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Role and Clinical Importance of Progressive Changes in Echocardiographic Parameters in Predicting Outcomes in Patients With Hypertrophic Cardiomyopathy

  • Kyehwan Kim;Seung Do Lee;Hyo Jin Lee;Hangyul Kim;Hye Ree Kim;Yun Ho Cho;Jeong Yoon Jang;Min Gyu Kang;Jin-Sin Koh;Seok-Jae Hwang;Jin-Yong Hwang;Jeong Rang Park
    • Journal of Cardiovascular Imaging
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    • 제31권2호
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    • pp.85-95
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    • 2023
  • BACKGROUND: The prognostic utility of follow-up transthoracic echocardiography (FU-TTE) in patients with hypertrophic cardiomyopathy (HCM) is unclear, specifically in terms of whether changes in echocardiographic parameters in routine FU-TTE parameters are associated with cardiovascular outcomes. METHODS: From 2010 to 2017, 162 patients with HCM were retrospectively enrolled in this study. Using echocardiography, HCM was diagnosed based on morphological criteria. Patients with other diseases that cause cardiac hypertrophy were excluded. TTE parameters at baseline and FU were analyzed. FU-TTE was designated as the last recorded value in patients who did not develop any cardiovascular event or the latest exam before event development. Clinical outcomes were acute heart failure, cardiac death, arrhythmia, ischemic stroke, and cardiogenic syncope. RESULTS: Median interval between the baseline TTE and FU-TTE was 3.3 years. Median clinical FU duration was 4.7 years. Septal trans-mitral velocity/mitral annular tissue Doppler velocity (E/e'), tricuspid regurgitation velocity, left ventricular ejection fraction (LVEF), and left atrial volume index (LAVI) at baseline were recorded. LVEF, LAVI, and E/e' values were associated with poor outcomes. However, no delta values predicted HCM-related cardiovascular outcomes. Logistic regression models incorporating changes in TTE parameters had no significant findings. Baseline LAVI was the best predictor of a poor prognosis. In survival analysis, an already enlarged or increased size LAVI was associated with poorer clinical outcomes. CONCLUSIONS: Changes in echocardiographic parameters extracted from TTE did not assist in predicting clinical outcomes. Cross-sectionally evaluated TTE parameters were superior to changes in TTE parameters between baseline and FU at predicting cardiovascular events.

Cordycepin Enhanced Therapeutic Potential of Gemcitabine against Cholangiocarcinoma via Downregulating Cancer Stem-Like Properties

  • Hong Kyu Lee;Yun-Jung Na;Su-Min Seong;Dohee Ahn;Kyung-Chul Choi
    • Biomolecules & Therapeutics
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    • 제32권3호
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    • pp.368-378
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    • 2024
  • Cordycepin, a valuable bioactive component isolated from Cordyceps militaris, has been reported to possess anti-cancer potential and the property to enhance the effects of chemotherapeutic agents in various types of cancers. However, the ability of cordycepin to chemosensitize cholangiocarcinoma (CCA) cells to gemcitabine has not yet been evaluated. The current study was performed to evaluate the above, and the mechanisms associated with it. The study analyzed the effects of cordycepin in combination with gemcitabine on the cancer stem-like properties of the CCA SNU478 cell line, including its anti-apoptotic, migratory, and antioxidant effects. In addition, the combination of cordycepin and gemcitabine was evaluated in the CCA xenograft model. The cordycepin treatment significantly decreased SNU478 cell viability and, in combination with gemcitabine, additively reduced cell viability. The cordycepin and gemcitabine co-treatment significantly increased the Annexin V+ population and downregulated B-cell lymphoma 2 (Bcl-2) expression, suggesting that the decreased cell viability in the cordycepin+gemcitabine group may result from an increase in apoptotic death. In addition, the cordycepin and gemcitabine co-treatment significantly reduced the migratory ability of SNU478 cells in the wound healing and trans-well migration assays. It was observed that the cordycepin and gemcitabine cotreatment reduced the CD44highCD133high population in SNU478 cells and the expression level of sex determining region Y-box 2 (Sox-2), indicating the downregulation of the cancer stem-like population. Cordycepin also enhanced oxidative damage mediated by gemcitabine in MitoSOX staining associated with the upregulated Kelch like ECH Associated Protein 1 (Keap1)/nuclear factor erythroid 2-related factor 2 (Nrf2) expression ratio. In the SNU478 xenograft model, co-administration of cordycepin and gemcitabine additively delayed tumor growth. These results indicate that cordycepin potentiates the chemotherapeutic property of gemcitabine against CCA, which results from the downregulation of its cancer-stem-like properties. Hence, the combination therapy of cordycepin and gemcitabine may be a promising therapeutic strategy in the treatment of CCA.

