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Mass vaccination with the Pfizer-BioNTech coronavirus disease 2019 (COVID-19) vaccine (BNT162b2) in Korea has resulted in many reported adverse effects. These side effects are the object of much scrutiny in the medical community. We report the case of a 29-year-old male who was diagnosed with myopericarditis after his second dose of Pfizer-BioNTech COVID-19 vaccine. This patient is the second recognized case of Pfizer-BioNTech COVID-19 vaccine induced myopericarditis in Korea and the first to have recovered from it. He originally presented with chest discomfort and exertional chest pain. Lab tests revealed elevated cardiac marker levels and echocardiographic findings displayed minimal pericardial effusion, prompting diagnosis as myopericarditis. We decided on two weeks of outpatient treatment with non-steroidal anti-inflammatory drugs (NSAIDs) due to the patient's mild symptoms and his occupation in the military. When this proved insufficient, we shifted to combination therapy with low dose corticosteroids and NSAIDs. After two weeks of treatment, the patient's symptoms and pericardial effusion had improved, and he was recovered completely 37 days after the onset.
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Vacinas contra COVID-19/efeitos adversos , Miocardite/etiologia , Vacinação/efeitos adversos , Adulto , Anti-Inflamatórios não Esteroides/uso terapêutico , Vacina BNT162 , Ecocardiografia , Humanos , Masculino , Miocardite/diagnóstico por imagem , Miocardite/tratamento farmacológicoRESUMO
BACKGROUND: There are no data on comparison between clopidogrel monotherapy and prolonged dual antiplatelet therapy (DAPT) in patients at high-risk undergoing percutaneous coronary intervention (PCI). METHODS: Of 2,082 consecutive patients undergoing PCI using second-generation drug-eluting stent (DES), we studied 637 patients at high-risk either angiographically or clinically who received clopidogrel longer than 24 months and were event-free at 12 months after index PCI. Patients were divided into 2 groups: the clopidogrel monotherapy group and the prolonged DAPT group. The primary outcome was a composite of all-cause death, non-fatal myocardial infarction (MI), definite or probable stent thrombosis, or stroke between 12 months and 36 months after the index PCI. RESULTS: In propensity score-matched population (246 pairs), the cumulative rate of primary outcome was 4.5% in the clopidogrel monotherapy group and 4.9% in the prolonged DAPT group (hazard ratio, 1.21; 95% confidence interval, 0.54-2.75; P = 0.643). There was no significant difference in all-cause death, MI, stent thrombosis, stroke between the clopidogrel monotherapy group and the prolonged DAPT group. CONCLUSION: Compared with prolonged DAPT, clopidogrel monotherapy showed similar long-term outcomes in patients at high-risk after second-generation DES implantation.
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Clopidogrel/efeitos adversos , Doença da Artéria Coronariana/complicações , Intervenção Coronária Percutânea/efeitos adversos , Inibidores da Agregação Plaquetária/efeitos adversos , Idoso , Clopidogrel/uso terapêutico , Doença da Artéria Coronariana/epidemiologia , Quimioterapia Combinada , Stents Farmacológicos/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/epidemiologia , Infarto do Miocárdio/etiologia , Inibidores da Agregação Plaquetária/uso terapêutico , República da Coreia/epidemiologia , Acidente Vascular Cerebral/etiologia , Trombose/etiologia , Resultado do TratamentoRESUMO
BACKGROUND: The invasive species Xanthium spinosum has been used as a traditional Chinese medicine for many years. Unfortunately, no extensive molecular studies of this plant have been conducted. RESULTS: Here, the complete chloroplast (cp) genome sequence of X. spinosum was assembled and analyzed. The cp genome of X. spinosum was 152,422 base pairs (bp) in length, with a quadripartite circular structure. The cp genome contained 115 unique genes, including 80 PCGs, 31 tRNA genes, and 4 rRNA genes. Comparative analyses revealed that X. spinosum contains a large number of repeats (999 repeats) and 701 SSRs in its cp genome. Fourteen divergences (Π > 0.03) were found in the intergenic spacer regions. Phylogenetic analyses revealed that Parthenium is a sister clade to both Xanthium and Ambrosia and an early-diverging lineage of subtribe Ambrosiinae, although this finding was supported with a very weak bootstrap value. CONCLUSION: The identified hotspot regions could be used as molecular markers for resolving phylogenetic relationships and species identification in the genus Xanthium.
