Poster Session : PS 0831 ; Upper GI Tract : Clinical Factors to Predict Angiographically Detectable Non-Variceal Upper Gastrointestinal Bleeding in Patients Refractory to Endoscopic Treatment

( Tae Hwan Ha ),( Tae Hoon Oh ),( Sung In Yu ),( Min Kim ),( Jong Wook Kim ),( Won Ki Bae ),( Jae Hyung Kim ),( Seung Suk Baek ),( Mi Jin Ryu ),( Ye Na Choi ),( Ji Young Park ),( Eileen L Yoon ),( Tae 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Non-variceal upper GI bleeding (NVUGIB) is a common medical problem that has signifi cant association with morbidity and mortality. Angiographic detection and subsequent transarterial embolization (TAE) is a primary treatment option when medical and endoscopic treatments fail. We investigated clinical factors that could affect the success of the angiographic detection and prognosis after TAE in patients with NVUGIB refractory to endoscopic therapy. Methods: A retrospective analysis of the clinical data was done in patients with failed endoscopic treatment who underwent angiography for the treatment of acute NVUGIB between May 2002 and May 2013. Patients were divided into detection or non-detection groups according to the presence of bleeding stigmata in angiographic fi nding. Rebleeding defi ned as subsequent bleeding event within 7 days and mortality within 30days were analyzed as outcome parameters after TAE following detection in angiography. Results: A total 45 patients 37 (male, mean age, 65.9±14.9 years) were analyzed and classifi ed as a detection group (n=25, 55.5%) and non-detection group (n=20, 44.6%). Peptic ulcers were the most common cause of refractory NVUGIB. Larger transfusion amount (5.7±3.9 unit vs. 3.5±2.8 unit; P=0.03), prolonged aPTT level (34.2±17.3 sec vs. 21.8±13.8 sec; P=0.01) and short time interval between last endoscopy and angiography (17.5±25.9 hours vs. 34.3±59.5 hours; P=0.04) were found to be signifi cant factors for predicting angiographic detection. TAE was performed in all patients detected in angiography. Rebleeding (44%) was significantly associated with higher Rockall score (8.3±1.5 vs. 6.6±2.4; P=0.046) and mortality (12%) was signifi cantly associated with higher Rockall score (9.3±0.6 vs. 7.1±2.2; P=0.002) and higher level of BUN (55.3±47.4 vs. 27.6±17.4; P=0.01). Conclusions: Clinical characteristics associated with angiographic detection in patients with NVUGIB refractory to endoscopic therapy were severe bleeding, bleeding tendency and early angiographic intervention. The Rockall score is useful parameter for predicting rebleeding and mortality after TAE.

형광검출 역상 액체크로마토그래피에 의한 Histamine의 정량

유희춘,김형룡,김상현,김대기,이영미,김형민,안년형,신태용 우석대학교 의약품개발연구소 1996 藥學硏究誌 Vol.1 No.-

Histamine을 정확하고 신속하게 정량하기 위해 9.Fiuorenylmethyl chloroformate를 형광유도체화제로 하여 역상 HPLC법으로 정량하였다. 히스타민을 형광유도체화할 때 반응액의 pH, 반응시간, 형광유도체화제의 농도 등 최적 반응 조건을 검토하였다. 이 방법으로 히스타민을 분석한 결과 0.1~0.5ug/ml의 농도범위에서 상관계수가 0.922인 양호한 직선성을 나타내었으며 검출한계는 0.01??/ml였다. A rapid and simple method for the determination of histamine by reverse-phase high performance liquid chromatography with fluorescence detection was established. 9-Fluorenylmethyl chloroformate(FMOC) was used as fluorescent derivative reagent. The optimum conditions for the derivatiation such as pH, reaction time and he concentration of FMOC were investigated. Linearity of calibration curve was obtained between 0.1ug/ml/and 0.5ug/ml(r=0.922) and the limit of detection was 0.01ug/ml.

