Publications by authors named "Young Kwon Cho"

48 Publications

Outcome of Percutaneous Intervention in Dysfunctional Loop versus Straight Arteriovenous Grafts in Hemodialysis Patients.

J Belg Soc Radiol 2020 Sep 9;104(1):46. Epub 2020 Sep 9.

Kangdong Seong-Sim Hospital, Hallym University College of Medicine, KR.

Objective: To compare the patency control of dysfunctioning forearm arteriovenous graft (AVG) using percutaneous transluminal angioplasty (PTA) in patients with loop versus straight grafts.

Materials And Methods: Between January 2012 and March 2017, hemodialysis patients with forearm AVG were treated with PTA at two hospitals. We reviewed technical and clinical success rates of each procedure. Procedure time and patency of the graft were compared for all patients as well as for subgroups of stenosis only and thrombosis using paired-sample t-test and Kaplan-Meier analysis.

Results: Sixty-six patients (mean age, 62.11 ± 11.85 years) underwent PTA. Thirty-eight patients (58%) had loop grafts and 28 (42%) had straight grafts. Among 66 patients, 54 (82%) had thrombosis. Technical success rate was 95.5% (only stenosis: 100%; thrombosis: 94%) and the mean procedure time was 48.00 ± 16.75 minutes in all patients. Although there was a tendency towards shorter procedure time in patients with loop grafts (45.24 ± 20.24 minutes) than those with straight grafts (51.85 ± 22.76 minutes), the difference was not statistically significant (), with or without thrombi. There was no statistical significance in primary and assisted primary patency (log rank 0.78, in primary patency; log rank 0.88, in assisted primary patency).

Conclusion: Our study suggests there is no different patency outcome between straight and loop arteriovenous grafts after PTA.
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http://dx.doi.org/10.5334/jbsr.2146DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7485400PMC
September 2020

Silibinin Attenuates Silica Dioxide Nanoparticles-Induced Inflammation by Suppressing TXNIP/MAPKs/AP-1 Signaling.

Cells 2020 03 10;9(3). Epub 2020 Mar 10.

College of Veterinary Medicine (BK21 Plus Project Team), Chonnam National University, 77 Yongbong-ro, Buk-gu, Gwangju 61186, Korea.

Silica dioxide nanoparticles (SiONPs) have been applied to several fields, such as drug delivery and gene therapy. However, SiONPs are a constituent of fine dust and can induce excessive inflammatory responses in the lungs via the airways. Silibinin, a major component of silymarin, has been known for its anti-oxidant and anti-inflammatory effects. In the present study, we explored the protective effects of silibinin against SiONPs-induced airway inflammation and explored its underlying mechanism of action, focusing on thioredoxin-interacting protein (TXNIP)/mitogen-activated protein kinases (MAPKs) in vitro and in vivo. In SiONPs-stimulated NCI-H292 airway epithelial cells, silibinin treatment effectively suppressed the elevation of the mRNA expression of tumor necrosis factor-α (TNF-α), interleukin (IL)-6, and IL-1β, which was accompanied by the reduction in the expression of TXNIP, MAPKs, and activator protein-1 (AP-1). In SiONPs-treated mice, silibinin administration inhibited the increase in inflammatory cell counts and proinflammatory mediators, and it alleviated airway inflammation by SiONPs exposure. In addition, silibinin administration effectively suppressed the elevation of TXNIP/MAPKs/AP-1 signaling by SiONPs exposure. Taken together, silibinin effectively inhibited SiONPs-induced inflammatory responses, and this effect was closely related to the inhibition of TXNIP/MAPK/AP-1 signaling. These results suggested that silibinin might be useful for reducing pulmonary inflammation induced by SiONPs.
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http://dx.doi.org/10.3390/cells9030678DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7140632PMC
March 2020

Analysis of the altmetric top 100 articles with the highest altmetric attention scores in medical imaging journals.

Jpn J Radiol 2020 Jul 9;38(7):630-635. Epub 2020 Mar 9.

Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, 150, Seongan-Ro Gangdong-Gu, Seoul, 05355, Korea.

Purpose: Alternative metrics (altmetrics) provides a complementary measure of the impact of scientific articles. The aim of this study was to identify and characterize the top 100 articles with the highest Altmetric attention score (AAS) in medical imaging journals.

Materials And Methods: We searched for AASs articles published in 116 journals in the subject category "Radiology, Nuclear Medicine and Medical Imaging" using the Web of Science. We determined the top 100 articles with the highest AAS using the Altmetric.com database, and then analyzed them with regard to the publishing journal, year, country of origin, type of article, subspecialty, main topic, and imaging technique.

Results: The top 100 articles were published in 18 imaging journals, led by Radiology (47%). These articles were published from 2016 to 2018 (94%). Most of the articles were from the United States (62%) and were original clinical studies (59%). The most common subspecialties and imaging technique of study were neuroimaging (30%) and MRI (35%). The main topics of articles were brain disease and function (30%).

Conclusion: Our study presents a detailed list and analysis of the top 100 articles with the highest AAS in imaging literature, which provides unique characteristics representing the public's attention in this field.
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http://dx.doi.org/10.1007/s11604-020-00946-0DOI Listing
July 2020

CT Angiographic Evaluation of Congenital Anastomoses between Femoropopliteal Vein and Deep Femoral Vein: Types and Incidence.

J Vasc Interv Radiol 2020 Feb 3;31(2):265-269. Epub 2019 Oct 3.

Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, Republic of Korea.

Purpose: To evaluate congenital anastomotic channels between femoropopliteal veins and deep femoral veins with the use of computed tomographic (CT) venography.

Materials And Methods: CT venography of 488 limbs in 244 patients (105 men; mean age, 61 y; age range, 18-96 y) performed between January 2016 and December 2016 was retrospectively evaluated. The presence or absence of anastomotic channels (> 3 mm in diameter) connecting a femoropopliteal vein to a deep femoral vein was determined, and the observed channels were classified based on their location and course.

Results: Two types of anastomotic channels were observed in 32 patients (13%): a persistent sciatic vein (PSV) in 24 limbs of 15 patients (6%) and a retrofemoral channel (RFC) in 22 limbs of 19 patients (8%). A PSV anastomosed with the popliteal vein in the popliteal fossa, coursed posterior to the adductor magnus muscle, and drained into the deep femoral vein. An RFC anastomosed with the femoral vein at the level of the adductor hiatus, coursed posterior to the femoral shaft, and drained into the deep femoral vein. PSVs and RFCs were of similar size or larger than adjacent femoropopliteal veins in 50% (12 of 24) and 22% of limbs (4 of 22), respectively.

Conclusions: Anastomotic channels connecting a femoropopliteal vein to a deep femoral vein are not a rare variation and may have an important role in collateral venous drainage of the lower extremities.
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http://dx.doi.org/10.1016/j.jvir.2019.06.024DOI Listing
February 2020

Clinical Outcomes of the Seal® Thoracic Stent Graft for Traumatic Aortic Injury in a Korean Multicenter Retrospective Study.

