• Asian Pacific Journal of Cancer Prevention
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• 제15권2호
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• pp.925-928
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• 2014

Background: Gestational trophoblastic neoplasia (GTN) is a spectrum of disease with abnormal trophoblastic proliferation. Treatment is based on FIGO stage and WHO risk factor scores. Patients whose score is 12 or more are considered as at extremely high risk with a high likelihood of resistance to first line treatment. Optimal therapy is therefore controversial. Objective: This study was conducted in order to summarize the regimen used for extremely high risk or resistant GTN patients in our institution the in past 10 years. Materials and Methods: All the charts of GTN patients classified as extremely high risk, recurrent or resistant during 1 January 2002 to 31 December 2011 were reviewed. Criteria for diagnosis of GTN were also assessed to confirm the diagnosis. FIGO stage and WHO risk prognostic score were also re-calculated to ensure the accuracy of the information. Patient characteristics were reviewed in the aspects of age, weight, height, BMI, presenting symptoms, metastatic area, lesions, FIGO stage, WHO risk factor score, serum hCG level, treatment regimen, adjuvant treatments, side effects and response to treatment, including disease free survival. Results: Eight patients meeting the criteria of extremely high risk or resistant GTN were included in this review. Mean age was 33.6 years (SD=13.5, range 17-53). Of the total, 3 were stage III (37.5%) and 5 were stage IV (62.5%). Mean duration from previous pregnancies to GTN was 17.6 months (SD 9.9). Mean serum hCG level was 864,589 mIU/ml (SD 98,151). Presenting symptoms of the patients were various such as hemoptysis, abdominal pain, headache, heavy vaginal bleeding and stroke. The most commonly used first line chemotherapeutic regimen in our institution was the VAC regimen which was given to 4 of 8 patients in this study. The most common second line chemotherapy was EMACO. Adjuvant radiation was given to most of the patients who had brain metastasis. Most of the patients have to delay chemotherapy for 1-2 weeks due to grade 2-3 leukopenia and require G-CSF to rescue from neutropenia. Five form 8 patients were still survived. Mean of disease free survival was 20.4 months. Two patients died of the disease, while another one patient died from sepsis of pressure sore wound. None of surviving patients developed recurrence of disease after complete treatment. Conclusions: In extremely high risk GTN patients, main treatment is multi-agent chemotherapy. In our institution, we usually use VAC as a first line treatment of high risk GTN, but since resistance is quite common, this may not suitable for extremely high risk GTN patients. The most commonly used second line multi-agent chemotherapy in our institution is EMA-CO. Adjuvant brain radiation was administered to most of the patients with brain metastasis in our institution. The survival rate is comparable to previous reviews. Our treatment demonstrated differences from other institutions but the survival is comparable. The limitation of this review is the number of cases is small due to rarity of the disease. Further trials or multicenter analyses may be considered.

• 대한간호
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• 제29권3호
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• pp.25-35
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• 1990

It is a fact that there are recent increasing trends or incidence of the colorectal carcinoma among other colorectal diseases. In such trend, the early detection remain to be most important by the air contrast barium enema and total colonofiberscopy. There are several ways to prepare the colon for barium enema and colonofiberscopy which include several agents. The mechanical cleansing have been used most frequently since Brown's method was adapted to be most perfect for colon deansing. The ideal laxatives and enema solutions were limited to adequate dose, it's effectiveness, patient's diet and bowel habit, minimal side effect, low cost and simple to perform. In order to compare the effectiveness of various cleansing solutions, six experimental methods were formed as shown; 1. normal saline enema, 2. castor oil with normal saline enema, 3. castor oil with soap suds enema, 4. magnesium citrate with normal saline, 5. magnesium citrate with soap suds enema and 6. ingestion of Golyetly solution. The authors have compared and determined the degree of cleanness by an experienced endoscopist. The total number of patients was 247, age distribution was $43{\pm}15$ years old, and sex distribution was 133 males and 114 females. The grade I and II represented no difficulties at performing the colonofiberscopy, but grade ill and N had some difficulties, even unable to perform the colonofiberscopy. The effectiveness the cleansing agents, represented with grade I and II was 95.9% (47/49) in method 6, 93.2%(54/58) in method 2, 83.3%(30/33) in method 3, 70.0%(28/10) in method 5, 66.7%(16/24) in method i, and 45.7%(18/40) in method 4. Method 2 and 6 were the most effective in normal bowel habit patients. In constipated patients, method 6 was the most effective and all method except method 11 were effective in diarrhea patients. The degrees of less mucosal irritation by various bowel cleansing method were in the order of method 6(100%), 1(100%), 5(74%), 2(69%). In subjective symptoms and cleansing groups, abdominal distension, pain, nausea and vomiting were complained, and that's subject symptoms were in the order of method 3(88.9%), 6 (79.6%), 1(75%), 5(72.5%), 2(72.4%), 4(67.5%). In conclusion, we believe that the Golytely of the mechanical cleansing solution for colonofiberscopy was the most effective, but others depended on the patient's condition und bowel habit.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제18권4호
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• pp.253-260
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• 2015

