• 대한족부족관절학회지
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• 제25권1호
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• pp.6-9
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• 2021

The term chronic lateral ankle instability (CLAI) embraces a spectrum of conditions that involve functional and mechanical instability, both in athletes and lower-demand patients. The hallmarks of CLAI are recurrent sprains, persistent pain, and repeated episodes of the ankle giving way. CLAI is the main complication of acute ankle sprains, which can cause discomfort in daily and sports activity. Approximately 10% to 30% of patients with acute ligament ruptures will develop chronic instability over the course of a year from the index injury. An accurate diagnostic approach and successful treatment plan should be established based on a comprehensive understanding of the concept of functional and mechanical instability. Unfortunately, the optimal modality for the management of CLAI is unclear. Even after conservative treatment or surgical intervention, it could result in degenerative changes to the ankle joint in the long term. Thus far, the incidence of ligamentous posttraumatic ankle osteoarthritis was reported to be 13% to 78%. The mean latency time between injury and osteoarthritis was at least 10 to 34.3 years. CLAI is an important pathological condition that can cause discomfort or dysfunction in daily activity in the short term, resulting in joint destruction in the long term. Therefore, it is important to understand the various complications that can occur when CLAI is not treated properly.

• Clinical and Experimental Pediatrics
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• 제56권6호
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• pp.247-253
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• 2013

Purpose: In children with acute leukemia, bone marrow genetic abnormalities (GA) have prognostic significance, and may be the basis for minimal residual disease monitoring. Since April 2007, we have used a multiplex reverse transcriptase-polymerase chain reaction tool (HemaVision) to detect of GA. Methods: In this study, we reviewed the results of HemaVision screening in 270 children with acute leukemia, newly diagnosed at The Catholic University of Korea from April 2007 to December 2011, and compared the results with those of fluorescence in situ hybridization (FISH), and G-band karyotyping. Results: Among the 270 children (153 males, 117 females), 187 acute lymphoblastic leukemia and 74 acute myeloid leukemia patients were identified. Overall, GA was detected in 230 patients (85.2%). HemaVision, FISH, and G-band karyotyping identified GA in 125 (46.3%), 126 (46.7%), and 215 patients (79.6%), respectively. TEL-AML1 (20.9%, 39/187) and AML1-ETO (27%, 20/74) were the most common GA in ALL and AML, respectively. Overall sensitivity of HemaVision was 98.4%, with false-negative results in 2 instances: 1 each for TEL-AML1 and MLL-AF4. An aggregate of diseases-specific FISH showed 100% sensitivity in detection of GA covered by HemaVision for actual probes utilized. G-band karyotype revealed GA other than those covered by HemaVison screening in 133 patients (49.3%). Except for hyperdiplody and hypodiploidy, recurrent GA as defined by the World Health Organizationthat were not screened by HemaVision, were absent in the karyotype. Conclusion: HemaVision, supported by an aggregate of FISH tests for important translocations, may allow for accurate diagnosis of GA in Korean children with acute leukemia.

• 대한임상독성학회지
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• 제16권2호
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• pp.86-92
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• 2018

Purpose: Cardiovascular or respiratory complications of acute intoxication are the most common causes of mortality. Advanced cardiac life support (ACLS) or specific antidotes help manage these cardiac or respiratory complications in acute intoxication. On the other hand, some cases do not respond to ACLS or antidotes and they require some special treatment, such as extracorporeal life support (ECLS). ECLS will provide the chance of recovery from acute intoxication. This study examined the optimal timing of ECLS in acute intoxication cases. Methods: This paper is a brief report of a case series about ECLS in acute poisoning. The cases of ECLS were reviewed and the effects of ECLS on the blood pressure and serum lactate level of the patients were analyzed. Results: A total of four cases were reviewed; three of them were antihypertensive agent-induced shock, and one was respiratory failure after the inhalation of acid. The time range of ECLS application was 4.8-23.5 hours after toxic exposure. The causes of ECLS implementation were one for recurrent cardiac arrest, two for shock that did not respond to ACLS, and one for respiratory failure that did not respond to mechanical ventilator support. Three patients showed an improvement in blood pressure and serum lactate level and were discharged alive. In case 1, ECLS was stared at 23.5 hours post toxic exposure; the patient died due to refractory shock and multiple organ failure. Conclusion: The specific management of ECLS should be considered when a patient with acute intoxication does not recovery from shock or respiratory failure despite ACLS, antidote therapies, or mechanical ventilator support. ECLS improved the hemodynamic and ventilator condition in complicated poisoned patients. The early application of ECLS may improve the tissue perfusion state and outcomes of these patients before the toxic damage becomes irreversible.

