• Radiation Oncology Journal
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• v.8 no.1
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• pp.85-93
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• 1990

A series of 25 patients with residual, recurrent, and unresectable gastric cancer received various combination of surgery, radiotherapy (RT), chemotherapy (CT), and hyperthermia (HT). They were placed into 7 categories; 1) CT and HT-14 patients; 2) RT and HT-15 patients; 3) surgery, RT and HT-2 patients; 4) surgery, RT, HT and CT-1 patient; 5) RT, HT and CT -1 patient; 6) RT and CT-1 patient; 7) RT alone-1 patient. Three patients had curative resection. 21 patients received irradiation with tightly contoured portals to spare as much small bowel, kidney and marrow as possible. Hyperthermia was applied regionally once or twice a week for 23 patients using 8 MHz radiofrequency capacitive heating device (Thermotron RF-8). HT was given approximately 30 min after RT 7 patients were treated with CT: 4 patients received HT and concomitant Mitomycin-C; 3 patients received HT and sequential 5-FU+Adriamycin+Mitomycin-C. There was not any treatment related deaths. There was also no evidence of treatment related problems with liver, kidney, stomach, or spinal cord except only one case of transient diabetic ketoacidosis. The tumor response was evaluable in 22 patients. None achieved complete remission.11 ($50\%$) achieved partial remission. The response rate was correlated with total radiation dose and achieved maximum temperature. 9 of 14 ($64\%$) received more than 4000 cGy showed partial remission; especially, all 3 patients received more than 5500 cGy achieved partial response.8 of the 12 patients ($67\%$) who achieved maximal temperature more than $41^{\circ}C$ showed partial response in comparing with $25\%$ (2 of 8 patients, below $41^{\circ}C$). The numbers of HT, however, was not correlated with the response. 3 of the 25 patients ($12\%$) remain alive. The one who was surgically unresectable and underwent irradiation alone is in progression of the disease with distant metastases. The remaining two patients with curative resection are alive with free of disease, 24 and 35 months, respectively. The median survival by response are 11.5 months in responders and 4.6 months in non-responders.

• Childhood Kidney Diseases
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• v.4 no.2
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• pp.111-119
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• 2000

Purpose : Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP) is a common pediatric discase presenting most frequently with skin, gastrointestinal, joint and renal manifestations. The prognosis of HSP is mainly determined by the involvement of the kidney, but prognostic markers have not been established. We evaluated the patients who have HSP nephritis with nephrotic syndrome. Method : Clinical manifestations and laboratory findings were observed and analyzed in 34 cases with HSP which were manifested by nephrotic syndrome hospitalized at Kyung Hee university Hospital during the period from Jan. 1990 to Dec. 1998. Results : 1) Male to female ratio was 1.3:1, and mean age at onset was 8.3 year. 2) Mean duration from symptom onset to renal biopsy was 10.5 weeks. 3) Proportion of patients presenting with acute nephritis was 32.4$\%$, gross hematuria 17.6$\%$, microscopic hematuria 50$\%$. 4) The findings of renal biopsy were 20 cases of grade II, 11 cases of grade III, 2 cases of grade I, 1 case of grade IV according to classification by ISKDC. 5) Patients with grade I were recovered with no residual defect, but patients with grade IV shows active renal disease(states C). Conclusion : Among the 디le patients with Henoch-$Sch{\ddot{o}}nlein$ purpura accompanying nephrotic syndrome, more aggressive treatment might be needed in patients showing crescents formation on renal biopsy. A prospective study will be needed to explore the progression of this disease.