Ann Vasc Surg 2019 Nov 6;61:400-409. Epub 2019 Aug 6.

Department of Radiology, Chonnam National University Hospital, Chonnam National University College of Medicine, Gwangju-si, Korea.

Background: Thoracic endovascular aneurysm repair (TEVAR) has been used as a primary treatment for blunt traumatic aortic injury (TAI). However, the outcomes of midterm surveillance of Seal® stent-graft durability for TAI have not been extensively studied. Thus, we aimed to report the midterm outcomes of TEVAR using the Seal® stent graft for blunt TAI.

Methods: Patients with blunt TAI treated with TEVAR using the Seal® thoracic stent graft between 2007 and 2013 in Korea were included. Midterm outcomes included technical/clinical success, in-hospital death, aorta/procedure/device-related adverse events, secondary procedures, and 30-day and all-cause mortality.

Results: A total of 99 patients (54% men; mean age, 48 years) were included. Grade III or higher injuries were present in 95% of patients, including 15 free ruptures of the thoracic aorta, and 64% of injuries were located in zone III. The median procedure and hospitalization duration were 90 min and 11 days, respectively. The technical success rate was 98%. The number of in-hospital mortalities (n = 8) and stroke (n = 2) were observed at 30 days. Late stroke and paraplegia (>30 days) were not observed during the mean 49 ± 26 months of follow-up (median, 48 months; range, 0-117 months). There were no aorta-related mortalities or conversions to open repair. Secondary procedures were performed in 8 patients, all of which were carotid-subclavian bypasses for delayed left subclavian occlusion. The all-cause mortality rate was 5% at 30 days and 8% at 1 year. The survival rate was 95% at 30 days, 92% at 1 year, 92% at 3 years, and 89% at 5 years. One type Ia endoleak occurred at 18 months after the procedure.

Conclusions: TEVAR with the Seal® stent graft for TAI showed favorable midterm outcomes. The incidence of major adverse events after the procedure was low.
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http://dx.doi.org/10.1016/j.avsg.2019.06.006DOI Listing
November 2019

Histologic Analysis with the Newly Designed Exoskeleton Seal Stent-Graft in the Porcine Abdominal Aorta.

Cardiovasc Intervent Radiol 2019 Sep 14;42(9):1331-1342. Epub 2019 Jun 14.

Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.

Purpose: To investigate the technical feasibility of a novel exoskeleton Seal stent-graft and analyze early histologic changes in the porcine abdominal aorta.

Materials And Methods: Six pigs received an abdominal stent-graft (Group I), and six received an iliac branch stent-graft (Group II). Groups were subdivided as follows: Group Ia, which received three bifurcated main-body stent-grafts; Group Ib, which received three bifurcated main-body stent-grafts with both iliac graft-stents; Group IIa, which received three simple uni-iliac tapered stent-grafts; and Group IIb, which received three uni-iliac tapered tapered stent-grafts with right straight limb and left branched limb. Statistical analyses were performed with the Wilcoxon signed-rank test and mixed-model regression analysis.

Results: The primary technical success rate (< 24 h) was 83% because of two acute thromboses in the lumen of the stented abdominal aorta immediately after stent-graft placement. At 4 weeks, late thrombosis occurred in two pigs. Higher mean neointimal hyperplasia areas (23.5% vs. 16.2%; P = .047), neointimal hyperplasia thicknesses (545.5 μm vs. 422.2 μm; P = .001), and degrees of collagen deposition (2.71 vs. 2.33; P = .002) were observed at the bare-metal stent-graft compared with the proximal exoskeleton portion of the stent-graft, with no significant differences between the patent and occluded groups or among the four types of stent-grafts.

Conclusions: The exoskeleton stent-graft demonstrates 66% of patency rate during 1-month follow-up due to four cases of thromboses; however, the endothelialization on the junction of proximal graft showed no significant differences between the patent and occluded groups. Further studies should investigate long-term outcomes with prolonged neointimal hyperplasia.
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http://dx.doi.org/10.1007/s00270-019-02261-2DOI Listing
September 2019

So-Cheong-Ryoung-Tang Attenuates Pulmonary Inflammation Induced by Cigarette Smoke in Bronchial Epithelial Cells and Experimental Mice.

Front Pharmacol 2018 21;9:1064. Epub 2018 Sep 21.

BK21 Plus Project Team, College of Veterinary Medicine, Chonnam National University, Gwangju, South Korea.

So-Cheong-Ryoung-Tang is a traditionally used herbal formula for the treatment of pulmonary diseases in China, Korea, and Japan. We investigated the protective effects of So-Cheong-Ryong-Tang water extract (SCWE) in cigarette smoke concentrate (CSC) stimulated human airway epithelial cell line NCI-H292 and mice exposed cigarette smoke (CS) and lipopolysaccharide (LPS). In the CSC-stimulated NCI-H292 cells, SCWE inhibited proinflammatory cytokines in a concentration-dependent manner, as evidenced by a reduction in their mRNA levels. Also, SCWE significant reduced inducible nitric oxide synthase (iNOS) expression and nuclear factor kappa B (NF-κB) phosphorylation in CSC-stimulated cells. The mice were exposed to CS for 1 h per day (a total of eight cigarettes per day) for 7 days and received LPS intranasally on day 5. The mice were administered a dose of SCWE (100 and 200 mg/kg) 1 h before CS exposure. In , SCWE decreased the inflammatory cell count and reduced the expression of the proinflammatory cytokines in the broncho-alveolar lavage fluid (BALF) compared with CS and LPS exposed mice. SCWE attenuated inflammatory cell infiltration in airway induced by CS and LPS exposure, and this decrease was accompanied by a reduction in the expression levels of iNOS and MMP-9 in lung tissue. The extract also inhibited the phosphorylation of inhibitor of kappa B alpha (IκBα) and NF-κB induced by CS and LPS exposure in lung tissue. These results suggest that SCWE may effectively inhibit airway inflammatory responses induced by CS and LPS exposure via the NF-κB pathway. Therefore, SCWE may be a potential treatment for airway inflammatory diseases, such as chronic obstructive pulmonary disease (COPD).
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http://dx.doi.org/10.3389/fphar.2018.01064DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6160558PMC
September 2018

Galgeun-tang Attenuates Cigarette Smoke and Lipopolysaccharide Induced Pulmonary Inflammation via IκBα/NF-κB Signaling.

Molecules 2018 Sep 28;23(10). Epub 2018 Sep 28.

Herbal Medicinal Research Center, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Daejeon 34054, Korea.

