좌심방에 발생한 원발성 미분류 방추세포 육종 1례

조정환,홍그루,송인욱,손창우,정선영,남종호,김미진 영남대학교 의과대학 2009 Yeungnam University Journal of Medicine Vol.26 No.2

Left Atrial Appendage Occlusion in Non-Valvular Atrial Fibrillation in a Korean Multi-Center Registry

Kim, Jung-Sun,Lee, Hancheol,Suh, Yongsung,Pak, Hui-Nam,Hong, Geu-Ru,Shim, Chi Young,Yu, Cheol-Woong,Lee, Hyun-Jong,Kang, Woong-Chol,Shin, Eun-Seok UNKNOWN 2016 CIRCULATION JOURNAL Vol.80 No.5

<P>Background: The aim of this study was to evaluate clinical outcome after left atrial appendage (LAA) occlusion in real clinical practice and compare between Amplatzer cardiac plug (ACP) and Watchman. Methods and Results: From October 2010 to February 2015, 96 successful LAA occlusion procedures were performed using either ACP (n=50) or Watchman device (n=46) in non-valvular atrial fibrillation (AF) patients (59 male; age, 65.1 +/- 9.4 years; CHADS2, 2.5 +/- 1.2; CHA(2)DS(2)-VASC, 3.9 +/- 1.6; HAS-BLED, 2.7 +/- 1.3). The procedure success rate was 96.8%. There were serious complications in 4 patients (4.1%; 2 cardiac tamponade, 1 device embolization, and 1 major bleed). The anticoagulation cessation rate after 6 weeks was 92.7%. During mean 21.9-month follow-up, the incidence of death, stroke, systemic embolization and major bleeding was 5.2%, 4.2%, 0% and 1.0%, respectively. On transesophageal echocardiography of 93 patients within 6 months after the procedure, 24 residual leaks were observed (25.8%; 2 mild, 18 moderate, and 4 major). Clinical outcome was similar for the 2 devices, but peridevice leakage was more frequent with the Watchman than the ACP. Conclusions: LAA occlusion was feasible in non-valvular AF patients with high risk of stroke and hemorrhage. The ACP and Watchman devices were similar in terms of procedural and clinical outcomes.</P>

Block Size Optimization of CBFM for Scattering Problems

Park, Chan-Sun,Jeong, Yi-Ru,Hong, Ic-Pyo,Yook, Jong-Gwan Institute of Electrical and Electronics Engineers 2018 IEEE transactions on antennas and propagation Vol.66 No.10

<P>The characteristic basis function method (CBFM) was developed as an algorithm to accelerate the analysis based on direct matrix solver. In CBFM, the optimum block size greatly influences the overall analysis time. In this paper, we propose a guideline for setting the optimal block size that can be applied to every algorithm based on CBFM. Rough estimation of the optimal block size is <TEX>$L_{B}^{rough} \approx 0.05 N^{6/{29}}$</TEX>, and the exact optimal block size can be determined through preprocessing based on rough estimation. Numerical results of electromagnetic scattering problems are shown to demonstrate the performance of the proposed method.</P>

좌심실 이완기능의 평가에 있어서 도플러 조직영상으로 평가한 승모판륜 속도의 유용성

홍그루(Gue Ru Hong),전대진(Dae Jin Jun),배준호(Jun Ho Bae),이종석(Jong Suk Lee),김형준(Hyung Jun Kim),박종선(Jong Sun Park),신동구(Dong Gu Shin),김영조(Young Jo Kim),심봉섭(Bong Sup Shim) 대한내과학회 1999 대한내과학회지 Vol.57 No.6

N/A Background : Doppler echocardiography is widely used for the noninvasive evaluation of left ventricular diastolic function. However the mitral flow velocity pattern is affected by several physiologic factors. The mitral annular velocity profile by Doppler tissue imaging may provide more additional information about left ventricular diastolic function. Thus, this study designed to assess the relationship between cardiac catheterization, MUGA scan, mitral flow velocity, and mitral annular velocity data and to assess the clinical availavility of mitral annulus velocity in the evaluation of left ventricular diastolic function. Methods : The study population consisted of 20 patients with dilated cardiomyopathy( 64±7years), 20 patients with normal left ventricular function (61±7years). Left ventricular catheterization was performed with fluid-filled catheter and left ventricular end diastolic pressure, -dP/dtmax were measured. The mitral flow velocity was recorded at mitral valve tip and the mitral annulus velocity during diastole was measured by Doppler tissue imaging(DTI). Simultaneously EF(ejection fraction), PER(Peak filling rate), PFR(Peak filling rate) were measured by MUGA blood pool scan. Results : Mean peak E velocity, mean peak A velocity, E/A ratio, mean peak E' velocity, mean peak A' velocity, E'/A' ratio and -dP/dtmax significantly difference betweeen two group. -dP/dtmax by cardiac catheterization showed significant correlation with mean peak E' velocity (r=0.552, p=0.003), E'/A' ratio(r=0.507, p=0.003), DT of E'(r=-0.556, p=0.001), TVI of E'(r=0.689, p<0.001) and DT of E wave(r=-0.538, p=0.003). PFR by MUGA scan also showed significant correlation with -dP/dtmax(r=0.537, p=0.01). Conclusion : Among mitral annulus velocity index mean peak E' velocity, E'/A' ratio, DT of E',TVI of E' had significant correlation with -dP/dtmax. And DT by mitral flow velocity, PFR by MUGA scan also had significant correlation with -dP/dtmax. Mitral annulus velocity determined by DTI is relatively convenient, safe, and preload-independent variable in evaluating diastole function. Thus mitral annulus velocity by Doppler tissue imaging is may be useful diagnostic modality for evaluating left ventricular diastolic function.(Korean J Med 57:1021-1029, 1999)

