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Lee DY, Kwon YN, Lee K, Kim SJ, Sung JJ. Dual effects of TGF-β inhibitor in ALS - inhibit contracture and neurodegeneration. J Neurochem 2024. [PMID: 38515326 DOI: 10.1111/jnc.16102] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 02/25/2024] [Accepted: 03/05/2024] [Indexed: 03/23/2024]
Abstract
As persistent elevation of transforming growth factor-β (TGF-β) promotes fibrosis of muscles and joints and accelerates disease progression in amyotrophic lateral sclerosis (ALS), we investigated whether inhibition of TGF-β would be effective against both exacerbations. The effects of TGF-β and its inhibitor on myoblasts and fibroblasts were tested in vitro and confirmed in vivo, and the dual action of a TGF-β inhibitor in ameliorating the pathogenic role of TGF-β in ALS mice was identified. In the peripheral neuromuscular system, fibrosis in the muscles and joint cavities induced by excessive TGF-β causes joint contracture and muscular degeneration, which leads to motor dysfunction. In an ALS mouse model, an increase in TGF-β in the central nervous system (CNS), consistent with astrocyte activity, was associated with M1 microglial activity and pro-inflammatory conditions, as well as with neuronal cell death. Treatment with the TGF-β inhibitor halofuginone could prevent musculoskeletal fibrosis, resulting in the alleviation of joint contracture and delay of motor deterioration in ALS mice. Halofuginone could also reduce glial cell-induced neuroinflammation and neuronal apoptosis. These dual therapeutic effects on both the neuromuscular system and the CNS were observed from the beginning to the end stages of ALS; as a result, treatment with a TGF-β inhibitor from the early stage of disease delayed the time of symptom exacerbation in ALS mice, which led to prolonged survival.
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Affiliation(s)
- Do-Yeon Lee
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea
- Department of Neurology, Seoul National University College of Medicine, Seoul, South Korea
| | - Young Nam Kwon
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Kwangkook Lee
- Research Department, Curamys Co., Ltd., Seoul, South Korea
| | - Sang Jeong Kim
- Department of Physiology, Seoul National University College of Medicine, Seoul, South Korea
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea
- Neuroscience Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Jung-Joon Sung
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea
- Department of Neurology, Seoul National University College of Medicine, Seoul, South Korea
- Neuroscience Research Institute, Seoul National University College of Medicine, Seoul, South Korea
- Wide River Institute of Immunology, Seoul National University, Hongcheon, Gangwon-do, South Korea
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Min YG, Moon Y, Kwon YN, Lee BJ, Park KA, Han JY, Han J, Lee HJ, Baek SH, Kim BJ, Kim JS, Park KS, Kim NH, Kim M, Nam TS, Oh SI, Jung JH, Sung JJ, Jang MJ, Kim SJ, Kim SM. Prognostic factors of first-onset optic neuritis based on diagnostic criteria and antibody status: a multicentre analysis of 427 eyes. J Neurol Neurosurg Psychiatry 2024:jnnp-2023-333133. [PMID: 38418215 DOI: 10.1136/jnnp-2023-333133] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/22/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND Optic neuritis (ON) prognosis is influenced by various factors including attack severity, underlying aetiologies, treatments and consequences of previous episodes. This study, conducted on a large cohort of first ON episodes, aimed to identify unique prognostic factors for each ON subtype, while excluding any potential influence from pre-existing sequelae. METHODS Patients experiencing their first ON episodes, with complete aquaporin-4 (AQP4) and myelin oligodendrocyte glycoprotein (MOG) antibody testing, and clinical data for applying multiple sclerosis (MS) diagnostic criteria, were enrolled. 427 eyes from 355 patients from 10 hospitals were categorised into four subgroups: neuromyelitis optica with AQP4 IgG (NMOSD-ON), MOG antibody-associated disease (MOGAD-ON), ON in MS (MS-ON) or idiopathic ON (ION). Prognostic factors linked to complete recovery (regaining 20/20 visual acuity (VA)) or moderate recovery (regaining 20/40 VA) were assessed through multivariable Cox regression analysis. RESULTS VA at nadir emerged as a robust prognostic factor for both complete and moderate recovery, spanning all ON subtypes. Early intravenous methylprednisolone (IVMP) was associated with enhanced complete recovery in NMOSD-ON and MOGAD-ON, but not in MS-ON or ION. Interestingly, in NMOSD-ON, even a slight IVMP delay in IVMP by >3 days had a significant negative impact, whereas a moderate delay up to 7-9 days was permissible in MOGAD-ON. Female sex predicted poor recovery in MOGAD-ON, while older age hindered moderate recovery in NMOSD-ON and ION. CONCLUSION This comprehensive multicentre analysis on first-onset ON unveils subtype-specific prognostic factors. These insights will assist tailored treatment strategies and patient counselling for ON.
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Affiliation(s)
- Young Gi Min
- Department of Translational Medicine, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
- Department of Neurology, Seoul National University Hospital, Seoul, Korea (the Republic of)
| | - Yeji Moon
- Department of Ophthalmology, University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
| | - Young Nam Kwon
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
| | - Byung Joo Lee
- Department of Ophthalmology, University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
| | - Kyung-Ah Park
- Department of Ophthalmology, Samsung Medical Center, Seoul, Korea (the Republic of)
| | - Jae Yong Han
- Institute of Vision Research, Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
| | - Jinu Han
- Institute of Vision Research, Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
| | - Haeng-Jin Lee
- Department of Ophthalmology, Jeonbuk National University Hospital, Jeonju, Korea (the Republic of)
| | - Seol-Hee Baek
- Department of Neurology, Korea University Anam Hospital, Seoul, Korea (the Republic of)
| | - Byung-Jo Kim
- Department of Neurology, Korea University Anam Hospital, Seoul, Korea (the Republic of)
| | - Jun-Soon Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea (the Republic of)
| | - Kyung Seok Park
- Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea (the Republic of)
| | - Nam-Hee Kim
- Department of Neurology, Dongguk University Ilsan Hospital, Ilsan, Korea (the Republic of)
| | - Martha Kim
- Department of Ophthalmology, Dongguk University Ilsan Hospital, Ilsan, Korea (the Republic of)
| | - Tai-Seung Nam
- Department of Neurology, Chonnam University Hospital, Hwasun, Korea (the Republic of)
| | - Seong-Il Oh
- Department of Neurology, Kyung Hee University Hospital, Seoul, Korea (the Republic of)
- Department of Neurology, Busan Paik Hospital, Busan, Korea (the Republic of)
| | - Jae Ho Jung
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
| | - Jung-Joon Sung
- Department of Translational Medicine, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
- Department of Neurology, Seoul National University Hospital, Seoul, Korea (the Republic of)
| | - Myoung-Jin Jang
- Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Korea (the Republic of)
| | - Seong-Joon Kim
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
| | - Sung-Min Kim
- Department of Translational Medicine, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
- Department of Neurology, Seoul National University Hospital, Seoul, Korea (the Republic of)
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Kim M, Kim WS, Cha H, Kim B, Kwon YN, Kim SM. Early involvement of peripherally derived monocytes in inflammation in an NMO-like mouse model. Sci Rep 2024; 14:1177. [PMID: 38216632 PMCID: PMC10786844 DOI: 10.1038/s41598-024-51759-4] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/09/2024] [Indexed: 01/14/2024] Open
Abstract
Neuromyelitis optica (NMO) is an autoimmune inflammatory disease that primarily affects the optic nerve and spinal cord within the central nervous system (CNS). Acute astrocyte injury caused by autoantibodies against aquaporin 4 (NMO-IgG) is a well-established key factor in the pathogenesis, ultimately leading to neuronal damage and patient disability. In addition to these humoral immune processes, numerous innate immune cells were found in the acute lesions of NMO patients. However, the origin and function of these innate immune cells remain unclear in NMO pathogenesis. Therefore, this study aims to analyze the origin and functions of these innate immune cells in an NMO-like mouse model and evaluate their role in the pathophysiology of NMO. The expression of Tmem119 on Iba1 + cells in brain tissue disappeared immediately after the injection of NMO-IgG + human complement mixture, while the expression of P2ry12 remained well-maintained at 1 day after injection. Based on these observations, it was demonstrated that monocytes infiltrate the brain during the early stages of the pathological process and are closely associated with the inflammatory response through the expression of the proinflammatory cytokine IL-1β. Understanding the variations in the expression patterns of P2ry12, Tmem119, and other markers could be helpful in distinguishing between these cell types and further analyzing their functions. Therefore, this research may contribute to a better understanding of the mechanisms and potential treatments for NMO.
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Affiliation(s)
- Moonhang Kim
- Biomedical Research Institute, Seoul National University Hospital, Seoul, 03082, Republic of Korea.
| | - Won Seok Kim
- Biomedical Research Institute, Seoul National University Hospital, Seoul, 03082, Republic of Korea
| | - Hyeuk Cha
- Biomedical Research Institute, Seoul National University Hospital, Seoul, 03082, Republic of Korea
| | - Boram Kim
- Biomedical Research Institute, Seoul National University Hospital, Seoul, 03082, Republic of Korea
| | - Young Nam Kwon
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Sung Min Kim
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, 03080, Republic of Korea.
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Min YG, Han HJ, Shin HY, Baek JG, Kim JS, Park KS, Baek SH, Yoo I, Huh SY, Kwon YN, Choi SJ, Kim SM, Hong YH, Sung JJ. Therapeutic Outcomes and Electrophysiological Biomarkers in Anti-Myelin-Associated Glycoprotein Neuropathy: A Multicenter Cohort Study in South Korea. J Clin Neurol 2024; 20:50-58. [PMID: 38179632 PMCID: PMC10782088 DOI: 10.3988/jcn.2023.0127] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/04/2023] [Accepted: 06/07/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND AND PURPOSE Unlike other immune-mediated neuropathies, anti-myelin-associated glycoprotein (MAG) neuropathy is often refractory to immunotherapy. It is necessary to compare the relative efficacies of various immunotherapies and develop objective biomarkers in order to optimize its clinical management. METHODS This study recruited 91 patients with high anti-MAG antibody titers from 7 tertiary hospitals in South Korea. We analyzed the baseline characteristics, therapeutic outcomes, and nerve conduction study (NCS) findings of 68 patients and excluded 23 false positive cases. RESULTS The rate of positive responses to treatment was highest using zanubrutinib (50%) and rituximab (36.4%), followed by corticosteroids (16.7%), immunosuppressants (9.5%), intravenous immunoglobulin (5%), and plasma exchange (0%). Disability and weakness were significantly associated with multiple NCS parameters at the time of diagnosis, especially distal compound muscle action potential (CMAP) amplitudes. Moreover, the longitudinal trajectory of the average CMAP amplitudes paralleled the clinical courses, with a 16.2 percentile decrease as an optimal cutoff for predicting a clinical exacerbation (area under the receiver operating characteristic curve=0.792). CONCLUSIONS Our study supports the use of NCS as an objective marker for estimating disease burden and tracking clinical changes in patients with anti-MAG neuropathy. We have described the beneficial effects of rituximab and a new drug, zanubrutinib, compared with conventional immunotherapies.
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Affiliation(s)
- Young Gi Min
- Department of Translational Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Neurology, Seoul National University Hospital, Seoul, Korea
| | - Hee-Jo Han
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Ha Young Shin
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Jong-Gyu Baek
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jun-Soon Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Kyung-Seok Park
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Seol-Hee Baek
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Ilhan Yoo
- Department of Neurology, Nowon Eulji Medical Center, Seoul, Korea
| | - So-Young Huh
- Department of Neurology, Kosin Medical University Hospital, Busan, Korea
| | - Young Nam Kwon
- Department of Neurology, Seoul National University Hospital, Seoul, Korea
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Seok-Jin Choi
- Department of Neurology, Seoul National University Hospital, Seoul, Korea
| | - Sung-Min Kim
- Department of Neurology, Seoul National University Hospital, Seoul, Korea
| | - Yoon-Ho Hong
- Department of Translational Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Neurology, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Jung-Joon Sung
- Department of Translational Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Neurology, Seoul National University Hospital, Seoul, Korea
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
- Neuroscience Research Institute, Seoul National University College of Medicine, Seoul, Korea.
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Kim M, Choi KS, Hyun RC, Hwang I, Kwon YN, Sung JJ, Kim SM, Kim JH. Structural disconnection is associated with disability in the neuromyelitis optica spectrum disorder. Brain Imaging Behav 2023; 17:664-673. [PMID: 37676409 DOI: 10.1007/s11682-023-00792-4] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2023] [Indexed: 09/08/2023]
Abstract
OBJECTIVES Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune inflammatory disease of the central nervous system. Accumulating evidence suggests there is a distinct pattern of brain lesions characteristic of NMOSD, and brain MRI has potential prognostic implications. However, the question of how the brain lesions in NMOSD are associated with its distinct clinical course remains incompletely understood. Here, we aimed to investigate the association between neurological impairment and brain lesions via brain structural disconnection. METHODS Twenty patients were diagnosed with NMOSD according to the 2015 International Panel for NMO Diagnosis criteria. The white matter lesions were manually drawn section by section. Whole-brain structural disconnection was estimated, and connectome-based predictive modeling (CPM) was used to estimate the patient's Expanded Disability Status Scale score (EDSS) from their disconnection severity matrix. Furthermore, correlational tractography was performed to assess the fractional anisotropy (FA) and axial diffusivity (AD) of white matter fibers, which negatively correlated with the EDSS score. RESULTS CPM successfully predicted the EDSS using the disconnection severity matrix (r = 0.506, p = 0.028; q2 = 0.274). Among the important edges in the prediction process, the majority of edges connected the motor to the frontoparietal network. Correlational tractography identified a decreased FA and AD value according to EDSS scores in periependymal white matter tracts. DISCUSSION Structural disconnection-based predictive modeling and local connectome analysis showed that frontoparietal and periependymal white matter disconnection is predictive and associated with the EDSS score of NMOSD patients.
