1.Levels of Soluble Receptor for Advanced Glycation End Products in Acute Ischemic Stroke without a Source of Cardioembolism.
Hyun Young PARK ; Kyeong Ho YUN ; Do Sim PARK
Journal of Clinical Neurology 2009;5(3):126-132
BACKGROUND AND PURPOSE: Low levels of soluble receptor for advanced glycation end products (sRAGE) are associated with three conventional vascular risk factors (3Fs: diabetes, hypertension, and hypercholesterolemia), nondiabetic coronary artery disease, and Alzheimer's disease. However, the association between sRAGE and acute ischemic stroke (AS), especially AS without a source of cardioembolism, has not yet been established. Methods: Patients with AS without a source of cardioembolism (n=259) and age-matched controls (n=300) were grouped according to the presence of 3Fs: AS patients with and without 3Fs (3Fs+ AS and 3Fs- AS, respectively) and controls with and without 3Fs (3Fs+ control and 3Fs- control, respectively). Levels of sRAGE were analyzed among the four groups. RESULTS: sRAGE was significantly higher in the controls than in the AS patients (855 pg/mL vs. 690 pg/mL, p<0.01). sRAGE was significantly higher in 3Fs- controls (996 pg/mL, p<0.05) than in 3Fs+ controls (721 pg/mL), and in AS group regardless of the 3Fs (629 pg/mL in 3Fs- and 705 pg/mL in 3Fs+). The lowest tertile of sRAGE was associated with an increased risk of AS in the 3Fs- group [adjusted odds ratio (OR) 4.0, 95% confidence interval (CI) 1.6-10.3, p<0.01] but not in the 3Fs+ group. The level of sRAGE was also correlated with neurological severity in the 3Fs- AS group (r=-0.32, p<0.05) but not in the 3Fs+ AS group. CONCLUSIONS: Low plasma levels of sRAGE is a potential biomarker for the risk of AS and may reflect the neurological severity of the condition, especially in subjects without identifiable conventional risk factors.
Alzheimer Disease
;
Coronary Artery Disease
;
Glycosylation End Products, Advanced
;
Humans
;
Hypercholesterolemia
;
Hypertension
;
Odds Ratio
;
Plasma
;
Risk Factors
;
Stroke
2.Rebleeding after Subarachnoid Hemorrhage.
Hack Gun BAE ; Seok Mann YOON ; Il Gyu YUN ; Jae Jun SIM ; Jae Won DOH ; Kyeong Seok LEE
Korean Journal of Cerebrovascular Surgery 2003;5(1):31-36
Based on the review of literatures, this article discussed the frequency and timing of rebleeding after initial subarachnoid hemorrhage (SAH), and the risk factors and preventive strategy for rebleeding. In view of the active policy of early aneurysm surgery, the peak interval for rebleeding was the first 24 hours after the aneurysmal SAH. Patients with poor grades, ventricular drainage, angiography within 6 hours post-SAH, time interval between the last attack and admission, and reduced platelet function were proposed as a risk factor of rebleeding. Rebleeding from giant aneurysms occurred at a rate comparable to that associated with smaller aneurysm. The efficacy of short-term antifibrinolytic drugs was expected to minimize ultraearly rebleeding. When ventriculostomy is necessary, intracranial pressure should be maintained between 15 and 25 mmHg to minimize transmural pressure gradients. Securing ruptured aneurysm on an emergency basis remained open to debate.
Aneurysm
;
Aneurysm, Ruptured
;
Angiography
;
Blood Platelets
;
Drainage
;
Emergencies
;
Humans
;
Intracranial Pressure
;
Risk Factors
;
Subarachnoid Hemorrhage*
;
Ventriculostomy
3.Patient Severity Classification in a Medical ICU using APACHE III and Patient Severity Classification Tool.
