Images in cardiovascular medicine. Neovascularization from coronary artery leaking to fungus ball in the lung.
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Aged↗
Biomedical subjects
Jin Yong Kim
Publications and source records attributed to Jin Yong Kim.
Segmental amputation of esophagus with bronchial-wall rupture during removal of a stent for benign esophageal stricture.
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Aged↗
Optimal scan window for detection of hypervascular hepatocellular carcinomas during MDCT examination.
OBJECTIVE: The purpose of this study was to define the optimal scan window for acquiring arterial phase images in the detection of hypervascular hepatocellular carcinomas (HCCs). MATERIALS AND METHODS: Biphasic arterial phase CT examinations were performed using a 16-MDCT scanner on 198 patients (159 men and 39 women; mean age, 59 years; age range, 25-82 years) with nodular HCC. All examinations were performed after administering 120-150 mL of a nonionic contrast media (370 mg I/mL) at a rate of 3-4 mL/s. The scan delay--the interval between when the bolus-tracking program detected the threshold enhancement of 100 H in the abdominal aorta and the start of the first arterial scan-was progressively lengthened by 2-second intervals, from 10 seconds in group 1 to 20 seconds in group 6. The second arterial phase scan was started 6 seconds after the end of the early scan. A tube collimation of 1.5 mm, a table feed of 18 mm per rotation, an image thickness of 3 mm, and 3-mm increments were used. The duration of each phase scan was 4.5-8.8 seconds. Tumor-to-liver attenuation difference (TLAD) at the first (TLAD1) and second (TLAD2) arterial phase images were compared lesion by lesion. Four observers assigned subjective ratings of visual conspicuity and individual preferences for each phase in each group. RESULTS: The mean threshold time (100 H) was 18.4 +/- 3.1 seconds, and 97% of patients were within the range of 13-24 seconds. The mean TLAD1 of groups 3 to 6 and the mean TLAD2 of groups 1 to 5 were all comparable; they were also all significantly (p < 0.005) higher than the mean TLAD1 of groups 1 and 2 and the mean TLAD2 of group 6. In groups 1 and 2, the mean TLAD2 was significantly higher than the mean TLAD1 (p < 0.001); in groups 5 and 6, the mean TLAD1 was significantly higher than the mean TLAD2 (p < 0.001). In groups 3 and 4, the mean TLAD1 and TLAD2 were similar. The visual conspicuity and individual preferences were higher for the first-phase image in groups 3 to 6 and the second-phase image in groups 1 and 2. CONCLUSION: The optimal scan window for arterial phase images in the detection of HCC seems to be approximately 14-30 seconds from the 100-H threshold.
Adult↗
[Significances of serum level and immunohistochemical stain of CA19-9 in simple hepatic cysts and intrahepatic biliary cystic neoplasms].
BACKGROUND/AIMS: In spite of various diagnostic modalities, biliary cystic neoplasms (biliary cystadenoma and cystadenocarcinoma) remain to be difficult to diagnose preoperatively. Recently, there are some reports that elevated CA19-9 level in serum and/or cystic fluid could be a useful finding in the differential diagnosis of biliary cystic neoplasm. This study aimed to evaluate the expression of CA19-9 and to elucidate its significances in intrahepatic biliary cystic neoplasms and simple hepatic cysts. METHODS: In 8 patients with biliary cystic neoplasms and 6 simple hepatic cysts, symptoms, radiologic and laboratory findings were reviewed retrospectively. In 5 biliary cystic neoplasms (4 biliary cystadenomas, 1 biliary cystadenocarcinoma) and 5 simple hepatic cysts, immunohistochemical stainings for CA19-9 were performed with formalin-fixed, paraffin-embedded tissues. RESULTS: In 8 biliary cystic neoplasms, two cases were suspected as biliary cystadenoma preoperatively and 6 cases could not be distinguished from simple cysts or cholangiocarcinoma preoperatively. In 6 simple hepatic cysts, 3 cases were diagnosed preoperatively and 3 cases could not be distinguished from biliary cystadenoma or pancreatic pseudocyst preoperatively. Expression of CA19-9 in simple hepatic cysts and biliary cystic neoplasms were 80% in both groups. Expression of CA19-9 is not related to the elevated level of CA19-9 in serum. CONCLUSIONS: Our data suggests that the elevated level of CA19-9 in serum may not be helpful in the preoprative diagnosis of biliary cystic neoplasm.
