Publications by authors named "Eun Young Choi"

443 Publications

Risk Factors and a Scoring System to Predict ARDS in Patients with COVID-19 Pneumonia in Korea: A Multicenter Cohort Study.

Dis Markers 2021 9;2021:8821697. Epub 2021 Apr 9.

Department of Infectious Diseases, Chonnam National University Hospital, Gwangju, Republic of Korea.

Predictive studies of acute respiratory distress syndrome (ARDS) in patients with coronavirus disease 2019 (COVID-19) are limited. In this study, the predictors of ARDS were investigated and a score that can predict progression to ARDS in patients with COVID-19 pneumonia was developed. All patients who were diagnosed with COVID-19 pneumonia between February 1, 2020, and May 15, 2020, at five university hospitals in Korea were enrolled. Their demographic, clinical, and epidemiological characteristics and the outcomes were collected using the World Health Organization COVID-19 Case Report Form. A logistic regression analysis was performed to determine the predictors for ARDS. The receiver operating characteristic (ROC) curves were constructed for the scoring model. Of the 166 patients with COVID-19 pneumonia, 37 (22.3%) patients developed ARDS. The areas under the curves for the infiltration on a chest X-ray, C-reactive protein, neutrophil/lymphocyte ratio, and age, for prediction of ARDS were 0.91, 0.90, 0.87, and 0.80, respectively (all < 0.001). The COVID-19 ARDS Prediction Score (CAPS) was constructed using age (≥60 years old), C-reactive protein (≥5 mg/dL), and the infiltration on a chest X-ray (≥22%), with each predictor allocated 1 point. The area under the curve of COVID-19 ARDS prediction score (CAPS) for prediction of ARDS was 0.90 (95% CI 0.86-0.95; < 0.001). It provided 100% sensitivity and 75% specificity when the CAPS score cutoff value was 2 points. CAPS, which consists of age, C-reactive protein, and the area of infiltration on a chest X-ray, was predictive of the development of ARDS in patients with COVID-19 pneumonia.
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http://dx.doi.org/10.1155/2021/8821697DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8052177PMC
April 2021

Two-stage Cox-nnet: biologically interpretable neural-network model for prognosis prediction and its application in liver cancer survival using histopathology and transcriptomic data.

NAR Genom Bioinform 2021 Mar 22;3(1):lqab015. Epub 2021 Mar 22.

Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI 48104, USA.

Pathological images are easily accessible data with the potential of prognostic biomarkers. Moreover, integration of heterogeneous data types from multi-modality, such as pathological image and gene expression data, is invaluable to help predicting cancer patient survival. However, the analytical challenges are significant. Here, we take the hepatocellular carcinoma (HCC) pathological image features extracted by CellProfiler, and apply them as the input for Cox-nnet, a neural network-based prognosis prediction model. We compare this model with the conventional Cox proportional hazards (Cox-PH) model, CoxBoost, Random Survival Forests and DeepSurv, using -index and log-rank -values. The results show that Cox-nnet is significantly more accurate than Cox-PH and Random Survival Forests models and comparable with CoxBoost and DeepSurv models, on pathological image features. Further, to integrate pathological image and gene expression data of the same patients, we innovatively construct a two-stage Cox-nnet model, and compare it with another complex neural-network model called PAGE-Net. The two-stage Cox-nnet complex model combining histopathology image and transcriptomic RNA-seq data achieves much better prognosis prediction, with a median -index of 0.75 and log-rank -value of 6e-7 in the testing datasets, compared to PAGE-Net (median -index of 0.68 and log-rank -value of 0.03). Imaging features present additional predictive information to gene expression features, as the combined model is more accurate than the model with gene expression alone (median -index 0.70). Pathological image features are correlated with gene expression, as genes correlated to top imaging features present known associations with HCC patient survival and morphogenesis of liver tissue. This work proposes two-stage Cox-nnet, a new class of biologically relevant and interpretable models, to integrate multiple types of heterogenous data for survival prediction.
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http://dx.doi.org/10.1093/nargab/lqab015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7985035PMC
March 2021

Clinical features and prognostic factors in 71 eyes over 20 years from patients with Coats' disease in Korea.

Sci Rep 2021 Mar 17;11(1):6124. Epub 2021 Mar 17.

Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, Eonjuro 211, Gangnam-gu, Seoul, 06273, Republic of Korea.

This retrospective study assesses the clinical features, treatment strategies, and long-term outcomes of patients with Coats' disease in Korea. Multimodal imaging and medical records of consecutive patients treated between July 2000 and April 2020 at two tertiary centers were evaluated based on onset age (adult vs. childhood [< 18 years]). Factors associated with final visual acuity (VA) and risk of treatment failure were assessed. A total of 71 eyes of 67 patients were included, with subgrouping by onset age showing 45% childhood and 55% adult cases. Overall, Stage 2 disease was most common at presentation (76%), though childhood cases had more Stage 3b (22% vs. 3%, P = 0.02) and greater clock hours of retinal telangiectasia (7 vs. 5, P = 0.005). First-line treatment included laser (25%), combined laser/anti-VEGF (23%), cryotherapy (20%), surgery (16%), and anti-VEGF only (9%). Cryotherapy was associated with a higher risk for secondary interventions (OR 11.8, P < 0.001), required in 56% overall. Despite a 3-line VA decrease in 34% overall, adult cases had superior final VA (P = 0.037). Multivariable regression showed that the number of anti-VEGF injections performed during the initial treatment period was associated with a 9.4 letter improvement in vision (P = 0.041). We observed a higher proportion of adult-onset Coats' disease than previously reported in other non-Asian populations. An aggressive treatment with the addition of anti-VEGF may yield the most favorable long-term visual outcomes.
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http://dx.doi.org/10.1038/s41598-021-85739-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7969742PMC
March 2021

Pregnancy outcomes in patients with structural heart disease: a single center experience.

Cardiovasc Diagn Ther 2021 Feb;11(1):81-90

Department of Pediatrics, Sejong General Hospital, Gyeonggi-do, Korea.

Background: In women, pregnancy is a period of relatively drastic hemodynamic change in a short period of time. Most pregnant women adapt well to these gradual hemodynamic changes. However, in women with congenital heart disease or other structural heart disease, adaptation to theses sudden hemodynamic changes is difficult, and heart failure or arrhythmia can get aggravated. This study shares our experiences on the outcomes of pregnancy in patients with structural heart disease.

Methods: From January 2007 to December 2016, we reviewed the medical records of all pregnant women with structural heart disease who received obstetric care at the Sejong General Hospital.

