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Development of a Novel Endoscopic Scoring System to Predict Relapse after Surgery in Intestinal Behçet's Disease

  • Park, Jung Won;Park, Yehyun;Park, Soo Jung;Kim, Tae Il;Kim, Won Ho;Cheon, Jae Hee
    • Gut and Liver
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    • v.12 no.6
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    • pp.674-681
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    • 2018
  • Background/Aims: The cumulative surgery rate and postoperative relapse of intestinal Behçet's disease (BD) have been reported to be high. This study aimed to establish a scoring system based on follow-up endoscopic findings that can predict intestinal BD recurrence after surgery. Methods: Fifty-four patients with intestinal BD who underwent surgery due to bowel complications and underwent follow-up colonoscopy were retrospectively investigated. Their clinical data, including colonoscopic findings, were retrieved. Classification and regression tree analysis was used to develop an appropriate endoscopic classification model that can explain the postsurgical recurrence of intestinal BD most accurately based on the following classification: e0, no lesions; e1, solitary ulcer <20 mm in size; e2, solitary ulcer ${\geq}20mm$ in size; and e3, multiple ulcers regardless of size. Results: Clinical relapse occurred in 37 patients (68.5%). Among 38 patients with colonoscopic recurrence, only 29 patients had clinically relapsed. Multivariate analysis identified higher disease activity index for intestinal BD at colonoscopy (hazard ratio [HR], 1.013; 95% confidence interval [CI], 1.005 to 1.021; p=0.002) and colonoscopic recurrence (HR, 2.829; 95% CI, 1.223 to 6.545; p=0.015) as independent risk factors for clinical relapse of intestinal BD. Endoscopic findings were classified into four groups, and multivariate analysis showed that the endoscopic score was an independent risk factor of clinical relapse (p=0.012). The risk of clinical relapse was higher in the e3 group compared to the e0 group (HR, 6.284; 95% CI, 2.036 to 19.391; p=0.001). Conclusions: This new endoscopic scoring system could predict clinical relapse in patients after surgical resection of intestinal BD.

Virulence factors, antimicrobial resistance patterns, and genetic characteristics of hydrogen sulfide-producing Escherichia coli isolated from swine

  • Park, Hyun-Eui;Shin, Min-Kyoung;Park, Hong-Tae;Shin, Seung Won;Jung, Myunghwan;Im, Young Bin;Yoo, Han Sang
    • Korean Journal of Veterinary Research
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    • v.55 no.3
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    • pp.191-197
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    • 2015
  • Escherichia (E.) coli is commensal bacteria found in the intestine; however, some pathogenic strains cause diseases in animals and humans. Although E. coli does not typically produce hydrogen sulfide ($H_2S$), $H_2S$-producing strains of E. coli have been identified worldwide. The relationship between virulence and $H_2S$ production has not yet been determined. Therefore, characteristics of $H_2S$-producing isolates obtained from swine feces were evaluated including antibiotic resistance patterns, virulence gene expression, and genetic relatedness. Rates of antibiotic resistance of the $H_2S$-producing E. coli varied according to antibiotic. Only the EAST1 gene was detected as a virulence gene in five $H_2S$-producing E. coli strains. Genes conferring $H_2S$ production were not transmissible although the sseA gene encoding 3-mercaptopyruvate sulfurtransferase was detected in all $H_2S$-producing E. coli strains. Sequences of the sseA gene motif CGSVTA around Cys238 were also identical in all $H_2S$- producing E. coli strains. Diverse genetic relatedness among the isolates was observed by pulsed-field gel electrophoresis analysis. These results suggested that $H_2S$-producing E. coli strains were not derived from a specific clone and $H_2S$ production in E. coli is not associated with virulence genes.

Cumulative live birth rate after up to three consecutive embryo transfer cycles in women with poor ovarian response

