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S-299 Prognostic value of E/e`` in patients with severely decreased left ventricular funct ion
( Yoon Jung Park ),( Jong Sung Park ),( Bo Eun Park ),( Se Yong Jang ),( Myung Hwan Bae ),( Jang Hoon Lee ),( Dong Heon Yang ),( Hun Sik Park ),( Yongkeun Cho ),( Shung Chull Chae ) 대한내과학회 2016 대한내과학회 추계학술발표논문집 Vol.2016 No.1
Background: The ratio of early transmitral velocity to tissue Doppler early diastolic velocity (E/e’) is used for estimating pulmonary capillary wedge pressure. However, E/e' may have less sensitive prognostic value in decreased left ventricular (LV) function. We aimed to investigate difference in prognostic impact of E/e’ on long term prognosis between decreased and preserved LV function in patients with acute decompensated heart failure (ADHF). Methods: A total of 836 patients (66.2±14.7 years-old, 442 men) with heart failure between Jan. 2005 and June. 2015 were included. Composite of all-cause mortality and re-hospitalization was recorded during follow-up. Results: During follow-up (22.0 ±18.5 months), 343 (41.0%) events were recorded. In overall patients, E/e’ was an independent prognostic marker for adverse events (hazard ratio [HR] 1.01 [1.00-1.03], p=0.023) together with age, NYHA class, and serum creatinine. Kaplan-Meier analysis revealed that patients with high E/e’ (E/e’ > 15) exhibited significantly worse prognosis (49.7% vs. 25.7%, p<0.001) compared to those with low E/e’ (E/e’ ≤ 15) in patients with preserved LV function (LVEF >30%), whereas there is no significant difference in prognosis between high and low E/E’ group (45.0% vs. 36.4%, p=0.144) in patients with decreased LV function (LVEF ≤ 30%). In crude analysis model, E/e’ significantly predicted prognosis in patients with preserved LV function group (HR 1.05 [1.03-1.07], p<0.001), whereas E/e’ could not (HR 1.00 [0.99-1.02], p=0.611) (p for interaction <0.001). In adjusted model including age, sex, body mass index, heart rate, hypertension, diabetes, serum sodium, serum creatinine and inotropics use, E/e’ still significantly predicted prognosis in patients with preserved LV function (HR 1.04 [1.02-1.06], p<0.001) and it could not in patients with decreased ejection fraction (HR 0.996 [0.98-1.01], p=0.634). There was significant interaction in adjusted model (p for interaction =0.011). Conclusions: E/e’ significantly predicted long-term outcome in patients with heart failure of preserved LV function, whereas it could not in patients with decreased LV function in ADHF.
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( Yoon Ji Shin ),( Jee Youn Oh ),( Young Seok Lee ),( Kyung Hoon Min ),( Sung Yong Lee ),( Jae Jeong Shim ),( Kyung Ho Kang ),( Gyu Young Hur ) 대한내과학회 2016 대한내과학회 추계학술발표논문집 Vol.2016 No.1
Background:?Hypereosinophilia, defined as an absolute eosinophil count (AEC) of >1.5×103/L can be caused by numerous allergic, infectious, paraneoplastic and neoplastic disorders. In case of hypereosinophilia with lymphoid proliferation, pathologic confirmation is essential to exclude myeloid and lymphoid malignancy. Kimura's disease, common in Asians, is idiopathic, chronic inflammatory disease with painless subcutaneous mass and prominent peripheral eosinophilia. We report a case of anaplastic large cell lymphoma, with initial presentation of marked peripheral eosinophilia, misconcepted as Kimura's disease.?Case:?A 38-year-old woman presented with bilateral cervical lymphadenopathy. She underwent core biopsy and was diagnosed as Kimura's disease at local clinic. She was referred to our hospital for evaluation and management of peripheral eosinophilia. At admission, there was no palpable cervical lymph node. Blood test showed hypereosinophilia (8,450/μL) with high total IgE level (>5,000 kU/L). All laboratory tests for parasite infestation were negative. Bone marrow biopsy only revealed hypercellular marrow without evidence of a lymphoproliferative disorder, and negative for screening of JAK2V617F,BCR-ABL1, PDGFRA and PDGFRB rearrangement. She received treatment for Kimura’s disease with prednisone and immunosuppressants, however, her AEC was wax and wane (from 495 to 1,720/μL) during 5 months. A new left inguinal mass was developed, and we performed excisional lymph node biopsy. Histopathological examination showed infiltration of large atypical lymphoid cells with numerous eosinophils. They were CD3+,CD20-,CD30+ and ALK- by immunohistochemistry. ALK-negative anaplastic large cell lymphoma was diagnosed. Careful review of the initial cervical lymph node biopsy showed only lymphoid proliferation with heavy eosinophils in H/E stain. However, after immunohistochemical study, there were a few irregular cells with CD30+.?Conclusions:?Marked peripheral eosinophilia in anaplastic large cell lymphoma observed in our case has been rarely reported. This emphasizes that immunohistochemical study should be performed to exclude myeloid and lymphoid malignancy in diagnosis of Kimura's disease.
