80 results on '"Hyung Sub Park"'
Search Results
2. Capmatinib suppresses LPS-induced interaction between HUVECs and THP-1 monocytes through suppression of inflammatory responses
- Author
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Hyung Sub Park, A.M. Abd El-Aty, Ji Hoon Jeong, Taeseung Lee, and Tae Woo Jung
- Subjects
Capmatinib ,Inflammation ,PPAR delta ,IL-10 ,HUVEC ,THP-1 ,Medicine (General) ,R5-920 ,Biology (General) ,QH301-705.5 - Abstract
Background: Capmatinib (CAP) is a drug that has been used to treat non-small cell lung cancer (NSCLC) in adults. Presently, its novel effects on skeletal muscle insulin signaling, inflammation, and lipogenesis in adipocytes have been uncovered with a perspective of drug repositioning. However, the impact of CAP on LPS-mediated interaction between human umbilical vein endothelial cells (HUVECs) and THP-1 monocytes has yet to be investigated. Methods: HUVECs and THP-1 monocytes were treated with LPS and CAP. The protein expression levels were determined using Western blotting. Target protein knockdown was conducted using small interfering (si) RNA transfection. Interactions between HUVECs and THP-1 cells were assayed using green fluorescent dye. Results: This study found that CAP treatment ameliorated cell adhesion between THP-1 monocytes and HUVECs and the expression of adhesive molecules, such as intracellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and E-selectin. Moreover, phosphorylation of inflammatory markers, such as NFκB and IκB as well as TNFα and monocyte chemoattractant protein-1 (MCP-1) released from HUVECs and THP-1 monocytes, was prevented by CAP treatment. Treatment with CAP augmented PPARδ and IL-10 expression. siRNA-associated suppression of PPARδ and IL-10 abolished the effects of CAP on cell interaction between HUVECs and THP-1 cells and inflammatory responses. Further, PPARδ siRNA mitigated CAP-mediated induction of IL-10 expression. Conclusion: These findings imply that CAP improves inflamed endothelial-monocyte adhesion via a PPARδ/IL-10-dependent pathway. The current study provides in vitro evidence for a therapeutic approach for treating atherosclerosis.
- Published
- 2023
- Full Text
- View/download PDF
3. The use of polytetrafluoroethylene graft for damaged renal artery in ABO-incompatible living donor kidney transplantation: a case report
- Author
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Won-Bae Chang, Young-Heun Shin, Hyung Sub Park, Dong-Hwan Kim, and Taeseung Lee
- Subjects
living donor ,kidney transplantation ,renal artery ,polytetrafluoroethylene ,Medical technology ,R855-855.5 - Abstract
Short donor renal vessels during donor nephrectomy represent a technical challenge. The allograft of vessels from deceased donors can be an option for reconstruction; however, cryopreserved vessels are not routinely prepared for living donor kidney transplantation (LDKT). We report a reconstruction of the damaged short renal artery (RA) in LDKT using a polytetrafluoroethylene (PTFE) graft. A 45-year-old male patient underwent ABO-incompatible LDKT from his wife. After donor nephrectomy, we detected a hematoma surrounding the proximal RA of the allograft. The injured segment of the RA was transected, and the short RA was connected to the right external artery of the recipient; however, the blood flow was interrupted by the graft location. Once the arterial anastomosis was removed, the graft was flushed with cold saline, and a PTFE graft was used for the reconstruction of the short RA. Immediate blood flow to the renal graft was excellent without sign of parenchymal infarction until fascial closure. Renal graft Doppler on postoperative day 7 and 3 months showed good blood flow. In this patient, the use of PTFE graft presented no additional morbidity to the kidney transplantation, and no postoperative complications related to its use were noted.
- Published
- 2022
- Full Text
- View/download PDF
4. Paraplegia after Open Repair of Suprarenal Abdominal Aortic Aneurysm
- Author
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Hyo Jun Kim, Hyung Sub Park, Chang Sik Shin, Jae S. Cho, and Taeseung Lee
- Subjects
paraplegia ,spinal cord ischemia ,abdominal aortic aneurysm ,Diseases of the blood and blood-forming organs ,RC633-647.5 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Spinal cord ischemia after open repair of abdominal aortic aneurysm (AAA) is an unpredictable and devastating complication. We present a case report of a patient who developed paraplegia 6 hours after open repair of suprarenal AAA. A 74-yearold man presented with asymptomatic 5.5-cm suprarenal AAA, for which he underwent open repair under general anesthesia. The paraplegia was identified 6 hours after the operation. Postoperative magnetic resonance imaging showed T2 signal hyperintensity and swelling of the spinal cord, which were consistent findings with subacute spinal cord infarction. Although intravenous steroid was administered and lumbar cerebral spinal fluid drainage was instituted, his neurological outcome did not improve. He was discharged after vigorous rehabilitation but still has paraplegia and requires wheelchair for ambulation.
- Published
- 2020
- Full Text
- View/download PDF
5. Clinical Manifestations of Symptomatic Spontaneous Dissection of the Celiac and Superior Mesenteric Arteries
- Author
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Jeong Woo Kim, Hyung Sub Park, Kyung Lim Koo, Chang Sik Shin, and Taeseung Lee
- Subjects
blood vessel dissection ,celiac artery ,superior mesenteric artery ,endovascular procedures ,Diseases of the blood and blood-forming organs ,RC633-647.5 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Purpose: Spontaneous isolated dissection of the celiac artery (SID-CA) and superior mesenteric artery (SID-SMA) are rare vascular diseases with similar presentation, yet comparative studies have not been reported. In this study, we compared their characteristics with the aim of providing insights into their etiology. Materials and Methods : : Patients diagnosed with symptomatic SID-CA and SIDSMA between July 2009 and December 2018 were included. Demographics, clinical presentation, radiologic findings, treatment strategies, and outcomes were analyzed. Results : : Twenty-one patients with SID-CA and 40 patients with SID-SMA were compared. Demographics and initial abdominal pain characteristics were similar, but pain severity was significantly higher and associated mean fasting time was significantly longer in patients with SID-CA than in those with SID-SMA (fasting time 3.2 vs 2.1 days, P=0.001). Most patients were successfully treated conservatively without recurrent pain or aneurysmal dilatation, but 33.3% patients with SID-CA and 17.5% with SID-SMA required endovascular intervention. More favorable remodeling in terms of dissection regression on follow-up computed tomography was found after stenting, where patients with SID-CA showed better remodeling than those with SID-SMA. The overall median follow-up period was 22-31 months, while for patients with stent insertion, it was 55-77 months, and no stent occlusions were found during this period. Conclusion : : Patients with SID-CA presented with severer and longer-duration abdominal pain than those with SID-SMA. Stenting in both groups showed good long-term patency and favorable remodeling, with a higher regression rate for SIDCA. Based on our results, patients with SID-CA may benefit more from active endovascular intervention.
- Published
- 2020
- Full Text
- View/download PDF
6. Clinical outcomes of the first 300 cases of kidney transplantation: a single-center retrospective cohort study
- Author
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Hyoung Won Koh, Kyunglim Koo, Chang Sik Shin, Hyung Sub Park, Jong Cheol Jeong, Sejoong Kim, Dong Wan Chae, Jong Jin Oh, Seok-Soo Byun, and Taeseung Lee
- Subjects
transplantation ,kidney transplantation ,Medical technology ,R855-855.5 - Abstract
Background : Kidney transplantation (KT) is regarded as the most effective treatment for end-stage renal disease. The annual number of KT cases in South Korea has increased rapidly as more centers are implementing a transplantation program. The objective of this study was to determine clinical outcomes of the first 300 consecutive cases of KT in a single center. Methods : Clinical data of 300 cases of KT at Seoul National University Bundang Hospital from January 2004 to March 2018 were obtained from a prospectively collected database and retrospectively reviewed. Results : The mean age of patients was 47.7±12.9 years, and 59% of patients were male. There were 225 living donors and 75 deceased donors. A total of 42 cases were from ABO-incompatible donors. During a mean follow-up of 68.6±43.5 months, 38 patients (12.7%) experienced rejection. The most common cause was acute T-cell mediated rejection (9.0%). Eighteen patients experienced graft loss. One-year and 5-year death-censored graft survival rates were 99% and 96.6%, respectively. One-year and 5-year patient survival rates were 98.3% and 96.6%, respectively. Multivariate analysis revealed that graft weight-to-recipient weight ratio and rejection were significant factors affecting graft survival. Conclusions: This single-center review demonstrates clinical outcomes comparable to other major centers. Such good outcomes were obtained by good patient selection, dedicated transplant physicians, and adequate use of immunosuppressive therapy.
