1.The Effects of Isoflurane on the Expression of iNOS mRNA in Endotoxemic Rats.
Seong Wan BAIK ; Sul Ki SONG ; Hae Kyu KIM ; Jae Young KWON ; Sang Wook SHIN ; Kyung Hoon KIM
Korean Journal of Anesthesiology 2000;38(6):1047-1053
BACKGROUND: It has been known that alveolar macrophage exposed to bacterial lipopolysaccharide (LPS) induces a lots of nitric oxide (NO) and inducible nitric oxide synthase (iNOS) mRNA expression. The Authors elucidated the effects of iNOS mRNA expression by inhalational anesthetics (isoflurane) on endotoxemic rats and positive pressure ventilation with and without LPS. METHODS: Fifty Sprague-Dawley rats (250 - 270 g) were anesthesized with urethane injected in the peritoneal cavity. Then the expression of iNOS mRNA in the alveolar macrophages of the rats were measured after injection of LPS, 2 hours of isoflurane (0.5 - 2.5%) anesthesia, and 2 hours of positive pressure ventilation. The activities of iNOS in macrophages were measured by analysing iNOS mRNA expression by Northern blot analysis with autoradiography using the polymerase chain reaction (PCR) method. RESULTS: The size and patterns of the iNOS mRNA band in the 0.5 - 2% isoflurane group were almost same as with the control group. The size of the iNOS mRNA band in the 2.5% isoflurane group increased more than in the control group. In the continous positive-pressure ventilation with LPS group, the iNOS mRNA band was slightly increased compared to the normal lung and the continous positive-pressure ventilation without LPS group. CONCLUSIONS: Higher concentrations of isoflurane anesthesia may evoke the expression of iNOS mRNA in a septic model. Positive pressure ventilation in sepsis may induce iNOS mRNA production.
Anesthesia
;
Anesthetics
;
Animals
;
Autoradiography
;
Blotting, Northern
;
Isoflurane*
;
Lung
;
Macrophages
;
Macrophages, Alveolar
;
Nitric Oxide
;
Nitric Oxide Synthase Type II
;
Peritoneal Cavity
;
Polymerase Chain Reaction
;
Positive-Pressure Respiration
;
Rats*
;
Rats, Sprague-Dawley
;
RNA, Messenger*
;
Sepsis
;
Urethane
2.A study of HLA-DR polymorphism in four physical constitution groups classified by Korean traditional medicine.
Taek Boo KWON ; Chee Won WHANG ; In Chan SUL ; Kyung Ok LEE ; Kyu Yoon HWANG ; Dong Ho YANG ; Sae Yong HONG
Korean Journal of Medicine 2000;58(1):91-101
BACKGROUND: In Korean traditional medicine, human beings are classified into 4 groups accordance with the characteristics of physical constitution, named; Taeum, Taeyang, Soum, and Soyang. Most of Korean traditional doctors believe that the back ground of pathophysiology is differ among each group in many diseases. HLA is the most polymorphic gene and related with human immune response. It has been used for determination of individual identification, genetic diversity and a study of disease association in different ethnic group. It has well known that the most human inflammatory disease which thought to have some autoimmune basis are in some way promoted by genes of the HLA region. The purpose of this study is to observe the distribution of HLA-DR genotypes in 4 types of physical constitution in Korean traditional medicine. METHODS: Three hundred and ten Korean subjects(Soyang : 58cases, Soum :142cases, Taeum : 92cases, Taeyang : 18cases) were enrolled for this study. Genomic DNAs extracted by phenol/chroloform were amplified with allele specific primers and determined by 2% agarose gel electrophoresis with ethidium bromide staining for analysis of HLA-DR polymorphism. RESULTS: The genotype frequency of HLA-DR in a total or 310 Koreans was DR1 ; 7.2%, DR 2; 10.5%, DR 3;1.7%, DR 4; 19.9%, DR 5; 11.9%, DR 6;19.9%, DR 7; 7.0%, DR 8; 10.6%, DR 9; 8.7%, DR10;1.9%. There was no significant diffrence of HLA-DR genotype distribution among four physical constitution groups classified by Korean traditional medicine. CONCLUSION: Our results suggest that the classification of physical constitution in Korean traditional medicine is not related to HLA-DR genotypes.
