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A Case of Acute Respiratory Distress Syndrome Induced by All-Trans-Retinoic Acid (ATRA로 유발된 급성호흡곤란증후군 1예)

  • Kim, Cheol;Ko, Won-Ki;Kwon, Seung-Hyun;Kang, Shin-Myung;Kim, Chang-Nyun;Yang, Dong-Gyoo;Kim, Se-Kyu;Chang, Joon;Kim, Sung-Kyu;Lee, Won-Young;Yang, Woo-Ik
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.1
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    • pp.93-98
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    • 2000
  • Acute respiratory distress syndrome (ARDS) has been reported to be associated with a variety of medical and surgical conditions, including All-trans-retinoic acid (ATTA). ATRA is very efficaceous drug to acute promyelocytic leukemia (APL). This drug can induce complete remission at APL without fatal risk of disseminated intravascular coagulation. But ATRA treatment, sometimes, produces the symptoms of fever, weight gain and acute respiratory distress, renal function impairment. The causes of these symptoms are not fully proved, but supposed as the result of leukostasis and capillary leak syndrome from excessive leukocyte differentiation and cytokines release. Recently, we experienced a 24-year-old woman who complained gum bleeding for 6 days. At bone marrow biopsy, she was diagnosed as APL. 2 days after ATRA treatment, she was suffered from the symptoms of dyspnea and general ache. At laboratory examination, total leukocyte count was 50,400/$mm^3$, $PaO_2$ was 42.5 mm Hg and chest PA revealed the findings compatible with ARDS. Treatment with low dose ara-C, corticosteroid and general supportive cares were tried. Within 3 days after treatment, the patient recovered from ARDS by evidence of arterial blood gas study and chest radiographs. She has acquired complete remission of APL with maintenance of A TRA. And so, we present this case with a review of related literatures.

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CT-Guided Percutaneous Transthoracic Needle Biopsy Using the Additional Laser Guidance System by a Pulmonologist with 2 Years of Experience in CT-Guided Percutaneous Transthoracic Needle Biopsy

  • Jeon, Min-Cheol;Kim, Ju Ock;Jung, Sung Soo;Park, Hee Sun;Lee, Jeong Eun;Moon, Jae Young;Chung, Chae Uk;Kang, Da Hyun;Park, Dong Il
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.4
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    • pp.330-338
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    • 2018
  • Background: We developed an additional laser guidance system to improve the efficacy and safety of conventional computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB), and we conducted this study to evaluate the efficacy and safety of our system. Methods: We retrospectively analyzed the medical records of 244 patients who underwent CT-guided PTNB using our additional laser guidance system from July 1, 2015, to January 20, 2016. Results: There were nine false-negative results among the 238 total cases. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of our system for diagnosing malignancy were 94.4% (152/161), 100% (77/77), 100% (152/152), 89.5% (77/86), and 96.2% (229/238), respectively. The results of univariate analysis showed that the risk factors for a false-negative result were male sex (p=0.029), a final diagnosis of malignancy (p=0.033), a lesion in the lower lobe (p=0.035), shorter distance from the skin to the target lesion (p=0.003), and shorter distance from the pleura to the target lesion (p=0.006). The overall complication rate was 30.5% (74/243). Pneumothorax, hemoptysis, and hemothorax occurred in 21.8% (53/243), 9.1% (22/243), and 1.6% (4/243) of cases, respectively. Conclusion: The additional laser guidance system might be a highly economical and efficient method to improve the diagnostic efficacy and safety of conventional CT-guided PTNB even if performed by inexperienced pulmonologists.

Correlations of Subclinical Hypothyroidism with Serum Lipid Profiles and Obesity Index (준임상적 갑상선 기능저하증과 혈청 지질 및 비만도의 상관관계)

