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Hong S, Son JW, Yoon Y. Clinical Midterm Results of Surgical Aortic Valve Replacement with Sutureless Valves. J Chest Surg 2024:jcs.23.142. [PMID: 38528758 DOI: 10.5090/jcs.23.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/20/2023] [Accepted: 01/18/2024] [Indexed: 03/27/2024] Open
Abstract
Background Sutureless aortic valves may enable shorter procedure times, which benefits patients with elevated surgical risk. We describe the outcomes of patients with aortic stenosis who underwent aortic valve replacement (AVR) using the sutureless Perceval aortic bioprosthesis. Methods Data from a retrospective cohort were obtained from a clinical database. The study enrolled patients with symptomatic severe aortic stenosis who underwent surgical AVR with a sutureless bioprosthesis between August 2015 and December 2020. In total, 113 patients were included (mean age, 75.3±8.4 years; 57.5% women; median Society of Thoracic Surgeons score, 9.7%; mean follow-up period, 51.19±20.6 months). Of these patients, 41 were octogenarians (36.2%) and 3 were nonagenarians (2.6%). Transthoracic echocardiography was employed to assess changes in ejection fraction (EF), left ventricular mass index (LVMI), and mean pressure gradient (MPG). Results The in-hospital mortality rate was 2.6%, and 13 patients developed new-onset atrial fibrillation. A permanent pacemaker was implanted in 3 patients (2.6%). The median intensive care unit stay was 1 day (interquartile range [IQR], 1-2 days), and the median hospital stay was 12 days (IQR, 9.5-15 days). The overall survival rate at 5 years was 95.9%. LVMI and MPG were reduced postoperatively, while EF increased over the follow-up period. No structural valve deterioration was observed, and no meaningful paravalvular leakage developed during follow-up. Conclusion The use of a sutureless valve in the aortic position is safe and feasible, even for high-risk elderly patients requiring surgical AVR. LVMI and MPG decreased postoperatively, while EF increased over the follow-up period.
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Affiliation(s)
- Soonchang Hong
- Department of Cardiothoracic Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jung-Woo Son
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Yungjin Yoon
- Department of Cardiothoracic Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
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Cho DH, Thom SR, Son JW, Ko SM, Cha YS. Practical Recommendations for the Evaluation and Management of Cardiac Injury Due to Carbon Monoxide Poisoning. JACC Heart Fail 2024:S2213-1779(24)00051-9. [PMID: 38385937 DOI: 10.1016/j.jchf.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/02/2024] [Accepted: 01/03/2024] [Indexed: 02/23/2024]
Abstract
Carbon monoxide (CO) is a relatively frequent cause of poisoning evaluated in emergency departments. The risk of neurologic injuries, such as cognitive, psychological, vestibular, and motor deficits, is 25% to 50%. However, the risk of cardiac injuries should also be considered. Among patients with CO poisoning, the mortality in patients with myocardial injury is approximately 3 times greater than that in patients without myocardial injury. In large-scale studies, up to 69.2% of patients with acute CO poisoning exhibiting elevated troponin I levels and no underlying cardiovascular illnesses had late gadolinium enhancement on cardiac magnetic resonance, suggesting covert CO-induced myocardial fibrosis. Myocardial damage can be evaluated using electrocardiography, echocardiography, computed tomography, and cardiac magnetic resonance. This paper offers recommendations for cardiac evaluations based on our collective experience of managing >2,000 cases of acute CO poisoning with supporting information taken from peer-reviewed published reports on CO poisoning.
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Affiliation(s)
- Dong-Hyuk Cho
- Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Stephen R Thom
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Jung-Woo Son
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Sung Min Ko
- Department of Radiology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Yong Sung Cha
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea; Research Institute of Hyperbaric Medicine and Science, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
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Son JW, Nam SH. Basic Management Strategies by Life Cycle for Treatment of the Persons With Autism Spectrum Disorder. Soa Chongsonyon Chongsin Uihak 2024; 35:22-28. [PMID: 38204737 PMCID: PMC10774562 DOI: 10.5765/jkacap.230011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 08/14/2023] [Accepted: 12/03/2023] [Indexed: 01/12/2024] Open
Abstract
Interventions for targeted symptoms are important when setting treatment strategies for individuals with autism spectrum disorder (ASD) and developmental disabilities. Especially, the goal should be to achieve individual "niche construction" by allowing them to select and adjust an environment where they can demonstrate their special characteristics and strengths. In addition, these choices should vary depending on the stage of development of each person with ASD and developmental disabilities. It is necessary to establish a detailed and systematic plan for diagnosis and treatment necessary for infants and toddlers, school placement in school age, and employment or self-reliance in adult transition period to establish customized treatment strategies that fit the individual level of people with ASD and developmental disabilities.
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Affiliation(s)
- Jung-Woo Son
- Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Seok-Hyun Nam
- Department of Psychiatry, Jeonbuk National University Hospital, Jeonju, Korea
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Son JW. The Last Rise and Fall Shown to us by the Man Who Chose "Swollen Foot": The Film The Whale. Soa Chongsonyon Chongsin Uihak 2024; 35:98-100. [PMID: 38204738 PMCID: PMC10774550 DOI: 10.5765/jkacap.230074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 12/04/2023] [Indexed: 01/12/2024] Open
Abstract
The film The Whale goes beyond just depicting one aspect of the life of a morbidly obese man. As the audience watches Charlie, the main character who helplessly chose to live a morbidly obese life, we are compelled to reflect on what it means for ourselves to rise from the ground as we live in a gravitational field. Ultimately, this film is in line with director Darren Arnofsky's previous masterpiece, Black Swan. While the Oedipus complex runs through both films, this film goes one step further than Black Swan to face head-on the theme of "swollen foot," which is the original meaning of Oedipus. Through this move, we realize the essence of the Oedipus complex-something more fundamental than castration anxiety-something that we have been missing.
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Affiliation(s)
- Jung-Woo Son
- Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
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Cho DH, Son JW, Kim YI, Lim J, Jeon HS, Ko SM, Cha YS. Clinical and Echocardiographic Predictors for the Presence of Late Gadolinium Enhancement on Cardiac Magnetic Resonance Imaging in Patients with Carbon Monoxide Poisoning. Diagnostics (Basel) 2023; 14:60. [PMID: 38201369 PMCID: PMC10795751 DOI: 10.3390/diagnostics14010060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/12/2023] [Accepted: 12/25/2023] [Indexed: 01/12/2024] Open
Abstract
Late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging (CMRI) reflects the burden of myocardial damage in carbon monoxide (CO) poisoning. This study aimed to identify the clinical and echocardiographic parameters that can predict myocardial LGE on CMRI in CO poisoning. This prospective observational study included patients who presented with acute CO poisoning and elevated troponin I and underwent echocardiography and CMRI to identify myocardial damage at a tertiary university hospital between August 2017 and May 2019 and August 2020 and July 2022. Based on the CMRI findings, participants were categorized into LGE and non-LGE groups. The median age of the 155 patients was 51.0 years, and 98 (63.2%) were males. Median times from emergency department arrival to either CMRI or echocardiography were 3.0 days each. The LGE group included 99 (63.9%) patients with LGE positivity on CMRIs. Time from rescue to hyperbaric oxygen therapy >4 h (odds ratio (OR): 3.31, 95% confidence interval (CI): 1.28-8.56, p = 0.01); serum lactate levels >2 mmol/L (OR: 2.62, 95% CI: 1.20-5.73, p = 0.02); and left ventricular global longitudinal strain >-16% (OR: 2.95, 95% CI: 1.35-6.47, p = 0.007) were significant predictors of LGE positivity. The area under the curve of these predictors was 0.711. Our prediction model, which combines the clinical parameters with left ventricular global longitudinal strain, may be helpful in the early detection of LGE positivity.
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Affiliation(s)
- Dong-Hyuk Cho
- Department of Cardiology, Korea University College of Medicine, Seoul 26426, Republic of Korea;
| | - Jung-Woo Son
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju 26493, Republic of Korea; (J.-W.S.); (Y.I.K.); (H.-S.J.)
| | - Young In Kim
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju 26493, Republic of Korea; (J.-W.S.); (Y.I.K.); (H.-S.J.)
| | - Jihye Lim
- Department of Biostatistics and Center of Biomedical Data Science, Yonsei University Wonju College of Medicine, Wonju 26493, Republic of Korea;
| | - Ho-Sung Jeon
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju 26493, Republic of Korea; (J.-W.S.); (Y.I.K.); (H.-S.J.)
| | - Sung Min Ko
- Department of Radiology, Yonsei University Wonju College of Medicine, Wonju 26493, Republic of Korea;
| | - Yong Sung Cha
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju 26493, Republic of Korea
- Research Institute of Hyperbaric Medicine and Science, Yonsei University Wonju College of Medicine, Wonju 26493, Republic of Korea
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Lee H, Jung JH, Chung S, Ju G, Kim S, Son JW, Shin CJ, Lee SI, Lee J. Graph Theoretical Analysis of Brain Structural Connectivity in Patients with Alcohol Dependence. Exp Neurobiol 2023; 32:362-369. [PMID: 37927134 PMCID: PMC10628861 DOI: 10.5607/en23026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/19/2023] [Accepted: 10/26/2023] [Indexed: 11/07/2023] Open
Abstract
This study aimed to compare brain structural connectivity using graph theory between patients with alcohol dependence and social drinkers. The participants were divided into two groups; the alcohol group (N=23) consisting of patients who had been hospitalized and had abstained from alcohol for at least three months and the control group (N=22) recruited through advertisements and were social drinkers. All participants were evaluated using 3T magnetic resonance imaging. A total of 1000 repeated whole-brain tractographies with random parameters were performed using DSI Studio. Four hundred functionally defined cortical regions of interest (ROIs) were parcellated using FreeSurfer based on the Schaefer Atlas. The ROIs were overlaid on the tractography results to generate 1000 structural connectivity matrices per person, and 1000 matrices were averaged into a single matrix per subject. Graph analysis was performed through igraph R package. Graph measures were compared between the two groups using analysis of covariance, considering the effects of age and smoking pack years. The alcohol group showed lower local efficiency than the control group in the whole-brain (F=5.824, p=0.020), somato-motor (F=5.963, p=0.019), and default mode networks (F=4.422, p=0.042). The alcohol group showed a lower global efficiency (F=5.736, p=0.021) in the control network. The transitivity of the alcohol group in the dorsal attention network was higher than that of the control (F=4.257, p=0.046). Our results imply that structural stability of the whole-brain network is affected in patients with alcohol dependence, which can lead to ineffective information processing in cases of local node failure.
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Affiliation(s)
- Hyunjung Lee
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju 28644, Korea
| | - Joon Hyung Jung
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju 28644, Korea
- Department of Psychiatry, College of Medicine, Seoul National University, Seoul 03080, Korea
| | - Seungwon Chung
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju 28644, Korea
- Department of Psychiatry, College of Medicine, Chungbuk National University, Cheongju 28644, Korea
| | - Gawon Ju
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju 28644, Korea
- Department of Psychiatry, College of Medicine, Chungbuk National University, Cheongju 28644, Korea
| | - Siekyeong Kim
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju 28644, Korea
- Department of Psychiatry, College of Medicine, Chungbuk National University, Cheongju 28644, Korea
| | - Jung-Woo Son
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju 28644, Korea
- Department of Psychiatry, College of Medicine, Chungbuk National University, Cheongju 28644, Korea
| | - Chul-Jin Shin
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju 28644, Korea
- Department of Psychiatry, College of Medicine, Chungbuk National University, Cheongju 28644, Korea
| | - Sang Ick Lee
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju 28644, Korea
- Department of Psychiatry, College of Medicine, Chungbuk National University, Cheongju 28644, Korea
| | - Jeonghwan Lee
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju 28644, Korea
- Department of Psychiatry, College of Medicine, Chungbuk National University, Cheongju 28644, Korea
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Moon DS, Yoo JH, Son JW, Bahn GH, Park MH, Kim BN, Yoo HJ. A Survey on the Journal of the Korean Academy of Child and Adolescent Psychiatry: Implications for Growth and Development. Soa Chongsonyon Chongsin Uihak 2023; 34:229-235. [PMID: 37841487 PMCID: PMC10568189 DOI: 10.5765/jkacap.230035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 07/23/2023] [Indexed: 10/17/2023] Open
Abstract
Objectives This study aimed to assess the status of the Journal of the Korean Academy of Child and Adolescent Psychiatry (JKACAP) and propose measures for its growth and development. Methods The study was conducted using a questionnaire survey targeting members of the Korean Academy of Child and Adolescent Psychiatry. The six key elements analyzed were Access to the journal, Convenience following conversion to English, Recognition as an international journal and institutional achievements, Author perspectives on manuscript submission,Transition to an online-only journal, and Content and identity of the journal. Results The survey revealed that email notification was highly effective for Journal Accessibility, with the website and search engines also frequently being used by members. Conversion to English in 2018 initially impacted readability and submission rates, but these concerns have decreased over time. However, the Recognition of JKACAP as an international academic journal was still not on par with SCIE journals, highlighting the need for further efforts towards SCIE inclusion. Despite these challenges and limited research opportunities, there was an active intention among members to submit manuscripts. Respondents showed a notable preference for the Transition to an online-only journal. Regarding content and identity of the JKACAP, members predominantly favored review articles and perceived the journal as a research and communication platform for Korean child and adolescent psychiatrists. Conclusion The results indicate the need for JKACAP to enhance its digital accessibility, provide more support for domestic and international authors, and actively seek SCIE indexing. Addressing the varied content preferences of its members, improving the submission process, and transitioning to an online-only format could further its growth and solidify its position as an internationally recognized academic journal in the field of child and adolescent psychiatry.
