Routine barium enema prior to closure of defunctioning ileostomy is not necessary

Sung Yeon Hong,Do Yun Kim,Seung Yeop Oh,Kwang Wook Suh 대한외과학회 2012 Annals of Surgical Treatment and Research(ASRT) Vol.83 No.2

Purpose: The use of barium enemas to confirm the anastomotic integrity prior to ileostomy closure is still controversial. The purpose of the study was to determine the utility of routine contrast enema prior to ileostomy closure and its impact on patient management in patients with a low pelvic anastomosis. Methods: One hundred forty-five patients had a temporary loop ileostomy constructed to protect a low colorectal or coloanal anastomosis following low anterior resection for rectal cancer. All patients were evaluated by physical examination, proctoscopy, and barium enema prior to ileostomy closure. Results: The median time from ileostomy creation to closure was 8 months. Five (3.5%) of the 144 patients were found to have clinically relevant strictures at the colorectal anastomosis on routine barium enema. One patient (0.7%) showed anastomotic leak on their barium enema. Overall, 141 patients (97.9%) had an uncomplicated postoperative course. Postoperative complication occurred in three patients (2.1%). None of them showed abnormal barium enema finding, which suggested that routine contrast enema examination did not predict postoperative complication. Conclusion: Routine barium enema evaluation of low pelvic anastomoses before loop ileostomy closure did not provide any additional information for postoperative colorectal anastomotic complication.

Robust Bearing Angle Error Estimation for Mobile Robots With a Gimballed Ultrasonic Seeker

Suh, Ui-Suk,Lee, Yunha,Ra, Won-Sang,Kim, Tae Wook IEEE 2018 IEEE transactions on industrial electronics Vol.65 No.7

<P>This paper deals with the bearing angle error (BAE) estimation problem associated with a one-axis gimballed ultrasonic seeker, which can be used as a low-cost sensor for mobile robot applications. Under the assumptions that the target has an ultrasonic transmitter and the gimbal control loops work properly, the moving target tracking reduces to an estimation problem of a piecewise constant BAE using real sinusoids measured by a receiver array mounted on the gimbal. To effectively cope with the real-time implementation issue, our estimation problem is formulated using linear robust state estimation and is resolved using the constrained robust weighted least squares method. Through experimental results obtained from a hardware-in-the-loop simulation (HILS) approach, it is demonstrated that the proposed scheme provides more reliable and consistent estimation performance than existing approaches.</P>

Intravenous Administration of Toll-Like Receptor Inhibitory Peptide 1 is Effective for the Treatment of Systemic Lupus Erythematosus in a Mus musculus Model

( Wook-young Baek ),( Sung-min Lee ),( Sang-won Lee ),( In-ok Son ),( Sangdun Choi ),( Chang-hee Suh ) 대한류마티스학회 2021 대한류마티스학회지 Vol.28 No.3

Objective. Systemic lupus erythematosus (SLE) is a common chronic autoimmune inflammatory disease. According to recent studies, signaling through Toll-like receptor (TLR) protein, which promotes the production of inflammatory cytokines, leads to the development of SLE. TLR-inhibitory peptide 1 (TIP1) has been newly identified for the treatment of autoimmune diseases. Methods. The effect of TIP1 was analyzed in an SLE mouse model (MRL/lpr). The mice in the control treatment group (n=5) were administered an intravenous injection of phosphate-buffered saline twice weekly, whereas the mice in the TIP1 treatment group (n=6) were administered an intravenous injection of TIP1 (1 nmol/g) twice weekly. MRL/mpj mice (n=5) were selected as normal controls. The mice were injected for 4 weeks between 14 and 18 weeks of age, followed by assays of their spleen, kidneys, lymph nodes, serum, and urine. Results. The antinuclear antibody and inflammatory cytokine (interferon-α) in the serum as well as levels of albumin in the urine of the mice in the TIP1 treatment group had decreased when compared to those of mice in the control treatment group. Kidney inflammation in mice in the TIP1 treatment group was alleviated. The mRNA expression levels of TLR7- or TLR9-related downstream signaling molecules also decreased in all organs of the mice in the TIP1 treatment group. Conclusion. Intravenous treatment with TIP1 reduces symptoms and markers of inflammation in MRL/lpr mice. Hence, TIP1 is a promising medication for the treatment of SLE. (J Rheum Dis 2021;28:133-142)

