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Long Term Outcome of In-Stent Stenosis after Stent Assisted Coil Embolization for Cerebral Aneurysm

  • Kim, Sung Jin;Kim, Young-Joon;Ko, Jung Ho
    • Journal of Korean Neurosurgical Society
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    • v.62 no.5
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    • pp.536-544
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    • 2019
  • Objective : The objective of this study was to evaluatelong-term radiologic prognosis and characteristics of in-stent stenosis (ISS) after stent assisted coiling (SAC) for cerebral aneurysm and analyze its risk factors. Methods : Radiological records of 362 cases of SAC during 10 years were retrospectively reviewed. Patients were included in this study if they had follow-up angiogram using catheter selected angiography at least twice. All subjected were followed up from 12 months to over 30 months. Of 120 patients, 123 aneurysms were enrolled. Patient data including age, sex, aneurysm size, neck size, procedural complication, kinds of stent, ISS associated symptom, ruptured state, location of ISS, degree of ISS, radiologic prognosis of ISS, follow-up period of time, and medical comorbidities such as hypertension, diabetes mellitus (DM), dyslipidemia, and smoking were collected.Statistical comparisons of group clinical characteristics were conducted for the total population. Results : Among 123 casesof aneurysm, 22 cases (17.9%) of ISS were revealed on follow-up angiography. Multiple stenting was performed in three cases and intra-procedural rupture occurred in two cases. Most cases were asymptomatic and symptomatic stenosis was identified in only one case. Sixteen cases were ruptured aneurysm. Mild stenosis was observed in 11 cases. Moderate stenosis was found in eight cases and severe stenosis was identified in three cases. Mean timing of identification of ISS was 8.90 months. The most common type was proximal type. Most cases were improved or not changed on follow-up angiography. Only one case was aggravated from mild stenosis to occlusion of parent artery. Mean follow-up period was 44.3 months. We compared risk factors and characteristic between ISS group and non-ISS group using univariate analysis. Multiple stenting was performed for three cases (13.6%) of the ISS group and four cases (4.0%) of the non-ISS group, showing no statistical difference between the two groups (p=0.108). Additionally, the proportion of patients who had more than two risk factors among four medical risk factors (hypertension, DM, dyslipidemia, and smoking) was higher in the ISS group than that in the non-ISS group, the difference between the two was not statistically significant either (31.8% vs. 12.9%, p=0.05). Conclusion : Clinical course and long-term prognosis of ISS might be benign. Most cases of ISS could be improved or not aggravated. Control of medical co-morbidity might be important. To the best of our knowledge, our study had more cases with longer follow-up period of time than other reports.

Prognostic Significance of Left Axis Deviation in Acute Heart Failure Patients with Left Bundle branch block: an Analysis from the Korean Acute Heart Failure (KorAHF) Registry

  • Choi, Ki Hong;Han, Seongwook;Lee, Ga Yeon;Choi, Jin-Oh;Jeon, Eun-Seok;Lee, Hae-Young;Lee, Sang Eun;Kim, Jae-Joong;Chae, Shung Chull;Baek, Sang Hong;Kang, Seok-Min;Choi, Dong-Ju;Yoo, Byung-Su;Kim, Kye Hun;Cho, Myeong-Chan;Park, Hyun-Young;Oh, Byung-Hee
    • Korean Circulation Journal
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    • v.48 no.11
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    • pp.1002-1011
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    • 2018
  • Background and Objectives: The prognostic impact of left axis deviation (LAD) on clinical outcomes in acute heart failure syndrome (AHFS) with left bundle branch block (LBBB) is unknown. The aim of this study was to determine the prognostic significance of axis deviation in acute heart failure patients with LBBB. Methods: Between March 2011 and February 2014, 292 consecutive AHFS patients with LBBB were recruited from 10 tertiary university hospitals. They were divided into groups with no LAD (n=189) or with LAD (n=103) groups according to QRS axis <-30 degree. The primary outcome was all-cause mortality. Results: The median follow-up duration was 24 months. On multivariate analysis, the rate of all-cause death did not significantly differ between the normal axis and LAD groups (39.7% vs. 46.6%, adjusted hazard ratio, 1.01; 95% confidence interval, 0.66, 1.53; p=0.97). However, on the multiple linear regression analysis to evaluate the predictors of the left ventricular ejection fraction (LVEF), presence of LAD significantly predicted a worse LVEF (adjusted beta, -3.25; 95% confidence interval, -5.82, -0.67; p=0.01). Right ventricle (RV) dilatation was defined as at least 2 of 3 electrocardiographic criteria (late R in lead aVR, low voltages in limb leads, and R/S ratio <1 in lead V5) and was more frequent in the LAD group than in the normal axis group (p<0.001). Conclusions: Among the AHFS with LBBB patients, LAD did not predict mortality, but it could be used as a significant predictor of worse LVEF and RV dilatation (Trial registry at KorAHF registry, ClinicalTrial.gov, NCT01389843).

