Publications by authors named "Soo-Han Kim"

112 Publications

Predictive Role of Prior Radiotherapy and Immunotherapy-Related Adverse Effects in Advanced NSCLC Patients Receiving Anti-PD-1/L1 Therapy.

J Clin Med 2021 Aug 21;10(16). Epub 2021 Aug 21.

Asan Medical Center, Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea.

The present study evaluated the impact of prior radiotherapy (RT) on patients with advanced non-small cell lung cancer (NSCLC) receiving therapy with immune checkpoint inhibitors (ICIs) and further assessed the prognostic factors in patients receiving both RT and ICI. Patients diagnosed with NSCLC at the Catholic Medical Center and Asan Medical Center between January 2016 and October 2020 and who received immunotherapy were retrospectively reviewed. Among 240 patients, poor Eastern Cooperative Oncology Group (ECOG) score, high PD-L1 expression, and ICI-related adverse events (AE) were significantly associated with progression-free survival (PFS) (HR, 2.654; 95% CI, 1.484-4.749; = 0.001; HR, 0.645; 95% CI, 0.449-0.926, = 0.017; HR, 0.430; 95% CI, 0.229-0.808; = 0.009, respectively). Among patients who received both RT and immunotherapy, poor ECOG status, squamous cell carcinoma, and ICI-related AE were significant factors associated with poor PFS (HR, 2.430; 95% CI, 1.464-4.034; = 0.001; HR, 0.667; 95% CI, 0.455-0.978, = 0.038; HR, 0.520; 95% CI, 0.284-0.953, = 0.034, respectively). The present study showed that prior RT showed no significant independent association with primary outcomes in patients with advanced NSCLC receiving immunotherapy. In patients who received both RT and immunotherapy, clinical parameters, including ICI-related AEs, were independently predictive of PFS.
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http://dx.doi.org/10.3390/jcm10163719DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8397093PMC
August 2021

Prevalence of asymptomatic bronchiectasis and associations among the health screening population in South Korea.

ERJ Open Res 2021 Jul 2;7(3). Epub 2021 Aug 2.

Dept of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Centre, Songpa-gu, Seoul, Korea.

Despite the burden of bronchiectasis, there is little data from South Korea regarding asymptomatic bronchiectasis. We aimed to investigate the prevalence of bronchiectasis based on computed tomography (CT) findings, with emphasis on asymptomatic bronchiectasis (CT-proven) and its related factors. We analysed data of individuals who underwent chest CT at a South Korean health screening centre from 2016 to 2017. The prevalence of bronchiectasis was evaluated and adjusted by sex, age, and corresponding year for the Korean general population. Logistic regression analysis was performed to identify factors related to asymptomatic bronchiectasis by comparison between a group without bronchiectasis and a group with symptomatic bronchiectasis. Among the 27 617 subjects screened, 1005 were diagnosed with bronchiectasis based on CT findings, representing an adjusted prevalence of 2329 out of 100 000. The adjusted prevalence of asymptomatic bronchiectasis was 1235 out of 100 000, and that of symptomatic bronchiectasis was 1094 out of 100 000. Compared with the non-bronchiectasis group, the factors related to asymptomatic bronchiectasis were female sex (OR 1.41; 95% CI 1.18-1.70), older age (OR 1.06; 95% CI 1.05-1.07), comorbid liver disease (OR 1.32; 95% CI 1.07-1.63) or COPD (OR 4.99; 95% CI 2.88-8.64), history of tuberculosis (OR 1.98; 95% CI 1.46-2.68) and low forced expiratory volume in 1 s (FEV; OR 0.99; 95% CI 0.98-0.998). In South Korea, the prevalence of asymptomatic bronchiectasis appeared higher than that of symptomatic bronchiectasis. Female sex, older age, liver disease, COPD, history of tuberculosis and low FEV may be the factors related to asymptomatic bronchiectasis.
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http://dx.doi.org/10.1183/23120541.00188-2021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8326713PMC
July 2021

A Proteomics-Based Analysis of Blood Biomarkers for the Diagnosis of COPD Acute Exacerbation.

Int J Chron Obstruct Pulmon Dis 2021;16:1497-1508. Epub 2021 Jun 1.

Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Purpose: The identification of blood biomarkers to diagnose acute exacerbation of chronic obstructive pulmonary disease (AECOPD) will have clinical utility. Here, we used a proteomics-based approach to identify biomarkers capable of identifying AECOPD.

Patients And Methods: This prospective, single-center pilot study enrolled 12 patients who came to Asan Medical Center (South Korea) via the outpatient clinic or emergency department with symptoms of AECOPD and were follow-up in the outpatient clinic during convalescence between 2015 and 2017. Paired blood samples collected from each patient during the treatment naïve AECOPD and convalescence stages were analyzed. A sequential window acquisition of all theoretical fragmentation spectra-mass spectrometry (SWATH-MS)-based proteome analysis was performed and a subset of the data were verified by ELISA.

Results: The SWATH-MS analysis identified 226 plasma proteins across all samples examined. The median coefficient of variation for triplicate technical replicates of each sample was 1.13 ± 1.38%, indicating high precision of the technique. Fold-change and paired -test analyses revealed that 14 proteins were present at higher levels in the AECOPD samples than in the convalescence samples. A gene ontology analysis revealed that these proteins are involved in the acute-phase response. A total of 15 proteins were present at higher levels during the recovery (convalescence) stage than during the acute exacerbation phase, and gene ontology analysis revealed that these proteins are related to lipid metabolism and transport. Verification of the SWATH-MS data was performed using ELISAs for three proteins that were up-regulated in AECOPD, namely, LBP, ORM2, and SERPINA3. Among them, SERPINA3 (p = 0.005) was up-regulated significantly in AECOPD compared with the convalescence state.

