<b><i>Background:</i></b> The optimal strategy to manage chronic total occlusion (CTO) remains unclear. The Japanese CTO multicenter registry (J-CTO) score is an established tool for predicting successful recanalization. However, it does not take into account nonangiographic predictors for final technique success. In the present study, we designed and tested a scoring model called the Busan single-center CTO registry (B-CTO) score combining clinical and angiographic characteristics to predict successful CTO recanalization in Korean patients. <b><i>Methods:</i></b> Prospectively enrolled CTO patients (<i>n</i> = 438) undergoing coronary intervention (1999-2015) were assessed. The B-CTO score comprises 6 independent predictors: age 60-74 years and lesion length ≥20 mm were assigned 1 point each, while age ≥75 years, female gender, lesion location in the right coronary artery, blunt stump, and bending >45° were assigned 2 points each. For each predictor, the points assigned were based on the associated odds ratio by multivariate analysis. The lesions were classified into 4 groups according to the summation of points scored to assess the probability of successful CTO recanalization: easy (score 0-1), intermediate (score 2-3), difficult (score 4-5), and very difficult (score ≥6). CTO opening was designated as the primary endpoint regardless of the interventional era or the skill of the operator. <b><i>Results:</i></b> The final success rate for B-CTO was 81.1%. The probability of successful recanalization for patient groups classified as easy (<i>n</i> = 64), intermediate (<i>n</i> = 148), difficult (<i>n</i> = 134), and very difficult (<i>n</i> = 92) was 95.3, 86.5, 79.1 and 65.2%, respectively (<i>p</i> for trend <0.001). When compared to the J-CTO, the B-CTO score demonstrated a significant improvement in discrimination as indicated by the area under the receiver-operator characteristic curve (AUC 0.083; 95% CI 0.025-0.141), with a positive integrated discrimination improvement of 0.042 and a net reclassification improvement of 56.0%. <b><i>Conclusions:</i></b> The B-CTO score has been designed and validated in Korean patients with native coronary CTO and is an improved tool for predicting successful recanalization. Wider application of the B-CTO score remains to be explored.
Inflammatory bowel diseases (IBD) induce inflammation in the colon and small intestine. IBD include ulcerative colitis and Crohn's disease, with such common symptoms as severe diarrhea, fever, and blood in the stool. In the current study, we explored the ability of peanut shell extract (PSE) to alleviate IBD in an experimental colonic inflammation model. Colitis was induced by orally administered dextran sulfate sodium (DSS) in mice. Peanut shell extract was prepared using a method of aqueous ethanol. DSS treatment reduced the colon length and mouse body weight, and aggravated disease condition compared with untreated control mice. Oral administration of 400 mg/kg PSE alleviated colon shortening, body weight loss, DAI, and colon injury score in DSS-induced colitis. These physiological improvements were validated by reduced levels of proinflammatory cytokines and infiltrating macrophage accumulation in the inflamed colon in the PSE administered group. These observations suggest that PSE may be developed as an alternative natural extract for the prevention or treatment of IBD.
We compared the long-term outcomes of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) for unprotected left main coronary artery (ULMCA) disease in a real-world population.
Background: Acute pulmonary thromboembolism (APTE) is often confused with myocardial infarction. Previous studies have shown that patients with APTE exhibit lower initial and peak cardiac troponin I (CTI) levels, but higher D-dimer (DD) levels, than patients with myocardial infarction. The present study aimed to reaffirm the tree model algorithm using an entirely new set of data.Methods: We reviewed retrospective clinical and laboratory data from patients who were diagnosed with APTE or non-ST-elevation myocardial infarction (NSTEMI) between 2015 and 2016. Subjects who were not classified with a diagnosis or did not have their CTI or DD levels assessed were excluded. We categorized patients according to the previous algorithm and compared the outcomes with the previous test dataset.Results: The analysis involved data from 156 patients with APTE and 363 patients with NSTEMI. In the validation data set, the APTE group showed higher initial DD levels (9.80±10.84 μg/mL) and lower initial CTI levels (0.17±0.54 μg/mL) than the NSTEMI group. The accuracy rate for the test dataset and the validation set were similar. The test set accuracy rate was 91.0%, while the accuracy rate in the validation set improved to 88.6%.Conclusions: Patients with APTE exhibited lower initial and peak CTI levels, but higher DD levels than NSTEMI patients. The accuracy rate estimates were similar between the test set obtained from the tree model algorithm and the validation set. The study findings demonstrate that the assessment of cardiac biomarkers can be useful for differentiating between APTE and NSTEMI.
