97 research outputs found

    Sympathetic withdrawal is associated with hypotension after hepatic reperfusion

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    Objective: Post-reperfusion syndrome (PRS), severe hypotension after graft reperfusion during liver transplantation, is an adverse clinical event associated with poorer patient outcomes. The purpose of this study was to determine whether alterations in autonomic control in liver transplant recipients prior to graft reperfusion are associated with the subsequent development of PRS. Methods: Heart rate variability (HRV), systolic arterial blood pressure (SBP) variability, and baroreflex sensitivity of 218 liver transplant recipients were evaluated using 5 min of ECG and arterial blood pressure signals 10 min before graft reperfusion along with other clinical parameters. Logistic regression analyses were performed to assess predictors of PRS occurrence. Results: Seventy-seven patients (35 %) developed PRS while 141 did not. There were significant differences in SBP (110 ± 16 vs. 119 ± 16 mmHg, P < 0.001) and the ratio of low frequency power to high frequency power (LF/HF) of HRV (1.0 ± 1.4 vs. 2.1 ± 3.7, P = 0.003) between the PRS group and No-PRS group. In multivariate logistic regression analysis, predictors were LF/HF (odds ratio 0.817, P = 0.028) and SBP (odds ratio 0.966, P < 0.001). Interpretation: Low LF/HF and SBP measured before hepatic graft reperfusion were significantly correlated with subsequent PRS occurrence, suggesting that sympathovagal imbalance and depressed SBP may be key factors predisposing to reperfusion-related severe hypotension in liver transplant recipients

    Role of Dual Flagella in the Pathogenesis of Vibrio parahaemolyticus

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    Vibrio parahaemolyticus possesses two flagella systems: polar and lateral flagella for swimming in liquid and swarming on solid surfaces or in viscous environments. To elucidate the pathogenic role of these dual flagella systems, we constructed single-and double-deletion mutants of the lafA and flhAB flagellum genes and investigated their biofilm formation, cell adhesion, and colonization of the small intestine of suckling mice. The double-mutant strain was more impaired in biofilm formation than either of the single-mutant strains. In addition, the lafA, flhAB, and double-mutant strains showed 40%, 45%, and 60%, respectively, lower adherence to HeLa cells than the wild-type strain. Moreover, the lafA, flhAB, and double-mutant strains exhibited 49%, 5.6 and 6.7 times, respectively, lower colonization in a competition assay than the wild-type strain. These findings indicated that polar flagella were more important than lateral flagella for the pathogenesis of V. parahaemolyticus

    Patterns of Using Complementary and Alternative Medicine by Stroke Patients at Two University Hospitals in Korea

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    This study measured the prevalence of complementary and alternative medicine (CAM) use among Korean stroke patients. Questionnaire-based 20-min interviews were conducted at the hospitals by a trained nurse after an outpatient visit. It included questions on demographic information, clinical information and the utilization of CAM. Of 304 stroke-patient respondents, 164 (54%) had used CAM, of which 66% had started taking CAM products following suggestions from family members and other relatives. Of the 57% of users who felt that CAM was effective, 84% considered that it improved the symptoms of stroke and 16% felt it was effective in achieving psychological relaxation. Of the eight CAM categories used by respondents, 92% used traditional Oriental medical treatments, 36% used plant- and animal-derived over-the-counter health care products, 24% used minerals and vitamins, and 11% used manual therapies. The majority of stroke patients (68%) were trying a new type of CAM, and half of the respondents (45%) relied on the knowledge of their general practitioner about CAMs when deciding whether to use them. Most of the stroke patients in this study used CAM, and a half of them reported beneficial effects. Despite the presence of adverse side effects, they tended to be used without discussion with chief physicians, and hence physicians should be actively involved in the usage of CAM

