1.Paraplegia due to Spinal Epidermoid Cyst Rupture at Asthma Attack.
Kweon Young KIM ; Jung Hun KANG ; Dae Woo CHOI ; Min Hong LEE ; Jae Hyouk JANG
Annals of Rehabilitation Medicine 2013;37(2):274-279
Spinal epidermoid cyst is less than 1% of the entire spinal cord tumor and a rare tumor. It is a slowly proliferating benign tumor and can be a result of either congenital or acquired factors. In particular, reports of acute paraplegia due to spinal epidermoid cyst rupture are very rare. Since authors experienced paraplegia resulting from congenital spinal epidermoid cyst rupture during an asthma attack, it is reported with a review of literature.
Asthma
;
Epidermal Cyst
;
Paraplegia
;
Rupture
;
Spinal Cord Neoplasms
2.A Clinical Study of Intercostal Neuropathy after Rib Fracture.
Jung Hun KANG ; Seog Ki LEE ; Min Bum SEO ; Jeong Yeop NA ; Jae Hyouk JANG ; Kweon Young KIM
The Korean Journal of Thoracic and Cardiovascular Surgery 2010;43(1):53-57
BACKGROUND: The purpose of this study is to evaluate intercostal neuropathy after rib fracture and to determine the severity of intercostal neuropathy with using a numerical rating scale and according to the duration of pain and the body mass index. MATERIAL AND METHOD: We measured the positive sharp wave and fibrillation on the intercostal and paraspinal muscles in the thoracic region by performing needle electromyography in 47 patients who had intercostal neuralgia after rib fracture and who had needed daily analgesic for more than three months. RESULT: We diagnosed 11 cases as intercostal neuropathy among the 47 cases. Of the total 11 cases, 8 were male and 3 were female and they were most often of an active generation in the community. The common location of intercostal neuropathy was the intercostal space below the rib fracture and from the 7th to the 12th intercostal rib area. The incidence of intercostal neuropathy was significantly related with multiple rib fracture rather than single rib fracture. The symptoms observed were chest pain (90.9%), sensory change (81.8%), paresthesia and numbness (63.6%), back pain (27.2%) and muscle atrophy (18.2%). The numerical rating scale, the duration of pain and the body mass index showed no significant correlation with the severity of intercostal neuropathy. CONCLUSION: We concluded that the electrodiagnostic approach with considering the affecting factors and the clinical findings will be helpful for diagnosing and treating persistent intercostal neuralgic pain (more than 3 months) after rib fracture.
Back Pain
;
Body Mass Index
;
Chest Pain
;
Electromagnetic Phenomena
;
Electromyography
;
Female
;
Humans
;
Hypesthesia
;
Incidence
;
Intercostal Nerves
;
Male
;
Muscles
;
Muscular Atrophy
;
Needles
;
Neuralgia
;
Paresthesia
;
Rib Fractures
;
Ribs
3.Characteristics of Adult Severe Refractory Asthma in Korea Analyzed From the Severe Asthma Registry.
Min Hye KIM ; Sang Heon KIM ; So Young PARK ; Ga Young BAN ; Joo Hee KIM ; Jae Woo JUNG ; Ji Yong MOON ; Woo Jung SONG ; Hyouk Soo KWON ; Jae Woo KWON ; Jae Hyun LEE ; Hye Ryun KANG ; Jong Sook PARK ; Tae Bum KIM ; Heung Woo PARK ; Kwang Ha YOO ; Yeon Mok OH ; Young Il KOH ; An Soo JANG ; Byung Jae LEE ; Young Joo CHO ; Sang Heon CHO ; Hae Sim PARK ; Choon Sik PARK ; Ho Joo YOON ; You Sook CHO
Allergy, Asthma & Immunology Research 2019;11(1):43-54
PURPOSE: Although mild to moderate asthma is much more common, the morbidity and mortality of severe asthma are much higher. This study was performed to identify and analyze the clinical characteristics of severe asthma in Korea. METHODS: We registered patients with severe refractory asthma into the Severe Asthma Registry supported by the Severe Asthma Work Group of the Korean Academy of Asthma, Allergy and Clinical Immunology. Patients were enrolled since 2010 from the 15 university hospitals nationwide in Korea. Severe asthma was defined according to modified European Respiratory Society/American Thoracic Society criteria. Information on demographics, medical history, pulmonary function tests and skin prick tests was collected; the clinical characteristics of severe asthmatics were analyzed from the collected data. RESULTS: A total of 489 patients were enrolled with a mean age of 62.3; 45% are male. Sixty percent of patients received Global Initiative for Asthma step 4 treatment, and 30% received step 5 treatment. The most common comorbidities were allergic rhinitis (58.7%). Aspirin hypersensitivity was observed in 14.0%. Approximately half (53.9%) are non-smokers. Atopy was proven in 38.5% of the patients. Regarding asthma medications, inhaled corticosteroids and long-acting β-agonist combination inhalers were most commonly prescribed (96.5%), followed by leukotriene antagonists (71.0%). A recombinant anti-immunoglobulin E monoclonal antibody (omalizumab) has been used in 1.8% of the patients. The mean forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and FEV1/FVC were 78.7%, 67.5% and 67.9% of predicted values, respectively. The mean Asthma Control Test and quality of life questionnaire scores were 16.5 out of 25 and 59.5 out of 85, respectively. CONCLUSIONS: The baseline characteristics of severe asthma patients in the Korea Severe Asthma Registry were analyzed and reported for the first time. With this cohort, further prospective studies should be performed to search for ways to improve management of severe refractory asthma.