Purpose: The aim of the present study was to investigate the clinical features and outcome of eosinophilic gastroenteritis (EGE) in children. Methods: Our study enrolled 24 children who were diagnosed with EGE from 1993 to 2014 at the Department of Pediatrics, Seoul National University Children's Hospital. The patients' clinical manifestations, treatments, and outcomes were reviewed from the medical records. Results: The mean age at diagnosis was 5.3 years. Most patients had gastrointestinal symptoms including diarrhea (54.2%) and abdominal pain (45.8%). Peripheral eosinophilia was present in 91.7% of the patients. Thirteen patients (54.2%) showed anemia, and 15 patients (62.5%) had hypoalbuminemia. EGE was classified as mucosal, subserosal, or muscular in 75.0%, 20.8%, and 4.2% of cases, respectively. Three patients showed gastroduodenal ulcers upon endoscopic analysis. A history of allergy was reported in 13 patients, including atopic dermatitis, allergic rhinitis, and asthma. Five patients (20.8%) improved with food restrictions. Among the 19 patients treated with steroids, 11 (57.9%) discontinued steroid treatment without subsequent relapse, 4 (21.1%) relapsed after ceasing steroid treatment, and 4 (21.1%) showed no response to steroids. Two patients who were resistant to steroids underwent therapeutic surgery. The presence of gastroduodenal ulcers was significantly associated with relapse and steroid resistance. Conclusion: A high suspicion of EGE is warranted when children have nonspecific gastrointestinal symptoms and peripheral eosinophilia. Most patients improved with food restrictions or steroid treatment, although one-third of patients showed a relapse or steroid resistance.

• Childhood Kidney Diseases
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• 제11권2호
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• pp.185-194
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• 2007

목 적 : HSP는 주로 소혈관을 침범하는 혈관염으로 대개 자연적으로 치유되지만 장기적 예후는 신장 침범의 정도에 달려 있으므로 신장 침범의 위험인자를 예측하고 예방하는 것이 중요하다. 이에 본 연구는 증상을 완화하기 위해 사용한 스테로이드가 HSP에서 신장 침범을 줄일 수 있는지를 알아보고자 하였다. 방 법 : 1993년 1월부터 2006년 12월까지 충북대학교병원 소아과에서 HSP로 진단 받은 환아를 대상으로 하여 스테로이드 사용 유무와 사용 기간, 지속성 자반의 유무에 따른 신장 침범의 유무와 정도를 분석하였다. 결 과 : 스테로이드 사용 유무와 사용 기간에 따른 신장 침범 빈도와 신장 침범 기간에는 유의한 차이가 없었다. 스테로이드의 사용 여부에 따른 신장 침범 양상을 보았을 때, 스테로이드를 사용한 경우에는 혈뇨가 많이 나타나고 사용하지 않은 경우에는 단백뇨가 많이 나타나는 경향을 보였으나 통계적으로는 유의한 차이가 없었다. 스테로이드의 사용과 자반의 지속성과는 유의한 관계가 없었다. 반면에 10일 이상의 지속성 자반이 있는 경우에 신장 침범이 유의하게 많은 것으로 나타났으며, 신장 침범의 기간도 지속성 자반이 있는 경우에 증가하는 것으로 나타났다. 결 론 : HSP로 진단받은 환아들에게 복통이나 관절통 등으로 스테로이드를 사용한 후 신장 침범의 유무를 비교해 본 결과, 스테로이드의 사용 여부와 사용 기간과는 유의한 결과를 보이지 않으므로 신장 침범에 대한 스테로이드의 예방효과는 없는 것으로 생각된다. 또한, 스테로이드 치료의 적응증이 아닌 자반의 지속성이 오히려 신장 침범의 유무와 기간과 관계있다는 사실은, 스테로이드가 신장 침범의 예방효과가 없음을 뒷받침해 주고 있다.

