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Soh RCC, Chen BZ, Hartono S, Lee MS, Lee W, Lim SL, Gan J, Maréchal B, Chan LL, Lo YL. The hindbrain and cortico-reticular pathway in adolescent idiopathic scoliosis. Clin Radiol 2024; 79:e759-e766. [PMID: 38388254 DOI: 10.1016/j.crad.2024.01.027] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 01/09/2024] [Accepted: 01/18/2024] [Indexed: 02/24/2024]
Abstract
AIM To characterise the corticoreticular pathway (CRP) in a case-control cohort of adolescent idiopathic scoliosis (AIS) patients using high-resolution slice-accelerated readout-segmented echo-planar diffusion tensor imaging (DTI) to enhance the discrimination of small brainstem nuclei in comparison to automated whole-brain volumetry and tractography and their clinical correlates. MATERIALS AND METHODS Thirty-four participants (16 AIS patients, 18 healthy controls) underwent clinical and orthopaedic assessments and brain magnetic resonance imaging (MRI) on a 3 T MRI machine. Automated whole-brain volume-based morphometry, tract-based spatial statistics analysis, and manual CRP tractography by two independent raters were performed. Intra-rater and inter-rater agreement of DTI metrics from CRP tractography were assessed by intraclass correlation coefficient. Normalised structural brain volumes and DTI metrics were compared between groups using Student's t-tests. Linear correlation analysis between imaging parameters and clinical scores was also performed. RESULTS AIS patients demonstrated a significantly larger pons volume compared to controls (p=0.006). Significant inter-side CRP differences in mean (p=0.02) and axial diffusivity (p=0.01) were found in patients only. Asymmetry in CRP fractional anisotropy significantly correlated with the Cobb angle (p=0.03). CONCLUSION Relative pontine hypertrophy and asymmetry in CRP DTI metrics suggest central supranuclear inter-hemispheric imbalance in AIS, and support the role of the CRP in axial muscle tone. Longitudinal evaluation of CRP DTI metrics in the prediction of AIS progression may be clinically relevant.
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Affiliation(s)
- R C C Soh
- Singapore General Hospital, Singapore; Duke-NUS Medical School, Singapore
| | - B Z Chen
- Singapore General Hospital, Singapore
| | - S Hartono
- Duke-NUS Medical School, Singapore; National Neuroscience Institute, Singapore
| | - M S Lee
- Singapore General Hospital, Singapore
| | - W Lee
- Singapore General Hospital, Singapore
| | - S L Lim
- Singapore General Hospital, Singapore
| | - J Gan
- Siemens Healthineers, Singapore
| | - B Maréchal
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland; Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland; Signal Processing Laboratory (LTS 5), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - L L Chan
- Singapore General Hospital, Singapore; Duke-NUS Medical School, Singapore.
| | - Y L Lo
- Duke-NUS Medical School, Singapore; National Neuroscience Institute, Singapore
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Lee JH, Kwon J, Lee MS, Cho Y, Oh IY, Park J, Jeon KH. Prediction of atrial fibrillation in patients with embolic stroke with undetermined source using electrocardiogram deep learning algorithm and clinical risk factors. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.558] [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
Combining the artificial intelligence algorithm with the known clinical risk factors may provide enhanced accuracy for prediction of the hidden atrial fibrillation (AF) in patients with embolic stroke with undetermined source (ESUS).
Purpose
We aimed to develop enhanced prediction models for AF with deep learning algorithm (DLA) and clinical predictors in patients with ESUS. The DLA was created to identify the patients with paroxysmal AF based on their electrocardiograms (ECG) during sinus rhythm.
Methods
We analyzed the 221 patients who underwent insertable cardiac monitor (ICM) for AF detection following ESUS. The DLA was previously developed with sinus rhythm ECGs of 10,605 paroxysmal AF patients and 50,522 non-AF patients. The convolutional neural network was used for the DLA. The primary endpoint was defined as any AF episode lasting over 5 min by ICM. The atrial ectopic burden (AEB) was calculated as the percentage of the number of conducted QRS by atrial ectopy on Holter monitoring.
Results
AF (≥5 min) was detected by ICM in 32 patients (14.5%) during follow-up period of 15.1±8.6 months. AF patients had higher AEB (0.199% vs 0.023%, p<0.001), larger left atrial diameters (LAD, 41.2 mm vs 35.7 mm, p<0.001), and larger left atrial volume index (LAVI, 46.4 ml/m2 vs 32.3 ml/m2, p<0.001) than those without AF. The means of calculated probabilities of AF by DLA were higher in patients with AF than those without AF (63.8% vs 40.2%, p<0.001). In the receiver operating characteristic curve analysis, the areas under the curve (AUC) were the highest in DLA (0.824) followed by AEB (0.784), LAVI (0.780), and LAD (0.768). The multivariable model with AEB, LAVI, and DLA demonstrated excellent prediction accuracy for paroxysmal AF (AUC: 0.902, Figure 1)
Conclusions
In patients with ESUS, the DLA outperformed other clinical risk factors for prediction of AF. Combining DLA with AEB, LAD and LAVI could is a potential useful tool to predict AF in ESUS patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J H Lee
- Seoul National University Bundang Hospital , Seongnam , Korea (Republic of)
| | - J Kwon
- Medical AI Inc, Medical research team , California , United States of America
| | - M S Lee
- Medical AI Inc, Medical research team , California , United States of America
| | - Y Cho
- Seoul National University Bundang Hospital , Seongnam , Korea (Republic of)
| | - I Y Oh
- Seoul National University Bundang Hospital , Seongnam , Korea (Republic of)
| | - J Park
- Mediplex Sejong Hospital, Critical Care and Emergency Medicine , Incheon , Korea (Republic of)
| | - K H Jeon
- Seoul National University Bundang Hospital , Seongnam , Korea (Republic of)
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Jeon KH, Kwon JM, Lee MS, Cho YJ, Oh IY, Lee JH. Deep learning-based electrocardiogram analysis detecting paroxysmal atrial fibrillation during sinus rhythm in patients with cryptogenic stroke: validation study using implantable cardiac monitoring. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is the most cause of cardioembolic source causing cryptogenic stroke. In these, anticoagulation therapy could reduce recurrence of stroke. However, paroxysmal AF would not be detected even by 24 hours Holter monitoring. Deep learning-based electrocardiogram (ECG) analysis models were recently developed to detect AF during sinus rhythm.
Purpose
We aimed to develop a deep learning algorithm (DLA) to detect AF during sinus rhythm and validate the model in patients with cryptogenic stroke who underwent implantable cardiac monitoring (ICM) to diagnose paroxysmal AF.
Methods
This cohort study involved three hospitals (A, B, and C). We developed a DLA to detect AF using sinus rhythm 10 s 12-lead ECG. We included adult patients aged ≥18 years from hospital A and B. We used development data from AF adult patients who had at least one atrial fibrillation rhythm in the study period (Jan 2016 to Dec 2021) and non-AF patients who had no reference to AF in the ECG and electronic medical record. DLA was based on convolutional neural network (CNN) using 10 s 12-lead. For external validation, the ECGs from 217 patients (hospital C) with cryptogenic stroke who underwent ICM were analyzed by using the DLA for validating the accuracy in the real-world clinical situations.
Results
We included 10,605 AF adult patients and 50,522 non-AF patients as development data. During the internal validation, the area under the curve (AUC) of the final DLA based on CNN was 0.793 (95% Confidence interval 0.778–0.807). In external validation data from cryptogenic stroke patients, the mean ICM duration was 15.1 months, and AF >5 mins was detected in 32 patients (14.5%). The diagnostic accuracy of DLA was 0.793 to detect AF during sinus rhythm, and AUC was 0.824. The sensitivity, specificity, positive predictive value, and negative predictive value of the model were 0.844, 0.784, 0.403, and 0.967, respectively, which outperformed other conventional predictive methods based on clinical factors, such as CHARGE-AF, C2hest, and HATCH.
Conclusions
In this study, DLA accurately detected paroxysmal AF using 12-leads normal sinus rhythm ECG in patients with cryptogenic stroke and outperformed the conventional models. The DLA could be used as a screening tool to identify the cause of stroke in the future.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K H Jeon
- Seoul National University Bundang Hospital , Seongnam , Korea (Republic of)
| | - J M Kwon
- Incheon Sejong Hospital, Department of Critical Care and Emergency Medicine , Incheon , Korea (Republic of)
| | - M S Lee
- Medical research team, Medical AI Inc , San Francisco , United States of America
| | - Y J Cho
- Seoul National University Bundang Hospital , Seongnam , Korea (Republic of)
| | - I Y Oh
- Seoul National University Bundang Hospital , Seongnam , Korea (Republic of)
| | - J H Lee
- Seoul National University Bundang Hospital , Seongnam , Korea (Republic of)
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Gyurjian K, Chiu S, Hammershaimb B, Nadadur M, Phan P, Shen YJ, Lin B, Lee MS. The association between diabetes and mortality in young adults presenting with myocardial infarction. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The incidence of diabetes mellitus and coronary artery disease continue to rise and collectively comprise two of the most prevalent and costly diseases worldwide. The goal of this study is to report the prognosis of young patients with diabetes presented with acute myocardial infarction (AMI).
Methods
This is a retrospective observational cohort study that included consecutive patients aged 18–45 years who underwent cardiac catheterization for AMI between 2006 and 2016 in an integrated healthcare system in Southern California. The prognosis of patients with diabetes were compared to those without diabetes.
Results
A total of 1,560 patients (average age 40.2±5.3 years, 25.6% female) presenting with AMI were included. Of these 272 (17.4%) had diabetes. Diabetics were older (41.1±4.4 vs 40.0±5.4 years), more likely to be female (32.4% vs 24.1%, p=0.006), Hispanic (51.5% vs 40.5%, p<0.001), have a higher body mass index (BMI) (33.6±7.1 vs 31.2±6.8kg/m2, p<0.001), have hypertension (HTN) (67.6% vs 23.8%, p<0.001), hyperlipidemia (HLD) (78.3% vs 24.1%, p<0.001), peripheral vascular disease (9.9% vs 1.9%, p<0.001), chronic kidney disease (CKD) (23.2% vs 2.7%, p<0.001), hypothyroidism (7% vs 4%, p=0.034), and prior strokes (4.4% vs 2.2%, p=0.034).
On multivariate analysis accounting for other cardiovascular risk factors, the association remained significant (OR 1.82, 95% CI 1.04–3.19, p=0.036). At a median follow-up of 5.8 years (interquartile range 3.7–8.7 years), diabetes was independently associated with increased all-cause mortality (Hazard ratio [HR] 3.10, 95% CI 1.68–5.69, p<0.001) when adjusting for age, sex, race, BMI, HTN, HLD, CKD, hypothyroidism, prior stroke, and ACS etiology. In a propensity score matched cohort, diabetes remained significantly associated with all-cause mortality (HR 5.29, 95% CI 2.34–12.02, p<0.001).
Conclusion
Diabetes is an independent predictor of increased mortality in young adults <45 years old presenting with AMI.
Funding Acknowledgement
Type of funding sources: Private hospital(s). Main funding source(s): KAISER PERMANENTE LOS ANGELES MEDICAL CENTER
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Affiliation(s)
- K Gyurjian
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, United States of America
| | - S Chiu
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, United States of America
| | - B Hammershaimb
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, United States of America
| | - M Nadadur
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, United States of America
| | - P Phan
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, United States of America
| | - Y J Shen
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, United States of America
| | - B Lin
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, United States of America
| | - M S Lee
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, United States of America
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Lee CI, Su YR, Chen CH, Chang TA, Kuo EES, Hsieh WT, Huang CC, Lee MS, Liu M. O-086 End-to-end deep learning for recognition of ploidy status using time-lapse videos. Hum Reprod 2021. [DOI: 10.1093/humrep/deab125.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Our Retrospective study is to investigate an end-to-end deep learning model in identifying ploidy status through raw time-lapse video.
Summary answer
Our deep learning model demonstrates a proof of concept and potential in recognizing the ploidy status.
What is known already
Since the time-lapse system has been introduced into the IVF lab, the relationship between morphogenetic and ploidy status has been often discussed. However, the result has not yet reached a united conclusion due to some limitations such as human labeling. Besides the statistical approach, deep learning models have been utilized for ploidy prediction. As such approaches are single image-based, the performance remains unpromising as previous statistical-based research. Therefore, in order to move further toward clinical application, better research design and approach are needed.