Results: During the study period, 103 pregnancies were observed in 79 women with structural heart disease. Of the 103 pregnancies, 55 were primiparous and 48 were multiparous. Echocardiography performed before pregnancy revealed that 52 patients had moderate to severe valvular regurgitation and 38 patients had moderate to severe valvular stenosis; 22 patients had mechanical valves and 5 patients had pulmonary hypertension. Overall, there were 9 maternal cardiac events, 7 obstetric events and 19 neonatal events. Pulmonary embolic events occurred only in 1 case; 77 deliveries were made, and 26 pregnancies did not last. Among 77 deliveries, 55 patients delivered by cesarean section (C/S) (71.43%). C/S in 16 of 55 patients was performed due to the maternal hemodynamic risk.

Conclusions: Overall complications associated with pregnancy in women with structural heart disease were very high at 28.16%. However, it is hoped that maternal and neonatal outcomes will be improved through careful observation and preparedness for anticipated complications.
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http://dx.doi.org/10.21037/cdt-20-786DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7944218PMC
February 2021

IDO1 scavenges reactive oxygen species in myeloid-derived suppressor cells to prevent graft-versus-host disease.

Proc Natl Acad Sci U S A 2021 Mar;118(10)

Department of Biomedical Sciences, Seoul National University College of Medicine, Chongno-gu, 03080 Seoul, Korea;

Tryptophan-catabolizing enzyme indoleamine 2,3-dioxygenase 1 (IDO1) also has an immunological function to suppress T cell activation in inflammatory circumstances, including graft-versus-host disease (GVHD), a fatal complication after allogeneic bone marrow transplantation (allo-BMT). Although the mononuclear cell expression of IDO1 has been associated with improved outcomes in GVHD, the underlying mechanisms remain unclear. Herein, we used IDO-deficient () BMT to understand why myeloid IDO limits the severity of GVHD. Hosts with BM exhibited increased lethality, with enhanced proinflammatory and reduced regulatory T cell responses compared with wild type (WT) allo-BMT controls. Despite the comparable expression of the myeloid-derived suppressor cell (MDSC) mediators, arginase-1, inducible nitric oxide synthase, and interleukin 10, Gr-1CD11b cells from allo-BMT or in vitro BM culture showed compromised immune-suppressive functions and were skewed toward the Ly6CLy6G subset, compared with the WT counterparts. Importantly, Gr-1CD11b cells exhibited elevated levels of reactive oxygen species (ROS) and neutrophil numbers. These characteristics were rescued by human IDO1 with intact heme-binding and catalytic activities and were recapitulated by the treatment of WT cells with the IDO1 inhibitor L1-methyl tryptophan. ROS scavenging by -acetylcysteine reverted the Gr-1CD11b composition and function to an MDSC state, as well as improved the survival of GVHD hosts with BM. In summary, myeloid-derived IDO1 enhances GVHD survival by regulating ROS levels and limiting the ability of Gr-1CD11b MDSCs to differentiate into proinflammatory neutrophils. Our findings provide a mechanistic insight into the immune-regulatory roles of the metabolic enzyme IDO1.
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http://dx.doi.org/10.1073/pnas.2011170118DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7958359PMC
March 2021

Opioid Literacy of Korean Americans in Rural Alabama: Addressing the Role of Social Determinants of Health.

J Transcult Nurs 2021 Feb 20:1043659621995902. Epub 2021 Feb 20.

Pusan Catholic University, Geumjeong-gu, Busan, South Korea.

Introduction: Opioid crisis has disproportionately affected Alabamians with the highest opioid prescription rate, and it is subjected to affect Korean Americans (KA) negatively based on common predictors of opioid misuse that KA possess.

Method: Cross-sectional data of KA in rural Alabama ( = 230) were analyzed. Opioid literacy was assessed by the Brief Opioid Overdose Knowledge survey. Six social determinants of health factors were considered: financial status, educational attainment, English proficiency, household food insecurity, health literacy, and social contact.

Results: Participants had limited opioid literacy ( = 3.56, = 3.06). After adjusting for demographics and health covariates, higher levels of overall opioid literacy were associated with higher household income ( = .48, < .01), higher levels of health literacy ( = .71, < .01), and less frequent social contact ( = -.40, < .01). Significant social determinants of health predictors varied across subdomains of opioid literacy.

Discussion: The findings suggest that culturally competent and community-level interventions are needed to increase opioid literacy in KA in rural Alabama.
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http://dx.doi.org/10.1177/1043659621995902DOI Listing
February 2021

Clinical features and prognostic factors of critically ill patients with COVID-19 in Daegu, South Korea: A multi-center retrospective study.

Medicine (Baltimore) 2021 Feb;100(7):e24437

Division of Pulmonary and Critical Care Medicine, Yeungnam University Medical Center, Daegu, Republic of Korea.

Abstract: To describe the clinical and demographic characteristics of critically ill patients with COVID-19 in Daegu, South Korea, and to explore the risk factors for in-hospital mortality in these patients.Retrospective cohort study of 110 critically ill patients with COVID-19 admitted to the ICU in Daegu, South Korea, between February 18 and April 5, 2020. The final date of follow-up was April 20, 2020.A total of 110 patient medical records were reviewed. The median age was 71 years (interquartile range [IQR] = 63-78 years). During the study period, 47 patients (42.7%) died in the hospital. The most common SARS-CoV-2 infection related complication was acute respiratory distress syndrome (ARDS) in 95 patients (86.4%). Of the 79 patients (71.8%) who received invasive mechanical ventilation, 46 (58.2%) received neuromuscular blockade injection, and 19 (24.1%) received ECMO treatment. All patients received antibiotic injection, 99 patients (90%) received hydroxychloroquine, 96 patients (87.3%) received lopinavir-ritonavir antiviral medication, and 14 patients (12.7%) received other antiviral agents, including darunavir-cobicistat and emtricitabine-tenofovir. In the multivariable logistic regression model, the odds ratio of in-hospital death was higher with APACHE II score (OR = 1.126; 95% CI = 1.014-1.252; P  = .027).The in-hospital mortality rate of critically ill patients with COVID-19 was approximately 40%. Higher APACHE II score at admission was an independent risk factor for death in these patients.
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http://dx.doi.org/10.1097/MD.0000000000024437DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7899898PMC
February 2021

Discordance Between Subjective and Objective Cognitive Function in Older Korean Americans.

J Aging Health 2021 Feb 18:898264320988407. Epub 2021 Feb 18.

