Yonsei Medical Journal最新文献

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Polycyclic Aromatic Hydrocarbons Mediate the Association between Tobacco Smoking and Alcohol Use Disorder. 多环芳烃介导吸烟与酒精使用障碍之间的关系。
IF 2.6 4区 医学
Yonsei Medical Journal Pub Date : 2024-12-01 DOI: 10.3349/ymj.2023.0488
Dongkyu Lee, Mun-Joo Bae, Mi-Ji Kim, Sung Soo Oh, Ki Soo Park, Chan Joo Lee, Sungha Park, Seung-Koo Lee, Sang-Baek Koh, Sun Jae Jung, Changsoo Kim, Jaelim Cho
{"title":"Polycyclic Aromatic Hydrocarbons Mediate the Association between Tobacco Smoking and Alcohol Use Disorder.","authors":"Dongkyu Lee, Mun-Joo Bae, Mi-Ji Kim, Sung Soo Oh, Ki Soo Park, Chan Joo Lee, Sungha Park, Seung-Koo Lee, Sang-Baek Koh, Sun Jae Jung, Changsoo Kim, Jaelim Cho","doi":"10.3349/ymj.2023.0488","DOIUrl":"10.3349/ymj.2023.0488","url":null,"abstract":"<p><strong>Purpose: </strong>Smoking is causally related to alcohol use disorder. Although polycyclic aromatic hydrocarbons (PAHs) are major neurotoxic pollutants in tobacco smoke, evidence is lacking on the role of PAHs in the relationship between smoking and alcohol use disorder. This study investigated the types of PAHs associated with smoking and whether exposure to those PAHs mediated the effect of smoking on alcohol use disorder.</p><p><strong>Materials and methods: </strong>A total of 968 male firefighters were analyzed. Smoking history and cumulative pack-years were obtained using self-reported questionnaires. Alcohol use disorder was defined using the Alcohol Use Disorder Identification Test. PAH exposure was assessed by urinary metabolites. Regression analyses were performed between exposure (smoking), outcome (alcohol use disorder), and mediator (PAH metabolites) variables. A mediation analysis was performed to test the indirect effect of PAH metabolites on the association between smoking and alcohol use disorder. All analyses were repeated for 770 participants who were followed up after 2 years, while alcohol use disorder was redefined from follow-up data ensuring the temporal sequence of the variables.</p><p><strong>Results: </strong>Both 2-naphthol [β=0.78, 95% confidence interval (CI): 0.59-0.98] and 2-hydroxyfluorene (β=0.69, 95% CI: 0.56-0.82) were associated with smoking history. Furthermore, 2-naphthol and 2-hydroxyfluorene mediated the associations of smoking history (proportion mediated: 14.2%, 23.6% respectively) or cumulative pack-years (proportion mediated: 14.4%, 25.4% respectively) with alcohol use disorder. The results were consistent in longitudinal settings.</p><p><strong>Conclusion: </strong>Exposure to PAHs mediated the association between tobacco smoking and alcohol use disorder. PAH exposure from tobacco may increase the risk of addictive disorders.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"65 12","pages":"752-760"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Percutaneous Coronary Intervention and Long-Term Management of Acute Myocardial Infarction in a Hemophilia Patient: Overcoming Bleeding Challenges. 经皮冠状动脉介入治疗和血友病患者急性心肌梗死的长期治疗:克服出血挑战。
IF 2.6 4区 医学
Yonsei Medical Journal Pub Date : 2024-12-01 DOI: 10.3349/ymj.2023.0577
Sang Min Park, Dong Woo Suh, Kyung Soon Hong, Christopher Y Kim, Soo Jung Gong
{"title":"Percutaneous Coronary Intervention and Long-Term Management of Acute Myocardial Infarction in a Hemophilia Patient: Overcoming Bleeding Challenges.","authors":"Sang Min Park, Dong Woo Suh, Kyung Soon Hong, Christopher Y Kim, Soo Jung Gong","doi":"10.3349/ymj.2023.0577","DOIUrl":"10.3349/ymj.2023.0577","url":null,"abstract":"<p><p>A 55-year-old male with hemophilia A came to the outpatient clinic with chest pain for several days after overdose injection of coagulation factor. He was a heavy smoker and a chronic alcoholic. An electrocardiogram (ECG) showed no specific change. A coronary computed tomography showed moderate stenosis with soft plaque at the distal segment of right coronary artery. His pain was improved with antianginal and reflux medications. Twenty days later, he ran to the emergency room complaining of squeezing chest pain. ECG showed mild ST segment elevation in inferior territories. Invasive coronary angiography via right radial artery revealed severe thrombotic occlusion at the same lesion. A bare metal stent was deployed and dual antiplatelet therapy including aspirin and clopidogrel had been maintained for 6 months under the conventional hemophilia management. The patient did not develop any coronary events just with single clopidogrel therapy for 5 years until he passed away from pancreatic cancer. Our case implicates that the invasive coronary intervention and post-procedural management could be safely performed with conventional standards of care while maintaining the usual dose of coagulation factors in a hemophilia patient with acute coronary syndrome.