Biography:

In the past Yang Hyun Cho has collaborated on articles with Salah E. Altarabsheh and Heemoon Lee. One of their most recent publications is Chapter 31 - Novel and Emerging Surveillance Markers for Bladder Cancer. Which was published in journal .

More information about Yang Hyun Cho research including statistics on their citations can be found on their Copernicus Academic profile page.

Yang Hyun Cho's Articles: (9)

Chapter 31 - Novel and Emerging Surveillance Markers for Bladder Cancer

AbstractA high likelihood of recurrence of bladder cancer has made the development of urinary markers a focus of intense pursuit with the hope of decreasing the burden which this disease places on patients and the healthcare system. Interests include the development of a single urinary marker that can be used in place of or as an adjunct to surveillance techniques, as well as identifying a molecular signature for an individual’s disease that can help predict progression, prognosis, and potential therapeutic response. Markers have shown potential value in improving diagnostic accuracy when used as an adjunct to current modalities, risk stratification of patients that could aid the clinician in determining aggressiveness of surveillance, and allowing for a decrease in invasive surveillance procedures. This review discusses the current understanding of emerging biomarkers, including gene signatures and their potential clinical value in surveillance tools, as well as limitations to their incorporation into medical practice.

Case reportImplantation of a HeartMate II Left Ventricular Assist Device via Left Thoracotomy

Left thoracotomy was used as an approach for the implantation of pulsatile ventricular assist devices. Avoiding the standard approach of median sternotomy is attractive in patients undergoing complicated redo cardiac surgery, especially with prior mediastinal radiation. We report a case of the use of left thoracotomy for the implantation of the HeartMate II axial-flow pump.

Original articleAdult cardiacMalperfusion Syndrome Without Organ Failure Is Not a Risk Factor for Surgical Procedures for Type A Aortic Dissection

BackgroundMalperfusion syndrome caused by acute type A aortic dissection is associated with high mortality. However, the impact of subclinical malperfusion is not clear. We reviewed surgical outcomes in acute type A dissection for the presence of clinical and subclinical malperfusion.MethodsFrom 1998 to 2012 at Samsung Medical Center, 268 consecutive patients had an emergency operation for acute type A dissection. We divided patients into three groups: clinical, subclinical, and no malperfusion. Clinical malperfusion was identified by signs or symptoms of organ dysfunction (n = 36). Subclinical malperfusion was defined as laboratory evidence of organ hypoperfusion or imaging findings without signs or symptoms (n = 40). Patients with no evidence of malperfusion were defined as having no malperfusion (n = 192).ResultsThe mean patient age was 57.3 ± 13.8 years, and 141 patients (53%) were women. Antegrade selective cerebral perfusion was used in 213 patients (79%). Total arch replacement was performed in 53 patients (20%). The average cardiopulmonary bypass time was 218.31 ± 72.17 minutes. Early mortality was 8% in all patients, 5% in the no-malperfusion group, 8% in the subclinical malperfusion group, and 25% in the clinical malperfusion group. Overall survival in the clinical malperfusion group was worse than in the subclinical (p = 0.026) and no-malperfusion (p < 0.001) groups. Survival rates in the subclinical and no-malperfusion groups were not different (p = 0.482). On multivariate Cox regression analysis, older age, longer cardiopulmonary bypass time, and clinical malperfusion syndrome were predictors of mortality.ConclusionsMortality was not increased in asymptomatic patients with malperfusion by laboratory or imaging findings. Immediate operation before progression of organ malperfusion is still a valid option for patients with acute type A dissection.

Original articleAdult cardiacOff-Pump Coronary Artery Bypass Reduces Early Stroke in Octogenarians: A Meta-Analysis of 18,000 Patients

