• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.6 no.2
• /
• pp.140-151
• /
• 2003

Purpose: We tried to evaluate the long term efficacy and positive predictive factors of interferon-alpha treatment in children with chronic hepatitis B. Methods: The study population included 113 children who received interferon therapy between May 1982 and July 2002 (20 years) for chronic hepatitis B in Department of Pediatrics, Yonsei University College of Medicine. Male to female ratio was 2.3 : 1 and the mean age at diagnosis was $11.1{\pm}4.1$ years old. Response to treatment was defined as normalization of alanine aminotransferase (ALT), disappearance of HBeAg and HBV-DNA Eighty two children responded while 32 did not. Interferon-alpha was given intramuscularly for 6 months at a dosage of $3{\times}10^6$ unit, 3 times weekly. In relapsed cases, lamivudine or interferon retreatment was done. Results: Seroconversion rate was 77.0% in terms of HBeAg, 74.3% in terms of HBV-DNA, and 80.5% in terms of ALT normalization after treatment. Seroconversion rate of both HBeAg and HBV-DNA was 72.6%. Analyzed by life table method, the effect of the treatment had been maintained over 10 years after cessation of therapy. Pre-treatment ALT level was the only significant positive predictive factor of response. Eleven cases (13.4%) relapsed, and 2 out of 3 showed response when treated with lamivudine and 1 out of 3 with interferon retreatment. Conclusion: Interferon-alpha showed significant efficacy in the treatment of chronic hepatitis B in our study. Further studies about the effect of interferon therapy on complications of hepatitis such as hepatocarcinoma, cirrhosis are warranted.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.7 no.1
• /
• pp.14-22
• /
• 1996

This study aims to look at main problems of visiting the clinic, diagnoses and other related factors of outpatients in a private psychiatric clinic f3r children and adolescents located in Seoul. The analyses were based on the reports of 2,785 patients who were 18 years old and less, and visited the clinic during last 4 years. The results showed that the ratio of boys to girls was 2.7 to 1, and about 64% of the whole sample were 6 years old and less. Especially the percentage of patients aged 3 and less was the highest and that of schoolage and more was gradually reduced. The average number of siblings was 195 and the percentage of the first child in a family was the highest. Particularly, there were more boys in rase of one child families and more girls in case of families with 3 children and more. The chief problems were mainly language-deficit, hyperactivity, autistic behaviour, tic, aggressive behavior and academic problem. The higher frequency of diagnoses was in the order of parent-child problem, mental retardation, developmental language disorder, reactive attachment disorder, other emotional disorder, and pervasive developmental disorder. The more frequently used method fir treatments was in the sequence of psychotherapy, play therapy, parental counseling, occupational therapy and speech therapy. The results from this study were compared with those from other studies and discussed.

• Proceedings of the Korean Society of Medical Physics Conference
• /
• 2003.09a
• /
• pp.40-40
• /
• 2003

