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Hwang H, Kim SE, Lee HJ, Lee DA, Park KM. Identification of amnestic mild cognitive impairment by structural and functional MRI using a machine-learning approach. Clin Neurol Neurosurg 2024; 238:108177. [PMID: 38402707 DOI: 10.1016/j.clineuro.2024.108177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 02/13/2024] [Accepted: 02/14/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVE The importance of early treatment for mild cognitive impairment (MCI) has been extensively shown. However, classifying patients presenting with memory complaints in clinical practice as having MCI vs normal results is difficult. Herein, we assessed the feasibility of applying a machine learning approach based on structural volumes and functional connectomic profiles to classify the cognitive levels of cognitively unimpaired (CU) and amnestic MCI (aMCI) groups. We further applied the same method to distinguish aMCI patients with a single memory impairment from those with multiple memory impairments. METHODS Fifty patients with aMCI were enrolled and classified as having either verbal or visual-aMCI (verbal or visual memory impairment), or both aMCI (verbal and visual memory impairments) based on memory test results. In addition, 26 CU patients were enrolled in the control group. All patients underwent structural T1-weighted magnetic resonance imaging (MRI) and resting-state functional MRI. We obtained structural volumes and functional connectomic profiles from structural and functional MRI, respectively, using graph theory. A support vector machine (SVM) algorithm was employed, and k-fold cross-validation was performed to discriminate between groups. RESULTS The SVM classifier based on structural volumes revealed an accuracy of 88.9% at classifying the cognitive levels of patients with CU and aMCI. However, when the structural volumes and functional connectomic profiles were combined, the accuracy increased to 92.9%. In the classification of verbal or visual-aMCI (n = 22) versus both aMCI (n = 28), the SVM classifier based on structural volumes revealed a low accuracy of 36.7%. However, when the structural volumes and functional connectomic profiles were combined, the accuracy increased to 53.1%. CONCLUSION Structural volumes and functional connectomic profiles obtained using a machine learning approach can be used to classify cognitive levels to distinguish between aMCI and CU patients. In addition, combining the functional connectomic profiles with structural volumes results in a better classification performance than the use of structural volumes alone for identifying both "aMCI versus CU" and "verbal- or visual-aMCI versus both aMCI" patients.
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Affiliation(s)
- Hyunyoung Hwang
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Si Eun Kim
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Ho-Joon Lee
- Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Dong Ah Lee
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Kang Min Park
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
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Kang H, Kim SE, Park YI, Kim JC, Jeong JE, Jung H, Lee H, Hwang SY, Cheong IW, Lee SH, Seo E. Polyether-based waterborne synergists: effect of polymer topologies on pigment dispersion. RSC Adv 2023; 13:31092-31100. [PMID: 37881755 PMCID: PMC10594153 DOI: 10.1039/d3ra06427a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 10/18/2023] [Indexed: 10/27/2023] Open
Abstract
Control of polymer topologies is essential to determine their unique physical properties and potential applications. The polymer topologies can have a critical effect on pigment dispersion owing to their unique architectures; however, studies using polymer topologies on pigment dispersion in aqueous systems are scarce. Thus, this study proposes various topologies of polyether-based waterborne synergists, such as linear, hyperbranched, and branched cyclic structures. Specifically, we applied branched types of polyglycidols (PGs) as a synergist to provide polymer topology-dependent dispersibility for the surface-modification of Red 170 particles through adsorption and steric hindrance. The topology-controlled PG synergists (PGSs) were successfully prepared by post-polymerization modification with phthalimide and benzoyl groups. Particularly, the branched types of PGSs, branched cyclic PGS (bc-PGS), and hyperbranched PGS (hb-PGS) exhibited improved dispersibility through adsorption on top of the pigment, interaction between dispersant (BYK 190) and pigment, and steric effect. Surprisingly, hb-PGS conferred the Red 170 pigment particles with superior storage stability than that of bc-PGS despite their similar structural features. This study suggests the widespread potential application of PGSs as waterborne synergists for various dispersion applications.
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Affiliation(s)
- Hansol Kang
- Center for Advanced Specialty Chemicals, Korea Research Institute of Chemical Technology Ulsan 44412 Republic of Korea
- Department of Applied Chemistry, Kyungpook National University (KNU) Daegu 41566 Republic of Korea
| | - Si Eun Kim
- Center for Advanced Specialty Chemicals, Korea Research Institute of Chemical Technology Ulsan 44412 Republic of Korea
| | - Young Il Park
- Center for Advanced Specialty Chemicals, Korea Research Institute of Chemical Technology Ulsan 44412 Republic of Korea
| | - Jin Chul Kim
- Center for Advanced Specialty Chemicals, Korea Research Institute of Chemical Technology Ulsan 44412 Republic of Korea
| | - Ji-Eun Jeong
- Center for Advanced Specialty Chemicals, Korea Research Institute of Chemical Technology Ulsan 44412 Republic of Korea
| | - Hyocheol Jung
- Center for Advanced Specialty Chemicals, Korea Research Institute of Chemical Technology Ulsan 44412 Republic of Korea
| | - Hyosun Lee
- Department of Chemistry and Green-Nano Materials Research Center, Kyungpook National University 80 Daehakro, Buk-gu Daegu 41566 Republic of Korea
| | - Sung Yeon Hwang
- Department of Plant & Environmental New Resources and Graduate School of Biotechnology, Kyung Hee University Gyeonggi-do 17104 Republic of Korea
| | - In Woo Cheong
- Department of Applied Chemistry, Kyungpook National University (KNU) Daegu 41566 Republic of Korea
| | - Sang-Ho Lee
- Center for Advanced Specialty Chemicals, Korea Research Institute of Chemical Technology Ulsan 44412 Republic of Korea
- Advanced Materials and Chemical Engineering, University of Science and Technology (UST) Daejeon 34113 Republic of Korea
| | - Eunyong Seo
- Center for Advanced Specialty Chemicals, Korea Research Institute of Chemical Technology Ulsan 44412 Republic of Korea
- Department of Chemical Engineering, Ulsan College Ulsan 44610 Republic of Korea
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Shin SP, Ryu HJ, Kim SE, Kim KH, Ha IS, Park JH, Park TS. Research Note: Interactions among the MDA5, MAVS, and STING signaling pathways in chicken cells. Poult Sci 2023; 102:102913. [PMID: 37473519 PMCID: PMC10371811 DOI: 10.1016/j.psj.2023.102913] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 07/22/2023] Open
Abstract
Innate immunity, as an organism's first line of defense, plays a crucial role in rapidly responding to and protecting the body against invading pathogens. As a cytosolic RNA sensor for viral infections, including infections caused by influenza virus, the innate immune system in chickens has 2 major pathogen-recognition receptors (PRRs): Toll-like receptor 3 (TLR3) and melanoma differentiation-associated protein 5 (MDA5). The signaling pathways activated by PRRs are complex, systemic processes that underlie the response to foreign molecules. In this study, we investigated the interactions among MDA5, mitochondrial antiviral signaling protein (MAVS), and stimulator of interferon genes (STING) signaling in chicken cells. To exclude the effects of TLR3, we transfected the clustered regularly interspaced palindromic repeats/CRISPR-associated protein 9 (CRISPR-Cas9) expression vector and TLR3-targeted gRNA plasmid into chicken DF-1 cells. We selected TLR3-knockout (KO) cell line and sequentially, we established 2 double-KO cell lines: TLR3-MAVS KO and TLR3-STING KO. After treatment with polyinosinic:polycytidylic acid (poly(I:C)), type I interferon (IFN), IFN-stimulated gene, and antiviral gene (IFN regulatory factor 7, IFNβ, Mx1, and protein kinase R1) expression was not completely activated in TLR3-MAVS KO cells, whereas it was consistently upregulated in wild-type and TLR3-STING KO DF-1 cells. These results suggest that STING is not an intermediator between MDA5 and MAVS; moreover, it does not directly interact with MDA5 during innate immune activation in chicken DF-1 cells.
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Affiliation(s)
- Seung Pyo Shin
- Institute of Green-Bio Science and Technology, Pyeongchang-gun, Gangwon-do 25354, South Korea
| | - Hyeong Ju Ryu
- Graduate School of International Agricultural Technology, Seoul National University, Pyeongchang-gun, Gangwon-do 25354, South Korea
| | - Si Eun Kim
- Graduate School of International Agricultural Technology, Seoul National University, Pyeongchang-gun, Gangwon-do 25354, South Korea
| | - Ki Hyun Kim
- Graduate School of International Agricultural Technology, Seoul National University, Pyeongchang-gun, Gangwon-do 25354, South Korea
| | - In Su Ha
- Institute of Green-Bio Science and Technology, Pyeongchang-gun, Gangwon-do 25354, South Korea
| | - Ji Hoon Park
- Graduate School of International Agricultural Technology, Seoul National University, Pyeongchang-gun, Gangwon-do 25354, South Korea
| | - Tae Sub Park
- Institute of Green-Bio Science and Technology, Pyeongchang-gun, Gangwon-do 25354, South Korea; Graduate School of International Agricultural Technology, Seoul National University, Pyeongchang-gun, Gangwon-do 25354, South Korea.
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Lee DA, Lee H, Kim SE, Park KM. Brain networks and epilepsy development in patients with Alzheimer disease. Brain Behav 2023; 13:e3152. [PMID: 37416994 PMCID: PMC10454249 DOI: 10.1002/brb3.3152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/26/2023] [Accepted: 06/26/2023] [Indexed: 07/08/2023] Open
Abstract
INTRODUCTION This study aimed to investigate the association between brain networks and epilepsy development in patients with Alzheimer disease (AD). METHODS We enrolled patients newly diagnosed with AD at our hospital who underwent three-dimensional T1-weighted magnetic resonance imaging at the time of AD diagnosis and included healthy controls. We obtained the cortical, subcortical, and thalamic nuclei structural volumes using FreeSurfer and applied graph theory to obtain the global brain network and intrinsic thalamic network based on the structural volumes using BRAPH. RESULTS We enrolled 25 and 56 patients with AD with and without epilepsy development, respectively. We also included 45 healthy controls. The global brain network differed between the patients with AD and healthy controls. The local efficiency (2.026 vs. 3.185, p = .048) and mean clustering coefficient (0.449 vs. 1.321, p = .024) were lower, whereas the characteristic path length (0.449 vs. 1.321, p = .048) was higher in patients with AD than in healthy controls. Both global and intrinsic thalamic networks were significantly different between AD patients with and without epilepsy development. In the global brain network, local efficiency (1.340 vs. 2.401, p = .045), mean clustering coefficient (0.314 vs. 0.491, p = .045), average degree (27.442 vs. 41.173, p = .045), and assortative coefficient (-0.041 vs. -0.011, p = .045) were lower, whereas the characteristic path length (2.930 vs. 2.118, p = .045) was higher in patients with AD with epilepsy development than in those without. In the intrinsic thalamic network, the mean clustering coefficient (0.646 vs. 0.460, p = .048) was higher, whereas the characteristic path length (1.645 vs. 2.232, p = .048) was lower in patients with AD with epilepsy development than in those without. CONCLUSION We found that the global brain network differs between patients with AD and healthy controls. In addition, we demonstrated significant associations between brain networks (both global brain and intrinsic thalamic networks) and epilepsy development in patients with AD.
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Affiliation(s)
- Dong Ah Lee
- Department of Neurology, Haeundae Paik HospitalInje University College of MedicineBusanRepublic of Korea
| | - Ho‐Joon Lee
- Department of Radiology, Haeundae Paik HospitalInje University College of MedicineBusanRepublic of Korea
| | - Si Eun Kim
- Department of Neurology, Haeundae Paik HospitalInje University College of MedicineBusanRepublic of Korea
| | - Kang Min Park
- Department of Neurology, Haeundae Paik HospitalInje University College of MedicineBusanRepublic of Korea
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Kim YJ, Kim SE, Hahn A, Jang H, Kim JP, Kim HJ, Na DL, Chin J, Seo SW. Classification and prediction of cognitive trajectories of cognitively unimpaired individuals. Front Aging Neurosci 2023; 15:1122927. [PMID: 36993907 PMCID: PMC10040799 DOI: 10.3389/fnagi.2023.1122927] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/27/2023] [Indexed: 03/14/2023] Open
Abstract
Objectives Efforts to prevent Alzheimer's disease (AD) would benefit from identifying cognitively unimpaired (CU) individuals who are liable to progress to cognitive impairment. Therefore, we aimed to develop a model to predict cognitive decline among CU individuals in two independent cohorts. Methods A total of 407 CU individuals from the Alzheimer's Disease Neuroimaging Initiative (ADNI) and 285 CU individuals from the Samsung Medical Center (SMC) were recruited in this study. We assessed cognitive outcomes by using neuropsychological composite scores in the ADNI and SMC cohorts. We performed latent growth mixture modeling and developed the predictive model. Results Growth mixture modeling identified 13.8 and 13.0% of CU individuals in the ADNI and SMC cohorts, respectively, as the "declining group." In the ADNI cohort, multivariable logistic regression modeling showed that increased amyloid-β (Aβ) uptake (β [SE]: 4.852 [0.862], p < 0.001), low baseline cognitive composite scores (β [SE]: -0.274 [0.070], p < 0.001), and reduced hippocampal volume (β [SE]: -0.952 [0.302], p = 0.002) were predictive of cognitive decline. In the SMC cohort, increased Aβ uptake (β [SE]: 2.007 [0.549], p < 0.001) and low baseline cognitive composite scores (β [SE]: -4.464 [0.758], p < 0.001) predicted cognitive decline. Finally, predictive models of cognitive decline showed good to excellent discrimination and calibration capabilities (C-statistic = 0.85 for the ADNI model and 0.94 for the SMC model). Conclusion Our study provides novel insights into the cognitive trajectories of CU individuals. Furthermore, the predictive model can facilitate the classification of CU individuals in future primary prevention trials.
