1.Participation of KATP Channels in the Antinociceptive Effect of Pregabalin in Rat Formalin Test.
Tae Dong KWEON ; Ji Young KIM ; Il Won KWON ; Jong Bum CHOI ; Youn Woo LEE
The Korean Journal of Pain 2011;24(3):131-136
BACKGROUND: Pregabalin is an anticonvulsant and analgesic agent that interacts selectively with the voltage-sensitive-Ca(2+)-channel alpha-2-delta subunit. The aim of this study was to evaluate whether the analgesic action of intrathecal (IT) pregabalin is associated with KATP channels in the rat formalin test. METHODS: IT PE-10 catheters were implanted in male Sprague-Dawley rats (250-300 g) under inhalation anesthesia using enflurane. Nociceptive behavior was defined as the number of hind paw flinches during 60 min after formalin injection. Ten min before formalin injection, IT drug treatments were divided into 3 groups: normal saline (NS) 20 microl (CON group); pregabalin 0.3, 1, 3 and 10 microg in NS 10 microl (PGB group); glibenclamide 100 microg in DMSO 5 microl with pregabalin 0.3, 1, 3 and 10 microg in NS 5 microl (GBC group). All the drugs were flushed with NS 10 microl. Immunohistochemistry for the KATP channel was done with a different set of rats divided into naive, NS and PGB groups. RESULTS: IT pregabalin dose-dependently decreased the flinching number only in phase 2 of formalin test. The log dose response curve of the GBC group shifted to the right with respect to that of the PGB group. Immunohistochemistry for the KATP channel expression on the spinal cord dorsal horn showed no difference among the groups 1 hr after the formalin test. CONCLUSIONS: The antinociceptive effect of pregabalin in the rat formalin test was associated with the activation of the KATP channel. However, pregabalin did not induce KATP channel expression in the spinal cord dorsal horn.
Anesthesia, Inhalation
;
Animals
;
Catheters
;
Dimethyl Sulfoxide
;
Enflurane
;
Formaldehyde
;
gamma-Aminobutyric Acid
;
Glyburide
;
Horns
;
Humans
;
Immunohistochemistry
;
KATP Channels
;
Male
;
Pain Measurement
;
Prostaglandins B
;
Rats
;
Rats, Sprague-Dawley
;
Spinal Cord
;
Thienamycins
;
Pregabalin
2.Thoracic Actinomycosis.
Kuhn PARK ; Jong Bum KWON ; Jong Ho LEE
The Korean Journal of Thoracic and Cardiovascular Surgery 2005;38(1):50-55
BACKGROUND: Thoracic actinomycosis is a rare, chronic debilitating disease and it is difficult to diagnose and treat. MATERIAL AND METHOD: Between March 1990 to December 2003, 17 patients were diagnosed and treated for actinomycosis in our center. Except 4 patients (involving cervicofacial, and abdominopelvic area), we reviewed the clinical characteristics, diagnosis method, and treatment in 13 patients. RESULT: In 8 patients, the operation was required for diagnosis and treatment. 7 of 8 patients had tumor-like lesions in radiological findings and they were not distinguished as lung cancer, and 1 of 8 patients was non-responsive to the antibiotics therapy. Among the 5 medically treated patients, 4 of 5 patients were diagnosed by bronchoscopic biopsy and one by CT-guided biopsy. All of them was well-responsive by the antibiotic treatment. CONCLUSION: Thoracic actinomycosis is a chronic inflammatory disease that respond well to antibiotics (penicillin therapy). It should be diagnosed by the repeated biopsy (CT-guided or bronchoscopic) before starting treatment. However, if the lesion is not distinguished as the lung cancer, non-responsive to the medical treatment, and the patients experience the recurrent hemoptysis, we can consider the operation for the diagnosis and treatment.
Actinomycosis*
;
Anti-Bacterial Agents
;
Biopsy
;
Diagnosis
;
Hemoptysis
;
Humans
;
Lung Neoplasms
3.Risk Factors of Various Cerebrovascular Diseases and Sonographic Findings of Carotid Artery in Cerebral Infarction.
