231 results on '"Dong Hyun Lee"'
Search Results
2. Longitudinal renal changes in chronic hepatitis B patients treated with entecavir versus TDF: a REAL-B study
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Masaru Enomoto, Sang Bong Ahn, Chao Wu, Dae Won Jun, Jae Yoon Jeong, Li Liu, Htet Htet Toe Wai Khine, Lung-Yi Mak, Ming-Lun Yeh, Rui Huang, Mindie H. Nguyen, Seng Gee Lim, Chien-Hung Chen, Soung Won Jeong, Chia-Yen Dai, Jee-Fu Huang, Hyunwoo Oh, Sung Eun Kim, Wan-Long Chuang, Vivien W.M. Tsui, Rex Wan-Hin Hui, Dong Hyun Lee, Sabrina Quek, Ramsey Cheung, Man-Fung Yuen, Pei-Chien Tsai, Allen Dao, Eileen Yoon, Grace Lai-Hung Wong, Chung-Feng Huang, Daniel Q. Huang, Ritsuzo Kozuka, Yong Kyun Cho, Eiichi Ogawa, Joseph Hoang, Jae-Jun Shim, Lindsey Trinh, Qing Xie, Ming-Lung Yu, Cheng Yuan Peng, Hyoung Su Kim, and Huy N. Trinh
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medicine.medical_specialty ,Hepatology ,Proportional hazards model ,business.industry ,Incidence (epidemiology) ,Urology ,Renal function ,Retrospective cohort study ,Entecavir ,medicine.disease ,Internal medicine ,Cohort ,medicine ,business ,Kidney disease ,medicine.drug - Abstract
We aimed to compare the longitudinal changes in estimated glomerular filtration rate (eGFR) in chronic hepatitis B (CHB) patients treated with entecavir (ETV) vs. tenofovir disoproxil fumarate (TDF). This is a retrospective study of 6189 adult treatment-naive CHB patients initiated therapy with TDF (n = 2482) or ETV (n = 3707) at 25 international centers using multivariable generalized linear modeling (GLM) to determine mean eGFR (mL/min/1.73 m2) and Kaplan–Meier method to estimate incidence of renal impairment (≥ 1 chronic kidney disease [CKD] stage worsening). We also examined above renal changes in matched ETV and TDF patients (via propensity score matching [PSM] on age, sex, diabetes mellitus [DM], hypertension [HTN], cirrhosis, baseline eGFR, and follow-up duration). In the overall cohort (mean age 49.7 years, 66.2% male), the baseline eGFR was higher for TDF vs. ETV group (75.9 vs. 74.0, p = 0.009). PSM yielded 1871 pairs of ETV or TDF patients with baseline eGFR ≥ 60 and 520 pairs for the eGFR
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- 2021
3. Contribution of dipeptidyl peptidase 10 to airway dysfunction in patients with NSAID‐exacerbated respiratory disease
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Hee-Ra Lee, Yoo Seob Shin, Dong-Hyun Lee, Youngwoo Choi, Soyoon Sim, and Hae-Sim Park
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medicine.medical_specialty ,Nerd ,Respiratory Tract Diseases ,Immunology ,Inflammation ,Gastroenterology ,Dipeptidyl peptidase ,Transforming Growth Factor beta1 ,Pathogenesis ,Mice ,Internal medicine ,medicine ,Animals ,Humans ,Immunology and Allergy ,Dipeptidyl-Peptidases and Tripeptidyl-Peptidases ,Lung ,medicine.diagnostic_test ,business.industry ,Anti-Inflammatory Agents, Non-Steroidal ,Respiratory disease ,Eosinophil ,medicine.disease ,Asthma ,medicine.anatomical_structure ,Bronchoalveolar lavage ,medicine.symptom ,business ,Ex vivo - Abstract
BACKGROUND Genetic variants of dipeptidyl peptidase 10 (DPP10) have been suggested to contribute to the development of NSAID-exacerbated respiratory disease (NERD). However, the mechanisms of how DPP10 contributes to NERD phenotypes remain unclear. OBJECTIVE To demonstrate the exact role of DPP10 in the pathogenesis of NERD. METHODS Patients with NERD (n = 110), those with aspirin-tolerant asthma (ATA, n = 130) and healthy control subjects (HCs, n = 80) were enrolled. Clinical characteristics were analysed according to the serum DPP10 levels in both NERD and ATA groups. The function of DPP10 in airway inflammation and remodelling was investigated with in vitro, ex vivo and in vivo experiments. RESULTS NERD patients had higher levels of serum DPP10 and TGF-β1 with lower FEV1 than ATA patients or HCs (p
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- 2021
4. Relationship between the presence of dedicated doctors in rapid response systems and patient outcome: a multicenter retrospective cohort study
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Yeon Joo Lee, Sang Min Lee, Jisoo Park, Jae Hwa Cho, Hyung Jun Kim, Byung Ju Kang, Jae Young Moon, Dong Hyun Lee, Sang-Bum Hong, Kyeongman Jeon, Jung Soo Kim, and Jong Joon Ahn
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Male ,medicine.medical_specialty ,Propensity score ,Population ,law.invention ,Diseases of the respiratory system ,law ,Physicians ,Republic of Korea ,medicine ,Humans ,Health Workforce ,Hospital Mortality ,Hospital rapid response system ,Mortality ,education ,Aged ,Retrospective Studies ,Aged, 80 and over ,education.field_of_study ,RC705-779 ,Septic shock ,business.industry ,Incidence (epidemiology) ,Research ,Hazard ratio ,Retrospective cohort study ,Odds ratio ,Middle Aged ,medicine.disease ,Intensive care unit ,Survival Rate ,Intensive Care Units ,Treatment Outcome ,Emergency medicine ,Propensity score matching ,Female ,business ,Hospital Rapid Response Team - Abstract
Background Rapid response systems (RRSs) improve patients’ safety, but the role of dedicated doctors within these systems remains controversial. We aimed to evaluate patient survival rates and differences in types of interventions performed depending on the presence of dedicated doctors in the RRS. Methods Patients managed by the RRSs of 9 centers in South Korea from January 1, 2016, through December 31, 2017, were included retrospectively. We used propensity score-matched analysis to balance patients according to the presence of dedicated doctors in the RRS. The primary outcome was in-hospital survival. The secondary outcomes were the incidence of interventions performed. A sensitivity analysis was performed with the subgroup of patients diagnosed with sepsis or septic shock. Results After propensity score matching, 2981 patients were included per group according to the presence of dedicated doctors in the RRS. The presence of the dedicated doctors was not associated with patients’ overall likelihood of survival (hazard ratio for death 1.05, 95% confidence interval [CI] 0.93‒1.20). Interventions, such as arterial line insertion (odds ratio [OR] 25.33, 95% CI 15.12‒42.44) and kidney replacement therapy (OR 10.77, 95% CI 6.10‒19.01), were more commonly performed for patients detected using RRS with dedicated doctors. The presence of dedicated doctors in the RRS was associated with better survival of patients with sepsis or septic shock (hazard ratio for death 0.62, 95% CI 0.39‒0.98) and lower intensive care unit admission rates (OR 0.53, 95% CI 0.37‒0.75). Conclusions The presence of dedicated doctors within the RRS was not associated with better survival in the overall population but with better survival and lower intensive care unit admission rates for patients with sepsis or septic shock.
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- 2021
5. MICROCYSTIC MACULAR EDEMA AND CYSTOID MACULAR EDEMA BEFORE AND AFTER EPIRETINAL MEMBRANE SURGERY
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Sung Eun Park, Christopher Seungkyu Lee, and Dong Hyun Lee
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Male ,medicine.medical_specialty ,Prognostic factor ,Visual acuity ,genetic structures ,Fundus Oculi ,Visual Acuity ,Foveal thickness ,Macular Edema ,Vitrectomy ,Humans ,Medicine ,Cyst ,Postoperative Period ,Fluorescein Angiography ,Macular edema ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Epiretinal Membrane ,General Medicine ,Prognosis ,medicine.disease ,eye diseases ,Surgery ,Ophthalmology ,Cross-Sectional Studies ,Preoperative Period ,Angiography ,Female ,sense organs ,Epiretinal membrane ,medicine.symptom ,business ,Tomography, Optical Coherence - Abstract
PURPOSE To investigate the types of intraretinal cysts that are associated with epiretinal membranes and to evaluate the effects of each type of intraretinal cyst on postoperative outcomes. METHODS Retrospective, cross-sectional study design. Patients who underwent preoperative fluorescent angiography and epiretinal membrane surgery from February 2014 to May 2019 were included. Intraretinal cysts were subdivided into cystoid macular edema with angiographic leakage and microcystic macular edema (MME) without angiographic leakage. RESULTS A total of 100 eyes from 100 patients were enrolled. Intraretinal cysts were present in 54 (54.0%) eyes before surgery, of which 27 (27.0%) eyes showed MME, 18 (18.0%) eyes showed cystoid macular edema, and 9 (9.0%) eyes showed cystoid macular edema and MME. After surgery, the number of eyes with cystoid macular edema decreased significantly (P < 0.001), whereas the number of eyes with MME did not (P = 0.302). Absence of preoperative MME, poorer initial visual acuity, increased central foveal thickness, and intact ellipsoidal zone were associated with favorable visual recovery (P = 0.035, 0.033, 0.018, and 0.035, respectively). CONCLUSION Microcystic macular edema associated with epiretinal membranes was a poor prognostic factor for epiretinal membrane surgery. The persistent existence of MME after surgery affirms related chronic structural changes. Further studies should investigate whether earlier surgical intervention (possibly before the development of MME) benefits visual outcomes.
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- 2021
6. Therapeutic Efficacy of Intravitreal Dexamethasone Implant in Korean Patients with Non-infectious Uveitis
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Eun Young Choi, Dong Hyun Lee, Jung Dong Kim, Min Kim, and Jae Yong Han
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Ophthalmology ,medicine.medical_specialty ,Infectious uveitis ,business.industry ,medicine ,Implant ,medicine.disease ,business ,Uveitis ,Dexamethasone ,medicine.drug - Published
- 2021
7. Diagnostic performance of computed tomography and diffusion-weighted imaging as first-line imaging modality according to the International Myeloma Working Group (IMWG) imaging algorithm for monoclonal plasma cell disorders
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Dong Hyun Lee, Choong Guen Chee, Kyung Won Kim, Hye Won Chung, and Min A Yoon
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Male ,Plasma Cells ,Whole body imaging ,Plasma cell ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Positron Emission Tomography Computed Tomography ,Humans ,Medicine ,Whole Body Imaging ,Radiology, Nuclear Medicine and imaging ,Multiple myeloma ,Modality (human–computer interaction) ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,General Medicine ,Guideline ,Middle Aged ,medicine.disease ,Diffusion Magnetic Resonance Imaging ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Monoclonal ,Multiple Myeloma ,Tomography, X-Ray Computed ,business ,Nuclear medicine ,Algorithms ,Diffusion MRI - Abstract
Background The latest International Myeloma Working Group (IMWG) guideline recommends low-dose whole-body (WB) computed tomography (CT) as the first-line imaging technique for the initial diagnosis of plasma cell disorders. Purpose To evaluate diagnostic performances of CT and diffusion-weighted imaging (DWI) as the first-line imaging modalities and assess misclassification rates obtained following the guideline. Material and Methods Two independent radiologists analyzed CT (acquired as PET/CT) and DWI (3-T; b-values = 50 and 900 s/mm2) of patients newly diagnosed with plasma cell disorder, categorizing the number of bone lesions. Diagnostic performance of CT and DWI was compared using the McNemar test, and misclassification rates were calculated with a consensus WB-MRI reading as the reference standard. Differences in lesion number categories were assessed using marginal homogeneity and kappa statistics. Results Of 56 patients (36 men; mean age = 63.5 years), 39 had myeloma lesions. DWI showed slightly higher sensitivity for detecting myeloma lesions (97.4%) than CT (84.6%–92.3%; P > 0.05). CT showed significantly higher specificity (88.2%) than DWI (52.9%–58.8%; PConclusion CT interpreted according to the IMWG guideline is a diagnostically effective first-line modality with relatively high sensitivity and specificity. DWI alone may not be an acceptable first-line imaging modality because of low specificity.
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- 2021
8. Fibrinolysis with Lower Dose Urokinase in Patients with Complicated Parapneumonic Effusion
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Hyun Kyung Lee, Choohee Son, Seul Lee, Heock Lee, Soo-Jung Um, Bo Hyoung Kang, Dong Hyun Lee, Mee Sook Roh, and Sung Hyun Kim
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,medicine.medical_treatment ,pleurisy ,Parapneumonic effusion ,catheters ,03 medical and health sciences ,0302 clinical medicine ,White blood cell ,Fibrinolysis ,medicine ,pneumonia ,030212 general & internal medicine ,Urokinase ,lcsh:RC705-779 ,business.industry ,indwelling ,lcsh:Diseases of the respiratory system ,Pleural Diseases ,medicine.disease ,Empyema ,Surgery ,Pneumonia ,Infectious Diseases ,medicine.anatomical_structure ,030228 respiratory system ,Pleurisy ,empyema ,Original Article ,fibrinolysis ,business ,Fibrinolytic agent ,medicine.drug - Abstract
Background Intrapleural urokinase is one of the most widely used fibrinolytic agents in the treatment of complicated parapneumonic effusion (CPPE). However, little research has been performed on the optimal urokinase dosage. The aim of this study was to evaluate the treatment efficacy of half dose urokinase compared with conventional dose urokinase. Methods We retrospectively enrolled 92 patients with CPPE or empyema who underwent intrapleural urokinase treatment at two tertiary hospitals. Patients received antibiotics, chest tube drainage, and other treatments as part of routine care. The primary outcome was the treatment success rate in the half dose urokinase group (50,000 IU daily for maximal 6 days) and the conventional dose urokinase group (100,000 IU daily). Treatment success was defined as clinical and radiological improvements without surgical treatment or re-admission within one month. Results Forty-four patients received half dose urokinase, whereas 48 patients were treated with conventional dose urokinase. Both groups were relatively well matched at baseline, excluding higher serum white blood cell count and higher empyema prevalence in the half dose urokinase group. The treatment success rate was not different between the two groups (p=0.048). There were no differences in the rate of in-hospital death and surgical treatment, hospitalization duration, and indwelling catheter duration. In the multivariate analysis, urokinase dose was not a predictor of treatment success. Conclusion Half dose intrapleural urokinase is equally effective conventional dose urokinase in treating patients with CPPE or empyema.
