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1.
Sci Rep ; 12(1): 3637, 2022 03 07.
Artigo em Inglês | MEDLINE | ID: mdl-35256626

RESUMO

In ischemic stroke patients undergoing endovascular treatment (EVT), we aimed to test the hypothesis that cerebral microbleeds (CMBs) are associated with clinical outcomes, while estimating the mediating effects of hemorrhagic transformation (HT), small-vessel disease burden (white matter hyperintensities, WMH), and procedural success. From a multicenter EVT registry, patients who underwent pretreatment MR imaging were analyzed. They were trichotomized according to presence of CMBs (none vs. 1-4 vs. ≥ 5). The association between CMB burden and 3-month mRS was evaluated using multivariable ordinal logistic regression, and mediation analyses were conducted to estimate percent mediation. Of 577 patients, CMBs were present in 91 (15.8%); 67 (11.6%) had 1-4 CMBs, and 24 (4.2%) had ≥ 5. Increases in CMBs were associated with hemorrhagic complications (ß = 0.27 [0.06-0.047], p = 0.010) in multivariable analysis. The CMB effect on outcome was partially mediated by post-procedural HT degree (percent mediation, 14% [0-42]), WMH (23% [7-57]) and lower rates of successful reperfusion (6% [0-25]). In conclusion, the influence of CMBs on clinical outcomes is mediated by small-vessel disease burden, post-procedural HT, and lower reperfusion rates, listed in order of percent mediation size.


Assuntos
Hemorragia Cerebral , Acidente Vascular Cerebral , Hemorragia Cerebral/complicações , Humanos , Imageamento por Ressonância Magnética/efeitos adversos , Acidente Vascular Cerebral/complicações , Trombectomia/efeitos adversos , Trombectomia/métodos
2.
Front Neuroinform ; 16: 795171, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35356447

RESUMO

There is a proven correlation between the severity of dementia and reduced brain volumes. Several studies have attempted to use activity data to estimate brain volume as a means of detecting reduction early; however, raw activity data are not directly interpretable and are unstructured, making them challenging to utilize. Furthermore, in the previous research, brain volume estimates were limited to total brain volume and the investigators were unable to detect reductions in specific regions of the brain that are typically used to characterize disease progression. We aimed to evaluate volume prediction of 116 brain regions through activity data obtained combining time-frequency domain- and unsupervised deep learning-based feature extraction methods. We developed a feature extraction model based on unsupervised deep learning using activity data from the National Health and Nutrition Examination Survey (NHANES) dataset (n = 14,482). Then, we applied the model and the time-frequency domain feature extraction method to the activity data of the Biobank Innovations for chronic Cerebrovascular disease With ALZheimer's disease Study (BICWALZS) datasets (n = 177) to extract activity features. Brain volumes were calculated from the brain magnetic resonance imaging of the BICWALZS dataset and anatomically subdivided into 116 regions. Finally, we fitted linear regression models to estimate each regional volume of the 116 brain areas based on the extracted activity features. Regression models were statistically significant for each region, with an average correlation coefficient of 0.990 ± 0.006. In all brain regions, the correlation was > 0.964. Particularly, regions of the temporal lobe that exhibit characteristic atrophy in the early stages of Alzheimer's disease showed the highest correlation (0.995). Through a combined deep learning-time-frequency domain feature extraction method, we could extract activity features based solely on the activity dataset, without including clinical variables. The findings of this study indicate the possibility of using activity data for the detection of neurological disorders such as Alzheimer's disease.