Chee Jeong KIM ; Kwangje LEE ; Jeong Taik KWON ; Wang Seong RYU ; Oh Sang KWON ; Byung Kook MIN ; Jong Bum LEE ; Jong Sik SUK ; Un Ho RYOO
Korean Circulation Journal 1998;28(4):560-567
BACKGROUND: In Korea, cerebrovascular accident (CVA) is the most significant cause of death among older people, and the incidence of cerebral hemorrhage is much higher than that of developed countries. There have been many investigations about the risk factors for CVA in both Korea as well as developed countries. A few papers reported various risk factors for cerebral hemorrhage in developed countries:however, well-designed studies of risk factors for the various causes of CVA were rare in Korea. Therefore, the purpose of this study was to compare the risk factors for the various causes of CVA and to evaluate the risk factors compared with age- and sex-matched control groups. In addition, duplex sonographic findings of the carotid artery were evaluated in patients with cerebral infarction. METHODS: One hundred and sixty-four patients admitted to the hospital in 1996 were enrolled. The four groups were divided based on the following states: cerebral infarction (n-63), cerebral hemorrhage (n-64), cerebral infarction with atrial fibrillation (n-19), and lacunar infarction (n-18). Major risk factors were compared with age- and sex-matched control groups and among CVA groups. Duplex sonography of the carotid artery was done in 14 patients with cerebral infarction. RESULTS: In multiple logistic regression analysis, patients with cerebral infarction had higher prevalence of diabetes mellitus and lower high density lipoprotein-cholesterol level than the control group, and hypertension showed borderline significance. Patients with cerebral hemorrhage had higher prevalence of hypertension, higher high density lipoprotein-cholesterol level, and more frequent prevalence of smoking compared with the control group. Patients with cerebral infarction showed lower high density lipoprotein-cholesterol, higher low density lipoprotein-cholesterol levels, more frequent diabetes mellitus, lower prevalence of hypertension and older age than patients with cerebral hemorrhage. Patients with cerebral infarction and atrial fibrillation showed only older age than patients with cerebral infarction only. There were no differences in risk factors between patients with cerebral infarction and lacuna infarction. Atheromatous plaque was found in 71% of patients with cerebral infarction. CONCLUSION: Metabolic abnormalities played more important role in the development of cerebral infarction and hemodynamic abnormalities in cerebral infarction. Sonographic examination of the carotid artery may be useful for predicting the occurrence of cerebrovascular accident in high risk patients.
Atrial Fibrillation
;
Carotid Arteries*
;
Cause of Death
;
Cerebral Hemorrhage
;
Cerebral Infarction*
;
Developed Countries
;
Diabetes Mellitus
;
Hemodynamics
;
Humans
;
Hypertension
;
Incidence
;
Infarction
;
Korea
;
Logistic Models
;
Prevalence
;
Risk Factors*
;
Smoke
;
Smoking
;
Stroke
;
Stroke, Lacunar
;
Ultrasonography*
4.Chylothorax after Endoscopic Thoracic Sympathicotomy: A Case Report.
Jong Bum KWON ; Chan Bum PARK ; Yong Soon WON ; Gun PARK ; Moon Sub KWAK
The Korean Journal of Thoracic and Cardiovascular Surgery 2000;33(3):273-275
Endoscopic sympathicotomy is the choice of the treatment for hyperhidrosis. There are some recognized risks such as Honer's syndrome and Hemopneumothorax; however, Chylothorax has very rarely been reported after thoracic sympathicotomy. We recently encountered a case of chylothorax. Early diagnosis and prompt treatment is noteworthy.
Chylothorax*
;
Early Diagnosis
;
Hemopneumothorax
;
Hyperhidrosis
5.Multidetector Computed Tomography for the Evaluation of Coronary Artery Disease; The Diagnostic Accuracy in Calcified Coronary Arteries, Comparing with IVUS Imaging.
Jong Kwan PARK ; Jong Youn KIM ; Hyuck Moon KWON ; Tae Hoon KIM ; Seung Jin OH ; Bum Kee HONG ; Young Won YOON ; Pil Ki MIN ; Sung Woo KWON ; Byoung Kwon LEE
Yonsei Medical Journal 2014;55(3):599-605
PURPOSE: Contrast enhanced multidetector computed tomography (MDCT) has been used as an alternative to coronary angiography for the assessment of coronary artery disease in the patient of the intermediate risk group. However, coronary calcium is a known limiting factor for MDCT evaluation. We investigated the diagnostic accuracy of 64-channel MDCT with each coronary artery calcium score (CACS) by compared with intravascular ultrasound (IVUS) imaging. MATERIALS AND METHODS: A total of 54 symptomatic patients with intermediate-risk (10 females, mean age 59.9+/-6.9 years, Framingham point scores 9-20) with 162 sites who had a culprit lesion on 64-channel MDCT before performing coronary angiography with IVUS were enrolled. Patients were divided into 4 subgroups depending on CACS: 0, 1-99, 100-399, and >400. Lesion length, external elastic membrane (EEM) cross sectional area (CSA), minimal luminal area, and plaque area were measured and compared between IVUS and MDCT. RESULTS: The correlation coefficients for the measurements of the EEM CSA, lumen CSA, and plaque area were r=0.514, r=0.837, and r=0.578, respectively. Furthermore, there were close correlation of plaque area between four subgroups of CACS (r=0.671, r=0.623, r=0.562, r=0.571, respectively). CONCLUSION: Despite the increase in CACS, the geometric analysis of coronary arteries using with 64-channel MDCT was comparable with IVUS in symptomatic patient of the intermediate risk group.