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Genoma de Cloroplastos , Xanthium , Repetições de Microssatélites , Mutação , Filogenia , Xanthium/genéticaRESUMO
BACKGROUND: Brown algae have been used for their nutritional value as well as a source of bioactive compounds with antioxidant, anti-inflammatory, antimicrobial and anti-obesity effects. Obesity is an important condition implicated in various diseases, including diabetes, hypertension, dyslipidemia and coronary heart disease. However, anti-obesity effects of Eisenia bicyclis remain unknown. RESULTS: We investigated the anti-obesity effects of 6,6'-bieckol, 6,8'-bieckol, 8,8'-bieckol, dieckol and phlorofucofuroeckol A isolated from E. bicyclis. Anti-obesity activity was evaluated by examining the inhibition of differentiation of 3T3-L1 adipocytes and the expression of peroxisome proliferator-activated receptor γ (PPARγ), CCATT/enhancer-binding protein α (C/EBPα) and sterol regulatory element binding protein-1c (SREBP-1c) at the mRNA and protein level. Differentiated 3T3-L1 cells were treated with the purified phlorotannins at concentrations of 10, 25 and 50 µg mL(-1) for 8 days. The results indicated that the purified phlorotannins suppressed the differentiation of 3T3-L1 adipocytes in a dose-dependent manner, without toxic effects. Among the five compounds, 6,6'-bieckol markedly decreased lipid accumulation and expression levels of PPARγ, C/EBPα, SREBP-1c (mRNA and protein), and fatty acid synthase and acyl-coA carboxylase (mRNA). CONCLUSION: These findings suggest that E. bicyclis suppressed differentiation of 3T3-L1 adipocyte through downregulation of adipogenesis and lipogenesis.
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Adipogenia/efeitos dos fármacos , Fármacos Antiobesidade/farmacologia , Dioxinas/farmacologia , Regulação para Baixo/efeitos dos fármacos , Metabolismo dos Lipídeos/efeitos dos fármacos , Células 3T3-L1 , Animais , Fármacos Antiobesidade/efeitos adversos , Fármacos Antiobesidade/química , Fármacos Antiobesidade/isolamento & purificação , Benzofuranos/efeitos adversos , Benzofuranos/química , Benzofuranos/isolamento & purificação , Benzofuranos/farmacologia , Carbono-Carbono Ligases/antagonistas & inibidores , Carbono-Carbono Ligases/genética , Carbono-Carbono Ligases/metabolismo , Sobrevivência Celular/efeitos dos fármacos , Dioxinas/efeitos adversos , Dioxinas/química , Dioxinas/isolamento & purificação , Ácido Graxo Sintase Tipo I/antagonistas & inibidores , Ácido Graxo Sintase Tipo I/genética , Ácido Graxo Sintase Tipo I/metabolismo , Camundongos , Estrutura Molecular , PPAR gama/antagonistas & inibidores , PPAR gama/genética , PPAR gama/metabolismo , Oceano Pacífico , Phaeophyceae/química , República da Coreia , Alga Marinha/química , EstereoisomerismoRESUMO
Carbon nanotubes (CNTs) were coated on a sample of glass fiber air filter medium at atmospheric pressure and room temperature using electro-aerodynamic deposition (EAD). In the EAD method, CNTs (diameter: 50 nm, length: 2-3 µm) were aerosolized, electrically charged, and injected through a nozzle. A voltage was applied externally between the ground nozzle and a planar electrode on which the sample was located. The charged CNTs were deposited on the sample in a vertically standing posture even at a low flow velocity. Before the deposition experiment, a calculation was performed to determine the applied voltage by simulating the electric field, flow field, and particle trajectory. Using CNT-coated filter samples, virus aerosol filtration and anti-viral tests were carried out using the aerosol number counting method and the plaque counting method, respectively. For this purpose, bacteriophage MS2 was aerosolized with an atomizer. The particle filtration efficiency was increased to 33.3% in the most penetration particle size zone (100 nm) and the antiviral efficiency of the CNT filter was 92% when the coating areal density was 1.5 × 109 #/cm2. The susceptibility constant of virus to CNTs was 0.2 cm2/µg.
