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Kang JW, Zhang H, Chen YN, Zheng ZY, Liu XY, Pan XX. [Effect of dexmedetomidine on the intraoperative and early postoperative complications of patients undergoing orthotopic liver transplantation]. Zhonghua Wai Ke Za Zhi 2024; 62:155-161. [PMID: 38310384 DOI: 10.3760/cma.j.cn112139-20230801-00031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/05/2024]
Abstract
Objective: To investigate the effect of dexmedetomidine on the intraoperative and early postoperative complications of patients undergoing orthotopic liver transplantation. Methods: This is a retrospective cohort study. The clinical data of 399 patients who underwent orthotopic liver transplantation at the First Affiliated Hospital of Nanjing Medical University from January 2016 to September 2020 were retrospectively collected. There were 319 males and 80 females, aged (50.9±10.2) years (range: 10 to 73 years). These patients were divided into the control group (369 cases) and the dexmedetomidine group (30 cases) according to whether dexmedetomidine was continuously pumped intravenously during the operation until the operation ended. The 1∶2 propensity score matching was used to match the preoperative and intraoperative conditions of the two groups of patients, and the caliper width was 0.2. Outcome indicators included intraoperative postreperfusion syndrome, acute kidney injury and pulmonary complications within 7 days after surgery, length of hospital stay, time of stay in ICU, duration of assisted mechanical ventilation, rate of reintubation, 6-month and 1-year survival and recurrence-free survival rate after surgery. The independent sample t test, χ2 test, Mann-Whitney U test or Fisher exact test was used to statistically analyze the data of the two groups of patients, respectively. Survival curves of overall survival and disease-free-survival were plotted by Kaplan-Meier method, and the survival rate and recurrence-free survival rate were compared by Log-rank test. Results: A total of 78 patients were included after propensity score matching, including 26 in the dexmedetomidine group and 52 in the control group. The incidence of acute kidney injury in the dexmedetomidine group within 7 days after surgery was 0 (0/26), significantly lower than that of the control group (21.2%,11/52)(corrected χ2=4.776, P=0.029). There were no significant differences in the incidence of intraoperative postreperfusion syndrome and pulmonary complications within 7 days after surgery, length of hospital stay, ICU time, the duration of assisted mechanical ventilation, rate of reintubation, 6-month and 1-year survival, and recurrence-free survival rate after surgery between the two groups (all P>0.05). Conclusion: Continuous infusion of dexmedetomidine via intravenous pump during operation may be beneficial in reducing the incidence of acute kidney injury within 7 days after orthotopic liver transplantation.
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Affiliation(s)
- J W Kang
- Department of Anesthesiology and Perioperative Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - H Zhang
- Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Y N Chen
- Department of Anesthesiology and Perioperative Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Z Y Zheng
- Department of Anesthesiology and Perioperative Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - X Y Liu
- Department of Anesthesiology and Perioperative Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - X X Pan
- Department of Anesthesiology and Perioperative Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
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Jeon Y, Shin SJ, Jin JC, Kang JW. Nodular mass in the nasal columella of a 15-year-old girl. Eur Ann Otorhinolaryngol Head Neck Dis 2023; 140:139-140. [PMID: 36639326 DOI: 10.1016/j.anorl.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/07/2022] [Accepted: 12/12/2022] [Indexed: 01/13/2023]
Affiliation(s)
- Y Jeon
- Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonju-ro, Gangnam-gu, Seoul 06273, Republic of Korea
| | - S-J Shin
- Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - J C Jin
- Department of Medicine, Jeju National University School of Medicine, Jeju, Republic of Korea
| | - J W Kang
- Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonju-ro, Gangnam-gu, Seoul 06273, Republic of Korea.
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Kang JW. Impact of coronavirus disease 2019 on children's health. Clin Exp Pediatr 2022; 65:498-499. [PMID: 36111437 PMCID: PMC9561188 DOI: 10.3345/cep.2022.00682] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/29/2022] [Indexed: 11/27/2022] Open
Affiliation(s)
- Joon Won Kang
- Department of Pediatrics & Medical Science, Brain Research Institute, College of Medicine, Chungnam National University, Daejeon, Korea.,Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea.,Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE, USA
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Erisken S, Nune G, Chung H, Kang JW, Koh S. Time and age dependent regulation of neuroinflammation in a rat model of mesial temporal lobe epilepsy: Correlation with human data. Front Cell Dev Biol 2022; 10:969364. [PMID: 36172274 PMCID: PMC9512631 DOI: 10.3389/fcell.2022.969364] [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: 06/14/2022] [Accepted: 08/03/2022] [Indexed: 11/25/2022] Open
Abstract
Acute brain insults trigger diverse cellular and signaling responses and often precipitate epilepsy. The cellular, molecular and signaling events relevant to the emergence of the epileptic brain, however, remain poorly understood. These multiplex structural and functional alterations tend also to be opposing - some homeostatic and reparative while others disruptive; some associated with growth and proliferation while others, with cell death. To differentiate pathological from protective consequences, we compared seizure-induced changes in gene expression hours and days following kainic acid (KA)-induced status epilepticus (SE) in postnatal day (P) 30 and P15 rats by capitalizing on age-dependent differential physiologic responses to KA-SE; only mature rats, not immature rats, have been shown to develop spontaneous recurrent seizures after KA-SE. To correlate gene expression profiles in epileptic rats with epilepsy patients and demonstrate the clinical relevance of our findings, we performed gene analysis on four patient samples obtained from temporal lobectomy and compared to four control brains from NICHD Brain Bank. Pro-inflammatory gene expressions were at higher magnitudes and more sustained in P30. The inflammatory response was driven by the cytokines IL-1β, IL-6, and IL-18 in the acute period up to 72 h and by IL-18 in the subacute period through the 10-day time point. In addition, a panoply of other immune system genes was upregulated, including chemokines, glia markers and adhesion molecules. Genes associated with the mitogen activated protein kinase (MAPK) pathways comprised the largest functional group identified. Through the integration of multiple ontological databases, we analyzed genes belonging to 13 separate pathways linked to Classical MAPK ERK, as well as stress activated protein kinases (SAPKs) p38 and JNK. Interestingly, genes belonging to the Classical MAPK pathways were mostly transiently activated within the first 24 h, while genes in the SAPK pathways had divergent time courses of expression, showing sustained activation only in P30. Genes in P30 also had different regulatory functions than in P15: P30 animals showed marked increases in positive regulators of transcription, of signaling pathways as well as of MAPKKK cascades. Many of the same inflammation-related genes as in epileptic rats were significantly upregulated in human hippocampus, higher than in lateral temporal neocortex. They included glia-associated genes, cytokines, chemokines and adhesion molecules and MAPK pathway genes. Uniquely expressed in human hippocampus were adaptive immune system genes including immune receptors CDs and MHC II HLAs. In the brain, many immune molecules have additional roles in synaptic plasticity and the promotion of neurite outgrowth. We propose that persistent changes in inflammatory gene expression after SE leads not only to structural damage but also to aberrant synaptogenesis that may lead to epileptogenesis. Furthermore, the sustained pattern of inflammatory genes upregulated in the epileptic mature brain was distinct from that of the immature brain that show transient changes and are resistant to cell death and neuropathologic changes. Our data suggest that the epileptogenic process may be a result of failed cellular signaling mechanisms, where insults overwhelm the system beyond a homeostatic threshold.
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Affiliation(s)
- Sinem Erisken
- Department of Pediatrics, Stanley Manne Children’s Research Institute, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University School of Medicine, Chicago, IL, United States
- Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL, United States
| | - George Nune
- Department of Pediatrics, Stanley Manne Children’s Research Institute, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University School of Medicine, Chicago, IL, United States
- Department of Neurology, University of Southern California, Los Angeles, CA, United States
| | - Hyokwon Chung
- Department of Pediatrics, Stanley Manne Children’s Research Institute, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University School of Medicine, Chicago, IL, United States
- Department of Pediatrics, Children’s Hospital & Medical Center, University of Nebraska, Omaha, NE, United States
| | - Joon Won Kang
- Department of Pediatrics, Children’s Hospital & Medical Center, University of Nebraska, Omaha, NE, United States
- Department of Pediatrics & Medical Science, Brain Research Institute, College of Medicine, Chungnam National University, Daejeon, South Korea
| | - Sookyong Koh
- Department of Pediatrics, Stanley Manne Children’s Research Institute, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University School of Medicine, Chicago, IL, United States
- Department of Pediatrics, Children’s Hospital & Medical Center, University of Nebraska, Omaha, NE, United States
- *Correspondence: Sookyong Koh,
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Jung SY, Yu SW, Lee KS, Yi YY, Kang JW. Transition from pediatric to adult care among patients with epilepsy: Cross-sectional surveys of experts and patients in Korea. Epilepsia Open 2022; 7:452-461. [PMID: 35766448 PMCID: PMC9436304 DOI: 10.1002/epi4.12621] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 06/27/2022] [Indexed: 12/03/2022] Open
Abstract
Objectives Many pediatric patients with epilepsy require treatment beyond the pediatric age. These patients require transition to an adult epilepsy center. Currently, many centers worldwide run epilepsy transition programs. However, a standardized protocol does not exist in Korea. The basic data required to establish a transition program are also unavailable. We aimed to assess the status and perceptions of patients and epilepsy care providers on transition. Methods To assess the status of epilepsy transition, we retrospectively collected data from patients with epilepsy older than 18 years who visited our pediatric epilepsy clinic between March 1990 and July 2019. To assess the perception of transition, we surveyed patients, parents, pediatric neurologists (PN), and adult epileptologists (AE). Results In a retrospective chart review, 39 of 267 (14.6%) patients visited the adult epilepsy clinic after consulting a pediatric neurologist, and three patients returned to the pediatric center. The average patient age at transition was 23.29 ± 5.10 years. A total of 94 patients or their guardians and 100 experts participated in the survey. About half of the patients or guardians (44.7%) did not want to transition and emotional dependence was the commonest reason. Most patients (52.1%) thought that the appropriate age of transition was above 20 years. PNs had greater concerns about patients' compliance than AEs. Regarding the age of transition, AEs believed that a younger age (18 years) was more appropriate than PNs (20 years). Significance This study describes difficulties in the transition from pediatric to adult epilepsy centers without appropriate support. There were differences in perspectives among patients, parents, and adult and pediatric epilepsy care providers. This study can assist in creating a standardized protocol in Korea.
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Affiliation(s)
- Seung Yeon Jung
- Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea
| | - Seung Woo Yu
- Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea
| | - Keon Su Lee
- Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea
| | - Yoon Young Yi
- Department of Pediatrics, Hallym University and Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Joon Won Kang
- Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea.,Department of Pediatrics and Medical Science, Brain Research Institute, Chungnam National University College of Medicine, Daejeon, Korea
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Shin HJ, Lee KY, Kang JW, Choi SG, Kim DW, Yi YY. Perampanel Reduces Brain Damage via Induction of M2 Microglia in a Neonatal Rat Stroke Model. Int J Nanomedicine 2022; 17:2791-2804. [PMID: 35782016 PMCID: PMC9248959 DOI: 10.2147/ijn.s361377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 06/18/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose Ischemic stroke is a leading cause of death and disability worldwide. Additionally, neonatal ischemia is a common cause of neonatal brain injury, resulting in cerebral palsy with subsequent learning disabilities and epilepsy. However, there is currently a lack of effective treatments available for patients with perinatal ischemic stroke. In this study, we investigated the effect of perampanel (PER)-loaded poly lactic-co-glycolic acid (PLGA) by targeting microglia in perinatal stroke. Methods After formation of focal ischemic stroke by photothrombosis in P7 rats, PER-loaded PLGA was injected intrathecally. Proinflammatory markers (TNF-α, IL-1β, IL-6, COX2, and iNOS) and M2 polarization markers (Ym1 and Arg1) were evaluated. We investigated whether PER increased M2 microglial polarization in vitro. Results PER-loaded PLGA nanoparticles decreased the pro-inflammatory cytokines compared to the control group. Furthermore, they increased M2 polarization. Conclusion PER-loaded PLGA nanoparticles decreased the size of the infarct and increased motor function in a perinatal ischemic stroke rat model. Pro-inflammatory cytokines were also reduced compared to the control group. Finally, this development of a drug delivery system targeting microglia confirms the potential to develop new therapeutic agents for perinatal ischemic stroke.
