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Heo MuHyung,Kim Myoung Young,Lee Jun Ho,Chung Su Ryeun,Sung Kiick,Kim Wook Sung,Cho Yang Hyun 대한흉부외과학회 2023 Journal of Chest Surgery (J Chest Surg) Vol.56 No.3
Background: The survival benefit of coronary artery bypass grafting (CABG) using the bilateral internal thoracic arteries (BITA) is well known; however, the role of BITA in concomitant aortic valve replacement (AVR) and CABG has not been studied. Methods: We retrospectively reviewed patients who underwent concomitant AVR and CABG. Cases not using an internal thoracic artery and less than 2 bypass grafts were excluded. We enrolled 114 patients in this study. The mean follow-up duration was 61.5±43.5 months. Results: Forty patients (35.1%) underwent CABG with a single internal thoracic artery (SITA) and 74 patients (64.9%) underwent CABG with BITA. The preoperative clinical characteristics were not significantly different between the 2 groups, with the exception of a higher prevalence of atrial fibrillation in the SITA group. Postoperative mortality and morbidity were not significantly higher in the BITA group than in the SITA group. In the univariable analysis, the survival of the BITA group was similar to that of the SITA group (p=0.157). Multivariable analysis showed that only mean age was a predictor of death (p=0.042), but using BITA was not an independent predictor (p=0.094). In low-risk patients whose preoperative ejection fraction was >45%, the survival of the BITA group was significantly better than that of the SITA group (p=0.043). Conclusion: BITA use in concomitant AVR and CABG showed no difference in mortality compared to using SITA. Although its impact on long-term survival was inconclusive, BITA use can be considered for low-risk patients.
Mutations in gyrA and gyrB Among Drug Resistant Mycobacterium Tuberculosis in Korea
( Seungmo Kim ),( Ryeun Heo ),( Hee Joo Lee ),( Cheon-Tae Kim ),( Hee-Jin Kim ),( Jong-Wook Hong ),( Soul-hee Kim ),( Tae-Shik Park ),( Dea-Seon Han ),( Hyeon-Su Kim ),( Jong-Myun Song ),( Mi-so Kim ) 대한결핵 및 호흡기학회 2020 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.128 No.0
Background Fluoroquinolones have been recognized as important anti-TB agents based on new tuberculosis treatment guidelines. In this study we have evaluated gyrA and gyrB how to relate with MIC based on 7H9 and phenotypic DST Results based on Löwenstein-Jensen (L-J) medium. Method Since 13th July 2020, 108 cases have analyzed gyrA and gyrB genes for fluoroquinolones. We have tested bedaquiline (0.03125~4 μg/mL), delamanid (0.00625~0.8 μg/mL), moxifloxacin (0.0625~8.0 μg/mL), levofloxacin (0.0625~8.0 μg/mL), linezolid (0.0625~8.0 μg/mL) using 7H9 broth. In Löwenstein-Jensen (L-J)medium, low concentration of moxifloxacin was 1.0 μg/mL and high concentration of moxifloxacin was 2.0 μg/mL, And that of levofloxacin and linezolid was 2.0μg/mL. Results All of mono-INH resistant cases analyzed wild type in gyrA and gyrB genes. There were 7 mutant type analyzed in gyrA and 1 mutant type in gyrB gene among 54 RIF resistant and MDR cases. All of 8 cases what we analyzed mutant type in gyrA and gyrB genes was interpreted resistant in phenotypic DST using L-J medium. Additionally all of 52 cases interpreted susceptible in phenotypic DST using L-J medium was wild type in gyrA and gyrB genes. The distribution of MICs for moxifloxacin what analyzed mutant type in gyrA gene was middle and high level (1.0 ~ 4.0 μg/mL). And The MIC for moxifloxacin what analyzed mutant type in gyrB gene was middle level (0.5 μg/mL). The distribution of MICs for levofloxacin what analyzed mutant type in gyrA gene was high level (4.0 ~ 8.0 μg/mL). And The MIC for levofloxacin what analyzed mutant type in gyrB gene was middle level (1.0 μg/mL). Conclusions We found 8 mutant type cases in gyrA and gyrB genes. Most of mutant type (75%) was gyrA_D94G(GAC/GGC). We observed gyrA and gyrB genes were associated with MICs based on 7H9 and phenotypic DST Results based on L-J medium.