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Hepatica is a small genus of Ranunculaceae with medicinal and horticultural value. We characterized nine complete chloroplast (cp) genomes of Hepatica, which ranged from 159,549 to 161,081 bp in length and had a typical quadripartite structure with a large single-copy region (LSC; 80,270-81,249 bp), a small single-copy region (SSC; 17,029-17,838 bp), and two copies of inverted repeat (IR; 31,008-31,100 bp). The cp genomes of Hepatica possess 76 protein-coding genes (PCGs), 29 tRNAs, and four rRNA genes. Comparative analyses revealed a conserved ca. 5-kb IR expansion in Hepatica and other Anemoneae; moreover, multiple inversion events occurred in Hepatica and its relatives. Analyses of selection pressure (dN/dS) showed that most of the PCGs are highly conserved except for rpl20 and rpl22 in Hepatica falconeri, Hepatica americana, and Hepatica acutiloba. Two genes (rps16 and infA) were identified as pseudogenes in Hepatica. In contrast, rpl32 gene was completely lost. The phylogenetic analyses based on 76 PCGs resolved the phylogeny of Hepatica and its related genera. Non-monophyly of Anemone s.l. indicates that Hepatica should be reclassified as an independent genus. In addition, Hepatica nobilis var. japonica is not closely related to H. nobilis.
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The plant Cardamine amaraeformis Nakai. is considered an endemic plant to Korea. However, due to the similar morphological characteristics of C. amaraeformis with C. scutata, it is not easy to distinguish these two species. Here, the complete chloroplast genome of C. amaraeformis was sequenced and characterized. The chloroplast genome of C. amaraeformis was 155,598 bp in length, comprising a large single-copy (LSC) region of 84,574 bp and a small single-copy (SSC) region of 17,976 bp and a pair of inverted repeats (IRs) of 26,524 bp. The genome contained 131 genes, including 86 protein-coding (PCGs), 37 tRNA and 8 rRNA genes. Of those, 6 PCGs, 8 tRNA and 4 rRNA genes were duplicated in the IR region and one gene was a pseudogene. The GC content of the C. amaraeformis chloroplast genome was 36.3%. Phylogenetic analysis revealed that all Cardamine species formed a monophyletic clade and C. amaraeformis was closely associated with C. parviflora. Therefore, the present study could help to distinguish C. scutata and resolve the phylogenetic relationships among the Cardamine lineage.
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Ultra-thin two-dimensional semiconducting crystals in their monolayer and few-layer forms show promising aspects in nanoelectronic applications. However, the ultra-thin nature of two-dimensional crystals inevitably results in high contact resistance from limited channel/contact volume as well as device-to-device variability, which seriously limit reliable applications using two-dimensional semiconductors. Here, we incorporate rather thick two-dimensional layered semiconducting crystals for reliable vertical diodes showing excellent Ohmic and Schottky contacts. Using the vertical transport of WSe2, we demonstrate devices which are functional at various frequency ranges from megahertz AM demodulation of audio signals, to gigahertz rectification for fifth-generation wireless electronics, to ultraviolet-visible photodetection. The WSe2 exhibits an excellent Ohmic contact to bottom platinum electrode with record-low contact resistance (~50 Ω) and an exemplary Schottky junction to top transparent conducting oxide electrode. Our semitransparent vertical WSe2 Schottky diodes could be a key component of future high frequency electronics in the era of fifth-generation wireless communication.
