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Bergh EP, Mann LK, Won JH, Nobles A, Johnson A, Papanna R. Anchoring device to prevent membrane detachment and preterm premature rupture of membranes after fetal intervention. Ultrasound Obstet Gynecol 2024. [PMID: 38514967 DOI: 10.1002/uog.27646] [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] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 03/07/2024] [Accepted: 03/12/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVE Anchoring the fetal membrane to the uterine wall via a novel suture delivery system could reduce the risk of preterm premature rupture of membranes (PPROM) after fetoscopic surgery. This study assesses the feasibility of using a novel device designed for minimally invasive suturing to anchor fetal membranes to the uterine wall and to close surgical defects after fetoscopy. METHODS We tested the suturing device both ex vivo and in vivo. In the ex vivo studies, 12-French trocar defects were created with a fetoscope in five specimens of human uterine tissue with fetal membranes attached. Specimens were examined for integrity of the anchoring stitch. For in vivo studies, trocar defects were created in the two uterine horns of three pregnant ewes, each carrying twins at ~79-90 days gestation. One trocar defect in each ewe was repaired using the suture device, and the other was left unrepaired as a control. The repair sites were examined for membrane anchoring integrity when the defect was created and at delivery. RESULTS Fetal membranes were successfully anchored to the uterine myometrium using this device in all five trials performed ex vivo. The in vivo trials also revealed successful membrane anchoring compared with controls both at the time of device deployment and five-to-eight weeks after the procedure. CONCLUSIONS We successfully anchored amniotic membranes to the underlying myometrium via suturing device both ex vivo and in vivo. Further studies are needed to evaluate the efficacy of the device and to determine whether it can successfully anchor fetal membranes percutaneously in human subjects. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- E P Bergh
- Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Maternal-Fetal Medicine, McGovern Medical School at UTHealth Houston, The Fetal Center at Children's Memorial Hermann Hospital, Houston, TX, USA
| | - L K Mann
- Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Maternal-Fetal Medicine, McGovern Medical School at UTHealth Houston, The Fetal Center at Children's Memorial Hermann Hospital, Houston, TX, USA
| | - J H Won
- Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Maternal-Fetal Medicine, McGovern Medical School at UTHealth Houston, The Fetal Center at Children's Memorial Hermann Hospital, Houston, TX, USA
| | - A Nobles
- HeartStitch, Inc., Fountain Valley, CA, USA
| | - A Johnson
- Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Maternal-Fetal Medicine, McGovern Medical School at UTHealth Houston, The Fetal Center at Children's Memorial Hermann Hospital, Houston, TX, USA
| | - R Papanna
- Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Maternal-Fetal Medicine, McGovern Medical School at UTHealth Houston, The Fetal Center at Children's Memorial Hermann Hospital, Houston, TX, USA
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Lee JP, Na JB, Choi HC, Choi HY, Kim JE, Shin HS, Won JH, Jo SH, Hong SJ, Yang WJ, Kim YW, Koo BJ, Jang IS, Park MJ. Lobar emphysema ratio of more than 1% in the lobe with lung cancer as poor predictor for recurrence and overall survival in patients with stage I non-small cell lung cancer. PLoS One 2023; 18:e0281715. [PMID: 36787324 PMCID: PMC9928128 DOI: 10.1371/journal.pone.0281715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 01/30/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND The purpose of this study was to examine the relationship between the lobar emphysema ratio (LER) and tumor recurrence and survival in patients with stage I non-small cell lung cancer (NSCLC). METHODS We enrolled 258 patients with surgically proven stage I NSCLC. These patients underwent noncontrast chest CT, and pulmonary lobe segmentation and lobar emphysema quantification were performed using commercially available software. We assessed the LER in the lobe with lung cancer. We divided the patients into two groups according to the LER, and the cut-off value was 1. Furthermore, we analyzed the disease-free survival of high LER and other clinical factors after surgical resection. RESULTS The 258 patients were divided into two groups: low LER (n = 195) and high LER (n = 63). The right upper lobe was the most frequent location in lung cancer and the most severe location in emphysema. In the Kaplan‒Meier curve, high LER showed a significantly lower disease-free survival (8.21 ± 0.27 years vs 6.53 ± 0.60 years, p = 0.005) and overall survival (9.56 ± 0.15 years vs. 8.51 ± 0.49 years, p = 0.011) than low LER. Stage Ib (2.812 [1.661-4.762], p<0.001) and high LER (2.062 [1.191-3.571], p = 0.010) were poor predictors for disease-free survival in multivariate Cox regression analysis. Stage Ib (4.729 [1.674-13.356], p = 0.003) and high LER (3.346 [1.208-9.269], p = 0.020) were significant predictors for overall survival in multivariate Cox regression analysis. CONCLUSION A LER of more than 1% in the lobe with lung cancer is a poor predictor for cancer recurrence and overall survival in patients with stage I NSCLC.
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Affiliation(s)
- Jeong Pyo Lee
- Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Jae Bum Na
- Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Ho Cheol Choi
- Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Hye Young Choi
- Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Ji Eun Kim
- Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Hwa Seon Shin
- Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Jung Ho Won
- Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Sa Hong Jo
- Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Seok Jin Hong
- Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Won Jeong Yang
- Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Yang Won Kim
- Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Byeong Ju Koo
- Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - In Seok Jang
- Department of Cardiothoracic Surgery, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Mi Jung Park
- Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
- * E-mail:
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Lim SG, Park SE, Nam IC, Choi HC, Won JH, Jo SH, Baek HJ, Moon JI, Cho E, Jang JY. Large gastroduodenal artery pseudoaneurysm, arterioportal fistula and portal vein stenosis in chronic pancreatitis treated using combined transarterial embolization and transportal stenting: A case report. Medicine (Baltimore) 2022; 101:e32593. [PMID: 36596040 PMCID: PMC9803455 DOI: 10.1097/md.0000000000032593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
RATIONALE Chronic pancreatitis is an ongoing fibroinflammatory disease of the pancreas characterized by irreversible damage to the pancreatic parenchyma and ductal system. Besides, chronic pancreatitis can present with a variety of life-threatening complications. PATIENT CONCERNS The patients visited our hospital due to abdominal pain and anemia, and had chronic pancreatitis as an underlying disease. DIAGNOSES Computed tomography showed a large gastroduodenal artery pseudoaneurysm, arterioportal vein fistula, and portal vein stenosis. INTERVENTIONS We would like to report the successful use of the coils, and N-butyl cyanoacrylate glue for the therapeutic embolization of the pseudoaneurysm and fistula between the gastroduodenal artery and the portal vein, and stenting for portal vein stenosis. OUTCOMES On the day following the endovascular management, the patient reported remission of abdominal pain, and hemoglobin level returned to normal after transfusion. It was confirmed that it was still well maintained in the follow-up examination after 1 month. LESSONS Although chronic pancreatitis causes many vascular complications, simultaneous occurrence of these lesions is extremely rare. Herein, we share our experience with a unique case of an extrahepatic arterioportal fistula induced by the rupture of gastroduodenal artery pseudoaneurysm with concomitant portal vein stenosis. In these complex cases, combined transarterial embolization and transportal stenting can be helpful.
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Affiliation(s)
- Sung Gong Lim
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Sung Eun Park
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Korea
- * Correspondence: Sung Eun Park, Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, 11 Samjeongja-ro, Seongsan-gu, Changwon 51472, Korea (e-mail: )
| | - In Chul Nam
- Department of Radiology, Jeju National University School of Medicine, Jeju National University Hospital, Jeju, Korea
| | - Ho Cheol Choi
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Korea
| | - Jung Ho Won
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Korea
| | - Sa Hong Jo
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Korea
| | - Hye Jin Baek
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Jin Il Moon
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Eun Cho
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Jae Yool Jang
- Department of General Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Korea
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Ahn JK, Won JH, Choi DS, Choi HC, Choi HY, Jo SH, Choi JH, Lee SH, Kim MJ, Park SE, Shin JH. Percutaneous nephrostomy for complex renal stones: Percutaneous renal access behind the stone versus renal calyx dilation. PLoS One 2022; 17:e0278485. [PMID: 36454857 PMCID: PMC9714915 DOI: 10.1371/journal.pone.0278485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 11/16/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To evaluate the technical success rate and complications associated with percutaneous nephrostomy (PCN) via percutaneous renal access behind the stone and renal calyx dilation in patients with complex renal stones. MATERIALS AND METHODS From January 2010 to February 2021, we identified 69 patients with 70 complex renal stones who underwent PCN. Complex renal stones were classified as simple (renal pelvis only) (27.1%, 19/70), borderline staghorn (8.6%, 6/70), partial staghorn (51.4%, 36/70), or complete staghorn (12.9%, 9/70). All PCNs were performed under ultrasound and fluoroscopic guidance using one of two renal-entry techniques: puncture behind the stone (56%, 39/70) or renal calyx dilation (44%, 31/70). Then, we retrospectively evaluated the technical success rates and complications associated with each renal entry access technique. RESULTS The overall technical success rate was 100%, and the complication rate was 20.0% (14/70). For those who underwent renal access behind the stone, the complication rate was 15.4% (6/39), and six patients (six PCNs) had transient gross hematuria. For those who underwent dilated renal calyx entry, the complication rate was 25.8% (8/31), and one patient had significant bleeding complications requiring transfusion. Furthermore, seven patients (seven PCNs) had transient gross hematuria. Overall, the complication rates did not differ between the technique groups (p = 0.279). CONCLUSION PCN for complex renal stones has a high technical success rate and an acceptable complication rate regardless of the specific technique. Renal entry behind the stone is as safe and feasible as approaching via a dilated renal calyx.
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Affiliation(s)
- Jae Kyeong Ahn
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Korea
| | - Jung Ho Won
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Korea
- * E-mail:
| | - Dae Seob Choi
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Korea
| | - Ho Cheol Choi
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Korea
| | - Hye Young Choi
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Korea
| | - Sa Hong Jo
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Korea
| | - Jae Hwi Choi
- Department of Urology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Korea
| | - Seung Hye Lee
- Department of Internal Medicine-Nephrology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Korea
| | - Mi Ji Kim
- Department of Preventive Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Sung Eun Park
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Ji Hoon Shin
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Park SE, Nam IC, Baek HJ, Ryu KH, Lim SG, Won JH, Kim DR. Effectiveness of ultrasound-guided percutaneous transhepatic biliary drainage to reduce radiation exposure: A single-center experience. PLoS One 2022; 17:e0277272. [PMID: 36331963 PMCID: PMC9635691 DOI: 10.1371/journal.pone.0277272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022] Open
Abstract
Percutaneous transhepatic biliary drainage (PTBD) has been an effective treatment to access the biliary tree, especially in case of endoscopically inaccessible biliary tree. In general, PTBD techniques are divided into two methods: fluoroscopy-guided PTBD and ultrasound (US)-guided PTBD. This study aimed to evaluate the effectiveness of US-guided PTBD, focusing on radiation exposure according to intrahepatic duct (IHD) dilatation degree, differences between right- and left-sided approaches and differences between benign and malignant biliary stenosis/obstruction. We evaluated technical success, clinical success, procedural data (the number of liver capsule punctures, procedural time, fluoroscopy time and radiation dose), and procedure-related complications. During the study period, a total of 123 patients with biliary stenosis/obstruction or bile leakage were initially eligible. We excluded 76 patients treated with only ERCP or initially treated with ERCP followed underwent PTBD insertion. Finally, a total of 50 procedures were performed in 47 patients. Of the 47 patients, 8 patients had anatomical alteration due to previous surgery, 6 patients refused ERCP, and 3 patients failed ERCP. For the remaining 30 patients, PTBD was performed on weekend or at night, 11 of whom had poor general condition, 10 patients underwent ERCP 3 to 4 days later after PTBD insertion, 6 patients improved after PTBD insertion without ERCP, 1 patient died, and 1 patient was referred to other hospital. Remaining 1 patient underwent surgery due to Mirizzi syndrome. All procedures were performed by two interventional radiologists. Technical success rate was 100%, clinical success was 94%, and the complication rate was 10%. Fluoroscopy time and the reported radiation dose were significantly lower in patients with dilated bile ducts than in those with non-dilated bile ducts, when biliary puncture under US guidance was performed initially. However, even in patients with non-dilated bile ducts undergoing initial trials of biliary puncture under US guidance, the fluoroscopy time and the reported radiation dose were low, based on current studies. No statistical significant differences were observed in terms of technical and dosimetry results according to right-sided and left-sided procedures and benign and malignant biliary stenosis/obstruction. Thus, US-guided PTBD was found to be a safe and effective technique that significantly reduced fluoroscopy time and radiation doses.
