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ROsulord® sAfety for Patients with Dyslipidemia Study: A Non-interventional, Multicenter, Prospective, Observational Study in South Korea
No full textINTRODUCTION: The ROsulord(R) sAfety for patients with Dyslipidemia study (ROAD study) in the Republic of Korea investigated the safety and efficacy of rosuvastatin in routine clinical practice. METHODS: This non-interventional, multicenter, prospective, observational study was conducted over a period of approximately 4.6 years and involved 14,243 participants. During this study, we assessed the adverse events, changes in laboratory test results, and efficacy endpoints associated with rosuvastatin use. RESULTS: The findings revealed a notably low adverse event rate of 1.63%, indicating a favorable safety profile for rosuvastatin in the management of dyslipidemia. Importantly, no clinically significant incidences of statin-associated myopathy, hepatotoxicity, or diabetes were observed during the study period. Moreover, this study demonstrated significant improvements in lipid profiles among patients receiving rosuvastatin treatment, with a reduction in total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels. These improvements contributed to a lower cardiovascular risk in the study population. CONCLUSION: Overall, these findings suggest that rosuvastatin is safe and effective in managing dyslipidemia in real-world clinical settings, providing clinicians with valuable insights into the benefits and risks associated with statin therapy in this patient population
Spatial dissection of tumour microenvironments in gastric cancers reveals the immunosuppressive crosstalk between CCL2+ fibroblasts and STAT3 -activated macrophages
No full textBACKGROUND: A spatially resolved, niche-level analysis of tumour microenvironments (TME) can provide insights into cellular interactions and their functional impacts in gastric cancers (GC). OBJECTIVE: Our goal was to translate the spatial organisation of GC ecosystems into a functional landscape of cellular interactions involving malignant, stromal and immune cells. DESIGN: We performed spatial transcriptomics on nine primary GC samples using the Visium platform to delineate the transcriptional landscape and dynamics of malignant, stromal and immune cells within the GC tissue architecture, highlighting cellular crosstalks and their functional consequences in the TME. RESULTS: GC spatial transcriptomes with substantial cellular heterogeneity were delineated into six regional compartments. Specifically, the fibroblast-enriched TME upregulates epithelial-to-mesenchymal transformation and immunosuppressive response in malignant and TME cells, respectively. Cell type-specific transcriptional dynamics revealed that malignant and endothelial cells promote the cellular proliferations of TME cells, whereas the fibroblasts and immune cells are associated with procancer and anticancer immunity, respectively. Ligand-receptor analysis revealed that CCL2-expressing fibroblasts promote the tumour progression via JAK-STAT3 signalling and inflammatory response in tumour-infiltrated macrophages. CCL2+ fibroblasts and STAT3-activated macrophages are co-localised and their co-abundance was associated with unfavourable prognosis. We experimentally validated that CCL2+ fibroblasts recruit myeloid cells and stimulate STAT3 activation in recruited macrophages. The development of immunosuppressive TME by CCL2+ fibroblasts were also validated in syngeneic mouse models. CONCLUSION: GC spatial transcriptomes revealed functional cellular crosstalk involving multiple cell types among which the interaction between CCL2+ fibroblasts and STAT3-activated macrophages plays roles in establishing immune-suppressive GC TME with potential clinical relevance
Anatomical, Functional, and Prognostic Results of Vitrectomy in Epiretinal Membranes Secondary to Retinal Vein Occlusions
No full textINTRODUCTION: We investigated the anatomical and functional results of vitrectomy associated with the peeling of secondary epiretinal membranes (ERM) in patients with retinal vein occlusion (RVO) and determined the prognostic factors of surgical outcomes. METHODS: This retrospective, multicenter, observational study included 50 patients with RVO who underwent vitrectomy with ERM removal between July 2012 and February 2021. Visual acuity (VA) and central macular thickness (CMT) were investigated up to 3 years. Univariate analysis identified the predictive factors associated with functional and anatomical outcomes. RESULTS: Fifty eyes from 50 patients (62% with central RVO) were included. The mean VA of 0.9 +/- 0.7 logMAR preoperatively