Journal of Yeungnam Medical Science

Jun Young Lee

7 Articles

Acute decompensated heart failure and acute kidney injury due to bilateral renal artery stenosis.: Ho Jin Jung, Won Suk Choi, Hyun Jae Kang, Byung Chun Jung, Bong Ryeol Lee, Jong Joo Lee, Jun Young Lee; Yeungnam Univ J Med. 2015;32(2):146-151. Published online December 31, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.2.146

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Abstract PDF: Atherosclerotic renal artery stenosis (RAS) may result in hypertension, azotemia, and acute pulmonary edema. We report on a renal angioplasty with stent placement for bilateral RAS in a patient with acute decompensated heart failure and acute kidney injury. A 67-year-old female patient was admitted to our hospital with acute shortness of breath and generalized edema. Echocardiography showed left ventricular wall motion abnormality and the follow up electrocardiography showed T wave inversion in the precordial leads. We performed a coronary angiography to differentiate ischemic heart disease from non-cardiac origin for the cause of the heart failure. The coronary angiography showed no significant luminal narrowing, but bilateral RAS was confirmed on the renal artery angiography, therefore, we performed renal artery revascularization. After the procedure, the pulmonary edema was improved and the serum creatinine was decreased. Two weeks later, an echocardiography showed improvement of the left ventricular systolic function.

Asymptomatic Isolate Tricuspid Regurgitation with Chordae Tendineae Rupture Caused by Blunt Chest Injury.: Min Hee Kim, Hyun Jae Kang, Byung Chun Jung, Bong Ryeol Lee, Ho Jin Jung, Jun Young Lee, Soo Hyun Bae, Dong Woo Shin; Yeungnam Univ J Med. 2013;30(2):112-115. Published online December 31, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.2.112

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Abstract PDF: The incidence and importance of tricuspid valve regurgitation after a blunt chest injury has risen with the increase in the number of automobile accidents and steering wheel traumas. This kind of injury has been reported more frequently in the last decade because of the better diagnostic procedures and understanding of the pathology. However, tricuspid valve regurgitation following a blunt chest injury can still be easily missed because most patients do not show symptoms at the time of the trauma. A 55-year-old male patient presented himself at our facility after suffering a chest injury from an automobile accident. His transthoracic echocardiography (TTE) revealed severe tricuspid valve regurgitation due to the prolapse of his anterior valve leaflet. We report a case of asymptomatic tricuspid regurgitation that developed after a blunt chest injury.

Black Pigmentation of Terminal Ileum after Long Term Ingestion of Charcoal: Jun Young Lee, Sung Bum Kim, Sang Hoon Lee, Hee Jung Moon, Jae Won Choi, Jong Ryul Eun, Byung Ik Jang, Tae Nyeun Kim, Joon Hyuk Choi; Yeungnam Univ J Med. 2007;24(2 Suppl):S623-626. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S623

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Abstract PDF: Isolated pigmentation of the terminal ileum is rare incidental finding when performing a colonoscopic examination. The common substances that cause gastrointestinal pigmentations are lipofuscin, iron sulphide(FeS), hemosiderin, and other exogenous materials such as silicates and titanium. In most cases, pigmentation of the terminal ileum has no subjective symptoms, so it is found in autopsy or incidental colonoscopic examination. The cause of pigmentation has not been clearly identified. We experienced a case of pigmentation of terminal ileum associated with long term charcoal ingestion. This finding supports that the source of ileal pigmentation is ingested material.

