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  • 1
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    Online Resource
    Impact of BMI on Complications of Gastric Endoscopic Submucosal Dissection
    S. Karger AG ; 2021
    In:  Digestive Diseases Vol. 39, No. 4 ( 2021), p. 301-309
    Details
    In: Digestive Diseases, S. Karger AG, Vol. 39, No. 4 ( 2021), p. 301-309
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Gastric endoscopic submucosal dissection (ESD) has a high rate of complications. However, it is unclear whether BMI affects ESD complications. We aimed to investigate the impact of BMI on ESD complications. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 A total of 7,263 patients who underwent gastric ESD were classified into 3 groups according to the Asia-Pacific classification of BMI: normal (BMI & #x3c;23 kg/m 〈 sup 〉 2 〈 /sup 〉 , 〈 i 〉 n 〈 /i 〉 = 2,466), overweight (BMI 23–24.9 kg/m 〈 sup 〉 2 〈 /sup 〉 , 〈 i 〉 n 〈 /i 〉 = 2,117), and obese (BMI ≥25 kg/m 〈 sup 〉 2 〈 /sup 〉 , 〈 i 〉 n 〈 /i 〉 = 2,680). Adjusted logistic regression analyses were conducted to assess the association between BMI and ESD complications. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Compared to the normal group, a lower incidence of perforation and a higher incidence of pneumonia and leukocytosis were found in the overweight and obese groups, and intra-ESD desaturation and hypertension were more frequent in the obese group. After adjustment for confounders, the risk of perforation significantly decreased in the overweight (odds ratio [OR] = 0.24, 95% confidence interval [CI] : 0.17–0.33) and obese (OR = 0.12, 95% CI: 0.08–0.18) groups compared to that in the normal group. Meanwhile, the risk of pneumonia significantly increased in the overweight (OR = 11.04, 95% CI: 6.31–19.31) and obese (OR = 10.71, 95% CI: 6.14–18.66) groups compared to the normal group. During sedation, the obese group had a significantly increased risk of desaturation (OR = 2.81, 95% CI: 1.18–6.69) and hypertension (OR = 1.35, 95% CI: 1.11–1.63) compared to the normal group. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 High BMI was significantly associated with ESD complications. More caution is needed in cases of obese patients undergoing ESD.
    Type of Medium: Online Resource
    ISSN: 0257-2753 , 1421-9875
    URL: Article
    DOI: 10.1159/000512899
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2021
    detail.hit.zdb_id: 1482221-0
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  • 2
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    The Frequency and Risk of Preclinical Coronary Artery Disease Detected Using Multichannel Cardiac Computed Tomography in Patients with Ischemic Stroke
    S. Karger AG ; 2012
    In:  Cerebrovascular Diseases Vol. 33, No. 3 ( 2012), p. 286-294
    Details
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 33, No. 3 ( 2012), p. 286-294
    Abstract: 〈 i 〉 Background: 〈 /i 〉 Atherosclerosis is a systemic disease. Many ischemic stroke patients may have concomitant coronary artery disease (CAD). Detection and treatment of preclinical CAD in stroke patients may improve long-term outcome and survival because CAD is a major cause of death during follow-up in stroke patients. However, association between coronary and cerebral artery atherosclerosis in stroke patients has not fully been investigated. This study aimed at examining the frequency and high-risk groups of CAD in ischemic stroke patients. 〈 i 〉 Methods: 〈 /i 〉 Consecutive patients who were admitted due to acute ischemic stroke between July 2006 and June 2010 were prospectively enrolled in this study. A total of 1,304 patients who underwent MSCT coronary angiography and cerebral angiography were included in this study. By using 64-multislice computed tomography coronary angiography, we investigated the frequency of CAD and association between coronary and cerebral artery atherosclerosis in terms of location and burden (severity and extent) in stroke patients. We also sought to identify high-risk groups for CAD among stroke patients. 〈 i 〉 Results: 〈 /i 〉 The frequency of significant (≧50%) CAD was 32.3% and the frequency of any degree of CAD was 70.1%. Diabetes mellitus, serum levels of total cholesterol, high-density lipoprotein cholesterol and triglyceride, and significant stenosis of the extracranial carotid, intracranial vertebral and basilar arteries were independently associated with CAD. However, no association was found between CAD and significant stenosis of the anterior, middle and posterior cerebral arteries. The association between CAD and cerebral atherosclerosis was stronger with increased severity and extent of cerebral atherosclerosis. When compared to patients with 〈 2 risk factors and without significant cerebral atherosclerosis, those with multiple (≧2) risk factors and atherosclerosis in both the carotid and the vertebrobasilar arteries had very high risks of CAD [odds ratio (OR) 8.36; 95% confidence interval (CI) 4.15–16.87]. The risk was also high in patients with multiple risk factors and atherosclerosis in either the carotid or the vertebrobasilar artery (OR 4.13; 95% CI 2.62–6.51), and in those with 〈 2 risk factors but atherosclerosis in both the carotid and the vertebrobasilar arteries (OR 3.40; 95% CI 1.22–9.47). 〈 i 〉 Conclusions: 〈 /i 〉 A substantial portion of stroke patients had preclinical CAD, and there was a clear relationship between coronary and cerebral artery atherosclerosis in terms of location and burden. The risk of CAD was particularly high in stroke patients with multiple risk factors and atherosclerosis of the carotid and/or vertebrobasilar arteries.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    URL: Article