- Published
- 2020
- Full Text
- View/download PDF
7. CASS (CyanoAcrylate closure versus Surgical Stripping for incompetent saphenous veins) study: a randomized controlled trial comparing clinical outcomes after cyanoacrylate closure and surgical stripping for the treatment of incompetent saphenous veins
- Author
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Sungsin Cho, Hyung Sub Park, Taeseung Lee, Seung Jae Byun, Woo-Sung Yun, Shin-Seok Yang, Hyangkyoung Kim, Woo-Shik Kim, Jin Hyun Joh, and In Mok Jung
- Subjects
Varicose vein ,Stripping ,Endovenous ablation ,Occlusion ,Quality of life ,Medicine (General) ,R5-920 - Abstract
Abstract Background Several modalities are used for the treatment of varicose veins. Open surgical treatment with ligation and stripping of the saphenous vein has been the standard of care for many years. Endovenous thermal ablation has been shown to be a safe and effective alternative with high, long-term, target-vein closure rates. Despite this, there is the possibility of thermal injury to surrounding structures. The recently introduced cyanoacrylate closure is also considered to be a good alternative and the risk of injury to surrounding structures is minimal. The purpose of this study is to demonstrate the non-inferiority of cyanoacrylate closure with the VenaSeal™ closure system compared to surgical stripping in terms of clinical outcomes for the treatment of incompetent great saphenous veins. Methods/design This is an open-label, multicenter, prospective, randomized controlled trial evaluating the non-inferior clinical outcomes of cyanoacrylate closure compared to surgical stripping for the treatment of incompetent saphenous veins. After baseline measurements, participants will be randomly allocated into either the cyanoacrylate closure group or the surgical-stripping group. The primary endpoint of the study is the complete closure rate of the target vein in the cyanoacrylate closure group, and the absence of venous reflux or residual venous tissue after surgical stripping in the surgical-stripping group. These endpoints will be measured by Doppler ultrasound performed by qualified vascular technologists or investigators at 3 months after treatment. Secondary outcomes include perioperative pain, postoperative ecchymosis, clinical assessment (including general and disease-specific quality of life evaluations), complete closure rate, and absence of venous reflux or residual venous tissue at the 12- and 24-month follow-ups, as well as all adverse event rates during the 24-month follow-up period. Discussion This multicenter randomized controlled trial is designed to show non-inferiority in terms of complete closure rate of cyanoacrylate compared to surgical stripping for the treatment of incompetent saphenous veins. Trial registration Clinical Research Information Service (CRIS), ID: KCT0003203 . Registered on 20 September 2018.
- Published
- 2020
- Full Text
- View/download PDF
8. β-aminoisobutyric acid attenuates LPS-induced inflammation and insulin resistance in adipocytes through AMPK-mediated pathway
- Author
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Tae Woo Jung, Hyung Sub Park, Geum Hee Choi, Daehwan Kim, and Taeseung Lee
- Subjects
BAIBA ,AMPK ,NFκB ,Inflammation ,Insulin resistance ,Adipocyte ,Medicine - Abstract
Abstract Background β-aminoisobutyric acid (BAIBA) is produced in skeletal muscle during exercise and has beneficial effects on obesity-related metabolic disorders such as diabetes and non-alcoholic fatty liver disease. Thus, it is supposed to prevent high fat diet (HFD)-induced inflammation and insulin resistance in adipose tissue though anti-inflammatory effects in obesity. Previous reports have also demonstrated strong anti-inflammatory effects of BAIBA. Methods We used BAIBA treated fully differentiated 3T3T-L1 mouse adipocytes to investigate the effects of exogenous BAIBA on inflammation and insulin signaling in adipocytes. Insulin signaling-mediated proteins and inflammation markers were measured by Western blot analysis. Secretion of pro-inflammatory cytokines were measured by ELISA. Lipid accumulation in differentiated 3 T3-L1 cells was stained by Oil red-O. Statistical analysis was performed by ANOVA and student’s t test. Results BAIBA treatment suppressed adipogenesis assessed by adipogenic markers as well as lipid accumulation after full differentiation. We showed that BAIBA treatment stimulated AMP-activated protein kinase (AMPK) phosphorylation in a dose-dependent manner and lipopolysaccharide (LPS)-induced secretion of pro-inflammatory cytokines such as TNFα and MCP-1 was abrogated in BAIBA-treated 3 T3-L1 cells. Treatment of 3 T3-L1 cells with BAIBA reduced LPS-induced NFκB and IκB phosphorylation. Furthermore, BAIBA treatment ameliorated LPS-induced impairment of insulin signaling measured by IRS-1 and Akt phosphorylation and fatty acid oxidation. Suppression of AMPK by small interfering (si) RNA significantly restored these changes. Conclusions We demonstrated anti-inflammatory and anti-insulin resistance effects of BAIBA in differentiated 3 T3-L1 cells treated with LPS through AMPK-dependent signaling. These results provide evidence for the beneficial effects of BAIBA not only in liver and skeletal muscle cells but also in adipose tissue.
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- 2018
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9. Early Experiences of Sandwich Technique to Preserve Pelvic Circulation during Endovascular Aneurysm Repair
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Daehwan Kim, Jung Kee Chung, Hyung Sub Park, In Mok Jung, and Taeseung Lee
- Subjects
Aortic aneurysm ,Endovascular ,Double barrel ,Sandwich ,Endovascular aneurysm repair ,Diseases of the blood and blood-forming organs ,RC633-647.5 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Purpose: To report experiences of the sandwich technique (ST) for preservation of pelvic flow during endovascular repair of complex aortic or aortoiliac aneurysms. Materials and Methods: Eight patients underwent elective endovascular aneurysm repair (EVAR) using the ST between March 2013 and February 2017. The anatomic indications for the ST were complex aortoiliac aneurysms (5 cases), abdominal aortic aneurysms (AAA) with non-diseased short common iliac arteries (2 cases) and AAA with unilateral occluded iliac artery (1 case). The ST was performed through both femoral and brachial approach. Patient clinical and radiologic data were collected and analyzed. Results: Eight patients (7 male; mean age, 73.4 years) were followed over a mean period of 277 days (range, 9–1,106 days). The technical success rate was 100%. The primary patency rate of the iliac stent-grafts was 88% (14/16 cases). One internal iliac and 1 external iliac stent-graft occlusion was observed during the early postoperative period. There was 1 gutter endoleak which disappeared spontaneously within 4 days, and there were 2 type II endoleaks: one treated by coil embolization after 13 months, and the other observed without treatment. There were no cases of sac growth or aneurysm-related deaths, and no cases of buttock claudication or impotence. Conclusion: The ST is a safe and feasible technique to preserve pelvic circulation during endovascular treatment of complex aortoiliac aneurysms. The need to expand the indications for complex EVARs with adjunctive procedures, such as the ST is highlighted in situations where branched/fenestrated device availability is limited.
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- 2017
- Full Text
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10. Use of Self-Assembling Peptides to Enhance Stem Cell Function for Therapeutic Angiogenesis
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Hyung Sub Park, Geum Hee Choi, Daehwan Kim, Tae Woo Jung, In Mok Jung, Jung Kee Chung, and Taeseung Lee
- Subjects
Internal medicine ,RC31-1245 - Abstract
The use of nanomaterials for biomedical applications has become a promising field in regenerative medicine. Self-assembling peptides (SAPs) have been proposed as a good candidate because they are able to self-assemble into stable hydrogels and interact with cells or molecules when combined together. This in turn can lead to the improved survival or action of cells or molecules to obtain the desired effects. In this study, we investigated whether the combination of mesenchymal stem cells (MSCs) with SAPs could improve angiogenesis in ischemic hindlimbs of rats compared to MSC or SAP treatment alone. The combination of MSCs and SAPs showed an overall higher expression of angiogenesis markers on fluorescent immunohistochemical analysis and a lower degree of fibrosis and cell apoptosis, which in turn led to an overall tendency for improved perfusion of the ischemic hindlimbs. Finally, SAPs also showed the ability to recruit endogenous host MSCs into the site of action, especially when modified to incorporate substance P as a functional motif, which when injected with exogenous MSCs, allowed for the dual presence of MSCs at the site of action. Overall, these results suggest that SAPs can be applied with stem cells to potentiate angiogenesis, with potential therapeutic application in vascular diseases.
- Published
- 2018
- Full Text
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11. Routine Ureteral Stenting in Kidney Transplant Reduces Postoperative Hydronephrosis and Percutaneous Ureteral Interventions: A Single-Center Experience.
- Author
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Dong-Hwan Kim, Hyung Sub Park, Ji Su Bang, Hyo Jin Shin, Byung Jun Yoon, Sejoong Kim, Jong Cheol Jeong, Seokwoo Park, and Taeseung Lee
- Published
- 2024
- Full Text
- View/download PDF
12. Technical Feasibility of Renal Artery Embolization on a Transplanted Kidney Due to Intractable Unilateral Hydronephrosis After En Bloc Kidney Transplantation: Case Report
- Author
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Dong-Hwan Kim, Hyung Sub Park, Young-Heun Shin, Chang Jin Yoon, and Taeseung Lee
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Radiology, Nuclear Medicine and imaging ,Surgery ,Cardiology and Cardiovascular Medicine - Abstract
Introduction: En bloc kidney transplantation (EBKT) is a technique used to transplant pediatric kidneys to adult recipients, but can lead to certain complications seldom found in single-kidney transplantation. We report a case of renal artery embolization after EBKT due to intractable unilateral hydronephrosis and highlight the technical details and challenges of the procedure. Case: An 18-year-old female with MELAS syndrome underwent EBKT from a 10-month-old male baby. Two months later, the patient developed unilateral hydronephrosis and recurrent urinary tract infections, which was intractable to conventional therapy. Therefore, we underwent embolization of the problematic transplanted left kidney. Owing to the complicated anatomy and multiple angulations, multiple microcatheters, wires and support catheters were needed to select the renal arteries. Repeated procedures were required due to remnant flow from small branches and accessory renal arteries that were not easily visualized by conventional angiography, which were eventually detected by adjunctive use of 3-dimensional rotational angiography. Conclusions: Selective renal artery embolization after EBKT is challenging due to the short renal artery length and multiple angulations, yet it can still be performed safely and effectively by use of meticulous catheter-wire interactions and adjunctive intraoperative imaging techniques to delineate the precise anatomy of the target arteries. Clinical Impact Selective renal artery embolization, which is less invasive than nephrectomy, can be considered if the culprit kidney must inevitably be sacrificed in en bloc kidney transplantation.
