Background : The occurrence of lung complications after allogenic bone marrow transplantation(BMT) has been reported as 40-60 percent. The risk factors for lung complications are whole body irradiation, high dose chemotherapy, graft versus host disease, old age and CMV infection. The prevalence of graft versus host disease is less in Korea than in Western countries, but frequency of CMV infection is higher. Therefore, the pattern of lung complications may be different in Korea from those in Western countries. Methods : A retrospective cohort study was performed on one hundred consecutive adult patients who underwent allogenic bone marrow transplantation from December, 1993 to May, 1999 at Asan Medical Center. Lung complications were divided into two groups by the time of development, within 30days (pre-engraftment) and beyond 30 days (post-engraftment), and then subdivided into infectious and non-infectious complication. Infectious complications were defined as having the organism in blood, BAL fluid, pleural fluid or sputum, or compatible clinical findings in patients, which improved with antibiotics or an anti-fungal therapy. Result: 1) Eighty three episodes of lung complications had occurred in 54 patients. 2) Within thirty days after BMT, non-infectious complications were more common than infections, but this pattern was reversed after 30 days. After one year post-BMT, there was no infectious complication except in cases of recurrence of underlying disease or development of chronic GVHD. 3) Among the non-infectious complications, pleural effusion (27 episodes) was most common, followed by pulmonary edema (8 episodes), bronchiolitis obliterans(2 episodes), diffuse alveolar hemorrhage (1 episode) and bronchiloitis obliterans with organizing pneumonia (1 episode). 4) The infectious complications were pneumonia (bacterial: 9 episodes, viral: 4 episodes, fungal : 5 episodes, pneumocystis carinii : 1 episode), pulmonary tuberculosis(3 episodes) and tuberculous pleurisy (3 episodes). 5) Lung complications were more frequent in CMV positive patients and in patients with delayed recovery of neutrophil count. 6) The mortality was higher in the patients with lung complications. Conclusion : Lung complications developed in 54% after allogenic BMT and were associated with higher mortality.
Sung Jun Lee;Min hwan Kim;Young Gap Yun;Kyu Sang Lim;Soong-in Lee
대한상한금궤의학회지
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v.14
no.1
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pp.1-26
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2022
Objectives: We aimed to confirm the safety and effectiveness of the decoction of Sibjo-tang, which is a powder type purgative. In addition, we checked whether the '發作' of 『Shanghanlun』 can be interpreted to have the same meaning as "seizure" in English. By confirming these objectives, we intend to lead the progress in the application of Sibjo-tang and to expand the clinical application of the 152nd provision and Sibjo-tang. Methods: We analyzed the medical records of patients who visited Apgujeongjeongin Oriental Clinic and Almyeon Oriental Clinic for seizures. We confirmed side effects in patients who took Sibjo-tang for a long time. Sibjo-tang was prepared as a hot water extract by using 5 g each of Euphorbiae Pekinensis Radix, Eurphobiae Kansui Radix, and Genkwae Flos and 15 g of Zizyphi Fructus. The "seizure" recorded in the 152nd provision was interpreted through the shape analysis of Oracle bone scripts. The seizure frequency of patients diagnosed with epilepsy after taking Sibjo-tang was compared, and we analyzed other symptoms and psychosocial conditions associated with seizures at the first episode. Results: No side effects were found in 7 patients who took Sibjo-tang for 16.57 ± 14.10 months. Seizures were eliminated in 6 cases while taking Sibjo-tang and significantly decreased in 1 case. Frequent indigestion (in 7 cases), mild exhaustion (in 5 cases), and inferiority complex (in 5 cases) were identified as accompanying pathogenic conditions. The "seizure" in the 152nd provision was interpreted as "a state of being stabbed by a sharp substance in clothes", confirming a deep connection with epileptic seizures. Conclusions: The results suggest that using a decoction of Sibjo-tang is safe and efficacious. In addition, the necessity of conducting an advanced study on epileptic seizures accompanied by frequent indigestion using Sibjo-tang was confirmed.
