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Kim JH, Choi YJ, Kwon HJ, Oh GM, Jung K, Kim SE, Moon W, Park MI, Park SJ. Colonoscopy Insertion in Patients with Gastrectomy: Does Position Impact Cecal Intubation Time? Dig Dis Sci 2022; 67:4533-4540. [PMID: 35122594 DOI: 10.1007/s10620-021-07325-3] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 11/03/2021] [Indexed: 12/09/2022]
Abstract
BACKGROUND A history of abdominal surgery is associated with difficulty in colonoscopy insertion. Few studies have reported effective colonoscopy insertion for patients who underwent abdominal surgery due to stomach cancer. AIM We aimed to compare the impact of supine position (SP) and left lateral position (LLP) as the starting position of colonoscopy insertion in patients who underwent abdominal surgery due to stomach cancer. METHODS This was a prospective, randomized controlled trial. Patients undergoing colonoscopy for screening or post-polypectomy surveillance after gastrectomy due to stomach cancer were enrolled and randomized to the SP or LLP group as the starting position of colonoscopy insertion. All colonoscopic examinations were performed with a transparent cap. The primary outcome was to compare the cecal intubation time between the two groups. RESULTS A total of 224 patients were enrolled. The mean cecal intubation time was not significantly different between the SP and LLP groups (364.5 s versus 306.9 s; p = 0.105). In patients with a lower body mass index (< 21 kg/m2) or who underwent gastrectomy within three years, the mean cecal intubation time of the LLP group was shorter than the SP group. In the multivariate analysis for the factors affecting to increase in the cecal intubation time (> 5 min), the starting position was not an independent factor. CONCLUSION Either the SP or LLP could serve as a possible starting position of colonoscopy insertion for patients who underwent abdominal surgery due to stomach cancer.
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Affiliation(s)
- Jae Hyun Kim
- Department of Internal Medicine, Kosin University College of Medicine, Gamcheonro 262, Seo-gu, Busan, 49267, Korea
| | - Youn Jung Choi
- Department of Internal Medicine, Kosin University College of Medicine, Gamcheonro 262, Seo-gu, Busan, 49267, Korea
| | - Hye Jung Kwon
- Department of Internal Medicine, Kosin University College of Medicine, Gamcheonro 262, Seo-gu, Busan, 49267, Korea
| | - Gyu Man Oh
- Department of Internal Medicine, Kosin University College of Medicine, Gamcheonro 262, Seo-gu, Busan, 49267, Korea
| | - Kyoungwon Jung
- Department of Internal Medicine, Kosin University College of Medicine, Gamcheonro 262, Seo-gu, Busan, 49267, Korea
| | - Sung Eun Kim
- Department of Internal Medicine, Kosin University College of Medicine, Gamcheonro 262, Seo-gu, Busan, 49267, Korea
| | - Won Moon
- Department of Internal Medicine, Kosin University College of Medicine, Gamcheonro 262, Seo-gu, Busan, 49267, Korea
| | - Moo In Park
- Department of Internal Medicine, Kosin University College of Medicine, Gamcheonro 262, Seo-gu, Busan, 49267, Korea
| | - Seun Ja Park
- Department of Internal Medicine, Kosin University College of Medicine, Gamcheonro 262, Seo-gu, Busan, 49267, Korea.
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Mitchell D, Kwon HJ, Kubica PA, Huff WX, O’Regan R, Dey M. Brain metastases: An update on the multi-disciplinary approach of clinical management. Neurochirurgie 2022; 68:69-85. [PMID: 33864773 PMCID: PMC8514593 DOI: 10.1016/j.neuchi.2021.04.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 02/04/2021] [Revised: 03/16/2021] [Accepted: 04/03/2021] [Indexed: 01/03/2023]
Abstract
IMPORTANCE Brain metastasis (BM) is the most common malignant intracranial neoplasm in adults with over 100,000 new cases annually in the United States and outnumbering primary brain tumors 10:1. OBSERVATIONS The incidence of BM in adult cancer patients ranges from 10-40%, and is increasing with improved surveillance, effective systemic therapy, and an aging population. The overall prognosis of cancer patients is largely dependent on the presence or absence of brain metastasis, and therefore, a timely and accurate diagnosis is crucial for improving long-term outcomes, especially in the current era of significantly improved systemic therapy for many common cancers. BM should be suspected in any cancer patient who develops new neurological deficits or behavioral abnormalities. Gadolinium enhanced MRI is the preferred imaging technique and BM must be distinguished from other pathologies. Large, symptomatic lesion(s) in patients with good functional status are best treated with surgery and stereotactic radiosurgery (SRS). Due to neurocognitive side effects and improved overall survival of cancer patients, whole brain radiotherapy (WBRT) is reserved as salvage therapy for patients with multiple lesions or as palliation. Newer approaches including multi-lesion stereotactic surgery, targeted therapy, and immunotherapy are also being investigated to improve outcomes while preserving quality of life. CONCLUSION With the significant advancements in the systemic treatment for cancer patients, addressing BM effectively is critical for overall survival. In addition to patient's performance status, therapeutic approach should be based on the type of primary tumor and associated molecular profile as well as the size, number, and location of metastatic lesion(s).
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Affiliation(s)
- D Mitchell
- Department of Neurosurgery, Indiana University School of Medicine, Indiana University Purdue University Indianapolis, IN, USA
| | - HJ Kwon
- Department of Neurosurgery, Indiana University School of Medicine, Indiana University Purdue University Indianapolis, IN, USA
| | - PA Kubica
- Department of Neurosurgery, University of Wisconsin School of Medicine & Public Health, UW Carbone Cancer Center, Madison, WI, USA
| | - WX Huff
- Department of Neurosurgery, Indiana University School of Medicine, Indiana University Purdue University Indianapolis, IN, USA
| | - R O’Regan
- Department of Medicine/Hematology Oncology, University of Wisconsin School of Medicine & Public Health, UW Carbone Cancer Center, Madison, WI, USA
| | - M Dey
- Department of Neurosurgery, University of Wisconsin School of Medicine & Public Health, UW Carbone Cancer Center, Madison, WI, USA,Correspondence Should Be Addressed To: Mahua Dey, MD, University of Wisconsin School of Medicine & Public Health, 600 Highland Ave, Madison, WI 53792; Tel: 317-274-2601;
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3
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Kim JH, Choi YJ, Kwon HJ, Jung K, Kim SE, Moon W, Park MI, Park SJ. Effect of gut microbiome on minor complications after a colonoscopy. Intest Res 2020; 19:341-348. [PMID: 33166441 PMCID: PMC8322026 DOI: 10.5217/ir.2020.00057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 06/30/2020] [Indexed: 12/11/2022] Open
Abstract
Background/Aims Minor complications that might occur after colonoscopy, including abdominal discomfort, bloating, diarrhea, and constipation, could a barrier for patients to undergo a screening colonoscopy. In this study, we aimed to identify the effect of gut microbial diversity and composition on minor complications after colonoscopy. Methods A total of 24 healthy subjects provided their stools before bowel preparation and on the 7th and 28th day after colonoscopy. On the 7th day after colonoscopy, the presence of minor complications was investigated using a questionnaire. We divided patients into 2 groups, the no complication group and complications group. The fecal microbial diversity, distribution, and composition were then compared between the groups. Results Five of the 24 subjects reported that they had undergone minor complications after colonoscopy. Most of the symptoms were mild and self-limited, but 1 patient needed medication. Interestingly, the Firmicutes/Bacteroidetes ratio of the initial stool samples before bowel preparation in the complication group was significantly higher than that in no complication group. After bowel preparation, the Firmicutes/Bacteroidetes ratio of the complication group decreased, but not in the no complication group. The microbial diversity of the no complication group decreased after bowel preparation, but not in the complication group. Conclusions The gut microbial composition and diversity before and after bowel preparation could be considered as one of the causes of minor complications after colonoscopy. Further studies are needed to delineate the role of gut microbiota in the occurrence of minor complications after colonoscopy.
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Affiliation(s)
- Jae Hyun Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Youn Jung Choi
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Hye Jung Kwon
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Kyoungwon Jung
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Sung Eun Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Won Moon
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Moo In Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Seun Ja Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
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4
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Kwon W, Kim H, Han Y, Hwang YJ, Kim SG, Kwon HJ, Vinuela E, Járufe N, Roa JC, Han IW, Heo JS, Choi SH, Choi DW, Ahn KS, Kang KJ, Lee W, Jeong CY, Hong SC, Troncoso AT, Losada HM, Han SS, Park SJ, Kim SW, Yanagimoto H, Endo I, Kubota K, Wakai T, Ajiki T, Adsay NV, Jang JY. Role of tumour location and surgical extent on prognosis in T2 gallbladder cancer: an international multicentre study. Br J Surg 2020; 107:1334-1343. [PMID: 32452559 DOI: 10.1002/bjs.11618] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 02/29/2020] [Accepted: 03/16/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND In gallbladder cancer, stage T2 is subdivided by tumour location into lesions on the peritoneal side (T2a) or hepatic side (T2b). For tumours on the peritoneal side (T2a), it has been suggested that liver resection may be omitted without compromising the prognosis. However, data to validate this argument are lacking. This study aimed to investigate the prognostic value of tumour location in T2 gallbladder cancer, and to clarify the adequate extent of surgical resection. METHODS Clinical data from patients who underwent surgery for gallbladder cancer were collected from 14 hospitals in Korea, Japan, Chile and the USA. Survival and risk factor analyses were conducted. RESULTS Data from 937 patients were available for evaluation. The overall 5-year disease-free survival rate was 70·6 per cent, 74·5 per cent for those with T2a and 65·5 per cent among those with T2b tumours (P = 0·028). Regarding liver resection, extended cholecystectomy was associated with a better 5-year disease-free survival rate than simple cholecystectomy (73·0 versus 61·5 per cent; P = 0·012). The 5-year disease-free survival rate was marginally better for extended than simple cholecystectomy in both T2a (76·5 versus 66·1 per cent; P = 0·094) and T2b (68·2 versus 56·2 per cent; P = 0·084) disease. Five-year disease-free survival rates were similar for extended cholecystectomies including liver wedge resection versus segment IVb/V segmentectomy (74·1 versus 71·5 per cent; P = 0·720). In multivariable analysis, independent risk factors for recurrence were presence of symptoms (hazard ratio (HR) 1·52; P = 0·002), R1 resection (HR 1·96; P = 0·004) and N1/N2 status (N1: HR 3·40, P < 0·001; N2: HR 9·56, P < 0·001). Among recurrences, 70·8 per cent were metastatic. CONCLUSION Tumour location was not an independent prognostic factor in T2 gallbladder cancer. Extended cholecystectomy was marginally superior to simple cholecystectomy. A radical operation should include liver resection and adequate node dissection.