목적 : 현재 국내에서 사용중인 Co-60 원격치료용 방사선 조사장치의 경우 tissue air ratio(TAR)는 조사 표면에서 최대 선량을 가지는 back scatter factor(BSF)를 적용하여 구한 값을 사용하고 있는데, 실제로 Co-60 원격치료용 방사선 조사장치의 최대선량 깊이는 조사 표면이 아니라, 조사 표면에서 0.5cm 떨어진 거리에서 최대 선량을 나타내므로, BJR 25 에서 권장하는 값인 peak scatter factor(PSF)를 이용해 구한 값이 더 정확한 값으로 사료되기 때문에 이를 본 실험을 통해 검증하고자 하였다. 대상 및 방법 : 방사선 종양학과에서 치료용으로 사용하고 있는 Co-60 원격치료용 방사선 조사장치를 대상으로 하였다. BSF 는 Khan이 저술한 The Physics of Radiation Therapy의 부록에 제시된 값을 사용하였으며, PSF와 TAR를 구하기 위해 물 팬톰(water phantom), Farmer형 이온 챔버(ion chamber), 전기계(electrometer)를 사용하였다. PSF와 TAR를 구하기 위해서 몇 가지 측정을 하였다. 먼저, 공기 중에서 챔버를 SSD=80.5cm에 고정시킨 후, 방사선을 조사하여 선량을 측정하고, 깊이에 따른 선량을 알아보기 위해, 물 팬톰 내에 챔버를 SSD=80cm 고정시킨 후, 물을 서서히 채워가면서 5$\times$5cm, 10$\times$10cm, 15$\times$15cm, 20$\times$20cm, 30$\times$30cm의 field size에 대해서, 물의 깊이가 0.5cm-2cm 까지는 0.5cm 단위로 선량을 측정하고, 물의 깊이가 2cm-l4cm까지는 1cm단위로 선량을 측정하였다. 측정된 선량을 이용하여 PSF를 구하고 난 후, BJR 25에서 제시한 PSF와 비교를 하였고 TAR은 Khan이 제시한 변환식에 PSF를 대입하여 알아보았다. 기존의 TAR과 PSF를 이용해 구한 TAR을 측정하여 구한 TAR과 비교하였다. 결과 : BJR25에서 제시한 PSF와 본 실험에서 측정하여 얻은 PSF를 비교한 결과, field size가 5$\times$5cm, 10$\times$10cm, 15$\times$l5cm, 20$\times$20cm인 경우, 측정하여 얻은 PSF가 0.8%, 0.2%, 0.4%, 0.2%로 약간 높지만, 두 값은 매우 유사한 것으로 나타났다. 그리고, 기존의 BSF를 이용해 구한 TAR과 BJR 25에서 권고하는 PSF를 이용해 구한 TAR을 비교한 결과 field size 에 따라 약 1%-1.5% 정도로 BSF를 이용하여 구한 TAR보다 PSF를 이용하여 구한 TAR이 1.3% 정도 높게 나타났지만, 이것은 두 값의 절대적인 차이일 뿐, 실제로는 PSF를 이용하여 구한 TAR이 측정해서 구한 TAR과는 매우 유사한 값을 보여주고 있다. 결론 : 기존의 BSF를 이용해 구한 TAR과 PSF를 이용해 구한 TAR을 비교하였을 때, 약 1.3% 정도 높게 내고 있지만, 기존의 TAR보다는 PSF를 이용해 구한 TAR이 BJR 25와 잘 일치하고 있으므로 Co-60 원격치료용 방사선 조사장치를 사용할 경우 BSF보다는 PSF를 사용하는 것이 타당한 것으로 사료된다.

• Clinical and Experimental Pediatrics
• /
• v.52 no.1
• /
• pp.119-123
• /
• 2009

Renal cell carcinoma (RCC) arising from epithelial cells of the renal tubules is a highly aggressive and malignant tumor in all ages; however, it rarely occurs in children. the standard treatment for RCC is radical nephrectomy with lymph node dissection when the tumor is localized and can be completely resected. Adjuvant chemotherapy, radiotherapy, and immunotherapy are used for pediatric patients with advanced RCC involving lymph nodes or metastatic lesions. Sorafenib is an oral, multikinase inhibitor that has recently been approved for use in metastatic RCC. Common toxicities that have been reported include dermatologic changes such as rash or desquamation and hand-foot skin reaction, diarrhea, fatigue, alopecia, and hypertension. In particular, hand-foot syndrome (HFS) an erythematous skin lesion of the palms and solesis most often caused by cytostatic chemotherapeutic agents. In this report, we have studied a 14-year-old female patient with hand-foot syndrome that occurred in association with sorafenib for the treatment of metastatic RCC. Furthermore, this case demonstrates that reversal of complications can be achieved by discontinuing the drug and intervention with topical steroids, vitamin E, and high-dose pyridoxine.

