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  • Ovid Technologies (Wolters Kluwer Health)  (16)
  • Kim, Tae Jung  (16)
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  • Ovid Technologies (Wolters Kluwer Health)  (16)
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  • 1
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 51, No. Suppl_1 ( 2020-02)
    Abstract: Background: There is evidence that smoking increases stroke risk. However, the impact of smoking status on age at onset of ischemic stroke has not been studied. The aim of this study is to explore the effect of smoking status on the age at onset of first-ever ischemic stroke using the Korean Stroke Registry(KSR), the nation-wide, multicenter, hospital-based stroke registry in Republic of Korea. Methods: This study used individual data of first-ever ischemic stroke patients from the KSR, between 2014 and 2018. We divided the patients into four groups according to their smoking status; current smokers, past-smokers - quit in recent 5 years, past smokers - quit over than 5 years, and never-smokers. Results: A total of 27,942 patients were included in the analysis. The mean age at onset of the first-ever stroke were 60.0±11.9 in current smokers, 65.9±11.9 past-smokers - quit in recent 5 years, 70.1±10.8 in past smoker - quit over than 5 years, and 70.5±12.8 in never-smokers (p 〈 0.001). In the stroke subtypes analysis, the mean age at onset of the first-ever stroke were 60.9±12.5, 66.7±11.2, 70.7±10.8, and 71.1±11.9 in large artery atherosclerosis group, 58.8±10.8, 63.8±11.1, 68.2±10.4, and 68.6±12.0 in small vessel occlusion group, and 64.1±11.9, 67.7±11.6, 71.8±10.3, and 73.8±11.4 in cardioembolism group, respectively (all p 〈 0.001). Conclusions: The smoking status of patients was associated with an earlier onset age of the first-ever stroke. The onset age tends to be delayed with the longer duration of cessation period.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 80381-9
    detail.hit.zdb_id: 1467823-8
    Location Call Number Limitation Availability
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  • 2
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 50, No. Suppl_1 ( 2019-02)
    Abstract: Introduction: Dynamic changes in lifestyle or healthcare system due to industrialization lead to changes in the pattern of disease. This study investigates the recent trends of acute ischemic stroke characteristics and treatment in Korea, a rapidly developed country. Methods: We analyzed individual data of ischemic stroke and transient ischemic attack patients from the Korean Stroke Registry (KSR), a nationwide hospital-based stroke database, between August 2014 and May 2018 (2nd generation KSR). We collected demographic data, risk factors, treatment including thrombolysis, and stroke subtypes. Linear or log-linear Poisson regression analyses were performed to assess the changes. Finally, we compared this data from January 2002 to November 2010 (1st generation KSR). Results: A total 39,291 patients of 2nd generation KSR were included in the analysis. The mean±SD age was 68.0±13.0 years, and 58.3% of the patients were male. Over the 5-year period, the mean age of the patients steadily increased by 0.21 year annually (p 〈 0.001). Proportions of hypertension and diabetes remained stable, but frequency of dyslipidemia increased and prior stroke decreased. Proportion of intravenous thrombolysis remained stable (p=0.147), but intra-arterial thrombectomy increased (p 〈 0.001). Relative proportions of stroke subtypes over the 5 years, small vessel occlusion increased, cardioembolism decreased, and large artery atherosclerosis remained stable. Compared with 46,098 patients of 1st generation KSR, the proportion of arrival within 3 hours increased from 25.6% to 33.9%, and any reperfusion therapy increased 6.8% to 15.3%, especially intravenous thrombolysis increased 5.6% to 11.7%. The proportions of stroke subtype also considerably changed compared with 1st generation KSR (large artery atherosclerosis; 36.1% to 32.6%; cardioembolism; 25.4% to 19.9%; small vessel occlusion; 17.1% to 21.3%). Conclusions: Stroke characteristics in Korea changed during the first two decades of 21st century. It is likely because of increased lifespan, westernized lifestyle, changed treatment modality and improved public awareness.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 80381-9