3.
World J Gastroenterol ; 28(8): 840-852, 2022 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-35317100

RESUMO

BACKGROUND: The clinical outcomes of endoscopic submucosal dissection (ESD) for undifferentiated (UD) intramucosal early gastric cancer (EGC) compared with those of surgery, regardless of lesion size, are not well known. Furthermore, there is a concern regarding the treatment plan before and after ESD in cases of UD intramucosal EGC within expanded indications. AIM: To evaluate clinical outcomes of ESD compared with those of surgery in UD intramucosal EGC patients regardless of tumor size. METHODS: We enrolled patients with UD intramucosal EGC after ESD with complete resection or surgery from January 2005 to August 2020 who met the within or beyond expanded indications with lesion size > 2 cm (the only non-curative factor). Overall, 123 and 562 patients underwent ESD and surgery, respectively. After propensity-score matching, clinical and long-term outcomes, i.e., recurrence-free survival (RFS) and overall survival (OS), were analyzed. The multivariable Cox proportional hazard model with treatment modality and ESD indication was used to evaluate the recurrence risk. RESULTS: After matching, 119 patients each were finally enrolled in the ESD and surgery groups. The median length of hospital stay was shorter in the ESD group than surgery group (4.0 vs 9.0 days, P < 0.001). Four cases of recurrence after ESD were local recurrences, all of which occurred within 1 year. Total recurrence was seven (5.9%) and two (1.7%) in the ESD and surgery groups, respectively. No difference was observed between the two groups with respect to OS (P = 0.948). However, the ESD group had inferior RFS compared with the surgery group (P = 0.031). ESD was associated with the risk of recurrence after initial treatment in all enrolled patients (hazard ratio, 5.2; 95% confidence interval: 1.0-25.8, P = 0.045). CONCLUSION: Although OS was similar between the two groups, surveillance endoscopy was important for the ESD than for the surgery group because RFS was inferior and local recurrence was an issue.


Assuntos
Adenocarcinoma , Ressecção Endoscópica de Mucosa , Neoplasias Gástricas , Adenocarcinoma/patologia , Ressecção Endoscópica de Mucosa/efeitos adversos , Humanos , Estudos Retrospectivos , Neoplasias Gástricas/patologia , Resultado do Tratamento
4.
Ann Dermatol ; 34(1): 7-13, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35221589

RESUMO

BACKGROUND: Palmoplantar pustulosis (PPP) is initiated from the acrosyringium. However, it is unclear whether PPP should be considered a distinct entity or should be classified into the spectrum of pustular psoriasis, also known as palmoplantar pustular psoriasis (PPPP). OBJECTIVE: We evaluated the differences in immunohistochemical staining in patients with PPP to determine whether they can be classified into two groups based on psoriatic properties or acrosyringeal properties. METHODS: Nineteen punch biopsy specimens diagnosed with PPP were collected. Antibodies were chosen for identifying the acrosyringeal properties of α-3-nicotine acetylcholine receptors (α-3-nAChR), psoriatic properties of interleukin (IL)-23 and IL-36R, inflammatory cell properties of human cathelicidin antimicrobial peptide 18/LL-37, IL-8, lipocalin-2 (LCN2), and CD3. The degree of staining of the epidermis was evaluated using the ordinal scale (0~3). The principal component analysis was used to derive principal components (PCs) of common variation between the stains, and the two groups were divided using PCs and cluster analysis. RESULTS: Three main PCs explained 64% of the total variance in PPP. PC1 (pustular psoriasis properties) showed a higher correlation with IL-36R. PC2 (acrosyringeal/inflammatory properties) showed a higher correlation with α-3-nAChR, IL-8, LCN2, and CD3. PC3 (psoriasis properties) showed a higher correlation with IL-23. PC1 showed a statistically significant difference (p=0.0284) between the two groups. We identified three PCs associated with the pathomechanisms of PPP. CONCLUSION: Although PC1 showed a statistically significant difference between the two groups, we did not identify differential protein expression related to the pathogenesis between PPP and PPPP.

5.
Sci Rep ; 12(1): 3107, 2022 02 24.
Artigo em Inglês | MEDLINE | ID: mdl-35210536

RESUMO

The incidence of fractures in patients with end-stage kidney disease (ESKD) is high which is associated with high morbidity and mortality. Since fractures are preventable diseases to some extent, epidemiologic studies are needed a lot. The aim of this study is to explore the epidemiology of fractures by modality of kidney replacement therapy (KRT). We performed a retrospective analysis of 52,777 patients dependent on KRT from 2008 to 2017 using the National Health Insurance System of Republic Korea. Fractures were occurred in 8995 (17.04%) of 52,777 patients with ESKD. Hemodialysis and kidney transplant patients had the highest (57.4 per 1000 person-year) and the lowest (25.2 per 1000 person-year) incidence rate, respectively. The two most common fracture sites were the lower limb and upper limb, regardless of KRT modality. The first fractures were about 2.55 ± 2.07 years after KRT initiation, the earliest in Hemodialysis patients. Diabetes mellitus, cerebrovascular disease, chronic lung and liver disease were risk factors of fractures. The use of steroids, anti-osteoporosis medications, and some classes of psychotropics and opioids was associated with an elevated risk. The results of this study inform the understanding of fractures in KRT patients.


