• Journal of Chest Surgery
• /
• v.42 no.2
• /
• pp.220-225
• /
• 2009

Background: Sternoclavicular septic arthritis manifests serious complications such as abscess, osteomyelitis, mediastinitis and empyema; therefore, a prompt diagnosis and appropriate treatment are necessary. Material and Method: The treatment results of eight patients with sternoclavicular septic arthritis and who had been surgically treated at our institutions between September 2005 and July 2008 were retrospectively reviewed. The surgical treatment they underwent was en bloc resection, including partial resection of the sternum, the clavicular head and the 1st rib. Result: The patients ranged in age from 40 to 74 years with an average of $55.1{\pm}10.3$ years. Five were men and three were women. There were 6 patients with spontaneous sternoclavicular septic arthritis and 2 patients had their condition induced by central venous catheters. The pathogens isolated from the patients’ blood and wounds were MRSA (3), Streptococcus intermedius (1), Streptococcus agalactiae (1) and Pseudomonas luteola (1). One patient expired from aggravation of preoperative sepsis on POD 31. Conclusion: The life-threatening complications from sternoclavicular septic arthritis can progress and lead to death unless appropriate treatment is administered. A prompt diagnosis, appropriate antibiotics therapy and effective surgical treatment such as radical en bloc resection can reduce the morbidity and mortality of this malady.

• Clinical and Experimental Pediatrics
• /
• v.48 no.10
• /
• pp.1132-1138
• /
• 2005

Purpose : The mucopolysaccharidoses (MPSs) are a heterogeneous group of lysosomal storage disorders. They are caused by a deficiency of the enzymes involved in the degradation of glycosaminoglycans. Early recognition is important because recombinant enzyme replacement therapy is now available for MPS. We studied the clinical characteristics of 80 MPS children with the object of determining the epidemiological, clinical and radiological features in Korean MPS children. Methods : Diagnosis of MPS was confirmed by skin fibroblast enzyme analysis in 80 patients between February 1995 and December 2004. Charts were retrospectively reviewed for clinical and radiological findings, as well as for intelligence and speech evaluations. Results : Hunter syndrome (MPS type II) was the most prevalent type, appearing in 51/80 cases (64 %), followed by Sanfilippo syndrome (MPS III-18%), Hurler syndrome (MPS I-15%), and Morquio syndrome (MPS IV-4%). The average age at diagnosis was 5.5 years (range 1 to 20), and the male-to-female ratio was 4.7 : 1. Typical radiographic changes were observed in 45/54 cases (83%). Mitral regurgitation was the most common cardiac defect. Moderate to profound mental retardation and hearing loss were present in 14/35 cases (56%) and 33/38 cases (82%), respectively. Four MPS II patients had bone marrow transplantation, with mixed outcomes. Five MPS I patients are currently on enzyme replacement therapy. Conclusion : Our study showed a high proportion of MPS II cases (64%), which may represent population variability. By studying the clinical features of these patients, we hope to alert pediatricians of the warning signs of MPS.

• Journal of Nutrition and Health
• /
• v.43 no.1
• /
• pp.26-33
• /
• 2010

This study was performed to investigate the changes of oral diet intake during the admission period and identify the factors related with nutritional status in discharging of leukemia patients. This is a retrospective cross sectional study on 46 leukemia patients receiving chemotherapy at the Catholic University of Korea Seoul St. Mary's Hospital from July to September 2009. The patients' charts were surveyed on the general characteristics and factors relating chemotherapy. The calorie count method was used to investigate diet intake during admission period. Multivariate logistic regression analysis was used to identify possible confounding factors. A p < 0.05 was considered statistically significant. The mean age was $42.8\;{\pm}\;14.6$ years and the average length of stay was $30.4\;{\pm}\;7.0$ days. The incidence of malnourished patients was 60.9% in discharging. There was a significant difference in chemotherapy sessions and chemotherapy period between well-nourished and malnourished patients. The average energy intake was 1,525.9 kcal in well-nourished patients and 1,143 kcal in malnourished patients, which was significant different. From repeated measures ANOVA test, the changes of oral intake during admission period were significant by groups. In addition, there were significant differences in oral intake according to each period between well-nourished and malnourished patients. In multivariate logistic regression analysis, both the ratio of total oral energy intake to recommended energy intake and chemotherapy sessions were significantly associated with nutritional status in discharging. The results of this study could be used to establish a protocol of nutritional management for leukemia patients receiving chemotherapy.

