Biomedical subjects

S J Hong

Publications and source records attributed to S J Hong.

At least 55 records · Page 3Linked to original sources

PubMed2001

Effects of drugs on cellular proliferation in cultured iris pigment epithelial cells and retinal pigment epithelial cells.

In this study, iris and retinal pigment epithelial cells were cultured from porcine and various drugs including methionine-enkephalin, isoproterenol, dibutyryl cAMP, endothelin-1, dexamethasone and phorbol 12-myristate 13-acetate (PMA) were used to investigate their effects on both cellular proliferation in cultured porcine iris and retinal pigment epithelial cells. Cellular proliferation was estimated with 3H-thymidine uptake. It is indicated that both pigment epithelial cells possess epithelial-like morphology and abundant pigment granules in cells obviously. Following the iris pigment epithelial cells being treated with endothelin-1, the 3H-thymidine uptake in the cells was increased to 126% as compared with the control. However, the cellular proliferation was decreased to 83% when the cells were treated with isoproterenol. In the case of methionine-enkephalin, dibutyryl cAMP, dexamethasone and phorbol 12-myristate 13-acetate (PMA), the thymidine uptake in the iris pigment epithelial cells was not affected by above drugs. In the retinal pigment epithelial cells, the 3H-thymidine uptakes were increased to 145% and 146% when the cells were incubated with methionine-enkephalin, and isoproterenol, respectively. In the presence of dibutyryl cAMP, dexamethasone and phorbol ester (PMA), the cellular proliferation was inhibited to 83%, 73% and 85% respectively. However, endothelin-1 did not affect the cellular proliferation in retinal pigment epithelial cells. These results show that the morphological shapes of iris pigment epithelial cells are similar to retinal pigment epithelial cells. However, the cellular proliferation in both cells may be regulated by distinct mechanisms.

Animals↗

PubMed2000

Paragonimus westermani: a cytosolic glutathione S-transferase of a sigma-class in adult stage.

We purified cytosolic glutathione S-transferase (GST) of adult Paragonimus westermani monitoring its activity with 1-chloro-2,4-dinitrobenzene (CDNB). The enzyme was purified 18.4-fold to electrophoretic homogeneity with 21% recovery rate through a three-step procedure. The purified enzyme (Pw28GST) has a subunit molecular weight of 28 kDa with an isoelectric point at 4.6. Monoclonal antibody (anti-Pw28GST) against Pw28GST did not cross-react with GSTs from other helminths. cDNA library was constructed in lambdaZAP II bacteriophage and screened with anti-Pw28GST. The corresponding gene containing a single open reading frame of 804 bp encoded 211 amino acids. The predicted amino acid sequence exhibited a higher homology with catalytic domain near N-terminus of class sigma GSTs (58%) than with schistosome 28-kDa GSTs (45-41%) or with class sigma GSTs themselves (33-31%). The sequence contained both Tyr-6 and Tyr-10 that are highly conserved in mammalian and helminth GSTs. The apparent K(m) value of a recombinant enzyme was 0.78 mM. Both native and recombinant enzymes showed the highest activity against CDNB, relatively weak activity against ethacrynic acid and reactive carbonyls, and no activity against epoxy-3-(p-nitrophenoxy)-propane. The activities were inhibited by bromosulfophthalein, cibacron blue, and albendazole, but not by praziquantel. These findings indicate that adult P. westermani has a class sigma GST.

Amino Acid Sequence↗

PubMed2000

Molecular cloning and immunological characterization of phosphoglycerate kinase from Clonorchis sinensis.

