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Bang HJ, Jeong WJ, Cha K, Oh SH, Park KN, Youn CS, Kim HJ, Lim JY, Kim HJ, Song H. A novel cardiac arrest severity score for the early prediction of hypoxic-ischemic brain injury and in-hospital death. Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.065] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Out-of-hospital cardiac arrest (OHCA) outcomes are unsatisfactory despite postcardiac arrest care. Early prediction of prognoses might help stratify patients and provide tailored therapy.
Purpose
In this study, we derived and validated a novel scoring system to predict hypoxic-ischaemic brain injury (HIBI) and in-hospital death (IHD).
Methods
We retrospectively analysed Korean Hypothermia Network prospective registry data collected from in Korea between 2015 and 2018. Patients without neuroprognostication data were excluded, and the remaining patients were randomly divided into derivation and validation cohorts. HIBI was defined when at least one prognostication predicted a poor outcome. IHD meant all deaths regardless of cause. In the derivation cohort, stepwise multivariate logistic regression was conducted for HIBI and IHD scores, and model performance was assessed. We then classified patients into four categories and analysed associations between the categories and cerebral performance categories (CPCs) at hospital discharge. Finally, we validated our models in the internal validation cohort.
Results
Among 1373 patients, 240 were excluded, and 1133 were randomised into derivation (n=754) and validation cohorts (n=379). In the derivation cohort, 7 and 8 predictors were selected for HIBI (0–8) and IHD scores (0–11), respectively, and the area under the curve (AUC) was 0.85 (95% CI 0.82–0.87) and 0.80 (95% CI 0.77–0.82), respectively. Applying optimum cutoff values of ≥6 points for HIBI and ≥7 points for IHD, patients were classified as follows: HIBI (-)/IHD (-), Category 1 (n=424); HIBI (-)/IHD (+), Category 2 (n=100); HIBI (+)/IHD (-), Category 3 (n=21); and HIBI (+)/IHD (+), Category 4 (n=209). CPCs at discharge were significantly different in each category (p<0.001). In the validation cohort, the model showed moderate discrimination (AUC 0.83, 95% CI 0.79–0.87 for HIBI and AUC 0.77, 95% CI 0.72–0.81 for IHD) with good calibration. Each category of the validation cohort showed a significant difference in discharge outcomes (p<0.001) and a similar trend to the derivation cohort.
Conclusions
We presented a novel approach for assessing illness severity after OHCA. Although external prospective studies are warranted, risk stratification for HIBI and IHD could help provide OHCA patients with appropriate treatment.
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Affiliation(s)
- H J Bang
- The Catholic University of Korea Seoul St. Mary's Hospital, Emergency medicine , Seoul , Korea (Republic of)
| | - W J Jeong
- St. Vincent's Hospital, Emergency medicine , Suwon , Korea (Democratic People's Republic of)
| | - K Cha
- St. Vincent's Hospital, Emergency medicine , Suwon , Korea (Democratic People's Republic of)
| | - S H Oh
- The Catholic University of Korea Seoul St. Mary's Hospital, Emergency medicine , Seoul , Korea (Republic of)
| | - K N Park
- The Catholic University of Korea Seoul St. Mary's Hospital, Emergency medicine , Seoul , Korea (Republic of)
| | - C S Youn
- The Catholic University of Korea Seoul St. Mary's Hospital, Emergency medicine , Seoul , Korea (Republic of)
| | - H J Kim
- The Catholic University of Korea Seoul St. Mary's Hospital, Emergency medicine , Seoul , Korea (Republic of)
| | - J Y Lim
- The Catholic University of Korea Seoul St. Mary's Hospital, Emergency medicine , Seoul , Korea (Republic of)
| | - H J Kim
- The Catholic University of Korea Seoul St. Mary's Hospital, Emergency medicine , Seoul , Korea (Republic of)
| | - H Song
- St. Vincent's Hospital, Emergency medicine , Suwon , Korea (Democratic People's Republic of)
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Lee SH, Kwun BD, Ryu J, Chung Y, Jeong WJ, Park CK, Lee KM, Kim EJ, Choi SK. Incidental Microaneurysms During Microvascular Surgery: Incidence, Treatment, and Significance. World Neurosurg 2019; 133:e149-e155. [PMID: 31476473 DOI: 10.1016/j.wneu.2019.08.159] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 08/21/2019] [Accepted: 08/23/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although new imaging tools have been developed for the detection of smaller aneurysms, angiographically negative microaneurysms are still encountered during cerebral microsurgery. Currently, only limited information regarding incidence and efficacy of treatment of these microaneurysms is available. METHODS We investigated the incidence and treatment of incidental microaneurysms (IMAs) in the last 5 years. IMAs are unidentifiable and invisible on preoperative angiography, but are detected during microvascular surgery. The inclusion criteria were aneurysm cases treated with microsurgery via transsylvian approaches, and those undergoing preoperative digital subtraction angiography. RESULTS This study enrolled 484 surgical cases (248 cases of subarachnoid hemorrhage and 236 cases of unruptured aneurysms) in 460 patients, and 33 tiny aneurysms were found in 31 operative cases (6.4% incidence per operation). The most typical type was located on another branching site of the middle cerebral artery found during neck clipping of the middle cerebral artery bifurcation aneurysm. A patient with multiple aneurysms presented a statistically significant risk (375/78 vs. 15/16; P < 0.001) of IMA identification. IMAs were treated by clipping and wrapping in 18 and 15 cases, respectively, without complications. CONCLUSIONS This study revealed a 6.4% incidence of IMAs; however, this could be underestimated because of the limited range of inspection. Early detection of an IMA through careful inspection during microvascular surgery could be beneficial, especially in patients with multiple aneurysms.
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Affiliation(s)
- Sung Ho Lee
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Byung Duk Kwun
- Department of Neurosurgery, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Jiwook Ryu
- Department of Neurosurgery, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Yeongu Chung
- Department of Neurosurgery, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea
| | - Won Joo Jeong
- Department of Neurosurgery, Osan Hankook Hospital, Osan, Korea
| | - Chang Kyu Park
- Department of Neurosurgery, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Kyung Mi Lee
- Department of Radiology, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Eui Jong Kim
- Department of Radiology, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Seok Keun Choi
- Department of Neurosurgery, College of Medicine, Kyung Hee University, Seoul, Korea.
