Bilateral Oculomotor Nerve Palsy after Head Trauma: A Case Report

( Hae Won Noh ),( Jae Young Song ),( Jong Hyun Kim ),( Jang Hun Kim ) 대한외상학회 2017 大韓外傷學會誌 Vol.30 No.2

We introduce a patient who was suffered from isolated traumatic bilateral oculomotor nerve palsy after head trauma. The patient presented with bilateral ptosis and abnormal pupilary responses with slightly drowsy mentality at first. Performed images demonstrated some hematomas along subarachnoid, intraventricular, subdural spaces and multiple small supratentorial contusions. There was no bony abnormality or ligament injury. We assumed that small amount of interpeduncular hematoma might be the proper lesion associated with oculomotor nerve palsies, since the clinical symptom and signs presented bilaterally and the oculomotor neural fascicles run through the interpeduncular fossa. [ J Trauma Inj 2017; 30: 66-69 ]

Orthopaedic Manifestations of Arthrogryposis-Renal Dysfunction-Cholestasis Syndrome

Jang, Woo Young,Cho, Tae-Joon,Bae, Jung Yun,Jung, Hae Woon,Ko, Jae Sung,Park, Moon Seok,Yoo, Won Joon,Chung, Chin Youb,Seo, Jeong Kee,Choi, In Ho Lippincott Williams Wilkins, Inc. 2011 Journal of pediatric orthopedics Vol.31 No.1

BACKGROUND: Arthrogryposis-Renal dysfunction-Cholestasis (ARC) syndrome (MIM♯208085) is a rare multisystem disorder, which involves the kidney, liver, skin, and central nervous and musculoskeletal systems. It is inherited as an autosomal-recessive trait, associated with germ-line mutations in the VPS33B gene. In this study, the authors reviewed the orthopaedic manifestations of ARC syndrome. MATERIALS: Ten patients diagnosed as having ARC syndrome were the subjects of this study. ARC syndrome was confirmed by mutation analysis in 8 of the 10 patients. Medical records and radiographs were retrospectively reviewed with a focus on musculoskeletal manifestations. RESULTS: Seven patients either expired at 4 to 19 months of age or were presumed to have expired. The remaining 3 patients remained alive at the time of writing this manuscript and were aged from 7 to 23 months. All patients showed musculoskeletal symptoms and/or signs, which included vertical talus (7 feet, 4 patients), pes calcaneovalgus (4 feet, 3 patients), hip dislocation (6 hips, 3 patients), pathologic fractures (5 fractures in 5 patients), and rigid kyphosis (2 patients). No surgical intervention was performed. Orthopaedic treatments, other than fracture management, were abandoned soon after diagnoses were made. CONCLUSIONS: ARC syndrome should be included in the differential diagnosis of arthrogryposis. As there is no specific effective treatment for renal dysfunction and cholestasis, orthopaedic intervention should be postponed until long-term survival is expected, though this is unlikely. LEVEL OF EVIDENCE: Level IV, diagnostic studies, case series.

The Role of Spleen Volume in Predicting Portal Hyper-tension in Patients with Cirrhosis

( Hae Won Yoo ),( Sang Gyune Kim ),( Young Seok Kim ),( Jeongju Yoo ),( Jae Woo Park ),( Yong Seok Lim ),( Jae Myeong Lee ),( Gab Jin Cheon ),( Jae Young Jang ),( Young Don Kim ),( Soung Won Jeong ),( 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: It is already well known that the size of the spleen increases as liver cirrhosis aggravates. However, there is few studies for establishing the correlation between portal hypertension and spleen volume (SV). In this study, we aimed to see the relationship between the splenic volume and hepatic venous wedge pressure (HVPG) and to find what determine the portal pressure. Methods: From May 2007 to February 2018, 337 cirrhotic patients who measured SV and HVPG simultaneously were included. SV was measured based on the ellipsoid volume calculation formula by measuring length, height, and width. Other clinical and biochemical factors which may contribute to increase portal pressure were also collected. Results: Mean HVPG was 14.2 ± 5.3 and Child-pugh class A, B, and C patients were 34%, 40%, and 16%, respectively. A significant positive correlation was noted between splenic volume and HVPG levels (r=0.127, P=0.019). Below 16mmHg of HVPG, the stronger correlation was noted between them (r=0.202, P=0.003) but this relation was not observed above 16mmHg of HVPG. We divided HVPG into various stages of portal hypertension(HVPG<5, 5≤HVPG<10, 10≤HVPG<16, HVPG≥16). The average spleen volume of each group tended to increase with increasing HVPG value. Mean splenic volume for each group was 320.74cm3, 464.78 cm3, 501.06 cm3, 525.94 cm3 respectively. But there was no significant difference in the mean spleen volume between the groups., HVPG was correlated with presence of ascites (P=0.038) as well as SV (P=0.043) after adjusted by MELD, Na, albumin, platelet count. Conclusions: The spleen volume tended to increase with increasing HVPG and this association was stronger when HVPG was below 16 mmHg. More studies with larger numbers are needed to predict the portal pressure non-invasively.