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"65 12","pages":"777-780"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Risk Factors for Intravenous Acetaminophen-Induced Hypotension in Patients with Repeated Acetaminophen Administration. 反复服用对乙酰氨基酚患者静脉注射对乙酰氨基酚致低血压的危险因素。
IF 2.6 4区 医学
Yonsei Medical Journal Pub Date : 2024-12-01 DOI: 10.3349/ymj.2024.0180
Sung-Ryeol Kim, Nak-Hoon Son, Kyung Hee Park, Jung-Won Park, Jae-Hyun Lee
{"title":"Risk Factors for Intravenous Acetaminophen-Induced Hypotension in Patients with Repeated Acetaminophen Administration.","authors":"Sung-Ryeol Kim, Nak-Hoon Son, Kyung Hee Park, Jung-Won Park, Jae-Hyun Lee","doi":"10.3349/ymj.2024.0180","DOIUrl":"10.3349/ymj.2024.0180","url":null,"abstract":"<p><strong>Purpose: </strong>Intravenous (IV) acetaminophen-induced hypotension is a clinically significant issue that remains difficult to predict. Therefore, this study aimed to identify the factors associated with hypotension in patients with repeated IV acetaminophen administration.</p><p><strong>Materials and methods: </strong>This observational cohort study included patients who received IV acetaminophen in the critical care unit of the Yongin Severance Hospital in 2020. All IV acetaminophen administration records for each patient were reviewed, and the blood pressure records within 2 h after IV acetaminophen administration were examined. Changes in blood pressure within 2 h of IV acetaminophen administration were monitored to identify hypotension, defined as a systolic blood pressure <90 mm Hg, a decrease in systolic blood pressure by 30 mm Hg, or a decrease in mean arterial pressure by 15%.</p><p><strong>Results: </strong>There were 1547 instances of IV acetaminophen administration among 398 patients. Of these, 416 instances (26.9%) resulted in hypotension among 204 patients (51.3%). A history of IV acetaminophen-induced hypotension did not predict subsequent hypotensive episodes, and there was no consistent tendency. The use of beta-blocker [odds ratio (OR)=1.50], gastrointestinal (GI) infection (OR=1.42), and septic shock (OR=1.68) were significant risk factors for IV acetaminophen-induced hypotension in multivariate analysis. In subgroup analysis of cases with beta-blocker, heart failure (OR=1.91), urinary tract infection (OR=2.16), GI infection (OR=1.83) were significant risk factors.</p><p><strong>Conclusion: </strong>Severe infections, heart failure, and the use of beta-blockers are associated with IV acetaminophen-induced hypotension. However, IV acetaminophen-induced hypotension is inconsistent and depends on the patient's condition.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"65 12","pages":"695-702"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Thirty-Day Mortality of Persistent Methicillin-Resistant Staphylococcus aureus Bacteremia: Insights from a Retrospective Cohort Study. 持续耐甲氧西林金黄色葡萄球菌菌血症的30天死亡率:来自回顾性队列研究的见解。
IF 2.6 4区 医学
Yonsei Medical Journal Pub Date : 2024-12-01 DOI: 10.3349/ymj.2023.0600
Minji Jeon, Sukbin Jang, Seok Jun Mun, Si-Ho Kim
