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Yoon HK, Kim HS. Analgesia nociception index for intra-operative remifentanil dose and pain after gynaecological laparotomy: a reply. Anaesthesia 2023; 78:1305. [PMID: 37395061 DOI: 10.1111/anae.16084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2023] [Indexed: 07/04/2023]
Affiliation(s)
- H-K Yoon
- Seoul National University Hospital, Seoul, Republic of Korea
| | - H-S Kim
- Seoul National University Hospital, Seoul, Republic of Korea
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2
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Yoon HK, Kim YJ, Lee HS, Seo JH, Kim HS. A randomised controlled trial of the analgesia nociception index for intra-operative remifentanil dose and pain after gynaecological laparotomy. Anaesthesia 2023; 78:988-994. [PMID: 36960477 DOI: 10.1111/anae.16008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2023] [Indexed: 03/25/2023]
Abstract
We aimed to investigate the effect of the analgesia nociception index on postoperative pain. We randomly allocated 170 women scheduled for gynaecological laparotomy and analysed results from 159: in 80 women, remifentanil was infused to maintain analgesia nociception indices 50-70; and in 79 women, remifentanil was infused to maintain systolic blood pressure < 120% of baseline values. The primary outcome was the proportion of women with pain scores ≥ 5 (scale 0-10) within 40 min of admission to recovery. The proportion of women with pain scores ≥ 5 was 62/80 (78%) vs. 64/79 (81%), p = 0.73. Mean (SD) doses of fentanyl in recovery were 53.6 (26.9) μg vs. 54.8 (20.8) μg, p = 0.74. Intra-operative remifentanil doses were 0.124 (0.050) μg.kg-1 .min-1 vs. 0.129 (0.044) μg.kg-1 .min-1 , p = 0.55.
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Affiliation(s)
- H-K Yoon
- Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Y J Kim
- Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H S Lee
- Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - J-H Seo
- Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H-S Kim
- Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
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3
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Choi S, Yoo HK, Shin KW, Kim YJ, Yoon HK, Park HP, Oh H. Videolaryngoscopy vs. flexible fibrescopy for tracheal intubation in patients with cervical spine immobilisation: a randomised controlled trial. Anaesthesia 2023; 78:970-978. [PMID: 37145935 DOI: 10.1111/anae.16035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2023] [Indexed: 05/07/2023]
Abstract
In patients with cervical spine immobilisation, tracheal intubation devices other than a direct laryngoscope are frequently used to facilitate tracheal intubation and avoid related complications. In this randomised controlled trial, we compared videolaryngoscopic and fibrescopic tracheal intubation in patients with a cervical collar. Tracheal intubation was performed using either a videolaryngoscope with a non-channelled Macintosh blade (n = 166) or a flexible fibrescope (n = 164) in patients having elective cervical spine surgery whose neck was immobilised with a cervical collar to simulate a difficult airway. The primary outcome was the first attempt success rate of tracheal intubation. Secondary outcomes were the overall success rate of tracheal intubation; time to tracheal intubation; use of additional airway manoeuvres; and incidence and severity of tracheal intubation-related airway complications. First attempt success rate was higher in the videolaryngoscope group than in the fibrescope group (164/166 (98.8%) vs. 149/164 (90.9%), p = 0.003). Tracheal intubation was successful within three attempts in all patients. Median (IQR [range]) time to tracheal intubation was shorter (50.0 (41.0-72.0 [25.0-170.0]) s vs. 81.0 (65.0-107.0 [24.0-178.0]) s, p < 0.001) and additional airway manoeuvres were less frequent (30/166 (18.1%) vs. 91/164 (55.5%), p < 0.001) in the videolaryngoscope group compared with the fibrescope group. The incidence and severity of intubation-related airway complications were not different between the two groups. When performing tracheal intubation in patients with a cervical collar, videolaryngoscopy with a non-channelled Macintosh blade was superior to flexible fibrescopy.
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Affiliation(s)
- S Choi
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H K Yoo
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - K W Shin
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Y J Kim
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H K Yoon
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H P Park
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H Oh
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
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4
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Cho HY, Yoon HK. Postoperative sore throat after laparoscopic surgery: a reply. Anaesthesia 2022; 77:935. [PMID: 35443289 DOI: 10.1111/anae.15744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 04/08/2022] [Indexed: 11/29/2022]
Affiliation(s)
- H-Y Cho
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H-K Yoon
- Seoul National University College of Medicine, Seoul, Republic of Korea
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5
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Lee GY, Shin GW, Park HY, Yoon HK, Kim TH, Lee A, Heo YJ, Lee YJ, Han JY, Park YM. Sonographic Features of Breast Fibroepithelial Masses: Distinguishing Fibroadenoma from Phyllodes Tumour. Hong Kong Journal of Radiology 2022. [DOI: 10.12809/hkjr2217333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- GY Lee
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, South Korea
| | - GW Shin
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, South Korea
| | - HY Park
- Department of Pathology, Busan Paik Hospital, Inje University College of Medicine, South Korea
| | - HK Yoon
- Department of Pathology, Busan Paik Hospital, Inje University College of Medicine, South Korea
| | - TH Kim
- Department of Surgery, Busan Paik Hospital, Inje University College of Medicine, South Korea
| | - A Lee
- Department of Surgery, Busan Paik Hospital, Inje University College of Medicine, South Korea
| | - YJ Heo
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, South Korea
| | - YJ Lee
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, South Korea
| | - JY Han
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, South Korea
| | - YM Park
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, South Korea
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Cho HY, Yang SM, Jung CW, Cheun H, Lee HC, Park HP, Yoon HK. A randomised controlled trial of 7.5-mm and 7.0-mm tracheal tubes vs. 6.5-mm and 6.0-mm tracheal tubes for men and women during laparoscopic surgery. Anaesthesia 2021; 77:54-58. [PMID: 34403493 DOI: 10.1111/anae.15568] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2021] [Indexed: 12/26/2022]
Abstract
Sore throat after tracheal intubation impairs postoperative recovery. We randomly allocated 172 ASA physical status 1-2 participants, scheduled for laparoscopic lower abdominal surgery, to tracheal intubation with larger tubes (n = 88) or smaller tubes (n = 84), with internal diameters 7.5-mm vs. 6.5-mm for men and 7.0-mm vs. 6.0-mm for women. Primary outcome was the rates of no, mild, moderate or severe sore throat 1 h after surgery, which were 60, 10, 17 and 1 with larger tracheal tubes and 79, 5, 0 and 0 with smaller tubes, p < 0.001. The equivalent rates 24 h after surgery were 64, 16, 8 and 0 vs. 74, 6, 3 and 1, p = 0.037. Intra-operative ventilatory variables were unaffected by tube diameter, including peak inspiratory pressure, plateau pressure and end-tidal carbon dioxide partial pressure. In summary, smaller tracheal tubes benefitted patients having laparoscopic operations.
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Affiliation(s)
- H Y Cho
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - S M Yang
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - C W Jung
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - H Cheun
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - H C Lee
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - H P Park
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - H K Yoon
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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Kim YJ, Ma S, Yoon HK, Lee HC, Park HP, Oh H. Supraclavicular versus infraclavicular approach for ultrasound-guided right subclavian venous catheterisation: a randomised controlled non-inferiority trial. Anaesthesia 2021; 77:59-65. [PMID: 34231204 DOI: 10.1111/anae.15525] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2021] [Indexed: 11/30/2022]
Abstract
Infraclavicular and supraclavicular approaches are used for subclavian venous catheterisation. We hypothesised that the supraclavicular approach is non-inferior to the infraclavicular approach in terms of safety during ultrasound-guided right subclavian venous catheterisation. We randomly allocated 401 neurosurgical patients undergoing ultrasound-guided right subclavian venous catheterisation into supraclavicular (n = 200) and infraclavicular (n = 201) groups. We assessed catheterisation-related complications (primary outcome measure) including catheter misplacement and mechanical complications (arterial puncture, haematoma formation, pneumothorax and haemothorax). We also recorded catheterisation success rates and time required for venous puncture and catheterisation. The number (proportion) of patients with catheterisation-related complications was six (3.0%) in the supraclavicular group and 27 (13.4%) in the infraclavicular group, mean difference (95%CI) -10.4% (-15.7 to -5.1%), p < 0.001, with a significant difference also seen for catheter misplacement. Except for a shorter time (median (IQR [range]) required for venous puncture in the supraclavicular group, being 9 (6-20 [2-138]) vs. 13 (8-20 [3-99]) s, the incidence of mechanical complications and other catheterisation characteristics were similar between the two groups. We recommend the supraclavicular approach for ultrasound-guided right subclavian venous catheterisation.