BackgroundData comparing results of off-pump and conventional operations in octogenarians is very limited. Thus we chose to compare early adverse events between off-pump coronary artery bypass grafting (OPCABG) and on-pump CABG (ONCABG) in patients older than 80 years.MethodsSystematic review of multiple databases was performed to obtain original studies fulfilling search criteria. End points—early mortality, stroke, respiratory failure, atrial fibrillation, and myocardial infarction—were compared between these cohorts. A random-effects weighted analysis was performed using the trim-fill adjustment when necessary. Results are presented as risk ratios (RRs) with 95% confidence intervals (CIs); p < 0.05 is considered statistically significant.ResultsSixteen retrospective studies (9,744 ONCABG and 8,566 OPCABG patients) were included in the systematic review. OPCAGB patients received significantly fewer grafts (2.54 ± 0.16) compared with ONCABG patients (3.22 ± 0.41). Early mortality was comparable at 4.6% and 5.2% in the OPCABG and ONCABG cohorts, respectively (risk ratio [RR], 0.91; 95% CI, 0.64–1.28; p = 0.598). Stroke rates were higher in the ONCABG cohort (RR, 0.65; 95% CI, 0.49– 0.87; p < 0.01). Respiratory failure was higher with ONCABG (RR, 0.74; 95% CI, 0.57–0.97; p = 0.03). New-onset renal failure (p = 0.99), atrial fibrillation (p = 0.27), and myocardial infarction (p = 0.99) were comparable.ConclusionsCoronary artery bypass in octogenarians can be performed safely with low early mortality. Although off-pump operations reduce the risk of early stroke, all other adverse events are comparable in on- and off-pump coronary artery bypass operations. Data regarding late mortality is at present limited; however, both on- and off-pump procedures appear to produce comparable survival.

Original articleCongenital heart surgeryAugmentation of the Lesser Curvature With an Autologous Vascular Patch in Complex Aortic Coarctation and Interruption

BackgroundReconstruction of the aortic arch in patients with complex aortic coarctation or interruption continues to be a challenge because of early left main bronchial compression or recoarctation and late Gothic arch formation. We propose a modified arch reconstruction technique augmenting the lesser curvature with an autologous vascular patch, which can relieve tension on the anastomosis without a prosthetic material.MethodsWe retrospectively reviewed 33 patients with coarctation and arch hypoplasia (n = 31) or arch interruption (n = 2) who underwent arch reconstruction with an autologous vascular patch from 2007 to 2012. Median age at the operation was 17 days (range, 5 to 200 days). Median body weight was 3.7 kg (range, 2.3 to 7.0 kg). Cardiopulmonary bypass was used for all operations. Median antegrade selective cerebral perfusion time was 35 minutes (range, 23 to 59 minutes). Combined intracardiac anomalies in 29 patients (88%) were corrected simultaneously. The reconstructed arch was supplemented in the lesser curvature with an autologous vascular patch that was harvested from aortic isthmus (n = 25), pulmonary artery (n = 4), left subclavian artery (n = 2), aberrant right subclavian artery (n = 1), or distal arch (n = 1).ResultsOne patient (3%) died of acute respiratory distress syndrome. All survivors were discharged at 15 days (range, 7 to 58 days) postoperatively without neurologic complications or bronchial obstructions. Median follow-up was 24.8 months (range, 0.2 to 48.5 months). No recoarctation was observed during follow-up, and no patient needed reoperation.ConclusionsAugmenting the lesser curvature with an autologous vascular patch during arch reconstruction resulted in excellent midterm outcomes. Not only can a more natural shape of arch and less tension on the anastomosis be obtained, but complications, such as left main bronchial obstruction or recoarctation, can also be minimized. Long-term follow-up is needed to evaluate late development of recoarctation, hypertension, or aneurysm formation.

Original articleGeneral thoracicThe Outcome of Extracorporeal Life Support After General Thoracic Surgery: Timing of Application

BackgroundExtracorporeal life support (ECLS) is widely used in refractory cardiac or pulmonary failure. Because complications of general thoracic surgery frequently involve the heart or lungs, ECLS can be a useful option. Therefore, we retrospectively reviewed our experience with ECLS after general thoracic surgery.MethodsThere were 17,185 adult general thoracic surgery procedures between 2005 and 2013 at our institution, including resection of the lung (n = 10,434; 60.7%), esophagus (n = 1,847; 0.7%), and other procedures (n = 4,904; 28.5%). Twenty-nine patients (0.2%) were supported by ECLS postoperatively.ResultsThe median age was 64 years (range, 24 to 81). Primary operations were lobectomy (n = 13; 44.8%), pneumonectomy (n = 11; 37.9%), and bilobectomy (n = 5; 17.2%). The initial mode of ECLS was venovenous in 20 patients (69.0%) and venoarterial in 9 patients (31.0%). There were 10 patients (34.5%) who survived to decannulation and 7 patients (24.1%) who survived to discharge. Over the same period, the survival to decannulation rate and survival to discharge rate were 49.5% and 35.0%, respectively, among all ECLS patients (n = 759) at our institution. The hospital mortality of patients with surgery to ECLS time of longer than 2 days was 90.9%. Multivariate analysis revealed that a longer surgery to ECLS time was a risk factor for hospital mortality (odds ratio 1.720, 95% confidence interval: 1.039 to 2.849, p = 0.035).ConclusionsECLS after general thoracic surgery can be a viable rescue therapy option. Late presentation of complications or ECLS for late complications of general thoracic surgery may be predictors of death.