    DOI: 10.1159/000334980
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2012
    detail.hit.zdb_id: 1482069-9
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  • 3
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    Dementia-Predicting Cognitive Risk Score and Its Correlation with Cortical Thickness in Parkinson Disease
    S. Karger AG ; 2017
    In:  Dementia and Geriatric Cognitive Disorders Vol. 44, No. 3-4 ( 2017), p. 203-212
    Details
    In: Dementia and Geriatric Cognitive Disorders, S. Karger AG, Vol. 44, No. 3-4 ( 2017), p. 203-212
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 We developed a risk score system to predict risks of developing dementia in individual Parkinson disease (PD) patients using baseline neuropsychological tests. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 A total of 216 nondemented PD patients underwent a baseline neuropsychological evaluation and were followed up for a mean of 2.7 (±1.1) years. Univariate Cox regression models controlled for age, gender, and education selected neuropsychological tests individually predicting dementia risk. Then, a multivariate Cox regression model combined them into a cognitive risk score system. Cortical areas correlating with cognitive risk score were investigated using a separate MRI data set from 207 nondemented PD patients. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Fifty-two patients (23.9%) developed dementia. The univariate Cox regression analyses identified the confrontational naming and semantic fluency tests, frontal/executive function tests, immediate verbal memory test, and visuospatial function test as predicting dementia risk. The calculated cognitive risk score (range 53-188) predicted future dementia with moderate accuracy (integrated area under the curve = 0.79; 95% CI: 0.73-0.85). A higher cognitive risk score correlated with cortical thinning in the right anteromedial temporal cortex, bilateral posterior cingulate cortex, right anterior cingulate cortex, left parahippocampal gyrus, and right superior frontal cortex in a separate MRI data set. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 The cognitive risk score system is a useful approach to predict the dementia risk among PD patients.
    Type of Medium: Online Resource
    ISSN: 1420-8008 , 1421-9824
    URL: Article
    DOI: 10.1159/000479057
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2017
    detail.hit.zdb_id: 1482186-2
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  • 4
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    Prediction of Survival by Tumor Area on Endosonography after Definitive Chemoradiotherapy for Locally Advanced Squamous Cell Carcinoma of the Esophagus
    S. Karger AG ; 2014
    In:  Digestion Vol. 90, No. 2 ( 2014), p. 98-107
    Details
    In: Digestion, S. Karger AG, Vol. 90, No. 2 ( 2014), p. 98-107
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Definitive chemoradiotherapy (CRT) is a reasonable approach for patients with locally advanced esophageal cancer who are not surgical candidates. This study was performed to investigate whether endosonography (EUS) assessment of tumor area response is a useful prognostic marker in patients with squamous cell carcinoma (SCC) of the esophagus who receive definitive CRT. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 A total of 33 patients who received definitive CRT for locally advanced esophageal SCC were enrolled. The maximal transverse cross-sectional area of the tumor was measured before and after definitive therapy. EUS response was defined as a ≥50% reduction of the tumor area after definitive CRT. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Based on EUS evaluation, there were 20 nonresponders (60.6%) and 13 responders (39.4%). The median progression-free survival (PFS) was significantly longer in EUS responders than EUS nonresponders (p = 0.005). However, there was no statistical significance in overall survival according to EUS response (p = 0.120). During multivariate analysis, EUS response to definitive CRT was the only significant factor associated with PFS (p = 0.045), whereas EUS response to definitive CRT was not associated with overall survival (p = 0.221). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 A reduction of the maximal cross-sectional tumor area measured by EUS correlates with a superior prognosis in patients with locally advanced SCC of the esophagus after definitive CRT.
