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BACKGROUND: The risk of dementia is increased in subjects with mild cognitive impairment (MCI). Despite the plethora of in-person cognitive tests, those that can be administered over the phone are lacking. We hypothesized that a home-based cognitive test (HCT) using phone calls would be feasible and useful in non-demented elderly. We aimed to assess feasibility and validity of a new HCT as an optional cognitive monitoring tool without visiting hospitals. METHODS: Our study was conducted in a prospective design during 24 weeks. We developed a new HCT consisting of 20 questions (score range 0-30). Participants with MCI (n = 38) were consecutively enrolled and underwent regular HCTs during 24 weeks. Associations between HCT scores and in-person cognitive scores and Alzheimer's disease (AD) biomarkers were evaluated. In addition, HCT scores in MCI participants were cross-sectionally compared with age-matched cognitively normal (n = 30) and mild AD dementia (n = 17) participants for discriminative ability of the HCT. RESULTS: HCT had good intra-class reliability (test-retest Cronbach's alpha 0.839). HCT scores were correlated with the Mini-Mental State Examination (MMSE), verbal memory delayed recall, and Stroop test scores but not associated with AD biomarkers. HCT scores significantly differed among cognitively normal, MCI, and mild dementia participants, indicating its discriminative ability. Finally, 32 MCI participants completed follow-up evaluations, and 8 progressed to dementia. Baseline HCT scores in dementia progressors were lower than those in non-progressors (p = 0.001). CONCLUSION: The feasibility and usefulness of the HCT were demonstrated in elderly subjects with MCI. HCT could be an alternative option to monitor cognitive decline in early stages without dementia.
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Doença de Alzheimer , Disfunção Cognitiva , Demência , Humanos , Idoso , Reprodutibilidade dos Testes , Estudos de Viabilidade , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/psicologia , Demência/diagnóstico , Doença de Alzheimer/diagnóstico , Testes Neuropsicológicos , Cognição , BiomarcadoresRESUMO
INTRODUCTION: Studies regarding multiple chronic lacunes (MCLs) and clinical outcome according to stroke etiology are scarce. We sought to evaluate the association between MCL and short-term/long-term clinical outcomes according to stroke etiology. PATIENTS AND METHODS: We analyzed a prospectively collected stroke registry of acute ischemic stroke patients over 4 years. The enrolled patients were classified as having large artery atherosclerosis (LAA), small vessel occlusion (SVO), cardioembolic (CE) stroke, and other etiology. The early neurological deterioration (END) and favorable outcome at 3 months were assessed. RESULTS: A total of 1070 patients were enrolled. Patients with MCL had significantly more END compared to those without MCL both in total population (adjusted odds ratio (OR), 1.7; 95% confidence interval [CI], 1.1-2.5; p = 0.013*) and in the LAA group (adjusted OR, 2.3; 95% CI, 1.3-4.2, p < 0.006). Patients with MCL had a significantly lower OR for favorable outcome at 3 months compared to those without MCL both in total population (adjusted OR, 0.7; 95% CI, 0.5-1.0, p = 0.035) and in the LAA group (adjusted OR, 0.6; 95% CI, 0.3-1.0, p = 0.043). However, MCL was not associated with END or long-term functional outcome in patients with SVO, CE, or other etiology. CONCLUSIONS: The presence of MCL was an independent predictive factor for END as well as long-term poor functional outcome in acute ischemic stroke patients. These associations were only observed in patients with LAA, not in those with SVO, CE, or other etiology.
