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- 저자 : Hui-Jin Uhm (검색결과 12 건)
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Park, Jin-Kyu,Park, Junbeom,Uhm, Jae-Sun,Joung, Boyoung,Lee, Moon-Hyoung,Pak, Hui-Nam Oxford University Press 2016 EUROPACE -LONDON- Vol.18 No.3
<P>We hypothesized that P-wave amplitude in lead I is related to left atrial (LA) remodelling and inter-atrial conduction pattern, and has a predictive value for recurrence after radiofrequency catheter ablation (RFCA) among patients with paroxysmal atrial fibrillation (PAF). A total of 525 consecutive patients with PAF (76% male, 56 +/- 12 years old) who underwent RFCA were included. We compared pre-procedural sinus rhythm electrocardiograms without antiarrhythmic drug effect with LA volume (CT), LA voltage (NavX), the earliest activation site (EAS) conduction pattern of LA, and clinical recurrence rate. P-wave amplitude in lead I was significantly lower in patients with recurrence than in those that remained in sinus rhythm (P < 0.001) during 21 +/- 10-month follow-up. P-wave amplitude in lead I was linearly correlated with LA voltage (beta = 2.52, 95% CI 0.606-4.425, P = 0.010), LA conduction velocity (beta = 1.91, 95% CI 0.941-2.876, P < 0.001), and low septal displacement of EAS (beta = -1.67, 95% CI -2.352 to -0.996, P < 0.001). P-wave amplitudes < 0.1 mV in lead I were independently associated with clinical recurrence of AF on multivariate Cox regression analysis (adjusted HR 2.163, 95% CI 1.307-3.581, P = 0.003). The integrated area under the curves was 0.705 (95% CI 0.655-0.755). Low P-wave amplitude (< 0.1 mV) in lead I is related to LA remodelling and displaced inter-atrial conduction pattern to low septum, and independently predicts clinical recurrence after RFCA in patients with PAF.</P>
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( Moo Nyun Jin ),( Jae Sun Uhm ),( Hui Nam Pak ),( Moon Hyoung Lee ),( Bo Young Joung ) 대한내과학회 2013 대한내과학회 추계학술대회 Vol.2013 No.1
Background: Subsequent development of atrial fibrillation (AF) is common after radiofrequency catheter ablation of typical atrial flutter (AFL); however, the risk factors of AF after successful AFL ablation have yet to be clearly established. This study investigates the prevalence of and risk factors for AF after successful AFL ablation. Methods: A total of 293 consecutive patients (236 men, mean age 56±14 years) without valvular heart disease who underwent radiofrequency catheter ablation of typical AFL were enrolled in the study. Results: AF was observed in 136 (46%) before ablation. During a follow-up of 40±37 months (1-199 months) 103 (35%) patients had AF after ablation including 37 (13%) newly diagnosed with AF. The patients with postablation AF had higher proportion of male sex (87% vs. 77%, p=0.003), had a larger LA diameter (43±6 vs. 41±6, p=0.03), and had AF before AFL ablation (65% vs. 36%, p<0.001) more frequently than those without postablation AF. In multivariate logistic regression analysis, male sex (OR 2.45, 95% CI 1.02-5.89, p=0.045) and AF before AFL ablation (OR 3.62, 95% CI 2.03-6.46, p<0.001) were significantly associated with the development of AF after AFL ablation. Conclusions: Patients with typical AFL undergoing successful ablation remain at an elevated risk for AF occurrence. Hypertrophic cardiomyopathy, AF before AFL ablation and male sex were independent risk factors of AF development after AFL ablation.