  • Kim, Se Jeong;Lee, Dayong;Kim, Seul Ki;Jee, Byung Chul;Kim, Seok Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.47 no.2
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    • pp.135-139
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    • 2020
  • Objective: In the present study, we aimed to retrospectively evaluate the cumulative live birth rate (LBR) after up to three consecutive embryo transfer (ET) cycles, either fresh or frozen, in women with expected poor ovarian response (ePOR). Methods: We selected 115 women who entered the first in vitro fertilization (IVF) cycle between August 2013 and July 2016. The women were divided into an ePOR group (37 women) and a non-ePOR group (78 women). All women in the ePOR group were ≥ 40 years old or had serum anti-Müllerian hormone levels of less than 1.1 ng/mL at the time of the first IVF cycle. Live birth outcomes were monitored until December 2017. The cumulative LBR (with both conservative and optimistic estimates) was calculated according to the serial number of ET cycles. Results: After up to three ET cycles, the overall cumulative LBR was significantly lower in the ePOR group than in the non-ePOR group (conservative estimate, 10.8% vs. 44.9%, respectively; optimistic estimate, 14.7% vs. 56.1%, respectively; log-rank test, p= 0.003). Conclusion: Women with ePOR exhibited a lower cumulative LBR than women in the non-ePOR group, and this information should be provided to ePOR women during counseling before starting IVF.

The Serial Change Analysis of Heart Rate According to Expiration-to-inspiration Time Ratio in Adults (호흡패턴에 따른 성인의 심박수 동태 해석)

  • Park, Young-Bae;Han, Kyung-Sook;Nam, Tong-Hyun
    • Journal of Society of Preventive Korean Medicine
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    • v.14 no.2
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    • pp.105-120
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    • 2010
  • Objectives : This study aims to evaluate the effects of expiration-to-inspiration time ratio (E/I-ratio) on heart rate, which represents cardiac autonomic function, and cold-heat in the healthy people. Methods : 49 healthy young volunteers(male : female = 32 : 17) were recruited in the study. The participants completed the questionnaire for yin-yang pattern identification and then we measured the chest plethysmogram for respiration signal and the electrocardiogram for NN intervals during different E/I-ratio from 1 to 2. We compared heart rate variability including RMS-SD, VLF, LF and HF, and the trend-cycle factors decomposed from NN interval data by time series analysis among the respective E/I-ratio. We also confirmed the difference on the trend-cycle factors according to the score of the questionnaire for cold and heat pattern identification. Results : There were differences on the trend-cycle factors from NN interval data, but no significant difference on heart rate variability, among the respective E/I-ratio. We also found significant relationship between the trend-cycle factors and the heat pattern identification scores. Conclusions : The results indicate that cardiac autonomic function can be modulated by the E/I-ratio and the modulation will be slower and more tendencious than respiratory sinus arrhythmia.

The Effects of Gudambopae-Tang on Changes of Cytokines in Allergic Rhinitis Model (거담보폐탕(去痰補肺湯)이 알레르기성 비염 모델 생쥐의 cytokine변화에 미치는 영향)

  • Yang, Hee-Yeon;Kim, Yoon-Bum
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.18 no.2
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    • pp.28-35
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    • 2005
  • In order to investigate the effects of Gudambopae-Tang on allergic rhinitis, laboratory study about cytokines and OVA-specific IgE was perfomed in the present study. The results are summarized as follow; 1. IL4, IL-5 was increased in medicating group than control group. 2. $IFN-{\gamma}$ was increased in medicating group than control group. 3. total IgE and OVA-specific IgE was significant decreased in medicating group than control group, statistically significant. This study shows experimentally that Gudambopae-tang could reduce allergic reaction in allergic rhinitis. Advanced studies are required to investigate the mechanisms of herbal medicine in allergic rhinitis model.

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Austropeplea ollula (Pulmonata: Lymnaeidae): A new molluscan intermediate host of a human intestinal fluke, Echinostoma cinetorchis (Trematoda: Echinostomatidae) in Korea

  • Chung, Pyung-Rim;Jung, Young-Hun;Park, Yun-Kyu;Hwnag, Myung-Ki
    • Parasites, Hosts and Diseases
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    • v.39 no.3
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    • pp.247-253
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    • 2001
  • Three freshwater snail species of the family Lymnaeidae have been reported from Korea, Radix auricularia coreana, Austropeplea ollula and Fossaria truncatula. Out of 3 lymnaeid snail species, A. ollula was naturally infected with the Echinostoma cinetorchis cercariae (infection rate : 0.7%). In the experiments with the laboratory-bred snails, F. truncatula as well as A. ollula was also susceptible to the E. cinetorchis miracidia with infection rates of 25% and 40%, respectively. All of three lymnaeid snail species exposed to the E. cinetorchis cercariae were infected with the E. cinetorchis metacercariae. It is evident that A. ollula acts as the first molluscan intermediate host of E. cinetorchis in Korea, and F. truncatula may be a possible candidate for the first intermediate host of this intestinal fluke. Also, three lymnaeid snail species targeted were experimentally infected with E. cinetorchis metacercariae.