• Tuberculosis and Respiratory Diseases
• /
• v.59 no.1
• /
• pp.30-38
• /
• 2005

Background : Arsenic trioxide ($As_2O_3$) has been used to treat acute promyelocytic leukemia, and it induces apoptosis in a variety of solid tumor cell lines including non-small cell lung cancer cells. However, nonsteroidal antiinflammatory drugs (NSAID) can enhance tumor response to chemotherapeutic drugs or radiation. It was previously demonstrated that a combination treatment with $As_2O_3$ and sulindac induces the apoptosis of NCI-H157 human lung carcinoma cells by activating the caspase cascade. This study aimed to determine if a combination treatment augmented its apoptotic potential through other pathways except for the activation of the caspase cascade. Material and Methods : The NCI-H157 cells were treated with $As_2O_3$, sulindac and antioxidants such as glutathione (GSH) and N-acetylcysteine (NAC). The cell viability was measured by a MTT assay, and the level of intracellular hydrogen peroxide ($H_2O_2$) generation was monitored fluorimetrically using a scopoletin-horse radish peroxidase (HRP) assay. Western blotting and mitochondrial membrane potential transition analysis were performed in order to define the mechanical basis of apoptosis. Results : The viability of the cells was decreased by a combination treatment of $As_2O_3$ and sulindac, and the cells were protected using antioxidants in a dose-dependent manner. The increased $H_2O_2$ generation by the combination treatment was inhibited by antioxidants. The combination treatment induced changes in the mitochondrial transmembrane potential as well as the expression of the Bcl-2 family proteins, and increased cytochrome c release into the cytosol. However, the antioxidants inhibited the effects of the combination treatment. Conclusion : Combination treatment with $As_2O_3$ and sulindac induces apoptosis in NCI-H157 human lung carcinoma cells via ROS generation with a mitochondrial dysfunction.

• Clinical and Experimental Pediatrics
• /
• v.45 no.8
• /
• pp.967-972
• /
• 2002

Purpose : A retrospective study was undertaken to evaluate the usefulness of low risk criteria for identifying febrile infants younger than three months unlikely to have serious bacterial infection. Methods : We conducted a retrospective study of 527 infants younger than three month with a axillary temperature ${\geq}37.4^{\circ}C$. If they met the following all four criteria, appear well, WBC $5,000-20,000/mm^3$, urine stick WBC(-) and nitrite(-), CSF WBC < $10/mm^3$, they were considered at low risk for serious bacterial infection(SBI). SBI was defined as a positive culture of urine, blood, or cerebrospinal fluid. The sensitivity, specificity, negative predictive value and positive predictive value of the low risk criteria were calculated. Results : Of 527 febrile infants, 110(21.0%) had serious bacterial infections. The 2.7% who met the low risk criteria had SBI and negative predictive value was 97.3%. SBI was diagnosed in 103 infants(38.6%) who didn't meet the low risk criteria including urinary tract infection(78.6%), most commonly, bacteremia(16.5%), bacterial meningitis(8.7%), Salmonella gastroenteritis(1%), osteomyelitis( 1%), septic arthritis of hip joint(1%). There were no differences in the sensitivity and negative predictive value according to the monthly-age-group. Conclusion : This low risk criteria to identify infants unlikely to have SBI early is available, however low risk infants must be carefully observed.

• Radiation Oncology Journal
• /
• v.11 no.1
• /
• pp.51-58
• /
• 1993

We tried to establish the theoretical basis of clinical use of combined modality of hyperthermia and radiation therapy. For this purpose, we made an in vitro experiment in order to get the synergistic and/or additive effects on the cell killing of hyperthermia combined with radiation therapy by using the microwave-hyperthermia machine already installed at our department. In our experiment, we use two human cell lines: MKN-45 (adenocarcinoma of stomach) and K-562 (leukemia cell lines). In cases of combined treatments of hyperthermia and gamma-irradiation, the therapeutic effect was the highest in the simultaneous trial. Hyperthermia after gamma irradiation showed slightly higher therapeutic effect than that before irradiation without significant difference, but its effect was the same in the interval of 6 hours between hyperthermia and irradiation. The higher temperature and the longer treatment time were applied, the higher therapeutic effects were observed. We could observe the thermoresistance by time elapse at $43^{\circ}C$. When hyperthermia was done for 30 minutes at the same temperature, thermal enhancement ratio (TER) at DO. 01 (dose required surviving fraction of 0.01) were $2.5{\pm}0.08,\;3.75{\pm}0.18$, and $5.0{\pm}0.15\;at\;436{\circ}C,\;44^{\circ}C,\;and\;45^{\circ}C$ respectively in K-562 leukemia cell lines. Our experimental data showed that more cell killing effect can be obtained in the leukemia cell lines, although they usually are known to be radiosensitive, when treated with combined hyperthermia and radiation therapy. Furthermore, our data show that leukemia cell lines may have various intrinsic radiosensitivity, especially in vitro experiments. The magnitude of cell killing effect, however, will be less than that of MKN-45.

