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Ideal Blood Pressure in Patients With Atrial Fibrillation
Kim, Daehoon,Yang, Pil-Sung,Kim, Tae-Hoon,Jang, Eunsun,Shin, Hyejung,Kim, Ha Yan,Yu, Hee Tae,Uhm, Jae-Sun,Kim, Jong-Youn,Pak, Hui-Nam,Lee, Moon-Hyoung,Joung, Boyoung,Lip, Gregory Y.H. Elsevier 2018 JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY - Vol.72 No.11
<P><B>Abstract</B></P> <P><B>Background</B></P> <P>The 2017 American College of Cardiology/American Heart Association (ACC/AHA) Guideline for High Blood Pressure in Adults redefined hypertension as systolic blood pressure (BP) ≥130 mm Hg or diastolic BP ≥80 mm Hg. The optimal BP for patients with atrial fibrillation (AF) is uncertain.</P> <P><B>Objectives</B></P> <P>The goal of this study was to investigate the impacts of the 2017 ACC/AHA guideline and to determine the ideal BP threshold for the management of high BP in patients with AF.</P> <P><B>Methods</B></P> <P>This study analyzed data for 298,374 Korean adults with oral anticoagulant–naive, nonvalvular AF obtained from the National Health Insurance Service database from 2005 to 2015.</P> <P><B>Results</B></P> <P>According to the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure guideline, 62.2% of the individuals in our sample had hypertension. After applying the 2017 ACC/AHA guideline, 79.4% had hypertension, including 17.2% with newly redefined hypertension (130 to 139/80 to 89 mm Hg). Those with newly redefined hypertension had greater risks of major cardiovascular events (hazard ratio: 1.07; 95% confidence interval: 1.04 to 1.10; p < 0.001), ischemic stroke, intracranial hemorrhage, and heart failure admission, compared with nonhypertensive patients (<130/80 mm Hg). Among patients with AF undergoing hypertension treatment, patients with BP ≥130/80 mm Hg or <120/80 mm Hg were at significantly higher risks of major cardiovascular events than patients with BP of 120 to 129/<80 mm Hg.</P> <P><B>Conclusions</B></P> <P>Patients with AF and newly redefined hypertension according to the 2017 ACC/AHA guideline were at higher risk of major cardiovascular events, suggesting that the new BP threshold is beneficial for timely diagnosis and intervention. BP of 120 to 129/<80 mm Hg was the optimal BP treatment target for patients with AF undergoing hypertension treatment.</P> <P><B>Central Illustration</B></P> <P>[DISPLAY OMISSION]</P>
S-276 Immediate and late outcomes of percutaneous transluminal angioplasty in Buerger``s disease
( Daehoon Kim ),( Young-guk Ko ),( Chul-min Ahn ),( Dong-ho Shin ),( Jung-sun Kim ),( Byeong-keuk Kim ),( Donghoon Choi ),( Myeong-ki Hong ),( Yangsoo Jang ) 대한내과학회 2016 대한내과학회 추계학술대회 Vol.2016 No.1
Objectives: The aim of this study was to appraise clinical outcomes after percutaneous transluminal angioplasty (PTA) for Buerger's disease patients with lower extremity artery disease. Methods: Between January 2006 and May 2015, 43 consecutive Buerger's disease patients with 48 target limbs were treated by PTA. The primary endpoint was clinically driven target lesion revascularization (TLR) at 24 months. Secondary endpoints included limb salvage rate, survival free from unexpected amputation, and changes in Rutherford class, ankle-brachial index (ABI). Results: Technical success using PTA was achieved in 35 (72.9%) of 48 limbs. The mean treated lesion length was 201±14 mm, including 39.6% multi-level lesions, 70.8% below-the-knee lesions, and 77.1% total occlusions. Clinical success rate was 70.8% with a significant improvement in Rutherford classes (p<0.001) and significantly increased ABIs, from 0.62±0.05 to 0.85±0.04 (p<0.001). At 24 months, the rate of clinically driven TLR was 23.1%, and limb salvage rate was 87.2% with 5 major amputations. The rate of freedom free from unexpected amputations was 91.7% with 3 unexpected amputations. Continuing smoking after PTA was the only independent predictor of TLR (HR: 5.10; 95% CI: 1.08 to 24.04, p=0.039).?Conclusions: PTA was feasible and effective for the revascularization in Buerger's disease patients. Technical success was achieved in the majority of the patients and the freedom free from clinically driven TLR and amputation at 2-year follow-up were favorable.
