Publications by authors named "De-Hyung Lee"

Background: Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system affecting approximately 2.8 million people worldwide. In addition to genetic and environmental factors, various lifestyle factors contribute to disease development and progression.

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  • The study investigates the impact of fingolimod treatment on heart rate (HR) and cardiovascular autonomic modulation in patients with relapsing-remitting multiple sclerosis (RRMS), particularly focusing on those who initially experienced prolonged HR slowing.
  • It involves monitoring 34 patients before and after fingolimod initiation, measuring various cardiovascular parameters to assess changes in autonomic function.
  • Findings indicate that while all patients experienced HR decreases after treatment, those with initial prolonged HR slowing showed persistent differences in HR and autonomic modulation six months later compared to those without this phenomenon.
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Background: Recent studies provide increasing evidence for a relevant role of lifestyle factors including diet in the pathogenesis of neuroinflammatory diseases such as multiple sclerosis (MS). While the intake of saturated fatty acids and elevated salt worsen the disease outcome in the experimental model of MS by enhanced inflammatory but diminished regulatory immunological processes, sugars as additional prominent components in our daily diet have only scarcely been investigated so far. Apart from glucose and fructose, galactose is a common sugar in the so-called Western diet.

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  • Atrophy of both white and grey matter in the brains of people with multiple sclerosis (pwMS) occurs early and has significant clinical implications, which can be measured using MRI scans and automated software tools like "md brain."
  • This study looked at brain volumes from routine MRI scans of 53 pwMS, comparing those with higher disability scores (EDSS ≥ 3.5) and longer disease duration (≥ 10 years) to those with lower scores and shorter disease duration, as well as considering the impact of immunotherapy.
  • Results indicated that pwMS with higher EDSS scores and longer disease duration had notably smaller total brain and regional grey matter volumes, particularly in various lobes, and that those not receiving immunotherapy
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Background: Borna disease virus 1 (BoDV-1) causes rare but severe zoonotic infections in humans, presenting as encephalitis. The case-fatality risk is very high and no effective countermeasures have been established so far. An immunopathology is presumed, while data on immune responses in humans are limited.

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  • Myasthenic crisis (MC) is a serious problem for people with myasthenia gravis (MG) that sometimes needs machines to help them breathe.
  • Researchers looked at many patients (a total of 138 episodes) in Germany to see how often they had trouble getting off the breathing machine and what made it harder for them.
  • They found that older age, having multiple health problems, and other complications made it harder to breathe on their own, and they saw that some treatments worked better than others in helping patients recover.
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Background: The development of permanent disability in multiple sclerosis (MS) is highly variable among patients, and the exact mechanisms that contribute to this disability remain unknown.

Methods: Following the idea that the brain has intrinsic network organization, we investigated changes of functional networks in MS patients to identify possible links between network reorganization and remission from clinical episodes in MS. Eighteen relapsing-remitting MS patients (RRMS) in their first clinical manifestation underwent resting-state functional MRI and again during remission.

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  • Patients with myasthenia gravis (MG) may experience more severe outcomes from COVID-19, and this study looked at how their immunosuppressive therapy (IST) affects both the risk of infection and the severity of the disease.
  • Analysis of data from the German myasthenia gravis registry revealed that out of 1379 patients, 95 contracted COVID-19, with a significant portion (76%) already on IST.
  • The results indicated that while IST did not increase the risk of contracting COVID-19, it was linked to a higher likelihood of hospitalization or death among those infected, highlighting the need for prevention strategies in this vulnerable population.*
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Myasthenic crisis (MC) is a life-threatening condition for patients with myasthenia gravis (MG). Seronegative patients represent around 10-15% of MG, but data on outcome of seronegative MCs are lacking. We performed a subgroup analysis of patients who presented with MC with either acetylcholine-receptor-antibody-positive MG (AChR-MG) or seronegative MG between 2006 and 2015 in a retrospective German multicenter study.

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Thymomas and thymic carcinomas (TC) are malignant thymic epithelial tumors (TETs) with poor outcome, if non-resectable. Metabolic signatures of TETs have not yet been studied and may offer new therapeutic options. Metabolic profiles of snap-frozen thymomas (WHO types A, AB, B1, B2, B3, = 12) and TCs ( = 3) were determined by high resolution magic angle spinning 1H nuclear magnetic resonance (HRMAS 1H-NMR) spectroscopy.

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  • Novel MRI techniques can measure tissue sodium noninvasively, highlighting the skin as a significant sodium storage area linked to health and diseases like multiple sclerosis (MS).
  • Increased sodium levels in the skin are correlated with proinflammatory immune responses, making it a potential target for MS-related research.
  • Studies using advanced sodium MRI revealed higher sodium content in the skin of mouse models and male RRMS patients, suggesting that skin sodium levels may predict future disease activity in MS patients.
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High-fat diets (HFD) are linked to obesity and associated comorbidities and induce pathogenic T helper (Th) 17 cells while decreasing regulatory T cells (Treg). This pro-inflammatory environment also aggravates immunopathology in experimental autoimmune encephalomyelitis (EAE) as a prototype model of T cell mediated autoimmunity. The strong association of HFD to obesity as well as the increasing risk of autoimmunity in the Western world stresses the importance to identify compounds that counteract this metabolically induced pro-inflammatory state in humans.