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- 2021
9. Clinical and radiological results of indirect decompression after anterior lumbar interbody fusion in central spinal canal stenosis
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Choon-Keun Park, Dae Hyeon Maeng, Dong Hyun Lee, Jae-Won Jang, Dong-Geun Lee, and Jin Sub Hwang
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Adult ,Male ,medicine.medical_specialty ,Nerve root ,Decompression ,Radiography ,Constriction, Pathologic ,Spinal canal stenosis ,Degenerative disc disease ,03 medical and health sciences ,Spinal Stenosis ,0302 clinical medicine ,Humans ,Medicine ,Spinal canal ,Aged ,Lumbar Vertebrae ,business.industry ,Lumbosacral Region ,General Medicine ,Middle Aged ,Decompression, Surgical ,medicine.disease ,Surgery ,Oswestry Disability Index ,Cross-Sectional Studies ,Spinal Fusion ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Radiological weapon ,Female ,business ,Spinal Canal ,030217 neurology & neurosurgery - Abstract
OBJECTIVE Whereas the benefits of indirect decompression after lateral lumbar interbody fusion are well known, the effects of anterior lumbar interbody fusion (ALIF) have not yet been verified. The purpose of this study was to evaluate the clinical and radiological effects of indirect decompression after ALIF for central spinal canal stenosis. In this report, along with the many advantages of the anterior approach, the authors share cases with good outcomes that they have encountered. METHODS The authors performed a retrospective analysis of 64 consecutive patients who underwent ALIF for central spinal canal stenosis with instability and mixed foraminal stenosis between January 2015 and December 2018 at their hospital. Clinical assessments were performed using the visual analog scale score, the Oswestry Disability Index, and the modified Macnab criteria. The radiographic parameters were determined from pre- and postoperative cross-sectional MRI scans of the spinal canal and were compared to evaluate neural decompression after ALIF. The average follow-up period was 23.3 ± 1.3 months. RESULTS All clinical parameters, including the visual analog scale score, Oswestry Disability Index, and modified Macnab criteria, improved significantly. The mean operative duration was 254.8 ± 60.8 minutes, and the intraoperative bleeding volume was 179.8 ± 119.3 ml. In the radiological evaluation, radiological parameters of the cross-sections of the spinal canal showed substantial development. The spinal canal size improved by an average of 43.3% (p < 0.001) after surgery. No major complications occurred; however, aspiration guided by ultrasonography was performed in 2 patients because of a pseudocyst and fluid collection. CONCLUSIONS ALIF can serve as a suitable alternative to extensive posterior approaches. The authors suggest that ALIF can be used for decompression in central spinal canal stenosis as well as restoration of the foraminal dimensions, thus allowing decompression of the nerve roots.
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- 2021
10. Clinical Efficacy of Platelet-Rich Plasma Injection and Its Association With Growth Factors in the Treatment of Mild to Moderate Knee Osteoarthritis: A Randomized Double-Blind Controlled Clinical Trial As Compared With Hyaluronic Acid
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Chul-Won Ha, Jun-Ho Kim, Yong-Beom Park, and Dong-Hyun Lee
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medicine.medical_specialty ,medicine.medical_treatment ,Physical Therapy, Sports Therapy and Rehabilitation ,Osteoarthritis ,Gastroenterology ,Injections, Intra-Articular ,Double blind ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Double-Blind Method ,Internal medicine ,Hyaluronic acid ,medicine ,Humans ,Orthopedics and Sports Medicine ,Clinical efficacy ,Hyaluronic Acid ,030222 orthopedics ,Platelet-Rich Plasma ,business.industry ,Growth factor ,030229 sport sciences ,Osteoarthritis, Knee ,medicine.disease ,Clinical trial ,Treatment Outcome ,Cytokine ,chemistry ,Platelet-rich plasma ,business - Abstract
Background: Although platelet-rich plasma (PRP) has potential as a regenerative treatment for knee osteoarthritis, its efficacy varies. Compositional differences among types of PRP could affect clinical outcomes, but the biological characterization of PRP is lacking. Purpose: To assess the efficacy of intra-articular PRP injection in knee osteoarthritis as compared with hyaluronic acid (HA) injection and to determine whether the clinical efficacy of PRP is associated with its biological characteristics. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 110 patients with symptomatic knee osteoarthritis received a single injection of leukocyte-rich PRP (1 commercial kit) or HA. Clinical data were assessed at baseline and at 6 weeks and 3 and 6 months after injection. The primary endpoint was an improvement in the International Knee Documentation Committee (IKDC) subjective score at 6 months, and the secondary endpoints were improvements in scores based on the Patient Global Assessment, the visual analog scale (VAS) for pain, the Western Ontario and McMaster Universities Osteoarthritis Index, and the Samsung Medical Center patellofemoral score. Cell counts and concentrations of growth factors and cytokines in the injected PRP were assessed to determine their association with clinical outcomes. Results: PRP showed significantly improvement in IKDC subjective scores at 6 months (11.5 in the PRP group vs 6.3 in the HA group; P = .029). There were no significant differences between groups in other clinical outcomes. The Patient Global Assessment score at 6 months was better in the PRP group ( P = .035). The proportion of patients who scored above the minimal clinically important difference (MCID) for VAS at 6 months was significantly higher in the PRP group ( P = .044). Within the PRP group, the concentrations of platelet-derived growth factors were high in patients with a score above the MCID for VAS at 6 months. The incidence of adverse events did not differ between the groups ( P > .05). Conclusion: PRP had better clinical efficacy than HA. High concentrations of growth factors were observed in patients who scored above the MCID for clinical outcomes in the PRP group. These findings indicate that concentration of growth factors needs to be taken into consideration for future investigations of PRP in knee osteoarthritis. Registration: NCT02211521 (ClinicalTrials.gov identifier).
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- 2021
11. Transition rates to cirrhosis and liver cancer by age, gender, disease and treatment status in Asian chronic hepatitis B patients
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Yasuhito Tanaka, Cheng Hao Tseng, Soung Won Jeong, Min Sun Kwak, Jae-Jun Shim, Grace Lai-Hung Wong, Man-Fung Yuen, Joseph Hoang, Michael Cheung, Christopher Wong, Yong Kyun Cho, Rui Huang, Changqing Zhao, Hyunwoo Oh, Ming-Lung Yu, Matt Liu, Hwai I. Yang, Sang Bong Ahn, Chao Wu, Dae Won Jun, Tai-Chung Tseng, Edward Gane, Qing Xie, Jian Zhang, Chien-Hung Chen, Dong Hyun Lee, Chung Feng Huang, Tawesak Tanwandee, Satoshi Yasuda, Hirokazu Takahashi, Ming Lun Yeh, Jia-Horng Kao, Masaru Enomoto, Pei-Chien Tsai, Eileen L. Yoon, Eiichi Ogawa, Chris Cunningham, Yao-Chun Hsu, Ritsuzo Kozuka, Clifford Wong, Teerapat Ungtrakul, Hidenori Toyoda, Yuichiro Eguchi, Jiayi Li, Jae Yoon Jeong, Hyo Suk Lee, Mindie H. Nguyen, Chia-Yen Dai, Sung Eun Kim, Cheng Yuan Peng, Huy N. Trinh, and Ramsey Cheung
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medicine.medical_specialty ,Cirrhosis ,Hepatology ,business.industry ,Incidence (epidemiology) ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Internal medicine ,Hepatocellular carcinoma ,Epidemiology ,medicine ,030211 gastroenterology & hepatology ,Liver cancer ,Viral hepatitis ,business ,Disease burden - Abstract
Increasing hepatitis-related mortality has reignited interest to fulfill the World Health Organization’s goal of viral hepatitis elimination by 2030. However, economic barriers have enabled only 28% of countries to implement countermeasures. Given the high disease burden among Asians, we aimed to present age, sex, disease activity and treatment-specific annual progression rates among Asian chronic hepatitis B (CHB) patients to inform health economic modeling efforts and cost-effective public health interventions. We analyzed 18,056 CHB patients from 36 centers across the U.S. and seven countries/regions of Asia Pacific (9530 treated; 8526 untreated). We used Kaplan–Meier methods to estimate annual incidence of cirrhosis and hepatocellular carcinoma (HCC). Active disease was defined by meeting the APASL treatment guideline criteria. Over a median follow-up of 8.55 years, there were 1178 incidences of cirrhosis and 1212 incidences of HCC (297 without cirrhosis, 915 with cirrhosis). Among the 8526 untreated patients (7977 inactive, 549 active), the annual cirrhosis and HCC incidence ranged from 0.26% to 1.30% and 0.04% to 3.80% in inactive patients, and 0.55 to 4.05% and 0.19 to 6.03% in active patients, respectively. Of the 9530 treated patients, the annual HCC rates ranged 0.03–1.57% among noncirrhotic males and 2.57–6.93% among cirrhotic males, with lower rates for females. Generally, transition rates increased with age, male sex, the presence of fibrosis/cirrhosis, and active disease and/or antiviral treatment. Using data from a large and diverse real-world cohort of Asian CHB patients, the study provided detailed annual transition rates to inform practice, research and public health planning.
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- 2021
12. The role of Ureaplasma parvum serovar-3 or serovar-14 infection in female patients with chronic micturition urethral pain and recurrent microscopic hematuria
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Jong Jin Oh, Dong Soo Park, Tae Jin Kim, Dong Hyun Lee, Moon Seong Kim, Seung Ryeol Rhee, and Young Dong Yu
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medicine.medical_specialty ,Josamycin ,medicine.drug_class ,Urology ,Urinary system ,media_common.quotation_subject ,Antibiotics ,Gastroenterology ,Urination ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,Medicine ,030212 general & internal medicine ,media_common ,Doxycycline ,030219 obstetrics & reproductive medicine ,business.industry ,Genitourinary system ,Female infertility ,medicine.disease ,Pristinamycin ,Reproductive Medicine ,chemistry ,Original Article ,business ,medicine.drug - Abstract
Background Ureaplasma parvum (UP) is commonly isolated in the genitor-urinary tract and may cause various clinical features, including microscopic hematuria (MH). Some UP serovars are more commonly related with specific urogenital disease, but the evidences have been conflicting. This study primarily aimed to research the possible associations between specific UP serotypes and genito-urinary pathogenicity in female patients showing MH with/without chronic micturition urethral pain (CMP). Methods This study retrospectively reviewed 276 female patients having MH with/without CMP, who visited health screening center or female infertility clinic. All patients underwent multiplex polymerase chain reaction (PCR) tests with vaginal and urine samples to evaluate the infection rate and serotypes of UP. The antimicrobial susceptibility of UP and the predictors of CMP among UP infected patients were also analyzed. All patients were followed up at least for 6-months. Results Forty-nine patients (17.8%) showed urinary UP infection. Urinary UP serotyping showed the prevalence of seorvar-1, -3, -6 and -14 were 24.5%, 30.6%, 18.4% and 26.5%, respectively. 79.6% of the urinary UP positive patients accompanied vaginal UP infection. 22 patients of the cohort (8.0%) had CMP whereas serovars-3 and -14 accompanied CMP in 54.5% and 41.0% cases, respectively. No serovars-6 infection case had CMP. 26.4% of the cohort were infertile whereas 10.9% of these infertile patients were positive for urinary tract infection with UP serotype-3 or -14. Doxycycline, josamycin and pristinamycin were the most active antibiotics with the lowest rate of resistance (0.0%) for treating UP. At 1-month post-initial treatment with doxycycline, all UP serotypes were eradicated and no patient complained of urethral discomfort. However, simultaneous urinary and vaginal reinfection of serovar-3 (5 cases) and serovar-5 (1 case) were confirmed at 3-months post-initial doxycycline therapy. The logistic regression analyses revealed that serovars-3 [hazard ratio (HR) 1.354, P value 0.018] and -14 (HR 1.103, P value 0.046) were significantly associated with CMP in female patients having MH. Conclusions UP serovars-3 and -14 infections could be associated with CMP in female patients having MH. Doxycycline, josamycin and pristinamycin were effective for treating UP. Serovar-3 showed higher reinfection rate than other serotypes after antibiotics treatment.