Diffuse Leptomeningeal Glioneuronal Tumor with FGFR1 Mutation in a 29-Year-Old Male (29세 남성에서 발생한 FGFR1 돌연변이를 동반한 미만성 연수막성 신경교종)

  • Minsu Kim;Ki Rim Lee;Gheeyoung Choe;Kihwan Hwang;Jae Hyoung Kim
    • Journal of the Korean Society of Radiology
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    • 제84권4호
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    • pp.970-976
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    • 2023
  • This study reports on diffuse leptomeningeal glioneuronal tumor (DL-GNT) in a 29- year-old male. DL-GNT is a rare central nervous system (CNS) tumor mostly seen in children and only few cases have been reported in adult patients. Our patient presented with a chronic headache that lasted for five months. MR imaging showed mild hydrocephalus, multiple rim-enhancing nodular lesions in the suprasellar cistern, diffuse leptomeningeal enhancement in the lumbosacral area, and multiple small non-enhancing cyst-appearing lesions not suppressed on fluid attenuated inversion recovery (FLAIR) images in the bilateral basal ganglia, thalami, and cerebral hemispheres. Under the impression of germ cell tumor with leptomeningeal seeding, the patient underwent trans-sphenoidal tumor removal. DL-GNT was pathologically confirmed and FGFR1 mutation was detected through a next-generation sequencing test. In conclusion, a combination of leptomeningeal enhancement and multiple parenchymal non-enhancing cyst-appearing lesions not suppressed on FLAIR images may be helpful for differential diagnosis despite overlapping imaging features with many other CNS diseases that have leptomeningeal enhancement.

Long-Term Clinical Outcomes of Iliac Artery Endovascular Therapy in the Korean Vascular Intervention Society Endovascular Therapy in Lower Limb Artery Diseases (K-VIS ELLA) Registry

  • Ji Woong Roh;Sanghoon Shin;Young-Guk Ko;Nak-Hoon Son;Chul-Min Ahn;Pil-Ki Min;Jae-Hwan Lee;Chang-Hwan Yoon;Cheol Woong Yu;Seung Whan Lee;Sang-Rok Lee;Seung Hyuk Choi;In-Ho Chae;Donghoon Choi
    • Korean Circulation Journal
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    • 제52권7호
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    • pp.529-540
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    • 2022
  • Background and Objectives: Limited data are available regarding long-term clinical outcomes of iliac artery endovascular therapy (EVT) in real-world practice. This study investigated long-term outcomes according to Trans-Atlantic Inter-Society Consensus (TASC) classifications. Methods: We analyzed data from 1,705 limbs of 1,364 patients from the retrospective cohort of the multicenter Korean Vascular Intervention Society Endovascular Therapy in Lower Limb Artery Disease registry. The primary endpoint was target lesion revascularization (TLR)-free survival. Results: TASC A, B, C, and D lesions were present in 19.4%, 26.2%, 28.7%, and 25.7% of the treated limbs, respectively. The technical success rate was 96.2% and did not differ between TASC lesion types. Complications occurred in 6.8% of cases and more occurred in TASC D (11.8%). Iliac artery EVT showed a 5-year TLR-free survival of 89.2%. The TASC D group had the lowest TLR-free rate of 79.3%. TASC D (hazard ratio [HR], 1.75; 95% confidence interval [CI], 1.12-2.73; p=0.014), plain old balloon angioplasty (HR, 4.25; 95% CI, 2.03-8.88; p<0.001), current smoker (HR, 1.89; 95% CI, 1.26-2.83; p=0.002), previous bypass surgery (HR, 3.04; 95% CI, 1.28-7.19; p=0.011), combined femoropopliteal treatment (HR, 4.89; 95% CI, 3.19-7.50; p<0.001), combined below the knee treatment (HR, 2.20; 95% CI, 1.25-3.89; p=0.007), and complications (HR, 1.86; 95% CI, 1.07-3.24; p=0.028) were predictors for TLR. Conclusions: Iliac artery EVT achieved excellent technical success and 5-year TLR-free survival. TASC D showed a favorable but lower 5-year TLR-free survival rate and higher complication rate compared with other TASC groups.

