70 results on '"Jun-Young Chang"'
Search Results
2. Hypercoagulability on Thromboelastography Can Predict the Functional Outcomes in Patients with Acute Ischemic Stroke
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Jae-Chan Ryu, Jae-Han Bae, Sang Hee Ha, Bum Joon Kim, Sang-Beom Jeon, Dong-Wha Kang, Sun U. Kwon, Jong S. Kim, and Jun Young Chang
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Hematology - Abstract
Background We investigated the association between the reaction time (R), a thromboelastography (TEG) parameter for hypercoagulability, and functional outcomes based on the occurrence of hemorrhagic transformation (HT) and early neurological deterioration (END). Methods We enrolled ischemic stroke patients and performed TEG immediately after the patients' arrival. The baseline characteristics, occurrence of HT and END, stroke severity, and etiology were compared according to the R. END was defined as an increase of ≥1 point in motor or ≥2 points in the total National Institute of Health Stroke Scale within 3 days after admission. The outcome was the achievement of functional independence (modified Rankin scale [mRS]: 0–2) at 3 months after stroke. Logistic regression analyses were performed to verify the association between R and outcome. Results HT and END were frequently observed in patients with an R of Conclusion Hypercoagulability on TEG (R
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- 2023
3. High serum total cholesterol associated with good outcome in endovascular thrombectomy for acute large artery occlusion
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Sang Hee Ha, Jae-Chan Ryu, Jae-Han Bae, Sujin Koo, Boseong Kwon, Yunsun Song, Deok Hee Lee, Jun Young Chang, Dong-Wha Kang, Sun U. Kwon, Jong S. Kim, and Bum Joon Kim
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Stroke ,Psychiatry and Mental health ,Treatment Outcome ,Endovascular Procedures ,Humans ,Arteries ,Neurology (clinical) ,Dermatology ,General Medicine ,Lipids ,Brain Ischemia ,Retrospective Studies ,Thrombectomy - Abstract
The effect of cholesterol on the functional outcome after endovascular thrombectomy (EVT) is still controversial. This study aimed to investigate whether the lipid profile is associated with the EVT prognosis.We retrospectively analyzed patients with emergent large vessel occlusion who underwent EVT. The blood lipid levels were measured in the fasting state, 1 day after admission. We divided patients into terciles of serum total cholesterol (TC) levels and compared the clinical characteristics among the groups. The factors associated with a good outcome at 3 months (modified Rankin scale 0-2) were investigated, considering the stroke mechanism and recanalization status.Among 274 patients, good outcomes were observed in 108 (39.4%) patients. Low initial severity (odds ratio (OR), 0.91, 95% confidence interval (CI), 0.858-0.954; p 0.001) and high TC level (1.35, 1.034-1.758; p = 0.041) were associated with good outcomes. In patients with cardioembolism, young age (0.95, 0.915-0.991; p = 0.021), low initial severity (0.92, 0.857-0.988; p = 0.024), and high TC level (1.60, 1.019-2.499; p = 0.036) were associated with good outcomes. The lipid profile was not associated with a functional outcome in those with large artery atherosclerosis. In patients with complete recanalization, young age (0.97, 0.941-0.994; p = 0.016), low initial severity (0.91, 0.864-0.961; p = 0.001), absence of diabetes (0.45, 0.218-0.947; p = 0.035) or any hemorrhage (0.33, 0.142-0.760; p = 0.009), and high TC level (1.40, 1.031-1.879; p = 0.031) were associated with good outcomes.A high TC level was associated with favorable outcomes after EVT, especially in patients with cardioembolism and complete recanalization.
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- 2022
4. Effect of Transverse Sinus Stenting on Diffuse Leukoencephalopathy with Idiopathic Intracranial Hypertension
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Hee-Jae Jung, Mina Jung, Kwan Young Park, and Jun Young Chang
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A diagnosis of idiopathic intracranial hypertension (IIH) can be made after excluding secondary causes. As stenosis of transverse sinuses is often revealed with IIH patients, transverse sinus stenting is used to release intracranial hypertension. It is rare to find a case of leukoencephalopathy secondary to IIH. Herein, we describe a case of diffuse leukoencephalopathy with IIH, which improved after stent insertion in the transverse sinus.
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- 2022
5. Delayed low cerebellar perfusion status is associated with poor outcomes in top-of-basilar occlusion treated with thrombectomy
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Jae-Chan Ryu, Boseong Kwon, Yunsun Song, Deok Hee Lee, Jun Young Chang, Dong-Wha Kang, Sun U. Kwon, Jong S. Kim, and Bum Joon Kim
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Neurology ,Neurology (clinical) - Abstract
Background and purposeTop-of-basilar artery occlusion (TOB) is one of the most devastating strokes despite successful mechanical thrombectomy (MT). We aimed to investigate the impact of initial low cerebellum perfusion delay on the outcomes of TOB treated with MT.MethodsWe included patients who underwent MT for TOB. Clinical and peri-procedural variables were obtained. Perfusion delay in the low cerebellum was defined as (1) time-to-maximum (Tmax) >10 s lesions or (2) relative time-to-peak (rTTP) map >9.5 s with a diameter of ≥6 mm in the low cerebellum. The good functional outcome was defined as the achievement of a modified Rankin Scale score of 0–3 at 3 months after stroke.ResultsAmong the 42 included patients, 24 (57.1%) patients showed perfusion delay in the low cerebellum. The admission National Institutes of Health Stroke Scale (NIHSS) score was significantly higher in those with perfusion delay [17 (12–24) vs. 8 (6–15), P = 0.002]. Accordingly, the proportion of good functional outcomes was lower in those with perfusion delay than in those without [5 (20.8%) vs. 13 (72.2%), P = 0.003]. From the multivariable analysis, the admission NIHSS score [odds ratio (OR) = 0.86, 95% confidence intervals (CIs) = 0.75–0.98, P = 0.021] and low cerebellum perfusion delay (OR = 0.18, 95% Cis = 0.04–0.86, P = 0.031) were independently associated with the 3-month functional outcomes.ConclusionWe found that initial perfusion delay proximal to TOB in the low cerebellum might be a predictor for poor functional outcomes in TOB treated with MT.
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- 2023
6. Characteristics of stroke after liver and kidney transplantation
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Hanim Kwon, Sung Shin, Chung Hee Baek, Jun Young Chang, Dong-Wha Kang, Sun U. Kwon, Jong S. Kim, and Bum Joon Kim
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Neurology ,Neurology (clinical) - Abstract
BackgroundThe mechanism and characteristics of a post-transplantation stroke may differ between liver (LT) and kidney transplantation (KT), as the associated comorbidities and peri-surgical conditions are different. Herein, we investigated the characteristics and etiologies of stroke occurring after LT and KT.MethodsConsecutive patients who received LT or KT between January 2005 to December 2020 who were diagnosed with ischemic or hemorrhagic stroke after transplantation were enrolled. Ischemic strokes were further classified according to the etiologies. The characteristics of stroke, including in-hospital stroke, perioperative stroke, stroke etiology, and timing of stroke, were compared between the LT and KT groups.ResultsThere were 105 (1.8%) and 58 (1.3%) post-transplantation stroke patients in 5,950 LT and 4,475 KT recipients, respectively. Diabetes, hypertension, and coronary arterial disease were less frequent in the LT than the KT group. In-hospital and perioperative strokes were more common in LT than in the KT group (LT, 57.9%; KT, 39.7%; p = 0.03, and LT, 43.9%; KT, 27.6%; p = 0.04, respectively). Hemorrhagic strokes were also more common in the LT group (LT, 25.2%; KT, 8.6%; p = 0.01). Analysis of ischemic stroke etiology did not reveal significant difference between the two groups; undetermined etiology was the most common, followed by small vessel occlusion and cardioembolism. The 3-month mortality was similar between the two groups (both LT and KT, 10.3%) and was independently associated with in-hospital stroke and elevated C-reactive protein.ConclusionsIn-hospital, perioperative, and hemorrhagic strokes were more common in the LT group than in the KT group. Ischemic stroke subtypes did not differ significantly between the two groups and undetermined etiology was the most common cause of ischemic stroke in both groups. High mortality after stroke was noted in transplantation patients and was associated with in-hospital stroke.
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- 2023
7. Silent brain infarcts after carotid or vertebrobasilar artery stenting
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Jae‐Chan Ryu, Deok Hee Lee, Jun Young Chang, Dong‐Wha Kang, Sun U. Kwon, and Bum Joon Kim
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Radiology, Nuclear Medicine and imaging ,Neurology (clinical) - Published
- 2023
8. In-stent restenosis and stented-territory infarction after carotid and vertebrobasilar artery stenting
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Jae-Chan Ryu, Jae-Han Bae, Sang Hee Ha, Boseong Kwon, Yunsun Song, Deok Hee Lee, Jun Young Chang, Dong-Wha Kang, Sun U. Kwon, Jong S. Kim, and Bum Joon Kim
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Neurology (clinical) ,General Medicine - Abstract
Background Prognosis after vertebrobasilar stenting (VBS) may differ from that after carotid artery stenting (CAS). Here, we directly compared the incidence and predictors of in-stent restenosis and stented-territory infarction after VBS and compared them with those of CAS. Methods We enrolled patients who underwent VBS or CAS. Clinical variables and procedure-related factors were obtained. During the 3 years of follow-up, in-stent restenosis and infarction were investigated in each group. In-stent restenosis was defined as reduction in the lumen diameter > 50% compared with that after stenting. Factors associated with the occurrence of in-stent restenosis and stented-territory infarction in VBS and CAS were compared. Results Among 417 stent insertions (93 VBS and 324 CAS), there was no statistical difference in in-stent restenosis between VBS and CAS (12.9% vs. 6.8%, P = 0.092). However, stented-territory infarction was more frequently observed in VBS than in CAS (22.6% vs. 10.8%; P = 0.006), especially a month after stent insertion. HbA1c level, clopidogrel resistance, and multiple stents in VBS and young age in CAS increased the risk of in-stent restenosis. Diabetes (3.82 [1.24–11.7]) and multiple stents (22.4 [2.4–206.4]) were associated with stented-territory infarction in VBS. However, in-stent restenosis (odds ratio: 15.1, 95% confidence interval: 3.17–72.2) was associated with stented-territory infarction in CAS. Conclusions Stented-territory infarction occurred more frequently in VBS, especially after the periprocedural period. In-stent restenosis was associated with stented-territory infarction after CAS, but not in VBS. The mechanism of stented-territory infarction after VBS may be different from that after CAS.