• Childhood Kidney Diseases
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• v.7 no.2
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• pp.133-141
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• 2003

Purpose : Idiopathic Membranous Nephropathy(IMN) is a rare renal disease in children. To help better understanding of its clinical course and treatment strategies, we reviewed the clinical manifestations and pathological findings of children with IMN. Methods : Among 58 cases with MN, from 1977 to 2003, 42(72.4%) were hepatitis B virus (HBV) associated and 16(27.6%), 6 males and 10 females, were idiopathic. All cases diagnosed aster 2000 were IMN. Several clinicopathological findings(sex, onset age, proteinuria, serum albumin, cholesterol, creatinine clearance, tubulointerstitial changes, glomerular sclerosis, hypertension, renal vein thrombosis, the use of ACE inhibitor, and immunosuppressive therapy) were compared between the remission and the non-remission group of the patients with IMN. Results : The median onset age was 13.4 years. Clinical manifestations were nephrotic syn-drome(7 cases, 43.8%), gross hematuria(5 cases, 31.3%) and microscopic hematuria with proteinuria(3 cases, 18.8%). Hypertension, hypocalcemic tetany and renal vein thrombosis were accompanied in 2, 1 and 2 cases, respectively. In addition to the typical findings of MN, the kidney biopsies showed segmental sclerosis(5 cases, 31.3%) or global sclerosis(6 cases, 37.5 %), diffuse crescents(1 case), and mild(11 cases, 68.7%) or moderate tubulointerstitial changes(3 cases, 18.8%). Thirteen cases(86.7%) received oral steroid. Among them 2 cases received cyclophophamide and 1 received cyclosporin as well. Ten cases(62.5%) received ACE inhibitors. In the patients followed up, 7 cases(46.7%) became free from proteinuria (remission group) while 8(53.3%) presented continous proteinuria (non-remission group), two (13.3%) of which progressed to renal failure. Clinicopathological findings showed no significant differences between the two groups. Conclusion : With HBV vaccination, HBV associated MN decreased markedly and IMN has taken up most of MN in children. For better understanding of this rare disease, a prospective multicenter study of the clinical course and treatment strategies should be done.

• Journal of Life Science
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• v.29 no.2
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• pp.265-271
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• 2019

In general, specific gravity (SG) and urinary creatinine (CR) have been used to adjust urinary cadmium (Cd) concentrations. However, the validity of correction methods has been controversial. We compared the two adjustments to evaluate associations between urinary Cd and various renal damage markers and to evaluate the relationship between urinary Cd concentration and renal disease markers, such as estimated glomerular filtration rate (eGFR), in a relatively large general population sample. Among the 1,086 volunteers who were enrolled in this study, 862 healthy volunteers who did not have kidney disease were included in the final analysis. Urinary Cd, malondialdehyde (MDA), and N-acetyl-${\beta}$-D-glucosaminidase (NAG) concentrations were measured, the creatinine-based eGFR was calculated, and the relationships between these markers were subsequently analyzed. This study showed the use of urinary Cd concentration adjusted with SG rather than with urinary creatinine may be appropriate in studies evaluating renal function based on Cd exposure. Urinary Cd concentration adjusted with SG had a positive correlation with urinary MDA levels and a negative correlation with eGFR. This relationship was relatively stronger in women than in men. This study showed that urinary Cd level was associated with decreased eGFR in the general population, and oxidative stress was likely to act as an intermediator in this process. These results suggest that eGFR can be a very good indicator of kidney damage caused by Cd exposure in the general population.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.1
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• pp.57-61
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• 2010

