HCC : Vascular Enhancement Patterns of HCC with Contrast-Enhanced Ultrasound

( Hae Lim Baek ),( Yun Soo Kim ),( Young Kul Jung ),( Oh Sang Kwon ),( Ju Hyun Kim ),( Duck Joo Choi ),( Yeon Suk Kim ),( Yang Suh Ku ),( Seung Jun Jang ),( Seung Kak Shin ),( Hyunhwa Yoon ),( Soo Yon 대한간학회 2013 춘·추계 학술대회 (KASL) Vol.2013 No.1

Background: Classic enhancement pattern of hepatocellular carcinoma(HCC) with dynamic CT or MRI includes hyperenhancement in arterial phase and hypoenhancement during portal and delayed phase. It is known that vascular pattern after SonoVue injection is similar to that observed with CT or MRI. However, atypical enhancement and washout pattern are not unusually encountered with CEUS. We have studied CEUS patterns of HCC in 32 consecutive patients with HCC. Methods: 32 HCCs were analysed(mean age 55.5, 6 females, 26 males). Twenty two were diagnosed with liver biopsy, and in 10 patients diagnosis was made with typical dynamic CT or MRI findings. CEUS using SonoVue(Bracco, Milan, Italy) were performed. Arterial, portal and delayed phases were determined as -30s, 31-120s and 121-360s. Results: HBsAg and anti-HCV were positive in 24 (75%) and 5 (15%) patients, respectively. Mean tumor size was 5.3±4.3 cm (1.1-20.0 cm). Mean serum alpha fetoprotein was 9,174 ng/mL (1.3-200,000 ng/mL). All the HCCs showed arterial enhancement (hyper or iso-). Arterial hyperenhancement was observed in 26 (81%) lesions, and remaining 6 (19%) HCCs showed isoenhancement relative to the adjacent liver parenchyme. Hypoenhancement (wash-out) in portal phase was observed in only 9 (28%) lesions (mean diameter: 5.1±4.2 cm), and remaining 23 lesions (72%) were isodense in portal phase (mean diameter: 5.4±4.5 cm). Hypoenhancement in delayed phase was observed in 28 lesions (88%) (mean diameter: 5.8±4.4 cm). And remaining 4 lesions showed persistent isoenhancement until 6 min, and their mean diameter was 2.2±0.9 cm (P=0.126). Enhancement during arterial phase, isoenhancement during portal and hypoenhancement during delayed phase was observed in 19 (59%) lesions, which was most common enhancement pattern. Conclusions: Arterial hyperenhancement with isodense portal phase and hypoenhancement in delayed phase was most common CEUS finding in HCC. It seems that tumor size affects on the hypoenhancement during delayed phase in CEUS.

Isolated Infective Endocarditis on Pulmonary Valve Caused by Aggregatibacter aphrophilus in Patient with Ventricular Septal Defect

Hae Lim Baek,Yong Kyun Cho,Mi-Seung Shin,Song Mi Moon,Suyoung Kim,Kang-lock Lee,Young Rock Jang,Woo Suk Choi 중앙대학교 의과대학 의과학연구소 2013 中央醫大誌 Vol.38 No.4

Infective endocarditis caused by Aggregatibacter aphrophilus, which is one of the members of HACEK group, is rare and mitral valve is known as a prominently affected site in most cases. We report a case of isolated pulmonary valve infective endocarditis caused by A. aphrophilus in a patient with congenital heart disease. Twenty five-year-old woman with ventricular septal defect visited our hospital complaining fever lasting 3 weeks. Not any vegetation was observed at transthoracic echocardiography due to limited echo window. However, transesophageal echocardiography showed a small vegetation attached to the pulmonary valve. The patient was successfully treated with ceftriaxone for 4 weeks.

Ultrasound-Guided Infraorbital Nerve Pulsed Radiofrequency Treatment for Intractable Postherpetic Neuralgia - A Case Report -

Lim, Seung Mo,Park, Hae Lang,Moon, Hyong Yong,Kang, Kyung Ho,Kang, Hyun,Baek, Chong Hwa,Jung, Yong Hun,Kim, Jin Yun,Koo, Gill Hoi,Shin, Hwa Yong The Korean Pain Society 2013 The Korean Journal of Pain Vol.26 No.1

A 60-year-old man presented with pain on the left cheek and lateral nose. The patient had been diagnosed with facial herpes zoster in the left V2 area 6 months previously. Medical treatment was prescribed for 6 months but it had little effect. We blocked the left infraorbital nerve under ultrasound guidance, but pain relief was short term. Therefore, we performed pulsed radiofrequency treatment on the left infraorbital nerve under ultrasound guidance. Six months after the procedure, the reduction of pain was still maintained, and there was no need for further management.