Kyeong Ok LEE ; Hyeon Ju SHIN ; Hyeoun Ae PARK ; Hyeon Myeong JEONG ; Mi Hye LEE ; Eun Ha CHOI ; Jeong Mi LEE ; Yu Ja KIM ; Yun Kyeong SIM ; Kyi Ju PARK
Journal of Korean Academy of Nursing 2000;30(5):1243-1253
The purpose of this study was to verify the validity of the Patient Severity Classification Tool by examining the correlations between the APACHE III and the Patient Severity Classification Tool and to propose admission criteria to the ICU. The instruments used for this study were the APACHE III developed by Knaus and thePatient Severity Classification Tool developed by Korean Clinical Nurses Association. Data was collected from the 156 Medical ICU patients during their first 24 hours of admission at the Seoul National University Hospital by three trained Medical ICU nurses from April 20 to August 31 1999. Data were analyzed using the frequency, X2, Wilcoxon rank sum test, and Spearman rho. There was statistically significant correlations between the scores of the APACHE III and the Patient Severity Classification Tool. Mortality rate was increased as patients classification of severity in both the APACHE III and the Patient Severity Classification Tool scored higher. The Patient Severity Classification Tool was proved to be a valid and reliable tool, and a useful tool as one of the severity predicting factors, ICU admission criteria, information sharing between ICUs, quality evaluations of ICUs, and ICU nurse staffing. 1) This paper was awarded the first prize at the Seoul National Hospital Nursing Department Research Contest.
APACHE*
;
Awards and Prizes
;
Classification*
;
Humans
;
Information Dissemination
;
Mortality
;
Nursing
;
Seoul
4.Antioxidative Activity after Rosuvastatin Treatment in Patients with Stable Ischemic Heart Disease and Decreased High Density Lipoprotein Cholesterol.
Do Sim PARK ; Kyeong Ho YUN ; Hyun Young PARK ; Sang Jae RHEE ; Nam Ho KIM ; Seok Kyu OH ; Jin Won JEONG
Korean Circulation Journal 2016;46(3):309-314
BACKGROUND AND OBJECTIVES: The clinical significance of statin-induced high-density lipoprotein cholesterol (HDL-C) changes is not well known. We investigated whether rosuvastatin-induced HDL-C changes can influence the anti-oxidative action of high-density lipoprotein particle. SUBJECTS AND METHODS: A total of 240 patients with stable ischemic heart disease were studied. Anti-oxidative property was assessed by paraoxonase 1 (PON1) activity. We compared the lipid profile and PON1 activity at baseline and at 8 weeks after rosuvastatin 10 mg treatment. RESULTS: Rosuvastatin treatment increased the mean HDL-C concentration by 1.9±9.2 mg/dL (6.4±21.4%). HDL-C increased in 138 patients (57.5%), but decreased in 102 patients (42.5%) after statin treatment. PON1 activity increased to 19.1% in all patients. In both, the patients with increased HDL-C and with decreased HDL-C, PON1 activity significantly increased after rosuvastatin treatment (+19.3% in increased HDL-C responder; p=0.018, +18.8% in decreased HDL-C responder; p=0.045 by paired t-test). Baseline PON1 activity modestly correlated with HDL-C levels (r=0.248, p=0.009); however, the PON1 activity evaluated during the course of the treatment did not correlate with HDL-C levels (r=0.153, p=0.075). CONCLUSION: Rosuvastatin treatment improved the anti-oxidative properties as assessed by PON1 activity, regardless of on-treatment HDL-C levels, in patients with stable ischemic heart disease.
Aryldialkylphosphatase
;
Cholesterol
;
Cholesterol, HDL*
;
Humans
;
Hydroxymethylglutaryl-CoA Reductase Inhibitors
;
Lipoproteins
;
Lipoproteins, HDL
;
Myocardial Ischemia*
;
Rosuvastatin Calcium*
5.Relationship between the Echocardiographic Epicardial Adipose Tissue Thickness and Serum Adiponectin in Patients with Angina.