• 혜화의학회지
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• 제1권1호
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• pp.151-165
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• 1992

Clinical studies were done on 18 people chosen from admission patients didn't have will of stop-smoking who were treated with the auricular acupuncture therapy to stop-smoking in the Dep. of the Acupuncture and Moxibution, Hospital of Oriental Medicine in Dae Jeon University from 1991. 5. 28 to 1991. 6. 15. The following results have obtained 1. Distribution of sex; male(83%), Female(17%) 2. In the distribution of age, 30s age group made up 33.3%, 20s, 50s, 60s age group made up each 16.6%, 40s made up 11.1%, 70s made up 5.5% of the group. 3. Distribution of occupation in descending order; labour man(38.8%), businessman(22.4%), housewife, office woker was each 16.6%, students(5.5%). 4. Distribution of human coporal constitution in descending order; Tae-Eum-In(50%), So-Yang-In(27.8%), So-Eum-In(22.2%). 5. Distribution of statring tense to smoking in descending order; 10s, 20s, were each 44. 4%, 30s(11.1%). 6. Distribution of duration in descending order; 10-19years(33.3%), 40-49years(22.2%), 1-9, 20-29years were each 16.6%, 30-39years(11.1%). 7. Distribution of smoking amount(1day) in descending order; 11-20 cigarettes(38.8%), 21-30 cigarettes(22.7%), 1-10 cigarettes, 31-40 cigarettes were each 16.6%. 8. Distribution of the motive to smoking in descending order; curiosity(61.1%), hyperemesis gravidarum, abdominal pain, stress, inducement. 9. Distribution of symptoms within smoking in descending order; sputum(83%), liver disorder(11%), stomach disorder(6%). 10. Distribution in symptoms of post treatment of stop-smoking by acupuncture in descending order; nausea, headache were 12%, ear-radiating pain(6%), no variation(82%). 11. Distribution in change of cigarettes taste after the auricular acupuncture treatment; some decrease, complete decrease were each 38. 8%, decrease of post taste in smoking, burning-paper odored were each 5.5%, no variation(11.1%). 12. Total judgement of efficacy in descending order; excellent(50. 0%), good(28.8%), fair(10. 0%), failure(11.1%).

• 사상체질의학회지
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• 제10권2호
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• pp.455-471
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• 1998

1. 연구배경 및 목적 소양인(少陽人) 신정방(新定方)의 하나인 양격산화탕(凉膈散火湯)의 효능(效能)과 활용(活用)에 대한 임상적(臨床的) 연구(硏究)를 통해 사상체질병증(四象體質病證)의 이해(理解)와 방제(方劑)의 운용(運用)에 도움을 주고자 한다. 2. 방법 1997년 3월부터 1998년 2월까지 1년간 동국대학교 분당한방병원 체질의학클리닉에 내원(來院)한 환자들 중 양격산화탕(凉膈散火湯)이 20첩 이상 투여되고 경과관찰(經過觀察)이 가능했던 65명(남자 40명, 여자 25명)을 대상으로 양격산화탕(凉膈散火湯)이 투여된 환자의 특성, 치료효과, 부작용 등에 관하여 조사하고 분석하였다. 3. 결과 소양인(少陽人)의 양격산화탕(凉膈散火湯)은 남녀 구별 없이 모든 연령층에서 사용되었으며, 대상환자들의 주소증은 흉민(胸悶), 수족병(手足病), 운동장애(運動障碍), 구건(口乾), 상열감(上熱感) 등 37종류였다. 치료효과의 분포는 호전이 58.5%, 우수가 12.3%, 별무변화가 29.3%였으며 악화는 없었다. 전신상태(全身狀態)의 특징으로는 설태(舌苔)가 백태(白苔) 또는 황태(黃苔)를 띄거나 간출이상(刊出異常)이 있는 경우가 많았다. 처방(處方)을 활용할 때는 처방의 변경없이 양격산화탕(凉膈散火湯)만을 사용한 경우가 많았으며 병증(病症)에 따라 약물을 증량(增量)하거나 가미(加味)하여 사용하였다. 양격산화탕(凉膈散火湯)의 치료효과(治療效果)에는 약물의 가감유무(加減有無)가 영향을 미쳤으며, 효과발현시간(效果發顯時間)은 연령이 젊을수록 빠른 것으로 나타났다. 부작용으로는 심계(心悸), 복통(腹痛) 및 소화불량(消化不良) 등이 있었다.