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Affiliation(s)
- Young Ju Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Si Eun Kim
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Alice Hahn
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Hyemin Jang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Jun Pyo Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea
- Center for Neuroimaging, Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Duk L. Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea
- Institute of Stem Cell and Regenerative Medicine, Seoul, Republic of Korea
- Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Juhee Chin
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea
- Institute of Stem Cell and Regenerative Medicine, Seoul, Republic of Korea
- Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, Republic of Korea
- Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Republic of Korea
- Department of Health Sciences and Technology, Seoul, Republic of Korea
- Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea
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Kang KS, Shin SP, Ha IS, Kim SE, Kim KH, Ryu HJ, Park TS. Production of chickens with GFP-knockin in the Z chromosome and detection of GFP-positive chicks in the embryonic stage. Anim Biosci 2023; 36:973-979. [PMID: 36915940 PMCID: PMC10164537 DOI: 10.5713/ab.22.0405] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/26/2023] [Indexed: 02/27/2023] Open
Abstract
Objective The clustered regularly interspaced short palindromic repeat (CRISPR)/CRISPR-associated protein 9 (Cas9) system, which is the most efficient and reliable tool for precisely targeted modification of the genome of living cells, has generated considerable excitement for industrial applications as well as scientific research. In this study, we developed a gene-editing and detection system for chick embryo sexing during the embryonic stage. Methods By combining the CRISPR/Cas9 technical platform and germ cell-mediated germline transmission, we not only generated Z chromosome-targeted knockin chickens but also developed a detection system for fluorescence-positive male chicks in the embryonic stage. Results We targeted a green fluorescent protein (GFP) transgene into a specific locus on the Z chromosome of chicken PGCs, resulting in the production of ZGFP-knockin chickens. By mating ZGFP-knockin females (ZGFP/W) with wild males (Z/Z) and using a GFP detection system, we could identify chick sex, as the GFP transgene was expressed on the Z chromosome only in male offspring (ZGFP/Z) even before hatching. Conclusion Our results demonstrate that the CRISPR/Cas9 technical platform with chicken PGCs facilitates the production of specific genome-edited chickens for basic research as well as practical applications.
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Affiliation(s)
- Kyung Soo Kang
- Depatment of Bio Life Science, ShinGu University, Seongnam 13174, Korea
| | - Seung Pyo Shin
- Institute of Green-Bio Science and Technology, Seoul National University, Pyeongchang 25354, Korea
| | - In Su Ha
- Institute of Green-Bio Science and Technology, Seoul National University, Pyeongchang 25354, Korea
| | - Si Eun Kim
- Graduate School of International Agricultural Technology, Seoul National University, Pyeongchang 25354, Korea
| | - Ki Hyun Kim
- Graduate School of International Agricultural Technology, Seoul National University, Pyeongchang 25354, Korea
| | - Hyeong Ju Ryu
- Graduate School of International Agricultural Technology, Seoul National University, Pyeongchang 25354, Korea
| | - Tae Sub Park
- Institute of Green-Bio Science and Technology, Seoul National University, Pyeongchang 25354, Korea.,Graduate School of International Agricultural Technology, Seoul National University, Pyeongchang 25354, Korea
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Jung SH, Kim HR, Chun MY, Jang H, Cho M, Kim B, Kim S, Jeong JH, Yoon SJ, Park KW, Kim EJ, Yoon B, Jang JW, Kim Y, Hong JY, Choi SH, Noh Y, Kim KW, Kim SE, Lee JS, Jung NY, Lee J, Lee AY, Kim BC, Cho SH, Cho H, Kim JH, Jung YH, Lee DY, Lee JH, Lee ES, Kim SJ, Moon SY, Son SJ, Hong CH, Bae JS, Lee S, Na DL, Seo SW, Cruchaga C, Kim HJ, Won HH. Transferability of Alzheimer Disease Polygenic Risk Score Across Populations and Its Association With Alzheimer Disease-Related Phenotypes. JAMA Netw Open 2022; 5:e2247162. [PMID: 36520433 PMCID: PMC9856322 DOI: 10.1001/jamanetworkopen.2022.47162] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
IMPORTANCE Polygenic risk scores (PRSs), which aggregate the genetic effects of single-nucleotide variants identified in genome-wide association studies (GWASs), can help distinguish individuals at a high genetic risk for Alzheimer disease (AD). However, genetic studies have predominantly focused on populations of European ancestry. OBJECTIVE To evaluate the transferability of a PRS for AD in the Korean population using summary statistics from a prior GWAS of European populations. DESIGN, SETTING, AND PARTICIPANTS This cohort study developed a PRS based on the summary statistics of a large-scale GWAS of a European population (the International Genomics of Alzheimer Project; 21 982 AD cases and 41 944 controls). This PRS was tested for an association with AD dementia and its related phenotypes in 1634 Korean individuals, who were recruited from 2013 to 2019. The association of a PRS based on a GWAS of a Japanese population (the National Center for Geriatrics and Gerontology; 3962 AD cases and 4074 controls) and a transancestry meta-analysis of European and Japanese GWASs was also evaluated. Data were analyzed from December 2020 to June 2021. MAIN OUTCOMES AND MEASURES Risk of AD dementia, amnestic mild cognitive impairment (aMCI), earlier symptom onset, and amyloid β deposition (Aβ). RESULTS A total of 1634 Korean patients (969 women [59.3%]), including 716 individuals (43.6%) with AD dementia, 222 (13.6%) with aMCI, and 699 (42.8%) cognitively unimpaired controls, were analyzed in this study. The mean (SD) age of the participants was 71.6 (9.0) years. Higher PRS was associated with a higher risk of AD dementia independent of APOE ɛ4 status in the Korean population (OR, 1.95; 95% CI, 1.40-2.72; P < .001). Furthermore, PRS was associated with aMCI, earlier symptom onset, and Aβ deposition independent of APOE ɛ4 status. The PRS based on a transancestry meta-analysis of data sets comprising 2 distinct ancestries showed a slightly improved accuracy. CONCLUSIONS AND RELEVANCE In this cohort study, a PRS derived from a European GWAS identified individuals at a high risk for AD dementia in the Korean population. These findings emphasize the transancestry transferability and clinical value of PRSs and suggest the importance of enriching diversity in genetic studies of AD.
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Affiliation(s)
- Sang-Hyuk Jung
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - Hang-Rai Kim
- Department of Neurology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Republic of Korea
| | - Min Young Chun
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Alzheimer’s Disease Convergence Research Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Hyemin Jang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Alzheimer’s Disease Convergence Research Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Minyoung Cho
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - Beomsu Kim
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - Soyeon Kim
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University Seoul Hospital, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Soo Jin Yoon
- Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea
| | - Kyung Won Park
- Department of Neurology, Dong-A University College of Medicine, Department of Translational Biomedical Sciences, Graduate School of Dong-A University, Busan, Republic of Korea
| | - Eun-Joo Kim
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Republic of Korea
| | - Bora Yoon
- Department of Neurology, Konyang University College of Medicine, Daejeon, Republic of Korea
| | - Jae-Won Jang
- Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Republic of Korea
| | - Yeshin Kim
- Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Republic of Korea
| | - Jin Yong Hong
- Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, Republic of Korea
| | - Young Noh
- Department of Neurology, Gachon University College of Medicine, Gil Medical Center, Incheon, Republic of Korea
| | - Ko Woon Kim
- Department of Neurology, School of Medicine, Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Si Eun Kim
- Department of Neurology, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Republic of Korea
| | - Jin San Lee
- Department of Neurology, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea
| | - Na-Yeon Jung
- Department of Neurology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Republic of Korea
| | - Juyoun Lee
- Department of Neurology, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Ae Young Lee
- Department of Neurology, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Byeong C. Kim
- Departmet of Neurology, Chonnam National University School of Medicine, Gwangju, Republic of Korea
| | - Soo Hyun Cho
- Departmet of Neurology, Chonnam National University School of Medicine, Gwangju, Republic of Korea
| | - Hanna Cho
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jong Hun Kim
- Department of Neurology, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Young Hee Jung
- Department of Neurology, Myongji Hospital, Hanyang University, Goyang, Republic of Korea
| | - Dong Young Lee
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jae-Hong Lee
- Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Eek-Sung Lee
- Department of Neurology, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Seung Joo Kim
- Department of Neurology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - So Young Moon
- Department of Neurology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Sang Joon Son
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Chang Hyung Hong
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Jin-Sik Bae
- Eone-Diagnomics Genome Center (EDGC), Incheon, Republic of Korea
| | - Sunghoon Lee
- Eone-Diagnomics Genome Center (EDGC), Incheon, Republic of Korea
| | - Duk L. Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Alzheimer’s Disease Convergence Research Center, Samsung Medical Center, Seoul, Republic of Korea
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Sang Won Seo
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Alzheimer’s Disease Convergence Research Center, Samsung Medical Center, Seoul, Republic of Korea
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
- Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Seoul, Republic of Korea
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St Louis, Missouri
- The Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, Missouri
| | - Hee Jin Kim
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Alzheimer’s Disease Convergence Research Center, Samsung Medical Center, Seoul, Republic of Korea
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Hong-Hee Won
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
- Samsung Genome Institute, Samsung Medical Center, Seoul, Republic of Korea
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8
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Kim SE, Chun KH, Oh J, Yu HT, Lee CJ, Kim TH, Pak HN, Lee MH, Joung B, Kang SM. Prediction of response to cardiac resynchronization therapy using cardiac magnetic resonance imaging in non-ischemic dilated cardiomyopathy. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1005] [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
Cardiac resynchronization therapy (CRT) is a well-established therapy for symptomatic heart failure with reduced ejection fraction, but the response is different for individuals. Although many modalities have been conducted to predict CRT response, cardiac magnetic resonance (CMR) to predict CRT response has still insufficient usefulness.
Purpose
We determine whether the parameters including late gadolinium enhancement (LGE) identified in CMR could act as predictors of CRT response.
Methods
We retrospectively investigated 124 patients with non-ischemic dilated cardiomyopathy who underwent CMR before CRT implantation between Jan 2010 and July 2021 in a single center. CRT response was defined as a decrease in left ventricular end-systolic volume (LVESV) >15% on echocardiography after at least 3 months after CRT implantation.
Results
Among the study population (mean age 65.7±11.2 years, mean EF 25±6.5%, 50% of female), 85 (69%) patients were defined as CRT responder. The CRT responders had more left bundle branch block (LBBB) compared with non-responders [79 (92.9%) vs. 23 (59.0%), p<0.001], but there was a no difference of QRS duration (158.7 vs 165.0ms, p=0.054) between two groups. CMR analysis showed that there were no significant differences in the left ventricular (LV) chamber volume and LV ejection fraction between CRT-responder and non-responder. However, the right ventricular (RV) chamber volume was smaller (RV end-diastolic volume index, 86.3 vs 103.5 ml/m2, p=0.039; RV end-systolic volume index, 49.3 vs 68.5 ml/m2, p=0.013) and the RV ejection fraction (RVEF) was higher (46.9 vs 37.6%, p=0.002) in CRT-responders compared with non-responders. The LGE on CMR was more shown in non-responders than in CRT-responders [33 (84.6%) vs 45 (52.9%), p<0.001]. In CMR parameters, RV dysfunction (RVEF <45%) [Odds ratio (OR), 0.21 (0.05–0.93), p=0.045] and LGE [OR, 0.21 (0.05–0.58), p=0.01] were significantly associated with poor CRT response.
Conclusions
The presence of LGE and RV dysfunction on CMR were associated with poor CRT response in patients with non-ischemic dilated cardiomyopathy. Further investigation with CMR for pre-CRT patients is needed to support these results.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S E Kim
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - K H Chun
- NHIS Ilsan Hospital, Cardiology , Goyang , Korea (Republic of)
| | - J Oh
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - H T Yu
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - C J Lee
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - T H Kim
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - H N Pak
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - M H Lee
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - B Joung
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - S M Kang
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
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9
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Kim SE, Kim HJ, Jang H, Weiner MW, DeCarli C, Na DL, Seo SW. Interaction between Alzheimer's Disease and Cerebral Small Vessel Disease: A Review Focused on Neuroimaging Markers. Int J Mol Sci 2022; 23:10490. [PMID: 36142419 PMCID: PMC9499680 DOI: 10.3390/ijms231810490] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 09/07/2022] [Accepted: 09/07/2022] [Indexed: 11/26/2022] Open
Abstract
Alzheimer's disease (AD) is characterized by the presence of β-amyloid (Aβ) and tau, and subcortical vascular cognitive impairment (SVCI) is characterized by cerebral small vessel disease (CSVD). They are the most common causes of cognitive impairment in the elderly population. Concurrent CSVD burden is more commonly observed in AD-type dementia than in other neurodegenerative diseases. Recent developments in Aβ and tau positron emission tomography (PET) have enabled the investigation of the relationship between AD biomarkers and CSVD in vivo. In this review, we focus on the interaction between AD and CSVD markers and the clinical effects of these two markers based on molecular imaging studies. First, we cover the frequency of AD imaging markers, including Aβ and tau, in patients with SVCI. Second, we discuss the relationship between AD and CSVD markers and the potential distinct pathobiology of AD markers in SVCI compared to AD-type dementia. Next, we discuss the clinical effects of AD and CSVD markers in SVCI, and hemorrhagic markers in cerebral amyloid angiopathy. Finally, this review provides both the current challenges and future perspectives for SVCI.
