1.Endovascular Recanalization Therapy in Acute Ischemic Stroke: Updated Meta-analysis of Randomized Controlled Trials.
Keun Sik HONG ; Sang Bae KO ; Ji Sung LEE ; Kyung Ho YU ; Joung Ho RHA
Journal of Stroke 2015;17(3):268-281
BACKGROUND AND PURPOSE: Recent randomized clinical trials (RCTs) have demonstrated benefits of endovascular recanalization therapy (ERT) contrary to earlier trials. We aimed to estimate the benefits of ERT added to standard therapy in acute ischemic stroke. METHODS: From a literature search of RCTs testing ERT, we performed a meta-analysis to estimate an overall efficacy and safety of ERT for all trials, stent-retriever trials, and RCTs comparing ERT and intravenous tissue plasminogen activator (IV-TPA). RESULTS: We identified 15 relevant RCTs including 2,899 patients. For all trials, ERT was associated with increased good outcomes (odds ratio [OR] 1.79; 95% confidence interval [CI] 1.34, 2.40; P<0.001) compared to the control. ERT also increased no or minimal disability outcomes, good neurological recovery, good activity of daily living, and recanalization. ERT did not significantly increase symptomatic intracranial hemorrhage (SICH) (OR 1.19; 95% CI 0.83, 1.69; P=0.345) or death (OR 0.87; 95% CI 0.71, 1.05; P=0.151). In contrast, ERT significantly reduced extreme disability or death (OR 0.77; 95% CI 0.61, 0.97; P=0.025). Restricting to five stent-retriever trials comparing ERT plus IV-TPA vs. IV-TPA alone, the benefit was even greater for good outcome (OR 2.39; 95% CI 1.88, 3.04; P<0.001) and extreme disability or death (OR 0.57; 95% CI 0.41, 0.78; P=0.001). Restricting to eight RCTs comparing ERT (plus IV-TPA in six trials) with IV-TPA alone showed similar efficacy and safety. CONCLUSIONS: This updated meta-analysis shows that ERT substantially improves clinical outcomes and reduces extreme disability or death without significantly increasing SICH compared to standard therapy.
Humans
;
Intracranial Hemorrhages
;
Stroke*
;
Thrombectomy
;
Tissue Plasminogen Activator
2.The Differences of the Smoking Habit Between Emphysema and Chronic Bronchitis.
Yeung Chul MUN ; Sung Keun YU ; Hye Jung PARK ; Kyeong Cheol SHIN ; Jin Hong CHUNG ; Kwan Ho LEE ; Jung Cheol LEE
Tuberculosis and Respiratory Diseases 2001;50(6):693-703
BACKGROUND: Smoking is the most important and consistent determinant of the development and progression of COPD(Ed Note : Define COPD). The fact that cigarette smokers develop a different type of COPD, chronic bronchitis and emphysema, with different clinical and pathological aspects, suggests that the development of COPD has a relationship with other smoking-associated factors beyoud just a simple smoking history. The aim of this was to analyze the smoking habits and history of patients with COPD and to evaluate the development of different types of COPD accordint to patient's smoking habits. METHOD: To evaluate the differences in the smoking patterens of patients with chronic bronchitis and emphysema, a pulmonary function test was conducted, and the smoking history and patterns was obtained through a smoking history questionnaire by a direct personal interview from 333 male cigarette smokers diagnosed with COPD, in the Yeungnam university medical center(190 patients diagnosed with chronic bronchitis, 143 patients diagnosed with emphysema). RESULT: The patients with emphysema smoked earlier and had a higher smoking history(ie, more pachyears, more total amounts of smoked cigarette, and more deep inhalation and longer duration of plain cigarette exposure) than those with chronic bronchitis. The depth of ingalation was also significantly higher in the emphysema patients after taking into account age, cumulative cagarette consumption and the type of cigarette smoked. CONCLUSION: Emphysema was more associated with the increasing degree of inhalation as assessed by the depth of inhalation. A high alveolar smoke exposure may be a significant risk factor for the development of emphysema.
