1.Magnetic resonance angiographic screening of aneurysms in migraine
Minjung Oh ; Keon-Joo Lee ; Hyun Jung Oh ; Hyun Jung Park ; Jiyoung Shim ; Manho Kim
Neurology Asia 2014;19(2):171-177
Objective: The purpose of the present study was to screen the prevalence of aneurysms in migraineurs; to differentiate presenting features in migraineurs with and without aneurysm; and also to correlate the locations of aneurysm to the clinical features of migraine. Methods: A total of 4,416 subjects were interviewed and completed self-reported questionnaires on headache. Of these, 1,773 subjects diagnosed to have migraines based on the International Classification of Headache Disorders II (ICHD-II) criteria were screened for aneurysm by magnetic resonance angiography (MRA). When aneurysm was suspected, further investigation with trans femoral cerebral angiography (TFCA) or three dimensional computerized tomography (CT) angiography was performed. Based upon MRA findings, subjects were grouped into unruptured aneurysm migraine patients (UAMP) and no aneurysm migraine patients (NAMP). Results: The prevalence of aneurysm was 3.6% (63 of 1,773) with the mean age of 56.0 years, which were not different from those of general population. There was no difference in migraine subtypes between UAMP and NAMP. Aggravation of headache by estrogen replacement therapy during menopause (p=.039), history of migraine in young age (p= .021), diplopia (p=.026), and retroauricular pain (p=.025) were significantly associated with presence of aneurysm. Although aneurysms were detected more in anterior circulation, there was no correlation between aneurysm site and headache location. The average size of aneurysm was 3.5 ± 2.1 mm and none were ruptured. Interventional therapy of aneurysm did not alter the feature of migraine. Conclusions: The incidence of aneurysm was not different in migraine patients as compared to the general population. Some features which significantly differentiate whether migrainuers have aneurysm or not warrant further study to have a predictive and localizing value.
2.Meta-analysis for genome-wide association studies using case-control design: application and practice.
Sungryul SHIM ; Jiyoung KIM ; Wonguen JUNG ; In Soo SHIN ; Jong Myon BAE
Epidemiology and Health 2016;38(1):e2016058-
This review aimed to arrange the process of a systematic review of genome-wide association studies in order to practice and apply a genome-wide meta-analysis (GWMA). The process has a series of five steps: searching and selection, extraction of related information, evaluation of validity, meta-analysis by type of genetic model, and evaluation of heterogeneity. In contrast to intervention meta-analyses, GWMA has to evaluate the Hardy–Weinberg equilibrium (HWE) in the third step and conduct meta-analyses by five potential genetic models, including dominant, recessive, homozygote contrast, heterozygote contrast, and allelic contrast in the fourth step. The ‘genhwcci’ and ‘metan’ commands of STATA software evaluate the HWE and calculate a summary effect size, respectively. A meta-regression using the ‘metareg’ command of STATA should be conducted to evaluate related factors of heterogeneities.
Case-Control Studies*
;
Genome-Wide Association Study*
;
Heterozygote
;
Homozygote
;
Models, Genetic
;
Population Characteristics
3.Chemical Investigation on an Endophytic fungus Gibberella moniliformis JS1055 Derived from a Halophyte Vitex rotundifolia
Jung Wha KIM ; Jiyoung RYU ; Sang Hee SHIM
Natural Product Sciences 2018;24(3):189-193
Chemical investigation of the ethyl acetate extract of Gibberella moniliformis JS1055 endophytic fungus derived from a halophyte, Vitex rotundifolia, led to the isolation of nine compounds including 7-butyl-6,8-dihydroxy-3(R)-pent-11-enylisochroman-1-one (1), 7-butyl-6,8-dihydroxy-3(R)-pentylisochroman-1-one (2), 7-butyl-6,8-dihydroxy-3(R)-pentylisochroman-1-one (3), 5α,8α-epidioxyergosta-6,9(11),22-trien-3-ol (4), ergosterol peroxide (5), tetradecanoic acid (6), 8-O-methylfusarubin (7), nicotinic acid (8) and adenosine (9). They were identified by extensive spectroscopic data analysis including 1D, 2D (¹H-¹H COSY, HSQC, HMBC) NMR, and ESIMS. All the isolates (1