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Affiliation(s)
- Si Eun Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
- Neuroscience Center, Samsung Medical Center, Seoul 06351, Korea
- Samsung Alzheimer Research Center, Samsung Medical Center, Seoul 06351, Korea
- Department of Neurology, Inje University College of Medicine, Haeundae Paik Hospital, Busan 48108, Korea
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
- Neuroscience Center, Samsung Medical Center, Seoul 06351, Korea
- Samsung Alzheimer Research Center, Samsung Medical Center, Seoul 06351, Korea
| | - Hyemin Jang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
- Neuroscience Center, Samsung Medical Center, Seoul 06351, Korea
- Samsung Alzheimer Research Center, Samsung Medical Center, Seoul 06351, Korea
| | - Michael W. Weiner
- Center for Imaging of Neurodegenerative Diseases, University of California, San Francisco, CA 94121, USA
| | - Charles DeCarli
- Department of Neurology and Center for Neuroscience, University of California, Davis, CA 95616, USA
| | - Duk L. Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
- Neuroscience Center, Samsung Medical Center, Seoul 06351, Korea
- Samsung Alzheimer Research Center, Samsung Medical Center, Seoul 06351, Korea
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul 06355, Korea
- Stem Cell and Regenerative Medicine Institute, Samsung Medical Center, Seoul 06351, Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
- Neuroscience Center, Samsung Medical Center, Seoul 06351, Korea
- Samsung Alzheimer Research Center, Samsung Medical Center, Seoul 06351, Korea
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul 06355, Korea
- Center for Clinical Epidemiology, Samsung Medical Center, Seoul 06351, Korea
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10
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Kang SJ, Kim SE, Seo MJ, Kim E, Rhee WJ. Suppression of inflammatory responses in macrophages by onion-derived extracellular vesicles. J IND ENG CHEM 2022. [DOI: 10.1016/j.jiec.2022.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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11
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Park HJ, An WS, Rha SH, Kim SE, Lee SM. Minimal change glomerulonephritis following the second dose of the Moderna COVID-19 vaccine. QJM 2022; 115:490-491. [PMID: 35380707 PMCID: PMC9383619 DOI: 10.1093/qjmed/hcac094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 03/30/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | - S H Rha
- Department of Pathology, College of Medicine, Dong-A University, 26, Daesingongwon-ro, Dongdaesin-dong 3-ga, Seo-gu, Busan 49201, Republic of Korea
| | | | - S M Lee
- Address correspondence to Dr Su Mi Lee, Department of Internal Medicine, College of Medicine, Dong-A University, 26 Daesingongwon-ro, Seo-gu, Busan 49201, Republic of Korea.
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12
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Shin JI, Kim SE, Lee MH, Kim MS, Lee SW, Park S, Shin YH, Yang JW, Song JM, Moon SY, Kim SY, Park Y, Suh DI, Yang JM, Cho SH, Jin HY, Hong SH, Won HH, Kronbichler A, Koyanagi A, Jacob L, Hwang J, Tizaoui K, Lee KH, Kim JH, Yon DK, Smith L. COVID-19 susceptibility and clinical outcomes in autoimmune inflammatory rheumatic diseases (AIRDs): a systematic review and meta-analysis. Eur Rev Med Pharmacol Sci 2022; 26:3760-3770. [PMID: 35647859 DOI: 10.26355/eurrev_202205_28873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This meta-analysis aims to assess the susceptibility to and clinical outcomes of COVID-19 in autoimmune inflammatory rheumatic disease (AIRD) and following AIRD drug use. MATERIALS AND METHODS We included observational and case-controlled studies assessing susceptibility and clinical outcomes of COVID-19 in patients with AIRD as well as the clinical outcomes of COVID-19 with or without use of steroids and conventional synthetic disease-modifying antirheumatic drugs (csDMARDs). RESULTS Meta-analysis including three studies showed that patients with AIRD are not more susceptible to COVID-19 compared to patients without AIRD or the general population (OR: 1.11, 95% CI: 0.58 to 2.14). Incidence of severe outcomes of COVID-19 (OR: 1.34, 95% CI: 0.76 to 2.35) and COVID-19 related death (OR: 1.21, 95% CI: 0.68 to 2.16) also did not show significant difference. The clinical outcomes of COVID-19 among AIRD patients with and without csDMARD or steroid showed that both use of steroid (OR: 1.69, 95% CI: 0.96 to 2.98) or csDMARD (OR: 1.35, 95% CI: 0.63 to 3.08) had no effect on clinical outcomes of COVID-19. CONCLUSIONS AIRD does not increase susceptibility to COVID-19, not affecting the clinical outcome of COVID-19. Similarly, the use of steroids or csDMARDs for AIRD does not worsen the clinical outcome.
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Affiliation(s)
- J I Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea.
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13
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Kim SE, Lee YR, Kim M, Seo E, Paik HJ, Kim JC, Jeong JE, Park YI, Kim BS, Lee SH. Highly Tunable Metal-Free Ring Opening Polymerization of Glycidol into Various Controlled Topologies Catalyzed by Frustrated Lewis Pairs. Polym Chem 2022. [DOI: 10.1039/d1py01442k] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Controlling the topology of a polymer is essential in determining its physical properties and processing. Even after numerous studies, obtaining a diverse array of topologies, particularly within the framework of...
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14
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Ha SY, Kim SE, Shin KJ, Park J, Park KM, Kim SE, Park S, Lee DA, Liebeskind DS. Existence and Significance of Internal Border Zone Infarcts with Accessory Lesions Located in the Anteromedial Temporal Lobe. J Stroke Cerebrovasc Dis 2021; 30:106004. [PMID: 34325272 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106004] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/29/2021] [Accepted: 07/09/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To examine the existence and significance of internal border zone (IBZ) infarcts with accessory lesions in the anteromedial temporal lobe (ATL). MATERIALS AND METHODS IBZ infarcts located at the corona radiata were selected based on diffusion-weighted imaging of 2535 consecutive patients with ischemic stroke and the presence of lesions in the ATL was identified. The Mann-Whitney U test, Student t-test, Pearson χ2 test, or Fisher exact test was used to analyze differences between the IBZ infarct groups with and without accessory lesions in the ATL. RESULTS Thirty-six of 2535 patients (1.4%) had IBZ infarcts. The IBZ group with accessory lesions in the ATL (17 cases, 47.2%) showed a higher portion of occluded middle cerebral arteries than the IBZ group without accessory lesions in the ATL (p = 0.02). The initial National Institutes of Health Stroke Scale score (odds ratio, 2.03; 95% confidence interval, 1.04-3.99; = 0.039) and progression after admission (odds ratio, 25.43; 95% confidence interval, 2.47-261.99; p = 0.007) were independently associated with poor prognosis in patients with IBZ infarcts. There were no differences in the progression rate and clinical outcomes, regardless of the presence of lesions in the ATL. CONCLUSIONS Our study suggests the existence of a distinct type of IBZ infarct characterized by accessory lesions in the ATL, which is associated with different arterial features but has a similar clinical course to IBZ infarcts without accessory lesions in the ATL.
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Affiliation(s)
- Sam Yeol Ha
- Department of Neurology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Sung Eun Kim
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan, South Korea
| | - Kyong Jin Shin
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan, South Korea
| | - JinSe Park
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan, South Korea
| | - Kang Min Park
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan, South Korea
| | - Si Eun Kim
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan, South Korea
| | - Seongho Park
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan, South Korea
| | - Dong Ah Lee
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan, South Korea
| | - David S Liebeskind
- Department of Neurology, UCLA Stroke Center, University of California, 635 Charles E. Young Drive South, Suite 225, Los Angeles, CA 90095, USA.
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15
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Cho SH, Choe YS, Kim YJ, Kim HJ, Jang H, Kim Y, Kim SE, Kim SJ, Kim JP, Jung YH, Kim BC, Lockhart SN, Farrar G, Na DL, Moon SH, Seo SW. Head-to-Head Comparison of 18F-Florbetaben and 18F-Flutemetamol in the Cortical and Striatal Regions. J Alzheimers Dis 2021; 76:281-290. [PMID: 32474468 DOI: 10.3233/jad-200079] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND 18F-florbetaben (FBB) and 18F-flutemetamol (FMM) amyloid PET have been developed and approved for clinical use. It is important to understand the distinct features of these ligands to compare and correctly interpret the results of different amyloid PET studies. OBJECTIVE We performed a head-to-head comparison of FBB and FMM to compare with regard to imaging characteristics, including dynamic range of retention, and differences in quantitative measurements between the two ligands in cortical, striatal, and white matter (WM) regions. METHODS Paired FBB and FMM PET images were acquired in 107 participants. Correlations of FBB and FMM amyloid deposition in the cortex, striatum, and WM were investigated and compared in different reference regions (cerebellar gray matter (CG), whole cerebellum (WC), WC with brainstem (WC + B), and pons). RESULTS The cortical SUVR (R2 = 0.97) and striatal SUVR (R2 = 0.95) demonstrated an excellent linear correlation between FBB and FMM using a WC as reference region. There was no difference in the cortical SUVR ratio between the two ligands (p = 0.90), but the striatal SUVR ratio was higher in FMM than in FBB (p < 0.001). Also, the effect size of differences in striatal SUVR seemed to be higher with FMM (2.61) than with FBB (2.34). These trends were similarly observed according to four different reference regions (CG, WC, WC + B, and pons). CONCLUSION Our findings suggest that FMM might be better than FBB to detect amyloid burden in the striatum, although both ligands are comparable for imaging AD pathology in vivo.
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Affiliation(s)
- Soo Hyun Cho
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Neurology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Korea
| | - Yeong Sim Choe
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Young Ju Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Hyemin Jang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Yeshin Kim
- Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea
| | - Si Eun Kim
- Departments of Neurology, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Korea
| | - Seung Joo Kim
- Department of Neurology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Jun Pyo Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Young Hee Jung
- Department of Neurology, Myoungji Hospital, Hanyang University, Goyangsi, Korea
| | - Byeong C Kim
- Department of Neurology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Korea
| | - Samuel N Lockhart
- Internal Medicine - Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Gill Farrar
- Pharmaceutical Diagnostics, GE Healthcare, Chalfont St Giles, UK
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea.,Stem Cell & Regenerative Medicine Institute, Samsung Medical Center, Seoul, Korea
| | - Seung Hwan Moon
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea.,Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea.,Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, Korea.,Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Korea
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16
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Lee YJ, Yoon E, Park S, Kim YW, Kim SE, Ko J, Park JH, Park KM, Kim IH, Park BS. Alteration of brain connectivity in neurologically asymptomatic patients with chronic kidney disease. Medicine (Baltimore) 2021; 100:e25633. [PMID: 33879740 PMCID: PMC8078245 DOI: 10.1097/md.0000000000025633] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 03/31/2021] [Indexed: 01/04/2023] Open
Abstract
Our previous study demonstrated that patients with end-stage renal disease had decreased structural and functional brain connectivity, and there was a significant association between brain connectivity and cognitive function. The aim of this study was to evaluate the alterations of structural and functional connectivity using graph theoretical analysis in neurologically asymptomatic patients with relatively early-stage chronic kidney disease (CKD).We enrolled 18 neurologically asymptomatic patients with early CKD and 28 healthy controls. All the subjects underwent diffusion-tension imaging and resting functional magnetic resonance imaging. We calculated structural and functional connectivity based on diffusion-tension imaging and resting functional magnetic resonance imaging using a graph theoretical analysis. Then, we investigated differences of structural and functional connectivity between the CKD patients and the healthy controls.All the measures of structural connectivity were significantly different between the patients with CKD and healthy controls. The global efficiency, local efficiency, mean clustering coefficient, and small-worldness index were decreased, whereas the characteristic path length was increased in the patients with CKD compared with healthy controls. The structural betweenness centrality of the left calcarine and right posterior cingulum was also significantly different from that in healthy participants. However, all the measures of global functional connectivity in patients with CKD were not different from those in healthy controls. In patients with CKD, the functional betweenness centrality of the right insular cortex, right occipital pole, and right thalamus was significantly different from that in healthy participants.There are significant alterations of the global structural connectivity between the patients with CKD and the healthy subjects, whereas the global functional connectivity of the brain network is preserved. We find that the efficiency of the structural brain network is decreased in the patients with CKD.
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Affiliation(s)
| | | | | | | | - Si Eun Kim
- Department of Neurology, Inje University Haeundae Paik Hospital, Busan, Korea
| | | | | | - Kang Min Park
- Department of Neurology, Inje University Haeundae Paik Hospital, Busan, Korea
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17
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Shin KJ, Kang JW, Sung KH, Park SH, Kim SE, Park KM, Ha SY, Kim SE, In Lee B, Park J. Quantitative gait and postural analyses in patients with diabetic polyneuropathy. J Diabetes Complications 2021; 35:107857. [PMID: 33610435 DOI: 10.1016/j.jdiacomp.2021.107857] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 01/08/2021] [Accepted: 01/08/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Although gait disturbances are relatively common symptoms in diabetic polyneuropathy (DPN), few studies have quantitatively analyzed gait and posture in DPN patients. This study aimed to analyze gait and posture quantitatively in DPN patients and to determine the association between clinical and electrophysiological parameters and gait and posture parameters. METHODS Sixty-four DPN patients were enrolled in this study. DPN was clinically assessed using the Toronto clinical neuropathy score (TCNS). All participants underwent nerve conduction study (NCS), three-dimensional motion analysis, and static posturography. We evaluate the correlation of gait and posture parameters with electrophysiological and clinical parameters. RESULTS Foot height, step length, and stride length among gait parameters were inversely correlated with the TCNS. Anteroposterior range during eyes-closed and mediolateral distance and range during eyes-open and eyes-closed were inversely correlated with the sensory nerve action potential amplitude in the sural nerve. Mediolateral distance during eyes-open and eyes-closed was correlated with the compound muscle action potential amplitude in the peroneal nerve. CONCLUSIONS Gait parameters are associated with clinical parameters, and postural parameters are associated with electrophysiological parameters, particularly sensory NCS. Gait and postural analysis can be a useful tool for assessing the neurological status in DPN patients.