Comparison of endoscopic ultrasound-guided drainage and percutaneous catheter drainage of postoperative fluid collection after pancreaticoduodenectomy

  • Da Hee Woo;Jae Hoon Lee;Ye Jong Park;Woo Hyung Lee;Ki Byung Song;Dae Wook Hwang;Song Cheol Kim
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • 제26권4호
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    • pp.355-362
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    • 2022
  • Backgrounds/Aims: Postoperative fluid collection is a common complication of pancreatic resection without clear management guidelines. This study aimed to compare outcomes of endoscopic ultrasound (EUS)-guided trans-gastric drainage and percutaneous catheter drainage (PCD) in patients who experienced this adverse event after pancreaticoduodenectomy (PD). Methods: Demographic and clinical data and intervention outcomes of 53 patients who underwent drainage procedure (EUS-guided, n = 32; PCD, n = 21) for fluid collection after PD between January 2015 and June 2019 in our tertiary referral center were retrospectively analyzed. Results: Prior to drainage, 83.0% had leukocytosis and 92.5% presented with one or more of the following signs or symptoms: fever (69.8%), abdominal pain (69.8%), and nausea/vomiting (17.0%). Within 8 weeks of drainage, 77.4% showed a diameter decrease of more than 50% (87.5% in EUS vs. 66.7% in PCD, p = 0.09). Post-procedural intravenous antibiotics were used for an average of 8.1 ± 4.3 days and 12.4 ± 7.4 days for EUS group and PCD group, respectively (p = 0.01). The EUS group had a shorter post-procedural hospital stay than the PCD group (9.8 ± 1.1 vs. 15.8 ± 2.2 days, p < 0.01). However, the two groups showed no statistically significant difference in technical or clinical success rate, reintervention rate, or adverse event rate. Conclusions: EUS-guided drainage and PCD are both safe and effective methods for managing fluid collection after PD. However, EUS-guided drainage can shorten hospital stay and duration of intravenous antibiotics use.

Effects of the Brown Seaweed Residues Supplementation on In Vitro Fermentation and Milk Production and Composition of Lactating Dairy Cows (미역부산물 첨가가 In Vitro 발효성상과 젖소의 산유량 및 유성분에 미치는 영향)

