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Kwak J, Cho SB, Jun H, Chung HH, Park SJ, Seo TS, Yang WJ. Transjugular approach in aspiration thrombectomy and angioplasty of a thrombosed straight arteriovenous graft compared to the direct hemodialysis access approach. Hemodial Int 2024; 28:162-169. [PMID: 38481062 DOI: 10.1111/hdi.13142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 02/17/2024] [Accepted: 02/20/2024] [Indexed: 04/13/2024]
Abstract
PURPOSE To evaluate the efficacy and outcome of the transjugular approach in endovascular recanalization of a thrombosed straight arteriovenous graft (AVG) compared to those of the direct hemodialysis access approach (conventional approach). MATERIALS AND METHODS We retrospectively assessed patients who underwent aspiration thrombectomy and percutaneous transluminal angioplasty for thrombosed straight AVG performed at a single institution between October 2006 and October 2021. A total of 138 thrombosed AVGs in 83 patients (39 male and 44 females) were divided into the transjugular approach group (Group A) and the conventional approach group (Group B). Technical and clinical success, postintervention primary patency, cumulative patency, and periprocedural complications were compared. RESULTS There was no statistical difference in demographic data between groups A and B. The technical success rate of group A and B was 96.4% (80/83) and 98.2% 54/55, respectively (p > 0.05). The mean procedure time was 61.4 min (Group A) and 70.5 min (Group B) (p > 0.05). There was no statistically significant difference between the two groups in postintervention primary patency. The cumulative patency of Groups A and B was 911.9 days (range 122-6277) and 1062.3 days (range 72-2302 days), respectively (p > 0.05). One patient in Group B experienced a major graft rupture. Pseudoaneurysm formation at the sheath insertion site occurred in two patients in Group B. No cases of stenosis or thrombosis of the IJV or hematoma at the puncture site were observed in Group A. CONCLUSION The transjugular approach is as safe and effective as the conventional approach for aspiration thrombectomy and percutaneous transluminal angioplasty of thrombosed straight AVGs.
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Affiliation(s)
- JungWon Kwak
- Department of Radiology, Anam Hospital, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Sung Bum Cho
- Department of Radiology, Anam Hospital, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Heungman Jun
- Department of Surgery, Anam Hospital, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Hwan Hoon Chung
- Department of Radiology, Ansan Hospital, College of Medicine, Korea University, Ansan-si, Gyeonggi-do, Republic of Korea
| | - Sung-Joon Park
- Department of Radiology, Ansan Hospital, College of Medicine, Korea University, Ansan-si, Gyeonggi-do, Republic of Korea
| | - Tae-Seok Seo
- Department of Radiology, Guro Hospital, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Woo Jin Yang
- Department of Radiology, Guro Hospital, College of Medicine, Korea University, Seoul, Republic of Korea
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Jun H, Shi Z, Mattke S. Projected Savings to Canadian Provincial Budgets from Reduced Long-Term Care Home Utilization Due to a Disease-Modifying Alzheimer's Treatment. J Prev Alzheimers Dis 2024; 11:179-184. [PMID: 38230731 DOI: 10.14283/jpad.2023.95] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
BACKGROUND A disease-modifying Alzheimer's treatment could provide budgetary savings to Canadian provinces from a reduction in long-term care home use, yet we do not know the magnitude of those potential savings. OBJECTIVE We project savings to each Canadian province's budget from 2023 to 2043. DESIGN Annual savings are projected using a Markov model. We account for reduction in long-term care home use and in use of Alternative Level of Care (ALC) beds, which are hospital beds occupied by care home-eligible patients on the wait list for admission. RESULTS A treatment that delays disease progression by 40% is projected to avoid 142,507 long-term care home and ALC years, resulting in $17.2 billion cumulative savings across all Canadian provinces, a 21% relative reduction among treatment eligible patients. Average per capita savings were $1,132, ranging from $734 (Alberta) to $2,895 (Prince Edward Island). Cumulative savings could increase to $22.7 billion with enhanced triage of patients in primary care stages and to $25.6 billion if all capacity constraints for diagnosis and treatment were removed. CONCLUSION A disease-modifying treatment could create budgetary savings from lower long-term care home use, offsetting part of the treatment cost. With the increasing demand for long-term care home beds and the high rates of patients being held in hospitals while wait-listed, such a treatment could additionally provide relief to the overburdened long-term care system in Canada.
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Affiliation(s)
- H Jun
- Dr. Soeren Mattke, Center for Economic and Social Research, University of Southern California, 635 Downey Way, #505N, Los Angeles, CA 90089, USA, ; Phone: (202) 468-5797
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Mattke S, Jun H, Hanson M, Chu S, Kordower JH, Reiman EM. Health Economic Considerations in the Deployment of an Alzheimer's Prevention Therapy. J Prev Alzheimers Dis 2024; 11:303-309. [PMID: 38374736 DOI: 10.14283/jpad.2024.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
INTRODUCTION As treatments for secondary prevention of Alzheimer's disease (AD) are being studied, concerns about their value for money have appeared. We estimate cost-effectiveness of a hypothetical screening and prevention program. METHODS We use a Markov model to project cost-effectiveness of a treatment that reduces progression to symptomatic AD by 50% with either chronic treatment until progression to mild cognitive impairment or treatment for one year followed by monitoring with AD blood tests and retreatment with one dose in case of amyloid re-accumulation. Diagnoses would be made with an AD blood test with sensitivity and specificity of 80%, and inconclusive results in 20%. Individuals testing negative would be re-tested in five years and those with inconclusive results in one. RESULTS The program would generate per-person value of $53,721 from a payer (reduction of direct cost and patient QALY gains) and $69,861 from a societal perspective (adding valuation of reduced caregiver burden). With chronic treatment, it would be cost-effective up to annual drug prices of $7,000 and $10,300, respectively. Time-limited treatment would be cost-effective at annual drug prices of $54,257 and $78,458 from a payer and societal perspective, respectively. Higher specificity of the blood test would decrease cost per person with similar value generation DISCUSSION: A hypothetical prevention treatment for AD could be economically viable from a payer and societal perspective.
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Affiliation(s)
- S Mattke
- Soeren Mattke, M.D., D.Sc., Director, Center for Improving Chronic Illness Care, Research Professor of Economics, USC Dornsife, 635 Downey Way, #505N, Los Angeles, CA 90089, Mobile: +1 202 468 5797,
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Liu Y, Jun H, Becker A, Wallick C, Mattke S. Detection Rates of Mild Cognitive Impairment in Primary Care for the United States Medicare Population. J Prev Alzheimers Dis 2024; 11:7-12. [PMID: 38230712 PMCID: PMC10995024 DOI: 10.14283/jpad.2023.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 09/17/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND Existing evidence points to substantial gaps in detecting mild cognitive impairment in primary care but is based on limited or self-reported data. The recent emergence of disease-modifying treatments for the Alzheimer's disease, the most common etiology of mild cognitive impairment, calls for a systematic assessment of detection rates in primary care. OBJECTIVES The current study aims to examine detection rates for mild cognitive impairment among primary care clinicians and practices in the United States using Medicare claims and encounter data. DESIGN Observational study. SETTING Medicare administrative data. PARTICIPANTS The study sample includes a total of 226,756 primary care clinicians and 54,597 practices that had at least 25 patients aged 65 or older, who were enrolled in Medicare fee-for-service or a Medicare Advantage plan between 2017 and 2019. MEASUREMENTS The detection rate for mild cognitive impairment is assessed as the ratio between the observed diagnosis rate of a clinician or practice as documented in the data, and the expected rate based on a predictive model. RESULTS The average detection rates for mild cognitive impairment is 0.08 (interquartile range=0.00-0.02) for both clinicians and practices, suggesting that only about 8% of expected cases were diagnosed on average. Only 0.1% of clinicians and practices had diagnosis rates within the expected range. CONCLUSIONS Mild cognitive impairment is vastly underdiagnosed, pointing to an urgent need to improve early detection in primary care.