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Affiliation(s)
- Kyong Jin Shin
- Department of Neurology, Haeundae-Paik Hospital, Inje University, College of Medicine, Busan, Republic of Korea
| | - Jong Woo Kang
- Department of Orthopaedic Surgery, Ansan Hospital, College of Medicine, Korea University, Ansan, Republic of Korea
| | - Kwon Hyuk Sung
- Department of Neurology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea
| | - Sung Ho Park
- Department of Neurology, Haeundae-Paik Hospital, Inje University, College of Medicine, Busan, Republic of Korea
| | - Si Eun Kim
- Department of Neurology, Haeundae-Paik Hospital, Inje University, College of Medicine, Busan, Republic of Korea
| | - Kang Min Park
- Department of Neurology, Haeundae-Paik Hospital, Inje University, College of Medicine, Busan, Republic of Korea
| | - Sam Yeol Ha
- Department of Neurology, Haeundae-Paik Hospital, Inje University, College of Medicine, Busan, Republic of Korea
| | - Sung Eun Kim
- Department of Neurology, Haeundae-Paik Hospital, Inje University, College of Medicine, Busan, Republic of Korea
| | - Byoung In Lee
- Department of Neurology, Haeundae-Paik Hospital, Inje University, College of Medicine, Busan, Republic of Korea
| | - Jinse Park
- Department of Neurology, Haeundae-Paik Hospital, Inje University, College of Medicine, Busan, Republic of Korea.
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18
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Huynh TTT, Kim SE, Kim SC, Kim JC, Park YI, Jeong JE, Yeo H, Lee SH. One-pot synthesis for gradient copolymers via concurrent tandem living radical polymerization: mild and selective transesterification of methyl acrylate through Al(acac) 3 with common alcohols. RSC Adv 2021; 11:26049-26055. [PMID: 35479477 PMCID: PMC9037116 DOI: 10.1039/d1ra04595d] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 07/22/2021] [Indexed: 11/21/2022] Open
Abstract
The acrylate based gradient copolymers were successfully synthesized by concurrent tandem living radical polymerization using Al(acac)3 as cocatalyst with common alcohols.
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Affiliation(s)
- Tam Thi-Thanh Huynh
- Center for Advanced Specialty Chemicals
- Korea Research Institute of Chemical Technology
- Ulsan 44412
- Republic of Korea
- Department of Science Education
| | - Si Eun Kim
- Center for Advanced Specialty Chemicals
- Korea Research Institute of Chemical Technology
- Ulsan 44412
- Republic of Korea
| | - Soon Cheon Kim
- Center for Advanced Specialty Chemicals
- Korea Research Institute of Chemical Technology
- Ulsan 44412
- Republic of Korea
| | - Jin Chul Kim
- Center for Advanced Specialty Chemicals
- Korea Research Institute of Chemical Technology
- Ulsan 44412
- Republic of Korea
| | - Young Il Park
- Center for Advanced Specialty Chemicals
- Korea Research Institute of Chemical Technology
- Ulsan 44412
- Republic of Korea
| | - Ji-Eun Jeong
- Center for Advanced Specialty Chemicals
- Korea Research Institute of Chemical Technology
- Ulsan 44412
- Republic of Korea
| | - Hyeonuk Yeo
- Department of Science Education
- Kyungpook National University
- Daegu
- Republic of Korea
- Department of Chemistry Education
| | - Sang-Ho Lee
- Center for Advanced Specialty Chemicals
- Korea Research Institute of Chemical Technology
- Ulsan 44412
- Republic of Korea
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19
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Lee KH, Kim JS, Hong SH, Seong D, Choi YR, Ahn YT, Kim KS, Kim SE, Lee S, Sim W, Kim D, Jun B, Yang JW, Yon DK, Lee SW, Kim MS, Dragioti E, Li H, Jacob L, Koyanagi A, Abou Ghayda R, Shin JI, Smith L. Risk factors of COVID-19 mortality: a systematic review of current literature and lessons from recent retracted articles. Eur Rev Med Pharmacol Sci 2020; 24:13089-13097. [PMID: 33378062 DOI: 10.26355/eurrev_202012_24216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Recently, two influential articles that reported the association of (hydroxy)chloroquine or angiotensin converting enzyme (ACE) inhibitors and coronavirus disease 2019 (COVID-19) mortality were retracted due to significant methodological issues. Therefore, we aimed to analyze the same clinical issues through an improved research method and to find out the differences from the retracted papers. We systematically reviewed pre-existing literature, and compared the results with those of the retracted papers to gain a novel insight. MATERIALS AND METHODS We extracted common risk factors identified in two retracted papers, and conducted relevant publication search until June 26, 2020 in PubMed. Then, we analyzed the risk factors for COVID-19 mortality and compared them to those of the retracted papers. RESULTS Our systematic review demonstrated that most demographic and clinical risk factors for COVID-19 mortality were similar to those of the retracted papers. However, while the retracted paper indicated that both (hydroxy)chloroquine monotherapy and combination therapy with macrolide were associated with higher risk of mortality, our study showed that only combination therapy of hydroxychloroquine and macrolide was associated with higher risk of mortality (odds ratio 2.33; 95% confidence interval 1.63-3.34). In addition, our study demonstrated that use of ACE inhibitors or angiotensin receptor blockers (ARBs) was associated with reduced risk of mortality (0.77; 0.65-0.91). CONCLUSIONS When analyzing the same clinical issues with the two retracted papers through a systematic review of randomized controlled trials and relevant cohort studies, we found out that (hydroxy)chloroquine monotherapy was not associated with higher risk of mortality, and that the use of ACE inhibitors or ARBs was associated with reduced risk of mortality in COVID-19 patients.
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Affiliation(s)
- K H Lee
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea.
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20
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Peterson LC, Kim SE. Minimally invasive fixation of a lateral tibial plateau fracture in a dog. J Small Anim Pract 2020; 62:161. [PMID: 33150589 DOI: 10.1111/jsap.13210] [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] [Received: 05/12/2020] [Revised: 07/02/2020] [Accepted: 07/06/2020] [Indexed: 11/29/2022]
Affiliation(s)
- L C Peterson
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, 32608, USA
| | - S E Kim
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, 32608, USA
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21
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Park BS, Lee HW, Lee YJ, Park S, Kim YW, Kim SE, Kim IH, Park JH, Park KM. Serum S100B represents a biomarker for cognitive impairment in patients with end-stage renal disease. Clin Neurol Neurosurg 2020; 195:105902. [DOI: 10.1016/j.clineuro.2020.105902] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 05/04/2020] [Accepted: 05/06/2020] [Indexed: 12/25/2022]
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22
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Khoo CS, Kim SE, Lee BI, Shin KJ, Ha SY, Park J, Park KM, Bae SY, Lee D, Kim BJ, Bae MJ, Kim SE. Characteristics of Perfusion Computed Tomography Imaging in Patients with Seizures Mimicking Acute Stroke. Eur Neurol 2020; 83:56-64. [DOI: 10.1159/000506591] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 02/15/2020] [Indexed: 11/19/2022]
Abstract
Introduction: Seizures as acute stroke mimics are a diagnostic challenge. Objective: The aim of the study was to characterize the perfusion patterns on perfusion computed tomography (PCT) in patients with seizures masquerading as acute stroke. Methods: We conducted a study on patients with acute seizures as stroke mimics. The inclusion criteria for this study were patients (1) initially presenting with stroke-like symptoms but finally diagnosed to have seizures and (2) with PCT performed within 72 h of seizures. The PCT of seizure patients (n = 27) was compared with that of revascularized stroke patients (n = 20) as the control group. Results: Among the 27 patients with seizures as stroke mimics, 70.4% (n = 19) showed characteristic PCT findings compared with the revascularized stroke patients, which were as follows: (1) multi-territorial cortical hyperperfusion {(73.7% [14/19] vs. 0% [0/20], p = 0.002), sensitivity of 73.7%, negative predictive value (NPV) of 80%}, (2) involvement of the ipsilateral thalamus {(57.9% [11/19] vs. 0% [0/20], p = 0.007), sensitivity of 57.9%, NPV of 71.4%}, and (3) reduced perfusion time {(84.2% [16/19] vs. 0% [0/20], p = 0.001), sensitivity of 84.2%, NPV of 87%}. These 3 findings had 100% specificity and positive predictive value in predicting patients with acute seizures in comparison with reperfused stroke patients. Older age was strongly associated with abnormal perfusion changes (p = 0.038), with a mean age of 66.8 ± 14.5 years versus 49.2 ± 27.4 years (in seizure patients with normal perfusion scan). Conclusions: PCT is a reliable tool to differentiate acute seizures from acute stroke in the emergency setting.
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23
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Cho SH, Choe YS, Kim HJ, Jang H, Kim Y, Kim SE, Kim SJ, Kim JP, Jung YH, Kim BC, Baker SL, Lockhart SN, Na DL, Park S, Seo SW. Correction to: A new Centiloid method for 18F-florbetaben and 18F-flutemetamol PET without conversion to PiB. Eur J Nucl Med Mol Imaging 2020; 47:1610. [PMID: 32055964 DOI: 10.1007/s00259-020-04692-3] [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: 11/28/2022]
Abstract
Funding information from the original version of this article was incomplete. Complete information is presented here.
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Affiliation(s)
- Soo Hyun Cho
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Neurology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Yeong Sim Choe
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Hyemin Jang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Yeshin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, South Korea
| | - Si Eun Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Neurology, Inje University College of Medicine, Haeundae Paik Hospital, Busan, South Korea
| | - Seung Joo Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Neurology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Jun Pyo Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Young Hee Jung
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Neurology, Myoungji Hospital, Hanyang University, Goyangsi, South Korea
| | - Byeong C Kim
- Department of Neurology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Suzanne L Baker
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Samuel N Lockhart
- Internal Medicine - Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea.,Stem Cell & Regenerative Medicine Institute, Samsung Medical Center, Seoul, South Korea
| | - Seongbeom Park
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. .,Neuroscience Center, Samsung Medical Center, Seoul, South Korea.
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea.,Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, South Korea.,Center for Clinical Epidemiology, Samsung Medical Center, Seoul, South Korea
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24
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Kim SE, Lee B, Park S, Cho SH, Kim SJ, Kim Y, Jang H, Jeong JH, Yoon SJ, Park KW, Kim EJ, Jung NY, Yoon B, Jang JW, Hong JY, Hwang J, Na DL, Seo SW, Choi SH, Kim HJ. Clinical significance of focal ß-amyloid deposition measured by 18F-flutemetamol PET. Alzheimers Res Ther 2020; 12:6. [PMID: 31901233 PMCID: PMC6942396 DOI: 10.1186/s13195-019-0577-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 12/23/2019] [Indexed: 12/14/2022]
Abstract
Background Although amyloid PET of typical Alzheimer’s disease (AD) shows diffuse ß-amyloid (Aß) deposition, some patients show focal deposition. The clinical significance of this focal Aß is not well understood. We examined the clinical significance of focal Aß deposition in terms of cognition as well as Aß and tau cerebrospinal fluid (CSF) levels. We further evaluated the order of Aß accumulation by visual assessment. Methods We included 310 subjects (125 cognitively unimpaired, 125 mild cognitive impairment, and 60 AD dementia) from 9 referral centers. All patients underwent neuropsychological tests and 18F-flutemetamol (FMM) PET. Seventy-seven patients underwent CSF analysis. Each FMM scan was visually assessed in 10 regions (frontal, precuneus and posterior cingulate, lateral temporal, parietal, and striatum of each hemisphere) and was classified into three groups: No-FMM, Focal-FMM (FMM uptake in 1–9 regions), and Diffuse-FMM (FMM uptake in all 10 regions). Results 53/310 (17.1%) subjects were classified as Focal-FMM. The cognitive level of the Focal-FMM group was better than that of Diffuse-FMM group and worse than that of No-FMM group. Among the Focal-FMM group, those who had FMM uptake to a larger extent or in the striatum had worse cognitive levels. Compared to the Diffuse-FMM group, the Focal-FMM group had a less AD-like CSF profile (increased Aß42 and decreased t-tau, t-tau/Aß42). Among the Focal-FMM group, Aß deposition was most frequently observed in the frontal (62.3%) and least frequently observed in the striatum (43.4%) and temporal (39.6%) regions. Conclusions We suggest that focal Aß deposition is an intermediate stage between no Aß and diffuse Aß deposition. Furthermore, among patients with focal Aß deposition, those who have Aß to a larger extent and striatal involvement show clinical features close to diffuse Aß deposition. Further longitudinal studies are needed to evaluate the disease progression of patients with focal Aß deposition. Electronic supplementary material The online version of this article (10.1186/s13195-019-0577-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Si Eun Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-ku, Seoul, 135-710, Republic of Korea.,Department of Neurology, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Korea
| | - Byungju Lee
- Department of Neurology, Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea
| | - Seongbeom Park
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-ku, Seoul, 135-710, Republic of Korea.,Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Soo Hyun Cho
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-ku, Seoul, 135-710, Republic of Korea.,Department of Neurology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Seung Joo Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-ku, Seoul, 135-710, Republic of Korea.,Department of Neurology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Yeshin Kim
- Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea
| | - Hyemin Jang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-ku, Seoul, 135-710, Republic of Korea.,Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea
| | - Soo Jin Yoon
- Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea
| | - Kyung Won Park
- Department of Neurology, Dong-A Medical Center, Dong-A University College of Medicine, Busan, Korea
| | - Eun-Joo Kim
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea
| | - Na Yeon Jung
- Department of Neurology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Yangsan, Korea
| | - Bora Yoon
- Department of Neurology, Konyang University College of Medicine, Daejeon, Korea
| | - Jae-Won Jang
- Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea
| | - Jin Yong Hong
- Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jihye Hwang
- Department of Neurology, Keimyung University Daegu Dongsan Hospital, Daegu, Korea
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-ku, Seoul, 135-710, Republic of Korea.,Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea.,Stem Cell & Regenerative Medicine Institute, Samsung Medical Center, Seoul, Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-ku, Seoul, 135-710, Republic of Korea.,Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea.,Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea.,Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, Korea.