Articles : Gas Absorption of Carbon Dioxide in a Hollow Fiber Contained Liquid Membrane Absorber

( Sang Wook Park ),( Dong Soo Suh ),( Kyoung Son Hwang ),( Hidehiro Kumazawa ) 한국화학공학회 1997 Korean Journal of Chemical Engineering Vol.14 No.4

Experiments on the absorption of CO₂ into a hollow fiber contained liquid membrane absorber were performed. The feed gas was a mixture of CO₂ and N₂, absorbent liquid was 2-amino-2-methyl-l-propanol and the hollow fiber was a microporous hydrophobic polytetrafluoroethylene membrane. Outlet concentration of CO₂from the absorber decreased as absorbent concentration increased, gas flow rate increased and were held constant for speed of agitation, but had a maximum value in the range of inlet concentration of CO₂from 5 to 40 mole %. The reaction rate constant obtained for CO₂-amine system was 231 ℓ/㏖·s at 25℃ using a flat stirred vessel, and the membrane-side-mass-transfer coefficient was 1.217 x 10^(-5) ㏖/㎠·s·atm in CO₂/N₂-amine system. A diffusion model based on mass transfer with fast-reaction was proposed to predict the performance of the absorber.

Basic Science ; The Preconditioning with AICAR Protects Against Subsequent Renal Ischemia Reperfusion Injury

( Sang Ju Lee ),( Yoon Kyoung Chang ),( Ki Rayng Na ),( Kang Wook Lee ),( Kwang Sun Suh ),( Suk Young Kim ),( Yoon Sik Chang ),( Young Tai Shin ),( Byung Kee Bang ) 대한신장학회 2009 Kidney Research and Clinical Practice Vol.28 No.2

Purpose: Preconditioning due to activation of AMPK might reduce ischemia-reperfusion (I/R) injury in the kidney, based on the key role of AMPK in preserving ATP. To evaluate this possibility, the effect of preconditioning with 5-aminoimidazole-4-carboxamide ribonucleoside (AICAR), AMPK activator, before sustained ischemia was investigated. Methods: Adult male Sprague-Dawley rats weighing approximately 220-250 g were used. To induce renal ischemia, a laparotomy was performed under ketamine and xylazine hydrochloride, and the blood supply to both kidneys was interrupted by placement of vessel clamps at the level of the renal pedicles. Reflow was initiated by removing the clamps. The following experimental groups were defined 1. Acute renal ischemia 0 sec, 10 min, 15 min, 2. AICAR treatment, 3. Sham group (S), 4. Ischemia/Reperfusion group (I/R), 5. AICAR+I/R group (A+I/R), 6. AraA (Adenine-9-b-D-arabinofuranoside, an AMPK) inhibitor+AICAR+I/R group (AraA+A+I/R). Results: There was only faint AMPK phosphorylation in the sham group. After 10 minutes of ischemia, or AICAR preconditioning however, Thr172 phosphorylation of AMPK was increased (p<0.05). The serum levels of BUN and creatinine were significantly decreased in AICAR preconditioning group (A+I/R). (128.0±7.33 mg/dL, 4.18±0.27 mg/dL vs. 90.2±11.13 mg/dL, 2.58±0.7 mg/dL, p<0.05), but these effects were attenuated by AMPK inhibitor, AraA (AraA+A+I/R group). In quantitative analysis of tubular injury, tubular injury score in AICAR preconditioning group significantly decreased (p<0.05). Conclusion: The AMPK activator AICAR has a protective effect against renal I/R injury.