Assuntos
Fraturas Ósseas/epidemiologia , Fraturas Ósseas/etiologia , Terapia de Substituição Renal/efeitos adversos , Adulto , Idoso , Feminino , Humanos , Incidência , Falência Renal Crônica/terapia , Transplante de Rim , Masculino , Pessoa de Meia-Idade , Diálise Renal , República da Coreia/epidemiologia , Estudos Retrospectivos , Fatores de Risco
6.
Sci Rep ; 12(1): 2538, 2022 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-35169195

RESUMO

The aim of the current study was to evaluate the association between changes in non-alcoholic fatty liver disease (NAFLD) over time and risk of incident diabetes mellitus (DM). In total, 3047 subjects without underlying DM were followed up for 14 years from the Anseong-Ansan cohort. NAFLD status was determined biennially using the hepatic steatosis index (HSI), and subjects were clustered into seven groups according to changes in HSI, body mass index (BMI), and homeostatic model assessment of insulin resistance (HOMA-IR): none, persistent, transient, transient resolved, resolved, incident, and recurrent NAFLD (Groups 1-7, respectively). Predictive abilities were compared between the dynamics of HSI and single time points. Regarding the changes in HSI, the risk of incident DM was highest in Group 2 (hazard ratio [HR] 2.710; P < 0.001), followed by Groups 7 (HR 2.062; P < 0.001) and 3 (HR 1.559; P = 0.027). The predictive ability for DM was powerful in order of HOMA-IR, HSI and BMI. The dynamics of NAFLD were less predictive of incident DM than single time-point NAFLD. In conclusion, NAFLD is more useful than BMI in predicting incident DM. However, NAFLD status at single time points can better predict incident DM than dynamic changes in HSI.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Adulto , Índice de Massa Corporal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco
7.
Kidney Res Clin Pract ; 41(2): 231-241, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34974656

RESUMO

BACKGROUND: The limited literature on mental illness in end-stage kidney disease (ESKD) patients suggests that this disease is common and burdensome but underrecognized in clinical practice. This study aimed to analyze the prevalence of mental illness in ESKD patients. METHODS: We assessed the prevalence and patterns of mental illnesses in a nationwide cohort of patients diagnosed with ESKD between January 1, 2008, and December 31, 2017. The risk of mental illness was evaluated using a multivariable Cox proportional hazards model. RESULTS: A total of 70,079 patients met all study inclusion criteria. A total of 28.3% of patients had mental illness, and the specific distribution was as follows: depression, 16.8%; anxiety, 20.0%; somatoform/conversion disorder, 0.9%; stress reaction/adjustment disorder, 2.5%; and substance abuse disorder, 0.6%. The frequency of mental illness was highest in patients on hemodialysis (HD), followed by patients on peritoneal dialysis (PD) and kidney transplant (KT) patients. The peak rate of mental illness in HD and PD patients was reached 1 to 2 years after renal replacement therapy initiation, but the peak rate of most mental illnesses in KT patients occurred before surgery. The prevalence of depression was 2.19 times higher in HD patients and 1.97 times higher in PD patients than in KT patients. CONCLUSION: ESKD patients are at high risk of mental illness, and the prevalence of mental illness is highest in HD patients. Since the onset of mental illness occurs around the initiation of renal replacement therapy, clinicians need to pay attention to mental illness when treating ESKD patients.

8.
Neuroimage ; 249: 118894, 2022 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-35007717

RESUMO

Ample studies have reported a strong association between emotion and subcortical volumes; still, the underlying mechanism regarding this relation remains unclear. Using a twin design, the current study aimed to explore the intrinsic association between emotion and subcortical volumes by examining their phenotypic, genetic, and environmental correlations. We used a group dataset of 960 individuals from the Human Connectome Project (234 monozygotic twins, 145 dizygotic twins, 581 not twins, males = 454, age = 22-37 years). We found that both emotion and subcortical volumes were heritable. Of the 17 emotional traits, 13 were significantly phenotypically correlated with the volumes of multiple subcortical regions. There was no environmental correlation between emotion and subcortical volumes; however, we found a genetic overlap between overall emotional traits and caudate volume. Taken together, our results showed that emotion and subcortical volumes were heritable and closely related. Although the caudate has been often studied with execution of movement, given that the caudate volume is genetically associated with diverse emotional domains, such as negative affect, psychological well-being, and social relationships, it may suggest that the caudate volume might also be an important factor when studying the brain basis of emotion.


