Publications by authors named "Chung Eun Lee"

48 Publications

Factors associated with caring behaviors of family caregivers for patients receiving home mechanical ventilation with tracheostomy: A cross-sectional study.

PLoS One 2021 21;16(7):e0254987. Epub 2021 Jul 21.

College of Nursing Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea.

Background: The number of patients on home mechanical ventilation (HMV) worldwide has been steadily rising as medical technological advanced. To ensure the safety and quality care of the patients receiving HMV with tracheostomy, caring behavior of family caregivers is critical. However, studies on caring behavior of family caregivers and its associated factors were remained unexplored. This study aimed to describe the caring behaviors of family caregivers for patients receiving home mechanical ventilation with tracheostomy and to identify factors associated with their caring behaviors.

Methods: This was a cross-sectional study for 95 family caregivers for patients with invasive home mechanical ventilation in South Korea. Caring behaviors were assessed by the Caring Behavior Scale with 74 items with 5-point Likert scale. Data were analyzed using multiple regression analysis.

Results: Caring behaviors score of caregivers was 304.68±31.05 out of 370. They were significantly associated with knowledge on emergency care (β = 0.22, p = .011), number of required instruments for care (β = 0.21, p = .010), frequency of home visit care (β = 0.19, p = .017), experience of emergency situation for the last six months (β = 0.19, p = .009) and activities of daily living of patient (β = 0.27, p = .002).

Conclusion: Development of standardized multidisciplinary discharge education for improving the caring capacity of caregivers is required for successful and healthy application of home mechanical ventilation.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0254987PLOS
July 2021

Development, Feasibility, and Acceptability of a Nationally Relevant Parent Training to Improve Service Access During the Transition to Adulthood for Youth with ASD.

J Autism Dev Disord 2021 Jul 7. Epub 2021 Jul 7.

Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, USA.

Many youth with autism spectrum disorder (ASD) face challenges accessing needed services as they transition to adulthood. The present study describes the development, feasibility and acceptability of a new intervention designed to teach parents of transition-aged youth with ASD about the adult service system and the most effective ways to access services and supports. As part of a randomized-controlled trial, the intervention-named ASSIST-was delivered to 91 participants in three states in the U.S. Results suggested that ASSIST is feasible and acceptable to participants. Though intended to be an in-person group-based program, due to COVID-19 restrictions ASSIST was primarily delivered online. Results and discussion explore the trade-offs and implications of these different treatment delivery modalities in relation to ASSIST.
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http://dx.doi.org/10.1007/s10803-021-05128-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8262127PMC
July 2021

Goal attainment scaling-community-based: A method to incorporate personalized outcomes into intervention research with youth and adults on the autism spectrum.

Autism 2021 Jun 15:13623613211024492. Epub 2021 Jun 15.

Vanderbilt University Medical Center, USA.

Lay Abstract: Among people with autism-all who have the same diagnosis-there are major differences on a nearly limitless number of areas, such as language, daily living skills, intellectual ability, sensory difficulties, and physical and mental health diagnoses. Despite these many differences, the targeted outcomes of intervention studies are often measured the same way across autistic adults, including outcomes such as getting a job, achieving greater independence, or getting more services. People have different goals and abilities, and it is important to have a way for intervention studies to measure outcomes in a way that is more personal to each individual. To address this issue, we developed a new approach-called "Goal Attainment Scaling-Community-based" or GAS-CB-to measure individualized outcomes across different research settings. In this article, we describe the need for individualized outcomes in autism intervention research and current approaches to gathering these outcomes, with our discussion focused on a method called goal attainment scaling. We then describe reasons why current goal attainment scaling approaches might not be useful in intervention research that takes place in the community. Finally, we discuss a new goal attainment scaling approach (GAS-CB) that can be flexibly used for research participants with very different characteristics.
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http://dx.doi.org/10.1177/13623613211024492DOI Listing
June 2021

Who Is Leading the Field in 2020?: AAIDD Students and Early Career Professionals.

Intellect Dev Disabil 2021 Jun;59(3):217-223

Susan M. Havercamp, Ohio State University.

The American Association on Intellectual and Developmental Disabilities (AAIDD) has been a leader in the field of intellectual and developmental disabilities since its founding in 1876. Today, student and early career professionals make up approximately 8.5% of the organization, with their engagement supported by the Student and Early Career Professional Interest Network (SECP). An article by Havercamp et al. (2003), "Who Will Lead the Field Beyond 2020?", recommended organizational changes that have been largely addressed in the years following by SECP. The present research replicates Havercamp et al.'s (2003) original survey of the organization's student and early career professionals, and results support the effectiveness of SECP as a welcoming platform from which students and early career professionals can establish themselves in the organization.
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http://dx.doi.org/10.1352/1934-9556-59.3.217DOI Listing
June 2021

A scoping review of cross-cultural experiences of siblings of individuals with intellectual and developmental disabilities in the United States.