Study design, size, duration
A retrospective analysis of the time-lapse videos and chromosomal status from 690 biopsied blastocysts cultured in a time-lapse incubator (EmbryoScope+, Vitrolife) between January 2017 and August 2018 in the Lee Women’s Hospital were assessed. The ploidy status of the blastocyst was derived from the PGT-A using high-resolution next-generation sequencing (hr-NGS). Embryo videos were obtained after normal fertilization through the intracytoplasmic sperm injection or conventional insemination.
Participants/materials, setting, methods
By randomly dividing the data into 80% and 20%, we developed our deep learning model based on Two-Stream Inflated 3D ConvNets(I3D) network. This model was trained by the 80% time-lapse videos and the PGT-A result. The remaining 20% has been tested by feeding the time-lapse video as input and the PGT-A prediction as output. Ploidy status was classified as Group 1 (aneuploidy) and Group 2 (euploidy and mosaicism).
Main results and the role of chance
Time-lapse videos were divided into 3-time partitions: day 1, day 1 to 3, and day 1 to 5. Deep learning models have been fed by RGB and optical flow. Combining 3 different time partitions with RGB, optical flow, and fused result from RGB and optical flow, we received nine sets of test results. According to the results, the longest time partition with the fusion method has the highest AUC result as 0.74, which appeared higher than the other eight experimental settings with a maximum increase of 0.17.
Limitations, reasons for caution
The present study is retrospective and future prospective research would help us to identify more key factors and improve this model. In addition, expanding sample size combined with cross-centered validation will also be considered in our future approach.
Wider implications of the findings
Group 1 and Group 2 approach provided deselection of aneuploidy embryos, while future deep learning approaches toward high mosaicism, low mosaicism, and euploidy will be needed, in order to provide a better clinical application.
Trial registration number
CS18082
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Affiliation(s)
- C I Lee
- Lee Women’s Hospital, Division of Infertility, Taichung, Taiwan R.O.C
| | - Y R Su
- Binflux Inc, R&D Department, Taipei, Taiwan R.O.C
| | - C H Chen
- Lee Women’s Hospital, Division of Infertility, Taichung, Taiwan R.O.C
| | - T A Chang
- University of Texas Health Science Center, Department of Obstetrics and Gynecology, San Antonio, USA
| | - E E S Kuo
- Binflux Inc, R&D Department, Taipei, Taiwan R.O.C
| | - W T Hsieh
- Binflux Inc, R&D Department, Taipei, Taiwan R.O.C
| | - C C Huang
- Lee Women’s Hospital, Division of Infertility, Taichung, Taiwan R.O.C
| | - M S Lee
- Lee Women’s Hospital, Division of Infertility, Taichung, Taiwan R.O.C
| | - M Liu
- Binflux Inc, R&D Department, Taipei, Taiwan R.O.C
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Chang LS, Lee HC, Hsu CT, Tsao HM, Huang CC, Lee MS. P–009 A modified sperm chromatin dispersion test, LensHooke® R10, for quick and accurate determination of human sperm DNA fragmentation. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
The performance and efficiency of the LensHooke® R10 test kit were evaluated by the clinical examination for precision, accuracy, and time.
Summary answer
The LensHooke® R10 based on sperm chromatin dispersion test offers not only quick testing for sperm DNA fragmentation but also reliable and accurate test results.
What is known already
Sperm chromatin dispersion (SCD) test, one of the most commonly used testing for sperm DNA fragmentation (SDF), can be conducted promptly and without the need for expensive laboratory instruments. However, the main disadvantage of the SCD test is inter-observer variability in categorizing the size of characteristics halos surrounding the core of sperm. Moreover, it takes more than one hour to accomplish whole assay procedures making this testing an inefficient diagnostic tool. These may hinder its broad availability among andrology laboratories or prevent it from being routinely used for the evaluation of male infertility.
Study design, size, duration
A total of 108 participants was included in this prospective study. Data was collected from the reproductive medicine center between June and December 2020.
Participants/materials, setting, methods
This study included 108 consecutive male partners of couples attending for assisted reproductive treatment. SDF was simultaneously tested by using LensHooke® R10 (R10) and Halosperm® G2 (G2) respectively. We evaluated the correlation and agreement between two SCD-based test kits. The repeatability and reproducibility of the SCD kits were assessed by intra-and inter-observer agreement experiments. The sensitivity, specificity, positive predictive value, negative predictive value for the R10 was determined by receiver operator characteristics (ROC) curve analysis.
Main results and the role of chance
The R10 produced more clear sperm core and dispersed chromatin, therefore highly recognizable images can be easily and accurately categorized when scoring of SDF. It took 50% less time for SDF testing by the R10 compared to the G2 (38.26 ± 9.85 minutes vs. 76.52 ± 19.7 minutes, P < 0.0001). The SDF% results showed a strong correlation for the R10 and G2 with Spearman’s coefficients of rank correlation (rho) above 0.8 (P < 0.0001, N = 108). The R10 showed 89.8% accuracy with 87.9% sensitivity, 90.8% specificity, 82.9% PPV, and 93.7% NPV on the measurement of SDF% at the threshold value of 22%. Intraclass correlation coefficients (ICC) >0.9 showed a strong agreement between two observers on the testing of SDF using the R10. ICC >0.9 showed a high intra-observer agreement within 4 repeated testing on SDF using the R10. The R10 showed an intra-observer’s precision of coefficient variation, CV < 10% for SDF%. In addition, SDF% test results obtained by the R10 for asthenospermic (31.8% ± 16.7%), teratospermic (22.9% ± 14.4%), and oligoasthenoteratozoospermic samples (36.6% ± 14.4%) were significantly higher than that observed in normozoospermic samples (15.3% ± 10.2%, p < 0.05), was comparable with the G2.
Limitations, reasons for caution
The sample size of 4 semen specimens used to evaluate the intra-and inter-observer agreement was a limitation. Besides, evaluating the relationship between the SDF and clinical outcome of ART is necessary for further study.
Wider implications of the findings: The new in vitro diagnostics reagent, LensHooke® R10, is a simple and quick test kit that offers reliable and accurate test results of sperm DNA fragmentation, can be routinely used in male infertility evaluation.
Trial registration number
CS2–20012
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Affiliation(s)
- L S Chang
- Bonraybio Co.- Ltd, Clinical Medicine Dept., Taichung, Taiwan R.O.C
| | - H C Lee
- Bonraybio Co.- Ltd, Clinical Medicine Dept., Taichung, Taiwan R.O.C
| | - C T Hsu
- Bonraybio Co.- Ltd, Executive Office, Taichung, Taiwan R.O.C
| | - H M Tsao
- Lee Women’s Hospital, IVF Center, Taichung, Taiwan R.O.C
| | - C C Huang
- Lee Women’s Hospital, IVF Center, Taichung, Taiwan R.O.C
| | - M S Lee
- Lee Women’s Hospital, IVF Center, Taichung, Taiwan R.O.C
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Hwang UJ, Lee MS, Jung SH, Ahn SH, Kwon OY. Relationship Between Sexual Function and Pelvic Floor and Hip Muscle Strength in Women With Stress Urinary Incontinence. Sex Med 2021; 9:100325. [PMID: 33662705 PMCID: PMC8072144 DOI: 10.1016/j.esxm.2021.100325] [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] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/06/2021] [Accepted: 01/12/2021] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION The pelvic floor muscle (PFM) could affect female sexual functions. The hip muscles are morphologically and functionally linked to PFM and are important elements of female sexual attraction. AIM To determine the relationship between female sexual function and hip muscle strength and PFM functions in women with stress urinary incontinence (SUI). METHODS A total of 42 women with SUI were recruited in this study. Female sexual function was measured using the pelvic organ prolapse urinary incontinence sexual function questionnaire (PISQ). PFM functions were measured using a perineometer. Hip muscle strength was measured using a Smart KEMA tension sensor. The relationship between female sexual function and PFM function and hip muscle strength was assessed using Pearson correlation coefficients and multiple regression analyses with forward selection. MAIN OUTCOME MEASURES PISQ score, PFM functions (strength and endurance), and strength of hip extensor, abductor, and adductor were the main outcome measures. RESULTS For the behavioral/emotive domain in the PISQ, hip extensor strength (r = 0.452), PFM strength (r = 0.441), PFM endurance (r = 0.362), and hip adductor strength (r = 0.324) were significantly correlated and hip extensor strength emerged in multiple regression. For the physical domain in the PISQ, hip abductor strength (r = 0.417), PFM endurance (r = 0.356), hip adductor strength (r = 0.332), and PFM strength (r = 0.322) were significantly correlated and hip abductor strength entered in multiple regression. For partner-related domain in the PISQ, hip adductor (r = 0.386) and abductor strength (r = 0.314) were significantly correlated and hip adductor strength appeared in multiple regression. For the PISQ total score, hip extensor strength (r = 0.484), PFM endurance (r = 0.470), hip adductor strength (r = 0.424), hip abductor strength (r = 0.393), and PFM strength (r = 0.387) were significantly correlated and hip extensor strength and PFM endurance emerged in multiple regression. CONCLUSION The female sexual function could be related to not only PFM functions but also hip muscle strength in women with SUI. Hwang UJ, Lee MS, Jung SH, Ahn SH, Kwon OY. Relationship Between Sexual Function and Pelvic Floor and Hip Muscle Strength in Women With Stress Urinary Incontinence. Sex Med 2021;9:100325.
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Affiliation(s)
- U J Hwang
- Department of Physical Therapy, Graduate School, Yonsei University, Wonju, South Korea
| | - M S Lee
- Sophie-Marceau Women's Clinic, Daegu, South Korea
| | - S H Jung
- Department of Physical Therapy, Graduate School, Yonsei University, Wonju, South Korea
| | - S H Ahn
- Department of Physical Therapy, Graduate School, Yonsei University, Wonju, South Korea
| | - O Y Kwon
- Department of Physical Therapy, College of Health Science, Laboratory of Kinetic Ergocise Based on Movement Analysis, Yonsei University, Wonju, South Korea.
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Park KH, Jung M, Kim DY, Lee YM, Lee MS, Ryu BH, Hong SI, Hong KW, Bae IG, Cho OH. Effects of subinhibitory concentrations of chlorhexidine and mupirocin on biofilm formation in clinical meticillin-resistant Staphylococcus aureus. J Hosp Infect 2020; 106:295-302. [PMID: 32679053 DOI: 10.1016/j.jhin.2020.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 07/06/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The effects of subinhibitory concentrations (sub-MICs) of antibacterial agents on the biofilm-forming ability of Staphylococcus aureus require further study. AIM To investigate the effects of sub-MICs of chlorhexidine and mupirocin on biofilm formation in clinical meticillin-resistant Staphylococcus aureus (MRSA) isolates. METHODS MRSA isolates were collected from patients with bloodstream infections at a tertiary care hospital. The basal level of biofilm formation and biofilm induction by sub-MICs of chlorhexidine and mupirocin were evaluated by measuring biofilm mass stained with Crystal Violet. FINDINGS Of the 112 MRSA isolates tested, 63 (56.3%) and 44 (39.3%) belonged to sequence type (ST)5 and ST72 lineages, respectively, which are the predominant healthcare- and community-associated clones in South Korea. ST5 isolates were more likely to have chlorhexidine MIC ≥4 (73.0% vs 29.5%), resistance to mupirocin (23.8% vs 0%), agr dysfunction (73.0% vs 9.1%), and qacA/B gene (58.7% vs 2.3%) compared to ST72 isolates. The basal level of biofilm formation ability was frequently stronger in ST72 isolates compared to ST5 isolates (77.3% vs 12.7%). Sub-MICs of chlorhexidine and mupirocin promoted biofilm formation in 56.3% and 53.6%, respectively, of all isolates. Biofilm induction was more prevalent in ST5 isolates (85.7% for chlorhexidine, 69.8% for mupirocin) than in ST72 isolates (15.9% for chlorhexidine, 27.3% for mupirocin). CONCLUSION Sub-MICs of chlorhexidine and mupirocin promoted biofilm formation in half of the clinical MRSA isolates. Our results suggest that ST5 MRSA biofilm can be induced together with some other bacterial virulent factors following exposure to chlorhexidine, which might confer a survival advantage to this clone in the healthcare environment.
