• Title/Summary/Keyword: Young-onset

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Factors Predicting the Development of Radiation Pneumonitis in the Patients Receiving Radiation Therapy for Lung Cancer (방사선 치료를 시행 받은 폐암 환자에서 방사선 폐렴의 발생에 관한 예측 인자)

  • An, Jin Yong;Lee, Yun Sun;Kwon, Sun Jung;Park, Hee Sun;Jung, Sung Soo;Kim, Jin whan;Kim, Ju Ock;Jo, Moon Jun;Kim, Sun Young
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.1
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    • pp.40-50
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    • 2004
  • Background : Radiation pneumonitis(RP) is the major serious complication of thoracic irradiation treatment. In this study, we attempted to retrospectively evaluate the long-term prognosis of patients who experienced acute RP and to identify factor that might allow prediction of RP. Methods : Of the 114 lung cancer patients who underwent thoracic radiotherapy between December 2000 and December 2002, We performed analysis using a database of 90 patients who were capable of being evaluated. Results : Of the 44 patients(48.9%) who experienced clinical RP in this study, the RP was mild in 33(36.6%) and severe in 11(12.3%). All of severe RP were treated with corticosteroids. The median starting corticosteroids dose was 34 mg(30~40) and median treatment duration was 68 days(8~97). The median survival time of the 11 patients who experienced severe RP was significantly poorer than the mild RP group. (p=0.046) The higher total radiation dose(${\geq}60Gy$) was significantly associated with developing in RP.(p=0.001) The incidence of RP did not correlate with any of the ECOG performance, pulmonary function test, age, cell type, history of smoking, radiotherapy combined with chemotherapy, once-daily radiotherapy dose fraction. Also, serum albumin level, uric acid level at onset of RP did not influence the risk of severe RP in our study. Conclusion : Only the higher total radiation dose(${\geq}60Gy$) was a significant risk factor predictive of RP. Also severe RP was an adverse prognostic factor.

A Clinical Study on Allergic rhinitis (알레르기 鼻炎의 臨床的 硏究)

  • Cho Soo-hyun;Jee Seon-young
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.14 no.2
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    • pp.173-182
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    • 2001
  • This Study is attempted in order to observe a clinical analysis from Constitution medical view point about allergic rhinitis. We studied 71 patients who had visited Dept. surgery, opthalmology & otolaryngology, col1ege of Oriental Medicine, Kyungsan University, Pohang, Korea and were treated by medications of Sasang Constitution and Constitution-Acupunture with allergic rhinitis from March 1, 2000 to February 28, 2001. The results were as follows: 1. The sex distribution was 71 males($69\%$), 22 femail($31\%$), In age distribution, the average was 29.6. The peak age was thirties($36.7\%$), teen-ager was $23.9\%,\;fortieth\;was\;15.5\%,\;under\;10\;years\;old\;was\;9.9\%,\;twenties\;was\;7\%,\;fifties\;was\;5.6\%,\;sixtisth\;was\;1.41\%$. 2. In the age of onset, thirties was $29.6\%$, teen-ager was $19.7\%$, twenties was $18.3\%$, under 10 years old and fortieth was $14.1\%$, fifties was $3.8\%$, sixtisth was $1.41\%$. 3 In monthly distribution. september was $25.8\%$, january was $14.1\%$, october was $11.3\%$. november and august was $8.5\%$, april was $7\%$, febuary and may were $5.6\%$, june, july. December were each $4.2\%$, In the distribution of season. the peak season was fall from september to November. 4. In the duration of the disease, 1-3 years was $26.8\%$, 3-5 years was $19.7\%$, 6 months - 1 year $16.9\%$, 5-10 years was $14.1\%$, under 6 months was $11.3\%$, over 10years and over 15 years were each $5.6\%$. 5. In the three main symptom, hydrorrhoea was $71.8\%$, nasal obstruction was $67.6\%$, sneezing was $64.8\%$. In others, fatique was $25.6\%$, headache was $14.1\%$, itching and cough was $11.3\%$, laryngopharyngeal discomfort and red eye were $4.2\%,\;infirmity\;was\;2.8\%$. 6. Patients whose families have allergic disease account for 26 cases($36.6\%$). 7. There was no past history in 37 cases($52.l\%$). In past history distribution, digestive tract disease was $12.7\%$, paranasal sinusitis was $8.5\%$, allergic dermatitis was $7\%$, common cold was $4.2\%$. otitis media, bronchitis, asthma, tonsillitis were $2.8\%$. 8. Sasang Constitution classification was Soyanggin in 52 cases($73.2\%$), Taeumgin in 12 cases($16.9\%$). Soumgin in 7 cases($9.9\%$). 9. In the duration of treatment, it was 1-2 weeks in 26 cases($36.6\%$), 2-4 weeks was $21.1\%$, under 1weeks was $14.1\%$, 4-6 weeks was $11.3\%$, 6-8 weeks was $8.5\%$, 8-10 weeks was $5.6\%$, over 10 weeks was $2.8\%$. 10. We had a follow-up survey the effect of treatment in the 60 cases. there was fair in 25 cases($41.7\%$), good in 21cases($35\%$), excellent in 3cases($5\%$)로 total rate of treatment was $81.7\%$. The case of no change was $16.7\%$, the case of poor was $1.6\%$.

