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  • S. Karger AG  (51)
  • English  (51)
  • 1
    In: Respiration, S. Karger AG, Vol. 101, No. 5 ( 2022), p. 465-475
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Targeted therapies have broadened the available treatment options for patients with severe eosinophilic asthma (SEA). However, differences in the magnitude of treatment responses among patients indicate the presence of various underlying pathophysiological processes and patient subgroups. 〈 b 〉 〈 i 〉 Objectives: 〈 /i 〉 〈 /b 〉 We aimed to describe the characteristics of SEA and identify its patient subgroups. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Clinical data from the Cohort for Reality and Evolution of Adult Asthma in Korea were analyzed. Cluster analysis was performed among those with SEA using 5 variables, namely, prebronchodilator forced expiratory volume in 1 s, body mass index, age at symptom onset, smoking amount, and blood eosinophil counts. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Patients with SEA showed prevalent sensitization to aeroallergens, decreased lung function, and poor asthma control status. Cluster analysis revealed 3 distinctive subgroups among patients with SEA. Cluster 1 ( 〈 i 〉 n 〈 /i 〉 = 177) consisted of patients reporting the lowest blood eosinophils (median, 346.8 cells/μL) and modest severe asthma with preserved lung function during the 12-month treatment period. Cluster 2 ( 〈 i 〉 n 〈 /i 〉 = 42) predominantly included smoking males with severe persistent airway obstruction and moderate eosinophilia (median, 451.8 cells/μL). Lastly, cluster 3 ( 〈 i 〉 n 〈 /i 〉 = 95) included patients with the most severe asthma, the highest eosinophil levels (median, 817.5 cells/μL), and good treatment response in terms of improved lung function and control status. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Three subgroups were identified in SEA through the cluster analysis. The distinctive features of each cluster may help physicians predict patients who will respond to biologics with greater magnitude of clinical improvement. Further research regarding the underlying pathophysiology and clinical importance of each subgroup is warranted.
    Type of Medium: Online Resource
    ISSN: 0025-7931 , 1423-0356
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2022
    detail.hit.zdb_id: 1464419-8
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  • 2
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 44, No. 1-2 ( 2017), p. 51-58
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 The beneficial effects of endovascular therapy (EVT) in acute ischemic stroke have been demonstrated in recent clinical trials using new-generation thrombectomy devices. However, the comparative effectiveness and safety of preceding intravenous thrombolysis (IVT) in this population has rarely been evaluated. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 From a prospective multicenter stroke registry database in Korea, we identified patients with acute ischemic stroke who were treated with EVT within 8 h of onset and admitted to 14 participating centers during 2008-2013. The primary outcome was a modified Rankin Scale (mRS) score at 3 months. Major secondary outcomes were successful recanalization defined as a modified Treatment in Cerebral Ischemia score of 2b-3, functional independence (mRS score 0-2), mortality at 3 months, and symptomatic hemorrhagic transformation (SHT) during hospitalization. Multivariable logistic regression analyses using generalized linear mixed models were performed to estimate the adjusted odds ratios (ORs) of preceding IVT. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Of the 639 patients (male, 61%; age 69 ± 12; National Institutes of Health Stroke Scale score of 15 [11-19]) who met the eligibility criteria, 458 received preceding IVT. These patients showed lower mRS scores (adjusted common OR, 1.38 [95% CI 0.98-1.96] ). Preceding IVT was associated with successful recanalization (1.96 [1.23-3.11]) and reduced 3-month mortality (0.58 [0.35-0.97] ) but not with SHT (0.96 [0.48-1.93]). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 In patients treated with EVT within 8 of acute ischemic stroke onset, preceding IVT may enhance survival and successful recanalization without additional risk of SHT, and mitigate disability at 3 months.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2017