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Affiliation(s)
- K-H Park
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - M Jung
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - D Y Kim
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - Y-M Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - M S Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - B-H Ryu
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Republic of Korea
| | - S I Hong
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Republic of Korea
| | - K-W Hong
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - I-G Bae
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea; Gyeongsang Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - O-H Cho
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Republic of Korea; Gyeongsang Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, Republic of Korea.
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Baek MS, Cho H, Lee HS, Choi JY, Lee JH, Ryu YH, Lee MS, Lyoo CH. Temporal trajectories of in vivo tau and amyloid-β accumulation in Alzheimer's disease. Eur J Nucl Med Mol Imaging 2020; 47:2879-2886. [PMID: 32350558 DOI: 10.1007/s00259-020-04773-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 03/11/2020] [Indexed: 01/07/2023]
Abstract
PURPOSE To investigate the temporal trajectories of tau and amyloid-β (Aβ) accumulation in Alzheimer's disease (AD) by using the longitudinal positron emission tomography (PET) study. METHODS A total of 132 participants, who were healthy volunteers or recruited in our memory disorder clinic, completed longitudinal 18F-flortaucipir and 18F-florbetaben PET studies with a mean follow-up time of 2 years. Referencing baseline data from 57 Aβ-negative cognitively unimpaired individuals, Z-scores and their annual changes were calculated with the global cortical or regional standardized uptake value ratios measured at baseline and follow-up after correcting for partial volume effect. The temporal trajectories of tau and Aβ burden as a function of time were obtained based on the spline models from the annual changes and baseline Z-score data. RESULTS Tau burden first emerged in the Braak's stage I-II regions, followed by stage III-IV regions, and finally in the stage V-VI regions. Time intervals between two time points at which Z-score curves rose above 2 were 17.3 years for the stages I-II and III-IV and 15.2 years for the stages III-IV and V-VI. Rise in the tau curve for stages I-II preceded that for global cortical Aβ, while the rise in global cortical Aβ curve preceded that for global cortical tau. Aβ accumulation rate was attenuated during the surge in tau burden in the global cortex and reached a plateau. CONCLUSION Sequential appearance of Aβ and tau accumulation supports a hypothetical dynamic biomarker model and Braak's hierarchical tau spreading model in AD.
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Affiliation(s)
- Min Seok Baek
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Hanna Cho
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, South Korea
| | - Jae Yong Choi
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.,Division of RI-Convergence Research, Korea Institute Radiological and Medical Sciences, Seoul, South Korea
| | - Jae Hoon Lee
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Young Hoon Ryu
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
| | - Myung Sik Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
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10
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Webster G, Draelos ZD, Graber E, Lee MS, Dhawan S, Salman M, Magrath GN. A multicentre, randomized, double-masked, parallel group, vehicle-controlled phase IIb study to evaluate the safety and efficacy of 1% and 3% topical minocycline gel in patients with papulopustular rosacea. Br J Dermatol 2020; 183:471-479. [PMID: 31907924 PMCID: PMC7496252 DOI: 10.1111/bjd.18857] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2020] [Indexed: 01/21/2023]
Abstract
Background Papulopustular rosacea is characterized by chronic facial erythema and inflammatory facial lesions. Minocycline has anti‐inflammatory properties which may be effective in the treatment of rosacea inflammatory lesions. Objectives To assess the safety and efficacy of once‐daily topical minocycline gel 1% and 3% in patients with papulopustular rosacea. Methods This was a prospective, 12‐week, double‐blinded study conducted at 26 sites in the United States; 270 patients with papulopustular rosacea and 12–40 inflammatory lesions were randomized to minocycline 1%, minocycline 3% or vehicle. The primary endpoint was the mean change in inflammatory lesions at week 12. Key secondary endpoints included success on an Investigator's Global Assessment (IGA). Results Baseline mean lesion counts were 24·6, 25·1 and 24·3 in the minocycline 1%, minocycline 3% and vehicle groups, respectively; at week 12, the counts had decreased by 12·6, 13·1 and 7·9, respectively. Minocycline significantly decreased lesions, compared with the vehicle [P = 0·01, 95% confidence interval (CI) 7·9 to 0·9, for minocycline 1%; P = 0·007, 95% CI 8·3 to 1·3, for minocycline 3%]. The proportion of patients achieving IGA success was 39% in the minocycline 1% arm [P = 0·34, odds ratio (OR) 1·396 and OR 95% CI 0·71 to 2·75 vs. vehicle], 46% in the minocycline 3% arm (P = 0·04, OR 2·03 and OR 95% CI 1·04 to 3·95 vs. vehicle) and 31% in the vehicle arm. Conclusions Minocycline topical gel appears to be safe and tolerable at concentrations of 1% and 3%, and both concentrations significantly decreased inflammatory lesion counts, with a significantly larger proportion of patients achieving IGA success at week 12 in the minocycline 3% arm. These findings support further evaluation of minocycline gel for treating inflammatory lesions associated with papulopustular rosacea. Linked Comment: Hampton. Br J Dermatol 2020; 183:412–413. What is already known about this topic? Papulopustular rosacea is characterized by inflammatory facial lesions and chronic erythema of the face. Oral minocycline has been reported to have efficacy in the treatment of inflammatory lesions of papulopustular rosacea.
What does this study add? The study shows that a topical gel preparation of minocycline significantly decreased the number of inflammatory lesions and significantly improved the Investigator's Global Assessment score in patients with papulopustular rosacea. This may offer a topical therapeutic alternative to oral doxycycline or oral minocycline for the treatment of inflammatory lesions in papulopustular rosacea, with potentially fewer systemic side‐effects, owing to lower systemic drug exposure.
Linked Comment: Hampton. Br J Dermatol 2020; 183:412–413. Plain language summary available online
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Affiliation(s)
- G Webster
- Department of Dermatology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA
| | - Z D Draelos
- Dermatology Consulting Services, High Point, NC, USA
| | - E Graber
- Northeastern University and The Dermatology Institute of Boston, Boston, MA, USA
| | - M S Lee
- Lee Medical Associates, San Antonio, TX, USA
| | - S Dhawan
- Center for Dermatology, Cosmetic, and Laser Surgery, Freemont, CA, USA
| | - M Salman
- Hovione Scientia Ltd., Loughbeg, Ringaskiddy, Cork, Ireland
| | - G N Magrath
- Hovione Scientia Ltd., Loughbeg, Ringaskiddy, Cork, Ireland.,Medical University of South Carolina, Charleston, SC, USA
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11
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Friedman N, Pancer Z, Savic R, Tseng F, Lee MS, Mclean L, Bagli DJ, Tessaro MO. Accuracy of point-of-care ultrasound by pediatric emergency physicians for testicular torsion. J Pediatr Urol 2019; 15:608.e1-608.e6. [PMID: 31455581 DOI: 10.1016/j.jpurol.2019.07.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 07/05/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Acute scrotum is a common presentation to the pediatric emergency department, and ultrasound is frequently used to narrow the differential diagnosis. Point-of-care ultrasound (POCUS) is increasingly used by urologists and emergency physicians and could potentially be used to detect pediatric testicular torsion. OBJECTIVES This study aimed to determine the accuracy of POCUS by pediatric emergency physicians in diagnosing testicular torsion and the agreement between point-of-care ultrasound and final diagnosis for other causes of acute scrotum. STUDY DESIGN A chart review of patients presenting to the study emergency department who received POCUS by a pediatric emergency physician, as well as radiology department ultrasound and/or surgery, was performed. Charts were reviewed for POCUS diagnoses, final diagnoses, and imaging time metrics. RESULTS A total of 120 patients met study criteria, with 12 cases of testicular torsion. The diagnostic accuracy of POCUS for testicular torsion is described in the summary table. For all causes of acute scrotum, point-of-care ultrasound agreed with final diagnosis in 70% (95% confidence interval [CI] 62-78%) of cases, and more experienced point-of-care ultrasound users displayed higher agreement with final diagnosis. Point-of-care ultrasound results were generated a median of 73 min (Q1 = 51, Q3 = 112) before radiology department ultrasound results. DISCUSSION Scrotal POCUS performed by pediatric emergency physicians appears to be an accurate tool to detect testicular torsion in children with acute scrotum and saves time compared with radiology ultrasound. The study results may not be generalizable to hospitals without a multidisciplinary POCUS system for quality assurance and image sharing. Future work on POCUS for acute scrotum should investigate its impact on patient outcomes, cost-effectiveness, and family satisfaction. CONCLUSION Point-of-care ultrasound by pediatric emergency physicians is accurate for detecting testicular torsion in children with acute scrotum and could expedite diagnosis of this time-sensitive condition.
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Affiliation(s)
- N Friedman
- Emergency Point-of-Care Ultrasound Program, Division of Pediatric Emergency Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, M5G 1X8, Canada.
| | - Z Pancer
- Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, M5G 1X8, Canada
| | - R Savic
- Emergency Point-of-Care Ultrasound Program, Division of Pediatric Emergency Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, M5G 1X8, Canada
| | - F Tseng
- Emergency Point-of-Care Ultrasound Program, Division of Pediatric Emergency Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, M5G 1X8, Canada
| | - M S Lee
- Emergency Point-of-Care Ultrasound Program, Division of Pediatric Emergency Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, M5G 1X8, Canada
| | - L Mclean
- Emergency Point-of-Care Ultrasound Program, Division of Pediatric Emergency Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, M5G 1X8, Canada
| | - D J Bagli
- Division of Urology, The Hospital for Sick Children, University of Toronto, Toronto, ON, M5G 1X8, Canada
| | - M O Tessaro
- Emergency Point-of-Care Ultrasound Program, Division of Pediatric Emergency Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, M5G 1X8, Canada
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12
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Lee YM, Kim DY, Kim YJ, Park KH, Lee MS. Clinical impacts of delayed central venous catheter removal according to the severity of comorbidities in patients with candidaemia. J Hosp Infect 2019; 103:420-427. [PMID: 31493475 DOI: 10.1016/j.jhin.2019.08.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 08/28/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND The effects of early central venous catheter (CVC) removal on the clinical outcomes of patients with candidaemia remain controversial. This study evaluated the impact of delayed CVC removal on mortality according to the severity of comorbidities in patients with candidaemia. METHODS Patients with candidaemia in a tertiary care hospital between January 2010 and December 2017 were included retrospectively. The severity of comorbidities was classified as low [Charlson Comorbidity Index (CCI) score ≤3] or high (CCI score ≥4). Cases with removal of CVC >2 days after the onset of candidaemia or without CVC removal were classified as having delayed CVC removal. RESULTS In total, 239 patients with candidaemia were included, excluding 18 who died within 2 days of onset of candidaemia. Of these, 149 had low CCI scores and 90 had high CCI scores. Septic shock [adjusted odds ratio (aOR)=9.5] and delayed CVC removal (aOR=4.7) were significantly associated with increased 30-day mortality, whereas Candida parapsilosis infection (aOR=0.2) and cerebrovascular disease (aOR=0.3) were associated with decreased 30-day mortality, in patients with low CCI scores. Septic shock (aOR=13.0) was the only risk factor for 30-day mortality in those with high CCI scores. Delayed CVC removal was associated with increased 30-day mortality in patients with low CCI scores (50.0% vs 20.3%; P=0.001), but not in those with high CCI scores (50.0% vs 47.9%; P=0.87). CONCLUSION Early CVC removal may improve the survival of patients with candidaemia and low CCI scores, but no such protective effect was evident in those with high CCI scores.
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Affiliation(s)
- Y-M Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - D Y Kim
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - Y J Kim
- Department of Laboratory Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - K-H Park
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - M S Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea.