Clinical significance of changes in the corrected QT interval in stress-induced cardiomyopathy

( Jung Hee Lee ),( Jae Sun Uhm ),( Dong Geum Shin ),( Boyoung Joung ),( Hui Nam Pak ),( Young Guk Ko ),( Geu Ru Hong ),( Moon Hyoung Lee ) 대한내과학회 2016 The Korean Journal of Internal Medicine Vol.31 No.3

Background/Aims: Although transient changes in the electrocardiogram (ECG) of patients with stress-induced cardiomyopathy (SCMP) are common, there are little data about ECG changes in patients with SCMP and the clinical implications of these variations. Methods: We investigated a total of 128 patients (age, 63.2 ± 15.4 years; female, 60.9%) diagnosed with SCMP. We compared the ECGs taken after SCMP diagnosis and during the recovery phase to those taken before SCMP diagnosis under baseline conditions. All patients were divided into two groups according to corrected QT (QTc) interval changes: recovered QTc group (QTc in SCMP > QTc in recovery phase, n = 77) and nonrecovered QTc group (QTc in SCMP ≤ QTc in recovery phase, n = 51). Results: In comparison of baseline, SCMP, and recovery phase, we found the mean heart rate (81.5 ± 18.7, 96.8 ± 25.3, and 83.0 ± 19.4/min, respectively; p < 0.001), frequencies of ST segment elevation (0.0%, 8.6%, and 1.6%, p = 0.004), ST segment depression (0.0%, 6.3%, and 1.6%, p = 0.007), T wave inversion (4.4 %, 43.8%, and 61.7%, p < 0.001), and QTc (447.4 ± 35.3, 488.9 ± 67.1, and 468.0 ± 49.5, p < 0.001) showed significant changes. In-hospital mortality (9.1% vs. 25.5%, p = 0.012) and critical care (54.5% vs. 72.5%, p = 0.040) occurred more frequently in the nonrecovered QTc group than in recovered QTc group. Conclusions: The QTc can be prolonged in patients with SCMP. Short-term mortality was increased in patients where the QTc did not recover.

S-221 : Catheter ablation of atrial fibrillation improves left ventricular functions at 1 year follow-up echocardiography, regardless of recurrence

( In Soo Kim ),( Hee Sun Mun ),( Jae Sun Uhm ),( Chi Young Shim ),( Boyoung Joung ),( Geu Ru Hong ),( Moon Hyoung Lee ),( Hui Nam Pak ) 대한내과학회 2013 대한내과학회 추계학술대회 Vol.2013 No.1

Background: Loss of atrioventricular synchrony has been known to impair left ventricular (LV) systolic and diastolic function in patients with atrial fibrillation (AF). We hypothesized that radiofrequency catheter ablation (RFCA) for AF improves LV function regardless of recurrence. Methods and Results: We included 521 patients with AF (male 76.2%, 57.1±11.2 years old, paroxysmal AF 68.5%) who underwent RFCA, and compared pre- and post-1-year RFCA follow-up echocardiography. The early transmitral flow velocity (E) and early mitral annular velocity (Em) were measured by Doppler imaging. Results: 1. AF ablation significantly reduced left atrium (LA) size (41.5±5.9 mm to 38.7±5.7 mm, p<0.001) and improved LV ejection fraction (EF; 63.1±8.7% to 64.7±8.0%, p=0.002). 2. In 67 patients (12.9%) with E/Em≥15, LA reverse remodeling (44.2±5.4 mm to 40.5±5.6 mm, p<0.001) was consistent, improving E/Em (19.6±7.0 to 16.2±6.1, p=0.004), but EF were not changed after RFCA. 3. During 25.6±8.9 months follow-up, 133 (25.5%) patients recurred AF, and the reduction of LA diameter (42.2±5.8 mm to 39.4±5.7 mm, p<0.001) and improvements of EF (63.2±6.6% to 65.5±5.7%, p=0.005) appeared even in recurred patients. Reduction of E/Em (18.7±4.3 to 15.6±3.6, p=0.045) was also shown in recurred 15. Conclusions: AF catheter ablation induces reverse remodeling of LA and improves LV function at 1 year follow-up, even in patients with recurrence. LV diastolic function was also improved in patients with baseline E/Em 15 1-year after AF ablation whether AF recur or not, potentially by reducing AF burden.

