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Biomedical subjects

Dong Joon Kim

Publications and source records attributed to Dong Joon Kim.

At least 19 recordsLinked to original sources
PubMed2006

Early recanalization after intravenous administration of recombinant tissue plasminogen activator as assessed by pre- and post-thrombolytic angiography in acute ischemic stroke patients.

BACKGROUND AND PURPOSE: Recanalization rates after the intravenous (IV) recombinant tissue plasminogen activator (rt-PA) treatment have been poorly studied in acute stroke. METHODS: CT angiography was performed before IV rt-PA in all patients and digital subtraction angiography was undertaken for intra-arterial thrombolysis in cases of no improvement after rt-PA infusion. RESULTS: Forty-five patients were treated with IV rt-PA. Initial CT angiography showed relevant arterial occlusions in 35 patients. Recanalization after rt-PA therapy was demonstrated by digital subtraction angiography in 7 of the 31 patients with the occlusion on initial CT angiography: 2/16 in the internal carotid or proximal middle cerebral artery, 3/11 in the distal middle cerebral artery and 2/4 in the basilar artery occlusion. CONCLUSIONS: The early recanalization rate after IV rt-PA use was very low in cases with large proximal arterial occlusions. CT angiography before IV rt-PA may be useful for the prediction of its efficacy.

Angiography, Digital Subtraction↗
PubMed2006

Moyamoya disease presenting with paroxysmal exercise-induced dyskinesia.

We report a patient with moyamoya disease presenting with paroxysmal exercise-induced dyskinesia (PED). A 31-year-old lathe man developed recurrent attacks of paroxysmal hemichorea. The attacks always affected his left limbs and occurred either after several hours of working or while playing football. The duration of attacks ranged from 30 min to 4h. Attacks were not provoked by sudden movements, consumption of coffee or alcohol, hyperventilation, emotional stress, exposure to cold or passive movement. An MRI of the brain showed no parenchymal lesions. However, (99m)Tc-ethylcysteine dimer SPECT study showed hypoperfusion in the right striatum. Digital subtraction angiography showed stenosis of the right internal carotid and middle cerebral artery with prominent basal collaterals, which was compatible with moyamoya disease. Imaging studies of the cerebral arteries should be done in patients with clinical features of PED in order to detect possible cases of moyamoya disease.

Adult↗
PubMed2006

Role of E2F1 in endoplasmic reticulum stress signaling.

The transcription factor E2F1 coordinates cell cycle progression and induces apoptosis in response to DNA damage stress. Aside from DNA damage, the role of E2F1 in the endoplasmic reticulum (ER) stress signaling pathways is unclear. We found that E2F1-/- murine embryonic fibroblasts (MEFs) are resistant to apoptosis triggered by the ER stress inducer thapsigargin. In addition, E2F1 deficiency results in enhanced phosphorylation of eukaryotic translation initiation factor 2a (eIF2a). These results therefore indicate that E2F1 deficiency increases phosphorylation of eIF2a in response to ER stress triggered by thapsigargin, and suggest that the reduction in ER stress-induced apoptosis in E2F1-deficient cells is related to the high level of eIF2a phosphorylation.

Animals↗
PubMed2006

[Two cases of acute hepatitis E in patients with hyperthyroidism].

Acute hepatitis E occur commonly as outbreaks in endemic areas, but can occur sporadically in other part of the world. Acute hepatitis E has been reported rarely in Korea. A case of concurrent acute hepatitis E virus (HEV) infection and hyperthyroidism was reported in an inactive hepatitis B surface antigen carrier. We experienced two cases of concomitant acute HEV infection in patients with hyperthyroidism. The first case had acute HEV infection with subclinical hyperthyroidism while taking propylthiouracil. The second case suffered from acute HEV infection in a patient with Graves' disease intractable to propylthiouracil. Herein, we suggest the possible association between HEV infection and hyperthyroidism.

Acute Disease↗
PubMed2005

Detection of thrombus in acute ischemic stroke: value of thin-section noncontrast-computed tomography.