Anti-Vascular Endothelial Growth Factor Treatment of Retinopathy of Prematurity: Efficacy, Safety, and Anatomical Outcomes

  • Kang, Hyun Goo;Choi, Eun Young;Byeon, Suk Ho;Kim, Sung Soo;Koh, Hyoung Jun;Lee, Sung Chul;Kim, Min
    • Korean Journal of Ophthalmology
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    • v.32 no.6
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    • pp.451-458
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    • 2018
  • Purpose: To investigate the efficacy, safety, and anatomical outcomes associated with intravitreal anti-vascular endothelial growth factor (VEGF) treatment of retinopathy of prematurity (ROP). Methods: We performed a retrospective review of intravitreal anti-VEGF (bevacizumab or ranibizumab) treatment of 153 eyes (83 infants) diagnosed with ROP at two tertiary hospitals from June 2011 to January 2017. The primary outcome was the rate of recurrence requiring additional treatment; secondary outcomes included incidence of major complications and final refractive error. Results: A total of 101 eyes were treated with bevacizumab, and 52 with ranibizumab. The bevacizumab and ranibizumab groups were characterized by mean birthweights of $941.8{\pm}296.1$ and $1,257.7{\pm}514.5g$, gestational ages at birth of $26.9{\pm}1.9$ and $28.1{\pm}3.2$ weeks, and postmenstrual ages at treatment of $40.4{\pm}2.4$ and $39.2{\pm}2.3$ weeks, respectively. The two groups differed significantly in birthweights and gestational ages at birth, but not in postmenstrual ages at treatment. The mean follow-up duration was $30.9{\pm}18.4$ months for the bevacizumab group, and $13.9{\pm}12.5$ months for ranibizumab. More cases were classified as zone 1 ROP in the ranibizumab group (44.2% vs. 11.9%, p < 0.001). Major surgical interventions included scleral encircling and vitrectomy (one and two eyes, respectively, both in the bevacizumab group). Retinal detachment was noted in one eye treated with bevacizumab. There was no significant difference in the most recent spherical equivalence for the two groups ($+0.10{\pm}3.66$ and $+0.22{\pm}3.00$ diopters for bevacizumab and ranibizumab, respectively). Univariable analysis revealed that only ROP stage influenced the occurrence of major complications (odds ratio, 9.046; p = 0.012). Conclusions: Intravitreal anti-VEGF treatment of ROP with both bevacizumab and ranibizumab achieved stable retinal vascularization with a low rate of complications and recurrence. Ranibizumab achieved similar anatomical outcomes as bevacizumab, without additional risk for major complications.

Method development to reduce the fiber content of wheat bran and rice bran through anaerobic fermentation with rumen liquor for use in poultry feed

