1.Factors Associated with Cheyne-Stokes Respiration in Acute Ischemic Stroke.
Yuna KIM ; Seongheon KIM ; Dong Ryeol RYU ; Seo Young LEE ; Kyoung Bin IM
Journal of Clinical Neurology 2018;14(4):542-548
BACKGROUND AND PURPOSE: Cheyne-Stokes respiration (CSR) is frequently observed in patients with acute stroke. There have been conflicting opinions about the associations of CSR with the location and size of the lesion. We aimed to better define the clinical relevance and pathogenesis of CSR in acute stroke. METHODS: We investigated patients who had been admitted with acute ischemic stroke and received an overnight sleep apnea test. We collected data on demographics, risk factors, etiologic subtypes, initial vital signs, clinical course of the stroke, and parameters associated with respiratory events during the sleep apnea test. We performed a multivariate logistic regression analysis to determine the factors associated with CSR. RESULTS: Among 182 patients, 35 patients showed CSR in sleep apnea testing. Large-artery atherosclerosis or cardioembolism, bilateral hemispheric involvement, atrial fibrillation, low left-ventricle ejection fraction (LVEF), and left atrium (LA) enlargement were all associated with the presence of CSR. Multivariate analysis revealed that the previous modified Rankin Scale (mRS) score, bilateral hemispheric involvement, low LVEF, and LA enlargement were significantly associated with CSR. Subgroup analysis with large-artery atherosclerosis without cardiac disease revealed that the previous mRS score is the only independent factor associated with CSR. CONCLUSIONS: CSR frequently occurs in strokes involving large arteries or due to cardioembolism, regardless of the location and severity of the stroke. Predisposing conditions such as preexisting neurologic disability, low LVEF, and LA enlargement are associated with CSR in acute stroke.
Arteries
;
Atherosclerosis
;
Atrial Fibrillation
;
Cheyne-Stokes Respiration*
;
Demography
;
Heart Atria
;
Heart Diseases
;
Humans
;
Logistic Models
;
Multivariate Analysis
;
Risk Factors
;
Sleep Apnea Syndromes
;
Stroke*
;
Vital Signs
3.A Case of Gastrointestinal Stromal Tumor in a Child.
Kyung Bin YUN ; Jae Young KIM ; Jae Hong RYU ; Ji Young SUL ; Dae Young KANG
Korean Journal of Pediatric Gastroenterology and Nutrition 2007;10(1):71-75
Gastrointestinal stromal tumors (GISTs) are the most common primary mesenchymal tumors of the digestive tract. They have been commonly observed in adults but have been rarely described in children. They arise typically from the intestinal wall and rarely in the mesentery, omentum, or retroperitoneum. GISTs originate from the interstitial cell of Cajal and are characterized by overexpression of the receptor tyrosine kinase c-kit. Up to 94% of these tumors express the CD117 on immunohistochemical stain. Surgery is the main modality of treatment for primary resectable GIST. Completely resectable GIST with low risk has excellent prognosis after primary surgical intervention, with over 90% of the 5-year survival. We report a case of 10-year-old girl presenting with an upper gastrointestinal bleeding caused by gastrointestinal stromal tumor.
Adult
;
Child*
;
Female
;
Gastrointestinal Stromal Tumors*
;
Gastrointestinal Tract
;
Hemorrhage
;
Humans
;
Mesentery
;
Omentum
;
Prognosis
;
Protein-Tyrosine Kinases
4.Diagnosis of Palpable Breast Masses by the Modified Triple Test Score: A prospective study.