Assuntos
Núcleo Caudado/anatomia & histologia , Emoções/fisiologia , Fenômenos Genéticos/fisiologia , Satisfação Pessoal , Personalidade/genética , Interação Social , Adulto , Núcleo Caudado/diagnóstico por imagem , Feminino , Humanos , Masculino , Adulto Jovem
9.
Psychiatry Investig ; 19(2): 100-109, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35042283

RESUMO

OBJECTIVE: We aimed to present the study design and baseline cross-sectional participant characteristics of biobank innovations for chronic cerebrovascular disease with Alzheimer's disease study (BICWALZS) participants. METHODS: A total of 1,013 participants were enrolled in BICWALZS from October 2016 to December 2020. All participants underwent clinical assessments, basic blood tests, and standardized neuropsychological tests (n=1,013). We performed brain magnetic resonance imaging (MRI, n=817), brain amyloid positron emission tomography (PET, n=713), single nucleotide polymorphism microarray chip (K-Chip, n=949), locomotor activity assessment (actigraphy, n=200), and patient-derived dermal fibroblast sampling (n=175) on a subset of participants. RESULTS: The mean age was 72.8 years, and 658 (65.0%) were females. Based on clinical assessments, total of 168, 534, 211, 80, and 20 had subjective cognitive decline, mild cognitive impairment (MCI), Alzheimer's dementia, vascular dementia, and other types of dementia or not otherwise specified, respectively. Based on neuroimaging biomarkers and cognition, 199, 159, 78, and 204 were cognitively normal (CN), Alzheimer's disease (AD)-related cognitive impairment, vascular cognitive impairment, and not otherwise specified due to mixed pathology (NOS). Each group exhibited many differences in various clinical, neuropsychological, and neuroimaging results at baseline. Baseline characteristics of BICWALZS participants in the MCI, AD, and vascular dementia groups were generally acceptable and consistent with 26 worldwide dementia cohorts and another independent AD cohort in Korea. CONCLUSION: The BICWALZS is a prospective and longitudinal study assessing various clinical and biomarker characteristics in older adults with cognitive complaints. Details of the recruitment process, methodology, and baseline assessment results are described in this paper.

10.
Korean J Intern Med ; 37(2): 460-467, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32872748

RESUMO

BACKGROUND/AIMS: Using a nationwide cohort, we investigated the cancer risk in Korean patients with gout. METHODS: Data were obtained from the Korean National Health Insurance Service Database. Patients with gout were defined as those aged ≥ 20 years who were diagnosed with gout and received anti-gout medication (allopurinol, colchicine, and benzbromarone) between 2008 and 2010. Patients with nail disorders were randomly assigned to a control group (1:1 ratio) after frequency matching for age and sex. Cancer incidence was then investigated between 2012 and 2018. Cox proportional hazard regression analysis was used to investigate the association between gout and cancer after adjusting for concomitant diseases. RESULTS: This study included 179,930 patients with gout and an equal number of matched controls. The incidence of overall cancer was higher in patients with gout than in controls (incidence rate ratio, 1.08). Cox proportional hazards regression analysis showed that gout was associated with a hazard ratio of 1.053 (95% confidence interval ,1.031 to 1.077) after adjusting for concomitant diseases. CONCLUSION: Gout was associated with a significantly high risk of cancer, especially esophageal, stomach, colon, liver, pancreatic, lung, ovarian, renal, and bladder cancers.


Assuntos
Gota , Neoplasias , Gota/diagnóstico , Gota/tratamento farmacológico , Gota/epidemiologia , Supressores da Gota/uso terapêutico , Humanos , Incidência , Neoplasias/tratamento farmacológico , Modelos de Riscos Proporcionais , República da Coreia/epidemiologia , Fatores de Risco
11.
J Affect Disord ; 299: 545-552, 2022 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-34952111