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BACKGROUND/AIMS: This study compared the prognostic values of the Model for End-stage Liver Disease (MELD) and the hepatic venous pressure gradient (HVPG) in the prediction of death within 3 and 12 months in patients with decompensated liver cirrhosis. METHODS: We used data from 136 consecutive patients with decompensated cirrhosis who underwent HVPG between January 2006 and June 2008. Cox regression analysis was used to investigate the independent relationships with death of MELD and HVPG. The prognostic accuracies of MELD and HVPG were analyzed by calculating the area under the receiver operating characteristic curve (AUROC) for the occurrence of death within 3 and 12 months. RESULTS: Both MELD and HVPG were independent predictors of death [hazard ratio (HR)=1.11 and 1.12, respectively; 95% confidence interval (CI)=1.04~1.20 and 1.08-1.16]. Analysis of the AUROC demonstrated that the prognostic power did not differ between MELD and HVPG for predicting the 3-month survival (HR=0.76 and 0.68, respectively; 95% CI=0.62~0.89 and 0.52~0.84; P=0.22) or the 12-month survival (HR=0.72 and 0.73, 95% CI=0.61~0.83 and CI=0.61~0.84). CONCLUSIONS: Both MELD and HVPG are independent prognostic factors of death within 3 and 12 months in patients with decompensated liver cirrhosis, and their accuracies are similar. However, HVPG has a limited role in the prediction of death in decompensated cirrhosis due to its invasiveness and limited use.
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Veias Hepáticas/fisiopatologia , Cirrose Hepática/mortalidade , Falência Hepática/mortalidade , Adulto , Idoso , Área Sob a Curva , Estudos de Coortes , Feminino , Humanos , Cirrose Hepática/diagnóstico , Cirrose Hepática/fisiopatologia , Falência Hepática/diagnóstico , Falência Hepática/fisiopatologia , Masculino , Pessoa de Meia-Idade , Modelos Biológicos , Valor Preditivo dos Testes , Prognóstico , Modelos de Riscos Proporcionais , Análise de Regressão , Estudos Retrospectivos , Índice de Gravidade de Doença , Análise de Sobrevida , Pressão VenosaRESUMO
The complete chloroplast genome of Lamium takesimense (Lamiaceae), an endemic species in South Korea, are presented in this article. The genome size is 150,626 bp in length, with 38.6% of GC content. It consists a large single-copy (LSC) region (82,527bp) and a small single-copy region (SSC) (17,185bp) which were separated by two inverted repeat (IRs) regions (25,457bp). The complete chloroplast genome contains 111 unique genes, including 77 protein-coding genes, 4 rRNA genes, and 30 tRNA genes.
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The complete chloroplast genome of Centaurea maculosa (Asteraceae) was presented in this article. The genome size is 152,518 bp in length, with 43.1% of GC content. It consists of a large single-copy (LSC) region (83,959 bp) and a small single-copy region (SSC) (18,487 bp) which were separated by two inverted repeat (IRs) regions (25,218 bp). The complete chloroplast genome contains 111 unique genes, including 80 coding genes, 4 rRNA genes, and 27 tRNA genes.
