1.Posterior Reversible Encephalopathy Syndrome in a Critically Ill Postoperative Patient.
Min Ae KEUM ; Hyo Keun NO ; Choong Wook LEE ; Sang Beom JEON ; Suk Kyung HONG
Korean Journal of Critical Care Medicine 2015;30(1):46-51
Posterior reversible encephalopathy syndrome (PRES) is a transient condition characterized by altered mental status, seizure, headache, and visual disturbance with typical neuro-imaging findings in the bilateral parieto-occipital regions. Clinicians should be aware of this syndrome because delayed diagnosis and treatment result in irreversible neurologic deficits. We present the case of a 77-year-old male diagnosed with PRES in the setting of postoperative critical illness caused by small-bowel strangulation.
Aged
;
Critical Illness*
;
Delayed Diagnosis
;
Headache
;
Humans
;
Intensive Care Units
;
Male
;
Neurologic Manifestations
;
Posterior Leukoencephalopathy Syndrome*
;
Postoperative Period
;
Seizures
2.Neuroendocrine Tumor in Upper Gastrointestinal Tract.
The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2011;11(2):75-81
Gastric neuroendocrine tumor (GNET) is rare, but increasing in incidence. GNET may be classified into three types on the basis of the background pathology. Type I GNET is related to autoimmune atrophic gastritis and hypergastrinemia. Type II is related to multiple endocrine neoplasia (MEN)-1, Zollinger-Ellison syndrome and hypergastrinemia and sporadic Type III is not related to any background pathology. Type I GNETs can be considered as benign tumors with unusual metastases. However, type II may be related to distant metastases, which is also common in type III GNETs. Type I and type II lesions can be treated by endoscopic excision or somatostatin analogues whereas surgical treatment should be considered for type III lesions. Hypergastrinemia is an essential precondition for the evolution of type I and II lesions, but hypergastrinemia alone is not enough for explanation of tumorigenesis. Furthermore, the pathogenesis of type III neuroendocrine tumors is still poorly understood. Despite improvements in our knowledge of GNET pathogenesis in diagnostic approach and treatment, further investigations and large scale clinical studies are warranted.
Cell Transformation, Neoplastic
;
Gastritis, Atrophic
;
Incidence
;
Multiple Endocrine Neoplasia
;
Multiple Endocrine Neoplasia Type 1
;
Neoplasm Metastasis
;
Neuroendocrine Tumors
;
Somatostatin
;
Upper Gastrointestinal Tract
;
Zollinger-Ellison Syndrome
3.A Case of Vesical Endometriosis.
Sang Keun PARK ; Hyo Kyu CHO ; Nam Kuk KIM ; Jong Keun YOO ; Ro Jung PARK
Korean Journal of Urology 1987;28(3):443-446
We report a case of vesical endometriosis in a 34 year old female patient and review literature. Managements include partial cystectomy, hormonal treatment and radiation. In this case, we select the hormonal treatrnent because the vesical endometriosis was in the fixed portion of the bladder.
Adult
;
Cystectomy
;
Endometriosis*
;
Female
;
Humans
;
Urinary Bladder
4.Endobronchial Metastases of Hepatocellular Carcinoma.
Keun Woo HA ; Pung KANG ; Hyo Jin CHOI ; Mee JOO ; Sung Lim JIN ; Jae Yong JIN ; Hyuk Pyo LEE ; Soo Jeon CHOI ; Ho Kee YUM
Tuberculosis and Respiratory Diseases 2001;51(4):386-389
An endobronchial metastasis is defined as a subsegmental or a more proximal central bronchial metastasis of a nonpulmonary neoplasm in the bronchoscopically visible range. However, the frequencies of endobronchial metastasis range from 2 to 50% of pulmonary metastases from extrathoracic neoplasms by a different difinition of an endobronchial metastasis. Primary neoplasms of an endobronchial metastasis including breast cancer, colon cancer, renal cell carcinoma, and ovarian cancer are relatively common. However, an endobronchial metastasis arising from thyroid cancer, parotid gland tumor, bone tumor, bladder cancer, and stomach cancer has only rarely been reported in the literature. Here we report a case of an endobrochial metastases from a hepatocellular carcinoma
Breast Neoplasms
;
Carcinoma, Hepatocellular*
;
Carcinoma, Renal Cell
;
Colonic Neoplasms
;
Neoplasm Metastasis*
;
Ovarian Neoplasms
;
Parotid Gland
;
Stomach Neoplasms
;
Thyroid Neoplasms
;
Urinary Bladder Neoplasms
5.Three Cases of Symptomatic Huge Arachnoid Cysts.
