1.Pulsed Intravenous Immunoglobulin Therapy in Livedo Vasculitis: Report of Two Cases.
Hee Jin BYUN ; Hyun Sun PARK ; Seong Uk MIN ; Hyo Seung SHIN ; Kapsok LI ; Chong Hyun WON ; Soyun CHO
Korean Journal of Dermatology 2006;44(10):1231-1234
Livedo vasculitis is a chronic dermatosis characterized by recurrent painful ulceration of the lower limbs, which heals to leave atrophie blanche. The precise pathophysiology is not known. Antiplatelet, anticoagulant, fibrinolytic therapies and anabolic steroids have been reported to be helpful in this syndrome. However, no consistent benefit has been demonstrated with any treatment modality. Recently, pulsed intravenous immunoglobulin therapy has been reported to be effective in some refractory cases. We herein report two cases of recalcitrant livedo vasculitis which were effectively treated with pulsed intravenous immunoglobulin therapy. These were the first trials carried out in Korea.
Immunization, Passive*
;
Immunoglobulins*
;
Korea
;
Lower Extremity
;
Skin Diseases
;
Steroids
;
Thrombolytic Therapy
;
Ulcer
;
Vasculitis*
2.Decision Making on the Non surgical, Surgical Treatment on Chronic Adult Periodontitis.
Si Eun SONG ; Seung Won LI ; Kyoo Sung CHO ; Jung Kiu CHAI ; Chong Kwan KIM
The Journal of the Korean Academy of Periodontology 1998;28(4):645-658
The purpose of this study was to make and ascertain a decision making process on the base of patient-oriented utilitarianism in the treatment of patients of chronic adult periodontitis. Fifty subjects were chosen in Yonsei Dental hospital and the other fifty were chosen in Severance dental hospital according to the selection criteria. Fifty four patients agreed in this study. NS group(N=32) was treated with scaling and root planing without any surgical intervention, the other S group(N=22) done with flap operation. During the active treatment and healing time, all patients of both groups were educated about the importance of oral hygiene and controlled every visit to the hospital. When periodontal treatment needed according to the diagnostic results, some patients were subjected to professional tooth cleaning and scaling once every 3 months according to an individually designed oral hygienic protocol. Probing depth was recorded on baseline and 18 months after treatments. A questionnaire composed of 6 kinds(hygienic easiness, hypersensitivity, post treatment comfort, complication, functional comfort, compliance) of questions was delivered to each patient to obtain the subjective evaluation regarding the results of therapy. The decision tree for the treatment of adult periodontal disease was made on the result of 2 kinds of periodontal treatment and patient's ubjective evaluation. The optimal path was calculated by using the success rate of the results as the probability and utility according to relative value and the economic value in the insurance system. The success rate to achieve the diagnostic goal of periodontal treatment as the remaining pocket depth less than 3mm and without BOP was 0.83+/-0.12 by non surgical treatment and 0.82+/-0.14 by surgical treatment without any statistically significant difference. The moderate success rate of more than 4mm probing pocket depth were 0.17 together. The utilities of non-surgical treatment results were 100 for a result with less than 3mm probing pocket depth, 80 for the other results with more than 4mm probing pocket depth, 0 for the extraction. Those of surgical treatment results were the same except 75 for the results with more than 4mm. The pooling results of subjective evaluation by using a questionnaire were 60% for satisfaction level and 40% for no satisfaction level in the patient group receiving non-surgical treatment and 33% and 67% in the other group receiving surgical treatment. The utilities for 4 satisfaction levels were 100, 75, 60, 50 on the base of that the patient would express the satisfaction level with normal distribution. The optimal path of periodontal treatment was rolled back by timing the utility on terminal node and the success rate, the distributed ratio of patient's satisfaction level. Both results of the calculation was non surgical treatment. Therefore, it can be said that non-surgical treatment may be the optimal path for this decision tree of treatment protocol if the goal of the periodontal treatment is to achieve the remaining probing pocket depth of less than 3mm for adult chronic periodontitis and if the utilitarian philosophy to maximise the expected utility for the patients is advocated.