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Affiliation(s)
- W Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - H Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Y Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Y J Hwang
- School of Medicine, Kyungpook National University, Daegu, South Korea.,Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - S G Kim
- School of Medicine, Kyungpook National University, Daegu, South Korea.,Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - H J Kwon
- School of Medicine, Kyungpook National University, Daegu, South Korea.,Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - E Vinuela
- Department of Digestive Surgery, Santiago, Chile
| | - N Járufe
- Department of Digestive Surgery, Santiago, Chile
| | - J C Roa
- Pathology, Faculty of Medicine, Catholic University of Chile, Santiago, Chile
| | - I W Han
- Department of Surgery, Samsung Medical Centre, Sungkyunkwan University College of Medicine, Seoul, South Korea
| | - J S Heo
- Department of Surgery, Samsung Medical Centre, Sungkyunkwan University College of Medicine, Seoul, South Korea
| | - S-H Choi
- Department of Surgery, Samsung Medical Centre, Sungkyunkwan University College of Medicine, Seoul, South Korea
| | - D W Choi
- Department of Surgery, Samsung Medical Centre, Sungkyunkwan University College of Medicine, Seoul, South Korea
| | - K S Ahn
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Keimyung University Dongsan Medical Centre, Daegu, South Korea
| | - K J Kang
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Keimyung University Dongsan Medical Centre, Daegu, South Korea
| | - W Lee
- Department of Surgery, Gyeongsang National University College of Medicine, Jinju, South Korea
| | - C-Y Jeong
- Department of Surgery, Gyeongsang National University College of Medicine, Jinju, South Korea
| | - S-C Hong
- Department of Surgery, Gyeongsang National University College of Medicine, Jinju, South Korea
| | - A T Troncoso
- Department of Surgery, Universidad de la Frontera, Temuco, Chile
| | - H M Losada
- Department of Surgery, Universidad de la Frontera, Temuco, Chile
| | - S-S Han
- Department of Surgery, Centre for Liver Cancer, National Cancer Centre, Goyang, South Korea
| | - S-J Park
- Department of Surgery, Centre for Liver Cancer, National Cancer Centre, Goyang, South Korea
| | - S-W Kim
- Department of Surgery, Centre for Liver Cancer, National Cancer Centre, Goyang, South Korea
| | - H Yanagimoto
- Department of Surgery, Kansai Medical University, Hirakata, Japan
| | - I Endo
- Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - K Kubota
- Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan
| | - T Wakai
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - T Ajiki
- Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - N V Adsay
- Department of Pathology, Koc University, Istanbul, Turkey.,Department of Pathology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - J-Y Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
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5
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Kim H, Kim JH, Choi YJ, Kwon HJ, Chang HK, Kim SE, Moon W, Park MI, Park SJ. Risk of Delayed Bleeding after a Colorectal Endoscopic Mucosal Resection without Prophylactic Clipping: Single Center, Observational Study. Korean J Gastroenterol 2020; 74:326-332. [PMID: 31870138 DOI: 10.4166/kjg.2019.74.6.326] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 07/29/2019] [Accepted: 09/02/2019] [Indexed: 12/17/2022]
Abstract
Background/Aims Bleeding is one of the major complications of a colorectal polypectomy. The aim of this study was to identify the risk of delayed bleeding, particularly after a colorectal endoscopic mucosal resection (EMR) without prophylactic clipping. Methods Between April 2014 and August 2014, patients who underwent colorectal EMR (≥6 mm and <2 cm) without prophylactic clipping were included. This study evaluated the incidence of delayed bleeding and the associated factors after colorectal EMR without prophylactic clipping. Results A total of 717 colorectal polyps (≥6 mm and <2 cm) of 243 patients resected by colorectal EMR in the study period were evaluated. The mean age of the patients was 63 years; 165 patients were men and 78 patients were women. The mean polyp size removed by colorectal EMR was 9.0 mm (range 6.0-19.0), and the number of polyps larger than 1 cm was 212 (29.6%). Delayed bleeding after colorectal EMR occurred in 12 polyps (1.7%) in eight patients (3.3%), and there were no significant risk factors affecting delayed bleeding. Conclusions This study identified that the incidence of delayed bleeding on colorectal polyps (≥6 mm and <2 cm) after EMR without prophylactic clipping was 3.3%, but no significant risk factors affecting delayed bleeding were found.
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Affiliation(s)
- Hyeonjin Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Jae Hyun Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Youn Jung Choi
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Hye Jung Kwon
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Hee Kyung Chang
- Department of Pathology, Kosin University College of Medicine, Busan, Korea
| | - Sung Eun Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Won Moon
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Moo In Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Seun Ja Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
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6
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Kim SE, Park MI, Park SJ, Moon W, Kim JH, Jung K, Kwon HJ, Kim GM, Joo HK. Mosapride Improves Lower Esophageal Sphincter and Esophageal Body Function in Patients With Minor Disorders of Esophageal Peristalsis. J Neurogastroenterol Motil 2020; 26:232-240. [PMID: 32235030 PMCID: PMC7176494 DOI: 10.5056/jnm19062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 07/02/2019] [Accepted: 09/20/2019] [Indexed: 11/20/2022] Open
Abstract
Background/Aims High-resolution manometry (HRM) has broadened the awareness of minor esophageal peristaltic disorders. However, the treatments for these minor disorders are limited and the role of prokinetics has been controversial. This study evaluates the effect of mosapride in patients with minor peristaltic disorders. Methods This study prospectively enrolled 21 patients with esophageal symptoms who were diagnosed with minor peristaltic disorders by gastroscopy and HRM using the Chicago classification version 3.0. Patients received mosapride 30 mg daily for 2 weeks. Symptoms were assessed using the abbreviated World Health Organization quality of life scale (WHOQOL-BREF) and a HRM study was performed before and after 2 weeks of treatment. Results HRM metrics of lower esophageal sphincter (LES) respiratory mean pressure (median 14.6 mmHg vs 17.3 mmHg; interquartile range [IQR] 8.7-22.5 mmHg vs 12.5-25.9 mmHg; P = 0.004) and distal contractile integral (median 343.8 mmHg·sec·cm vs 698.1 mmHg·sec·cm; IQR 286.5-795.9 mmHg·sec·cm vs 361.0-1127.6 mmHg·sec·cm; P = 0.048) were significantly increased after treatment. Complete response (≥ 80.0%), satisfactory response (≥ 50.0%), partial response (< 50.0%), and refractory response rates were 19.0%, 52.4%, 14.3%, and 14.3%, respectively. However, there was no statistical difference in all WHOQOL-BREF scores before and after treatment. Univariate analysis showed LES respiratory mean pressure (P = 0.036) was associated with symptom improvement (complete + satisfactory group). However, no statistical difference was found in other factors after multivariate analysis. Conclusions Mosapride improved esophageal symptoms and significantly increased LES respiratory mean pressure and distal contractile integral. Therefore, mosapride could enhance LES and esophageal body contraction pressures in patients with minor peristaltic disorders.
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Affiliation(s)
- Sung Eun Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.,Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
| | - Moo In Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.,Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
| | - Seun Ja Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.,Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
| | - Won Moon
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.,Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
| | - Jae Hyun Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.,Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
| | - Kyoungwon Jung
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.,Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
| | - Hye Jung Kwon
- Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
| | - Gyung Mi Kim
- Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
| | - Hee Kyoung Joo
- Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
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Kim JH, Byun S, Choi YJ, Kwon HJ, Jung K, Kim SE, Park MI, Moon W, Park SJ. Efficacy and Safety of Etomidate in Comparison with Propofol or Midazolam as Sedative for Upper Gastrointestinal Endoscopy. Clin Endosc 2020; 53:555-561. [PMID: 32229801 PMCID: PMC7548146 DOI: 10.5946/ce.2019.210] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/04/2020] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND/AIMS In this study, we compared the efficacy and safety of etomidate with those of propofol or midazolam for the maintenance of sedation during endoscopy. METHODS The study enrolled patients who underwent sedative endoscopy in our hospital and divided them into three groups. Patients in each group were administered midazolam as induction therapy and were subsequently administered either midazolam (M + M group), propofol (M + P group), or etomidate (M + E group) as maintenance medication. The primary outcome was overall cardiovascular and respiratory adverse events. RESULTS In total, 105 patients who underwent sedative endoscopic examination were enrolled. The outcomes related to the procedure and sedation were not significantly different among the groups. Overall cardiovascular and respiratory adverse events were observed in 9 patients (25.7%) in the M + M group, 8 patients (23.5%) in the M + P group, and 10 patients (27.8%) in the M + E group. The logistic regression analysis revealed that etomidate use was not an independent risk factor for overall cardiovascular and respiratory adverse events. CONCLUSION The outcomes following the use of etomidate for maintenance after induction with midazolam for sedation in upper gastrointestinal endoscopy were not inferior to those following midazolam or propofol use from the perspectives of safety and efficacy.
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Affiliation(s)
- Jae Hyun Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Sanghwan Byun
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Youn Jung Choi
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Hye Jung Kwon
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Kyoungwon Jung
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Sung Eun Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Moo In Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Won Moon
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Seun Ja Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
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8
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Kwon HJ, Park MI, Park SJ, Moon W, Kim SE, Kim JH, Choi YJ, Lee SK. Insulin Resistance Is Associated with Early Gastric Cancer: A Prospective Multicenter Case Control Study. Gut Liver 2019; 13:154-160. [PMID: 30400721 PMCID: PMC6430436 DOI: 10.5009/gnl17556] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 08/08/2018] [Accepted: 08/08/2018] [Indexed: 12/15/2022] Open
Abstract
Background/Aims Recently, increased body weight has been found to be associated with an increasing risk of several cancers, including gastric cancer. The true pathogenic role of hyperglycemia in the development of gastric cancer remains unclear as hyperglycemia and its associated conditions may work as carcinogenic factors. The goal of this study was to clarify the factors associated with early gastric cancer and evaluate a homeostasis model assessment of the insulin resistance (HOMA-IR) index, fasting glucose, and lipid profile as predictors of early gastric cancer. Methods A total of 63 patients with early gastric cancer between November 2012 and March 2013 were included. Preoperative serum lipid profile levels and serum fasting glucose were examined prospectively in patients with early gastric cancer. The same number of controls were evaluated and matched to the early gastric cancer group for age and gender. We performed multivariate logistic regression analysis to identify independent risk factors for early gastric cancer. Results Univariate analysis showed that risk for early gastric cancer was associated with diastolic blood pressure (BP), total cholesterol, fasting glucose, and HOMA-IR. In the multivariate-adjusted model, higher total cholesterol, fasting glucose, body mass index, and diastolic BP were strongly associated with an increased risk of early gastric cancer. Conclusions Hyperglycemia, a lower high-density lipoprotein cholesterol level, and a low HOMA-IR level appear to be associated with early gastric cancer risk.
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Affiliation(s)
- Hye Jung Kwon
- Division of Gastroenterology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Moo In Park
- Division of Gastroenterology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Seun Ja Park
- Division of Gastroenterology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Won Moon
- Division of Gastroenterology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Sung Eun Kim
- Division of Gastroenterology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Jae Hyun Kim
- Division of Gastroenterology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Youn Jung Choi
- Division of Gastroenterology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Sang Kil Lee
- Division of Gastroenterology, Department of Internal Medicine, Institute of Gastroenterology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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9
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Yeo GE, Kwon HJ, Kim JH, Chang HK, Park JG. A Incidentally Diagnosed Duodenal Subepithelial Mass: Gangliocytic Paraganglioma Treated by Endoscopic Mucosal Resection. Korean J Helicobacter Up Gastrointest Res 2019. [DOI: 10.7704/kjhugr.2019.19.2.132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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10
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Kwon HJ, Jeon J, Kim DH, Jang HR, Sung HH, Han DH, Park JB, Lee JE, Huh W, Kim SJ, Kim YG, Kim DJ, Oh HY. Clinical Impact of a Protocolized Kidney Donor Follow-up System. Transplant Proc 2019; 51:692-700. [PMID: 30979452 DOI: 10.1016/j.transproceed.2018.10.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 10/23/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Adequate kidney donor management after donation is increasingly emphasized due to concerns of renal function impairment after nephrectomy with increasing life expectancy. In this study, the clinical impact of a protocolized kidney donor follow-up system by nephrologists was evaluated. METHODS A total of 427 living kidney donors underwent nephrectomy from January 2010 to December 2014 and were followed for at least 2 years at the Samsung Medical Center. Donors were followed-up by nephrologists after the establishment of a donor clinic with systemized protocols in January 2013. The primary outcomes were incidence of post-donation low estimated glomerular filtration rate (eGFR) and renal function adaptability. Secondary outcomes were changes in compliance and incidence of hyperuricemia and microalbuminuria. RESULTS The patients were divided into 2 groups according to the time of nephrectomy: the pre-donor clinic period (n = 182) and the donor clinic period (n = 172). Preoperative eGFR in patients in the pre-donor clinic period was higher than that in patients in the donor clinic period. After donation, poor renal adaptation was less frequent in the donor clinic period compared to the pre-donor clinic period. Low eGFR tended to be less common during the donor clinic period. Shorter mean outpatient clinic visit intervals with more visits within 6 months after donation and earlier detection of de novo hyperuricemia were found during the donor clinic period. CONCLUSION A protocolized donor clinic run by nephrologists may improve post-nephrectomy renal outcomes and compliance and facilitate better management of potential risk factors of chronic kidney disease in donors.
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Affiliation(s)
- H J Kwon
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - J Jeon
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - D H Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - H R Jang
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - H H Sung
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - D H Han
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - J B Park
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - J E Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - W Huh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - S J Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Y G Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - D J Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - H Y Oh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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11
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Kwon HJ, Lim JH, Kang D, Lim S, Park SJ, Kim JH. Is stool frequency associated with the richness and community composition of gut microbiota? Intest Res 2019; 17:419-426. [PMID: 30704159 PMCID: PMC6667361 DOI: 10.5217/ir.2018.00149] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 12/24/2018] [Indexed: 12/11/2022] Open
Abstract
Background/Aims Recently, a number of studies have reported that the gut microbiota could contribute to human conditions, including obesity, inflammation, cancer development, and behavior. We hypothesized that the composition and distribution of gut microbiota are different according to stool frequency, and attempted to identify the association between gut microbiota and stool frequency. Methods We collected fecal samples from healthy individuals divided into 3 groups according to stool frequency: group 1, a small number of defecation (≤2 times/wk); group 2, normal defecation (1 time/day or 1 time/2 day); and group 3, a large number of defecation (≥2–3 times/day). We evaluated the composition and distribution of the gut microbiota in each group via 16S rRNA-based taxonomic profiling of the fecal samples. Results Fecal samples were collected from a total of 60 individuals (31 men and 29 women, aged 34.1±5.88 years), and each group comprised 20 individuals. The microbial richness of group 1 was significantly higher than that of group 3 and tended to decrease with increasing number of defecation (P<0.05). The biological community composition was fairly different according to the number of defecation, and Bacteroidetes to Firmicutes ratio was higher in group 1 than in the other groups. Moreover, we found specific strains at the family and genus levels in groups 1 and 3. Conclusions Bacteroidetes to Firmicutes ratio and the abundance of Bifidobacterium were different according to the stool frequency, and specific bacteria were identified in the subjects with large and small numbers of defecation, respectively. These findings suggest that stool frequency might be associated with the richness and community composition of the gut microbiota.