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Oh TK, Heo E, Song IA, Jeong WJ, Han M, Bang JS. Increased Glucose Variability During Long-Term Therapeutic Hypothermia as a Predictor of Poor Neurological Outcomes and Mortality: A Retrospective Study. Ther Hypothermia Temp Manag 2019; 10:106-113. [PMID: 31161969 DOI: 10.1089/ther.2019.0004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Therapeutic hypothermia (TH) is considered as a treatment option in patients with stroke and brain injury for controlling intracranial pressure. A relatively longer duration of TH is required in such patients than in cardiac arrest patients. We aimed to investigate blood glucose parameters during TH that predict unfavorable neurological outcomes and mortality in patients admitted to the neurological or neurosurgical intensive care unit (ICU). This retrospective study evaluated electronic medical records of patients admitted to the ICU from January 1, 2012, to May 20, 2017. A total of 103 patients were included in the analyses. Multivariable analyses revealed that age and glycemic variability (GV) index were significantly associated with poor neurological outcomes (odds ratio [OR] 1.09, 95% confidence interval [CI] 1.03-1.15, p = 0.002, and OR 1.04, 95% CI 1.02-1.06, p < 0.001, respectively); furthermore, cumulative input-output balance, sequential organ failure assessment score, and glucose variability index were associated with 90-day mortality (hazard ratio [HR] 1.13, 95% CI 1.05-1.21, p < 0.001; HR 1.20, 95% CI 1.04-1.38, p = 0.010; and HR 1.01, 95% CI 1.01-1.02, p < 0.001, respectively). Receiver operating characteristic curve analyses of the GV index for prediction of 90-day mortality and poor neurological outcomes revealed that the areas under the curves were 0.747 (95% CI 0.65-0.85) and 0.826 (95% CI 0.75-0.91), respectively. In conclusion, variability in glucose levels may be valuable for predicting 90-day mortality and poor neurological outcomes in patients undergoing long-term TH.
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Affiliation(s)
- Tak Kyu Oh
- Interdepartment of Critical Care Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Eunjeong Heo
- Interdepartment of Critical Care Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Department of Pharmacy, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - In-Ae Song
- Interdepartment of Critical Care Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Won Joo Jeong
- Department of Neurosurgery, School of Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Moonku Han
- Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jae Seung Bang
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
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Kim YD, Bang JS, Lee SU, Jeong WJ, Kwon OK, Ban SP, Kim TK, Kim SB, Oh CW. Long-term outcomes of treatment for unruptured intracranial aneurysms in South Korea: clipping versus coiling. J Neurointerv Surg 2018; 10:1218-1222. [DOI: 10.1136/neurintsurg-2018-013757] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 03/23/2018] [Accepted: 04/03/2018] [Indexed: 11/04/2022]
Abstract
BackgroundThe long-term outcomes of endovascular coiling and surgical clipping for the treatment of unruptured intracranial aneurysms are unclear.MethodsWe performed a nationwide retrospective cohort study using claims data from the Korean Health Insurance Review and Assessment Service on patients undergoing surgical clipping or endovascular coiling from 2008 to 2014. Inverse probability treatment weighting for average treatment effect on the treated and the multiple imputation method were used to balance covariates and handle missing values. The primary outcome was all-cause mortality at 7 years.ResultsWe identified 26 411 patients of whom 11 777 underwent surgical clipping and 14 634 underwent endovascular coiling. After adjustment with the use of inverse probability treatment weighting for average treatment effect on the treated, all-cause mortality rates at 7 years were 3.8% in the endovascular coiling group and 3.6% in the surgical clipping group (HR 1.05; 95% CI 0.86 to 1.28; P=0.60, log-rank test). The adjusted probabilities of aneurysm rupture at 7 years were 0.9% after endovascular coiling and 0.7% after surgical clipping (HR 0.9; 95% CI 0.61 to 1.34; P=0.63, log-rank test). The probabilities of retreatment at 7 years after adjustment were 4.9% in the endovascular coiling group and 3.2% in the surgical clipping group (HR 1.52; 95% CI 1.28 to 1.81; P<0.001, log-rank test).ConclusionsAll-cause mortality at 7 years was similar between the elective surgical clipping and endovascular coiling groups in patients with unruptured aneurysms who had no history of subarachnoid hemorrhage due to aneurysm rupture.
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Jeong WJ, Bang JS, Yum KS, Lee S, Chung I, Kwon OK, Oh CW, Kim BJ, Bae HJ, Han MK. Radiologic Measurement of Brain Swelling in Patients with Large Hemispheric Infarctions During Targeted Temperature Management. Ther Hypothermia Temp Manag 2018; 8:136-142. [PMID: 29447082 DOI: 10.1089/ther.2017.0045] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Brain herniation is most often the result of severe brain swelling and can rapidly lead to death or brain death. We retrospectively identified radiologic indicators to evaluate the effects of targeted temperature management (TTM) on the extent of cerebral edema and determine the cutoff values that best predict TTM outcomes in patients with large hemispheric infarction. We retrospectively reviewed brain computed tomography (CT) scans of 21 patients with large hemispheric infarctions, who were treated with TTM. We excluded 4 patients whose CT scans were inadequate for evaluation, which left 17 patients. We divided the patients into success and failure groups. TTM failure was defined as death or the need for decompressive hemicraniectomy (DHC) after TTM. Infarction size was measured as the total restricted area in diffusion-weighted imaging that was performed on admission. CT scans were obtained on the first and second days after TTM initiation and then every 2 days. We measured septum pellucidum shifts (SPS) and pineal gland shifts (PGS) on CT scans. The median time from symptom onset to TTM initiation was 14.5 hours. Ten patients were successfully treated with TTM, six patients died, and one patient underwent a DHC. Initial infarction sizes were not significantly different between the success and failure groups (p = 0.529), but the SPS and PGS at 36-72 hours after TTM initiation were (mean SPS: 5.0 vs. 14.9 mm, p = 0.001; mean PGS: 2.3 vs. 7.9 mm, p = 0.001). The sensitivity and negative predictive value for TTM failure caused by cerebral edema (SPS ≥9.25 mm and PGS ≥3.70 mm) at 36-72 hours after TTM initiation were both 100%. The SPS and PGS on CT scans taken 36-72 hours after TTM initiation may help to estimate the effect of TTM on cerebral edema and guide further treatment.
