1.A Clinical Analysis on Traumatic Subarachnoid Hemorrhage.
Tae Heon GOO ; Han Sik KIM ; Jin Ho MOK ; Kyu Chun LEE ; Yong Seok PARK ; Young Bae LEE
Journal of Korean Neurosurgical Society 2000;29(1):108-112
No abstract available.
Subarachnoid Hemorrhage, Traumatic*
2.Effect of Helicobacter pylori eradication on proliferation and apoptosis of gastric epithelial cells.
Goo LEE ; Suk Jin CHOI ; Young Hwan CHOI ; Dong Gun PARK ; Wan Da SEO ; Jeong Il SUH ; Chang Heon YANG ; Chang Woo LEE ; Tae Jung JANG ; Jung Ran KIM
Korean Journal of Medicine 1999;57(3):288-297
Helicobacter pylori (H. pylori) is the principle cause of type B gastritis and peptic ulcer disease and has been classified as group I carcinogen for gastric cancer. H. pylori may affect the normal balance between gastric cell proliferation and epithelial cell death, thus interfering with the maintenance of gastric mucosal integrity. The aim of this study was to investigate the effect of H. pylori on cell proliferation and apoptosis according to the effect of eradication of H. pylori. METHODS: The subjects were 45 patients who had undergone diagnostic gastroduodenoscopy; 11 with gastritis, seven with gastric ulcer and 27 duodenal ulcer. H. pylori infection was assessed by H&E and immunohistochemical stain with anti-H. pylori polyclonal antibody and rapid urease test. Acute and chronic inflammation, apoptosis and intestinal metaplasia were scored according to the updated Sydney system. Gastric epithelial cell proliferation was assessed by immunohostochemical method using Ki-67 monoclonal antibody. In situ apoptosis was detected with in situ terminal deoxyribonucleotide transferase (TdT)-mediated dUTP nick end labeling. RESULTS: Acute and chronic inflammation, intestinal metaplasia, Ki-67 labeling index, and apoptosis were significantly higher in H. pylori infected persons (n=45) than in uninfected persons (n=5)(p<0.05). Acute and chronic inflammation, intestinal metaplasia, Ki-67 labeling index and apoptosis in H. pylori eradicated group (n=25) significantly decreased after eradication therapy (p<0.05), but no significant differences of them was observed in H. pylori non-eradicated goup (n=20) after eradication therapy. Ki-67 labeling index was significantly correlated with acute inflammation, chronic inflammation and apoptosis (p<0.05). Apoptosis was significantly correlated with acute and chronic inflammation (p<0.05). CONCLUSION: In eradicated group, epithelial apoptosis and proliferation closely associated with gastric carcinogenesis are stabilized after treatment, which suggests H. pylori eradication therapymay preven the early step of gastric carcinogenesis.
Apoptosis*
;
Carcinogenesis
;
Cell Proliferation
;
Duodenal Ulcer
;
Epithelial Cells*
;
Gastritis
;
Helicobacter pylori*
;
Helicobacter*
;
Humans
;
Inflammation
;
Metaplasia
;
Peptic Ulcer
;
Stomach Neoplasms
;
Stomach Ulcer
;
Transferases
;
Urease
3.A Case Report of Very Severe Hyperphosphatemia (19.3 mg/dL) in a Uremic Patient Taking Honey and Persimmon Vinegar
Su Hyun SONG ; Young Jin GOO ; Tae Ryom OH ; Sang Heon SUH ; Hong Sang CHOI ; Chang Seong KIM ; Seong Kwon MA ; Soo Wan KIM ; Eun Hui BAE
Electrolytes & Blood Pressure 2021;19(2):51-55
