1.A Case of Gastric Ulcer Bleeding by Direct Connection to the Splenic Artery.
Pil Kyu JANG ; Yoon Jae KIM ; Dong Kyun PARK ; Jung Yoon HAN ; Pyung Hwa PARK ; Si Hun KIM ; Hyun Sun WOO ; Jeong Ho KIM
The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2014;14(3):211-214
Gastric ulcer bleeding is commonly encountered in emergency situations for gastroenterologist. Usually depth of gastric ulcer does not exceed the muscle layer. We report a case of a 67-year-old male with massive gastric ulcer bleeding caused by direct connection to the splenic artery. Bleeding control was not effectively performed by endoscopy due to massive bleeding with unstable vital sign. Angiography for embolization was performed. Active extravasation of contrast agents at the splenic artery stenosis was noted on splenic arteriogram. Bleeding stopped after embolization with histoacryl and lipiodol was successfully performed. After 1 month, complete ulcer healing was confirmed by follow up endoscopy. There was no evidence of invasive disease on biopsy.
Aged
;
Angiography
;
Biopsy
;
Constriction, Pathologic
;
Contrast Media
;
Emergencies
;
Enbucrilate
;
Endoscopy
;
Ethiodized Oil
;
Follow-Up Studies
;
Hemorrhage*
;
Humans
;
Male
;
Splenic Artery*
;
Stomach Ulcer*
;
Ulcer
;
Vital Signs
2.Therapeutic Effect of HDAC5 Binding and Cell Penetrating Peptide for the Treatment of Inflammatory Bowel Disease
Deogil KIM ; Dong Woo LEE ; Gookjin YOON ; Eui Kyun JEONG ; Moon Sil CHOI ; Hoo Cheol LEE ; Yoon Shin PARK ; Chong Pyung CHUNG ; Jue-Yeon LEE ; Yoon Jeong PARK
Tissue Engineering and Regenerative Medicine 2023;20(6):965-979
BACKGROUND:
Inflammatory bowel disease (IBD) is an incurable disease that negatively influences the quality of life of patients. Current and emerging therapies target proinflammatory cytokines and/or receptors to downregulate proinflammatory responses, but insufficient remission requires other therapeutic agents. Herein, we report that the synthetic antiinflammatory peptide 15 (SAP15) is capable of cell penetration and anti-inflammatory activity in human macrophages.
METHODS:
SAP15 was labeled with fluorescence and administered to human leukemia monocytic cells (THP-1) cells for cell penetration analysis. Using biolayer interferometry analysis, the binding affinity of SAP15 with histone deacetylase 5 (HDAC5) was measured. SAP15-treated THP-1 cells were analyzed by protein phosphorylation assay, flow cytometry, and enzyme-linked immunosorbent assay (ELISA). In addition, in vivo analysis of the therapeutic effect on IBD was observed in a dextran sulfate sodium (DSS)-induced model. Samples from SAP15-treated mice were analyzed at both the macroscopic and microscopic levels using ELISA, myeloperoxidase (MPO) assays, and histological evaluations.
RESULTS:
SAP15 was internalized within the cytosol and nucleus of THP-1 cells and bound to the HDAC5 protein. SAP15-treated macrophages were assessed for protein phosphorylation and showed inhibited phosphorylation of HDAC5 and other immune-related proteins, which led to increased M2-like macrophage markers and decreased M1-like macrophage markers and tumor necrosis factor-a and interleukin-6 cytokine levels. The SAP15 treatment on IBD model showed significant recovery of colon length. Further histological analysis of colon demonstrated the therapeutic effect of SAP15 on mucosal layer. Moreover, proinflammatory cytokine levels and MPO activity from the plasma show that SAP15 is effective in reduced proinflammatory responses.
CONCLUSION
These findings suggest that SAP15 is a novel peptide with a novel cell-penetrating peptide with antiinflammatory property that can be used as a therapeutic agent for IBD and other inflammatory diseases.
3.Perirenal Lymphangioma Combined With Multiple Splenic and Hepatic Cysts.