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Affiliation(s)
- Y J Kim
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - S Ma
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - H K Yoon
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - H C Lee
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - H P Park
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - H Oh
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
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Lee GY, Shin GW, Park HY, Yoon HK, Kim TH, Lee A, Heo YJ, Lee YJ, Han JY, Park YM. Predictive sonographic features for differentiation of breast fibroepithelial
tumors: fibroadenoma versus phyllodes tumor. Hong Kong Journal of Radiology 2021. [DOI: 10.12809/hkjr2117333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- GY Lee
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - GW Shin
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - HY Park
- Department of Pathology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - HK Yoon
- Department of Pathology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - TH Kim
- Department of Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - A Lee
- Department of Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - YJ Heo
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - YJ Lee
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - JY Han
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - YM Park
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
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Lee NJ, Shin JH, Lee SS, Park DH, Lee SK, Yoon HK. Transcatheter arterial embolization for iatrogenic bleeding after endoscopic ultrasound-guided pancreaticobiliary drainage. Diagn Interv Imaging 2018; 99:717-724. [PMID: 30033142 DOI: 10.1016/j.diii.2018.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 06/26/2018] [Accepted: 06/28/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE The purpose of this study was to report the incidence of massive bleeding after endoscopic ultrasound-guided transmural pancreaticobiliary drainage (EUS-TPBD) and the clinical outcomes in patients with this condition treated with transcatheter arterial embolization (TAE). PATIENTS AND METHODS We performed a 9-year retrospective analysis of 797 EUS-TPBD procedures (excluding gallbladder or pseudocysts) in 729 patients. Among them, twelve (12/729, 1.65%) patients were referred for TAE to manage active bleeding adjacent to the TPBD sites. There were 8 men and 4 women with a mean age of 66.1 years±13.4 (SD) (range: 45-89 years). The clinical and procedure data of these 12 patients were reviewed. RESULTS Thirteen TAE procedures in 12 patients were performed. The bleeding sites were the left hepatic artery (n=7), the right hepatic artery (n=3), the left gastric artery (n=1), the left accessory gastric artery (n=1) and gastroduodenal artery (n=1). TAE was performed with gelatin sponge particles (n=1), coil (n=1) and n-butyl-2 cyanoacrylate with/without coils (n=11), with technical and clinical success rates of 100% (13/13) and 85% (11/13), respectively. Re-bleeding following embolization with gelatin sponge particles occurred in one patient. Procedure-related ischemic hepatitis was observed in another patient with pancreatic cancer with portal vein involvement. CONCLUSION On the basis of our results, TAE using n-butyl-2 cyanoacrylate seems safe and effective for the treatment of bleeding after EUS-TPBD procedures. When the portal vein is compromised, TAE of the hepatic artery can cause ischemic liver damage.
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Affiliation(s)
- N J Lee
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
| | - J H Shin
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea.
| | - S S Lee
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - D H Park
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - S K Lee
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - H-K Yoon
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
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Koo JW, Myong JP, Yoon HK, Rhee CK, Kim Y, Kim JS, Jo BS, Cho Y, Byun J, Choi M, Kim HR, Kim EA. Occupational exposure and idiopathic pulmonary fibrosis: a multicentre case-control study in Korea. Int J Tuberc Lung Dis 2018; 21:107-112. [PMID: 28157473 DOI: 10.5588/ijtld.16.0167] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Multicentred hospital-based cases and control subjects in Korea. OBJECTIVE To evaluate the association between idiopathic pulmonary fibrosis (IPF) and hazardous materials to which people are occupationally exposed. DESIGN A multicentre, hospital-based, matched case-control study was performed. The ratio of IPF cases to controls was 1:1 (n = 78 in each group). IPF cases and controls were matched in terms of age group, sex and place of residence. Conditional logistic regression analysis was performed. RESULTS In simple logistic regression analysis, exposure to metal dust and any exposure for >1 year in an occupational setting were significantly associated with IPF (metal dust OR 4.00, 95%CI 1.34-11.97; any exposure OR 3.67, 95%CI 1.02-13.14). After adjustment for environmental and military exposures and smoking history, the OR for metal dust exposure was 4.97 (95%CI 1.36-18.17) in multiple logistic regression analysis. CONCLUSIONS Metal dust was associated with incident IPF in Seoul and Gyeonggi Provinces in Korea. This information will be used to support a tailored preventive strategy in specific industries or occupations.
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Affiliation(s)
- J-W Koo
- Department of Occupational and Environmental Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, South Korea; Center for Occupational and Environmental Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, South Korea
| | - J-P Myong
- Department of Occupational and Environmental Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, South Korea<; Center for Occupational and Environmental Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, South Korea
| | - H-K Yoon
- Department of Internal Medicine, Yeouido St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea
| | - C K Rhee
- Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea
| | - Y Kim
- Department of Internal Medicine, Bucheon St Mary's Hospital, College of Medicine, Catholic University of Korea, Bucheon, South Korea
| | - J S Kim
- Department of Internal Medicine, Incheon St Mary's Hospital, College of Medicine, Catholic University of Korea, Incheon, South Korea
| | - B S Jo
- Department of Occupational and Environmental Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, South Korea
| | - Y Cho
- Department of Occupational and Environmental Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, South Korea
| | - J Byun
- Department of Occupational and Environmental Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, South Korea
| | - M Choi
- Department of Occupational and Environmental Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, South Korea
| | - H-R Kim
- Department of Occupational and Environmental Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, South Korea; Center for Occupational and Environmental Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, South Korea
| | - E-A Kim
- Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Ulsan, Republic of Korea
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Kim SW, Myong JP, Yoon HK, Koo JW, Kwon SS, Kim YH. Health care burden and medical resource utilisation of idiopathic pulmonary fibrosis in Korea. Int J Tuberc Lung Dis 2018; 21:230-235. [PMID: 28234090 DOI: 10.5588/ijtld.16.0402] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Despite the clinical importance of idiopathic pulmonary fibrosis (IPF), its epidemiology has been rarely reported. The economic burden from IPF is therefore difficult to predict. OBJECTIVE To analyse the health care burden and current situation with respect to medical resource utilisation in patients with IPF in Korea. METHODS We analysed nationwide data collected between 2009 and 2013 from the Korean Health Insurance Review and Assessment (HIRA) database. Patients with IPF were defined by the K-J84.18 code of the Korean Classification of Disease, 6th revision. RESULTS The total direct health care costs increased from US$19 805 167 in 2009 to US$31 410 083 in 2013; the principal factor responsible for the highest proportion of costs was hospitalisation. The proportion of the total IPF patient population who were hospitalised at least once a year was 27.2%, and the average length of hospital stay was 12.7 days. From post-hoc analysis, hospital admission, emergency room visit and intensive care unit admission rates showed significant seasonal variations; the admission rates were highest in the spring and lowest in autumn. CONCLUSIONS Health care costs of IPF are increasing annually, with hospital admissions representing the major financial burden.
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Affiliation(s)
- S W Kim
- Division of Pulmonology, Department of Internal Medicine, Yeouido St Mary's Hospital, Seoul, Korea
| | - J-P Myong
- Department of Occupational & Environmental Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - H K Yoon
- Division of Pulmonology, Department of Internal Medicine, Yeouido St Mary's Hospital, Seoul, Korea
| | - J-W Koo
- Department of Occupational & Environmental Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - S S Kwon
- Division of Allergy and Pulmonology, Department of Internal Medicine, Bucheon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| | - Y H Kim
- Division of Allergy and Pulmonology, Department of Internal Medicine, Bucheon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
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12
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Lee HE, Myong JP, Kim HR, Rhee CK, Yoon HK, Koo JW. Incidence and prevalence of idiopathic interstitial pneumonia and idiopathic pulmonary fibrosis in Korea. Int J Tuberc Lung Dis 2018; 20:978-84. [PMID: 27287654 DOI: 10.5588/ijtld.16.0003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Although the incidence and prevalence of idiopathic interstitial pneumonia (IIP) and idiopathic pulmonary fibrosis (IPF) have been assessed in Western countries, their epidemiology has not been analysed in Asian countries, including the Republic of Korea. OBJECTIVE To estimate the prevalence and incidence of IIP, including IPF, in Korea, using a large, nationwide database. DESIGN The Health Insurance Review and Assessment Services claims database, which includes information on every patient with diagnostic codes for IPF and IIP from 2010 to 2013, was reviewed. Age- and sex-specific IPF and IIP prevalence and incidence rates were estimated. RESULTS Among Korean males and females, IPF prevalence from 2010 to 2013 was estimated at respectively 39.7 and 24.3 per 100 000 population, while IIP prevalence was estimated at respectively 97.1 and 66.5/100 000. The annual incidence rates among Korean males and females during 2011 and 2012 were respectively 16.4 and 9.7/100 000, for IPF, and respectively 42.3 and 27.5/100 000 for IIP. CONCLUSIONS IPF is more prevalent in Korea than previously reported; its prevalence may be similar to or higher than in the United States and in European countries.
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Affiliation(s)
- H-E Lee
- Department of Occupational and Environmental Medicine, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - J-P Myong
- Department of Occupational and Environmental Medicine, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - H-R Kim
- Department of Occupational and Environmental Medicine, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - C K Rhee
- Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - H-K Yoon
- Department of Internal Medicine, Yeouido St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - J-W Koo
- Department of Occupational and Environmental Medicine, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
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Kim SW, Kim JH, Park CK, Kim TJ, Lee SY, Kim YK, Kwon SS, Rhee CK, Yoon HK. Effect of roflumilast on airway remodelling in a murine model of chronic asthma. Clin Exp Allergy 2017; 46:754-63. [PMID: 26542330 DOI: 10.1111/cea.12670] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 09/16/2015] [Accepted: 10/17/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND Airway remodelling is associated with irreversible, or partially reversible, airflow obstruction and ultimately unresponsiveness to asthma therapies such as corticosteroids. Roflumilast is a selective phosphodiesterase-4 inhibitor that has an anti-inflammatory effect in chronic obstructive pulmonary disease (COPD). OBJECTIVE The objective of this study was to study the effect of roflumilast on airway inflammation and remodelling in a murine model of chronic asthma. METHODS BALB/c mice sensitized to ovalbumin (OVA) were chronically exposed to intranasal OVA administration twice a week for additional 3 months. Roflumilast was administered orally during the intranasal OVA challenge. A lung fibroblast cell line was used in the proliferation assay. RESULTS Compared with control mice, mice chronically exposed to OVA developed eosinophilic airway inflammation, airway hyper-responsiveness (AHR), and exhibited features of airway remodelling. Administration of roflumilast significantly inhibited airway inflammation and AHR. Roflumilast also significantly decreased goblet cell hyperplasia and pulmonary fibrosis, which are parameters of airway remodelling. The levels of interleukin (IL)-4, IL-5, and IL-13 in the bronchoalveolar lavage (BAL) fluids were significantly lower in the roflumilast group. In vitro, roflumilast significantly inhibited stem cell factor (SCF)-induced cell proliferation of fibroblasts. The SCF concentration and mRNA expression in a murine model also significantly decreased with roflumilast treatment. CONCLUSIONS These results suggest that the administration of roflumilast regulates airway inflammation, AHR, and airway remodelling in a model of chronic asthma. The beneficial effects from roflumilast may be related to the SCF/c-kit pathway.
