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Choi KH, Mun SM, Seol Y, Lee YK, Lee JH, Lee IK, Lee YS, Jang H. The Role of Postoperative Radiotherapy in T4 Rectal Cancer with Synchronous Distant Metastasis. Int J Radiat Oncol Biol Phys 2023; 117:e288. [PMID: 37785066 DOI: 10.1016/j.ijrobp.2023.06.1279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Studieson the role of surgery and local treatment in M1 rectal cancer have been actively studied recently. However, there is still controversy because no significant results have been reported for local control. The purpose of this study was to analyze the local control rates of postoperative radiotherapy for tumor stage T4 in M1 rectal cancer. MATERIALS/METHODS We investigated local recurrence after surgery for M1 rectal cancer that was operated at Seoul St. Mary's Hospital between 1995 and 2021. Locoregional recurrence rates were compared in patients who received postoperative pelvic radiotherapy and those who did not. In addition, an analytical comparison was performed only for patients with T4 rectal cancer. Statistical analysis was performed using the log rank test, and a p-value of less than 0.05 was considered significant. RESULTS During the investigation period, a total of 206 patients underwent surgery for M1 rectal cancer. There were 55 patients with T4 tumor stage. Of the 55 patients, 11 patients received radiotherapy after surgery, and 44 patients received systemic treatment such as chemotherapy after surgery without radiotherapy. During a median follow-up of 22 months, locoregional recurrence occurred in 1 (RT group) and 25 (no RT group) patients, respectively. Log-rank analysis of locoregional recurrence showed a significant difference between the two groups (p- value = 0.008). Death occurred in 10 (RT group) and 38 (no RT group) patients, respectively. The 2-year locoregional recurrence free-survival rates were 45.5% and 53.0%, respectively, and there was no significant difference between the two groups in the log-rank analysis. CONCLUSION Pelvic radiotherapy could be expected to improve locoregional recurrence in stage T4 of rectal cancer with synchronous distant metastasis. It would be warranted to prove this in a large-scale prospective study.
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Affiliation(s)
- K H Choi
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - S M Mun
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - Y Seol
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - Y K Lee
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - J H Lee
- Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea, Republic of (South) Korea
| | - I K Lee
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - Y S Lee
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - H Jang
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
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Park CB, Kang YN, Jang H, Kim YS, Choi BO, Son SH, Song JH, Choi KH, Lee YK, Sung W, Kim JL. Evaluation of Usefulness of Yeast-Based Biological Phantom and Preliminary Study for Verification of Hypoxic Effect of Flash Radiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e704. [PMID: 37786063 DOI: 10.1016/j.ijrobp.2023.06.2193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) As a basic hypothesis for the effectiveness of flash radiation therapy, the effect of preserving normal tissue during flash radiation is due to the instantaneous chemical depletion of oxygen. A yeast-based biological phantom was created to verify the hypoxic effect of flash radiation therapy. A study to upgrade the previously developed X-Band LINAC to a flash irradiation mode is in progress, and a preceding study is conducted to evaluate the usefulness of a yeast-based biological phantom manufactured by analyzing the change in oxygen by irradiating a high dose in a general radiation therapy device. MATERIALS/METHODS Freeze-dried yeast sample (Saccharomyces cerevisiae, S288C) is activated and sub-cultured. For mass production of yeast samples, yeast culture medium is prepared by adding yeast colonies to the ypd medium. This study was conducted to verify the hypoxic effect among the biological mechanisms that occur during flash radiation therapy at the basic stage, and the oxygen concentration change during general radiation irradiation was measured in real time using a DO (Dissolved oxygen) meter and fiber optic sensor designed to do that. To prevent scatter, which is a concern during flash irradiation, the fiber form was used, and precise experiments are possible as a non-invasive oxygen concentration measurement method. Based on 10MV of general radiation therapy device, high-dose radiation of 500-10,000 cGy is irradiated to measure real-time oxygen concentration change. RESULTS As a result of irradiation with high-dose (500-10,000 cGy) radiation of general LINAC, it was confirmed that the oxygen concentration of the yeast culture medium decreased by 5.7-63.2%, and the usefulness of the biological phantom fabricated based on the yeast culture medium was evaluated. CONCLUSION Prior to the analysis of oxygen concentration change in yeast cells during X-Band LINAC flash irradiation, a preliminary study was conducted at a high dose in a general LINAC to obtain a significant result of oxygen concentration change and confirm the usefulness of the yeast-based biological phantom. Prior research was conducted and verified as a general irradiation experiment using a yeast-based biological phantom manufactured based on a DO meter and a fiber optic oxygen sensor. After irradiation with high-dose radiation, the oxygen concentration of the yeast culture medium was measured 5 times, and it was confirmed that there was a change in oxygen concentration of 5.7-63.2%, verifying the usefulness and stability of the biological phantom. The usefulness of the yeast-based biological phantom for high doses was confirmed, and it is expected that the usefulness of the biological phantom for flash radiation can be verified by additionally measuring the change in oxygen concentration of the biological phantom according to the high dose rate in the future.
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Affiliation(s)
- C B Park
- Department of Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - Y N Kang
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - H Jang
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - Y S Kim
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - B O Choi
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - S H Son
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - J H Song
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - K H Choi
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - Y K Lee
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - W Sung
- Department of Biomedical Engineering and Department of Biomedicine and Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South) Korea
| | - J L Kim
- Electro-Medical Device Research Center, Korea Electrotechnology Research Institute, Ansan, Korea, Republic of (South) Korea
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Kwon W, Yang JH, Lee SH, Choi KH, Park TK, Lee JM, Song YB, Hahn JY, Choi SH, Ahn CM, Ko YG, Yu CW, Jang WJ, Kim HJ, Kwon SU. Impact of obesity paradox between genders on in-hospital mortality in cardiogenic shock: a retrospective cohort study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
In a few studies, obesity was associated with better outcomes in patients with cardiogenic shock (CS). Although this phenomenon, the “obesity paradox”, reportedly manifests differently based on sex in other disease entities, it has not yet been investigated in CS patients.
Methods and results
1,227 patients with CS from The REtrospective and prospective observational Study to investigate Clinical oUtcomes and Efficacy of left ventricular assist device for Korean patients with cardiogenic shock (RESCUE) registry in Korea were analyzed. The study population was classified into obese and non-obese groups according to Asian-Pacific criteria (BMI >25.0 kg/m2 for obese). Clinical impact of obesity on in-hospital mortality according to sex was analyzed using logistic regression analysis and restricted cubic spline curves. In-hospital mortality rate was significantly lower in obese men than non-obese men (34.2% vs. 24.1%, p=0.004) while the difference was not significant in women (37.3% vs. 35.8%, p=0.884). As a continuous variable, higher BMI showed a protective effect in men conversely, BMI was not associated with clinical outcomes in women. Comparing to normal-weight patients, obesity was associated with a decreased risk of in-hospital death in men (multivariable-adjusted OR 0.63, CI 0.43–0.92, p=0.016), not in women (multivariable-adjusted OR 0.94, 95% CI 0.55–1.61, p=0.828). Interaction P value for the association between BMI and sex was 0.023.
Conclusions
Obesity paradox exists and apparently occurs in men among CS patients. The differential effect of BMI on in-hospital mortality was observed according to sex.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- W Kwon
- Samsung Medical Center , Seoul , Korea (Republic of)
| | - J H Yang
- Samsung Medical Center , Seoul , Korea (Republic of)
| | - S H Lee
- Chonnam National University Hospital , Gwangju , Korea (Republic of)
| | - K H Choi
- Samsung Medical Center , Seoul , Korea (Republic of)
| | - T K Park
- Samsung Medical Center , Seoul , Korea (Republic of)
| | - J M Lee
- Samsung Medical Center , Seoul , Korea (Republic of)
| | - Y B Song
- Samsung Medical Center , Seoul , Korea (Republic of)
| | - J Y Hahn
- Samsung Medical Center , Seoul , Korea (Republic of)
| | - S H Choi
- Samsung Medical Center , Seoul , Korea (Republic of)
| | - C M Ahn
- Yonsei Cardiovascular Center , Seoul , Korea (Republic of)
| | - Y G Ko
- Yonsei Cardiovascular Center , Seoul , Korea (Republic of)
| | - C W Yu
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - W J Jang
- Ewha Womans University Seoul Hospital , Seoul , Korea (Republic of)
| | - H J Kim
- Konkuk University Hospital , Seoul , Korea (Republic of)
| | - S U Kwon
- Inje University Sanggye Paik Hospital , Seoul , Korea (Republic of)
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Bak M, Choi KH, Kim JH, Park TK, Kim EK, Kim SM, Choi SH, Park SJ. Risk factors and clinical effects of late leaflet thrombosis after transcatheter aortic valve replacement. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
As the indications for trans-catheter aortic valve replacement (TAVR) expand, it is expected that the number of TAVR patients would increase and the follow-up duration would be longer. It is known that the incidence of leaflet thrombosis is higher in TAVR than in surgical aortic valve replacement (SAVR), but not much is known about the risk factors of late leaflet thrombosis in TAVR.
Aim
Therefore, in this study, the incidence and risk factors of late leaflet thrombosis at late term after TAVR and the effect on clinical course of late leaflet thrombosis would be investigated.
Method
There were 176 patients undergone TAVR from January 2015 to October 2020 in one tertiary hospital of south korea. 94 patients had follow-up cardiovascular computed tomography (CT) between 3 months and 2 years after TAVR. Among 94 patients, late leaflet thrombosis was discovered at 20 patients, and risk factors were analyzed by comparing clinical factors, echocardiographic and cardiovascular CT information, and angiographic data between the group with and without late leaflet thrombosis. And the difference in aortic valve hemodynamics between the group with and without leaflet thrombosis was examined and clinical outcomes were compared. Clinical outcome was defined as the composite of all-cause death, stroke, heart failure (HF) admission, redo-aortic valve (AV) replacement and major bleeding after detection of late leaflet thrombosis.
Results
Indexed mean sinus of Valsalva diameter, AV calcium score and post procedure estimated orifice area (EOA) had predictability of late leaflet thrombosis with AUC value of 0.670 (95% CI [0.546–0.795], p value = 0.020), AUC value of 0.698 (95% CI [0.544–0.851], p value = 0.012) and AUC value of 0.665 (95 percent CI [0.548–0.782], p value = 0.031), respectively (Figure 1).
In echocardiography performed at the time of follow-up CT, AV max velocity and AV mean pressure gradient were higher in thrombosis group and EOA and Doppler velocity index were lower in thrombosis group than in no thrombosis group within normal range (Figure 2). Clinical outcome was not significant different between the two groups (log rank p value = 0.560).
Conclusion
Larger indexed sinus of Valsalva diameter, higher AV calcium score and smaller post procedure AV EOA were risk factors for late leaflet thrombosis after TAVR. Subclinical late leaflet thrombosis have a benign course when properly managed.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Bak
- Samsung Medical Center, Division of Cardiology, Cardiovascular Imaging Center, Heart Vascular Stroke Institute , Seoul , Korea (Republic of)
| | - K H Choi
- Samsung Medical Center , Seoul , Korea (Republic of)
| | - J H Kim
- Samsung Medical Center, Division of Cardiology, Cardiovascular Imaging Center, Heart Vascular Stroke Institute , Seoul , Korea (Republic of)
| | - T K Park
- Samsung Medical Center , Seoul , Korea (Republic of)
| | - E K Kim
- Samsung Medical Center, Division of Cardiology, Cardiovascular Imaging Center, Heart Vascular Stroke Institute , Seoul , Korea (Republic of)
| | - S M Kim
- Samsung Medical Center, Department of Radiology, Cardiovascular Imaging Center, Heart Vascular Stroke Institute , Seoul , Korea (Republic of)
| | - S H Choi
- Samsung Medical Center , Seoul , Korea (Republic of)
| | - S J Park
- Samsung Medical Center, Division of Cardiology, Cardiovascular Imaging Center, Heart Vascular Stroke Institute , Seoul , Korea (Republic of)
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Lee KJ, Kim BJ, Han MK, Kim JT, Choi KH, Shin DI, Cha JK, Kim DH, Kim DE, Ryu WS, Park JM, Kang K, Lee SJ, Oh MS, Yu KH, Lee BC, Hong KS, Cho YJ, Choi JC, Park TH, Park SS, Kwon JH, Kim WJ, Lee J, Sohn SI, Hong JH, Lee KB, Lee JS, Lee J, Gorelick PB, Bae HJ. One-Year Blood Pressure Trajectory After Acute Ischemic Stroke. J Am Heart Assoc 2022; 11:e023747. [PMID: 35195014 PMCID: PMC9075074 DOI: 10.1161/jaha.121.023747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Although the effect of blood pressure on poststroke outcome is well recognized, the long-term trajectory of blood pressure after acute ischemic stroke and its influence on outcomes have not been studied well. Methods and Results We analyzed systolic blood pressure (SBP) measurements in 5514 patients with acute ischemic stroke at ≥2 of 7 prespecified time points during the first year after stroke among those enrolled in a multicenter prospective registry. Longitudinal SBPs were categorized using a group-based trajectory model. The primary outcome was a composite of stroke recurrence, myocardial infarction, and all-cause mortality up to 1 year after stroke. The study subjects were categorized into 4 SBP trajectory groups: low (27.0%), moderate (59.5%), persistently high (1.2%), and slowly dropping (12.4%). In the first 3 groups, SBP decreased during the first 3 to 7 days and remained steady thereafter. In the slowly dropping SBP group, SBPs decreased from 182 to 135 mm Hg during the first 30 days, then paralleled the trajectory of the moderate SBP group. Compared with the reference, the moderate SBP group, the slowly dropping SBP group was at higher risk for the primary outcome (adjusted hazard ratio [HR], 1.32; 95% CI, 1.05‒1.65) and mortality (adjusted HR, 1.35; 95% CI, 1.03‒1.78). Primary outcome rates were similarly high in the persistently high SBP group. Conclusions Four 1-year longitudinal SBP trajectories were identified in patients with acute ischemic stroke. Patients in the slowly dropping SBP and persistently high SBP trajectory groups were prone to adverse cardiovascular outcomes after stroke.