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BACKGROUND AND OBJECTIVES: There are no data comparing clinical outcomes of complex percutaneous coronary intervention (PCI) between biodegradable polymer-biolimus-eluting stents (BP-BES) and durable polymer-everolimus-eluting stents (DP-EES). We sought to evaluate the safety and efficacy of BP-BES compared with DP-EES in patients undergoing complex PCI. METHODS: Patients enrolled in the SMART-DESK registry were stratified into 2 categories based on the complexity of PCI. Complex PCI was defined as having at least one of the following features: unprotected left main lesion, ≥2 lesions treated, total stent length >40 mm, minimal stent diameter ≤2.5 mm, or bifurcation as target lesion. The primary outcome was target lesion failure (TLF), defined as a composite of cardiac death, target vessel-related myocardial infarction (TV-MI), or target lesion revascularization (TLR) at 2 years of follow-up. RESULTS: Of 1,999 patients, 1,145 (57.3%) underwent complex PCI: 521 patients were treated with BP-BES and 624 with DP-EES. In propensity-score matching analysis (481 pairs), the risks of TLF (3.8% vs. 5.2%, adjusted hazard ratio [HR], 0.578; 95% confidence interval [CI], 0.246-1.359; p=0.209), cardiac death (2.5% vs. 2.5%, adjusted HR, 0.787; 95% CI, 0.244-2.539; p=0.689), TV-MI (0.5% vs. 0.4%, adjusted HR, 1.128; 95% CI, 0.157-8.093; p=0.905), and TLR (1.1% vs. 2.9%, adjusted HR, 0.390; 95% CI, 0.139-1.095; p=0.074) did not differ between 2 stent groups after complex PCI. CONCLUSIONS: Clinical outcomes of BP-BES were comparable to those of DP-EES at 2 years after complex PCI. Our data suggest that use of BP-BES is acceptable, even for complex PCI.
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The vasculature is an essential component of the circulatory system that plays a vital role in the development, homeostasis, and disease of various organs in the human body. The ability to emulate the architecture and transport function of blood vessels in the integrated context of their associated organs represents an important requirement for studying a wide range of physiological processes. Traditional in vitro models of the vasculature, however, largely fail to offer such capabilities. Here we combine microfluidic three-dimensional (3D) cell culture with the principle of vasculogenic self-assembly to engineer perfusable 3D microvascular beds in vitro. Our system is created in a micropatterned hydrogel construct housed in an elastomeric microdevice that enables coculture of primary human vascular endothelial cells and fibroblasts to achieve de novo formation, anastomosis, and controlled perfusion of 3D vascular networks. An open-top chamber design adopted in this hybrid platform also makes it possible to integrate the microengineered 3D vasculature with other cell types to recapitulate organ-specific cellular heterogeneity and structural organization of vascularized human tissues. Using these capabilities, we developed stem cell-derived microphysiological models of vascularized human adipose tissue and the blood-retinal barrier. Our approach was also leveraged to construct a 3D organotypic model of vascularized human lung adenocarcinoma as a high-content drug screening platform to simulate intravascular delivery, tumor-killing effects, and vascular toxicity of a clinical chemotherapeutic agent. Furthermore, we demonstrated the potential of our platform for applications in nanomedicine by creating microengineered models of vascular inflammation to evaluate a nanoengineered drug delivery system based on active targeting liposomal nanocarriers. These results represent a significant improvement in our ability to model the complexity of native human tissues and may provide a basis for developing predictive preclinical models for biopharmaceutical applications.
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Adenocarcinoma de Pulmão/patologia , Técnicas de Cultura de Células , Engenharia Celular , Células Endoteliais/citologia , Fibroblastos/citologia , Técnicas Analíticas Microfluídicas , Adenocarcinoma de Pulmão/irrigação sanguínea , Humanos , Hidrogéis/química , MicrocirculaçãoRESUMO
Occlusion of distal airways due to mucus plugs is a key pathological feature common to a wide variety of obstructive pulmonary diseases. Breathing-induced movement of airway mucus plugs along the respiratory tract has been shown to generate abnormally large mechanical stresses, acting as an insult that can incite acute injury to the airway epithelium. Here, we describe a unique microengineering strategy to model this pathophysiological process using a bioinspired microfluidic device. Our system combines an air-liquid interface culture of primary human small airway epithelial cells with a microengineered biomimetic platform to replicate the process of mucus exudation induced by airway constriction that leads to the formation of mucus plugs across the airway lumen. Specifically, we constructed a compartmentalized three-dimensional (3D) microfluidic device in which extracellular matrix hydrogel scaffolds reminiscent of airway stroma were compressed to discharge fluid into the airway compartment and form liquid plugs. We demonstrated that this plug formation process and subsequent movement of liquid plugs through the airway channel can be regulated in a precisely controlled manner. Furthermore, we examined the detrimental effect of plug propagation on the airway epithelium to simulate acute epithelial injury during airway closure. Our system allows for a novel biomimetic approach to modeling a complex and dynamic biophysical microenvironment of diseased human airways and may serve as an enabling platform for mechanistic investigation of key disease processes that drive the progression and exacerbation of obstructive pulmonary diseases.