Galgeun-tang water extract (GGWE) is used to treat various diseases such as the common cold, eczema and asthma in China and Korea. In this study, we investigated the anti-inflammatory effect of GGWE using a cigarette smoke (CS)- and lipopolysaccharide (LPS)-induced induced pulmonary inflammation mouse model. The mice were exposed to CS for a total of seven days (eight cigarettes per day for 1 h) and LPS was administered intranasally to mice on day 4. GGWE was administered by oral gavage at doses of 50 mg/kg or 100 mg/kg 1 h before exposure to CS. GGWE decreased inflammatory cell counts, and expression of inflammatory cytokines such as interleukin (IL)-6 and tumor necrosis factor alpha (TNF-α) in bronchoalveolar lavage fluid (BALF) from mice exposed to CS and LPS. GGWE reduced the expression of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2), as well as the phosphorylation of inhibitor of kappa-B subunit alpha (IκBα) and nuclear factor kappa-B (NF-κB) in CS- and LPS-exposed mice. Histological examinations revealed that GGWE suppressed inflammatory cell infiltration into lung tissue compared to untreated CS- and LPS-exposed mice. In conclusion, GGWE effectively suppressed CS- and LPS-induced pulmonary inflammation. Our results indicate that GGWE may be used as a protective drug to control pulmonary inflammation diseases such as chronic obstructive pulmonary disease.
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http://dx.doi.org/10.3390/molecules23102489DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6222390PMC
September 2018

Lobeglitazone Attenuates Airway Inflammation and Mucus Hypersecretion in a Murine Model of Ovalbumin-Induced Asthma.

Front Pharmacol 2018 8;9:906. Epub 2018 Aug 8.

K-herb Research Center, Korea Institute of Oriental Medicine, Daejeon, South Korea.

Lobeglitazone (LB) is a novel agonist of peroxisome proliferator-activated receptor (PPAR)-α and γ that was developed as a drug to treat diabetes mellitus. We explored the ameliorative effects of LB on allergic asthma using a murine model of ovalbumin (OVA)-induced asthma. To boost the immune response of animals, OVA sensitization was performed on days 0 and 14. LB (250 or 500 μg/kg) was administered by oral gavage on days 18 to 23, and the OVA challenge was performed using an ultrasonic nebulizer on days 21 to 23. Plethysmography showed airway hyperresponsiveness (AHR) on day 24. LB treatment effectively decreased inflammatory cell recruitment, T-helper type 2 cytokines in the bronchoalveolar lavage fluid, and immunoglobulin (Ig) E in the serum of the animals with OVA-induced asthma, which was accompanied by a marked reduction in AHR. It also decreased airway inflammation, mucus hypersecretion, phosphorylation of nuclear transcription factor-kappa-B (NF-κB), and expression of activating protein (AP)-1 and mucin 5AC (MUC5AC). Overall, LB effectively attenuated the pathophysiological changes of asthma and its effects appear related to a reduction in the phosphorylation of NF-κB and the expression of AP-1. Thus, our results suggest that LB has a potential to treat allergic asthma.
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http://dx.doi.org/10.3389/fphar.2018.00906DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6092601PMC
August 2018

The most downloaded and most cited articles in radiology journals: a comparative bibliometric analysis.

Eur Radiol 2018 Nov 7;28(11):4832-4838. Epub 2018 May 7.

Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, 150, Seongan-ro Gangdong-Gu, Seoul, 134-701, Korea.

Objectives: To evaluate and compare the characteristics of the most downloaded and most cited articles in radiology journals.

Methods: We selected 41 radiology journals that provided lists of both the most downloaded and most cited articles on their websites, and identified the 596 most downloaded articles and 596 most cited articles. We compared the following characteristics of the most downloaded and most cited articles: year of publication, journal title, department of the first author, country of origin, publication type, radiologic subspecialty, radiologic technique and accessibility.

Results: Compared to the most cited articles, the most downloaded articles were more frequently review articles (36.1% vs 17.1%, p < 0.05), case reports (5.9% vs 3.2%, p < 0.05), guidelines/consensus statements (5.4% vs 2.7%, p < 0.05), editorials/commentaries (3.7% vs 0.7%, p < 0.05) and pictorial essays (2.0% vs 0.2%, p < 0.05). Compared to the most cited articles, the most downloaded articles more frequently originated from the UK (8.7% vs 5.0%, p < 0.05) and were more frequently free-access articles (46.0% vs 39.4%, p < 0.05).

Conclusion: Educational and free-access articles are more frequent among the most downloaded articles.

Key Points: • There was only small overlap between the most downloaded and most cited articles. • Educational articles were more frequent among the most downloaded articles. • Free-access articles are more frequent among the most downloaded articles.
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http://dx.doi.org/10.1007/s00330-018-5423-1DOI Listing
November 2018

Interventional management of central vein occlusion in patients with peripherally inserted central catheter placement.

J Vasc Surg Venous Lymphat Disord 2018 09 31;6(5):566-574. Epub 2018 Mar 31.

Department of Surgery, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, Korea.

Objective: This study evaluated the incidence of central vein occlusion (CVO) and analyzed the interventional management for CVO during peripherally inserted central catheter (PICC) placement to suggest an adequate management protocol to ensure the success and patency of PICCs.

Methods: We retrospectively reviewed the records of 2568 PICCs to identify CVO in two medical centers between January 2016 and June 2017. Procedural images were reviewed for the following items: date and indication for the PICC; type of catheter; accessed vein and arm; characteristics of CVO on ascending arm venography; PICC placement technique; indwelling period of the PICC; and follow-up records. A guidewire passage trial was performed to the CVO, as follows: a trial with a 0.018-inch single or double guidewire through the pretrimmed PICC lumen; and a trial with a combination of a 0.035-inch guidewire and a curved 5F diagnostic catheter through the PICC introducer sheath.

Results: The incidence of CVO was 3.2% (71/2232), and 59 patients were analyzed (23 men; mean age, 69 ± 11 years; median age, 80 years; age range, 31-92 years). Forty-four patients had thrombotic CVO, and 12 patients had acute thrombotic CVO. Thirty-six patients had occlusion of the left innominate vein, and six patients had contiguous involvement of the adjacent central vein. Forty-two patients had obtuse stump morphology of CVO, and 28 patients had grade >III collateral development. The PICC indwelling time was statistically different between the group with successful catheter advancement (n = 36, success group) and the group with failed catheter advancement (n = 18, failure group; P = .007) with ipsilateral trimmed PICCs. Eight patients had a symptomatic catheter associated with upper extremity deep venous thrombosis (UEDVT; <30 days), one in the success group and seven in the failure group. The incidence of catheter-associated UEDVT after primary PICC placement on each arm was statistically different between the success and failure groups (P = .004).

Conclusions: A PICC passage trial for ipsilateral CVO is challenging but frequently successful with a simple guidewire technique, which can preserve catheter patency, decrease contralateral arm access, and prevent the development of new catheter-associated UEDVT.
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http://dx.doi.org/10.1016/j.jvsv.2018.01.006DOI Listing
September 2018

Clinical Outcomes of Endovascular Aneurysm Repair with the Kilt Technique for Abdominal Aortic Aneurysms with Hostile Aneurysm Neck Anatomy: A Korean Multicenter Retrospective Study.

Cardiovasc Intervent Radiol 2018 Apr 26;41(4):554-563. Epub 2017 Dec 26.