Alleles
;
Classification
;
Constitution and Bylaws*
;
DNA
;
Electrophoresis, Agar Gel
;
Ethidium
;
Ethnic Groups
;
Genetic Variation
;
Genotype
;
HLA-DR Antigens*
;
Humans
;
Medicine, Korean Traditional*
3.The Use of Thiopental Sodium with BIS Monitoring in Hypoxic Brain Damage.
Jae Young KWON ; Sul Ki SONG ; Kyung Hoon KIM ; Sang Wook SHIN ; Seong Wan BAIK
The Korean Journal of Critical Care Medicine 2000;15(1):52-55
Hypoxemia is a common and potentially serious postoperative complication. Hypoxic encephalopahty may occur in prolonged hypoxemia. This condition needs brain protection. There are many brain protective methods. The primary cental nervous system protective mechanism of the barbiturates is attributed to their ability to decrease the cerebral metabolic rate, thus improving the ratio of oxygen (O2) supply to O2 demand. The electroencephalogram-derived bispectral index system (BIS) is a promising new method to predict probability of recovery of consciousness. We experienced two cases of hypoxic brain damage in recovery room. The patients were treated with thiopental and monitored with BIS. The use of thiopental as brain protection during complete global ischemia after cardiac arrest was not effective.
Anesthetics
;
Anoxia
;
Barbiturates
;
Brain
;
Consciousness
;
Heart Arrest
;
Humans
;
Hypoxia, Brain*
;
Ischemia
;
Nervous System
;
Oxygen
;
Postoperative Complications
;
Recovery Room
;
Thiopental*
4.A Childhood Case of Pigmented Spindle Cell Nevus for Whom Dermoscopy Was Used as an Adjuvant Diagnostic Tool.
Sung Won SUH ; Sang Hee SEO ; Do Sang JUNG ; Hyun Chang KO ; Kyung Sul KWON ; Moon Bum KIM
Korean Journal of Dermatology 2009;47(3):371-374
Pigmented spindle cell nevus (PSCN) is a solitary heavily pigmented macule or papule that usually occurs on the lower legs of women in the second decade of life. Histologically, fascicles of uniform, elongated, pigmented nevoid cells at the dermo-epidermal junction tend to fuse with neighboring nests. PSCN should be differentiated from Spitz nevus, dysplastic nevus, and malignant melanoma. For making the differential diagnosis of PSCN from malignant melanoma of nevoid cells, the overall symmetry, relative uniformity, maturation with depth and no nuclear atypia are important clues. A 3-year-old girl presented with a black papule on the anterior aspect of the ankle. We diagnosed PSCN by the histologic findings and the specific "starburst" dermoscopic pattern.
Animals
;
Ankle
;
Dermoscopy
;
Diagnosis, Differential
;
Dysplastic Nevus Syndrome
;
Female
;
Humans
;
Leg
;
Melanoma
;
Nevus, Epithelioid and Spindle Cell
;
Nevus, Spindle Cell
;
Preschool Child
5.Cumulative Trauma Disorders among Telephone Directory Assistance Operators.
Hae Kwan CHEONG ; Byung Soon CHOI ; Ji Yong KIM ; Sun Hee YU ; Hyun Sul LIM ; Yong Min KIM ; Kyung Yun UH ; Yong Wook KWON
Korean Journal of Occupational and Environmental Medicine 1997;9(1):140-155
To evaluate the prevalence of cumulative trauma disorders in relation to ergonomic evaluation of their work, 260 female directory assistance operators employed in three branch facilities of the nation-wide telecommunication company. Ergonomic evaluation of the work status was done by two industrial hygienists through inspection. Workers were surveyed with standardized self-administered questionnaire and examined by family physicians and an orthopaedician for cumulative trauma disorders. Laboratory examination of serum aspartate aminotransferase(AST), creatinine phosphokinase(CPK), aldolase and rheumatoid factor was done and X-ray of cervical spine and both shoulders was taken from all subjects and nerve conduction velocity test was done on 57 subjects with suspected nerve entrapment cases. Cumulative trauma disorders were categorized into 3 category according to work-relatedness of the disorders. On ergonomic evaluation of the working