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Impact of atrial fibrillation on the clinical course of apical hypertrophic cardiomyopathy
Lee, Sang-Eun,Park, Jin-Kyu,Uhm, Jae-Sun,Kim, Jong Youn,Pak, Hui-Nam,Lee, Moon-Hyoung,Joung, Boyoung BMJ Publishing Group Ltd 2017 Heart Vol.103 No.19
<P>Conclusion In patients with ApHCM, AF was common and was associated with a substantial risk for strokes and mortality suggesting that AF should be carefully managed in ApHCM.</P>
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Bleeding Risk and Major adverse Events in Patients with Cancer on Oral Anticoagulation Therapy
( Yong-joon Lee ),( Jin-kyu Park ),( Jae-sun Uhm ),( Jong-yun Kim ),( Hui-nam Pak ),( Moon-hyoung Lee ),( Boyoung Joung ) 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1
Background: Malignancy is a well-established hypercoagulable state that predisposes to thromboembolisms. However, the efficacy of oral anticoagulation therapy (OAT) might be influenced by the type, treatment, and duration of cancer in atrial fibrillation (AF) patients with newly diagnosed malignancies. Objective: To evaluate the thromboembolic and bleeding events, in patients with cancer and a history of AF according to whether or not they received OAT. Methods: In 2,168 consecutive non-valvular AF patients with newly diagnosed malignancies, we analyzed the composite endpoints including major adverse cardiac events (MACEs) and major bleeding. Results: The CHA2DS2-VASc and HAS-BELD score were higher in patients with OAT (OAC+, n=1,182) than without (OAT-, n=936). During a follow up period of 3.9±2.8 years, 142 (12%) and 88 (9%) patients had MACEs in the OAT+ and OAT- groups, respectively (p=0.055). The incidence of major bleeding (11% vs. 8%, p=0.023) and composite endpoints(21% vs. 16%, p=0.002) was significantly higher in the OAT+ than OAT- group. OAT increased the adjusted hazard ratio (relative risk 1.241, 95% CI 1.01 to 1.53, p=0.04) for composite endpoints. During the year after the cancer diagnosis, the optimal INR level was achieved in only 288 (24%) patients, and the annual incidence of MACEs and major bleeding was 34.7% and 29.2%. respectively. OAT+ significantly increased MACEs in stomach and renal cancer (all p<0.05). Conclusions: In AF patients with newly diagnosed malignancies, OAT did not improve the composite endpoint including MACEs and major bleeding during the first year of a cancer diagnosis because of an INR variability. Therefore, careful and meticulous control of the INR is needed in these patients. Moreover, OAT might fail to prevent MACEs in specific types of cancers.
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( Young Ah Park ),( Jae Sun Uhm ),( Tae Hoon Kim ),( Han Cheol Lee ),( Jun Beom Park ),( Jin Kyu Park ),( Bo Young Joung ),( Hui Nam Pak ),( Moon Hyoung Lee ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: In patients with sick sinus syndrome (SSS) or atrioventricular block (AVB), hypertension can be uncontrollable due to the compensatory increase of sympathetic tone. The aim of this study was to elucidate changes of blood pressure (BP) before and after pacemaker implantation. Methods: We retrospectively reviewed the medical record of patients who underwent pacemaker implantation from January 2010 through December 2013 in one center, who were diagnosed with hypertension and taking antihypertensive drugs before pacemaker implantation. Results: A total of 58 patients met the eligible criteria, and they showed signifi cant decreases of systolic BP (143.5±17.3mmHg vs 127.1±13.7mmHg, p<0.001) and mean BP (120.0±14.1mmHg vs 69.4±12.1mmHg, p=0.001) after 3 months of pacemaker implantation. The systolic BP of 36 patients (68.4%) and mean BP of 34 patients (59.6%) were decreased after 3 months of implantation compared to the initial systolic BP and mean BP. The tendency of BP decrease were more obvious in patients with borderline to high initial systolic BP. However, the BP in normotensive patients were increased over time (% of patients with decreased BP, 31.8% vs 82.9%, p<0.001 after 3 months). The reduction of BP in patients with borderline and high initial systolic BP persisted after 9 months of follow up compared with baseline BP (Difference of systolic BP, 22.1 ± 3.7mmHg, p<0.001, difference of mean BP, 15.7 ± 3.0mmHg, p<0.001). The fi nding was independent of the cause of pacemaker implantation (SSS vs AVB 54.8% vs 73.1%, p=0.179 at discharge, 58.1% vs 61.5%, p=1.00 after 3 months). The number of antihypertensive drugs before implantation was not signifi cantly different from that after implantation (before implantation vs after implantation 1.6±0.7, 1.6±0.6, p=0.568). Conclusions: Pacemaker implantation can be helpful for blood pressure control in patients with hypertension and SSS or AVB.