{"title":"Thirty-Day Mortality of Persistent Methicillin-Resistant <i>Staphylococcus aureus</i> Bacteremia: Insights from a Retrospective Cohort Study.","authors":"Minji Jeon, Sukbin Jang, Seok Jun Mun, Si-Ho Kim","doi":"10.3349/ymj.2023.0600","DOIUrl":"10.3349/ymj.2023.0600","url":null,"abstract":"<p><p>Although glycopeptides remain the preferred treatment for methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) bacteremia, the treatment of persistent MRSA bacteremia has been challenging. We investigated real-world treatment strategies for persistent MRSA bacteremia, with a specific emphasis on the use of antimicrobial agents and the frequency of changes during the treatment course. We retrospectively identified patients with persistent MRSA bacteremia in four university-affiliated hospitals between 2017 and 2021. The primary objective of this study was to investigate the patterns of antimicrobial uses for MRSA bacteremia. The secondary objectives were evaluating the associated factors with 1) overall 30-day mortality and 2) changing agents during the treatment course. Time-dependent Cox regression analysis was used to adjust for immortal time bias. Among 116 patients, 37.1% underwent antimicrobials switching, primarily prompted by persistent bacteremia. The 30-day mortality rates of groups with and without antimicrobial switching were 21.4% and 44.2%, respectively (<i>p</i>=0.010 by log-rank test); however, after adjustment for immortal time bias, there was no statistical significance between the two groups (adjusted hazard ratio 0.24, 95% confidence interval 0.03-2.17, <i>p</i>=0.238). Only the Pitt bacteremia score on day 4 and pneumonia were associated with 30-day mortality. Meanwhile, the factors associated with antimicrobial switching were the duration of bacteremia, the initial use of teicoplanin, echocardiogram, and Charlson comorbidity index. This study showed that while over one-third of persistent MRSA bacteremia patients experience changes in antimicrobial agents during treatment, this practice does not significantly improve the 30-day mortality. Our study suggests the need for more effective treatment strategies in managing persistent MRSA bacteremia.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"65 12","pages":"770-776"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Development and Assessment of a Novel Ulcerative Colitis-Specific Quality of Life Questionnaire: A Prospective, Multi-Institutional Study. 新型溃疡性结肠炎生活质量问卷的开发与评估:一项前瞻性多机构研究。
IF 2.6 4区 医学
Yonsei Medical Journal Pub Date : 2024-11-01 DOI: 10.3349/ymj.2023.0503
Jihye Park, Hyun-Soo Zhang, Chung Mo Nam, Joo Sung Kim, Young-Ho Kim, Dong Il Park, Byong Duk Ye, Yoon Tae Jeen, Sehyun Kim, Jae Hee Cheon
{"title":"Development and Assessment of a Novel Ulcerative Colitis-Specific Quality of Life Questionnaire: A Prospective, Multi-Institutional Study.","authors":"Jihye Park, Hyun-Soo Zhang, Chung Mo Nam, Joo Sung Kim, Young-Ho Kim, Dong Il Park, Byong Duk Ye, Yoon Tae Jeen, Sehyun Kim, Jae Hee Cheon","doi":"10.3349/ymj.2023.0503","DOIUrl":"10.3349/ymj.2023.0503","url":null,"abstract":"<p><strong>Purpose: </strong>Interest in the quality of life (QoL) of patients with inflammatory bowel disease (IBD) has recently increased. Although measurement tools have been devised for IBD in general, there is no specific tool for measuring the QoL of patients with ulcerative colitis (UC). Therefore, we developed a QoL questionnaire specifically for patients with UC.</p><p><strong>Materials and methods: </strong>The Korean Ulcerative Colitis-Specific Questionnaire (K-UCSQ) was developed through item generation, raw-scale construction, focus group meetings, and multi-center field tests. Two hundred patients with UC were recruited for a field test of the K-UCSQ, and subsequent responses to the Inflammatory Bowel Disease Questionnaire (IBDQ) were also obtained. After performing factor analyses to ensure construct validity, the K-UCSQ was finalized as a four-domain, 28-item questionnaire. Subsequent analyses evaluated the reliability of the K-UCSQ in terms of Cronbach's alpha, concurrent validity in comparison with the pre-established IBDQ, and predictive validity of the area under the ROC curve (AUC) for clinically relevant QoL outcomes.</p><p><strong>Results: </strong>A Cronbach's alpha of 0.94 showed excellent reliability. Furthermore, correlation analyses demonstrated the concurrent validity of the K-UCSQ in comparison with the IBDQ. The K-UCSQ also showed high validity in predicting the perceived overall health (AUC of 0.812 vs. 0.797 using the IBDQ) and past 2-week QoL (AUC of 0.864 vs. 0.859 using the IBDQ).</p><p><strong>Conclusion: </strong>The newly developed K-UCSQ is concise, bathroom problem-emphasizing, and UC-specific, suggesting that it could be a valid and reliable UC-specific instrument for QoL measurement.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"65 11","pages":"636-644"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical Manifestations and Adverse Cardiovascular Events in Patients with Cardiovascular Symptoms after mRNA Coronavirus Disease 2019 Vaccines. 2019年mRNA冠状病毒疾病疫苗接种后心血管症状患者的临床表现和不良心血管事件。