Adult
;
Male
;
Female
;
Humans
3.The usefulness of non-invasive liver stiffness measurements in predicting clinically significant portal hypertension in cirrhotic patients: Korean data.
Won Ki HONG ; Moon Young KIM ; Soon Koo BAIK ; Seung Yong SHIN ; Jung Min KIM ; Yong Seok KANG ; Yoo Li LIM ; Young Ju KIM ; Youn Zoo CHO ; Hye Won HWANG ; Jin Hyung LEE ; Myeong Hun CHAE ; Hyoun A KIM ; Hye Won KANG ; Sang Ok KWON
Clinical and Molecular Hepatology 2013;19(4):370-375
BACKGROUND/AIMS: Liver stiffness measurement (LSM) has been proposed as a non-invasive method for estimating the severity of fibrosis and the complications of cirrhosis. Measurement of the hepatic venous pressure gradient (HVPG) is the gold standard for assessing the presence of portal hypertension, but its invasiveness limits its clinical application. In this study we evaluated the relationship between LSM and HVPG, and the predictive value of LSM for clinically significant portal hypertension (CSPH) and severe portal hypertension in cirrhosis. METHODS: LSM was performed with transient elastography in 59 consecutive cirrhotic patients who underwent hemodynamic HVPG investigations. CSPH and severe portal hypertension were defined as HVPG > or =10 and > or =12 mmHg, respectively. Linear regression analysis was performed to evaluate the relationship between LSM and HVPG. Diagnostic values were analyzed based on receiver operating characteristic (ROC) curves. RESULTS: A strong positive correlation between LSM and HVPG was observed in the overall population (r2=0.496, P<0.0001). The area under the ROC curve (AUROC) for the prediction of CSPH (HVPG > or =10 mmHg) was 0.851, and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for an LSM cutoff value of 21.95 kPa were 82.5%, 73.7%, 86.8%, and 66.7%, respectively. The AUROC at prediction of severe portal hypertension (HVPG > or =12 mmHg) was 0.877, and the sensitivity, specificity, PPV, and NPV at LSM cutoff value of 24.25 kPa were 82.9%, 70.8%, 80.6%, and 73.9%, respectively. CONCLUSIONS: LSM exhibited a significant correlation with HVPG in patients with cirrhosis. LSM could be a non-invasive method for predicting CSPH and severe portal hypertension in Korean patients with liver cirrhosis.
Adult
;
Aged
;
Alcohol-Related Disorders/complications
;
Area Under Curve
;
*Elasticity Imaging Techniques
;
Female
;
Hepatitis B/complications
;
Hepatitis C/complications
;
Humans
;
Hypertension, Portal/*complications/*diagnosis
;
Linear Models
;
Liver Cirrhosis/*complications/*diagnosis/pathology
;
Male
;
Middle Aged
;
ROC Curve
;
Republic of Korea
;
Sensitivity and Specificity
4.Troubleshooting Arterial-Phase MR Images of Gadoxetate Disodium-Enhanced Liver.
Jimi HUH ; So Yeon KIM ; Benjamin M YEH ; Seung Soo LEE ; Kyoung Won KIM ; En Haw WU ; Z Jane WANG ; Li Qin ZHAO ; Wei Chou CHANG
Korean Journal of Radiology 2015;16(6):1207-1215
Gadoxetate disodium is a widely used magnetic resonance (MR) contrast agent for liver MR imaging, and it provides both dynamic and hepatobiliary phase images. However, acquiring optimal arterial phase images at liver MR using gadoxetate disodium is more challenging than using conventional extracellular MR contrast agent because of the small volume administered, the gadolinium content of the agent, and the common occurrence of transient severe motion. In this article, we identify the challenges in obtaining high-quality arterial-phase images of gadoxetate disodium-enhanced liver MR imaging and present strategies for optimizing arterial-phase imaging based on the thorough review of recent research in this field.