    detail.hit.zdb_id: 1467823-8
    Location Call Number Limitation Availability
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  • 3
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 50, No. Suppl_1 ( 2019-02)
    Abstract: Introduction: Prediction of outcome after stroke may help clinicians provide effective stroke management and plan long-term care for patients. Hypothesis: We aimed to develop and validate a risk score for predicting functional outcome available at hospital after ischemic stroke using linked big data. Methods: A total of 24,907 cases with acute ischemic stroke (within 7 days after onset) were enrolled, who were registered in the Clinical Research Center for Stroke (CRCS) registry from 2006 to 2014 and successfully linked the Health Insurance Review and Assessment Service (HIRA) database. Among them, 22,005 cases were derivation and internal validation group, and 2,902 cases were external validation group. We assessed the functional outcome using a modified Rankin Scale (mRS) at 3-month after onset ischemic stroke. We evaluated the predictive value of variables associated with the favorable 3-month outcome (mRS ≤ 2) and developed the score using the logistic regression coefficients. The prediction model performance was assessed by the area under the receiver-operating characteristic curve (AUC). Results: Proportion of cases with favorable outcome were 67.0% (n=14,748) in the derivation and internal validation group, and 68.4% (n=1,986) in the external validation group. Multivariable predictors of functional outcome at 3-month included age, gender, stroke severity, body mass index, stroke subtype, previous functional status, recanalization treatment, pre-stroke antiplatelet or anticoagulation therapy, fasting glucose level, history of stroke, hyperlipidemia, diabetes mellitus, hypertension, congestive heart failure, kidney disease on dialysis, cancer before the stroke. The AUC of the prediction model was 0.855 (0.850 - 0.860) in the derivation group and 0.854 (0.849 - 0.860) in the internal validation group for 3-month functional outcome. In addition, the AUC of the model was 0.860 (0.846 - 0.874) in the external validation group for outcome at 3-month. Conclusions: This prediction of functional outcome model is a valid clinical tool to predict functional outcome following ischemic stroke and reliable externally. This prediction model may assist to estimate functional outcome after stroke and to decide the care plan after stroke.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 80381-9
    detail.hit.zdb_id: 1467823-8
    Location Call Number Limitation Availability
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  • 4
    In: Journal of Thoracic Imaging, Ovid Technologies (Wolters Kluwer Health)
    Abstract: Focal interstitial fibrosis (FIF) manifesting as a persistent part-solid nodule (PSN) has been mistakenly treated surgically due to similar imaging features to invasive adenocarcinoma (ADC). The purpose of this study was to observe predictive imaging features correlated with FIF through CT morphologic analysis. Materials and Methods: From January 2009 to December 2020, 44 patients with surgically proven FIF in a single institution were enrolled and compared with 88 ADC patients through propensity score matching. Patient characteristics and CT morphologic analysis of persistent PSNs were used to identify predictive imaging features of FIF. Receiver operating characteristic (ROC) curve analysis was used to quantify the performance of imaging features. Results: A total of 132 patients with 132 PSNs (44 FIF, 88 ADC; mean age, 67.7±7.58; 75 females) were involved in our analysis. Multivariable analysis demonstrated that preserved peritumoral vascular margin (preserved vascular margin), preserved secondary pulmonary lobule margin (preserved lobular margin), and lower coronal to axial ratio (C/A ratio; cutoff: 1.005) were significant independent predictors of FIF ( P 〈 0.05). ROC curve analysis to evaluate the predictive value of the logistic model based on the imaging features of FIF, and the AUC value was 0.881. Conclusion: CT imaging features of preserved vascular margin, preserved lobular margin, and lower C/A ratio (cutoff, 〈 1.005) might be helpful imaging features in discriminating FIF over ADC among persistent PSN in clinical practice.