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Affiliation(s)
- Duk-Soo Moon
- Department of Psychiatry, Jeju National University School of Medicine, Jeju, Korea
| | - Jae Hyun Yoo
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung-Woo Son
- Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Geon Ho Bahn
- Division of Child & Adolescent Psychiatry, Department of Neuropsychiatry, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Min-Hyeon Park
- Department of Psychiatry, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Bung-Nyun Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hee Jeong Yoo
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Joo HJ, Yum Y, Kim YH, Son JW, Kim SH, Choi S, Han S, Shin MS, Jeong JO, Kim EJ. Gender Difference of Blood Pressure Control Rate and Clinical Prognosis in Patients With Resistant Hypertension: Real-World Observation Study. J Korean Med Sci 2023; 38:e124. [PMID: 37096308 PMCID: PMC10125792 DOI: 10.3346/jkms.2023.38.e124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 01/05/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND There are several differences in the clinical course of hypertension due to the biological and social differences between men and women. Resistant hypertension is an advanced disease state, and significant gender difference could be expected, but much has not been revealed yet. The purpose of this study was to compare gender differences on the current status of blood pressure (BP) control and clinical prognosis in patients with resistant hypertension. METHODS This is a multicenter, retrospective cohort study using common data model databases of 3 tertiary hospitals in Korea. Total 4,926 patients with resistant hypertension were selected from January 2017 to December 2018. Occurrence of dialysis, heart failure (HF) hospitalization, myocardial infarction, stroke, dementia or all-cause mortality was followed up for 3 years. RESULTS Male patients with resistant hypertension were younger but had a higher cardiovascular risk than female patients. Prevalence of left ventricular hypertrophy and proteinuria was higher in men than in women. On-treatment diastolic BP was lower in women than in men and target BP achievement rate was higher in women than in men. During 3 years, the incidence of dialysis and myocardial infarction was higher in men, and the incidence of stroke and dementia was higher in women. After adjustment, male sex was an independent risk factor for HF hospitalization, myocardial infarction, and all-cause death. CONCLUSION In resistant hypertension, men were younger than women, but end-organ damage was more common and the risk of cardiovascular event was higher. More intensive cardiovascular prevention strategies may be required in male patients with resistant hypertension.
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Affiliation(s)
- Hyung Joon Joo
- Department of Medical Informatics, Korea University College of Medicine, Seoul, Korea
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Yunjin Yum
- Department of Biostatistics, Korea University College of Medicine, Seoul, Korea
| | - Yong Hyun Kim
- Division of Cardiology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Jung-Woo Son
- Department of Cardiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sung Hea Kim
- Division of Cardiology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea
| | - Seonghoon Choi
- Division of Cardiology, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Seongwoo Han
- Division of Cardiology, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Mi-Seung Shin
- Division of Cardiology, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Jin-Ok Jeong
- Division of Cardiology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
| | - Eung Ju Kim
- Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea.
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Chung S, Son JW. How Well Do We Understand Autistic Savant Artists: A Review of Various Hypotheses and Research Findings to Date. Soa Chongsonyon Chongsin Uihak 2023; 34:93-111. [PMID: 37035790 PMCID: PMC10080252 DOI: 10.5765/jkacap.230004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/13/2023] [Accepted: 02/17/2023] [Indexed: 04/11/2023] Open
Abstract
The authors investigated the artistic characteristics of autistic savant artists, hypotheses on the proximate and ultimate causes of their emergence, recent psychological and other studies about them, and psychological and neuroaesthetic studies about non-savant autistic individuals. The artistic features of autistic savant artists were significantly similar to those of outsider artists. Furthermore, the authors investigated the explanatory power of the paradoxical functional facilitation theory, the superior visual perception hypothesis, the "Hmmmmm" hypothesis, and the Neanderthal theory of autism regarding the emergence of autistic savant artists. In addition, we investigated whether an increase in savant characteristics was related to a decrease in the ability for social communication. The authors suggested that in studies on the aesthetic experience of non-savant autistic individuals, their aesthetic experience ability is never lower than that of neurotypical individuals and that some non-savant autistic individuals may potentially have artistic talent. Finally, the authors reviewed the effectiveness of the "autism savant spectrum syndromic disorder" proposed by some researchers. More scientific and systematic studies on autistic savant artists from a multidisciplinary perspective are warranted.
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Affiliation(s)
- Seungwon Chung
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju, Korea
- Autism and Developmental Disorder Treatment Center, Chungbuk National University Hospital, Cheongju, Korea
| | - Jung-Woo Son
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju, Korea
- Autism and Developmental Disorder Treatment Center, Chungbuk National University Hospital, Cheongju, Korea
- Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
- Address for correspondence: Jung-Woo Son, Department of Neuropsychiatry, College of Medicine, Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju 28644, Korea Tel: +82-43-269-6187, Fax: +82-43-267-7951, E-mail:
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Song ZY, Kim MH, Lee HC, Park SJ, Rhee MY, Choi JI, Kim SH, Chae IH, Hong YJ, Lee NH, Hwang GS, Hur SH, Son JW, Chae JK, Kim HS. Efficacy and Safety of Coadministered Ezetimibe-Rosuvastatin plus Telmisartan in South Korean Patients with Dyslipidemia and Hypertension: A Multicenter, Randomized, Double-Blind, Active-Controlled, Phase III Trial. J Clin Med 2023; 12:jcm12062377. [PMID: 36983377 PMCID: PMC10053813 DOI: 10.3390/jcm12062377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/11/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND The introduction of a fixed-dose combination (FDC) is expected to improve treatment compliance. METHODS There were 181 subjects who were randomized to three groups: ezetimibe-rosuvastatin 10/20 mg + telmisartan 80 mg, ezetimibe-rosuvastatin 10/20 mg, and telmisartan 80 mg. The primary outcomes were change in mean sitting systolic blood pressure (MSSBP) and percentage change in low-density-lipoprotein cholesterol (LDL-C) compared to baseline at week 8. RESULTS The least-square mean (SE) in MSSBP changes between the ezetimibe-rosuvastatin 10/20 mg + telmisartan 80 mg group and the ezetimibe-rosuvastatin 10/20 mg group were -25.81 (2.34) mmHg and -7.66 (2.45) mmHg. There was a significant difference between the two groups (-18.15 (2.83) mmHg, 95% CI -23.75 to -12.56, p < 0.0001). Changes in least-square mean (SE) in LDL-C between the ezetimibe-rosuvastatin 10/20 mg + telmisartan 80 mg group and the telmisartan 80 mg group were -63.82 (2.87)% and -2.48 (3.12)%. A significant difference was observed between the two groups (-61.34 (3.33)%, 95% CI -67.91 to -54.78, p < 0.0001). No serious adverse events were observed. CONCLUSIONS Ezetimibe-rosuvastatin plus telmisartan treatment is effective and safe when compared to either ezetimibe-rosuvastatin or telmisartan.
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Affiliation(s)
- Zhao-Yan Song
- Department of Cardiology, Dong-A University Hospital, Busan 49201, Republic of Korea
| | - Moo-Hyun Kim
- Department of Cardiology, Dong-A University Hospital, Busan 49201, Republic of Korea
| | - Han-Cheol Lee
- Division of Cardiology, Department of Internal Medicine, Pusan National University Hospital, Busan 49241, Republic of Korea
| | - Sung-Ji Park
- Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Moo-Yong Rhee
- Cardiovascular Center, Dongguk University Ilsan Hospital, Goyang 10326, Republic of Korea
| | - Jong-Il Choi
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Republic of Korea
| | - Sang-Hyun Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of Korea
| | - In-Ho Chae
- Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea
| | - Young-Joon Hong
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital and Medical School, Gwangju 61469, Republic of Korea
| | - Nam-Ho Lee
- Division of Cardiology, Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Republic of Korea
| | - Gyo-Seung Hwang
- Department of Cardiology, Ajou University School of Medicine, Suwon 16499, Republic of Korea
| | - Seung-Ho Hur
- Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu 42601, Republic of Korea
| | - Jung-Woo Son
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Seoul 26426, Republic of Korea
| | - Jei-Keon Chae
- Department of Cardiology, Chunbuk National University Hospital, Jeonju 54907, Republic of Korea
| | - Hyo-Soo Kim
- Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul Naional University College of Medicine, Seoul 03080, Republic of Korea
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Eum S, Son JW, Min C, Cho W, Kim S, Woo HG, Kwon R, Lee KN, Han KD, Yon DK, Rhee SY. Ethnic and sex differences in the distributions of body mass index and waist circumference among adults: a binationally representative study in South Korea and the United States. Eur Rev Med Pharmacol Sci 2023; 27:1889-1903. [PMID: 36930486 DOI: 10.26355/eurrev_202303_31555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE The ethnic and sex differences in the distributions of body mass index (BMI) and waist circumference (WC) among adults are largely unknown. Therefore, we aimed to investigate the percentiles of BMI and WC in groups divided according to age, sex, and ethnicity. PATIENTS AND METHODS We conducted a population-based binational study of adults aged ≥20 years based on data from two sources: US National Health and Nutrition Examination Survey (2015 to 2020) and Korea National Health and Nutrition Examination Survey (2016 to 2019). RESULTS Weight, height, and WC were measured in 13,144 American adults and 30,191 Korean adults. Overall, BMI increased at younger ages and decreased at older ages, which indicates a reversed U-shaped relationship, and differed in terms of age, sex, and ethnicity. Women in the other Hispanic, non-Hispanic white, non-Hispanic black, and "other ethnic groups" showed a common BMI peak at ages 50-54 years. The patterns of WC distribution were similar to those of BMI distribution. CONCLUSIONS In this binational representative study, we found varied distributions of ethnic and sex differences in BMI and WC. Considering the differences in these distributions may help improve individual and personalized treatment strategies.
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Affiliation(s)
- S Eum
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
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Youn YJ, Jeon HS, Kim YI, Lee JH, Park YJ, Cho DH, Son JW, Lee JW, Ahn MS, Ahn SG, Kim JY, Yoo BS, Lee SH, Yoon J. Impact of the ultra-long 48 mm drug-eluting stent on procedural and clinical outcomes in patients with diffuse long coronary artery disease. Clin Cardiol 2023; 46:416-424. [PMID: 36807273 PMCID: PMC10106662 DOI: 10.1002/clc.23997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/25/2023] [Accepted: 01/29/2023] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND Diffuse coronary artery disease (CAD) is a prognostic factor after percutaneous coronary intervention (PCI) and requires multiple overlapping stent implantations. HYPOTHESIS We investigated the impact of ultra-long 48 mm drug-eluting stent (DES) on procedural and clinical outcomes in real-world practice. METHODS Patients who underwent DES implantation for a lesion length of >40 mm were selected from a prospective registry between 2019 and 2021. Patients treated with one or more ultra-long 48 mm DES were in the ultra-long DES group (n = 221). The others comprised the conventional DES group (n = 428). Procedural and clinical outcomes were compared after propensity score matching (PSM). The primary endpoint was a device-oriented composite outcome (DOCO) consisting of cardiac death, target vessel-related myocardial infarction, and target lesion revascularization at 1-year follow-up. RESULTS After PSM, 158 matched pairs of patients showed no differences in the baseline clinical and angiographic characteristics. The stent delivery failure rate, the use of guide-extension catheter or anchor balloon technique, and the procedural success rate were similar for both groups. Approximately two-thirds of lesions could be treated with one DES in the ultra-long DES group. At 1-year follow-up, the DOCO was similar for both groups (2.5% vs. 0.6%, p = .168). CONCLUSIONS In daily clinical practice, ultra-long DES implantation is as safe and effective as multiple overlapping conventional DES implants in treating diffuse long CAD. However, ultra-long DES can reduce the number of stents. (Trial Registration: ClinicalTrials.gov Identifier: NCT02038127).