Angiography
;
Arteries/anatomy & histology
;
Contrast Media/*chemistry
;
Gadolinium DTPA/*chemistry
;
Humans
;
Liver/*radiography
;
*Magnetic Resonance Imaging
5.Age-related Changes in Anterior, Posterior Corneal Astigmatism in a Korean Population.
Yoon Seob SIM ; Soon Won YANG ; Yu Li PARK ; Kyung Sun NA ; Hyun Seung KIM
Journal of the Korean Ophthalmological Society 2017;58(8):911-915
PURPOSE: To evaluate age-related changes in anterior and posterior corneal astigmatism in Koreans. METHODS: The anterior and posterior corneal astigmatisms of 160 subjects with age ranging from 11 to 92 years, none of whom experienced any complications, were measured with a rotating Scheimpflug camera (Pentacam®). Using this data, the changing proportions of with-the-rule to against-the-rule and changing tendency of anterior and posterior corneal astigmatisms with age were evaluated using polar value analysis according to the Naeser method. RESULTS: For the anterior cornea, the proportion of with-the-rule astigmatisms decreased with age (p < 0.0001). On the other hand, for the posterior cornea, the proportion of against-the-rule astigmatisms decreased with age (p = 0.012). In the polar value analysis, there was a trend toward against-the-rule astigmatism associated with increasing age for the anterior cornea (p < 0.0001) and toward with-the-rule astigmatism for the posterior cornea (p < 0.0001). CONCLUSIONS: In previous studies, the anterior corneal surface shifted from with-the-rule to against-the-rule astigmatism with increasing age, whereas the posterior corneal surface remained as against-the-rule astigmatism in most cases. But, our results showed that the proportion of against-the-rule astigmatisms of the posterior cornea decreased with age. Thus, evaluation of posterior corneal astigmatisms should be performed before cataract surgery in old patients, especially when using a multifocal or toric intraocular lens.
Astigmatism*
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Cataract
;
Cornea
;
Hand
;
Humans
;
Lenses, Intraocular
;
Methods
6.A Comprehensive Review of Coronavirus Disease 2019: Epidemiology, Transmission, Risk Factors, and International Responses
Han LI ; Seung Won BURM ; Sung Hwi HONG ; Ramy Abou GHAYDA ; Andreas KRONBICHLER ; Lee SMITH ; Ai KOYANAGI ; Louis JACOB ; Keum Hwa LEE ; Jae Il SHIN
Yonsei Medical Journal 2021;62(1):1-11
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a worldwide pandemic. The first reports of patients with COVID-19 were provided to World Health Organization on December 21, 2019 and were presumably associated with seafood markets in Wuhan, China. As of October 25, 2020, more than 42 million cases have been confirmed worldwide, with more than 1.1 million deaths. Asymptomatic transmission contributes significantly to transmission, and clinical features are non-specific to the disease. Thus, the diagnosis of COVID-19 requires specific viral RNA testing. The disease demonstrates extensive human-to-human transmissibility and has infected healthcare workers at high rates. Clinical awareness of the epidemiology and the risk factors for nosocomial transmission of COVID-19 is essential to preventing infection. Moreover, effective control measures should be further identified by comprehensive evaluation of hospital and community responses. In this review, we provide a comprehensive update on the epidemiology, presentation, transmission, risk factors, and public health measures associated with COVID-19. We also review past insights from previous coronavirus epidemics [i.e., severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS)] to suggest measures to reduce transmission.