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Affiliation(s)
- Hye Jung Kwon
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | | | | | | | - Seun Ja Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Jae Hyun Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
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12
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Peng C, de Sousa FB, Gan HY, Kwon HJ, Park S, Kilpatrick-Liverman L, Wang W, Lavender S, Pilch S, Han J. Enhanced Delivery of F -, Ca 2+, K +, and Na + Ions into Enamel by Electrokinetic Flows. J Dent Res 2019; 98:430-436. [PMID: 30676839 DOI: 10.1177/0022034518818463] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
As the outermost layer of the tooth crown, dental enamel is the most mineralized tissue in mammals, consisting of hydroxyapatite crystallites separated by long and narrow nanochannels. A major challenge in dentistry is how various molecules can be infiltrated into these nanopores in an efficient and controlled way. Here we show a robust method to transport various ions of interest, such as fluoride (F-), potassium (K+), calcium (Ca++), and sodium (Na+), into these nanopores by electrokinetic flows. It is verified by fluorescence microscopy, laser-scanning confocal microscopy, mass spectrometry, and ion selective electrode technique. Different ions are demonstrated to infiltrate through the entire depth of the enamel layer (~1 mm), which is significantly enhanced penetration compared with diffusion-based infiltration. Meanwhile, transport depth and speed can be controlled by infiltration time and applied voltage. This is the first demonstration of reliably delivering both anions and cations into the enamel nanopores. This technique opens opportunities in caries prevention, remineralization, tooth whitening, and nanomedicine delivery in clinical dentistry, as well as other delivery challenges into various biomaterials such as bones.
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Affiliation(s)
- C Peng
- 1 Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - F B de Sousa
- 2 Department of Morphology, Health Sciences Center, Fereral University of Paraiba, Joao Pessoa, Cidade Universitaria, Paraiba, Brazil
| | - H Y Gan
- 3 Engineering Cluster, Singapore Institute of Technology, Singapore
| | - H J Kwon
- 1 Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - S Park
- 4 Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA, USA
| | | | - W Wang
- 5 Colgate-Palmolive Technology Center, Piscataway, NJ, USA
| | - S Lavender
- 5 Colgate-Palmolive Technology Center, Piscataway, NJ, USA
| | - S Pilch
- 5 Colgate-Palmolive Technology Center, Piscataway, NJ, USA
| | - J Han
- 1 Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, USA.,6 Department of Electric Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA.,7 Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
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13
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Jeon SC, Kim JH, Kim SJ, Kwon HJ, Choi YJ, Jung K, Kim SE, Moon W, Park MI, Park SJ. Effect of Sending Educational Video Clips via Smartphone Mobile Messenger on Bowel Preparation before Colonoscopy. Clin Endosc 2018; 52:53-58. [PMID: 30153724 PMCID: PMC6370934 DOI: 10.5946/ce.2018.072] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 06/02/2018] [Indexed: 02/07/2023] Open
Abstract
Background/Aim We aimed to evaluate the efficacy of sending educational video clips via smartphone mobile messenger (SMM) on enhancing bowel preparation before colonoscopy.
Methods This was a prospective, endoscopist-blinded, randomized controlled study. Patients in the SMM group received two video clips sent via SMM that explained the diet and regimen for bowel preparation, whereas those in the control group did not receive any video clips. We compared the quality of bowel preparation between the two groups, which was assessed by an endoscopist using the Ottawa scale.
Results Between August and November 2014, 140 patients in the SMM group and 141 patients in the control group underwent colonoscopic examination. The total Ottawa score of the SMM group was significantly lower than that of the control group (5.47±1.74 vs. 5.97±1.78, p=0.018). These results were particularly prominent in the younger age group; the total Ottawa score of patents in the SMM group aged <40 years was significantly lower than that of patients in the control group aged <40 years (5.10±1.55 vs. 6.22±2.33, p=0.034).
Conclusions We demonstrated that sending educational video clips via SMM could result in better bowel preparation, especially in the younger age group.
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Affiliation(s)
- Sung Chan Jeon
- Department of Gastroenterology, Kosin University College of Medicine, Busan, Korea
| | - Jae Hyun Kim
- Department of Gastroenterology, Kosin University College of Medicine, Busan, Korea
| | - Sun Jung Kim
- Department of Gastroenterology, Kosin University College of Medicine, Busan, Korea
| | - Hye Jung Kwon
- Department of Gastroenterology, Kosin University College of Medicine, Busan, Korea
| | - Youn Jung Choi
- Department of Gastroenterology, Kosin University College of Medicine, Busan, Korea
| | - Kyoungwon Jung
- Department of Gastroenterology, Kosin University College of Medicine, Busan, Korea
| | - Sung Eun Kim
- Department of Gastroenterology, Kosin University College of Medicine, Busan, Korea
| | - Won Moon
- Department of Gastroenterology, Kosin University College of Medicine, Busan, Korea
| | - Moo In Park
- Department of Gastroenterology, Kosin University College of Medicine, Busan, Korea
| | - Seun Ja Park
- Department of Gastroenterology, Kosin University College of Medicine, Busan, Korea
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14
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Ku KH, Park SJ, Kim JH, Kwon HJ, Chang HK, Park JG. [Gastric Cancer Recurrence in 12 Years after Surgical Resection]. Korean J Gastroenterol 2017; 70:296-300. [PMID: 29277092 DOI: 10.4166/kjg.2017.70.6.296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Recurrence of gastric cancer after 10 years of surgical resection is highly rare. There are limited data on the surveillance of patients with gastric cancer after 10 years from gastrectomy. A 50-year-old man presented to the gastroenterology clinic at our hospital for the management of abnormal findings on a routine colonoscopic exam. He had undergone gastrectomy for advanced gastric cancer 12 years ago. At presentation, colonoscopic examination revealed asymmetrically edematous and hyperemic mucosal change with luminal narrowing on transverse colon. Abdominal computed tomography showed no evidence of distant metastasis, except for focal bowel wall thickening on transverse colon. He underwent a laparoscopic right-hemicolectomy, and the resected specimen revealed a recurrent and metastatic lesion. We report a case of recurrence of gastric cancer after 10 years from surgical resection with relevant literature review.
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Affiliation(s)
- Ki Hwan Ku
- Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
| | - Seun Ja Park
- Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
| | - Jae Hyun Kim
- Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
| | - Hye Jung Kwon
- Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
| | - Hee Kyung Chang
- Department of Pathology, Kosin University Gospel Hospital, Busan, Korea
| | - Jung Gu Park
- Department of Radiology, Kosin University Gospel Hospital, Busan, Korea
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15
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Kwon HJ, Kim DH, Jang HR, Jung SH, Han DH, Sung HH, Park JB, Lee JE, Huh W, Kim SJ, Kim YG, Kim DJ, Oh HY. Predictive Factors of Renal Adaptation After Nephrectomy in Kidney Donors. Transplant Proc 2017; 49:1999-2006. [PMID: 29149951 DOI: 10.1016/j.transproceed.2017.09.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 08/01/2017] [Accepted: 09/02/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Despite compensatory hyperfiltration in remaining nephrons following donor nephrectomy, some donors show impaired renal adaptation and low estimated glomerular filtration rate (eGFR). We investigated the factors predicting early renal adaptation after nephrectomy and identified kidney donors at risk of inadequate renal adaptation. METHODS A total of 265 living kidney donors from 2010 to 2013 were retrospectively analyzed. Renal function was serially followed for 6 months after the operation. Regression analyses were performed to identify the independent predictors of low eGFR (eGFR <60 mL/min/1.73 m2) and impaired renal adaptation (%Modification of Diet in Renal Disease [MDRD] <66% of baseline eGFR). RESULTS A total of 148 donors belonged to the low eGFR group, and changes in eGFR (ΔeGFR) at postoperative (PO) 1 day and 1 month were identified as independent predictors of low eGFR. Impaired renal adaptation was related to age, ΔeGFR PO 2-3 days, and ΔeGFR PO 1 month. Early renal adaptation was associated with age, male gender, and residual kidney computerized tomography angiography (CTA) volume. The best sensitivity and specificity were obtained with a cutoff value of ΔeGFR 31 at PO 1 day and 1 month for predicting low eGFR and with a value of ΔeGFR 27 at PO 2-3 days and 1 month for predicting impaired renal adaptation. CONCLUSIONS Our study showed that the degree of early renal adaptation determines subsequent renal function in kidney donors. Closer monitoring and management may be required in old or male donors with small residual CTA kidney volume as well as donors with persistent ΔeGFR >27 within 1 month of nephrectomy.
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Affiliation(s)
- H J Kwon
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - D H Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H R Jang
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - S-H Jung
- Biostatics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - D H Han
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H H Sung
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J B Park
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J E Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - W Huh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S J Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Y-G Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - D J Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H Y Oh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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16
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Yoo CH, Kim JH, Kwon HJ, Moon W, Park SJ, Park MI, Kim SE, Park JG, Chang HK. Phlebosclerotic colitis mimicking colon cancer. Turk J Gastroenterol 2017; 28:537-539. [PMID: 28928104 DOI: 10.5152/tjg.2017.17055] [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] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Chang Hun Yoo
- Department of Internal Medicine, Kosin University School of Medicine, Busan, Korea.
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17
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Kim JH, Nam KS, Kwon HJ, Choi YJ, Jung K, Kim SE, Moon W, Park MI, Park SJ. Assessment of colon polyp morphology: Is education effective? World J Gastroenterol 2017; 23:6281-6286. [PMID: 28974894 PMCID: PMC5603494 DOI: 10.3748/wjg.v23.i34.6281] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 06/09/2017] [Accepted: 07/12/2017] [Indexed: 02/07/2023] Open
Abstract
AIM To determine the inter-observer variability for colon polyp morphology and to identify whether education can improve agreement among observers.
METHODS For purposes of the tests, we recorded colonoscopy video clips that included scenes visualizing the polyps. A total of 15 endoscopists and 15 nurses participated in the study. Participants watched 60 video clips of the polyp morphology scenes and then estimated polyp morphology (pre-test). After education for 20 min, participants performed a second test in which the order of 60 video clips was changed (post-test). To determine if the effectiveness of education was sustained, four months later, a third, follow-up test was performed with the same participants.
RESULTS The overall Fleiss’ kappa value of the inter-observer agreement was 0.510 in the pre-test, 0.618 in the post-test, and 0.580 in the follow-up test. The overall diagnostic accuracy of the estimation for polyp morphology in the pre-, post-, and follow-up tests was 0.662, 0.797, and 0.761, respectively. After education, the inter-observer agreement and diagnostic accuracy of all participants improved. However, after four months, the inter-observer agreement and diagnostic accuracy of expert groups were markedly decreased, and those of beginner and nurse groups remained similar to pre-test levels.
CONCLUSION The education program used in this study can improve inter-observer agreement and diagnostic accuracy in assessing the morphology of colon polyps; it is especially effective when first learning endoscopy.