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13
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Cho H, Choi JY, Baek MS, Lee HS, Lee JH, Ryu YH, Lee MS, Jack CR, Lyoo CH. P4-301: PROGRESSIVE TAU ACCUMULATION IN ALZHEIMER'S DISEASE: TWO-YEAR FOLLOW-UP STUDY. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.3971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Hanna Cho
- Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of South Korea
| | - Jae Yong Choi
- Division of RI-Convergence Research; Korea Institute Radiological and Medical Sciences; Seoul Republic of South Korea
| | - Min Seok Baek
- Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of South Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit; Yonsei University College of Medicine, Yonsei University College of Medicine; Seoul Republic of South Korea
| | - Jae Hoon Lee
- Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of South Korea
| | - Young Hoon Ryu
- Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of South Korea
| | - Myung Sik Lee
- Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of South Korea
| | | | - Chul Hyoung Lyoo
- Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of South Korea
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14
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Cho H, Baek MS, Lee HS, Choi JY, Lee JH, Ryu YH, Lee MS, Lyoo CH. IC-P-164: MEDIAL TEMPORAL TAU CAN BE A PREDICTOR OF AMYLOID-POSITIVITY IN MILD COGNITIVE IMPAIRMENT. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.4279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Hanna Cho
- Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of South Korea
| | - Min seok Baek
- Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of South Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit; Yonsei University College of Medicine; Seoul Republic of South Korea
| | - Jae Yong Choi
- Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of South Korea
- Division of RI-Convergence Research; Korea Institute Radiological and Medical Sciences; Seoul Republic of South Korea
| | - Jae Hoon Lee
- Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of South Korea
| | - Young Hoon Ryu
- Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of South Korea
| | - Myung Sik Lee
- Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of South Korea
| | - Chul Hyoung Lyoo
- Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of South Korea
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15
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Cho H, Baek MS, Choi JY, Lee HS, Lee JH, Ryu YH, Lee MS, Lyoo CH. IC-P-163: TEMPORAL TRAJECTORIES OF IN VIVO TAU AND AMYLOID-β ACCUMULATION IN ALZHEIMER'S DISEASE. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.4278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Hanna Cho
- Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of South Korea
| | - Min seok Baek
- Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of South Korea
| | - Jae Yong Choi
- Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of South Korea
- Division of RI-Convergence Research; Korea Institute Radiological and Medical Sciences; Seoul Republic of South Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit; Yonsei University College of Medicine; Seoul Republic of South Korea
| | - Jae Hoon Lee
- Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of South Korea
| | - Young Hoon Ryu
- Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of South Korea
| | - Myung Sik Lee
- Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of South Korea
| | - Chul Hyoung Lyoo
- Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of South Korea
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16
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Cho H, Choi JY, Lee HS, Lee JH, Ryu YH, Lee MS, Jack CR, Lyoo CH. Progressive Tau Accumulation in Alzheimer Disease: 2-Year Follow-up Study. J Nucl Med 2019; 60:1611-1621. [PMID: 30926651 DOI: 10.2967/jnumed.118.221697] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 03/18/2019] [Indexed: 12/18/2022] Open
Abstract
Tau PET enables in vivo visualization and quantitation of tau accumulation in Alzheimer disease (AD). In cross-sectional tau PET studies, tau burden reflects disease severity and phenotypic variation. We investigated longitudinal changes in cortical tau accumulation and their association with cognitive decline in patients with AD. Methods: We enrolled 107 participants (45 amyloid-β-negative cognitively unimpaired [CU-], 7 amyloid-β-positive cognitively unimpaired [CU+], 31 with prodromal AD [mild cognitive impairment; MCI+], and 24 with AD dementia [DEM+]) who completed 2 baseline PET scans (18F-flortaucipir and 18F-florbetaben), MRI, and neuropsychologic tests. All participants underwent the same assessments after 2 y. After correcting for partial-volume effect, we created SUV ratio (SUVR) images. By using a linear mixed-effect model, we investigated the changes in SUVR across time within each group. We also investigated a correlation between the progression of tau accumulation and cognitive decline. Results: In contrast to no change in global cortical SUVR in the CU- and CU+ groups during the 2-y period, global cortical SUVR increased by 0.06 (2.9%) in the MCI+ group and 0.19 (8.0%) in the DEM+ group at follow-up. The MCI+ group was associated with additional tau accumulation predominantly in the medial and inferior temporal cortices, whereas the DEM+ group showed increases in the lateral temporal cortex. Progressive tau accumulation occurred in the diffuse cortical areas in the MCI+ patients who developed dementia and the DEM+ patients who showed deterioration of global cognition, whereas there was only a small increase of additional tau accumulation in the lateral temporal cortex in those who did not show worsening of cognition. Deterioration of global cognition and language functions was associated with progression of diffuse tau accumulation in the association neocortex. Conclusion: Progressive tau accumulation occurs in prodromal AD and DEM patients in the cortical areas at different levels of tau accumulation. Progression of cognitive dysfunction may be related to the additional tau accumulation in regions of higher Braak stage. 18F-flortaucipir PET is an imaging biomarker for monitoring the progression of AD.
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Affiliation(s)
- Hanna Cho
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Jae Yong Choi
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.,Division of RI-Convergence Research, Korea Institute Radiological and Medical Sciences, Seoul, South Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea; and
| | - Jae Hoon Lee
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Young Hoon Ryu
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Myung Sik Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | | | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
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17
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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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Cho H, Kim HJ, Choi JY, Ryu YH, Lee MS, Na DL, Seo SW, Lyoo CH. 18F-flortaucipir uptake patterns in clinical subtypes of primary progressive aphasia. Neurobiol Aging 2018; 75:187-197. [PMID: 30594046 DOI: 10.1016/j.neurobiolaging.2018.11.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 11/14/2018] [Accepted: 11/15/2018] [Indexed: 11/19/2022]
Abstract
We analyzed 18F-flortaucipir uptake patterns and structural changes in patients with subtypes of primary progressive aphasia (PPA) using 18F-flortaucipir positron emission tomography and volumetric magnetic resonance imaging. We enrolled 34 consecutive patients with PPA (10 nonfluent/agrammatic PPA [nfvPPA], 18 semantic variant PPA [svPPA], and 6 logopenic variant PPA [lvPPA], as well as 20 healthy controls, and 20 patients with Alzheimer's disease. 18F-flortaucipir uptake was increased in the frontal cortex and underlying white matter, and subcortical nuclei in the 10 nfvPPA and 8 nfvPPA-amyloid-β (Aβ)- subgroup patients. In the svPPA patients (both the 13 svPPA-Aβ- and 5 svPPA-Aβ+), uptake generally increased in the widespread neocortex with left anterior temporal predominance. 18F-flortaucipir uptake patterns in the 6 lvPPA and the 5 lvPPA-Aβ+ subgroup patients were similar to those seen in the patients with Alzheimer's disease with mild predominance in the left lateral temporal cortex. Cortical thinning in each PPA subtype corresponded with increased 18F-flortaucipir uptake. 18F-flortaucipir uptake patterns and cortical atrophy were distinct and corresponded to areas related to the specific language functions that are impaired in each subtype of PPA.
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Affiliation(s)
- Hanna Cho
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hee Jin Kim
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Yong Choi
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Division of RI-Convergence Research, Korea Institute Radiological and Medical Sciences, Seoul, South Korea
| | - Young Hoon Ryu
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Myung Sik Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Duk L Na
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang Won Seo
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
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19
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Yim HJ, Kim IH, Suh SJ, Jung YK, Kim JH, Seo YS, Yeon JE, Kim CW, Kwon SY, Park SH, Lee MS, Um SH, Byun KS. Switching to tenofovir vs continuing entecavir for hepatitis B virus with partial virologic response to entecavir: a randomized controlled trial. J Viral Hepat 2018; 25:1321-1330. [PMID: 29772084 DOI: 10.1111/jvh.12934] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 04/16/2018] [Indexed: 12/19/2022]
Abstract
Entecavir 0.5 mg (ETV) is widely used among treatment-naïve chronic hepatitis B (CHB) patients. However, 10%-30% of patients show partial virologic response (PVR) to the drug. If the hepatitis B virus (HBV) continues to replicate, the underlying liver disease may progress. Herein, we compared the efficacy of switching to tenofovir disoproxil fumarate (TDF) with that of continuing ETV in CHB patients with PVR to ETV. This was an open-label randomized controlled trial including CHB patients who had been receiving 0.5 mg of ETV for >12 months, but who still had detectable HBV DNA levels of >60 IU/mL without known resistance to ETV. Sixty patients were enrolled and 45 qualified for the study: Twenty-two patients were randomly assigned into the TDF group and 23 into the ETV group. After 12 months of treatment, the virologic response rate (HBV DNA <20 IU/mL) was significantly higher in the TDF group than in the ETV group, as measured using per-protocol analysis (55% vs 20%; P = .022) and intention-to-treat analysis (50% vs 17.4%; P = .020). The reduction in HBV DNA was greater (-1.13 vs -0.67 log10 IU/mL; P = .024), and the mean HBV DNA level was lower (1.54 vs 2.01 log10 IU/mL; P = .011) in the TDF group than in the ETV group. In conclusion, to achieve optimal response in CHB patients with PVR to ETV, switching to TDF would be a better strategy than continuing ETV. Appropriate modification of therapy would further improve the outcome of chronic HBV infection.
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Affiliation(s)
- H J Yim
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea
| | - I H Kim
- Department of Internal Medicine, Chonbuk National University Hospital, Jeonju, South Korea
| | - S J Suh
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea
| | - Y K Jung
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea.,Department of Internal Medicine, Gachon University Gil Hospital, Incheon, South Korea
| | - J H Kim
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, South Korea
| | - Y S Seo
- Department of Internal Medicine, Korea University Anam Hospital, Seoul, South Korea
| | - J E Yeon
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, South Korea
| | - C W Kim
- Department of Internal Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - S Y Kwon
- Department of Internal Medicine, Konkuk University Hospital, Seoul, South Korea
| | - S H Park
- Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, South Korea
| | - M S Lee
- Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, South Korea
| | - S H Um
- Department of Internal Medicine, Korea University Anam Hospital, Seoul, South Korea
| | - K S Byun
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, South Korea
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Kuo FC, Lu YD, Wu CT, You HL, Lee GB, Lee MS. Comparison of molecular diagnosis with serum markers and synovial fluid analysis in patients with prosthetic joint infection. Bone Joint J 2018; 100-B:1345-1351. [PMID: 30295521 DOI: 10.1302/0301-620x.100b10.bjj-2018-0096.r1] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [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: 12/28/2022]
Abstract
AIMS The aim of this study was to compare the results of 16S/28S rRNA sequencing with the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, and synovial fluid analysis in the diagnosis of prosthetic joint infection (PJI). PATIENTS AND METHODS Between September 2015 and August 2016, 214 consecutive patients were enrolled. In the study population, there were 25 patients with a PJI and 189 controls. Of the PJI patients, 14 (56%) were women, and the mean age at the time of diagnosis was 65 years (38 to 83). The ESR and CRP levels were measured, and synovial fluid specimens were collected prospectively. Synovial fluid was subjected to reverse transcription polymerase chain reaction (RT-PCR)/sequence analysis targeting the 16S/28S rRNA, and to conventional culture. Laboratory personnel who were blind to the clinical information performed all tests. The diagnosis of PJI was based on the criteria of the Musculoskeletal Infection Society. RESULTS A total of 25 patients had a confirmed PJI. In 20 cases of monomicrobial PJI, the PCR products could be perfectly matched with the 16S/28S rRNA genes specific for different species of bacteria provided by sequence analysis. Of the five polymicrobial cases of PJI, 16S/28S rRNA PCR sequence analysis failed to identify the concordant bacteria species. In the 189 control patients, there was one false-positive RT-PCR result. The sensitivity and specificity of the molecular diagnosis method were 100% (95% confidence interval (CI) 85.7 to 100) and 99.5% (95% CI 97.1 to 99.9), respectively, whereas the positive and negative predictive values of PCR were 96.1% (95% CI 79.6 to 99.9) and 100% (95% CI 98.1 to 100), respectively. The PCR results were significantly better than serological diagnostic methods (p = 0.004 and p = 0.010 for ESR and CRP, respectively), the synovial fluid white blood cell (WBC) count (p = 0.036), and percentage of polymorphonuclear cells (PMN%) (p = 0.014). CONCLUSION Stepwise RT-PCR and sequence analysis of the 16S/28S rRNA carried out under stringent laboratory conditions achieved highly sensitive and specific results for the differentiation between aseptic and septic joints undergoing arthroplasty. Sequence analysis successfully identified bacterial strains in monomicrobial infections but failed to identify molecular targets in polymicrobial infections. Further refinement of the protocols to identify the bacteria in polymicrobial infections is needed. Cite this article: Bone Joint J 2018;100-B:1345-51.