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Lee, Seung-Jun,Sung, Jung-Hoon,Kim, Jin-Bae,Ahn, Min-Soo,Lee, Hye Young,Uhm, Jae-Sun,Pak, Hui-Nam,Lee, Moon-Hyoung,Kim, Jong-Yun,Joung, Boyoung Wolters Kluwer Health 2016 Medicine Vol.95 No.47
<▼1><P>Supplemental Digital Content is available in the text</P></▼1><▼2><P><B>Abstract</B></P><P>This study aimed to evaluate the safety and efficacy of vitamin K antagonist (VKA) in atrial fibrillation (AF) patients with previous ulcer bleeding.</P><P>In this multicenter, retrospective analysis, clinical outcomes of 754 AF patients with a history of ulcer bleeding were evaluated. After ulcer treatment, 458 patients (61%) were treated with VKA, and the outcomes were compared to 296 patients (39%) without VKA.</P><P>VKA treatment significantly increased major bleeding (7.3%/year vs 3.2%/year, <I>P</I> < 0.001), and reduced major adverse cardiac events (MACE) (5.4%/year vs 10.0%/year, <I>P</I> < 0.001). Specifically, risk of gastrointestinal bleeding was significantly higher in the VKA group than no-VKA group (5.7%/year vs 2.6%/year, <I>P</I> < 0.001). Consequently, there was no difference in the incidence of composite of a MACE and major bleeding, between the 2 groups. In patients with time in the therapeutic range (TTR) ≥65%, VKA significantly decreased MACE (2.8%/year vs 10.0%/year, <I>P</I> < 0.001) without increasing major bleeding. Net clinical benefit model showed beneficial effects of VKA in patients with TTR ≥65%, and harmful effects in those with TTR < 55%.</P><P>In AF patients with previous ulcer bleeding, VKA treatment did not improve clinical outcomes unless the international normalized ratio level was constantly maintained (TTR ≥65%), as the gastrointestinal bleeding (GIB) risk significantly increased.</P></▼2>
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Byung Gyu Kim,Jae-Sun Uhm,Pil-Sung Yang,Hee Tae Yu,Tae-Hoon Kim,Boyoung Joung,Hui-Nam Pak,Song Yee Kim,Moo Suk Park,Jin Gu Lee,Hyo Chae Paik,Moon-Hyoung Lee 대한내과학회 2020 The Korean Journal of Internal Medicine Vol.35 No.4
Background/Aims: Atrial arrhythmia (AA) occasionally occurs after lung transplantation (LT); however, risk factors for AA and their impact on clinical outcomes are inconsistent. We aimed to investigate the incidence, predisposing factors, and clinical outcomes of AA after LT. Methods: We retrospectively evaluated 153 consecutive patients who underwent LT between January 2010 and August 2016. An AA episode was defined as a documented atrial fibrillation (AF), atrial flutter, or atrial tachycardia on 12-lead electrocardiography or episodes lasting ≥ 30 seconds on telemetry monitoring. Results: The mean follow-up time was 22.0 ± 19.1 months. Postoperative AA occurred in 46 patients (30.1%) after LT. Patients with postoperative AA were older, had larger body surface area, and had an increased incidence of paroxysmal AF prior to transplantation, idiopathic pulmonary fibrosis, and postoperative tracheostomy than patients without AA. Preoperative right atrial pressure (RAP) (odds ratio [OR], 1.19; p = 0.005) and longer periods of mechanical ventilation (OR, 1.03; p = 0.008) were found to be independent risk factors for AA after surgery. Development of AA was a significant predictor of long-term overall mortality (hazard ratio, 2.75; p = 0.017). Conclusions: Patients with elevated preoperative RAP and long-term ventilator care had a higher risk of AA after LT. Further, AA after LT was associated with poor long-term survival.