School of Nursing, University of Texas at Austin, TX, USA.

To examine predictors of membership in discordant groups identified by subjective and objective measures of cognitive function. Participants in the Study of Older Korean Americans ( = 2046) were classified according to their subjective cognitive ratings (// vs. /) and Mini-Mental State Examination scores (normal cognition vs. cognitive impairment), yielding two discordant groups: (1) positive ratings but cognitive impairment and (2) negative ratings but normal cognition. Logistic regression models examined how the discordant group membership was associated with personal resources. Among those with positive cognitive ratings, the odds of belonging to the discordant group were associated with low personal resources (advanced age and lower levels of education, acculturation, and knowledge about Alzheimer's disease). However, an opposite pattern was observed among those with negative ratings. The pattern of discordance suggests ways to promote early detection of cognitive impairment and close the gap in cognitive health care.
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http://dx.doi.org/10.1177/0898264320988407DOI Listing
February 2021

Cognitive health risks posed by social isolation and loneliness in older Korean Americans.

BMC Geriatr 2021 02 16;21(1):123. Epub 2021 Feb 16.

School of Nursing, University of Texas at Austin, Austin, USA.

Background: This study examines associations among social isolation, loneliness, and cognitive health risks in older Korean Americans, focusing on the mediating role of loneliness in the relationship between social isolation and objective and subjective measures of cognitive impairment.

Methods: Data are from 2061 participants in the Study of Older Korean Americans, a multi-state survey of Korean immigrants age 60 and older (M = 73.2, SD = 7.93). Social isolation was indexed with the Lubben Social Network Scale- 6; loneliness, with the short-form UCLA Loneliness Scale. Objective and subjective measures of cognitive impairment included the Mini-Mental State Examination and a single-item self-rating of cognitive health.

Results: In the logistic regression model for objective cognitive impairment, social isolation was significantly associated, but loneliness was not. In the model for subjective cognitive impairment, both social isolation and loneliness were significant factors. However, the effect of social isolation became non-significant when loneliness was considered, suggesting a potential mediating role of loneliness. The subsequent mediation analysis confirmed that the indirect effect of social isolation on subjective cognitive impairment through loneliness was significant (B = .20, SE = .03, 95% CI = .12, .28).

Conclusion: Our analyses provide evidence for the proposed mediating effect of loneliness in the relationship between social isolation and subjective cognitive impairment. Intervention efforts should focus on reducing feelings of loneliness experienced by older immigrants, possibly by engaging them in socially meaningful and cognitively stimulating activities.
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http://dx.doi.org/10.1186/s12877-021-02066-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7885241PMC
February 2021

The Association between Job Quality Profiles and Work-Life Balance among Female Employees in Korea: A Latent Profile Analysis.

Int J Environ Res Public Health 2021 02 9;18(4). Epub 2021 Feb 9.

Red Cross College of Nursing, Chung-Ang University, Seoul 06974, Korea.

Women's participation in society has been increasing; however, they often remain overloaded with housework, and this gender role difference can hinder their work-life balance in Korea. Therefore, this study classified latent profiles according to job quality indices for South Korean female employees and examined the characteristics of each profile and how they affect work-life balance. This study was a secondary analysis of data collected through the fifth Korean Working Conditions Survey in South Korea. The Bayesian information criterion, entropy, and the Lo-Mendell-Rubin adjusted likelihood ratio test were used to determine the number of latent profiles. Chi-square tests were conducted to understand the characteristics of each profile. Comparisons between work-life balance and the latent profiles were made using the Bolck-Croon-Hagenaars method. Female employees in South Korea were classified into five profiles: "high-flying," "smooth," "footloose," "strict," and "manual." The "footloose" profile showed the most positive work-life balance, and the "manual" profile had the highest level of work-family conflict. Therefore, policies and social supports should be created with the aim of improving the implementation of current strategies promoting work-life balance to better fit each working condition.
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http://dx.doi.org/10.3390/ijerph18041672DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7916201PMC
February 2021

Social isolation in Asian Americans: risks associated with socio-demographic, health, and immigration factors.

Ethn Health 2021 Feb 8:1-14. Epub 2021 Feb 8.

Department of Child and Family Studies, University of South Florida, Tampa, FL, USA.

Objectives: The present study examined the factors associated with social isolation in Asian Americans. Three types of social isolation (social isolation from family, social isolation from friends, and overall social isolation), identified by the Lubben Social Network Scale-6, were examined with a sample of Asian Americans representing diverse ethnic groups (Chinese, Asian Indian, Korean, Vietnamese, Filipino, and other Asians) and a broad age range (18-98).

Design: Using data from the 2015 Asian American Quality of Life Survey ( = 2609), logistic regression models examined how each type of social isolation was predicted by sociodemographic (age, gender, ethnic origin, marital status, education, and perceived financial status), health-related (chronic medical conditions and self-rated health), and immigration-related (proportion of life in the United States and English proficiency) variables.

Results: The percentage of the sample that fell into the category of social isolation from family, social isolation from friends, and overall isolation ranged from 18.2% to 19.3%. At 36% in the friend category and 33% in the overall category, the Vietnamese sample showed a heightened risk of social isolation. Regression analyses indicated that, for both family and friend categories, individuals who were in the middle-aged group (40-59 years old) and who had limited English proficiency demonstrated higher odds of being isolated. Reflecting relational differences in family and friend networks, the risk associated with unmarried status was specific to social isolation from family, whereas having unmet financial needs was only associated with social isolation from friends.

Conclusions: The study findings expand our understanding of the multiple domains of social isolation in an understudied population and emphasize the importance of developing prevention and intervention programs to foster social connectedness among Asian Americans. Our findings on risk factors and ethnic variations help identify the groups to be prioritized in intervention efforts and suggest ways to approach them.
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http://dx.doi.org/10.1080/13557858.2021.1881765DOI Listing
February 2021

Progressive retinal vessel malformation in a premature infant with Sturge-Weber syndrome: a case report and a literature review of ocular manifestations in Sturge-Weber syndrome.

BMC Ophthalmol 2021 Jan 22;21(1):56. Epub 2021 Jan 22.

Department of Ophthalmology, The 2nd Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China.

Background: Sturge-Weber syndrome is a disorder marked by a distinctive facial capillary malformation, neurological abnormalities, and ocular abnormalities such as glaucoma and choroidal hemangioma.