IF 2.6 4区 医学
Yonsei Medical Journal Pub Date : 2024-11-01 DOI: 10.3349/ymj.2023.0354
William D Kim, Min Jae Cha, Subin Kim, Dong-Gil Kim, Jae-Jin Kwak, Sung Woo Cho, Joon Hyung Doh, Sung Uk Kwon, June Namgung, Sung Yun Lee, Jiwon Seo, Geu-Ru Hong, Ji-Won Hwang, Iksung Cho
{"title":"Clinical Manifestations and Adverse Cardiovascular Events in Patients with Cardiovascular Symptoms after mRNA Coronavirus Disease 2019 Vaccines.","authors":"William D Kim, Min Jae Cha, Subin Kim, Dong-Gil Kim, Jae-Jin Kwak, Sung Woo Cho, Joon Hyung Doh, Sung Uk Kwon, June Namgung, Sung Yun Lee, Jiwon Seo, Geu-Ru Hong, Ji-Won Hwang, Iksung Cho","doi":"10.3349/ymj.2023.0354","DOIUrl":"10.3349/ymj.2023.0354","url":null,"abstract":"<p><strong>Purpose: </strong>The number of patients presenting with vaccination-related cardiovascular symptoms after receiving mRNA vaccines (mRNA-VRCS) is increasing. We investigated the incidence of vaccine-related adverse events (VAEs), including myocarditis and pericarditis, in patients with mRNA-VRCS after receiving BNT162b2-Pfizer-BioNTech and mRNA-1273-Moderna vaccines.</p><p><strong>Materials and methods: </strong>We retrospectively collected data on patients presenting with mRNA-VRCS who visited the outpatient clinic of two tertiary medical centers. Clinical characteristics, laboratory findings, echocardiographic findings, and electrocardiographic findings were evaluated. VAE was defined as myocarditis or pericarditis in patients after mRNA vaccination. Clinical outcomes during short-term follow-up, including emergency room (ER) visit, hospitalization, or death, were also assessed among the patients.</p><p><strong>Results: </strong>A total of 952 patients presenting with mRNA-VRCS were included in this study, with 89.7% receiving Pfizer-BioNTech and 10.3% receiving Moderna vaccines. The mean duration from vaccination to symptom was 5.6±7.5 days. VAEs, including acute myocarditis and acute pericarditis, were confirmed in 11 (1.2%) and 10 (1.1%) patients, respectively. The VAE group showed higher rates of dyspnea, echocardiography changes, and ST-T segment changes. During the short-term follow-up period of 3 months, the VAE group showed a higher hospitalization rate compared to the control group; there was no significant difference in ER visit (<i>p</i>=0.320) or mortality rates (<i>p</i>>0.999).</p><p><strong>Conclusion: </strong>Amongst the patients who experienced mRNA-VRCS, the total incidence of VAEs, including acute myocarditis and pericarditis, was 2.2%. Patients with VAEs showed higher rates of dyspnea, echocardiographic changes, and ST-T segment changes compared to those without VAEs. With or without the cardiovascular events, the prognosis in patients with mRNA-VRCS was favorable.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"65 11","pages":"629-635"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Spatial Similarity of MRI-Visible Perivascular Spaces in Healthy Young Adult Twins. 健康青壮年双胞胎核磁共振成像可见血管周围空间的空间相似性
IF 2.6 4区 医学
Yonsei Medical Journal Pub Date : 2024-11-01 DOI: 10.3349/ymj.2023.0581
Boeun Lee, Na-Young Shin, Chang-Hyun Park, Yoonho Nam, Soo Mee Lim, Kook Jin Ahn
{"title":"Spatial Similarity of MRI-Visible Perivascular Spaces in Healthy Young Adult Twins.","authors":"Boeun Lee, Na-Young Shin, Chang-Hyun Park, Yoonho Nam, Soo Mee Lim, Kook Jin Ahn","doi":"10.3349/ymj.2023.0581","DOIUrl":"10.3349/ymj.2023.0581","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to determine whether genetic factors affect the location of dilated perivascular spaces (dPVS) by comparing healthy young twins and non-twin (NT) siblings.