Adult↗
[The decision-making value of magnetic resonance cholangiopancreatography in patients suspicious for pancreatobiliary diseases].
BACKGROUND/AIMS: Endoscopic retrograde cholangiopancreatography (ERCP) is an operator-dependent procedure and has significant procedure-related morbidity and mortality. Magnetic resonance cholangiopancreatography (MRCP) is a safe noninvasive method for pancreatobiliary imaging. The aims of this study were to evaluate the potential impact of MRCP on performing ERCP and to evaluate the decision-making value of MRCP in patients suspicious for pancreatobiliary diseases. METHODS: Two hundreds twelve patients (M:F 108:104, mean age 59.3 +/- 13.7) who underwent MRCP due to clinical or sonographic suggesting pancreatobiliary disease were included. We divided patients into four groups according to their presumptive diagnosis: biliary stone (group 1), biliary tumor (group 2), gallstone pancreatitis (group 3) and other biliary diseases (group 4). RESULTS: Numbers of cases in group 1, 2, 3 and 4 were 145, 43, 17 and 7, respectively. In 144 cases (67.9%), ERCP was unnecessary and 76 cases (35.8%) required neither ERCP nor any other treatment. Thereafter, these cases were thought to be a patient group in whom the workload of performing ERCP could be reduced. CONCLUSIONS: MRCP can reduce the number and efforts doing ERCP and is helpful in decision-making for the treatment of pancreatobiliary disease. Therefore, MRCP could be the primary diagnostic tool before choosing ERCP.
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Is cytokeratin immunoreactivity useful in the diagnosis of short-segment Barrett's oesophagus in Korea?
BACKGROUND: Cytokeratin 7/20 staining has been reported to be helpful in diagnosing Barrett's oesophagus and gastric intestinal metaplasia. However, this is still a matter of some controversy. OBJECTIVE: To determine the diagnostic usefulness of cytokeratin 7/20 immunostaining for short-segment Barrett's oesophagus in Korea. METHODS: In patients with Barrett's oesophagus, diagnosed endoscopically, at least two biopsy specimens were taken from just below the squamocolumnar junction. If goblet cells were found histologically with alcian blue staining, cytokeratin 7/20 immunohistochemical stains were performed. Intestinal metaplasia at the cardia was diagnosed whenever biopsy specimens taken from within 2 cm below the oesophagogastric junction revealed intestinal metaplasia. Barrett's cytokeratin 7/20 pattern was defined as cytokeratin 20 positivity in only the superficial gland, combined with cytokeratin 7 positivity in both the superficial and deep glands. RESULTS: Barrett's cytokeratin 7/20 pattern was observed in 28 out of 36 cases (77.8%) with short-segment Barrett's oesophagus, 11 out of 28 cases (39.3%) with intestinal metaplasia at the cardia, and nine out of 61 cases (14.8%) with gastric intestinal metaplasia. The sensitivity and specificity of Barrett's cytokeratin 7/20 pattern were 77.8 and 77.5%, respectively. CONCLUSION: Barrett's cytokeratin 7/20 pattern can be a useful marker for the diagnosis of short-segment Barrett's oesophagus, although the false positive or false negative rate is approximately 25%.
Adult↗
Prevalence of Barrett's esophagus in Korea.
BACKGROUND: In contrast to Western countries, the prevalence of Barrett's esophagus (BE) is still believed to be very low in the Far East. The aim of the present paper was to assess the prevalence of BE in Korea. METHODS: Nine hundred and ninety-two consecutive patients undergoing their first diagnostic upper gastrointestinal endoscopies due to various indications were included from four university hospitals in Korea. Esophagus of each patient was examined during insertion of the endoscope with minimum air inflation. From subjects who were found, during endoscopy, to have columnar-lined esophagus, at least two biopsy samples were taken from the columnar epithelium. Patients exhibiting specialized columnar epithelium on histological examination were diagnosed as having BE. RESULTS: Among 992 patients, 108 cases (10.9%) were endoscopically diagnosed as short-segment BE, and three cases (0.3%) were endoscopically diagnosed as long-segment BE. However, only 36 patients (3.6%) met the histological criteria for BE. Among these patients, only one (0.1%) was histologically diagnosed as having long-segment BE. Reflux esophagitis, mostly in a mild degree, was found in 25.0% of the BE group, and 8.6% of the non-BE group (P = 0.0022). Hiatal hernias were more commonly found in the BE group than in the non-BE group (22.2% vs 8.9%, P = 0.0163). CONCLUSIONS: Although the prevalence of BE in Korea appears to be lower than the reported rates from Western countries, it may not be as low as was previously thought.