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Affiliation(s)
- Y Liu
- Ying Liu, PhD, Center for Economic and Social Research, University of Southern California, 635 Downey Way, Los Angeles, CA 90089, USA,
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Shim YE, Ko Y, Lee JP, Jeon JS, Jun H, Yang J, Kim MS, Lim SJ, Kwon HE, Jung JH, Kwon H, Kim YH, Lee J, Shin S. Evaluating anti-thymocyte globulin induction doses for better allograft and patient survival in Asian kidney transplant recipients. Sci Rep 2023; 13:12560. [PMID: 37532735 PMCID: PMC10397229 DOI: 10.1038/s41598-023-39353-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 07/24/2023] [Indexed: 08/04/2023] Open
Abstract
Anti-thymocyte globulin (ATG) is currently the most widely prescribed induction regimen for preventing acute rejection after solid organ transplantation. However, the optimal dose of ATG induction regimen in Asian kidney recipients is unclear. Using the Korean Organ Transplantation Registry, we performed a retrospective cohort study of 4579 adult patients who received renal transplantation in South Korea and divided them into three groups according to the induction regimen: basiliximab group (n = 3655), low-dose ATG group (≤ 4.5 mg/kg; n = 467), and high-dose ATG group (> 4.5 mg/kg; n = 457). We applied the Toolkit for Weighting and Analysis of Nonequivalent Groups (TWANG) package to generate high-quality propensity score weights for intergroup comparisons. During four-year follow-ups, the high-dose ATG group had the highest biopsy-proven acute rejection rate (basiliximab 20.8% vs. low-dose ATG 22.4% vs. high-dose ATG 25.6%; P < 0.001). However, the rates of overall graft failure (4.0% vs. 5.0% vs. 2.6%; P < 0.001) and mortality (1.7% vs. 2.8% vs. 1.0%; P < 0.001) were the lowest in the high-dose ATG group. Our results show that high-dose ATG induction (> 4.5 mg/kg) was superior to basiliximab and low-dose ATG induction in terms of graft and patient survival in Asian patients undergoing kidney transplant.
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Affiliation(s)
- Ye Eun Shim
- Division of Kidney and Pancreas Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Youngmin Ko
- Division of Kidney and Pancreas Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Jung Pyo Lee
- Department of Nephrology, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
| | - Jin Seok Jeon
- Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
| | - Heungman Jun
- Department of Surgery, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Jaeseok Yang
- Division of Nephrology, Department of Internal Medicine, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea
| | - Myoung Soo Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seong Jun Lim
- Division of Kidney and Pancreas Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Hye Eun Kwon
- Division of Kidney and Pancreas Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Joo Hee Jung
- Division of Kidney and Pancreas Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Hyunwook Kwon
- Division of Kidney and Pancreas Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Young Hoon Kim
- Division of Kidney and Pancreas Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Jungbok Lee
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
| | - Sung Shin
- Division of Kidney and Pancreas Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
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Oh YJ, Lee J, Kim Y, Jun H, Sim J, Kim MG, Jung CW. Eculizumab as rescue therapy in a kidney transplant recipient with atypical hemolytic uremic syndrome: a case report. Korean J Transplant 2022; 36:283-288. [PMID: 36704807 PMCID: PMC9832595 DOI: 10.4285/kjt.22.0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/18/2022] [Accepted: 10/05/2022] [Indexed: 11/12/2022] Open
Abstract
A 61-year-old female patient with chronic kidney disease due to diabetes mellitus and hypertension-induced nephropathy received a deceased donor kidney transplant in March 2020. In July 2020, she was transferred from a local hospital due to the exacerbation of general weakness and diarrhea. Upon her arrival, we noticed a high level of serum creatinine (sCr) of 1.5 mg/dL and a decrease in urine output. Her laboratory results indicated significant hemolysis, with a hemoglobin level of 7.0 g/dL, platelet count of 20 ×103/μL, and a lactate dehydrogenase level of 3,207 IU/L. Kidney biopsy showed severe thrombotic microangiopathy without any evidence of acute rejection. Under the impression of atypical hemolytic uremic syndrome (aHUS), we immediately started plasmapheresis and hemodialysis for anuria. Eculizumab was considered as a kidney graft rescue therapy since her sCr level was not effectively decreased, and her anuria continued despite hemodialysis and plasmapheresis. Eculizumab (900 mg) was administered weekly for 4 weeks. An additional 600 mg of eculizumab was administered on the day of plasmapheresis. Since the patient's laboratory data gradually improved, hemodialysis and plasmapheresis were ceased on admission day 37. After that, eculizumab was administered biweekly (1,200 mg) two more times. The patient's sCr and platelet count normalized after 2 months of eculizumab treatment. Based on our experience, a shorter interval between the clinical diagnosis of aHUS and administration of eculizumab increases the likelihood of rescuing the kidney.
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Affiliation(s)
- Young Ju Oh
- Department of Surgery, Korea University Anam Hospital, Seoul, Korea
| | - Joohyun Lee
- Department of Surgery, Korea University Anam Hospital, Seoul, Korea
| | - Yeonmi Kim
- Department of Rehabilitation Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Heungman Jun
- Department of Surgery, Korea University Anam Hospital, Seoul, Korea
| | - Jongmin Sim
- Department of Pathology, Korea University Anam Hospital, Seoul, Korea
| | - Myung-Gyu Kim
- Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Cheol Woong Jung
- Department of Surgery, Korea University Anam Hospital, Seoul, Korea,Corresponding author: Cheol Woong Jung Department of Surgery, Korea University Anam Hospital, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Korea, Tel: +82-2-920-6385, Fax: +82-2-928-1631, E-mail:
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Jang Y, Jung SM, Heo TG, Choi PW, Kim JI, Jung SW, Jun H, Shin YC, Um E. Determining the etiology of small bowel obstruction in patients without intraabdominal operative history: a retrospective study. Ann Coloproctol 2022; 38:423-431. [PMID: 34875819 PMCID: PMC9816557 DOI: 10.3393/ac.2021.00710.0101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 09/23/2021] [Indexed: 01/13/2023] Open
Abstract
PURPOSE Most of the causes of small bowel obstruction (SBO) in patients without a history of abdominal surgery are unclear at initial assessment. This study was conducted to identify the etiology and clinical characteristics of SBO in virgin abdomens and discuss the proper management. METHODS A retrospective review involving operative cases of SBO from a single institute, which had no history of abdominal surgery, was conducted between January 2010 and December 2020. Clinical information, including radiological, operative, and pathologic findings, was investigated to determine the etiology of SBO. RESULTS A total of 55 patients were included in this study, with a median age of 57 years and male sex (63.6%) constituting the majority. The most frequently reported symptoms were abdominal pain and nausea or vomiting. Neoplasm as an underlying cause accounted for 34.5% of the cases, of which 25.5% were malignant cases. In patients aged ≥60 years (n=23), small bowel neoplasms were the underlying cause in 12 (52.2%), of whom 9 (39.1%) were malignant cases. Adhesions and Crohn disease were more frequent in patients aged <60 years. Coherence between preoperative computed tomography scans and intraoperative findings was found in 63.6% of the cases. CONCLUSION There were various causes of surgical cases of SBO in virgin abdomens. In older patients, hidden malignancy should be considered as a possible cause of SBO in a virgin abdomen. Patients with symptoms of recurrent bowel obstruction who have no history of prior abdominal surgery require thorough medical history and close follow-up.