    Ab initio study of thallium nanoclusters on Si(111)-7x7

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    We have studied the stability of a thallium nanocluster of various numbers of atoms (N=1,2,...,10) on a Si(111)-7x7 substrate using density functional theory total energy calculations. We have compared it with clusters of other group III elements (Al, Ga, and In). Thallium is found to be unstable with the triangular cluster, which has been known to be stable for other group III elements. Instead, a slightly different structure, in which Si atop atoms are lower than thallium atoms in height by 2.56 angstrom, was found to be quite stable. Such an abnormal structure originates from the inert pair of 6s(2) electrons due to the significant spin-orbit interaction. The initial relaxed N=6 Tl cluster continues to grow with increasing N up to N=9 in the faulted-half unit cell, which is consistent with experimental observationsclose121

    The Correlation between F-wave Motor Unit Number Estimation (F-MUNE) and Functional Recovery in Stroke Patients

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    The aim of this study was to follow up the changes in the number of motor units according to the Brünnstrom stage through a motor unit number estimation of the F-wave (F-MUNE) after a stroke, and to identify the functional significance of F-MUNE. Twenty-five patients (15 men, 10 women) with a first unilateral stroke were recruited. The maximal M-potential was evoked by the supramaximal stimulation of the median nerve at the wrist, and the maximal stimulation intensity was determined on both hemiplegic and unaffected hands. The reproducible all-or-none F-wave was evoked in 30% of the maximal stimulation intensity and was constantly stimulated at that level. The prototypes of the F-wave were chosen, and the values of F-MUNE were calculated by dividing the amplitude of the maximal M-potential by the mean amplitude of the F-prototype. The changes in F-MUNE were compared according to the progression of the Brünnstrom stage and correlated with those of the functional scales. The mean motor unit numbers decreased significantly in the hemiplegic side compared with the unaffected side. According to the progression of the Brünnstrom stage, the values of F-MUNE were reduced significantly by increasing the amplitude and recruitment of the F-prototype, and the functional scores also improved. These results show that the F-MUNE equation did not show a functional recovery-related increase in stroke patients

    Satellite cell-specific ablation of Cdon impairs integrin activation, FGF signalling, and muscle regeneration

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    Background: Perturbation in cell adhesion and growth factor signalling in satellite cells results in decreased muscle regenerative capacity. Cdon (also called Cdo) is a component of cell adhesion complexes implicated in myogenic differentiation, but its role in muscle regeneration remains to be determined. Methods: We generated inducible satellite cell-specific Cdon ablation in mice by utilizing a conditional Cdon allele and Pax7 CreERT2. To induce Cdon ablation, mice were intraperitoneally injected with tamoxifen (tmx). Using cardiotoxin-induced muscle injury, the effect of Cdon depletion on satellite cell function was examined by histochemistry, immunostaining, and 5-ethynyl-2&apos;-deoxyuridine (EdU) incorporation assay. Isolated myofibers or myoblasts were utilized to determine stem cell function and senescence. To determine pathways related to Cdon deletion, injured muscles were subjected to RNA sequencing analysis. Results: Satellite cell-specific Cdon ablation causes impaired muscle regeneration with fibrosis, likely attributable to decreased proliferation, and senescence, of satellite cells. Cultured Cdon-depleted myofibers exhibited 32 ± 9.6% of EdU-positive satellite cells compared with 58 ± 4.4% satellite cells in control myofibers (P &lt; 0.05). About 32.5 ± 3.7% Cdon-ablated myoblasts were positive for senescence-associated β-galactosidase (SA-β-gal) while only 3.6 ± 0.5% of control satellite cells were positive (P &lt; 0.001). Transcriptome analysis of muscles at post-injury Day 4 revealed alterations in genes related to mitogen-activated protein kinase signalling (P &lt; 8.29 e−5) and extracellular matrix (P &lt; 2.65 e−24). Consistent with this, Cdon-depleted tibialis anterior muscles had reduced phosphorylated extracellular signal-regulated kinase (p-ERK) protein levels and expression of ERK targets, such as Fos (0.23-fold) and Egr1 (0.31-fold), relative to mock-treated control muscles (P &lt; 0.001). Cdon-depleted myoblasts exhibited impaired ERK activation in response to basic fibroblast growth factor. Cdon ablation resulted in decreased and/or mislocalized integrin β1 activation in satellite cells (weak or mislocalized integrin1 in tmx = 38.7 ± 1.9%, mock = 21.5 ± 6%, P &lt; 0.05), previously linked with reduced fibroblast growth factor (FGF) responsiveness in aged satellite cells. In mechanistic studies, Cdon interacted with and regulated cell surface localization of FGFR1 and FGFR4, likely contributing to FGF responsiveness of satellite cells. Satellite cells from a progeria model, Zmpste24−/− myofibers, showed decreased Cdon levels (Cdon-positive cells in Zmpste24−/− = 63.3 ± 11%, wild type = 90 ± 7.7%, P &lt; 0.05) and integrin β1 activation (weak or mislocalized integrin β1 in Zmpste24−/− = 64 ± 6.9%, wild type = 17.4 ± 5.9%, P &lt; 0.01). Conclusions: Cdon deficiency in satellite cells causes impaired proliferation of satellite cells and muscle regeneration via aberrant integrin and FGFR signalling. © 2020 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley &amp; Sons Ltd on behalf of Society on Sarcopenia, Cachexia and Wasting Disorders1