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Affiliation(s)
- S W Kim
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - J H Kim
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - C K Park
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - T J Kim
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - S Y Lee
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Y K Kim
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - S S Kwon
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - C K Rhee
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - H K Yoon
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Cho B, Kim DW, Park K, Lee JS, Yoo S, Kang J, Lee S, Kim C, Jang S, Kim YC, Yoon HK, Kim SW. A real world treatment study of osimertinib: ASTRIS study Korean subgroup analysis. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx671.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Myong JP, Yoon HK, Rhee CK, Kim HR, Koo JW. Risk factors for lung function impairment among the general non-smoking Korean population. Int J Tuberc Lung Dis 2016; 19:1019-26, i-iii. [PMID: 26260818 DOI: 10.5588/ijtld.14.0929] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Nationwide general population in South Korea. OBJECTIVE Except for tobacco smoking, risk factors for the impairment of lung function have not been widely evaluated. We evaluated the risk factors for lung function impairment among the general non-smoking Korean population. DESIGN A total of 8164 non-smokers from the spirometry data set of the Korean National Health and Nutrition Examination Surveys IV and V (2008-2010) were included in the study. After sex stratification, multiple survey logistic regression analyses were performed to estimate the association between potential risk factors and impaired lung function in this nationwide cross-sectional study. RESULTS The proportion of non-smokers among the general Korean population with forced expiratory volume in 1 s (FEV1) < 80% of predicted, forced vital capacity (FVC) < 80% of predicted and FEV1/FVC ratio < 0.7 were respectively 46.2%, 50.3% and 30.2%. In multiple survey logistic regression analyses, lung function impairment was associated with tuberculosis (TB) and asthma in female non-smokers and asthma in male non-smokers. CONCLUSIONS TB and asthma are risk factors for lung function impairment among Korean non-smokers. To prevent further lung function impairment, a careful control system for these factors should be considered when setting health policy priorities.
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Affiliation(s)
- J-P Myong
- Department of Occupational and Environmental Medicine, College of Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, Korea; Center for Occupational and Environmental Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, Korea
| | - H-K Yoon
- Department of Internal Medicine, Yeouido St Mary's Hospital College of Medicine, Catholic University of Korea, Seoul, Korea
| | - C K Rhee
- Department of Internal Medicine, College of Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, Korea
| | - H-R Kim
- Department of Occupational and Environmental Medicine, College of Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, Korea; Center for Occupational and Environmental Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, Korea
| | - J-W Koo
- Department of Occupational and Environmental Medicine, College of Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, Korea; Center for Occupational and Environmental Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, Korea
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16
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Song Y, Shin JH, Yoon HK, Kim JW, Ko GY, Won HS. Bleeding after dilatation and curettage: the efficacy of transcatheter uterine artery embolisation. Clin Radiol 2015; 70:1388-92. [PMID: 26382745 DOI: 10.1016/j.crad.2015.07.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Revised: 04/19/2015] [Accepted: 07/22/2015] [Indexed: 10/23/2022]
Abstract
AIM To evaluate safety and clinical outcomes of uterine artery embolisation (UAE) for bleeding after dilatation and curettage (D&C) performed for abortion or termination. MATERIALS AND METHODS The outcomes were analysed in 11 patients who underwent UAE for bleeding after D&C for missed abortions (n=8), caesarean scar pregnancies (n=2), or planned termination (n=1) between October 2001 and December 2013. Angiograms and medical records were retrospectively reviewed in order to obtain the patients' baseline characteristics, technical/clinical success rate, complications, and follow-up data regarding menstruation. RESULTS Technical success, defined as successful catheterisation of both uterine arteries with embolisation to haemostasis, was 100%, whereas clinical success, defined as cessation of bleeding after the initial session of UAE and without the need for additional UAE or surgery for the purpose of haemostasis, was 81.8% (nine of 11). In the two patients with clinical failure due to recurrent vaginal bleeding after UAE, one patient underwent repeat UAE and showed a successful outcome, whilst the other patient required hysterectomy with pathological results of placenta increta. Two other patients underwent hysterectomy for placenta percreta or hydatidiform mole-mimicking remnant placenta. None of the patients included in the present series had procedure-related complications. Menstruation resumed in all eight patients with an intact uterus during the mean follow-up period. CONCLUSION UAE may be a safe and effective treatment for bleeding after D&C, especially for women who wish to preserve their fertility; however, hysterectomy may be indicated for patients with a placental abnormality.
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Affiliation(s)
- Y Song
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, South Korea
| | - J H Shin
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, South Korea.
| | - H-K Yoon
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, South Korea
| | - J W Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, South Korea
| | - G-Y Ko
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, South Korea
| | - H-S Won
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, South Korea
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17
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Eom HJ, Shin JH, Cho YJ, Nam DH, Ko GY, Yoon HK. Transarterial embolisation of renal arteriovenous malformation: safety and efficacy in 24 patients with follow-up. Clin Radiol 2015; 70:1177-84. [PMID: 26183132 DOI: 10.1016/j.crad.2015.06.079] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 05/06/2015] [Accepted: 06/05/2015] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the efficacy and safety of renal artery embolisation (RAE) for renal arteriovenous malformation (AVM) as well as its outcomes. MATERIALS AND METHODS The technical and clinical success rates, radiological and laboratory findings, and complications of RAE for 31 renal AVMs in 24 patients (M:F=9:15, mean age 46 years) at two separate medical institutions were retrospectively evaluated. Technical success was defined as complete occlusion of feeding arteries with no residual nidus seen on post-treatment angiography. Clinical failure was defined as recurrence of haematuria, presence of AVM on follow-up ultrasound or computed tomography, repeated RAE or surgery for the control of haematuria. Overall clinical success was defined as resolution haematuria or disappearance of AVM on follow-up imaging after single or multiple sessions of RAE. RESULTS Types of renal AVM were AVM, arterio-venous fistula (AVF) with intranidal aneurysm, and acquired AVF in 19, 1, and 4 patients, respectively. 18 patients (75%) underwent a single session of RAE, while 6 patients (25%) had two or more sessions of RAE. The level of embolisation was feeder, segmental artery, and main renal artery in 28 (90%), 2 (6%), and 1 (4%) procedures, respectively. Coil, n-butyl 2-cyanoacrylate, and polyvinyl alcohol were the most frequently chosen embolic materials and were used in 19, 14, and 8 procedures, respectively. The clinical success rate after initial RAE was 67% (16/24). Overall clinical success rate, including multisession RAE, was 88% (21/24). The technical success rate of 31 procedures was 65% (20/31). Among 11 technical failures in 10 patients, 4 achieved clinical success without additional RAE, 3 underwent second session RAE to achieve clinical success, and 3 patients underwent nephrectomy due to recurrence. CONCLUSION RAE is a safe and effective treatment for renal AVM. Technical failure of RAE does not always lead to clinical failure and multiple embolisation sessions may be effective for recurrent renal AVM.
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Affiliation(s)
- H-J Eom
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - J H Shin
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
| | - Y J Cho
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - D H Nam
- Department of Radiology, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - G-Y Ko
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - H-K Yoon
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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Yoon HM, Lee JS, Hwang JY, Cho YA, Yoon HK, Yu J, Hong SJ, Yoon CH. Post-infectious bronchiolitis obliterans in children: CT features that predict responsiveness to pulse methylprednisolone. Br J Radiol 2015; 88:20140478. [PMID: 25710129 DOI: 10.1259/bjr.20140478] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE Intravenous pulse methylprednisolone therapy (IPMT) is an important treatment option for post-infectious obliterative bronchiolitis (OB), although it must be used carefully and only in selected patients because of its drawbacks. This study evaluated whether CT and clinical features of children with post-infectious OB can predict their responsiveness to IPMT. METHODS We searched the medical records for patients (less than 18 years of age) who were diagnosed with post-infectious OB between January 2000 and December 2011. 17 children who received IPMT were included in this study. All underwent chest CT before and after IPMT. The radiological features seen on pre-treatment CT were recorded. The air-trapping area percentages on pre- and post-treatment CT images were determined. The nine patients who exhibited decreased air trapping on post-treatment CT scans relative to pre-treatment scans were classed as responders. The patient ages and time from initial pneumonia to IPMT were recorded. RESULTS All responders and only four non-responders had thickened bronchial walls before treatment (p = 0.029). The two groups did not differ significantly in terms of bronchiolitis, bronchiectasis or the extent of air trapping, although the responders had a significantly shorter median interval between initial pneumonia and IPMT (4 vs 50 months; p = 0.005) and were significantly younger (median, 2.0 vs 7.5 years; p = 0.048). CONCLUSION Immediate IPMT may improve the degree of air trapping in children with post-infectious OB if they show a thickened bronchial wall on CT. ADVANCES IN KNOWLEDGE Children with post-infectious OB may respond favourably to IPMT when pre-treatment CT indicates bronchial-wall thickening.
