1.Enhancement of Thrombolytic Therapy by Transcutaneous Ultrasound and Perfluorocarbon Exposed Sonicated Dextrose Albumin in Thrombotic Arterial Occlusion.
Se Joong RIM ; Seok Min KANG ; Jong Won HA ; Kwang Hoe CHUNG ; Yangsoo JANG ; Namsik CHUNG
Korean Circulation Journal 2000;30(5):621-628
BACKGROUND AND OBJECTIVES: Perfluorocarbon exposed sonicated dextrose albumin (PESDA) microbubbles has been suggested to facilitate thrombus disruption under the transcutaneous ultrasound (US). Thus, we investigated whether such a noninvasive approach could augment thrombolytic effect of fibrinolytic agent in an experimental thrombotic model. MATERIALS AND METHODS: Thrombus formation was induced with electrical injury in the rabbit iliofemoral arteries (n=20): Thrombus occlusion was documented by angiography in all arteries. In the control group, only tissue plasminogen activator (t-PA, 3 mg/kg) was administered intrav-enously in five rabbits. In the Group 1 (n=9), injured arteries were exposed to transcutaneous US (20 kHz, 30 W/cm2, continuous mode) with t-PA (3 mg/kg). In the Group 2 (n=6), the same treatment was given while administering PESDA continuously (10 ml/min, intravenous). Angiographic results were evaluated at 10 minute interval for 1 hour respectively. RESULTS: In the control group, two of five iliofemoral arteries (40.0%) were recanalized and one of nine iliofemoral arteries (11.1%) was recanalized in Group 1. In contrast, four of six iliofemoral arteries (66.7%) were recanalized angiographically in Group 2 (p=0.392 vs. control group: p=0.047 vs. Group 1). However, late reocclusion occurred in all iliofemoral arteries of Group 2. CONCLUSION: Although PESDA with transcutaneous US significantly enhanced initial angiographic patency rate of t-PA, it was associated with high rate of reocclusion. Further studies will be necessary for clinical application of this noninvasive method in acute arterial occlusion.
Angiography
;
Arteries
;
Glucose*
;
Microbubbles
;
Rabbits
;
Thrombolytic Therapy*
;
Thrombosis
;
Tissue Plasminogen Activator
;
Ultrasonography*
2.Studies on Bradycardiac Effect of Methoxamine in Rabbits.
Korean Journal of Anesthesiology 1987;20(3):341-348
The bradycardiac and presor to intravenous and intraventricular methoxamine were examined in urethane-anesthetized rabbits 1) Intravenous methoxamine produced bradycardiac pressor responses. Atropine (2 mg/kg, i,v.) weakened but not abloished the bradycardiac effect. 2) The bradycardiac effect elicited by intravenous methoxamine was not affected by int-ravenous prazosin, rehimbiine, guanethidine and propranolol, butt was attenuated by intra venous chlorisondamine reserpine. 3) The pressor effect elioited by intravenous methoxamine was weakened by prazosin, but was scarcely affected, rather potentiated, by intraTenous yohimblne, guanethidine, chlorisondamine, propranolol and resperpine. 4) Intraventricular methoxamine produced pressor and bradycardiac responses. 5) The bradycardiac effect elicited by intraventricular methoxamine was net affected by intravenous atropine, prasosin and yohimbine. This was attenuated by intravenous guane- thidine, chlorisondamine, propranolol and reserpine, and by intraventricular atropine prazosin and propranolol, respectively. 6) The pressor effect elicited by intraventricular methoxamine was attenuated by intra- ventricular and intravenous prazosin. This was not affected by intravenous atropine, gua-nethidine, chlorisondamine, propranolol, reserpine and yohimbine, and by intraventricular atropine, prasosin and Propranolol, respectivelr. 7) From these results it was inferred that bradycardiac effect elicited by methoxamine was not an action through the mediation of aleph 1-adrenoceptors but was a result from non-specific actions on some brain receptors.
Atropine
;
Brain
;
Chlorisondamine
;
Guanethidine
;
Methoxamine*
;
Negotiating
;
Prazosin
;
Propranolol
;
Rabbits*
;
Reserpine
;
Yohimbine
3.Clinical study on the 200 airway foreign bodies.
Kwang Hyun KIM ; Hun Jong DHONG ; Ha Won JUNG ; Won Ho CHUNG
Korean Journal of Otolaryngology - Head and Neck Surgery 1991;34(4):808-815
No abstract available.