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- 2021
13. HCC risk post-SVR with DAAs in East Asians: findings from the REAL-C cohort
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Mayumi Maeda, Ming-Lun Yeh, Sang Bong Ahn, Dae Won Jun, Yoshiyuki Ueno, Dong Hyun Lee, Etsuko Iio, Yuichiro Eguchi, Norihiro Furusyo, Man-Fung Yuen, Akihiro Tamori, Hansen Dang, Yasuhito Tanaka, Satoshi Yasuda, Carla Pui-Mei Lam, Ramsey Cheung, Hideyuki Nomura, Mindie H. Nguyen, Grace Lai-Hung Wong, Makoto Nakamuta, Linda Henry, Jang Han Jung, Do Seon Song, Ming-Lung Yu, Cheng-Hao Tseng, Hidenori Toyoda, Chung-Feng Huang, Real-C Investigators, Hiroaki Haga, Jun Hayashi, Pei-Chien Tsai, Masaru Enomoto, Eileen L. Yoon, Eiichi Ogawa, Hirokazu Takahashi, and Yao-Chun Hsu
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medicine.medical_specialty ,Cirrhosis ,Hepatology ,business.industry ,Incidence (epidemiology) ,virus diseases ,medicine.disease ,Gastroenterology ,digestive system diseases ,Colorectal surgery ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Internal medicine ,Cohort ,Propensity score matching ,medicine ,030211 gastroenterology & hepatology ,Risk factor ,Liver cancer ,business ,neoplasms - Abstract
Despite HCV cure, patients remain at risk for HCC, but risk factor data for HCC following SVR are limited for Asian patients. To address this gap, we analyzed 5814 patients (5646 SVR, 168 non-SVR) from the Real-World Evidence from the Asia Liver Consortium for HCV (REAL-C) who did not have HCC or a history of HCC at baseline (pre-DAA treatment) and did not develop HCC within 6 months of baseline. To assess the effect of SVR on HCC incidence, we used 1:4 propensity score matching [(PSM), age, sex, baseline cirrhosis, and baseline AFP] to balance the SVR and non-SVR groups. In the PSM cohort (160 non-SVR and 612 SVR), the HCC incidence rate per 100 person years was higher in the non-SVR compared to the SVR group (5.26 vs. 1.94, p
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- 2020
14. Uveal Effusion Associated with Presumed Viral Encephalitis
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Dong Hyun Lee, Tae-Young Kim, Sung Chul Lee, and Min Kim
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Male ,Pathology ,medicine.medical_specialty ,Uveal Effusion Syndrome ,Uveal effusion syndrome ,Serous Retinal Detachment ,03 medical and health sciences ,0302 clinical medicine ,Ciliary body ,Rare case ,Humans ,Immunology and Allergy ,Medicine ,Encephalitis, Viral ,Aged ,030203 arthritis & rheumatology ,business.industry ,Viral encephalitis ,Retinal Detachment ,Choroid Diseases ,Exudates and Transudates ,Uveal Diseases ,medicine.disease ,eye diseases ,Ophthalmology ,medicine.anatomical_structure ,Effusion ,030221 ophthalmology & optometry ,sense organs ,Choroid ,business ,Choroidal Effusions ,Rare disease - Abstract
Uveal effusion is a rare disease that is characterized by exudative detachment of the ciliary body and choroid. Herein, we report a rare case of uveal effusion associated with viral encephalitis, which resolved following the treatment of the viral encephalitis and administration of corticosteroids.A 67-year-old man who was hospitalized for viral encephalitis was referred to our clinic. He had been treated for herpes zoster ophthalmicus in his left eye 3 weeks previously. Choroidal detachment and uveal effusion between the ciliary body and sclera were observed. He was prescribed oral and topical steroids and cycloplegics to treat uveal effusion, and an antiviral agent (Acyclovir) to treat viral encephalitis. After 4 weeks, the choroidal detachment resolved completely.Uveal effusion syndrome can develop in association with viral encephalitis and be treated successfully with oral and topical steroids; we suggest that medical treatment should be attempted prior to surgery.ADEM: Acute disseminated encephalomyelitis; BCVA: Best corrected visual acuity; CSF: Cerebrospinal fluid; CT: Computed tomography; MRI: Magnetic resonance imaging; WBC: White blood cell.
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- 2020
15. Impacts of migraine on the prevalence and clinical presentation of depression: A population-based study
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Kwang Ik Yang, Won Joo Kim, Dong Hyun Lee, Min Kyung Chu, Kyung Min Kim, Soo-Jin Cho, and Chang-Ho Yun
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Adult ,medicine.medical_specialty ,Pediatrics ,Migraine Disorders ,Population ,Anxiety ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,Epidemiology ,Prevalence ,medicine ,Humans ,education ,Depression (differential diagnoses) ,Aged ,education.field_of_study ,Depression ,business.industry ,Headache ,Small sample ,Middle Aged ,medicine.disease ,030227 psychiatry ,Population based study ,Psychiatry and Mental health ,Clinical Psychology ,Cross-Sectional Studies ,Increased risk ,Migraine ,Presentation (obstetrics) ,business ,030217 neurology & neurosurgery - Abstract
A close association has been reported between depression and migraine. However, information concerning the impacts of migraine on the clinical presentation and prevalence of depression in a population-based study is currently limited.Data from the Korean Headache-Sleep Study, a nationwide survey about headache and sleep for adults aged 19-69 years were used. Depression was defined when Patient Health Questionnaire-9 score ≥ 10.Of 2,695 participants who included in this study, 116 (4.3%), 143 (5.3%), and 1130 (41.9%) had depression, migraine, and non-migraine headache, respectively. Migraine (24/116 [20.5%] vs. 119/2579 [4.7%], p 0.001) and non-migraine headache (67/116 [58.1%] vs. 1063/2579 [41.3%], p 0.001) was more prevalent in the group of participants with depression than among participants without depression. Among participants with depression, there was no statistically differences in total Patient Health Questionnaire-9 (PHQ-9) scores among migraine, non-migraine headache, and non-headache groups (median with interquartile range, 12.0 [10.2-18.0] vs. 13.0 [11.0-16.0] vs. 12.0 [10.0-15.2], p = 0.514). Among subcomponent scores of PHQ-9, all subcomponent scores did not significantly differ by headache status except feeling tired or having little energy scores (non-migraine headache 2.0 [2.0-3.0] vs. non-headache 2.0 [1.0-2.0], p = 0.010).Diagnosis of depression based on PHQ-9 questionnaire and small sample size in subgroup analyses.Participants with depression exhibit an increased risk of migraine and non-migraine headache compared with participants without depression. Among participants with depression, the severity of depression did not significantly differ on the basis of headache status.
- Published
- 2020
16. Ultrasonographic Features and the Diagnostic Role of Core Needle Biopsy at Metastatic Breast Cancer in the Thyroid gland: A Case Report
- Author
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Dong Hyun Lee, Ra Gyoung Yoon, Jin Kyung An, and Jeong Joo Woo
- Subjects
lcsh:Medical physics. Medical radiology. Nuclear medicine ,Pathology ,medicine.medical_specialty ,endocrine system ,endocrine system diseases ,thyroid gland ,business.industry ,lcsh:R895-920 ,Thyroid ,ultrasonography ,core needle biopsy ,medicine.disease ,Metastasis ,medicine.anatomical_structure ,medicine ,breast neoplasms ,metastasis ,Radiology, Nuclear Medicine and imaging ,Ultrasonography ,business - Abstract
Metastases to the thyroid gland have rarely been reported in clinical settings, and the thyroid gland is an uncommon site for breast carcinoma metastasis. We report a case of a 64-year-old breast cancer patient diagnosed with metastatic breast carcinoma in the thyroid gland after performing ultrasonography (US)-guided core needle biopsy (CNB) and subsequent total thyroidectomy. On US, the thyroid lesion appeared to be mildly enlarged with multiple internal hypoechoic lines and a few microcalcifications without mass formation. Under US-guidance, CNB was performed by targeting the area with microcalcifications and subsequently diagnosed as metastatic breast carcinoma. Total thyroidectomy revealed that the patient had metastatic invasive ductal carcinoma of the breast with lymphatic spread involving both lobes and the isthmus of the thyroid gland. Although the thyroid gland is an uncommon metastatic site, the unusual features of thyroid metastasis can be observed on US; thus, US-guided CNB effectively aids the diagnosis of thyroid metastasis.
- Published
- 2020
17. Protection of Medical Staff during Tracheotomy: Lessons Learned from the COVID-19 Pandemic
- Author
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Ji-Sun Kim, Subin Kim, Ki-Hong Chang, Byung Guk Kim, Jun Ook Park, and Dong Hyun Lee
- Subjects
Male ,Operating Rooms ,Infectious Disease Transmission, Patient-to-Professional ,Isolation (health care) ,medicine.medical_treatment ,0211 other engineering and technologies ,Airway management ,Review Article ,02 engineering and technology ,01 natural sciences ,010104 statistics & probability ,Tracheotomy ,Pandemic ,Medical Staff ,Humans ,Medicine ,0101 mathematics ,Pandemics ,Personal Protective Equipment ,Personal protective equipment ,Aged, 80 and over ,Protocol (science) ,Infection Control ,Surgical team ,021103 operations research ,Novel coronavirus ,Medical staff protection ,SARS-CoV-2 ,business.industry ,COVID-19 ,medicine.disease ,Ventilation ,EXPOSE ,Otorhinolaryngology ,Medical emergency ,business - Abstract
Background: During the ongoing pandemic of COVID-19, tracheotomy under emergency situation is considered a high-risk procedure that causes probable expose to aerosolized secretion. Summary: We reviewed our case and previous reports, and summarized a detailed protocol that is needed to protect medical staffs who perform tracheotomy under the COVID-19 pandemic, considering the patient’s condition, experience of medical staff members, and available facilities and equipment. Key Messages: For efficient protection of medical staff who perform tracheotomy under the COVID-19 pandemic period, we suggest that the following needs to be considered: assessment of patient’s condition (COVID-19 infection and the airway problem), route (safest route to the operating room), experienced surgical team, negative-pressure isolation facility and appliance (personal protective equipment) availability, and safe and appropriate post-tracheotomy care.
- Published
- 2020
18. Alterations in glucose metabolism in Vibrio cholerae serogroup O1 El Tor biotype strains
- Author
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Eun Jin Kim, G. B. Nair, Young-bae Yoon, Jiwon Lee, Yeongjun Baek, Dong Hyun Lee, Dong Wook Kim, and Sang Sun Yoon
- Subjects
0301 basic medicine ,Vibrio cholerae Serogroup O1 ,030106 microbiology ,lcsh:Medicine ,Biology ,Carbohydrate metabolism ,Serogroup ,medicine.disease_cause ,El Tor ,Article ,Microbiology ,03 medical and health sciences ,medicine ,lcsh:Science ,Gene ,Microbial Viability ,Multidisciplinary ,lcsh:R ,Vibrio cholerae O1 ,Hydrogen-Ion Concentration ,medicine.disease ,biology.organism_classification ,Cholera ,Diarrhoea ,Glucose ,030104 developmental biology ,Batch Cell Culture Techniques ,Vibrio cholerae ,Fermentation ,lcsh:Q ,Bacterial infection ,Bacteria - Abstract
The 2 biotypes of Vibrio cholerae O1 serogroup strains—classical and El Tor—use glucose in distinct ways. Classical biotype strains perform organic acid-producing fermentation and eventually lose viability due to the self-induced creation of an acidic environment, whereas El Tor biotype strains use an alternative neutral fermentation pathway, which confers them with survival advantages. However, we report that the neutral fermentation pathway has only been recruited in prototype Wave 1 El Tor biotype strains, which have not been isolated since the mid-1990s. Current Wave 2 and Wave 3 atypical El Tor strains contain a single-base deletion in a gene that directs bacteria toward neutral fermentation, resulting in the loss of neutral fermentation and an appearance that is similar to classical biotype strains. Moreover, when sufficient glucose was supplied, Wave 1 El Tor strains maintained their use of acid-producing fermentation, in parallel with neutral fermentation, and thus lost viability in the late stationary phase. The global replacement of Wave 1 El Tor strains by Wave 2 and 3 atypical El Tor strains implies that the acidic fermentation pathway may not be disadvantageous to V. cholerae. The characteristics that we have reported might improve oral rehydration in the treatment of cholera.
- Published
- 2020
19. Oxygen supplementation via high-flow nasal cannula is an effective treatment for pneumocephalus
- Author
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Jae-Kwan Cha, Jin-Heon Jeong, Deok-Soo Lee, Ki Sup Byun, and Dong Hyun Lee
- Subjects
Oxygen supplementation ,high-flow nasal cannula ,business.industry ,medicine.medical_treatment ,oxygen therapy ,medicine.disease ,medicine.disease_cause ,lcsh:RC346-429 ,Pneumocephalus ,Anesthesia ,Oxygen therapy ,medicine ,Effective treatment ,pneumocephalus ,High flow ,business ,Nasal cannula ,lcsh:Neurology. Diseases of the nervous system - Abstract
Background Oxygen supplementation through a high-flow nasal cannula (HFNC) is a powerful technique that promotes the absorption of air by delivering high concentrations of oxygen to patients who are not intubated, and may be a viable treatment option for pneumocephalus. Case Report A 75-year-old female presented in a stuporous state. She had received an epidural injection due to back pain 2 hours ago. Non-contrast brain computed tomography revealed a pneumocephalus at the interhemispheric fissure and the prepontine cistern. HFNC oxygen therapy at 60 L/min with a fraction of inspired oxygen of 1 was started. By the next morning, her mental status had recovered and a repeat brain computed tomography 15 hours later revealed complete absorption of the pneumocephalus. Conclusion Supplemental high oxygen via HFNC can be successfully used in patients with pneumocephalus who are not intubated and mechanically ventilated.
