Comparison of Clinical Outcomes between the Right and Left Radial Artery Approaches from the Korean Transradial Coronary Intervention Registry.

PURPOSE: Transradial intervention (TRI) shows anatomical and technical differences between the right radial approach (RRA) and left radial approach (LRA). The aim of this study was to evaluate the efficacy and safety using LRA, compared with RRA. MATERIALS AND METHODS: A total of 1653 consecutive patients who underwent TRI from November 2004 to October 2010 were enrolled in the Korean multicenter TRI registry. The patients were divided into two groups: the RRA group (n=792 patients) and the LRA group (n=861 patients). To adjust for any potential confounders, propensity score matched (PSM) analysis was performed (C-statistic: 0.726). After PSM, a total of 1100 patients were enrolled for analysis. RESULTS: After PSM, the RRA group exhibited a larger contrast volume (259.3±119.6 mL vs. 227.0±90.7 mL, p<0.001), a longer fluoroscopic time (22.5±28.0 minutes vs. 17.1±12.6 minutes) and higher access site change (12.3% vs. 1.0%, p<0.001) than the LRA group. Meanwhile, the LRA group showed a shorter procedure time (49.2±30.4 minutes vs. 55.4±28.7 minutes, p=0.003) than the RRA group. After PSM, in-hospital complications and 12-month cumulative clinical outcomes were similar between the two groups. CONCLUSION: Of the two TRI methods, LRA was associated with better procedural efficacy, including shorter procedural time, smaller contrast volume, and less access site change than RRA. However, both methods showed similar 12-month cumulative clinical outcomes. Therefore, LRA was deemed superior to RRA in terms of procedural feasibility without a significant difference in clinical outcomes.

Effect of Tianeptine on Depressed Tinnitus Patients.

BACKGROUND AND OBJECTIVES: Tianeptine is a tricyclic antidepressant that has a novel pharmacological property: it increases the reuptake of 5-hydroxytryptamine. Recent studies have reported that the prevalence of depression is greater in patients with tinnitus than in control subjects who do not have tinnitus. The purpose of this study was to assess the efficacy of tianeptine for the relief of tinnitus, especially in patients with depressive mood. SUBJECTS AND METHODS: Among a total of 52 tinnitus patients, 15 had depressive mood. The depressed tinnitus patients were prescribed Stablon® 12.5 mg once daily for 1 month without any other drug. We assessed the severity of tinnitus, level of depression, and the quality of sleep in these patients by using the Tinnitus Handicap Inventory (THI), Beck Depression Inventory (BDI), and Pittsburgh Sleep Quality Index (PSQI). Hearing impairment and severity of tinnitus were measured with pure tone audiometry, speech audiometry, and tinnitograms. These evaluations were conducted before and after medication treatment. RESULTS: For the 15 depressed tinnitus patients, THI scores significantly correlated with BDI and PSQI scores prior to medication treatment. These results showed that the discomfort of tinnitus was closely related to depression and sleep disorder. After medication treatment, THI and BDI scores significantly decreased, indicating that tinnitus and depression improved. However, no significant alteration in PSQI score was observed, indicating that there was no improvement in sleep quality. CONCLUSIONS: In the treatment of depressed tinnitus patients, tianeptine might be an efficient drug to treat both tinnitus and depression. However, tianeptine is unlikely to improve the quality of sleep in these patients.

Increased expression of the aryl hydrocarbon receptor in allergic nasal mucosa, contributing to chemokine secretion in nasal epithelium.