Ki Hyun JEON ; Hyo Geun JU ; Tae Hyung CHO ; Keun Mo KIM ; Young Jong WOO ; Jung Kil LEE ; Jae Hyu KIM
Journal of the Korean Child Neurology Society 1998;6(1):142-148
Congenital arachnoid cysts are commonly located at sylvian cistern or middle cranial fossa which are usually asymptomatic and incidentally found. Posterior fossa cysts, however, are usually large when diagnosed, and symptomatic. Three cases of large posterior fossa cysts were recognized on the diagnostic MRI investigation for infantile spasm, developmental delay, and the precocious puberty. Surgical decompression of the cysts by craniectomy, cyst excision and fenestration were performed successfully in two patients with arachnoid cysts in the cerebellopontine cistern and the suprasellar, right cerebellopontine, and prepontine cisterns, but an additional cystoperitoneal shunt was needed in a case with the cyst in the quadrigemial cistern with obstructive hydrocephalus. Infantile spasm was treated with vigabatrin and pyridoxine, and the true precocious puberty was managed with LHRH analogue(Decapeptyl ).
Arachnoid Cysts*
;
Arachnoid*
;
Cranial Fossa, Middle
;
Decompression, Surgical
;
Gonadotropin-Releasing Hormone
;
Humans
;
Hydrocephalus
;
Infant
;
Infant, Newborn
;
Magnetic Resonance Imaging
;
Puberty, Precocious
;
Pyridoxine
;
Spasms, Infantile
;
Vigabatrin
6.Particulate Matter from Asian Dust Storms Induces the Expression of Proinflammatory Cytokine in A549 Epithelial Cells.
Jung Ho KIM ; Hyo Keun JEON ; Mi Kyeong KIM ; Sun Yong KYUNG ; Chang Hyeok AN ; Sang Pyo LEE ; Jung Woong PARK ; Sung Hwan JEONG
Tuberculosis and Respiratory Diseases 2006;60(6):663-672
BACKGROUND: PM10(Particulate matter with a diameter < 10micrometer), which is characterized by different environmental conditions, is a complex mixture of organic and inorganic compounds. The Asian dust event caused by meteorological phenomena can also produce unique particulate matter in affected areas. This study investigated the cytokine produced by A549 epithelial cells exposed to particles collected during both the Asian dust pfenomenon and ambient air particles in a non-dusty period. METHOD: Air samples were collected using a high volume air sampler(Sibata Model HV500F) with an air flow at 500l/min for at least 6 hours. The cytokine messenger RNA(mRNA) was measured using a reverse transcriptase polymerase chain reaction(RT-PCR). The A549 cells were exposed to 10 to 500microgram/microliter of a suspension containing PM10 for 24 hours. Each was compared with those in the non-exposed control cells. RESULT: The mRNA levels of interleukin(IL)-1alpha, IL-Ibeta , IL-8, and the granulocyte macrophage colony stimulating factor(GM-CSF) increased after veing exposed to PM10 in the ambient air particles, compared with those in the non-exposed control cells. The increase in IL-1alpha and IL-8 were dose dependent at a PM10 concentration between 100microgram/microliter and 500microgram/microliter. The mRNA level of IL-8 in the A549 epithelial cells was higher during the in the Asian dust period(500microgram/microliter) than during the non dust period. CONCLUSION: A549 cells exposed to the PM10 collected during the Asian dust period produce more proinflammatory cytokine than during non-dusty period. This cytokine enhances the local inflammatory response in the airways and can also contribute to the systemic component of this inflammatory process.
Asian Continental Ancestry Group*
;
Dust*
;
Epithelial Cells*
;
Granulocytes
;
Humans
;
Interleukin-8
;
Macrophages
;
Particulate Matter*
;
RNA, Messenger
;
RNA-Directed DNA Polymerase
7.Analysis of the Hepatic Segments on the Isotropic Multi-planar Reformatted CT Images.