- Published
- 2019
20. Hepatitis C Virus Cure Rates Are Reduced in Patients With Active but Not Inactive Hepatocellular Carcinoma: A Practice Implication
- Author
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Norihiro Furusyo, Mindie H. Nguyen, Yoshiyuki Ueno, Shinji Iwane, Hidenori Toyoda, Masaru Enomoto, Chia-Yen Dai, Sally Tran, Akihiro Tamori, Yao-Chun Hsu, Toshifumi Tada, Ming-Lung Yu, Ramsey Cheung, Chen-Hua Liu, Hideyuki Nomura, Etsuko Iio, Jee-Fu Huang, Wan-Long Chuang, Dae Won Jun, Yasuhito Tanaka, Chung-Feng Huang, Hirokazu Takahashi, Jun Hayashi, Jia-Horng Kao, Hiroaki Haga, Yuichiro Eguchi, Cheng-Hao Tseng, Grace Lai-Hung Wong, Hwai I. Yang, Mei Hsuan Lee, Satoshi Yasuda, Linda Henry, Scott D. Barnett, Mi Jung Jun, Yee Hui Yeo, Makoto Nakamuta, Dong Hyun Lee, and Eiichi Ogawa
- Subjects
Microbiology (medical) ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Cirrhosis ,Sustained Virologic Response ,Hepatitis C virus ,Population ,Taiwan ,Hepacivirus ,medicine.disease_cause ,Antiviral Agents ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Internal medicine ,Republic of Korea ,medicine ,Humans ,Adverse effect ,education ,neoplasms ,education.field_of_study ,business.industry ,Liver Neoplasms ,Hepatitis C, Chronic ,medicine.disease ,Hepatitis C ,digestive system diseases ,Discontinuation ,Infectious Diseases ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Propensity score matching ,Hong Kong ,Population study ,030211 gastroenterology & hepatology ,business - Abstract
Background Cure rates of hepatitis C virus (HCV) treatment with direct-acting antivirals (DAAs) for patients with active and inactive hepatocellular carcinoma (HCC) may differ, but well-controlled studies are limited. We aimed to evaluate DAA outcomes in a large East Asian HCV/HCC population compared with HCV/non-HCC patients. Methods Using data from the Real-World Evidence from the Asia Liver Consortium (REAL-C) registry (Hong Kong, Japan, South Korea, and Taiwan), we used propensity score matching (PSM) to match HCC and non-HCC (1:1) groups for age, sex, cirrhosis, prior treatment, HCV genotype, treatment regimen, baseline platelet count, HCV RNA, total bilirubin, alanine aminotransferase, and albumin levels to evaluate DAA treatment outcomes in a large population of HCV/HCC compared with HCV/non-HCC patients. Results We included 6081 patients (HCC, n = 465; non-HCC, n = 5 616) treated with interferon-free DAAs. PSM of the entire study population yielded 436 matched pairs with similar baseline characteristics. There was no statistically significant difference in the overall SVR rate of HCC (92.7%) and non-HCC (95.0%) groups. Rates of treatment discontinuation, adverse effects, and death were also similar between HCC and non-HCC groups. Among patients with HCC, those with active HCC had a lower SVR than inactive HCC cases (85.5% vs 93.7%; P = .03). On multivariable analysis, active HCC, but not inactive HCC, was significantly associated with lower SVR (OR, 0.28; P = .01) when compared with non-HCC. Conclusions Active HCC but not inactive HCC was independently associated with lower SVR compared with non-HCC patients undergoing DAA therapy, although cure rate was still relatively high (85%) in active HCC patients.
- Published
- 2019
21. Changes in Treatment Patterns and Globe Salvage Rate of Advanced Retinoblastoma in Korea: Efficacy of Intra-Arterial Chemotherapy
- Author
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Jung Woo Han, Chuhl Joo Lyu, Christopher Seungkyu Lee, Seung Min Hahn, Dong Joon Kim, Sung Chul Lee, Byung Moon Kim, and Dong Hyun Lee
- Subjects
medicine.medical_specialty ,genetic structures ,medicine.medical_treatment ,Enucleation ,Intra arterial chemotherapy ,Article ,retinoblastoma ,intra-arterial chemotherapy ,medicine ,antineoplastic agents ,skin and connective tissue diseases ,Survival rate ,Chemotherapy ,intravenous chemotherapy ,intravitreal chemotherapy ,business.industry ,Retinoblastoma ,Intravenous chemotherapy ,General Medicine ,medicine.disease ,eye diseases ,Surgery ,Safety profile ,Medicine ,Primary treatment ,sense organs ,business - Abstract
(1) Background: To analyze changes in treatment patterns for advanced retinoblastoma over time and differences in globe salvage rates, (2) Methods: Retrospective, observational case-control study of 97 eyes of 91 patients with advanced retinoblastoma (Group D and E)., (3) Results: Patients were divided into two groups based on whether they were treated before or after intraarterial chemotherapy (IAC) was introduced in our center in 2010. Before 2010, primary treatment pattern was enucleation, which was performed in 57.6% of cases, whereas primary treatment pattern after 2010 was IAC combined with intravenous chemotherapy (IVC), which was performed in 78.1%. Intravitreal chemotherapy (IVitC) has been performed to treat vitreous and subretinal seeding since 2015. The 5-year globe salvage rate of IVC alone was 24.0% for Group D and 0% for Group E, whereas that of IVC–IAC was 50.4% for Group D and 49.7% for Group E. Whether IVitC was performed or not did not significantly contribute to globe salvage rate. There was one metastatic death in the IVC alone group., (4) Conclusions: Primary treatment pattern changed from enucleation to IAC-based treatment, which can now save nearly half of eyes with advanced retinoblastoma with excellent safety profile and survival rate.
- Published
- 2021
22. Deep Learning Techniques for Fatty Liver Using Multi-View Ultrasound Images Scanned by Different Scanners: Development and Validation Study
- Author
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Dong Hyun Lee, Sanghun Choi, Taewoo Kim, and Eun-Kee Park
- Subjects
Coefficient of determination ,diagnosis ,detection ,Health Informatics ,Overfitting ,transfer learning ,Liver disease ,Health Information Management ,medicine ,informatics ,fatty liver ,Original Paper ,medicine.diagnostic_test ,business.industry ,magnetic resonance imaging–proton density fat fraction ,machine imaging ,Fatty liver ,Ultrasound ,deep learning ,imaging ,Magnetic resonance imaging ,Regression analysis ,medicine.disease ,artificial intelligence ,multi-view ultrasound images ,Regression ,classification ,fatty liver disease ,regression ,business ,Nuclear medicine - Abstract
Background Fat fraction values obtained from magnetic resonance imaging (MRI) can be used to obtain an accurate diagnosis of fatty liver diseases. However, MRI is expensive and cannot be performed for everyone. Objective In this study, we aim to develop multi-view ultrasound image–based convolutional deep learning models to detect fatty liver disease and yield fat fraction values. Methods We extracted 90 ultrasound images of the right intercostal view and 90 ultrasound images of the right intercostal view containing the right renal cortex from 39 cases of fatty liver (MRI–proton density fat fraction [MRI–PDFF] ≥ 5%) and 51 normal subjects (MRI–PDFF < 5%), with MRI–PDFF values obtained from Good Gang-An Hospital. We obtained combined liver and kidney-liver (CLKL) images to train the deep learning models and developed classification and regression models based on the VGG19 model to classify fatty liver disease and yield fat fraction values. We employed the data augmentation techniques such as flip and rotation to prevent the deep learning model from overfitting. We determined the deep learning model with performance metrics such as accuracy, sensitivity, specificity, and coefficient of determination (R2). Results In demographic information, all metrics such as age and sex were similar between the two groups—fatty liver disease and normal subjects. In classification, the model trained on CLKL images achieved 80.1% accuracy, 86.2% precision, and 80.5% specificity to detect fatty liver disease. In regression, the predicted fat fraction values of the regression model trained on CLKL images correlated with MRI–PDFF values (R2=0.633), indicating that the predicted fat fraction values were moderately estimated. Conclusions With deep learning techniques and multi-view ultrasound images, it is potentially possible to replace MRI–PDFF values with deep learning predictions for detecting fatty liver disease and estimating fat fraction values.
- Published
- 2021
23. Pyoderma Gangrenosum Mimicking Necrotizing Fasciitis on Magnetic Resonance Imaging: A Case Report and Literature Review
- Author
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Hyoshim Shin, Dong-Hyun Lee, Jeong-Hee Lee, Gyeong-Won Lee, Sungwoo Park, and Eun-Ha Koh
- Subjects
medicine.medical_specialty ,Magnetic Resonance Spectroscopy ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,General Medicine ,medicine.disease ,Magnetic Resonance Imaging ,Dermatology ,Pyoderma Gangrenosum ,medicine ,Humans ,Colitis, Ulcerative ,Female ,Fasciitis, Necrotizing ,business ,Fasciitis ,Pyoderma gangrenosum ,Aged - Abstract
BACKGROUND Pyoderma gangrenosum (PG) is a sterile neutrophilic dermatosis that can be associated with systemic diseases, such as ulcerative colitis, polyarthritis, diabetes mellitus, myelodysplastic syndrome, and/or myeloid leukemia, and is often misdiagnosed as a necrotizing infection. Few reports have described imaging studies of PG; however, necrotizing fasciitis (NF) exhibits distinct imaging characteristics. If deep fascial involvement is not demonstrated on magnetic resonance imaging (MRI), NF is excluded. CASE REPORT We present a case of PG mimicking NF on MRI in a 67-year-old woman with acute myeloblastic leukemia. After undergoing a second cycle of decitabine therapy, she was admitted for pain in her lower left leg. The condition was initially misdiagnosed as NF because MRI findings demonstrated signal intensity in the fascia. MRI revealed fasciitis that exhibited linear fluid signal intensity in the fascia of lower left leg. Despite broad-spectrum antibiotics, the lesion rapidly progressed to a swollen hemorrhagic patch with bullae and an ulcer. Skin biopsy results ultimately led to the diagnosis of PG, based on histopathological findings. The patient was treated with intravenous steroids and regular wound dressing. The skin lesion on the lower left leg exhibited a good response. CONCLUSIONS Despite the presence of a lesion that invaded the fascia on MRI, our patient was diagnosed with PG following a skin biopsy and completely recovered with steroid treatment. To distinguish PG from NF, it is more important to identify the characteristic clinical features than to rely solely on imaging findings.
- Published
- 2021
24. A physician-led medical emergency team increases the rate of medical interventions: A multicenter study in Korea
- Author
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Sang-Bum Hong, Dong Hyun Lee, Jung Soo Kim, Su Yeon Lee, Jisoo Park, Sang Min Lee, Jee Hwan Ahn, Kyeongman Jeon, Yeon Joo Lee, Byung Ju Kang, and Jae Young Moon
- Subjects
Male ,Critical Care and Emergency Medicine ,medicine.medical_treatment ,Health Care Providers ,Psychological intervention ,law.invention ,Diagnostic Radiology ,law ,Ultrasound Imaging ,Outcome Assessment, Health Care ,Medicine and Health Sciences ,Cardiac Arrest ,Medicine ,Intubation ,Medical Personnel ,Hospital Mortality ,Multidisciplinary ,Respiratory distress ,Mortality rate ,Radiology and Imaging ,Intensive care unit ,Hospitals ,Intensive Care Units ,Professions ,Cohort ,Female ,Medical emergency ,Emergency Service, Hospital ,Rapid response system ,Research Article ,Death Rates ,Imaging Techniques ,Science ,Cardiology ,Surgical and Invasive Medical Procedures ,Research and Analysis Methods ,Signs and Symptoms ,Population Metrics ,Diagnostic Medicine ,Sepsis ,Physicians ,Republic of Korea ,Humans ,Rapid response team ,Aged ,Population Biology ,business.industry ,Biology and Life Sciences ,medicine.disease ,Health Care ,Health Care Facilities ,People and Places ,Population Groupings ,Clinical Medicine ,business ,Hospital Rapid Response Team - Abstract
Background According to the rapid response system’s team composition, responding teams were named as rapid response team (RRT), medical emergency team (MET), and critical care outreach. A RRT is often a nurse-led team, whereas a MET is a physician-led team that mainly plays the role of an efferent limb. As few multicenter studies have focused on physician-led METs, we comprehensively analyzed cases for which physician-led METs were activated. Methods We retrospectively analyzed cases for which METs were activated. The study population consisted of subjects over 18 years of age who were admitted in the general ward from January 2016 to December 2017 in 9 tertiary teaching hospitals in Korea. The data on subjects’ characteristics, activation causes, activation methods, performed interventions, in-hospital mortality, and intensive care unit (ICU) transfer after MET activation were collected and analyzed. Results In this study, 12,767 cases were analyzed, excluding those without in-hospital mortality data. The subjects’ median age was 67 years, and 70.4% of them were admitted to the medical department. The most common cause of MET activation was respiratory distress (35.1%), followed by shock (11.8%), and the most common underlying disease was solid cancer (39%). In 7,561 subjects (59.2%), the MET was activated using the screening system. The commonly performed procedures were arterial line insertion (17.9%), intubation (13.3%), and portable ultrasonography (13.0%). Subsequently, 29.4% of the subjects were transferred to the ICU, and 27.2% died during hospitalization. Conclusions This physician-led MET cohort showed relatively high rates of intervention, including arterial line insertion and portable ultrasonography, and low ICU transfer rates. We presume that MET detects deteriorating patients earlier using a screening system and begins ICU-level management at the patient’s bedside without delay, eventually preventing the patient’s condition from worsening and transfer to the ICU.