A Case of Gastric Bezoar Causing Ileal Obstruction During Treatment with Coca-Cola: Jun Young Lee, Sung Bum Kim, Sang Hoon Lee, Hee Jung Moon, Jong Ryul Eun, Tae Nyeun Kim, Byung Ik Jang; Yeungnam Univ J Med. 2007;24(2 Suppl):S683-688. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S683

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Gastric bezoars are usually occur in patients who have undergone gastric surgery and have delayed gastric emptying. Recently, the efficacy of nasogastric lavage or endoscopic injection therapy with Coca-Cola has been reported. But the complication like intestinal obstruction has poorly been reported. We report a case of gastric bezoar causing ileal obstruction during treatment with oral administration and endoscopic injection of Coca-Cola. A 53-year-old man was referred because of epigastric pain for a day. He had a history of subtotal gastrectomy with gastroduodenostomy since 8 years ago. On upper gastrointestinal endoscopy, about 6cm sized, dark-greenish hard bezoar was impacted at gastric antrum and about 3-5cm sized three bezoars were found at body. We injected Coca-Cola into the bezoar through the endoscopy and the patient was instructed to drink four liters of Coca-Cola per day. On the 12^th day of admission, the patient complained severe abdominal pain. On plain abdominal X-ray and CT scan, small bowel obstruction at proximal ileum with bezoar was suspected and exploration was performed. About 4cm sized two bezoars were impacted at proximal ileum, and small bowel resection with primary closure after removal of bezoar was performed. The patient was discharged on the 10th postoperative day without any complication.

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A Case of Huge Gastric Bezoar Removed by Endoscopic Combination Therapy with Coca-Cola Injection
Min Suk Jung, Jang Won Lee, Seung Hyun Lee, Dong Hyun Kim, Sang Hwan Byun, Yeong Muk Kim
Yeungnam University Journal of Medicine.2013; 30(1): 62. CrossRef

Gastric Phytobezoar Treated by Oral Intake and Endoscopic Injection of Coca-Cola.: Hee Jung Moon, Sang Hoon Lee, Jun Young Lee, Dong Hee Kim, Ji Eun Lee, Chang Hun Yang, Jong Ryul Eun, Tae Nyeun Kim, Heon Ju Lee, Byung Ik Jang; Yeungnam Univ J Med. 2006;23(2):247-251. Published online December 31, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.2.247

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Bezoars are collections or concretions of indigestible foreign material that accumulate and coalesce in the gastrointestinal tract; they usually occur in patients who have undergone gastric surgery and have delayed gastric emptying. Treatment options include dissolution with enzymes, endoscopic fragmentation with removal or aspiration, and surgery. Recently, the efficacy of nasogastric lavage or endoscopic infusion of Coca-Cola for the dissolution of phytobezoar have been reported. We report a case of phytobezoar successfully treated by oral administration and endoscopic injection of Coca-Cola. A 62-year-old woman was referred to Yeungnam University Hospital for epigastric pain. Upper gastrointestinal endoscopy revealed one very large, dark-greenish, solid bezoar in the stomach with gastric ulcer and duodenal bulb deformity. We performed endoscopic injection of Coca-Cola into the bezoar. The patient was instructed to drink four liters of Coca-Cola per day. At endoscopy two days later, the phytobezoar was easily broken into pieces. At endoscopy on the 11th day of admission, the phytobezoar was decreased in size and removed by endoscopic fragmentation with a polypectomy snare. At follow up endoscopy after 13 days, the bezoar was completely dissolved.

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Systematic review: Coca-Cola can effectively dissolve gastric phytobezoars as a first-line treatment
S. D. Ladas, D. Kamberoglou, G. Karamanolis, J. Vlachogiannakos, I. Zouboulis-Vafiadis
Alimentary Pharmacology & Therapeutics.2013; 37(2): 169. CrossRef

Clinical Experience of Nephron Sparing Surgery for Renal Tumor with a Normal Opposite Kidney.: Jun Young Lee, Jung Hyun Kim, Kang Min Lee, Ki Hak Moon, Hee Chang Jung, Tong Choon Park; Yeungnam Univ J Med. 1999;16(1):94-100. Published online June 30, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.1.94

