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Hong SJ, Kim C, Lee DW, Jang HJ, Cho SM, Choi KH, Hwang JH, Choe JY. Foreign body ingestion trends in children in the Daegu-Kyungpook Province, Korea before and during the COVID-19 period: a repeated cross-sectional study. Transl Pediatr 2023; 12:1364-1372. [PMID: 37575898 PMCID: PMC10416120 DOI: 10.21037/tp-23-21] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 05/29/2023] [Indexed: 08/15/2023] Open
Abstract
Background During the coronavirus disease 2019 (COVID-19) period, children spent more time at home, which is where most foreign body ingestions (FBIs) in children occur. We compared the rate of FBI in children in the Daegu-Kyungpook Province during COVID-19 to the rate in the 2 years before the COVID-19 period. Methods The period from January to December in the year 2020 was defined as the COVID-19 period, and the corresponding time period in 2018 and 2019 was defined as the pre-COVID-19 period. Medical records were analyzed retrospectively for pediatric patients aged 0-15 years who visited outpatient and emergency rooms at seven tertiary referral hospitals in Daegu-Kyungpook Province. Results The annual occurrence rate of FBIs in patients visiting seven tertiary referral hospitals was not different during COVID-19 compared to that in the pre-COVID-19 period and the median age of these patients during the COVID-19 and pre-COVID-19 periods was similar. However, occurrence rates increased in the groups aged 0-3 and 4-6 years but decreased in the group aged 7-15 years during the COVID-19 period. The proportion of male patients as well as inpatients increased significantly during the COVID-19 period (both P=0.01). The proportion of foreign bodies located in the post-pyloric region increased during the COVID-19 period (P=0.02). The most common symptom, foreign body sensation in the neck, was similar in both groups. There was no significant difference in the foreign body removal method between the two groups. The occurrence rates of swallowing of toys, coins, magnets, button batteries, and superabsorbent polymers non-significantly increased; and the food ingestion rate decreased, while the non-food ingestion rate increased in all age groups during the COVID-19 period. Conclusions The FBI rate in children did not differ during the COVID-19 period compared to that in the pre-COVID-19 period. The occurrence of FBI in boys, the number of foreign bodies located in the post-pyloric region, and the number of hospitalizations due to FBI increased during the COVID-19 period.
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Affiliation(s)
- Suk Jin Hong
- Department of Pediatrics, School of Medicine, Daegu Catholic University, Daegu, Korea
| | - Changho Kim
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Dong Won Lee
- Department of Pediatrics, Daegu Fatima Hospital, Daegu, Korea
| | - Hyo Jeong Jang
- Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea
| | - Seung Man Cho
- Department of Pediatrics, Dongguk University School of Medicine, Gyeongju, Korea
| | - Kwang Hae Choi
- Department of Pediatrics, Yeungnam University School of Medicine, Yeungnam University Hospital, Daegu, Korea
| | - Jun Hyun Hwang
- Department of Preventive Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Jae Young Choe
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
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Park JH, Park KK, Choe JY, Jang KM. Identification of sphingosine 1-phosphate level and MAPK/ERK signaling in pancreatic β cells. Ann Pediatr Endocrinol Metab 2021; 26:252-258. [PMID: 34015900 PMCID: PMC8749023 DOI: 10.6065/apem.2040266.133] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 03/11/2021] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Sphingosine kinase is a lipid kinase that phosphorylates sphingosine to generate sphingosine 1-phosphate (S1P). S1P regulates pancreatic islet β-cell endoplasmic reticulum stress and proliferation. Type 1 and type 2 diabetes share some key pathogenic processes. In this study, we investigated whether secretion of insulin and production of S1P is altered in alloxan and glucose-treated cells from the rat pancreatic β-cell line RIN-5F. METHODS RIN-5F cells were treated with 2 mM alloxan and 20 mM glucose for 6 hours or 24 hours before being evaluated by enzyme linked immunosorbent assay (ELISA) and Western blotting. RESULTS Insulin secretion and expression was higher in RIN-5F cells treated with glucose compared to control cells. In contrast, alloxan treatment did not affect insulin secretion and expression in RIN-5F cells. Interestingly, compared with normal control levels, S1P/EDG-5 was increased in both alloxan and glucose-treated pancreatic β cell than normal control. Mitogen-activated protein kinase/extracellular signal-regulated kinase (MAPK/ERK) inhibition strongly decreased the expression of insulin and S1P in glucose- or alloxan-treated RIN-5F cells. CONCLUSION We observe that production of S1P is increased in both diabetic cell models. In addition, MAPK/ERK signaling regulates secretion of insulin and S1P expression in pancreatic β-cells. Based on the literature and our findings, S1P may be a promising agent for the treatment of insulin-related disorders.
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Affiliation(s)
- Ji Hyun Park
- Department of Pathology, College of Medicine, Catholic University of Daegu, Daegu, Korea
| | - Kwan Kyu Park
- Department of Pathology, College of Medicine, Catholic University of Daegu, Daegu, Korea
| | - Jae Young Choe
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Kyung Mi Jang
- Department of Pediatrics, College of Medicine, Yeungnam University, Daegu, Korea,Address for correspondence: Kyung Mi Jang Department of Pediatrics, College of Medicine, Yeungnam University, Hyeonchung-ro, Nam-gu, Daegu 42415, Korea
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3
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Lee MJ, Shin TY, Lee CH, Moon JD, Roh SG, Kim CW, Park HE, Woo SH, Lee SJ, Shin SL, Oh YT, Lim YS, Choe JY, Na SH, Hwang SO. 2020 Korean Guidelines for Cardiopulmonary Resuscitation. Part 9. Education and system implementation for enhanced chain of survival. Clin Exp Emerg Med 2021; 8:S116-S124. [PMID: 34034453 PMCID: PMC8171173 DOI: 10.15441/ceem.21.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 03/28/2021] [Indexed: 02/07/2023] Open
Affiliation(s)
- Mi Jin Lee
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Tae-Yong Shin
- Department of Emergency Medicine, Asan Chungmu General Hospital, Asan, Korea
| | - Chang Hee Lee
- Department of Emergency Medical Technician, Namseoul University, Cheonan, Korea
| | - Jun Dong Moon
- Department of Emergency Medical Service, College of Health & Nursing, Kongju National University, Gongju, Korea
| | - Sang Gyun Roh
- Department of Emergency Medical Services, Sun Moon University, Asan, Korea
| | - Chan Woong Kim
- Department of Emergency Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Hyo Eun Park
- Division of Cardiology, Department of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
| | - Seon Hee Woo
- Department of Emergency Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Seung Joon Lee
- National Medical Emergency Center, National Medical Center, Seoul, Korea
| | - Seung Lyul Shin
- Department of Emergency Medicine, Inha University College of Medicine, Incheon, Korea
| | - Young Taeck Oh
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Yong Su Lim
- Department of Emergency Medicine, Gachon University College of Medicine, Incheon, Korea
| | - Jae Young Choe
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Sang-Hoon Na
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sung Oh Hwang
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
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4
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Lim D, Kim JK, Kim YJ, Cho YJ, Cho JW, Park J, Choe JY, Choe BH. Factors affecting successful esophageal foreign body removal using a Foley catheter in pediatric patients. Clin Exp Emerg Med 2021; 8:30-36. [PMID: 33845520 PMCID: PMC8041577 DOI: 10.15441/ceem.20.070] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 10/12/2020] [Indexed: 11/23/2022] Open
Abstract
Objective This study aimed to determine the factors that affect successful esophageal foreign body (FB) removal using a Foley catheter and to identify methods to increase the success rate. Methods In this retrospective, cross-sectional study, we included pediatric patients who presented with esophageal FB impaction that was removed using a Foley catheter in the emergency departments of tertiary care and academic hospitals. We analyzed the effect of the patients’ age, sex, and symptoms; FB type, size, and location; Foley catheter size; complications during FB removal; duration between FB ingestion and removal; operator’s years of training; sedation; success rate of FB removal; endoscopy; and patient’s posture during FB removal on the success of Foley catheter-based FB removal. Results Of the 43 patients we enrolled, Foley catheter-based FB removal was successful in 81.4% (35/43) but failed in 18.6% (8/43) of patients; no FB-removal-related complications were reported. There was no significant association between the success rate of Foley catheter-based FB removal and any study variable. A higher number of years in training tended to increase the success rate of Foley catheter-based FB removal, although statistical significance was not achieved. Conclusion Children’s esophageal FB removal is a practical challenge in the emergency rooms, and using a Foley catheter is associated with a high success rate of the removal and low occurrence of complications. In this study, no single variable was found correlated with the success rate of Foley catheter-based esophageal FB removal in pediatric patients, which may indicate multiple variables interacting with one another to affect the success rate.
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Affiliation(s)
- Donghoon Lim
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jong Kun Kim
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Yun Jeong Kim
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Yeon Joo Cho
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jae Wan Cho
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jungbae Park
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jae Young Choe
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Byung-Ho Choe
- Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
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Kim CH, Hahm MH, Lee DE, Choe JY, Ahn JY, Park SY, Lee SH, Kwak Y, Yoon SY, Kim KH, Kim M, Chang SH, Son J, Cho J, Park KS, Kim JK. Clinical usefulness of deep learning-based automated segmentation in intracranial hemorrhage. Technol Health Care 2021; 29:881-895. [PMID: 33682736 DOI: 10.3233/thc-202533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Doctors with various specializations and experience order brain computed tomography (CT) to rule out intracranial hemorrhage (ICH). Advanced artificial intelligence (AI) can discriminate subtypes of ICH with high accuracy. OBJECTIVE The purpose of this study was to investigate the clinical usefulness of AI in ICH detection for doctors across a variety of specialties and backgrounds. METHODS A total of 5702 patients' brain CTs were used to develop a cascaded deep-learning-based automated segmentation algorithm (CDLA). A total of 38 doctors were recruited for testing and categorized into nine groups. Diagnostic time and accuracy were evaluated for doctors with and without assistance from the CDLA. RESULTS The CDLA in the validation set for differential diagnoses among a negative finding and five subtypes of ICH revealed an AUC of 0.966 (95% CI, 0.955-0.977). Specific doctor groups, such as interns, internal medicine, pediatrics, and emergency junior residents, showed significant improvement with assistance from the CDLA (p= 0.029). However, the CDLA did not show a reduction in the mean diagnostic time. CONCLUSIONS Even though the CDLA may not reduce diagnostic time for ICH detection, unlike our expectation, it can play a role in improving diagnostic accuracy in specific doctor groups.