We report a case of severe hyperphosphatemia in advanced CKD with poor compliance. A 55-year-old male patient with underlying type 2 diabetes mellitus, hypertension, and chronic kidney disease presented emergently with general weakness and altered mental status. The creatinine level was 14 mg/dL (normal range: 0.5-1.3 mg/dL) 2 months prior to consultation, and he was advised initiation of hemodialysis, which he refused. Subsequently, the patient stopped taking all prescribed medications and self-medicated with honey and persimmon vinegar with the false belief it was detoxifying. At the time of admission, he was delirious, and his laboratory results showed blood urea nitrogen level of 183.4 mg/dL (8-23 mg/dL), serum creatinine level of 26.61 mg/dL (0.5-1.3 mg/dL), serum phosphate level of 19.3 mg/dL (2.5-5.5 mg/dL), total calcium level of 4.3 mg/dL (8.4-10.2 mg/dL), vitamin D (25(OH)D) level of 5.71 ng/mL (30-100 ng/mL) and parathyroid hormone level of 401 pg/ml (9-55 pg/mL). Brain computed tomography revealed non-traumatic spontaneous subdural hemorrhage, presumably due to uremic bleeding.Emergent hemodialysis was initiated, and hyperphosphatemia and hypocalcemia were rectified; calcium acetate and cholecalciferol were administered. The patient’s general condition and laboratory results improved following dialysis. Strict dietary restrictions with patient education were implemented. Multifaceted interventions, including dietary counseling, administration of phosphate-lowering drugs, and lifestyle modifications, should be implemented when encountering patients with CKD, considering the extent of the patient’s adherence.
4.Expression of p27(Kip1) in gastric cancers and precancerous lesions.
Nam Il KIM ; Hyeock Joo KANG ; Hee Chul JUNG ; Sung Ja KIM ; Goo LEE ; Jeong Il SUH ; Chang Woo LEE ; Kyu Chun LEE ; Han Sik KIM ; Tae Jung JANG ; Chang Heon YANG
Korean Journal of Medicine 2002;62(4):396-404
BACKGROUND: The cyclin-dependent kinase inhibitor p27(Kip1) is a negative regulator of cell cycle progression at G1/S transition. Recently, the expression level of p27(Kip1) was decreased in many cancers such as breast, pituitary gland, colon and stomach. We studied the expression of p27(Kip1) in gastric cancers, precancerous lesions and normal gastric tissues and analysed its correlation to clinicopathologic data including tumor differentiation, tumor depth, nodal and distant metastasis in gastric cancers. METHODS: p27(Kip1) were immunohistochemically stained in the tissue specimens of 62 resected cancers, 110 corresponding adjacent non-neoplastic tissues, 22 gastric adenomas and 10 normal gastric tissues. Adjacent non-neoplastic tissues consisted of 32 chronic gastritis, 29 intestinal metaplasia and 49 transitional mucosa. RESULTS: Gastric cancers showed significantly decreased expression level of p27(Kip1) when compared with non-neoplastic lesions and adenomas. Labeling index of p27(Kip1) were more decreased in chronic gastritis, intestinal metaplasia and transitional mucosa than in normal mucosa. Early gastric cancers showed significantly decreased expression level of p27(Kip1) when compared with advanced gastric cancers. In gastric cancers, p27(Kip1) labeling index was significantly decreased in diffuse type and presence of nodal metastasis however did not show relationship with distant metastasis and tumor depth of advanced gastric cancers. CONCLUSION: We suggest that p27(Kip1) may be decreased in the early stage of gastric carcinogenesis and play an important role in the progression and differentiation of gastric cancers. More further studies are thought to be necessary in order to evaluate its prognostic factor in gastric cancers.
Adenoma
;
Breast
;
Carcinogenesis
;
Cell Cycle
;
Colon
;
Gastritis
;
Metaplasia
;
Mucous Membrane
;
Neoplasm Metastasis
;
Phosphotransferases
;
Pituitary Gland
;
Precancerous Conditions
;
Stomach
;
Stomach Neoplasms*
5.Trends in the Eradication Rates of Helicobacter pylori Infection in Daegu and Gyeongsangbuk-do, Korea: Multicenter Study over 13 Years.