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Affiliation(s)
- Young Jin Youn
- Department of Internal Medicine, Division of Cardiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Ho Sung Jeon
- Department of Internal Medicine, Division of Cardiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Young In Kim
- Department of Internal Medicine, Division of Cardiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Jung-Hee Lee
- Department of Internal Medicine, Division of Cardiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Young Jun Park
- Department of Internal Medicine, Division of Cardiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Dong-Hyuk Cho
- Department of Internal Medicine, Division of Cardiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Jung-Woo Son
- Department of Internal Medicine, Division of Cardiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Jun-Won Lee
- Department of Internal Medicine, Division of Cardiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Min-Soo Ahn
- Department of Internal Medicine, Division of Cardiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Sung Gyun Ahn
- Department of Internal Medicine, Division of Cardiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Jang-Young Kim
- Department of Internal Medicine, Division of Cardiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Byung-Su Yoo
- Department of Internal Medicine, Division of Cardiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Seung-Hwan Lee
- Department of Internal Medicine, Division of Cardiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Junghan Yoon
- Department of Internal Medicine, Division of Cardiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, South Korea
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Son JW. How Well Did We Know About Our Communication? “Origins of Human Communication”. Soa Chongsonyon Chongsin Uihak 2023. [DOI: 10.5765/jkacap.220042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Affiliation(s)
- Jung-Woo Son
- Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
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Choi YJ, Son JW, Kim EK, Kim IC, Kim HY, Seo JS, Sun BJ, Shim CY, Yoon SJ, Lee S, Lee SH, Park JB, Kang DH. Epidemiologic Profile of Patients With Valvular Heart Disease in Korea: A Nationwide Hospital-Based Registry Study. J Cardiovasc Imaging 2023; 31:51-61. [PMID: 36693346 PMCID: PMC9880350 DOI: 10.4250/jcvi.2022.0076] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/23/2022] [Accepted: 09/13/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Valvular heart disease (VHD) is a common cause of cardiovascular morbidity and mortality worldwide; however, its epidemiological profile in Korea requires elucidation. METHODS In this nationwide retrospective cohort study from the Korean valve survey, which collected clinical and echocardiographic data on VHD from 45 medical centers, we identified 4,089 patients with VHD between September and October 2019. RESULTS The aortic valve was the most commonly affected valve (n = 1,956 [47.8%]), followed by the mitral valve (n = 1,598 [39.1%]) and tricuspid valve (n = 1,172 [28.6%]). There were 1,188 cases of aortic stenosis (AS) and 926 cases of aortic regurgitation. The most common etiology of AS was degenerative disease (78.9%). The proportion of AS increased with age and accounted for the largest proportion of VHD in patients aged 80-89 years. There were 1,384 cases of mitral regurgitation (MR) and 244 cases of mitral stenosis (MS). The most common etiologies for primary and secondary MR were degenerative disease (44.3%) and non-ischemic heart disease (63.0%), respectively, whereas rheumatic disease (74.6%) was the predominant cause of MS. There were 1,172 tricuspid regurgitation (TR) cases, of which 46.9% were isolated and 53.1% were associated with other valvular diseases, most commonly with MR. The most common type of TR was secondary (90.2%), while primary accounted for 6.1%. CONCLUSIONS This report demonstrates the current epidemiological status of VHD in Korea. The results of this study can be used as fundamental data for developing Korean guidelines for VHD.
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Affiliation(s)
- You-Jung Choi
- Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University, Seoul, Korea
| | - Jung-Woo Son
- Division of Cardiology, Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Eun Kyoung Kim
- Division of Cardiology, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - In-Cheol Kim
- Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea
| | - Hyung Yoon Kim
- Department of Cardiovascular Medicine, Chonnam National University Medical School and Hospital, Gwangju, Korea
| | - Jeong-Sook Seo
- Division of Cardiology, Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University, Busan, Korea
| | - Byung Joo Sun
- Division of Cardiology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea
| | - Chi Young Shim
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Se-Jung Yoon
- Division of Cardiology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Sahmin Lee
- Division of Cardiology, Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sun Hwa Lee
- Division of Cardiology, Department of Internal Medicine, Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, Korea
| | - Jun-Bean Park
- Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Duk-Hyun Kang
- Division of Cardiology, Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Cho DH, Lee CJ, Son JW, Choi J, Hwang J, Yoo BS. Temporal trends in heart failure over 11 years in the aging Korean population: A retrospective study using the national health insurance database. PLoS One 2022; 17:e0279541. [PMID: 36576935 PMCID: PMC9797091 DOI: 10.1371/journal.pone.0279541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 12/09/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Understanding national trends of heart failure (HF) is crucial for establishing prevention and treatment strategies. We aimed to investigate the 11-year trends of HF in the South Korean population. METHODS Using the Korean National Health Insurance Service database, we identified 3,446,256 patients with HF between 2004 and 2014. RESULTS The prevalence of HF was 1.42% in 2004, steadily increasing to 1.98% in 2014. However, the age-adjusted prevalence of HF remained stable (1.43% in 2014). The incidence of HF was 6.1/1000 person-years in 2004 and remained at similar levels, reaching 5.4/1000 person-years in 2014. The age-adjusted incidence of HF slowly decreased to 3.94/1000 person-years in 2014. The event rate for hospitalized patients with HF remained stable increasing from 1.40 in 2004 to 1.87/1000 person-years in 2014, and the age-adjusted event rate of hospitalized HF decreased to 1.22 in 2014. CONCLUSIONS In South Korea, between 2004 and 2014, the prevalence of HF increased while the incidence of HF remained stable. Furthermore, the age-adjusted HF prevalence was stable, and the age-adjusted incidence decreased. This indicates that the aging population is the main cause of the increasing national burden associated with HF and that further attention is warranted in the management of HF in older adults.
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Affiliation(s)
- Dong-Hyuk Cho
- Division of Cardiology, Department of Internal Medicine, Korea University, Seoul, South Korea
| | - Chan Joo Lee
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Jung-Woo Son
- Division of Cardiology, Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Seoul, South Korea
| | - Jimi Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Jinseub Hwang
- Department of Computer Science and Statistics, Daegu University, Gyeongsangbuk-do, South Korea
| | - Byung-Su Yoo
- Division of Cardiology, Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Seoul, South Korea
- * E-mail:
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16
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Kim Y, Cho DH, Cha YS, Son JW. Global longitudinal strain to predict myocardial fibrosis in patients in carbon monoxide poisoning. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Carbon monoxide (CO) inhibits oxygen delivery and subsequently causes ischemic changes that can lead to myocardial damage. Late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging (CMR) reflects myocardial fibrosis and detects subclinical myocardial damage in patients with acute CO poisoning. However, CMR is expensive and hard to perform in patients with neurologic deficit. Therefore, this study aims to investigate which echocardiographic parameters could predict the presence of myocardial fibrosis represented by LGE in CO intoxication patients.
Methods
This prospective observational study included 128 consecutive patients (Mean age: 52.2±16.2) with acute CO poisoning and elevated troponin I (defined as >0.045 ng/mL) at the emergency department of a tertiary university hospital. All participants underwent hyperbaric oxygen therapy (HBOT). CMR and conventional echocardiography with 2D speckle-tracking were performed within 7 days. Subjects were categorized into late gadolinium enhancement (LGE) and no LGE group according to the CMR findings.
Results
Mean left ventricular (LV) ejection fraction (EF) and global longitudinal strain (GLS) were 57.0±10.0% and −16.3±3.7% respectively. LGE was observed in 89 (69.5%) patients and the most common pattern was mid-wall involvement. Clinical characteristics such as age, sex, shock, time elapsed from rescue to HBOT, and the level of troponin I were not different between groups with LGE and without LGE. Among echocardiographic parameters, LV EF was not significantly different between groups (LGE: 56.0±10.5% vs 59.3±8.1%, p=0.089). LV GLS was more impaired in patients with LGE compared to those without LGE (−15.7±3.8% vs −17.9±3.0%, p=0.003). In multivariate logistic analysis, LV GLS was independently associated with the presence of LGE [Odds ratio (OR) 1.279, 95% confidence interval (CI) (1.047–1.563), p=0.016], but not LV EF.
Conclusion
In patients with acute CO poisoning and elevated troponin I, LV GLS predicted the presence of LGE in CMR. These finding suggest that subclinical myocardial dysfunction represented by LV GLS may reflect the burden of CO induced myocardial fibrosis.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- Y Kim
- Wonju Severance Christian Hospital , Wonju , Korea (Republic of)
| | - D H Cho
- Wonju Severance Christian Hospital , Wonju , Korea (Republic of)
| | - Y S Cha
- Wonju Severance Christian Hospital , Wonju , Korea (Republic of)
| | - J W Son
- Wonju Severance Christian Hospital , Wonju , Korea (Republic of)
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Yoon TY, Lee HS, Son JW, Kim SM, Lee JJ. Clinical Characteristics of Adolescents Hospitalized Through Emergency Room for Intentional Self-Harm or Suicide Attempts. Soa Chongsonyon Chongsin Uihak 2022; 33:59-66. [PMID: 35832864 PMCID: PMC9242849 DOI: 10.5765/jkacap.220002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/27/2022] [Accepted: 05/10/2022] [Indexed: 11/05/2022] Open
Affiliation(s)
- Tae Yeon Yoon
- Department of Psychiatry, Gongju National Hospital, Gongju, Korea
| | - Hyun Sook Lee
- Department of Health Administration, Kongju National University, Gongju, Korea
| | - Jung-Woo Son
- Department of Neuropsychiatry, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Sang Mi Kim
- Department of Health Management, College of Medical Sciences, Jeonju University, Jeonju, Korea
| | - Je Jung Lee
- Department of Psychiatry, Gongju National Hospital, Gongju, Korea
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18
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Kim SE, Cho DH, Son JW, Kim JY, Kang SM, Cho MC, Lee HY, Choi DJ, Jeon ES, Yoo BS. Impact of NT-proBNP on prognosis of acute decompensated chronic heart failure versus de novo heart failure. Int J Cardiol 2022; 363:163-170. [PMID: 35753618 DOI: 10.1016/j.ijcard.2022.06.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/02/2022] [Accepted: 06/20/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND NT-pro B-type natriuretic peptide (NT-proBNP) is a powerful prognostic factor for acute heart failure. We investigated whether NT-proBNP levels differ based on the type of heart failure present. METHODS Using the Korean Acute Heart Failure Registry, a prospective, multicenter cohort, we categorized patients into two groups: de novo heart failure (DNHF, n = 1617) and acute decompensated chronic heart failure (ADHF, n = 1212). NT-proBNP levels were measured on admission. The primary outcome was all-cause mortality, and the secondary outcomes were re-hospitalization for heart failure and a composite of all-cause mortality or re-hospitalization for heart failure at 90 days and 1 year. RESULTS NT-proBNP levels were significantly lower in patients with DNHF than in those with ADHF (median 4213 vs. 5523 ng/L, p < 0.001). Compared to patients with DNHF, patients with ADHF had a significantly worse prognosis for 1-year all-cause mortality (adjusted hazard ratio (HR) = 1.46 [95% confidence interval (CI) = 1.07-1.98], p = 0.017). A higher NT-proBNP level was associated with higher 1-year all-cause mortality for both heart failure types (adjusted HR = 2.00, p = 0.002 in ADHF; adjusted HR = 2.41, p = 0.003 in DNHF). However, all-cause mortality risk was always higher in patients with ADHF than in those with DNHF for any given NT-proBNP level. CONCLUSION NT-proBNP levels are an important prognostic factor for both DNHF and ADHF. Notably, patients with ADHF had consistently higher risks than those with DNHF with the same NT-proBNP level for 1-year all-cause mortality.
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Affiliation(s)
- Se-Eun Kim
- Department of Cardiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea; Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dong-Hyuk Cho
- Department of Cardiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Jung-Woo Son
- Department of Cardiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Jang Young Kim
- Department of Cardiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Seok-Min Kang
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Myeong-Chan Cho
- Division of Cardiology, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Hae-Young Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Dong-Ju Choi
- Division of Cardiology, Department of Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Republic of Korea
| | - Eun-Seok Jeon
- Department of Internal Medicine, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Byung-Su Yoo
- Department of Cardiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
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Lee J, Ju G, Park H, Chung S, Son JW, Shin CJ, Lee SI, Kim S. Hippocampal Subfields and White Matter Connectivity in Patients with Subclinical Geriatric Depression. Brain Sci 2022; 12:brainsci12030329. [PMID: 35326285 PMCID: PMC8946804 DOI: 10.3390/brainsci12030329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 02/22/2022] [Accepted: 02/24/2022] [Indexed: 02/01/2023] Open
Abstract
Despite an abundance of research related to the functional and structural changes of the brain in patients with geriatric depression, knowledge related to early alterations such as decreased white matter connectivity and their association with cognitive decline remains lacking. We aimed to investigate early alterations in hippocampal microstructure and identify their associations with memory function in geriatric patients with subclinical depression. Nineteen participants with subclinical geriatric depression and 19 healthy controls aged ≥65 years exhibiting general cognitive function within the normal range were included in the study and underwent assessments of verbal memory. Hippocampal subfield volumes were determined based on T1-weighted magnetization-prepared rapid gradient echo (T1-MPRAGE) images, while group tractography and connectometry analyses were conducted using diffusion tensor images. Our findings indicated that the volumes of whole bilateral hippocampus, cornus ammonis (CA) 1, molecular layer, left subiculum, CA3, hippocampal tail, right CA4, and granule cell/molecular layers of the dentate gyrus (GC-ML-DG) were significantly smaller in the subclinical depression group than in the control group. In the subclinical depression group, verbal learning was positively correlated with the volumes of the CA1, GC-ML-DG, molecular layer, and whole hippocampus in the right hemisphere. The fractional anisotropy of the bilateral fornix was also significantly lower in the subclinical depression group and exhibited a positive correlation with verbal learning and recall in both groups. Our results suggest that hippocampal microstructure is disrupted and associated with memory in patients with subclinical depression.
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Affiliation(s)
- Jeonghwan Lee
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju 28644, Korea; (J.L.); (G.J.); (H.P.); (S.C.); (J.-W.S.); (C.-J.S.); (S.I.L.)
- Department of Psychiatry, College of Medicine, Chungbuk National University, Cheongju 28644, Korea
| | - Gawon Ju
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju 28644, Korea; (J.L.); (G.J.); (H.P.); (S.C.); (J.-W.S.); (C.-J.S.); (S.I.L.)
- Department of Psychiatry, College of Medicine, Chungbuk National University, Cheongju 28644, Korea
| | - Hyemi Park
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju 28644, Korea; (J.L.); (G.J.); (H.P.); (S.C.); (J.-W.S.); (C.-J.S.); (S.I.L.)
- Department of Psychiatry, College of Medicine, Chungbuk National University, Cheongju 28644, Korea
| | - Seungwon Chung
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju 28644, Korea; (J.L.); (G.J.); (H.P.); (S.C.); (J.-W.S.); (C.-J.S.); (S.I.L.)