posture and work environment, improvement of work posture revealed inappropriate postures and devices. Mean age of the subjects were 39 years old and more than 80% graduated high school or above. Ninety-eight percent of the workers employed in the company for more than 15 years and 74.6% of the workers worked at the VDT job for more than 4 years. Mean daily work hours was 8.0 hours per day and mean break hours was 90.5 minutes per day with mean extra work hours of 10.7 hours per month. Mean daily calls were 1128.6 calls in maximum and 864.8 calls in minimum. On laboratory examination, 13 (5.0%) workers had abnormal AST, 53(20.4%) had abnormal CPK, and 1 (0.4%) had abnormal aldolase level. On x-ray examination of cervical spine, 111 (42.7%) had loss of or reversed normal cervical lordosis, 10(3.8%) had narrowing of intervertebral space. Nerve conduction velocity test was abnormal in 11 (19.2%) among 57 workers. Among disorders categorized as work-related, 131 (50.4%) were diagnosed to have fatigue myalgia of levator scapulae, 108 (41.5%) had cervical strain or sprain, 47 (18.1%) had fatigue arthralgia of phalangeal joints, and 47 (18.1%) had probable carpal tunnel syndrome, in 10 (3.8%) of those diagnosis was confirmed electrophysiologically. Age, seniority, work duration at present job, workload nor location of facilities were associated with the prevalence of symptoms nor specific diagnoses on simple statistical analysis and multiple logistic regression, which deems to be due to highly selected and homogeneous characteristics of the study subjects. Above results shows that cumulative trauma disorders are very prevalent among directory assistance operators and elaborate effort is needed to reduce the cumulative trauma disorders among the operators.
Adult
;
Animals
;
Arthralgia
;
Aspartic Acid
;
Carpal Tunnel Syndrome
;
Creatinine
;
Cumulative Trauma Disorders*
;
Diagnosis
;
Fatigue
;
Female
;
Fructose-Bisphosphate Aldolase
;
Humans
;
Joints
;
Logistic Models
;
Lordosis
;
Myalgia
;
Nerve Compression Syndromes
;
Neural Conduction
;
Physicians, Family
;
Posture
;
Prevalence
;
Questionnaires
;
Rheumatoid Factor
;
Shoulder
;
Spine
;
Sprains and Strains
;
Superficial Back Muscles
;
Telecommunications
;
Telephone*
6.Three Cases of Churg-Strauss Syndrome Diagnosed after Presence of Cutaneous Manifestation.
Tae Wook KIM ; Margaret SONG ; Hyun Je PARK ; Hoon Soo KIM ; Su Han KIM ; Hyun Chang KO ; Byung Soo KIM ; Moon Bum KIM ; Kyung Sul KWON
Korean Journal of Dermatology 2011;49(1):62-67
Churg-Strauss syndrome (CSS) is an uncommon disorder that is characterized by asthma or allergic rhinitis, fever, systemic vasculitis, extravascular granulomas and hypereosinophilia. Cutaneous manifestations of CSS are one of the most common extra-pulmonary findings, and they occur in approximately 60% of the cases. Other manifestations include pulmonary infiltrates and heart, kidney, gastrointestinal tract, peripheral and central nervous system involvement and the patients also complain of systemic symptoms, including malaise, fever, myalgia and weight loss. The diagnosis of CSS is difficult because the manifestations vary with the disease stage and delayed treatment can lead to fatal major organ damage. We report here on 3 cases of CSS that were first diagnosed by the dermatologic department and with consultation from other departments. So, we want to remind dermatologists that if the patients of asthma or other allergic diseases have purpuric skin lesion, then CSS should be included in the differential diagnosis.
Asthma
;
Central Nervous System
;
Churg-Strauss Syndrome
;
Diagnosis, Differential
;
Fever
;
Gastrointestinal Tract
;
Granuloma
;
Heart
;
Humans
;
Kidney
;
Rhinitis
;
Rhinitis, Allergic, Perennial
;
Skin
;
Systemic Vasculitis
;
Vasculitis
;
Weight Loss
7.Clinical Experience of the 121 Patients with Testis Tumors.