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Aterosclerose , Isquemia Encefálica , AVC Isquêmico , Acidente Vascular Cerebral , Humanos , AVC Isquêmico/complicações , Acidente Vascular Cerebral/epidemiologia , Artérias , Isquemia Encefálica/epidemiologia , Fatores de RiscoRESUMO
INTRODUCTION: This study is to explore the long-term functional outcome of antihypertensive medication-naïve, untreated hypertension (HTN) patients with acute ischemic stroke compared to those with no prior HTN and those with treated HTN. PATIENTS AND METHODS: We analyzed a prospectively collected stroke registry of all patients with acute ischemic stroke consecutively admitted to Incheon St. Mary's Hospital. Patients who received reperfusion therapy were excluded. Long-term functional outcomes were assessed at a 3-month follow-up visit using the modified Rankin Scale. RESULTS: A total of 1044 patients was enrolled. Compared to patients with no or treated HTN, those with untreated HTN had higher odds for more favorable outcomes (adjusted odds ratio (OR): 1.7 [95% CI: 1.0-2.7, p = 0.050*] and 1.7 [95% CI: 1.0-2.8, p = 0.047*], respectively) when the stroke was large vessel atherosclerosis (LAA)/cardioembolic (CE) with large vessel occlusion/stenosis. However, no such association was observed when there was no large vessel occlusion or stenosis, in total patients, or if the index stroke was related to SVO. In untreated HTN patients with LAA/CE and large vessel occlusion/stenosis compared to patients in the lowest mean arterial pressure quartile (< 96.7 mmHg), patients in the second and third highest quartiles had higher odds of favorable outcomes. CONCLUSIONS: Patients with untreated HTN had significantly more favorable outcomes at 3 months after ischemic stroke compared to those with no or treated HTN when the stroke was LAA/CE with large vessel occlusion/stenosis. Untreated HTN patients also showed an association between higher MAP and favorable outcomes.
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Aterosclerose , Isquemia Encefálica , Hipertensão , AVC Isquêmico , Acidente Vascular Cerebral , Humanos , AVC Isquêmico/complicações , Isquemia Encefálica/complicações , Isquemia Encefálica/terapia , Constrição Patológica , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/terapia , Acidente Vascular Cerebral/complicações , Prognóstico , Hipertensão/complicações , Hipertensão/epidemiologia , Resultado do TratamentoRESUMO
While Active Hexose Correlated Compound (AHCC) and CpG oligodeoxynucleotide (ODN) are separately known to modulate oxidative stress and immune responses in cancer patients, the combined effect of these two compounds is unknown. To clarify this, we investigated whether AHCC plus KSK-CpG ODN would be therapeutic in B16 melanoma mouse model, if so, and how in reduction-oxidation (redox) balance and cytokines network. We found that treatment groups (AHCC only, KSK-CpG ODN only and AHCC/KSK-CpG ODN) markedly reduced (p<0.001) tumor size when compared to the positive control (PC) group. The total white blood cell (WBC) of AHCC only and KSK-CpG ODN only-treated groups showed significant lower counts than that of PC group. Next, the production of nitric oxide (NO) was significantly increased (p<0.01) in AHCC/KSK-CpG ODN group compared to the PC group. Further, the redox balance was improved in AHCC/KSK-CpG ODN group through significantly low (p<0.001) reactive oxygen species (ROS) production and significantly high (p<0.05) glutathione peroxidase (GPx) activity compared to the PC group. Finally, AHCC/KSK-CpG ODN (p<0.01) and KSK-CpG ODN (p<0.001)-treated groups augmented tumor immune surveillance as shown by significantly increased level of anti-inflammatory cytokine (IL-10) and significantly decreased (p<0.05) level of pro-tumorigenic IL-6 of AHCC/KSK-CpG ODN treated group as compared to the PC group. Collectively, our study indicates therapeutic effect of Active Hexose-Correlated Compound (AHCC) combined with KSK-CpG ODN in B16 melanoma murine model via balancing redox and cytokines network.