• Clinical and Experimental Pediatrics
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• 제57권10호
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• pp.434-439
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• 2014

Treatment outcomes of pediatric cancers have improved greatly with the development of improved treatment protocols, new drugs, and better supportive measures, resulting in overall survival rates greater than 70%. Survival rates are highest in acute lymphoblastic leukemia, reaching more than 90%, owing to risk-based treatment through multicenter clinical trials and protocols developed to prevent central nervous system relapse and testicular relapse in boys. New drugs including clofarabine and nelarabine are currently being evaluated in clinical trials, and other targeted agents are continuously being developed. Chimeric antigen receptor-modified T cells are now attracting interest for the treatment of recurrent or refractory disease. Stem cell transplantation is still the most effective treatment for pediatric acute myeloid leukemia (AML). However, in order to reduce treatment-related death after stem cell transplantation, there is need for improved treatments. New drugs and targeted agents are also needed for improved outcome of AML. Surgery and radiation therapy have been the mainstay for brain tumor treatment. However, chemotherapy is becoming more important for patients who are not eligible for radiotherapy owing to age. Stem cell transplant as a means of high dose chemotherapy and stem cell rescue is a new treatment modality and is often repeated for improved survival. Drugs such as temozolomide are new chemotherapeutic options. In order to achieve 100% cure in children with pediatric cancer, every possible treatment modality and effort should be considered.

• Clinical and Experimental Pediatrics
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• 제51권8호
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• pp.892-895
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• 2008

H-형태의 식도기관루 또는 선천 식도 폐쇄 없는 식도 기관루는 소아에서 매우 드문 형태이며, 그 임상 양상도 질환의 중등도에 따라 다양하게 나타난다. 몇몇의 성인에서 발견된 선천 식도 기관루는 이 질환이 조기 진단되기 어려움을 반영한다고 볼 수 있다. 위식도역류는 만성적인 흡인을 일으킬 수 있으며 폐흡인, 생명이 위험할 정도의 호흡기증상 또는 성장장애 등이 흔히 일으킬 수 있는 중한 합병증이다. 저자들은 통상의 치료에 반응을 보이지 않는 반복적인 폐렴과 천명을 동반하고 급성호흡곤란증후군으로까지 진행하였으며 반복된 식도조영촬영에서 심한 위식도역류와 H-형태의 식도기관루가 발견되었던 5개월 남아의 증례를 경험하였기에 이를 보고하는 바이다.

• Journal of Chest Surgery
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• 제44권5호
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• pp.343-347
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• 2011

Background: Acute pulmonary thromboembolism is fatal because of abruptly occurring hypoxemia and right ventricular failure. There are several treatment modalities, including anticoagulation, thrombolytics, ECMO (extracorporeal membrane oxygenator), and thromboembolectomy, for managing acute pulmonary thromboembolism. Materials and Methods: Medical records from January 1999 to December 2004 at our institution were retrospectively reviewed for pulmonary thromboembolectomy. There were 7 patients (4 men and 3 women), who underwent a total of 8 operations because one patient had post-operative recurrent emboli and underwent reoperation. Surgery was indicated for mild hypoxemia and performed with CPB (cardiopulmonary bypass) in a beating heart state. Results: The patients had several symptoms, such as dyspnea, chest discomfort, and palpitation. Four patients had deep vein thromboembolisms and 3 had psychotic problems, specifically schizophrenia. Post-operative complications included hemothorax, pleural effusion, and pericardial effusion. There were two hospital deaths, one each by brain death and right heart failure. Conclusion: Emergency operation should be performed when medical treatments are no longer effective.

