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St. Marys, South Korea

Suk K.S.,Yonsei University | Baek J.H.,Yonsei University | Park J.-O.,Yonsei University | Kim H.-S.,Yonsei University | And 4 more authors.
Spine Journal | Year: 2015

Background context The functional level of children with progressive neuromuscular disease is a major factor that affects the quality of life (QOL) of parents. However, only a few publications have reported changes in the QOL of parents after correctional spinal surgery. Purpose The purpose was to compare changes in QOL for both patients and parents after spinal correctional surgery for better sitting balance and to analyze correlation among radiographic parameters, functional outcome, and QOL questionnaires. Finally, the QOL of patients and parents was compared with the population norm. Study design This study is a retrospective analysis of prospectively gathered data. Patient sample From 2008 to 2011, 58 patients who underwent correctional surgery for progressive neuromuscular scoliosis and their parents were enrolled. Outcome measures A Muscular Dystrophy Spine Questionnaire (MDSQ) and short-form questionnaire 36 (SF-36) were used. Methods The gathered functional outcome and QOL data using MDSQ and SF-36 for both enrolled patients and parents were compared preoperatively, postoperatively at 3 months, and at 1-year follow-up. Results Mean age was 15.0±4.1 years. Forty male and 18 female patients were enrolled. Mean follow-up was 38.4±13.7 months. Cobb angle was 61.5°±23.5° preoperatively, 39.0°±20.1° immediately postoperative, and 40.0°±20.2° at the final follow-up. Cobb angle, pelvic obliquity, and lumbar lordosis were significantly improved after surgery (p<.001). Among sitting-related questions, answers to questions 15 (sitting comfortably), 16 (change weight in wheelchair), 22 (sit all day), 24 (sit at table for meal), 26 (keep balance while sitting in wheelchair), and 27 (look good while sitting in wheelchair) were significantly improved after correctional surgery (p<.001). Regarding the SF-36 scales for patients, bodily pain and social functioning significantly improved postoperatively (p<.001). Conclusions Muscular Dystrophy Spine Questionnaire results indicated that patients had significantly improved sitting balance-related outcomes, whereas the SF-36 indicated improvements only in bodily pain and social functioning scales. For parents, no SF-36 scales improved significantly postoperatively. Accordingly, improved sitting balance and QOL for neuromuscular scoliosis patients after surgery do not necessarily increase parent QOL. © 2015 Elsevier Inc.

Lee S.-Y.,International St. Marys Hospital | Hur S.-H.,Keimyung University | Lee S.-G.,University of Ulsan | Kim S.-W.,Chung - Ang University | And 7 more authors.
Circulation: Cardiovascular Interventions | Year: 2015

Background-Despite the enhanced properties of the second-generation drug-eluting stent (DES), its association with neoatherosclerosis has not been sufficiently evaluated. Therefore, we sought to evaluate and compare neoatherosclerosis in second-generation DESs to first-generation DESs. Methods and Results-A total of 212 DES-treated patients with >50% percent neointimal cross-sectional area stenosis were retrospectively enrolled from the Korean multicenter optical coherence tomography (OCT) registry. Within this population, 111 patients had a second-generation DES (40 zotarolimus, 36 everolimus, and 35 biolimus) and 101 patients had a firstgeneration (65 sirolimus and 36 paclitaxel) DES. Neoatherosclerosis on OCT was defined as neointima formation with the presence of lipids or calcification. OCT-determined neoatherosclerosis was identified in 27.4% (58/212) of all DES-treated lesions. The frequency of neoatherosclerosis increased with the stent age. Stent age was shorter in the secondgeneration DES group (12.4 months versus 55.4 months, P<0.001), and neoatherosclerosis was less frequently observed in that group (10.8% versus 45.5%, P<0.001). However, after adjusting for cardiovascular risk factors, chronic kidney disease (odds ratio, 4.113; 95% confidence interval, 1.086-15.575; P=0.037), >70 mg/dL of low-density cholesterol at follow-up OCT (odds ratio, 2.532; 95% confidence interval, 1.054-6.084; P=0.038), and stent age (odds ratio, 1.710; 95% confidence interval, 1.403-2.084; P<0.001) were all independent predictors for neoatherosclerosis, whereas the type of DES (first-versus second-generation) was not. Patients with neoatherosclerosis showed a higher rate of acute coronary syndrome at follow-up OCT (19.0% versus 3.9%, respectively, P=0.001). Conclusions-The second-generation DES is not more protective against neoatherosclerosis compared with the firstgeneration DES. © 2015 American Heart Association, Inc.