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Affiliation(s)
- Hyo Jung Shin
- Department of Anatomy and Cell Biology, Chungnam National University, Daejeon, Republic of Korea
- Brain Research Institute, Chungnam National University, Daejeon, Republic of Korea
| | - Ka Young Lee
- Department of Anatomy and Cell Biology, Chungnam National University, Daejeon, Republic of Korea
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Joon Won Kang
- Department of Medical Science, Chungnam National University, Daejeon, Republic of Korea
- Department of Pediatrics, Chungnam National Hospital, School of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Seung Gyu Choi
- Department of Anatomy and Cell Biology, Chungnam National University, Daejeon, Republic of Korea
- Department of Pediatrics, Chungnam National Hospital, School of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Dong Woon Kim
- Department of Anatomy and Cell Biology, Chungnam National University, Daejeon, Republic of Korea
- Brain Research Institute, Chungnam National University, Daejeon, Republic of Korea
- Department of Medical Science, Chungnam National University, Daejeon, Republic of Korea
- Correspondence: Dong Woon Kim; Yoon Young Yi, Tel +82-42-580-8207; +82-2-2224-2251, Email ;
| | - Yoon Young Yi
- Department of Pediatrics, College of Medicine, Hallym University and Gangdong Sacred Heart Hospital, Seoul, Republic of Korea
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Jeong DY, Lee J, Kim JY, Lee KH, Li H, Lee JY, Jeong GH, Yoon S, Park EL, Hong SH, Kang JW, Song TJ, Leyhe T, Eisenhut M, Kronbichler A, Smith L, Solmi M, Stubbs B, Koyanagi A, Jacob L, Stickley A, Thompson T, Dragioti E, Oh H, Brunoni AR, Carvalho AF, Kim MS, Yon DK, Lee SW, Yang JM, Ghayda RA, Shin JI, Fusar-Poli P. Empirical assessment of biases in cerebrospinal fluid biomarkers of Alzheimer's disease: an umbrella review and re-analysis of data from meta-analyses. Eur Rev Med Pharmacol Sci 2021; 25:1536-1547. [PMID: 33629323 DOI: 10.26355/eurrev_202102_24862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Alzheimer's disease (AD) is a leading cause of years lived with disability in older age, and several cerebrospinal fluid (CSF) markers have been proposed in individual meta-analyses to be associated with AD but field-wide evaluation and scrutiny of the literature is not available. MATERIALS AND METHODS We performed an umbrella review for the reported associations between CSF biomarkers and AD. Data from available meta-analyses were reanalyzed using both random and fixed effects models. We also estimated between-study heterogeneity, small-study effects, excess significance, and prediction interval. RESULTS A total of 38 meta-analyses on CSF markers from 11 eligible articles were identified and reanalyzed. In 14 (36%) of the meta-analyses, the summary estimate and the results of the largest study showed non-concordant results in terms of statistical significance. Large heterogeneity (I2≥75%) was observed in 73% and small-study effects under Egger's test were shown in 28% of CSF biomarkers. CONCLUSIONS Our results suggest that there is an excess of statistically significant results and significant biases in the literature of CSF biomarkers for AD. Therefore, the results of CSF biomarkers should be interpreted with caution.
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Affiliation(s)
- D Y Jeong
- Yonsei University College of Medicine, Seoul, Republic of Korea.
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Abstract
Paroxysmal nonepileptic events (PNE) comprise of a variety of nonepileptic behaviors and are divided into various types. A more accurate diagnosis is possible by examining the video clip provided by the caregiver. In infants, physiologic PNE accounts for the majority of the PNE. It is important to exclude epilepsy, for which blood tests, electroencephalography, and imaging tests can facilitate differential diagnosis. Since most PNE have a benign progress, symptoms often improve with age and without special treatment. Therefore, it is important to reassure the caregivers after making an accurate diagnosis.
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Affiliation(s)
- Seung Yeon Jung
- Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea
| | - Joon Won Kang
- Department of Pediatrics & Medical Science, Chungnam National University School of Medicine, Daejeon, Korea
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Lim SJ, Koo HJ, Cho MS, Nam GB, Kang JW, Yang DH. Late Gadolinium Enhancement of Left Ventricular Papillary Muscles in Patients with Mitral Regurgitation. Korean J Radiol 2021; 22:1609-1618. [PMID: 34402246 PMCID: PMC8484157 DOI: 10.3348/kjr.2020.1485] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 09/24/2020] [Revised: 03/16/2021] [Accepted: 03/21/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Arrhythmogenic mitral valve prolapse (MVP) is an important cause of sudden cardiac death characterized by fibrosis of the papillary muscles or left ventricle (LV) wall, and an association between late gadolinium enhancement (LGE) of the LV papillary muscles and ventricular arrhythmia in MVP has been reported. However, LGE of the papillary muscles may be observed in other causes of mitral regurgitation, and it is not limited to patients with MVP. This study was to evaluate the association of LGE of the LV papillary muscles or ventricular wall on cardiac magnetic resonance imaging (CMR) and ventricular arrhythmia in patients with mitral regurgitation. MATERIALS AND METHODS This study included 88 patients (mean age ± standard deviation, 58.3 ± 12.0 years; male, 42%) with mitral regurgitation who underwent CMR. They were allocated to the MVP (n = 43) and non-MVP (n = 45) groups, and their LGE images on CMR, clinical characteristics, echocardiographic findings, and presence of arrhythmia were compared. RESULTS LV myocardial wall enhancement was more frequent in the MVP group than in the non-MVP group (28% vs. 11%, p = 0.046). Papillary muscle enhancement was observed in 7 (7.9%) patients. Of the 43 patients with MVP, 15 (34.8%) showed LGE in the papillary muscles or LV myocardium, including 12 (27.9%) with LV myocardial wall enhancement and 4 (9.3%) with papillary muscle enhancement. One patient with bilateral diffuse papillary muscle enhancement experienced sudden cardiac arrest due to ventricular fibrillation. Univariable logistic regression analysis showed that high systolic blood pressure (BP; odds ratio [OR], 1.05; 95% confidence interval [CI], 1.01-1.09; p = 0.027) and ventricular arrhythmia (OR, 6.84; 95% CI, 1.29-36.19; p = 0.024) were significantly associated with LGE of the papillary muscles. CONCLUSION LGE of the papillary muscles was present not only in patients with MVP, but also in patients with other etiologies of mitral regurgitation, and it was associated with high systolic BP and ventricular arrhythmia. Papillary muscle enhancement on CMR should not be overlooked.
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Affiliation(s)
- Su Jin Lim
- Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyun Jung Koo
- Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | - Min Soo Cho
- Department of Internal Medicine, Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Gi Byoung Nam
- Department of Internal Medicine, Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon Won Kang
- Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong Hyun Yang
- Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Lee JG, Kim H, Kang H, Koo HJ, Kang JW, Kim YH, Yang DH. Fully Automatic Coronary Calcium Score Software Empowered by Artificial Intelligence Technology: Validation Study Using Three CT Cohorts. Korean J Radiol 2021; 22:1764-1776. [PMID: 34402248 PMCID: PMC8546141 DOI: 10.3348/kjr.2021.0148] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [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: 02/19/2021] [Revised: 04/26/2021] [Accepted: 05/13/2021] [Indexed: 11/26/2022] Open
Abstract
Objective This study aimed to validate a deep learning-based fully automatic calcium scoring (coronary artery calcium [CAC]_auto) system using previously published cardiac computed tomography (CT) cohort data with the manually segmented coronary calcium scoring (CAC_hand) system as the reference standard. Materials and Methods We developed the CAC_auto system using 100 co-registered, non-enhanced and contrast-enhanced CT scans. For the validation of the CAC_auto system, three previously published CT cohorts (n = 2985) were chosen to represent different clinical scenarios (i.e., 2647 asymptomatic, 220 symptomatic, 118 valve disease) and four CT models. The performance of the CAC_auto system in detecting coronary calcium was determined. The reliability of the system in measuring the Agatston score as compared with CAC_hand was also evaluated per vessel and per patient using intraclass correlation coefficients (ICCs) and Bland-Altman analysis. The agreement between CAC_auto and CAC_hand based on the cardiovascular risk stratification categories (Agatston score: 0, 1–10, 11–100, 101–400, > 400) was evaluated. Results In 2985 patients, 6218 coronary calcium lesions were identified using CAC_hand. The per-lesion sensitivity and false-positive rate of the CAC_auto system in detecting coronary calcium were 93.3% (5800 of 6218) and 0.11 false-positive lesions per patient, respectively. The CAC_auto system, in measuring the Agatston score, yielded ICCs of 0.99 for all the vessels (left main 0.91, left anterior descending 0.99, left circumflex 0.96, right coronary 0.99). The limits of agreement between CAC_auto and CAC_hand were 1.6 ± 52.2. The linearly weighted kappa value for the Agatston score categorization was 0.94. The main causes of false-positive results were image noise (29.1%, 97/333 lesions), aortic wall calcification (25.5%, 85/333 lesions), and pericardial calcification (24.3%, 81/333 lesions). Conclusion The atlas-based CAC_auto empowered by deep learning provided accurate calcium score measurement as compared with manual method and risk category classification, which could potentially streamline CAC imaging workflows.
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Affiliation(s)
- June Goo Lee
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - HeeSoo Kim
- Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Heejun Kang
- Divison of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyun Jung Koo
- Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon Won Kang
- Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Hak Kim
- Divison of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | - Dong Hyun Yang
- Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Lee NY, Kim NR, Kang JW, Kim G, Han MS, Jang JA, Ahn D, Jeong JH, Han MH, Nam EJ. Increased salivary syndecan-1 level is associated with salivary gland function and inflammation in patients with Sjögren's syndrome. Scand J Rheumatol 2021; 51:220-229. [PMID: 34212822 DOI: 10.1080/03009742.2021.1923162] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objectives: Syndecan-1 (SDC-1), a transmembrane heparin sulphate proteoglycan predominantly expressed on epithelial cells, also exists in a soluble form through ectodomain shedding. SDC-1 expression and shedding may be modulated in the inflammatory milieu of primary Sjögren's syndrome (SS). We investigated SDC-1 expression in minor salivary glands (MSGs) and analysed the association between salivary or plasma levels of SDC-1 and clinical parameters in SS.Method: We measured salivary and plasma SDC-1 levels via an enzyme-linked immunosorbent assay and assessed the salivary flow rates (SFRs) in 70 patients with SS and 35 healthy subjects. Disease activity indices, serological markers, salivary gland scintigraphy, and MSG biopsy were evaluated in patients with SS.Results: SDC-1 expression was upregulated on ductal epithelial cells in inflamed salivary glands. Salivary SDC-1 levels in patients significantly exceeded those in healthy subjects [median (interquartile range) 49.0 (20.7-79.1) vs 3.7 (1.7-6.3) ng/mL, p < 0.001] and inversely correlated with SFRs (r = -0.358, p = 0.032) and ejection fractions of the parotid (r = -0.363, p = 0.027) and submandibular (r = -0.485, p = 0.002) glands in salivary gland scintigraphy. Plasma SDC-1 levels were significantly correlated with the EULAR Sjögren's Syndrome Disease Activity Index (r = 0.507, p < 0.001) and EULAR Sjögren's Syndrome Patient Reported Index (r = 0.267, p = 0.033). Focus scores were correlated with salivary SDC-1 levels (r = 0.551, p = 0.004).Conclusion: Salivary and plasma SDC-1 levels may constitute potential biomarkers for salivary gland function and disease activity, respectively, in SS.
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Affiliation(s)
- N Y Lee
- Department of Laboratory Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Daegu, Republic of Korea
| | - N R Kim
- Division of Rheumatology, Department of Internal Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Daegu, Republic of Korea
| | - J W Kang
- Division of Rheumatology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Republic of Korea
| | - G Kim
- Division of Rheumatology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Republic of Korea.,Laboratory for Arthritis and Bone Biology, Fatima Research Institute, Daegu Fatima Hospital, Daegu, Republic of Korea
| | - M-S Han
- Laboratory for Arthritis and Bone Biology, Fatima Research Institute, Daegu Fatima Hospital, Daegu, Republic of Korea
| | - J A Jang
- Laboratory for Arthritis and Bone Biology, Fatima Research Institute, Daegu Fatima Hospital, Daegu, Republic of Korea
| | - D Ahn
- Department of Otolaryngology-Head and Neck Surgery, Kyungpook National University Hospital, School of Medicine, Daegu, Republic of Korea
| | - J H Jeong
- Department of Nuclear Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Daegu, Republic of Korea
| | - M-H Han
- Department of Pathology, Kyungpook National University Hospital, School of Medicine, Daegu, Republic of Korea
| | - E J Nam
- Division of Rheumatology, Department of Internal Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Daegu, Republic of Korea
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12
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Ahn Y, Koo HJ, Kang JW, Choi WJ, Kim DH, Song JM, Kang DH, Song JK, Kim JB, Jung SH, Choo SJ, Chung CH, Lee JW, Yang DH. Prognostic Implication of Right Ventricle Parameters Measured on Preoperative Cardiac MRI in Patients with Functional Tricuspid Regurgitation. Korean J Radiol 2021; 22:1253-1265. [PMID: 33938647 PMCID: PMC8316784 DOI: 10.3348/kjr.2020.1084] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 12/08/2020] [Accepted: 01/03/2021] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE To investigate the prognostic value of preoperative cardiac magnetic resonance imaging (MRI) for long-term major adverse cardiac and cerebrovascular events (MACCEs) in patients undergoing tricuspid valve (TV) surgery for functional tricuspid regurgitation (TR). MATERIALS AND METHODS The preoperative cardiac MR images, New York Heart Association functional class, comorbidities, and clinical events of 78 patients (median [interquartile range], 59 [51-66.3] years, 28.2% male) who underwent TV surgery for functional TR were comprehensively reviewed. Cox proportional hazards analyses were performed to assess the associations of clinical and imaging parameters with MACCEs and all-cause mortality. RESULTS For the median follow-up duration of 5.4 years (interquartile range, 1.2-6.6), MACCEs and all-cause mortality were 51.3% and 23.1%, respectively. The right ventricular (RV) end-systolic volume index (ESVI) and the systolic RV mass index (RVMI) were higher in patients with MACCEs than those without them (77 vs. 68 mL/m², p = 0.048; 23.5 vs. 18.0%, p = 0.011, respectively). A high RV ESVI was associated with all-cause mortality (hazard ratio [HR] per value of 10 higher ESVI = 1.10, p = 0.03). A high RVMI was also associated with all-cause mortality (HR per increase of 5 mL/m² RVMI = 1.75, p < 0.001). After adjusting for age and sex, only RVMI remained a significant predictor of MACCEs and all-cause mortality (p < 0.05 for both). After adjusting for multiple clinical variables, RVMI remained significantly associated with all-cause mortality (p = 0.005). CONCLUSION RVMI measured on preoperative cardiac MRI was an independent predictor of long-term outcomes in patients who underwent TV surgery for functional TR.