  • Baek, I.K.;Maeng, W.J.;Lee, S.H.;Lee, H.G.;Lee, S.R.;Ha, J.K.;Lee, S.S.;Hwang, J.H.
    • Journal of Animal Science and Technology
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    • 제46권3호
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    • pp.373-386
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    • 2004
  • This study was conducted to investigate effects of the brown seaweed residues supplementation on in vitro fermentation, and milk yield and milk composition of dairy cows. Therefore, two experiments consisting of an in vitro and an in vivo growth trial were used. In in vitro experiment, brown seaweed residues(BSR) was supplemented in basal diet with 0, 1, 2 and 4% respectively, and incubated for 3, 6, 9, 12, and 24 h. The pH value, ammonia-N and VFA were investigated. The pH value tended to increase with increasing BSR during the incubation. Particularly, pH was significantly higher in BSR treatments compared with control at 9 h(p < 0.05). While, ammonia-N concentration was not significantly different across treatments during the whole incubation. BSR supplementation did not affect total VFA production, but acetate was linearly increased in BSR treatments compared with control at 12 h(p < 0.05), and its concentration was highest(92.70 mM) in 4% BSR among treatments. The concentration of iso-butyrate tended to increase in BSR treatments in comparison to control during the incubation. In addition, the concentration of iso-valerate was higher in BSR treatments compared with control at 12 and 24 h. In growth trial, BSR was added(800 g/d/animaI) to diets of dairy cow. Dry matter intake was not affected by BSR supplementation, but daily milk yield(kg) significantly increased in BSR treatment compared with control(p < 0.05). However, milk composition(%) and milk yield(kg) were not significantly different between treatments. Milk fat(% and kg/d) tended to slightly decrease in BSR treatment compared with control(3.59% and 1.06 kg/d vs. 3.32% and 1.01 kg/d), The contents of C16:0 and C20:4 in milk significantly increased in BSR treatment compared with control reflecting from dietary fatty acid composition. The content of C18:0 in milk which is end product of biohydrogenation of CI8 unsaturated fatty acids in the rumen significantly increased in BSR treatment compared with control(p < 0.05). C18:2 content in milk tended to decrease, but tended to increase trans-II C18:l and CLA contents in milk in BSR treatment compared with control. In conclusion, it could be summarized that BSR may stabilize rumen pH, and it could improve milk yield and CIA content in milk with more than 4% of diet. Therefore, BSR could be beneficially used in dairy diets as a feed additive.

Effects of Hysteroscopic Septotomy on Pregnancy in Patients with History of Infertility or Recurrent Spontaneous Abortion (불임 또는 습관성 유산 환자에서 중격자궁의 치료가 임신에 미치는 영향)

  • Koo, Hwa-Seon;Cha, Sun-Hwa;Yang, Kwang-Moon;Bae, Ju-Youn;Ahn, Hyun-Suk;Han, Ae-Ra;Park, Chan-Woo;Kang, Inn-Soo;Koong, Mi-Kyoung;Lee, Kyung-Sang
    • Clinical and Experimental Reproductive Medicine
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    • 제37권4호
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    • pp.361-368
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    • 2010
  • Objective: The aim of this study was to evaluate the influences of uterine septum and their elimination on the reproductive outcomes in women who have history of recurrent spontaneous abortion (RSA) and/or infertility. Methods: The medical records of reproductive outcomes in patients who have had history of RSA and infertility who were diagnosed with uterine septum only by hysterosalpingogram (HSG) between January 2008 and December 2009 were retrospectively analyzed. The subjects who have had severe male factor, tubal factors, other uterine factors, endocrine abnormalities, peritoneal factors, and abnormal karyotyping among both partners were excluded. In 27 patients, confirmation of diagnosis by laparoscopy and elimination of uterine septum by trans-vaginal hysteroscopy was done. Seventeen patients were strongly suspected to uterine septum on HSG but tried to get pregnancy without any other procedure for evaluation and management of uterine anomaly. Age matched 42 patients who have history of RSA and/or infertility and diagnosed to normal HSG finding at same period were randomly selected as control. The medical records of reproductive outcomes were analyzed and compared between groups. Results: The mean time of observation after diagnosis was 21.8 months (10 to 32). 55.6% (15/27) of patients in patients who received trans-vaginal hysteroscopic uterine septotomy were success to get pregnancies and was significantly higher than that of 17 patients who did not receive proper management (23.5%, 4/17, p<0.05). In control population, 40.5% (17/42) were success to pregnancies and the differences were not statistically significant compared to both two study groups. The live birth rate which was excluded pregnancy loss by abnormal fetal karyotyping and congenital anomaly were 75% (9/12) in treated septated uterus group and 84.6% (11/13) in control group each which have no statistically significant different. In patients with septated uterus who did not receive proper management showed lower delivery rate (50%, 2/4) than that of other groups but was not statistically significant. Conclusion: According to present data, women with a uterine septum have an increased chance of successful pregnancy with improved obstetric outcome after proper management of the uterine cavity. And these results were showed in patients with no regard to their reproductive history. But, in case of failed to receive proper management, uterine septum can affect not only pregnancy ongoing but successful pregnancy too.