Foreign Bodies*
4.Meta-analysis of Alpha Receptor Antagosist for Benign Prostatic Hyperplasia from Papers that were Published in Korea.
Byung Ha CHUNG ; Kwang Mo YANG ; Sung Joon HONG
Korean Journal of Urology 2005;46(3):252-258
PURPOSE: Many reliable articles on the effectiveness of alpha blockers have been published. Evidence-based diagnostic guidelines and therapeutic guidelines for benign prostatic hypertrophy (BPH), which is one of the most common urological diseases, have been proposed in many foreign countries. This paper examines the efficacy of alpha blocker, a common therapeutic drug for BPH, in Korean patients through meta-analysis. MATERIALS AND METHODS: From 1993 to 2001, the term 'BPH' and alpha blocker for BPH were used as key words to search for related articles in the Medical Research Information Center, the National Assembly Library of the Republic of Korea, the Korean Journal of Andrology and the Korean Journal of Urology. A total of 10 articles were selected as being suitable for evaluation and these articles were ranked with levels ranging from I to V, where level I indicated a large randomized controlled trial and level V indicated a non-controlled case accumulation study. RESULTS: There were improvements for the symptom score (45.3%), and for the maximum urinary flow rate (36.0%). The reasons for patient drop-outs were follow-up loss for 60%, drug side effects for 11%, and ineffectiveness of drug for 6.8%. The common side effects were dizziness (4.2%), orthostatic hypotension (2.2%), and headache (1.7%). The blood pressure was sustained in the normotensive patients, wheareas BP showed a tendency to be reduced in hypertensive patients. CONCLUSIONS: Treatment with alpha blocker resulted in the BPH patients in all the studies receiving sustained benefit. Yet most of these papers were short-term, non randomized case-accumulation studies. However, BPH is a chronic disease that may worsen over time. Therefore, evaluation of long term tolerability and efficacy of alpha blocker is necessary.
Adrenergic alpha-Antagonists
;
Andrology
;
Blood Pressure
;
Chronic Disease
;
Dizziness
;
Follow-Up Studies
;
Headache
;
Humans
;
Hypotension, Orthostatic
;
Information Centers
;
Korea*
;
Prostatic Hyperplasia*
;
Republic of Korea
;
Urologic Diseases
;
Urology
5.Risk and Management of Postoperative Urinary Retention Following Spinal Surgery.
Kwang Suk LEE ; Kyo Chul KOO ; Byung Ha CHUNG
International Neurourology Journal 2017;21(4):320-328
PURPOSE: Postoperative urinary retention (POUR) is a common complication after spinal surgery. However, no clear definition of POUR currently exists, and no studies have evaluated the management of POUR. We aimed to investigate the prognostic factors for eventual POUR-free status in spinal surgery patients. METHODS: The records of patients who received a urologic consultation for POUR from January 2015 to December 2016 were reviewed. POUR-free status was defined as a voiding volume (VV) >100 mL and a VV ratio >50%. Patients with an indwelling Foley catheter and those with any postoperative complications were excluded. The patients were divided into 2 groups according to the primary management method (Foley catheterization [FC] or intermittent catheterization [IC]). RESULTS: In total, 205 patients (median age, 70.6 years) were evaluated. Significant prognostic factors for eventual POUR-free status were intraoperative FC, previous spinal surgery, operative level (L3–5), lumbar fusion, and total volume (TV) at the time of POUR. Bladder training and medication did not reduce the time to POUR-free status. In patients who underwent FC, the duration of indwelling FC was a significant prognostic factor for POUR-free status. In a subanalysis, the TV (≥500 mL) and VV ratio at the time of POUR were significant prognostic factors for POUR-free status after primary management. Among the patients who achieved a POUR-free status, 8 (6.4%) experienced recurrent POUR. The VV ratio (<62.0%) was the only predictor of recurrent POUR. CONCLUSIONS: The criterion of POUR-free status is useful after spinal surgery. IC and FC were similar in their efficacy for the management of these patients.
Catheterization
;
Catheters
;
Humans
;
Methods
;
Postoperative Complications
;
Postoperative Period
;
Urinary Bladder
;
Urinary Catheterization
;
Urinary Retention*
6.Usefulness of Prostate-Specific Antigen Density as an Indicator for Recommending Prebiopsy Magnetic Resonance Imaging to Prevent Missed Prostate Cancer Diagnoses
Jin Hyung JEON ; Kyo Chul KOO ; Byung Ha CHUNG ; Kwang Suk LEE
Korean Journal of Urological Oncology 2021;19(3):155-163
Purpose:
To identify the indication for recommending prebiopsy magnetic resonance imaging (MRI) to prevent prostate cancer missed diagnoses in cases without prebiopsy MRI.