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Affiliation(s)
- Won Joo Jeong
- 1 Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam, South Korea
| | - Jae Seung Bang
- 1 Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam, South Korea
| | - Kyu Sun Yum
- 2 Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam, South Korea
| | - Sangkil Lee
- 3 Department of Neurology, Chungbuck National University Hospital , Cheongju, South Korea
| | - Inyoung Chung
- 2 Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam, South Korea
| | - O-Ki Kwon
- 1 Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam, South Korea
| | - Chang Wan Oh
- 1 Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam, South Korea
| | - Beom Joon Kim
- 2 Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam, South Korea
| | - Hee-Joon Bae
- 2 Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam, South Korea
| | - Moon-Ku Han
- 2 Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam, South Korea
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Jeong WJ, So BH, Kim HM, Wee JH, Park JH, Choi SP, Woo SH. The clinical usefulness of initial serum procalcitonin as an aggravation predictor in a hepatobiliary tract infection at emergency department. Niger J Clin Pract 2018; 18:659-63. [PMID: 26096246 DOI: 10.4103/1119-3077.158973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND AND OBJECTIVES The ability to predict future clinical deterioration early in patients who present to an emergency care center with a hepatobiliary tract infection is difficult. We studied the clinical usefulness of the initial serum levels of procalcitonin in a hepatobiliary tract infection as an indicator for predicting aggravation in the early stages. METHODS Of the patients who presented with the clinical symptoms of a hepatobiliary tract infection, 99 were diagnosed with a hepatobiliary tract infection by imaging studies and subsequently enrolled in the study. Laboratory tests were obtained in the early stage of disease after presentation to an emergency care center. We assessed and compared the serum levels of many early inflammatory markers (white blood cell [WBC] counts, C-reactive protein and procalcitonin) between patients whose symptoms were initially stable upon arrival to an emergency care center but then deteriorated to, those whose symptoms remained consistently stable. Thus, we examined if the above serum markers are useful in predicting the possibility of future symptom aggravation. RESULTS Of a total of 99 patients, 27 were assigned to the symptom aggravation group. The serum levels of WBC counts and C-reactive protein in the aggravation group were elevated. However, the median value (interquartile range) of procalcitonin was relatively increased at 2.28 (0.41-7.84 ng/ml), demonstrating a significant difference. CONCLUSIONS In conclusion, initial serum levels of procalcitonin might be used as an indicator for aggravation in patients with hepatobiliary tract infection at the emergency department, even though there is hemodynamic stability.
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Affiliation(s)
| | - B H So
- Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, St. Vincent Hospital, Suwon, Korea
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Kang IG, Jeong WJ, Park CS, Ryu HS, Lee MJ, Park SS, Kim HJ. Hydrothorax Due to Extravasation of Intravenous Contrast after Power Injection through Right Subclavian Catheter. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791101800111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We report a case of hydrothorax after receiving intravenous (IV) contrast material by power injector through right subclavian central venous catheter (CVC) line. A 38-year-old woman presented to the local emergency department with hypotension after a pedestrian accident. After resuscitation, CVC was inserted into her right subclavian vein and fluid was administered well before computed tomography (CT) enhancement. Contrast-enhanced CT scan showed a large amount of extravasation of contrast material and fluid collection in the thoracic and pericardial cavities which was not shown in non-enhanced CT scan. During operation, vascular perforation was found in right subclavian vein. This case highlights that emergency physicians must keep in mind the possibility of vessel injury after CVC insertion and contrast material is preferably injected via peripheral IV access.
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Park CS, Kang IG, Heo SJ, Chae YS, Kim HJ, Park SS, Lee MJ, Jeong WJ. A Randomised, Cross over Study Using a Mannequin Model to Evaluate the Effects on CPR Quality of Real-Time Audio-Visual Feedback Provided by a Smartphone Application. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791402100304] [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: 11/17/2022] Open
Abstract
Objective To evaluate the effect of real time feedback provided by smartphone application on cardiopulmonary resuscitation (CPR) performance. Methods Participants were randomised in two groups based on whether chest compression with or without the assistance of the smartphone application. Both groups performed hands-only CPR on a mannequin for 4 minutes. Data on CPR performance of both groups was compared. To assess the reliability the feedback value, we compared the CPR data from Skillmeter and data from smartphone. A questionnaire survey to participants about the usefulness of the application was also evaluated. Results Twenty-one subjects were recruited for the study. We found no significant difference in mean chest compression rate (103.3±5.0/min vs. 107.1±1.7/min; p=0.133) and depth between the two groups (47.3 [39.3, 56.2] mm vs. 45.8 [40.3, 49.9] mm; p=0.085). The proportion of adequate compression depth over the total compression was significantly higher in the group using the smartphone (38.1% vs. 22.2%; p=0.034). The CPR data displayed on smartphone application in mannequin's chest was not different from Skillmeter software. The majority of the participants considered the application easy to use, but holding the smartphone during CPR hampered compression. Conclusions Real-time audio-visual feedback on CPR depth and rate using a smartphone application can help to maintain the adequate chest compression depth in prolonged CPR. A better method to hold the smartphone may maximise the feedback effect on CPR quality. (Hong Kong j.emerg.med. 2014;21:153-160)
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Affiliation(s)