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S-667 Cytokine mRNA expression profiles in human keratinocytes infected with rhinovirus
( Sung-do Moon ),( Sung-yoon Kang ),( Soon-hee Kim ),( Sae-hoon Kim ),( Jin-ho Yu ),( Yoon-seok Chang ) 대한내과학회 2016 대한내과학회 추계학술발표논문집 Vol.2016 No.1
Introduction: Keratinocytes have an important role in the pathogenesis of atopic dermatitis (AD) through the production of numerous inflammatory signals and innate immune responses of the skin. We hypothesized that rhinovirus could induce pro-inflammatory cytokine, chemokine and cytokines which may drive Th2 immune response from human keratinocyte. We evaluated mRNA expression of cytokines from human keratinocytes infected by human rhinovirus (HRV) 16 and 1B. Materials and Methods: Established lines of human immortalized keratinocytes (HaCaT cell line) were infected with HRV 16 and 1B at a multiplicity of infection (MOI) equal to 1-2. mRNA expressions of IL-8, IL-25, IL-33 TSLP, RANTES, TNF-α, and IFN-β were analyzed using real time quantitative polymerase chain reaction (RT-qPCR) at 6, 16, and 24 hours after HRV 16 infection and 6, 16, 24 and 48 hours after HRV 1B infection. Results: mRNA expression of IL-8, IL-25, TSLP, and IFN-β by HRV 16 and 1B, IL-33 and TNF-α by HRV 16 were higher than those in non-infected control cells. mRNA expressions of RANTES by HRV 16 and 1B also showed increased trends. Meaningful mRNA expression patterns of IL-25, TSLP, RANTES, TNF-α and IFN-β occurred earlier in stimulated HRV 16 than in HRV 1B. Conclusions: This study suggests that rhinovirus may play a role in modulating the Th2 mediated inflammation in human keratinocytes. Keywords: keratinocyte, Rhinovirus, cytokine
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Sung-Woo Park,Jung Hee Kim,Hyun Jung Lee,Dong Hoon Shin,Sang Don Lee,Sik Yoon 대한남성과학회 2019 The World Journal of Men's Health Vol.37 No.1
Purpose: To evaluate changes in the expression of androgen receptor (AR) and its variants (ARVs) in human prostate cancer (PCa) tissues according to disease status, and its prognostic significance following radical prostatectomy (RP). Materials and Methods: A total of 282 PCa cases were evaluated, which included 252 localized PCa, 8 metastatic castra-tion resistant prostate cancer (CRPC), and 22 benign prostatic hyperplasia (BPH) cases. Samples were collected from patients who underwent RP or transurethral resection and were stored in ethically approved tissue banks. Quantitative real-time polymerase chain reaction, Western blotting, and immunohistochemistry were performed for AR and ARVs. Each tissue was confirmed as cancerous (greater than 80%) using hematoxylin and eosin staining. AR and ARVs expression was compared according to disease status. The biochemical recurrence free survival (BCRFS) rates in men with localized PCa was analyzed according to AR and ARV7 expression using the Kaplan-Meier curve. Results: Only 58 of the 252 localized PCa were included in the analysis because of insufficient cancer tissue. AR and ARV7 mRNA expression was higher in the CRPC tissue than in the localized PCa tissue (p=0.025, p=0.002, respectively). In local-ized PCa tissue, high AR mRNA and protein level was associated with a low BCRFS rate (log-ranked, p=0.019, p<0.001, re-spectively). Conclusions: Overall AR and ARV7 mRNA expression levels were increased in CRPC tissues compared to localized PCa and BPH tissues. High AR protein and mRNA expression in the tumor tissue may be considered a predictive factor of BCRFS fol-lowing RP.