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Affiliation(s)
- Keon-Joo Lee
- Department of Neurology Seoul National University Bundang Hospital Seongnam Korea.,Department of Neurology Korea University Guro Hospital Seoul Korea
| | - Beom Joon Kim
- Department of Neurology Seoul National University Bundang Hospital Seongnam Korea
| | - Moon-Ku Han
- Department of Neurology Seoul National University Bundang Hospital Seongnam Korea
| | - Joon-Tae Kim
- Department of Neurology Chonnam National University Hospital Gwangju Korea
| | - Kang Ho Choi
- Department of Neurology Chonnam National University Hospital Gwangju Korea
| | - Dong-Ick Shin
- Department of Neurology Chungbuk National University Hospital Cheongju Korea
| | - Jae-Kwan Cha
- Department of Neurology Dong-A University Hospital Busan Korea
| | - Dae-Hyun Kim
- Department of Neurology Dong-A University Hospital Busan Korea
| | - Dong-Eog Kim
- Department of Neurology Dongguk University Ilsan Hospital Goyang Korea
| | - Wi-Sun Ryu
- Department of Neurology Dongguk University Ilsan Hospital Goyang Korea
| | - Jong-Moo Park
- Department of Neurology Uijeongbu Eulji Medical CenterEulji University Seoul Korea
| | - Kyusik Kang
- Department of Neurology Nowon Eulji Medical CenterEulji University Seoul Korea
| | - Soo Joo Lee
- Department of Neurology Eulji University Hospital Daejeon Korea
| | - Mi-Sun Oh
- Department of Neurology Hallym University Sacred Heart Hospital Anyang Korea
| | - Kyung-Ho Yu
- Department of Neurology Hallym University Sacred Heart Hospital Anyang Korea
| | - Byung-Chul Lee
- Department of Neurology Hallym University Sacred Heart Hospital Anyang Korea
| | - Keun-Sik Hong
- Department of Neurology Inje University Ilsan Paik Hospital Goyang Korea
| | - Yong-Jin Cho
- Department of Neurology Inje University Ilsan Paik Hospital Goyang Korea
| | - Jay Chol Choi
- Department of Neurology Jeju National University Hospital Jeju Korea
| | - Tai Hwan Park
- Department of Neurology Seoul Medical Center Seoul Korea
| | - Sang-Soon Park
- Department of Neurology Seoul Medical Center Seoul Korea
| | - Jee-Hyun Kwon
- Department of Neurology Ulsan University Hospital Ulsan Korea
| | - Wook-Joo Kim
- Department of Neurology Ulsan University Hospital Ulsan Korea
| | - Jun Lee
- Department of Neurology Yeungnam University Medical Center Daegu Korea
| | - Sung Il Sohn
- Department of Neurology Keimyung University Dongsan Medical Center Daegu Korea
| | - Jeong-Ho Hong
- Department of Neurology Keimyung University Dongsan Medical Center Daegu Korea
| | - Kyung Bok Lee
- Department of Neurology Soonchunhyang University Hospital Seoul Korea
| | - Ji Sung Lee
- Clinical Research Center Asan Medical Center Seoul Korea
| | - Juneyoung Lee
- Department of Biostatistics Korea University Seoul Korea
| | - Philip B Gorelick
- Davee Department of Neurology Feinberg School of MedicineNorthwestern University Chicago IL.,Department of Translational Neuroscience Michigan State UniversityCollege of Human Medicine Grand Rapids MI
| | - Hee-Joon Bae
- Department of Neurology Seoul National University Bundang Hospital Seongnam Korea
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Cho MJ, Kim YJ, Kim MJ, Kim YS, Park E, Choi KH, Kang JY, Kim HO, Koong MK, Kim YS, Yoon TK, Ko JJ, Lee JH. P–205 Epothilone D as an actin cytoskeleton stabilizer improved mitochondria bioenergenesis and blastocyst formation of mouse preimplantation embryo. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
What is primary factor of bioenergetics product activity between microtubule instability and the functional activity of mitochondria in embryo?
Summary answer
The actin cytoskeleton instability is presumably the primary cause for the bioenergenesis of mitochondrial function to the preimplantation embryo development.
What is known already
Mitochondria are cellular organelles dynamically moving and morphological changes. It provides for homeostatic energy to the cell. The dynamic property of the mitochondria is associated with the microtubule network in the cell. However, the stability of the microtubule was clearly identified for preimplantation embryo development.
Study design, size, duration
This study is designed to assess the ATP productivity of the mitochondria, and specifically to observe what its primary factor is in terms of providing microtubule stability in mammalian cells. Additionally, we investigated the relationship between blastocyst formation and actin cytoskeleton stabilization by EpD with 2-cell mice.
Participants/materials, setting, methods
We prepared the microtubule stability regulation model with the HEK293 cell line by using the microtubule stabilizer as an Epothilone D (EpD). Then we analyzed the metabolic activity of the cells through oxidative phosphorylation (OXP) ratios analysis. Also, we performed confocal live imaging to observe mitochondria morphology depending on the cells’ microtubule. Next, we treated EpD to 2-cell culture media for the analysis of blastocyst development ratios.
Main results and the role of chance
EpD significantly increased fusion form. Also, EpD enhance bioenergy ratios like OXP in the mitochondria and functional activity related marker, like mTOR compared with the control. These results suggest that microtubule stabilization enhances mitochondrial metabolism by increasing oxygen consumption. Also, EpD in 2-cell culture media led to a significant increase in the speed of development and 50% higher hatched out blastocyst formation ratios compared to the control group.
Limitations, reasons for caution
This study had limited animal experiments. For the next study, we are planning with an aim to improve the quality and development ratios of human embryos by EpD.
Wider implications of the findings: Microtubule stabilizer has a possibility to recover the mitochondria’s functional activity in the preimplantation embryo development. Mitochondrial functional activity along the actin cytoskeleton may play a pivotal role in determining the embryo quality and development ratios for archive pregnancy.
Trial registration number
non-clinical trials
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Affiliation(s)
- M J Cho
- CHA University, Biomedical Sciences, Seoul, Korea- South
| | - Y J Kim
- CHA Medical Group, Reproductive and Molecular Medicine, Seoul, Korea- South
| | - M J Kim
- CHA Fertility Center Seoul Station, Clinic, Seoul, Korea- South
| | - Y S Kim
- CHA Fertility Center Seoul Station, Clinic, Seoul, Korea- South
| | - E Park
- CHA Fertility Center Seoul Station, Embryology lab, Seoul, Korea- South
| | - K H Choi
- CHA Fertility Center Seoul Station, Embryology lab, Seoul, Korea- South
| | - J Y Kang
- CHA Fertility Center Seoul Station, Embryology lab, Seoul, Korea- South
| | - H O Kim
- CHA Fertility Center Seoul Station, Clinic, Seoul, Korea- South
| | - M K Koong
- CHA Fertility Center Seoul Station, Clinic, Seoul, Korea- South
| | - Y S Kim
- CHA Fertility Center Seoul Station, Clinic, Seoul, Korea- South
| | - T K Yoon
- CHA Fertility Center Seoul Station, Clinic, Seoul, Korea- South
| | - J J Ko
- CHA University, Biomedical Sciences, Seoul, Korea- South
| | - J H Lee
- CHA fertility seoul center seoul sequare 3floor, Reproductive and Molecular Medicine., Seoul, Korea- South
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7
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Choi KH, Kim YJ, Kang KY, Park EA, Kim YS, Kim MJ, Kim HO, Koong MK, Kim YS, Yoon TK, Ko JJ, Lee JH. P–657 Prostaglandin D2 is correlated with follicles development and a reliable marker of ovarian reserve of poor ovarian responder patients. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Is the prostaglandin D2 (PGD2) associated with growing follicles and ovarian reserve of poor ovarian responders?
Summary answer
PGD2 is correlated with ovarian stimulation activity and follicle growth. Especially, poor ovarian responders show a significant decrease in the level of follicular fluid.
What is known already
Prostaglandins (PGs) are involved in the female reproductive process, mainly ovulation, fertilization, and implantation.
Study design, size, duration
We investigated the PGD2 level in the follicular fluid of poor ovarian responders. The collection of human follicular fluid was approved by the Institutional Research and Ethical Committees of CHA University (approval number: 1044308–201611-BR–027–04) from January to December 2019. Follicular fluid was collected from patients with normal ovarian response and patients with POR.
Participants/materials, setting, methods
We studied whether prostaglandin has related to POR in the clinical key factor by measuring human follicular fluid. Follicular fluid was collected from patients with normal ovarian response and patients with POR. The concentration of PGD2 in follicular fluid was determined with ELISA kits following the manufacturer’s protocol.
Main results and the role of chance
We analyzed the level of PGD2 in the follicular fluid of patients with normal ovarian response and patients with POR using an ELISA. The PGD2 concentration was significantly lower in the follicular fluid of patients with POR than in the follicular fluid of young and old patients with normal ovarian response.
Limitations, reasons for caution
This study has an identification of biomarker of the clinical samples as POR criteria patients. Therefore, further investigations aimed at specific recovery of low PGD2 metabolic activity in the CCs during control ovarian stimulation.
Wider implications of the findings: Until now there is no specific biomarker of POR. AMH is just an ovary reserve marker for an indication of ovary function. PGD2 is one of the metabolites in steroid metabolism in the ovary. Therefore, we can find some cure through further study for improved PGD2 production to POR patients.
Trial registration number
none
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Affiliation(s)
- K H Choi
- CHA Fertility Center Seoul Station, Embryology Lab, Seoul, Korea- South
| | - Y J Kim
- CHA Medical Group, Advanced Research Division of Reproductive Medicine, Seoul, Korea- South
| | - K Y Kang
- CHA Fertility Center Seoul Station, Embryology Lab, Seoul, Korea- South
| | - E A Park
- CHA Fertility Center Seoul Station, Embryology Lab, Seoul, Korea- South
| | - Y S Kim
- CHA Fertility Center Seoul Station, IVF clinic, Seoul, Korea- South
| | - M J Kim
- CHA Fertility Center Seoul Station, IVF clinic, Seoul, Korea- South
| | - H O Kim
- CHA Fertility Center Seoul Station, IVF clinic, Seoul, Korea- South
| | - M K Koong
- CHA Fertility Center Seoul Station, IVF clinic, Seoul, Korea- South
| | - Y S Kim
- CHA Fertility Center Seoul Station, IVF clinic, Seoul, Korea- South
| | - T K Yoon
- CHA Fertility Center Seoul Station, IVF clinic, Seoul, Korea- South
| | - J J Ko
- CHA University, Biomedical Science, Pocheon-si, Korea- South
| | - J H Lee
- CHA Fertility Center Seoul Station, Embryology Lab, Seoul, Korea- South
- CHA University, Biomedical Science, Pocheon-si, Korea- South
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8
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Kim YJ, Choi KH, Kang KY, Park EA, Kim YS, Kim MJ, Kim HO, Koong MK, Kim YS, Yoon TK, Ko JJ, Lee JH. P–658 Lovastatin promotes the expression of LDL receptor and enhances E2 production in the cumulus cells. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Study question
Lovastatin enhanced E2 productive ratios in the cumulus cells through promoted expression of Low-density lipoprotein receptor (LDLR).
Summary answer
Lovastatin up-regulated gene expression of LDLR in the CCs. And the high expression of LDLR promoted E2 productive ratios from CCs.
What is known already
We already reported that the up-regulation of LDLR correlated with clinical pregnancy. Therefore, we found lovastatin as an up-regulator of LDLR expression of clinical pregnancy.
Study design, size, duration
This is an expended study of LDLR to enhance steroidogenesis regarding the effect of lovastatin in the CCs. The collection of human cumulus cells was approved by the Institutional Research and Ethical Committees of CHA University (approval number: 1044308–201611-BR–027–04) from January to December 2019. The CCs were collected from 12 patients with normal ovarian response after oocyte denudation for ICSI.
Participants/materials, setting, methods
We studied whether lovastatin has up-regulated LDLR expression in human CCs. Cumulus cells were collected from patients with young (∼ 36) and old aged patients (37 ∼). After culturing human CCs, they were treated lovastatin for one day. The concentration of E2 in culture medium was measured using Chemiluminescence immunoassay. The mRNA isolated from CCs was analyzed gene expression level through real time-PCR.
Main results and the role of chance
The concentration of E2 was significantly increased in the culture medium treated with lovastatin. The CCs treated with lovastatin increased the expression of LDLR and StAR which are components of the steroidogenesis pathway.
Limitations, reasons for caution
We have found that the role of lovastatin promotes the E2 production by increasing the ldlr gene of CCs. Therefore, further investigations aimed at lovastatin effect on human oocytes embryo whether enhanced quality of oocytes or not.
Wider implications of the findings: Previous data show that high activation of LDLR and StAR was associated with embryo quality and clinical pregnancy in infertile women. Our data suggest that lovastatin is stimulated LDLR expression to enhanced pregnancy ratios of IVF patients.
Trial registration number
none
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Affiliation(s)
- Y J Kim
- CHA Medical Group, Advanced Research Division of Reproductive Medicine, Seoul, Korea- South
| | - K H Choi
- CHA Fertility Center Seoul Station, Embryology Lab, Seoul, Korea- South
| | - K Y Kang
- CHA Fertility Center Seoul Station, Embryology Lab, Seoul, Korea- South
| | - E A Park
- CHA Fertility Center Seoul Station, Embryology Lab, Seoul, Korea- South
| | - Y S Kim
- CHA Fertility Center Seoul Station, IVF clinic, Seoul, Korea- South
| | - M J Kim
- CHA Fertility Center Seoul Station, IVF clinic, Seoul, Korea- South
| | - H O Kim
- CHA Fertility Center Seoul Station, IVF clinic, Seoul, Korea- South
| | - M K Koong
- CHA Fertility Center Seoul Station, IVF clinic, Seoul, Korea- South
| | - Y S Kim
- CHA Fertility Center Seoul Station, IVF clinic, Seoul, Korea- South
| | - T K Yoon
- CHA Fertility Center Seoul Station, IVF clinic, Seoul, Korea- South
| | - J J Ko
- CHA University, Biomedical Science, Pocheon-si, Korea- South
| | - J H Lee
- CHA Fertility Center Seoul Station, Embryology Lab, Seoul, Korea- South
- CHA University, Biomedical Science, Pocheon-si, Korea- South
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9
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Kim BJ, Cho YJ, Hong KS, Lee J, Kim JT, Choi KH, Park TH, Park SS, Park JM, Kang K, Lee SJ, Kim JG, Cha JK, Kim DH, Lee BC, Yu KH, Oh MS, Kim DE, Ryu WS, Choi JC, Kim WJ, Shin DI, Sohn SI, Hong JH, Lee JS, Lee J, Han MK, Gorelick PB, Bae HJ. Treatment Intensification for Elevated Blood Pressure and Risk of Recurrent Stroke. J Am Heart Assoc 2021; 10:e019457. [PMID: 33787300 PMCID: PMC8174371 DOI: 10.1161/jaha.120.019457] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Background It remains unclear whether physicians' attitudes toward timely management of elevated blood pressure affect the risk of stroke recurrence. Methods and Results From a multicenter stroke registry database, we identified 2933 patients with acute ischemic stroke who were admitted to participating centers in 2011, survived at the 1‐year follow‐up period, and returned to outpatient clinics ≥2 times after discharge. As a surrogate measure of physicians' attitude, individual treatment intensification (TI) scores were calculated by dividing the difference between the frequencies of observed and expected medication changes by the frequency of clinic visits and categorizing them into 5 groups. The association between TI groups and the recurrence of stroke within 1 year was analyzed using hierarchical frailty models, with adjustment for clustering within each hospital and relevant covariates. Mean±SD of the TI score was −0.13±0.28. The TI score groups were significantly associated with increased risk of recurrent stroke compared with Group 3 (TI score range, −0.25 to 0); Group 1 (range, −1 to −0.5), adjusted hazard ratio (HR) 13.43 (95% CI, 5.95–30.35); Group 2 (range, −0.5 to −0.25), adjusted HR 4.59 (95% CI, 2.01–10.46); and Group 4 (TI score 0), adjusted HR 6.60 (95% CI, 3.02–14.45); but not with Group 5 (range, 0–1), adjusted HR 1.68 (95% CI, 0.62–4.56). This elevated risk in the lowest TI score groups persisted when confining analysis to those with hypertension, history of blood pressure‐lowering medication, no atrial fibrillation, and regular clinic visits and stratifying the subjects by functional capacity at discharge. Conclusions A low TI score, which implies physicians' therapeutic inertia in blood pressure management, was associated with a higher risk of recurrent stroke. The TI score may be a useful performance indicator in the outpatient clinic setting to prevent recurrent stroke.
