ApoB/ApoA-I ratio is independently associated with carotid atherosclerosis in type 2 diabetes mellitus with well-controlled LDL cholesterol levels

( Ji Eun Jun ),( Young Ju Choi ),( Yong-ho Lee ),( Dae Jung Kim ),( Seok Won Park ),( Byung Wook Huh ),( Eun Jig Lee ),( Sun-ha Jee ),( Kyu Yeon Hur ),( Sung Hee Choi ),( Kap Bum Huh ) 대한내과학회 2018 The Korean Journal of Internal Medicine Vol.33 No.1

Background/Aims: This study aimed to investigate whether the apolipoprotein (Apo) B/ApoA-I ratio is associated with carotid intima-media thickness (CIMT) in type 2 diabetes mellitus (T2DM) subjects with low density lipoprotein cholesterol (LDL-C) levels less than 100 mg/dL. Methods: This cross-sectional study included 845 subjects aged with T2DM 40 to 75 years who had visited Huh’s Diabetes Center in Seoul, Republic of Korea for CIMT measurement. Traditional fasting lipid profiles, ApoB and ApoA-I levels were examined. CIMT was measured at three points on the far wall of 1 cm long section of the common carotid artery in the proximity of the carotid bulb. The mean value of six measurements from right and left carotid arteries were used as the mean CIMT. In this study, carotid atherosclerosis was defined as having a focal plaque or diffuse thickening of the carotid wall (mean CIMT ≥ 1.0 mm) Results: The prevalence of carotid atherosclerosis increased with ApoB/ApoA-I ratio. The ApoB/ApoA-I ratio, expressed as both quartiles (odds ratio [OR], 2.14; 95% confidence interval [CI], 1.21 to 3.79; p for trend = 0.014) and continuous values (OR, 10.05; 95% CI, 3.26 to 30.97; p < 0.001), was significantly associated with a higher risk for carotid atherosclerosis, regardless of conventional cardiovascular disease risk factors. The optimal ApoB/ApoA-I ratio cutoff value for detecting carotid atherosclerosis was 0.57, based on receiver operating characteristic curve analysis with a sensitivity of 58.0% and a specificity of 55.1%. Conclusions: A high ApoB/ApoA-I ratio was significantly associated with carotid atherosclerosis in T2DM patients with LDL-C levels less than 100 mg/dL.

Risk Assessment of Axially Loaded Single Piles using RSM-based Reliability Method

Huh, Jung Won,Kwak, Kiseok Trans Tech Publications, Ltd. 2006 Key Engineering Materials Vol.321 No.-

<P>An efficient and accurate hybrid reliability method is developed to quantify the risk of an axially loaded pile considering pile-soil interaction behavior and uncertainties in various design variables. It intelligently integrates the concepts of the response surface method, the finite difference method, the first-order reliability method, and the iterative linear interpolation scheme. Uncertainties associated with load conditions, material and section properties of the pile and soil properties are explicitly considered. The algorithm is verified using the Monte Carlo Simulation technique.</P>

A combination of early warning score and lactate to predict intensive care unit transfer of inpatients with severe sepsis/septic shock

( Jung Wan Yoo ),( Ju Ry Lee ),( Youn Kyung Jung ),( Sun Hui Choi ),( Jeong Suk Son ),( Byung Ju Kang ),( Tai Sun Park ),( Jin Won Huh ),( Chae Man Lim ),( Younsuck Koh ),( Sang Bum Hong ) 대한내과학회 2015 The Korean Journal of Internal Medicine Vol.30 No.4

Background/Aims: The modified early warning score (MEWS) is used to predict patient intensive care unit (ICU) admission and mortality. Lactate (LA) in the blood lactate (BLA) is measured to evaluate disease severity and treatment efficacy in patients with severe sepsis/septic shock. The usefulness of a combination of MEWS and BLA to predict ICU transfer in severe sepsis/septic shock patients isunclear. We evaluated whether use of a combination of MEWS and BLA enhances prediction of ICU transfer and mortality in hospitalized patients with severe sepsis/ septic shock. Methods: Patients with severe sepsis/septic shock who were screened or contacted by a medical emergency team between January 2012 and August 2012 were enrolled at a university-affiliated hospital with ~2,700 beds, including 28 medical ICU beds. Results: One hundred patients were enrolled and the rate of ICU admittance was38%. MEWS (7.37 vs. 4.85) and BLA concentration (5 mmol/L vs. 2.19 mmol/L) were significantly higher in patients transferred to ICU than those in patients treatedin general wards. The combination of MEWS and BLA was more accurate than MEWS alone in terms of ICU transfer (C-statistics: 0.898 vs. 0.816, p = 0.019). The 28-day mortality rate was 19%. MEWS was the only factor significantly associatedwith 28-day mortality rate (odds ratio, 1.462; 95% confidence interval, 1.122 to 1.905; p = 0.005). Conclusions: The combination of MEWS and BLA may enhance prediction of ICU transfer in patients with severe sepsis/septic shock.