BACKGROUND AND PURPOSE: Previous studies on the hyperdense middle cerebral artery (MCA) sign were conducted using > or =5-mm thickness noncontrast-computed tomography (NCT). The purpose of this study was to compare thin-section NCT with 5-mm NCT in the detection of thrombus in acute ischemic stroke. METHODS: Enrolled were consecutive 51 patients with acute infarction in the anterior or MCA territory. All patients underwent both 5-mm NCT and either 1.25- or 1-mm thin-section helical NCT within 6 hours of symptom onset. Patients were assigned to either the single or multisegmental occlusion group, depending on the thrombus extent on thin-section NCT. Thin-section NCT and 5-mm NCT were compared in the detection of thrombi. RESULTS: Thrombi were identified in 45 patients (88%) on thin-section NCT and 16 on 5-mm NCT (31%; P<0.001). No occlusion was seen in 6 patients. Both sensitivity and specificity of thin-section NCT in detection of thrombus were 100%. CONCLUSIONS: Acute thrombus can be detected with higher sensitivity on thin-section NCT than on 5-mm NCT, and its extent is more accurately determined on thin-section NCT.

Aged↗
PubMed2005

Stent-assisted coil embolization of intracranial wide-necked aneurysms.

The endovascular treatment of cerebral aneurysms with coils poses significant technical challenges, particularly with respect to wide-necked aneurysms. We present the results of our initial experiences in using a stent for endovascular treatment of aneurysms, with an emphasis on potential applications, technical aspects, and associated complications. Twenty-three wide-necked aneurysms from 22 patients were treated during the 13-month study period. Seven patients presented with subarachnoid hemorrhage. Aneurysms were located at the internal carotid artery (n=14), the vertebral artery (n=3), the basilar artery (n=5), and the middle cerebral artery (n=1). A Neuroform stent2 was used for stent-assisted procedures. Premedication with antithrombotic agents was available for unruptured cases. Postprocedural antithrombotic medication was prescribed for all patients. Nineteen aneurysms were primarily stented, followed by coil placement. For five of these aneurysms, stenting was performed subsequent to failure of an attempt to frame with an initial coil. Stenting for the remaining four aneurysms was performed as a rescue procedure to prevent the migration of previously placed coils. Complete occlusion was obtained in ten aneurysms, nearly complete occlusion (95% or more occluded) in 11 aneurysms, and partial occlusion (less than 95% occluded) in one aneurysm. In one aneurysm, we failed to navigate the microcatheter into the aneurysmal sac through the interstices of the stent. Stent thrombosis was noted during the procedure in one patient. Hemorrhagic complication on the 25th day after the procedure was noted in one patient. No procedure-related complications were observed during the procedure or during follow-up in the remaining 20 patients, including seven patients who did not receive antithrombotic agents prior to endovascular treatment owing to recent subarachnoid hemorrhage. To overcome the technical limitation in the coiling of wide-necked aneurysms, stent-assisted coil embolization may be a technically feasible and relatively safe method, even though longer periods of follow-up are required.

Adult↗
PubMed2005

Rescue localized intra-arterial thrombolysis for hyperacute MCA ischemic stroke patients after early non-responsive intravenous tissue plasminogen activator therapy.

The outcome of patients who show no early response to intravenous (i.v.) tissue plasminogen activator (tPA) therapy is poor. The objective of this study was to evaluate the feasibility of rescue localized intra-arterial thrombolysis (LIT) therapy for acute ischemic stroke patients after an early non-responsive i.v. tPA therapy. Patients with proximal MCA occlusions who were treated by LIT (n = 10) after failure of early response [no improvement or improvement of National Institute of Health Stroke Scale (NIHSS) scores of < or = 3] to i.v. tPA therapy (0.9 mg/kg-10% bolus and 90% i.v. infusion over 60 min) were selected. The recanalization rates, incidence of post-thrombolysis hemorrhage and clinical outcomes [baseline and discharge NIHSS scores, mortality, 3 months Barthel index (BI) and modified Rankin score (mRS)] were evaluated. Rescue LIT therapy was performed on ten MCA occlusion patients (male:female = 3:7, mean age 71 years). The mean time between the initiation of i.v. tPA therapy and the initiation of intra-arterial urokinase (i.a. UK) was 117+/-25.0 min [time to i.v. tPA 137+/-32 min; time to digital subtraction angiography (DSA) 221+/-42 min; time to i.a. UK 260+/-46 min]. The baseline NIHSS scores showed significant improvement at discharge (median from 18 to 6). Symptomatic hemorrhage and, consequent, mortality were noted in 2/10 (20%) patients. Three months good outcome was noted in 4/10 (40%, mRS 0-2) and 3/10 (30%, BI > or = 95). In conclusion, rescue LIT therapy can be considered as a treatment option for patients not showing early response to full dose i.v. tPA therapy. Larger scale studies for further validation of this protocol may be necessary.