Effect of Methanol Extract from Cassia mimosoides var. nomame on Ischemia/Reperfusion-induced Renal Injury in Rats

Baek, Hae Sook,Lim, Sun Ha,Ahn, Ki Sung,Lee, Jong Won The Korea Association of Herbology 2013 大韓本草學會誌 Vol.28 No.6

Objectives : The purpose of this study was to determine whether the methanol extract of Cassia mimosoides var. nomame Makino, a naturally growing plant in Korea, could prevent the renal-ischemia/reperfusion injury in a rat model or not. Methods : The radical scavenging activities of the extracts, and ascorbic acid as a positive control, were measured in vitro. At one hour after an intraperitoneal injection of the extract (400 mg/kg), renal ischemia/reperfusion injury was generated by 40 min clamping of the left renal artery in rats. After renal ischemia/reperfusion and 24 hr restoration of blood circulation, the serum creatinine concentration was measured. And the extent of epithelial cell injury and apoptosis was assessed by various staining technologies. The Bax/Bcl-2 ratio and activated caspase-3 were assessed by immunohistochemistry. Results : The extract showed a slightly lower level of radical scavenging activity than that of ascorbic acid. Compared to those of the vehicle-treated group, the extract-treated group displayed a significantly smaller tubular epithelial cell injury of 54% reduction in the outer medulla region and a lower serum creatinine concentration of 50% reduction. It seems that the reduction in cellular injury is due to the attenuation of the Bax/Bcl-2 ratio, and the inhibition of caspase-3 activation by the extract of Cassia mimosoides. Conclusions : Cassia mimosoides var. nomame Makino could be a good candidate for a prophylactic agent against the ischemia/reperfusion/induced kidney injury.

Hot Water Extract of Triticum aestivum L. (Common Wheat) Ameliorates Renal Injury by Inhibiting Apoptosis in a Rat Model of Ischemia/Reperfusion

Baek, Hae Sook,Lim, Sun Ha,Ahn, Ki Sung,Lee, Jong Won The Korea Association of Herbology 2013 大韓本草學會誌 Vol.28 No.3

Objectives : Interruption and subsequent restoration of blood flow into the kidney result in renal injury. As an approach to preventing the renal injury, we determined the optimal conditions and the underlying mechanisms by which supernatant of hot water extract of ground Triticum aestivum L. (extract) attenuated ischemia/reperfusion (I/R) injury. Methods : One hour after administration of the extract (400 mg/kg) by intraperitoneal injection, renal I/R injury was generated by clamping the left renal artery in rats after surgical removal of the right kidney, followed by reperfusion. The maximal difference between the vehicle-treated and the extract-treated group under ketamine/xylazine or enflurane anesthetization was assessed at varying periods of ischemia (30-45 min) and reperfusion (3-48 hr), based on the renal function assessed with serum creatinine levels, tissue injury with hematoxylin/eosin staining, and apoptosis with terminal deoxynucleotidyltransferase-mediated dUTP nick-end labeling staining. Results : Enflurane anesthetization with 40 min of ischemia and 24 hr of reperfusion was identified to be the optimal condition, under which condition serum creatinine levels and tubular damage in the extract-treated group were significantly reduced compared with those in the vehicle-treated group ($1.3{\pm}0.2$ versus $2.7{\pm}0.3$ mg/dL, P < 0.01, and average score $1.8{\pm}0.1$ versus $3.5{\pm}0.3$, P < 0.01, respectively). These beneficial effects were mediated by inhibition of apoptotic cascades through attenuation of renal tissue malondialdehyde levels, Bax/Bcl-2 ratio and caspase-3 levels. Conclusions : The extract conferred renal protection against ischemia/reperfusion injury in rats by scavenging reactive oxygen species and consequently blocking apoptotic cascades, plausibly augmented by enflurane protection.