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Melanoma Experimental/tratamento farmacológico , Melanoma Experimental/imunologia , Oligodesoxirribonucleotídeos/uso terapêutico , Polissacarídeos/uso terapêutico , Animais , Linhagem Celular Tumoral , Citocinas/sangue , Citocinas/química , Citocinas/imunologia , Modelos Animais de Doenças , Quimioterapia Combinada , Feminino , Glutationa Peroxidase/sangue , Interleucina-10/sangue , Interleucina-12/sangue , Interleucina-6/sangue , Células Matadoras Naturais/imunologia , Melanoma Experimental/metabolismo , Camundongos Endogâmicos C57BL , Óxido Nítrico/sangue , Oxirredução , Estresse Oxidativo , Distribuição Aleatória , Espécies Reativas de Oxigênio/sangueRESUMO
BACKGROUND: Microglia are involved in immune surveillance in intact brains and become activated in response to inflammation and neurodegeneration. Microglia have different functions, neuroprotective or neurotoxic, according to aging in patients with PD. The clinical effect of microglia in patients with Alzheimer's disease (AD) is poorly defined. This prospective study was conducted to investigate the clinical effects of microglia according to the aging process in newly diagnosed AD. METHODS: We examined 532 patients with newly diagnosed AD and 119 healthy controls, and the differences in hs-CRP between these groups were investigated. The patients with AD were classified into 3 subgroups according to age of newly diagnosed AD to investigate the relationship between hs-CRP and the aging process in newly diagnosed AD. RESULTS: There was significantly higher serum high-sensitivity C-reactive protein (hs-CRP), levels in patients with AD compared with healthy controls. A post-hoc analysis of the 3 AD subgroups showed no significant differences in serum hs-CRP level between each group. CONCLUSION: We assumed that neuroinflammation play a role in the pathogenesis of AD, but found no clinical evidence that microglia senescence underlies the microglia switch from neuroprotective in young brains to neurotoxic in aged brains. To clarify the role of microglia and aging in the pathogenesis of AD, future longitudinal studies involving a large cohort are required.
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Envelhecimento/sangue , Doença de Alzheimer/sangue , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , Idoso , Idoso de 80 Anos ou mais , Encéfalo/patologia , Estudos de Casos e Controles , Feminino , Humanos , Inflamação/patologia , Imageamento por Ressonância Magnética , Masculino , Microglia/patologia , Doenças Neurodegenerativas/patologia , Neurônios/patologia , Estudos ProspectivosRESUMO
In this study, a shallow water flow code was developed and tested against four benchmark problems of practical relevance. The results demonstrated that as the eddy viscosity increased, the velocity slope along the spanwise direction decreased, and the larger roughness coefficient induced a higher flow depth over the channel width. The mass conservation rate was determined to be 99.2%. This value was measured by the variation of the total volume of the fluid after a cylinder break. As the Re increased to 10,000 in the internal recirculating flow problem, the intensity of the primary vortex had a clear trend toward the theoretically infinite Re value of -1.886. The computed values of the supercritical flow evolved by the oblique hydraulic jump agreed well with the analytic solutions within an error bound of 0.2%. The present model adopts the nonconservative form of shallow water equations. These equations are weighted by the SU/PG scheme and integrated by a fully implicit method, which can reproduce physical problems with various properties. The model provides excellent results under various flow conditions, and the solutions of benchmark tests can present criteria for the evaluation of various algorithmic approaches.
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Modelos Teóricos , Hidrodinâmica , Água/químicaRESUMO
Nutrient runoff into rivers caused by human activity has led to global eutrophication issues. The Nakdong River in South Korea is currently facing significant challenges related to eutrophication and harmful algal blooms, underscoring the critical importance of managing total nitrogen (T-N) levels. However, traditional methods of indoor analysis, which depend on sampling, are labor-intensive and face limitations in collecting high-frequency data. Despite advancements in sensor allowing for the measurement of various parameters, sensors still cannot directly measure T-N, necessitating surrogate regression methods. Therefore, we conducted T-N predictions using a water quality dataset collected from 2018 to 2022 at 157 observatories within the Nakdong River basin. To account for the water quality characteristics of each location, we employed a clustering technique to divide the basin and compared a Gaussian mixture model with K-means clustering. Moreover, optimal regressor for each cluster was selected by comparing multiple linear regression (MLR), random forest, and XGBoost. The results showed that forming four clusters via K-means clustering was the most suitable approach and MLR was reasonably accurate for all clusters. Subsequently, recursive feature elimination cross-validation was used to identify suitable parameters for T-N prediction, thus leading to the construction of high-accuracy T-N prediction models. Clustering was useful not only for improving the regressors but also for spatially analyzing the water quality characteristics of the Nakdong River. The MLR model can reveal causal relationships and thus is useful for decision-making. The results of this study revealed that the combination of a simple linear regression model and clustering method can be applied to a wide watershed. The clustering-based regression model showed potential for accurately predicting T-N at the basin level and is expected to contribute to nationwide water quality management through future applications in various fields.