BACKGROUND: Pollutants produced by industrial and traffic-related activities have been linked to allergic responses. These noxious agents induce their effects through the aryl hydrocarbon receptor (AhR). OBJECTIVE: We analyzed the expression and distribution pattern of AhR in normal and allergic nasal mucosa, and cytokine-driven regulation of its expression. The production levels of chemokine in cultured nasal epithelial cells were evaluated after stimulation with AhR ligand. METHODS: The expression levels and distribution pattern of AhR in normal, mild, and moderate-severe persistent allergic nasal mucosa were assessed by using real-time polymerase chain reaction, Western blot, and immunohistochemistry. The expression levels of AhR were determined in cultured nasal epithelial cells treated with T-helper 2 cytokines. In cultured epithelial cells stimulated with 2-(10H-indole-30-carbonyl)-thiazole-4-carboxylic acid methyl ester, the expression levels of granulocyte macrophage colony-stimulating factor, thymus and activation regulated chemokine, macrophage inflammatory protein 1 α, monocyte chemotactic protein 1, regulated on activation normal T-cell expressed and secreted, eotaxin, and interleukin 8 were measured with real-time polymerase chain reaction and enzyme-linked immunosorbent assay. RESULTS: Expression of AhR was observed in normal and allergic nasal mucosa where it is distributed in the epithelial layer, submucosal glands, endothelial cells, and inflammatory cells. Its expression levels are increased in allergic nasal mucosa and upregulated after stimulation with T-helper 2 cytokines. The stimulation with 2-(10H-indole-30-carbonyl)-thiazole-4-carboxylic acid methyl ester resulted in increased production of chemokines in cultured epithelial cells. CONCLUSION: Analysis of the study results indicated that increased expression levels of AhR may play a role in the pathogenesis of allergic rhinitis, which contributes to chemokine production in nasal mucosa.

Comparison of Learning Curves for Retroauricular and Transaxillary Endoscopic Hemithyroidectomy.

OBJECTIVE: This study aimed to evaluate and compare learning curves for the retroauricular (RA) and transaxillary (TA) approaches in endoscopic hemithyroidectomy. METHODS: The medical records of 290 patients who underwent hemithyroidectomy by either the RA or TA approach from November 2007 through December 2015 were retrospectively reviewed (113 patients with RA and 177 with TA). The two groups were compared with regard to patient characteristics, perioperative clinical results, and complications. Learning curves for the two approaches were compared based on the number of cases required to reach a consistent operation time and drainage amount. RESULTS: Age at diagnosis, tumor size and location, and thyroid size were not significantly different between the two approach groups. Multiplicity and extrathyroid extension were more prevalent in the RA approach (p = 0.048 and 0.020, respectively). Operation time and hospital day were significantly shorter in the RA approach (p < 0.001 and p = 0.030), while postoperative bleeding was less common in the TA approach (p = 0.021). Operation time and drainage amount stabilized after 50 cases for RA and 90 cases for TA. Additionally, operation time, amount of drainage, hospital stay, and complication rates significantly decreased after stabilization of the learning curve. When comparing the two approaches before stabilization, postoperative bleeding was more frequent in the RA approach (p = 0.044), while no difference was observed after stabilization. CONCLUSIONS: The RA approach seems to be beneficial for reducing operation time and hospital stay, and for stabilization of the learning curve. Postoperative bleeding should be considered during the period of early experience for the RA approach.

Increased expression of hCLCA1 in chronic rhinosinusitis and its contribution to produce MUC5AC.

OBJECTIVES/HYPOTHESIS: Mucus hypersecretion is a hallmarks of chronic rhinosinusitis. The expression of MUC5AC, a major respiratory mucin gene, is increased in chronic rhinosinusitis. The mechanisms inducing mucus hypersecretion have not been fully evaluated in chronic rhinosinusitis. Human Ca2+ -activated Cl- channel 1 (hCLCA1) is implicated in the regulation of mucus production, airway fluid, and electrolyte transport. The present study objectives was to investigate the expression of hCLCA1 in chronic rhinosinusitis and evaluate whether its level is altered by stimulation with type 1 T helper (Th1) and Th2 cytokines, and to determine the possible role of hCLCA1 on the regulation of mucin 5AC (MUC5AC) production. STUDY DESIGN: Controlled prospective study. METHODS: The expression of hCLCA1 and MUC5AC in normal and inflammatory ethmoid mucosa was determined by real-time polymerase chain reaction, immunohistochemistry, and Western blot. In cultured cells, the expression of hCLCA1 and MUC5AC was measured after stimulation with Th1 and Th2 cytokines. In a supernatant, the MUC5AC level was analyzed using enzyme-linked immunosorbent assay after treatment with niflumic acid. RESULTS: The levels of hCLCA1 and MUC5AC were increased in chronic rhinosinusitis, irrespective of nasal polyp presence, where they were distributed in superficial epithelial cells and submucosal glands. In cultured cells treated with interleukin (IL)-9, IL-4, IL-13, tumor necrosis factor-α, transforming growth factor-ß, interferon-γ, and IL-1ß, the expression of hCLCA1 and MUC5AC was increased. In cells treated with niflumic acid, the production of MUC5AC was inhibited. CONCLUSIONS: The current findings indicate that the expression of hCLCA1 is increased in chronic rhinosinusitis and may be regulated by Th1 and Th2 cytokines, possibly contributing to the production of MUC5AC. LEVEL OF EVIDENCE: NA Laryngoscope, 126:E347-E355, 2016.

