• Clinical and Experimental Pediatrics
• /
• 제49권7호
• /
• pp.784-789
• /
• 2006

목 적 : HSP는 피부, 관절, 위장관, 신장을 포함한 전신의 소혈관을 침범하는 혈관염이다. HSP의 위장관 증상은 때로 다량의 위장관 출혈, 장천공, 장중첩 등의 위중한 형태로 나타날 수 있는데, 이 중 일부 환자는 corticosteroid 치료에도 불구하고 증상이 호전되지 않는 경우가 있다. 저자들은 심한 위장관 증세를 보이면서 스테로이드에 반응하지 않는 HSP 환아에서 IVIG 치료의 효과를 알아보고자 하였다. 방 법 : 1999년 4월부터 2005년 1월까지 심각한 위장관 증상으로 입원한 22명의 HSP 환아들의 의무기록을 조사하였다. 이들 모두에서 처음엔 methylprednisolone(2 mg/kg)을 정맥 투여하였으며, 스테로이드 치료에 반응이 없는 환아들을 대상으로 하여 IVIG(2 g/kg)을 투여하였다. 결 과 : 대량의 위장관 출혈과 복통 등이 동반된 심한 위장관 증상을 나타낸 22명의 환아(연령 : 2.3-15세, 성별 M : F=12 : 10)중에 12명이 스테로이드 치료에도 불구하고 증상이 호전되지 않아 고용량 IVIG 치료를 받았다. IVIG 투여 전, methylprednisolone 정맥주사의 평균 투여기간은 $5.6{\pm}4.9$일이었으며 12명 중 11명에서 IVIG 투여 후 1시간에서 5일 사이에 위장관 증상이 호전되었다. 나머지 1명은 IVIG 투여 후에도 복통이 있었으나, 혈변은 소실되었다. IVIG을 투여받은 환아들과 corticosteroid만을 투여받은 환아들간에 입원기간의 차이는 없었다($12.8{\pm}7.6$일 vs. $13.2{\pm}7.8$일, P=0.777). 복통이 지속되었던 총기간은 IVIG 투여군이 짧았으나 통계적으로는 유의하지 않았다($8.8{\pm}8.1$일 vs. $14.8{\pm}16.9$일, P=0.306). Methylprednisolone 정맥주사만을 단독으로 치료받은 10명 중 2명(20%)은 장천공으로 수술을 받았으나, IVIG 투여군 12명에서는 장천공이 전혀 발생하지 않았다. 결 론 : 심한 위장관 침범이 있는 HSP 환아의 복부증상이 기존의 스테로이드 치료에도 불구하고 호전되지 않을 때에는 고용량 정맥 면역글로불린 투여를 고려해 볼 수 있을 것이다.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권1호
• /
• pp.133-137
• /
• 2015

Background: Cancer is a major public health problem and the leading cause of mortality in both males and females in developed and developing countries. The incidence of cancer is gender dependent. Among Iranians, it is the third cause of death. Materials and Methods: The information recorded in the files of all patients (7,695 individuals) pathologically diagnosed with cancer in Imam Reza referral hospital of Kermanshah University of Medical Sciences during the four year period of 2006-2009 were reviewed and analyzed using SPSS statistical software package version 16.0. Results: Around 61.6% of reported cancer cases were males and 38.4% were females. The most prevalent reported malignant tumors occurred at the age group of 70-79 years in males and in females these tumors were presented in the ages of 60-69 years. The most prevalent cancers among studied patients were gastrointestinal (GI) cancers with a frequency of 22.9% [gastric 10.7%, colorectal 6.9%, and esophageal 6%]. The second, third and forth prevalent cancers were blood at 16.4%, lung 13.5% and bladder 12.8%, respectively. In males the cancers of GI (25.6%) were the most prevalent followed in order of frequency by bladder (18%), blood (17.6%), lung (17.4%) and prostate (6.8%). In females the most frequent recorded cancer was breast (24.1%) followed in order of frequency by GI (20.5%), blood (14.4%), lung (7.3%), uterus (6.2%) and ovary (5.1%). Breast cancer was the most prevalent cancer (27%) in the age group of 40-49 years. Conclusions: The present study provides frequency data for various types of cancers in both males and females from a referral hospital of Kermanshah that are comparable with some reports from other areas of the country.