Conclusion: Potential plasma biomarkers of AECOPD were discovered using the SWATH-MS proteomics method, and functional molecular associations were investigated. SERPINA3 could be a promising diagnostic biomarker for the early identification and tracking of AECOPD.
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http://dx.doi.org/10.2147/COPD.S308305DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8183188PMC
July 2021

Comparison of muscle activity during sit-to-stand movement at different chair heights between obese and normal-weight subjects.

J Exerc Rehabil 2021 Feb 23;17(1):39-44. Epub 2021 Feb 23.

Department of Physical Therapy, College of Biomedical Science, Kaya University, Gimhae, Korea.

The purpose of present study was to compare the tibialis anterior (TA), rectus femoris (RF), and erector spinae (ES) muscle activities at variety chair height during sit-to-stand (STS) on normal weight and obese subjects. Also, we compared the muscle activity difference between the normal weight and obese subjects. The study included 26 subjects (normal weight 13 and obese 13). Each subject performed STS at three chair heights (40 cm, 50 cm, 60 cm) and TA, RF, and ES muscle activities measured. According to the results of the measurement, muscle activation of TA showed significantly higher than RF and ES muscle activation during STS at all chair heights on obese subjects. The muscle activation of TA showed significantly higher than RF muscle activation during STS at all chair heights on normal weight subjects. The muscle activation of RF and ES showed significantly higher in normal weight subjects than obese subjects at 40 cm and 50 cm of chair heights. However, the TA muscle activation showed no significant difference between normal weight subjects and obese subjects. This study's results suggested that obese subjects should practice the use of RF and ES muscles in a low-height chair during STS.
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http://dx.doi.org/10.12965/jer.2040800.400DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7939984PMC
February 2021

Clinical outcomes of nivolumab in patients with advanced non-small cell lung cancer in real-world practice, with an emphasis on hyper-progressive disease.

J Cancer Res Clin Oncol 2020 Nov 24;146(11):3025-3036. Epub 2020 Jun 24.

Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.

Purpose: Although immune checkpoint inhibitors have been shown to be effective in many clinical trials, real-world data remain limited. We investigated the outcomes of non-small cell lung cancer (NSCLC) patients who received nivolumab, with an emphasis on hyper-progressive disease (HPD).

Methods: This retrospective study enrolled stage IV NSCLC patients who received nivolumab after progression on prior chemotherapy between July 2016 and June 2018 at a single center in Korea. HPD was defined by response evaluation criteria in solid tumors as progression at the first evaluation, with a ≥ two-fold increase in the tumor growth rate during nivolumab treatment.

Results: A total of 83 patients with a median age of 60 years were enrolled [squamous, 25(30%) and non-squamous, 58(70%)]. The median progression-free survival (PFS) and overall survival (OS) were 2.6 months [95% confidence interval (CI) 0.82-4.31] and 8.6 months (95% CI 5.56-11.59), respectively. HPD developed in 16 (19.2%). The median OS of HPD patients was 2.2 months (95% CI 0.92-3.75) compared with 4.1 months for progressive disease (PD) patients without HPD (95% CI 1.54-6.67). Among patients with pleura or pericardium metastasis, increased effusion was seen more frequently in HPD patients compared with PD patients without HPD [90% (9/10) vs. 28.6% (4/14); p = 0.005]. HPD patients also showed a significant decrease in circulating albumin after treatment with nivolumab (p = 0.030).

Conclusion: Although the efficacy of nivolumab in real-world patients was comparable to that seen in clinical trials, clinicians should be aware of HPD because it is not uncommon and represents a worse prognosis.
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http://dx.doi.org/10.1007/s00432-020-03293-9DOI Listing
November 2020

Reply.

J Cataract Refract Surg 2020 05;46(5):807

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http://dx.doi.org/10.1097/j.jcrs.0000000000000180DOI Listing
May 2020

The effect of adjunctive hyperbaric oxygen therapy in patients with central retinal artery occlusion.

Undersea Hyperb Med 2020 First Quarter;47(1):57-64

Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.

Purpose: Central retinal artery occlusion (CRAO) is an ophthalmic emergency with poor prognosis, despite diligent conventional treatment. According to the clinical recommendations of the Undersea and Hyperbaric Medical Society, hyperbaric oxygen (HBO2) is a potentially beneficial treatment; however, the benefit of adjunctive HBO2 in patients with CRAO in Korea remains unclear. The present study aimed to evaluate the effect of adjunctive HBO2 in patients with CRAO.

Methods: This registry-based observational study included adult patients who presented to the emergency department or ophthalmology outpatient department within 24 hours of the onset of CRAO symptoms. Data of patients from October 2016 to February 2019 were analyzed. The patients were categorized into two groups according to the use of adjunctive HBO2: no HBO2 and HBO2.

Result: During the study period, 34 consecutive patients were enrolled, of which 19 were included in the study. In the total cohort, 10 patients (52.6%) were treated with adjunctive HBO2. There were no statistically significant differences in terms of age, sex, comorbidities, duration from symptoms onset to hospital visit, presence of the cilioretinal artery, and use of anterior chamber paracentesis between the two groups. The HBO2 group showed significantly higher change in best-corrected visual acuity than the no HBO2 group (p=0.043).

Conclusion: Patients with CRAO in the HBO2 group showed significantly greater visual improvement than those in the no-HBO2 group. Clinicians should consider adjunctive HBO2 in the treatment approach in patients with CRAO who visit the hospital within 24 hours of symptoms onset.
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January 2021

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J Cataract Refract Surg 2020 03;46(3):492-493

Wonju, Korea Daejeon, Korea.

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http://dx.doi.org/10.1097/j.jcrs.0000000000000092DOI Listing
March 2020

The prevalence of stroke according to indoor radon concentration in South Koreans: Nationwide cross section study.

