Kim S.W.,Yeouido St Marys Hospital |
Myong J.-P.,Catholic University of Korea |
Yoon H.K.,Yeouido St Marys Hospital |
Koo J.-W.,Catholic University of Korea |
And 2 more authors.
International Journal of Tuberculosis and Lung Disease | Year: 2017
S E T T ING: Despite the clinical importance of idiopathic pulmonary fibrosis (IPF), its epidemiology has been rarely reported. The economic burden from IPF is therefore difficult to predict. OBJECTIVE : To analyse the health care burden and current situation with respect to medical resource utilisation in patients with IPF in Korea. METHODS : We analysed nationwide data collected between 2009 and 2013 from the Korean Health Insurance Review and Assessment (HIRA) database. Patients with IPF were defined by the K-J84.18 code of the Korean Classification of Disease, 6th revision. RESULT S : The total direct health care costs increased from US19 805 167 in 2009 to US31 410 083 in 2013; the principal factor responsible for the highest proportion of costs was hospitalisation. The proportion of the total IPF patient population who were hospitalised at least once a year was 27.2%, and the average length of hospital stay was 12.7 days. From post-hoc analysis, hospital admission, emergency room visit and intensive care unit admission rates showed significant seasonal variations; the admission rates were highest in the spring and lowest in autumn. CONCLUS IONS : Health care costs of IPF are increasing annually, with hospital admissions representing the major financial burden. © 2017 Chipinduro et al.
PubMed | Bucheon St Marys Hospital, St Vincents Hospital, Daejeon St Marys Hospital, Uijeongbu St Marys Hospital and 3 more.
Type: Journal Article | Journal: Cancer research and treatment : official journal of Korean Cancer Association | Year: 2016
Breast cancer treatment has progressed significantly over the past 20 years. However, knowledge regarding male breast cancer (MBC) is sparse because of its rarity. This study is an investigation of the clinicopathologic features, treatments, and clinical outcomes of MBC.Clinical records of 59 MBC patients diagnosed during 1995-2014 from seven institutions in Korea were reviewed retrospectively.Over a 20-year period, MBC patients accounted for 0.98% among total breast cancer patients, and increased every 5 years. The median age of MBC patientswas 66 years (range, 24 to 87 years). Forty-three patients (73%) complained of a palpable breast mass initially. The median symptom duration was 5 months (range, 1 to 36 months). Mastectomy was performed in 96% of the patients. The most frequent histology was infiltrating ductal carcinoma (75%). Ninety-one percent of tumors (38/43) were estrogen receptor-positive, and 28% (11/40) showed epidermal growth factor receptor 2 (HER-2) overexpression. After curative surgery, 42% of patients (19/45) received adjuvant chemotherapy; 77% (27/35) received hormone therapy. Five out of ten patients with HER-2 overexpressing tumors did not receive adjuvant anti-HER-2 therapy, while two out of four patients with HER-2 overexpressing tumors received palliative trastuzumab for recurrent and metastatic disease. Letrozole was used for one patient in the palliative setting. The median overall survival durations were 7.2 years (range, 0.6 to 17.0 years) in patients with localized disease and 2.9 years (range, 0.6 to 4.3 years) in those with recurrent or metastatic disease.Anti-HER-2 and hormonal therapy, except tamoxifen, have been underutilized in Korean MBC patients compared to female breast cancer patients. With the development of precision medicine, active treatment with targeted agents should be applied. Further investigation of the unique pathobiology of MBC is clinically warranted.
Jeong H.,Catholic University of Korea |
Yim H.W.,Catholic University of Korea |
Cho Y.,Occupational and Environmental Medicine |
Park H.J.,Seoul St Marys Hospital |
And 4 more authors.