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Introduction: Women can experience various reproductive events, such as pregnancy, childbirth, lactation, and contraception, which cause long-term changes in female hormones. In middle-aged women, the prevalence of migraine is high, and a clear gender difference is evident. This study investigated the effects of factors associated with past reproductive events on the risk of new migraine in middle-aged premenopausal women. Methods: The influence of reproductive factors on migraine in middle-aged women was investigated using the Korean National Health Insurance Service (KNHIS) and Korean Health Examination (KHE) databases. The reproductive factors of interest were parity, breastfeeding, and oral contraceptive (OC) use. The study included 949,704 middle-aged premenopausal women 40-60 years of age. The study population was divided into two groups based on new diagnosis of migraine during the follow-up period (2009-2018). Results: The risk of new migraine tended to increase in the primiparous (hazard ratio, HR: 1.179; 95% confidence interval, CI: 1.137-1.221) and multiparous groups (HR: 1.181; 95% CI: 1.142-1.221) compared with the nulliparous group. The breastfeeding ≥12 months group (HR: 1.071; 95% CI: 1.052-1.091) showed a significantly increased risk of new migraine compared with the non-breastfeeding group. All women in the OC groups (< 1 year, HR: 1.048; 95% CI: 1.028-1.069 and ≥ 1 year, HR: 1.100; 95% CI: 1.067-1.134) showed a higher risk of new migraine than those in the non-OC group. Conclusion: The results of the current study indicate that childbirth, longer breastfeeding, and OC use may be associated with a higher risk of new migraine in middle-aged premenopausal women.
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Previous studies have demonstrated a decreased density of dopamine transporters (DAT) in basal ganglia in patients with idiopathic Parkinson disease (IPD) using I-n-fluoropropyl-2b-carbomethoxy-3b-(4-iodophenyl) nortropane (FP-CIT), and the reductions in striatal DAT levels were inversely correlated with the severity of motor dysfunction in IPD. However, there has been no study on the correlation of DAT levels between IPD patients with and without cognitive dysfunction. Thus, we evaluated the differences in regional DAT density in the brain of patients with IPD without dementia and those with dementia using FP-CIT positron emission tomography. We recruited 24 consecutive patients with IPD, including 7 with IPD without dementia and 17 with IPD with dementia, and 18 healthy controls. FP-CIT positron emission tomography scans were acquired 90 and 210 minutes after the FP-CIT injection. The DAT density did not differ in the caudate nucleus or the putamen between patients with IPD without dementia and those with dementia. However, the DAT density between the 2 groups with IPD demonstrated a significantly decreased density compared with that of healthy controls in the putamen. We cautiously suggest that there is no relationship between DAT density and cognitive severity because there were no significant differences in the DAT density between IPD with dementia and those without dementia.
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Demência/diagnóstico por imagem , Neurônios Dopaminérgicos/diagnóstico por imagem , Doença de Parkinson/diagnóstico por imagem , Compostos Radiofarmacêuticos , Tropanos , Idoso , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Demência/etiologia , Demência/patologia , Neurônios Dopaminérgicos/patologia , Feminino , Humanos , Interpretação de Imagem Assistida por Computador , Masculino , Doença de Parkinson/complicações , Doença de Parkinson/patologia , Tomografia por Emissão de Pósitrons/métodosRESUMO
Water environment pollution due to chemical spills occurs constantly worldwide. When a chemical accident occurs, a quick initial response is most important. In previous studies, samples collected from chemical accident sites were subjected to laboratory-based precise analysis or predictive research through modeling. These results can be used to formulate appropriate responses in the event of chemical accidents; however, there are limitations to this process. For the initial response, it is important to quickly acquire information on chemicals leaked from the site. In this study, pH and electrical conductivity (EC), which are easy to measure in the field, were applied. In addition, 13 chemical substances were selected, and pH and EC data for each were established according to concentration change. The obtained data were applied to machine learning algorithms, including decision trees, random forests, gradient boosting, and XGBoost (XGB), to determine the chemical substances present. Through performance evaluation, the boosting method was found to be sufficient, and XGB was the most suitable algorithm for chemical substance detection.