- Department of Psychiatry, College of Medicine, Chungbuk National University, Cheongju 28644, Korea
| | - Jung-Woo Son
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju 28644, Korea; (J.L.); (G.J.); (H.P.); (S.C.); (J.-W.S.); (C.-J.S.); (S.I.L.)
- Department of Psychiatry, College of Medicine, Chungbuk National University, Cheongju 28644, Korea
| | - Chul-Jin Shin
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju 28644, Korea; (J.L.); (G.J.); (H.P.); (S.C.); (J.-W.S.); (C.-J.S.); (S.I.L.)
- Department of Psychiatry, College of Medicine, Chungbuk National University, Cheongju 28644, Korea
| | - Sang Ick Lee
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju 28644, Korea; (J.L.); (G.J.); (H.P.); (S.C.); (J.-W.S.); (C.-J.S.); (S.I.L.)
- Department of Psychiatry, College of Medicine, Chungbuk National University, Cheongju 28644, Korea
| | - Siekyeong Kim
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju 28644, Korea; (J.L.); (G.J.); (H.P.); (S.C.); (J.-W.S.); (C.-J.S.); (S.I.L.)
- Department of Psychiatry, College of Medicine, Chungbuk National University, Cheongju 28644, Korea
- Correspondence: ; Tel.: +82-43-269-6364; Fax: +82-43-267-7951
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20
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Lee JW, Son JW, Go TH, Kang DR, Lee SJ, Kim SE, Cho DH, Park YJ, Youn YJ, Ahn MS, Ahn SG, Kim JY, Yoo BS, Yoon J, Lee SH. Reference diameter and characteristics of the distal radial artery based on ultrasonographic assessment. Korean J Intern Med 2022; 37:109-118. [PMID: 35000375 PMCID: PMC8747912 DOI: 10.3904/kjim.2020.685] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 10/21/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND/AIMS While distal radial artery (DRA) access is increasingly being used for diagnostic coronary angiography, limited information is available regarding DRA size. We aimed to determine the DRA reference diameters of Korean patients and identify the predictors of DRA diameter < 2.3 mm. METHODS The outer bilateral DRA diameters were assessed using a linear ultrasound probe in 1,162 consecutive patients who underwent transthoracic echocardiography. The DRA diameter was measured by the perpendicular angle in the dorsum of the hand, and the average values were compared by sex. DRA diameter < 2.3 mm was defined as unsuitable for routine diagnostic coronary angiography using a 5 Fr introducer sheath. RESULTS The mean DRA diameters were 2.31 ± 0.43 mm (right) and 2.35 ± 0.45 mm (left). The DRA was smaller in women than men (right: 2.15 ± 0.38 mm vs. 2.43 ± 0.44 mm, p < 0.001; left: 2.18 ± 0.39 mm vs. 2.47 ± 0.45 mm, p < 0.001). The DRA diameter was approximately 20% smaller than the radial artery diameter. A total of 630 (54.2%) and 574 (49.4%) patients had DRA diameter < 2.3 mm in the right and left hands, respectively. Female sex, low body mass index (BMI), and low body surface area (BSA) were significant predictors of DRA diameter < 2.3 mm. CONCLUSION We provided reference DRA diameters for Korean patients. Approximately 50% of the studied patients had DRA diameter < 2.3 mm. Female sex, low BMI, and low BSA remained significant predictors of DRA diameter < 2.3 mm.
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Affiliation(s)
- Jun-Won Lee
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jung-Woo Son
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Tae-Hwa Go
- Department of Biostatistics, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Dae Ryong Kang
- Department of Precision Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sang Jun Lee
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Se Eun Kim
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Dong-Hyuk Cho
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Young Jun Park
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Young Jin Youn
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Min-Soo Ahn
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sung Gyun Ahn
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jang-Young Kim
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Byung-Su Yoo
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Junghan Yoon
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Seung-Hwan Lee
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
- Correspondence to Seung-Hwan Lee, M.D. Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 26426, Korea Tel: +82-33-741-0920, Fax: +82-33-741-1219, E-mail:
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21
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Shin J, Kim JH, Shin JH, Jung MH, Son JW, Lee EM, Kim YM, Cho JS, Choi JH, Kim HL, Lee SK, Choi SH, Ihm SH. Impact of a screening protocol for blood pressure level for hypertension in the Korean community health survey. Blood Press 2021; 30:403-410. [PMID: 34720006 DOI: 10.1080/08037051.2021.1997094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE A community program is an efficient model for improving the management of chronic diseases such as hypertension, diabetes, and dyslipidemia. A specific blood pressure (BP) measurement protocol was developed for community settings in which BP was measured by the interviewer at the interviewee's home. MATERIALS AND METHODS In the 2018 Korean Community Health Survey, BP was measured twice at a five-minute interval after a five-minute resting period at the beginning of the survey. In 2019, BP was measured at the end of the survey after a two-minute rest and was obtained as three measurements at one-minute intervals. As factors related to BP level, stressful stimuli within 30 min before BP measurement such as smoking, caffeine, and/or exercise; duration of rest; and survey year were analysed. RESULTS The mean age of participants was 55.2 years, and females accounted for 55.4% of the participants (n = 399,838). Stressful stimuli were observed in 21.9% of the participants in 2018 (n = 188,440) and 11.3% in 2019 (n = 211,398). Duration of rest was 0 min (2.1%), two minutes (55.0%), and five minutes (47.9%). When adjusted for age, sex, body mass index, antihypertensive medication, the arm of measurement, survey year (beta= -4.092), stressful stimuli (beta = 0.834), and resting time (beta = -1.296 per one minute of rest) were significant factors for mean systolic BP. A two-minute rest was not a significant factor in mean BP. The differences in adjusted mean systolic BPs were significant for rest times of five minutes vs. two minutes (3.1 mmHg, p < 0.0001), for stressful stimuli (0.8 mmHg, p < 0.0001), and for survey year (127.8 ± 0.2 mmHg vs. 122.2 ± 0.3 mmHg for 2018 vs. 2019, p < 0.0001). CONCLUSION For the community-based home visit survey, avoidance of stressful stimuli, five-minute rest, and allocation of BP measurement in the last part of the survey was useful for obtaining a stable BP level.
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Affiliation(s)
- Jinho Shin
- Division of Cardiology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Ju-Han Kim
- Department of Cardiology, Chonnam National University Hospital, Gwang-ju, Republic of Korea
| | - Jeong Hun Shin
- Division of Cardiology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Mi Hyang Jung
- Division of Cardiology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Dongtan, Republic of Korea
| | - Jung-Woo Son
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Eun Mi Lee
- Division of Cardiology, Department of Internal Medicine, Wonkwang University Sanbon Hospital, Gunpo, Republic of Korea
| | - Yu Mi Kim
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Jung Sun Cho
- Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jung Hyun Choi
- Division of Cardiology, Department of Internal Medicine, Busan National University Hospital, Busan, Republic of Korea
| | - Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Seon Kui Lee
- Division of Chronic Disease Control, Bureau of Chronic Disease Prevention and Control, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Sun Hye Choi
- Division of Chronic Disease Control, Bureau of Chronic Disease Prevention and Control, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Sang Hyun Ihm
- Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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22
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Ahn MS, Yoo BS, Son JW, Park YJ, Lee HY, Jeon ES, Kang SM, Choi DJ, Kim KH, Cho MC, Kim SY, Kang DR, Go TH. Evaluation of Adherence to Guideline for Heart Failure with Reduced Ejection Fraction in Heart Failure with Preserved Ejection Fraction and with or without Atrial Fibrillation. J Korean Med Sci 2021; 36:e252. [PMID: 34664798 PMCID: PMC8524233 DOI: 10.3346/jkms.2021.36.e252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 08/24/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND This study evaluated the relationship between guideline adherence for heart failure (HF) with reduced ejection fraction (HFrEF) at discharge and relevant clinical outcomes in patients with acute HF with preserved ejection fraction (HFpEF) with or without atrial fibrillation (AF). METHODS We analyzed Korean Acute Heart Failure Registry data for 707 patients with HFpEF with documented AF and 687 without AF. Guideline adherence was defined as good or poor according to the prescription of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, β-blockers, and mineralocorticoid receptor antagonists. Anticoagulation adherence was also incorporated for the AF group. RESULTS Among patients with normal sinus rhythm, those with poor guideline adherence had a reduced prevalence of comorbidities and favorable clinical characteristics when compared with those with good guideline adherence. Using inverse probability of treatment weighting (IPTW) to address the bias of nonrandom treatment assignment, good adherence was associated with a poor 60-day composite endpoint in the multivariable Cox model (weighted hazard ratio [wHR], 1.74; 95% confidence interval [CI], 1.01-3.00; P = 0.045). For patients with AF, baseline clinical characteristics were similar according to the degree of adherence. The IPTW-adjusted analysis indicated that good adherence was significantly associated with the 60-day composite endpoint (wHR, 0.47; 95% CI, 0.27-0.79; P = 0.005). In the analysis excluding warfarin, good adherence was associated with 60-day re-hospitalization (wHR, 0.60; 95% CI, 0.37-0.98; P = 0.040), 1-year re-hospitalization (wHR, 0.67; 95% CI, 0.48-0.93; P = 0.018), and the composite endpoint (wHR, 0.77; 95% CI, 0.59-0.99; P = 0.041). CONCLUSION Our findings indicate that good adherence to guidelines for HFrEF is associated with a better 60-day composite endpoint in patients with HFpEF with AF.
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Affiliation(s)
- Min-Soo Ahn
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Byung-Su Yoo
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea.
| | - Jung-Woo Son
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Young Jun Park
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Hae-Young Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Eun-Seok Jeon
- Department of Internal Medicine, Sungkyunkwan University College of Medicine, Seoul, Korea
| | - Seok-Min Kang
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Dong-Ju Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kye Hun Kim
- Department of Internal Medicine, Heart Research Center of Chonnam National University, Gwangju, Korea
| | - Myeong-Chan Cho
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | | | - Dae Ryong Kang
- Department of Biostatics, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Tae-Hwa Go
- Department of Biostatics, Wonju College of Medicine, Yonsei University, Wonju, Korea
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23
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Kim BJ, Park JI, Nam JH, Lee JH, Lee CH, Son JW, Park JS, Shin DG, Kim U, Her SH, Chang KY, Ahn TH, Jeong MH, Rha SW, Kim HS. Clinical impact of intravascular ultrasound guidance in patients of ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention with drug eluting stent. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
There is little data about clinical role of intravascular ultrasound (IVUS)-guided Percutaneous (PCI) in the setting of ST-segment elevation myocardial infarction (STEMI).
Methods
From 2005 to 2018, a total of 8,129 patients who underwent PCI with STEMI were investigated from the Korea Acute Myocardial Infarction Registry-National Institute of Health database. Patients with Non-ST segment elevation myocardial infarction, cardiogenic shock, bare metal stent implantation, thrombolytic treatment, and coronary artery bypass graft surgery were excluded. We categorized patients into two groups based on the treatment strategy: IVUS-guided PCI group (n=1,544), and coronary angiography guidance (CAG)-guided PCI group (n=6,585). The primary endpoint was composite of major adverse cardiovascular (MACE), including, cardiac death, myocardial infarction (MI), repeat target vessel revascularization (TVR) and stent thrombosis (ST).
Results
IVUS-guided PCI was performed in 19% patients (1544/8129). After propensity score matching, there were no statistically difference in the rate of cardiac death (0% in IVUS vs. 0.26% in CAG, p=0.947), MI (2.01% vs. 2.01%, p=0.408), TVR (1.23% vs. 0.91%, p=0.131), ST (0.32% vs. 0.45%, p=0.828) and composite of MACE at 1 year between two groups (2.01% vs. 2.40%, p=0.843). Independent risk factors for MACE were diabetes mellitus and multi-vessel disease, but not IVUS-guided PCI (HR 1.167, 95% CI, 0.896–1.520, p=0.251).