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- 2023
9. Cerebral Infarction Caused by Direct Cardiac Tumor Emboli Mixed with Thrombus
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Jun Young Chang, Hyo Jae Kim, Seung Taek Oh, Kwan Young Park, Hyae Lee You, and Hee-Jae Jung
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medicine.medical_specialty ,Cerebral infarction ,business.industry ,Internal medicine ,cardiovascular system ,medicine ,Cardiology ,cardiovascular diseases ,Thrombus ,medicine.disease ,business ,Cardiac Tumors - Abstract
Cerebral infarction in cancer patients is often caused by thrombosis due to hypercoagulability, and in some cases, caused by direct tumor embolism. We report the case of cerebral infarction due to direct tumor embolism mixed with thrombus. Biopsy of blood clots obtained during thrombectomy is important for diagnosis. If there is a high risk of thrombosis among cancer patients with cerebral infarction, the use of appropriate antithrombotic agents along with maintaining a certain level of platelets should be considered.
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- 2021
10. Method to Check Sample Reproducibility by Measuring Magnetic Domain Wall Motion in Perpendicular Magnetic Anisotropy Thin Films
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Joon Kwon Moon, Kitae Kim, Seong-Hyub Lee, Ji-Sung Yu, Junghyun Park, Sug-Bong Choe, and Jun-Young Chang
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Reproducibility ,Materials science ,Magnetic domain ,Condensed matter physics ,Perpendicular magnetic anisotropy ,Wall motion ,Thin film ,Sample (graphics) - Published
- 2021
11. Association of Prestroke Glycemic Control With Vascular Events During 1-Year Follow-up
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Dong-Eog Kim, Hee-Joon Bae, Kyung Bok Lee, Dae-Hyun Kim, Jay Chol Choi, Sung Il Sohn, Tai Hwan Park, Byung-Chul Lee, Joon-Tae Kim, Mi Sun Oh, Jeong-Ho Hong, Yong-Jin Cho, Ji Sung Lee, Keun-Sik Hong, Chulho Kim, Jong-Moo Park, Moon-Ku Han, Dong-Ick Shin, Jun Young Chang, Jee Hyun Kwon, Sang-Hwa Lee, Wook-Joo Kim, Soo Joo Lee, Jae Kwan Cha, Beom Joon Kim, and Jun Lee
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Adult ,Male ,medicine.medical_specialty ,Myocardial Infarction ,1 year follow up ,Glycemic Control ,Cohort Studies ,Fasting glucose ,Recurrence ,Risk Factors ,Internal medicine ,Diabetes mellitus ,Diabetes Mellitus ,medicine ,Humans ,Myocardial infarction ,Stroke ,Aged ,Retrospective Studies ,Glycemic ,Aged, 80 and over ,Glycated Hemoglobin ,business.industry ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Clinical research ,Cardiology ,Female ,Neurology (clinical) ,business ,Follow-Up Studies - Abstract
Background and ObjectivesWe evaluated the association between admission glycated hemoglobin (HbA1c) and subsequent risk of composite vascular events, including stroke, myocardial infarction (MI), and vascular death, in patients with acute ischemic stroke and diabetes.MethodsPatients who had a TIA or an acute ischemic stroke within 7 days of symptom onset and diabetes were included in a retrospective cohort design using the stroke registry of the Clinical Research Center for Stroke in Korea. The association between admission HbA1c and composite vascular events, including stroke, MI, and vascular death, during 1-year follow-up was estimated using the Fine-Gray model. The risk of composite vascular events according to the ischemic stroke subtype was explored using fractional polynomial and linear-quadratic models.ResultsOf the 18,567 patients, 1,437 developed composite vascular events during follow-up. In multivariable analysis using HbA1c as a categorical variable, the risk significantly increased at a threshold of 6.8%–7.0%. The influence of admission HbA1c level on the risk of composite vascular events was pronounced particularly among those in whom fasting glucose at admission was ≤130 mg/dL. The optimal ranges of HbA1c associated with minimal risks for composite vascular events were lowest for the small vessel occlusion subtype (6.6 [95% confidence internal [CI], 6.3–6.9]) compared to the large artery atherosclerosis (7.3 [95% CI, 6.8–7.9]) or the cardioembolic subtype (7.4 [95% CI, 6.3–8.5]).DicussionIn patients with ischemic stroke and diabetes, the risks of composite vascular events were significantly associated with admission HbA1c. The optimal range of admission HbA1c was below 6.8%–7.0% and differed according to the ischemic stroke subtype.
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- 2021
12. Outcome in Patients Treated with Intra-arterial thrombectomy: The optiMAL Blood Pressure control (OPTIMAL-BP) Trial
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Hyo Suk Nam, Jin Kyo Choi, Yoonkyung Chang, Kwon-Duk Seo, Bang-Hoon Cho, Hye S. Lee, Minyoul Baik, Seong Hwan Ahn, Yo Han Jung, Tae Jin Song, Jun Young Chang, JoonNyung Heo, Sungha Park, Dong Joon Kim, Han-Jin Cho, Jong-Won Chung, Jung Hwa Seo, Gyu Sik Kim, Goeun Park, Chan Joo Lee, Hyungjong Park, Sung Il Sohn, Jang Hyun Baek, Jun Lee, Jae Guk Kim, Woo-Keun Seo, Jinkwon Kim, Joonsang Yoo, Jeong-Ho Hong, Oh Young Bang, Byung Moon Kim, Yang-Ha Hwang, Kijeong Lee, Kyung-Yul Lee, Dong Hoon Shin, Sun U. Kwon, Chi Kyung Kim, and Young Dae Kim
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Blood pressure control ,medicine.medical_specialty ,Stroke patient ,business.industry ,Cerebral infarction ,medicine.disease ,Blood pressure ,Reperfusion therapy ,Neurology ,Internal medicine ,Intra arterial ,Cardiology ,Medicine ,In patient ,Stage (cooking) ,business - Abstract
Rationale Very early stage blood pressure (BP) levels may affect outcome in stroke patients who have successfully undergone recanalization following intra-arterial treatment, but the optimal target of BP management remains uncertain. Aim We hypothesized that the clinical outcome after intensive BP-lowering is superior to conventional BP control after successful recanalization by intra-arterial treatment. Sample-size estimates We aim to randomize 668 patients (334 per arm), 1:1. Methods and design We initiated a multicenter, prospective, randomized, open-label trial with a blinded end-point assessment (PROBE) design. After successful recanalization (thrombolysis in cerebral infarction score ≥ 2 b), patients with elevated systolic BP level, defined as the mean of two readings ≥ 140 mmHg, will be randomly assigned to the intensive BP-lowering (systolic BP Study outcomes The primary efficacy outcomes are from dichotomized analysis of modified Rankin Scale (mRS) scores at three months (mRS scores: 0–2 vs. 3–6). The primary safety outcomes are symptomatic intracerebral hemorrhage and death within three months. Discussion The OPTIMAL-BP trial will provide evidence for the effectiveness of active BP control to achieve systolic BP Clinical trial registration ClinicalTrials.gov Identifier: NCT04205305.
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- 2021
13. Cyclophosphamide-Associated Reversible Cerebral Vasoconstriction Syndrome Presenting as Concurrent Cerebral Infarction and Subarachnoid Hemorrhage
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Yun-Jik Park, Keon-Woo Kim, Dong-Young Jeong, Yeon-Jung Kim, and Jun Young Chang
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medicine.medical_specialty ,Subarachnoid hemorrhage ,Cyclophosphamide ,Cerebral infarction ,business.industry ,Internal medicine ,medicine ,Cardiology ,medicine.disease ,business ,Reversible cerebral vasoconstriction syndrome ,medicine.drug - Abstract
Reversible cerebral vasoconstriction syndrome (RCVS) has several trigger factors, including physical exertion, pregnancy, and the intake of vasoconstrictive agents. These triggers activate the sympathetic nervous system and induce vasoconstriction, thereby leading to an ischemic or hemorrhagic stroke. In this study, we describe case of RCVS in a 73-year-old woman who complained of sudden bilateral leg weakness after taking cyclophosphamide for anti-neutrophil cytoplasmic antibody associated vasculitis. She was diagnosed with concurrent cerebral hemorrhage and cerebral infarction with multiple intracranial vasoconstrictions on imaging analyses.
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- 2021
14. Focal Severe Stenosis of the Artery of Percheron Revealed by Conventional Angiography in Bilateral Thalami Infarction
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Soo Jeong, Sang Hee Ha, Jun Young Chang, and Bum Joon Kim
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Advanced and Specialized Nursing ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine - Published
- 2022
15. Association between lipid profile changes and risk of in-stent restenosis in ischemic stroke patients with intracranial stenosis: A retrospective cohort study
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Jae-Chan Ryu, Jae-Han Bae, Sang Hee Ha, Boseong Kwon, Yunsun Song, Deok Hee Lee, Bum Joon Kim, Dong-Wha Kang, Sun U. Kwon, Jong S. Kim, and Jun Young Chang
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Multidisciplinary - Abstract
Objective The risk of ischemic stroke with intracranial stenosis is associated with various serum lipid levels. However, the effects of changes in the lipid profile on the risk of in-stent restenosis have not been verified. Therefore, we investigated the association between the occurrence of in-stent restenosis at 12-month follow-up and changes in various lipid profiles. Methods In this retrospective cohort study, we included ischemic stroke patients who had undergone intracranial stenting for symptomatic intracranial stenosis between February 2010 and May 2020. We collected data about serum low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), and triglyceride (TG) levels, and calculated the TC/HDL-C and LDL-C/HDL-C ratios at baseline and after 12 months. We conducted multivariable logistic regression analyses to verify the association between various lipid profile changes and in-stent restenosis at 12 months. Results Among the 100 patients included in the study (mean age, 60.8 ± 10.0 years; male: 80 [80.0%]), in-stent restenosis was found in 13 (13.0%) patients. The risk of in-stent restenosis of more than 50% was significantly decreased when TC/HDL-C ratio (odds ratio [OR] 0.22, [95% confidence interval (CI) 0.05–0.87]) and LDL-C/HDL-C ratio (OR 0.23, [95% CI 0.06–0.93]) decreased or when HDL-C levels (OR 0.10, [95% CI 0.02–0.63]) were increased at 12 months compared with baseline measurements. Conclusions Improvement of HDL-C levels, TC/HDL-C ratio, and LDL-C/HDL-C ratio were associated with decreased risk of in-stent restenosis at 12-month follow-up. Management and careful monitoring of various lipid profiles including HDL-C levels, TC/HDL-C ratio, and LDL-C/HDL-C ratio may be important to prevent in-stent restenosis in patients with intracranial stenting.