    detail.hit.zdb_id: 1482069-9
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  • 3
    In: Ophthalmologica, S. Karger AG
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 The aim of the study was to determine the short-term real-world safety and efficacy of intravitreal brolucizumab injections in Korean patients with neovascular age-related macular degeneration (nAMD). 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 This multicenter retrospective study involved 294 eyes (treatment naïve 20 eye [6.8%] and nontreatment naïve 274 eyes [93.2%] ) of 290 patients from 13 hospitals or retinal centers in South Korea. Patients with nAMD who received brolucizumab injection(s) between April 1 and November 30, 2021, with a follow-up ≥1 month, were included. Primary outcomes were safety, incidence of intraocular inflammation (IOI), and potential risk factors. The secondary outcome was efficacy, i.e., change in best-corrected visual acuity (BCVA) and optical coherence tomography-measured macular thickness and retinal fluid. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The mean age was 71.63 ± 8.66. The follow-up period was 2.38 ± 0.79 months. The mean number of brolucizumab injections during the follow-up was 1.52 ± 0.58. The overall incidence of IOI was 13.9% ( 〈 i 〉 n 〈 /i 〉 = 41 eyes). Most IOI cases were of anterior uveitis (8.8%, 26 eyes), followed by retinal vasculitis (2.4%, seven eyes) and occlusive retinal vasculitis (0.3%, one eye). Most eyes showed IOI resolution ( 〈 i 〉 n 〈 /i 〉 = 40, 97.5%) and BCVA restoration ( 〈 i 〉 n 〈 /i 〉 = 39, 95.1%) with or without corticosteroid treatment during the follow-up. Age, sex, IOI history, or other anti-vascular endothelial growth factor injection histories were not associated with the occurrence of IOI. However, only thin subfoveal choroidal thickness (SFCT) was associated with the occurrence of IOI (odds ratio = 0.995, 〈 i 〉 p 〈 /i 〉 = 0.020). BCVA at 1 month improved from baseline (baseline 0.518 ± 0.356 vs. 1 month 0.503 ± 0.383, 〈 i 〉 p 〈 /i 〉 = 0.023), but the improvement was not maintained. Anatomical improvement was significant after 3 months. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 In Korean patients with nAMD, the incidence of IOI following brolucizumab injections was 13.9%. IOI was well-controlled with or without steroid treatment. Most IOI eyes (95.1%) were restored to the level of vision before. IOI occurrence and occlusive vasculitis was rare. In the short term, brolucizumab injection effectively improved vision at 1 month and dried retinal fluid for 3 months.
    Type of Medium: Online Resource
    ISSN: 0030-3755 , 1423-0267
    RVK:
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2023
    detail.hit.zdb_id: 1483531-9
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  • 4
    In: American Journal of Nephrology, S. Karger AG, Vol. 24, No. 4 ( 2004), p. 410-414
    Abstract: 〈 i 〉 Background/Aim: 〈 /i 〉 Cytokines play an important role in the pathogenesis of kidney diseases. The aim of the study was to investigate the impact of interleukin (IL)-1 cluster genes on diabetic nephropathy in Korean patients with type 2 diabetes mellitus (DM). 〈 i 〉 Methods: 〈 /i 〉 We investigated –511 C/T polymorphism of IL-1β and tandem repeat polymorphism in intron 2 of IL-1 receptor antagonist in type 2 DM patients with end-stage kidney failure as compared with patients without nephropathy. 〈 i 〉 Results: 〈 /i 〉 The IL1B2 allele was found more frequently in patients with kidney failure than in controls (57.4 vs. 46.1%, p 〈 0.05). An excessive homozygous carriage of IL1B2 was found in patients with kidney failure when compared with controls (30.5 vs. 18.3%, p 〈 0.05). The allelic frequency of IL1RN*2 was also higher in cases than in controls without nephropathy (8.4 vs. 2.8 %, p 〈 i 〉 〈 〈 /i 〉 0.05). The carriage rate of IL1RN*2 was significantly associated with an increased risk of kidney failure (15.8 vs. 5.6%; OR 3.19, 95% CI 1.24–8.17). The risk of kidney failure was highest in those carrying both IL1RN*2 and IL1B2 (OR 3.90, 95% CI 1.34–11.40). 〈 i 〉 Conclusion: 〈 /i 〉 IL1B2 and IL1RN*2 genotypes of the IL-1 cluster genes are associated with diabetic nephropathy in Korean patients with type 2 DM.