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Affiliation(s)
- Jae Hyun Kim
- Division of Gastroenterology, Department of Internal Medicine, Kosin University College of Medicine, Busan 602-702, South Korea
| | - Kyoung Sik Nam
- Division of Gastroenterology, Department of Internal Medicine, Kosin University College of Medicine, Busan 602-702, South Korea
| | - Hye Jung Kwon
- Division of Gastroenterology, Department of Internal Medicine, Kosin University College of Medicine, Busan 602-702, South Korea
| | - Youn Jung Choi
- Division of Gastroenterology, Department of Internal Medicine, Kosin University College of Medicine, Busan 602-702, South Korea
| | - Kyoungwon Jung
- Division of Gastroenterology, Department of Internal Medicine, Kosin University College of Medicine, Busan 602-702, South Korea
| | - Sung Eun Kim
- Division of Gastroenterology, Department of Internal Medicine, Kosin University College of Medicine, Busan 602-702, South Korea
| | - Won Moon
- Division of Gastroenterology, Department of Internal Medicine, Kosin University College of Medicine, Busan 602-702, South Korea
| | - Moo In Park
- Division of Gastroenterology, Department of Internal Medicine, Kosin University College of Medicine, Busan 602-702, South Korea
| | - Seun Ja Park
- Division of Gastroenterology, Department of Internal Medicine, Kosin University College of Medicine, Busan 602-702, South Korea
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18
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Kwon HJ, Brasch HD, Benison S, Marsh RW, Itinteang T, Titchener GW, Evans J, Tan ST. Erratum to "Changing prevalence and treatment outcomes of patients with p16 human papillomavirus related oropharyngeal squamous cell carcinoma in New Zealand" [Br J Oral Maxillofac Surg 54 (8) (2016) 898-903]. Br J Oral Maxillofac Surg 2017; 55:754. [PMID: 28687136 DOI: 10.1016/j.bjoms.2017.01.013] [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: 11/30/2022]
Affiliation(s)
- H J Kwon
- Department of Otolaryngology - Head and Neck Surgery, Wellington Regional Hospital, Wellington, New Zealand
| | - H D Brasch
- Gillies McIndoe Research Institute, Wellington, New Zealand; Department of Pathology, Hutt Hospital, Wellington, New Zealand
| | - S Benison
- Department of Pathology, Hutt Hospital, Wellington, New Zealand
| | - R W Marsh
- Gillies McIndoe Research Institute, Wellington, New Zealand; Auckland University, Auckland, New Zealand
| | - T Itinteang
- Gillies McIndoe Research Institute, Wellington, New Zealand
| | - G W Titchener
- Department of Otolaryngology - Head and Neck Surgery, Wellington Regional Hospital, Wellington, New Zealand
| | - J Evans
- Wellington Blood and Cancer Centre, Wellington Regional Hospital, Wellington, New Zealand
| | - S T Tan
- Gillies McIndoe Research Institute, Wellington, New Zealand; Wellington Regional Plastic, Maxillofacial & Burns Unit, Hutt Hospital, Wellington, New Zealand.
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19
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Kim YY, Hwang J, Kim HS, Kwon HJ, Kim S, Lee JH, Lee JH. Genetic alterations in mesiodens as revealed by targeted next-generation sequencing and gene co-occurrence network analysis. Oral Dis 2017; 23:966-972. [PMID: 28415132 DOI: 10.1111/odi.12680] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 12/15/2016] [Revised: 03/21/2017] [Accepted: 04/06/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Mesiodens is the most common type of supernumerary tooth which includes a population prevalence of 0.15%-1.9%. Alongside evidence that the condition is heritable, mutations in single genes have been reported in few human supernumerary tooth cases. Gene sequencing methods in tradition way are time-consuming and labor-intensive, whereas next-generation sequencing and bioinformatics are cost-effective for large samples and target sizes. MATERIALS AND METHODS We describe the application of a targeted next-generation sequencing (NGS) and bioinformatics approach to samples from 17 mesiodens patients. Subjects were diagnosed on the basis of panoramic radiograph. A total of 101 candidate genes which were captured custom genes were sequenced on the Illumina HiSeq 2500. Multistep bioinformatics processing was performed including variant identification, base calling, and in silico analysis of putative disease-causing variants. RESULTS Targeted capture identified 88 non-synonymous, rare, exonic variants involving 42 of the 101 candidate genes. Moreover, we investigated gene co-occurrence relationships between the genomic alterations and identified 88 significant relationships among 18 most recurrent driver alterations. CONCLUSION Our search for co-occurring genetic alterations revealed that such alterations interact cooperatively to drive mesiodens. We discovered a gene co-occurrence network in mesiodens patients with functionally enriched gene groups in the sonic hedgehog (SHH), bone morphogenetic proteins (BMP), and wingless integrated (WNT) signaling pathways.
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Affiliation(s)
- Y Y Kim
- Institute of Oral Science, Apple Tree Dental Hospital, Ilsansuh-gu, Goyang, Korea
| | - J Hwang
- Department of IT Convergence and Engineering, Pohang University of Science and Technology, Pohang, Gyeongbuk, Korea
| | - H-S Kim
- Institute of Oral Science, Apple Tree Dental Hospital, Ilsansuh-gu, Goyang, Korea
| | - H J Kwon
- Institute of Oral Science, Apple Tree Dental Hospital, Ilsansuh-gu, Goyang, Korea
| | - S Kim
- Department of Life Science, Pohang University of Science and Technology, Pohang, Gyeongbuk, Korea
| | - J H Lee
- Department of Clinical Pharmacology and Therapeutics, Kyung Hee University College of Medicine, Dongdaemoon-gu, Seoul, Korea
| | - J H Lee
- Department of Prosthodontics, Yonsei University College of Dentistry, Seodaemoon-gu, Seoul, Korea
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No YA, Kwon HJ, Park KY, Hong SA, Seo SJ, Hong CK. Unilateral, erythematous, swollen, sclerosing patch with nodular progression on the right side of the face. Clin Exp Dermatol 2016; 41:945-947. [PMID: 27766675 DOI: 10.1111/ced.12919] [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] [Accepted: 12/07/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Y A No
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - H J Kwon
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - K Y Park
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - S A Hong
- Department of Pathology, Chung-Ang University College of Medicine, Seoul, Korea
| | - S J Seo
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - C K Hong
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
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21
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Park JI, Kim JS, Kim YB, Kwon HJ, Park YJ. Evaluation of Polyethersulfone-based Composite for Selective Separation of Cesium from Acidic Media. B KOREAN CHEM SOC 2016. [DOI: 10.1002/bkcs.10768] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Jai Il Park
- Nuclear Chemistry Research Division; Korea Atomic Energy Research Institute; 305-353 Daejeon Korea
| | - Jung Suk Kim
- Nuclear Chemistry Research Division; Korea Atomic Energy Research Institute; 305-353 Daejeon Korea
| | - Young Bok Kim
- Nuclear Chemistry Research Division; Korea Atomic Energy Research Institute; 305-353 Daejeon Korea
| | - Hye Jung Kwon
- Nuclear Chemistry Research Division; Korea Atomic Energy Research Institute; 305-353 Daejeon Korea
| | - Yong Joon Park
- Nuclear Chemistry Research Division; Korea Atomic Energy Research Institute; 305-353 Daejeon Korea
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22
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Jeong HS, Lee J, Lim BJ, Kwon HJ, Kim YS, Kim BS, Huh KH, Kim SI, Kim MS, Jeong HJ. Concurrent Post-Transplantation Diabetes Mellitus in Renal Allograft Recipients With Immunoglobulin A Nephropathy. Transplant Proc 2016; 48:887-9. [PMID: 27234759 DOI: 10.1016/j.transproceed.2015.11.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 11/06/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND The prevalence of post-transplantation immunoglobulin A nephropathy (PTIgAN) and diabetes mellitus (PTDM) increases with time after transplantation, and recognition and management of these conditions is becoming more important in renal allograft recipients as graft survival increases. METHODS We explored the influence of concurrent PTDM on renal allograft histology and function in 111 cases with PTIgAN diagnosed from 2000 to 2010 at our institution. RESULTS Sixteen patients (14.4%) had PTDM at the time of diagnosis of PTIgAN, which increased to 28 patients (25.2%) at the last follow-up (10.4 years after transplantation). Donor ages were younger in PTIgAN patients with concurrent PTDM. However, other clinical and demographic data were not significantly different between PTIgAN patients with and without PTDM. Histologically, Banff "mm" scores were higher and "M1" of the Oxford classification was more frequent in PTIgAN patients with concurrent PTDM than in patients without PTDM, but the difference did not reach statistical significance. Serum creatinine levels and proteinuria at the time of biopsy and overall graft survival did not vary according to the presence of PTDM both at biopsy and at the last follow-up. CONCLUSIONS Concurrent PTDM does not significantly influence graft function or outcome for 10 years after transplantation in PTIgAN patients.
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Affiliation(s)
- H S Jeong
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - J Lee
- Department of Transplantation Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - B J Lim
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - H J Kwon
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - Y S Kim
- Department of Transplantation Surgery, Yonsei University College of Medicine, Seoul, Korea; Institute of Transplantation, Yonsei University College of Medicine, Seoul, Korea
| | - B S Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - K H Huh
- Department of Transplantation Surgery, Yonsei University College of Medicine, Seoul, Korea; Institute of Transplantation, Yonsei University College of Medicine, Seoul, Korea
| | - S I Kim
- Department of Transplantation Surgery, Yonsei University College of Medicine, Seoul, Korea; Institute of Transplantation, Yonsei University College of Medicine, Seoul, Korea
| | - M S Kim
- Department of Transplantation Surgery, Yonsei University College of Medicine, Seoul, Korea; Institute of Transplantation, Yonsei University College of Medicine, Seoul, Korea
| | - H J Jeong
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea; Institute of Transplantation, Yonsei University College of Medicine, Seoul, Korea.
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Kwon HJ, Park MI, Park SJ, Moon W, Kim SE, Lee HW, Choi YJ, Kim JH. [Efficacy and Safety of FOLFIRI after Failure of FOLFOX-4 in Advanced Gastric Cancer]. Korean J Gastroenterol 2016; 66:10-6. [PMID: 26194124 DOI: 10.4166/kjg.2015.66.1.10] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND/AIMS The purpose of this study was to investigate the efficacy and safety of irinotecan based FOLFIRI chemotherapy as a second-line treatment after failure of FOLFOX-4 chemotherapy in patients with advanced gastric cancer. METHODS Fifty-two patients who were pathologically diagnosed with unresectable gastric cancer and received FOLFIRI chemotherapy after failure of FOLFOX-4 chemotherapy between September 2005 and February 2012 were enrolled in this study. Data were collected by retrospectively reviewing the medical records. The response to chemotherapy was assessed every 3 cycles by World Health Organization criteria and long term survival was analyzed. The toxicities were evaluated for every course of chemotherapy according to National Cancer Institution (NCI) toxicity criteria version 3.0. RESULTS Median age of the patients was 57 years. Median overall survival (OS) and time to progression (TTP) were 7.8 and 5 months, respectively. The number of patients showing complete remission, partial remission, stable disease, and progressive disease were 0 (0.0%), 9 (17.3%), 30 (57.7%), and 13 (25.0%), respectively. The overall response rate was 17.3%. During a total of 345 cycles, anemia worse than NCI toxicity grade 3 occurred in 2.9%, leukopenia in 20.3%, neutropenia in 12.2%, and thrombocytopenia in 1.5%. Patients with less organ involvement by metastasis, less than 34 U/mL of CA 19-9 and good responsiveness to third cycle of second line chemotherapy were associated with longer OS and TTP. CONCLUSIONS FOLFIRI chemotherapy has a modest efficacy with acceptable toxicities in patients with advanced gastric cancer as a second-line treatment. Further well-controlled studies are needed to elucidate the efficacy of FOLFIRI chemotherapy as second-line treatment in patients with advanced stomach cancer.
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Affiliation(s)
- Hye Jung Kwon
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Moo In Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Seun Ja Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Won Moon
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Sung Eun Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Hae Won Lee
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Youn Jung Choi
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Jae Hyun Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
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Choi YJ, Park MI, Park SJ, Moon W, Kim SE, Kwon HJ, Kim JH, Kang SJ. A Mallory-Weiss tear treated with transarterial embolization complicated by disseminated intravascular coagulation. Endoscopy 2016; 47 Suppl 1 UCTN:E247-8. [PMID: 26099074 DOI: 10.1055/s-0034-1377366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Youn Jung Choi
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Moo In Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Seun Ja Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Won Moon
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Sung Eun Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Hye Jung Kwon
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Jae Hyun Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Seong Joo Kang
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
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Kim JH, Park SJ, Park MI, Moon W, Kim SE, Kwon HJ, Choi YJ. Gastrojejunocolic fistula as a cause of hypoalbuminemia and bilateral leg edema. Endoscopy 2016; 47 Suppl 1 UCTN:E333-4. [PMID: 26134432 DOI: 10.1055/s-0034-1377210] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Jae Hyun Kim
- Department of Gastroenterology, Kosin University College of Medicine, Busan, Korea
| | - Seun Ja Park
- Department of Gastroenterology, Kosin University College of Medicine, Busan, Korea
| | - Moo In Park
- Department of Gastroenterology, Kosin University College of Medicine, Busan, Korea
| | - Won Moon
- Department of Gastroenterology, Kosin University College of Medicine, Busan, Korea
| | - Sung Eun Kim
- Department of Gastroenterology, Kosin University College of Medicine, Busan, Korea
| | - Hye Jung Kwon
- Department of Gastroenterology, Kosin University College of Medicine, Busan, Korea
| | - Youn Jung Choi
- Department of Gastroenterology, Kosin University College of Medicine, Busan, Korea
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Kim SE, Park MI, Park SJ, Moon W, Choi YJ, Cheon JH, Kwon HJ, Ku KH, Yoo CH, Kim JH, Lee GW, Song SE. Trends in Helicobacter pylori eradication rates by first-line triple therapy and related factors in eradication therapy. Korean J Intern Med 2015; 30:801-7. [PMID: 26552455 PMCID: PMC4642009 DOI: 10.3904/kjim.2015.30.6.801] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Revised: 07/29/2014] [Accepted: 09/25/2014] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND/AIMS Trends in successful eradication of Helicobacter pylori using first-line triple therapy, consisting of a proton pump inhibitor, amoxicillin, and clarithromycin, have been understudied. We evaluated H. pylori eradication rates at a single center over the last 10 years and identified risk factors related to eradication failure. METHODS This study included 1,413 patients who were diagnosed with H. pylori infection and received 7 days of triple therapy between January 2003 and December 2012. We investigated H. pylori eradication rates retrospectively with respect to the year of therapy, as well as demographic and clinical factors. H. pylori eradication was confirmed by a (13)C-urea breath test or a rapid urease test at least 4 weeks after the completion of triple therapy. RESULTS The overall H. pylori eradication rate was 84.9%. Annual eradication rates from 2003 to 2012 were 93.5%, 80.0%, 87.2%, 88.5%, 92.0%, 88.3%, 85.7%, 84.1%, 83.7%, and 78.8%, respectively, by per-protocol analysis. The eradication rate with first-line triple therapy decreased during the last 10 years (p = 0.015). Multivariate analysis showed that female gender (odds ratio [OR], 1.69; 95% confidence interval [CI], 1.12 to 2.55) and smoking (OR, 1.61; 95% CI, 1.05 to 2.47) were associated with the failure of H. pylori eradication therapy. CONCLUSIONS The efficacy of first-line triple therapy for H. pylori infection has decreased over the last 10 years, suggesting an increase in antibiotic-resistant H. pylori strains. Thus, other first-line therapies may be necessary for H. pylori eradication in the near future.