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Affiliation(s)
- Sung Eun Park
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Seongsan-gu, Changwon, Korea
| | - In Chul Nam
- Department of Radiology, Jeju National University School of Medicine, Jeju Natuional University Hospital, Jeju, Korea
- * E-mail:
| | - Hye Jin Baek
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Seongsan-gu, Changwon, Korea
| | - Kyeong Hwa Ryu
- Department of Radiology, Samsung Changwon Hospital, Changwon, Korea
| | - Sung Gong Lim
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Seongsan-gu, Changwon, Korea
| | - Jung Ho Won
- Department of Radiology, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Korea
| | - Doo Ri Kim
- Department of Radiology, Jeju National University School of Medicine, Jeju Natuional University Hospital, Jeju, Korea
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Bak S, Choi HY, Lee JH, Na JB, Choi DS, Cho JM, Choi HC, Park MJ, Kim JE, Shin HS, Won JH, Kim JY, Kim JM. Mucoepidermoid carcinoma of the breast: A case report and literature review focused on radiological findings. Medicine (Baltimore) 2022; 101:e29745. [PMID: 35777033 PMCID: PMC9239627 DOI: 10.1097/md.0000000000029745] [Citation(s) in RCA: 3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Mucoepidermoid carcinoma (MEC) of the breast is a rare entity, with an estimated incidence of only 0.2% to 0.3% of all primary breast tumors. The radiological features of breast MEC have scarcely been investigated mainly because of its rarity. In this article, we present a case of breast MEC diagnosed at our hospital and review the literature, focusing on radiological findings and radiologic-pathologic correlations that could improve clinical management of this entity. To the best of our knowledge, our study is the first review of the literature that focuses on the radiological features of breast MEC. PATIENT CONCERNS A 47-year-old premenopausal woman presented with a painless palpable mass in the right breast. DIAGNOSIS Mammography and ultrasonography revealed a mass with suspicious malignant features, which was categorized as Breast Imaging Reporting and Data System category 4c. A 14-gauge core-needle biopsy revealed an intermediate-grade MEC of the breast. The patient underwent breast magnetic resonance imaging and chest computed tomography for preoperative evaluation. Postoperative histopathological examination confirmed a diagnosis of intermediate-grade MEC. The clinical staging was T2N0M0. INTERVENTIONS The patient underwent breast-conserving surgery, adjuvant chemotherapy, radiotherapy, and hormonal therapy. OUTCOMES No evidence of recurrence has been reported over 37 months. LESSONS The imaging characteristics of breast MEC were variable, and there were no specific radiological features for diagnosis. The presence of cystic components on radiological imaging is likely to be an indicator of a low-grade tumor and better prognosis, although the number of reported cases is limited.
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Affiliation(s)
- Seongjun Bak
- Department of Radiology, College of Medicine, Gyeongsang National University and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Hye Young Choi
- Department of Radiology, College of Medicine, Gyeongsang National University and Gyeongsang National University Hospital, Jinju, Republic of Korea
- *Correspondence: Hye Young Choi, Department of Radiology, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, 79 Gangnam-ro, Jinju 52727, Republic of Korea (e-mail: )
| | - Jeong-Hee Lee
- Department of Pathology, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Jae Beom Na
- Department of Radiology, College of Medicine, Gyeongsang National University and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Dae Seob Choi
- Department of Radiology, College of Medicine, Gyeongsang National University and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Jae Min Cho
- Department of Radiology, College of Medicine, Gyeongsang National University and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Ho Cheol Choi
- Department of Radiology, College of Medicine, Gyeongsang National University and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Mi Jung Park
- Department of Radiology, College of Medicine, Gyeongsang National University and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Ji Eun Kim
- Department of Radiology, College of Medicine, Gyeongsang National University and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Hwa Seon Shin
- Department of Radiology, College of Medicine, Gyeongsang National University and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Jung Ho Won
- Department of Radiology, College of Medicine, Gyeongsang National University and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Ju-Yeon Kim
- Department of Surgery, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Jae-Myung Kim
- Department of Surgery, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
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Ho Won J, Jin Yang W, Hoon Shin J, Woo Kim J, Ho Chu H, Min Lee S, Cheol Choi H, Eun Park S. Percutaneous nephrostomy for nondilated renal collecting system with ultrasound and fluoroscopic guidance: The results of a 10-year experience. Diagn Interv Radiol 2022; 28:244-248. [PMID: 35748207 PMCID: PMC9634922 DOI: 10.5152/dir.2022.20728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE This study aimed to evaluate the technical success rate, complications, and radiation doses of ultrasound- and fluoroscopy-guided percutaneous nephrostomy (PCN) in patients with a nondi- lated renal collecting system. METHODS Over a 10-year period, 50 patients were referred for PCN of 60 kidneys with a nondilated renal collecting system. The patients included 22 males and 28 females with a mean age of 63.2 years (range: 35-87 years). The most common reason for PCN in these patients was postoperative ure- teral leaks and/or fistula (21/50 patients). PCN was performed under ultrasound and fluoroscopic guidance. During PCN, intravenous contrast media or diuretics were not used. Technical success rate, complications, procedure time, and radiation exposure of the procedure were retrospec- tively evaluated. RESULTS Ultrasound- and fluoroscopy-guided PCN for nondilated renal collecting system showed a suc- cess rate of 83.3% (50/60 kidneys) in the initial attempt. Four PCNs were repeated and were suc- cessful after the initial PCN failure. There was 1 major complication of bleeding that required transfusion in 1.9% (1/54) PCNs and there were minor complications of transient gross hematuria through the PCN catheter in 31.5% (17/54) PCNs. Mean duration of the procedure was 15.97 ± 7.81 min and median fluoroscopy time was 4.2 min (range: 1.2-15.3 min). Median dose area product and cumulative dose were 345.37 μGy·m2 (range: 42.57-1659.76 μGy·m2) and 46.9 mGy (range: 7.7-267.8 mGy), respectively. CONCLUSION Ultrasound- and fluoroscopy-guided PCN for nondilated renal collecting system was feasible with acceptable technical success rate, complication rate, procedure time, and radiation exposure.
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Affiliation(s)
- Jung Ho Won
- From the Department of Radiology (J.H.W., S.M.L., H.C.C.), Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Korea; Department of Radiology (W.J.Y.), Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea Department of Radiology and Research Institute of Radiology (J.H.S. ✉ , J.W.K., H.H.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Radiology (S.E.P.), Gyeongsang National University College of Medicine and Gyeonsang National University Changwon Hospital, Changwon, Korea
| | - Woo Jin Yang
- From the Department of Radiology (J.H.W., S.M.L., H.C.C.), Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Korea; Department of Radiology (W.J.Y.), Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea Department of Radiology and Research Institute of Radiology (J.H.S. ✉ , J.W.K., H.H.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Radiology (S.E.P.), Gyeongsang National University College of Medicine and Gyeonsang National University Changwon Hospital, Changwon, Korea
| | - Ji Hoon Shin
- From the Department of Radiology (J.H.W., S.M.L., H.C.C.), Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Korea; Department of Radiology (W.J.Y.), Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea Department of Radiology and Research Institute of Radiology (J.H.S. ✉ , J.W.K., H.H.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Radiology (S.E.P.), Gyeongsang National University College of Medicine and Gyeonsang National University Changwon Hospital, Changwon, Korea
| | - Jong Woo Kim
- From the Department of Radiology (J.H.W., S.M.L., H.C.C.), Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Korea; Department of Radiology (W.J.Y.), Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea Department of Radiology and Research Institute of Radiology (J.H.S. ✉ , J.W.K., H.H.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Radiology (S.E.P.), Gyeongsang National University College of Medicine and Gyeonsang National University Changwon Hospital, Changwon, Korea
| | - Hee Ho Chu
- From the Department of Radiology (J.H.W., S.M.L., H.C.C.), Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Korea; Department of Radiology (W.J.Y.), Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea Department of Radiology and Research Institute of Radiology (J.H.S. ✉ , J.W.K., H.H.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Radiology (S.E.P.), Gyeongsang National University College of Medicine and Gyeonsang National University Changwon Hospital, Changwon, Korea
| | - Sang Min Lee
- From the Department of Radiology (J.H.W., S.M.L., H.C.C.), Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Korea; Department of Radiology (W.J.Y.), Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea Department of Radiology and Research Institute of Radiology (J.H.S. ✉ , J.W.K., H.H.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Radiology (S.E.P.), Gyeongsang National University College of Medicine and Gyeonsang National University Changwon Hospital, Changwon, Korea
| | - Ho Cheol Choi
- From the Department of Radiology (J.H.W., S.M.L., H.C.C.), Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Korea; Department of Radiology (W.J.Y.), Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea Department of Radiology and Research Institute of Radiology (J.H.S. ✉ , J.W.K., H.H.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Radiology (S.E.P.), Gyeongsang National University College of Medicine and Gyeonsang National University Changwon Hospital, Changwon, Korea
| | - Sung Eun Park
- From the Department of Radiology (J.H.W., S.M.L., H.C.C.), Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Korea; Department of Radiology (W.J.Y.), Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea Department of Radiology and Research Institute of Radiology (J.H.S. ✉ , J.W.K., H.H.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Radiology (S.E.P.), Gyeongsang National University College of Medicine and Gyeonsang National University Changwon Hospital, Changwon, Korea
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Nam IC, Lee ES, Shin JH, Li VX, Chu HH, Park SE, Won JH. Cardiac Arrest during Interventional Radiology Procedures: A 7-Year Single-Center Retrospective Study. J Clin Med 2022; 11:jcm11030511. [PMID: 35159963 PMCID: PMC8836515 DOI: 10.3390/jcm11030511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 01/15/2022] [Accepted: 01/18/2022] [Indexed: 12/29/2022] Open
Abstract
An intervention radiology (IR) unit collected cardiac arrest data between January 2014 and July 2020. Of 344,600 procedures, there were 23 cardiac arrest patients (0.0067%). The patient data was compared to a representative sample (N = 400) of the IR unit to evaluate the incidence and factors associated with cardiac arrest during IR procedures. Age, procedure urgency, American Society of Anesthesiologists (ASA) physical status, procedure type, and underlying medical conditions were identified as valuable predictors of a patient’s susceptibility to cardiac arrest during an IR procedure. The proportion of pediatrics was higher for cardiac arrest patients, and most required immediate procedures. The distribution of high ASA physical status (III or greater) was skewed compared to that of the non-cardiac arrest patients. Vascular procedures were associated with higher risk than non-vascular procedures. The patients who underwent non-transarterial chemoembolization arterial procedures demonstrated relative risks of 4.4 and 11.7 for cardiac arrest compared to biliary procedures and percutaneous catheter drainage, respectively. In addition, the six patients (26.1%) who died before discharge all underwent vascular procedures. Relative to patients with acute kidney injury, patients with malignancy, hypertension, and diabetes mellitus demonstrated relative risks of 3.3, 3.4, and 4.8 for cardiac arrest, respectively.