Yeoun Su JUNG ; Si Hyung LEE ; Chan Seo PARK ; Myung Jin OH ; Kyeong Ok KIM ; Byung Ik JANG ; Seong Woo JEON ; Min Kyu JUNG ; Kyung Sik PARK ; Eun Soo KIM ; Kwang Bum CHO ; Jin Tae JUNG ; Joong Goo KWON ; Eun Young KIM ; Wan Jung KIM ; Chang Heon YANG
The Korean Journal of Gastroenterology 2014;63(2):82-89
BACKGROUND/AIMS: The eradication rates of Helicobacter pylori infection have been reported to have decreased over the years due to antibiotics resistance. The aim of this study is to investigate the trend of eradication rates of first-line triple therapy for H. pylori over the past 13 year period, and to evaluate factors affecting H. pylori eradication in Daegu and Gyeongsangbuk-do, Korea. METHODS: A total of 2,982 patients with H. pylori infection who were treated with either 1 week or 2 weeks first-line therapy (proton pump inhibitor [PPI], amoxicillin, and clarithromycin) from January 1999 through December 2011 were included in this study. Data were collected by retrospectively reviewing the medical records. RESULTS: The overall H. pylori eradication rate was 87.2%. The eradication rates from 1999 to 2011 fluctuated between 78.0% and 95.7%, but no definite evidence of a decreasing tendency was seen over the 13 year period (p=0.113). Furthermore, there was no significant difference in the eradication rate according to the duration of therapy (p=0.592). However, there was a significant difference in the eradication rate among various PPIs (p<0.01). CONCLUSIONS: There was no decreasing trend in the H. pylori eradication rate over the past 13 years in Daegu and Gyeongsangbuk-do, Korea. There also was no difference in the eradication rates depending on duration of therapy. However, a significant difference was noted among various PPIs.
Adult
;
Aged
;
Amoxicillin/therapeutic use
;
Anti-Bacterial Agents/*therapeutic use
;
Clarithromycin/therapeutic use
;
Disease Eradication/*trends
;
Drug Administration Schedule
;
Drug Therapy, Combination
;
Endoscopy, Gastrointestinal
;
Esomeprazole/therapeutic use
;
Female
;
Helicobacter Infections/*drug therapy/pathology
;
*Helicobacter pylori
;
Humans
;
Logistic Models
;
Male
;
Middle Aged
;
Omeprazole/therapeutic use
;
Proton Pump Inhibitors/*therapeutic use
;
Rabeprazole/therapeutic use
;
Republic of Korea
;
Retrospective Studies
;
Treatment Outcome
6.Relation between gastric epithelial cell proliferation and expression of CagA and VacA in Helicobacter pylori infection.
Nam Il KIM ; Jung Hyun LEE ; Yeoung Sil LEE ; Jae Uk LEE ; Goo LEE ; Jeong Ill SUH ; Chang Heon YANG ; Chang Woo LEE ; Hwan Jung YUN ; Tae Jung JANG ; Jung Ran KIM ; Gyoung Yim HA
Korean Journal of Medicine 2000;58(5):516-525
BACKGROUND: Infection with Helicobacter pylori (H. pylori) has been associated with an increased risk for developing gastric cancer. This risk is further enhanced with CagA positive H. pylori strains. Increased epithelial cell proliferation is associated with an increased risk for gastric cancer. The aim of the study was to investigate whether the gastric epithelial cell proliferation was related to the expression of CagA and VacA in H. pylori infection. METHODS: The subjects were 77 patients who had undergone diagnostic esophagogastroduodenoscopy with biopsy; 18 gastritis, 18 gastric ulcer, 17 duodenal ulcer and 24 gastric cancer. The expression of cytotoxic genes was determined indirectly by assaying serum IgG antibodies to specific antigens of H. pylori. Gastric epithelial cell proliferation was assessed using immunohistochemical method using Ki-67 monoclonal antibody. Acute and chronic inflammation, intestinal metaplasia and glandular atrophy were scored according to the updated Sydney system. RESULTS: Ki-67 labeling index, acute and chronic inflammation were significantly higher in H. pylori infected persons (n=70, 90.9%) than in uninfected persons (n=7, 9.1%) (p< 0.05), but the difference in intestinal metaplasia and glandular atrophy between the two groups was not statistically significant. Ki-67 labeling indices in persons infected with CagA positive strains (n=56, 80.0%) were significantly higher than in persons infected with CagA negative strains (n=14, 20%) (0.55+/-0.13 vs 0.37+/-0.17, p< 0.05), but the differences in acute and chronic inflammation, intestinal metaplasia and glandular atrophy between the two groups were not statistically significant. No significant difference was found in Ki-67 labeling index, acute and chronic inflammation, intestinal metaplasia and glandular atrophy according to expression of VacA. CONCLUSION: Gastric mucosal cell proliferation, which might be closely involved in the pathogenesis of gastric carcinoma, was significantly higher in CagA positive H. pylori infected persons.