Jang Mi Young,Lee Jun Ho,Heo MuHyung,Lim Suk Kyung,Chung Su Ryeun,Sung Kiick,Kim Wook Sung,Cho Yang Hyun 대한흉부외과학회 2023 Journal of Chest Surgery (J Chest Surg) Vol.56 No.3
Background: Complete surgical excision is the only curative treatment for primary cardiac tumors. For wide excision, interatrial septal reconstruction (ISR) is commonly performed. We hypothesized that ISR may increase the risk of postoperative atrial tachyarrhythmia (AT) after surgical resection of cardiac myxoma. Methods: After excluding patients with a history of cardiac surgery and concomitant procedures unrelated to tumor resection and those with AT or permanent pacemakers, we finally enrolled 272 adult patients who underwent benign cardiac tumor surgery from 1995 to 2021 at our institution. They were divided into the ISR (n=184) and non-ISR (n=88) groups. The primary outcome was postoperative new-onset AT. Results: The study cohort predominantly consisted of women (66.2%), with a mean age of 57.2±13.6 years. The incidence of postoperative new-onset AT was 15.4%. No 30- day mortality or recurrence was observed. The cardiopulmonary bypass time and aortic cross-clamping time were significantly longer in the ISR group than in the non-ISR group (p<0.001). The median duration of hospital stay of all patients was 6.0 days (interquartile range, 5.0–7.0 days), and no significant difference was observed between the 2 groups (p=0.329). ISR was not an independent predictor of new-onset AT (p=0.248). Male sex and hypertension were found to be independent predictors of new-onset AT. Conclusion: ISR was not a significant predictor of postoperative new-onset AT. ISR might be a feasible and safe procedure for surgical resection of cardiac myxoma and should be considered if needed.
Mutations in gyrA and gyrB among Drug Resistant Mycobacterium Tuberculosis in Korea
( Hee Joo Lee ),( Hwi-Jun Kim ),( Ryeun Heo ),( Cheon-Tae Kim ),( Hee-Jin Kim ),( Jeong-hui Gwon ),( Gicheon Bae ),( Sumi Kang ),( Soul-hee Kim ),( Seungmo Kim ),( Eunseon Kim ),( Arim Song ),( Dea-Se 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.0
Purpose In 2020 KATRD, we analyzed 65 isolates to see how gyrA and gyrB are associated with 7H9 broth microdilution method (BMD) and Lowenstein-Jensen (L-J) drug susceptibility test (DST) because fluoroquinolones (FLQ) have been recognized as important anti-TB agents. In this study, the aim is to evaluate the correlation between gyrA and gyrB mutations and resistance to FLQ with BMD and L-J DST as a follow up of the previous study. Method Since 2020, we have analyzed 304 INH or RIF mono resistant cases by molecular DST using sequencing for gyrA and gyrB genes of FLQ. MICs were measured by BMD for moxifloxacin (MFX, 0.0625~8.0 μg/mL) and levofloxacin (LFX, 0.0625~8.0 μg/ mL). In L-J DST, concentration of MFX was 1.0 μg/mL, 2.0 μg/mL and LFX was 2.0 μg/mL. Results In gyrA and gyrB sequencing, 270 strains (88.81%) were wild type (WT), 34 strains (11.18%) were mutant type (MT). Among 29 gyrA MT strains, 13 isolates (44.82%) had mutation at D94G, 7 isolates (24.14%) at A90V and 5 isolates (17.24%) at D94A. Among 5 gyrB MT strains, 2 isolates (40%) had D500N mutation. In L-J DST, 100% of gyrA MT strains were resistant to MFX. On the other hand gyrB MT strains, 60% to MFX and 40% to LFX were resistant. In BMD, 93.10% of gyrA MT strains ranged 0.5 ~ 4.0 μg/mL and 60% of gyrB MT strains ranged 0.5 ~ 4.0 μg/mL to MFX. Meanwhile 96.55% of gyrA MT strains ranged 1.0 ~ 8.0 μg/mL and 80% of gyrB MT strains ranged 1.0 ~ 8.0 μg/mL to LFX. Conclusions Most of the mutant isolates had mutations in gyrA and most of mutant type (38.23%) was gyrA_D94G (GAC/GGC). In this study we observed gyrA genes were associated with higher MICs based on 7H9 and L-J DST than gyrB genes. # No.2021R1F1A1061358