- Published
- 2023
13. Clinical Manifestations of Symptomatic Spontaneous Dissection of the Celiac and Superior Mesenteric Arteries
- Author
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Chang Sik Shin, Taeseung Lee, Kyung Lim Koo, Jeong Woo Kim, and Hyung Sub Park
- Subjects
blood vessel dissection ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,Abdominal pain ,medicine.medical_treatment ,endovascular procedures ,030204 cardiovascular system & hematology ,030230 surgery ,03 medical and health sciences ,0302 clinical medicine ,Celiac artery ,medicine.artery ,medicine ,celiac artery ,Superior mesenteric artery ,Mesenteric arteries ,lcsh:RC633-647.5 ,business.industry ,superior mesenteric artery ,Stent ,lcsh:Diseases of the blood and blood-forming organs ,Surgery ,Dissection ,medicine.anatomical_structure ,lcsh:RC666-701 ,Etiology ,Original Article ,medicine.symptom ,Presentation (obstetrics) ,Cardiology and Cardiovascular Medicine ,business - Abstract
Purpose: Spontaneous isolated dissection of the celiac artery (SID-CA) and superior mesenteric artery (SID-SMA) are rare vascular diseases with similar presentation, yet comparative studies have not been reported. In this study, we compared their characteristics with the aim of providing insights into their etiology. Materials and Methods : : Patients diagnosed with symptomatic SID-CA and SIDSMA between July 2009 and December 2018 were included. Demographics, clinical presentation, radiologic findings, treatment strategies, and outcomes were analyzed. Results : : Twenty-one patients with SID-CA and 40 patients with SID-SMA were compared. Demographics and initial abdominal pain characteristics were similar, but pain severity was significantly higher and associated mean fasting time was significantly longer in patients with SID-CA than in those with SID-SMA (fasting time 3.2 vs 2.1 days, P=0.001). Most patients were successfully treated conservatively without recurrent pain or aneurysmal dilatation, but 33.3% patients with SID-CA and 17.5% with SID-SMA required endovascular intervention. More favorable remodeling in terms of dissection regression on follow-up computed tomography was found after stenting, where patients with SID-CA showed better remodeling than those with SID-SMA. The overall median follow-up period was 22-31 months, while for patients with stent insertion, it was 55-77 months, and no stent occlusions were found during this period. Conclusion : : Patients with SID-CA presented with severer and longer-duration abdominal pain than those with SID-SMA. Stenting in both groups showed good long-term patency and favorable remodeling, with a higher regression rate for SIDCA. Based on our results, patients with SID-CA may benefit more from active endovascular intervention.
- Published
- 2020
14. Paraplegia after Open Repair of Suprarenal Abdominal Aortic Aneurysm
- Author
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Hyung Sub Park, Hyo Jun Kim, Jae S. Cho, Taeseung Lee, and Chang Sik Shin
- Subjects
medicine.medical_specialty ,lcsh:Diseases of the circulatory (Cardiovascular) system ,spinal cord ischemia ,medicine.medical_treatment ,Case Report ,030204 cardiovascular system & hematology ,030230 surgery ,Asymptomatic ,03 medical and health sciences ,0302 clinical medicine ,Lumbar ,paraplegia ,abdominal aortic aneurysm ,medicine ,cardiovascular diseases ,Rehabilitation ,medicine.diagnostic_test ,business.industry ,lcsh:RC633-647.5 ,Magnetic resonance imaging ,lcsh:Diseases of the blood and blood-forming organs ,Spinal cord ,medicine.disease ,Abdominal aortic aneurysm ,Surgery ,medicine.anatomical_structure ,lcsh:RC666-701 ,cardiovascular system ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,Complication ,Paraplegia ,business - Abstract
Spinal cord ischemia after open repair of abdominal aortic aneurysm (AAA) is an unpredictable and devastating complication. We present a case report of a patient who developed paraplegia 6 hours after open repair of suprarenal AAA. A 74-year-old man presented with asymptomatic 5.5-cm suprarenal AAA, for which he underwent open repair under general anesthesia. The paraplegia was identified 6 hours after the operation. Postoperative magnetic resonance imaging showed T2 signal hyperintensity and swelling of the spinal cord, which were consistent findings with subacute spinal cord infarction. Although intravenous steroid was administered and lumbar cerebral spinal fluid drainage was instituted, his neurological outcome did not improve. He was discharged after vigorous rehabilitation but still has paraplegia and requires wheelchair for ambulation.
- Published
- 2020
15. The outcome and risk factor of refractory T-cell–mediated rejection on renal allograft transplantation based on the Korean Organ Transplantation Registry
- Author
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Eun-Jeong Kwon, Gi-Ae Yun, Seokwoo Park, Sejoong Kim, Ho Jun Chin, Ki Young Na, Dong-Wan Chae, Hyung Sub Park, Taeseung Lee, and Jong Cheol Jeong
- Subjects
Transplantation ,Immunology - Published
- 2022
16. Clinical outcomes of the first 300 cases of kidney transplantation: a single-center retrospective cohort study
- Author
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Kyunglim Koo, Jong Cheol Jeong, Jong Jin Oh, Sejoong Kim, Taeseung Lee, Hyung Sub Park, Seok-Soo Byun, Chang Sik Shin, Dong Wan Chae, and Hyoung Won Koh
- Subjects
medicine.medical_specialty ,Multivariate analysis ,business.industry ,Retrospective cohort study ,Patient survival ,Disease ,Single Center ,medicine.disease ,Transplantation ,Internal medicine ,medicine ,Effective treatment ,business ,Kidney transplantation - Abstract
Background: Kidney transplantation (KT) is regarded as the most effective treatment for end-stage renal disease. The annual number of KT cases in South Korea has in creased rapidly as more centers are implementing a transplantation program. The objective of this study was to determine clinical outcomes of the first 300 consecutive cases of KT in a single center. Methods: Clinical data of 300 cases of KT at Seoul National University Bundang Hos pital from January 2004 to March 2018 were obtained from a prospectively collected database and retrospectively reviewed. Results: The mean age of patients was 47.7±12.9 years, and 59% of patients were male. There were 225 living donors and 75 deceased donors. A total of 42 cases were from ABO-incompatible donors. During a mean follow-up of 68.6±43.5 months, 38 patients (12.7%) experienced rejection. The most common cause was acute T-cell mediat ed rejection (9.0%). Eighteen patients experienced graft loss. One-year and 5-year death-censored graft survival rates were 99% and 96.6%, respectively. One-year and 5-year patient survival rates were 98.3% and 96.6%, respectively. Multivariate analysis revealed that graft weight-to-recipient weight ratio and rejection were significant fac tors affecting graft survival. Conclusions: This single-center review demonstrates clinical outcomes comparable to other major centers. Such good outcomes were obtained by good patient selection, dedicated transplant physicians, and adequate use of immunosuppressive therapy.
- Published
- 2020
17. Mid- to Long-Term Outcomes in Management of Spontaneous Isolated Coeliac Artery Dissection (SICAD)
- Author
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Chang Sik Shin, So Hyun Kang, Chang Jin Yoon, Hyung Sub Park, Kwon Cheol Yoo, and Taeseung Lee
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,Ischemia ,Arterial Occlusive Diseases ,030204 cardiovascular system & hematology ,030230 surgery ,Conservative Treatment ,Time-to-Treatment ,03 medical and health sciences ,Hepatic Artery ,0302 clinical medicine ,Aneurysm ,Celiac Artery ,Celiac artery ,Median follow-up ,medicine.artery ,medicine ,Humans ,Retrospective Studies ,business.industry ,Endovascular Procedures ,Middle Aged ,medicine.disease ,Thrombosis ,Surgery ,Aortic Dissection ,Dissection ,Treatment Outcome ,medicine.anatomical_structure ,Practice Guidelines as Topic ,Feasibility Studies ,Female ,Stents ,Tomography, X-Ray Computed ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies ,Rare disease ,Artery - Abstract
Objective Spontaneous Isolated Coeliac Artery Dissection (SICAD) is a rare disease with few reports of management strategies. This study reports the mid- to long-term outcomes of conservative management and endovascular intervention of SICAD treatment. Methods Sixteen patients presenting with symptomatic SICAD from September 2006 to October 2018 were reviewed retrospectively. The clinical manifestations, initial radiological findings, methods of treatment, and serial follow up studies were analysed. Results The mean age of the patients was 51.2 ± 7.9 years, with a median follow up of 33.3 (range 1.0–118.9) months. Four patients received early intervention because of aneurysmal dilatation or distal hypoperfusion. Four patients who received conservative management showed progression of disease and were recommended for delayed intervention. Although collaterals prevented further hepatic ischaemia, one of these four patients failed in delayed intervention because of extensive thrombi completely occluding the hepatic artery. In the remaining eight patients who were managed conservatively, three (37.5%) showed regression of disease, one (12.5%) showed partial regression, and five (62.5%) showed no change in intimal flap or thrombosis, but all had symptomatic improvement. The median follow up duration for the seven patients who underwent successful intervention was 77.3 (range 34.3–118.9) months, and all stenting remained patent during the follow up period. Conclusion Early intervention in symptomatic SICAD patients may be necessary in over 50% of patients, and endovascular stenting has durable long term outcomes.
- Published
- 2020
18. Capmatinib suppresses LPS-induced interaction between HUVECs and THP-1 monocytes through suppression of inflammatory responses
- Author
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Hyung Sub Park, A.M. Abd El-Aty, Ji Hoon Jeong, Taeseung Lee, and Tae Woo Jung
- Subjects
General Medicine - Abstract
Capmatinib (CAP) is a drug that has been used to treat non-small cell lung cancer (NSCLC) in adults. Presently, its novel effects on skeletal muscle insulin signaling, inflammation, and lipogenesis in adipocytes have been uncovered with a perspective of drug repositioning. However, the impact of CAP on LPS-mediated adhesion between human umbilical vein endothelial cells (HUVECs) and THP-1 monocytes has yet to be investigated.HUVECs and THP-1 monocytes were treated with LPS and CAP. The protein expression levels were determined using Western blotting. Target protein knockdown was conducted using small interfering (si) RNA transfection. Adhesion between HUVECs and THP-1 cells was assayed using green fluorescent dye.This study found that CAP treatment ameliorated cell adhesion between THP-1 monocytes and HUVECs and the expression of adhesive molecules, such as intracellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and E-selectin. Moreover, phosphorylation of inflammatory markers, such as NFκB and IκB as well as TNFα and monocyte chemoattractant protein-1 (MCP-1) released from HUVECs and THP-1 monocytes, was prevented by CAP treatment. Treatment with CAP augmented PPARα and IL-10 expression. siRNA-associated suppression of PPARδ and IL-10 attenuated the effects of CAP on cell adhesion between HUVECs and THP-1 cells and inflammatory responses. Further, PPARα siRNA mitigated CAP-mediated induction of IL-10 expression.These findings imply that CAP improves inflamed endothelial-monocyte adhesion via a PPAR/IL-10-dependent pathway. The current study provides in vitro evidence for a therapeutic approach for treating atherosclerosis.