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Background Whether use of high-intensity statins is more important than achieving low-density lipoprotein cholesterol ( LDL -C) target remains controversial in patients with coronary artery disease. We sought to investigate the association between statin intensity and long-term clinical outcomes in patients achieving treatment target for LDL -C after percutaneous coronary intervention. Methods and Results Between February 2003 and December 2014, 1746 patients who underwent percutaneous coronary intervention and achieved treatment target for LDL -C (<70 mg/dL or >50% reduction from baseline level) were studied. We classified patients into 2 groups according to an intensity of statin prescribed after index percutaneous coronary intervention: high-intensity statin group (atorvastatin 40 or 80 mg, and rosuvastatin 20 mg, 372 patients) and non-high-intensity statin group (the other statin treatment, 1374 patients). The primary outcome was a composite of cardiac death, myocardial infarction, or stroke. Difference in time-averaged LDL -C during follow-up was significant, but small, between the high-intensity statin group and non-high-intensity statin group (59±13 versus 61±12 mg/dL; P=0.04). At 5 years, patients receiving high-intensity statins had a significantly lower incidence of the primary outcome than those treated with non-high-intensity statins (4.1% versus 9.9%; hazard ratio, 0.42; 95% confidence interval, 0.23-0.79; P<0.01). Results were consistent after propensity-score matching (4.2% versus 11.2%; hazard ratio, 0.36; 95% confidence interval, 0.19-0.69; P<0.01) and across various subgroups. Conclusions Among patients achieving treatment target for LDL -C after percutaneous coronary intervention, high-intensity statins were associated with a lower risk of major adverse cardiovascular events than non-high-intensity statins despite a small difference in achieved LDL -C level.
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Atorvastatina/administração & dosagem , LDL-Colesterol/sangue , LDL-Colesterol/efeitos dos fármacos , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/cirurgia , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Intervenção Coronária Percutânea , Rosuvastatina Cálcica/administração & dosagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Pós-OperatóriosRESUMO
Symplocarpus renifolius is a member of Araceae family that is extraordinarily diverse in appearance. Previous studies on chloroplast genomes in Araceae were focused on duckweeds (Lemnoideae) and root crops (Colocasia, commonly known as taro). Here, we determined the chloroplast genome of Symplocarpus renifolius and compared the factors, such as genes and inverted repeat (IR) junctions and performed phylogenetic analysis using other Araceae species. The chloroplast genome of S. renifolius is 158,521 bp and includes 113 genes. A comparison among the Araceae chloroplast genomes showed that infA in Lemna, Spirodela, Wolffiella, Wolffia, Dieffenbachia and Colocasia has been lost or has become a pseudogene and has only been retained in Symplocarpus. In the Araceae chloroplast DNA (cpDNA), psbZ is retained. However, psbZ duplication occurred in Wolffia species and tandem repeats were noted around the duplication regions. A comparison of the IR junction in Araceae species revealed the presence of ycf1 and rps15 in the small single copy region, whereas duckweed species contained ycf1 and rps15 in the IR region. The phylogenetic analyses of the chloroplast genomes revealed that Symplocarpus are a basal group and are sister to the other Araceae species. Consequently, infA deletion or pseudogene events in Araceae occurred after the divergence of Symplocarpus and aquatic plants (duckweeds) in Araceae and duplication events of rps15 and ycf1 occurred in the IR region.
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The complete chloroplast (cp) genome sequence of Clematis fusca var. coreana, an endemic plant in Korea, was determined. The genome size is 159,609 bp in length, with 38% GC content. A pair of inverted repeats (IRs) of 31,039 bp is separated by a large single copy (LSC) and a small single copy (SSC) of 79,478 bp and 18,053 bp, respectively. The complete cp genome contains 112 unique genes, including 79 coding genes, 4 rRNA genes, and 29 tRNA genes.
