Periodontal disease is a potential predictor of stroke and cognitive impairment. However, this association is unclear in adults aged 50 yr and above without a history of stroke or dementia. We evaluated the association between the number of teeth lost, indicating periodontal disease, and cognitive impairment in community-dwelling adults without any history of dementia or stroke. Dental examinations were performed on 438 adults older than 50 yr (315 females, mean age 63 ± 7.8 yr; 123 males, mean age 61.5 ± 8.5 yr) between January 2009 and December 2010. In the unadjusted analysis, odds ratios (OR) of cognitive impairment based on MMSE score were 2.46 (95% CI, 1.38-4.39) and 2.7 (95% CI, 1.57-4.64) for subjects who had lost 6-10 teeth and those who had lost more than 10 teeth, respectively, when compared with subjects who had lost 0-5 teeth. After adjusting for age, education level, hypertension, diabetes, hyperlipidemia, and smoking, the relationship remained significant (OR, 2.0; 95% CI, 1.08-3.69, P = 0.027 for those with 6-10 teeth lost; OR, 2.26; 95% CI, 1.27-4.02, P = 0.006 for those with more than 10 teeth lost). The number of teeth lost is correlated with cognitive impairment among community-dwelling adults aged 50 and above without any medical history of stroke or dementia.

Background and PurposeYKL-40 is associated with various neurological disorders. However, circulatory YKL-40 levels early after onset of acute ischemic stroke (AIS) have not been systematically assessed. We aimed to identify the temporal changes and clinical usefulness of measuring serum YKL-40 immediately following AIS.MethodsSerum YKL-40 and C-reactive protein (CRP) levels were monitored over time in AIS patients (n = 105) and compared with those of stroke-free controls (n = 34). Infarct volume and stroke severity (National Institutes of Health Stroke Scale; NIHSS) were measured within 48 hours of symptom onset, and functional outcome (modified Rankin Scale; mRS) was measured 3 months after AIS.ResultsWithin 12 hours of symptom onset, levels of YKL-40 (251 vs. 41 ng/mL) and CRP (1.50 vs. 0.96 µg/mL) were elevated in AIS patients compared to controls. The power of YKL-40 for discriminating AIS patients from controls was superior to that of CRP (area under the curve 0.84 vs. 0.64) and YKL-40 (r = 0.26, P<0.001) but not CRP levels were correlated with mRS. On day 2 of admission (D2), YKL-40 levels correlated with infarct volume and NIHSS. High YKL-40 levels predicted poor functional outcome (odds ratio 5.73, P = 0.03). YKL-40 levels peaked on D2 and declined on D3, whereas CRP levels were highest on D3.ConclusionsOur results demonstrate serial changes in serum YKL-40 levels immediately following AIS and provide the first evidence that it is a valid indicator of AIS extent and an early predictor of functional outcome.

Background: There are conflicting evidences on endothelial function in lacunar infarction. This may be attributed to the effects of risk factors on the vascular smooth muscle. To test endothelial function only in patients with lacunar infarction, we evaluated the endothelium-dependent and -independent vasodilatation of the brachial artery. Methods: We enrolled consecutive patients with lacunar infarction defined by clinical characteristics and MRI findings. The control group included age- and sex-matched patients with hypertension who do not have any history of clinical stroke, coronary artery disease or peripheral vascular disease. Endothelial function was evaluated using flow-mediated dilatation (FMD) and nitrogen-mediated dilatation (NMD) of the brachial artery. FMD and NMD were examined by an experienced vascular sonographer using a high-resolution ultrasound. Intracranial stenosis was defined as flow gap or >50% reduction in vessel diameter on MRA. Results: FMD was 6.6 ± 4.5% in the lacunar infarction group and 12.2 ± 4.6% in the control group (p = 0.000). NMD was 14.3 ± 4.9% in the lacunar infarction group and 13.8 ± 4.9% in the control group (p = 0.37). FMD in patients with lacunar infarction and intracranial arterial stenosis was 6.4 ± 3.9%, and FMD in patients with lacunar infarction was only 6.9 ± 5.5%. In the control group, it was 12.2 ± 4.6%. Conclusion: FMD was low in patients with lacunar infarction. NMD was similar between the lacunar infarction group and the control group. These results are suggestive of pure endothelial dysfunction in lacunar infarction. Endothelial dysfunction was as severe in lacunar infarction as in intracranial arterial stenosis.

The recent advances of wearable sensors are remarkable but there are still limitations that they need to be refabricated to tune the sensor for target signal. However, biological sensory systems have the inherent potential to adjust their sensitivity according to the external environment, allowing for a broad and enhanced detection. Here, we developed a Tunable, Ultrasensitive, Nature-inspired, Epidermal Sensor (TUNES) that the strain sensitivity was dramatically increased (GF ~30k) and the pressure sensitivity could be tuned (10–254 kPa−1) by preset membrane tension. The sensor adjusts the sensitivity to the pressure regime by preset tension, so it can measure a wide range (0.05 Pa–25 kPa) with the best performance: from very small signals such as minute pulse to relatively large signals such as muscle contraction and respiration. We verified its capabilities as a wearable health monitoring system by clinical trial comparing with pressure wire which is considered the current gold standard of blood pressure (r = 0.96) and home health care system by binary classification of Old’s/Young’s pulse waves via machine learning (accuracy 95%).

NCT01822002.