Medicine (Baltimore) 2020 Jan;99(4):e18859

Department of Occupational Therapy, Konyang University, Dae-jeon, Republic of Korea.

To investigate the relationship between indoor radon level and stroke, which is a major factor for background radiation.This study combines 2 nationwide studies. Demographic characteristics and medical history of participants were obtained from Korean National Health and Nutrition Examination Survey (KNHANES) from 2007 to 2012. Participants over 40 years old and who completed the questionnaire were included in the study. Indoor radon concentration was analyzed using the mean value of winter housing radon concentration from 2012 to 2016 published by the National Institute of Environmental Research. The average values of each metropolitan city and province were assigned to the residence of the participant. To eliminate the potential confounding factors, participants' age, sex, hypertension, diabetes, dyslipidemia, ischemic heart disease, education level, occupation, smoking, drinking, exercise, and dietary intake were adjusted in multivariable logistic regression.Total of 28,557 participants were included in this study. Indoor radon levels were significantly higher in the participants with stroke, and the prevalence of stroke increased as indoor radon levels increased (P < .001, P for linear trend <.001). Indoor radon level was associated with stroke even after adjusting potential confounding factors (OR: 1.004 [95CI: 1.001-1.007], P = .010) and high radon exposure (indoor radon over 100Bq/m3) was also associated with stroke (OR: 1.242 [95CI: 1.069-1.444], P = .005). Trend analysis showed linear correlation of increased odds between radon quartile and stroke (P for linear trend < .001). In subgroup analysis, elevated indoor radon was most strongly associated in participants with age over 76(OR: 1.872[95%CI:1.320-2.654], P < .001).High indoor radon concentration may be associated with stroke. Specifically, elevated radon was associated with stroke in participants over 76 years old. In high-risk population, home modification to reduce indoor radon may help decreasing the risk of stroke.
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http://dx.doi.org/10.1097/MD.0000000000018859DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004733PMC
January 2020

Effect of slope angle on muscle activity during variations of the Nordic exercise.

J Exerc Rehabil 2019 Dec 31;15(6):832-838. Epub 2019 Dec 31.

Department of Physical Therapy, College of Health Sciences, Catholic University of Pusan, Busan, Korea.

This study investigated the muscular activity of the lower muscles during variation of Nordic exercises following changes of the Nordic angles and the base slope angles. Twenty-one healthy participants were participated in this study. Participants performed six variations of Nordic exercises including two Nordic angles positions and three base slope angles. Each Nordic exercise defined as Nordic angle 10°, 15° and base slope angle 0°, 10°, 15°. During the Nordic exercises, erector spine, gluteus maximus, biceps femoris, gastrocnemius activities and subjective difficulties (Borg RPE score) were measured. The activities of all muscles and subjective difficulties were significantly greater with the 15° of Nordic exercise compared to the 10° of Nordic exercise, regardless of base slope angles. There were significant differences in gluteus maximus, biceps femoris, gastrocnemius, and the Borg RPE score between three base slope conditions (P<0.05). The Borg RPE score and activities of the gluteus maximus were increased with the increases of base slop angles from 0° to 15°. Conversely, the activities of the gastrocnemius and biceps femoris were decreased with the increases of base slop angles from 0° to 15°. Present study indicates that application of the greater Nordic angle during the Nordic exercise is advantageous for activating lower extremity muscles. Using the base slopes during the Nordic exercise could be used for selective activation of the lower muscles. High base slope angles inducing greater knee flexion could maximize the exercise effects for activating gluteal muscles rather than lower leg muscles such as biceps femoris and gastrocnemius.
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http://dx.doi.org/10.12965/jer.1938670.335DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6944874PMC
December 2019

QuantiFERON-TB Gold PLUS versus QuantiFERON- TB Gold In-Tube test for diagnosing tuberculosis infection.

Korean J Intern Med 2020 03 26;35(2):383-391. Epub 2019 Dec 26.

Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Background/aims: QuantiFERON-TB Gold PLUS (QFT-PLUS) was developed as a new version of the interferon-γ (IFN-γ) release assay that contains an extra antigen tube to elicit a CD8+ T-cell response in addition to a CD4+ T-cell response. This study aimed to evaluate the performances of QFT-PLUS versus QuantiFERON-TB Gold In-Tube (QFT-GIT) for detecting tuberculosis (TB) infection.

Methods: Between October, 2016 and May, 2018, 137 participants were prospectively recruited and subjected to QFT-GIT and QFT-PLUS testing. The concordance between tests and performance based on different immune states and/or TB infection risk were evaluated.

Results: The 137 participants were classified as follows: active TB (n = 14), TB contact (n = 14), screening before biologic therapy (n = 85) and other disease (n = 24). The positive results for either test were 100% (n = 14/14), 42.9% (n = 6/14), 15.3% (n = 13/85), and 62.5% (n = 15/24) in each four groups, respectively. The QFT-GIT and QFT-PLUS test results showed good concordance with 91.2% agreement and a Cohen's κ of 0.807. The good concordance between two tests was also observed in 64 immunocompromised subjects (agreement of 90.6% and a Cohen's κ of 0.711). The intra-class correlation coefficient for each antigen tube of the QFT-PLUS showed a good correlation with the IFN-γ release of the QFT-GIT (TB1 = 0.912, p < 0.001; TB2 = 0.918, p < 0.001).

Conclusion: QFT-PLUS showed highly comparable results to those of QFT-GIT for diagnosing TB infection in South Korea as well as in immunocompromised subjects.
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http://dx.doi.org/10.3904/kjim.2019.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7061006PMC
March 2020

Seasonal variation in acute post-cataract surgery endophthalmitis incidences in South Korea.