Conclusion
This study suggests that routine usage of IVUS in the setting of STEMI may not be necessary. Large-scaled random study will be needed for further evaluation.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- B J Kim
- Yeungnam University Hospital, Daegu, Korea (Republic of)
| | - J I Park
- Yeungnam University Hospital, Daegu, Korea (Republic of)
| | - J H Nam
- Yeungnam University Hospital, Daegu, Korea (Republic of)
| | - J H Lee
- Yeungnam University Hospital, Daegu, Korea (Republic of)
| | - C H Lee
- Yeungnam University Hospital, Daegu, Korea (Republic of)
| | - J W Son
- Yeungnam University Hospital, Daegu, Korea (Republic of)
| | - J S Park
- Yeungnam University Hospital, Daegu, Korea (Republic of)
| | - D G Shin
- Yeungnam University Hospital, Daegu, Korea (Republic of)
| | - U Kim
- Yeungnam University Hospital, Daegu, Korea (Republic of)
| | - S H Her
- St. Vincent's Hospital, College of Medicine, Suwon, Korea (Republic of)
| | - K Y Chang
- The Catholic University of Korea Seoul St. Mary's Hospital, Seoul, Korea (Republic of)
| | - T H Ahn
- Gachon University Gil Medical Center, Incheon, Korea (Republic of)
| | - M H Jeong
- Chonnam National University Hospital, Gwangju, Korea (Republic of)
| | - S W Rha
- Korea University Guro Hospital, Seoul, Korea (Democratic People's Republic of)
| | - H S Kim
- Seoul National University Hospital, Seoul, Korea (Republic of)
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24
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Lee J, Son JW, Kim S, Kim JE, Chung S, Ghim HR, Lee SI, Shin CJ, Ju G. Disrupted Association Between Empathy and Brain Structure in Attention-Deficit/Hyperactivity Disorder. Soa Chongsonyon Chongsin Uihak 2021; 32:129-136. [PMID: 34671185 PMCID: PMC8499037 DOI: 10.5765/jkacap.210009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/25/2021] [Accepted: 05/07/2021] [Indexed: 11/16/2022] Open
Abstract
Objectives To investigate the relationship between brain structure and empathy in early adolescents with attention-deficit/hyperactivity disorder (ADHD). Methods Nineteen early adolescents with ADHD and 20 healthy controls underwent 3T MRI. All the participants were assessed for different aspects of empathy using measures including the Interpersonal Reactivity Index and Empathy Quotient. Cortical thickness and subcortical structural volume based on T1-weighted scans were analyzed using FreeSurfer. Results Cognitive empathy (t=-2.52, p=0.016) and perspective taking (t=-2.10, p=0.043) were impaired in the ADHD group compared with the control group. The cluster encompassing the left posterior insular, supramarginal, and transverse temporal cortices [cluster-wise p-value (CWP)=0.001], which are associated with emotional empathy, was significantly smaller in the ADHD group, and the volume of the left nucleus accumbens was greater than that of the control group (F=10.12, p=0.003, effect size=0.22). In the control group, the left superior temporal (CWP=0.002) and lingual cortical (CWP=0.035) thicknesses were positively associated with cognitive empathy, while the right amygdala volume was positively associated with empathic concern (Coef=14.26, t=3.92, p=0.001). However, there was no significant correlation between empathy and brain structure in the ADHD group. Conclusion The ADHD group had a smaller volume of the cortical area associated with emotional empathy than the control group, and there was no brain region showing significant correlation with empathy, unlike in the control group.
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Affiliation(s)
- Jeonghwan Lee
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju, Korea.,Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Jung-Woo Son
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju, Korea.,Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Siekyeong Kim
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju, Korea.,Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Ji-Eun Kim
- Ma-Eum Pyong-On Psychiatric Clinic, Yongin, Korea
| | - Seungwon Chung
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju, Korea.,Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Hei-Rhee Ghim
- Department of Psychology, Chungbuk National University, Cheongju, Korea
| | - Sang-Ick Lee
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju, Korea.,Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Chul-Jin Shin
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju, Korea.,Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Gawon Ju
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju, Korea.,Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
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25
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Son JW. The Facts That We Have Been Mistaken About Our Minds, Language, and Octopuses; “Other Minds: The Octopus, The Sea, and The Deep Origins of Consciousness”. Soa Chongsonyon Chongsin Uihak 2021. [PMCID: PMC8499036 DOI: 10.5765/jkacap.210025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
To date, we have made inferences on the behavior and mind of humans and animals from the perspective of humans, or for the sake of familiarity, vertebrates. The book, “Other Minds; The Octopus, The Sea, and The Deep Origins of Consciousness” by Peter Godfrey-Smith makes us realize how erroneous preconceived notions could be, and presents a novel perspective on the results of evolution. Through-out this book, readers will learn about the characteristics of the nervous system, behavior, and habits of cephalopods, which include oc-topuses. Through this book, readers will gain a new perspective on the embodiment, minds, nervous systems, consciousness, and soci-ality of humans and animals. Furthermore, the book will provide the imaginary experience of swimming in “Octopolis” inside the ocean with the author.
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Affiliation(s)
- Jung-Woo Son
- Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
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26
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Lee J, Ju G, Son JW, Shin CJ, Lee SI, Park H, Kim S. White matter integrity in alcohol-dependent patients with long-term abstinence. Medicine (Baltimore) 2021; 100:e26078. [PMID: 34032740 PMCID: PMC8154411 DOI: 10.1097/md.0000000000026078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 05/05/2021] [Indexed: 11/26/2022] Open
Abstract
Based on association studies on amounts of alcohol consumed and cortical and subcortical structural shrinkage, we investigated the effect of chronic alcohol consumption on white matter pathways using probabilistic tractography.Twenty-three alcohol-dependent men (with an average sobriety of 13.1 months) from a mental health hospital and 22 age-matched male healthy social drinkers underwent 3T magnetic resonance imaging. Eighteen major white matter pathways were reconstructed using the TRActs Constrained by UnderLying Anatomy tool (provided by the FreeSurfer). The hippocampal volumes were estimated using an automated procedure. The lifetime drinking history interview, Alcohol Use Disorder Identification Test, Brief Michigan Alcoholism Screening Test, and pack-years of smoking were also evaluated.Analysis of covariance controlling for age, cigarette smoking, total motion index indicated that there was no definite difference of diffusion parameters between the 2 groups after multiple comparison correction. As hippocampal volume decreased, the fractional anisotropy of the right cingulum-angular bundle decreased. Additionally, the axial diffusivity of right cingulum-angular bundle was positively correlated with the alcohol abstinence period.The results imply resilience of white matter in patients with alcohol dependence. Additional longitudinal studies with multimodal methods and neuropsychological tests may improve our findings of the changes in white matter pathways in patients with alcohol dependence.
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Affiliation(s)
- Jeonghwan Lee
- Department of Psychiatry, Chungbuk National University Hospital
- Department of Psychiatry, Chungbuk National University College of Medicine, Cheongju, South Korea
| | - Gawon Ju
- Department of Psychiatry, Chungbuk National University Hospital
- Department of Psychiatry, Chungbuk National University College of Medicine, Cheongju, South Korea
| | - Jung-Woo Son
- Department of Psychiatry, Chungbuk National University Hospital
- Department of Psychiatry, Chungbuk National University College of Medicine, Cheongju, South Korea
| | - Chul-Jin Shin
- Department of Psychiatry, Chungbuk National University Hospital
- Department of Psychiatry, Chungbuk National University College of Medicine, Cheongju, South Korea
| | - Sang Ick Lee
- Department of Psychiatry, Chungbuk National University Hospital
- Department of Psychiatry, Chungbuk National University College of Medicine, Cheongju, South Korea
| | - Hyemi Park
- Department of Psychiatry, Chungbuk National University Hospital
- Department of Psychiatry, Chungbuk National University College of Medicine, Cheongju, South Korea
| | - Siekyeong Kim
- Department of Psychiatry, Chungbuk National University Hospital
- Department of Psychiatry, Chungbuk National University College of Medicine, Cheongju, South Korea
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27
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Cho DH, Ko SM, Son JW, Park EJ, Cha YS. Myocardial Injury and Fibrosis From Acute Carbon Monoxide Poisoning: A Prospective Observational Study. JACC Cardiovasc Imaging 2021; 14:1758-1770. [PMID: 33865788 DOI: 10.1016/j.jcmg.2021.02.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 02/10/2021] [Accepted: 02/12/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES This study sought to evaluate the prevalence and patterns of late gadolinium enhancement (LGE) after carbon monoxide (CO) poisoning using cardiac magnetic resonance (CMR) imaging (CMRI) and transthoracic echocardiography (TTE). BACKGROUND In acute CO poisoning, cardiac injury can predict mortality. However, it remains unclear why increased mortality and cardiovascular events occur despite normalization of CO-induced elevated troponin I (TnI) and cardiac dysfunction. METHODS Patients with acute CO poisoning with elevated TnI were evaluated. CMRI was performed within 7 days of CO exposure and after 4 to 5 months. Patients were divided into LGE (n = 72; 69.2%) and no-LGE (n = 32; 30.8%) groups. RESULTS In the LGE group, 39.4%, 4.8%, and 25.0% of patients exhibited midwall, subendocardial, and right ventricular insertion point injury, respectively. Diffuse injury was observed in 22.1% of patients, and 67.6% of the 37 patients who underwent follow-up CMRI showed no interval change. On TTE, baseline left ventricular ejection fraction and global longitudinal strain were significantly deteriorated in the LGE group; serial TTE within 7 days indicated that only left ventricular global longitudinal strain remained significantly deteriorated. Three cases of mortality occurred in the LGE group during the 1-year follow-up. CONCLUSIONS The LGE prevalence in patients with acute CO poisoning with elevated TnI levels, with no underlying cardiovascular diseases and eligible for CMRI, was 69.2%; this proportion primarily comprised patients with a midwall injury. Of the 37 patients who underwent follow-up CMRI, most chronic phase images showed no interval change. Myocardial fibrosis detected on CMR images was related to acute myocardial dysfunction and subacute deterioration of myocardial strain on TTE. (Cardiac Magnetic Resonance Image in Acute Carbon Monoxide Poisoning; NCT04419298).
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Affiliation(s)
- Dong-Hyuk Cho
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Sung Min Ko
- Department of Radiology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Jung-Woo Son
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Eung Joo Park
- Department of Biostatistics, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Yong Sung Cha
- Department of Emergency Medicine and Research Institute of Hyperbaric Medicine and Science, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
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28
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Son JW, Choi SH, Jang JH, Koh JT, Oh WM, Hwang YC, Lee BN. Irisin promotes odontogenic differentiation and angiogenic potential in human dental pulp cells. Int Endod J 2020; 54:399-412. [PMID: 33089893 DOI: 10.1111/iej.13435] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 10/19/2020] [Accepted: 10/19/2020] [Indexed: 12/31/2022]
Abstract
AIM To determine whether irisin, a newly discovered myokine that links exercise-induced and metabolic homeostasis, is able to promote odontogenic differentiation and angiogenesis in human dental pulp cells (HDPCs). METHODOLOGY Cell viability in the presence of irisin was measured. Real-time PCR and Western blot analysis were performed to evaluate the expression levels of irisin, odontogenic and angiogenic markers. The involvement of mitogen-activated protein kinase (MAPK) and the protein kinase B (Akt) signalling pathway was evaluated by Western blot. To evaluate mineralization nodule formation, alkaline phosphatase (ALP) staining and alizarin red S staining were performed. Scratch wound assays were performed to evaluate the effects of irisin on cell migration. The data were analysed using one-way analysis of variance (anova) followed by Tukey post hoc test and Student's t-test. Statistical significance was considered at P < 0.05. RESULTS Irisin significantly promoted odontogenic differentiation as evidenced by formation of mineralized nodules, induction of ALP activity and upregulation of odontogenic and angiogenic markers (P < 0.05). Scratch wound assays revealed that irisin significantly increased migration of HDPCs (P < 0.05). Phosphorylation of both MAPK and Akt was increased by irisin. MAPK and Akt inhibitors inhibited mineralization, cell migration and the increased expression of odontogenic and angiogenic markers. CONCLUSIONS Irisin promoted odontogenic differentiation and mineralization and has the potential for angiogenesis through activation of the MAPK and Akt signalling pathways in HDPCs.
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Affiliation(s)
- J W Son
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - S H Choi
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - J H Jang
- Department of Conservative Dentistry, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - J T Koh
- Department of Pharmacology and Dental Therapeutics, Hard-tissue Biointerface Research Center, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - W M Oh
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - Y C Hwang
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - B N Lee
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
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29
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Lee JW, Choi E, Son JW, Youn YJ, Ahn SG, Ahn MS, Kim JY, Lee SH, Yoon J, Ryu DR, Park SM, Hong KS, Yoo BS. Comparison of Blood Pressure Variability Between Losartan and Amlodipine in Essential Hypertension (COMPAS-BPV). Am J Hypertens 2020; 33:748-755. [PMID: 32267481 DOI: 10.1093/ajh/hpaa060] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 03/14/2020] [Accepted: 04/07/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Antihypertensive therapy using renin-angiotensin system blockers and calcium channel blockers to target blood pressure variability (BPV) has not yet been established. We aimed to compare the ability of losartan and amlodipine to lower BPV and systolic blood pressure (SBP) in essential hypertensive patients. METHODS Patients were randomly assigned either losartan 50 mg or amlodipine 5 mg. Medications were uptitrated and hydrochlorothiazide was added according to protocol for 6 months. The primary endpoint was the office visit-to-visit SD of SBP. The secondary endpoints included average real variability (ARV), office SBP, and home SBP. RESULTS The losartan group (n = 71) and amlodipine group (n = 73) finished the scheduled visits between April 2013 and May 2017. The office visit-to-visit SD of SBP was comparable between the losartan and amlodipine groups (11.0 ± 4.2 vs. 10.5 ± 3.8, P = 0.468). The office visit-to-visit ARV of SBP was significantly elevated in the losartan group (10.6 ± 4.3 vs. 9.1 ± 3.4, P = 0.02). The absolute SBP decrement from baseline to 6 months was similar between groups, although the office mean SBP at 6 months was higher in the losartan group (132.3 ± 12.9 vs. 127.5 ± 9.0 mm Hg, P = 0.011). In home blood pressure analysis, evening day-to-day BPV indexes (SD and ARV) were significantly higher in the losartan group at 6 months. CONCLUSIONS The lowering effect of the office visit-to-visit SD of SBP was similar between losartan and amlodipine. However, the losartan group showed a higher office visit-to-visit ARV of SBP and evening day-to-day home BPV indexes. Therefore, amlodipine may be better to lower BPV in essential hypertensive patients.
