Synergy of specific microRNAs (miRNAs) with cardiovascular risk factors to estimate atherosclerosis presence in ischemic stroke patients has not been investigated. The present study aimed to identify atherosclerosis-related circulating miRNAs and to evaluate interaction with other cardiovascular markers to improve the estimation of atherosclerosis presence. We performed a miRNA profiling study using serum of 15 patients with acute ischemic stroke who were classified by the presence of no (n = 8) or severe (n = 7) stenosis on intracranial and extracranial vessels, which identified miR-212, -372, -454, and -744 as miRNAs related with atherosclerosis presence. Of the 4 miRNAs, only miR-212 showed a significant increase in expression in atherosclerosis patients in a validation study (atherosclerotic patients, n = 32, non-atherosclerotic patients, n = 33). Hemoglobin A1c, a high-density lipoprotein cholesterol, and lipoprotein(a), both established risk markers, were independently related with atherosclerosis presence in the validation population. miR-212 enhanced the accuracy of atherosclerosis presence by the three existing markers (three markers, 78.5%; three markers+miR-212, 84.6%, P<0.05) and significantly added to the area under the receiver operating characteristic curve (three markers, 0.8258; three markers+miR-212, 0.8646, P<0.05). The inclusion of miR-212 increased the reclassification index calculated using net reclassification improvement (0.4527, P<0.05) and integrated discrimination improvement (0.0737, P<0.05). We identified circulating miR-212 as a novel marker of atherosclerosis. miR-212 enhanced the estimation of atherosclerosis presence in combination with hemoglobin A1c, high-density lipoprotein cholesterol, and lipoprotein(a). Thus, miR-212 is expected to improve the estimation of atherosclerosis using peripheral blood of patients.
ed to be HDM and ragweed pollen. 7,8 However, differences in the clinical features of bronchial asthma according to the offending allergens had not yet been elucidated.Therefore, this study was conducted to investigate the clinical characteristics and distributions of common offending allergens and to determine the relationship between the type and number of sensitized allergens and clinical manifestations in adult Korean patients with bronchial asthma.
The clinical course of idiopathic pulmonary fibrosis (IPF) is difficult to predict, partly owing to its heterogeneity. Composite physiologic index (CPI) and gender-age-physiology (GAP) models are easy-to-use predictors of IPF progression. This study aimed to compare the predictive values of these two models. From 2003 to 2007, the Korean Interstitial Lung Disease (ILD) Study Group surveyed ILD patients using the 2002 ATS/ERS criteria. A total of 832 patients with IPF were enrolled in this study. CPI was calculated as follows: 91.0 - (0.65 × %DLCO) - [0.53 × %FVC + [0.34 × %FEV1. GAP stage was calculated based on gender (0-1 points), age (0-2 points), and two physiologic lung function parameters (0-5 points). The two models had similar significant predictive values for patients with IPF (p < 0.001). The area under the curve (AUC) was higher for CPI than GAP for prediction of 1-, 2-, and 3-year mortality in this study. The AUC was higher for surgically diagnosed IPF patients than for clinically diagnosed patients. However, neither CPI nor GAP yielded good predictions of outcomes; the AUC was approximately 0.61~0.65. Although both CPI and GAP stage are significantly useful predictors for IPF, they have limited capability to accurately predict outcomes.
Background and Objectives: To search circulating microRNAs related to atherosclerosis, we first performed a microRNA expression profiling using atherosclerotic plaques. Then, their expression significance was validated using the serum of stroke patients having severe atherosclerosis on cranial vessels. Methods: We performed miRNA expressions from 10 carotid endarterectomy (CEA) plaques and 2 human umbilical vein endothelial cell (HUVEC) lines using a microRNA microarray kit (TaqMan® Array MicroRNA Cards, Applied Biosystems®, Life Technologies). The expression differences were compared using relative quantitation (RQ=2 -(miRNA expression -reference RNA expression) ) between the CEA plaques and the HUVECs following a criteria including over 4-fold-up or less than 0.25-fold-down regulations after log2 transformation of the expression difference. Among the microRNAs showing significant expression differences, target microRNAs were selected using an internal clustering validation measurement (Xie-Beni index). The expression of the target microRNAs was validated with the serum of 32 patients with severe atherosclerosis and that of 33 patients with no atherosclerosis in intra- and extra-cranial vessels. Results: A total of 151 microRNAs were identified after the comparison of the microRNA expressions between CEA and HUVECs. Among them, eight miRNAs (miR199b, miR142-3p, miR145, miR145, miR204, miR9, miR370, miR23b, and miR363) were selected as the final target microRNAs after the clustering validation analysis. As for the validation experiments with the serum of the atherosclerosis and non-atherosclerosis patients, the RQ of miR142-3p (atherosclerosis, 3.79±7.57; no-atherosclerosis patients, 1.10±1.45, p=0.043), among the 8 target miRNAs, showed significant differences in the serum of patients with atherosclerosis. Conclusion: The present study profiled miRNAs from CEA plaques and validated their significance within the serum of atherosclerosis patients. These findings suggest that miR142-3P could be a potential marker for atherosclerosis that is detectable from the circulating blood.