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Affiliation(s)
| | - Moo In Park
- Correspondence to Moo In Park, M.D. Department of Internal Medicine, Kosin University College of Medicine, 262 Gamcheon-ro, Seo-gu, Busan 49267, Korea Tel: +82-51-990-6719 Fax: +82-51-990-5055 E-mail:
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Kim JH, Choi YJ, Kwon HJ, Park SJ, Park MI, Moon W, Kim SE. Simple colonoscopy reporting system checking the detection rate of colon polyps. World J Gastroenterol 2015; 21:9380-9386. [PMID: 26309364 PMCID: PMC4541390 DOI: 10.3748/wjg.v21.i31.9380] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 03/20/2015] [Accepted: 04/28/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To present a simple colonoscopy reporting system that can be checked easily the detection rate of colon polyps.
METHODS: A simple colonoscopy reporting system Kosin Gastroenterology (KG quality reporting system) was developed. The polyp detection rate (PDR), adenoma detection rate (ADR), serrated polyp detection rate (SDR), and advanced adenoma detection rate (AADR) are easily calculated to use this system.
RESULTS: In our gastroenterology center, the PDR, ADR, SDR, and AADR test results from each gastroenterologist were updated, every month. Between June 2014, when the program was started, and December 2014, the overall PDR and ADR in our center were 62.5% and 41.4%, respectively. And the overall SDR and AADR were 7.5% and 12.1%, respectively.
CONCLUSION: We envision that KG quality reporting system can be applied to develop a comprehensive system to check colon polyp detection rates in other gastroenterology centers.
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Jeon JS, Kim BH, Lee SH, Kwon HJ, Bae HJ, Kim SK, Park JA, Shim JH, Abd El-Aty AM, Shin HC. Simultaneous determination of arbutin and its decomposed product hydroquinone in whitening creams using high-performance liquid chromatography with photodiode array detection: Effect of temperature and pH on decomposition. Int J Cosmet Sci 2015; 37:567-73. [PMID: 25857400 DOI: 10.1111/ics.12228] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [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: 03/02/2015] [Accepted: 03/31/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Arbutin is an effective agent for the treatment of melanin disorders. Arbutin may be converted to hydroquinone under conditions of high temperature, ultraviolet (UV) radiation and dilute acid. The aim of the current study was to develop an analytical method to determine the levels of arbutin and hydroquinone in whitening cosmetic products using high-performance liquid chromatography with photodiode array detection (HPLC-DAD). In addition, we investigated the effects of high temperature and pH on the decomposition of arbutin. METHODS Samples extracted using two-step sonications were separated on a C18 column using a gradient mobile phase consisting of water and methanol. A 60-mm (40 μL) DAD cell was used to enhance the sensitivity of hydroquinone determination. Thermal decomposition of arbutin was evaluated at temperatures ranging from 60 to 120°C for 1-36 h. RESULTS The method showed good linearity (R(2) ≥ 0.9997), precision (relative standard deviation, RSD < 5%) and acceptable extraction recovery (90-102.6%). The limits of quantitation for arbutin and hydroquinone were 0.0085 and 0.0119 μg mL(-1) , respectively. One sample of 21 cosmetic products tested contained arbutin at a concentration 1.61 g 100 g(-1) cream and 0.12 g 100 g(-1) cream of hydroquinone. Arbutin (327.18 ppm) decomposed after 6 h at 120°C and produced 10.73 ppm of hydroquinone. CONCLUSION The developed method is simple to detect both arbutin and hydroquinone simultaneously in cosmetic products, at an adequate level of sensitivity. Notably, temperature and pH did not influence the decomposition of arbutin to hydroquinone in a 2% arbutin cream.
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Affiliation(s)
- J S Jeon
- Department of Veterinary Pharmacology and Toxicology, College of Veterinary Medicine, Konkuk University, Nuengdong-ro, Gwangjin-gu, Seoul, 143-701, Korea.,Public Health Research Division, Gyeonggi Province Institute of Health and Environment, 95, Pajang cheon-ro, Jangan-gu, Suwonsi, Gyeonggi Province, 440-290, Korea
| | - B H Kim
- Public Health Research Division, Gyeonggi Province Institute of Health and Environment, 95, Pajang cheon-ro, Jangan-gu, Suwonsi, Gyeonggi Province, 440-290, Korea
| | - S H Lee
- Public Health Research Division, Gyeonggi Province Institute of Health and Environment, 95, Pajang cheon-ro, Jangan-gu, Suwonsi, Gyeonggi Province, 440-290, Korea
| | - H J Kwon
- Public Health Research Division, Gyeonggi Province Institute of Health and Environment, 95, Pajang cheon-ro, Jangan-gu, Suwonsi, Gyeonggi Province, 440-290, Korea
| | - H J Bae
- Public Health Research Division, Gyeonggi Province Institute of Health and Environment, 95, Pajang cheon-ro, Jangan-gu, Suwonsi, Gyeonggi Province, 440-290, Korea
| | - S K Kim
- Department of Veterinary Pharmacology and Toxicology, College of Veterinary Medicine, Konkuk University, Nuengdong-ro, Gwangjin-gu, Seoul, 143-701, Korea
| | - J A Park
- Department of Veterinary Pharmacology and Toxicology, College of Veterinary Medicine, Konkuk University, Nuengdong-ro, Gwangjin-gu, Seoul, 143-701, Korea
| | - J H Shim
- Biotechnology Research Institute, College of Agriculture and Life Sciences, Chonnam National University, 300 Yongbong-dong, Buk-gu, Gwangju, 500-757, Korea
| | - A M Abd El-Aty
- Department of Veterinary Pharmacology and Toxicology, College of Veterinary Medicine, Konkuk University, Nuengdong-ro, Gwangjin-gu, Seoul, 143-701, Korea.,Department of Pharmacology, Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt
| | - H C Shin
- Department of Veterinary Pharmacology and Toxicology, College of Veterinary Medicine, Konkuk University, Nuengdong-ro, Gwangjin-gu, Seoul, 143-701, Korea
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Oh ST, Zheng L, Kwon HJ, Choo YK, Lee KW, Kang CW, An BK. Effects of Dietary Fermented Chlorella vulgaris (CBT(®)) on Growth Performance, Relative Organ Weights, Cecal Microflora, Tibia Bone Characteristics, and Meat Qualities in Pekin Ducks. Asian-Australas J Anim Sci 2015; 28:95-101. [PMID: 25557680 PMCID: PMC4283193 DOI: 10.5713/ajas.14.0473] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 08/13/2014] [Accepted: 09/18/2014] [Indexed: 12/24/2022]
Abstract
Fermented Chlorella vulgaris was examined for its effects on growth performance, cecal microflora, tibia bone strength, and meat qualities in commercial Pekin ducks. A total of three hundred, day-old male Pekin ducks were divided into three groups with five replicates (n = 20 ducklings per replicate) and offered diets supplemented with commercial fermented C. vulgaris (CBT(®)) at the level of 0, 1,000 or 2,000 mg/kg, respectively for 6 wks. The final body weight was linearly (p = 0.001) increased as the addition of fermented C. vulgaris into diets increased. Similarly, dietary C. vulgaris linearly increased body weight gain (p = 0.001) and feed intake (p = 0.001) especially at the later days of the feeding trial. However, there was no C. vulgaris effect on feed efficiency. Relative weights of liver were significantly lowered by dietary fermented C. vulgaris (linear effect at p = 0.044). Dietary fermented C. vulgaris did not affect total microbes, lactic acid bacteria, and coliforms in cecal contents. Finally, meat quality parameters such as meat color (i.e., yellowness), shear force, pH, or water holding capacity were altered by adding fermented C. vulgaris into the diet. In our knowledge, this is the first report to show that dietary fermented C. vulgaris enhanced meat qualities of duck meats. In conclusion, our study indicates that dietary fermented C. vulgaris exerted benefits on productivity and can be employed as a novel, nutrition-based strategy to produce value-added duck meats.
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Affiliation(s)
- S T Oh
- Dan Biotech Inc., Cheonan 330-834, Korea
| | - L Zheng
- Dan Biotech Inc., Cheonan 330-834, Korea
| | - H J Kwon
- Dan Biotech Inc., Cheonan 330-834, Korea
| | - Y K Choo
- Dan Biotech Inc., Cheonan 330-834, Korea
| | - K W Lee
- Dan Biotech Inc., Cheonan 330-834, Korea
| | - C W Kang
- Dan Biotech Inc., Cheonan 330-834, Korea
| | - B K An
- Dan Biotech Inc., Cheonan 330-834, Korea
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Choi YJ, Park MI, Park SJ, Moon W, Kim SE, Kwon HJ, Kim JH, Jeon WS. The effect of water bolus temperature on esophageal motor function as measured by high-resolution manometry. Neurogastroenterol Motil 2014; 26:1628-34. [PMID: 25307526 DOI: 10.1111/nmo.12441] [Citation(s) in RCA: 12] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 08/19/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND Ingestion of cold fluids may induce pain in patients with esophageal motility disorders. Hot fluids, on the other hand, may help to relieve pain. We studied changes in esophageal motility as a variable of water bolus temperature using high-resolution manometry (HRM) in healthy human. METHODS Thirty-two healthy subjects were recruited at Kosin University Hospital. HRM was performed in a sitting position, with room temperature (RT, 25 °C), hot (45 °C), and cold (2 °C) water swallowed in that order. This exam included single swallowing (10 swallows of 5 mL water, 30 s intervals) and multiple water swallows (MWS; 100 mL water within 30 s). KEY RESULTS In the single swallowing, hot water caused a decrease in lower esophageal sphincter (LES) residual pressure (5.87 ± 4.20 mmHg vs 7.45 ± 4.17 mmHg (RT), p = 0.001) and duration of esophageal body (EB) contraction (3.01 ± 0.80 s vs 3.15 ± 1.16 s (RT), p = 0.009). Cold water caused an increase in the duration of EB contraction (3.52 ± 0.87 s vs 3.15 ± 1.16 s (RT), p = 0.001) and a decrease in contractile front velocity (CFV) (4.43 ± 1.50 cm/s vs 4.90 ± 2.53 cm/s (RT), p = 0.007). Similarly, in the MWS, hot water caused a decrease in the duration of EB contraction (12.95 ± 5.02 s vs 16.33 ± 5.94 s (RT), p = 0.024) and an increase in the amplitude of EB contraction (114.27 ± 83.36 mmHg vs 82.70 ± 46.77 mmHg (RT), p = 0.007). Cold water caused an increase in the duration of EB contraction (27.38 ± 2.89 s vs 16.33 ± 5.94 s (RT), p = 0.03) and a decrease in the amplitude of EB contraction (51.68 ± 33.94 mmHg vs 82.70 ± 46.77 mmHg (RT), p = 0.001). CONCLUSIONS & INFERENCES This study showed changes in esophageal motility to be dependent on water temperature. Especially, MWS showed clear changes in esophageal motility at different temperatures of water.