J Cataract Refract Surg 2019 12;45(12):1711-1716

Department of Ophthalmology, Konyang University College of Medicine, Myunggok Medical Research Center, Daejeon, South Korea. Electronic address:

Purpose: Previous studies have reported conflicting results on the influence of seasons on post-cataract surgery endophthalmitis incidences. This study aimed to investigate the seasonality associated with the incidence of postoperative endophthalmitis, and to evaluate its association with climate variables in South Korea.

Setting: South Korea.

Design: Retrospective cohort study.

Methods: The postoperative endophthalmitis incidences were identified using the Health Insurance Review and Assessment Service claim data from July 2014 to June 2017. The monthly climate data were obtained from the Korea Meteorological Administration. The incidences of endophthalmitis were analyzed by the month of the year, and by the season. The association between postoperative endophthalmitis and the climatic variables, including mean temperature, relative humidity, precipitation, and hours of sunshine, was investigated.

Results: The incidences were the highest in July, and they were the most prevalent during the summer months, although fewer cataract surgeries were performed in the summer months than during the rest of the year. The postoperative endophthalmitis incidences tended to increase with increasing relative humidity and increasing precipitation.

Conclusions: The incidences of post-cataract surgery endophthalmitis peaked during the hot and humid months. Understanding the seasonal and climatic influences on postoperative infection might help in risk stratification and outcome improvisation after the cataract surgery is performed.
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http://dx.doi.org/10.1016/j.jcrs.2019.07.022DOI Listing
December 2019

Comparison of Solar Radiation and Myopia Occurrence in South Korean Children.

J Ophthalmol 2019 10;2019:7643850. Epub 2019 Jun 10.

Department of Ophthalmology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.

Purpose: To investigate the association between regional solar radiation and myopia occurrence in South Korean children.

Materials And Methods: A population-based cross-sectional study using data of 1218 children aged 7-9 years from the Korea National Health and Nutritional Examination Survey was conducted from January 1, 2008, to December 31, 2012. Myopia prevalence and the mean spherical equivalent were estimated; myopia was defined as spherical equivalent refraction <-1.5 D. Data regarding solar radiation and sunshine duration were collected from 21 national monitoring stations in South Korea. Multiple logistic regression analyses and multiple linear regression analyses were used to evaluate the associations. However, the most important covariate, the time spent outdoors, was not measured and could not be used.

Results: In the entire cohort of 1218 participants, solar radiation and sunshine duration were significantly associated with the mean spherical equivalent (=0.001 and =0.014,  = 0.088 and  = 0.069, respectively) and solar radiation was significantly associated with myopia prevalence (=0.008). And, a negative but not statistically significant association between sunshine duration and myopia prevalence was observed (=0.064, respectively).

Conclusions: Solar radiation and sunshine duration are associated with the mean spherical equivalent and myopia prevalence in South Korean children.
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http://dx.doi.org/10.1155/2019/7643850DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6590540PMC
June 2019

Utility of Computed Tomography in a Differential Diagnosis for the Patients with an Initial Diagnosis of Chronic Obstructive Pulmonary Disease Exacerbation.

Tuberc Respir Dis (Seoul) 2019 Jul 31;82(3):234-241. Epub 2019 May 31.

Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Background: The utility of computed tomography (CT) in the differential diagnosis of patients with chronic obstructive pulmonary disease (COPD) exacerbation remains uncertain. However, due to the low cost associated with CT scan along with the impact of Koreas' health insurance system, there has been a rise in the number of CT scans in the patients with initial diagnosis of COPD exacerbations. Therefore, the utility of CT in the differential diagnosis was investigated to determine whether performing CT scans affect the clinical outcomes of the patients with an initial diagnosis of COPD exacerbation.

Methods: This study involved 202 COPD patients hospitalized with an initial diagnosis of COPD exacerbation. We evaluated the change in diagnosis or treatment after performing a CT scan, and compared the clinical outcomes of patient groups with vs. without performing CT (non-CT group vs. CT group).

Results: After performing CT, the diagnosis was changed for two (3.0%) while additional diagnoses were made for 27 of the 64 patients (42.1%). However, the treatment changed for only one (1.5%), and six patients (9.3%) received supplementary medication. There were no difference in the median length of hospital stay (8 [6-13] days vs. 8 [6-12] days, p=0.786) and intensive care unit care (14 [10.1%] vs. 11 [16.7%], p=0.236) between the CT and non-CT groups, respectively. These findings remained consistent even after the propensity score matching.

Conclusion: Utility of CT in patients with acute COPD exacerbation might not be helpful; therefore, we do not recommend chest CT scan as a routine initial diagnostic tool.
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http://dx.doi.org/10.4046/trd.2018.0087DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6609529PMC
July 2019

Traumatic lumbar disc herniation mimicking epidural hematoma: A case report and literature review.

Medicine (Baltimore) 2019 May;98(18):e15438

Department of Neurosurgery, Chonnam National University Hospital and Medical School, Gwangju, Republic of Korea.

Rationale: We report a rare case of traumatic lumbar disc herniation mimicking epidural hematoma.

Patient Concerns: A 39-year old man presented with acute bilateral leg and back pain, following a crushing injury caused by a crane collapse.

Diagnosis: A computed tomography scan revealed multiple compression fractures of the thoracolumbar spine, including a burst fracture of the L4 vertebral body. Magnetic resonance imaging (MRI) showed an epidural mass, extending longitudinally and causing dural sac compression behind the L3 vertebra. The mass had isosignal intensity on T1-weighted imaging and showed mixed high and low signals on T2-weighted imaging. On the basis of the patient's clinical history and imaging findings, our provisional diagnosis was an epidural hematoma following major trauma.

Interventions: An emergency L3 laminectomy was performed with percutaneous screw fixation of L3-5. Intraoperatively, 3 large herniated disc fragments were found at L3 with no evidence of hematoma.