7.Outcome of Canalith Repositioning Procedure in Patients with Persistent and Transient Geotropic Direction-Changing Positional Nystagmus: Short-term Follow-up Evaluation
Seung Sik JEON ; Sung Won LI ; Sung Kyun KIM ; Yong Bok KIM ; Il Seok PARK ; Seok Min HONG
Journal of the Korean Balance Society 2018;17(3):109-115
OBJECTIVES: Patients, who showed persistent geotropic-direction changing positional nystagmus (p-DCPN) tend to have different clinical manifestations from those who showed transient geotropic DCPN (t-DCPN). We investigated the clinical characteristics between p-DCPN and t-DCPN patients, and its recovery rate after canalith repositioning procedure (CRP). METHODS: Based on the duration of nystagmus, 117 geotropic DCPN patients were classified to 2 groups, p-DCPN and t-DCPN. Barbeque maneuver had been introduced towards the opposite direction of null plane for the p-DCPN patients, and to the opposite direction of stronger nystagmus for the t-DCPN patients. RESULTS: Seventy-four patients showed t-DCPN and 43 patients were classified to the p-DCPN cases. No p-DCPN patient showed prompt improvement after the 1st canalolith reposition therapy. Among the t-DCPN patients, 18 canal switch cases were found , but, there was no canal switch cases found among the p-DCPN The CRP has showed less effective for the p-DCPN patients than the t-DCPN patients (after the 1st CRP, 37 in 74 improved, p < 0.001). CONCLUSIONS: Due to its distinguishing clinical manifestation, p-DCPN may have different pathogenesis and clinical mechanisms from t-DCPN. And for the p-DCPN patients, the CRP seems not an efficient treatment compared to the t-DCPN patients. Further study with larger number of enrolled subjects is necessary.
Benign Paroxysmal Positional Vertigo
;
Follow-Up Studies
;
Humans
;
Nystagmus, Physiologic
8.Effects of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Criteria Changes for Schizophrenia on Diagnoses of First-Episode Schizophrenia Spectrum Disorders
WooRi CHO ; Sung-Wan KIM ; Seung-Hee WON ; Bong-Ju LEE ; Naohisa TSUJINO ; Youji TAKUBO ; Taiju YAMAGUCHI ; Takahiro NEMOTO ; Ling LI ; Thi-Hung LE ; Fatima Zahra RAMI ; Young-Chul CHUNG
Psychiatry Investigation 2025;22(2):212-217
Objective:
Impact of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) changes on the criteria for schizophrenia (SZ) has been reported to be minimal in previous studies. However, this could be different in first-episode schizophrenia spectrum disorders (FE-SSDs). We investigated what proportion of patients with FE-SSDs was diagnosed based on the sole presence of bizarre delusions (BDs) or first rank auditory hallucinations (FRAHs). Their alternative diagnosis by the DSM-5 was established and diagnostic stability over 1-year was identified.
Methods:
This was a retrospective review study on the medical records, case report forms for the subjects with FE-SSDs (n=404) participated in the Korea Early Psychosis Study. The two Japanese sites reviewed retrospectively only medical records of the subjects with FE-SSDs (n=103). We used three different definitions of BDs (strict, narrow, and broad) and specified subtypes of Other Specified Schizophrenia spectrum and Other psychotic disorders (OSSOs). To ensure inter-rater reliability between the hospitals, regular zoom meetings were held.
Results:
Forty (7.89%) subjects out of 507 were found to be diagnosed as SSDs based on the sole presence of BDs or FRAHs. All these patients met the criteria of OSSOs and were classified as having pure delusion (n=22), delusion with attenuated auditory hallucinations (AHs) (n=5), pure AHs (n=3) and AHs with attenuated delusion (n=10). The patients with first and second subtypes (n=27) were found to have BDs. The BDs fulfilled mostly strict definitions or satisfied the next broadest definition. The diagnostic stability of FE-OSSOs and its subgroups (first and second subtypes) over 1-year was substantially high (70.27% and 84% respectively).
Conclusion
These findings suggest that more rigorous diagnostic assessment should be performed especially to differentiate OSSOs from SZ in patients with FE-SSDs and more refined classification of the subtypes for OSSOs considered in the next DSM revision.
9.Effects of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Criteria Changes for Schizophrenia on Diagnoses of First-Episode Schizophrenia Spectrum Disorders
WooRi CHO ; Sung-Wan KIM ; Seung-Hee WON ; Bong-Ju LEE ; Naohisa TSUJINO ; Youji TAKUBO ; Taiju YAMAGUCHI ; Takahiro NEMOTO ; Ling LI ; Thi-Hung LE ; Fatima Zahra RAMI ; Young-Chul CHUNG
Psychiatry Investigation 2025;22(2):212-217
Objective:
Impact of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) changes on the criteria for schizophrenia (SZ) has been reported to be minimal in previous studies. However, this could be different in first-episode schizophrenia spectrum disorders (FE-SSDs). We investigated what proportion of patients with FE-SSDs was diagnosed based on the sole presence of bizarre delusions (BDs) or first rank auditory hallucinations (FRAHs). Their alternative diagnosis by the DSM-5 was established and diagnostic stability over 1-year was identified.