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Affiliation(s)
- Beom Joon Kim
- Department of Neurology and Cerebrovascular Center Seoul National University Bundang HospitalSeoul National University College of Medicine Seongnam Republic of Korea
| | - Yong-Jin Cho
- Department of Neurology Ilsan Paik HospitalInje University Goyang Republic of Korea
| | - Keun-Sik Hong
- Department of Neurology Ilsan Paik HospitalInje University Goyang Republic of Korea
| | - Jun Lee
- Department of Neurology Yeungnam University Hospital Daegu Republic of Korea
| | - Joon-Tae Kim
- Department of Neurology Chonnam National University Medical School and Hospital Gwangju Republic of Korea
| | - Kang Ho Choi
- Department of Neurology Chonnam National University Medical School and Hospital Gwangju Republic of Korea
| | - Tai Hwan Park
- Department of Neurology Seoul Medical Center Seoul Republic of Korea
| | - Sang-Soon Park
- Department of Neurology Seoul Medical Center Seoul Republic of Korea
| | - Jong-Moo Park
- Department of Neurology Eulji General Hospital Eulji University Seoul Republic of Korea
| | - Kyusik Kang
- Department of Neurology Eulji General Hospital Eulji University Seoul Republic of Korea
| | - Soo Joo Lee
- Department of Neurology Eulji University HospitalEulji University Daejeon Republic of Korea
| | - Jae Guk Kim
- Department of Neurology Eulji University HospitalEulji University Daejeon Republic of Korea
| | - Jae-Kwan Cha
- Department of Neurology Dong-A University College of Medicine Busan Republic of Korea
| | - Dae-Hyun Kim
- Department of Neurology Dong-A University College of Medicine Busan Republic of Korea
| | - Byung-Chul Lee
- Department of Neurology Hallym University Sacred Heart Hospital Anyang Republic of Korea
| | - Kyung-Ho Yu
- Department of Neurology Hallym University Sacred Heart Hospital Anyang Republic of Korea
| | - Mi-Sun Oh
- Department of Neurology Hallym University Sacred Heart Hospital Anyang Republic of Korea
| | - Dong-Eog Kim
- Department of Neurology Dongguk University Ilsan Hospital Goyang Republic of Korea
| | - Wi-Sun Ryu
- Department of Neurology Dongguk University Ilsan Hospital Goyang Republic of Korea
| | - Jay Chol Choi
- Department of Neurology Jeju National University Jeju Republic of Korea
| | - Wook-Joo Kim
- Department of Neurology Ulsan University HospitalUniversity of Ulsan College of Medicine Ulsan Republic of Korea
| | - Dong-Ick Shin
- Department of Neurology Chungbuk National University Hospital Cheongju Republic of Korea
| | - Sung Il Sohn
- Department of Neurology Keimyung University Dongsan Medical Center Daegu Republic of Korea
| | - Jeong-Ho Hong
- Department of Neurology Keimyung University Dongsan Medical Center Daegu Republic of Korea
| | - Ji Sung Lee
- Clinical Research Center Asan Medical Center Seoul Republic of Korea
| | - Juneyoung Lee
- Department of Biostatistics College of Medicine Korea University Seoul Republic of Korea
| | - Moon-Ku Han
- Department of Neurology and Cerebrovascular Center Seoul National University Bundang HospitalSeoul National University College of Medicine Seongnam Republic of Korea
| | - Philip B Gorelick
- Davee Department of Neurology Northwestern University Feinberg School of Medicine Chicago IL
| | - Hee-Joon Bae
- Department of Neurology and Cerebrovascular Center Seoul National University Bundang HospitalSeoul National University College of Medicine Seongnam Republic of Korea
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10
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Hyun YY, Lee KB, Han SH, Choi KH, Park HC, Oh YK, Park SK, Oh KH, Ahn C. Risk factors and renal outcomes of low bone mineral density in patients with non-dialysis chronic kidney disease. Osteoporos Int 2020; 31:2373-2382. [PMID: 32642852 DOI: 10.1007/s00198-020-05531-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 06/30/2020] [Indexed: 12/24/2022]
Abstract
UNLABELLED Bone disorder is a common complication of chronic kidney disease (CKD). The clinical usefulness of bone mineral density (BMD) in CKD is not well known. Our study shows that low BMD is associated with physical activity and dietary Na/K intake ratio and can predict poor renal outcome in non-dialysis CKD. PURPOSE Despite evidence of a link between bone mineral disorders and chronic kidney disease (CKD), the clinical implications of bone mineral density (BMD) in CKD are not well established. We investigated risk factors and renal outcomes of low BMD in CKD. METHODS We analyzed data from the KNOW-CKD. BMD measured by dual-energy x-ray absorptiometry was classified by T score: normal (T score ≥ - 1.0), osteopenia (- 1.0 > T score > - 2.5), and osteoporosis (T score ≤ - 2.5) of the lumbar spine, hip, or femoral neck. Logistic regression analysis to assess risk factors of low BMD (T score < - 1.0) and Cox proportional hazards models to estimate risk of incident end-stage renal disease (ESRD). RESULTS Low BMD was prevalent (osteopenia 33%; osteoporosis 8%) in 2128 adults with CKD (age 54 ± 12 years; male 61%). Over a median follow-up of 4.3 years, there were 521 cases of incident ESRD. Lower BMD was associated with female sex, older age, low eGFR, low BMI, and lifestyle factors of physical activity (odds ratio (OR) = 0.62, 95% confidence interval (0.49-0.77)) and spot urine Na/K ratio (1.07 (1.00-1.15)). In adjusted Cox models, low BMD was associated with increased incident ESRD (hazard ratio (HR) = 1.14 (0.92-1.41) for osteopenia; 1.43 (1.01-2.04) for osteoporosis, P for trend < 0.05) compared with the reference of normal BMD. The association between low BMD and ESRD was similar according to T score discordance classification. CONCLUSIONS Low BMD was associated with modifiable lifestyle factors including low physical activity and high dietary Na/K intake ratio. The presence of low BMD is associated with poor renal outcomes in non-dialysis CKD.
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Affiliation(s)
- Y Y Hyun
- Division of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181, Republic of Korea
| | - K-B Lee
- Division of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181, Republic of Korea.
| | - S H Han
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, South Korea
| | - K H Choi
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, South Korea
| | - H C Park
- Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Seoul, South Korea
| | - Y K Oh
- Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul, South Korea
| | - S K Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - K-H Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - C Ahn
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
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11
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Kim EH, Jung MH, Park MS, Choi KH, Lee SJ, Kim HS. Abstract 466: Vascular Claudin-11 Plays a Protective Role for Human Atherosclerosis Progression. Circ Res 2020. [DOI: 10.1161/res.127.suppl_1.466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Aims:
The expression and the role of tight junction protein, Claudin-11 (CLDN11) in vasculat smooth muscle cell (vSMC) is unknown.
Methods:
To understand the role of CLDN11 in the vSMC, we transfected siRNA-CLDN11 into human coronary vascular smooth muscle cell line (hCSMC). cDNA microarray using Agilent Human mRNA arrays, immunocytochemistry, tube formation assay, FACS, and cell cycle analysis were performed 7 days after CLDN11 knock-down. To know the role of CLDN11 in the human cardiovascular system, we obtained vascular smooth muscle layer from autopsied left anterior descending artery and CLDN11 mRNA expression was evaluated following modified AHA Consensus Classification Based on Morphologic Descriptions (three groups, total n=45).
Results:
CLDN11 was well expressed in vascular smooth mucscle layer in immunohistochemisty and western blot analysis. We observed the angiogenesis (CXCL8, SOX17, HEY1), cell proliferation (EGR3, ITGB2), and extracellular matrix (BMPER, WNT1) associated gene expression. Following CLDN11-siRNA transfection, the tube formation assay and proliferating cellular phase was markedly increased in siRNA treatment group (p<0.01, respectively). In the human sample, CLDN11 expression was inversely correlated with the progression of coronary atherosclerosis (p=0.0026), and the sudden cardiac death with complicated coronary atherosclerosis (p<0.05).
Conclusions:
These results indicate that CLDN11 could tightly regulate the vascular smooth muscle physiology. And CLDN11 might play a certain role for atherosclerosis propagation to regulate the vSMCs plasticity and possible new etiology for cardiovascular events.
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Affiliation(s)
- Eun Hee Kim
- Chonnam National Univ. Med. Sch., Gwangju, Korea, Republic of
| | - Moon Hee Jung
- Chonnam National Univ. Med. Sch., Gwangju, Korea, Republic of
| | - Man Seok Park
- Chonnam National Univ. Med. Sch., Gwangju, Korea, Republic of
| | - Kang Ho Choi
- Chonnam National Univ. Med. Sch., Gwangju, Korea, Republic of
| | - Su Jin Lee
- Chonnam National Univ. Med. Sch., Gwangju, Korea, Republic of
| | - Hyung Seok Kim
- Chonnam National Univ. Med. Sch., Gwangju, Korea, Republic of
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12
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Lee KJ, Kim BJ, Han MK, Kim JT, Choi KH, Shin DI, Cha JK, Kim DH, Kim DE, Ryu WS, Park JM, Kang K, Lee SJ, Oh MS, Yu KH, Lee BC, Hong KS, Cho YJ, Choi JC, Park TH, Park SS, Kwon JH, Kim WJ, Lee J, Sohn SI, Hong JH, Lee JS, Lee J, Bae HJ. Abstract WP94: Higher Mortality in Slow Blood Pressure Droppers: Blood Pressure Trajectory Groups of 1-Year After Acute Ischemic Stroke. Stroke 2020. [DOI: 10.1161/str.51.suppl_1.wp94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction:
Although the effect of blood pressure in post-stroke outcome is well recognized, the long-term time course of BP following acute ischemic stroke and it’s influence to outcomes have not been well elucidated.
Method:
From a multicenter prospective registry of acute ischemic stroke patients, a total of 5,514 patients with measurement of systolic blood pressure (SBP) in more than 2 of 7 prespecified time points up to 1 year after symptom onset were analyzed. The patients were grouped according to longitudinal SBPs of each patient using a group-based trajectory model, and number of groups were determined by the optimal delta-Bayesian Information Criterion. Outcome measures, which were stroke recurrence, mortality and composite of each events along with myocardial infarction were prospectively collected up to 1 year after symptom onset.
Results:
Patients were categorized into four groups according to their SBP trajectories: low (27.0%), moderate (59.5%), persistently high (1.2%), and slowly dropping (12.4%). After adjustment for pre-determined covariates, there were higher risk of stroke recurrence in persistently high SBP group (hazard ratio (HR), 2.28 [95% confidence interval (CI), 1.01-5.12]). Mortality was higher only in the slowly dropping SBP group (HR, 1.50 [95% CI, 1.09-2.05]). Composite events were higher in both persistently high (HR, 1.96 [95% CI, 1.02-3.75]) and slowing dropping (HR, 1.54 [95% CI, 1.18-2.00]) SBP groups.
Conclusion:
There were a group of patterns in long-term longitudinal SBP changes after acute ischemic stroke. Especially, slow BP droppers might have a distinct nature with higher mortality and would be a target for future investigations.
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Affiliation(s)
- Keon-Joo Lee
- Neurology, Seoul National Univ Bundang Hosp, Seongnam, Korea, Republic of
| | - Beom Joon Kim
- Neurology, Seoul National Univ Bundang Hosp, Seongnam, Korea, Republic of
| | - Moon-Ku Han
- Neurology, Seoul National Univ Bundang Hosp, Seongnam, Korea, Republic of
| | - Joon-Tae Kim
- Neurology, Chonnam National Univ Hosp, Gwangju, Korea, Republic of
| | - Kang Ho Choi
- Neurology, Chonnam National Univ Hosp, Gwangju, Korea, Republic of
| | - Dong-Ick Shin
- Neurology, Chungbuk National Univ Hosp, Cheongju, Korea, Republic of
| | - Jae-Kwan Cha
- Neurology, Dong-A Univ Hosp, Busan, Korea, Republic of
| | - Dae-Hyun Kim
- Neurology, Dong-A Univ Hosp, Busan, Korea, Republic of
| | - Dong-Eog Kim
- Neurology, Dongguk Univ Ilsan Hosp, Goyang, Korea, Republic of
| | - Wi-Sun Ryu
- Neurology, Dongguk Univ Ilsan Hosp, Goyang, Korea, Republic of
| | - Jong-Moo Park
- Neurology, Nowon Eulji Med Cntr, Eulji Univ, Seoul, Korea, Republic of
| | - Kyusik Kang
- Neurology, Nowon Eulji Med Cntr, Eulji Univ, Seoul, Korea, Republic of
| | - Soo Joo Lee
- Neurology, Eulji Univ Hosp, Daejeon, Korea, Republic of
| | - Mi-Sun Oh
- Neurology, Hallym Univ Sacred Heart Hosp, Anyang, Korea, Republic of
| | - Kyung-Ho Yu
- Neurology, Hallym Univ Sacred Heart Hosp, Anyang, Korea, Republic of
| | - Byung-Chul Lee
- Neurology, Hallym Univ Sacred Heart Hosp, Anyang, Korea, Republic of
| | - Keun-Sik Hong
- Neurology, Inje Univ Ilsan Paik Hosp, Goyang, Korea, Republic of
| | - Yong-Jin Cho
- Neurology, Inje Univ Ilsan Paik Hosp, Goyang, Korea, Republic of
| | - Jay Chol Choi
- Neurology, Jeju National Univ Hosp, Jeju, Korea, Republic of
| | - Tai Hwan Park
- Neurology, Seoul Med Cntr, Seoul, Korea, Republic of
| | | | - Jee-Hyun Kwon
- Neurology, Ulsan Univ Hosp, Ulsan, Korea, Republic of
| | - Wook-Joo Kim
- Neurology, Ulsan Univ Hosp, Ulsan, Korea, Republic of
| | - Jun Lee
- Neurology, Yeungnam Univ Med Cntr, Daegu, Korea, Republic of
| | - Sung Il Sohn
- Neurology, Keimyung Univ Dongsan Med Cntr, Daegu, Korea, Republic of
| | - Jeong-Ho Hong
- Neurology, Keimyung Univ Dongsan Med Cntr, Daegu, Korea, Republic of
| | - Ji Sung Lee
- Clinical Rsch Cntr, Asan Med Cntr, Seoul, Korea, Republic of
| | - Juneyoung Lee
- Biostatistics, Korea Univ, Seoul, Korea, Republic of
| | - Hee-Joon Bae
- Neurology, Seoul National Univ Bundang Hosp, Seongnam, Korea, Republic of
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13
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Jung JM, Kim YH, Yu S, O K, Kim CK, Song TJ, Kim YJ, Kim BJ, Heo SH, Park KY, Kim JM, Park JH, Choi JC, Park MS, Kim JT, Choi KH, Hwang YH, Chung JW, Bang OY, Kim GM, Seo WK. Long-Term Outcomes of Real-World Korean Patients with Atrial-Fibrillation-Related Stroke and Severely Decreased Ejection Fraction. J Clin Neurol 2019; 15:545-554. [PMID: 31591844 PMCID: PMC6785482 DOI: 10.3988/jcn.2019.15.4.545] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/29/2019] [Accepted: 07/29/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND AND PURPOSE The clinical implications of echocardiography findings for long-term outcomes in atrial fibrillation (AF)-related stroke patients are unknown. METHODS This was a substudy of the Korean ATrial fibrillaTion EvaluatioN regisTry in Ischemic strOke patieNts (K-ATTENTION), which is a multicenter-based cohort comprising prospective stroke registries from 11 tertiary centers. Stroke survivors who underwent two-dimensional transthoracic echocardiography during hospitalization were enrolled. Echocardiography markers included the left-ventricle (LV) ejection fraction (LVEF), the left atrium diameter, and the ratio of the peak transmitral filling velocity to the mean mitral annular velocity during early diastole (E/e' ratio). LVEF was categorized into normal (≥55%), mildly decreased (>40% and <55%), and severely decreased (≤40%). The E/e' ratio associated with the LV filling pressure was categorized into normal (<8), borderline (≥8 and <15), and elevated (≥15). Kaplan-Meier and Cox regression analyses were performed for recurrent stroke, major adverse cardiac events, and all-cause death. RESULTS This study finally included 1,947 patients. Over a median follow-up of 1.65 years (interquartile range, 0.42-2.87 years), the rates of recurrent stroke, major adverse cardiac events, and all-cause death were 35.1, 10.8, and 69.6 cases per 1,000 person-years, respectively. Multivariable analyses demonstrated that severely decreased LVEF was associated with a higher risks of major adverse cardiac events [hazard ratio (HR), 3.91; 95% confidence interval (CI), 1.58-9.69] and all-cause death (HR, 1.95; 95% CI, 1.23-3.10). The multivariable fractional polynomial plot indicated that recurrent stroke might be associated with a lower LVEF. CONCLUSIONS Severe LV systolic dysfunction could be a determinant of long-term outcomes in AF-related stroke.