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Affiliation(s)
- Chang Ho Kim
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.,Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Myong Hun Hahm
- Department of Radiology, School of Medicine, Kyungpook National University, Daegu, Korea.,Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Dong Eun Lee
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jae Young Choe
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jae Yun Ahn
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Sin-Youl Park
- Department of Emergency Medicine College of Medicine, Yeungnam University, Daegu, Korea
| | - Suk Hee Lee
- Department of Emergency Medicine Daegu Catholic University Medical Center, Daegu, Korea
| | - Youngseok Kwak
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Sang-Youl Yoon
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Ki-Hong Kim
- Department of Neurosurgery, School of Medicine of Daegu Catholic University, Daegu, Korea
| | - Myungsoo Kim
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Sung Hyun Chang
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jeongwoo Son
- Department of Emergency Medicine College of Medicine, Yeungnam University, Daegu, Korea
| | | | - Ki-Su Park
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jong Kun Kim
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
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Jang KM, Ahn JY, Choi HJ, Lee S, Kim D, Lee DW, Choe JY. Erratum: Correction of Text in the Article "Pediatric Emergency Department Utilization and Coronavirus Disease in Daegu, Korea". J Korean Med Sci 2021; 36:e32. [PMID: 33463099 PMCID: PMC7813585 DOI: 10.3346/jkms.2021.36.e32] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 01/11/2021] [Indexed: 11/20/2022] Open
Abstract
This corrects the article on p. e11 in vol. 36, PMID: 33398945.
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Affiliation(s)
- Kyung Mi Jang
- Department of Pediatrics, Yeungnam University School of Medicine, Yeungnam University Hospital, Daegu, Korea
| | - Ji Young Ahn
- Department of Pediatrics, Yeungnam University School of Medicine, Yeungnam University Hospital, Daegu, Korea
| | - Hee Joung Choi
- Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea
| | - Sukhee Lee
- Department of Emergency Medicine, School of Medicine, Daegu Catholic University, Daegu, Korea
| | - Dongsub Kim
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Dong Won Lee
- Department of Pediatrics, Daegu Fatima Hospital, Korea
| | - Jae Young Choe
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.
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Jang KM, Ahn JY, Choi HJ, Lee S, Kim D, Lee DW, Choe JY. Pediatric Emergency Department Utilization and Coronavirus Disease in Daegu, Korea. J Korean Med Sci 2021; 36:e11. [PMID: 33398945 PMCID: PMC7781850 DOI: 10.3346/jkms.2021.36.e11] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 12/13/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Limited data exist on children's utilization of the emergency department (ED) in the ongoing coronavirus disease 2019 (COVID-19) pandemic. Thus, we aimed to examine ED utilization among pediatric patients and the impact of COVID-19 in one large city affected by the outbreak. METHODS This retrospective study included data from six EDs in Daegu, Korea. We compared the demographic and clinical data of patients presenting to the ED during the COVID-19 pandemic (February 1st-June 30th 2020) with those of patients who visited the ED in this period during 2018 and 2019. RESULTS Fewer patients, particularly children visited the EDs during the study period in 2020 than those in the previous (2018/2019) year period: the number of adult patient decreased by 46.4% and children by 76.9%. Although the number of patients increased from the lowest point of the decrease in March 2020, the number of pediatric patients visiting the ED remained less than half (45.2%) in June 2020 compared with that of previous years. The proportion of patients with severe conditions increased in adults, infants, and school-aged children, and consequently resulted in increased ambulance use and higher hospitalization rates. Fewer infants and young children but more school-aged children visited the ED with febrile illnesses in 2020 than in 2018/2019. CONCLUSION The COVID-19 pandemic has led to a substantial decrease in pediatric ED utilization. These findings can help reallocate human and material resources in the EDs during infectious disease outbreaks.
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Affiliation(s)
- Kyung Mi Jang
- Department of Pediatrics, Yeungnam University School of Medicine, Yeungnam University Hospital, Daegu, Korea
| | - Ji Young Ahn
- Department of Pediatrics, Yeungnam University School of Medicine, Yeungnam University Hospital, Daegu, Korea
| | - Hee Joung Choi
- Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea
| | - Sukhee Lee
- Department of Emergency Medicine, School of Medicine, Daegu Catholic University, Daegu, Korea
| | - Dongsub Kim
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Dong Won Lee
- Department of Pediatrics, Daegu Fatima Hospital, Korea
| | - Jae Young Choe
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.
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Kim HA, Kwon JE, Ahn JY, Choe JY, Kim DS, Park SH, Hyun MC, Choi BS. Analysis of PC 20-FEF 25%–75% and ΔFVC in the methacholine bronchial provocation test. Allergy Asthma Respir Dis 2021. [DOI: 10.4168/aard.2021.9.3.141] [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: 11/20/2022]
Affiliation(s)
- Hyeon A Kim
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jung Eun Kwon
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Ji Young Ahn
- Department of Pediatrics, Yeungnam University College of Medicine, Daegu, Korea
| | - Jae Young Choe
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Dong Sub Kim
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Sook Hyun Park
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Myung Chul Hyun
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Bong Seok Choi
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
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Choe JY, Choi S, Song KH, Jang HJ, Choi KH, Yi DY, Hong SJ, Hwang JH, Cho SM, Kim YJ, Choe BH, Kang B. Incidence and Prevalence Trends of Pediatric Inflammatory Bowel Disease in the Daegu-Kyungpook Province From 2017 to 2020. Front Pediatr 2021; 9:810173. [PMID: 35059365 PMCID: PMC8764442 DOI: 10.3389/fped.2021.810173] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 11/06/2021] [Accepted: 12/13/2021] [Indexed: 12/30/2022] Open
Abstract
Background and Aim: There is paucity of data regarding the epidemiology of pediatric IBD in Asia compared to that of Western countries. We aimed to investigate the incidence and prevalence trends of pediatric inflammatory bowel disease (IBD) in the Daegu-Kyungpook province of South Korea from 2017 to 2020. Methods: This study was a multicenter, retrospective study conducted in eight IBD referral centers located in the Daegu-Kyungpook province. Children and adolescents of ≤18 years who were initially diagnosed with IBD between 2017 and 2020 were included. The annual number of children and adolescents newly diagnosed with IBD and the annual resident population of children and adolescents ≤18 years of age in the Daegu-Kyungpook province were investigated to calculate the annual incidence and prevalence in the region. Results: A total 304 children and adolescents that had been diagnosed with IBD were included in this study. Among these patients, 71.4% had been diagnosed with Crohn's disease (CD), and 28.6% with ulcerative colitis (UC). The population based annual incidences of IBD from 2017 to 2020 were each 7.24, 6.82, 10.27, and 13.33 per 100,000, respectively (P for trend <0.001), 4.48, 5.26, 7.39, and 9.8 per 100,000, respectively, for CD (P for trend <0.001), and 2.76, 1.56, 2.88, and 3.53 per 100,000, respectively, for UC (P for trend = 0.174). Conclusion: Pediatric IBD, especially CD has significantly increased recently in the Daegu-Kyungpook province. Epidemiology studies from other regions of Asia are required to better elucidate this trend of increase in Asia.
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Affiliation(s)
- Jae Young Choe
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, South Korea.,Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Sujin Choi
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Ki Hwan Song
- Department of Surgery, Goo Hospital, Daegu, South Korea
| | - Hyo-Jeong Jang
- Department of Pediatrics, Keimyung University School of Medicine, Daegu, South Korea
| | - Kwang-Hae Choi
- Department of Pediatrics, Yeungnam University School of Medicine, Daegu, South Korea
| | - Dae Yong Yi
- Department of Pediatrics, College of Medicine, Chung-Ang University, Seoul, South Korea
| | - Suk Jin Hong
- Department of Pediatrics, Daegu Catholic University School of Medicine, Daegu, South Korea
| | - Jun Hyun Hwang
- Department of Preventive Medicine, Daegu Catholic University School of Medicine, Daegu, South Korea
| | - Seung-Man Cho
- Department of Pediatrics, Dongguk University School of Medicine, Gyeongju, South Korea
| | - Young Jin Kim
- Department of Pediatrics, Daegu Fatima Hospital, Daegu, South Korea
| | - Byung-Ho Choe
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Ben Kang
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, South Korea
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Kim C, Kim JK, Yeo IH, Choe JY, Lee JE, Kang SJ, Park CS, Kwon KT, Hwang S. Appendectomy in patient with suspected COVID-19 with negative COVID-19 results: A case report. World J Clin Cases 2020; 8:1944-1949. [PMID: 32518785 PMCID: PMC7262723 DOI: 10.12998/wjcc.v8.i10.1944] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 04/30/2020] [Accepted: 05/16/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Even at present, we are in the middle of the novel coronavirus disease 2019 (COVID-19) pandemic and are facing challenges in trial and error. Presently, emergency surgery for patients with suspected COVID-19 is burdensome not only for patients but also for healthcare workers. Therefore, we established a surveillance system in the emergency room and established principles for managing patients suspected of COVID-19 who require emergency surgery.
CASE SUMMARY A 67-year-old man was diagnosed with appendicitis in March 2020. His wife was diagnosed with COVID-19 10 d earlier, and the patient was in close contact with her. The patient tested negative twice on an upper respiratory COVID-19 reverse transcription–polymerase chain reaction screening test, but chest X-ray and chest computed tomography revealed patchy ground-glass opacity in both upper lobes of the patient’s lungs. The same emergency surgery procedure for patients with confirmed COVID-19 was applied to this patient suspected of having the disease to ensure that surgery was not delayed while waiting for the reverse transcription–polymerase chain reaction results. A few hours after surgery, the upper respiratory tract specimen taken in the emergency room was negative for COVID-19 but the lower respiratory tract specimen was found to be positive for the disease.
CONCLUSION When COVID-19 is suspected, emergency surgery should be performed as for confirmed COVID-19 without delay.