Inflammatory Cytokines and the Change of Th1/Th2 Balance as Prognostic Indicators for Hepatocellular Carcinoma in Patients Treated with Transarterial Chemoembolization

( Hae Lim Lee ),( Sung Won Lee ),( Nam Ik Han ),( Sun Hong Yoo ),( Jung Hyun Kwon ),( Soon Woo Nam ),( Jeong Won Jang ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Hepatocellular carcinoma (HCC) usually develops in chronically inflamed or cirrhotic liver, suggesting that immune status can largely influence the behavior of HCC. This study evaluated the role of circulating regulatory T cells, T cell cytokines, and the change in Th1/Th2 cytokine ratio as prognostic markers for HCC. Methods: This study included a total of 206 newly diagnosed HCC patients treated with transarterial chemoembolization (TACE) between 2011 and 2012. We used cytometric bead immunoassays to measure 13 cytokines (IL-12p70, IFN-γ, IL-17A, IL-2, IL-10, IL-9, IL-22, IL-6, IL-13, IL-4, IL-5, IL-1b and TNF-α, n=167) and regulatory T cells (CD4+CD25+ T cell and CD4+CD25+FoxP3+ T cell, n=147) at the time of HCC diagnosis. The follow-up cytokine values measured before 2^nd TACE were available in 77 patients. Results: The proportions of detectable IL-4 and IL-6 were significantly higher in patients with Child-Turcotte-Pugh class B or C than with A (p=0.002, p< 0.001, respectively). In regard to tumor characteristics, patients with large ( > 5cm), multiple tumors or portal vein thrombosis (PVT) had significantly higher proportions of detectable IL-6 levels (p<0.001, p=0.010, p<0.001, respectively), whereas those with extrahepatic metastasis had significantly lower proportion of detectable IL-17A (p=0.018). Patients with increased IL-1/IL-10 ratio at the time of diagnosis and before 2^nd TACE had significantly longer survival than the patients with decreased IL-1/IL-10 ratio (p=0.043) or no change in cytokine levels. Additionally, patients with increased IFN-γ /IL-10 ratio had longer survival than those without (p=0.050). Overall, the association of the interval increase in Th1/Th2 ratios with favorable outcome was more apparent when compared with those with the decreased Th1/Th2 ratios. In multivariate analysis, CTP class B or C, presence of PVT, extrahepatic metastasis, and higher IL-6 levels were independently predictive of poor overall survival. Conclusions: This study suggests that circulating IL-6 acts as an indicator of unfavorable outcome of HCC. A shift toward increased Th1 response among CD4 T cell subsets after treatment could exert favorable immunological effects on HCC prognosis.

Paraquat Induces Apoptosis through a Mitochondria-Dependent Pathway in RAW264.7 Cells

Jang, Yeo Jin,Won, Jong Hoon,Back, Moon Jung,Fu, Zhicheng,Jang, Ji Min,Ha, Hae Chan,Hong, SeungBeom,Chang, Minsun,Kim, Dae Kyong The Korean Society of Applied Pharmacology 2015 Biomolecules & Therapeutics(구 응용약물학회지) Vol.23 No.5

Paraquat dichloride (N,N-dimethyl-4-4'-bipiridinium, PQ) is an extremely toxic chemical that is widely used in herbicides. PQ generates reactive oxygen species (ROS) and causes multiple organ failure. In particular, PQ has been reported to be an immunotoxic agrochemical compound. PQ was shown to decrease the number of macrophages in rats and suppress monocyte phagocytic activity in mice. However, the effect of PQ on macrophage cell viability remains unclear. In this study, we evaluated the cytotoxic effect of PQ on the mouse macrophage cell line, RAW264.7 and its possible mechanism of action. RAW264.7 cells were treated with PQ (0, 75, and $150{\mu}M$), and cellular apoptosis, mitochondrial membrane potential (MMP), and intracellular ROS levels were determined. Morphological changes to the cell nucleus and cellular apoptosis were also evaluated by DAPI and Annexin V staining, respectively. In this study, PQ induced apoptotic cell death by dose-dependently decreasing MMP. Additionally, PQ increased the cleaved form of caspase-3, an apoptotic marker. In conclusion, PQ induces apoptosis in RAW264.7 cells through a ROS-mediated mitochondrial pathway. Thus, our study improves our knowledge of PQ-induced toxicity, and may give us a greater understanding of how PQ affects the immune system.