Outcomes: The patient recovered normal motor function after surgery. At the last follow-up, 3 years after surgery, there was no residual neurological deficit apart from intermittent lower back pain.

Lessons: In cases where MRI findings reveal an epidural lesion with a longitudinal shape, similar to an epidural hematoma, with mixed signal intensity on T2-weighted images and high peripheral signal intensity on T1-weighted images, traumatic disc herniation should be included in the differential diagnosis.
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http://dx.doi.org/10.1097/MD.0000000000015438DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6504302PMC
May 2019

Endophthalmitis after Cataract Surgery in Korea: A Nationwide Study Evaluating Incidence and Risk Factors in a Korean Population.

Yonsei Med J 2019 May;60(5):467-473

Department of Ophthalmology, Yonsei University Wonju College of Medicine, Wonju, Korea.

Purpose: To assess the nationwide rate of acute postoperative endophthalmitis (APE) after cataract extraction in Korea and to evaluate potential risk factors thereof.

Materials And Methods: Nationwide insurance claims data from July 2014 to June 2017 were reviewed. All patients with phacoemulsification or extracapsular/intracapsular cataract extraction were included. Exclusion criteria were combined glaucoma surgery or total vitrectomy or when the patient had a history of intraocular foreign body.

Results: In total, 1505103 cases (982203 patients) were included. APE developed in 953 cases (938 patients) with an overall incidence of 0.063%. After adjusting for possible confounding factors, male sex [odds ratio (OR) 1.42; 95% confidence interval (CI) 1.25-1.61; <0.001], primary clinical setting, operations performed in non-major cities, usage of sutures (OR 2.82; 95% CI 2.13-3.74; <0.001), anterior vitrectomy (OR 8.71; 95% CI 6.71-11.32; <0.001), aphakic cataract surgery (OR 1.52; 95% CI 1.03-2.22; =0.033), hypertension (OR 1.40; 95% CI 1.18-1.66; <0.001), diabetes (OR 1.59; 95% CI 1.31-1.93; <0.001), and chronic renal failure (OR 1.28; 95% CI 1.01-1.62; =0.039) were found to be related to APE development.

Conclusion: The incidence of APE after cataract extraction was consistent with reports from other studies. Additional research is needed to determine the relationship of newly found risk factors, such as hypertension, primary clinical setting, chronic renal failure, and usage of suturing, with APE development.
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http://dx.doi.org/10.3349/ymj.2019.60.5.467DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6479122PMC
May 2019

Spinal Extradural Meningeal Cyst: A Case Report.

Chonnam Med J 2019 Jan 25;55(1):62-63. Epub 2019 Jan 25.

Department of Neurosurgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.

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http://dx.doi.org/10.4068/cmj.2019.55.1.62DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351322PMC
January 2019

Successful treatment of central retinal artery occlusion using hyperbaric oxygen therapy.

Clin Exp Emerg Med 2018 Dec 31;5(4):278-281. Epub 2018 Dec 31.

Department of Ophthalmology, Yonsei University Wonju College of Medicine, Wonju, Korea.

Central retinal artery occlusion (CRAO) is considered an ophthalmologic emergency. The prognosis of this disease is very poor. Currently, there is no generally effective therapy available to treat CRAO. Hyperbaric oxygen therapy (HBOT) can increase the volume of oxygen delivered to the ischemic retinal tissue until spontaneous or assisted reperfusion occurs. We report the case of a patient who experienced sudden visual loss due to CRAO that was treated with HBOT. The patient was an 81-year-old woman who presented with CRAO in her right eye (OD). She exhibited "hand motion" visual acuity before treatment. She underwent three sessions of HBOT at a pressure of 2.8 atmospheres absolute, performed over 3 days. After 4 days in hospital, her visual acuity improved to 0.4 (OD) for far vision and 0.5 (OD) for near vision. Her vision was stable without the supply of oxygen; therefore, she was discharged.
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http://dx.doi.org/10.15441/ceem.17.271DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6301864PMC
December 2018

Effect of the body mass index and sexual difference on the muscle activity during trunk exercise: a preliminary study.

J Exerc Rehabil 2018 Oct 31;14(5):778-782. Epub 2018 Oct 31.

Department of Physical Therapy, College of Health Science, Kaya University, Gimhae, Korea.

There was lack of study which evaluated the effects of characteristics of subjects such as the body mass index (BMI) or waist circumference (WC), as well as sexual differences on trunk muscle activities. The purpose of the present study was to compare the abdominal muscle activities among the groups dividing criterion as the BMI, WC, and the gender. As a criterion of BMI and WC, subjects were arranged to three groups. Female subjects who were less than 25 kg/m BMI, and less than 90 WC were arranged as female with underweight group (FU), male subjects who were greater than 25 kg/m BMI and greater than 85 WC were arranged as male with overweight group (MO), male subjects who were less than 25 kg/m BMI and less than 85 WC were arranged in male with underweight group (MU). Surface electromyography responses of the rectus abdominis, internal oblique, external oblique muscles and lumbar level of erector spinae were obtained during the plank and maximal voluntary isometric contraction (MVIC). The MO group showed significantly higher %MVIC value of the internal oblique and lumbar level of erector spinae, compared to the MU group (<0.05). The %MVIC of the rectus abdominis was significantly greater with the FU group (<0.05). There were significant differences in the root mean squared (RMS) values from MVIC among the three groups (<0.05). Regardless of muscles differences, the MO group showed significantly lower RMS activity values than the FU and the MU groups (<0.05). Present study indicates some considerations of interpreting surface electromyography (sEMG) signal from region overlapping large fat tissue especially for trunk muscles. Individual characteristics such as gender, BMI, and WC could affect the sEMG signals. The female and male with overweight represent relatively high %MVICs during exercise, but it might be due to relatively low RMS values from procedure of MVICs.
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http://dx.doi.org/10.12965/jer.1836330.165DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6222157PMC
October 2018

Association Between Osteoporosis and Age-Related Macular Degeneration: The Korea National Health and Nutrition Examination Survey.

