https://ir.ymlib.yonsei.ac.kr/handle/22282913/168850 Tue, 12 May 2026 22:29:45 GMT 2026-05-12T22:29:45Z https://ir.ymlib.yonsei.ac.kr/handle/22282913/211936 Title: Germinal centers are associated with poor prognosis in patients with thymoma-associated myasthenia gravis Authors: Chung, Hye Yoon; Shin, Ha Young; Park, Hyung Jun; Kim, Gi Jeong; Kim, Seung Woo Abstract: Background: Germinal centers (GCs) can be observed in the thymic tissues of individuals with thymomaassociated myasthenia gravis (TAMG). This study aimed to investigate the association between the presence of GCs in the thymus and the clinical outcomes of patients with TAMG following thymoma resection. Methods: A retrospective review was conducted on patients diagnosed with TAMG who underwent surgical removal of the thymoma. Upon reviewing thymic tissue slides to determine the presence of GCs, patients were divided into GC-positive and GC-negative groups. The association between the presence of GCs and the achievement of minimal manifestation (MM) or pharmacological remission (PR) was analyzed after adjusting for clinical characteristics. Results: Of the 111 patients, 41 (36.9%) with thymic follicular hyperplasia were classified into the GC-positive group, and the remaining patients were classified into the GC-negative group. Initial analyses including the entire patient cohort did not demonstrate a significant association between GC and achieving MM or PR postthymectomy. However, a refined analysis that excluded patients treated with prednisolone before thymectomy revealed a significantly lower cumulative incidence of MM in the GC-positive group (p = 0.011). The presence of GCs was negatively associated with achieving MM, even after adjusting for confounding variables (hazard ratio = 0.479, 95% confidence interval = 0.237-0.968, p = 0.040). Conclusion: Ectopic GCs in the thymus may serve as a prognostic factor for poor outcomes in patients with TAMG. Further research is needed to elucidate the role of GCs in the pathogenesis of TAMG and predict clinical outcomes following treatment. Sat, 01 Aug 2026 00:00:00 GMT https://ir.ymlib.yonsei.ac.kr/handle/22282913/211936 2026-08-01T00:00:00Z https://ir.ymlib.yonsei.ac.kr/handle/22282913/211443 Title: Interplay of age-sensitive cortical vulnerability and dopaminergic degeneration in clinical manifestations of Parkinson's disease Authors: Kang, Sungwoo; Na, Han Kyu; Yoon, So Hoon; Kim, Han-Kyeol; Ryu, Young Hoon; Lee, Hye Sun; Yoo, Han Soo; Lyoo, Chul Hyoung; 유한수 Abstract: To identify the pattern of cortical atrophy variation in Parkinson's disease (PD) and its contribution to clinical manifestations beyond dopaminergic dysfunction, 45 healthy controls (HCs) underwent MRI, and 222 participants with PD additionally underwent dopamine transporter (DAT)-PET, Unified PD Rating Scale (UPDRS), and neuropsychological tests. Using principal component analysis in PD, a single pattern in cortical thickness (PC1PD) was identified. Linear regressions models were applied to investigate the effects of PC1PD and putaminal DAT (DAT-P) on parkinsonism, and PC1PD and caudate DAT (DAT-C) on cognition. PC1PD accounted for more than 80% of total cortical variance and showed a strong negative correlation with age. The spatial pattern of PC1PD was similar to that of PC1 derived from HCs, but its age-related association was more pronounced in PD. Independent of DAT-P, lower PC1PD was associated with higher UPDRS motor score and showed a synergistic significant interaction with DAT-P on the axial subscore. Independent of DAT-C, lower PC1PD was associated with worse performance in global cognition, language, and executive functions, with synergistic interaction with DATC on global cognition and executive function. The associations of PC1PD with UPDRS motor scores, general cognition, and executive function were stronger in older participants, indicating that aging amplifies the clinical effect of PC1PD. PC1PD represents an age-sensitive cortical vulnerability axis whose expression is amplified in PD, and its interplay with dopaminergic depletion and aging contributes to axial motor symptoms and executive dysfunction in PD. Wed, 01 Jul 2026 00:00:00 GMT https://ir.ymlib.yonsei.ac.kr/handle/22282913/211443 2026-07-01T00:00:00Z https://ir.ymlib.yonsei.ac.kr/handle/22282913/211939 Title: Design and rationale of the clinical trial to obtain the highest efficacy of dual antiplatelet therapy after carotid artery stenting in high bleeding risk patients (CHET): A