• Journal of Nutrition and Health
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• v.43 no.2
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• pp.189-196
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• 2010

Malnutrition has been associated with higher hospital costs, mortality, rates of complications and longer length of hospital stay. Several nutritional screening tools have been developed to identify patients with malnutrition risk. However, many of those require much time and labor to administer and may not be applicable to a Korean population. Therefore, the aim of this study was to develop nutritional screening tool for Korean inpatients. Then we compare nutritional screening tools that developed and previously described. Seven hundred sixty-four patients at hospital admission were screened nutritional status and classified as well nourished, malnutrition stage 1 or stage 2 by the KNNRS (Kyunghee Neo Nutrition Risk Screening), PG-SGA (Patient-Generated Subjective Global Assessment) and NRS-2002 (Nutritional Risk Screening-2002). The KNNRS, PG-SGA and NRS-2002 respectively classified 28.7%, 51.3%, 48.5% of patients as malnourished status. Compared to the PG-SGA, the KNNRS had sensitivity 60.7% (95% CI 54.2-67.0) and specificity 81.2% (95% CI 75.3-85.2). Agreement was fair between KNNRS and PG-SGA (k = 0.34). Compared to the NRS-2002, the KNNRS had sensitivity 57.8% (95% CI 53.4-60.9) and specificity 64.4% (95% CI 60.2-69.8). Agreement was poor between KNNRS and NRS-2002 (k = 0.18). These result should include that the KNNRS and PGSGA have clinical relevance and fair concordance. However the rate of malnourished patients by KNNRS were less than by PG-SGA. For more effectivity of nutritional screening and management, the criteria of KNNRS would be better revised.

• Tuberculosis and Respiratory Diseases
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• v.46 no.5
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• pp.685-696
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• 1999

Background : Idiopathic pulmonary fibrosis (IPF) is a diffuse inflammatory and fibrosing process that occurs within the interstitium and alveolus of the lung with invariably poor prognosis. The major problem in management of IPF results from the variable rate of disease progression and the difficulties in predicting the response to therapy. The purpose of this retrospective study was to evaluate the short-term efficacy of steroid and immunosuppressive therapy for IPF and to identify the pre-treatment determinants of favorable response. Method : Twenty patients of IPF were included. Diagnosis of IPF was proven by thoracoscopic lung biopsy and they were presumed to have active progressive disease. The baseline evaluation in these patients included clinical history, pulmonary function test, bronchoalveolar lavage (BAL), and chest high resolution computed tomography (HRCT). Fourteen patients received oral prednisolone treatment with initial dose of 1mg/kg/day for 8 to 12 weeks and then tapering to low-dose prednisolone (0.25mg/kg/day). Six patients who previously had experienced significant side effects to steroid received 2mg/kg/day of oral cyclophosphamide with or without low-dose prednisolone. Follow-up evaluation was performed after 6 months of therapy. If patients met more than one of followings, they were considered to be responders : (1) improvement of more than one grade in dyspnea index, (2) improvement in FVC or TLC more than 10% or improvement in DLco more than 20% (3) decreased extent of disease in chest HRCT findings. Result : One patient died of extrapulmonary cause after 3 month of therapy, and another patient gave up any further medical therapy due to side effect of steroid. Eventually medical records of 18 patients were analyzed. Nine of 18 patients were classified into responders and the other nine patients into nonresponders. The histopathologic diagnosis of the responders were all nonspecific interstitial pneumonia (NSIP) and that of nonresponders were all usual interstitial pneumonia (UIP) (p<0.001). The other significant differences between the two groups were female predominance (p<0.01), smoking history (p<0.001), severe grade of dyspnea (p<0.05), lymphocytosis in BAL fluid ($23.8{\pm}16.3%$ vs $7.8{\pm}3.6%$, p<0.05), and less honeycombing in chest HRCT findings (0% vs $9.2{\pm}2.3%$, p<0.001). Conclusion : Our results suggest that patients with histopathologic diagnosis of NSIP or lymphocytosis in BAL fluid are more likely to respond to steroid or immunosuppressive therapy. Clinical results in large numbers of IPF patients will be required to identify the independent variables.