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Affiliation(s)
- In Chul Nam
- Department of Radiology, Gyeongsang National University College of Medicine, Gyeongsang National University Changwon Hospital, Changwon 51472, Korea; (I.C.N.); (S.E.P.)
| | - Esther Sangeun Lee
- Harvard College, Harvard University, Cambridge, MA 02138, USA; (E.S.L.); (V.X.L.)
| | - Ji Hoon Shin
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea;
- Correspondence:
| | - Vincent Xinrui Li
- Harvard College, Harvard University, Cambridge, MA 02138, USA; (E.S.L.); (V.X.L.)
| | - Hee Ho Chu
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea;
| | - Sung Eun Park
- Department of Radiology, Gyeongsang National University College of Medicine, Gyeongsang National University Changwon Hospital, Changwon 51472, Korea; (I.C.N.); (S.E.P.)
| | - Jung Ho Won
- Department of Radiology, Gyeongsang National University College of Medicine, Gyeongsang National University Hospital, Jinju 52727, Korea;
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9
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Hong S, Kim JE, Cho JM, Choi HC, Won JH, Na JB, Choi DS, Park MJ, Choi HY, Shin HS, Cho HC, Kim HO. Quantification of liver extracellular volume using dual-energy CT for ruling out high-risk varices in cirrhosis. Eur J Radiol 2022; 148:110151. [PMID: 35032849 DOI: 10.1016/j.ejrad.2022.110151] [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] [Received: 11/09/2021] [Revised: 12/10/2021] [Accepted: 01/03/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE To determine the performance of quantification of liver extracellular volume fraction (fECV) using dual-energy CT (DECT) compared with CT imaging for ruling out high-riskesophageal varices(HRV) in cirrhotic patients. METHODS We retrospectively analyzed 229 cirrhotic patients (training [n = 159] and internal validation cohorts [n = 70]) who underwent dual-source DECT, serum marker assessment, and esophagogastroduodenoscopy (EGD) from 2017 to 2020. The fECV score was measured using iodine maps from 3-minute delayed, equilibrium-phase images at 100/140 Sn kVp. The association of CT parameters and serum markers with HRV was investigated. Criteria combining the fECV score (≤ 25.1%) or CT imaging with platelet count (> 150,000/mm3) were created and compared to rule out HRV. RESULTS In the training cohort, the fECV score (odds ratio (OR), 1.20; 95% confidence interval (CI), 1.09, 1.32) and CT imaging (OR, 28.21; 95% CI, 9.31, 85.93) were independent predictors of HRV, along with platelet count (OR, 0.85 and 0.78). Criteria combining the fECV score with platelet count showed significantly better performance than those combining CT imaging with platelet count in ruling out HRV (p < 0.001). Applying the criteria could have safely avoided an additional 10.7% and 8.6% of EGDs in the training and validation cohorts, respectively, achieving a final value of 36.5% and 35.7% spared EGDs (0 HRV missed) compared to CT imaging with platelet count. CONCLUSIONS The combined DECT-based fECV score with platelet count is useful for ruling out HRV and can safely avoid more EGDs than CT imaging with platelet count.
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Affiliation(s)
- Seokjin Hong
- Department of Radiology, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Ji Eun Kim
- Department of Radiology, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea.
| | - Jae Min Cho
- Department of Radiology, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Ho Cheol Choi
- Department of Radiology, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Jung Ho Won
- Department of Radiology, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Jae Beom Na
- Department of Radiology, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Dae Seob Choi
- Department of Radiology, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Mi Jung Park
- Department of Radiology, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Hye Young Choi
- Department of Radiology, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Hwa Seon Shin
- Department of Radiology, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Hyun Chin Cho
- Department of Internal Medicine, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Hyun Ok Kim
- Department of Internal Medicine, Gyeongsang National University College of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
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Kim YW, Lee SM, Choi HC, Won JH, Na JB, Cho JM, Choi DS, Park MJ, Shin HS, Kim JE, Park SE, Shim JJ. Percutaneous removal of common bile duct stones using a modified balloon technique. Medicine (Baltimore) 2021; 100:e24486. [PMID: 33832061 PMCID: PMC8036119 DOI: 10.1097/md.0000000000024486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 12/29/2020] [Indexed: 01/05/2023] Open
Abstract
To evaluate the effectiveness of percutaneous removal of common bile duct (CBD) stones using a modified balloon technique (balloon catheter sphincteroplasty and expulsion of the stones using half-captured balloons within the sheath) in patients difficult to treat with endoscopy.Fifty patients underwent a modified balloon technique (balloon group), and 53 patients underwent CBD stone removal by the basket method (stone basket group) between 2016 and 2019. We compared the balloon and stone basket groups to evaluate the effectiveness of the modified balloon technique. Outcome variables such as demographics, technical success rates, procedural details, and complications were analyzed. Statistical analysis was performed using Student t test, Fisher exact test, or the χ2 test.The technical success rate in the balloon group was 66% (33/50) in 1 session, 32% (16/50) in 2 sessions, and 2% (1/50) in 3 sessions. That of the stone basket group was 45% (24/53) in 1 session, 38% (20/53) in 2 sessions, and 17% (9/53) in 3 sessions.The total procedure time was significantly shorter in the balloon group (29.5 ± 15.1 minutes) than in the stone basket group (41.7 ± 20.2 minutes) (P < .01), whereas the number of stones was higher in the balloon group than in the stone basket group (P = .03). Maximal stone size, balloon size, pancreatitis, and hospitalization stay did not show statistical differences between the 2 groups. Most complications (9 patients, balloon group; 8 patients, stone basket group) were mild and transient. Major complications occurred in one patient in the stone basket group, who experienced hemobilia due to arterial injury caused by percutaneous transhepatic biliary drainage, which was treated by endovascular embolization without mortality.The modified balloon technique is an effective and safe treatment method for CBD stone removal in patients presenting difficulties in the endoscopic approach.
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Affiliation(s)
- Yang Won Kim
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
| | - Sang Min Lee
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
| | - Ho Cheol Choi
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
| | - Jung Ho Won
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
| | - Jae Boem Na
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
| | - Jae Min Cho
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
| | - Dae Seob Choi
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
| | - Mi Jung Park
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
| | - Hwa Seon Shin
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
| | - Ji Eun Kim
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
| | - Sung Eun Park
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeonsang National University Changwon Hospital, Changwon
| | - Jong Joon Shim
- Department of Radiology, Soonchunhyang University College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
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Hong SJ, Lee SM, Won JH. Iatrogenic Iliac Vein Injury Following Extracorporeal Membrane Oxygenation Cannulation in a Patient with May-Thurner Syndrome: A Case Report and Literature Review. J Korean Soc Radiol 2021; 82:244-249. [PMID: 36237460 PMCID: PMC9432406 DOI: 10.3348/jksr.2020.0084] [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] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/18/2020] [Accepted: 05/23/2020] [Indexed: 12/03/2022]
Abstract
A 53-year-old woman presented with dyspnea. She had undergone extended thymectomy for an invasive thymoma two months prior. CT revealed numerous small nodules in the lung. After that, she deteriorated owing to acute respiratory distress syndrome (ARDS), and the vascular surgeon planned veno-venous extracorporeal membrane oxygenation (ECMO). During percutaneous cannulation through the left femoral vein, a vascular injury was suspected, and the patient's vital signs became unstable. Diagnostic angiography showed a ruptured left common iliac vein, and the bleeding was stopped by placement of a stent-graft. May-Thurner syndrome was diagnosed on abdominal CT. Here, we report a rare case of ECMO-related vascular injury in a patient with an unrecognized anatomical variant, May-Thurner syndrome.
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Affiliation(s)
- Seok Jin Hong
- Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Sang Min Lee
- Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Jung Ho Won
- Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
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12
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Hong SJ, Lee SM, Choi HC, Won JH, Na JB, Kim JE, Choi HY. Successful Transcatheter Arterial Embolization following Diverticular Bleeding in the Third Portion of the Duodenum: A Case Report. J Korean Soc Radiol 2021; 82:237-243. [PMID: 36237461 PMCID: PMC9432395 DOI: 10.3348/jksr.2020.0074] [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] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/13/2020] [Accepted: 05/18/2020] [Indexed: 11/16/2022]
Abstract
본 증례는 73세 남자 환자가 십이지장 3부에서 발생한 상부위장관 출혈로 인해 경동맥 색전술로 치료한 드문 증례이다. 환자는 혈변을 주소로 내원하여 시행한 초기 상부 및 하부 위장관 내시경과 전산화단층촬영에서 출혈 부위를 발견하지 못하였다. 입원 3일째에 혈색소 수치가 지속적으로 감소하여 테크네슘-적혈구 스캔을 시행하였고 십이지장 3부의 게실 내에 출혈이 의심되어 혈관조영술을 시행하였다. 상장간동맥 혈관조영술에서 십이지장 게실에 혈류를 공급하는 하췌십이지장동맥의 활동성 출혈이 관찰되어 색전술을 시행하였다. 이후 7일 동안 재출혈이나 합병증이 없어 퇴원하였다. 이에 발생빈도가 매우 낮고 초기 진단이 어려웠던 십이지장 게실 출혈의 보고와 관련된 문헌고찰을 하고자 한다.
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Affiliation(s)
- Seok Jin Hong
- Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Sang Min Lee
- Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Ho Cheol Choi
- Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Jung Ho Won
- Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Jae Boem Na
- Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Ji Eun Kim
- Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Hye Young Choi
- Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
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Shin HS, Choi DS, Na JB, Choi HY, Kim JE, Choi HC, Won JH, Lee SJ, Park MJ. Low pectoralis muscle index, cavitary nodule or mass and segmental to lobar consolidation as predictors of primary multidrug-resistant tuberculosis: A comparison with primary drug sensitive tuberculosis. PLoS One 2020; 15:e0239431. [PMID: 33017424 PMCID: PMC7535045 DOI: 10.1371/journal.pone.0239431] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 09/06/2020] [Indexed: 12/17/2022] Open
Abstract
Background The loss of muscle mass in primary multidrug-resistant tuberculosis (MDR-TB) has not been examined in previous studies. This study aimed to investigate that low pectoralis muscle index and characteristic CT features can help differentiate patients with primary MDR-TB from those with drug-sensitive tuberculosis (DS-TB). Material and methods From 2010 to 2016, we retrospectively enrolled 90 patients with primary MDR-TB and 90 age- and sex-matched patients with primary DS-TB. The pectoralis muscle mass was quantitatively measured on axial CT images using density histogram analysis. The pectoralis muscle index (PMI) was defined as the pectoralis muscle mass divided by body mass index. We compared the PMI and characteristic CT features of pulmonary tuberculosis between the two groups. Results Low PMI, segmental to lobar consolidation, cavity in consolidation, cavitary nodule or mass, and bilateral involvement were more frequently observed in patients with MDR-TB than in those with DS-TB. In stepwise multivariate logistic regression analysis, low PMI (odds ratio, 2.776; 95% confidence interval, 1.450–5.314; p = 0.002), segmental or lobar consolidation (odds ratio, 3.123; 95% confidence interval, 1.629–5.987; p = 0.001), and cavitary nodule or mass (odds ratio, 2.790; 95% confidence interval, 1.348–5.176; p = 0.002) were significant factors for MDR-TB. Conclusion Low pectoralis muscle index, segmental to lobar consolidation and cavitary nodule or mass can help differentiate primary MDR-TB from DS-TB.