RESUMO

BACKGROUND: Suicide is influenced by complex interactions among various psychopathological features. We aimed to examine the relationship between suicide risk and psychological risk factors such as defense mechanisms, personality, and anxiety. METHODS: We established a psychiatric database by utilizing the Observational Medical Outcomes Partnership Common Data Model. We conducted a 1:1 propensity score matching with age, sex, and depression severity, and identified a sample (n = 258) with two groups: those with suicidal behavior and those with non-suicidal behavior. Using principal component analysis, we extracted nine psychological scales and applied network analysis to compare relationships among psychological factors between the two groups. RESULTS: Patients with non-suicidal behaviors showed associations between trait anxiety and defense mechanisms, while those with suicidal behaviors did not. For patients with suicidal ideation there was an association between somatization and trait anxiety. Patients with suicide attempts showed associations between paranoia and dissociation connected to trait anxiety. LIMITATIONS: Longitudinal research is required to fully observe transitions from suicidal ideation to attempts and recurrent suicidal events. In addition, these networks may not generalize suicidal behaviors because the group participants are not homogeneous. Lastly, data from self-report questionnaires limits the reliability of responses. CONCLUSIONS: We presented important new insights on suicidal behavior by estimating psychological networks. Patients with non-suicidal behavior may exhibit discrete relationships between defense mechanisms and anxiety, compared to those with suicidal behavior. Patients with suicidal ideation and suicide attempts may show distinct associations between anxiety and psychopathological features.


Assuntos
Ideação Suicida , Tentativa de Suicídio , Ansiedade/epidemiologia , Estudos Transversais , Humanos , Reprodutibilidade dos Testes , Fatores de Risco
12.
Sci Rep ; 11(1): 21408, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34725444

RESUMO

To date, there exists no established endoscopic surveillance interval strategy after endoscopic submucosal dissection (ESD) for gastric adenoma. In this study, we suggest a risk factor-based statistical model for optimal surveillance intervals for gastric adenoma after ESD with curative resection. A cox proportional hazard model was applied to identify risk factors for recurrence after ESD. Patients (n = 698) were categorized into groups based on the identified risk factors. The cumulative density of recurrence over time was computed using a cubic splined baseline hazard function, and the customized surveillance interval was modeled for each risk group. The overall cumulative incidence of recurrence was 7.3% (n = 51). Risk factors associated with recurrence were male (hazard ratio [HR], 2.60, P = 0.030), protruded scar (HR, 3.18, P < 0.001), and age ≥ 59 years (HR, 1.05, P < 0.001). The surveillance interval for each group was developed by using the recurrence limit for the generated risk groups. According to the developed schedule, high-risk patients would have a maximum of seven surveillance visits for 5 years, whereas low-risk patients would have biennial surveillance for cancer screening. We proposed a simple and promising strategy for determining a better endoscopic surveillance interval by parameterizing diverse and group-specific recurrence risk factors into a well-known survival model.


Assuntos
Adenoma/diagnóstico por imagem , Ressecção Endoscópica de Mucosa/métodos , Endoscopia/métodos , Neoplasias Gástricas/diagnóstico por imagem , Adenoma/cirurgia , Pólipos Adenomatosos , Idoso , Detecção Precoce de Câncer , Feminino , Mucosa Gástrica/microbiologia , Gastroscopia , Helicobacter pylori , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Óptica e Fotônica , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de Risco , Neoplasias Gástricas/cirurgia
13.
Sci Rep ; 11(1): 19529, 2021 09 30.
Artigo em Inglês | MEDLINE | ID: mdl-34593890

RESUMO

Accumulating evidence indicates that amyloid-beta (Aß) deposition and biogenic aldehyde accumulation contribute to the pathogenesis of neurodegenerative diseases. Human aldehyde dehydrogenase 2 (ALDH2) metabolizes biogenic aldehydes produced in the brain to prevent damage. However, r671G>A, a single nucleotide polymorphism of ALDH2, causes aldehyde accumulation and decreased ALDH2 activity. We aimed to investigate whether Aß deposition and rs671 polymorphism have an interaction effect on cortical thickness (CTh). We grouped 179 participants in the Biobank Innovations for chronic Cerebrovascular disease With ALZheimer's disease Study as follows: amyloid (-) [A(-)] and amyloid (+) [A(+)] groups based on the Aß deposition degree; A-carrier (AC) and GG (GG) groups based on the presence/absence of the rs671 A allele; and their combinations, i.e., A(-)AC, A(-)GG, A(+)AC, and A(+)GG groups. A multiple regression analysis identified nine regions of interest. Compared with the A(-)GG group, the A(-)AC group showed thinner CTh in all regions. There were no significant differences between the A(+)AC and A(+)GG groups. We observed an interaction effect of amyloid deposition and rs671 polymorphism on CTh. The CTh in the A(-) group appeared to be strongly influenced by rs671 polymorphism, which could have contributed to cortical thinning and biogenic aldehyde accumulation in the AC group. Additionally, CTh in the A(+) group appeared to be strongly influenced by amyloid deposition.