• Journal of Chest Surgery
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• v.36 no.6
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• pp.379-383
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• 2003

Background: An accurate diagnosis of the severity of the rejection after a heart transplantation relies on endomyo-cardial biopsy, but because of its invasiveness and the need for repeated examination makes it is an inappropriate monitoring method. Therefore, we have tried to find a monitoring method that is continuous and less invasive. Material and Method: Heterotopic heart transplantation using Ono-Lindsey Method was done in 20 rats, and then $^{99m}$ Tc-Pyrophosphate (PYP) scan was done after a month, Uptake ratio of transplanted heart to vertebrae (H/V) was obtained to be compared with the biopsy result. Result: Rejection was defined when the H/V uptake ratio was higher than 0.09, and we compared the uptake ratio with the results of biopsy. The result was true positives was 3, true negatives 12, false negatives 2, andfalse positives 3. Therefore sensitivity was 60% and specificity was 80%, diagnostic value was 75%. Conclusion: $^{99m}$Tc-Pyrophosphate (PYP) scan was a useful method for the evaluation of the heart transplantation rejection and it will be helpful for monitoring rejection as an non-invasive and simple method.hod.

• Journal of Chest Surgery
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• v.21 no.6
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• pp.957-969
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• 1988

There is tendency of increasing number and decreasing age of patients who are indicated for Rastelli operation for their cyanotic congenita heart disease. So there is the need to find the creiterion which saves the patients from early postoperative hemodynamic disturbances. We reviewed the 26 patients who had been performed Rastelli operation at Seoul national University hOipital from January 1981 to June 1988. mean age of the patients was 7.8 $\pm$ 3.4 years (range 2.5-1.5 years), mean body surface area(BSA) 0.79 $\pm$ 0.25 $m^{2}$(range 0.49-1.51 $m^{2}$) and mean hematocrit 57.95 $\pm$ 12%(range 48-80%). We diveded these patients into survived group and died group before postoperative 72 hours, and analysed preoperative arterial oxygen saturation($SaO_{2}$), the ratio of diameter of fight pulmonary artery to ascending aorta(RA:/AA), the ratio of both right and left pulmonary artery diameter to descending thoracic aorta(RPA+LPA/DTA), pulmonary artery index(PA index), cardiopulmonary bypass time, aorta cross-clamping time, postoperative perfusion state and total amount of dopamine infused postoperatively. The results showed that RPA+LPA/DTA and PA index were statistically significatn factors to influence early postoperative cardiac death rate (P<0.05). Especially there were good linear correlations between PA index(X) and perpheral perfusion index(Y)(Y = -1.15 + 0.02 X, r = 0.86, P<0.01) and between PA index(X) and total amount of dopamine infused before postoperative 72 hours(mg/kg, Y)(Y = 61.94 - 0.15 X, r = - 0.80, P<0.01). Also there were tendencies that the higher RPA + LPA/DTA(Y), the betterperipheral perfusion (X) and the lower need of dopamine(X), but no statistical significance. (Y = 0.78 + 1.60 X, r = 0.49, P>0.05) And the discrimant analysis showed that patients with PA index over 221 $mm^{2}$/BSA could undergo correction with 25 per cent of error rate. In conclusion, early postoperative hemodynamic states could be predicted by preoperatively measured PA index, and which can be used as a criterion for Rastelli operation performed on cyanotic congenital heart disease.

• Journal of the Korean Arthroscopy Society
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• v.6 no.2
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• pp.131-135
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• 2002

Object : To evaluate the prognostic factors of the rotator cuff tear after anterior dislocation of the shoulder over the 5th decades of age. Methods : We evaluated twelve patients who had rotator cuff tears combined with primary anterior dislocation of the glenohumeral joint between May 1995 and October 1998. Their age were ranged from 42 to 67-years-old. Two of them were initially presumed to have an injury of the axillary nerve and associated with avulsion fracture of the greater tuberosity. Among twelve patients who had rotator cuff tears, 8 cases had massive, 3 cases had medium and one case had a small sized tear. Results : All the tears of the rotator cuff were repaired and the results were obtained by UCLA shoulder rating scale. Ten cases of them revealed more than good results except for 2 cases who had been unhappy triad of the shoulder injury. Conclusions : In the case of anterior dislocation of shoulder, it is necessary to check the injury of rotator cuff and axillary nerve in the middle age group. If these injuries are combined, proper rotator cuff repair and axillary nerve rehabilitation program would be asked for better results.

• The Korean Journal of Nuclear Medicine
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• v.27 no.2
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• pp.175-182
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• 1993

We evaluated the usefulness of $^{99m}Tc$-HMPAO SPECT in 21 Patients with subarachnoid hemorrhage due to ruptured intracranial aneurysm and in 3 patients with unruptured intracranial aneurysm. SPECT study could detect the bilaterally hypoperfused cases in 10 patients (48%), but CT/MRI showed the bilateral abnormalities in only 3 patients (14%). The number of abnormal lesions were 56 in SPECT and 25 in CT/MRI. The lesions found in SPECT were well correlated with the neurological signs of the patients such as aphasia or hemiplegia. SPECT study during Matas test was helpful in evaluating the risk for carotid artery occlusion therapy. We thought that $^{99m}Tc$-HMPAO brain SPECT is helpful in evaluating the functional changes in patients with subarachnoid hemorrhage.