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Affiliation(s)
- Yura Ahn
- Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyun Jung Koo
- Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon Won Kang
- Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | - Won Jin Choi
- Department of Radiology, Busan Veterans Hospital, Busan, Korea
| | - Dae Hee Kim
- Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong Min Song
- Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Duk Hyun Kang
- Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Kwan Song
- Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon Bum Kim
- Department of Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Ho Jung
- Department of Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Suk Jung Choo
- Department of Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Cheol Hyun Chung
- Department of Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Won Lee
- Department of Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong Hyun Yang
- Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Kim W, Lim M, Jang YJ, Koo HJ, Kang JW, Jung SH, Yang DH. Novel Resectable Myocardial Model Using Hybrid Three-Dimensional Printing and Silicone Molding for Mock Myectomy for Apical Hypertrophic Cardiomyopathy. Korean J Radiol 2021; 22:1054-1065. [PMID: 33856135 PMCID: PMC8236372 DOI: 10.3348/kjr.2020.1164] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 09/25/2020] [Accepted: 12/01/2020] [Indexed: 12/30/2022] Open
Abstract
Objective We implemented a novel resectable myocardial model for mock myectomy using a hybrid method of three-dimensional (3D) printing and silicone molding for patients with apical hypertrophic cardiomyopathy (ApHCM). Materials and Methods From January 2019 through May 2020, 3D models from three patients with ApHCM were generated using the end-diastolic cardiac CT phase image. After computer-aided designing of measures to prevent structural deformation during silicone injection into molding, 3D printing was performed to reproduce anatomic details and molds for the left ventricular (LV) myocardial mass. We compared the myocardial thickness of each cardiac segment and the LV myocardial mass and cavity volumes between the myocardial model images and cardiac CT images. The surgeon performed mock surgery, and we compared the volume and weight of the resected silicone and myocardium. Results During the mock surgery, the surgeon could determine an ideal site for the incision and the optimal extent of myocardial resection. The mean differences in the measured myocardial thickness of the model (0.3, 1.0, 6.9, and 7.3 mm in the basal, midventricular, apical segments, and apex, respectively) and volume of the LV myocardial mass and chamber (36.9 mL and 14.8 mL, 2.9 mL and −9.4 mL, and 6.0 mL and −3.0 mL in basal, mid-ventricular and apical segments, respectively) were consistent with cardiac CT. The volume and weight of the resected silicone were similar to those of the resected myocardium (6 mL [6.2 g] of silicone and 5 mL [5.3 g] of the myocardium in patient 2; 12 mL [12.5 g] of silicone and 11.2 mL [11.8 g] of the myocardium in patient 3). Conclusion Our 3D model created using hybrid 3D printing and silicone molding may be useful for determining the extent of surgery and planning surgery guided by a rehearsal platform for ApHCM.
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Affiliation(s)
- Wooil Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | | | | | - Hyun Jung Koo
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Joon Won Kang
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Sung Ho Jung
- Department of Thoracic and Cardiovascular Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Dong Hyun Yang
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
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Jung SY, Yi YY, Kang JW. Once-Daily Extended-Release Levetiracetam Improves Medication Compliance in Adolescent Epilepsy Patients. Ann Child Neurol 2021. [DOI: 10.26815/acn.2020.00290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Cha SM, Kang JW, Shin HD, Ga IH. Acute Seymour fractures in children/adolescents overlooked as a simple nail injury: Reduction without pinning. Hand Surg Rehabil 2021; 40:171-176. [PMID: 33508522 DOI: 10.1016/j.hansur.2020.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 11/28/2020] [Accepted: 11/29/2020] [Indexed: 10/22/2022]
Abstract
We retrospectively report the outcomes of several cases in which acute Seymour fractures were treated by open reduction of displaced distal bony fragments with concurrent nail repair, following complete incision and drainage without K-wire fixation. Among 21 patients surgically treated between March 2004 and December 2018, the final 12 were evaluated after at least 2 years of follow-up. All children/adolescents presented more than 24 h after the injury. All injuries were unreduced in the emergency department, with typical features of skin disruption around the eponychium/perionychium. Reduction was maintained without a K-wire after repairing the bone-periosteum-nail bed-nail plate of the distal fragment and the corresponding physis-periosteum-germinal matrix-proximal nail-fold of the proximal stump. Dorsal angulation, finger length, postoperative pain on visual analog scale (VAS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, and active range of motion (ROM) were evaluated at the final follow-up. The mean patient age was 9.3 years (range, 3-13 years) and the mean time from injury to surgery was 35 h (range, 28-44 h). Only one child suffered a superficial infection; however, it resolved with 1 week of oral antibiotic treatment. At the final follow-up, mean dorsal angulation was 0.50° ± 1.24°; the length ratio compared with the corresponding contralateral phalanx was 98% (both, P > 0.05). The final pain on VAS, DASH score, and ROM ratio were 0.25 ± 0.45, 0.83 ± 1.34, and 99 ± 2%, respectively. Unreduced Seymour fractures presenting more than 24 h after the injury were treated by proper debridement and reduction of the fracture without the use of a K-wire. However, to determine whether the infection rate is definitively lower, this procedure should be compared with the conventional procedure using a K-wire. Level of Evidence: Therapeutic level IV.
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Affiliation(s)
- S M Cha
- Department of Orthopedic Surgery, Regional Rheumatoid and Degenerative Arthritis Center, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munhwa-ro, Daesa-dong, Jung-gu, Daejeon, South Korea
| | - J W Kang
- Department of Orthopedic Surgery, Korea University Ansan Hospital, 123 Jeokgeum-ro, Gojan-dong, Danwon-gu, Ansan-si, Gyeonggi-do, Korea
| | - H D Shin
- Department of Orthopedic Surgery, Regional Rheumatoid and Degenerative Arthritis Center, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munhwa-ro, Daesa-dong, Jung-gu, Daejeon, South Korea.
| | - I H Ga
- Department of Orthopedic Surgery, Regional Rheumatoid and Degenerative Arthritis Center, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munhwa-ro, Daesa-dong, Jung-gu, Daejeon, South Korea
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16
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Kwon HH, Lee JS, Park H, Shin J, Yin Y, Shin N, Shin HJ, Hwang JA, Kim DW, Kang JW. Vitamin E reduces spasms caused by prenatal stress by lowering calpain expression. Epilepsy Behav 2021; 114:107609. [PMID: 33257295 DOI: 10.1016/j.yebeh.2020.107609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/28/2020] [Accepted: 10/28/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Prenatal stress increases the susceptibility of infants to seizures and is known to be associated with oxidative stress. Recent studies suggest that vitamin E has beneficial effects in various neurological diseases due to its antioxidant properties. In this study, we investigated the relationship between prenatal stress and vitamin E treatment on N-methyl-D-aspartate (NMDA)-induced spasms. METHODS We used pregnant female Sprague Dawley rats and induced prenatal stress with an injection of betamethasone on G15. They were then treated orally with 200 mg/kg vitamin E or saline twice a day from G15-G21. On postnatal day 15, NMDA was administered to trigger spasms in offspring. The total number of spasms and latency to the first spasm were recorded. We also measured oxidative stress in the medial cortex using western blot, and calpain activity, thiobarbituric acid reactive substances (TBARS), glutathione (GSH)/GSH/glutathione disulfide (GSSG), superoxide dismutase (SOD) activity, catalase activity, and nitric oxide (NO) assays. RESULTS We observed that rats treated with vitamin E while exposed to prenatal stress demonstrated reduced total number and frequency of spasms. Expression of glutamate decarboxylase 67 (GAD67) and K+/Cl- co-transporter (KCC2) were reduced after prenatal stress; this recovered in the vitamin E treated group. Further, expression of calpain 2 was decreased and various markers of oxidative stress (malondialdehyde (MDA), GSH/GSSG, SOD, catalase, and NO) were reduced in the vitamin E treated group. CONCLUSIONS Our results provide evidence that vitamin E lowers oxidative stress and decreases seizure susceptibility in rat offspring exposed to prenatal stress. Given the well-known safety profile of vitamin E, these results indicate its potential as a strategy for preventing seizures.
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Affiliation(s)
- Hyeok Hee Kwon
- Department of Medical Science, School of Medicine, Chungnam National University, Daejeon, Republic of Korea; Department of Anatomy, School of Medicine, Chungnam National University, Daejeon, Republic of Korea; Department of Pediatrics, Chungnam National University Hospital, School of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Jin-Seok Lee
- Liver and Immunology Research Center, Oriental Medical College of Daejeon University, 22-5 Daehung-dong, Jung-gu, Daejeon 301-724, Republic of Korea
| | - Hyewon Park
- Department of Medical Science, School of Medicine, Chungnam National University, Daejeon, Republic of Korea; Department of Anatomy, School of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Juhee Shin
- Department of Medical Science, School of Medicine, Chungnam National University, Daejeon, Republic of Korea; Department of Anatomy, School of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Yuhua Yin
- Department of Medical Science, School of Medicine, Chungnam National University, Daejeon, Republic of Korea; Department of Anatomy, School of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Nara Shin
- Department of Medical Science, School of Medicine, Chungnam National University, Daejeon, Republic of Korea; Department of Anatomy, School of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Hyo Jung Shin
- Department of Medical Science, School of Medicine, Chungnam National University, Daejeon, Republic of Korea; Department of Anatomy, School of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Jeong-Ah Hwang
- Department of Medical Science, School of Medicine, Chungnam National University, Daejeon, Republic of Korea; Department of Anatomy, School of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Dong Woon Kim
- Department of Medical Science, School of Medicine, Chungnam National University, Daejeon, Republic of Korea; Department of Anatomy, School of Medicine, Chungnam National University, Daejeon, Republic of Korea.
| | - Joon Won Kang
- Department of Medical Science, School of Medicine, Chungnam National University, Daejeon, Republic of Korea; Department of Pediatrics, Chungnam National University Hospital, School of Medicine, Chungnam National University, Daejeon, Republic of Korea.
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Ahn Y, Koo HJ, Lee S, Kim DH, Song JM, Kang DH, Song JK, Kim HJ, Kim JB, Jung SH, Choo SJ, Chung CH, Lee JW, Kang JW, Yang DH. Preoperative Cardiac Computed Tomography Characteristics Associated with Recurrent Aortic Regurgitation after Aortic Valve Re-Implantation. Korean J Radiol 2020; 21:181-191. [PMID: 31997593 PMCID: PMC6992440 DOI: 10.3348/kjr.2019.0446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 09/25/2019] [Indexed: 12/30/2022] Open
Abstract
Objective To identify the preoperative cardiac computed tomography (CT) factors influencing postoperative recurrent aortic regurgitation (AR) in patients who underwent aortic valve repair with the re-implantation technique (David operation) due to AR. Materials and Methods A total of 117 patients (age, 49.4 ± 15.6 years; 83 males) who underwent the David operation for AR were included in this retrospective study. Aortic root profiles including the aortic regurgitant orifice area (ARO) and the aortic cusp asymmetry ratio of the areas (ASRarea), which is defined as the maximum/minimum areas among the three cusp areas at the level of the commissures, were measured on preoperative cardiac CT scans. Clinical and CT findings were compared between a group with recurrent AR grade < 3 (no, trivial, or mild AR) and recurrent ≥ 3 + AR. To determine the optimal cut-off values of ASR and ARO, the receiver operating characteristic (ROC) curve was used. Cox regression analysis was used for the analysis of the factors affecting recurrent 3 + AR. Results Postoperatively, recurrent 3 + AR developed in 17 (14.5%) patients and occurred within a median of 268 days (interquartile range: 78–582 days). The cut-off ARO value for discriminating the patients with recurrent 3 + AR was > 24 mm2 (sensitivity, 76.5%; specificity 64.8%), and the area under the ROC curve (AUC) was 0.72. For ASRarea, the cut-off value was > 1.58 (sensitivity, 76.5%; specificity, 58.0%) and the AUC was 0.64. Multivariable Cox regression showed that ARO > 24 mm2 (hazard ratio = 3.79, p = 0.020) was a potential independent parameter for recurrent 3 + AR. ROC for the linear regression model showed that the AUC for both ARO and ASRarea was 0.73 (95% confidence interval, 0.64–0.81, p < 0.001). Conclusion ARO and ASRarea detected on preoperative cardiac CT would be potentially helpful for identifying AR patients who may benefit from the David operation.