Barrett Esophagus↗
Factors related to post-treatment relapse in chronic hepatitis B patients who lost HBeAg after lamivudine therapy.
BACKGROUND AND AIM: It is uncertain if a patient's lamivudine response after HBeAg loss is durable. In Korean chronic hepatitis B patients, the relapse rate is high after termination of lamivudine therapy for patients with HBeAg loss. We evaluated the factors related to relapse in chronic hepatitis B patients with HBeAg loss after lamivudine therapy. METHODS: A total of 132 chronic hepatitis B patients, who initially had HBeAg and did not have decompensated features, were analyzed in this study. These patients lost the HBeAg after lamivudine therapy and then their therapy was stopped. Post-treatment serum alanine aminotransferase (ALT), HBeAg, anti-HBe and hepatitis B virus (HBV) DNA were monitored until relapse. RESULTS: Seventy-five patients relapsed (cumulative relapse rate: 56% at 6 months). Upon univariate analysis, the factors of age, serum total bilirubin, presence of anti-HBe after HBeAg loss, and the duration of additional lamivudine therapy after HBeAg loss were associated with relapse. Upon multivariate analysis, older age, a higher serum total bilirubin and the shorter duration of additional lamivudine therapy were significant risk factors for relapse. Patterns of relapse were the re-elevation of ALT, re-emergence of HBV DNA (69 patients) and reappearance of HBeAg (55 patients). CONCLUSIONS: To prevent relapse in patients with chronic hepatitis B infection after lamivudine therapy, age and serum bilirubin level of patients as well as a prolonged duration of additional lamivudine therapy should be considered.
Adult↗
[Expression of epidermal growth factor receptor, ErbB2 and matrix metalloproteinase-9 in hepatolithiasis and cholangiocarcinoma].
BACKGROUND/AIMS: Hepatolithiasis is a common disease in East Asia and presents as a histological feature of proliferative glands containing mucin. 5-10% of hepatolithiasis is known to be associated with cholangiocarcinoma. Recent studies reported that epidermal growth factor receptor (EGFR) could be activated through heparin binding- EGF cleavage by metalloproteinases. Matrix metalloproteinases (MMPs) which digest the extracellular matrix are required for cancer cell invasion and the expression of MMP-9 is known to be increased in cholangiocarcinoma. However, there has been few studies on the expressions and roles of EGFR and MMP in hepatolithiasis. This study was performed to clarify and compare the expressions of EGFR, erbB2 and MMP-9 in hepatolithiasis and cholangiocarcinoma. METHODS: Surgically resected liver tissues with hepatolithiasis (n = 14), cholangiocarcinoma (n = 20) and trauma (n = 2 as controls) were included. The expressions of EGFR, erbB2 and MMP-9 in tissue samples were examined by immunohistochemistry using respective monoclonal antibodies. RESULTS: In traumatic livers, the expressions of EGFR, erbB2 and MMP-9 were all negative. The expression of EGFR was increased in hepatolithiasis group (79%, 11/14) compared with cholangiocarcinoma group (25%, 5/20) (p < 0.05). The expression of erbB2 was detected only in cholangiocarcinoma (25%, 5/20). MMP-9 was increased in both hepatolithiasis (79%, 11/14) and cholangiocarcinoma (95%, 19/20) (p > 0.05). CONCLUSIONS: EGFR expression appears to be the dominant component in periductular hyperplasia of hepatolithiasis and MMP-9 is upregulated not only in cholangiocarcinoma but also in hepatolithiasis. This study suggests that EGFR and MMP-9 are associated with cholangiocarcinoma and hepatolithiasis.