</p><p><strong>Materials and methods: </strong>A total of 700 healthy young adult twins and NT siblings [138 monozygotic (MZ) twin pairs, 79 dizygotic (DZ) twin pairs, and 133 NT sibling pairs] were collected from the Human Connectome Project dataset. dPVS was automatically segmented and normalized to standard space. Then, spatial similarity indices [mean squared error (MSE), structural similarity (SSIM), and dice similarity (DS)] were calculated for dPVS in the basal ganglia (BGdPVS) and white matter (WMdPVS) between paired subjects before and after propensity score matching of dPVS volumes between groups. Within-pair correlations for the regional volumes of dVPS were also assessed using the intraclass correlation coefficient.</p><p><strong>Results: </strong>The spatial similarity of dPVS was significantly higher in MZ twins [higher DS (median, 0.382 and 0.310) and SSIM (0.963 and 0.887) and lower MSE (0.005 and 0.005) for BGdPVS and WMdPVS, respectively] than in DZ twins [DS (0.121 and 0.119), SSIM (0.941 and 0.868), and MSE (0.010 and 0.011)] and NT siblings [DS (0.106 and 0.097), SSIM (0.924 and 0.848), and MSE (0.016 and 0.017)]. No significant difference was found between DZ twins and NT siblings. Similar results were found even after the subjects were matched according to dPVS volume. Regional dPVS volumes were also more correlated within pairs in MZ twins than in DZ twins and NT siblings.</p><p><strong>Conclusion: </strong>Our results suggest that genetic factors affect the location of dPVS.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"65 11","pages":"661-668"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Serum Soluble Receptors for Advanced Glycation End-Products May Predict Mortality in Microscopic Polyangiitis and Granulomatosis with Polyangiitis. 血清高级糖化终产物可溶性受体可预测显微镜下多血管炎和肉芽肿性多血管炎患者的死亡率
IF 2.6 4区 医学
Yonsei Medical Journal Pub Date : 2024-11-01 DOI: 10.3349/ymj.2023.0466
Taejun Yoon, Sung Soo Ahn, Jang Woo Ha, Eunhee Ko, Jason Jungsik Song, Yong-Beom Park, Sang-Won Lee
{"title":"Serum Soluble Receptors for Advanced Glycation End-Products May Predict Mortality in Microscopic Polyangiitis and Granulomatosis with Polyangiitis.","authors":"Taejun Yoon, Sung Soo Ahn, Jang Woo Ha, Eunhee Ko, Jason Jungsik Song, Yong-Beom Park, Sang-Won Lee","doi":"10.3349/ymj.2023.0466","DOIUrl":"10.3349/ymj.2023.0466","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate whether the serum extracellular newly identified receptor for advanced glycation end products binding protein (EN-RAGE) and the soluble form of RAGE (sRAGE) measured at diagnosis are associated with all-cause mortality in patients with microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA).</p><p><strong>Materials and methods: </strong>Serum EN-RAGE and sRAGE were measured in 75 immunosuppressive drug-naïve MPA and GPA patients using an immunoassay, with their clinical and laboratory data reviewed. The optimal cut-off point of EN-RAGE and sRAGE was calculated by finding the threshold with the maximum sum of sensitivity and specificity. In addition, the least absolute shrinkage and selection operator regression was adopted to select variables included in the multivariable Cox proportional hazards (PH) regression model.</p><p><strong>Results: </strong>The median age of the patients was 67.0 years, and 34% were male. Neither serum EN-RAGE nor sRAGE at diagnosis was correlated with the Birmingham Vasculitis Activity Score. Furthermore, no correlation was observed between serum EN-RAGE and sRAGE. Deceased patients had significantly lower serum EN-RAGE and higher serum sRAGE at diagnosis compared to surviving patients. Patients with serum EN-RAGE at diagnosis ≤84.37 ng/mL and serum sRAGE at diagnosis ≥1.82 ng/mL showed significantly lower survival probabilities compared to those without. In multivariable Cox PH regression model, only serum sRAGE at diagnosis ≥1.82 ng/mL, rather than serum EN-RAGE at diagnosis ≤84.37 ng/mL, was independently associated with all-cause mortality (hazard ratio 7.094).</p><p><strong>Conclusion: </strong>This study is the first to demonstrate that serum sRAGE at diagnosis may independently predict all-cause mortality during follow-up in patients with MPA and GPA.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"65 11","pages":"651-660"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Incidence and Pattern of Recurrence after Surgical Resection in Organ-Confined Renal Cell Carcinoma. 器官局限性肾细胞癌手术切除后复发的发生率和模式