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Affiliation(s)
- Jun-Won Lee
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju, Republic of Korea
| | - Eunhee Choi
- Department of Medicine, Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Jung-Woo Son
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju, Republic of Korea
| | - Young Jin Youn
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju, Republic of Korea
| | - Sung-Gyun Ahn
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju, Republic of Korea
| | - Min-Soo Ahn
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju, Republic of Korea
| | - Jang-Young Kim
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju, Republic of Korea
| | - Seung-Hwan Lee
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju, Republic of Korea
| | - Junghan Yoon
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju, Republic of Korea
| | - Dong Ryeol Ryu
- Department of Internal Medicine, Kangwon National University College of Medicine, Chuncheon, Republic of Korea
| | - Sang-Min Park
- Division of Cardiology, Cardiovascular Center, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Kyung-Soon Hong
- Division of Cardiology, Cardiovascular Center, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Byung-Su Yoo
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju, Republic of Korea
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Son JW. The Area of Brain Imaging Research in the Field of Child and Adolescent Psychiatry Is Rapidly Developing. Soa Chongsonyon Chongsin Uihak 2020; 31:96. [PMID: 32665753 PMCID: PMC7350547 DOI: 10.5765/jkacap.200027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Jung-Woo Son
- Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
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Chung S, Son JW. Visual Perception in Autism Spectrum Disorder: A Review of Neuroimaging Studies. Soa Chongsonyon Chongsin Uihak 2020; 31:105-120. [PMID: 32665755 PMCID: PMC7350544 DOI: 10.5765/jkacap.200018] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/31/2020] [Accepted: 06/05/2020] [Indexed: 12/13/2022] Open
Abstract
Although autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social impairments, patients with ASD frequently manifest atypical sensory behaviors. Recently, atypical sensory perception in ASD has received much attention, yet little is known about its cause or neurobiology. Herein, we review the findings from neuroimaging studies related to visual perception in ASD. Specifically, we examined the neural underpinnings of visual detection, motion perception, and face processing in ASD. Results from neuroimaging studies indicate that atypical visual perception in ASD may be influenced by attention or higher order cognitive mechanisms, and atypical face perception may be affected by disrupted social brain network. However, there is considerable evidence for atypical early visual processing in ASD. It is likely that visual perceptual abnormalities are independent of deficits of social functions or cognition. Importantly, atypical visual perception in ASD may enhance difficulties in dealing with complex and subtle social stimuli, or improve outstanding abilities in certain fields in individuals with Savant syndrome. Thus, future research is required to elucidate the characteristics and neurobiology of autistic visual perception to effectively apply these findings in the interventions of ASD.
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Affiliation(s)
- Seungwon Chung
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju, Korea
| | - Jung-Woo Son
- Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
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Kim EJ, Son JW, Park SK, Chung S, Ghim HR, Lee S, Lee SI, Shin CJ, Kim S, Ju G, Park H, Lee J. Cognitive and Emotional Empathy in Young Adolescents: an fMRI Study. Soa Chongsonyon Chongsin Uihak 2020; 31:121-130. [PMID: 32665756 PMCID: PMC7350548 DOI: 10.5765/jkacap.200020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/25/2020] [Accepted: 06/01/2020] [Indexed: 11/28/2022] Open
Abstract
Objectives We investigated the differences in cognitive and emotional empathic ability between adolescents and adults, and the differences of the brain activation during cognitive and emotional empathy tasks. Methods Adolescents (aged 13–15 years, n=14) and adults (aged 19–29 years, n=17) completed a range of empathic ability questionnaires and were scanned functional magnetic resonance imaging (fMRI) during both cognitive and emotional empathy task. Differences in empathic ability and brain activation between the groups were analyzed. Results Both cognitive and emotional empathic ability were significantly lower in the adolescent compared to the adult group. Comparing the adolescent to the adult group showed that brain activation was significantly greater in the right transverse temporal gyrus (BA 41), right insula (BA 13), right superior parietal lobule (BA 7), right precentral gyrus (BA 4), and right thalamus whilst performing emotional empathy tasks. No brain regions showed significantly greater activation in the adolescent compared to the adult group while performing cognitive empathy task. In the adolescent group, scores of the Fantasy Subscale in the Interpersonal Reactivity Index, which reflects cognitive empathic ability, negatively correlated with activity of right superior parietal lobule during emotional empathic situations (r=-0.739, p=0.006). Conclusion These results strongly suggest that adolescents possess lower cognitive and emotional empathic abilities than adults do and require compensatory hyperactivation of the brain regions associated with emotional empathy or embodiment in emotional empathic situation. Compensatory hyperactivation in the emotional empathy-related brain areas among adolescents are likely associated with their lower cognitive empathic ability.
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Affiliation(s)
- Eun Jin Kim
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju, Korea
| | - Jung-Woo Son
- Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
| | | | - Seungwon Chung
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju, Korea
| | - Hei-Rhee Ghim
- Department of Psychology, Chungbuk National University, Cheongju, Korea
| | - Seungbok Lee
- Department of Psychology, Chungbuk National University, Cheongju, Korea
| | - Sang-Ick Lee
- Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Chul-Jin Shin
- Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Siekyeong Kim
- Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Gawon Ju
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju, Korea
| | - Hyemi Park
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju, Korea
| | - Jeonghwan Lee
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju, Korea
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Ahn MS, Eom YW, Oh JE, Cha SK, Park KS, Son JW, Lee JW, Youn YJ, Ahn SG, Kim JY, Lee SH, Yoon J, Yoo BS. Transient receptor potential channel TRPV4 mediates TGF-β1-induced differentiation of human ventricular fibroblasts. Cardiol J 2020; 27:162-170. [PMID: 32329036 DOI: 10.5603/cj.a2019.0050] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 05/13/2019] [Accepted: 05/04/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Cardiac fibroblasts (CFs) are principal extracellular matrix-producing cells. In response to injury, CFs transdifferentiate into myofibroblasts. Intracellular calcium (Ca2+) signaling, involved in fibroblast proliferation and differentiation, is activated in fibroblasts through transient receptor potential (TRP) channels, but the function of these channels has not been investigated in human ventricular CFs. Under evaluation in this study, was the role of TRP channels in the differentiation of human ventricular CFs induced by transforming the growth factor beta (TGF-β), a pro-fibrotic cytokine. METHODS Human ventricular CFs were used in this study. The differentiation of CFs into myofibroblast was induced with TGF-β and was identified by the expression of smooth muscle actin. RESULTS Results indicate that Ca2+ signaling was an essential component of ventricular CF dif-ferentiation. CFs treated with TGF-β demonstrated increased expression of a TRP channel, TRPV4, both at the mRNA and protein levels, which corresponded with CF-myofibroblast trans-differentiation, as evidenced by the upregulation of α-smooth muscle actin, a myofibroblast marker, and plasminogen activator inhibitor-1, which are fibrogenesis markers. An agonist of TRPV4 induced the conversion of CFs into myofibroblasts, whereas it's antagonist as well a Ca2+ chelating agent reduced it, indicating that the Ca2+ influx throughTRPV4 is required for CF trans-differentiation. Overall, these results dem-onstrate that TRPV4-mediated Ca2+ influx participates in regulating the differentiation of human ventricular CFs into myofibroblasts through the MAPK/ERK pathway. CONCLUSIONS Overall, these results demonstrate that TRPV4-mediated Ca2+ influx participates in regulating the differentiation of human ventricular CFs into myofibroblasts through the MAPK/ERK pathway.
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Affiliation(s)
- Min-Soo Ahn
- Cardiology Division, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea, Republic Of
| | - Young Woo Eom
- Cell Therapy and Tissue Engineering Center, Yonsei University Wonju College of Medicine, Wonju, Korea, Republic Of
| | - Ji-Eun Oh
- Cell Therapy and Tissue Engineering Center, Yonsei University Wonju College of Medicine, Wonju, Korea, Republic Of
| | - Seung-Kuy Cha
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Korea, Republic Of
| | - Kyu Sang Park
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Korea, Republic Of
| | - Jung-Woo Son
- Cardiology Division, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea, Republic Of
| | - Jun-Won Lee
- Cardiology Division, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea, Republic Of
| | - Young Jin Youn
- Cardiology Division, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea, Republic Of
| | - Sung Gyun Ahn
- Cardiology Division, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea, Republic Of
| | - Jang-Young Kim
- Cardiology Division, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea, Republic Of
| | - Seung-Hwan Lee
- Cardiology Division, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea, Republic Of
| | - Junghan Yoon
- Cardiology Division, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea, Republic Of
| | - Byung-Su Yoo
- Cardiology Division, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea, Republic Of.
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Park SJ, Son JW, Hong KS, Choi HH. Effect of inter-arm blood pressure differences on outcomes after percutaneous coronary intervention. J Cardiol 2020; 75:648-653. [PMID: 32037252 DOI: 10.1016/j.jjcc.2019.12.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 12/01/2019] [Accepted: 12/19/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND We investigated the effect of inter-arm blood pressure differences (IABPD) on the percutaneous coronary intervention (PCI) outcomes of patients with coronary artery diseases. METHODS We retrospectively reviewed the data of blood pressures measured simultaneously in the bilateral arms of 855 patients (560 males) who underwent PCI with drug-eluting stents for coronary artery diseases. IABPD was defined as the difference of blood pressure in both arms. The primary outcome was the presence of major adverse cardiac events (MACE) consisting of cardiovascular death, myocardial infarction, stroke, and ischemia-driven target vessel revascularization. RESULTS The mean age of the included patients was 66.2 ± 11.6 years, with a mean follow-up period of 44.5 ± 26.4 months. MACE occurred in 15.2% of patients, showing a higher rate in the higher IABPD group (≥10 mmHg) than in the lower IABPD group (<10 mmHg) (22.5% vs 14.5%, p = 0.081). The difference was induced by a higher rate of ischemia-driven target vessel revascularization (17.5% vs 8.3%, p = 0.011). The Kaplan-Meier survival analysis revealed a greater incidence of MACE in patients with a higher IABPD (log rank p = 0.054). The Cox proportional hazard analysis showed that IABPD was an independent predictor of long-term MACE (hazard ratio, 1.028; 95% confidence interval, 1.002-1.055; p = 0.037), along with age, diabetes mellitus, and number of implanted stents. CONCLUSION Among patients treated with PCI, the incidence of MACE was significantly higher in those with a higher IABPD (≥10 mmHg) than in those with a lower IABPD (<10 mmHg), which was mainly driven by ischemia-driven target vessel revascularization.
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Affiliation(s)
- Se-Jun Park
- Division of Cardiology, Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea
| | - Jung-Woo Son
- Department of Cardiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Kyung-Soon Hong
- Division of Cardiology, Cardiovascular Center, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Hyun-Hee Choi
- Division of Cardiology, Cardiovascular Center, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea.
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Park JJ, Kim SH, Oh IY, Choi DJ, Park HA, Cho HJ, Lee HY, Cho JY, Kim KH, Son JW, Yoo BS, Oh J, Kang SM, Baek SH, Lee GY, Choi JO, Jeon ES, Lee SE, Kim JJ, Lee JH, Cho MC, Jang SY, Chae SC, Oh BH. The Effect of Door-to-Diuretic Time on Clinical Outcomes in Patients With Acute Heart Failure. JACC Heart Fail 2019; 6:286-294. [PMID: 29598933 DOI: 10.1016/j.jchf.2017.12.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 12/28/2017] [Indexed: 02/04/2023]
Abstract
OBJECTIVES This study sought to examine the impact of door-to-diuretic (D2D) time on mortality in patients with acute heart failure (AHF) who were presenting to an emergency department (ED). BACKGROUND Most patients with AHF present with congestion. Early decongestion with diuretic agents could improve their clinical outcomes. METHODS The Korea Acute Heart Failure registry enrolled 5,625 consecutive patients hospitalized for AHF. For this analysis, the study included patients who received intravenous diuretic agents within 24 h after ED arrival. Early and delayed groups were defined as D2D time ≤60 min and D2D time >60 min, respectively. The primary outcomes were in-hospital death and post-discharge death at 1 month and 1 year on the basis of D2D time. RESULTS A total of 2,761 patients met the inclusion criteria. The median D2D time was 128 min (interquartile range: 63 to 243 min), and 663 (24%) patients belonged to the early group. The baseline characteristics were similar between the groups. The rate of in-hospital death did not differ between the groups (5.0% vs. 5.1%; p > 0.999), nor did the post-discharge 1-month (4.0% vs. 3.0%; log-rank p = 0.246) and 1-year (20.6% vs. 19.3%; log-rank p = 0.458) mortality rates. Get With the Guidelines-Heart Failure risk score was calculated for each patient. In multivariate analyses with adjustment for Get With the Guidelines-Heart Failure risk score and other significant clinical covariates and propensity-matched analyses, D2D time was not associated with clinical outcomes. CONCLUSIONS The D2D time was not associated with clinical outcomes in a large prospective cohort of patients with AHF who were presenting to an ED. (Registry [Prospective Cohort] for Heart Failure in Korea [KorAHF]; NCT01389843).