Aged↗
PubMed2005

Pathophysiologic heterogeneity in the development of type 2 diabetes mellitus in Korean subjects.

OBJECTIVE: To investigate the clinical characteristics and predisposing metabolic abnormalities in the development of glucose intolerance and diabetes mellitus in obese and non-obese Korean subjects. METHODS: Four hundred Korean subjects were classified into five groups according to degree of glucose tolerance by OGTT: NGT, IGT alone, IFG alone, IFG+IGT, and DM. The groups were also subdivided into obese and non-obese group according to body mass index. Insulin resistance was assessed by using homeostasis model assessment of insulin resistance (HOMA-R), and insulinogenic index was used as an index of early-phase insulin secretion. RESULTS: Impaired early-phase insulin secretion was seen in non-obese IGT alone, IFG alone, and IFG+IGT, though more profound secretory defects were noted in IFG+IGT and DM. No significant difference were found in HOMA-R among non-obese IGT alone, IFG alone, or IFG+IGT, or in terms of early-phase insulin secretion in obese IGT alone, IFG alone, or IFG+IGT. However, the magnitude of insulin resistance differed in the obese group, IFG+IGT and DM being more insulin resistant than IGT alone or IFG alone. CONCLUSIONS: These results suggest that the predisposing metabolic abnormality in non-obese subjects with IGT alone or IFG alone and in progression to IFG+IGT might be deterioration of early phase insulin secretion, whereas insulin resistance might be the major contributory factor in obese subjects. The predisposing metabolic abnormality leading to diabetes in both obese and non-obese groups was deterioration of early-phase insulin secretion.

Adult↗
PubMed2005

Responsiveness to interferon alpha in chronic hepatitis B by presumed vertical transmission.

This study was to evaluate responsiveness to IFN-alpha and investigate the benefits of sustained response (SR) in patients who were presumed as being vertically transmitted in Korea. A total of 46 patients of presumed vertical transmission with biopsy-proven HBeAg-positive chronic HBV infection were treated with IFN-alpha and followed. We tried to find the factors associated with SR and compared the cumulative rate of HCC and survival between SR group and non-sustained/non-responder (NSR) group. HBeAg loss was acquired in 35% (16/46) within a year but SR was observed in 22% (10/46). Age <35 years and ALT levels >7xULN were significant favorable factors for SR (OR 0.56, 0.49, 95%CI 0.38-0.82, 0.29-0.81, respectively) (both P<0.05). There were no significant differences of cumulative HCC-free survival (100 vs. 68% at 12 years, P=0.36) and survival (100 vs. 73% at 12 years, P=0.3) between SR group and NSR group. In conclusion, age below 35 years old and serum ALT levels above 7xULN may predict IFN-alpha therapy-induced SR among them, although we cannot affirm the effects on HCC prevention or survival.

Adolescent↗
PubMed2005

[Effectiveness of triple therapy and quadruple therapy for Helicobacter pylori eradication].