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Affiliation(s)
- Changho Kim
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu 41944, South Korea
| | - Jong Kun Kim
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu 41944, South Korea
| | - In Hwan Yeo
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu 41944, South Korea
| | - Jae Young Choe
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu 41944, South Korea
| | - Jeong Eun Lee
- Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu 41944, South Korea
| | - So Jeong Kang
- Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu 41944, South Korea
| | - Chan Sub Park
- Department of Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu 41944, South Korea
| | - Ki Tae Kwon
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea; Department of Infection Control, Kyungpook National University Chilgok Hospital, Daegu 41944, South Korea
| | - Soyoon Hwang
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea; Department of Infection Control, Kyungpook National University Chilgok Hospital, Daegu 41944, South Korea
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11
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Park BG, Kim H, Kwon JE, Kim DS, Choe JY, Ahn JY, Choi BS. Correlations of induced sputum eosinophils with blood allergic markers in pediatric asthma and eosinophilic bronchitis. Allergy Asthma Respir Dis 2020. [DOI: 10.4168/aard.2020.8.4.220] [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: 11/20/2022]
Affiliation(s)
- Bae Gyun Park
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hyeona Kim
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jung Eun Kwon
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Dong Sub Kim
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jae Young Choe
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Ji Young Ahn
- Department of Pediatrics, Yeungnam University College of Medicine, Daegu, Korea
| | - Bong Seok Choi
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
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12
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Kang B, Kim JE, Jung JH, Choe JY, Kim MJ, Choe YH, Kim S, Koh H, Lee YM, Lee JH, Lee Y, Lee JH, Lee HJ, Jang HJ, Choi Y, Choi SY, Kim JY, Choe BH. Korean Children and Adolescents with Crohn's Disease Are More Likely to Present with Perianal Fistulizing Disease at Diagnosis Compared to Their European Counterparts. Pediatr Gastroenterol Hepatol Nutr 2020; 23:49-62. [PMID: 31988875 PMCID: PMC6966217 DOI: 10.5223/pghn.2020.23.1.49] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 12/19/2019] [Accepted: 12/26/2019] [Indexed: 12/11/2022] Open
Abstract
PURPOSE We aimed to investigate the disease phenotype of Korean pediatric Crohn's disease (CD) patients at diagnosis according to the Paris classification by comparison with patients from the European multicenter 5-years recruitment of children with newly developed IBD (EUROKIDS registry). METHODS Korean children and adolescents who had been newly diagnosed with CD at the age of <18 years during 2013-2016 were included in this multicenter retrospective study. Disease phenotype at diagnosis was classified according to the Paris classification, and compared with the published data from the EUROKIDS study. RESULTS A total of 255 patients were included. The median diagnosis age was 14.7 years (range, 0.8-17.9 years). No significant difference was observed in male-to-female ratio with EUROKIDS (1.9:1 vs. 1.45:1, p=0.062). The proportion of children aged <10 years was significantly lower in Koreans (7.1% vs. 19.6%, p<0.001). Colonic disease was less prominent (10.0% vs. 27.3%, p<0.001), while upper GI involvement was more prominent in Korean children (59.3% vs. 46.2%, p<0.001). The proportion with perianal fistulizing disease at diagnosis was significantly higher in Korean patients (44.8% vs. 8.2%, p<0.001). A separate analysis of Korean patients revealed that perianal fistulizing disease at diagnosis was positively associated with male sex and body mass index z-score (odds ratio [OR]=2.12, 95% confidence interval [CI]=1.20-3.76, p=0.010; and OR=1.29, 95% CI=1.05-1.58, p=0.015, respectively). CONCLUSION Approximately half of pediatric CD patients in Korea present with perianal fistulas and/or abscesses at diagnosis, which is a distinct feature of CD in Korean children and adolescents compared to their European counterparts. An underlying genetic difference between ethnicities may play a role in this expression of different phenotypes in pediatric CD.
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Affiliation(s)
- Ben Kang
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea.,Crohn's and Colitis Association in Daegu-Gyeongbuk (CCAiD), Daegu, Korea
| | - Jung Eun Kim
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea.,Crohn's and Colitis Association in Daegu-Gyeongbuk (CCAiD), Daegu, Korea
| | - Jae Hun Jung
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jae Young Choe
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Mi Jin Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yon Ho Choe
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seung Kim
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hong Koh
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yoo Min Lee
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Jee Hyun Lee
- Department of Pediatrics, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Yoon Lee
- Department of Pediatrics, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Ji-Hyuk Lee
- Department of Pediatrics, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Hae Jeong Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Hyo-Jeong Jang
- Crohn's and Colitis Association in Daegu-Gyeongbuk (CCAiD), Daegu, Korea.,Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea
| | - Youjin Choi
- Department of Pediatrics, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - So Yoon Choi
- Department of Pediatrics, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Ju Young Kim
- Department of Pediatrics, Eulji University School of Medicine, Daejeon, Korea
| | - Byung-Ho Choe
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea.,Crohn's and Colitis Association in Daegu-Gyeongbuk (CCAiD), Daegu, Korea
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13
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Choe JY, Jang KM, Min SY, Hwang SK, Kang B, Choe BH. Propionic Acidemia with Novel Mutation Presenting as Recurrent Pancreatitis in a Child. J Korean Med Sci 2019; 34:e303. [PMID: 31808324 PMCID: PMC6900407 DOI: 10.3346/jkms.2019.34.e303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 08/05/2019] [Accepted: 11/01/2019] [Indexed: 12/27/2022] Open
Abstract
Propionic acidemia (PA) is a rare organic acidemia resulting from a deficiency of the mitochondrial enzyme propionyl-coenzyme A carboxylase. Most cases are diagnosed after the detection of metabolic abnormalities-such as hyperammonemia, metabolic acidosis, and ketosis-associated with complaints of vomiting, feeding difficulties, and hypotonia during the neonatal period. However, in rare late-onset cases, mild or vague symptoms make the diagnosis more challenging. Even though acute pancreatitis is relatively uncommon in children, it can occur in association with PA. We present the case of a 4-year-old child who was admitted owing to the complaint of recurrent pancreatitis and had not previously been diagnosed with having metabolic disease. During inpatient treatment for acute pancreatitis, convulsions occurred with concomitant hyperammonemia, metabolic acidosis, coagulopathy, and shock 1 week after the administration of total parenteral nutrition. He was diagnosed to have PA after a metabolic work-up and confirmed to have novel mutation by molecular genetic analysis. Because children with PA may have acute pancreatitis, although rare, vomiting and abdominal pain should raise a suspicion of acute pancreatitis. On the contrary, even among children who have never been diagnosed with a metabolic disease, if a child has recurrent pancreatitis, metabolic pancreatitis caused by organic acidemia should be considered.
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Affiliation(s)
- Jae Young Choe
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Kyung Mi Jang
- Department of Pediatrics, Yeungnam University College of Medicine, Yeungnam University Hospital, Daegu, Korea
| | - So Yoon Min
- Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Su Kyeong Hwang
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Ben Kang
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Byung Ho Choe
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea.
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Kim JK, Lee YM, Lee SD, Lee DE, Choe JY, Kim YJ, Seo KS, Park J, Han HS. A simple blood preparation method for nucleic acid amplification tests using membranes. Technol Health Care 2019; 27:651-659. [PMID: 31594267 DOI: 10.3233/thc-191715] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND To detect most of bloodborne pathogens, serum must be separated from whole blood for efficient nucleic acid amplification. Centrifugation is the most commonly used preparation step for whole blood, but it is not easy to use a centrifuge in rural areas where electricity is not accessible. OBJECTIVE This study aimed to develop a simple method for obtaining serum suitable for nucleic acid amplification without the use of any instruments. METHODS Whole blood spiked with Escherichia coli (E. coli) was separated into serum and cellular fraction using 2 closely attached membranes with different characteristics. After brief heating, bacterial DNA in the serum was used for polymerase chain reaction (PCR). RESULTS Serum was successfully separated from cellular fraction after filtration of one membrane sheet. Membrane sheet containing serum was heated and bacterial DNA in the serum was used for PCR. The quality and concentration of DNA in the heated serum was sufficient for PCR and amplified E. coli gene products were observed. CONCLUSIONS Separation of bacteria-containing serum was feasible using two membrane sheets and the DNA isolated from serum can be used for PCR after brief heating.
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Affiliation(s)
- Jong Kun Kim
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Young Mi Lee
- Departments of Physiology, Molecular Diagnostics and Imaging Center, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Seon Duk Lee
- Departments of Physiology, Molecular Diagnostics and Imaging Center, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Dong Eun Lee
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jae Young Choe
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Yun Jeong Kim
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Kang Suk Seo
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jungbae Park
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hyung Soo Han
- Departments of Physiology, Molecular Diagnostics and Imaging Center, School of Medicine, Kyungpook National University, Daegu, Korea
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15
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Choe JY, Choe BH. Foreign Body Removal in Children Using Foley Catheter or Magnet Tube from Gastrointestinal Tract. Pediatr Gastroenterol Hepatol Nutr 2019; 22:132-141. [PMID: 30899689 PMCID: PMC6416381 DOI: 10.5223/pghn.2019.22.2.132] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 09/05/2018] [Revised: 10/31/2018] [Accepted: 11/04/2018] [Indexed: 12/12/2022] Open
Abstract
Foreign body (FB) ingestion of children is a common pediatric emergency requiring medical attention. Pediatric emergency physicians and gastroenterologists often encounter nervous and distressed situations, because of children presenting with this condition in the common clinical practice. When determining the appropriate timing and indications for intervention, physicians should consider multiple patient- and FB-related factors. The utilization of a flexible endoscopy is considered safe and effective to use in these cases, with a high success rate, for the effective extraction of FBs from the gastrointestinal tract of a child. Additionally, a Foley catheter and a magnet-attached Levin tube have been used for decades in the case of FB removal. Although their use has decreased significantly in recent times, these instruments continue to be used for several indications. Using a Foley catheter for this purpose does not require special training and does not necessarily require sedation of the patient or fluoroscopy, which serve as advantages of utilizing this method for foreign object retrieval. An ingested magnet or iron-containing FB can be retrieved using a magnet-attached tube, and can be effective to retrieve an object from any section of the upper gastrointestinal tract that can be reached. Simple and inexpensive devices such as Foley catheters and magnet-attached tubes can be used in emergencies such as with the esophageal impaction of disk batteries if endoscopy cannot be performed immediately (e.g., in rural areas and/or in patients presenting at midnight in a facility, especially in those without access to endoscopes or emergency services, or in any situation that warrants urgent removal of a foreign object).
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Affiliation(s)
- Jae Young Choe
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Byung-Ho Choe
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
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16
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Choi SY, Kang B, Choe JY, Lee Y, Jang HJ, Park HD, Lee SK, Choe YH. A Case of Glycogen Storage Disease IV with Rare Homozygous Mutations in the Glycogen Branching Enzyme Gene. Pediatr Gastroenterol Hepatol Nutr 2018; 21:365-368. [PMID: 30345254 PMCID: PMC6182483 DOI: 10.5223/pghn.2018.21.4.365] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 01/09/2018] [Revised: 03/13/2018] [Accepted: 03/17/2018] [Indexed: 11/14/2022] Open
Abstract
Glycogen storage disease (GSD) IV is a rare autosomal recessive inherited disorder caused by mutations in the gene coding for glycogen branching enzyme leading to progressive liver disease. GSD IV is associated with mutations in GBE1, which encodes the glycogen branching enzyme. We report a case of GSD IV with rare homozygous mutations in the GBE1 gene (c.791G>A (p.Gly264Glu), which was successfully treated by liver transplantation.