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Affiliation(s)
- F-C Kuo
- Department of Orthopaedic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung, Taiwan
| | - Y-D Lu
- Department of Orthopaedic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung, Taiwan
| | - C-T Wu
- Department of Orthopaedic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung, Taiwan
| | - H-L You
- Department of Laboratory Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - G-B Lee
- Department of Power Mechanical Engineering, Institute of Nano Engineering and Microsystems, and Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - M S Lee
- Department of Orthopaedic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung, Taiwan
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Sung PH, Chiang HJ, Yang YH, Lee MS, Yip HK. P1567Nationwide study on the risk of major adverse cardiovascular and cerebrovascular events in Asian women with endometriosis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- P H Sung
- Chang Gung Memorial Hospital Kaohsiung, Division of Cardiology, Department of Internal Medicine, Kaohsiung, Taiwan ROC
| | - H J Chiang
- Chang Gung Memorial Hospital Kaohsiung, Department of Obstetrics and Gynecology, Kaohsiung, Taiwan ROC
| | - Y H Yang
- Chang Gung Memorial Hospital, Department of Traditional Chinese Medicine, Chiayi, Taiwan ROC
| | - M S Lee
- Chang Gung Memorial Hospital Kaohsiung, Department of Orthopedics, Kaohsiung, Taiwan ROC
| | - H K Yip
- Chang Gung Memorial Hospital Kaohsiung, Division of Cardiology, Department of Internal Medicine, Kaohsiung, Taiwan ROC
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22
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Lee SH, Lee MJ, Lyoo CH, Cho H, Lee MS. Impaired finger dexterity and nigrostriatal dopamine loss in Parkinson's disease. J Neural Transm (Vienna) 2018; 125:1333-1339. [PMID: 29971496 DOI: 10.1007/s00702-018-1901-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 06/29/2018] [Indexed: 11/28/2022]
Abstract
Impaired finger dexterity occurs in Parkinson's disease (PD) and has been considered a limb-kinetic apraxia associated with primary sensory cortical dysfunction. To study the role of nigrostriatal dopamine loss and elementary parkinsonian motor deficits in impaired finger dexterity of PD. Thirty-two right-handed untreated PD patients and 30 right-handed healthy controls were included. All patients underwent [18F] FP-CIT positron emission tomography studies. We examined the associations among unilateral coin rotation (CR) score, Unified Parkinson's Disease Rating Scale (UPDRS) subscores for bradykinesia and rigidity of the corresponding arm, and contralateral regional striatal dopamine transporter (DAT) uptake. We also measured the effect of oral levodopa dose on CR scores and UPDRS subscores. PD patients performed worse than controls on the CR task. Unilateral arm UPDRS bradykinesia scores were associated with DAT uptake in the contralateral putamen. The left CR score was associated with left arm bradykinesia and rigidity scores and DAT uptake in the right posterior putamen, whereas no such associations were found for the right CR score. There was a significant effect of handedness on the association of putamen DAT uptake with CR scores, but not with UPDRS subscores. An oral levodopa challenge improved CR scores and UPDRS subscores on both sides. Impaired finger dexterity in PD is related to elementary parkinsonian motor deficits and nigrostriatal dopamine loss. Impaired dominant hand dexterity associated with nigrostriatal dopamine loss seems to be compensated to some extent by the dominant cerebral cortex specialized for controlling precise finger movements.
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Affiliation(s)
- S H Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Eonjuro 211, Gangnam-gu, Seoul, South Korea
| | - M J Lee
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, South Korea
| | - C H Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Eonjuro 211, Gangnam-gu, Seoul, South Korea
| | - H Cho
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Eonjuro 211, Gangnam-gu, Seoul, South Korea
| | - M S Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Eonjuro 211, Gangnam-gu, Seoul, South Korea.
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Cho H, Lee HS, Choi JY, Lee JH, Ryu YH, Lee MS, Lyoo CH. Predicted sequence of cortical tau and amyloid-β deposition in Alzheimer disease spectrum. Neurobiol Aging 2018; 68:76-84. [PMID: 29751288 DOI: 10.1016/j.neurobiolaging.2018.04.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 04/04/2018] [Accepted: 04/11/2018] [Indexed: 12/23/2022]
Abstract
We investigated sequential order between tau and amyloid-β (Aβ) deposition in Alzheimer disease spectrum using a conditional probability method. Two hundred twenty participants underwent 18F-flortaucipir and 18F-florbetaben positron emission tomography scans and neuropsychological tests. The presence of tau and Aβ in each region and impairment in each cognitive domain were determined by Z-score cutoffs. By comparing pairs of conditional probabilities, the sequential order of tau and Aβ deposition were determined. Probability for the presence of tau in the entorhinal cortex was higher than that of Aβ in all cortical regions, and in the medial temporal cortices, probability for the presence of tau was higher than that of Aβ. Conversely, in the remaining neocortex above the inferior temporal cortex, probability for the presence of Aβ was always higher than that of tau. Tau pathology in the entorhinal cortex may appear earlier than neocortical Aβ and may spread in the absence of Aβ within the neighboring medial temporal regions. However, Aβ may be required for massive tau deposition in the distant cortical areas.
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Affiliation(s)
- Hanna Cho
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, South Korea
| | - Jae Yong Choi
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea; Division of RI-Convergence Research, Korea Institute Radiological and Medical Sciences, Seoul, South Korea
| | - Jae Hoon Lee
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Young Hoon Ryu
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Myung Sik Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
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24
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Cho H, Seo SW, Choi JY, Lee HS, Ryu YH, Lee MS, Na DL, Kim HJ, Lyoo CH. Predominant subcortical accumulation of 18F-flortaucipir binding in behavioral variant frontotemporal dementia. Neurobiol Aging 2018; 66:112-121. [PMID: 29554554 DOI: 10.1016/j.neurobiolaging.2018.02.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 02/13/2018] [Accepted: 02/15/2018] [Indexed: 11/28/2022]
Abstract
Behavioral variant frontotemporal dementia (bvFTD) is the most common form of frontotemporal dementia, and tau pathology can be found in 40%-50% of bvFTD patients. In this study, we sought to investigate 18F-flortaucipir-binding patterns and their correlates in clinically diagnosed bvFTD patients by comparing with results for Alzheimer's disease (AD) patients. We enrolled 20 bvFTD, 20 AD, and 20 age-matched healthy subjects who underwent neuropsychological tests, magnetic resonance imaging, and tau positron emission tomography scans with 18F-flortaucipir. Regional standardized uptake value ratios for the cerebral cortex and underlying white matter were compared between the 2 groups. The bvFTD patients showed increased 18F-flortaucipir binding in the putamen and globus pallidus when compared to the healthy controls. In addition, bvFTD was associated with increased binding in the white matter regions underlying the frontal, anterior cingulate, and insula cortices. The bvFTD patients may exhibit predominantly subcortical 18F-flortaucipir-binding pattern that is distinct from the patterns seen in AD patients. We hypothesize that the clinical characteristics of bvFTD patients may be attributable to the dysfunctional frontal-subcortical networks. However, concerns remain regarding unknown "off-target" binding in the white matter and the basal ganglia.
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Affiliation(s)
- Hanna Cho
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sang Won Seo
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Yong Choi
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Division of RI-Convergence Research, Korea Institute Radiological and Medical Sciences, Seoul, South Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, South Korea
| | - Young Hoon Ryu
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Myung Sik Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Duk L Na
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee Jin Kim
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
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25
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Lee MS, Lee MJ, Conte A, Berardelli A. Abnormal somatosensory temporal discrimination in Parkinson’s disease: Pathophysiological correlates and role in motor control deficits. Clin Neurophysiol 2018; 129:442-447. [DOI: 10.1016/j.clinph.2017.11.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 11/13/2017] [Accepted: 11/21/2017] [Indexed: 12/14/2022]
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26
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Lyoo CH, Cho H, Choi JY, Ryu YH, Lee MS. Tau Positron Emission Tomography Imaging in Degenerative Parkinsonisms. J Mov Disord 2018; 11:1-12. [PMID: 29381890 PMCID: PMC5790630 DOI: 10.14802/jmd.17071] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 11/20/2017] [Indexed: 01/08/2023] Open
Abstract
In recent years, several radiotracers that selectively bind to pathological tau proteins have been developed. Evidence is emerging that binding patterns of in vivo tau positron emission tomography (PET) studies in Alzheimer’s disease (AD) patients closely resemble the distribution patterns of known neurofibrillary tangle pathology, with the extent of tracer binding reflecting the clinical and pathological progression of AD. In Lewy body diseases (LBD), tau PET imaging has clearly revealed cortical tau burden with a distribution pattern distinct from AD and increased cortical binding within the LBD spectrum. In progressive supranuclear palsy, the globus pallidus and midbrain have shown increased binding most prominently. Tau PET patterns in patients with corticobasal syndrome are characterized by asymmetrical uptake in the motor cortex and underlying white matter, as well as in the basal ganglia. Even in the patients with multiple system atrophy, which is basically a synucleinopathy, 18F-flortaucipir, a widely used tau PET tracer, also binds to the atrophic posterior putamen, possibly due to off-target binding. These distinct patterns of tau-selective radiotracer binding in the various degenerative parkinsonisms suggest its utility as a potential imaging biomarker for the differential diagnosis of parkinsonisms.
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Affiliation(s)
- Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hanna Cho
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Yong Choi
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.,Division of RI-Convergence Research, Korea Institute Radiological and Medical Sciences, Seoul, Korea
| | - Young Hoon Ryu
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Myung Sik Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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27
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Lee YM, Moon C, Kim YJ, Lee HJ, Lee MS, Park KH. Clinical impact of delayed catheter removal for patients with central-venous-catheter-related Gram-negative bacteraemia. J Hosp Infect 2018; 99:106-113. [PMID: 29330016 DOI: 10.1016/j.jhin.2018.01.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 01/04/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Gram-negative bacteria are increasingly the cause of catheter-related bloodstream infection (CRBSI), and the prevalence of multi-drug-resistant strains is rising rapidly. This study evaluated the impact of delayed central venous catheter (CVC) removal on clinical outcomes in patients with Gram-negative CRBSI. METHODS Between January 2007 and December 2016, patients with Gram-negative bacteraemia and CVC placement, from two tertiary care hospitals, were included retrospectively. Cases with CVC removal more than three days after onset of bacteraemia or without CVC removal were classified as having delayed CVC removal. RESULTS In total, 112 patients were included. Of these, 78 had CRBSI (43 definite and 35 probable) and 34 had Gram-negative bacteraemia from another source (non-CRBSI). Enterobacteriaceae were less common pathogens in patients with CRBSI than in patients with non-CRBSI (11.5% vs 41.3%; P<0.001). Delayed CVC removal was associated with increased 30-day mortality (40.5% vs 11.8%; P=0.01) in patients with Gram-negative CRBSI; this was not seen in patients with non-CRBSI (25.0% vs 14.3%; P>0.99). Delayed CVC removal [odds ratio (OR) 6.8], multi-drug-resistant (MDR) Gram-negative bacteraemia (OR 6.3) and chronic renal failure (OR 11.1) were associated with 30-day mortality in patients with CRBSI. The protective effect of early CVC removal on mortality was evident in the MDR group (48.3% vs 18.2%; P=0.03), but not in the non-MDR group (11.1% vs 0%; P=0.43). CONCLUSION CVCs should be removed early to improve clinical outcomes in patients with Gram-negative CRBSI, especially in settings where MDR isolates are prevalent.
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Affiliation(s)
- Y-M Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - C Moon
- Department of Infectious Diseases, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Y J Kim
- Department of Laboratory Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - H J Lee
- Department of Laboratory Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - M S Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - K-H Park
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea.
