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Lee Y, Song JW, Chae EJ, Lee HJ, Lee CW, Do KH, Seo JB, Kim MY, Lee JS, Song KS, Shim TS. CT findings of pulmonary non-tuberculous mycobacterial infection in non-AIDS immunocompromised patients: a case-controlled comparison with immunocompetent patients. Br J Radiol 2013; 86:20120209. [PMID: 23440166 DOI: 10.1259/bjr.20120209] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To describe CT findings of non-tuberculous mycobacteria (NTM) pulmonary infection in non-AIDS immunocompromised patients (ICPs) and to compare these findings with those in immunocompetent patients. METHODS From July 2000 to August 2007, 369 patients (mean age 58.3 years; 169 males and 200 females) with pulmonary NTM infection were retrospectively reviewed. Of these 369 patients, 24 ICPs (mean age 64.8 years; 15 males and 9 females) were identified. 16 patients had diabetes mellitus, and 6 patients had received long-term steroid therapy. One had received solid organ transplantation and one had received high-dose chemotherapy for haematological disease. 24 age- and sex-matched immunocompetent patients (mean age 64.6 years; 15 males and 9 females) were selected as the control group from the same registry. CT images were reviewed in consensus by three chest radiologists, who were blinded to immune status. Each lung lobe was evaluated in terms of extent of the lesion, bronchiectasis, parenchymal opacity and the presence of ancillary findings. results: A total of 287 lobes were evaluated in ICPs and the control group. The ICPs showed a higher prevalence of ill-defined nodules, with cavities and large opacity >2 cm with/without cavity (p=0.03, 0.04 and 0.02, respectively). Regardless of the immune status, the most common CT findings were bronchiectasis and ill-defined nodules without cavity. CONCLUSION The most common CT findings of pulmonary NTM infection in ICPs were bronchiectasis and ill-defined nodules, similar to those in the control group. Ill-defined nodules with cavity and large opacity >2 cm with/without cavity were more frequently found in ICPs. ADVANCES IN KNOWLEDGE In patients affected by NTM infection, large opacities and cavitation in pulmonary nodules are more frequent in ICPs than in immunocompetent patients.
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Kim MY, Chaudhary P, Shulman IA, Pullarkat V. Major non-ABO incompatibility caused by anti-Jk(a) in a patient before allogeneic hematopoietic stem cell transplantation. Immunohematology 2013; 29:11-14. [PMID: 24046917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
A 49-year-old white man with blood group AB, D+ was found to have alloanti-Jk(a) and -K when he developed a delayed hemolytic transfusion reaction before allogeneic hematopoietic stem cell transplant (HSCT). Given that his stem cell donor was blood group O, D+, Jk(a+), K-, rituximab was added to his conditioning regimen of fludarabine and melphalan to prevent hemolysis of engrafting Jk(a+) donor red blood cells. The patient proceeded to receive a peripheral blood stem cell transplant from a matched unrelated donor with no adverse events. To our knowledge, this is the first case of successful management of major non-ABO incompatibility caused by anti-Jk(a) in a patient receiving an allogeneic HSCT reported in the literature.
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Kim MY, Lim JH, Youn HH, Hong YA, Yang KS, Park HS, Chung S, Ko SH, Shin SJ, Choi BS, Kim HW, Kim YS, Lee JH, Chang YS, Park CW. Resveratrol prevents renal lipotoxicity and inhibits mesangial cell glucotoxicity in a manner dependent on the AMPK-SIRT1-PGC1α axis in db/db mice. Diabetologia 2013; 56:204-17. [PMID: 23090186 DOI: 10.1007/s00125-012-2747-2] [Citation(s) in RCA: 232] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Accepted: 09/03/2012] [Indexed: 12/14/2022]
Abstract
AIMS/HYPOTHESIS Many of the effects of resveratrol are consistent with the activation of AMP-activated protein kinase (AMPK), silent information regulator T1 (SIRT1) and peroxisome proliferator-activated receptor (PPAR)γ co-activator 1α (PGC-1α), which play key roles in the regulation of lipid and glucose homeostasis, and in the control of oxidative stress. We investigated whether resveratrol has protective effects on the kidney in type 2 diabetes. METHODS Four groups of male C57BLKS/J db/m and db/db mice were used in this study. Resveratrol was administered via gavage to diabetic and non-diabetic mice, starting at 8 weeks of age, for 12 weeks. RESULTS The db/db mice treated with resveratrol had decreased albuminuria. Resveratrol ameliorated glomerular matrix expansion and inflammation. Resveratrol also lowered the NEFA and triacylglycerol content of the kidney, and this action was related to increases in the phosphorylation of AMPK and the activation of SIRT1-PGC-1α signalling and of the key downstream effectors, the PPARα-oestrogen-related receptor (ERR)-1α-sterol regulatory element-binding protein 1 (SREBP1). Furthermore, resveratrol decreased the activity of phosphatidylinositol-3 kinase (PI3K)-Akt phosphorylation and class O forkhead box (FOXO)3a phosphorylation, which resulted in a decrease in B cell leukaemia/lymphoma 2 (BCL-2)-associated X protein (BAX) and increases in BCL-2, superoxide dismutase (SOD)1 and SOD2 production. Consequently, resveratrol reversed the increase in renal apoptotic cells and oxidative stress, as reflected by renal 8-hydroxy-deoxyguanosine (8-OH-dG), urinary 8-OH-dG and isoprostane concentrations. Resveratrol prevented high-glucose-induced oxidative stress and apoptosis in cultured mesangial cells through the phosphorylation of AMPK and activation of SIRT1-PGC-1α signalling and the downstream effectors, PPARα-ERR-1α-SREBP1. CONCLUSIONS/INTERPRETATION The results suggest that resveratrol prevents diabetic nephropathy in db/db mice by the phosphorylation of AMPK and activation of SIRT1-PGC-1α signalling, which appear to prevent lipotoxicity-related apoptosis and oxidative stress in the kidney.