Case Presentation: We report a case of progressively formed retinal vessel malformation in a premature male infant with Sturge-Weber syndrome and retinopathy of prematurity, after treatment with intravitreal anti-vascular endothelial growth factor (VEGF). The baby was born at 30 weeks gestation with a nevus flammeus involving his left eyelids and maxillary area. On postmenstrual age week 39, he received intravitreal anti-VEGF. Diffuse choroidal hemangioma became evident at 40 weeks, with the classic "tomato catsup fundus" appearance. These clinical findings characterized Sturge-weber syndrome. He presented with posterior retinal vessel tortuosity and vein-to-vein anastomoses at 44 weeks.

Conclusion: This is a rare case of documented progression of retinal vessel malformations in a patient with Sturge-Weber syndrome and retinopathy of prematurity.
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http://dx.doi.org/10.1186/s12886-021-01815-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7821406PMC
January 2021

Changes in retinal microvasculature and retinal layer thickness in association with apolipoprotein E genotype in Alzheimer's disease.

Sci Rep 2021 Jan 19;11(1):1847. Epub 2021 Jan 19.

Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.

Biomarker tests of Alzheimer's disease (AD) are invasive and expensive. Recent developments in optical coherence tomography (OCT) and OCT angiography (OCTA) have enabled noninvasive, cost-effective characterization of retinal layer vasculature and thickness. Using OCTA and OCT, we characterized retinal microvascular changes in the mild cognitive impairment (MCI) stage of AD and assessed their correlation with structural changes in each retinal neuronal layer. We also evaluated the effect of the APOE-ε4 genotype on retinal microvasculature and layer thickness. Retinal layer thickness did not differ between MCI patients (40 eyes) and controls (37 eyes, all p > 0.05). MCI patients had lower vessel density (VD) (p = 0.003) of the superficial capillary plexus (SCP) and larger foveal avascular zone area (p = 0.01) of the deep capillary plexus (DCP) than those of controls. VD of the SCP correlated with the ganglion cell layer (r = 0.358, p = 0.03) and inner plexiform layer thickness (r = 0.437, p = 0.007) in MCI patients. APOE-ε4-carrying MCI patients had a lower VD of the DCP than non-carriers (p = 0.03). In conclusion, retinal microvasculature was reduced in patients with AD-associated MCI, but retinal thickness was not changed; these changes might be affected by the APOE genotype. OCTA of the retinal microvasculature may be useful to detect vascular changes in AD.
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http://dx.doi.org/10.1038/s41598-020-80892-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7815838PMC
January 2021

Development and Evaluation of a Screening Scale for Indirect Trauma Caused by Media Exposure to Social Disasters.

Int J Environ Res Public Health 2021 01 15;18(2). Epub 2021 Jan 15.

Red Cross College of Nursing, Chung-Ang University, Seoul 06974, Korea.

As a result of mass media development, disaster-related information, such as the severity of damage, can be easily shared; thus, the issue of consequent indirect trauma has become as important as that of direct trauma. This study developed a scale to measure the degree of indirect trauma caused by media exposure to social disasters and then verified this scale's reliability and validity. Initial items were developed through a literature review; 39 items were selected by examining their content validity and conducting a pretest. To verify the scale's validity and reliability, exploratory factor analyses were conducted, and Cronbach's alpha coefficients were calculated. The explanatory power of the screening scale developed through this study was 62.2%. The scale was ultimately composed of three factors comprising 24 items. Through exploratory factor analyses, factors were identified as "psychological, physical, and behavioral responses to social disasters" (factor 1), "moral resentment due to social disasters" (factor 2), and "a sense of threat to life due to social disasters" (factor 3). Regarding internal reliability, Cronbach's alpha values ranged between 0.85 and 0.96. Future studies with expanded participant populations are suggested, which could further verify the scale's validity and reliability and complement its shortcomings.
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http://dx.doi.org/10.3390/ijerph18020698DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7830079PMC
January 2021

Demographic and Multimodal Imaging Features of Macular Telangiectasia Type 2: Korean Macular Telangiectasia Type 2 Study - Report No. 2.

Ophthalmic Epidemiol 2021 Jan 17:1-8. Epub 2021 Jan 17.

Department of Ophthalmology, Ajou University School of Medicine , Suwon, Korea.

: To investigate the demographic and multimodal imaging features of macular telangiectasia (MacTel) type 2 in Korea and their relationship with visual acuity and the clinical stage. : A retrospective multicentre cross-sectional study was conducted in six tertiary hospitals in Korea and the study included 84 patients. Demographic data and imaging data of fundus photography, fundus autofluorescence (FAF), confocal blue-light reflectance (CBR), fluorescein angiography (FAG), and optical coherence tomography (OCT) were collected. : The Korean patients with MacTel type 2 were predominantly female (75%), and the mean logMAR visual acuity was 0.282 ± 0.280 at initial presentation. Most commonly presented signs were the loss of retinal transparency in fundus photographs (68.3%); increased autofluorescence in FAF (83.6%); increased blue reflectance involving the centre in CBR (68.0%); telangiectatic vessels in FAG (88.2%); and hyporeflective cavities in OCT (77.7%). The eyes diagnosed in the first half of the study period (2009-2014) showed a tendency to be diagnosed at more advanced severe stages than those diagnosed in the second half of the study period (2015-2019), using new severity scales based on FAG, FAF and OCT findings. : The clinical features of MacTel type 2 in Korean patients assessed by newer imaging modalities suggest that Korean patients and the Caucasian-dominant population show similar presentations. This study showed that MacTel type 2 can be diagnosed in the earlier phase of the disease by using new imaging modalities and through better understanding of the disease.
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http://dx.doi.org/10.1080/09286586.2021.1872088DOI Listing
January 2021

Long-term surgical outcomes of primary retropupillary iris claw intraocular lens implantation for the treatment of intraocular lens dislocation.

Sci Rep 2021 Jan 12;11(1):726. Epub 2021 Jan 12.

Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonjuro, Gangnam-gu, Seoul, 06273, Korea.