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Lee SH, Cho H, Choi JY, Lee JH, Ryu YH, Lee MS, Lyoo CH. Distinct patterns of amyloid-dependent tau accumulation in Lewy body diseases. Mov Disord 2017; 33:262-272. [DOI: 10.1002/mds.27252] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Revised: 09/25/2017] [Accepted: 10/02/2017] [Indexed: 01/06/2023] Open
Affiliation(s)
- Seung Ha Lee
- Department of Neurology, Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of Korea
| | - Hanna Cho
- Department of Neurology, Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of Korea
| | - Jae Yong Choi
- Department of Nuclear Medicine, Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of Korea
- Division of RI-Convergence Research; Korea Institute Radiological and Medical Sciences; Seoul Republic of Korea
| | - Jae Hoon Lee
- Department of Nuclear Medicine, Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of Korea
| | - Young Hoon Ryu
- Department of Nuclear Medicine, Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of Korea
| | - Myung Sik Lee
- Department of Neurology, Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of Korea
| | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of Korea
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Lee MS, Yang YL, Chen YL, Tzean SS, Lee TH. Efficient Dereplication of Fungal Antimicrobial Principles by Tandem MS and NMR Database. Am J Transl Res 2017. [DOI: 10.1055/s-0037-1608227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- MS Lee
- 1 School of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - YL Yang
- 2 Agricultural Biotechnology Research Center, Academia Sinica, Taipei, Taiwan
| | - YL Chen
- 3 Department of Plant Pathology and Microbiology, National Taiwan University, Taipei, Taiwan
| | - SS Tzean
- 3 Department of Plant Pathology and Microbiology, National Taiwan University, Taipei, Taiwan
| | - TH Lee
- 4 Institute of Fisheries Science, National Taiwan University, Taipei, Taiwan
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Choi SH, Kim T, Park KH, Kwak YG, Chung JW, Lee MS. Early administration of neuraminidase inhibitors in adult patients hospitalized for influenza does not benefit survival: a retrospective cohort study. Eur J Clin Microbiol Infect Dis 2017; 36:1673-1677. [PMID: 28417272 DOI: 10.1007/s10096-017-2982-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 04/04/2017] [Indexed: 11/26/2022]
Abstract
The administration of neuraminidase inhibitors (NAIs) within 2 days after the onset of symptoms (early NAI therapy) has been shown to reduce mortality in adult patients with severe influenza. However, there is no sufficiently solid evidence supporting the effectiveness of early NAI therapy on mortality. We reviewed the clinical data from 506 adult patients who were hospitalized for influenza between March 2010 and March 2014, to investigate the impact of early NAI therapy on mortality. Nearly one-third of the study patients were infected with influenza B (influenza A, influenza B, and co-infection of both in 68.8%, 28.1%, and 3.2%, respectively), and were diagnosed using the polymerase chain reaction (PCR) method (33.6%). Less than half (233, 46.0%) had received early NAI therapy. Patients with early NAI therapy were admitted to the hospital earlier, more frequently infected with influenza A, and more frequently diagnosed using rapid influenza detection tests compared to those without early NAI therapy. Although patients without early NAI therapy presented with more serious clinical manifestations, such as an initial symptom of dyspnea, pneumonia, and intensive care unit admission, than those with early NAI therapy, the in-hospital mortality of the former (2.9%, 8/273) did not differ from that of the latter (3.4%, 8/233) (p = 0.75). We did not find a reduction in mortality associated with early NAI therapy in adult patients hospitalized for influenza. Further clinical studies including a large number of influenza B-infected patients with virus identification using PCR methodology rather than viral culture may be required to confirm the beneficial impact of early NAI therapy on mortality.
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Affiliation(s)
- S-H Choi
- Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul, Republic of Korea
| | - T Kim
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - K-H Park
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - Y G Kwak
- Division of Infectious Diseases, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
| | - J-W Chung
- Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul, Republic of Korea.
| | - M S Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Republic of Korea
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Cho H, Baek MS, Choi JY, Lee SH, Kim JS, Ryu YH, Lee MS, Lyoo CH. 18F-AV-1451 binds to motor-related subcortical gray and white matter in corticobasal syndrome. Neurology 2017; 89:1170-1178. [PMID: 28814462 DOI: 10.1212/wnl.0000000000004364] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 06/22/2017] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate tau distribution in patients with corticobasal syndrome (CBS) using 18F-AV-1451 PET. METHODS Six consecutively recruited patients with CBS and 20 age-matched healthy controls underwent 2 PET scans with 18F-AV-1451 (for tau) and 18F-florbetaben (for β-amyloid). We compared standardized uptake value ratio maps of the 18F-AV-1451 PET images between the patients with CBS and controls. RESULTS Compared to controls, patients with CBS exhibited asymmetrically increased 18F-AV-1451 binding in the putamen, globus pallidus, and thalamus contralateral to the clinically more affected side and in the ipsilateral globus pallidus and dentate nucleus. Voxel-based comparison additionally showed asymmetrically increased 18F-AV-1451 binding in the focal regions of the precentral gray and white matter and in the midbrain, predominantly in the contralateral side. 18F-AV-1451 binding in the precentral white matter correlated with motor severity. CONCLUSIONS 18F-AV-1451 asymmetrically binds to motor-related subcortical gray and white matter structures in patients with CBS. This pattern corresponds to tau pathology distribution in postmortem studies, and motor deficit in patients with CBS may be associated with tau accumulation predominantly in the subcortical white matter underlying the motor cortex, leading to disruptions in motor-related networks.
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Affiliation(s)
- Hanna Cho
- From the Departments of Neurology (H.C., M.S.B., S.H.L., M.S.L., C.H.L.) and Nuclear Medicine (Y.H.R.), Gangnam Severance Hospital, Yonsei University College of Medicine; Division of RI-Convergence Research (J.Y.C.), Korea Institute Radiological and Medical Sciences; and Department of Neurology (J.S.K.), College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Korea
| | - Min Seok Baek
- From the Departments of Neurology (H.C., M.S.B., S.H.L., M.S.L., C.H.L.) and Nuclear Medicine (Y.H.R.), Gangnam Severance Hospital, Yonsei University College of Medicine; Division of RI-Convergence Research (J.Y.C.), Korea Institute Radiological and Medical Sciences; and Department of Neurology (J.S.K.), College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Korea
| | - Jae Yong Choi
- From the Departments of Neurology (H.C., M.S.B., S.H.L., M.S.L., C.H.L.) and Nuclear Medicine (Y.H.R.), Gangnam Severance Hospital, Yonsei University College of Medicine; Division of RI-Convergence Research (J.Y.C.), Korea Institute Radiological and Medical Sciences; and Department of Neurology (J.S.K.), College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Korea
| | - Seung Ha Lee
- From the Departments of Neurology (H.C., M.S.B., S.H.L., M.S.L., C.H.L.) and Nuclear Medicine (Y.H.R.), Gangnam Severance Hospital, Yonsei University College of Medicine; Division of RI-Convergence Research (J.Y.C.), Korea Institute Radiological and Medical Sciences; and Department of Neurology (J.S.K.), College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Korea
| | - Joong Seok Kim
- From the Departments of Neurology (H.C., M.S.B., S.H.L., M.S.L., C.H.L.) and Nuclear Medicine (Y.H.R.), Gangnam Severance Hospital, Yonsei University College of Medicine; Division of RI-Convergence Research (J.Y.C.), Korea Institute Radiological and Medical Sciences; and Department of Neurology (J.S.K.), College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Korea
| | - Young Hoon Ryu
- From the Departments of Neurology (H.C., M.S.B., S.H.L., M.S.L., C.H.L.) and Nuclear Medicine (Y.H.R.), Gangnam Severance Hospital, Yonsei University College of Medicine; Division of RI-Convergence Research (J.Y.C.), Korea Institute Radiological and Medical Sciences; and Department of Neurology (J.S.K.), College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Korea
| | - Myung Sik Lee
- From the Departments of Neurology (H.C., M.S.B., S.H.L., M.S.L., C.H.L.) and Nuclear Medicine (Y.H.R.), Gangnam Severance Hospital, Yonsei University College of Medicine; Division of RI-Convergence Research (J.Y.C.), Korea Institute Radiological and Medical Sciences; and Department of Neurology (J.S.K.), College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Korea
| | - Chul Hyoung Lyoo
- From the Departments of Neurology (H.C., M.S.B., S.H.L., M.S.L., C.H.L.) and Nuclear Medicine (Y.H.R.), Gangnam Severance Hospital, Yonsei University College of Medicine; Division of RI-Convergence Research (J.Y.C.), Korea Institute Radiological and Medical Sciences; and Department of Neurology (J.S.K.), College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Korea.
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Choi JY, Cho H, Ahn SJ, Lee JH, Ryu YH, Lee MS, Lyoo CH. Off-Target 18F-AV-1451 Binding in the Basal Ganglia Correlates with Age-Related Iron Accumulation. J Nucl Med 2017; 59:117-120. [PMID: 28775201 DOI: 10.2967/jnumed.117.195248] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 07/05/2017] [Indexed: 11/16/2022] Open
Abstract
Off-target binding in the basal ganglia is commonly observed in the 18F-AV-1451 PET studies of the elderly. We sought to investigate the relationship between this phenomenon in the basal ganglia and iron accumulation using iron-sensitive R2* MRI. Methods: Fifty-nine healthy controls and 61 patients with Alzheimer disease and mild cognitive impairment underwent 18F-AV-1451 PET and R2* MRI studies. A correlation analysis was performed for age, 18F-AV-1451 binding, and R2* values. Results: There was an age-related increase in both 18F-AV-1451 binding in the basal ganglia and R2* values in the putamen in both the controls and the Alzheimer disease/mild cognitive impairment patients. 18F-AV-1451 binding in the basal ganglia increased with R2* values. Conclusion: Off-target 18F-AV-1451 binding in the basal ganglia is associated with the age-related increases in iron accumulation. Postmortem studies are required to further investigate the nature of this association.
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Affiliation(s)
- Jae Yong Choi
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.,Division of Rhode Island-Convergence Research, Korea Institute Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Hanna Cho
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; and
| | - Sung Jun Ahn
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae Hoon Lee
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Hoon Ryu
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Myung Sik Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; and
| | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; and
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Lee SH, Lyoo CH, Cho H, Rinne JO, Lee MS. Parkinsonian Patients with Striatal Cribriform State Present Rapidly Progressive Axial Parkinsonism. Eur Neurol 2017; 78:119-124. [PMID: 28746923 DOI: 10.1159/000479227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 07/05/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To define the significance of striatal cribriform state (SCS) observed in patients with primary progressive parkinsonism. METHODS We reviewed medical records and brain magnetic resonance imaging studies of 1,260 patients with primary progressive parkinsonism. We identified 23 patients with SCS and analyzed their clinical features. RESULTS All 23 patients had rapidly progressive parkinsonism predominated by postural instability and gait disturbance. Clinical features of 18 of the 23 patients were compatible with progressive supranuclear palsy (PSP); 2 patients were compatible with parkinsonian type multiple system atrophy; 2 patients were compatible with mixed clinical features of both; and 1 patient had PSP-like clinical features. CONCLUSIONS Most parkinsonian patients with SCS present rapidly progressive parkinsonism predominated by postural instability and gait disturbance. SCS observed in patients with parkinsonism does not seem to be a coincidental finding associated with the generalized cerebrovascular process.