The parasite Clonorchis sinensis was determined to utilize a large amount of external glucose to carry its energy metabolism. Phosphoglycerate kinase (PGK), a glycolytic enzyme, found in many parasites, has been identified as one of the candidate molecules distinguished from human counterparts for vaccine and drug developments. A cDNA clone purified by screening a C. sinensis cDNA library using a heterologous cDNA probe encoded a putative peptide of 415 amino acids with over 60% identities with PGKs from a number of animals. The putative peptides revealed domains corresponding to 12 beta-sheets and inner loops forming a substrate-binding cleft of animal PGKs. The gene product was overexpressed in Escherichia coli and showed a PGK-like enzyme activity. A polyclonal antibody raised against the recombinant C. sinensis PGK was specific to native C. sinensis PGK and localized it to the muscular tissue and tegument of the adult flukes. The C. sinensis PGK elicited antibodies in C. sinensis-infected rabbits. Therefore, it is proposed that C. sinensis PGK could be used as an immunoreagent in the serodiagnosis for clonorchiasis.

Amino Acid Sequence↗

PubMed2000

Molecular evidence of natural hybridization between Fasciola hepatica and F. gigantica.

Nucleotide sequences of two regions, cytochrome c-oxidase subunit 1 (CO1) and NADH dehydrogenase subunit 1 (ND1) of the mitochondrial DNA and two regions, internal-transcribed spacer 2 (ITS2) and the D2 region in the 28S rDNA (28S) of the nuclear DNA were obtained from five Korean worms of the genus Fasciola in order to elucidate their taxonomic status. The CO1 and ND1 regions are all monomorphic in the Korean worms and similar to those of F. gigantica. On the other hand, the ITS2 and D2 regions were found to be polymorphic; that is, out of five worms, two possessed a F. gigantica-type sequence, one, a F. hepatica-type sequence and two possessed sequences of both types indicating an existence of different alleles at the loci. It should be noted that these variations of the ITS2 and D2 regions co-occur at the same individual worms. This was confirmed by sequencing five to six cloned PCR products for each worm. The present study strongly suggests interspecific cross-hybridization between the two species coexisting in Korea.

Amino Acid Sequence↗

PubMed2000

Inhibition of mouse neuromuscular transmission and contractile function by okadaic acid and cantharidin.

1. Phosphorylations of cellular proteins modulate biological activities. The effects of okadaic acid (0.1 - 10 microM) and cantharidin (1 - 100 microM), inhibitors of protein phosphatases, on the synaptic transmission at the mouse neuromuscular junction were explored. 2. Both inhibitors almost completely depressed twitch forces elicited by electrical stimulation of diaphragm muscles (the IC(50)s for okadaic acid and cantharidin were 1.1+/-0.2 and 13+/-1 microM, n=5, respectively) and suppressed contractures evoked by high K(+) and ryanodine more than 70%. Contractures caused by cardiotoxin, which destroys the integrity of sarcolemma, were not depressed. 3. Both okadaic acid (10 microM) and cantharidin (100 microM) depolarized muscle membranes from approximately -80 to approximately -60 mV in a partially reversible and tetrodotoxin-sensitive manner. The initial short-term enhancement of twitch responses (up to approximately 40%) was correlated with the inhibitors-induced repetitive firings of muscle action potential. 4. Treatment with either agent resulted in nearly complete inhibitions of endplate potential (epp). The IC(50)s were 0.8+/-0.2 and 9+/-2 microM (n=5), respectively, for okadaic acid and cantharidin. On high frequency stimulation, the coefficient of epps was increased more than 10 fold and the extent of epp run-down during stimulations intensified from approximately 25 to approximately 75%. Analyses of presynaptic quantal releases revealed decreases in epp quantal content and the immediately available vesicle pool. 5. The frequency of miniature epp was initially elevated up to 2 fold then suppressed down to approximately 30%. The small reduction in the amplitude was antagonized when the membrane of endplate area was repolarized. 6. The data suggest that okadaic acid and cantharidin inhibit mobilizations of synaptic vesicles and depress Ca(2+) release from sarcoplasmic reticulum and that protein phosphatases participate in the modulation of motor function.