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Affiliation(s)
- H M Yoon
- 1 Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Suh CH, Shin JH, Yoon HM, Yoon HK, Ko GY, Gwon DI, Kim JH, Sung KB. Angiographic evaluation of hepatic arterial injury after cisplatin and Gelfoam-based transcatheter arterial chemoembolization for hepatocellular carcinoma in a 205 patient cohort during a 6-year follow-up. Br J Radiol 2014; 87:20140054. [PMID: 24970695 DOI: 10.1259/bjr.20140054] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To evaluate the overall and cumulative incidence, degree, interval change and predictors of hepatic arterial injury (HAI) after cisplatin and Gelfoam® (Upjohn, Kalamazoo, MI)-based transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). METHODS A total of 205 patients with HCC who underwent three or more sessions of TACE without additional surgical or local treatment were included. HAI was evaluated at each segment of the hepatic artery using a three-grade scale: 1 (slight wall irregularity), 2 (overt stenosis) and 3 (occlusion). HAI interval change was categorized into three groups: progression, stable state and improvement. Cumulative incidence of HAI was analysed using Kaplan- Meier method, and predictors of HAI (patient age, sex, portal vein thrombosis and Child-Pugh classification) were analysed by univariate logistic regression. RESULTS HAI occurred in 50 of the 205 study patients (24.4%). The cumulative incidence of HAI was 16.0% [95% confidence interval (CI), 10.21-21.77] during 5 sessions of TACE, 52.1% (95% CI, 37.83-66.29) during 10 sessions and 68.0% (95% CI, 67.62-88.46) during 15 sessions. Initial HAI was interpreted as grades 1, 2 and 3 in 11 (22.0%), 17 (34.0%) and 22 (44.0%) patients, respectively. When the interval change was assessed in 48 patients with available follow-up TACE, 40 (83.3%) were included in the progression, 2 (4.2%) in the stable state and 6 (12.5%) in the improvement groups. The univariate analysis used to determine the predictors of HAI revealed no significant predictors. CONCLUSION In three or more sessions of TACE, the incidence of HAI was 24%. Increasing TACE causes increased incidence of HAI. The initial presentation was most commonly grade 3, and 12.5% of the patients with HAI showed improvement of the HAI grade during follow-up TACE. ADVANCES IN KNOWLEDGE In patients who underwent three or more sessions of cisplatin and Gelfoam-based TACE, the overall incidence of HAI was 24.4%, and increasing TACE causes increased incidence of HAI.
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Affiliation(s)
- C H Suh
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul, Republic of Korea
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20
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Abstract
The aim of this study was to quantify the amount of tendon excursion and load experienced during simulated active and passive rehabilitation exercises. Six cadaver specimens were utilized to examine tendon excursion and load. Lateral fluoroscopic images were used to measure the excursions of metal markers placed in the flexor digitorum superficialis and profundus tendons of the index, middle, and ring fingers. Measurements were performed during ten different passive and active simulated motions. Mean tendon forces were higher in all active versus passive movements. Blocking movements placed the highest loads on the flexor tendons. Active motion resulted in higher tendon excursion than did passive motion. Simulated hook position resulted in the highest total tendon excursion and the highest inter-tendinous excursion. This knowledge may help optimize the management of the post-operative exercise therapy regimen.
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Affiliation(s)
- A Sapienza
- Department of Orthopaedic Surgery, NYU Langone Medical Center, New York, NY, USA
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Park HW, Yoon HK, Han SB, Lee BS, Sung IY, Kim KS, Kim EA. Brain MRI measurements at a term-equivalent age and their relationship to neurodevelopmental outcomes. AJNR Am J Neuroradiol 2013; 35:599-603. [PMID: 23988755 DOI: 10.3174/ajnr.a3720] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND PURPOSE An increased prevalence of disabilities is being observed as more preterm infants survive. This study was conducted to evaluate correlations between brain MR imaging measurements taken at a term-equivalent age and neurodevelopmental outcome at 2 years' corrected age among very low-birth-weight infants. MATERIALS AND METHODS Of the various brain MR imaging measurements obtained at term-equivalent ages, reproducible measurements of the transcerebellar diameter and anteroposterior length of the corpus callosum on sagittal images were compared with neurodevelopmental outcomes evaluated by the Bayley Scales of Infant Development (II) at 2 years' corrected age (mean ± standard deviation, 16.1 ± 6.4 months of age). RESULTS Ninety infants were enrolled. The mean gestational age at birth was 27 weeks and the mean birth weight was 805.5 g. A short corpus callosal length was associated with a Mental Developmental Index <70 (P = .047) and high-risk or diagnosed cerebral palsy (P = .049). A small transcerebellar diameter was associated with a Psychomotor Developmental Index <70 (P = .003), Mental Developmental Index <70 (P = .004), and major neurologic disability (P = .006). CONCLUSIONS A small transcerebellar diameter and short corpus callosal length on brain MR imaging at a term-equivalent age are related to adverse neurodevelopmental outcomes at a corrected age of 2 years and could be a useful adjunctive tool for counseling parents about future developmental outcomes.
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Affiliation(s)
- H W Park
- From the Department of Pediatrics (H.W.P.), Division of Neonatology, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Korea
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22
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Rhee CK, Yoo KH, Lee JH, Park MJ, Kim WJ, Park YB, Hwang YI, Kim YS, Jung JY, Moon JY, Rhee YK, Park HK, Lim JH, Park HY, Lee SW, Kim YH, Lee SH, Yoon HK, Kim JW, Kim JS, Kim YK, Oh YM, Lee SD, Kim HJ. Clinical characteristics of patients with tuberculosis-destroyed lung. Int J Tuberc Lung Dis 2013; 17:67-75. [PMID: 23232006 DOI: 10.5588/ijtld.12.0351] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Multicentre study. OBJECTIVE To define the clinical characteristics of patients with tuberculosis (TB) destroyed lung due to past TB. DESIGN We reviewed patients with TB-destroyed lung between May 2005 and June 2011. RESULTS A total of 595 patients from 21 hospitals were enrolled. The mean age was 65.63 ± 0.47 (mean ± standard error); 60.5% were male. The mean number of lobes involved was 2.59 ± 0.05. Pleural thickening was observed in 54.1% of the patients. Mean forced vital capacity (FVC), forced expiratory volume in 1 s (FEV(1)), FEV(1)/FVC, bronchodilator response and number of exacerbations per year were respectively 2.06 ± 0.03 l (61.26% ± 0.79), 1.16 ± 0.02 l (49.05% ± 0.84), 58.03% ± 0.70, 5.70% ± 0.34, and 0.40 ± 0.04. The number of lobes involved was significantly correlated with FVC and FEV(1), and with the number of exacerbations per year. Use of long-acting muscarinic antagonists or long-acting beta-2 agonists plus inhaled corticosteroids resulted in bronchodilatory effects. Multivariable regression analysis showed that age, initial FEV(1) (%) and number of exacerbations during follow-up were independent factors affecting change in FEV(1). CONCLUSION Decreased lung function with exacerbation, and progressive decline of FEV(1) were observed in patients with TB-destroyed lung.
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Affiliation(s)
- C K Rhee
- Department of Internal Medicine, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Korea
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Park SY, Kim JH, Yoon HJ, Lee IS, Yoon HK, Kim KP. Transarterial chemoembolization versus supportive therapy in the palliative treatment of unresectable intrahepatic cholangiocarcinoma. Clin Radiol 2011; 66:322-8. [PMID: 21356394 DOI: 10.1016/j.crad.2010.11.002] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2010] [Revised: 11/02/2010] [Accepted: 11/08/2010] [Indexed: 12/11/2022]
Abstract
AIM To evaluate the clinical outcome and the survival benefits of transarterial chemoembolization (TACE) for unresectable intrahepatic cholangiocarcinoma (ICC) compared with supportive therapy. MATERIALS AND METHODS From January 1996 to April 2009, a total of 155 patients with unresectable ICC met the entry criteria and underwent TACE (72 patients) or supportive treatment (83 patients). Their survival was the primary end point. RESULTS The baseline patients and tumour characteristics were well-balanced in the two groups. The median number of sessions per patient was 2.5 (range 1-17 sessions) in the TACE group. After TACE, the incidence of significant (≥ grade 3) haematological and non-haematological toxicities was 13 and 24%, respectively, and no patients died within 30 days following TACE. The objective tumour regression (≥ partial response) was achieved in 23% of the patients in the TACE group. The Kaplan-Meier survival analysis showed that the survival period was significantly longer in the TACE group (median 12.2 months) than in the symptomatic treatment (median 3.3 months) group (p < 0.001). CONCLUSIONS TACE is safe and offers greater survival benefits than supportive treatment for the palliative treatment of unresectable ICC.
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Affiliation(s)
- S-Y Park
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Lee EJ, Choo HJ, Kim DW, Yoon JH, Cha SS, Lee WJ, Yoon HK. A retroperitoneal granular cell tumour that mimics pancreatic cancer. Br J Radiol 2009; 82:e194-6. [PMID: 19729550 DOI: 10.1259/bjr/25160895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Granular cell tumour is a rare disorder that is characterised by an oval-shaped tumour that has with eosinophilic granules within the tumour cells. It is extremely rare to find this disease arising from the retroperitoneum. We report here on a case of a 46-year-old man with a retroperitoneal granular cell tumour that mimics pancreatic cancer, and describe the CT and MRI findings.