BACKGROUND/AIMS: Quadruple therapy can be considered as a first-line therapy in areas where the resistance rate to clarithromycin is high. Comparison study of triple therapy and quadruple therapy for Helicobacter pylori (H. pylori) eradication is still lacking in Korea despite the increasing prevalence of antibiotic resistance. This study was conducted to compare the efficacy of triple and quadruple therapy as a first-line treatment in H. pylori infected patients with peptic ulcer. METHODS: Consecutive 149 cases of peptic ulcer disease associated with H. pylori infection were randomized either to proton pump inhibitor (PPI, bid), amoxicillin (1,000 mg, bid), and clarithromycin (500 mg, bid) (PAC group) or to PPI (bid), bismuth subcitrate (300 mg, qid), metronidazole (500 mg, tid), and tetracycline (500 mg, qid) (PBMT group) eradication treatments for 7 days. Outcome of eradication therapy was assessed by 13C-urea breath test performed 4-6 weeks after eradication. RESULTS: Eradication rates in PAC and PBMT group were 78.7% (59/75) and 71.6% (53/74) by intention to treat analysis, respectively (p=0.424). By per protocol analysis, eradication rates of PAC and PBMT group were 85.5% (59/69) and 85.5% (53/62), respectively (p=1.012). Adverse reactions occurred in 5 (6.6%) and 7 (9.5%) patients in PAC and PBMT group, respectively (p=0.346). CONCLUSIONS: One week-quadruple therapy as a first-line treatment for H. pylori infection does not offer any advantage over PPI-based triple therapy in Korean patients.

Adolescent↗
PubMed2004

A rapid, simple measurement of human albumin in whole blood using a fluorescence immunoassay (I).

BACKGROUND: Human serum albumin (HSA) is the most abundant plasma protein and plays key a role in metabolism. The variation in albumin concentration provides valuable information related to metabolic diseases and diagnostic application. METHODS: We constructed two assay systems to quantify the albumin concentration. The immunoassay used a fluorescence (FL) dye to detect albumin in samples and employed the conventional chromatography as a separation system. The assay system consists of an anti-HSA-mAb or an HSA immobilized test strip in a disposable cartridge, a fluorescence-labeled detector buffer and a laser-fluorescence scanner. We mixed the sample with detector, loaded it onto a cartridge, incubated it for 10 min and measured the concentration of albumin in a laser-fluorescence scanner. We examined the comparability of assay with an automated BCG dye binding method using a Hitachi 747 biochemical analyzer. RESULTS: The correlation of coefficient between AT/AC as converted from the relative fluorescence units (RFU) and albumin concentration displayed reasonable reliability in both the competition and the inhibition assay systems (r = 0.998). Using the Bland-Altman difference plot analysis, we observed an acceptable agreement between two methods, the fluorescence immunochromatography assay (FL-ICA) and the automated BCG dye-binding method of a Hitachi biochemical analyzer, over the clinical relevant range of HSA concentrations. The coefficient of variation (CV) of within- and between-run variation in the immunoassay system was < 8% and the recovery fell within 5% in each control sample. In addition to its reliable analytical performance, the assay with whole blood can be completed in 12 min using a one-step operation without any pretreatment. CONCLUSION: The developed immunoassay system using fluorescence dye and lateral-flow chromatography is a simple, fast and reliable method for quantifying the albumin concentration in whole blood.

Antibodies, Monoclonal↗
PubMed2004

Diffusion tensor MR imaging visualizes the altered hemispheric fiber connection in callosal dysgenesis.

We report three cases of callosal dysgenesis that were evaluated by diffusion tensor imaging and fiber tractography. In partial agenesis of corpus callosum, fiber tracts from all regions of brain converged to a partially developed small genu portion and connected to the contralateral side. In complete callosal agenesis, fibers from the hemispheres failed to cross the midline and formed thick bundles running anteroposteriorly (eg, Probst bundle). The thickness of the anterior commissure was enlarged or smaller than normal brain, and other white matter tracts were not markedly different from normal brain tissue.

Abnormalities, Multiple↗
PubMed2004

Malignant gastrointestinal stromal tumor of the ampulla of Vater: a case report.

GIST is a rare neoplasm, the majority of GISTs are located in the stomach and small intestine. Most GISTs are diagnosed histopathologically after resection because of submucosal location. A 37-year-old female patient presented with a 2-weeks history of generalized weakness, nausea accompanied by intermittent passage of black, tarry stools. Esophagogastroduodenoscopy and ERCP showed a large round mass measuring 5 cm in diameter in the ampulla of Vater with ulcer crack. Endoscopic multiple biopsies from the mass including ulcer base were taken. Light microscopic findings showed spindle-shaped and epitheloid tumor cells having high cellularity and frequent mitotic figures. On immunohistochemical stainings, the tumor cells were positive for CD34 and smooth muscle actin. Based on these preoperative findings, a diagnosis of malignant GIST of the ampulla of Vater was made probably. After operation, immunohistochemical studies revealed positive reaction for c-kit and vimentin, as well as focally reactive for CD34 and smooth muscle actin. We report a case of GIST in the ampulla of Vater presenting with melena that was diagnosed preoperatively and postoperatively.