- Published
- 2021
25. Therapeutic prognostic factors associated with retinal detachment and visual outcomes in acute retinal necrosis
- Author
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Sung Soo Kim, Jae Won Jun, Eun Young Choi, Suk Ho Byeon, Hyoung Jun Koh, Dong Hyun Lee, and Min Kim
- Subjects
medicine.medical_specialty ,Visual acuity ,business.industry ,medicine.medical_treatment ,Incidence (epidemiology) ,Retinal Detachment ,Retinal detachment ,Retinitis ,Vitrectomy ,Retrospective cohort study ,Retinal Necrosis Syndrome, Acute ,Odds ratio ,medicine.disease ,Prognosis ,Ophthalmology ,Treatment Outcome ,medicine ,Humans ,Acute retinal necrosis ,medicine.symptom ,business ,Retrospective Studies - Abstract
BACKGROUND Acute retinal necrosis (ARN) is a fulminant necrotizing vaso-occlusive retinitis associated with a high incidence of vision loss. Prognostic factors associated with the treatment of ARN have not been comprehensively identified. This study aimed to determine therapeutic prognostic factors associated with long-term clinical outcomes in eyes with ARN. METHODS This retrospective cohort study included patients with ARN who were treated between 2005 and 2019 in two tertiary ophthalmology departments in Seoul, Korea. Multiple logistic regression analysis was performed to investigate prognostic factors associated with late-onset retinal detachment (RD) and vision loss (
- Published
- 2021
26. Transoral endoscopic thyroidectomy using a self-retaining retractor as an alternative to carbon dioxide gas insufflation: A comparative analysis of 131 cases
- Author
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Mi Ra Kim, Jun-Ook Park, Dong Hyun Lee, Sang-Yeon Kim, Jae Hong Han, and Dong-Il Sun
- Subjects
Insufflation ,Natural Orifice Endoscopic Surgery ,Cancer Research ,medicine.medical_specialty ,Embolism ,Thyroid Lobectomy ,Suture (anatomy) ,Medicine ,Humans ,Thyroid Neoplasms ,business.industry ,Thyroid ,Carbon Dioxide ,medicine.disease ,Subcutaneous Emphysema ,Surgery ,Retractor ,medicine.anatomical_structure ,Oncology ,Endoscopic thyroidectomy ,Thyroidectomy ,Oral Surgery ,medicine.symptom ,business ,Subcutaneous emphysema - Abstract
Although transoral endoscopic thyroid surgery affords several advantages, the use of carbon dioxide (CO2) gas to create and maintain the working space may cause complications such as subcutaneous emphysema and a CO2 embolism. We have used a self-retaining retractor as an alternative to CO2 gas insufflation for some time; we here report its feasibility and safety. We reviewed the medical records of 131 patients who underwent transoral endoscopic thyroid lobectomy; we compared the “CO2 group” and the “retractor” group. All thyroid tumors were completely removed with negative surgical margins. No major complication occurred in the retractor group. Two major events occurred in the CO2 group: one case of permanent vocal cord palsy and one CO2 embolism. Significant subcutaneous emphysema of the neck and chest were noted in 17.7% of CO2 group patients, but in no retractor group patient. Wound infection occurred in one patient in each group but improved after appropriate management. The total operation times from incision to suture did not differ significantly between the two groups (p = 0.514). Transoral endoscopic thyroidectomy using a self-retaining retractor as an alternative to CO2 gas insufflation is feasible and safe. The superiority of transoral endoscopic thyroidectomy would be emphasized by avoiding CO2 gas insufflation, thus eliminating the risk of CO2 gas-related complications.
- Published
- 2021
27. Peduncular Hallucinosis Associated with Midbrain Cavernous Hemangioma
- Author
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Gwanhee Ehm, Dong Hyun Lee, Jong Yun Lee, and Yeo Jeong Cho
- Subjects
Hemangioma ,Midbrain ,business.industry ,Cerebral peduncle ,medicine ,Peduncular hallucinosis ,Anatomy ,medicine.disease ,business - Published
- 2020
28. A Case of Henoch-Schönlein Purpura with Fulminant Complications and Its Long-term Outcome
- Author
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Eun So Lee, Jeong Hong, Dong Hyun Lee, Ki Soo Pai, and Kwang Hwa Park
- Subjects
Pleural hemorrhage ,medicine.medical_specialty ,Henoch-Schonlein purpura ,business.industry ,Fulminant ,Internal medicine ,General Earth and Planetary Sciences ,Medicine ,business ,medicine.disease ,Nephritis ,Gastroenterology ,General Environmental Science - Published
- 2019
29. Tenofovir Versus Entecavir for Hepatocellular Carcinoma Prevention in an International Consortium of Chronic Hepatitis B
- Author
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Yasuhito Tanaka, Satoshi Yasuda, Ming Lun Yeh, Ka Shing Cheung, Tyng Yuan Jang, Joseph Hoang, Chenghai Liu, Eiichi Ogawa, Norihiro Furusyo, Changqing Zhao, Dong Hyun Lee, Christopher Wong, Chung Feng Huang, Man-Fung Yuen, Chao Wu, Jiayi Li, Mindie H. Nguyen, Takashi Kumada, Rui Huang, Pei-Chien Tsai, Hirokazu Takahashi, Hwai I. Yang, Chien-Hung Chen, Yao-Chun Hsu, Grace Lai-Hung Wong, Li Liu, Cheng Yuan Peng, Huy N. Trinh, Masaru Enomoto, Qing Xie, Ming-Lung Yu, Jian Q. Zhang, Hidenori Toyoda, Yuichiro Eguchi, Ritsuzo Kozuka, Clifford Wong, and Yen-Tsung Huang
- Subjects
medicine.medical_specialty ,Hepatology ,Tenofovir ,business.industry ,Gastroenterology ,Retrospective cohort study ,Entecavir ,Hepatitis B ,medicine.disease ,digestive system diseases ,03 medical and health sciences ,0302 clinical medicine ,Chronic hepatitis ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Internal medicine ,medicine ,Carcinoma ,030211 gastroenterology & hepatology ,business ,Cohort study ,medicine.drug - Abstract
INTRODUCTION:It is unclear whether entecavir (ETV) and tenofovir disoproxil fumarate (TDF) differ in their effectiveness for preventing hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB).METHODS:This retrospective cohort study analyzed an international consortium that encompas
- Published
- 2019
30. A Nationwide Study of Inpatient Admissions, Mortality, and Costs for Patients with Cirrhosis from 2005 to 2015 in the USA
- Author
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Yee Hui Yeo, Donghak Jeong, Erik Ingelsson, Edward Sheen, Dong Hyun Lee, Biyao Zou, Haesuk Park, Gabriel Garcia, Linda Henry, Ramsey Cheung, and Mindie H. Nguyen
- Subjects
Adult ,Liver Cirrhosis ,Male ,medicine.medical_specialty ,Cirrhosis ,Physiology ,Population ,medicine.disease_cause ,03 medical and health sciences ,Liver disease ,0302 clinical medicine ,Cost of Illness ,Non-alcoholic Fatty Liver Disease ,Internal medicine ,Nonalcoholic fatty liver disease ,medicine ,Humans ,Hospital Mortality ,Hospital Costs ,education ,Aged ,Retrospective Studies ,Hepatitis B virus ,education.field_of_study ,business.industry ,Gastroenterology ,Middle Aged ,Hepatology ,medicine.disease ,Hepatitis C ,United States ,Hospitalization ,030220 oncology & carcinogenesis ,Emergency medicine ,Hospitalization cost ,Etiology ,Female ,030211 gastroenterology & hepatology ,Health Expenditures ,business - Abstract
Liver cirrhosis is a substantial health burden in the USA, but population-based data regarding the trend and medical expenditure are limited and outdated. We investigated the trends of inpatient admissions, costs, and inpatient mortality from 2005 to 2015 among cirrhotic patients. A retrospective analysis was conducted using the National Inpatient Sample database. We adjusted the costs to 2015 US dollars using a 3% inflation rate. National estimates of admissions were determined using discharge weights. We identified 1,627,348 admissions in cirrhotic patients between 2005 and 2015. From 2005 to 2015, the number of weighted admissions in cirrhotic patients almost doubled (from 505,032 to 961,650) and the total annual hospitalization cost in this population increased three times (from 5.8 to 16.3 billion US dollars). Notably, admission rates varied by liver disease etiology, decreasing from 2005 to 2015 among patients with hepatitis C virus (HCV)-related cirrhosis while increasing (almost tripled) among patients with nonalcoholic fatty liver disease (NAFLD)-related cirrhosis. The annual inpatient mortality rate per 1000 admissions overall decreased from 63.8 to 58.2 between 2005 and 2015 except for NAFLD (27.2 to 35.8) (P
- Published
- 2019
31. Isolated hemorrhage in the cerebellar vermis with vertigo and body lateropulsion to the contralesional side
- Author
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Se Jin Lee and Dong Hyun Lee
- Subjects
medicine.medical_specialty ,Infarction ,Case Report ,Hemorrhage ,Nystagmus ,Vascular risk ,Hematoma ,Vertigo ,medicine ,Vestibulopathy ,lcsh:R5-920 ,biology ,business.industry ,medicine.disease ,biology.organism_classification ,Peripheral ,nervous system ,Cerebellar vermis ,Radiology ,Abnormality ,medicine.symptom ,business ,lcsh:Medicine (General) - Abstract
There have been several reports of patients with isolated lesions of the cerebellar vermis presenting with clinical features similar to those of peripheral vestibulopathy. We report a case of small, isolated hematoma in the cerebellar vermis in a patient who presented with vertigo, ipsilesional nystagmus, and body lateropulsion to the contralesional side without the usual signs or symptoms of cerebellar dysfunction. Although they present with symptoms that mimic those of peripheral vestibulopathy, and brain computed tomography shows no abnormality, as there may be a small, isolated hematoma or infarction in the cerebellar vermis. Thus, brain magnetic resonance imaging should be performed in elderly patients with vascular risk factors.
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- 2019
32. Direct-acting antivirals in East Asian hepatitis C patients: real-world experience from the REAL-C Consortium
- Author
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Dae Won Jun, Gin-Ho Lo, Chung-Feng Huang, Hiroaki Haga, Cheng-Hao Tseng, Yuichiro Eguchi, Satoshi Yasuda, Ming-Lung Yu, Yasuhito Tanaka, Leslie Y. Kam, Akihiro Tamori, Jae Yoon Jeong, Etsuko Iio, Jee-Fu Huang, Mindie H. Nguyen, Chi-Ming Tai, Dong Hyun Lee, Hwai I. Yang, Mei Hsuan Lee, Seung Ha Park, Hidenori Toyoda, Linda Henry, Chen-Hua Liu, Yoshiyuki Ueno, Makoto Nakamuta, Eiichi Ogawa, Shinji Iwane, Ramsey Cheung, Hideyuki Nomura, Norihiro Furusyo, Jun Hayashi, Yao-Chun Hsu, Sally Tran, Jia-Horng Kao, Wan-Long Chuang, Masaru Enomoto, Grace Lai-Hung Wong, and Toshifumi Tada
- Subjects
Male ,medicine.medical_specialty ,Pyrrolidines ,Daclatasvir ,Sofosbuvir ,Hepatitis C virus ,Taiwan ,medicine.disease_cause ,Antiviral Agents ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Japan ,Internal medicine ,Republic of Korea ,Ribavirin ,medicine ,Humans ,Aged ,Sulfonamides ,Hepatology ,business.industry ,Imidazoles ,Valine ,Hepatitis C ,Middle Aged ,Isoquinolines ,medicine.disease ,Treatment Outcome ,chemistry ,030220 oncology & carcinogenesis ,Cohort ,Hong Kong ,Asunaprevir ,Drug Therapy, Combination ,Female ,030211 gastroenterology & hepatology ,Carbamates ,business ,medicine.drug - Abstract
One-third of the global hepatitis C virus (HCV) burden is found in Asia. Real-world data from diverse East Asian cohorts remain limited. This study addressed the real-world status of direct-acting antiviral (DAA) therapy among patients from East Asia. Chronic hepatitis C (CHC) patients from clinical sites in Japan, Taiwan, South Korea, and Hong Kong were recruited in the REAL-C registry, an observational chart review registry. The primary outcome was sustained virologic response (SVR12, HCV RNA PCR
- Published
- 2019
33. A Case of Rapid Eye Movement Sleep-Related Bradyarrhythmia Syndrome with Severe Obstructive Sleep Apnea Syndrome
- Author
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Dong Hyun Lee, Kyoung Heo, and Tae Hoon Kim
- Subjects
Obstructive sleep apnea ,medicine.medical_specialty ,business.industry ,Internal medicine ,medicine ,Cardiology ,Rapid eye movement sleep ,medicine.disease ,business ,Atrioventricular block - Published
- 2019
34. Kyoto Classification of Gastritis and Gastric Cancer
- Author
-
Dong Hyun Lee
- Subjects
lcsh:Internal medicine ,medicine.medical_specialty ,biology ,business.industry ,Stomach ,digestive, oral, and skin physiology ,Cancer ,Helicobacter pylori ,Classification ,medicine.disease ,biology.organism_classification ,Gastroenterology ,digestive system diseases ,medicine.anatomical_structure ,Gastritis ,Neoplasms ,Internal medicine ,medicine ,medicine.symptom ,lcsh:RC31-1245 ,business - Abstract
Identification of patients with a high risk of gastric cancer during gastric cancer surveillance is highly important. Most gastric cancers develop in the background of chronic gastritis associated with Helicobacter pylori (H. pylori) infection. Pathological evaluation using biopsy specimen was proposed to stratify gastric cancer risk in the operative link for gastritis assessment and operative link for gastric intestinal metaplasia assessment staging systems from the West. However, biopsy specimens cannot represent the whole stomach, and endoscopic biopsy confers a risk of bleeding in certain patients. In the Kyoto classification of gastritis proposed by a Japanese study group, five endoscopically visible findings (atrophy, intestinal metaplasia, enlarged folds, nodularity, and diffuse redness) were selected, which are closely related to gastric cancer development due to H. pylori infection. Furthermore, the gastric cancer risk grading system based on the Kyoto classification of gastritis was suggested to identify patients with an increased risk of developing gastric cancer. Although this grading system needs validation to prove its efficacy, it is expected to be useful for most endoscopists who are involved in gastric cancer surveillance.