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Ahn JY, Jung HY, Choi JY, Kim MY, Lee JH, Choi KS, Kim DH, Choi KD, Song HJ, Lee GH, Kim JH, Park YS. Natural course of noncurative endoscopic resection of differentiated early gastric cancer. Endoscopy 2012. [PMID: 23188661 DOI: 10.1055/s-0032-1325676] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND STUDY AIMS Following noncurative endoscopic resection of early gastric cancer (EGC), the patient should be observed when the underlying disease is severe, the patient is elderly, or the patient refuses further treatment. The aim of this study was to analyze the clinical outcomes of patients with differentiated EGC who underwent noncurative endoscopic resection without additional treatment. PATIENTS AND METHODS Included patients underwent noncurative endoscopic resection for differentiated EGC without additional treatment at the Asan Medical Center between July 1994 and January 2009. Clinical and oncological outcomes were analyzed. RESULTS A total of 159 patients were included in the analysis. The median follow-up period was 33 months (interquartile range [IQR] 22 - 52 months). In total, 40 patients died (25.2 %) - 3 due to stomach cancer, 34 due to other causes, and 3 from unknown causes; the median survival time after endoscopic treatment for these patients was 27.5 months (IQR 13.8 - 48.3 months). Multivariate analysis showed that the rates of underlying disease (P < 0.001) and lymphovascular invasion (P = 0.005) were higher among the 40 patients who died than among the 119 survivors. The overall 3- and 5-year survival rates were 82.9 % and 77.1 %, respectively; the rates of the patients with lymphovascular invasion were 61.9 % and 42.4 %, respectively, and the rates of patients without lymphovascular invasion were 86.1 % and 81.8 %, respectively (P < 0.001). CONCLUSIONS Additional treatment provides fewer benefits to patients who do not have long life expectancies. Additional surgery can be considered for patients with lymphovascular invasion because of its high mortality rate; however, the benefits and risks of surgery should be considered carefully.
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Kim BS, Kim MY, Leem YH. Hippocampal neuronal death induced by kainic acid and restraint stress is suppressed by exercise. Neuroscience 2011; 194:291-301. [PMID: 21722713 DOI: 10.1016/j.neuroscience.2011.06.029] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 06/08/2011] [Accepted: 06/09/2011] [Indexed: 11/26/2022]
Abstract
The present study investigated whether chronic exercise suppressed hippocampal neuronal death due to repeated stress followed by i.c.v. kainic acid (KA) injection, and whether cAMP response element-binding protein (CREB), mitogen-activated protein kinase (MAPKs), and calcium/calmodulin-dependent protein kinase II (CaMKII) activation contributed to the neuroprotective effect in this experimental paradigm. To achieve the objective, mice were subjected to treadmill running for 8 weeks (19 m/min, 1 h/d, 5 d/wk) followed by seven consecutive days of repeated restraint stress (2 h/d), and then i.c.v. injection of KA (0.05 μg/5 μL). Hippocampal neuronal death was assessed using Nissl staining, and protein levels were measured using Western blot and immunohistochemical analysis. Hippocampal neuronal loss in mice subjected to restraint stress and KA injection was exacerbated compared with KA injection alone, which was reversed in the hippocampal CA3 region with prior chronic exercise. To further identify the neuroprotective effects of chronic exercise administration on hippocampal insults by repeated stress, levels of stress-related factors were measured. First, there was no significant difference in serum corticosterone and glucocorticoid (Gc) receptor levels in mice with restraint alone and restraint combined with prior chronic exercise. Second, malondialdehyde (MDA) and nitrite levels were significantly enhanced in restrained mice and were revered in restraint with chronic exercise. However, pCREB levels in the hippocampus in restraint mice with chronic exercise were profoundly increased compared with levels in restraint-alone mice. Among the MAPKs, pERK1/2 levels in restraint mice with chronic exercise were significantly higher than levels in mice with restraint alone. Furthermore, pCaMKII levels in restraint mice with chronic exercise were markedly elevated compared with levels in mice after restraint alone. Prior chronic exercise suppressed KA-induced hippocampal neuronal death in hippocampal CA3 region in restrained mice via declined ROS levels, which was lower MDA and nitrite levels, and activation of CREB, which was mediated by ERK1/2 and CaMKII, suggesting that chronic exercise exerts a protective effect on excitatory neurodegenerative disorders including epileptic seizure.