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Affiliation(s)
- Minchul Kim
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyu Sung Choi
- Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, Seoul, 110-744, Republic of Korea
| | - Ryoo Chang Hyun
- Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, Seoul, 110-744, Republic of Korea
| | - Inpyeong Hwang
- Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, Seoul, 110-744, Republic of Korea
| | - Young Nam Kwon
- Department of Neurology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, Seoul, 110-744, Republic of Korea
| | - Jung-Joon Sung
- Department of Neurology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, Seoul, 110-744, Republic of Korea
| | - Sung Min Kim
- Department of Neurology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, Seoul, 110-744, Republic of Korea.
| | - Ji-Hoon Kim
- Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, Seoul, 110-744, Republic of Korea.
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Park SY, Kwon YN, Kim S, Kim SH, Kim JK, Kim JS, Nam TS, Min YG, Park KS, Park JS, Seok JM, Sung JJ, Sohn E, Shin KJ, Shin JH, Shin HY, Oh SI, Oh J, Yoon BA, Lee S, Lee JM, Lee HL, Choi K, Huh SY, Jang MJ, Min JH, Kim BJ, Kim SM. Early rituximab treatment reduces long-term disability in aquaporin-4 antibody-positive neuromyelitis optica spectrum. J Neurol Neurosurg Psychiatry 2023; 94:800-805. [PMID: 37268404 DOI: 10.1136/jnnp-2022-330714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 05/12/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND Neuromyelitis optica spectrum disorder (NMOSD) causes relapsing inflammatory attacks in the central nervous system, leading to disability. As rituximab, a B-lymphocyte-depleting monoclonal antibody, is an effective in preventing NMOSD relapses, we hypothesised that earlier initiation of rituximab can also reduce long-term disability of patients with NMOSD. METHODS This multicentre retrospective study involving 19 South Korean referral centres included patients with NMOSD with aquaporin-4 antibodies receiving rituximab treatment. Factors associated with the long-term Expanded Disability Status Scale (EDSS) were assessed using multivariable regression analysis. RESULTS In total, 145 patients with rituximab treatment (mean age of onset, 39.5 years; 88.3% female; 98.6% on immunosuppressants/oral steroids before rituximab treatment; mean disease duration of 121 months) were included. Multivariable analysis revealed that the EDSS at the last follow-up was associated with time to rituximab initiation (interval from first symptom onset to initiation of rituximab treatment). EDSS at the last follow-up was also associated with maximum EDSS before rituximab treatment. In subgroup analysis, the time to initiation of rituximab was associated with EDSS at last follow-up in patients aged less than 50 years, female and those with a maximum EDSS score ≥6 before rituximab treatment. CONCLUSIONS Earlier initiation of rituximab treatment may prevent long-term disability worsening in patients with NMOSD, especially among those with early to middle-age onset, female sex and severe attacks.
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Affiliation(s)
- Su Yeon Park
- Department of Neurology, Korea Cancer Center Hospital, Seoul, Korea (the Republic of)
| | - Young Nam Kwon
- Department of Neurology, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea (the Republic of)
| | - Sunyoung Kim
- Department of Neurology, Ulsan University Hospital College of Medicine, Ulsan, Korea (the Republic of)
| | - Seung-Hyun Kim
- Department of Neurology, Hanyang University College of Medicine, Seoul, Korea (the Republic of)
| | - Jong Kuk Kim
- Department of Neurology, Dong-A University College of Medicine, Busan, Korea (the Republic of)
| | - Jun-Soon Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea (the Republic of)
| | - Tai-Seung Nam
- Department of Neurology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Korea (the Republic of)
| | - Young Gi Min
- Department of Neurology, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
| | - Kyung Seok Park
- Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea (the Republic of)
| | - Jin-Sung Park
- Department of Neurology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Korea (the Republic of)
| | - Jin Myoung Seok
- Department of Neurology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea (the Republic of)
| | - Jung-Joon Sung
- Department of Neurology, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
| | - Eunhee Sohn
- Department of Neurology, Chungnam National University, College of Medicine, Daejeon, Korea (the Republic of)
| | - Kyong Jin Shin
- Department of Neurology, Haeundae Paik Hospital, Inje University, Busan, Korea (the Republic of)
| | - Jin-Hong Shin
- Department of Neurology, Pusan National University Yangsan Hospital, Yangsan, Korea (the Republic of)
| | - Ha Young Shin
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
| | - Seong-Il Oh
- Department of Neurology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea (the Republic of)
| | - Jeeyoung Oh
- Department of Neurology, Konkuk University School of Medicine, Seoul, Korea (the Republic of)
| | - Byeol-A Yoon
- Department of Neurology, Dong-A University College of Medicine, Busan, Korea (the Republic of)
| | - Sanggon Lee
- Department of Neurology, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea (the Republic of)
| | - Jong-Mok Lee
- Department of Neurology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea (the Republic of)
| | - Hye Lim Lee
- Department of Neurology, Korea University College of Medicine, Seoul, Korea (the Republic of)
| | - Kyomin Choi
- Department of Neurology, Konkuk University School of Medicine, Seoul, Korea (the Republic of)
| | - So-Young Huh
- Department of Neurology, Kosin University College of Medicine, Busan, Korea (the Republic of)
| | - Myoung-Jin Jang
- Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Korea (the Republic of)
| | - Ju-Hong Min
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
| | - Byoung Joon Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
| | - Sung-Min Kim
- Department of Neurology, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
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Lee WJ, Kwon YN, Kim B, Moon J, Park KI, Chu K, Sung JJ, Lee SK, Kim SM, Lee ST. MOG antibody-associated encephalitis in adult: clinical phenotypes and outcomes. J Neurol Neurosurg Psychiatry 2023; 94:102-112. [PMID: 36261287 DOI: 10.1136/jnnp-2022-330074] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 07/28/2022] [Accepted: 10/04/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND We investigated the clinical characteristics and outcomes of myelin oligodendrocyte glycoprotein (MOG) antibody-associated autoimmune encephalitis (MOGAE) in adult patients. METHODS From an institutional cohort, we analysed adult patients with MOGAE followed-up for more than 1 year. Disease severity was assessed using the modified Rankin scale (mRS) and Clinical Assessment Scale in Autoimmune Encephalitis scores. Immunotherapy profiles, outcomes and disease relapses were evaluated along with serial brain MRI data. RESULTS A total of 40 patients were enrolled and categorised into cortical encephalitis (18 patients), limbic encephalitis (LE, 5 patients) and acute disseminated encephalomyelitis (ADEM, 17 patients). 80.0% of patients achieved good clinical outcomes (mRS 0‒2) and 40.0% relapsed. The LE subtype was associated with an older onset age (p=0.004) and poor clinical outcomes (p=0.014) than the other subtypes but with a low rate of relapse (0.0%). 21/25 (84.0%) relapse attacks were associated with an absence or short (≤6 months) immunotherapy maintenance. On MRI, the development of either diffuse cerebral or medial temporal atrophy within the first 6 month was correlated with poor outcomes. MOG-antibody (MOG-Ab) was copresent with anti-N-methyl-D-aspartate receptor (NMDAR)-antibody in 13 patients, in whom atypical clinical presentation (cortical encephalitis or ADEM, p<0.001) and disease relapse (46.2% vs 0.0%, p<0.001) were more frequent compared with conventional NMDAR encephalitis without MOG-Ab. CONCLUSIONS Outcomes are different according to the three phenotypes in MOGAE. Short immunotherapy maintenance is associated with relapse, and brain atrophy was associated with poor outcomes. Patients with dual antibodies of NMDAR and MOG have a high relapse rate.
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Affiliation(s)
- Woo-Jin Lee
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.,Department of Neurology, Seoul National University Bundang Hospital, Seoul, South Korea
| | - Young Nam Kwon
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Boram Kim
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Jangsup Moon
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Kyung-Il Park
- Department of Neurology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea
| | - Kon Chu
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Jung-Joon Sung
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Sang Kun Lee
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Sung-Min Kim
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Soon-Tae Lee
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
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Kwon YN, Woodhall M, Sung JJ, Kim KK, Lim YM, Kim H, Kim JE, Baek SH, Kim BJ, Park JS, Seok HY, Kim DS, Kwon O, Park KH, Sohn E, Bae JS, Yoon BN, Kim NH, Ahn SW, Choi K, Oh J, Park HJ, Shin KJ, Lee S, Park J, Kim SH, Seok JI, Bae DW, An JY, Joo IS, Choi SJ, Nam TS, Kim S, Park KJ, Kwon KH, Waters P, Hong YH. Clinical pitfalls and serological diagnostics of MuSK myasthenia gravis. J Neurol 2023; 270:1478-1486. [PMID: 36396811 PMCID: PMC9971039 DOI: 10.1007/s00415-022-11458-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/22/2022] [Accepted: 10/25/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND We aimed to evaluate the diagnostic accuracy of enzyme-linked immunosorbent assay (ELISA) for anti-muscle specific tyrosine kinase (MuSK) antibody (Ab) in a large cohort of anti-acetylcholine receptor (AChR) Ab-negative generalized myasthenia gravis (MG), and also to investigate clinical contexts for the diagnosis of MuSK MG. METHODS A retrospective study of 160 patients with a clinical suspicion of AChR Ab-negative generalized MG was performed. The serum samples were tested for anti-clustered AChR Ab by cell-based assay (CBA), anti-MuSK Ab by ELISA, CBA and/or radioimmunoprecipitation assay (RIPA). Clinical data were compared between anti-MuSK Ab-positive MG and double seronegative (AChR and MuSK) MG groups. RESULTS After excluding non-MG and clustered AChR Ab-positive patients, we identified 89 patients as a cohort of AChR Ab-negative generalized MG. Anti-MuSK Ab was positive by ELISA in 22 (24.7%) patients. While CBA identified five additional anti-MuSK Ab-positive patients, the results of ELISA were mostly consistent with CBA and RIPA with Cohen's kappa of 0.80 and 0.90, respectively (p < 0.001). The most frequent differential diagnosis was motor neuron disease particularly of bulbar onset which showed remarkably overlapping clinical and electrophysiological features with MuSK MG at presentation. CONCLUSION While confirming the highest sensitivity of CBA for detecting anti-MuSK Ab, our results highlight the clinical pitfalls in making a diagnosis of MuSK MG and may support a diagnostic utility of MuSK-ELISA in clinical practice.
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Affiliation(s)
- Young Nam Kwon
- Department of Neurology, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul, Republic of Korea
- Department of Neurology, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Mark Woodhall
- Oxford Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, Neuroimmunology Group, University of Oxford, John Radcliffe Hospital, Level 5, West Wing, Headley Way, Oxford, OX3 9DU, UK
| | - Jung-Joon Sung
- Department of Neurology, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Neurology, Seoul National University College of Medicine, Neuroscience Research Institute, Seoul National University Medical Research Council, 20 Boramae-Ro 5-Gil, Dongjak-Gu, Seoul, 07061, Republic of Korea
| | - Kwang-Kuk Kim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Young-Min Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyunjin Kim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jee-Eun Kim
- Department of Neurology, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Seol-Hee Baek
- Department of Neurology, Korea University College of Medicine, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Byung-Jo Kim
- Department of Neurology, Korea University College of Medicine, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Jin-Sung Park
- Department of Neurology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Hung Youl Seok
- Department of Neurology, Dongsan Hospital, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Dae-Seong Kim
- Department of Neurology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Ohyun Kwon
- Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Republic of Korea
| | - Kee Hong Park
- Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea
| | - Eunhee Sohn
- Department of Neurology, Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Jong Seok Bae
- Department of Neurology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Byung-Nam Yoon
- Department of Neurology, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea
| | - Nam-Hee Kim
- Department of Neurology, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Suk-Won Ahn
- Department of Neurology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Kyomin Choi
- Department of Neurology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Jeeyoung Oh
- Department of Neurology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Hyung Jun Park
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyong Jin Shin
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Sanggon Lee
- Department of Neurology, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Jinseok Park
- Department of Neurology, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Seung Hyun Kim
- Department of Neurology, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Jung Im Seok
- Department of Neurology, School of Medicine, Catholic University of Daegu, Daegu, Republic of Korea
| | - Dae Woong Bae
- Department of Neurology, College of Medicine, St. Vincent Hospital, The Catholic University of Korea, Suwon, Republic of Korea
| | - Jae Young An
- Department of Neurology, College of Medicine, St. Vincent Hospital, The Catholic University of Korea, Suwon, Republic of Korea
| | - In Soo Joo
- Department of Neurology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Seok-Jin Choi
- Department of Neurology, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Tai-Seung Nam
- Department of Neurology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sunyoung Kim
- Department of Neurology, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Ki-Jong Park
- Department of Neurology, College of Medicine, Gyeongsang National University, Gyeonsang Institute of Health Science, Jinju, Republic of Korea
| | - Ki-Han Kwon
- Department of Neurology, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea
| | - Patrick Waters
- Oxford Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, Neuroimmunology Group, University of Oxford, John Radcliffe Hospital, Level 5, West Wing, Headley Way, Oxford, OX3 9DU, UK.
| | - Yoon-Ho Hong
- Department of Neurology, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul, Republic of Korea.