Assuntos
Aldeído-Desidrogenase Mitocondrial/genética , Alelos , Amiloide/metabolismo , Córtex Cerebral/metabolismo , Córtex Cerebral/patologia , Predisposição Genética para Doença , Polimorfismo de Nucleotídeo Único , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/etiologia , Doença de Alzheimer/metabolismo , Doença de Alzheimer/patologia , Peptídeos beta-Amiloides/metabolismo , Biomarcadores , Córtex Cerebral/diagnóstico por imagem , Cognição , Feminino , Genótipo , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Tomografia por Emissão de Pósitrons
14.
J Pers Med ; 11(9)2021 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-34575705

RESUMO

Outpatient detection of total bilirubin levels should be performed regularly to monitor the recurrence of jaundice in hepatobiliary and pancreatic disease patients. However, frequent hospital visits for blood testing are burdensome for patients with poor medical conditions. This study validates a novel deep-learning-based smartphone application for the self-diagnosis of scleral jaundice in such patients. The system predicts total serum bilirubin levels using the deep-learning-based regression analysis of scleral photos taken by the smartphone's built-in camera. Enrolled patients were randomly assigned to either the training cohort (n = 90, 1034 photos) or the validation cohort (n = 40, 426 photos). The intraclass correlation coefficient value for predicted serum total bilirubin (PSB) derived from the images repeatedly taken at the same time for the same patient showed good reliability (0.86). A strong correlation between measured serum total bilirubin (MSB) and PSB was observed in the subgroup with MSB levels ≥1.5 mg/dL (Spearman rho = 0.70, p < 0.001). The receiver operating characteristic curve for PSB showed that the area under the curve was 0.93, demonstrating good test performance as a predictor of hyperbilirubinemia (p < 0.001). Using a cut-off PSB ≥1.5, the prediction sensitivity of hyperbilirubinemia was 80.0%, with a specificity of 92.6%. Hence, the tool is effective for patient monitoring.

15.
Front Syst Neurosci ; 15: 671735, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34512278

RESUMO

The hippocampus, which engages in the process of consolidating long-term memories and learning, shows active development during childhood and adolescence. The hippocampus also functionally influences attention. Based on the influence of hippocampal function on attention, it was expected that the volume of the hippocampus would be associated with the difference in attention during childhood and adolescence, in which the brain develops actively. Thus, this study examined the association between hippocampal volume and attention metrics measured by the continuous performance test (CPT) in 115 children and adolescents (mean age = 12.43 ± 3.0, 63 male and 52 female). In association studies with both auditory and visual attention, we found that the bilateral hippocampal volumes showed negative relationships with auditory omission errors. A smaller volume of the left hippocampus also led to a longer auditory response time. However, visual attention did not show any significant relationship with the hippocampal volume. These findings were consistent even after adjusting for the effects of the related covariates (e.g., age, insomnia, and depression). Taken together, this study suggested that the increase in hippocampal volume during childhood and adolescence was associated significantly with better auditory attention.