Bronchitis, Chronic*
;
Emphysema*
;
Humans
;
Inhalation
;
Male
;
Pulmonary Disease, Chronic Obstructive
;
Respiratory Function Tests
;
Risk Factors
;
Smoke*
;
Smoking*
;
Tobacco Products
3.A Case of Nonfunctioning Paraganglioma of the Posterior Mediastinum.
Young Chul MUN ; Sung Keun YU ; Hye Jung PARK ; Kyeong Cheol SHIN ; Choong Ki LEE ; Jin Hong CHUNG ; Kwan Ho LEE ; Mee Jin KIM ; Jung Cheul LEE
Yeungnam University Journal of Medicine 2000;17(2):155-160
Paraganglioma is a tumor from the extra adrenal paraganglion system and is rarely observed in the mediastinum. The authors experienced a case of nonfunctioning paraganglioma of the posterior mediastinum. The patient was 34-years-old male in whom abnormal mass lesion was nites in chest radiograph with hemoptysis. His blood pressure and serologic examination were within normal range upon admission to our hospital. Chest CT revealed a tumor in the left lower lobe. Diagnostic thoracoscopy was performed and diagnosed a posterior mediastinal mass. Surgical resection was them performed. Posterior mediastinal mass was removed successfully and histological examination of the surgical specimen diagnosed paraganglioma. He received radiotherapy after surgery and was followed up. Related literature are reviewed.
Blood Pressure
;
Hemoptysis
;
Humans
;
Male
;
Mediastinum*
;
Paraganglioma*
;
Radiography, Thoracic
;
Radiotherapy
;
Reference Values
;
Thoracoscopy
;
Tomography, X-Ray Computed
4.A Case of Obstructive Sleep Apnea Syndrome Associated with Primary Hypothyroidism and Dilated Cardiomyopathy.
Sung Keun YU ; Ji Young PARK ; Jong Hae PACK ; Hye Jung PARK ; Kyeong Cheol SHIN ; Jin Hong CHUNG ; Kwan Ho LEE
Tuberculosis and Respiratory Diseases 2001;51(6):590-596
The hallmarks of sleep apnea syndrome include daytime hypersomnolence, snoring, obesity, disturbed nocturnal sleep, and apneic episodes. Thyroid deficiency states are now a well recognized cause of sleep apnea. Central, obstructive, and mixed patterns of sleep apnea may be observed in hypothyroidism. A 33-yr-old man was admitted complaining of daytime hypersomnolence, snoring, sleep apnea and obesity. A polysomnogram showed obstructive pattern of sleep apnea syndrome. Physical examination and hormonal study revealed a narrowing of the upper airway and primary hypothyroidism. Dilated cardiomyopathy was diagnosed by echocardiogram. The poctients was treated for obstructive sleep apnea syndrome with nasal continuous positive airway pressure(CPAP) for 2 months and the underlying hypothyroidism with thyroid hormone therapy. This successfully controlled the snoring, sleep apnea, and other apnea-related symptoms. Here, we describe our experience of nasal CPAP and thyroid hormone therapy in a patient with primary hypothyroidism associated with obstructive sleep apnea syndrome and dilated cardimyopathy with review of the relevant literature.
Cardiomyopathies
;
Cardiomyopathy, Dilated*
;
Disorders of Excessive Somnolence
;
Humans
;
Hypothyroidism*
;
Obesity
;
Physical Examination
;
Polysomnography
;
Sleep Apnea Syndromes
;
Sleep Apnea, Obstructive*
;
Snoring
;
Thyroid Gland
5.The Differences in Resting Pulmonary Function in Relation to the Nutritional status of Patients with Chronic Obstructive Pulmonary Disease.