Objective: Second primary malignancy (SPM) that occur in various period and region are important factors that deteriorate long-term survival rate in patients who recovered from oral cancer. Researches such as chemoprevention are being tried to reduce occurrence of SPMs. Only if analysis of clinical features of patients who develop SPM such as period, region and factors precedes, adequate prevention and treatment of SPM is possible. But, there are few researches about clinical features of SPMs that have primary lesion in oral cavity. In this study, we analysis that occurrence rates, regions that happen, risk factors and effect to survival rates of 2nd primary malignancies in oral cancer patients. From this survey, we willing to collect basic data for prevention and early diagnosis of SPMs. Methods: The medical records of 139 patients of oral oncology clinic of National Cancer Center who had up to 2-years follow up records after surgical or radiological treatment due to squamus cell carcinoma of oral cavity were reviewed. In these patients, survey of occurrence rate of SPMs, duration, survival rate and risk factors about occurrence of SPMs such as history of smoking, body mass index, age, sex, stage of primary lesion and history of radiologic treatment were achieved. Results: There are 15 patients who developed SPM in 139 cases. The actual occurrence rate of SPM was 10.79% and SPM were more likely to occur in male patients with 11 male Vs 4 female patients. Median age of these patient is 61.47 within 32 to 74 range. The regions that develop SPM are oral cavities (2 cases), stomach (4 cases), esophagus (2 cases), lung (2 cases) and others (1 case each breast, larynx, cervix, liver and kidney). In addition, metachronous cancers were 11 cases which happened more common than 4cases of synchronous cancers. Surveys of risk factors that relate to development of SPMs, such as sex, age, history of radiologic treatment, body mass index, history of smoking and stage of primary disease were done. Among them, factor of sex is only appear statistically significant (P=0.001), but rest are not significant in statistically. Conclusion: Occurrence rates of SPMs were reported from 10% to 20% by precede study. In this study, occurrence rate of SPMs is 10.79% that is similar to results of precede research. In comparison of 5-yr survival rates of groups that develop SPMs or not, there is statistically significance between two groups. Present treatment modalities of SPMs are surgical operation, radiotherapy, chemotherapy and combination of these modalities. In choosing the treatment modality, we must consider the first treatment modality, region of primary disease, region of SPMs and general conditions of patient. Because development of SPMs have big effect on prognosis, prevention of SPMs must regard to important objective of treatments in patients of SCCa in oral cavity.

• Korean Journal of Clinical Pharmacy
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• v.22 no.2
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• pp.103-112
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• 2012

Performance of coronary angiography for exact diagnosis and treatments of cardiovascular disease have been increased recently and it also brings increase of the contrast-induced nephropathy (CIN) referred from increasing use of radiological contrast agents. The variation of estimated glomerular filtration rate (eGFR) is an indicator of CIN, which is known to increase when renal function is decreased. Therefore, this study was to evaluate the affecting factors including concomitant drug on variation of eGFR of patients who underwent coronary angiography according to the conditions of renal function. Medical records of 66 patients were evaluated retrospectively and the patients underwent coronary angiography or angioplasty with nonionic and isotonic contrast media (iodixanol) at Chungnam national university hospital from 1 Jan 2008 to 30 Jul 2010. Patients group was divided into 2 groups; the patients in stages 3-4 chronic kidney disease (CKD) and the patients in stage 2 CKD. Each group was researched about the effect of concomitant drug and clinical characteristics on eGFR variation. The change of eGFR was compared among baseline and 2 or 3 day after coronary angiography. In results, the eGFR variation in group over age 75 was significantly decreased after radiological contrast agents exposure (p $$\leq_-$$ 0.05). The eGFR variation in anemia was significantly decreased after radiological contrast agents exposure in stage 2 CKD (p > 0.05). The eGFR variation in group under $HbA_{1c}$ 6.5% was significantly decreased after radiological contrast agents exposure in stages 3-4 CKD (p $$\leq_-$$ 0.05). The eGFR variation by taking statins, angiotensin converting enzyme inhibitors, calcium channel blockers and nitroglycerin was increased after radiological contrast agents exposure in stage 2 CKD (p $$\leq_-$$ 0.05). The eGFR variation by using of diuretics was significantly decreased after radiological contrast agents exposure in stages 3-4 CKD (p $$\leq_-$$ 0.05). The eGFR variation by taking statins, nitroglylcerin was increased after radiological contrast agents exposure in stages 3-4 CKD(p > 0.05). The eGFR variation in group over contrast dosage 150 ml was significantly decreased after radiological contrast agents exposure in stages 3-4 CKD (p $$\leq_-$$ 0.05). Therefore, when undergoing coronary angiography, contrast dosage should be minimized less than 150 ml, and diuretics should be restricted as possible in stages 3-4 CKD. Patients over age 75 require special attention to prevent CIN, and if patients undergo coronary angiography in stages 3-4 CKD, $HbA_{1c}$ is also requried to maintain below 6.5% to prevent CIN.