In adults, aspiration of foreign bodies into tracheobronchus is sometimes presented atypically, mimicking chronic pulmonary diseases such as bronchial asthma, pneumonia, or empyema, especially without notice of aspiration or choking. In such cases, diagnosis and adequate treatments are often delayed. Suspicion of foreign body aspiration and computed tomography and bronchoscopic examination make correct diagnosis more early.We report a case of bronchial foreign body, which had been misdiagnosed as bronchial asthma with wheezing in the whole lung filed, and reversible airway obstruction in the spirometry
Dominant inflammatory cytokines might be different depending on the underlying causes of acute lung injury (ALI). The role of kertinocyte-derived chemokine (KC), a potent chemoattractant for neutrophils, has not been clearly established in hemorrhage-induced ALI. In this study, lung injury and cytokine expression were evaluated in LPS- or hemorrhage-induced ALI models of BALB/c mice. The myeloperoxidase activities at 4 hr after hemorrhage and LPS-injection were 47.4+/-13.0 and 56.5+/-16.4 U/g, respectively. NF-kappaB activity peaked at 4 hr after hemorrhage, which was suppressed to the control level by anti-high mobility group B1 (HMGB1) antibody. Lung expressions of TNF-alpha, MIP-2, and IL-1beta were increased by LPS injection. However, there was only a minimal increase in IL-1beta and no expressions of TNF-alpha or MIP-2 in hemorrhage-induced ALI. In contrast, lung KC increased significantly at 4 hr after hemorrhage compared to control levels (83.1+/-12.3 vs. 14.2+/-1.6 pg/mL/mg by ELISA) (P<0.05). By immunohistochemical staining, lung neutrophils stained positive for KC. Increased KC was also observed in bronchoalveolar lavage fluid and plasma. KC plays an important role in hemorrhage-induced ALI.
Background: Although ultrasound is widely used in clinical practice, educational opportunities for medical students, particularly those in neurology, remain limited. This study aimed to evaluate the impact of neurological US education on first-year medical students and provide insights for future curriculum development.Methods: A prospective, single-center study was conducted from 2022 to 2023 involving 231 first-year medical students over two years at the Chungnam National University College of Medicine. The sessions on Transcranial Doppler and carotid Doppler included a 30 minutes lecture, a 30 minutes demonstration by a neurology specialist, and optional hands-on practice, respectively. A post-session survey assessed students’ feedback, preferences, and willingness to engage in US education. For the analysis, the Likert-scale responses were dichotomized into positive and negative responses, and comparisons between years were conducted using chi-square or Fisher’s exact tests.Results: Over 80% of students found the sessions helpful in understanding anatomy and physiology. Student interest in US education significantly increases from 2022 to 2023 (80.5% vs. 92.4%, <i>p</i>=0.013), along with overall satisfaction (82.5% vs. 96.2%, <i>p</i><0.001). Students preferred optional programs and instructions from specialists or residents. The demand for expanded US education showed an increasing trend (68.0–78.1%), although the difference was not statistically significant.Conclusion: Neurological US education positively affects student learning and motivates students to use US in future practice. This study highlights the importance of neurological US education and provides insights for the development of future specialized curricula in neurology.
Rationale: In recent decades, diagnosis and treatment recommendations for idiopathic pulmonary fibrosis (IPF) have changed. In Korea, the average life expectancy has increased, unmet healthcare needs have been reduced, and the number of computed tomographic examinations performed has nearly doubled. The Korean Interstitial Lung Disease Study Group conducted a nationwide cohort study for idiopathic interstitial pneumonia, including IPF, and established a registry for IPF.Objectives: Using study data collected by the study group, this study aimed to evaluate longitudinal changes in clinical features, diagnosis, treatment, and mortality and analyze the extent to which changes in medication usage affected IPF-associated mortality.Methods: The study population included newly diagnosed patients with IPF from a cohort study (January 2002 to September 2008, n = 1,839, 2008 group) and prospective registry (January 2012 to August 2018, n = 1,345, 2018 group). Survival curves were estimated using the Kaplan-Meier method, and Cox regression models were used to identify mortality-associated risk factors in each group.Results: The 2018 group was younger, had fewer symptoms, had less honeycombing, underwent more serologic autoimmune marker and pulmonary function tests, had higher oxygen partial pressure and lower carbon dioxide partial pressure values, was less frequently diagnosed by surgical biopsy, and had better survival than the 2008 group. Steroid use and conservative care declined, whereas N-acetylcysteine use increased in this group. Antifibrotic agents were used in only the 2018 group. In the 2008 group, N-acetylcysteine was associated with lower mortality, whereas conservative care was associated with higher mortality. In the 2018 group, the use of antifibrotic agents was associated with lower mortality, and steroid use was associated with higher mortality. The survival rates in the 2008 and 2018 non-antifibrotic agent subgroups were similar.Conclusions: This study analyzed national IPF cohort data spanning 17 years. In clinical practice, the IPF diagnosis was made earlier, steroid and immunosuppressive agent use was reduced, and antifibrotic agents were administered. The survival of patients with IPF has improved over the decades, and antifibrotic use was consistently associated with improved survival.Clinical trial registered with clinicaltrials.gov (NCT04160715).
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