Developing Athletes' Self-Management Model

Huh, Jung-Hoon,Choi, Jae-Won 한국스포츠심리학회 2003 한국스포츠심리학회지 Vol.14 No.3

본 연구는 선행연구를 바탕으로 가설화된 운동선수 자기관리 이론적 모형을 검증하는데 그 목적이 있다. 구체적으로 운동선수 자기관리 4개 하위요인 중 몸관리, 정신관리, 훈련관리는 자신감에, 대인관리는 팀단합에 긍정적 영향을 미치고, 자신감과 팀단합은 중재변인으로서 운동수행에 영향을 미칠 것이다 라는 가설을 수립하고 이를 검증하였다. 수립된 모델 검증을 위해 329명의 전국체전 참가선수들을 조사하였다. 육상, 수영, 양궁, 배드민턴, 복싱, 레슬링, 태권도, 농구, 배구 등 총 20개 종목에 참여한 선수들은 남녀 각각 171명과 158명이었다. AMOS를 사용한 구조방정식 모형 검증결과 가설화된 모형은 양호한 적합도 지수를 나타냈다: GFI=.96, CFI=.95, RMR=.035. 이러한 적합도 지수는 성, 종목, 수준별로 검증한 결과에서도 승인되었다. 구체적으로 살펴보면 몸관리와 정신관리는 자신감에, 자신감은 운동수행에 긍정적인 영향을 미쳤다. 또 대인관리는 팀단합에 긍정적인 영향을 미쳤지만 팀단합은 수행에 유의한 영향을 미치지 못하였다. 또한 훈련관리는 자신감에 부정적인 영향을 미쳤다. 이는 연구자가 설정한 가설을 전체적으로 지지하였으나 일면 상이한 결과를 나타내고 있다. The purpose of this study is to prove the theoretical models on the self-management of athletes by applying a covariance structure analysis. The first hypothesis to verify in this study is whether physical, mental, and training management significantly influence confidence. The second hypothesis is to examine whether interpersonal management has a direct influence on the team's unity. The third hypothesis is to verify that confidence has significant effects on performance level, whereas team unity does not. The fourth hypothesis states that the theoretical model on the self-management of athletes will show an appropriate level of reliability. Finally, the last hypothesis states that the established model will show the appropriateness of the verification dassified by event and level. The 329 participants who participated in the 81st National Athletic Meet held in Pusan, October, 2000 were selected from high schools, colleges, and professional teams based in Seoul, Incheon, and Kyeonggi for this research. The average age was 20.36 years (SD=3.99). The instrument of measurement in this research was ASMQ(Athletics'Self-Management Questionnaire), Self-Confidence and Team unity. The 4.01 WINDOWS version of the AMOS (Analysis of Moment Structure) was used for these serial procedures. The hypothesized cause and effect model for 329 athletes revealed a good fit index and was approved in the test of the model by groups (GFI=96, CFI=95, RMR=.035). In the specific hypothesized path, physical management and mental management had a positive effect on self-confidence which, in turn, affected performance. And interpersonal management affected team integrity positively, which did not significantly affect performance. However, training management had a negative influence on self-confidence. These results generally supported the hypotheses but there were some differences

F-131 : Free Paper Presentation ; The Clinical Utility of Modified Early Warning Score and Biomarkers to Predict Intensive Care Unit Transfer of Hospitalized Patients with Severe Sepsis/Septic Shock by a Medical Emergency Team

( Jung Wan Yoo ),( Ju Ry Lee ),( Youn Kyung Jung ),( Sun Hui Choi ),( Jeong Suk Son ),( Byung Ju Kang ),( Tai Sun Park ),( Jin Won Huh ),( Chae Man Lim ),( Younsuck Koh ),( Sang Bum Hong ) 대한결핵 및 호흡기학회 2013 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.116 No.-