Stem Cell Research and Therapy | Year: 2013
Introduction. Although blinding is a methodologic safeguard to ensure obtaining comparability of groups in a clinical trial, it is very difficult to maintain blinding from the beginning to the end of a study. The aim of the study was to see how proper blinding of both participants and treatment providers from the planning phase of the study to during the study affected the study outcomes. Methods. We searched Medline, EMBASE, and Cochrane databases from inception to November 2011. The studies included in this review were randomized controlled trials, with acute myocardial infarction (AMI) patients who received percutaneous coronary intervention (PCI), intracoronary (IC) infusion of autologous bone marrow stem cells (BMSCs), unselected BMSCs, 108 or more cell dose, and up to 6-month follow-up periods. Results: The initial search identified 881 references, of which 17 references were eligible for inclusion. Six of 17 trials isolated cells directly from bone marrow by aspiration in the control group as well as in the BMSC group. Nine of 17 trials underwent both cardiac catheterization and an identical injection procedure on the control group as well as the BMSC group.Compared with the control group, BMSC transplantation improved left ventricular ejection fraction (LVEF) by 2.51 (95% CI, 1.20 to 3.83; P = 0.0002; I 2 = 75%) at 6 months. In the present results, the studies that did not perform bone marrow aspiration in the control group showed significant improvement in LVEF by 3.81% (95% CI, 2.44 to 5.17), whereas no significant treatment effect was found in the studies in which the control group underwent bone marrow aspiration, as indicated the LVEF change of -1.29% (95% CI, 4.15 to 1.58). The trials that did not conduct catheterization on control subjects showed significant LVEF changes (4.45%; 95% CI, 2.48 to 6.43); however, those with cardiac catheterization as a sham procedure on the control group did not show significant changes in LVEF at 6 months (0.92%; 95% CI, -0.61 to 2.44). Conclusions: Unblinding might be overestimating the treatment effect. These findings suggest that randomized controlled trials testing the efficacy of BMSC therapy should be appropriately designed and rigorously applied to avoid bias. © 2013 Jeong et al.; licensee BioMed Central Ltd.
Lee S.-H.,Catholic University of Korea |
Lee S.-H.,Seoul St Marys Hospital |
Han K.,Catholic University of Korea |
Yang H.K.,Catholic University of Korea |
And 5 more authors.
Clinical Endocrinology | Year: 2015
Objective To determine whether the TyG index, a product of the levels of triglycerides and glucose, may be a valuable marker for identifying metabolically obese but normal weight (MONW) or metabolically healthy but obese (MHO) individuals. Design and subjects A total of 17 029 nondiabetic subjects (7185 men and 9844 women) were selected from the Korea National Health and Nutrition Examination Survey conducted in 2008-2010. Individuals with a normal body mass index (BMI) (≥18·5 and <23 kg/m2) and the highest quartile of the homoeostasis model assessment of insulin resistance (HOMA-IR) were classified as MONW. Individuals with obesity (BMI ≥25 kg/m2) and the lowest quartile of HOMA-IR were classified as MHO. Measurements The TyG index was calculated as ln[fasting triglycerides (mg/dl) × fasting glucose (mg/dl)/2]. Results The levels of the TyG index paralleled with various metabolic risk parameters. The index was significantly higher in the MONW group and lower in the MHO group when compared with the non-MONW group and the non-MHO group, respectively. The odds ratios (ORs) of being categorized into the MONW group were approximately fourfold higher in the highest vs lowest quartiles of the TyG index (3·999: 95% CI, 2·508-6·376 in men; 4·737: 95% CI, 3·418-6·565 in women) among normal weight subjects. Conversely, there was a stepwise decrease in the OR of being categorized into the MHO group across the TyG index quartiles among obese subjects. Conclusions These data highlight the value of the TyG index in discriminating those subjects with higher risks of metabolic diseases. © 2014 John Wiley & Sons Ltd.
Park Y.-J.,St Vincents Hospital |
Kim J.-Y.,Catholic University of Korea |
Park J.,Yeouido St Marys Hospital |
Choi J.-J.,Korea University |
And 2 more authors.