Animals↗

PubMed2000

Hydrocortisone enhances allergen-specific IgE production by peripheral blood mononuclear cells from atopic patients with high serum allergen-specific IgE levels.

BACKGROUND: Although there is convincing evidence that human B cells can be induced to produce IgE by a combination of interleukin 4 (IL-4) and hydrocortisone (HC) in atopic subjects, it is still uncertain if this performs the same functions in allergen-specific IgE synthesis. OBJECTIVE: This study was designed to investigate the differences of IgE regulation between atopics and nonatopics, interactions of HC with IL-4, and the correlation between in vitro total IgE, allergen-specific IgE synthesis and serum IgE levels. METHODS: Peripheral blood mononuclear cells (PBMCs) from 16 atopic asthma patients sensitive to Dermatophagoides farinae and seven nonatopic controls were cultured with IL-4 and/or HC. Total IgE and D. farinae-specific IgE in culture supernatant were measured by ELISA and FAST. RESULTS: IL-4 increased total IgE synthesis in PBMCs from both atopics and nonatopics, whereas, HC had this effect only in some atopics who showed spontaneous IgE production in vitro. HC acted synergistically with IL-4 in total IgE synthesis. Their effects were more remarkable in cases with lower total serum IgE levels. PBMCs from eight of 16 atopics produced D. farinae-specific IgE in vitro either spontaneously or by IL-4 and/or HC. HC had more profound effects than IL-4 in these patients. They also showed higher total IgE synthesis by HC, and higher specific serum IgE levels than the others. IL-4 and/or HC did not induce any D. farinae-specific IgE synthesis by PBMCs from nonatopics. CONCLUSION: HC had a more profound effect than IL-4 on the induction of D. farinae-specific IgE synthesis in atopic patients with high serum allergen specific IgE levels. Further studies to determine the causes of these effects, such as the presence of long lived allergen specific B cells as the result of the priming effect of IL-4 in vivo, may be needed.

Adolescent↗

PubMed2000

Transthoracic echocardiographic demonstration of massive pulmonary thrombus caused by protein C deficiency.

Few cases of pulmonary embolism detected by transthoracic echocardiography (TTE) have been reported. We present a case of a patient affected by pulmonary embolism caused by protein C deficiency. Transthoracic echocardiography showed a thrombus in transit (ie, visualization of a thrombus within the pulmonary artery). A hypercoagulable state caused by deficiency of protein C is a rare cause of pulmonary thromboembolism. Our experience demonstrates a massive pulmonary thrombus resulting from such a deficiency. Transthoracic echocardiography should be considered as the first diagnostic method for patients with suspected pulmonary embolism.

Adult↗

PubMed2000

Change of calcium and cAMP concentration by adrenoceptor agents in cultured porcine corneal endothelial cells.

It has been reported that beta-adrenergic receptors are localized in the corneal endothelial cells. In this study, the change of cellular signal transduction, such as intracellular calcium and cAMP, was determined with pure adrenergic agonists and commercial antiglaucoma adrenergic agents. The intracellular calcium of cultured porcine corneal endothelial cells was inhibited by 10 microM isoproterenol and norepinephrine, but enhanced by propranolol and 50 mM KCl. In the case of phenylephrine, calcium mobility did not alter significantly. Verapamil, at 10 microM, decreased intracellular calcium concentration. In the presence of isoproterenol, cellular cAMP concentration increased from 28.8 pmole/mg protein (1 microM) to 42.2 pmole/mg protein (100 microM) compared with control of 6.07 pmole/mg protein. Incubation with commercial adrenergic eye drops, such as betaxolol, caused the cAMP concentration to increase from 21.6 pmole/mg protein (0.0005%) to 39.1 pmole/mg protein (0.05%). Adding commercial levobunolol and timolol into cells caused cellular cAMP to increase from 14.3 pmole/mg protein (0.0005%) to 840.5 pmole/mg protein (0.05%) and from 115.2 pmole/mg protein (0.00025%) to 931.0 pmole/mg protein (0.025%), respectively. However, the preservative, benzalkonium chloride, increased cellular cAMP from 15.4 pmole/mg protein (0.00001 mg/ml) to 1087.4 pmole/mg protein (0.01 mg/ml). It is concluded that the intracellular calcium of corneal endothelium decreases when the cellular adrenergic receptor is activated by agonists. Benzalkonium chloride, due to its preservative in commercial antiglaucoma agents which increases cellular cAMP, may alter corneal endothelial physiology through long-term use.