Introduction: Modified early warning score (MEWS) is used to predict intensive care unit (ICU) admission and mortality. Biomarkers such as blood lactate (LA) and procalcitonin (PCT) are used as prognostic, therapeutic, and diagnostic tools. The aim of this study was to evaluate the ability of MEWS plus LA and/or PCT to predict the ICU transfer of severe sepsis/septic shock patients by Medical emergency team (MET) and their in-hospital mortality. Methods: This retrospective study of a 27 bed medical ICU was performed over 8 months. MEWS was calculated at MET activation, and LA and PCT were measured within 1 hour of MET activation. Results: One hundred patients were enrolled and the rate of ICU admittance was 38%. MEWS (7.37 vs 4.85), LA concentration (5 vs 2.19 mmol/L), and PCT concentration (25.62 vs 14.39 mg/dl) were significantly higher in patients transferred to ICU than in patients treated on general wards. MEWS-LA (12.46 vs 7.02), MEWS-PCT (33.04 vs 19.24), and MEWS-LA-PCT scores (38.25 vs 21.42) were significantly higher in patients transferred to ICU than in patients treated on general wards. MEWS-LA was a better predictor of ICU admittance than MEWS (AUC: 0.903 vs 0.811, p<0.001), whereas MEWS-PCT and MEWS-LA- PCT were not. The abilities of MEWS and MEWS-LA to predict in-hospital mortality did not significantly differ. Conclusions: MEWS is a useful system to identify hospitalized patients who develop severe sepsis/septic shock and need to be transferred to ICU. LA improves the ability of MEWS to discriminate patients who should be admitted to ICU.Introduction: Modified early warning score (MEWS) is used to predict intensive care unit (ICU) admission and mortality. Biomarkers such as blood lactate (LA) and procalcitonin (PCT) are used as prognostic, therapeutic, and diagnostic tools. The aim of this study was to evaluate the ability of MEWS plus LA and/or PCT to predict the ICU transfer of severe sepsis/septic shock patients by Medical emergency team (MET) and their in-hospital mortality. Methods: This retrospective study of a 27 bed medical ICU was performed over 8 months. MEWS was calculated at MET activation, and LA and PCT were measured within 1 hour of MET activation. Results: One hundred patients were enrolled and the rate of ICU admittance was 38%. MEWS (7.37 vs 4.85), LA concentration (5 vs 2.19 mmol/L), and PCT concentration (25.62 vs 14.39 mg/dl) were significantly higher in patients transferred to ICU than in patients treated on general wards. MEWS-LA (12.46 vs 7.02), MEWS-PCT (33.04 vs 19.24), and MEWS-LA-PCT scores (38.25 vs 21.42) were significantly higher in patients transferred to ICU than in patients treated on general wards. MEWS-LA was a better predictor of ICU admittance than MEWS (AUC: 0.903 vs 0.811, p<0.001), whereas MEWS-PCT and MEWS-LA- PCT were not. The abilities of MEWS and MEWS-LA to predict in-hospital mortality did not significantly differ. Conclusions: MEWS is a useful system to identify hospitalized patients who develop severe sepsis/septic shock and need to be transferred to ICU. LA improves the ability of MEWS to discriminate patients who should be admitted to ICU.

Is Radiotherapy Necessary for Stage 1 Testicular Seminoma?

Jung Ae Lee(이정애),Won Park(박원),Do Hoon Lim(임도훈),Yong Chan Ahn(안용찬),Seung Jae Huh(허승재),Jeong Il Yu(유정일),Han Yong Choi(최한용),Hyun Moo Lee(이현무),Eun Yoon Cho(조은윤) 대한방사선종양학회 2009 Radiation Oncology Journal Vol.27 No.2

