The efficacy of selective nerve root block for the long-term outcome of postherpetic neuralgia

Doo, A Ram,Choi, Jin-Wook,Lee, Ju-Hyung,Kim, Ye Sull,Ki, Min-Jong,Han, Young Jin,Son, Ji-Seon The Korean Pain Society 2019 The Korean Journal of Pain Vol.32 No.3

Background: Several nerve blocks can reduce the incidence of postherpetic neuralgia (PHN) as well as relieve acute zoster-related pain, but the long-term outcome of PHN has not been clearly determined. This study investigated the efficacy of selective nerve root block (SNRB) for herpes zoster (HZ) on the long-term outcome of PHN. Methods: We prospectively conducted an interview of patients who had undergone an SNRB for HZ from January 2006 to December 2016 to evaluate their long-term PHN status. The relationship between the time from HZ onset to the first SNRB and the long-term outcome of PHN was investigated. Results: The data of 67 patients were collected. The patients were allocated to acute ($SNRB{\leq}14days$, n = 16) or subacute (SNRB > 14 days, n = 51) groups. The proportions of cured patients were 62.5% and 25.5% in the acute and subacute groups (P = 0.007), respectively. In logistic regression, an SNRB >14 days was the significant predictor of PHN (adjusted odd ratio, 3.89; 95% confidence interval, 1.02-14.93; P = 0.047). Kaplan-Meier analysis revealed that time from the SNRB to the cure of PHN was significantly shorter in the acute group ($2.4{\pm}0.7yr$) than in the subacute group ($5.0{\pm}0.4yr$; P = 0.003). Conclusions: An early SNRB during the acute stage of HZ (within 14 days) appears to decrease the incidence and shorten the duration of PHN, with a median of 5.0 years of follow-up.

A Comparison of Two Techniques for Ultrasound-guided Caudal Injection: The Influence of the Depth of the Inserted Needle on Caudal Block

( A Ram Doo ),( Jin Wan Kim ),( Ji Hye Lee ),( Young Jin Han ),( Ji Seon Son ) 대한통증학회 2015 The Korean Journal of Pain Vol.28 No.2

Background: Caudal epidural injections have been commonly performed in patients with low back pain and radiculopathy. Although caudal injection has generally been accepted as a safe procedure, serious complications such as inadvertent intravascular injection and dural puncture can occur. The present prospective study was designed to investigate the influence of the depth of the inserted needle on the success rate of caudal epidural blocks. Methods: A total of 49 adults scheduled to receive caudal epidural injections were randomly divided into 2 groups: Group 1 to receive the caudal injection through a conventional method, i.e., caudal injection after advancement of the needle 1 cm into the sacral canal (n = 25), and Group 2 to receive the injection through a new method, i.e., injection right after penetrating the sacrococcygeal ligament (n = 24). Ultrasound was used to identify the sacral hiatus and to achieve accurate needle placement according to the allocated groups. Contrast dyed fluoroscopy was obtained to evaluate the epidural spread of injected materials and to monitor the possible complications. Results: The success rates of the caudal injections were 68.0% in Group 1 and 95.8% in Group 2 (P = 0.023). The incidences of intravascular injections were 24.0% in Group 1 and 0% in Group 2 (P = 0.022). No intrathecal injection was found in either of the two groups. Conclusions: The new caudal epidural injection technique tested in this study is a reliable alternative, with a higher success rate and lower risk of accidental intravascular injection than the conventional technique. (Korean J Pain 2015; 28: 122-128)

Bilateral vocal cord paralysis detected incidentally during direct laryngoscopy on general anesthesia

A Ram Doo,이상귀,Woo Joo Jeong 대한마취통증의학회 2013 Korean Journal of Anesthesiology Vol.65 No.6

The efficacy of selective nerve root block for the long-term outcome of postherpetic neuralgia