Invest Ophthalmol Vis Sci 2018 03;59(4):AMD132-AMD142

Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea.

Purpose: Previous studies have reported a possible link between low bone mineral density and AMD. The aim of the present study was to investigate the association between osteoporosis and AMD in a South Korean cohort.

Methods: This cross-sectional, nationwide study included 3496 women and 2789 men who had participated in the Korean National Health and Nutrition Examination Survey from 2008 to 2011. All retinal photographs were graded using an international classification and grading system. Osteoporosis was assessed using dual-energy x-ray absorptiometry. Multivariate logistic regression analysis was performed to examine the relationship between osteoporosis and AMD after adjustment for potential confounders, including age, the body mass index, dietary calcium intake, and the serum vitamin D level. The odds ratios (OR) for other aging-related eye diseases, including cataract, open-angle glaucoma, and diabetic retinopathy, were analyzed in accordance with the presence of osteoporosis.

Results: Multivariate regression analysis revealed that osteoporosis was significantly associated with all types of AMD (early and late: OR, 1.31; P = 0.017) and early AMD (OR, 1.36; P = 0.007) in women. Late AMD was not associated with osteoporosis (OR, 0.84; P = 0.670). In men, osteoporosis was not associated with any type of AMD. In women, the status of osteoporosis in the femoral neck showed a linear relationship with AMD (P = 0.004). Although osteoporosis was associated with AMD in women, it showed no association with other age-related eye diseases; this suggested a disease-specific association.

Conclusions: Our findings suggest that osteoporosis plays a role in AMD development in postmenopausal women.
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http://dx.doi.org/10.1167/iovs.18-24059DOI Listing
March 2018

Effect of hip position and breathing pattern on abdominal muscle activation during curl-up variations.

J Exerc Rehabil 2018 Jun 30;14(3):445-450. Epub 2018 Jun 30.

Department of Physical Therapy, College of Health Science, Kaya University, Gimhae, Korea.

Recent studies have indicated that applying different breathing pattern and changes of extremity positions could be a useful way of performing challenging exercises that include coactivation of the abdominal muscles. The aim of this study was to investigate the effects of changes of breathing pattern and hip position on abdominal muscle activity during curl-up exercises. Surface electromyography responses of the rectus abdominis (RA), internal oblique (IO), external oblique (EO) muscles and rectus femoris (RF), and Borg rating of perceived exertion (Borg RPE) score were investigated during the curl up exercises. A total of 20 healthy, physically active male volunteers completed two hip positions (45° and 90° hip flexion) and three breath types (slow expiration, maximal inspiration, and maximal expiration) for curl-up variations. The curl-up with 90° of hip flexion significantly increased the muscular activities of IO, EO, RF, and Borg RPE score (<0.05). The curl-up with maximal expiration significantly elevated the IO and EO activity, compared to other breathing conditions. There were no significant difference in RA activities (>0.05). The present study showed both the hip position and breathing pattern affect abdominal muscle activities during the curl-up exercise, especially of the oblique muscles. Among the breathing patterns investigated herein, the curl-up with maximum expiration produced greater activation of the oblique muscles compared to slow expiration and maximum inspiration.
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http://dx.doi.org/10.12965/jer.1836170.085DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6028217PMC
June 2018

Visual Recovery after Macular Hole Surgery and Related Prognostic Factors.

Korean J Ophthalmol 2018 04 13;32(2):140-146. Epub 2018 Mar 13.

Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Purpose: To describe the visual recovery and prognostic factors after macular hole surgery.

Methods: A retrospective chart review was conducted. Charts of patients with idiopathic macular holes who underwent surgery by a single surgeon at Severance Hospital between January 1, 2013 and July 31, 2015 were reviewed. The best-corrected visual acuity (BCVA) score was recorded preoperatively and at 1 day and 1, 3, 6, 9, and 12 months after surgery. The variables of age, sex, macular hole size, basal hole diameter, choroidal thickness, and axial length were also noted.

Results: Twenty-six eyes of 26 patients were evaluated. Twenty-five patients (96.2%) showed successful macular hole closure after the primary operation. The BCVA stabilized 6 months postoperatively. A large basal hole diameter (p = 0.006) and thin choroid (p = 0.005) were related to poor visual outcomes. Poor preoperative BCVA (p < 0.001) and a thick choroid (p = 0.020) were associated with greater improvement in BCVA after surgery.

Conclusions: Visual acuity stabilized by 6 months after macular hole surgery. Choroidal thickness was a protective factor for final BCVA and visual improvement after the operation.
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http://dx.doi.org/10.3341/kjo.2017.0085DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5906399PMC
April 2018

Incidence and Risk Factors of Cystoid Macular Edema after Vitrectomy with Silicone Oil Tamponade for Retinal Detachment.

Korean J Ophthalmol 2018 06 12;32(3):204-210. Epub 2017 Oct 12.

Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Purpose: To investigate the incidence and risk factors of cystoid macular edema (CME) after silicone oil (SO) injection for retinal detachment.

Methods: Fifty-eight patients with retinal detachment treated by vitrectomy with SO tamponade during 2011 to 2015 were retrospectively assigned to CME and non-CME groups. Patients underwent complete ophthalmological examination, including color fundus photography and preoperative and postoperative optical coherence tomography. Risk factors for CME during SO tamponade were determined by regression analyses.

Results: Of the 58 eyes, 21 (36.2%) exhibited CME. The presence of posterior staphyloma in the CME group was significantly more frequent than in the non-CME group (p = 0.026). There were no significant differences in other demographic or clinical characteristics between the CME and non-CME groups. Significant correlations were observed between CME after vitrectomy with SO tamponade and the presence of posterior staphyloma (odds ratio, 4.03; p = 0.031). Of the 21 eyes with CME, 13 underwent SO removal, among which 11 experienced resolution of CME with or without further intervention.

