1.A survey on the actual situations and attitude of medical servicewith usual medical provider.
Seon Kook KWEON ; Young Lok SHIN ; Hyun Suk SHIN ; Young Chan LA ; Ki Hyung KIM
Journal of the Korean Academy of Family Medicine 1992;13(7):627-635
No abstract available.
2.Comparison of Clinical Findings and Coronary Angiographic Findings between Q Wave and Non-Q Wave Myocardial Infarction.
Se Hwan HAN ; San HWANG ; Sung Koo KIM ; Young Joo KWON ; Gyeu Hyuk KIM ; Seong Chan LA ; Dong Ha CHUN ; Jung Gun UH
Korean Circulation Journal 1995;25(3):589-597
BACKGROUND: Patients with non-Q wave myocardial infarction tend to have smaller infarcts and less degree of ventricular function impairment initially, however, uncomplicated non-Q wave infarctions are known to be as serious as Q wave myocardal infarction due to residual myocardal ischemia and higher reinfarction rate. METHODS: Inorder to compare the clinical and coronary angiographic findings of Q wave infarction with those of non-Q wave infarction. 58 partients with acute myocardial infarction were reviewed retrospectively. Patients were classified into Q wave(n=45) and non-Q wave infarction(n=13) according to electrocardiographic findings. RESULTS: 1) There were no significant differences between the two groups in risk factors of coronary artery disease such as hypertension, hypercholesterolemia, smoking and diabets mellitus. 2) The peak myocardial enzyme levels of CPK, CPK-MB were significantly higher in the Q wave MI group, and the percentage of wall motion abnormality on two-dimensional echocardiography was significantly higher in Q wave MI than in the non-Q wave MI group. 3) The number of involved vessel, degree of stenosis and collateral circulation were not different but high degree of stenosis of infarct-related artery was more frequent in Q wave MI group. 4) There were no significant differences between the two groups in the incidence of arrhythmia and in-hospital mortality. CONCLUSION: There were some differences in clinical and angiographic findings, but in-hospital mortality was not significant different between two groups. Futher prospective studies should be performed to clarify the long term prognosis.
Arrhythmias, Cardiac
;
Arteries
;
Collateral Circulation
;
Constriction, Pathologic
;
Coronary Angiography
;
Coronary Artery Disease
;
Echocardiography
;
Electrocardiography
;
Hospital Mortality
;
Humans
;
Hypercholesterolemia
;
Hypertension
;
Incidence
;
Infarction
;
Ischemia
;
Myocardial Infarction*
;
Prognosis
;
Retrospective Studies
;
Risk Factors
;
Smoke
;
Smoking
;
Ventricular Function
3.Comparison of Clinical Outcomes for Glycopeptides and Beta-Lactams in Methicillin-Susceptible Staphylococcus Aureus Bloodstream Infections
Yeon Ju LA ; Hye Rim KIM ; Dong Hyun OH ; Jin Young AHN ; Yong Chan KIM
Yonsei Medical Journal 2022;63(7):611-618
Purpose:
This study aimed to provide compelling evidence of anti-staphylococcal beta-lactam use for methicillin-susceptible Staphylococcus aureus bloodstream infection (MSSA BSI).
Materials and Methods:
We retrospectively collected data on patients with MSSA BSI who were admitted to two academic tertiary-care hospitals from 2010 to 2018. Only patients who received nafcillin, cefazolin, vancomycin, or teicoplanin as definitive therapy were included. The primary outcome was 28-day mortality. To perform unbiased comparisons between both treatments, we used inverse probability of treatment weighting (IPTW) analysis.
Results:
A total of 359 patients were divided into two groups based on the definitive therapy used: beta-lactams (n=203), including nafcillin or cefazolin; and glycopeptides (n=156), including vancomycin or teicoplanin. In the IPTW analysis, glycopeptides were associated with significantly increased odds of 28-day mortality (adjusted odds ratio, 3.37; 95% confidence interval, 1.71– 6.61; p<0.001). The rate of primary outcome in prespecified subgroups was largely consistent with the main analysis.