Adrenal Cortex Hormones
;
Adult*
;
Allergy and Immunology
;
Aspirin
;
Asthma*
;
Cohort Studies
;
Comorbidity
;
Demography
;
Forced Expiratory Volume
;
Hospitals, University
;
Humans
;
Hypersensitivity
;
Korea*
;
Leukotriene Antagonists
;
Male
;
Mortality
;
Nebulizers and Vaporizers
;
Prospective Studies
;
Quality of Life
;
Respiratory Function Tests
;
Rhinitis, Allergic
;
Skin
;
Vital Capacity
4.Perceptions of Severe Asthma and Asthma-COPD Overlap Syndrome Among Specialists: A Questionnaire Survey.
Sang Heon KIM ; Ji Yong MOON ; Jae Hyun LEE ; Ga Young BAN ; Sujeong KIM ; Mi Ae KIM ; Joo Hee KIM ; Min Hye KIM ; Chan Sun PARK ; So Young PARK ; Hyouk Soo KWON ; Jae Woo KWON ; Jae Woo JUNG ; Hye Ryun KANG ; Jong Sook PARK ; Tae Bum KIM ; Heung Woo PARK ; You Sook CHO ; Kwang Ha YOO ; Yeon Mok OH ; Byung Jae LEE ; An Soo JANG ; Sang Heon CHO ; Hae Sim PARK ; Choon Sik PARK ; Ho Joo YOON
Allergy, Asthma & Immunology Research 2018;10(3):225-235
PURPOSE: Severe asthma and asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) are difficult to control and are often associated with poor clinical outcomes. However, much is not understood regarding the diagnosis and treatment of severe asthma and ACOS. To evaluate the current perceptions of severe asthma and COPD among asthma and COPD specialists, we designed an e-mail and internet-based questionnaire survey. METHODS: Subjects were selected based on clinical specialty from among the members of the Korean Academy of Asthma, Allergy and Clinical Immunology and the Korean Academy of Tuberculosis and Respiratory Diseases. Of 432 subjects who received an e-mail invitation to the survey, 95 subjects, including 58 allergists and 37 pulmonologists, responded and submitted their answers online. RESULTS: The specialists estimated that the percentage of severe cases among total asthma patients in their practice was 13.9%±11.0%. Asthma aggravation by stepping down treatment was the most common subtype, followed by frequent exacerbation, uncontrolled asthma despite higher treatment steps, and serious exacerbation. ACOS was estimated to account for 20.7% of asthma, 38.0% of severe asthma, and 30.1% of COPD cases. A history of smoking, persistently low forced expiratory volume in 1 second (FEV1), and low FEV1 variation were most frequently classified as the major criteria for the diagnosis of ACOS among asthma patients. Among COPD patients, the highly selected major criteria for ACOS were high FEV1 variation, positive bronchodilator response, a personal history of allergies and positive airway hyperresponsiveness. Allergists and pulmonologists showed different assessments and opinions on asthma phenotyping, percentage, and diagnostic criteria for ACOS. CONCLUSIONS: Specialists had diverse perceptions and clinical practices regarding severe asthma and ACOS patients. This heterogeneity must be considered in future studies and strategy development for severe asthma and ACOS.
Allergy and Immunology
;
Asthma*
;
Diagnosis
;
Electronic Mail
;
Forced Expiratory Volume
;
Humans
;
Hypersensitivity
;
Lung Diseases, Obstructive
;
Population Characteristics
;
Pulmonary Disease, Chronic Obstructive
;
Smoke
;
Smoking
;
Specialization*
;
Tuberculosis
5.Design of Korean Noninvasive Risk Evaluation Study for Sudden Cardiac Death from Infarction or Heart Failure: Myocardial infarction study of K-REDEFINE registry.
