• Annals of Pediatric Endocrinology and Metabolism
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• 제23권4호
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• pp.226-228
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• 2018

Various endocrine dysfunctions occur during chemotherapy, including hypoglycemia. However, reports of hypoglycemia associated with 6-mercaptopurine (6-MP) are rare. Herein, we report an 8-year-old boy with severe symptomatic hypoglycemia likely due to 6-MP during chemotherapy. He had been diagnosed with acute lymphoblastic leukemia 3 years previously and was in the maintenance chemotherapy period. Treatment included oral dexamethasone, methotrexate, and 6-MP, of which only 6-MP was administered daily. Hypoglycemic symptoms appeared mainly at dawn, and his serum glucose dropped to a minimum of 37 mg/dL. Laboratory findings showed nothing specific other than increased serum cortisol, free fatty acids, ketone, alanine aminotransferase, and aspartate aminotransferase. Under the hypothesis of hypoglycemia due to chemotherapy drugs, we changed the time of 6-MP from evening to morning and recommended him to ingest carbohydrate-rich foods before bedtime. Hypoglycemia improved dramatically, and there was no further episode during the remaining maintenance chemotherapy period. To the best of our knowledge, this is the first report of this type of hypoglycemia occurring in an Asian child including Korean.

• Clinical and Experimental Pediatrics
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• 제56권8호
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• pp.351-354
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• 2013

Isovaleric aciduria (IVA) is caused by an autosomal recessive deficiency of isovaleryl-CoA dehydrogenase (IVD). IVA presents either in the neonatal period as an acute episode of fulminant metabolic acidosis, which may lead to coma or death, or later as a "chronic intermittent form" that is associated with developmental delays, with or without recurrent acidotic episodes during periods of stress, such as infections. Here, we report the case of a 2-year old boy with IVA who presented with the chronic intermittent form. He was admitted to Asan Medical Center Children's Hospital with recurrent vomiting. Metabolic acidosis, hyperammonemia, elevated serum lactate and isovalerylcarnitine levels, and markedly increased urine isovalerylglycine concentration were noted. Sequence analysis of the IVD gene in the patient revealed the novel compound mutations-a missense mutation, c.986T>C (p.Met329Thr) and a frameshift mutation, c.1083del (p.Ile361fs$^*11$). Following stabilization during the acute phase, the patient has remained in a stable condition on a low-leucine diet.

• Childhood Kidney Diseases
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• 제18권1호
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• pp.42-46
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• 2014

가와사끼병은 전신성 혈관염을 일으키는 질환중의 하나로 여러 장기들을 침범할 수 있다. 신장증세로는 농뇨, 혈뇨, 단백뇨, 간질성 신염, 급성 신부전증, 용혈성 요독 증후군, 신반흔 등이 있다. 가와사끼병의 신장침범에 대한 병리기전은 아직 알려져 있지 않지만, 자가면역질환으로 인한 것으로 사려된다. 가와사끼병이 요로감염 이 후에 발병한다는 몇몇 보고들이 있었다. 하지만, 이미 보고된 논문들에 포함된 많은 요로감염 환자들은 신장방광 초음파, DMSA 스캔이나 배뇨중 요도방광조영술 등을 모두 받은 경우는 없었다. 이에 저자들은 급성 신우신염이 재발한 후 불완전 가와사끼병이 발생한 고도의 방광요관역류가 있는 8개월 남아를 보고하는 바이다. 급성 신우신염은 가와사끼병의 초기 증세일 수 있다. 그런 경우, 환아가 가와사끼병으로 확진되더라도 요로감염 진료지침에 따라 요로기형에 대한 이미지 검사를 시행할 필요가 있다고 생각한다.

• Journal of the Korean Data and Information Science Society
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• 제25권3호
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• pp.555-565
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• 2014

본 연구에서는 엘리트 운동선수들이 국가대표 선수로써 공식적으로 수행한 훈련 기간 동안 발생한 스포츠 손상에 대해 종목별로 분석하였다. 국가대표 선수들을 진료하고 관리하는 의사, 물리치료사 및 종목별 트레이너들은 훈련도중 발생한 모든 스포츠 손상을 보고서 양식에 기록하였고, 이 중 기존에 이환되어 있는 만성 스포츠 손상을 제외한 급성 및 재발성 스포츠 손상들에 대해 분석하였다. 그 결과 1년간 총 3,421건의 스포츠 손상이 발생하였고, 이 중 1,560건은 급성 스포츠 손상, 1,861건은 재발성 급성 손상이었다. 남자 선수와 여자 선수에서 급성 스포츠 손상이 가장 많이 발생한 종목은 각각 복싱과 하키였다. 남자 선수와 여자 선수에서 재발성 급성 스포츠 손상이 가장 많이 발생한 종목은 각각 레슬링과 펜싱이었다. 또한 본 연구에서는 국가대표 선수들의 공식적인 훈련기간 동안 발생한 종목별 스포츠 손상과 관련된 특징 및 발생률 (incidence rates)에 대한 다양한 분석 결과를 포함하였다. 따라서 본 연구의 결과는 대한민국 국가대표 선수들의 훈련 중 발생하는 스포츠 손상 예방을 위한 프로그램 마련에 유용한 정보를 제공할 수 있을 것이다.

