• Radiation Oncology Journal
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• 제17권4호
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• pp.275-280
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• 1999

목 적 :국소적으로 진행된 비인두암환자에서 선행보조 항암화학요법의 실행 용이성과 부작용의 정도를 평가한다. 대상 및 방법 : 77명의 조직학적으로 비인두암으로 확진 되고 이전에 치료를 받은 적이 없는 진행된 병기의 비인두암 환자들이 1984년부터 1996년까지 서울대학교병원에서 선행보조 항암화학요법과 방사선치료를 시행 받았다. 환자군의 병기분포는 다음과 같다. 1992년 AJCC 분류법에 따라 제 3 병기에 속하는 환자가 2명이었고 제 4병기에 속하는 환자가 75명이었다. 방사선치료 시행 전에 선행보조 항암화학요법으로 66명의 환자가 5-FU와 Cisplatin의 정맥 내 투여를 시행 받았고, 11명의 환자가 5-FU와 Carboplatin의 정맥 내 투여를 시행 받았다. 생존환자의 중앙추적기간은 44개월이었다. 결 과 :항암화학요법에의 반응율은 87$\%$였다. 항암화학요법의 부작용은 심하지 않았다. 3명의 환자만이 3도의 부작용을 경험하였다. 1명은 백혈구 감소증을 보였고 2명은 오심과 구토의 부작용을 보였다. 방사선에 의한 점막염도 심하지 않았는데, 10명의 환자에서 2도의 점막염이 발생하였다. 5년 생존율과 5년 무병생존율은 각각 68$\%$와 65$\%$였다. 5년 무원격전이율은 82$\%$였으며 5년 국소 치유율은 75$\%$였다. 결 론 : 선행보조 항암화학요법이 진행된 병기의 비인두암 환자에 있어서 부작용을 크게 증가시키지 않으면서 효과적인 치료방법임을 알 수 있었다.

• Childhood Kidney Diseases
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• 제22권1호
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• pp.1-6
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• 2018

Rituximab (RTX) is a chimeric monoclonal antibody that inhibits CD20-mediated B-cell proliferation and differentiation. Several studies have examined its use in intractable nephrotic syndrome (NS) with some positive results. However, those studies examined such effects for a short-term period of 1 year, and some patients continued to relapse after a lapse in RTX treatment. Our use of RTX as a maintenance therapy (RTX injection when the CD19 cell count exceeded $100-200/{\mu}L$ before relapse) showed some noticeable efficacy. We used RTX in 19 patients with steroid-dependent NS (SDNS). In 12 patients treated with RTX maintenance therapy, only one relapse occurred. The mean treatment period was $23.4{\pm}12.7months$, and the mean number of RTX administrations was $3.9{\pm}1.6$. The relapse rates were decreased (from 2.68/year to 0.04/year), and the drug-free period also increased (from 22.5 days/year to 357.1 days/year) during maintenance therapy. The other seven patients were treated with one cycle of RTX or additional cycles in case of relapse (non-maintenance therapy). Relapse rates were significantly decreased after RTX treatment (from 1.76/year to 0.96/year, P=0.017). The relapse-free period was $15.55{\pm}7.38$ (range, 5.3-30.7) months. No severe side effects of RTX were found except for a hypersensitivity reaction such as fever and chills during its infusion. In conclusion, RTX is considered an effective and safe option to reduce the relapse rate by a single- or maintenance-interval therapy in SDNS.

• Journal of Korean Biological Nursing Science
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• 제4권2호
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• pp.113-125
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• 2002

This study is to evaluate contamination of the 3-way stopcocks connected to infusion set, which is used to the patients admitted to emergency room in a general hospital in D city. The data were collected from Oct. 1, 2001 to Feb. 25, 2002. First of all, in order to select microorganisms, From the 50 patients were randomized, Coagulase Negative Staphylococcus, Staphylococcus aureus, micrococcus, Pseudomonas aeruginosa, Acinetobacter detected. Coagulase Negative Staphylococcus, Staphylococcus aureus, micrococcus were determined to be evaluated in this study. As a result, 8 of the patients were Coagulase Negative Staphylococcus positive(>15 colonies), 4 were Staphylococcus aureus positive(>15 colonies). 1 was micrococcus positive(>15 colonies). Among the patients who were Coagulase Negative Staphylococcus positive 112(average) colonies were detected on the first day, 429 were on the second day, and 563 were on the third day. In case of patients of Staphylococcus aureus positive, 85(average) colonies were detected on the first day, 151 were on the second day, and the 203 were on the third day. CNS was cultured using API kit for the 8 patients who were in CNS positive. One case was detected Staphylococcus capitis, another one case was Staphylococcus chromogenes. Two cases were Staphylococcus xylosus, another two were Staphylococcus hominis, and the remainer were Staphylococcus epidermidis. As a result, the API codes of two Staphylococcus epidermidis had shown the same pattern, and the resistance patterns of the them were the same, too. As a result of resistance test among 5 patients who have shown that the same resistance pattern in 02SAK1, 02SAK5, 02SAK2, 02SAK4. As a result of this study, aseptic technique of 3-way stopcock intravenous therapy can protect infections, and it is needed the sterilization of the 3-way stopcock just before injection using disinfectants. It needs to improve the 3 way stopcock change intervals from 48 hours.