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-ku, Seoul, 135-710, Republic of Korea. .,Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, Korea. .,Neuroscience Center, Samsung Medical Center, Seoul, Korea.
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25
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Park BS, Kim SE, Lee HJ, Kim YW, Kim IH, Park JH, Park SH, Lee YJ, Seo SA, Park KM. Alterations in Structural and Functional Connectivities in Patients with End-Stage Renal Disease. J Clin Neurol 2020; 16:390-400. [PMID: 32657059 PMCID: PMC7354985 DOI: 10.3988/jcn.2020.16.3.390] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 09/05/2019] [Accepted: 09/06/2019] [Indexed: 12/12/2022] Open
Abstract
Background and Purpose The aim of this study was to evaluate the structural and functional connectivities of brain network using graph theoretical analysis in neurologically asymptomatic patients with end-stage renal disease (ESRD). We further investigated the prevalence of cognitive impairment (CI) in ESRD patients and analyzed the association between network measures of brain connectivity and cognitive function. Methods We prospectively enrolled 40 neurologically asymptomatic ESRD patients, 40 healthy controls, and 20 disease controls. All of the subjects underwent diffusion-tensor imaging (DTI) and resting-state functional magnetic resonance imaging (rs-fMRI). We calculated measures of structural and functional connectivities based on DTI and rs-fMRI, respectively, and investigated differences therein between the ESRD patients and the healthy controls. We assessed cognitive function in the ESRD patients using the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease neuropsychological battery. Results The ESRD patients exhibited decreased global structural and functional brain connectivities, as well as alterations of network hubs compared to the healthy controls and disease controls. About 70% of the ESRD patients had CI. Moreover, ESRD patients without CI exhibited decreased global connectivity and alterations of network hubs. Furthermore, there was a significant positive association between measures of brain connectivity and cognitive function. Conclusions We found that ESRD patients exhibited decreased structural and functional brain connectivities, and that there was a significant association between brain connectivity and cognitive function. These alterations in the brain network may contribute to the pathophysiological mechanism of CI in ESRD patients.
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Affiliation(s)
- Bong Soo Park
- Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Si Eun Kim
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Ho Joon Lee
- Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Yang Wook Kim
- Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Il Hwan Kim
- Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Jin Han Park
- Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Si Hyung Park
- Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Yoo Jin Lee
- Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Sol A Seo
- Department of Biomedical Engineering, Inje University, Gimhae, Korea
| | - Kang Min Park
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
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26
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Park DG, Seo WW, Kim SE, Lee JH, Han KR, Oh DJ. P1478 Evaluation of reversibility of alcoholic cardiomyopathy using doubaimine stress echocardiography. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.903] [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
Alcoholic cardiomyopathy (CM) is known as a reversible CM. Appropriate medications with cessation of alcohol may lead to full recovery of chamber size and contractility. But there is not much information about morphologic and hemodynamic changes over the course of treatment, and predictors of reversibility. We experienced the patient with alcoholic CM who was admitted with heart failure and recovered over 1 year and 5 months. He consumed daily 180g alcohol for 6 months before admission. On initial echocardiography, left atrial (LA) dimension, left ventricular (LV) systolic dimension (SD) and diastolic dimension (DD), inferior vena cava (IVC) size, and ejection fraction (EF) were 50 mm, 69 mm, 78 mm, 27 mm and 22%, respectively. Doppler examination revealed a restrictive pattern in tansmitral flow, and a systolic peak velocity/diastolic peak velocity (S/D) ratio of less than 1 in pulmonary vein flow (PVF). Pressure gradient through tricuspid regurgitation was 29 mmHg. Coronary angiogram confirmed no significant stenosis. Within 1 week after medications, LVEF increased mainly by decrease of enlarged LVSD which might be partly caused by volume overload, evidenced by respiratory variation of transmitral flow. On 8th day, we performed dobutamine stress echocardiography (DSE) to evaluate reversibility because LVEF slightly decreased despite decrease of LVDD. During dobutamine infusion, both LVDD and LVSD decreased along with increase of LVEF according to dose escalation. From 1 to 2 months, LVEF slightly increased with decrease of LVDD and LVSD. Afterwards, LVEF was normalized mainly with decrease of LVSD, and LVEF was completely normalized at 1 year and 5 month after initiation of treatment. Initial increase of LVEF might reflect decrease of LVSD by relief of volume overload rather than improving LV contractility. Based on this observation of serial change of chambers and LVEF, we speculate that increased LV wall tension, which is induced by increase of preload as a compensating mechanism for increasing stroke volume, might aggravate LVEF in later stage of heart failure with reduced EF. The sequence of normalization in chamber size was IVC, and then LA, and then LVDD. Transmitral flow as an indicator of diastolic dysfunction changed from restrictive (transiently existed only for 1 week) to abnormal relaxation pattern (no change since that time). PVF pattern showed S/D ratio < 1 until 1 week, and then triphasic pattern at 1 month, finally biphasic pattern at 8 month after initiation of medications. We observed a serial change of echocardiographic findings in patient with alcoholic CM, which might provide an insightful information to understand reverse of LV or LA remodeling associated with hemodynamic parameters, and DSE might be helpful to evaluate reversibility of LV systolic function and convince patients who are reluctant to medications.
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Affiliation(s)
- D G Park
- Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea (Republic of)
| | - W W Seo
- Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea (Republic of)
| | - S E Kim
- Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea (Republic of)
| | - J H Lee
- Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea (Republic of)
| | - K R Han
- Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea (Republic of)
| | - D J Oh
- Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea (Republic of)
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27
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Kim Y, Lee H, Son TO, Jang H, Cho SH, Kim SE, Kim SJ, Lee JS, Kim JP, Jung YH, Lockhart SN, Kim HJ, Na DL, Park HY, Seo SW. Reduced forced vital capacity is associated with cerebral small vessel disease burden in cognitively normal individuals. Neuroimage Clin 2019; 25:102140. [PMID: 31896465 PMCID: PMC6940695 DOI: 10.1016/j.nicl.2019.102140] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 12/13/2019] [Accepted: 12/21/2019] [Indexed: 01/18/2023]
Abstract
Decreased FVC (% pred) was associated with increased cerebral small vessel disease burden even in cognitively normal subjects. This reduced lung function was related to low Mini-Mental Status Examination (MMSE) scores in cognitively normal subjects. Path analyses showed that white matter hyperintensities partially mediated the positive relationship between FVC (% pred) and MMSE score. There was no significant association between low FVC (% pred) and cortical thickness in cognitively normal subjects.
Background Pulmonary dysfunction is associated with elevated risk of cognitive decline. However, the mechanism underlying this relationship has not been fully investigated. In this study, we investigate the relationships between pulmonary function, cerebral small vessel disease (CSVD) markers, cortical thickness, and the Mini-Mental Status Examination (MMSE) scores in cognitively normal individuals. Methods We used a cross-sectional study design. We identified 1924 patients who underwent pulmonary function testing, three-dimensional brain magnetic resonance imaging (MRI), and the MMSE. Pulmonary function was analyzed according to the quintiles of percentage predicted values (% pred) for forced vital capacity (FVC) or forced expiratory volume in 1 s (FEV1). Regarding CSVD markers, we visually rated white matter hyperintensities (WMH) and manually counted lacunes and microbleeds. Cortical thickness was measured by surface-based methods. Results Compared with the highest quintile of FVC, the lowest quintile of FVC (% pred) showed a higher risk of WMH (OR 1.98, 95% CI: 1.21–3.24) and lacunes (OR 1.86, 95% CI: 1.12–3.08). There were no associations between FVC or FEV1 and cortical thickness. Low FVC, but not FEV1, was associated with low MMSE scores. Path analyses showed that WMH partially mediated the positive relationship between FVC (% pred) and MMSE score. Conclusions Our findings suggested that decreased pulmonary function was associated with increased CSVD burdens, which in turn wass associated with decreased cognition, even in cognitively normal subjects.
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Affiliation(s)
- Yeshin Kim
- Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, South Korea
| | - Hyun Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang Medical Center, Hanyang University College of Medicine, South Korea
| | - Tea Ok Son
- Cheongju Samsung Rehabilitation Hospital, Cheongju, South Korea
| | - Hyemin Jang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea; Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, South Korea
| | - Soo Hyun Cho
- Department of Neurology, Chonnam National University Hospital, Gwangju, South Korea
| | - Si Eun Kim
- Departments of Neurology, Inje University College of Medicine, Haeundae Paik Hospital, Busan, South Korea
| | - Seung Joo Kim
- Department of Neurology, Gyeongsang National University School of Medicine and Gyeonsang National University Changwon Hospital, Changwon, South Korea
| | - Jin San Lee
- Department of Neurology, Kyung Hee University Hospital, Seoul, South Korea
| | - Jun Pyo Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea; Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, South Korea
| | - Young Hee Jung
- Department of Neurology, Myongji Hospital, Hanyang University Medical Center, Republic of Korea
| | - Samuel N Lockhart
- Department of Internal Medicine, Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea; Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, South Korea
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea; Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, South Korea; Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Gangnam-gu, Republic of Korea
| | - Hye Yun Park
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Kangnam-ku, Seoul 06351, South Korea.
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea; Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, South Korea; Center for Clinical Epidemiology, Samsung Medical Center, Seoul, South Korea; Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea.
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Jang H, Jang YK, Park S, Kim SE, Kim SJ, Cho SH, Youn J, Seo SW, Kim HJ, Na DL. Presynaptic dopaminergic function in early-onset Alzheimer's disease: an FP-CIT image study. Neurobiol Aging 2019; 86:75-80. [PMID: 31843258 DOI: 10.1016/j.neurobiolaging.2019.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 10/11/2019] [Accepted: 10/12/2019] [Indexed: 10/25/2022]
Abstract
We aimed to investigate whether amyloid-β (Aβ) positive early-onset Alzheimer's disease (EOAD) patients have presynaptic dopaminergic deficits on in vivo 18F-FP-CIT PET imaging. We enrolled 34 EOAD patients and 9 cognitively normal controls (NC), all of whom underwent 18F-florbetaben and 18F-FP-CIT PET at Samsung Medical Center. We assessed motor symptoms using Unified Parkinson's Disease Rating Scale (UPDRS) and divided the EOAD patients into 2 groups using a UPDRS cutoff of 10. We compared regional florbetaben and FP-CIT uptake across the NC and the 2 EOAD groups with lower and higher UPDRS and investigated the associations between regional florbetaben or FP-CIT uptake and UPDRS in EOAD patients. Among the 30 EOAD patients who were Aβ positive on florbetaben PET, the higher UPDRS (>10) group (n = 9) had a longer disease duration (7.2 ± 3.3 vs. 4.1 ± 1.8, p = 0.002), and had a tendency to have lower Mini-Mental State Examination (9.6 ± 7.9 vs. 15.0 ± 6.0, p = 0.052) than the lower UPDRS (≤10) group (n = 21). Across the NC and the 2 EOAD groups, there were no significant differences in FP-CIT uptake in caudate (p = 0.122) and putamen (p = 0.685) or florbetaben uptake in midbrain (p = 0.890). Finally, regression analyses showed that UPDRS was not associated with FP-CIT uptake in caudate (p = 0.913) or putamen (p = 0.407), or with florbetaben PET uptake in caudate (p = 0.553), putamen (p = 0.617), midbrain (p = 0.843), or global cortex (p = 0.658). This study showed that parkinsonian signs in EOAD patients may be related with mechanisms other than presynaptic dopaminergic deficit. Our finding is clinically important because it suggests that L-dopa treatment in EOAD with parkinsonian signs may not improve motor symptoms.
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Affiliation(s)
- Hyemin Jang
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea; Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, South Korea
| | - Young Kyoung Jang
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Seongbeom Park
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Si Eun Kim
- Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, South Korea
| | - Seung Joo Kim
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Soo Hyun Cho
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Jinyoung Youn
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Sang Won Seo
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea; Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, South Korea; Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea
| | - Hee Jin Kim
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea; Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, South Korea
| | - Duk L Na
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea; Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, South Korea; Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea.
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Kim SE, Woo S, Kim SW, Chin J, Kim HJ, Lee BI, Park J, Park KW, Kang DY, Noh Y, Ye BS, Yoo HS, Lee JS, Kim Y, Kim SJ, Cho SH, Na DL, Lockhart SN, Jang H, Seo SW. A Nomogram for Predicting Amyloid PET Positivity in Amnestic Mild Cognitive Impairment. J Alzheimers Dis 2019; 66:681-691. [PMID: 30320571 DOI: 10.3233/jad-180048] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Most clinical trials focus on amyloid-β positive (Aβ+) amnestic mild cognitive impairment (aMCI), but screening failures are high because only a half of patients with aMCI are positive on Aβ PET. Therefore, it becomes necessary for clinicians to predict which patients will have Aβ biomarker. OBJECTIVE We aimed to compare clinical factors, neuropsychological (NP) profiles, and apolipoprotein E (APOE) genotype between Aβ+ aMCI and Aβ-aMCI and to develop a clinically useful prediction model of Aβ positivity on PET (PET-Aβ+) in aMCI using a nomogram. METHODS We recruited 523 aMCI patients who underwent Aβ PET imaging in a nation-wide multicenter cohort. The results of NP measures were divided into following subgroups: 1) Stage (Early and Late-stage), 2) Modality (Visual, Verbal, and Both), 3) Recognition failure, and 4) Multiplicity (Single and Multiple). A nomogram for PET-Aβ+ in aMCI patients was constructed using a logistic regression model. RESULTS PET-Aβ+ had significant associations with NP profiles for several items, including high Clinical Dementia Rating Scale Sum of Boxes score (OR 1.47, p = 0.013) and impaired memory modality (impaired both visual and verbal memories compared with visual only, OR 3.25, p = 0.001). Also, presence of APOEɛ4 (OR 4.14, p < 0.001) was associated with PET-Aβ+. These predictors were applied to develop the nomogram, which showed good prediction performance (C-statistics = 0.79). Its prediction performances were 0.77/0.74 in internal/external validation. CONCLUSIONS The nomogram consisting of NP profiles, especially memory domain, and APOEɛ4 genotype may provide a useful predictive model of PET-Aβ+ in patients with aMCI.