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- 2023
16. Blood pressure variability and early neurological deterioration according to the chronic kidney disease risk categories in minor ischemic stroke patients
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Jae-Chan Ryu, Jae-Han Bae, Sang Hee Ha, Jun Young Chang, Dong-Wha Kang, Sun U. Kwon, Jong S. Kim, Chung Hee Baek, and Bum Joon Kim
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Stroke ,Multidisciplinary ,Humans ,Blood Pressure ,Blood Pressure Determination ,Renal Insufficiency, Chronic ,United States ,Ischemic Stroke - Abstract
Objective Chronic kidney disease (CKD) increases blood pressure variability (BPV) and affects stroke outcomes. However, the effect of BPV on early neurological deterioration (END) may be different according to the renal function. Methods We enrolled ischemic stroke patients with a National Institutes of Health Stroke Scale of ≤5. END was defined as worsening of ≥1 point in motor power or ≥2 points in total score. BPV was calculated with BP measured during the first 5 days and presented as standard deviation (SD) and coefficient of variation (CoV). Renal function was classified using the Kidney Disease Improving Global Outcomes (KDIGO) classification of CKD. Variables were compared between those with (KDIGO classification: moderate- to very-high-risk) and without renal impairment (KDIGO classification: low-risk) and factors associated with END were investigated. Results Among the 290 patients (136 [46.9%] renal impairment), END was observed in 59 (20.3%) patients. BPV parameters and the risk of END increased as renal function was impaired. Renal function and systolic BP (SBP) mean, SD, CoV, and diastolic BP (DBP) mean, SD were independently associated with END. We found no association between BPV parameters and END in normal renal function patients; however, among impaired renal function patients, SBP SD (odds ratio [OR]: 1.20, 95% confidence interval [CI]: 1.09–1.32, PP Conclusions The association between END and BPV parameters differs according to renal function in minor ischemic stroke; BPV was associated with END in patients with renal impairment, but less in those with normal renal function.
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- 2022
17. Effects of Exposure to Lead and Cadmium on Health of Inhabitants of Abandoned Metal Mine Area in Korea
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Joon Sakong, Heon Kim, Man Joong Jeon, Joo-Young Moon, Sang-Yong Eom, Jung-Duck Park, Won-Ju Park, Byung-Sun Choi, Jung-Eum Lee, Young-Seoub Hong, Jun Young Chang, and Jeong-Wook Seo
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Adult ,Male ,010504 meteorology & atmospheric sciences ,Health, Toxicology and Mutagenesis ,Population ,chemistry.chemical_element ,Environmental pollution ,Urine ,010501 environmental sciences ,Toxicology ,Risk Assessment ,01 natural sciences ,Mining ,Young Adult ,chemistry.chemical_compound ,Environmental health ,Republic of Korea ,Biomonitoring ,Humans ,Medicine ,Ecotoxicology ,education ,Aged ,0105 earth and related environmental sciences ,Whole blood ,Aged, 80 and over ,education.field_of_study ,Creatinine ,Cadmium ,business.industry ,Spectrophotometry, Atomic ,Oryza ,Environmental Exposure ,General Medicine ,Middle Aged ,Pollution ,Lead ,chemistry ,Housing ,Environmental Pollutants ,Female ,Graphite ,Environmental Pollution ,business ,Biological Monitoring - Abstract
People living near abandoned mines are at increased risk of exposure to toxic metals. We surveyed 4500 inhabitants with the mean age of 68.5 years old (male: 1768, female: 2732) living near 104 abandoned metal mines from 2013 to 2017 (the 2nd phase health survey in Korea). We conducted personal interviews, blood and urine sampling, and analyzed the concentrations of lead (Pb) and cadmium (Cd) in whole blood and Cd in urine using a graphite furnace atomic absorption spectrometer. The geometric means of blood Pb, blood Cd, and urine Cd were 2.27 μg/dL, 1.42 μg/L, and 1.66 μg/g creatinine, respectively. The level of metal exposure was lower than that reported from the first phase health survey in Korea (2008‒2011) but was higher than in the general population of Korea. Blood Pb was higher in males while blood Cd and urine Cd were significantly higher in females. Blood Pb was highest in the 40‒59 age group, while blood and urine Cd levels continuously increased until age 80 or older. The Cd levels in blood and urine were affected by consumption of locally produced rice and duration of residence near abandoned mines. Furthermore, negative correlations were observed between blood Pb and blood and urine Cd levels. Additionally, 252 of the 4500 subjects exceeded the thresholds of blood Cd or urine Cd levels. Together, these findings suggest that Cd has more sustainable and adverse health effects on the abandoned mine inhabitants, who are mostly aged. Therefore, continuous biomonitoring and risk assessment to environmental health risks are necessary for environmental pollution control and health promotion.
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- 2021
18. Enlarged left atrium may be associated with laterality of anterior circulation cardioembolic stroke
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Sang Hee Ha, So Young Yang, Soo Jeong, Jae Young Park, Jun Young Chang, Dong-Wha Kang, Sun U. Kwon, Jong-Sung Kim, and Bum Joon Kim
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Rehabilitation ,Surgery ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
19. Experimental verification of the Thiele equation for skyrmion Hall angle
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Kitae Kim, Seong-Hyub Lee, Yooleemi Shin, Ji-Wan Kim, Jung-Hyun Park, Jun-Young Chang, and Sug-Bong Choe
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General Engineering ,General Physics and Astronomy - Abstract
Magnetic skyrmions are a topologically stable spin configurations that are currently extensively studied as promising information carriers in spintronic devices. When an electric current is injected, the skyrmions exhibit the skyrmion Hall effect. This skyrmion Hall effect can be described by the Thiele equation. Here, we experimentally examined the validity of the Thiele equation. For this study, a series of Pt/Co/W films with a wide range of Co layer thicknesses were examined. The results verified the Thiele equation of the skyrmion Hall angle as a function of the magnetic anisotropy and Gilbert damping constants.
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- 2023
20. Blood Pressure Variability Can Predict Carotid Sinus Reaction After Carotid Stenting
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Jae-Chan Ryu, Jae-Han Bae, Sang Hee Ha, Jun Young Chang, Dong-Wha Kang, Sun U Kwon, Jong S Kim, and Bum Joon Kim
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Carotid Sinus ,Risk Factors ,Internal Medicine ,Odds Ratio ,Humans ,Blood Pressure ,Stents - Abstract
BACKGROUND Carotid stenting has become an important treatment for carotid disease. Carotid sinus reaction (CSR), a complication which is not uncommon and affects the outcome of carotid stenting. We investigated the predictors of CSR, including blood pressure variability and heart rate variability (BPV and HRV, respectively). METHODS We enrolled patients who underwent carotid stenting. CSR was defined as any episode of systolic blood pressure (SBP) RESULTS Among the 176 patients, 61 (34.7%) patients showed CSR. Blood pressure and HR were measured 14 times before carotid stenting on average. The risk of CSR was independently associated with the use of longer stent (odds ratio: 1.08, 95% confidence interval: 1.00–1.16, P = 0.042) and increased SBP SD (1.07 [1.00–1.14], P = 0.048). Moreover, when the SBP parameter changed to SBP CoV, total stent length (1.08 [1.00–1.16], P = 0.042) and SBP CoV (1.12 [1.02–1.23], P = 0.023) were associated with the occurrence of CSR. CONCLUSIONS The use of a longer stent and increased SBP variability before carotid stent insertion were associated with the risk of CSR after carotid stenting. Underlying autonomic dysregulation may increase the risk of CSR during carotid stenting. SBP variability before carotid stenting might be considered a predictor of CSR.
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- 2022
21. Factors associated with two different stroke mechanisms in perforator infarctions regarding the shape of arteries
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Sang Hee Ha, Jae-Chan Ryu, Jae-Han Bae, Sujin Koo, Jun Young Chang, Dong-Wha Kang, Sun U. Kwon, Jong S. Kim, Dae-il Chang, and Bum Joon Kim
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Stroke ,Middle Cerebral Artery ,Multidisciplinary ,Infarction ,Humans ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,Plaque, Atherosclerotic ,Ischemic Stroke ,Retrospective Studies - Abstract
Two different stroke mechanisms are involved in small vessel disease: branch atheromatous disease (BAD) and lipohyalinotic degeneration (LD). We compared mechanisms of stroke in lenticulostriate arteries (LSA) vs. anterior pontine arteries (APA) and verified factors associated with stroke mechanisms, including shape of middle cerebral artery (MCA) and basilar artery (BA). We retrospectively reviewed patients with acute ischemic stroke with penetrating artery territory confirmed by MRI. The mechanisms of stroke were categorized based on diffusion-weighted imaging; BAD was defined as lesion larger than 10 mm in LSA and lesions involving basal pontine in APA. Other lesions were classified as LD. The shapes of MCA and BA were classified as straight, with one angle, or with two angles (U, C or S shape, respectively) using anterior–posterior view. The study included 221 patients. LD was more common in LSA infarcts, but BAD was more common in APA infarcts (p
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- 2022
22. Early Response to Endovascular Thrombectomy after Stroke: Early, Late, and Very Late Time Windows
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Sang Hee Ha, Jae-Chan Ryu, Jae-Han Bae, Sujin Koo, Boseong Kwon, Deok Hee Lee, Jun Young Chang, Dong-Wha Kang, Sun U. Kwon, Jong-Sung Kim, and Bum Joon Kim
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Neurology ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine - Abstract
Background and Purpose: Endovascular thrombectomy (EVT) has benefits in selected patients 6–24 h after stroke onset. However, the response to EVT >24 h after stroke onset is still unclear. We compared the early response to EVT in patients with different time windows. Methods: Patients who underwent EVT in an emergency setting were enrolled and categorized according to when EVT was performed: within 6 (early), 6–24 (late), and >24 h (very late) after stroke onset. Early neurological improvement (ENI) and deterioration (END) were defined as improvement and worsening, respectively, of National Institutes of Health Stroke Scale (NIHSS) score by ≥4 points after EVT. The three groups’ clinical characteristics and response to EVT were compared. We also investigated factors associated with ENI and END. Results: During study period, 274 patients underwent EVT (109 early, 104 late, and 61 very late). Patients who underwent EVT very late were younger (p = 0.007), had smaller ischemic cores, and had lower initial NIHSS scores (8 ± 5) than those who underwent EVT early (14 ± 6) and late (13 ± 7; p < 0.001). Stroke mechanisms also differed according to the time window (p < 0.001): cardioembolism was more common after early EVT, whereas large-artery atherosclerosis was more prevalent among patients who underwent EVT very late. ENI was significantly more common after early (60.6%) and late EVT (51.0%) than after very late EVT (29.5%; p = 0.001); however, rates of END did not differ (11.0%, 13.5%, and 4.9%, respectively). ENI was independently associated with male, higher NIHSS score, and early and late EVT. END was associated with failure of recanalization. Conclusions: ENI was more observed and associated with early and late EVT. Highly selected patients receiving very late EVT may not benefit from ENI but may still have a chance to prevent END. The occurrence of END was associated not with time window but with failure of recanalization.