Seong Bong PYO ; Dea Hun LIM ; Ji Min JEONG ; An Doc JUNG ; Pyung Kyun PARK ; Min Ho SHIN ; Seung Il JUNG ; Yoo Duk CHOI ; Nam Ho KIM
Korean Journal of Nephrology 2009;28(5):485-489
Lymphangioma usually occurs in children and usually involves neck and axillary region. Renal or perirenal cystic lymphangioma, hepatic lymphangiomatosis and splenic lymphangiomatosis are very rare disorders. Perirenal cystic lymphangioma combined with multiple hepatic cysts or multiple splenic cysts suspected to be lymphangiomatosis has not been reported in adults in this country until now. The patient was a 43-year-old woman who had been diagnosed with multiple splenic cysts about ten years ago. She presented with a perirenal cystic lesion discovered incidentally and we detected small multiple hepatic cysts additionally with abdominal CT. We removed perirenal cyst surgically and a perirenal lymphangioma was confirmed.
Adult
;
Child
;
Female
;
Humans
;
Kidney
;
Liver
;
Lymphangioma
;
Lymphangioma, Cystic
;
Neck
;
Spleen
4.The Prognostic Value of the First Day and Daily Updated Scores of the APACHE III System in Sepsis.
Chae Man LIM ; Jae Kyun LEE ; Sung Soon LEE ; Younsuck KOH ; Woo Sung KIM ; Dong Soon KIM ; Won Dong KIM ; Pyung Hwan PARK ; Jong Moo CHOI
Tuberculosis and Respiratory Diseases 1995;42(6):871-877
BACKGROUND: The index which could predict the prognosis of critically ill patients is needed to find out high risk patients and to individualize their treatment. The APACHE III scoring system was established in 1991, but there has been only a few studies concerning its prognostic value. We wanted to know whether the APACHE III scores have prognostic value in discriminating survivors from nonsurvivors in sepsis. METHODS: In 48 patients meeting the Bones criteria for sepsis, we retrospectively surveyed the day 1 (Dl), day 2(D2) and day 3(D3) scores of patients who were admitted to intensive care unit. The scores of the sepsis survivors and nonsurvivors were compared in respect to the Dl score, and also in respect to the changes of the updated D2 and D3 scores. RESULTS: 1) Of the 48 sepsis patients, 21(43.5%) survived and 27(56.5%) died. The nonsurvivors were older(62.7+/-12.6 vs 51.1+/-18.1 yrs), presented with lower mean arterial pressure(56.9+/-26.2 vs 67.7 +/-14.2 mmHg) and showed greater number of multisystem organ failure(1.2+/-0.8 vs 0.2+/-0.4) than the survivors(p <0.05, respectively). There were no significant differences in sex and initial body temperature between the two groups. 2) The Dl score was lower in the survivors (n=21) than in the nonsurvivors (44.1 +/-14.6, 78.5+/- 18.6, p=0.0001). The D2 and D3 scores significantly decreased in the survivors (Dl vs D2, 44.1+/- 14.6: 37.9+/-15.0, p=0.035; D2 vs D3, 37.9+/-15.0: 30.1 +/-9.3, p=0.0001) but showed a tendency to increase in the nonsurvivors (Dl vs D2 (n=21), 78.5+/-18.6: 81.3+/-23.0, p=0.1337; D2 vs D3 (n=11), 68.2+/-19.3: 75.3+/-18.8, p=0.0078). 3) The D1 scores of 12 survivors and 6 nonsurvivors were in the same range of 42~67 (mean D1 score, 53.8+/-10.0 in the survivors, 55.3+/-10.3 in the nonsurvivors). The age, sex, initial body temperature, and mean arterial pressure were not different between the two groups. In this group, however, D2 and D3 was significantly decreased in the survivors(Dl vs D2, 53.3+/-10.0: 43.6+/- 16.4, p=0.0278; D2 vs D3, 43.6+/-16.4: 31.2+/-10.3, p=0.0005), but showed a tendency to increase in the nonsurvivors(Dl vs D2 (n=6), 55.3+/-10.3:66.7+/-13.9, p=0.1562; D2 vs D3 (n=4), 64.0+/- 16.4:74.3+/-18.6, p=0.1250). Among the individual items of the first day APACHE III score, only the score of respiratory rate was capable of discriminating the nonsurvivors from the survivors (5.5 +/-2.9 vs 1.9+/-3.7, p=0.046) in this group. CONCLUSION: In sepsis, nonsurvivors had higher first day APACHE III score and their updated scores on the following days failed to decline but showed a tendency to increase. Survivors, on the other hand, had lower first day score and showed decline in the updated APACHE scores. These results suggest that the first day and daily updated APACHE III scores are useful in predicting the outcome and assessing the response to management in patients with sepsis.