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Affiliation(s)
- Jin Man Jung
- Department of Neurology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Yong Hyun Kim
- Department of Cardiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Sungwook Yu
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Kyungmi O
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Chi Kyung Kim
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Tae Jin Song
- Department of Neurology, Mokdong Hospital, Ewha Womans University, College of Medicine, Seoul, Korea
| | - Yong Jae Kim
- Department of Neurology, Eunpyeong St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Bum Joon Kim
- Department of Neurology, Kyung Hee University College of Medicine, Seoul, Korea
| | - Sung Hyuk Heo
- Department of Neurology, Kyung Hee University College of Medicine, Seoul, Korea
| | - Kwang Yeol Park
- Department of Neurology, Chung-Ang University College of Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - Jeong Min Kim
- Department of Neurology, Chung-Ang University College of Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - Jong Ho Park
- Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
| | - Jay Chol Choi
- Department of Neurology, Jeju National University, Jeju, Korea
| | - Man Seok Park
- Department of Neurology, Chonnam National University Hospital, Gwangju, Korea
| | - Joon Tae Kim
- Department of Neurology, Chonnam National University Hospital, Gwangju, Korea
| | - Kang Ho Choi
- Department of Neurology, Chonnam National University Hospital, Gwangju, Korea.,Department of Neurology, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Yang Ha Hwang
- Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jong Won Chung
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Oh Young Bang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gyeong Moon Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Woo Keun Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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14
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Song NA, Lee S, Hwang HS, Choi KH, Kang KH, Om SY, Kim DH, Song JM, Song JK, Kang DH, Yang HM. P5989Effect of neprilysin inhibitor for ischemic mitral regurgitation after myocardial injury. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
After myocardial infarction (MI), mitral valve (MV) tethering and fibrosis stimulate functional mitral regurgitation (MR), resulting in high morbidity of heart failure and cardiac mortality. However, pharmacological treatment has not been proven effective in reducing ischemic MR. MV change post-MI is associated with an excessive endothelial-to-mesenchymal transition (EMT) by transforming growth factor (TGF)-β overexpression and also with left ventricular (LV) remodeling. In a recent clinical study using echocardiography, angiotensin receptor neprilysin inhibitor (ARNI) reduced functional MR to a greater extent than did valsartan, but the mechanism was not revealed.
Purpose
This study tested the hypothesis that treatment of neprilysin inhibitor attenuates functional MR after MI by facilitating LV reverse remodeling and suppressing EMT which mitigates inadequate leaflet adaptation.
Methods
In male Sprague-Dawley rats (n=31), functional MR was induced by occluding the left circumflex coronary artery. Two weeks after MI, MR and LV dilatation were confirmed by echocardiography and magnetic resonance imaging (MRI). Rats were randomly assigned to LCZ696 treatment (ARNI, 60 mg/kg/d, n=10), valsartan treatment (30mg/kg/d, n=10), or corn oil only (MR control group; n=11). After 6 weeks, LV volumes, functions and MR extent were quantified by using echocardiography, cardiac MRI and pressure-volume loop analysis. Also, excised mitral leaflets and LV were analyzed by histopathology and primary cultured valvular endothelial cells (VECs) were evaluated focusing on molecular changes.
Results
LCZ696 significantly attenuated post-MI LV dilatation after 6 weeks when compared with the control group (LV end-diastolic volume (EDV), 461.3±41.3 uL versus 525.1±78.2 uL; p<0.05), while valsartan did not (LV EDV, 471.2±26.8 uL; p>0.05 to control). There were no significant differences in the change of arterial pressure and ejection fraction between the treatment groups, however, dP/dt was greater in the LCZ696 group than in the MR control group (8203±286 mmHg/s for LCZ696 versus 6936±555 mmHg/s for MR control; p=0.01). MR extent and LA volume were significantly decreased in the LCZ696 group compared with the valsartan group. Pathological analysis showed that fibrosis was more prominent in the MR control than in the LCZ696 group. LCZ696 strongly reduced leaflet thickness, TGF-β, and downstream phosphorylated extracellular-signal-regulated kinase and EMT (25.4±11.8% vs. 53.4±12.6% α-smooth muscle actin-positive VECs; p<0.05). Leaflet area increased comparably (5%) in the LCZ696 group compared with the valsartan group.
Conclusions
Neprilysin inhibitor has positive effects on LV reverse remodeling and also directly modulates profibrotic changes of MV leaflets post-MI without eliminating adaptive growth. Understanding the mechanisms could provide new opportunities to ARNI reducing ischemic MR.
Acknowledgement/Funding
This work was supported by the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2014R1A6A3A04056205). It was also
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Affiliation(s)
- N A Song
- Asan Medical Center, Seoul, Korea (Republic of)
| | - S Lee
- Asan Medical Center, Seoul, Korea (Republic of)
| | - H S Hwang
- Asan Medical Center, Seoul, Korea (Republic of)
| | - K H Choi
- Asan Medical Center, Seoul, Korea (Republic of)
| | - K H Kang
- Asan Medical Center, Seoul, Korea (Republic of)
| | - S Y Om
- Asan Medical Center, Seoul, Korea (Republic of)
| | - D H Kim
- Asan Medical Center, Seoul, Korea (Republic of)
| | - J M Song
- Asan Medical Center, Seoul, Korea (Republic of)
| | - J K Song
- Asan Medical Center, Seoul, Korea (Republic of)
| | - D H Kang
- Asan Medical Center, Seoul, Korea (Republic of)
| | - H M Yang
- Seoul National University Hospital, Seoul, Korea (Republic of)
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Hong D, Choi KH, Youn T, Lee SY, Bak M, M KM, Cho YH, Yang JH. P1711The association of multidisciplinary team approach with clinical outcomes in patients with acute myocardial infarction underwent veno-arterial extracorporeal membrane oxygenation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Multidisciplinary team approach is necessary for the management of critically-ill patients. However, limited data are available on the impact of specialized extracorporeal membrane oxygenation (ECMO) team on clinical outcomes in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock.
Objectives
This study aimed to identify whether specialized ECMO team is associated with improved in-hospital mortality in AMI patients underwent venoarterial ECMO.
Methods
A total of 255 AMI patients underwent venoarterial ECMO from May 2004 to July 2018 were enrolled. In January 2014, multidisciplinary ECMO team was founded at our institution. Eligible patients were classified into pre-ECMO team group (n=131) and post-ECMO team group (n=124). The primary outcome was in-hospital mortality.
Results
In-hospital mortality (54.2% vs. 33.9%, p=0.002) and cardiac intensive care unit mortality (45.0% vs. 25.0%, p=0.001) were significantly lower after the implantation of multidisciplinary ECMO team (pre ECMO team vs. post-ECMO team). On binary logistic regression model, the multidisciplinary ECMO team approach was associated with lower risk of in-hospital mortality (odds ratio 0.36, 95% confidence interval 0.19–0.67, p=0.001). Incidence of all-cause mortality (58.3% vs. 35.2%, p<0.001) and rehospitalization due to heart failure (28.2% vs. 6.4%, p=0.001) at 6-months follow-up were also significantly lower in the post-ECMO team group than in the pre-ECMO team group.
Clinical outcomes Variables Total (N=255) Pre-ECMO team (N=131) Post-ECMO team (N=124) P value In-hospital mortality 113 (44.3) 71 (54.2) 42 (33.9) 0.002 Cardiovascular death 90 (35.3) 59 (45.0) 31 (25.0) 0.001 Noncardiovascular death 23 (9.0) 12 (9.2) 11 (8.9) >0.99 Cardiac intensive care unit mortality 106 (41.6) 68 (51.9) 38 (30.6) 0.001 Successful weaning of ECMO 169 (66.3) 75 (57.3) 94 (75.8) 0.002 Data are presented as n (%). Abbreviations: ECMO, extracorporeal membrane oxygenation.
Incidence of death, readmission for HF
Conclusions
The multidisciplinary ECMO team approach was associated with improved clinical outcomes in AMI patients complicated by cardiogenic shock. Our data support that specialized ECMO team is indispensable to improve outcomes in patients with AMI with refractory cardiogenic shock.
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Affiliation(s)
- D Hong
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - K H Choi
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - T Youn
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - S Y Lee
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - M Bak
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - K M M
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - Y H Cho
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - J H Yang
- Samsung Medical Center, Seoul, Korea (Republic of)
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16
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Kim BJ, Cho YJ, Hong KS, Lee J, Kim JT, Choi KH, Park TH, Park SS, Park JM, Kang K, Lee SJ, Kim JG, Cha JK, Kim DH, Nah HW, Lee BC, Yu KH, Oh MS, Kim DE, Ryu WS, Choi JC, Kim WJ, Shin DI, Yeo MJ, Sohn SI, Hong JH, Lee JS, Lee J, Han MK, Gorelick PB, Bae HJ. Trajectory Groups of 24-Hour Systolic Blood Pressure After Acute Ischemic Stroke and Recurrent Vascular Events. Stroke 2019; 49:1836-1842. [PMID: 30012819 DOI: 10.1161/strokeaha.118.021117] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background and Purpose- Blood pressure dynamics in patients with acute ischemic stroke may serve as an important modifiable and prognostic factor. Methods- A total of 8376 patients with acute ischemic stroke were studied from a prospective multicenter registry. Patients were eligible if they had been admitted within 24 hours of symptom onset and had ≥5 systolic blood pressure (SBP) measurements during the first 24 hours of hospitalization. SBP trajectory groups in the first 24 hours were identified using the TRAJ procedure in SAS software with delta-Bayesian Information Criterion and prespecified modeling parameters. Vascular events, including recurrent stroke, myocardial infarction, and death, were prospectively collected. The risk of having vascular events was calculated using the frailty model to adjust for clustering by hospital. Results- The group-based trajectory model classified patients with acute ischemic stroke into 5 SBP trajectory groups: low (22.3%), moderate (40.8%), rapidly stabilized (11.9%), acutely elevated (18.5%), and persistently high (6.4%) SBP. The risk of having vascular events was increased in the acutely elevated (hazard ratio, 1.28 [95% confidence interval, 1.12-1.47]) and the persistently high SBP groups (hazard ratio, 1.67 [95% confidence interval, 1.37-2.04]) but not in the rapidly stabilized group (hazard ratio, 1.13 [95% confidence interval, 0.95-1.34]), when compared with the moderate SBP group. Conclusions- SBP during the first 24 hours after acute ischemic stroke may be categorized into distinct trajectory groups, which differ in relation to stroke characteristics and frequency of subsequent recurrent vascular event risks. The findings may help to recognize potential candidates for future blood pressure control trials.