Adenosine
;
Ergosterol
;
Fungi
;
Gibberella
;
Moniliformis
;
Myristic Acid
;
Niacin
;
Salt-Tolerant Plants
;
Statistics as Topic
;
Vitex
4.Atypical Manifestation of Primary Hepatocellular Carcinoma and Hepatic Malignancy Mimicking Lesions
Jiyoung YOON ; So Hyun PARK ; Su Joa AHN ; Young Sup SHIM
Journal of the Korean Radiological Society 2022;83(4):808-829
Hepatocellular carcinoma (HCC) can be diagnosed noninvasively on multiphasic CT and MRI based on its distinctive imaging findings. These features include arterial phase hyperenhancement and washout on portal or delayed phase images. However, radiologists face significant diagnostic challenges because some HCCs exhibit atypical imaging characteristics. In addition to many HCC-mimicking lesions, such as arterioportal shunts, combined HCC-cholangiocarcinoma, intrahepatic cholangiocarcinoma, and hemangioma present a challenge for radiologists in actual clinical practice. The ability to distinguish HCCs from mimickers on initial imaging examinations is crucial for appropriate management and treatment decisions. Therefore, this pictorial review presents the imaging findings of atypical HCCs and HCCs mimicking malignant and benign lesions and discusses important clues that may help narrow down the differential diagnosis.
5.Prognostic Estimation of Advanced Heart Failure With Low Left Ventricular Ejection Fraction and Wide QRS Interval.
Changmyung OH ; Hyuk Jae CHANG ; Ji Min SUNG ; Ji Ye KIM ; Wooin YANG ; Jiyoung SHIM ; Seok Min KANG ; Jongwon HA ; Se Joong RIM ; Namsik CHUNG
Korean Circulation Journal 2012;42(10):659-667
BACKGROUND AND OBJECTIVES: Cardiac resynchronization therapy (CRT) has been known to improve the outcome of advanced heart failure (HF) but is still underutilized in clinical practice. We investigated the prognosis of patients with advanced HF who were suitable for CRT but were treated with conventional strategies. We also developed a risk model to predict mortality to improve the facilitation of CRT. SUBJECTS AND METHODS: Patients with symptomatic HF with left ventricular ejection fraction < or =35% and QRS interval >120 ms were consecutively enrolled at cardiovascular hospital. After excluding those patients who had received device therapy, 239 patients (160 males, mean 67+/-11 years) were eventually recruited. RESULTS: During a follow-up of 308+/-236 days, 56 (23%) patients died. Prior stroke, heart rate >90 bpm, serum Na < or =135 mEq/L, and serum creatinine > or =1.5 mg/dL were identified as independent factors using Cox proportional hazards regression. Based on the risk model, points were assigned to each of the risk factors proportional to the regression coefficient, and patients were stratified into three risk groups: low- (0), intermediate-(1-5), and high-risk (>5 points). The 2-year mortality rates of each risk group were 5, 31, and 64 percent, respectively. The C statistic of the risk model was 0.78, and the model was validated in a cohort from a different institution where the C statistic was 0.80. CONCLUSION: The mortality of patients with advanced HF who were managed conventionally was effectively stratified using a risk model. It may be useful for clinicians to be more proactive about adopting CRT to improve patient prognosis.
Cardiac Resynchronization Therapy
;
Cohort Studies
;
Creatinine
;
Follow-Up Studies
;
Heart
;
Heart Failure
;
Heart Rate
;
Humans
;
Male
;
Mustard Compounds
;
Prognosis
;
Risk Factors
;
Stroke
;
Stroke Volume
6.Total Arterial Off-Pump Coronary Revascularization with Multiple Y Arterial Composite Grafts.