목 적: 제 1 병기 성인 고환 정상피종 환자에 대한 임상적 고찰과 함께 근치적 고환절제술 후 보조적 방사선 치료와 고환절제술 단독치료의 결과를 후향적으로 분석 비교하고자 하였다. 대상 및 방법: 1996년 1월부터 2005년 9월까지 삼성서울병원에서 제 1 병기 정상피종으로 진단을 받은 환자 32명의 순수 정상피종(pure seminoma) 환자를 대상으로 하였다. 근치적 고환절제술 후 22명은 보조적 방사선 치료를 시행하였고, 10명은 추가치료 없이 종양표지자와 복부골반 전산화단층촬영을 이용한 정기적 추적관찰을 행하였다. 방사선 치료는 10∼15 MV 광자선을 사용하였으며 일일치료선량 1.8∼2 Gy로 총 24∼30.6 Gy (중앙값, 25.2Gy)를 대동맥주위림프절(L1∼L5)에 이문조사하였다. 전체 추적관찰기간은 근치적 고환절제술 시행일을 기준으로 24∼155개월(중앙값, 96개월)이었다. 결 과: 환자의 연령은 22∼58세(중앙값 34세)였고, 임상적으로 진단 전 주증상은 음낭 종괴 및 불편감이 대부분이었다. 이중 2명에서 잠복고환의 병력이 있었으며, 병리적으로 32명 중 23명에서 정상피종에 관내배아세포종(intratubular germ cell neoplasia)이 동반되어 있었다. 술후 보조적 방사선 치료를 시행한 군은 분석시점에 모든 환자가 무병상태로 100%의 국소제어율 및 생존율을 보였다. 술후 추적관찰만을 시행한 군은 10명 중 1명에서 좌측대동맥주위 림프절에 재발하여 구제 항암화학요법 후 완전관해되었으며 국소제어율 88.9%, 생존율 100%를 보였다. 결 론: 제 1 병기 정상피종에서 근치적 고환절제술 후 보조적 방사선 치료를 시행한 군과 추적관찰만을 시행한 군간에 생존율의 차이는 없었다. 환자수가 적고 추적관찰기간이 짧기는 하지만 재발 후 항암화학요법으로 구제가 잘되고, 방사선 치료시 이차암의 가능성이 있음을 고려한다면 정기적인 추적관찰이 가능한 환자에서 수술 후 방사선치료를 생략할 수도 있겠다. Purpose: To report on the clinical outcome of patients with stage I testicular seminoma by postoperative radiotherapy (PORT) or surveillance after radical inguinal orchiectomy. Materials and Methods: This study is a retrospective review of 32 stage I pure seminoma patients treated between 1996 and 2005 at the Samsung Medical Center. Twenty two of the patients were treated by PORT, which was directed at the paraaortic lymphatics with a median dose of 25.2 Gy in 14 fractions for 3 weeks. The 10 remaining patients were managed by surveillance. The median follow-up period was 96 months with a range of 24 to 155 months. Results: Clinically, most patients presented with a testicular mass or discomfort. Two of the patients had a history of undescended testes. Pathologically, 23 of the patients had intratubular germ cell neoplasia with seminoma. Both recurrence-free survival (RFS) and overall survival (OS) rates of patients treated by PORT were 100%. In the control group, 1 of the 10 patients suffered a para-aortic lymph node relapse. The RFS and OS rates of the surveillance group were 88.9% and 100%, respectively. Conclusion: No difference in survival was observed between the two groups. Moreover, symptom recurrence was only observed in 1 patient in the control group. The use of PORT may reduce the risk of relapse. With the availability of effective diagnostic and salvage modalities, surveillance monitoring may be considered for patients in good compliance.

Intralesional Injection of Cyclosporine A on Patch Alopecia Areata

( Jung Won Choi ),( Hyo Sub Ryu ),( Beom Joon Kim ),( Sang Woong Youn ),( Kyoung Chan Park ),( Chang Hun Huh ) 대한피부과학회 2007 초록집 Vol.45 No.10

Polymyxin B Hemoperfusion in Pneumonic Septic Shock Caused by Gram-Negative Bacteria

Jung-Wan Yoo,Su Yeon Park,Jin Jeon,Jin-Won Huh, M.D., Ph.D.,Chae-Man Lim,Younsuck Koh,Sang-Bum Hong 대한중환자의학회 2015 Acute and Critical Care Vol.30 No.3

Severe sepsis and septic shock are the main causes of death in critically ill patients. Early detection and appropriate treatment according to guidelines are crucial for achieving favorable outcomes. Endotoxin is considered to be a main element in the pathogenic induction of gram-negative bacterial sepsis. Polymyxin B hemoperfusion can remove endotoxin and is reported to improve clinical outcomes in patients with intra-abdominal septic shock, but its clinical efficacy for pneumonic septic shock remains unclear. Here, we report a case of a 51-year-old man with pneumonic septic shock caused by Pseudomonas aeruginosa, who recovered through polymyxin B hemoperfusion.