Seung Jung PARK ; Gyo Seung HWANG ; Gi Byoung NAM ; Hyung Wook PARK ; Joong Wha CHUNG ; Seung Yong SHIN ; Sang Min KIM ; Jun Hyung KIM ; Young Soo LEE ; Yae Min PARK ; Jong Youn KIM ; Dae Hyeok KIM ; Dae Kyeong KIM ; June NAMGUNG ; Dae Hee SHIN ; Joon Hyouk CHOI ; Hyoung Seob PARK ; Jong Il CHOI ; Jin Seok KIM ; Tae Joon CHA ; Sang Weon PARK ; Jae Sun UHM ; Nam Ho KIM ; Minsoo AHN ; Dong Gu SHIN ; Nuri JANG ; Meemo PARK ; June Soo KIM
International Journal of Arrhythmia 2017;18(1):6-15
BACKGROUND AND OBJECTIVES: Despite significant advances in the treatment of acute myocardial infarction (MI), the prevention of sudden cardiac death (SCD), the most common mode of death in patients with MI, remains challenging. Furthermore, previous Korean MI registries did not address the issue of post-MI SCD. Additional risk stratifiers of post-MI SCD are still required to compensate for the limitation of using left ventricular ejection fraction to predict lethal arrhythmic events. SUBJECTS AND METHODS: We designed the first Korean prospective nationwide multicenter registry primarily focused on SCD; the Korean noninvasive Risk Evaluation study for sudden cardiac DEath From INfarction or heart failurE (K-REDEFINE). The registry consists of 2 groups of patients presenting with (1) acute MI or (2) acute heart failure (HF) at 25 tertiary referral cardiovascular centers. The primary endpoint of the MI group study of K-REDEFINE registry is the incidence and risk factors of post-MI SCD. In particular, the association between the risk of SCD and non-invasive Holter-based electrocardiogram (ECG) variables will be evaluated, such as T-wave alternans (marker of repolarization heterogeneity) and heart rate turbulence/variability (a marker of autonomic function). Other secondary study outcomes include atrioventricular arrhythmias, HF-related admission, repeated myocardial ischemic events, stroke, and overall deaths. CONCLUSION AND PERSPECTIVE: The K-REDEFINE registry will provide new prospects for the better management of MI patients with high risk of SCD by clarifying the burden and predictors of SCD and the clinical utility of various non-invasive ambulatory ECG-based variables in risk stratification for SCD in this patient population.
Arrhythmias, Cardiac
;
Death, Sudden, Cardiac*
;
Electrocardiography
;
Heart Failure*
;
Heart Rate
;
Heart*
;
Humans
;
Incidence
;
Infarction*
;
Myocardial Infarction*
;
Prospective Studies
;
Referral and Consultation
;
Registries
;
Risk Factors
;
Stroke
;
Stroke Volume
6.Design of Korean Noninvasive Risk Evaluation Study for Sudden Cardiac Death from Infarction or Heart Failure: Heart failure study of K-REDEFINE registry.
Seung Jung PARK ; Gyo Seung HWANG ; Gi Byoung NAM ; Hyung Wook PARK ; Joong Wha CHUNG ; Seung Yong SHIN ; Sang Min KIM ; Jun Hyung KIM ; Young Soo LEE ; Yae Min PARK ; Jong Youn KIM ; Dae Hyeok KIM ; Dae kyeong KIM ; June NAMGUNG ; Dae Hee SHIN ; Joon Hyouk CHOI ; Hyoung Seob PARK ; Jong Il CHOI ; Jin Seok KIM ; Tae Joon CHA ; Sang Weon PARK ; Jae Sun UHM ; Nam Ho KIM ; Minsoo AHN ; Dong Gu SHIN ; Nuri JANG ; Meemo PARK ; June Soo KIM
International Journal of Arrhythmia 2016;17(4):181-189
BACKGROUND AND OBJECTIVES: Sudden cardiac death (SCD) is one of the most common causes of death in patients with heart failure (HF). However, there are no available data on SCD in previous Korean HF registries. Additionally, although widely used, the utility of left ventricular (LV) ejection fraction (EF) in risk stratification for SCD is limited. SUBJECTS AND METHODS: The Korean non-invasive Risk Evaluation study for sudden cardiac DEath From INfarction or heart failurE (KREDEFINE) is the first Korean prospective, nationwide multicenter registry, primarily focused on SCD. The registry consists of 2 groups of patients presenting with (1) acute HF or (2) acute myocardial infarction (MI) at 25 tertiary referral cardiovascular centers. Using the HF-group data of the K-REDEFINE registry, the incidence and risk factors of SCD in patients with HF will be assessed. In particular, the efficacy of Holter-based ECG variables, such as T-wave alternans (marker of repolarization heterogeneity) and heart rate turbulence/ variability (maker of autonomic function), in risk stratification for SCD will be evaluated. Other cardiovascular outcomes will also be analyzed, including atrioventricular arrhythmias, HF-related admission, stroke, and overall deaths. CONCLUSION AND PERSPECTIVE: The K-REDEFINE registry will pave the way for better management of patients with HF at high risk of SCD by elucidating the burden and risk factors of SCD and the clinical utility of various non-invasive ambulatory ECG-based parameters in risk stratification for SCD in this patient population.