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Ahn JY, Choi KD, Choi JY, Kim MY, Lee JH, Choi KS, Kim DH, Song HJ, Lee GH, Jung HY, Kim JH. Transnasal endoscope-assisted endoscopic submucosal dissection for gastric adenoma and early gastric cancer in the pyloric area: a case series. Endoscopy 2011; 43:233-5. [PMID: 21165828 DOI: 10.1055/s-0030-1256037] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Endoscopic submucosal dissection (ESD) is an important therapeutic option for gastric adenoma and early gastric cancer (EGC). However, ESD is technically difficult when lesions are located in the pyloric area. Our aim was to introduce the transnasal endoscope-assisted ESD method, which provides for excellent cutting-line visualization through control of submucosal traction. A total of eight patients with gastric adenoma or EGC located in the pyloric area were consecutively enrolled. A primary operating endoscope was used to perform marking, incision, submucosal dissection, and hemostasis, while a thinner, transnasal endoscope operated by a second endoscopist was used to retract connective submucosal tissue to provide cutting-line visualization using V-shaped grasping forceps. En bloc resection was achieved in all eight cases, as was complete resection. The median longest lesion diameter was 19 mm (range: 12-25 mm), and the median procedure time was 37.5 minutes (range: 29-59 minutes). There were no incidents of significant bleeding or perforation. Transnasal endoscope-assisted ESD was useful for treating gastric neoplasms in the pyloric area. The procedure was relatively easy and safe, provided excellent visualization through tissue retraction, and allowed for complete en bloc resection.
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Lee HJ, Han JY, Yook JH, Choi JS, Ahn HK, Kim MY, Song IO, Yang JH, Nava-Ocampo AA. A prospective cohort study of pregnancy outcomes of women inadvertently exposed to methylephedrine in the 1st trimester of pregnancy. J OBSTET GYNAECOL 2011; 30:563-6. [PMID: 20701502 DOI: 10.3109/01443615.2010.487577] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
No information is currently available on the safety of methylephedrine, a component of various cold medications available in South Korea. With previous approval by an Institutional Review Board, 349 women inadvertently exposed to methylephedrine during the 1st trimester of pregnancy and an age- and gravidity-matched control group, were enrolled in a prospective cohort study. Study outcomes, for example gestational age at birth, birth weight and major and minor malformations were evaluated in 282 cases and 280 controls. Exposure to methylephedrine was at a gestational age of 4.0 weeks (median), at doses ranging from 52.5 to 1,575 mg/day, for a median duration of 3 (range: 1-30) days. No differences were observed between cases and controls in any of the pregnancy outcomes studied. There were 4/265 (1.5%) babies born with major malformations in the case group and 4/260 (1.5%) in the control group. In conclusion, inadvertent exposure to methylephedrine as a component of over-the counter oral cold remedies in early pregnancy was not associated with an increased rate of adverse pregnancy outcomes. Co-exposure with acetaminophen, cigarette smoking or alcohol did not appear to modify the outcomes.