Arthritis and Rheumatology | Year: 2014
Objective To identify factors influencing endothelial progenitor cell (EPC) counts in patients with rheumatoid arthritis (RA). Methods The number of circulating CD34+/vascular endothelial growth factor receptor 2-positive EPCs was measured in 126 RA patients and 46 non-RA control patients. Endothelial function was assessed by brachial flow-mediated dilation (FMD). Serum CXCL12 concentrations were determined using an enzyme-linked immunosorbent assay. EPCs and FMD were measured at baseline and after 24 weeks of anti-tumor necrosis factor α (TNFα) therapy in 29 patients with active RA. Results The numbers of circulating EPCs were significantly lower in the RA patients than in the non-RA controls. In multivariate analysis, older age, reduced levels of high-density lipoprotein cholesterol, and higher bone erosion scores were independent risk factors for reduced EPC counts in RA patients. Serum CXCL12 levels correlated negatively with EPC counts, but positively with bone erosion scores. FMD was impaired in RA patients, and a decreased FMD in RA was closely associated with a higher bone erosion score and a reduced EPC count. In addition, EPC counts were restored by anti-TNFα therapy, and this increase was paralleled by improvement in FMD. Interestingly, restoration of EPC counts was attenuated in patients with higher bone erosion scores than in those with lower scores, despite similar levels of improvement in disease activity. Conclusion The numbers of circulating EPCs in RA patients are reduced and are inversely correlated with serum levels of CXCL12. Reduced EPC counts are closely associated not only with bone erosion, but also with endothelial dysfunction. Copyright © 2014 by the American College of Rheumatology.
PubMed | Catholic University of Korea, Yeouido St Marys Hospital and U.S. National Institutes of Health
Type: Journal Article | Journal: PloS one | Year: 2016
We sought to identify the distribution and cut-off value of the homeostasis model assessment of insulin resistance (HOMA-IR) according to gender and menopausal status for metabolic syndrome in Koreans.Data were from the Korean National Health and Nutrition Examination Survey in 2008-2010. The subjects included adults aged 20 years or older. We excluded participants who had diabetes or fasting serum glucose 7 mmol/L. Finally, 11,121 subjects (4,911 men, 3,597 premenopausal women, 2,613 postmenopausal women) were enrolled. The modified Adult Treatment Panel III criteria were used to define metabolic syndrome.The mean HOMA-IR was 2.11 (2.07-2.15) for men, 2.0 (1.97-2.04) for premenopausal women, and 2.14 (2.2-2.19) for postmenopausal women. The first cut-off values in men, premenopausal women, and postmenopausal women were 2.23 (sensitivity 70.6%, specificity 66.9%), 2.39 (sensitivity 72.3%, specificity 76.4%), and 2.48 (sensitivity 51.9%, specificity 80.2%), respectively. Based on the first HOMA-IR cut-off value, the prevalence of metabolic syndrome was 22.9% in men, 13.7% in premenopausal women, and 51.6% in postmenopausal women. The second cut-off value was around 3.2 in all three groups. Based on the second HOMA-IR cut-off value, the prevalence of metabolic syndrome was 50.8% in men, 42.5% in premenopausal women, and 71.6% in postmenopausal women.In conclusion, the first cut-off values for HOMA-IR were 2.2-2.5 and the second cut-off value was 3.2 in Korea. The distribution of HOMA-IR showed differences according to gender and menopausal status. When we apply HOMA-IR, we should consider gender, menopausal status, and the prevalence of metabolic syndrome.