Corynebacterium세균의 이종간 원형질체 융합에 의한 재조합주의 유전학적 분석과 L-glutamate 와 L-glutamine 생성

백선영,이혜경,최순영,김종욱,이세배,임번삼,민경희 한국산업미생물학회 1990 한국미생물·생명공학회지 Vol.18 No.3

자외선 조사와 NTG를 처리하여 Brevibacterium flavum 10AHR(arg his Rif^r)과 Corynebacterium glutamicum 11TS(trp Sm^r)의 돌연변이주를 분리하였다. B. flavum 10AHR과 C. glutamicum 11TS를 300㎍/㎖의 lysozyme으로 18시간 처리하여 원형질체를 형성하고, 융합시 30%의 PEG 6,000으로 처리하였을 때 가장 높은 3.7×10 exp(-6)의 융합빈도를 나타내었다. 재조합주의 유전적 분석결과 재조합주들은 FMM(Rif^r Sm^r), FA(Rif^r Sm^r arg), FH(Rif^r Sm^r his), FT(Rif^r Sm^r trp), FAH(Rif^r Sm^r arg his), FAT(Rif^r Sm^r arg trp), FAHT(Rif^r Sm^r arg his trp)으로 분류되었다. FAH에 속하는 균주들은 대부분 모균주에 비해 glutamate와 glutamine의 생산성이 월등히 증가하였으며, FAH1의 경우 glutamate 생성에 있어 모균주인 B. flavum 10AHR에 비해 12배, glutamine은 모균주인 C. glutamicum 11TS에 비해 2.6배 정도 생성이 현저히 증가하였다. 재조합주들의 효소활성을 측정해본 결과 glutamate와 glutamine의 생성량은 GDH와 GS의 활성도와 각각 관련이 있음을 알 수 있었다. For interspecific portoplast fusion, Brevibacterium flavum 10AHR(Rif^r arg his) and Corynebacterium glutamicum 11TS(Sm^r trp) were induced by UV and NTG treatment. The protoplast fusion frequency between B. flavum 10AHR and C. glutamicum 11TS was 3.7×10 exp(-6) with the lysozyme treatment(300㎍/㎖) for 18 hrs. Genotypes of recombinants were analized as FMM(Rif^r Sm^r), FA (Rif^r Sm^r arg), FH(Rif^r Sm^r his), FT(Rif^r Sm^r trp), FAH(Rif^r Sm^r arg trp), FAT(Rif^r Sm^r arg trp), and FAHT(Rif^r Sm^r arg his trp). FAH 1 produced 12 fold of glutamate production compared to parental type, B. flavum 10AHR. In glutamine productivity, it produced 2.6 fold to parental type, C. glutamicum 11TS. Production of glutamate or glutamine by recombinants was involved in the specific activities of glutamate dehydrogenase(GDH) and glutamine synthetase(GS), respectively.

Impact of the β-1 adrenergic receptor polymorphism on tolerability and effcacy of bisoprolol therapy in Korean heart failure patients: association between βadrenergic receptor polymorphism and bisoprolol therapy in heart failure (ABBA)

( Hae Young Lee ),( Wook Jin Chung ),( Hui Kyung Jeon ),( Hong Seog Seo ),( Dong Ju Choi ),( Eun Seok Jeon ),( Jae Joong Kim ),( Joon Han Shin ),( Seok Min Kang ),( Sung Cil Lim ),( Sang Hong Baek ) 대한내과학회 2016 The Korean Journal of Internal Medicine Vol.31 No.2

Background/Aims: We evaluated the association between coding region variants of adrenergic receptor genes and therapeutic effect in patients with congestive heart failure (CHF). Methods: One hundred patients with stable CHF (left ventricular ejection fraction [LVEF] < 45%) were enrolled. Enrolled patients started 1.25 mg bisoprolol treatment once daily, then up-titrated to the maximally tolerable dose, at which they were treated for 1 year. Results: Genotypic analysis was carried out, but the results were blinded to the investigators throughout the study period. At position 389 of the β-1 adrenergic receptor gene (ADRB1), the observed minor Gly allele frequency (Gly389Arg + Gly389Gly) was 0.21, and no deviation from Hardy-Weinberg equilibrium was observed in the genotypic distribution of Arg389Gly (p = 0.75). Heart rate was reduced from 80.8 ± 14.3 to 70.0 ± 15.0 beats per minute (p < 0.0001). There was no significant difference in final heart rate across genotypes. However, the Arg389Arg genotype group required significantly more bisoprolol compared to the Gly389X (Gly389Arg + Gly389Gly) group (5.26 ± 2.62 mg vs. 3.96 ± 2.05 mg, p = 0.022). There were no significant differences in LVEF changes or remodeling between two groups. Also, changes in exercise capacity and brain natriuretic peptide level were not significant. However, interestingly, there was a two-fold higher rate of readmission (21.2% vs. 10.0%, p = 0.162) and one CHF-related death in the Arg389Arg group. Conclusions: The ADRB1 Gly389X genotype showed greater response to bisoprolol than the Arg389Arg genotype, suggesting the potential of individually tailoring β-blocker therapy according to genotype.