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Park SH, Kim EJ, Oh SA, Kim CK, Choi SS, Cho SJ, Han KY, Lee JI, Kim MY, Jung HS, Chun DS, Kim HS. Viral agents associated with acute gastroenteritis in Seoul, Korea. Clin Lab 2011; 57:59-65. [PMID: 21391466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND The present study was carried out to describe the epidemiologic characteristics of viral gastroenteritis and determine the phylogenetic composition of norovirus strains detected in hospitalized children with acute gastroenteritis in Seoul, Korea. METHODS AND RESULTS In total, 10,603 stool samples were collected from 2004 to 2008 and tested by RT-PCR or ELISA. In 4,170 (39.3%) samples at least one viral pathogen was present. Rotavirus (RoV) (1,864, 17.5%) was found to be the causative agent followed by norovirus (NoV) (1,845, 17.4%), human adenovirus (HAdV) (266, 2.5%), human astrovirus (HAstV) (194, 1.8%), and sapovirus (SV) (1, 0.009%). Five GI genotypes (GI-1, GI-3, GI-4, GI-8, and GI-9) and eight GII genotypes (GII-2, GII-3, GII-4, GII-6, GII-7, GII-12, GII-16, and GII-17) of NoV were identified in acute gastroenteritis patients in 2008. CONCLUSIONS The genetic characteristics of norovirus and the epidemiologic patterns of a viral pathogen from acute gastroenteritis patients may give potentially effective data for epidemiological studies in Seoul, Korea.
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Lee CS, Song JW, Chae EJ, Lee CW, Do KH, Seo JB, Kim MY, Lee JS, Song KS. Radiological findings and clinical features of thoracic immunoglobulin G4-positive plasma cell granuloma: two cases. Br J Radiol 2010; 83:e150-3. [PMID: 20603401 DOI: 10.1259/bjr/77516426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Plasma cell granulomas, inflammatory pseudotumours and myofibroblastomas are synonymous with characteristic plasma cell infiltration in various body organs including the pancreas, liver, retroperitoneum and mediastinal structures causing idiopathic fibrosclerosis. Recently, a new concept has arisen regarding the relationship between immunoglobulin (Ig)G4-positive cell infiltration and idiopathic systemic fibrosclerosis. We report two cases showing IgG4-positive cell infiltration in the lung presenting as lung nodules with or without extrapulmonary manifestations.
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Kim SU, Seo YS, Cheong JY, Kim MY, Kim JK, Um SH, Cho SW, Paik SK, Lee KS, Han KH, Ahn SH. Factors that affect the diagnostic accuracy of liver fibrosis measurement by Fibroscan in patients with chronic hepatitis B. Aliment Pharmacol Ther 2010; 32:498-505. [PMID: 20491742 DOI: 10.1111/j.1365-2036.2010.04353.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Interquartile range/median value (IQR/M) of liver stiffness measurement (LSM) is a factor in chronic hepatitis C (CHC) leading to over estimation of fibrosis by Fibroscan. AIM To investigate factors that affect the accuracy of LSM in chronic hepatitis B (CHB). METHODS One hundred and ninety-nine patients were enrolled. Only procedures yielding > or =10 valid measurements were considered reliable. Liver fibrosis was evaluated using the Batts and Ludwig system. Liver biopsy (LB) specimens <15 mm were considered ineligible. RESULTS The mean age (142 men and 57 women) was 40.1 years. A significant discordance (discordance of at least two stages between LB and LSM) was identified in 38 (19.1%) and 47 (23.6%) patients respectively, according to Marcellin et al. and Chan et al.'s cutoff values. In multivariate analyses, BMI and fibrosis stage (F0-2 vs. F3-4) were identified as independent predictors for significant discordance (P = 0.040; hazard ratio [HR], 1.126; 95% confidence interval [CI], 1.005-1.261 and P = 0.036; HR, 0.450; 95% CI, 0.213-0.949 respectively) with Marcellin et al.'s cutoffs, whereas fibrosis stage was the only independent predictor (P = 0.004; HR, 0.300; 95% CI, 0.131-0.685) with Chan's cutoffs. CONCLUSIONS Success rate and IQR/M were not predictive factors of the accuracy for diagnosing liver fibrosis by Fibroscan in CHB. Fibrosis stage (F0-2) was the only factor to predict significant discordance between LB and LSM.
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Kim MY, Kaduwal S, Yang DH, Choi KY. Bone morphogenetic protein 4 stimulates attachment of neurospheres and astrogenesis of neural stem cells in neurospheres via phosphatidylinositol 3 kinase-mediated upregulation of N-cadherin. Neuroscience 2010; 170:8-15. [PMID: 20638445 DOI: 10.1016/j.neuroscience.2010.07.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2010] [Revised: 07/01/2010] [Accepted: 07/09/2010] [Indexed: 11/15/2022]
Abstract
The neurosphere culture system is useful for expanding neural stem cells (NSCs) without affecting self-renewal potential and multipotency. However, the extrinsic signals that affect the formation or dissociation of neurospheres are poorly understood. Here, we found that bone morphogenetic protein 4 (BMP4) induced the attachment of neurospheres, astrocytic differentiation, and migration of neurosphere NSCs. These outcomes were accompanied by Akt activation and upregulation of the adhesion molecule, N-cadherin. A phosphatidylinositol 3 kinase (PI3 kinase) inhibitor (LY294002) blocked attachment of neurosphere, astrocytic differentiation, migration, and N-cadherin upregulation of neurosphre NSCs. The PI3 kinase-Akt pathway appeared to selectively mediate the effects of BMP4, as neurosphere attachment was unaffected by MEK inhibitors (PD98059 and U0126). Importantly, a neutralizing N-cadherin antibody inhibited BMP4-induced neurosphere attachment, astrocytic differentiation, and migration of neurosphere NSCs. Together, these findings show that BMP4-induced attachment of neurospheres is related to the astrocytic differentiation of these cells and that these effects are attributable, at least in part, to PI3 kinase-Akt pathway-dependent induction of N-cadherin.