Yeung Chul MUN ; Sung Keun YU ; Hye Jung PARK ; Jong Won PARK ; Kyeong Cheol SHIN ; Jin Hong CHUNG ; Kwan Ho LEE ; Jung Soon KIM
Tuberculosis and Respiratory Diseases 2001;51(6):570-578
BACKGROUND: With cases of chronic obstructive pulmonary disease(COPD), weight loss and low body weight have been found to correlate with increased mortality and poor prognosis. Therefore, nutritional aspects are an important part of the treatment in cases of COPD. In Korea, there is only limited data available for the changes of resting pulmonary function in relation to nutritional status. This study was carried out to investigated the differences of resting pulmonary function in relation to the nutritional status of patients with COPD. METHOD: 83 stable patients, with moderate to severe COPD, were clinically assessed for their nutritional status and resting pulmonary function. The patients' nutritional status was evaluated by body weight and fat-free mass (FFM), which was assessed by bioelectrical impedance analysis. According to their nutritional status, the 83 patients were divided into two groups, designated as the depleted, and non-depleted, groups. RESULT: Of the 83 patients, 31% were characterized by body weight loss and depletion of FFM, whereas 28% had either weight loss or depleted FFM. In the depleted group, significantly lower peak expiratory flow rate(p<0.05) and Kco(p<0.01), but significantly higher airway resistance(Raw, p<0.05) were noted. There was no difference for the non-depleted group in forced expiratory volume at one second, residual volume, inspiratory vital capacity, or total lung capacity. Maximal inspiratory pressure(PImax) was also significantly lower in the depleted group(p<0.05). CONCLUSION: We conclude, from our clinical studies, that nutritional depletion is significantly associated with the change in resting pulmonary function for patients with moderate to severe COPD.
Body Weight
;
Electric Impedance
;
Forced Expiratory Volume
;
Humans
;
Korea
;
Mortality
;
Nutritional Status*
;
Prognosis
;
Pulmonary Disease, Chronic Obstructive*
;
Residual Volume
;
Total Lung Capacity
;
Vital Capacity
;
Weight Loss
6.Surgical Outcome of Patients with Ischemic Cardiomyopathy Selected by the Results of Myocardial Viability by Preoperative F-18 FDG PET.
Jae Sung KIM ; Dong Soo LEE ; Suk Keun HONG ; Young Tak LEE ; Yu Kyeong KIM ; Youn Jung KIM ; Keon Sik MOON ; Tae Kyoung WON ; Hweung Kon HWANG
Korean Journal of Nuclear Medicine 2000;34(4):276-284
PURPOSE: We investigated the operative outcome after bypass surgery in patients selected using viability criteria on F-18 FDG PET. MATERALS AND METHODS: Rest-24hr delay redistribution imaging of Tl-201 SPECT and F-18 FDG PET were performed in 11 patients. Seven of these 11 patients (6 men, 1 woman) were evaluated to have viable myocardium by F-18 FDG PET. Changes in symptoms and left ventricular ejection fraction (LVEF) after operation were evaluated. RESULTS: In seven of 11 patients, a significant amount of viable myocardium was found on F-18 FDG PET and Tl-201 SPECT. Severity of both chest pain and dyspnea improved markedly in all patients. Mean LVEF improved from 22% to 32%. CONCLUSION: F-18 FDG PET could be used to select the patients who will benefit from coronary artery bypass surgery.
Cardiomyopathies*
;
Chest Pain
;
Coronary Artery Bypass
;
Dyspnea
;
Humans
;
Male
;
Myocardium
;
Positron-Emission Tomography
;
Stroke Volume
;
Tomography, Emission-Computed, Single-Photon
7.Fracture strength of the IPS empress crown: The effect of occlusal using depth and axial inclination on lower first molar.
Sung Hoon KIM ; Jin Han LEE ; Yu Lee KIM ; Jin Keun DONG
The Journal of Korean Academy of Prosthodontics 2003;41(1):48-60
The purpose of this study was to compare the fracture strength of the IPS Empress ceramic crown according to the occlusal depth (1.5mm, 2.0mm, 2.5mm) and axial inclination (4degree, 8degree, 12degree) of the lower First Molar. After 10 metal dies were made for each group, the IPS Empress ceramic crowns were fabricated and cemented with resin cement(Bistite resin cement, Tokuyama Soda Co. LTD., Japan). The cemented crowns were mounted on the testing jig with inclination of 30 degrees and the universal testing machine(Zwick Z020, Zwick, Germany)was used to measure the fracture strength. The results of this study were as follows : 1. The fracture strength of the ceramic crown with 2.5mm depth and 12degree inclination was the highest (1789 N). Crowns of 1.5 mm depth and 4degree inclination had the lowest strength (1091 N). 2. There were no significant differences in the fracture strength by axial inclination of the same occlusal depth group. 3. Most fracture lines began at the loading area and extended through proximal surface perpendicular to the margin, irrespective of occlusal depth. Size of fragment was affected by the amount of occlusal reduction.