  • Kim, Ho-jun;Park, Jung-Hyun;Lee, Myeong-Jong;Park, Ji-Hun;Song, Mi-Young
    • The Journal of Korean Medicine
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    • v.29 no.3
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    • pp.38-49
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    • 2008
  • Objectives: Though overt thyroid dysfunction is well recognized to affect serum lipid profiles and obesity, there are conflicting reports on the effect of subclinical hypothyroidism on serum lipid profiles and obesity. In most reports, the definition of the upper normal limit of serum thyroid stimulation hormone (TSH) of 4.0${\sim}$5.0mU/L has been used to diagnose. However, recent studies have suggested a much lower TSH cut off with an upper limit of 2.5mU/L, because >95% of rigorously screened normal euthyroid volunteers had serum TSH values between 0.4 and 2.5mU/L. Therefore we defined subclinical hypothyroidism as a TSH level greater than 2.5mU/L. We sought to evaluate the correlations of subclinical hypothyroidism with obesity index and serum lipid profiles Methods: TSH levels were measured in 6190 men and 4223 women that participated in health examination and free T4, lipid profiles (total-cholesterol, triglyceride, LDL-C), and obesity index (body mass index, body fat, waist circumference, C-reactive protein) were also measured. Results: There were significant differences of triglyceride between subclinical hypothyroidism men and normal control subjects. In women, there were also significant differences of triglyceride and LDL-C between subclinical hypothyroidism and normal control subjects. Subclinical hypothyroidism women showed significant correlations of TSH with total cholesterol, LDL-C, triglyceride, and C-reactive protein. Subclinical hypothyroidism men and women with a TSH level 2.5${\sim}$4.0mU/L had significant differences of triglyceride and body fat. In men, there were significant differences of waist circumference andC-reactive protein. In women, there were significant differences of LDL-C. Conclusions: We have demonstrated correlations of subclinical hypothyroidism with serum lipid profiles and obesity index. These findings suggested that subclinical hypothyroidism people had an increased risk of dyslipidemia and obesity. Subclinical hypothyroidism people with a TSH level 2.5${\sim}$4.0mU/L may be also considered suspect since it may signal a case of evolving thyroid underactivity eligible to be prevented.

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A Comparative Study on Total Payment of Mental and Behavioral Disorders Patients Admitted through the Emergency Room: Focusing on Main & Sub Sick (응급실 경유 정신 및 행동장애 입원환자들의 총진료비 비교 : 주상병과 부상병 환자 중심으로)

  • Choi, Hyun-Sik;Lee, Hyun-Sook
    • The Journal of the Korea Contents Association
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    • v.14 no.10
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    • pp.562-569
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    • 2014
  • The purpose of this study was to investigate the determinants of total payment for mental and behavioral disorders patients admitted through the emergency room. Study data was selected from the Korean National Health Insurance sample data in 2009. This data was consisted of 753 inpatients who are 331 inpatients with only main sick(F31-F39) and 422 inpatients with main sick codes(F31-F39) and sub sick(F00-F99) admitted through the emergency room. SPSS v.18 was used for the statistical analysis such as descriptive analysis, t-test, ANOVA, and multiple regression analysis. In multiple regression analysis, significant variables affecting total payment of main sick patients were gender(p<.01), treatment result(p<.001), path of the emergency room(p<.001), and length of stay(p<.001). Also, main sick patients with sub sick were gender(p<.01), age(p<.001), treatment result(p<.001), path of the emergency room(p<.001), and length of stay(p<.001). These findings implied that it is necessary to build short, middle, and longterm program and system for high risk mental and behavioral disorders groups.

Effect of Magnolia Obovata Water-extracts on the Atherosclerosis Treated with High-cholesterol Diet in Rat (고(高)콜레스테롤 식이로 유발된 흰쥐 동맥경화에 Magnolia obovata가 미치는 영향)

  • Na, Sun-Taek;Lee, Young-Yang;Kim, Young-Hwan;Yang, Young-Yi;Jung, Hyun-Jung;Kim, Jae-Eun;Park, Won-Hwan
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.5
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    • pp.1055-1062
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    • 2009
  • Magnolia obovata exhibit several beneficial effects including anti-oxidant effects. Magnolia obovata is used as a therapeutic agent to stop hemorrhages and a tonic to promoted health in Korean and Chinese medicine. The pharmacokinetic profiles of the main Magnolia obovata is still not accurately investigated. In present study, I examined the effects of water extracts of Magnolia obovata on atherosclerosis induced high cholesterol diet in rats in serum and abdominal aorta. A total of 3-week old 9 male rats of Sprague-Dawley were divided into 3 groups and fed with the basal diet (normal group), high cholesterol diet (atherosclerosis induced group) for 8 weeks, high cholesterol diet supplemented with water extracts of Magnolia obovata (Magnolia obovata group) for 2 weeks. And rats were sacrificed, serum lipid level, abodominal aortic anti-oxidant activities and lipid peroxide were measured. These results indicated that serum total cholesterol, LDL-cholesterol, triglycerides concentration significantly lower in Magnolia obovata group than high cholesterol diet group. But HDL-cholesterol concentration had significantly higher in Magnolia obovata group than high cholesterol diet group. In conclusion, Magnolia obovata controls of lipid level of hyperlipidemia and hypercholesterolemia, thus suppresses the proliferation of intima in endothelial cells, which is risk factors of atherosclerosis induced high cholesterol diet in rats. I consider as Magnolia obovata is worth to using as atherosclerosis treatment.