Expression of DOG1, PDGFRA, and p16 in Gastrointestinal Stromal Tumors

( Sung Hee Jung ),( Kwang Sun Suh ),( Dae Young Kang ),( Dong Wook Kang ),( Young Beum Kim ),( Eun Sun Kim ) 대한소화기기능성질환·운동학회 2011 Gut and Liver Vol.5 No.2

Background/Aims: The diagnosis of gastrointestinal stromal tumors (GIST) relies on the demonstration of KIT expression, but KIT expression is absent or reduced in approximately 15% of GIST. Methods: Eighty-one GISTs were diagnosed between January 1998 and December 2007 at the Department of Pathology at both Chungnam National University Hospital and Eulji University Hospital, Daejeon. Medical history, patient follow-up, and radiographic data were collected if available in the medical records. To determine diagnostic and prognostic markers for GISTs focused on PDGFRA mutation and clinicopathologic features, we analyzed 81 GIST cases for KIT, PDGFRA, DOG1, and p16 expression and for mutation of PDGFRA genes. Results: Among 81 GIST cases, 20 high risk cases (24.7%) were recurred or metastasized. Immunohistochemically, KIT was positive in 76 (93.8%), PDGFRA in 75 (92.7%), and DOG1 in 77 (95.1%). With a cutoff value of 50%, p16 expression was positive in 26 cases were positive (32.1%). A correlation between p16 expression or negative DOG1 expression and recurrence or metastasis was demonstrated (p<0.05). Four cases showed a missense mutation in exon 12 of PDGFRA gene, three of these were of epithelioid GISTs. Two cases showed a silent mutation in exon 18 of PDGFRA. Conclusions: These results indicate that the expression of DOG1 and PDGFRA is observed in a majority of GIST cases. Expression of p16 and negative DOG1 expression is predictive for development of recurrence and/ or metastasis. Even though mutation of the PDGFRA gene is frequently seen in epithelioid GISTs, a clinicopathologic correlation was not demonstrated. (Gut Liver 2011;5:171-180)

HBV : Application of Roadmap-concept on Chronic Hepatitis B Patient with Entecavir Therapy Previously Exposed to Lamivudine: A Long Term Follow-up Study

( Sang Jun Suh ),( Hyung Joon Yim ),( Yeon Seok Seo ),( Chang Wook Kim ),( Chang Don Lee ),( Sang Hoon Park ),( Myung Seok Lee ),( Choong Kee Park ),( Hee Bok Chae ),( Moon Young Kim ),( Soon Koo Baik 대한간학회 2013 춘·추계 학술대회 (KASL) Vol.2013 No.1

Background/Aim: Many patients with lamivudine-resistant (LAM-R) chronic hepatitis B (CHB) had been treated by switching to entecavir (ETV) 1.0mg. Although rate of resistance to ETV (ETV-R) is reported high, current medical insurance system doesn`t pay-back for change from ETV to other agent in patients whose resistance to ETV was not identified. This study was aimed to stratify ETV therapy in LAM-R patients. Methods: One hundred and ten CHB patients who occurred LMV-R and received ETV 1.0mg up to 5 years were evaluated prospectively. At 12 months of switching to ETV, we divided subjects into non-detection group (HBV DNA<20 IU/mL) and detection group (HBV DNA≥20 IU/mL), which was subdivided into low viral load group (20≤HBV DNA<2,000 IU/mL) and high viral load group (2,000 IU/mL≤ HBV DNA). Virologic response rate (VR; HBV DNA<20 IU/mL) and ETV-R were evaluated as end point. Results: One hundred and ten patents were enrolled. The mean age was 45±11years, the proportion of male and HBeAgpositive patient was 71% (80/110) and 77% (85/110), respectively. The mean serum HBV DNA levels were 6.89±1.03, 3.26±1.81, 3.06±1.82, 2.49±1.53, 2.43±1.35 and 1.73±0.87 log10IU/ ml at baseline, month 12, 24, 36, 48 and 60, respectively. The VR (95% vs. 29%, P<0.001) was higher and ETV-R (10% vs. 54%, P=0.001) was lower in non-detection group than in detection group. The VR (27% vs. 29%, P=0.853) and ETV-R (45% vs. 57%, P=0.367) was not significantly different between low viral load and high viral load group. Resistance to ETV occurred at 26±10.3 months (median 24 months, 12-48 months) in detection group. Conclusion: Resistance rates were high in patients with detectable HBV DNA at 12 months of ETV therapy. Therefore, switching to or adding a potent nucleotide analogue (e.g. tenofovir) is warranted in LAM-R CHB patients whose HBV DNA is detected after 12 months of ETV therapy.