• 동의생리학회지
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• 제14권2호통권20호
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• pp.189-198
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• 1999

Aminoglycosides, including gentamicin, have been used as antibiotics for the various infections by gram-negative bacteria. However, there are some restrictions for using these drugs. Gentamicin, a typical aminoglycoside, has the side effect of nephrotoxicity, including polyuria, glycosuria, proteinuria, glomerulonephritis, and uremia. The aims of this study were to examine the prevention or reduction effects of Jinmootang on the gentamicin-induced nephrotoxicity and to investigate the possible mechanisms on the effect of Jinmootang. The subcutaneous injections of 60mg of gentamicin per kg of boby weight to Sprague-Dawley rats for 8 days induced typical symptoms of nephrotoxicity by aminoglycosides. 0.6ml of water extract Jinmootang (100ml/chup) was orally treated in the experimental animal. 24-hour urine was collected with the metabolic cage and plasma was sampled from the abdominal aorta. The plasma concentration of sodium was significantly decreased by the treatment of gentamicin but it was not-significantly changed by the treatment of Jinmootang to the animal. The concentration of potassium was greatly decreased in the gentamicin-treated animals. However. it was returned to the normal level in the Jinmootang-treated animals. The concentrations of creatinine and urea were increased by gentamicin treatment. But, Jinmootang reduced these concentrations. Nevertheless, the osmolalities of plasma in both group were not different from each other. Even though the plasma concentration of aldosterone was not significantly changed, the mean value was increased by the gentamicin intoxication. The concentration of aldosterone was decreased by the treatment of Jinmootang. The reduction of aldosterone level in plasma could be a factor to improve the hypokalemia. The fractional excretion of potassium was much higher than normal by the treatment of gentamicin and it was decreased by 50% in the Jinmootang-treated rats. Therefore, the reabsorption of potassium was significantly increased by the treatment of Jinmootang, even though the filtered load of potassium in the experimental group was much highter than control. Even though the concentration of plasma aldosterone was decreased by the treatment of Jinmootang, the fractional excretion of sodium was not increased, slightly lower. These data suggested that Na reabsorption was increased in the proximal tubule by Jinmootang. The filtered load of glucose in the Jinmootang-treated group was greater than in control. Nevertheless, the fractional excretion of glucose in the experimental group was not different from that in control. These results indicate that glucose reabsorption was increase in the proximal tubule by Jinmootang treatment. The results of this study suggest that Jinmootang could improve the some nephrotoxic symptoms induced by gentramicin treatment. Hypokalemia, the reduced glomerular filtration rate, and dysfunctions of renal proximal tubule and distal nephron were significantly recovered to normal level. The increase of glomerular filtration rate by Jinmootang might contribute to eliminate the waste product, including creatinine and urea, and/or gentamicin through the kidney.

• 동의생리병리학회지
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• 제20권6호
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• pp.1431-1441
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• 2006

Following conclusions were drawn from the examination of the usage of semen persicae and fols carthami from the view of Hyungsang Medicine. Semen persicae is used to vitalize the blood flow and eliminate the blood stagnation of the whole body in ${\ulcorner}$Donguibogam${\lrcorner}$, and therefor it is used for the blood flow of the heptal meridian and sometimes the intestinal meridian. Flos carthami is applied to vitalize the blood flow, remove obstructions in meridians, eliminate the blood stagnations, and stop the pain in ${\ulcorner}$Donguibogam${\lrcorner}$, therefore used in such symptoms of blood flow of the heptal meridian as amenorrhea, spasm of muscles, and coldness of the genitals. Also is applied in those cases of exhaustion, perspiration, and in digestive remedies which belong to the symptoms of cardiac blood flow. And it is used for dryness of the skin in which case the blood should be developed and malaria for the elimination of the blood stagnation and production of new blood. The combination of semen persicae and flos carthami is applied to eliminate the blood stagnation and stimulate menstrual discharge in uterus, as well as in the cases of lumbago and stomachache due to blood stagnation, blood stasis, mass in the abdomen, and abdominal distention. This combination is also used for the eyes, ears, numbness, and paralysis of hands and feet for the purpose of making the flow of the meridian smooth, and for diabetes, dryness of the skin, malaria, anal itching and pain for the purpose of eliminating the mass and renewing the tissues. The combination is diversly used in the book of ${\ulcorner}$Special lectures on clinical cases${\lrcorner}$ for the aftereffects of traffic accident, constipation, diabetes, dryness of the skin, paralysis of hands and feet, numbness of finger of hand and foot, and especially used frequently with prescription of Yijintang and Samultang combined in the cases of numbness. The prescription is used in Hyungsang medicine when the uterus, the external appearance(axis), hands and feet, heart, and the stomach is not good for the vitalization of the flow of the 12 meridians. It was though difficult to find extinguishing differences between the two herbs in the clinical cases applied in the book of ${\ulcorner}$Special lectures on clinical cases${\lrcorner}$.

