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Sung Il Im 3 Articles
Postoperative effects of bariatric surgery on heart rate recovery and heart rate variability
Han Su Park, Kyungwon Seo, Hyeon Soo Kim, Sung il Im, Bong Joon Kim, Bu Kyung Kim, Jung Ho Heo
Kosin Med J. 2022;37(2):119-126.   Published online June 27, 2022
DOI: https://doi.org/10.7180/kmj.22.020
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Background
Several studies have reported associations between obesity and autonomic dysfunction. However, little research has investigated the effect of bariatric surgery on heart rate recovery (HRR) in the treadmill test and heart rate variability (HRV) in 24-hour Holter monitoring. We investigated the effects of bariatric surgery on HRR and HRV, which are parameters related to autonomic dysfunction.
Methods
We retrospectively investigated patients who underwent bariatric surgery in 2019. The treadmill test, 24-hour Holter monitoring, and echocardiography were performed before and 6 months after surgery. We compared the changes in HRR in the treadmill test and HRV parameters such as the time domain and spectral domain in 24-hour Holter monitoring before and after surgery.
Results
Of the 40 patients who underwent bariatric surgery, 25 patients had the treadmill test or 24-hour Holter monitoring both before and after surgery. Body weight and body mass index significantly decreased after surgery (112.86±24.37 kg vs. 89.10±20.26 kg, p<0.001; 39.22±5.69 kg/m2 vs. 31.00±5.09 kg/m2, p<0.001, respectively). HRR significantly increased (n=23; 43.00±20.97 vs. 64.29±18.49, p=0.001). The time domain of HRV parameters increased (n=21; standard deviation of the N-N interval 123.57±28.05 vs. 152.57±39.49, p=0.002 and mean N-N interval 791.57±88.84 vs. 869.05±126.31, p=0.002).
Conclusions
Our data showed that HRR after exercise and HRV during 24-hour Holter monitoring improved after weight reduction with bariatric surgery through improved cardiac autonomic function.
How to write case reports in medicine
Sung Il Im
Kosin Med J. 2022;37(2):102-106.   Published online June 24, 2022
DOI: https://doi.org/10.7180/kmj.22.109
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Medical research has become an important part of providing care to patients. Case reports published in medical journals can communicate information to the medical community about rare or unreported features, conditions, complications, or interventions. Case reports are generally short, focusing on key components such as a summary and introduction, case presentation, and discussion. Authors now have access to free, continuously updated case reports of different types from multiple journals. This review introduces the process and mechanisms for how and when to prepare a case report. We briefly review the editorial process of each of these complementary journals, along with author anecdotes, hoping to inspire authors to write and continue writing case reports; and discusses the essentials of a case report, aiming to provide guidelines for improving medical writing skills.
Association between Ischemic Electrocardiographic Changes during Acetylcholine Provocation Test and Long-Term Clinical Outcomes in Patients with Vasospastic Angina
Sung Il Im, Seung-Woon Rha, Byoung Geol Choi, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Jin Won Kim, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo
Kosin Med J. 2019;34(1):1-14.   Published online June 30, 2019
DOI: https://doi.org/10.7180/kmj.2019.34.1.1
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Objectives

Intracoronary injection of acetylcholine (Ach) has been shown to induce significant coronary artery spasm (CAS) in patients with vasospastic angina. Clinical significance and angiographic characteristics of patients with ischemic electrocardiogram (ECG) changes during the Ach provocation test are not clarified yet.

Methods

A total 4,418 consecutive patients underwent coronary angiography with Ach provocation tests from 2004 to 2012 were enrolled. Ischemic ECG changes were defined as transient ST-segment depression or elevation ( > 1 mm) and T inversion with/without chest pain. Finally, a total 2,293 patients (28.5% of total subjects) proven CAS were enrolled for this study.

Results

A total 119 patients (5.2%) showed ECG changes during Ach provocation tests. The baseline clinical and procedural characteristics are well balanced between the two groups. Ischemic ECG change group showed more frequent chest pain, higher incidence of baseline spasm, severe vasospasm, multi-vessel involvement, and more diffuse spasm ( > 30 mm) than those without ischemic ECG changes. At 5 years, the incidences of death, major adverse cardiac events (MACE) and major adverse cardiac and cerebral events (MACCE) were higher in the ischemic ECG change group despite of optimal medical therapy.

Conclusions

The patients with ischemic ECG changes during Ach provocation tests were associated with more frequent chest pain, baseline spasm, diffuse, severe and multi-vessel spasm than patients without ischemic ECG changes. At 5-years, the incidences of death, MACE and MACCE were higher in the ischemic ECG change group, suggesting more intensive medical therapy with close clinical follow up will be required.


KMJ : Kosin Medical Journal