A 10b 250MS/s $1.8mm^2$ 85mW 0.13um CMOS ADC Based on High-Accuracy Integrated Capacitors (높은 정확도를 가진 집적 커페시터 기반의 10비트 250MS/s $1.8mm^2$ 85mW 0.13un CMOS A/D 변환기)

  • Sa, Doo-Hwan;Choi, Hee-Cheol;Kim, Young-Lok;Lee, Seung-Hoon
    • Journal of the Institute of Electronics Engineers of Korea SD
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    • 제43권11호
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    • pp.58-68
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    • 2006
  • This work proposes a 10b 250MS/s $1.8mm^2$ 85mW 0.13um CMOS A/D Converter (ADC) for high-performance integrated systems such as next-generation DTV and WLAN simultaneously requiring low voltage, low power, and small area at high speed. The proposed 3-stage pipeline ADC minimizes chip area and power dissipation at the target resolution and sampling rate. The input SHA maintains 10b resolution with either gate-bootstrapped sampling switches or nominal CMOS sampling switches. The SHA and two MDACs based on a conventional 2-stage amplifier employ optimized trans-conductance ratios of two amplifier stages to achieve the required DC gain, bandwidth, and phase margin. The proposed signal insensitive 3-D fully symmetric capacitor layout reduces the device mismatch of two MDACs. The low-noise on-chip current and voltage references can choose optional off-chip voltage references. The prototype ADC is implemented in a 0.13um 1P8M CMOS process. The measured DNL and INL are within 0.24LSB and 0.35LSB while the ADC shows a maximum SNDR of 54dB and 48dB and a maximum SFDR of 67dB and 61dB at 200MS/s and 250MS/s, respectively. The ADC with an active die area of $1.8mm^2$ consumes 85mW at 250MS/s at a 1.2V supply.

Study on the Whitening Efficacy and Skin Barrier by Lysosome-related Organelle Extract (LOE) from Egg White (난백(Egg White)에서 추출한 리소좀 추출물(LOE)의 미백 효능 및 피부장벽에 관한 연구)

  • Choi, Da Hee;Jeon, Gyeongchan;Yoon, Jihee;Min, Jiho;Park, Si Jun;Kim, Jung Su;Hwang, Ee Taek;Hwang, Hyung Seo
    • Journal of the Society of Cosmetic Scientists of Korea
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    • 제45권4호
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    • pp.389-397
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    • 2019
  • Lysosomes are cellular organelles involved in energy metabolism and intracellular digestion in eukaryotic cells, including protease, nuclease, glycosidase, lipase, and phosphatase. Our previous studies have confirmed that egg white lysosomes had melanin decolorization and reduction activity. However, there have been few studies on skin barrier and skin regeneration as well as inhibition of melanin production by egg white lysosomes on B16F10 melanocyte cell line. In this study, we attempted to identify the effect of lysosome-related organelle extract (LOE) extracted from egg white on the melanin content change and skin barrier enhancement in cells. First, cytotoxicity evaluation was performed on B16F10 melanocyte cell line to confirm the whitening efficacy of LOE. Cytotoxicity by LOE was not observed at 20 mg/mL concentration, but cytotoxicity was observed at 40 mg/mL, and the maximum concentration value was set to 20 mg/mL in all subsequent experiments. LOE samples of 5, 10, 20 mg/mL inhibited melanin production by 61.5 ± 4.0%, 61.4 ± 7.3%, 58.3 ± 8.3%, respectivly, compared to α-MSH, a negative control in melanin contents assay. MITF mRNA expression was reduced by about 39.7 ± 3.2% compared to the α-MSH treatment group. TEER assay using HaCaT showed that LOE increased TEER resistance in a dose-dependent manner, indicating that LOE is involved in strengthening the skin barrier. LOE also increased the TEER resistance under TNF-α treatment. Skin barrier was normally restored by LOE even under the condition of inflammation. LOE had a positive effect on cell division and cell migration promotion, confirmed by the observing the effect of promoting cell migration by LOE through cell migration assay. Taken together, we expect that LOE can be developed as a cosmetic material to enhance has effects on skin regeneration and skin barrier strengthening as well as whitening function if enzyme stabilization and formulation technology are combined.