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Sang Won Jeon,Changsu Han,Joonho Choi,Young-Hoon Ko,Ho-Kyoung Yoon,Yong-Ku Kim 대한정신약물학회 2017 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.15 No.4
Objective: The purpose of this study was to investigate the therapeutic effects of eye movement desensitization and reprocessing (EMDR) on post-traumatic growth (PTG). Methods: This study was conducted using a sample of ten survivors of a large-scale maritime disaster that occurred in the Yellow Sea, South Korea, in April 2014. A total of eight EMDR sessions were administered by a psychiatrist at two-week intervals over a period of five months, starting two or three months after the accident. Post-Traumatic Growth Inventory (PTGI), Stress-Related Growth Scale (SRGS), Clinician-Administered PTSD Scale (CAPS), and Connor-Davidson Resilience Scale (CD-RISC) were measured before treatment, after sessions 4 and 8, and at three months after treatment completion. Results: After three months from treatment completion, significant increases were observed in PTG (PTGI: Z(8)=–2.380, p =0.017; SRGS: Z(8)=–2.380, p =0.017) and resilience (CD-RISC: Z(8)=–2.386, p =0.017). A decrease in post-traumatic stress disorder (PTSD) level was also significant (CAPS: Z(8)=–2.176, p =0.030). The reduction of CAPS scores was correlated with increases of PTGI (rho=0.78, p =0.023) and SRGS (rho=0.79, p =0.020) scores. The changes in CAPS, PTGI, and SRGS scores between time point of end 8-session and three months follow-up was not significant (all p >0.05). Subjects with higher pre-treatment CD-RISC scores showed more significant improvements in PTGI (rho=0.88, p =0.004) and SRGS (rho=0.83, p =0.010) scores after treatment than did those with lower pre-treatment CD-RISC scores. Conclusion: EMDR therapy using standard protocol for trauma processing helped facilitating PTG in disaster survivors. To generalize these findings, further controlled studies comparing with other treatment modalities for PTSD are needed.
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Flavored candy drops can improve the patient’s compliance when taking PEG solution for colonoscopy
( Sang Hyun Kim ),( In Kyung Yoo ),( Hyuk Soon Choi ),( Eun Sun Kim ),( Bora Keum ),( Yoon Tae Jeen ),( Hoon Jai Chun ),( Hong Sik Lee ) 대한내과학회 2015 대한내과학회 추계학술발표논문집 Vol.2015 No.1
Background and Aims: Polyethylene glycol (PEG) based solution has been widely used for bowel cleansing before colonoscopy. The main disadvantages of this preparation were its large volume and poor palatability. Recently, PEG with ascorbic acid was developed for low-volume and better taste. However, this method still requires moderate amount of volume and has brought just a little taste improvement. We aimed to investigate whether adding various kinds of flavored candy drops can improve the pateints’ compliance and the quality of bowel cleansing when taking 4-L, split-dose, PEG with ascorbic acid solution for colonoscopy. Methods: Single center, randomized study was performed during May to November 2014. A total of 120 patients were prospectively enrolled. The patients were classified into 3 groups. (40 control group, 40 menthol candy group, and 40 cherry flavored candy group.) All patients received colonoscopy using split-dose PEG ascorbic acid preparation method. In the candy drops added group, patients were provided 10 candy drops and instructed to suck on a candy while drinking the split-dose PEG solution. To investigate the compliance and palatability, a questionnaire was performed before colonoscopy. Quality of preparation, remaining unconsumed volume, and side effects were also investigated. Results: The mean palatability score and patient compliance were significantly better in both candy drops users versus controls. Patients with cherry candies complained of fewer side effects such as nausea or abdominal fullness than the menthol group. Quality of colon preparation was also significantly better in the both flavored candy groups than the controls. Cherry candy group achieved the best preparation quality. Conclusions: Flavored candy drops can improve the taste and patient’s compliance when taking PEG solution, and are associated with better bowel cleansing. It seems taking flavored candy drops based on a patient’s preference when taking PEG solution is a safe and easy method to enhance the quality of bowel preparation.
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