Arrhythmias, Cardiac
;
Cause of Death
;
Death, Sudden, Cardiac*
;
Electrocardiography
;
Heart Failure*
;
Heart Rate
;
Heart*
;
Humans
;
Incidence
;
Infarction*
;
Myocardial Infarction
;
Prospective Studies
;
Referral and Consultation
;
Registries
;
Risk Factors
;
Stroke
7.Comparison of Factors Associated With Direct Versus Transferred-in Admission to Government-Designated Regional Centers Between Acute Ischemic Stroke and Myocardial Infarction in Korea
Dae-Hyun KIM ; Seok-Joo MOON ; Juneyoung LEE ; Jae-Kwan CHA ; Moo Hyun KIM ; Jong-Sung PARK ; Byeolnim BAN ; Jihoon KANG ; Beom Joon KIM ; Won-Seok KIM ; Chang-Hwan YOON ; Heeyoung LEE ; Seongheon KIM ; Eun Kyoung KANG ; Ae-Young HER ; Cindy W YOON ; Joung-Ho RHA ; Seong-Ill WOO ; Won Kyung LEE ; Han-Young JUNG ; Jang Hoon LEE ; Hun Sik PARK ; Yang-Ha HWANG ; Keonyeop KIM ; Rock Bum KIM ; Nack-Cheon CHOI ; Jinyong HWANG ; Hyun-Woong PARK ; Ki Soo PARK ; SangHak YI ; Jae Young CHO ; Nam-Ho KIM ; Kang-Ho CHOI ; Juhan KIM ; Jae-Young HAN ; Jay Chol CHOI ; Song-Yi KIM ; Joon-Hyouk CHOI ; Jei KIM ; Min Kyun SOHN ; Si Wan CHOI ; Dong-Ick SHIN ; Sang Yeub LEE ; Jang-Whan BAE ; Kun Sei LEE ; Hee-Joon BAE
Journal of Korean Medical Science 2022;37(42):e305-
Background:
There has been no comparison of the determinants of admission route between acute ischemic stroke (AIS) and acute myocardial infarction (AMI). We examined whether factors associated with direct versus transferred-in admission to regional cardiocerebrovascular centers (RCVCs) differed between AIS and AMI.
Methods:
Using a nationwide RCVC registry, we identified consecutive patients presenting with AMI and AIS between July 2016 and December 2018. We explored factors associated with direct admission to RCVCs in patients with AIS and AMI and examined whether those associations differed between AIS and AMI, including interaction terms between each factor and disease type in multivariable models. To explore the influence of emergency medical service (EMS) paramedics on hospital selection, stratified analyses according to use of EMS were also performed.
Results:
Among the 17,897 and 8,927 AIS and AMI patients, 66.6% and 48.2% were directly admitted to RCVCs, respectively. Multivariable analysis showed that previous coronary heart disease, prehospital awareness, higher education level, and EMS use increased the odds of direct admission to RCVCs, but the odds ratio (OR) was different between AIS and AMI (for the first 3 factors, AMI > AIS; for EMS use, AMI < AIS). EMS use was the single most important factor for both AIS and AMI (OR, 4.72 vs. 3.90). Hypertension and hyperlipidemia increased, while living alone decreased the odds of direct admission only in AMI;additionally, age (65–74 years), previous stroke, and presentation during non-working hours increased the odds only in AIS. EMS use weakened the associations between direct admission and most factors in both AIS and AMI.
Conclusions
Various patient factors were differentially associated with direct admission to RCVCs between AIS and AMI. Public education for symptom awareness and use of EMS is essential in optimizing the transportation and hospitalization of patients with AMI and AIS.