- Department of Neurology, Seoul National University College of Medicine, Neuroscience Research Institute, Seoul National University Medical Research Council, 20 Boramae-Ro 5-Gil, Dongjak-Gu, Seoul, 07061, Republic of Korea.
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9
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Oh SJ, Kwon YN, Lee CK, Lee JS. Anti-NMDAR encephalitis in Crohn’s disease undergoing long-term infliximab treatment: A case report. Front Immunol 2022; 13:957575. [PMID: 36389693 PMCID: PMC9659735 DOI: 10.3389/fimmu.2022.957575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 10/19/2022] [Indexed: 12/05/2022] Open
Abstract
Infliximab, a chimeric monoclonal antibody against anti-tumor necrosis factor-α (TNF-α), has revolutionized the management of inflammatory bowel disease. However, a recent nested case-control study showed that anti-TNF-α therapy exposure in patients with autoimmune diseases is associated with an increased risk of inflammatory central nervous system (CNS) events. A 27-year-old man diagnosed with Crohn’s disease at 17 years of age was referred to our clinic for suffering with Wernicke’s aphasia and the right-hand weakness over two weeks. Nine years of treatment for Crohn’s disease with infliximab anti-TNF-α therapy was well tolerated. An initial MRI revealed diffuse leptomeningeal enhancement along the bilateral cerebral sulci without any parenchymal abnormalities. Cerebrospinal fluid (CSF) and serum N-methyl-D-aspartate receptor (NMDAR) antibody testing yielded positive results. Anti-NMDAR encephalitis was diagnosed, and the patient was treated with rituximab. A follow-up brain MRI showed new multiple cerebral lesions in the left insular cortex and subcortical white matter of the left frontal and temporal gyri. Approximately 8 months after symptom onset, the CSF and serum NMDAR antibody converted to negative. Twelve months later, the patient fully recovered from anti-NMDAR encephalitis without any neurological deficits and is currently being treated with the anti-interleukin 12/23 agent ustekinumab for Crohn’s disease. This is the first report of not only a patient with infliximab-associated anti-NMDAR encephalitis in Crohn’s disease but also of an inflammatory non-demyelinating CNS event during long-term suppression of TNF-α. Our case highlights the need for clinicians to recognize the possibility of a paradoxical autoimmune response occurring with novel biological therapies.
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Affiliation(s)
- Shin Ju Oh
- Center for Crohn’s and Colitis, Department of Gastroenterology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Young Nam Kwon
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Chang Kyun Lee
- Center for Crohn’s and Colitis, Department of Gastroenterology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Jin San Lee
- Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, South Korea
- *Correspondence: Jin San Lee,
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10
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Lee JH, Moon Y, Kwon YN, Shin JH, Kim SM, Jung JH. Changes of retinal structure and visual function in patients with demyelinating transverse myelitis. Neurol Sci 2022; 43:6425-6431. [DOI: 10.1007/s10072-022-06315-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 08/02/2022] [Indexed: 11/27/2022]
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11
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Kim KM, Kim SM, Kang H, Ji SY, Dho YS, Choi YD, Kwak GH, Kim BE, Oh H, Park HP, Kang KM, Choi SH, Kwon YN, Lee ST, Seo HG, Park CK. Preservation of language function by mapping the arcuate fasciculus using intraoperative corticocortical evoked potential under general anesthesia in glioma surgery. J Neurosurg 2022; 137:1-9. [PMID: 35303703 DOI: 10.3171/2022.1.jns212658] [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: 11/19/2021] [Accepted: 01/31/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Intraoperative language mapping under general anesthesia is imperative for brain tumor surgery because awake surgery is not always feasible. Monitoring corticocortical evoked potential (CCEP) is known to be a useful method for tracking neuronal connectivity and localizing functional areas. The authors evaluated the clinical benefit of intraoperative CCEP monitoring for language function preservation in patients undergoing glioma surgery. METHODS Between January 2019 and June 2021, the authors performed a total of 29 consecutive glioma surgeries using CCEP monitoring under general anesthesia because of a risk of speech impairment; these were analyzed. Language area mapping was implemented by the anterior language area to posterior language area CCEP method for arcuate fasciculus mapping, and tumor resection was performed while avoiding the localized language areas. Language function before and after surgery was evaluated by the Controlled Oral Word Association Test (COWAT). RESULTS Intraoperative CCEP was successfully monitored in 25 patients (86.2%), and a valid signal was undetectable in the other 4 patients. Language function evaluation was possible before and after surgery in a total of 20 patients. Overall, the preservation rate of language function was 65.0%, and the deterioration rate was 35.0% after tumor resection with CCEP monitoring. Among those 8 patients with preoperative COWAT scores ≥ 18, 5 patients (62.5%) successfully preserved their language function, with COWAT scores > 18 after tumor resection. Among the 12 patients with preoperative deteriorated language function (COWAT score < 18), 8 patients (66.7%) showed improvement or preserved language function after surgery. CONCLUSIONS Intraoperative CCEP monitoring of the arcuate fasciculus is an acceptable technology for the preservation of language function under general anesthesia in glioma surgery in patients in whom awake surgery is not feasible.
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Affiliation(s)
- Kyung Min Kim
- 1Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul
| | - Sung-Min Kim
- 2Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul
| | - Ho Kang
- 1Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul
| | - So Young Ji
- 3Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam
| | - Yun-Sik Dho
- 4Department of Neurosurgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju
| | - Young-Doo Choi
- 1Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul
| | - Gil Ho Kwak
- 1Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul
| | - Bo Eun Kim
- 1Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul
| | - Hyongmin Oh
- 5Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul
| | - Hee-Pyoung Park
- 5Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul
| | - Koung Mi Kang
- 6Department of Radiology, Seoul National University College of Medicine, Seoul; and
| | - Seung Hong Choi
- 6Department of Radiology, Seoul National University College of Medicine, Seoul; and
| | - Young Nam Kwon
- 2Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul
| | - Soon-Tae Lee
- 2Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul
| | - Han Gil Seo
- 7Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Chul-Kee Park
- 1Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul
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12
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Kim JE, Min YG, Shin JY, Kwon YN, Bae JS, Sung JJ, Hong YH. Guillain–Barré Syndrome and Variants Following COVID-19 Vaccination: Report of 13 Cases. Front Neurol 2022; 12:820723. [PMID: 35153993 PMCID: PMC8833101 DOI: 10.3389/fneur.2021.820723] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [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] [Received: 11/23/2021] [Accepted: 12/29/2021] [Indexed: 12/24/2022] Open
Abstract
Background Amidst growing concern about an increased risk of Guillain–Barré syndrome (GBS) following COVID-19 vaccination, clinical and electrodiagnostic features have not been fully characterized. Methods We retrospectively reviewed medical records of the patients diagnosed with GBS and its variants following COVID-19 vaccination at four referral hospitals during the period of the mass vaccination program in South Korea (February to October 2021). Results We identified 13 patients with GBS and variants post COVID-19 vaccination: AstraZeneca vaccine (Vaxzevria) in 8, and Pfizer-BioNTech vaccine (Comirnaty) in 5. The mean time interval from vaccination to symptom onset was 15.6 days (range 4–30 days). Electrodiagnostic classification was demyelinating in 7, axonal in 4 and normal in 2 cases. Clinical manifestations were diverse with varying severity: classical GBS in 8 cases, paraparetic variant in 3, Miller-Fisher syndrome in 1 and acute cervicobrachial weakness in 1. Four patients developed respiratory failure, and 2 of them showed treatment-related fluctuations. Conclusion Our observations suggest that COVID-19 vaccines may be associated with GBS of distinctive clinical features characterized by severe quadriplegia, disproportionately frequent bilateral facial palsy or atypical incomplete variants. Continuous surveillance and further studies using robust study designs are warranted to fully assess the significance of the association.
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Affiliation(s)
- Jee-Eun Kim
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, South Korea
| | - Young Gi Min
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea
- Department of Translational Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Je-Young Shin
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea
| | - Young Nam Kwon
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea
| | - Jong Seok Bae
- Department of Neurology, Kangdong Hanlym University Hospital, Seoul, South Korea
| | - Jung-Joon Sung
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, South Korea
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea
| | - Yoon-Ho Hong
- Department of Neurology, Seoul National University College of Medicine, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul, South Korea
- *Correspondence: Yoon-Ho Hong
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13
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Huh SY, Kim SH, Kim KH, Kwon YN, Kim SM, Kim SW, Shin HY, Chung YH, Min JH, So J, Lim YM, Kim KK, Kim NH, Nam TS, Kang SY, Oh J, Oh SI, Sohn E, Kim HJ. Safety and Temporal Pattern of the Lymphocyte Count During Fingolimod Therapy in Patients With Multiple Sclerosis: Real-World Korean Experience. J Clin Neurol 2022; 18:663-670. [DOI: 10.3988/jcn.2022.18.6.663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/17/2022] [Accepted: 03/17/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- So-Young Huh
- Department of Neurology, College of Medicine, Kosin University, Busan, Korea
| | - Su-Hyun Kim
- Department of Neurology, Research Institute and Hospital of National Cancer Center, Goyang, Korea
| | - Ki Hoon Kim
- Department of Neurology, Research Institute and Hospital of National Cancer Center, Goyang, Korea
| | - Young Nam Kwon
- Department of Neurology, Seoul National University Hospital, Seoul, Korea
| | - Sung-Min Kim
- Department of Neurology, Seoul National University Hospital, Seoul, Korea
| | - Seung Woo Kim
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Ha Young Shin
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Yeon Hak Chung
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ju-Hong Min
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jungmin So
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young-Min Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kwang-Kuk Kim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Nam-Hee Kim
- Department of Neurology, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Tai-Seung Nam
- Department of Neurology, Chonnam National University Medical School and Hospital, Gwangju, Korea
| | - Sa-Yoon Kang
- Department of Neurology, Jeju National University School of Medicine, Jeju, Korea
| | - Jeeyoung Oh
- Department of Neurology, Konkuk University Medical Center, Seoul, Korea
| | - Seong-il Oh
- Department of Neurology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Eunhee Sohn
- Department of Neurology, Chungnam National University Hospital, Daejeon, Korea
| | - Ho Jin Kim
- Department of Neurology, Research Institute and Hospital of National Cancer Center, Goyang, Korea
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14
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Kwon YN, Kim YJ. Gut-Brain-Microbiota Axis and Hypertension: A Literature Review. Curr Pharm Des 2021; 27:3939-3946. [PMID: 34727853 DOI: 10.2174/1381612827666210706161733] [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: 12/30/2020] [Accepted: 06/01/2021] [Indexed: 11/22/2022]
Abstract
The gut and brain are linked via various bidirectional pathways, and they communicate withand affect each other. The interaction between the gut-brain axis and the gut microbiota has attracted much attention in the development of hypertension. In this review, we have discussed the gut-brain-microbiota axis and its association with gut dysbiosis in terms of regulation of blood pressure using the autonomic nervous system, immune system, metabolites, hormones, and neurotransmitters. In addition, the treatments using microbiota that have been tried, to date, are briefly summarized. By understanding the mechanism by which gut-brainmicrobiota regulates blood pressure, the novel targets for hypertension treatment or a new therapeutic approach using the gut-brain-microbiota could be investigated.
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Affiliation(s)
- Young Nam Kwon
- Department of Neurology, Eunpyeong St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Yong-Jae Kim
- Department of Neurology, Eunpyeong St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
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15
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Kwon YN, Kim B, Kim JS, Mo H, Choi K, Oh SI, Kim JE, Nam TS, Sohn EH, Heo SH, Kim SB, Park KC, Yoon SS, Oh J, Baek SH, Kim BJ, Park KS, Sung JJ, Jung JH, Kim SJ, Park SH, Waters P, Kim SM. Myelin Oligodendrocyte Glycoprotein-Immunoglobulin G in the CSF: Clinical Implication of Testing and Association With Disability. Neurol Neuroimmunol Neuroinflamm 2021; 9:9/1/e1095. [PMID: 34711644 PMCID: PMC8554713 DOI: 10.1212/nxi.0000000000001095] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 09/08/2021] [Indexed: 11/29/2022]
Abstract
Background and Objective To investigate the clinical relevance of CSF myelin oligodendrocyte glycoprotein-immunoglobulin G (MOG-IgG) testing in a large multicenter cohort. Methods In this multicenter cohort study, paired serum-CSF samples from 474 patients with suspected inflammatory demyelinating disease (IDD) from 11 referral hospitals were included. After serum screening, patients were grouped into seropositive myelin oligodendrocyte glycoprotein antibody associated disease (MOGAD, 31), aquaporin-4-IgG-positive neuromyelitis optica spectrum disorder (AQP4-IgG + NMOSD, 60), other IDDs (217), multiple sclerosis (MS, 45), and non-IDDs (121). We then screened CSF for MOG-IgG and compared the clinical and serologic characteristics of patients uniquely positive for MOG-IgG in the CSF to seropositive patients with MOGAD. Results Nineteen patients with seropositive MOGAD (61.3%), 9 with other IDDs (CSF MOG + IDD, 4.1%), 4 with MS (8.9%), but none with AQP4-IgG + NMOSD nor with non-IDDs tested positive in the CSF for MOG-IgG. The clinical, pathologic, and prognostic features of patients uniquely positive for CSF MOG-IgG, with a non-MS phenotype, were comparable with those of seropositive MOGAD. Intrathecal MOG-IgG synthesis, observed from the onset of disease, was shown in 12 patients: 4 of 28 who were seropositive and 8 who were uniquely CSF positive, all of whom had involvement of either brain or spinal cord. Both CSF MOG-IgG titer and corrected CSF/serum MOG-IgG index, but not serum MOG-IgG titer, were associated with disability, CSF pleocytosis, and level of CSF proteins. Discussion CSF MOG-IgG is found in IDD other than MS and also in MS. In IDD other than MS, the CSF MOG-IgG positivity can support the diagnosis of MOGAD. The synthesis of MOG-IgG in the CNS of patients with MOGAD can be detected from the onset of the disease and is associated with the severity of the disease. Classification of Evidence This study provides Class II evidence that the presence of CSF MOG-IgG can improve the diagnosis of MOGAD in the absence of an MS phenotype, and intrathecal synthesis of MOG-IgG was associated with increased disability.