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Affiliation(s)
- Beom Joon Kim
- From the Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, South Korea (B.J.K., M.-K.H., H.-J.B.)
| | - Yong-Jin Cho
- Department of Neurology, Ilsan Paik Hospital, Inje University, Goyang, South Korea (Y.-J.C., K.-S.H.)
| | - Keun-Sik Hong
- Department of Neurology, Ilsan Paik Hospital, Inje University, Goyang, South Korea (Y.-J.C., K.-S.H.)
| | - Jun Lee
- Department of Neurology, Yeungnam University Hospital, Daegu, South Korea (J.L.)
| | - Joon-Tae Kim
- Department of Neurology, Chonnam National University Medical School and Hospital, Gwangju, South Korea (J.-T.K., K.H.C.)
| | - Kang Ho Choi
- Department of Neurology, Chonnam National University Medical School and Hospital, Gwangju, South Korea (J.-T.K., K.H.C.)
| | - Tai Hwan Park
- Department of Neurology, Seoul Medical Center, South Korea (T.H.P., S.-S.P.)
| | - Sang-Soon Park
- Department of Neurology, Seoul Medical Center, South Korea (T.H.P., S.-S.P.)
| | - Jong-Moo Park
- Department of Neurology, Eulji General Hospital (J.-M.P., K.K.)
| | - Kyusik Kang
- Department of Neurology, Eulji General Hospital (J.-M.P., K.K.)
| | - Soo Joo Lee
- Department of Neurology, Eulji University Hospital (S.J.L., J.G.K.), Eulji University, Daejeon, South Korea
| | - Jae Guk Kim
- Department of Neurology, Eulji University Hospital (S.J.L., J.G.K.), Eulji University, Daejeon, South Korea
| | - Jae-Kwan Cha
- Department of Neurology, Dong-A University College of Medicine, Busan, South Korea (J.-K.C., D.-H.K., H.-W.N.)
| | - Dae-Hyun Kim
- Department of Neurology, Dong-A University College of Medicine, Busan, South Korea (J.-K.C., D.-H.K., H.-W.N.)
| | - Hyun-Wook Nah
- Department of Neurology, Dong-A University College of Medicine, Busan, South Korea (J.-K.C., D.-H.K., H.-W.N.)
| | - Byung-Chul Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, South Korea (B.-C.L., K.-H.Y., M.-S.O.)
| | - Kyung-Ho Yu
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, South Korea (B.-C.L., K.-H.Y., M.-S.O.)
| | - Mi-Sun Oh
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, South Korea (B.-C.L., K.-H.Y., M.-S.O.)
| | - Dong-Eog Kim
- Department of Neurology, Dongguk University Ilsan Hospital, Goyang, South Korea (D.-E.K., W.-S.R.)
| | - Wi-Sun Ryu
- Department of Neurology, Dongguk University Ilsan Hospital, Goyang, South Korea (D.-E.K., W.-S.R.)
| | - Jay Chol Choi
- Department of Neurology, Jeju National University, South Korea (J.C.C.)
| | - Wook-Joo Kim
- Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine, South Korea (W.-J.K.)
| | - Dong-Ick Shin
- Department of Neurology, Chungbuk National University Hospital, Cheongju, South Korea (D.-I.S., M.-J.Y.)
| | - Min-Ju Yeo
- Department of Neurology, Chungbuk National University Hospital, Cheongju, South Korea (D.-I.S., M.-J.Y.)
| | - Sung Il Sohn
- Department of Neurology, Keimyung University Dongsan Medical Center, Daegu, South Korea (S.I.S., J.-H.H.)
| | - Jeong-Ho Hong
- Department of Neurology, Keimyung University Dongsan Medical Center, Daegu, South Korea (S.I.S., J.-H.H.)
| | - Ji Sung Lee
- Clinical Research Center, Asan Medical Center, Seoul, South Korea (J.S.L.)
| | - Juneyoung Lee
- Department of Biostatistics, College of Medicine, Korea University, Seoul, South Korea (J.L.)
| | - Moon-Ku Han
- From the Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, South Korea (B.J.K., M.-K.H., H.-J.B.)
| | - Philip B Gorelick
- Department of Translational Science and Molecular Medicine, Mercy Health Hauenstein Neurosciences, Michigan State University College of Human Medicine, Grand Rapids (P.B.G.)
| | - Hee-Joon Bae
- From the Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, South Korea (B.J.K., M.-K.H., H.-J.B.)
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17
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Kang KW, Kim SH, Kim JM, Nam TS, Choi KH, Kim MK. Ictal SPECT in Diagnosis of Non-Ketotic Hyperglycemia-Related Seizure Manifesting as Speech Arrest. J Clin Neurol 2019; 15:253-255. [PMID: 30877697 PMCID: PMC6444151 DOI: 10.3988/jcn.2019.15.2.253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 07/24/2018] [Revised: 10/15/2018] [Accepted: 10/17/2018] [Indexed: 11/25/2022] Open
Affiliation(s)
- Kyung Wook Kang
- Department of Neurology, Chonnam National University Hospital, Gwangju, Korea
| | - Sang Hoon Kim
- Department of Neurology, Chonnam National University Hospital, Gwangju, Korea
| | - Jae Myung Kim
- Department of Neurology, Chonnam National University Hospital, Gwangju, Korea
| | - Tai Seung Nam
- Department of Neurology, Chonnam National University Hospital, Gwangju, Korea
| | - Kang Ho Choi
- Department of Neurology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Myeong Kyu Kim
- Department of Neurology, Chonnam National University Hospital, Gwangju, Korea.,Department of Neurology, Chonnam National University Medical School, Gwangju, Korea.
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18
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Jin ES, Kim JY, Min JK, Jeon SR, Choi KH, Lee MS, Jeong JH. Bilateral ovario-hysterectomy induced osteoporotic rabbit model. J BIOL REG HOMEOS AG 2019; 33:391-396. [PMID: 30915825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- E S Jin
- Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
- Laboratory of Stem Cell Therapy, College of Medicine, Asan Medical Center, University of Ulsan, Ulsan, Republic of Korea
| | - J Y Kim
- Laboratory of Stem Cell Therapy, College of Medicine, Asan Medical Center, University of Ulsan, Ulsan, Republic of Korea
| | - J K Min
- Laboratory of Stem Cell Therapy, College of Medicine, Asan Medical Center, University of Ulsan, Ulsan, Republic of Korea
| | - S R Jeon
- Laboratory of Stem Cell Therapy, College of Medicine, Asan Medical Center, University of Ulsan, Ulsan, Republic of Korea
- Department of Neurological surgery, Asan Medical Center, College of Medicine, University of Ulsan, Ulsan, Republic of Korea
| | - K H Choi
- Laboratory of Stem Cell Therapy, College of Medicine, Asan Medical Center, University of Ulsan, Ulsan, Republic of Korea
- Department of Rehabilitation Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Ulsan, Republic of Korea
| | - M S Lee
- OSTEONIC, Co., Ltd., Seoul, Republic of Korea
| | - J H Jeong
- Laboratory of Stem Cell Therapy, College of Medicine, Asan Medical Center, University of Ulsan, Ulsan, Republic of Korea
- Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Gyunggi-do, Republic of Korea
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19
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Kim BJ, Cho YJ, Hong KS, Lee J, Kim JT, Choi KH, Park TH, Park SS, Park JM, Kang K, Lee SJ, Kim JG, Cha JK, Kim DH, Nah HW, Lee BC, Yu KH, Oh MS, Kim DE, Ryu WS, Choi JC, Kim WJ, Shin DI, Yeo MJ, Sohn SI, Hong JH, Lee JS, Lee J, Han MK, Bae HJ. Abstract 91: Physicians’ Attitudes Toward Elevated Blood Pressure and Recurrent Events After Acute Ischemic Stroke. Stroke 2019. [DOI: 10.1161/str.50.suppl_1.91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Strict blood pressure (BP) control among acute ischemic stroke (AIS) survivors would improve prognosis and decrease recurrent vascular events, which, however, has not been investigated in detail.
Methods:
AIS survivors at discharge who was admitted between 2010 and 2011 were included in the analysis dataset. Baseline characteristics were gathered through a multicenter prospective stroke registry (CRCS-K). BP measurements, clinic visit and prescription of BP-lowering medications after discharge were collected through medical records until 1 year (± 2 months of grace period). Recurrent vascular events until 1 year after stroke including stroke, myocardial infarction and death were gathered through a structured telephone interview by trained research registrars or medical records review. Individual treatment intensification (TI) scores were calculated by the following equation; (observed medication change - predicted medication change by a standard guideline) / number of clinic visit. TI scores were categorized into quintile groups and their associations with recurrent events were assessed by Cox proportional hazard models.
Results:
Of the 3482 AIS survivors, 2675 (77%) were diagnosed of hypertension and 1977 (57%) had BP-lowering medication prescription at discharge. Median NIHSS score at admission was 3 [1 - 6] points and 1573 (45.3%) had mRS score 0f 0 - 1 at discharge. TI score over 1-year after discharge was mean - 0.24 ± 0.30 and median - 0.15 [- 0.42, 0]. Compared to Q3 (third quintile; group TI score, - 0.15 ± 0.05), Q5 (group TI score, 0.04 ± 0.08) had higher proportion of cardioembolic stroke (32% vs 20%) and higher median NIHSS score (4 vs 3). Extreme groups of TI scores, Q1 or Q5, showed increased hazard for having mortality or composite events (see Table).
Conclusions:
Physicians’ attitudes toward elevated BP, represented by the TI score, was significantly associated with long-term vascular outcomes.
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Affiliation(s)
- Beom Joon Kim
- Seoul National Univ Bundang Hosp, Seongnam-si Gyeonggi-do, Korea, Republic of
| | | | | | - Jun Lee
- Yeungnam Univ Hosp, Daegu, Korea, Republic of
| | - Joon-tae Kim
- Chonnam National Univ Med Sch and Hosp, Gwangju, Korea, Republic of
| | - Kang Ho Choi
- Chonnam National Univ Med Sch and Hosp, Gwangju, Korea, Republic of
| | | | | | | | - Kyusik Kang
- Eulji General Hosp, Seoul, Korea, Republic of
| | - Soo Joo Lee
- Eulji Univ Hosp, Daejeon, Korea, Republic of
| | - Jae Guk Kim
- Eulji Univ Hosp, Daejeon, Korea, Republic of
| | - Jae-kwan Cha
- Dong-A Univ College of Medicine, Busan, Korea, Republic of
| | - Dae-hyun Kim
- Dong-A Univ College of Medicine, Busan, Korea, Republic of
| | - Hyun-wook Nah
- Dong-A Univ College of Medicine, Busan, Korea, Republic of
| | - Byung-chul Lee
- Hallym Univ Sacred Heart Hosp, Anyang, Korea, Republic of
| | - Kyung-ho Yu
- Hallym Univ Sacred Heart Hosp, Anyang, Korea, Republic of
| | - Mi-sun Oh
- Hallym Univ Sacred Heart Hosp, Anyang, Korea, Republic of
| | - Dong-eog Kim
- Dongguk Univ Ilsan Hosp, Goyang, Korea, Republic of
| | - Wi-sun Ryu
- Dongguk Univ Ilsan Hosp, Goyang, Korea, Republic of
| | - Jay Chol Choi
- Jeju National Univ Hosp, Seongnam-si Gyeonggi-do, Korea, Republic of
| | | | - Dong-ick Shin
- Chungbuk National Univ Hosp, Cheongju, Korea, Republic of
| | - Min-ju Yeo
- Chungbuk National Univ Hosp, Cheongju, Korea, Republic of
| | - Sung Il Sohn
- Keimyung Univ Dongsan Med Cntr, Daegu, Korea, Republic of
| | - Jeong-ho Hong
- Keimyung Univ Dongsan Med Cntr, Daegu, Korea, Republic of
| | | | - Juneyoung Lee
- Korea Univ College of Medicine, Seoul, Korea, Republic of
| | - Moon-ku Han
- Seoul National Univ Bundang Hosp, Seongnam-si Gyeonggi-do, Korea, Republic of
| | - Hee-joon Bae
- Seoul National Univ Bundang Hosp, Seongnam-si Gyeonggi-do, Korea, Republic of
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20
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Kim SH, Park KN, Kim J, Eun CK, Park YM, Oh MK, Choi KH, Kim HJ, Kim DW, Choo HJ, Cho JH, Oh JH, Park HY. Accuracy of Plain Abdominal Radiography in the Differentiation between Small Bowel Obstruction and Small Bowel Ileus in Acute Abdomen Presenting to Emergency Department. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791101800202] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Introduction Our purpose was to evaluate whether plain abdominal radiography (PAR) could accurately differentiate between small bowel obstruction (SBO) and small bowel ileus (SBI) in an emergency setting. We also evaluated the value of known classic signs on the PAR for differentiating between SBO and SBI. Methods This retrospective study included 216 emergency room patients who had small bowel distension (maximal small bowel diameter ≥2.5 cm) on the PAR and who underwent successive abdominal computed tomography. One radiologist and one emergency physician retrospectively reviewed PAR in consensus, unaware of the patients' clinical data; they divided the patients into an SBO group and an SBI group according to the radiographic findings. Presence or numeric values of 10 radiographic signs were also recorded. Final diagnoses of SBO and SBI were established by a combined analysis of medical charts, surgical records, radiographic findings on abdominal computed tomography, and small bowel studies. The differential diagnoses based on PAR and the final diagnoses were compared, and the sensitivity and specificity of PAR were calculated. We also evaluated the differences among 10 radiographic signs between the final SBO and SBI groups. Results Sensitivity and specificity of PAR for SBO were 82.0% and 92.4%, respectively. Among the 10 radiographic signs, all except maximal colon diameter were statistically significant predictors on the final diagnosis. Conclusions PAR is an accurate and effective initial imaging modality for differentiating between SBO and SBI in an emergency setting, and most of the classic radiographic signs have a diagnostic value.
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Affiliation(s)
- SH Kim
- Inje University Haeundae Paik Hospital, Department of Emergency Medicine, 1435 Jwa-dong, Haewondae-gu, Busan 612-030, Republic of Korea
| | - KN Park
- Inje University Haeundae Paik Hospital, Department of Emergency Medicine, 1435 Jwa-dong, Haewondae-gu, Busan 612-030, Republic of Korea
| | - J Kim
- Inje University Haeundae Paik Hospital, Department of Emergency Medicine, 1435 Jwa-dong, Haewondae-gu, Busan 612-030, Republic of Korea
| | - CK Eun
- Inje University Haeundae Paik Hospital, Department of Emergency Medicine, 1435 Jwa-dong, Haewondae-gu, Busan 612-030, Republic of Korea
| | - YM Park
- Inje University Haeundae Paik Hospital, Department of Emergency Medicine, 1435 Jwa-dong, Haewondae-gu, Busan 612-030, Republic of Korea
| | - MK Oh
- Inje University Haeundae Paik Hospital, Department of Emergency Medicine, 1435 Jwa-dong, Haewondae-gu, Busan 612-030, Republic of Korea
| | - KH Choi
- Inje University Haeundae Paik Hospital, Department of Emergency Medicine, 1435 Jwa-dong, Haewondae-gu, Busan 612-030, Republic of Korea
- Uijeongbu St. Mary's Hospital, Department of Emergency Medicine, The Catholic University of Korea, 65-1 Geumo-dong, Uijeongbu-si, Gyeonggi-do, 480-717, Republic of Korea
| | - HJ Kim
- Uijeongbu St. Mary's Hospital, Department of Emergency Medicine, The Catholic University of Korea, 65-1 Geumo-dong, Uijeongbu-si, Gyeonggi-do, 480-717, Republic of Korea
| | - DW Kim
- Inje University Haeundae Paik Hospital, Department of Emergency Medicine, 1435 Jwa-dong, Haewondae-gu, Busan 612-030, Republic of Korea
| | - HJ Choo
- Inje University Haeundae Paik Hospital, Department of Emergency Medicine, 1435 Jwa-dong, Haewondae-gu, Busan 612-030, Republic of Korea
| | - JH Cho
- Inje University Haeundae Paik Hospital, Department of Emergency Medicine, 1435 Jwa-dong, Haewondae-gu, Busan 612-030, Republic of Korea
| | - JH Oh
- Inje University Haeundae Paik Hospital, Department of Emergency Medicine, 1435 Jwa-dong, Haewondae-gu, Busan 612-030, Republic of Korea
| | - HY Park
- Inje University Haeundae Paik Hospital, Department of Emergency Medicine, 1435 Jwa-dong, Haewondae-gu, Busan 612-030, Republic of Korea
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21
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Kim SR, Kim KY, Jeong JS, Kim MJ, Kim KH, Choi KH, Kim I. Population genetic characterization of the Japanese oak silkmoth, Antheraea yamamai (Lepidoptera: Saturniidae), using novel microsatellite markers and mitochondrial DNA gene sequences. Genet Mol Res 2017; 16:gmr-16-02-gmr.16029608. [PMID: 28407192 DOI: 10.4238/gmr16029608] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The Japanese oak silkmoth, Antheraea yamamai Guérin-Méneville, 1861 (Lepidoptera: Saturniidae), is an important natural resource of industrial value for silk fiber production. Owing to a lack of geographic and population genetic information, systematic domestication of An. yamamai has not been possible yet. In this study, 10 microsatellite markers developed using next-generation sequencing and two mitochondrial DNA (mtDNA) gene sequences (COI and ND4) were used to investigate the genetic variation and geographic structure of An. yamamai populations in South Korea. The two mtDNA gene sequences revealed very low total genetic variation and, consequently, low geographic variation, validating the use of more variable molecular markers. Genotyping of 76 An. yamamai individuals from nine localities in South Korea showed that the observed number of alleles at each locus ranged from 3 to 26, the polymorphism information content was 0.2990-0.9014, the observed and expected heterozygosities were 0.3252-0.9076 and 0.2500-0.9054, respectively, and FIS was -0.654-0.520. The population-based FIS, FST, RST, and global Mantel tests all suggested that the An. yamamai populations were overall well-interconnected, suggesting that any population can be used as a genetic source for domestication. Nevertheless, STRUCTURE analyses using microsatellite data and mtDNA sequences indicated the presence of two genetic pools in many populations, although a plausible explanation for this observation requires further studies.