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Affiliation(s)
- E J Lee
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
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Kim SJ, Kim JS, Kim SC, Kim YK, Kim YK, Kang JY, Yoon HK, Song JS, Lee SH, Moon HS, Kim JW, Kim KH, Kim CH, Shim BY, Kim HK. A multicenter phase II study of belotecan, new camptothecin analogue, in patients with previously untreated extensive stage disease small cell lung cancer. Lung Cancer 2009; 68:446-9. [PMID: 19683359 DOI: 10.1016/j.lungcan.2009.07.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2009] [Revised: 06/26/2009] [Accepted: 07/04/2009] [Indexed: 10/20/2022]
Abstract
Belotecan (Camtobell, CKD602) is a new camptothecin derivative antitumor agent that belongs to the topoisomerase inhibitors. The aim of this phase II study was to evaluate the efficacy and safety of single agent belotecan in patients with small cell lung cancer (SCLC). Patients with previously untreated extensive stage disease (ED) SCLC were entered into the study. Belotecan was given by daily intravenous infusion at 0.5mg/m(2)/day for 5 consecutive days, every 3 weeks. 62 patients were enrolled in this study. The overall response rate to chemotherapy on an intention-to-treat basis was 53.2%. The median overall survival was 10.4 months, the median time to progression 4.6 months, and the 1-year survival rate 49.9%. The most common toxicity was hematologic. Grade 3/4 neutropenia occurred in 71.0% of patients and grade 3/4 thrombocytopenia 12.9%. Non-hematologic toxicity of grade 3 or 4 was low. The results suggest that belotecan is relatively active and well tolerable as single agent in patients with ED SCLC. Further investigations with platinum or other active agents are needed.
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Affiliation(s)
- S J Kim
- Division of Pulmonology, Department of Internal Medicine, Kangnam St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
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Kim JH, Yoon HK, Kim SY, Kim KM, Ko GY, Gwon DI, Sung KB. Transcatheter arterial chemoembolization vs. chemoinfusion for unresectable hepatocellular carcinoma in patients with major portal vein thrombosis. Aliment Pharmacol Ther 2009; 29:1291-8. [PMID: 19392861 DOI: 10.1111/j.1365-2036.2009.04016.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Transcatheter arterial chemoembolization (TACE) has been limited in palliative treatment of unresectable hepatocellular carcinoma (HCC) with major portal vein (PV) invasion due to the possibility of liver failure following embolization. Transcatheter arterial chemoinfusion (TACI) has been an option in such cases. AIM To compare clinical outcomes after TACE vs. TACI in HCC patients with major PV occlusion. METHODS We compared clinical outcomes after TACE vs. TACI in HCC patients with major PV occlusion. From 2005 to 2007, 110 HCC patients with major PV thrombosis were treated with TACE (n = 49) or TACI (n = 61). RESULTS The morbidity rate was similar for both TACE (6.1%) and TACI (6.5%) patients, and complications were adequately managed using medical treatment. The Kaplan-Meier survival analysis showed that the survival period was significantly longer for the TACE group (median: 14.9 months) than for the TACI (median: 4.4 months) group (P < 0.001). There was a higher probability of death in the TACI group than in the TACE group in both our multivariate Cox-proportional hazards (OR 3.09, P < 0.001) and the propensity score-matched (27 pairs) cohort analyses (OR 2.27, P = 0.024). CONCLUSIONS Transcatheter arterial chemoembolization can be safely performed in HCC patients with main PV occlusion. Compared with TACI, TACE may result in longer survival of HCC patients with major PV occlusion.
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Affiliation(s)
- J H Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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27
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Abstract
Fudosteine is a novel mucoactive agent, although little is known about how fudosteine decreases mucin production. The present study examined the effects of fudosteine on MUC5AC mucin synthesis and cellular signalling. An animal model of lipopolysaccharide (LPS)-induced inflammation and a bronchial epithelial cell line model of tumour necrosis factor (TNF)-alpha-induced inflammation were used. Fudosteine was administered before stimulation with LPS or TNF-alpha. The MUC5AC mucin levels were assayed and the expression of the MUC5AC gene was measured. Western blotting was carried out for the detection of phosphorylated epidermal growth factor receptor (p-EGFR), phosphorylated p38 mitogen-activated protein kinase (p-p38 MAPK) and phosphorylated extracellular signal-related kinase (p-ERK). MUC5AC mucin synthesis and the expression of the MUC5AC gene were increased by LPS in rats or TNF-alpha in NCI-H292 cells; these effects were inhibited by fudosteine treatment. After stimulation with LPS or TNF-alpha, the expression of p-EGFR, p-p38 MAPK and p-ERK were detected. Fudosteine treatment reduced the expression levels of p-p38 MAPK and p-ERK in vivo and of p-ERK in vitro. The present results suggest fudosteine inhibits MUC5AC mucin hypersecretion by reducing MUC5AC gene expression and the effects of fudosteine are associated with the inhibition of extracellular signal-related kinase and p38 mitogen-activated protein kinase in vivo and extracellular signal-related kinase in vitro.
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Affiliation(s)
- C K Rhee
- Dept of Internal Medicine, St Mary's Hospital, The Catholic University Medical College, #62 Yeoi-Do Dong, Young Dung Po Gu, Seoul, Korea
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Abstract
BACKGROUND AND OBJECTIVE CYP3A, the drug-metabolizing enzyme is an important factor in the pharmacokinetics of many drugs. Polymorphism of the CYP3A5 gene is known to influence the functionality of the CYP3A5 enzymes. The full extent of CYP3A5 genetic polymorphism was analysed in a Korean population. METHODS Specific polymerase chain reaction-restriction fragment length polymorphism tests for CYP 3AP1 through CYP3A5*7 or direct sequencing were used to identify reported CYP3A5 variant alleles, using 194 unrelated samples. RESULTS AND DISCUSSION The most frequent single nucleotide polymorphism (SNP) was 6986A>G (CYP3A5*3). The next most frequent SNP was 31611C>T. Haplotype analysis using detected SNPs revealed that the most frequent haplotype was *3A (frequency: 0.724), followed by *1E (frequency: 0.211), *3C (frequency: 0.034) and *1A (frequency: 0.023). We did not find CYP3AP1*3, CYP3A5*6, or *7 in this Korean sample. CONCLUSION A large proportion of Koreans may have relatively low levels of metabolically active CYP3A5 protein and therefore may be at risk of high levels of drugs metabolized by this enzyme, after administration of conventional doses.
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Affiliation(s)
- S Y Park
- Department of Medicine, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea
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29
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Jeong DH, Youm MY, Kim YN, Lee KB, Sung MS, Yoon HK, Kim KT. Promoter methylation of p16, DAPK, CDH1, and TIMP-3 genes in cervical cancer: correlation with clinicopathologic characteristics. Int J Gynecol Cancer 2007; 16:1234-40. [PMID: 16803511 DOI: 10.1111/j.1525-1438.2006.00522.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
This study was conducted to investigate the promoter methylation status of the p16, DAPK, CDH1, and TIMP-3 genes in primary cervical cancer and its correlation with clinicopathologic characteristics. Promoter methylation was evaluated using a methylation-specific polymerase chain reaction in 78 cervical cancer tissue specimens and 24 control, normal cervical tissue specimens. Clinicopathologic parameters were obtained from medical records, and the relationship between the discrete variables and the methylation status was evaluated. The frequencies of promoter methylation of p16, DAPK, CDH1, and TIMP-3 in cervical cancer were 57%, 44.9%, 52.6%, and 9%, respectively. Primary cervical cancer had significantly higher methylation frequencies for the p16 and DAPK promoters than did the control, normal cervix (P < 0.0001). The promoter methylation of TIMP-3 was significantly higher in adenocarcinoma than in squamous cell carcinoma (41.7% vs 3%, respectively, P= 0.0175). High-stage cancers exhibited an increased promoter methylation frequency for p16 (P= 0.0061). The promoter methylation of the p16 gene is a frequent event in cervical carcinogenesis and may have potential clinical application as a marker for the progression and prognosis of cancer.
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Affiliation(s)
- D H Jeong
- Department of Obstetrics and Gynecology, Paik Institute for Clinical Research, and Department of Pathology, Busan Paik Hospital, Inje University College of Medicine, 633-165 Gaegum-Dong, Busanjin-Gu, Busan 614-735, South Korea.
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Abstract
The case history is presented of a patient with pathologically proven dendriform pulmonary ossification and rare earth pneumoconiosis confirmed by analytical transmission electron microscopy. This is thought to be the first report of this association.
