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51.
Jay Chol Choi Joong-Goo Kim Chul-Hoo Kang Hee-Joon Bae Jihoon Kang Soo-Joo Lee Jong-Moo Park Tai Hwan Park Yong-Jin Cho Kyung Bok Lee Jun Lee Dong-Eog Kim Jae-Kwan Cha Joon-Tae Kim Byung-Chul Lee Ji-Sung Lee Anthony S. Kim 《Journal of Korean medical science》2021,36(11)
BackgroundWe investigated the association between geographic proximity to hospitals and the administration rate of reperfusion therapy for acute ischemic stroke.MethodsWe identified patients with acute ischemic stroke who visited the hospital within 12 hours of symptom onset from a prospective nationwide multicenter stroke registry. Reperfusion therapy was classified as intravenous thrombolysis (IVT), endovascular therapy (EVT), or combined therapy. The association between the proportion of patients who were treated with reperfusion therapy and the ground transport time was evaluated using a spline regression analysis adjusted for patient-level characteristics. We also estimated the proportion of Korean population that lived within each 30-minute incremental service area from 67 stroke centers accredited by the Korean Stroke Society.ResultsOf 12,172 patients (mean age, 68 ± 13 years; men, 59.7%) who met the eligibility criteria, 96.5% lived within 90 minutes of ground transport time from the admitting hospital. The proportion of patients treated with IVT decreased significantly when stroke patients lived beyond 90 minutes of the transport time (P = 0.006). The proportion treated with EVT also showed a similar trend with the transport time. Based on the residential area, 98.4% of Korean population was accessible to 67 stroke centers within 90 minutes.ConclusionThe use of reperfusion therapy for acute stroke decreased when patients lived beyond 90 minutes of the ground transport time from the hospital. More than 95% of the South Korean population was accessible to 67 stroke centers within 90 minutes of the ground transport time. 相似文献
52.
Ji Hyun Lee In Tae Moon Youngjin Cho Jun Yup Kim Jihoon Kang Beom Joon Kim Moon-Ku Han Il-Young Oh Hee-Joon Bae 《JOURNAL OF CLINICAL NEUROLOGY》2021,17(2):213
Background and PurposeAn insertable cardiac monitor (ICM) has been demonstrated to be a useful tool for detecting subclinical atrial fibrillation (AF) in patients with embolic stroke of undetermined source (ESUS). This study aimed to identify the clinical predictors of AF in ESUS patients with ICMs.MethodsWe retrospectively selected consecutive patients with an ICM implanted for AF detection following ESUS. The primary endpoint was defined as any AF episode lasting for longer than 5 min. The atrial ectopic burden (AEB) was calculated as the percentage of the number of conducted QRS from atrial ectopy on Holter monitoring.ResultsThis study included 136 patients. AF lasting ≥5 min was detected in 20 patients (14.7%) during a median follow-up period of 6.6 months (interquartile range, 3.3–10.8 months). AF patients had a higher AEB (0.20% vs. 0.02%, p<0.001) and a larger left atrial diameter (LAD, 41.0 mm vs. 35.3 mm, p<0.001) than those without AF. The areas under the receiver operating characteristic curves were 0.795 and 0.816 for the LAD and log-transformed AEB, respectively, for the best cutoff values of 38.5 mm for LAD and 0.050% for AEB. AF lasting ≥5 min was detected in 34.6% (9/26) of patients with LAD ≥38.5 mm and AEB ≥0.050%, and in 0% (0/65) of those with LAD <38.5 mm and AEB <0.050%.ConclusionsAF was detected in a significant proportion of ESUS patients during a 6.6-month follow-up. The LAD and AEB are good predictors of AF and might be useful for AF risk stratification in ESUS patients. 相似文献
53.
Hong-Kyun Park Hang Rai Kim Beom Joon Kim Jihoon Kang Cheolkyu Jung Byung Se Choi Jae Hyoung Kim Moon-Ku Han Seong-Ho Park Hee-Joon Bae 《Journal of clinical neuroscience》2013,20(10):1455-1457
Transient monocular blindness (TMB) is a well-known warning symptom of impending cerebral or retinal infarction, which suggests vulnerable ipsilateral carotid disease. Instability of free-floating thrombus may cause recurrent artery-to-artery embolism. A recent study showed that a combination of clopidogrel and aspirin might reduce microthromboembolisms. Here, we report a patient with frequent TMB despite aspirin monotherapy whose symptom disappeared after the addition of clopidogrel.This is the first report of aspirin-resistant frequent TMB caused by thromboembolism from vulnerable plaque that remitted after the addition of clopidogrel. These findings highlight the need for a randomized controlled trial to illustrate the most efficacious treatment strategy in this situation. 相似文献
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56.