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Iodine is commonly used as a dichroic material in polarizing films, while dichroic dyes are employed when high heat resistance is necessary. Direct dyes, which can be applied to poly(vinyl alcohol) (PVA) in an acidic environment, are the most popular; however, their hydrogen bonding interaction with the PVA chain can weaken in high-humidity conditions, leading to a potential change in color value or polarization property. Reactive dyes offer a promising alternative for use in high-humidity environments. In this study, five novel reactive dyes were synthesized and used to prepare dye-based polarizing films. The dichroic ratios, order parameters, and transition moments of the reactive dyes were calculated and compared to those of corresponding direct dyes. Molecular orbital calculations indicated minimal effects on the optical anisotropy of the polarizing films due to the transition moments of the reactive dyes remaining close to their molecular axes. As a result, the dichroic ratios of the polarizing films were mainly dependent on the orientation of the dyes towards their stretching direction, and showed a similar behavior compared to direct dyes. Under high-temperature and high-humidity conditions, the polarizing film using reactive dyes showed superior durability compared to the direct dye-based film.
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Total knee replacement (TKR) is associated with a large amount of bleeding; therefore, the prevalence of postoperative anemia is high. In particular, patients with chronic kidney disease (CKD) are more vulnerable to postoperative anemia than are healthy individuals. Accordingly, the effect of intraoperative intravenous ferric derisomaltose (FDI) supplementation on postoperative anemia and blood transfusion volume reduction in patients with CKD was studied. Patients who underwent unilateral TKR between January 2019 and December 2020 were retrospectively reviewed. In analyzing the data, the patients fell into the CKD group (n = 85) and the non-CKD group (n = 106). Each group was divided into a group using FDI and a non-FDI group, and classified into 4 groups. The postoperative hemoglobin level for each postoperative day (POD) was determined as the primary outcome. In addition, the patient transfusion rate, volume of transfusion, and length of hospital stay were set as secondary study outcomes during the period from surgery to discharge. There was no statistically significant difference in hemoglobin levels on PODs 0, 1, 2, 7, and 14 in the CKD group. In the CKD group, the transfusion volume of the FDI group was 0.58 ± 0.91 units per person, which was statistically significantly lower than 1.28 ± 1.28 units of the non-FDI group (P = .01). In the CKD group, the transfusion rate of the FDI group was 30.2%, which was statistically significantly lower than that of the non-FDI group, which was 56.3% (P = .02). This study showed that intravenous FDI supplementation after TKR in CKD patients did not reduce postoperative anemia but was an effective and safe treatment to reduce transfusion volume and transfusion rate. There was no statistically significant difference in hemoglobin levels on POD 0, 1, 2, 7, and 14 in the non-CKD group. In the non-CKD group, the transfusion volume of the FDI group was 0.46 ± 0.88 units per person, which was lower than the 0.56 ± 0.91 units of the non-FDI group, but it was not statistically significant (P = .59). In the non-CKD group, the transfusion rate of the FDI group was 23.0%, which was lower than that of the non-FDI group, which was 31.3%, but it was not statistically significant (P = .37).
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Anemia , Artroplastia do Joelho , Insuficiência Renal Crônica , Anemia/complicações , Anemia/epidemiologia , Anemia/terapia , Artroplastia do Joelho/efeitos adversos , Transfusão de Sangue , Suplementos Nutricionais , Dissacarídeos , Compostos Férricos , Hemoglobinas/análise , Humanos , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/terapia , Estudos RetrospectivosRESUMO
Chemical accidents in rivers may be triggered by natural or anthropogenic causes and refer to the flow of large quantities of hazardous chemicals into rivers. In South Korea, domestic water is sourced from large rivers, such as the Nakdong River. However, owing to rapid industrialization, industrial facilities have become heavily concentrated in the middle and upper reaches of the Nakdong River. Therefore, severe problems could arise if harmful chemicals are leaked from industrial facilities into the river, and this contaminated river water is supplied to cities. Quantitative evaluation based on instrumental analysis during chemical accidents and prediction research based on modeling is actively being conducted however, research on the initial response is insufficient. Therefore, in this study, the variations in pH and EC were analyzed according to their chemical concentrations for seven chemicals. These seven chemicals are designated accident-preparedness substances that frequently cause chemical spills in South Korea. Additionally, we evaluated the possibility of identifying unknown substances by comparing the variations in pH and EC and statistics while diluting unknown substances. Thus, the potential of pH and EC as alternative indicators for detecting and identifying chemicals was evaluated in this study. NaF, NH4HF2, NaCN, and NH4OH were classified by comparing their spatial distributions in a pH-EC relation curve. However, H2SO4, HCl, and SOCl2 showed similar spatial distributions in the pH-EC curves and were difficult to identify. The results of this study provide information for chemical detection and identification using alternative sensors that permit easy and rapid field measurements in the event of a chemical spill and could be used as preliminary data for rapidly responding to accidents.