Kyeong Ho YUN ; Sang Jae RHEE ; Nam Jin YOO ; Seok Kyu OH ; Nam Ho KIM ; Jin Won JEONG ; Do Sim PARK ; Hyun Young PARK
Journal of Cardiovascular Ultrasound 2009;17(4):121-126
BACKGROUND: It is still unknown whether increased cardiac adiposity is related to the risk factors of coronary artery disease (CAD). We measured epicaridal adopose tissue (EAT) and mediastinal adipose tissue (MAT) using echocardiography and examined their correlations with CAD and serum adiponectin. METHODS: One hundred fifty three patients who underwent elective coronary angiography for chest pain were measured cardiac adiposity by transthoracic echocardiography. The correlations of cardiac adipose tissue with the presence and severity of CAD and the serum adiponectin level were examined. RESULTS: EAT was thicker in patients with CAD (1.8+/-1.4 vs. 3.8+/-1.9 mm, p<0.001), but MAT was not different according to the presence of CAD (2.9+/-2.8 vs. 3.5+/-2.5 mm, p=0.121). EAT showed a significant positive correlation with age (r=0.225, p=0.005), homocystein (r=0.289, p=0.001), fasting glucose (r=0.167, p=0.042), and fibrinogen (r=0.218, p=0.009), and a significant negative correlation with serum adiponectin (r=-0.194, p=0.016). EAT thickness (OR 11.53, 95% CI; 3.61-36.84, p<0.001) and low serum adiponectin (OR 2.88, 95% CI; 1.02-8.15, p=0.046) were independent predictors of obstructive CAD. However, MAT thickness was not associated with CAD. CONCLUSION: EAT was associated with the severity and risk factors of CAD and correlated with serum adiponectin level. In contrast with EAT, MAT was not associated with CAD and adiponectin.
Adiponectin
;
Adipose Tissue
;
Adiposity
;
Chest Pain
;
Coronary Angiography
;
Coronary Artery Disease
;
Echocardiography
;
Fasting
;
Fibrinogen
;
Glucose
;
Humans
;
Pericardium
;
Risk Factors
6.A Case of Erdheim-Chester Disease Mimicking Systemic Lymphangitic Metastasis.
Yun Su SIM ; Jin Kyeong PARK ; Jin Hwa LEE ; Dong Eun SONG ; Jung Hyun CHANG
Korean Journal of Medicine 2011;80(6):712-717
Erdheim-Chester disease (ECD) is non-Langerhans cell histiocytosis that leads to multi-organ involvement with unknown etiology. We report a 64-year-old woman with a dry cough and dyspnea. She had interlobular septal thickening and ground-glass opacity in both lungs, suggesting lymphangitic lung metastasis. However, she was diagnosed with ECD after a long bone and immunohistological evaluation.
Cough
;
Dyspnea
;
Erdheim-Chester Disease
;
Female
;
Histiocytosis
;
Humans
;
Lung
;
Middle Aged
;
Neoplasm Metastasis
;
Retroperitoneal Fibrosis
7.Clinical Practice Guideline of Acute Respiratory Distress Syndrome.
Young Jae CHO ; Jae Young MOON ; Ein Soon SHIN ; Je Hyeong KIM ; Hoon JUNG ; So Young PARK ; Ho Cheol KIM ; Yun Su SIM ; Chin Kook RHEE ; Jaemin LIM ; Seok Jeong LEE ; Won Yeon LEE ; Hyun Jeong LEE ; Sang Hyun KWAK ; Eun Kyeong KANG ; Kyung Soo CHUNG ; Won Il CHOI
Korean Journal of Critical Care Medicine 2016;31(2):76-100
There is no well-stated practical guideline for mechanically ventilated patients with or without acute respiratory distress syndrome (ARDS). We generate strong (1) and weak (2) grade of recommendations based on high (A), moderate (B) and low (C) grade in the quality of evidence. In patients with ARDS, we recommend low tidal volume ventilation (1A) and prone position if it is not contraindicated (1B) to reduce their mortality. However, we did not support high-frequency oscillatory ventilation (1B) and inhaled nitric oxide (1A) as a standard treatment. We also suggest high positive end-expiratory pressure (2B), extracorporeal membrane oxygenation as a rescue therapy (2C), and neuromuscular blockage for 48 hours after starting mechanical ventilation (2B). The application of recruitment maneuver may reduce mortality (2B), however, the use of systemic steroids cannot reduce mortality (2B). In mechanically ventilated patients, we recommend light sedation (1B) and low tidal volume even without ARDS (1B) and suggest lung protective ventilation strategy during the operation to lower the incidence of lung complications including ARDS (2B). Early tracheostomy in mechanically ventilated patients can be performed only in limited patients (2A). In conclusion, of 12 recommendations, nine were in the management of ARDS, and three for mechanically ventilated patients.