    Type of Medium: Online Resource
    ISSN: 0883-5993
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2024
    detail.hit.zdb_id: 632900-7
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  • 5
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 47, No. suppl_1 ( 2016-02)
    Abstract: Introduction: The mechanisms of early neurological deterioration (END) in patients with acute stroke remain unclear. Despite that systemic hypoxia is associated with stroke risk and poor outcome following acute stroke, the association between nocturnal desaturation and END remains to be elucidated Hypothesis: We assessed the relationship between nocturnal oxygen desaturation in the stroke unit and END in patients with acute stroke. Methods: A consecutive 225 patients with acute ischemic stroke who were admitted to the stroke unit within 7 days after stroke onset between July 2013 and June 2014 were included for analysis Physiological variables including pulse oximetry were sampled every 1 minute. The ODI was calculated using pulse oximetry data during 9 hours on the first night (10:00 PM-7:00 AM) of the stroke unit admission and nocturnal oxygen desaturation was defined as an ODI of 5 or greater per hour. We compared the clinical characteristics, nocturnal oxygen desaturation, laboratory findings, and radiologic findings in patients with and without END. Results: Among the total patients, 52.4 % were male, with a mean age of 66.8 years. Twenty patients experienced early neurological worsening after stroke onset. The proportion of patients with nocturnal desaturation was significantly greater in the group of patients who also showed END (40.0% vs. 9.8%, P 〈 0.001). Moreover, more patients with END showed poor outcomes at 3 months (65.0% vs. 28.8%, P = 0.001). The stroke lesion locations did not significantly differ between the two groups. After controlling for relevant confounding factors, we found that nocturnal oxygen desaturation was associated with a risk of END (Odds ratio, 5.81; 95% confidence interval, 1.57-21.51). Conclusions: In conclusion, our study found that recurrent nocturnal desaturation in the stroke unit was associated with END in patients with acute stroke. In this context, our data could suggest that intensive monitoring of nocturnal desaturation in the stroke unit could be an important factor in preventing the risk of END and poor outcomes following acute stroke. .
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 80381-9
    detail.hit.zdb_id: 1467823-8
    Location Call Number Limitation Availability
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  • 6
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Stroke Vol. 47, No. suppl_1 ( 2016-02)
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 47, No. suppl_1 ( 2016-02)
    Abstract: Introduction: Wake-up stroke (WUS) may represent a specific subgroup and comprise of a quarter of all ischemic strokes. Nocturnal desaturation secondary due to sleep apnea is an independent risk factor for stroke, however, the association between nocturnal desaturation and WUS remains unclear. Hypothesis: We assessed the relationship between the overnight oxygen desaturation index (ODI) and WUS in patients with acute stroke in the stroke unit. Methods: A consecutive 225 patients with acute ischemic stroke who were admitted to the stroke unit within 7 days after stroke onset between July 2013 and June 2014 were included for analysis. Physiological variables including pulse oximetry were sampled every 1 minute. The ODI was calculated using pulse oximetry data during 9 hours on the first night (10:00 PM-7:00 AM) of the stroke unit admission and nocturnal oxygen desaturation was defined as an ODI of 5 or greater per hour. We compared the clinical characteristics, nocturnal oxygen desaturation, laboratory findings, and radiologic findings in patients with and without WUS. Results: Among the total patients, 26.2% (n=59) patients had WUS. These patients were mostly male (52.4%), with a mean age of 66.8 years. The proportion of nocturnal desaturation was significantly greater in WUS compared to non-WUS (23.7% vs. 8.4%, P = 0.002). The age, gender, vascular risk factors, stroke severity, and stroke lesion locations were similar in the two groups (WUS and non-WUS). After controlling for relevant confounding factors, nocturnal oxygen desaturation in the first night of the stroke unit stay was significantly more common in patients with WUS (Odds ratio, 4.39; 95% confidence interval, 1.76-10.93). Conclusions: Nocturnal desaturation was more frequently observed in patients with WUS over the first night stay in the stroke unit. This suggests that nocturnal desaturation is a possible and modifiable risk factor for the occurrence of WUS.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 80381-9