Antibodies
;
Atrophy
;
Biopsy
;
Cell Proliferation
;
Duodenal Ulcer
;
Endoscopy, Digestive System
;
Epithelial Cells*
;
Gastritis
;
Helicobacter pylori*
;
Helicobacter*
;
Humans
;
Immunoglobulin G
;
Inflammation
;
Metaplasia
;
Stomach Neoplasms
;
Stomach Ulcer
7.Endoscopic Experience Improves Interobserver Agreement in the Grading of Esophagitis by Los Angeles Classification: Conventional Endoscopy and Optimal Band Image System.
Si Hyung LEE ; Byung Ik JANG ; Kyeong Ok KIM ; Seong Woo JEON ; Joong Goo KWON ; Eun Young KIM ; Jin Tae JUNG ; Kyung Sik PARK ; Kwnag Bum CHO ; Eun Soo KIM ; Chang Geun PARK ; Chang Heon YANG
Gut and Liver 2014;8(2):154-159
BACKGROUND/AIMS: Interobserver variation by experience was documented for the diagnosis of esophagitis using the Los Angeles classification. The aim of this study was to evaluate whether interobserver agreement can be improved by higher levels of endoscopic experience in the diagnosis of erosive esophagitis. METHODS: Endoscopic images of 51 patients with gastroesophageal reflux disease (GERD) symptoms were obtained with conventional endoscopy and optimal band imaging (OBI). Endoscopists were divided into an expert group (16 gastroenterologic endoscopic specialists guaranteed by the Korean Society of Gastrointestinal Endoscopy) and a trainee group (individuals with fellowships, first year of specialty training in gastroenterology). All endoscopists had no or minimal experience with OBI. GERD was diagnosed using the Los Angeles classification with or without OBI. RESULTS: The mean weighted paired kappa statistics for interobserver agreement in grading erosive esophagitis by conventional endoscopy in the expert group was better than that in the trainee group (0.51 vs 0.42, p<0.05). The mean weighted paired k statistics in the expert group and in the trainee group based on conventional endoscopy with OBI did not differ (0.42, 0.42). CONCLUSIONS: Interobserver agreement in the expert group using conventional endoscopy was better than that in the trainee group. Endoscopic experience can improve the interobserver agreement in the grading of esophagitis using the Los Angeles classification.
Clinical Competence/*standards
;
Esophagitis/classification/*pathology
;
Esophagoscopy/*standards
;
Gastroenterology/*standards
;
Gastroesophageal Reflux/classification/pathology
;
Humans
;
Observer Variation
;
Retrospective Studies
8.Impact of Parenchymal Tuberculosis Sequelae on Mediastinal Lymph Node Staging in Patients with Lung Cancer.
