FAM19A5, a novel secretory protein highly expressed in the brain, is potentially associated with the progression of Alzheimer's disease (AD). However, its role in the AD pathogenesis remains unclear. Here, we investigated the potential function of FAM19A5 in the context of AD. We generated APP/PS1 mice with partial FAM19A5 deficiency, termed APP/PS1/FAM19A5+/LacZ mice. Compared with control APP/PS1 mice, APP/PS1/FAM19A5+/LacZ mice exhibited significantly lower Aβ plaque density and prolonged the lifespan of the APP/PS1 mice. To further explore the therapeutic potential of targeting FAM19A5, we developed a FAM19A5 antibody. Administration of this antibody to APP/PS1 mice significantly improved their performance in the Y-maze and passive avoidance tests, indicating enhanced cognitive function. This effect was replicated in 5XFAD mice, a model of early-onset AD characterized by rapid Aβ accumulation. Additionally, FAM19A5 antibody treatment in 5XFAD mice led to enhanced exploration of novel objects and increased spontaneous alternation behavior in the novel object recognition and Y-maze tests, respectively, indicating improved cognitive function. These findings suggest that FAM19A5 plays a significant role in AD pathology and that targeting with FAM19A5 antibodies may be a promising therapeutic strategy for AD.

Objective: : This study aims to determine the optimal dose of recombinant-human bone morphogenic protein-2 (rhBMP-2) for successful bone fusion in minimally invasive lateral lumbar interbody fusion (MIS LLIF). Previous studies show that rhBMP is an effective alternative to autologous iliac crest bone graft, but the optimal dose remains uncertain. The study analyzes the fusion rates associated with different rhBMP doses to provide a recommendation for the optimal dose in MIS LLIF. Methods: : Ninety-three patients underwent MIS LLIF using demineralized bone matrix (DBM) or a mixture of rhBMP-2 and DBM as fusion material. The group was divided into the following three groups according to the rhBMP-2 usage : group A, only DBM was used (n=27); group B, 1 mg of rhBMP-2 per 5 mL of DBM paste (n=41); and group C, 2 mg of rhBMP-2 per 5 mL of DBM paste (n=25). Demographic data, clinical outcomes, postoperative complication and fusion were assessed. Results: : At 12 months post-surgery, the overall fusion rate was 92.3% according to Bridwell fusion grading system. Groups B and C, who received rhBMP-2, had significantly higher fusion rates than group A, who received only DBM. However, there was no significant increase in fusion rate when the rhBMP-2 dosage was increased from group B to group C. The groups B and C showed significant improvement in back pain and Oswestry disability index compared to the group A. The incidence of screw loosening was decreased in groups B and C, but there was no significant difference in the occurrence of other complications. Conclusion : Usage of rhBMP-2 in LLIF surgery leads to early and increased final fusion rates, which can result in faster pain relief and return to daily activities for patients. The benefits of using rhBMP-2 were not significantly different between the groups that received 1 mg/5 mL and 2 mg/5 mL of rhBMP-2. Therefore, it is recommended to use 1 mg of rhBMP-2 with 5 mL of DBM, taking both economic and clinical aspects into consideration.

Careful evaluation of vertebral artery injuries is important after cervical translation injuries or transverse foramen fractures. Treatment of trauma can be complicated in cases of concomitant vertebral artery injuries. A 76-year-old woman was admitted to our hospital with left hemiparesis (Motor grade 3) after a motorcycle accident. Cervical spine magnetic resonance imaging (MRI) and computed tomography (CT) revealed a C3 burst fracture and a left C3 lateral mass and lamina fracture. CT angiography revealed fracture fragments that predisposed the vertebral artery to injury throughout its course in the area. CT angiography confirmed that both vertebral arteries were occluded at the C3 fracture site. Subsequent brain MRI revealed acute infarction in the right occipital area. Although both vertebral arteries were occluded, the infarction site did not correspond to the territory supplied by these vessels; therefore, we performed transfemoral cerebral angiography, which revealed collateralization of the bilateral vertebral arteries by the deep cervical artery.. The deep cervical arteries are located between the posterior muscles; therefore, a fixation operation performed using the posterior approach may have affected the collateral circulation and led to exacerbation of the infarction site. Therefore, surgery was performed using an anterior approach and it was possible to minimize the risk of cerebral infarction through preservation of collateral circulation.