• 한국임상약학회지
• /
• 제30권1호
• /
• pp.11-18
• /
• 2020

Background: Nivolumab and pembrolizumab are antagonists of the programmed death-ligand 1 (PD-L1) receptor that function as immuno-oncological agents. This study aimed to evaluate the safety and efficacy of nivolumab and pembrolizumab in elderly patients in outpatient settings. Methods: The safety and efficacy of nivolumab and pembrolizumab were compared retrospectively among patients at the Veterans Health Service (VHS) Medical Center in Seoul, South Korea, from September 1, 2017 to August 25, 2018. Results: Eighty-seven patients were selected for the study. The median progression-free survival was 63 days for nivolumab (95% confidence interval (CI), [14 to 282]) vs. 243 days for pembrolizumab (95% CI, [22 to 348]) (p =0.04). The objective response rate (ORR) was 0% in the nivolumab group vs 5.6% in the pembrolizumab group (p =0.310). All the patients exhibited treatment-related adverse effects. More than 89% of the patients exhibited diseases of the gastrointestinal (GI) tract. Pneumonia, of grades three or higher, was the most common adverse effect, followed by weakness and anorexia. Conclusions: There was no statistically significant difference between the nivolumab group and the pembrolizumab group with respect to the ORR. The incidence and severity of the adverse effects in this study were higher than those of previous studies; however, these adverse effects are generally manageable in a real-world clinical setting. Further randomized controlled studies will be necessary to confirm these results in elderly patients.

• 대한약침학회지
• /
• 제5권1호
• /
• pp.171-180
• /
• 2002

Objective: The purpose of this study is to develop and activate the methods of using the arsenic compounds as the anti-cancer medicine. Methods: We investigated some literatures on the using methods, the effects for anti-cancer, and the toxicity of the arsenic compounds. Results: The results are summarized as follows. 1. As is the one of the nitrogen familIy(5A familly). 2. The Arsenic compounds which have been used as the one of the oriental medicine are the Arsenicum Sulbimatum($As_2O_3$) and the Realgar(AsS). 3. As+ 3 is more toxic than the other arsenic compounds. The fatal amount is 100-300 mg. So, it is used 1-5 mg/day as a medicine. 4. The Arsenicwn Sulbimatum($As_2O_3$) and the Realgar(AsS) are used after the heat treatment or the boiling with the acetic acid. 5. The gastrointestinal tract, vessel, and respiration are affected by the acute toxicity of the arsenic compounds. 6. The arsenic compounds are good for the dermatosis and the malignant cancer, especially the acute promyelocytic leukcrnia(APL). we should study the reason of these and the different effect in concentration, also develop new methods of using the the arsenic compounds as getting rid of their toxicity.

• The Korean Journal of Physiology and Pharmacology
• /
• 제12권6호
• /
• pp.323-330
• /
• 2008

The properties of voltage dependent $Ca^{2+}$ current (VDCC) were investigated in interstitial cells of Cajal (ICC) distributed in the myenteric layer (ICC-MY) of guinea-pig antrum. In tissue, ICC-MY showed c-Kit positive reactions and produced driving potentials with the amplitude and frequency of about 62 mV and 2 times $min^{-1}$ respectively, in the presence of $1{\mu}M$ nifedipine. Single ICC-MY isolated by enzyme treatment also showed c-Kit immunohistochemical reactivity. These cells were also identified by generation of spontaneous inward current under $K^+$ -rich pipette solution. The voltage clamp experiments revealed the amplitude of - 329 pA inward current at irregular frequency. With $Cs^+$-rich pipette solution at $V_h=-80\;mV$, ICC-MY produced voltage-dependent inward currents (VDIC), and nifedipine ($1{\mu}M$) blocked VDIC. Therefore, we successfully isolated c-Kit positive single ICC from guinea-pig stomach, and found that ICC-MY potently produced dihydropiridine sensitive L-type voltage-dependent $Ca^{2+}$ currents ($VDCC_L$).