Department of Surgery, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, Korea.

Purpose: We aimed to evaluate the clinical efficacy and short-term clinical outcomes of Kilt technique-based endovascular aneurysm repair (EVAR) with Seal stent-grafts for abdominal aortic aneurysms (AAAs) with hostile neck anatomy (angle > 60°).

Materials And Methods: We retrospectively evaluated the pre-EVAR and follow-up computed tomography angiography findings of 24 patients (mean age 71 ± 11 years; age range 32-87 years; mean follow-up 50 ± 12 months) with hostile neck AAAs treated between 2010 and 2015. Serial change in aneurysmal neck angle was calculated using a standardized protocol. Relationships between clinical variables and outcomes were evaluated using univariate and multivariate Cox analyses and mixed-model regression. In addition, the Kaplan-Meier method was used to assess the cumulative rates of survival, endoleak, and reintervention.

Results: The primary technical success rate (success within 24 h after EVAR) was 100% (24/24). The survival rate was 96 ± 8% at 1 month, 6 months, 1 year, and 3 years, and 87 ± 18% at 5 years. Endoleaks occurred in three patients. Four reinterventions were performed in three patients; no surgical revisions were required. Causes of post-EVAR mortality included intracerebral hemorrhage at 14 days and rhabdomyolysis at 32 months. The most remarkable change after Kilt-based EVAR was an acute decrease in the neck angle, which was observed between the pre-EVAR and first follow-up visits (at 1 month) (P = 0.001).

Conclusion: Kilt-based EVAR with Seal stent-grafts for AAAs with a severely angulated neck (angle > 60°) provided high technical success, low mortality, and low complication rates during short-term follow-up.
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http://dx.doi.org/10.1007/s00270-017-1867-yDOI Listing
April 2018

The blind pushing technique for peripherally inserted central catheter placement through brachial vein puncture.

J Vasc Surg 2018 03 16;67(3):860-867. Epub 2017 Nov 16.

Department of Surgery, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, Korea.

Objective: The objective of this study was to conduct a prospective clinical trial evaluating the technical feasibility and short-term clinical outcome of the blind pushing technique for placement of pretrimmed peripherally inserted central catheters (PICCs) through brachial vein access.

Methods: Patients requiring PICC placement at any of the three participating institutions were prospectively enrolled between January and December 2016. The review boards of all participating institutions approved this study, and informed consent was obtained from all patients. PICC placement was performed using the blind pushing technique and primary brachial vein access. The following data were collected from unified case report forms: access vein, obstacles during PICC advancement, procedure time, and postprocedural complications.

Results: During the 12-month study period, 1380 PICCs were placed in 1043 patients. Of these, 1092 PICCs placed in 837 patients were enrolled, with 834 PICCs (76%) and 258 PICCs (34%) placed through brachial vein and nonbrachial vein access, respectively. In both arms, obstacles were most commonly noted in the subclavian veins (n = 220) and axillary veins (n = 94). Successful puncture of the access vein was achieved at first try in 1028 PICCs (94%). The technical success rate was 99%, with 1055 PICCs (97%) placed within 120 seconds of procedure time and 1088 PICCs (99%) having the tip located at the ideal position. Follow-up Doppler ultrasound detected catheter-associated upper extremity deep venous thrombosis (UEDVT) for 18 PICCs in 16 patients and late symptomatic UEDVT for 16 PICCs in 16 patients (3.1%). Catheter-associated UEDVT was noted for 28 PICCs (82%) and 6 PICCs (18%) placed through brachial vein and nonbrachial vein access, respectively. The incidence of obstacles and the procedure time (<120 seconds) differed significantly between brachial vein and nonbrachial vein access (P = .001). There was no statistically significant difference between brachial vein and nonbrachial vein access in the incidence of UEDVT (odds ratio, 0.68; 95% confidence interval, 0.59-3.52; P = .22).

Conclusions: The placement of pretrimmed PICCs by the blind pushing technique and primary brachial vein access is technically feasible and may represent an alternative to the conventional PICC placement technique, having low incidences of UEDVT and other complications, with no significant difference in outcomes between brachial vein and nonbrachial vein access.
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http://dx.doi.org/10.1016/j.jvs.2017.09.016DOI Listing
March 2018

4-Hydroxycinnamic acid protects mice from cigarette smoke-induced pulmonary inflammation via MAPK pathways.

Food Chem Toxicol 2017 Dec 18;110:151-155. Epub 2017 Oct 18.

College of Veterinary Medicine BK21 Plus Project Team, Chonnam National University, Gwangju 61186, Republic of Korea. Electronic address:

Cigarette smoke (CS) is the main etiological cause of chronic obstructive pulmonary disease, the prevalence of which has continuously increased in recent years. 4-Hydroxycinnamic acid (HA) is a plant phenolic acid that has anti-inflammatory activities. In this study, we explored the therapeutic effects of HA on airway inflammation caused by CS and lipopolysaccharide (LPS) in mice. The animals received 1 h of CS exposure for 7 days and intranasal instillation of LPS on day 4. HA (10 and 20 mg/kg) was administered to animals via oral gavage 1 h before CS exposure. HA treatment significantly decreased the accumulation of inflammatory cells and production of cytokines, including tumor necrosis factor-α, interleukin (IL)-6, and IL-1β, caused by CS and LPS exposure. After histological examination, we observed that HA treatment significantly reduced the infiltration of inflammatory cells into lung tissue caused by CS and LPS exposure. Furthermore, HA-treated groups showed significantly decreased phosphorylation of extracellular signal-regulated kinase, c-Jun N-terminal kinase, p38, and nuclear factor-κB, and activity of cytochrome c oxidase subunit-2 caused by CS and LPS. In conclusion, HA effectively suppresses the airway inflammatory response induced by CS and LPS exposure, and is closely associated with the downregulation of mitogen-activated protein kinases signaling.
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http://dx.doi.org/10.1016/j.fct.2017.10.027DOI Listing
December 2017

Genipin inhibits allergic responses in ovalbumin-induced asthmatic mice.

Int Immunopharmacol 2017 Dec 15;53:49-55. Epub 2017 Oct 15.

