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

• Journal of Preventive Medicine and Public Health
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• v.42 no.5
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• pp.315-322
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• 2009

Objectives : Knowledge about the management status of diabetic melitus (DM) is essential to improve diabetic management. Moreover, low income is associated with poor adherence to treatment and increased mortality. This study was performed to evaluate the management status of DM in low-income patients in a rural area. Methods : We enrolled 370 patients with type 2 DM living in Gokseong county, JeollaNamdo. A well-trained examiner measured the height, weight, waist circumference, blood pressure, total cholesterol, triglyceride, high density lipoprotein cholesterol, fasting blood sugar and glycosylated hemoglobin (HbA1c) levels. Carotid ultrasonography was used to measure carotid artery carotid artery intima media thickness (IMT) and plaque. anklebrachial index (ABI) was used to evaluate peripheral artery disease. A fundoscopic examination was performed to evaluate diabetic retinopathy. A history of diabetes complications and health-related questionnaires were also completed. Results : The age of diabetic subjects was 68.7$\pm$8.7 years and the duration of diabetes was 8.9$\pm$8.2 years. Most (63.5%) had hypertension, and 45.7% had triglycerides below 150 mg/dl, 38.1% had low density lipoprotein cholesterol (LDL) cholesterol below 100 mg/dl, 48.7% had urine albumin to creatinine ratio (UACR) below 30 mg/g. Less than half (45.9%) achieved the goal of HbA1c less than 7% suggested by the American Diabetes Association (ADA). 10.6% had peripheral vascular disease, 11.9% had retinopathy, and 60.8% had chronic kidney disease. Conclusions : DM management in low income patients is very poor and requires further work to improve.

• The Korean Journal of Nuclear Medicine
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• v.3 no.2
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• pp.39-47
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• 1969

A clinical analysis was made on 161 cases of hyperthyroidism seen at the Radioisotope Laboratory of Kyungpook National University Hospital. This series consisted of 144 cases of diffuse goiter and 17 cases of nodular goiter. 1) Hyperthyroidism was most prevalent in the 4th decade and male to female ratio was 1:4.6. 2) Cardinal symptoms in the order of frequency were weakness, easy fatigability, palpitation, weight loss, nervousness, perspiration, heat intolerance, increased appetite, insomnia and dysmenorrhea. 3) Major physical findings in the order of frequency were goiter, fine tremor, tachycardia, wide pulse pressure, emaciation, warm moist skin, exophthalmos, systolic hypertension and atrial fibrillation. 4) The complications were ophthalmopathy (34.2%), thyrotoxic heart disease (5.6%), thyroid crisis (1 case), pretibial myxedema (1 case) and thyrotoxic myopathy (1 case). 5) Mean values of the six hour and twenty-four hour $^{131}I$ uptakes by the thyroid glands were 67.5% and 71.6%, respectively, in diffuse goiter and 64.5% and 65.0%, respectively, in nodular goiter. 6) Mean values of twenty-four hour $PB^{131}I$ conversion ratio were 76.3% in diffuse goiter and 70.2% in nodular goiter and those of the basal metabolic rate was +51% in the former and +41% in the latter. Mean serum cholesterol level was 152mg% in diffuse goiter and that in nodular goiter was 175mg%. 7) Among the 134 cases treated with $^{131}I$, 66 cases (49.3%) were successful1y controlled with single dose and in the majority of the cases the initial therapeutic dose required was $4.1{\sim}5.0mC$ in diffuse goiter and $5.1{\sim}6.0mC$ in nodular goiter. 8) With $^{131}I$ treatment the symptoms improved in the following order: heat intolerance, emaciation, nervousness, insomnia, easy fatigability, weakness, fine tremor, goiter, perspiration, exertional dyspnea and palpitation. And in a few cases improvement of even exophthalmos was seen. 9) Following $^{131}I$ treatment myxedema occurred in 4 cases (3%) and reccurrence in 9 cases (6.8%).