Bin Soo KIM ; Jin Kwon KIM ; Sung Il CHO ; Donghee RYU ; Hyo Young YUN ; Young Jin SONG
Journal of Korean Breast Cancer Society 2002;5(1):46-51
PURPOSE: The modified triple test (MTT; physical examination, ultrasonography, and fine-needle aspiration cytology) for palpable breast masses yielded 100% diagnostic accuracy when all 3 components were concordant (all benign or all malignant) in our previous study. However, about 30% of cases were discordant and required open or core needle biopsy. This study is designed to evaluate the modified triple test by scoring system, based on our experience, and to develop a method to further limit the need for surgical biopsy of discordant cases. METHODS: The MTT was performed in 175 palpable breast masses of 166 female patients between August 1998 and June 2001 at the Outpatient Clinic, Department of Surgery, Chungbuk National University Hospital. Each component of the MTT was assigned 1, 2, or 3 points for a benign, suspicious, or malignant result, respectively, yielding a total modified triple test score (MTTS) from 3 to 9 points, and 25 cases with 3 points of MTTS were clinically followed up without histological confirmation. RESULTS: Among 175 cases, concordant cases were 120 (68.6%); benign cases was 66 (37.7%), and malignant cases were 54 (30.8%). Concordant cases had 100% of diagnostic accuracy, sensitivity, and specificity. Among the 25 cases of benign concordant (MTTS 3 points), no case was proved to be malignant through clinical follow-up observation. Total discordant cases were 55 (31.4%); 15 cases of 4 points (8.6%), 11 cases of 5 points (6.3%), 4 cases of 6 points (2.3%), 18 cases of 7 points (10.3%), 7 cases of 8 points (4.0%). In each discordant group, 0 cases of 4 points (0%), 2 cases of 5 points (18.2%), 3 cases of 6 points (75%), 15 cases of 7 points (83.8%), and 7 cases of 8 points (100%) were proved to be malignant by histologic confirmation. Aspiration cytology has the highest specificity and positive predictive value of the 3 MTT components. CONCLUSION: Palpable breast masses that score 3 or 4 points by MTTS are benign and could be clinically followed up, and masses that score 8 or 9 points are malignant and should undergo defiitive therapy. Confirmatory biopsy might be applied on only 20% of the masses the reserve MMTTS of 5, 6, and 7 points.
Ambulatory Care Facilities
;
Biopsy
;
Biopsy, Fine-Needle
;
Biopsy, Large-Core Needle
;
Breast*
;
Chungcheongbuk-do
;
Diagnosis*
;
Female
;
Follow-Up Studies
;
Humans
;
Physical Examination
;
Prospective Studies*
;
Sensitivity and Specificity
;
Ultrasonography
5.Lower limb ischemia after bee sting.
Hee Yun RYU ; Min Seok YOO ; Ji Young PARK ; Jae Woong CHOI ; Sung Kee RYU ; Seunghwan KIM ; Se Jin LEE ; Young Bin KIM
Yeungnam University Journal of Medicine 2016;33(2):134-137
Bee sting causes mild symptoms such as urticaria and localized pain, and severe symptoms including anaphylaxis, cardiovascular collapse, and death. We reported on a patient with arterial thrombotic occlusion and severe ischemia in the lower limb after multiple bee stings. The patient was stung 5 times and complained of pallor, pain, and coldness in the left toe, and did not have dorsalis pedis pulsation. Computed tomography angiography showed multiple thrombotic occlusion of the anterior and posterial tibial artery below the knee. Local thrombolytic therapy using urokinase was administered and the occluded arteries were successfully recanalized.
Anaphylaxis
;
Angiography
;
Angioplasty, Balloon
;
Arteries
;
Bee Venoms
;
Bees*
;
Bites and Stings*
;
Humans
;
Ischemia*
;
Knee
;
Lower Extremity*
;
Pallor
;
Thrombolytic Therapy
;
Tibial Arteries
;
Toes
;
Urokinase-Type Plasminogen Activator
;
Urticaria
6.A Case Report of Giant Cell Arteritis Combined with Oculomotor Nerve Palsy.