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Affiliation(s)
- Yura Ahn
- Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyun Jung Koo
- Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | - Sahmin Lee
- Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dae Hee Kim
- Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong Min Song
- Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Duk Hyun Kang
- Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Kwan Song
- Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ho Jin Kim
- Department of Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon Bum Kim
- Department of Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Ho Jung
- Department of Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Suk Jung Choo
- Department of Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Cheol Hyun Chung
- Department of Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Won Lee
- Department of Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon Won Kang
- Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong Hyun Yang
- Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Kim YS, Mahmood M, Kwon S, Maher K, Kang JW, Yeo WH. Wireless, Skin-Like Membrane Electronics With Multifunctional Ergonomic Sensors for Enhanced Pediatric Care. IEEE Trans Biomed Eng 2020; 67:2159-2165. [DOI: 10.1109/tbme.2019.2956048] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Lim SJ, Koo HJ, Jung SC, Kang DY, Ahn JM, Park DW, Park SJ, Yang DH, Kang JW. Sinus of Valsalva Thrombosis Detected on Computed Tomography after Transcatheter Aortic Valve Replacement. Korean Circ J 2020; 50:572-582. [PMID: 32281322 PMCID: PMC7321751 DOI: 10.4070/kcj.2019.0385] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 02/06/2020] [Accepted: 03/03/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Leaflet thrombosis after transcatheter aortic valve replacement (TAVR) has been reported recently, whereas thrombus formation in sinus of Valsalva has yet to be fully evaluated. This study describes clinical and cardiac computed tomography (CT) findings of patients with sinus of Valsalva thrombosis. METHODS Between March 2011 and Aug 2019, 192 patients underwent cardiac CT after TAVR. After a retrospective review of CT images, 9 patients (82 years, male:female=2:7) who had sinus of Valsalva thrombosis identified by cardiac CT were selected for this study. Patient demographics, interval between TAVR and cardiac CT scan, location and CT attenuation of sinus of Valsalva thrombosis, and presence of concurrent leaflet thrombosis were evaluated. RESULTS The median interval between TAVR and cardiac CT was 11 days. Sinus of Valsalva thrombosis was frequently detected in the non-coronary sinus (89%, 8/9), and predominantly located in the bottom of the sinus extending upward towards the sinotubular junction. Three patients had concomitant leaflet thrombosis, and 3 patients had subclinical embolic stroke noted on brain magnetic resonance imaging. All patients had been prescribed aspirin and clopidogrel after TAVR for at least 6 months without anticoagulants. CONCLUSIONS Cardiac CT after TAVR can detect sinus of Valsalva thrombosis, and attention should be paid to this potential source of subsequent systemic embolization.
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Affiliation(s)
- Su Jin Lim
- Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyun Jung Koo
- Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seung Chai Jung
- Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Do Yoon Kang
- Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jung Min Ahn
- Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Duk Woo Park
- Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seung Jung Park
- Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong Hyun Yang
- Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon Won Kang
- Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Park GM, Lee CH, Lee SW, Yun SC, Kim YH, Kim YG, Won KB, Ann SH, Kim SJ, Yang DH, Kang JW, Lim TH, Koh EH, Lee WJ, Kim MS, Park JY, Kim HK, Choe J, Lee SG. Impact of Diabetes Control on Subclinical Atherosclerosis: Analysis from Coronary Computed Tomographic Angiography Registry. Diabetes Metab J 2020; 44:470-479. [PMID: 31769239 PMCID: PMC7332335 DOI: 10.4093/dmj.2019.0073] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 08/07/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND There are limited data on the impact of diabetes control on the risk of subclinical coronary atherosclerosis. METHODS We analyzed 6,434 consecutive asymptomatic individuals without previous history of coronary artery disease who underwent coronary computed tomographic angiography (CCTA) (mean age, 53.7±7.6 years and 4,694 men [73.0%]). The degree and extent of subclinical coronary atherosclerosis were assessed by CCTA, and ≥50% diameter stenosis was defined as significant. A cardiac event was defined as a composite of all-cause death, myocardial infarction, unstable angina, or coronary revascularization. Study participants were categorized as normal (n=5,319), controlled diabetes (glycosylated hemoglobin [HbA1c] <7%, n=747), or uncontrolled diabetes (HbA1c ≥7%, n=368), respectively. RESULTS Compared with normal individuals, there were no statistically significant differences in the risk of for any atherosclerotic plaque (odds ratio [OR], 1.16; 95% confidence interval [CI], 0.98 to 1.38; P=0.086) and significant coronary artery stenosis (OR, 1.08; 95% CI, 0.82 to 1.42; P=0.583) in controlled diabetic individuals. In contrast, uncontrolled diabetic individuals had consistently higher risks of any atherosclerotic plaque (OR, 2.16; 95% CI, 1.70 to 2.75; P<0.001) and significant coronary artery stenosis (OR, 3.34; 95% CI, 2.52 to 4.43; P<0.001) than normal individuals. During a follow-up of median 5.4 years, there was no significant difference in cardiac events between normal and controlled diabetic individuals (P=0.365). However, uncontrolled diabetes was associated with an increased risk of cardiac events compared with normal individuals (P<0.001) and controlled diabetic individuals (P=0.023). CONCLUSION Asymptomatic uncontrolled diabetes was associated with significant subclinical coronary atherosclerosis with subsequent high risk for cardiac events.
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Affiliation(s)
- Gyung Min Park
- Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Chang Hoon Lee
- Department of Cardiology, Veterans Health Service Medical Center, Seoul, Korea
| | - Seung Whan Lee
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | - Sung Cheol Yun
- Department of Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Hak Kim
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yong Giun Kim
- Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Ki Bum Won
- Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Soe Hee Ann
- Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Shin Jae Kim
- Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Dong Hyun Yang
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon Won Kang
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae Hwan Lim
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Hee Koh
- Department of Endocrinology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo Je Lee
- Department of Endocrinology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Min Seon Kim
- Department of Endocrinology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joong Yeol Park
- Department of Endocrinology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hong Kyu Kim
- The Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jaewon Choe
- The Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang Gon Lee
- Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
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Koo HJ, Lee JG, Ko JY, Lee G, Kang JW, Kim YH, Yang DH. Automated Segmentation of Left Ventricular Myocardium on Cardiac Computed Tomography Using Deep Learning. Korean J Radiol 2020; 21:660-669. [PMID: 32410405 PMCID: PMC7231613 DOI: 10.3348/kjr.2019.0378] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 01/23/2020] [Accepted: 02/09/2020] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE To evaluate the accuracy of a deep learning-based automated segmentation of the left ventricle (LV) myocardium using cardiac CT. MATERIALS AND METHODS To develop a fully automated algorithm, 100 subjects with coronary artery disease were randomly selected as a development set (50 training / 20 validation / 30 internal test). An experienced cardiac radiologist generated the manual segmentation of the development set. The trained model was evaluated using 1000 validation set generated by an experienced technician. Visual assessment was performed to compare the manual and automatic segmentations. In a quantitative analysis, sensitivity and specificity were calculated according to the number of pixels where two three-dimensional masks of the manual and deep learning segmentations overlapped. Similarity indices, such as the Dice similarity coefficient (DSC), were used to evaluate the margin of each segmented masks. RESULTS The sensitivity and specificity of automated segmentation for each segment (1-16 segments) were high (85.5-100.0%). The DSC was 88.3 ± 6.2%. Among randomly selected 100 cases, all manual segmentation and deep learning masks for visual analysis were classified as very accurate to mostly accurate and there were no inaccurate cases (manual vs. deep learning: very accurate, 31 vs. 53; accurate, 64 vs. 39; mostly accurate, 15 vs. 8). The number of very accurate cases for deep learning masks was greater than that for manually segmented masks. CONCLUSION We present deep learning-based automatic segmentation of the LV myocardium and the results are comparable to manual segmentation data with high sensitivity, specificity, and high similarity scores.
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Affiliation(s)
- Hyun Jung Koo
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - June Goo Lee
- Biomedical Engineering Research Center, Asan Institute of Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Yeon Ko
- Biomedical Engineering Research Center, Asan Institute of Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Gaeun Lee
- Biomedical Engineering Research Center, Asan Institute of Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon Won Kang
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Hak Kim
- Division of Cardiology, Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong Hyun Yang
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Kang BS, Woo YS, Lee J, Yi YY, Koo BS, Kang JW. Treatment Outcomes of Vagus Nerve Stimulation in Lennox-Gastaut Syndrome. Ann Child Neurol 2019. [DOI: 10.26815/acn.2019.00108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Kwon HH, Neupane C, Shin J, Gwon DH, Yin Y, Shin N, Shin HJ, Hong J, Park JB, Yi Y, Kim DW, Kang JW. Calpain 2 contributes prenatal stress-induced epileptic spasms in the infant rat. IBRO Rep 2019. [DOI: 10.1016/j.ibror.2019.07.301] [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: 11/26/2022] Open
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25
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Kwon HH, Neupane C, Shin J, Gwon DH, Yin Y, Shin N, Shin HJ, Hong J, Park JB, Yi Y, Kim DW, Kang JW. Calpain-2 as a Treatment Target in Prenatal Stress-induced Epileptic Spasms in Infant Rats. Exp Neurobiol 2019; 28:529-536. [PMID: 31495081 PMCID: PMC6751866 DOI: 10.5607/en.2019.28.4.529] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 05/21/2019] [Accepted: 07/08/2019] [Indexed: 12/23/2022] Open
Abstract
Stress can induce a serious epileptic encephalopathy that occurs during early infancy. Recent studies have revealed that prenatal stress exposure is a risk factor for the development of infantile spasms. Our previous work demonstrates that prenatal stress with betamethasone-induced alterations to the expression of the K+/Cl- co-transporter (KCC2) in gamma-aminobutyric acid (GABA) interneurons lowers the seizure threshold in exposed animals. Here, we further investigated the mechanisms involved in this KCC2 dysfunction and explored possible treatment options. We stressed Sprague-Dawley rats prenatally and further treated dams with betamethasone on gestational day 15, which increases seizure susceptibility and NMDA (N-Methyl-D-aspartate)-triggered spasms on postnatal day 15. In this animal model, first, we evaluated baseline calpain activity. Second, we examined the cleavage and dephosphorylation of KCC2. Finally, we checked the effect of a calpain inhibitor on seizure occurrence. The phosphorylated-N-methyl-Daspartate Receptor 2B (NR2B):non-phosphorylated NR2B ratio was found to be higher in the cortex of the prenatally stressed betamethasone model. We further found that the betamethasone model exhibited increased phosphorylation of calpain-2 and decreased phosphorylation of KCC2 and Glutamic acid decarboxylase 67 (GAD67). After using a calpain inhibitor in prenatal-stress rats, the seizure frequency decreased, while latency increased. GABAergic depolarization was further normalized in prenatal-stress rats treated with the calpain inhibitor. Our study suggests that calpain-dependent cleavage and dephosphorylation of KCC2 decreased the seizure threshold of rats under prenatal stress. Calpain-2 functions might, thus, be targeted in the future for the development of treatments for epileptic spasms.
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Affiliation(s)
- Hyeok Hee Kwon
- Department of Medical Science, Chungnam National University, Daejeon 35015, Korea.,Department of Anatomy, School of Medicine, Chungnam National University, Daejeon 35015, Korea.,Department of Pediatrics, Chungnam National University Hospital, Daejeon 35015, Korea
| | - Chiranjivi Neupane
- Department of Medical Science, Chungnam National University, Daejeon 35015, Korea.,Department of Physiology, School of Medicine, Chungnam National University, Daejeon 35015, Korea
| | - Juhee Shin
- Department of Medical Science, Chungnam National University, Daejeon 35015, Korea.,Department of Anatomy, School of Medicine, Chungnam National University, Daejeon 35015, Korea
| | - Do Hyeong Gwon
- Department of Medical Science, Chungnam National University, Daejeon 35015, Korea.,Department of Anatomy, School of Medicine, Chungnam National University, Daejeon 35015, Korea
| | - Yuhua Yin
- Department of Medical Science, Chungnam National University, Daejeon 35015, Korea.,Department of Anatomy, School of Medicine, Chungnam National University, Daejeon 35015, Korea
| | - Nara Shin
- Department of Medical Science, Chungnam National University, Daejeon 35015, Korea.,Department of Anatomy, School of Medicine, Chungnam National University, Daejeon 35015, Korea
| | - Hyo Jung Shin
- Department of Medical Science, Chungnam National University, Daejeon 35015, Korea.,Department of Anatomy, School of Medicine, Chungnam National University, Daejeon 35015, Korea.,Brain Research Institute, School of Medicine, Chungnam National University, Daejeon 35015, Korea
| | - Jinpyo Hong
- Department of Anatomy, School of Medicine, Chungnam National University, Daejeon 35015, Korea.,Brain Research Institute, School of Medicine, Chungnam National University, Daejeon 35015, Korea
| | - Jin Bong Park
- Department of Medical Science, Chungnam National University, Daejeon 35015, Korea.,Brain Research Institute, School of Medicine, Chungnam National University, Daejeon 35015, Korea.,Department of Physiology, School of Medicine, Chungnam National University, Daejeon 35015, Korea
| | - YoonYoung Yi
- Department of Pediatrics, Chungnam National University Hospital, Daejeon 35015, Korea
| | - Dong Woon Kim
- Department of Medical Science, Chungnam National University, Daejeon 35015, Korea.,Department of Anatomy, School of Medicine, Chungnam National University, Daejeon 35015, Korea.,Brain Research Institute, School of Medicine, Chungnam National University, Daejeon 35015, Korea
| | - Joon Won Kang
- Department of Medical Science, Chungnam National University, Daejeon 35015, Korea.,Brain Research Institute, School of Medicine, Chungnam National University, Daejeon 35015, Korea.,Department of Pediatrics, Chungnam National University Hospital, Daejeon 35015, Korea
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Shin J, Yin Y, Kim DK, Lee SY, Lee W, Kang JW, Kim DW, Hong J. Foxp3 plasmid-encapsulated PLGA nanoparticles attenuate pain behavior in rats with spinal nerve ligation. Nanomedicine: Nanotechnology, Biology and Medicine 2019; 18:90-100. [DOI: 10.1016/j.nano.2019.02.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 02/11/2019] [Accepted: 02/24/2019] [Indexed: 11/29/2022]
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Wang S, Guo ZP, Zhang XP, Zhang A, Kang JW. On the mechanism of dendritic fragmentation by ultrasound induced cavitation. Ultrason Sonochem 2019; 51:160-165. [PMID: 30389407 DOI: 10.1016/j.ultsonch.2018.10.031] [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] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 10/14/2018] [Accepted: 10/24/2018] [Indexed: 06/08/2023]
Abstract
A dedicated solidification device and high speed camera were used to capture dendritic fragmentation of pure succinonitrile (SCN) induced by oscillating ultrasonic bubbles. Theoretical analysis of the melting behavior of the dendrite was performed based on local solidification thermodynamics. The dendritic growth or the evolution of the solid-liquid interface is closely related to both thermodynamics of the cavitation bubble and the local geometry of the dendrite. Accordingly, for the first time, a dimensionless scaling formulation was developed by fitting both theoretical and experimental data to determine the variational pressure exerted by the cavitation bubble.