Conclusion
Definitive therapy with beta-lactams in patients with MSSA BSI was associated with lower 28-day mortality compared to definitive therapy with glycopeptides.
4.4 Cases of Mucosal Bridges in the Esophagus.
Chan Sup SHIM ; Moon Sung LEE ; Joo Young CHO ; Dong Ha CHUN ; Jae Il KIM ; In Hwan YU ; Gyeu Hyuk KIM ; Ju Il PARK ; Jung Kun EO ; Seong Chan LA ; Soo Kyung KIM ; Sae Hwan HAN
Korean Journal of Gastrointestinal Endoscopy 1996;16(6):969-975
Mucosal bridge, endoscopically observed, is a cord-like mucosal connection across the lumen. The bridge is very elastic and stretches easily, unlike granulation tissue. Mucosal bridges of the esophagus have been occasionally described in various circumstances, particularly in congenital or acquired origin as the inflammatory diseases. The occurrence of mucosal bridges due to inflammatory process may arise anywhere from the esophagus to the colon. It has been more frequently reported in the colon than in the esophagus, stomach, and duodenum. We experienced four cases of esophageal mucosal bridges and three of them were accompanied by esophageal diverticulum. We report these cases with a review of relevant literatures.
Colon
;
Diverticulum
;
Diverticulum, Esophageal
;
Duodenum
;
Esophagus*
;
Granulation Tissue
;
Stomach
5.4 Cases of Mucosal Bridges in the Esophagus.
Chan Sup SHIM ; Moon Sung LEE ; Joo Young CHO ; Dong Ha CHUN ; Jae Il KIM ; In Hwan YU ; Gyeu Hyuk KIM ; Ju Il PARK ; Jung Kun EO ; Seong Chan LA ; Soo Kyung KIM ; Sae Hwan HAN
Korean Journal of Gastrointestinal Endoscopy 1996;16(6):969-975
Mucosal bridge, endoscopically observed, is a cord-like mucosal connection across the lumen. The bridge is very elastic and stretches easily, unlike granulation tissue. Mucosal bridges of the esophagus have been occasionally described in various circumstances, particularly in congenital or acquired origin as the inflammatory diseases. The occurrence of mucosal bridges due to inflammatory process may arise anywhere from the esophagus to the colon. It has been more frequently reported in the colon than in the esophagus, stomach, and duodenum. We experienced four cases of esophageal mucosal bridges and three of them were accompanied by esophageal diverticulum. We report these cases with a review of relevant literatures.
Colon
;
Diverticulum
;
Diverticulum, Esophageal
;
Duodenum
;
Esophagus*
;
Granulation Tissue
;
Stomach
6.The Significance of VEGF Expression in Stage II Carcinoma of Uterine Cervix Treated with Definitive Radiotherapy.
Won PARK ; Yoon La CHOI ; Seung Jae HUH ; Sang Min YOON ; Young Je PARK ; Hee Rim NAM ; Yong Chan AHN ; Do Hoon LIM ; Hee Chul PARK
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2006;24(1):37-43
PURPOSE: We wanted to determine the clinical characteristics and prognosis according to the VEGF expression in stage II cervical carcinoma patients treated with definitive radiotherapy. MATERIALS AND METHODS: We enrolled 31 patients who were diagnosed with cervical cancer from 1995 to 2003 at Samsung Medical Center and their paraffin block tissue samples were available for study. The median age of the patients was 65 years. The mean tumor size was 4.1 cm (range: 1.2~8.2 cm). Seven patients (22.6%) were suspected of having pelvic lymph node metastasis. An external beam irradiation dose of 45-56.4 Gy was administered to the whole pelvis with a 15 MV linear accelerator, and an additional 24 Gy was given to point A by HDR intracavitary brachytherapy. VEGF staining was defined as positive when more than 10% of the tumor cells were stained. The median follow-up duration was 58 months. RESULTS: A positive VEGF expression was observed in 21 patients (67.7%). There was no significant correlation between the VEGF expression and pelvic lymph node metastasis, tumor size and the response of radiotherapy. During follow-up, 7 patients had recurrence. The complete response rate was not significant between the VEGF (-) and VEGF (+) tumors. However, the VEGF (+) tumors showed a significantly higher recurrence rate in comparison with the VEGF (-) tumors (p=0.040). The three year disease-free survival rates were 100% and 66.7%, respectively, for patients with VEGF (-) or VEGF (+) tumor (p=0.047). CONCLUSION: The VEGF expression was a significant factor for recurrence and disease-free survival. However, the significance of the VEGF expression is still controversial because of the various definitions of VEGF expression and the mismatches of the clinical data in the previous studies.