Yoo Jeong YIM ; Won Jae LEE ; Yong Hwan JEON ; Jongmee LEE ; Kwang Bo PARK ; Hyo Keun LIM ; Jae Hoon LIM
Journal of the Korean Radiological Society 2005;53(5):353-362
PURPOSE: We wanted to evaluate the diverse distribution and relation of the hepatic segments, as divided by the portal venous territories, on the isotropic multi-planar reformatted (MPR) CT images and we wanted to find their correlation to the intrahepatic venous structures. MATERIALS AND METHODS: Fifty adult patients who underwent portal phase CT images and who had the normal liver contours at CT were included in our study. The portal phase images were obtained with a slice collimation and reconstruction interval of 1.25 mm, and they were reformatted in the coronal and sagittal planes with a slab thickness of 3 mm. For analysis of these MPR images, various terms were newly defined according to the portal venous territories (e.g., three vertical planes [right, middle and left] and one transverse plane and their plane angles, the transverse and longitudinal angles). Also, the dominant segments of the right lobe were newly divided into the S7- and S8-dominant types by comparing the transverse angles. The imaging analysis was then conducted for the following: (1) the diversity of the three vertical planes and the one transverse plane and their plane angles, (2) the proportion of the dominant segments of the right lobe and their relation with the plane angles, and (3) the correlation between the dominant segments and the intrahepatic venous structures. RESULTS: The number of the S7- and the S8-dominant types was 21 and 29, respectively. The vertical and transverse planes were undulating and diverse according to the dominant segments as follows: the plane angles of the right vertical and middle vertical planes were more vertical in the S7-dominant type than in the S8-dominant type (p < 0.001). The right transverse plane angle was more horizontal in the S8-dominant type (p < 0.05). The left transverse plane angle seemed to be rather vertical than horizontal. For the intrahepatic venous structures, despite of our limited data, the anomalous intrahepatic venous structures might have some correlation with the dominant segments. CONCLUSION: According to our results, we suggest that the isotropic MPR images could successfully depict the vertical and transverse planes of the real hepatic segments, as divided by the portal venous territories, which were diverse according to their dominant types.
Adult
;
Humans
;
Liver
8.Usefulness of Forward-Viewing Endoscope for Endoscopic Retrograde Cholangiopancreatography in Patients with Billroth II Gastrectomy.
Jong Won BYUN ; Jae Woo KIM ; Se Yong SUNG ; Ho Yeon JUNG ; Hyo Keun JEON ; Hong Jun PARK ; Moon Young KIM ; Hyun Soo KIM ; Soon Koo BAIK
Clinical Endoscopy 2012;45(4):397-403
BACKGROUND/AIMS: Patients undergoing Billroth II (B II) gastrectomy are at higher risk of perforation during endoscopic retrograde cholangiopancreatography (ERCP). We assessed the success rate and safety of forward-viewing endoscopic biliary intervention in patients with B II gastrectomy. METHODS: A total of 2,280 ERCP procedures were performed in our institution between October 2008 and June 2011. Of these, forward-viewing endoscopic biliary intervention was performed in 46 patients (38 men and 8 women with B II gastrectomy). Wire-guided selective cannulations of the common bile duct using a standard catheter and guide wire were performed in all patients. RESULTS: The success rate of afferent loop entrance was 42 out of 46 patients (91.3%) and of biliary cannulation after the approach of the papilla was 42 out of 42 patients (100%). No serious complications were encountered, except for one case of small perforation due to endoscopic sphincterotomy site injury. CONCLUSIONS: When a biliary endoscopist has less experience and patient volume is low, ERCP with a forward-viewing endoscope is preferred because of its ease and safety in all patients with prior B II gastrectomies. Also, forward-viewing endoscope can be used to improve the success rate of biliary intervention in B II patients.
Catheterization
;
Catheters
;
Cholangiopancreatography, Endoscopic Retrograde
;
Common Bile Duct
;
Endoscopes
;
Female
;
Gastrectomy
;
Gastroenterostomy
;
Humans
;
Male
;
Sphincterotomy, Endoscopic
9.Effect of Helicobacter pylori Infection on p16, p53, CEA, EGFR Expression in Gastric Neoplasia.