- CS Park
- Konyang University Hospital, Department of Emergency Medicine, Republic of Korea
| | - IG Kang
- Konyang University Hospital, Department of Emergency Medicine, Republic of Korea
| | - SJ Heo
- Konyang University Hospital, Department of Emergency Medicine, Republic of Korea
| | - YS Chae
- Konyang University Hospital, Department of Emergency Medicine, Republic of Korea
| | - HJ Kim
- Konyang University Hospital, Department of Emergency Medicine, Republic of Korea
| | - SS Park
- Konyang University Hospital, Department of Emergency Medicine, Republic of Korea
| | - MJ Lee
- Kyungpook National University Hospital, Department of Emergency Medicine, Republic of Korea
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Yum KS, Chang JY, Jeong WJ, Lee S, Jeong JH, Yeo MJ, Hong JH, Park HK, Chung I, Kim BJ, Bang JS, Bae HJ, Han MK. Effect of statin on progression of symptomatic basilar artery stenosis and subsequent ischemic stroke. PLoS One 2017; 12:e0183798. [PMID: 29020008 PMCID: PMC5636063 DOI: 10.1371/journal.pone.0183798] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 08/13/2017] [Indexed: 11/18/2022] Open
Abstract
Background and objective Symptomatic basilar artery stenosis (BAS) is associated with high risk of ischemic stroke recurrence. We aimed to investigate whether statin therapy might prevent the progression of symptomatic BAS and stroke recurrence. Methods We retrospectively analyzed the data of patients with acute ischemia with symptomatic BAS, which was assessed using magnetic resonance angiogram (MRA) imaging on admission day, and 1 year later (or the day of the clinical event). The clinical endpoints were recurrent ischemic stroke and its composites, transient ischemic attack, coronary disease, and vascular death. Results Of the 153 patients with symptomatic BAS, 114 (74.5%) were treated with a statin after experiencing a stroke. Statin therapy significantly prevented the progression of symptomatic BAS (7.0% vs 28.2%) and induced regression (22.8% vs 15.4%) compared to non-statin users (p = 0.002). There were 31 ischemic stroke incidences and 38 composite vascular events. Statin users showed significantly lower stroke recurrence (14.9% vs 35.9%, p = 0.05) and composite vascular events (17.5% vs 46.2%; odds ratio [OR], 0.29; 95% confidence interval [CI], 0.13–0.64) than those not using statins did. Recurrent stroke in the basilar territory and composite vascular events were more common in patients with progression of BAS than they were in other patients (OR, 5.16; 95% CI, 1.63–16.25 vs OR, 4.2; 95% CI, 1.56–11.34). Conclusion Our study suggests that statin therapy may prevent the progression of symptomatic BAS and decrease the risk of subsequent ischemic stroke. Large randomized trials are needed to confirm this result.
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Affiliation(s)
- Kyu Sun Yum
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jun Young Chang
- Department of Neurology, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Won Joo Jeong
- Department of Critical Care, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sangkil Lee
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jin-Heon Jeong
- Department of Intensive Care Medicine and Neurology, Dong-A University Hospital, Busan, Korea
| | - Min-Ju Yeo
- Department of Neurology, Chungbuk National University Hospital, Chungju, Korea
| | - Jeong-Ho Hong
- Department of Neurology, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Hong-Kyun Park
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Inyoung Chung
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Beom Joon Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jae Seung Bang
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hee-Joon Bae
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Moon-Ku Han
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- * E-mail:
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Ahn HJ, Lee SJ, Park JK, Jun BG, Seo HI, Han KH, Kim YD, Jeong WJ, Cheon GJ. Catheter probe endoscopic ultrasonography by using cold lubricating jelly-filled method for esophageal subepithelial tumors. Dis Esophagus 2017; 30:1-6. [PMID: 28575248 DOI: 10.1093/dote/dox035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 03/29/2017] [Indexed: 12/11/2022]
Abstract
Catheter probe endoscopic ultrasonography (C-EUS) by ultrasonographic jelly-filled method has been used to evaluate esophageal subepithelial tumors (SETs). Ultrasonographic jelly is safe on the skin, but its internal safety has not been demonstrated. The jelly stored at room temperature is easily injected into the esophagus through the instrument channel of the endoscope. However, using jelly stored at room temperature remains problematic because the jelly is drained rapidly. We used cold lubricating jelly and an intravenous extension tube to resolve these problems. In this study, we evaluated the safety and efficacy of cold lubricating jelly-filled method. The medical records of patients who underwent C-EUS by using water or cold lubricating jelly-filled method for esophageal SETs from March 2013 to September 2016 in Gangneung Asan hospital were reviewed. Clinical characteristics and EUS findings were evaluated retrospectively. Image quality and procedure time between water and cold lubricating jelly-filled method were compared retrospectively. This study included 138 patients (74 males, 64 females) with esophageal SET with a mean age of 57.1 ± 11.1 years. Thirty-four patients had lesions in the upper esophagus, 58 patients had lesions in the middle esophagus, and 46 patients had lesions in the lower esophagus. The EUS diagnoses were leiomyoma (82.6%), hemangioma (4.3%), extrinsic compressive lesion (3.6%), granulosa cell tumor (2.9%), ectopic calcification (1.4%), cyst (1.4%), lipoma (0.7%), varix (0.7%), and inconclusive lesion (2.2%). The mean image score in the cold lubricating jelly filled-method group was higher than that in the water-filled method group (3.2 ± 0.7 vs. 2.8 ± 0.7, P = 0.002). The procedure time in the cold lubricating jelly filled-method group was shorter than that in the water-filled method group (10 minutes 27 seconds ± 4 minutes 22 seconds versus 13 minutes 20 seconds ± 6 minutes 20 seconds, P = 0.045). No procedure-related complication was observed. C-EUS using the cold lubricating jelly-filled method seems to provide better image quality and shorter procedure time compared with C-EUS using the water-filled method.
