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RISS 인기검색어
- 검색키워드
- 발행기관 : Chonnam National University Medical School (검색결과 34 건)
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Baek, Dong Won,Kang, Byung Woog,Hwang, Soyoon,Kim, Jong Gwang,Seo, An Na,Bae, Han Ik,Kwon, Oh Kyoung,Lee, Seung Soo,Chung, Ho Young,Yu, Wansik Chonnam National University Medical School 2017 CMJ Vol.53 No.2
<P>This study assessed the expression of the p53 protein, beta-catenin, and HER2 and their prognostic implications in patients with EBV-associated gastric cancer (EBVaGC). After reviewing 1318 consecutive cases of surgically resected or endoscopic submucosal dissected gastric cancers, 117 patients were identified as EBV-positive using EBV-encoded RNA in-situ hybridization. The immunohistochemistry results were interpreted as follows: strong p53 nuclear expression in at least 50% of tumor nuclei was interpreted as a positive result, strong beta-catenin expression in at least 10% of cytoplasmic nuclei was interpreted as a positive result, and moderate or strong complete or basolateral membrane staining in 10% of tumor cells was interpreted as a positive result for HER2. Immunohistochemical staining for p53 was performed on tumor tissue from 105 patients, among whom 25 (23.8%) tested positive. Meanwhile, beta-catenin expression was positive in 10 patients (17.5%) and HER2 expression was positive in 8 patients (6.8%). The positive expression of p53 was significantly associated with a high T stage (p=0.006). More patients with lymph node metastasis were p53-positive (p=0.013). In the univariate analysis, the p53-positive patients showed significantly decreased disease-free survival (DFS) when compared with the p53-negative patients (p=0.022), although the p53 status was only marginally associated with overall survival (OS) (p=0.080). However, p53 expression showed no prognostic significance on DFS in the multivariate analysis. Moreover, beta-catenin and HER2 showed no association with DFS and OS in the survival analysis. The current study found a significant correlation between p53 expression and tumor progression and lymph node metastases in patients with EBVaGC.</P>
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Park, Hyukjin,Hong, Young Joon,Lee, Seunghun,Oh, Tae Ryom,Choi, Jungho,Kim, Minah,Park, Keun Ho,Sim, Doo Sun,Ahn, Youngkeun,Jeong, Myung Ho,Cho, Jeong Gwan,Park, Jong Chun Chonnam National University Medical School 2015 CMJ Vol.51 No.1
<P>An anomalous aortic origin of a coronary artery is rare and surgical intervention is recommended when the patient is symptomatic. We performed coronary artery bypass graft surgery in a 21-year-old male patient with a right coronary artery anomalously originating from the left coronary sinus. The artery was significantly stenosed by external compression between the aorta and the pulmonary artery. However, the graft became occluded 1 year after the operation. In such cases, the dynamic nature of the stenosis can cause relatively intact antegrade competitive flow from the native coronary artery and lead to an occlusion of the grafted artery. Methods for evaluating flow rates or intraluminal pressures of native arteries could be helpful in decision-making in similar cases.</P>
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Han, Changsu,Wang, Sheng-Min,Lee, Soo-Jung,Jun, Tae-Youn,Pae, Chi-Un Chonnam National University Medical School 2015 CMJ Vol.51 No.2
<P>Major depressive disorder (MDD) is a recurrent, chronic, and devastating disorder leading to serious impairment in functional capacity as well as increasing public health care costs. In the previous decade, switching therapy and dose adjustment of ongoing antidepressants was the most frequently chosen subsequent treatment option for MDD. However, such recommendations were not based on firmly proven efficacy data from well-designed, placebo-controlled, randomized clinical trials (RCTs) but on practical grounds and clinical reasoning. Aripiprazole augmentation has been dramatically increasing in clinical practice owing to its unique action mechanisms as well as proven efficacy and safety from adequately powered and well-controlled RCTs. Despite the increased use of aripiprazole in depression, limited clinical information and knowledge interfere with proper and efficient use of aripiprazole augmentation for MDD. The objective of the present review was to enhance clinicians' current understanding of aripiprazole augmentation and how to optimize the use of this therapy in the treatment of MDD.</P>
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Kim, Ju Han,Jeong, Myung Ho,Ahn, Youngkeun,Kim, Young Jo,Chae, Sung Chull,Seong, In Whan,Kim, Chong Jin,Cho, Myeong Chan,Seung, Ki Bae,Park, Seung Jung Chonnam National University Medical School 2011 CMJ Vol.47 No.1