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Affiliation(s)
- Si Eun Kim
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.,Department of Neurology, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Korea
| | - Sookyoung Woo
- Statistics and Data Center, Samsung Medical Center, Seoul, Korea
| | - Seon Woo Kim
- Statistics and Data Center, Samsung Medical Center, Seoul, Korea
| | - Juhee Chin
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Hee Jin Kim
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Byung In Lee
- Department of Neurology, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Korea
| | - Jinse Park
- Department of Neurology, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Korea
| | - Kyung Won Park
- Department of Neurology, Dong-A University College of Medicine, Dong-A University Medical Center, Busan, Korea
| | - Do-Young Kang
- Department of Nuclear Medicine, Dong-A University College of Medicine, Dong-A University Medical Center, Busan, Korea
| | - Young Noh
- Department of Neurology, Gachon University Gil Medical Center, Incheon, Korea
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University School of Medicine, Severance hospital, Seoul, Korea
| | - Han Soo Yoo
- Department of Neurology, Yonsei University School of Medicine, Severance hospital, Seoul, Korea
| | - Jin San Lee
- Department of Neurology, Kyung Hee University Hospital, Seoul, Korea
| | - Yeshin Kim
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.,Department of Neurology, Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do, Korea
| | - Seung Joo Kim
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Soo Hyun Cho
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Duk L Na
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Samuel N Lockhart
- Department of Internal Medicine, Division of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Hyemin Jang
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Sang Won Seo
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
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Kim SE, Lee JS, Woo S, Kim S, Kim HJ, Park S, Lee BI, Park J, Kim Y, Jang H, Kim SJ, Cho SH, Lee B, Lockhart SN, Na DL, Seo SW. Sex-specific relationship of cardiometabolic syndrome with lower cortical thickness. Neurology 2019; 93:e1045-e1057. [PMID: 31444241 DOI: 10.1212/wnl.0000000000008084] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 04/10/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate whether cardiometabolic factors were associated with age-related differences in cortical thickness in relation to sex. METHODS In this cross-sectional study, we enrolled 1,322 cognitively normal elderly (≥65 years old) individuals (774 [58.5%] men, 548 [41.5%] women). We measured cortical thickness using a surface-based analysis. We analyzed the associations of cardiometabolic risk factors with cortical thickness using multivariate linear regression models after adjusting for possible confounders and interactions with age. RESULT Among women, hypertension (β = -1.119 to -0.024, p < 0.05) and diabetes mellitus (β = -0.920, p = 0.03) were independently associated with lower mean cortical thickness. In addition, there was an interaction effect between obesity (body mass index [BMI] ≥27.5 kg/m2) and age on cortical thickness in women (β = -0.324 to -0.010, p < 0.05), suggesting that age-related differences in cortical thickness were more prominent in obese women compared to women with normal weight. Moreover, low education level (<6 years) was correlated with lower mean cortical thickness (β = -0.053 to -0.046, p < 0.05). Conversely, among men, only being underweight (BMI ≤18.5 kg/m2, β = -2.656 to -0.073, p < 0.05) was associated with lower cortical thickness. CONCLUSIONS Our findings suggest that cortical thickness is more vulnerable to cardiometabolic risk factors in women than in men. Therefore, sex-specific prevention strategies may be needed to protect against accelerated brain aging.
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Affiliation(s)
- Si Eun Kim
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Jin San Lee
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Sookyoung Woo
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Seonwoo Kim
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Hee Jin Kim
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Seongbeom Park
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Byung In Lee
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Jinse Park
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Yeshin Kim
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Hyemin Jang
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Seung Joo Kim
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Soo Hyun Cho
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Byungju Lee
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Samuel N Lockhart
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Duk L Na
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Sang Won Seo
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC.
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Cho SH, Choe Y, Kim HJ, Jang H, Kim Y, Kim SE, Kim SJ, Kim JP, Jung YH, Na DL, Park S, Seo SW. P2-383: 18
F-FLORBETABEN AND 18
F-FLUTEMETAMOL PET BETA-AMYLOID BINDING EXPRESSED IN CENTILOIDS WITHOUT CONVERSION TO PIB. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.2790] [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: 11/30/2022]
Affiliation(s)
- Soo Hyun Cho
- Samsung Medical Center; Seoul Republic of South Korea
| | - Yeongsim Choe
- Samsung Medical Center; Seoul Republic of South Korea
| | - Hee Jin Kim
- Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Republic of South Korea
| | - Hyemin Jang
- Samsung Medical Center; Seoul Republic of South Korea
| | - Yeshin Kim
- Kangwon National University Hospital; Chuncheon Republic of South Korea
| | - Si Eun Kim
- Samsung Medical Center; Seoul Republic of South Korea
- Inje University College of Medicine; Busan Republic of South Korea
| | - Seung Joo Kim
- Samsung Medical Center; Seoul Republic of South Korea
| | - Jun Pyo Kim
- Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Republic of South Korea
| | | | - Duk L. Na
- Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Republic of South Korea
| | | | - Sang Won Seo
- Samsung Medical Center; Seoul Republic of South Korea
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Kim SJ, Jung NY, Kim YJ, Park SB, Kim K, Kim Y, Jang H, Kim SE, Cho SH, Kim JP, Jung YH, Woo SY, Kim SW, Lockhart SN, Kim EJ, Kim HJ, Lee JM, Chin J, Na DL, Seo SW. Clinical Effects of Frontal Behavioral Impairment: Cortical Thickness and Cognitive Decline in Individuals with Subjective Cognitive Decline and Amnestic Mild Cognitive Impairment. J Alzheimers Dis 2019; 69:213-225. [PMID: 30958372 DOI: 10.3233/jad-190007] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Frontal behavioral impairment (FrBI) is commonly observed in various degenerative diseases and refers to various behavioral symptoms. OBJECTIVE We investigated the effects of the presence of FrBI on cortical thickness, and the longitudinal neuropsychological changes in people in the predementia stage. METHODS A total of 794 individuals completed neuropsychological tests and the Frontal Behavioral Inventory (FBI) Questionnaire, and underwent magnetic resonance (MR) scanning. Participants were analyzed and grouped into non-FrBI (FBI = 0) or FrBI (FBI≥1). Cortical thickness was measured on MR images using a surface-based method. RESULTS In total, 281 people with subjective cognitive decline (SCD) and 513 with amnestic mild cognitive impairment (aMCI) were assessed for FrBI. Relative to people without FrBI, those with FrBI presented reduced cortical thickness in the frontal, anterior temporal and lateral parietal regions (p < 0.05, FDR corrected). People with FrBI developed Alzheimer's disease, rather than behavioral variant frontotemporal dementia, as observed over seven years. Mixed effects models reported that people with FrBI have greater cognitive decline than those with non-FrBI in multiple domains, including language, memory, and executive functions (p < 0.05, FDR corrected). Furthermore, while negative FrBI symptoms (e.g., deficit behaviors) were associated with greater declines in multiple domains, positive FrBI symptoms (e.g., disinhibition symptoms) were related to declines in visuospatial function and verbal memory. Finally, the occurrence of both types of symptoms correlated with multi-domain cognitive decline. CONCLUSIONS FrBI predicted worse clinical outcomes, including reduced cortical thickness and cognitive decline, which are not necessarily specific to frontal dysfunction.
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Affiliation(s)
- Seung Joo Kim
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Departments of Neurology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Na-Yeon Jung
- Department of Neurology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine and Medical Research Institute, Yangsan, South Korea
| | - Young Ju Kim
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Seong Beom Park
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - KoWoon Kim
- Department of Neurology, Chonbuk National University Hospital, Chun-Ju, South Korea
| | - Yeshin Kim
- Department of Neurology, Kangwon National University Hospital, Chuncheon, South Korea
| | - Hyemin Jang
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Si Eun Kim
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Neurology, Inje University College of Medicine, Haeundae Paik Hospital, Busan, South Korea
| | - Soo Hyun Cho
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Neurology, Chonnam National University Hospital, Gwangju, South Korea
| | - Jun Pyo Kim
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Young Hee Jung
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sook-Young Woo
- Biostatistics team, Samsung Biomedical Research Institute, Seoul, South Korea
| | - Seon Woo Kim
- Biostatistics team, Samsung Biomedical Research Institute, Seoul, South Korea
| | - Samuel N Lockhart
- Internal Medicine-Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, USA
| | - Eun-Joo Kim
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, South Korea
| | - Hee Jin Kim
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jong-Min Lee
- Department of Biomedical Engineering, Hanyang University, Seoul, South Korea
| | - Juhee Chin
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Duk L Na
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sang Won Seo
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea.,Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, South Korea.,Center for Clinical Epidemiology, Samsung Medical Center, Seoul, South Korea.,Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea
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Park KM, Lee BI, Shin KJ, Ha SY, Park J, Kim SE, Kim SE. Pivotal Role of Subcortical Structures as a Network Hub in Focal Epilepsy: Evidence from Graph Theoretical Analysis Based on Diffusion-Tensor Imaging. J Clin Neurol 2019; 15:68-76. [PMID: 30618219 PMCID: PMC6325361 DOI: 10.3988/jcn.2019.15.1.68] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 08/24/2018] [Accepted: 08/24/2018] [Indexed: 12/02/2022] Open
Abstract
Background and Purpose There is accumulating evidence that epilepsy is caused by network dysfunction. We evaluated the hub reorganization of subcortical structures in patients with focal epilepsy using graph theoretical analysis based on diffusion-tensor imaging (DTI). In addition, we investigated differences in the values of diffusion tensors and scalars, fractional anisotropy (FA), and mean diffusivity (MD) of subcortical structures between patients with focal epilepsy and healthy subjects. Methods One hundred patients with focal epilepsy and normal magnetic resonance imaging (MRI) findings and 80 age- and sex-matched healthy subjects were recruited prospectively. All subjects underwent DTI to obtain data suitable for graph theoretical analysis. We investigated the differences in the node strength, cluster coefficient, eigenvector centrality, page-rank centrality measures, FA, and MD of subcortical structures between patients with epilepsy and healthy subjects. Results After performing multiple corrections, the cluster coefficient and the eigenvector centrality of the globus pallidus were higher in patients with epilepsy than in healthy subjects (p=0.006 and p=0.008, respectively). In addition, the strength and the page-rank centrality of the globus pallidus tended to be higher in patients with epilepsy than in healthy subjects (p=0.092 and p=0.032, respectively). The cluster coefficient of the putamen was lower in patients with epilepsy than in healthy subjects (p=0.004). The FA values of the caudate nucleus and thalamus were significantly lower in patients with epilepsy than in healthy subjects (p=0.009 and p=0.007, respectively), whereas the MD value of the thalamus was higher than that in healthy subjects (p=0.005). Conclusions We discovered the presence of hub reorganization of subcortical structures in focal epilepsy patients with normal MRI findings, suggesting that subcortical structures play a pivotal role as a hub in the epilepsy network. These findings further reinforce the idea that epilepsy is a network disease.
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Affiliation(s)
- Kang Min Park
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Byung In Lee
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Kyong Jin Shin
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Sam Yeol Ha
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - JinSe Park
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Si Eun Kim
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Sung Eun Kim
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
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Jang JW, Kim Y, Choi YH, Lee JM, Yoon B, Park KW, Kim SE, Kim HJ, Yoon SJ, Jeong JH, Kim EJ, Jung NY, Hwang J, Kang JH, Hong JY, Choi SH. Association of Nutritional Status with Cognitive Stage in the Elderly Korean Population: The Korean Brain Aging Study for the Early Diagnosis and Prediction of Alzheimer's Disease. J Clin Neurol 2019; 15:292-300. [PMID: 31286699 PMCID: PMC6620466 DOI: 10.3988/jcn.2019.15.3.292] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 12/15/2018] [Accepted: 12/18/2018] [Indexed: 01/08/2023] Open
Abstract
Background and Purpose Epidemiological studies have suggested the presence of strong correlations among diet, lifestyle, and dementia onset. However, these studies have unfortunately had major limitations due to their inability to fully control the various potential confounders affecting the nutritional status. The purpose of the current study was to determine the nutritional status of participants in the Korean Brain Aging Study for the Early Diagnosis and Prediction of Alzheimer's Disease (KBASE) and to identify clinical risk factors for being at risk of malnutrition or being malnourished. Methods Baseline data from 212 participants [119 cognitively unimpaired (CU), 56 with mild cognitive impairment (MCI), and 37 with dementia] included in the KBASE database were analyzed. All participants underwent a comprehensive cognitive test and MRI at baseline. The presence of malnutrition at baseline was measured by the Mini Nutritional Assessment score. We examined the cross-sectional relationships of clinical findings with nutritional status using multiple logistic regression applied to variables for which p<0.2 in the univariate analysis. Differences in cortical thickness according to the nutritional status were also investigated. Results After adjustment for demographic, nutritional, and neuropsychological factors, participants with dementia had a significantly higher odds ratio (OR) for being at risk of malnutrition or being malnourished than CU participants [OR=5.98, 95% CI=1.20–32.97] whereas participants with MCI did not (OR=0.62, 95% CI=0.20–1.83). Cortical thinning in the at-risk/malnutrition group was observed in the left temporal area. Conclusions Dementia was found to be an independent predictor for the risk of malnutrition compared with CU participants. Our findings further suggest that cortical thinning in left temporal regions is related to the nutritional status.