• Journal of Gastric Cancer
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• v.18 no.3
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• pp.287-295
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• 2018

Purpose: The surgical outcomes of end-stage renal disease (ESRD) patients undergoing radical gastrectomy for gastric cancer were inferior compared with those of non-ESRD patients. This study aimed to evaluate the short- and long-term surgical outcomes of ESRD patients undergoing laparoscopic gastrectomy (LG) and open gastrectomy (OG) for gastric cancer. Materials and Methods: Between 2004 and 2014, 38 patients (OG: 21 patients, LG: 17 patients) with ESRD underwent gastrectomy for gastric cancer. Comparisons were made based on the clinicopathological characteristics, surgical outcomes, and long-term survival rates. Results: No significant differences were noted in the clinicopathological characteristics of either group. LG patients had lower estimated blood loss volumes than OG patients (LG vs. OG: 94 vs. 275 mL, P=0.005). The operation time and postoperative hospital stay were similar in both the groups. The postoperative morbidity for LG and OG patients was 41.1% and 33.3%, respectively (P=0.873). No significant difference was observed in the long-term overall survival rates between the 2 groups (5-year overall survival, LG vs. OG: 82.4% vs. 64.7%, P=0.947). Conclusions: In ESRD patients, LG yielded non-inferior short- and long-term surgical outcomes compared to OG. Laparoscopic procedures might be safely adopted for ESRD patients who can benefit from the advantages of minimally invasive surgery.

• The Journal of Internal Korean Medicine
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• v.21 no.3
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• pp.409-416
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• 2000

Objective : In order to study effects of Chungsanggyuntong-tang on Hyperlipidemia which causes Hypertension, Arteriosclerosis, Cerebral vascular disease and Ischemic heart disease Methods : The changes of serum total lipid, triglyceride, total cholesterol, HDL-cholesterol, LDL-cholesterol, body weight and organ weight were observed after the liquid extracts of Single-dosage Chungsanggyuntong-tang and Double-dosage Chungsanggyuntong-tang were administered p.o to the Hyperlipidemic rats induced by 1% cholesterol diet for 10, 20 and 30 days. Results : The food consumption and the body weight were significantly decreased in both Chungsanggyuntong-tang group compared with control group, except Double-dosage 30days. The contents of total lipid were significantly decreased in Double-dosage Chungsanggyuntong-tang group for 20, 30 days, but Single-dosage Chungsanggyuntong-tang group did not show any significant change compared with control group. The contents of total cholesterol were decreased in Single-dosage Chungsanggyuntong-tang group and Double-dosage Chungsanggyuntong-tang group, but did not show any significant changes compared with control group. The contents of triglyceride were significantly decreased in Double-dosage Chungsanggyuntong-tang group for 10, 30 days, but Single-dosage Chungsanggyuntong-tang group did not show significant changes compared with control group. The contents of HDL-cholesterol were significantly increased in Single-dosage Chungsanggyuntong-tang group for 10 days compared with control group. The contents of LDL-cholesterol were significantly decreased in both Chungsanggyuntong-tang group for 10 and 30 days compared with control group. The liver and spleen weight were significantly increased in control group compared with normal group. The liver weight was significantly decreased in Single-dosage Chungsanggyuntong-tang group compared with control group. The liver, spleen and kidney weight were significantly decreased in Double-dosage Chungsanggyuntong-tang group compared with control group. Conclusions : It was thought that Single-dosage Chungsanggyuntong-tang and Double-dosage Chungsanggyuntong-tang could be applied effectively to the Hyperlipidemia.