• Tuberculosis and Respiratory Diseases
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• 제51권3호
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• pp.265-269
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• 2001

저자들은 악성 늑막삼출 환자에서 talc로 늑막유착술을 시행하여 급성 호흡곤란증후군을 보인 환자를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Korean Neurosurgical Society
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• 제47권4호
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• pp.258-264
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• 2010

Objective : The objectives of this study were to analyze the outcome and hemorrhagic risk of intravenous (IV) argatroban in patients with acute ischemic stroke presenting beyond six hours of ischemic symptom onset. Methods : Eighty patients with acute ischemic stroke who were admitted to the hospital beyond six hours from ischemic symptom onset were retrospectively analyzed. We could not perform IV thrombolysis or intra-arterial thrombolysis because of limited time window. So, IV argatroban was performed to prevent recurrent thrombosis and progression of infarcted area. The outcome was assessed by the National Institute of Health Stroke Scale (NIHSS) score and related hemorrhagic risk was analyzed. Also, each outcome was analyzed according to the initial stroke severity, subtype, and location. Results : The median NIHSS was 8.0 at admission, 4.1 upon discharge, and 3.3 after three months. A good outcome was achieved in 81% of patients upon discharge and 88% after three months. Symptomatic hemorrhage occurred in only two patients (3%). IV argatroban was effective regardless of initial stroke severity, subtype, and location. Conclusion : IV argatroban may be an effective and safe treatment modality for acute ischemic stroke presenting beyond six hours of ischemic symptom onset.

• Radiation Oncology Journal
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• 제31권4호
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• pp.206-215
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• 2013

Purpose: Re-irradiation (re-RT) is considered a treatment option for inoperable locoregionally recurrent head and neck cancer (HNC) after prior radiotherapy. We evaluated the efficacy and safety of re-RT using Helical Tomotherapy as image-guided intensity-modulated radiotherapy in recurrent HNC. Materials and Methods: Patients diagnosed with recurrent HNC and received re-RT were retrospectively reviewed. Primary endpoint was overall survival (OS) and secondary endpoints were locoregional control and toxicities. Results: The median follow-up period of total 9 patients was 18.7 months (range, 4.1 to 76 months) and that of 3 alive patients was 49 months (range, 47 to 76 months). Median dose of first radiotherapy and re-RT was 64.8 and 47.5 $Gy_{10}$. Median cumulative dose of the two courses of radiotherapy was 116.3 $Gy_{10}$ (range, 91.8 to 128.9 $Gy_{10}$) while the median interval between the two courses of radiation was 25 months (range, 4 to 137 months). The response rate after re-RT of the evaluated 8 patients was 75% (complete response, 4; partial response, 2). Median locoregional relapse-free survival after re-RT was 11.9 months (range, 3.4 to 75.1 months) and 5 patients eventually presented with treatment failure (in-field failure, 2; in- and out-field failure, 2; out-field failure, 1). Median OS of the 8 patients was 20.3 months (range, 4.1 to 75.1 months). One- and two-year OS rates were 62.5% and 50%, respectively. Grade 3 leucopenia developed in one patient as acute toxicity, and grade 2 osteonecrosis and trismus as chronic toxicity in another patient. Conclusion: Re-RT using Helical Tomotherapy for previously irradiated patients with unresectable locoregionally recurrent HNC may be a feasible treatment option with long-term survival and acceptable toxicities.

• Clinical and Experimental Pediatrics
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• 제52권2호
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• pp.261-264
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• 2009

장 중복낭종은 드문 선천성 기형 질환으로 구강에서 항문까지 어느 곳에서나 발견할 수 있고 장관과 교통하기도 한다. 특히 맹장의 장 중복낭종은 더욱 드문 질환이다. 이들은 구토나 반복적인 복통과 위장관 출혈 및 변비 등의 증상으로 급성 장폐색을 발생시키며 생후 2년내 80%에서 발견된다. 저자들은 신생아에서 맹장의 장 중복낭종에 의해 발생한 장 폐색 1예를 경험하였기에 보고하고자 한다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권15호
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• pp.6099-6101
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• 2014

Purpose: To retrospectively analyze variability and clinical significance of serum ferritin levels in Chinese patients with hematologic malignancies. Materials and Methods: Serum ferritin were measured by radioimmunoassay, using a kit produced by the Beijing Institute of Atomic Energy. Patients with hematologic malignancies, and treated in the Department of Hematology in Nanjing First Hospital and fulfilled study criteria were recruited. Results: Of 473 patients with hematologic malignancies, 262 patients were diagnosed with acute leukemia, 131 with lymphoma and 80 with multiple myeloma. Serum ferritin levels of newly diagnosed and recurrent patients were significantly higher than those entering complete remission stage or in the control group (p<0.001). Conclusions: Serum ferritin lever in patients with hematologic malignancies at early stage and recurrent stage are significantly increased, so that detection and surveillance of changes of serum ferritin could be helpful in assessing conditions and prognosis of this patient cohort.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제5권1호
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• pp.79-82
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• 2002

저자들은 간헐적인 구토와 복통을 주소로 내원한 6세 된 남아에서 상부 위장관 조영술과 복부단층촬영으로 진단된 중장염전을 동반한 장 이상회전 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.