- Published
- 2019
35. Recurrent aseptic meningitis as an initial clinical presentation of primary Sjögren’s syndrome
- Author
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Dong Hyun Lee and Se Jin Lee
- Subjects
Pediatrics ,medicine.medical_specialty ,Meningitis, aseptic ,business.industry ,Autoimmune diseases ,Aseptic meningitis ,medicine.disease ,lcsh:RC346-429 ,stomatognathic diseases ,medicine ,Sjogren’s syndrome ,Aseptic processing ,Presentation (obstetrics) ,Sjogren s ,business ,Meningitis ,lcsh:Neurology. Diseases of the nervous system - Abstract
Background The neurological manifestations of Sjögren’s syndrome (SjS) are nonspecific and may precede the onset of sicca symptoms. Hence, the diagnosis of SjS is often delayed. Recurrent aseptic meningitis is an uncommon neurological manifestation of primary SjS; only few cases have been reported in the medical literature. Case ReportA 54-year-old woman was admitted for recurrent aseptic meningitis. The patient had a history of two episodes of aseptic meningitis, which had occurred 12 and 7 years before this presentation. The patient had overt sicca symptoms for 5 years. SjS was diagnosed based on the results of serum autoantibody tests, Schirmer’s test, and salivary scintigraphy. We concluded that recurrent aseptic meningitis occurred as an initial presentation of primary SjS. ConclusionThis case suggest that SjS should be included in the differential diagnosis of recurrent aseptic meningitis.
- Published
- 2019
36. Surgical outcome and prognostic factors influencing visual acuity in myopic foveoschisis patients
- Author
-
Sung Chul Lee, Dong Hyun Lee, Suk Ho Byeon, Sung Soo Kim, Hyoung Jun Koh, Eun Young Choi, Min Kim, Hyun Goo Kang, and Inhee Moon
- Subjects
Male ,medicine.medical_specialty ,Multivariate analysis ,Visual acuity ,genetic structures ,Retinoschisis ,medicine.medical_treatment ,Sulfur Hexafluoride ,Visual Acuity ,Vitrectomy ,Endotamponade ,Article ,Foveoschisis ,03 medical and health sciences ,0302 clinical medicine ,Bayesian multivariate linear regression ,Ophthalmology ,Humans ,Medicine ,Retrospective Studies ,Univariate analysis ,business.industry ,Epiretinal Membrane ,Retrospective cohort study ,Middle Aged ,Prognosis ,medicine.disease ,eye diseases ,Myopia, Degenerative ,030221 ophthalmology & optometry ,Female ,sense organs ,Epiretinal membrane ,medicine.symptom ,business ,Tomography, Optical Coherence ,030217 neurology & neurosurgery - Abstract
BACKGROUND: To analyze the optical coherence tomography (OCT) characteristics and visual outcome of vitrectomy in myopic foveoschisis (MF) patients and identify prognostic factors. METHODS: This study is a retrospective clinical cohort study in tertiary care hospital. Thirty-two eyes of 32 patients who underwent MF-related vitrectomy in were investigated retrospectively. Best-corrected visual acuity (BCVA) measured at 1 year post surgery and changes in central foveal thickness (CFT) and co-existing macular pathologies, such as foveal detachment (FD), lamellar holes, and macular holes were the main outcome measures. Prognostic factors were identified using multivariate linear regression analysis. RESULTS: Average BCVA (in logarithm of the minimum angle of resolution) and mean CFT had improved from 0.46 ± 0.06 to 0.37 ± 0.07 (P = 0.089) and from 485.72 ± 164.69 to 341.71 ± 109.70 (P
- Published
- 2019
37. Cerebrospinal fluid vitamin D-binding protein as a new biomarker for the diagnosis of meningitis
- Author
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Min-Chul Cho, Dong-Hyun Lee, Jin Hyun Kim, Myeong Hee Jung, and Heeyoung Kang
- Subjects
Adult ,Male ,Vitamin ,medicine.medical_specialty ,Neurology ,Adolescent ,Vitamin D-binding protein ,Dermatology ,Sensitivity and Specificity ,Gastroenterology ,Young Adult ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Cerebrospinal fluid ,Internal medicine ,medicine ,Humans ,Meningitis ,Prospective Studies ,030212 general & internal medicine ,Child ,Prospective cohort study ,Aged ,Receiver operating characteristic ,business.industry ,Vitamin D-Binding Protein ,Infant ,General Medicine ,Middle Aged ,medicine.disease ,Psychiatry and Mental health ,chemistry ,Child, Preschool ,Biomarker (medicine) ,Female ,Neurology (clinical) ,business ,Biomarkers ,030217 neurology & neurosurgery - Abstract
Meningitis is an inflammatory process involving meninges. It is difficult to diagnose because of the absence of a diagnostic biomarker. We first report here the possibility of cerebrospinal fluid (CSF) vitamin D-binding protein (VDBP) as a new biomarker for the diagnosis of meningitis. This prospective study enrolled a total of 102 subjects (58 patients with non-neurologic disease, 17 patients with meningitis, and 27 patients with other neurologic diseases) from 2017 to 2018. CSF and blood samples were collected in pairs. Total 25(OH)D in CSF and serum and VDBP levels in serum were measured. GC genotyping was also performed to determine polymorphisms of rs4588 and rs7041. CSF total 25(OH)D and VDBP levels were compared with serum total 25(OH)D and VDBP levels according to disease (meningitis vs. non-meningitis). Receiver operating characteristic (ROC) analysis for the diagnosis of meningitis using CSF VDBP level was performed. Mean CSF VDBP and serum VDBP levels of all patients were 1.48 ± 1.32 and 181.28 ± 56.90 μg/mL, respectively. CSF VDBP level in the meningitis disease group (3.20 ± 1.49 μg/mL) was significantly (P
- Published
- 2019
38. Colchicine for steroid-resistant recurrent pericarditis in a child
- Author
-
Hee Joung Choi, Ju Hee Shin, and Dong Hyun Lee
- Subjects
medicine.medical_specialty ,Case Report ,030204 cardiovascular system & hematology ,Epigastric pain ,Pericardial effusion ,Gastroenterology ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Quality of life ,030225 pediatrics ,Internal medicine ,medicine ,Colchicine ,Children ,lcsh:R5-920 ,Anakinra ,business.industry ,medicine.disease ,Steroid resistant ,chemistry ,Corticosteroid therapy ,Recurrent pericarditis ,lcsh:Medicine (General) ,business ,medicine.drug - Abstract
Recurrent pericarditis is rare in children and is considered idiopathic in most cases. Its course is chronic, and preventing recurrences is important for the patient’s quality of life. Although a treatment strategy in pediatric recurrent pericarditis has not yet been established, non-steroidal anti-inflammatory drugs (NSAIDs) are the most common treatment for management of this condition, followed by corticosteroids, colchicine, immunosuppressive agents, immunoglobulins, and interleukin-1β receptor antagonists (e.g. anakinra). Herein, we report a case of recurrent pericarditis with pericardial effusion in a 5-year-old child who presented with fever and epigastric pain. He responded poorly to NSAIDs and corticosteroid therapy, but was successfully treated with colchicine.
- Published
- 2018
39. The first Korean case with Floating-Harbor syndrome with a novel mutation diagnosed by targeted exome sequencing
- Author
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Ja-Hyun Jang, Jong In Jeong, Joon Sik Kim, Seok Jin Kang, Heung Sik Kim, Ye Jee Shim, Jung-Sook Ha, Eun Mi Choi, and Dong Hyun Lee
- Subjects
0301 basic medicine ,Clinodactyly ,Nasal bridge ,Case Report ,Pediatrics ,DNA sequencing ,03 medical and health sciences ,symbols.namesake ,Next generation sequencing ,Medicine ,Floating-Harbor syndrome ,gene ,Exome sequencing ,Genetics ,Sanger sequencing ,Massive parallel sequencing ,business.industry ,Genetic disorder ,lcsh:RJ1-570 ,lcsh:Pediatrics ,medicine.disease ,Pelletier-Leisti syndrome ,030104 developmental biology ,Floating–Harbor syndrome ,Pediatrics, Perinatology and Child Health ,symbols ,SRCAP gene ,medicine.symptom ,business - Abstract
Floating-Harbor syndrome is a rare autosomal dominant genetic disorder associated with SRCAP mutation. To date, approximately 50 cases of Floating-Harbor syndrome have been reported, but none have been reported in Korea yet. Floating-Harbor syndrome is characterized by delayed bony maturation, unique facial features, and language impairment. Here, we present a 6-year-old boy with a triangular face, deep-set protruding eyes, low-set ears, wide nose with narrow nasal bridge, short philtrum, long thin lips, clinodactyly, and developmental delay that was transferred to our pediatric clinic for genetic evaluation. He showed progressive delay in the area of language and cognition-adaption as he grew. He had previously undergone chromosomal analysis at another hospital due to his language delay, but his karyotype was normal. We performed targeted exome sequencing, considering several syndromes with similar phenotypes. Library preparation was performed with the TruSight One sequencing panel, which enriches the sample for about 4,800 genes of clinical relevance. Massively parallel sequencing was conducted with NextSeq. An identified variant was confirmed by Sanger sequencing of the patient and his parents. Finally, the patient was confirmed as the first Korean case of Floating-Harbor syndrome with a novel SRCAP (Snf2 related CREBBP activator protein) mutation (c.7732dupT, p.Ser2578Phefs*6), resulting in early termination of the protein; it was not found in either of his healthy parents or a control population. To our knowledge, this is the first study to describe a boy with Floating-Harbor syndrome with a novel SRCAP mutation diagnosed by targeted exome sequencing in Korea.
- Published
- 2018
40. Association of Olfactory and Pulmonary Function in Middle-Aged and Older Adults: The Korea National Health and Nutrition Examination Survey
- Author
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Dong Hyun Lee, Jun-Ook Park, Ji-Sun Kim, Ki-Hong Chang, and Byung Guk Kim
- Subjects
Olfactory system ,medicine.medical_specialty ,National Health and Nutrition Examination Survey ,KNHANES ,lcsh:Medicine ,Article ,Pulmonary function testing ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Risk factor ,030223 otorhinolaryngology ,Suicidal ideation ,obstructive ,business.industry ,lcsh:R ,pulmonary function ,olfactory function ,General Medicine ,Odds ratio ,medicine.disease ,Confidence interval ,risk factor ,030220 oncology & carcinogenesis ,medicine.symptom ,business ,Dyslipidemia - Abstract
Objectives: To identify the relationship between pulmonary function and subjective olfactory dysfunction in middle-aged and older adults. Materials and Methods: We used Korea National Health and Nutrition Examination Survey data from 2010 to 2012 to analyze 6191 participants in their 50s or older. Results: The frequency of olfactory dysfunction was 6.8% among the subjects with normal pulmonary function tests, but was significantly more frequent in those diagnosed with restrictive (9.6%) or obstructive (10.1%) pulmonary function. Forced volume vital capacity, forced expiratory volume (FEV)1, FEV6, and peak expiratory flow were significantly lower in the olfactory dysfunction group. The risk of olfactory dysfunction was significantly associated with obstructive pulmonary function (odds ratio (OR) [95% confidence interval (CI)]: 1.449 [1.010–2.081]) after adjusting for confounders (sex, rhinitis, chronic rhinosinusitis, hypertension, dyslipidemia, education level, stress, depressed mood, and suicidal ideation). Conclusion: Middle-aged and older adults with obstructive pulmonary function had a higher incidence of subjective olfactory dysfunction than the normal pulmonary function group. Early olfactory testing may improve the quality of life of patients with obstructive pulmonary function.