16.
Front Oncol ; 11: 634219, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34513658

RESUMO

BACKGROUND: Endoscopy is the most important tool for gastric cancer diagnosis. However, it relies on naked-eye evaluation by endoscopists, and the histopathologic confirmation is time-consuming. We aimed to visualize and measure the activity of various enzymes through two-photon microscopy (TPM) using fluorescent probes and assess its diagnostic potential in gastric cancer. METHODS: ß-Galactosidase (ß-gal), carboxylesterase (CES), and human NAD(P)H: quinone oxidoreductase (hNQO1) enzyme activities in the normal mucosa, ulcer, adenoma, and gastric cancer biopsy samples were measured using two-photon enzyme probes. The fluorescence emission ratio at long and short wavelengths (Ch2/Ch1) for each probe was comparatively analyzed. Approximately 8,000 - 9,000 sectional images in each group were obtained by measuring the Ch2/Ch1 ratio according to the tissue depth. Each probe was cross-validated by measuring enzymatic activity from a solution containing lysed tissue. RESULTS: Total of 76 subjects were enrolled in this pilot study (normal 21, ulcer 18, adenoma 17, and cancer 20 patients, respectively). There were significant differences in the mean ratio values of ß-gal (0.656 ± 0.142 vs. 1.127 ± 0.109, P < 0.001) and CES (0.876 ± 0.049 vs. 0.579 ± 0.089, P < 0.001) between the normal and cancer, respectively. The mean ratio value of cancer tissues was different compared to ulcer and adenoma (P < 0.001). The hNQO1 activity showed no significant difference between cancer and other conditions. Normal mucosa and cancer were visually and quantitatively distinguished through ß-gal and CES analyses using TPM images, and enzymatic activity according to depth, was determined using sectional TPM ratiometric images. The results obtained from lysis buffer-treated tissue were consistent with TPM results. CONCLUSIONS: TPM imaging using ratiometric fluorescent probes enabled the discrimination of gastric cancer from normal, ulcer, and adenoma. This novel method can help in a visual differentiation and provide quantitative depth profiling in gastric cancer diagnosis.

17.
Front Psychiatry ; 12: 686174, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34326786

RESUMO

Background: During late childhood and adolescence, the frontal lobe undergoes critical developmental changes, affecting a wide range of executive functions significantly. Conversely, abnormality in the maturation of the frontal lobe during this period may result in a limited ability to effectively use various executive functions. However, at present, it is still unclear how the structural development of the frontal lobe is associated with different aspects of executive functions during this developmental period. To fill the gap in evidence, we aimed to elucidate gray matter volume (GMV) in the frontal lobe and its relationship with multiple aspects of executive functions in late childhood and adolescence. Methods: We recruited our participants aged between 6 and 17 years to assess GMV in the frontal lobe and its relationship with different domains of executive functions in late childhood and adolescence. We used the voxel-based morphometry-DARTEL procedure to measure GMVs in multiple frontal sub-regions and Stroop test and Advanced Test of Attention (ATA) to measure executive functions. We then conducted partial correlation analyses and performed multiple comparisons with different age and sex groups. Results: Overall, 123 participants took part in our study. We found that many regional GMVs in the frontal lobe were negatively correlated with ATA scores in participants in late childhood and positively correlated with ATA scores in participants in adolescence. Only a few correlations of the GMVs with Stroop test scores were significant in both age groups. Although most of our results did not survive false discovery rate (FDR) correction (i.e., FDR <0.2), considering their novelty, we discussed our results based on uncorrected p-values. Our findings indicate that the frontal sub-regions that were involved in attentional networks may significantly improve during late childhood and become stabilized later in adolescence. Moreover, our findings with the Stroop test may also present the possibility of the later maturation of higher-order executive functioning skills. Conclusion: Although our findings were based on uncorrected p-values, the novelty of our findings may provide better insights into elucidating the maturation of the frontal lobe and its relationship with the development of attention networks in late childhood and adolescence.

18.
Sci Rep ; 11(1): 10468, 2021 05 17.
Artigo em Inglês | MEDLINE | ID: mdl-34001983

RESUMO

The EOS is a medical imaging system that incorporates simultaneous orthogonal images, producing three-dimensional (3D) reconstructions of the whole skeletal system in various functional positions. Despite growing interest in the pelvic 3D position, the validity of the EOS has not yet been well studied. We investigated the trueness and precision of EOS imaging for pelvic parameters and orientation and assessed whether the measurement using the EOS was affected by the pelvic orientation itself. The orientation of the anterior pelvic plane and pelvic parameters of a custom-made pelvic phantom were measured by three raters using the EOS, and the measurements obtained were compared with the true values. The standard deviations of the measurement errors were 3.23°, 0.26°, 0.23°, 2.98°, 0.88°, and 3.22° for flexion, obliquity, rotation, pelvic incidence, spinopelvic tilt, and sacral slope, respectively. The root-mean square averages of the standard deviation of each measurement were 4.05°, 0.41°, 0.28°, 4.80°, 0.99°, and 5.13°, respectively. The measurement errors for sacral slope correlated significantly with geometric means of flexion, obliquity, and rotation (r = 0.364, p = 2.67 × 10-11). The EOS rendered accurate and reliable measurements regarding pelvic 3D position, even with positional variation, but positional variation could affect measurements of sacral slope.