- Published
- 2021
19. A multicenter randomized controlled trial of cyanoacrylate closure and surgical stripping for incompetent great saphenous veins
- Author
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Taeseung Lee, Sungsin Cho, Woo-Sung Yun, Shin-Seok Yang, In Mok Jung, Seung Jae Byun, Jin Hyun Joh, Hyung Sub Park, Hyangkyoung Kim, and Woo-Shik Kim
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Seoul ,Ecchymosis ,law.invention ,Varicose Veins ,Randomized controlled trial ,law ,Surveys and Questionnaires ,Varicose veins ,medicine ,Clinical endpoint ,Humans ,Saphenous Vein ,Cyanoacrylates ,Prospective Studies ,Vein ,Aged ,Pain Measurement ,Pain, Postoperative ,Ultrasonography, Doppler, Duplex ,business.industry ,Ultrasound ,Endovascular Procedures ,Middle Aged ,Vein occlusion ,Surgery ,medicine.anatomical_structure ,Treatment Outcome ,Venous Insufficiency ,Cyanoacrylate ,cardiovascular system ,Quality of Life ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Vascular Surgical Procedures - Abstract
The treatment of varicose veins has shifted from conventional surgical stripping (SS) to minimally invasive endovenous modalities. Cyanoacrylate closure (CAC) with the VenaSeal system (Medtronic, Dublin, Ireland) has increased in popularity owing to its nonthermal and nontumescent technique. The purpose of the present study was to compare the clinical outcomes of CAC and SS for the treatment of incompetent great saphenous veins.An open-label, multicenter, prospective, randomized controlled trial was conducted. The subjects were randomized to either the CAC or SS procedure. The primary endpoint of the present study was to evaluate complete closure of the target vein at 3 months. Target vein occlusion was assessed on the third day and 1, 3, 6, and 12 months postoperatively using duplex ultrasound. The pain and ecchymosis grades were also assessed. Additionally, the clinical outcomes, such as the venous clinical severity score and Aberdeen Varicose Vein Questionnaire score, were assessed.Three-month follow-up data were obtained for all 126 enrolled and randomized subjects (63 with CAC and 63 with SS). At 3 months, complete target vein closure was observed in both groups. The postoperative pain score was significantly better in the CAC group than in the SS group (0.3 ± 0.6 in the CAC group and 1.1 ± 1.5 in the SS group; P .001). In addition, the mean ecchymosis grade was 0.3 ± 0.5 in the CAC group and 1.1 ± 1.1 in the SS group (P .001). The venous clinical severity score and quality of life had improved equally in both groups. The adverse events after both procedures were mostly minor complications (9 events in CAC group and 20 events in SS group). Major complications occurred in one patient who had undergone the SS procedure.The CAC and SS procedures were both associated with complete occlusion of the target vein at 3 months. The postoperative pain and ecchymosis grades were significantly lower in the CAC group. Other differences between the two groups included the frequency and nature of the complications. The results showed that CAC has high success with few complications.
- Published
- 2021
20. Salsalate ameliorates the atherosclerotic response through HO-1- and SIRT1-mediated suppression of ER stress and inflammation
- Author
-
Tae Woo Jung, Taeseung Lee, Ji Hoon Jeong, and Hyung Sub Park
- Subjects
Lipopolysaccharides ,0301 basic medicine ,THP-1 Cells ,Immunology ,Inflammation ,Proinflammatory cytokine ,03 medical and health sciences ,0302 clinical medicine ,Sirtuin 1 ,Human Umbilical Vein Endothelial Cells ,medicine ,Salsalate ,Humans ,RNA, Small Interfering ,Cell adhesion ,Chemokine CCL2 ,Pharmacology ,Tumor Necrosis Factor-alpha ,Chemistry ,Cell adhesion molecule ,NF-kappa B ,Atherosclerosis ,Endoplasmic Reticulum Stress ,Salicylates ,Heme oxygenase ,030104 developmental biology ,030220 oncology & carcinogenesis ,Unfolded protein response ,Cancer research ,lipids (amino acids, peptides, and proteins) ,Tumor necrosis factor alpha ,medicine.symptom ,Heme Oxygenase-1 ,medicine.drug - Abstract
Inflammation plays a causative role in atherosclerosis development. Salsalate is an anti-inflammatory drug used to treat atherosclerosis, but the mechanisms by which it affects atherosclerotic progression remain unclear. Human umbilical vascular endothelial cells (HUVECs) and THP-1 human monocytes were treated with salsalate. Heme oxygenase 1 (HO-1) and sirtuin 1 (SIRT1) small interfering RNAs (siRNAs) were used to suppress each gene expression. Protein analyses were performed for measuring the expression of HO-1, SIRT1, nuclear factor kappa B (NFκB), cell adhesion molecules, and endoplasmic reticulum (ER) stress markers. Furthermore, cell adhesion assay, caspase 3 activity assay, and ELISA were also performed. In this study, we show that salsalate increases the expression of HO-1 and SIRT1 in HUVEC and suppresses lipopolysaccharide (LPS)-induced atherosclerotic responses via HO-1- and SIRT1-mediated pathways. Salsalate treatment of HUVEC and THP-1 cells reduced LPS-induced phosphorylation of NFκB and secretion of the proinflammatory cytokines TNFα and MCP-1. Salsalate treatment of HUVEC reduced the expression of the adhesion molecules ICAM, VCAM, and E-selectin and the LPS-induced adhesion of THP-1 cells to HUVEC. Salsalate treatment also attenuated LPS-induced ER stress and cell apoptosis. These anti-atherosclerotic effects were reversed by treating cells with siRNA for HO-1 and SIRT1. Salsalate ameliorates LPS-induced atherosclerotic reactions via HO-1 and SIRT1-dependent reduction of inflammation and ER stress. Activation of these pathways by salsalate may provide therapeutic strategies for treating atherosclerosis.
- Published
- 2019
21. Eugène Ionesco and The Vichy Government
- Author
-
Hyung-Sub Park
- Subjects
Government ,Political science ,Public administration - Published
- 2018
22. Re 'Mid to Long Term Outcomes in Management of Spontaneous Isolated Coeliac Artery Dissection'
- Author
-
So Hyun Kang, Hyung Sub Park, and Taeseung Lee
- Subjects
Aortic Dissection ,Celiac Artery ,Mesenteric Artery, Superior ,Humans ,Surgery ,Cardiology and Cardiovascular Medicine - Published
- 2020
23. Maresin 1 attenuates pro-inflammatory reactions and ER stress in HUVECs via PPARα-mediated pathway
- Author
-
Tae Woo Jung, Geum Hee Choi, Dong-Seok Kim, Sung Ho Ahn, Daehwan Kim, Hyung Sub Park, Taeseung Lee, and Ji Hoon Jeong
- Subjects
Lipopolysaccharides ,0301 basic medicine ,Docosahexaenoic Acids ,Lipopolysaccharide ,THP-1 Cells ,Clinical Biochemistry ,Inflammation ,Umbilical vein ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Human Umbilical Vein Endothelial Cells ,medicine ,Humans ,PPAR alpha ,Molecular Biology ,Cell adhesion molecule ,Endoplasmic reticulum ,Cell Biology ,General Medicine ,Endoplasmic Reticulum Stress ,Cell biology ,030104 developmental biology ,chemistry ,Apoptosis ,030220 oncology & carcinogenesis ,Unfolded protein response ,Peroxisome proliferator-activated receptor alpha ,medicine.symptom - Abstract
The current study was designed to investigate the therapeutic effects of Maresin 1 (MAR1) on atherosclerotic response. Human monocytes THP-1 and human umbilical vein endothelial cells (HUVECs) were used to investigate the effects of MAR1 on lipopolysaccharide (LPS)-induced inflammation and apoptosis. In this study, we found that MAR1 induces peroxisome proliferator-activated receptor alpha (PPARα) expression. We also demonstrated that MAR1 suppresses atherosclerotic reactions caused by LPS treatment via a PPARα-dependent pathway. MAR1 treatment inhibited LPS-induced phosphorylation of nuclear factor kappa B (NF-κB) and secretion of pro-inflammatory cytokines in HUVECs and THP-1 cells. In HUVEC cells, expression of adhesion molecules and LPS-stimulated adhesion of THP-1 cells to the endothelium were significantly decreased after MAR1 treatment. Furthermore, LPS-induced endoplasmic reticulum (ER) stress and cell apoptosis was significantly decreased after MAR1 treatment of HUVECs. MAR1 also led to a dose-dependent increase in oxygen-regulated protein 150 (ORP150) expression which is responsible for the inhibition of ER stress. Notably, all of the pro-atherosclerotic effects were completely abrogated by treatment with small interfering (si) RNA targeting PPARα. In conclusion, MAR1 ameliorates LPS-induced atherosclerotic reactions via PPARα-mediated suppression of inflammation and ER stress.