Background: The prevalence of pulmonary hypertension (PH) in myeloproliferative neoplasms (MPNs) varies among studies. We analyzed the prevalence of PH in Korean patients with Philadelphia-negative (Ph-) MPNs. Methods: Medical records of patients with Ph- MPNs [essential thrombocythemia (ET), polycythemia vera (PV), or primary myelofibrosis (PMF)] visiting a single hospital between 1993 and 2019 were reviewed retrospectively. Transthoracic echocardiographic examination (TTE) results were reviewed and PH was diagnosed according to established guidelines. Results: Of the 320 MPN (179 ET, 107 PV, and 34 PMF) patients, 225 (121 ET, 83 PV, and 21 PMF) underwent TTE. Of these 225 MPN patients, 19 of 121 (15.7%) ET, 9 of 83 (10.8%) PV, and 6 of 21 (28.6%) PMF patients had PH. PV patients with PH were older [71 (42‒85) vs. 61.5 (26‒91) yr, respectively; P =0.049], predominantly female (male:female ratio, 0.29 vs. 1.96, respectively; P =0.010), had lower hemoglobin levels (15.9±2.6 g/dL vs. 18.4±2.6 g/dL, respectively; P =0.010), and higher platelet counts (616.6±284.2×109/L vs. 437.7±191.7×109/L, respectively; P =0.020) than PV patients without PH. PMF patients with PH had higher monocyte counts (1.3±0.5×109/L vs. 0.8±0.4×109/L, respectively; P =0.031) than those without PH. PH was a risk factor for poor survival in PV (HR, 12.4; 95% CI, 1.8‒86.6). Conclusion PH is common in patients with Ph- MPNs and hence, careful screening for PH is warranted.

BACKGROUND: Recently, biplanar fluoroscopy is used to evaluate the cervical kinematics, especially to locate the instant center of rotation (ICR) during in vivo motion. This study aims to ascertain the ICR at each cervical segment in the sagittal plane during dynamic motion and assess the differences from previous studies. METHODS: While three healthy subjects were performing full flexion-extension, two oblique views aligned horizontally and angled at approximately 55° were obtained by biplanar fluoroscopy. The minimum degree to detect significant movement in a helical axis model was set at 2°, and anterior-posterior and superior-inferior locations of each ICR were defined. To evaluate the possible distribution area and overlapping area of the ICR with disc space, we drew a circle by using the calculated distance between each coordination and the mean coordination of ICR as the radius. RESULTS: During flexion-extension motion, the mean superior-inferior location of the ICR became progressively more superior, except the C5–6 segment (p = 0.015), and the mean anterior-posterior location of the ICR became progressively more anterior without exception from C2–3 to C6–7 segments, but anterior-posterior ICR locations were not significantly different among segments. The overlapping area with the distribution circle of ICR was mainly located in the posterior half in the C3–4 segment, but the overlapping area was about 80% of the total disc space in C4–5 and C6–7 segments. The overlapping was more noticeable in the lower cervical segments after exclusion of the outlier data of the C5–6 segment in subject 1. CONCLUSIONS: The ICR in the cervical spine showed a trend of moving progressively more superiorly and anteriorly and the disc space overlapping the distribution circle of ICR increased along the lower motion segments except the C5–6 segment. These findings could provide a good basis for level-specific cervical arthroplasty designs.
Arthroplasty ; Biomechanical Phenomena ; Fluoroscopy ; Healthy Volunteers ; Radius ; Spine