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Affiliation(s)
- Hwa Seon Shin
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Gyeongsangnam-do, Republic of Korea
| | - Dae Seob Choi
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Gyeongsangnam-do, Republic of Korea
| | - Jae Boem Na
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Gyeongsangnam-do, Republic of Korea
| | - Hye Young Choi
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Gyeongsangnam-do, Republic of Korea
| | - Ji-Eun Kim
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Gyeongsangnam-do, Republic of Korea
| | - Ho Cheol Choi
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Gyeongsangnam-do, Republic of Korea
| | - Jung Ho Won
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Gyeongsangnam-do, Republic of Korea
| | - Seung Jun Lee
- Division of Pulmonology, Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Gyeongsangnam-do, Republic of Korea
| | - Mi Jung Park
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Gyeongsangnam-do, Republic of Korea
- * E-mail:
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Lee SM, Na JB, Choi HC, Won JH, Kim JE, Shin JH, Park HO, Park SE. Percutaneous intervention for salvage of non-maturing arteriovenous fistulas: Which is the better approach, arterial or venous? PLoS One 2020; 15:e0238788. [PMID: 32991608 PMCID: PMC7523969 DOI: 10.1371/journal.pone.0238788] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 08/24/2020] [Indexed: 11/18/2022] Open
Abstract
Objectives To evaluate the efficacy and long-term patency of endovascular treatment for non-maturing native arteriovenous fistulas according to the approach route (arterial vs. venous). Methods Eighty-five patients underwent percutaneous transluminal angioplasty for non-maturing fistulas (63 radiocephalic and 22 brachiocephalic) between 2010 and 2019. Outcome variables such as procedural success, complications, and primary and secondary patency rates were analyzed from the patients’ demographic, angiographic, clinical, and hemodialysis records according to the approach route (venous access group, n = 53 and arterial access group, n = 32). The Kaplan-Meier method was used to analyze the patency rates. Results The mean duration from fistula creation to fistulography was 78.4±51.4 days (range, 1–180 days). The anatomical and clinical success rates were 98.8% and 83.5%, respectively. Lesions were most commonly located at the juxta-anastomosis (55.3%). Accessory cephalic veins were observed in 16 patients. The primary patency rates were 83.9%, 71.9%, and 66.3% and the secondary patency rates were 98.6%, 95.9%, and 94.2% at 3 months, 6 months, and 1 year, respectively. The degree of hypertension (P = 0.023), minimal preoperative vein size (P = 0.041), and increment in postoperative vein diameter were higher in the venous access group than in the arterial access group (P<0.01). The frequency of using cutting balloons (P = 0.026) and complication rate were higher in the arterial access group than in the venous access group (arterial access: 1 major, 8 minor; venous access: 4 minor; P = 0.015). Conclusions Aggressive evaluation and endovascular therapy can salvage most non-maturing fistulas. Transradial and distal radial approaches can be effective even for challenging lesions.
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Affiliation(s)
- Sang Min Lee
- Department of Radiology, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Jae Boem Na
- Department of Radiology, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
- * E-mail:
| | - Ho Cheol Choi
- Department of Radiology, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Jung Ho Won
- Department of Radiology, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Ji Eun Kim
- Department of Radiology, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Ji Hoon Shin
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyun Oh Park
- Thoracic and Cardiovascular Surgery, Gyeongsang National University School of Medicine and Gyeonsang National University Hospital, Jinju, Republic of Korea
| | - Sung Eun Park
- Department of Radiology, Gyeongsang National University College of Medicine and Gyeonsang National University Changwon Hospital, Changwon, Republic of Korea
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Abstract
A number of studies have evaluated the variable courses of facial artery. However, the results of these differed substantially from each other so not consistent relationships have yet been established. There has also yet to be a relevant study using conventional angiography.We assessed the variant branching pattern of the facial artery and its branches using conventional angiography.Two radiologists retrospectively reviewed 284 cases of angiographies of the external carotid artery in 198 patients. The courses of the facial artery and infraorbital branch of the maxillary artery were classified into 4 types and 2 types, according to the end branch.Among 284 cases of facial artery, type 1 (angular branch) made up 104 cases (36.6%), type 2 (lateral nasal branch) made up 138 cases (48.6%), type 3 (superior labial branch) made up 24 cases (8.5%), and type 4 (inferior labial branch) made up 18 cases (6.3%).Regarding the 284 total cases of maxillary artery, 163 cases (57.4%) had anastomosis with the angular artery or extended to the territory of the angular artery. In addition, 121 cases (42.6%) had nothing done in regard to the angular artery.The results may be helpful for avoiding complications related to facial and maxillary arteries during facial surgeries and cosmetic procedures.
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Affiliation(s)
- Seok Jin Hong
- Department of Radiology, Gyeongsang National University School of Medicine, Jinju
| | - Sung Eun Park
- Department of Radiology, Gyeongsang National University Changwon Hospital, Changwon
| | - Jeong Won Jo
- Department of Dermatology, Gyeongsang National University School of Medicine, Jinju
| | | | - Dae Seob Choi
- Department of Radiology, Gyeongsang National University School of Medicine, Jinju
- Gyeongsang Institute of Health Science, Jinju, Republic of Korea
| | - Jung Ho Won
- Department of Radiology, Gyeongsang National University School of Medicine, Jinju
| | - Minhee Hwang
- Department of Radiology, Gyeongsang National University School of Medicine, Jinju
| | - Chi Yeon Kim
- Department of Dermatology, Gyeongsang National University School of Medicine, Jinju
- Gyeongsang Institute of Health Science, Jinju, Republic of Korea
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Lee SM, Jeong SY, Shin JH, Choi HC, Na JB, Won JH, Park SE, Chen CS. Transcatheter arterial embolization for gastrointestinal bleeding related to pancreatic adenocarcinoma: clinical efficacy and predictors of clinical outcome. Eur J Radiol 2020; 123:108787. [PMID: 31877509 DOI: 10.1016/j.ejrad.2019.108787] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 10/13/2019] [Accepted: 12/08/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE To evaluate the clinical efficacy of transcatheter arterial embolization (TAE) for managing pancreatic adenocarcinoma-related gastrointestinal (GI) bleeding, and to determine the factors associated with clinical outcomes. METHOD From 2001-2017, this retrospective study included 58 patients who underwent TAE for pancreatic adenocarcinoma-related GI bleeding. The technical and clinical success of TAE, clinical factors including patient characteristics and embolization details, complications, and the 30-day mortality were evaluated. Univariate analyses were performed to determine the factors related to the clinical outcomes. RESULTS On angiography, bleeding foci were detected in 47 patients (81%), while the other 11 patients showed tumor staining. Technical success rate was 98%, and first session and overall clinical success rates were 79% and 88%, respectively. N-butyl cyanoacrylate (NBCA) was the most commonly used embolic agent (53%). Stent-related bleeding was shown in 22 patients with characteristic angiogram such as arterial cut-off (13/22) and arteriobiliary fistula (5/22), with comparable clinical success rate (82%). Bleeding from the superior mesenteric artery (n = 3) at the first session of angiography and complications (n = 2), such as ischemic hepatitis and small bowel infarction, were all associated with a 30-day mortality. The overall 30-day mortality rate was 22%. Univariate analysis showed that massive transfusion and TNM stage 4 were related to clinical failure (P = 0.035 and 0.038, respectively). CONCLUSIONS TAE was effective and safe for pancreatic adenocarcinoma-related GI bleeding. Stent-related bleeding was not uncommon, and associated with vascular abnormality amenable to TAE. Massive transfusion and TNM stage 4 were related to clinical failure.
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Affiliation(s)
- Sang Min Lee
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - So Yeong Jeong
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ji Hoon Shin
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Ho Cheol Choi
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Jae Boem Na
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Jung Ho Won
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Sung Eun Park
- Department of Radiology, Gyeongsang National University Hospital, Changwon, Republic of Korea
| | - Cheng Shi Chen
- Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
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Kim HW, Choi YS, Won JH, Lee JM, Heo JY, Choi JA, Oh MJ. Acute generalized exanthematous pustulosis presumed to be caused by acetaminophen. Allergy Asthma Respir Dis 2017. [DOI: 10.4168/aard.2017.5.1.52] [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)
- Hyeong Woo Kim
- Department of Internal Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea
| | - Yong Sun Choi
- Department of Internal Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea
| | - Jung Ho Won
- Department of Internal Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea
| | - Jae Min Lee
- Department of Internal Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea
| | - Jin Young Heo
- Department of Internal Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea
| | - Jung Ah Choi
- Department of Internal Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea
| | - Mi-Jung Oh
- Department of Internal Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea
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Lee MH, Jang JH, Min HJ, Jang HI, Nah JH, Lyu CJ, Han KS, Won JH, Lee YH, Chong SY, Mun YC, Lee WS, Kim SJ, Kim I. Predictors of general discomfort, limitations in activities of daily living and intention of a second donation in unrelated hematopoietic stem cell donation. Bone Marrow Transplant 2016; 52:258-263. [PMID: 27819689 DOI: 10.1038/bmt.2016.260] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 08/22/2016] [Accepted: 08/24/2016] [Indexed: 11/09/2022]
Abstract
We performed a retrospective study of 1868 consecutive unrelated donors to predict the risk factors related to general discomfort, limitations in activities of daily living (ADLs) and intention of a second donation in hematopoietic stem cell (HSC) donation. General discomfort and limitations in ADLs were assessed by numerical measurement (scores of 0-10) and donor's intention of a second donation by yes or no reply. The post-donation questionnaires were completed within 48 h after HSC collection and at 1 week, 4 weeks, and 4 months thereafter. Predictors of general discomfort included female sex (P<0.0001), bone marrow (BM) collection (P<0.0001) or PBSC collection through a central line (CL; P=0.0349), 2-day collection (P=0.0150) and negative or undetermined intention of a second donation on day 1 (P<0.0001). Predictors of limitations in ADLs included age group of 30-39 years (P=0.0046), female sex (P<0.0001), BM collection (P<0.0001) or PBSC collection through a CL (P<0.0001) and negative or undetermined intention of a second donation on day 1 (P<0.0001). The only predictor of positive intention of a second donation was male sex (P=0.0007). Age, sex and collection method and period should be considered risk factors when unrelated HSC donation is performed.