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Affiliation(s)
- Young Nam Kwon
- From the Department of Neurology, Seoul National University Hospital (Y.N.K., J.J.S., S.M.K); Department of Neurology, Neuroscience Research Institute, Seoul National University College of Medicine (B.K., J.J.S., S.M.K); Department of Neurology (J.S.K.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (H.M.), Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong; Department of Neurology (K.C.), Konkuk University School of Medicine, Konkuk University Medical Center; Department of Neurology (S-.i.O.), Busan Paik Hospital, Inje University College of Medicine, Busan; Department of Neurology (J.-E.K.), Seoul Hospital, Ewha Womans University College of Medicine; Department of Neurology (T.-S.N.), Chonnam National University Medical School, Gwangju; Department of Neurology (E.H.S.), Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon; Department of Neurology (S.H.H., K-C.P., S.S.Y.), Kyung Hee University Hospital, Kyung Hee University School of Medicine; Department of Neurology (S.B.K.), Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine; Department of Neurology (S-H.B., B.-J.K.), Korea University College of Medicine, Korea University Anam Hospital; Department of Ophthalmology (J.H.J., S.-J.K.), Seoul National University College of Medicine; Department of Pathology (S.-H.P.), Seoul National University Hospital, Seoul National University, College of Medicine, Seoul; Autoimmune Neurology Group (P.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Boram Kim
- From the Department of Neurology, Seoul National University Hospital (Y.N.K., J.J.S., S.M.K); Department of Neurology, Neuroscience Research Institute, Seoul National University College of Medicine (B.K., J.J.S., S.M.K); Department of Neurology (J.S.K.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (H.M.), Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong; Department of Neurology (K.C.), Konkuk University School of Medicine, Konkuk University Medical Center; Department of Neurology (S-.i.O.), Busan Paik Hospital, Inje University College of Medicine, Busan; Department of Neurology (J.-E.K.), Seoul Hospital, Ewha Womans University College of Medicine; Department of Neurology (T.-S.N.), Chonnam National University Medical School, Gwangju; Department of Neurology (E.H.S.), Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon; Department of Neurology (S.H.H., K-C.P., S.S.Y.), Kyung Hee University Hospital, Kyung Hee University School of Medicine; Department of Neurology (S.B.K.), Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine; Department of Neurology (S-H.B., B.-J.K.), Korea University College of Medicine, Korea University Anam Hospital; Department of Ophthalmology (J.H.J., S.-J.K.), Seoul National University College of Medicine; Department of Pathology (S.-H.P.), Seoul National University Hospital, Seoul National University, College of Medicine, Seoul; Autoimmune Neurology Group (P.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK.
| | - Jun-Soon Kim
- From the Department of Neurology, Seoul National University Hospital (Y.N.K., J.J.S., S.M.K); Department of Neurology, Neuroscience Research Institute, Seoul National University College of Medicine (B.K., J.J.S., S.M.K); Department of Neurology (J.S.K.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (H.M.), Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong; Department of Neurology (K.C.), Konkuk University School of Medicine, Konkuk University Medical Center; Department of Neurology (S-.i.O.), Busan Paik Hospital, Inje University College of Medicine, Busan; Department of Neurology (J.-E.K.), Seoul Hospital, Ewha Womans University College of Medicine; Department of Neurology (T.-S.N.), Chonnam National University Medical School, Gwangju; Department of Neurology (E.H.S.), Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon; Department of Neurology (S.H.H., K-C.P., S.S.Y.), Kyung Hee University Hospital, Kyung Hee University School of Medicine; Department of Neurology (S.B.K.), Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine; Department of Neurology (S-H.B., B.-J.K.), Korea University College of Medicine, Korea University Anam Hospital; Department of Ophthalmology (J.H.J., S.-J.K.), Seoul National University College of Medicine; Department of Pathology (S.-H.P.), Seoul National University Hospital, Seoul National University, College of Medicine, Seoul; Autoimmune Neurology Group (P.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK.
| | - Heejung Mo
- From the Department of Neurology, Seoul National University Hospital (Y.N.K., J.J.S., S.M.K); Department of Neurology, Neuroscience Research Institute, Seoul National University College of Medicine (B.K., J.J.S., S.M.K); Department of Neurology (J.S.K.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (H.M.), Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong; Department of Neurology (K.C.), Konkuk University School of Medicine, Konkuk University Medical Center; Department of Neurology (S-.i.O.), Busan Paik Hospital, Inje University College of Medicine, Busan; Department of Neurology (J.-E.K.), Seoul Hospital, Ewha Womans University College of Medicine; Department of Neurology (T.-S.N.), Chonnam National University Medical School, Gwangju; Department of Neurology (E.H.S.), Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon; Department of Neurology (S.H.H., K-C.P., S.S.Y.), Kyung Hee University Hospital, Kyung Hee University School of Medicine; Department of Neurology (S.B.K.), Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine; Department of Neurology (S-H.B., B.-J.K.), Korea University College of Medicine, Korea University Anam Hospital; Department of Ophthalmology (J.H.J., S.-J.K.), Seoul National University College of Medicine; Department of Pathology (S.-H.P.), Seoul National University Hospital, Seoul National University, College of Medicine, Seoul; Autoimmune Neurology Group (P.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Kyomin Choi
- From the Department of Neurology, Seoul National University Hospital (Y.N.K., J.J.S., S.M.K); Department of Neurology, Neuroscience Research Institute, Seoul National University College of Medicine (B.K., J.J.S., S.M.K); Department of Neurology (J.S.K.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (H.M.), Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong; Department of Neurology (K.C.), Konkuk University School of Medicine, Konkuk University Medical Center; Department of Neurology (S-.i.O.), Busan Paik Hospital, Inje University College of Medicine, Busan; Department of Neurology (J.-E.K.), Seoul Hospital, Ewha Womans University College of Medicine; Department of Neurology (T.-S.N.), Chonnam National University Medical School, Gwangju; Department of Neurology (E.H.S.), Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon; Department of Neurology (S.H.H., K-C.P., S.S.Y.), Kyung Hee University Hospital, Kyung Hee University School of Medicine; Department of Neurology (S.B.K.), Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine; Department of Neurology (S-H.B., B.-J.K.), Korea University College of Medicine, Korea University Anam Hospital; Department of Ophthalmology (J.H.J., S.-J.K.), Seoul National University College of Medicine; Department of Pathology (S.-H.P.), Seoul National University Hospital, Seoul National University, College of Medicine, Seoul; Autoimmune Neurology Group (P.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Seong-Il Oh
- From the Department of Neurology, Seoul National University Hospital (Y.N.K., J.J.S., S.M.K); Department of Neurology, Neuroscience Research Institute, Seoul National University College of Medicine (B.K., J.J.S., S.M.K); Department of Neurology (J.S.K.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (H.M.), Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong; Department of Neurology (K.C.), Konkuk University School of Medicine, Konkuk University Medical Center; Department of Neurology (S-.i.O.), Busan Paik Hospital, Inje University College of Medicine, Busan; Department of Neurology (J.-E.K.), Seoul Hospital, Ewha Womans University College of Medicine; Department of Neurology (T.-S.N.), Chonnam National University Medical School, Gwangju; Department of Neurology (E.H.S.), Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon; Department of Neurology (S.H.H., K-C.P., S.S.Y.), Kyung Hee University Hospital, Kyung Hee University School of Medicine; Department of Neurology (S.B.K.), Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine; Department of Neurology (S-H.B., B.-J.K.), Korea University College of Medicine, Korea University Anam Hospital; Department of Ophthalmology (J.H.J., S.-J.K.), Seoul National University College of Medicine; Department of Pathology (S.-H.P.), Seoul National University Hospital, Seoul National University, College of Medicine, Seoul; Autoimmune Neurology Group (P.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Jee-Eun Kim
- From the Department of Neurology, Seoul National University Hospital (Y.N.K., J.J.S., S.M.K); Department of Neurology, Neuroscience Research Institute, Seoul National University College of Medicine (B.K., J.J.S., S.M.K); Department of Neurology (J.S.K.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (H.M.), Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong; Department of Neurology (K.C.), Konkuk University School of Medicine, Konkuk University Medical Center; Department of Neurology (S-.i.O.), Busan Paik Hospital, Inje University College of Medicine, Busan; Department of Neurology (J.-E.K.), Seoul Hospital, Ewha Womans University College of Medicine; Department of Neurology (T.-S.N.), Chonnam National University Medical School, Gwangju; Department of Neurology (E.H.S.), Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon; Department of Neurology (S.H.H., K-C.P., S.S.Y.), Kyung Hee University Hospital, Kyung Hee University School of Medicine; Department of Neurology (S.B.K.), Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine; Department of Neurology (S-H.B., B.-J.K.), Korea University College of Medicine, Korea University Anam Hospital; Department of Ophthalmology (J.H.J., S.-J.K.), Seoul National University College of Medicine; Department of Pathology (S.-H.P.), Seoul National University Hospital, Seoul National University, College of Medicine, Seoul; Autoimmune Neurology Group (P.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK.
| | - Tai-Seung Nam
- From the Department of Neurology, Seoul National University Hospital (Y.N.K., J.J.S., S.M.K); Department of Neurology, Neuroscience Research Institute, Seoul National University College of Medicine (B.K., J.J.S., S.M.K); Department of Neurology (J.S.K.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (H.M.), Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong; Department of Neurology (K.C.), Konkuk University School of Medicine, Konkuk University Medical Center; Department of Neurology (S-.i.O.), Busan Paik Hospital, Inje University College of Medicine, Busan; Department of Neurology (J.-E.K.), Seoul Hospital, Ewha Womans University College of Medicine; Department of Neurology (T.-S.N.), Chonnam National University Medical School, Gwangju; Department of Neurology (E.H.S.), Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon; Department of Neurology (S.H.H., K-C.P., S.S.Y.), Kyung Hee University Hospital, Kyung Hee University School of Medicine; Department of Neurology (S.B.K.), Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine; Department of Neurology (S-H.B., B.-J.K.), Korea University College of Medicine, Korea University Anam Hospital; Department of Ophthalmology (J.H.J., S.-J.K.), Seoul National University College of Medicine; Department of Pathology (S.-H.P.), Seoul National University Hospital, Seoul National University, College of Medicine, Seoul; Autoimmune Neurology Group (P.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Eun Hee Sohn
- From the Department of Neurology, Seoul National University Hospital (Y.N.K., J.J.S., S.M.K); Department of Neurology, Neuroscience Research Institute, Seoul National University College of Medicine (B.K., J.J.S., S.M.K); Department of Neurology (J.S.K.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (H.M.), Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong; Department of Neurology (K.C.), Konkuk University School of Medicine, Konkuk University Medical Center; Department of Neurology (S-.i.O.), Busan Paik Hospital, Inje University College of Medicine, Busan; Department of Neurology (J.-E.K.), Seoul Hospital, Ewha Womans University College of Medicine; Department of Neurology (T.-S.N.), Chonnam National University Medical School, Gwangju; Department of Neurology (E.H.S.), Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon; Department of Neurology (S.H.H., K-C.P., S.S.Y.), Kyung Hee University Hospital, Kyung Hee University School of Medicine; Department of Neurology (S.B.K.), Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine; Department of Neurology (S-H.B., B.-J.K.), Korea University College of Medicine, Korea University Anam Hospital; Department of Ophthalmology (J.H.J., S.-J.K.), Seoul National University College of Medicine; Department of Pathology (S.-H.P.), Seoul National University Hospital, Seoul National University, College of Medicine, Seoul; Autoimmune Neurology Group (P.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Sung Hyuk Heo
- From the Department of Neurology, Seoul National University Hospital (Y.N.K., J.J.S., S.M.K); Department of Neurology, Neuroscience Research Institute, Seoul National University College of Medicine (B.K., J.J.S., S.M.K); Department of Neurology (J.S.K.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (H.M.), Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong; Department of Neurology (K.C.), Konkuk University School of Medicine, Konkuk University Medical Center; Department of Neurology (S-.i.O.), Busan Paik Hospital, Inje University College of Medicine, Busan; Department of Neurology (J.-E.K.), Seoul Hospital, Ewha Womans University College of Medicine; Department of Neurology (T.-S.N.), Chonnam National University Medical School, Gwangju; Department of Neurology (E.H.S.), Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon; Department of Neurology (S.H.H., K-C.P., S.S.Y.), Kyung Hee University Hospital, Kyung Hee University School of Medicine; Department of Neurology (S.B.K.), Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine; Department of Neurology (S-H.B., B.-J.K.), Korea University College of Medicine, Korea University Anam Hospital; Department of Ophthalmology (J.H.J., S.-J.K.), Seoul National University College of Medicine; Department of Pathology (S.-H.P.), Seoul National University Hospital, Seoul National University, College of Medicine, Seoul; Autoimmune Neurology Group (P.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Sang Beom Kim
- From the Department of Neurology, Seoul National University Hospital (Y.N.K., J.J.S., S.M.K); Department of Neurology, Neuroscience Research Institute, Seoul National University College of Medicine (B.K., J.J.S., S.M.K); Department of Neurology (J.S.K.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (H.M.), Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong; Department of Neurology (K.C.), Konkuk University School of Medicine, Konkuk University Medical Center; Department of Neurology (S-.i.O.), Busan Paik Hospital, Inje University College of Medicine, Busan; Department of Neurology (J.-E.K.), Seoul Hospital, Ewha Womans University College of Medicine; Department of Neurology (T.-S.N.), Chonnam National University Medical School, Gwangju; Department of Neurology (E.H.S.), Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon; Department of Neurology (S.H.H., K-C.P., S.S.Y.), Kyung Hee University Hospital, Kyung Hee University School of Medicine; Department of Neurology (S.B.K.), Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine; Department of Neurology (S-H.B., B.-J.K.), Korea University College of Medicine, Korea University Anam Hospital; Department of Ophthalmology (J.H.J., S.-J.K.), Seoul National University College of Medicine; Department of Pathology (S.-H.P.), Seoul National University Hospital, Seoul National University, College of Medicine, Seoul; Autoimmune Neurology Group (P.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK.