Conclusions: The presence of posterior staphyloma is significantly associated with CME after vitrectomy with SO tamponade. Patients with retinal detachment exhibiting posterior staphyloma should be evaluated for potential CME during SO tamponade.
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http://dx.doi.org/10.3341/kjo.2017.0050DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5990636PMC
June 2018

The effects of occupation-centered activity program on fall-related factors and quality of life in patients with dementia.

J Phys Ther Sci 2017 Jul 15;29(7):1188-1191. Epub 2017 Jul 15.

Department of Occupational Therapy, Woosuk University, Republic of Korea.

[Purpose] The purpose of this study was to investigate the effects of an occupation-centered activity program for dementia patients living in a local community, and examined the effects of the occupation-centered activity program on their cognitive functions, fall-related factors, and quality of life. [Subjects and Methods] Thirty subjects were divided into two groups: the experiment group (n=15) and the control group (n=15). The occupation-centered activity program was then applied to dementia patients for 60 minutes, 5 times/week for 12 weeks. To identify their cognitive functions before and after the intervention occupation-centered activity program, Mini-Mental State Examination-Korea (MMSE-K) and the Global Deterioration Scale (GDS) were used. To assess fall-related factors, Korean Falls Efficacy Scale for the Elderly (FES-K) was used and leg strength, agility, and balance of the participants was measured. To examine quality of life, the Korean version of Quality of Life-Alzheimer's Disease Scale (KQOL-AD) was used. [Results] The results of the intervention showed that although cognitive function improved in both the experimental and control groups, fall-related factors and the quality of life significantly improved only in the experimental group. [Conclusion] This indicates that the occupation-centered activity program had a positive effect on dementia patients' cognitive functions, fall-related factors, and quality of life.
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http://dx.doi.org/10.1589/jpts.29.1188DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5509588PMC
July 2017

The effects of repetitive transcranial magnetic stimulation (rTMS) on depression, visual perception, and activities of daily living in stroke patients.

J Phys Ther Sci 2017 Jun 7;29(6):1036-1039. Epub 2017 Jun 7.

Rehabilitation Science, Daegu University, Republic of Korea.

[Purpose] The present study aimed to investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on visual perception, depression, and activities of daily livings (ADLs) in stroke patients. [Subjects and Methods] Forty-four stroke patients were divided equally into an experimental group that underwent rTMS and a control group that underwent mock rTMS. Changes in patient visual perception, depression, and ADLs were evaluated. All subjects underwent treatment for 20 minutes, 5 times per week, for 4 weeks. Beck Depression Inventory (BDI), Motor-free Visual Perception Test (MVPT) and Functional Independent Measurement (FIM) were respectively used to assess depression, visual perception and ADLs. [Results] The experimental group showed significant improvements in depression, visual perception, and ADLs between week 1 and 4, between week 1 and 8, and between week 4 and 8. Meanwhile, the control group showed no differences between week 1 and 4, and although, like in the experimental group, a significant difference was observed in depression and visual perception between Week 1 and 8, there was no significant difference in ADLs. [Conclusion] These demonstrate that rTMS has a positive impact on visual perception, depression, and ADLs.
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http://dx.doi.org/10.1589/jpts.29.1036DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5468193PMC
June 2017

Effect of transcranial direct current stimulation of stroke patients on depression and quality of life.

J Phys Ther Sci 2017 Mar 22;29(3):505-507. Epub 2017 Mar 22.

Rehabilitation Science, Daegu University, Republic of Korea.

[Purpose] The aim of this study was to assess the effects of transcranial direct current stimulation (tDCS) on depression and quality of life (QOL) in patients with stroke, by conducting conventional occupational therapy with and without tDCS on 20 patients each. [Subjects and Methods] The experimental group (N=20) received both tDCS and conventional occupational therapy, while the control group (N=20) received false tDCS and conventional occupational therapy. The treatment was conducted 20 times over a four-week period; each session was 30 minutes long. The Beck Depression Inventory (BDI) was administered to score the depression levels in patients before and after the intervention, while the stroke-specific quality of life (SS-QOL) was measured to compare the QOL. [Result] Following the intervention, the patients in the experimental group showed a significant decrease in depression and an increase in the QOL. In contrast, the control group showed no significant changes in depression or QOL. Our findings indicate that tDCS decreased depression while increasing QOL in patients with stroke. [Conclusion] In other words, our study confirmed that the application of tDCS during stroke rehabilitation improves the depression symptoms and QOL in patients.
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http://dx.doi.org/10.1589/jpts.29.505DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5361020PMC
March 2017

Polyetheretherketone Cage with Demineralized Bone Matrix Can Replace Iliac Crest Autografts for Anterior Cervical Discectomy and Fusion in Subaxial Cervical Spine Injuries.

J Korean Neurosurg Soc 2017 Mar 1;60(2):211-219. Epub 2017 Mar 1.

Department of Neurosurgery, Chonnam National University Medical School & Research Institute of Medical Sciences, Gwangju, Korea.

Objective: This study aimed to compare the clinical and radiologic outcomes of patients with subaxial cervical injury who underwent anterior cervical discectomy and fusion (ACDF) with autologous iliac bone graft or polyetheretherketone (PEEK) cages using demineralized bone matrix (DBM).

Methods: From January 2005 to December 2010, 70 patients who underwent one-level ACDF with plate fixation for post-traumatic subaxial cervical spinal injury in a single institution were retrospectively investigated. Autologous iliac crest grafts were used in 33 patients (Group I), whereas 37 patients underwent ACDF using a PEEK cage filled with DBM (Group II). Plain radiographs were used to assess bone fusion, interbody height (IBH), segmental angle (SA), overall cervical sagittal alignment (CSA, C2-7 angle), and development of adjacent segmental degeneration (ASD). Clinical outcome was assessed using a visual analog scale (VAS) for pain and Frankel grade.