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Affiliation(s)
- Jae Won Jang
- Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea
| | - Yeshin Kim
- Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea
| | - Yong Ho Choi
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - Jong Min Lee
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - Bora Yoon
- Department of Neurology, Konyang University College of Medicine, Daejeon, Korea
| | - Kyung Won Park
- Department of Neurology, Dong-A Medical Center, Dong-A University College of Medicine, Busan, Korea
| | - Si Eun Kim
- Department of Neurology, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Korea
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soo Jin Yoon
- Department of Neurology, Eulji University College of Medicine, Daejeon, Korea
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University School of Medicine, Seoul, Korea
| | - Eun Joo Kim
- Department of Neurology, Pusan National University School of Medicine, Busan, Korea
| | - Na Yeon Jung
- Department of Neurology, Pusan National University School of Medicine, Busan, Korea
| | - Jihye Hwang
- Department of Neurology, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Ju Hee Kang
- Department of Pharmacology and Medicinal Toxicology Research Center, Inha University School of Medicine, Incheon, Korea
| | - Jin Yong Hong
- Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, Korea.
| | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, Korea.
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Kim SE, Park KM, Park J, Ha SY, Kim SE, Lee BI, Shin KJ. Vascular factors and neuropathy in lower limb of diabetic patients. J Clin Neurosci 2018; 59:130-135. [PMID: 30420207 DOI: 10.1016/j.jocn.2018.10.115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 10/27/2018] [Indexed: 01/30/2023]
Abstract
Asymmetric clinical presentation in some patients with diabetic polyneuropathy may result from the different vascular environments in both lower limbs. The aim of the study is to determine the association of neuropathy with vascular factors in each lower limb of diabetic patients. A total of 102 patients (204 lower limbs) given a diagnosis of diabetic polyneuropathy were enrolled. The primary end points are sensory nerve action potential (SNAP) amplitude and conduction velocity (CV) of the sural nerve and independent variables are vascular and nonvascular factors. Vascular factors include mean arterial pressure and pulse pressure at the ankle, ankle-brachial index, and arterial stiffness assessed by pulse wave velocity. Nonvascular factors include age, gender, height, body weight, body mass index, total cholesterol, and hemoglobin A1C. Age, hemoglobin A1C, and ankle pulse pressure were inversely correlated with SNAP amplitude of the sural nerve, while no factors were correlated with CV of the sural nerve. Increased arterial stiffness was significant in the limbs group with abnormal SNAP amplitude of the sural nerve, while increased height was significant in the limbs group with abnormal CV of the sural nerve. Vascular factors were more significantly associated with decreased SNAP amplitude rather than decreased CV of the sural nerve in the nerve conduction study of diabetic patients.
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Affiliation(s)
- Si Eun Kim
- Department of Neurology, Haeundae-Paik Hospital, Inje University, College of Medicine, South Korea
| | - Kang Min Park
- Department of Neurology, Haeundae-Paik Hospital, Inje University, College of Medicine, South Korea
| | - Jinse Park
- Department of Neurology, Haeundae-Paik Hospital, Inje University, College of Medicine, South Korea
| | - Sam Yeol Ha
- Department of Neurology, Haeundae-Paik Hospital, Inje University, College of Medicine, South Korea
| | - Sung Eun Kim
- Department of Neurology, Haeundae-Paik Hospital, Inje University, College of Medicine, South Korea
| | - Byung In Lee
- Department of Neurology, Haeundae-Paik Hospital, Inje University, College of Medicine, South Korea
| | - Kyong Jin Shin
- Department of Neurology, Haeundae-Paik Hospital, Inje University, College of Medicine, South Korea.
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Kim Y, Jang H, Kim SJ, Cho SH, Kim SE, Kim ST, Kim HJ, Moon SH, Ewers M, Im K, Kwon H, Na DL, Seo SW. Vascular Effects on Depressive Symptoms in Cognitive Impairment. J Alzheimers Dis 2018; 65:597-605. [PMID: 30056427 DOI: 10.3233/jad-180394] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Late life depression is related to pathologic burdens, such as cerebral small vascular disease (CSVD) and amyloid, which are associated with brain network changes and cortical thinning. To examine the associations of various CSVD imaging markers, amyloid, and network changes with depression in cognitively impaired patients, we prospectively recruited 228 cognitively impaired patients having various degrees of amyloid and CSVD who underwent diffuse tensor image and PiB PET. Greater CSVD burden was associated with greater Geriatric Depression Scale (GDS) (white matter hyperintensities, WMH: p = 0.025, lacunes: p < 0.001) but not with amyloid (p = 0.095), and cortical thinning (p = 0.630) was not associated with greater GDS. The changes in white matter networks were related to GDS with decreasing integration (global efficiency: p < 0.001) and increasing segregation (clustering coefficient: p = 0.009). The network changes mediated the relationships of WMH and lacunes with GDS. Our findings provide insight to better understand how CSVD burdens contribute to depression in cognitively impaired patients having varying degrees of amyloid and vascular burdens.
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Affiliation(s)
- Yeshin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea.,Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Republic of Korea
| | - Hyemin Jang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Seung Joo Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Soo Hyun Cho
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Si Eun Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea.,Department of Neurology, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Republic of Korea
| | - Sung Tae Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Seung Hwan Moon
- Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea.,Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Michael Ewers
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Kiho Im
- Division of Newborn Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Hunki Kwon
- Department of Neurology, Yale University School of Medicine, New Haven, CT, USA
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea.,Stem Cell and Regenerative Medicine Institute, Samsung Medical Center, Seoul ,South Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea.,Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
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37
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Au Yong JA, Lewis DD, Evans RB, Kim SE, Pozzi A. Retrospective evaluation of the efficacy of minimally invasive, fluoroscopic-assisted reduction and stabilisation of unicondylar humeral fractures. Aust Vet J 2018; 96:302-307. [DOI: 10.1111/avj.12723] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 03/08/2018] [Accepted: 04/30/2018] [Indexed: 11/30/2022]
Affiliation(s)
- JA Au Yong
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, 2015 SW 16th Ave; University of Florida; Gainesville FL 32608 USA
| | - DD Lewis
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, 2015 SW 16th Ave; University of Florida; Gainesville FL 32608 USA
| | - RB Evans
- Department of Orthopedic Surgery, School of Medicine, University of Missouri; Columbia, MO USA
| | - SE Kim
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, 2015 SW 16th Ave; University of Florida; Gainesville FL 32608 USA
| | - A Pozzi
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, 2015 SW 16th Ave; University of Florida; Gainesville FL 32608 USA
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Cho SH, Shin JH, Jang H, Park S, Kim HJ, Kim SE, Kim SJ, Kim Y, Lee JS, Na DL, Lockhart SN, Rabinovici GD, Seong JK, Seo SW. Amyloid involvement in subcortical regions predicts cognitive decline. Eur J Nucl Med Mol Imaging 2018; 45:2368-2376. [PMID: 29980831 DOI: 10.1007/s00259-018-4081-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Accepted: 06/25/2018] [Indexed: 01/31/2023]
Abstract
PURPOSE We estimated whether amyloid involvement in subcortical regions may predict cognitive impairment, and established an amyloid staging scheme based on degree of subcortical amyloid involvement. METHODS Data from 240 cognitively normal older individuals, 393 participants with mild cognitive impairment, and 126 participants with Alzheimer disease were acquired at Alzheimer's Disease Neuroimaging Initiative sites. To assess subcortical involvement, we analyzed amyloid deposition in amygdala, putamen, and caudate nucleus. We staged participants into a 3-stage model based on cortical and subcortical amyloid involvement: 382 with no cortical or subcortical involvement as stage 0, 165 with cortical but no subcortical involvement as stage 1, and 203 with both cortical and subcortical involvement as stage 2. RESULTS Amyloid accumulation was first observed in cortical regions and spread down to the putamen, caudate nucleus, and amygdala. In longitudinal analysis, changes in MMSE, ADAS-cog 13, FDG PET SUVR, and hippocampal volumes were steepest in stage 2 followed by stage 1 then stage 0 (p value <0.001). Stage 2 showed steeper changes in MMSE score (β [SE] = -0.02 [0.004], p < 0.001), ADAS-cog 13 (0.05 [0.01], p < 0.001), FDG PET SUVR (-0.0008 [0.0003], p = 0.004), and hippocampal volumes (-4.46 [0.65], p < 0.001) compared to stage 1. CONCLUSIONS We demonstrated a downward spreading pattern of amyloid, suggesting that amyloid accumulates first in neocortex followed by subcortical structures. Furthermore, our new finding suggested that an amyloid staging scheme based on subcortical involvement might reveal how differential regional accumulation of amyloid affects cognitive decline through functional and structural changes of the brain.
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Affiliation(s)
- Soo Hyun Cho
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Jeong-Hyeon Shin
- School of Biomedical Engineering, Korea University, Seoul, Republic of Korea
| | - Hyemin Jang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Seongbeom Park
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Si Eun Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Seung Joo Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Yeshin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Jin San Lee
- Department of Neurology, Kyung Hee University Hospital, Seoul, South Korea
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea.,Stem Cell & Regenerative Medicine Institute, Samsung Medical Center, Seoul, South Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea
| | - Samuel N Lockhart
- Internal Medicine - Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, 27101, USA
| | - Gil D Rabinovici
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Joon-Kyung Seong
- School of Biomedical Engineering, Korea University, Seoul, Republic of Korea.
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea. .,Neuroscience Center, Samsung Medical Center, Seoul, South Korea. .,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea. .,Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.
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Kim SE, Lee B, Jeong JH, Yoon SJ, Park KW, Kim EJ, Yoon B, Jang JW, Hong JY, Na DL, Seo SW, Choi SH, Kim HJ. P4‐104: CLINICAL SIGNIFICANCE OF FOCAL
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F‐FLUTEMETAMOL UPTAKE. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.2508] [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: 10/28/2022]
Affiliation(s)
- Si Eun Kim
- Samsung Medical CenterSeoulRepublic of South Korea
- Inje University College of MedicineBusanRepublic of South Korea
| | - Byungju Lee
- Yuseong Geriatric Rehabilitation HospitalPohangRepublic of South Korea
| | - Jee Hyang Jeong
- Ewha Womans University Mokdong HospitalEwha Womans University School of MedicineSeoulRepublic of South Korea
| | - Soo Jin Yoon
- Eulji University HospitalDaejeonRepublic of South Korea
| | - Kyung Won Park
- Dong-A University College of MedicineBusanRepublic of South Korea
| | - Eun-Joo Kim
- Pusan National University HospitalBusanRepublic of South Korea
| | - Bora Yoon
- Konyang University HospitalCollege of MedicineDaejeonRepublic of South Korea
| | - Jae-Won Jang
- Kangwon National University HospitalChuncheonRepublic of South Korea
| | - Jin Yong Hong
- Wonju Severance Christian HospitalWonjuRepublic of South Korea
| | - Duk L. Na
- Samsung Medical CenterSeoulRepublic of South Korea
| | - Sang Won Seo
- Samsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of South Korea
| | - Seong Hye Choi
- Inha University College of MedicineInchonRepublic of South Korea
| | - Hee Jin Kim
- Samsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of South Korea
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Jang H, Jang YK, Kim HJ, Werring DJ, San Lee J, Choe Y, Park S, Lee J, Kim KW, Kim Y, Cho SH, Kim SE, Kim SJ, Na DL, Seo SW. P3‐346: CLINICAL SIGNIFICANCE OF AMYLOID BETA POSITIVITY IN PATIENTS WITH CEREBRAL AMYLOID ANGIOPATHY MARKERS. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.1707] [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: 10/28/2022]
Affiliation(s)
| | | | - Hee Jin Kim
- Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
| | | | - Jin San Lee
- Kyung Hee University HospitalSeoulSouth Korea
| | | | | | - Juyoun Lee
- Chungnam National University HospitalDaejeonSouth Korea
| | | | - Yeshin Kim
- Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
| | | | - Si Eun Kim
- Inje University College of MedicineBusanSouth Korea
| | | | - Duk L. Na
- Samsung Medical CenterSeoulSouth Korea
| | - Sang Won Seo
- Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
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Kim SE, Woo SY, Kim SW, Kim HJ, Park S, Lee BI, Park J, Kim Y, Jang H, Kim SJ, Cho SH, Na DL, San Lee J, Seo SW. IC‐P‐121: EFFECTS OF CARDIOMETABOLIC RISK FACTORS ON BRAIN AGING IN THE ELDERLY. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.2187] [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: 10/28/2022]
Affiliation(s)
- Si Eun Kim
- Samsung Medical CenterSeoulSouth Korea
- Inje University College of MedicineBusanSouth Korea
| | | | | | - Hee Jin Kim
- Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
| | | | - Byung In Lee
- Inje University College of MedicineBusanSouth Korea
| | - JinSe Park
- Inje University College of MedicineBusanSouth Korea
| | | | | | | | | | - Duk L. Na
- Samsung Medical CenterSeoulSouth Korea
| | - Jin San Lee
- Kyung Hee University HospitalSeoulSouth Korea
| | - Sang Won Seo
- Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
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Cho SH, Shin JH, Jang H, Park S, Kim HJ, Kim Y, Kim SE, Kim SJ, Cho H, San Lee J, Lockhart SN, Na DL, Seong JK, Seo SW. IC‐P‐050: AMYLOID DEPOSITION IN THE SUBCORTICAL REGION PREDICTS COGNITIVE DECLINE. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.2114] [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: 10/28/2022]
Affiliation(s)
| | | | | | | | - Hee Jin Kim
- Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
| | | | | | | | - Hanna Cho
- Yonsei UniversityCollege of MedicineSeoulSouth Korea
| | - Jin San Lee
- Kyung Hee University HospitalSeoulSouth Korea
| | | | - Duk L. Na
- Samsung Medical CenterSeoulSouth Korea
| | | | - Sang Won Seo
- Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
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Son YK, Kwon H, Lee HW, Jeong EG, Lee SM, Kim SE, Park Y, An WS. Modification of Erythrocyte Membrane Fatty Acid Contents After Kidney Transplantation: A Prospective Study. Transplant Proc 2018; 50:1332-1335. [PMID: 29880354 DOI: 10.1016/j.transproceed.2018.01.057] [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] [Received: 11/17/2017] [Accepted: 01/23/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Modifications of erythrocyte membrane fatty acid (FA) contents may affect cellular function or transmembrane receptors. One cross-sectional study has shown that kidney transplant (KTP) recipients have lower erythrocyte membrane oleic acid content than dialysis patients do. Therefore, we prospectively tested whether erythrocyte membrane contents of FA including oleic acid change after KTP. METHODS We recruited 23 KTP recipients (September 2011 through May 2014). Blood samples were obtained immediately before KTP and 6 months after. Erythrocyte membrane FA contents were measured by gas chromatography. RESULTS Mean age of the enrolled KTP recipients was 45.3 ± 10.9 years, and men represented 66.7% of the cases. ABO-incompatible KTPs constituted 14.3% and cadaver donors 42.9% of the cases. Steroids, mycophenolate mofetil, and tacrolimus were used as immunosuppressive treatment. There was no significant difference in dietary consumption between time points before and 6 months after KTP. Total cholesterol and low-density lipoprotein cholesterol levels were significantly higher at 6 months after KTP as compared with baseline. Erythrocyte membrane contents of polyunsaturated FA, ω-3 FA, ω-6 FA, and the ω-3 index were significantly higher, but erythrocyte membrane contents of total saturated FAs, total monounsaturated FAs, including oleic acid, total trans-FA, palmitoleic acid, and the ω-6-to-ω-3 ratio were significantly lower at 6 months after KTP. CONCLUSIONS Erythrocyte membrane FA contents significantly changed toward a more favorable cardiovascular profile after KTP. These changes in erythrocyte membrane FA contents may be related to improved renal function because of the absence of significant dietary changes.
