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허애영,정영훈,김병극,주형준,장기육,박용휘,송영빈,안성균,서정원,이상엽,조정래,김효수,김무현,임도선,신은석,On Behalf of the PTRG-DES Consortium Investigators 연세대학교의과대학 2022 Yonsei medical journal Vol.63 No.5
Purpose: Platelet function test (PFT) results and genotype hold unique prognostic implications in East Asian patients. The aim ofthe PTRG-DES (Platelet function and genoType-Related long-term proGnosis in Drug-Eluting Stent-treated Patients with coronaryartery disease) consortium is to assess the clinical impact thereof on long-term clinical outcomes in Korean patients withcoronary artery disease during dual antiplatelet therapy (DAPT) including clopidogrel. Materials and Methods: Searching publications on the PubMed, we reviewed clopidogrel treatment studies with PFT and/orgenotype data for potential inclusion in this study. Lead investigators were invited to share PFT/genotype results, patient characteristics,and clinical outcomes to evaluate relationships among them. Results: Nine registries from 32 academic centers participated in the PTRG-DES consortium, contributing individual patient datafrom 13160 patients who underwent DES implantation between July 2003 and August 2018. The PTRG-PFT cohort was composedof 11714 patients with available VerifyNow assay results. Platelet reactivity levels reached 218±79 P2Y12 reaction units (PRU), and high on-clopidogrel platelet reactivity based on a consensus-recommended cutoff (PRU >208) was observed in 55.9%. The PTRGGenotypecohort consisted of 8163 patients with candidate genotypes related with clopidogrel responsiveness. Of those with cytochromeP450 (CYP) 2C19 genotype, frequencies of carrying one and two loss-of-function allele (s) (*2 or *3) were 47.9% (intermediatemetabolizers) and 14.2% (poor metabolizers), respectively. Conclusion: The PTRG-DES consortium highlights unique values for on-clopidogrel platelet reactivity and CYP2C19 phenotypethat may be important to developing optimal antiplatelet regimens in East Asian patients. Trial Registration: ClinicalTrials.gov Identifier: NCT04734028.
Phenotypic Characterization of Genetically Lowered Human Lipoprotein(a) Levels
CHARGE-Heart Failure Consortium,CARDIoGRAM Exome Consortium,Emdin, C.A.,Khera, A.V.,Natarajan, P.,Klarin, D.,Won, H.H.,Peloso, G.M.,Stitziel, N.O.,Nomura, A.,Zekavat, S.M.,Bick, A.G.,Gupta, N.,Asselta Elsevier Inc. 2016 Journal of the American College of Cardiology Vol.68 No.25
<P>CONCLUSIONS Beyond CHD, genetically lowered Lp(a) levels are associated with a lower risk of peripheral vascular disease, stroke, heart failure, and aortic stenosis. As such, pharmacological lowering of plasma Lp(a) may influence a range of atherosclerosis-related diseases. (C) 2016 by the American College of Cardiology Foundation.</P>
한은아,공태영,유제성,박인철,박고은,이수지,정성필,Korean Cardiac Arrest Research Consortium (KoCARC) Investigators 연세대학교의과대학 2022 Yonsei medical journal Vol.63 No.2
Purpose: A pilot project using epinephrine at the scene under medical control is currently underway in Korea. This study aimedto determine whether prehospital epinephrine administration is associated with improved survival and neurological outcomesin out-of-hospital cardiac arrest (OHCA) patients who received epinephrine during cardiopulmonary resuscitation (CPR) in theemergency department. Materials and Methods: This retrospective observational study used a nationwide multicenter OHCA registry. Patients were classifiedinto two groups according to whether they received epinephrine at the scene or not. The associations between prehospitalepinephrine use and outcomes were assessed using propensity score (PS)-matched analysis. Multivariable logistic regression analysiswas performed using PS matching. The same analysis was repeated for the subgroup of patients with non-shockable rhythm. Results: PS matching was performed for 1084 patients in each group. Survival to discharge was significantly decreased in the patientswho received prehospital epinephrine [odds ratio (OR) 0.415, 95% confidence interval (CI) 0.250–0.670, p<0.001]. However,no statistical significance was observed for good neurological outcome (OR 0.548, 95% CI 0.258–1.123, p=0.105). For the patientsubgroup with non-shockable rhythm, prehospital epinephrine was also associated with lower survival to discharge (OR 0.514, 95%CI 0.306–0.844, p=0.010), but not with neurological outcome (OR 0.709, 95% CI 0.323–1.529, p=0.382). Conclusion: Prehospital epinephrine administration was associated with decreased survival rates in OHCA patients but not statisticallyassociated with neurological outcome in this PS-matched analysis. Further research is required to investigate the reasonfor the detrimental effect of epinephrine administered at the scene.
What is the interobserver agreement of displaced humeral surgical neck fracture patterns?