Methods:
This was a retrospective review study on the medical records, case report forms for the subjects with FE-SSDs (n=404) participated in the Korea Early Psychosis Study. The two Japanese sites reviewed retrospectively only medical records of the subjects with FE-SSDs (n=103). We used three different definitions of BDs (strict, narrow, and broad) and specified subtypes of Other Specified Schizophrenia spectrum and Other psychotic disorders (OSSOs). To ensure inter-rater reliability between the hospitals, regular zoom meetings were held.
Results:
Forty (7.89%) subjects out of 507 were found to be diagnosed as SSDs based on the sole presence of BDs or FRAHs. All these patients met the criteria of OSSOs and were classified as having pure delusion (n=22), delusion with attenuated auditory hallucinations (AHs) (n=5), pure AHs (n=3) and AHs with attenuated delusion (n=10). The patients with first and second subtypes (n=27) were found to have BDs. The BDs fulfilled mostly strict definitions or satisfied the next broadest definition. The diagnostic stability of FE-OSSOs and its subgroups (first and second subtypes) over 1-year was substantially high (70.27% and 84% respectively).
Conclusion
These findings suggest that more rigorous diagnostic assessment should be performed especially to differentiate OSSOs from SZ in patients with FE-SSDs and more refined classification of the subtypes for OSSOs considered in the next DSM revision.
10.Effects of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Criteria Changes for Schizophrenia on Diagnoses of First-Episode Schizophrenia Spectrum Disorders
WooRi CHO ; Sung-Wan KIM ; Seung-Hee WON ; Bong-Ju LEE ; Naohisa TSUJINO ; Youji TAKUBO ; Taiju YAMAGUCHI ; Takahiro NEMOTO ; Ling LI ; Thi-Hung LE ; Fatima Zahra RAMI ; Young-Chul CHUNG
Psychiatry Investigation 2025;22(2):212-217
Objective:
Impact of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) changes on the criteria for schizophrenia (SZ) has been reported to be minimal in previous studies. However, this could be different in first-episode schizophrenia spectrum disorders (FE-SSDs). We investigated what proportion of patients with FE-SSDs was diagnosed based on the sole presence of bizarre delusions (BDs) or first rank auditory hallucinations (FRAHs). Their alternative diagnosis by the DSM-5 was established and diagnostic stability over 1-year was identified.
Methods:
This was a retrospective review study on the medical records, case report forms for the subjects with FE-SSDs (n=404) participated in the Korea Early Psychosis Study. The two Japanese sites reviewed retrospectively only medical records of the subjects with FE-SSDs (n=103). We used three different definitions of BDs (strict, narrow, and broad) and specified subtypes of Other Specified Schizophrenia spectrum and Other psychotic disorders (OSSOs). To ensure inter-rater reliability between the hospitals, regular zoom meetings were held.
Results:
Forty (7.89%) subjects out of 507 were found to be diagnosed as SSDs based on the sole presence of BDs or FRAHs. All these patients met the criteria of OSSOs and were classified as having pure delusion (n=22), delusion with attenuated auditory hallucinations (AHs) (n=5), pure AHs (n=3) and AHs with attenuated delusion (n=10). The patients with first and second subtypes (n=27) were found to have BDs. The BDs fulfilled mostly strict definitions or satisfied the next broadest definition. The diagnostic stability of FE-OSSOs and its subgroups (first and second subtypes) over 1-year was substantially high (70.27% and 84% respectively).
Conclusion
These findings suggest that more rigorous diagnostic assessment should be performed especially to differentiate OSSOs from SZ in patients with FE-SSDs and more refined classification of the subtypes for OSSOs considered in the next DSM revision.