College of Veterinary Medicine (BK21 Plus Project Team), Chonnam National University, 77 Yongbong-ro, Buk-gu, Gwangju 61186, Republic of Korea. Electronic address:

Genipin is a natural compound isolated from the fruit of Gardenia jasminoides with various pharmacological effects. In this study, we investigated whether genipin effectively alleviates allergic responses in a murine model of ovalbumin (OVA)-induced asthma. The mice were administered an intraperitoneal injection of OVA on day 0 and 14 to boost the immune response; genipin was then administered from day 18 to 23 by oral gavage. On days 21 to 23, mice were OVA-challenged using am ultrasonic nebulizer, and airway hyperresponsiveness (AHR) was determined on day 24 by plethysmography. Genipin significantly reduced the inflammatory cell count in bronchoalveolar lavage fluids (BALF) and AHR, which were accompanied by lower interleukin-5 (IL-5), IL-13 and OVA-specific immunoglobulin (Ig) E levels in the BALF or serum from OVA-induced asthmatic mice. In histology, genipin significantly decreased airway inflammation and mucus hypersecretion in OVA-induced asthmatic mice. Additionally, genipin inhibited OVA-induced increases in the expression of inducible nitric oxide synthase and cyclooxygenase-2 proteins. Further, genipin reduced the activity and protein levels of matrix metalloproteinase-9 in lung tissue from OVA induced asthmatic mice. Overall, genipin effectively alleviated the asthmatic inflammatory response in an OVA-induced asthmatic model. Therefore, our results suggest that genipin has therapeutic potential for treating asthma.
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http://dx.doi.org/10.1016/j.intimp.2017.10.010DOI Listing
December 2017

Pine bark extract (Pycnogenol®) suppresses cigarette smoke-induced fibrotic response via transforming growth factor-β1/Smad family member 2/3 signaling.

Lab Anim Res 2017 Jun 30;33(2):76-83. Epub 2017 Jun 30.

College of Veterinary Medicine (BK21 Plus Project Team), Chonnam National University, 77 Yongbongro, Buk-gu, Gwangju 500-757, Korea.

Chronic obstructive pulmonary diseases (COPD) is an important disease featured as intense inflammation, protease imbalance, and air flow limitation and mainly induced by cigarette smoke (CS). In present study, we explored the effects of Pycnogenol® (PYC, pine bark extract) on pulmonary fibrosis caused by CS+lipopolysaccharide (LPS) exposure. Mice were treated with LPS intranasally on day 12 and 26, followed by CS exposure for 1 h/day (8 cigarettes per day) for 4 weeks. One hour before CS exposure, 10 and 20 mg/kg of PYC were administered by oral gavage for 4 weeks. PYC effectively reduced the number of inflammatory cells and proinflammatory mediators caused by CS+LPS exposure in bronchoalveolar lavage fluid. PYC inhibited the collagen deposition on lung tissue caused by CS+LPS exposure, as evidenced by Masson's trichrome stain. Furthermore, transforming growth factor-β1 (TGF-β1) expression and Smad family member 2/3 (Smad 2/3) phosphorylation were effectively suppressed by PYC treatment. PYC markedly reduced the collagen deposition caused by CS+LPS exposure, which was closely involved in TGF-β1/Smad 2/3 signaling, which is associated with pulmonary fibrotic change. These findings suggest that treatment with PYC could be a therapeutic strategy for controlling COPD progression.
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http://dx.doi.org/10.5625/lar.2017.33.2.76DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5527150PMC
June 2017

Intraobserver and Interobserver Variability in Ultrasound Measurements of Thyroid Nodules.

J Ultrasound Med 2018 Jan 24;37(1):173-178. Epub 2017 Jul 24.

Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, Korea.

Objectives: The purpose of this study was to assess the intraobserver and interobserver variability in ultrasound (US) measurements of thyroid nodules.

Methods: We performed a prospective study of the US examinations of 73 patients with 122 thyroid nodules greater than 5 mm in size. Ultrasound measurements in 4 dimensions (anteroposterior, transverse, longitudinal, and maximum diameters) and measurement of the estimated volume (using the ellipsoid formula) of each thyroid nodule were performed twice by 2 independent radiologists (A and B, with 10 years and 6 months of experience, respectively). The intraobserver and interobserver variability in measurements of thyroid nodules was assessed by a Bland-Altman analysis of agreement. The absolute values for intraobserver and interobserver variability were compared by a paired t test.

Results: The 95% intraobserver and interobserver limits of agreement for the anteroposterior, transverse, longitudinal, and maximum diameters and estimated volume of thyroid nodules were ±18.2%, ± 14.3%, and ±21.0%; ± 17.2%%, ± 17.3%, and 18.2%; ± 14.6%, ± 15.5%, and ±22.3%; ± 13.8%, ± 15.5%, and ±19.6%; and ±30.2%, ± 27.7%, and ±44.1%, respectively. The absolute values for intraobserver variability were lower than those for interobserver variability for all measurements.

Conclusions: There was considerable intraobserver and interobserver variability in US measurement of thyroid nodules, which must be taken into account during follow-up US examinations of patients with thyroid nodules.
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http://dx.doi.org/10.1002/jum.14316DOI Listing
January 2018

Silibinin inhibits the fibrotic responses induced by cigarette smoke via suppression of TGF-β1/Smad 2/3 signaling.

Food Chem Toxicol 2017 Aug 8;106(Pt A):424-429. Epub 2017 Jun 8.

College of Veterinary Medicine (BK21 Plus Project Team), Chonnam National University, 77 Yongbong-ro, Buk-gu, Gwangju 500-757, Republic of Korea. Electronic address:

Cigarette smoke (CS) is generally accepted as a major contributor to chronic obstructive pulmonary disease (COPD) which is characterized by chronic inflammation, fibrotic response, and airway obstruction. In this study, we investigated the preventive effects of silibinin, an active constitute of silymarin on CS and lipopolysaccharide (LPS) exposure-induced fibrotic response. Mice were exposed to CS for 1 h per day (8 cigarettes per day) for 4 weeks. On day 12 and 26, mice were treated with LPS intranasally. Silibinin (10 or 20 mg/kg) was administered orally 1 h before CS exposure. Silibinin markedly decreased the inflammatory cell count in the bronchoalveolar lavage fluid, and reduced levels of proinflammatory mediators. Silibinin suppressed CS + LPS-induced collagen deposition in lung tissue, as evidenced via immunohistochemistry and Masson's trichrome stain. Additionally, silibinin effectively inhibited CS + LPS-mediated expression of transforming growth factor-β1 (TGF-β1) and Smad 2/3 phosphorylation. Taken together, our data indicate that silibinin effectively inhibits the fibrotic response induced by CS + LPS exposure, possibly via suppression of TGF-β1/Smad 2/3 signaling, which results in reduced collagen deposition. These findings suggest that silibinin has therapeutic potential for the treatment of COPD.
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http://dx.doi.org/10.1016/j.fct.2017.06.016DOI Listing
August 2017

Clinical Outcomes for Endovascular Repair of Thoracic Aortic Disease Using the Seal Thoracic Stent Graft: A Korean Multicenter Retrospective Study.

J Vasc Interv Radiol 2017 May 28;28(5):645-654. Epub 2017 Feb 28.

Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.

Purpose: To investigate the midterm outcomes of thoracic endovascular aneurysm repair (TEVAR) with the use of the Seal stent graft for four categories of thoracic aortic disease.

Materials And Methods: This retrospective multicenter study evaluated the records of 216 Korean patients who underwent TEVAR with the Seal stent graft during 2007-2010. The study outcomes were (i) perioperative death, (ii) endoleak, (iii) repeat intervention, (iv) aortic-related death, and (v) all sudden unexplained late deaths.