Materials and Methods:
Between January 2017 and September 2020, 585 patients suspected with prostate cancer underwent prostate biopsy after MRI. For patients with visible lesions, MRI-targeted biopsy using an image-based fusion program was performed in addition to the 12- core systematic biopsy. Patients for whom MRI was performed in other institutions (n=4) and patients who underwent target biopsy alone (n=7) were excluded.
Results:
Of 574 patients (median prostate-specific antigen [PSA] level, 6.88 ng/mL; mean age, 68.2 years), 342 (59.6%) were diagnosed with prostate cancer (visible lesions=312/449 [69.5%]; nonvisible lesions=30/123 [24.0%]). The detection rates of visible lesions stratified using the Prostate Imaging Reporting and Data System score (3 vs. 4 vs. 5) were 30.9% (54 of 175), 61.2% (150 of 245), and 90.1% (127 of 141), respectively. Multivariate analysis showed that PSA density was a significant factor for presence of visible lesions, prostate cancer, and significant prostate cancer diagnosis. Among patients with positive lesions, 27 (8.2%) were diagnosed with prostate cancer concomitant with negative systematic biopsy results. A PSA density of 0.15 ng/mL/cm3 was identified as the significant cutoff value for predicting positive target biopsy in groups with negative systematic biopsy. Sixty of the negative target lesions (26.1%) were diagnosed using systematic biopsy.
Conclusions
To maximize cancer detection rates, both targeted and systematic biopsies should be implemented. PSA density was identified as a useful factor for recommending prebiopsy MRI to patients suspected with prostate cancer.
7.Usefulness of Prostate-Specific Antigen Density as an Indicator for Recommending Prebiopsy Magnetic Resonance Imaging to Prevent Missed Prostate Cancer Diagnoses
Jin Hyung JEON ; Kyo Chul KOO ; Byung Ha CHUNG ; Kwang Suk LEE
Korean Journal of Urological Oncology 2021;19(3):155-163
Purpose:
To identify the indication for recommending prebiopsy magnetic resonance imaging (MRI) to prevent prostate cancer missed diagnoses in cases without prebiopsy MRI.
Materials and Methods:
Between January 2017 and September 2020, 585 patients suspected with prostate cancer underwent prostate biopsy after MRI. For patients with visible lesions, MRI-targeted biopsy using an image-based fusion program was performed in addition to the 12- core systematic biopsy. Patients for whom MRI was performed in other institutions (n=4) and patients who underwent target biopsy alone (n=7) were excluded.
Results:
Of 574 patients (median prostate-specific antigen [PSA] level, 6.88 ng/mL; mean age, 68.2 years), 342 (59.6%) were diagnosed with prostate cancer (visible lesions=312/449 [69.5%]; nonvisible lesions=30/123 [24.0%]). The detection rates of visible lesions stratified using the Prostate Imaging Reporting and Data System score (3 vs. 4 vs. 5) were 30.9% (54 of 175), 61.2% (150 of 245), and 90.1% (127 of 141), respectively. Multivariate analysis showed that PSA density was a significant factor for presence of visible lesions, prostate cancer, and significant prostate cancer diagnosis. Among patients with positive lesions, 27 (8.2%) were diagnosed with prostate cancer concomitant with negative systematic biopsy results. A PSA density of 0.15 ng/mL/cm3 was identified as the significant cutoff value for predicting positive target biopsy in groups with negative systematic biopsy. Sixty of the negative target lesions (26.1%) were diagnosed using systematic biopsy.
Conclusions
To maximize cancer detection rates, both targeted and systematic biopsies should be implemented. PSA density was identified as a useful factor for recommending prebiopsy MRI to patients suspected with prostate cancer.
8.Therapeutic Effects of Imipramine and DDAVP in Enuretic Children: A Randomized Prospective Study.