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Affiliation(s)
- Seung Ha Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hanna Cho
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Juha O Rinne
- Turku PET Centre, University of Turku, Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland
| | - Myung Sik Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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Baek MS, Cho H, Choi JY, Lee SH, Choi YS, Ryu YH, Lee MS, Lyoo CH. [P2–342]:
18
F‐AV‐1451 BINDS TO THE MOTOR‐RELATED SUBCORTICAL GRAY AND WHITE MATTER IN CORTICOBASAL SYNDROME. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Min Seok Baek
- Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of South Korea
| | - Hanna Cho
- Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of South Korea
| | - Jae Yong Choi
- Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of South Korea
| | - Seung Ha Lee
- Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of South Korea
| | - Young Sook Choi
- St. Andrew's Neuropsychiatric HospitalIncheonRepublic of South Korea
| | - Young Hoon Ryu
- Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of South Korea
| | - Myung Sik Lee
- Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of South Korea
| | - Chul Hyoung Lyoo
- Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of South Korea
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Yoon SH, Cho H, Choi JY, Lee SH, Baek MS, Ryu YH, Lee MS, Lyoo CH. [P2–346]: EXCESSIVE NEOCORTICAL TAU ACCUMULATION IN DOWN SYNDROME. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.1000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- So Hoon Yoon
- Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of South Korea
| | - Hanna Cho
- Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of South Korea
| | - Jae Yong Choi
- Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of South Korea
| | - Seung Ha Lee
- Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of South Korea
| | - Min Seok Baek
- Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of South Korea
| | - Young Hoon Ryu
- Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of South Korea
| | - Myung Sik Lee
- Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of South Korea
| | - Chul Hyoung Lyoo
- Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of South Korea
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Cho H, Choi JY, Lee HS, Lee JH, Ryu YH, Lee MS, Lyoo CH. [S2–01–04]: IN VIVO CORTICAL SPREADING OF TAU AND AMYLOID. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.07.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Hanna Cho
- Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of South Korea
- Biostatistics Collaboration UnitYonsei University College of Medicine, Yonsei University College of MedicineRepublic of South Korea
| | - Jae Yong Choi
- Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of South Korea
| | - Hye Sun Lee
- Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of South Korea
| | - Jae Hoon Lee
- Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of South Korea
| | - Young Hoon Ryu
- Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of South Korea
| | - Myung Sik Lee
- Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of South Korea
| | - Chul Hyoung Lyoo
- Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of South Korea
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Lee SH, Cho H, Choi JY, Choi YS, Lee JH, Ryu YH, Lee MS, Lyoo CH. [P1–386]: DISTINCT TAU ACCUMULATION PATTERN IN DEMENTIA WITH LEWY BODY. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Seung Ha Lee
- Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of South Korea
| | - Hanna Cho
- Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of South Korea
| | - Jae Yong Choi
- Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of South Korea
| | - Young Sook Choi
- St. Andrew's Neuropsychiatric HospitalIncheonRepublic of South Korea
| | - Jae Hoon Lee
- Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of South Korea
| | - Young Hoon Ryu
- Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of South Korea
| | - Myung Sik Lee
- Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of South Korea
| | - Chul Hyoung Lyoo
- Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of South Korea
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Hwang HW, Lee SH, Lyoo CH, Lee MS. Paroxysmal freezing of gait in a patient with mesial frontal transient ischemic attacks. BMC Neurol 2017; 17:122. [PMID: 28659126 PMCID: PMC5490189 DOI: 10.1186/s12883-017-0901-7] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 06/21/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rare patients have been reported who developed a mixture of gait disturbances following a focal lesion in the frontal lobe. Thus, the exact location of frontal lesion responsible for a specific gait disturbance is not well defined. CASE PRESENTATION We describe a 47-year-old man who experienced two episodes of paroxysmal freezing of gait of the right leg. During the attacks, he had no motor weakness, sensory change, or disequilibrium. He had past history of panic attacks. Recently, he had been under severe emotional stress. T2 and diffusion brain magnetic resonance imaging scans were normal. So far, the most likely clinical diagnosis might be functional freezing of gait. However, magnetic resonance angiography showed atherosclerosis in the proximal left anterior cerebral artery. Perfusion scans showed a delayed mean transit time in the left mesial frontal lobe. He developed two more attacks during the four months of follow up. CONCLUSIONS The presented case illustrates that the mesial frontal lobe may be important in the pathophysiology of freezing of gait. We speculate that the supplementary motor area may generate a neuronal command for the initiation of locomotion that in our case may have been inhibited by a transient ischemia.
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Affiliation(s)
- Hee Won Hwang
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Eonjuro 211, Gangnam-gu, Seoul, South Korea
| | - Seung Ha Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Eonjuro 211, Gangnam-gu, Seoul, South Korea
| | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Eonjuro 211, Gangnam-gu, Seoul, South Korea
| | - Myung Sik Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Eonjuro 211, Gangnam-gu, Seoul, South Korea.
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Kim HK, Ki CS, Kim YJ, Lee MS. Radiological Findings of Two Sisters with Aceruloplasminemia Presenting with Chorea. Clin Neuroradiol 2017; 27:385-388. [PMID: 28258281 DOI: 10.1007/s00062-017-0573-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 02/21/2017] [Indexed: 12/14/2022]
Affiliation(s)
- H K Kim
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Eonjuro 211, 06274, Seoul, South Korea
| | - C S Ki
- Department of Laboratory Medicine and Genetics, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Y J Kim
- Ilsong Institute of Life Science, Hallym University, Anyang, South Korea
| | - M S Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Eonjuro 211, 06274, Seoul, South Korea.
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Lee SH, Kim HK, Lee YG, Lyoo CH, Ahn SJ, Lee MS. Clinical Features Indicating Nigrostriatal Dopaminergic Degeneration in Drug-Induced Parkinsonism. J Mov Disord 2016; 10:35-39. [PMID: 28122428 PMCID: PMC5288665 DOI: 10.14802/jmd.16045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 11/09/2016] [Accepted: 11/10/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Patients with drug-induced parkinsonism (DIP) may have nigrostriatal dopaminergic degeneration. We studied the clinical features that may indicate nigrostriatal dopaminergic degeneration in patients with DIP. METHODS Forty-one DIP patients were classified into normal and abnormal [18F] FP-CIT scan groups. Differences in 32 clinical features and drug withdrawal effects were studied. RESULTS Twenty-eight patients had normal (Group I) and 13 patients had abnormal (Group II) scans. Eight patients of Group I, but none of Group II, had taken calcium channel blockers (p = 0.040). Three patients of Group I and six of Group II had hyposmia (p = 0.018). After drug withdrawal, Group I showed greater improvement in Unified Parkinson's Disease Rating Scale total motor scores and subscores for bradykinesia and tremors than Group II. Only hyposmia was an independent factor associated with abnormal scans, but it had suboptimal sensitivity. CONCLUSION None of the clinical features were practical indicators of nigrostriatal dopaminergic degeneration in patients with DIP.
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Affiliation(s)
- Seung Ha Lee
- Department of Neurology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea
| | - Han Kyeol Kim
- Department of Neurology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea
| | - Young Gun Lee
- Department of Neurology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea
| | - Chul Hyoung Lyoo
- Department of Neurology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea
| | - Sung Jun Ahn
- Department of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea
| | - Myung Sik Lee
- Department of Neurology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea
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Lyoo CH, Cho H, Choi JY, Hwang MS, Hong SK, Kim YJ, Ryu YH, Lee MS. Tau Accumulation in Primary Motor Cortex of Variant Alzheimer's Disease with Spastic Paraparesis. J Alzheimers Dis 2016; 51:671-5. [PMID: 26890779 DOI: 10.3233/jad-151052] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We studied topographic distribution of tau and amyloid-β in a patient with variant Alzheimer's disease with spastic paraparesis (VarAD) by comparing AD patients. The proband developed progressive memory impairment, dysarthria, and spastic paraparesis at age 23. Heterozygous missense mutation (L166P) was found in exon 6 of presenilin-1 gene. The proband showed prominently increased amyloid binding in striatum and cerebellum and asymmetrical tau binding in the primary sensorimotor cortex contralateral to the side more affected by spasticity. We suspect that upper motor neuron dysfunctions may be attributed to excessive abnormal tau accumulation rather than amyloid-β in the primary motor cortex.
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Affiliation(s)
- Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Hanna Cho
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Jae Yong Choi
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Mi Song Hwang
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Sang Kyoon Hong
- Hallym Institute of Translational Genomics and Bioinformatics, Anyang, Gyeonggi-do, South Korea
| | - Yun Joong Kim
- Hallym Institute of Translational Genomics and Bioinformatics, Anyang, Gyeonggi-do, South Korea.,ILSONG Institute of Life Science, Department of Neurology, Hallym University Sacred Heart hospital, Anyang, Gyeonggi-do, South Korea
| | - Young Hoon Ryu
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Myung Sik Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
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Cho H, Choi JY, Lee SH, Ryu YH, Lee MS, Lyoo CH. 18 F-AV-1451 binds to putamen in multiple system atrophy. Mov Disord 2016; 32:171-173. [PMID: 27859717 DOI: 10.1002/mds.26857] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 09/24/2016] [Accepted: 09/28/2016] [Indexed: 01/13/2023] Open
Affiliation(s)
- Hanna Cho
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae Yong Choi
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seung Ha Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Hoon Ryu
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Myung Sik Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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Cho H, Choi JY, Hwang MS, Lee SH, Ryu YH, Lee MS, Lyoo CH. Subcortical 18
F-AV-1451 binding patterns in progressive supranuclear palsy. Mov Disord 2016; 32:134-140. [DOI: 10.1002/mds.26844] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 09/22/2016] [Accepted: 09/25/2016] [Indexed: 01/05/2023] Open
Affiliation(s)
- Hanna Cho
- Department of Neurology, Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of Korea
| | - Jae Yong Choi
- Department of Nuclear Medicine, Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of Korea
| | - Mi Song Hwang
- Department of Neurology, Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of Korea
| | - Seung Ha Lee
- Department of Neurology, Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of Korea
| | - Young Hoon Ryu
- Department of Nuclear Medicine, Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of Korea
| | - Myung Sik Lee
- Department of Neurology, Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of Korea
| | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of Korea
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Cho H, Choi JY, Hwang MS, Kim YJ, Lee HM, Lee HS, Lee JH, Ryu YH, Lee MS, Lyoo CH. In vivo cortical spreading pattern of tau and amyloid in the Alzheimer disease spectrum. Ann Neurol 2016; 80:247-58. [PMID: 27323247 DOI: 10.1002/ana.24711] [Citation(s) in RCA: 319] [Impact Index Per Article: 39.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 06/03/2016] [Accepted: 06/05/2016] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To determine the in vivo cortical spreading pattern of tau and amyloid and to establish positron emission tomography (PET) image-based tau staging in the Alzheimer disease (AD) spectrum. METHODS We included 195 participants (53 AD, 52 amnestic mild cognitive impairment [MCI], 23 nonamnestic MCI, and 67 healthy controls) who underwent 2 PET scans ((18) F-florbetaben for amyloid-β and (18) F-AV-1451 for tau). We assumed that regions with earlier appearances of pathology may show increased binding in a greater number of participants and acquired spreading order of tau accumulation by sorting the regional frequencies of involvement. We classified each participant into image-based tau stage based on the Z score of the composite region for each stage. RESULTS Tau accumulation was most frequently observed in the medial temporal regions and spread stepwise to the basal and lateral temporal, inferior parietal, posterior cingulate, and other association cortices, and then ultimately to the primary cortical regions. In contrast, amyloid accumulation was found with similar frequency in the diffuse neocortical areas and then finally spread to the medial temporal regions. The image-based tau stage correlated with the general cognitive status, whereas cortical thinning was found only in the advanced tau stages: medial temporal region in stage V and widespread cortex in stage VI. INTERPRETATION Our PET study replicated postmortem spreading patterns of tau and amyloid-β pathologies. Unlike the diffuse accumulation of amyloid throughout the neocortex, tau spreading occurred in a stepwise fashion through the networks. Image-based tau staging may be useful for the objective assessment of AD progression. Ann Neurol 2016;80:247-258.
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Affiliation(s)
- Hanna Cho
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine
| | - Jae Yong Choi
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine
| | - Mi Song Hwang
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine
| | - You Jin Kim
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine
| | - Hye Mi Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, South Korea
| | - Jae Hoon Lee
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine
| | - Young Hoon Ryu
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine
| | - Myung Sik Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine
| | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine
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Cho H, Choi JY, Hwang MS, Ryu YH, Lee MS, Lyoo CH. P3‐263: TAU PET in Alzheimer’S Disease and Mild Cognitive Impairment. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.1926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Hanna Cho
- Gangnam Severance Hospital, Yonsei University College of MedicineSeoulThe Republic Korea
| | - Jae Yong Choi
- Gangnam Severance Hospital, Yonsei University College of MedicineSeoulThe Republic Korea
| | - Mi Song Hwang
- Gangnam Severance Hospital, Yonsei University College of MedicineSeoulThe Republic Korea
| | - Young Hoon Ryu
- Gangnam Severance Hospital, Yonsei University College of MedicineSeoulThe Republic Korea
| | - Myung Sik Lee
- Gangnam Severance Hospital, Yonsei University College of MedicineSeoulThe Republic Korea
| | - Chul Hyoung Lyoo
- Gangnam Severance Hospital, Yonsei University College of MedicineSeoulThe Republic Korea
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Cho H, Choi JY, Hwang MS, Lee JH, Kim YJ, Lee HM, Lyoo CH, Ryu YH, Lee MS. Tau PET in Alzheimer disease and mild cognitive impairment. Neurology 2016; 87:375-83. [PMID: 27358341 DOI: 10.1212/wnl.0000000000002892] [Citation(s) in RCA: 182] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 04/14/2016] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate the topographical distribution of tau pathology and its effect on functional and structural changes in patients with Alzheimer disease (AD) and mild cognitive impairment (MCI) by using (18)F-AV-1451 PET. METHODS We included 20 patients with AD, 15 patients with MCI, and 20 healthy controls, and performed neuropsychological function tests, MRI, as well as (18)F-florbetaben (for amyloid) and (18)F-AV-1451 (for tau) PET scans. By using the regional volume-of-interest masks extracted from MRIs, regional binding values of standardized uptake value ratios and volumes were measured. We compared regional binding values among 3 diagnostic groups and identified correlations among the regional binding values, performance in each cognitive function test, and regional atrophy. RESULTS (18)F-AV-1451 binding was increased only in the entorhinal cortex in patients with MCI, while patients with AD exhibited greater binding in most cortical regions. In the 35 patients with MCI and AD, (18)F-AV-1451 binding in most of the neocortex increased with a worsening of global cognitive function. The visual and verbal memory functions were associated with the extent of (18)F-AV-1451 binding, especially in the medial temporal regions. The (18)F-AV-1451 binding also correlated with the severity of regional atrophy of the cerebral cortex. CONCLUSIONS Tau PET imaging with (18)F-AV-1451 could serve as an in vivo biomarker for the evaluation of AD-related tau pathology and monitoring disease progression. The accumulation of pathologic tau is more closely related to functional and structural deterioration in the AD spectrum than β-amyloid.