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Affiliation(s)
- So Yoon Choi
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Pediatrics, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Ben Kang
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jae Young Choe
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Yoon Lee
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Hyo Jeong Jang
- Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea
| | - Hyung-Doo Park
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Suk-Koo Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yon Ho Choe
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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17
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Lee DE, Lee H, Lee SD, Han HS, Choe JY, Yun S, Park HJ, Park J, Kim JK. Comparison of different methods of RNA preparation from peripheral blood for nucleic acid amplification assay. Indian J Med Microbiol 2018; 36:77-80. [PMID: 29735831 DOI: 10.4103/ijmm.ijmm_18_104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Nucleic acid amplification assays (NAAs), such as polymerase chain reaction or loop-mediated isothermal amplification (LAMP), are used for disease diagnosis. Current nucleic acid isolation kits require several hours for completion of protocol including the complicated handling steps. Objective In this study, a simple and cost-effective nucleic acid preparation method was developed, and its performance was compared with those of commercial kits. Materials and Methods RNA was prepared using our method and three commercial RNA isolation kits. The RNA quantity and quality were evaluated using the NanoDrop spectrophotometer and Agilent 2100 bioanalyser. Reverse transcription LAMP (RT-LAMP) reactions were performed to determine the usability of the RNA preparation methods. Results The concentrations of RNA extracted from blood samples by four different methods were sufficient for use in NAAs. The RNA integrity number was> 7.0 when RNA was isolated using other RNA isolation kits but lower when prepared using our method. The RT-LAMP reaction was successfully performed when RNA was prepared using any of the methods. Conclusions These results demonstrate that despite the lower purity and integrity of RNA, our RNA preparation protocol is simple and rapid and shows reasonable performance in RT-LAMP.
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Affiliation(s)
- Dong Eun Lee
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Hanna Lee
- Department of Physiology, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Seon Duk Lee
- Department of Physiology, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Hyung Soo Han
- Department of Physiology, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Jae Young Choe
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Sora Yun
- Mmonitor Inc., Daegu, South Korea
| | | | - Jungbae Park
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Jong Kun Kim
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
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18
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Choe JY, Han HS, Lee SD, Lee H, Lee DE, Ahn JY, Ryoo HW, Seo KS, Kim JK. A comparative study of three different gene expression analysis methods. Technol Health Care 2018; 25:1073-1080. [PMID: 28854526 DOI: 10.3233/thc-170967] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND TNF-α regulates immune cells and acts as an endogenous pyrogen. Reverse transcription polymerase chain reaction (RT-PCR) is one of the most commonly used methods for gene expression analysis. Among the alternatives to PCR, loop-mediated isothermal amplification (LAMP) shows good potential in terms of specificity and sensitivity. OBJECTIVE However, few studies have compared RT-PCR and LAMP for human gene expression analysis. Therefore, in the present study, we compared one-step RT-PCR, two-step RT-LAMP and one-step RT-LAMP for human gene expression analysis. METHODS We compared three gene expression analysis methods using the human TNF-α gene as a biomarker from peripheral blood cells. Total RNA from the three selected febrile patients were subjected to the three different methods of gene expression analysis. RESULTS In the comparison of three gene expression analysis methods, the detection limit of both one-step RT-PCR and one-step RT-LAMP were the same, while that of two-step RT-LAMP was inferior. One-step RT-LAMP takes less time, and the experimental result is easy to determine. CONCLUSIONS One-step RT-LAMP is a potentially useful and complementary tool that is fast and reasonably sensitive. In addition, one-step RT-LAMP could be useful in environments lacking specialized equipment or expertise.
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Affiliation(s)
- Jae Young Choe
- Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
| | - Hyung Soo Han
- Department of Physiology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Seon Duk Lee
- Department of Physiology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Hanna Lee
- Department of Physiology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Dong Eun Lee
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jae Yun Ahn
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Hyun Wook Ryoo
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Kang Suk Seo
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jong Kun Kim
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
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Shin J, Kim YJ, Kim JK, Lee DE, Moon S, Choe JY, Lee WK, Lee HM, Cho KH. Probability of Early Retirement Among Emergency Physicians. J Prev Med Public Health 2018; 51:154-162. [PMID: 29886711 PMCID: PMC5996188 DOI: 10.3961/jpmph.18.079] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 05/17/2018] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Early retirement occurs when one's job satisfaction suffers due to employment mismatch resulting from factors such as inadequate compensation. Medical doctors report high levels of job stress and burnout relative to other professionals. These levels are highest among emergency physicians (EPs), and despite general improvements in their working conditions, early retirement continues to become more common in this population. The purpose of this study was to identify the factors influencing EPs intention to retire early and to develop a probability equation for its prediction. METHODS A secondary analysis of data from the 2015 Korean Society of Emergency Physicians Survey was performed. The variables potentially influencing early retirement were organized into personal characteristics, extrinsic factors, and intrinsic factors. Logistic regression analysis was performed to identify risk factors and to develop a probability equation; these findings were then arranged in a nomogram. RESULTS Of the 377 survey respondents included in the analysis, 48.0% intended to retire early. Risk factors for early retirement included level of satisfaction with the specialty and its outlook, slanderous reviews, emergency room safety, health status, workload intensity, age, and hospital type. Intrinsic factors (i.e., slanderous reviews and satisfaction with the specialty and its outlook) had a stronger influence on early retirement than did extrinsic factors. CONCLUSIONS To promote career longevity among EPs, it is vital to improve emergency room safety and workload intensity, to enhance medical professionalism through a stronger vision of emergency medicine, and to strengthen the patient-doctor relationship.
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Affiliation(s)
- Jaemyeong Shin
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Yun Jeong Kim
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jong Kun Kim
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Dong Eun Lee
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Sungbae Moon
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jae Young Choe
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Won Kee Lee
- Medical Research Collaboration Center in Kyungpook National University Hospital & Kyungpook National University School of Medicine, Daegu, Korea
| | - Hyung Min Lee
- Department of Emergency Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Kwang Hyun Cho
- Department of Emergency Medicine, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
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20
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Lee KJ, Choe BH, Choe JY, Kim JY, Jeong IS, Kim JW, Yang HR, Chang JY, Kim KM, Moon JS, Ko JS. A Multicenter Study of the Antiviral Efficacy of Entecavir Monotherapy Compared to Lamivudine Monotherapy in Children with Nucleos(t)ide-naïve Chronic Hepatitis B. J Korean Med Sci 2018; 33:e63. [PMID: 29441755 PMCID: PMC5809752 DOI: 10.3346/jkms.2018.33.e63] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 09/01/2017] [Accepted: 12/18/2017] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The aim of this study was to compare the long-term efficacy of entecavir (ETV) and lamivudine (LAM) therapy in children with chronic hepatitis B (CHB) who had not received nucleoside analogue treatment. METHODS In this multicenter, retrospective study, we included pediatric CHB patients younger than 20 years who received ETV or LAM treatment for at least 12 months and had no concomitant diseases. All of the patients were followed up every 1 to 3 months. At each visit, the patients underwent clinical evaluation and biochemical testing. RESULTS Eight (53.3%), 14 (93.3%), and 2 (15.4%) of the ETV-treated patients achieved virologic suppression, alanine aminotransferase (ALT) normalization and hepatitis B e antigen (HBeAg) seroconversion, respectively, at 1 year. In the ETV group, the cumulative rate of virologic suppression at 3 years was 91.7%, which was significantly higher than that in the LAM group (P < 0.001). The mean duration of treatment before virologic suppression was shorter in the ETV group than in the LAM group (P = 0.040). The cumulative rate of seroconversion in the ETV group at 3 years was 39.4%, which was not significantly different from that in the LAM group (P = 0.439). The ETV group showed lower cumulate rates of virologic breakthrough (33.3% at 6 years) and genotypic mutation than the LAM group (P = 0.033 and P = 0.011, respectively). CONCLUSION ETV is superior to LAM in pediatric CHB treatment because of its higher virologic suppression rate and lower cumulative rates of virologic breakthrough and genotypic mutation.
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Affiliation(s)
- Kyung Jae Lee
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Byung Ho Choe
- Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jae Young Choe
- Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
| | - Ju Young Kim
- Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - In Sook Jeong
- Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine Seoul, Korea
| | - Ju Whi Kim
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Hye Ran Yang
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Ju Yuong Chang
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung Mo Kim
- Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine Seoul, Korea
| | - Jin Soo Moon
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Sung Ko
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
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Choe JY, Ko JS, Choe BH, Kim JE, Kang B, Lee KJ, Yang HR. Antiviral Efficacy of Tenofovir Monotherapy in Children with Nucleos(t)ide-naive Chronic Hepatitis B. J Korean Med Sci 2018; 33:e11. [PMID: 29215820 PMCID: PMC5729652 DOI: 10.3346/jkms.2018.33.e11] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 08/01/2017] [Accepted: 10/14/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The purpose was to compare the efficacy between tenofovir disoproxil fumarate (TDF) and lamivudine (LMV) in children with nucleos(t)ide-naive chronic hepatitis B (CHB) infection. Patients with CHB were treated with TDF in the immune-reactive phase and compared with a historical control group of patients treated with LMV before the TDF era. METHODS Hepatitis B virus (HBV) DNA titer decrements (> 3 log₁₀ IU/mL) were monitored after treatment initiation. The treatment duration for HBV DNA clearance (< 357 IU/mL) and complete response (HBeAg loss and HBV DNA clearance) were analyzed. The follow-up period was 96 weeks. RESULTS Sixteen patients were treated with TDF and compared with a historical control group of 24 patients treated with LMV. HBV DNA decrement (> 3 log₁₀ IU/mL) was achieved in 100% (16/16) of the TDF group but in only 62.5% (15/24) of the LMV group (P = 0.005) at 48 weeks. The HBV DNA clearance (< 357 IU/mL) in the TDF and LMV groups was, respectively, as follows: 62.5% (10/16) and 25.0% (6/24) at 12 weeks (P = 0.018), 81.3% (13/16) and 37.5% (9/24) at 24 weeks (P = 0.006), 93.8% (15/16) and 50.0% (12/24) at 48 weeks (P = 0.004), and 100% (16/16) and 54.2% (13/24) at 96 weeks (P = 0.001). Complete response occurred in 41.7% (5/12) of HBeAg-positive patients in the TDF group and 28.6% (6/21) of the LMV group at 96 weeks (P = 0.443). CONCLUSION TDF monotherapy for 96 weeks produced a significantly more effective virologic response than LMV monotherapy in children with nucleos(t)ide-naive CHB.
