Background: Poor outcomes after acute ischemic stroke (AIS) revascularization are anticipated in patients with dementia due to advanced age, comorbidities, and reduced disease awareness. This study investigated clinical characteristics and short-term outcomes of AIS revascularization in patients undergoing dementia treatment. Methods: We retrospectively reviewed patients who underwent AIS revascularization therapy at eight centers of the Catholic University of Korea. Patients receiving anti-dementia medication for cognitive impairment before stroke onset were analyzed. Clinical characteristics and outcomes, including the modified Rankin Scale (mRS) score, hemorrhagic transformation, and mortality, were collected. Results: Among 1,379 patients who received AIS revascularization over 5 years, 13 (0.94%; mean age 83 years; 8 females) had a preexisting diagnosis of dementia (Alzheimer’s disease in 11, mild cognitive impairment in 2) and were on anti-dementia medication. Two patients underwent intravenous thrombolysis combined with endovascular therapy, whereas 11 underwent endovascular therapy alone. Most patients (11/13, 84.6%) presented with an unclear onset time. Stroke lesions were located in the right middle cerebral artery (MCA) in seven cases, left MCA in three, bilateral MCAs in one, and posterior circulation in two. Hemorrhagic transformation occurred in six patients (46%), of whom three (23%) were symptomatic. The mRS scores at discharge were 6 in two patients, 5 in one patient, 4 in nine patients, and 3 in one patient. Four patients died within 3 months of stroke onset. Conclusion The proportion of patients with cognitive impairment receiving anti-dementia medication among those undergoing stroke revascularization therapy was very small. The rates of hemorrhagic transformation and mortality were high. None of the patients achieved favorable outcomes at discharge.

Background: Lung cancer has a high incidence and mortality worldwide, and smoking, age, sex, and body mass index are known risk factors. Using a health examination cohort, we constructed a comprehensive lung cancer risk-prediction model. Methods: This study comprised 308,804 adults aged 20 years and older who underwent health examinations at one general hospital in Korea, from 2011 to 2018. We developed a lung cancer risk prediction model using a multivariate Cox proportional hazards regression analysis for lung cancer risk factors and estimated the hazard ratios and coefficients. The model evaluation included discrimination and calibration assessments. Results: Among the 308,804 adults in the study cohort, there were 338 (0.11%) patients lung cancer, with 215 males (0.07% of 169,420 males) and 123 females (0.04% of 139,384 females). The prevalence of lung cancer was higher in males and females aged over 60 years. Age, sex, body mass index, and smoking behavior were identified as risk factors for lung cancer prevalence in this model through multivariate Cox proportional hazards analysis. The C-statistic of the development cohort was 0.785 (0.749, 0.821) and that of the validation cohort was 0.823 (0.769, 0.878). Conclusion Our lung cancer risk prediction model showed statistical significance, similar to previous prediction models, among variables that included young age, female sex, and body mass index. Future improvements should focus on population-wide applicability and associated health examination policies.

Background: Lung cancer has a high incidence and mortality worldwide, and smoking, age, sex, and body mass index are known risk factors. Using a health examination cohort, we constructed a comprehensive lung cancer risk-prediction model. Methods: This study comprised 308,804 adults aged 20 years and older who underwent health examinations at one general hospital in Korea, from 2011 to 2018. We developed a lung cancer risk prediction model using a multivariate Cox proportional hazards regression analysis for lung cancer risk factors and estimated the hazard ratios and coefficients. The model evaluation included discrimination and calibration assessments. Results: Among the 308,804 adults in the study cohort, there were 338 (0.11%) patients lung cancer, with 215 males (0.07% of 169,420 males) and 123 females (0.04% of 139,384 females). The prevalence of lung cancer was higher in males and females aged over 60 years. Age, sex, body mass index, and smoking behavior were identified as risk factors for lung cancer prevalence in this model through multivariate Cox proportional hazards analysis. The C-statistic of the development cohort was 0.785 (0.749, 0.821) and that of the validation cohort was 0.823 (0.769, 0.878). Conclusion Our lung cancer risk prediction model showed statistical significance, similar to previous prediction models, among variables that included young age, female sex, and body mass index. Future improvements should focus on population-wide applicability and associated health examination policies.