Determination of Citrulline in Watermelon (Citrullus vulgaris) Lines

Jang Won Kim,Bing Tian Zhao,Hae Ik Rhee 한국응용생명화학회 2008 Applied Biological Chemistry (Appl Biol Chem) Vol.51 No.5

Extending the shelf life of kimchi with Lactococcus lactis strain as a starter culture

Jang, Ja-Young,Lee, Mo Eun,Lee, Hae-Won,Lee, Jong-Hee,Park, Hae Woong,Choi, Hak-Jong,Pyun, Yu-Ryang,Kim, Tae-Woon Springer-Verlag 2015 Food Science and Biotechnology Vol.24 No.3

S-19 : Colonic Intramural Hematoma After Argon Plasma Coagulation

( *hae Min Yang ),( Hyun Woo Park ),( Se Young Jang ),( Sun Young Ahn ),( Hyun Seok Lee ),( Soo Young Park ),( Won Young Tak ),( Young Oh Kweon ),( Sung Kook Kim ),( Chang Min Cho ),( Min Kyu Jung ),( 대한내과학회 2013 대한내과학회 추계학술대회 Vol.2013 No.1

Argon plasma coagulation (APC) is a noncontact endoscopic method of hemostasis achieving coagulation without physical contact of APC probe with tissues. APC was first developed for surgical interventions but has been introduced to endoscopic procedures since 1991. It is currently used for the management of bleeding caused by varices, ulcers and vascular ectasias as well as for ablation of Barret`s esophagus, remnant adenomatous tissues after polypectomy and debulking malignant tumors. It is the most preferred method to manage angiodysplasia owing to its ease of application, minimum depth of thermal effects and speedy treatment for wide areas. It is known to be an effective method of hemostasis to treat colonic angiodysplasia and complication rates are also low when it is performed after submucosal injection of saline. The main advantage of APC is the safety owing to minimum depth of the thermal effect but procedure-related complications such as pneumoperitoneum, perforation, subcutaneous emphysema, bleeding, stricture and pain can occur if it is inappropriately used. However, incidence of intramural hematoma is rare. There is only one reported case of intramural hematoma which developed in the stomach after argon plasma coagulation to remove residual tissues after gastric polypectomy. Herein, we report a case of colon intramural hematoma and delayed bleeding after argon plasma coagulation performed to manage bleeding secondary to colonic angiodysplasia in a 57-year old female with liver cirrhosis and end stage renal disease.

Neurofibromatosis Type 1 with Arnold Chiari Type 1 Malformation in A Child

Hae Young Ro,Seok Won Yoon,Woo Ri Jang,Young Se Kwon 대한소아신경학회 2023 대한소아신경학회지 Vol.31 No.4

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The Prediction of Liver Decompensation Using Hepatic Collagen Deposition Assessed by Computer-Assisted Image Analysis with Masson-Trichrome Stain

( Hae Won Yoo ),( Jae Woo Park ),( Jeong-ju Yoo ),( Sang-gyune Kim ),( Young Seok Kim ),( Young Chang ),( Soung Won Jeong ),( Jae Young Jang ),( Sae Hwan Lee ),( Hong Soo Kim ),( Baekgyu Jun ),( Young 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1

Aims: METAVIR staging classifies structural deformation caused by hepatic fibrosis semi-quantitatively. However, there could be disagreement of fibrosis staging by METAVIR among pathologists. Quantification of fibrosis using computer-assisted image analysis can offer relative objective information for liver fibrosis. We measured hepatic fibrosis quantitatively using collagen proportionate area (CPA) and assessed its impact on predicting the development of liver decompensation (which was defined as the presence of ascites, variceal bleeding and hepatic encephalopathy). Methods: During January 2010 to June 2018, we assessed 582 patients who got liver biopsy and computer assisted image analysis (ZEN 2.3 lite software by ZEISS) were available. Clinical and laboratory data were collected at baseline and at the time of the last follow-up or progression to liver decompensation (LD). Forty-two patients with acute hepatitis who had no underlying chronic liver disease were excluded. Results: The mean age was 45.3±13.7 years, and most common etiology of liver disease was chronic hepatitis B (28.6%) and followed by fatty liver disease (26.9%). Median follow-up duration was 37 months during which 28 out of 540 patients experienced LD. Mean analyzed dimension of collagen was 5653362±2423925 μm2 and included portal tract was 8.9±3.9. Mean CPA was 8.91±7.10%. A positive correlation between CPA and liver fibrosis stage was observed (r=0.553, P<0.001) (Figure 1). Albumin at baseline (HR: 0.257, 95% CI: 0.094- 0.701, P=0.008), CPA (HR: 1.107 per 1% increase, 95% CI: 1.059-1.157, P<0.001), presence of diabetes mellitus (HR: 4.315, 95% CI: 1.063-17.510, P=0.041), and presence of alcoholic hepatitis (reference : chronic hepatitis B) (HR : 5.811, CI : 1.351-24.987, P=0.018) were independent predictors of liver decompensation on multivariate Cox-regression analysis. The concordance indices of CPA and METAVIR stage for progression to LD were 0.803±0.044 and 0.758±0.041, respectively, without significant difference. When dividing patients with calculating cut-point with maximally selected rank difference, higher CPA (≥16.6%) predicts LD better than lower CPA (Logrank test: P<0.001) (Figure 2). Conclusions: The CPA correlates very well with the METAVIR stage of liver fibrosis and also is an independent predictor of clinical outcomes in liver disease. It is expected to be useful quantitative determination of liver fibrosis and prognosis.