phys 2000; 47:435-42. [PMID: 10802371 DOI: 10.1016/s0360-3016(00)00462-4] [Citation(s) in RCA: 140] [Impact Index Per Article: 5.8] [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: 12/13/2022]
Abstract
PURPOSE To evaluate the treatment outcome, patterns of failure, and prognostic factors for patients with unresectable hepatocellular carcinoma (HCC) treated with local radiotherapy alone or as an adjunct to transcatheter arterial chemoembolization (TACE). METHODS AND MATERIALS From March 1994 to December 1997, 25 patients with unresectable HCC underwent local radiotherapy to a portion of the liver. Twenty-three patients were classified as having cirrhosis in Child-Pugh class A and 2 in class B. Mean diameter of the treated hepatic tumor was 10.3 cm. Mean dose of radiation was 46.9 +/- 5.9 Gy in a daily fraction of 1.8-2 Gy. Sixteen patients were also treated with Lipiodol and chemotherapeutic agents mixed with Ivalon or Gelfoam particles for chemoembolization, either before and/or after radiotherapy. Percutaneous ethanol injection therapy (PEIT) was given to one patient. All patients were monitored for treatment-related toxicity and for survival and patterns of failure. RESULTS In a median follow-up period of 23 months, 11 patients were alive and 14 dead. The median survival duration from treatment was 19.2 months with a 2-year survival of 41%. Only 3 of 25 patients had local progression of the treated hepatic tumor. The recurrences were seen within the liver or extrahepatic. The 2-year local, regional, and extrahepatic progression-free survival rates were 78%, 46%, and 39%, respectively. The local control ranked the highest. Patients with Okuda Stage I disease had significantly longer survival than those with Stage II and III (p = 0.02). Patients with T4 disease (p = 0.02) or treated with radiotherapy alone (p = 0.003) had significantly shorter survival. T4 disease (p = 0.03) and pretreatment alpha-fetoprotein level of more than 200 ng/ml (p = 0. 03) were associated with significantly worse regional progression-free survival. A significant difference was observed in both regional progression-free survival (p = 0.0001) and extrahepatic progression-free survival (p = 0.005) between patients with and without portal vein thrombosis before treatment. The presence of satellite nodules had a significantly worse impact on regional progression-free survival (p = 0.04) and extrahepatic progression-free survival (p = 0.03). Patients with hepatic tumor more than 6 cm in diameter or portal vein thrombosis tended to have shorter survival. Radiation-induced liver disease (RILD) and gastrointestinal bleeding were the most common treatment-related toxicities. CONCLUSION Radiotherapy is effective in the treatment of patients with unresectable HCC. Its effect appeared to be more prominent within the site to which radiation was given. The combination of TACE and radiation was associated with better control of HCC than radiation given alone, probably due to the selection of patients with favorable prognosis for the combined treatment. A dose-volume model should be established in the next phase of research in the treatment of unresectable HCC.
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Affiliation(s)
- J C Cheng
- Departments of Department ofRadiation Oncology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan.
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Xu X, Yang PS, Ma Y, Sun SZ, Li Q, Wang JT. [Induction of osteointegration of rabbit mandibular central fissure with guided tissue regeneration]. Shanghai Kou Qiang Yi Xue 1999; 8:193-4. [PMID: 15048205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
OBJECTIVE:To observe the effect of guided tissue regeneration (GTR) on induction of ostegenesis in developmental bone clefts,and provide a basis for the use of GTR to repair bony clefts in cleft lip and palate patients.METHODS:The e-PTFE membrane was placed on the labial and lingual sides of the rabbit mandibular central fissure.A radiological and pathological study was performed to determine the healing of the fissure integration.RESULTS:The results showed that the bony cleft was completely integrated 4 weeks after placement of the barrier membrane.CONCLUSION:GTR is an effective approach to reconstruct bony cleft,and is likely to be used in repair of alveolar cleft and cleft palate.
