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The natural clinical course of hemodynamically stable adult moyamoya disease
Cho, Won-Sang,Chung, Young Seob,Kim, Jeong Eun,Jeon, Jin Pyeong,Son, Young Je,Bang, Jae Seung,Kang, Hyun-Seung,Sohn, Chul-Ho,Oh, Chang Wan American Association of Neurological Surgeons 2015 Journal of Neurosurgery Vol.122 No.1
<B>OBJECT</B><P>Moyamoya disease (MMD) is a rare cerebrovascular disease and its natural history is still unclear. The authors aimed to investigate the natural course of hemodynamically stable cases of adult MMD, with the analysis of stroke risk factors.</P><B>METHODS</B><P>Two hundred forty-one patients were included in this retrospective study. One hundred sixty-six (68.9%) were female, and mean age (± SD) at first visit was 41.3 ± 12.0 years (range 18-69 years). Unilateral involvement was identified in 33 patients, and 19 patients (7.9%) had a family history of MMD. According to the clinical presentations, patients were classified into hemorrhagic (n = 62, 25.7%), ischemic (n = 144, 59.8%), and asymptomatic (n = 35, 14.5%) groups. The mean duration of follow-up was 82.5 ± 62.9 months (range 7.3-347.0 months).</P><B>RESULTS</B><P>The annual stroke risk was 4.5%, and the annual risks of rebleeding in the hemorrhagic group and recurrent ischemic events in the ischemic group were 4.3% and 3.0%, respectively. There was no significant difference in cumulative stroke risk between the 3 groups (p = 0.461). Risk factors included thyroid disease for overall strokes (HR 2.56, 95% CI 1.16-5.67), initial hemorrhagic presentation for hemorrhagic strokes (HR 2.53, 95% CI 1.24-5.17), and initial ischemic presentation for ischemic strokes (HR 2.69, 95% CI 1.15-6.27). Familial MMD was a common risk factor for all types of stroke. Among the 3 clinical groups, the hemorrhagic group showed the worst clinical status at discharge and at most recent follow-up. Twenty-three patients (9.5%) eventually underwent revascularization surgery.</P><B>CONCLUSIONS</B><P>There was no statistically significant difference in the incidence of stroke in the different clinical groups; clinical status, however, was most severe in patients with hemorrhagic presentation. In patients who experienced stroke during the follow-up period, the stroke type tended to correspond to their initial presentation. Close follow-up is needed in patients with thyroid disease and a family history of MMD.</P>
Won, Ki-Bum,Nam, Chang-Wook,Cho, Yun-Kyeong,Yoon, Hyuck-Jun,Park, Hyoung-Seob,Kim, Hyungseop,Han, Seongwook,Hur, Seung-Ho,Kim, Yoon-Nyun,Park, Sang-Hyun,Han, Jung-Kyu,Koo, Bon-Kwon,Kim, Hyo-Soo,Doh, J The Korean Academy of Medical Sciences 2016 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.31 No.12
<P>Data on the clinical outcomes in deferred coronary lesions according to functional severity have been limited. This study evaluated the clinical outcomes of deferred lesions according to fractional flow reserve (FFR) grade using Korean FFR registry data. Among 1,294 patients and 1,628 lesions in Korean FFR registry, 665 patients with 781 deferred lesions were included in this study. All participants were consecutively categorized into 4 groups according to FFR; group 1: ≥ 0.96 (n = 56), group 2: 0.86–0.95 (n = 330), group 3: 0.81–0.85 (n = 170), and group 4: ≤ 0.80 (n = 99). Primary endpoint was major adverse cardiac events (MACE), a composite of all-cause death, myocardial infarction, and target vessel revascularization. The median follow-up period was 2.1 years. During follow-up, the incidence of MACE in groups 1–4 was 1.8%, 7.6%, 8.8%, and 13.1%, respectively. Compared to group 1, the cumulative rate by