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Abstract PDF: The aims of this retrospective study were to determine whether a nephron sparing surgery might be feasible in patients with a small solid renal tumor. Materials and methods: Between 1988 and 1999, 21 patients with radiologically detectable small solid renal tumor underwent enucleoresection, wedge resection and polar segmental nephrectomy. The mean age of the 11 men and 10 women in this study was 43 years (range 14 to 68). According to the preoperative radiological diagnosis, 15 among the 21 patients were considered to have renal cell carcinoma, 4 were considered to have angiomyolipoma, and the remaining 2 patients were difficult to differentiate as renal tumors radiologically. Among 15 patients considered to have renal cell carcinoma, 14 were found to have renal cell carcinoma and the remaining one patient was diagnosed as having oncocytoma on pathologic examination. Radiological determination of angiomyolipoma in four patients was confirmed to be correct on pathological examination. The 2 patients whose radiological diagnose wasdificult were founf to have cavernous hemangioma and angiomyolipoma. One patient with renal cell carcinoma developed arteriocaliceal fistula, the only immediate complication in this series, and underwent nephrectomy on postoperative 10th day. The mean follow-up duration for the 14 patients with renal cell carcinoma was 18.6 months(range:1-103). There were no other tumor involvement in the resection margins following the nephron sparing surgery. These results suggest that nephron sparing surgery provides an effective treatment for patients with a single, small, unilateral, localized renal tumor. Longer follow-up is suggested for more definite verification of the role of nephron sparing surgery.

Comparison OF Northgate SD-3 and Modulith SLX Lithotriptors: Treatment Results with 2,000 Renal and Ureteral Stones.: Jun Young Lee, Hee Chang Jung, Ki Hak Moon, Chul Kyu Cho, Tong Choon Park; Yeungnam Univ J Med. 1999;16(1):85-93. Published online June 30, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.1.85

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Abstract PDF: Some reports have shown a decreased effectiveness of extracorporeal shock wave lithotripsy(ESWL) with newer lithotriptors. We compared the treatment results of ESWL with a second generation Northgate SD-3 and a third generation Modulith SLX device. A total of 2,000 patients underwent ESWL treatments for single urinary calculus between September, 1988 and July, 1998. The 1,241 patients were treated with Northgate SD-3 between September, 1988 and December, 1995. The 759 patients were treated with Modulith SLX between January, 1996 and July 1998. The treatment results were compared using the chi-square test to determine statistical significance. The overall success rate, success rate according to the location and size, the mean number of sessions, complication rate and retreatment rate were obtained, according to lithotriptor. The overall success rate was 90.6% with Northgate SD-3 and 89.1% with Modulith SLX. With Northgate SD-3 and modulith SLX. the success rate according to the location was 91.0%(579/636), 88.1%(236/268) in the kidney, 93.2%(517/555), 89.9%(258/287) in upper ureter; 83.3%(10/12) and 94.4%(167/177) in middle and lower ureter; 47.4%(18/38) and 55.6%(15/27) in staghorn stone, respectively, The success rate According to the size of stone with Northgate SD-3 and Modulith SLX for stone with the size under 10mm was 96.1% (612/637) and 93.1%(470/505); from 11mm to 20mm was 87.3%(421/482) and 86.4%(165/191); from 21mm to 30mm, 77.5%(62/80) and 67.5%(23/34); and for stone larger then 31mm was 69%(29/42) and 62.1%(18/29), respectively, Mean number of sessions for successful fragmentation was 1.21 and 1.69, respectively, with Northgate SD-3 and Modulith SLX. Retreatment rate was 16.7% and 17.5%, respectively. The complications after treatment were severe pain(6.2% with Northgate SD-3 vs. 2.0% with Modulith SLX), steinstrasse(3.4% vs. 1.9%), fever(1.2% vs. 0.5%) and perirenal hematoma(0.2% vs. 0%) in order of frequency. There was no significant difference in the effectiveness between of Northgate SD-3 and Modulith SLX. However, a statistically significant difference was observed between the two lithotriptors. We concluded that ESWL with Modulith SLX is more safe compared to Northgate SD-3.

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