    Type of Medium: Online Resource
    ISSN: 0012-2823 , 1421-9867
    URL: Article
    DOI: 10.1159/000365073
    RVK:
    XA 40650
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2014
    detail.hit.zdb_id: 1482218-0
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  • 5
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    Placenta-Derived Mesenchymal Stem Cells Have an Immunomodulatory Effect That Can Control Acute Graft-Versus-Host Disease in Mice
    S. Karger AG ; 2013
    In:  Acta Haematologica Vol. 129, No. 4 ( 2013), p. 197-206
    Details
    In: Acta Haematologica, S. Karger AG, Vol. 129, No. 4 ( 2013), p. 197-206
    Abstract: 〈 b 〉 〈 i 〉 Background and Aims: 〈 /i 〉 〈 /b 〉 Immunomodulatory properties of mesenchymal stem cells (MSCs) have been applied to reduce the incidence of graft-versus-host disease (GVHD) after hematopoietic stem cell transplantation (HSCT). Among the various sources of MSCs that have immunomodulatory effects in vitro, only placenta-derived MSCs (PD-MSCs) have not been evaluated in an in vivo model of GVHD. In this study, we investigated the immunomodulatory properties of PD-MSCs in vitro and evaluated their clinical potential for controlling GVHD in an animal model. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 A GVHD animal model was established by transplanting C57BL/6 donor bone marrow cells and spleen cells into lethally irradiated BALB/c recipient mice. To control GVHD, human PD-MSCs were transplanted into recipient mice (5 × 10 〈 sup 〉 5 〈 /sup 〉 or 1 × 10 〈 sup 〉 6 〈 /sup 〉 cells). 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 PD-MSCs suppressed mitogen-stimulated T cell proliferation in vitro in a dose-dependent manner. Moreover, PD-MSCs inhibited cytokine secretion (interleukin-12, tumor necrosis factor-α and interferon- & #947;) of activated T cells. In vivo, the survival rate in the PD-MSC group (transplanted with 1 × 10 〈 sup 〉 6 〈 /sup 〉 cells) was higher than that in the control group and histological scores were low in the PD-MSC group. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 We present the first evidence that human PD-MSCs can efficiently control GVHD in an HSCT in vivo model.
    Type of Medium: Online Resource
    ISSN: 0001-5792 , 1421-9662
    URL: Article
    DOI: 10.1159/000345267
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2013
    detail.hit.zdb_id: 1481888-7
    detail.hit.zdb_id: 80008-9
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  • 6
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    Inadvertently Found Thoracic Ectopic Liver Confirmed without Surgery
    S. Karger AG ; 2011
    In:  Respiration Vol. 81, No. 4 ( 2011), p. 343-344
    Details
    In: Respiration, S. Karger AG, Vol. 81, No. 4 ( 2011), p. 343-344
    Type of Medium: Online Resource
    ISSN: 1423-0356 , 0025-7931
    URL: Article
    DOI: 10.1159/000322412
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2011
    detail.hit.zdb_id: 1464419-8
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  • 7
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    Clinical Significance of Crescent Formation in IgA Nephropathy – a Multicenter Validation Study
    S. Karger AG ; 2019
    In:  Kidney and Blood Pressure Research Vol. 44, No. 1 ( 2019), p. 22-32
    Details
    In: Kidney and Blood Pressure Research, S. Karger AG, Vol. 44, No. 1 ( 2019), p. 22-32
