https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/849 2026-04-05T00:49:03Z https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/25656 Title: Brachial plexus block using only 1% lidocaine to reduce pain during the endovascular treatment of dysfunctional arteriovenous access Authors: Park, Sung-Joon; Chung, Hwan Hoon; Lee, Yun Hak; Lee, Hyoung Nam; Cho, Youngjong; Lee, Sangjoon; Lee, Seung Hwa; Yang, Woo Young Abstract: Background: Interventional endovascular treatments of dysfunctional arteriovenous (AV) access for hemodialysis can cause pain and discomfort to the patients. Ultrasound-guided brachial plexus block (BPB) is an alternative regional anesthesia method, but conventional BPB using ropivacaine or bupivacaine may cause long-lasting motor power loss, significantly reducing patient satisfaction. This study aimed to introduce BPB using only 1% lidocaine, which induces sensory loss while minimizing motor block, and evaluate the efficacy and safety of this procedure.Methods: This retrospective study was conducted on 277 consecutive patients with dysfunctional AV access requiring percutaneous transluminal angioplasty (PTA). Of these, 174 patients underwent the BPB procedure using 1% lidocaine. Time data were recorded, and the motor strength grade (MRC scale, grade 0-5) was evaluated. Numeric rating pain score (NRPS, grade 0-10) was asked during every PTA, and overall NRPS and satisfaction scores (scale 1-3) were asked after the procedure was completed.Results: Of the 174 patients who received BPB, the success rate was 100%, and there were no significant complications related to BPB. The MRC scale measured at the time when the complete sensory loss was achieved was 1.99 +/- 0.63, and that at the point of sensory recovery when the block effect expired was 3.93 +/- 0.62, indicating a good grade of motor strength. The average NRPS during PTA in the BPB group was significantly lower than that of the control group without BPB (1.04 +/- 2.04vs 6.30 +/- 2.71, p < 0.001). The overall satisfaction score was significantly higher in the BPB group than in the control group (2.79 +/- 0.50vs 2.00 +/- 0.81, p < 0.001).Conclusions: BPB using only 1% lidocaine can induce a sensory block while minimizing the effect on motor function. It can be applied safely in an outpatient clinic setting with relatively higher satisfaction. 2025-09-01T00:00:00Z https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/28279 Title: Development of a prediction model for progression of rheumatoid arthritis-associated interstitial lung disease using serologic and clinical factors: The prospective KORAIL cohort Authors: Chang, Sung Hae; Paudel, Misti L.; Mcdermott, Gregory C.; Zhang, Qianru; Fukui, Sho; Kim, Minuk; Ha, You-Jung; Lee, Jeong Seok; Lee, Sung Won; Park, Chan Ho; Kim, Ji-Won; Ha, Jang Woo; Chung, Sang Wan; Ha Kang, Eun; Lee, Yeon-Ah; Park, Yong-Beom; Choe, Jung-Yoon; Lee, Eun Young; Sparks, Jeffrey A. Abstract: Objective: To develop a prediction model for rheumatoid arthritis-associated interstitial lung disease (RA-ILD) progression. Methods: We investigated predictors of RA-ILD progression in the Korean RA-ILD (KORAIL) cohort, a prospective study that enrolled patients with RA meeting ACR/EULAR criteria and ILD on chest computed tomography (CT) scans and followed for 3 years. Pulmonary function tests (PFTs) and chest CT scans were conducted annually. RAILD progression was defined as both physiological and radiological worsening, adapted from the 2023 ATS/ERS/ JRS/ALAT definition of progressive pulmonary fibrosis. Baseline factors included clinical factors and biomarkers (autoantibodies, inflammatory markers, and pulmonary damage markers). Results: We analyzed 138 RA-ILD patients (mean age 66.4 years, 30.4 % male, 60.1 % usual interstitial pneumonia [UIP] pattern). During a median follow-up of 2.9 years, 34.8 % (n = 48) had RA-ILD progression. Baseline associations with progression included: UIP pattern, ILD extent >10 %, DLCO %pred., anti-cyclic citrullinated peptide (anti-CCP), Krebs von den Lungen-6 (KL-6), and human surfactant protein D. We developed prediction models using UIP pattern, ILD extent, DLCO % pred., and anti-CCP titer with or without serum KL-6 levels. The models had areas under the curve (AUCs) of 0.73 and 0.75, respectively. The high-risk group had a positive predictive value for progression of 85.7 %, while the low-risk group had a negative predictive value of 94.7 %. Conclusion: In this prospective cohort, UIP pattern, ILD extent, lower DLCO, RA disease activity, anti-CCP levels, and pulmonary damage biomarkers were associated with RA-ILD progression. We developed prediction models that may be clinically useful to risk stratify once externally validated. 