    Type of Medium: Online Resource
    ISSN: 0250-8095 , 1421-9670
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2004
    detail.hit.zdb_id: 1468523-1
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  • 5
    In: Kidney and Blood Pressure Research, S. Karger AG, Vol. 37, No. 2-3 ( 2013), p. 95-102
    Abstract: 〈 b 〉 〈 i 〉 Background 〈 /i 〉 〈 /b 〉 〈 b 〉 〈 i 〉 : 〈 /i 〉 〈 /b 〉 Post-transplant diabetes mellitus (PTDM) is a common and serious metabolic complication. Genetic polymorphisms of angiotensin-converting enzyme ( 〈 i 〉 ACE 〈 /i 〉 ) and angiotensinogen ( 〈 i 〉 AGT 〈 /i 〉 ) genes have been reported to be related to diabetes mellitus and insulin sensitivity; however, the role of these genes in the development of PTDM is not known. For this purpose, we investigated the association of 〈 i 〉 ACE 〈 /i 〉 and 〈 i 〉 AGT 〈 /i 〉 genetic polymorphisms with PTDM. 〈 b 〉 〈 i 〉 Methods 〈 /i 〉 〈 /b 〉 〈 b 〉 〈 i 〉 : 〈 /i 〉 〈 /b 〉 A total of 302 subjects without previously diagnosed diabetes who had received kidney transplants were included. One 〈 i 〉 ACE 〈 /i 〉 single nucleotide polymorphism (SNP) (rs4291) and two 〈 i 〉 AGT 〈 /i 〉 SNPs (rs 699 and rs 4762) were genotyped from genomic DNA with direct sequencing. 〈 b 〉 〈 i 〉 Results 〈 /i 〉 〈 /b 〉 〈 b 〉 〈 i 〉 : 〈 /i 〉 〈 /b 〉 PTDM developed in 49 (16.2%) of 302 subjects. Subjects in the PTDM were older than those in the non-PTDM. There was a significant difference between the two groups in tacrolimus use ( 〈 i 〉 p 〈 /i 〉 =0.03). Of the three SNPs, the rs4762 of the 〈 i 〉 AGT 〈 /i 〉 gene was significantly associated with the development of PTDM in the dominant models ( 〈 i 〉 p 〈 /i 〉 = 0.03) after adjusting for age and tacrolimus usage. 〈 b 〉 〈 i 〉 Conclusions 〈 /i 〉 〈 /b 〉 〈 b 〉 〈 i 〉 : 〈 /i 〉 〈 /b 〉 〈 i 〉 AGT 〈 /i 〉 gene rs4762 polymorphisms may serve as genetic markers for the development of PTDM. The exact molecular mechanisms still need to be clarified.
    Type of Medium: Online Resource
    ISSN: 1420-4096 , 1423-0143
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2013
    detail.hit.zdb_id: 1482922-8
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  • 6
    In: Nephron, S. Karger AG, Vol. 130, No. 3 ( 2015), p. 151-158
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 The number of circulating endothelial progenitor cells (EPCs) has been identified as a surrogate biologic marker for vascular function and cumulative cardiovascular (CV) risk in the general population. Patients with end-stage renal disease (ESRD) on hemodialysis (HD) have markedly decreased EPC counts and function. We hypothesized that the number of circulating EPCs predicts death from all causes and CV events in patients with ESRD on HD. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We quantified the EPCs in blood samples from 70 patients with ESRD on HD. Circulating EPCs were counted by flow cytometry as the number of CD45 〈 sup 〉 low 〈 /sup 〉 CD34 〈 sup 〉 + 〈 /sup 〉 VEGFR2 〈 sup 〉 + 〈 /sup 〉 cells. Death from all causes and CV events served as outcome variables over a median follow-up period of 20 months. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 It has been postulated that the number of circulating EPCs at baseline ranged from 1 to 350 cells/200 μl, with a mean of ± standard deviation (SD) of 26.0 ± 48.2 cells/200 μl. The median, lowest and highest tertiles of EPC counts were 11.0, 9.0, and 17.0 cells/200 μl, respectively. Patients with the lowest tertile EPC counts had significantly higher rates of CV events, but mortality was similar between the two groups. After adjusting for these risk factors, HbA1c and the lowest tertile EPC count remained as independent predictors of CV events. A cutoff value of 9.5 cells/200 μl maximized the power of the EPC count to predict future CV events as determined by ROC curve analysis. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Reduced circulating EPC counts independently predicted CV events in 70 patients with ESRD on maintenance HD. Circulating EPCs may play a role in vascular repair, thereby affecting the clinical course of CV events.
