Primary Undifferentiated Pleomorphic Sarcoma of the Left Atrium that Presented as Acute Pulmonary Edema

서성환,박태호,유정남,차광수,김무현,김영대,우종수,노미숙 연세대학교의과대학 2007 Yonsei medical journal Vol.48 No.1

A 37-year-old woman was admitted to Dong-A University Hospital for rapidly progressive congestive heart failure. Transthoracic echocardiography demonstrated a large mass with a stalk that appeared to be a myxoma on the posterior wall of the left atrium. However, the histological diagnosis was undifferentiated pleomorphic sarcoma. We report a case of primary undifferentiated pleomorphic sarcoma of the left atrium with acute pulmonary edema caused by mitral inflow obstruction.

Smaller Mean LDL Particle Size and Higher Proportion of Small Dense LDL in Korean Type 2 Diabetic Patients

서성환,박형두,김세원,배지철,단현경,정혜수,허규연,김재현,김광원,이문규 대한당뇨병학회 2011 Diabetes and Metabolism Journal Vol.35 No.5

Background: Small dense low density lipoprotein (sdLDL) has recently emerged as an important risk factor of coronary heart disease. Methods: The mean LDL particle size was measured in 203 patients with type 2 diabetes mellitus (T2DM) and 212 matched subjects without diabetes using polyacrylamide tube gel electrophoresis. Major vascular complications were defined as stroke, angiographically-documented coronary artery disease or a myocardial infarction. Peripheral vascular stenosis, carotid artery stenosis (≥50% in diameter) or carotid artery plaque were considered minor vascular complications. Overall vascular complications included both major and minor vascular complications. Results: Diabetic patients had significantly smaller mean-LDL particle size (26.32 nm vs. 26.49 nm) and a higher percentage of sdLDL to total LDL compared to those of subjects without diabetes (21.39% vs. 6.34%). The independent predictors of sdLDL in this study were serum triglyceride level and body mass index (odds ratio [OR], 1.020 with P<0.001 and OR 1.152 with P<0.027, respectively). However, no significant correlations were found between sdLDL and major vascular complications (P=0.342), minor vascular complications (P=0.573) or overall vascular complications (P=0.262) in diabetic subjects. Conclusion: Diabetic patients had a smaller mean-LDL particle size and higher proportion of sdLDL compared to those of subjects without diabetes. Obese diabetic patients with hypertriglyceridemia have an increased risk for atherogenic small dense LDL. However, we could not verify an association between LDL particle size and vascular complications in this study.

조합 논리회로의 재귀적 분석에 관한 연구

서성환 동양대학교 2000 동양대학교 논문집 Vol.6 No.1

In this paper, an analytical method using recursive technique is introduced for combinational logic circuits. This method uses the concept of EFFR(Extended Fanout Free Region) which is extended from FFR(Fanout Free Region). EFFR is defined as the domain that contains the FOS(Fan-Out Stem) inputs in FFR. To find EFFRS, firstly, a circuit is divided into Cones where each Cone has a single PO(Primary Output). Secondly, a Cone is divided into possible EFFRS again. the obtained EFFR is considered as a functional gate. Repeatedly dividing higher level structure using same procedure until no more FOS left, a single Cone can be reduced as a single EFFR. A comparison was made between FFR and EFFR analyses for the ISCAS85 bench mark test circuits.

mRNA Expression of SLC5A5 and SLC2A Family Genes in Papillary Thyroid Cancer: An Analysis of The Cancer Genome Atlas

서성환,김윤학,고태식,정대천,이치승,장전엽,차원재,한명은,김성장,김인주,박경준 연세대학교의과대학 2018 Yonsei medical journal Vol.59 No.6

Purpose: The present study investigated the dynamics and prognostic role of messenger RNA (mRNA) expression responsible for18F-fluorodeoxyglucose (FDG) uptake in FDG positron emission tomography (PET) and radioactive iodine (131I) uptake in wholebodyradioactive iodine scans (WBS) in papillary thyroid cancer (PTC) patients. Materials and Methods: The primary and processed data were downloaded from the Genomic Data Commons Data Portal. Expressiondata for sodium/iodide symporter (solute carrier family 5 member 5, SLC5A5), hexokinase (HK1–3), glucose-6-phosphatedehydrogenase (G6PD), and glucose transporter (solute carrier family 2, SLC2A1–4) mRNA were collected. Results: Expression of SLC5A5 mRNA were negatively correlated with SLC2A1 mRNA and positively correlated with SLC2A4mRNA. In PTC with BRAF mutations, expressions of SLC2A1, SLC2A3, HK2, and HK3 mRNA were higher than those in PTC withoutBRAF mutations. Expression of SLC5A5, SLC2A4, HK1, and G6PD mRNA was lower in PTC without BRAF mutation. PTCswith higher expression of SLC5A5 mRNA had more favorable disease-free survival, but no association with overall survival. Conclusion: Expression of SLC5A5 mRNA was negatively correlated with SLC2A1 mRNA. This finding provides a molecular basisfor the management of PTC with negative WBS using 18F-FDG PET scans. In addition, higher expression of SLC5A5 mRNA wasassociated with less PTC recurrence, but not with deaths.