APACHE*
;
Arterial Pressure
;
Body Temperature
;
Critical Illness
;
Hand
;
Humans
;
Intensive Care Units
;
Prognosis
;
Respiratory Rate
;
Retrospective Studies
;
Sepsis*
;
Survivors
5.Does Post-Warming Extended Culture Duration Affect the Clinical and Obstetric Outcomes of Patients of Advanced Maternal Age? A SingleCenter Study
Jae Kyun PARK ; So-Yeon AHN ; Su Hee SEOK ; Eun Mi CHANG ; Ji Won KIM ; In Pyung KWAK ; Woo Sik LEE
Journal of Korean Medical Science 2022;37(12):e96-
Background:
The single vitrified-warmed blastocyst transfer (SVBT) cycle has been increasingly utilized for assisted reproductive technology. Women of advanced maternal age (AMA) comprise a significant portion of patients who have undergone ‘freeze-all’ cycles. This study investigated the association between the post-warming extended culture duration and pregnancy outcomes in patients of AMA.
Methods:
This retrospective cohort study analyzed the outcomes of 697 SVBT cycles between January 2016 and December 2017. The cycles were divided into 3 groups based on the age of the female partners: group I: < 35 years (n = 407), group II: 35–37 years (n = 176); and group III, 38–40 years (n = 114). Data are shown as the mean ± standard error of the mean. Data were analyzed using one-way ANOVA followed by Duncan’s multiple range test. Statistical significance was set at P < 0.001.
Results:
The blastocyst rate, clinical pregnancy rate, and live birth rate (LBR) was significantly lower in the AMA groups. However, there were no significant differences in LBR in the transfer between the AMA and younger groups according to blastocyst morphology and post-warming extended culture duration.
Conclusion
Post-warming extended culture of blastocysts is not harmful to patients of AMA. It could be a useful parameter in clinical counseling and decision making for fertility treatments.
6.Renoprotective effect of deflazacort in IgA nephropathy with proteinuria.
Ji Min JEONG ; Dae Hun LIM ; Hyung Chul LEE ; Seul Hyun OH ; Joon Seok CHOI ; Pyung Kyun PARK ; An Doc JUNG ; Jeong Woo PARK ; Eun Hui BAE ; Seong Kwon MA ; Soo Wan KIM ; Nam Ho KIM
Korean Journal of Medicine 2009;77(5):593-600
BACKGROUND/AIMS: Steroid therapy is reported to improve the clinical outcome of IgA nephropathy. In addition, recent studies have revealed that deflazacort has fewer side effects than prednisolone. This study examined the effect of steroids and compared the clinical efficacy of deflazacort and prednisolone in patients with IgA nephropathy. METHODS: We retrospectively reviewed 136 patients with biopsy-proven IgA nephropathy who received deflazacort (n=50), prednisolone (n=29), or neither (n=59), and in whom blood pressure was controlled with angiotensin converting enzyme inhibitors or angiotensin receptor blockers. The mean duration of steroid administration was 9.5+/-9.1 months. The initial clinical status and change in the amount of protein in the 24-hour urine were compared among the three groups. RESULTS: The baseline characteristics (age, blood pressure, serum creatinine level, initial protein in the 24-hour urine, and creatinine clearance) did not differ significantly among the groups. The decrement of protein in the 24-hour urine was higher in the deflazacort and prednisolone groups, as compared with the control group (4.4+/-5.4, 4.2+/-1.5, and 2.1+/-3.1 g/day, respectively, p=0.013). The increment in the creatinine clearance was higher in the deflazacort and prednisolone groups, as compared with the control group (11.5+/-16.4, 12.3+/-26.2, and 4.8+/-14.91.3+/-0.9, respectively, p=0.009). There were no significant differences in the above parameters between the deflazacort and prednisolone groups. CONCLUSIONS: Steroid therapy reduces urinary protein excretion in IgA nephropathy, and the clinical efficacy of deflazacort and prednisolone was found to be similar.
Angiotensin Receptor Antagonists
;
Angiotensin-Converting Enzyme Inhibitors
;
Blood Pressure
;
Creatinine
;
Glomerulonephritis
;
Glomerulonephritis, IGA
;
Humans
;
Immunoglobulin A
;
Prednisolone
;
Pregnenediones
;
Proteinuria
;
Retrospective Studies
;
Steroids
7.Idiopathic Retroperitoneal Fibrosis Associated with a Horseshoe Kidney.