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Affiliation(s)
- S Wang
- School of Materials Science and Engineering, Tsinghua University, Beijing, China
| | - Z P Guo
- School of Materials Science and Engineering, Tsinghua University, Beijing, China.
| | - X P Zhang
- School of Materials Science and Engineering, Tsinghua University, Beijing, China
| | - A Zhang
- School of Materials Science and Engineering, Tsinghua University, Beijing, China
| | - J W Kang
- School of Materials Science and Engineering, Tsinghua University, Beijing, China; Key Laboratory for Advanced Materials Processing Technology, Ministry of Education, China.
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Kim MH, Lee YJ, Kim JY, Yi YY, Kang JW. Tuberous Sclerosis Complex with Crohn’s Disease. Child Neurol 2018. [DOI: 10.26815/jkcns.2018.26.4.284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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29
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Kang JW, Eom S, Hong W, Kwon HE, Park S, Ko A, Kang HC, Lee JS, Lee YM, Kim DS, Kim HD. Long-term Outcome of Resective Epilepsy Surgery in Patients With Lennox-Gastaut Syndrome. Pediatrics 2018; 142:peds.2018-0449. [PMID: 30194277 DOI: 10.1542/peds.2018-0449] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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] [Accepted: 07/06/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE We aimed to evaluate the long-term outcome of resective epilepsy surgery in patients with Lennox-Gastaut syndrome (LGS). METHODS We reviewed the case reports of 90 patients with LGS who had undergone resective surgery between 2003 and 2014 at the Severance Children's Hospital and managed them for a minimum period of 2 years. RESULTS At the time of surgery, the patients were between 3.0 and 23.5 years old (mean ± SD: 9.3 ± 4.4). The time from seizure onset to surgery ranged from 0.7 to 20.1 years (7.2 ± 4.3). On postoperative follow-up for an average period of 6.1 ± 2.2 years (range: 2.1-11.4 years), 45 patients (50.0%) had no seizures, and 15 (16.7%) reported infrequent seizures. Seizure-free outcomes were achieved in 15 of the 21 (71.4%) hemispherectomies, 23 of the 51 (45.1%) multilobar resections, and 7 of the 18 (38.9%) single lobar resections. On high-resolution MRIs, 20 patients (22.2%) had negative findings, 8 of whom (40.0%) became seizure-free after resective surgery. Malformation of cortical development was the most common pathologic finding and was noted in 57 patients (63.3%). Seizure-free patients achieved better adaptive behavior and social competence than did patients with persistent seizures at the second (2-3 years after surgery) and third (4-6 years after surgery) follow-ups, as indicated by social quotients (P < .05). CONCLUSIONS Resective surgery is a viable option in some patients to treat seizures that are associated with LGS, with a high probability of seizure control and better adaptive function.
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Affiliation(s)
- Joon Won Kang
- Departments of Pediatrics and Medical Science, Chungnam National University Hospital and College of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Soyong Eom
- Epilepsy Research Institute, College of Medicine
| | - William Hong
- Section of Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Hye Eun Kwon
- Department of Pediatrics, International St Mary's Hospital and College of Medicine, Catholic Kwandong University, Incheon, Republic of Korea; and
| | - Soyoung Park
- Department of Pediatrics, Soon Chun Hyang University Hospital and College of Medicine, Soonchunhyang University, Bucheon, Republic of Korea
| | - Ara Ko
- Epilepsy Research Institute, College of Medicine.,Pediatric Epilepsy Clinics, Division of Pediatric Neurology, Department of Pediatrics, Severance Children's Hospital
| | - Hoon-Chul Kang
- Epilepsy Research Institute, College of Medicine.,Pediatric Epilepsy Clinics, Division of Pediatric Neurology, Department of Pediatrics, Severance Children's Hospital
| | - Joon Soo Lee
- Epilepsy Research Institute, College of Medicine.,Pediatric Epilepsy Clinics, Division of Pediatric Neurology, Department of Pediatrics, Severance Children's Hospital
| | - Young-Mock Lee
- Department of Pediatrics, Gangnam Severance Hospital, and
| | - Dong Seok Kim
- Division of Pediatric Neurosurgery, Severance Hospital, Yonsei University, Seoul, Republic of Korea
| | - Heung Dong Kim
- Epilepsy Research Institute, College of Medicine, .,Pediatric Epilepsy Clinics, Division of Pediatric Neurology, Department of Pediatrics, Severance Children's Hospital
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Kang BS, Lee J, Choi JH, Kwon HH, Kang JW. Clinical manifestations of headache in children younger than 7 years. Korean J Pediatr 2018; 61:355-361. [PMID: 30304907 PMCID: PMC6258963 DOI: 10.3345/kjp.2018.06331] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 07/16/2018] [Indexed: 11/27/2022]
Abstract
PURPOSE Headache is a common symptom during childhood. It is usually persistent and requires special care. This study aimed to identify the characteristics of headache in children <7 years of age. METHODS We reviewed 3 years of clinical files on children <7 years of age with a chief complaint of headache. RESULTS This study included 146 children (66 males, 80 females; mean age, 5.5±1.0 years). Mean symptom duration was 5.8±7.9 months. Attack durations were longer than 2 hours in 31 patients, shorter than 2 hours in 70 patients, and unchecked in 45 patients. Attack frequency was 15.1±10.6 times per month. Pain locations and characteristics were also variable. Mean pain severity score was 5.1±2.2 on the visual analog scale. Of 38 patients who underwent electroencephalography, 9 showed positive findings. Of 41 who underwent brain magnetic resonance imaging, 20 showed positive findings. The diagnoses were migraine (including probable migraine) in 34, tension-type headache in 5, and congenital malformations in 3. Medications were used in 29 patients: acetaminophen in 17, ibuprofen in 8, naproxen sodium in 1, and topiramate or amitriptyline in 3. CONCLUSION In children aged <7 years, headache has a relatively benign course, but detailed history taking is needed for more accurate diagnosis.
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Affiliation(s)
- Bu Seon Kang
- Department of Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Jinsun Lee
- Department of Pediatrics, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea
| | - Jin Hyuk Choi
- Department of Pediatrics, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea
| | - Hyeok Hee Kwon
- Department of Medical Science, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Joon Won Kang
- Department of Pediatrics, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea.,Department of Medical Science, College of Medicine, Chungnam National University, Daejeon, Korea.,Brain Research Institute, Chungnam National University School of Medicine, Daejeon, Korea
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Lee JY, Lee PH, Lee SW, Lee WJ, Kang JW, Shin MJ. Assessment of Tissue Perfusion with Blood Oxygenation Level-Dependent Magnetic Resonance Imaging in Critical Limb Ischemia. Korean Circ J 2018; 48:658-660. [PMID: 29968440 PMCID: PMC6031722 DOI: 10.4070/kcj.2018.0019] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 03/25/2018] [Accepted: 04/18/2018] [Indexed: 12/01/2022] Open
Affiliation(s)
- Joo Yeon Lee
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Pil Hyung Lee
- Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | - Seung Whan Lee
- Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo Je Lee
- Division of Endocrinology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon Won Kang
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Myung Jin Shin
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Choi JH, Lee T, Kwon HH, You SK, Kang JW. Outcome of ultrasonographic imaging in infants with sacral dimple. Korean J Pediatr 2018; 61:194-199. [PMID: 29963103 PMCID: PMC6021363 DOI: 10.3345/kjp.2018.61.6.194] [Citation(s) in RCA: 7] [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] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 10/25/2017] [Accepted: 10/31/2017] [Indexed: 11/27/2022]
Abstract
Purpose Sacral dimples are a common cutaneous anomaly in infants. Spine ultrasonography (USG) is an effective and safe screening tool for patients with a sacral dimple. The aim of this study was to determine the clinical manifestations in patients with an isolated sacral dimple and to review the management of spinal cord abnormalities identified with USG. Methods We reviewed clinical records and collected data on admissions for a sacral dimple from March 2014 through February 2017 that were evaluated with spine USG by a pediatric radiologist. During the same period, patients who were admitted for other complaints, but were found to have a sacral dimple were also included. Results This study included 230 infants under 6-months-old (130 males and 100 females; mean age 52.8±42.6 days). Thirty-one infants with a sacral dimple had an echogenic filum terminale, and 57 children had a filar cyst. Twenty-seven patients had a low-lying spinal cord, and only one patient was suspected of having a tethered cord. Follow-up spine USG was performed in 28 patients, which showed normalization or insignificant change. Conclusion In this study, all but one infant with a sacral dimple had benign imaging findings. USG can be recommended in infants with a sacral dimple for its convenience and safety.
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Affiliation(s)
- Jin Hyuk Choi
- Department of Pediatrics, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea
| | - Taekwan Lee
- Department of Pediatrics, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea
| | - Hyeok Hee Kwon
- Department of Medical Science, Chungnam National University School of Medicine, Daejeon, Korea
| | - Sun Kyoung You
- Department of Radiology, Chungnam National University Hospital, Daejeon, Korea
| | - Joon Won Kang
- Department of Pediatrics, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea.,Department of Medical Science, Chungnam National University School of Medicine, Daejeon, Korea.,Brain Research Institute, Chungnam National University School of Medicine, Daejeon, Korea
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Kwon HH, Lee T, Hong J, Kim DW, Kang JW. Long-term prenatal stress increases susceptibility of N-methyl-D-aspartic acid-induced spasms in infant rats. Korean J Pediatr 2018; 61:150-155. [PMID: 29853939 PMCID: PMC5976564 DOI: 10.3345/kjp.2018.61.5.150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 10/29/2017] [Accepted: 11/09/2017] [Indexed: 11/27/2022]
Abstract
Purpose Infantile spasms, also known as West syndrome, is an age-specific epileptic seizure. Most patients with this condition also exhibit delayed development. This study aimed to determine the effect of long-term prenatal stress on susceptibility to infantile spasms. Methods We subjected pregnant rats to acute or chronic immobilization stress. Resulting offspring received N-methyl-D-aspartic acid (15 mg/kg, intraperitoneally) on postnatal day 15, and their behaviors were observed 75 minutes after injection. The expression of KCC2 and GAD67 was also determined using immunohistochemistry. Results Exposure to long-term prenatal stress increased the frequency of spasms and decreased the latency to onset of spasms compared with offspring exposed to short-term prenatal stress. Expression of KCC2 and GAD67 also decreased in the group exposed to long-term prenatal stress compared with the group exposed to short-term prenatal stress. Conclusion Our study suggests that exposure to long-term prenatal stress results in increased susceptibility to seizures.