Background: Lung cancer has a high incidence and mortality worldwide, and smoking, age, sex, and body mass index are known risk factors. Using a health examination cohort, we constructed a comprehensive lung cancer risk-prediction model. Methods: This study comprised 308,804 adults aged 20 years and older who underwent health examinations at one general hospital in Korea, from 2011 to 2018. We developed a lung cancer risk prediction model using a multivariate Cox proportional hazards regression analysis for lung cancer risk factors and estimated the hazard ratios and coefficients. The model evaluation included discrimination and calibration assessments. Results: Among the 308,804 adults in the study cohort, there were 338 (0.11%) patients lung cancer, with 215 males (0.07% of 169,420 males) and 123 females (0.04% of 139,384 females). The prevalence of lung cancer was higher in males and females aged over 60 years. Age, sex, body mass index, and smoking behavior were identified as risk factors for lung cancer prevalence in this model through multivariate Cox proportional hazards analysis. The C-statistic of the development cohort was 0.785 (0.749, 0.821) and that of the validation cohort was 0.823 (0.769, 0.878). Conclusion Our lung cancer risk prediction model showed statistical significance, similar to previous prediction models, among variables that included young age, female sex, and body mass index. Future improvements should focus on population-wide applicability and associated health examination policies.

Background: Lung cancer has a high incidence and mortality worldwide, and smoking, age, sex, and body mass index are known risk factors. Using a health examination cohort, we constructed a comprehensive lung cancer risk-prediction model. Methods: This study comprised 308,804 adults aged 20 years and older who underwent health examinations at one general hospital in Korea, from 2011 to 2018. We developed a lung cancer risk prediction model using a multivariate Cox proportional hazards regression analysis for lung cancer risk factors and estimated the hazard ratios and coefficients. The model evaluation included discrimination and calibration assessments. Results: Among the 308,804 adults in the study cohort, there were 338 (0.11%) patients lung cancer, with 215 males (0.07% of 169,420 males) and 123 females (0.04% of 139,384 females). The prevalence of lung cancer was higher in males and females aged over 60 years. Age, sex, body mass index, and smoking behavior were identified as risk factors for lung cancer prevalence in this model through multivariate Cox proportional hazards analysis. The C-statistic of the development cohort was 0.785 (0.749, 0.821) and that of the validation cohort was 0.823 (0.769, 0.878). Conclusion Our lung cancer risk prediction model showed statistical significance, similar to previous prediction models, among variables that included young age, female sex, and body mass index. Future improvements should focus on population-wide applicability and associated health examination policies.

BACKGROUND: A subanalysis study of the ENGAGE AF-TIMI 48 trial showed that cardiac troponin I, N-terminal proB-type natriuretic peptide, and D-dimer, were powerful predictors of cerebrovascular adverse events. We aimed to evaluate D-dimer and cardiac troponin I levels during the acute period of ischemic stroke in anticoagulation-naïve patients with non-valvular atrial fibrillation (NVAF) and also studied the association between these biomarkers and stroke severity. METHODS: Consecutive anticoagulation-naïve patients with acute ischemic stroke due to NVAF were enrolled within two days after each stroke event, and all patients were stratified into either moderate-to-severe or mild neurologic deficit groups using the National Institutes of Health Stroke Scale (NIHSS) at admission. RESULTS: A total of 98 patients were enrolled in this study. The median value for the D-dimer was above the upper limit of the normal reference range, but the troponin I value was within the normal range for all patients. After adjusting for CHA2DS2-VASc risk factors, the log-transformed values for D-dimer were positively correlated with an increasing NIHSS score (r=0.233; P=0.051). In the multivariate logistic analysis, the log-transformed D-dimer was positively associated with more severe strokes (odds ratio, 30.1; 95% confidence interval [CI], 1.9–486.2 and 29.7; 95% CI, 2.0–430.8 in the upper two quartiles respectively). The log-transformed values for troponin I did not correlate with the NIHSS score. CONCLUSION: D-dimer levels were higher and an independent risk factor for severe stroke in anticoagulation-naïve patients with NVAF related stroke. In contrast, troponin I levels were normal and were not associated with stroke severity.
Atrial Fibrillation ; Biomarkers ; Humans ; National Institutes of Health (U.S.) ; Neurologic Manifestations ; Reference Values ; Risk Factors ; Stroke ; Troponin I