We aimed to investigate the efficacy and safety of primary retropupillary iris claw intraocular lens (R-IOL) implantation in patients with complete intraocular lens (IOL) dislocation. In this single-center retrospective case series, we reviewed the medical records of patients who underwent R-IOL implantation surgery with pars plana vitrectomy for the treatment of IOL dislocation between September 2014 and July 2019. The primary outcome was change in visual acuity (VA) up to 24 months postoperatively. The secondary outcomes included changes in intraocular pressure (IOP), refractive errors, and endothelial cell count (ECC) over the same period. Data of 103 eyes (98 patients) were analyzed. The mean uncorrected VA was significantly improved at one month postoperatively (- 0.69 logMAR, P < 0.001), compared to the preoperative value. IOP (- 2.3 mmHg, P = 0.008) and ECC (- 333.4 cells/mm, P = 0.027) significantly decreased one month post-surgery and remained stable thereafter. Postoperative mean spherical equivalents were similar to the prediction error throughout the follow-up period. IOP elevation (n = 8, 7.8%), cystoid macular edema (n = 4, 3.9%), and dislocation of the R-IOL (n = 10, 9.7%) were managed successfully. Overall, primary R-IOL implantation with pars plana vitrectomy is effective and safe for correcting IOL dislocation due to various causes.
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http://dx.doi.org/10.1038/s41598-020-80292-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7804091PMC
January 2021

COVID-19 Social Distancing Measures and Loneliness Among Older Adults.

J Gerontol B Psychol Sci Soc Sci 2021 Jan 11. Epub 2021 Jan 11.

Leonard Davis School of Gerontology, University of Southern California, Los Angeles.

Objectives: In response to the COVID-19 pandemic, older adults are advised to follow social distancing measures to prevent infection. However, such measures may increase the risk of loneliness. The current study aimed to investigate (1) whether social distancing measures, particularly limiting close social interactions, are associated with loneliness among older adults, and (2) whether the association between social distancing measures and loneliness is moderated by sociodemographic characteristics.

Methods: Data were from the fourth wave (April 29 to May 26, 2020) of the nationally representative Understanding America Study COVID-19 Survey. We used data on adults 50 years or older (N = 3,253). Logistic regression models of loneliness were performed. Five indicators of social distancing measures were considered: (a) avoiding public spaces, gatherings, or crowds, (b) canceling or postponing social activities, (c) social visits, (d) no close contact (within 6 feet) with people living together, and (e) with people not living together.

Results: Cancelling or postponing social activities and avoiding close contact with people living together were associated with 33% (OR=1.33, CI=1.06-1.68, p < .05) and 47% (OR=1.47, CI=1.09-1.99, p < .05) greater odds of loneliness, respectively. Furthermore, limiting close contact with co-residents increased the probability of loneliness more for males, non-Hispanic Whites, those with higher levels of education and income.

Discussion: Efforts should be made to help older adults maintain social connectedness with close others by virtual communication methods. Our findings also call special attention to vulnerable groups at elevated risks of loneliness, emphasizing the need for tailored interventions.
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http://dx.doi.org/10.1093/geronb/gbab009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7928665PMC
January 2021

Predicting Global Test-Retest Variability of Visual Fields in Glaucoma.

Ophthalmol Glaucoma 2020 Dec 11. Epub 2020 Dec 11.

Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts. Electronic address:

Purpose: To model the global test-retest variability of visual fields (VFs) in glaucoma.

Design: Retrospective cohort study.

Participants: Test-retest VFs from 4044 eyes of 4044 participants.

Methods: We selected 2 reliable VFs per eye measured with the Humphrey Field Analyzer (Swedish interactive threshold algorithm 24-2) within 30 days of each other. Each VF had fixation losses (FLs) of 33% or less, false-negative results (FNRs) of 20% or less, and false-positive results (FPRs) of 20% or less. Stepwise linear regression was applied to select the model best predicting the global test-retest variability from 3 categories of features of the first VF: (1) base parameters (age, mean deviation, pattern standard deviation, glaucoma hemifield test results, FPR, FNR, and FL); (2) total deviation (TD) at each location; and (3) computationally derived archetype VF loss patterns. The global test-retest variability was defined as root mean square deviation (RMSD) of TD values at all 52 VF locations.

Main Outcome Measures: Archetype models to predict the global test-retest variability.

Results: The mean ± standard deviation of the root mean square deviation was 4.39 ± 2.55 dB. Between the 2 VF tests, TD values were correlated more strongly in central than in peripheral VF locations (intraclass coefficient, 0.66-0.89; P < 0.001). Compared with the model using base parameters alone (adjusted R = 0.45), adding TD values improved prediction accuracy of the global variability (adjusted R = 0.53; P < 0.001; Bayesian information criterion [BIC] decrease of 527; change of >6 represents strong improvement). Lower TD sensitivity in the outermost peripheral VF locations was predictive of higher global variability. Adding archetypes to the base model improved model performance with an adjusted R of 0.53 (P < 0.001) and lowering of BIC by 583. Greater variability was associated with concentric peripheral defect, temporal hemianopia, inferotemporal defect, near total loss, superior peripheral defect, and central scotoma (listed in order of decreasing statistical significance), and less normal VF results and superior paracentral defect.

Conclusions: Inclusion of archetype VF loss patterns and TD values based on first VF improved the prediction of the global test-retest variability than using traditional global VF indices alone.
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http://dx.doi.org/10.1016/j.ogla.2020.12.001DOI Listing
December 2020

Corticostriatal Projections of Macaque Area 44.

Cereb Cortex Commun 2020 5;1(1):tgaa079. Epub 2020 Nov 5.

Basic Neuroscience Division, McLean Hospital, Belmont, MA 02478, USA.

Ventrolateral frontal area 44 is implicated in inhibitory motor functions and facilitating prefrontal control over vocalization. The contribution of corticostriatal circuits to area 44 functions is unclear, as prior investigation of area 44 projections to the striatum-a central structure in motor circuits-is limited. Here, we used anterograde and retrograde tracing in macaques to map the innervation zone of area 44 corticostriatal projections, quantify their strengths, and evaluate their convergence with corticostriatal projections from other frontal cortical regions. First, whereas terminal fields from a rostral area 44 injection site were found primarily in the central caudate nucleus, those from a caudal area 44 injection site were found primarily in the ventrolateral putamen. Second, amongst sampled injection sites, area 44 input as a percentage of total frontal cortical input was highest in the ventral putamen at the level of the anterior commissure. Third, area 44 projections converged with orofacial premotor area 6VR and other motor-related projections (in the putamen), and with nonmotor prefrontal projections (in the caudate nucleus). Findings support the role of area 44 as an interface between motor and nonmotor functional domains, possibly facilitated by rostral and caudal area 44 subregions with distinct corticostriatal connectivity profiles.
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http://dx.doi.org/10.1093/texcom/tgaa079DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7699020PMC
November 2020

Inter-Eye Association of Visual Field Defects in Glaucoma and Its Clinical Utility.

Transl Vis Sci Technol 2020 11 17;9(12):22. Epub 2020 Nov 17.

Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.