• Journal of Chest Surgery
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• v.31 no.7
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• pp.650-659
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• 1998

Between August 1996 and August 1997, 22 patients underwent extracardiac Fontan operations. The basic diagnoses included univentricular heart of the right ventricular type (n=12); univentricular heart of the left ventricular type (n=4); tricuspid atresia (n=4); left isomerism, transposition of great arteries, ventricular septal defect and pulmonary stenosis (n=1); and criss-cross heart with uneven ventricle (n=1). The median age of the 14 men and 8 women was 29 months (range from 21 months to 26 years). Previous procedures included bidirectional cavopulmonary shunt (n=15, interval=15.6$\pm$3.4 months), Kawashima operation (n=4, interval=37.5$\pm$20 months), and classic Glenn shunt (n=1, interval=14 years). In 2 patients, extracardiac Fontan operations were done without any previous procedures. A 16- to 22-mm flexible Gore-Tex tube graft (n=18), Hemashield graft (n=3), or, alternatively, a nonvalved aortic allograft (n=1) was cut and anastomosed end-to-end between inferior vena cava and undersurface of pulmonary artery using Gore-Tex or Prolene suture in a running fashion. In risk Fontan patients (n=12), a communication between the extracardiac conduit and the right atrium was constructed. In the most 13 recent patients, the procedures were done without cross-clamping of the aorta and with a beating heart. Operative mortality was 9.1% (n=2). Complications included persistent chest tube drainage for more than 7 days (n=5), chorea (n=2), and low cardiac output (n=1). There were no late deaths. Follow-up echocardiogram (mean: 6 months) demonstrated satisfactory hemodynamic results in the surviving 20 patients. Potential advantages of this technique consist of minimization of surgical manipulation of atrial tissue, reduction or elimination of myocardial ischemia, creationof a uniform and stable inferior vena cava-to-pulmonary artery conduit, and increased flexibility and safety in certain high-risk patients such as those with increased pulmonary vascular resistance, pulmonary hypertension, and impaired ventricular function. Further investigations during a longer follow-up are needed to confirm the intermediate and long-term results, especially the reduction of late atrial arrhythmias.

• Biomedical Science Letters
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• v.11 no.3
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• pp.343-347
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• 2005

Bambusae caulis in Liquamen is one of the important herbal medicine produced by heating bamboo indirectly and is used for treatment of stroke, hypertension, and diabetes etc. Recently the mechanism of clinical effects on Bambusae caulis in Liquamen has been studied. This experiment was conducted to confirm the clinical effects of Bambusae caulis in Liquamen on type 1 diabetes and its related mechanism. We divided C57BL/6 mice into 3 groups and induced them to be type 1 diabetes by injection of streptozocin into peritoneum. The dosage of each group was 150 mg/kg once only, 140 mg/kg once only and 40 mg/kg for 5 days respectively. The two groups injected streptozocin for once took orally Bambusae caulis in Liquamen after the induction of diabetes, and the other one group was given Bambusae caulis in Liquamen during the diabetes inducing period. As the result, the two diabetes-induced groups showed blood glucose decreasing effect by Bambusae caulis in Liquamen on an average, but they didn't show the signiftcant differences statistically. But Bambusae caulis in Liquamen showed the anti-diabetic effect suppressing blood sugar rising trend during the diabetes inducing peried (P<0.05). The anti-oxidative effect of Bambusae caulis in Liquamen was measured with the hypoxanthine/xanthine oxidase (HX/XOD) system. The quantity of ROS was measured using DCFDA reagent indirectly. As the result, $10\%$ solution of Bambusae caulis in Liquamen showed anti-oxidative effect by scavenging $93.4\%$ superoxide as compared with control group. It is suspected that the anti-oxidative effect of Bambusae caulis in Liquamen suppressed the increase of blood glucose in the diabetes-inducing group. These results could be useful data to understand the effect of Bambusae caulis in Liquamen on type 1 diabetes and type 1 diabetes developing because ROS were closely connected with the induction and complications of diabetes.