A Case of Successful MitraClip for Severe Mitral Regurgitation with Left Ventricular Dysfunction in Korea

차정준,Sung-Jin Hong,Jung-Sun Kim,Jiwon Seo,Seunghyun Lee,Sak Lee,Chi Young Shim,Geu-Ru Hong 대한심장학회 2020 Korean Circulation Journal Vol.50 No.9

Feasibility of Left Atrial Appendage Occlusion for Left Atrial Appendage Thrombus in Patients With Persistent Atrial Fibrillation

Lee, Oh-Hyun,Kim, Jung-Sun,Pak, Hui-Nam,Hong, Geu-Ru,Shim, Chi Young,Uhm, Jae-Sun,Cho, In-Jeong,Joung, Boyoung,Yu, Cheol-Woong,Lee, Hyun-Jong,Kang, Woong-Chol,Shin, Eun-Seok,Choi, Rak-kyeong,Lim, Do-S Elsevier 2018 The American Journal of Cardiology Vol.121 No.12

<P>This study sought to investigate the safety of percutaneous left atrial appendage (LAA) occlusion for stroke prevention in patients with nonvalvular atrial fibrillation who have LAA thrombus. From October 2010 to October 2016, LAA occlusions were performed in facilities within a Korean multicenter registry in patients without (n = 132) or with (n = 10) LAA thrombus (detected during preprocedural assessments). The incidences of periprocedural complications, including stroke, pericardial tamponade, major bleeding, and device embolization, were assessed and compared between the groups. The incidence of periprocedural complications was not significantly different between patients with and without LAA thrombus (0% vs 5% [6 of 132]; p = 0.49). During the mean 23.2 ± 17.5-month follow-up duration, 7 major adverse cardiac events occurred (1 cardiovascular death, 6 ischemic strokes), but overall event rates were not significantly different between the groups (14% vs 9%; p = 0.47). In conclusion, percutaneous LAA occlusion in nonvalvular atrial fibrillation patients with LAA thrombus may be a safe and feasible alternative to anticoagulation in select patients at a high risk of bleeding or contraindication to anticoagulation, or in whom anticoagulation failed to prevent stroke.</P>

Parasympathetic Modulation Plays a Key Role in Initiation of Paroxysmal Atrial Fibrillation

Lee, Won Jae,Shin, Dong Gu,Hong, Geu Ru,Park, Jong Sun,Kim, Young Jo 영남대학교 의과대학 2007 Yeungnam University Journal of Medicine Vol.24 No.2