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Affiliation(s)
- Youngjin Jang
- Department of Surgery, University of Inje College of Medicine, Ilsan Paik Hospital, Goyang, Korea
| | - Sung Min Jung
- Department of Surgery, University of Inje College of Medicine, Ilsan Paik Hospital, Goyang, Korea,Correspondence to: Sung Min Jung, M.D. Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, 170 Juhwa-ro, Ilsanseo-gu, Goyang 10380, Korea Tel: +82-31-911-7993, Fax: +82-31-911-7319 E-mail:
| | - Tae Gil Heo
- Department of Surgery, University of Inje College of Medicine, Ilsan Paik Hospital, Goyang, Korea
| | - Pyong Wha Choi
- Department of Surgery, University of Inje College of Medicine, Ilsan Paik Hospital, Goyang, Korea
| | - Jae Il Kim
- Department of Surgery, University of Inje College of Medicine, Ilsan Paik Hospital, Goyang, Korea
| | - Sung-Won Jung
- Department of Surgery, University of Inje College of Medicine, Ilsan Paik Hospital, Goyang, Korea
| | - Heungman Jun
- Department of Surgery, University of Inje College of Medicine, Ilsan Paik Hospital, Goyang, Korea
| | - Yong Chan Shin
- Department of Surgery, University of Inje College of Medicine, Ilsan Paik Hospital, Goyang, Korea
| | - Eunhae Um
- Department of Surgery, University of Inje College of Medicine, Ilsan Paik Hospital, Goyang, Korea
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Kim J, Oh YJ, Jun H, Jung CW. Preliminary results of pharmacist’s periodic counseling program on medication adherence and satisfaction in kidney transplantation recipients. Korean Journal of Transplantation 2022. [DOI: 10.4285/atw2022.f-5173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Jinyeo Kim
- Department of Pharmacy, Korea University Anam Hospital, Seoul, Korea
| | - Young Ju Oh
- Department of Transplantation Surgery, Korea University Anam Hospital, Seoul, Korea
| | - Heungman Jun
- Department of Transplantation Surgery, Korea University Anam Hospital, Seoul, Korea
| | - Cheol Woong Jung
- Department of Transplantation Surgery, Korea University Anam Hospital, Seoul, Korea
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Eum SH, Lee JH, Jeon JS, Jun H, Yang J, Kim MS, Yoon HE. Incident fractures in kidney transplant recipients: a nationwide cohort study from South Korea. Korean Journal of Transplantation 2022. [DOI: 10.4285/atw2022.f-4512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Sang Hun Eum
- Department of Nephrology, The Catholic University of Korea, Incheon St. Mary's Hospital, Incheon, Korea
| | - Jeong-Hoon Lee
- Department of Surgery, Hanyang University College of Medicine, Seoul, Korea
| | - Jin Seok Jeon
- Department of Nephrology, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Heungman Jun
- Department of Surgery, Korea University Anam Hospital, Seoul, Korea
| | - Jaeseok Yang
- Department of Nephrology, Yonsei University College of Medicine, Seoul, Korea
| | - Myoung Soo Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Hye Eun Yoon
- Department of Nephrology, The Catholic University of Korea, Incheon St. Mary's Hospital, Incheon, Korea
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Oh YJ, Jun H, Kim MG, Jung CW. Impact of iliac artery calcification of deceased-donors on graft outcomes after kidney transplantation. Korean Journal of Transplantation 2022. [DOI: 10.4285/atw2022.f-5250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Young Ju Oh
- Department of Transplantation Surgery, Korea University Anam Hospital, Seoul, Korea
| | - Heungman Jun
- Department of Transplantation Surgery, Korea University Anam Hospital, Seoul, Korea
| | - Myung Gyu Kim
- Department of Nephrology, Korea University Anam Hospital, Seoul, Korea
| | - Cheol Woong Jung
- Department of Transplantation Surgery, Korea University Anam Hospital, Seoul, Korea
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Kim MG, Gwon JG, Cho DH, Choi J, Jung CW, Jun H. Impact of the longitudinal changes of myocardial remodeling on kidney transplantation outcomes. Korean Journal of Transplantation 2022. [DOI: 10.4285/atw2022.f-3272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Myung Gyu Kim
- Department of Nephrology, Korea University Anam Hospital, Seoul, Korea
| | - Jun Gyo Gwon
- Department of Vascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong-Hyuk Cho
- Department of Cardiology, Korea University Anam Hospital, Seoul, Korea
| | - Jimi Choi
- Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Cheol Woong Jung
- Department of Transplantation Surgery, Korea University Anam Hospital, Seoul, Korea
| | - Heungman Jun
- Department of Transplantation Surgery, Korea University Anam Hospital, Seoul, Korea
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Jeong H, Jung S, Heo TG, Choi PW, Kim JI, Jung SM, Jun H, Shin YC, Um E. Could the Injury Severity Score be a new indicator for surgical treatment in patients with traumatic splenic injury? J Trauma Inj 2022. [DOI: 10.20408/jti.2021.0065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Jun H, Yun S. First-generation therapy for varicose veins: medication, compression, sclerotherapy, and stripping. J Korean Med Assoc 2022. [DOI: 10.5124/jkma.2022.65.4.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: Improving the understanding varicose veins (VV) is increasing due to life extension and concerns regarding quality of life. Recently, endovascular treatment has become more common, even in mild cases. Excessive procedures are often performed before conservative and non-surgical treatments. We aimed to explain the efficacy of medication, compression, sclerotherapy, and stripping of treatments and to consider the appropriate indications for many treatment methods, including endovascular procedures.Current Concepts: Venoactive drugs can be used as first-line agents for symptoms, such as edema, at all stages of varicose vein. These are effective adjuvant agents and can help achieve compression before and after procedures. Compression therapy is effective for skin change and ulcers and is excellent for the improvement of symptoms. Sclerotherapy has been widely used as an adjuvant treatment, but recently, its indications have been expanded for non-invasive causes. Traditional high ligation and stripping is still the recommended treatment option for recurrent or complicated varicose veins.Discussion and Conclusion: The patients’ symptoms should be evaluated more critically than assessing only the venous reflux using ultrasound. Additionally, objective evaluation of various causes of lower extremity discomfort should be considered. Treatment according to appropriate indications, such as medication, compression, sclerotherapy, stripping, and endovascular therapy, can improve the patients’ quality of life and prevent complications.
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Hwang JW, Jun H. Characteristics from the 100 most influential articles on carotid stenosis. Ann Palliat Med 2022; 11:2210-2214. [PMID: 35272469 DOI: 10.21037/apm-21-3420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 12/24/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND There are three main competing treatment modalities for carotid artery stenosis (CS), i.e., carotid endarterectomy (CEA), carotid artery angioplasty/stenting (CAS), and medical treatment. In this study, we analyzed the performance and trends of CS research through bibliometric analysis. METHODS We searched the Thomson Reuters Web of Science citation indexing database. The key words used in the search were "carotid artery" and "carotid stenosis". The top 100 most cited manuscripts (T100) were analyzed based on title, author, institution, country of origin, year of publication, and topic. RESULTS The T100 were published between 1990 and 2016. The Stroke published the most manuscripts (n=22) and the New England Journal of Medicine was the most cited (n=15,113). The United States had the greatest number of publications (n=43), and the University of Oxford was the institution with the most publications (n=7). Peter M. Rothwell was the corresponding author with the most publications (n=10). The main topics were in the following categories: CEA (n=22), medication (n=11), CAS (n=9), diagnosis (n=44), and CEA vs. CAS (n=14). CONCLUSIONS This bibliometric analysis of CS research provides insight into publication trends and perspective on the treatment of CS.
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Affiliation(s)
- Ji Woong Hwang
- Department of Surgery, Gwangmyeong Chung-Ang University Hospital, Chung-Ang University College of Medicine, Gwangmyeong, Korea
| | - Heungman Jun
- Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
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Jun H, Hwang JW. The most influential articles on kidney transplantation: A PRISMA-compliant bibliometric and visualized analysis. Medicine (Baltimore) 2022; 101:e28614. [PMID: 35060533 PMCID: PMC8772660 DOI: 10.1097/md.0000000000028614] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/29/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Kidney transplantation (KT) has become common in the treatment of end-stage renal disease. However, to date, there have been no bibliometric analyses of KT research to identify the most influential articles. The purpose of this research is to identify and characterize the 100 most cited articles that focus on KT and to clarify the trends in the accomplishments in this field. METHODS We searched the Thomson Reuters Web of Science citation indexing database and used keyword mapping of VOSviewer. The top 100 most cited manuscripts were analyzed based on their titles, authors, institutions, countries of origin, years of publication, and topics. RESULTS The New England Journal of Medicine has published the most manuscripts on kidney transplantation (n = 26) and is the most cited journal (n = 15,642). The United States has the highest number of publications (n = 61). Kashika is the corresponding author with the most published papers (n = 5; 2892 citations). The most common topics of publication are immunosuppressant (n = 34), clinical outcome (n = 26), and pathology (n = 22). Keywords related to immunosuppressant are the most common in keyword mapping with VOSviewer. CONCLUSIONS This bibliometric analysis of KT research provides the research characteristics and publication trends of this topic. In KT research, immunosuppressants and post-transplant clinical outcomes have been important topics.