Res Dev Disabil 2021 May 28;112:103916. Epub 2021 Feb 28.

Univeristy of Kansas Medical Center, Kansas City, KS, USA.

Background: Siblings undergo unique experiences in growing up with brothers and sisters with intellectual and developmental disabilities (IDD). Although sibling relationships or adjustments among individuals with IDD have received greater attention from the disability field, there has been still less attention to how cultural identities (e.g., race, ethnicity) may influence experiences of siblings of individuals with IDD.

Aim: This study used scoping review methodology to understand cross-cultural experiences of siblings of individuals with IDD in the United States.

Method: Eight articles met inclusion criteria, using the PubMed, Web of Knowledge, PsycINFO, and ERIC databases.

Results: Studies reported the impact of cultural identities on sibling emotional and behavioral functioning, school functioning, and caregiving responsibilities.

Conclusions: The need for culturally responsive sibling interventions and implications for international contexts is discussed.
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http://dx.doi.org/10.1016/j.ridd.2021.103916DOI Listing
May 2021

Examining Growth Among College Students With Intellectual and Developmental Disability: A Longitudinal Study.

Behav Modif 2021 03 23;45(2):324-348. Epub 2020 Dec 23.

Vanderbilt University Medical Center, Nashville, TN, USA.

Inclusive postsecondary education programs for adults with intellectual and developmental disabilities (IDD) are proliferating across the United States. Although college can be a formative time for any student, there has been limited research on the growth that college students with IDD may experience during their time on campus. We address this gap by using a longitudinal design to examine the adaptive behavior, self-determination, executive functioning, and social skills of college students with IDD across three points in time-upon initial entry into the program, at the end of their first year, and at the end of their second year. Analyses suggested significant improvements in adaptive behavior and self-determination across the first year of the program. We offer recommendations for research and practice aimed at documenting and promoting growth for students with IDD throughout their collegiate experience.
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http://dx.doi.org/10.1177/0145445520982968DOI Listing
March 2021

Internet use among adults with intellectual and developmental disabilities in South Korea.

J Appl Res Intellect Disabil 2021 May 27;34(3):724-732. Epub 2020 Nov 27.

Department of General Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.

Background: It is evident that people with disabilities worldwide face digital divide; although this divide has been mitigated owing to greater access to technologies, a gap remains in terms of Internet use. Given that South Korea has one of the highest Internet access rates, it is necessary to examine how adults with intellectual and developmental disabilities (IDD) access the Internet, and what correlates with Internet usage.

Method: A total of 298 adults with IDD in South Korea participated in the survey.

Results: The participants reported benefits from the Internet including increased opportunities for leisure and entertainment, updated news and networking with friends. Internet access was found to be pervasive among people of younger ages and less severe disabilities. Further, Internet usage corresponded to material access, digital literacy and a positive attitude towards digital applications.

Conclusions: Targeted digital literacy programmes can be developed for adults with IDD.
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http://dx.doi.org/10.1111/jar.12843DOI Listing
May 2021

Chemical pleurodesis with L. extract for secondary spontaneous pneumothorax in elderly patients.

J Thorac Dis 2020 Oct;12(10):5440-5445

The Department of Cardiothoracic surgery, School of Medicine, Gyeonsang National University, Gyeongsang National University Chang-Won Hospital, Chang-Won, Republic of South Korea.

Background: Secondary spontaneous pneumothorax is generally managed by surgery, if pneumothorax was not improved following chest tube insertion or in the event of persistent air leakage lasting more than 5 days. However, if surgery is not an option, chemical pleurodesis with sclerosants can be performed. Several sclerosants have been used in the chemical pleurodesis of secondary spontaneous pneumothorax, However, there is still controversy for what is the ideal sclerosant for Secondary spontaneous pneumothorax. The use of L. for chemical pleurodesis in patients with secondary spontaneous pneumothorax aged >65 years has not been described to date, despite its extensive use. The authors tried to find out the effect of L. for sclerosant for Secondary spontaneous pneumothorax in elder.

Methods: This retrospective analysis examined 25 patients (aged >65 years) with secondary spontaneous pneumothorax with persistent air leakage who underwent chemical pleurodesis with Abnova Viscum-F ( L.).

Results: The duration of chest tube drainage was 5.08 days after chemical pleurodesis. Adverse effects related to chemical pleurodesis with Abnova Viscum-F were fever (7/25), pain (4/25), leukocytosis (10/25), and dyspnea with desaturation (7/25); however all the patients recovered without sequela and were subsequently discharged.

Conclusions: The present study demonstrated the successful use of chemical pleurodesis with L. in the management of elderly patients with secondary spontaneous pneumothorax. Because of the high probability of dyspnea with desaturation in the elderly, caution must be exercised.
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http://dx.doi.org/10.21037/jtd-20-708DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7656335PMC
October 2020

Veno-Arterial-Venous Extracorporeal Membrane Oxygenation in a Critically Ill Patient with Coronavirus Disease 2019.