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Review of 2011 Major Medical Decisions (2011년 주요 의료 판결 분석)

  • Yoo, Hyun-Jung;Seo, Young-Hyun;Lee, Jung-Sun;Lee, Dong-Pil
    • The Korean Society of Law and Medicine
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    • v.13 no.1
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    • pp.199-247
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    • 2012
  • According to the review and analysis of medical cases that are assigned to the Supreme Court and all local High Court in 2011 and that are presented in the media, it was found that the following categories were taken seriously, medical and pharmaceutical product liability, the third principle of trust between medical institutions, negligence and causation estimation, responsibility limit, the meaning of medical records and related judgment of disturbed substantiation, Oriental doctors' duties to explain the procedures, IMS events, whether one can claim for each medical care operated by non-physician health care institutions to the nonmedical domain in the National Health Insurance Corporation, and the basis of norms for each claim. In the cases related to medical pharmaceutical product liability, Supreme Court alleviated burden of proof for accidents with medical and pharmaceutical products prior to the practice of Product Liability Law and onset the point of negative prescription as the time of damage strikes to condition feasibility of the specific situation. In the cases related to the 3rd principle of trust between medical institutions, the Supreme Court refused to sentence the doctor who has trusted the judgment of the same third-party doctors the violations of the care duty. With respect to proof of a causal relationship and damages in a medical negligence case, the Supreme Court decided that it is unjust to deny negligence by the materials of causal relationship rejecting the original verdict and clarified that the causal relationship shall not deny the reasons to limit doctors' responsibilities. In order not put burden on patients with disadvantages in which medical records and the description of the practice or the most fundamental and important evidence to prove negligence and causation are being neglected, the Supreme Court admitted in the hospital's responsibility for the case of the neonate death of suffocation without properly listed fetal heart rate and uterine contraction monitor. On the other hand, the Seoul Western District Court has admitted alimony for altering and forging medical records. With respect to doctors' obligations to description, the Supreme Court decided that it is necessary to explain the foreseen risks by the combination of oriental and western medicines emphasizing the right of patient's self-determination. However, questions have arisen whether it is realistically feasible or not. In a case of an unlicensed doctor performing intramuscular stimulation treatment (IMS), the Supreme Court put off its decision if it was an unlicensed medical practice as to put limitation of eastern and western medical practices, but it declared that IMS practice was an acupuncture treatment therefore the plaintiff's conduct being an illegal act. In the future, clear judgment on this matter should be made. With respect to the claim of bills from non-physical health care institutions, the Supreme Court decided to void it for the implementation of the arrangement is contrary to the commitments made in the medical law and therefore, it is invalid to claim. In addition, contrast to the private healthcare professionals, who are subject to redemption according to the National Healthcare Insurance Law, the Seoul High Court explicitly confirmed that the non-professionals who receive the tort operating profit must return the unjust enrichment and have the liability for damages. As mentioned above, a relatively wide range of topics were discussed in medical field of 2011. In Korea's health care environment undergoing complex changes day by day, it is expected to see more diverse and in-depth discussions striding out to the development in the field of health care.

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Functional implications of gene expression analysis from rice tonoplast intrinsic proteins during seed germination and development (벼 종자에서 액포막 aquaporin (tonoplast intrinsic protein) 유전자의 발현과 기능)