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Affiliation(s)
- Jae Young Choe
- Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jae Sung Ko
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Byung Ho Choe
- Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea.
| | - Jung Eun Kim
- Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
| | - Ben Kang
- Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
| | - Kyung Jae Lee
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Hye Ran Yang
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
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Choe JY, Kim JK, Lee DE, Seo KS, Park JB, Lee MJ, Ryoo HW, Ahn JY, Moon S. Descending necrotizing mediastinitis after a trigger point injection. Clin Exp Emerg Med 2017; 4:182-185. [PMID: 29026893 PMCID: PMC5635456 DOI: 10.15441/ceem.16.197] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 07/07/2017] [Accepted: 07/25/2017] [Indexed: 11/23/2022] Open
Abstract
Descending necrotizing mediastinitis (DNM) is a rare form of mediastinal infection. Most cases are associated with esophageal rupture. DNM after a trigger point injection in the upper trapezius has not been described previously. We present a case of DNM after a trigger point injection in the upper trapezius. A 70-year-old man visited the emergency department with chest discomfort and fever after a trigger point injection in the left upper trapezius. Chest computed tomography showed evidence of DNM, and antibiotic therapy was immediately administered intravenously. Because of the risk of sudden death, poor prognosis due to underlying disease, and his age, he declined surgical treatment and died of septic shock. Although trigger point injections are generally considered safe, caution should be used in patients with an underlying disease or in the elderly. Early diagnosis, broad-spectrum antibiotics, and aggressive surgical management are essential to improve the prognosis.
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Affiliation(s)
- Jae Young Choe
- Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jong Kun Kim
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Dong Eun Lee
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Kang Suk Seo
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jung Bae Park
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Mi Jin Lee
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Hyun Wook Ryoo
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jae Yun Ahn
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Sungbae Moon
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
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Yang A, Kang B, Choe JY, Kim HS, Kim K, Choe YH. Prevalence and Epidemiological Characteristics of Endoscopically Proven Reflux Esophagitis in Children in Korea. Pediatr Gastroenterol Hepatol Nutr 2017; 20:160-166. [PMID: 29026732 PMCID: PMC5636932 DOI: 10.5223/pghn.2017.20.3.160] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 04/03/2017] [Accepted: 05/26/2017] [Indexed: 12/22/2022] Open
Abstract
PURPOSE The prevalence of reflux esophagitis (RE) has increased recently in Korea. Little is known concerning the prevalence and characteristics of RE in pediatric patients. This study investigated the prevalence and influence of risk factors in endoscopically proven RE in Korea in pediatric patients over a period of 14 years. METHODS A retrospective chart review of all patients between the ages of 1 month and 20 years who underwent esophagogastroduodenoscopy at Samsung Medical Center between 2001 and 2014 was carried out. Univariate and multivariate analyses were conducted to identify independent risk factors for RE. RESULTS The prevalence rate of endoscopically proven RE in this study was 28.7% (978/3,413). The prevalence of RE increased from 11.8% from 2001 to 2007 to 37.7% from 2008 to 2014. Multivariate logistic regression analysis revealed that residency in the Greater Gangnam area (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.02-1.44) and age (OR, 1.13; 95% CI, 1.11-1.15) were significant predictive factors for the presence of RE. CONCLUSION The prevalence rate of endoscopically proven pediatric RE has increased over the past 14 years. Residency and older age are more important independent risk factors for pediatric RE in Korea.
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Affiliation(s)
- Aram Yang
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ben Kang
- Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jae Young Choe
- Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
| | - Hye Seung Kim
- Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyunga Kim
- Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yon Ho Choe
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Abstract
Intussusception is rarely observed in adults. Adult cases account for only 5% of all cases of intussusceptions and almost 1%-5% of bowel obstruction cases. The etiology, presentation and management of intussusception in adults are different from those in children. The clinical presentation in adults often includes nonspecific signs and symptoms, thereby complicating differential diagnosis from other causes of abdominal pain. We report a 29-year-old Asian woman who visited our emergency department with complaints of fever associated with epigastric pain since one day. Abdominal computed tomography demonstrated ileocolic intussusception, and laparoscopic small bowel luminal mass resection was performed. Histopathology report confirmed a 3.5 cm × 2.7 cm submucosal lipoma in the terminal ileum. Sufficient vigilance and appropriate investigations are important for prompt diagnosis and surgical referral of patients to enable favorable outcomes. A computed tomography scan can be a helpful modality in establishing a diagnosis.
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Koh JH, Kwok SK, Lee J, Son CN, Kim JM, Kim HO, Park SH, Sung YK, Choe JY, Lee SS, Park SH. Pain, xerostomia, and younger age are major determinants of fatigue in Korean patients with primary Sjögren’s syndrome: a cohort study. Scand J Rheumatol 2016; 46:49-55. [DOI: 10.3109/03009742.2016.1153142] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- JH Koh
- Division of Rheumatology, Department of Internal Medicine, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - SK Kwok
- Division of Rheumatology, Department of Internal Medicine, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - J Lee
- Division of Rheumatology, Department of Internal Medicine, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - CN Son
- Division of Rheumatology, Department of Internal Medicine, Keimyung University Dongsan Medical Centre, Daegu, South Korea
| | - J-M Kim
- Division of Rheumatology, Department of Internal Medicine, Keimyung University Dongsan Medical Centre, Daegu, South Korea
| | - HO Kim
- Division of Rheumatology, Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, South Korea
| | - SH Park
- Division of Rheumatology, Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, South Korea
| | - YK Sung
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea
| | - JY Choe
- Division of Rheumatology, Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, South Korea
| | - SS Lee
- Division of Rheumatology, Department of Internal Medicine, Chonnam National University School of Medicine, Gwangju, South Korea
| | - SH Park
- Division of Rheumatology, Department of Internal Medicine, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Jang KM, Choe BH, Choe JY, Hong SJ, Park HJ, Chu MA, Cho SM, Kim JM. Changing Prevalence of Helicobacter pylori Infections in Korean Children with Recurrent Abdominal Pain. Pediatr Gastroenterol Hepatol Nutr 2015; 18:10-6. [PMID: 25866728 PMCID: PMC4391995 DOI: 10.5223/pghn.2015.18.1.10] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 10/13/2014] [Accepted: 10/21/2014] [Indexed: 11/14/2022] Open
Abstract
PURPOSE The aim of this study is to investigate the changing prevalence rate of Helicobacter pylori infection in children, of different age groups, with recurrent abdominal pain over a 10-year period. METHODS Children with recurrent abdominal pain who visited the pediatric outpatient clinic at university hospital were screened for H. pylori. Children were divided into 3 age categories of 4-5, 6-11, and 12-16 years. To study the changes in the annual prevalence rates of H. pylori infection, the study period was divided into 3 time periods: 2004-2007, 2008-2010, and 2011-2014. Urea breath test was performed for all children aged 4-16 years, with a cut-off value of 4.0‰ for children aged ≥6 years and 7‰ for children aged <6 years. RESULTS A total of 2,530 children (1,191 boys) with a mean age of 10.0±3.0 years (range, 4.0-16.9 years) were included in the study. The total prevalence of H. pylori infection was 7.4% (187/2,530). The prevalence rate of H. pylori infection in children with recurrent abdominal pain was 8.0% (70/873) in 2004-2007, 7.7% (51/666) in 2008-2010, and 6.7% (66/991) in the 2011-2014. Nevertheless, a significant difference was observed in the prevalence rate between children <12 years old and ≥12 years of age (p=0.018). CONCLUSION The prevalence of H. pylori infection in Korean children with recurrent abdominal pain was 7.4%, showing no significant decrease in the last 11 years; however, the prevalence rate in children <12 years old was significantly lower than that in those ≥12 years old.
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Affiliation(s)
- Kyung Mi Jang
- Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
| | - Byung-Ho Choe
- Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jae Young Choe
- Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
| | - Suk Jin Hong
- Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
| | - Hyo Jung Park
- Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
| | - Mi Ae Chu
- Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
| | - Seung Man Cho
- Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jung Mi Kim
- Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
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Lee H, Park SH, Kim SK, Choe JY, Park JS. Pyogenic arthritis, pyoderma gangrenosum, and acne syndrome (PAPA syndrome) with E250K mutation in CD2BP1 gene treated with the tumor necrosis factor inhibitor adalimumab. Clin Exp Rheumatol 2012; 30:452. [PMID: 22513199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Accepted: 11/28/2011] [Indexed: 05/31/2023]
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Choe JY, Youn JC, Park JH, Park IS, Jeong JW, Lee WH, Lee SB, Park YS, Jhoo JH, Lee DY, Kim KW. The Severe Cognitive Impairment Rating Scale--an instrument for the assessment of cognition in moderate to severe dementia patients. Dement Geriatr Cogn Disord 2008; 25:321-8. [PMID: 18319591 DOI: 10.1159/000119124] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2007] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS This study aimed to develop a brief, reliable and valid test for cognitive function of severely demented patients. METHODS We constructed the Severe Cognitive Impairment Rating Scale, which consisted of 11 items covering memory, language, visuospatial function, frontal function and orientation, and investigated its reliability and validity on 267 subjects [normal: 65, very mild Alzheimer's disease (AD): 42, mild AD: 58, moderate AD: 36, severe AD: 44, profound AD: 22]. RESULTS The internal consistency obtained by Cronbach's coefficient alpha was 0.93. The interrater reliability and test-retest reliability in the moderately to severely impaired subjects with an MMSE score of <or=14 was 0.99 (p < 0.001) and 0.90 (p < 0.001), respectively. It showed significant correlation with Severe MMSE (r = 0.96, p < 0.01), MMSE (r = 0.86, p < 0.01) and Clinical Dementia Rating (r = -0.83, p < 0.01). It was robust to both the floor effect in the severe/profound stage of AD and the ceiling effect in the mild/moderate stage of AD. Exploratory factor analysis yielded 2 factors (automatic informational processing and controlled informational processing) accounting for 73.5% of the total variance. CONCLUSIONS The Severe Cognitive Impairment Rating Scale is a valid and reliable test for evaluating the cognitive function of advanced AD patients.