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Affiliation(s)
- S R Kim
- Department of Agricultural Biology, National Academy of Agricultural Science, Rural Development Administration, Wanju-gun, Republic of Korea
| | - K Y Kim
- Department of Agricultural Biology, National Academy of Agricultural Science, Rural Development Administration, Wanju-gun, Republic of Korea
| | - J S Jeong
- College of Agriculture & Life Sciences, Chonnam National University, 300 Yongbong-dong, Buk-gu, Gwangju, Republic of Korea
| | - M J Kim
- College of Agriculture & Life Sciences, Chonnam National University, 300 Yongbong-dong, Buk-gu, Gwangju, Republic of Korea
| | - K-H Kim
- C & K Genomics Inc., Seoul National University, Seoul, Republic of Korea
| | - K H Choi
- Department of Agricultural Biology, National Academy of Agricultural Science, Rural Development Administration, Wanju-gun, Republic of Korea
| | - I Kim
- College of Agriculture & Life Sciences, Chonnam National University, 300 Yongbong-dong, Buk-gu, Gwangju, Republic of Korea
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22
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Abstract
BACKGROUND The popularity of cognitive remediation (CR) interventions for individuals with psychosis is in part based on the well-established link between cognition and functioning and the assumption that by targeting cognition, function can improve. While numerous trials have reported CR's efficacy, it is still not considered an evidence-based treatment. Importantly, little is known about the mechanisms through which it may affect functioning. METHOD In this study, we evaluated CR's proximal and distal effects, and examined potential mechanisms. A total of 75 individuals with psychotic disorders were randomized to a combination of strategy-based and drill-and-practice CR or wait-list control, with assessments of training task performance, neurocognition, functional capacity, symptoms and functioning conducted at baseline, end of the 2-month intervention, and 2-month follow-up. RESULTS Compared with treatment as usual, CR was associated with large post-training improvements on training tasks targeting attention, visuospatial memory, and verbal learning and memory, with persisting group differences at the 2-month follow-up. These generalized to mostly large improvements on neuropsychological measures targeting visuospatial memory, verbal learning and memory, delayed verbal memory and verbal working memory. While there were no CR-associated improvements on measures of functional capacity, symptoms, or a self-report measure of independent living skills, there was an effect on an interviewer-rated measure of functioning (Quality of Life Scale), which appeared primarily driven by the Intrapsychic Foundations subscale. Finally, for those randomized to CR, there were significant, medium-sized correlations between training task improvement, neuropsychological improvement and functioning measures. CONCLUSIONS This suggests a complex, multifactorial relationship between CR, and cognitive and functional change.
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Affiliation(s)
- J M Fiszdon
- VA Connecticut Healthcare System and Yale University School of Medicine,Psychology Service (116B),950 Campbell Avenue,West Haven, CT,USA
| | - K H Choi
- Department of Psychology,Korea University,Seoul,Republic of Korea
| | - M D Bell
- VA Connecticut Healthcare System and Yale University School of Medicine,Psychology Service (116B),950 Campbell Avenue,West Haven, CT,USA
| | - J Choi
- The Institute of Living at Hartford Hospital,200 Retreat Avenue,Hartford, CT,USA
| | - S M Silverstein
- Rutgers University - Robert Wood Johnson Medical School Department of Psychiatry and University Behavioral Health Care,151 Centennial Avenue,Piscataway, NJ,USA
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Huh JW, Yoo J, Kim MS, Choi KH, Jue MS, Park HJ. Late-onset bulky naevocytoma of the perineum masquerading as a malignant melanoma. Clin Exp Dermatol 2016; 42:178-181. [PMID: 27862168 DOI: 10.1111/ced.12971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/01/2016] [Indexed: 11/29/2022]
Abstract
Bulky naevocytoma of the perineum is a very rare variant of giant congenital melanocytic naevus (GCMN). It presents as a bulky naevocytic tumour in the perineal region with characteristic histological findings, such as extensive areas with a neural appearance called 'lames foliacees', formation of a pseudofollicular structure and extension of naevus cells between collagen bundles in a row called 'Indian-file' pattern. We report a case of late-onset bulky naevocytoma of the perineum in a 13-year-old girl. The patient presented with two bulky, pedunculated, heavily pigmented masses in the vulvar area that developed in a pre-existing GCMN lesion, which began around puberty and caused severe gait disturbance. Given the possibility of malignant transformation, we conducted staged reduction surgery of the tumour masses, which were found to be intradermal naevi without evidence of malignancy. The patient's gait disturbance improved markedly after surgery.
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Affiliation(s)
- J W Huh
- Department of Dermatology, VHS Medical Centre, Seoul, Korea
| | - J Yoo
- Department of Dermatology, VHS Medical Centre, Seoul, Korea
| | - M S Kim
- Department of Dermatology, VHS Medical Centre, Seoul, Korea
| | - K H Choi
- Department of Dermatology, VHS Medical Centre, Seoul, Korea
| | - M S Jue
- Department of Dermatology, VHS Medical Centre, Seoul, Korea
| | - H J Park
- Department of Dermatology, VHS Medical Centre, Seoul, Korea
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Yoon YE, Choi KH, Kim KH, Yang SC, Han WK. Clinical assessment of lipid profiles in live kidney donors. Transplant Proc 2015; 47:584-7. [PMID: 25891691 DOI: 10.1016/j.transproceed.2014.12.035] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Accepted: 12/31/2014] [Indexed: 01/11/2023]
Abstract
BACKGROUND Abnormal serum lipid profiles are an issue in chronic kidney disease (CKD), but the clinical ramifications of dyslipidemia in live kidney donors are unclear. Thus, we explored the relationship between serum lipids and residual renal function in living donors post-nephrectomy. METHODS Charts of living donors who underwent nephrectomy between January 2010 and March 2013 were reviewed, targeting those with 6-month follow-up examinations at minimum. Altogether, 282 donors were studied, examining total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) levels assayed before donation by standard techniques. Median follow-up time was 14 months. The relationship between postoperative renal function and allograft biopsy results was assessed. Recursive partitioning was applied to identify optimal cut-off points for each parameter. RESULTS Median (interquartile range) serum TC, TG, LDL, and HDL levels were 183 (161-205) mg/dL, 86 (63-131) mg/dL, 108 (92-128) mg/dL, and 53 (44-62) mg/dL, respectively. The glomerular filtration rate at last follow-up was associated with TC (r = -0.187; P = .002) and LDL (r = -0.172; P = .005) levels, but showed no correlation with TG and HDL. Root nodes of TC and LDL determinations in recursive partitioning were 170.5 mg/dL and 80.5 mg/dL, respectively, serving as thresholds for further evaluation. On logistic regression analysis, the likelihood of CKD (glomerular filtration rate < 60 mL/min/1.73 m(2)) at last follow-up was greater in donors with elevated TC and LDL levels (odds ratio = 1.96 and 3.33; P = .021 and .029, respectively). CONCLUSION Kidney donors with serum TC and LDL elevations require close observation, given their demonstrable predisposition to CKD after donation.
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Affiliation(s)
- Y E Yoon
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - K H Choi
- Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam-si, Korea
| | - K H Kim
- Department of Urology, Ewha Women's University Mokdong Hospital, Seoul, Korea
| | - S C Yang
- Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam-si, Korea
| | - W K Han
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
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25
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Yoon YE, Choi KH, Lee KS, Kim KH, Yang SC, Han WK. Impact of metabolic syndrome on postdonation renal function in living kidney donors. Transplant Proc 2015; 47:290-4. [PMID: 25769562 DOI: 10.1016/j.transproceed.2014.10.051] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 10/13/2014] [Accepted: 10/28/2014] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Optimization of kidney donor selection is critical to ensure recovery of the donor. The goal of this study was to determine the influence of metabolic syndrome on renal histology and perioperative renal function in living kidney donors. PATIENTS AND METHODS Between January 2010 and March 2013, a total of 363 living kidney donors who underwent donor nephrectomy at our institution were enrolled. Metabolic syndrome was diagnosed in patients according to the National Cholesterol Education Program's Adult Treatment Panel III, and renal histology of implantation biopsy specimens and perioperative renal function were compared in participants with or without metabolic syndrome. Using multivariate regression analysis, the goal was to identify which component of metabolic syndrome induces chronic histologic changes and delayed renal function recovery. RESULTS We identified 30 donors (8.45%) with metabolic syndrome. Donors with metabolic syndrome were older (48.4 ± 9.2 years vs 39.7 ± 11.4 years; P < .001) and more likely to have chronic histologic changes (36.8% vs 9.7%; P = .001) than subjects without metabolic syndrome. Results of the multivariate regression analysis indicated that obesity, hyperglycemia, and hypertriglyceridemia were independently associated with chronic histologic changes. Perioperative renal function was correlated with the presence of metabolic syndrome rather than with chronic histologic changes, and patients with metabolic syndrome were more likely to experience delayed renal function recovery. Linear regression models found that the sum of the metabolic components correlated with renal function 6 months postoperatively, but among all risk factors, only obesity was significantly associated with the occurrence of delayed renal function recovery (odds ratio, 2.67; P = .001). CONCLUSIONS Although metabolic syndrome in living kidney donors is characterized by chronic histologic changes, perioperative renal function is affected by the syndrome itself rather than by the histologic changes. Obesity is the most important metabolic factor for predicting delayed renal function recovery in living kidney donors, providing an important clinical indicator of postoperative renal function in these patients.
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Affiliation(s)
- Y E Yoon
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - K H Choi
- Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam-si, South Korea
| | - K S Lee
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - K H Kim
- Department of Urology, Ewha Women's University Mokdong Hospital, Seoul, South Korea
| | - S C Yang
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - W K Han
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea.
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Akula N, Barb J, Jiang X, Wendland JR, Choi KH, Sen SK, Hou L, Chen DTW, Laje G, Johnson K, Lipska BK, Kleinman JE, Corrada-Bravo H, Detera-Wadleigh S, Munson PJ, McMahon FJ. RNA-sequencing of the brain transcriptome implicates dysregulation of neuroplasticity, circadian rhythms and GTPase binding in bipolar disorder. Mol Psychiatry 2014; 19:1179-85. [PMID: 24393808 PMCID: PMC5560442 DOI: 10.1038/mp.2013.170] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [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: 03/28/2013] [Revised: 10/24/2013] [Accepted: 10/29/2013] [Indexed: 11/09/2022]
Abstract
RNA-sequencing (RNA-seq) is a powerful technique to investigate the complexity of gene expression in the human brain. We used RNA-seq to survey the brain transcriptome in high-quality postmortem dorsolateral prefrontal cortex from 11 individuals diagnosed with bipolar disorder (BD) and from 11 age- and gender-matched controls. Deep sequencing was performed, with over 350 million reads per specimen. At a false discovery rate of <5%, we detected five differentially expressed (DE) genes and 12 DE transcripts, most of which have not been previously implicated in BD. Among these, Prominin 1/CD133 and ATP-binding cassette-sub-family G-member2 (ABCG2) have important roles in neuroplasticity. We also show for the first time differential expression of long noncoding RNAs (lncRNAs) in BD. DE transcripts include those of serine/arginine-rich splicing factor 5 (SRSF5) and regulatory factor X4 (RFX4), which along with lncRNAs have a role in mammalian circadian rhythms. The DE genes were significantly enriched for several Gene Ontology categories. Of these, genes involved with GTPase binding were also enriched for BD-associated SNPs from previous genome-wide association studies, suggesting that differential expression of these genes is not simply a consequence of BD or its treatment. Many of these findings were replicated by microarray in an independent sample of 60 cases and controls. These results highlight common pathways for inherited and non-inherited influences on disease risk that may constitute good targets for novel therapies.
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Affiliation(s)
- N Akula
- Human Genetics Branch, National Institute of Mental Health Intramural
Research Program, National Institutes of Health, US Department of Health and Human Services,
Bethesda, MD, USA
| | - J Barb
- Mathematical and Statistical Computing Laboratory, Center for Information
Technology, National Institutes of Health, US Department of Health and Human Services,
Bethesda, MD, USA
| | - X Jiang
- Human Genetics Branch, National Institute of Mental Health Intramural
Research Program, National Institutes of Health, US Department of Health and Human Services,
Bethesda, MD, USA
| | - JR Wendland
- Human Genetics Branch, National Institute of Mental Health Intramural
Research Program, National Institutes of Health, US Department of Health and Human Services,
Bethesda, MD, USA
| | - KH Choi
- Department of Psychiatry, Uniformed Services University of the Health
Sciences, Bethesda, MD, USA
| | - SK Sen
- Genetic Disease Research Branch, National Human Genome Research Institute,
National Institutes of Health, US Department of Health and Human Services, Bethesda, MD,
USA
| | - L Hou
- Human Genetics Branch, National Institute of Mental Health Intramural
Research Program, National Institutes of Health, US Department of Health and Human Services,
Bethesda, MD, USA
| | - DTW Chen
- Human Genetics Branch, National Institute of Mental Health Intramural
Research Program, National Institutes of Health, US Department of Health and Human Services,
Bethesda, MD, USA
| | - G Laje
- Human Genetics Branch, National Institute of Mental Health Intramural
Research Program, National Institutes of Health, US Department of Health and Human Services,
Bethesda, MD, USA
| | - K Johnson
- Bioinformatics Section, Information Technology & Bioinformatics
Program, Division of Intramural Research, National Institute of Neurological Disorders
& Stroke, National Institutes of Health, US Department of Health and Human Services,
Bethesda, MD, USA
| | - BK Lipska
- Human Brain Collection Core, Division of Intramural Research Programs,
National Institute of Mental Health Intramural Research Program, National Institutes of
Health, US Department of Health and Human Services, Bethesda, MD, USA
| | - JE Kleinman
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus,
Baltimore, MD, USA
| | - H Corrada-Bravo
- Department of Computer Science, Institute for Advanced Computer Studies and
Center for Bioinformatics and Computational Biology, University of Maryland, College Park,
MD, USA
| | - S Detera-Wadleigh
- Human Genetics Branch, National Institute of Mental Health Intramural
Research Program, National Institutes of Health, US Department of Health and Human Services,
Bethesda, MD, USA
| | - PJ Munson
- Mathematical and Statistical Computing Laboratory, Center for Information
Technology, National Institutes of Health, US Department of Health and Human Services,
Bethesda, MD, USA
| | - FJ McMahon
- Human Genetics Branch, National Institute of Mental Health Intramural
Research Program, National Institutes of Health, US Department of Health and Human Services,
Bethesda, MD, USA
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Abstract
CONTEXT Metaflumizone is a voltage-dependent sodium channel blocker insecticide, which is chemically similar to indoxacarb. Although indoxacarb poisoning is known as a cause of methemoglobinemia, the effect of metaflumizone poisoning in humans is still unknown. CASE DETAILS A 57-year-old man presented with a decreased mentality following ingestion of 100 ml of metaflumizone, 150 ml of glyphosate and alcohol. Although initial methemoglobin (MetHb) level was slightly higher than the normal limit, it gradually rose to reach a maximum level of 27.8%, on the 19 h after ingestion. After hemodialysis, MetHb level was reduced to 15.8%, which decreased further to the level of 6%, following methylene blue administration. DISCUSSION Metaflumizone shares a similar chemical structure to indoxacarb, which is known to be a cause of methemoglobinemia. Physicians should be alert for the development of methemoglobinemia in symptomatic patients when facing potential pesticide poisoning such as metaflumizone poisoning.