• Journal of Korean Traditional Oncology
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• v.23 no.1
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• pp.23-32
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• 2018

Objective: The purpose of this study is to report the case of a patient with non-small cell lung adenocarcinoma (NSCLC) with anaplastic lymphoma kinase (ALK) mutation treated by Samchilchoongcho-Jung in conjunction with Crizotinib. Methods: An NSCLC patient diagnosed with multiple pleural and lymph nodes metastasis has been taking Crizotinib (500 mg/day) since January 2014. The patient has been treated with Samchilchoongcho-Jung (1,500 mg/day) since June 2014. The tumor size was measured by computed tomography (CT) and laboratory analysis was conducted. Adverse events were evaluated by the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 5.0. Results: After combining treatment, stable disease was shown on CT. The tumor marker (CEA, Cyfra 21-1) levels were maintained. NCI-CTCAE 5.0 showed no adverse events. Conclusion: This case study suggests that Samchilchoongcho-Jung may contribute to tumor response, in conjunction with Crizotinib on the treatment of patients with NSCLC.

• Journal of Korean Ophthalmic Optics Society
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• v.21 no.3
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• pp.281-288
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• 2016

Purpose: The present study was aimed to investigate the change of optical quality in fully cured eyes from central serous chorioretionopathy(CSC) and CSC under treatment, respectively. Methods: A total of 136 eyes(68 subjects) was divided into CMC under treatment and its asymptomatic contralateral eye, fully cured eyes after being diagnosed with CMC and its contralateral eye, and normal eyes. Objective scattering index, cut-off value in modulation transfer function, focusing rate, PSF(Point Spread Function) width at 50%, 10% and the contrast sensitivity were measured and analyzed. Results: CMC under treatment showed statistically significant decrease in all evaluations of optical quality compared with asymptomatic contralateral eyes, fully cured eyes and normal eyes. Although there was no significant difference in optical quality between asymptomatic contralateral eyes of CMC under treatment and fully cured eyes, there was tendence in optical quality decreasing compared with normal eyes. Conclusions: From the study, it was revealed that the optical quality was different according to the treatment phase in CMC. The use of optical quality assessment for the decision of complete cure and the evaluation of prognosis in CMC is also proposed.

• Journal of Genetic Medicine
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• v.6 no.1
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• pp.1-7
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• 2009

Epigenetic changes represented by promoter CpG island hypermethylation and histone modification are an important carcinogenetic mechanism, which is found in virtually all histologic types of human cancer. About 60-70% of human genes harbor CpG islands in their promoters and 5' exonal sequences, and some of them undergo aberrant promoter CpG island hypermethylation and subsequent downregulation of gene expression. The loss of expression in tumor suppressor or tumor-related genes results in acceleration of tumorigenic processes. In addition to regional CpG island hypermethylation, diffuse genomic hypomethylation represents an important aspect of DNA methylation changes occurring in human cancer cells and contributes to chromosomal instability. These apparently contrasting methylation changes occur not only in human cancer cells, but also in premalignant cells. CpG island hypermethylation has gained attention for not only the tumorigenic mechanistic process, but also its potential utilization as a tumor biomarker. DNA methylation markers are actively investigated for their potential uses as tumor biomarkers for diagnosis of tumors in body fluids, prognostication of cancer patients, or prediction of chemotherapeutic drug response. In this review, these aspects will be discussed in detail.

• The Journal of Internal Korean Medicine
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• v.36 no.1
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• pp.58-68
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• 2015

Objectives : To evaluate the long-term survival effects of traditional Korean medicine (TKM) on refractory metastatic lung cancer and small cell lung cancer (SCLC), which have historically poor survival rates. Methods : A retrospective study was conducted using the medical records of two patients in Daejeon University hospital. The first patient, with SCLC, was treated from January 2000 to December 2009 and the other, with metastatic pulmonary cancer from primary hepatocellular carcinoma (HCC), was treated from September 2004 to February 2014. The patients were treated with herbal medicines at one-month intervals. During hospitalization, acupuncture and indirect moxibustion were performed concurrent with the administration of Western therapy. Treatment efficacy was assessed monthly using chest radiography, chest computed tomography, and laboratory examination data, and by measuring patient performance status. Results : Both patients exhibited a stable disease course for more than 9 years after the initial diagnosis of intractable lung cancer, suggesting that their disease status was controlled by TKM. Conclusions : We suggest that a combination of TKM with conventional Western therapy for refractory lung cancer patients is effective in controlling various symptoms related to lung cancer and improving quality of life, and may potentially prolong overall survival.