Extracorporeal Membrane Oxygenation
;
Humans
;
Incidence
;
Lung
;
Mortality
;
Nitric Oxide
;
Positive-Pressure Respiration
;
Prone Position
;
Respiration, Artificial
;
Respiratory Distress Syndrome, Adult*
;
Steroids
;
Tidal Volume
;
Tracheostomy
;
Ventilation
;
Ventilators, Mechanical
8.Determinants of Nicotine Dependence in Chronic Obstructive Pulmonary Disease.
Yun Su SIM ; Jin Hwa LEE ; Ki Uk KIM ; Seung Won RA ; Hye Yun PARK ; Chang Hoon LEE ; Deog Kyeom KIM ; Kyeong Cheol SHIN ; Sang Haak LEE ; Hun Gyu HWANG ; Joong Hyun AHN ; Yong Bum PARK ; Yu Il KIM ; Kwang Ha YOO ; Ina JEONG ; Yeon Mok OH ; Sang Do LEE
Tuberculosis and Respiratory Diseases 2017;80(3):277-283
BACKGROUND: Smoking cessation is the most powerful intervention to modify progress of chronic obstructive pulmonary disease (COPD), and nicotine dependence is one of the most important determinants of success or failure in smoking cessation. We evaluated nicotine dependence status and investigated factors associated with moderate to high nicotine dependence in patients with COPD. METHODS: We included 53 current smokers with COPD in the Korean Obstructive Lung Disease II cohort enrolled between January 2014 and March 2016. Nicotine dependence was measured by using Fagerstrom test for nicotine dependence (FTND). Cognitive function was assessed by Korean version of Montreal Cognitive Assessment. RESULTS: The median FTND score was 3, and 32 patients (60%) had moderate to high nicotine dependence. The median smoking amount was 44 pack-years, which was not related to nicotine dependence. Multiple logistic regression analysis revealed that high education status (odds ratio, 1.286; 95% confidence interval, 1.036–1.596; p=0.023), age <70 (odds ratio, 6.407; 95% confidence interval, 1.376–29.830; p=0.018), and mild to moderate airflow obstruction (odds ratio, 6.969; 95% confidence interval, 1.388–34.998; p=0.018) were related to moderate to high nicotine dependence. CONCLUSION: Nicotine dependence does not correlate with smoking amount, but with education level, age, and severity of airflow obstruction. Physicians should provide different strategies of smoking cessation intervention for current smokers with COPD according to their education levels, age, and severity of airflow obstruction.
Cognition
;
Cohort Studies
;
Education
;
Humans
;
Logistic Models
;
Lung Diseases, Obstructive
;
Nicotine*
;
Pulmonary Disease, Chronic Obstructive*
;
Smoke
;
Smoking
;
Smoking Cessation
;
Tobacco Use Disorder*
9.Clinical Practice Guideline of Acute Respiratory Distress Syndrome.