Young Bin RYU ; Kyung Ream HAN ; Chan KIM
The Korean Journal of Pain 2007;20(2):255-257
Giant cell arteritis, which is also referred to as temporal arteritis, is defined as a systemic vasculitis in individuals over 50 years of age. Here, we report a case of giant cell arteritis combined with oculomotor nerve palsy. An 81-year old female patient experienced a headache for 10 days in her left temporoparietal area, that was characterized by a continuous dull ache and heaviness with intermittent shooting and lancinating pain. Her symptoms persisted in spite of receiving strong analgesics in another hospital. Upon physical examination, she was found to have marked tenderness over the left temporal area, especially along the path of the temporal artery as well as limitation of adduction, supraduction and infraduction of the left eyeball. At the time of admission, her erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were 52 mm/hr and 3.94 mg/dl. In addition her brain MRI revealed no specific findings. Giant cell arteritis was suspected based on the clinical symptoms and signs as well as the elevated ESR and CRP. Oral steroid therapy started was started with an initial dose of 40 mg of prednisolone per day that was gradually tapered to 5 mg a day for 2 weeks. Her headache subsided one day after the steroid therapy and oculomotor nerve palsy was markedly improved after 2 weeks of the therapy. After 2 months she had recovered completely from her symptoms.
Aged, 80 and over
;
Analgesics
;
Blood Sedimentation
;
Brain
;
C-Reactive Protein
;
Female
;
Giant Cell Arteritis*
;
Giant Cells*
;
Headache
;
Humans
;
Magnetic Resonance Imaging
;
Oculomotor Nerve Diseases*
;
Oculomotor Nerve*
;
Physical Examination
;
Prednisolone
;
Systemic Vasculitis
;
Temporal Arteries
7.Clinical Correlates of Metabolic Syndrome in Patients with Chronic Schizophrenia.
Yoon Young NAM ; Chul Sik KIM ; Chul Woo AHN ; Kyung Min PARK ; Bin RYU ; Chan Hyung KIM
Korean Journal of Psychopharmacology 2006;17(4):335-341
OBJECTSIVE: This study investigated the frequency of metabolic syndrome, associated factors and its risk for cardiovascular morbidity in schizophrenic patients. METHODS: In this cross-sectional study, nineteen-six patients with schizophrenia defined by DSM-IV criteria were included. All subjects were assessed for the presence of metabolic syndrome by means of the criteria of the National Cholesterol Education Program-Adult Treatment Panel III. In addition, we compared clinical characteristics, laboratory variables and risk for cardiovascular morbidity between patients with and without metabolic syndrome. RESULTS: Of patients, 43% had metabolic syndrome. Metabolic syndrome was associated with illness chronicity and current status of antipsychotic agents use, total duration of atypical agents used, but not with daily chlorpromazine equivalent dose. Compared with the patients without metabolic syndrome, patients with metabolic syndrome had higher risk for cardiovascular morbidity. CONCLUSION: This study suggests that metabolic syndrome is common among patients with chronic schizophrenia. Clinicians should be cautious to aware the increased risk for the metabolic syndrome and intervene actively to prevent and treat metabolic morbidity among chronic patients with schizophrenia.
Antipsychotic Agents
;
Chlorpromazine
;
Cholesterol
;
Cross-Sectional Studies
;
Diabetes Mellitus
;
Diagnostic and Statistical Manual of Mental Disorders
;
Dyslipidemias
;
Education
;
Humans
;
Hypertension
;
Obesity
;
Schizophrenia*
8.Early and Atypical Radiologic Presentations of Pulmonary Langerhans Cell Histiocytosis:A Report of Two Cases
Kyunghwa RYU ; Bo Da NAM ; Jung Hwa HWANG ; Dong Won KIM ; Young Woo PARK ; Hong Chul OH ; Soo Bin PARK
Journal of the Korean Radiological Society 2021;82(3):756-763
Pulmonary Langerhans cell histiocytosis (PLCH) is a rare, multi-systemic disease primarily affecting young male adults with a history of smoking. The two patients with PLCH in our report showed relatively early and atypical radiologic presentations at initial evaluation. On chest CT, PLCH presents variable radiologic features depending on the evolutional stage of the disease. Atypical CT features of PLCH may render precise radiologic diagnosis difficult and usually require lung biopsy for a confirmation of the diagnosis. Our case review is aimed at raising the awareness of radiologists on the atypical CT features of PLCH, to help make accurate radiologic diagnosis and prevent unnecessary and invasive diagnostic procedures.