<P>The Thrombolysis in Myocardial Infarction (TIMI) risk score (TRS) has proven value in predicting prognosis in unstable angina/non ST-elevation myocardial infarction (NSTEMI) as well as in ST-elevation myocardial infarction. The TRS system has little implication, however, in the extent of myocardial damage in high-risk patients with NSTEMI. A total of 1621 patients (63.6±12.2 years; 1043 males) with NSTEMI were enrolled in the Korea Acute Myocardial Infarction Registry (KAMIR). We analyzed the risk for major adverse cardiac events (MACE) during a 6-month follow-up period. The TRS system showed good correlation with MACE for patients in the low and intermediate groups but had poor correlation when the high-risk group was included (p=0.128). The MACE rate was 3.8% for TRS 1, 9.4% for TRS 2, 10.7% for TRS 3, and 12.3% for TRS 4 (HR=1.29, p=0.026). Among the biomarkers and clinical risk factors, elevated N-terminal pro-brain natriuretic peptide (NT-proBNP) (HR=2.61, p=0.001) and Killip class above III showed good correlation with MACE (HR=0.302, p<0.001). Therefore, we revised an alternative clinical scoring system by including these two variables that reflect left ventricular dysfunction: age > 65 years, history of ischemic heart disease, Killip class above III, and elevated pro-BNP levels above the 75th percentile. This modified scoring system, when tested for validity, showed good predictive value for MACE (HR=1.64, p<0.001). Compared with the traditional TRS, the novel alternative scoring system based on age, history of ischemic heart disease, Killip class, and NT-proBNP showed a better predictive value for 6-month MACE in high-risk patients with NSTEMI.</P>
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Cho, Suck Ju,Sung, Sang Min,Park, Sung Wook,Kim, Hyung Hoi,Hwang, Seong Youn,Lee, Young Hwan,Cho, Jung Hong Chonnam National University Medical School 2012 CMJ Vol.48 No.3
<P>The Ministry of Health and Welfare of Korea recently designated cerebrovascularspecified centers (CSCs) to improve the regional stroke care system for acute ischemic stroke (AIS) patients. This study was performed to evaluate the changes in the flow of AIS patients between hospitals and to describe the role of the Emergency Medical Information Center (EMIC) after the designation of the CSCs. Data for coordination of interhospital transfers by the EMIC were reviewed for 6 months before and after designation of the CSCs. The data included the success or failure rate, the time used for coordination of interhospital transfer, and the changes in the interhospital transfer pattern between transfer-requesting and transfer-accepting hospitals. The total number of requests for interhospital transfer increased from 198 to 244 after designation of the CSCs. The median time used for coordination decreased from 8.0 minutes to 4.0 minutes (p<0.001). The success rate of coordination increased from 88.9% to 96.7% (p<0.001). The proportion of requests by CSCs decreased from 3.5% to 0.4% (p=0.017). However, the proportion of acceptance by non-CSC hospitals increased from 15.9% to 25.8% (p=0.015). With the designation of CSCs, the EMIC could coordinate interhospital transfers more quickly. However, AIS patients are more dispersed to CSC and non-CSC hospitals, which might be because the CSCs still do not have sufficient resources to cover the increasing volume of AIS patients and non-CSC hospitals have changed their policies. Further studies based on patients' outcome are needed to determine the adequate type of interhospital transfer for AIS patients.</P>
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Cho, Sook Hee,Jeong, Myung Ho,Sim, Doo Sun,Hong, Young Joon,Park, Hyung Wook,Kim, Ju Han,Ahn, Youngkeun,Cho, Jeong Gwan,Park, Jong Chun,Kang, Jung Chaee Chonnam National University Medical School 2011 CMJ Vol.47 No.1
<P>The purpose of the present study was to clarify the possible relationship between nitroglycerin (NTG)-induced headache and both vascular functional and organic atherosclerosis. The study included 96 patients with NTG-induced headache (group I: 54.7±9.5 years, 52 males) and 204 patients without headache (group II: 58.1±9.1 years, 127 males) who suffered from new-onset chest pain. Flow-mediated dilation and nitroglycerin-mediated dilation were significantly greater in group I than in group II (8.8±4.1% vs. 7.1±3.5%, p=0.001, and 23.1±7.3% vs. 17.1±11.8%, p<0.001, respectively). The carotid intima-media thickness was significantly smaller in group I than in group II (0.55±0.15 mm vs. 0.67±0.22 mm, p=0.001). Heart-carotid pulse wave velocity was significantly lower in group I than in group II (784.5±160.1 m/s vs. 979.1±215.6 m/s, p=0.003). In the multiple regression analysis, the absence of NTG-induced headache was a predictor of coronary artery disease (CAD) (odds ratio: 17.89, 95% confidence interval: 7.89-40.02, p<0.001). NTG-induced headache developed more frequently in patients with normal coronary arteries or minimal CAD than in patients with obstructive CAD. The presence of NTG-induced headache might be helpful and provide additional information in evaluating patients with chest pain syndrome.</P>
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A Case of Papillary Thyroid Cancer Recurring as an Esophageal Submucosal Tumor