Purpose: To investigate intereye associations of visual field (VF) defects.

Methods: We selected 24-2 VF pairs of both eyes from 63,604 patients tested on the same date with mean deviation (MD) ≥ -12 dB. VFs were decomposed into one normal and 15 defect patterns previously identified using archetypal analysis. VF pattern weighting coefficients were correlated between the worse and better eyes, as defined by MD. VF defect patterns (weighting coefficients > 10%) in the better eye were predicted from weighting coefficients of the worse eye by logistic regression models, which were evaluated by area under the receiver operating characteristic curve (AUC).

Results: Intereye correlations of archetypal VF patterns were strongest for the same defect pattern between fellow eyes. The AUCs for predicting the presence of 15 defect patterns in the better eye based on the worse eye ranged from 0.69 (superior nasal step) to 0.92 (near total loss). The AUC for predicting superior paracentral loss was 0.89. Superior paracentral loss in the better eye was positively correlated with coefficients of superior paracentral loss, central scotoma, superior altitudinal defect, nasal hemianopia, and inferior paracentral loss in the worse eye, and negatively correlated with coefficients of the normal VF, superior peripheral defect, concentric peripheral defect, and temporal wedge. The parameters are presented in the descending order of statistical significance.

Conclusions: VF patterns of the worse eye are predictive of VF defects in the better eye.

Translational Relevance: Our models can potentially assist clinicians to better interpret VF loss under measurement uncertainty.
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http://dx.doi.org/10.1167/tvst.9.12.22DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7683854PMC
November 2020

Effect of Intravitreal Bevacizumab Injection before Panretinal Photocoagulation on the Prevention of Macular Edema Aggravation in Proliferative Diabetic Retinopathy.

J Clin Med 2020 Nov 23;9(11). Epub 2020 Nov 23.

Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul 03722, Korea.

Objective: To investigate the effects of intravitreal bevacizumab (IVB) injection before PRP on the prevention of macular edema (ME) in patients with PDR.

Methods: This retrospective observational study included patients diagnosed with PDR treated by PRP with (combination group) or without (PRP alone group) preoperative IVB injection (1.25 mg/0.05 mL). The primary outcome measure was the change in the central macular thickness (CMT), while the secondary outcome measure was the change in visual acuity. Measurements were made before and at one, two, and three months after treatment.

Results: In the PRP alone group, the mean baseline CMT of 277.8 μm increased to 290.4 μm at one month ( = 0.201) and 308.8 μm at two months ( = 0.002), followed by a decrease to 271.2 μm at three months ( = 0.437). In the combination group, the values at baseline and one, two, and three months after PRP were 322.9 μm, 295.4 μm ( = 0.002), 330.1 μm ( = 0.906), and 274.5 μm ( = 0.030), respectively. Visual acuity changes were comparable between the two groups at all time points.

Conclusion: IVB injection before PRP leads to decreased CMT in comparison to CMT in patients with PRP alone.
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http://dx.doi.org/10.3390/jcm9113772DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7700292PMC
November 2020

Tricarbonyldichlororuthenium(II) dimer, the lipid-soluble carbon monoxide-releasing molecule, attenuates Prevotella intermedia lipopolysaccharide-induced production of nitric oxide and interleukin-1β in murine macrophages.

Int Immunopharmacol 2021 Jan 19;90:107190. Epub 2020 Nov 19.

Department of Periodontology, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan, Gyeongsangnam-do 626-870, Republic of Korea; Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Gyeongsangnam-do, Republic of Korea; Dental and Life Science Institute, Pusan National University, Yangsan, Gyeongsangnam-do, Republic of Korea. Electronic address:

Carbon monoxide (CO) is increasingly being appreciated as an important mediator that has pleiotropic biological properties and appears to have a possible therapeutic application for a variety of disorders. Nevertheless, whether this gaseous molecule may be utilized as a therapeutic intervention for periodontal disease is unclear. Here, we examined the potential beneficial effect of CO-releasing molecule-2 (CORM-2), a tricarbonyldichlororuthenium(II) dimer, against the elaboration of proinflammatory mediators by murine macrophages challenged with lipopolysaccharide (LPS) isolated from Prevotella intermedia, a pathogenic bacterium implicated in inflammatory periodontal disease. We found that NO and IL-1β production, iNOS protein expression and mRNA expressions of iNOS and IL-1β were significantly down-regulated when LPS-challenged RAW264.7 cells were exposed to CORM-2. In addition, HO-1 expression was upregulated by CORM-2 in cells activated with P. intermedia LPS, and the inhibitory influence of CORM-2 upon NO production was attenuated by tin protoporphyrin IX, an inhibitor of HO activity. PPAR-γ did not function in the attenuation of NO and IL-1β by CORM-2. JNK and p38 phosphorylation caused by LPS was not altered by CORM-2. CORM-2 reduced NF-κB reporter activity and IκB-α degradation elicited by P. intermedia LPS. Additionally, CORM-2 inhibited LPS-induced phosphorylation of STAT1/3. In conclusion, CORM-2 suppresses NO and IL-1β production caused by P. intermedia LPS. CORM-2 exerts its effect by a mechanism involving anti-inflammatory HO-1 induction and attenuation of NF-κB and STAT1/3 activation, independently of PPAR-γ as well as JNK and p38. CORM-2 may hold promise as host response modulation agent for periodontal disease, though further research is indicated to verify the therapeutic effect.
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http://dx.doi.org/10.1016/j.intimp.2020.107190DOI Listing
January 2021

Utilization of pain and sedation therapy on noninvasive mechanical ventilation in Korean intensive care units: a multi-center prospective observational study.

Acute Crit Care 2020 Nov 9;35(4):255-262. Epub 2020 Nov 9.

Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Background: The use of sedative drugs may be an important therapeutic intervention during noninvasive ventilation (NIV) in intensive care units (ICUs). The purpose of this study was to assess the current application of analgosedation in NIV and its impact on clinical outcomes in Korean ICUs.

Methods: Twenty Korean ICUs participated in the study, and data was collected on NIV use during the period between June 2017 and February 2018. Demographic data from all adult patients, NIV clinical parameters, and hospital mortality were included.