Results: The overall technical success rate was 94% (203 cases), and the disease-specific rates were 97% (88 cases) for aneurysms, 96% (71 cases) for dissections, 82% (32 cases) for traumatic aortic disease, and 100% (12 cases) for intramural hematoma and/or penetrating aortic ulcer. There were 6 acute surgical conversions (2 for aneurysms and 4 for dissections). There were 18 endoleaks, 4 retrograde ascending aortic dissections, and 6 stent graft-induced new entries. The 1-, 3-, and 5-year overall survival rates were 93% ± 3, 90% ± 4, and 90% ± 4, respectively.

Conclusions: TEVAR with the Seal thoracic stent graft provided a high technical success rate and low mortality and complication rates during midterm follow-up. However, additional long-term studies are needed to evaluate the durability and late complications associated with this device.
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http://dx.doi.org/10.1016/j.jvir.2016.12.1227DOI Listing
May 2017

Protective effect of HwangRyunHaeDok-Tang water extract against chronic obstructive pulmonary disease induced by cigarette smoke and lipopolysaccharide in a mouse model.

J Ethnopharmacol 2017 Mar 16;200:60-65. Epub 2017 Feb 16.

College of Veterinary Medicine (BK21 Plus Project Team), Chonnam National University, 77 Yongbong-ro, Buk-gu, Gwangju 500-757, Republic of Korea. Electronic address:

Ethnopharmacological Relevance: Hwangryunhaedok-tang is an oriental herbal formula treated to cure inflammation and gastric disorders in China, Japan, and Korea. We explored the protective effects of Hwangryunhaedok-tang water extract (HRWE) against airway pathophysiological changes caused by cigarette smoke (CS) and lipopolysaccharide (LPS) in a mouse.

Materials And Methods: We performed quantitative analyses of five marker components, namely geniposide, baicalin, coptisine, plamatine, and berberine, using high-performance liquid chromatography. Animals were received CS exposure (1h per day) for 7 days. LPS was administered intranasally on day 4. Mice were received HRWE at dose of 100 or 200mg/kg for 1h before CS exposure.

Results: Treatment with HRWE significantly suppressed the increased inflammatory cell count induced by CS and LPS exposure. In addition, reduction in IL-6, TNF-α and IL-1β in broncho-alveolar lavage fluid (BALF) was observed after HRWE treatment. HRWE not only decreased inflammatory cell infiltration in lung, but also decreased the expression of iNOS, NF-κB and matrix metallopeptidase (MMP)-9 in lung tissues.

Conclusion: This study showed that HRWE can attenuate respiratory inflammation caused by CS and LPS exposure. Therefore, HRWE has potential for treating airway inflammatory disease.
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http://dx.doi.org/10.1016/j.jep.2017.02.027DOI Listing
March 2017

Outcomes of Esophageal Arterial Embolization for Treatment of Hemoptysis.

J Vasc Interv Radiol 2017 Feb 7;28(2):284-290. Epub 2016 Dec 7.

Department of Radiology, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, United Arab Emirates.

Purpose: To investigate safety and efficacy of esophageal arterial embolization (EAE) in addition to bronchial arterial embolization (BAE) for treatment of hemoptysis as well as the importance and characteristics of esophageal arteries in patients with hemoptysis.

Materials And Methods: Between January 2013 and December 2014, 20 patients (13 men and 7 women, mean age 58.4 y) underwent EAE in addition to BAE for hemoptysis. Retrospective review of patient records was performed to evaluate major causes of hemoptysis, treatment indications based on CT findings, esophageal angiography findings, and outcomes after embolization including clinical success rate and complications.

Results: Hemoptysis was caused by bronchiectasis (12 patients), tuberculosis (7 patients), and lobectomy (1 patient). CT showed lower lobe lung lesions in all (100%) patients. The esophageal arteries originated from the aorta between the carina and diaphragm (18 patients) or from the inferior phrenic arteries (2 patients) and were tortuous with longitudinal off-midline courses. Communications between the esophageal and the bronchial or inferior phrenic arteries were present in 12 patients. One patient who was treated using N-butyl cyanoacrylate developed dysphagia that resolved with medical treatment. Repeat BAE was performed in 2 patients 5 days and 20 days later, and the clinical success rate was 90% (18/20).

Conclusions: EAE in addition to BAE is safe in the treatment of hemoptysis and should be considered for lower lobe lesions.
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http://dx.doi.org/10.1016/j.jvir.2016.09.026DOI Listing
February 2017

Clinical outcomes for endovascular repair of abdominal aortic aneurysm with the Seal stent graft.

J Vasc Surg 2016 Nov 6;64(5):1270-1277. Epub 2016 May 6.

Department of Radiology, KEPCO Medical Center, Seoul, Korea.

Objective: Since 2007, the availability of the Seal (S & G Biotech Inc, Seong-nam, Gyeonggi-do, Korea) stent graft for endovascular aneurysm repair (EVAR) has improved short-term outcomes in Korea. However, midterm outcome data are lacking. This retrospective study evaluated the midterm outcomes of 126 patients who underwent EVAR using the Seal stent graft between 2007 and 2010.

Methods: Data regarding use of the Seal stent graft for EVAR were collected from 16 Korean centers, and were analyzed retrospectively using Kaplan-Meier and Cox univariate and multivariate analyses.

Results: The mean patient age was 71 ± 8 years (median, 70; range, 49-87 years). Patients who were treated using a bifurcated graft (113; 90%) were generally symptomatic (56; 44%, which included 13 ruptured abdominal aortic aneurysms [10%]) and male (105; 83%). The primary technical success rate was 99%. Four patients (3%) died within 30 days, 5 patients (4%) died after 30 days, and 12 patients (9%) were lost to follow-up. The survival rates were 97% ± 2% (1 month), 97% ± 2% (3 months), 96% ± 2% (6 months), 96% ± 2% (1 year), 94% ± 3% (3 years), and 81% ± 10% (5 years). During a mean follow-up of 55 ± 22 months (median, 40; range, 0.03-91.2 months), 18 reinterventions were performed for 16 patients (13%). The freedom from reintervention rates were 96% ± 2% (1 month), 96% ± 2% (3 months), 94% ± 2% (6 months), 89% ± 3% (1 year), 84% ± 4% (3 years), and 57% ± 17% (5 years). The mean aneurysm diameter significantly decreased from 69.6 to 46.6 mm during the follow-up (P < .0001). A proximal neck of less than 15 mm, different simultaneous endoleaks, and insufficient bilateral coverage of the iliac aneurysm were associated with significantly higher rates of increased or unchanged aneurysm diameters (all P < .0001). Significantly higher rates of clinical failure were observed in patients who were less than 70 years old (P = .04), had a neck length of less than 15 mm (P = .02), and had a neck diameter of greater than 28 mm (P = .02).