  • Huh, Sun-Mi;Lee, In-Sook;Kim, Beom-Gi;Shin, Young-Seop;Lee, Gang-Seop;Kim, Dool-Yi;Byun, Myung-Ok;Kim, Dong-Hern;Yoon, In-Sun
    • Journal of Plant Biotechnology
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    • v.37 no.4
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    • pp.517-528
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    • 2010
  • Rice seed maturation and germination involve drastic changes in water and nutrient transport, in which tonoplast aquaporins may play an important role. In the present study, gene expression profiles of 10 tonoplast intrinsic proteins (TIP) from rice were investigated by RT-PCR during seed development and germination. OsTIP3;1 and OsTIP3;2 were specifically expressed in mature seeds. Their transcript level rapidly decreased after onset of seed germination and gene expression was induced by ABA treatment. In contrast, expression of OsTIP2;1 and OsTIP4;3 was not seed specific as transcripts were found in vegetative tissues as well. Their respective transcript levels decreased at an early stage of seed development, whereas they increased at a later stage of seed germination and elongation of embryonic roots and shoots. When seed germination was inhibited by various stress conditions and ABA, expression of OsTIP2;1 and OsTIP4;3 was completely suppressed. In contrast, the expression level of OsTIP2;2 rapidly increased after seed imbibition and the transcript level was maintained under conditions inhibiting seed germination. These results implicate that tissue specific and developmental transcriptional regulation of OsTIPs in rice seeds depends on their specific function. In addition, OsTIPs can be discriminated by different potential phosphorylation and methylation sites in their protein structures. OsTIP3;1 and OsTIP3;2 possess unique phosphorylation signatures at their N-terminal domain, loop B and loop E, respectively. OsTIP2;1 and OsTIP4;3 have a potential methylation site at their Nterminal domain. This suggests that activity of specific tonoplast aquaporins may be regulated by post-translational modification as well as by transcriptional control.

A Histological and Clinical Study of the Children with Thin Glomerular Basement Membrane (사구체 기저막 비박화를 보인 소아들의 조직학적 및 임상적 고찰)

  • Kim Young-Chol;Lee Dong-Won;Cho Min-Hyun;Kwak Jung-Sik;Ko Cheol-Woo
    • Childhood Kidney Diseases
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    • v.9 no.1
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    • pp.31-37
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    • 2005
  • Puruose : Thin glomerular basement membrane disease(TGBMD) is found in patients with family history of hematuria. TGBMD is autosomal dominant and is known to be one of the commonest causes of asymptomatic hematuria. This study was conducted to evaluate the histological and clinical features of patients with TGBMD. Methods : 150 cases diagnosed with TGBMD by renal biopsy while admitted in the department of pediatrics, Kyungpook National University Hospital between January 1999 and December 2003 comprised the study group. The following parameters were retrospectively anaIyzed age of onset, hematuria pattern, existence of proteinuria, process of diagnosis, laboratory findings, thickness and character of basement membrane and family history. Results : The mean age at the time of diagnosis was 7.9 years. The male to female ratio was 65:77. 94 patients or 66% visited the hospital with a chief complaint of persistent microscopic hematuria. Gross hematuria accounted for 13 cases or 9%. 78 cases(55%) were found to have hematuria for the first time from a routine school urinalysis screening. The renal biopsy showed the thickness of basement membrane to be 186$\pm$36 nm. Focal lamellation of the basement membrane was found in eight cases. In the family history, hematuria was shown in 10 cases on the Paternal side, 13 on The maternal side and none on both sides. In seven cases, hematuria was shown among siblings. No significant differences were found among the laboratory test results which were conducted at an average interval of fifteen months. Conclusion : TGBMD is one of the major causes of asymptomatic hematuria in children, which was diagnosed in increasing numbers since school urinary mass screening test started in 1998. In cases with familial progressive renal disease or focal duplication in the basement membrane Alport syndrome should be considered.

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Analysis of Structural Safety of the Welded Pipe Columns Adopted in Paprika Greenhouse (파프리카 재배용 온실에서 용접 파이프 기둥재의 구조적 안전성 검토)

  • Suh, Won-Myung;Choi, Man-Kwon;Im, Jae-Un;Kwon, Sun-Ju;Kim, Hyeon-Tae;Kim, Young-Ju;Yoon, Yong-Cheol
    • Journal of agriculture & life science
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    • v.45 no.2
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    • pp.125-133
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    • 2011
  • This study was conducted on greenhouses whose side heights had been raised after the columns of 1-2W basic type greenhouses had been cut and welding with the same-sized pipes. When the wind load or snow load affects restructured pipe greenhouse like this, those parts will be structurally unsafe. To examine this, the bending strength of welded columns were measured through four stages and compared with the pipes in their original condition. Results are as follows. In the case of a bending test on welded joints about steel pipes used for greenhouses, satisfactory results couldn't be drawn because sections of both ends and the loading parts couldn't endure loads and sank regardless of loading methods. Partial problems could be solved by inserting inside pipe(steel bar) at the sections and the loading parts, but it was necessary to devise more satisfactory bending test methods. The strength of welded joints wasn't much different compared with original conditions and demonstrated only slight differences according to the sample production conditions. However, significant incompleteness in the welding process was expected to cause a decisive loss in strength. On the assumption that there were no problems in the welding process or with regard to the inclination of sub materials for columns after connection, it was deemed reasonable to assume that the strength of welded pipes was about 84~90% of the strength of the pipes in their original condition. Considering mid- and long-term strength decline following the onset of rust at joints or welding sections, structural changes in the main sub materials that are used for greenhouses at farmhouses have to be avoided to ensure structural safety, unless these changes are inevitable.