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Affiliation(s)
- X Xu
- Affiliated Hospital of Stomatology,Shandong Medical University.Jinan 250012, Shandong province, China
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Cheng SH, Lin YM, Chuang VP, Yang PS, Cheng JC, Huang AT, Sung JL. A pilot study of three-dimensional conformal radiotherapy in unresectable hepatocellular carcinoma. J Gastroenterol Hepatol 1999; 14:1025-33. [PMID: 10530500 DOI: 10.1046/j.1440-1746.1999.01994.x] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.4] [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: 01/02/2023]
Abstract
BACKGROUND The purpose of this study was to determine the potential role of three-dimensional (3-D) conformal radiotherapy (RT) in treatment of unresectable hepatocellular carcinoma (HCC). METHODS Thirteen patients were included in this study, which was conducted between 1993 and 1996. Nine patients (group A) were treated with 3-D conformal RT alone because of main portal vein thrombosis, inferior vena cava thrombosis, obstructive jaundice and failure of previous transcatheter arterial chemoembolization (TACE) to control the disease. The remaining four patients (group B) were treated with a combination of TACE and 3-D conformal RT. RESULTS The greatest dimension of the main tumour in the whole group of patients ranged from 6 to 25 cm (median 15 cm). The radiation dose ranged from 40 to 60 Gy. The tumour response was evaluated by computed tomography scans of the liver 6-8 weeks after completion of radiotherapy. Partial response was observed in 58% of the patients (seven of 12) and minimal response in another 25% of patients (three of 12). One patient could not be evaluated because of the development of hepatic failure 1 month after completion of RT. All patients in group B lived for more than 1 year (range 16-40 months). In group A, one patient who had a large tumour (11 x 10 x 21 cm) with portal vein thrombosis was converted to become resectable after 45 Gy of radiation. The resection specimen revealed no residual cancer cells. This patient is alive longer than 15 months after treatment without the evidence of disease. CONCLUSIONS Our experience indicates that HCC is more radiosensitive than it was traditionally expected. Three-dimensional reconstruction of tumour and surrounding organs helps to avoid excessive exposure of the liver and adjacent organs to RT and makes it a safer treatment modality for unresectable HCC. Our preliminary data show promise and are worthy of further study to explore the potential role of radiotherapy in the treatment strategy for HCC at various stages of involvement.
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Affiliation(s)
- S H Cheng
- Department of Radiation Oncology, Koo Foundation, Sun Yat-Sen Cancer Center, Taipei, Taiwan.
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Abstract
To investigate risk factors for breast cancer in Taiwan, a low-incidence area, a case-control study was conducted. This comprised 244 subjects with diagnosed and pathologically confirmed breast cancer (age range 20-80 years) and 450 female ophthalmology outpatients as controls. Univariate and multiple logistic regression analysis suggests that breast cancer in Taiwan is aetiologically similar to breast cancer in high to moderate-incidence areas. A family history of breast cancer appears to be the most important factor contributing to the risk of breast cancer (odds ratio = 4.69). The effect of reproductive hormones (represented by the years of history of menses in premenopausal women, odds ratio = 3.35; or the age at menarche in post-menopausal women, odds ratio = 2.67) plays a significant role in tumorigenesis. Breast feeding appears to be a particularly important protective factor in Taiwanese women (odds ratio = 0.57).
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Affiliation(s)
- P S Yang
- Mackay Memorial Hospital, Academia Sinica, Taipei, Taiwan
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Yang PS, Yeh EK, Yang JG, Liu CY, Chen JC, Yang YY. [Organic mental disorders in psychiatric consultation: a preliminary report]. Changgeng Yi Xue Za Zhi 1994; 17:248-54. [PMID: 7954004] [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: 01/28/2023]
Abstract
In 200 cases for psychiatric consultation, 73 (36.5%) cases, 51 males and 22 females, were diagnosed as suffered from organic mental syndrome/disorder according to DSM-III-R criteria. Their mean age was 47.9 +/- 18.9 years. The leading psychiatric diagnosis were delirium (45.2%) and substance intoxication/withdrawal (20.5%). The main reasons for psychiatric consultation were psychotic symptoms (31.5%) and conscious disturbance (19.2%). The most common presumed etiologies for organic mental disorders were psycoactive substance related (39.7%) and metabolic (15.1%) causes. The comparisons of the results reported by several medical centers in recent years were further discussed in the text.
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Affiliation(s)
- P S Yang
- Department of Psychiatry, Chang Gung Memorial Hospital, Kaohsiung, Linkou, Taiwan, R.O.C
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Wang QW, Zheng ZF, Yang PS. [Studies on endotoxin lipopolysaccharides of infected root canals in cytotoxicity in vitro]. Zhonghua Kou Qiang Yi Xue Za Zhi 1994; 29:217-9. [PMID: 7859571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Guan ZZ, Zhuang ZJ, Yang PS, Pan S. Synergistic action of iodine-deficiency and fluorine-intoxication on rat thyroid. Chin Med J (Engl) 1988; 101:679-84. [PMID: 3148411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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Liu JL, Zhuang ZJ, Cao XM, Liu SA, Zhong FG, Gu ZG, Yang PS, Deng CJ. Changes in thyroid, cerebral cortex and bones of therapeutically aborted fetuses from endemic goiter region supplied with iodized salt for 5 years. Chin Med J (Engl) 1988; 101:133-6. [PMID: 3136979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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