Chan Sik WON ; Mee Yon CHO ; Hyun Soo KIM ; Ki Tae SUK ; Jae Woo KIM ; Hong Jun PARK ; Hyo Keun JEON ; Soon Koo BAIK ; Sang Ok KWON
The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2011;11(1):45-51
BACKGROUND/AIMS: Gastric cancer is one of the most widespread cancers and the second leading cause of cancer-related death worldwide. Although Helicobacter pylori (H. pylori) has been classified as a type I carcinogen for gastric cancer, the exact pathway has remained indistinct. In this study, we investigated the effects of H. pylori on oncogenic proteins (epidermal growth factor receptor [EGFR], CEA), tumor suppressor (p53) and cell-cycle regulator (p16) expression, using immunohistochemical stains, in gastric neoplasias. MATERIALS AND METHODS: From April 2007 until July 2009, 166 patients with consecutive gastric neoplasias resected were retrospectively enrolled; 35 gastric dysplasias, 70 early gastric cancers and 60 advanced gastric cancers. We examined the relationship of clinicopathologic features of gastric neoplasias such as age, sex, p16, p53, EGFR, tissue CEA, TNM stage, Lauren classification, location, histologic type of neoplasia to H. pylori infection status. RESULTS: H. pylori infection detected in the samples of gastric dysplasia, early gastric cancer (EGC) and advanced gastric cancer (AGC) were 15 (41.7%), 38 (54.3%) and 33 (55.0%) samples. p53, CEA and EGFR stains expression were associated with cancer stage (P<0.05). There was no relation between the immunohistochemical stains (p16, p53, CEA, EGFR) and H. pylori infection. CONCLUSIONS: This study failed to show any relation of immunohistochemical markers of p16, p53, EGFR, CEA expressions to H. pylori infection in gastric dysplasia as well as gastric cancer. Further study is necessary to investigate the effect of H. pylori infection on p16, p53, CEA, EGFR expressions in precancerous lesions such as atrophic gastritis and intestinal metaplasia.
Coloring Agents
;
Cyclin-Dependent Kinase Inhibitor p16
;
Gastritis, Atrophic
;
Helicobacter
;
Helicobacter pylori
;
Humans
;
Metaplasia
;
Proteins
;
Retrospective Studies
;
Stomach Neoplasms
10.Prevalence and Risk Factors of Colorectal Neoplasms according to Coronary Artery Obstructive Disease.
Ki Tae SUK ; Hyun Soo KIM ; Hyun Jun MIN ; Hong Jun PARK ; Hyo Keun JEON ; Moon Young KIM ; Jae Woo KIM ; Soon Koo BAIK ; Sang Ok KWON
Intestinal Research 2011;9(2):112-116
BACKGROUND/AIMS: Both colorectal neoplasm (CN) and coronary artery obstructive disease (CAOD) are prevalent and major leading causes of death in Korea. Although CN and CAOD share similar risk factors such as male gender, smoking, hyperlipidemia, diabetes mellitus, and obesity, few studies of both CN and CAOD have been reported. In this study, we evaluated clinical correlations between CN and CAOD. METHODS: Between June 2003 and December 2007, 176 patients (Male: 101, average age: 62.1+/-9.7 yr) who underwent colonoscopy after or before coronary angiography were retrospectively enrolled. The colonoscopic findings (normal, adenoma, or cancer) of patients as well as clinical and laboratory data according to the extent of CAOD (normal, minimal CAOD, or CAOD) were compared. RESULTS: CAOD negative, minimal CAOD, and CAOD patients totaled 36, 40, and 100, respectively. The presence of CN (adenoma and adenocarcinoma) in CAOD negative, minimal CAOD, and CAOD cases was 42%, 48%, and 63%, respectively, which was significantly different (P<0.05). In multivariate analysis, old age (> or =60 yr; P=0.03, odds ratio 2.47) and the presence of CAOD (P=0.02, odds ratio 4.11) were associated with the presence of CN. CONCLUSIONS: The prevalence of CN increased in proportion to the severity of CAOD. Colorectal cancer screening by fecal occult blood tests or colonoscopy should be a priority in patients with CAOD, particularly the elderly.
Adenoma
;
Aged
;
Cause of Death
;
Colonoscopy
;
Colorectal Neoplasms
;
Coronary Angiography
;
Coronary Artery Disease
;
Coronary Vessels
;
Diabetes Mellitus
;
Humans
;
Hyperlipidemias
;
Korea
;
Male
;
Mass Screening
;
Multivariate Analysis
;
Obesity
;
Occult Blood
;
Odds Ratio
;
Prevalence
;
Retrospective Studies
;
Risk Factors
;
Smoke
;
Smoking