Three Cases of Rare Anatomic Variations of the Long Head of Biceps Brachii

Sang-Ho Kwak,Seung-Jun Lee,Byung Wook Song,Min-Soo Lee,Kuen Tak Suh 대한견주관절의학회 2015 대한견주관절학회지 Vol.18 No.2

In general, the long head of the biceps brachii originates from the superior glenoid labrum and the supraglenoid tubercle, crosses the rotator cuff interval, and extends into the bicipital groove. However, rare anatomic variations of the origins of the long head have been reported in the past. In this report, we review the clinical history, radiologic findings, and arthroscopic identifications of 3 anatomic variants of the biceps tendon long head. As the detection of long head of biceps tendon pathology during preoperative radiologic assessment can be difficult without prior knowledge, surgeons should be aware of such possible anatomic variations.

Chemotherapy followed by allogeneic peripheral blood stem cell infusion for treatment of relapsed leukemia after bone marrow transplantation

Suh, Jung Gon,Min, Chang Ki,Park, Soo Jeong,Kim, Hee Je,Lee, Jong Wook,Min, Woo Sung,Kim, Chun Choo,Kim, Dong Jip 대한조혈모세포이식학회 1998 대한조혈모세포이식학회지 Vol.3 No.2

Relapsed leukemia after allogeneic bone marrow transplantation(BMT) is difficult to treat mainly due to poor performance status and associated infection. Second BMT is possible for only small proportion of patients and treatment related mortality is high. Also, relapse rate after second BMT is high which limits successful second BMT. Donor leukemia infusion(DLI) has been successful for relapsed leukemia following BMT but mortality has been high due to prolonged pancytopenia and GVHD. We gave Chemotherapy to reduce tumor burden followed by allogeneic peripheral blood stem cell(PBSC) infusion to shorten pancytopenia and to induce graft-versus-leukemia effect. Four AML and 4 CML patients(2 blast crisis and 2 granulocytic sarcoma relapse) were treated with 9 cycles of chemotherapy followed by allo-PBSC infusion. Two case of blast after BAT showed no response with 3 cycle and to out of 2 granulocytic sarcoma relapse, one patient is in CR after 3month and the other patient died during neutropenic period. Out of AML patients, 3 patients achieved CR. Two patients are in continuous CR after 3 and 7 months and one patients died with servere gut GVHD while in CR. One patient had partial response and alive. In terms of GVHD, Out of 4 AML patients, one patient died of severe gut GVHD and one patient developed grade 2 GVHD but responded well to steroid therapy. Out of 4 CML patients, only one patient developed severe hepatic GVHD which was cause of death. Neutropenic period was relatively short with median of 13days(range 11 to 16). Chemotherapy followed by allogeneic PBSC infusion was feasible and well tolerated and toxicity was minimal. Therefore, this could be one of the treatment options for relapsed leukemia following allogeneic BMT.

Basic : Lactococcus garvieae septicemia with Liver abscess in an immunocompetent patient (초)

( Sang Wook Lee ),( Hyung Joon Kim ),( Suh Yoon Yang ),( Hyun Woong Lee ),( Bong Ki Cha ),( Beom Jin Kim ),( Hyoung Chul Oh ),( Chang Hwan Choi ),( Jeong Wook Kim ),( Jae Hyuk Do ),( Jae Gyu Kim ),( S 대한간학회 2011 Clinical and Molecular Hepatology(대한간학회지) Vol.17 No.3(S)