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Affiliation(s)
- H J Ahn
- Department of Internal Medicine, Gangneung Asan Hospital, Ulsan University College of Medicine, Gangneung, Korea
| | - S J Lee
- Department of Internal Medicine, Gangneung Asan Hospital, Ulsan University College of Medicine, Gangneung, Korea
| | - J K Park
- Department of Internal Medicine, Gangneung Asan Hospital, Ulsan University College of Medicine, Gangneung, Korea
| | - B G Jun
- Department of Internal Medicine, Gangneung Asan Hospital, Ulsan University College of Medicine, Gangneung, Korea
| | - H I Seo
- Department of Internal Medicine, Gangneung Asan Hospital, Ulsan University College of Medicine, Gangneung, Korea
| | - K H Han
- Department of Internal Medicine, Gangneung Asan Hospital, Ulsan University College of Medicine, Gangneung, Korea
| | - Y D Kim
- Department of Internal Medicine, Gangneung Asan Hospital, Ulsan University College of Medicine, Gangneung, Korea
| | - W J Jeong
- Department of Internal Medicine, Gangneung Asan Hospital, Ulsan University College of Medicine, Gangneung, Korea
| | - G J Cheon
- Department of Internal Medicine, Gangneung Asan Hospital, Ulsan University College of Medicine, Gangneung, Korea
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Chang JY, Han MK, BAE HJ, Yum KS, Lee SK, Jeong WJ, Park TH, Lee SJ, Lee KB, Lee J, Park JM, Choi JC, Kim DE, Kim JT, Cha JK, Lee BC, Lee J, Cho YJ, Hong KS, Kim WJ, Shin DI, Sohn SI. Abstract WP227: Association Of Anemia With Stroke Recurrence In Acute Ischemic Stroke: An Analysis From The Clinical Research Center For Stroke-5th Division Registry In Korea. Stroke 2017. [DOI: 10.1161/str.48.suppl_1.wp227] [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] [Indexed: 11/16/2022]
Abstract
Background:
We have evaluated whether anemia at admission is associated with ischemic stroke recurrence and composite outcome events (stroke, myocardial infarction, and vascular death) according to the age, presence of cerebral artery stenosis, stroke subtype, and initial severity of stroke.
Methods:
All 27145 patients with transient ischemia attack or acute ischemic stroke admitted between April 2008 and November 2014 from the stroke registry of the fifth section of the Clinical Research Center for Stroke (CRCS-5) were selected. The association between anemia and 1-year stroke recurrence, composite outcome events according to age, presence of cerebral artery stenosis, stroke mechanism, and initial severity of stroke were evaluated.
Results:
The cumulative 1-year stroke recurrence rate, composite outcome events were significantly higher in patients with anemia than without anemia ( 7.2% vs. 4.8%, p<0.01 for stroke recurrence, 11.8% vs.7.3%, p<0.01 for composite event). Anemia was still an independent predictor of 1-year stroke recurrence and composite vascular event after adjustment (adjusted HR 1.35, 95% CI 1.09-1.66, p<0.01 for stroke recurrence, adjusted HR 1.21, 95% CI 1.03-1.43, p=0.03 for composite outcome events). Anemia significantly increase the stroke recurrence risk in patients with mild to moderate neurological deficit (NIHSS <16, p for interaction=0.04), with stroke of other determined etiology (p for interaction=0.06). Anemia substantially increase the risk of composite outcome events in patients with mild to moderate stroke severity (NIHSS <16, HR 1.84, 95% CI 1.53-2.21, p for interaction<0.01), without cerebral artery stenosis ≥50% (HR 2.02, 95% CI 1.57-2.59, p for interaction=0.03), with stroke of small vessel occlusion (HR 2.74, 95% CI 1.34-5.63, p for interaction=0.09), and with stroke of other determined etiology (HR 2.95, 95% CI 1.69-5.14, p for interaction=0.02).
Conclusion:
Anemia is an independent predictor of 1-year ischemic stroke recurrence, composite outcome events of stroke, myocardial infarction, and vascular death. Our data suggests that more attention should be paid to the anemic patients with mild to moderate neurological deficit, small vessel occlusion subtype, and stroke of other determined etiology.
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Affiliation(s)
- Jun-Young Chang
- Gyeongsang National Univ Changwon Hosp, Changwon, Korea, Republic of
| | - Moon Ku Han
- Seoul National Univ Bundang Hosp, Seongnam, Korea, Republic of
| | - Hee-Jun BAE
- Seoul National Univ Bundang Hosp, Seongnam, Korea, Republic of
| | - Kyu Sun Yum
- Seoul National Univ Bundang Hosp, Seongnam, Korea, Republic of
| | - Sang Kil Lee
- Seoul National Univ Bundang Hosp, Seongnam, Korea, Republic of
| | - Won Joo Jeong
- Seoul National Univ Bundang Hosp, Seongnam, Korea, Republic of
| | | | - Soo Joo Lee
- Eulji Univ Hosp, Daejeon, Korea, Republic of
| | | | - Jun Lee
- Yeungnam Univ Hosp, Daegu, Korea, Republic of
| | | | | | - Dong-Eog Kim
- Dongguk Univ Ilsan Hosp, Ilsan, Korea, Republic of
| | - Joon-Tae Kim
- Chonnam National Univ Hosp, Gwangju, Korea, Republic of
| | | | - Byung-Chul Lee
- Hallym Univ Sacred Heart Hosp, Anyang, Korea, Republic of
| | - Juneyoung Lee
- Korea Univ College of Medicine, Seoul, Korea, Republic of
| | | | | | | | - Dong-Ick Shin
- Chungbuk National Univ Hosp, Cheongju, Korea, Republic of
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Jeong WJ, Yum KS, Lee S, Han MK. Abstract TP74: Therapeutic Benefit of Hypothermia After Decompressive Hemicraniectomy in Patients with Ischemic Stroke. Stroke 2017. [DOI: 10.1161/str.48.suppl_1.tp74] [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] [Indexed: 11/16/2022]
Abstract
Objective:
Several reports described a beneficial effect of both decompressive hemicraniectomy and therapeutic hypothermia in the management of intractable cerebral edema caused by ischemic stroke. We compared the clinical course and functional outcome in patient with ischemic stroke who were treated with a combination therapy with decompressive hemicraniectomy and therapeutic hypothermia of 33.5°C (DT) or received decompressive hemicraniectomy alone (DA), respectively.
Methods:
We retrospectively reviewed of subjects who were received decompressive hemicraniectomy secondary to ischemic stroke involving the middle cerebral artery, internal carotid artery, or both from 2004 to 2015. 26 patients were treated by DA and 10 patients received a combination of DT. functional outcome was assessed at 30 days and at 90 days.
Results:
Age, initial National institutes of Health Stroke Scale score, volume of cerebral infarction in diffusion weight imaging, risk factors for ischemic stroke were not significantly different between both groups. Median time from symptom onset to decompressive hemicraniectomy were not significantly different. Therapeutic hypothermia was induced after surgery and maintained. (median duration : 159.9 hours). The difference between presurgical and postsurgical midline shift of septum pellucidum and pineal gland in cranial computed tomography scans did not differ significantly between both groups. Duration of need for intensive care or for mechanical ventilation were not significantly different between both groups. There is a difference in mortality rate at 30 days (0% in DT group vs. 26.9% in DA group). The median modified Rankin Scale (mRS) score at 30 and 90 days were 5 and 4, respectively in both groups. Good functional outcome (mRS scores of 0-3) at 90days was observed in 10% of DT group and 5.9% in DA group.
