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Sungsin Cho,조진현 대한혈관외과학회 2019 Vascular Specialist International Vol.35 No.1
Iliac artery aneurysms are usually asymptomatic. Herein, we report a novel strat-egy for the repair of a pseudoaneurysm involving the external iliac artery using a conventional artificial graft and bare metal stent. A 76-year-old male patient pre-sented with severe resting pain and right foot discoloration. Computed tomogra-phy angiography revealed a right distal external iliac artery pseudoaneurysm, with severe calcified occlusion at the right common and superficial femoral arteries. After exposing the right femoral artery, long-segment endarterectomy and patch angioplasty with the ipsilateral greater saphenous vein were performed. Before the completion of patch angioplasty, a surgeon-modified 8-mm expanded polytetra-fluoroethylene (ePTFE) graft was inserted for complete pseudoaneurysm repair. If a commercial covered stent is not available, minimally invasive endovascular repair can be safely performed using a surgeon-modified ePTFE graft and bare metal stent.
( Sungsin Jo ),( Yun Young Lee ),( Jinil Han ),( Young Lim Lee ),( Subin Yoon ),( Jaehyun Lee ),( Younseo Oh ),( Joong-soo Han ),( Il-hoon Sung ),( Ye-soo Park ),( Tae-hwan Kim ) 생화학분자생물학회(구 한국생화학분자생물학회) 2019 BMB Reports Vol.52 No.6
Receptor activator of nuclear factor kappa B ligand (RANKL) expression in osteoblasts is regulated by 1,25-dihydroxyvitamin D3 (1,25D3). CCAAT/enhancer-binding protein beta (C/EBPβ) has been proposed to function as a transcription factor and upregulate RANKL expression, but it is still uncertain how C/EBPβ is involved in 1,25D3-induced RANKL expression of osteoblasts. 1,25D3 stimulation increased the expression of RANKL and C/EPBβ genes in osteoblasts and enhanced phosphorylation and stability of these proteins. Moreover, induction of RANKL expression by 1,25D3 in osteoblasts was downregulated upon knockdown of C/EBPβ. In contrast, C/EBPβ overexpression directly upregulated RANKL promoter activity and exhibited a synergistic effect on 1,25D3-induced RANKL expression. In particular, 1,25D3 treatment of osteoblasts increased C/EBPβ protein binding to the RANKL promoter. In conclusion, C/EBPβ is required for induction of RANKL by 1,25D3. [BMB Reports 2019; 52(6): 391-396]
Directional Atherectomy for Treating In-Stent Restenosis of the Superficial Femoral Artery
Sungsin Cho,Ahram Han,Sanghyun Ahn,Sang-Il Min,하종원,Hwan Jun Jae,민승기 대한혈관외과학회 2020 Vascular Specialist International Vol.36 No.3
Purpose: The optimal treatment for in-stent restenosis (ISR) of the superficial femoral artery (SFA) is still in debate. This study aimed to evaluate the safety and effectiveness of directional atherectomy (DA) as a primary treatment modality for ISR in SFA. Materials and Methods: A retrospective single-center analysis was conducted. In total, 617 stents were deployed in 242 limbs for SFA diseases during the study period. ISR was identified in 29 limbs (12.0%); 14 limbs were treated with DA and 15 limbs with balloon angioplasty (BAP) alone. Technical success rate, target lesion revascularization (TLR) and patency rates (PRs) at 12 months, and any complications were evaluated. Results: DA group included complete occlusions in 50% of patients and BAP group included in 40%. Mean improvement in the ankle-brachial index was 0.29 and 0.32, respectively (P=0.638). Technical success was achieved in all patients. The procedural success rates were 85.7% and 73.3%, respectively (P=0.651). There was no significant difference regarding residual stenosis, distal embolization, or flow-limiting dissection. Primary PRs at 1 year were 85.7% and 73.3%, secondary PRs were 100.0% and 93.3%, and TLR rates were 14.3% and 20.0% (P=0.411, 0.326, and 0.684, respectively). Conclusion: Short-term outcomes after DA for ISR were not different from those after BAP but showed a tendency of better primary PR and TLR. Larger multicenter prospective studies are needed to define the role of DA in ISR treatment.
The TNF-NF-κB-DKK1 Axis Promoted Bone Formation in the Enthesis of Ankylosing Spondylitis
( Sungsin Jo ),( Bora Nam ),( Young Lim Lee ),( Hyosun Park ),( Subin Weon ),( Sung-hoon Choi ),( Ye-soo Park ),( Tae-hwan Kim ) 대한류마티스학회 2021 대한류마티스학회지 Vol.28 No.4
Objective. This study aimed to determine the serum Dickkopf 1 (DKK1) levels in ankylosing spondylitis (AS) patients and decipher the mechanism of tumor necrosis factor (TNF)-mediated DKK1 regulation in human AS enthesis cells. Methods. The sera were obtained from 103 patients with AS and 30 healthy controls (HCs). The enthesis of facet joints were obtained from 4 AS patients and 5 controls. The serum levels of DKK1 were measured using ELISA and compared between AS and HCs. The impact of TNF on DKK1 expression in human primary spinal enthesis cells was evaluated using various molecular biology techniques and bone formation indicators. Results. AS patients showed higher serum DKK1 levels than HCs after adjusting for age (917.4 [615.3∼1,310.0] pg/mL vs. 826.2 [670.3∼927.8] pg/mL, p=0.043). TNF treatment promoted bone formation and DKK1 expression in both control enthesis cells and those of AS. This enhanced bone formation by TNF was pronounced in AS-enthesis than those of controls. Mechanically, TNF induced NF-κB activation upregulates the DKK1 transcript level. While, NF-κB inhibitor led to downregulate DKK1 expression in the enthesis. Besides, DKK1 overexpression promoted bone formation in enthesis. Conclusion. TNF induced DKK1 expression in the enthesis through NF-κB activation. TNF-induced DKK1 expression may play a bone formation in the radiologic progression of ankylosing spondylitis. (J Rheum Dis 2021;28:216-224)
Sungsin Cho,Seung Hwan Lee,조진현 대한외과학회 2019 Annals of Surgical Treatment and Research(ASRT) Vol.97 No.4
Purpose: Peripheral arterial disease (PAD) is a common vascular problem and has serious morbidity and mortality in advanced situations. However, the prevalence and risk factors for PAD in Korea have not been reported. The purpose of this study was to evaluate the prevalence and risk factors of PAD in the Korean population. Methods: The study was processed by visiting community welfare centers. Inclusion criteria were people who participated in this study. Screening was performed by history taking followed by the measurement of ankle brachial index (ABI). PAD was defined when an ABI of 0.9 or less was found in one or both legs. All statistical analyses were conducted with SPSS ver. 22.0. Results: Between January 2008 and December 2012, a total of 2,044 participants were included with 810 men (39.6%) and 1,234 women (60.4%). PAD was detected in 95 (4.6%). Borderline ABI (0.91–0.99) showed in 212 (10.4%), and severe decreased ABI defined as 0.5 or less showed in 3 (0.1%). Significant risk factors for PAD were old age (odd ratio, 1.952; P = 0.045), hypertension (odd ratio, 1.645; P = 0.050), and cardiovascular disease (odd ratio, 2.047; P = 0.039). Significant risk factors for borderline PAD were old age (odd ratio, 1.019; P = 0.024), hypertension (odd ratio, 1.461; P = 0.038), and chronic obstructive lung disease (odd ratio, 3.393; P = 0.001). Conclusion: The prevalence of PAD in the Korean population was 4.6%. Old age, hypertension, and cardiovascular disease were significant risk factors for PAD. Further nationwide study is needed