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.

Development of a noninvasive KIM-1-based live-imaging technique in the context of a drug-induced kidney-injury mouse model

Tae-Jun Kwon,Da-Sol Lee,Md. Enamul Haque,Rang-Woon Park,Byungheon Lee,Dongkyu Kim,Yong-Hyun Jeon,Kil-Soo Kim,Sang Kyoon Kim 한국실험동물학회 2021 한국실험동물학회 학술발표대회 논문집 Vol.2021 No.7

The development of reliable methods to diagnose acute kidney injury is essential to allow the adoption of early therapeutic interventions and evaluate their effectiveness. Based on the fact that kidney injury molecule-1 (KIM-1) expression levels in kidneys are markedly upregulated early after a damage event, here we developed a noninvasive KIM- 1-based molecular imaging technique to detect kidney injury. First, we took advantage of a phage-display platform to select small peptides demonstrating a specific high binding affinity to KIM-1. The promising candidate was conjugated with fluorescent probes, and its imaging potential was validated in vitro and in vivo. This peptide, with the sequence CNRRRA, not only showed a high imaging potential in vitro, allowing a strong detection of KIM-1 expressing cells by microscopy and flow cytometry but also generated a strong kidney-specific signal in live-imaging in vivo experiments in the context of a drug-induced kidney-injury mouse model. Our data overall suggest that the CNRRRA peptide is a promising probe to use in the context of in vivo imaging for the detection of KIM-1 overexpression in damaged kidneys.

서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

太谿穴의 臨床 活用에 대한 文獻考察

구성태,송문영,강정묵,김용명,박보라,이은석,홍정아,김경식,손인철 한국전통의학연구소 2003 한국전통의학지 Vol.13 No.1

Literally, the mean of Tae-gye is highest brook. And on the basis of the acupuncture theory, Tae-gye point is the Soo earth point and source point of the Kidney Channel as well. In addition, Tae-gye point is one of the Yang-Returning Nine points. We were trying to study bibliographically on the Tae-gye point because Tae-gye point can be used very broadly across the symptoms in the theoretical aspect described above. As a results, we found out that according to the classical books of acupuncture, Tae-gye point is entering point of the Meridian Water as a source point and can be used at both Kidney-Sufficient Syndrom and Kidney-Deficient Syndrom. And Tae-gye can be applied to the disease of kidney or bladder that is urogenital symtoms, Also, Tae-gye is an useful option of tooth-ache, asthma, indigestion, constipation, edema etc whose cause is related with decrease of Kidney ki.

Surgical technique for single-port laparoscopy in huge ovarian tumors: SW Kim`s technique and comparison to laparotomy

( Jeong Sook Kim ),( In Ok Lee ),( Kyung Jin Eoh ),( Young Shin Chung ),( Inha Lee ),( Jung-yun Lee ),( Eun Ji Nam ),( Sunghoon Kim ),( Young Tae Kim ),( Sang Wun Kim ) 대한산부인과학회 2017 Obstetrics & Gynecology Science Vol.60 No.2

Objective This study aimed to introduce a method to remove huge ovarian tumors (≥15 cm) intact with single-port laparoscopic surgery (SPLS) using SW Kim`s technique and to compare the surgical outcomes with those of laparotomy. Methods Medical records were retrospectively reviewed for patients who underwent either SPLS (n=21) with SW Kim`s technique using a specially designed 30×30-cm2-sized 3XL LapBag or laparotomy (n=22) for a huge ovarian tumor from December 2008 to May 2016. Perioperative surgical outcomes were compared. Results In 19/21 (90.5%) patients, SPLS was successfully performed without any tumor spillage or conversion to multi-port laparoscopy or laparotomy. There was no significant difference in patient characteristics, including tumor diameter and total operation time, between both groups. The postoperative hospital stay was significantly shorter for the SPLS group than for the laparotomy group (median, 2 [1 to 5] vs. 4 [3 to 17] days; P<0.001). The number of postoperative general diet build-up days was also significantly shorter for the SPLS group (median, 1 [1 to 4] vs. 3 [2 to 16] days; P<0.001). Immediate post-operative pain score was lower in the SPLS group (median, 2.0 [0 to 8] vs. 4.0 [0 to 8]; P=0.045). Patient-controlled anesthesia was used less in the SPLS group (61.9% vs. 100%). Conclusion SPLS was successful in removing most large ovarian tumors without rupture and showed quicker recovery and less immediate post-operative pain in comparison to laparotomy. SPLS using SW Kim`s technique could be a feasible solution to removing huge ovarian tumors.

Disruption of rsmA Gene of Pectobacterium carotovorum subsp. carotovorum LY34 and Effect on Pathogenicity

Kim, Min Keun,Kang, Tae Ho,Kim, Sung Kyum,Jeong, Yu Seok,Yun, Han Dae,Kim, Hoon The Korean Society for Applied Biological Chemistr 2012 Applied Biological Chemistry (Appl Biol Chem) Vol.55 No.6

The rsmA gene was cloned from soft-rot bacterium Pectobacterium carotovorum subsp. carotovorum LY34 (Pcc LY34), and its role in pathogenicity was investigated by marker exchange mutagenesis. From a cosmid library of Pcc LY34 genomic DNA, a positive clone carrying the rsmA gene was selected, and the gene was cloned by polymerase chain reaction (PCR) amplification. The gene is 186 bp in size and encodes a protein of 62 amino acids with a predicted molecular mass of 6,839 Da. The calculated pI of the RsmA is 8.16. The phylogenetic tree showed that the RsmA of Pcc LY34 appeared genetically identical to the CsrA of Pectobacterium atrosepticum SCRI1043 (100% identity) and similar to the CsrA of Yersinia pestis KIM10+(98.3%). The gene was disrupted by the $Km^r$ gene, and the cells became mutated (i.e., $RsmA^-$ mutant). The pathogenicity test revealed that the disease rating of the $RsmA^-$ mutant only differed slightly from that of the wild type on a slice of potato tuber and a Chinese cabbage stalk. These results suggest that RsmA is not an essential factor for the pathogenicity of Pcc LY34 and that the rsmA gene of Pcc LY34 is not completely derepressed in the $RsmA^-$ mutant for virulence-related genes, contrary to the results of Erwinia carotovora subsp. carotovora $RsmA^-$ mutant, which proved hypervirulent for celery petioles. These results showed that the microenvironmental conditions of the host and/or strain of pathogen are important for the coordination of virulence gene expression.