Conclusion:
The present study suggests that a combination therapy of decompressive hemicraniectomy and therapeutic hypothermia improves mortality rate and functional outcome as compared with decompressive hemicraniectomy alone. The main limitation of this study include its retrospective single-center nature, which may limit generalizablility of the study
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Affiliation(s)
- Won Joo Jeong
- Dept of Interdisciplinary Care Medicine, Seoul National Univ Bundang Hosp, Seongnam, Korea, Republic of
| | - Kyu Sun Yum
- Dept of Neurology, Seoul National Univ Bundang Hosp, Seongnam, Korea, Republic of
| | - Sangkil Lee
- Dept of Interdisciplinary Care Medicine, Seoul National Univ Bundang Hosp, Seongnam, Korea, Republic of
| | - Moon-Ku Han
- Dept of Interdisciplinary Care Medicine, Seoul National Univ Bundang Hosp, Seongnam, Korea, Republic of
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Choi BJ, Jeong WJ, Lee IK, Lee SC. Single-port versus conventional three-port laparoscopic totally extraperitoneal inguinal hernia repair: a randomized controlled trial. Hernia 2016; 20:789-795. [PMID: 27142209 DOI: 10.1007/s10029-016-1499-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [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: 12/06/2015] [Accepted: 04/24/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Single-port laparoscopic surgery (SPLS) has been introduced for totally extraperitoneal (TEP) inguinal hernia repair. Clinically, however, the benefits of single-port TEP (SP TEP) are unclear. This study aimed to compare short-term surgical outcomes between SP TEP and conventional laparoscopic TEP(CL TEP) inguinal hernia repair. METHODS Between January 2013 and February 2015, 99 men with primary unilateral inguinal hernia were randomized to the single-port or conventional 3-port TEP procedures. The primary end point was postoperative pain. Secondary end points were complications, postoperative hospital stay, days to return to daily normal activities, cosmesis, and quality of life (QOL). RESULTS We randomized 50 patients to SP TEP and 49 to CL TEP repair. The SP TEP group patients had significantly lower pain scores (visual analog scale) 7 days postoperation (p = 0.017). However, there were no significant differences between the two groups in postoperative pain scores 24 h (p = 0.44) and 4 weeks (p = 0.677) after operation and analgesic requirements on the operation day (p = 0.303) and 7 days after the operation (p = 0.204). Operation time, postoperative hospital stay, and complications were comparable between the two groups. The days to return to daily normal activities, QOL, and cosmetic satisfaction were not different between the two groups. CONCLUSION The outcomes of SP TEP hernia repair for operation time and morbidities were comparable to CL TEP, and postoperative pain was lower at 7 days than in CL TEP hernia repair. The SP TEP technique can be recommended as an alternative treatment for inguinal hernia repair in experienced hands.
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Affiliation(s)
- B J Choi
- Department of Surgery, College of Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daeheung-ro 64, Jung-gu, Daejeon, 301-723, Republic of Korea
| | - W J Jeong
- Department of Surgery, College of Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daeheung-ro 64, Jung-gu, Daejeon, 301-723, Republic of Korea
| | - I K Lee
- Department of Surgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - S C Lee
- Department of Surgery, College of Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daeheung-ro 64, Jung-gu, Daejeon, 301-723, Republic of Korea.
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14
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Woo SH, Lee WJ, Seol SH, Kim DH, Wee JH, Choi SP, Jeong WJ, Oh SH, Kyong YY, Kim SW. Physician and nurse knowledge about patient radiation exposure in the emergency department. Niger J Clin Pract 2016; 19:502-7. [DOI: 10.4103/1119-3077.183298] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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15
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Lee YS, Lee JW, Lee J, Min NE, Park JE, Jung JW, Park DI, Kim KD, Ahn HJ, Choi JW, Park YH, Ryu S, Jeong WJ, Moon JY. The usefulness of modified national early warning score with the age level in critically ill medical patients. Intensive Care Med Exp 2015. [PMCID: PMC4797895 DOI: 10.1186/2197-425x-3-s1-a834] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Jeong WJ, Park JH, Lee EJ, Kim JH, Kim CJ, Cho YH. Efficacy and Safety of Fractionated Stereotactic Radiosurgery for Large Brain Metastases. J Korean Neurosurg Soc 2015; 58:217-24. [PMID: 26539264 PMCID: PMC4630352 DOI: 10.3340/jkns.2015.58.3.217] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [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: 03/27/2015] [Revised: 06/01/2015] [Accepted: 08/20/2015] [Indexed: 01/19/2023] Open
Abstract
Objective To investigate the efficacy and safety of fractionated stereotactic radiosurgery for large brain metastases (BMs). Methods Between June 2011 and December 2013, a total of 38 large BMs >3.0 cm in 37 patients were treated with fractionated Cyberknife radiosurgery. These patients comprised 16 men (43.2%) and 21 women, with a median age of 60 years (range, 38-75 years). BMs originated from the lung (n=19, 51.4%), the gastrointestinal tract (n=10, 27.0%), the breast (n=5, 13.5%), and other tissues (n=3, 8.1%). The median tumor volume was 17.6 cc (range, 9.4-49.6 cc). For Cyberknife treatment, a median peripheral dose of 35 Gy (range, 30-41 Gy) was delivered in 3 to 5 fractions. Results With a median follow-up of 10 months (range, 1-37 months), the crude local tumor control (LTC) rate was 86.8% and the estimated LTC rates at 12 and 24 months were 87.0% and 65.2%, respectively. The median overall survival (OS) and progression-free survival (PFS) rates were 16 and 11 months, respectively. The estimated OS and PFS rates at 6, 12, and 18 months were 81.1% and 65.5%, 56.8% and 44.9%, and 40.7% and 25.7%, respectively. Patient performance status and preoperative focal neurologic deficits improved in 20 of 35 (57.1%) and 12 of 17 patients (70.6%), respectively. Radiation necrosis with a toxicity grade of 2 or 3 occurred in 6 lesions (15.8%). Conclusion These results suggest a promising role of fractionated stereotactic radiosurgery in treating large BMs in terms of both efficacy and safety.