BACKGROUND: Malnutrition is associated with many adverse clinical outcomes. The present study aimed to identify the prevalence of malnutrition in hospitalized patients in Korea, evaluate the association between malnutrition and clinical outcomes, and ascertain the risk factors of malnutrition. METHODS: A multicenter cross-sectional study was performed with 300 patients recruited from among the patients admitted in 25 hospitals on January 6, 2014. Nutritional status was assessed by using the Subjective Global Assessment (SGA). Demographic characteristics and underlying diseases were compared according to nutritional status. Logistic regression analysis was performed to identify the risk factors of malnutrition. Clinical outcomes such as rate of admission in intensive care units, length of hospital stay, and survival rate were evaluated. RESULTS: The prevalence of malnutrition in the hospitalized patients was 22.0%. Old age (≥ 70 years), admission for medical treatment or diagnostic work-up, and underlying pulmonary or oncological disease were associated with malnutrition. Old age and admission for medical treatment or diagnostic work-up were identified to be risk factors of malnutrition in the multivariate analysis. Patients with malnutrition had longer hospital stay (SGA A = 7.63 ± 6.03 days, B = 9.02 ± 9.96 days, and C = 12.18 ± 7.24 days, P = 0.018) and lower 90-day survival rate (SGA A = 97.9%, B = 90.7%, and C = 58.3%, P < 0.001). CONCLUSION: Malnutrition was common in hospitalized patients, and resulted in longer hospitalization and associated lower survival rate. The rate of malnutrition tended to be higher when the patient was older than 70 years old or hospitalized for medical treatment or diagnostic work-up compared to elective surgery.
Cross-Sectional Studies ; Hospitalization ; Humans ; Intensive Care Units ; Korea ; Length of Stay ; Logistic Models ; Malnutrition ; Multivariate Analysis ; Nutrition Assessment ; Nutritional Status ; Prevalence ; Risk Factors ; Survival Rate

BACKGROUND: The Korean Red Cross blood laboratory centers use Treponema pallidum particle agglutination assay on the PK7300 instrument as a primary donor screening test for syphilis, and semi-quantitative TPPA and RPR card as supplementary tests. We compared the results of Treponema pallidum latex agglutination and RPR tests on the automated analyzer with those of TPPA and RPR card tests. METHODS: A total of 1,000 samples with negative TPPA results and 103 samples with positive TPPA results (> or =1:80 titers) were evaluated in this study. HiSens Auto TP, RPR (HBI, Anyang, Korea) and Mediace TPLA, RPR (Sekisui, Tokyo, Japan) reagents were used on the automated analyzer. FTA-ABS test was performed as a confirmatory test to evaluate the sensitivity and specificity of HiSens Auto TPLA, RPR and Mediace TPLA, RPR reagents. RESULTS: The concordance rate between HiSens Auto TP, Mediace TPLA and TPPA was 95.5% and 95.4%, respectively. The concordance rate between HiSens Auto RPR, Mediace RPR and RPR card was 79.6% and 80.6%, respectively. Sensitivity of HiSens Auto TP and Mediace TPLA was 87.7% and 90.8%, respectively, and specificity was 99.5% and 99.0%, respectively. CONCLUSION: Despite the high concordance rate between TPLA and TPPA, there were negative TPLA results which were positive for both TPPA and FTA-ABS tests. Therefore, changing the primary donor screening test for syphilis from current TPPA to TPLA on the automated analyzer requires further investigation.
Agglutination* ; Blood Donors* ; Donor Selection ; Fluorescent Treponemal Antibody-Absorption Test ; Gyeonggi-do ; Humans ; Indicators and Reagents ; Latex* ; Plasma* ; Red Cross ; Sensitivity and Specificity ; Syphilis ; Treponema pallidum*

PURPOSE: As a result of various independently proposed nomenclatures and classifications, there is confusion in the diagnosis and prediction of biological behavior of gastroenteropancreatic neuroendocrine tumors (GEP-NETs). A comprehensive nationwide study is needed in order to understand the biological characteristics of GEP-NETs in Korea. MATERIALS AND METHODS: We collected 4,951 pathology reports from 29 hospitals in Korea between 2000 and 2009. Kaplan-Meier survival analysis was used to determine the prognostic significance of clinicopathological parameters. RESULTS: Although the GEP-NET is a relatively rare tumor in Korea, its incidence has increased during the last decade, with the most significant increase found in the rectum. The 10-year survival rate for well-differentiated endocrine tumor was 92.89%, in contrast to 85.74% in well differentiated neuroendocrine carcinoma and 34.59% in poorly differentiated neuroendocrine carcinoma. Disease related death was most common in the biliary tract (62.2%) and very rare in the rectum (5.2%). In Kaplan-Meier survival analysis, tumor location, histological classification, extent, size, mitosis, Ki-67 labeling index, synaptophysin expression, lymphovascular invasion, perineural invasion, and lymph node metastasis showed prognostic significance (p<0.05), however, chromogranin expression did not (p=0.148). The 2000 and 2010 World Health Organization (WHO) classification proposals were useful for prediction of the prognosis of GEP-NET. CONCLUSION: The incidence of GEP-NET in Korea has shown a remarkable increase during the last decade, however, the distribution of tumors in the digestive system differs from that of western reports. Assessment of pathological parameters, including immunostaining, is crucial in understanding biological behavior of the tumor as well as predicting prognosis of patients with GEP-NET.
Biliary Tract ; Carcinoma, Neuroendocrine ; Digestive System ; Humans ; Incidence ; Intestinal Neoplasms ; Korea ; Lymph Nodes ; Mitosis ; Neoplasm Metastasis ; Neuroendocrine Tumors ; Pancreatic Neoplasms ; Population Characteristics ; Prognosis ; Rectum ; Stomach Neoplasms ; Survival Rate ; Synaptophysin ; World Health Organization