- Published
- 2021
41. NASH/Liver Fibrosis Prevalence and Incidence of Nonliver Comorbidities among People with NAFLD and Incidence of NAFLD by Metabolic Comorbidities: Lessons from South Korea
- Author
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Sang Bong Ahn, Mi Jung Jun, Dae Won Jun, Jiyoon Park, Mindie H. Nguyen, Fajuan Rui, Eileen Yoon, Eunice Yewon Lee, Ramsey Cheung, Dong Hyun Lee, Biyao Zou, Linda Henry, Jie Li, Chuanli Liu, and Hongli Yang
- Subjects
medicine.medical_specialty ,education.field_of_study ,business.industry ,Incidence (epidemiology) ,Fatty liver ,Population ,Gastroenterology ,nutritional and metabolic diseases ,General Medicine ,medicine.disease ,digestive system ,digestive system diseases ,Internal medicine ,Diabetes mellitus ,Meta-analysis ,Epidemiology ,medicine ,Metabolic syndrome ,education ,business ,Liver: Systematic Review and Meta-Analysis ,Kidney disease - Abstract
Background: NAFLD incidence, NASH prevalence, NAFLD fibrosis prevalence, incidence of metabolic comorbidities, and mortality data in the NAFLD population remain limited. Aims: We used a meta-analytic approach to “stage” NAFLD among the Korean population. Methods: We searched PubMed, Embase, Cochrane Library, and KoreaMed from inception until June 29, 2019, and calculated pooled estimates via the random-effects model. Results: We screened 1,485 studies and analyzed 191 eligible studies: 179 (3,556,579 participants) for NAFLD prevalence and outcome analysis and 32 (1,089,785 participants) for NAFLD incidence analysis. NAFLD prevalence was 31.46% overall and 50–60% in those with metabolic risks. The incidence (per 1,000 person-years) of NAFLD was 42.8 overall and 70–77% in those with metabolic risk. The incidence (per 1,000 person-years) of new-onset T2DM, hypertension, cardiovascular disease, and chronic kidney disease was found to be 16.9, 47.9, 100.6, and 13.9, respectively. From biopsy data, 30.21% of the NAFLD population had moderate-to-severe steatosis (9 studies, 2,461 participants) and 52.27% had NASH (7 studies, 1,168 participants) and 85.41% had fibrosis Conclusions: The overall prevalence of NAFLD was 31.46% with an incidence rate of 42.8 per 1,000 person-years. NASH prevalence was 52% but
- Published
- 2021
42. Progression Rates by Age, Sex, Treatment, and Disease Activity by AASLD and EASL Criteria: Data for Precision Medicine
- Author
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Masaru Enomoto, Yong Kyun Cho, Teerapat Ungtrakul, Hidenori Toyoda, Yasuhito Tanaka, Jiayi Li, Ming-Lung Yu, Tai-Chung Tseng, Cheng Yuan Peng, Soung Won Jeong, Hirokazu Takahashi, Hyunwoo Oh, Ritsuzo Kozuka, Min Sun Kwak, Jae Yoon Jeong, Man-Fung Yuen, Eileen L. Yoon, Satoshi Yasuda, Cheng Hao Tseng, Clifford Wong, Pei-Chien Tsai, Ka Shing Cheung, Edward Gane, Rui Huang, Hwai I. Yang, An K. Le, Jia-Horng Kao, Chien-Hung Chen, Sang Bong Ahn, Jae-Jun Shim, Chao Wu, Dae Won Jun, Dong Hyun Lee, Chung Feng Huang, Eiichi Ogawa, Hyo Suk Lee, Ming Lun Yeh, Huy N. Trinh, Mindie H. Nguyen, Qing Xie, Tawesak Tanwandee, Chia-Yen Dai, Grace Lai-Hung Wong, Joseph Hoang, Sung Eun Kim, Ramsey Cheung, Jian Zhang, Christopher Wong, Yao-Chun Hsu, Yuichiro Eguchi, Changqing Zhao, Chris Cunningham, and Jiyoon Park
- Subjects
Liver Cirrhosis ,Male ,medicine.medical_specialty ,Cirrhosis ,Carcinoma, Hepatocellular ,medicine.disease_cause ,Antiviral Agents ,03 medical and health sciences ,0302 clinical medicine ,Hepatitis B, Chronic ,Median follow-up ,Interquartile range ,Internal medicine ,Epidemiology ,medicine ,Humans ,Precision Medicine ,Retrospective Studies ,Hepatitis B virus ,Hepatology ,business.industry ,Incidence ,Liver Neoplasms ,Gastroenterology ,Entecavir ,Middle Aged ,medicine.disease ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Cohort ,030211 gastroenterology & hepatology ,Female ,business ,medicine.drug - Abstract
Background & AIMS Antiviral treatment criteria are based on disease progression risk, and hepatocellular carcinoma (HCC) surveillance recommendations for patients with chronic hepatitis B (CHB) without cirrhosis is based on an annual incidence threshold of 0.2%. However, accurate and precise disease progression estimate data are limited. Thus, we aimed to determine rates of cirrhosis and HCC development stratified by age, sex, treatment status, and disease activity based on the 2018 American Association for the Study of Liver Diseases and 2017 European Association for the Study of the Liver guidelines. Methods We analyzed 18,338 patients (8914 treated, 9424 untreated) from 6 centers from the United States and 27 centers from Asia-Pacific countries. The Kaplan-Meier method was used to estimate annual progression rates to cirrhosis or HCC in person-years. Results The cohort was 63% male, with a mean age of 46.19 years, with baseline cirrhosis of 14.3% and median follow up of 9.60 years. By American Association for the Study of Liver Diseases criteria, depending on age, sex, and disease activity, annual incidence rates ranged from 0.07% to 3.94% for cirrhosis, from 0.04% to 2.19% for HCC in patients without cirrhosis, and from 0.40% to 8.83% for HCC in patients with cirrhosis. Several subgroups of patients without cirrhosis including males younger than 40 years of age and females younger than 50 years of age had annual HCC risk near or exceeding 0.2%. Similar results were found using European Association for the Study of the Liver criteria. Conclusion There is great variability in CHB disease progression rates even among “lower-risk” populations. Future CHB modeling studies, public health planning, and HCC surveillance recommendation should be based on more precise disease progression rates based on sex, age, and disease activity, plus treatment status.
- Published
- 2021
43. Incidences and Determinants of Functional Cure During Entecavir or Tenofovir Disoproxil Fumarate for Chronic Hepatitis B
- Author
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Ramsey Cheung, Vincent Wai-Sun Wong, Man-Fung Yuen, Mindie H. Nguyen, Mar Riveiro-Barciela, Qing Xie, Li Liu, Chia-Yen Dai, Yao-Chun Hsu, Ming-Lung Yu, Cheng Yuan Peng, Joseph Hoang, Ming-Lun Yeh, Masaru Enomoto, Ka Shing Cheung, Huy N. Trinh, Maria Buti, Elena Vargas Accarino, Carmen Monica Preda, Jia-Ling Wu, Yee Hui Yeo, Wan-Long Chuang, Jee-Fu Huang, Dong Hyun Lee, Chung-Feng Huang, Ritsuzo Kozuka, Chien-Hung Chen, Grace Lai-Hung Wong, Doina Istratescu, and Pei-Chien Tsai
- Subjects
0301 basic medicine ,Male ,medicine.medical_specialty ,HBsAg ,China ,Hepatitis B virus ,Guanine ,Viremia ,Malignancy ,medicine.disease_cause ,Gastroenterology ,Antiviral Agents ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Hepatitis B, Chronic ,Internal medicine ,medicine ,Immunology and Allergy ,Humans ,Cumulative incidence ,Tenofovir ,Hepatitis B Surface Antigens ,business.industry ,Incidence ,Fatty liver ,Alanine Transaminase ,Bilirubin ,Entecavir ,Middle Aged ,medicine.disease ,Fatty Liver ,030104 developmental biology ,Infectious Diseases ,Treatment Outcome ,DNA, Viral ,030211 gastroenterology & hepatology ,Female ,business ,medicine.drug ,Cohort study - Abstract
Background Long-term incidences and baseline determinants of functional cure (hepatitis B surface antigen [HBsAg] seroclearance) during entecavir (ETV) or tenofovir disoproxil fumarate (TDF) treatment are incompletely understood. Methods This is an international multicenter cohort study of treatment-naive patients with chronic hepatitis B who started ETV or TDF treatment without baseline cancer. Patients were observed for HBsAg seroclearance until death or loss to follow-up. We calculated the incidences and explored the baseline determinants of HBsAg seroclearance using competing risk regression. Results The analysis included 4769 patients (median age, 50 years; 69.05% male), with a median follow-up of 5.16 years (26 614.47 person-years). HBsAg clearance occurred in 58 patients, yielding a 10-year cumulative incidence of 2.11% (95% confidence interval, 1.54%–2.88%) and an annual rate of 0.22% (.17%–.28%). Baseline predictors included low-level viremia with hepatitis B virus DNA 200 U/L (3.68 [2.07–6.53]), serum bilirubin (1.11 per mg/dL; [1.06–1.17 mg/dL]), and fatty liver (1.84 [1.03–3.29]). Conclusion HBsAg seroclearance rarely occurs in patients with chronic hepatitis B treated with ETV or TDF and is associated with low-level viremia, alanine aminotransferase flare, bilirubin level, and fatty liver. Functional cure of hepatitis B virus infection rarely occurred at an average annual rate of 0.22% during first-line oral antiviral treatment, with higher chances observed in patients with low-level viremia, high-level aminotransferase flare, elevation of serum bilirubin, and fatty liver.
- Published
- 2021
44. Association between ischemic stroke and seropositive rheumatoid arthritis in Korea: A nationwide longitudinal cohort study
- Author
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Seil Sohn, Inbo Han, Dong Hyun Lee, Dong-Geun Lee, Seung Hun Sheen, Dong Chan Lee, Jae-Won Jang, Hakyung Kim, Je Beom Hong, and Seung-Ho Shin
- Subjects
Male ,Epidemiology ,Kaplan-Meier Estimate ,Cardiovascular Medicine ,Vascular Medicine ,Brain Ischemia ,Arthritis, Rheumatoid ,Geographical Locations ,Medical Conditions ,Endocrinology ,0302 clinical medicine ,Risk Factors ,Medicine and Health Sciences ,Stroke ,Multidisciplinary ,Incidence (epidemiology) ,Hazard ratio ,Middle Aged ,Neurology ,Cardiovascular Diseases ,Antirheumatic Agents ,Hypertension ,Cohort ,Medicine ,Female ,Research Article ,Adult ,medicine.medical_specialty ,Asia ,Endocrine Disorders ,Death Rates ,Cerebrovascular Diseases ,Science ,Immunology ,Cardiology ,Rheumatoid Arthritis ,Subgroup analysis ,Autoimmune Diseases ,03 medical and health sciences ,Rheumatology ,Population Metrics ,Internal medicine ,Diabetes Mellitus ,medicine ,Humans ,Aged ,Dyslipidemias ,Ischemic Stroke ,Proportional Hazards Models ,030203 arthritis & rheumatology ,Insurance, Health ,Korea ,Population Biology ,business.industry ,Arthritis ,Biology and Life Sciences ,Cardiovascular Disease Risk ,medicine.disease ,Confidence interval ,Dyslipidemia ,Metabolic Disorders ,Relative risk ,People and Places ,Clinical Immunology ,Clinical Medicine ,business ,030217 neurology & neurosurgery - Abstract
The purpose of this longitudinal follow-up study was to investigate the risk of ischemic stroke nationwide in patients with seropositive rheumatoid arthritis (RA) and controls who were matched in age and sex. Patient data were collected from the National Health Insurance Service (NHIS) Health Screening (HEALS) cohort. Using the International Classification of Diseases code M05 (seropositive RA), with a prescription of any disease-modifying anti-rheumatic drug (DMARD), RA was identified. A total of 2,765 patients and 13,825 control subjects were included in our study. The 12-year incidence of ischemic stroke in each group was calculated using the Kaplan–Meier method. The risk ratio of ischemic stroke was estimated using Cox proportional hazards regression. Sixty-four patients (2.31%) in the seropositive RA group and 512 (3.70%) in the control group experienced ischemic stroke (P < 0.001) during the follow-up period. The hazard ratio of ischemic stroke in the seropositive RA group was 1.32 (95% confidence interval (CI), 1.02–1.73) after adjusting for age and sex. The adjusted hazard ratio of ischemic stroke in the seropositive RA group was 1.40 (95% CI, 1.07–1.82) after adjusting for demographics and comorbid medical disorders. According to the subgroup analysis, the hazard ratios of ischemic stroke risks in the female and hypertensive subgroups were 1.44 (95% CI, 1.05–1.97) and 1.66 (95% CI, 1.16–2.38), respectively. In the non-diabetes and non-dyslipidemia subgroups, the corresponding hazard ratios of ischemic stroke were 1.47 (95% CI, 1.11–1.95) and 1.43 (95% CI, 1.07–1.91). Seropositive RA patients have an increased risk of ischemic stroke. In female, hypertension, non-diabetes, and non-dyslipidemia RA subgroups, even without the traditional risk factors for stroke (except for hypertension), increased the risk, which could be potentially attributed to RA.