Hong J Lee Y Park Y Kim SG Hwang KH Park SH Jeong J Kim KH Ahn JY Park S Park J Lee JH 《Annals of hematology》2012,91(5):687-695
To evaluate the role of FDG-PET/CT in detecting bone marrow (BM) involvement, pre-treatment bilateral bone marrow biopsies (BMBs) and FDG-PET/CT scans of 89 patients with diffuse large B-cell lymphoma (DLBCL) treated with rituximab-CHOP were reviewed and analyzed. Fourteen patients (15.7%) had lymphomatous involvement based on BMB (BMB+), and 17 patients (19.1%) had the possibility of BM involvement on FDG-PET/CT (FDG-PET/CT+). Seventy-two patients (80.8%) had concordant results between BMB and FDG-PET/CT (seven patients were positive for both, and 65 patients were negative for both), but 17 patients (19.2%) had a discordant interpretation (seven patients were BMB+ and FDG-PET/CT-, and ten were BMB- and FDG-PET/CT+). Although BMB+ patients had an inferior 2-year EFS (37.0% vs. 79.8%, p?0.001) and OS (36.3% vs. 81.0%, p?0.001) compared to BMB- patients, no differences in EFS (62.6% vs. 72.7%, p?=?0.185) and OS (59.4% vs. 78.0%, p?=?0.146) were shown between FDG-PET/CT+ and FDG-PET/CT- patients. Whereas six of seven patients with diffuse hypermetabolism were BMB+, only one of ten patients with focal hypermetabolism was BMB+. The results suggest that FDG-PET/CT had a limited value to detect BM involvement in patients with DLBCL. Focal hypermetabolism of hematopoietic BM in FDG-PET/CT had no impact on survival. 相似文献
57.
Jihoon Cha Sung Tae Kim Hyung-Jin Kim Hye Jeong Kim Byung-joon Kim Pyoung Jeon Keon Ha Kim Hong Sik Byun 《European radiology》2013,23(3):879-886
Objectives
To evaluate the added value of diffusion-weighted imaging (DWI) to perfusion-weighted imaging (PWI) for differentiating tumour progression from radiation necrosis.Methods
Sixteen consecutive patients who underwent removal of a metastatic brain tumour that increased in size after stereotactic radiosurgery were retrospectively reviewed. The layering of the ADC was categorised into three patterns. ADC values were measured on each layer, and the maximum rCBV was measured. rCBV and the layering pattern of the ADC of radiation necrosis and tumour progression were compared.Results
Nine cases of radiation necrosis and seven cases of tumour progression were pathologically confirmed. Radiation necrosis (88.9 % vs. 14.3 %) showed a three-layer pattern of ADC with a middle layer of minimum ADC more frequently. If rCBV larger than 2.6 was used to differentiate radiation necrosis and tumour progression, the sensitivity was 100 % but specificity was 56 %. If the lesions with the three-layer pattern of ADC with moderately increased rCBV (2.6–4.1) were excluded from tumour progression, the sensitivity and specificity increased to 100 %.Conclusions
The three-layer pattern of ADC shows high specificity in diagnosing radiation necrosis; therefore, combined analysis of the ADC pattern with rCBV may have added value in the correct differentiation of tumour progression from radiation necrosis.Key Points
?MRI follow-up often reveals increasing size of enhancing lesions after stereotactic radiosurgery ?Inflammation around tumour necrosis increases regional cerebral blood volume (rCBV), mimicking progression ?A three-layer apparent diffusion coefficient (ADC) pattern on diffusion-weighted MRI suggests radiation necrosis. ?The combined use of rCBV and DW MRI enables accurate differentiation. 相似文献58.
59.
Jihoon Park Taesun Kang Suhyun Jin Yong Heo Kyungran Kim Kyungsuk Lee 《Journal of agromedicine》2016,21(2):144-148
Livestock workers are involved in a variety of tasks, such as caring for animals, maintaining the breeding facilities, cleaning, and manure handling, and are exposed to health and safety risks. Hydrogen sulfide is considered the most toxic by-product of the manure handling process at livestock facilities. Except for several reports in developed countries, the statistics and cause of asphyxiation incidents in farms have not been collected and reported systematically, although the number of these incidents is expected to increase in developing and underdeveloped countries. In this study, the authors compiled the cases of work-related asphyxiation incidents at livestock manure storage facilities and analyzed the main causes. In this survey, a total of 17 incidents were identified through newspapers or online searches and public reports. Thirty workers died and eight were injured due to work-related tasks and rescue attempts from 1998 to 2013 in Korea. Of the 30 fatalities, 18 occurred during manure handling/maintenance tasks and 12 during rescue attempts. All incidents except for one case occurred during the warm season from the late spring (April) to early autumn (September) when manure is likely to decompose rapidly. It is important to train employees involved in the operation of the facilities (i.e., owners, managers, employees) regarding the appropriate prevention strategies for confined space management, such as hazard identification before entry, periodical facility inspection, restriction of unnecessary access, proper ventilation, and health and safety. Sharing information or case reports on previous incidents could also help prevent similar cases from occurring and reduce the number of fatalities and injuries. 相似文献