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Affiliation(s)
- Heungman Jun
- Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Ji Woong Hwang
- Department of Surgery, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University, Gwangmyeong, Republic of Korea
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16
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Jun H. Mesenteric and myocardial ischemia revealing lower limb sarcoma. Int J Surg Case Rep 2021; 89:106616. [PMID: 34856441 PMCID: PMC8640440 DOI: 10.1016/j.ijscr.2021.106616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 10/19/2021] [Accepted: 11/16/2021] [Indexed: 11/22/2022] Open
Abstract
Introduction and importance Although most of the causes of acute superior mesenteric artery (SMA) embolism with a poor clinical course originate from the heart, we report a case of SMA embolism secondary to advanced sarcoma of the lower extremities. Case presentation A 66-year-old man presented with chest and epigastric discomfort that lasted for 1 day. Coronary angioplasty was performed, followed by laparotomy with an embolectomy of the SMA, small bowel resection, and ileostomy. After surgery, leiomyosarcoma was diagnosed on a biopsy performed in the left thigh, and lung metastasis was confirmed. He had recurrent peritonitis for 2 months and died of multiple organ failure. Clinical discussion The common etiologies of SMA embolism include cardioembolic sources with atrial fibrillation and recent myocardial infarction. Rare etiologies include atherosclerotic plaque, mural thrombus of the aneurysm, and cardiac sarcoma. Conclusion Efforts are required for the systemic evaluation of various etiologies in patients with SMA embolism who require rapid diagnosis and intervention. Mesenteric ischemia and myocardial ischemia caused by advanced sarcoma of lower extremities are rare. When evaluating patients with SMA embolism, systemic evaluation of various etiologies is required. We present a case of SMA embolism secondary to advanced sarcoma of the lower extremities.
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Affiliation(s)
- Heungman Jun
- Department of Surgery, Inje University College of Medicine, Ilsan-Paik Hospital, Goyang, Republic of Korea.
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17
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Jun H. The most influential articles on kidney transplantation: a bibliometric and visualized analysis. Korean Journal of Transplantation 2021. [DOI: 10.4285/atw2021.po-1281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Heungman Jun
- Department of Surgery-Transplantation, Inje University Ilsan Paik Hospital, Goyang, Korea
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18
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Jun H. Analysis of the donor’s serum creatinine timing appropriate for. Korean Journal of Transplantation 2021. [DOI: 10.4285/atw2021.po-1282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Heungman Jun
- Department of Surgery-Transplantation, Inje University Ilsan Paik Hospital, Goyang, Korea
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Jun H, Jo HA, Han KH, Kang HK, Jang HY, Han SY. Pulse Pressure Variation is a Valuable Marker for Predicting Fluid Responsiveness in Brain-Dead Donors. Transplant Proc 2021; 53:565-568. [PMID: 33549349 DOI: 10.1016/j.transproceed.2021.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 11/20/2020] [Accepted: 01/08/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE Hemodynamic management in brain-dead donors (BDDs) is challenging due to hemodynamic instabilities. We compared functional parameters with traditional parameters for hemodynamic monitoring in BDDs. MATERIALS AND METHODS Seventeen BDDs with a positive balance of >500 mL for 8 hours were included. Functional hemodynamic monitoring, including pulse pressure variation (PPV), stroke volume variation (SVV), cardiac output, and systemic vascular resistance index (SVRI) was performed in the setting of tidal volume of 6 mL/kg to 8 mL/kg and minimal positive end-expiratory pressure of 5 cm to 8 cm H2O. Responders were defined by a cardiac output increase of >15% after fluid therapy. RESULTS Among the 17 BDDs (mean age, 46.80±13.91 years), 15 were male. Seven responders out of 17 (41.1%) had a significantly higher PPV (22.8±8.4 vs 13.4±5.9%, P = .038) and serum albumin level (3.2±0.6 vs 2.6±0.5 g/L, P = .040) at baseline than nonresponders. However, other hemodynamic markers such as SVV and SVRI were similar between groups. Traditional markers of volume status, such as heart rate, central venous pressure, hemoglobin, and serum uric acid level were also similar between the 2 groups. Hemodynamic markers including PPV, SVV, and SVRI were significantly reduced in responders. CONCLUSIONS PPV was the most valuable hemodynamic marker for predicting volume responsiveness in BDDs.
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Affiliation(s)
- Heungman Jun
- Department of Surgery, Inje University College of Medicine, Ilsan-Paik Hospital, Goyang, Korea; Organ Transplantation Center, Inje University College of Medicine, Ilsan-Paik Hospital, Goyang, Korea
| | - Hyung Ah Jo
- Department of Internal Medicine, Inje University College of Medicine, Ilsan-Paik Hospital, Goyang, Korea
| | - Kum Hyun Han
- Department of Internal Medicine, Inje University College of Medicine, Ilsan-Paik Hospital, Goyang, Korea
| | - Hyung Koo Kang
- Department of Internal Medicine, Inje University College of Medicine, Ilsan-Paik Hospital, Goyang, Korea
| | - Hye Yeon Jang
- Organ Transplantation Center, Inje University College of Medicine, Ilsan-Paik Hospital, Goyang, Korea
| | - Sang Youb Han
- Organ Transplantation Center, Inje University College of Medicine, Ilsan-Paik Hospital, Goyang, Korea; Department of Internal Medicine, Inje University College of Medicine, Ilsan-Paik Hospital, Goyang, Korea.
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20
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Jun H, Yoon HE, Lee KW, Lee DR, Yang J, Ahn C, Han SY. Kidney Donor Risk Index Score Is More Reliable Than Kidney Donor Profile Index in Kidney Transplantation From Elderly Deceased Donors. Transplant Proc 2020; 52:1744-1748. [DOI: 10.1016/j.transproceed.2020.03.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 02/23/2020] [Accepted: 03/12/2020] [Indexed: 10/24/2022]
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Cho JM, Jun H, Jo HA, Han KH, Kim HS, Han SY. A case of successful late steroid withdrawal after ABO-incompatible kidney transplantation. Korean Journal of Transplantation 2020; 34:121-125. [PMID: 35769349 PMCID: PMC9188928 DOI: 10.4285/kjt.2020.34.2.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/04/2020] [Accepted: 06/10/2020] [Indexed: 11/24/2022] Open
Abstract
Few data exist regarding steroid withdrawal in ABO-incompatible (ABO-i) kidney transplantation (KT). Here, we report a case of steroid withdrawal after ABO-i KT. A 46-year-old man diagnosed with Henoch-Schonlein purpura received ABO-i KT from his 42-year-old sister. The recipient and donor blood types were O and AB, respectively. His preoperative ABO antibody titers were anti-A of 1:16 and anti-B of 1:8 in isoagglutinin test. HLA mismatch was 0 and he received a single 325 mg/m2 dose of intravenous (IV) rituximab 4 weeks before KT. Three sessions of plasma exchange were undertaken before KT and low-dose IV immunoglobulin of 0.1 g/kg was administered after plasma exchange. On the day of the operation, ABO antibody titer decreased to anti-A of 1:4 and anti-B of 1:2. Renal function remained stable after KT. The patient wished to stop steroid treatment despite the risk of rejection after withdrawal. Steroid tapering was initiated at 20 months and accomplished at 26 months after KT. At that time, serum creatinine level was 1.13 mg/dL, and anti-A and anti-B titers were 1:8 and 1:2, respectively. No issues were observed after steroid withdrawal. At 48 months after KT, serum creatinine level was 1.21 mg/dL, and anti-A and anti-B antibody titers were 1:32 and 1:2, respectively. Steroid withdrawal in ABO-i KT might be considered in immunologically low-risk patients.
