BACKGROUND AND PURPOSE: Elucidating the factors that predict the quality of life (QOL) in stroke patients is important. However, the residual sensory symptoms that are common in stroke patients have not usually been included as factors that influence the QOL. The purpose of the present study was to elucidate the factors that predict the QOL of chronic-stage patients with special attention to residual sensory symptoms. METHODS: We examined 214 patients who had experienced a first-time stroke during the subacute (i.e., approximately 3 months poststroke) stage; 151 patients from this group were followed up by telephone interview during the chronic (i.e., approximately 3 years poststroke) stage. Physical disabilities, including motor dysfunction, sensory symptoms that included central poststroke pain (CPSP, described using a standardized questionnaire with a visual analogue scale), activities of daily living (ADL, measured by the Barthel index score), as well as the presence of depression (using the DSM IV criteria), were assessed during both the subacute and chronic stages. Economic and job statuses during the chronic stage were also assessed. QOL ratings were determined by the World Health Organization QOL scale. RESULTS: The following factors at 3 months poststroke were related to low QOL at 3 years poststroke: dependency in ADL, motor dysfunction, depression, and CPSP. At 3 years poststroke, dependency in ADL, depression, CPSP, poor economic status, and unemployment were all factors that were related to low QOL. Multiple regression analysis showed that dependency in ADL (19%), presence of CPSP (12%), and poor economic status (10%) were important explanatory factors for overall QOL. In the analysis of QOL subdomains, the most important explanatory factors were CPSP for both physical and psychological domains, dependency in ADL for both independence and social-relationships domains, economic status for the environmental domain, and female sex for the spiritual domain. CONCLUSIONS: We conclude that dependency in ADL, depression, low socioeconomic status, and the presence of CPSP either at 3 months or 3 years poststroke are factors that are related to a low QOL at 3 years poststroke. The recognition of these factors may allow strategies to be developed to improve the QOL for stroke patients.
Activities of Daily Living ; Depression ; Female ; Humans ; Interviews as Topic ; Quality of Life* ; Social Class ; Stroke ; Unemployment ; World Health Organization ; Surveys and Questionnaires

OBJECTIVE: To analyze the magnetic resonance (MR) imaging findings of invasive micropapillary carcinoma of the breast. MATERIALS AND METHODS: MR images were retrospectively evaluated in 14 patients (age range: 37-67, mean age: 49 years) with pathologically confirmed invasive micropapillary carcinoma of the breast. The enhancement type (mass/non-mass), shape, margin, contrast enhancement, and time-intensity curve pattern on the dynamic study were correlated with the histopathologic features. Associated findings, such as edema, nipple change, skin change and enlarged axillary lymph nodes were also studied. RESULTS: The most common features of the masses were irregular shape (12 of 14 patients, 85.8%) and irregular or spiculated margin (11 of 14 patients, 78.7%). The contrast enhancement was heterogeneous in 11 patients (78.7%), rim enhancement in 2 cases (14.2%), and homogeneous in one patient (7.1%). The predominant kinetic pattern was rapid increase (14 of 14, 100%) in the initial phase and washout (11 of 14, 78.7%) in the delayed phase. Associated non-mass like enhancement was shown in 4 patients, representing ductal carcinoma in situ. MR imaging helped detect additional sites of cancer other than the index lesion in 3 patients (21.4%). Enlarged axillary lymphadenopathy was identified in 7 of the 14 patients (50%). CONCLUSION: Invasive micropapillary carcinoma appears as a mass with an irregular shape, irregular or spiculated margin and heterogeneous enhancement on MR imaging. Though these findings are not specific and are also observed with other breast malignancies, invasive micropapillary carcinoma frequently showed multiple lesions, accompanying non-mass enhancement and axillary lymph node enlargement.
Adult ; Aged ; Breast Neoplasms/*diagnosis/pathology ; Carcinoma, Papillary/*diagnosis/pathology ; Diagnosis, Differential ; Female ; Humans ; Magnetic Resonance Imaging/*methods ; Middle Aged ; Neoplasm Invasiveness ; Reproducibility of Results ; Retrospective Studies

No abstract available.
Arteries* ; Stroke*

An improved procedure for preparing PCR cloning vectors was developed. This procedure includes the incorporation of adapters to create XcmI restriction enzyme sites in pBluescript II SK(+) vectors, digestion with XcmI followed by further digestion of the small fragment produced by XcmI digestion with additional enzymes, and purification with PCR purification kits. Using this procedure, PCR cloning vectors with high ligation efficiencies and low blue or false-positive colonies were obtained.
Clone Cells ; Cloning, Organism ; Digestion ; Genetic Vectors ; Ligation ; Polymerase Chain Reaction