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Clematis/genética , Genoma de Cloroplastos/genética , Ranunculaceae/genética , Composição de Bases/genética , Cloroplastos/genética , Genes de Plantas/genética , Tamanho do Genoma/genética , Genoma de Planta/genética , Filogenia , RNA de Transferência/genética , República da Coreia , Análise de Sequência de DNA/métodosRESUMO
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is a useful treatment for refractory out-of-hospital cardiac arrest (OHCA). However, little is known about the predictors of survival and neurologic outcome after ECMO. We analyzed our institution's experience with ECMO for refractory OHCA and evaluated the predictors of survival and neurologic outcome after ECMO. METHODS: This was a retrospective review of the medical records of 23 patients who were treated with ECMO due to OHCA that was unresponsive to conventional cardiopulmonary resuscitation, between January 2009 and January 2014. RESULTS: Our ECMO team was activated within 10 min for refractory OHCA, and the 30-day survival rate was 43.5 %. In a multivariate analysis that evaluated independent factors contributing to mortality, urine output ≤ 0.5 mL · kg(-1) · h(-1) (defined as oliguria) during the 24 h after ECMO was statistically significant (OR, 32.271; 95 % CI, 1.379-755.282; p = 0.031). Just after ECMO implantation, 6 of the 9 patients (66.7 %) who had normal findings on brain computed tomography (CT) survived with a cerebral performance category (CPC) of grade 1. However, only 3 of the 11 patients (27 %) who had evidence of hypoxic brain damage on initial brain CT survived (their CPC grade was 4). CONCLUSIONS: Based on our findings, the survival rate can be improved by rapid implantation of ECMO, and oliguria seen during the first 24 h after ECMO may be an independent predictor of mortality. Furthermore, findings on brain CT just after ECMO and subsequent images may represent an important predictor for neurologic outcome after ECMO.
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Reanimação Cardiopulmonar/métodos , Oxigenação por Membrana Extracorpórea/métodos , Hipóxia Encefálica/prevenção & controle , Parada Cardíaca Extra-Hospitalar/terapia , Adulto , Idoso , Feminino , Humanos , Hipóxia Encefálica/epidemiologia , Hipóxia Encefálica/etiologia , Incidência , Masculino , Pessoa de Meia-Idade , Parada Cardíaca Extra-Hospitalar/complicações , Parada Cardíaca Extra-Hospitalar/mortalidade , República da Coreia/epidemiologia , Estudos Retrospectivos , Taxa de Sobrevida/tendências , Resultado do TratamentoRESUMO
OBJECTIVES: Recent studies have emphasized the potential information embedded in peripheral fingertip photoplethysmogram (PPG) signals for the assessment of arterial wall stiffening during aging. For the discrimination of arterial stiffness with age, the brachial-ankle pulse wave velocity (baPWV) has been widely used in clinical applications. The second derivative of the PPG (acceleration photoplethysmogram [APG]) has been reported to correlate with the presence of atherosclerotic disorders. In this study, we investigated the association among age, the baPWV, and the APG and found a new aging index reflecting arterial stiffness for a healthcare device. METHODS: The APG and the baPWV were simultaneously applied to assess the accuracy of the APG in measuring arterial stiffness in association with age. A preamplifier and motion artifact removal algorithm were newly developed to obtain a high quality PPG signal. In total, 168 subjects with a mean ± SD age of 58.1 ± 12.6 years were followed for two months to obtain a set of complete data using baPWV and APG analysis. RESULTS: The baPWV and the B ratio of the APG indices were correlated significantly with age (r = 0.6685, p < 0.0001 and r = -0.4025, p < 0.0001, respectively). A regression analysis revealed that the c and d peaks were independent of age (r = -0.3553, p < 0.0001 and r = -0.3191, p < 0.0001, respectively). CONCLUSIONS: We determined the B ratio, which represents an improved aging index and suggest that the APG may provide qualitatively similar information for arterial stiffness.