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Kim MY, Ann EJ, Mo JS, Dajas-Bailador F, Seo MS, Hong JA, Jung J, Choi YH, Yoon JH, Kim SM, Choi EJ, Hoe HS, Whitmarsh AJ, Park HS. JIP1 binding to RBP-Jk mediates cross-talk between the Notch1 and JIP1-JNK signaling pathway. Cell Death Differ 2010; 17:1728-38. [PMID: 20508646 DOI: 10.1038/cdd.2010.50] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Notch1 signaling has a critical function in maintaining a balance among cell proliferation, differentiation, and apoptosis. Our earlier work showed that the Notch1 intracellular domain interferes with the scaffolding function of c-Jun N-terminal kinase (JNK)-interacting protein-1 (JIP1), yet the effect of JIP1 for Notch1-recombining binding protein suppressor of hairless (RBP-Jk) signaling remains unknown. Here, we show that JIP1 suppresses Notch1 activity. JIP1 was found to physically associate with either intracellular domain of Notch1 or RBP-Jk and interfere with the interaction between them. Furthermore, we ascertained that JIP1 caused the cytoplasmic retention of RBP-Jk through an interaction between the C-terminal region of JIP1 including Src homology 3 domain and the proline-rich domain of RBP-Jk. We also found that RBP-Jk inhibits JIP1-mediated activation of the JNK1 signaling cascade and cell death. Our results suggest that direct protein-protein interactions coordinate cross-talk between the Notch1-RBP-Jk and JIP1-JNK pathways.
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Moon MH, Cho JY, Kim JH, Min JY, Yang JH, Kim MY. In-utero development of the fetal anal sphincter. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2010; 35:556-559. [PMID: 20183865 DOI: 10.1002/uog.7598] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To investigate the in-utero development of the fetal anal sphincter using transabdominal ultrasound. METHODS This was a cross-sectional study in which the diameter of the fetal anal sphincter was measured sonographically once in 631 well-dated, non-anomalous fetuses scanned between 19 and 38 weeks of gestation. Visualization rates were determined. Regression analysis was used to assess the relationship between the diameter of the fetal anal sphincter and gestational age (GA), and reference values including the mean and 95% reference interval were calculated for each GA. RESULTS The sonographic visualization rate of the fetal anal sphincter increased with gestational age, plateauing at 90-100% between 23-34 weeks of gestation. There was a significant positive relationship between fetal anal sphincter diameter and GA, which was best described by the equation: anal sphincter diameter (mm) = - 0.014 x GA(2) + 1.107 x GA - 11.664 (R(2) = 0.62). CONCLUSION We have provided reference values for the in-utero development of the fetal anal sphincter throughout gestation.
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Park W, Kim NK, Kim MY, Rhee YM, Kim HJ. Osteonecrosis of the jaw induced by oral administration of bisphosphonates in Asian population: five cases. Osteoporos Int 2010; 21:527-33. [PMID: 19484166 DOI: 10.1007/s00198-009-0973-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2009] [Revised: 04/10/2009] [Accepted: 04/15/2009] [Indexed: 10/20/2022]
Abstract
SUMMARY Bisphosphonate-related osteonecrosis of the jaw (BRONJ) can occur irrespective of race. Old age and long-term use of corticosteroid may be a more reliable risk factor than racial characteristics. INTRODUCTION BRONJ is an increasingly common problem. Most BRONJ occurs following an intravenous administration of bisphosphonate treatment for malignant bone disease and metastatic cancer. As the incidence of BRONJ caused by oral administration of bisphosphonate is quite low, it is believed that this medication is relatively safe and effective in preventing complications of osteoporosis, such as hip or spine fractures. The many known risk factors for BRONJ can be classified as drug-related, local, demographic, and systemic. One demographic and systemic risk factor is race. Most of the case reports of BRONJ present elderly, white women. METHODS In this report, we describe five cases of BRONJ caused by oral administration of bisphosphonate in Asian population. RESULTS All the patients were female and over 65 years old. Three patients had been prescribed with corticosteroids for rheumatoid arthritis. CONCLUSION Irrespective of race, elderly women undergoing steroid therapy have an increased incidence of BRONJ even with oral administration of bisphosphonate.