Do kyun KIM ; Kyo Joon LEE ; Hyun Chul JOO ; Gyjong LI ; Jiyoung AHN ; Yunhee SHIM ; Kyung Jong YOO
The Korean Journal of Thoracic and Cardiovascular Surgery 2005;38(8):551-556
BACKGROUND: Complete arterial off-pump coronary artery bypass grafting (OPCAB) by sequential anastomoses with one or two arterial grafts provides favorable outcomes. However, problems of insufficient graft length, hypoperfusion, kinking of graft, and unfavorable course of graft may be encountered. To solve these problems, we have used different technique with multiple arterial Y composite graft to allow end-to-side rather than sequential anastomoses and evaluated the results of this method. MATERIAL AND METHOD: Between February 2003 and October 2004, 71 patients underwent total arterial OPCAB using multiple arterial Y composite grafts with left internal mammary artery (LIMA), radial artery (RA), and right internal mammary artery (RIMA). We divided RA into multiple segments by number of distal target site after measuring of individual proper length and constructed arterial composite graft. One of segments was sutured end-to-side to LIMA and other segment was sutured end-to-side to the previously constructed radial graft. Postoperative graft patency was evaluated in 61 patients by multi-slice computed tomography. RESULT: An average of 2.5+/-0.6 arteries and 3.7+/-0.7 distal anastomoses per patient were done. There was no perioperative myocardial infarction, clinical hypoperfusion syndromes, and operative mortality. Postoperative mean CK-MB level was 17.4+/-29.7 IU/L. Overall graft patency was 99.1% (214/216)(LIMA: 100%, RA: 98.4%, RIMA: 100%). CONCLUSION: This technique allows total arterial OPCAB without technical problems and provides excellent early clinical results and graft patency. We believe that this technique is more convenient in the obtuse marginal area compared to sequential technique, and helpful in patients who require complex arterial grafting.
Arteries
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Coronary Artery Bypass
;
Coronary Artery Bypass, Off-Pump
;
Humans
;
Mammary Arteries
;
Mortality
;
Myocardial Infarction
;
Radial Artery
;
Transplants*
7.Primary Malignant Melanoma of the Esophagus Treated by Early Diagnosis and Surgical Resection.
Jihyun LEE ; Ji Yoon KIM ; Ji Yun BAE ; Joo Young KIM ; Jung Eun CHOI ; Jiyoung JANG ; Chung Hyun TAE ; Ki Nam SHIM
The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2015;15(2):127-131
Primary malignant melanoma of the esophagus is an extremely rare disease and accounts for approximately 0.1~0.2% of all esophageal malignancies. It is also a very aggressive disease with 5 year survival rates ranging from 2.2% to 37.5%. A 51-year-old woman with no previous medical history visited the hospital complaining of mild epigastric discomfort and belching. Endoscopy revealed a dark pigmented, polypoid lesion which was later diagnosed as primary malignant melanoma of the esophagus. Here we report a case of primary malignant melanoma of the esophagus that was diagnosed in a very early phase and successfully resected with an Ivor-Lewis procedure.
Early Diagnosis*
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Endoscopy
;
Eructation
;
Esophagectomy
;
Esophagus*
;
Female
;
Humans
;
Melanoma*
;
Middle Aged
;
Rare Diseases
;
Survival Rate
8.Assessment of Left Ventricular Diastolic Pressures with Pulmonary Venous Flow and Transmitral Inflow by Doppler Echocardiography.
Dongsoo KIM ; Namsik CHUNG ; Se Joong RIM ; June KWON ; Hyuck Moon KWON ; Hyun Seung KIM ; Hyun Young PARK ; Jiyoung KIM ; Jong Won HA ; Yangsoo JANG ; Wonheum SHIM ; Seung Yun CHO ; Sungsoon KIM
Korean Circulation Journal 1997;27(3):312-317
BACKGROUND: Doppler variable of mitral inflow have been used to assess left ventricular siastolic function indirectly. Pulmonary venous flow(PVF) variables could supplement mitral inflow in the estimation of left ventricular diastolic function. The purpose of this study are to assess the feasibility of PVF measurement by using transthoracic pulsed wave Doppler echocardiogram and to estimate the LV end-diastolic pressure with PVF parameters. METHODS: Fifty six patients underwent transthoracic pulsed wave Doppler echocardiagraphy (HP Sonos 1500) within 2 hours before left heart catheterization for the measurement of left ventricular pressure. RESULTS: 1) Measurement of transthoracic PVF was feasible in 50 patients(89.3%). 2) The difference between the duration of pulmonary venous reversal flow and mitral A wave(D difference, delta D) was strongly correlated with left ventricular end diastolic pressure(r=0.73, p<0.01). PVF reversal duration exceeding that of mitral A wave predicted left ventricular end diastolic pressure > or =12mmHg(sensitivity 90.6%, specificity 50.0%). CONCLUSION: PVF could be assessed with transthoracic Doppler ultrasound with good feasibility. PVF may be an important parameter in the evaluation of left ventricular diastolic function. PVF reveral duration exceeding that of mitral A wave would be a marker of elevated left ventricular end diastolic pressure(> or =12mmHg). Plumonary venous flow . Transmitral inflow . Left ventricular end diastolic pressure. Transthorasic doppler echocardiography.