• Tuberculosis and Respiratory Diseases
• /
• v.63 no.1
• /
• pp.24-30
• /
• 2007

Background: Pleural effusion develops in approximately 40% of pneumonia patients. In 5-10% of these cases, it progresses to complicated parapneumonic effusion (CPPE) or empyema that requires drainage. The prognostic factors of CPPE and empyema remain to be clarified. We examined the treatment outcomes of CPPE and empyema and elucidating their prognostic factors. Methods: One hundred and fifteen patients with CPPE or empyema, who were diagnosed and treated in Kyungpook National University Hospital (Daegu, Korea) between September 2001 and December 2005, were retrospectively analyzed. All the data was acquired from their chart review, and regarding treatment results, the time to defervescence and the length of hospital stay were analyzed. Results: The treatment was successful in 101 patients with a success rate of 87.8%. Multivariate analysis showed the level of pleural fluid lactate dehydrogenase (LDH) to be a significant prognostic factor (odds ratio [OR] 7.37; 95% confidence interval [CI], 1.63 to 33.37; p=0.009). Pussy pleural fluid (r=0.236; p=0.01) and the frequency of urokinase use (r=0.257; p=0.01) correlated with the time to defervescence. However, there was no clinical factor that correlated with the length of hospital stay. Conclusion: The pleural fluid LDH level is a useful prognostic factor for monitoring treatment results of CPPE and empyema.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.18 no.4
• /
• pp.706-711
• /
• 1996

다발성 골수증은 다양한 증세를 보이는 형질세포로부터 기원하는 악성종양으로 40세이상의 남성에서 호발되며 alkylating agent 단독, 혹은 corticosteroid와 병용하는 항암제 치료로 생존율이 크게 증가되기는 하였지만 치료후 평균생존기간의 20개월 내외로 완치율이 그다지 높지않은 형편이다. 악골에서의 발생은 극히 드물고 대개 늑골, 편평골, 척추, 골반, 두개골등에 광범위한 patchy destruction의 형태로 나타나는데 악골에 발생할 경우 임상증상은 장기적인 무통성 종창이 가장 흔하며 때로는 동통, 악골의 팽창, 감각이상, 치아의 동요, 악골골절등을 보이기도 한다. 전신적증상으로 무력감, 체중감소, 빈혈, 신부전, hypercalcemia, hyperiviscosity syndrome을 나타내기도 하는데 약 10%의 환자에서 전신적인 amyloidosis를 보인다. 진단은 골수생검상 골수의 plasmacytosis가 10% 이상이면서 혈장이나 뇨전기영동법에서 monoclonal globulin peak이 있을 때 가능하다. 여러 학자들은 처음에는 독립적인 고립성병소로 나타났다가 장기적으로 다발성골수종으로 이행됨을 주장하면서 장기적인 추적을 권하고 있지만 골내 고립성 형질세포종(solitary plasmacytoma in bone), 수질외 형질세포종(extramedullary plasmacytoma) 등은 다발성골수종과는 다른 질환이라 주장하는 등 아직 많은 논란이 있는 형편이다. 치료는 $4000{\sim}6000$ rad의 방사선치료와 여러 가지 약제의 복합적인 항암요법이 사용되고 있으며 국소적인 병소의 경우 외과적 절제술이 추천되기도 한다. 저자들은 59세 여자환자에서 하악골에 발생된 다발성골수종을 치험하였기에 문헌고찰과 함께 보고하는 바이다.