PURPOSE: This study aimed to evaluate ichroma™ IGRA-TB, a novel point-of-care platform for assaying IFN-γ release, and to compare it with QuantiFERON-TB Gold In-Tube (QFT-GIT) for identifying Mycobacterium tuberculosis (M. tb) infection. MATERIALS AND METHODS: We recruited 60 healthy subjects, and blood samples were obtained in QFT-GIT blood collection tubes. The blood collection tubes were incubated at 37℃, and culture supernatant was harvested after 18–24 hours. IFN-γ responses were assessed by the ichroma™ IGRA-TB cartridge and the QFT-GIT IFN-γ enzyme-linked immunosorbent assay. Three active TB patients were recruited as a positive control for M. tb infection. RESULTS: The area under the receiver operating characteristic curve of the ichroma™ IGRA-TB test for differentiating between infected and non-infected individuals was 0.9706 (p < 0.001). Inconsistent positivity between the two tests was found in three participants who showed weak positive IFN-γ responses ( < 1.0 IU/mL) with QFT-GIT. However, the two tests had excellent agreement (95.2%, κ=0.91, p < 0.001), and a very strong positive correlation was observed between the IFN-γ values of both tests (r=0.91, p < 0.001). CONCLUSION: The diagnostic accuracy demonstrated in this study indicates that the ichroma™ IGRA-TB test could be used as a rapid diagnostic method for detecting latent TB infection. It may be particularly beneficial in resource-limited places that require cost-effective laboratory diagnostics.
Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Feasibility Studies ; Healthy Volunteers ; Humans ; Korea ; Latent Tuberculosis ; Methods ; Mycobacterium tuberculosis ; Point-of-Care Systems ; ROC Curve ; Tuberculosis

BACKGROUND AND PURPOSE: Little is known about prognosis after endovascular therapy (EVT) for acute large artery occlusion (LAO) caused by underlying intracranial atherosclerotic stenosis (ICAS). Therefore, we investigated the prognosis following EVT according to the underlying etiology of LAO. METHODS: Patients from the Acute Stroke due to Intracranial Atherosclerotic occlusion and Neurointervention-Korean Retrospective (ASIAN KR) registry (n=720) were included if their occlusion was in the intracranial anterior circulation and their onset-to-puncture time was < 24 hours. Occlusion was classified according to etiology as follows: no significant stenosis after recanalization (Embolic group), and fixed significant focal stenosis in the occlusion site with flow impairment or re-occlusion observed during EVT (ICAS group). Patients were excluded when significant extracranial carotid lesions existed, and when the intracranial occlusion was intractable to EVT so that the etiology was undetermined. The effect of angiographic etiologic classification on outcomes was evaluated using multivariable analysis that was adjusted for potential confounders. RESULTS: Among eligible patients (n=520), 421 and 99 were classified in the Embolic and ICAS groups, respectively. Patients in the Embolic and ICAS groups had similar successful reperfusion rates with EVT (79.6% vs. 76.8%, P=0.537) and 3-month functional independence (54.5% vs. 45.5%, P=0.104). In multivariable analysis, ICAS-related occlusion (odds ratio, 0.495; 95% confidence interval, 0.269 to 0.913; P=0.024) showed poorer 3-month functional independence compared to embolic occlusion. CONCLUSIONS: After EVT, patients with acute ICAS-related occlusion have relatively poor functional outcomes compared to those with embolic occlusion. Novel strategies need to be developed to improve EVT outcomes for ICAS occlusion.
Arteries ; Atherosclerosis ; Cerebral Infarction ; Classification ; Constriction, Pathologic ; Embolism ; Humans ; Prognosis* ; Reperfusion ; Retrospective Studies ; Stroke ; Thrombectomy ; Treatment Outcome

BACKGROUND AND PURPOSE: The purpose of the current study is to evaluate the influence of temporal patterns related to the availability of new endovascular treatment (EVT) devices on care processes and outcomes among patients with AIS. MATERIALS AND METHODS: We enrolled 720 consecutive patients (January 2011 to May 2016) in a retrospective registry, ASIAN KR, from three Korean hospitals, who received EVT for acute ischemic stroke (AIS) caused by cervicocephalic arterial occlusions. We performed period-to-period analyses based on stent retriever reimbursement and the availability of second-generation direct-aspiration devices (Period 1: January 2011–July 2014 vs. Period 2: August 2014–May 2016); time metrics and outcomes were compared when the onset-to-puncture time was <720 min among patients with EVT for intracranial occlusion. RESULTS: Period 2 had better post-EVT outcomes (3-month modified Rankin Scale 0–2 or equal to prestroke score, 48.3% vs. 60.2%, P=0.004), more successful reperfusion rates (modified Treatment In Cerebral Ischemia 2b–3, 74.2% vs. 82.2%, P=0.019), fewer subarachnoid hemorrhages (modified Fisher grade 3–4, 5.5% vs. 2.0%, P=0.034) and lower hemorrhagic transformation rates (any intracerebral hemorrhage, 35.3 vs. 22.7%, P=0.001) than Period 1. Compared to Period 1, Period 2 had a shorter door-to-puncture time (median 109 vs. 90 min, P<0.001), but longer onset-to-door time (129 vs. 143 min, P=0.057). CONCLUSION: Recent temporal improvements in post-EVT AIS outcomes in Korea are likely due to a combination of enhanced hospital care processes and administration of newer thrombectomy devices.
Asian Continental Ancestry Group ; Brain Ischemia ; Cerebral Hemorrhage ; Cerebral Infarction ; Humans ; Korea ; Learning Curve ; Reperfusion ; Retrospective Studies* ; Stents ; Stroke* ; Subarachnoid Hemorrhage ; Thrombectomy ; Treatment Outcome