Ceramics
;
Crowns*
;
Molar*
;
Resin Cements
8.Analysis of LHbeta Exon 3 (Gly102Ser) Gene Mutation in Infertile Patients with Endometriosis and Polycystic Ovary Syndrome (PCOS).
Nam Keun KIM ; Eu Gene LEE ; Min Soon CHO ; Yoon Sung NAM ; Hyung Min CHUNG ; Ki Wha CHUNG ; Yu Kyoung OH ; Jung Jae KO ; Kwang Yul CHA
Korean Journal of Fertility and Sterility 2000;27(3):291-294
No abstract available.
Endometriosis*
;
Exons*
;
Female
;
Humans
;
Polycystic Ovary Syndrome*
9.Limited Open Repair Technique of Achilles Tendon Ruptures: Operative Technique and Early Results.
Keun Bae LEE ; Yu Bok PARK ; Byung Soo KIM ; Jin CHOI ; Sung Taek JUNG
Journal of Korean Foot and Ankle Society 2006;10(1):37-41
PURPOSE: To investigate the early results of limited open repair technique of Achilles tendon ruptures, and to describe the surgical technique. MATERIALS AND METHODS: From October 2004 to February 2005, a total of 10 patients with Achilles tendon rupture underwent limited open repair. The average age of the patients was 39.3 years, and the average follow-up period was 9 months. The causes of injury were sports injuries in 8 cases, and slip down in 2. The mean interval between the injury and the operation was 9 days. The clinical results were assessed by patient's satisfaction, incision length, hospitalization, the ankle-hindfoot scale of American Foot and Ankle Society (AOFAS), and complications. RESULTS: Of 10 patients, 8 were very satisfied, and the remaining 2 were satisfied. The mean incision length was 2.0 cm, and the mean hospitalization was 2 days. The mean AOFAS score was 97 points, and there was no complications such as infection, rerupture, or nerve injury. All patients returned to work at approximately 2 months, and resumed light exercise such as jogging at approximately 3 months. CONCLUSION: Limited open repair technique of Achilles tendon ruptures is provided for better cosmetic results, high patient's satisfaction, and functionally successful results without postoperative complications.
Achilles Tendon*
;
Ankle
;
Athletic Injuries
;
Follow-Up Studies
;
Foot
;
Hospitalization
;
Humans
;
Jogging
;
Postoperative Complications
;
Rupture*
10.A Case of Isolated Choroidal Cystic Lesion With Good Visual Acuity.
Jae Keun JEOUNG ; Yoon Jung CHO ; Hyeong Gon YU ; Sung Pyo PARK
Journal of the Korean Ophthalmological Society 2009;50(11):1740-1744
PURPOSE: To report a case of isolated choroidal cystic lesion in the macula with no interval change for two years. CASE SUMMARY: A 29-year-old woman who had suspicious maculopathy was referred to our clinic. Her best corrected visual acuity was 20/20 in the affected right eye, which showed a choroidal cystic lesion on a fundus exam, fluorescein angiography, USG and OCT. The multifocal ERG showed reduced amplitudes of the cystic area in the right eye, and SLO microperimetry revealed reduced retinal sensitivity in the cystic lesion as well as a stable fixation and spared foveal function. There was no evidence of underlying ocular disease in clinical assessment, and the lesion had not undergone interval change for the past two years.
Adult
;
Choroid
;
Eye
;
Female
;
Fluorescein Angiography
;
Humans
;
Retinaldehyde
;
Visual Acuity