Adult↗
PubMed2004

[Therapeutic efficacy of balloon-occluded retrograde transvenous obliteration in the treatment of gastric varices in cirrhotic patients with gastrorenal shunt].

BACKGROUND/AIMS: Rupture of gastric varices was one of the most dreadful complications of cirrhosis. Recently, a new interventional procedure, balloon-occluded retrograde transvenous obliteration (B-RTO) was introduced for the treatment of gastric variceal bleeding. This study was performed to evaluate the therapeutic efficacy of B-RTO in the treatment of gastric varices with gastro-renal shunts. METHODS: From March 2000 to June 2003, we performed B-RTO in 17 patients with gastric varices and gastrorenal shunts. All patients had history or high risk factors of gastric variceal bleeding. For the evaluation of therapeutic efficacy, we performed esophagogastroduodenoscopy (EGD) and computed tomography (CT) at 1, 6 and 12 months after B-RTO. Successful B-RTO was judged by combined CT findings and EGD findings (disappearance of gastric varices or markedly reduced gastric variceal size or bleeding risk) during follow-up periods (1-14 months, mean:6.18). We analyzed the clinical factors related to clinical success of B-RTO. RESULTS: Technical success were achieved in all patients except one (94.1%). Gastric varices were disappeared or decreased after B-RTO in 13 patients (81.2%). Complications related to procedure included transient hematuria (n=5), puncture site oozing (n=1) and partial splenic infarction (n=1), and all were conservatively managed. During the follow up periods, neither significant hepatic nor renal functional damages occurred. Statistically, no significant factors related with B-RTO success. CONCLUSIONS: B-RTO is effective and safe in the management of gastric varices in cirrhotic patients with gastrorenal shunt.

Adult↗
PubMed2004

Reperfusion cellular injury in an animal model of transient ischemia.

BACKGROUND AND PURPOSE: Early thrombolytic therapy is encouraged in hyperacute stroke, although this might result in delayed reperfusion injury. Our purpose was to investigate the serial changes in cerebral perfusion following transient ischemia by means of MR imaging and to correlate them with the histologic findings obtained by using the TdT-mediated dUTP-biotin nick-end labeling (TUNEL) assay. METHODS: One-hour transient occlusion of the middle cerebral artery was produced in 10 cats. Serial perfusion-weighted MR imaging was performed for 3 days after reperfusion. The reperfusion characteristics in each region of the brain were classified into four groups according to the serial perfusion MR imaging status: normal perfusion (N), continuous hyperperfusion (I), early hyperperfusion and gradual decrease (II), and persistent hypoperfusion (III). After the last imaging session, a specimen was obtained, and TUNEL staining was performed. TUNEL-positive cells were counted under a high-power-field (HPF) light microscope (x200). The degree of TUNEL positivity was compared among the four reperfusion groups classified on the basis of serial perfusion-weighted imaging findings. RESULTS: Group N had 16.8 +/- 5.1 TUNEL-positive cells per HPF. Groups I and II had a statistically significant increase in TUNEL positivity (39.5 +/- 13.4 and 43.6 +/- 16.7 cells per HPF; P < .01, one-way analysis of variance), whereas group III had a statistically insignificant increase in TUNEL positivity (23.3 +/- 6.9 cells per HPF). CONCLUSION: Reperfusion followed by hyperperfusion induced cellular damage, although the initial MR imaging findings were normal. The inclusion of anti-reperfusion injury therapy should be considered in thrombolytic treatment.

Animals↗
PubMed2003

Homonymous hemianopia after embolization of an aneurysm-associated AVM supplied by the anterior choroidal artery.

The primary objective for the treatment of arteriovenous malformations (AVM) of the brain is to reduce the risk of hemorrhage. The risk of hemorrhage is known to increase with the presence of an aneurysm associated with AVM. The purpose of this report is to describe the development of visual complications after the embolization of a hemorrhagic anterior choroidal artery feeding AVM with an associated aneurysm and to describe the possible causes.

Adult↗