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Affiliation(s)
- Hanna Cho
- From the Departments of Neurology (H.C., M.S.H., Y.J.K., H.M.L., C.H.L., M.S.L.) and Nuclear Medicine (J.Y.C., J.H.L., Y.H.R.), Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae Yong Choi
- From the Departments of Neurology (H.C., M.S.H., Y.J.K., H.M.L., C.H.L., M.S.L.) and Nuclear Medicine (J.Y.C., J.H.L., Y.H.R.), Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Mi Song Hwang
- From the Departments of Neurology (H.C., M.S.H., Y.J.K., H.M.L., C.H.L., M.S.L.) and Nuclear Medicine (J.Y.C., J.H.L., Y.H.R.), Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae Hoon Lee
- From the Departments of Neurology (H.C., M.S.H., Y.J.K., H.M.L., C.H.L., M.S.L.) and Nuclear Medicine (J.Y.C., J.H.L., Y.H.R.), Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - You Jin Kim
- From the Departments of Neurology (H.C., M.S.H., Y.J.K., H.M.L., C.H.L., M.S.L.) and Nuclear Medicine (J.Y.C., J.H.L., Y.H.R.), Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hye Mi Lee
- From the Departments of Neurology (H.C., M.S.H., Y.J.K., H.M.L., C.H.L., M.S.L.) and Nuclear Medicine (J.Y.C., J.H.L., Y.H.R.), Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Chul Hyoung Lyoo
- From the Departments of Neurology (H.C., M.S.H., Y.J.K., H.M.L., C.H.L., M.S.L.) and Nuclear Medicine (J.Y.C., J.H.L., Y.H.R.), Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Young Hoon Ryu
- From the Departments of Neurology (H.C., M.S.H., Y.J.K., H.M.L., C.H.L., M.S.L.) and Nuclear Medicine (J.Y.C., J.H.L., Y.H.R.), Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Myung Sik Lee
- From the Departments of Neurology (H.C., M.S.H., Y.J.K., H.M.L., C.H.L., M.S.L.) and Nuclear Medicine (J.Y.C., J.H.L., Y.H.R.), Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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Chee KY, Tripathi A, Avasthi A, Chong MY, Xiang YT, Sim K, Kanba S, He YL, Lee MS, Chiu HFK, Yang SY, Kuga H, Udomratn P, Tanra AJ, Maramis MM, Grover S, Mahendran R, Kallivayalil RA, Shen WW, Shinfuku N, Tan CH, Sartorius N. Prescribing Pattern of Antidepressants in Children and Adolescents: Findings from the Research on Asia Psychotropic Prescription Pattern. East Asian Arch Psychiatry 2016; 26:10-17. [PMID: 27086755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Pharmacotherapy of depression in children and adolescents is complex. In the absence of research into the efficacy and safety of antidepressants in this group of patients, their off-label prescription is common. This paper aimed to illustrate the prescription pattern of antidepressants in children and adolescents from major psychiatric centres in Asia. METHODS The Research on Asia Psychotropic Prescription Pattern on Antidepressants worked collaboratively in 2013 to study the prescription pattern of antidepressants in Asia using a unified research protocol and questionnaire. Forty psychiatric centres from 10 Asian countries / regions participated and 2321 antidepressant prescriptions were analysed. RESULTS A total of 4.7% antidepressant prescriptions were for children and adolescents. Fluoxetine, sertraline, and escitalopram were the most common antidepressants prescribed for children and adolescents. Almost one-third (30.3%) of prescriptions were for diagnoses other than depressive and anxiety disorders. There was less antidepressant polypharmacy and concomitant use of benzodiazepine, but more concomitant use of antipsychotics in children and adolescents compared with adults. CONCLUSION Off-label use of antidepressants in children and adolescents was reported by 40 Asian psychiatric institutions that participated in the study. In-service education and regulatory mechanisms should be reinforced to ensure efficacy and safety of antidepressants in children and adolescents.
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Affiliation(s)
- K Y Chee
- Department of Psychiatry & Mental Health, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
| | - A Tripathi
- Department of Psychiatry, King George's Medical University, Chowk, Lucknow, India
| | - A Avasthi
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - M Y Chong
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital-Kaohsiung Medical Center and School of Medicine, Chang Gung University, Taiwan
| | - Y T Xiang
- Faculty of Health Sciences, University of Macao, Macao SAR, PR China
| | - K Sim
- Institute of Mental Health, Buangkok View, Buangkok Green Medical Park, Singapore
| | - S Kanba
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Y L He
- Department of Psychiatric Epidemiology, Shanghai Mental Health Center, Shanghai, PR China
| | - M S Lee
- Department of Psychiatry, College of Medicine, Korea University, Seoul, South Korea
| | - H F K Chiu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, PR China
| | - S Y Yang
- Department of Pharmacy, Taipei City Hospital, Taipei, Taiwan
| | - H Kuga
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - P Udomratn
- Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - A J Tanra
- Department of Psychiatry, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia
| | - M M Maramis
- Dr Soetomo Hospital-Faculty of Medicine, Airlangga University, Jawa Timur, Indonesia
| | - S Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - R Mahendran
- Department of Psychological Medicine, National University Hospital, Singapore
| | - R A Kallivayalil
- Department of Psychiatry, Pushpagiri Medical College, Thiruvalla, India
| | - W W Shen
- Department of Psychiatry, TMU-Wan Fang Medical Center and School of Medicine, Taipei Medical University, Taipei, Taiwan
| | - N Shinfuku
- Department of Psychiatry, Kobe University, Kobe, Japan
| | - C H Tan
- Department of Pharmacology, National University of Singapore, Singapore
| | - N Sartorius
- Association for the Improvement of Mental Health Programmes, Geneva, Switzerland
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Chuang TL, Wang YF, Tsai CH, Chiu JE, Lee MS, Chiou WY, Lin HY, Tsai WT, Hung SK. Evaluation of salivary function by sialoscintigraphy in locally advanced nasopharyngeal cancer patients after intensity modulated radiotherapy. Indian J Cancer 2016; 52:398-401. [PMID: 26905151 DOI: 10.4103/0019-509x.176733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
PURPOSE This study aimed to evaluate the salivary gland function changes by sialoscintigraphy in locally advanced nasopharyngeal cancer (NPC) after intensity modulated radiotherapy (IMRT). MATERIALS AND METHODS Salivary function was assessed by sialoscintigraphy. Quantitative sialoscintigraphy was performed in 24 NPC patients prior to and after IMRT. Results were categorized in four groups according to the duration of treatment. The sialoscintigraphy parameters were examined. RESULTS Sialoscintigraphy showed a significant difference in the secretion of each interval groups. The parameters of scintigraphy, except maximum accumulation (MA) of submandibular glands, decreased first after radiotherapy, and then recovered. However, the MA of submandibular glands was continuously downhill after radiation. CONCLUSIONS The sialoscintigraphy parameters of each gland changed with the different radiation dose and follow-up intervals. The salivary function was influenced after radiotherapy in locally advanced NPC, especially, in the submandibular gland. Strategies to improve the salivary function should be assessed.
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Affiliation(s)
| | | | | | | | | | | | | | | | - S K Hung
- School of Medicine, Tzu Chi University, Hualian; Department of Radiation Oncology, Buddhist Dalin Tzu Chi Hospital, Chiayi, Taiwan
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Lee JH, Park J, Ryu HS, Park H, Kim YE, Hong JY, Nam SO, Sung YH, Lee SH, Lee JY, Lee MJ, Kim TH, Lyoo CH, Chung SJ, Koh SB, Lee PH, Cho JW, Park MY, Kim YJ, Sohn YH, Jeon BS, Lee MS. Clinical Heterogeneity of Atypical Pantothenate Kinase-Associated Neurodegeneration in Koreans. J Mov Disord 2016; 9:20-7. [PMID: 26828213 PMCID: PMC4734989 DOI: 10.14802/jmd.15058] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 12/07/2015] [Accepted: 12/07/2015] [Indexed: 02/04/2023] Open
Abstract
Objective Neurodegeneration with brain iron accumulation (NBIA) represents a group of inherited movement disorders characterized by iron accumulation in the basal ganglia. Recent advances have included the identification of new causative genes and highlighted the wide phenotypic variation between and within the specific NBIA subtypes. This study aimed to investigate the current status of NBIA in Korea. Methods We collected genetically confirmed NBIA patients from twelve nationwide referral hospitals and from a review of the literature. We conducted a study to describe the phenotypic and genotypic characteristics of Korean adults with atypical pantothenate kinase-associated neurodegeneration (PKAN). Results Four subtypes of NBIA including PKAN (n = 30), PLA2G6-related neurodegeneration (n = 2), beta-propeller protein-associated neurodegeneration (n = 1), and aceruloplasminemia (n = 1) have been identified in the Korean population. The clinical features of fifteen adults with atypical PKAN included early focal limb dystonia, parkinsonism-predominant feature, oromandibular dystonia, and isolated freezing of gait (FOG). Patients with a higher age of onset tended to present with parkinsonism and FOG. The p.R440P and p.D378G mutations are two major mutations that represent approximately 50% of the mutated alleles. Although there were no specific genotype-phenotype correlations, most patients carrying the p.D378G mutation had a late-onset, atypical form of PKAN. Conclusions We found considerable phenotypic heterogeneity in Korean adults with atypical PKAN. The age of onset may influence the presentation of extrapyramidal symptoms.
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Affiliation(s)
- Jae-Hyeok Lee
- Department of Neurology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jongkyu Park
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Ho-Sung Ryu
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyeyoung Park
- Department of Neurology, Seoul National University Hospital, Seoul, Korea
| | - Young Eun Kim
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Jin Yong Hong
- Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sang Ook Nam
- Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Young-Hee Sung
- Department of Neurology, Gachon University Gil Hospital, Incheon, Korea
| | - Seung-Hwan Lee
- Department of Neurology, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Jee-Young Lee
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Myung Jun Lee
- Department of Neurology, Pusan National University Hospital, Busan, Korea
| | - Tae-Hyoung Kim
- Department of Neurology, Dong-Eui Hospital, Busan, Korea
| | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Seoul, Korea
| | - Sun Ju Chung
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seong Beom Koh
- Department of Neurology, Korea University College of Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Jin Whan Cho
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Mee Young Park
- Department of Neurology, Yeungnam University Medical Center, Daegu, Korea
| | - Yun Joong Kim
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Beom Seok Jeon
- Department of Neurology, Seoul National University Hospital, Seoul, Korea
| | - Myung Sik Lee
- Department of Neurology, Korea University College of Medicine, Korea University Guro Hospital, Seoul, Korea
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Lee MS, Lee SH, Ahn SJ. Re-emergent Tremor Without Rest Tremor After Lenticular Infarctions. Mov Disord Clin Pract 2015; 3:96-97. [PMID: 30713903 DOI: 10.1002/mdc3.12224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 06/24/2015] [Accepted: 06/30/2015] [Indexed: 11/08/2022] Open
Affiliation(s)
- Myung Sik Lee
- Department of Neurology Gangnam Severance Hospital Yonsei University College of Medicine Seoul Korea
| | - Seung Ha Lee
- Department of Neurology Gangnam Severance Hospital Yonsei University College of Medicine Seoul Korea
| | - Sung Jun Ahn
- Department of Radiology Gangnam Severance Hospital Yonsei University College of Medicine Seoul Korea
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