  • Debi, Momota Rani;Wichert, Brigitta A;Liesegang, Annette
    • Asian-Australasian Journal of Animal Sciences
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    • v.32 no.3
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    • pp.395-404
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    • 2019
  • Objective: Wheat bran (WB) and rice bran (RB) are the agricultural by-products used as poultry feed in many developing countries. However, their use for poultry feed is limited due to high fiber and the presence of anti-nutritional substances (e.g. ${\beta}-glucans$). The objective of this study was to develop a method to improve the quality of those brans by reducing the fiber content. Methods: A two-step fermentation method was developed where the second fermentation of first fermented dry bran was carried out. Fermentation was performed at a controlled environment for 3 h and 6 h (n = 6). The composition of brans, buffer solution and rumen liquor was maintained in a ratio of 1:2:3, respectively. Brans were analyzed for dry matter, crude fiber (CF), acid detergent fiber (ADF), neutral detergent fiber (NDF), and acid detergent lignin (ADL) content. Celluloses and hemicelluloses were calculated from the difference of ADF-ADL and NDF-ADF, respectively. Samples were compared by two-factor analysis of variance followed by Tukey's multiple comparison tests (p<0.05). Results: CF %, ADF % and cellulose tended to decrease and NDF % and hemicellulose content was reduced significantly (p<0.05). After the 1st fermentation step, NDF decreased $10.7%{\pm}0.55%$ after 3 h vs $17.0%{\pm}0.78%$ after 6 h in case of WB. Whereas, these values were $2.3%{\pm}0.30%$ (3 h) and $7.5%{\pm}0.69%$ (6 h) in case of RB. However, after the 2nd fermentation step, the decrease in the NDF content amounted to $9.1%{\pm}0.72%$ (3 h), $17.4%{\pm}1.13%$ (6 h) and $9.3%{\pm}0.46%$ (3 h), $10.0%{\pm}0.68%$ (6 h) in WB and RB, respectively. Cellulose and hemicellulose content was reduced up to $15.6%{\pm}0.85%$ (WB), $15.8%{\pm}2.20%$ (RB) and $36.6%{\pm}2.42%$ (WB), $15.9%{\pm}3.53%$ (RB), respectively after 2nd fermentation of 6 h. Conclusion: Two-step fermentation process improved the quality of the brans for their use in poultry feed.

Factors Associated with Lung Function Recovery at the First Year after Lung Transplantation

  • Yoon, Bo Ra;Park, Ji Eun;Kim, Chi Young;Park, Moo Suk;Kim, Young Sam;Chung, Kyung Soo;Song, Joo Han;Paik, Hyo-Chae;Lee, Jin Gu;Kim, Song Yee
    • Yonsei Medical Journal
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    • v.59 no.9
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    • pp.1088-1095
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    • 2018
  • Purpose: Post-operative pulmonary function is an important prognostic factor for lung transplantation. The purpose of this study was to identify factors affecting recovery of forced expiratory volume in 1 second (FEV1) at the first year after lung transplantation. Materials and Methods: We retrospectively reviewed the medical records of lung transplantation patients between October 2012 and June 2016. Patients who survived for longer than one year and who underwent pulmonary function test at the first year of lung transplantation were enrolled. Patients were divided into two groups according to whether they recovered to a normal range of FEV1 (FEV1 ${\geq}80%$ of predicted value vs. <80%). We compared the two groups and analyzed factors associated with lung function recovery. Results: Fifty-eight patients were enrolled in this study: 28 patients (48%) recovered to a FEV1 ${\geq}80%$ of the predicted value, whereas 30 patients (52%) did not. Younger recipients [odds ratio (OR), 0.92; 95% confidence interval (CI), 0.87-0.98; p=0.010], longer duration of mechanical ventilator use after surgery (OR, 1.14; 95% CI, 1.03-1.26; p=0.015), and high-grade primary graft dysfunction (OR, 8.08; 95% CI, 1.67-39.18; p=0.009) were identified as independent risk factors associated with a lack of full recovery of lung function at 1 year after lung transplantation. Conclusion: Immediate postoperative status may be associated with recovery of lung function after lung transplantation.

Effects of Working Postures on Headache/Eye Strain in Korean Waged Workers: The 5th Working Condition Survey(2017) (근무자세가 두통/눈의 피로에 미치는 영향: 제5차 2017년 근로환경조사)