Kaplan-Meier analysis of MACE was not different for groups 2 and 3. However, group 4 had higher cumulative rate of MACE compared to group 1 (log-rank <I>P</I> = 0.013). In the multivariate Cox hazard models, only FFR (hazard ratio [HR], 0.95; <I>P</I> = 0.005) was independently associated with MACE among all participants. In contrast, previous history of percutaneous coronary intervention (HR, 2.37; <I>P</I> = 0.023) and diagnosis of acute coronary syndrome (ACS) (HR, 2.35; <I>P</I> = 0.015), but not FFR, were independent predictors for MACE in subjects with non-ischemic (FFR ≥ 0.81) deferred coronary lesions. Compared to subjects with ischemic deferred lesions, clinical outcomes in subjects with non-ischemic deferred lesions according to functional severity are favorable. However, longer-term follow-up may be necessary.</P>
Cho, Jung Sun,Jeong, Myung Ho,Sim, Doo Sun,Hong, Young Joon,Lim, Kyung Seob,Kim, Jung Ha,Kim, Hyoung Doo,Baek, Ju Yeal,Yoon, Hee Jeoung,Her, Sung-Ho,Jin, Seung Won,Kim, Ju Han,Ahn, Youngkeun,Cho, Jeon The Korean Academy of Medical Sciences 2010 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.25 No.5
<P>The aim of this study was to examine the anti-proliferative and anti-inflammatory effects of ezetimibe/simvastatin (E/S) after drug-eluting stent (DES) implantation in a porcine coronary restenosis model. Pigs were randomized into two groups in which the coronary arteries (23 pigs) had DES. Stents were deployed with oversizing (stent/artery ratio 1.3:1) in porcine coronary arteries. Fifteen pigs were taken 10/20 mg of E/S and eight pigs were not taken E/S. Histopathologic analysis was assessed at 28 days after stenting. In neointima, most inflammatory cells were lymphohistiocytes. Lymphohistiocyte count was not different between two groups (337±227 vs. 443±366 cells, <I>P</I>=0.292), but neointima area was significantly smaller (1.00±0.49 mm<SUP>2</SUP> vs. 1.69±0.98 mm<SUP>2</SUP>, <I>P</I>=0.021) and percent area stenosis was significantly lower (23.3±10% vs. 39±19%, <I>P</I>=0.007) in E/S group compared with control group. There were no significant differences in fibrin score (1.99±0.79 vs. 1.81±0.88, <I>P</I>=0.49), endothelial score (1.75±0.66 vs. 1.80±0.59, <I>P</I>=0.79), and the percent of endothelium covered lumen (43±21% vs. 45±21%, <I>P</I>=0.84) between E/S group and control group. Combined therapy with ezetimibe and simvastatin inhibits neointimal hyperplasia, but does not inhibit inflammatory infiltration and arterial healing after DES implantation in a porcine coronary restenosis model.</P>
Cho, Yong Jae,Im, Hyung Soon,Myung, Yoon,Kim, Chang Hyun,Kim, Han Sung,Back, Seung Hyuk,Lim, Young Rok,Jung, Chan Su,Jang, Dong Myung,Park, Jeunghee,Cha, Eun Hee,Choo, Sung Ho,Song, Min Seob,Cho, Won The Royal Society of Chemistry 2013 Chemical communications Vol.49 No.41
<P>Germanium sulfide (GeS and GeS<SUB>2</SUB>) nanoparticles were synthesized by novel gas-phase laser photolysis and subsequent thermal annealing. They showed excellent cycling performance for lithium ion batteries, with a maximum capacity of 1010 mA h g<SUP>−1</SUP> after 100 cycles. Metastable tetragonal phase Ge nanoparticles were suggested as active materials for a reversible lithium insertion–extraction process.</P> <P>Graphic Abstract</P><P>Novel gas-phase photolysis produces germanium sulfide(<SMALL>II</SMALL> and <SMALL>IV</SMALL>) nanoparticles as excellent anode materials of lithium ion batteries. <IMG SRC='http://pubs.rsc.org/services/images/RSCpubs.ePlatform.Service.FreeContent.ImageService.svc/ImageService/image/GA?id=c3cc41853g'> </P>
Role of the rice hexokinases OsHXK5 and OsHXK6 as glucose sensors.