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Affiliation(s)
- J Y Choe
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggido, Korea
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Jeong JW, Kim KW, Lee DY, Lee SB, Park JH, Choi EA, Choe JY, Do YJ, Ryang JS, Roh HA, Park YS, Choi Y, Woo JI. A normative study of the Revised Hasegawa Dementia Scale: comparison of demographic influences between the Revised Hasegawa Dementia Scale and the Mini-Mental Status Examination. Dement Geriatr Cogn Disord 2007; 24:288-93. [PMID: 17717415 DOI: 10.1159/000107592] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/26/2007] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND/AIMS We investigated the demographic influence on the performance of the Revised Hasegawa Dementia Scale (HDS-R) and provided normative data of the HDS-R in the elderly. METHODS The HDS-R was administered to 803 community-dwelling cognitively normal elderly subjects aged 55 years or over. Cognitive disorders and psychiatric disorders were strictly excluded using the CERAD-K assessment packet and the Mini-International Neuropsychiatric Interview. The demographic influence on the performance of the HDS-R was examined using multiple linear regression analyses, and compared with that on the performance of the Mini-Mental Status Examination (MMSE) using the Chow test and t statistics. Overlapping strata were used in developing age-, education- and gender-specific normative data of the HDS-R. RESULTS Age, education, and gender influenced significantly the performance of the HDS-R, and explained 22.5% of the total score variance. Older age, lower education, and male gender were associated with lower performance of the HDS-R. However, the demographic influence on the HDS-R was much weaker than that on the MMSE (t = 5.578, d.f. = 800, p < 0.001). The normative data of the HDS-R stratified by age (60-69, 70-79, > or =80), education (0-6, 7-12, > or =13), and gender were presented. CONCLUSIONS The HDS-R was more robust to demographic influences than the MMSE, and normative data may contribute to improving further its diagnostic accuracy for dementia.
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Affiliation(s)
- J W Jeong
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggi-do, Korea
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Park JH, Lee SB, Lee TJ, Lee DY, Jhoo JH, Youn JC, Choo IH, Choi EA, Jeong JW, Choe JY, Woo JI, Kim KW. Depression in vascular dementia is quantitatively and qualitatively different from depression in Alzheimer's disease. Dement Geriatr Cogn Disord 2007; 23:67-73. [PMID: 17114882 DOI: 10.1159/000097039] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/20/2006] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS To compare the prevalence and characteristics of depression in vascular dementia (VaD) and Alzheimer's disease (AD) after adjusting for dementia severity and gender. METHODS One hundred and eight pairs of VaD and AD patients matched for dementia severity and gender were assessed. RESULTS Major depressive disorder (MDD) was more prevalent in the VaD group than in the AD group (20.4% in VaD, 10.2% in AD, p = 0.04, Cochran-Mantel-Haenszel, CMH, test) regardless of the dementia severity and gender. The odds ratio for developing MDD in the VaD group versus the AD group was estimated to be 2.20 (95% confidence interval = 1.02-4.74). Neurovegetative symptoms such as 'felt tired and weak all the time' (30.6% in VaD, 13.9% in AD, p = 0.003, CMH test) and 'changed weight without trying' (16.7% in VaD, 6.5% in AD, p = 0.02, CMH test) were more prevalent in the VaD group than in the AD group. CONCLUSION Depression in VaD was quantitatively and qualitatively different from that in AD regardless of the severity of dementia and gender; depression was more prevalent, severer and more retarded and vegetative in VaD than in AD.
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Affiliation(s)
- J H Park
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnamsi, Gyeonggido, Korea
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Chang HK, Lee SS, Bai HJ, Lee YW, Yoon BY, Lee CH, Lee YH, Song GG, Chung WT, Lee SW, Choe JY, Kim CG, Chang DK. Validation of the classification criteria commonly used in Korea and a modified set of preliminary criteria for Behçet's disease: a multi-center study. Clin Exp Rheumatol 2004; 22:S21-6. [PMID: 15515778] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
OBJECTIVE Recently we have proposed a modified set of criteria to settle the questions raised regarding the International Study Group (ISG) criteria for Behçet's disease (BD). The aim of the present study was to validate the two pre-existing criteria sets commonly used in Korea, the ISG criteria and the criteria of the Behçet's Disease Research Committee of Japan (Japanese criteria), as well as the proposed modified criteria. METHODS The study population included 155 consecutive patients with BD and 170 controls with non-Behçet's rheumatic diseases. Detailed data for all of the subjects were recorded prospectively by the participating physicians on a standard form that listed the clinical features of BD. The sensitivity, specificity, and accuracy of each set of the criteria were measured. RESULTS Of the three criteria sets employed, the modified criteria were the most accurate, with an accuracy of 96.3%. The ISG criteria often failed to classify the following patients with BD: patients with only oral and genital ulcerations, certain patients with intestinal ulcerations, patients who did not manifest oral ulcerations, and patients with acute disease but fewer than three recurrent oral ulceration relapses in a 1-year period. The Japanese criteria also failed to categorize the following patients with BD: patients with oral and genital ulcerations, and patients with oral ulcerations, skin lesions, and a positive pathergy reaction. In addition, the Japanese criteria misclassified some of the control subjects with non-Behçet's uveitis as having BD. CONCLUSIONS The results of this study suggest that there are some points that need to be reconsidered in the clinical application of the two pre-existing sets of criteria. Although the modified criteria were the most accurate, further validation studies will be required in other ethnic populations.
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Affiliation(s)
- H K Chang
- Division of Rheumatology, Department of Internal Medicine, College of Medicine, Dankook University, 16-5 Anseo-Dong, Cheonan, Chungcheong Nam Do, 330-715, South Korea.
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Joung CI, Lee HS, Lee SW, Kim CG, Song YH, Jun JB, Chung WT, Choe JY, Kim TG, Yoo DH. Association between HLA-DR B1 and clinical features of adult onset Still's disease in Korea. Clin Exp Rheumatol 2003; 21:489-92. [PMID: 12942703] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
OBJECTIVE To determine whether HLA-DR alleles are associated with the development and clinical features of Adult Onset Still's Disease (AOSD) in Korea. METHODS Forty-seven patients (41 women, 6 men, mean age at diagnosis 31.6 yr) meeting Yamaguchi's criteria for AOSD and 144 healthy controls were enrolled in this study. The patients with AOSD were subdivided into groups according to their chronicity: monocyclic systemic, polycyclic systemic, and chronic destructive type, and were furthermore classified as non-articular, oligoarticular or polyarticular types (having arthritis involving 5 or more joints) according to the extent of articular involvement. HLA-DRB1 genotypes were assessed by PCR-SSOP. RESULTS Patients with AOSD had more frequent DRB1*12 (p = 0.028, relative risk (RR) = 2.27, 95% confidence interval (CI): 1.08-4.80) and DRB1*15 (p = 0.013, RR = 2.16, 95% CI: 1.17-4.00). They had less frequent DRB1*04 (p = 0.006, RR = 0.35, 95% CI: 0.16-0.75) compared to controls. DRB1*14 (p = 0.011, RR = 3.80, 95% CI: 1.27-11.31) were associated with the monocyclic systemic type. CONCLUSION Korean AOSD patients had more frequent DRB1*12 and DRB1*15, and less frequent HLA-DRB1*04. The patients with the monocyclic systemic type had more frequent DRB1*14 alleles. This study suggests that Korean AOSD patients have distinct immunogenetic profiles, and that it would be valuable to assess the relationships between HLA-DRB1 genes and polymorphisms of proinflammatory cytokines in the pathogenesis of AOSD.
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Affiliation(s)
- C I Joung
- Division of Rheumatology, Hospital for Rheumatic Diseases, Hanyang University, Seoul, Korea
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Yun HR, Koh HK, Kim SS, Chung WT, Kim DW, Hong KP, Song GG, Chang HK, Choe JY, Bae SC, Salmon JE, Yoo DH, Kim TY, Kim SY. FcgammaRIIa/IIIa polymorphism and its association with clinical manifestations in Korean lupus patients. Lupus 2002; 10:466-72. [PMID: 11480843 DOI: 10.1191/096120301678416015] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The aim of this study was to determine the distribution of the FcgammaRlla and FcgammaRIIIa polymorphisms and their association with clinical manifestations in Korean lupus patients. Three hundred SLE (systemic lupus erythematosus) patients (48 male, 252 female) meeting 1982 ACR criteria and 197 Korean disease-free controls were enrolled. Genotyping for FcgammaRlla 131 R/H and FcgammaRIIIa 176 F/V was performed by PCR of genomic DNA using allele-specific primers and the FcgammaRIIIa genotype was confirmed by direct sequencing of PCR product in some cases. There was significant skewing in the distribution of the three FcgammaRIIa genotypes between the SLE and the controls (P=0.002 for R/R131 vs R/H131 and H/H131, OR 2.5 (95% Cl 1.4-4.5), but not in FcgammaRIIIa genotypes. FcgammaRIIa-R allele was a significant predictor of lupus nephritis, as compared with SLE patients without nephritis (P=0.034 for R131 vs H131, OR 1.4 (95% Cl 1.03-1.9)), but proliferative nephritis (WHO class III and IV) was less common in patients with FcgammaRlla-R/R131 and in FcgammaRIIa-R allele. In 300 SLE patients, high binding allele combination H131/V176 was less common in SLE with nephritis than in SLE without nephritis. Hemolytic anemia was less common in R131/F176 allele combination among four FcgammaRIIa/FcgammaRIIIa allelic combinations. Male SLE patients showed a higher frequency of renal involvement, serositis, thrombocytopenia, malar rash and discoid rash than female SLE, and male SLE had a higher frequency of FcgammaRIIa-R/R131 or R131-allele than male controls, but FcgammaRIIa or FcgammaRIIIa genotypes had no association with renal involvement in male SLE patients. FcgammaRIIa-H/H131 showed a higher frequency of hemolytic anemia and less pulmonary complications in male SLE. Female SLE patients showed higher frequency of any hematologic abnormality, lymphopenia, anticardiolipin antibody (+) and anti-Ro antibody (+) than male SLE, and had earlier onset of first symptoms. There was no skewing in FcgammaRIIa or FcgammaRIIIa genotypes between female SLE and female controls, but FcgammaRIIa-R131 allele showed skewing between female SLE with nephritis and female SLE without nephritis. The age at onset of thrombocytopenia was earlier in FcgammaRIIa R/R131 among three FcgammaRIIa genotypes, and serositis in FcgammaRIIIa-F/F176 among three FcgammaRIIIa genotypes. FcgammaRIIa-R131 homozygote was a major predisposing factor to the development of SLE and FcgammaRIIa-RI31 homozygote and R131 allele were a predisposing factor, and H131/V176 was a protective allele combination in lupus nephritis. In contrast to other ethnic patients, in our study cohort, clinical manifestation was different between male and female, and FcgammaRIIa and FcgammaRIIIa showed somewhat different clinical associations between the genders.