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Affiliation(s)
- Y J Choi
- Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea
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Kim EJ, Kwon HJ, Ha M, Lim MH, Oh SY, Kim JH, Yoo SJ, Paik KC. Relationship among attention-deficit hyperactivity disorder, dietary behaviours and obesity. Child Care Health Dev 2014; 40:698-705. [PMID: 24438547 DOI: 10.1111/cch.12129] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/08/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND Attention-deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders of childhood and can be associated with obesity. The aim of this study was to reveal the connection between ADHD symptoms, food habits and obesity. METHODS We examined 12 350 children (6010 boys, 6340 girls) from 27 elementary schools in Cheonan, the Republic of Korea. The study subjects were 5- to 13-year-old children (9.4 ± 1.7 years). Parents completed the DuPaul ADHD Rating Scale. Food habits were measured by a questionnaire adapted from the Korea Youth Risk Behavior Web-based Survey and a validated mini-dietary assessment tool. The full set of hypothesized associations was tested using covariance structural modelling. RESULTS The prevalence of ADHD was 7.6% and that of obesity was 4.5% in our study population. The data was well fit by the model. ADHD was associated with body mass index (BMI; standardized β = 0.086, P < 0.001). Bulimic dietary behaviours was related to BMI (standardized β = 0.548, P < 0.001). Socio-economic status was associated with BMI (standardized β = -0.017, P = 0.027). CONCLUSION Our analysis suggested that ADHD was a risk factor for obesity through dietary behavioural change and socio-economic status.
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Affiliation(s)
- E J Kim
- The Environmental Health Center (Neurodevelopment), Dankook University Medical Center, Cheonan, Korea
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Choo YK, Kwon HJ, Oh ST, Kang CW, Kim HK, Hong EC, Heo KN, Lee SK, An BK. Growth performance and carcass characteristics of korean native ducks fed diets with varying levels of limiting amino acids. Asian-Australas J Anim Sci 2014; 27:518-23. [PMID: 25049982 PMCID: PMC4093530 DOI: 10.5713/ajas.2013.13675] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 01/20/2014] [Accepted: 12/17/2013] [Indexed: 12/02/2022]
Abstract
There are multiple experiments conducted with male Korean native ducks (KND) to evaluate the optimal levels of limiting amino acids (AA). In Exp. 1, a total of 450 one-d-old male KNDs were divided into five groups with six replicates and fed experimental diets with varying levels of lysine, total sulfur amino acids (TSAA) and threonine (T1, 0.90/0.74/0.70%; T2, 1.00/0.82/0.77%; T3, 1.10/0.90/0.85%; T4, 1.20/0.98/0.93%; T5, 1.30/1.07/1.01%) to 21 d of age. In Exp. 2, one-d-old male KND were received and fed commercial starter diet from hatching to 21 d of age, and then divided into five groups with six replicates and fed one of five diets varying levels of lysine, TSAA, and threonine (T1, 0.73/0.62/0.54%; T2, 0.80/0.68/0.60%; T3, 0.87/0.74/0.65%; T4, 0.94/0.80/0.70%; T5, 1.01/0.86/0.75%) during 22 to 56 d of age, respectively. The BW gain was linearly increased as dietary limiting AA levels increased to 1.20% lysine, 0.98% TSAA and 0.93% threonine. There were no significant differences in feed intake, gain:feed and uniformity among groups. In Exp. 2, the BW gain and gain:feed were not affected by dietary limiting AA levels. There were no significant differences in carcass characteristics and meat quality among groups. The growth performance and carcass characteristics did not show the significant response to increasing dietary limiting AA levels in KND during 22 to 56 d of age. In conclusion, the levels of lysine, TSAA and threonine necessary to maximize growth for starter phase were at least 1.20%, 0.98%, and 0.93%, respectively. On the other hands, KND require relatively low levels of limiting AA for late growth and carcass yield. The dietary levels of 0.73% lysine, 0.62% TSAA and 0.54% threonine appear to be adequate during growing phase.
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Affiliation(s)
- Y K Choo
- Poultry Science Division, National Institute of Animal Science, RDA, Seonghwan 330-801, Korea
| | - H J Kwon
- Poultry Science Division, National Institute of Animal Science, RDA, Seonghwan 330-801, Korea
| | - S T Oh
- Poultry Science Division, National Institute of Animal Science, RDA, Seonghwan 330-801, Korea
| | - C W Kang
- Poultry Science Division, National Institute of Animal Science, RDA, Seonghwan 330-801, Korea
| | - H K Kim
- Poultry Science Division, National Institute of Animal Science, RDA, Seonghwan 330-801, Korea
| | - E C Hong
- Poultry Science Division, National Institute of Animal Science, RDA, Seonghwan 330-801, Korea
| | - K N Heo
- Poultry Science Division, National Institute of Animal Science, RDA, Seonghwan 330-801, Korea
| | - S K Lee
- Department of Animal Products and Food Science, Kangwon National University, Chuncheon 200-701, Korea
| | - B K An
- Poultry Science Division, National Institute of Animal Science, RDA, Seonghwan 330-801, Korea
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Choo YK, Kwon HJ, Oh ST, Um JS, Kim BG, Kang CW, Lee SK, An BK. Comparison of growth performance, carcass characteristics and meat quality of korean local chickens and silky fowl. Asian-Australas J Anim Sci 2014; 27:398-405. [PMID: 25049967 PMCID: PMC4093260 DOI: 10.5713/ajas.2013.13638] [Citation(s) in RCA: 17] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 01/20/2014] [Accepted: 01/02/2014] [Indexed: 11/27/2022]
Abstract
This study was conducted to compare growth performance, carcass characteristics and meat quality of 4 breeds of local chicken. A total of 480 1-d-old chicks were distributed to 16 pens, with 4 treatments of breed, 4 replicates and 30 chicks per pen. Three Korean local breeds of white-mini broiler, Hanhyup-3-ho, and Woorimatdag, and a breed of silky fowl were raised under identical rearing and feeding conditions for 31-d, 37-d, 36-d, and 59-d, respectively. The BW and feed consumption on a pen basis were weekly measured for all pens, and ADFI, ADG and gain:feed were calculated for each pen. The ADFI and ADG of 3 breeds of Korean local chicken were greater than those of silky fowl (p<0.05). Within the Korean local breeds, ADFI of white-mini broiler was the highest (p<0.05), and ADG of Hanhyup-3-ho and white-mini broiler was the highest (p<0.05). Gain:feed of silky fowl was less than that of the 3 breeds of Korean local chicken. The carcass and breast yield of white-mini broiler were the greater than those of other breeds (p<0.05). The breast meat color (CIE L*, a*, and b*) of 3 breeds of Korean local chicken were higher than that of silky fowl (p<0.05). The breast meat of Hanhyup-3-ho had greater cooking loss (p<0.05), whereas water holding capacity and pH were less than those of other breeds (p<0.05). The color score of 3 breeds of Korean local chicken was higher than that of silky fowl (p<0.05). Woorimatdag had a higher score on tenderness (p<0.05), whereas flavor score was less than that of other breeds (p<0.05). In conclusion, 4 local breeds of chicken have some unique features and seem to have more advantages, and this information can help consumers who prefer healthy and premium chicken meat.
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Affiliation(s)
- Y K Choo
- Nonghyup Feed Inc., Seoul 134-763, Korea
| | - H J Kwon
- Nonghyup Feed Inc., Seoul 134-763, Korea
| | - S T Oh
- Nonghyup Feed Inc., Seoul 134-763, Korea
| | - J S Um
- Nonghyup Feed Inc., Seoul 134-763, Korea
| | - B G Kim
- Nonghyup Feed Inc., Seoul 134-763, Korea
| | - C W Kang
- Nonghyup Feed Inc., Seoul 134-763, Korea
| | - S K Lee
- Department of Animal Products and Food Science, Kangwon National University, Chuncheon 200-701, Korea
| | - B K An
- Nonghyup Feed Inc., Seoul 134-763, Korea
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Kim DW, Woo HD, Joo J, Park KS, Oh SY, Kwon HJ, Park JD, Hong YS, Sohn SJ, Yoon HJ, Hwang MS, Kim J. Estimated long-term dietary exposure to lead, cadmium, and mercury in young Korean children. Eur J Clin Nutr 2014; 68:1322-6. [PMID: 24961543 DOI: 10.1038/ejcn.2014.116] [Citation(s) in RCA: 17] [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] [Received: 05/07/2013] [Revised: 03/10/2014] [Accepted: 04/13/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND Controlling for day-to-day variation is a key issue in estimating long-term dietary exposure to heavy metals using 24-hour recall (24HR) data from a relatively small number of days. OBJECTIVES This study was conducted to estimate long-term dietary exposure to lead, cadmium and mercury among Korean children using the Iowa State University (ISU) method and to assess the contributions of different food groups to heavy metal intake. METHODS We analyzed 2 days of 24HR data from 457 children between 0 and 6 years of age in 2010. Using bootstrapped concentration data for 118 representative foods, 93.5% of total intake was included in the exposure estimates in this study. Using the 2-day exposure data, we estimated long-term exposure by controlling for within-individual variation using the ISU method. RESULTS The long-term dietary exposure estimates (mean±standard deviation) for lead, cadmium, and mercury were 0.47±0.14, 0.38±0.20, and 0.22±0.08 μg/kg bw/day, respectively. For lead and cadmium, the percentages of children whose exposure was greater than the reference value were 35 and 42%, respectively. Fruits were an important source of lead exposure, and cereal and fish and shellfish made the greatest contributions to the total cadmium and mercury exposure. CONCLUSIONS Our findings also suggest that the long-term exposure to lead and cadmium was somewhat greater than the reference values, whereas mercury exposure was well below than the reference value in this population. Further studies may be necessary to evaluate the food items contributing to heavy metal exposure, and continuous monitoring is needed to ensure the safety of food intake and dietary patterns among vulnerable groups in Korea.
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Affiliation(s)
- D W Kim
- Molecular Epidemiology Branch, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea
| | - H D Woo
- Molecular Epidemiology Branch, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea
| | - J Joo
- Biometric Research Branch, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea
| | - K S Park
- Advanced Analysis Center, Research Planning & Coordination Division, Korea Institute of Science and Technology, Seoul, Republic of Korea
| | - S Y Oh
- Department of Food & Nutrition, College of Human Ecology, Kyung Hee University, Seoul, Republic of Korea
| | - H J Kwon
- Department of Preventive Medicine, College of Medicine, Dankook University, Cheonan-si, Chungcheongnam-do, Republic of Korea
| | - J D Park
- Department of Preventive Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Y S Hong
- Dong-A University, Regional Cardiocerebrovascular Center, Busan, Republic of Korea
| | - S J Sohn
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - H J Yoon
- Risk Analysis & Research Division, National Institute of Food and Drug Safety Evaluation, Cheongwon-gun, Chungcheongbuk-do, Republic of Korea
| | - M S Hwang
- Risk Analysis & Research Division, National Institute of Food and Drug Safety Evaluation, Cheongwon-gun, Chungcheongbuk-do, Republic of Korea
| | - J Kim
- Molecular Epidemiology Branch, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea
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Choi YJ, Park MI, Park SJ, Moon W, Kim SE, Yoo CH, Kwon HJ. Relationship between multiple water swallows and gastroesophageal reflux in patients with normal esophageal motility. Dis Esophagus 2014; 28:520-3. [PMID: 24898795 DOI: 10.1111/dote.12232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Multiple water swallows (MWS) stimulates neural inhibition, resulting in abolition of contractions in the esophageal body and complete lower esophageal sphincter relaxation, which is followed by peristalsis and the lower esophageal sphincter contraction. We assessed the relationship between MWS and gastroesophageal reflux in patients with esophageal symptoms and with normal findings by high-resolution manometry (HRM). We retrospectively reviewed the clinical records of patients who underwent HRM and a 24-hour ambulatory impedance-pH study. Correlation between the findings of the impedance-pH study and abnormal MWS responses without motility disorders was evaluated. Independent t-tests were used for statistical analysis. Of 28 patients, 20 (71%) had abnormal MWS responses: four (20%) had abnormal responses during MWS, six (30%) had abnormal responses after MWS, and 10 (50%) had abnormal responses both during and after MWS. Total acid exposure times were significantly longer in patients with abnormal MWS responses than in patients with normal MWS responses. In particular, upright acid exposure time and all reflux percent times were significantly longer in patients with abnormal MWS responses. However, bolus clearance time and longest reflux episode were not different between the two groups. Abnormal MWS responses predicted increased acid exposure times in patients with normal findings of HRM by the Chicago classification.