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Myasthenic crisis (MC) is a life-threatening condition for patients with myasthenia gravis (MG). Muscle-specific kinase-antibodies (MuSK-ABs) are detected in ~ 6% of MG, but data on outcome of MuSK-MCs are still lacking. We made a subgroup analysis of patients who presented with MC with either acetylcholine-receptor-antibody positive MG (AchR-MG) or MuSK-MG between 2006 and 2015 in a retrospective German multicenter study.

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Thymomas exhibit a unique genomic landscape, comprising the lowest on average total mutational burden among adult human cancers; a unique point mutation in the GTF2I gene in WHO type A and AB thymomas (and rarely others); almost unique KMT2A-MAML2 translocations in rare WHO type B2 and B3 thymomas; a unique YAP1-MAML2 translocation in almost all metaplastic thymomas; and unique miRNA profiles in relation to GTF2I mutational status and WHO histotypes. While most thymomas can be diagnosed solely on the basis of morphological features, mutational analyses can solve challenging differential diagnostic problems. No molecular biomarkers have been identified that predict the response of unresectable thymomas to chemotherapy or agents with known molecular targets.

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  • In 2017, eculizumab was approved to treat generalised myasthenia gravis (TRgMG), but the definition of treatment-refractory status is still unclear and needs clarification.* -
  • A structured consensus process involving 12 experts aimed to create a simple scoring system to operationalize TRgMG status for better clinical decision making.* -
  • The scoring system uses 13 specific criteria related to disease severity and treatment inefficacy, and it helps clarify eculizumab's use while establishing new criteria for future clinical studies.*
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Background And Purpose: Initial cardiovascular fingolimod effects might compromise baroreflex responses to rapid blood pressure (BP) changes during common Valsalva-like maneuvers. This study evaluated cardiovascular responses to Valsalva maneuver (VM)-induced baroreceptor unloading and loading upon fingolimod initiation.

Patients And Methods: Twenty-one patients with relapsing-remitting multiple sclerosis performed VMs before and 0.

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Background: Myasthenic crisis (MC) requiring mechanical ventilation (MV) is a rare and serious complication of myasthenia gravis. Here we analyzed the frequency of performed tracheostomies, risk factors correlating with a tracheostomy, as well as the impact of an early tracheostomy on ventilation time and ICU length of stay (LOS) in MC.

Methods: Retrospective chart review on patients treated for MC in 12 German neurological departments between 2006 and 2015 to assess demographic/diagnostic data, rates and timing of tracheostomy and outcome.

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Intravenous immunoglobulins (IVIg) represent an established cornerstone for the immunotherapy of chronic inflammatory demyelinating polyneuropathy (CIDP). Efficacy of IVIg for CIDP was proven in a large phase III trial. Yet, data on longer-term efficacy and effects in distinct subgroups are scarce.

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Background: Pivotal trials showed good clinical efficiency of the monoclonal antibody ocrelizumab while being well tolerated and manageable in multiple sclerosis (MS). However, data on adverse events in everyday practice are scarce. Hence, our study aims at investigating short-term tolerability of ocrelizumab in a "real-world" setting.

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Lumbar puncture (LP) is commonly used in the diagnostic workup of neurological patients, often to exclude inflammatory diseases of the central nervous system. In clinical practice, an increase of white blood cell count (WBC) in the cerebrospinal fluid (CSF) after a LP is often assumed as reactive to the first puncture. Scientific evidence of this hypothesis, however, is lacking.

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During neuroinflammation, the shaker type potassium channel Kv1.4 is re-expressed in oligodendrocytes (Ol), but not immune cells. Here, we analyze the role of endogenous Kv1.

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Background: Gait deficits are common in multiple sclerosis (MS) and contribute to disability but may not be easily detected in the early stages of the disease.

Objectives: We investigated whether sensor-based gait analysis is able to detect gait impairments in patients with MS (PwMS).

Methods: A foot-worn sensor-based gait analysis system was used in 102 PwMS and 22 healthy controls (HC) that were asked to perform the 25-foot walking test (25FWT) two times in a self-selected speed (25FWT_pref), followed by two times in a speed as fast as possible (25FWT_fast).

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Aims: Besides spinal lesions, urinary incontinence may be attributed to particular cerebral lesion sites in multiple sclerosis (MS) patients. We intended to determine the contribution of suprapontine lesions to urinary incontinence in MS using a voxel-wise lesion analysis.

Methods: In this retrospective study, we sought MS patients with documented urinary incontinence in a local database.

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Cardiovascular autonomic dysfunction is common in multiple sclerosis (MS) and contributes significantly to disability. We hypothesized that cerebral MS-lesions in specific areas of the central autonomic network might account for imbalance of the sympathetic and parasympathetic cardiovascular modulation. Therefore, we used voxel-based lesion symptom mapping (VLSM) to determine associations between cardiovascular autonomic dysfunction and cerebral MS-related lesion sites.

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Article Synopsis
  • * Researchers analyzed data from 51 multiple sclerosis patients reporting bowel incontinence and identified significant lesion sites in the left supramarginal gyrus and right parahippocampal gyrus/amygdala.
  • * Findings suggest that the left hemisphere is crucial for sensory integration related to bowel control, while the right hemisphere is linked to the autonomic response involved in defecation, highlighting a need for further studies to assess bowel incontinence more effectively.
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