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Affiliation(s)
- J S Oh
- Department of Emergency Medicine, College of Medicine, The Catholic University of Korea , Seoul , Republic of Korea
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Lee MN, Choi KH, Kim DK, Kim SH. Mosaic double aneuploidy (45,X/47,XX,+8) with aortic dissection. Genet Couns 2014; 25:177-182. [PMID: 25059016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Chromosomal aneuploidy is considerably frequent and may involve either autosomes or sex chromosomes. While double aneuploidy involving both autosomal and sex chromosomes is rare, several reports described the cases of sex chromosomal aneuploidies in combination with trisomy 21, such as Down-Klinefelter and Down-Turner syndrome. However, trisomy 8-Turner syndrome has been rarely described to date. Here we report a case of a 28-year-old female with mosaic trisomy 8-Turner syndrome. The patient was referred to our hospital for aortic dissection. On physical evaluation, features of her phenotype, which included short stature, webbed neck and cubitus valgus, suggested congenital anomalies such as Turner syndrome. Chest CT revealed aortic dissection with bicuspid aortic valve and coarctation. G-banding cytogenetic analysis of peripheral blood showed mosaicism with two cell lines (45,X[17]/47,XX,+8[33]). FISH analysis indicated that 15% of the cells were of monosomy X karyotype and 85% of the cells were with XX karyotype and trisomy 8 was detected only in XX cells. Though the patient exhibited clinical features of Turner syndrome, somatic stigmas present were not clearly distinguishable from those of trisomy 8, such as short stature, skeletal and cardiac abnormalities. Observations from most of the double aneuploidy cases indicated that the patient's phenotype was not necessarily in correlation to the ratio of autosomal and sex chromosomal aberrations. Mosaicism in trisomy 8-Turner syndrome was rarely documented and we believe this is the first reported case of mosaicism in trisomy 8-Turner syndrome presenting with aortic dissection and surviving into adulthood.
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Kim HR, Lee MJ, Song JE, Han JH, Yoo TH, Kang SW, Choi KH, Han SH. Drainage failure because of spontaneous fracture of the peritoneal dialysis catheter. Perit Dial Int 2013; 33:218-20. [PMID: 23478378 DOI: 10.3747/pdi.2012.00045] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Abstract
Abstract Lipodissolve is a product that is composed of phosphatidylcholine and deoxycholate mixture, and other adjuvant. Lipodissolve injection seems to be performed in many countries for local fat reduction without any legal and scientific evidences of its safety and efficacy despite the US FDA warning.1 Herein, we report a case with agitation and metabolic acidosis following lipodissolve injection.
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Affiliation(s)
- Y Y Kyong
- Department of Emergency Medicine, The Catholic University of Korea , Geumo-Dong, Uiljeongbu, Gyeonggi-do , Republic of Korea
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Chambers RA, McClintick JN, Sentir AM, Berg SA, Runyan M, Choi KH, Edenberg HJ. Cortical-striatal gene expression in neonatal hippocampal lesion (NVHL)-amplified cocaine sensitization. Genes Brain Behav 2013; 12:564-75. [PMID: 23682998 DOI: 10.1111/gbb.12051] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 05/01/2013] [Accepted: 05/14/2013] [Indexed: 11/30/2022]
Abstract
Cortical-striatal circuit dysfunction in mental illness may enhance addiction vulnerability. Neonatal ventral hippocampal lesions (NVHL) model this dual diagnosis causality by producing a schizophrenia syndrome with enhanced responsiveness to addictive drugs. Rat genome-wide microarrays containing >24 000 probesets were used to examine separate and co-occurring effects of NVHLs and cocaine sensitization (15 mg/kg/day × 5 days) on gene expression within medial prefrontal cortex (MPFC), nucleus accumbens (NAC), and caudate-putamen (CAPU). Two weeks after NVHLs robustly amplified cocaine behavioral sensitization, brains were harvested for genes of interest defined as those altered at P < 0.001 by NVHL or cocaine effects or interactions. Among 135 genes so impacted, NVHLs altered twofold more than cocaine, with half of all changes in the NAC. Although no genes were changed in the same direction by both NVHL and cocaine history, the anatomy and directionality of significant changes suggested synergy on the neural circuit level generative of compounded behavioral phenotypes: NVHL predominantly downregulated expression in MPFC and NAC while NVHL and cocaine history mostly upregulated CAPU expression. From 75 named genes altered by NVHL or cocaine, 27 had expression levels that correlated significantly with degree of behavioral sensitization, including 11 downregulated by NVHL in MPFC/NAC, and 10 upregulated by NVHL or cocaine in CAPU. These findings suggest that structural and functional impoverishment of prefrontal-cortical-accumbens circuits in mental illness is associated with abnormal striatal plasticity compounding with that in addictive disease. Polygenetic interactions impacting neuronal signaling and morphology within these networks likely contribute to addiction vulnerability in mental illness.
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Affiliation(s)
- R A Chambers
- Lab for Translational Neuroscience of Dual Diagnosis & Development, Department of Psychiatry, Institute for Psychiatric Research, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
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Kim HN, Kim DE, Hwang JE, Bae WK, Cho SH, Joo YE, Choi KH, Chung IJ, Shim HJ. Paradoxical cerebral embolism during endoscopic esophageal stenting in a patient with esophageal cancer. Endoscopy 2013; 44 Suppl 2 UCTN:E406-7. [PMID: 23169038 DOI: 10.1055/s-0032-1310143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- H N Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
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Chung BN, Choi YJ, Choi KH, Do YS, Lee SY. First Report of Stolbur Phytoplasma Infection in Commercial Freesia hybrida Cultivars. Plant Dis 2012; 96:1820. [PMID: 30727291 DOI: 10.1094/pdis-07-12-0677-pdn] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In January 2012, disease symptoms including chlorosis, leaf crinkle, leaf curving and stunting of whole plants, virescence, and curving and necrosis of flower stalks were observed in Freesia hybrida cvs. Evone, Honey Moon, Golden Gem, and Pallas in Icheon and Suwon (Gyeonggi Province in Korea). To determine a possible phytoplasma infection, the symptomatic freesia plants were examined for the presence of phytoplasma 16S rDNA fragment by PCR with the primer pair P1/P6 (2) and R16F1/R16R1 (in nested PCR), which amplifies phytoplasma 16S rDNA regions (4). An expected PCR product of ~1,096 bp was obtained from the symptomatic freesia plants, and they were designated as FreLN, Fre-phy-Ev4, Fre-phy-Ev6, Fre-phy-GG, Fre-phy-HM, and Fre-phy-Pal. The PCR products were sequenced and registered as GenkBank accessions AB695174 and AB709951-55. The sequence corresponding to symptomatic freesia had 98.8 to 99.4% identity with Stolbur phytoplasma strains in the 16S rDNA region, and it had only 95.7 to 96.3% identity with AY phytoplasma strains. In the ultra-thin sections of the leaf midribs, globous phytoplasmal bodies 54 to 214 nm in size were observed in sieve tube elements of phloem tissue. Fre-Phy-Ev6 and Fre-Phy-HM were doube-infected with Stolbur phytoplasma and Freesia mosaic virus (FreMV). Fre-Phy-Ev6 and Fre-Phy-HM revealed necrosis of flower stalks and flower color breaking besides curving of flower stalks. Therefore, flower color breaking and flower stalk necrosis were assumed to be caused by FreMV (1). Symptoms of chlorosis and stunting of whole plants shown in FreLN and virescence of Fre-phy-GG were typical symptoms of phytoplasmal diseases, while leaf crinkle, leaf curving, and curving of flower stalks appeared to be unique symptoms in F. hybrida. Stolbur phytoplasma was abundant in commercial freesia cultivation fields. Some of the cultivars, such as cv. Pallas, showed only curving of leaf and flower stalks without any typical symptom of phytoplasmal diseases. A phytoplasmal disease was reported in Poland in 2001 from F. hybrida exhibiting leaf chlorotic and necrotic spots, and classified as AY I-B based on RFLP analysis of PCR products (3). To our knowledge, this is the first report of Stolbur phytoplasma in F. hybrida. This result is significant because F. hybrida could be the infection source of Stolbur phytoplasma disease in floricultural crops. Interestingly, we found a prevalence of Stolbur phytoplasma in Petunia hybrida cultivars (GenBank Accession Nos. AB713757 to AB713758). High nucleotide sequence identity of 99.8% in the 16S rDNA region of Stolbur phytoplasma isolates from petunia and freesia support the inference that those Stolbur phytoplasma isolates could infect both floricultural crops. References: (1) A. A. Brunt. Freesia. Page 274 in: Virus and virus-like Diseases of Bulb and Flower Crops, John Wiley & Sons, Chichester, 1995. (2) S. Deng and C. Hiruki. J. Microbiol. Methods. 14:53, 1991. (3) M. Kamińska and H. Sliwa. Plant Dis. 85:336, 2001. (4) I. M. Lee et al. Phytopathology 84:559, 1994.
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Affiliation(s)
- B N Chung
- National Institute of Horticultural and Herbal Science, RDA, Suwon 440-310, Rep. of Korea
| | - Y J Choi
- National Institute of Horticultural and Herbal Science, RDA, Suwon 440-310, Rep. of Korea
| | - K H Choi
- National Institute of Horticultural and Herbal Science, RDA, Suwon 440-310, Rep. of Korea
| | - Y S Do
- National Institute of Horticultural and Herbal Science, RDA, Suwon 440-310, Rep. of Korea
| | - S Y Lee
- National Institute of Horticultural and Herbal Science, RDA, Suwon 440-310, Rep. of Korea
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Lim SW, Jeon SJ, Choi SS, Choi KH. Synovial chondromatosis in the temporomandibular joint: a case with typical imaging features and pathological findings. Br J Radiol 2011; 84:e213-6. [PMID: 22011825 DOI: 10.1259/bjr/69067316] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Synovial chondromatosis of the temporomandibular joint is a rare benign joint disorder that has been reported in only a few studies. However, we recently encountered a pathologically proven case of this disorder. This case also showed the typical imaging findings on panoramic radiographs and on CT and MR images. Therefore, we report this case and the imaging and pathological findings.
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Affiliation(s)
- S W Lim
- Department of Radiology, Wonkwang University Hospital, Iksan, Jeonbuk, Korea
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Kim YT, Park MY, Choi KH, Tai WS, Shim WH, Park SY, Kang JW, Lee KH, Jeong Y, Kim YD, Lim DC. ZnO nanosheets decorated with CdSe and TiO2 for the architecture of dye-sensitized solar cells. J Nanosci Nanotechnol 2011; 11:2263-2268. [PMID: 21449378 DOI: 10.1166/jnn.2011.3152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Pure and TiO2- and CdSe-deposited ZnO nanosheets aligned vertically to the surface of ITO (Indium tin oxide) are prepared using electrodeposition, which is used for building blocks of dye sensitized solar cell. A significant improvement in the photovoltaic efficiency can be obtained by depositing TiO2 or CdSe on ZnO. Photoluminescence spectra show that the TiO2 and CdSe nanostructures suppress the recombination of the electron-hole pair of ZnO. We suggest that the interface charge transfer at TiO2-ZnO and CdSe-ZnO should be responsible for the suppression of the electron-hole pair recombination and enhanced solar cell efficiency by TiO2 and CdSe nanostructures.
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Affiliation(s)
- Young Tae Kim
- Materials Processing Division, Korea Institute of Materials Science, Changwon 641-010, Korea
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Nam TS, Lee SH, Park MS, Choi KH, Kim JT, Choi SM, Kim BC, Kim MK, Cho KH. Mononeuropathy multiplex in a patient with chronic active hepatitis B. J Clin Neurol 2010; 6:156-8. [PMID: 20944818 PMCID: PMC2950922 DOI: 10.3988/jcn.2010.6.3.156] [Citation(s) in RCA: 4] [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: 02/07/2009] [Revised: 07/10/2009] [Accepted: 07/10/2009] [Indexed: 12/02/2022] Open
Abstract
Background Mononeuropathy multiplex is a rare complication during the course of chronic hepatitis B, despite various neuropathies following acute hepatitis B having been reported previously. Case Report A 30-year-old man presented with sensorimotor symptoms in multiple peripheral nerves. The serological tests for hepatitis were consistent with chronic active hepatitis B. After treatment with oral prednisone combined with an antiviral agent, the sensory and motor symptoms improved and hepatitis B virus replication was reduced. Conclusions We suggest that chronic immune-mediated neuropathy associated with hepatitis B virus infection should be considered in the differential diagnosis of patients with hepatitis B.
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Affiliation(s)
- Tai Seung Nam
- Department of Neurology, Chonnam National University Hwasun Hospital, Hwasun, Korea
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Kim S, Zhang S, Choi KH, Reister R, Do C, Baykiz A, Gershenfeld H. An E3 ubiquitin ligase, Really Interesting New Gene (RING) Finger 41, is a candidate gene for anxiety-like behavior and beta-carboline-induced seizures. Biol Psychiatry 2009; 65:425-31. [PMID: 18986647 PMCID: PMC2667267 DOI: 10.1016/j.biopsych.2008.09.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2007] [Revised: 09/05/2008] [Accepted: 09/11/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND Identification of the genes underlying psychiatric illness remains a thorny problem. Previously, Quantitative Trait Loci (QTL) for anxiety-like behaviors and beta-carboline-induced seizure vulnerability have been mapped to the distal portion of mouse chromosome 10, with crosses of A/J and C57BL6 mice. METHODS An interval specific congenic strain for this chromosomal 10 region facilitated the genetic dissection of novelty-induced exploratory behaviors. RESULTS By microarray studies, an unsuspected E3 ubiquitin ligase, Really Interesting New Gene (RING) Finger 41 (Rnf41) was differentially expressed in the region of interest, being upregulated in the hippocampi of B6 compared with A/J as well as congenic A.B6(chr10) versus A/J. By quantitative real-time polymerase chain reaction (qRT-PCR), Rnf41 expression levels were significantly increased 1.5- and 1.3-fold in the hippocampi of C57BL6/J and A.B6(chr10) mice compared with A/J mice, respectively. Protein levels of Rnf41 were increased in hippocampi of B6 mice compared with A/J mice across postnatal development with a 5.5-fold difference at P56. Yeast two-hybrid studies searching for Rnf41 binding partners in fetal hippocampus identified several potential targets. An interaction between Rnf41 and NogoA was validated by glutathionine-S-transferase-Rnf41 pulldown experiments. Re-analysis of a microarray database of human postmortem prefrontal cortex (Brodmann's Area 46/10) found that RNF41 messenger RNA expression levels were reduced significantly in patients with major depression and bipolar disorder compared with unaffected control subjects and confirmed by qRT-PCR. CONCLUSIONS Overall, Rnf41 is nominated as a candidate gene for anxiety-like behaviors, depression, and vulnerability to seizures. The RNF41 and its binding partners suggest molecular pathways underlying behavior, highlighting a potential role for the ubiquitin proteasome system in psychiatric illness.