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Affiliation(s)
- Jin Joo Park
- Cardiovascular Center, Division of Cardiology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Sun-Hwa Kim
- Cardiovascular Center, Division of Cardiology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Il-Young Oh
- Cardiovascular Center, Division of Cardiology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Dong-Ju Choi
- Cardiovascular Center, Division of Cardiology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
| | - Hyun-Ah Park
- Department of Family Medicine, Inje University Seoul Paik Hospital, Seoul, Republic of Korea
| | - Hyun-Jai Cho
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hae-Young Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jae-Yeong Cho
- Heart Research Center of Chonnam National University, Gwangju, Republic of Korea
| | - Kye Hun Kim
- Heart Research Center of Chonnam National University, Gwangju, Republic of Korea
| | - Jung-Woo Son
- Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Byung-Su Yoo
- Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Jaewon Oh
- Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seok-Min Kang
- Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sang Hong Baek
- Department of Internal Medicine, the Catholic University of Korea, Seoul, Republic of Korea
| | - Ga Yeon Lee
- Department of Internal Medicine, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea
| | - Jin Oh Choi
- Department of Internal Medicine, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea
| | - Eun-Seok Jeon
- Department of Internal Medicine, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea
| | - Sang Eun Lee
- Division of Cardiology, Asan Medical Center, Seoul, Republic of Korea
| | - Jae-Joong Kim
- Division of Cardiology, Asan Medical Center, Seoul, Republic of Korea
| | - Ju-Hee Lee
- Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Myeong-Chan Cho
- Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Se Yong Jang
- Kyungpook National University College of Medicine, Daegu, Republic of Korea
| | - Shung Chull Chae
- Kyungpook National University College of Medicine, Daegu, Republic of Korea
| | - Byung-Hee Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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Yoo BS, Ahn MS, Lee SJ, Son JW, Kim JY, Park SW. P783Guideline-directed therapy at discharge is important in patients with heart failure and atrial fibrillation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
There are limited and conflicting data regarding the prognostic implication of guideline-directed therapy, especially in heart failure (HF) patients with atrial fibrillation (AF). Thus, this study evaluated the relationship between guideline adherence to recommended therapy at discharge and relevant 60-day clinical outcomes in acute HF patients with AF having reduced ejection fraction (HFrEF) or preserved ejection fraction (HFpEF).
Methods and results
Of 5,625 acute HF patients in the Korean Acute Heart Failure Registry, 2,071 with documented AF (HFrEF, n=986; HFpEF, n=1,085) were separately analysed. A guideline adherence score was calculated for the prescription of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, β-blockers, mineralocorticoid receptor antagonists, and anticoagulants. In HFrEF patients with AF, there was significant trend of increase in mortality (p for trend <0.001) and composite endpoint (p for trend = 0.002) according to guideline adherence. Poor adherence was associated with a significantly high risk of mortality (hazard ratio [HR], 4.75; 95% confidence interval [95% CI], 1.77–12.74) and composite endpoint (HR, 2.36; 95% CI, 1.33–4.18). In HFpEF patients with AF, there was a significant increasing trend for rehospitalization (p for trend = 0.04) and composite endpoint (p for trend = 0.03). However, the beneficial effect of good guideline adherence was statistically non-significant for all clinical outcomes
Conclusion
Better adherence to guidelines was associated with a better 60-day prognosis in both HFrEF and HFpEF patients with AF. However, the beneficial effect of guideline adherence was more pronounced in HFrEF patients with AF.
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Affiliation(s)
- B S Yoo
- Wonju College of Medicine, Yonsei University, Division of Cardiology, Department of Internal Medicin, Wonju, Korea (Republic of)
| | - M S Ahn
- Wonju College of Medicine, Yonsei University, Division of Cardiology, Department of Internal Medicin, Wonju, Korea (Republic of)
| | - S J Lee
- Wonju College of Medicine, Yonsei University, Division of Cardiology, Department of Internal Medicin, Wonju, Korea (Republic of)
| | - J W Son
- Wonju College of Medicine, Yonsei University, Division of Cardiology, Department of Internal Medicin, Wonju, Korea (Republic of)
| | - J Y Kim
- Wonju College of Medicine, Yonsei University, Division of Cardiology, Department of Internal Medicin, Wonju, Korea (Republic of)
| | - S W Park
- Wonju College of Medicine, Yonsei University, Division of Cardiology, Department of Internal Medicin, Wonju, Korea (Republic of)
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Ahn MS, Yoo BS, Yoon J, Lee SH, Kim JY, Ahn SG, Youn YJ, Lee JW, Son JW, Kim HS, Kang DR, Cho HJ, Lee HY, Jeon ES, Kang SM, Choi DJ, Cho MC. Guideline-directed therapy at discharge in patients with heart failure and atrial fibrillation. Heart 2019; 106:292-298. [PMID: 31492703 PMCID: PMC7027027 DOI: 10.1136/heartjnl-2019-315240] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 07/08/2019] [Accepted: 07/24/2019] [Indexed: 01/28/2023] Open
Abstract
Objectives This study evaluated the relationship between guideline adherence for recommended therapy on discharge and relevant 60-day and 1-year clinical outcomes in patients with acute heart failure (HF) with reduced ejection fraction and atrial fibrillation (AF). Methods Of 5625 acute patients with HF in the Korean Acute Heart Failure registry, 986 patients with HF and documented AF were analysed. Guideline adherence scores were calculated for the prescription of ACE inhibitors, angiotensin receptor blockers, β-blockers, mineralocorticoid receptor antagonists and anticoagulants. Results In patients with HF with AF, there was a significant trend of reduced 60-day and 1-year mortality rates and the composite end point with guideline adherence. According to the Cox proportion hazard model, poor adherence was associated with a significantly higher risk of 60-day mortality (HR 4.75; 95% CI 1.77 to 12.74) and the composite end point (HR 2.36; 95% CI 1.33 to 4.18) compared with good adherence. Furthermore, poor adherence was associated with a significantly higher risk of 1-year mortality compared with moderate (HR 1.64; 95% CI 1.15 to 2.33) and good adherence (HR 2.34; 95% CI 1.39 to 3.97) and with a higher risk of the 1-year composite end point compared with good adherence (HR 1.58; 95% CI 1.07 to 2.33). Conclusion Better adherence to guidelines was associated with better 60-day and 1-year prognoses in patients with HF with AF.
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Affiliation(s)
- Min-Soo Ahn
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| | - Byung Su Yoo
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| | - Junghan Yoon
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| | - Seung-Hwan Lee
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| | - Jang Young Kim
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| | - Sung Gyun Ahn
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| | - Young Jin Youn
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| | - Jun-Won Lee
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| | - Jung-Woo Son
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| | - Hye Sim Kim
- Center of Biomedical Data Science, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| | - Dae Ryong Kang
- Center of Biomedical Data Science, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| | - Hyun-Jai Cho
- Division of Cardiology, Department of Internal Medicine/Cardiovascular Center, Seoul National University Hospital, Jongno-gu, Seoul, Republic of Korea
| | - Hae-Young Lee
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Eun Seok Jeon
- Division of Cardiology, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea
| | - Seok-Min Kang
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Wonju College of Medicine, Seoul, Republic of Korea
| | - Dong-Ju Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Myeong-Chan Cho
- Chungbuk National University Hospital, Chungju-si, Republic of Korea
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Lee JW, Choi E, Khanam SS, Son JW, Youn YJ, Ahn MS, Ahn SG, Kim JY, Lee SH, Yoon J, Yoo BS. Prognostic value of short-term follow-up B-type natriuretic peptide levels after hospital discharge in patients with acute myocardial infarction. Int J Cardiol 2019; 289:19-23. [PMID: 30638981 DOI: 10.1016/j.ijcard.2019.01.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 11/05/2018] [Accepted: 01/07/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Elevated B-type natriuretic peptide (BNP) levels in patients hospitalized for acute myocardial infarction (AMI) are associated with heart failure and mortality. However, the role of BNP after hospital discharge is not clear. Therefore, we assessed the relationship between short-term follow-up BNP levels and clinical outcomes including all-cause mortality and major adverse cardiovascular events (MACE) in patients with AMI after hospital discharge. METHODS From a prospective single-center percutaneous coronary intervention (PCI) registry, a total of 442 out of 2157 patients with AMI who had measurements for both initial and follow-up BNP levels within 2 months after discharge were retrospectively enrolled. Patients were divided into 4 groups (low-low, high-low, low-high, and high-high) according to their follow-up log-transformed BNP median values. RESULTS The median follow-up period was 441 days (interquartile range [IQR], 362-861 days). Logistic regression analysis demonstrated that short-term follow-up BNP level was a significant predictor for all-cause mortality (odds ratio [OR], 2.265; 95% confidence interval [CI], 1.455-3.527) and MACE (OR, 1.43; 95% CI, 1.101-1.858) after adjustments for covariates. The initial BNP level did not predict both all-cause mortality and MACE. The group with high initial and high follow-up BNP levels was significantly associated with all-cause mortality (OR, 3.465; 95% CI, 1.122-10.700). CONCLUSIONS Short-term follow-up BNP level after hospital discharge was a powerful prognostic marker for all-cause mortality and MACE in patients with AMI. The combination of short-term follow-up BNP level with initial BNP level was a better predictor of all-cause mortality.
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Affiliation(s)
- Jun-Won Lee
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Eunhee Choi
- Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Sayma Sabrina Khanam
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Jung-Woo Son
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Young-Jin Youn
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Min-Soo Ahn
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Sung Gyun Ahn
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Jang-Young Kim
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Seung-Hwan Lee
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Junghan Yoon
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Byung-Su Yoo
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
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Lee CJ, Son JW, Hwang J, Oh J, Kang SM, Choi DJ, Yoo BS. Characteristics of Incident Heart Failure over 11 Years in Korea: Analysis from National Health Insurance Database. J Card Fail 2019. [DOI: 10.1016/j.cardfail.2019.07.265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Lee JW, Park SW, Son JW, Ahn SG, Lee SH. Real-world experience of the left distal transradial approach for coronary angiography and percutaneous coronary intervention: a prospective observational study (LeDRA). EUROINTERVENTION 2018; 14:e995-e1003. [PMID: 30222122 DOI: 10.4244/eij-d-18-00635] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS This study aimed to evaluate the feasibility and safety of the left distal transradial approach (ldTRA) as a default route for coronary angiography (CAG) and percutaneous coronary intervention (PCI). METHODS AND RESULTS Between October 2017 and January 2018, 200 consecutive patients were enrolled in a single centre. The left distal radial artery was punctured with a 20-gauge venipuncture catheter needle by three expert left radial approach operators. The success rates of arterial puncture, CAG, and PCI were 95.5% (191/200), 100% (187/187), and 98.9% (86/87), respectively. Four patients scheduled for staged PCI skipped the routine diagnostic CAG. Puncture time and fluoroscopic time were 3.0±2.8 minutes and 11.3±18.4 minutes, respectively. Haemostasis time was 151.8±39.9 minutes. A total of 15 (7.9%) puncture site complications occurred, including 14 (7.4%) minor haematomas and one (0.5%) arterial dissection, in which the artery was patent at one-month follow-up. Two patients complained of left thumb numbness at one-month follow-up. No distal radial artery occlusion, perforation, pseudoaneurysm, or arteriovenous fistula occurred. CONCLUSIONS The success and complication rates of ldTRA support the feasibility and safety of this procedure. Larger randomised comparison studies are needed to support this preliminary evidence.
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Affiliation(s)
- Jun-Won Lee
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
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Lee JH, Son BC, Jung SY, Lee CH, Son JW, Kim U, Park JS, Shin DG. P1715Clinical effects of beta blocker selectivity and dosage regimens in acute myocardial infarction: propensity-score matching analysis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J H Lee
- Yeungnam University Hospital, Cardiology, Daegu, Korea Republic of
| | - B C Son
- Yeungnam University Hospital, Cardiology, Daegu, Korea Republic of
| | - S Y Jung
- Yeungnam University Hospital, Cardiology, Daegu, Korea Republic of
| | - C H Lee
- Yeungnam University Hospital, Cardiology, Daegu, Korea Republic of
| | - J W Son
- Yeungnam University Hospital, Cardiology, Daegu, Korea Republic of
| | - U Kim
- Yeungnam University Hospital, Cardiology, Daegu, Korea Republic of
| | - J S Park
- Yeungnam University Hospital, Cardiology, Daegu, Korea Republic of
| | - D G Shin
- Yeungnam University Hospital, Cardiology, Daegu, Korea Republic of
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Park SK, Son JW, Chung S, Lee S, Ghim HR, Lee SI, Shin CJ, Kim S, Ju G, Choi SC, Kim YY, Koo YJ, Kim BN, Yoo HJ. Autism and Beauty: Neural Correlates of Aesthetic Experiences in Autism Spectrum Disorder. Soa Chongsonyon Chongsin Uihak 2018; 29:101-113. [PMID: 32595302 PMCID: PMC7289455 DOI: 10.5765/jkacap.170031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 01/25/2018] [Accepted: 02/14/2018] [Indexed: 11/30/2022] Open
Abstract
Objectives: The purpose of this study was to investigate whether the neural activity of autism spectrum disorder (ASD) patients is different from that of normal individuals when performing aesthetic judgments. Methods: We recruited typical ASD patients without savant skills (ASD group, n=17) and healthy controls (HC group, n=19) for an functional magnetic resonance imaging study. All subjects were scanned while performing aesthetic judgment tasks on two kinds of artwork (magnificent landscape images and fractal images). Differences in brain activation between the two groups were assessed by contrasting neural activity during the tasks. Results: The aesthetic judgment score for all images was significantly lower in the ASD group than in the HC group. During the aesthetic judgment tasks, the ASD group showed less activation than the HC group in the anterior region of the superior frontal gyrus, and more activation in the temporoparietal area and insula, regardless of the type of images being judged. In addition, during the aesthetic judgment task for the fractal images, the ASD group exhibited greater neural activity in the amygdala and the posterior region of the middle/inferior temporal gyrus (Brodmann area 37) than the HC group. Conclusion: The results of this study suggest that the brain activation patterns associated with aesthetic experiences in ASD patients may differ from those of normal individuals.