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Affiliation(s)
- Jeong Min Cho
- Department of Internal Medicine, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea
| | - Heungman Jun
- Department of Surgery, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea
| | - Hyung Ah Jo
- Department of Internal Medicine, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea
| | - Kum Hyun Han
- Department of Internal Medicine, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea
| | - Han-Seong Kim
- Department of Pathology, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea
| | - Sang Youb Han
- Department of Internal Medicine, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea
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22
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Jun H, Kim YH, Kim JK, Kim CD, Yang J, Ahn C, Han SY. Outcomes of kidney transplantation from elderly deceased donors of a Korean registry. PLoS One 2020; 15:e0232177. [PMID: 32525880 PMCID: PMC7289373 DOI: 10.1371/journal.pone.0232177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 05/23/2020] [Indexed: 12/04/2022] Open
Abstract
To overcome organ shortage, expanded criteria donors, including elderly deceased donors (DDs), should be considered. We analyzed outcomes of kidney transplantation (KT) from elderly DDs in a nationwide study. In total, data of 1049 KTs from DDs using the database of Korean Organ Transplantation Registry (KOTRY) were retrospectively analyzed based on the age of DDs: age ≥60 years vs. <60 years. Clinical information, graft status, and adverse events were reviewed in DDs and recipients. The mean age of the 1006 DDs was 51.04±10.54 years, and 21.5% of donors were aged ≥60 years. Elderly DDs had a significantly higher prevalence of diabetes and hypertension and higher Kidney Donor Risk Index (KDRI) and Kidney Donor Profile Index (KDPI). The mean age of the recipients was 47.45±14.87 years. Patients who received KT from elderly DDs were significantly older (53.12±15.14 vs. 45.88±14.41, P<0.001) and had a higher rate of diabetes (41.9 vs. 24.4%, P<0.001). Graft outcomes were not significantly different. Renal function was similar between the groups at the time of discharge and at 6 months, 1 year, and 2 years after KT. The rate of delayed graft function (DGF) was not significantly different. Risk factors of DGF were significantly different in DDs aged ≥60 years and <60 years. In the multivariable model, male sex (odds ratio: 3.99, 95% confidence interval: 1.42–11.22; P = 0.009) and KDRI (12.17, 2.23–66.34; P = 0.004) were significant risk factors for DGF in DDs aged ≥60 years. In DDs aged <60 years, thymoglobulin induction (2.62, 1.53–4.48; P<0.001) and continuous renal replacement therapy (3.47, 1.52–7.96; P = 0.003) were significant factors. Our data indicated that graft outcomes, including renal function and DGF, were similar for elderly DDs and DDs aged <60 years. Elderly DDs might be considered tolerable donors for KT, with active preoperative surveillance.
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Affiliation(s)
- Heungman Jun
- Department of Surgery, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea
| | - Yeong Hoon Kim
- Department of Internal Medicine, Inje University College of Medicine, Busan Paik Hospital, Busan, Korea
| | - Joong Kyung Kim
- Division of Nephrology, Department of Internal Medicine, Bong Seng Memorial Hospital, Busan, Korea
| | - Chan-Duck Kim
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu Korea
| | - Jaeseok Yang
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
- Transplantation Research Institute, Seoul National University College of Medicine, Seoul, Korea
- Transplantation Center, Seoul National University Hospital, Seoul, Korea
| | - Curie Ahn
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Youb Han
- Department of Internal Medicine, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea
- * E-mail:
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Lee Y, Koo H, Kim M, Lee J, Hwang S, Moon J, Park H, Sung A, Choi Y, Jun H, Nam E. Neuroregenerative evidences demonstrated by diverse MRI analysis in cerebral palsy children who showed significant clinical improvement following repeated G-CSF injection. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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24
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Jun H, Hwang JW. The 100 most-cited articles on chronic venous disease: a bibliometric analysis. J Int Med Res 2020; 48:300060520918711. [PMID: 32340501 PMCID: PMC7218469 DOI: 10.1177/0300060520918711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective To use bibliometric analysis to understand characteristics and trends in the research on chronic venous disease (CVD), which affects patients’ quality of life by causing pain, swelling, and ulceration. Methods We searched the Thomson Reuters Web of Science citation indexing database to identify the 100 most-cited manuscripts on CVD. The resulting articles were analyzed by title, author, institution, topic, year of publication, and country of origin. Results The Journal of Vascular Surgery published the most manuscripts on CVD (n = 36) and was the most-cited journal (n = 5356). The United Kingdom was the country with the greatest number of publications (n = 32). Imperial College London was the institution with the highest number of publications (n = 6). Endovenous thermal ablation was the most widely studied research specialty (n = 30). Conclusions Our analysis showed that the majority of CVD research is carried out in Western countries, and that the number of research studies is increasing in line with recent advances in CVD.
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Affiliation(s)
- Heungman Jun
- Department of Surgery, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Ji Woong Hwang
- Department of Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
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25
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Kim JH, Um E, Jung SM, Shin YC, Jung SW, Kim JI, Heo TG, Lee MS, Jun H, Choi PW. The Management of Retained Rectal Foreign Body. Ann Coloproctol 2020; 36:335-343. [PMID: 32054243 PMCID: PMC7714380 DOI: 10.3393/ac.2019.10.03.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 10/03/2019] [Indexed: 12/27/2022] Open
Abstract
Purpose Because insertion of a foreign body (FB) into the anus is considered a taboo practice, patients with a retained rectal FB may hesitate to obtain medical care, and attending surgeons may lack experience with removing these FBs. We performed this study to evaluate the clinical characteristics of Korean patients with a retained rectal FB and propose management guideline for such cases based on our experience. Methods We retrospectively investigated 14 patients between January 2006 and December 2018. We assessed demographic features, mechanism of FB insertion, clinical course between diagnosis and management, and outcomes. Results All patients were male (mean age, 43 years) and presented with low abdominal pain (n = 2), anal bleeding (n = 2), or concern about a retained rectal FB without symptoms (n = 10). FB insertion was most commonly associated with sexual gratification or anal eroticism (n = 11, 78.6%). All patients underwent general anesthesia for anal sphincter relaxation with the exception of 2 who underwent FB removal in the emergency department. FBs were retrieved transanally using a clamp (n = 2), myoma screw (n = 1), clamp application following abdominal wall compression (n = 2), or laparotomy followed by rectosigmoid colon milking (n = 2). Colotomy and primary repair were performed in four patients, and Hartmann operation was performed in one patient with fecal peritonitis. No morbidity or mortality was reported. All patients refused postextraction anorectal functional and anatomical evaluation and psychological counseling. Conclusion Retained rectal FB is rare; however, colorectal surgeons should be aware of the various methods that can be used for FB retrieval and the therapeutic algorithm applicable in such cases.
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Affiliation(s)
- Ju Hun Kim
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Eunhae Um
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Sung Min Jung
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Yong Chan Shin
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Sung-Won Jung
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Jae Il Kim
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Tae Gil Heo
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Myung Soo Lee
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Heungman Jun
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Pyong Wha Choi
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
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26
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Moon J, Shin YC, Heo TG, Choi PW, Kim JI, Jung SW, Jun H, Jung SM, Um E. Differentiation of gallbladder adenomyomatosis from early-stage gallbladder cancer before surgery. Ann Hepatobiliary Pancreat Surg 2019; 23:334-338. [PMID: 31824998 PMCID: PMC6893059 DOI: 10.14701/ahbps.2019.23.4.334] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 10/01/2019] [Accepted: 10/02/2019] [Indexed: 11/17/2022] Open
Abstract
Backgrounds/Aims This study aimed to compare the perioperative and clinical outcomes in patients undergoing laparoscopic cholecystectomy for gallbladder adenomyomatosis (GBA) or early-stage gallbladder cancer (GBC). Methods The perioperative and clinical outcomes of 194 patients diagnosed with GBA and 30 patients diagnosed with GBC who underwent laparoscopic cholecystectomy in our institution from January 2011 to December 2017 were retrospectively compared. Results There were no significant differences between the GBA and GBC groups in sex (male:female ratio 1.0:0.8 vs. 1.0:0.7, p=0.734), BMI (23.9±3.4 vs. 24.0±3.8 kg/m2, p=0.916), or preoperative liver function tests. Patients in the GBC group were significantly older (50.5±14.1 vs. 65.9±10.6 years, p<0.001) and had a higher ASA grade (40.3 vs. 63.4% grade II or III, p=0.043) than patients in the GBA group. Although there was no significant difference in preoperative diagnostic methods (p=0.442), the GBC group showed a significantly higher rate of misdiagnosis on preoperative imaging compared with postoperative histopathologic findings (30.9% vs. 53.3%, p=0.011). There were significantly more patients with gallstones in the GBA group than in the GBC group (68.6% vs. 40.0%, p=0.004). Conclusions In older patients hospitalized for biliary colic without gallstones but with a thickened gallbladder wall with inflammation on preoperative diagnostic exam, the possibility of early-stage GBC should be considered.