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Affiliation(s)
- Y K Son
- Department of Internal Medicine, Dong-A University, Busan, Korea
| | - H Kwon
- Department of Internal Medicine, BHS Hanseo Hospital, Busan, Korea
| | - H W Lee
- Department of Internal Medicine, Dong-A University, Busan, Korea
| | - E G Jeong
- Department of Internal Medicine, Dong-A University, Busan, Korea
| | - S M Lee
- Department of Internal Medicine, Dong-A University, Busan, Korea
| | - S E Kim
- Department of Internal Medicine, Dong-A University, Busan, Korea
| | - Y Park
- Department of Food and Nutrition, Hanyang University, Seoul, Korea
| | - W S An
- Department of Internal Medicine, Dong-A University, Busan, Korea.
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Cornelissen L, Kim SE, Lee JM, Brown EN, Purdon PL, Berde CB. Electroencephalographic markers of brain development during sevoflurane anaesthesia in children up to 3 years old. Br J Anaesth 2018; 120:1274-1286. [PMID: 29793594 PMCID: PMC6617966 DOI: 10.1016/j.bja.2018.01.037] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 01/30/2018] [Accepted: 01/30/2018] [Indexed: 12/14/2022] Open
Abstract
Background General anaesthetics generate spatially defined brain oscillations in the EEG that relate fundamentally to neural-circuit architecture. Few studies detailing the neural-circuit activity of general anaesthesia in children have been described. The study aim was to identify age-related changes in EEG characteristics that mirror different stages of early human brain development during sevoflurane anaesthesia. Methods Multichannel EEG recordings were performed in 91 children aged 0–3 yr undergoing elective surgery. We mapped spatial power and coherence over the frontal, parietal, temporal, and occipital cortices during maintenance anaesthesia. Results During sevoflurane exposure: (i) slow–delta (0.1–4 Hz) oscillations were present in all ages, (ii) theta (4–8 Hz) and alpha (8–12 Hz) oscillations emerge by ∼4 months, (iii) alpha oscillations increased in power from 4 to 10 months, (iv) frontal alpha-oscillation predominance emerged at ∼6 months, (v) frontal slow oscillations were coherent from birth until 6 months, and (vi) frontal alpha oscillations became coherent ∼10 months and persisted in older ages. Conclusions Key developmental milestones in the maturation of the thalamo-cortical circuitry likely generate changes in EEG patterns in infants undergoing sevoflurane general anaesthesia. Characterisation of anaesthesia-induced EEG oscillations in children demonstrates the importance of developing age-dependent strategies to monitor properly the brain states of children receiving general anaesthesia. These data have the potential to guide future studies investigating neurodevelopmental pathologies involving altered excitatory–inhibitory balance, such as epilepsy or Rett syndrome.
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Affiliation(s)
- L Cornelissen
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Anaesthesia, Harvard Medical School, Boston, MA, USA.
| | - S E Kim
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - J M Lee
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - E N Brown
- Department of Anaesthesia, Harvard Medical School, Boston, MA, USA; Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA; Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - P L Purdon
- Department of Anaesthesia, Harvard Medical School, Boston, MA, USA; Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - C B Berde
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Anaesthesia, Harvard Medical School, Boston, MA, USA
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45
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Hong JY, Kim CW, Noh H, Lee DH, Kim SE, Lee SJ. The Effect of Animation-Assisted Informed Consent Using Tablet Personal Computer for Contrast-Enhanced Computed-Tomography in Emergency Department. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791201900404] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction Informed consent is essential patient's right even in overcrowded emergency department (ED). We compared the effect of animation-assisted informed consent using tablet PC with the standard informed consent for contrast-enhanced computed-tomography (CT) in ED. Methods We included 150 patients scheduled to undergo contrast-enhanced CT in ED from November 2010 through January 2011. Participants were randomised to either animation-assisted information (AAI) (n=75) or standard verbal information (SVI) group (n=75). AAI was provided by tablet personal computer (PC); and SVI by clinicians. All participants completed 10-point scale questionnaires after the CT scan. The questionnaires included two main categories – understanding and satisfaction of informed consent. Results Participants in the AAI group had a better understanding of purpose (8.95±1.48 vs. 8.32±1.88, p=0.026) and methods (8.93±1.43 vs. 8.37±1.83, p=0.048) of CT scans compared to participants in the SVI group. Every score in satisfaction categories was significantly higher in the AAI group. In the SVI group, relatively low-educated participants had a lower score in understanding when compared with university-educated participants (7.53±2.28 vs. 8.52±1.40, p=0.029). Regardless of education level, understanding score was high in the AAI group (8.73±1.27 vs. 8.57±1.50, p=0.71). Conclusions Participants receiving animation assisted informed consent with tablet PC shows a higher degree of understanding and satisfaction compared with patients receiving standard verbal informed consent. Particularly in patients with lower education, animation-assisted informed consent may be better for understanding of contrast-enhanced CT.
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Affiliation(s)
- JY Hong
- Chung-Ang University College of Medicine, Department of Emergency Medicine, Chung-Ang University Medical Center, Heukseok-dong, Dongjak-gu, Seoul, 156-755, Korea
| | - CW Kim
- Chung-Ang University College of Medicine, Department of Emergency Medicine, Chung-Ang University Medical Center, Heukseok-dong, Dongjak-gu, Seoul, 156-755, Korea
| | | | - DH Lee
- Chung-Ang University College of Medicine, Department of Emergency Medicine, Chung-Ang University Medical Center, Heukseok-dong, Dongjak-gu, Seoul, 156-755, Korea
| | - SE Kim
- Chung-Ang University College of Medicine, Department of Emergency Medicine, Chung-Ang University Medical Center, Heukseok-dong, Dongjak-gu, Seoul, 156-755, Korea
| | - SJ Lee
- Chung-Ang University College of Medicine, Department of Emergency Medicine, Chung-Ang University Medical Center, Heukseok-dong, Dongjak-gu, Seoul, 156-755, Korea
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Abstract
Background Escalator-related injuries have been considered uncommon and most likely to occur in children. In this study, we described the epidemiology of these injuries with focus on the aged population in order to determine whether escalators are safe for the aged, and to obtain information to help in preventing escalator-related injuries. Methods A prospective survey was taken to identify the number and nature of these injuries from May 2004 to December 2008. We enrolled patients who had sustained escalator-related injuries. A standard list of questions and answers were recorded by the emergency physician. A total of 104 questionnaires were completed during the study period. Results The average patient age was 59.2±24.0 years (range 1-94). There were 64 (61.5%) females. Only 11 (10.6%) were younger than 15 years old, and 59 (56.7%) were aged 65 or above; 35 (59.3%) of the aged people were injured while standing on the escalator. However, out of the 45 patients younger than age 65, 22 (48.9%) were injured from walking on a moving escalator. Head injury was the commonest site of injury overall and all were due to fall or slipping down. Conclusions Escalator-related injuries are not as rare as previously believed and the aged population 65 years old or above is the highest risk group. In particular, walking on a moving escalator was the main cause of injury in people under age 65. Therefore, primary prevention strategies are needed to prevent users from walking on escalators, especially young people, and educate aged people the safe utilization of escalators to prevent slip and fall injuries.
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Abstract
Cases of deep venous thrombosis (DVT) and pulmonary thromboembolism (PTE) related to the isolated risk factor of uterine myoma are very rare. In a setting of emergency department (ED), it is unlikely that uterine myoma would be suspected as the primary cause of symptoms in a patient with thromboembolism. We presented a 44-year-old woman who visited the ED for DVT presenting with right lower leg swelling with an underlying cause of a huge uterine myoma. Various aetiologies, including obstetric and gynaecological causes (especially uterine myoma), should be considered in female patients visiting the ED with suspected DVT or PTE.
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Oh JH, Kim CW, Kim SE, Lee DH. Does the Bed Frame Deflection Occur along with Mattress Deflection during In-Hospital Cardiopulmonary Resuscitation? an Experiment Using Mechanical Devices. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791602300205] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives When we perform chest compression on a patient on a bed, the mattress and bed frame can be depressed together with the patient's chest. This study was conducted to assess whether bed frame deflection occurred during chest compressions. Methods We designed a firm bed (“bed like the ground,” BLG) to assess the bed frame deflection in the Stryker Trauma Stretcher (STS) and the ER stretcher cart (ER-SC). The STS included a soft mattress and the ER-SC a hard mattress. We performed 50 continuous chest compressions on the Resusci Anne Skill Reporter with CPRmeter in each experiment. The experiments were done in four settings. Test 1 included the BLG; test 2 included a mattress and backboard on each bed; test 3 included the mattress of each bed and a backboard on the BLG; and test 4 included the mattress of each bed on the BLG. We calculated the mattress and bed frame deflections using the gaps of compression depths between the values measured by Resusci Anne and CPRmeter. Results The mattress deflections of the STS and ER-SC mattress were determined to be 11.2 and 0.67 mm, respectively. The bed frame deflection for the STS and ER-SC were 0.95 and 5.17 mm, respectively. Conclusion The study confirms that bed frame deflection will occur when we perform chest compressions on the manikin lying on a bed. Additionally, the bed frame deflections differ depending on the type of bed. (Hong Kong j.emerg.med. 2016;23:35-41)
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Kim SE, Lee SJ, Noh H, Lee DH, Kim CW. Is There Any Difference in Cardiopulmonary Resuscitation Performance According to Different Instructional Models of Cardiopulmonary Resuscitation Education for Junior and Senior High School Students? HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791101800602] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective This study aims to determine whether or not cardiopulmonary resuscitation (CPR) skills differ according to different instructional models for CPR education and training for junior and senior high school students. Methods This was a prospective and randomised study including 519 junior and senior high school students. After the lecture on CPR, students practiced the skill on the manikin. Group 1 used model 1 and Group 2 used model 2 for practical training and practical skills and CPR performance quality were evaluated. Results Data from skill tests were analysed in 229 students in group 1 and 210 students in group 2. The total score of sequence skill tests was 17.8±2.0 points. During 2 cycles, no chest elevation was observed in 33.3% and was significantly lower in group 1. There were no significant differences in the frequency of proper ventilation and in ventilation volume between the 2 groups. Excessive ventilation was more frequently observed in group 1 and insufficient ventilation was observed more frequently in group 2. The percentage of the frequency of a proper chest compression rate was 80.5±31.2% and there were no significant differences in proper and insufficient depths, mean rate and recoil of the chest in chest compression between the 2 groups. Conclusions There were differences in CPR skills according to different CPR training manikins. Therefore, certain conditions seem to be considered in selection of instructional models for CPR psychomotor skills. (Hong Kong j.emerg.med. 2011;18:375-382)
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Affiliation(s)
- SE Kim
- Myongji Hospital, Department of Emergency Medicine, Seoul, Korea; Noh Hyun, MD
| | - SJ Lee
- Myongji Hospital, Department of Emergency Medicine, Seoul, Korea; Noh Hyun, MD
| | - H Noh
- Myongji Hospital, Department of Emergency Medicine, Seoul, Korea; Noh Hyun, MD
| | - DH Lee
- Myongji Hospital, Department of Emergency Medicine, Seoul, Korea; Noh Hyun, MD
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Abstract
Pneumomediastinum is an uncommon radiographic finding resulting from various causes, such as trauma, infection and unknown causes. The pneumomediastinum due to minor trauma is rarely reported and treatment and diagnostic process is not established. We report on a 20-year-old female patient who initially presented with neck pain and dyspnoea following manual strangulation. Her chest X-ray and computed tomography (CT) of neck imaging showed subcutaneous emphysema and extensive pneumomediastinum, but pneumothorax was not shown. She was transferred to the thoracic surgery and admitted to the general ward. The patient's condition improved and she was discharged on the sixth hospital day. In conclusion, patients with pneumomediastinum following a minor strangulation injury can be observed alone without invasive testing or repeated imaging. CT scans are of great value for safe observation in determined patients and for the further evaluation of pneumomediastinum.
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Affiliation(s)
| | | | | | - JH Hong
- Chung-Ang University Hosiptal, Department of Thoracic and Cardiovascular Surgery, College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul, Korea
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