Efficacy and safety of liposome-encapsulated 4-<i>n</i>-butylresorcinol 0.1% cream for the treatment of melasma: A randomized controlled split-face trial

HUH, Sun Young,SHIN, Jung-Won,NA, Jung-Im,HUH, Chang-Hun,YOUN, Sang-Woong,PARK, Kyoung-Chan Wiley (Blackwell Publishing) 2010 The Journal of Dermatology Vol.37 No.4

<P>Abstract Melasma is an acquired pigmentary disorder that most commonly occurs in women of child-bearing age. Melasma is therapeutically challenging, and most commercially available hypopigmenting agents include tyrosinase inhibitors, which regulate the rate-limiting step of melanogenesis. 4-n-Butylresorcinol has received considerable attention as a novel hypopigmenting agent in the last 15 years because it has an inhibitory effect against tyrosinase and tyrosinase-related protein-1. However, the hypopigmenting effect of 4-n-butylresorcinol in human subjects has only been shown in a few studies. Liposome encapsulation is known to improve stabilization and enhance penetration of the product. Therefore, this study was conducted to evaluate the hypopigmenting efficacy and safety of liposome-encapsulated 4-n-butylresorcinol 0.1% cream in patients with melasma. This was a randomized, double-blind, vehicle-controlled and split-face comparison study. Twenty-three patients with a clinical diagnosis of melasma were included. 4-n-Butylresorcinol 0.1% cream or vehicle was applied to each side of the face twice daily for 8 weeks. Clinical and photographic evaluations, Mexameter measurements and assessment of patient satisfaction and side-effects were performed at baseline, 4 and 8 weeks. All subjects completed the study. Mexameter measurements demonstrated that the melanin index of the 4-n-butylresorcinol-treated side showed a significant decrease when compared with the vehicle-treated side after 8 weeks (P = 0.043). No adverse reactions were observed throughout the study. Subjectively, 4-n-butylresorcinol was considered to be efficacious in more than 60% of the patients after 8 weeks of treatment. In conclusion, liposome-encapsulated 4-n-butylresorcinol 0.1% cream was well tolerated and showed significant higher efficacy than vehicle alone for the treatment of melasma.</P>

Mycophenolic Acid Trough Concentration and Dose Are Associated with Hematologic Abnormalities but Not Rejection in Kidney Transplant Recipients

Jung Hee-Yeon,Lee Sukyung,Jeon Yena,Choi Ji-Young,Cho Jang-Hee,Park Sun-Hee,Kim Yong-Lim,Kim Hyung-Kee,Huh Seung,Won Dong Il,김찬덕 대한의학회 2020 Journal of Korean medical science Vol.35 No.24

Background: Little is known regarding the safe fixed dose of mycophenolic acid (MPA) for preventing biopsy-proven acute rejection (BPAR) in kidney transplant recipients (KTRs). We investigated the correlation of MPA trough concentration (MPA C0) and dose with renal transplant outcomes and adverse events. Methods: This study included 79 consecutive KTRs who received MPA with tacrolimus (TAC) and corticosteroids. The MPA C0 of all the enrolled KTRs was measured, which was determined monthly by using particle-enhanced turbidimetric inhibition immunoassay for 12 months, and clinical data were collected at each time point. The clinical endpoints included BPAR, any cytopenia, and BK or cytomegalovirus infections. Results: No differences in MPA C0 and dose were observed between KTRs with or without BPAR or viral infections under statistically comparable TAC concentrations. MPA C0 was significantly higher in patients with leukopenia (P = 0.021) and anemia (P = 0.002) compared with those without cytopenia. The MPA dose was significantly higher in patients with thrombocytopenia (P = 0.002) compared with those without thrombocytopenia. MPA C0 ≥ 3.5 µg/mL was an independent risk factor for leukopenia (adjusted odds ratio [AOR], 3.80; 95% confidence interval [CI], 1.24–11.64; P = 0.019) and anemia (AOR, 5.90; 95% CI, 1.27–27.51; P = 0.024). An MPA dose greater than the mean value of 1,188.8 mg/day was an independent risk factor for thrombocytopenia (AOR, 3.83; 95% CI, 1.15–12.78; P = 0.029). However, an MPA dose less than the mean value of 1,137.3 mg/day did not increase the risk of BPAR. Conclusion: Either a higher MPA C0 or dose is associated with an increased risk of cytopenia, but neither a lower MPA C0 nor dose is associated with BPAR within the first year of transplantation. Hence, a reduced MPA dose with TAC and corticosteroids might be safe in terms of reducing hematologic abnormalities without causing rejection.