Seung Heon LEE ; Joo Won MIN ; Chang Hoon LEE ; Chang Min PARK ; Jin Mo GOO ; Doo Hyun CHUNG ; Chang Hyun KANG ; Young Tae KIM ; Young Whan KIM ; Sung Koo HAN ; Young Soo SHIM ; Jae Joon YIM
Journal of Korean Medical Science 2011;26(1):67-70
Because tuberculous (TB) involvement of mediastinal lymph nodes (LN) could cause false positive results in nodal staging of lung cancer, we examined the accuracy of nodal staging in lung cancer patients with radiographic sequelae of healed TB. A total of 54 lung cancer patients with radiographic TB sequelae in the lung parenchyma ipsilateral to the resected lung, who had undergone at least ipsilateral 4- and 7-lymph node dissection after both chest computed tomography (CT) and fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT were included for the analysis. The median age of 54 subjects was 66 yr and 48 were males. Calcified nodules and fibrotic changes were the most common forms of healed parenchymal pulmonary TB. Enlarged mediastinal lymph nodes (short diameter > 1 cm) were identified in 21 patients and positive mediastinal lymph nodes were identified using FDG-PET/CT in 19 patients. The overall sensitivity and specificity for mediastinal node metastasis were 60.0% and 69.2% with CT and 46.7% and 69.2% with FDG-PET/CT, respectively. In conclusion, the accuracy of nodal staging using CT or FDG-PET/CT might be low in lung cancer patients with parenchymal TB sequelae, because of inactive TB lymph nodes without viable TB bacilli.
Aged
;
Aged, 80 and over
;
Female
;
Fluorodeoxyglucose F18/diagnostic use
;
Humans
;
Latent Tuberculosis/*complications/pathology
;
Lung Neoplasms/complications/*diagnosis/pathology
;
Lymph Nodes/pathology
;
Lymphatic Metastasis
;
Male
;
Mediastinum
;
Middle Aged
;
Neoplasm Staging
;
Positron-Emission Tomography
;
Predictive Value of Tests
;
Radiopharmaceuticals/diagnostic use
;
Sensitivity and Specificity
;
Tomography, X-Ray Computed
9.Impact of Parenchymal Tuberculosis Sequelae on Mediastinal Lymph Node Staging in Patients with Lung Cancer.
Seung Heon LEE ; Joo Won MIN ; Chang Hoon LEE ; Chang Min PARK ; Jin Mo GOO ; Doo Hyun CHUNG ; Chang Hyun KANG ; Young Tae KIM ; Young Whan KIM ; Sung Koo HAN ; Young Soo SHIM ; Jae Joon YIM
Journal of Korean Medical Science 2011;26(1):67-70
Because tuberculous (TB) involvement of mediastinal lymph nodes (LN) could cause false positive results in nodal staging of lung cancer, we examined the accuracy of nodal staging in lung cancer patients with radiographic sequelae of healed TB. A total of 54 lung cancer patients with radiographic TB sequelae in the lung parenchyma ipsilateral to the resected lung, who had undergone at least ipsilateral 4- and 7-lymph node dissection after both chest computed tomography (CT) and fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT were included for the analysis. The median age of 54 subjects was 66 yr and 48 were males. Calcified nodules and fibrotic changes were the most common forms of healed parenchymal pulmonary TB. Enlarged mediastinal lymph nodes (short diameter > 1 cm) were identified in 21 patients and positive mediastinal lymph nodes were identified using FDG-PET/CT in 19 patients. The overall sensitivity and specificity for mediastinal node metastasis were 60.0% and 69.2% with CT and 46.7% and 69.2% with FDG-PET/CT, respectively. In conclusion, the accuracy of nodal staging using CT or FDG-PET/CT might be low in lung cancer patients with parenchymal TB sequelae, because of inactive TB lymph nodes without viable TB bacilli.
Aged
;
Aged, 80 and over
;
Female
;
Fluorodeoxyglucose F18/diagnostic use
;
Humans
;
Latent Tuberculosis/*complications/pathology
;
Lung Neoplasms/complications/*diagnosis/pathology
;
Lymph Nodes/pathology
;
Lymphatic Metastasis
;
Male
;
Mediastinum
;
Middle Aged
;
Neoplasm Staging
;
Positron-Emission Tomography
;
Predictive Value of Tests
;
Radiopharmaceuticals/diagnostic use
;
Sensitivity and Specificity
;
Tomography, X-Ray Computed