• Journal of mucopolysaccharidosis and rare diseases
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• 제4권1호
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• pp.7-10
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• 2018

Rare diseases are life threatening or chronically debilitating diseases with a low prevalence (less than 2,000 people in a population), which includes lysosomal storage diseases. These diseases are often seen as unimportant especially in developing countries, such as Indonesia, due to small number of patients. National Rare Disease Center in Indonesia was pioneered almost 20 years ago and officially established in 2017 by the Indonesian Minister of Health. Lysosomal storage disease become the most commonly found inborn errors of metabolism (IEM) in Indonesia due to easily accessible diagnostic facilities. Currently there are 7 patients receiving ERT in this mixed-donation scheme, one patient with Gaucher disease and 6 patients with MPS type II. Few challenges for ERT in Indonesia include importation through special access scheme, preparation of ERT infusion in intensive care settting, and cost of treatment. Even with limited resources, healthcare professionals in Indonesia have been giving the best care possible for rare disease patients, especially to provide diagnostic facilities through collaboration and treatment options for treatable rare diseases. Improvements in care for rare disease patients are still needed.

• Journal of Yeungnam Medical Science
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• 제32권1호
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• pp.17-21
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• 2015

Amlodipine, a calcium channel blocker of the dihydropyridine group, is commonly used in management of hypertension, angina, and myocardial infarction. Amlodipine overdose, characterized by severe hypotension, arrythmias, and pulmonary edema, has seldom been reported in Korean literature. We report on a fatal case of amlodipine intoxication with complications including rhabdomyolysis and oliguric acute kidney injury. A 70-year-old woman with a medical history of hypertension was presented at the author's hospital 6 hours after ingestion of 50 amlodipine (norvasc) tablets (total dosage 250 mg) in an attempted suicide. Her laboratory tests showed a serum creatinine level of 2.5 mg/dL, with elevated serum creatine phosphokinase and myoglobin. The patient was initially treated with fluids, alkali, calcium gluconate, glucagon, and vasopressors without a hemodynamic effect. High-dose insulin therapy was also started with a bolus injection of regular insulin (RI), followed by continuous infusion of RI and 50% dextrose with water. Despite intensive treatment including insulin therapy, inotropics, mechanical ventilation, and continuous venovenous hemodiafiltration, the patient died of refractory shock and cardiac arrest with no signs of renal recovery 116 hours after her hospital admission.

• Childhood Kidney Diseases
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• 제23권1호
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• pp.43-47
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• 2019

Atypical hemolytic uremic syndrome (aHUS), a rare form of thrombotic microangiopathy, is distinguished from the typical form by the absence of a preceding verotoxin-producing Escherichia coli infection. Notably, aHUS occurs in association with genetic or acquired disorders causing dysregulation of the alternative complement pathway. Patients with aHUS may show the presence of anti-complement factor H (CFH) autoantibodies. This acquired form of aHUS (antiCFH-aHUS) primarily affects children aged 9-13 years. We report a case of a 13-year-old Lao girl with clinical features of aHUS (most likely anti-CFH-aHUS). The initial presentation of the patient met the classical clinical triad of thrombotic microangiopathy (microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury) without preceding diarrheal illness. Low serum levels of complement 3 and normal levels of complement 4 indicated abnormal activation of the alternative complement pathway. Plasma infusion and high-dose corticosteroid therapy resulted in improvement of the renal function and hematological profile, although the patient subsequently died of infectious complications. This is the first case report that describes aHUS (possibly anti-CFH-aHUS) in Laos.