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Affiliation(s)
- Hyeok Hee Kwon
- Department of Medical Science, College of Medicine, Chungnam National University, Daejeon, Korea.,Department of Anatomy, College of Medicine, Chungnam National University, Daejeon, Korea.,Department of Pediatrics, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea
| | - Taekwan Lee
- Department of Pediatrics, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea
| | - Jinpyo Hong
- Department of Anatomy, College of Medicine, Chungnam National University, Daejeon, Korea.,Brain Research Institute, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Dong Woon Kim
- Department of Medical Science, College of Medicine, Chungnam National University, Daejeon, Korea.,Department of Anatomy, College of Medicine, Chungnam National University, Daejeon, Korea.,Brain Research Institute, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Joon Won Kang
- Department of Medical Science, College of Medicine, Chungnam National University, Daejeon, Korea.,Department of Pediatrics, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea.,Brain Research Institute, College of Medicine, Chungnam National University, Daejeon, Korea
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Shin JY, Choi SR, Jeon JH, Kang JW, Heo J. Temporary Haptic Externalization and Four-point Fixation of Intraocular Lens in Scleral Fixation to Enhance Stability. Korean J Ophthalmol 2018; 32:23-28. [PMID: 29376226 PMCID: PMC5801086 DOI: 10.3341/kjo.2017.0038] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 05/02/2017] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To report the results of a new technique for intraocular lens scleral fixation of temporary haptic externalization and four-point fixation for enhanced stability. METHODS Two 10-0 polypropylene strands were fixed at two points 2 mm apart on each haptic of a conventional three-piece intraocular lens, using our previously reported method of temporary haptic externalization after injector implantation. Postoperative refractive outcome and stability were evaluated. RESULTS Although the intraocular lens was fixed at a total of four points, no intraoperative difficulties were observed during the process. Patients showed successful fixation of the intraocular lens postoperatively. The fixed intraocular lens showed good centering and minimal tilting. When compared to the two-point fixation technique, postoperative astigmatism was significantly smaller in the four-point fixation group (1.80 ± 0.84 vs. 1.00 ± 0.0.50, p = 0.033). Lens-induced astigmatism calculated from subtraction of corneal astigmatism from total astigmatism was also significantly smaller in the four-point fixation group (2.23 ± 0.98 vs.1.17 ± 0.0.70, p = 0.043). No postoperative complications were identified during a mean follow-up period of 14.8 months (range, 10 to 19 months). CONCLUSIONS By fixing the intraocular lens at two points on each side of the haptics, this method minimizes the tilting of the intraocular lens and thus decreases postoperative lens-induced astigmatism. Also, the possibility of intraocular lens dislocation in the long term might be decreased by this two-point fixation technique.
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Affiliation(s)
- Joo Young Shin
- Department of Ophthalmology, VHS Medical Center, Seoul, Korea
| | - Se Rang Choi
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Hoon Jeon
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Joon Won Kang
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jangwon Heo
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
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Song CW, Kang JW, Kim JY. Different Clinical Features and Lower Scores in Clinical Scoring Systems for Appendicitis in Preschool Children: Comparison with School Age Onset. Pediatr Gastroenterol Hepatol Nutr 2018; 21:51-58. [PMID: 29383305 PMCID: PMC5788951 DOI: 10.5223/pghn.2018.21.1.51] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 10/20/2017] [Accepted: 10/23/2017] [Indexed: 01/07/2023] Open
Abstract
PURPOSE To clarify the clinical features of appendicitis in preschool children and to explore clinical appendicitis scoring systems in this age group. METHODS We retrospectively collected data on 142 children, aged 10 years or younger, with confirmed diagnosis of appendicitis based on surgical and pathologic findings. Enrolled subjects were divided into two groups: Group 1 (preschool children aged ≤5 years, n=41) and Group 2 (school children aged >5 to ≤10 years, n=101). Data analyzed included clinical presentation, laboratory findings, the pediatric appendicitis score (PAS), and the modified Alvarado score (MAS). RESULTS The most common presenting symptom was abdominal pain in both groups (92.7% vs. 97.0%). Other presenting symptoms were as follows: fever (65.9%), vomiting (68.3%), right lower quadrant (RLQ) localization (24.4%), anorexia (14.6%), and diarrhea (7.3%) in Group 1, and RLQ localization (74.3%), vomiting (71.3%), anorexia (52.5%), fever (47.5%), and diarrhea (11.9%) in Group 2. Perforation and abscess occurred more frequently in Group 1 than in Group 2 (43.9% vs. 12.9%, p<0.001; 34.1% vs. 5.0%, p<0.001; respectively). PAS and MAS were lower in Group 1 than in Group 2 (4.09±1.97 vs. 6.91±1.61, p=0.048; 4.65±1.79 vs. 6.51±1.39, p=0.012; respectively). CONCLUSION In preschool children, appendicitis often presents with atypical features, more rapid progression, and higher incidence of complications. This age group is more likely to have lower PAS and MAS than those of school children.
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Affiliation(s)
- Chun Woo Song
- Department of Pediatrics, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea
| | - Joon Won Kang
- Department of Pediatrics, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea
| | - Jae Young Kim
- Department of Pediatrics, Gyeongsang National University Changwon Hospital, Changwon, Korea
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Kim SW, Jun JW, Giri SS, Chi C, Yun S, Kim HJ, Kim SG, Kang JW, Park SC. First report of carp oedema virus infection of koi (Cyprinus carpio haematopterus) in the Republic of Korea. Transbound Emerg Dis 2017; 65:315-320. [PMID: 29226602 DOI: 10.1111/tbed.12782] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Indexed: 11/29/2022]
Abstract
Twenty-five koi (Cyprinus carpio haematopterus) bought from a wholesale fish market in Korea, showed lethargic behaviour and 100% mortality within 20 days. Carp oedema virus (CEV) was detected by PCR in all 25 koi. Results of detailed histopathological and clinical examinations of 17 koi indicated loss of body balance, severe infiltration of inflammatory cells into the inter-lamellar spaces of the gills and vacuolization and inclusion bodies in gill epithelial cells. Sequence analysis of PCR products of these koi showed up to 99% identity to the previously reported sequences, suggesting that the observed mass mortality resulted from koi sleepy disease (KSD) due to CEV infection. To the best of our knowledge, this study is the first report of KSD in the Republic of Korea. Partial sequences of 4a protein from the virus indicated that the present CEV detected in koi from Korea is more closely related to that from the UK and Poland than from Japan. The present findings indicate that the prevalence and spread of KSD must be closely monitored in both European and Asian countries to avoid potential economic losses to the global koi industry.
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Affiliation(s)
- S W Kim
- Laboratory of Aquatic Biomedicine, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, Korea
| | - J W Jun
- Laboratory of Aquatic Biomedicine, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, Korea
| | - S S Giri
- Laboratory of Aquatic Biomedicine, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, Korea
| | - C Chi
- Laboratory of Aquatic Biomedicine, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, Korea
| | - S Yun
- Laboratory of Aquatic Biomedicine, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, Korea
| | - H J Kim
- Laboratory of Aquatic Biomedicine, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, Korea
| | - S G Kim
- Laboratory of Aquatic Biomedicine, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, Korea
| | - J W Kang
- Laboratory of Aquatic Biomedicine, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, Korea
| | - S C Park
- Laboratory of Aquatic Biomedicine, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, Korea
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Baek H, Shin HJ, Kim JJ, Shin N, Kim S, Yi MH, Zhang E, Hong J, Kang JW, Kim Y, Kim CS, Kim DW. Primary cilia modulate TLR4-mediated inflammatory responses in hippocampal neurons. J Neuroinflammation 2017; 14:189. [PMID: 28927423 PMCID: PMC5606072 DOI: 10.1186/s12974-017-0958-7] [Citation(s) in RCA: 21] [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: 11/09/2016] [Accepted: 09/03/2017] [Indexed: 12/15/2022] Open
Abstract
Background The primary cilium is an organelle that can act as a master regulator of cellular signaling. Despite the presence of primary cilia in hippocampal neurons, their function is not fully understood. Recent studies have demonstrated that the primary cilium influences interleukin (IL)-1β-induced NF-κB signaling, ultimately mediating the inflammatory response. We, therefore, investigated ciliary function and NF-κB signaling in lipopolysaccharide (LPS)-induced neuroinflammation in conjunction with ciliary length analysis. Methods Since TLR4/NF-κB signaling is a well-known inflammatory pathway, we measured ciliary length and inflammatory mediators in wild type (WT) and TLR4−/− mice injected with LPS. Next, to exclude the effects of microglial TLR4, we examined the ciliary length, ciliary components, inflammatory cytokine, and mediators in HT22 hippocampal neuronal cells. Results Primary ciliary length decreased in hippocampal pyramidal neurons after intracerebroventricular injection of LPS in WT mice, whereas it increased in TLR4−/− mice. LPS treatment decreased primary ciliary length, activated NF-κB signaling, and increased Cox2 and iNOS levels in HT22 hippocampal neurons. In contrast, silencing Kif3a, a key protein component of cilia, increased ARL13B ciliary protein levels and suppressed NF-κB signaling and expression of inflammatory mediators. Conclusions These data suggest that LPS-induced NF-κB signaling and inflammatory mediator expression are modulated by cilia and that the blockade of primary cilium formation by Kif3a siRNA regulates TLR4-induced NF-κB signaling. We propose that primary cilia are critical for regulating NF-κB signaling events in neuroinflammation and in the innate immune response. Electronic supplementary material The online version of this article (10.1186/s12974-017-0958-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hyunjung Baek
- Department of Anatomy, Department of Medical Science, Brain Research Institute, Chungnam National University School of Medicine, Daejeon, 35015, Republic of Korea.,Department of Pediatrics, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, 35015, Republic of Korea
| | - Hyo Jung Shin
- Department of Anatomy, Department of Medical Science, Brain Research Institute, Chungnam National University School of Medicine, Daejeon, 35015, Republic of Korea
| | - Jwa-Jin Kim
- Department of Anatomy, Department of Medical Science, Brain Research Institute, Chungnam National University School of Medicine, Daejeon, 35015, Republic of Korea.,LES Corporation Inc., Gung-Dong 465-16, Yuseong-Gu, Daejeon, 305-335, Republic of Korea
| | - Nara Shin
- Department of Anatomy, Department of Medical Science, Brain Research Institute, Chungnam National University School of Medicine, Daejeon, 35015, Republic of Korea.,Department of Anesthesia and Pain Medicine, Chungnam National University Hospital, Daejeon, 35015, Republic of Korea
| | - Sena Kim
- Department of Anatomy, Department of Medical Science, Brain Research Institute, Chungnam National University School of Medicine, Daejeon, 35015, Republic of Korea.,Department of Plastic Surgery, Chungnam National University Hospital, Daejeon, 35015, Republic of Korea
| | - Min-Hee Yi
- Department of Anatomy, Department of Medical Science, Brain Research Institute, Chungnam National University School of Medicine, Daejeon, 35015, Republic of Korea.,Department of Neuroscience and Cell Biology, The University of Texas Medical Branch School of Medicine, 301 University Boulevard, Galveston, TX, 77555, USA
| | - Enji Zhang
- Department of Anatomy, Department of Medical Science, Brain Research Institute, Chungnam National University School of Medicine, Daejeon, 35015, Republic of Korea.,Department of Anesthesia Medicine, Yanbian University Hospital, Yanbian, 133000, China
| | - Jinpyo Hong
- Department of Anatomy, Department of Medical Science, Brain Research Institute, Chungnam National University School of Medicine, Daejeon, 35015, Republic of Korea
| | - Joon Won Kang
- Department of Pediatrics, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, 35015, Republic of Korea
| | - Yonghyun Kim
- Department of Chemical and Biological Engineering, The University of Alabama, Tuscaloosa, AL, 35487, USA
| | - Cuk-Seong Kim
- Department of Physiology, Department of Medical Science, Chungnam National University School of Medicine, Daejeon, 35015, Republic of Korea.
| | - Dong Woon Kim
- Department of Anatomy, Department of Medical Science, Brain Research Institute, Chungnam National University School of Medicine, Daejeon, 35015, Republic of Korea.
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Kang JW, Seo JH, Youn KW, Seo YI, Huh K, Choi GR, Min HK, Oh DJ, Jo HJ, Kim JN. Use of supplemental anti-HBc testing of donors showing non-discriminating reactive results in multiplex nucleic acid testing. Vox Sang 2017; 112:622-627. [PMID: 28891069 DOI: 10.1111/vox.12553] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 06/19/2017] [Accepted: 06/22/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVES The Korean Red Cross began nucleic acid amplification testing (NAT) for HIV and HCV in February 2005, and added HBV NAT beginning in June 2012. The current NAT system utilizes a multiplex assay for simultaneous detection of HBV DNA, HCV RNA and HIV-1 RNA. For samples that are reactive in the multiplex assay, we do specific tests for each virus. However, there have been cases of non-discriminated reactive (NDR) results which appear to be the result of non-specific reactions or cross-contamination, although some cases are considered to arise from the presence of low levels of HBV DNA due to occult hepatitis B infection. MATERIALS AND METHODS We examined the incidence of NDR results in previous donations of some NAT-reactive donors. Additionally, for those donors with NDR results, we performed an HBV core antibody (anti-HBc) assay. RESULTS From November 2015 to March 2016, there were 408 NAT-reactive donors. Of these, nineteen HBV NAT-reactive donors showed a history of NDR results in the past donations. Seven donors showed NDR results more than once. Of 771 NDR donors, 362 (47·0%) were anti-HBc reactive. CONCLUSION The NDR donors had a substantially higher rate of anti-HBc reactivity than other blood donors indicating that some with anti-HBc reactivity represent donors with occult HBV. Therefore, the incorporation of an anti-HBc testing for NDR donors could improve blood safety testing for the Korean Red Cross.