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Affiliation(s)
- Won Joo Jeong
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Hong Park
- Radiosurgery Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Jung Lee
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jeong Hoon Kim
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chang Jin Kim
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Hyun Cho
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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17
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Jeong WJ, Choi I, Seong HY, Roh SW. Thoracic Extradural Cavernous Hemangioma Mimicking a Dumbbell-Shaped Tumor. J Korean Neurosurg Soc 2015; 58:72-5. [PMID: 26279817 PMCID: PMC4534743 DOI: 10.3340/jkns.2015.58.1.72] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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: 05/18/2014] [Revised: 01/21/2015] [Accepted: 01/23/2015] [Indexed: 11/27/2022] Open
Abstract
Dumbbell-shaped spinal extradural cavernous hemangioma is rare. The differential diagnosis of dumbbell-shaped spinal tumors based on magnetic resonance imaging includes schwannoma and lymphoma. Here, we report a dumbbell-shaped spinal extradural cavernous hemangioma with intrathoracic growth on T2-3 in a 64-year-old man complaining of right side infrascapular area back pain with no neurologic deficit. The cavernous hemangioma was resected through combined video-assisted thoracoscopy and laminectomy without a fusion procedure. The patient had tolerable operative wound pain with no neurologic deficit after surgery. Based on magnetic resonance imaging findings and a review of the literature, we discuss cavernous hemangioma among the differential diagnosis of paravertebral dumbbell-shaped spinal tumors and the importance of complete resection.
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Affiliation(s)
- Won Joo Jeong
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Il Choi
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Han Yu Seong
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Woo Roh
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Kim HM, So BH, Jeong WJ, Choi SM, Park KN. The effectiveness of ultrasonography in verifying the placement of a nasogastric feeding tube in patients with low consciousness at an emergency center. Crit Ultrasound J 2014. [PMCID: PMC4101373 DOI: 10.1186/2036-7902-6-s1-a16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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19
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Jeong WJ, Cho SJ, Lee HS, Deb GK, Lee YS, Kwon TH, Kong IK. Effect of cytoplasmic lipid content on in vitro developmental efficiency of bovine IVP embryos. Theriogenology 2009; 72:584-9. [PMID: 19501898 DOI: 10.1016/j.theriogenology.2009.04.015] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2009] [Revised: 03/05/2009] [Accepted: 04/08/2009] [Indexed: 11/26/2022]
Abstract
The objective was to evaluate the effect of cytoplasmic lipid content on the embryonic developmental efficiency of bovine in vitro embryo production (IVP) embryos. Ovaries from Korean native cows (Bos taurus coreanae) were collected from a local abattoir, and cumulus-oocyte complexes (COCs) were recovered from follicles 2 to 8mm in diameter. The oocytes were divided into three groups, dependent on their cytoplasm color: pale color (PC), brown color (BC), and dark color (DC). The COCs were fertilized using frozen-thawed semen from a single Hanwoo bull. Based on measurement of the cytoplasmic color intensity of oocytes after 22h of in vitro maturation (IVM), the DC group had lower (P<0.05) color intensity than that in the BC and PC groups (56.3+/-2.7, 93.3+/-5.1, and 123.9+/-12.0, respectively). Based on MitoTracker Green FM staining, the number of mitochondria in the DC (170.1+/-31.2) group was significantly higher than that in the BC (137.5+/-30.8) and PC (105.5+/-25.3) groups. The cleavage rate in the DC (81.5%) group was also higher than that in the PC (50.4%) group (P<0.05), as was the development rate to blastocyst stage (18.9% vs. 9.8%). Finally, cell numbers of blastocysts in the DC (150.8+/-28.0) group were higher (P<0.05) than that in the BC (107.6+/-17.8) and PC (80.5+/-12.3) groups. In conclusion, cytoplasm color was a useful selection parameter for abattoir-derived oocytes destined for IVP.
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Affiliation(s)
- W J Jeong
- Division of Applied Life Science (BK21), Graduate School of Gyeongsang National University, Jinju 660-701, Republic of Korea
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20
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Hwang EI, Yun BS, Kim YK, Kwon BM, Kim HG, Lee HB, Jeong WJ, Kim SU. Phellinsin A, a novel chitin synthases inhibitor produced by Phellinus sp. PL3. J Antibiot (Tokyo) 2000; 53:903-11. [PMID: 11099223 DOI: 10.7164/antibiotics.53.903] [Citation(s) in RCA: 28] [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] [Indexed: 11/21/2022]
Abstract
Phellinsin A, a novel chitin synthases inhibitor was isolated from the cultured broth of fungus PL3, which was identified as Phellinus sp. PL3. Phellinsin A was purified by solvent partition, silica gel, ODS column chromatographies, and preparative HPLC, consecutively. The structure of phellinsin A was assigned as a phenolic compound on the basis of various spectroscopic analyses including UV, IR, Mass, and NMR. Its molecular weight and formula were found to be 358 and C18H14O8, respectively. Phellinsin A selectively inhibited chitin synthase I and II of Saccharomyces cerevisiae with an IC50 value of 76 and 28 microg/ml, respectively, in our cell free assay system. This compound showed antifungal activity against Colletotrichum lagenarium, Pyricularia oryzae, Rhizoctonia solani, Aspergillus fumigatus, and Trichophyton mentagrophytes.