RADIOLOGICAL STUDY OF THE CONDYLAR HEADS IN TEMPOROMANDIBULAR JOINT ARTHROSIS (악관절증에서의 하악과두의 방사선학적 소견)

  • You Dong Soo
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • 제15권1호
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    • pp.13-20
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    • 1985
  • The author obtained the oblique lateral trans cranial radiograms from 376 patients (114 of male, and 262 of female) with temporomandibular joint arthrosis. After tracing each film, the author analyzed the dimensional changes of the condylar heads with pain, clicking, mouth opening limitation, and masticatory difficulty respectively, which were the chief complaints of the TMJ arthrosis and compared these data with control group. The results were as follows; 1. There was a great predilection for occurrence of the TMJ arthrosis in female (262 cases) over male (114 cases). But there was no significant difference in ratio between the sexes on each symptom. In male, 60 patients (52.6%) had pain, 28 patients (24.6%) had clicking, 21 patients (18.4%) had mouth opening limitation, and 5 patients (4.4%) had masticatory difficulty. In female, 148 parients (56.5%) had pain, 57 patients (21.8%) had clicking, 47 patients (17.9%) had mouth opening limitation, and 10 patients (3.8%) had masticatory difficulty. 2. Examined controlled group, the author analyzed the dimension of W-W', 0-H, 0-A, 0-B on the right side first, and left side second. In male, the dimension of W-W' was 14.52㎜, 14.13㎜; 0-H was 13.92㎜, 13. 71㎜' 0-A was 8.91㎜, 9.0㎜ and 0-B was 8.67㎜, 8.78㎜. In female, W-W' was 13.77㎜, 13.51㎜; 0-H was 13.42㎜, 13.35㎜; 0-A was 8.92㎜, 9.01㎜; and 0-B was 8.59㎜, 8.80㎜. 3. W-W' and 0-H of the experimental group were distinctly lesser than the controlled group. Male with mouth opening limitation show the least (12.70㎜, 13.00㎜) on W-W', but both sexes with pain show the least on 0-H. There was no significant difference between experimental group with Clicking and controlled group on 0-H, 0-A, and 0-B. And also there was no difference on 0-B in patients with every symptom except masticatory difficulty. The dimensional changes of the condylar heads with those symptoms were as follows; a) In male patients, complaing of pain, W-W' of the right and left was 13.80㎜, 12.80㎜; 0-H was 13.10㎜, 12.90㎜; 0-A was 8.69㎜, 8.18㎜; 0-B was 8.33㎜, 8.42㎜. In female, W-W' was 13.01㎜, 12.90㎜; 0-H was 12.48㎜, 12.80㎜; 0-A was 8.60㎜, 8.49㎜; 0-B was 8.48㎜, 8.50㎜. b) In male patients with clicking, W-W' was 13.70㎜, 13.10㎜; 0-H was 13.90㎜, 13.10㎜; 0-A was 8.81㎜, 8.16㎜ 0-B was 8.34㎜, 8.25㎜. In female, W-W' was 13.10㎜, 13.50㎜; 0-H was 13.30㎜, 12.91㎜; 0-A was 8.95㎜, 8.49㎜; 0-B was 8.23㎜, 8.70㎜. c) In male patients with mouth opening limitation, W-W' was 12.70㎜, 13.00㎜; 0-H was 13.40㎜, 13.40㎜; 0-A was 8.37㎜, 8.48㎜; 0-B was 8.33㎜, 8.62㎜. In female, W-W' was 13.00㎜, 12.50㎜ 0-H was 12.90㎜, 13.10㎜; 0-A was 8.49㎜, 8.09㎜; 0-B was 8.77㎜, 8.01㎜. d) In male patients with masticatory difficulty, W-W' was 13.30㎜, 13.20㎜; 0-H was 13.40㎜, 12.60㎜; 0-A was 8.26㎜, 8.32㎜; 0-B was 7.80㎜, 8.20㎜. In female, W-W' was 12.30㎜, 12.00㎜; 0-H was 13.10㎜, 13.20㎜; 0-A was 8.68㎜, 7.95㎜; 0-B was 7.46㎜, 7.87㎜.

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