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Affiliation(s)
- M H Lee
- Division of Hematology-Oncology, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, South Korea
| | - J H Jang
- Korea Marrow Donor Program, Seoul, South Korea
| | - H J Min
- Clinical Research Institute, Konkuk University Medical Center, Seoul, South Korea
| | - H I Jang
- Korea Marrow Donor Program, Seoul, South Korea
| | - J H Nah
- Korea Marrow Donor Program, Seoul, South Korea
| | - C J Lyu
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - K-S Han
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - J H Won
- Department of Hematology-Oncology, Soon Chun Hyang University Hospital, Seoul, South Korea
| | - Y-H Lee
- Department of Pediatrics, Hanyang University Medical Center, Hanyang University College of Medicine, Seoul, South Korea
| | - S Y Chong
- Department of Internal Medicine, Bundang Cha Hospital, Seongnam, South Korea
| | - Y C Mun
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, South Korea
| | - W S Lee
- Department of Hematology and Oncology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - S J Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - I Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
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Lee J, Yoo SH, Sohn W, Kim HW, Choi YS, Won JH, Heo JY, Park SJ, Park YM. Obesity and hepatocellular carcinoma in patients receiving entecavir for chronic hepatitis B. Clin Mol Hepatol 2016; 22:339-349. [PMID: 27729627 PMCID: PMC5066372 DOI: 10.3350/cmh.2016.0021] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 06/13/2016] [Accepted: 06/29/2016] [Indexed: 12/11/2022] Open
Abstract
Background/Aims This study aimed to clarify the effect of obesity on the development of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients receiving antiviral treatment. Methods This study applied a retrospective analysis to a historical cohort in Bundang Jesaeng Hospital. In total, 102 CHB patients were treated with entecavir as an initial treatment for CHB and checked for obesity using a body composition analyzer. Hepatic steatosis was measured semiquantitatively using Hamaguchi’s scoring system in ultrasonography. Risk factors for the development of HCC were analyzed, including obesity-related factors (body mass index [BMI], waist circumference [WC], waist-to-hip ratio [WHR], visceral fat area [VFA], and hepatic steatosis). Results The median follow-up duration of the patients was 45.2 months (interquartile range: 36.0-58.3 months). The cumulative incidence rates of HCC at 1 year, 3 years, and 5 years were 0%, 5.3%, and 9.0%, respectively. Univariable analysis revealed that the risk factors for HCC development were a platelet count of <120,000 /mm2 (hazard ratio [HR]=5.21, P=0.031), HBeAg negativity (HR=5.61, P=0.039), and liver cirrhosis (HR=10.26, P=0.031). Multivariable analysis showed that the significant risk factor for HCC development was liver cirrhosis (HR=9.07, P=0.042). However, none of the obesity-related risk factors were significantly associated with HCC: BMI ≥25 kg/m2 (HR=0.90, P=0.894), WC ≥90 cm (HR=1.10, P=0.912), WHR ≥0.9 (HR=1.94, P=0.386), VFA ≥100 cm2 (HR=1.69, P=0.495), and hepatic steatosis (HR=0.57, P=0.602). Conclusion HCC development is associated with liver cirrhosis but not obesity-related factors in CHB patients receiving entecavir.
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Affiliation(s)
- Jaemin Lee
- Department of Internal Medicine, Bundang Jesaeng Hospital, Seongnam, Korea
| | - Sun Hong Yoo
- Department of Internal Medicine, Bundang Jesaeng Hospital, Seongnam, Korea.,Liver Center, Bundang Jesaeng Hospital, Seongnam, Korea
| | - Won Sohn
- Department of Internal Medicine, Bundang Jesaeng Hospital, Seongnam, Korea.,Liver Center, Bundang Jesaeng Hospital, Seongnam, Korea
| | - Hyung Woo Kim
- Department of Internal Medicine, Bundang Jesaeng Hospital, Seongnam, Korea
| | - Yong Sun Choi
- Department of Internal Medicine, Bundang Jesaeng Hospital, Seongnam, Korea
| | - Jung Ho Won
- Department of Internal Medicine, Bundang Jesaeng Hospital, Seongnam, Korea
| | - Jin Young Heo
- Department of Internal Medicine, Bundang Jesaeng Hospital, Seongnam, Korea
| | - Sang Jong Park
- Department of Internal Medicine, Bundang Jesaeng Hospital, Seongnam, Korea.,Liver Center, Bundang Jesaeng Hospital, Seongnam, Korea
| | - Young Min Park
- Department of Internal Medicine, Bundang Jesaeng Hospital, Seongnam, Korea.,Liver Center, Bundang Jesaeng Hospital, Seongnam, Korea
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Park SY, Kim J, Kim BW, Wang HJ, Kim SS, Cheong JY, Cho SW, Won JH. Embolization of percutaneous transhepatic portal venous access tract with N-butyl cyanoacrylate. Br J Radiol 2014; 87:20140347. [PMID: 25027034 PMCID: PMC4453156 DOI: 10.1259/bjr.20140347] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Revised: 07/07/2014] [Accepted: 07/14/2014] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To evaluate the safety and feasibility of N-butyl cyanoacrylate (N-BCA) embolization of percutaneous transhepatic portal venous access tract and to establish an appropriate technique. METHODS 40 consecutive patients underwent percutaneous transhepatic portal venous intervention for various reasons. Embolization of percutaneous transhepatic portal venous access tract was performed after the procedure in all of the patients using N-BCA and Lipiodol® (Lipiodol Ultra Fluide; Laboratoire Guerbet, Aulnay-sous-Bois, France) mixture. Immediate ultrasonography and fluoroscopy were performed to evaluate perihepatic haematoma formation and unintended embolization of more than one segmental portal vein. Follow-up CT was performed, and haemoglobin and haematocrit levels were checked to evaluate the presence of bleeding. RESULTS Immediate haemostasis was achieved in all of the patients, without development of perihepatic haematoma or unintended embolization of more than one segmental portal vein. Complete embolization of percutaneous access tract was confirmed in 39 out of 40 patients by CT. Seven patients showed decreased haemoglobin and haematocrit levels. Other complications included mild pain at the site of embolization and mild fever, which resolved after conservative management. 16 patients died during the follow-up period owing to progression of the underlying disease. CONCLUSION Embolization of percutaneous transhepatic portal vein access tract with N-BCA is feasible and technically safe. With the appropriate technique, N-BCA can be safely used as an alternate embolic material since it is easy to use and inexpensive compared with other embolic materials. ADVANCES IN KNOWLEDGE This is the first study to investigate the efficacy of N-BCA for percutaneous transhepatic portal venous access tract embolization.
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Affiliation(s)
- S Y Park
- 1 Department of Radiology, Ajou University School of Medicine, Suwon, Republic of Korea
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21
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Lee JH, Won JH, Oh CK, Jung HA. Clinical significance of upper-arm cephalic vein patency in autogenous radial-cephalic wrist fistulas for hemodialysis. Eur J Vasc Endovasc Surg 2012; 44:514-20. [PMID: 23022033 DOI: 10.1016/j.ejvs.2012.08.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Accepted: 08/28/2012] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To investigate the significance of upper-arm cephalic veins (UACVs) in radial-cephalic arteriovenous fistulas (RCAVFs), the medical records of 183 patients who had undergone RCAVF creation were reviewed retrospectively. METHODS The patients were divided into two groups according to the status of the UACV upon preoperative venography: group A of 153 cases (83.6%) with a patent UACV and group B of 30 cases (16.3%) with a stenosed or occluded UACV. The clinical outcomes were compared. RESULT RCAVFs in group B had a significantly higher maturation failure rate (26.7% vs. 9.8%, p = 0.009) and lower primary/secondary patency rates (log-rank test, p < 0.0001) than those in the group A. The patients in group B required more frequent endovascular intervention to maintain access function (p = 0.002). The most common stenosis site was a draining vein in group B, in comparison to juxta-anastomosis in group A. In the multivariate analyses, the status of the UACV was an independent predictor of the primary and secondary patency rates of RCAVFs (p < 0.005). CONCLUSION UACV patency has a significant impact on clinical outcome for RCAVFs. When planning an RCAVF placement, venous status including the UACV should be considered.
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Affiliation(s)
- J H Lee
- Department of Surgery, Ajou University School of Medicine, Wonchon-Dong, Yeongtong-Gu, Suwon, Republic of Korea
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Kim BW, Bae BK, Lee JM, Won JH, Park YK, Xu WG, Wang HJ, Kim MW. Duct-to-duct biliary reconstructions and complications in 100 living donor liver transplantations. Transplant Proc 2009; 41:1749-55. [PMID: 19545721 DOI: 10.1016/j.transproceed.2009.02.097] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2008] [Accepted: 02/23/2009] [Indexed: 02/07/2023]
Abstract
OBJECTIVE We evaluated the risk factors for biliary complications and surgical procedures for duct-to-duct reconstructions in adult living donor liver transplantation (LDLT). PATIENTS AND METHODS From February 2005 to March 2008, we performed 100 cases of adult LDLT with duct-to-duct biliary reconstruction, using 64 right lobe grafts, 33 left lobe grafts, and 3 right lateral grafts. We employed 4 types of duct-to-duct procedures: all interrupted 6-0 Prolene suture (group 1, n = 9); continuous posterior and interrupted anterior wall 6-0 Prolene suture (group 2, n = 49); all continuous 7-0 Prolene suture (group 3, n = 26); and all continuous 7-0 Prolene suture with external stent (group 4, n = 16). Biliary complications were defined as an anastomosis stricture or a leakage. RESULTS Thirty-four patients experienced biliary complications during the follow-up period (median, 27 months). The incidence of stricture was 27% and that of leakage, 8%. There were no perioperative, intraoperative, or anatomic risk factors for biliary complications, except the type of duct-to-duct procedure. Group 1 and 2 patients showed higher incidences of biliary strictures than groups 3 and 4 (43.1% vs 4.7%; P = .00). Group 3 patients experienced a higher incidence of bile leakage than the other groups (23.1% vs 2.7%; P = .004). CONCLUSIONS The type of biliary reconstruction is a factor affecting biliary complications following duct-to-duct anastomosis in LDLT. Duct-to-duct biliary anastomosis with 7-0 monofilament suture and a small external stent is a feasible procedure in LDLT that significantly reduces the incidence of biliary complications.
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Affiliation(s)
- B W Kim
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea
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Abstract
The effect of the aqueous extract of Alpinia oxyphylla Miq. (Zingiberaceae) fruits (AOFE) on anaphylactic reaction was investigated. AOFE completely inhibited compound 48/80-induced systemic anaphylactic shock at dose of 1.0 g/kg. When AOFE was pretreated at concentrations ranging from 0.01 to 1.0 g/kg, the plasma histamine levels induced by compound 48/80 were reduced in a dose-dependent manner. AOFE also inhibited the histamine release from rat peritoneal mast cells (RPMC) by compound 48/80. The level of cAMP in RPMC, when AOFE was added, transiently and significantly increased about 4-fold compared with that of basal cells. These results indicate that AOFE may be beneficial in the treatment of non-specific anaphylactic reactions.