Medicina (Kaunas) 2020 Sep 30;56(10). Epub 2020 Sep 30.

Department of Thoracic and Cardiovascular Surgery, Institute Health Science, College of Medicine, Gyeongsang National University, Gyeongsang National University Jinju Hospital, Jinju 52727, Korea.

Patients with cardiopulmonary failure may not be fully supported with typical configurations of extracorporeal membrane oxygenation (ECMO), either veno-arterial (VA) or veno-venous (VV). Veno-arterial-venous (VAV)-ECMO is a technique used to support the cardiopulmonary systems during periods of inadequate gas exchange and perfusion. In the severe case of coronavirus disease 2019 (COVID-19), which simultaneously affects the heart and lung, VAV-ECMO may improve a patient's recovery potential. We report the case of a 72-year-old woman with acute respiratory distress syndrome and circulatory failure following COVID-19, who was treated with VAV-ECMO.
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http://dx.doi.org/10.3390/medicina56100510DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7600367PMC
September 2020

Future planning for individuals with intellectual and developmental disabilities: Perspectives of siblings in South Korea.

J Appl Res Intellect Disabil 2021 Jan 17;34(1):286-294. Epub 2020 Sep 17.

Department of Social Welfare, Soongsil University, Seoul, Korea.

Background: Future planning has emerged as a global issue for families of individuals with intellectual and developmental disabilities due to the longer lives and limited long-term services and supports in the adult disability system. While it has received greater attention, most future planning studies only included parents of individuals with intellectual and developmental disabilities within the context of European or American countries. The purpose of this study was to examine future planning among siblings of individuals with intellectual and developmental disabilities in South Korea.

Method: In this study, 185 Korean siblings of individuals with intellectual and developmental disabilities responded to a survey.

Results: Few siblings engaged in future planning activities and reported a range of barriers to conduct future planning. Further, greater future planning involvement was associated with older siblings, greater advocacy level and greater sibling caregiving.

Conclusion: For future research, culturally relevant measures and intervention should be addressed.
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http://dx.doi.org/10.1111/jar.12806DOI Listing
January 2021

Exploring the nature and correlates of caregiving among parents of adults with intellectual and developmental disabilities.

J Appl Res Intellect Disabil 2020 Nov 20;33(6):1259-1267. Epub 2020 Apr 20.

Department of Disability Studies, University of California at Berkeley, Berkeley, California.

Background: As adults with intellectual and developmental disabilities (IDD) have longer lives, parents may remain caregivers into old age. In addition, it is unknown who will fulfil caregiving roles after parents are no longer able to be caregivers. In the current study, we explored the nature (e.g. number of hours of caregiving) and correlates of parental caregiving for their adult offspring with intellectual and developmental disabilities and their future caregiving plans.

Method: In the United States, data were collected from 334 parents of adults with intellectual and developmental disabilities via a national survey.

Results: Altogether, 55% of the sample spent more than 15 hr conducting caregiving per week. Individual characteristics (e.g. maladaptive behaviour and functional abilities) and parent characteristics (e.g. physical proximity of the adult with intellectual and developmental disabilities and caregiving ability) positively correlated with caregiving hours. Notably, 38.58% of participants were unsure who would fulfil caregiving roles.

Conclusion: Implications for research about caregiving and practice are discussed.
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http://dx.doi.org/10.1111/jar.12745DOI Listing
November 2020

Compound sibling caregivers of individuals with intellectual and developmental disabilities.

J Appl Res Intellect Disabil 2020 Sep 19;33(5):1069-1079. Epub 2020 Mar 19.

University of California at Berkeley, Berkeley, CA, USA.

Background: Given the increasing lifespans of individuals with intellectual and developmental disabilities (IDD), siblings may fulfil multiple caregiving roles simultaneously for their ageing parents, their offspring, and their brother or sister with IDD. Yet, little is known about compound sibling caregivers. The purpose of this study was to compare the perspectives of compound, single and non-caregiving siblings of adults with IDD.

Method: This study investigated 332 adult siblings of individuals with IDD in the United States via a national web-based survey. Participants included: 152 non-caregivers, 94 single caregivers (i.e., caregivers only for their brothers and sisters with IDD), and 86 compound caregivers (i.e., caregivers for their brothers and sisters with IDD and at least one other vulnerable individual).

Results: Single and compound sibling caregivers (versus non-caregivers) had more positive relationships and conducted greater advocacy and future planning activities.

Conclusions: Given the potential for compound sibling caregiving, further investigation is warranted.
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http://dx.doi.org/10.1111/jar.12729DOI Listing
September 2020

Assessment of the Initial Risk Factors for Mortality among Patients with Severe Trauma on Admission to the Emergency Department.

Korean J Thorac Cardiovasc Surg 2019 Dec 5;52(6):400-408. Epub 2019 Dec 5.

Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea.