2025-08-01T00:00:00Z https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/28258 Title: Risk of Contrast-Induced Acute Kidney Injury in Computed Tomography A 16 Institutional Retrospective Cohort Study Authors: Choi, Byungjin; Heo, Subin; Mcdonald, Jennifer S.; Choi, Sang Hyun; Choi, Won-Mook; Lee, Jung Bok; Lee, Eunyoung Angela; Park, Seong Ho; Seol, Soobeen; Gan, Sujin; Park, Bumhee; Choi, Hee Jung; Kim, Byoung Je; Rhee, Sang Youl; Hong, Seung Baek; Kim, Kyung-Hee; Lee, Young Hwan; Kim, Seung Soo; Park, Rae Woong Abstract: Objectives: Concern about contrast-induced acute kidney injury (CI-AKI) may delay the timely administration of contrast media for computed tomography (CT). The precise causative effect of iodinated contrast media on CI-AKI and its relevant risk factors remains an area of ongoing investigation. Therefore, this study aimed to determine the risk of CI-AKI following contrast-enhanced CT and its predisposing risk factors. Materials and Methods: This study employed a 1:1 propensity score matching analysis using electronic medical records gathered between January 2006 and December 2022 from 16 institutions in South Korea. Contrast-enhanced and nonenhanced CT scans in patients aged 18 years and above were matched for baseline estimated glomerular filtration rate (eGFR), demographic characteristics, and clinical variables to assess the risk of CI-AKI. Subgroup analyses were conducted to evaluate any significant risk factors for CI-AKI. Results: A total of 182,170 CT scans with contrast were matched to 182,170 CT scans without contrast. The risk of CI-AKI in the entire study cohort was not statistically significant (odds ratio [OR], 1.036; 95% confidence interval [CI], 0.968-1.109; P = 0.34). Subgroup analyses revealed a significantly higher risk of CI-AKI in patients with eGFR <30 mL/min/1.73m(2) (OR, 1.176; 95% CI, 1.080-1.281; P = 0.011) or eGFR 30-45 mL/min/1.73m(2) (OR, 1.139; 95% CI, 1.043-1.244; P = 0.019), patients diagnosed with chronic kidney disease (OR, 1.215; 95% CI, 1.084-1.361; P = 0.011), and those administered with iso-osmolar contrast media (OR, 1.392; 95% CI, 1.196-1.622; P = 0.011). Conclusions: The risk of CI-AKI following CT was minimal in the general population. However, caution is warranted for patients with chronic kidney disease and eGFR lower than 45 mL/min/1.73m2, or those administered with iso-osmolar contrast media. 2025-06-01T00:00:00Z https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/28259 Title: Serum Biomarkers of Pulmonary Damage and Risk for Progression of Rheumatoid Arthritis-Associated Interstitial Lung Disease Authors: Chang, Sung Hae; Park, Yong-Beom; Mcdermott, Gregory C.; Paudel, Misti L.; Hayashi, Keigo; Ha, You-Jung; Lee, Jeong Seok; Kim, Min Uk; Park, Chan Ho; Kim, Ji-Won; Ha, Jang Woo; Chung, Sang Wan; Lee, Sung Won; Ha Kang, Eun; Lee, Yeon Ah; Choe, Jung-Yoon; Lee, Eun Young; Sparks, Jeffrey A. Abstract: . Objective. To investigate baseline and change of pulmonary damage biomarkers (serum Krebs von den Lungen 6 [KL-6], human surfactant protein D [hSP-D], and matrix metalloproteinase 7 [MMP-7]) with cohort, we enrolled patients with RA and ILD confirmed by chest computed tomography imaging and followed annually. ILD progression was defined as worsening in physiological and radiological domains Latin American Thoracic Society guideline for progressive pulmonary fibrosis (PPF). Associations between biomarkers and RA-ILD progression were analyzed using multivariable Cox regression, adjusting for potential confounders. Results. We analyzed 136 patients with RA-ILD (mean age 66.5 yrs, 30% male, 60.3% with usual interstitial pneumonia pattern). During a median 3.0 years of follow-up, 47 patients (34.6%) experienced progression. Higher baseline KL-6 and hSP-D levels were associated with higher risk of ILD progression (multivariable hazard ratios [HRs] 1.37 [95% CI 1.03-1.82] and 1.51 [95% CI 1.09-2.08], respectively), whereas only the highest quartile of MMP-7 showed an increased risk (multivariable HR 2.60 [95% CI 1.07-6.33]). Increasing levels of serum KL-6 at 1 year showed the strongest association with progression (triangle KL-6: multivariable HR 2.00 [95% CI 1.29-3.11]), additionally adjusting for baseline biomarker levels. Conclusion. In this first prospective study to apply PPF criteria to RA-ILD, 34.6% progressed over 3 years. Higher baseline KL-6 and hSP-D were associated with progression. In follow-up, greater change in KL-6 was associated with progression. Serial measurement of pulmonary damage biomarkers may predict RA-ILD progression and may be helpful in monitoring patients and treatment decisions. 2025-04-01T00:00:00Z