Conclusions: Most Seal stent grafts were implanted successfully (even in cases with a physical status of grade IV or higher or a ruptured abdominal aortic aneurysm), had an appropriate reintervention rate, and were stable during the midterm follow-up. However, there was a high rate of type I endoleak, which may be related to the early device model that we used. Therefore, long-term radiologic follow-up is recommended for the early detection of stent graft migration or endoleaks.
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http://dx.doi.org/10.1016/j.jvs.2016.02.057DOI Listing
November 2016

Characteristics and quality of published animal research in the field of radiology.

Acta Radiol 2017 Jun 26;58(6):685-691. Epub 2016 Aug 26.

Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, Republic of Korea.

Background Animal research has played an important role in the field of radiology. Purpose To evaluate the characteristics and quality of published radiological animal research. Material and Methods A PubMed search was performed for radiological animal research articles (defined as studies using animal models with a radiologist as the first author) published in 1994, 2004, and 2014. The following information was extracted from each article: journal name, radiological subspecialty, imaging technique, animal species, number of animals used, number of authors, declared funding, country of origin, methodological quality, and ethical quality. Methodological and ethical quality of studies were assessed with seven-item (sample size calculation, animal age, animal sex, animal weight, inclusion and exclusion criteria, randomization, and blinded outcome assessment) and four-item (ethical review committee approval, anesthesia, pain control, and euthanasia) scales, respectively. Results The numbers of radiological animal studies markedly increased, from 91 in 1994 to 163 in 2004 and to 305 in 2014. One hundred and sixty-two (29.0%) articles focused on the neuroradiology/head and neck subspecialty, 233 (41.7%) used magnetic resonance imaging (MRI), 190 (34.0%) used mice, 254 (45.4%) used 10-30 animals, 297 (53.1%) had 4-7 authors, 392 (70.1%) were funded, and 222 (39.7%) were from the USA. Six of 7 methodological and 3/4 ethical quality items significantly improved over time. Conclusion The quantity and quality of radiological animal research has increased over the last two decades; however, methodological and ethical quality remains suboptimal.
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http://dx.doi.org/10.1177/0284185116665423DOI Listing
June 2017

Predicting Factors for Successful Maturation of Autogenous Haemodialysis Fistulas After Salvage Percutaneous Transluminal Angioplasty in Diabetic Nephropathy: A Study on Follow-Up Doppler Ultrasonography.

Iran J Radiol 2016 Jan 30;13(1):e32559. Epub 2016 Jan 30.

Department of Internal Medicine, National Police Hospital, Seoul, Republic of Korea.

Background: Maturation failure of autogenous arteriovenous fistula (aAVF) has been increasing after surgical procedures and the salvage percutaneous transluminal angioplasty (sPTA) for immature aAVF has been identified as an effective treatment modality.

Objectives: The aim of this study was to identify factors predicting successful aAVF maturation and to determine positive technical aspects of sPTA.

Patients And Methods: We retrospectively reviewed medical records and radiological images of 59 patients who had undergone sPTA for non-maturing aAVFs. We analysed images from pre-surgical mapping Doppler ultrasonography, angiography, and angioplasty and follow-up Doppler ultrasonography performed within two weeks after sPTA. We assessed the following factors, for their ability to predict successful aAVF maturation: 1) patient factors (age; sex; co-morbidities; and aAVF age, side and type); 2) vessel factors (cephalic vein diameter and depth, presence of accessory veins, and pre- and postoperative radial artery disease); 3) lesion factors (stenosis number, location and severity); and 4) technical factors (presence of residual stenosis and anatomic success ratio (ASR) on follow-up Doppler ultrasonography).

Results: The technical and clinical success rates were both 94.9% (56/59); the mean ASR was 0.84. An ASR of ≥ 0.7 and no significant residual stenosis (< 30%) (both P < 0.001) on two-week follow-up Doppler ultrasonography predicted successful aAVF maturation.

Conclusion: For more precise prediction of successful aAVF maturation after sPTA, short-term follow-up Doppler ultrasonography (< 2 weeks) was useful. If the ASR was < 0.7 or if residual stenosis was ≥ 30%, immediate repeat sPTA is recommended.
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http://dx.doi.org/10.5812/iranjradiol.32559DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4841897PMC
January 2016

Copper oxide nanoparticle induces inflammatory response and mucus production via MAPK signaling in human bronchial epithelial cells.

Environ Toxicol Pharmacol 2016 Apr 11;43:21-6. Epub 2016 Feb 11.

College of Veterinary Medicine, Chonnam National University, 77 Yongbong-ro, Buk-gu, Gwangju 500-757, Republic of Korea. Electronic address:

Copper nanoparticles (CuONPs) can pose risks to industrial workers. With increase of its applications especially in electronic fields, it is necessary to assess the toxicity of CuONPs, including pulmonary toxicity. In this study, we investigated the effect of CuONPs on human epithelial cell line H292. CuONPs treatment caused a significant increase in IL-6 and IL-8 mRNA expression and protein levels in H292 cells in a concentration-dependent manner. The mRNA expression and protein levels of MUC5AC were consistent with those of proinflammatory mediators. Additionally, CuONPs treatment increased phosphorylation of mitogen-activated protein kinases (MAPKs), Erk, JNK, and p-38 compared to that of control in a concentration-dependent manner. However, co-treatment with CuONPs and each MAPK inhibitor significantly decreased the phosphorylation of each MAPK, resulting in decreased mRNA expression and protein levels of proinflammatory mediators and MUC5AC compared to that in H292 cells only treated with CuONPs. In summary, CuONPs-induced inflammatory mediators and MUC5AC associated with MAPKs phosphorylation. Our results will provide useful information on CuONPs-induced pulmonary toxicity.
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http://dx.doi.org/10.1016/j.etap.2016.02.008DOI Listing
April 2016

Characteristics and Quality of Radiologic Randomized Controlled Trials: A Bibliometric Analysis Between 1995 and 2014.

AJR Am J Roentgenol 2016 May 25;206(5):917-23. Epub 2016 Feb 25.

1 All authors: Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, 150, Seongan-Ro Gangdong-Gu, Seoul 134-701, Korea.

Objective: The aim of this bibliometric study was to assess the characteristics and quality of radiologic randomized controlled trials (RCTs) over the past 20 years.

Materials And Methods: A PubMed search was conducted to identify radiologic RCTs (defined as RCTs in which the first author or corresponding author is affiliated with a radiology department) published between 1995 and 2014. The following information was extracted from each article: journal, radiologic subspecialty, imaging technique, number of subjects, study result, funding, number of authors, number of institutions, country of origin, and methodologic quality (assessed using the Jadad scale).

Results: A total of 358 radiologic RCTs were published between 1995 and 2014. Dramatic increases in the numbers of radiologic RCTs were found, from 43 conducted in 1995-1999 to 172 conducted in 2010-2014. One-hundred seventeen (32.7%) RCTs were concerned with the field of vascular and interventional radiology; 78 (21.8%) evaluated more than one imaging technique; 164 (45.8%) had a sample size of 50-150 subjects; 246 (68.7%) showed positive study results; 185 (51.7%) were not funded; 179 (50.0%) had four to seven authors; 263 (73.5%) were single-center trials; 88 (24.6%) had a first author or corresponding author located in the United States; and 187 (52.2%) were of low quality. In the time trend analysis, the following variables showed a significantly positive trend: abdominal imaging subspecialty, CT as the imaging technique, more than 150 subjects, more than seven authors, and high methodologic quality.