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Affiliation(s)
- Seong Kyoung Park
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju, Korea
| | - Jung-Woo Son
- Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Seungwon Chung
- Department of Psychiatry, Bugok National Hospital, Changnyeong, Korea
| | - Seungbok Lee
- Department of Psychology, Chungbuk National University, Cheongju, Korea
| | - Hei-Rhee Ghim
- Department of Psychology, Chungbuk National University, Cheongju, Korea
| | - Sang-Ick Lee
- Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Chul-Jin Shin
- Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Siekyeong Kim
- Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Gawon Ju
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju, Korea
| | | | - Yang Yeol Kim
- SeoulTop Child Adolescent Psychiatric Clinic, Seoul, Korea
| | | | - Bung-Nyun Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Hee Jeong Yoo
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Ahn SG, Kang DR, Kim HS, Go TH, Yu MH, Park S, Son JW, Lee JW, Ahn MS, Youn YJ, Kim JY, Yoo BS, Lee SH, Yoon J. COMPLETE REVASCULARIZATION VERSUS CULPRIT VESSEL INTERVENTION-ONLY IN PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION AND MULTI VESSEL CORONARY DISEASE: STRATIFIED ANALYSES IN HIGH-RISK GROUPS FROM A PROSPECTIVE KOREA ACUTE MYOCARDIAL INFARCTION-NATIONAL INSTITUTES OF HEALTH REGISTRY. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)30606-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Kim JY, Son JW, Park S, Yoo TH, Kim YJ, Ryu DR, Chin HJ. FimAsartaN proTeinuriA SusTaIned reduCtion in comparison with losartan in diabetic chronic kidney disease (FANTASTIC): study protocol for randomized controlled trial. Trials 2017; 18:632. [PMID: 29284530 PMCID: PMC5747165 DOI: 10.1186/s13063-017-2375-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 12/04/2017] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Fimasartan is the ninth angiotensin receptor blocker to be developed. However, it has not yet been evaluated for reno-protective effects in hypertensive diabetic chronic kidney disease (CKD). The target blood pressure (BP) for hypertensive diabetic CKD is also a controversial topic. This trial was designed to assess the reno-protective effects of fimasartan compared to those of losartan as a primary outcome. This study also compares the two drugs with regard to cardiovascular and renal outcomes in accordance with target systolic BP (SBP) (as secondary outcomes). METHODS This study is a prospective, phase III, randomized, double-blind, active-controlled, non-inferiority, four-parallel group, dose-titration, multicenter trial. We recruit patients with hypertensive diabetic CKD with overt proteinuria. Participants will be randomized into four groups (1:1:1:1): fimasartan standard SBP control (SBP < 140 mmHg); fimasartan strict SBP control (SBP < 130 mmHg); losartan standard SBP control; and losartan strict SBP control. After 24 weeks, all individuals are treated with fimasartan for an additional 120 weeks in an open-label design, maintaining their assigned SBP control groups as randomized. The primary endpoint is the rate of change in proteinuria, which is assessed using the spot urine albumin-creatinine ratio at 24 weeks. The secondary endpoints are the cardiovascular and renal outcomes at 144 weeks compared between the strict SBP and standard SBP control groups. DISCUSSION The FANTASTIC is a clinical study to provide: (1) the reno-protective effect of fimasartan; and (2) the target BP to reduce adverse outcomes in hypertensive diabetic CKD with overt proteinuria. TRIAL REGISTRATION Clinicaltrials.gov, NCT02620306. Registered on 1 December 2015.
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Affiliation(s)
- Jang-Young Kim
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Jung-Woo Son
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Sungha Park
- Divison of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Tea-Hyun Yoo
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yong-Jin Kim
- Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Dong-Ryeol Ryu
- Department of Internal Medicine, School of Medicine, Ewha Womans University, 1071, Anyangcheon-ro, Yangcheon-gu, Seoul 158-710 Republic of Korea
| | - Ho Jun Chin
- Division of nephrology, Department of internal medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do Republic of Korea
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Kim SA, Kim BN, Kim JW, Shin MS, Park TW, Son JW, Chung US, Park M. Polymorphism in the Promoter Region of SEMA5A Is Associated with Sociality Traits in Korean Subjects with Autism Spectrum Disorders. Psychiatry Investig 2017; 14:876-878. [PMID: 29209394 PMCID: PMC5714732 DOI: 10.4306/pi.2017.14.6.876] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Revised: 12/11/2016] [Accepted: 02/15/2017] [Indexed: 01/27/2023] Open
Abstract
In this study, we evaluated the association between autism spectrum disorders (ASDs) and 10 single-nucleotide polymorphisms (SNPs) in the 5' region of the semaphorin 5A gene (SEMA5A) for 250 Korean trios including children with ASDs. Family-based association testing and haplotype analysis revealed a statistically significant association between rs194085 and multiple sociality traits with Korean ASDs in the dominant model (p<0.001, corrected p=0.035). This indicates that genetic variations in the 5' region of SEMA5A play a role in the genetic predisposition to sociality traits in Korean ASDs.
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Affiliation(s)
- Soon Ae Kim
- Department of Pharmacology, School of Medicine, Eulji University, Daejeon, Republic of Korea
| | - Boong-Nyun Kim
- Department of Child and Adolescent Psychiatry, College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jae-Won Kim
- Department of Child and Adolescent Psychiatry, College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Min-Sup Shin
- Department of Child and Adolescent Psychiatry, College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Tae-Won Park
- Department of Psychiatry, Chonbuk National University Medical School, Jeonju, Republic of Korea
| | - Jung-Woo Son
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Un-Sun Chung
- Department of Psychiatry, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Mira Park
- Department of Preventive Medicine, School of Medicine, Eulji University, Daejeon, Republic of Korea
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Cha YS, Kim H, Lee Y, Kwon W, Son JW, Youk H, Kim HI, Kim OH, Park KH, Cha KC, Lee KH, Hwang SO. Evaluation of relationship between coronary artery status evaluated by coronary computed tomography angiography and development of cardiomyopathy in carbon monoxide poisoned patients with myocardial injury: a prospective observational study. Clin Toxicol (Phila) 2017; 56:30-36. [DOI: 10.1080/15563650.2017.1337910] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Yong Sung Cha
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Hyun Kim
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Yoonsuk Lee
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Woocheol Kwon
- Department of Radiology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Jung-Woo Son
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Hyun Youk
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Hyung Il Kim
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Oh Hyun Kim
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Kyung Hye Park
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
- Department of Medical Education, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Kyoung-Chul Cha
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Kang Hyun Lee
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Sung Oh Hwang
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
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Youn YJ, Yoo BS, Son JW, Lee JW, Ahn MS, Ahn SG, Kim JY, Lee SH, Yoon J, Eom YW, Oh JE, Choi SK. Remote Ischemic Conditioning by Effluent Collected from a Novel Isolated Hindlimb Model Reduces Infarct Size in an Isolated Heart Model. Korean Circ J 2017; 47:714-726. [PMID: 28955390 PMCID: PMC5614948 DOI: 10.4070/kcj.2017.0092] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 05/16/2017] [Accepted: 05/22/2017] [Indexed: 02/03/2023] Open
Abstract
Background and Objectives Experimental protocols for remote ischemic conditioning (RIC) utilize models in which a tourniquet is placed around the hindlimb or effluent is collected from an isolated heart. In analyzing the humoral factors that act as signal transducers in these models, sampled blood can be influenced by systemic responses, while the effluent from an isolated heart might differ from that of the hindlimb. Thus, we designed a new isolated hindlimb model for RIC and tested whether the effluent from this model could affect ischemia/reperfusion (IR) injury and if the reperfusion injury salvage kinase (RISK) and survivor activating factor enhancement (SAFE) pathways are involved in RIC. Materials and Methods After positioning needles into the right iliac artery and vein of rats, Krebs-Henseleit buffer was perfused using a Langendorff apparatus, and effluent was collected. The RIC protocol consisted of 3 cycles of IR for 5 minutes. In the RIC effluent group, collected effluent was perfused in an isolated heart for 10 minutes before initiating IR injury. Results Compared with the control group, the infarct area in the RIC effluent group was significantly smaller (31.2%±3.8% vs. 20.6%±1.8%, p<0.050), while phosphorylation of signal transducer and activation of transcription-3 (STAT-3) was significantly increased. However, there was a trend of increased phosphorylation of extracellular signal-regulated kinase (ERK) 1/2 in this group. Conclusion This is the first study to investigate the effect of effluent from a new isolated hindlimb model after RIC on IR injury in an isolated heart model. The RIC effluent was effective in reducing the IR injury, and the cardioprotective effect was associated with activation of the SAFE pathway.
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Affiliation(s)
- Young Jin Youn
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Byung-Su Yoo
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jung-Woo Son
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jun-Won Lee
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Min-Soo Ahn
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sung Gyun Ahn
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jang-Young Kim
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Seung-Hwan Lee
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Junghan Yoon
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Young Woo Eom
- Cell Therapy and Tissue Engineering Center, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Ji-Eun Oh
- Cell Therapy and Tissue Engineering Center, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Seong-Kyung Choi
- Animal Core, Central Research Laboratory, Yonsei University Wonju College of Medicine, Wonju, Korea
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Khanam SS, Son JW, Lee JW, Youn YJ, Yoon J, Lee SH, Kim JY, Ahn SG, Ahn MS, Yoo BS. Prognostic value of short-term follow-up BNP in hospitalized patients with heart failure. BMC Cardiovasc Disord 2017; 17:215. [PMID: 28774268 PMCID: PMC5543427 DOI: 10.1186/s12872-017-0632-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Accepted: 07/14/2017] [Indexed: 12/28/2022] Open
Abstract
Background B-type natriuretic peptide (BNP) has prognostic significance in heart failure (HF), and reductions in BNP may predict clinical improvement. However, there are limited data regarding the prognostic value of BNP during short-term follow-up. The aim of this study was to evaluate the relationship between short-term follow-up BNP and mortality after discharge in patients with HF. Methods We analyzed 427 patients hospitalized with HF from the Wonju Severance Christian Hospital Heart Failure Registry from April 2011 to December 2013, with a planned follow-up period through February 2016. Of the 427 patients, 240 (mean age, 75 years; 102 males, 42.5%) had BNP measured on admission and within the short-term follow-up period (3 months). We compared all-cause mortality during the clinical follow-up period (median length of follow-up, 709.5 days) according to the median value of BNP on admission (as a baseline value) and over a short-term follow-up period after discharge. Results Median BNP at admission was 816.5 pg/ml, and median follow-up BNP was 369.7 pg/ml. Multivariate analysis revealed a positive association between risk of death and high BNP. High BNP during follow-up was significantly associated with a greater risk of all-cause mortality compared to low BNP (P < 0.001). Initial BNP was not significantly associated with all-cause mortality. A multivariate model showed that follow-up BNP and percent change in BNP were independently associated with all-cause mortality after adjustment for covariates. Of the 3 BNP measurement strategies, BNP after discharge (IDI of 0.072, P < .0001 and NRI of 0.707, P < .0001) and percent change in BNP (IDI of 0.113, P < .0001 and NRI of 0.782, P < .0001) demonstrated the greatest increase in discrimination and net reclassification for mortality. Unfortunately, we did not find any significant value with initial BNP. Kaplan-Meier survival analysis was performed to assess mortality stratified by BNP according to the median value, high median of follow-up BNP and percent change in BNP were associated with significantly higher mortality compared to the below median (log-rank, p < 0.001). Conclusions Short-term follow-up BNP and percent change in BNP level are significant prognostic factors of all-cause mortality. These values will be clinically useful when evaluating prognosis in hospitalized patients with heart failure.
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Affiliation(s)
- Sayma Sabrina Khanam
- Department of Cardiology, Wonju College of Medicine, Yonsei University, 20 Ilsan-ro, Gangwon-do, 26426, Wonju, Republic of Korea
| | - Jung-Woo Son
- Department of Cardiology, Wonju College of Medicine, Yonsei University, 20 Ilsan-ro, Gangwon-do, 26426, Wonju, Republic of Korea
| | - Jun-Won Lee
- Department of Cardiology, Wonju College of Medicine, Yonsei University, 20 Ilsan-ro, Gangwon-do, 26426, Wonju, Republic of Korea
| | - Young Jin Youn
- Department of Cardiology, Wonju College of Medicine, Yonsei University, 20 Ilsan-ro, Gangwon-do, 26426, Wonju, Republic of Korea
| | - Junghan Yoon
- Department of Cardiology, Wonju College of Medicine, Yonsei University, 20 Ilsan-ro, Gangwon-do, 26426, Wonju, Republic of Korea
| | - Seung-Hwan Lee
- Department of Cardiology, Wonju College of Medicine, Yonsei University, 20 Ilsan-ro, Gangwon-do, 26426, Wonju, Republic of Korea
| | - Jang-Young Kim
- Department of Cardiology, Wonju College of Medicine, Yonsei University, 20 Ilsan-ro, Gangwon-do, 26426, Wonju, Republic of Korea
| | - Sung Gyun Ahn
- Department of Cardiology, Wonju College of Medicine, Yonsei University, 20 Ilsan-ro, Gangwon-do, 26426, Wonju, Republic of Korea
| | - Min-Soo Ahn
- Department of Cardiology, Wonju College of Medicine, Yonsei University, 20 Ilsan-ro, Gangwon-do, 26426, Wonju, Republic of Korea
| | - Byung-Su Yoo
- Department of Cardiology, Wonju College of Medicine, Yonsei University, 20 Ilsan-ro, Gangwon-do, 26426, Wonju, Republic of Korea.
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Park SJ, Son JW, Park SM, Choi HH, Hong KS. The impact of inter-arm blood pressure differences to coronary intervention in patients with coronary artery diseases. Atherosclerosis 2017. [DOI: 10.1016/j.atherosclerosis.2017.06.479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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