1.Utility of blood urea nitrogen as a predictor of endoscopic hemostasis in patients with suspected acute non-variceal upper gastrointestinal bleeding
Nak Young CHOI ; Young Mo CHO ; Il Jae WANG ; Seok Ran YEOM ; Sung Wook PARK
Journal of the Korean Society of Emergency Medicine 2022;33(4):346-354
Objective:
Urgent upper endoscopy is performed to achieve acute hemostasis in patients with high-risk bleeding sources. Emergency physicians must identify patients who require urgent endoscopic treatments. This study assessed the performance of blood urea nitrogen (BUN) for predicting severe bleeding that necessitates urgent endoscopic hemostasis compared to the risk assessment scores in patients with acute non-variceal upper gastrointestinal bleeding (ANVUGIB).
Methods:
The presumed ANVUGIB patients were classified into endoscopic and non-endoscopic hemostasis groups. Data including historical features, symptoms, signs, and routine laboratory tests were collected and compared.
Results:
Three hundred and ninety-one patients were analyzed, including 116 patients in the endoscopic hemostasis and 275 patients in the non-endoscopic hemostasis group. In the area under curve (AUC) of the receiver operator characteristic curve, BUN (AUC 0.733; 95% confidence interval [CI], 0.681-0.785) and BUN/creatinine (AUC, 0.727; 95% CI, 0.672-0.783) were superior to total protein, Glasgow-Blatchford score (GBS), modified GBS (AUC, 0.649, 0.623 and 0.646, respectively) for predicting endoscopic hemostasis. Pre-endoscopy Rockall score and AIMS65 were statistically insignificant. The same results were obtained when the patients with liver and chronic kidney diseases were excluded.
Conclusion
The current results suggest that BUN was an independent predictor of endoscopic hemostasis in patients with ANVUGIB. Further studies will be needed to determine if BUN can be used in clinical practice.
6.Alginate/PEI/DNA polyplexes: a new gene delivery system.
Ge JIANG ; Sang-Hyun MIN ; Mi-Na KIM ; Dong-Chul LEE ; Mi-Jung LIM ; Young-Il YEOM
Acta Pharmaceutica Sinica 2006;41(5):439-445
AIMTo avoid the limitation of the use of cationic polyethlenimine (PEI)-complexed plasmid DNA use for in vitro or in vivo gene delivery due to its cytotoxicity and lower efficiency in the presence of serum.
METHODSA polyplex with decreased positive charge on the complex surface was designed. The PEI/DNA (PD) complexes coated with an anionic biodegradable polymer, alginate were prepared and their gene delivery behavior with PD was compared.
RESULTSThe alginate-coated PD polyplex, where alginate : PEI : DNA [alginate : DNA, 0.15 (w/w); PEI : DNA, N : P = 10] showed about 10 - 30 fold-increased transfection efficiency compared to corresponding non-coated complexes to C3 cells in the presence of 50% serum. The surface charge of the alginate-coated complex was approximately half of that of the alginate-lacking complex. The size of alginate-coated complex was slightly smaller than that of the corresponding complex without alginate. The former complex also showed a reduced erythrocyte aggregation activity and decreased cytotoxicities to C3 cells in comparison with PD complex.
CONCLUSIONThe alginate-coated PD polyplexes as a new gene delivery system can improve transfection efficiency in high serum concentration with low cytotoxicity to C3 cells.
Alginates ; administration & dosage ; metabolism ; Animals ; Cell Line, Transformed ; Cell Survival ; Culture Media ; DNA ; administration & dosage ; genetics ; metabolism ; Erythrocyte Aggregation ; Fibroblasts ; cytology ; metabolism ; Gene Transfer Techniques ; Genetic Vectors ; Glucuronic Acid ; administration & dosage ; metabolism ; Hexuronic Acids ; administration & dosage ; metabolism ; Mice ; Mice, Inbred C57BL ; Plasmids ; Polyethyleneimine ; administration & dosage ; metabolism ; Serum ; Transfection
7.Metabolic Signaling to Epigenetic Alterations in Cancer
Biomolecules & Therapeutics 2018;26(1):69-80
Cancer cells reprogram cellular metabolism to support the malignant features of tumors, such as rapid growth and proliferation. The cancer promoting effects of metabolic reprogramming are found in many aspects: generating additional energy, providing more anabolic molecules for biosynthesis, and rebalancing cellular redox states in cancer cells. Metabolic pathways are considered the pipelines to supply metabolic cofactors of epigenetic modifiers. In this regard, cancer metabolism, whereby cellular metabolite levels are greatly altered compared to normal levels, is closely associated with cancer epigenetics, which is implicated in many stages of tumorigenesis. In this review, we provide an overview of cancer metabolism and its involvement in epigenetic modifications and suggest that the metabolic adaptation leading to epigenetic changes in cancer cells is an important non-genetic factor for tumor progression, which cooperates with genetic causes. Understanding the interaction of metabolic reprogramming with epigenetics in cancers may help to develop novel or highly improved therapeutic strategies that target cancer metabolism.
Acetylation
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Carcinogenesis
;
Epigenomics
;
Metabolic Networks and Pathways
;
Metabolism
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Methylation
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Neoplasm Metastasis
;
Oxidation-Reduction
8.Analysis of prognostic factors for postoperative complications and mortality in elderly patients undergoing emergency surgery for intestinal perforation or irreversible intestinal ischemia
Hyung Suk KIM ; Hyun Il KIM ; Young Joon YOON ; Jong Hoon YEOM ; Min Gyu KIM
Annals of Surgical Treatment and Research 2023;105(4):198-206
Purpose:
Because the global geriatric population continues to increase, the assessment of emergency surgical outcomes in elderly patients with acute peritonitis will become more important.
