Tricuspid regurgitation: a hidden risk factor for atrial fibrillation related stroke?

Background and purposeTricuspid regurgitation (TR) is a common but overlooked valvular disease, and its association with the etiologic subtypes of ischemic stroke is unclear. We explored the relationship between TR and atrial fibrillation (AF) in patients with acute ischemic stroke.MethodsThis retrospective analysis of ongoing stroke registry assessed 6,886 consecutive acute ischemic stroke patients who underwent transthoracic echocardiography during their in-hospital care. Multivariable logistic regression models adjusted for age, sex, stroke characteristics, and echocardiographic indices were used to investigate the association between TR and total AF, and newly diagnosed AF during hospitalization and a 1-year follow-up period, respectively.ResultsTR was present in 877 (12.7%) patients (mild, 9.9%; moderate, 2.4%; severe, 0.5%). AF was identified in 24.1% (medical history, 11.1%; first detected in the emergency room, 6.6%; newly diagnosed after admission, 6.4%). TR was associated with AF [adjusted odds ratio (aOR) 4.87 (95% confidence interval (CI), 2.63–9.03)], compared with no/trivial TR. The association between TR and AF was consistent regardless of severity (aOR [95% CI], 4.57 [2.63–7.94] for mild and 7.05 [2.57–19.31] for moderate-to-severe TR) or subtype of TR (5.44 [2.91–10.14] for isolated and 3.81 [2.00–7.28] for non-isolated TR). Among the AF-naïve patients at admission, TR was associated with newly diagnosed AF during hospitalization and a 1-year follow-up period (aOR [95% CI], 2.68 [1.81–3.97]).ConclusionsTR is associated with AF in acute ischemic stroke patients regardless of severity and subtypes of TR. TR is also associated with newly diagnosed AF after stroke

Dynamic Temporal Change of Cerebral Microbleeds: Long-Term Follow-Up MRI Study

Background: Cerebral microbleeds (MBs) are understood as an important radiologic marker of intracerebral hemorrhage. We sought to investigate the temporal changes of MBs and clinical factors associated with the changes using long-term follow-up MRI. Methods/Principal Findings: From October 2002 to July 2006, we prospectively enrolled patients with stroke or transient ischemic attack, and followed-up their brain MRIs with an interval.12 mo. We compared demographic factors, vascular risk factors, laboratory findings, and radiologic factors according to the presence or changes of MBs. A total of 224 patients successfully completed the follow-up examinations (mean, 27 months). Newly developed MBs were noted in 10 patients (6.8%) among those without MBs at baseline (n = 148), and in those with MBs at baseline (n = 76), the MB count had decreased in 11 patients (14.5%), and increased in 41 patients (53.9%). The estimated annual rate of change of MB numbers was 0.80 lesions per year in all patients, a value which became greater in those patients who exhibited MBs at baseline (MBs$5, 5.43 lesions per year). Strokes due to small vessel occlusion and intracerebral hemorrhage, as well as white matter lesions were independently associated with an increased MB count, whereas the highest quartile of low-density lipoprotein (LDL) cholesterol was associated with a decreased MB count. Conclusion: During the follow-up period, most of MBs showed dynamic temporal change. Symptomatic or asymptomati

Treatment of Verrucous Carcinoma of the Lower Lip with Topical Imiquimod (Aldara®) and Debulking Therapy

Verrucous carcinoma is an unusual, non-metastasizing, distinct variant of squamous cell carcinoma composed of four subtypes according to the site of occurrence: oral type, anogenital type, plantar type, and other cutaneous sites. Oral type verrucous carcinoma usually shows slow progression with a low incidence of metastases. Treatment of verrcous carcinoma is challenging; multiple medical and surgical therapies are often attempted, with limited success. We reported on 2 cases of verrucous carcinoma of the lip treated with topical imiquimod and debulking therapy

Incontinentia Pigmenti: Clinical Observation of 40 Korean Cases

Incontinentia pigmenti (IP) is an uncommon genodermatosis that usually occurs in female infants. It is characterized by ectodermal, mesodermal, neurological, ocular, and dental manifestations. The aim of this study was to clarify clinical symptoms, accompanying diseases, and complications of IP. Forty cases of IP have been reviewed by their medical records, laboratory data, clinical photographs, and telephone survey. Male-to-female ratio was 1 to 19 and their onsets were mostly in utero. They were usually diagnosed during the neonatal period owing to their early expression of skin manifestation. Central nervous system anomalies were found in 46.7%. Ocular disorders and dental defects were detected in 66.7% and 72.7% respectively. The most commonly diagnosed anomalies were hypodontia, retinopathy, and seizure. For better understanding of IP, long term and close cooperation between dermatologists, pediatricians, neuroscientists, genentic counselors, and even dentists is crucial

Edge-carboxylated graphene nanoplatelets as oxygen-rich metal-free cathodes for organic dye-sensitized solar cells

Edge-carboxylated graphene nanoplatelets (ECGnPs) were synthesized by the simple, efficient and eco-friendly ball-milling of graphite in the presence of dry ice and used as oxygen-rich metal-free counter electrodes (CEs) in organic dye-sensitized solar cells (DSSCs), for the first time. The resultant ECGnPs are soluble in many polar solvents including 2-propanol due to the polar nature of numerous carboxylic acids at edges, allowing an electrostatic spray (e-spray) to be deposited on fluorine-doped SnO2 (FTO)/glass substrates. The ECGnP-CE exhibited profound improvements in the electrochemical stability for the Co(bpy)3 2+/3+ redox couple compared to the platinum (Pt)-CE. The charge transfer resistance (RCT), related to the interface between an electrolyte and a CE, was significantly reduced to 0.87 ?? cm2, much lower than those of (Pt)-CE (2.19 ?? cm 2), PEDOT:PSS-CE (2.63 ?? cm2) and reduced graphene oxide (rGO)-CE (1.21 ?? cm2). The DSSC based on the JK-303-sensitizer and ECGnP-CE displayed a higher photovoltaic performance (FF, Jsc, and ??, 74.4%, 14.07 mA cm-2 and 9.31%) than those with the Pt-CE (71.6%, 13.69 mA cm-2 and 8.67%), PEDOT:PSS (68.7%, 13.68 mA cm-2 and 8.25%) and rGO-CE (72.9%, 13.88 mA cm-2 and 8.94%).close3