• 대한상부위장관⦁헬리코박터학회지
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• 제18권4호
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• pp.231-234
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• 2018

Peptic ulcer bleeding (PUB) is the most common cause of non-variceal upper gastrointestinal bleeding, and its frequency has been declining over the past decades. However, mortality from PUB persists, and it is still a serious challenge in clinical practice. Although endoscopic intervention is the basic treatment modality for PUB, pharmacological therapy is an important adjunct. The emergence of proton pump inhibitors (PPIs) enables maintenance of intragastric pH >6, which greatly helps in the treatment of PUB. Continuous intravenous infusion of high-dose PPI reduces the re-bleeding rate, thereby helping avoid additional surgery in patients with high-risk stigmata. Moreover, administration of PPIs prior to endoscopy may reduce the need for additional endoscopic intervention. Recently introduced gastric acid suppressants, such as potassium-competitive acid blockers, have shown promising results in further treatment of PUB.

• Clinical and Experimental Reproductive Medicine
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• 제19권1호
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• pp.81-85
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• 1992

The effects of pulsatile GnRH therapy have been studied for the treatment of different forms of hypogonadotropic hypogonadism, including idiopathic hypogonadotropic hypogonadism and hypogonadism developed as a result of treatment with combination of surgery and irradiation for pituitary or hypothalamic tumor. GnRH was administered subcutaneously in a dose of $10{\mu}g$ every 2 hours with the pulsatile infusion pump. With GnRH therapy, all patients improved secretion of LH, FSH and testosterone. Testicular volumes increased. Spermatogenesis was induced in 8 patients. Pulsatile GnRH therapy is an effective treatment for idiopathic hypogonadotropic hypogonadism and can have a role in hypogonadism previously treated with combination of surgery and irradiation for pituitary or hypothalamic tumor.

• 한국전문물리치료학회지
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• 제19권3호
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• pp.72-80
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• 2012

The purpose of the present study was to investigate the effects of familiar exercise and novel exercise on motor function after intracerebral hemorrhage (ICH) in rats. The rats were subjected to a unilateral striatal ICH via collagenase infusion. The rats were randomly divided into the following three groups: the CON (control group; rested one week post-ICH), the FE (familiar exercise group; familiar exercise was performed two weeks after one-week post-ICH period), and NE (novel exercise group; novel exercise was performed two weeks after one-week post-ICH period). We measured neurological behavior using a ladder rung walking test and a beam walking test; we measured the level of nerve growth factor (NGF) using immunohistochemistry and western blot analysis. We performed a one-way ANOVA test to analyze the scores obtained from the neurological behavior tests and the differences of NGF protein levels among the three groups. In the present study, the FE group and the NE group showed significant improvement during the neurological behavior tests and in their expression of NGF protein level, as compared to the CON group. Especially, NE group more increase than FE group in neurological behavior tests, the expression of NGF on motor cortex. In conclusion, these results suggest that, after ICH, familiar exercise and novel exercise enhance motor function and, novel exercise is more effective than familiar exercise.

• The Korean Journal of Pain
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• 제31권3호
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• pp.155-173
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• 2018

Chronic postsurgical pain (CPSP) is an unwanted adverse event in any operation. It leads to functional limitations and psychological trauma for patients, and leaves the operative team with feelings of failure and humiliation. Therefore, it is crucial that preventive strategies for CPSP are considered in high-risk operations. Various techniques have been implemented to reduce the risk with variable success. Identifying the risk factors for each patient and applying a timely preventive strategy may help patients avoid the distress of chronic pain. The preventive strategies include modification of the surgical technique, good pain control throughout the perioperative period, and preoperative psychological intervention focusing on the psychosocial and cognitive risk factors. Appropriate management of CPSP patients is also necessary to reduce their suffering. CPSP usually has a neuropathic pain component; therefore, the current recommendations are based on data on chronic neuropathic pain. Hence, voltage-dependent calcium channel antagonists, antidepressants, topical lidocaine and topical capsaicin are the main pharmacological treatments. Paracetamol, NSAIDs and weak opioids can be used according to symptom severity, but strong opioids should be used with great caution and are not recommended. Other drugs that may be helpful are ketamine, clonidine, and intravenous lidocaine infusion. For patients with failed pharmacological treatment, consideration should be given to pain interventions; examples include transcutaneous electrical nerve stimulation, botulinum toxin injections, pulsed radiofrequency, nerve blocks, nerve ablation, neuromodulation and surgical management. Physical therapy, cognitive behavioral therapy and lifestyle modifications are also useful for relieving the pain and distress experienced by CPSP patients.