Brachytherapy
;
Cervix Uteri*
;
Disease-Free Survival
;
Female
;
Follow-Up Studies
;
Humans
;
Lymph Nodes
;
Neoplasm Metastasis
;
Paraffin
;
Particle Accelerators
;
Pelvis
;
Prognosis
;
Radiotherapy*
;
Recurrence
;
Uterine Cervical Neoplasms
;
Vascular Endothelial Growth Factor A*
7.Robust and Reproducible Generation of Induced Neural Stem Cells from Human Somatic Cells by Defined Factors
Tae Hwan KWAK ; Sai HALI ; Sungmin KIM ; Jonghun KIM ; Hyeonwoo LA ; Kee-Pyo KIM ; Kwon Ho HONG ; Chan Young SHIN ; Nam-Hyung KIM ; Dong Wook HAN
International Journal of Stem Cells 2020;13(1):80-92
Background and Objectives:
Recent studies have described direct reprogramming of mouse and human somatic cells into induced neural stem cells (iNSCs) using various combinations of transcription factors. Although iNSC technology holds a great potential for clinical applications, the low conversion efficiency and limited reproducibility of iNSC generation hinder its further translation into the clinic, strongly suggesting the necessity of highly reproducible method for human iNSCs (hiNSCs). Thus, in orderto develop a highly efficient and reproducible protocol for hiNSC generation, we revisited the reprogramming potentials of previously reported hiNSC reprogramming cocktails by comparing the reprogramming efficiency of distinct factor combinations including ours.
Methods:
We introduced distinct factor combinations, OSKM (OCT4+SOX2+KLF4+C-MYC), OCT4 alone, SOX2 alone, SOX2+HMGA2, BRN4+SKM+SV40LT (BSKMLT), SKLT, SMLT, and SKMLT and performed comparative analysis of reprogramming potentials of distinct factor combinations in hiNSC generation.
Results:
Here we show that ectopic expression of five reprogramming factors, BSKMLT leads the robust hiNSC generation (>80 folds enhanced efficiency) from human somatic cells compared with previously described factor combinations. With our combination, we were able to observe hiNSC conversion within 7 days of transduction. Throughout further optimization steps, we found that both BRN4 and KLF4 are not essential for hiNSC conversion.
Conclusions
Our factor combination could robustly and reproducibly generate hiNSCs from human somatic cells with distinct origins. Therefore, our novel reprogramming strategy might serve as a useful tool for hiNSC-based clinical application.
8.A Case of Pyrazinamide Induced Fulminant Hepatic Failure.
Dae Sung MOON ; Tae Won JANG ; Chul Ho OAK ; Maan Hong JUNG ; Chan Hui YOO ; Jun Young SONG ; Sung Eun KIM ; Ja Kyung KIM ; Lee La JANG ; Eun Young LEE ; Gyu Sik JUNG
Tuberculosis and Respiratory Diseases 2007;63(5):435-439
Standard antituberculous therapy, including isoniazid (INH), rifampin, ethambutol, and pyrazinamide (PZA), is widely used to treat active tuberculosis. The most important side effect is hepatotoxicity. In a standard four-drug regimen, PZA was the most common cause of drug-induced hepatitis and was dose-related. The incidence of drug-induced hepatitis is high at doses of 40~70 mg/kg per day but has fallen significantly since the recommended dose was reduced. Liver toxicity induced by PZA is rare at doses of 25 mg/kg per day or less. PZA-induced fulminant hepatic failure is also rare but fatal. We report a case of fulminant hepatic failure caused by a re-challenge of PZA.