Blood Pressure
;
Cardiac Catheterization
;
Cardiac Catheters
;
Echocardiography, Doppler*
;
Humans
;
Sensitivity and Specificity
;
Ultrasonography
;
Ventricular Pressure
9.Gender Specific Differences in Prevalence and Risk Factors for Gastro-Esophageal Reflux Disease
Sang Yoon KIM ; Hye Kyung JUNG ; Jiyoung LIM ; Tae Oh KIM ; A Reum CHOE ; Chung Hyun TAE ; Ki Nam SHIM ; Chang Mo MOON ; Seong Eun KIM ; Sung Ae JUNG
Journal of Korean Medical Science 2019;34(21):e158-
BACKGROUND: Gender-related factors might play an important role in the development of reflux esophagitis (RE) and symptomatic gastro-esophageal reflux disease (GERD). We aimed to evaluate the prevalence and risk factors for RE and symptomatic GERD and determine whether gender specific differences exist. METHODS: This study was conducted on a health cohort consisting of 10,158 participants who underwent comprehensive health screening. Lifestyles and gastrointestinal symptoms were investigated using a self-reported structured questionnaire. Questionnaires about menstrual status were added for the women. RESULTS: The prevalence of RE in men was significantly higher than that in women (10.6% vs. 2.0%, P < 0.001); however, symptomatic GERD showed predominance in women (6.2% vs. 2.5%, P < 0.001). Although the prevalence of RE gradually increased with the duration of menopause stratified by decade (P = 0.007), that of symptomatic GERD rapidly increased across the menopausal transit in women. Apart from common risk factors of obesity and current smoking for RE, over 70 years of age in women and hiatal hernia and hypertriglyceridemia in men were significant risk factors. In symptomatic GERD, high somatization was a common risk factor. Excessive alcohol drinking was a significant risk factor in men, but not in women. CONCLUSION: This study showed a predominance of RE in men, but a predominance of symptomatic GERD in women. In women, dynamic increase in the prevalence of GERD is closely related to the menopause conditions and its duration. There are specific risk factors for RE and symptomatic GERD according to gender differences.
Alcohol Drinking
;
Cohort Studies
;
Esophagitis, Peptic
;
Female
;
Gastroesophageal Reflux
;
Hernia, Hiatal
;
Humans
;
Hypertriglyceridemia
;
Life Style
;
Male
;
Mass Screening
;
Menopause
;
Obesity
;
Prevalence
;
Risk Factors
;
Smoke
;
Smoking
10.A Collision Tumor of the Esophagus: Mixed Squamous Cell Carcinoma and Neuroendocrine Carcinoma
A Reum CHOE ; Ki-Nam SHIM ; Jiyoung LIM ; Eun Mi SONG ; Chung Hyun TAE ; Sung-Ae JUNG ; Min Sun JO
The Korean Journal of Gastroenterology 2020;75(4):207-211
Collision tumors are extremely rare, and currently, no therapeutic protocols are established. A 64-year-old man presented to his physician with complaints of right chest and abdominal pain. The contrast-enhanced CT scan showed a mass measuring 3.6 cm around the gastric fundus. Esophagogastroduodenoscopy was performed and a semicircular longitudinal ulcerative mass was found at the distal esophagus. A mass measuring about 4 cm with central ulceration was noted at the cardia. The esophageal biopsy revealed positivity for a component of neuroendocrine carcinoma adjacent to a squamous cell carcinoma. PET-CT revealed a mass in the esophagus and cardia and several tumors in the whole liver, pancreas, and bone. The patient was finally diagnosed with a collision tumor of the esophagus with multiple metastases. In conclusion, patients with collision tumors must undergo active multidisciplinary management that will include pathologists and oncologists, who will decide on proper treatment strategies.