Adrenergic Agonists↗

PubMed2000

Expressions of human sodium iodide symporter mRNA in primary and metastatic papillary thyroid carcinomas.

The sodium iodide symporter (NIS) is a plasma membrane protein that is responsible for iodide transport into thyroid cells. To understand the regulation and expression of human NIS (hNIS) in papillary thyroid carcinomas, we evaluated the expression levels of hNIS mRNA in primary and lymph node metastatic papillary carcinoma tissues. The correlation of mRNA levels between hNIS and thyroid-specific genes, thyrotropin (TSH) receptor, and thyroglobulin (Tg), were also investigated. Twenty-three cases of papillary carcinoma and 7 pairs of primary and lymph node metastastic tissues were included in this study. We measured the expression levels of hNIS, TSH receptor, and Tg mRNAs by semiquantitative reverse transcription-polymerase chain reaction (RT-PCR) and RNase protection assay (RPA). The levels of hNIS mRNA in lymph node metastatic tissues were evaluated by RT-PCR. By semiquantitative RT-PCR, 87% of papillary carcinoma (20/23) expressed hNIS mRNA, but the degrees of expression were variable and were lower than those of normal thyroid tissues. The decreased expression of hNIS mRNA in papillary carcinoma compared to normal thyroid tissue was also noticed by RPA. All 23 papillary carcinomas in this study showed the expression of TSH receptor and Tg mRNAs. The levels of TSH receptor mRNA were again lower in papillary thyroid carcinomas than in normal controls. The level of hNIS mRNA was correlated with the levels of TSH receptor (r = 0.449, p < 0.05), but not with Tg mRNA. In addition, significant correlation of mRNA level was observed between TSH receptor and Tg (r = 0.706, p < 0.01). Two of six lymph node metastatic tissues did not show hNIS mRNA even with significant hNIS expressions in papillary carcinoma tissues in thyroid. The levels of hNIS expression of the remaining four lymph node metastatic tissues were lower than those of corresponding primary tissues. Interestingly, one case showed no hNIS expression in primary tissue, but significant hNIS expression in lymph node metastatic tissue. No correlation was found in hNIS mRNA expression between primary and lymph node metastatic tissues. Our results suggest that the measurements of hNIS mRNA level in primary tissues may not predict the therapeutic response to radioactive iodine.

Adult↗

PubMed2000

A human case of Stellantchasmus falcatus infection in Korea.

In an attempt to find the worm producing unidentified egg, one minute fluke was collect from a Korean patient after praziquantel administration. The fluke was identified to be Stellantchasmus falcatus by the expulsor. Brackish water fish was suggested to be a probable source of the infection.

Aged↗

PubMed2000

A case of chronic cerebral paragonimiasis westermani.

We report a chronic cerebral paragonimiasis from a 41-year-old Korean man who complains a headache and weakness of left motor neuron components. Magnetic resonance images of the brain revealed conglomerates of multiple ring-like enhancements in temporo-occipital and frontal lobes of the right hemisphere. An intradermal test for paragonimiasis westermani was positive. The patient was born near an endemic area of paragonimiasis and used to eat boiled or grilled freshwater crayfish in his childhood. Nodules in the brain were resected through craniotomies. The eggs of P. westermani were identified pathologically and parasitologically in the calcified necrotic lesions. Examinations on sputum and fecal specimens for the eggs of P. westermani were shown to be negative and a chest radiograph was normal. It is presumed that the brain lesions were formed by P. westermani approximately 30 years ago.