• Journal of Preventive Medicine and Public Health
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• 제26권2호
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• pp.202-209
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• 1993

지난 1991년 3월 16일 대구지역에서 발생한 상수도 페놀오염이 인체에 미치는 영향을 조사하기 위해 대구지역의 상수도 공급분포와 초 중 고등학교 지역적 분포를 비교하여 대상학교 10개교를 선정하여 이를 폭로군과 비폭로군으로 나누어 학생들의 가족구성원 전체를 대상으로 하여 설문지를 통하여 자기기입법으로 조사하였다. 분석내용은 노출지역과 비노출지역에서의 증상호소의 차이, 음용수 유형의 변화형태 등이다. 노출지역과 비노출지역에서 수도물만 먹은 사람을 비교하였을 때 페놀의 영향으로 볼 수 있는 증상으로 노출지역에서 3배 이상의 호소율을 나타낸 증상은 구역질, 구토, 설사, 복통, 두통, 입 목이 따끔거림, 피부증상으로 나타났다. 유관증상을 한가지 이상 호소한 경우는 노출군이 비노출군보다 약 3.5배(39 9% 대 9.4%)였으며 의료기관 이용율은 노출군에서 18.5%인 반면 비노출군에서는 4.7%로 약 4배의 차이를 보였다. 유관증상은 노출정도가 심할 수록 호소율이 높아지는 용량-반응 현상을 나타내었다. 그리고 이번 사건이후 생수. 혹은 약수를 찾거나 정수기를 설치하는 가구가 늘어났음을 관찰할 수 있었다. 노출지역에서 사건 전에 65.4%를 차지하던 수도물 사용이 페놀확인 후 32.2%로 떨어졌으나 비노출군에서는 57%에서 46.2%로 떨어졌다.

• 한국학교보건학회지
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• 제20권1호
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• pp.91-101
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• 2007

Purpose: The present study intended to reveal the association between the physique of adolescent women and dysmenorrhea, and the factors related to the frequency of dysmenorrhea. Methods: The study subjects included 511 girls of a women's high school in Daejeon city and they were, during the period of March 1st through April 30th, 2005, given self-administered questionnaires about frequency of menstruation, age, physique, exercise, and such menstruation-related items as age of menarche, menstrual period and days, and amount. Results: As with the frequency of dysmenorrhea, 38.4% experienced it 「always」, 44.6% 「occasionally」, and 17.0% 「almost scarcely」, and those with dysmenorrhea accounted for 83.0% of the subjects. The frequency of dysmenorrhea was not significant difference according to the BMI and HPI. However, the lower the age of menarche and the greater the amount of menstrual flow, the more frequent dysmenorrhea. The symptoms of dysmenorrhea included the highest frequency of low back pain(68.5%) and it was followed by abdominal pain(65.9%), sensibility(54.0%), fatigue(51.7%), and nervousness(49.5%). These accompanied symptoms tended to be worse as the frequency of dysmenorrhea increased. The multiple logistic regression analysis revealed that the relative risk of frequency of dysmenorrhea is 2.2 times in age of 14, by a standard age of 15 as menarchial age, 2.2 in 13, and 3.1 in below 12. The menstrual days was 3.0 times in both below 2 days and over 8 days with the standard days of 3-7 days. The menstrual amount was 1.9 times in the group with a greater amount of menstrual bleeding and 1.5 times in the group with a less amount than the normal group, respectively. Conclusion: The above results suggest that the rate of experiencing dysmenorrhea was up to 83.0% and 38.4% from these had dysmenorrhea upon every menstruation. It is thought that dysmenorrhea could be a great disadvantage sufficient to impair optimal health to a larger body of school girls. Further, for quality of life, it is required that more fundamental strategies instead of pain killers or others for palliation of dysmenorrhea would be established among adolescents.