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Jeong WK, Kim KW, Kim MY, Shin YM, Kim PN, Kim Y, Song GW, Ha TY, Hwang S, Lee SG. Increase of modified retrograde to antegrade flow ratio on doppler ultrasounds of the hepatic vein indicating tricuspid regurgitation during follow-up of liver transplantation: correlation with echocardiographic results. Transplant Proc 2009; 41:4238-42. [PMID: 20005376 DOI: 10.1016/j.transproceed.2009.07.110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2008] [Accepted: 07/28/2009] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to explore the best parameter of hepatic vein (HV) Doppler ultrasounds (DUS) that correlated with echocardiographic findings of and particularly the optimal cutoff value for tricuspid regurgitation (TR) following liver transplantation (LT). Thirty-six patients underwent echocardiography and DUS after LT from January 2006 to July 2007. Echocardiographic records were searched for TR grade and peak velocity of TR flow. The HV DUS parameters included peak velocity of retrograde flow (R), peak velocity of antegrade flow (A), the difference between R and A (R-A), the ratio of R to A (R/A ratio), and a modified R/A ratio, namely, the product of the R/A ratio and the R/A duration ratio. Correlation tests and receiver-operator characteristic analyses explored their interrelations and to obtained cutoff values to diagnose moderate and severe TR. TR grade best correlated with the modified R/A ratio (rho = 0.585), followed by the R/A ratio (rho = 0.503) and R (rho = 0.455). The modified R/A ratio was the most accurate parameter for the diagnosis of moderate and severe TR (Az = 0.825 and 0.895, respectively); its cutoff value was > or =0.11 for moderate TR (sensitivity and specificity both 77.78%) and 0.13 for severe TR (sensitivity, 100%; specificity, 81.2%). The modified R/A ratio best correlated with echocardiographic results of TR, although the strength of correlation was only moderate. Additionally, the modified R/A ratio was an accurate DUS parameter to diagnose moderate and severe TR among patients following LT.
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Han JY, Yang JH, Chung JH, Choi JS, Ahn HK, Ryu HM, Kim MY, Cho SI, Nava-Ocampo AA. Teratogen risk counselling by internet: A prospective cohort study. J OBSTET GYNAECOL 2009; 25:427-31. [PMID: 16183573 DOI: 10.1080/01443610500160584] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Although the internet may play a role in providing proper teratogen-risk counselling for pregnant women, the experience with this type of service has not been reported. We aimed to compare the pregnancy outcome of women counselled by the internet to women that received typically in-clinic teratogen risk counselling in the clinic. In a prospective cohort design, 1,011 patients were counselled in the clinic and 235 patients were counselled via the internet. Teratogen risk counselling was provided according with the information obtained from medical literature and specialised software. Information about pregnancy outcome (delivery, spontaneous abortion, or termination of pregnancy and major malformations) was obtained from 903 (89.3%) patients from the clinic group and 141 (60%) from the internet group. The amount of alcohol, cigarettes smoked, and millirads of X-ray were greater ( p < 0.05) in patients counselled by internet than in clinic. The rate of deliveries, ongoing pregnancies, pregnancy terminations, and spontaneous abortions were similar between clinic and internet (chi2 = 1.32; p = 0.7). Of 498 babies born to mothers counselled in the clinic, major malformations were identified in 3.6%. Of 67 babies born to mothers counselled by internet, major malformations were present in 1.5% ( p = 0.6). Teratogen-risk counselling by internet and clinic seems to have a similar efficacy in pregnancy outcome.
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Cho YJ, Han JY, Choi JS, Ahn HK, Ryu HM, Kim MY, Yang JH, Nava-Ocampo AA, Koren G. Prenatal multivitamins containing folic acid do not decrease prevalence of depression among pregnant women. J OBSTET GYNAECOL 2009; 28:482-4. [PMID: 18850419 DOI: 10.1080/01443610802196658] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Several studies have reported an association between depression and folic acid deficiency. We investigated whether intake of prenatal multivitamins containing folic acid (MVandFA) was associated with decreased rates of depression among pregnant women. A questionnaire was given to 1,314 low-risk pregnant women. Of them, 1,277 (97.2%) women completed the questionnaire. The overall prevalence of depression was 8.1%. Of 652 participants who did not take MVandFA, 9.4% had depression, whereas 6.9% of 624 women who had MVandFA had depression (p = 0.11). In a multivariate logistic regression analysis, family history of depression (adjusted OR 3.7; 95% CI 1.9-7.3) and premenstrual syndrome (adjusted OR 3.0, 95% CI 1.8-4.8) were identified as risk factors for depression during pregnancy. In conclusion, intake of MVandFA was not associated with lower rates of depression during pregnancy whereas family history of depression and personal history of premenstrual syndrome were significant risk factors.
