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.

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.

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.

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.

A Type II Segmental Vitiligo Developed under Infliximab Treatment for Ulcerative Colitis

( Tae Hyung Ryu ),( Dong Won Lee ),( Jae Eun Choi ),( Hyo Hyun Ahn ),( Young Chul Kye ),( Soo Hong Seo ) 대한피부과학회 2017 Annals of Dermatology Vol.29 No.6

Comparison of Clinical Features and Laboratory Findings of Acute Hepatitis A in relation to Peak Total Bilirubin Level (초)

( Hyung Hun Kim ),( Soo Hyung Ryu ),( Hyun Tae Kim ),( Pei Chuan Tsung ),( Hyung Rae Sohn ),( Jung Hwan Lee ),( You Sun Kim ),( Jeong Seop Moon ) 대한간학회 2010 Clinical and Molecular Hepatology(대한간학회지) Vol.16 No.3(S)

Infliximab induced vitiligo in patients treated for ulcerative colitis

( Tae Hyung Ryu ),( Dae Yeon Kim ),( Dong Won Lee ),( In Hyuk Kwon ),( Jae Eun Choi ),( Hyo Hyun Ahn ),( Young Chul Kye ),( Soo Hong Seo ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1

Infliximab, an anti-tumor necrosis factor(TNF) α inhibitor, is the first biologic drug approved for the treatment of ulcerative colitis(UC). The widespread use of this drug has shown a wide range of skin-adverse reactions, such as alopecia areata, atopic dermatitis, acne, lichenoid-drug reaction etc. Vitiligo is a depigmentating skin disorder resulting from the loss of melanocytes in the epidermis. Although the exact etiology of vitiligo has not yet been established, the abnormal immune responses have been frequently observed in vitiligo patients. A 34-year-old male presented with multiple hypopigmented patches on right facial area; upper medial eyelid, perioral, mandible. The cutaneous lesions appeared 4 months after initiating intravenous infliximab therapy at a dose of 5 mg/kg, when he had received 4 infusions of this drug. Wood test was positive. Thyroid function test, anti-thyroglobulin antibodies and fluorescent antinuclear antibodies screening test were within normal range. The patient was put on therapy for vitiligo in the form of topical tacrolimus 0.1% ointment, combined with excimer laser. After twice excimer laser treatment, the patient refused the treatment. The development of biological auto-immunity is a well-known side effect of anti-TNF α agents. Therefore, despite the great therapeutic advantages of TNF α blocking agents, dermatologist should be aware of adverse cutaneous reactions.

Purpura associated with onion extract consumption

( 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

Extravasation of red blood cells from cutaneous vessels into skin or mucous membranes results in reddish-purple lesions are included under the term purpura. Onion is a universal staple herb and it has been consumed for prevention of cardiovascular disorders. In recent years, extensive research has been focused on the medicinal properties of the onion contain biologically active substances affecting blood clotting. It was reported that the anticlotting effect of onions closely correlates with their content of organosulfur compounds. A 50-year-old female presented with mildly itching petechial patches on left abdominal wall intermittently and recently aggravated for 2days ago. The patient had no medical diseases but had drunk onion extract for several months. A blood clotting screening is within normal range. However, platelet count was slightly lower than normal(144000). Histopathologic examination revealed a superficial perivascular lymphocytic infiltrate in the dermis and extravasated RBCs with no evidence of vasculitis. We recommended her to stop taking onion extract. The purpuric eruption was treated with oral antihistamine and topical desonide lotion and it resolved within 2 weeks. Although, pathomechanism of the purpura is unclear, onion extract comsumption might be related. Herein, we report a case of purpura associated with onion extract consumption and it may be worth to know.

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