• 대한임상독성학회지
• /
• 제9권1호
• /
• pp.34-38
• /
• 2011

Vinegar is a very popular ingredient used in many cuisines. It is also known for its beneficial health, beauty and possible weight-loss properties. The authors report on a patient who presented to the emergency department with unstable vital signs complaining of generalized abdominal pain after ingestion of 450 ml of apple cider vinegar. We documented a case of corrosive gastrointestinal injury with persistent metabolic acidosis occurring after ingesting apple cider vinegar with an acetic acid concentration of 12~14%. Toxic damage to the liver and kidney were also observed, peaking on post-ingestion day 3. The patient received supportive care and hemoperfusion for three days without much clinical improvement and died in the seventh day of intensive care due to disseminated intravascular coagulation and multi organ failure. Edible vinegar, when taken in large amounts, is capable of inducing corrosive injuries of the GI tract as well as severe systemic toxicities, such as metabolic acidosis. Safety precautions regarding vinegar deserve more public attention and clinicians also should be astute enough to recognize the potential damage accompanying vinegar ingestion.

• Journal of Oral Medicine and Pain
• /
• 제35권2호
• /
• pp.155-163
• /
• 2010

피부근염은 특발성의 염증성 결합조직 질환으로서 점진적인 근육의 쇠약과 특징적인 피부 발진의 증상을 보이는 전신적 자가 면역 질환의 일종이며 근력 약화와 함께 나타나거나 흔히 선행하는 특징적 발진에 의해 진단된다. 가장 특징적인 피부증상은 상안검의 부종과 함께 나타나는 푸르면서 보라색 발진인 heliotrophic rash, 안면부와 상부 흉부의 넓적하고 붉은 발진 (flat red rash), 피부의 인설(scaling)현상을 나타내는 손가락 관절(knuckle)부위의 두드러진 Gottron's papules (violaceous scaly eruption)등 이다. 근육 증상으로 주로 근위부 사지 근육의 약화를 동반한 근육의 염증성 및 퇴행성 변화를 보인다. 피부 근염은 종종 소화기계 (gastrointestinal tract)와 호흡기계 (respiratory system)를 침범하며 15%~25%에서 악성변화를 보인다. 치료는 피부증상뿐 아니라 근육 증상도 악화시킬 수 있는 자외선에 대한 노출을 피하고 일차적으로 전신적 corticosteroid를 사용하며 증상이 심하거나 steroid에 반응이 없을 때 다른 면역억제제를 사용할 수 있다. 피부근염에서 안면근은 침범되지 않으며 저작근의 이환 역시 거의 없다. 본 증례를 통해 피부근염을 앓고 있는 환자에서 개구장애가 발생할 수 있으며, 이는 근경축과 유사한 양상을 보임을 알 수 있었다. 따라서 피부근염 환자에서 발생할 수 있는 개구장애는 회복이 어려울 수 있으므로, 점진적으로 개구량이 줄어드는 것을 막고 정상적인 개구량을 확보 할 수 있도록 지속적인 개구운동 등의 치료가 필요하다고 사료된다.

• Radiation Oncology Journal
• /
• 제11권1호
• /
• pp.159-166
• /
• 1993

A retrospective analysis was done for 69 patients with Stage I and II non-Hodgkin's lymphoma who were treated from May 1981 to December 1990, in the Department of Radiadtion Oncology, Korea University Hospital. We used Ann Arbor Staging system and Working Formulation for histological classification. Forty-three patients (43/69, $62.3{\%}$) were Stage I and 26 patients (26/69, $37.7{\%}$) were Stage II, and B symptom was found in $10.1{\%}$ (7/69). Nodal lymphoma was $21.7{\%}$ (15/69); 14 patients with supradiaphragmatic disease and 1 patient with infradiaphragmatic disease. Extranodal lymphoma was $78.3{\%}$ (54/69): $64.8{\%}$ (35/54) for head and neck, $25.9{\%}$ (14/54) for gastrointestinal tract. Histologically, low grade consists of $8.7{\%}$ (6/69), intermediate grade $84.2{\%}$ (56/69), high grade $10.1{\%}$ (7/69), and diffuse large cell type was the most frequent form with 36 patients (36/69, $52.2{\%}$). Eighteen patients ($26.1{\%}$) were treated with radiation therapy alone,20 patients ($29.0{\%}$) with radiation therapy combined with chemotherapy, 15 patients ($21.7{\%}$) with radiation therapy combined with surgery and chemotherapy, Median survival duration was 28 months, and the range of survival time was from 1 month to 134 months. Overall five-year survival rate for Stage I and II disease was $54.2{\%}$, with $64.5{\%}$ for Stage I and $37.1{\%}$ for Stage II. For nodal lymphoma,5-year survival rate was $45.9{\%}$, and $56.5{\%}$ for extranodal lymphoma; $60.6{\%}$ for head and neck, $52.9{\%}$ for GI tract primary disease. Local control rate for all patients was $88.4{\%}$ (61/69), with $80{\%}$ (12/15) for nodal lymphoma and $90.7{\%}$ (49/54) for extranodal lymphoma. The total failure rate was $34.8{\%}$ (24/69). Five of 24 ($20.8{\%}$) patients who were failed developed local failure only, $12.5{\%}$ (3/24) local failure with distant failure, and distant failure only were found in $66.7{\%}$ (16/24). Between nodal lymphoma and extranodal lymphoma, there was no significant survival difference, but extranodal lymphoma showed higher incidence.