Chung H.W.,International St. Marys Hospital | Kong H.Y.,Yonsei University | Lim J.-B.,Yonsei University
World Journal of Gastroenterology | Year: 2015

AIM: To evaluate the clinical usefulness of soluble heparin-binding epidermal growth factor (sHB-EGF) as a serum biomarker for gastric cancer (GC). METHODS: Serum sHB-EGF levels were measured by a commercially available human HB-EGF ELISA Kit and compared among 60 normal controls, 30 high-risk patients, 37 early gastric cancer (EGC), and 30 advanced gastric cancer (AGC) through ANOVA test. Correlations between serum sHB-EGF and clinicopathological features of GC were analyzed through Spearman's correlation. The diagnostic performance of serum sHB-EGF for GC was evaluated through receiver operating characteristic (ROC) curve and logistic regression analysis. RESULTS: Serum sHB-EGF levels were significantly higher in AGC group (314.4 ± 127.5 pg/mL) than EGC (165.3 ± 123.2 pg/mL), high-risk (98.7 ± 67.3 pg/mL), and control (94.7 ± 83.6 pg/mL) groups (post-hoc Bonferroni, all P < 0.001), respectively. Serum sHB-EGF levels were also significantly higher in EGC group than high-risk (P = 0.049) and control (P = 0.006) groups. Clinicopathologically, serum sHB-EGF levels closely correlated with depth of invasion (T-stage, γs = 0.669, P < 0.001), lymph node metastasis (N-stage, γs = 0.407, P = 0.001), and distant metastasis (M-stage, γs = 0.261, P = 0.030). ROC curve and logistic regression analysis demonstrated a remarkable diagnostic potential of serum sHB-EGF. CONCLUSION: Serum sHB-EGF is closely correlated with advanced stage GC and can be a promising serological biomarker for GC. © The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.

Lim J.-B.,Yonsei University | Kim D.-K.,Yonsei University | Chung H.W.,International St. Marys Hospital
Cancer Science | Year: 2014

Thymus and activation-regulated chemokine (TARC) can stimulate cancer cell proliferation and migration. The present study evaluated the clinical significance of serum TARC in gastric cancer (GC). We measured serum TARC, macrophage-derived chemokine, monocyte chemotactic protein-1 and stem cell factor (SCF) levels using a chemiluminescent immunoassay along the GC carcinogenesis (normal, high-risk, early GC [EGC] and advanced GC [AGC]) in both training (N = 25 per group) and independent validation datasets (90 normal, 30 high-risk, 50 EGC and 50 AGC). Serum levels were compared among groups using one-way analysis of variance. To evaluate the diagnostic potential of serum TARC for GC, receiver operating characteristic curve and logistic regression analyses were performed. Correlations between serum TARC and GC clinicopathological features were analyzed using Spearman's correlation. In the training dataset, serum TARC correlated with serum MDC, MCP-1 and SCF. However, only serum TARC and SCF were significantly higher in cancer groups than non-cancer groups (P < 0.001). In the validation dataset, serum TARC also increased along the GC carcinogenesis; the AGC group (167.2 ± 111.1 ng/mL) had significantly higher levels than the EGC (109.1 ± 67.7 ng/mL), the high-risk (66.2 ± 47.7 ng/mL) and the normal (67.5 ± 36.2 ng/mL) groups (Bonferroni, all P < 0.001). Receiver operating characteristic curves and logistic regression demonstrated the remarkable diagnostic potential of serum TARC as a single marker (72.0% sensitivity and 71.1% specificity; cutoff point, 0.37; logistic regression) and in a multiple-marker panel (72.6% sensitivity and 88.2% specificity; cutoff point, 0.54). Spearman's correlation showed that serum TARC was closely correlated with tumor size (γs = 0.227, P = 0.028), T-stage (γs = 0.340, P = 0.001), N-stage (γs = 0.318, P = 0.002) and M-stage (γs = 0.346, P = 0.001). Serum TARC is a promising serum biomarker for GC. © 2014 The Authors.

Park J.,Chonbuk National University | Jeong S.Y.,International St. Marys Hospital
Clinics in Orthopedic Surgery | Year: 2014

Background: The minimally invasive plate osteosynthesis (MIPO) technique using periarticular locking plates may be a good option for the repair of displaced proximal humeral fractures. However, axillary nerve complications related to this technique may be underestimated. The purpose of this study is to evaluate the outcomes of the minimally invasive plating, focusing on the complications. Methods: The records of 21 consecutive patients treated for proximal humerus fractures using the MIPO technique with locking plates were retrospectively reviewed. These patients were treated between March 2009 and March 2011 with a minimum one-year follow-up. The clinical function, complications, and radiological bony union were evaluated. Results: All of the patients, with one exception, showed at least 90 degrees of flexion and abduction at the shoulder joint six months postoperatively. The average Constant scores at three months, six months, and one year follow-ups were 74.0 (range, 62 to 90), 79.4 (range, 64 to 91), and 82.7 (range, 66 to 92), respectively. All of the patients achieved bony union within the average of 3.2 months (range, 2 to 6 months). There was one case of delayed union, one case of intra-articular screw penetration, and one case of axillary nerve paresis (incomplete injury), which did not completely recover during the one year of follow-up. Conclusions: The MIPO technique using periarticular locking plates is a useful option for the treatment of selected cases of displaced proximal humeral fractures. However, nerve complications such as axillary nerve paresis should be considered along with implant-related complications when choosing patients for minimally invasive plating. © 2014 by The Korean Orthopaedic Association.

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