Results: A total of 155 patients treated with NIV in the ICUs were included, of whom 26 received pain and sedation therapy (sedation group) and 129 did not (control group). The primary cause of ICU admission was due to acute exacerbation of obstructed lung disease (45.7%) in the control group and pneumonia treatment (53.8%) in the sedation group. In addition, causes of NIV application included acute hypercapnic respiratory failure in the control group (62.8%) and post-extubation respiratory failure in the sedation group (57.7%). Arterial partial pressure of carbon dioxide (PaCO2) levels before and after 2 hours of NIV treatment were significantly decreased in both groups: from 61.9±23.8 mm Hg to 54.9±17.6 mm Hg in the control group (P<0.001) and from 54.9±15.1 mm Hg to 51.1±15.1 mm Hg in the sedation group (P=0.048). No significant differences were observed in the success rate of NIV weaning, complications, length of ICU stay, ICU survival rate, or hospital survival rate between the groups.

Conclusions: In NIV patients, analgosedation therapy may have no harmful effects on complications, NIV weaning success, and mortality compared to the control group. Therefore, sedation during NIV may not be unsafe and can be used in patients for pain control when indicated.
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http://dx.doi.org/10.4266/acc.2020.00164DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7808848PMC
November 2020

Endogenous DEL-1 restrains melanoma lung metastasis by limiting myeloid cell-associated lung inflammation.

Sci Adv 2020 Nov 6;6(45). Epub 2020 Nov 6.

Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Distant metastasis represents the primary cause of cancer-associated death. Pulmonary metastasis is most frequently seen in many cancers, largely driven by lung inflammation. Components from primary tumor or recruited leukocytes are known to facilitate metastasis formation. However, contribution of target site-specific host factor to metastasis is poorly understood. Here, we show that developmental endothelial locus-1 (DEL-1), an anti-inflammatory factor abundant in the lung and down-regulated by inflammatory insults, protects from melanoma lung metastasis independently of primary tumor development and systemic immunosurveillance. DEL-1 deficiency is associated with gene profiles that favor metastatic progression with inflammation and defective immunosurveillance. Mechanistically, DEL-1 deficiency primarily influences Ly6G neutrophil accumulation in lung metastatic niche, leading to IL-17A up-regulation from γδ T cells and reduced antimetastatic NK cells. In support, neutrophil depletion or recombinant DEL-1 treatment profoundly reverses these effects. Thus, our results identify DEL-1 as a previously unrecognized link between tumor-induced inflammation and pulmonary metastasis.
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http://dx.doi.org/10.1126/sciadv.abc4882DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7673713PMC
November 2020

Relationship of Handgrip Strength to Metabolic Syndrome Among Korean Adolescents 10-18 Years of Age: Results from the Korean National Health and Nutrition Examination Survey 2014-18.

Authors:
Eun Young Choi

Metab Syndr Relat Disord 2021 03 2;19(2):93-99. Epub 2020 Nov 2.

Department of Family Medicine, School of Medicine, Dankook University, Cheonan, South Korea.

Handgrip strength (HGS), a simple, convenient, and economic measurement of muscle strength, is known to be related to metabolic syndrome (MetS) in adults. This relationship in adolescents, however, has not been widely examined. this study investigated the relationship of MetS (as defined by the International Diabetes Federation [IDF]'s criteria) to HGS in Korean adolescents. This cross-sectional study analyzed data on 2802 adolescents 10-18 years of age from the Korean National Health and Nutrition Examination Survey (KNHANES) 2014-18, which had measured and recorded HGS, body mass index, and other parameters relevant to MetS. Normalized HGS was defined as the sum of the maximum HGS from both hands normalized per weight. Complex sample multivariate logistic regression analyses were performed to investigate the relationship between HGS and MetS. The risk of MetS decreased with increasing sex-specific quartile of normalized HGS in both boys and girls after adjustment for age ( < 0.001). Higher HGS was associated with lower odds of having MetS, such that for every 5% increase of normalized HGS, the odds were decreased by factors of 0.79 (0.73-0.85) and 0.67 (0.59-0.77) for boys and girls, respectively, after age adjustment. This population-based, nationally representative study suggests that higher HGS is associated with lower risk of MetS in Korean adolescents regardless of sex.
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http://dx.doi.org/10.1089/met.2020.0074DOI Listing
March 2021

Nurses' experiences of patient safety incidents in Korea: a cross-sectional study.

BMJ Open 2020 10 31;10(10):e037741. Epub 2020 Oct 31.

Department of Preventive Medicine, University of Ulsan College of Medicine, Ulsan, Republic of Korea.

Objectives: The aim of this study was to investigate the scope and severity of the second victim problem among nurses by examining the experiences and effects of patient safety incidents (PSIs) on them.

Participants/setting: 492 nurses who had experienced PSIs and provide direct care in South Korean medical institutions.

Design: A cross-sectional study with anonymous online self-report questionnaires was conducted to nurses in order to examine the experiences and effects of PSIs. Scales measuring post-traumatic stress disorder (PTSD) and post-traumatic embitterment disorder (PTED) were used for a more quantitative examination of the effects of PSIs. A χ test was administered to find any difference in responses to difficulties due to PSIs between the direct and indirect experience of PSIs. Furthermore, linear regression analysis was conducted to investigate the factors related to scores on the PTSD and PTED scales.

Results: A statistically significant difference was observed for participants who reported having experienced sleeping disorders, with those with direct experience showing 42.4% sleeping disorders and indirect experience at 21.0%. Also, there was a statistically significant difference between the 34.3% with direct experience and the 22.1% with indirect experience regarding having considered duty or job changes (resignation). Regression analysis showed total PTSD scores for indirect experience at 11.97 points (95% CI: -17.31 to -6.63), lower than direct experience. Moreover, those who thought the medical error was not involved in PSI had a total PTED score 4.39 points (95% CI: -7.23 to -1.55) lower than those who thought it was involved.

Conclusions: A considerable number of nurses experienced psychological difficulties due to PSIs at levels that could interfere with their work. The effect of PSIs on nurses with direct experience of PSIs was greater compared with those with indirect experience. There need to be psychological support programmes for nurses to alleviate the negative effects of PSIs.
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http://dx.doi.org/10.1136/bmjopen-2020-037741DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7783619PMC
October 2020

Subretinal Deposits in Pre-eclampsia and Malignant Hypertension: Implications for Age-Related Macular Degeneration.

Ophthalmol Retina 2020 Oct 28. Epub 2020 Oct 28.

Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address:

Purpose: To describe the incidence of subretinal deposits that are similar in structure and stage on OCT imaging to subretinal drusenoid deposits (SDDs) in age-related macular degeneration (AMD) in patients with hypertensive choroidopathy secondary to severe pre-eclampsia and malignant hypertension (MHT) and the implications of this ischemic choroidopathy for the pathophysiologic characteristics of SDDs in AMD.