• Journal of Physiology & Pathology in Korean Medicine
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• v.18 no.6
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• pp.1580-1584
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• 2004

On the basis of the widely collected fork prescriptions, long clinical practice of himself, together with integration of all the good points of earlier medical specialists, 孫思邈 wrote 『千金方』 of thirty volumes. Among them Volumes 『食治』 (Food Therapy) and 『養性』(Cultivating the Character) are especially meaningful for in gerontology. Thirty years after its completion, as a supplement, he wrote another thirty volumes of 『千金翼方』. Mr. Sun integrated his discoveries in the treatments of the aged patients, and his opinions for longevity into the Volumes 『養性』 (Cultivating the Character), 『?穀』(Fasting), 『退居』(Retirement), 『補益』(Supplementation). Thus he laid down the basic foundation for the gerontology of Chinese medicine. 『千金要方』 and 『千金翼方』 by Mr. Sun discuss mainly the prevention of illness for aged patients. As for the function of food therapy, he explains: 'Food can dispel evil elements of the body and settle down its organs. It can further bring pleasure to man's spirit and help the circulation of blood and breath.' He then propose the major method of food therapy: 'For a medical doctor, he should understand the causes of disease, then treat it with food. Only after the food treatment fails, medicine is employed.' He thinks that medicine does work in treatment, but it also creates imbalance in the body, and makes the latter vulnerable to outside harms. Therefore, a good doctor is the one who cures the disease and bring pleasure to the patient with food. He stresses that food therapy is always a priority. Mr. Sun prefers animal's organs in the food therapy for aged. For example, he uses powder of sheep's kidney to treat the lumbago. He suggests the viewpoint of 'Curing man's organs with animal's organs' and 'Strengthening man's organs with animal's organs,' and sets the theoretical foundation of 'Organic Treatment.' Mr. Sun's gerontology and food therapy received further development latter. The prescriptions contained therein had been widely used in 王懷隱's 『太平聖惠方』 and 陳直's 『養老奉親書』, both in the Song Dynasty. Eventually they had become a science of food therapy for aged patients.

• Childhood Kidney Diseases
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• v.19 no.2
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• pp.98-104
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• 2015

Objective: To find out clinical features and long-term outcomes of idiopathic childhood nephrotic syndrome(NS) patients with late steroid resistance(LSR)/late steroid sensitiveness(LSS). Patients and Methods: A retrospective chart review was performed on 480 patients diagnosed with idiopathic childhood NS at Asan Medical Center Children's Hospital from 1990 to 2013. Twenty-four patients whose responsiveness to steroids changed over a minimum 2 year follow-up period (2-17.5 years) were investigated. All patients had undergone a renal biopsy. Results: Among 480 nephrotic children, 428 (89%) were sensitive to the first steroid course. Of those who initially responded, 11 (2.5%) developed resistance to steroid therapy after relapses. LSR mostly developed between 1 month and 1 year after the initial episode. Six patients showed a minimal change and five showed focal segmental glomerulosclerosis (FSGS). Nine (82%) responded to cyclosporine or methylprednisolone pulse therapy. Of these, two had no further relapse, whereas the other seven experienced several relapses that ranged in length from 1.1 to 13.9 years. Three of the nine who initially responded to immunosuppression went on to experience several changes in steroid responsiveness. Two (18%) with resistance to immunosuppressants, including steroids, eventually progressed to end stage renal disease. Among the 52 patients (11%) who were initially steroid resistant, 13 (23%) were converted to steroid sensitive at relapses. Among these, 9 showed minimal change and 4 showed FSGS. Two had no further relapse and the other 11 responded to steroids on subsequent relapses ranging in length from 1.3 to 9.4 years. All these patients have had no further changes in steroid responsiveness with normal renal function. Conclusions: In this study, 2.5% of initial steroid responders and 25% of initial steroid non-responders changed their responsiveness to steroids at subsequent relapses. Eighteen percent of LSR patients developed end stage renal disease. All of the LSS patients showed preserved normal renal function. Responsiveness to immunosuppressants seemed to be the most important factor determining longterm outcomes in LSR/LSS patients.