• Korean Journal of Radiology
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• 제22권1호
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• pp.63-71
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• 2021

Objective: To identify the CT findings associated with treatment failure after antibiotic therapy for acute appendicitis. Materials and Methods: Altogether, 198 patients who received antibiotic therapy for appendicitis were identified by searching the hospital's surgery database. Selection criteria for antibiotic therapy were uncomplicated appendicitis with an appendiceal diameter equal to or less than 11 mm. The 86 patients included in the study were divided into a treatment success group and a treatment failure group. Treatment failure was defined as a resistance to antibiotic therapy or recurrent appendicitis during a 1-year follow-up period. Two radiologists independently evaluated the following CT findings: appendix-location, involved extent, maximal diameter, thickness, wall enhancement, focal wall defect, periappendiceal fat infiltration, and so on. For the quantitative analysis, two readers independently measured the CT values at the least attenuated wall of the appendix by drawing a round region of interest on the enhanced CT (HU_post) and non-enhanced CT (HU_pre). The degree of appendiceal wall enhancement (HU_sub) was calculated as the subtracted value between HU_post and HU_pre. A logistic regression analysis was used to identify the CT findings associated with treatment failure. Results: Sixty-four of 86 (74.4%) patients were successfully treated with antibiotic therapy, with treatment failure occurring in the remaining 22 (25.5%). The treatment failure group showed a higher frequency of hypoenhancement of the appendiceal wall than the success group (31.8% vs. 7.8%; p = 0.005). Upon quantitative analysis, both HU_post (46.7 ± 21.3 HU vs. 58.9 ± 22.0 HU; p = 0.027) and HU_sub (26.9 ± 17.3 HU vs. 35.4 ± 16.6 HU; p = 0.042) values were significantly lower in the treatment failure group than in the success group. Conclusion: Hypoenhancement of the appendiceal wall was significantly associated with treatment failure after antibiotic therapy for acute appendicitis.

• Journal of Korean Neurosurgical Society
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• 제50권2호
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• pp.119-122
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• 2011

We report a case of 70-year-old man with glioblastoma presenting as acute encephalitic illness. The patient exhibited sudden onset of cognitive impairment and headache for 2 days. Initial brain MRI showed left temporal lobe hyperintensity, and cerebrospinal fluid cytology revealed a mild pleocytosis. The patient had initially improved after medical treatment with a presumptive diagnosis of herpes simplex encephalitis (HSE). After 8 months, the patient complained of recurrent seizures. A follow-up brain MRI revealed marked increases in size and surrounding perilesional edema in the left temporal lesion on T2-weighted images and a new contrast-enhancing lesion on gadolinium-enhanced T1-weighted images. Stereotactic brain biopsy revealed a glioblastoma. The atypical encephalitic presentation of glioblastoma should be considered if definitive evidence for the diagnosis of HSE cannot be obtained.

• Clinical and Experimental Pediatrics
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• 제48권7호
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• pp.691-695
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• 2005

There is scientific evidence that administration of probiotics is effective in the treatment of acute infectious diarrhea in children and the prevention of antibiotic associated diarrhea and nosocomial/community acquired diarrhea. Probiotics prevent relapse of recurrent pouchitis and decrease the initial onset of pouchitis in ulcerative colitis. Probiotic organisms suppress growth of pathogens as well as their epithelial attachment and/or invasion either directly by secreting antimicrobial substances or by stimulating host expression of protective molecules. Additionally, probiotics enhance mucosal barrier function and can stimulate host production of immunosuppressive molecules that downregulate inflammatory responses or allergic immune response. Mechanisms of action explain therapeutic effects and randomized controlled trials are warranted before recommendations for therapeutic or preventive use can be given.

• The Korean Journal of Pain
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• 제23권1호
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• pp.88-91
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• 2010

The piriformis syndrome is a condition allegedly attributable to compression of the sciatic nerve by the piriformis muscle. Recently, magnetic resonance neurography and electrophysiologic study have helped to diagnose piriformis syndrome. High dose radiotherapy could induce acute and delayed muscle damage. We had experienced piriformis syndrome with fatty atrophy of piriformis muscle after radiotherapy for recurrent cervical cancer.