• The Monthly Diabetes
• /
• s.210
• /
• pp.14-16
• /
• 2007

65세 김모씨는 가족들과 외출을 하려다가 갑자기 발음이 어눌해 지면서 우측에 힘이 빠지기 시작하였다. 가족들은 일단 김씨를 다시 집안으로 데리고 들어와 팔 다리를 주므르고 바늘로 손을 따 보았지만 상태는 점점 악화되어 전혀 말도 못하고 일어설 수 도 없었으며 정신도 흐려지는 등 급속히 악화되었다. 김씨의 아들은 뇌졸중이 아닌가 하는 생각이 들었고 최근에 언론매체를 통해 혈관이 막히는 뇌졸중의 경우에 빨리 병원에 가면 막힌 혈관을 다시 뚫어주는 치료가 가능하다는 이야기를 들은 기억을 떠올렸다. 김씨의 아들은 119에 연락해 아버님을 응급실로 모시고 왔다. 김씨가 병원에 도착한 시간은 증상이 발생한 후 약 1시간 만이였다. 뇌촬영을 비롯한 피검사 등이 시행되었고 의료진은 김씨가 혈관이 막힌 뇌졸중, 즉 뇌경색이라고 하였고, 현재 발병한 지 채 2시간이 지나지 않았으므로 혈관을 뚫어주는 혈전용해술을 시행하겠다고 했다. 혈관이 막힌 원인은 오랫동안 가지고 있던 당뇨, 고혈압, 고지혈증 등이 복합적으로 작용하여 혈관에 동맥경화를 유발하고 있다가 혈전이 생기면서 혈관이 막힌 것이라고 하였다. 그리고 혈관을 막고 있는 혈전을 녹이기 위해 혈전용해술을 시행하는 것이라고 하였다. 뇌출혈등의 부작용이 일부에서 동반될 수 있지만 지금 상태에서 가장 최선의 치료는 혈전용해술이라 것이 의료진의 설명이었다. 다음날 김씨는 완벽하지는 않았지만 말하는 기능과 우측 팔다리 마비가 상당히 호전되었다. 1주일 후 김씨의 상태는 더욱 호전 되었고 열심히 재활치료를 받고 있었다. 김씨와 가족들은 의료진으로부터 꾸준히 재활치료를 하면서 3개월 후 정도면 이전과 거의 비슷한 상태로 회복될 수 있을 것이라는 희망적인 이야기를 들을 수 있었다.

• Proceedings of the KOR-BRONCHOESO Conference
• /
• 1981.05a
• /
• pp.9.2-9
• /
• 1981

Now we are encountering with a growing number of severe head and neck injuries owing to automobile accidents, violence, and industrial injuries etc. In these circumstances, emergency tracheostomy and neurosurgical treatment are frequently necessary. When cervical trauma was ignored at initial stage, significant complications and sequelae may follow. So it deserves attention that meticulous and thoughtful treatments should be given to the cervical injuries as well as head injuries. We have recently experienced a case of laryngeal stenosis resulted from head and neck trauma. The patient was a 20-year-old male who underwent craniectomy and tracheostomy at another hospital about one and a half years prior to admission. With multistaged operations, we were able to re-establish an adequate natural air way.

• Journal of fish pathology
• /
• v.13 no.2
• /
• pp.143-146
• /
• 2000

The effectiveness of bronopol and bithionol in treating Ichthyobodo sp. infestation in cultured olive flounder was investigated, and compared them with formalin. Bath with formalin at 200 ppm or bithionol at 100 ppm for 1 h showed complete removal of Ichthyobodo sp. from all the experimental fish. Baths with lower concentrations of formalin (50 and 100 ppm) or bithionol (25 and 50 ppm) significantly reduced infection intensities of Ichthyobodo sp. On the other hand, baths with bronopol or intubation of bithionol at various concentrations were not effective against Ichthyobodo sp. infestation.

• Journal of TMJ Balancing Medicine
• /
• v.11 no.1
• /
• pp.20-24
• /
• 2021

Objectives: This study was designed to report the clinical improvement of the patient with glossodynia. Methods: During the treatment period (from Jul. 7^th, 2021 to Aug. 3^rd), a patient was treated using acupuncture, Korean Medicine, pharmacopuncture and FCST (Functional Cerebrospinal Therapy). Symptoms were evaluated by Visual Analogue Scale (VAS), the Oral Health Impact Profile-14 (OHIP-14). Results: After the treatments for 28 days, the OHIP-14 score decreased from 53 to 7. Also, the patient's VAS score decreased from 6 to 0. Conclusions: Korean medicine treatment with FCST may be valuable for glossodynia patients. Nevertheless further studies are needed.