We investigated the expression of MAGE-1, -2, and -3 genes in tissues of 51 gastric carcinomas from Korean patients and in 11 gastric cancer cell lines established in Korea using reverse transcriptase-polymerase chain reaction along with immunohistochemical analyses and DNA sequencing. Among the 51 gastric carcinomas, MAGE-1, -2, and -3 genes were expressed in 16 (31%), 22 (43%), and 17 (33%), respectively, and 31 (60%) expressed at least one of the three genes. In contrast, none of the three MAGE genes were expressed in normal sites of gastric tissue from each cancer patient. Out of 11 gastric cancer cell lines, MAGE-1, -2, and -3 genes were expressed in two (18%), five (46%), and four (36%), respectively. According to the clinicopathological analysis, the expression of any of the three MAGE genes was not significantly correlated with several clinicopathological factors except histologic types (p= 0.067). Immunohistochemical analyses identified positive staining with monoclonal antibodies 77B and 57B specifically against MAGE-1 and -3 proteins, respectively, in nuclei and cytoplasms of cells in mRNA-positive tumor tissue. These findings suggest the possibility as a target for tumor-specific immunotherapy for Korean patients.
This study aims to prospectively analyze the effects of anticholinergic therapy using imidafenacin on detrusor overactivity occurring after robot-assisted radical prostatectomy (RARP).
We evaluated the availability of toluidine blue stain in body fluids, such as peritoneal and pleural fluid and urine. Nine hundreds specimens, i.e., 400 pleural and 400 peritoneal fluids and 100 urine samples, respectively, from Jan. 1995 to May 1996 were included. We obtained the result of high sensitivity and high specificity. In toluidine blue stained body fluid in comparison with Papanicolaou stained result. Additionally, we found the diagnostically important crystals in chylothorax and some urine samples, which can not be seen in routine Papanicolaou stain. We thought the toluidine blue stain in body fluid is one of very useful diagnostic methods.
Cholesterol homeostasis is mediated by Scap, a polytopic endoplasmic reticulum (ER) protein that transports sterol regulatory element-binding proteins from the ER to Golgi, where they are processed to forms that activate cholesterol synthesis. Scap has eight transmembrane helices and two large luminal loops, designated Loop1 and Loop7. We earlier provided indirect evidence that Loop1 binds to Loop7, allowing Scap to bind COPII proteins for transport in coated vesicles. When ER cholesterol rises, it binds to Loop1. We hypothesized that this causes dissociation from Loop7, abrogating COPII binding. Here we demonstrate direct binding of the two loops when expressed as isolated fragments or as a fusion protein. Expressed alone, Loop1 remained intracellular and membrane-bound. When Loop7 was co-expressed, it bound to Loop1, and the soluble complex was secreted. A Loop1-Loop7 fusion protein was also secreted, and the two loops remained bound when the linker between them was cleaved by a protease. Point mutations that disrupt the Loop1-Loop7 interaction prevented secretion of the Loop1-Loop7 fusion protein. These data provide direct documentation of intramolecular Loop1-Loop7 binding, a central event in cholesterol homeostasis.
Introduction: Dysregulation of the lipid metabolism has been implicated in the pathogenesis of idiopathic pulmonary fibrosis (IPF);however, the role of free fatty acids (FFA) is not well defined. Aim: to investigate the role of FFA in the pathogenesis in IPF Methods: Fatty acid methyl esters were analyzed with Agilent 7890/5975 Gas Chromatography-Mass Spectrometry and HP-5 MS 30 m * 250 µm * 0.25 µm column (Agilent 19091S-433) in the lung tissues of controls (n=10) and IPF patients (n=10). To evaluate the function of FFA, human lung fibroblasts (MRC-5 cells) were treated with TGF-ß1 (5 ng/ml) and/or FFAs including palmitic acid, stearic acid, oleic acid and linoleic acid. Cell viability and protein expression were measured via MTT assay and western blot analysis, respectively. Results: Although the levels of palmitic acid, oleic acid and linoleic acid were elevated, the level of stearic acid was significantly reduced in the lung tissues of patients. Palmitic acid, oleic acid or linoleic acid significantly enhanced the TGF-ß1 induced expression of α-smooth muscle actin (SMA) and collagen type-1 in MRC-5 cells;however, stearic acid significantly reduced them. Moreover, palmitic acid and linoleic acid increased the TGF-ß1 induced proliferation of MRC-5 cells, but stearic acid decreased it. Stearic acid significantly inhibited the levels of p-Smad2/3 in MRC-5 cells treated with TGF-ß1. Conclusion: Our findings suggest that FFAs may have effects on pulmonary fibrosis by regulating TGF-ß1 induced activation and proliferation of fibroblasts and be implicated as potential therapeutic targets in IPF.
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