Pyung Kyun PARK ; Sung Bong PYO ; An Doc JUNG ; Ji Min JEONG ; Dae Hun LIM ; Joon Suk CHOI ; Hyung Chul LEE ; Kyung Jin OH ; Jin Woong KIM ; Nam Ho KIM
Korean Journal of Nephrology 2010;29(3):376-380
A case of a 52-year-old man with retroperitoneal fibrosis and a horseshoe kidney is presented. Horseshoe kidney is one of the most common renal anomalies and complicated with urinary tract infection, hydronephrosis, calculi, tumor of the renal pelvis, and other multiple congenital abnormalities. Idiopathic retroperitoneal fibrosis is a rare disease characterized by the presence of a retroperitoneal tissue, consisting of chronic inflammation and marked fibrosis, which often entraps ureters or other abdominal organs. The correlation between horseshoe kidney and retroperitoneal fibrosis has not been described. We report a rare case of idiopathic retroperitoneal fibrosis with horseshoe kidney disease demonstrating good response to steroid therapy.
Calculi
;
Congenital Abnormalities
;
Fibrosis
;
Humans
;
Hydronephrosis
;
Inflammation
;
Kidney
;
Kidney Diseases
;
Kidney Pelvis
;
Middle Aged
;
Rare Diseases
;
Retroperitoneal Fibrosis
;
Steroids
;
Ureter
;
Urinary Tract Infections
8.Correlation between Morphologic Grading and Euploidy Rates of Blastocysts, and Clinical Outcomes in In Vitro Fertilization Preimplantation Genetic Screening.
Min Kyoung KIM ; Jae Kyun PARK ; Yunmi JEON ; Seung Ah CHOE ; Hee Jun LEE ; Jayeon KIM ; Eun Mi CHANG ; Ji Won KIM ; Sang Woo LYU ; Jin Young KIM ; In Pyung KWAK ; Woo Sik LEE ; Tae Ki YOON
Journal of Korean Medical Science 2019;34(4):e27-
BACKGROUND: The standard morphological evaluation has been widely used for embryo selection, but it has limitations. This study aimed to investigate the correlation between morphologic grading and euploidy rate of in vitro fertilization (IVF) preimplantation genetic screening (PGS) and compare the pregnancy rates in young and old ages. METHODS: This is a retrospective study using the medical records of patients who underwent IVF procedures with PGS between January 2016 and February 2017 in a single center. The embryo grades were categorized into 4 groups: excellent, good, fair, and poor. Basic characteristics, euploidy rates, clinical pregnancy (CP) rates and ongoing pregnancy rates were analyzed. RESULTS: The excellent group had significantly higher rate of euploid embryos than fair group (47.82% vs. 29.33%; P = 0.023) and poor group (47.82% vs. 29.60%; P = 0.005). When the four groups were recategorized into two groups (excellent and good vs. fair and poor), they also showed significant difference in euploidy rates (44.52% vs. 29.53%; P = 0.002). When the patients were divided into two groups by age 35, the CP rates for those under and over 35 years old were 44.74% and 47.83%, respectively, which showed no significant difference. CONCLUSION: The significant differences among the euploidy rates of different morphologic embryo grades demonstrated the positive correlations between the morphologic grading of the embryo and the euploidy rate of PGS. Additionally, there was no significant difference between the younger and older patients' CP rates. These findings emphasize the fact that old age patients might benefit from PGS whatever the indication of PGS is.
Blastocyst*
;
Embryonic Structures
;
Fertilization in Vitro*
;
Genetic Testing*
;
Humans
;
In Vitro Techniques*
;
Medical Records
;
Pregnancy
;
Pregnancy Rate
;
Retrospective Studies
9.Hereditary Hemolytic Anemia in Korea: a Retrospective Study from 1997 to 2006.