- Published
- 2018
24. Chitinase‐3‐like protein 1 ameliorates atherosclerotic responses via PPARδ‐mediated suppression of inflammation and ER stress
- Author
-
Geum Hee Choi, Tae Woo Jung, Taeseung Lee, Ji Hoon Jeong, Hyung Sub Park, and Daehwan Kim
- Subjects
Lipopolysaccharides ,0301 basic medicine ,THP-1 Cells ,Inflammation ,030204 cardiovascular system & hematology ,Systemic inflammation ,Biochemistry ,Proinflammatory cytokine ,03 medical and health sciences ,0302 clinical medicine ,Human Umbilical Vein Endothelial Cells ,medicine ,Humans ,Chitinase-3-Like Protein 1 ,PPAR delta ,Molecular Biology ,Chemokine CCL2 ,Tumor Necrosis Factor-alpha ,Cell adhesion molecule ,Chemistry ,NF-kappa B ,Cell Biology ,Atherosclerosis ,Endoplasmic Reticulum Stress ,Cell biology ,030104 developmental biology ,Unfolded protein response ,Tumor necrosis factor alpha ,Peroxisome proliferator-activated receptor delta ,medicine.symptom - Abstract
Chitinase 3-like protein 1 (CHI3L1) is a novel biomarker of systemic inflammation. However, the effects of CHI3L1 on the progression of atherosclerosis remain to be explored. In the current study, we found that CHI3L1 induces peroxisome proliferator-activated receptor delta (PPARδ) expression, leading to a dose-dependent increase in oxygen-regulated protein 150 (ORP150) expression. We demonstrated that CHI3L1 suppresses atherosclerotic reactions caused by LPS treatment via a PPARδ-dependent pathway. Treatment of HUVECs and THP-1 cells with CHI3L1 suppressed LPS-induced phosphorylation of nuclear factor kappa B (NFκB) and secretion of proinflammatory cytokines such as TNFα and MCP-1. In HUVECs, expression of adhesion molecules and LPS-stimulated adhesion of THP-1 cells to the endothelium were significantly reduced after CHI3L1 treatment. Furthermore, LPS-induced endoplasmic reticulum (ER) stress and cell apoptosis were significantly ameliorated after treatment of HUVECs with CHI3L1. Particularly, all of the pro-atherosclerotic effects were significantly mitigated by treatment with small interfering (si) RNA for PPARδ. In conclusion, CHI3L1 ameliorates LPS-induced atherosclerotic reactions via PPARδ-mediated suppression of inflammation and ER stress.
- Published
- 2018
25. Early Experiences of Sandwich Technique to Preserve Pelvic Circulation during Endovascular Aneurysm Repair
- Author
-
Taeseung Lee, Jung Kee Chung, Daehwan Kim, In Mok Jung, and Hyung Sub Park
- Subjects
lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Endovascular aneurysm repair ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Aortic aneurysm ,0302 clinical medicine ,Occlusion ,medicine ,cardiovascular diseases ,Endovascular treatment ,Sandwich technique ,Coil embolization ,Iliac artery ,Endovascular ,lcsh:RC633-647.5 ,business.industry ,lcsh:Diseases of the blood and blood-forming organs ,medicine.disease ,Buttock claudication ,Surgery ,lcsh:RC666-701 ,Double barrel ,cardiovascular system ,Original Article ,Sandwich ,Radiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Purpose: To report experiences of the sandwich technique (ST) for preservation of pelvic flow during endovascular repair of complex aortic or aortoiliac aneurysms. Materials and Methods: Eight patients underwent elective endovascular aneurysm repair (EVAR) using the ST between March 2013 and February 2017. The anatomic indications for the ST were complex aortoiliac aneurysms (5 cases), abdominal aortic aneurysms (AAA) with non-diseased short common iliac arteries (2 cases) and AAA with unilateral occluded iliac artery (1 case). The ST was performed through both femoral and brachial approach. Patient clinical and radiologic data were collected and analyzed. Results: Eight patients (7 male; mean age, 73.4 years) were followed over a mean period of 277 days (range, 9–1,106 days). The technical success rate was 100%. The primary patency rate of the iliac stent-grafts was 88% (14/16 cases). One internal iliac and 1 external iliac stent-graft occlusion was observed during the early postoperative period. There was 1 gutter endoleak which disappeared spontaneously within 4 days, and there were 2 type II endoleaks: one treated by coil embolization after 13 months, and the other observed without treatment. There were no cases of sac growth or aneurysm-related deaths, and no cases of buttock claudication or impotence. Conclusion: The ST is a safe and feasible technique to preserve pelvic circulation during endovascular treatment of complex aortoiliac aneurysms. The need to expand the indications for complex EVARs with adjunctive procedures, such as the ST is highlighted in situations where branched/fenestrated device availability is limited.
- Published
- 2017
26. Chronological Change of the Sac after Endovascular Aneurysm Repair
- Author
-
Taeseung Lee, Hyung Sub Park, Sanghyun Ahn, Sang Il Min, Min Hyun Kim, Jongwon Ha, and Seung-Kee Min
- Subjects
medicine.medical_specialty ,Endoleak ,medicine.medical_treatment ,Technical success ,030204 cardiovascular system & hematology ,030230 surgery ,Inferior mesenteric artery ,Endovascular aneurysm repair ,03 medical and health sciences ,0302 clinical medicine ,medicine.artery ,Transarterial embolization ,medicine ,Neck diameter ,Potential risk ,business.industry ,medicine.disease ,Abdominal aortic aneurysm ,Surgery ,Original Article ,Cardiology and Cardiovascular Medicine ,business ,Sac enlargement ,Calcification - Abstract
Purpose: The purpose of this study was to evaluate the potential risk factors of type II endoleak and sac growth after endovascular aneurysm repair (EVAR) and the outcomes of secondary interventions. Materials and Methods: Ninety seven patients underwent elective EVAR for infrarenal abdominal aortic aneurysms in two tertiary centers between April 2005 and July 2013. Clinical and imaging parameters were compared among sac growth (>5 mm) and non-growth groups. Risk factors associated with sac growth and persistent type II endoleak were analyzed. The outcomes of reinterventions for persistent type II endoleak were determined. Results: Sac growth was observed in 20 cases (20.6%) and endoleak was found in 90% of them compared to 28.6% (22/77) in the non-growth group (P
- Published
- 2016
27. A. Artaud or the Prisoner of Language
- Author
-
Hyung-Sub Park
- Subjects
General Medicine - Published
- 2016
28. Spontaneous Renal Artery Dissection Complicated by Renal Infarction: Three Case Reports
- Author
-
Daehwan Kim, Taeseung Lee, Chami Im, and Hyung Sub Park
- Subjects
Abdominal pain ,medicine.medical_specialty ,Infarction ,Physical examination ,Case Report ,030204 cardiovascular system & hematology ,Kidney ,Asymptomatic ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine.artery ,Renal artery ,Medicine ,medicine.diagnostic_test ,business.industry ,Dissection ,medicine.disease ,medicine.anatomical_structure ,Endovascular procedures ,Cardiology ,Surgery ,Radiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery ,Rare disease - Abstract
Spontaneous renal artery dissection (SRAD) is a rare disease entity. The diagnosis is usually delayed because clinical presentation is non-specific. We report three cases of symptomatic SRAD complicated by renal infarction which occurred in previously healthy middle-aged male patients. They visited the hospital due to acute abdominal or flank pain. They had no specific underlying disease or trauma history. The laboratory tests and physical examination were normal. They were not suspected of having SRAD initially, but computed tomography (CT) revealed dissection of the renal artery with distal hypoperfusion leading to renal infarction. They were treated conservatively with anticoagulation and/or antiplatelets for 6 months. They had a 6-month regular follow-up with CT, where resolution was confirmed in one patient and all patients remained asymptomatic. These cases emphasize the importance of clinical suspicion of SRAD in previously healthy patients who complain of abdominal pain without specific findings on initial investigation.
- Published
- 2016
29. L’Action culturelle sous Vichy en France
- Author
-
Hyung-Sub Park
- Subjects
General Medicine - Published
- 2016
30. Successful Treatment of Life-Threatening Small Bowel Bleeding With Thalidomide After Living Donor Kidney Transplantation: A Case Report
- Author
-
Hyung Sub Park, Kwon Cheol Yoo, Taeseung Lee, Chang Sik Shin, Daehwan Kim, and Yoonjung Heo
- Subjects
Male ,medicine.medical_specialty ,Gastrointestinal bleeding ,Vital signs ,Angiogenesis Inhibitors ,Tacrolimus ,Diabetic nephropathy ,Postoperative Complications ,Refractory ,Melena ,medicine ,Living Donors ,Humans ,Kidney transplantation ,Aged ,Transplantation ,business.industry ,Middle Aged ,medicine.disease ,Kidney Transplantation ,Surgery ,Thalidomide ,medicine.symptom ,business ,Complication ,Gastrointestinal Hemorrhage ,Immunosuppressive Agents ,medicine.drug - Abstract
Gastrointestinal bleeding after kidney transplantation is a complication that can occur from immunosuppressant use. We present a case of refractory small bowel bleeding treated successfully with thalidomide after multiple failed attempts of conventional treatment. A 65-year-old male patient with diabetic nephropathy underwent living donor kidney transplantation. The surgery was uneventful, however, he developed immunosuppressant-induced melena with unstable vital signs 11 days later. There were a total of 4 bleeding episodes until the 90th postoperative day, and he received a total of 290 units of red blood cell transfusion during this period. Endoscopic clipping, transarterial embolization, and 2 surgical interventions failed to stop the bleeding. A trial of thalidomide 100 mg per day finally stopped the bleeding and the patient was discharged on the 110th postoperative day with a functioning renal graft. This case shows that thalidomide can be a safe option to treat immunosuppressant-induced refractory gastrointestinal bleeding in the setting of kidney transplantation. Additionally, this is the first case that reports the survival of a renal graft after more than 3000 mL of transfusion.