- Published
- 2022
23. Hemorrhagic Brain Metastasis in Angiosarcoma
- Author
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Hanim Kwon, Jun Young Chang, Yun Jik Park, Kyubong Lee, and Yeon-Jung Kim
- Subjects
Pathology ,medicine.medical_specialty ,business.industry ,medicine ,Angiosarcoma ,business ,medicine.disease ,Brain metastasis - Published
- 2019
24. Chirality-dependent roughness of magnetic domain walls
- Author
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Ji-Sung Yu, Dae-Yun Kim, Joon Moon, Seong-Hyub Lee, Jun-Young Chang, Duck-Ho Kim, Byoung-Chul Min, and Sug-Bong Choe
- Subjects
Physics and Astronomy (miscellaneous) - Abstract
Dzyaloshinskii–Moriya interaction (DMI) plays a key role in the formation and stability of chiral magnetic objects, such as skyrmions and chiral domain-walls (DWs), which are used as building blocks of emerging high-density and high-speed devices. Here, we demonstrate that the DMI determines also the roughness of chiral DWs. Such DMI-dependent chiral roughness was observed from magnetic multilayer films of the Pt/Co/Pt heterostructure. Despite the stochastic nature of the DW roughness, the films clearly showed the roughness variation with respect to the DW chirality in balance with the DMI. The present analysis of the DW roughness offers a way to quantitatively determine the DMI-induced effective field as an essential parameter for the stability and dynamic characteristics of chiral DWs.
- Published
- 2022
25. Prestroke Glucose Control and Functional Outcome in Patients With Acute Large Vessel Occlusive Stroke and Diabetes After Thrombectomy
- Author
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Jeong-Ho Hong, Mi Sun Oh, Ji Hyun Kwon, Sang Hwa Lee, Sung Il Sohn, Jay Chol Choi, Jong Moo Park, Byung-Chul Lee, Jae Kwan Cha, Dong Ick Shin, Jun Lee, Dae-Hyun Kim, Joon-Tae Kim, Keun-Sik Hong, Moon Ku Han, Wook-Joo Kim, Yong-Jin Cho, Chulho Kim, Ji Sung Lee, Jun Young Chang, Soo Joo Lee, Hee-Joon Bae, Kyung Bok Lee, Tae Hwan Park, Beom Joon Kim, and Dong-Eog Kim
- Subjects
Blood Glucose ,Research design ,Cardiovascular and Metabolic Risk ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Brain Ischemia ,Modified Rankin Scale ,Diabetes mellitus ,Internal medicine ,Occlusion ,Diabetes Mellitus ,Internal Medicine ,medicine ,Humans ,Stroke ,Retrospective Studies ,Thrombectomy ,Advanced and Specialized Nursing ,Groin ,business.industry ,Thrombolysis ,medicine.disease ,Treatment Outcome ,Clinical research ,medicine.anatomical_structure ,Cardiology ,business - Abstract
OBJECTIVE To evaluate whether prestroke glucose control is associated with functional outcomes in patients with acute large vessel occlusive stroke and diabetes who underwent intra-arterial thrombectomy (IAT). RESEARCH DESIGN AND METHODS From the Clinical Research Center for Stroke–Korea registry, we included patients with emergent large vessel occlusive stroke with diabetes who underwent IAT between January 2009 and March 2020. The association between the HbA1c level at admission and functional outcomes (modified Rankin Scale at 3 months after the index stroke) was assessed. RESULTS A total of 1,351 patients were analyzed. Early neurological deterioration was more common in patients with higher levels of HbA1c at admission (P = 0.02 according to HbA1c quintiles, P = 0.003 according to an HbA1c cutoff value of 7.0%) than in those with lower HbA1c levels. Higher HbA1c levels at admission were significantly associated with decreased odds of favorable functional outcomes at a threshold of 7.0–7.1%. The association was consistently observed in subgroups divided according to age, sex, stroke subtype, occlusion site, degree of recanalization, thrombolysis modalities, time from symptom onset to groin puncture, and treatment period. CONCLUSIONS Prestroke glucose control with a target HbA1c of ≤7.0% may be beneficial for neurological recovery in patients with diabetes undergoing IAT for large vessel occlusive stroke, regardless of stroke subtype, bridging intravenous thrombolysis, occlusion site, degree of recanalization, and treatment period.
- Published
- 2021
26. Clinical-Diffusion Mismatch Is Associated with Early Neurological Improvement after Late-Window Endovascular Treatment
- Author
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Jong S. Kim, Deok Hee Lee, Yun Sun Song, Bum Joon Kim, Sun U. Kwon, Jun Young Chang, Dong-Wha Kang, Boseong Kwon, and Yoo Jin Lee
- Subjects
medicine.medical_specialty ,Lesion volume ,Brain Ischemia ,Stroke onset ,Internal medicine ,Medicine ,Humans ,In patient ,Thrombolytic Therapy ,Endovascular treatment ,Ischemic Stroke ,Thrombectomy ,business.industry ,Stroke scale ,Penumbra ,Endovascular Procedures ,Odds ratio ,Confidence interval ,Stroke ,Diffusion Magnetic Resonance Imaging ,Treatment Outcome ,Neurology ,Cardiology ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background: Clinical-diffusion mismatch (CDM) and perfusion-diffusion mismatch (PDM) are used to select patients for endovascular thrombectomy (EVT) in the late-window period. As CDM well reflects true penumbra, we hypothesized that patients with CDM and PDM would respond better to EVT than those with PDM only at the late-window period. Methods: Acute ischemic stroke patients who received EVT 6–24 h after stroke onset were included. PDM (perfusion-/diffusion-weighted image (DWI) lesion volume >1.8) was used to select candidates for EVT in this time-period in our center. CDM was defined according to the DAWN trial criteria. Response to EVT was compared between patients with and without CDM. Early neurological improvement (ENI) was defined as improvement >4 points on National Institutes of Health Stroke Scale (NIHSS) score 1 day after EVT. Multivariable analysis was performed to investigate independent factors associated with ENI. The correlation between DWI lesion volume and NIHSS score was investigated in those with and without CDM. Results: Among 94 patients enrolled, all patients had PDM and 44 (46.3%) had CDM. Forty-eight patients (51.1%) showed ENI. The prevalence of hypertension, initial NIHSS score, improvement in NIHSS score after EVT, and prevalence of ENI were greater in patients with CDM than those without. ENI was independently associated with onset-to-door time (odds ratio [95% confidence interval]: 0.998 [0.997–1.000]; p = 0.042), complete recanalization (23.912 [2.238–255.489]; p = 0.009), initial NIHSS score (1.180 [1.012–1.377]; p = 0.034), and the presence of CDM (5.160 [1.448–18.386]; p = 0.011). The correlation between DWI lesion volume and initial NIHSS score was strong in patients without CDM (r = 0.731) but only moderate in patients with CDM (r = 0.355). Conclusion: Patients with both CDM and PDM had a better response to late-window EVT than those with PDM only.
- Published
- 2021
27. Postthrombectomy Systolic Blood Pressure and Clinical Outcome among Patients with Successful Recanalization
- Author
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Jun Young Chang and Moon Ku Han
- Subjects
Male ,medicine.medical_specialty ,Blood Pressure ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Modified Rankin Scale ,Internal medicine ,Occlusion ,medicine ,Humans ,Middle cerebral artery occlusion ,Symptom onset ,Stroke ,Aged ,Retrospective Studies ,Thrombectomy ,Computed tomography angiography ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Cerebral Infarction ,Recovery of Function ,Middle Aged ,medicine.disease ,Treatment Outcome ,Blood pressure ,Neurology ,Cardiology ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,Large vessel occlusion - Abstract
Background: Optimal blood pressure (BP) management after intraarterial thrombectomy (IAT) has yet to be thoroughly elucidated. We assessed whether maintaining a systolic BP (SBP) of ≤130 mm Hg for 24 h following IAT was associated with better outcomes in patients with successful recanalization. Methods: Patients presenting with large vessel occlusion within 4 h from symptom onset underwent IAT based on multiphase computed tomography angiography, and those achieving successful recanalization were included in this retrospective analysis. Patients were dichotomized based on a 24-h mean SBP after IAT >130 or ≤130 mm Hg, and functional outcomes were compared at 3 months. At 3 months, 24-h mean SBPs were compared based on recanalization degree, baseline collateral status, stroke mechanism, and occlusion site. Results: The proportion of favorable outcomes at 3 months (modified Rankin Scale [mRS] 0–2) was significantly lower in patients with a mean SBP >130 mm Hg over the 24 h after IAT (40.5 vs. 66.7%, p = 0.02). The distribution of mRS varied significantly among patients with complete recanalization, poor baseline collateral status (pial arterial filling score 0–3), cardioembolic stroke, or middle cerebral artery occlusion, with higher mRS values associated with higher mean SBPs. A mean SBP >130 mm Hg during the 24 h after IAT was associated with worse functional outcomes after multivariable adjustment (OR 2.66; 95% CI 1.11–6.41; p= 0.03). Conclusion: Stricter BP control during the 24 h following IAT may improve clinical outcomes in patients with large vessel occlusion who achieved successful recanalization.
- Published
- 2019
28. Effects of Dose Titration on Dipyridamole-Induced Headache: A Randomized, Double-Blind Clinical Trial
- Author
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Min Kyoung Kang, Jae-Kwan Cha, Dae-il Chang, Hyun Young Kim, Jong-Won Chung, Keun-Hwa Jung, Keun-Sik Hong, Jun Young Chang, Joung-Ho Rha, Jong-Moo Park, Byung-Kun Kim, Soo Joo Lee, Man-Seok Park, Kyung-Yul Lee, Dong-Ick Shin, and Byung-Woo Yoon
- Subjects
Stroke ,Neurology ,Aspirin ,Double-Blind Method ,Ischemic Attack, Transient ,Headache ,Humans ,Drug Therapy, Combination ,Neurology (clinical) ,Dipyridamole ,Cardiology and Cardiovascular Medicine ,Platelet Aggregation Inhibitors ,Ischemic Stroke - Abstract
Purpose: The aim of this study is to investigate the effect of gradual dipyridamole titration and the incidence of dipyridamole-induced headache in patients with ischemic stroke or transient ischemic attack (TIA). Methods: A randomized, double-blind, double-placebo, parallel group, phase 4 clinical trial (KCT0005457) was conducted between July 1, 2019, and February 25, 2020, at 15 medical centers in South Korea. The study included patients aged >19 years diagnosed with a noncardioembolic ischemic stroke or TIA within the previous 3 weeks. The participants were randomized 1:1:1 to receive Adinox® (aspirin 25 mg/dipyridamole 200 mg) and aspirin (100 mg) once daily for the first 2 weeks followed by Adinox® twice daily for 2 weeks (titration group), Adinox® twice daily for 4 weeks (standard group), and aspirin 100 mg once daily for 4 weeks (control group). The primary endpoint was incidence of headache over 4 weeks. The key secondary endpoint was mean cumulative headache. Results: Ninety-six patients were randomized into the titration (n = 31), standard (n = 32), and control (n = 33) groups. The titration and standard groups (74.1% vs. 74.2%, respectively) showed no difference in the primary endpoint. However, the mean cumulated headache was significantly lower in the titration group than in the standard group (0.31 ± 0.46 vs. 0.58 ± 0.51, p = 0.023). Further, adverse drug reactions were more common in the standard group than in the titration group (28.1% vs. 9.7%, respectively, p = 0.054), although not significantly different. Conclusion: The titration strategy was effective in lowering the incidence of cumulative dipyridamole-induced headache.