Reinier W. A. Spek,Laura J. Kim,Traumaplatform 3D Consortium 대한견주관절의학회 2022 대한견주관절의학회지 Vol.25 No.4
Background: The Boileau classification distinguishes three surgical neck fracture patterns: types A, B, and C. However, the reproducibility of this classification on plain radiographs is unclear. Therefore, we questioned what the interobserver agreement and accuracy of displaced surgical neck fracture patterns is categorized according to the modified Boileau classification. Does the reliability to recognize these fracture patterns differ between orthopedic residents and attending surgeons? Methods: This interobserver study consisted of a randomly retrieved series of 30 plain radiographs representing clinical practice in a level 1 and a level 2 trauma center. Radiographs were included from patients (≥18 years) who sustained an isolated displaced surgical neck fracture if they were taken ≤1 week after initial injury. A ground truth was established by consensus among three senior orthopedic surgeons. All images were assessed by 17 orthopedic residents and 17 attending orthopedic trauma surgeons. Results: Agreement for the modified Boileau classification was fair (κ=0.37; 95% confidence interval [CI], 0.36–0.38) with an accuracy of 62% (95% CI, 57%–66%). Comparison of interobserver variability between residents and attending surgeons revealed a significant but clinically irrelevant difference in favor of attending surgeons (0.34 vs. 0.39, respectively, Δ κ=0.05, 95% CI, 0.02–0.07). Conclusions: The modified Boileau classification yields a low interobserver agreement with an unsatisfactory accuracy in a panel of orthopedic residents and attending surgeons. This supports the hypothesis that surgical neck fractures are challenging to categorize and that this classification should not be used to determine prognosis if only plain radiographs are available.
장호영,한영주,정상진,박종,이성훈,김태형,김철홍,김상수,Fahd Al-Mulla,윤찬현,유향숙,The HUGO Pan-Asian SNP Consortium 한국유전체학회 2011 Genomics & informatics Vol.9 No.4
In planning a model-based phylogenic study for highly related ethnic data, the SNP marker number is an important factor to determine for relationship inferences. Genotype frequency data, utilizing a sub sampling method,from 63 Pan Asian ethnic groups was used for determining the minimum SNP number required to establish such relationships. Bootstrap random sub-samplings were done from 5.6K PASNPi SNP data. DA distance was calculated and neighbour-joining trees were drawn with every re-sampling data set. Consensus trees were made with the same 100 sub-samples and bootstrap proportions were calculated. The tree consistency to the one obtained from the whole marker set, improved with increasing marker numbers. The bootstrap proportions became reliable when more than 7,000 SNPs were used at a time. Within highly related ethnic groups, the minimum SNPs number for a robust neighbor-joining tree inference was about 7,000 for a 95% bootstrap support.
Review of Cohort Studies for Mood Disorders
Hong Jin Jeon,Ji Hyun Baek,Yong Min Ahn,김세주,Tae Hyun Ha,Bo-Seok Cha,Eun Soo Moon,강희주,Vin Ryu,조철현,Jung-Yoon Heo,Ki-Won Kim,Heon-Jeong Lee,Mood Disorders Cohort Research Consortium 대한신경정신의학회 2016 PSYCHIATRY INVESTIGATION Vol.13 No.3
This paper aimed to review currently available cohort studies of subjects with mood disorders such as major depressive disorder (MDD) and bipolar disorder (BD). Using the PubMed and KoreaMed databases, we reviewed eight major cohort studies. Most studies recruited participants with MDD and BD separately, so direct comparison of factors associated with diagnostic changes was difficult. Regular and frequent follow-up evaluations utilizing objective mood ratings and standardized evaluation methods in a naturalistic fashion are necessary to determine detailed clinical courses of mood disorders. Further, biological samples should also be collected to incorporate clinical findings in the development of new diagnostic and therapeutic approaches. An innovative cohort study that can serve as a platform for translational research for treatment and prevention of mood disorders is critical in determining clinical, psychosocial, neurobiological and genetic factors associated with long-term courses and consequences of mood disorders in Korean patients.
Ghang, Ho-Young,Han, Young-Joo,Jeong, Sang-Jin,Bhak, Jong,Lee, Sung-Hoon,Kim, Tae-Hyung,Kim, Chul-Hong,Kim, Sang-Soo,Al-Mulla, Fahd,Youn, Chan-Hyun,Yoo, Hyang-Sook,The HUGO Pan-Asian SNP Consortium, T Korea Genome Organization 2011 Genomics & informatics Vol.9 No.4
In planning a model-based phylogenic study for highly related ethnic data, the SNP marker number is an important factor to determine for relationship inferences. Genotype frequency data, utilizing a sub sampling method, from 63 Pan Asian ethnic groups was used for determining the minimum SNP number required to establish such relationships. Bootstrap random sub-samplings were done from 5.6K PASNPi SNP data. DA distance was calculated and neighbour-joining trees were drawn with every re-sampling data set. Consensus trees were made with the same 100 sub-samples and bootstrap proportions were calculated. The tree consistency to the one obtained from the whole marker set, improved with increasing marker numbers. The bootstrap proportions became reliable when more than 7,000 SNPs were used at a time. Within highly related ethnic groups, the minimum SNPs number for a robust neighbor-joining tree inference was about 7,000 for a 95% bootstrap support.