    Type of Medium: Online Resource
    ISSN: 1660-8151 , 2235-3186
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2015
    detail.hit.zdb_id: 2810853-X
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  • 7
    In: Nephron, S. Karger AG, Vol. 133, No. 4 ( 2016), p. 279-286
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Posttransplantation diabetes mellitus (PTDM) is an important metabolic complication after renal transplantation. Activation of the innate immune system via toll-like receptors (TLRs) is implicated in the pathogenesis of insulin resistance and deficiency. Although links between diabetes, dysregulated innate immune responses, and the TLR signaling pathway have been reported, no study so far has investigated their associations with PTDM. In this study, we ascertained whether single nucleotide polymorphisms (SNPs) in TLRs are associated with PTDM in the Korea population. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 A total of 305 patients who received renal transplants without previously diagnosed diabetes were included. We analyzed the association between PTDM development and 6 SNPs within 2 genes of 〈 i 〉 TLR2 〈 /i 〉 , 1 gene of 〈 i 〉 TLR4 〈 /i 〉 , and 3 genes of 〈 i 〉 TRL6 〈 /i 〉 . 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Of 305 patients, PTDM developed in 51 patients (16.6%). Patients in the PTDM group were older than those in the non-PTDM group (45.56 ± 1.28 vs. 38.28 ± 0.71 years). Patients with PTDM had significantly higher allele frequency compared to those without PTDM for the 〈 i 〉 TLR 〈 /i 〉 4 rs1927914*T, 〈 i 〉 TLR6 〈 /i 〉 rs3775073*A, 〈 i 〉 TLR6 〈 /i 〉 rs3821985*C, and 〈 i 〉 TLR6 〈 /i 〉 rs1039559*C alleles. Of the 6 SNPs, rs1927914 in the 〈 i 〉 TLR4 〈 /i 〉 gene and rs1039559 in the 〈 i 〉 TLR6 〈 /i 〉 gene were significantly associated with the development of PTDM after adjustment for age, gender, and tacrolimus usage. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Our study demonstrates a significant association between SNPs 〈 i 〉 rs1927914 〈 /i 〉 in 〈 i 〉 TLR4 〈 /i 〉 and rs1039559 in 〈 i 〉 TLR6 〈 /i 〉 and PTDM in the renal transplantation recipient group. These data suggest that the activation of the innate immune system and inflammation via TLR activation might have an essential role in the pathogenesis of PTDM in renal transplantation.
    Type of Medium: Online Resource
    ISSN: 1660-8151 , 2235-3186
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2016
    detail.hit.zdb_id: 2810853-X
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  • 8
    In: Dermatology, S. Karger AG, Vol. 239, No. 5 ( 2023), p. 700-711
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Limited clinicopathological and prognostic data are available on hydroa vacciniforme (HV)-like lymphoproliferative diseases (HVLPD). 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 This systematic review searched HVLPD reports in Medline via PubMed, Embase, Cochrane, and CINAHL databases in October 2020. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 A total of 393 patients (65 classic HV, 328 severe HV/HV-like T-cell lymphoma [HVLL]) were analyzed. Among severe HV/HVLL cases, 56.0% were Asians, whereas 3.1% were Caucasians. Facial edema, hypersensitivity to mosquito bites, the onset of skin lesion, and percentage of severe HV/HVLL differed significantly by race. Progression to systemic lymphoma was confirmed in 9.4% of HVLPD patients. Death occurred in 39.7% patients with severe HV/HVLL. Facial edema was the only risk factor associated with progression and overall survival. Mortality risk was higher in Latin Americans than in Asians and Caucasians. CD4/CD8 double-negativity was significantly associated with the worst prognosis and increased mortality. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 HVLPD is a heterogeneous entity with variable clinicopathological features associated with genetic predispositions.