Background : An acceleration or deceleration of the heart rate (HR), which reflects autonomic effects, is observed before the onset of paroxysmal atrial fibrillation (PAF). The purpose of this study was to assess the discrepancy in the autonomic interactions before the onset of PAF for different patterns of change in the HR. Materials and Methods : From 105 Holter tapes with the PAF recorded, 55 episodes (42 patients, 34 men, 58±12 years) of PAF (>5 min), Preceded by a sinus rhythm for more than 1 hour, were selected and submitted to time-domain and frequency-domain HR variability analyses. Fifty-five episodes were divided into 2 groups: group A PAF (n=30) with acceleration of the HR during the last 2 minutes before the PAF and group B (n=25) with deceleration of the HR. Results : A significant linear decrease in the mean R-R interval was observed in group A (924±30 to 835±28 ms, P=0.001) and an increase from 831±32 to 866±31 ms in group B PAF episodes (P=0.046). In the frequency-domain analyses, the LF/HF ratio exhibited a progressive linear increase before the PAF in group A (P=0.005). The HF normalized units (HFnu) and natural logarithm-transformed HF (InHF) values decreased from 30.8±4.0 to 16.1±1.8 (P=0.003) and 4.49±0.25 to 4.07±0.22 (P=0.001), respectively. Contrary to the results in group A, a significant increase in the HF components (HFnu and InHF) (from 22.6±3.2 to 30.2±4.0, P=0.005, and 4.27±0.27 to 4.75 0.33, P=0.001, respectively) and a resultant decrease in the LF/HF ratio were observed in group B PAF episodes. No significant changes were observed in the LF components in either PAF group. Conclusion : Autonomic stimuli leading to an acceleration or deceleration of the HR before the onset of AF are due to parasympathetic modulation. Parasympathetic modulation plays a key role in the initiation of PAF. 배경 : 자율 신경의 영향력을 반영하는 심박동의 가속 또는 감속은 발작성 심방세동의 시작전 관찰된다. 본 연구의 목적은 심방세동 시작전에 선행하는 두 다른 형태의 심박동의 변화가 자율 신경에 상호작용하는 차이를 평가하기 위함이다. 재료 및 방법 : 발작성 심방 세동이 기록된 105개의 홀터 결과 중에 5분 이상의 발작성 심방세동이 발생하기 전에 최소 한 시간 이상동안 정상 동율동을 보인 55개의 홀터 결과를 선택하여 심박동의 다양성에 대한 시간-우선 및 빈도-우선 분석을 시행하였다. 55개의 홀터 결과를 두 그룹으로 나누었는데, 발작성 심방 세동이 발생하기 전 마지막 2분 동안 심박동의 가속이 있었던 결과들을 그룹 A(n=30)로 분류 하였고, 심박동의 감소가 있었던 결과들은 그룹 B(n=25)로 분류하였다. 결과 : 그룹 A에서 저명하게 비교적 균일한 평균 RR 간격의 감소(924 ± 30 to 835 ± 28ms, P=0.001)가 관찰되었고, 그룹 B에서는 평균 RR 간격의 증가(831 ± 32 to 866 ± 31ms, P=0.046)가 관찰되었다. 그룹 A는 빈도-우선 분석에서 LF/HF 비가 점진적으로 비교적 균일하게 증가하였다(P=0.005). 그룹 A에서 HF normalized units (HF_(nu))값은 30.8 ± 4.0에서 16.1 ± 1.8으로 감소하였고(P=0.003), natural logarithm-transformed HF (InHF) 값은 4.49 ± 0.25에서 4.07 ± 0.22로 감소하였다(P=0.001). 그룹 A와는 정반대로 그룹 B에서 HF_(nu) 값은 22.6 ± 3.2에서 30.2 ± 4.0으로 증가하였고(P=0.005), InHF 값도 4.27 ± 0.27에서 4.75 ± 0.33으로 증가하였다(P=0.001). LF/HF 비도 그룹 B에서 결과적으로 감소하였다. 두 그룹 사이에 LF 구성요소의 저명한 차이는 관찰되지 않았다. 결론 : 발작성 심방세동이 시작되기 전에 선행하는 심박동의 가속과 감속을 유발하는 자율신경의 구동은 부교감 신경의 가감조절 때문이다. 부교감 신경의 가감조절이 발작성 심방세동의 시작에 중요한 역할을 하는 것으로 판단 된다.

Methylation Status of Transcriptional Modulatory Genes Associated with Colorectal Cancer in Northeast China

Han-Lu Gao,Xuan Wang,Hong-Ru Sun,Jun-De Zhou,Shang-Qun Lin,Yu-Hang Xing,Lin Zhu,Hai-Bo Zhou,Ya-Shuang Zhao,Qiang Chi,Yu-Peng Liu 거트앤리버 소화기연관학회협의회 2018 Gut and Liver Vol.12 No.2

Background/Aims: Methylation status plays a causal role in carcinogenesis in targeted tissues. However, the relationship between the DNA methylation status of multiple genes in blood leukocytes and colorectal cancer (CRC) susceptibility as well as interactions between dietary factors and CRC risks are unclear. Methods: We performed a case-control study with 466 CRC patients and 507 cancer-free controls to investigate the association among the methylation status of individual genes, multiple CpG site methylation (MCSM), multiple CpG site heterogeneous methylation and CRC susceptibility. Peripheral blood DNA methylation levels were detected by performing methylation-sensitive high-resolution melting. Results: Total heterogeneous methylation of CA10 and WT1 conferred a significantly higher risk of CRC (adjusted odds ratio [ORadjusted], 5.445; 95% confidence interval [CI], 3.075 to 9.643; ORadjusted, 1.831; 95% CI, 1.100 to 3.047; respectively). Subjects with high-level MCSM (MCSM-H) status demonstrated a higher risk of CRC (ORadjusted, 4.318; 95% CI, 1.529 to 12.197). Additionally, interactions between the high-level intake of fruit and CRH, WT1, and MCSM on CRC were statistically significant. Conclusions: The gene methylation status of blood leukocytes may be associated with CRC risk. MCSM-H of blood leukocytes was associated with CRC, especially in younger people. Some dietary factors may affect hypermethylation status and influence susceptibility to CRC.