    Abstract: 〈 b 〉 〈 i 〉 Background/Aims: 〈 /i 〉 〈 /b 〉 Additional validation study was warranted to confirm the clinical significance of C score, which was recently added to the Oxford classification for immunoglobulin A nephropathy (IgAN). 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We performed a multicenter retrospective cohort study in four hospitals in Korea. Patients who had biopsied glomeruli less than eight or inadequate follow-up information were excluded. Clinicopathologic parameters, including the degree of cellular or fibrocellular crescents, were collected and included in multivariable models for Cox regression analysis. The main outcome was a composite renal outcome, defined as a merge of progression to end-stage renal disease (ESRD) and halving of estimated glomerular filtration rate (eGFR) from baseline. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Among included 3,380 biopsy-confirmed IgAN patients, there were 664 (19.6%) patients with C1 and 60 (1.8%) patients with C2 scores in the study population. Although C0 and C1 patients shared similar baseline characteristics, C2 patients frequently had more clinicopathologic risk factors for poor prognosis of IgAN. Both C1 [adjusted HR 1.33 (1.11-1.58), P=0.002] and C2 [adjusted HR 2.24 (1.46-3.43), P & #x3c; 0.001] scores were associated with an increased risk of the composite outcome. C2 was a strong predictive parameter associated with both progression to ESRD and halving of eGFR, whereas C1 was mainly associated with the increased risk of halving of eGFR. Notably, the proportion of crescent showed a linear association with the risk of adverse renal outcome. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 The C score in the Oxford classification is a valid predictive parameter for IgAN prognosis. Additional clinical attention is necessary for IgAN patients with identified cellular or fibrocellular crescents.
    Type of Medium: Online Resource
    ISSN: 1420-4096 , 1423-0143
    URL: Article
    DOI: 10.1159/000497808
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2019
    detail.hit.zdb_id: 1482922-8
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  • 8
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    Genotype–Phenotype Analysis in Pediatric Patients with Distal Renal Tubular Acidosis
    S. Karger AG ; 2018
    In:  Kidney and Blood Pressure Research Vol. 43, No. 2 ( 2018), p. 513-521
    Details
    In: Kidney and Blood Pressure Research, S. Karger AG, Vol. 43, No. 2 ( 2018), p. 513-521
    Abstract: 〈 b 〉 〈 i 〉 Background/Aims: 〈 /i 〉 〈 /b 〉 Primary distal renal tubular acidosis (dRTA) in children is a rare genetic disorder, and three causative mutated genes have been identified: 〈 i 〉 SLC4A1 〈 /i 〉 , 〈 i 〉 ATP6V1B1 〈 /i 〉 , and 〈 i 〉 ATP6V0A4 〈 /i 〉 . We analyzed the prevalence and phenotypic differences of genetic mutations in children with dRTA. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 A total of 17 children with dRTA were enrolled in the study. All patients underwent genetic testing for all three candidate genes. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Pathogenic mutations, including six novel mutations, were detected in 15 (88.2%) patients: dominant 〈 i 〉 SLC4A1 〈 /i 〉 mutations in ten (58.8%) patients, recessive 〈 i 〉 ATP6V0A4 〈 /i 〉 mutations in three (17.6%) patients, and recessive 〈 i 〉 ATP6V1B1 〈 /i 〉 mutations in two (11.8%) patients. Compared to other patients, patients with 〈 i 〉 SLC4A1 〈 /i 〉 mutations showed an older age of onset (3.7 ± 2.6 years) and less severe metabolic acidosis at initial presentation. All patients developed nephrocalcinosis, and sensorineural hearing loss was observed in two patients with 〈 i 〉 ATP6V1B1 〈 /i 〉 mutations. Three (17.6%) patients had decreased renal function (chronic kidney disease stage 2), and five (29.4%) patients had persistent growth retardation at the last follow-up. Long-term prognosis showed no genotype–phenotype correlation. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 〈 i 〉 SLC4A1 〈 /i 〉 is the most common defective gene in Korean children with dRTA. Patients with 〈 i 〉 SLC4A1 〈 /i 〉 mutations show later onset and milder disease severity. Long-term follow-up of hearing ability, renal function, and growth is necessary for patients with dRTA.