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Affiliation(s)
- T Y Shin
- College of Pharmacy, Woosuk University, Chonju, Chonbuk, South Korea
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Kim HM, Lee JH, Won JH, Park EJ, Chae HJ, Kim HR, Kim CH, Baek SH. Inhibitory effect on immunoglobulin E production in vivo and in vitro by Siegesbeckia glabrescens. Phytother Res 2001; 15:572-6. [PMID: 11746835 DOI: 10.1002/ptr.749] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Elevated levels of immunoglobulin (Ig)E are associated with immediate-type allergic reactions. The effect of an aqueous extract of Siegesbeckia glabrescens (Compositae) whole plants (SGWP) on in vivo and in vitro IgE production was studied in mice. SGWP dose-dependently inhibited the active systemic anaphylaxis and serum IgE production induced by immunization with ovalbumin and Bordetella pertussis toxin absorbed to aluminium hydroxide gel. SGWP dose-dependently inhibited IL-4-dependent IgE production by lipopolysaccharide-stimulated murine whole spleen cells. In the case of U266 human IgE-bearing B cells, SGWP also showed an inhibitory effect on IgE production. These results suggest that SGWP has an anti-allergic activity by inhibiting IgE production from B cells.
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Affiliation(s)
- H M Kim
- Department of Oriental Pharmacy, College of Pharmacy, Center of Oriental Medicinal Science, Wonkwang University, Sukjang-Dong, 707, Kyung-Ju City, Kyungpook 780-714, South Korea.
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Peng XY, Won JH, Rutherford T, Fujii T, Zelterman D, Pizzorno G, Sapi E, Leavitt J, Kacinski B, Crystal R, Schwartz P, Deisseroth A. The use of the L-plastin promoter for adenoviral-mediated, tumor-specific gene expression in ovarian and bladder cancer cell lines. Cancer Res 2001; 61:4405-13. [PMID: 11389068] [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: 02/20/2023]
Abstract
A 2.4-kb truncated L-plastin promoter was inserted either 5' to the LacZ gene (Ad-Lp-LacZ) or 5' to the cytosine deaminase (CD) gene (Ad-Lp-CD) in a replication-incompetent adenoviral vector backbone. Infectivity and cytotoxicity experiments with the LacZ and CD vectors suggested that the L-plastin promoter-driven transcriptional units were expressed at much higher levels in explants of ovarian cancer cells from patients and in established ovarian or bladder cancer cell lines than they were in normal peritoneal mesothelial cells from surgical specimens, in organ cultures of normal ovarian cells, or in the established CCD minimal deviation fibroblast cell line. Control experiments showed that this difference was not attributable to the lack of infectivity of the normal peritoneal cells, the normal ovarian cells, or the minimal deviation CCD fibroblast cell line, because these cells showed expression of the LacZ reporter gene when exposed to the replication-incompetent adenoviral vector carrying the cytomegalovirus (CMV)-driven LacZ gene (Ad-CMV-LacZ). The Ovcar-5 and Skov-3 ovarian cancer cell lines exposed to the Ad-Lp-CD adenoviral vector were much more sensitive to the prodrug 5-fluorocytosine (5FC), which is converted from the 5FC prodrug into the toxic chemical 5-fluorouracil, than was the CCD minimal deviation fibroblast cell line after exposure to the same vector. A mouse xenograft model was used to show that the Ad-Lp-CD vector/5FC system could prevent engraftment of ovarian cancer cells in nude mice. Finally, injection of the Ad-Lp-CD vector into s.c. tumor nodules generated a greater reduction of the size of the tumor nodules than did injection of the Ad-CMV-LacZ vectors into tumor nodules. The Ad-Lp-CD vectors were as suppressive to tumor growth as the Ad-CMV-CD vectors. These results suggest that an adenoviral vector carrying the CD gene controlled by the L-plastin promoter (Ad-Lp-CD) may be of potential value for the i.p. therapy of ovarian cancer.
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Affiliation(s)
- X Y Peng
- Genetic Therapy Program, Yale Cancer Center, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA
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Abstract
We present the radiologic findings of gastric glomus tumors in two patients, in whom upper gastrointestinal series and computed tomography (CT) were primarily used for diagnosis. The diagnosis was surgically confirmed. Contrast-enhanced CT showed peripheral nodular or homogeneous strong enhancement in the arterial phase and prolonged enhancement in the delayed phase.
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Affiliation(s)
- J K Kim
- Department of Diagnostic Radiology, Ajou University, College of Medicine, Mt. 5 Wonchun-Dong, Paldal-Gu, Suwon-si, Kyunggido, 442-749, Korea
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Bae SB, Lee KK, Kim JS, Lee JH, Lee NS, Lee GT, Park SK, Won JH, Baick SH, Hong DS, Lee DW, Park HS. A case of malignant proliferating trichilemmoma of the scalp with multiple metastases. Korean J Intern Med 2001; 16:40-3. [PMID: 11417304 PMCID: PMC4531700 DOI: 10.3904/kjim.2001.16.1.40] [Citation(s) in RCA: 14] [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] [Indexed: 11/27/2022] Open
Abstract
We report a case of malignant proliferating trichilemmal tumor showing multiple distant metastases. The patient demonstrated a round mass in the right occipital area for 12 months and the lesion grew rapidly to assume 8 x 6.5 x 4 cm in diameter, with areas of superficial erosion and crusting within the recent 3 months. The entire lesion was removed with a wide surgical excision. It recurred on the neck area 4 months after excision and the lesion was removed with surgical resection again. There was evidence of multiple metastases on CNS and mediastinal lymph nodes after 6 months. The patient was treated with cisplatin and etoposide combination chemotherapy and a partial response was achieved.
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Affiliation(s)
- S B Bae
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea
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Won JH, Cho SD, Park SK, Lee GT, Baick SH, Suh WS, Hong DS, Park HS. Thrombopoietin is synergistic with other cytokines for expansion of cord blood progenitor cells. J Hematother Stem Cell Res 2000; 9:465-73. [PMID: 10982244 DOI: 10.1089/152581600419125] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We investigated the effects of recombinant human thrombopoietin (TPO) in combination with various cytokines including erythropoietin (EPO), interleukin-3 (IL-3), interleukin-6 (IL-6), and stem cell factor (SCF) on megakaryopoiesis, and the expansion of CD34+CD41a+ cells from human cord blood CD34+ cells with these cytokines under serum-free conditions. Human cord blood CD34+ cells were cultured in Megacult (Stem Cell Technologies Inc. Vancouver, Canada) in the presence of recombinant growth factors. Colony-forming unit-megakaryocyte (CFU-M) colonies were counted on day 14. CD34+CD41a+ and CD34-CD41a+ cell expansion was analyzed using a serum-free liquid culture system for 7 days with recombinant growth factors. TPO alone had a concentration-dependent effect on megakaryocyte colony growth. At concentrations above 1 ng/ml, TPO supported significant CFU-Meg colony formation in a concentration-dependent manner. The combination of TPO plus other cytokines, including EPO, IL-3, and SCF, resulted in a synergistic enhancement of the number of CFU-Meg colonies, but IL-6 failed to enhance the effect of TPO. The number of CD41a+ cells increased after 7 days in liquid culture of human cord blood CD34+ cells with various cytokines (EPO, IL-3, IL-6, SCF) combined with TPO, but SCF plus TPO only resulted in a significant synergistic increment of CD34+CD41a+ cells compared with TPO alone. The results of the present study indicate that EPO, IL-3, and SCF can be synergistic with TPO to stimulate proliferation of CFU-Meg and suggest that SCF plus TPO can expand CD34+CD41a+ cells to effect the rapid recovery of platelets in patients following stem cell transplantation.
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Affiliation(s)
- J H Won
- Department of Internal Medicine and Institute for Clinical Molecular Biology Research, Soon Chun Hyang University College of Medicine, Seoul, Korea.
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Abstract
While pleural effusion in multiple myeloma is relatively infrequent, myelomatous pleural effusion is extremely rare. We experienced a 61-year-old woman with IgD-lambda multiple myeloma and pleural effusion. The diagnosis was made originally by pleural biopsy, pleural fluid cytology and immunoelectropheresis of pleural fluid. Transient improvement of the pleural effusion was observed after administration of combination chemotherapy of vincristine, melphalan, cyclophosphamide, prednisone (VMCP)/vincristine, cyclophosphamide, adriamycin, prednisone (VCAP). Two months later, myelomatous pleural effusion recurred and no response to salvage therapy was observed. We reviewed the clinical feature of this case and literature concerning myelomatous pleural effusion.
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Affiliation(s)
- Y M Kim
- Department of Internal Medicine, Soonchunhyang University, College of Medicine, Seoul, Korea
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Sweeney TE, Bonadio JA, Freiman MA, Getts RT, Lloyd BT, McKeown K, Platt MP, Won JH. A new in vivo microvascular preparation of the hamster ovary. Microcirculation 1999; 6:315-20. [PMID: 10654282] [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: 02/15/2023]
Abstract
Ovarian function in the cycling female is intimately related to and dependent upon significant microvascular regulation and restructuring. To enable investigation of the microvascular determinants of ovarian function, we present an in vivo preparation of the golden hamster ovary. The preparation does not compromise the ovarian vascular supply. The viability and responsiveness of the preparation were confirmed by quantifying arteriolar responses to vasoactive agents in 17 hamsters. Small surface arterioles (mean diameter 15-16 microns) responded with statistically significant changes in diameter to adenosine and oxygen and showed significant, dose-dependent constriction in response to norepinephrine and the NO synthase inhibitor L-NAME. Other key findings included extremely high microvascular permeability that varied with the day of the estrous cycle and functionally significant architectural features of the utero-ovarian vascular network. Potential applications of the preparation include elucidation of the role of the microvasculature in follicular development and luteal regression, investigation of utero-ovarian crossregulation, and development of a model for the study of ovarian angiogenesis and vascular regression.
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Affiliation(s)
- T E Sweeney
- Department of Biology, University of Scranton, PA 18510-4625, USA.
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31
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Won JH, Parekattil SJ, Davidson SD, Luddy JS, Choudhury MS, Mallouh C, Tazaki H, Konno S. Ammonium-chloride-induced prostatic hypertrophy in vitro: urinary ammonia as a potential risk factor for benign prostatic hyperplasia. Urol Res 1999; 27:376-81. [PMID: 10550527 DOI: 10.1007/s002400050166] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
To test the possibility that urinary ammonia could be a risk factor for benign prostatic hyperplasia (BPH), we explored the cellular effects of ammonium chloride (NH(4)Cl) on prostatic cancer cells used as an experimental model. Following treatment of human prostatic cancer DU-145 cells with the varying concentrations of NH(4)Cl for 3 days, cell growth was inhibited by approximately 50% at 5 mM NH(4)Cl and almost completely inhibited at 10 mM NH(4)Cl. However, the individual cell size in these treated cells became approximately 2-fold larger and cellular protein content was also up to 2.5-fold greater than in untreated cells. This protein increase appeared to result from the reduced protein degradation, verified by metabolic labeling with [(14)C]valine. Western blot analysis further suggested that such reduced protein turnover could in part be due to the inactivation of a lysosomal acid protease, cathepsin D. Taken together, these studies demonstrate NH(4)Cl-induced hypertrophy in prostatic cancer cells, as evidenced by the growth inhibition, cell enlargement, and cellular protein increase. Therefore, ammonia is not an inert metabolic product; instead, its chronic effects on the prostate may ultimately lead to significant cellular and biochemical alterations of the prostate such as BPH.