A Ram Doo,Jin-Wook Choi,Ju-Hyung Lee,Ye Sull Kim,Min-Jong Ki,Young Jin Han,Ji-Seon Son 대한통증학회 2019 The Korean Journal of Pain Vol.32 No.3

Background: Several nerve blocks can reduce the incidence of postherpetic neuralgia (PHN) as well as relieve acute zoster-related pain, but the long-term outcome of PHN has not been clearly determined. This study investigated the efficacy of selective nerve root block (SNRB) for herpes zoster (HZ) on the long-term outcome of PHN.Methods: We prospectively conducted an interview of patients who had undergone an SNRB for HZ from January 2006 to December 2016 to evaluate their long-term PHN status. The relationship between the time from HZ onset to the first SNRB and the long-term outcome of PHN was investigated.Results: The data of 67 patients were collected. The patients were allocated to acute (SNRB ≤ 14 days, n = 16) or subacute (SNRB > 14 days, n = 51) groups. The proportions of cured patients were 62.5% and 25.5% in the acute and subacute groups (P = 0.007), respectively. In logistic regression, an SNRB >14 days was the significant predictor of PHN (adjusted odd ratio, 3.89; 95% confidence interval, 1.02-14.93; P = 0.047). Kaplan–Meier analysis revealed that time from the SNRB to the cure of PHN was significantly shorter in the acute group (2.4 ± 0.7 yr) than in the subacute group (5.0 ± 0.4 yr; P = 0.003).Conclusions: An early SNRB during the acute stage of HZ (within 14 days) appears to decrease the incidence and shorten the duration of PHN, with a median of 5.0 years of follow-up.

급성 신부전 환자에서 지속적 신대체요법을 이용한 마취관리 -증례 보고-

두아람 ( A Ram Doo ),장은주 ( Eun Joo Jang ),김덕규 ( Deok Kyu Kim ) 전북대학교 의과학연구소 2014 全北醫大論文集 Vol.38 No.2

The treatments for acute renal failure include recovery of renal perfusion, correction of reversible cause, normalization of plasma electrolytes and renal replacement therapy. Continuous renal replacement therapy (CRRT) is preferred to intermittent hemodialysis due to its superior hemodynamic stability with resultant effective elimination of water and toxins in critical care fields. We report a case of successful anesthetic management using CRRT in patient receiving emergent small bowel resection with acute renal failure complicated by sepsis.

미추 경막외 주사에 의해 발생한 척수 경막하 혈종으로 오인된 자발성 두개내압 저하증 -증례 보고-

두아람 ( A Ram Doo ),김봉곤 ( Bong Gon Kim ),김동찬 ( Dong Chan Kim ) 전북대학교 의과학연구소 2015 全北醫大論文集 Vol.39 No.1

자발성 두개내압 저하증은 뇌척수막의 구조적 위약으로 인한 뇌척수액의 누출로 인하여 발생한다. 자발성 두개내압 저하증의 진단에 있어서 뇌 자기공명영상 소견이 필수적이라고 할 수 있지만, 척추 내 수액 고임, 경막의 조영 증강, 경막외 혈관 확장 등의 특징적인 척추의 영상학적 소견이 관찰될 수도 있다. 저자는 최근의 급성 뇌경색으로 3일간의 항응고요법 후 항혈소판제제를 복용중이었던 환자에서 요통으로 미추 주사를 시행한 후 발생한 경막하 혈종으로 오인된 자발성 두개내압 저하증의 증례를 소개하고자 한다. Spontaneous intracranial hypotension(SIH) is manifested by spinal cerebrospinal fluid leakage due to the structural weakness of the spinal meninges. Although brain MRI is essential to the diagnosis of SIH, characteristic imaging findings of the spine such as spinal fluid collection, dural enhancement, and epidural venous enlargement may be detected. We report a rare case of spontaneous intracranial hypotension misunderstood as spinal hematoma complicated by prior caudal block during antiplatelet medication followed by anticoagulation for 3 days for acute cerebral infarction.