multicenter, randomized, open-label, superiority trial Authors: Kim, Hyung Jun; Song, Tae-Jin; Park, Moo-Seok; Baek, Jang-Hyun; Kim, Yong-Won; Eun, Mi-Yeon; Woo, Ho Geol; Jeong, Darda; Park, Hyungjong; Jung, Jin-Man; Kim, Jun Yup; Kim, Bum Joon; Kim, Young-Dae; Park, Hee-Kwon; Choi, Kang-Ho; Kim, Joong-Goo; Cho, Han-Jin; An, Sang Joon; Lee, Seok-Yoon; Lee, Seung-Jae; Lee, Seong-Joon; Lee, Jun; Yoo, Joonsang; Shin, Dong-Woo; Kang, Hyun Goo; Seo, Jung-Hwa; Bang, Oh Young; Seo, Woo-Keun Abstract: Rationale Abbreviated dual antiplatelet therapy (DAPT) strategies effective in percutaneous coronary intervention among patients with high bleeding risk (HBR) may not be applicable to carotid artery stenting (CAS) owing to anatomical and procedural differences. Primary Hypothesis Among patients with HBR undergoing CAS, abbreviated DAPT followed by SAPT will reduce clinically significant bleeding compared to prolonged DAPT, while maintaining noninferiority in net clinical outcomes, including ischemic and major bleeding events. Design CHET trial is a multicenter, randomized, open-label, superiority trial in HBR patients undergoing CAS. Assuming a 38% relative reduction in bleeding (10.4%-6.45%), 1,524 participants (762 per group) provide 80% power with a twosided alpha of 0.05; the final target is 1,556 (778 per group), allowing 2% dropout. Key HBR criteria include age >= 75 years, ischemic stroke within 6 months, renal insufficiency, anemia, and thrombocytopenia. All patients will receive aspirin and clopidogrel for 30 days after CAS (enrichment period). Event-free patients on day 30 were randomized 1:1 to receive SAPT (aspirin 100 mg daily or clopidogrel 75 mg daily, at the treating physician's discretion) or continued DAPT for 11 months. The primary safety endpoint is clinically significant bleeding (BARC 2, 3, or 5) from day 30 to 12 months post-CAS. The secondary efficacy endpoint is a composite of nonfatal stroke, nonfatal myocardial infarction, cardiovascular death, and major bleeding (BARC 3 or 5). Enrollment Dates and Current Status CHET began enrollment on July 15, 2024. As of February 5, 2026, the trial is currently enrolling, with 328 participants enrolled. Enrollment is expected to be completed by November 2029, and follow-up by December 2030. Conclusions CHET trial is the first randomized controlled trial to define optimal DAPT duration in HBR patients after CAS. Trial Registration www.clinicaltrials.gov (NCT06276374). (Am HeartJ 2026;297:107418.) Wed, 01 Jul 2026 00:00:00 GMT https://ir.ymlib.yonsei.ac.kr/handle/22282913/211939 2026-07-01T00:00:00Z https://ir.ymlib.yonsei.ac.kr/handle/22282913/211944 Title: Exposure to topiramate may not increase the risk of urolithiasis: A nationwide cohort study Authors: Chang, Kimoon; Ha, Woo-Seok Abstract: Background and purpose: Although topiramate is mechanistically linked to an increased risk of urolithiasis, real-world evidence remains conflicting. This study aimed to evaluate the risk of a first-time episode of urolithiasis associated with topiramate exposure in the Korean population. Methods: Using the Korean National Health Insurance Service-National Sample Cohort, we identified participants from the 2015 national health screening. After excluding individuals with a prior diagnosis of urolithiasis, we performed 1:4 propensity score matching between patients with and without topiramate exposure. Matching variables included age, sex, body mass index, comorbidities, and a history of gout. Participants were followed longitudinally, and the risk of urolithiasis was assessed using Kaplan-Meier analysis and Cox proportional hazards regression. Results: The final cohort included 1,560 patients exposed to topiramate and 6,240 matched controls who were followed for five years. During the follow-up period, urolithiasis was diagnosed in 47 patients (3.0%) in the topiramate group and 170 patients (2.7%) in the control group. The risk of developing urolithiasis was not significantly different between the two groups (p = 0.545). Furthermore, subgroup analyses stratified by current use or the cumulative duration of topiramate exposure also showed no significant associations. Conclusions: In this large, nationwide cohort, topiramate exposure was not associated with an increased risk of urolithiasis. Our findings suggest that in a real-world setting, the risk may not be as significant as suggested by its pharmacological mechanism. Mon, 01 Jun 2026 00:00:00 GMT https://ir.ymlib.yonsei.ac.kr/handle/22282913/211944 2026-06-01T00:00:00Z