Background: For decades, trauma has been recognized globally as a major cause of death. Reducing the mortality of patients with trauma is an extremely pressing issue, particularly for those with severe trauma. An early and accurate assessment of the risk of mortality among patients with severe trauma is important for improving patient outcomes.

Methods: We performed a retrospective medical record review of 582 patients with severe trauma admitted to the emergency department between July 2011 and June 2016. We analyzed the associations of in-hospital mortality with the baseline characteristics and initial biochemical markers of patients with severe trauma on admission.

Results: The overall in-hospital mortality rate was 14.9%. Multivariate logistic regression analysis showed that the patient's Rapid Emergency Medicine Score (REMS; odds ratio [OR], 1.186; 95% confidence interval [CI], 1.018-1.383; p=0.029), Emergency Trauma Score (EMTRAS; OR, 2.168; 95% CI, 1.570-2.994; p<0.001), serum lactate levels (SLL; OR, 1.298; 95% CI, 1.118-1.507; p<0.001), and Injury Severity Score (ISS; OR, 1.038; 95% CI, 1.010-1.130; p=0.021) were significantly associated with in-hospital mortality.

Conclusion: The REMS, EMTRAS, and SLL can easily and rapidly be used as alternatives to the injury severity score to predict in-hospital mortality for patients who present to the emergency department with severe trauma.
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http://dx.doi.org/10.5090/kjtcs.2019.52.6.400DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6901184PMC
December 2019

Perspectives about adult sibling relationships: A dyadic analysis of siblings with and without intellectual and developmental disabilities.

Res Dev Disabil 2020 Jan 26;96:103538. Epub 2019 Nov 26.

Boston University Two Silber Way Boston, MA 02215 United States; Vanderbilt University, United States; University of Illinois at Urbana-Champaign, United States; University of Minnesota, United States.

Most siblings of individuals with intellectual and developmental disabilities (IDD) report positive sibling relationships. However, extant research often only examines the perspective of the nondisabled sibling; it is unclear whether siblings with IDD report close sibling relationships. Thus, the aim of this study was to understand adult sibling relationships from the perspectives of both siblings with and without IDD. Using dyadic interviews, we examined the perspectives of eight adult sibling dyads. The study was conducted in the United States. Data were analyzed using constant comparative analysis and cross-case analysis to identify themes within and across dyads. Overall, siblings with and without IDD reported enjoying spending time with one another. However, siblings with and without Down syndrome (versus autism spectrum disorder) reported more reciprocal sibling relationships, more frequent contact, and a greater range of shared activities. Implications for future research and practice are discussed.
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http://dx.doi.org/10.1016/j.ridd.2019.103538DOI Listing
January 2020

Management of acute type A aortic dissection with acute lower extremities malperfusion.

J Cardiothorac Surg 2019 Nov 27;14(1):206. Epub 2019 Nov 27.

Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea.

Background: Acute type A aortic dissection complicated by malperfusion is a life - threatening emergency. The optimal management strategy for malperfusion remains controversial.

Case Presentation: A 46-year-old man presented to another institution with acute type A aortic dissection with abdominal aorta occlusion. Motor and sensory grade of both lower extremities were zero. Immediate antegrade distal perfusion of both lower extremities was achieved, and total arch replacement with left axillo-bifemoral bypass was performed. At the time of discharge, motor and sensory grades of both lower extremities were 2 and 3, respectively.

Conclusion: This case demonstrates many of the techniques in the management of acute type A aortic dissection with abdominal aorta occlusion. In this case, direct antegrade perfusion of both lower extremities and axillo-bifemoral bypass may be helpful for patients presenting with severe malperfusion of both lower extremities with acute type A aortic dissection.
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http://dx.doi.org/10.1186/s13019-019-1033-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6882334PMC
November 2019

Perforation of inferior vena cava and duodenum by strut of inferior vena cava filter: A case report.

Medicine (Baltimore) 2019 Nov;98(47):e17835

Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju.

Introduction: An Inferior vena cava (IVC) filter is an intravascular filter that is implanted into the IVC to prevent pulmonary embolism in medical, surgical, and trauma patients. The insertion of an IVC filter is a relatively safe procedure, but rarely may be associated with symptomatic perforation of the IVC wall, particularly in the long term.

Patient Concerns And Diagnosis: A 74-year-old-woman with a medical history of IVC filter insertion visited the emergency department complaining of abdominal pain. A computed tomography scan showed perforation of the IVC wall and penetration into the duodenum by one of the filter's struts.

Interventions: We performed a laparotomy to remove the IVC filter.

Outcomes: Postoperatively, the patient was admitted to the general ward. On hospital day 12, she was discharged without any complications. We followed her up and computed tomography did not show any abnormal findings six months after discharge.