Design: Retrospective cross-sectional study.

Participants: Thirty-three pre-eclampsia patients and 25 MHT patients with serous retinal detachment (SRD) in at least 1 eye were included.

Methods: Serial multimodal images, including enhanced depth imaging spectral-domain OCT of eyes with hypertensive choroidopathy secondary to pre-eclampsia and MHT, were reviewed at 2 time points, the acute phase (within 4 weeks of initial hypertensive insult) and the recovery phase (beyond 4 weeks).

Main Outcome Measures: Incidence of SDD-like lesions in patients with hypertensive choroidopathy secondary to pre-eclampsia and MHT.

Results: Subretinal drusenoid deposit-like lesions were observed exclusively in eyes with SRD. Serous retinal detachment occurred in 87.87% of eyes of pre-eclampsia patients and in 94% of eyes of MHT patients. Subretinal drusenoid deposit-like lesions occurred in 28.57% of all eyes with SRD, in 32.76% of eyes with SRD from the pre-eclampsia group, and in 23.40% of eyes with SRD from the MHT group. Vascular imaging suggested underlying choroidal ischemia in all patients (12 eyes) in which it was performed.

Conclusions: Choroidal ischemia may be the underlying mechanism of SDD-like lesions in patients with pre-eclampsia and MHT choroidopathy. These findings potentially are of utmost importance in understanding the mechanism of the reticular macular disease subtype of AMD. Reticular macular disease is characterized by the known association of choroidal insufficiency and SDD, with choroidal insufficiency postulated, but not proven, to be causative. Pre-eclampsia and MHT choroidopathy seems to be a model for lesions similar to SDD in AMD developing based on choroidal insufficiency and, as such, may offer further insights into the pathoetiologic features of SDD in AMD.
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http://dx.doi.org/10.1016/j.oret.2020.10.018DOI Listing
October 2020

Nonhuman primate meso-circuitry data: a translational tool to understand brain networks across species.

Brain Struct Funct 2021 Jan 30;226(1):1-11. Epub 2020 Oct 30.

Basic Neuroscience Division, McLean Hospital, Belmont, MA, USA.

The foundation for understanding brain connections and related psychiatric diseases lies in human and animal circuitry studies. In rodents and nonhuman primates (NHPs), axonal tracing methods provide the ground-truth connectivity information of brain circuits, coupled with the ability to experimentally manipulate them when combined with other methods. In humans, neuroimaging approaches have taken the lead for studying connectivity patterns in vivo and the changes in network profiles associated with disease. To integrate knowledge from animal models and humans, a critical question is how similar the animal brains and circuits are to the humans'. In this review, we demonstrate the use of meso-circuitry information from tracing studies in NHPs to understand common network connections across species. We show that the meso-circuitry information help establish homologies of cortical and striatal regions and fiber pathways between rodents and NHPs, facilitate the translation of connections that are detailed in animal models to humans, and can locate critical hubs in large-scale brain networks. This review combines anatomic studies across animal models and imaging studies across NHPs and humans to provide a more comprehensive understanding of the hard-wired connectivity that underlies neuroimaging-derived brain networks.
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http://dx.doi.org/10.1007/s00429-020-02133-3DOI Listing
January 2021

IL-7Rα CD8 T Cells from Healthy Individuals Are Anergic with Defective Glycolysis.

J Immunol 2020 12 26;205(11):2968-2978. Epub 2020 Oct 26.

Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea;

Effector memory (EM) CD8 T cells expressing lower levels of IL-7R α (IL-7Rα) from healthy individuals are partly compromised in vitro, but the identity of these cells has remained unclear. In this study, we demonstrate that human IL-7Rα EM CD8 T cells are naturally occurring anergic cells in vivo and impaired in proliferation and IL-2 production but competent in IFN-γ and TNF-α production, a state that can be restored by IL-2 stimulation. IL-7Rα EM CD8 T cells show decreased expression of GATA3 and c-MYC and are defective in metabolic reprogramming toward glycolysis, a process required for the proliferation of T cells. However, IL-7Rα EM CD8 T cells can proliferate with TCR stimulation in the presence of IL-2 and IL-15, suggesting that these cells can be restored to normality or increased activity by inflammatory conditions and may serve as a reservoir for functional immunity.
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http://dx.doi.org/10.4049/jimmunol.1901470DOI Listing
December 2020

Interobserver study on histologic features of idiopathic non-cirrhotic portal hypertension.

Diagn Pathol 2020 Oct 23;15(1):129. Epub 2020 Oct 23.

Department of Pathology, Albany Medical Center, 47 New Scotland Ave., MC81, Albany, NY, 12208, USA.

Background: Histologic features of idiopathic non-cirrhotic portal hypertension (INCPH) may overlap with those without INCPH. Recently, these features have been recognized as part of the larger spectrum of porto-sinusoidal vascular disease (PSVD). We assessed interobserver agreement on histologic features that are commonly associated with INCPH and studied whether a provision of relevant clinical history improves interobserver agreement.

Methods: The examined histologic features include lobular (such as anisocytosis, nodular regeneration, sinusoidal dilatation, increased parenchymal draining veins, and incomplete fibrous septa) and portal tract changes (such as paraportal shunting vessel(s), portal tract remnant, increased number of portal vessels, and obliterative portal venopathy). Thirty-four archived liver samples from patients with (group A) and without (group B) INCPH were retrieved. A total of 90 representative images of lobules (L) and portal tracts (P) were distributed among 9 liver pathologists blinded to true clinical history. Each pathologist answered multiple choice questions based on the absence (Q1) or presence (Q2) of clinical history of portal hypertension. Fleiss' kappa coefficient analysis (unweighted) was performed to assess interobserver agreement on normal versus abnormal diagnosis, in L and P, based on Q1 and Q2.

Results: The kappa values regarding normal versus abnormal diagnosis were 0.24, 0.24, 0.18 and 0.18 for L-Q1, L-Q2, P-Q1, and P-Q2, respectively. With true clinical history provided, the kappa values were L- 0.32, P-0.17 for group A and L-0.12, P-0.14 for group B. Four pathologists changed their assessments based on the provided history. Interobserver agreement on the interpretation of L and P as normal versus abnormal was slight to fair regardless of provision of clinical history.

Conclusions: Our findings indicate that the histologic features of INCPH/PSVD are not limited to patients with portal hypertension and are subject to significant interobserver variation.
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http://dx.doi.org/10.1186/s13000-020-01049-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7583235PMC
October 2020