Drug-Induced Liver Injury
;
Ethambutol
;
Incidence
;
Isoniazid
;
Liver
;
Liver Failure, Acute*
;
Pyrazinamide*
;
Rifampin
;
Tuberculosis
9.Clinical outcomes of erlotinib, gefitinib, or pemetrexed in patients with non-squamous, non-small-cell lung cancer.
La Young YOON ; Mi Yean YANG ; Jina YUN ; Hyun Jung KIM ; Han Jo KIM ; Kyung Ha KIM ; Se Hyung KIM ; Sang Cheol LEE ; Chan Kyu KIM ; Nam Su LEE ; Sung Kyu PARK ; Kyu Taek LEE ; Jong Ho WON ; Hee Sook PARK ; Dae Sik HONG
Korean Journal of Medicine 2010;79(4):394-403
BACKGROUND/AIMS: This study compared the clinical benefits of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) with pemetrexed to identify the clinical parameters that correlated with response. METHODS: A retrospective chart review examined patients who were 1) treated with EGFR TKI or pemetrexed, 2) diagnosed with advanced non-squamous non-small-cell lung cancer, and 3) previously treated with platinum-based chemotherapy in Soonchunhyang Bucheon Hospital. RESULTS: Sixty-one patients (18 erlotinib, 18 gefitinib, 25 pemetrexed) were investigated from February 2002 to August 2009. The median follow-up period was 37 months (7~97 months). Overall, their median age was 63 years, 41 patients were non-smokers, 57 patients had adenocarcinoma, and 55 patients were at stage IV. Twenty-one patients received the study drugs as second-line chemotherapy, and others as third-line or more. No significant differences in the overall response rate (erlotinib 33.3% vs. gefitinib 38.9% vs. pemetrexed 20.0%) and progression-free survival (erlotinib 1.9 months vs. gefitinib 3.0 months vs. pemetrexed 2.9 months) were found among the three groups. Female gender was related to a good response to EGFR TKIs (p=0.047). Skin rash in the erlotinib group (p=0.037) and adenocarcinoma in the pemetrexed group (p=0.02) were related to improved progression-free survival. Few side effects were reported. CONCLUSIONS: Both EGFR TKIs and pemetrexed therapy for non-squamous non-small-cell lung cancer were efficient and tolerable after the failure of first-line platinum-based chemotherapy. Further prospective studies are needed to validate the predictive role of the suggested clinical parameters in this study.
Adenocarcinoma
;
Disease-Free Survival
;
Exanthema
;
Female
;
Follow-Up Studies
;
Glutamates
;
Guanine
;
Humans
;
Lung
;
Lung Neoplasms
;
Protein-Tyrosine Kinases
;
Quinazolines
;
Receptor, Epidermal Growth Factor
;
Retrospective Studies
;
Erlotinib Hydrochloride
;
Pemetrexed
10.A Case of Enteropathy-Type T-Cell Lymphoma Diagnosed by Small Bowel Enteroscopy: A Perspective on Imaging-Enhanced Endoscopy.
Jun Yong BAE ; Bong Min KO ; Seul Ki MIN ; Jong Chan LEE ; Gun Wha LEE ; La Young YOON ; Su Jin HONG ; Moon Sung LEE ; Hee Kyung KIM
Gut and Liver 2012;6(4):516-519
Enteropathy-type T-cell lymphoma (ETL) or enteropathy-associated T-cell lymphoma is a very rare malignant intestinal tumor. ETL is usually diagnosed by surgery. Endoscopic findings of ETL are not well known, and there are few reports of findings from endoscopy that has been performed only using white light. Additionally, there are no definite treatment guidelines for ETL. Therefore, we report a case of ETL diagnosed by enteroscopy with imaging-enhanced endoscopy and also review recently developed treatment options.
Endoscopy
;
Enteropathy-Associated T-Cell Lymphoma
;
Humans
;
Light
;
Lymphoma, T-Cell
;
T-Lymphocytes