Methods:
A retrospective review was conducted on the data of 174 elderly patients who underwent emergency surgery for intestinal perforation or intestinal infarction between June 2010 and November 2022. We conducted an analysis of the risk factors associated with postoperative complications and mortality by evaluating the characteristics of patients and their surgical outcomes.
Results:
In our study, most patients (94.3%) had preexisting comorbidities, and many patients (84.5%) required transfer to the intensive care unit following emergency surgery. Postoperative complications were observed in 84 individuals (48.3%), with postoperative mortality occurring in 29 (16.7%). Multivariate analysis revealed preoperative acute renal injury, hypoalbuminemia, and postoperative ventilator support as significant predictors of postoperative mortality.
Conclusion
When elderly patients undergo emergency surgery for intestinal perforation or infarction, it is important to recognize that those with preoperative acute renal injury, hypoalbuminemia, and a need for postoperative ventilator support have a poor prognosis. Therefore, these patients require intensive care from the early stages of treatment.
9.Plasmodium falciparum Cultivation Using the Petri Dish: Revisiting the Effect of the 'Age' of Erythrocytes and the Interval of Medium Change.
Young A KIM ; Je Eun CHA ; Sun Young AHN ; Seung Ho RYU ; Joon Sup YEOM ; Hyo Il LEE ; Chang Gyun KIM ; Ju Young SEOH ; Jae Won PARK
Journal of Korean Medical Science 2007;22(6):1022-1025
Differences in the characteristics of the culture conditions can influence the multiplication rate of Plasmodium falciparum. The Petri dish method is one of the most popular methods of cultivating this parasite. In many previous studies, ideal culture conditions of the Petri dish method were achieved by using erythrocytes collected from blood that had been stored for at least 2 weeks, with daily changes of the medium. In the present study, we studied the multiplication rate of P. falciparum in cultures containing erythrocytes of various ages together with changing the medium at various intervals of time. Our results strongly suggest that the rate of in vitro multiplication of P. falciparum was higher in freshly collected erythrocytes than in aged erythrocytes regardless of the anticoagulant and that when the parasitemia is lower than 8% with a hematocrit of 5%, the medium change interval can be as long as 48 hr without a great reduction in the rate of multiplication.
Animals
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Blood Specimen Collection
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Cell Aging
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Culture Media
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Erythrocytes/*parasitology
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Plasmodium falciparum/*growth & development
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Time Factors
10.DNA Variation of Helicobacter Pylori in the Gastroduodenal Disease.
Im Hwan ROE ; Chang In KIM ; Dong Ryul HA ; Young Joo JIN ; Il Han SONG ; Chang Young LIM ; Jung Won KIM ; Jung Taik KIM ; Jong Hwa KIM ; Jung Sun YEOM
Korean Journal of Medicine 1997;53(4):520-526
BACKGROUND: The evidence for H. pylori as a gastrointestnal pathogen is now very strong, if not overwhelming. Among the pathogenic factors of H. pylori, flagella and urease are considered to be major factors causing the gastrododenal disease. We observed the gene diversity of H. pylori using the PCR-amplified 1.4Kb fla A gene and 0.9Kb ure B gene and examined the relationship between the gene pattern and the gastroduodenal disease. METHOD: Fifty-one cases of isolated strains were cultured at the Helicobacter-selective blood agar plates. To compare the gene diversity among the isolates of gastroduodenal disease genotypes was analyzed by PCR-based RFLP. 1.4Kb fla A gene and 0.9Kb ure B genes from isolates were amplified by PCR and digested with Hae 3 restriction enzymes to observe the restriction fragment length polymophysm. Protein patterns were also compared to examine the antigenic variations. Total cell proteins, and octyl-glucose extracts from isolates were analyzed by SDS-PAGE gel electrophoresis. RESULTS: 41 cases (80.4%) of H. pylori were isolated in the 51 cases of gastroduodenal diseases. We could classify theses isolates 3 types of PCR-RFLP in the fla A gene, 900+500bp, 500+500+400bp, 600+800bp, and 9 types in the ure B gene. PCR-RFLP in the fla A gene and ure B gene of the isolates was different from the standard strain of Australia and the genetic diversity was not related to the types of the gastroduodenal disease. We demonstrated variations in the protein pattern and antigenic profiles among the isolates by SDS-PAGE analysis. These data also did not show any relationship between protein pattern and types of gastroduodenal diseases. CONCLUSION: Tese studies showed many different gene diversity in the flagella and urease gene without any relationship with the types of gastoduodenal disease. And variable protein pattern were noted among the strains of H. pylori. Further studies to demonstrate the pathgenecity of H. pylori should be continued even if there was no relationship between the genomic diversity of the flagella or urease and the types of gastroduodenal disease.
Agar
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Australia
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DNA*
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Electrophoresis
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Electrophoresis, Polyacrylamide Gel
;
Flagella
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Genes, vif
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Genetic Variation
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Genotype
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Helicobacter pylori*
;
Helicobacter*
;
Polymerase Chain Reaction
;
Polymorphism, Restriction Fragment Length
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Urease