1.Undiagnosed Traumatic Tricuspid Regurgitation Identified by Intraoperative Transesophageal Echocardiography.
Yun Yong JEONG ; Jonghwan MOON ; Sang Hyun LIM ; Yeo Jin KIM ; Hyoeun AHN ; Sung Yong PARK
Journal of Acute Care Surgery 2016;6(2):68-70
In the critically injuried and hemodynamically unstable patient, extended focused assessment with sonography for trauma (E-FAST) examination can be performed for a rapid assessment of peritoneal and/or pericardial fluid. We report a case of traumatic tricuspid regurgitation that was missed in the emergency department by E-FAST and identified by intraoperative transesophageal echocardiography.
Echocardiography
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Echocardiography, Transesophageal*
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Emergency Service, Hospital
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Humans
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Pericardial Fluid
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Thoracic Injuries
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Tricuspid Valve
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Tricuspid Valve Insufficiency*
2.POEMS Syndrome: Bone Marrow, Laboratory, and Clinical Findings in 24 Korean Patients
Hyoeun SHIM ; Chang Ahn SEOL ; Chan Jeoung PARK ; Young Uk CHO ; Eul Ju SEO ; Jung Hee LEE ; Dok Hyun YOON ; Cheol Won SUH ; Sang Hyuk PARK ; Seongsoo JANG
Annals of Laboratory Medicine 2019;39(6):561-565
POEMS syndrome is a rare paraneoplastic syndrome, which includes polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes due to plasma cell (PC) neoplasm. Diagnosis of this disease is challenging because of its rarity and complex clinical manifestations. We attempted to identify the key clinical features and characteristic bone marrow (BM) findings of POEMS syndrome, by reviewing the medical records and BM analyses of 24 Korean patients. Frequent clinical manifestations included polyneuropathy (100%), monoclonal gammopathy (100%), organomegaly (92%), extravascular volume overload (79%), and endocrinopathy (63%). The BM analyses revealed mild PC hyperplasia (median PCs: 5.5%) and frequent megakaryocytic hyperplasia (88%), megakaryocyte clusters (88%), and hyperlobation (100%). Flow cytometry of BM aspirates using CD138/CD38/CD45/CD19/CD56 showed normal (67%, 4/6) or neoplastic PC immunophenotypes (33%, 2/6). A diagnosis of POEMS syndrome must be considered when a patient suspected of having PC dyscrasia shows the above clinical presentation and BM findings.
Bone Marrow
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Diagnosis
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Flow Cytometry
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Humans
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Hyperplasia
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Medical Records
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Megakaryocytes
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Paraneoplastic Syndromes
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Paraproteinemias
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Plasma Cells
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POEMS Syndrome
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Polyneuropathies
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Skin
3.Lipid-Lowering Efficacy and Safety of a New Generic Rosuvastatin in Koreans: an 8-Week Randomized Comparative Study with a Proprietary Rosuvastatin
Hyoeun KIM ; Chan Joo LEE ; Donghoon CHOI ; Byeong-Keuk KIM ; In-Cheol KIM ; Jung-Sun KIM ; Chul-Min AHN ; Geu-Ru HONG ; In-Jeong CHO ; Chi-Young SHIM ; Sang-Hak LEE
Journal of Lipid and Atherosclerosis 2020;9(2):283-290
Objective:
The aim of this study was to investigate whether a new generic rosuvastatin is non-inferior to a proprietary one in terms of lipid-lowering efficacy. We also evaluated its non-lipid effects including adverse events.
Methods:
One-hundred and fifty-eight patients with cardiovascular risks requiring pharmacological lipid-lowering therapy were screened. After a 4-week run-in period, 126 individuals who met the lipid criteria for drug therapy were randomly assigned to receive the new generic or proprietary rosuvastatin 10 mg daily for 8 weeks. The primary outcome variables were low-density lipoprotein-cholesterol (LDL-C) reduction and LDL-C target achievement. Hematological and biochemical parameters and adverse events were assessed.
Results:
After 8 weeks of drug treatment, the mean percentage change in LDL-C was not different between the groups (−45.5%±19.9% and −45.1%±19.0% for generic and proprietary rosuvastatin, respectively; p=0.38). The LDL-C target achievement rate was similar between the groups (75.0% and 77.1% for generic and proprietary rosuvastatin, respectively; p=0.79). The percentage change in the other lipid profiles was not significantly different. Although generic- and proprietary rosuvastatins modestly affected creatine kinase and blood pressure, respectively, the changes were all within normal ranges. Incidence of adverse events did not differ between the receivers of the 2 formulations.
Conclusion
The new generic rosuvastatin was non-inferior to the proprietary rosuvastatin in terms of lipid-lowering efficacy. The rosuvastatin formulations did not exhibit clinically significant non-lipid effects with good safety profiles. Our study provides comprehensive data regarding 2 rosuvastatin formulations in East Asian subjects.
4.Coronary Artery Aneurysm after Second-Generation Drug-Eluting Stent Implantation
Sung Jin HONG ; Hyoeun KIM ; Chul Min AHN ; Jung Sun KIM ; Byeong Keuk KIM ; Young Guk KO ; Bum Kee HONG ; Donghoon CHOI ; Yangsoo JANG ; Myeong Ki HONG
Yonsei Medical Journal 2019;60(9):824-831
PURPOSE: We evaluated the incidence, predictors, and prognosis of coronary artery aneurysm (CAA) after second-generation drug-eluting stent (DES) implantation. MATERIALS AND METHODS: A total of 976 consecutive patients (1245 lesions) who underwent follow-up angiography after second-generation DES implantation were analyzed. Incidence and predictors of CAA were assessed, and clinical prognosis was compared with 34 cases of CAA after first-generation DES implantation using previous CAA registry data. RESULTS: All 10 cases of CAA (0.80% per lesion) in 10 patients (1.02% per patient) were detected at follow up. Compared to lesions without CAA, those with CAA had greater involvement of the proximal segment (90% vs. 51%, p=0.014), a higher proportion of pre-intervention, a Thrombolysis in Myocardial Infarction score of 0 or 1 flow (80% vs. 16%, p<0.001), more chronic total occlusions (40% vs. 10%, p<0.001), and longer implanted stents (41.9±23.2 mm vs. 28.8±14.8 mm, p=0.006). As for CAA morphology, instances of CAA after second-generation DES were predominantly the single fusiform type (90%), whereas instances of CAA after first-generation DES were multiple saccular (47%) and single saccular (35%) types (p<0.001). Myocardial infarction with stent thrombosis occurred in 5 patients with CAA after first-generation DES (15%), and no adverse events were observed in patients with CAA after second-generation DES over a median follow-up duration of 4.3 years (p=0.047, log-rank). CONCLUSION: Although CAAs after second-generation DES implantation were detected at a similar incidence to that for CAAs after first-generation DES implantation, second-generation DES-related CAAs had different morphologies and more benign clinical outcomes versus first-generation DES-related CAAs.
Aneurysm
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Angiography
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Coronary Artery Disease
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Coronary Vessels
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Drug-Eluting Stents
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Follow-Up Studies
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Humans
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Incidence
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Myocardial Infarction
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Percutaneous Coronary Intervention
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Prognosis
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Stents
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Thrombosis