IF 2.6 4区 医学
Yonsei Medical Journal Pub Date : 2024-11-01 DOI: 10.3349/ymj.2023.0587
Jongchan Kim, Won Sik Ham, Jee Soo Park, Won Sik Jang
{"title":"Incidence and Pattern of Recurrence after Surgical Resection in Organ-Confined Renal Cell Carcinoma.","authors":"Jongchan Kim, Won Sik Ham, Jee Soo Park, Won Sik Jang","doi":"10.3349/ymj.2023.0587","DOIUrl":"10.3349/ymj.2023.0587","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the incidence and pattern of recurrence after surgery in patients with organ-confined renal cell carcinoma (RCC) to establish an appropriate follow-up plan.</p><p><strong>Materials and methods: </strong>In this retrospective study, we evaluated data from 2960 patients who underwent radical or partial nephrectomy for stage 1 or 2 RCC. We investigated the location of first recurrence and recurrence-free survival (RFS) by plotting Kaplan-Meier curves and analyzed the associated variables using Cox regression analysis.</p><p><strong>Results: </strong>During a median follow-up of 59 months, the 10-year RFS rates were 94.5%, 75.0%, and 57.9%, for T1a, T1b, and T2 RCC, respectively. A total of 211 patients experienced recurrence: 67 after 5 years, and 14 after 10 years. The most common sites of the first recurrence were the lungs, bones, and contralateral kidneys. Male sex, older age, higher pathologic T stage, higher nuclear grade, clear-cell RCC, and presence of differentiation were associated with recurrence. Among patients followed up for more than 60 months, higher pathologic T stage and grade, as well as clear cell RCC were predictors of RFS.</p><p><strong>Conclusion: </strong>Late recurrence after surgery is common in patients with organ-confined RCC, with recurrence occurring even after 10 years. Consequently, long-term follow-up, of perhaps 10 years or more, including imaging studies of the abdomen, lungs, and bone, should be considered for the early detection of recurrence.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"65 11","pages":"623-628"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Elder Abuse in Association with Depression and Suicidal Ideation among Community-Dwelling Elderly in Korea. 虐待老人与韩国社区老年人抑郁和自杀倾向的关系
IF 2.6 4区 医学
Yonsei Medical Journal Pub Date : 2024-11-01 DOI: 10.3349/ymj.2023.0613
Jong-Il Park
{"title":"Elder Abuse in Association with Depression and Suicidal Ideation among Community-Dwelling Elderly in Korea.","authors":"Jong-Il Park","doi":"10.3349/ymj.2023.0613","DOIUrl":"10.3349/ymj.2023.0613","url":null,"abstract":"<p><p>There has been limited research on the association between elder abuse and depression, as well as elder abuse and suicidal ideation concurrently. Therefore, the present study aimed to investigate this association using the dataset from a nationally representative elderly sample in Korea. This study analyzed the dataset from the 2020 National Survey of Older Koreans. Elderly participants (aged over 65 years, n=9920) were included. Multivariate regression analysis was utilized to explore the risk factors associated with depression and suicidal ideation in the context of elder abuse. In this study, 5.1% of the elderly reported having elder abuse in the past year, while 12.8% and 1.9% reported having depression and suicidal ideation, respectively. In addition, among the elderly with depression, 8.4% had experienced elder abuse, while among those reporting suicidal ideation, 17.6% had suffered from elder abuse. Multiple logistic regression revealed that elder abuse is independently associated with both depression [odds ratio (OR) for elder abuse=1.642] and suicidal ideation (OR for elder abuse=3.237). Besides elder abuse, poor subjective health status and poor social support were linked to higher risk of depression and suicidal ideation. Our findings revealed that elder abuse represented a substantial risk factor associated with both depression and suicidal ideation. Implementing preventive interventions to address these risk factors could have significant implications for public mental health.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"65 11","pages":"677-681"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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