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OBJECTIVE: Acute ischemic stroke in the territory of anterior cerebral artery (ACA) is uncommon. Therefore, large population studies evaluating ACA infarction are scarce. We sought to evaluate epidemiological and etiological characteristics of ACA infarction compared to other territorial infarctions. METHODS: We analyzed a prospectively collected stroke registry of all acute ischemic stroke patients for 19 years at two tertiary hospitals. We included patients with acute ischemic stroke caused by large vessel stenosis or occlusion including ACA, middle cerebral artery (MCA), posterior cerebral artery (PCA), and vertebrobasilar artery (VBA). RESULTS: A total of 4171 patients were enrolled. Patients with ACA infarction (N = 288) were significantly older with more females than those with MCA, PCA, or VBA infarction. There were more patients with history of prior ischemic stroke in the ACA infarction group than in other groups. The etiology of the ACA infarction was similar to those of the MCA, PCA and also the total population (66.7-71.8% of LAA and 17.9-20.9% of CE). When patients had prior ischemic stroke history, ACA infarction was more likely to be caused by LAA than MCA or PCA infarction (OR = 6.2, 95% CI 2.0-19.2, p = 0.002 and OR = 4.0, 95% CI 1.1-14.6, p = 0.038, respectively). CONCLUSIONS: Patients with ACA infarction had significantly more prior ischemic stroke than those with MCA, PCA, or VBA infarction. The etiology of ACA infarction in patients with prior ischemic stroke showed significantly more LAA than that of MCA or PCA infarction.
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Infarto da Artéria Cerebral Anterior , Infarto da Artéria Cerebral Posterior , AVC Isquêmico , Acidente Vascular Cerebral , Artéria Cerebral Anterior/diagnóstico por imagem , Feminino , Humanos , Infarto da Artéria Cerebral Anterior/diagnóstico por imagem , Infarto da Artéria Cerebral Anterior/epidemiologia , Infarto da Artéria Cerebral Média/complicações , Infarto da Artéria Cerebral Posterior/complicações , Infarto da Artéria Cerebral Posterior/diagnóstico por imagem , Infarto da Artéria Cerebral Posterior/epidemiologia , Acidente Vascular Cerebral/complicaçõesRESUMO
Micromesoporous magnesium oxide architectures with cubic morphologies were prepared via the chemical reaction of magnesium hydroxide in a supercritical carbon dioxide (CO2)-ethanol system, and via the sequential thermal combustion of the reaction products. The morphological change to the cube shape from an irregular form was induced by the dehydoxylation-carbonation reaction of magnesium hydroxide with supercritical CO2 at a reaction temperature of 150 degrees C, which leads to the greatly improved carbonation efficiency of magnesium hydroxide to magnesium carbonate. The precursor cubes with 3-5 microm sizes were decarbonized and transformed into the nanocrystalline MgO phase with pore sizes of 1.3-6 nm after calcining at 600 degrees C. The micromesoporous cube with high surface area of 117.5 m2/g was obtained by the thermal decarbonation with phase transition from rhombohedral to cubic phase. As a result, nanograined magnesium oxide cubes with micromesoporous structures and high specific surface areas were formed by the carbonation reaction of the magnesium hydroxide with the supercritical CO2, and the subsequent thermal decomposition of the magnesium carbonate cubes.
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BACKGROUND: In some patients with neuropathic pain (NP), such as complex regional pain syndrome (CRPS), itching rather than pain is the main symptom making diagnosis and treatment difficult. CASE: We report a case of a 23-year-old male with a history of hypoxic brain damage who presented with pruritus of the left foot and ankle. His left foot was fractured, and he underwent surgery 6 months previously. After the operation and cast application, he developed uncontrolled pruritus, swelling, sweating, and flushing of the left foot skin with limping. On examination, he showed well-known features of CRPS without pain. He was diagnosed with an atypical CRPS with neuropathic itching (NI). With treatment modalities used for NP and CRPS, his pruritus subsided gradually, and the his ankle mobility improved. CONCLUSIONS: Unexplained itching can be the main symptom in some CRPS patients. Treatment according to NP can improve symptoms of NI in CRPS patients.