Lessons: There is currently no evidence testifying to the benefits of IVC filter removal. Detailed, evidence-based guidelines on the indications, timing and procedure for IVC filter removal are needed. Documenting cases of long-term complications of IVC filter s such as in this patient serve to accelerate the publication of updated guidelines and are aimed at improving outcomes of similar cases in the future.
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http://dx.doi.org/10.1097/MD.0000000000017835DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6882657PMC
November 2019

Combined treatment (image-guided thrombectomy and endovascular therapy with open femoral access) for acute lower limb ischemia: Clinical efficacy and outcomes.

PLoS One 2019 15;14(11):e0225136. Epub 2019 Nov 15.

Department of Radiology, Gyeongsang National University School of Medicine and Gyeonsang National University Changwon Hospital, Changwon, Korea.

Objectives: To evaluate the effectiveness and safety of combined treatment (image guided thrombectomy and endovascular therapy with open femoral access) for acute lower limb ischemia.

Methods: From 2009 to 2017, 52 patients (44 men, eight women, mean 67.2 years) underwent combined treatment for acute thrombotic occlusion of lower extremity arteries. The patients presented with acute limb ischemia and we selectively perform combined treatment in the cases with challenging clinical considerations (e.g. various spectrum of thrombus, underlying atherosclerotic lesions). Combined treatment included cutdown of common femoral artery, thrombectomy using a Fogarty balloon catheter, balloon angioplasty, stenting, and catheter-introduced thrombus fragmentation and aspiration. Patients' medical records were retrospectively reviewed and follow-up data were collected. The technical and clinical success rates and limb salvage were assessed. The Kaplan-Meier method was used to analyze primary patency rates and overall survival rates. Univariate analyses were performed to determine the factors related to clinical outcomes.

Results: Technical and clinical success rate was 90.4% and 80.8%, respectively. The mean follow-up duration was 26.5 ± 25.8 months. Primary patency was 91.4%, 86.1%, and 74.6% at six months, 1-, and 2-year, respectively. Limb salvage without amputation was 88.5% (46/52). The overall survival rates at six months, 1-, and 3-year were 82.6%, 80.2, and 56.9%, respectively. The 30-day mortality was 5.8% (3/52). Univariate analysis showed that percutaneous transluminal angioplasty (PTA) type (balloon versus stent) was related to clinical failure.

Conclusions: Combined treatment can be effective and safe for ALI patients even under challenging clinical conditions.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0225136PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6857913PMC
March 2020

Immunoglobulin G4-Related Aortitis of the Abdominal Aorta.

Korean J Thorac Cardiovasc Surg 2019 Aug 5;52(4):239-242. Epub 2019 Aug 5.

Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea.

Noninfectious aortitis, inflammatory abdominal periaortitis, and idiopathic retroperitoneal fibrosis are chronic inflammatory diseases with unclear causes. Recent studies have shown that some cases of aortitis are associated with immunoglobulin G4 (IgG4)-related systemic disease. Herein, we report a case of IgG4-related aortitis (IgG4-RA) that was diagnosed after surgery. Our patient was a 46-year-old man who had experienced abdominal pain for several weeks. Preoperative evaluations revealed an area of aortitis on the infrarenal aorta. He underwent surgery, and histological examination resulted in a diagnosis of IgG4-RA.
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http://dx.doi.org/10.5090/kjtcs.2019.52.4.239DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6687050PMC
August 2019

Correlates of current caregiving among siblings of adults with intellectual and developmental disabilities.

J Appl Res Intellect Disabil 2019 Nov 5;32(6):1490-1500. Epub 2019 Jul 5.

University of California at Berkeley, Berkeley, CA, USA.

Background: As individuals with intellectual and developmental disabilities (IDD) grow older, siblings are likely to become caregivers for their brothers and sisters with IDD. Thus, it is important to identify the correlates of sibling caregiving to facilitate transitions to caregiving roles.

Method: This study involved the secondary analysis of a national data set of 429 adult siblings of individuals with IDD.

Results: Current sibling caregiving was positively correlated with sibling relationship quality, sibling advocacy and future planning, maladaptive behaviours of individuals with IDD, and family size. Current sibling caregiving was negatively correlated with parent caregiving abilities and functional abilities of individuals with IDD. Further, among siblings who provided care, the level and nature of sibling caregiving were negatively correlated with parent caregiving abilities.

Conclusions: The results identify the correlates of current caregiving among siblings of individuals with IDD. More research is needed to understand current sibling caregiving.
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http://dx.doi.org/10.1111/jar.12644DOI Listing
November 2019

Exploring the Perspectives of Parents and Siblings Toward Future Planning for Individuals With Intellectual and Developmental Disabilities.

Intellect Dev Disabil 2019 06;57(3):198-211

Chung eun Lee, Meghan M. Burke, and Claire R. Stelter, Department of Special Education, University of Illinois at Urbana-Champaign.