- Published
- 2021
29. Response by Chang and Han to Letter Regarding Article, 'Influence of Hemoglobin Concentration on Stroke Recurrence and Composite Vascular Events'
- Author
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Jun Young Chang and Moon-Ku Han
- Subjects
Advanced and Specialized Nursing ,medicine.medical_specialty ,business.industry ,Stroke recurrence ,Internal medicine ,medicine ,MEDLINE ,Neurology (clinical) ,Hemoglobin ,Cardiology and Cardiovascular Medicine ,business - Published
- 2020
30. Transcranial Doppler as a Screening Tool for High-Risk Patent Foramen Ovale in Cryptogenic Stroke
- Author
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Ji Sung Lee, Jin Kyung Oh, Jong S. Kim, Seongho Park, Jun Young Chang, Jae Kwan Song, Dong-Wha Kang, Sun U. Kwon, Bum Joon Kim, and Boseong Kwon
- Subjects
Adult ,Male ,medicine.medical_specialty ,Stroke patient ,Ultrasonography, Doppler, Transcranial ,medicine.medical_treatment ,Foramen Ovale, Patent ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Valsalva maneuver ,Medicine ,Humans ,Mass Screening ,Radiology, Nuclear Medicine and imaging ,Screening tool ,Ischemic Stroke ,Retrospective Studies ,Receiver operating characteristic ,business.industry ,Middle Aged ,medicine.disease ,Transcranial Doppler ,Cryptogenic stroke ,cardiovascular system ,Cardiology ,Patent foramen ovale ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,Shunt (electrical) - Abstract
BACKGROUND AND PURPOSE The identification of high-risk patent foramen ovale (PFO) is important for selecting suitable patients for PFO closure to prevent recurrent stroke in those with cryptogenic stroke. We aimed to evaluate the predictability of transcranial Doppler (TCD) in diagnosing high-risk PFO compared with that of transesophageal echocardiography (TEE), which is not feasible for some stroke patients. METHODS We retrospectively reviewed the data of 461 cryptogenic stroke patients who underwent TEE and TCD for PFO evaluation. High-risk PFO on TEE was defined as PFO with atrial septal aneurysm (phasic septal excursion ≥10 mm) or large PFO (≥2 mm). Spencer grading of right-to-left shunt was used to classify the amount of shunt on TCD. RESULTS PFO on TEE was observed for 242 (52.5%) patients, and high-risk PFO was detected for 123 (26.7%) patients. However, PFO on TCD was observed for 336 (72.9%) patients. Among patients with significant shunt (Spencer grade III or higher) who underwent TCD after Valsalva maneuver (VM), 60.0% of patients had high-risk PFO. However, only 5.3% of patients had high-risk PFO among those without significant shunt. Receiver operating characteristic curves showed that significant shunt after VM had higher predictability (AUC = .876, 95% CI: .843-.905) for detecting the high-risk PFO compared with the predictability based on significant shunt at rest (AUC = .718, 95% CI: .674-.759). (P
- Published
- 2020
31. Neurological Emergencies in Patients Hospitalized With Nonneurological Illness
- Author
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Jung Hwa Lee, H Lee, Bobin Park, Sang-Ahm Lee, Suyeon Jeong, Chae-Man Lim, Han-Bin Lee, Sang-Beom Jeon, Yong Seo Koo, Sang-Bum Hong, Jun Young Chang, and Soh Hyun Choi
- Subjects
Adult ,Pediatrics ,medicine.medical_specialty ,Leadership and Management ,Status epilepticus ,03 medical and health sciences ,0302 clinical medicine ,Intensive care ,medicine ,Humans ,In patient ,030212 general & internal medicine ,Rapid response team ,Stroke ,Proportional hazards model ,business.industry ,030503 health policy & services ,Hazard ratio ,Public Health, Environmental and Occupational Health ,Length of Stay ,medicine.disease ,Confidence interval ,Hospitalization ,Intensive Care Units ,medicine.symptom ,Emergencies ,0305 other medical science ,business - Abstract
OBJECTIVE We aimed to present neurological profiles and clinical outcomes of patients with acute neurological symptoms, which developed during hospitalization with nonneurological illness. METHODS We organized the neurological alert team (NAT), a neurological rapid response team, to manage in-hospital neurological emergencies. In this registry-based study, we analyzed the clinical profiles and outcomes of patients who were consulted to the NAT. We also compared the 3-month mortality of patients with acute neurological symptoms with that of patients without acute neurological symptoms. RESULTS Among the 85,507 adult patients, 591 (0.7%) activated the NAT. The most common reason for NAT activation was stroke symptoms (37.6%), followed by seizures (28.6%), and sudden unresponsiveness (24.0%). The most common diagnosis by the NAT neurologists was metabolic encephalopathy (45.5%), followed by ischemic stroke (21.2%) and seizures or status epilepticus (21.0%). Patients with NAT activation had high rates in mortality before hospital discharge (22.5%) and at 3 months (34.7%), transfer to intensive care units (39.6%), and length of hospital stay (43.1 ± 57.1 days). They also had high prevalence of poor functional status (78.1%) and recurrence of neurological symptoms at 3 months (27.2%). In a Cox proportional hazards model, patients with in-hospital neurological emergencies had a hazard ratio of 13.2 in terms of mortality at 3 months (95% confidence interval, 11.5-15.3; P < 0.001). CONCLUSIONS Occurrence of acute neurological symptoms during hospital admission was associated with high rate of mortality and poor functional status. These results call for enhanced awareness and hospital-wide strategies for managing in-hospital neurological emergencies.
- Published
- 2020
32. Newly developed stroke in patients admitted to non-neurological intensive care units
- Author
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Suyeon Jeong, Jun Young Chang, Sungyang Jo, Soo Jeong, and Sang-Beom Jeon
- Subjects
Adult ,medicine.medical_specialty ,medicine.medical_treatment ,Critical Illness ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,law ,Coagulopathy ,Intensive care ,Internal medicine ,medicine ,Extracorporeal membrane oxygenation ,Humans ,030212 general & internal medicine ,Hospital Mortality ,Stroke ,APACHE ,Retrospective Studies ,Intracerebral hemorrhage ,Original Communication ,APACHE II ,business.industry ,Mortality rate ,Odds ratio ,medicine.disease ,Intensive care unit ,Intensive Care Units ,Critical care ,Neurology ,Cerebral infarction ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Background Little is known about newly developed stroke in patients admitted to the intensive care unit (ICU). Objective This study aimed to investigate characteristics and outcomes of newly developed stroke in patients admitted to the non-neurological intensive care units (ICU-onset stroke, IOS). Methods A consecutive series of adult patients who were admitted to the non-neurological ICU were included in this study. We compared neurological profiles, risk factors, and mortality rates between patients with IOS and those without IOS. Results Of 18,604 patients admitted to the ICU for non-neurological illness, 218 (1.2%) developed stroke (ischemic, n = 182; hemorrhagic, n = 36). The most common neurological presentation was altered mental status (n = 149), followed by hemiparesis (n = 55), and seizures (n = 28). The most common etiology of IOS was cardioembolism (50% [91/182]) for ischemic IOS and coagulopathy (67% [24/36]) for hemorrhagic IOS. In multivariable analysis, the Acute Physiology and Chronic Health Evaluation II (APACHE II) score (adjusted odds ratio [AOR] = 1.04, 95% CI = 1.03−1.06, P
- Published
- 2020
33. Influence of Hemoglobin Concentration on Stroke Recurrence and Composite Vascular Events
- Author
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Jun Lee, Jong-Moo Park, Soo Joo Lee, Sung Il Sohn, Ji Sung Lee, Jun Young Chang, Joon-Tae Kim, Dae-Hyun Kim, Keun-Sik Hong, Dong-Eog Kim, Byung-Chul Lee, Hee-Joon Bae, Kyung Bok Lee, Mi Sun Oh, Yong-Jin Cho, Jay Chol Choi, Wook-Joo Kim, Tae Hwan Park, Jae Kwan Cha, Moon-Ku Han, Dong-Ick Shin, and Beom Joon Kim
- Subjects
Male ,medicine.medical_specialty ,Anemia ,Stroke recurrence ,Myocardial Infarction ,Brain Ischemia ,Cerebral artery stenosis ,Hemoglobins ,Recurrence ,Internal medicine ,Medicine ,Humans ,cardiovascular diseases ,Myocardial infarction ,Prospective Studies ,Stroke ,Aged ,Advanced and Specialized Nursing ,business.industry ,Hazard ratio ,Stroke subtype ,Middle Aged ,medicine.disease ,Cardiology ,Female ,Neurology (clinical) ,Hemoglobin ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers ,Follow-Up Studies - Abstract
Background and Purpose— We evaluated whether hemoglobin concentration at admission was associated with stroke recurrence and composite vascular events (stroke, myocardial infarction, and vascular death) in acute ischemic stroke. Methods— We collected data from patients with acute ischemic stroke or transient ischemic attack from a multicenter stroke registry database in Korea. The association of hemoglobin concentration with 1-year stroke recurrence and composite vascular events was evaluated with respect to age, presence of cerebral artery stenosis, stroke severity, and stroke subtype. Results— Hemoglobin levels were inversely associated with stroke recurrence and composite vascular events. One-year rates of stroke recurrence and composite vascular events were significantly higher in patients with anemia or moderate anemia. In multivariable analyses, moderate anemia remained an independent predictor of stroke recurrence (adjusted hazard ratio, 1.43 [95% CI, 1.16–1.75]) and composite vascular events (adjusted hazard ratio, 1.26 [95% CI, 1.07–1.48]). Moderate anemia increased the risk of composite vascular events in patients with mild-to-moderate stroke severity (National Institutes of Health Stroke Scale score P =0.01 for interaction). Conclusions— Hemoglobin concentration could be an independent predictor of stroke recurrence and composite vascular events.