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Affiliation(s)
- Jisum Moon
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Yong Chan Shin
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Tae-Gil Heo
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Pyong Wha Choi
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Jae Il Kim
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Sung Won Jung
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Heungman Jun
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Sung Min Jung
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Eunhae Um
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
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Jung SM, Jun H. Recurrent thrombosis of splanchnic and lower extremity arteries with essential thrombocythemia. SAGE Open Med Case Rep 2019; 7:2050313X19880079. [PMID: 31632677 PMCID: PMC6767714 DOI: 10.1177/2050313x19880079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 09/10/2019] [Indexed: 12/02/2022] Open
Abstract
Essential thrombocythemia is a myeloproliferative neoplasm characterized by
platelet aggregation and thrombosis. Clinically, essential thrombocythemia
increases the risk of both thrombosis and bleeding. Essential thrombocythemia is
more involved in micro- and small-sized arteries than in large arteries. Many
essential thrombocythemia patients exhibit various symptoms, including
microvascular thrombosis with acute coronary disease, digital ischemia, and
transient ischemic attack. This study reports a rare case of recurrent
thrombosis in relatively large vessels including splanchnic, lower extremity
arteries, and aorta in essential thrombocythemia. A 70-year-old woman was
admitted to the emergency room with abdominal pain and fever for a day. The
patient underwent three operations due to recurrent arterial thrombosis of
superior mesenteric, splenic, aorta, and lower extremities. She had recurrent
diarrhea and acute kidney injury because of short bowel syndrome after extensive
bowel resection. In conclusion, essential thrombocythemia patients aged >60
years and who have risk factors such as history of major ischemic events or
severe leukocytosis must be careful of thrombosis of the medium- and large-sized
arteries, including splanchnic and lower extremity arteries.
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Affiliation(s)
- Sung Min Jung
- Department of Surgery, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, South Korea
| | - Heungman Jun
- Department of Surgery, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, South Korea
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Jun H. Endovenous Intervention of May-Thurner Syndrome with Thrombus beyond Iliac Vein Stenosis. Vasc Specialist Int 2019; 35:90-94. [PMID: 31297358 PMCID: PMC6609025 DOI: 10.5758/vsi.2019.35.2.90] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 03/22/2019] [Accepted: 04/15/2019] [Indexed: 12/12/2022] Open
Abstract
Purpose With the increase in the incidence of venous thrombosis, interest in May-Thurner syndrome (MTS) accompanying iliac vein compression has increased. Some patients with MTS have inferior vena cava thrombosis or thrombosis beyond iliac vein stenosis (TBIVS). This study aimed to identify the characteristics of MTS with TBIVS including pulmonary embolism (PE) and post-thrombotic syndrome (PTS) compared to those of MTS without TBIVS. Materials and Methods Thirty-five patients with deep vein thrombosis associated with MTS were treated between March 2012 and February 2016. Demographic data, medical history, computed tomography findings (iliac vein size of stenosis and stenotic ratio compared with the other side), and clinical outcomes (preoperative PE and PTS) were retrospectively collected and reviewed by dividing into groups with or without TBIVS. Results Eight of the 35 patients with MTS had TBIVS. The group with TBIVS had a statistically significantly greater iliac vein size (P<0.001) and ratio (P=0.001). PE was more prevalent in the group with TBIVS (63% vs. 15%, P=0.007). However, no statistically significant intergroup difference in PTS prevalence was found. Conclusion The presence of mild iliac vein stenosis in MTS can be used to predict TBIVS and the requirement for more attention to PE.
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Affiliation(s)
- Heungman Jun
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
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Jun H, Hwang SH. Diagnostic performance of multidetector computed tomography for symptomatic lymphoceles in kidney transplant recipients. Korean J Transplant 2019; 33:30-35. [PMID: 35769147 PMCID: PMC9186869 DOI: 10.4285/jkstn.2019.33.2.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 05/08/2019] [Accepted: 05/10/2019] [Indexed: 11/04/2022] Open
Affiliation(s)
- Heungman Jun
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Sung Ho Hwang
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
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Jo HA, Han KH, So YK, Jun H, Han SY. Effect of Cinacalcet in Kidney Transplant Patients With Hyperparathyroidism. Transplant Proc 2019; 51:1397-1401. [PMID: 31155177 DOI: 10.1016/j.transproceed.2019.01.141] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 01/28/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE In dialysis patients, cinacalcet could be an effective alternative to parathyroidectomy for treating hyperparathyroidism. In the present study, we aimed to determine the characteristics of subjects with persistent hyperparathyroidism who require parathyroidectomy despite the use of cinacalcet. METHODS Nine kidney transplant patients (7 men, 2 women; mean age 53.2 [SD, 8.9] years) who had tertiary hyperparathyroidism were reviewed in a single center. Pre- and postcinacalcet levels of calcium, phosphorous, intact parathyroid hormone (iPTH), and renal function were analyzed to evaluate the effect of cinacalcet treatment in these patients. The baseline parameters before cinacalcet treatment were compared in patients who did and did not undergo parathyroidectomy. RESULTS Cinacalcet reduced serum calcium levels in all patients (11.48 [SD, 0.73] mg/dL to 10.20 [0.70] mg/dL; P = .008). Serum phosphorous levels significantly increased from 2.28 (SD, 0.77) mg/dL to 3.02 (SD, 0.65) mg/dL (P = .03). The iPTH levels in 7 patients decreased, while the mean level remained unchanged in total subjects. The iPTH levels increased even with cinacalcet treatment in 2 patients. In 3 patients, serum calcium levels abruptly increased after cinacalcet withdrawal. Five patients who showed persistent hypercalcemia due to hyperparathyroidism underwent parathyroidectomy. These 5 patients had significantly different characteristics compared with 4 patients who did not undergo parathyroidectomy: hypercalcemia (11.92 [SD, 0.68] mg/dL vs 10.93 [SD, 0.26] mg/dL; P = .02), hypophosphatemia (1.74 [SD, 0.36] mg/dL vs 2.95 [SD, 0.58] mg/dL; P = .03), and hyperparathyroidism (252.2 [SD, 131.4] pg/dL vs 101.5 [SD, 18.4] pg/dL; P = .02). CONCLUSION Cinacalcet reduced hypercalcemia due to hyperparathyroidism in the transplant patients. However, patients who had pre-existing higher iPTH, hypercalcemia, and hypophosphatemia needed parathyroidectomy. Therefore, cinacalcet could be considered an alternative to parathyroidectomy in selected patients.
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Affiliation(s)
- Hyung Ah Jo
- Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea
| | - Kum Hyun Han
- Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea
| | - Yoon Kyoung So
- Department of Otolaryngology-Head and Neck Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea
| | - Heungman Jun
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea
| | - Sang Youb Han
- Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea.
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31
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Cho JW, Choi JJ, Um E, Jung SM, Shin YC, Jung SW, Kim JI, Choi PW, Heo TG, Lee MS, Jun H. Clinical Manifestations of Superior Mesenteric Venous Thrombosis in the Era of Computed Tomography. Vasc Specialist Int 2019; 34:83-87. [PMID: 30671416 PMCID: PMC6340699 DOI: 10.5758/vsi.2018.34.4.83] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 07/09/2018] [Accepted: 09/11/2018] [Indexed: 12/15/2022] Open
Abstract
Purpose Thrombosis of the portal vein, known as pylephlebitis, is a rare and fatal complication caused by intraperitoneal infections. The disease progression of superior mesenteric venous thrombosis (SMVT) is not severe. This study aimed to determine the clinical features, etiology, and prognosis of SMVT. Materials and Methods We retrospectively reviewed the medical records of 41 patients with SMVT from March 2000 to February 2017. We obtained a list of 305 patients through the International Classification of Disease-9 code system and selected 41 patients with SMVT with computed tomography. Data from the medical records included patient demographics, comorbidities, review of system, laboratory results, clinical courses, and treatment modalities. Results The causes of SMVT were found to be intraperitoneal inflammation in 27 patients (65.9%), malignancy in 7 patients (17.1%), and unknown in 7 patients (17.1%). Among the patients with intraperitoneal inflammation, 14 presented with appendicitis (51.9%), 7 with diverticulitis (25.9%), and 2 with ileus (7.4%). When comparing patients with and without small bowel resection, the differences in symptom duration, bowel enhancement and blood culture were significant (P=0.010, P=0.039, and P=0.028, respectively). Conclusion SMVT, caused by intraperitoneal inflammation, unlike portal vein thrombosis including pylephlebitis, shows mild prognosis. In addition, rapid symptom progression and positive blood culture can be the prognostic factors related to extensive bowel resection. Use of appropriate antibiotics and understanding of disease progression can help improve the outcomes of patients with SMVT.