Adult↗
CD1d function is regulated by microsomal triglyceride transfer protein.
CD1d is a major histocompatibility complex (MHC) class I-related molecule that functions in glycolipid antigen presentation to distinct subsets of T cells that express natural killer receptors and an invariant T-cell receptor-alpha chain (invariant NKT cells). The acquisition of glycolipid antigens by CD1d occurs, in part, in endosomes through the function of resident lipid transfer proteins, namely saposins. Here we show that microsomal triglyceride transfer protein (MTP), a protein that resides in the endoplasmic reticulum of hepatocytes and intestinal epithelial cells (IECs) and is essential for lipidation of apolipoprotein B, associates with CD1d in hepatocytes. Hepatocytes from animals in which Mttp (the gene encoding MTP) has been conditionally deleted, and IECs in which Mttp gene products have been silenced, are unable to activate invariant NKT cells. Conditional deletion of the Mttp gene in hepatocytes is associated with a redistribution of CD1d expression, and Mttp-deleted mice are resistant to immunopathologies associated with invariant NKT cell-mediated hepatitis and colitis. These studies indicate that the CD1d-regulating function of MTP in the endoplasmic reticulum is complementary to that of the saposins in endosomes in vivo.
Abetalipoproteinemia↗
Reduced expression of peroxisome proliferator-activated receptor-alpha may have an important role in the development of non-alcoholic fatty liver disease.
BACKGROUND: Although the pathogenesis of non-alcoholic fatty liver disease (NAFLD) remains poorly understood, metabolic syndrome associated with insulin resistance is the most reproducible factor in the development of NAFLD. Fat accumulation in hepatocytes results from an imbalance in the input, output and oxidation of fatty acid. Peroxisomes contain a battery of fatty acid oxidizing enzymes, the first of which, acyl-CoA oxidase (AOX), initiates the beta-oxidation spiral. One of the mammalian peroxisome proliferator-activated receptors (PPAR), PPAR-alpha, regulates the transcriptional expression of the enzymes involved in fatty acid beta-oxidation. The aim of the present study was to define the role of PPAR-alpha and AOX in the development of NAFLD using the Otsuka Long-Evans Tokushima fatty (OLETF) rat model. METHODS: Liver tissue from OLETF (n = 12) and control (n = 10) rats 12, 28, and 40 weeks old were processed for histopathological and western blot analysis. The messenger RNA of PPAR-alpha and AOX were quantified by real-time RT-PCR. RESULTS: At 40 weeks old, the histological analysis of the OLETF rat liver had steatosis (approximately 66%) and mild inflammation, which were comparable to those in NAFLD. Histological changes were unremarkable in 12 week and 28 week rats. In 12 week OLETF rats, the mRNA of AOX was 63% of the control. Expression of PPAR-alpha mRNA was also reduced to 3% that of the control. Along with the changes of mRNA, the protein expression of PPAR-alpha was also significantly reduced to 17% that of the control. In 28 week and 40 week animals, PPAR-alpha protein expression gradually increased to 75% and 78% that of the control. Expression of PPAR-alpha mRNA was also increased by up to 26% and 110% of the control. AOX, regulated by PPAR-alpha, also increased to 149% and 120% of the control. CONCLUSION: Reduced expression of PPAR-alpha and AOX was observed even before definite steatosis had developed. The alteration of peroxisomal fatty acid metabolism may have an important role in the development of NAFLD.
Acyl-CoA Oxidase↗
Evaluation of the Abbott Cell-Dyn 4000 hematology analyzer for detection and therapeutic monitoring of Plasmodium vivax in the Republic of Korea.
The Cell-Dyn 4000 automated hematology analyzer (CD4000) has the ability to detect malaria patients, but it remained unclear whether it could detect persistent malaria post-treatment. To investigate this, we used the CD4000 to evaluate 68 Korean patients with Plasmodium vivax malaria, and control groups of 50 patients with fever and 50 asymptomatic patients. The results from the instrument-generated scatter plot (derived by laser light depolarization) were compared with microscopy results. During the initial diagnosis, the sensitivity of the CD4000 in detecting malaria was 91.2%. On day 3 of follow-up, the CD4000 results matched those from microscopy by 96.7%. Malaria was not detected by either method beyond 14 days post-presentation. Interestingly, the atypical depolarizing events, which typify the presence of malaria in the analyzer, were highly correlated with the levels of parasitaemia in serially diluted samples of the leucocyte-depleted blood, and the CD4000 detected parasites down to the level of 288 +/- 17.7/microl. Our findings suggest that the phenomenon of atypical light depolarization could be influenced by parasitaemia levels, and be used as a screening method for P. vivax malaria patients, as well as for the therapeutic monitoring.