As a continuation of series of works on the pharmacological actions of Panax ginseng. three kinds of behavioral experiments were carried out using rats and mice. The occurrence of component Posterns of general behavioral activity in rat was examined by visual scanning using the ting sample method in the ad lib. And he hunger deprivated situation. In normal ad lib. situation, the eating behavior of rat treated with 100mg/kg of ginseng saponin was significantly more frequent than that of saline control at the night and throughout the 24 hr period. But grooming was less frequent than the control at the same period. In the hunger situation followed by 90~120 hrs of feed deprivation, the locomotive activity and rearing awe significantly more often and sleeping was less frequent in the two dosage g roups of ginseng saponin (10 and 100 mg/kg) than in the saline group though out the observation period. Training of avoidance conditioning in rats was done in a two-way shuttle box. The number of conditioned response (CR) in which the animal avoided sucessfully an electric shock by running in to the other compartment of the hex was regarded as an index of learning performance. Ginseng saponin in doses of 2.5 mg/kg Produced a significantly increased CR in total avoidance tria1s compared with the control. Although other dosage groups of ginseng saponin (5.0, 50mg and 100 mg/kg) showed no significant statistical difference from the normal control, it tended to increase in CR in the ginseng groups than in the control. An aggressive behavior in mice was observed in n shock-generating fighting box. The occurrence of reflexive fighting between two animals induced by an electric shock applied to the feet war checked as an index of aggression. The occurrence of reciprocal fighting episode immediately after the onset. Of the shock was significantly decreased in the dosage group of 400 mg/kg ginseng saponin, but it did net differ in the 100 mg/kg group of ginseng saponin from the control group. The dose, 400 mg/kg of ginseng saponin, inhibited fighting behavior in more than 80% of the Pairs. but 100 mg/kg of ginseng did inhibit it in less than 20% of the pairs.
Purpose : Several methods of IV ${\gamma}-globulin$(IVG) infusion are effective in the treatment of autoimmune disease, including idiopathic thrombocytopenic purpura(ITP). But it is not known which method is more effective in the treatment of ITP. The effectiveness of these two methods of IVG infusion was studied in terms of platelet recovery rate, side effects and recurrence rate. Methods : Forty seven patients with acute ITP in the department of pediatrics, Eulji University Hospital from January 1995 to June 2001 were enrolled. We assesssed the treatment effects of 47 patients blindly selected; IV ${\gamma}-globulin$ 2 g/kg/day in one day(treatment group A, n=25), 400 mg/kg/day in five days(treatment group B, n=22). Results : Treatment group A increased platelet count more rapidly on the 2nd, 4th and 6th day of treatment than treatment group B. Side effects like fever, chill and vomiting were more frequent in treatment group A than treatment group B. The platelet count on the sixth day of treatment showed a greater increase in the cases which had side effects than in the cases which did not. There was no difference between the two groups in the recurrence rate. Conclusion : IV ${\gamma}-globulin$ 2 g/kg/day in one day increases platelet count more rapidly than 400 mg/kg/day in five days, and is favorable for the prevention of a severe hemorrhagic episode like early intracranial hemorrhage.
Journal of Korean Academy of Fundamentals of Nursing
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v.4
no.1
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pp.73-85
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1997
The purpose of this study was to find out the prevalence of the urinary incontinence and it's relating factors in women. The target population is 327 community dwelling women in the age of 30-70 years old at 6 cities in Korea. The data were collected from August, 1996 to December. 1996 with interview using structured questionaire composing of items of general characteristics, obstetric characteristics, disease characteristics, situation of experiencing urinary incontinence, discomfort due to urinary incontinence, and depression. The data were analysed with $SPSS/PC^+$ program, T-test, $x^2$ test, and ANOVA test. The results obtained from this study were as follows : 1) The prevalence of urinary incontinence in women is 37.7%(130/327). 2) The mean duration of experiencing the urinary incontinence was 75.9 months and the 60% of the respondents experienced a few frequency of urinary incontinence and the most common amount of urinary incontinence(91.5%) was somewhat small expressed as 'wetting their clothes'. 3) The common factors related to the urinary incontinence were coughing, sneezing, laughing aloudly, and the activities of need for hurry. 4) The most common situations of discomforts associated with urinary incontinence were having long journey, exercise, playing, and social meeting. 5) The incidence of urinary incontinence was significantly higher in woman who had more children, older age of last delivery, more vaginal delivaries, and less c-section. 6) The incidence of urinary incontinence was not affected with the disease characteristics of the respondents, however it was higher when the women had the physical problems of constipation, abdominal laparatomy and episode of urinary catheterization than who had not. 7) The most common symptom of urinary incontinence was the frequent urine(43.1%), and the next was the urgent urine(12.3), delayed urine(9.2%). 8) 90.7% of the epsodic urinary incontinence were not treated at al, however, they wanted to try the herb medicine(41.5%), Kegel exercise(27.7%), and biofeedback(10.0%). 9) The level of Depression in the group of urinary incontinence was higher than that of non incontinence group significantly. In conclusion, as urinary incontinence in women proved severe health problem, health care providers need to develop and provide nursing intervention of urinary incontinence such as pelvic muscle exercise with bio-feedback and psychological care.