    Type of Medium: Online Resource
    ISSN: 1420-4096 , 1423-0143
    URL: Article
    DOI: 10.1159/000488698
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2018
    detail.hit.zdb_id: 1482922-8
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  • 9
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    Liver Fibrosis, Not Steatosis, Associates with Long-Term Outcomes in Ischaemic Stroke Patients
    S. Karger AG ; 2019
    In:  Cerebrovascular Diseases Vol. 47, No. 1-2 ( 2019), p. 32-39
    Details
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 47, No. 1-2 ( 2019), p. 32-39
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 To investigate whether there are differences in long-term all-cause and cardiovascular mortality according to the burden of liver fibrosis or steatosis in patients with ischaemic stroke or transient ischaemic attack (TIA). ­ 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Consecutive patients with acute ischaemic stroke or TIA who underwent transient elastography (TE) from January 2014 to December 2014 were considered eligible. The influence of liver fibrosis or steatosis, assessed via TE, on long-term outcomes was investigated using Cox proportional hazard models. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Among 395 patients included in this study, there were 37 (9%) patients with significant fibrosis ( & #x3e; 8.0 kPa) and 164 (41.5%) patients with fatty liver ( & #x3e; 250 dB/m). During the follow-up period (median 2.7 years), all-cause and cardiovascular mortality occurred in 28 (7.1%) and 20 (5.1%) patients. On multivariate analyses, significant liver fibrosis was independently associated with increased risk of all-cause (hazard ratio [HR] 8.14, 95% CI 3.03–21.90, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001) and cardiovascular (HR 4.29, 95% CI 1.10–16.73, 〈 i 〉 p 〈 /i 〉 = 0.036) mortality, whereas fatty liver was not (all 〈 i 〉 p 〈 /i 〉 & #x3e; 0.05). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 This study found that the burden of liver fibrosis but not that of steatosis, assessed via TE, was an independent predictor of all-cause and cardiovascular mortality during long-term follow-up in patients with ischaemic stroke.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    URL: Article
    DOI: 10.1159/000497069
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2019
    detail.hit.zdb_id: 1482069-9
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  • 10
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    Advanced Liver Fibrosis Predicts Unfavorable Long-Term Prognosis in First-Ever Ischemic Stroke or Transient Ischemic Attack
    S. Karger AG ; 2020
    In:  Cerebrovascular Diseases Vol. 49, No. 5 ( 2020), p. 474-480
    Details
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 49, No. 5 ( 2020), p. 474-480
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 There are a limited number of studies investigating the relationship between the degree of liver fibrosis and the long-term prognosis, especially ischemic stroke (IS) recurrence, in first-ever IS or transient ischemic attack (TIA). 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 We investigated whether there are differences in the long-term all-cause and cardiovascular mortalities and IS recurrence based on the degree of liver fibrosis in first-ever IS or TIA. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 This analysis included 2,504 patients with first-ever IS or TIA recruited from a prospective stroke cohort. Liver fibrosis was predicted using the fibrosis-4 (FIB-4) index, and advanced fibrosis was defined as an FIB-4 index of & #x3e;3.25. Using Cox regression models, we compared the all-cause and cardiovascular mortalities and IS recurrence. As measures for the additive predictive value of the FIB-4 index for prediction of all-cause mortality, the integrated area under the receiver operating characteristic curve (iAUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were used. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 There were 231 (9.2%) patients with advanced fibrosis. During a median follow-up of 1.2 years, the cumulative all-cause and cardiovascular mortalities were 6.4 and 1.9%, and IS recurrence was observed in 5.3%. The advanced fibrosis was associated with an increased risk of all-cause mortality (hazard ratio [HR] = 3.98, 95% confidence interval [CI] = 2.40–6.59), cardiovascular mortality (HR = 4.48, 95% CI = 1.59–12.65), and IS recurrence (HR = 1.95, 95% CI = 1.05–3.65). Adding the FIB-4 index to the model consisting of traditional cardiovascular risk factors improved the predictive accuracy for all-cause mortality as measured using the iAUC (from 0.7594 to 0.7729) and for all-cause mortality at 1 year as measured using the NRI (38.6%) and IDI (0.037). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 The burden of liver fibrosis is associated with unfavorable long-term prognosis, including recurrent IS, in first-ever IS or TIA.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    URL: Article
    DOI: 10.1159/000510436
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2020
    detail.hit.zdb_id: 1482069-9
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