Adult↗
[Expression of MUC3, MUC5AC, MUC6 and epidermal growth factor receptor in gallbladder epithelium according to gallstone composition].
BACKGROUND/AIMS: Gallbladder (GB) mucin is one of the key factors in the gallstone formation. However, there is little information about the diversity of mucin secretion according to the stone composition. Epidermal growth factor receptor (EGFR) functions in proliferation including mucin secreting goblet cell hyperplasia. We compared the expressions of MUC3, MUC5AC, MUC6 and EGFR in the GB epithelium with cholesterol gallstones (GB-chol) group and pigment gallstones (GB-pig group). METHODS: GBs from elective laparoscopic cholecystectomy for the gallstone disease were studied. Stone composition was analyzed by the spectrophotometer. Immunohistochemical stain was performed using each monoclonal antibody. The percentage of stained proportion was scored by the NIH image program and the results were compared between both groups. RESULTS: Total 20 patients were enrolled (10 patients with cholesterol gallstones, 10 patients with pigment gallstones). The percentages of stained proportion for MUC3, MUC5AC, and MUC6 were 42 +/- 27%, 31 +/- 15%, and 17 +/- 9%, respectively in GB-chol group and 32 +/- 22%, 33 +/- 23%, and 15 +/- 10%, respectively in GB-pig group (p>0.05). The expression of EGFR was 50% (5/10) in the GB-chol group and 80% (8/10) in the GB-pig group respectively. CONCLUSIONS: There was no difference in the expressions of MUC3, MUC5AC, and MUC6 between the two groups. Further studies are needed to elucidate the role of EGFR in the gallstone formation.
Bile Pigments↗
Visible Korean Human: another trial for making serially-sectioned images.
In this ongoing study, we are trying to make Visible Korean Human (Mar 2000--Feb 2005). The complete MRIs and CTs of the Korean cadaver's entire body are scanned. The cadaver is serially-sectioned at 0.2 mm thickness without any missing images. The anatomical structures in the sectioned images are segmented. The Visible Korean Human is expected to be more helpful than Visible Human in the following ways. First, the Korean data will be more helpful in diagnosing and treating the patients belonging to the yellow race. Second, MRIs and CTs of the entire body at 1 mm thickness will be more helpful in studying the MRIs and CTs. Third, sectioned images without any missing images will be more helpful in making the complete 3D images. Fifth, small pixel size (0.2 mm x 0.2 mm) and thin thickness (0.2 mm) of sectioned images will be more helpful in showing the small anatomical structures greater than 0.2 mm. Sixth, the additional segmented images will be more helpful in making the 3D image and virtual dissection software. The Visible Korean Human will be the basis for making better 3D image and virtual dissection software which will be more helpful in medical education.
Adult↗
Seroprevalence of malaria infections in Korean troops on a peacekeeping mission in East Timor from 2001 to 2002.
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Adult↗
Transmural migration of surgical sponge evacuated by defecation: mimicking an intraperitoneal gossypiboma.
The spontaneous defecation of the surgical retained sponge is very rare. Here, we report a case of migrating surgical sponge that was retained in the colon and it was evacuated by defecation.
Adult↗
Ectopic varices in colonic stoma: MDCT findings.
Ectopic stomal varices are an unusual cause of gastrointestinal hemorrhage. The term "ectopic stomal varices" means abnormally dilated veins that have developed in the stomal mucosa. We describe the 2D reformatted and 3D volume rendered images by MDCT in a patient with an episode of acute bleeding from the colonic stoma. This case indicates that the 2D reformatted and 3D volume rendered images are useful to detect this rare complication of portal hypertension, and they help to tailor adequate treatment for the patients with bleeding from stomal varices.
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