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Affiliation(s)
- S. Kim
- Dept. of Psychiatry, Univ. of Texas Southwestern Medical Center, Dallas, Texas 75390-9070, Stanley Laboratory of Brain Research, Rockville, MD 20850
| | - S. Zhang
- Dept. of Psychiatry, Univ. of Texas Southwestern Medical Center, Dallas, Texas 75390-9070
| | - KH Choi
- Stanley Laboratory of Brain Research, Rockville, MD 20850
| | - R. Reister
- Dept. of Psychiatry, Univ. of Texas Southwestern Medical Center, Dallas, Texas 75390-9070
| | - Chi Do
- Dept. of Psychiatry, Univ. of Texas Southwestern Medical Center, Dallas, Texas 75390-9070
| | - A.F. Baykiz
- Dept. of Psychiatry, Univ. of Texas Southwestern Medical Center, Dallas, Texas 75390-9070
| | - H.K. Gershenfeld
- Dept. of Psychiatry, Univ. of Texas Southwestern Medical Center, Dallas, Texas 75390-9070, Dept. Integrative Biology, Univ. of Texas Southwestern Medical Center, Dallas, Texas 75390,Corresponding author: Howard K. Gershenfeld, M.D., Ph.D., Department of Psychiatry, Univ. of Texas Southwestern Medical Center, Dallas, Tx. 75390-9070, Phone: 214-732-3804, E-mail:
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Choi SP, Park HK, Park KN, Kim YM, Ahn KJ, Choi KH, Lee WJ, Jeong SK. The density ratio of grey to white matter on computed tomography as an early predictor of vegetative state or death after cardiac arrest. Emerg Med J 2008; 25:666-9. [DOI: 10.1136/emj.2007.053306] [Citation(s) in RCA: 105] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Chae HJ, Choi KH, Chae SW, Kim HM, Shin TK, Lee GY, Jeong GS, Park HR, Choi HI, Kim SB, Yoo SK, Kim HR. Placenta hominis protects osteoporosis in ovariectomized rats. Immunopharmacol Immunotoxicol 2006; 28:165-73. [PMID: 16684675 DOI: 10.1080/08923970600626197] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In China, Japan, and Korea, placenta hominis extracts (PHEs) are used clinically for the treatment of osteoporosis. The anti-osteoporotic effect of PHEs was studied. The trabecular bone area and thickness in OVX rats decreased by 50% from those in sham-operated rats; these decreases were completely inhibited by administration of PHEs for 7 weeks. Osteoclast numbers and the osteoblast surface were enhanced in OVX rats, but PHEs had no effect on these phenomena. Serum phosphorus and alkaline phosphatase in OVX rats increased compared to those in sham-operated rats, but the increases were not affected by the administration of PHEs. Thyroxine (T4) level was stimulated in OVX rats. The extracts inhibited the T4 level in the OVX rats. These results strongly suggest that PHEs be effective in preventing the development of bone loss induced by OVX in rats.
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Affiliation(s)
- H J Chae
- Department of Dental Pharmacology and Wonkwang Biomaterial Implant Research Institute, School of Dentistry, Iksan, Chonbuk, South Korea
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Zoh KD, Kim TS, Kim JG, Choi KH. Degradation of parathion and the reduction of acute toxicity in TiO2 photocatalysis. Water Sci Technol 2005; 52:45-52. [PMID: 16312950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Photocatalytic degradation of methyl parathion was done using a circulating TiO2/UV and TiO2/solar reactor. Indoor experimental results showed that, under the photocatalysis conditions, parathion was more effectively degraded than under the photolysis and TiO2 only conditions. Parathion (38 microM) was completely degraded under photocatalysis within 90 min, and more than 80% TOC decrease after 150 minutes. The main ionic byproducts during the photocatalysis were measured, and almost complete nitrogen recovery was achieved as mainly NO3- NO2-, and NH4+, and 80% of sulfur as recovered as SO4(2)-. Organic intermediates such as nitrophenol and methyl paraoxon were also identified during the photocatalysis of parathion, and these were further degraded after 90 minutes. Microtox bioassay using Vibrio fischeri was used in evaluating the toxicity of solutions treated by photocatalysis and photolysis of parathion. The results showed that the acute toxicity expressed as EC50 almost reduced after 90 min under the photocatalysis condition whereas only 40% reduction of toxicity as EC50 was achieved in photolysis condition. The outdoor results using a TiO2/solar system were similar to the TiO2 indoor system, indicating the possibility of applying TiO2/solar system for the treatment of parathion-contaminated water.
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Affiliation(s)
- K D Zoh
- Institute of Health and Environment, Seoul National University, South Korea.
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Park MC, Park YB, Jung SY, Chung IH, Choi KH, Lee SK. Risk of ovarian failure and pregnancy outcome in patients with lupus nephritis treated with intravenous cyclophosphamide pulse therapy. Lupus 2004; 13:569-74. [PMID: 15462485 DOI: 10.1191/0961203304lu1063oa] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This study was designed to investigate the risk of ovarian failure and the pregnancy outcomes in women treated with intravenous cyclophosphamide (IVCYC) pulse therapy for lupus nephritis. Sixty-seven women with proliferative lupus nephritis were studied. The clinical and laboratory data, SLEDAI and damage indices at IVCYC initiation, doses and numbers of IVCYC pulses, pregnancy and fetal outcomes were evaluated. During a follow-up of 74.4+/-20.6 months, amenorrhea occurred in 25 (37.3%) and was sustained permanently in 10 patients (14.9%). Thirteen women became pregnant with a total of 19 pregnancies. Seventeen pregnancies ended without complications and all babies were born healthy without any congenital anomalies or perinatal illnesses. Two pregnancies were terminated by induced abortion but no congenital anomaly was noted in these cases. Logistic regression analysis showed that old age, high damage index at the initiation of IVCYC pulse therapy and high cumulative dosage of IVCYC were the independent risk factors of ovarian failure, and that the presence of amenorrhea, regardless of its duration, was the risk factor of pregnancy failure. Pregnancy was possible with a favorable outcome after the withdrawal of IVCYC pulse therapy, unless amenorrhea develops.
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Affiliation(s)
- M-C Park
- Department of Internal Medicine, Institute for Immunology and Immunologic Diseases, Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
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Chae KJ, Yim SK, Choi KH. Application of a sponge media (BioCube) process for upgrading and expansion of existing caprolactam wastewater treatment plant for nitrogen removal. Water Sci Technol 2004; 50:163-171. [PMID: 15537004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
For the upgrade and expansion of an existing caprolactam wastewater treatment plant, a freely floating sponge media (BioCube) process was selected based on extensive pilot-plant tests, due to extreme space constraints. In order to protect nitrifier inhibition caused by high strength organics in caprolactam wastewater, the pilot plant consisted of an organics removal reactor, which functioned as a pretreatment for nitrification, and followed the nitrogen removal reactor. The suspended MLSS was 1,800-4,000 and the media attached MLSS was maintained at 22,000-26,000 mg/L. The final effluent COD was noticeably low, around 20.4-37 mg/L, even with fairly large fluctuations in the feed levels, between 1,400-6,770 mg/L. The removal of total nitrogen with the system, when denitrification was close to completion, was approximately 97.6%. For the entire run, complete nitrification of 99.6% was achieved, which might have been due to well-acclimatized nitrifiers attached in the BioCube media. Specifically, after adaptation, the nitrification continuously increased in the organics removal reactor, even under high residual organics conditions. From the numerous experimental results, the BioCube process seemed to be an effective method for the upgrading and expansion of the existing wastewater treatment plant, with minimum reactor enlargement.
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Affiliation(s)
- K J Chae
- R&D Institute, Kolon Eng and Const Co, Ltd, 207-2, Mabuk-Ri, Guseong-Eup, Yongin, Kyungki, Korea.
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Chae KJ, Yim SK, Choi KH, Kim SK, Park WK. Integrated biological and electro-chemical treatment of swine manure. Water Sci Technol 2004; 49:427-434. [PMID: 15137454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
A full-scale biogas plant was applied to the processing of 10 m3/d of swine manure. The plant consisted of an anaerobic digester and an engine-generator. The digester operation resulted in an 81% of COD removal, a 55% of VS reduction, and methane-rich biogas production that is used to generate electrical and thermal energies. To further treat the digested manure, for compliance with discharge limits, an electro-chemical oxidation with a dimensionally sable anode was investigated for the simultaneous elimination of both the remaining COD and ammonia nitrogen. It was able to reduce NH4+-N levels from as high as 1552 down to 25 mg/L in 160 min, and the COD from 1542 to 0.21 mg/L under the experimental conditions of 8 V, 30 A and 20,000 microS/cm. The amount of electricity required for a 90% removal of the residual COD and ammonia in 1 m3 of filtered digester manure, via electrochemical oxidation, were approximately 153 and 151 kWh, respectively. These values exceed the maximum potential capacity of the biogas-originated electricity through the digestion of swine manure containing normal VS content. However, approximately 50% of the required electricity for the electrochemical oxidation could be supplied from the engine-generator.
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Affiliation(s)
- K J Chae
- R&D Institute, Kolon Engineering and Construction Co., Ltd., 207-2, Mabuk-Ri, Guseong-Eup, Youngin, Kyungki, Korea.
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Hong SW, Jeong HJ, Kim YS, Kim SI, Choi KH, Lee HY, Han DS, Park K. Nuclear factor kappa B activation in glomeruli of posttransplant IgA nephropathy using southwestern histochemistry. Transplant Proc 2003; 35:179-80. [PMID: 12591356 DOI: 10.1016/s0041-1345(02)03944-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- S W Hong
- Department of Pathology, Yonsei University College of Medicine Seoul, South Korea
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Jeong HJ, Hong SW, Kim YS, Kim SI, Kim MS, Choi KH, Lee HY, Han DS, Park K. Histologic factors associated with nephrotic-range proteinuria in recurrent IGA nephropathy. Transplant Proc 2003; 35:291. [PMID: 12591405 DOI: 10.1016/s0041-1345(02)04011-3] [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] [Indexed: 11/29/2022]
Affiliation(s)
- H J Jeong
- Department of Pathology, Yonsei University College of Medicine, Seoul, South Korea
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Park HC, Kang SW, Choi KH, Ha SK, Han DS, Lee HY. Clinical outcome in continuous ambulatory peritoneal dialysis patients is not influenced by high peritoneal transport status. Perit Dial Int 2002; 21 Suppl 3:S80-5. [PMID: 11887869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVES We undertook this study to examine the influence of demographics, peritoneal membrane transport characteristics, nutrition indices, dialysis adequacy, and comorbid diseases on patient survival on continuous ambulatory peritoneal dialysis (CAPD), and to identify whether high peritoneal membrane transport is an independent risk factor for mortality on CAPD. DESIGN Our retrospective study was carried out in CAPD patients in a large tertiary care teaching hospital. METHODS Until December 2000, we followed 212 patients who started CAPD between 1994 and 1997 and who underwent a peritoneal equilibration test (PET) within 3 months of CAPD initiation. RESULTS By univariate analysis, comorbid diseases, old age, high peritoneal transport, and serum albumin predicted patient mortality. Independent predictors of mortality as determined by the Cox proportional hazard model included diabetes mellitus, cardiovascular disease, serum albumin, and old age. High peritoneal transport failed to independently influence mortality in our CAPD patients.
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Affiliation(s)
- H C Park
- Department of Internal Medicine, Institute of Kidney Disease, Yonsei University College of Medicine, Seoul, Korea
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Chung H, Kang YS, Hwang CS, Moon IK, Yim CH, Choi KH, Han KO, Jang HC, Yoon HK, Han IK. Deflazacort increases osteoclast formation in mouse bone marrow culture and the ratio of RANKL/OPG mRNA expression in marrow stromal cells. J Korean Med Sci 2001; 16:769-73. [PMID: 11748360 PMCID: PMC3054787 DOI: 10.3346/jkms.2001.16.6.769] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Information on precise effects of deflazacort on bone cell function, especially osteoclasts, is quite limited. Therefore, the present study was undertaken to test effects of deflazacort on osteoclast-like cell formation in mouse bone marrow cultures and on the regulation of osteoprotegerin (OPG) and its ligand (RANKL) mRNA expressions by RT-PCR in the ST2 marrow stromal cells. TRAP-positive mononuclear cells increased after the treatment of deflazacort at 10(-9) to 10(-7) M alone for 6 days in a dose-dependent manner. Number of TRAP-positive multi-nucleated cells (MNCs) increased significantly with combined treatment of deflazacort at 10(-7) M and 1,25-(OH)2D3 at 10(-9) M compared to that of cultures treated with 1,25-(OH)2D3 alone (p<0.05). Exposure to deflazacort at 10(-7) M in the presence of 1,25-(OH)2D3 at 10(-9) M in the last 3-day culture had greater stimulatory effect on osteoclast-like cell formation than that of the first 3-day culture did. Deflazacort at 10(-10) -10(-6) M downregulated OPG and upregulated RANKL in mRNA levels in a dose-dependent manner. These observations suggest that deflazacort stimulate osteoclast precursor in the absence of 1,25-(OH)2D3 and enhance differentiation of osteoclasts in the presence of 1,25-(OH)2D3. These effects are, in part, thought to be mediated by the regulation of the expression of OPG and RANKL mRNA in marrow stromal cells.
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Affiliation(s)
- H Chung
- Department of Medicine, Sungkyunkwan University School of Medicine, Samsung Cheil Hospital, Seoul, Korea.
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Abstract
We had an opportunity to evaluate a child who developed fever approximately two to three weeks after the open heart surgery for tetralogy of Fallot. His peripheral blood smear showed rings and various stages of Plasmodium vivax. The patient had received packed red blood cells during the surgery and postoperative care, one unit of which was later proved sero-positive for malaria. The possibility of malaria should be included in the differential diagnosis of the patients with unexplained fever after multiple blood product transfusions for the open heart surgery.
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Affiliation(s)
- Y H Lee
- Department of Pediatrics Yeungnam University Hospital, Taegu, Korea.
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