Soo Bang RYU ; Joon Hwa NOH ; Dong Deuk KWON ; Bong Ryul OH ; Kwang Sung PARK ; Yang Il PARK ; Young Kyung PARK ; Moon Kee CHUNG ; Yoon Kyu PARK ; Chong Koo SUL
Korean Journal of Urology 1999;40(11):1465-1470
PURPOSE: A multicenter study was performed to evaluate the clinical characteristics and the results of chemotherapy in patients with testicular tumor. MATERIALS AND METHODS: We retrospectively reviewed the records of 121 patients with testicular tumor treated at five university hospital between 1980 and 1997. We analyzed the clinical characteristics, additional treatments after orchiectomy and results of chemotherapy. RESULTS: Patients age ranged from 1 month to 74 years with a mean of 24 years. The common presenting symptoms were scrotal swelling in 63 patients, palpable mass in 50, and testicular pain in 12. The location of the tumor was on the right side in 62, left in 58, and both in 1 with lymphoma. The histologic type was germinal neoplasm in 101 patients, nongerminal neoplasm in 1, and other tumors in 19. Clinically, 76 patients(62.8%) were stage I, 16(13.2%) stage IIa, 12(9.9%) stage IIb, 3(2.5%) stage IIc, 9(7.4%) stage III and 5(4.1%) stage IV. After orchiectomy, 73 patients(60.3%) were underwent close observation, 30(24.8%) chemotherapy, 14(11.6%) radiation therapy, 3(2.5%) radiation plus chemotherapy and 1(0.8%) retroperitoneal lymph node dissection. Among the 33 chemotherapy patients, 12(36.4%) patients achieved a clinical complete remission(CR), 5(15.2%) partial remission(PR), 4(12.1%) minor response and stabilization, 5(15.2%) progression and 7(21.2%) patients were follow-up loss, and the overall clinical response rate was 65.4%. Among the 18 chemotherapy patients with nonseminomatous germ cell tumor(NSGCT), 9(50.0%) patients achieved a clinical CR, 4(22.2%) PR, 1(5.6%) minor response and stabilization, 2(11.1%) progression and 2(11.1%) patients were follow-up loss, and the overall clinical response rate was 81.3%. CONCLUSIONS: Our study group was relatively small and insufficient to evaluate the chemotherapeutic results, but NSGCT seems to have a better clinical response to chemotherapy.
Drug Therapy
;
Follow-Up Studies
;
Germ Cells
;
Humans
;
Lymph Node Excision
;
Lymphoma
;
Orchiectomy
;
Retrospective Studies
;
Testis*
8.Aldosterone-Producing Adenoma Diagnosed by Selective Adrenal Venous Catheterization.
Sung Kil LIM ; Young Duk SONG ; Hyun Chul LEE ; Kap Bum HUH ; Min Kyung SONG ; Hyun Soo KIM ; Kyung Rae KIM ; Seok Won PARK ; Yoo Mi LEE ; Yong Suk YOON ; Suk Ho KWON ; Jae Hyun NAM ; Sul Hye HAN ; Do Yeon LEE
Journal of Korean Society of Endocrinology 1998;13(4):652-658
Primary aldosteronism, not a common cause of high blood pressure, is a syndrome which results from excessively secreted aldosterone from adrenal gland and it accounts for 0.05-2.2% of unselected hypertension. In this case the lesion was not visualized on routine abdominal computed tomographic scan due to its small size. Therefore the selective adrenal venous catherterization & venous sampling was done. As there is some difficulty of sampling from Rt. adrenal vein, the method of measuring aldosterone vs. cortisol ratio of Lt. adrenal vein and inferior vena cava was used to localize the aldosterone-producing adenoma. Clinical symptoms normalized and laboratory data returned to normal range after the surgical adrenalectomy.
Adenoma*
;
Adrenal Glands
;
Adrenalectomy
;
Aldosterone
;
Catheterization*
;
Catheters*
;
Hydrocortisone
;
Hyperaldosteronism
;
Hypertension
;
Reference Values
;
Veins
;
Vena Cava, Inferior
9.Clinical profiles of patients with surgically resected pheochromocytoma and paraganglioma
Sun Hwa LEE ; Jae-Hyeong PARK ; Ja-Yeon LEE ; Sang-Rok LEE ; Kyoung-Suk RHEE ; Jei-Keon CHAE ; Won-Ho KIM ; Ji-Young SUL ; Jin Kyung OH ; Hee-Jin KWON ; Jae-Hwan LEE ; In-Whan SEONG
The Korean Journal of Internal Medicine 2020;35(2):351-359
Background/Aims:
Pheochromocytoma and paraganglioma (PPGL) are catecholamine-producing tumors that can cause blood pressure (BP) elevation and cardiovascular complications. Clinical presentation of these tumors may be changed through widespread use of imaging studies, which enables detection of PPGLs before onset of symptoms. We investigated clinical profiles of patients with surgically resected PPGLs.