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Affiliation(s)
- H K Yoon
- Division of Pulmonary and Critical Care, Department of Medicine, College of Medicine, Catholic University of Korea, Seoul, Korea
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31
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Chang YW, Kim Han BK, Yoon HK, Lee SK. Multidetector-row CT appearance of acute torsion of wandering spleen in a child. Acta Radiol 2003; 44:107. [PMID: 12631009 DOI: 10.1034/j.1600-0455.2003.00001.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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32
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Han KO, Choi JT, Moon IG, Jeong MS, Yim CH, Chung HY, Jang HC, Yoon HK, Han IK. Nonassociation of interleukin-1 receptor antagonist genotypes with bone mineral density, bone turnover status, and estrogen responsiveness in Korean postmenopausal women. Bone 2002; 31:612-5. [PMID: 12477576 DOI: 10.1016/s8756-3282(02)00873-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Interleukin-1 receptor antagonist (IL-1ra), a natural inhibitor of interleukin-1 (IL-1), completely inhibits the stimulatory effects of IL-1 on bone resorption. Bioactivity of IL-1 increases in the estrogen-deficient state with an increased IL-1:IL-1ra ratio and decreases after estrogen replacement therapy with a decreased IL-1:IL-1ra ratio. An association was found between an 86 basepair variable number tandem-repeat (VNTR) polymorphism of the IL-1ra gene and an increased production of IL-1ra in a cultured monocyte system. The IL-1ra VNTR polymorphism, therefore, is an attractive candidate gene for osteoporosis susceptibility as well as hormone responsiveness after estrogen replacement. We examined the association of this VNTR polymorphism with bone mass, bone turnover, and the change of bone mineral density (BMD) after 1 year of hormone replacement therapy (HRT). The frequencies of the five alleles were as follows: A1, 90.8% (410 bp, four repeats); A2, 7.2% (240 bp, two repeats); A3, 1.6% (500 bp, five repeats); A4, 0.4% (326 bp, three repeats); and A5, 0% (595 bp, six repeats), in 714 healthy ethnically Korean postmenopausal women, aged 41-74 years (55.2 +/- 6.3 years mean +/- SD). Spine (L2-4) and femoral neck BMD were not significantly different among IL-1ra genotypes, and no significant genotypic differences were found in bone markers. There were no differences in genotypic proportions when we categorized the subjects into a high-loss group and a normal-loss group with regard to levels of bone marker. No significant genotypic differences were found in changes in lumbar and femoral neck BMD and those in bone markers before and after 1 year of HRT in 312 women. Our data suggest that these IL-1ra polymorphisms are not associated with BMD, bone turnover, or the change of BMD after 1 year of HRT in Korean women.
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Affiliation(s)
- K O Han
- Department of Medicine, Samsung Cheil Hospital and Women's Healthcare Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
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Chung H, Kang YS, Hwang CS, Moon IK, Yim CH, Choi KH, Han KO, Jang HC, Yoon HK, Han IK. Deflazacort increases osteoclast formation in mouse bone marrow culture and the ratio of RANKL/OPG mRNA expression in marrow stromal cells. J Korean Med Sci 2001; 16:769-73. [PMID: 11748360 PMCID: PMC3054787 DOI: 10.3346/jkms.2001.16.6.769] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Information on precise effects of deflazacort on bone cell function, especially osteoclasts, is quite limited. Therefore, the present study was undertaken to test effects of deflazacort on osteoclast-like cell formation in mouse bone marrow cultures and on the regulation of osteoprotegerin (OPG) and its ligand (RANKL) mRNA expressions by RT-PCR in the ST2 marrow stromal cells. TRAP-positive mononuclear cells increased after the treatment of deflazacort at 10(-9) to 10(-7) M alone for 6 days in a dose-dependent manner. Number of TRAP-positive multi-nucleated cells (MNCs) increased significantly with combined treatment of deflazacort at 10(-7) M and 1,25-(OH)2D3 at 10(-9) M compared to that of cultures treated with 1,25-(OH)2D3 alone (p<0.05). Exposure to deflazacort at 10(-7) M in the presence of 1,25-(OH)2D3 at 10(-9) M in the last 3-day culture had greater stimulatory effect on osteoclast-like cell formation than that of the first 3-day culture did. Deflazacort at 10(-10) -10(-6) M downregulated OPG and upregulated RANKL in mRNA levels in a dose-dependent manner. These observations suggest that deflazacort stimulate osteoclast precursor in the absence of 1,25-(OH)2D3 and enhance differentiation of osteoclasts in the presence of 1,25-(OH)2D3. These effects are, in part, thought to be mediated by the regulation of the expression of OPG and RANKL mRNA in marrow stromal cells.
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Affiliation(s)
- H Chung
- Department of Medicine, Sungkyunkwan University School of Medicine, Samsung Cheil Hospital, Seoul, Korea.
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Han KO, Kang YS, Hwang CS, Moon IG, Yim CH, Chung HY, Jang HC, Yoon HK, Han IK, Choi YK. Identification of a mutation in the human raloxifene response element of the transforming growth factor-beta 3 gene. J Korean Med Sci 2001; 16:549-52. [PMID: 11641521 PMCID: PMC3057605 DOI: 10.3346/jkms.2001.16.5.549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The human transforming growth factor-beta 3 (TGF-beta 3) is an important cytokine to maintain bone mass by inhibiting osteoclast differentiation. Recently raloxifene response element (RRE), a new enhancer with a polypurine sequence for estrogen receptor (ER)-mediated gene activation, was identified on the TGF-beta 3 gene. Functional analysis of the RRE-mediated pathway has shown that this would be an important pathway for bone preserving effect. We found a novel mutation in the RRE sequence by single-strand conformational polymorphism analysis in one of 200 Korean women. Cloning and sequencing revealed a heterozygote in which one allele had an insertion of 20 nucleotides (AGAGAGGGAGAGGGAGA GGG) between nucleotide +71 and +72 and a point mutation at nucleotide +75 (G-A transition), and the other allele had normal sequence. The insertion was a nearly perfect tandem duplication of the wild type DNA sequence. The bone mineral density of the affected woman was not much lower than that of age-matched controls. Transient transfection of the mutant allele showed no significantly different activity compared with that of the wild type allele. These observations suggest that the heterozygote variation of the RRE sequence seems not to be operative in determination of bone mass.
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Affiliation(s)
- K O Han
- Department of Internal Medicine, Samsung Cheil Women's Healthcare Center and Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
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35
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Kang SG, Lee DY, Maeda M, Kim ES, Choi D, Kim BO, Yoon HK, Sung KB, Song HY. Aortic dissection: percutaneous management with a separating stent-graft--preliminary results. Radiology 2001; 220:533-9. [PMID: 11477265 DOI: 10.1148/radiology.220.2.r01au24533] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The authors used a separating stent-graft to treat Stanford type B aortic dissection. The separating stent-graft consists of two stents: a stent-graft and an inner bare stent. The separating stent-graft has three parts: a proximal stent, a graft made of synthetic polyester textile fiber, and a distal stent. A 12-F introducing sheath was used. After the separating stent-graft was placed, false-lumen thrombosis was evident in all six patients during a follow-up period of 206 days. The major advantages of this technique are that a cutdown and blood pressure control are not required.
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Affiliation(s)
- S G Kang
- Department of Diagnostic Radiology Chosun University College of Medicine, Kwangju, Korea
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36
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Song BC, Chung YH, Kim JA, Lee HC, Yoon HK, Sung KB, Yang SH, Yoo K, Lee YS, Suh DJ. Association between insulin-like growth factor-2 and metastases after transcatheter arterial chemoembolization in patients with hepatocellular carcinoma: a prospective study. Cancer 2001. [PMID: 11413529 DOI: 10.1002/1097-0142(20010615)91:12<2386::aid-cncr1272>3.0.co;2-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Hypoxia up-regulates insulin-like growth factor-2 (IGF-2) and thus stimulates the growth of hepatocellular carcinoma (HCC) cells. In the current study, the authors prospectively evaluated changes in plasma IGF-2 levels in HCC patients after transcatheter arterial chemoembolization (TACE), which usually results in hypoxic insult to liver tissue. The authors also examined the association between changes in plasma IGF-2 levels after TACE and HCC progression, especially in relation to metastasis. METHODS Plasma IGF-2 levels were measured before and 4 weeks after TACE in 46 patients with HCC. Three months after TACE, the patients were evaluated for the occurrence of metastatic HCC. RESULTS In 13 of the 46 patients, post-TACE plasma IGF-2 levels decreased by > 20% (Group 1) compared with their basal levels; in 18 patients, the IGF-2 levels changed within 20% (Group 2) and in 15 patients the IGF-2 levels increased by > 20% (Group 3). Plasma IGF-2 levels had a tendency to increase in patients with large-sized tumors, high serum alpha-fetoprotein (AFP) levels, and the heterogeneous uptake of iodized oil. Metastatic foci were found in 9 patients in Group 3 (60%), in contrast to only 3 patients in Group 2 (17%) and in none of the patients in Group 1 (P = 0.001). On multivariate analysis, higher Child-Pugh scores and increased plasma IGF-2 levels (Group 3) were found to be independent risk factors for metastasis. CONCLUSIONS Increased plasma IGF-2 levels after TACE, which are common in patients with large-sized tumors and high serum AFP levels, appear to be associated with the occurrence of metastatic HCC after TACE.
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Affiliation(s)
- B C Song
- Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Songpa-gu, Seoul, Korea
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37
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Abstract
BACKGROUND The gross appearance and echogenicity of the normal thymus have been described, but specific intrathymic anatomy has not been evaluated with imaging. SUBJECTS AND METHODS The thymus from a 34-week-gestation stillborn male was examined with ultrasound, and the images were correlated with microscopic findings. Thymic ultrasound was performed in 12 infants without any evidence of thymic abnormality, severe infection, or chronic illness. Images were evaluated focusing on intrathymic parenchymal anatomy and compared to the liver, spleen, and thyroid gland. RESULTS In the specimen thymus, ultrasound demonstrated connective-tissue septa as echogenic linear structures. The cortex was relatively hypoechoic, whereas the medulla was echogenic. The blood vessels within the septa were seen as discrete echoes. In vivo ultrasound demonstrated multiple branching echogenic linear structures and foci throughout the parenchyma, representing connective-tissue septa or blood vessels within the septa. The normal thymus was easily differentiated from the liver, spleen, and thyroid glands. CONCLUSION Ultrasound is capable of demonstrating intrathymic anatomy, including the medulla, cortex, septa, and blood vessels in a fresh specimen. In vivo connective-tissue septa and blood vessels in the thymic parenchyma produce a unique echo pattern.