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Kim MY, Kim KS, McConnell F, Lane P. Lymphoid tissue inducer cells: architects of CD4 immune responses in mice and men. Clin Exp Immunol 2009; 157:20-6. [PMID: 19659766 DOI: 10.1111/j.1365-2249.2009.03932.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
In this review, we summarize the current understanding of the multiple functions of the mouse lymphoid tissue inducer (LTi) cells in: (i) the development of organized lymphoid tissue, (ii) the generation and maintenance of CD4-dependent immunity in adult lymphoid tissues; and (iii) the regulation of central tolerance in thymus. By contrast with mouse LTi cells, which have been well described, the human equivalent is only just beginning to be characterized. Human LTi-like cells expressing interleukin (IL)-22 have been identified recently and found to differentiate into natural killer (NK) cells. The relationship of LTi cells to NK cells is discussed in the light of several studies reporting a close relationship in the mouse between LTi cells and transcription factor retinoid-related orphan receptor gammat-dependent IL-22 producing NK cells in the gut. We also outline our data suggesting that these cells are present in adult human lymphoid tissues.
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Kim MY, Rha SE, Oh SN, Lee YJ, Byun JY, Jung CK, Kang WK. Case report. Lipomatous haemangiopericytoma (fat-forming solitary fibrous tumour) involving the perineum: CT and MRI findings and pathological correlation. Br J Radiol 2009; 82:e23-6. [PMID: 19168684 DOI: 10.1259/bjr/26727658] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Lipomatous haemangiopericytoma (a fat-forming solitary fibrous tumour) is a rare soft-tissue tumour histologically characterized by haemangiopericytomatous vasculature and the presence of mature adipocytes. We report the CT and MRI findings of a case of lipomatous haemangiopericytoma involving the perineum. CT showed a well-circumscribed soft-tissue density mass containing a small area of fat density and a punctuate calcification. On MR images, the mass was mostly isointense to the muscle on T(1) weighted images, with heterogeneous signal intensity on T(2) weighted images, and showed strong contrast enhancement except for the fatty and dense collagenous components. This is the first case report of imaging findings of a lipomatous haemangiopericytoma in the radiological literature. Although rare, lipomatous haemangiopericytoma should be considered as a differential diagnosis of fat-containing, hypervascular soft-tissue tumours with variable signal intensity on T(2) weighted images.
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Kim MY, Rha SE, Oh SN, Lee YJ, Jung ES, Byun JY. Case report: Ovarian cavernous haemangioma presenting as a heavily calcified adnexal mass. Br J Radiol 2008; 81:e269-71. [PMID: 18941040 DOI: 10.1259/bjr/21920101] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Haemangioma is an extremely rare tumour of the ovary. We describe the CT and MRI findings of a heavily calcified ovarian haemangioma in a 69-year-old woman presenting with adnexal torsion. CT showed a well-circumscribed mass with extensive punctate calcifications, located posterior to the uterus. MR images showed dark signal intensities of the mass on both T(1) and T(2) weighted images, with poor enhancement of the mass on contrast-enhanced T(1) weighted images. MR images also demonstrated a beak-like protrusion from the adnexal mass, representing the adnexal torsion. This is the first case report of a heavily calcified ovarian haemangioma in the English literature. Although rare, ovarian haemangioma should be included in the differential diagnosis of a heavily calcified adnexal mass.
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Ahn HK, Choi JS, Han JY, Kim MH, Chung JH, Ryu HM, Kim MY, Yang JH, Koong MK, Nava-Ocampo AA, Koren G. Pregnancy outcome after exposure to oral contraceptives during the periconceptional period. Hum Exp Toxicol 2008; 27:307-13. [PMID: 18684801 DOI: 10.1177/0960327108092290] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To evaluate whether periconceptional exposure to oral contraceptives (OCs) increased adverse pregnancy outcomes, 136 pregnant women taking OCs within the periconceptional period were identified at the Korean Motherisk Program. Of them, 120 pregnant women accepted to participate in their study and were followed up until completion of the pregnancy. A control group of 240 age- and gravidity-matched pregnant women exposed to non-teratogen drugs for at least 1 month before pregnancy was also included. The median gestational age at delivery was 39.1 (27.0-41.0) weeks in the exposed group and 39.3 (27.4-42.0) weeks in the control group (P = 0.19). In the exposed group, 7.1% of babies were born with low birth weight versus 2.6% in the control group (P = 0.068). The number of preterm deliveries or babies born large for gestational age did not differ between the two groups. In the exposed group, the rate of birth defects was 3.2% (n = 3/99) versus 3.6% (n = 7/193) in the control group (P = 1.0). There were 15 women who took high doses of progesterone (emergency contraception) and no adverse fetal outcomes were observed. In conclusion, periconceptional exposure to OCs does not appear to increase the risk for adverse pregnancy outcomes.