Recent Advances in Understanding the Mechanisms of Particulate Matter-mediated Ocular Diseases (미세먼지에 의한 안구질환 발병 연구 동향)

  • Lee, Hyesook;Choi, Yung Hyun
    • Journal of Life Science
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    • v.30 no.8
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    • pp.722-730
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    • 2020
  • As one of the most serious health risk factors, air pollution can no longer be ignored. Particulate matter (PM) is an important and harmful component of air pollution that originates from a variety of sources. Numerous recent studies have linked PM to a range of conditions including cancer, cardiovascular, respiratory, and skin disease. The eye, despite being directly exposed to air pollution, has been investigated in very few of these studies. In this review, we describe the evidence from in vitro and in vivo studies, as well as epidemiological investigations, that supports the association between exposure to PM and the development of ocular conditions such as surface and retinal disease and glaucoma. Based on the results of previous studies, we suggest that PM exposure can lead to oxidative stress, inflammation, autophagy, and, ultimately, ocular surface disease. Nevertheless, almost no studies focus on ocular surface damage from PM while some epidemiological and clinical studies report on the posterior of the eye. However, the underlying pathological mechanisms in the posterior following PM exposure have yet to be identified, and further studies are therefore warranted of the ocular surface as well as the posterior part of the eye.

An Epidemiological Investigation on Severity of Cerebro-Vascular Accident Patients in Korea (한국인의 뇌졸중 위중도에 관한 역학적 분석)

  • Jeon Jae-Kyun;Roh Pyong-Ui
    • The Journal of Korean Physical Therapy
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    • v.11 no.1
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    • pp.23-43
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    • 1999
  • A study on severity of cerebro-vascular accident patients in Korea was conduced in order to determine the risk factors affecting the severity of stroke patients. This study was performed by interviewing a total of 477 hospitalized and ambulatory patient of CVA in Seoul, Taejon, and Taegu and Pusan areas from April 1, 1998 through June 30, 1998. The results are as follows; 1. Two hundred and sixty seven $(56\%)$ at Four hundred and seventy seven subjects were manes, md two hundred and ten $(44\%)$ were females. $28.3\%$ of the subjects' ages were 50's and $27.3\%$ were 60's and $18.5\%$ were 70's. $22.6\%$ of the subjects' occupations were home makers, $17.8\%$ were farming. $66.4\%$ of the subjects spent their childhood in urban areas and $33.1\%$in rural areas. $41.7\%$ of the subjects became violin of CVA in Spring, $35.0\%$ in Winter. 2. On physical and mental conditions of the subjects at the occurrence of CVA, $28.7\%$ of the subjects were engaged in physical activities. $22.6\%$ were in a rest stale $19.5\%$ were in sleeping and $18.9\%$ were mentally shocked. $79.4\%$ of the male subjects and $14.8\%$ of female subjects smoked cigarettes. $82\%$ of male subjects drank coffee. $81.1\%$ of the subjects did not exercise regularly. $45.9\%$ of the subjects had the systolic blood pressures in the range of 160 to 199 mmHg and $5.6\%$ of the subjects had hypertension before the occurrence of stroke and $11.7\%$ had diabetes. 3. Of the types of strokes, cerebral hemorrhage was the highest $(49.1\%)$. cerebral infarction was the second $(41.1\%)$. Severe strokes were found in cerebral hemorrhage cases $(52.0\%)$ and cerebral infarction cases $(40.1\%).\;50.9\%$. of the male subjects were moderate cases, $50.9\%$ were severe cases. In females, moderate cases were $72.4\%$, severe cases $15.2\%$. $37.5\%$ of the subjects who had preceding diseases were severe cases, and $15.6\%$ of the subjects without preceding diseases were severe cases. $50.7\%$ of the subjects whose family members had strokes had severe strokes. $34\%$ of the subjects sleeping less than 6 hours a day, $42.4\%$ of the subjects with irregular eating habits, $33.3\%$ of the subjects who liked meat, and $42.3\%$ of the subjects who liked salty foods had severe strokes. $35.9\%$ of the subjects with hot temper, $27.6\%$ of the subjects with moderate temper and $14.5\%$ of subjects with mild temper were severe cases. 4. The correlation coefficient between obesity and blood pressure was 0.094.