• The Journal of Korean Medicine
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• v.18 no.2
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• pp.223-244
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• 1997

Clinical observation was done on 290 cases of patients who were diagnosed as CVA with brain CT, TCD, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from 1st January to 31st December in 1996. 1. The cases were classified into the following kinds : cerebral infarction, cerebral hemorrhage, and transient ischemic attack. The most case of them was the cerebr진 infarction. 2. There is no significant difference in the frequency of strokes in male and female. And the frequency of strokes was highest in the aged over 50. 3. In cerebral infarction the most frequent lesion was the territory of middle cerebral artery, and in cerebral hemorrhage the most frequent lesion was the basal ganglia. 4. The most ordinary preceding disease was hypertension, and the next was diabetes. 5. The rate of recurrence was high in cerebral infarction. 6. The frequency of strokes seems to have no relation to the season. 7. The cerebral infarction occurred usually in resting and sleeping, and the cerebral hemorrhage in acting. 8. The course of entering hospital, most patients visited this hospital as soon as CVA occurred. And the half of patient visited this hospital within 2 days after CVA attack. 9. In the cases of patients who were unconscious at the admission, the prognosis was worse than that of the alert patients. 10. The common symptoms were motor disability and verbal disturbance. 11. The average duration of hospitalization was 27.4 days, and in case of cerebral hemorrhage the duration was prolonged. 12. The average time to start physical therapy was 13.3rd day after stroke in cerebral infarction and it was 19.9th day after stroke in cerebral hemorrhage. 13. The common complications were urinary tract infection, pneumonia, myocardial infarction and so on. 15. At the time of entering hospital, in most cases the blood pressure was high, but blood pressure was well controlled at the time of discharge. 16. Generally reported, hypercholesterolemia and hypertriglyceridemia are usually found in cerebral infarction. But in this study, they were found more frequently in cerebral hemorrhage than in infarction. 17, In the most cases, western and oriental medical treatments were given simultaneously. 18. In acute or subacute stage, the methods of smoothening the flow of KI(順氣), dispelling phlegm(祛痰), clearing away heat(淸熱) or purgation(瀉下) were frequently used. And in recovering stage, the methods of replenishing KI(補氣), tonifying the blood(補血) or tranquilization(安神) were frequently used.

• Clinical and Experimental Pediatrics
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• v.52 no.3
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• pp.370-375
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• 2009

Purpose : The risk of metabolic syndrome (MS) and cardiovascular disease in Turner syndrome (TS) patients is high. We analyzed metabolic factors in adults with TS and evaluated the metabolic risk of insulin resistance. Methods : Forty-three adults with TS were enrolled. The frequency of MS and the values of the metabolic factors were analyzed. Patients were divided into insulin resistant and non-resistant groups according to values of homeostasis model assessment of insulin resistance (HOMA-IR). The correlations of HOMA-IR with metabolic parameters were analyzed. Results : The frequency of MS was 7% and those of each metabolic parameter were as follows: insulin resistance, 16.3%; central obesity, 15.4%; hypertriglyceridemia, 2.3%; low HDL cholesterol, 9.3%; hypertension, 36.8%. The insulin-resistant group had significantly higher values of body mass index (BMI), waist circumference (WC), fasting plasma glucose (FPG), HOMA-IR, and systolic blood pressure (SBP) than the non-resistant group (P<0.05). HOMA-IR showed a significantly positive correlation with BMI, WC, FPG, and SBP and showed a negative correlation with HDL cholesterol. Conclusion : This study suggests that adults with TS have a high risk of metabolic syndrome, and insulin resistance is correlated with metabolic factors. Therefore, TS patients should have their metabolic parameters monitored regularly to minimize metabolic complications and prevent cardiovascular diseases.