Methods:
From 2005 to 2017, 111 consecutive patients with surgically resected PPGLs in two tertiary hospitals in Korea were studied.
Results:
Mean age was 52 ± 16 years, 57 patients (51.4%) were male and 54 (48.6%) were hypertensive. Twenty-nine PPGLs (26.1%) were extra-adrenal paragangliomas. Sixteen (14.4%) and seven patients (6.3%) (Group 1, n = 23) were diagnosed during work-up of hypertension and transient cardiomyopathy respectively, and the remainder (Group 2, n = 88) were incidentalomas detected during routine abdominal imaging. Patients in the Group 1 were younger and more frequently symptomatic, and had higher BPs, heart rates and levels of urinary catecholamines than those in the Group 2. Paragangliomas were less frequent and secretion of epinephrine and metanephrine was more predominant in the Group 1 than in Group 2. After the surgical resections, 18.2% of patients still needed antihypertensive medications.
Conclusions
Out of 111 patients with surgically resected PPGLs, 88 (79.3%) were diagnosed as incidentalomas. Seven patients presented with transient cardiomyopathy and 16 with hypertension. Tumor location and secretion of catecholamine may vary depending on the presence of symptoms.
10.Laparoscopy Assisted versus Open Distal Gastrectomy with D2 Lymph Node Dissection for Advanced Gastric Cancer: Design and Rationale of a Phase II Randomized Controlled Multicenter Trial (COACT 1001).
Byung Ho NAM ; Young Woo KIM ; Daniel REIM ; Bang Wool EOM ; Wan Sik YU ; Young Kyu PARK ; Keun Won RYU ; Young Joon LEE ; Hong Man YOON ; Jun Ho LEE ; Oh JEONG ; Sang Ho JEONG ; Sang Eok LEE ; Sang Ho LEE ; Ki Young YOON ; Kyung Won SEO ; Ho Young CHUNG ; Oh Kyoung KWON ; Tae Bong KIM ; Woon Ki LEE ; Seong Heum PARK ; Ji Young SUL ; Dae Hyun YANG ; Jong Seok LEE
Journal of Gastric Cancer 2013;13(3):164-171
PURPOSE: Laparoscopy-assisted distal gastrectomy for early gastric cancer has gained acceptance and popularity worldwide. However, laparoscopy-assisted distal gastrectomy for advanced gastric cancer is still controversial. Therefore, we propose this prospective randomized controlled multi-center trial in order to evaluate the safety and feasibility of laparoscopy assisted D2-gastrectomy for advanced stage gastric cancer. MATERIALS AND METHODS: Patients undergoing distal gastrectomy for advanced gastric cancer staged cT2/3/4 cN0/1/2/3a cM0 by endoscopy and computed tomography are eligible for enrollment after giving their informed consent. Patients will be randomized either to laparoscopy-assisted distal gastrectomy or open distal gastrectomy. Sample size calculation revealed that 102 patients are to be included per treatment arm. The primary endpoint is the non-compliance rate of D2 dissection; relevant secondary endpoints are three-year disease free survival, surgical and postoperative complications, hospital stay and unanimity rate of D2 dissection evaluated by reviewing the intraoperative video documentation. DISCUSSION: Oncologic safety is the major concern regarding laparoscopy-assisted distal gastrectomy for advanced gastric cancer. Therefore, the non-compliance rate of clearing the N2 area was chosen as the most important parameter for the technical feasibility of the laparoscopic procedure. Furthermore, surgical quality will be carefully reviewed, that is, three independent experts will review the video records and score with a check list. For a long-term result, disease free survival is considered a secondary endpoint for this trial. This study will offer promising evidence of the feasibility and safety of Laparoscopy-assisted distal gastrectomy for advanced gastric cancer.Trial Registration: NCT01088204 (international), NCCCTS-09-448 (Korea).
Arm
;
Disease-Free Survival
;
Endoscopy
;
Gastrectomy
;
Humans
;
Informed Consent
;
Laparoscopy
;
Length of Stay
;
Lymph Node Excision
;
Lymph Nodes
;
Postoperative Complications
;
Prospective Studies
;
Sample Size
;
Stomach Neoplasms