Aged
;
Coronary Artery Disease/*diagnosis/*radiography/ultrasonography
;
Female
;
Humans
;
Male
;
Middle Aged
;
Multidetector Computed Tomography/*methods
;
Predictive Value of Tests
;
Ultrasonography, Interventional/*methods
6.Mediastinal Neurofibroma in a the Patient with Type 1 Neurofibromatosis: A case report.
Jong Ho LEE ; Jong Bum KWON ; Mi Hyoung MOON ; Kuhn PARK
The Korean Journal of Thoracic and Cardiovascular Surgery 2007;40(4):317-320
Neurogenic tumors are the most common posterior mediastinal tumors and accounting for 19~39% of all mediastinal tumors and 75% of all posterior mediastinal tumors. Neurofibromatosis is an autosomal dominant disorder with variable expression of tumors, including neurologic tumors of the peripheral nerves, nerve roots, and plexi. A posterior mediastinal neufibroma in neurofibromatosis patients is rare. We report here a case of posterior mediastinal neurofibroma in a patient with type 1 neurofibromatosis.
Humans
;
Neurofibroma*
;
Neurofibromatoses
;
Neurofibromatosis 1*
;
Peripheral Nerves
7.Chest Wall Lipoblastoma in a Nineteen-months-old Boy: A case report.
Jong Ho LEE ; Jong Bum KWON ; Mi Hyoung MOON ; Kuhn PARK
The Korean Journal of Thoracic and Cardiovascular Surgery 2007;40(5):395-397
Lipoblastoma is a rare benign mesenchymal tumor that occurs primarily in infancy and childhood. There are two types of lipoblastoma: focal or diffuse (lipoblastomatosis). This is typically located in the extremities, and less frequently in the trunk, head and neck, and the retroperitoneum. Lipoblastoma is a tumor with a good prognosis with no reported metastasis, despite of its potential for local invasion, local recurrence and rapid growth. Complete surgical resection is essential for treatment, and long term follow up is needed.
Extremities
;
Follow-Up Studies
;
Head
;
Humans
;
Lipoblastoma*
;
Male*
;
Neck
;
Neoplasm Metastasis
;
Prognosis
;
Recurrence
;
Thoracic Wall*
;
Thorax*
8.Prognostic Value of Elevated Homocysteine Levels in Korean Patients with Coronary Artery Disease: A Propensity Score Matched Analysis.
Sung Woo KWON ; Jong Youn KIM ; Young Ju SUH ; Dae Hyung LEE ; Young Won YOON ; Byoung Kwon LEE ; Young Hak JUNG ; Eui Young CHOI ; Bum Kee HONG ; Se Joong RIM ; Hyuck Moon KWON
Korean Circulation Journal 2016;46(2):154-160
BACKGROUND AND OBJECTIVES: We sought to determine whether an elevated homocysteine (Hcy) level is associated with a worse prognosis in Korean patients with coronary artery disease (CAD). SUBJECTS AND METHODS: A total of 5839 patients (60.4% male, mean age 61.3±11.2 years) with CAD were enrolled from 2000 to 2010 at Gangnam Severance Hospital. CAD was diagnosed by invasive coronary angiography. Laboratory values including Hcy level were obtained on the day of coronary angiography and analyses were performed shortly after sampling. Patients were divided into two groups according to their Hcy levels. Baseline risk factors, coronary angiographic findings, length of follow-up, and composite endpoints including cardiac death (CD) and non-fatal myocardial infarction (NFMI) were recorded. 1:1 propensity score matched analysis was also performed. RESULTS: Over a mean follow-up period of 4.4±2.5 years, there were 132 composite endpoints (75 CD and 57 NFMI) with an event rate of 2.3%. Mean Hcy level was 9.9±4.3 µmol/L (normal Hcy 7.9±1.5 µmol/L and elevated Hcy 13.9±5.1 µmol/L). Kaplan-Meier survival analysis showed an association of elevated Hcy level with worse prognosis (p<0.0001). In addition, a multivariate Cox regression analysis showed an association of elevated Hcy level with worse prognosis for both the entire cohort (hazard ratio [HR] 2.077, 95% confidence interval [CI] 1.467-2.941, p<0.0001) and the propensity score matched cohort (HR 1.982, 95% CI 1.305-3.009, p=0.001). CONCLUSION: Elevated Hcy level is associated with worse outcomes in Korean patients with CAD.