• 한국가금학회지
• /
• 제14권1호
• /
• pp.9-13
• /
• 1987

3주령 부로일러형 병아리를 암수 혼합하여 12처리에 battery 당 10마리씩 2반복의 4$\times$3$\times$2형 요인 실험설계에 의하여 실험을 실시하였다. 시험사료는 0, 10 그리고 20%의 밀기울 첨가구와 20% 밀기울에 0.008 %의 cellulase를 첨가하여 이용하였다. 5주간 사양이 끝난 후 위의 4가지 다른 비율로 밀기울이 혼합된 사료에 1%의 chromic oxide를 배합하여 하루 100g씩 급여하였다. 2일간의 예비기간을 거친 후 다음 2일동안 사료급여후 2시간, 4시간, 8시간 마다 하루 3번씩 분을 취채하여 다음 분석을 위하여 빙점 이하에서 보관하였다. 2일 동안의 분 채취를 끝낸후 각 battery에서 임으로 5마리씩 채취하여 도살 후 곧 소화기 전부(식도 첫 부분에서 항문까지)를 수집하여 각 부위별로 (근위, 십이지장과 공장, 회장, 맹장, 직장) 묶은 다음 각 부위의 길이를 측정하였으며 근위는 내용물을 제거한 후 무게를 측정하였다. 시험결과에 의하면 밀기울 첨가 수준이 다른 구와 Cellulase를 첨가한 구들간에 소화기의 길이는 차이를 보이지 않았다. 그러나 대조구에서 각 부위에서 근위의 무게는 현저히 (P〈0.05) 가벼웠으며 소화기 각 부위에서 chromium이 머무는 시간은 밀기울 처리수준에 따라 차이가 나타나지 않았다.

• Journal of Gastric Cancer
• /
• 제3권4호
• /
• pp.195-200
• /
• 2003

Purpose: Advancement of computed tomography (CT) hardware and software has allowed thin section scanning and reconstruction of fascinating 2-dimentional (2D) and 3- dimentional (3D) images. Especially, the reconstruction of 3D images of gastrointestinal tract has been used in the detection and diagnosis of pre-malignant and malignant diseases. To compare the efficacy of CT gastrography with conventional upper gastrointenstinal series (UGIs) in gastric cancer patients. Materials and Methods: During Nov. 2002 and Mar. 2003, twenty-seven patients who had gastric cancer received both double contrast upper GI series and CT gastrography prior to radical surgery. Among these patients, nineteen had early gastric cancer (EGC) and 8 had advanced gastric cancer (AGC). Fifteen patients were male and 12 were female. The mean age was 54 yrs (range, $27\∼75$ yrs). The patients were placed on NPO and Stomach was distended with gas in fasting state prior to CT scanning. Double contrast upper GI series were performed as routine manual. CT scan was conducted in all patients using 8 or 16-channel multidetector CT in this study. The collimation and reconstruction for CT scanning were set at 2.5 mm and 1.25 mm, respectively. CT scanning was performed in the supine position. For image processing, CT gastrography, in which raysum and surface rendering images were constructed, virtual and 2D image in coronal and sagittal images were performed. The detectability of gastric cancer was assessed between UGIs and CT gastrography. Results: In AGCs, the detection rate of cancer using CT gastrography and virtual gastroscopy was higher than EGC cases. However, CT gastrography and virtual gastroscopy showed less favorable results than UGIs. Even though only a small number of cases had been studied, we might conclude that CT gastrography and virtual gastroscopy could replace UGIs in the detection of AGC cases. Conclusion: The detection rate used with CT gastrography and Virtual gastroscopy is not better than that of UGIs in early gastric cancer, however, in advanced gastric cancer cases, it is nearly equal to that of UGIs.