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Affiliation(s)
- H R Yun
- Division of Rheumatology, Hospital for Rheumatic Diseases, Hanyang University, Seoul, Korea
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Iancu CV, Borza T, Choe JY, Fromm HJ, Honzatko RB. Recombinant mouse muscle adenylosuccinate synthetase: overexpression, kinetics, and crystal structure. J Biol Chem 2001; 276:42146-52. [PMID: 11560929 DOI: 10.1074/jbc.m106294200] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Vertebrates possess two isozymes of adenylosuccinate synthetase. The acidic isozyme is similar to the synthetase from bacteria and plants, being involved in the de novo biosynthesis of AMP, whereas the basic isozyme participates in the purine nucleotide cycle. Reported here is the first instance of overexpression and crystal structure determination of a basic isozyme of adenylosuccinate synthetase. The recombinant mouse muscle enzyme purified to homogeneity in milligram quantities exhibits a specific activity comparable with that of the rat muscle enzyme isolated from tissue and K(m) parameters for GTP, IMP, and l-aspartate (12, 45, and 140 microm, respectively) similar to those of the enzyme from Escherichia coli. The mouse muscle and E. coli enzymes have similar polypeptide folds, differing primarily in the conformation of loops, involved in substrate recognition and stabilization of the transition state. Residues 65-68 of the muscle isozyme adopt a conformation not observed in any previous synthetase structure. In its new conformation, segment 65-68 forms intramolecular hydrogen bonds with residues essential for the recognition of IMP and, in fact, sterically excludes IMP from the active site. Observed differences in ligand recognition among adenylosuccinate synthetases may be due in part to conformational variations in the IMP pocket of the ligand-free enzymes.
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Affiliation(s)
- C V Iancu
- Department of Biochemistry, Biophysics, and Molecular Biology, Molecular Biology Building, Iowa State University, Ames, Iowa 5011, USA
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Abstract
Retinal vascular lesions are the most common ophthalmologic manifestation of systemic lupus erythematosus (SLE), occurring in 3% to 29% of cases, generally late in the disease. More rare is the severe vaso-occlusive disease, often termed "retinal vasculitis", which includes central retinal artery occlusion, multifocal arteriolar occlusions, extensive capillary nonperfusion and central venous occlusion. Patients with SLE and raised serum concentrations of anticardiolipin antibodies (ACA) have a higher risk of developing occlusive ocular vascular disease. We report a case in which retinal involvement was an earlier manifestation of SLE in a patient without ACA.
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Affiliation(s)
- Y H Song
- Department of Internal Medicine, Catholic University of Daegu, School of Medicine, Korea
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Abstract
OBJECTIVE Our aim was to assess current demand for care of pelvic floor disorders and create projections for future demand for care. We also sought to better understand the characteristics of women seeking care. STUDY DESIGN Current demand for care was calculated by comparing those women seeking care through the female pelvic floor disorders clinic with those women of the same age range at risk within an integrated health care delivery program. Patients underwent complete urogynecologic evaluation including cystometry. Women seeking care were compared with regard to age, distribution of conditions (pelvic organ prolapse, stress conditions, urge conditions), and probability of undergoing surgery. Modeling the study population by use of data from the US Census Bureau, which projects population changes over the next 30 years, created predictions of future demand. RESULTS Data were available on 2070 consecutive patients with an age range of 30 to 89 years normally distributed around a median age of 61.5 years drawn from an at-risk population of 149,000 women aged 30 to 89 years. Older women generated more consults per 1000 woman years than did the younger cohorts (1.7 vs 18.6 consults per 1000 woman years for those 30-39 years old vs those 70-79 years old; P <.05). Estimates of growth in demand at 30 years indicate a 45% increase in demand while net growth of the same population segment should be 22%. Stress conditions were more common among younger women and urge conditions were more common among older women. Pelvic organ prolapse was equally distributed throughout the age ranges. CONCLUSIONS Over the next 30 years, growth in demand for services to care for female pelvic floor disorders will increase at twice the rate of growth of the same population. Demand for care for pelvic floor disorders comes from a wide age range of women, although mature age groups generate 10 times the number of consults per 1000 woman years as do their younger counterparts. Age plays a major role in the distribution of conditions with which patients present. These findings have broad implications for those responsible for administering programs to care for women, allocating research funds in women's health and geriatrics, and training physicians to meet this rapidly escalating demand.
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Affiliation(s)
- K M Luber
- Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Southern California Permanenete Medical Group, San Diego, USA.
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Nelson SW, Choe JY, Honzatko RB, Fromm HJ. Mutations in the hinge of a dynamic loop broadly influence functional properties of fructose-1,6-bisphosphatase. J Biol Chem 2000; 275:29986-92. [PMID: 10896931 DOI: 10.1074/jbc.m000473200] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Loop 52-72 of porcine fructose-1,6-bisphosphatase may play a central role in the mechanism of catalysis and allosteric inhibition by AMP. The loop pivots between different conformational states about a hinge located at residues 50 and 51. The insertion of proline separately at positions 50 and 51 reduces k(cat) by up to 3-fold, with no effect on the K(m) for fructose 1,6-bisphosphate. The K(a) for Mg(2+) in the Lys(50) --> Pro mutant increases approximately 15-fold, whereas that for the Ala(51) --> Pro mutant is unchanged. Although these mutants retain wild-type binding affinity for AMP and the fluorescent AMP analog 2'(3')-O-(trinitrophenyl)adenosine 5'-monophosphate, the K(i) for AMP increases 8000- and 280-fold in the position 50 and 51 mutants, respectively. In fact, the mutation Lys(50) --> Pro changes the mechanism of AMP inhibition with respect to Mg(2+) from competitive to noncompetitive and abolishes K(+) activation. The K(i) for fructose 2,6-bisphosphate increases approximately 20- and 30-fold in the Lys(50) --> Pro and Ala(51) --> Pro mutants, respectively. Fluorescence from a tryptophan introduced by the mutation of Tyr(57) suggests an altered conformational state for Loop 52-72 due to the proline at position 50. Evidently, the Pro(50) mutant binds AMP with high affinity at the allosteric site, but the mechanism of allosteric regulation of catalysis has been disabled.
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Affiliation(s)
- S W Nelson
- Department of Biochemistry, Biophysics, and Molecular Biology, Iowa State University, Ames, Iowa 50011, USA
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Nelson SW, Iancu CV, Choe JY, Honzatko RB, Fromm HJ. Tryptophan fluorescence reveals the conformational state of a dynamic loop in recombinant porcine fructose-1,6-bisphosphatase. Biochemistry 2000; 39:11100-6. [PMID: 10998248 DOI: 10.1021/bi000609c] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Wild-type porcine fructose-1,6-bisphosphatase (FBPase) has no tryptophan residues. Hence, the mutation of Try57 to tryptophan places a unique fluorescent probe in the structural element (loop 52-72) putatively responsible for allosteric regulation of catalysis. On the basis of steady-state kinetics, circular dichroism spectroscopy, and X-ray crystallography, the mutation has little effect on the functional and structural properties of the enzyme. Fluorescence intensity from the Trp57 mutant is maximal in the presence of divalent cations, fructose 6-phosphate and orthophosphate, which together stabilize an R-state conformation in which loop 52-72 is engaged with the active site. The level of fluorescence emission decreases monotonically with increasing levels of AMP, an allosteric inhibitor, which promotes the T-state, disengaged-loop conformation. The titration of various metal-product complexes of the Trp57 mutant with fructose 2,6-bisphosphate (F26P(2)) causes similar decreases in fluorescence, suggesting that F26P(2) and AMP individually induce similar conformational states in FBPase. Fluorescence spectra, however, are sensitive to the type of divalent cation (Zn(2+), Mn(2+), or Mg(2+)) and suggest conformations in addition to the R-state, loop-engaged and T-state, loop-disengaged forms of FBPase. The work presented here demonstrates the utility of fluorescence spectroscopy in probing the conformational dynamics of FBPase.
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Affiliation(s)
- S W Nelson
- Department of Biochemistry, Biophysics, and Molecular Biology, Iowa State University, Ames, Iowa 50011, USA
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Choe JY, Fromm HJ, Honzatko RB. Crystal structures of fructose 1,6-bisphosphatase: mechanism of catalysis and allosteric inhibition revealed in product complexes. Biochemistry 2000; 39:8565-74. [PMID: 10913263 DOI: 10.1021/bi000574g] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Crystal structures of metal-product complexes of fructose 1, 6-bisphosphatase (FBPase) reveal competition between AMP and divalent cations. In the presence of AMP, the Zn(2+)-product and Mg(2+)-product complexes have a divalent cation present only at one of three metal binding sites (site 1). The enzyme is in the T-state conformation with a disordered loop of residues 52-72 (loop 52-72). In the absence of AMP, the enzyme crystallizes in the R-state conformation, with loop 52-72 associated with the active site. In structures without AMP, three metal-binding sites are occupied by Zn(2+) and two of three metal sites (sites 1 and 2) by Mg(2+). Evidently, the association of AMP with FBPase disorders loop 52-72, the consequence of which is the release of cations from two of three metal binding sites. In the Mg(2+) complexes (but not the Zn(2+) complexes), the 1-OH group of fructose 6-phosphate (F6P) coordinates to the metal at site 1 and is oriented for a nucleophilic attack on the bound phosphate molecule. A mechanism is presented for the forward reaction, in which Asp74 and Glu98 together generate a hydroxide anion coordinated to the Mg(2+) at site 2, which then displaces F6P. Development of negative charge on the 1-oxygen of F6P is stabilized by its coordination to the Mg(2+) at site 1.
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Affiliation(s)
- J Y Choe
- Department of Biochemistry, Iowa State University, Ames 50011, USA
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Paek EG, Im YS, Choe JY, Oh TK. Acoustically steered and rotated true-time-delay generator based on wavelength-division multiplexing. Appl Opt 2000; 39:1298-1308. [PMID: 18338014 DOI: 10.1364/ao.39.001298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The acoustically steered and rotated (ASTRO) true-time-delay (TTD) generator, capable of two-dimensional (2D) multiple beam generation without causing extraneous beams, is described. It is based on wavelength-division multiplexing to encode and decode various linear chirp time delays with wavelengths. An array of equally spaced light stripes with linear chirp time delays among them is formed and is subsequently rotated to a desired angle by use of our nonmechanical acousto-optic dove prism, believed to be novel. Our architecture reduces hardware complexity significantly by avoiding redundancy in conventional TTD generators. Experimental results to prove the concept of 2D multiple beam generation are shown. Also, an extension of the system for bidirectional communications is proposed. Various technical issues for practical applications are discussed.