Conclusion: The quantity and quality of radiologic RCTs have significantly increased over the past 2 decades; however, the methodologic quality remains suboptimal.
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http://dx.doi.org/10.2214/AJR.15.15640DOI Listing
May 2016

Clinical outcome of angiosome-oriented infrapopliteal percutaneous transluminal angioplasty for isolated infrapopliteal lesions in patients with critical limb ischemia.

Diagn Interv Radiol 2016 Jan-Feb;22(1):52-8

Department of Radiology, Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.

Purpose: We aimed to evaluate the clinical usefulness and outcome of angiosome-oriented percutaneous transluminal angioplasty (IP-PTA) and its clinical outcome for isolated infrapopliteal lesions in diabetic critical limb ischemia.

Methods: We retrospectively reviewed 70 patients (82 limbs) with diabetic critical limb ischemia who had localized disease at the level of the infrapopliteal artery. Patients underwent IP-PTA between January 2011 and December 2013 and were followed up for a mean of 13 months. The primary target arterial lesions were chosen according to the angiosome concept. We evaluated clinical findings, technical success, and patients' clinical outcome. The angiographic outcome of IP-PTA was assessed using the angiosome score. We analyzed the relationship between the angiosome score and the amputation rate.

Results: There were 69 anterior tibial artery (ATA) lesions, 70 posterior tibial artery (PTA) lesions, and 58 peroneal artery (PA) lesions. The primary target arteries were the ATA (n=43), PTA (n=26), PA (n=2), and ATA + PTA (n=11). We divided the treated limbs into target (n=63) and nontarget (n=19) groups. The overall initial technical success rate was 91.4%. Successful wound healing rates were 87.3% (55/63) and 47.3% (9/19) in the target and nontarget groups, respectively (P < 0.05).

Conclusion: Angiosome-oriented primary targeted IP-PTA shows a highly effective treatment outcome in diabetic critical limb ischemia. In cases with inadequate angioplastic results of the target artery, IP-PTA of the nontarget artery should be recommended to improve the limb salvage rates.
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http://dx.doi.org/10.5152/dir.2015.15129DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4712899PMC
February 2017

Trend Toward an Increase in Authorship for Leading Radiology Journals.

AJR Am J Roentgenol 2015 Nov;205(5):924-8

1 All authors: Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, 150, Seongan-ro, Gangdong-Gu, Seoul, 134-701, Korea.

Objective: The purpose of this study was to determine authorship trends in two leading radiology journals over the past 2 decades.

Materials And Methods: All original articles (n = 5195) published in AJR and Radiology for the periods 1991-1993, 2001-2003, and 2011-2013 were reviewed. The following variables were extrapolated from each article: number of authors, radiologic subspecialty, and country of origin. The number of authors listed per article was correlated with the publication period, journal, radiologic subspecialty, and country of origin.

Results: The mean number of authors per article increased from 5.1 in 1991-1993 to 6.2 in 2001-2003 and to 7.1 in 2011-2013 across both journals (p < 0.0001). Both AJR and Radiology had statistically significant increases in the number of authors per article over time, but the number of authors per article in Radiology was significantly higher than that in AJR (p < 0.0001 for all study periods). The number of authors per article significantly increased for all radiologic subspecialties. The mean numbers of authors per article by country of origin are as follows: Italy, 8.3; Japan, 7.6; France, 7.5; Germany, 7.4; China, 7.3; Austria, 7.2; and South Korea, 6.8. These were significantly higher than the mean number of authors from Switzerland, which was 6.3.

Conclusion: The number of authors significantly and consistently increased in two leading radiology journals over the past 2 decades.
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http://dx.doi.org/10.2214/AJR.15.14979DOI Listing
November 2015

Angiographic analysis of the lateral intercostal artery perforator of the posterior intercostal artery: anatomic variation and clinical significance.

Diagn Interv Radiol 2015 Sep-Oct;21(5):415-8

Department of Radiology, Hallym University College of Medicine, Sacred Heart Hospital, Anyang, Korea.

Purpose: Knowledge of the anatomic variations of the posterior intercostal artery (PICA) and its major branches is important during transthoracic procedures and surgery. We aimed to identify the anatomic features and variations of the lateral intercostal artery perforator (LICAP) of the PICA with selective PICA arteriography.

Methods: We retrospectively evaluated 353 PICAs in 75 patients with selective PICA arteriography for the following characteristics: incidence, length (as number of traversed intercostal spaces), distribution at the hemithorax (medial half vs. lateral half), and size as compared to the collateral intercostal artery of the PICA.

Results: The incidence of LICAPs was 35.9% (127/353). LICAPs were most commonly observed in the right 8th-11th intercostal spaces (33%, 42/127) and in the medial half of the hemithorax (85%, 108/127). Most LICAPs were as long as two (35.4%, 45/127) or three intercostal spaces (60.6%, 77/127). Compared to the collateral intercostal artery, 42.5% of LICAPs were larger (54/127), with most of these observed in the right 4th-7th intercostal spaces (48.8%, 22/54).

Conclusion: We propose the clinical significance of the LICAP as a potential risk factor for iatrogenic injury during posterior transthoracic intervention and thoracic surgery. For example, skin incisions must be as superficial as possible and directed vertically at the right 4th-7th intercostal spaces and the medial half of the thorax. Awareness of the anatomical variations of the LICAPs of the PICA will allow surgeons and interventional radiologists to avoid iatrogenic arterial injuries during posterior transthoracic procedures and surgery.
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http://dx.doi.org/10.5152/dir.2015.15096DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4557326PMC
December 2016

Korean Guidelines for Interventional Recanalization of Lower Extremity Arteries.

Korean J Radiol 2015 Jul-Aug;16(4):696-722. Epub 2015 Jul 1.

Department of Radiology, Yonsei University College of Medicine, Seoul 120-752, Korea.

Peripheral arterial occlusive disease caused by atherosclerosis can present with intermittent claudication or critical limb ischemia. Proper diagnosis and management is warranted to improve symptoms and salvage limbs. With the introduction of new techniques and dedicated materials, endovascular recanalization is widely performed for the treatment of peripheral arterial occlusive disease because it is less invasive than surgery. However, there are various opinions regarding the appropriate indications and procedure methods for interventional recanalization according to operator and institution in Korea. Therefore, we intend to provide evidence based guidelines for interventional recanalization by multidisciplinary consensus. These guidelines are the result of a close collaboration between physicians from many different areas of expertise including interventional radiology, interventional cardiology, and vascular surgery. The goal of these guidelines is to ensure better treatment, to serve as a guide to the clinician, and consequently, to contribute to public health care.
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http://dx.doi.org/10.3348/kjr.2015.16.4.696DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4499534PMC
February 2016