Direct Detection of Drug-Resistant Hepatitis B Virus in Serum Using a Dendron-Modified Microarray

( Doo Hyun Kim ),( Hong Seok Kang ),( Seong-suk Hur ),( Seobo Sim ),( Sung Hyun Ahn ),( Yong Kwang Park ),( Eun-sook Park ),( Ah Ram Lee ),( Soree Park ),( So Young Kwon ),( Jeong-hoon Lee ),( Kyun-hw 대한간학회 2018 Gut and Liver Vol.12 No.3

Background/Aims: Direct sequencing is the gold standard for the detection of drug-resistance mutations in hepatitis B virus (HBV); however, this procedure is time-consuming, labor-intensive, and difficult to adapt to high-throughput screening. In this study, we aimed to develop a dendron-modified DNA microarray for the detection of genotypic resistance mutations and evaluate its efficiency. Methods: The specificity, sensitivity, and selectivity of dendron-modified slides for the detection of representative drug-resistance mutations were evaluated and compared to those of conventional slides. The diagnostic accuracy was validated using sera obtained from 13 patients who developed viral breakthrough during lamivudine, adefovir, or entecavir therapy and compared with the accuracy of restriction fragment mass polymorphism and direct sequencing data. Results: The dendron-modified slides significantly outperformed the conventional microarray slides and were able to detect HBV DNA at a very low level (1 copy/μL). Notably, HBV mutants could be detected in the chronic hepatitis B patient sera without virus purification. The validation of our data revealed that this technique is fully compatible with sequencing data of drug-resistant HBV. Conclusions: We developed a novel diagnostic technique for the simultaneous detection of several drug-resistance mutations using a dendron-modified DNA microarray. This technique can be directly applied to sera from chronic hepatitis B patients who show resistance to several nucleos(t)ide analogues. (Gut Liver 2018;12:331-341)

Factors associated with prediction of residual lesion in conization

( Bo Ram Choi ),( Doo Byung Chay ),( Han Byoul Cho ),( Hyun Sun Lim ),( Young Tae Kim ),( Jae Hoon Kim ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.98 No.-

We investigated factors affecting margin involvement, follow-up cytology and high risk human papillomavirus (HPV) testing within 6 months after conization, following surgical treatment after conization as predictors of incomplete excision in conization. One thousand four hundred forty six patients who underwent conization due to diagnose and treat cervical intraepithelial neoplasia (CIN) in Gangnam Serverance and Severance Hospital from January 2008 to December 2011 were included in this retrospective study. We analyzed their clinical and pathologic characteristics. Aging (odd ratio [OR], 1.039; 95% confidence interval [CI], 1.022-1.056), high grade group of preconization cytology(OR, 1.800; 95% CI, 1.333-2.431), preconization high risk HPV testing positivity (OR, 5.215; 95% CI, 1.824-5.215) were statistically significant factors that affect conization margin positivity. The width of specimen in conization was predictive factor for follow-up cytology within 6 months after conization (OR, 0.579; 95% CI, 0.370-0.906). Low grade group of preconization cytology (OR, 0.619; 95% CI, 0.426-0.900), preconizaton HPV testing positivity (OR, 4.726; 95% CI, 2.172-10.28) were significantly different in follow-up high risk HPV testing within 6 months after conization. Aging (OR, 1.066; 95% CI, 1.044-1.090), high grade group of preconization cytology (OR, 2.293; 95% CI, 1.575-3.338), preconization high risk HPV testing (OR, 4.560; 95% CI, 2.158-9.639), local anesthesia (OR, 1.885; 95% CI, 1.136-3.128) were relative to the following surgical treatment after conization. It is important to predict residual lesion after conization that affected by age, parity, preconization cytology and high risk HPV testing, anesthesia. These findings could be used to determine appropriate follow-up protocols.