Cohort Studies
;
Coronary Angiography
;
Coronary Artery Disease*
;
Coronary Vessels*
;
Death
;
Follow-Up Studies
;
Homocysteine*
;
Humans
;
Male
;
Myocardial Infarction
;
Prognosis
;
Propensity Score*
;
Risk Factors
9.Correlation of Clinical Symptoms and Physical Signs with Electrodiagnostic Findings in Carpal Tunnel Syndrome.
Jung Keun HYUN ; Seong Jae LEE ; Ho Jang KWON ; Mina HA ; Jongmin LEE ; Jeong Yi KWON ; Joon Sung KIM ; Nam Jong PAIK ; Ho LEE ; Bum Sun KWON
Journal of the Korean Academy of Rehabilitation Medicine 2003;27(3):361-368
OBJECTIVE: This study was to evaluate the correlation of clinical symptoms and physical signs with electrodiagnostic findings in carpal tunnel syndrome (CTS), and to increase the usefulness of clinical symptoms and physical signs in the diagnosis of CTS. METHOD: We prospectively identified 322 hands from 172 subjects clinically from 5 tertiary hospitals. All subjects completed 6 clinical symptoms and 6 physical signs including 3 provocative tests. Each symptoms and signs were divided motor and sensory symptoms and signs, and the correlation between symptoms and signs and the results of motor and sensory conduction studies and needle electromyography were evaluated. The sensitivity and specificity of each valuable symptoms and signs for electrodiagnostic results were also assessed. RESULTS: Tingling sensation, nocturnal pain, worsening, and Phalen sign were correlated with motor conduction study, and falling tendency, abductor pollicis brevis weakness and atrophy, tingling sensation, hypoesthesia, and Tinel and Phalen signs were correlated with needle electromyography. The Phalen sign had the best sensitivity and specificity for median motor conduction study, and the best sensitive physical sign for needle electromyography. CONCLUSION: Motor and sensory symptoms and signs were not correlated with motor and sensory conduction studies, but motor symptoms and signs were correlated with needle electromyography. The Phalen test was the most useful evaluating tool to diagnose CTS.
Atrophy
;
Carpal Tunnel Syndrome*
;
Diagnosis
;
Electrodiagnosis
;
Electromyography
;
Hand
;
Hypesthesia
;
Needles
;
Prospective Studies
;
Sensation
;
Sensitivity and Specificity
;
Tertiary Care Centers
10.Effect of Sternal Closure Method on Sternal Dehiscence With or Without Infection.
Sam Youn LEE ; Kwon Jae PARK ; Kwang Pyo KOH ; Jong Bum CHOI
The Korean Journal of Thoracic and Cardiovascular Surgery 2001;34(6):485-489
BACKGROUND: The most important factor in preventing sternal complications is stable sternal approximation. We have tried to find the most effective sternal closure method by examining the incidence of sternal dehiscence with or without infection in patients with cardiac surgery through median sternotomy. MATERIAL AND METHOD: This study was performed in 489 patients over 45 years of age with median sternotomy for open cardiac surgery. Simple closure with interrupted 6 wires was performed in 159 patients, figure-of-8 closure technique in 119, overlapping interrupted closure using 10 wires in 150, and combined closure technique of interrupted simple closure and figure-of-8 suture closure in 61. Two hundred thirty-four patients underwent valve and aortic operations and 213 patients coronary artery bypass surgery. RESULT: Sternal dehiscence with or without infection occurred in 12 (2.5%) patients. The complication developed in 5 of 159 patients (3.1%) with six interrupted simple closure, in 4 of 119 patients (3.4%) with figure-of-8 closure, and in 3 of 150 patients (2.0%) with overlapping interrupted closure using 10 wires, but there was no complication in 61 patients with combined closure technique (relative risk for other closure techniques, p<0.05). There was no significant difference in the incidence of the sternal complication between valve and aortic operation group and coronary artery bypass group (3.0% vs 2.3%, not significant), but diabetes mellitus was a significant independent risk factor (odds ratio and multivariate analysis, p<0.05). CONCLUSION: The sternal closure technique that combines simple interrupted suture closure and figure-of-8 suture closure may be a more useful technique to enhance sternal stabilization compared to other closure techniques, such as simple interrupted closure, 8-figure closure, and overlapping interrupted closure.
Coronary Artery Bypass
;
Diabetes Mellitus
;
Humans
;
Incidence
;
Mediastinitis
;
Multivariate Analysis
;
Risk Factors
;
Sternotomy
;
Sutures
;
Thoracic Surgery
;
Wound Infection