Study on Volume Measurement of Cerebral Infarct using SVD and the Bayesian Algorithm (SVD와 Bayesian 알고리즘을 이용한 뇌경색 부피 측정에 관한 연구)

  • Kim, Do-Hun;Lee, Hyo-Young
    • Journal of the Korean Society of Radiology
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    • v.15 no.5
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    • pp.591-602
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    • 2021
  • Acute ischemic stroke(AIS) should be diagnosed within a few hours of onset of cerebral infarction symptoms using diagnostic radiology. In this study, we evaluated the clinical usefulness of SVD and the Bayesian algorithm to measure the volume of cerebral infarction using computed tomography perfusion(CTP) imaging and magnetic resonance diffusion-weighted imaging(MR DWI). We retrospectively included 50 patients (male : female = 33 : 17) who visited the emergency department with symptoms of AIS from September 2017 to September 2020. The cerebral infarct volume measured by SVD and the Bayesian algorithm was analyzed using the Wilcoxon signed rank test and expressed as a median value and an interquartile range of 25 - 75 %. The core volume measured by SVD and the Bayesian algorithm using was CTP imaging was 18.07 (7.76 - 33.98) cc and 47.3 (23.76 - 79.11) cc, respectively, while the penumbra volume was 140.24 (117.8 - 176.89) cc and 105.05 (72.52 - 141.98) cc, respectively. The mismatch ratio was 7.56 % (4.36 - 15.26 %) and 2.08 % (1.68 - 2.77 %) for SVD and the Bayesian algorithm, respectively, and all the measured values had statistically significant differences (p < 0.05). Spearman's correlation analysis showed that the correlation coefficient of the cerebral infarct volume measured by the Bayesian algorithm using CTP imaging and MR DWI was higher than that of the cerebral infarct volume measured by SVD using CTP imaging and MR DWI (r = 0.915 vs. r = 0.763 ; p < 0.01). Furthermore, the results of the Bland Altman plot analysis demonstrated that the slope of the scatter plot of the cerebral infarct volume measured by the Bayesian algorithm using CTP imaging and MR DWI was more steady than that of the cerebral infarct volume measured by SVD using CTP imaging and MR DWI (y = -0.065 vs. y = -0.749), indicating that the Bayesian algorithm was more reliable than SVD. In conclusion, the Bayesian algorithm is more accurate than SVD in measuring cerebral infarct volume. Therefore, it can be useful in clinical utility.

Somatic Cell Analysis and Cobalamin Responsiveness Study in Ten Korean Patients with Methylmalonic Aciduria (한국 메틸말로닌산혈증 환아 10례에서 Somatic Cell 분석과 cobalamin 반응성 연구)

  • Lim, Han Hyuk;Song, Wung Joo;Kim, Gu-Hwan;Watkins, David;Rosenblatt, David S.;Kim, Yoo-Mi;Chang, Mea Young;Kil, Hong Ryang;Kim, Sook Za
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.19 no.1
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    • pp.12-19
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    • 2019
  • Purpose: Isolated methylmalonic acidemia (MMA) is an autosomal recessive inherited disorder of propionate metabolism. There are two subtypes of MMUT gene defects. $Mut^0$ represents complete loss of methylmalonyl-CoA mutase (MCM) activity while mut- is associated with residual MCM activity, which can be stimulated by hydroxocobalamin (OHCbl) supplementation. The objective of this study is to investigate cobalamin responsiveness and mutations present in Korean MMA population. Methods: We evaluated 10 MMA patients using somatic cell complementation analysis on their fibroblasts to measure MCM activity and vitamin B12 responsiveness for the optimal treatment. MMUT gene was sequenced to identify the MMA mutations. Results: For all patients, the incorporation of $[^{14}C]-propionate$ was low, and there was no response to OHCbl. The incorporation of $[^{14}C]-methyltetrahydrofolate$ and $[^{57}Co]-CNCbl$ fell within the normal range. There was adequate synthesis of methylcobalamin while the synthesis of adenosylcobalamin was low. The complementation analysis showed all patients were $mut^0$. The sequence analysis identified 12 different MMUT mutations, including 2 novel mutations, p.Gln267Ter and p.Ile697Phe, were identified. All the patients in this study had neonatal onset of symptoms, belonged to $mut^0$ complementation class, and as a result, showed no cobalamin responsiveness. Conclusion: No Korean MMA patient showed cobalamin responsiveness.