- Published
- 2020
34. Abstract TP431: Association of Systolic Blood Pressure and Cardiovascularrisk According to Hemoglobin Concentration
- Author
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Sun-Uck Kwon, Jun Young Chang, and Se Young Jang
- Subjects
Advanced and Specialized Nursing ,medicine.medical_specialty ,Optimal cutoff ,Blood pressure ,business.industry ,Internal medicine ,medicine ,Cardiology ,cardiovascular diseases ,Neurology (clinical) ,Hemoglobin ,Cardiology and Cardiovascular Medicine ,business - Abstract
Introduction: We evaluated whether the optimal cutoff of blood pressure to reduce cardiovascular risk is different according to hemoglobin (Hb) concentration and its changing pattern using the National Health Insurance Service-Health Screening Cohort. Methods: The study population consisted of individuals who underwent both 2002-2003 and 2004-2005 health examinations. Individuals who were diagnosed with cardiovascular disease or who died before index date of 1 January 2006 were excluded. The primary outcome of the study was the association between systolic blood pressure (SBP) and MACE (composite of myocardial infarction, stroke, and cardiovascular death) according to Hb concentration. Hazard ratios (HR) were calculated using Cox regression analysis adjusted for age and sex. Results: A total of 290573 were included in the analysis. During the follow up period from 1 January 2006 to 31 December 2013, a total of 18292 experienced MACE. There was a significant interaction between SBP and Hb concentration with regard to cardiovascular diseases (p for interaction= 0.07). Among the subjects with Hb Conclusion: The threshold of SBP which increases cardiovascular risk may be different according to the hemoglobin concentration and change pattern of hemoglobin.
- Published
- 2020
35. High-on-Aspirin Platelet Reactivity Differs Between Recurrent Ischemic Stroke Associated With Extracranial and Intracranial Atherosclerosis
- Author
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Kyung Chul Noh, Hye-yeon Choi, Ho Geol Woo, Jun Young Chang, Sung Hyuk Heo, Dae-il Chang, and Bum Joon Kim
- Subjects
Neurology ,Neurology (clinical) - Abstract
Ischemic stroke recurs despite the use of antiplatelet agents. Various mechanisms are involved in recurrence due to intracranial atherosclerosis (ICAS) and extracranial atherosclerosis (ECAS). High-on-aspirin platelet reactivity (HAPR) may differ between recurrent stroke due to ICAS and ECAS.Patients with recurrent ischemic stroke as a result of large-artery atherosclerosis despite taking aspirin were enrolled consecutively. Ischemic stroke was classified as stroke due to ICAS or ECAS according to the location of the culprit stenosis. An aspirin reaction units (ARU) value of550 IU was defined as HAPR. HAPR and its associated factors were compared between the two groups and also considering the mechanism of stroke.Among the 190 patients with recurrent stroke (111 with ICAS and 79 with ECAS), 36 (18.3%) showed HAPR. The ARU value was higher in the ECAS than the ICAS group (492±83 vs. 465±78, mean±standard deviation;Recurrent stroke due to ECAS was more strongly associated with HAPR and insufficient antiplatelet inhibition than was that due to ICAS. Artery-to-artery embolism was associated with HAPR in recurrent ischemic stroke as a result of ICAS or ECAS.
- Published
- 2022
36. A Study on the Feasibility of a Permanent Performance Contents of a Drone Performance Based on Formation Flight Control Scheme
- Author
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Jun Young Chang, Young Jae Oh, Heon Young Lim, Byung Kyu Park, and Young Ah Rue
- Subjects
Scheme (programming language) ,Robotic art ,Computer science ,Control (management) ,Synchronization (computer science) ,Real-time computing ,Ocean Engineering ,computer ,Drone ,Storytelling ,computer.programming_language - Published
- 2018
37. The Relationship between Blood Pressure Variability, Recanalization Degree, and Clinical Outcome in Large Vessel Occlusive Stroke after an Intra-Arterial Thrombectomy
- Author
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Jung Hwa Lee, Sang-Beom Jeon, O-Ki Kwon, Jun Young Chang, and Moon-Ku Han
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Diastole ,Blood Pressure ,Large vessel ,030204 cardiovascular system & hematology ,Brain Ischemia ,Degree (temperature) ,Disability Evaluation ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,medicine ,Intra arterial ,Humans ,Registries ,Stroke ,Aged ,Retrospective Studies ,Thrombectomy ,business.industry ,Endovascular Procedures ,Recovery of Function ,Middle Aged ,medicine.disease ,Target organ damage ,Treatment Outcome ,Blood pressure ,Neurology ,Occlusive stroke ,Cardiology ,Female ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery - Abstract
Background: Blood pressure variability (BPV) is associated with target organ damage progression and increased cardiovascular events, including stroke. The aim of this study was to evaluate the associations between short-term BPV during acute periods and recanalization degree, early neurological deterioration (END) occurrence, and functional outcomes in acute ischemic stroke patients who had undergone intra-arterial thrombectomy (IAT). Methods: We retrospectively analyzed 303 patients with large vessel occlusive stroke who underwent IAT. The following BPV parameters, measured over 24 and 48 h after IAT, were compared: the mean, SD, coefficient of variation (CV), variation independent of the mean (VIM) for both the systolic BP (SBP) and diastolic BP, and the proportion of nocturnal SBP risers. Results: BPV parameters decreased with higher recanalization degree. The mean SBP (SBPmean) over 24 and 48 h after IAT, and the SD of SBP (SBPSD), CV of SBP (SBPCV), and VIM of SBP (SBPVIM) during the 48 h following the procedure had significant associations with recanalization degree. Patients with END had higher BPV than that of those without END, and the difference was more evident for incomplete recanalization. Increased BPV was associated with a shift toward poor functional outcome at 3 months after adjustment, including recanalization degree (OR range for significant parameters, 1.26–1.64, p = 0.006 for 48 h SBPmean, p = 0.003 for 48 h SBPCV, otherwise p < 0.002). Conclusions: Short-term BPV over 24 and 48 h after IAT in acute ischemic stroke patients was related to recanalization degree, and END occurrence, and may be an independent predictor of clinical outcome.
- Published
- 2018
38. Early partial recanalization after intravenous thrombolysis leads to prediction of favorable outcome in cases of acute ischemic stroke with major vessel occlusion
- Author
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Seunguk Jung, O-Ki Kwon, Se Young Jang, Hyun Oh Park, Jun Young Chang, Moon-Ku Han, and Hee-Joon Bae
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Vessel occlusion ,030204 cardiovascular system & hematology ,Revascularization ,Brain Ischemia ,03 medical and health sciences ,0302 clinical medicine ,Fibrinolytic Agents ,Modified Rankin Scale ,Physiology (medical) ,Odds Ratio ,medicine ,Humans ,Thrombolytic Therapy ,Favorable outcome ,Aged ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,General Medicine ,Odds ratio ,Thrombolysis ,Middle Aged ,Surgery ,Stroke ,Treatment Outcome ,Neurology ,Tissue Plasminogen Activator ,Ischemic stroke ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
We investigated the association between early recanalization degree after intravenous thrombolysis (IVT), occurrence of hemorrhagic transformation, and functional outcome. We also evaluated whether recombinant tissue plasminogen activator (rTPA) dosing error could influence the outcome. Patients with ischemic stroke with major vessel occlusion (n=256) who underwent IVT were included. Recanalization status (no recanalization, partial recanalization, and complete recanalization) was confirmed by subsequent magnetic resonance or conventional angiography. Association between early recanalization degree and favorable outcome (modified Rankin Scale score ≤2) was evaluated using logistic regression analysis. Early partial recanalization was achieved in 33 (12.9%), and complete recanalization in 7 (2.7%) patients. Patients with the highest quintile of rTPA dosage achieved complete recanalization more frequently than the lower four quintiles (8.0% vs 2.0%, P=0.03). Hemorrhagic transformation tended to occur more frequently in patients with complete recanalization as compared with patients with partial recanalization (57.1% vs 21.2%, P=0.15). The proportion of favorable outcome was significantly lower in patients with the highest quintile of rTPA dosage used as compared with the patients with lower four quintiles (40.8%, 57.0%, P=0.04). In multivariable analysis, partial recanalization was significantly associated with favorable outcome (adjusted odds ratio, 3.15; 95% CI, 1.06-9.35), but complete recanalization was not. Early partial recanalization after IVT may be an indicator of favorable outcome with low occurrence of any hemorrhagic transformation.
- Published
- 2017
39. Clinical significance of lncRNA-ATB expression in human hepatocellular carcinoma
- Author
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Won Young Tak, Soo-Young Park, Jung Gil Park, Gyeonghwa Kim, Jun Seob Lee, Young Seok Han, Se Young Jang, Byung-Heon Lee, Hyeong Seok Kim, Yu Rim Lee, Young-Oh Kweon, Jae Min Chun, Won Kee Lee, Jun Sik Yoon, Sang Hoon Kwon, Jun Young Chang, Heon Tak Ha, and Keun Hur
- Subjects
0301 basic medicine ,Oncology ,medicine.medical_specialty ,Pathology ,epithelial mesenchymal transition ,medicine.medical_treatment ,survival ,Targeted therapy ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Medicine ,Clinical significance ,business.industry ,hepatocellular carcinoma ,University hospital ,medicine.disease ,Lncrna expression ,BCLC Stage ,Long non-coding RNA ,030104 developmental biology ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,prognosis ,long noncoding RNA ATB ,Lncrna atb ,business ,Research Paper - Abstract
// Se Young Jang 1, * , Gyeonghwa Kim 2, * , Soo Young Park 1 , Yu Rim Lee 1 , Sang Hoon Kwon 1 , Hyeong Seok Kim 1 , Jun Sik Yoon 1 , Jun Seob Lee 1 , Young-Oh Kweon 1 , Heon Tak Ha 3 , Jae Min Chun 3 , Young Seok Han 3 , Won Kee Lee 4 , Jun Young Chang 5 , Jung Gil Park 6 , Byungheon Lee 2 , Won Young Tak 1 and Keun Hur 2 1 Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea 2 Department of Biochemistry and Cell Biology, Cell and Matrix Research Institute, School of Medicine, Kyungpook National University, Daegu, Republic of Korea 3 Department of Surgery, Kyungpook National University School of Medicine, Daegu, Republic of Korea 4 Biostatistics, Medical Research Collaboration Center in Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Republic of Korea 5 Department of Neurology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea 6 Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea * These authors contributed equally to this work Correspondence to: Keun Hur, email: KeunHur@knu.ac.kr Won Young Tak, email: wytak@knu.ac.kr Keywords: hepatocellular carcinoma, long noncoding RNA ATB, survival, prognosis, epithelial mesenchymal transition Received: June 28, 2017 Accepted: September 04, 2017 Published: September 20, 2017 ABSTRACT Hepatocellular carcinoma (HCC) is a worldwide health problem and it is important to understand the mechanistic roles of the biomolecules involved in its pathogenesis. Long non-coding RNAs (lncRNAs) are frequently and aberrantly expressed in various human cancers and are known to play a role in cancer pathogenesis. The aim of this study was to analyze the expression of lncRNA-ATB in HCC and investigate the implications for prognoses. In total, 100 samples of HCC tissues and their corresponding, adjacent, non-cancerous liver tissues were collected. Total RNAs were extracted and the expression levels of lncRNA-ATB were measured by qRT-PCR. The association of lncRNA expression with clinicopathological features and patient survival were then analyzed. LncRNA-ATB was significantly upregulated in HCC tissues compared with the levels in corresponding non-cancerous tissues. Expression of lncRNA-ATB was significantly associated with portal vein thrombosis, intrahepatic or extrahepatic metastases, mUICC stage, and the BCLC stage. Large tumors (> 5 cm, HR = 3.851, 95% CI = 1.431–10.364, p = 0.008) and higher lncRNA-ATB expression (HR = 4.158, 95% CI = 1.226–14.107, p = 0.022) were the significant prognostic factors for overall survival. With this novel evidence of the involvement of lncRNA-ATB in HCC pathogenesis and clinical features, lncRNA-ATB can be concluded to have potential as a biomarker for the prognosis of HCC and as a targeted therapy for afflicted patients.