환경 오염물질의 진보된 독성 평가 기법

류재천,최윤정,김연정,김형태,방형애,송윤선 한국환경독성학회 1999 환경독성보건학회지 Vol.14 No.1

Recently, several new methods for the detection of genetic damages in vitro and in vivo based on molecular biological techniques were introduced according to the rapid progress in toxicology combined with cellular and molecular biology. Among these methods, mouse lymphoma thymidine kanase (tk) gene forward mutation assay, single cell gel electrophoresis (comet assay) and transgenic animal and cell line model as a target gene of lac I (Big Blue) and lac Z (Muta Mouse) gene mutation are newly introduced based on molecular toxicological approaches. The mouse lymphoma tk^(+/-) gene assay (MOLY) using L5178Y tk+i- mouse lymphoma cell line is one of the mammalian forward mutation assays, and has many advantages and more sensitive than hprt assay. The target gene of MOLY is a heterozygous tk^(+/-) gene located in 11 chromosome, so it is able to detect the wide range of genetic changes like point mutation, deletion, rearrangement, and mitotic recombination within tk gene or deletion of entire chromosome 11. The comet assay is a rapid, simple, visual and sensitive technique for measuring and analysing DNA breakages in mammalian cells. Also, transgenic animal and cell line models, which have exogenous DNA incorporated into their genome, carry recoverable shuttle vector containing reporter genes to assess endogenous effects or alteration in specific genes related to disease process, are powerful tools to study the mechanism of mutation in vivo and in vitro, respectively. Also in vivo acridine orange supravital staining micronucleus assay by using mouse peripheral reticulocytes was introduced as an alternative of bone marrow micronucleus assay. In this respect, there was an International workshop on genotoxicity procedure (IWGTP) supported by OECD and EMS (Environmental Mutagen Society) at Washington D, C, in March 25-26, 1999. The objective of IWGTP is to harmonize the testing procedures internationally, and to extend to finalization of OECD guideline, and to the agreement of new guidelines under the International Conference of Harmonization (ICH) for these methods mentioned above. Therefore, we introduce and review the principle, detailed procedure, and application of MOLY, comet assay, transgenic mutagenesis assay and supravital staining micronucleus assay.

알루미늄 연속주조 용탕의 탈 가스 일체화 장치 개발

이용중,김태원,김기대,류재엽,이형우 한국공작기계학회 2004 한국공작기계학회 추계학술대회논문집 Vol.2004 No.-

It is necessary for managing a perfect process for degasing aluminum molten metal according to the increase of a grade of aluminum and its alloy products. There are some methods that have been used to manage a degasing process in recent years, such as an injection method that uses aluminum molten metal powder and chemicals supplier and input method that supplies argon and nitrogen, or chlorine gas by using a gas blow-tube. However, these methods show some problems, and it shows that it is a difficult process to handle, pollution due to the producing a lot of toxic gases like chlorine and fluoride gas, irregular effects, and lowering work efficiency due to the excessive processing time. The problems that are the most fatal are the producing a lot of sludge due to the reaction of aluminum molten metal with chemicals, loss of metals, and decreasing the life of refractory materials. In order to solve these problems, this paper develops a technology that is related to aluminum continuous casting molten metal and monolithic degasing apparatus. A degasing apparatus developed in this study improved the existing methods and prevented environmental pollution with smokeless, odorless, and harmlessness by using a new method that applies argon and nitrogen gas in which the methods used in the West and Japan are eliminated. The developed method can significantly reduce product faults that are caused by the production of gas and oxidation because it uses a preprocessed molten metal with chemicals. In addition, the amount of the produced sludge can also be reduced by 60~80% maximum compared with the existing methods. Then, it makes it possible to minimize the loss of metals. Moreover, the molten metal processing and settling time is also shortened by comparing it with the existing methods that are applied by using chemicals. In addition, it does much to improve the workers' health, safety and environment because there is no pollution. The improvement of productivity and prevention effects of disaster from the results of the development can be summarized as follows. It will contribute to the process rationalization because it does not have any unnecessary processes that the molten metal will be moved to an agitator by using a ladle and returned to process for degasing like the existing process due to the monolithic configuration. There are no floating impurities due to the oxidation caused by the contact with the air as same as the existing process. In addition, it can protect the blending of precipitation impurities. Because it has a monolithic configuration, it can avoid the use of additional energy to compensate the temperature decreasing about 60? that is caused by the moving of molten metal. It is not necessary to invest an extra facilities in order to discharge the gas generated from a degasing process by using an agitator. The working environment can be improved by the hospitable air in the factory because the molten metal is almost not exposed in the interior of the area.