- Published
- 2019
31. Kynurenic acid attenuates pro-inflammatory reactions in lipopolysaccharide-stimulated endothelial cells through the PPARδ/HO-1-dependent pathway
- Author
-
Tae Woo Jung, Hyung Sub Park, Ji Hoon Jeong, and Taeseung Lee
- Subjects
0301 basic medicine ,Lipopolysaccharides ,Lipopolysaccharide ,Endothelium ,THP-1 Cells ,medicine.medical_treatment ,030209 endocrinology & metabolism ,Inflammation ,Apoptosis ,Kynurenic Acid ,Biochemistry ,Models, Biological ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Endocrinology ,Kynurenic acid ,medicine ,Cell Adhesion ,Human Umbilical Vein Endothelial Cells ,Humans ,PPAR delta ,Phosphorylation ,Molecular Biology ,Cell adhesion molecule ,NF-kappa B ,Cell biology ,Heme oxygenase ,030104 developmental biology ,Cytokine ,medicine.anatomical_structure ,chemistry ,embryonic structures ,cardiovascular system ,Cytokines ,lipids (amino acids, peptides, and proteins) ,I-kappa B Proteins ,medicine.symptom ,Inflammation Mediators ,Cell Adhesion Molecules ,Heme Oxygenase-1 ,Signal Transduction - Abstract
Kynurenic acid (KA) regulates energy homeostasis and alleviates inflammation in adipose tissue but how KA affects the atherosclerotic response in HUVECs remains unclear. We evaluated the effects of KA on lipopolysaccharide (LPS)-induced inflammation and apoptosis in HUVECs. KA enhanced peroxisome proliferator-activated receptor delta (PPARδ) expression in HUVECs and THP-1 cells and suppressed LPS-induced atherosclerotic responses through PPARδ-mediated signaling. Moreover, KA treatment mitigated LPS-induced phosphorylation of nuclear factor kappa B and pro-inflammatory cytokine release in HUVECs and THP-1 cells, and down-regulated adhesion molecules in HUVECs and adhesion of THP-1 cells to HUVECs following LPS treatment. KA treatment decreased LPS-induced inflammation and apoptosis, and also promoted heme oxygenase (HO)-1 expression, which suppresses inflammation in HUVECs. Suppression of PPARδ or HO-1 expression markedly mitigated the effects of KA on atherosclerotic responses in HUVECs. Thus, KA attenuates LPS-induced atherosclerotic responses by suppressing inflammation via the PPARδ/HO-1-dependent pathway.
- Published
- 2019
32. Implementation of a resident night float system in a surgery department in Korea for 6 months: electronic medical record-based big data analysis and medical staff survey
- Author
-
Eunyoung Kang, June Young Choi, Sang Hoon Ahn, Ho-Seong Han, Eun Kyu Kim, YoungRok Choi, Heung Kwon Oh, Taeseung Lee, Duck Woo Kim, Yoo Seok Yoon, Hyung Ho Kim, Sung Bum Kang, Hyeong Won Yu, Do Joong Park, Hyung Sub Park, Young Suk Park, and Jai Young Cho
- Subjects
medicine.medical_specialty ,Night shift work ,Medical staff ,business.industry ,Medical record ,Mortality rate ,Electronic health record ,Vital signs ,Electronic medical record ,Night float ,Residency ,Surgery ,Patient management ,03 medical and health sciences ,Big data ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Medicine ,Original Article ,030212 general & internal medicine ,Single institution ,business ,General surgery - Abstract
Purpose To evaluate superiority of a night float (NF) system in comparison to a traditional night on-call (NO) system for surgical residents at a single institution in terms of efficacy, safety, and satisfaction. Methods A NF system was implemented from March to September 2017 and big data analysis from electronic medical records was performed for all patients admitted for surgery or contacted from the emergency room (ER). Parameters including vital signs, mortality, and morbidity rates, as well as promptness of response to ER calls, were compared against a comparable period (March to September 2016) during which a NO system was in effect. A survey was also performed for physicians and nurses who had experienced both systems. Results A total of 150,000 clinical data were analyzed. Under the NO and NF systems, a total of 3,900 and 3,726 patients were admitted for surgery. Mortality rates were similar but postoperative bleeding was significantly higher in the NO system (0.5% vs. 0.2%, P = 0.031). From the 1,462 and 1,354 patients under the NO and NF systems respectively, that required surgical consultation from the ER, the time to response was significantly shorter in the NF system (54.5 ± 70.7 minutes vs. 66.8 ± 83.8 minutes, P < 0.001). Both physicians (90.4%) and nurses (91.4%) agreed that the NF system was more beneficial. Conclusion This is the first report of a NF system using big data analysis in Korea, and potential benefits of this new system were observed in both ward and ER patient management.
- Published
- 2018
33. Erratum to 'Re Mid to Long Term Outcomes in Management of Spontaneous Isolated Coeliac Artery Dissection' [European Journal of Vascular & Endovascular Surgery 60 (1) (2020) 151–152]
- Author
-
So Hyun Kang, Hyung Sub Park, and Taeseung Lee
- Subjects
Coeliac artery ,medicine.medical_specialty ,business.industry ,Endovascular surgery ,MEDLINE ,medicine ,Long term outcomes ,Surgery ,Dissection (medical) ,Cardiology and Cardiovascular Medicine ,medicine.disease ,business - Published
- 2020
34. Rescue Therapy of Inadvertent Coil Migration for Endovascular Treatment of Type II Endoleak
- Author
-
Hyung Sub Park, Taeseung Lee, and Kanghaeng Lee
- Subjects
medicine.medical_specialty ,Type 2 endoleak ,medicine.medical_treatment ,Case Report ,Endovascular aneurysm repair ,Inferior mesenteric artery ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,Rescue therapy ,medicine.artery ,Occlusion ,medicine ,cardiovascular diseases ,Embolization ,Endovascular treatment ,business.industry ,Coil embolization ,medicine.disease ,Surgery ,Electromagnetic coil ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery - Abstract
Coil migration during endovascular procedures is not an unusual complication, but there is no standard management strategy for bailout. Here, we describe a technique for removal of a migrated coil using a snare. During embolization of type II endoleak from the inferior mesenteric artery in a post-endovascular aneurysm repair patient, the coil migrated to the sigmoidal artery causing an occlusion. We used a microsnare loop and successfully retrieved the migrated coil. This is the first case in Korea that uses a loop snare for the removal of a migrated coil during visceral endovascular treatment to our knowledge. This technique of using a microsnare for removal of displaced coils can be a good resort in selected cases.
- Published
- 2016
35. Spontaneous Iliac Vein Rupture
- Author
-
Hyung Sub Park, Daehwan Kim, and Taeseung Lee
- Subjects
Vein rupture ,medicine.medical_specialty ,business.industry ,Deep vein ,Rare entity ,Inferior vena cava filter ,Case Report ,Pelvic cavity ,Spontaneous rupture ,medicine.disease ,Thrombosis ,Surgery ,medicine.anatomical_structure ,Hematoma ,Hemoperitoneum ,medicine ,Iliac vein ,Radiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Spontaneous iliac vein rupture (SIVR) is a rare entity, which usually occurs without a precipitating factor, but can be a life-threatening emergency often requiring an emergency operation. This is a case report of SIVR in a 62-year-old female who presented to the emergency room with left leg swelling. Workup with contrast-enhanced computed tomography revealed a left leg deep vein thrombosis with May-Thurner syndrome and a hematoma in the pelvic cavity without definite evidence of arterial bleeding. She was managed conservatively without surgical intervention, and also underwent inferior vena cava filter insertion and subsequent anticoagulation therapy for pulmonary thromboembolism. This case shows that SIVR can be successfully managed with close monitoring and conservative management, and anticoagulation may be safely applied despite the patient presenting with venous bleeding.
- Published
- 2015
36. Recent Advances in the Development of Experimental Animal Models Mimicking Human Aortic Aneurysms
- Author
-
Taeseung Lee, Hyung Sub Park, Geum Hee Choi, and Young Sun Yoo
- Subjects
Aorta ,medicine.medical_specialty ,Disease occurrence ,business.industry ,Research ,Experimental Animal Models ,Review ,Disease ,medicine.disease ,Aneurysm ,Surgery ,Aortic aneurysm ,Animal model ,medicine.artery ,cardiovascular system ,Medicine ,cardiovascular diseases ,Cardiology and Cardiovascular Medicine ,business ,Intensive care medicine - Abstract
Aortic aneurysm is a common and life-threatening disease that can cause death from rupture. Current therapeutic options are limited to surgical or endovascular procedures because no pharmacological approaches have been proven to decrease the chance of expansion or rupture. The best approach to the management of aortic aneurysm would be the understanding and prevention of the processes involved in disease occurrence, progression, and rupture. There is a need for animal models that can reproduce the pathophysiological features of human aortic aneurysm, and several such models have been studied. This review will emphasize recent advances in animal models used in the determination of mechanisms and treatments of aortic aneurysms.