RAW264.7 대식세포에서 MAPK 및 NF-κB 신호전달 경로 억제를 통한 황기 및 지치 복합물의 항염증 효과

최두진 ( Doo Jin Choi ),김금숙 ( Geum Soog Kim ),최보람 ( Bo-ram Choi ),이영섭 ( Young-seob Lee ),한경숙 ( Kyung Sook Han ),이동성 ( Dong-sung Lee ),이대영 ( Dae Young Lee ) 한국응용생명화학회(구 한국농화학회) 2020 Journal of Applied Biological Chemistry (J. Appl. Vol.63 No.4

본 연구는 황기와 지치 복합물인 ALM16이 lipopolysaccharide 처리에 의해 자극된 RAW264.7 대식세포의 염증반응에 미치는 영향에 대하여 조사하였다. ALM16은 RAW264.7 대식세포에 대하여 최대 200 μg/mL의 농도까지 독성은 보이지 않았다. 항염증 활성을 검정하기 위해 nitric oxide (NO), prostaglandin E₂ (PGE₂) 및 pro-inflammatory cytokines 생성량을 측정한 결과, ALM16은 각각의 생성량을 농도의존적으로 감소시켰다. 또한 ALM16은 NO와 PGE₂ 생성에 관여하는 inducible nitric oxide synthase (iNOS)와 cyclooxygenase-2 (COX-2)의 단백질 발현을 억제하였다. 한편, 항염증 활성 조절 기전을 확인하기 위하여 NK-kB의 핵으로의 이동과 DNA-binding activity 및 MAPK 신호전달 경로에 대한 ALM16의 영향을 확인한 결과, ALM16은 NF-κB의 핵으로 이동과 DNA-binding activity를 유의적으로 억제하였으며, JNK와 ERK 특이적으로 인산화를 억제함으로써 MAPK 신호전달 경로 활성을 억제하였다. 이러한 결과를 종합하여 볼 때 ALM16이 MAPK와 NF-κB의 신호전달 경로 억제를 통한 iNOS와 COX-2의 발현을 조절하고, 이로 인하여 NO, PGE₂ 및 pro-inflammatory cytokines의 생성이 감소하여 염증 반응을 조절하는 능력이 있는 것으로 판단된다. This study investigated a mixture of Astragalus membranaceus (AM) and Lithospermum erythrorhizon (LE) extracts (ALM16), exerts anti-inflammatory effects in lipopolysaccharide (LPS)-induced RAW264.7 macrophage cells, and its underlying mechanism. ALM16 was prepared by mixing AM and LE extracts in a ratio of 7:3 (w/w). Cytotoxicity of ALM16 in RAW264.7 cells was not shown up to 200 μg/mL of ALM16. The results of this study showed that ALM16 does-dependently inhibits the production of nitric oxide, prostaglandin E2 and pro-inflammatory cytokines (interleukin-1β, interleukin-6, and tumor necrosis factor- α) in LPS-induced RAW264.7 cells. ALM16 not only markedly reduced the protein expression levels of inducible nitric oxide synthase and cyclooxygenase-2 (COX-2) in LPS-stimulated RAW264.7 cells, but also inhibited the nuclear translocation and DNA-binding activity of nuclear factor-kappa B (NF-κB). In addition, ALM16 specifically inhibited the phosphorylation of c- Jun N-terminal kinase and extracellular signal-regulated kinases in LPS-stimulated RAW264.7 cells. In conclusion, these results suggest that ALM16 may exert anti-inflammatory effect by modulating mitogen-activated protein kinase and NF-κB signaling pathways.

Analytical Method Validation for the Marker Compounds of Saposhnikoviae Radix and Peucedani Japonici Radix

Bo Ram Choi(최보람),Dae Young Lee(이대영),Da Hye Yoon(윤다혜),Young Seob Lee(이영섭),Doo Jin Choi(최두진),Geum Soog Kim(김금숙),Kyung Sook Han(한경숙) 한국약용작물학회 2020 한국약용작물학회 학술대회논문집 Vol.2020 No.1