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Lee SW, Kim MY, Yang JH, Moon MH, Cho JY. Sonographic findings of uterine sacculation during pregnancy. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2008; 32:595-597. [PMID: 18726934 DOI: 10.1002/uog.6118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Kim SY, Lim JH, Yang JH, Kim MY, Kim MH, Park SY, Ryu HM. The 769G>A variant of the inhibin-alpha gene in Korean patients with preeclampsia. J Endocrinol Invest 2008; 31:700-3. [PMID: 18852530 DOI: 10.1007/bf03346418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Increased inhibin A serum and plasma levels in the second trimester are significantly associated with the development of preeclampsia. The measurement of inhibin A during early pregnancies may be helpful to predict those at risk of this disorder. The purpose of this study was to determine whether the 769G>A variant of the inhibin alpha (INHalpha) gene was associated with preeclampsia. PATIENTS AND METHODS We screened the 769G>A variation in 162 preeclamptic patients and in 202 normal pregnancies. The 769G>A variant of the INHalpha gene was determined by the PCR-based restriction fragment length polymorphism analysis and DNA sequencing. RESULTS We found no variation between the normal subjects and the preeclamptic patients. CONCLUSION The 769G>A variant of the INHalpha gene may be rare in Korean patients with preeclampsia.
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Rivera TL, Izmirly PM, Birnbaum BK, Byrne P, Brauth JB, Katholi M, Kim MY, Fischer J, Clancy RM, Buyon JP. Disease progression in mothers of children enrolled in the Research Registry for Neonatal Lupus. Ann Rheum Dis 2008; 68:828-35. [PMID: 18625627 DOI: 10.1136/ard.2008.088054] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To evaluate autoimmune disease progression in asymptomatic and pauci-symptomatic mothers of children with neonatal lupus (NL). METHODS Clinical information on mothers enrolled in the Research Registry for NL (RRNL) was obtained from medical records. Genotyping was performed for -308A/G tumour necrosis factor (TNF)alpha, 869T/C transforming growth factor (TGF)beta and -889C/T interleukin (IL)1alpha. RESULTS Of the 321 mothers enrolled, 229 had at least 6 months of follow-up. Of the 51 mothers who were asymptomatic at the NL child's birth, 26 progressed: 12 developed pauci-undifferentiated autoimmune syndrome (pauci-UAS), 2 poly-UAS, 7 SS, 4 SLE and 1 SLE/SS. The median time to develop any symptom was 3.15 years. Of the 37 mothers classified as pauci-UAS at the NL child's birth, 16 progressed: 5 developed poly-UAS, 6 Sjögren syndrome (SS), 4 systemic lupus erythematosus (SLE) and 1 SLE/SS. Of the pauci-UAS mothers enrolled within 1 year, the median time to progression was 6.7 years. Four mothers developed lupus nephritis (two asymptomatic, two pauci-UAS). The probability of an asymptomatic mother developing SLE by 10 years was 18.6%, and developing probable/definite SS was 27.9%. NL manifestations did not predict disease progression in an asymptomatic mother. Mothers with anti-Sjögren syndrome A antigen (SSA/)Ro and anti-Sjögren syndrome B antigen (SSB)/La were nearly twice as likely to develop an autoimmune disease as mothers with anti-SSA/Ro only. Only TGFbetaT/T was significantly higher in SLE mothers compared to asymptomatic mothers (p = 0.03). CONCLUSIONS Continued follow-up of asymptomatic NL mothers is warranted since nearly half progress, albeit few develop SLE. While the anti-SSB/La antibodies may be a risk factor for progression, further work is needed to determine reliable biomarkers in otherwise healthy women with anti-SSA/Ro antibodies identified solely because of an NL child.
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Lee MS, Kang MJ, Kim MY, Kim HO, Song KY, Park YM. Congenital Bednar tumour (pigmented dermatofibrosarcoma protuberans). J Eur Acad Dermatol Venereol 2008; 22:509-11. [DOI: 10.1111/j.1468-3083.2007.02373.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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