Hee Soon CHO ; Jeong Ok HAH ; Im Ju KANG ; Hyung Jin KANG ; Jae Yong KWAK ; Hong Hoe KOO ; Hoon KOOK ; Byoung Kook KIM ; Soon Ki KIM ; Seung Taik KIM ; Young Dae KIM ; Ji Yoon KIM ; Chul Soo KIM ; Thad GHIM ; Heung Sik KIM ; Sang Gyu PARK ; Seon Yang PARK ; Jun Eun PARK ; Soo Mee BANG ; Jong Jin SEO ; Chang In SUH ; Sang Kyun SOHN ; Ho Jin SHIN ; Hee Young SHIN ; Hyo Sup AHN ; Doyeun OH ; Eun Sun YOO ; Chuhl Joo LYU ; Sung Soo YOON ; Kun Soo LEE ; Kwang Chul LEE ; Kee Hyun LEE ; Soon Yong LEE ; Young Ho LEE ; Jung Ae LEE ; Jong Seok LEE ; Young Tak LIM ; Jae Young LIM ; Ho Joon IM ; Dae Chul JEONG ; So Young CHONG ; Joo Seop CHUNG ; Hye Lim JUNG ; Goon Jae CHO ; Deog Yeon JO ; Jong Youl JIN ; Eun Jin CHOI ; Myung Soo HYUN ; Pyung Han HWANG
Korean Journal of Hematology 2007;42(3):197-205
BACKGROUND: The aim of this study was to investigate the prevalence, clinical and laboratory findings of hereditary hemolytic anemia (HHA) in Korea from 1997 to 2006 and to develop the appropriate diagnostic approach for HHA. METHODS: By the use of questionnaires, information on the clinical and laboratory findings ofHHA diagnosed from 1997 to 2006 in Korea was collected and analyzed retrospectively. A total of 431 cases were enrolled in this study from 46 departments of 35 hospitals. RESULTS: The overall frequency of HHA did not change through the 10-year period for pediatrics but did show an increasing tendency for internal medicine. The overall male to female sex ratio did not show sex predominance (1.17:1), but a significant male predominance with a ratio of 1.49:1 was seen for pediatrics while a significant female predominance with a ratio of 1:1.97 was seen forinternal medicine. Of the total cases, 74.2% (282/431) were diagnosed before the age of 15 years. The etiologies of HHA were classified as red cell membrane defects, hemoglobinopathies, red cell enzyme deficiencies and unknown causes. There were 382 cases (88.6%) of red cell membrane defects with 376 cases (87.2%) of hereditary spherocytosis and 6 cases (1.4%) of hereditary elliptocytosis, 20 cases (4.6%) of hemoglobinopathies with 18 cases (4.2%) of beta-thalassemia, a case (0.2%) of alpha-thalassemia and a case (0.2%) of Hemoglobin Madrid, 7 cases (1.6%) of red cell enzyme deficiencies with 5 cases (1.2%) of glucose-6- phosphate dehydrogenase (G-6-PD) deficiency, a case (0.2%) of pyruvate kinase (PK) deficiency and a case (0.2%) of enolase deficiency, and 22 cases (5.1%) of unknown causes. The most common chief complaint in pediatric patients was pallor and that in adult patients was jaundice. In the red cell membrane defect group of patients, the level of hemoglobin was significantly higher than in adult patients. The mean corpuscular volume, mean corpuscular hemoglobin, corrected reticulocyte count, total and indirect bilirubin level and lactate dehydrogenase levels in the hemoglobinopathy group of patients were significantly lower than the values in the red cell membrane defect group of patients. The mean concentration of G-6-PD was 0.8+/-0.7U/1012RBC in the G-6-PD deficient patients, PK was 1.7U/1010 RBC in the PK deficient patient, and the level of enolase was 0.04U/g of Hb in the enolase deficient patient. CONCLUSION: The most prevalent cause of HHA in Korea during 1997 to 2006 was hereditary spherocytosis, but HHA by other causes such as hemoglobinopathy and red cell enzyme deficiency gradually increased with the development of molecular diagnostic methods and increasing general interest. However, the etiologies of HHA need to be pursued further in 5.1% of the patients. An systematic standard diagnostic approach is needed in a nationwide prospective study for correct diagnoses and appropriate management of HHA.
Adult
;
alpha-Thalassemia
;
Anemia, Hemolytic, Congenital*
;
beta-Thalassemia
;
Bilirubin
;
Cell Membrane
;
Diagnosis
;
Elliptocytosis, Hereditary
;
Erythrocyte Indices
;
Female
;
Hemoglobinopathies
;
Humans
;
Internal Medicine
;
Jaundice
;
Korea*
;
L-Lactate Dehydrogenase
;
Male
;
Oxidoreductases
;
Pallor
;
Pathology, Molecular
;
Pediatrics
;
Phosphopyruvate Hydratase
;
Prevalence
;
Pyruvate Kinase
;
Reticulocyte Count
;
Retrospective Studies*
;
Sex Ratio
;
Surveys and Questionnaires