improved to 0.5 +/- 0.5 logMAR after 24 months (p = 0.01). Anatomically, the mean preoperative CMT was 501 +/- 168 mum, decreasing to 348 +/- 108 mum at month 24 (p = 0.008). By 36 months, VA had improved or stabilized in 90% of the eyes, whereas CMT had been reduced by at least 20% from baseline in 80% of the eyes. A lower number of intravitreal injections (IVI) were required after vitrectomy. Worse preoperative VA, absence of preoperative panretinal photocoagulation, and postoperative use of adjunctive IVI were associated with VA recovery. Higher baseline CMT and the use of preoperative dexamethasone injections were associated with an improvement in CMT. CONCLUSION: Vitrectomy for ERM secondary to RVO was effective in improving VA and recovering CMT for up to 3 years and reduced the number of IVIs. INTRODUCTION: We investigated the anatomical and functional results of vitrectomy associated with the peeling of secondary epiretinal membranes (ERM) in patients with retinal vein occlusion (RVO) and determined the prognostic factors of surgical outcomes. METHODS: This retrospective, multicenter, observational study included 50 patients with RVO who underwent vitrectomy with ERM removal between July 2012 and February 2021. Visual acuity (VA) and central macular thickness (CMT) were investigated up to 3 years. Univariate analysis identified the predictive factors associated with functional and anatomical outcomes. RESULTS: Fifty eyes from 50 patients (62% with central RVO) were included. The mean VA of 0.9 +/- 0.7 logMAR preoperatively improved to 0.5 +/- 0.5 logMAR after 24 months (p = 0.01). Anatomically, the mean preoperative CMT was 501 +/- 168 mum, decreasing to 348 +/- 108 mum at month 24 (p = 0.008). By 36 months, VA had improved or stabilized in 90% of the eyes, whereas CMT had been reduced by at least 20% from baseline in 80% of the eyes. A lower number of intravitreal injections (IVI) were required after vitrectomy. Worse preoperative VA, absence of preoperative panretinal photocoagulation, and postoperative use of adjunctive IVI were associated with VA recovery. Higher baseline CMT and the use of preoperative dexamethasone injections were associated with an improvement in CMT. CONCLUSION: Vitrectomy for ERM secondary to RVO was effective in improving VA and recovering CMT for up to 3 years and reduced the number of IVIs
Treatment of placental abruption following blunt abdominal trauma: a case report
No full textTrauma during pregnancy poses a potentially tragic risk to both the fetus and mother, making its management particularly challenging. Here, we present the case of a 35-year-old woman at 34 weeks and 2 days gestation who was in a motor vehicle accident and subsequently suffered placental abruption and underwent an emergency cesarean section. We also present a review of traumatic placental abruption and its epidemiology. On arrival at the trauma bay, the patient showed no significant abdominal findings other than a seat belt sign. However, 2 hours after admission, the patient developed abdominal pain and vaginal bleeding. Ultrasonography revealed no clear evidence of placental abruption. This case demonstrates the necessity of close maternal and fetal monitoring with cooperation between the trauma and obstetric teams. Even in the absence of typical symptoms such as abdominal pain on initial presentation, a high-energy mechanism of injury should be suspected
Different risk factors for elevated blood pressure according to abdominal obesity in overweight children and adolescents
No full textBACKGROUND: The increasing hypertension (HTN) prevalence in children, largely driven by obesity, highlights the need to investigate its risk factors, including the role of abdominal obesity. METHODS: We analysed data from the Korea National Health and Nutrition Examination Survey (2007-2021) to assess the prevalence of overweight and obesity (OW-OB), elevated blood pressure (EBP), and HTN among 11,554 participants aged 10-18 years. EBP and HTN were defined according to the 2017 American Academy of Pediatrics guidelines, and abdominal obesity was defined as a waist-to-height ratio (WHtR) of >/= 0.5. Secular trends in the prevalence of OW-OB and EBP-HTN were examined across five time periods, and risk factors for EBP-HTN were evaluated in OW-OB children stratified by abdominal obesity status. RESULTS: The prevalence of EBP, HTN, and OW-OB was 8.22% (95% confidence interval [CI], 7.60-8.86), 10.46% (95% CI, 9.72-11.20), and 25.11% (95% CI, 24.17-26.05), respectively. Among the 3,015 participants with OW-OB, 13.53% (95% CI, 12.03-15.04) and 17.64% (95% CI, 15.98-19.31) were diagnosed with EBP and HTN, respectively. Although