- Published
- 2015
37. L'Etude sur l'identité de Ionesco - dans les oeuvres de L'Homme aux valises et Voyages chez les morts
- Author
-
Hyung-Sub Park
- Subjects
General Medicine - Published
- 2014
38. Midterm Results of Radiofrequency Ablation for Incompetent Small Saphenous Vein in Terms of Recanalization and Sural Neuritis
- Author
-
Young Sun Yoo, Hyung Sub Park, Jae Young Park, Azimbaev Galimzahn, and Taeseung Lee
- Subjects
Adult ,Male ,medicine.medical_specialty ,Radiofrequency ablation ,medicine.medical_treatment ,Neuritis ,Sural nerve ,Dermatology ,Severity of Illness Index ,law.invention ,Varicose Veins ,Young Adult ,Small saphenous vein ,Sural Nerve ,Recurrence ,law ,Severity of illness ,Humans ,Medicine ,Saphenous Vein ,Risk factor ,Aged ,Aged, 80 and over ,Ultrasonography, Doppler, Duplex ,business.industry ,Reflux ,General Medicine ,Middle Aged ,Ablation ,Surgery ,Venous Insufficiency ,Catheter Ablation ,Female ,business ,Follow-Up Studies - Abstract
Background Safety and effectiveness of radiofrequency ablation for incompetent small saphenous vein is not established. Objective To report midterm clinical and ultrasonograhic results of radiofrequency ablation (RFA) for small saphenous vein (SSV) in terms of recanalization and sural neuritis. Methods and materials We examined 39 patients (46 limbs) who had been examined using a duplex scan more than 1 year after RFA of SSV. Postoperative clinical results, risk factors for SSV recanalization, and sural neuritis were analyzed. Results CEAP score and CIVIQ2 score improved significantly in all patients (CEAP: 2.45 to 1.43 (p = .03); CIVIQ2: 25.34 to 13.21 (p = .01). SSV obliteration rate was 93.4% at 1 year and 89.1% at 2 years. Preoperative peak reflux velocity in the recanalization group (54.9 cm/s) was significantly higher (p
- Published
- 2014
39. Access site pseudoaneurysms after endovascular intervention for peripheral arterial diseases
- Author
-
Ahmed Eleshra, Daehwan Kim, Taeseung Lee, and Hyung Sub Park
- Subjects
medicine.medical_specialty ,Complications ,Percutaneous ,Femoral artery ,030204 cardiovascular system & hematology ,Single Center ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Pseudoaneurysm ,0302 clinical medicine ,False aneurysm ,medicine.artery ,Peripheral arterial disease ,medicine ,Vascular closure device ,cardiovascular diseases ,Brachial artery ,business.industry ,Ultrasound ,Vascular closure devices ,medicine.disease ,Surgery ,Endovascular procedures ,cardiovascular system ,Access site ,Original Article ,business - Abstract
Purpose Pseudoaneurysms after percutaneous vascular access are common and potentially fatal if left untreated. The aim of this study was to determine the incidence and risk factors associated with access site pseudoaneurysms after endovascular intervention for peripheral arterial disease (PAD) under a routine postintervention ultrasound (US) surveillance protocol. Methods A total of 254 PAD interventions were performed in a single center between January 2015 and November 2016, and puncture site duplex US surveillance was routinely performed within 48 hours of the procedure. Clinical, procedural and follow-up US data were analyzed. Results The overall incidence of pseudoaneurysm was 2.75% (6 cases in the femoral artery and 1 in the brachial artery). There was no difference between retrograde and antegrade approach, but there was a higher rate of pseudoaneurysm formation after manual compression compared to arterial closure device (ACD) use (4.3% vs. 0.87%). Manual compression was more commonly used for antegrade punctures (79.0%) and ACD for retrograde punctures (67.7%). Calcification was more frequently found in antegrade approach cases (46.8% vs. 16.9% for retrograde cases) and manual compression was preferred in its presence. All pseudoaneurysms were treated successfully at the time of diagnosis by US-guided compression repair and there were no cases of rupture. Conclusion Pseudoaneurysm rates after therapeutic endovascular intervention for PAD were comparable to other cardiologic or interventional radiologic procedures despite the higher possibility of having a diseased access vessel. Routine US surveillance of access sites allowed for early diagnosis and noninvasive treatment of pseudoaneurysms, preventing potentially fatal complications.
- Published
- 2019
40. Early experiences of endovascular aneurysm repair for ruptured abdominal aortic aneurysms
- Author
-
Taeseung Lee, Daehwan Kim, Jang Yong Kim, Dayoung Ko, and Hyung Sub Park
- Subjects
Rupture ,medicine.medical_specialty ,Abdominal compartment syndrome ,business.industry ,Decompression ,medicine.medical_treatment ,Stent ,030204 cardiovascular system & hematology ,medicine.disease ,Endovascular aneurysm repair ,Abdominal aortic aneurysm ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Endovascular procedures ,Laparotomy ,medicine ,Original Article ,cardiovascular diseases ,030212 general & internal medicine ,Cardiopulmonary resuscitation ,Presentation (obstetrics) ,business - Abstract
Purpose The use of endovascular aneurysm repair (EVAR) for ruptured abdominal aortic aneurysms (r-AAA) is steadily increasing. We report early experiences of EVAR for r-AAA performed in two tertiary referral centers in Korea. Methods We retrospectively reviewed r-AAA patients treated by EVAR from May 2013 to December 2017. An EVAR-first strategy for r-AAA was adopted whenever feasible. The demographic information, anatomic characteristics, operative details, postoperative complications with special attention to abdominal compartment syndrome (ACS), and 30-day mortality were collected and analyzed. Results We identified 13 patients who underwent EVAR for r-AAA. Mean age was 74.2 years and mean AAA size was 74.2 mm. Two patients underwent cardiopulmonary resuscitation at initial presentation. Bifurcated stent grafts were used in 12 out of 13 cases and physician-modified endografts with fenestrated/chimney techniques were performed in 2 cases with short neck. Successful stent graft deployment was achieved in all cases. Three patients were suspected of having ACS and 2 of them underwent laparotomy for decompression. The 30-day mortality was 7.7% (1 of 13), the only mortality being a patient that refused decompressive laparotomy for suspected ACS. Conclusion Despite the small numbers, the outcomes of EVAR for treatment of r-AAA were very promising, even in selected cases with unfavorable anatomy. These outcomes were achieved by a dedicated and well-trained team approach, and by use of high-end angiographic technology. Finally, ACS after EVAR is not uncommon, and requires a high index of suspicion as well as liberal use of decompressive surgery.
- Published
- 2019
41. A Reflection on the Avant-garde Small Theater in Paris, France
- Author
-
Hyung-Sub Park
- Subjects
media_common.quotation_subject ,Media studies ,Art history ,Avant garde ,Performance art ,General Medicine ,Art ,Reflection (computer graphics) ,media_common - Published
- 2013
42. Total Laparoscopic Abdominal Aortic Aneurysm Repair: A Case Report
- Author
-
Hyung Sub Park, Tae Seung Lee, and Young Sun Yoo
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,medicine ,Surgery ,Cardiology and Cardiovascular Medicine ,medicine.disease ,Laparoscopy ,business ,Abdominal aortic aneurysm - Published
- 2013
43. Muscle-Derived Stem Cells Promote Angiogenesis and Attenuate Intimal Hyperplasia in Different Murine Vascular Disease Models
- Author
-
Taeseung Lee, Geum Hee Choi, Soli Hahn, Ji Youl Lee, Young Sun Yoo, and Hyung Sub Park
- Subjects
Male ,Pathology ,medicine.medical_specialty ,Intimal hyperplasia ,Endothelium ,Angiogenesis ,medicine.medical_treatment ,Neovascularization, Physiologic ,Biology ,Rats, Sprague-Dawley ,Neovascularization ,Mice ,chemistry.chemical_compound ,Ischemia ,medicine ,Animals ,Cells, Cultured ,Mice, Inbred BALB C ,Wound Healing ,Hyperplasia ,Cell Differentiation ,Cell Biology ,Hematology ,Stem-cell therapy ,medicine.disease ,Hindlimb ,Rats ,Vascular endothelial growth factor ,Adult Stem Cells ,Disease Models, Animal ,Carotid Arteries ,medicine.anatomical_structure ,chemistry ,Immunology ,Endothelium, Vascular ,medicine.symptom ,Stem cell ,Tunica Intima ,Wound healing ,Developmental Biology - Abstract
Muscle-derived stem cells (MDSCs) are known to promote angiogenesis, but have never been studied in vascular diseases. We differentiated MDSCs into endothelial lineage cells in vitro by stimulation with shear stress and vascular endothelial growth factor. Such differentiated MDSCs (diff-MDSC) showed strong angiogenic potential in vitro. When tested in ischemic hindlimbs of mice, diff-MDSCs increased perfusion and decreased necrosis of the ischemic limbs, by promoting new vessel formation and by upregulating genes involved in endothelial expression. Such effects were not observed with native MDSCs (without endothelial stimulation in vitro). Diff-MDSCs were also injected into carotid arteries of rats after balloon denudation of the intima layer to induce intimal hyperplasia. The cell-treated group had significantly reduced intima-to-media thickness ratio compared to control, thus attenuating intimal hyperplasia by early re-endothelialization of the intima layer. Our findings suggest that MDSCs are a potential source of stem cell therapy for treatment of various vascular diseases, by inducing angiogenesis to improve perfusion in sites of ischemia, and by preventing intimal hyperplasia in sites of vessel injury.
- Published
- 2013
44. Feasibility of Superficial Femoral Artery Intervention Using Mobile C-arms Compared to Fixed C-arms
- Author
-
Hyung Sub Park, Chang Jin Yoon, Tae Seung Lee, Eon Chul Han, and Sung Kwon Kang
- Subjects
medicine.medical_specialty ,Superficial femoral artery ,business.industry ,Intervention (counseling) ,Medicine ,Surgery ,Radiology ,Cardiology and Cardiovascular Medicine ,business - Published
- 2012
45. Ureteropelvic junction obstruction and renal cell carcinoma in a patient with solitary functioning kidney
- Author
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Seung Chol Park, Jong Kwan Park, Hyung Jin Kim, Hyung Sub Park, Jai Seong Cha, Yu Seob Shin, Oh Seok Ko, and Young Beom Jeong
- Subjects
Pyeloplasty ,medicine.medical_specialty ,Single stage ,Solitary Functioning Kidney ,business.industry ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Ureteropelvic junction ,Case Report ,medicine.disease ,urologic and male genital diseases ,Nephrectomy ,female genital diseases and pregnancy complications ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Oncology ,Renal cell carcinoma ,030220 oncology & carcinogenesis ,medicine ,business - Abstract
We present a case of ureteropelvic junction obstruction (UPJO) and renal cell carcinoma (RCC) in a solitary functioning kidney (SFK), managed by robot-assisted dismembered pyeloplasty with partial nephrectomy in a single stage. To our best knowledge, we report the first case of UPJO with RCC in a congenital SFK.