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Affiliation(s)
- B K Han
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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38
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Abstract
BACKGROUND The aberrant cervical thymus is an uncommon entity to be considered in the differential diagnosis of neck masses in children, so a preoperative diagnosis has rarely been made. OBJECTIVE The purpose of this study was to assess the ultrasound features of aberrant cervical thymus and determine if recognition of the previously described unique intrathymic echo pattern allows us to make a specific diagnosis. MATERIALS AND METHODS We present four patients with an aberrant cervical thymus and one patient with a cervical thymic cyst. All five patients had ultrasound, which was evaluated with special attention to the detailed echo pattern of the mass. In two patients, the mass was surgically removed. Four patients had MRI, which was evaluated. Medical records were reviewed. RESULTS In all cases, the mass was painless and nontender. All occurred in the expected path of the thymopharyngeal duct. In four patients, ultrasound demonstrated multiple echogenic linear structures and foci previously described as characteristic echo pattern of normal thymic tissue. In one patient, ultrasound showed a large cystic mass and echogenic solid component superiorly with a characteristic echo pattern of normal thymus. CONCLUSIONS The ultrasound appearance of thymic tissue is unique, allowing a specific diagnosis of aberrant cervical thymus. Biopsy or other imaging is probably not indicated when it presents with typical clinical features.
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Affiliation(s)
- B K Han
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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39
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Abstract
BACKGROUND Various mediastinal interfaces and lines are well known in adults, but not fully understood in children. OBJECTIVE To review the mediastinal interfaces and lines on plain radiographs in the paediatric age group with CT correlation. MATERIALS AND METHODS Soft copies of 195 sets of CT examinations and concurrent chest radiographs in 180 paediatric patients (age 1 month to 15 years) were retrospectively reviewed. The frequency of visualisation and the anatomical basis of the mediastinal interfaces and lines were assessed. The evaluated mediastinal interfaces and lines were superior vena cava interface, descending aorta interface, left paraspinal interface, azygoesophageal recess interface, right paratracheal stripe, anterior junction line and posterior junction line. RESULTS Chest radiographs showed the SVC interface in 161, the descending aorta interface in 155, the left paraspinal interface in 98, the azygoesophageal recess in 94, the right paratracheal stripe in 53, the anterior junction line in 15 and the posterior junction line in 10. Non-visualisation of mediastinal interfaces and lines on plain radiographs was explained by normal anatomical difference compared with the adult and underlying intrathoracic abnormalities when they were correlated with CT. The frequency of visualisation of the SVC interface, descending aortic interface, left paraspinal interface and azygoesophageal recess fluctuated with age, while the frequency of the right paratracheal stripe, anterior junction line and posterior junction line increased with age. CONCLUSIONS Awareness of the frequency of visualisation and the anatomical basis of the mediastinal interfaces and lines in paediatric patients may be helpful for interpretation of chest radiographs.
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Affiliation(s)
- H K Yoon
- Department of Radiology, Sungkyunkwan University School of Medicine, Kangnam-gu, Seoul, South Korea
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Abstract
Understanding the metabolic changes in women is one of the important ways to prevent and treat osteoporosis. To reveal the metabolic characteristics of 289 healthy women aged between 35-65 yr in Tae-An, Korea we evaluated the association between bone mass assessed by broadband ultrasound attenuation (BUA) using quantitative ultrasound 2 (QUS2) and various parameters such as age, body mass index, serum levels of alkaline phosphatase, calcium, phosphorus, parathyroid hormone, 25(OH)D, and urinary ratios of calcium/creatinine and deoxypyridinoline (Dpyd)/creatinine. Among the subjects, 3.0% were osteoporotic, and 40.9% were osteopenic. When the subjects were classified according to their years since menopause (YSM) and age, the prevalence of osteoporosis increased along with an increase of YSM and age. Bone turnover markers such as serum alkaline phosphatase and fasting urinary Dpyd/creatinine were significantly higher in the group with low bone mass than in the normal group. In summary, this study shows, by use of biochemical markers of bone turnover and QUS2, the prevalence of osteoporosis in women aged between 35-65 in Tae-An was 3.0% and the risk of low bone mass increased with the bone turnover markers.
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Affiliation(s)
- H K Yoon
- Division of Endocrinology, Department of Medicine, Samsung Cheil Hospital & Women's Healthcare Center, Sungkyunkwan University, School of Medicine, Samsung Biomedical Research Institute, Seoul, Korea.
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Kim HK, Chung YH, Song BC, Yang SH, Yoon HK, Yu E, Sung KB, Lee YS, Lee SG, Suh DJ. Ischemic bile duct injury as a serious complication after transarterial chemoembolization in patients with hepatocellular carcinoma. J Clin Gastroenterol 2001; 32:423-7. [PMID: 11319315 DOI: 10.1097/00004836-200105000-00013] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Bile duct injuries after transarterial chemoembolization (TACE) have been reported; however, the exact pathogenic mechanisms and clinical implications of the injuries remain to be clarified. STUDY A total of 950 consecutive patients with hepatocellular carcinoma (HCC) were studied. Among them, 807 were treated with TACE and the remaining 143 were treated with transarterial chemoinfusion (TACI) of cisplatin. RESULTS None of 143 patients with HCC treated with TACI were found to have any radiographic evidence of biliary injury. In contrast, of the 807 patients treated with TACE, 17 (2%) developed biliary complications. Of all complications, 12 (71%) were subcapsular bilomas; 3 (17%), focal strictures of the common hepatic duct or common bile duct; and 2 (12%), diffuse mild dilatation of the intrahepatic bile ducts. Interestingly, 2 of the 12 bilomas were found in the lobe that was not embolized with gelatin sponge particles. The median numbers of TACE tended to be greater in the patients with focal stricture than in those with bilomas (6.0 vs. 2.5; p = 0.08). All 3 patients with focal strictures and 4 of the 12 patients with bilomas had associated serious bacterial infections at presentation. CONCLUSIONS Bilomas seem to be caused by iodized oil rather than gelatin sponge particles; focal strictures of large bile ducts seem to be caused by gelatin sponge particles. We suggest that adjustments in the amounts of iodized oil or gelatin sponge particles and in the sites of embolization may reduce ischemic biliary injuries after TACE.
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Affiliation(s)
- H K Kim
- Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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Abstract
We present a case of splenic artery aneurysm (SAA) treated with stent-grafts. This new method offers the benefit of preserving the blood flow through the splenic artery. This in turn allows for subsequent sequential embolization of the spleen when indicated, as in our patient with hypersplenism. This is the first reported case of stent-graft repair of SAA.
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Affiliation(s)
- H K Yoon
- Department of Diagnostic Radiology, Malmö University Hospital, University of Lund, S-205 02 Malmö, Sweden
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Lee KH, Yoon CS, Choe KO, Kim MJ, Lee HM, Yoon HK, Kim B. Use of imaging for assessing anatomical relationships of tracheobronchial anomalies associated with left pulmonary artery sling. Pediatr Radiol 2001; 31:269-78. [PMID: 11321746 DOI: 10.1007/s002470000423] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Proper recognition, classification and assessment of the tracheobronchial anatomy are essential for surgical management planning in left pulmonary artery sling (LPAS). OBJECTIVE To demonstrate the various imaging modalities in diagnosing and assessing anatomical relationships with tracheobronchial tree in LPAS. MATERIALS AND METHODS Seven patients (three infants, three children, one adult) with LPAS were evaluated. The confirmative imaging modalities included electron-beam tomography (EBT, n = 2), MRI (n = 1) and helical CT (n = 4). Other imaging modalities included plain chest radiographs (n = 7), barium oesophagogram (n = 2), echocardiography (n = 3), cardiac and pulmonary angiography (n = 2) and bronchoscopy (n = 5). RESULTS There were two cases of type IA, one case of type IIA and four cases of type IIB. All five cases of type II had a long segment of tracheobronchial stenosis. A long segment of thoracic tracheal stenosis was unusually associated in one case of type IA. All confirmative modalities were sufficient for diagnosing LPAS and assessing the tracheobronchial tree anomaly. However, helical CT could not obviate angiography due to associated congenital cardiac defects. CONCLUSIONS Sectional imaging modalities of EBT, MRI and helical CT were all sufficient for diagnosing and assessing the anatomical relationships of the tracheobronchial tree in LPAS.
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Affiliation(s)
- K H Lee
- Department of Diagnostic Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, 146-92 Dogok-dong, Kangnam-ku, Seoul, South Korea, 135-270
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Abstract
BACKGROUND Rhabdoid tumour of the kidney (RTK) is a rare tumour, but it is the most aggressive malignant neoplasm of the kidney in children. OBJECTIVE To analyse the radiological findings of RTK in children. MATERIALS AND METHODS The clinical and radiological findings in seven children (age range 6 months to 4.7 years; median 18 months) with pathologically proven RTK were retrospectively reviewed. We analysed tumour size, tumour location, tumour margin, subcapsular haematoma, tumour necrosis, haemorrhage, calcification and lymphadenopathy. RESULTS Tumour size varied from 5 to 12 cm. Four tumours were located mainly in the central portion of the kidney, while three tumours were mainly sited peripherally. The margins of the tumour were ill-defined in four (57%) of seven cases, a lobulated tumour surface was depicted in all seven (100%), subcapsular haematoma was present in four (57%), tumour necrosis or haemorrhage in seven (100%), calcifications in three (43%) and retroperitoneal lymphadenopathy in four (57%). CONCLUSIONS Imaging findings of RTK are subcapsular haematoma, a lobulated surface of the tumour, calcification and tumour necrosis or haemorrhage.