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Affiliation(s)
- Y J Choi
- Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea
| | - M I Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea
| | - S J Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea
| | - W Moon
- Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea
| | - S E Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea
| | - C H Yoo
- Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea
| | - H J Kwon
- Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea
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Yoo JS, Cho EJ, Gwoo S, Kwon HJ, Lim SK, Jang TW, Oak CH. A Case of Endobronchial Actinomycosis with a Broncholith cured by Cryotherapy through a Flexible Bronchoscope. KMJ 2013. [DOI: 10.7180/kmj.2013.28.2.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
<p>We report the case of a 53-year-old man who presented with obstructive pneumonitis and broncholithiasis. We attempted to remove the broncholith with forceps through a flexible endoscope, but the potential for bleeding due to partial synechia did not allow this. We succeeded in removing it with cryotherapy. The histopathological diagnosis was thoracic actinomycosis associated with broncholithiasis. Endobronchial actinomycosis with a broncholith is very rare. We successfully treated a patient with endobronchial actinomycosis with a broncholith by administering short-term antibiotics after broncholithectomy via cryotherapy through a flexible bronchoscope.</p>
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Cheon JH, Moon W, Park SJ, Park MI, Kim SE, Choi YJ, Kim JB, Kwon HJ. [A case of intestinal tuberculosis with perianal fistula diagnosed after 30 years]. Korean J Gastroenterol 2013; 62:370-4. [PMID: 24365737 DOI: 10.4166/kjg.2013.62.6.370] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Tuberculosis can occur anywhere in the gastrointestinal tract. However, anorectal tuberculosis has rarely been reported. A 46-years-old male presented with abdominal pain and perianal discharge of 30 years' duration. The patient had received operations for anal fistula and inflammation three times. Although he had been taking mesalazine for the past three years after being diagnosed with Crohn's disease, his symptoms persisted. Colonoscopy performed at our hospital revealed cicatricial change of ileocecal valve and diffuse ulcer scar with mild luminal narrowing of the ascending, transverse, and descending colon without active lesions. Multiple large irregular active ulcers were observed in the distal sigmoid and proximal rectum. An anal fistula opening with much yellowish discharge and background ulcer scar was observed in the anal canal. However, cobble-stone appearance and pseudopolyposis were not present. Therefore, we clinically diagnosed him as having intestinal tuberculosis with anal fistula and prescribed antituberculosis medications. Follow-up colonoscopy performed 3 months later showed much improved multiple large irregular ulcers in the distal sigmoid colon and proximal rectum along with completely resolved anal fistula without evidence of pus discharge.
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Affiliation(s)
- Ji Hyun Cheon
- Division of Gastroenterology, Department of Internal Medicine, Kosin University Gospel Hospital, 262 Gamcheon-ro, Seo-gu, Busan 602-702, Korea
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Kwon HJ, Kang JH, Lee JW, Chung NG, Kim HK, Cho B. Treatment of BK virus-associated hemorrhagic cystitis in pediatric hematopoietic stem cell transplant recipients with cidofovir: a single-center experience. Transpl Infect Dis 2013; 15:569-74. [PMID: 24028353 DOI: 10.1111/tid.12136] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [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: 09/19/2012] [Revised: 01/08/2013] [Accepted: 03/24/2013] [Indexed: 01/07/2023]
Abstract
BACKGROUND BK virus (BKV)-associated hemorrhagic cystitis (BKV-HC) is a severe complication after hematopoietic stem cell transplantation (HSCT). Cidofovir (CDV) has emerged as an effective agent for the treatment of BKV nephropathy, but its use for BKV-HC in pediatric HSCT recipients has not yet been established as a standard therapy. PATIENT AND METHODS We retrospectively investigated the efficacy and safety of CDV therapy for patients with BKV-HC at a single institution and analyzed the clinical management outcomes. RESULTS From April 2009 to July 2011, 12 patients developed BKV-HC at a median of 37 days after transplant (range 15-59 days). The cumulative incidence was 9% and the median peak of the urine BKV load was 2.5 × 10(10) copies/mL (range 1.4 × 10(9) -1.2 × 10(11) copies/mL). Eleven patients received intravenous CDV (5 mg/kg/dose, with probenecid), whereas 1 patient received CDV (5 mg/kg/dose, without probenecid) intravesically. The median duration of therapy was 25 days (range 9-73 days), and a median of 2 doses was given (range 1-4). A reduction of ≥ 1 log in the BKV load was found in 11 patients, while 1 patient did not have any significant change in BKV load. Clinical improvement was observed in all cases, and no HC-related death was observed. CDV-related toxicity occurred in 1 patient (8%) and spontaneously resolved. CONCLUSIONS CDV appears to be an effective and safe treatment for BKV-HC in pediatric HSCT recipients, but prospective trials are warranted to support its use.
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Affiliation(s)
- H J Kwon
- Division of Infectious Diseases, Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea; Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Park J, Lee H, Kim YK, Kim KH, Lee W, Lee KY, Park YJ, Kahng J, Kwon HJ, Kim Y, Oh EJ, Lim J, Kim M, Han K. Automated screening for tuberculosis by multiparametric analysis of data obtained during routine complete blood count. Int J Lab Hematol 2013; 36:156-64. [PMID: 24034225 DOI: 10.1111/ijlh.12148] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [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: 04/18/2013] [Accepted: 07/30/2013] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The main goal of this study was to develop a multiparametric cell population data (CPD) model that combines information from several morphologic parameters generated by DxH800, in addition to the traditional parameters regularly reported in the CBC-diff, and to test the performance of this model in screening the general population for primary tuberculosis (TB). METHODS A total of 3741 study cases were divided into two groups, test and validation set at cut-off value of 6000 WBCs/μL. We developed multiparametric model for primary TB screening (TB hemeprint), selected CPD, and calculated parameters which could discriminate primary TB from other non-TB diseases and normal control in test set. We applied it to the validation set, which was a set of completely different samples, to test its reproducibility if applied to a routine laboratory test. RESULTS After screening primary TB using TB hemeprint, sensitivity, specificity, PPV, and NPV were 85.4%, 89.6%, 31.1%, and 99.1%, respectively, in primary TB with lower than 6000 WBCs/μL of test set (test set-L). In primary TB with higher than 6000 WBCs/μL of test set (test set-H), those values were 83.1%, 85.6%, 29.7%, and 98.6%, respectively. There were only 0.4% (2/461) and 0.6% (2/326) of normal control samples included in test set-L and -H, respectively. Diagnostic efficiencies except sensitivity in each validation set were very comparable with those in each test set. CONCLUSION Tuberculosis hemeprint may allow us to screen primary TB with acceptable sensitivity and specificity using combination of TB-specific CPD and calculated parameters.
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Affiliation(s)
- J Park
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Kwon HJ, Sung BK, Kim JW, Lee JH, Kim ND, Yoo MA, Kang HS, Baek HS, Bae SJ, Choi JS, Takahashi R, Goto S, Chung HY. The effect of lipopolysaccharide on enhanced inflammatory process with age: Modulation of NF-κB. J Am Aging Assoc 2013; 24:163-71. [PMID: 23604881 DOI: 10.1007/s11357-001-0017-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Oxidative stress is thought to be a causative factor for age-related damage in a wide variety of cellular constituents that can lead to dysfunction and various pathological conditions, including the inflammatory process. At the molecular level, the redox-sensitive transcription factor, NF-κB plays a key role in the regulation of the inflammatory process, along with cytokines, cyclooxygenase-2 (COX-2), and inducible nitric oxide synthase (iNOS). We studied the mechanism underlying the modulation of the inflammatory reaction with age by investigating NF-κB activation and the expression of COX-2, iNOS, and cytokines genes in hepatic tissues isolated from young and old rats. We expanded our investigation of these factors in rats injected with the inflammatory activator, lipopolysaccharide (LPS). Data showed that NF-κB activity was up-regulated with age and was further enhanced by LPS injection, indicating an increased susceptibility and sensitivity to the inflammatory stimulus with age. To explore further the molecular events leading to NF-κB activation, we investigated the inhibitory component of NF-κB complex, IκB. Cytosolic IκBα, but not IκBβ, was significantly decreased in both old and LPS-treated rats, signifying the enhanced migration of cytosolic NF-κB complex into the nucleus following dissociation from the inhibitor. The appearance of the polypeptide, p65, as determined in the nucleus, corresponded with the change in IκBα, providing further supporting evidence for the molecular process involved in NF-κB activation. Our additional investigation of two proinflammatory-related enzymes, COX-2 and iNOS, and three cytokines, interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α, clearly showed aged-related increases, in corroboration with the NF-κB activation. Our results demonstrated that LPS injection caused the enhanced gene expression of inducible proinflammatory proteins, COX-2 and iNOS through NF-κB activation.
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Affiliation(s)
- H J Kwon
- College of Pharmacy, Pusan National University, Pusan, 609-735 Korea
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Abstract
Various patterns of calcification have been detected in benign and malignant thyroid nodules on ultrasonography (US). Microcalcification has been found to be highly associated with papillary thyroid carcinoma. However, other patterns of calcification have unclear clinical significance. The aim of this study was to evaluate which pattern of calcification could be predictive of malignancy. A total of 1,431 thyroid nodules of 1,078 patients who received preoperative ultrasound examinations and subsequently underwent thyroidectomy were retrospectively reviewed. The types of calcification were defined as follows: microcalcification, annular-like peripheral calcification, crescent-like peripheral calcification, intranodular coarse calcification, and calcified spot. Of these 1,431 nodules, 1,305 (91.1%) were thyroid carcinomas and 126 (8.9%) were benign nodules. Calcifications were detected in 38.6% (552/1,431) of all nodules. Calcifications were found in 40.2% (524/1,305) of malignant nodules and 22.2% (28/126) of benign nodules. Of the 524 malignant nodules with calcification, microcalcification was the most common pattern, occurring in 42.9% (225/524), and annular type was the least common pattern, occurring in 5.9% (31/524). Among the calcification types, only microcalcification and intranodular had a significant association with malignancy (p = 0.001, 0.035), with OR values of 3.5 (95% CI, 1.6-7.7) and 2.4 (95% CI, 1.1-5.6). Though using the patterns of calcification alone for predicting malignancy had limitation, microcalcification and intranodular calcification were significantly associated with malignancy.
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Affiliation(s)
- Bu Kyung Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
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Choi YS, Kwon HJ, Kim BK, Kwon SK, Park YH, Kim JH, Jung SB, Lee CH, Lee SK, Uchino S. A Case of medullary thyroid carcinoma with de novo V804M RET germline mutation. J Korean Med Sci 2013; 28:156-9. [PMID: 23341727 PMCID: PMC3546095 DOI: 10.3346/jkms.2013.28.1.156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 08/27/2012] [Indexed: 11/20/2022] Open
Abstract
Many cases of RET proto-oncogene mutations of hereditary medullary thyroid carcinoma (MTC) have been reported in Korea. However, MTC with V804M RET proto-oncogene germline mutations have not been reported in Korea. A 33-yr-old man was diagnosed with a 0.7-cm sized thyroid nodule. Laboratory testing revealed serum calcitonin was elevated. The patient underwent total thyroidectomy with central compartment neck dissection for the thyroid tumor. RET gene analysis was performed in both the index patient and his family. There were no V804M RET mutation and abnormal laboratory findings within his family except the index patient. Therefore, this patient was a de novo V804M RET germline mutation.
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Affiliation(s)
- Young Sik Choi
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
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Park DH, Lee SU, Yu JS, Lee JS, Kwon HJ. The Combination Therapy with Peg-interferon Alfa and Ribavirin for Chronic Hepatitis C in Korea as an Initial Treatment. KMJ 2012. [DOI: 10.7180/kmj.2012.27.2.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objectives The combination therapy with peginterferon and ribavirin has been used to treat chronic hepatitis C for several years in Korea but there is a few report about the results of the treatment. We evaluated safety and efficacy of the combination therapy with Peg-interferon and ribavirin and analyzed factors that may affect treatment. Methods Total 72 untreated chronic hepatitis C patients were administered pegylated interferon alfa-2a (180µg/week) or alfa-2b (1.5µg/kg/week) and ribavirin (800 mg/day in genotype 2, 1000-1200 mg/day in genotype 1). Duration of the treatment was 24 weeks in genotype 2 and 48 weeks in genotype 1. Response of the treatment was evaluated by rapid virologic response (RVR), early virologic response (EVR), end treatment virologic response (ETR), sustained virologic response (SVR) and adverse event. Results The RVR, EVR, ETR, SVR were 61.8%, 82.5%, 88.9% and 80.5% retrospectively. The SVR of genotype 1 was 63.4% and non-genotype 1 was 96.7%. Genotype (Odds ratio: 14.92) was an independent predictor of the SVR. Leukocytopenia, flu-like symptoms, itching, rash and anemia were common adverse events of the combination therapy and if then we reduced dose and there was one case of cessation. Conclusions The combination therapy with Peg-interferon and ribavirin shows efficacy to the Korean patients with chronic hepatitis C as an initial treatment. Genotypes 2 and 3 were more likely to have a sustained virologic response.
