• Tuberculosis and Respiratory Diseases
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• 제76권4호
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• pp.184-187
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• 2014

A nasal-type extranodal natural killer/T-cell lymphoma is considered an aggressive form of non-Hodgkin's lymphoma, with approximately half of all patients relapsing during the follow-up period, and most relapses occurring within the first 2 years of remission. Here we report an unusual case of a 42-year-old man who experienced recurrence in single pleura after 8 years of remission.

• Journal of Chest Surgery
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• 제25권12호
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• pp.1516-1522
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• 1992

Thirty patients with myasthenis gravis[MG] underwent transternal extended thymectomy between 1983 and 1992 in Pusan National University Hospital. The age of patients was 11 to 62 years[mean; 35.2 years] with female dominant[M: F=l: 4]. According to modified Osserman classification, group I was in 6, II A in 7, II B in 13, III in 2, IV in 2 patients respectively. Their clinical response to thymectomy was evaluated. The follow-up period ranged from 2 months to 9.5 years[average; 51.3 months]. Fourteen patients[13.3%] had remission and eleven[43.3%] were improved after operation; half of patients were benefited from operation. Twenty patients had thymic hyperplasia and seven had non-infiltrating thymoma. In thymomatous MG one patient had remission and five were improved. Postoperative death was in a female patient. The cause of death was respiratory failure in the severe generalized MG preoperatively.

• 한국임상약학회지
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• 제14권1호
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• pp.11-23
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• 2004

Although most children with idiopathic nephrotic syndrome respond to corticosteroid therapy, many responders show steroid dependency and frequent relapse. In these children, one of the major problems is the serious side effects resulting from continuous steroid therapy. Thus, this study was conducted to assess the therapeutic efficacy and safety of six-month cyclosporine treatment with the low-dose deflazacort therapy in children with nephrotic syndrome. Thirty children with steroid dependence (SD), frequent relapse (FR) and steroid resistance (SR) were enrolled in this study. They were treated with 6-month oral cyclosporine $(Cypol-N^{(R)})$ plus the low-dose deflazacort $(Calcort^{(R)})$ therapy at Samsung Medical Center from September 2002. The dosage of cyclosporine was started at 5 mg/kg/day and was monthly adjusted to maintain clinical remission and/or a trough blood level, while deflazacort dosage was reduced gradually. Clinical evaluation and monitoring of cyclosporine toxicity were performed every $2\sim4$ weeks. Outcomes were compared to the latest sir-month period of steroid only therapy before cyclosporine treatment. Student's t-test and ANOVA were used for statistical analysis. Out of 28 children with SD and FR, 23 $(82.1\%)$ sustained remission, and 5 $(17.9\%)$ experienced 1 or 2 relapses during therapy. Out of 2 children with SR, 1 child sustained remission, and 1 child showed no response. The mean duration of remission and occurrence of relapse were significantly improved (p <.0001). In addition, the mean dosage of steroid was significantly reduced (p=.003). Although a number of adverse effects occurred in this study, they were not so serious as to necessitate discontinuation of the therapy. No nephrotoxicity was observed. Twenty out of the 28 children who had been in remission relapsed after withdrawal of cyclosporine. Fifteen of these children showed relapse within a month. These results demonstrated that the combination of cyclosporine with the low-dose deflazacort was efficient and safe in children with SD and FR during the six-month treatment. However, further studies are necessary in order to resolve the problem of high relapse rate after discontinuation of cyclosporine.

• Journal of Korean Neurosurgical Society
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• 제63권4호
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• pp.495-503
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• 2020

Objective : Thyroid-stimulating hormone (TSH)-secreting pituitary adenoma (PA) is an extremely rare functioning form of PA that accounts for 0.7-2% of all such cases. The previously reported outcomes of the surgical removal of TSH-PA are poor. Owing to its extremely low incidence, most available reports on TSH-PA are case reports or small case series. Thus, we investigated the clinical and endocrinological outcomes of surgically treated TSH-PA through our institutional series. Methods : We retrospectively reviewed 14 consecutive cases of surgically treated TSH-PA, focusing on the clinical, radiological, surgical, and endocrinological data. Results : There were seven male (50%) and seven female (50%) patients. The mean age was 42.5 years (range, 19-63). The mean tumor size was 16.6 mm (range, 4-30). Optic chiasm compression was noted in six patients (42.9%), and no patient showed cavernous sinus invasion. Thirteen of 14 patients (92.8%) underwent transnasal transsphenoidal approach (TSA), and one patient underwent TSA followed by transcranial approach for residual tumor removal. Thirteen of 14 patients (92.8%) showed endocrinological remission; all patients who experienced remission showed subnormal levels of TSH (<0.4 μU/mL) on postoperative day 2. Recurrence occurred in two patients (14.2%). One patient underwent subsequent revision transnasal TSA for recurrent tumor removal, and the other patient underwent gamma knife radiosurgery for recurrence. Conclusion : Surgical treatment showed excellent surgical outcomes. The TSH level in the immediate postoperative period may be a predictor for endocrinological remission.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권6호
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• pp.461-472
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• 2022