    Type of Medium: Online Resource
    ISSN: 1018-8665 , 1421-9832
    RVK:
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2023
    detail.hit.zdb_id: 1482189-8
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  • 9
    In: International Archives of Allergy and Immunology, S. Karger AG, Vol. 176, No. 3-4 ( 2018), p. 272-279
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Hereditary angioedema (HAE) is a genetically heterogeneous autosomal dominant disorder characterized by recurrent episodes of nonpruritic, nonpitting edema increasing after puberty. It can be fatal due to laryngeal or gastrointestinal (GI) involvement with varied and changing frequency of mortality according to studies published from the Western countries. Epidemiological and clinical data of HAE in Asian countries are sparse. We sought to examine the clinical characteristics of HAE patients in Korea. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Patients diagnosed with HAE at 15 tertiary hospitals across the country until 2016 were retrospectively reviewed. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 A total of 65 patients diagnosed with HAE by 2016 were identified. The prevalence of HAE was estimated at 1.3/1,000,000 in Korea. Of the 65 patients, 21 (32.3%) were males. A total of 90.8% patients had type I HAE, while the remaining 9.2% patients had type II HAE. The first symptom developed after 20 years in 73.8% of patients, with a mean age 28.4 ± 14.1 years. The age at diagnosis was 36.5 ± 15.8 years, with a mean time delay of 7.8 ± 10.5 years. While the face (82.3%) and extremities (upper 71.0%, lower 62.9%) were the most frequently involved, the GI tract was affected in 40.5% of Korean HAE patients. Prophylaxis was maintained in 62.5% of patients. There was no reported case of death from HAE so far. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 The clinical manifestation and severity of HAE may vary according to ethnicity. HAE is more infrequent and GI involvement is less likely in Korea compared with Western countries.
    Type of Medium: Online Resource
    ISSN: 1018-2438 , 1423-0097
    RVK:
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2018
    detail.hit.zdb_id: 1482722-0
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  • 10
    In: European Neurology, S. Karger AG, Vol. 69, No. 1 ( 2013), p. 33-40
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 This study is intended to evaluate the propensities of cilostazol to reduce the pulsatility index (PI) in patients with acute lacunar infarction using the serial transcranial Doppler (TCD) examinations. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 In a multicenter, randomized, double-blind, placebo-controlled trial, patients were randomly assigned to receive either placebo or 100 mg cilostazol twice a day as well as aspirin 100 mg a day. The primary outcomes were the changes of middle cerebral artery (MCA) and basilar artery (BA) PIs at 14 and 90 days from the baseline TCD study. This study is registered with ClinicalTrials.gov (NCT00741286). 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Trial medication was given to 203 patients, with 100 receiving cilostazol and 103 receiving placebo, and 164 were included in the per-protocol analysis of the primary outcome. Results from the linear mixed model showed that significant effects were obtained for time-by-group interactions (p = 0.008 in right MCA, p = 0.015 in left MCA, p = 0.002 in BA), suggesting that changes of PIs from the baseline to the 90-day study were different across the groups. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Cilostazol further decreased TCD PIs at 90 days from baseline compared to placebo in acute lacunar infarction. This result may be related to pleiotropic effects, such as vasodilation, beyond its antiplatelet activity.
    Type of Medium: Online Resource
    ISSN: 0014-3022 , 1421-9913
    RVK:
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2013
    detail.hit.zdb_id: 1482237-4
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