Hae Young Kim,Hye Jin Lee,Tae-lim Kim,EunYoung Kim,Daehoon Ham,Jaejoon Lee,Tayeun Kim,Ji Won Shin,Minkyoung Son,Jun Hun Sung,Zee-A Han 대한재활의학회 2020 Annals of Rehabilitation Medicine Vol.44 No.6
Objective To identify the prevalence and characteristics of neuropathic pain (NP) in patients with spinal cord injury (SCI) and to investigate associations between NP and demographic or disease-related variables. Methods We retrospectively reviewed medical records of patients with SCI whose pain was classified according to the International Spinal Cord Injury Pain classifications at a single hospital. Multiple statistical analyses were employed. Patients aged <19 years, and patients with other neurological disorders and congenital conditions were excluded. Results Of 366 patients, 253 patients (69.1%) with SCI had NP. Patients who were married or had traumatic injury or depressive mood had a higher prevalence rate. When other variables were controlled, marital status and depressive mood were found to be predictors of NP. There was no association between the prevalence of NP and other demographic or clinical variables. The mean Numeric Rating Scale (NRS) of NP was 4.52, and patients mainly described pain as tingling, squeezing, and painful cold. Females and those with below-level NP reported more intense pain. An NRS cut-off value of 4.5 was determined as the most appropriate value to discriminate between patients taking pain medication and those who did not. Conclusion In total, 69.1% of patients with SCI complained of NP, indicating that NP was a major complication. Treatment planning for patients with SCI and NP should consider that marital status, mood, sex, and pain subtype may affect NP, which should be actively managed in patients with an NRS ≥4.5.
Kim, Daehoon,Yang, Pil-Sung,Kim, Tae-Hoon,Uhm, Jae-Sun,Park, Junbeom,Pak, Hui-Nam,Lee, Moon-Hyoung,Joung, Boyoung UNKNOWN 2018 CIRCULATION JOURNAL Vol.82 No.8
<P>Conclusions: Comorbid AF in patients with osteoporosis was associated with an increased risk of bone fracture and death after fracture.</P>
Kim, Hyung Jun,Park, Daehoon,Yang, Paul,Beom, Keonwon,Kim, Min Ju,Shin, Chansun,Kang, Chi Jung,Yoon, Tae-Sik IOP 2018 Nanotechnology Vol.29 No.26
<P>A crossbar array of Pt/CeO<SUB>2</SUB>/Pt memristors exhibited the synaptic characteristics such as analog, reversible, and strong resistance change with a ratio of ∼10<SUP>3</SUP>, corresponding to wide dynamic range of synaptic weight modulation as potentiation and depression with respect to the voltage polarity. In addition, it presented timing-dependent responses such as paired-pulse facilitation and the short-term to long-term memory transition by increasing amplitude, width, and repetition number of voltage pulse and reducing the interval time between pulses. The memory loss with a time was fitted with a stretched exponential relaxation model, revealing the relation of memory stability with the input stimuli strength. The resistance change was further enhanced but its stability got worse as increasing measurement temperature, indicating that the resistance was changed as a result of voltage- and temperature-dependent electrical charging and discharging to alter the energy barrier for charge transport. These detailed synaptic characteristics demonstrated the potential of crossbar array of Pt/CeO<SUB>2</SUB>/Pt memristors as artificial synapses in highly connected neuron-synapse network.</P>
Kim, Tae-Hoon,Yang, Pil-Sung,Kim, Daehoon,Yu, Hee Tae,Uhm, Jae-Sun,Kim, Jong-Youn,Pak, Hui-Nam,Lee, Moon-Hyoung,Joung, Boyoung,Lip, Gregory Y.H. American Heart Association 2017 Stroke Vol. No.
<P>Conclusions-The CHA(2)DS(2)-VASc score shows good performance in defining truly low-risk Asian patients with atrial fibrillation for stroke compared with CHADS(2) and ATRIA scores.</P>