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Affiliation(s)
- E G Paek
- Information Technology Laboratory, National Institute of Standards and Technology, Gaithersburg, Maryland 20899-8951, USA.
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41
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Abstract
OBJECTIVE To determine the association between advanced pelvic organ prolapse and changes in lumbar lordosis and/or pelvic inlet orientation. METHODS Lateral lumbosacral spine/pelvic x-rays were taken of women with grade 2 or greater uterovaginal prolapse and women with grade 1 or less prolapse standing in their usual upright posture. The angles of lumbar lordosis and the pelvic inlet were measured by a radiologist who was masked to the pelvic examination findings. RESULTS Twenty women with prolapse were matched with 20 women without significant prolapse. There were no significant differences in the mean (+/- standard deviation [SDI) age (55.3 +/- 9.0 years compared with 53.4 +/- 9.5 years), body mass index (BMI) (28.9 +/- 5.6 compared with 28.4 +/- 5.2), gravidity (5.6 +/- 3.5 compared with 5.0 +/- 2.7), and vaginal parity (4.65 +/- 3.3 compared with 4.5 +/- 2.9) between the prolapse and nonprolapse groups, respectively. All participants were vaginally parous. The mean lumbar lordotic angle in women with pelvic organ prolapse (32.0 degrees +/- 9.8 degrees) was significantly lower than that of controls (42.4 degrees +/- 10.9 degrees) (P < .003). The mean angle of the pelvic inlet in women with pelvic organ prolapse (37.5 degrees +/- 7.0 degrees) was significantly larger than that of controls (29.5 degrees +/- 7.3 degrees) (P < .001). The differences in the mean angles of lumbar lordosis and the pelvic inlet, between the case and control groups, remained significant after multivariable logistic regression was performed. CONCLUSION Women with advanced uterovaginal prolapse have less lumbar lordosis and a pelvic inlet that is oriented less vertically than women without prolapse.
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Affiliation(s)
- J K Nguyen
- Department of Obstetrics and Gynecology, Harbor-University of California, Los Angeles 90509, USA.
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Choe JY, Poland BW, Fromm HJ, Honzatko RB. Mechanistic implications from crystalline complexes of wild-type and mutant adenylosuccinate synthetases from Escherichia coli. Biochemistry 1999; 38:6953-61. [PMID: 10346917 DOI: 10.1021/bi990159s] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Asp13 and His41 are essential residues of adenylosuccinate synthetase, putatively catalyzing the formation of adenylosuccinate from an intermediate of 6-phosphoryl-IMP. Wild-type adenylosuccinate synthetase and three mutant synthetases (Arg143 --> Leu, Lys16 --> Gln, and Arg303 --> Leu) from Eschericha coli have been crystallized in the presence of IMP, hadacidin (an analogue of L-aspartate), Mg2+, and GTP. The active site of each complex contains 6-phosphoryl-IMP, Mg2+, GDP, and hadacidin, except for the Arg303 --> Leu mutant, which does not bind hadacidin. In response to the formation of 6-phosphoryl-IMP, Asp13 enters the inner coordination sphere of the active site Mg2+. His41 hydrogen bonds with 6-phosphoryl-IMP, except in the Arg303 --> Leu complex, where it remains bound to the guanine nucleotide. Hence, recognition of the active site Mg2+ by Asp13 evidently occurs after the formation of 6-phosphoryl-IMP, but recognition of the intermediate by His41 may require the association of L-aspartate with the active site. Structures reported here support a mechanism in which Asp13 and His41 act as the catalytic base and acid, respectively, in the formation of 6-phosphoryl-IMP, and then act together as catalytic acids in the subsequent formation of adenylosuccinate.
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Affiliation(s)
- J Y Choe
- Department of Biochemistry, Biophysics, and Molecular Biology, Iowa State University, Ames 50011, USA
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Choe JY, Poland BW, Fromm HJ, Honzatko RB. Role of a dynamic loop in cation activation and allosteric regulation of recombinant porcine fructose-1,6-bisphosphatase. Biochemistry 1998; 37:11441-50. [PMID: 9708979 DOI: 10.1021/bi981112u] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
A disordered loop (loop 52-72, residues 52-72) in crystal structures of fructose-1,6-bisphosphatase (FBPase) has been implicated in regulatory and catalytic phenomena by studies in directed mutation. A crystal structure of FBPase in a complex with three zinc cations and the products fructose 6-phosphate (F6P) and phosphate (Pi) reveals loop 52-72 for the first time in a well-defined conformation with strong electron density. Loop 52-57 interacts primarily with the active site of its own subunit. Asp68 of the loop hydrogen bonds with Arg276 and a zinc cation located at the putative potassium activation site. Leu56 and Tyr57 of the loop pack against hydrophobic residues from two separate subunits of FBPase. A mechanism of allosteric regulation of catalysis is presented, in which AMP, by binding to its allosteric pocket, displaces loop 52-72 from the active site. Furthermore, the current structure suggests that both the alpha- and beta-anomers of F6P can be substrates in the reverse reaction catalyzed by FBPase. Mechanisms of catalysis are proposed for the reverse reaction in which Asp121 serves as a catalytic base for the alpha-anomer and Glu280 serves as a catalytic base for the beta-anomer.
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Affiliation(s)
- J Y Choe
- Department of Biochemistry and Biophysics, Iowa State University, Ames 50011, USA
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Abstract
An experimental acousto-optic tunable filter that has a narrow spectral bandwidth (0.2 nm at 1550 nm) and a fast (10-micros) tuning capability with a continuous tuning range of approximately 50 nm is described. The tunable filter consists of an acousto-optic beam deflector with a diffraction grating whose grating vector is transverse to the direction of light propagation.
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Kurbanov FT, Choe JY, Honzatko RB, Fromm HJ. Directed mutations in the poorly defined region of porcine liver fructose-1,6-bisphosphatase significantly affect catalysis and the mechanism of AMP inhibition. J Biol Chem 1998; 273:17511-6. [PMID: 9651342 DOI: 10.1074/jbc.273.28.17511] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Asn64, Asp68, Lys71, Lys72, and Asp74 of porcine liver fructose-1, 6-bisphosphatase (FBPase) are conserved residues and part of a loop for which no electron density has been observed in crystal structures. Yet mutations of the above dramatically affect catalytic rates and/or AMP inhibition. The Asp74 --> Ala and Asp74 --> Asn mutant enzymes exhibited 50,000- and 2,000-fold reductions, respectively, in kcat relative to wild-type FBPase. The pH optimum for the catalytic activity of the Asp74 --> Glu, Asp68 --> Glu, Asn64 --> Gln, and Asn64 --> Ala mutant enzymes shifted from pH 7.0 (wild-type enzyme) to pH 8.5, whereas the Lys71 --> Ala mutant and Lys71,72 --> Met double mutant had optimum activity at pH 7.5. Mg2+ cooperativity, Km for fructose 1,6-bisphosphate, and Ki for fructose 2,6-bisphosphate were comparable for the mutant and wild-type enzymes. Nevertheless, for the Asp74 --> Glu, Asp68 --> Glu, Asn64 --> Gln, and Asn64 --> Ala mutants, the binding affinity for Mg2+ decreased by 40-125-fold relative to the wild-type enzyme. In addition, the Asp74 --> Glu and Asn64 --> Ala mutants exhibited no AMP cooperativity, and the kinetic mechanism of AMP inhibition with respect to Mg2+ was changed from competitive to noncompetitive. The double mutation Lys71,72 --> Met increased Ki for AMP by 175-fold and increased Mg2+ affinity by 2-fold relative to wild-type FBPase. The results reported here strongly suggest that loop 51-72 is important for catalytic activity and the mechanism of allosteric inhibition of FBPase by AMP.
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Affiliation(s)
- F T Kurbanov
- Department of Biochemistry and Biophysics, Iowa State University, Ames, Iowa 50011, USA
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Abstract
We report what we believe to be the first method for nonmechanical and programmable image rotation. The method uses a pair of crossed acousto-optic beam deflectors and a polygon mirror to emulate the mechanical dove prism. It is capable of fast (of the order of microseconds) image rotation to an arbitrary angle in a programmable manner. An experimental result that proves the concept is provided.
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Denehy TR, Choe JY, Gregori CA, Breen JL. Modified Le Fort partial colpocleisis with Kelly urethral plication and posterior colpoperineoplasty in the medically compromised elderly: a comparison with vaginal hysterectomy, anterior colporrhaphy, and posterior colpoperineoplasty. Am J Obstet Gynecol 1995; 173:1697-701; discussion 1701-2. [PMID: 8610747 DOI: 10.1016/0002-9378(95)90412-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- T R Denehy
- Department of Obstetrics and Gynecology, Saint Barnabas Medical Center, Livingston, NJ 07039, USA
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Choe JY, Combs AB, Saji S, Folkers K. Study of the combined and separate administration of doxorubicin and coenzyme Q10 on mouse cardiac enzymes. Res Commun Chem Pathol Pharmacol 1979; 24:595-8. [PMID: 451343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Administration of an acutely toxic dose of doxorubicin to mice did not increase, but rather decreased the percent deficiency of coenzyme Q10 (CoQ10) as calculated according to the coenzyme-apoenzyme system principle. The date indicate that doxorubicin may occupy CoQ10-empty receptors on the apoenzyme, with or without some destruction of enzyme-menbrane structure close to the receptor. Data from mice receiving both CoQ10 and doxorubicin indicated that CoQ10 may protect against doxorubicin. CoQ10 alone corrected the pre-existing deficiency found in control mice.
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Choe JY, Combs AB, Folkers K. Prevention by coenzyme Q10 of the electrocardiographic changes induced by adriamycin in rats. Res Commun Chem Pathol Pharmacol 1979; 23:199-202. [PMID: 441512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The administration of adriamycin (ADM) to rats has consistently caused a widening of the QRS complex of the electrocardiogram. When coenzyme Q10 was also administered, beginning two days before ADM, this widening of the QRS complex and the elongation of the Q-T interval were reduced or totally prevented, depending upon conditions. ADM alone or with coenzyme Q10 did not alter the P-R interval. Some control by coenzyme Q10 of the cardiotoxicity of adriamycin in cancer patients is promising.
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