Comparison of long-term clinical outcomes between revascularization versus medical treatment in patients with silent myocardial ischemia

Highlights•In patients with silent ischemia, the role of revascularization is uncertain and previous studies show conflicting results.•This study showed a significantly lower risk of mortality in the revascularization group than in the medical treatment group.•Patients with resolution of ischemia showed significantly lower risk of cardiac death than those with residual ischemia after PCI.

Clinical PotpourriA nationwide analysis of intensive care unit admissions, 2009–2014 – The Korean ICU National Data (KIND) study

AbstractPurposeTo evaluate unbiased information on the characteristics, procedures, and outcomes of intensive care unit (ICU) admissions in a long-term nationwide study.Materials and methodsCohort study of all ICU admissions in patients > 18 years of age in Korea between August 1, 2009 and September 30, 2014 (1,553,673 ICU admissions in 1,265,509 patients).ResultsFrom August 2009 to September 2014, the age-standardized ICU admission rate was 744.6 per 100,000 person-years (869.5 per 100,000 person-years in men and 622.0 per 100,000 person-years in women). The overall in-hospital mortality was 13.8% (14.1% in men and 13.5% in women). Among all Koreans, the ICU mortality rate was 102.9 per 100,000 person-years (122.5 per 100,000 person years in men and 83.8 per 100,000 person years in women). The median ICU and hospital length of stay were 4 and 13 days, respectively. The median cost per ICU admission was $5051, which increased steadily over the study period. There were marked differences by gender in ICU admission rates, aggressive support, and outcomes.ConclusionsOur study identified increasing trends in ICU admissions and utilization of advance life support systems that add to the burden of care in a developed society.

Original articleRisk Prediction Model of In-hospital Mortality in Patients With Myocardial Infarction Treated With Venoarterial Extracorporeal Membrane OxygenationModelo de predicción de riesgo de mortalidad hospitalaria para pacientes con infarto de miocardio tratados con oxigenador extracorpóreo de membrana venoarterial

AbstractIntroduction and objectivesThere are limited data to develop a risk prediction model of in-hospital mortality for acute myocardial infarction (AMI) patients treated with venoarterial (VA)-extracorporeal membrane oxygenation (ECMO). We aimed to develop a risk prediction model for in-hospital mortality in patients with AMI who were treated with VA-ECMO.MethodsA total of 145 patients with AMI who underwent VA-ECMO between May 2004 and April 2016 were included from the Samsung Medical Center ECMO registry. The primary outcome was in-hospital mortality. To develop a new predictive scoring system, named the AMI-ECMO score, backward stepwise elimination and β coefficient-based scoring were used based on logistic regression analyses. The leave-one-out cross-validation method was performed for internal validation.ResultsIn-hospital mortality occurred in 69 patients (47.6%). On multivariable logistic regression analysis, the AMI-ECMO score comprised 6 pre-ECMO or angiographic parameters: age > 65 years, body mass index > 25 kg/m2, Glasgow coma score < 6, lactic acid > 8 mmol/L, anterior wall infarction, and no or failed revascularization. The C-statistic value of AMI-ECMO score for predicting in-hospital mortality was 0.880 (95%CI, 0.820-0.940). The incidence of in-hospital mortality after VA-ECMO insertion was 6.2%, 28.1%, 51.6%, and 93.8% for AMI-ECMO score quartiles (0 to 16, 17 to 19, 20 to 26, and > 26), respectively (P < .001 for trend). The AMI-ECMO scores were also significantly associated with the estimated rate of all-cause mortality during follow-up (per 1 increase, HR, 1.11; 95%CI, 1.08-1.14; P < .001).ConclusionsThe AMI-ECMO score can help predict early prognosis in AMI patients who undergo VA-ECMO.

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