| | - Key-Chung Park
- From the Department of Neurology, Seoul National University Hospital (Y.N.K., J.J.S., S.M.K); Department of Neurology, Neuroscience Research Institute, Seoul National University College of Medicine (B.K., J.J.S., S.M.K); Department of Neurology (J.S.K.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (H.M.), Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong; Department of Neurology (K.C.), Konkuk University School of Medicine, Konkuk University Medical Center; Department of Neurology (S-.i.O.), Busan Paik Hospital, Inje University College of Medicine, Busan; Department of Neurology (J.-E.K.), Seoul Hospital, Ewha Womans University College of Medicine; Department of Neurology (T.-S.N.), Chonnam National University Medical School, Gwangju; Department of Neurology (E.H.S.), Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon; Department of Neurology (S.H.H., K-C.P., S.S.Y.), Kyung Hee University Hospital, Kyung Hee University School of Medicine; Department of Neurology (S.B.K.), Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine; Department of Neurology (S-H.B., B.-J.K.), Korea University College of Medicine, Korea University Anam Hospital; Department of Ophthalmology (J.H.J., S.-J.K.), Seoul National University College of Medicine; Department of Pathology (S.-H.P.), Seoul National University Hospital, Seoul National University, College of Medicine, Seoul; Autoimmune Neurology Group (P.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Sung Sang Yoon
- From the Department of Neurology, Seoul National University Hospital (Y.N.K., J.J.S., S.M.K); Department of Neurology, Neuroscience Research Institute, Seoul National University College of Medicine (B.K., J.J.S., S.M.K); Department of Neurology (J.S.K.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (H.M.), Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong; Department of Neurology (K.C.), Konkuk University School of Medicine, Konkuk University Medical Center; Department of Neurology (S-.i.O.), Busan Paik Hospital, Inje University College of Medicine, Busan; Department of Neurology (J.-E.K.), Seoul Hospital, Ewha Womans University College of Medicine; Department of Neurology (T.-S.N.), Chonnam National University Medical School, Gwangju; Department of Neurology (E.H.S.), Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon; Department of Neurology (S.H.H., K-C.P., S.S.Y.), Kyung Hee University Hospital, Kyung Hee University School of Medicine; Department of Neurology (S.B.K.), Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine; Department of Neurology (S-H.B., B.-J.K.), Korea University College of Medicine, Korea University Anam Hospital; Department of Ophthalmology (J.H.J., S.-J.K.), Seoul National University College of Medicine; Department of Pathology (S.-H.P.), Seoul National University Hospital, Seoul National University, College of Medicine, Seoul; Autoimmune Neurology Group (P.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Jeeyoung Oh
- From the Department of Neurology, Seoul National University Hospital (Y.N.K., J.J.S., S.M.K); Department of Neurology, Neuroscience Research Institute, Seoul National University College of Medicine (B.K., J.J.S., S.M.K); Department of Neurology (J.S.K.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (H.M.), Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong; Department of Neurology (K.C.), Konkuk University School of Medicine, Konkuk University Medical Center; Department of Neurology (S-.i.O.), Busan Paik Hospital, Inje University College of Medicine, Busan; Department of Neurology (J.-E.K.), Seoul Hospital, Ewha Womans University College of Medicine; Department of Neurology (T.-S.N.), Chonnam National University Medical School, Gwangju; Department of Neurology (E.H.S.), Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon; Department of Neurology (S.H.H., K-C.P., S.S.Y.), Kyung Hee University Hospital, Kyung Hee University School of Medicine; Department of Neurology (S.B.K.), Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine; Department of Neurology (S-H.B., B.-J.K.), Korea University College of Medicine, Korea University Anam Hospital; Department of Ophthalmology (J.H.J., S.-J.K.), Seoul National University College of Medicine; Department of Pathology (S.-H.P.), Seoul National University Hospital, Seoul National University, College of Medicine, Seoul; Autoimmune Neurology Group (P.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Seol-Hee Baek
- From the Department of Neurology, Seoul National University Hospital (Y.N.K., J.J.S., S.M.K); Department of Neurology, Neuroscience Research Institute, Seoul National University College of Medicine (B.K., J.J.S., S.M.K); Department of Neurology (J.S.K.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (H.M.), Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong; Department of Neurology (K.C.), Konkuk University School of Medicine, Konkuk University Medical Center; Department of Neurology (S-.i.O.), Busan Paik Hospital, Inje University College of Medicine, Busan; Department of Neurology (J.-E.K.), Seoul Hospital, Ewha Womans University College of Medicine; Department of Neurology (T.-S.N.), Chonnam National University Medical School, Gwangju; Department of Neurology (E.H.S.), Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon; Department of Neurology (S.H.H., K-C.P., S.S.Y.), Kyung Hee University Hospital, Kyung Hee University School of Medicine; Department of Neurology (S.B.K.), Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine; Department of Neurology (S-H.B., B.-J.K.), Korea University College of Medicine, Korea University Anam Hospital; Department of Ophthalmology (J.H.J., S.-J.K.), Seoul National University College of Medicine; Department of Pathology (S.-H.P.), Seoul National University Hospital, Seoul National University, College of Medicine, Seoul; Autoimmune Neurology Group (P.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Byung-Jo Kim
- From the Department of Neurology, Seoul National University Hospital (Y.N.K., J.J.S., S.M.K); Department of Neurology, Neuroscience Research Institute, Seoul National University College of Medicine (B.K., J.J.S., S.M.K); Department of Neurology (J.S.K.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (H.M.), Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong; Department of Neurology (K.C.), Konkuk University School of Medicine, Konkuk University Medical Center; Department of Neurology (S-.i.O.), Busan Paik Hospital, Inje University College of Medicine, Busan; Department of Neurology (J.-E.K.), Seoul Hospital, Ewha Womans University College of Medicine; Department of Neurology (T.-S.N.), Chonnam National University Medical School, Gwangju; Department of Neurology (E.H.S.), Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon; Department of Neurology (S.H.H., K-C.P., S.S.Y.), Kyung Hee University Hospital, Kyung Hee University School of Medicine; Department of Neurology (S.B.K.), Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine; Department of Neurology (S-H.B., B.-J.K.), Korea University College of Medicine, Korea University Anam Hospital; Department of Ophthalmology (J.H.J., S.-J.K.), Seoul National University College of Medicine; Department of Pathology (S.-H.P.), Seoul National University Hospital, Seoul National University, College of Medicine, Seoul; Autoimmune Neurology Group (P.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK.
| | - Kyung Seok Park
- From the Department of Neurology, Seoul National University Hospital (Y.N.K., J.J.S., S.M.K); Department of Neurology, Neuroscience Research Institute, Seoul National University College of Medicine (B.K., J.J.S., S.M.K); Department of Neurology (J.S.K.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (H.M.), Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong; Department of Neurology (K.C.), Konkuk University School of Medicine, Konkuk University Medical Center; Department of Neurology (S-.i.O.), Busan Paik Hospital, Inje University College of Medicine, Busan; Department of Neurology (J.-E.K.), Seoul Hospital, Ewha Womans University College of Medicine; Department of Neurology (T.-S.N.), Chonnam National University Medical School, Gwangju; Department of Neurology (E.H.S.), Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon; Department of Neurology (S.H.H., K-C.P., S.S.Y.), Kyung Hee University Hospital, Kyung Hee University School of Medicine; Department of Neurology (S.B.K.), Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine; Department of Neurology (S-H.B., B.-J.K.), Korea University College of Medicine, Korea University Anam Hospital; Department of Ophthalmology (J.H.J., S.-J.K.), Seoul National University College of Medicine; Department of Pathology (S.-H.P.), Seoul National University Hospital, Seoul National University, College of Medicine, Seoul; Autoimmune Neurology Group (P.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Jung-Joon Sung
- From the Department of Neurology, Seoul National University Hospital (Y.N.K., J.J.S., S.M.K); Department of Neurology, Neuroscience Research Institute, Seoul National University College of Medicine (B.K., J.J.S., S.M.K); Department of Neurology (J.S.K.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (H.M.), Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong; Department of Neurology (K.C.), Konkuk University School of Medicine, Konkuk University Medical Center; Department of Neurology (S-.i.O.), Busan Paik Hospital, Inje University College of Medicine, Busan; Department of Neurology (J.-E.K.), Seoul Hospital, Ewha Womans University College of Medicine; Department of Neurology (T.-S.N.), Chonnam National University Medical School, Gwangju; Department of Neurology (E.H.S.), Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon; Department of Neurology (S.H.H., K-C.P., S.S.Y.), Kyung Hee University Hospital, Kyung Hee University School of Medicine; Department of Neurology (S.B.K.), Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine; Department of Neurology (S-H.B., B.-J.K.), Korea University College of Medicine, Korea University Anam Hospital; Department of Ophthalmology (J.H.J., S.-J.K.), Seoul National University College of Medicine; Department of Pathology (S.-H.P.), Seoul National University Hospital, Seoul National University, College of Medicine, Seoul; Autoimmune Neurology Group (P.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Jae Ho Jung
- From the Department of Neurology, Seoul National University Hospital (Y.N.K., J.J.S., S.M.K); Department of Neurology, Neuroscience Research Institute, Seoul National University College of Medicine (B.K., J.J.S., S.M.K); Department of Neurology (J.S.K.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (H.M.), Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong; Department of Neurology (K.C.), Konkuk University School of Medicine, Konkuk University Medical Center; Department of Neurology (S-.i.O.), Busan Paik Hospital, Inje University College of Medicine, Busan; Department of Neurology (J.-E.K.), Seoul Hospital, Ewha Womans University College of Medicine; Department of Neurology (T.-S.N.), Chonnam National University Medical School, Gwangju; Department of Neurology (E.H.S.), Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon; Department of Neurology (S.H.H., K-C.P., S.S.Y.), Kyung Hee University Hospital, Kyung Hee University School of Medicine; Department of Neurology (S.B.K.), Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine; Department of Neurology (S-H.B., B.-J.K.), Korea University College of Medicine, Korea University Anam Hospital; Department of Ophthalmology (J.H.J., S.-J.K.), Seoul National University College of Medicine; Department of Pathology (S.-H.P.), Seoul National University Hospital, Seoul National University, College of Medicine, Seoul; Autoimmune Neurology Group (P.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Seong-Joon Kim
- From the Department of Neurology, Seoul National University Hospital (Y.N.K., J.J.S., S.M.K); Department of Neurology, Neuroscience Research Institute, Seoul National University College of Medicine (B.K., J.J.S., S.M.K); Department of Neurology (J.S.K.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (H.M.), Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong; Department of Neurology (K.C.), Konkuk University School of Medicine, Konkuk University Medical Center; Department of Neurology (S-.i.O.), Busan Paik Hospital, Inje University College of Medicine, Busan; Department of Neurology (J.-E.K.), Seoul Hospital, Ewha Womans University College of Medicine; Department of Neurology (T.-S.N.), Chonnam National University Medical School, Gwangju; Department of Neurology (E.H.S.), Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon; Department of Neurology (S.H.H., K-C.P., S.S.Y.), Kyung Hee University Hospital, Kyung Hee University School of Medicine; Department of Neurology (S.B.K.), Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine; Department of Neurology (S-H.B., B.-J.K.), Korea University College of Medicine, Korea University Anam Hospital; Department of Ophthalmology (J.H.J., S.-J.K.), Seoul National University College of Medicine; Department of Pathology (S.-H.P.), Seoul National University Hospital, Seoul National University, College of Medicine, Seoul; Autoimmune Neurology Group (P.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK.