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Affiliation(s)
- J W Kang
- Blood Transfusion Research Institute, Korean Red Cross, Wonju, Korea
| | - J H Seo
- Blood Transfusion Research Institute, Korean Red Cross, Wonju, Korea
| | - K W Youn
- Blood Transfusion Research Institute, Korean Red Cross, Wonju, Korea
| | - Y I Seo
- Blood Transfusion Research Institute, Korean Red Cross, Wonju, Korea
| | - K Huh
- Blood Transfusion Research Institute, Korean Red Cross, Wonju, Korea
| | - G R Choi
- Blood Service Headquarter, Korean Red Cross, Wonju, Korea
| | - H K Min
- Blood Service Headquarter, Korean Red Cross, Wonju, Korea
| | - D J Oh
- Blood Service Headquarter, Korean Red Cross, Wonju, Korea
| | - H J Jo
- Division of Human Blood Safety Surveillance, Korea Center for Disease Control and Prevention, Osong, Korea
| | - J N Kim
- Division of Human Blood Safety Surveillance, Korea Center for Disease Control and Prevention, Osong, Korea
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Baek H, Yi MH, Pandit S, Park JB, Kwon HH, Zhang E, Kim S, Shin N, Kim E, Lee YH, Kim Y, Kim DW, Kang JW. Altered expression of KCC2 in GABAergic interneuron contributes prenatal stress-induced epileptic spasms in infant rat. Neurochem Int 2016; 97:57-64. [PMID: 27180051 DOI: 10.1016/j.neuint.2016.05.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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: 12/26/2015] [Revised: 04/25/2016] [Accepted: 05/10/2016] [Indexed: 02/06/2023]
Abstract
Long-term stress during pregnancy causes neurologic deficits to offspring with altered gamma-aminobutyric acid (GABA) system in the brain. However, it is not clear how prenatal stress affects the maturing GABAergic interneurons and the resulting abnormalities in infantile seizures. Here, we showed that prenatal stress alters the maturation of GABA inhibitory system using a seizure model induced by prenatal stress. Prenatal stress with betamethasone or acute immobilization stress (AIS) on gestational day 15 increased the seizure susceptibility to N-methyl-d-aspartate-triggered spasms on postnatal day 15. The expression of GABA was lower in the prenatally stressed group, which compromise the decrease of glutamate decarboxylase 67-immunopositive cells. Prenatal stress markedly decreased the expression of K(+)/Cl(-) co-transporter (KCC2) in the cortex. GABA induced membrane depolarization demonstrated prenatal stress models had significant higher membrane depolarization compared to control. GABA increased KCC2 expression in cultured cortex-containing slices. Taken together, our results showed that prenatal stress with betamethasone or AIS altered the maturation of GABAergic progenitors and resulted in the lack of GABA input, which in turn, decreased KCC2 expression and lowered seizure threshold. We conclude that delayed GABA excitatory/inhibitory shift would render the cortical neuronal circuit more susceptible to excitatory input in prenatal stress induced seizure.
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Affiliation(s)
- Hyunjung Baek
- Department of Anatomy, Brain Research Institute, Chungnam National University School of Medicine, Munwha-ro 266, Jung-gu, Daejeon, 301-747, Republic of Korea; Department of Pediatrics, Chungnam National University Hospital, Brain Research Institute, Chungnam National University School of Medicine, Munwha-ro 282, Jung-gu, Daejeon, 301-721, Republic of Korea
| | - Min-Hee Yi
- Department of Anatomy, Brain Research Institute, Chungnam National University School of Medicine, Munwha-ro 266, Jung-gu, Daejeon, 301-747, Republic of Korea
| | - Sudip Pandit
- Department of Physiology, Brain Research Institute, Chungnam National University School of Medicine, Munwha-ro 266, Jung-gu, Daejeon, 301-747, Republic of Korea
| | - Jin Bong Park
- Department of Physiology, Brain Research Institute, Chungnam National University School of Medicine, Munwha-ro 266, Jung-gu, Daejeon, 301-747, Republic of Korea
| | - Hyeok Hee Kwon
- Department of Anatomy, Brain Research Institute, Chungnam National University School of Medicine, Munwha-ro 266, Jung-gu, Daejeon, 301-747, Republic of Korea; Department of Pediatrics, Chungnam National University Hospital, Brain Research Institute, Chungnam National University School of Medicine, Munwha-ro 282, Jung-gu, Daejeon, 301-721, Republic of Korea
| | - Enji Zhang
- Department of Anatomy, Brain Research Institute, Chungnam National University School of Medicine, Munwha-ro 266, Jung-gu, Daejeon, 301-747, Republic of Korea
| | - Sena Kim
- Department of Anatomy, Brain Research Institute, Chungnam National University School of Medicine, Munwha-ro 266, Jung-gu, Daejeon, 301-747, Republic of Korea; Department of Plastic Surgery, Chungnam National University Hospital, Munwha-ro 282, Jung-gu, Daejeon, 301-721, Republic of Korea
| | - Nara Shin
- Department of Anatomy, Brain Research Institute, Chungnam National University School of Medicine, Munwha-ro 266, Jung-gu, Daejeon, 301-747, Republic of Korea; Anesthesia and Pain Medicine, Chungnam National University Hospital, Munwha-ro 282, Jung-gu, Daejeon, 301-721, Republic of Korea
| | - Eunjee Kim
- Department of Anatomy, Brain Research Institute, Chungnam National University School of Medicine, Munwha-ro 266, Jung-gu, Daejeon, 301-747, Republic of Korea
| | - Young Ho Lee
- Department of Anatomy, Brain Research Institute, Chungnam National University School of Medicine, Munwha-ro 266, Jung-gu, Daejeon, 301-747, Republic of Korea
| | - Yonghyun Kim
- Department of Chemical and Biological Engineering, The University of Alabama, Tuscaloosa, AL 35487, USA
| | - Dong Woon Kim
- Department of Anatomy, Brain Research Institute, Chungnam National University School of Medicine, Munwha-ro 266, Jung-gu, Daejeon, 301-747, Republic of Korea.
| | - Joon Won Kang
- Department of Pediatrics, Chungnam National University Hospital, Brain Research Institute, Chungnam National University School of Medicine, Munwha-ro 282, Jung-gu, Daejeon, 301-721, Republic of Korea.
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Kim WJ, Kwon CH, Han S, Lee WS, Kang JW, Ahn JM, Lee JY, Park DW, Kang SJ, Lee SW, Kim YH, Lee CW, Park SW, Park SJ. Role of Coronary Artery Calcium Scoring in Detection of Coronary Artery Disease according to Framingham Risk Score in Populations with Low to Intermediate Risks. J Korean Med Sci 2016; 31:902-8. [PMID: 27247499 PMCID: PMC4853669 DOI: 10.3346/jkms.2016.31.6.902] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 09/13/2015] [Accepted: 03/28/2016] [Indexed: 11/25/2022] Open
Abstract
Current guidelines recommend that coronary artery calcium (CAC) screening should only be used for intermediate risk groups (Framingham risk score [FRS] of 10%-20%). The CAC distributions and coronary artery disease (CAD) prevalence in various FRS strata were determined. The benefit to lower risk populations of CAC score-based screening was also assessed. In total, 1,854 participants (aged 40-79 years) without history of CAD, stroke, or diabetes were enrolled. CAC scores of > 0, ≥ 100, and ≥ 300 were present in 33.8%, 8.2%, and 2.9% of the participants, respectively. The CAC scores rose significantly as the FRS grew more severe (P < 0.01). The total CAD prevalence was 6.1%. The occult CAD prevalence in the FRS ≤ 5%, 6%-10%, 11%-20%, and > 20% strata were 3.4%, 6.7%, 9.0%, and 11.6% (P < 0.001). In multivariate logistic regression analysis adjusting, not only the intermediate and high risk groups but also the low risk (FRS 6%-10%) group had significantly increased odds ratio for occult CAD compared to the very low-risk (FRS ≤ 5%) group (1.89 [95% confidence interval, CI, 1.09-3.29] in FRS 6%-10%; 2.48 [95% CI, 1.47-4.20] in FRS 11%-20%; and 3.10 [95% CI, 1.75-5.47] in FRS > 20%; P < 0.05). In conclusion, the yield of screening for significant CAC and occult CAD is low in the very low risk population but it rises in low and intermediate risk populations.
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Affiliation(s)
- Won-Jang Kim
- Department of Cardiology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Chang Hee Kwon
- Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Seungbong Han
- Department of Applied Statistics, Gachon University, Seongnam, Korea
| | - Woo Seok Lee
- Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Joon Won Kang
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jung-Min Ahn
- Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jong-Young Lee
- Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Duk-Woo Park
- Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Soo-Jin Kang
- Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Seung-Whan Lee
- Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Young-Hak Kim
- Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Cheol Whan Lee
- Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Seong-Wook Park
- Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Seung-Jung Park
- Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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Chang SJ, Lee JH, Kim SH, Lee JS, Kim HD, Kang JW, Lee YM, Kang HC. Chronic inflammatory demyelinating polyneuropathy in children: a report of four patients with variable relapsing courses. Korean J Pediatr 2015; 58:194-8. [PMID: 26124851 PMCID: PMC4481041 DOI: 10.3345/kjp.2015.58.5.194] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Revised: 09/26/2014] [Accepted: 11/21/2014] [Indexed: 11/27/2022]
Abstract
Chronic inflammatory demyelinating polyneuropathy (CIDP) is a chronically progressive or relapsing symmetric sensorimotor disorder presumed to occur because of immunologic antibody-mediated reactions. To understand the clinical courses of CIDP, we report variable CIDP courses in children with respect to initial presentation, responsiveness to medical treatment, and recurrence interval. Four patients who were diagnosed with acute-onset and relapsing CIDP courses at Severance Children's Hospital, Seoul, Korea, were enrolled in this retrospective study. We diagnosed each patient on the basis of the CIDP diagnostic criteria developed in 2010 by the European Federation of Neurological Societies/Peripheral Nerve Society Guidelines. We present the cases of four pediatric patients diagnosed with CIDP to understand the variable clinical course of the disease in children. Our four patients were all between 8 and 12 years of age. Patients 1 and 2 were diagnosed with acute cerebellar ataxia or Guillain-Barré syndrome as initial symptoms. While patients 1 and 4 were given only intravenous dexamethasone (0.3 mg/kg/day) for 5 days at the first episode, Patients 2 and 3 were given a combination of intravenous immunoglobulin (2 g/kg) and dexamethasone (0.3 mg/kg/day). All patients were maintained with oral prednisolone at 30 mg/day, but their clinical courses were variable in both relapse intervals and severity. We experienced variable clinical courses of CIDP in children with respect to initial presentation, responsiveness to medical treatment, and recurrence interval.
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Affiliation(s)
- Soo Jin Chang
- Division of Pediatric Neurology, Department of Pediatrics, Pediatric Epilepsy Clinic, Severance Children's Hospital, Epilepsy Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Hyun Lee
- Division of Pediatric Neurology, Department of Pediatrics, Pediatric Epilepsy Clinic, Severance Children's Hospital, Epilepsy Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Shin Hye Kim
- Department of Pediatrics, Myongji Hospital, Kwandong University College of Medicine, Goyang, Korea
| | - Joon Soo Lee
- Division of Pediatric Neurology, Department of Pediatrics, Pediatric Epilepsy Clinic, Severance Children's Hospital, Epilepsy Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Heung Dong Kim
- Division of Pediatric Neurology, Department of Pediatrics, Pediatric Epilepsy Clinic, Severance Children's Hospital, Epilepsy Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Joon Won Kang
- Department of Pediatrics, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
| | - Young Mock Lee
- Department of Pediatrics, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hoon-Chul Kang
- Division of Pediatric Neurology, Department of Pediatrics, Pediatric Epilepsy Clinic, Severance Children's Hospital, Epilepsy Research Institute, Yonsei University College of Medicine, Seoul, Korea
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Yi MH, Zhang E, Baek H, Kim S, Shin N, Kang JW, Lee S, Oh SH, Kim DW. Growth Differentiation Factor 15 Expression in Astrocytes After Excitotoxic Lesion in the Mouse Hippocampus. Exp Neurobiol 2015; 24:133-8. [PMID: 26113792 PMCID: PMC4479809 DOI: 10.5607/en.2015.24.2.133] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 02/16/2015] [Accepted: 02/21/2015] [Indexed: 12/16/2022] Open
Abstract
Growth differentiation factor 15 (GDF15) is, a member of the transforming growth factor β (TGF-β) superfamily of proteins. Although GDF15 is well established as a potent neurotrophic factor for neurons, little is known about its role in glial cells under neuropathological conditions. We monitored GDF15 expression in astrocyte activation after a kainic acid (KA)-induced neurodegeneration in the ICR mice hippocampus. In control, GDF15 immunoreactivity (IR) was evident in the neuronal layer of the hippocampus; however, GDF15 expression had increased in activated astrocytes throughout the hippocampal region at day 3 after the treatment with KA. LPS treatment in astrocytes dramatically increased GDF15 expression in primary astrocytes. In addition, LPS treatment resulted in the decrease of the IκB-α degradation and increase of the phosphorylation level of RelA/p65. These results indicate that GDF15 has a potential link to NF-κB activation, making GDF15 a valuable target for modulating inflammatory conditions.