PubMed | Yonsei University, Yeouido St Marys Hospital and Catholic University of Korea
Type: | Journal: Clinical hypertension | Year: 2016
It has been reported that the chemotherapeutic agent, adriamycin, not only has an effect on the myocardium but also on the arteries. The aim of this study is to elucidate effects of adriamycin and an angiotensin receptor blocker, candesartan, on collagen and elastin of the aorta in rats.Twenty four male 8-week-old Wistar-Kyoto rats were divided into four groups: control (C) group, adriamycin-treated (AD) group, candesartan-treated (CA) group, and adriamycin- and candesartan-treated (AD+CA) group. Adriamycin of 2.5mg/kg/wk was administered intraperitoneally one time per week for 6weeks, and candesartan of 10mg/kg/day was administered orally everyday for 6weeks. After 6weeks, the rats were sacrificed and the aortas were harvested. Hematoxylin-eosin staining, Verhoffs elastic, and Goldners trichrome staining were performed for histopathologic analyses. Tunica media thickness, collagen, and elastic area fractions were measured quantitatively with a computerized digital image analyzer.Tunica media thickness in the CA and AD+CA groups was significantly lesser than that in the C and AD groups, respectively. The AD and AD+CA groups had a tendency of lower elastin area fraction than the C and CA groups, respectively. Collagen area fraction in the AD+CA group was significantly lower than that in the AD group. There were no significant differences of collagen/elastin ratio between groups.These findings suggest that adriamycin has a tendency of decreasing the quantity of elastin fibers and candesartan cannot mitigate the effects of adriamycin on elastin fibers.
PubMed | Yeouido St Marys Hospital, Duke University and University of North Carolina at Chapel Hill
Type: | Journal: Maturitas | Year: 2016
Advances in computer and Internet technologies have allowed health care providers to develop, use, and test various types of Web-based interventions for their practice and research. Indeed, an increasing number of Web-based interventions have recently been developed and tested in health care fields. Despite the great potential for Web-based interventions to improve practice and research, little is known about the current status of Web-based interventions, especially those related to menopause. To identify the current status of Web-based interventions used in the field of menopause, a literature review was conducted using multiple databases, with the keywords online, Internet, Web, intervention, and menopause. Using these keywords, a total of 18 eligible articles were analyzed to identify the current status of Web-based interventions for menopause. Six themes reflecting the current status of Web-based interventions for menopause were identified: (a) there existed few Web-based intervention studies on menopause; (b) Web-based decision support systems were mainly used; (c) there was a lack of detail on the interventions; (d) there was a lack of guidance on the use of Web-based interventions; (e) counselling was frequently combined with Web-based interventions; and (f) the pros and cons were similar to those of Web-based methods in general. Based on these findings, directions for future Web-based interventions for menopause are provided.
PubMed | St Vincent Hospital, Yeouido St Marys Hospital and Seoul St Marys Hospital
Type: Journal Article | Journal: Lupus | Year: 2016
Antiphospholipid antibodies (aPL) are present in a proportion of patients with rheumatoid arthritis but their clinical significance remains unclear. We investigated the association between aPL and thrombotic events in rheumatoid arthritis patients.In this cross-sectional study, aPL profiles were evaluated in 376 rheumatoid arthritis patients in accordance with the standard guidelines. Clinical and radiographic data were retrospectively collected.aPL were identified in 39 patients (10.4%). Lupus anticoagulant was the most common subtype (n=25, 6.6%); anti-cardiolipin antibodies and anti-aPL was found in a subset of rheumatoid arthritis patients, who were more often smokers, and aPL was independently associated with development of arterial thrombosis. This result suggests that aPL may contribute to an increased risk of arterial thrombosis in rheumatoid arthritis patients.
Jeong M.-Y.,Yeouido St Marys Hospital
Journal of Invasive Cardiology | Year: 2013
Complex regional pain syndrome (CRPS) is a very rare complication of transradial coronary intervention (TRI). We present the case of a 51-year-old man who suffered severe pain of the right forearm after TRI and progressed to type I CRPS. The patient had effort angina and underwent successful coronary artery stent deployment on the right coronary artery. After removing the hemostatic device, the patient had swelling and severe pain that was not relieved by analgesics. Continued pain progressed to allodynia, hyperalgesia, and hyperesthesia, which met the diagnostic criteria for CRPS. Electromyography showed no abnormalities in nerve conduction and thermography of the forearm showed temperature discrepancy between both forearms, which confirmed the diagnosis of CRPS. We treated the patient with sympathetic nerve block, but he still suffers from minor pain in the right forearm. This case demonstrates that unalleviated pain after TRI can progress to CRPS, and that thermography is a useful method to diagnose CRPS.