the prevalence of OW-OB and EBP-HTN had increasing trends from 2007 to 2009 to 2019-2021, these trends were not statistically significant. In the children with OW-OB, obesity severity, male sex, older age, and paternal HTN were associated with EBP-HTN. The HTN risk factors differed according to abdominal obesity status. In participants with abdominal obesity, male sex (OR 2.32, 95% CI 1.643-3.299; p < 0.0001), older age (OR 1.16, 95% CI 1.102-1.233; p < 0.0001), and severe obesity (OR 3.12, 95% CI 1.991-4.895; p < 0.0001) were significant risk factors; whereas, in those without abdominal obesity, paternal HTN (OR 1.66, 95% CI 1.207-2.303; p = 0.0025), hypercholesterolemia (OR 1.85, 95% CI 1.114-3.083; p = 0.0178), male sex (OR 1.83, 95% CI 1.329-2.530; p = 0.0002), and older age (OR 1.11, 95% CI 1.036-1.198; p = 0.0038) were significant risk factors. CONCLUSIONS: In children with overweight or obesity, the risk factors for EBP-HTN vary depending on the presence of abdominal obesity. These findings highlight the need for differentiated surveillance and prevention strategies based on abdominal obesity status in this high-risk population. CLINICAL TRIAL NUMBER: Not applicable
Spinal morphological change after posterior lumbar interbody fusion in lumbar spondylolisthesis patients
No full textLumbar spondylolisthesis is a degenerative status in the spine. Posterior lumbar interbody fusion (PLIF) with instrumentation has considered as the standard surgical treatment for lumbar instability. Spinal canal and dural sac cross-sectional area (CSA) has been major parameters for evaluating neurologic symptoms. This study is aimed at finding the radiological change using the dural sac CSA and spinal canal CSA as an objective morphological parameter after PLIF. Of the 74 patients (24 men, 50 women; mean age 66.49 years) who had PLIF surgery were checked for preoperative magnetic resonance imaging (MRI) and MRI within 1 week after surgery. T2-weighted axial MRI scans were obtained from each patient. We measured the dural sac and spinal canal CSA on an axial MRI image at the center of L4 to L5 intervertebral disc. The average spinal canal CSA was 70.28 +/- 27.77 mm2 in the preoperative MR images and 149.59 +/- 35.20 mm2 in the postoperative MR images. The average dural sac CSA was 42.46 +/- 18.49 mm2 in the preoperative MR images and 98.93 +/- 29.32 mm2 in the postoperative MR images. After the PLIF operation, the mean spinal canal CSA was 112.84 percent increase, and the measn dural sac CSA was 132.99 percent increase. After PLIF, patients had significantly higher dural sac CSA (P < .001) and spinal canal CSA (P < .001). Spinal canal CSA have increased by 112.84 percent and Dural sac CSA have increased by 132.99 percent after PLIF. Thus, before PLIF, the treating physician should carefully explain this result to patient
Thermal transformation of CBD, CBDA, and Δ9-THC during e-cigarette vaping: Identification of conversion products by GC–MS
No full textThe use of electronic cigarettes (e-cigarettes) has gained popularity worldwide for reducing the unpleasant odors and flavors of smoking marijuana. However, due to the high vaporization temperature of the heating coil in e-cigarettes, cannabinoids could be converted into secondary cannabinoid products, potentially causing unintended psychological and harmful effects. A lab-built impinger and aerosol collection device was prepared to study the thermal transformation of cannabinoids during e-cigarette vaping, optimizing collection conditions according to variations in coil wattage, cartridge oil, and collection solvents. Thermal conversion of individual cannabidiolic acid (CBDA), cannabidiol (CBD), and Delta(9)-tetrahydrocannabinol (Delta(9)-THC) in e-cartridge liquid was performed with increasing coil power from 45 W to 105 W. Collected aerosol solution was derivatized with trimethylsilyl reagents and analyzed by gas chromatography-mass spectrometry (GC-MS) scan mode. Thermal vaping profiles of individual authentic cannabinoids were studied according to the variation of coil power of the e-cigarette. During the CBDA vaping process of the e-cigarette, most of the acidic CBDA was converted to neutral CBD through thermal decarboxylation and further degraded to produce several thermal products. Several interesting psychoactive Delta(8)-iso and Delta(9)-THC isomers, and cannabichromene (CBC) and CBD quinone (CBDQ) were observed from the vaping process of CBDA and CBD. In the case of Delta(9)-THC vaping, psychoactive hexahydrocannabinol (HHC) derivatives and cannabinol (CBN), were produced via thermal reduction and oxidation. These thermal products were identified by comparing retention times and mass spectra of authentic standards and interpreting their mass spectra. The amounts of most thermal products were increased with increasing coil power from 45 W to 105 W. In contrast, potentially harmful CBDQ was found to be highest amount at 45 W and decreased with increasing coil power. From the profile data and identification results, thermal transformation pathways of cannabinoids during the vaping process are proposed. This study will provide important information on the formation mechanism of thermal conversion products and basic guidance for risk assessment of Cannabis oil vaping by e-cigarette