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Affiliation(s)
- Min-Hee Yi
- Department of Anatomy, Brain Research Institute, Chungnam National University School of Medicine, Daejeon 301-747, Korea
| | - Enji Zhang
- Department of Anatomy, Brain Research Institute, Chungnam National University School of Medicine, Daejeon 301-747, Korea
| | - Hyunjung Baek
- Department of Anatomy, Brain Research Institute, Chungnam National University School of Medicine, Daejeon 301-747, Korea. ; Department of Pediatrics, Chungnam National University Hospital, Daejeon 301-721, Korea
| | - Sena Kim
- Department of Anatomy, Brain Research Institute, Chungnam National University School of Medicine, Daejeon 301-747, Korea. ; Department of Plastic Surgery, Chungnam National University Hospital, Daejeon 301-721, Korea
| | - Nara Shin
- Department of Anatomy, Brain Research Institute, Chungnam National University School of Medicine, Daejeon 301-747, Korea. ; Department of Anesthesia and Pain Medicine, Chungnam National University Hospital, Daejeon 301-721, Korea
| | - Joon Won Kang
- Department of Pediatrics, Chungnam National University Hospital, Daejeon 301-721, Korea
| | - Sunyeul Lee
- Department of Anesthesia and Pain Medicine, Chungnam National University Hospital, Daejeon 301-721, Korea
| | - Sang-Ha Oh
- Department of Plastic Surgery, Chungnam National University Hospital, Daejeon 301-721, Korea
| | - Dong Woon Kim
- Department of Anatomy, Brain Research Institute, Chungnam National University School of Medicine, Daejeon 301-747, Korea
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Lee SM, Kang JW, Jo YH, Kim K, Lee JH, Lee J, Rim KP. UNDERWEIGHT IS ASSOCIATED WITH MORTALITY IN PATIENTS WITH SEVERE SEPSIS AND SEPTIC SHOCK. Intensive Care Med Exp 2015. [PMCID: PMC4798033 DOI: 10.1186/2197-425x-3-s1-a876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Kang JW, Lee SM, Koo KY, Lee YM, Nam HS, Quan Z, Kang HC. Isolated cerebellar variant of adrenoleukodystrophy with a de novo adenosine triphosphate-binding cassette D1 (ABCD1) gene mutation. Yonsei Med J 2014; 55:1157-60. [PMID: 24954351 PMCID: PMC4075381 DOI: 10.3349/ymj.2014.55.4.1157] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [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] [Indexed: 11/27/2022] Open
Abstract
X-linked adrenoleukodystrophy (X-ALD) shows a wide range of phenotypic expression, but clinical presentation as an isolated lesion of the cerebellar white matter and dentate nuclei has not been reported. We report an unusual presentation of X-ALD only with an isolated lesion of the cerebellar white matter and dentate nuclei. The proband, a 37-year-old man presented with bladder incontinence, slurred speech, dysmetria in all limbs, difficulties in balancing, and gait ataxia. Brain magnetic resonance imaging showed an isolated signal change of white matter around the dentate nucleus in cerebellum. With high level of very long chain fatty acid, gene study showed a de novo mutation in exon 1 at nucleotide position c.277_296dup20 (p.Ala100Cysfs*10) of the adenosine triphosphate-binding cassette D1 gene. It is advised to consider X-ALD as a differential diagnosis in patients with isolated cerebellar degeneration symptoms.
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Affiliation(s)
- Joon Won Kang
- Department of Pediatrics, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
| | - Sang Mi Lee
- Division of Pediatric Neurology, Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Kyo Yeon Koo
- Department of Clinical Genetics, Yonsei University College of Medicine, Seoul, Korea
| | - Young-Mock Lee
- Department of Pediatrics, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyo Suk Nam
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Zhejiu Quan
- Division of Pediatric Neurology, Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hoon-Chul Kang
- Division of Pediatric Neurology, Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
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Kwon SY, Kim IS, Bae JE, Kang JW, Cho YJ, Cho NS, Lee SW. Pathogen inactivation efficacy of Mirasol PRT System and Intercept Blood System for non-leucoreduced platelet-rich plasma-derived platelets suspended in plasma. Vox Sang 2014; 107:254-60. [PMID: 24806328 DOI: 10.1111/vox.12158] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 03/14/2014] [Accepted: 04/13/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES This study was conducted to evaluate the efficacy of pathogen inactivation (PI) in non-leucoreduced platelet-rich plasma-derived platelets suspended in plasma using the Mirasol PRT System and the Intercept Blood System. METHODS Platelets were pooled using the Acrodose PL system and separated into two aliquots for Mirasol and Intercept treatment. Four replicates of each viral strain were used for the evaluation. For bacteria, both low-titre (45-152 CFU/unit) inoculation and high-titre (7·34-10·18 log CFU/unit) inoculation with two replicates for each bacterial strain were used. Platelets with non-detectable bacterial growth and platelets inoculated with a low titre were stored for 5 days, and culture was performed with the BacT/ALERT system. RESULTS The inactivation efficacy expressed as log reduction for Mirasol and Intercept systems for viruses was as follows: human immunodeficiency virus 1, ≥4·19 vs. ≥4·23; bovine viral diarrhoea virus, 1·83 vs. ≥6·03; pseudorabies virus, 2·73 vs. ≥5·20; hepatitis A virus, 0·62 vs. 0·76; and porcine parvovirus, 0·28 vs. 0·38. The inactivation efficacy for bacteria was as follows: Escherichia coli, 5·45 vs. ≥9·22; Staphylococcus aureus, 4·26 vs. ≥10·11; and Bacillus subtilis, 5·09 vs. ≥7·74. Postinactivation bacterial growth in platelets inoculated with a low titre of S. aureus or B. subtilis was detected only with Mirasol. CONCLUSION Pathogen inactivation efficacy of Intercept for enveloped viruses was found to be satisfactory. Mirasol showed satisfactory inactivation efficacy for HIV-1 only. The two selected non-enveloped viruses were not inactivated by both systems. Inactivation efficacy of Intercept was more robust for all bacteria tested at high or low titres.
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Affiliation(s)
- S Y Kwon
- Blood Transfusion Research Institute, Korean Red Cross, Seoul, Korea
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Kang JW, Shin KC. Changes in Central Corneal Thickness and Corneal Endothelial Morphology in Contact Lens-Wearing Diabetic Patients. J Korean Ophthalmol Soc 2014. [DOI: 10.3341/jkos.2014.55.10.1426] [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: 11/23/2022]
Affiliation(s)
- Joon Won Kang
- Department of Ophthalmology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Ki Cheul Shin
- Department of Ophthalmology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
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Hur JA, Kang JW, Kang HC, Kim HD, Kim JT, Lee JS. The significance of insular hypometabolism in temporal lobe epilepsy in children. J Epilepsy Res 2013; 3:54-62. [PMID: 24649474 PMCID: PMC3952253 DOI: 10.14581/jer.13011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 11/22/2013] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND AND PURPOSE Temporal lobe epilepsy is one of the most common forms of medically refractory epileptic syndromes. In a small percentage, temporal lobectomy fails to control the seizures in patients with epilepsy of clear temporal origin, and in some of these patients, seizures originating from the insular cortex is believed to be the cause behind the surgical failures. We retrospectively analyzed the [(18)F]FDG-positron emission tomography (PET) results of patients who received temporal lobe surgery for presence of insular hypometabolism, and compared the surgical outcome to verify whether insular hypometablism was related with difference in post-operative results. METHODS 13 patients were enrolled, and clinical variables, post-operative pathology, magnetic resonance imaging and PET results were analyzed for possible differences between the patients with or without insular hypometabolism. RESULTS 7 patients showed insular hypometabolism, while 6 patients were clear of insular lesion on PET exam. 8 patients received anterior temporal lobectomy with amygdalohippocampectomy (AH), 2 patients received radical temporal lobectomy with AH, and 3 patients received insular cortisectomy. Post-operative results were favorable in 8 patients and unfavorable in 5, with unfavorable outcomes in all recipients of insular cortisectomy. Presence of insular hypometabolism did not have any significant relationship with the post-surgical outcome (p=0.266), but its trend showed a tendency towards favorable outcome if insular hypometabolism was not present. CONCLUSIONS Presence of insular hypometabolism in [(18)F]FDG-PET analysis was not significantly correlated with the post-operative outcome, and recipients of insular cortisectomy among our patients with insular hypometabolism resulted in poor surgical outcome. However, the outcome trend showed a tendency towards better surgical outcome with absence of hypometabolic lesion in the ipsilateral insular cortex. Further studies employing a larger patient group is needed.
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Affiliation(s)
- Ji Ae Hur
- Division of Pediatric Neurology, Department of Pediatrics, Pediatric Epilepsy Clinic, Severance Children's Hospital, Epilepsy Research Institute, Yonsei University College of Medicine, Seoul
| | - Joon Won Kang
- Department of Pediatrics, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
| | - Hoon-Chul Kang
- Division of Pediatric Neurology, Department of Pediatrics, Pediatric Epilepsy Clinic, Severance Children's Hospital, Epilepsy Research Institute, Yonsei University College of Medicine, Seoul
| | - Heung Dong Kim
- Division of Pediatric Neurology, Department of Pediatrics, Pediatric Epilepsy Clinic, Severance Children's Hospital, Epilepsy Research Institute, Yonsei University College of Medicine, Seoul
| | - Jeong Tae Kim
- Division of Pediatric Neurology, Department of Pediatrics, Pediatric Epilepsy Clinic, Severance Children's Hospital, Epilepsy Research Institute, Yonsei University College of Medicine, Seoul
| | - Joon Soo Lee
- Division of Pediatric Neurology, Department of Pediatrics, Pediatric Epilepsy Clinic, Severance Children's Hospital, Epilepsy Research Institute, Yonsei University College of Medicine, Seoul
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Kang JW, Rhie SK, Yu R, Eom S, Hong W, Kim SH, Kang HC, Lee JS, Lee YM, Kim HD. Seizure outcome of infantile spasms with focal cortical dysplasia. Brain Dev 2013; 35:816-20. [PMID: 23871103 DOI: 10.1016/j.braindev.2013.06.013] [Citation(s) in RCA: 31] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2012] [Revised: 06/20/2013] [Accepted: 06/21/2013] [Indexed: 12/01/2022]
Abstract
PURPOSE This study sought to evaluate the seizure outcome of infantile spasms (IS) with focal cortical dysplasia (FCD). METHODS We retrospectively reviewed infantile spasms patients with FCD from 2004 to 2010. We investigated seizure outcome from antiepileptic drug (AED), ketogenic diet (KD), resective surgery, and analyzed the results according to individual imaging studies. RESULTS Among 404 patients of IS, FCD was confirmed in 51 patients. In retrospective review of brain MRI, only 21 patients (41.2%) were suspected of FCD before 1year of age, but 45 patients (88.2%) became confirmed to FCD by MRI after the age of 1year. Once the spasms were not controlled by 1 or 2 AEDs, the chance of becoming seizure free with additional third or more drugs was very low (2.3%). The seizure free rate was 33.3% (7/21) in patients treated with ketogenic diet, and 73.3% (22/30) in surgical patients, who were both intractable to AEDs. There were no significant differences in seizure free rate in both ketogenic diet and surgical patients, between MRI negative and positive patients prior to 1year of age. CONCLUSIONS KD and surgery should be considered in medically refractory IS with FCD.
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Affiliation(s)
- Joon Won Kang
- Department of Pediatrics, Chungnam Naional University Hospital, Chungnam National University College of Medicine, Daejeon, Republic of Korea
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Yi MH, Kim S, Zhang E, Kang JW, Park JB, Lee YH, Chung CK, Kim YM, Kim DW. IQGAP1 expression in spared CA1 neurons after an excitotoxic lesion in the mouse hippocampus. Cell Mol Neurobiol 2013; 33:1003-12. [PMID: 23907317 DOI: 10.1007/s10571-013-9968-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 07/22/2013] [Indexed: 10/26/2022]
Abstract
Repeated seizures induce permanent alterations in the hippocampal circuits in experimental models with intractable temporal lobe epilepsy. Sprouting and synaptic reorganization induced by seizures has been well-studied in the mossy fiber pathway. However, studies investigating sprouting and synaptic reorganization beyond the mossy fiber pathway are limited. The present study examined the biochemical changes of CA1 pyramidal neurons undergoing morphological changes after excitotoxicity-induced hippocampal CA3 neuronal death. IQ-domain GTPase-activating proteins (IQGAP1), is an effector of Rac1 and Cdc42 and an actin-binding protein, was upregulated in CA1 pyramidal neurons after kainic acid-induced hippocampal CA3 neuronal degeneration. IQGAP1 + cells were colocalized with Nestin, but not in astrocytes or mature neurons. Furthermore, IQGAP1 did not originate from newly divided local precursors or NG2 + cells. IQGAP1 and adenomatous polyposis coli localized in CA1 pyramidal neurons, and Cdc42 activation was followed by IQGAP1 recruitment. These findings suggest that IQGAP1 is upregulated in pre-existed sparing neurons of the CA1 layer undergoing morphological changes after excitoxicity-induced hippocampal CA3 neuronal death. It demonstrates the utility of IQGAP1 as a possible marker for spared pyramidal neurons, which may contribute to structural and functional alternations responsible for the development of epilepsy.
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Affiliation(s)
- Min-Hee Yi
- Department of Anatomy, Brain Research Institute, Chungnam National University School of Medicine, Daejeon, 301-747, South Korea
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Affiliation(s)
- Joon Won Kang
- Department of Pediatrics Chungnam National University College of Medicine
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