| | - Sung-Hye Park
- From the Department of Neurology, Seoul National University Hospital (Y.N.K., J.J.S., S.M.K); Department of Neurology, Neuroscience Research Institute, Seoul National University College of Medicine (B.K., J.J.S., S.M.K); Department of Neurology (J.S.K.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (H.M.), Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong; Department of Neurology (K.C.), Konkuk University School of Medicine, Konkuk University Medical Center; Department of Neurology (S-.i.O.), Busan Paik Hospital, Inje University College of Medicine, Busan; Department of Neurology (J.-E.K.), Seoul Hospital, Ewha Womans University College of Medicine; Department of Neurology (T.-S.N.), Chonnam National University Medical School, Gwangju; Department of Neurology (E.H.S.), Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon; Department of Neurology (S.H.H., K-C.P., S.S.Y.), Kyung Hee University Hospital, Kyung Hee University School of Medicine; Department of Neurology (S.B.K.), Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine; Department of Neurology (S-H.B., B.-J.K.), Korea University College of Medicine, Korea University Anam Hospital; Department of Ophthalmology (J.H.J., S.-J.K.), Seoul National University College of Medicine; Department of Pathology (S.-H.P.), Seoul National University Hospital, Seoul National University, College of Medicine, Seoul; Autoimmune Neurology Group (P.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Patrick Waters
- From the Department of Neurology, Seoul National University Hospital (Y.N.K., J.J.S., S.M.K); Department of Neurology, Neuroscience Research Institute, Seoul National University College of Medicine (B.K., J.J.S., S.M.K); Department of Neurology (J.S.K.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (H.M.), Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong; Department of Neurology (K.C.), Konkuk University School of Medicine, Konkuk University Medical Center; Department of Neurology (S-.i.O.), Busan Paik Hospital, Inje University College of Medicine, Busan; Department of Neurology (J.-E.K.), Seoul Hospital, Ewha Womans University College of Medicine; Department of Neurology (T.-S.N.), Chonnam National University Medical School, Gwangju; Department of Neurology (E.H.S.), Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon; Department of Neurology (S.H.H., K-C.P., S.S.Y.), Kyung Hee University Hospital, Kyung Hee University School of Medicine; Department of Neurology (S.B.K.), Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine; Department of Neurology (S-H.B., B.-J.K.), Korea University College of Medicine, Korea University Anam Hospital; Department of Ophthalmology (J.H.J., S.-J.K.), Seoul National University College of Medicine; Department of Pathology (S.-H.P.), Seoul National University Hospital, Seoul National University, College of Medicine, Seoul; Autoimmune Neurology Group (P.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Sung-Min Kim
- From the Department of Neurology, Seoul National University Hospital (Y.N.K., J.J.S., S.M.K); Department of Neurology, Neuroscience Research Institute, Seoul National University College of Medicine (B.K., J.J.S., S.M.K); Department of Neurology (J.S.K.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (H.M.), Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong; Department of Neurology (K.C.), Konkuk University School of Medicine, Konkuk University Medical Center; Department of Neurology (S-.i.O.), Busan Paik Hospital, Inje University College of Medicine, Busan; Department of Neurology (J.-E.K.), Seoul Hospital, Ewha Womans University College of Medicine; Department of Neurology (T.-S.N.), Chonnam National University Medical School, Gwangju; Department of Neurology (E.H.S.), Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon; Department of Neurology (S.H.H., K-C.P., S.S.Y.), Kyung Hee University Hospital, Kyung Hee University School of Medicine; Department of Neurology (S.B.K.), Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine; Department of Neurology (S-H.B., B.-J.K.), Korea University College of Medicine, Korea University Anam Hospital; Department of Ophthalmology (J.H.J., S.-J.K.), Seoul National University College of Medicine; Department of Pathology (S.-H.P.), Seoul National University Hospital, Seoul National University, College of Medicine, Seoul; Autoimmune Neurology Group (P.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK.
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Kwon YN, Kim B, Ahn S, Seo J, Kim SB, Yoon SS, Sung JJ, Choi YS, Kim SM. Serum level of IL-1β in patients with inflammatory demyelinating disease: Marked upregulation in the early acute phase of MOG antibody associated disease (MOGAD). J Neuroimmunol 2020; 348:577361. [DOI: 10.1016/j.jneuroim.2020.577361] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 07/09/2020] [Accepted: 08/11/2020] [Indexed: 01/21/2023]
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Affiliation(s)
- Young Nam Kwon
- From the Department of Neurology (Y.N.K., J.-J.S., S.-M.K.) and Departments of Ophthalmology (J.H.J., S.-J.K.) and Neurology (J.-J.S., S.-M.K.), College of Medicine, Seoul National University, Seoul National University Hospital; and Department of Neurology (Y.N.K.), The Catholic University of Korea, Eunpyeong St. Mary's Hospital, Korea
| | - Jae Ho Jung
- From the Department of Neurology (Y.N.K., J.-J.S., S.-M.K.) and Departments of Ophthalmology (J.H.J., S.-J.K.) and Neurology (J.-J.S., S.-M.K.), College of Medicine, Seoul National University, Seoul National University Hospital; and Department of Neurology (Y.N.K.), The Catholic University of Korea, Eunpyeong St. Mary's Hospital, Korea
| | - Seong-Joon Kim
- From the Department of Neurology (Y.N.K., J.-J.S., S.-M.K.) and Departments of Ophthalmology (J.H.J., S.-J.K.) and Neurology (J.-J.S., S.-M.K.), College of Medicine, Seoul National University, Seoul National University Hospital; and Department of Neurology (Y.N.K.), The Catholic University of Korea, Eunpyeong St. Mary's Hospital, Korea.
| | - Jung-Joon Sung
- From the Department of Neurology (Y.N.K., J.-J.S., S.-M.K.) and Departments of Ophthalmology (J.H.J., S.-J.K.) and Neurology (J.-J.S., S.-M.K.), College of Medicine, Seoul National University, Seoul National University Hospital; and Department of Neurology (Y.N.K.), The Catholic University of Korea, Eunpyeong St. Mary's Hospital, Korea
| | - Sung-Min Kim
- From the Department of Neurology (Y.N.K., J.-J.S., S.-M.K.) and Departments of Ophthalmology (J.H.J., S.-J.K.) and Neurology (J.-J.S., S.-M.K.), College of Medicine, Seoul National University, Seoul National University Hospital; and Department of Neurology (Y.N.K.), The Catholic University of Korea, Eunpyeong St. Mary's Hospital, Korea.
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Lee JS, Soh Y, Kim HG, Lee KM, Kwon YN, Yoon SS, Park KC, Rhee HY. Interactive Effects of Apolipoprotein E ε4 and Triiodothyronine on Memory Performance in Patients With Subjective Cognitive Decline. Front Med (Lausanne) 2020; 7:298. [PMID: 32671080 PMCID: PMC7330104 DOI: 10.3389/fmed.2020.00298] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 05/26/2020] [Indexed: 01/16/2023] Open
Abstract
Background: The aim of the present study was to investigate the associations between thyroid hormones, cognitive performance, and apolipoprotein E (APOE) genotype in euthyroid patients with subjective cognitive decline (SCD). Methods: We recruited 197 euthyroid patients that fulfilled the criteria for SCD. All participants were classified into APOE ε4 carriers and non-carriers based on the presence of the APOE ε4 allele. Patients with SCD who had the APOE ε2/ε4 genotype were excluded from the study. We then performed correlation and regression analyses to evaluate the associations between cognitive performance and thyroid hormones in APOE ε4 carriers and non-carriers. Results: We found no significant differences in cognitive function between APOE ε4 carriers and non-carriers. However, higher levels of triiodothyronine (T3) were associated with better verbal memory performance (immediate and delayed recall tasks) in APOE ε4 carriers, whereas a negative association was found in APOE ε4 non-carriers. Furthermore, there was a significant interactive effect of APOE ε4 status and T3 levels on verbal memory performance (immediate and delayed recall tasks). Conclusions: These findings suggest that in patients with SCD, T3 might have a protective effect on memory in those who are APOE ε4 carriers. The differential susceptibility hypothesis would thus support a gene-by-hormone crossover interaction between APOE ε4 allele and T3 in this study. Early identification and intervention of high-risk individuals for cognitive decline is important to establish new strategies for preventing dementia.
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Affiliation(s)
- Jin San Lee
- Departments of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Yunsoo Soh
- Departments of Rehabilitation Medicine, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Hyug-Gi Kim
- Departments of Radiology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Kyung Mi Lee
- Departments of Radiology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Young Nam Kwon
- Department of Medicine, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Sung Sang Yoon
- Departments of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Key-Chung Park
- Departments of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Hak Young Rhee
- Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, South Korea
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Hyun JW, Kwon YN, Kim SM, Lee HL, Jeong WK, Lee HJ, Kim BJ, Kim SW, Shin HY, Shin HJ, Oh SY, Huh SY, Kim W, Park MS, Oh J, Jang H, Park NY, Lee MY, Kim SH, Kim HJ. Value of Area Postrema Syndrome in Differentiating Adults With AQP4 vs. MOG Antibodies. Front Neurol 2020; 11:396. [PMID: 32581992 PMCID: PMC7287121 DOI: 10.3389/fneur.2020.00396] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 04/17/2020] [Indexed: 12/30/2022] Open
Abstract
Objectives: To compare the frequency of area postrema syndrome (APS) in adults with anti-aquaporin-4 (AQP4) and anti-myelin oligodendrocyte glycoprotein (MOG) antibodies. Methods: APS is defined as acute or subacute, single or combined, episodic or constant nausea, vomiting, or hiccups, persisting for at least 48 h, which cannot be attributed to any other etiology. The presence of APS was investigated in 274 adults with AQP4 antibodies and 107 adults with MOG antibodies from 10 hospitals. Results: The study population comprised Korean adults (≥18 years). At the time of disease onset, 14.9% (41/274) adults with AQP4 antibodies had APS, while none of the participants with MOG antibodies developed APS (p < 0.001). During the course of the disease, 17.2% (47/274) adults with AQP4 antibodies had APS in contrast to 1.9% (2/107) adults with MOG antibodies with APS (p < 0.001). Conclusions: APS, one of the core clinical characteristics of individuals with AQP4 antibodies, is an extremely rare manifestation in Korean adults with MOG antibodies.
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Affiliation(s)
- Jae-Won Hyun
- Department of Neurology, National Cancer Center, Goyang, South Korea
| | - Young Nam Kwon
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea.,The Catholic University of Korea, Eunpyeong St. Mary's Hospital, Seoul, South Korea
| | - Sung-Min Kim
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea
| | - Hye Lim Lee
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Woo Kyo Jeong
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Neurology, Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Hye Jung Lee
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Neurology, Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Byoung Joon Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Neurology, Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Seung Woo Kim
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Ha Young Shin
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyun-June Shin
- Department of Neurology, School of Medicine, Chonbuk National University, Jeonju, South Korea
| | - Sun-Young Oh
- Department of Neurology, School of Medicine, Chonbuk National University, Jeonju, South Korea
| | - So-Young Huh
- Department of Neurology, Kosin University College of Medicine, Busan, South Korea
| | - Woojun Kim
- Department of Neurology, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, South Korea
| | - Min Su Park
- Department of Neurology, Yeungnam University College of Medicine, Daegu, South Korea
| | - Jeeyoung Oh
- Department of Neurology, Konkuk University School of Medicine, Seoul, South Korea
| | - Hyunmin Jang
- Department of Neurology, National Cancer Center, Goyang, South Korea
| | - Na Young Park
- Department of Neurology, National Cancer Center, Goyang, South Korea
| | - Min Young Lee
- Department of Neurology, National Cancer Center, Goyang, South Korea
| | - Su-Hyun Kim
- Department of Neurology, National Cancer Center, Goyang, South Korea
| | - Ho Jin Kim
- Department of Neurology, National Cancer Center, Goyang, South Korea
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Hyun JW, Kwon YN, Lee HL, Jeong WK, Lee HJ, Kim BJ, Kim SW, Shin HY, Shin HJ, Oh SY, Lee MY, Kim SH, Huh SY, Kim W, Park MS, Kim SY, Kim SM, Kim HJ. Recurrence of clinical events at the same anatomical location in patients with MOG antibody-associated disease. Mult Scler 2020; 27:449-452. [PMID: 32228287 DOI: 10.1177/1352458520913970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Likelihood of clinical events occurring within the same anatomical location in patients with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) was retrospectively investigated. METHODS A total of 236 clinical events in 90 patients with MOGAD from nine referral hospitals were analyzed via logistic regression, and odds ratios (ORs) were calculated. Anatomical lesion location was divided into four groups; optic nerve, spinal cord, cerebral hemisphere, and brainstem/cerebellum. RESULTS At all locations, there was an increased likelihood of a second attack occurring at the same location as the initial event (cerebral hemisphere OR = 22.14, brainstem/cerebellum OR = 18.4, spinal cord OR = 9.1, and optic nerve OR = 7.8). There was an increased likelihood of a third attack occurring at the same location as the initial event in the optic nerve (OR = 14.9), cerebral hemisphere (OR = 11.7), and spinal cord (OR = 6.7). There were positive trends toward a third clinical event occurring at the same location as the first and/or second events if the event was in the optic nerve (OR = 13.5), cerebral hemisphere (OR = 6.9), or spinal cord (OR = 5.7). CONCLUSIONS The current study suggests that clinical relapses of MOGAD during early stage tend to recur at the same anatomical locations in the central nervous system.