Results: The mean follow-up duration for patients in Group I and Group II was 28.9 and 25.4 months, respectively. All patients from both groups achieved solid fusion during the follow-up period. The IBH and SA of the fused segment and CSA in Group II were better maintained during the follow-up period. Nine patients in Group I and two patients in Group II developed radiologic ASD. There were no statistically significant differences in the VAS score and Frankel grade between the groups.

Conclusion: This study showed that PEEK cage filled with DBM, and plate fixation is at least as safe and effective as ACDF using autograft, with good maintenance of cervical alignment. With advantages such as no donor site morbidity and no graft-related complications, PEEK cage filled with DBM, and plate fixation provide a promising surgical option for treating traumatic subaxial cervical spine injuries.
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http://dx.doi.org/10.3340/jkns.2015.0203.014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5365290PMC
March 2017

The effects a respiration rehabilitation program on IADL, satisfaction with leisure, and quality of sleep of patients with chronic obstructive pulmonary disease.

J Phys Ther Sci 2016 Dec 27;28(12):3357-3360. Epub 2016 Dec 27.

Rehabilitation Science, Daegu University, Republic of Korea.

[Purpose] This study was designed to determine the effect of a respiration rehabilitation program on daily activities, satisfaction with leisure, and quality of sleep of patients with chronic obstructive pulmonary disease. [Subjects and Methods] The program was conducted three times a week for 12 weeks (a total of 36 times) with 20 patients aged between 50 and 70 years old. The Frenchay Activity Index was used to determine the instrumental activities of daily living before and after the intervention. The Korean scale of satisfaction with leisure was employed to determine the satisfaction with leisure, and the Korean version of the Pittsburgh Sleep Quality Index was used to measure the quality of sleep. [Results] The total score of all three instruments (instrumental activities of daily living (IADL), satisfaction with leisure, and quality of sleep) improved significantly after the intervention. [Conclusion] In conclusion, the scores of all three instruments (IADL, satisfaction with leisure, and quality of sleep) improved significantly after the intervention, indicating that the respiration rehabilitation program was effective at improving the overall quality of life for patients with chronic obstructive pulmonary disease.
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http://dx.doi.org/10.1589/jpts.28.3357DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5276760PMC
December 2016

The influence of peripheral vision induced by moving people on postural control in healthy adults.

J Exerc Rehabil 2016 Oct 31;12(5):413-416. Epub 2016 Oct 31.

Department of Physical Therapy, Kaya University, Gimhae, Korea.

This study was conducted to examine the influence of the peripheral vision (PV) induced by moving people on postural control in healthy adults. The subjects consisted of 12 healthy adult volunteers (5 males, 7 females) who had been informed of the study purpose and procedure. The visual interventions were composed of three types. PV1 and PV2 were stimulated using a one-way vertical striped pattern and a two-way vertical striped pattern, respectively. To embody the features of moving people reflected in the mirrors, researchers recorded movements of people or objects provided by mirrors on video image. In this study, this was named PV3. The subjects were exposed to each of the visual stimuli for 3 min in a random order, and their postural control was then evaluated. All the subjects were allowed to practice once prior to performing the one leg stand test, functional reaching test and body sway test. All the evaluations were made before and after the visual intervention, and the subjects rested for 30 min between each intervention. PV3 ranked second in before and after differences of trace length and velocity and had no significant difference from PV2, demonstrating that the PV3, as well as PV2, affected the amount and velocity of body sway. In addition, the standard deviation velocity, trace length and velocity values of PV3 were higher than the PV1 values. Therefore, the treatment of those who have difficulty with postural control and balance maintenance should take place in a controlled therapeutic environment.
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http://dx.doi.org/10.12965/jer.1632718.359DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5091055PMC
October 2016

Long-term outcomes of surgery for chronic thromboembolic pulmonary hypertension compared with medical therapy at a single Korean center.

Korean J Intern Med 2017 Sep 13;32(5):855-864. Epub 2016 Oct 13.

Department of Pulmonary and Critical Care Medicine, Center for Pulmonary Hypertension and Venous Thrombosis, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Background/aims: Pulmonary endarterectomy (PEA) is the gold standard for treating chronic thromboembolic pulmonary hypertension (CTEPH) in Western countries. The aim of this study was to investigate the long-term outcomes of performing PEA on CTEPH patients in comparison with medical therapy at a single Korean center.

Methods: This retrospective study included 88 CTEPH patients. These patients were classified into the PEA group (n = 37) or non-PEA group (i.e., medical therapy; n = 51). The clinical characteristics, hemodynamic data, and long-term survival rates were compared. Independent prognostic factors for CTEPH were also investigated.

Results: CTEPH was not associated with either gender, and the mean age at diagnosis was 53.3 ± 13.7 years. Echocardiography revealed that the mean peak velocity of the tricuspid regurgitation jet was 4.2 ± 0.7 m/sec and the mean pulmonary arterial pressure was 51.7 ± 15.1 mmHg. The PEA and non-PEA groups demonstrated no significant differences, except in terms of the right ventricular end-diastolic diameter. The survival rates of the PEA group were significantly higher than the non-PEA group at 1, 3, 5, and 10 years ( = 0.032). Multivariate analyses indicated that World Health Organization class IV and PEA were significant predictors of poorer and better outcomes, respectively.

Conclusions: PEA demonstrates more favorable effects on long-term survival than medical therapy in Korean CTEPH patients who were considered operable.
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http://dx.doi.org/10.3904/kjim.2016.049DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5583453PMC
September 2017
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