2형 당뇨 환자에 있어서 C형 간염의 유병률에 관한 연구

김구영,서광섭,유광렬,임병욱,채선애,강남훈,김창훈,권영우,김희수,류성태,이정환,박성우,오웅식,김정한 중앙대학교 의과대학 의과학연구소 2003 中央醫大誌 Vol.28 No.1

Background: We have doubt about the truth that Type 2 DM is associated with chronic hepatitis C infection. The aim of our study was to prove a close relationship between chronic HCV infection and type 2 DM in korean patients. Methods: We reviewed the out-patient's medical records of 466 patients with type 2 DM who visit the Sung-ae hospital from March 2000 to August 2001. Diabetic patients were analyzed for the following variables: age, sex, waist circumference, weight, waist/hip ratio, using of self monitoring of blood glucose, method of therapy, duration of disease, experience of previous transfusion, major surgical procedure, accompanied disease, liver function tests (LFT), HbA1 c. We ruled out patients with liver cirrhosis. Results: Hepatitis C virus infection was observed more frequently in patient with Type 2 DM. Of 466 Type 2 DM patients, 13 patients were infected with Hepatitis C virus (2.79%). Compared with mean prevalence of Korean population (1.3~1.6%), it's value is very high. the other hand, 21 patients were infected with Hepatitis B virus (4.5%). Such results are similar to mean prevalence of the general public (4~5%). Conclusions: Prevalence of hepatitis C was closely associated in korean patients with type 2 DM. And an increased prevalence is independent of cirrhosis.

Effect of Developmental Lead Exposure on the Expression of Hippocampal NMDA Receptor Subunit mRNA

Kim, Tae-Wan,Chung, In-Sung,Bae, Jae-Hoon,Shin, Dong-Hoon,Lee, Mi-Young,Kim, Joon-Sik 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

목적: in vivo 및 vitro에서 해마 신경세포의 발생단계별 NMDA 수용체 아단위 mRNA 발현에 대한 연 폭로 영향을 알아보고자 하였다. 방법: 흰쥐 해마 신경세포의 발생단계별 NMDA 수용체 NR2A, NR2B 아단위 mRNA 발현에 대한 연의 영향은 정상군과 연 폭로군의 출생 후 7일, 14일, 22일 흰쥐의 해마에서 in situ hybridization으로 mRNA 발현 정도를 densitometer로 측정하여 비교하였고, 연과 NMDA 의 세포독성은 해마 신경세포 일차배양 후 도립현미경을 이용한 형태학적인 관찰과 LDH 활성도를 이용하여 측정하였다. 결과: 연 과 NMDA 에 의한 세포독성에 대한 in vitro 실험에서 형태학적 소견과 LDH 활성도에서 해마 미성숙 신경세포와 성숙 신경세포사이의 차이가 있었으므로, 연과 NMDA 독성효과는 해마 신경세포의 발달 단계에 따라 차이가 있다. 정상군의 해마에서의 NR2A mRNA 발현은 출생 후 연령이 증가함에 따라 점진적으로 증가하였으나, NR2B mRNA 발현은 출생 후 연령이 증가함에 따라 점진적으로 증가하였으나 NR2B mRNA 발현은 연령의 증가에 따른 변화가 없었다. 연 폭로에 희한 NR2A mRNA 발현은 유의하게 감소하였으나(p<0.05), NR2B mRNA 발현은 변화가 나타나지 않았다. 만성적 연 폭로는 NR2A를 포함하는 NMDA 수용체를 감소시킬 수 있음을 알 수 있다. 결론: 연은 해마신경세포의 발생단계에서 NMDA 수용체 아단위 특히 NR2A mRNA 발현의 변화를 야기하여 시냅스 신호 전달에 영향을 나타냄을 알 수 있었다. Hippocampus

부산지역 무균성 뇌막염 원인 바이러스의 분리 및 동정 : 1998년을 중심으로

김영희,정영기,김기순,지영미,윤재득,김병준,구평태,민상기,정구영,김만수,조경순 동의대학교 기초과학연구소 2000 基礎科學硏究論文集 Vol.10 No.1

The incidence of aseptic meningitis infection is ensuing and threatening the health of children. Enteroviruses are the major agents of aseptic meningitis and identification of virus has been a clue to diagnosis and epidemiology. The outbreak of aseptic meningitis occurred in Pusan, 1998. Patients were concentrated from April through November. Children were more susceptible than adults. Among 306 cases of specimens from stool, throat swab tested, only 7.2% were positive on virus isolation, 12 cases from stool and 10 from throat, respectively. All isolated 7 serotypes of viruses represented cytopathic effect on cultured cells. Three types of echovirus 6, 25, 30 and coxsackievirus B2, B3, B4, B6 were identified by neutralizing anti body test. Isolated coxsackievirus and echovirus were observed by an electron microscope with negative staining.

위절제술 환자의 표준진료지침 개발 및 적용 효과

김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2

Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.