• Journal of Korean Foot and Ankle Society
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• v.15 no.4
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• pp.232-239
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• 2011

Purpose: Diabetic foot ulcer is one of the most important diabetic complications because it increases the risk of amputations. Moreover, it lowers the quality of patients' life and increases the social medical expenses. Authors analyzed risk factors of intractable diabetic foot ulcer using retrospective study. Materials and Methods: From January 2007 to December 2010, 40 patients who could not achieve complete healing despite more than 12 weeks of proper management among who had been diagnosed and treated as diabetic foot ulcer at our hospital were included and evaluated retrospectively. We compared the risk factors between two groups who were finally treated by amputation and non-amputation. Results: The sample was composed of 31 male patients (77.5%) and 9 female patients (22.5%). Comorbidity including hypertension and hyperlipidemia were 77.5% and 80% each. By Wagner classification, 30 patients (80%) had ulcerative lesion over the grade 3. From bacteriology results, 29 patients (72.5%) had polybacteria infection. 35 patients (87.5%) had neuropathy and 26 patients (65%) had vascular stenosis at least one level. The mean initial ankle-brachial index and toe-brachial index were 0.982 and 0.439. In comparison between amputation group and non-amputation group, ulcer severity, number of stenotic vessel and initial ankle-brachial index/toe-brachial index had statistical significance. Conclusion: The most commonly risk factor of intractable diabetic foot ulcer was peripheral neuropathy reaching 87.5% of cases. In comparison with non-amputation group, ulcer severity according to Wagner classification, number of stenotic vessel and initial ankle-brachial index/toe-brachial index were demonstrated as a risk factor of amputation in intractable diabetic foot ulcer.

• Radiation Oncology Journal
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• v.8 no.1
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• pp.95-102
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• 1990

From May, 1979 to October,1987, 38 patients with endometrial carcinoma were treated with radiotherapy at Seoul National University Hospital. Of these, 32 patients received radiotherapy Postoperatively, one received radiotherapy preoperatively, and five received radiotherapy only. Relative frequencies of obesity, nulliparity, late menopause, diabetes mellitus, and hypertension were all higher than those reported in normal women in Korea, and those of obesity, diabetes mellitus, and nulliparity were significantly high. The overall actuarial five-year survival rate was $75.6\%$. The overall actuarial five year survival rates of stage I (22 cases), stage II (six cases), and stage III (10 cases) were $90.0\%,\;80.0\%,\;and\;44.4\%$, respectively, and were significantly different from each other. Among various factors, stage only proved to be prognostic by multivariate analysis. There were two local failures, three local failures combined with distant metastasis, and three distant metastasis. Stages I and II could be adequately controlled by local modalities without severe complications, stage III endometrial carcinoma might need more aggressive treatment for better survival.

• Archives of Plastic Surgery
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• v.44 no.6
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• pp.516-522
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• 2017

Background Implant-based breast reconstruction is being performed more frequently, and implants are associated with an increased risk of infection. We reviewed the clinical features of cases of implant infection and investigated the risk factors for breast device salvage failure. Methods We retrospectively analyzed 771 patients who underwent implant-based breast reconstruction between January 2010 and December 2016. Age, body mass index, chemotherapy history, radiation exposure, and smoking history were assessed as potential risk factors for postoperative infection. We also evaluated the presence and onset of infection symptoms, wound culture pathogens, and other complications, including seroma, hematoma, and mastectomy skin necrosis. Additionally, we examined the mastectomy type, the use of acellular dermal matrix, the presence of an underlying disease such as hypertension or diabetes, and axillary node dissection. Results The total infection rate was 4.99% (58 of 1,163 cases) and the total salvage rate was 58.6% (34 of 58). The postoperative duration to closed suction drain removal was significantly different between the cellulitis and implant removal groups. Staphylococcus aureus infection was most frequently found, with methicillin resistance in 37.5% of the cases of explantation. Explantation after infection was performed more often in patients who had undergone 2-stage expander/implant reconstruction than in those who had undergone direct-to-implant reconstruction. Conclusions Preventing infection is essential in implant-based breast reconstruction. The high salvage rate argues against early implant removal. However, when infection is due to methicillin-resistant S. aureus and the patient's clinical symptoms do not improve, surgeons should consider implant removal.