    detail.hit.zdb_id: 1467823-8
    Location Call Number Limitation Availability
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  • 7
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 47, No. suppl_1 ( 2016-02)
    Abstract: Introduction: Serum cystatin C has emerged as a risk factor of cardiovascular disease and death. Cystatin C is promoted a better marker of renal function compared to estimated glomerular filtration rate (GFR). However, the impact of cystatin C on the functional outcome after ischemic stroke in patients with CKD remains unclear. Hypothesis: We assessed the prognostic value of cystatin C for functional outcome after ischemic stroke in CKD patients. Methods: A consecutive 239 patients with CKD who were admitted within 7 days after ischemic stroke onset between January 2010 and February 2014 were included for analysis. An estimated GFR 〈 60mL/min/1.73 m 2 defined CKD. We compared the demographic information, clinical characteristics and laboratory findings including serum cystatin C level. We evaluated the short-term outcomes using a modified Rankin Scale (mRS) at three-months after onset of ischemic stroke. We divided patients into two groups with favorable outcome (mRS score ≤2) and unfavorable outcome (mRS score ≥3). Results: Among the total patients, 36.0% (n=86) patients had unfavorable outcome. These patients were mostly male (52.9%), with a mean age of 73.5 years. Older age, atrial fibrillation and history of previous stroke were significantly higher in the unfavorable outcome group. Participants with unfavorable outcome tended to have lower body mass index, higher initial NIHSS, lower estimated GFR, and higher C-reactive protein concentration. Compared to the favorable outcome group, cystatin C level was significantly higher (1.25±0.41 vs. 1.54±0.64 mg/dL, P = 0.001) in the unfavorable outcome group. After controlling for confounding factors, higher cystatin C levels were independently related to the unfavorable outcome at three-months (Odds ratio, 3.19; 95% Confidence interval, 1.02-9.96). In contrast, estimated GFR did not show any significant association with the unfavorable outcome (Odds ratio, 1.01; 95% Confidence interval, 0.96-1.06). Conclusions: In conclusion, our study showed that elevated cystatin C levels were independently associated with the unfavorable functional outcome after ischemic stroke in patients with CKD. Cystatin C may be a potent predictor of short-term functional outcome after ischemic stroke in CKD patients.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 80381-9
    detail.hit.zdb_id: 1467823-8
    Location Call Number Limitation Availability
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  • 8
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 47, No. suppl_1 ( 2016-02)
    Abstract: Introduction: Sleep duration has been regarded as a potential risk factor for cardiovascular disease and stroke. Short sleep duration is linked with higher stroke incidence, and mortality. Moreover, and paradoxically, long sleep duration is also reported to be positively associated with stroke incidence. However, the impact of sleep duration on the intracerebral hemorrhage (ICH) risk remains unclear. Hypothesis: We assessed the relationship between sleep duration and the risk of ICH. Methods: We performed a nationwide, multicenter matched case-control study to investigate the risk factors for hemorrhagic stroke, using patients from 33 hospitals in Korea. We enrolled a total of 490 patients with ICH and 980 age- and sex-matched controls. We obtained information regarding sleep, sociodemographic factors, lifestyle, and medical history before ICH onset, using qualified structured questionnaires. Sleep duration was categorized as ≤5, 6, 7, 8, and ≥9 hours. We chose sleep duration of 7 h as the reference duration. Results: The included patients were mostly male (58.2%) with a mean age of 57 years. The number of subjects with long sleep duration, more than 8 h, was significantly greater in the ICH group than in the control group (≥8 h, 30.4% vs. 22.6%, P = 0.002). Compared to 7 h, long sleep duration participants tended to be older, be more hypertensive, and be more likely to have blue collar jobs, lower education levels, and poorer marital status (i.e., unmarried or divorced/separated). After controlling for confounding factors, we found that longer sleep duration was independently associated with the risk of ICH in a dose-response manner (8 h: Odds ratio, 1.44; confidence interval, 1.01-2.07; ≥9 h: Odds ratio, 2.60; confidence interval, 1.50–4.49). Conclusions: In conclusion, our study suggested that long sleep duration is positively related to ICH risk in a dose-dependent manner. In this context, our data might suggest that sleep duration is a modifiable risk factor for ICH.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 80381-9