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Affiliation(s)
- Jae-Won Hyun
- Department of Neurology, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Young Nam Kwon
- National Cancer Center, Goyang, Korea/Department of Neurology, Seoul National University Hospital, Seoul, Korea
| | - Hye Lim Lee
- Department of Neurology, Korea University Guro Hospital, College of Medicine, Korea University, Seoul, Korea
| | - Woo Kyo Jeong
- Department of Neurology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea/Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Hye Jung Lee
- Department of Neurology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea/Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Byoung Joon Kim
- Department of Neurology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea/Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Seung Woo Kim
- Department of Neurology, College of Medicine, Yonsei University, Seoul, Korea
| | - Ha Young Shin
- Department of Neurology, College of Medicine, Yonsei University, Seoul, Korea
| | - Hyun-June Shin
- Department of Neurology, School of Medicine, Chonbuk National University, Jeonju-si, Korea
| | - Sun-Young Oh
- Department of Neurology, School of Medicine, Chonbuk National University, Jeonju-si, Korea
| | - Min Young Lee
- Department of Neurology, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Su-Hyun Kim
- Department of Neurology, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - So-Young Huh
- Department of Neurology, College of Medicine, Kosin University, Busan, Korea
| | - Woojun Kim
- Department of Neurology, The Catholic University of Korea, Seoul, Korea
| | - Min Su Park
- College of Medicine, Yeungnam University, Daegu, Korea
| | - Sun-Young Kim
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Sung-Min Kim
- National Cancer Center, Goyang, Korea/Department of Neurology, Seoul National University Hospital, Seoul, Korea
| | - Ho Jin Kim
- Department of Neurology, Research Institute and Hospital, National Cancer Center, Goyang, Korea
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Kwon YN, Koh J, Jeon YK, Sung JJ, Park SH, Kim SM. A case of MOG encephalomyelitis with T- cell lymphoma. Mult Scler Relat Disord 2020; 41:102038. [PMID: 32155461 DOI: 10.1016/j.msard.2020.102038] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 03/01/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Myelin oligodendrocyte glycoprotein immunoglobulin-G (IgG)-associated encephalomyelitis (MOG-EM) is a distinct inflammatory demyelinating disease. We present an unusual MOG-EM cases with concomitant T-cell lymphoma. CASE REPORT A 38-year-old Caucasian male presented with bilateral optic neuritis and multifocal transverse myelitis. He tested positive for MOG-IgG1 and his neurologic symptoms improved with high dose steroid treatment. Six months after his first MOG-EM symptoms, he developed ulcerative skin lesions on his leg and was diagnosed with primary cutaneous γδ T-cell lymphoma. The immunohistochemistry study, performed on his cancer tissue, was negative for MOG. CONCLUSION Diagnosis of MOG-EM can be considered in patients with concomitant hematologic malignancy, which might be associated with the dysregulated adaptive immunity rather than the direct presentation of the onconeural antigen by cancer. Further studies need to be conducted for the risks and incidence of malignancy in a larger cohort of MOG-EM.
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Affiliation(s)
- Young Nam Kwon
- Department of Neurology, Seoul National University Hospital, Seoul, Korea; Department of Neurology, The Catholic University of Korea, Eunpyeong St. Mary's Hospital, Seoul, Korea; Department of Medicine, Graduate School Kyung Hee University, Seoul, Korea
| | - Jiwon Koh
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yoon Kyung Jeon
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jung-Joon Sung
- Department of Neurology, Seoul National University Hospital, Seoul, Korea; Department of Neurology, Seoul National University College of Medicine, Seoul, Korea
| | - Sung-Hye Park
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sung-Min Kim
- Department of Neurology, Seoul National University Hospital, Seoul, Korea; Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
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Byun JM, Kwon YN, Koh Y, Yoon SS, Sung JJ, Kim I. Distinctive patterns of peripheral neuropathy across the spectrum of plasma cell disorders. Sci Rep 2019; 9:16769. [PMID: 31727997 PMCID: PMC6856063 DOI: 10.1038/s41598-019-53289-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 10/25/2019] [Indexed: 11/11/2022] Open
Abstract
Many patients with plasma cell disorders suffer from peripheral neuropathy, but differential diagnosis with chronic inflammatory demyelinating polyneuropathy (CIDP) is difficult. We aimed to (1) identify factors useful for differential diagnosis between peripheral neuropathy associated with plasma cell disorders versus CIDP and (2) determine whether neuropathy presentations and severity varied across the spectrum of different plasma cell disorders. A retrospective chart review of 18 monoclonal gammopathy of unknown significance (MGUS) patients, 15 POEMS syndrome patients and 34 CIDP patients between January 2005 and December 2016 was conducted. The peripheral neuropathy associated with plasma cell disorders seemed to be more sensory oriented compared to CIDP. MGUS patients were significantly older than CIDP patients (median age 70 vs. 59, respectively, p = 0.027). POEMS syndrome patients showed significantly higher platelet count at the time of neuropathy presentation compared to CIDP (p = 0.028). Lambda type MGUS patients were associated with less severe symptoms compared to POEMS syndrome patients despite harboring lambda monoclonal gammopathy as a common denominator. Kappa type MGUS patients showed predominantly axonal type neuropathy compared to its counterpart and POEMS syndrome. Careful inspection of clinical profiles and symptoms of patients presenting with neuropathy can help to discriminate those with underlying plasma cell disorders. The phenotype of neuropathy, platelet count and age at presentation seem to be the most useful indicators.
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Affiliation(s)
- Ja Min Byun
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Young Nam Kwon
- Department of Neurology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Youngil Koh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Sung-Soo Yoon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Jung-Joon Sung
- Department of Neurology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea.
| | - Inho Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea.
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Abstract
Although both multiple sclerosis (MS) and neuromyelitis optica (NMO) are demyelinating diseases, their psychiatric disturbances may differ given differences in the neurological manifestations. We used subjective and objective measurements to compare the psychiatric disturbances in patients with MS and NMO.Psychiatric disturbances were assessed in 24 MS and 35 NMO patients using the Beck Hopelessness Scale, Symptom Checklist-95 and the brief version of World Health Organization Quality of Life. Personality was assessed using the Big Five Inventory-10. Disease-related function was assessed using the Fatigue Severity Scale, Short-Form McGill Pain Questionnaire, and the Global Assessment of Function. Positivity offset (PO) and negativity bias (NB) and heart rate variability (HRV) were measured using a modified implicit affect test and photoplethysmograph, respectively. Data were analyzed using analysis of covariance with age and sex as covariates.MS patients had higher levels of depression, anxiety, panic attacks, obsessive-compulsiveness, aggression, paranoia, interpersonal sensitivity, self-regulation problems, stress vulnerability, and lower psychological quality of life (QOL) compared with NMO patients. The PO and NB and HRV values were not significantly different between groups. However, NMO patients had lower QOL, and higher levels of hopelessness, suicidality, and fatigue than the normal range. Disease duration was associated with hopelessness in NMO patients and with several psychiatric disturbances, but not hopelessness, in MS patients.Subjective psychiatric disturbances were more severe in patients with MS than in those with NMO, whereas PO and NB and HRV in patients with NMO were comparable with those of MS patients. Our findings highlight the need for different clinical approaches to assess and treat psychiatric disturbances in patients with MS and NMO.
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Affiliation(s)
| | - Young Nam Kwon
- Department of Neurology, Seoul National University Hospital
| | | | | | | | | | - Soo-Hee Choi
- Department of Psychiatry
- Department of Psychiatry, Institute of Human Behavioral Medicine in SNU-MRC, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sung-Min Kim
- Department of Neurology, Seoul National University Hospital
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Kwon YN, Waters PJ, Kim M, Choi YS, Kim JW, Sung JJ, Park SH, Kim SM. Peripherally derived macrophages as major phagocytes in MOG encephalomyelitis. Neurol Neuroimmunol Neuroinflamm 2019; 6:6/5/e600. [PMID: 31454776 PMCID: PMC6705630 DOI: 10.1212/nxi.0000000000000600] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 06/18/2019] [Indexed: 01/16/2023]
Affiliation(s)
- Young Nam Kwon
- From the Department of Neurology (Y.N.K., J.-J.S., S.-M.K.), Seoul National University Hospital, Republic of Korea; Department of Neurology (Y.N.K.), Seoul National University Seoul Metropolitan Government Boramae Medical Center, Republic of Korea; Department of Medicine (Y.N.K.), Graduate School, Kyung Hee University, Republic of Korea; Neuroimmunology Group (P.J.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom; Biomedical Research Institute (M.K.), Seoul National University Hospital, Republic of Korea; Department of Medicine (Y.S.C.), Seoul National University, College of Medicine, Republic of Korea; Department of Neurosurgery (J.W.K.), Seoul National University Hospital, Republic of Korea; Department of Neurology (J.-J.S., S.-M.K.), Neuroscience Research Institute, Seoul National University, College of Medicine, Seoul, Republic of Korea; and Department of Pathology (S.-H.P.), Seoul National University, College of Medicine, Seoul, Republic of Korea
| | - Patrick J Waters
- From the Department of Neurology (Y.N.K., J.-J.S., S.-M.K.), Seoul National University Hospital, Republic of Korea; Department of Neurology (Y.N.K.), Seoul National University Seoul Metropolitan Government Boramae Medical Center, Republic of Korea; Department of Medicine (Y.N.K.), Graduate School, Kyung Hee University, Republic of Korea; Neuroimmunology Group (P.J.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom; Biomedical Research Institute (M.K.), Seoul National University Hospital, Republic of Korea; Department of Medicine (Y.S.C.), Seoul National University, College of Medicine, Republic of Korea; Department of Neurosurgery (J.W.K.), Seoul National University Hospital, Republic of Korea; Department of Neurology (J.-J.S., S.-M.K.), Neuroscience Research Institute, Seoul National University, College of Medicine, Seoul, Republic of Korea; and Department of Pathology (S.-H.P.), Seoul National University, College of Medicine, Seoul, Republic of Korea
| | - Moonhang Kim
- From the Department of Neurology (Y.N.K., J.-J.S., S.-M.K.), Seoul National University Hospital, Republic of Korea; Department of Neurology (Y.N.K.), Seoul National University Seoul Metropolitan Government Boramae Medical Center, Republic of Korea; Department of Medicine (Y.N.K.), Graduate School, Kyung Hee University, Republic of Korea; Neuroimmunology Group (P.J.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom; Biomedical Research Institute (M.K.), Seoul National University Hospital, Republic of Korea; Department of Medicine (Y.S.C.), Seoul National University, College of Medicine, Republic of Korea; Department of Neurosurgery (J.W.K.), Seoul National University Hospital, Republic of Korea; Department of Neurology (J.-J.S., S.-M.K.), Neuroscience Research Institute, Seoul National University, College of Medicine, Seoul, Republic of Korea; and Department of Pathology (S.-H.P.), Seoul National University, College of Medicine, Seoul, Republic of Korea.
| | - Youn Soo Choi
- From the Department of Neurology (Y.N.K., J.-J.S., S.-M.K.), Seoul National University Hospital, Republic of Korea; Department of Neurology (Y.N.K.), Seoul National University Seoul Metropolitan Government Boramae Medical Center, Republic of Korea; Department of Medicine (Y.N.K.), Graduate School, Kyung Hee University, Republic of Korea; Neuroimmunology Group (P.J.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom; Biomedical Research Institute (M.K.), Seoul National University Hospital, Republic of Korea; Department of Medicine (Y.S.C.), Seoul National University, College of Medicine, Republic of Korea; Department of Neurosurgery (J.W.K.), Seoul National University Hospital, Republic of Korea; Department of Neurology (J.-J.S., S.-M.K.), Neuroscience Research Institute, Seoul National University, College of Medicine, Seoul, Republic of Korea; and Department of Pathology (S.-H.P.), Seoul National University, College of Medicine, Seoul, Republic of Korea
| | - Jin Wook Kim
- From the Department of Neurology (Y.N.K., J.-J.S., S.-M.K.), Seoul National University Hospital, Republic of Korea; Department of Neurology (Y.N.K.), Seoul National University Seoul Metropolitan Government Boramae Medical Center, Republic of Korea; Department of Medicine (Y.N.K.), Graduate School, Kyung Hee University, Republic of Korea; Neuroimmunology Group (P.J.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom; Biomedical Research Institute (M.K.), Seoul National University Hospital, Republic of Korea; Department of Medicine (Y.S.C.), Seoul National University, College of Medicine, Republic of Korea; Department of Neurosurgery (J.W.K.), Seoul National University Hospital, Republic of Korea; Department of Neurology (J.-J.S., S.-M.K.), Neuroscience Research Institute, Seoul National University, College of Medicine, Seoul, Republic of Korea; and Department of Pathology (S.-H.P.), Seoul National University, College of Medicine, Seoul, Republic of Korea.
