1.One case of Lynch type II syndrome.
Kyongjin KIM ; Nam Eui KIM ; Yongho LEE ; Kyounga KIM ; Sangki HONG ; Sukyung BAEK ; Myungjin JOO
Korean Journal of Obstetrics and Gynecology 2009;52(11):1164-1168
Lynch syndrome is also called Hereditary nonpolyposis colorectal cancer (HNPCC). It is characterized by a risk of colorectal cancer and other cancers of the endometrium, ovary, stomach, small intestine etc. The increased risk is due to inherited mutations that impaired DNA mismatch repair. Two to three percentage of colon cancer is caused by Lynch syndrome. A family history of colon cancer occurs at a young age. We experienced one case of Lynch syndrome who had had stomach cancer, endometrial cancer and colon cancer recently. Hence we report this case with a brief review of literature.
Colonic Neoplasms
;
Colorectal Neoplasms
;
Colorectal Neoplasms, Hereditary Nonpolyposis
;
DNA Mismatch Repair
;
Endometrial Neoplasms
;
Endometrium
;
Female
;
Humans
;
Intestine, Small
;
Ovary
;
Stomach
;
Stomach Neoplasms
2.Prognostic Value of Coronary CT Angiography forPredicting Poor Cardiac Outcome in Stroke Patientswithout Known Cardiac Disease or Chest Pain:The Assessment of Coronary Artery Disease in StrokePatients Study
Sung Hyun YOON ; Eunhee KIM ; Yongho JEON ; Sang Yoon YI ; Hee-Joon BAE ; Ik-Kyung JANG ; Joo Myung LEE ; Seung Min YOO ; Charles S. WHITE ; Eun Ju CHUN
Korean Journal of Radiology 2020;21(9):1055-1064
Objective:
To assess the incremental prognostic value of coronary computed tomography angiography (CCTA) in comparison toa clinical risk model (Framingham risk score, FRS) and coronary artery calcium score (CACS) for future cardiac events in ischemicstroke patients without chest pain.
Materials and Methods:
This retrospective study included 1418 patients with acute stroke who had no previous cardiac diseaseand underwent CCTA, including CACS. Stenosis degree and plaque types (high-risk, non-calcified, mixed, or calcified plaques) wereassessed as CCTA variables. High-risk plaque was defined when at least two of the following characteristics were observed:low-density plaque, positive remodeling, spotty calcification, or napkin-ring sign. We compared the incremental prognosticvalue of CCTA for major adverse cardiovascular events (MACE) over CACS and FRS.
Results:
The prevalence of any plaque and obstructive coronary artery disease (CAD) (stenosis ≥ 50%) were 70.7% and 30.2%,respectively. During the median follow-up period of 48 months, 108 patients (7.6%) experienced MACE. Increasing FRS, CACS,and stenosis degree were positively associated with MACE (all p< 0.05). Patients with high-risk plaque type showed the highestincidence of MACE, followed by non-calcified, mixed, and calcified plaque, respectively (log-rank p< 0.001). Among theprediction models for MACE, adding stenosis degree to FRS showed better discrimination and risk reclassification compared toFRS or the FRS + CACS model (all p< 0.05). Furthermore, incorporating plaque type in the prediction model significantly improvedreclassification (integrated discrimination improvement, 0.08; p= 0.023) and showed the highest discrimination index(C-statistics, 0.85). However, the addition of CACS on CCTA with FRS did not add to the prediction ability for MACE (p> 0.05).
Conclusion
Assessment of stenosis degree and plaque type using CCTA provided additional prognostic value over CACS andFRS to risk stratify stroke patients without prior history of CAD better.