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Yong-Rae Jang,Sung-Jun Joo,Ji-Hyeon Chu,Hui-Jin Uhm,Jong-Whi Park,Chung-Hyeon Ryu,Myeong-Hyeon Yu,김학성 한국정밀공학회 2021 International Journal of Precision Engineering and Vol.8 No.1
Intense pulsed light (IPL) sintering or annealing technology has attracted tremendous attention from many researchers and a variety of industries owing to its unique features. In IPL process, the pulsed white flash-light from xenon lamp is irradiated on the target materials and converts it to the desired conductive layer. The IPL process is ambient condition and room temperature process. The irradiated IPL on the materials can induce an extremely quick heating (several milliseconds) to the certain temperature by the synergetic opto-chemical, opto-thermal phenomena without damage on the low temperature substrates such as polymer and paper. The exact mechanisms of these opto-synergetic phenomena has been intensively studied by many researchers for a decade. Also, the applications of IPL techniques have become more extensive in printed electronics. In this review, we summarized the brief history and various applications of the intense pulsed light technology to conductive electrodes as well as several applications. The IPL process can provide a paved route to revolutionary eco-benign and low-cost manufacturing process for many applications.
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Kim, In-Soo,Sohn, Jungwoo,Lee, Seung-Jun,Park, Jin-Kyu,Uhm, Jae-Sun,Pak, Hui-Nam,Lee, Moon-Hyoung,Kim, Changsoo,Joung, Boyoung Elsevier/North-Holland Biomedical Press 2017 International journal of cardiology Vol.240 No.-
<P><B>Abstract</B></P> <P><B>Background</B></P> <P>This study investigated the acute effects of exposure to air pollution on ventricular tachyarrhythmias (VTAs) in an East Asian population. The association between air pollution and VTA has not yet been studied in an East Asian country affected by the Asian dust phenomenon, which worsens air quality.</P> <P><B>Methods</B></P> <P>The study cohort consisted of 160patients with implantable cardioverter defibrillator (ICD) devices in the Seoul metropolitan area who were followed for 5.5±3.8years. We used ICD records of VTAs and matched these with hourly measurements of air pollutant concentrations and meteorological data. Fine particle mass and gaseous air pollution plus temperature and relative humidity were measured hourly during the study period.</P> <P><B>Results</B></P> <P>During the study period, 1064 VTA events including 204 instances of ventricular fibrillation (VF) were observed. We found a statistically significant association between overall VTA events and SO<SUB>2</SUB> (lag 24h; OR 1.49, 95%CI 1.16–1.92, p=0.002), PM<SUB>10</SUB> (lag 2h; OR 2.56, 95%CI 2.03–3.23, p<0.001), NO<SUB>2</SUB> (lag 24h; OR 1.25, 95%CI 1.19–1.31, p<0.001) and CO (lag 24h; OR 1.05, 95%CI 1.02–1.08, p=0.003). Sustained ventricular tachycardia or VF was also independently associated with SO<SUB>2</SUB>, PM<SUB>10</SUB>, NO<SUB>2</SUB> and CO (all p<0.01). Exposures to SO<SUB>2</SUB>, PM<SUB>10</SUB>, NO<SUB>2</SUB>, and CO (all p<0.01) were significantly related to overall VTAs, especially in patients with structural heart disease (SHD).</P> <P><B>Conclusions</B></P> <P>Associations between air pollution and VTA were observed in a metropolitan area of an East Asian country. Exposures to SO<SUB>2</SUB>, PM<SUB>10</SUB>, NO<SUB>2</SUB>, and CO were significantly associated with VTAs in ICD patients with SHD.</P>
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