Adult↗

PubMed2000

Recurrent asystoles associated with vasovagal reaction during venipuncture.

A 17-year-old high school student presented with a history of habitual faintings. On 24-hour Holter monitoring, cardiac asystoles were recorded, the longest lasting approximately 7 or 8 seconds during venipuncture procedures. The asystole associated with venipuncture demonstrated the cardioinhibitory effects of vasovagal reaction with blood-injury phobia. He also had a positive response during head-up tilt test showing hypotension and relative bradycardia after intravenous isoproterenol injection. After administration of oral beta blocker, he did not show further or recurrent cardiac asystole during blood injury procedure on electrocardiographic examination. Venipuncture is the most common invasive medical procedure performed in hospital settings. While venipuncture is considered to be reasonably safe, serious complication may occur even when only a small volume of blood is withdrawn. Therefore, medical personnel should be prepared to provide appropriate care.

Adolescent↗

PubMed2000

Reduction of neuronal damage in ischemic stroke using a combination therapy of TMB-8 with L-arginine.

Treatment with a combination of a calcium antagonist TMB-8 and NO donors, L-arginine and N alpha-benzoyl-L-arginine ethyl ester (BAEE) to prevent experimental ischemic stroke were studied in rats through the permanent occlusion of the middle cerebral artery and common carotid artery for 60 minutes. When the animals were treated with TMB-8, L-arginine, BAEE or NO synthetase inhibitor, nitro-L-arginine at time 0 of ischemia, the areas of neuronal necrosis were reduced by 98%, 99%, 99% and 89%, respectively. When these compounds were administered at 6 hrs after ischemia, the areas of neuronal necrosis were reduced by 91%, 96%, 86% and 81%, respectively. When TMB-8, L-arginine, BAEE or nitro-L-arginine were administered at 24 hours after ischemia, the necrosis areas were reduced less effectively by 80%, 89%, 77% and 60%, respectively. A combination with TMB-8 and L-arginine at time 0, 6 or 24 hr after ischemia resulted in the areas of necrosis being reduced by 99%, 99%, and 89%, respectively. Treatment with the combination of TMB-8 and BAEE at time 0, 6 or 24 hrs after ischemia, resulted in the areas of necrosis being reduced by 99%, 96%, and 82%, respectively. When the drugs were administered at 0 hr of ischemia, L-arginine, BAEE and nitro-L-arginine increased NO synthase activity in the ischemic cortex from 369 +/- 27 of ischemic control to 614 +/- 39, 511 +/- 32 and 406 +/- 16 respectively 1 days after stroke. TMB-8 was a potent agent in reducing intracellular calcium from the base line and blocking the elevation of calcium induced by KCl. The spectrin proteolysis protein, a calcium-activated proteolysis protein was also inhibited by TMB-8 in the ischemic cortex. These results indicated that a combination of TMB-8 and L-arginine is more effective in treating ischemic stroke by simultaneously reducing calcium-activated proteolysis and improving of cerebral blood flow than using TMB-8 or L-arginine alone.

Animals↗

PubMed2000

Regulation of tyrosine hydroxylase gene transcription by the cAMP-signaling pathway: involvement of multiple transcription factors.