In Korea, many open-air upper palaeolithic sites are located at the river valley, particularly exposed in gently rotting terrain along the river course. They are situated at an altitude less trail 30 m above present river bottom, and covered with the blankets of slope deposits of several meters in thickness. The purpose of this research is to eluridate depositional and vegetational environment of the alluvial upper palaeolithic Jangheung-ri sites on the basis of analytical properties of grain size population, chronology, palynology, soil chemistry and clay mineralogy and magnetic susceptibility of the Jangheung-ri Quaternary formations. The lithostratograpy of Jangheung-ri sit is subdivided into 3 layers based on the depositional sequence and radiocarbon ages. From bottom to top, they are composed of slope deposits with lower paleosol layers, young fluvial sand and gravel with backswamp organic muds, and upper paleosol layers. The upper paleosol was formed under rather dry climatic condition between each flooding period. Dessication cracks were prevalent in the soil solum which was filled with secondarily minuted fragments due to pedogenetic process. The soil structure shows typical braided-typed cracks in the root part of cracking texture, and more diversified pattern of crackings downward. The young fluvial sand gravel were formed by rather perennial streams after LGM. The main part of organic muds was particularly formed after 15Ka. Local backswamp were flourished with organic muds and graded suspension materials in the flooding muds were intermittently accumulated in the organic muds until ca. 11Ka. This episode was associated with migration of Nam River toward present course. Organic muds were formed in backswamp or local pond. Abies/Picea-Betula with Ranunculaceae, Compositae, Cyperaceae were prevalent. This period is characterized with B$\Phi$lling, Older Dryas, Allerod, and Younger Dryas (MIS-1). Stone artefacts were found in the lower paleosol layers formed as old as 18Ka-22Ka. Based on the artefacts and landscape settings of the Jangheung-ri site, it is presumed that settlement grounds of old people were buried by frequent floodings of old Nam River, the river-beds of which were heavily fluctuated laterally and river-bed erosions were activated from south to north in Jangheung-ri site until the terminal of LGM9ca 17Ka).
Despite optimal local therapy such as surgery and/or radiotherapy, the long term outcome is poor for patients with advanced squamous cell carcinomma of head and neck, due to frequent loco-regional recurrence and distant metastases. We studied to determine whether the combination chemotherapy, especially as an adjuvant chemotherapy, would improve the survival of these patients. Between January, 1986 and December, 1992, 57 patients with previously untreated, locally advanced squamous cell arcinoma of head and neck were assigned to receive 2-3 cycles of induction chemotherapy consisting of 5-fluorouracil(F) and cisplatin(P) every 3 weeks and standard local therapy such as surgery and/or radiotherapy followed by adjuvant chemotherapy with the same FP regimens. Of the 57 enroled patients, 45 patients were evaluable. The obtained results were as following: 1) Among 45 evaluable patients, 18 patients finished all treatment protocol including adjuvant chemotherapy and 27 patients had no adjuvant chemotherapy. The difference of age, sex, performance status, disease stage, and tumor differentiation was not significant statistically between adjuvant chemotherapy group and no-adjuvant chemotherapy group. 2) After induction chemotherapy, 7/45(15.4%), 30/45(67%) achieved complete remission and partial remission respectively with 82.4% overall response rates in entire patients. 3) The 4year progression free survival was 43.3% in adjuvant chemotherapy group and 24.1% in no-adjuvant chemotherapy group(p>0.05). The 4year overall survival was 56.9% and 25.5% respectively(p>0.05). There was no significant different in the patterns of local recurrence and distant metastasis between the two groups. 4) Adverse reactions from combination chemotherapy included nausea, vomiting, mucositis, diarrhea and hematologic bone marrow depression. These were mild and tolerated by patients, and these was no episode of any life threatening toxicities. In conclusion, adjuvant chemotherapy after induction chemotherapy and local therapy did not show statistically significant survival improvement, but there was trend of prolongation of survival when compared to no adjuvant chemotherapy. Thus, large scale phase III randomized controlled studies are strongly recommended.