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BACKGROUND: Herpes zoster (HZ) is strongly associated with decreased immune function, a factor of cancer development. Previous studies suggested inconsistent results regarding the association between HZ and increased cancer risk. We aimed to analyze the association between HZ and specific cancer risk. METHODS: Of 134,454 patients diagnosed with HZ between 2002 and 2015, 81,993 HZ patients were matched 1:1 with non-HZ individuals by age, sex, and Charlson comorbidity index. Both groups were examined at 1, 3, and 5 years for cancer diagnosis. A Cox proportional hazard regression model was used to estimate cancer risk in both groups. The postherpetic neuralgia (PHN) and non-HZ groups were compared for specific cancer risk. RESULTS: The HZ group showed a slightly decreased overall cancer risk compared with the non-HZ group (hazard ratio [HR] 0.94, 95% confidence interval [CI] 0.90-0.97, p = 0.002). The HRs for specific cancer risk were 0.41 (95% CI, 0.33-0.50, p < 0.001); 0.86 (95% CI, 0.81-0.91, p < 0.001); 0.87 (95% CI, 0.78-0.97, p = 0.014); 0.80 (95% CI 0.73-0.87, p < 0.001); 1.20 (95% CI, 1.07-1.34, p = 0.001); and 1.66 (95% CI, 1.35-2.03, p < 0.001) for cancers of the lips, mouth, and pharynx; digestive system; respiratory system; unknown secondary and unspecified sites; thyroid and endocrine glands; and lymphoid and hematopoietic systems, respectively. The HZ with PHN group showed higher HR for specific cancer risk, such as lymphoid and hematopoietic systems (95% CI, 1.27-2.39, p < 0.001). CONCLUSION: HZ was associated with increased or decreased incidence of specific cancers. PHN further increased the risk of developing certain cancers in HZ patients.
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Herpes Zoster , Neoplasias , Neuralgia Pós-Herpética , Herpes Zoster/complicações , Herpes Zoster/epidemiologia , Herpesvirus Humano 3 , Humanos , Incidência , Neoplasias/epidemiologia , Neoplasias/etiologia , RiscoRESUMO
Objective: Clinical and radiological findings on neurosyphilis are fairly non-specific and there is a paucity of functional neuroimaging studies on neurosyphilis other than case reports and case series. The purpose of this study was to investigate brain perfusion abnormalities in patients with neurosyphilis. Methods: Four HIV-negative neurosyphilis patients and 4 healthy controls underwent clinical evaluation, brain technetium-99m ethyl cysteinate dimer (99mTc-ECD) single-photon emission computed tomography (SPECT) imaging, and neuropsychological assessments which included the Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), Clinical Dementia Rating-Sum of Boxes (CDR-SOB), and Global Deterioration Scale (GDS). Voxel-wise differences in regional cerebral blood flow were compared between the two groups. Results: Neuropsychological test results indicated cognitive impairment in all patients. SPECT analysis revealed multifocal hypoperfusion predominantly in the frontal, insular, and posterior cingulate regions in neurosyphilis patients compared with healthy controls (family-wise error corrected p < 0.05). Conclusions: Together with previous findings, our results suggest that the hypoperfusion in the frontal, insular, and posterior cingulate regions may reflect cognitive impairments observed in neurosyphilis patients. Further studies with larger samples are needed to confirm our findings.
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The incidence of neurosyphilis has declined since effective penicillin therapy against Treponema pallidum was introduced. However, the diagnosis of neurosyphilis early in the disease course is very important in order to select appropriate antibiotic therapy. We report brain MRI, SPECT with Tc-99m ECD, and PET with F-18 FDG findings before antibiotic therapy in a neurosyphilis patient with neurological symptoms. The cerebral cortices showed hypoperfusion with a patchy distribution on SPECT and foci with high signal intensity on MRI, suggesting ischemia. Brain PET showed areas with hypometabolism in the temporoparietal lobes bilaterally.