Nanoparticle-based indicator-displacement assay for pyrophosphate.

Silica nanoparticles functionalized with a Zn(II) -dipicolylamine derivative are used as the receptor component of a sensing ensemble for an indicator-displacement assay. The nano-ensemble system, constructed with pyrocatechol violet as an indicator, selectively senses pyrophosphate over other anions including hydrogen phosphate, thus showing a visible blue-to-yellow color change and the corresponding absorption spectral changes in a buffer solution of pH 7. A distinct recognition behavior--the nano-ensemble does not sense hydrogen phosphate that was sensed by the traditional ensemble with the same molecular receptor--is explained by an incomplete-displacement model in the case of the integrated receptor system. The present work demonstrates that the nanoparticle-based competition assay is as effective as the traditional approach with molecular receptors. Furthermore, such an integrated receptor system can provide distinct recognition behavior from its molecular receptor.

Zinc(II)-dipicolylamine-functionalized polydiacetylene-liposome microarray: a selective and sensitive sensing platform for pyrophosphate ions.

A microarray-chip assay system for the fluorescence detection of phosphate-containing analytes in aqueous media has been constructed from stimuli-responsive polymerized poly(diacetylene)-liposomes for the first time. Proper combination of the liposome components (Zn(II)-dipicolylamine for phosphate binding and an amine-terminated component for anchoring the liposome onto an aldehyde-derivatized glass plate), has led to a microarray chip that selectively detects pyrophosphate, an important biomarker, over competing anions, such as phosphate and adenosine triphosphate, with nanomolar sensitivity. The chip-based assay shows advantages, such as high specificity and sensitivity, over solution-based assays that use the same liposomes, and over known homogeneous molecular sensing systems.

Selective colorimetric sensing of geometrical isomers of dicarboxylates in water by using functionalized gold nanoparticles.

A colorimetric sensing system based on gold nanoparticles functionalized with a water-soluble anion-recognition motif, an o-(carboxamido)trifluoroacetophenone analogue, has been developed. The nanoparticle system selectively senses specific isomers of dicarboxylates that are geometrically favorable for the binding-induced aggregation process; thus, it discriminates a trans-dicarboxylate fumarate from its cis-isomer maleate, and benzene-1,4-dicarboxylate from its isomeric benzene-1,2-and benzene-1,3-dicarboxylates in water, exhibiting a color change from red to blue.

Fluorescent sensing of IP3 with a Trifurcate Zn(II)-containing chemosensing ensemble system.

A trifurcate receptor containing Zn(II)-dipicolylamine ligands is developed for the fluorescent sensing of IP 3, myo-inositol 1,4,5-tris(phosphate), through an indicator displacement approach. The chemosensing ensemble containing the Zn(II) complex and eosin Y as indicator shows the maximum fluorescence restoration for IP 3 among various other anions including phosphate derivatives in water buffered at pH = 7.

Inhibition of alpha-chymotrypsin with thiol-bearing substrate analogues in the presence of zinc ion.

We have demonstrated that thiol-bearing analogues of alpha-chymotrysin (alpha-CT) substrates such as (S)-(1-benzyl-2-thiolethyl)-carbamic acid, benzyl ester (3) inhibits alpha-CT, a prototypical serine protease, in the presence of Zn(II) ion. They constitute a novel class of small molecule inhibitors for alpha-CT believed to inhibit the enzyme by forming a ternary complex consisting of alpha-CT, Zn(II) ion, and the inhibitor.