  • Kim, You Hyun;Koh, Seokjae;Cho, Kyung Min;Chae, Jinkyeong;Oh, Hyun Jung;Chang, Sei-Jin
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.32 no.2
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    • pp.116-128
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    • 2022
  • Objectives: The aim of this study was to examine the association of working posture with headache/eye strain in Korean waged workers. Methods: Data were collected from the 5th Korean Working Condition Survey. A total of 30,955 workers participated in this study. A four-items of working postures were measured using a 7-point Likert scale, and we categorized them into three groups ('normal', 'moderate', and 'severe') each 4 items. Headache/eye strain were measured using a self-administrative questionnaire ('yes' vs. 'no'). To examine the relationship between the total working postures score and headache/eye strain, we summed a 4-items of working postures. It was categorized into five groups according to the severity of exposures('normal', 'mild', 'moderate', 'severe', and 'very severe'). The multivariate logistic regression analysis was performed using the IBM SPSS(Ver. 25), and a p<.05 was considered significant. Results: The results show that 'fatiguing and painful posture' and 'posture repetitively using hands or arms' were associated with headache/eye strain after controlling for control variables. The total working posture score was positively associated with headache/eye strain. People with higher levels of the total working posture score were more likely to increase the risk of headache/eye strain compared to those of normal(OR: 1.844, 95% CI: 1.549~2.195 for 'mild'; OR: 2.564, 95% CI: 2.152~3.503 for 'moderate'; OR: 4.140, 95% CI: 3.432~4.994 for 'severe'; OR: 7.613, 95% CI: 5.625~10.304 for 'very severe') (p<.05 for trend). Conclusions: These results indicate that inappropriate working postures might play a crucial role in developing headache/eye strain. It is needed to improve the working environment, especially focusing on reducing inappropriate working posture at the organizational level.

A Study on the Electrical Characteristics of Ge2Sb2Te5/Ti/W-Ge8Sb2Te11 Structure for Multi-Level Phase Change Memory (다중준위 상변환 메모리를 위한 Ge2Sb2Te5/Ti/W-Ge8Sb2Te11 구조의 전기적 특성 연구)

  • Oh, Woo-Young;Lee, Hyun-Yong
    • Journal of the Korean Institute of Electrical and Electronic Material Engineers
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    • v.35 no.1
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    • pp.44-49
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    • 2022
  • In this paper, we investigated current (I)- and voltage (V)-sweeping properties in a double-stack structure, Ge2Sb2Te5/Ti/W-doped Ge8Sb2Te11, a candidate medium for applications to multilevel phase-change memory. 200-nm-thick and W-doped Ge2Sb2Te5 and W-doped Ge8Sb2Te11 films were deposited on p-type Si(100) substrate using magnetron sputtering system, and the sheet resistance was measured using 4 point-probe method. The sheet resistance of amorphous-phase W-doped Ge8Sb2Te11 film was about 1 order larger than that of Ge2Sb2Te5 film. The I- and V-sweeping properties were measured using sourcemeter, pulse generator, and digital multimeter. The speed of amorphous-to-multilevel crystallization was evaluated from a graph of resistance vs. pulse duration (t) at a fixed applied voltage (12 V). All the double-stack cells exhibited a two-step phase change process with the multilevel memory states of high-middle-low resistance (HR-MR-LR). In particular, the stable MR state is required to guarantee the reliability of the multilevel phase-change memory. For the Ge2Sb2Te5 (150 nm)/Ti (20 nm)/W-Ge8Sb2Te11 (50 nm), the phase transformations of HR→MR and MR→LR were observed at t<30ns and t<65ns, respectively. We believe that a high speed and stable multilevel phase-change memory can be optimized by the double-stack structure of proper Ge-Sb-Te films separated by a barrier metal (Ti).

Cardiac Complications Associated with Eating Disorders in Children: A Multicenter Retrospective Study

  • Choi, So Yoon;Lee, Kyung Jae;Kim, Soon Chul;Lee, Eun Hye;Lee, Yoo Min;Kim, Yu-Bin;Yi, Dae Yong;Kim, Ju Young;Kang, Ben;Jang, Hyo-Jeong;Hong, Suk Jin;Choi, You Jin;Kim, Hyun Jin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.5
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    • pp.432-440
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    • 2022
  • Purpose: Eating disorders often result in somatic complications, including cardiac abnormalities. Cardiac abnormalities may involve any part of the heart, including the cardiac conduction system, and can lead to sudden cardiac death. The current study aimed to evaluate the incidence of cardiac complications in pediatric patients with eating disorders and their associated factors. Methods: We retrospectively analyzed patients aged 10-18 years who were diagnosed with DSM-V (Diagnostic and Statistical Manual of Mental Disorder-V) eating disorders and underwent electrocardiography (ECG) and/or echocardiography between January 2015 and May 2020. Results: In total, 127 patients were included, of whom 113 (89.0%) were female. The median body mass index (BMI) was 15.05±3.69 kg/m2. Overall, 74 patients (58.3%) had ECG abnormalities, with sinus bradycardia being the most common abnormality (91.9%). Patients with ECG abnormalities had significantly lower BMI (14.35±2.78 kg/m2 vs. 16.06± 4.55 kg/m2, p<0.001) than patients without ECG abnormalities, as well as lower phosphorus and higher cholesterol levels. Among the 46 patients who underwent echocardiographic evaluation, 23 (50.0%) had echocardiographic abnormalities, with pericardial effusion being the most common (60.9%). The median left ventricular mass (LVM) and ejection fraction were 67.97±21.25 g and 66.91±28.76%, respectively. LVM and BMI showed a positive correlation (r=0.604, p<0.001). After weight gain, the amount of pericardial effusion was reduced in 3 patients, and 30 patients presented with normal ECG findings. Conclusion: Cardiac abnormalities are relatively frequent in patients with eating disorders. Physicians should focus on this somatic complication and careful monitoring is required.