Parents often provide the bulk of caregiving supports for their adult offspring with intellectual and developmental disabilities (IDD). Given the longer lives of people with IDD, however, such caregiving roles may transition to siblings. Thus, it is critical to conduct future planning among family members (e.g., parents, siblings) to prepare for the transition of caregiving roles. To this end, we interviewed 10 parent-sibling dyads ( = 20) of people with IDD about long-term planning. Both parents and siblings reported family-related and systemic barriers to developing future plans. Siblings (unlike parents) reported wanting more communication among family members about planning. Implications for future research and practice are discussed.
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http://dx.doi.org/10.1352/1934-9556-57.3.198DOI Listing
June 2019

Understanding Decision Making Among Individuals With Intellectual and Developmental Disabilities (IDD) and Their Siblings.

Intellect Dev Disabil 2019 02;57(1):26-41

Meghan M. Burke and Chung eun Lee, University of Illinois at Urbana-Champaign; Sarah A. Hall, Ashland University; and Zach Rossetti, Boston University.

Many siblings anticipate fulfilling caregiving roles for their brothers and sisters with intellectual and developmental disabilities (IDD). Given these roles and the importance of supported decision making, it is crucial to understand how individuals with IDD and their siblings make decisions. Using dyadic interviews, we examined the perspectives of nine sibling dyads ( N = 18) about decision making in relation to self-determination, independent living, and employment. The ages of participants ranged from 19 to 57. Data were analyzed using constant comparative analysis to identify themes. Decision making was characterized by: parents and siblings primarily identifying courses of action; the probability of respective consequences based on the person-environment fit; and the role of the sibling in making the final decision. Characteristics related to the individual with IDD, the family, the sibling, and the environment impacted decision making. Individuals with IDD were more likely to make their own decisions about leisure activities; however, siblings were more likely to make formal decisions for their brothers and sisters.
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http://dx.doi.org/10.1352/1934-9556-57.1.26DOI Listing
February 2019

Exploring the preliminary outcomes of a sibling leadership program for adult siblings of individuals with intellectual and developmental disabilities.

Int J Dev Disabil 2018 Oct 31;66(1):82-89. Epub 2018 Oct 31.

Department of Special Education, University of Illinois at Chicago College of Applied Health Sciences, USA.

Although adult siblings often fulfill caregiving roles for their brothers and sisters with intellectual and developmental disabilities (IDD) and report needing support, little intervention research has been conducted with adult siblings of individuals with IDD. The purpose of this pilot study was to examine the preliminary outcomes of a leadership and support program for adult siblings of individuals with IDD. Pre, post and follow-up survey data indicated that the program correlated with increased sibling connectedness and empowerment. Additionally, the program met sibling expectations with respect to: connectedness, empowerment, and resources. Siblings were highly satisfied with the program. Also, siblings wanted to impact systemic change, especially with respect to the adult service delivery system. Implications for research and practice are discussed.
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http://dx.doi.org/10.1080/20473869.2018.1519632DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8115446PMC
October 2018

Clinical usefulness of the angle between left main coronary artery and left anterior descending coronary artery for the evaluation of obstructive coronary artery disease.

PLoS One 2018 13;13(9):e0202249. Epub 2018 Sep 13.

Department of Cardiology, Gyeongsang National University College of Medicine,Changwon, Republic of Korea.

Background: A wider angle between the left anterior descending coronary artery (LAD) and left circumflex coronary artery (LCX) has been suggested to induce plaque formation in the arterial system via changes in shear stress. However, the relationship between the left main coronary artery (LM)-LAD angle and LAD stenosis has not been investigated. Therefore, we aimed to evaluate the associations between the LM-LAD and LAD-LCX angles and LAD stenosis.

Methods: Coronary computed tomography angiographies (CTAs) of 201 patients with suspected coronary artery disease were analyzed. Angle measurements were performed twice by experts using CTA images, and the values were averaged. The patients were divided into two groups, based on the presence of significant LAD stenosis (luminal diameter narrowing ≥50%) on CTA.

Results: The mean LM-LAD and LAD-LCX angles were 37.46° and 63.04°, respectively. The LM-LAD and LAD-LCX angles of the group with significant LAD stenosis were significantly wider than that of the group with nonsignificant LAD stenosis (P<0.001; P = 0.020, respectively). In a multivariate analysis, an LAD-LCX angle greater than 60° showed a trend toward predicting significant LAD stenosis (HR, 3.14; 95% CI: 0.96-1026; P = 0.058). In contrast, an LM-LAD angle greater than 40° was a significant predictor of significant LAD stenosis (HR, 12.2; 95% CI: 2.60-56.52; P = 0.001).

Conclusions: The results of the present study may suggest that a wider LM-LAD angle could be used to identify patients at higher risk for coronary artery disease (CAD). Thus, close follow-up and preventive management of other risk factors may be needed in such cases.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0202249PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6136703PMC
February 2019

Comparing differences in support needs as perceived by parents of adult offspring with down syndrome, autism spectrum disorder and cerebral palsy.

J Appl Res Intellect Disabil 2019 Jan 12;32(1):194-205. Epub 2018 Aug 12.