    The effect of sex and physical frailty on incident disability after 2 years among community-dwelling older adults: KFACS study

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    Background : This study investigated the impact of physical frailty on the development of disabilities in mobility, activities of daily living (ADL), and instrumental activities of daily living (IADL) according to sex among community-dwelling Korean older adults. Methods : We used data of 2,905 older adults aged 70-84 years from the Korean Frailty and Aging Cohort Study (KFACS) at baseline (2016-2017) and Wave 2 (2018-2019). Fried’s physical frailty phenotype was used to identify frailty. Results : After adjustment, frailty showed a higher impact for women than men on developing mobility disability (odds ratio [OR]=14.00, 95% confidence interval [CI]=4.8–40.78 vs. OR=9.89, 95% CI=4.28–22.86) and IADL disability after two years (OR=7.22, 95% CI=2.67–19.56 vs. OR=3.19, 95% CI=1.17–8.70). Pre-frailty led to mobility disability for women and men (OR=2.77, 95% CI=1.93–3.98 vs. OR=2.49, 95% CI=1.66–3.72, respectively), and IADL disability only for women (OR=3.01, 95% CI=1.28–7.09). Among the IADL components, both men and women who were prefrail or frail showed increased disability in ‘using transportation’. Among men, pre-frailty was significantly associated with disability in “going out” and “shopping”. In women, frailty was significantly associated with disability in “doing laundry,” “performing household chores,” “shopping,” and “managing money”. Conclusions : Physical frailty increased disability over 2 years for women more than men. Physical frailty increased disability in outdoor activity-related IADL components in men and household work-related IADL components in women. This study highlights the need for gender-specific policies and preventative programs for frailty, particularly restorative interventions that focus on women who are physically frail.This research was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), which is funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI15C3153), and the Research Program funded by the National Institute of Health, Korea Disease Control and Prevention Agency (2021-ER060500). The funding bodies had no role in the study design the collection, analysis and interpretation of the data; the writing of the report; or the decision to submit this article for publication

    Korean Brain Rehabilitation Registry for Rehabilitation of Persons with Brain Disorders: Annual Report in 2009

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    This first annual report provides a description of patients discharged from rehabilitation facilities in Korea based on secondary data analysis of Korean Brain Rehabilitation Registry V1.0 subscribed in 2009. The analysis included 1,697 records of patients with brain disorders including stroke, traumatic brain injury, brain tumor and other disorders from 24 rehabilitation facilities across Korea. The data comprised 1,380 cases of stroke, 104 cases of brain injury, 55 cases of brain tumor, and 58 cases of other brain diseases. The functional status of each patient was measured using the Korean version of the Modified Barthel Index (KMBI). The average change in the KMBI score was 15.9 for all patients in the inpatient rehabilitation facility. The average length of stay for inpatient rehabilitation was 36.9 days. The transfer rates to other hospitals were high, being 62.4% when all patients were considered. Patients with brain disorders of Korea in 2009 and measurable functional improvement was observed in patients. However, relatively high percentages of patients were not discharged to the community after inpatient rehabilitation. Based on the results of this study, consecutive reports of the status of rehabilitation need to be conducted in order to provide useful information to many practitioners
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