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Sternal defect reconstruction using a double-barrel vascularized free fibula flap: a case report

  • Gravina, Paula Rocha;Chang, Daniel K.;Mentz, James A.;Dibbs, Rami Paul;Maricevich, Marco
    • Archives of Plastic Surgery
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    • v.48 no.5
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    • pp.498-502
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    • 2021
  • Total and subtotal sternectomy oncological defects can result in large deficits in the chest wall, disrupting the biomechanics of respiration. Reviewing the current literature involving respiratory function and rib motion after sternectomy, autologous rigid reconstruction was determined to provide the optimal reconstructive option. We describe a novel technique for sternal defect reconstruction utilizing a double-barrel, longitudinally oriented, vascularized free fibula flap associated with rib titanium plates fixation. Our reconstructive approach was able to deliver a physiological reconstruction, providing rigid support and protection while allowing articulation with adjacent ribs and preservation of chest wall mechanics.

Clinical Significance of CLDN18.2 Expression in Metastatic Diffuse-Type Gastric Cancer

  • Kim, Seo Ree;Shin, Kabsoo;Park, Jae Myung;Lee, Han Hong;Song, Kyo Yong;Lee, Sung Hak;Kim, Bohyun;Kim, Sang-Yeob;Seo, Junyoung;Kim, Jeong-Oh;Roh, Sang-Young;Kim, In-Ho
    • Journal of Gastric Cancer
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    • v.20 no.4
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    • pp.408-420
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    • 2020
  • Purpose: Isoform 2 of tight junction protein claudin-18 (CLDN18.2) is a potential target for gastric cancer treatment. A treatment targeting CLDN18.2 has shown promising results in gastric cancer. We investigated the clinical significance of CLDN18.2 and other cell-adherens junction molecules (Rho GTPase-activating protein [RhoGAP] and E-cadherin) in metastatic diffuse-type gastric cancer (mDGC). Materials and Methods: We evaluated CLDN18.2, RhoGAP, and E-cadherin expression using two-plex immunofluorescence and quantitative data analysis of H-scores of 77 consecutive mDGC patients who received first-line platinum-based chemotherapy between March 2015 and February 2017. Results: CLDN18.2 and E-cadherin expression was significantly lower in patients with peritoneal metastasis (PM) than those without PM at the time of diagnosis (P=0.010 and 0.013, respectively), whereas it was significantly higher in patients who never developed PM from diagnosis to death than in those who did (P=0.001 and 0.003, respectively). Meanwhile, CLDN18.2 and E-cadherin expression levels were significantly higher in patients with bone metastasis than in those without bone metastasis (P=0.010 and 0.001, respectively). Moreover, we identified a positive correlation between the expression of CLDN18.2 and E-cadherin (P<0.001), RhoGAP and CLDN18.2 (P=0.004), and RhoGAP and E-cadherin (P=0.001). Conversely, CLDN18.2, RhoGAP, and E-cadherin expression was not associated with chemotherapy response and survival. Conclusions: CLDN18.2 expression was reduced in patients with PM but significantly intact in those with bone metastasis. Furthermore, CLDN18.2 expression was positively correlated with other adherens junction molecules, which is clinically associated with mDGC and PM pathogenesis.

Pulmonary Features of Hyperimmunoglobulin E (Job's) Syndrome (Hyperimmunoglobulin E (Job's) syndrome에서 발현되는 호흡기증상)

  • Min, Byoung-Ju;Shin, Jae-Seung;Lee, In-Sung;Shin, Young-Kyoo
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.6
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    • pp.651-656
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    • 2002
  • Hyperimmunoglobulin E syndrome, otherwise known as Job's syndrome, is an immune disorder characterized by an abnormal elevation of the circulating immunoglobulin E level, and recurrent infections of the skin and sinopulmonary tract. The syndrome has various pulmonary features, e.g., pneumonia, pneumatocele, pneumothorax, lung abscesses and empyema. We report a case of hyperimmunoglobulin E syndrome, with various respiratory clinical manifestation. Medical therapy, including prophylactic antibiotics, has been the cornerstone for the treatment of hyperimmunoglobulin E syndrome. Even if surgical intervention is required, minimal pulmonary parenchymal resection is recommended.