Jeong Yoon KANG ; Il Soo HA ; Hae Il CHUNG ; Kwang Myung KIM
Korean Journal of Urology 2003;44(7):665-671
PURPOSE: The therapeutic effects of imipramine and DDAVP in primary monosymptomatic enuretic children were compared using a randomized, prospective study. MATERIALS AND METHODS: The study subjects consisted of 23 children, with a mean age of 7.9 years, complaining of monosymptomatic nocturnal enuresis. Baseline evaluations, at the first visit, included voiding diary, enuresis diary, uroflowmetry, urine osmolality, and urine and serum osmolality after a water deprivation test and electrocardiography. After the administration of medication, the changes in the enuretic episodes and adverse effects were evaluated every month. RESULTS: Sixteen children received medication, and after 2 weeks the drug response rate was 57.1% (4/7) in the imipramine group and 33.3% (3/9) in the DDAVP group. Ten of the 16 children completed the study. After 12 weeks of study, the response rate was 75% (3/4) in the imipramine group and 50% (3/6) in the DDAVP group. There were no significant differences in mean urine osmolalities and functional bladder capacities between the response and no-response groups. During the study, side effects developed in only three of the children in the imipramine group. Of these, one demonstrated tachycardia on a follow-up electrocardiography and another complained of irritability, insomnia, a dry mouth and blurred vision. Subsequently, the two children dropped out due to these side effects. CONCLUSIONS: The imipramine and DDAVP had similar therapeutic effects, but the DDAVP had fewer side effects, and was better tolerated, than the imipramine.
Child*
;
Deamino Arginine Vasopressin*
;
Electrocardiography
;
Enuresis
;
Follow-Up Studies
;
Humans
;
Imipramine*
;
Mouth
;
Nocturnal Enuresis
;
Osmolar Concentration
;
Prospective Studies*
;
Sleep Initiation and Maintenance Disorders
;
Tachycardia
;
Urinary Bladder
;
Water Deprivation
9.Steroid-Responsive Recurrent Encephalopathy Associated with Subacute Thyroiditis.
Yun Jae CHUNG ; Kwang Yeol PARK ; Jihyun AHN ; Sam Yeol HA ; Young Chul YOUN
Journal of Clinical Neurology 2008;4(4):167-170
BACKGROUND: Steroid-responsive encephalopathy associated with subacute thyroiditis has, to our knowledge, not been reported previously. CASE REPORT: A 49-year-old woman was found collapsed and brought to our institution with decreased mentality, dysarthria, and gait disturbance. Brain magnetic resonance imaging and angiography were normal but blood tests revealed thyroid-autoantibody-negative thyrotoxicosis. Results of a (99m)technetium-pertechnetate scan were compatible with the thyrotoxic phase of subacute thyroiditis. 14-3-3 proteins were detected in cerebrospinal fluid. Her mental status began to improve from the day following steroid administration. Recurrent encephalopathy was found 2 months after the initial admission, which was also effectively treated with steroid. CONCLUSIONS:We speculate that steroid-responsive recurrent encephalopathy associated with subacute thyroiditis is a subtype of Hashimoto's encephalopathy, and consider that steroid treatment should not be delayed in suspected patients.
14-3-3 Proteins
;
Angiography
;
Brain
;
Brain Diseases
;
Dysarthria
;
Female
;
Gait
;
Hashimoto Disease
;
Hematologic Tests
;
Humans
;
Magnetic Resonance Imaging
;
Middle Aged
;
Thyroiditis, Subacute
;
Thyrotoxicosis
10.A Case of Typhoid Fever to Failed Ciprofloxacin, Infected in Korea.
Kwang Sun LEE ; Ha Yeon LEE ; Eun Ju JEON ; Jin Won CHUNG
Infection and Chemotherapy 2008;40(3):175-178
Typhoid fever caused by Salmonella enterica serovar Typhi (S. typhi) and usually ciprofloxacin is first used for treatment. However, the incidence of fluoroquinolone resistance or reduced susceptibility in S. typhi has been increased in Asia over the past decade and there have been reports of failed treatment with ciprofloxacin. Recently, if typhoid fever does not improved with ciprofloxacin treatment, S. typhi with reduced susceptibility to ciprofloxacin should be considered. We experienced a case of nalidixic acid-resistant S. typhi infection that was refractory to treatment with ciprofloxacin in Korea. A 47-year-old woman presented with fever and headache for 14 days. Blood culture revealed the presence of S. typhi that was susceptible to ciprofloxacin. However, she remained feverish and new symptoms of abdominal pain and bloody diarrhea developed after 5 days treatment with ciprofloxacin and subsequent testing showed that isolate was resistant to nalidixic acid.
Abdominal Pain
;
Asia
;
Ciprofloxacin
;
Diarrhea
;
Female
;
Fever
;
Headache
;
Humans
;
Incidence
;
Korea
;
Middle Aged
;
Nalidixic Acid
;
Salmonella typhi
;
Typhoid Fever