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Affiliation(s)
- E I Hwang
- Antibiotics Research Lab, Korea Research Institute of Bioscience & Biotechnology, Yusung, Taejon
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Bae JM, Ahn MY, Harn CH, Jeong WJ, Jung M, Lim YP, Liu JR. Cloning and characterization of plastid ribosomal protein S16 gene from potato (Solanum tuberosum L. cv Désirée). Mol Cells 1998; 8:466-70. [PMID: 9749535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
The plastid ribosomal protein s16 (rps16) gene was cloned from potato (Solanum tuberosum L. ssp. tuberosum cv Desiree) by PCR amplification to obtain a new homologous recombination site of plastid transformation. The potato rps16 genomic clone was 1627 bp in size and the coding region was interrupted by an 859 bp intron. Exon I was 40 bp, encoding 13 amino acids and exon II was 227 bp, encoding a 76 amino acid polypeptide. The nucleotide sequence of the rps16 gene from the "Désirée" potato shared perfect identity with the sequence from the "Superior" potato in the coding region. Three nucleotide substitutions, two nucleotide insertions, and one nucleotide deletion were found between the intron sequence of both "Désirée" and "Superior" cultivars. The amino acid sequence of the potato rps16 gene showed a high level of identity with rice, maize, tobacco, and mustard (84-94%) and a relatively low level compared with Bacillus stearothermophilus and E. coli (27-28%). Expression of the rps16 gene was strong in chloroplasts and transcripts were detectable in amyloplasts, suggesting that the rps16 gene is active in nonphotosynthetic plastids as well as in photosynthetic plastids. These results indicate that the potato rps16 gene can be used as a new homologous recombination site of plastid transformation for potato cultivars.
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Affiliation(s)
- J M Bae
- Plant Cell and Molecular Biology Research Unit, Korea Research Institute of Bioscience & Biotechnology, Taejon
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Jeong WJ, Min SR, Liu JR. Somatic embryogenesis and plant regeneration in tissue cultures of radish (Raphanus sativus L.). Plant Cell Rep 1995; 14:648-651. [PMID: 24194314 DOI: 10.1007/bf00232731] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/1994] [Revised: 01/04/1995] [Indexed: 06/02/2023]
Abstract
Hypocotyl segments of 2- to 3-week-old radish (Raphanus sativus L. cv. F1 Handsome Fall) seedlings produced yellowish compact calli when cultured on Murashige and Skoog's (MS) medium supplemented with 1 mgl(-1) 2,4-dichlorophenoxyacetic acid (2,4-D). Upon transfer onto medium containing 6-benzyladenine and α-naphthaleneacetic acid, up to 5.3% of the calli gave rise to a few somatic embryos. When subcultured for 3 to 6 months, 7% of the yellowish, compact calli produced white, compact calli which formed numerous embryos. These calli maintained their embryogenic capacity for over 18 months. When cultured on medium containing 0.1 to 3 mgl(-1) 2,4-D, up to 90% of longitudinally sliced somatic embryo halves produced calli with numerous secondary embryos. Embryos were transferred onto medium containing 0.1 mgl(-1) 2,4-D and 1 mgl(-1) abscisic acid where they developed into the cotyledonary stage. Upon transfer onto half-strength MS basal medium, approximately 90% of the embryos developed into plantlets. These plantlets were successfully transplanted in potting soil and after cold treatment they were grown to maturity in a phytotron.
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Affiliation(s)
- W J Jeong
- Bioresources Research Group, Genetic Engineering Research Institute, KIST, P.O. Box 115, 305-600, Taedok Science Town, Taejon, Korea
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Ryoo YG, Chang YH, Choi GS, Jeong WJ, Kim JW, Joung NK, Oh YK, Lee BH, Rim SS, Kim YH. Hepatitis B viral markers in pregnant women and newborn infants in Korea. Korean J Intern Med 1987; 2:258-68. [PMID: 3154838 PMCID: PMC4534940 DOI: 10.3904/kjim.1987.2.2.258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
A study of the 5,284 pregnant women who delivered at St. Columban’s Hospital in Mokpo City between April 1, 1985 to June 30, 1987 was conducted to determine the presence of hepatitis B viral (HBV) markers in the mothers and infants and to evaluate their effects. Medical histories, physical examinations, liver function studies and the ELISA test for HBV markers were reviewed. The following results were obtained: 1. Of the 5,284 pregnant women, 448 (8.48%) were positive for HBsAg. Three hundred and thirty four women tested positive for HBsAg; 130 (38.92%) were HBeAg positive, 105 (31.44%) were HBeAg and anti-HBe negative, and 99 (29.64%) were anti-HBe positive. 2. Women positive for HBsAg exhibited a slight increase in toxemia (p<0.1), and no significant difference in postpartum hemorrhage (0.05< p <0.1) and the severity of hyper-emesis. 3. SGPT was significantly higher in HBeAg positive women than in HBeAg negative women (p<0.01), and it was significantly more elevated in both eclamptic and preeclamptic women than in normal pregnant women (p<0.005). 4. The frequency of congenital malformation, spontaneous abortion, infantile death and physiologic jaundice was increased in the newborns of chronic HBV carriers, while women with active hepatitis B experienced more premature births. 5. Mother to infant transmission of HBsAg and HBeAg was high in the HBeAg positive group (18.0%, 42.7%) respectively, but very low in the HBeAg negative group (7.8%, 0.0%). Mother to infant transmission of antibodies was in the order of anti-HBc (95.5%), anti-HBe (91.2%) and anti-HBs (75.0%). The effects of the HBV carrier state in pregnant women included increases in toxemia, postpartum hemorrhage, congenital malformations and premature births, however none of them were statistically significant. There was a significant difference in the elevation of SGPT between toxemic and normal pregnant women, and between HBeAg positive and HBeAg negative carrier women. The mother to infant transmission rate of HBeAg was more frequent than that of HBsAg.
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Abstract
The positive rates of hepatitis B viral markers according to many epidemiologic factors were analyzed in 2,873 pregnant women who delivered at St. Columban’s Hospital in Mokpo City from April 1st, 1985 to March 31st, 1986. The following results were obtained: The overall HBsAg positivity in all pregnant women was 8.3%. The positive rate of HBsAg was unrelated to age. It was 13.2% in the 11–20 year age group. 12.5% in the 31–40 year age group, 7.8% in the 21–30 year age group and 0.0% in the 41–50 year age group. The positive rate of HBsAg was slightly related to locality. It was a little higher in women who grew up in rural areas (8.6%) than in urban areas (7.7%). The positive rate of HBsAg was unrelated to educational background. The positive rate of HBsAg was unrelated to economic status. It was 8.7% in the highest income group and 8.6% in the lowest income group. The positive rate of HBsAg was higher in cases who had injections more than four times. The positive rate of HBsAg was higher, but not significantly, in cases who had received blood transfusion. The positive rate of HBsAg was higher, but not significantly, in cases who had more than three siblings (0.05
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