OBJECTIVE: This study was conducted to investigate satisfaction surveys of the emergency medical system in Korea administered to both members of the Korean Society of Emergency Medicine and patients and their guardians. METHODS: The joint survey was conducted by the Korea Scientist Journalists Association and the Public Affairs Committee of the Korean Society of Emergency Medicine. Questionnaires administered to each group included questions about the general environment, safety, and overcrowding. Satisfaction of medical staffs and awareness of cardiopulmonary resuscitation were only included in the patient questionnaire, while public health was only surveyed in the member questionnaire. The satisfaction was evaluated on a 5-point scale. RESULTS: Patient questionnaires were answered by 20 of 413 national emergency medical centers, and about 4.3% of the medical institutions participated in the questionnaire. A total of 704 reply sheets were returned by patients. Member questionnaires were answered by 280 of the 1,108 members (25%). Among patients, the lowest satisfaction was the item of “medical expenses,” followed by “waiting time”. Among providers, the lowest satisfaction was “appropriateness of medical staff”, while the highest complaint was “overcrowding.” CONCLUSION: Emergency care users had the lowest satisfaction with “medical expenses,” while members had the lowest satisfaction with “lack of manpower” and were most dissatisfied with “violence” and “overcrowding.”
Cardiopulmonary Resuscitation ; Emergencies* ; Emergency Medical Services ; Emergency Medicine* ; Health Care Surveys ; Humans ; Job Satisfaction ; Joints* ; Korea* ; Medical Staff ; Patient Satisfaction ; Public Health

Sumoylation, the conjugation of a small ubiquitin-like modifier (SUMO) protein to a target, has diverse cellular effects. However, the functional roles of the SUMO modification during myogenesis have not been fully elucidated. Here, we report that basal sumoylation of histone deacetylase 1 (HDAC1) enhances the deacetylation of MyoD in undifferentiated myoblasts, whereas further sumoylation of HDAC1 contributes to switching its binding partners from MyoD to Rb to induce myocyte differentiation. Differentiation in C2C12 skeletal myoblasts induced new immunoblot bands above HDAC1 that were gradually enhanced during differentiation. Using SUMO inhibitors and sumoylation assays, we showed that the upper band was caused by sumoylation of HDAC1 during differentiation. Basal deacetylase activity was not altered in the SUMO modification-resistant mutant HDAC1 K444/476R (HDAC1 2R). Either differentiation or transfection of SUMO1 increased HDAC1 activity that was attenuated in HDAC1 2R. Furthermore, HDAC1 2R failed to deacetylate MyoD. Binding of HDAC1 to MyoD was attenuated by K444/476R. Binding of HDAC1 to MyoD was gradually reduced after 2 days of differentiation. Transfection of SUMO1 induced dissociation of HDAC1 from MyoD but potentiated its binding to Rb. SUMO1 transfection further attenuated HDAC1-induced inhibition of muscle creatine kinase luciferase activity that was reversed in HDAC1 2R. HDAC1 2R failed to inhibit myogenesis and muscle gene expression. In conclusion, HDAC1 sumoylation plays a dual role in MyoD signaling: enhancement of HDAC1 deacetylation of MyoD in the basally sumoylated state of undifferentiated myoblasts and dissociation of HDAC1 from MyoD during myogenesis.
Creatine Kinase, MM Form ; Gene Expression ; Histone Deacetylase 1 ; Histone Deacetylases ; Histones ; Luciferases ; Muscle Cells ; Muscle Development ; Myoblasts ; Myoblasts, Skeletal ; Sumoylation ; Transfection

Eczematous lesions of atopic dermatitis (AD) patients are known to be a source of Staphylococcus aureus (SA) transmission and might be a reservoir for community-associated methicillin-resistant SA (MRSA). The BD Max StaphSR (BD-SR) is a fully automated, multiplex real-time PCR assay for the direct detection and differentiation of SA and MRSA from nasal swab samples. We evaluated the detection rates of SA and MRSA from skin lesions of outpatients with AD using the BD-SR assay, and determined the usefulness of the BD-SR assay. A total of 244 skin swab samples (skin lesions of 213 outpatients with AD and normal skin of 31 healthy controls) were tested directly by using the BD-SR assay. Of the 213 samples from patients with AD, 69 (32.4%) were positive for SA, 6 (8.7%) of which were positive for MRSA. Only 1 (3.2%) of 31 samples from healthy controls was positive for SA. The BD-SR assay is effective for the rapid detection of SA and MRSA from skin swab samples, which can provide important information for managing patients with AD and preventing the spread of MRSA.
Dermatitis, Atopic* ; Humans ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus ; Outpatients ; Real-Time Polymerase Chain Reaction ; Skin ; Staphylococcus aureus* ; Staphylococcus*