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Affiliation(s)
- J H Won
- New York Medical College, Department of Urology, Munger Pavilion 4th Floor, Valhalla, NY 10595, USA
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Kim HM, Kim HW, Lyu YS, Won JH, Kim DK, Lee YM, Morii E, Jippo T, Kitamura Y, An NH. Inhibitory effect of mast cell-mediated immediate-type allergic reactions by Cichorium intybus. Pharmacol Res 1999; 40:61-5. [PMID: 10378992 DOI: 10.1006/phrs.1999.0474] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [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] [Indexed: 11/22/2022]
Abstract
We investigated the effect of an aqueous extract of Cichorium intybus (CIAE) on mast cell-mediated immediate type allergic reactions. CIAE (0.1-1000 mg kg-1) dose-dependently inhibited systemic anaphylactic reaction induced by compound 48/80 in mice. Especially, CIAE inhibited compound 48/80-induced anaphylactic reaction 100% with the dose of 1000 mg kg-1. CIAE 1000 mg kg-1also significantly inhibited local anaphylactic reaction activated by anti-dinitrophenyl (DNP) IgE. When mice were pretreated with CIAE at a concentration ranging from 0.1 to 1000 mg kg-1, the plasma histamine levels were reduced in a dose-dependent manner. CIAE (1-1000 microg ml-1) dose-dependently inhibited histamine release from the rat peritoneal mast cells (RPMC) activated by compound 48/80 or anti-DNP IgE. The level of cAMP in RPMC, when CIAE (1000 microg ml-1) was added, increased significantly compared with that of control cells. These results indicate that CIAE inhibits mast cell-mediated immediate-type allergic reactions in vivo and in vitro.
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Affiliation(s)
- H M Kim
- College of Pharmacy, Wonkwang University, Iksan, Chonbuk, 570-749, South Korea
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Won JH, Kim MJ, Kim BM, Ji H, Chung JJ, Yoo HS, Lee JT, Park YN, Hong SW. Focal eosinophilic infiltration of the liver: a mimick of hepatic metastasis. Abdom Imaging 1999; 24:369-72. [PMID: 10390559 DOI: 10.1007/s002619900516] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
We present three cases of focal eosinophilic infiltration in the liver that mimicked hepatic malignancy on computed tomography during hepatic arteriography (CTHA) and computed tomography during arterial portography (CTAP). In all patients, focal eosinophilic liver infiltration appeared as a solitary nodule or as two nodules without hepatosplenomegaly and showed homogeneous hyperattenuation on CTHA and hypoattenuation on CTAP.
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Affiliation(s)
- J H Won
- Department of Diagnostic Radiology, Ajou University, College of Medicine, Mt. 5 Wonchun-Dong, Paldal-Gu, Suwon-si, Kyounggido, 442-749, Korea
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34
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Garcia-Sanchez F, Pizzorno G, Fu SQ, Nanakorn T, Krause DS, Liang J, Adams E, Leffert JJ, Yin LH, Cooperberg MR, Hanania E, Wang WL, Won JH, Peng XY, Cote R, Brown R, Burtness B, Giles R, Crystal R, Deisseroth AB. Cytosine deaminase adenoviral vector and 5-fluorocytosine selectively reduce breast cancer cells 1 million-fold when they contaminate hematopoietic cells: a potential purging method for autologous transplantation. Blood 1998; 92:672-82. [PMID: 9657770] [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: 02/08/2023] Open
Abstract
Ad.CMV-CD is a replication incompetent adenoviral vector carrying a cytomegalovirus (CMV)-driven transcription unit of the cytosine deaminase (CD) gene. The CD transcription unit in this vector catalyzes the deamination of the nontoxic pro-drug, 5-fluorocytosine (5-FC), thus converting it to the cytotoxic drug 5-fluorouracil (5-FU). This adenoviral vector prodrug activation system has been proposed for use in selectively sensitizing breast cancer cells, which may contaminate collections of autologous stem cells products from breast cancer patients, to the toxic effects of 5-FC, without damaging the reconstitutive capability of the normal hematopoietic cells. This system could conceivably kill even the nondividing breast cancer cells, because the levels of 5-FU generated by this system are 10 to 30 times that associated with systemic administration of 5-FU. The incorporation of 5-FU into mRNA at these high levels is sufficient to disrupt mRNA processing and protein synthesis so that even nondividing cells die of protein starvation. To test if the CD adenoviral vector sensitizes breast cancer cells to 5-FC, we exposed primary explants of normal human mammary epithelial cells (HMECs) and the established breast cancer cell (BCC) lines MCF-7 and MDA-MB-453 to the Ad.CMV-CD for 90 minutes. This produced a 100-fold sensitization of these epithelial cells to the effects of 48 hours of exposure to 5-FC. We next tested the selectivity of this system for BCC. When peripheral blood mononuclear cells (PBMCs), collected from cancer patients during the recovery phase from conventional dose chemotherapy-induced myelosuppression, were exposed to the Ad.CMV-CD for 90 minutes in serum-free conditions, little or no detectable conversion of 5-FC into 5-FU was seen even after 48 hours of exposure to high doses of 5-FC. In contrast, 70% of 5-FC was converted into the cytotoxic agent 5-FU when MCF-7 breast cancer cells (BCCs) were exposed to the same Ad.CMV-CD vector followed by 5-FC for 48 hours. All of the BCC lines tested were shown to be sensitive to infection by adenoviral vectors when exposed to a recombinant adenoviral vector containing the reporter gene betagalactosidase (Ad.CMV-betagal). In contrast, less than 1% of the CD34-selected cells and their more immature subsets, such as the CD34+CD38- or CD34(+)CD33- subpopulations, were positive for infection by the Ad.CMV-betagal vector, as judged by fluorescence-activated cell sorting (FACS) analysis, when exposed to the adenoviral vector under conditions that did not commit the early hematopoietic precursor cells to maturation. When artificial mixtures of hematopoietic cells and BCCs were exposed for 90 minutes to the Ad.CMV-CD vector and to 5-FC for 10 days or more, a greater than 1 million fold reduction in the number of BCCs, as measured by colony-limiting dilution assays, was observed. To test if the conditions were damaging for the hematopoietic reconstituting cells, marrow cells collected from 5-FU-treated male donor mice were incubated with the cytosine deaminase adenoviral vector and then exposed to 5-FC either for 4 days in vitro before transplantation or for 14 days immediately after transplantation in vivo. There was no significant decrease in the reconstituting capability of the male marrow cells, as measured by their persistence in female irradiated recipients for up to 6 months after transplantation. These observations suggest that adenovirus-mediated gene transfer of the Escherichia coli cytosine deaminase gene followed by exposure to the nontoxic pro-drug 5-FC may be a potential strategy to selectively reduce the level of contaminating BCCs in collections of hematopoietic cells used for autografts in breast cancer patients.
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Affiliation(s)
- F Garcia-Sanchez
- Department of Internal Medicine, Section of Medical Oncology, Yale University School of Medicine, New Haven, CT 06520-8032, USA
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35
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Han KJ, Jung IS, Kim CK, Park SK, Kim DW, Baick SH, Won JH, Hong DS, Hwang SD, Moon C, Park HS. A case of CMV disease of the jejunum in a patient with non-Hodgkin's lymphoma. Korean J Intern Med 1998; 13:143-6. [PMID: 9735673 PMCID: PMC4531948 DOI: 10.3904/kjim.1998.13.2.143] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
CMV infection may occur anywhere in the gastrointestinal tract. Among the small intestine, ileum is the most common site of CMV disease and infection of jejunum is a rare one in patients with CMV gastroenteritis. Although rare, the reason why the recognition of this diagnosis is important is that it cause the lethal hemorrhage and perforation of gastrointestinal tract when its diagnosis and treatment was delayed. Rapid diagnosis are able to using the immunohistochemical stain in shell vial culture of infected specimen or peripheral neutrophils preparation in viremic patients within 8 to 36 hours. The treatment of choice is antiviral agent or surgical resection. We experienced a case of CMV disease of jejunum in patient with non-Hodgkin's lymphoma who showed severe ulceration in jejunum and massive intestinal hemorrhage, and he survived after successful treatment with segmental resection of jejunum and intravenous ganciclovir.
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Affiliation(s)
- K J Han
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea
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36
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Park ES, Won JH, Han KJ, Suh PG, Ryu SH, Lee HS, Yun HY, Kwon NS, Baek KJ. Phospholipase C-delta1 and oxytocin receptor signalling: evidence of its role as an effector. Biochem J 1998; 331 ( Pt 1):283-9. [PMID: 9512491 PMCID: PMC1219350 DOI: 10.1042/bj3310283] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Although the oxytocin receptor modulates intracellular Ca2+ ion levels in myometrium, the identities of signal molecules have not been clearly clarified. Our previous studies on oxytocin receptor signalling demonstrated that 80 kDa Ghalpha is a signal mediator [Baek, Kwon, Lee, Kim, Muralidhar and Im (1996) Biochem. J. 315, 739-744]. To elucidate the effector in the oxytocin receptor signalling pathway, we evaluated the oxytocin-mediated activation of phospholipase C (PLC) by using solubilized membranes from human myometrium and a three-component preparation containing the oxytocin receptor-Ghalpha-PLC-delta1 complex. PLC-delta1 activity in the three-component preparation, as well as PLC activity in solubilized membranes, was increased by oxytocin in the presence of Ca2+ and activated Ghalpha (GTP-bound Ghalpha). Furthermore the stimulated PLC-delta1 activity resulting from activation of Ghalpha via the oxytocin receptor was significantly attenuated by the selective oxytocin antagonist desGly-NH2d(CH2)5[Tyr(Me)2,Thr4]ornithine vasotocin or GDP. Consistent with these observations, co-immunoprecipitation and co-immunoadsorption of PLC-delta1 in the three-component preparation by anti-Gh7alpha antibody resulted in the PLC-delta1 being tightly coupled to activated Ghalpha on stimulation of the oxytocin receptor. These results indicate that PLC-delta1 is the effector for Ghalpha-mediated oxytocin receptor signalling.
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Affiliation(s)
- E S Park
- Department of Biochemistry, College of Medicine, Chung-Ang University, 221 Heuksuk-Dong, Dongjak-Gu, Seoul 156-756, South Korea
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Abstract
Reports of lymphangiectases that occur in lesions of morphea are rare. We describe a 24-year-old woman with a solitary morphea profunda associated with lymphangiectasia. Unlike previously reported cases, our case showed lymphatic dilatation resembling Swiss cheese and developed around a milium.
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Affiliation(s)
- S K Ahn
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea
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38
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Abstract
Factor V deficiency is a relatively uncommon disorder, inherited as an autosomal recessive trait that manifests clinically only in individuals who inherit the defective gene from both parents. The hemorrhage of nasal and oral cavity and ecchymosis are common but intracranial hemorrhage is very rare. We experienced a 53 year old male patient with intracranial hemorrhage due to factor V deficiency. The laboratory tests showed prolongation of APTT and PT, normal bleeding time and normal thrombin time. The levels of the coagulation profiles on the patient revealed a significant decrease factor V, below 1% of normal range (60-140%). Other coagulation factors were normal. He was treated with fresh frozen plasma and completely recovered 3 weeks after treatment.