Assuntos
Imageamento Tridimensional/métodos , Pelve/diagnóstico por imagem , Postura/fisiologia , Sacro/diagnóstico por imagem , Simulação por Computador , Humanos , Pelve/anatomia & histologia , Pelve/fisiologia , Imagens de Fantasmas , Reprodutibilidade dos Testes , Sacro/fisiologia , Software
19.
Sci Rep ; 11(1): 6918, 2021 03 25.
Artigo em Inglês | MEDLINE | ID: mdl-33767276

RESUMO

Hydroxychloroquine has recently received attention as a treatment for COVID-19. However, it may prolong the QTc interval. Furthermore, when hydroxychloroquine is administered concomitantly with other drugs, it can exacerbate the risk of QT prolongation. Nevertheless, the risk of QT prolongation due to drug-drug interactions (DDIs) between hydroxychloroquine and concomitant medications has not yet been identified. To evaluate the risk of QT prolongation due to DDIs between hydroxychloroquine and 118 concurrent drugs frequently used in real-world practice, we analyzed the electrocardiogram results obtained for 447,632 patients and their relevant electronic health records in a tertiary teaching hospital in Korea from 1996 to 2018. We repeated the case-control analysis for each drug. In each analysis, we performed multiple logistic regression and calculated the odds ratio (OR) for each target drug, hydroxychloroquine, and the interaction terms between those two drugs. The DDIs were observed in 12 drugs (trimebutine, tacrolimus, tramadol, rosuvastatin, cyclosporin, sulfasalazine, rofecoxib, diltiazem, piperacillin/tazobactam, isoniazid, clarithromycin, and furosemide), all with a p value of < 0.05 (OR 1.70-17.85). In conclusion, we found 12 drugs that showed DDIs with hydroxychloroquine in the direction of increasing QT prolongation.


Assuntos
COVID-19/tratamento farmacológico , Hidroxicloroquina/efeitos adversos , Síndrome do QT Longo/induzido quimicamente , COVID-19/virologia , Estudos de Casos e Controles , Interações Medicamentosas , Eletrocardiografia , Humanos , Hidroxicloroquina/administração & dosagem , Síndrome do QT Longo/fisiopatologia , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2/isolamento & purificação
20.
PLoS One ; 16(2): e0246399, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33529265

RESUMO

Obstructive sleep apnea is a highly prevalent cyclic repetitive hypoxia-normoxia respiratory sleep disorder characterized by intermittent upper-airway collapse. It is mainly diagnosed using in-laboratory polysomnography. However, the time-spatial constraints of this procedure limit its application. To overcome these limitations, there have been studies aiming to develop clinical prediction formulas for screening of obstructive sleep apnea using the risk factors for this disorder. However, the applicability of the formula is restricted by the group specific factors included in it. Therefore, we aimed to assess the risk factors for obstructive sleep apnea and develop clinical prediction formulas, which can be used in different situations, for screening and assessing this disorder. We enrolled 3,432 Asian adult participants with suspected obstructive sleep apnea who had successfully undergone in-laboratory polysomnography. All parameters were evaluated using correlation analysis and logistic regression. Among them, age, sex, hypertension, diabetes mellitus, anthropometric factors, Berlin questionnaire and Epworth Sleepiness Scale scores, and anatomical tonsil and tongue position were significantly associated with obstructive sleep apnea. To develop the clinical formulas for obstructive sleep apnea, the participants were divided into the development (n = 2,516) and validation cohorts (n = 916) based on the sleep laboratory visiting date. We developed and selected 13 formulas and divided them into those with and without physical examination based on the ease of application; subsequently, we selected suitable formulas based on the statistical analysis and clinical applicability (formula including physical exam: sensitivity, 0.776; specificity, 0.757; and AUC, 0.835; formula without physical exam: sensitivity, 0.749; specificity, 0.770; and AUC, 0.839). Analysis of the validation cohort with developed formulas showed that these models and formula had sufficient performance and goodness of fit of model. These tools can effectively utilize medical resources for obstructive sleep apnea screening in various situations.


Assuntos
Apneia Obstrutiva do Sono/epidemiologia , Adulto , Fatores Etários , Índice de Massa Corporal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polissonografia , Prognóstico , Fatores de Risco , Fatores Sexuais , Apneia Obstrutiva do Sono/diagnóstico
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