PURPOSE: Axium(TM) coils were developed to improve the durability of coil-embolized cerebral aneurysms by increasing packing density. The purpose of this prospective multicenter registry was to evaluate the safety and durability of Axium(TM) coils. MATERIALS AND METHODS: One hundred twenty-six patients with 135 aneurysms of < or = 15 mm in size underwent coil embolization using bare platinum coils, with Axium(TM) coils constituting over 50% of the total coil length. Immediate and short-term follow-up results were prospectively registered and retrospectively evaluated. RESULTS: Of the 135 aneurysms (83 unruptured and 52 ruptured), immediate post-embolization angiography revealed complete occlusion in 80 aneurysms (59.3%), neck remnants in 47 (34.8%), and incomplete occlusion in 8 (5.9%). The mean packing density was 42.8% (range, 9.5 - 90%) with Axium(TM) coil length constituting a mean of 87.9% of total coil length. The rate of procedure-related complications was 16.3%. Procedure-related permanent morbidity and mortality rates were 3.2% and 0.8%, respectively. Follow-up catheter or MR angiography, which was available in 101 aneurysms at 6 - 15 months (mean, 7.7 months), revealed stable or improved occlusion in 95 aneurysms and worsening in 6 aneurysms (5.9%). Lower packing density (< 30%) remained the only predictor for anatomical worsening on multivariable logistic regression analysis (P < 0.05). CONCLUSION: In this registry, Axium(TM) coils showed a relatively low rate of anatomical worsening on short-term follow-up imaging with an acceptable periprocedural safety profile compared to reports of other platinum coils. These results may warrant further study of long-term durability with Axium(TM) coils in larger populations.
Aneurysm ; Angiography ; Catheters ; Follow-Up Studies ; Humans ; Intracranial Aneurysm ; Logistic Models ; Neck ; Platinum ; Prospective Studies ; Retrospective Studies

Natural killer (NK) cells play an important role in innate immunity, especially in the response to viral infections, such as hepatitis C virus (HCV). Killer cell immunoglobulin-like receptors (KIRs) are the primary receptors of NK cells that mediate innate immunity. KIRs are also involved in acquired immunity, because some KIRs are expressed on the surface of certain subsets of T cells. In this study, the frequency of KIR genes, HLA-C allotypes, and combinations of KIR genes with their HLA-C ligands were evaluated in two different groups of the Korean population: controls and patients with chronic HCV infection. The study population consisted of 147 Korean patients with chronic HCV infection. The frequency of KIR2DS2 in patients with chronic HCV infection was 9.5% which was significantly lower than 19.5% of the control (P < 0.01). However, there were no significant differences in the frequency of other KIR genes, HLA-C allotypes or different combinations of KIR genes with their HLA-C ligands. This study can contribute to the further prospective study with a larger scale, suggesting the assumption that KIR2DS2 might aid in HCV clearance by enhancing both the innate and acquired immune responses of people in Korea.
Adult ; Aged ; Female ; Genes, MHC Class I ; Genotype ; HLA-C Antigens/genetics ; Hepacivirus/immunology ; Hepatitis C, Chronic/*genetics/immunology ; Humans ; Killer Cells, Natural/immunology/virology ; Male ; Middle Aged ; Receptors, KIR/*genetics/immunology ; Republic of Korea ; T-Lymphocyte Subsets/immunology