The conversion of L-tyrosine to 3,4-dihydroxy-L-phenylalanine by tyrosine hydroxylase (TH) is the first and rate-limiting step in biosynthesis of catecholamine neurotransmitters. TH gene expression is regulated in a cell type-specific and cAMP-dependent manner. Evidence from this laboratory and others indicates that the cAMP response element (CRE), residing at -45 to -38 bp upstream of the transcription initiation site, is essential for both basal and cAMP-inducible transcription of the TH gene. To understand the control mechanisms of TH gene transcription in greater detail, we sought to identify and characterize the transcription factors involved in recognition and activation of the CRE of the TH gene. Remarkably, electrophoretic mobility shift assay and antibody supershift experiments indicated that all three major CRE-binding protein factors, i.e. CREB, ATF1, and CREM, may participate in forming specific DNA/protein complexes with the CRE of the TH gene. To address the transcriptional activation function of individual factors, we replaced the TH CRE with a GAL4-binding site and cotransfected this modified TH promoter-reporter gene with an effector plasmid that encodes GAL4-fused transcription factor. Our results indicate that CREB but not ATF1 can support basal promoter activity while both can robustly induce the promoter activity in response to co-expression of the catalytic subunit of cAMP-dependent protein kinase (PKA). We further show that the coactivator CBP up-regulates PKA-mediated activation of the TH promoter and, if tethered to the TH promoter by a GAL4-fusion, can robustly transactivate the TH promoter even in the absence of PKA. Collectively, our results suggest that multiple CRE-binding factors interact with the CRE and regulate, in conjunction with the coactivator CBP, the transcriptional activity of the TH gene.

Activating Transcription Factor 1↗

PubMed2000

Effects of crude drugs on glucose uptake in 3T3-L1 adipocytes.

In this study, various water-extracted crude drugs from Radix Asparagi, Radix Ginseng, Radix Scutellariae, Cortex Lycii Radicis, Cortex Phellodendri and Radix Ophiopogonis were investigated in their effects on [3H]-2-deoxyglucose uptake in 3T3-L1 adipocytes. Following treatment of cells with various crude drugs for 60 mim, the basal [3H]-2-deoxyglucose uptake in cultured 3T3-L1 cells was changed by Radix Asparagi from 140 pmole/min/mg protein of control to 513 (0.1 mg/ml), 201 (1 mg/ml) and 97 (10 mg/ml). Glucose uptake was changed to 324 (0.1 mg/ml), 146 (1 mg/ml) and 46 (10 mg/ml) with Radix Ginseng. In the presence of Radix Scutellariae, glucose uptake was changed to 215 (0.1 mg/ml), 213 (1 mg/ml) and 34 (10 mg/ml). In the presence of Cortex Lycii Radicis, glucose uptake was 230 (0.1 mg/ml), 188 (1 mg/ml) and 38 (10 mg/ml). In the case of Cortex Phellodendri and Radix Ophiopogonis, uptake was changed to 142 (0.1 mg/ml), 132 (1 mg/ml), 24 (10 mg/ml) and 489 (0.1 mg/ml), 374 (1 mg/ml), 344 (10 mg/ml), respectively. In insulin-stimulated cells, the [3H]-2-deoxyglucose uptake was changed by Radix Asparagi from 570 pmole/min/mg protein of the control to 816 (0.1 mg/ml), 674 (1 mg/ml) and 532 (10 mg/ml). After incubation with Radix Ginseng, the glucose uptake was changed to 254 (0.1 mg/mi), 123 (1 mg/mi) to 76 (10 mg/mi). In the presence of Radix Scutellariae, the glucose uptake was changed to 315 (0.1 mg/ml), 265 (1 mg/ml) and 33 (10 mg/ml). After incubation of Cortex Lycii Radicis, the uptake activity was changed to 281 (0.1 mg/ml), 248 (1 mg/ml) and 37 (10 mg/ml). In the case of Cortex Phellodendri and Radix Ophiopogonis, the activity of glucose uptake was measured as 747 (0.1 mg/ml), 523 (1 mg/ml), 33 (10 mg/ml) and 753 (0.1 mg/ml), 740 (1 mg/ml), and 421 (10 mg/ml), respectively. These results indicate that the water-extracted materials of Radix Asparagi and Radix Ophiopogonis increase the glucose uptake in basal and insulin-stimulated 3T3-L1 adipocytes.

3T3 Cells↗

PubMed1999

Purification of granulin-like polypeptide from the blood-sucking leech, Hirudo nipponia.