- Published
- 2016
46. Prospective investigation of penile length with newborn male circumcision and second to fourth digit ratio
- Author
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Joo Heung Kim, Myung Ki Kim, Yu Seob Shin, Seung Chol Park, A Ram Doo, Hyung J. Kim, Hwang Choi, Young Gon Kim, Jong Kwan Park, Hyung Sub Park, Young Beom Jeong, and Jung Mo Do
- Subjects
medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,Multivariate analysis ,business.industry ,Urology ,030232 urology & nephrology ,Numerical digit ,Surgery ,Fourth digit ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Oncology ,Male circumcision ,medicine ,business ,Glans ,Penis ,Original Research - Abstract
Introduction: We prospectively investigated the relationship between newborn male circumcision (NMC) and second to fourth digit ratio with penile length.Methods: As participants for our study, we identified already circumcised young patients who visited our hospital for urological treatment. The age at which the circumcision had been done was assessed. The patients’ height and weight were measured. Second to fourth digit ratio was calculated by measuring the second and fourth digit lengths. The flaccid and erectile penile lengths were measured from the base of the penis to the tip of the glans in standing position.Results: A total of 248 patients were included in our study. In univariate analysis, height, second to fourth digit ratio, flaccid penile length, and age of circumcision were associated with erectile penilelength. Among these variables, second to fourth digit ratio, flaccid penile length, and age of circumcision were significant predictive factors for erectile penile length in multivariate analysis. The subjects were divided into two groups, including 72 patients in the NMC group and 176 patients in the non-NMC group. No significant difference was found in height, weight, and second to fourth digit ratio between both groups. However, flaccid (pConclusions: Despite the small number of subjects, this study shows that NMC was associated with shorter penile length. Second to fourth digit ratio, flaccid penile length, and age of circumcision were also significant predictive factors for erectile penile length. Further multicentre studies with larger number of subjects and biochemical analyses are needed for potential clinical applicability
- Published
- 2016
47. Clinical Manifestations of BK Virus Infection in Kidney Transplant Recipients: A Single Center Experience
- Author
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Hyung Sub Park, Young Sun Yoo, Se Won Oh, Taeseung Lee, and Dong-Wan Chae
- Subjects
Transplantation ,medicine.medical_specialty ,business.industry ,viruses ,medicine.medical_treatment ,Immunology ,virus diseases ,Immunosuppression ,Decoy cells ,medicine.disease ,medicine.disease_cause ,Single Center ,Nephropathy ,BK virus ,Internal medicine ,medicine ,BK Virus Infection ,Outpatient clinic ,medicine.symptom ,business ,Leflunomide ,medicine.drug - Abstract
Background: BK virus (BKV) has emerged as an important cause of graft dysfunction and failure in renal transplant recipients. Reduction of immunosuppressive therapy is accepted as the primary strategy for management of BKV infection in renal transplant recipients, a strategy which frequently results in graft dysfunction and failure. Herein, a single center experience of BKV infection in renal transplant recipients is presented with an emphasis on the management of BKV infection. Methods: We retrospectively reviewed the medical records of 107 renal transplant recipients who were treated at the outpatient clinic in Seoul National University Bundang Hospital from April 2003 to April 2011. The effects of the modification of immunosuppression on the replication of BKV and graft outcome were analyzed. Results: Of a total of 35 patient evaluated for BKV infection, 20 tested positive in at least one BK virus test. Decoy cells in urine were detected in 13 of the 20 patients. Of these patients, 7 developed BKV nephropathy. Four out of seven of the BKV nephropathy patients were diagnosed with biopsy, and the other three were diagnosed based on a high titer of BKV replication detected in plasma samples. Despite the reduction in immunosuppression and use of leflunomide in the seven BKV nephropathy patients, two patients suffered deterioration of renal function and one patient lost the graft with progressive renal dysfunction. Conclusions: BK virus nephropathy was not an uncommon disease and was a major cause of graft dysfunction or loss. Appropriate modification of immunosuppressive therapy, early in the course of BK nephropathy or before the occurrence of massive replication of BKV, is essential for the protection of renal allografts.
- Published
- 2012
48. Ionesco et Roumanie
- Author
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Hyung-Sub Park
- Subjects
General Medicine - Published
- 2012
49. Treatment Strategy for Persistent Sciatic Artery and Novel Classification Reflecting Anatomic Status
- Author
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Sanghyun Ahn, Taeseung Lee, Seung-Kee Min, Suhnggwon Kim, In Mok Jung, Jongwon Ha, Sang Il Min, and Hyung Sub Park
- Subjects
Male ,medicine.medical_specialty ,Computed Tomography Angiography ,Vascular Malformations ,medicine.medical_treatment ,Arterial Occlusive Diseases ,Femoral artery ,030204 cardiovascular system & hematology ,Amputation, Surgical ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Blood Vessel Prosthesis Implantation ,0302 clinical medicine ,Aneurysm ,Predictive Value of Tests ,Risk Factors ,medicine.artery ,Occlusion ,medicine ,Humans ,Aged ,business.industry ,Incidence (epidemiology) ,Patient Selection ,Endovascular Procedures ,Stent ,Arteries ,Middle Aged ,medicine.disease ,Embolization, Therapeutic ,Surgery ,Femoral Artery ,Treatment Outcome ,Embolism ,Amputation ,Bypass surgery ,Lower Extremity ,Female ,Stents ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Vascular Surgical Procedures - Abstract
Background Persistent sciatic artery (PSA) is a relatively rare congenital variant of the lower limb vasculature and can have highly variable clinical presentations. The purpose of this study was to analyze the relationship between PSA anatomy and clinical presentation, and to suggest an optimal management strategy. Methods Between 2001 and 2014, 24 PSAs in 19 patients were diagnosed by computed tomography and referred to the vascular surgery department. Patient demographics, types of PSA and femoral artery, aneurysmal changes, symptoms, and treatment methods were assessed. Additionally, all English literature from 1964 to 2014 was reviewed and compared using the PubMed database (224 PSAs in 171 patients). Results PSA was diagnosed in 10 men (52.6%) and nine women (47.4%). PSAs were bilateral in five patients (26.3%) and symptomatic in 12 patients, while in seven patients PSA was found incidentally. According to the Pillet-Gauffre classification, Type 2a was the most common variant ( n = 15/24, 62.5%), with unclassifiable types in two limbs. Compared with cases in the literature, the PSA occlusion rate in this study was higher ( n = 10/24, 41.7% vs. n = 54/224, 27.5%), but aneurysm incidence was higher in the literature cases ( n = 5/24, 20.8% vs. n = 112/224; 50.7%). In this study, 16 limbs (66.6%) were treated conservatively, and six limbs were treated by open surgery, including four bypasses, one amputation, and one thrombo-embolectomy. Endovascular coil embolization was performed in one limb, and a hybrid procedure with stent graft was performed in one limb with PSA aneurysm. Based on the present series and the literature review, a new classification system and treatment option is proposed according to the anatomic status and the presence of aneurysm. According to the new classification, class III was the most common in both the present study (18/24; 75%) and the literature review, and the presence of aneurysm was the most important determinant of surgical treatment. Conclusions The new classification system is simple and provides guidance for management. Limb anatomy of the femoral artery system and the presence of PSA aneurysm should be considered when selecting the optimal treatment. The risk of embolism from the presence of aneurysm is an important factor for treatment, and bypass surgery is mostly required in classes III and IV.
- Published
- 2015
50. Role of Laser Doppler for the Evaluation of Pedal Microcirculatory Function in Diabetic Neuropathy Patients
- Author
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Taeseung Lee, Han Mi Yun, In Mok Jung, and Hyung Sub Park
- Subjects
Male ,medicine.medical_specialty ,Diabetic neuropathy ,Physiology ,Provocation test ,030209 endocrinology & metabolism ,030204 cardiovascular system & hematology ,Microcirculation ,03 medical and health sciences ,Prospective analysis ,0302 clinical medicine ,Physiology (medical) ,Diabetes mellitus ,Internal medicine ,medicine ,Laser-Doppler Flowmetry ,Humans ,Diabetic Nephropathies ,Molecular Biology ,Aged ,Retrospective Studies ,Skin ,business.industry ,Curve analysis ,Laser Doppler velocimetry ,Middle Aged ,medicine.disease ,Microcirculatory flow ,Endocrinology ,Diabetes Mellitus, Type 2 ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Blood Flow Velocity - Abstract
OBJECTIVE We evaluated whether LD can detect alterations in skin microcirculatory flow in type II diabetic neuropathy patients and determined which parameters were most predictive. METHODS A prospective analysis was performed for three groups with presumed varying degrees of microvascular dysfunction: diabetics with neuropathy (DMN, n = 20), diabetics without microangiopathic complications (DM, n = 20), and healthy controls (n = 16). LD was performed under strictly controlled protocols with provocation, consisting of vasoconstrictive (valsalva, postural) and vasodilative tests (PORH, LTH). RESULTS There was an overall decrease in LD values in response to both vasoconstrictive and vasodilative provocations in DMN patients compared to DM and control groups. Statistically significant parameters were as follows: valsalva, PORH and LTH between DMN and control; valsalva only between DMN and DM; and PORH and LTH between DM and control. ROC curve analysis showed that Valsalva was the most accurate parameter in DMN patients. CONCLUSIONS LD could consistently detect differences in microcirculatory flow between the three study groups consisting of gradually more severe microvascular dysfunction. The Valsalva parameter was the most accurate in detecting established microvascular dysfunction, whereas PORH and LTH may have a possible role for detection of early microvascular impairment.
- Published
- 2015
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