Statin Intolerance: an Overview of the Current Status and Possible Treatment Options

서성환,정창희,홍순준,최성희 한국지질동맥경화학회 2018 지질·동맥경화학회지 Vol.7 No.2

Lowering serum low-density lipoprotein cholesterol (LDL-C) is the mainstay for reduction of risk of cardiovascular disease (CVD), the second most common cause of death in Korea. The 2015 Korean guidelines for management of dyslipidemia strongly recommend the use of statins in patients at risk of CVD. Statin therapy, which is the gold standard for CVD, reduces LDL-C level by 40% to 60% and is generally well tolerated. However, many patients are intolerant to statins and discontinue therapy or become nonadherent to therapy because of actual/perceived side effects. The most common of these side effects is the statin-associated muscle symptom (SAMS). Discontinuation and repetitive re-challenge with statins can help identify SAMS. If serum creatinine kinase level is more than 10 times the upper limit of normal, statin therapy must be stopped immediately, and the physician should identify possible causes including rhabdomyolysis and treat appropriately. In other patients, it might help to switch to a less potent statin or to use statins at intermittent non-daily dosing. To achieve target LDL-C level, non-statin lipid-lowering therapies such as dietary modifications, ezetimibe, and bile acid sequestrants may be added. Several new drugs have recently been approved for lowering LDL-C level. Alirocumab and evolocumab are monoclonal antibodies that inhibit proprotein convertase subtilisin/kexin type 9, and both drugs cause large reductions in LDL-C, similar to statins. Lomitapide and mipomersen are orphan drugs used as adjuncts to other lipid-lowering therapies in patients with homozygous familial hypercholesterolemia.

Effects of Resistance Training and Aerobic Exercise on Insulin Sensitivity in Overweight Korean Adolescents: A Controlled Randomized Trial

서성환,정인경,김미연,김연수,신수,김순신,김재현 대한당뇨병학회 2011 Diabetes and Metabolism Journal Vol.35 No.4

Background: Data on the impact of resistance training on insulin resistance in overweight or obese children are inconclusive. Methods: Thirty overweight South Korean adolescents (mean age of 13.10 years) were divided by sex, and then randomly assigned to one of three treatment groups, which were the diet only (DO), diet with aerobic exercise (AE), or diet with resistance training (RT) group. Physiologic and metabolic parameters were assessed at baseline and after 12 weeks of exercise training and diet modification. Results: Both exercise groups (aerobic and resistance) showed significant improvements in their insulin area under the curve and insulin sensitivity index values when compared to their baseline values while the DO group showed no significant changes in these variables. Age-, sex-, and body mass index (BMI)-adjusted intergroup comparison analyses showed a marked reduction in BMI and a significant reduction in muscle mass in the AE group when compared to the RT group and the DO group, respectively. Conclusion: A 12-week exercise training program of either resistance or aerobic activity improved insulin sensitivity in overweight adolescents, although it failed to show superiority over a DO program. Aerobic exercise decreased both body weight and BMI, and it was noted that this group also had a significant reduction in muscle mass when compared to the DO group.

Increased Risk of Hospitalization for Heart Failure with Newly Prescribed Dipeptidyl Peptidase-4 Inhibitors and Pioglitazone Using the Korean Health Insurance Claims Database

서성환,서기현,정창희,김미경,진상만,황유철,이병완,김재현 대한당뇨병학회 2015 Diabetes and Metabolism Journal Vol.39 No.3

Background: We assessed the association of dipeptidyl peptidase 4 inhibitors (DPP4i) with hospitalization for heart failure (HF) using the Korean Health Insurance claims database. Methods: We collected data on newly prescribed sitagliptin, vildagliptin, and pioglitazone between January 1, 2009 and December 31, 2012 (mean follow-up of 336.8 days) to 935,519 patients with diabetes (518,614 males and 416,905 females) aged 40 to 79 years (mean age of 59.4 years). Results: During the study, 998 patients were hospitalized for primary HF (115.7 per 100,000 patient-years). The incidence rate of hospitalization for HF was 117.7 per 100,000 per patient-years among patients on pioglitazone, 105.7 for sitagliptin, and 135.8 for vildagliptin. The hospitalization rate for HF was greatest in the first 30 days after starting the medication, which corresponded to a significantly higher incidence at days 0 to 30 compared with days 31 to 360 for all three drugs. The hazard ratios were 1.85 (pioglitazone), 2.00 (sitagliptin), and 1.79 (vildagliptin). The incidence of hospitalization for HF did not differ between the drugs for any time period. Conclusion: This study showed an increase in hospitalization for HF in the initial 30 days of the DPP4i and pioglitazone compared with the subsequent follow-up period. However, the differences between the drugs were not significant.

Glycemic Variability: How Do We Measure It and Why Is It Important?

서성환,김재현 대한당뇨병학회 2015 Diabetes and Metabolism Journal Vol.39 No.4

Chronic hyperglycemia is the primary risk factor for the development of complications in diabetes mellitus (DM); however, it is believed that frequent or large glucose fluctuations may independently contribute to diabetes-related complications. Postprandial spikes in blood glucose, as well as hypoglycemic events, are blamed for increased cardiovascular events in DM. Glycemic variability (GV) includes both of these events; hence, minimizing GV can prevent future cardiovascular events. Correcting GV emerges as a target to be pursued in clinical practice to safely reduce the mean blood glucose and to determine its direct effects on vascular complications in diabetes. Modern diabetes management modalities, including glucagon-related peptide-1-based therapy, newer insulins, modern insulin pumps and bariatric surgery, significantly reduce GV. However, defining GV remains a challenge primarily due to the difficulty of measuring it and the lack of consensus regarding the optimal approach for its management. The purpose of this manuscript was not only to review the most recent evidence on GV but also to help readers better understand the available measurement options and how the various definitions relate differently to the development of diabetic complications.

통일의 영성 : 남북화해 시대에 독일통일의 경우에 비추어

서성환 장로회신대학교 2000 敎會와 神學 Vol.41 No.-

남성갱년기치료

서성환 대한내과학회 2022 대한내과학회 춘계학술대회 Vol.2022 No.-