림프질 전이가 있는 하인두암과 하부식도암의 진단에 활용된 내시경초음파 유도하 Trucut 생검 1예

광명옥,이정환,문정섭,김유선,류수형,총배천,김형훈,김현태 仁濟大學校 白病院 2010 仁濟醫學 Vol.31 No.-

The incidence of double primary cancer is about 10% in all kinds of cancers. Double primary cancer is usually accompanied by gastrointestinal cancer. Esophageal cancer is supposed to be frequently accompanied by squamous cell carcinoma of the head and neck or the upper respiratory tract, because of such common carcinogens as smoking and alcohol ingestion. Esophageal cancer and hypopharyngeal cancer are usually diagnosed by esophagogastric endoscopy with biopsy. We performed endoscopic ultrasound-guided Trucut biopsy(EUS-TCB) to diagnose a mediastinal mass in a 49 year-old patient, who visited our hospital because of voice change. During procedure, we accidently found enlarged celiac lymph node, and obtained tissue from the mediastinal lymph node and the celiac lymph node. We confirmed double primary cancer of squamous cell carcinoma in the esophagus and the hypopharynx via esophagogastric endoscopy.

P599 : Lack of effect of the Low-fluence Q-switched Nd:YAG Laser in the treatment of acquired bilateral melanosis of the neck in perimenopausal woman

( Tae Hyung Ryu ),( In Hyuk Kwon ),( Hee Sang Kye ),( Dai Hyun Kim ),( Hwa Jung Ryu ),( Soo Hong Seo ),( Hyo Hyun Ahn ),( Young Chul Kye ),( Jae Eun Choi ) 대한피부과학회 2014 대한피부과학회 학술발표대회집 Vol.66 No.1

Perianal Bowen’s disease in HIV patient which was refractory to 5% imiquimod treatment

( Tae Hyung Ryu ),( Dong Won Lee ),( In Hyuk Kwon ),( Heesang Kye ),( Jae Eun Choi ),( Hyo Hyun Ahn ),( Young Chul Kye ),( Soo Hong Seo ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1

Perianal bowen’s disease is squamous cell carcinoma(SCC) in situ occurring in the perianal skin. It is not only having the potential to progress SCC, but also difficult to treat. The incidence of perianal bowen’s disease is increasing among the HIV infected man. In previous studies, topical 5% imiquimod cream, a topical immune response modifier that stimulates the production of interferon alfa and other cytokines, is an effective alternative treatment option for patients and body sites that are unsuitable for surgery. A 57-year-old man, who infected with HIV, presented with a 3~4 months history of persistent black pigmented plaques based on background erythema in the perianal region and coccyx area, histologically consistent with bowen’s disease. The lesions treated with 5% imiquimod cream three times a week for 3months, but unresponsive. In recent study, topical imiquimod has been successfully used in the treatment of anogenital neoplasia, but may be less efficacious in HIV positive individuals with low CD4 counts. The patient’s WBC counts 5,910/uL and CD4 counts 790/uL(nl: 410 - 1540/uL) where within normal range. The patient was referred to general surgery department for excision operation. After the wide excision, margin involvement was reported. The patient has followed up closely. This case highlights the difficulties faced in the treatment of perianal bowen’s disease in HIV infected patients.

P356 : A case of secondary infection of chapped skin in a scrubber of a public bath house, which manifests as a Dego`s disease

( Tae Hyung Ryu ),( In Hyuk Kwon ),( Hee Sang Kye ),( Dai Hyun Kim ),( Hwa Jung Ryu ),( Soo Hong Seo ),( Hyo Hyun Ahn ),( Young Chul Kye ),( Jae Eun Choi ) 대한피부과학회 2014 대한피부과학회 학술발표대회집 Vol.66 No.1

Xerosis Cutis with Secondary Bacterial Infection: An Occupational Disease of Scrubbers in Public Bathhouses

( Tae Hyung Ryu ),( In Hyuk Kwon ),( Soo Hong Seo ),( Hyo Hyun Ahn ),( Young Chul Kye ),( Jae Eun Choi ) 대한피부과학회 2017 大韓皮膚科學會誌 Vol.55 No.2