Comparison of Safety and Diagnostic Efficacy of Iohexol 240 mgI/mL, Iopamidol 250 mgI/mL, and Iodixanol 270 mgI/mL in Cerebral Angiography: A Prospective, Multicenter Study

Baek Jin Wook,Hae Woong Jeong,Heo Young Jin,Yun Suyoung,Kang Myongjin,Kim Byungjun,Kim Eui Jong,Lim Soo Mee,이보은 대한신경중재치료의학회 2024 Neurointervention Vol.19 No.2

Purpose: This multicenter prospective study aimed to evaluate the quality and diagnostic effectiveness of cerebral angiography images obtained using low-concentration iodinated contrast agents (iohexol 240 mgI/mL, iopamidol 250 mgI/mL, and iodixanol 270 mgI/mL) and to assess the safety thereof. The study addresses the need for safer contrast agent alternatives without compromising the diagnostic quality of identifying cerebrovascular disease.Materials and Methods: Conducted in 5 medical centers in South Korea, we enrolled patients aged 19 years or older who were referred for diagnostic cerebral angiography under non-emergency conditions, excluding those with specific health conditions and sensitivities. The study design included a prospective, observational approach with a 1-way analysis of variance (ANOVA) for sample size calculation, aiming for a total sample of 231 participants for adequate power. Image quality was evaluated using a 4-level scale by 2 independent, blinded radiologists, and adverse reactions were monitored both immediately and up to 7 days post-procedure. Statistical analysis involved 1-way ANOVA and Kruskal–Wallis tests to assess the image quality and safety profiles of the contrast agents.Results: Among 266 patients screened, 243 were included in the final analysis. The evaluation revealed no statistically significant differences in image quality among the 3 types of low-concentration contrast agents. Adverse events were observed in 28.8% of patients, with 27.2% experiencing acute reactions, primarily mild reactions, and 3.3% experiencing delayed reactions. The overall safety profile showed no significant changes in vital signs or electrocardiogram readings before and after contrast agent injection.Conclusion: Using low-concentration iodinated contrast agents for cerebral angiography provides image quality comparable to that of conventional high-concentration agents, with no significant increase in adverse events, suggesting a safer alternative for patients.

Effect of Methanol Extract from Cassia mimosoides var. nomame on Ischemia/Reperfusion-induced Renal Injury in Rats

( Hae Sook Baek ),( Sun Ha Lim ),( Ki Sung Ahn ),( Jong Won Lee ) 대한본초학회 2013 大韓本草學會誌 Vol.28 No.6

Objectives: The purpose of this study was to determine whether the methanol extract of Cassia mimosoides var. nomame Makino, a naturally growing plant in Korea, could prevent the renal-ischemia/reperfusion injury in a rat model or not. Methods : The radical scavenging activities of the extracts, and ascorbic acid as a positive control, were measured in vitro. At one hour after an intraperitoneal injection of the extract (400 mg/kg), renal ischemia/reperfusion injury was generated by 40 min clamping of the left renal artery in rats. After renal ischemia/reperfusion and 24 hr restoration of blood circulation, the serum creatinine concentration was measured. And the extent of epithelial cell injury and apoptosis was assessed by various staining technologies. The Bax/Bcl-2 ratio and activated caspase-3 were assessed by immunohistochemistry. Results : The extract showed a slightly lower level of radical scavenging activity than that of ascorbic acid. Compared to those of the vehicle-treated group, the extract-treated group displayed a significantly smaller tubular epithelial cell injury of 54% reduction in the outer medulla region and a lower serum creatinine concentration of 50% reduction. It seems that the reduction in cellular injury is due to the attenuation of the Bax/Bcl-2 ratio, and the inhibition of caspase-3 activation by the extract of Cassia mimosoides. Conclusions : Cassia mimosoides var. nomame Makino could be a good candidate for a prophylactic agent against the ischemia/reperfusion?induced kidney injury.

Intractable Hemifacial Spasm Treated by Pulsed Radiofrequency Treatment

( Hae Lang Park ),( Seung Mo Lim ),( Tae Hwa Kim ),( Kyung Ho Kang ),( Hyun Kang ),( Yong Hun Jung ),( Chong Wha Baek ),( Young Cheol Woo ),( Jin Yun Kim ),( Gill Hoi Koo ),( Hwa Yong Shin ) 대한통증학회 2013 The Korean Journal of Pain Vol.26 No.1

Hemifacial spasm is defined as unilateral, involuntary, irregular twitching of all or parts of the muscles innervated by facial nerves. Here, we present a case of recurrent hemifacial spasm after microvascular decompression (MVD) treated with pulsed radiofrequency (PRF) treatment with good results. A 35-year-old woman suffered from recurrent hemifacial spasm after MVD that was refractory to medical treatment and botulinum toxin injections. We attempted a left facial nerve block twice. Then, we applied PRF at a maximum temperature of 42oC for 120 sec. Some response was observed, so we applied PRF two additional times. The frequency of twitch decreased from 3-4 Hz to < 0.5 Hz, and subjective severity on a visual analogue scale also decreased from 10/10 to 2-3/10. PRF treatment might be an effective medical treatment for refractory hemifacial spasm and has fewer complications and is less invasive compared with those of surgery. (Korean J Pain 2013; 26: 62-64)