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Affiliation(s)
- S G Yoon
- Institute for Clinical molecular Biology Research, College of Medicine, Soonchunhyang University, Seoul, Korea
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39
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Lee NS, Cha SW, Hong SJ, Shin WY, Lee GT, Jeon JW, Won JH, Baick SH, Hong DS, Park HS. A case of lymphomatoid papulosis occurred simultaneously with Ki-1-positive anaplastic large cell lymphoma. Korean J Intern Med 1997; 12:84-8. [PMID: 9159045 PMCID: PMC4531975 DOI: 10.3904/kjim.1997.12.1.84] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Lymphomatoid papulosis (LyP) is a chronic self-healing skin eruption that is clinically benign but histologically mimics a malignant lymphoma. However, lymphomatoid papulosis with anaplastic large cell lymphoma responds poorly to medical treatments, including chemotherapies. We experienced a 60-year-old male patient with lymphomatoid papulosis occurred simultaneously with relapsed Ki-1-positive anaplastic large cell lymphoma who was treated with salvage chemotherapy but, unfortunately, failed to be rescued. We report it with a review of the literature.
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Affiliation(s)
- N S Lee
- Department of Internal Medicine, Soonchunhyang University, College of Medicine, Seoul, Korea
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40
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Won JH, Oishi N, Kawamura T, Sugiwaka T, Fukuda S, Sato R, Naito Y. Mineral metabolism in plasma, urine and bone of periparturient cows fed anionic diets with different calcium and phosphorous contents. J Vet Med Sci 1996; 58:1187-92. [PMID: 8996701 DOI: 10.1292/jvms.58.12_1187] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [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: 02/03/2023] Open
Abstract
The objective of this experiment was to evaluate the influences of Ca and P contents in an anionic diet on the mineral metabolism in plasma, urine and bone in periparturient diary cows. Fifteen multiparous Holstein-Friesian cows were divided into 3 dietary groups (5 cows/group) by dietary Ca and P contents and dietary cation-anion balance [(Na + K) - (Cl + S) mEq/kg DM]; diet 1 [low Ca (0.46%), low P (0.24%), cationic (+195.8 mEq/kg DM)]; diet 2 [low Ca (0.46%), low P (0.24%), anionic (-32.4 mEq/kg DM)]; and diet 3 [high Ca (0.93%), high P (0.60%), anionic (-41.0 mEq/kg DM)]. Cows were fed one of these 3 diets from approximately 4 weeks before the expected calving date to 5 days after calving. There was no outbreak of milk fever in any cows fed these 3 diets; however, plasma Ca levels at 1 and 2 days after calving tended to be higher in the cows fed diet 3 than those in the cows fed diets 1 or 2. Fractional urinary excretion of Ca in the cows fed diet 2 or 3 was higher than that in the cows fed diet 1. Fractional urinary excretion and plasma level of Pi were higher during the periparturient period in the cows fed diet 3 than those in the cows fed diets 1 or 2. There were no significant differences in plasma parathyroid hormone levels among the 3 groups. In the spongy substance of ilium at 5 days after calving, the Ca and Mg contents bone volume and trabecular thickness were the lowest, but not significant, in the cows fed diet 2. These data suggest that sufficient Ca and P contents in an anionic diet may be effective in maintaining plasma Ca and Pi levels of periparturient cows and further in preventing of potential bone damage brought about by increased urinary mineral excretion following the feeding of an anionic diet.
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Affiliation(s)
- J H Won
- Department of Veterinary Internal Medicine, Faculty of Agriculture, Iwate University, Japan
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41
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Abstract
Lymphoepithelial cyst of the oral cavity is an uncommon cystic lesion lined with stratified squamous epithelium surrounded by lymphoid tissue. We report a case of lymphoepithelial cyst associated with two large epithelial inclusion cysts.
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Affiliation(s)
- S K Ahn
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, South Korea
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42
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Won JH, Fukuda S, Sato R, Naito Y. Bone histomorphometric changes due to differences in calcium intake under metabolic acidosis in rats. J Vet Med Sci 1996; 58:611-6. [PMID: 8844595 DOI: 10.1292/jvms.58.611] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Effects of differences in calcium (Ca) intake on bone metabolism under metabolic acidosis were examined by bone histomorphometry in rats. Rats were divided into 5 diets; low Ca (0.02%) diet (LCD), moderate low Ca (0.3%) diet (LmCD), standard Ca (0.62%) diet (SCD), moderate high Ca (1%) diet (HmCD) and high Ca (3%) diet (HCD). Each diet rats were subdivided into the acidotic group given a 1.8% ammonium chloride solution as drinking water and control group given deionized water. Blood and double labeled bone were collected 30 days later. Arterial blood pH was significantly lower, and plasma ionized Ca level and urinary Ca excretion were higher in the acidotic groups than those in the control groups in all diets. Breaking force in femur and bone volume in tibial proximal metaphysis were significantly lower in the acidotic groups than those in the control groups in LCD, LmCD and SCD. In the acidotic groups, osteoid thickness was significantly higher in LCD than that in LmCD, HmCD and HCD. Mineral apposition rate in the acidotic groups was significantly higher in LCD and LmCD than that in HmCD and HCD. These results suggest that bone mineral loss and bone fragility under metabolic acidosis may be accelerated by high turnover of bone metabolism due to insufficient dietary Ca intake, but can be prevented by adequate supplementation of Ca.
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Affiliation(s)
- J H Won
- Department of Veterinary Internal Medicine, Faculty of Agriculture, Iwate University, Japan
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Abstract
We report a case of pulmonary aspergilloma which developed within intralobar pulmonary sequestration.
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Affiliation(s)
- J Y Park
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Taegu, Korea
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44
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Ahn SK, Won JH, Choi EH, Kim SC, Lee SH. Perforating plate-like osteoma cutis in a man with solitary morphoea profunda. Br J Dermatol 1996; 134:949-52. [PMID: 8736344] [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: 02/01/2023]
Abstract
Solitary morphoea profunda is an unusual form of scleroderma, characterized by marked fibrosis, hyalinization of collagen fibres, and inflammatory cell infiltration in the deep dermal and subcutaneous layers. We describe a 58-year-old man showing solitary morphoea profunda. Plate-like osteoma cutis, with transepidermal elimination of bony material, within the morphoea profunda, was present.
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Affiliation(s)
- S K Ahn
- Department of Dermatology, Yonsei University Wonju College of Medicine, Korea
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45
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Affiliation(s)
- S C Kim
- Department of Dermatology, Yonsei University College of Medicine, Seoul, Korea
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46
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Abstract
PURPOSE Our goal was to describe the MR appearance of distal femoral cortical irregularity (DFCI). METHOD With plain radiographs and MR images of 100 knees, the presence of DFCIs was determined, and the shapes of DFCIs were classified into three subgroups: concave, convex, and divergent cortical shapes. Radiographic and MR shapes of DFCIs were compared. RESULTS DFCIs were shown in various shapes on both the radiographs and the MR images. Forty-four DFCIs were found both on radiograph and by MR image. An additional 14 DFCIs were identifiable only on MR images. However, the majority of DFCIs showed an association between radiographic and MR shapes. MRI revealed that all 58 DFCIs were located at the attachment site of the medial gastrocnemius muscle. DFCIs were enhanced in three of the four patients who underwent postcontrast MR study. CONCLUSION A good understanding of radiographic and MR findings of the DFCI may be of great help in the differential diagnosis of distal femoral lesions.
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Affiliation(s)
- J S Suh
- Department of Diagnostic Radiology, Medical College of Yonsei University, Seoul, Korea
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47
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Won JH, Lee JD, Chung TS, Park CY, Lee BI. Increased contralateral cerebellar uptake of technetium-99m-HMPAO on ictal brain SPECT. J Nucl Med 1996; 37:426-9. [PMID: 8772637] [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: 02/02/2023] Open
Abstract
UNLABELLED Crossed cerebellar diaschisis (CCD) is a well-known brain SPECT finding in stroke patients. Two reports, however, have described supratentorial and contralateral cerebellar hyperperfusion (crossed cerebellar hyperperfusion) on ictal brain SPECT in epileptic patients. The purpose of this study was to assess the usefulness of crossed cerebellar hyperperfusion (CCH) for the detection of epileptic foci on ictal scan. METHODS Twelve patients with complex partial seizures having characteristic clinical, electroencephalographic (EEG) and brain SPECT findings were included. Fifteen to 20 mCi 99mTc-HMPAO were injected intravenously during the seizure period or the aura for the ictal SPECT study. The SPECT findings were visually assessed to determine whether the finding of CCH was valuable in the localization of ictal foci. RESULTS Epileptic foci were found in the right temporal (n = 6), left temporal (n = 4), right occipital (n = 1) and left frontal (n = 1) areas. CCH was observed in 8 (75%) of the 12 patients. In two patients, contralateral cerebellar uptake was more obvious than that in the epileptic foci. In the interictal scans, cerebellar activity, which was increased in ictal period, was equalized in seven of eight patients, while perfusion was diminished in the remaining patient. CONCLUSION CCH is a frequent finding of ictal brain SPECT and may aid in the lateralization of epileptic foci.
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Affiliation(s)
- J H Won
- Department of Radiology and Neurology, Yonsei University College of Medicine, Seoul, Korea
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48
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Won JH, Taniguchi K, Sato R, Naito Y. Effects of vitamin D3 injection on activity of thyroid parafollicular cells in pregnant rats. J Vet Med Sci 1996; 58:75-6. [PMID: 8645762 DOI: 10.1292/jvms.58.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Effects of vitamin D3 (VD3) injection on the activity of thyroid parafollicular cells (C cells) and calcium (Ca) metabolism were examined in rats of non-(NP), middle (MP) and late pregnancy (LP). At 3 days after injection, the average area of a C cell was significantly wider (P<0.01) in the VD3 groups than that in their control groups in NP, MP, and LP. On the otherhand, the plasma ca concentration in the VD3 groups decreased significantly (P<0.05) in comparison with that in their control groups in NP and LP, and tended to decrease in MP. These results suggest that injection of VD3 may accelerate the activity of C cells, which may result in the decrease of plasma Ca concentration in both non-pregnant and pregnant rats.
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Affiliation(s)
- J H Won
- Department of Veterinary Internal Medicine, Faculty of Agriculture, Iwate University, Japan
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49
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Park JY, Park JG, Won JH, Lee JM, Kim NS, Jung TH. Effects of corticosteroid and chlorambucil on multiple pulmonary artery aneurysms in Behcet's syndrome. A case report. J Korean Med Sci 1995; 10:470-3. [PMID: 8924235 PMCID: PMC3053889 DOI: 10.3346/jkms.1995.10.6.470] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
A patient with Behcet's syndrome in whom multiple pulmonary artery aneurysms were completely resolved after a combined treatment with corticosteroid and chlorambucil is reported.
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Affiliation(s)
- J Y Park
- Department of Internal Medicine, Kyungpook National University, Taegu, Korea
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50
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Abstract
We report herein a case of idiopathic solitary neuroma with vascular proliferation and neurofibroma-like features. Clinically, the skin lesion was a 0.7 cm nodule without tenderness on the forearm. Histologically, there was vascular proliferation in the upper dermis, some neural structures among the proliferative vasculature in the mid dermis and large bundles of neural structures extending in various directions in the mid and deep dermis (resembling neurofibroma). Special stains, such as Masson's trichrome and Luxol fast blue, and immunohistochemical studies, including S-100 protein, neuron-specific enolase (NSE), vimentin, desmin, factor-VIII related antigen and epithelial membrane antigen (EMA), were added for this very rare case.
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Affiliation(s)
- S K Ahn
- Department of Dermatology, Yonsei University, Wonju, Korea
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