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Affiliation(s)
- Joon Whoi Cho
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | | | - Eunhae Um
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Sung Min Jung
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Yong Chan Shin
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Sung-Won Jung
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Jae Il Kim
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Pyong Wha Choi
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Tae Gil Heo
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Myung Soo Lee
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Heungman Jun
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
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Sacco P, Jun H, Hochheimer M, Kuerbis A, Moore A. SOCIODEMOGRAPHIC AND HEALTH RELATED CORRELATES OF PAST YEAR HELP SEEKING FOR ALCOHOL AND DRUG USE: DIFFERENCES BY AGE. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | | | - A Kuerbis
- Hunter College, City University of New York
| | - A Moore
- University of California-San Diego
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Lim M, Jun H. THE RELATIONSHIPS BETWEEN KOREAN ADULT CHILDREN’S OUTCOMES AND THEIR PARENTS’ PSYCHOLOGICAL WELLBEING. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Lim
- Department of Child and Famliy Studies, Yonsei University, Seoul, 03722, Korea
| | - H Jun
- Yonsei University, Seoul, Republic of Korea
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Song S, Jun H, Joo S. THE MODERATING EFFECT OF SELF-RATED HEALTH IN BETWEEN GRANDPARENTING AND DEPRESSIVE SYMPTOMS AMONG GRANDPARENTS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - H Jun
- Yonsei University, Seoul, Republic of Korea
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35
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Park H, Jun H, Joo S. THE EFFECT OF SIMILARITY IN GENDER ROLE ATTITUDE ON MARITAL SATISFACTION AMONG MIDDLE-AGED COUPLES. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - H Jun
- Yonsei University, Seoul, Republic of Korea
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36
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Lee S, Jun H, Joo S, Chai H, Sin N, Almeida D. THE INTERPLAY BETWEEN DAILY POSITIVE EVENTS AND DAILY STRESS SEVERITY ON INFLAMMATION IN ADULTHOOD. Innov Aging 2018. [DOI: 10.1093/geroni/igy031.3709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - H Jun
- . Yonsei University, Seoul, Republic of Korea
| | | | - H Chai
- The Pennsylvania State University
| | - N Sin
- University of British Columbia
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37
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Lee E, Jun H. GRANDPARENTING OF KOREAN GRANDMOTHERS AND THEIR DEPRESSIVE SYMPTOMS: USING PROPENSITY SCORE MATCHING. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - H Jun
- Yonsei University, Seoul, Republic of Korea
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38
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Lee K, Jun H, Joo S. THE EFFECTS OF MONETARY REWARDS FOR GRANDCHILD CARE ON THE MENTAL HEALTH OF GRANDPARENTS IN DIFFERENT INCOME CONTEXTS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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39
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Choi B, Jun H. THE ASSOCIATIONS OF LEISURE ACTIVITY AND HEALTH AMONG KOREAN BABY BOOMERS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- B Choi
- Yonsei University, Seoul, Seoul-t’ukpyolsi, Republic of Korea
| | - H Jun
- Child and Family Studies, Yonsei University, Seoul, Republic of Korea
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40
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Park H, Jun H, Joo S. THE EFFECT OF GRANDCHILD CARE ON SPOUSAL RELATIONSHIP SATISFACTION OF GRANDPARENTS: A COARSENED EXACT MATCHING. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | - H Jun
- Yonsei University, Seoul, Republic of Korea
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41
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Hwang JW, Jun H. Trends in endovascular aneurysm repair research: bibliometric analysis from 1994 to 2017. Ann Surg Treat Res 2018; 96:47-52. [PMID: 30746351 PMCID: PMC6358595 DOI: 10.4174/astr.2019.96.2.47] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 10/04/2018] [Accepted: 10/12/2018] [Indexed: 11/30/2022] Open
Abstract
Purpose Since endovascular aneurysm repair (EVAR) was first introduced in 1991, it has undergone rapid technical and quantitative developments. We analyzed the characteristics and trends of EVAR research through bibliometric analysis. Methods Comprehensive online searches focused on EVAR were performed from January 1994 to August 2017. The following information was collected: title, year of publication, countries' contribution, authorship, subspecialty, institution, subject category, and top 10 cited articles. Results A significant increase was demonstrated globally in the number of annual publications on EVAR. The highest number of publications was from the United States (n = 849, 35.08%), followed by England (n = 343, 14.17%), and the institutions with highest number of publications were Stanford University (n = 61, 2.52%) and Skane University Hospital Malmo (n = 45, 1.86%). The Journal of Vascular Surgery published approximately one quarter of the total publications. Vascular surgeons produced the most publications (n = 1871, 78.14%), followed by radiologists (n = 377, 15.58%) and cardiologists (n = 73, 3.02%). The most studied topics on EVAR were complications and procedures. The number of publications on complex EVAR and EVAR in juxtarenal aneurysm has increased more from 2013 to 2017 (5.1%, 9.5%) compared with from 1998 to 2002 (2.1%, 1.8%). Conclusion Our bibliometric analysis showed the characteristics and trends of publications on EVAR over a period of 25 years. The results of the bibliometric analysis revealed the quantitative improvements of publications and the qualitative improvements in challenging EVAR.
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Affiliation(s)
- Ji Woong Hwang
- Department of Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Heungman Jun
- Department of Surgery, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
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42
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Kim DI, Liao J, Emont MP, Park MJ, Jun H, Ramakrishnan SK, Lin JD, Shah YM, Omary MB, Wu J. An OLTAM system for analysis of brown/beige fat thermogenic activity. Int J Obes (Lond) 2018; 42:939-945. [PMID: 29359735 PMCID: PMC5962373 DOI: 10.1038/ijo.2017.308] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 10/12/2017] [Accepted: 11/22/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND/OBJECTIVES Thermogenic fat is present in humans and emerging evidence indicates that increasing the content and activity of these adipocytes may lead to weight loss and improved metabolic health. Multiple reporter systems have been developed to assay thermogenic fat activity based on the transcriptional and translational activation of Ucp1, the key molecule that mediates nonshivering thermogenesis. Our study aims to develop a much-needed tool to monitor thermogenic fat activity through a mechanism independent of Ucp1 regulation, therefore effectively assaying not only canonical β-adrenergic activation but also various non-UCP1-mediated thermogenic pathways that have been increasingly appreciated. METHODS We detected increased luciferase activity upon thermogenic activation in interscapular brown and inguinal subcutaneous fat in ODD-Luc mice, a hypoxia reporter mouse model. We then developed an OLTAM (ODD-Luc based Thermogenic Activity Measurement) system to assay thermogenic fat cell activity. RESULTS In both primary murine and human adipocytes and an immortalized adipose cell line that were transduced with the OLTAM system, luciferase activity can be readily measured and visualized by bioluminescence imaging in response to a variety of stimuli, including UCP1-independent thermogenic signaling. This system can offer a convenient method to assay thermogenic activity for both basic and translational research. CONCLUSIONS The OLTAM system offers a convenient way to measure of the activation of thermogenic fat and presents opportunities to discover novel signaling pathways and unknown compounds targeting metabolically active adipocytes to counteract human obesity.