University of Illinois at Chicago, Chicago, Illinois.

Background: Parents often face many barriers when taking care of their offspring with disabilities. In childhood, support needs vary with families of children with Down syndrome often reporting less caregiving challenges. However, it is unclear whether support needs vary in adulthood. This study compared parents of adults with Down syndrome (DS), autism spectrum disorder (ASD) and cerebral palsy (CP) regarding support needs of their offspring with intellectual and developmental disabilities (IDD) and their families.

Method: Data were collected via a national survey in the United States with 189 parents of adults with IDD.

Results: Across the quantitative and qualitative analyses, parents of adults with DS (versus CP and ASD) reported significantly greater recreational, natural supports, more formal services and less future planning barriers.

Conclusion: The results indicate that the DS advantage may persist in adulthood regarding support needs. More research is needed to understand different types of support needs.
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http://dx.doi.org/10.1111/jar.12521DOI Listing
January 2019

A case report of pseudoaneurysm of left sinus of Valsalva invaded into the left ventricle with severe aortic regurgitation.

J Cardiothorac Surg 2018 Jun 7;13(1):63. Epub 2018 Jun 7.

Department of Thoracic and Cardiovascular Surgery, Jinju Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea.

Background: The pseudoaneurysms of sinus of Valsalva is an uncommon and serious complication of an infection, trauma, or after cardiac surgery or procedure. Pseudoaneurysms of sinus of Valsalva from left is rare. We describe a case of pseudoaneurysm of the left coronary sinus of Valsalva invaded into the left ventricle (LV) diagnosed by transthoracic echocardiography (TTE), transesophageal ecoccardiography (TEE), and multiple detector computed tomography (MDCT).

Case Presentation: A 44-year-old male patient had New York Heart Association (NYHA) class II / III dyspnea during 4 months. He underwent surgery including aortic valve replacement using mechanical prosthesis, and he was discharged well without significant complications on follow - up TTE and chest computed tomography (CT) post-operative 7 days.

Conclusions: We report this rare case in which a ruptured pseudoaneurysm of sinus of Valsalva into LV with severe AR due to perforation of LCC was successfully-treated.
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http://dx.doi.org/10.1186/s13019-018-0754-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5992747PMC
June 2018

A Report of Two Cases of Adventitial Cystic Disease of the Popliteal Artery.

Knee Surg Relat Res 2018 Jun;30(2):167-170

Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea.

Two patients were admitted to our department because of recent aggravation of claudication in the leg, which was exacerbated by walking. They were diagnosed as having a Baker cyst or acute thrombosis in the popliteal fossa at another hospital. There was no evidence of ischemia, and the ankle brachial index was normal. Computed tomography and magnetic resonance imaging were performed, revealing a cystic mass of the popliteal artery (PA). Intraoperatively, the cystic lesion was found within the adventitia of the PA; based on the biopsy findings, both patients were diagnosed as having adventitial cystic disease of the PA.
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http://dx.doi.org/10.5792/ksrr.17.058DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5990233PMC
June 2018

Case of a cardiac arrest patient who survived after extracorporeal cardiopulmonary resuscitation and 1.5 hours of resuscitation: A case report.

Medicine (Baltimore) 2017 Nov;96(47):e8646

Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Changwon Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea.

Rationale: Per the American Heart Association guidelines, extracorporeal cardiopulmonary resuscitation should be considered for in-hospital patients with easily reversible cardiac arrest. However, there are currently no consensus recommendations regarding resuscitation for prolonged cardiac arrest cases.

Patient Concerns And Diagnosis: We encountered a 48-year-old man who survived a cardiac arrest that lasted approximately 1.5 hours. He visited a local hospital's emergency department complaining of chest pain and dyspnea that had started 3 days earlier. Immediately after arriving in the emergency department, a cardiac arrest occurred; he was transferred to our hospital for extracorporeal membrane oxygenation (ECMO).

Interventions: Resuscitation was performed with strict adherence to the American Heart Association/American College of Cardiology advanced cardiac life support guidelines until ECMO could be placed.

Outcomes: On hospital day 7, he had a full neurologic recovery. On hospital day 58, additional treatments, including orthotopic heart transplantation, were considered necessary; he was transferred to another hospital.

Lessons: To our knowledge, this is the first case in South Korea of patient survival with good neurologic outcomes after resuscitation that lasted as long as 1.5 hours. Documenting cases of prolonged resuscitation may lead to updated guidelines and improvement of outcomes of similar cases in future.
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http://dx.doi.org/10.1097/MD.0000000000008646DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5708936PMC
November 2017

Comparison of Clinical Outcomes between Surgical Repair and Endovascular Stent for the Treatment of Abdominal Aortic Aneurysm.

Vasc Specialist Int 2017 Dec 31;33(4):140-145. Epub 2017 Dec 31.

Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.