Cho, Jung-Il,Ryoo, Nayeon,Eom, Joon-Seob,Lee, Dae-Woo,Kim, Hyun-Bi,Jeong, Seok-Won,Lee, Youn-Hyung,Kwon, Yong-Kook,Cho, Man-Ho,Bhoo, Seong Hee,Hahn, Tae-Ryong,Park, Youn-Il,Hwang, Ildoo,Sheen, Jen,Jeo American Society of Plant Physiologists 2009 Plant Physiology Vol.149 No.2
<P>The Arabidopsis (Arabidopsis thaliana) hexokinase 1 (AtHXK1) is recognized as an important glucose (Glc) sensor. However, the function of hexokinases as Glc sensors has not been clearly demonstrated in other plant species, including rice (Oryza sativa). To investigate the functions of rice hexokinase isoforms, we characterized OsHXK5 and OsHXK6, which are evolutionarily related to AtHXK1. Transient expression analyses using GFP fusion constructs revealed that OsHXK5 and OsHXK6 are associated with mitochondria. Interestingly, the OsHXK5DeltamTP-GFP and OsHXK6DeltamTP-GFP fusion proteins, which lack N-terminal mitochondrial targeting peptides, were present mainly in the nucleus with a small amount of the proteins seen in the cytosol. In addition, the OsHXK5NLS-GFP and OsHXK6NLS-GFP fusion proteins harboring nuclear localization signals were targeted predominantly in the nucleus, suggesting that these OsHXKs retain a dual-targeting ability to mitochondria and nuclei. In transient expression assays using promoterluciferase fusion constructs, these two OsHXKs and their catalytically inactive alleles dramatically enhanced the Glc-dependent repression of the maize (Zea mays) Rubisco small subunit (RbcS) and rice alpha-amylase genes in mesophyll protoplasts of maize and rice. Notably, the expression of OsHXK5, OsHXK6, or their mutant alleles complemented the Arabidopsis glucose insensitive2-1 mutant, thereby resulting in wild-type characteristics in seedling development, Glc-dependent gene expression, and plant growth. Furthermore, transgenic rice plants overexpressing OsHXK5 or OsHXK6 exhibited hypersensitive plant growth retardation and enhanced repression of the photosynthetic gene RbcS in response to Glc treatment. These results provide evidence that rice OsHXK5 and OsHXK6 can function as Glc sensors.</P>
( Cho-rong Kim ),( Sung-jin Choi ),( Won-seob Shin ) 대한물리치료학회 2013 대한물리치료학회지 Vol.25 No.6
Purpose: The purpose of this study was to compare muscle activation patterns of lower extremities in stroke patients during stepper climbing, stair-up, and level-ground gait conditions by surface electromyography (EMG). Methods: Subjects included 19 hemiplegic patients comprehensive rehabilitation center for inpatients with stroke. Surface EMG was used to measure the subjects` medial gastrocnemius (GCM), tibialis anterior (TA), biceps femoris (BF), and rectus femoris (RF) activity as they took six steps during stepper climbing, stair-up, and level-ground gait conditions. Results: There was no significant difference in the BF or RF muscle activity for the stepper climbing, stair-up, and level-ground gait conditions. However, there were significant differences in the medial GCM and TA muscle activity between each condition on the patients` hemiplegic side(p<0.05). There was significant difference in the medial GCM, TA, RF, and BF muscle activity between each condition on the patients` non-hemiplegic side (p<0.05). Conclusion: As a result, the overall muscle activity during the level-ground gait was higher than the stair-up condition, and the muscle activity during the stair-up condition was higher than the muscle activity during the stepper climbing condition. As one of the many methods used for gait training, we suggest that the stepper exercise could be applied at an earlier stage in the gait training process.
( Hyoung Seob Park ),( Hyung Seop Kim ),( Ji Hyun Sohn ),( Hong Won Shin ),( Yun Kyeong Cho ),( Hyuck Jun Yoon ),( Chang Wook Nam ),( Seung Ho Hur ),( Yoon Nyun Kim ),( Kwon Bae Kim ),( Hee Joon Park 대한내과학회 2010 The Korean Journal of Internal Medicine Vol.25 No.3
Background/Aims: In patients with heart failure (HF), N-terminal prohormone brain natriuretic peptide (NT-ProBNP) is a standard prognostic indicator. In addition, uric acid (UA) was recently established as a prognostic marker for poor outcome in chronic HF. The aim of this study was to determine the combined role of UA and NT-ProBNP as prognostic markers for short-term outcomes of acute heart failure (AHF). Methods: The levels of UA and NT-ProBNP were determined in 193 patients (age, 69±13 years; 76 males) admitted with AHF. Patients were followed for 3 months and evaluated for cardiovascular events, defined as cardiac death and/or readmission for HF. Results: Of the 193 patients, 23 (11.9%) died and 20 (10.4%) were readmitted for HF during the 3-month followup period. Based on univariate analysis, possible predictors of short-term cardiovascular events were high levels of UA and NT-ProBNP, low creatinine clearance, no angiotensin converting enzyme inhibitors or angiotensin receptor blockers, and old age. Multivariate Cox hazard analysis showed that UA levels were independently associated with increased incidence of cardiovascular events (hazard ratio, 1.115; 95% confidence interval, 1.006 to 1.235; p=0.037). Kaplan-Meier survival analysis revealed that patients with UA levels >8.0 mg/dL and NT-ProBNP levels >4,210 pg/mL were at highest risk for cardiac events (p=0.01). Conclusions: The combination of UA and NT-ProBNP levels appears to be more useful than either marker alone as an independent predictor for short-term outcomes in patients with AHF. (Korean J Intern Med 2010; 25:253-259)