    detail.hit.zdb_id: 1467823-8
    Location Call Number Limitation Availability
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  • 9
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 47, No. 7 ( 2016-07), p. 1748-1753
    Abstract: Wake-up stroke (WUS) represents a quarter of all ischemic strokes and may be a specific subgroup. Nocturnal desaturation secondary to sleep-disordered breathing is an independent risk factor for stroke, but the association between nocturnal desaturation and WUS remains unclear. We investigated the relationship between nocturnal desaturation using oxygen desaturation index and WUS in patients with acute stroke in the stroke unit. Methods— A total of 298 patients admitted for acute ischemic stroke to the stroke unit between July 2013 and May 2015 were enrolled. The oxygen desaturation index was calculated using pulse oximetry data sampled every 1 minute during 9 hours on the first night (10:00 pm –7:00 am ) of the stroke unit admission, and nocturnal desaturation was defined as an oxygen desaturation index of 5 at least per hour. We compared the clinical characteristics and nocturnal desaturations between patients with and without WUS. Results— Among all patients (age, 67.7±12.6 years; male, 54.4%), 26.5% patients had WUS. The proportion of nocturnal desaturation was significantly greater in patients admitted with WUS (29.1% versus 12.3%, P =0.001). The age, sex, risk factors except for hyperlipidemia, stroke severity, and stroke mechanisms were similar between the 2 groups. After adjustment for covariates, it was found that nocturnal desaturation was significantly more common in the WUS group (odds ratio, 3.25; 95% confidence interval, 1.63–6.46). Conclusions— Nocturnal desaturation was more frequently observed in patients admitted with WUS during the first night in the stroke unit. This suggests that nocturnal desaturation is a possible modifiable risk factor for the occurrence of WUS.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 80381-9
    detail.hit.zdb_id: 1467823-8
    Location Call Number Limitation Availability
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  • 10
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Stroke Vol. 51, No. Suppl_1 ( 2020-02)
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 51, No. Suppl_1 ( 2020-02)
    Abstract: Introduction: Temperature affects human health. It is widely known that mean ambient temperature with both short-term and cumulative lagged effect, is the exposure measure for ischemic stroke. Recently, not only mean temperature, larger diurnal temperature range (DTR, difference between high- and low-daily temperature) was associated with coronary heart disease mortality and ischemic stroke hospitalizations. We hypothesized that a larger DTR results in environmental stress to the human cardiovascular system, thereby increasing the risk for acute ischemic stroke severity. Methods: We used both time-series and case-crossover approaches to assess the relation between DTR and ischemic stroke severity between summer of 2016 and 2018 in Korea. Data were obtained from Korean Stroke Registry and Korean Meteorological Administration. We used exposures averaged over periods varying from 1 to 14 days to assess the effects of DTR on stroke severity. We estimated the relation between DTR and ischemic stroke severity after adjustment for classical stroke risk factor and weather conditions of stroke index day. Results: A 9,249 patients were included in both time-series and case-crossover analyses. The results showed that DTR was significantly associated with stroke severity. The lag effect of DTR was stabilized at about 3-4 days. A 5 °C increase of three-day moving average of DTR corresponded to a 1.67 (95% Confidential Interval, CI 1.64-1.70, p 〈 0.001) and a 5°C increase of DTR of stroke onset day corresponded to a 1.09 (95% CI 1.07-1.12, p 〈 0.001) increase of NIHSS with unidirectional case-crossover analysis after adjustment for classical stroke risk factor and meteorological factor. Discussion: The current study supported our hypothesis that diurnal temperature variation could be a new severity factor for acute ischemic stroke. Moreover, the two different methods we used provided relatively similar results, suggesting that the association between DTR and stroke severity was reasonably robust. Our data added additional evidence that exposure to large DTR was associated with increased burden of stroke. This findings would contribute public health program to prevent unstable thermal environments.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 80381-9
    detail.hit.zdb_id: 1467823-8
    Location Call Number Limitation Availability
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