Journal of agricultural medicine and community health
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v.29
no.1
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pp.147-161
/
2004
Objectives: There are many habitual drinking in rural area. So it is the key point of drinking control policy in rural community to understand the drinking behavior in leisure time and to have an appropriate screening method for problem drinking. CAGE and AUDIT are famous screening tools for problem drinking and alcoholics. Even though there are some studies to validate CAGE and AUDIT which translated in Korean, they were not studied with community based population but with hospital based patients. In this study we assessed the usefulness of CAGE and AUDIT for selecting problem drinking in a rural population, and compared problem drinkers with normal group about spending leisure, Methods: The study subjects were 120 residents over 20 years old who lived in 3 districts in Dong-San Myun near Chun-chon city. We made up questionnaire by interview from Feb. 13 to 19, 2004. Results: The mean age of study population was 66.01 .26 years old. Defining the problem drinking as more than 12 score in AUDIT and more than 2 score in CAGE, the proportion of problem drinker was 30.600 and 28.9% respectively. This proportions were higher than those of other national wide studies. There were significant difference in drinking frequency per week and amount per one episode between problem drinker and normal group. Experience about driving, accident, injury, disturbance in working and quarrel after drinking were also significantly different. Problem drinker were more tolerable to the bad social culture about drinking (eg. force to drink, bad drunken habit. overdrinking, drinking relay etc.) than normal group. Watching TV and playing with neighborhood were most frequent method of spending leisure in this study population, normal male group exercised more frequently in leisure time than problem drinker. Conclusions: It may be useful to use CAGE and AUDIT score for screening problem drinking in rural community. Appropriate utilization of leisure time may he important for control of problem drinking in rural area.
Purpose: Dermatolymphangioadenitis (DLA) is a common and serious complication of lymphedema which deteriorates lymphatic function. The purpose of this study was to assess the risk of DLA by lymphos-cintigraphy in patients with lower extremity lymphedema. Materials and Methods: The subjects were 59 edematous lower extremities of 50 patients without previous episode of DLA and 12 lower extremities of 6 controls. Whole body images were acquired 1 min and 2 hr after subcutaneous injection of 37 MBq of Tc-99m-antimony sulfide colloid into interdigital spaces of both feet before therapy for lymphedema. The lymphosintigraphic and clinical variables were compared between groups with or without occurrence of DLA during clinical follow up. Results: There were 20 episodes of DLA in 12 extremities during clinical follow-up (19 :6 months). On univariate analysis, there were significant differences in ilioinguinal lymph node uptake, uptake pattern of main lymphatic vessel, clinical stage and therapy compliance between the two groups. After multivariate analysis, only the uptake pattern of main lymphatic vessel and therapy compliance fore confirmed to be independent variables. In other words, non-visualized main lymphatic vessel and poor compliance to therapy were more frequent in extremities with subsequent occurrence of DLA. Conclusion: Lymphoscintigraphy can be used to predict the risk of DLA and may thus be helpful for determining the initial therapeutic plan in patients with lower extremity lymphedema.
Sohn, Young Bae;Ahn, Sunhyun;Jang, Ja-Hyun;Lee, Sae-Mi
Journal of The Korean Society of Inherited Metabolic disease
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v.19
no.1
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pp.20-25
/
2019
Very-long-chain acyl-CoA dehydrogenase (VLCAD) deficiency (OMIM#201475) is an autosomal recessively inherited metabolic disorder of mitochondrial long-chain fatty acid oxidation. The clinical features of VLCAD deficiency is classified by three clinical forms according to the severity. Here, we report a case of later-onset episodic myopathic form of VLCAD deficiency whose diagnosis was confirmed by plasma acylcarnitine analysis and" multigene panel multigene panel sequencing. A 34-year old female patient visited genetics clinic for genetic evaluation for history of recurrent myopathy with intermittent rhabdomyolysis. She suffered first episode of rhabdomyolysis with acute renal failure requiring hemodialysis at twelve years old. After then, she suffered several times of recurrent rhabdomyolysis provoked by prolonged exercise or fasting. Physical and neurologic exam was normal. Serum AST/ALT and creatinine kinase (CK) levels were mildly elevated. However, according to her previous medical records, her AST/ALT, CK were highly elevated when she had rhabdomyolysis. In suspicion of fatty acid oxidation disorder, multigene panel sequencing and plasma acylcarnitine analysis were performed in non-fasting, asymptomatic condition for the differential diagnosis. Plasma acylcarnitine analysis revealed elevated levels of C14:1 ($1.453{\mu}mol/L$; reference, 0.044-0.285), and C14:2 ($0.323{\mu}mol/L$; 0.032-0.301) and upper normal level of C14 ($0.841{\mu}mol/L$; 0.065 -0.920). Two heterozygous mutation in ACADVL were detected by multigene panel sequencing and confirmed by Sanger sequencing: c.[1202G>A(;) 1349G>A] (p.[(Ser 401Asn)(;)(Arg450His)]). Diagnosis of VLCAD deficiency was confirmed and frequent meal with low-fat diet was educated for preventing acute metabolic derangement. Fatty acid oxidation disorders have diagnostic challenges due to their intermittent clinical and laboratorial presentations, especially in milder late-onset forms. We suggest that multigene panel sequencing could be a useful diagnostic tool for the genetically and clinically heterogeneous fatty acid oxidation disorders.
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