- Published
- 2017
40. A Dedicated Neurological Intensive Care Unit Offers Improved Outcomes for Patients With Brain and Spine Injuries
- Author
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Jun Young Chang, Kiwon Lee, Kyu Sun Yum, Jae Seung Bang, Won Joo Jeong, Jin-Heon Jeong, Jeong-Ho Hong, and Moon Ku Han
- Subjects
medicine.medical_specialty ,business.industry ,030208 emergency & critical care medicine ,Critical Care and Intensive Care Medicine ,Intensive care unit ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,law ,medicine ,Spine injury ,Neurointensive care unit ,Neurological intensive care unit ,Intensive care medicine ,business - Abstract
Background: Admission to an intensive care unit (ICU) specialized for brain and spine injury patients is associated with improved outcome. We investigated the effects of the first dedicated, combined neurological and neurosurgical ICU (NeuroICU) in Korea on patient outcomes. Methods: The first dedicated NeuroICU in Korea was established in March 2013. We retrospectively analyzed the clinical data and compared the outcomes between patients admitted to the ICU before and after NeuroICU establishment. The predicted mortality of NeuroICU patients was calculated using their Acute Physiology and Chronic Health Evaluation II scores. Patients’ functional outcomes were evaluated using their modified Rankin scale (mRS) scores at 6 months after ICU admission, which were obtained from medical records or telephone interviews. Results: We included 2487 patients, 1572 and 915 of whom were admitted prior to and after NeuroICU establishment, respectively. The demographic characteristics, Glasgow Coma Scale scores, and disease proportions did not differ significantly between the groups. The length of ICU stay and the number of days on ventilation were significantly lower in NeuroICU patients than they were in general ICU patients ( P = .024, P = .001). Intensive care unit mortality was significantly lower in NeuroICU patients (7.3% vs 4.7%, P = .012). The predicted mortality was obtained from 473 NeuroICU patients. The mortality ratio (observed mortality/predicted mortality) was 0.34 (8.9%/26.1%), and 228 (48.1%) patients showed good functional recovery (mRS, 0-2). Conclusion: Our findings suggest that admission to a dedicated NeuroICU significantly improves the neurological outcomes of patients with brain and spine injuries, including their postoperative care, in Korea.
- Published
- 2017
41. Dominant vertebral artery status and functional outcome after endovascular therapy of symptomatic basilar artery occlusion
- Author
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Jun Young Chang, Moon Ku Han, Cheolkyu Jung, Seunguk Jung, O-Ki Kwon, and Hee-Joon Bae
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Male ,medicine.medical_specialty ,Younger age ,Computed Tomography Angiography ,Vertebral artery ,Clinical manifestation ,Endovascular therapy ,030218 nuclear medicine & medical imaging ,Lesion ,03 medical and health sciences ,0302 clinical medicine ,medicine.artery ,Occlusion ,Vertebrobasilar Insufficiency ,Basilar artery ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Vertebral Artery ,Aged ,Aged, 80 and over ,Radiological and Ultrasound Technology ,business.industry ,Endovascular Procedures ,Basilar artery occlusion ,Surgery ,Treatment Outcome ,Basilar Artery ,Female ,Neurology (clinical) ,medicine.symptom ,business ,Magnetic Resonance Angiography ,030217 neurology & neurosurgery - Abstract
Summary Background and purpose To determine whether status of dominant vertebral artery could affect clinical outcome in patients with symptomatic basilar artery occlusion (BAO). Methods We reviewed patients with symptomatic BAO who underwent endovascular treatment at the institute between January 2007 and July 2014. Patients were categorized into 2 groups according to functional outcome and baseline characteristics, treatment related factors were compared. Variables including clinical and imaging parameters were also compared according to the dominant V1 lesion. Results Fifty-nine of 101 patients underwent endovascular treatment and 23 patients (39.0%) showed favorable outcome (modified Rankin score ≤3 at 3 month). Younger age, male sex, lower baseline NIHSS score, higher PC-ASPECTS, absence of hemorrhagic transformation, shorter procedure time, and complete recanalization were associated with favorable outcome. Procedure time tended to be longer in patients with dominant V1 lesion (130.0; range, 105.0–179.0 vs. 101.5; range, 48.0–138.0, P = 0.05). Among patients with large artery disease (LAD), higher initial NIHSS, and clinical manifestation of decreased mental status were significantly associated with dominant V1 lesion. Endovascular procedure time tended to be longer, distal basilar occlusion tended to be more frequent, and proportion of the patients with complete recanalization tended to be less in patient with dominant V1 lesion. Poor outcome tended to be more frequent in dominant V1 lesion with LAD (88.9% vs. 42.9%, P = 0.05). These findings were comparable in patients who underwent mechanical thrombectomy. Conclusion Dominant V1 steno-occlusion may be associated with poor functional outcome in patients with the symptomatic BAO. Status of dominant VA and various treatment strategy should be considered when performing endovascular treatment for recanalization in patients with symptomatic BAO.
- Published
- 2017
42. Numerical analysis on the reduction of the inflow of black carbon from a road into an elementary school by a noise barrier
- Author
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Jun-Young Chang, Ho-Hyun Kim, Sung, Minki, and Seongmin Jo
- Subjects
Reduction (complexity) ,Physics ,Petroleum engineering ,business.industry ,Numerical analysis ,Environmental engineering ,Carbon black ,Inflow ,Computational fluid dynamics ,business ,Noise barrier - Published
- 2016
43. DGA-based malware detection using DNS traffic analysis
- Author
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Jun Young Chang, Jong Youn Lee, and Eul Gyu Im
- Subjects
021110 strategic, defence & security studies ,Domain generation algorithm ,Network security ,business.industry ,Computer science ,Domain Name System ,0211 other engineering and technologies ,020206 networking & telecommunications ,02 engineering and technology ,computer.software_genre ,Domain (software engineering) ,Software security assurance ,Server ,0202 electrical engineering, electronic engineering, information engineering ,Malware ,Malware analysis ,business ,computer ,Computer network - Abstract
A large number of malicious software communicate with C & C (Command and Control) servers to download resources for malicious actions or to receive commands to perform desired attacks. Malware needs to know C & C servers' IP addresses to communicate with, and these IP addresses are usually obtained through DNS (Domain Name System) communications by sending domain names to DNS servers instead of using hard-coded IP addresses in order to avoid analysis and detection. In this process, malware usually uses DGA (Domain Generation Algorithm) to hide domain names of C & C servers and to make difficult to block C & C servers or domain names. Although DGA techniques have been studied extensively, most of previous studies have been based on the analysis of the domain names generated by DGA focusing on the characteristics of the strings. However, this kind of analysis methods has difficulties to detect some domain names generated by DGA with creative criteria. In this paper, we have conducted research to detect malicious code generated by DGA based on the value of flags included in the DNS communication process, deviating from the existing research focusing on domain name only.
- Published
- 2019
44. Abstract WP217: Light Alcohol Increment May Have Protective Effect on Cardiovascular Disease Occurrence Among Nondrinkers
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Seulggie Choi, Jun-Young Chang, Se Young Jang, and Sang Min Park
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Advanced and Specialized Nursing ,medicine.medical_specialty ,Disease occurrence ,business.industry ,Alcohol ,Moderate amount ,Disease ,medicine.disease ,Coronary heart disease ,chemistry.chemical_compound ,chemistry ,Internal medicine ,medicine ,Alcohol intake ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,business ,Stroke ,Alcohol consumption - Abstract
Introduction: Light to moderate amount of alcohol intake may have preventive effect on cardiovascular disease. Even though the benefit of light to moderate alcohol consumption, nondrinkers are not advised to start drinking. The purpose of our study is to evaluate the association between alcohol consumption increment and primary prevention of major adverse cardiovascular events (MACE), such as stroke, coronary artery disease, or cardiovascular death, among nondrinkers. Methods: The National Health Insurance Service (NHIS) data collected from 2007 to 2013 was used for the analysis. Among the subjects who completed data on their drinking status both the first (2007-2008) and the second (2009-2010) medical checkup, the subjects who respond not to drink at all at the first NHIS medical checkup were included. Alcohol increment, measured by glass per day at the second medical checkup, was categorized into 0, 0< ≤1, 1< ≤ 2, 2< ≤4, >4. Hazard ratios (HRs) and 95% confidence interval (CI) for alcohol increment and MACE occurrence were calculated using Cox regression analysis. Results: Among 284511 subjects who performed both first and second medical checkup, nondrinker was 115870 (40.7%). Compared with the group who maintain nondrinking at the second checkup, the risk of MACE significantly decreased among the subjects with alcohol increment equal or less than 1 glass per day (HR 0.78, 95% CI 0.64-0.93). The risk of stroke, coronary artery disease, and all cause death were also decreased only the group with alcohol increment equal or less than 1 glass per day (stroke, HR 0.89, 95% CI 0.60-0.99; coronary artery disease, HR 0.74, 95% CI 0.56-0.98; all cause death, HR 0.75, 95% CI 0.58-0.97). The protective effect of light alcohol increment (0< ≤1) on MACE was not maintained among the subgroup with female, history of hypertension, current smoking. Conclusion: Light alcohol increment equal or less than 1 glass per day from nondrinking significantly reduced the risk of MACE occurrence.