Accuracy of Astigmatic Correction Using Toric Intraocular Lens by Position and Size of Corneal Incision (각막절개 위치와 크기에 따른 난시교정인공수정체의 난시교정의 정확성)

  • Park, Wookyung;Kim, Man Soo;Kim, Eun Chul
    • Journal of The Korean Ophthalmological Society
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    • v.60 no.2
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    • pp.126-134
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    • 2019
  • Purpose: To assess the accuracy of toric intraocular lens (IOL) implantation by the location and size of the corneal incision. Methods: We retrospectively reviewed the medical records of 98 patients (98 eyes) who underwent phacoemulsification with toric IOL implantation from January 2014 to March 2017. The patients were divided into two groups: group 1 got an incision of the superior side of the cornea (n = 54) and group 2 received an incision on the temporal side of the eye (n = 44). For both groups, incisions were made at their steep corneal astigmatism axises. Each group was further divided into subgroups for whom different sized blades were employed (2.75 vs. 2.2 mm widths). We measured the refractive index and autokeratometric parameters. We postoperatively assessed residual astigmatism and any reduction thereof. Results: In both groups, uncorrected and best-corrected visual acuity, refraction cylinder astigmatism, and autokeratometric astigmatism improved statistically. Between two groups, corneal astigmatism decrease was not significant. Residual astigmatism also showed no significant differences between the two. Patients in both groups treated using 2.75 mm wide blades exhibited greater increases in corneal astigmatism. Conclusions: During cataract surgery, precise correction of astigmatism via toric IOL implantation is possible when surgically induced astigmatism is minimized by careful choice of the location and size of the corneal incision.

Type 3 Gastric Neuroendocrine Neoplasm Clinical Features: A Multicenter Study in Korea

  • Kyong Joo Lee;Hee Man Kim;Sang Kil Lee;Ho Sun Choi;Jie-Hyun Kim;Seun Ja Park;Sung Chul Park;Byung Ik Jang;Jin Tae Jung;Tae Joo Jeon;Jong Hun Lee ;Jae Kyu Sung;Semi Park;Yoon Jae Kim;Jae Hee Cho
    • Journal of Digestive Cancer Research
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    • v.5 no.2
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    • pp.86-90
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    • 2017
  • Background: The aim of this study was to investigate clinicopathologic features of type 3 gastric neuroendocrine neoplasm (NEN) by treatment modality. Methods: The Korean Society of Gastrointestinal Cancer conducted the Korean Gastroenteropancreatic Neuroendocrine Tumor Registry, a retrospective registry database of gastroenteropancreatic neuroendocrine tumors from 16 hospitals in Korea. The normal serum gastrin level range was defined as <100 pg/mL, and gastric NEN patients with normal gastrin level were selected for analysis. Results: Among 358 patients with gastric NEN, 21 (5.9%) patients were classified with type 3 gastric NEN. The median age was 53 years (range 30-74). According to the WHO 2010 classification, 13 (61.9%) patients had grade 1, and 8 (38.1%) patients had grade 2 or 3. Endoscopic treatment was performed in 14 (66.7%) patients, and surgery was performed in 7 (33.3%) patients. The tumor size was smaller in the endoscopic treatment group than in the surgery group (0.6 cm vs 1.3 cm, p=0.006). After treatment, there was one recurrence in the surgery group. Conclusion: In small size Type 3 gastric NEN, endoscopic treatment was associated with a good prognosis, compared to surgery. Thus, endoscopic treatment can be used an alternative modality in selected cases of type 3 gastric NEN.

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