Occupational skin diseases are ranked internationally as the second largest group of occupational diseases after musculoskeletal disorders¹. Although they are rarely found in foreign countries, scrubbers are common in Korea and work at public bathhouses. They work in hot and humid environments on their feet all day, which can easily cause skin dryness and promote bacterial and fungal infections. Degos disease is a marker of cutaneous thrombo-obliterative vasculopathy and not a specific disease per se. It is characterized by pathognomonic skin lesions and centrally porcelainwhite atrophic papules with erythematous and telangiectatic rings^2,3. A 55-year-old man presented with erythematous papules, patches, and multiple asymptomatic small depressed porcelain-white atrophic papules with a rim of rosy erythema spots 2 to 5 mm in diameter and dry skin on both lower extremities for 2 months (Fig. 1). The patient had been working at a public bathhouse as a scrubber on his feet all day for 10 years and had poor and irregular meals. He had no specific medical history. Mild pitting edema was observed on both lower legs. A punch biopsy was performed, and the histology showed hyperkeratosis and confluent parakeratosis in the epidermis. In the dermis, there were ectatic vessels with mild swelling of endothelial cells and both superficial and deep perivascular lymphocytic infiltrations (Fig. 2). We performed an atypical mycobacterial analysis, including nested polymerase chain reaction (PCR), which revealed negative results. However, gram staining of the tissue showed the presence of gram-positive cocci (1+), and bacteriological culture indicated the presence of methicillin-sensitive Staphylococcus aureus. His nutritional status was assessed by measuring the serum levels of several vitamins and minerals, which indicated normal levels of vitamin D3 and vitamin B12, but decreased levels of Zn (60 g/dL, normal range 70∼ 121) and Fe (59 ng/dL, normal range 70∼180). The lesion was finally diagnosed as xerosis cutis with secondary bac-terial infection. The skin lesions almost cleared after 2 months of oral administration of cefaclor (750 mg/day), pentoxifylline (800 mg/day), and epinastine (20 mg/day) together with the application of a moisturizer. Pentoxifylline was used to improve blood circulation of the lower ex-tremities. In this case, dry and chapped skin caused by hot and humid working environments may cause disruption of the skin barrier, which can lead to secondary infection by Staphylococcus aureus. In addition to the complications caused by the harsh environment, venous stasis resulting from prolonged standing at work and malnutrition owing to irregular meals may exacerbate healing impairment and pro-mote secondary infection, leading to the aforementioned unique clinical features. Although zinc deficiency can also cause xerosis and impairment of wound healing, the scrubber`s working environment is considered as a major precipitating factor in this case. The amount of zinc deficiency was insignificant in the patient, and other symptoms or signs that can accompany zinc deficiency, such as alopecia, sto-matitis, and diarrhea were not observed. In Korea, there are many public bathhouses and pro-fessional scrubbers who work in hot and humid environ-ments near the bathtubs. Because of this scrubbing culture in Korea, we often meet patients with folliculitis, irritant dermatitis, or xerotic eczema due to intense scrubbing. Herein, we report a case of xerosis cutis with secondary infection of the chapped skin in a scrubber of a public bathhouse. This case may be worth knowing because such unusual clinical features could develop in specific occupa-tional groups in countries where scrubbing is common.

Nevus lipomatosus superficialis derived from pericyte around vessel in infant

( Tae Hyung Ryu ),( Dong Won Lee ),( In Hyuk Kwon ),( Heesang Kye ),( Jae Eun Choi ),( Hyo Hyun Ahn ),( Young Chul Kye ),( Soo Hong Seo ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.1

Nevus lipomatosus superficialis(NLS) is an uncommon benign hamartomatous condition characterized by the presence of mature ectopic adiopocytes in the dermis. The classical form of NLS is characterized by groups of multiple, soft, pedunculated, cerebriform, skin-colored papules, nodules, or plaques. Lymphangioma circumscriptum(LC) is malformation of the superficial lymphatics and presenting vesicle-like papules resembling frog spawn. A 10-month male infant presented with asymptomatic tiny pink colored papules based on background pinkish patch on right shin. Since birth, the lesion had been developed and recently his parents noticed the lesion expanding. Incisional biopsy was performed and histologically consistent with LC. 5 months later, the patient visited again for total excision. Unprecedentedly, clinical aspect of the lesion was changed and it was similar to NLS. The lesion was totally excised and the histopathology showed groups of fat cells located on perivascular area of dermis and numerous dilated lymphatics in the papillary dermis. The proposed pathogenesis of NLS includes adipose metaplasia in the pericytes of dermal vessles. In our case, groups of adipocytes perched on perivascular area of dermis and it supports the hypothesis. Herein we report an exceptionally rare case of NLS derived from pericyte around vessel and provide academic information regarding its clinicopathologic features