| | - Jung-Joon Sung
- From the Department of Neurology (Y.N.K., J.-J.S., S.-M.K.), Seoul National University Hospital, Republic of Korea; Department of Neurology (Y.N.K.), Seoul National University Seoul Metropolitan Government Boramae Medical Center, Republic of Korea; Department of Medicine (Y.N.K.), Graduate School, Kyung Hee University, Republic of Korea; Neuroimmunology Group (P.J.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom; Biomedical Research Institute (M.K.), Seoul National University Hospital, Republic of Korea; Department of Medicine (Y.S.C.), Seoul National University, College of Medicine, Republic of Korea; Department of Neurosurgery (J.W.K.), Seoul National University Hospital, Republic of Korea; Department of Neurology (J.-J.S., S.-M.K.), Neuroscience Research Institute, Seoul National University, College of Medicine, Seoul, Republic of Korea; and Department of Pathology (S.-H.P.), Seoul National University, College of Medicine, Seoul, Republic of Korea
| | - Sung-Hye Park
- From the Department of Neurology (Y.N.K., J.-J.S., S.-M.K.), Seoul National University Hospital, Republic of Korea; Department of Neurology (Y.N.K.), Seoul National University Seoul Metropolitan Government Boramae Medical Center, Republic of Korea; Department of Medicine (Y.N.K.), Graduate School, Kyung Hee University, Republic of Korea; Neuroimmunology Group (P.J.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom; Biomedical Research Institute (M.K.), Seoul National University Hospital, Republic of Korea; Department of Medicine (Y.S.C.), Seoul National University, College of Medicine, Republic of Korea; Department of Neurosurgery (J.W.K.), Seoul National University Hospital, Republic of Korea; Department of Neurology (J.-J.S., S.-M.K.), Neuroscience Research Institute, Seoul National University, College of Medicine, Seoul, Republic of Korea; and Department of Pathology (S.-H.P.), Seoul National University, College of Medicine, Seoul, Republic of Korea.
| | - Sung-Min Kim
- From the Department of Neurology (Y.N.K., J.-J.S., S.-M.K.), Seoul National University Hospital, Republic of Korea; Department of Neurology (Y.N.K.), Seoul National University Seoul Metropolitan Government Boramae Medical Center, Republic of Korea; Department of Medicine (Y.N.K.), Graduate School, Kyung Hee University, Republic of Korea; Neuroimmunology Group (P.J.W.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom; Biomedical Research Institute (M.K.), Seoul National University Hospital, Republic of Korea; Department of Medicine (Y.S.C.), Seoul National University, College of Medicine, Republic of Korea; Department of Neurosurgery (J.W.K.), Seoul National University Hospital, Republic of Korea; Department of Neurology (J.-J.S., S.-M.K.), Neuroscience Research Institute, Seoul National University, College of Medicine, Seoul, Republic of Korea; and Department of Pathology (S.-H.P.), Seoul National University, College of Medicine, Seoul, Republic of Korea.
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Shin C, Nam Kwon Y, Lee D, Ahn TB. Incongruent hemiatrophy and hemiparkinsonism in a patient with schizencephaly. Clin Neurol Neurosurg 2018; 175:106-107. [PMID: 30390483 DOI: 10.1016/j.clineuro.2018.10.008] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 10/09/2018] [Accepted: 10/13/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Chaewon Shin
- Department of Neurology, Kyung Hee University Hospital, 23, Kyungheedae-ro, Dongdaemun-gu, 02447 Seoul, Republic of Korea
| | - Young Nam Kwon
- Department of Neurology, Kyung Hee University Hospital, 23, Kyungheedae-ro, Dongdaemun-gu, 02447 Seoul, Republic of Korea
| | - Dokyung Lee
- Department of Neurology, Kyung Hee University Hospital, 23, Kyungheedae-ro, Dongdaemun-gu, 02447 Seoul, Republic of Korea
| | - Tae-Beom Ahn
- Department of Neurology, Kyung Hee University Hospital, 23, Kyungheedae-ro, Dongdaemun-gu, 02447 Seoul, Republic of Korea; Department of Neurology, College of Medicine, Kyung Hee University, 23, Kyungheedae-ro, Dongdaemun-gu, 02447 Seoul, Republic of Korea.
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Kwon YN, Yoon SS, Lee KH. Sarcopenic Obesity in Elderly Korean Women: A Nationwide Cross-sectional Study. J Bone Metab 2018; 25:53-58. [PMID: 29564306 PMCID: PMC5854823 DOI: 10.11005/jbm.2018.25.1.53] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 02/19/2018] [Accepted: 02/19/2018] [Indexed: 12/25/2022] Open
Abstract
Background Sarcopenia causes loss of muscle mass in the elderly and is associated with development of metabolic syndrome in those with obesity. This study evaluated the prevalence of sarcopenic obesity (SO) in healthy Korean elderly women. Methods This study was based on data from the Korea National Health and Nutrition Examination Survey IV and V, 2008–2011. Whole body dual energy X-ray absorptiometry and body mass index measurement were performed for all patients. Women aged 65 years or older were included in this study. Total appendicular extremity muscle mass was used to determine the skeletal muscle mass index. Results Of 2,396 women aged 65 years or older, a total of 1,491 (62.2%) were underweight, normal weight, or overweight, while 905 (37.8%) were obese. The prevalence of sarcopenia using a cut-off value of 5.4 kg/m2 was 64.9% (63/97) in underweight women, 38.2% (320/838) in normal weight women, 17.1% (95/556) in overweight women, and 6.1% (55/905) in obese women. Conclusions The prevalence of sarcopenia was different among groups. The prevalence rate in obese women was lower than that in non-obese women. SO is a new category of obesity in older adults with high adiposity coupled with low muscle mass. The prevalence of SO was lower than that in previous studies because of differences in the definition. A consensus definition of SO needs to be established.
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Affiliation(s)
- Young Nam Kwon
- Department of Neurology, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Sung Sang Yoon
- Department of Neurology, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Kyung-Hag Lee
- Department of Orthopaedic Surgery, National Medical Center, Seoul, Korea
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Shin C, Kwon YN, Lee D, Hong IK, Kim HG, Lee KM, Ahn TB. Anterior cingulate cortex as an element of a possible novel motor circuit of the basal ganglia. Parkinsonism Relat Disord 2017; 46:90-91. [PMID: 29097082 DOI: 10.1016/j.parkreldis.2017.10.018] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 10/01/2017] [Accepted: 10/22/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Chaewon Shin
- Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Young Nam Kwon
- Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Dokyung Lee
- Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Il Ki Hong
- Department of Nuclear Medicine, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Hyug-Gi Kim
- Department of Radiology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Kyung Mi Lee
- Department of Radiology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Tae-Beom Ahn
- Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
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Abstract
Sarcopenia is an age-related geriatric syndrome which is characterized by the gradual loss of muscle mass, muscle strength, and muscle quality. There are a lot of neurologic insults on sarcopenia at various levels from the brain to the neuromuscular junctions (NMJs) to generate a volitional task. Dopaminergic downregulation, inadequate motor programming and motor coordination impairment lead to decline of supraspinal drive. Motor unit reorganization and inflammatory changes in motor neuron decrease conduction velocity and amplitude of compound muscle action potential. Furthermore, NMJ remodeling and age related neurophysiological alterations may contribute to neuromuscular impairment. Sarcopenia is an age-associated, lifelong process which links to multiple etiological factors. Although not all the causes are completely understood, we suggest that compromised nervous system function may be one of the important contributors to the sarcopenia.
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Affiliation(s)
- Young Nam Kwon
- Department of Neurology, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Sung Sang Yoon
- Department of Neurology, College of Medicine, Kyung Hee University, Seoul, Korea
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Lee D, Kwon YN, Shon SH, Lee JH, Ahn TB. Glycemic and vascular choreoballism as main causes of secondary choreoballism involving the putamen. Parkinsonism Relat Disord 2016; 30:29-35. [PMID: 27353422 DOI: 10.1016/j.parkreldis.2016.06.016] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Revised: 05/23/2016] [Accepted: 06/19/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND The putamen is frequently involved in cases of secondary choreoballism (CB). To date, no study has investigated clinical features of secondary CB such as vascular CB (vCB) and glycemic CB (gCB) in view of putaminal involvement. OBJECTIVES Cases of CB with putaminal lesions from our hospital were identified in hospital records. Historical cases were obtained from the MEDLINE database. Cases of gCB are defined as those with CB, diabetes mellitus and high signal intensities (HSIs) in the putamen on T1 weighted imaging (T1WI). Cases of vCB are identified among those with CB and stroke involving the putamen. RESULTS A total of 284 cases (in-hospital cases, 11 gCB and 3 vCB; historical cases, 225 gCB and 45 vCB) were included after excluding 23 glycemic cases without HSIs on T1WI and 53 cases with non-glycemic etiologies. Persistence of CB was longer than one month in 84 cases (gCB, 36.9%, and vCB, 63.0%). Extra-putaminal lesions occurred more frequently in vCB (71.1%) than gCB (50.7%). Age, cerebrovascular etiology and extra-putaminal lesions were found to be significant predictors for persistence of CB one month after onset. Female gender and extra-putaminal lesions were significant predictors for persistence of CB one year after onset. CONCLUSIONS gCB was the primary common cause of secondary CB involving the putamen. Older age, female gender, vascular etiologies and extensive lesions (putaminal and extra-putaminal) were significant predictors of CB persistence.
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Affiliation(s)
- Dokyung Lee
- Department of Neurology, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Young Nam Kwon
- Department of Neurology, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Sang Hyun Shon
- Department of Neurology, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Ju Hie Lee
- Department of Pathology, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Tae-Beom Ahn
- Department of Neurology, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
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Kwon YN, Shin SM, Cho IJ, Kim SG. Oxidized metabolites of oltipraz exert cytoprotective effects against arachidonic acid through AMP-activated protein kinase-dependent cellular antioxidant effect and mitochondrial protection. Drug Metab Dispos 2009; 37:1187-97. [PMID: 19299524 DOI: 10.1124/dmd.108.025908] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Oltipraz protects cells from chemical-induced carcinogenesis partly because of phase 2 enzyme induction. Certain oltipraz metabolites also induce phase 2 enzymes. This study investigated the cytoprotective effects of the oxidized metabolites of oltipraz against arachidonic acid (AA), a proinflammatory fatty acid that causes cellular reactive oxygen species (ROS) production and mitochondrial impairment, and the mechanistic basis of their action in HepG2 cells. Treatment with 4-methyl-5-(pyrazin-2-yl)-3H-1,2-dithiol-3-one (M1) or 7-methyl-6,8-bis(methylthio)H-pyrrolo[1,2-a]-pyrazine (M2), but not 7-methyl-8-(methylsulfinyl)-6-(methylthio)H-pyrrolo[1,2-a]pyrazine (M3) or 7-methyl-6,8-bis(methylsulfinyl)H-pyrrolo[1,2-a]pyrazine (M4), enabled cells to protect against AA-induced apoptosis. M1 and M2 treatment protected cells from ROS produced by AA and inhibited AA-induced glutathione depletion. Moreover, both M1 and M2 effectively inhibited mitochondrial dysfunction induced by AA, although M2 alone slightly elicited it at a relatively high concentration. M1 and M2 activated AMP-activated protein kinase (AMPK), but M3 and M4 failed to do so. AMPK activation by M1 and M2 contributed to cell survival against AA through a decrease in cellular ROS production and prevention of mitochondrial dysfunction, as shown by the reversal of the metabolites' restoration of mitochondrial membrane potential by compound C treatment or overexpression of a dominant-negative mutant AMPK. Consistently, 5-aminoimidazole-4-carboxamide-1-beta-d-ribofuranoside, an AMPK activator, also had a cytoprotective and antioxidant effect against AA. Our results demonstrate that, of the major metabolites of oltipraz, M1 and M2 are capable of protecting cells from AA-induced ROS production and mitochondrial dysfunction, which may be associated with AMPK activation.
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Affiliation(s)
- Young Nam Kwon
- Innovative Drug Research Center for Metabolic and Inflammatory Disease, College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, South Korea
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Byk T, Sokolov V, Gaevskaya T, Skorb E, Sviridov D, Noh CH, Song KY, Kwon YN, Cho SH. Photochemical selective deposition of nickel using a TiO2–Pd2+ layer. J Photochem Photobiol A Chem 2008. [DOI: 10.1016/j.jphotochem.2007.06.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Lee KH, Kim DW, Bae SH, Kim JA, Ryu GH, Kwon YN, Kim KA, Koo HS, Seo YS. The endonuclease activity of the yeast Dna2 enzyme is essential in vivo. Nucleic Acids Res 2000; 28:2873-81. [PMID: 10908349 PMCID: PMC102684 DOI: 10.1093/nar/28.15.2873] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2000] [Accepted: 06/14/2000] [Indexed: 11/12/2022] Open
Abstract
Dna2 is a multifunctional enzyme in yeast that possesses endonuclease activity well suited to remove RNA-DNA primers of Okazaki fragments, raising the question of whether endonuclease activity is essential for in vivo Dna2 function. Systematic site-directed mutations of amino acid residues in Saccharomyces cerevisiae DNA2 conserved in the central region of many eukaryotic DNA2 homologs allowed us to identify mutant dna2 alleles that were divided into three groups based on the viability of the mutant cells: (i) viable; (ii) inviable only when expression was repressed; (iii) inviable. Biochemical analyses of recombinant mutant Dna2 proteins isolated from the latter two groups revealed that they possessed normal ATPase/helicase activity, but were impaired in their endonuclease activity. Cells expressing mutant Dna2 enzymes partially impaired in endonuclease activity were viable, but were unable to grow when expression of their mutant Dna2 enzymes was further reduced. Their growth was restored when the mutant Dna2 proteins decreased in nuclease activity were induced to overexpress. In contrast, mutant Dna2 proteins lacking endonuclease activity did not allow cells to grow under any conditions tested. These in vivo and in vitro results demonstrate that the endonuclease activity of Dna2 is essential for Okazaki fragment processing.
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Affiliation(s)
- K H Lee
- National Creative Research Initiative Center for Cell Cycle Control, Sungkyunkwan University School of Medicine, 300 Chunchun-Dong, Changan-Ku, Suwon-Si, Kyunggi-Do 440-746, Korea
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