- Published
- 2021
45. Clinical features and long-term treatment outcomes in choroidal tuberculoma
- Author
-
Eun Young Choi, Min Kim, Hyuna Cho, Dong Hyun Lee, Junwon Lee, and Sung Chul Lee
- Subjects
Adult ,Male ,medicine.medical_specialty ,Tuberculosis ,Long term treatment ,Antitubercular Agents ,Tuberculin ,Tuberculosis, Ocular ,Eye neoplasm ,Cellular and Molecular Neuroscience ,Medicine ,Humans ,Tuberculoma ,Retrospective Studies ,Lung ,business.industry ,Medical record ,Choroid Diseases ,Middle Aged ,medicine.disease ,Sensory Systems ,Ophthalmology ,medicine.anatomical_structure ,Treatment Outcome ,Female ,Radiology ,business ,Uveitis - Abstract
PURPOSE To investigate the clinical features and treatment outcomes of patients with choroidal tuberculoma. METHODS In this retrospective, observational case series, the medical records of five patients with choroidal tuberculoma who were followed up at a university hospital for at least 6 months were analyzed. RESULTS Of five patients, one was male and four were female. The overall mean age was 38.0 ± 9.4 years (mean follow-up: 41.2 ± 33.8 months). Tuberculin skin test was performed in three patients, and it was positive in two of them. Interferon-gamma assay was performed in two patients and was positive in all two. Three patients had systemic tuberculosis involving the lung or other organs. Five patients were treated with antitubercular therapy for a period of 9.6 ± 8.6 months. Systemic corticosteroid treatment was performed in 3 patients, with a period of 3.5 ± 0.7 months. One patient with a recurrent vascularized tuberculoma was successfully treated with single intravitreal bevacizumab injection. CONCLUSION Choroidal tuberculoma can develop without evidence of systemic tuberculosis and can recur despite antitubercular treatment. High index of suspicion is important in early detection, and management of choroidal tuberculoma. In cases of suspected choroidal tuberculoma, positive results on immunological tests would be sufficient to initiate antitubercular therapy even if radiological evidence of systemic tuberculosis is not found. Antitubercular therapy combined with systemic corticosteroids provided favorable results. Intravitreal injection of anti-vascular endothelial growth factor may be considered for highly vascularized choroidal tuberculoma.
- Published
- 2020
46. Correlation of epidermal growth factor receptor mutation status in plasma and tissue samples of patients with non-small cell lung cancer
- Author
-
Dong Hyun Lee, Bo-Hyoung Kang, Mee-Sook Roh, Seul Lee, Choonhee Son, Soo-Jung Um, and Neul-Bom Yoon
- Subjects
Adult ,Male ,Lung Neoplasms ,Mutant ,medicine.disease_cause ,Melting curve analysis ,Circulating Tumor DNA ,T790M ,Carcinoma, Non-Small-Cell Lung ,medicine ,Biomarkers, Tumor ,Humans ,Radiology, Nuclear Medicine and imaging ,Digital polymerase chain reaction ,Epidermal growth factor receptor ,Liquid biopsy ,Lung cancer ,Aged ,Aged, 80 and over ,Mutation ,biology ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,ErbB Receptors ,Oncology ,Cancer research ,biology.protein ,Female ,business - Abstract
Background Somatic mutations of the gene encoding epidermal growth factor receptor (EGFR) are detected in approximately 30%-50% of patients with non-small cell lung cancers (NSCLC), so detection of EGFR mutation is the pivotal step of treatment in patients with advanced NSCLC. However, difficulty in obtaining sufficient tissue and bias from the heterogeneity of the tumor samples are the major obstacles. Although analyzing EGFR with circulating tumor DNA (ctDNA) in plasma is a breakthrough, accuracy is the problem in variable methods. Peptide nucleic acid (PNA) clamping-assisted fluorescence melting curve analysis (PANAMutyper®) is a novel and highly sensitive method of detecting EGFR mutation in tumor tissues. Aims and objectives This study was designed to evaluate PANAMutyper® for detecting EGFR mutation with ctDNA of patients with lung cancer. Materials and methods EGFR mutation status detected by PNA clamp with tissue samples and by PANAMutyper® with ctDNA was compared. Tissue biopsy was done in 158 patients with lung tumor, in which 23 cases were excluded and 135 cases were enrolled. EGFR mutation rate was 23.0% (31/135) in overall patients. All the plasma samples of the cases with mutant EGFR in tissue samples were verified by an already known highly sensitive method of droplet digital polymerase chain reaction (ddPCR). Results The concordance rate of tissue and plasma samples was 91.9% (124/135). The sensitivity, specificity, negative predictive value, and positive predictive value were 64.5%, 100%, 90.4%, and 100%, respectively, according to the tissue samples as a standard. PANAMutyper® method was not inferior to ddPCR for the detection of EGFR mutation including T790M with ctDNA. These results suggest that the detection of EGFR mutation status using ctDNA in plasma by PANAMutyper® is a feasible test prior to tissue biopsy.
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- 2020
47. Test-retest reliability of the virtual reality sickness evaluation using electroencephalography (EEG)
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Dong-uk Han, Hyun Kyoon Lim, Sun Gu Nam, Kyoungha Ji, Kyoung-Mi Jang, Ye Shin Woo, and Dong-Hyun Lee
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0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,Motion Sickness ,Virtual reality ,Audiology ,Electroencephalography ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Cronbach's alpha ,medicine ,Humans ,Virtual reality sickness ,Reliability (statistics) ,medicine.diagnostic_test ,business.industry ,General Neuroscience ,Significant difference ,Virtual Reality ,Reproducibility of Results ,Middle Aged ,medicine.disease ,Test (assessment) ,030104 developmental biology ,Motion sickness ,Female ,business ,030217 neurology & neurosurgery ,Photic Stimulation - Abstract
No reliable quantitative and objective measurement method for virtual reality (VR) sickness has been firmly established to date. Electroencephalography (EEG) may be a strong candidate to evaluate VR sickness objectively. However, no test-retest evaluation has been made for VR sickness using EEG. To recruit VR sickness-sensitive participants, we tested 858 participants (age = 20′s–50′s) using the Motion Sickness Susceptibility Questionnaire (MSSQ). Among them, we recruited 21 males (average age = 25.0) who obtained the 75th percentile of scores on the MSSQ (32.9 ± 5.7). VR sickness was evaluated twice (one week apart) using EEG with VR video content designed to cause VR sickness. A Simulation Sickness Questionnaire (SSQ) was also used to evaluate VR sickness. In terms of the reliability of EEG, ICC and Cronbach’s alpha analyses showed that three waves (delta, theta, and alpha) were consistent in two areas (frontal and central). A significant difference in EEG was also found repeatedly between the baseline and VR sickness (delta, theta, and alpha) in two areas (frontal and central). We evaluated EEG for its reliability and found specific waves and areas that showed good consistency and significant changes associated with VR sickness. These findings may support further research of VR sickness evaluation.
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- 2020
48. Modified desk height helps children with cerebral palsy perform sit-to-stand
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Dong-Hyun Lee, Hyun Kyoon Lim, Jooyeon Ko, and Dong-uk Han
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medicine.medical_specialty ,Sit to stand ,Cerebral Palsy ,Movement ,Rehabilitation ,Biomedical Engineering ,Physical Therapy, Sports Therapy and Rehabilitation ,medicine.disease ,Hand ,Cerebral palsy ,Speech and Hearing ,Physical medicine and rehabilitation ,Motor Skills ,medicine ,Humans ,Orthopedics and Sports Medicine ,Range of Motion, Articular ,Psychology ,Child ,Motor skill ,Desk - Abstract
Children with cerebral palsy (CP) have difficulties performing activities that require the use of fundamental motor skills such as sit-to-stand (STS). In this study, we used a height adjustable chair and desk to investigate the role of desk support in STS and how it might benefit children with CP.Seventeen typically developing children (TDC), average age = 9.7 years, and 28 children with CP (Gross Motor Function Classification System [GMFCS] I and II), average age = 10.3 years, participated in the test. Elapsed time and body sway were measured using a pressure mat and load cell while each child performed a STS task. Two different desk heights were tested for time consumption and sway under the condition of hands-on-desk and arms-crossed.We found that the elapsed time of hands-on-desk with the elbow flexion height was the shortest (Results of this study may be a useful reference in rehabilitation training and designing a desk height beneficial for children with CP.Implications for RehabilitationBetter performance of sit-to-stand for a child with cerebral palsy could be made by a desk supportElapsed time during preparation period for sit-to-stand could be reduced by desk support for all CP childrenSway amount during sit-to-stand could be reduced by desk support, especially for the CP children with GMFCS level IIDesk height is an important parameter and should be studied in detail.
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- 2020
49. Voice change after thyroidectomy without vocal cord paralysis: Analysis of 2,297 thyroidectomy patients
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Young-Hak Park, Geun-Jeon Kim, Sohee Lee, Yeon-Shin Hwang, Ja-Seong Bae, Dong Hyun Lee, Dong-Il Sun, Jeong Soo Kim, Sang-Yeon Kim, and Mi-Ran Shim
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Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Multivariate analysis ,Voice Quality ,medicine.medical_treatment ,Logistic regression ,Short stature ,Risk Assessment ,Postoperative Complications ,Sex Factors ,Risk Factors ,Medicine ,Humans ,Vocal cord paralysis ,Thyroid Neoplasms ,Retrospective Studies ,business.industry ,Thyroidectomy ,Age Factors ,Retrospective cohort study ,Odds ratio ,Middle Aged ,medicine.disease ,Surgery ,Voice change ,Female ,medicine.symptom ,business ,Follow-Up Studies - Abstract
Some patients experience long-term voice change after thyroidectomy. One of the most common symptoms of voice change is pitch lowering, which is closely related to unfavorable voice quality. Here we observed voice outcomes for 6 months of follow-up after thyroidectomy to identify factors closely related to low-pitched voice.We retrospectively reviewed the records of 2,297 patients who underwent thyroidectomy between January 2014 and December 2017. All the patients had their vocal status examined using videostroboscopy, acoustic voice analyses, aerodynamic study, and Thyroidectomy-Related Voice Questionnaire scores. We stratified patients into 2 groups (low-pitched voice versus favorable voice) according to pitch lowering (reduction in speaking fundamental frequency ≥12 Hz 1 month after thyroidectomy compared to the preoperative value). We compared preoperative data with postoperative data collected 1, 3, and 6 months after thyroidectomy to identify factors contributing to low-pitched voice.Univariate logistic regression analyses showed that factors related to low-pitched voice were female sex, older age, low body weight, short stature, and a high positive lymph node ratio. Multivariate analyses showed that female sex and older age were significantly associated with a negative prognosis for low-pitched voice 1 month after thyroidectomy (odds ratios 0.41 and 1.04, respectively; P.001). Receiver operating characteristic curves for predicting sustained low-pitched voice during 6 months showed that speaking fundamental frequency ≥12.48 Hz 1 month after thyroidectomy was the optimal cutoff value, with 87.9% sensitivity and 95.8% specificity (P.001).Female sex and older age are strongly associated with increased risk for low-pitched voice after thyroidectomy. Speaking fundamental frequency ≥12.48 Hz 1 month after thyroidectomy can be used to predict sustained low-pitched voice after thyroidectomy.
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- 2020
50. Novel Treatment Strategy for Management of Traumatic Bulbar Urethral Rupture Using Temporary Urethral Stent after Primary Realignment; Retrospective Comparison between Thermo-Expandable Urethral Stent and Self-Expandable Polymer-Coated Urethral Stent
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Dong Hyun Lee, Du Geon Moon, Jong Wook Kim, and Sun Tae Ahn
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medicine.medical_specialty ,Urethral stricture ,medicine.medical_treatment ,Urethroplasty ,030232 urology & nephrology ,lcsh:Medicine ,Urethral stent ,Article ,03 medical and health sciences ,0302 clinical medicine ,medicine ,urethral realignment ,business.industry ,Urethral rupture ,lcsh:R ,Granulation tissue ,Stent ,General Medicine ,medicine.disease ,equipment and supplies ,Surgery ,medicine.anatomical_structure ,Urethra ,trauma ,Blunt trauma ,030220 oncology & carcinogenesis ,rupture ,urethral stenting ,urethra ,business - Abstract
A variety of retrievable and other types of temporarily placed stents are currently being used. However, only a few studies have considered primary endoscopic realignment with temporary urethral stent insertion in the event of traumatic bulbar urethral injury. We aimed to compare the clinical effectiveness and complications between thermo-expandable urethral stents and polymer-coated bulbar urethral stents (BUSs) for the treatment of traumatic bulbar urethral strictures. Between September 2011 and March 2018, 30 patients who had been diagnosed with complete bulbar urethral rupture following blunt trauma underwent temporary urethral stent placement after primary realignment. Thermo-expandable nickel-titanium alloy urethral stents were placed for 15 patients (group M), and retrievable self-expandable polymer-coated BUSs were placed for another 15 patients (group A). All stents were removed within 6 months after placement. The complications and maintained patency rates were compared between the two groups. The mean stent indwelling period was 5.0 ± 2.5 months in group M and 4.9 ± 4.0 months in group A. Both groups maintained high patency rates (Group M 12/15 (80.0%) and group A 13/15 (86.7%)). Five patients who developed urethral stricture underwent direct visual internal urethrotomy (DVIU), and no patients required repeat DVIU or open surgical urethroplasty. Both groups maintained the mean maximal urinary flow rate (Qmax) at 12 months after stent removal. Discomfort (46.7% vs. 6.7%), granulation tissue formation (73.3% vs. 26.7%) and post-void dribbling (80.0% vs. 20.0%) were more frequent in group M than in group A (p = 0.013, p = 0.011 and p = 0.001, respectively). In conclusion, both stents were effective for managing traumatic complete bulbar urethral rupture after primary realignment. However, the thermo-expandable urethral stents had a higher complication rate while the stent was in situ than the BUSs.
- Published
- 2020
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