Comparative analysis of Elecsys and ELISA for differentiating amyloid-PET status in a Korean memory clinic based on cerebrospinal fluid biomarkers
No full textBackground: The adoption of Alzheimer's disease (AD) biomarkers in clinical practice is expected to increase following recent approval of disease-modifying therapies. Fully automated immunoassays, Elecsys platform, offer convenience and enhanced reliability. Objective: This study was performed to evaluate the performance of the Elecsys assay in a Korean clinical setting, comparing its effectiveness to ELISA for detecting amyloid-PET positivity. Methods: Cerebrospinal fluid (CSF) Abeta(42), pTau(181), tTau, pTau(181)/Abeta(42), and tTau/Abeta(42) were evaluated using Elecsys kits on a Cobas e 411 analyzer and manual Innotest ELISA with paired frozen samples (n = 118) from subjects with cognitive status ranging from unimpaired to mild cognitive impairment and dementia. Results: Strong linear correlations were observed between Elecsys- and ELISA-measured Abeta(42), pTau(181), and tTau levels. Receiver operating characteristic-based cutoff points for pTau(181)/Abeta(42) (0.0252) and tTau/Abeta(42) (0.258) in Elecsys demonstrated the highest areas under the curve (0.97 and 0.96) and predictive values (96.6% for both) for detecting amyloid-PET abnormalities. No cases of abnormal amyloid PET status were found without concurrent abnormal CSF biomarkers when considering Elecsys Abeta(42) and the pTau(181)/Abeta(42) ratio simultaneously. In addition, previously established cutoffs for combined ratios effectively differentiated amyloid PET status in our samples. Conclusions: This study demonstrated the utility of Elecsys-measured CSF AD biomarkers in agreement with amyloid-PET classification in the Korean population. The pTau(181)/Abeta(42) and tTau/Abeta(42) ratios were the most accurate in detecting amyloid-PET (+), with Elecsys showing higher accuracy than ELISA. The study also supported the applicability of common cutoffs from Western countries for these biomarkers in our samples
Risk of Contrast-Induced Acute Kidney Injury in Computed Tomography: A 16 Institutional Retrospective Cohort Study
No full textOBJECTIVES: Concern about contrast-induced acute kidney injury (CI-AKI) may delay the timely administration of contrast media for computed tomography (CT). The precise causative effect of iodinated contrast media on CI-AKI and its relevant risk factors remains an area of ongoing investigation. Therefore, this study aimed to determine the risk of CI-AKI following contrast-enhanced CT and its predisposing risk factors. MATERIALS AND METHODS: This study employed a 1:1 propensity score matching analysis using electronic medical records gathered between January 2006 and December 2022 from 16 institutions in South Korea. Contrast-enhanced and nonenhanced CT scans in patients aged 18 years and above were matched for baseline estimated glomerular filtration rate (eGFR), demographic characteristics, and clinical variables to assess the risk of CI-AKI. Subgroup analyses were conducted to evaluate any significant risk factors for CI-AKI. RESULTS: A total of 182,170 CT scans with contrast were matched to 182,170 CT scans without contrast. The risk of CI-AKI in the entire study cohort was not statistically significant (odds ratio [OR], 1.036; 95% confidence interval [CI], 0.968-1.109; P = 0.34). Subgroup analyses revealed a significantly higher risk of CI-AKI in patients with eGFR <30 mL/min/1.73m 2 (OR, 1.176; 95% CI, 1.080-1.281; P = 0.011) or eGFR 30-45 mL/min/1.73m 2 (OR, 1.139; 95% CI, 1.043-1.244; P = 0.019), patients diagnosed with chronic kidney disease (OR, 1.215; 95% CI, 1.084-1.361; P = 0.011), and those administered with iso-osmolar contrast media (OR, 1.392; 95% CI, 1.196-1.622; P = 0.011). CONCLUSIONS: The risk of CI-AKI following CT was minimal in the general population. However, caution is warranted for patients with chronic kidney disease and eGFR lower than 45 mL/min/1.73m 2 , or those administered with iso-osmolar contrast media