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Kwon HJ, Choi YS, Lee JS, Park DH, Choi YJ, Yoo JS. A Case of Thyrotoxic Periodic Paralysis Associated with Transient Thyrotoxicosis. KMJ 2012. [DOI: 10.7180/kmj.2012.27.2.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
<p>Thyrotoxic periodic paralysis is an acute muscle weakness of the limbs associated with hypokalemia. It can occur with any form of thyrotoxicosis. Thyrotoxic periodic paralysis associated with transient thyrotoxicosis due to thyroiditis is very rare. We experienced a case of thyrotoxic periodic paralysis associated with transient thyrotoxicosis. A 39-yr-old man was referred to our hospital because of paralysis of upper and lower extremity. The laboratory results were hypokalemia and mild thyrotoxicosis. A thyroid scan with Tc-99m revealed decreased uptake in the thyroid area compatible with destructive thyroiditis. The paralytic attack did not recur after the patient recovered to euthyroid state.</p>
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Han JY, Cho JH, Kwon HJ, Nam KJ. Predicting portal hypertension as assessed by acoustic radiation force impulse: correlations with the Doppler ultrasound. Br J Radiol 2012; 85:e404-9. [PMID: 22815421 DOI: 10.1259/bjr/74648924] [Citation(s) in RCA: 10] [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: 02/07/2023] Open
Abstract
OBJECTIVE The purpose of this study was to assess the value of acoustic radiation force impulse (ARFI) for evaluating portal hypertension by correlating the elasticity of liver cirrhosis, as measured by ARFI, with haemodynamic indices measured by Doppler ultrasound. METHODS We evaluated the data of a total of 154 prospectively enrolled patients who underwent both duplex Doppler ultrasound and ARFI imaging. The duplex Doppler ultrasound indices, including the mean portal vein velocity, splenic index (SI) and splenoportal index (SPI) were evaluated to determine the statistical correlation with shear wave velocity (SWV) of ARFI. We also analysed the differences in the correlations between the SI, SPI and SWV of the group who had varices. The correlations were assessed with Spearman's rank correlation coefficients. RESULTS There was an increase of SWV in parallel with the increase of the SI (ρ=0.409, p<0.01) and SPI (ρ=0.451, p<0.01). In the patient group who did not have varices (n=74), the Doppler indices were found to be more correlated with the SWV (SI: ρ=0.447, SPI: ρ=0.552, p<0.01). However, the group with varices showed no correlation between the SWV and the Doppler parameters. CONCLUSION SWV of ARFI was well correlated statistically with Doppler parameters, but is of limited value in predicting portal hypertension directly owing to great variability of Doppler parameters. By evaluating the correlation between ARFI and Doppler ultrasound, we suggest that the SWV might be a non-invasive supplementary tool for predicting portal hypertension.
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Affiliation(s)
- J-Y Han
- Department of Radiology, Dong-A University Hospital, Busan, Republic of Korea
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Park SY, Kwon HJ, Choi Y, Lee HE, Kim SW, Kim JH, Kim IA, Jung N, Cho NY, Kang GH. P1-05-04: Distinct Patterns of Promoter CpG Island Methylation of Breast Cancer Subtype Are Associated with Different Stem Cell Phenotype. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p1-05-04] [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: 11/16/2022]
Abstract
Abstract
Background: Although DNA methylation profiles in breast cancer have been connected to breast cancer molecular subtype, there have been no studies of the association of DNA methylation with stem cell phenotype. This study was designed to evaluate promoter CpG islands methylation of 15 genes with regard to breast cancer subtype and to investigate whether the patterns of CpG island methylation in each subtype are associated with cancer stem cell phenotype represented by CD44+/CD24- or ALDH1 expression.
Methods: We performed MethyLight analysis for the methylation status of 15 promoter CpG island loci involved in breast cancer progression (APC, DLEC1, GRIN2B, GSTP1, HOXA1, HOXA10, IGF2, MT1G, RARB, RASSF1A, RUNX3, SCGB3A1, SFRP1, SFRP4, and TMEFF2) and determined cancer stem cell phenotype by CD44/CD24 and ALDH1 immunohistochmeistry in 36 luminal A, 33 luminal B, 30 luminal-HER2, 40 HER2 enriched, and 40 basal-like subtypes of breast cancer.
Results: The number of CpG island loci methylated was significantly different among subtypes and it was highest in luminal-HER2 subtype and lowest in basal-like subtype. Methylation frequencies and levels in 12 out of the 15 genes were significantly different among all subtypes and basal-like subtype showed significantly lower methylation frequencies and levels in nine genes, compared to luminal A, luminal B, HER2 enriched, and luminal-HER2 subtypes. CD44+/CD24- or ALDH1+ putative stem cell populations were most enriched in basal-like subtype. The methylation of promoter CpG islands was significantly lower in CD44+/CD24-cell (+) tumors, compared to CD44+/CD24-cell (−) tumors, even within the basal-like subtype. ALDH1 (+) tumors also had significantly lower methylation, compared to ALDH1 (−) tumors.
Conclusions: Our findings showed that promoter CpG island methylation was significantly different according to breast cancer subtype and stem cell phenotype of tumor, suggesting that breast cancers have different methylation patterns according to molecular subtypes and it is associated with stem cell phenotypes of the tumor.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-05-04.
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Affiliation(s)
- SY Park
- 1Seoul National University Bundang Hospital; Seoul National University Hospital; Cancer Research Institute, Seoul National University
| | - HJ Kwon
- 1Seoul National University Bundang Hospital; Seoul National University Hospital; Cancer Research Institute, Seoul National University
| | - Y Choi
- 1Seoul National University Bundang Hospital; Seoul National University Hospital; Cancer Research Institute, Seoul National University
| | - HE Lee
- 1Seoul National University Bundang Hospital; Seoul National University Hospital; Cancer Research Institute, Seoul National University
| | - S-W Kim
- 1Seoul National University Bundang Hospital; Seoul National University Hospital; Cancer Research Institute, Seoul National University
| | - JH Kim
- 1Seoul National University Bundang Hospital; Seoul National University Hospital; Cancer Research Institute, Seoul National University
| | - IA Kim
- 1Seoul National University Bundang Hospital; Seoul National University Hospital; Cancer Research Institute, Seoul National University
| | - N Jung
- 1Seoul National University Bundang Hospital; Seoul National University Hospital; Cancer Research Institute, Seoul National University
| | - N-Y Cho
- 1Seoul National University Bundang Hospital; Seoul National University Hospital; Cancer Research Institute, Seoul National University
| | - GH Kang
- 1Seoul National University Bundang Hospital; Seoul National University Hospital; Cancer Research Institute, Seoul National University
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Lee SY, Kwon HJ, Ahn HS, Seo KY, Kim EK, Kim TI. Comparison of patient outcomes after implantation of Visian toric implantable collamer lens and iris-fixated toric phakic intraocular lens. Eye (Lond) 2011; 25:1409-17. [PMID: 21852802 DOI: 10.1038/eye.2011.176] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE We compared visual and refractive outcomes after implantation of Visian toric implantable collamer lenses (toric ICLs) and iris-fixated toric pIOLs (toric Artisans). PATIENTS AND METHODS A comparative retrospective analysis was performed. Toric ICLs were implanted into 30 eyes of 18 patients, and toric Artisans into 31 eyes of 22 recipients. We measured the logarithms of the minimum angle of resolution of uncorrected visual acuity (logMAR UCVA), logMAR of best spectacle-corrected corrected VA (logMAR BSCVA), MR, SE, and astigmatism (by the power vector method) before surgery and 1, 3, and 6 months thereafter. Differences between patients receiving each type of lens were compared by using a mixed model of repeated measures. RESULTS Visual improvements were evident after operation in both groups. By comparing the attempted to the achieved SE values, we were able to confirm that correction of refractive error was similar in both groups. However, the logMAR UCVA was significantly higher in the toric ICL group at all postoperative time points. Although manifest cylinder power and astigmatism (calculated by using the power vector method) gradually decreased in the toric ICL group, cylinder power 1 month postoperatively increased from -2.62 to -2.75 D; astigmatism was also increased at this time in the toric Artisan group. CONCLUSION The two tested toric pIOLs were similar in terms of the ability to correct refractive error, as assessed 3 months postoperatively. However toric ICLs corrected astigmatism more rapidly and safely. Notably, the large difference in astigmatism level between the two groups 1 month postoperatively indicates that toric ICLs are more effective when used to correct astigmatism.
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Affiliation(s)
- S Y Lee
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
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Kim SH, Kwon HJ, Cho JH, Lee SW, Rha SH, Choi J, Nam KJ. Atypical radiological features of a leiomyosarcoma that arose from the ovarian vein and mimicked a vascular tumour. Br J Radiol 2010; 83:e95-7. [PMID: 20418463 DOI: 10.1259/bjr/50917539] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Leiomyosarcomas of the ovarian vein are extremely rare tumours. Most tumours are hypervascular and typically have a large avascular centre of necrosis. We experienced a case of a retroperitoneal leiomyosarcoma that arose from the ovarian vein with marked vascular proliferation and dilatation within the tumour. To the best of our knowledge, this is the first case report of a retroperitoneal leiomyosarcoma with an atypical vascular structure in the clinical literature.
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Affiliation(s)
- S H Kim
- Department of Diagnostic Radiology, Dong-A University College of Medicine, Dongdaesin-dong, Seo-gu, Busan South Korea
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Hong IS, Park BS, Jang JH, Kwon HJ, Cho YS, Hwang YS. Design and construction of a compact microwave proton source for a proton linac. Rev Sci Instrum 2010; 81:02A314. [PMID: 20192335 DOI: 10.1063/1.3271170] [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] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A 100 MeV, 20 mA proton linear accelerator is being developed by the Proton Engineering Frontier Project at the Korea Atomic Energy Research Institute. 20 MeV acceleration system using radio frequency quadrupole and drift tube linac was already developed and has been tested. To operate this acceleration system with a long time, more reliable proton source is needed. A compact microwave proton source was proposed and has been designed and constructed as a prototype ion source for the 100 MeV proton linear accelerator. The design of microwave power injection system is based on the microwave proton injector at LANL and CEA. The wave power from a 2.45 GHz, 2 kW magnetron source is introduced into a compact plasma chamber with 7 cm diameter and 5 cm length through a standard tapered, double-ridged waveguide (WRD250) and a quartz window. The microwave power supply is installed on high voltage platform. Axial magnetic fields up to 1 kG can be provided with a water-cooled solenoid coil. A single-hole three electrode extraction system is designed for an extraction current up to 30 mA at a 50 kV extraction voltage. The design and initial operations of the proton source are presented.
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Affiliation(s)
- I S Hong
- Proton Engineering Frontier Project, Korea Atomic Energy Research Institute, Daejeon 305-353, Republic of Korea.
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Park HW, Wang JH, Kim JU, Koo SW, Kwon HJ, Jang YJ. Does isoflurane enhance rhinovirus replication and virus-induced cytokine secretion in airway epithelial cells? Acta Anaesthesiol Scand 2008; 52:1046-50. [PMID: 18840102 DOI: 10.1111/j.1399-6576.2008.01691.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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]
Abstract
BACKGROUND There have been no previous studies regarding the effect of volatile anesthetics on human rhinovirus (RV) infection in airway epithelial cells of patients with an upper respiratory infection (URI). We have therefore evaluated in vitro the effect of isoflurane on RV infection in airway epithelial cells. METHODS A549 cells and RV-infected A549 cells were treated with isoflurane for 2 or 4 h. Surface expression of intercellular adhesion molecule-1 (ICAM-1) was assessed by flow cytometry, and effects on the secretion of interleukin (IL)-6 and IL-8 were measured by ELISA. The effect on RV replication in the cells was determined by viral titer. RESULTS Isoflurane treatment for 2 or 4 h had no significant effect on ICAM-1 expression and secretion of IL-6 and IL-8 in control cells. Isoflurane also had no significant additional effect on RV-induced ICAM-1 expression and secretion of IL-6 and IL-8. Viral titers were not significantly influenced by isoflurane. CONCLUSION Isoflurane treatment showed no additional effects with RV on ICAM-1 expression, secretion of IL-6 and IL-8, and viral titer in A549 cells. These results suggest that isoflurane itself may not increase further RV infections, inflammations, and viral replication in patients with a viral URI.
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Affiliation(s)
- H-W Park
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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