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Comparative Analysis of Differences in Reaction Time and Divided Attention with Elderly Age: Using the Driving Ability Assessment Tool (고령자 연령별 반응속도 및 분리집중력 차이에 대한 비교분석: 운전능력 평가도구를 이용하여)

  • Woo, Ye Shin;Shin, Ga-In;Park, Hae Yean
    • Therapeutic Science for Rehabilitation
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    • v.9 no.3
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    • pp.53-61
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    • 2020
  • Objective : The purpose of this study is to evaluate the reaction time and divided attention related to driving in elderly subjects using the driving ability assessment tool. By analyzing differences in average score according to age group, we also aim to, provide data for identifying the risk of driving in elderly people. Methods : A total of 70 elderly subjects, who participated in a driving evaluation program for people over 65 years of aged and who live in W city, Gangwon-do from August to December 2019, were included in the study. After the driving questionnaire was completed, the mobile driving assessment tool was explained, and then the patients carried out the reaction time and the divided attention task. Collected data were analyzed using the statistical program SPSS 25.0, and the significance level was set to 0.1. Results : The reaction time of the younger-old was 0.717 s, while that of the older-old was 0.843 s, this difference was statistically significant (p=.084). The response time for the task of divided attention was 0.669 s in the younger-old and 0.695 s for the older-old. In this case, there was no statistically significant difference between the two groups (p=.901). Conclusion : Using the mobile driving ability assessment tool, it was possible to evaluate the reaction rate and divided attention of elderly while driving.

The Clinical Evaluation between Overtraining Syndrome and Exercise-related Immunity (과훈련증후군과 면역반응의 임상적 분석)

  • Choi, Seung-Jun;Park, Song-young;Kwak, Yi-Sub
    • Journal of Life Science
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    • v.25 no.11
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    • pp.1324-1330
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    • 2015
  • The present study was performed to analyze and review the physical and immune responses to overtraining syndrome in humans. Overreaching refers to the initial phage of overtraining syndrome and has been known as a physical fatigue which is mainly from metabolic imbalance. It has been known that overtraining also results in a loss of adaptability which may lead to an attenuation of exercise performance, sleeping disorder, central fatigue, neurohormonal changes, difficulty recovery to physical stress, and immunological changes. Additionally, overtraining syndrome is characterized by persistent fatigue, poor performance in sport due to the prolonged and strenuous physical training. Also, previous studies reported that endurance athletes experienced a high incidence of URTI during intense training and the post training. And also, high-performance athletes reported that suppression of cell mediated and anti-body mediated immune function. NK cell numbers were also reduced in the period of overtraining syndrome. Major components of prevention and treatment for the overtraining syndrome are screening, education, and detraining. Furthermore, the combination of these prevention and treatment strategies will be much helpful. Therefore, the current review will be helpful for athletes and individuals who are at the risk of overtraining syndrome.

Korean Epithelial Ovarian Cancer Study (Ko-EVE): Protocols and Interim Report

  • Ma, Seung Hyun;Kim, Byoung-Gie;Choi, Ji-Yeob;Kim, Tae-Joong;Kim, Yong-Man;Kim, Jae Weon;Kang, Sokbom;Kang, Daehee;Yoo, Keun-Young;Park, Sue K.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.3731-3740
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    • 2012
  • Background: There have been few studies of Asian ovarian cancer and benign tumors. The primary aim of this paper was to report the protocol of the Ko-EVE study to examine epidemiological and molecular factors for ovarian cancer and benign neoplasms and to ascertain the major risk factors for ovarian cancer control in Korea. Methods: This case-control study covers incident epithelial ovarian cancers and benign neoplasms, four major centers participating in enrolling incident cases and 3 hospitals enrolling healthy controls among health examinees. Standardized questionnaires were administered by trained interviewers, including sections on socio-demographics characteristics, past medical history, medication usage, family history, lifetime consumption of alcohol and tobacco, diet, physical activity, and reproductive factors for women. Various biological specimens were collected in the biorepository according to the standardized protocol. Annual follow-up for cancer cases and follow-up at the 1st year for benign tumor cases are performing to evaluate treatment effect and progression. Passive follow to see long-term survival will be conducting using record linkage with national data. Results: The total number recruited in 2010-2011 was 246 epithelial ovarian cancer cases, 362 benign epithelial tumors and 345 controls. We are planning to collect subjects for at least 1,500 sets of ovarian cancer, 2,000 benign tumors and 1,500 controls till 2018. Conclusions: The Ko-EVE will provide unique and important data to probe the etiology and natural history of Korean epithelial ovarian cancer. It will be continued by genomic and proteomic epidemiological analyses and future intervention studies for the prevention of ovarian cancer among Koreans.