- Published
- 2019
45. Postreperfusion Blood Pressure Variability After Endovascular Thrombectomy Affects Outcomes in Acute Ischemic Stroke Patients With Poor Collateral Circulation
- Author
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Jun Young Chang, Sang-Beom Jeon, Cheolkyu Jung, Dong Seok Gwak, and Moon-Ku Han
- Subjects
medicine.medical_specialty ,viruses ,Ischemia ,030204 cardiovascular system & hematology ,lcsh:RC346-429 ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Occlusion ,medicine ,collateral circulation ,Stroke ,lcsh:Neurology. Diseases of the nervous system ,Computed tomography angiography ,Original Research ,medicine.diagnostic_test ,business.industry ,Confounding ,blood pressure ,biochemical phenomena, metabolism, and nutrition ,medicine.disease ,Collateral circulation ,stroke ,Mean blood pressure ,Blood pressure ,Neurology ,thrombectomy ,Cardiology ,Neurology (clinical) ,business ,computed tomography angiography ,030217 neurology & neurosurgery - Abstract
Background and Purpose: We evaluated the effect of 24 h blood pressure variability (BPV) on clinical outcomes in acute ischemic stroke patients with successful recanalization after endovascular recanalization therapy (ERT). Methods: Patients with anterior circulation occlusion were evaluated if they underwent ERT based on multiphase computed tomography angiography and achieved successful recanalization (≥thrombolysis in cerebral ischemia 2b). Collateral degrees were dichotomized based on the pial arterial filling score, with a score of 0-3 defined as a poor collateral status. BPV parameters include mean, standard deviation, coefficient of variation, and variation independent of the mean (VIM) for systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure, and pulse rate (PR). These parameters were measured for 24 h after ERT and were analyzed according to occlusion sites and stroke mechanisms. Associations of BPV parameters with clinical outcomes were investigated with stratification based on the baseline collateral status. Results: BPV was significantly different according to the occlusion sites and stroke mechanisms, and higher BPV was observed in patients with internal carotid artery occlusion or cardioembolic occlusion. After adjustment for confounders, most BPV parameters remained significant to predict functional outcomes at 3 months in patients with poor collateral circulation. However, no significant association was found between BPV parameters and clinical outcomes in patients with good collateral circulation. Conclusion: Postreperfusion BP management by decreasing BPV may have influence on improving clinical outcome in cases of poor collateral circulation among patients achieving successful recanalization after ERT.
- Published
- 2018
46. Chronic Exposure to Lead and Cadmium in Residents Living near a Zinc Smelter
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HyeJeong Jo, Geun-Bae Kim, Chulwoo Lee, Kwan Lee, Jun-Young Chang, and Bo-Eun Lee
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Male ,Chronic exposure ,cadmium ,Health, Toxicology and Mutagenesis ,environmental exposure ,lcsh:Medicine ,chemistry.chemical_element ,010501 environmental sciences ,01 natural sciences ,Article ,03 medical and health sciences ,0302 clinical medicine ,Exposure group ,Adverse health effect ,Environmental health ,Republic of Korea ,Zinc smelter ,Humans ,Medicine ,030212 general & internal medicine ,Aged ,0105 earth and related environmental sciences ,lead ,Cadmium ,business.industry ,lcsh:R ,technology, industry, and agriculture ,Public Health, Environmental and Occupational Health ,Environmental exposure ,polluted area ,zinc smelter ,Zinc ,chemistry ,Female ,Environmental Pollution ,business - Abstract
This study aimed to measure lead (Pb) and cadmium (Cd) exposure levels in residents living near a zinc (Zn) smelter in Seokpo-myeon, Bonghwa-gun, South Korea, and identify factors affecting exposure. Residents aged ≥20 years living within 3 km and ≥30 km away from the smelter were classified as the exposure group (n = 549), and the control group (n = 265), respectively. Data were obtained through a questionnaire survey. Blood Pb levels in the exposure group (4.19 µg/dL) were higher than in the control group (2.70 µg/dL). The exposure group (1.32 µg/L) also had higher urinary Cd concentrations than the control group (0.80 µg/L). Male sex, older age, previous work at the smelter, smoking, and proximity to the smelter were associated with higher blood Pb levels on multivariate analysis, urinary Cd concentration was significantly higher in women, those who were older, those with experience of working in a Zn smelter or mine, those with proximity to the Zn smelter, and those who consumed locally grown vegetables. In conclusion, Zn smelters are major source of Pb and Cd pollution and require ongoing public health management to prevent potential adverse health effects.
- Published
- 2021
47. Mechanism of Stroke According to the Severity and Location of Atherosclerotic Middle Cerebral Artery Disease
- Author
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Bum Joon Kim, Sang Hun Lee, Jun Young Chang, Dae-Il Chang, Sang Hee Ha, Sung Hyuk Heo, and Kyung Mi Lee
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Databases, Factual ,Platelet Aggregation ,Infarction ,Hemodynamics ,Disease ,Severity of Illness Index ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,medicine.artery ,Internal medicine ,Occlusion ,medicine ,Humans ,cardiovascular diseases ,Stroke ,Aged ,Ischemic Stroke ,Retrospective Studies ,Aged, 80 and over ,Rupture, Spontaneous ,business.industry ,Rehabilitation ,Infarction, Middle Cerebral Artery ,Middle Aged ,Intracranial Arteriosclerosis ,medicine.disease ,Plaque, Atherosclerotic ,Cerebral Angiography ,Stenosis ,Diffusion Magnetic Resonance Imaging ,Intracranial Embolism ,Embolism ,Cerebrovascular Circulation ,Middle cerebral artery ,cardiovascular system ,Cardiology ,Female ,Surgery ,Neurology (clinical) ,Intracranial Thrombosis ,Cardiology and Cardiovascular Medicine ,business ,Magnetic Resonance Angiography ,030217 neurology & neurosurgery - Abstract
Strategy for secondary prevention of ischemic stroke depends on the mechanism of stroke. The aim of this study was to compare the stroke mechanism according to the location and severity of middle cerebral artery (MCA) disease.We analyzed acute ischemic stroke patients within 7 days of onset with symptomatic MCA disease. The location of MCA disease was classified into proximal MCA M1 (pMCA) and distal MCA M1/proximal M2 (dMCA). The mechanism of stroke was categorized according to the pattern of ischemic lesion: local branch occlusion, artery-to-artery embolism/hemodynamic infarction, in situ-thrombosis, or a combined mechanism. The mechanism and imaging characteristics of stroke were compared according to the location and severity. The factors associated with the stroke mechanism were also investigated.A symptomatic MCA disease was observed in 126 patients (74 pMCA and 52 dMCA). The mechanism of stroke differed according to the location (p 0.001); the combined mechanism was most common in pMCA disease (54.1%), especially in those who presented with MCA occlusion and with a susceptible vessel sign. Artery-to-artery embolism/hemodynamic infarction was most common in dMCA disease (46.2%). A longer length of stenosis was observed in local branch occlusion than in other mechanisms (p = 0.04) and was an independent factor associated with local branch occlusion (OR=1.631, 95% CI=1.161-2.292; p = 0.005).The mechanism of stroke differed according to the location of MCA disease: occlusion caused by plaque rupture with combined mechanism of stroke type was predominant in pMCA. Longer length of stenosis was associated with local branch occlusion.
- Published
- 2021
48. A Case Study on the Evaluation of Environmental Health Status based on Environmental Health Indicators
- Author
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Kyunghee Choi, Jun-Young Chang, Soon-Won Jung, Sung-Joon Hong, Choong-Hee Park, Young-Mee Lee, and Seung-Do Yu
- Subjects
03 medical and health sciences ,0302 clinical medicine ,Geography ,010504 meteorology & atmospheric sciences ,business.industry ,Environmental health ,Fuzzy set ,Principal component analysis ,Environmental resource management ,030212 general & internal medicine ,business ,01 natural sciences ,0105 earth and related environmental sciences - Published
- 2016
49. A Comparison between Mechanical Thrombectomy and Intra-arterial Fibrinolysis in Acute Basilar Artery Occlusion: Single Center Experiences
- Author
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Jun Young Chang, Cheolkyu Jung, Bae Ju Kwon, Seunguk Jung, Moon-Ku Han, Sang Wha Lee, Jae Hyoung Kim, Beom Joon Kim, Byung Se Choi, Youn Jung Bae, Sang-Hoon Cha, and Hee-Joon Bae
- Subjects
lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,medicine.medical_treatment ,Single Center ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,medicine.artery ,Internal medicine ,Fibrinolysis ,Intra arterial ,Basilar artery ,Medicine ,basilar artery ,In patient ,thrombolytic therapy ,business.industry ,Cerebral infarction ,Basilar artery occlusion ,cerebral infarction ,medicine.disease ,Mechanical thrombectomy ,thrombectomy ,lcsh:RC666-701 ,Cardiology ,Original Article ,Neurology (clinical) ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery - Abstract
Background and Purpose Recent advances in intra-arterial techniques and thrombectomy devices lead to high rate of recanalization. However, little is known regarding the effect of the evolvement of endovascular revascularization therapy (ERT) in acute basilar artery occlusion (BAO). We compared the outcome of endovascular mechanical thrombectomy (EMT) versus intra-arterial fibrinolysis (IAF)-based ERT in patients with acute BAO. Methods After retrospectively reviewed a registry of consecutive patients with acute ischemic stroke who underwent ERT from September 2003 to February 2015, 57 patients with acute BAO within 12 hours from stroke onset were enrolled. They were categorized as an IAF group (n=24) and EMT group (n=33) according to the primary technical option. We compared the procedural and clinical outcomes between the groups. Results The time from groin puncture to recanalization was significantly shorter in the EMT group than in the IAF group (48.5 [25.3 to 87.8] vs. 92 [44 to 179] minutes; P=0.02) The rate of complete recanalization was significantly higher in the EMT group than in the IAF group (87.9% vs 41.7%; P
- Published
- 2016
50. Investigation on Field Applicability through Linked Treatment of Element Technology for Water Purification
- Author
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Seung-Wook Son, Jun-Seok Park, Jun-Young Chang, Dae-Seuk Seo, Joon-Heon Lee, Yun-Yung Kim, and Bong-Kyun Kim
- Subjects
geography ,geography.geographical_feature_category ,Revetment ,Field (physics) ,Detention basin ,Environmental engineering ,Environmental science ,Wetland ,Portable water purification - Published
- 2015
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