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Affiliation(s)
- T I Han
- Department of Diagnostic Radiology, Eulji University School of Medicine, 24-14, Mok-Dong, Jung-Gu, Taejon 301-726, South Korea.
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Abstract
PURPOSE To evaluate the initial and long-term results of balloon dacryocystoplasty in the treatment of epiphora caused by obstruction of the lacrimal system with analysis of the procedure's favorable effects. MATERIALS AND METHODS Four hundred thirty eyes of 350 patients with obstructions of the lacrimal system were enrolled. Dacryocystoplasty was performed with use of a balloon catheter and a ball-tipped guide wire. The lesions were categorized according to cause, severity, site of the obstruction, and diameter and inflation time of the balloon. The technical success, initial success (improvement of symptoms after 1 week), and long-term patency rates were calculated. These rates in each group were compared with the chi(2) test and the Kaplan-Meier method. RESULTS The overall technical success rate was 95.3%. The overall initial success rate was 57.4%. There was no significant complication except for mild epistaxis in 12%. The 2-month, 1-year, and 5-year patency rates were 48.2%, 39.4%, and 36.9%, respectively. Initial success was influenced by the severity (P =.014) and the site (P <.001) of the obstruction, and the diameter of the balloon (P =.047). Long-term patency was affected by the site of the obstruction (P <.001) and the balloon inflation time (P <.001). Among the 183 initially ineffective and 88 recurrent cases, 62 underwent repeat balloon dacryocystoplasty, and the initial success rate was 38.7%. CONCLUSIONS The initial success rate of balloon dacryocystoplasty is relatively low. However, long-term patency can be expected in cases with initial success. Some additional factors also should be considered for better results.
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Affiliation(s)
- D H Lee
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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46
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Abstract
The pathogenesis of endocervical glandular lesions are not clearly understood. The aims of this study are to evaluate the etiologic role of human papillomavirus (HPV) 16/18 and the relationship of HPV 16/18, p53 and MIB-1 expressions in endocervical glandular dysplasia (EGD), adenocarcinoma in situ (AIS) and adenocarcinoma. The materials included 14 endocervical adenocarcinoma and 5 AIS and 18 high grade EGD and 39 low grade EGD. Immunohistochemistry for p53 and MIB-1, and in situ PCR for HPV 16/18 were done. HPV 16/18 positivity was 84.2%, 16.7% and 17.9% in malignant glandular lesion (adenocarcinoma and AIS), high grade EGD and low grade EGD, respectively. P53 protein expression rates of malignant glandular lesions, high grade EGD and low grade EGD were 31.6%, 11.1%, and 0%, respectively. High MIB-1 labelling index was found in 73.7% of malignant glandular lesions, but in only 5.7% and 3.6% of high and low grade EGD, respectively. There were statistically significant differences in HPV 16/18, p53 and MIB-1 expressions between malignant endocervical glandular lesions and EGD, but no significant difference in p53 and MIB-1 expressions in relation to HPV 16/18 expression. In malignant endocervical glandular lesions, HPV 16/18 infection may be a major causative factor, but not be related to p53 and MIB-1 expressions.
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Affiliation(s)
- H K Yoon
- Department of Anatomic Pathology, Pusan Paik Hospital, Pusan, Korea.
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47
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Lee JH, Kim JH, Hwang SW, Lee WJ, Yoon HK, Lee HS, Hong SS. High-level expression of antimicrobial peptide mediated by a fusion partner reinforcing formation of inclusion bodies. Biochem Biophys Res Commun 2000; 277:575-80. [PMID: 11061996 DOI: 10.1006/bbrc.2000.3712] [Citation(s) in RCA: 89] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A gene expression system for antimicrobial peptides, which could be effectively used for various studies or applications of the antimicrobial peptides, has been developed. To avoid the harmful effects on an expression host, Escherichia coli, the antimicrobial peptides were expressed as fusion proteins with a polypeptide F4, which is a truncated PurF fragment that highly tends to form inclusion bodies. Seven different kinds of antimicrobial peptides have been successfully expressed by this expression system and the resulting expression level of fusion proteins reached up to 30% of total cell proteins. To confirm the identity of the recombinant peptide, MSI-344 was selected as a model peptide and purified to homogeneity, and we could obtain the recombinant MSI-344 of a high purity and with a good yield, which was identical to the authentic peptide in the aspects of the chemical and antimicrobial properties. These results show that the neutral fusion partner, which reinforces the formation of inclusion bodies, could mediate a high-level expression of the antimicrobial peptides.
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Affiliation(s)
- J H Lee
- Samyang Genex Biotech Research Institute, 63-2 Hwaam-dong, Yusung-gu, Taejon, 305-348, Korea
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48
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Abstract
PURPOSE To evaluate the safety and effectiveness of balloon dilation for the treatment of congenital lacrimal system obstruction. MATERIALS AND METHODS Fluoroscopically guided balloon dilation was attempted in 20 eyes of 16 patients with an age range of 12-78 months (mean, 33 mo) for congenital lacrimal system obstruction. Fifteen eyes had complete obstruction at the valve of Hasner, three eyes had completely obstruction at the junction between the lacrimal sac and the nasolacrimal duct, and two eyes had partial obstruction at the nasolacrimal duct. Under general anesthesia, a ball-tipped guide wire was introduced through the superior punctum into the inferior meatus of the nasal cavity and pulled out through the naris with use of a hook. A deflated 3-mm-diameter balloon catheter was then advanced in a retrograde direction and the balloon was dilated. Every patient underwent an ophthalmic evaluation before the procedure and was scheduled to be followed with office examination at 1, 3, and 6 months after the procedure. RESULTS There were no major complications. "Technical success" was defined as free passage of contrast medium through the entire lacrimal system to the nasal cavity. The procedure failed in one eye. After balloon dilation, all 19 eyes in which technical success was achieved showed improvement of epiphora. During the follow-up period of 2-33 months (mean, 16 mo), all eyes maintained improvement of epiphora and needed no further treatment. CONCLUSION Balloon dilation is a safe and effective therapeutic technique for the treatment of congenital lacrimal system obstruction.
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Affiliation(s)
- Y S Cho
- Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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49
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Chung YH, Song IH, Song BC, Lee GC, Koh MS, Yoon HK, Lee YS, Sung KB, Suh DJ. Combined therapy consisting of intraarterial cisplatin infusion and systemic interferon-alpha for hepatocellular carcinoma patients with major portal vein thrombosis or distant metastasis. Cancer 2000. [PMID: 10813709 DOI: 10.1002/(sici)1097-0142(20000501)88:9<1986::aid-cncr2>3.0.co;2-i] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) patients with major vascular involvement or extrahepatic metastasis are not good candidates for surgery or transarterial chemoembolization (TACE). In this study, the authors evaluated the efficacy of combined therapy with intraarterial cisplatin infusion and systemic administration of interferon-alpha (IFN-alpha) as a palliative treatment for these patients. METHODS Sixty-eight HCC patients with major portal vein thrombosis (n = 47) or distant metastasis (n = 27) were randomly allocated to 1 of 3 groups. Group I (n = 19) received combined therapy consisting of intraarterial cisplatin infusion and systemic IFN-alpha, Group II (n = 23) received intraarterial cisplatin infusion, and Group III (n = 26) was managed with only supportive care. Cisplatin 2 mg/kg was infused through the proper hepatic artery every 8 weeks, and IFN-alpha 3 million IU/m2 was administered subcutaneously 3 times a week. RESULTS The partial response (defined as a 50% or greater reduction in the product of the 2 longest perpendicular tumor measurements) rate of Group I was significantly higher than that of Group II (33% vs. 14%; P < 0.05). Also, the 1-year survival rate of Group I (27%) was higher than that of Group II (9%) or Group III (0%) (P < 0.05 and P < 0.01, respectively). The median survival period of Group I was 19 weeks, which was significantly longer than that of Group II (11 weeks) or Group III (5 weeks) (P < 0.05 and P < 0.01, respectively). CONCLUSIONS These results suggest that combined therapy consisting of intraarterial cisplatin infusion and systemic IFN-alpha may be useful as a palliative treatment for HCC patients with major vascular involvement or extrahepatic metastasis.
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Affiliation(s)
- Y H Chung
- Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
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Kim HS, Song HY, Kim TH, Kang SG, Kim JH, Yoon HK, Sung KB. Use of a lacrimal stent retrieval hook in the removal of occluded plastic and expandable metallic lacrimal stents. J Vasc Interv Radiol 2000; 11:762-6. [PMID: 10877423 DOI: 10.1016/s1051-0443(07)61637-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To evaluate the clinical usefulness of a stent retrieval hook in the removal of occluded lacrimal stents. MATERIALS AND METHODS The hook consisted of an inner hook part and an outer pusher part. Under administration of local anesthetic, the retrieval hook was introduced into the nasal cavity and aimed laterally toward the inferior meatus to grasp the distal end of the stent. After grasping the end of the stent, the sheath was pushed to fully grasp it. After that, the hook was pulled out of the external naris. The retrieval hook was used to remove 267 occluded lacrimal plastic or metallic stents. RESULTS Technical success rate was 97% in the removal of plastic stents and 96% in the removal of metallic stents. The causes of technical failure were entrenchment of granulation tissue into the stent in six plastic stents and one metallic stent, and inaccessibility of the hook to the distal tip of the stent in one plastic stent. These eight stents were removed by an otorhinolaryngologist or an ophthalmologist. Epistaxis occurred in six patients, which was controlled by a nasal pack. CONCLUSIONS The lacrimal stent retrieval hook seems useful for the removal of occluded stents.
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Affiliation(s)
- H S Kim
- Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-Gu, Seoul, Korea
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