9.Early and Atypical Radiologic Presentations of Pulmonary Langerhans Cell Histiocytosis:A Report of Two Cases
Kyunghwa RYU ; Bo Da NAM ; Jung Hwa HWANG ; Dong Won KIM ; Young Woo PARK ; Hong Chul OH ; Soo Bin PARK
Journal of the Korean Radiological Society 2021;82(3):756-763
Pulmonary Langerhans cell histiocytosis (PLCH) is a rare, multi-systemic disease primarily affecting young male adults with a history of smoking. The two patients with PLCH in our report showed relatively early and atypical radiologic presentations at initial evaluation. On chest CT, PLCH presents variable radiologic features depending on the evolutional stage of the disease. Atypical CT features of PLCH may render precise radiologic diagnosis difficult and usually require lung biopsy for a confirmation of the diagnosis. Our case review is aimed at raising the awareness of radiologists on the atypical CT features of PLCH, to help make accurate radiologic diagnosis and prevent unnecessary and invasive diagnostic procedures.
10.The Effect of 1, 25-Dihydroxyvitamin D3 on Dopaminergic Neurons and Microglial Activation in Parkinsonian Rat Model Induced by 6-Hydroxydopamine.
Seon Young RYU ; Joong Seok KIM ; Young Bin CHOI ; Si Ryung HAN ; Jeong Wook PARK ; Sung Kyung PARK ; Yeong In KIM
Journal of the Korean Neurological Association 2005;23(3):368-373
BACKGROUND: Recent studies have shown increasing evidence for microglial activation in neuronal degeneration in Parkinson's disease (PD), although the cause of PD remains unclear. Recent studies have also shown that 1alpha, 25-dihydroxyvitamin D3 (vitamin D3) exert neuroprotective effects by inducing an increased expression of neurotrophic factors, suggesting the possibility of vitamin D3 for the treatment of PD and other neurodegenerative diseases. The purpose of this study was to investigate the effect of vitamin D3 on 6-hydroxydopamine (6-OHDA)-induced neurotoxicity and microglial activation in adult rats. METHODS: Adult male Sprague-Dawley rats were subcutaneously injected with vitamin D3 or 0.1% ethanol for seven consecutive days and then infused unilaterally with 6-OHDA in the medial forebrain bundle. After 7 days of injection with 6-OHDA, the substantia nigra was examined by immunohistochemistry. RESULTS: The number of tyrosine hydroxylase (TH)-positive neurons in the lesioned substantia nigra pars compacta of vitamin D3 and ethanol groups was 84.8 +/- 18.84 and 52.6 +/- 13.23, respectively, fewer than that of the contralateral side (122.35 +/- 9.79 and 123.81 +/- 12.11, respectively) (P<0.05). The vitamin D3 group showed significantly higher numbers of the TH-positive neurons than that of the ethanol group (P<0.05). CD11b-positive microglial immunoreactivity was stronger in the lesion side than that of the normal side, and it was much weaker in the vitamin D3 group than that of the ethanol group (P<0.05). CONCLUSIONS: These results indicate that vitamin D3 protects dopaminergic neurons from the neuronal injury induced by 6-OHDA, possibly by the mechanism involving microglial activation.
Adult
;
Animals
;
Cholecalciferol
;
Dopaminergic Neurons*
;
Ethanol
;
Humans
;
Immunohistochemistry
;
Male
;
Medial Forebrain Bundle
;
Microglia
;
Models, Animal*
;
Nerve Growth Factors
;
Neurodegenerative Diseases
;
Neurons
;
Neuroprotective Agents
;
Oxidopamine*
;
Parkinson Disease
;
Rats*
;
Rats, Sprague-Dawley
;
Substantia Nigra
;
Tyrosine 3-Monooxygenase