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Affiliation(s)
- D-I Kim
- Life Sciences Institute, University of Michigan, Ann Arbor, MI, USA
| | - J Liao
- Life Sciences Institute, University of Michigan, Ann Arbor, MI, USA.,Department of Endocrinology and Metabolism, 2nd Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - M P Emont
- Life Sciences Institute, University of Michigan, Ann Arbor, MI, USA.,Department of Molecular & Integrative Physiology, University of Michigan, Ann Arbor, MI, USA
| | - M-J Park
- Department of Molecular & Integrative Physiology, University of Michigan, Ann Arbor, MI, USA
| | - H Jun
- Life Sciences Institute, University of Michigan, Ann Arbor, MI, USA
| | - S K Ramakrishnan
- Department of Molecular & Integrative Physiology, University of Michigan, Ann Arbor, MI, USA
| | - J D Lin
- Life Sciences Institute, University of Michigan, Ann Arbor, MI, USA.,Department of Cell & Developmental Biology, University of Michigan, Ann Arbor, MI, USA
| | - Y M Shah
- Department of Molecular & Integrative Physiology, University of Michigan, Ann Arbor, MI, USA
| | - M B Omary
- Department of Molecular & Integrative Physiology, University of Michigan, Ann Arbor, MI, USA
| | - J Wu
- Life Sciences Institute, University of Michigan, Ann Arbor, MI, USA.,Department of Molecular & Integrative Physiology, University of Michigan, Ann Arbor, MI, USA
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Song S, Lee E, Jun H, Lee K, Yoon D. THE EFFECTS OF EMPLOYMENT ON DEPRESSION AMONG OLDER ADULTS: MEDIATING ROLE OF SELF-EESTEEM. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S. Song
- Dep. of child and family studies, Yonsei University, Seoul, Korea (the Republic of)
| | - E. Lee
- Dep. of child and family studies, Yonsei University, Seoul, Korea (the Republic of)
| | - H. Jun
- Dep. of child and family studies, Yonsei University, Seoul, Korea (the Republic of)
| | - K. Lee
- Dep. of child and family studies, Yonsei University, Seoul, Korea (the Republic of)
| | - D. Yoon
- Dep. of child and family studies, Yonsei University, Seoul, Korea (the Republic of)
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44
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Hye Lim S, Jun H, Joo S, Kim S. AN EMPIRICAL TEST OF ROLE THEORY IN THE RELATIONSHIP BETWEEN WIDOWHOOD AND LIFE SATISFACTION. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S. Hye Lim
- Yonsei University, Seoul, Korea (the Republic of)
| | - H. Jun
- Yonsei University, Seoul, Korea (the Republic of)
| | - S. Joo
- Yonsei University, Seoul, Korea (the Republic of)
| | - S. Kim
- Yonsei University, Seoul, Korea (the Republic of)
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45
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Park H, Jun H, Joo S. THE PATTERN OF GENDER ROLE ATTITUDE AND MARITAL QUALITY AMONG MIDDLE-AGED KOREANS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- H. Park
- Child and Family Studies, Yonsei University, Seoul, Korea (the Republic of)
| | - H. Jun
- Child and Family Studies, Yonsei University, Seoul, Korea (the Republic of)
| | - S. Joo
- Child and Family Studies, Yonsei University, Seoul, Korea (the Republic of)
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46
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Joo S, Jun H, Bomi C. THE EFFECTS OF PHYSICAL LIMIT AND NEIGHBORHOOD COMPOSITION ON DEPRESSIVE SYMPTOMS IN LATER LIFE. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S. Joo
- Dept. of Child and Family Studies, Yonsei, Seoul, Korea (the Republic of)
| | - H. Jun
- Dept. of Child and Family Studies, Yonsei, Seoul, Korea (the Republic of)
| | - C. Bomi
- Dept. of Child and Family Studies, Yonsei, Seoul, Korea (the Republic of)
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47
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Jun H, Jung CW, Lim S, Kim MG. Kidney Donor Risk Index as the Predictor for the Short-term Clinical Outcomes After Kidney Transplant From Deceased Donor With Acute Kidney Injury. Transplant Proc 2017; 49:88-91. [PMID: 28104166 DOI: 10.1016/j.transproceed.2016.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The Kidney Donor Risk Index (KDRI) scoring system for deceased donors has been widely introduced for postoperative evaluation of graft function. We analyzed the usefulness of the KDRI in deceased donors with acute kidney injury (AKI). METHODS Forty-nine recipients from deceased donors with AKI between January 2009 and December 2014 were reviewed retrospectively. Data collected from donor medical records included age, height, weight, hypertension or diabetes history, cause of death, serum creatinine (sCr), and donation after cardiac death. Graft function data including sCr, estimated glomerular filtration rate (eGFR), and acute rejection episodes were monitored for 1 year. Correlations between KDRI score and factors indicating graft function were analyzed. A cutoff value for KDRI score was calculated using a receiver operating characteristic (ROC) curve for significant graft function. RESULTS The mean ages of donors and recipients were 46.81 ± 13.13 and 47.69 ± 11.43, respectively. The mean KDRI score was 1.24 ± 0.40. Univariable analysis of KDRI score and factors indicating graft function indicated that sCr at 6 to 12 months, eGFR at 1 year, and slow graft function (SGF) had statistical significance. The ROC curve of KDRI score for SGF showed an optimal cutoff value of 1.20, with sensitivity of 69.2% and specificity of 69.4% (area under the curve = 0.75) in deceased donors with AKI. CONCLUSIONS KDRI score in deceased donors with AKI was correlated with postoperative graft values including eGFR and SGF. KDRI could be used as a predictor for the short-term clinical outcome after kidney transplant from deceased donor with AKI.
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Affiliation(s)
- H Jun
- Department of Surgery, Korea University Anam Hospital, Seoul, Korea
| | - C W Jung
- Department of Surgery, Korea University Anam Hospital, Seoul, Korea.
| | - S Lim
- Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
| | - M G Kim
- Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
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48
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Jun H, Jung CW. Immunoglobulin G4-Related Inflammatory Abdominal Aortic Aneurysm Associated With Myasthenia Gravis, With Contained Rupture. Vasc Endovascular Surg 2017; 50:571-574. [DOI: 10.1177/1538574416678557] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Immunoglobulin (Ig) G4-related disease is reportedly among the various causes of inflammatory abdominal aortic aneurysm (IAAA). Many IgG4-related diseases are closely related to allergic constitution and autoimmune disease. We report a case of a 72-year-old man with IgG4-related IAAA associated with myasthenia gravis, with contained rupture.
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Affiliation(s)
- Heungman Jun
- Department of Surgery, Korea University Anam Hospital, Seoul, Korea
| | - Cheol Woong Jung
- Department of Surgery, Korea University Anam Hospital, Seoul, Korea
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49
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Kim JS, Jung CW, Jun H, Park KT. Hand-assisted Laparoscopic Donor Surgery for Living Donor Pancreas and Kidney Transplantation: A Single Center Experience. Korean J Transplant 2016. [DOI: 10.4285/jkstn.2016.30.4.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Jeong Sub Kim
- Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Cheol Woong Jung
- Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Heungman Jun
- Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Kwan-Tae Park
- Department of Surgery, National Medical University of Mongolia, Ulaanbaatar, Mongolia
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50
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Jun H, Hwang SH, Lim S, Kim MG, Jung CW. Evaluation of postoperative lymphocele according to amounts and symptoms by using 3-dimensional CT volumetry in kidney transplant recipients. Ann Surg Treat Res 2016; 91:133-8. [PMID: 27617254 PMCID: PMC5016603 DOI: 10.4174/astr.2016.91.3.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 05/23/2016] [Accepted: 05/30/2016] [Indexed: 12/05/2022] Open
Abstract
Purpose To analyze the risk factors for postoperative lymphocele, for predicting and preventing complications. Methods We evaluated 92 kidney transplant recipients with multidetector CT (MDCT) at 1-month posttransplantation. From admission and 1-month postoperative records, data including diabetes, dialysis type, immunosuppressant use, steroid pulse therapy, and transplantation side were collected. Lymphocele volume was measured with 3-dimensional reconstructed, nonenhanced MDCT at one month postoperatively. The correlations between risk factors and lymphocele volume and between risk factors and symptomatic lymphocele (SyL) were analyzed. The cutoff was calculated by using the receiver operating characteristic (ROC) curve for SyL volume. Results Among 92 recipients, the mean volume was 44.53 ± 176.43 cm3 and 12 had SyL. Univariable analysis between risk factors and lymphocele volume indicated that donor age, retransplantation, and inferiorly located lymphocele were statistically significant. The ROC curve for SyL showed that 33.20 cm3 was the cutoff, with 83.3% sensitivity and 93.7% specificity. On univariable analysis between risk factors and SyL, steroid pulse, inferiorly located lymphocele, and >33.20 cm3 were statistically significant. Multivariable analysis indicated that steroid pulse, >33.20 cm3, and serum creatinine level at one month were significant factors. Conclusion Risk factors including donor age, retransplantation, steroid pulse therapy, and inferiorly located lymphocele are important predictors of large lymphoceles or SyL. In high-risk recipients, careful monitoring of renal function and early image surveillance such as CT or ultrasound are recommended. If the asymptomatic lymphocele is >33.20 cm3 or located inferiorly, early interventions can be considered while carefully observing the changes in symptoms.
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Affiliation(s)
- Heungman Jun
- Department of Surgery, Korea University Anam Hospital, Seoul, Korea
| | - Sung Ho Hwang
- Department of Radiology, Korea University Anam Hospital, Seoul, Korea
| | - Sungyoon Lim
- Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Myung Gyu Kim
- Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Cheol Woong Jung
- Department of Surgery, Korea University Anam Hospital, Seoul, Korea.; Department of Surgery, Korea University College of Medicine, Seoul, Korea
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