Seoung, Hyeog Gyu,Kim, Ji Hye,Choi, Jeong Cheon,Kim, Sang Mi,Kim, Sang Soo,Kim, Bo Hyun,Kim, In Ju,Song, Geun Am,Kim, Gwang Ha Chonnam National University Medical School 2012 CMJ Vol.48 No.1
<P>A 75-year-old woman who underwent a total thyroidectomy for papillary thyroid cancer 7 years previously presented with a palpable neck mass. Computed tomography (CT) showed two metastatic masses on the thyroid bed and another mass that looked benign originating from the esophageal wall. Endoscopic ultrasonography (EUS) showed a hypoechoic mass in the esophageal wall that looked similar to a gastrointestinal stromal tumor. The mass on the esophagus had intense fluorodeoxyglucose (FDG) uptake in positron emission tomography-computed tomography (PET-CT), which suggested the possibility of malignancy. Subsequently, after surgery, the mass in the esophagus was confirmed as a metastasis from the thyroid papillary carcinoma. Here we report this unusual case of papillary thyroid cancer that recurred as an esophageal submucosal tumor.</P>
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Park, Sung Jun,Jeong, Ji Min,Jeong, Han-Seong,Park, Jong-Seong,Kim, Nam-Ho Chonnam National University Medical School 2011 CMJ Vol.47 No.2
<P>Epigallocatechin-3-gallate (EGCG) is the most potent antioxidant polyphenol in green tea. In the present study, we investigated whether EGCG plays a role in the expression of transforming growth factor-beta1 (TGF-β1), protein kinase C (PKC) α/βII, and nuclear factor-kappaB (NF-κB) in glomerular epithelial cells (GECs) against high-glucose injury. Treatment with high glucose (30 mM) increased reactive oxygen species (ROS)/lipid peroxidation (LPO) and decreased glutathione (GSH) in GECs. Pretreatment with 100 µM EGCG attenuated the increase in ROS/LPO and restored the levels of GSH, whereas ROS, LPO, and GSH levels were not affected by treatment with 30 mM mannitol as an osmotic control. Interestingly, high-glucose treatment affected 3 separate signal transduction pathways in GECs. It increased the expression of TGF-β1, PKC α/βII, and NF-κB in GECs, respectively. EGCG (1, 10, 100 µM) pretreatment significantly decreased the expression of TGF-β1 induced by high glucose in a dose-dependent manner. In addition, EGCG (100 µM) inhibited the phosphorylation of PKC α/βII caused by glucose at 30 mM. Moreover, EGCG (1, 10, 100 µM) pretreatment significantly decreased the transcriptional activity of NF-κB induced by high glucose in a dose-dependent manner. These data suggest that EGCG could be a useful factor in modulating the injury to GECs caused by high glucose.</P>
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Cerebellar Embolization in Patients with Heart Murmur
Lee, Min Goo,Park, Jong Chun,Ahn, Byoung Hee,Jeong, Myung Ho Chonnam National University Medical School 2011 CMJ Vol.47 No.1
<P>A 76-year-old female present to the emergency department with dysarthria, dizziness, dyspnea. The patient had hypertension and atrial fibrillation. Brain MRI revealed right cerebellar infarction. Transthoracic echocardiography showed a large round mass in the left atrium. Transesophageal echocardiography showed large complex echogenic round mass lesion attached on left atrial side of interatrial septum. Coronary angiogram revealed round movable mass lesion in left atrium with feeding arteries originated from right coronary artery. She underwent removal of mass and Maze operation, and pathologic finding was compatible with myxoma.</P>
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Addressing the Side Effects of Contemporary Antidepressant Drugs: A Comprehensive Review
Wang, Sheng-Min,Han, Changsu,Bahk, Won-Myoung,Lee, Soo-Jung,Patkar, Ashwin A.,Masand, Prakash S.,Pae, Chi-Un Chonnam National University Medical School 2018 CMJ Vol.54 No.2
<P>Randomized trials have shown that selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) have better safety profiles than classical tricyclic antidepressants (TCAs). However, an increasing number of studies, including meta-analyses, naturalistic studies, and longer-term studies suggested that SSRIs and SNRIs are no less safe than TCAs. We focused on comparing the common side effects of TCAs with those of newer generation antidepressants including SSRIs, SNRIs, mirtazapine, and bupropion. The main purpose was to investigate safety profile differences among drug classes rather than the individual antidepressants, so studies containing comparison data on drug groups were prioritized. In terms of safety after overdose, the common belief on newer generation antidepressants having fewer side effects than TCAs appears to be true. TCAs were also associated with higher drop-out rates, lower tolerability, and higher cardiac side-effects. However, evidence regarding side effects including dry mouth, gastrointestinal side effects, hepatotoxicity, seizure, and weight has been inconsistent, some studies demonstrated the superiority of SSRIs and SNRIs over TCAs, while others found the opposite. Some other side effects such as sexual dysfunction, bleeding, and hyponatremia were more prominent with either SSRIs or SNRIs.</P>
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