• Journal of Preventive Medicine and Public Health
• /
• v.27 no.1 s.45
• /
• pp.11-24
• /
• 1994

The studies reported here were undertaken to investigate the effects of mercury chloride on immune system of Balb/c mouse employing a flexible tier of in vitro and in vivo assays. Mercury chloride inhibited the proliferative responses of spleen cells to lipopolysaccharide, pokeweed mitogen, and phytohemagglutinin as a dose-dependent manner. This inhibitory effect was observed not only when $HgCl_2$ was added 2nd or 3rd day of 3 days culture period but also when spleen cells was pretreated with $HgCl_2$ for 2 hours. Mercury chloride, however, potentiated the production of IgM and IgG from spleen cells. During the $HgCl_2$ administration by drinking for 3 weeks, the weight gain of mice was significantly blunted than that o control group mice, while no overt signs related to mercury toxicity were noted in any mice of experimental group. There was no change in thymus and spleen weights, and in histological findings of kidney, bone marrow of femur, thymus, spleen, and popliteal lymph node after 3 weeks of mercury exposure. However, $HgCl_2$ induced a significant increase of total serum IgM, IgG including $IgG_1,\;IgG_{2a}\;and\;IgG_{2b}$, and IgE in Balb/c mice. Treatment in vivo with anti-IL-4 monoclonal antibody significantly abrogated the $HgCl_2$-induced increase in total serum IgG1 and IgE. Whereas $HgCl_2$ potentiated total serum IgM and IgG, there was no difference in total serum hemagglutinin to SRBC (Sheep Red Blood Cell) between experimental and control group mice when these mice were immunized with SRBC. All these findings observed in Balb/c mice suggest that mercury perturbates well-orchestrated regulation of immune responses before developing histopathological changes in lymphoid tissues.

• The Korean Journal of Nuclear Medicine
• /
• v.28 no.1
• /
• pp.124-132
• /
• 1994

Radioactive iodine has been widely used in patients with thyroid cancer combined with surgical treatment. However, due to individual variations in absorption and excretion and uptake by tumor tissue of radioactive iodine, there are differences in therapeutic effect and adverse effects even if the same doses are administrated. So this study compared the therapeutic effect and radiation hazard by measuring internal radiation dose. Of total 27 patients with well differentiated thyroid cancer who had been thyroidectomized, we administered radioactive iodine 100 mCi, 150 mCi, 200 mCi. According to BEL DOSIMETRY PROTO-COL, beta and gamma ray dose were estimated from a pelt of the logarithm of the percent of dose per liter of whole blood versus day, and percent dose retained versus day using somilogarithmic paper, respectively. 1) Physical dose to whole blood averaged $56.54{\pm}13.02$ rad in 100 mCi administered group, $76.83{\pm}19.97$ rad in 150 mCi administered group, $95.08{\pm}25.51$ rad in 200 mCi administered group and there has been a significant correlation among the groups. 2) Mean percent dose retained 48 hours later was 26.34%. 3) There was no significant correlation of physical dose between absence and presence of metastasis. 4) 17 of 19 patients who has been followed up with TSH and serum throglobulin, Thallium scan were successfully ablated by radioactive iodine. 5) Leukocyte, lymphocyte, neutrophil, platelet counts all deelined in 4.6 weeks and most of all were restored 3 months later. 6) There was no significant correlation between physical dosimetry and biologic dosimetry. Generally administered doses of radioactive iodine (100-200 mCi) to patients with thyroid cancer postoperatively had developed transient bone marrow suppression and minimal chromosomal aberration, but they were within safety dose to blood (200 rad). And there has been no significant differences in residual dose 48 hours later between Korean and western people.

• The Korean Journal of Nuclear Medicine
• /
• v.28 no.1
• /
• pp.85-88
• /
• 1994