Purpose: This study was performed to compare the treatment outcomes between endovascular aneurysm repair (EVAR) and open surgical repair (OSR) of abdominal aortic aneurysms (AAAs) in a South Korean population.

Materials And Methods: We performed a retrospective review of the medical records of 99 patients with AAAs who were managed at Gyeongsang National University Hospital between January 2005 and December 2014. We reviewed the demographic characteristics and perioperative treatment outcomes of patients with AAA undergoing EVAR or OSR. In-hospital mortality and reintervention rates were assessed and compared between the EVAR and OSR groups.

Results: In-hospital mortality was not significantly higher in the OSR group versus the EVAR group (3.8% vs. 8.7%, respectively, P=0.41). Intervention time (209.6 mins vs. 350.9 mins, P<0.001) and length of hospital stay (7.79 days vs. 17.46 days, P<0.001) were significantly longer in the OSR group vs. the EVAR group. Median follow-up time was 24.1±20 months for the EVAR group and 43.9±28 months for the OSR group. The cumulative rate of freedom from reintervention at 60 months was 62.0% for the EVAR group and 100% for the OSR group (P<0.001).

Conclusion: EVAR was favorable in terms of intervention time and length of hospital stay, but the long-term durability of EVAR remains open for further debate.
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http://dx.doi.org/10.5758/vsi.2017.33.4.140DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5754071PMC
December 2017

Usability verification of the Emergency Trauma Score (EMTRAS) and Rapid Emergency Medicine Score (REMS) in patients with trauma: A retrospective cohort study.

Medicine (Baltimore) 2017 Nov;96(44):e8449

Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju Department of Emergency Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon Department of Emergency Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea.

Early estimation of mortality risk in patients with trauma is essential. In this study, we evaluate the validity of the Emergency Trauma Score (EMTRAS) and Rapid Emergency Medicine Score (REMS) for predicting in-hospital mortality in patients with trauma. Furthermore, we compared the REMS and the EMTRAS with 2 other scoring systems: the Revised Trauma Score (RTS) and Injury Severity score (ISS).We performed a retrospective chart review of 6905 patients with trauma reported between July 2011 and June 2016 at a large national university hospital in South Korea. We analyzed the associations between patient characteristics, treatment course, and injury severity scoring systems (ISS, RTS, EMTRAS, and REMS) with in-hospital mortality. Discriminating power was compared between scoring systems using the areas under the curve (AUC) of receiver operating characteristic (ROC) curves.The overall in-hospital mortality rate was 3.1%. Higher EMTRAS and REMS scores were associated with hospital mortality (P < .001). The ROC curve demonstrated adequate discrimination (AUC = 0.957 for EMTRAS and 0.9 for REMS). After performing AUC analysis followed by Bonferroni correction for multiple comparisons, EMTRAS was significantly superior to REMS and ISS in predicting in-hospital mortality (P < .001), but not significantly different from the RTS (P = .057). The other scoring systems were not significantly different from each other.The EMTRAS and the REMS are simple, accurate predictors of in-hospital mortality in patients with trauma.
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http://dx.doi.org/10.1097/MD.0000000000008449DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5682808PMC
November 2017

The thorax trauma severity score and the trauma and injury severity score: Do they predict in-hospital mortality in patients with severe thoracic trauma?: A retrospective cohort study.

Medicine (Baltimore) 2017 Oct;96(42):e8317

Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.

Several scoring systems are commonly used to evaluate severity in patients with traumatic injuries. However, there is no generally accepted standard scoring system to assess the severity of thoracic trauma, specifically in patients who have sustained severe injuries. The present study aimed to evaluate the validity of the trauma and injury severity score (TRISS) and the thorax trauma severity score (TTSS) as predictors of in-hospital mortality in patients with severe thoracic trauma.We conducted a retrospective, consecutive review of the medical records of patients with severe thoracic trauma who were managed at our institution between January 2005 and December 2015. Inclusion criteria were patients with severe thoracic injury (injury severity score > 18) who required intensive care therapy and who had no local or systemic infection. We analyzed the association between the trauma severity scores (TTSS and TRISS) and in-hospital mortality in these patients. We also determined the predictive value of the scores using receiver-operating characteristic (ROC) curves.A total of 228 patients with severe thoracic trauma were included in this study. The in-hospital mortality rate was 21.9%. There was a statistically significant association between the TRISS and in-hospital mortality (P < .001), but the association between the TTSS and in-hospital mortality was not statistically significant (P = .547). The ROC curve demonstrated adequate discrimination, as demonstrated by an area under the curve value of 0.787 for the TRISS. At a cut-off value of 25.9%, the TRISS had a sensitivity of 83.6% and specificity of 73.5% to predict in-hospital mortality.The present study demonstrated that the TRISS, but not the TTSS, can be used to predict in-hospital mortality in patients with severe thoracic trauma; hence, additional prospective studies are required.
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http://dx.doi.org/10.1097/MD.0000000000008317DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5662406PMC
October 2017
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