A cysteine-rich (approximately 20%), low molecular weight (MW 6 kDa) polypeptide has been isolated from the Korean blood-sucking leech, Hirudo nipponia. From its amino acid composition and N-terminal amino acid sequence analysis, the new protein is similar to granulin (or epithelin), and so it has been named leech granulin. The leech granulin behaved as a thrombin inhibitor in the purification steps of size-exclusion, ion-exchange, chromatofocusing, and reverse-phase high-performance liquid chromatography. The leech granulin is an acidic peptide (pI 3.75) containing high cysteine residues with a unique sequence similar to granulins or epithelins isolated from other organisms. For the first time, a granulin-like polypeptide having thrombin inhibitory activity has been isolated from a leech species.

Amino Acid Sequence↗

PubMed1999

Comparison of fatty acid profiles in the serum of patients with prostate cancer and benign prostatic hyperplasia.

OBJECTIVE: The role of dietary fatty acids (FAs) in benign and malignant prostatic diseases was investigated by comparing the composition value of serum fatty acids in the normal controls, and patients with prostate cancer (PC) and benign prostatic hyperplasia (BPH). Also, to estimate a possible association between PC risk and PUFAs, omega-3, omega-6 and omega-3/omega-6 FA composition ratios were compared among these groups. METHODS: Serum samples were obtained from 24 BPH and 19 PC patients, and from 21 age-matched normal male subjects. The serum concentration of 21 fatty acids was determined using gas chromatography/mass spectrometry. RESULT: The proportional values of saturated fatty acids (SFAs) groups demonstrated no specific difference between the control subjects and the patients. In the polyunsaturated fatty acids (PUFAs), we found that the omega-3 PUFAs level was significantly decreased in patient with BPH and PC and that the omega-6 PUFAs level was increased in PC only. The ratio of omega-3/omega-6 PUFAs decreased in the following order of normal, BPH, and PC. CONCLUSION: It was proposed that the changed composition level of PUFAs including omega-3 and omega-6 PUFAs have certain relationship with both prostatic diseases. Therefore, the ratio of omega-3/omega-6 PUFAs also may have an important association with the benign and malignant status of prostatic disease.

Case-Control Studies↗

PubMed1999

Mini-detachable snare ligation for the treatment of esophageal varices.

BACKGROUND: We manufactured and studied the usefulness of a newly designed mini-detachable snare in the treatment of esophageal varices. The use of a multiple rubber band ligator, although generally effective and well tolerated, has certain limitations, including high cost, reduced visual field, and inadvertent band release. METHODS: We performed a prospective randomized controlled trial of the use of mini-detachable snare ligation vs. multiple band ligation in patients with recent or active esophageal variceal bleeding. The outcomes assessed were immediate hemostasis and rates of recurrent bleeding, eradication, and recurrence. RESULTS: From March 1997 to October 1998, 103 patients were entered into this trial; 46 underwent mini-detachable snare ligations and 57 multiple band ligations. Among patients with active bleeding, hemostasis was achieved in 6 of 7 (86%) in the mini-detachable snare ligation group and 11 of 13 (85%) in multiple band ligation group. Recurrent bleeding after initial treatment occurred in 2 of 46 (5.5%) in the mini-detachable snare ligation group and 3 of 57 (5.3%) in the multiple band ligation group. Esophageal varices were eradicated or reduced to grade I in 4.8 +/- 2.1 and 4.5 +/- 1.9 sessions in the mini-detachable snare ligation group and multiple band ligation group, respectively. The recurrence rate was 5 of 46 (11%) and 6 of 57 (11%) in the mini-detachable snare ligation group and multiple band ligation group during a follow-up period of 6 and 16 months, respectively. No serious complication occurred in either group. CONCLUSION: The mini-detachable snare is a new device that provides safe and effective treatment for esophageal varices that is comparable to multiple band ligation.

Adolescent↗