Moon S, et al. Yonsei Med J. 2021 Nov;62(11):969-980. https://doi.org/10.3349/ymj.2021.62.11.969

An JH, et al. Ann Dermatol. 2021 Dec;33(6):515-521. https://doi.org/10.5021/ad.2021.33.6.515

Emic strokes and causes significant morbidity. 1,2 Early neurological deterioration (END) can occur in 20-30% of patients with lacunar infarction during the first few days and lead to worse neurological outcomes. 3 The mechanisms of lacunar infarction are still un-Background: The mechanisms of lacunar infarction are still unclear and may be heterogenous. We aimed to investigate the presence of parent artery atheroma, cerebral vasodilatory function, and blood-brain barrier (BBB) breakdown and their role in the development of early neurological deterioration (END) in patients with acute lacunar infarction. Methods: Patients with acute lacunar infarction prospectively underwent transcranial Doppler breath-holding test, contrast-enhanced f luid-attenuated inversion recovery magnetic resonance imaging, and magnetic resonance angiography with/without high-resolution vessel wall imaging to determine the cerebral vasomotor reactivity to carbon dioxide (CO 2-CVR) of the symptomatic artery, BBB breakdown, and the presence of branch atheromatous disease in the parent artery, respectively, before the development of END. We compared the presence of each mechanism between patients who developed END and those without END and the role in predicting END between mechanisms. Results: Among the 41 patients included, three (7.3%) experienced END. Reduced CO 2-CVR, branch atheromatous disease, and widespread BBB breakdown were observed in eight (19.5%), 10 (24.4%), and 11 patients (26.8%), respectively. Among these factors, CO 2-CVR was significantly lower in patients with END than in those without END (breath-holding index, 0.64 [interquartile range, 0.47-0.70] vs. 1.05 [0.81-1.33], p=0.028) and best predicted END (area under the curve=0.889; 95% confidence interval, 0.779-0.999; p<0.001). Conclusion: Cerebral vasodilatory dysfunction is associated with END in patients with acute lacunar infarction. Our study suggests that CO 2-CVR testing has a role in the risk stratification of lacunar infarction, and a confirmatory study is required in the future.

Moon S, et al. Yonsei Med J. 2022 Sep;63:e12. https://doi.org/10.3349/ymj.2022.0160

Atopic dermatitis (AD) is a prevalent inflammatory skin disease characterized by epidermal barrier dysfunction and Th2-skewed inflammation. Campanula takesimana (C. takesimana), a Korean endemic plant grown on Ulleng Island, has long been associated with a traditional alternative medicine for asthma, tonsillitis, and sore throat. In this study, we reported the effect of C. takesimana callus extract on upregulating epidermal barrier-related proteins dysregulated by Th2 cytokines. C. takesimana callus extract induced the expression of skin barrier proteins, such as filaggrin, claudin-1, and zonula occludens-1, in both human primary keratinocytes and Th2-induced AD-like skin-equivalent models. Additionally, RNA sequencing analysis demonstrated that C. takesimana callus extract partially restored Th2 cytokine-induced dysregulation of the epidermal development and lipid metabolic pathways. Considering the advantages of callus as a sustainable eco-friendly source of bioactive substances, and its effect on skin barrier proteins and lipid metabolic pathways, C. takesimana callus extracts can possibly be utilized to improve the integrity of the skin barrier.