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The effect of economic crisis on success attribution among Korean students and adults: An indigenous psychological analysis (IMF시대 이후 한국 학생과 성인의 성공에 대한 의식: 토착심리학적 분석)

  • Young-Shin Park;Uichol Kim;Soo-Yeon Tak
    • Korean Journal of Culture and Social Issue
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    • v.8 no.1
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    • pp.103-139
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    • 2002
  • Korean society has significantly changed with the onset of a dramatic economic crisis in 1998. From 2000, however, the Korean economy has recovered and currently Korea is enjoying a similar standard of living and economic growth as the pre-1998 levels. This study is a follow-up analysis, comparing the results examining the success attribution of Korean students and adults in 2001 with the results obtained before the economic crisis in 1997. Using the indigenous psychological approach, this study compares the similarities and differences in Korean students and adults' attribution of their personal success before and after the economic crisis. A total of 988 participants, consisting of 481 primary, junior high, senior high and university students and 507 adults (236 fathers and 271 mothers of the students) completed the questionnaire developed by Kim and Park (1998). The results indicate that students perceived their academic achievement and adults perceived successful family life as their most proud achievement. Successful family life included items such as academic success of children, healthy development of their children, and harmonious family life. The person who provided the most significant support for students were parents and for adults, it was their spouse. For students, the importance of friends' social support increased during the high school years. In terms of type of social support, emotional support was reported to be the most important for both students and adults. As for the reason for their success, majority of students and men reported self-regulation and for women, supportive family environment was reported as being the most important. Comparing 2001 results with the 1997 results, the importance of family increased after the economic crisis. Even with the dramatic economic crisis, however, some of the underlying pattern remain strong (such as importance of academic achievement for students, family life for adults, the importance of social support, especially emotional social support from family members, and believing that self-regulation would lead to success). The similar pattern of results obtain before and after the economic crisis indicate that the above results reflect a fundamental values and belief system deeply imbedded in Korean mentality.

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The Spectrum of CT Findings of COVID-19 Pneumonia: Acute Alveolar Insult and Organizing Pneumonia as Different Phases of Lung Injury and Repair (COVID-19 폐렴의 다양한 CT 영상 소견: 급성 폐포 손상과 기질화 폐렴)

  • Yun Su Kim;Ung Rae Kang;Young Hwan Kim
    • Journal of the Korean Society of Radiology
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    • v.82 no.2
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    • pp.359-370
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    • 2021
  • Purpose To analyze the findings and serial changes in chest CT lesions in 123 symptomatic patients with coronavirus disease 2019 (COVID-19). Materials and Methods From February 19 to April 7, 2020, a total of 123 confirmed COVID-19 patients (male, 44; female, 79; mean age, 59.2 ± 18.6) were enrolled in this retrospective study. A total of 234 CT scans were reviewed for the following patterns: acute alveolar insult (AAI) patterns: ground-glass opacity (GGO), crazy-paving appearance, mixed pattern, and consolidation; organizing pneumonia (OP) patterns: perilobular patterns, band opacity, curvilinear opacity, reversed halo opacity, and small nodular consolidation; resolving patterns: pure GGO, remnant curvilinear, small nodular consolidation, and serial changes of lung abnormalities. We compared the proportions of AAI pattern, OP pattern, or resolving pattern with time progression and analyzed the association between the patterns and disease severity using Pearson chi-square and Fisher's exact test. Results Predominant CT patterns were AAI pattern (87%) in the early hospital period group (0-10 days, after the onset of symptoms), OP pattern (45.7%) in the later hospital period group (after 10 days), and resolving pattern in discharge and follow-up group (47.2% and 84.8%, respectively). The difference in the proportions of predominant CT patterns with time progression was statistically significant (p < 0.001, Pearson's chi-square test). No statistically significant association was observed between the patterns and disease severity (p = 0.055, Fisher's exact test). No fibrous changes in the lesions were observed on follow-up CT scans. Conclusion The serial CT scans of COVID-19 patients showed the spectrum of COVID pneumonia CT manifestations as different phases of lung injury and repair.