Young Jae CHO ; Jae Young MOON ; Ein Soon SHIN ; Je Hyeong KIM ; Hoon JUNG ; So Young PARK ; Ho Cheol KIM ; Yun Su SIM ; Chin Kook RHEE ; Jaemin LIM ; Seok Jeong LEE ; Won Yeon LEE ; Hyun Jeong LEE ; Sang Hyun KWAK ; Eun Kyeong KANG ; Kyung Soo CHUNG ; Won Il CHOI
Tuberculosis and Respiratory Diseases 2016;79(4):214-233
There is no well-stated practical guideline for mechanically ventilated patients with or without acute respiratory distress syndrome (ARDS). We generate strong (1) and weak (2) grade of recommendations based on high (A), moderate (B) and low (C) grade in the quality of evidence. In patients with ARDS, we recommend low tidal volume ventilation (1A) and prone position if it is not contraindicated (1B) to reduce their mortality. However, we did not support high-frequency oscillatory ventilation (1B) and inhaled nitric oxide (1A) as a standard treatment. We also suggest high positive end-expiratory pressure (2B), extracorporeal membrane oxygenation as a rescue therapy (2C), and neuromuscular blockage for 48 hours after starting mechanical ventilation (2B). The application of recruitment maneuver may reduce mortality (2B), however, the use of systemic steroids cannot reduce mortality (2B). In mechanically ventilated patients, we recommend light sedation (1B) and low tidal volume even without ARDS (1B) and suggest lung protective ventilation strategy during the operation to lower the incidence of lung complications including ARDS (2B). Early tracheostomy in mechanically ventilated patients can be performed only in limited patients (2A). In conclusion, of 12 recommendations, nine were in the management of ARDS, and three for mechanically ventilated patients.
Extracorporeal Membrane Oxygenation
;
Humans
;
Incidence
;
Lung
;
Mortality
;
Nitric Oxide
;
Positive-Pressure Respiration
;
Prone Position
;
Respiration, Artificial
;
Respiratory Distress Syndrome, Adult*
;
Steroids
;
Tidal Volume
;
Tracheostomy
;
Ventilation
;
Ventilators, Mechanical
10.Clinical Practice Guideline of Acute Respiratory Distress Syndrome
Young Jae CHO ; Jae Young MOON ; Ein Soon SHIN ; Je Hyeong KIM ; Hoon JUNG ; So Young PARK ; Ho Cheol KIM ; Yun Su SIM ; Chin Kook RHEE ; Jaemin LIM ; Seok Jeong LEE ; Won Yeon LEE ; Hyun Jeong LEE ; Sang Hyun KWAK ; Eun Kyeong KANG ; Kyung Soo CHUNG ; Won Il CHOI ;
The Korean Journal of Critical Care Medicine 2016;31(2):76-100
There is no well-stated practical guideline for mechanically ventilated patients with or without acute respiratory distress syndrome (ARDS). We generate strong (1) and weak (2) grade of recommendations based on high (A), moderate (B) and low (C) grade in the quality of evidence. In patients with ARDS, we recommend low tidal volume ventilation (1A) and prone position if it is not contraindicated (1B) to reduce their mortality. However, we did not support high-frequency oscillatory ventilation (1B) and inhaled nitric oxide (1A) as a standard treatment. We also suggest high positive end-expiratory pressure (2B), extracorporeal membrane oxygenation as a rescue therapy (2C), and neuromuscular blockage for 48 hours after starting mechanical ventilation (2B). The application of recruitment maneuver may reduce mortality (2B), however, the use of systemic steroids cannot reduce mortality (2B). In mechanically ventilated patients, we recommend light sedation (1B) and low tidal volume even without ARDS (1B) and suggest lung protective ventilation strategy during the operation to lower the incidence of lung complications including ARDS (2B). Early tracheostomy in mechanically ventilated patients can be performed only in limited patients (2A). In conclusion, of 12 recommendations, nine were in the management of ARDS, and three for mechanically ventilated patients.
Extracorporeal Membrane Oxygenation
;
Humans
;
Incidence
;
Lung
;
Mortality
;
Nitric Oxide
;
Positive-Pressure Respiration
;
Prone Position
;
Respiration, Artificial
;
Respiratory Distress Syndrome, Adult
;
Steroids
;
Tidal Volume
;
Tracheostomy
;
Ventilation
;
Ventilators, Mechanical