근래 골조직에 있어서 자율신경의 기능에 대하여 많은 연구가 이루어지고 있으며, 골내의 자율신경의 해부학적 분포는 많이 알려져 있다. 그러나 임상적으로 반사적 교감신경 이상이나 레이노드 현상등과 같은 교감신경의 기능이상증에서나, 버거씨병 등의 치료 목적으로 시행되고 있는 교감신경 절제술 후, 자율신경기능의 변화가 사지골의 혈류나 골대사에 미치는 영향에 대하여는 아직도 논란의 여지가 있다. 저자들은 교감신경절제술 후 시간 경과에 따른 골에 미치는 영향을 알아보기 위하여 흰쥐에서 골대사와 혈류상태를 비교적 충실히 반영하는 정량적 골스캔을 시행하였다. 체중 $300{\sim}400g$의 수컷 흰쥐 10마리에서 복강을 통한 편측 요추부 교감신경절제술을 시행하였고, 수술 전과 후 1일, 3일, 1주, 2주, 3주, 4주에 양측 하지에서 각각 골스캔을 시행하고 교감신경 절제측 하지와 정상 하지에 대칭적으로 관심구역을 정하여 양측의 골스캔상 섭취계수를 비교하였다. 측정부위는 각 하지의 대퇴골간, 경골간 및 중족골로 하였다. 교감신경 절제술을 시행한 하지에서는 골스캔 소견상 수술 후 1일 또는 3일부터 동위원소 집적이 유의하게 증가되었으며 원위부로 갈수록 더욱 증가되었다. 그러나 3주 이후에는 정상측 수준으로 환원되었다. 교감신경절제술 후 골스캔상 동위원소집적이 증가되는 것은 골자체의 혈류가 증가되기 때문이며 이차적으로 골의 흡수를 유발하여 골밀도가 감소하는 것으로 생각되는데 이러한 변화는 시술 후 1일 째부터 관찰되어 사지골이 교감신경 절제에 매우 민감하게 반응하는 것을 알 수 있었다.9m}Tc$-MAA를 이용한 간 동맥 혈류 검사는 간암에서 색전술의 효과를 정확히 평가할 수 있는 유용한 검사법으로 이용될 수 있으리라 생각한다. 활성화 과정을 알아볼 수 있었으며 위상영상히스토그램을 통하여 이를 정량화하여 심실내 전기적 활성의 비동시성 여부를 추적관찰 할 수 있는 비관혈적검사임을 확인하였다.며, 3. $^{99m}Tc$으로 표지된 avidin과 streptavidin은 먼저 간으로 흡수된 후 대사된 다음 신장으로 배설된다는 사실을 알았다.damole에 의한 부작용은 흉통, 두통, 복통 등의 순이었고 전예에서 호전되었으며 생명에 위험을 초래할 수 있는 정도의 심장마비나 심부정맥은 한 예에서도 없었다. 결론적으로 dipyridamole은 약물부하 심근 SPECT 검사에 안전하게 사용할 수 있는 약물로 사료된다. 미소핵 빈도수가 증가하는 경향을 보였으나, 각 군간에 통계학적으로 유의한 차이는 없었다(p>0.05). 결론 : 임상적으로 치료를 중단하게 되는 1000mCi/60 Kg(16.67 mCi/Kg)를 투여한 군에서도 생쥐 골수내 미소핵이 발현되지 않는 것으로 보아, 방사성옥소는 비교적 안심하고 치료에 사용할 수 있는 제제로 사료되었다.반드시 비례하지만은 않아서 시간경과에 따른 추후 검사가 필요하리라 생각된다. 또한 방광요관역류가 있는 환아에서 DMSA 섭취율로 신기능을 평가할 때, 특히 영유아에서 연령에 따른 고려가 있어야 할 것으로 보인다.었다. 4) $^{99m}Tc-DISIDA$ hepatobiliary scintigram 음성율을

• Journal of Dental Rehabilitation and Applied Science
• /
• v.38 no.2
• /
• pp.97-109
• /
• 2022

Purpose: This study aims to investigate the risk indicators contributing to implant failure, and analyze the relationship between risk indicators and marginal bone loss (MBL) through long-term follow-up over 3 years. Materials and Methods: From 2003 to 2017, patients' medical charts with a history of dental implant surgery at Chonnam National University Dental Hospital were reviewed retrospectively. The patient's demographic variables, and clinical variables were recorded. Periapical radiographs were used to evaluated the changes in MBL around implants. And we analyzed implant survival rates. Multiple regression analysis with backward elimination was conducted to correlate the patient's clinical variables and implant failure and Pearson correlation analysis was performed to the correlated between implant long-term survival rates and MBL and initial stability. Results: In multiple regression analysis, there was a statistically significant negative correlation between abutment connection type (β = -.189, P < .05), with or without SPT (β = -.163, P < .05), diabetes (β = -.164, P < .05), osteoporosis (β = -.211, P < .05) and MBL. Anticoagulant medication influenced the long-term success rate of implants. PTV values at the second implant surgery showed a statistically significant negative correlation with long-term implant survival (P < .05). Conclusion: For the long-term success of the implant, the appropriate abutment connection type must be selected and the periodic SPT is recommended. Systemic diseases such as diabetes and osteoporosis and anticoagulant medication should be considered. Furthermore, since high PTV at the second implant surgery correlated with the long-term survival rates of the implant, initial stability should be carefully considered before undergoing the prosthetic procedure.