Purpose: Golimumab (GLM) is an anti-tumor necrosis factor (TNF)-α antibody preparation known to be less immunogenic than infliximab (IFX) or adalimumab. Few reports on GLM in pediatric patients with ulcerative colitis (UC) are available. This study aimed to review the long-term durability and safety of GLM in a pediatric center. Methods: The medical records of 17 pediatric patients (eight boys and nine girls) who received GLM at the National Center for Child Health and Development were retrospectively reviewed. Results: The median age at GLM initiation was 13.9 (interquartile range 12.0-16.3) years. Fourteen patients had pancolitis, and 11 had severe disease (pediatric ulcerative colitis activity index ≥65). Ten patients were biologic-naive, and 50% achieved corticosteroid-free remission at week 54. Two patients discontinued prior anti-TNF-α agents because of adverse events during remission. Both showed responses to GLM without unfavorable events through week 54. However, the efficacy of GLM in patients who showed primary nonresponse or loss of response to IFX was limited. Four of the five patients showed non-response at week 54. Patients with severe disease had significantly lower corticosteroid-free remission rate at week 54 than those without severe disease. No severe adverse events were observed during the study period. Conclusion: GLM appears to be safe and useful for pediatric patients with UC. Patients with mild to moderate disease who responded to but had some adverse events with prior biologics may be good candidates for GLM. Its safety and low immunogenicity profile serve as favorable options for selected children with UC.

• 한국환경보건학회지
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• 제46권5호
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• pp.588-598
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• 2020

Objectives: Human indices were developed to determine returning point of residents and damage restoration after the chemical accident Methods: To determine the returning point of residents after the chemical accident, a new concept, the standard man model was introduced as a human index, in which both H-code and its acute effects were main idea. To evaluate the applicability, a hydrogen fluoride leakage accident in Gumi was applied. The returning point were suggested as the conservative remission period of acute effects among relevant hazard effects and compared with actual returning point. The coverage of each age group were considered with reflecting average daily dose expected for actual residents. In addition, a relief-index as a social-scientific approach was reflected as well to apply the damage restoration Results: Actual returning point of residents in Gumi was 88 days; and that of standard man model suggested was 84 days. The expected amount of exposure at aged 12 or under was at least 2.35 times greater than that of this model, 40s, theoretically. However, their population ratio was less than 1%, so 99% of residents could be applied when the standard man model was applied. The relief-index was as an objective and quantitative methodology to apply the qualitative aspect. Conclusions: Although evaluated as a relatively positive result, there was a limitation such as the number of accident applied to the verification of standard man model. The relief index was also considered, but further research should be carried out to find threshold level for the relief.

• Journal of Oral Medicine and Pain
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• 제18권1호
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• pp.73-82
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• 1993

To investigate the changes in aerobic and facultative anaerobic oral microflora during remission-induction chemotherapy in patients with acute myeloid leukemia, 10 consecutive patients were studied during a period of 28 days. One day before, during and after the induction therapy, patients were given 10% Betadine solution for mouthrinses after breakfast and kept from eating and drinking. After 3 hours, paraffin-stimulated whole saliva was obtained for 2 minutes and transported to the laboratory. The samples were dispersed and homogenized by use of vortex mixer for 20 seconds. From these samples 10-fold serial dilutions (from 10-1 through 10-3) were prepared. Each dilution of 0.1 ml was plated on duplicate set of one nonselective medium (Blood agar) and four selective media (Sabourauds dextrose agar, Mannitol salt agar, Mac-Conkey agar, SF medium ) using applicator woods. All agar plate were incubated at 37$^{\circ}C$ for 48 hours. The total number of microorganisms was calculated and the percentage distribution of the various microorganisms from each specimen was drawn. 1. The salivary flow rate decreased by 66%, going from 5.38 ml/2min to 1.81 ml/2min over two days during the chemotherapy. 2. The total number of microorganisms in saliva increased by 22%, going from 4.88$\times$105/ml to 6.00$\times$105/ml over two days during the chemotherapy. 3. The salivary flow rate and the total number of microorganisms in saliva were recovered within 28 days after the chemotherapy. 4. The quantitative alteration in oral Enterobacteria, Enterococci, Staphylococci, Cndida during the chemotherapy had no statistical significance. 5. In saliva of the patients with acute myeloid leukemia who ahd intraoral ulcer, Enterobacteria was quantitatively predominent. Our study suggests that chemotherapy-induced transient xerostomia may induce acute oral infection. Consequently, the use of saliva substitute, the removal of intraoral infection source and the consistent oral hygiene care seem to be required to avoid the transmission of potential pathogenes in this group of patients.

• 대한족부족관절학회지
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• 제11권1호
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• pp.57-61
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• 2007

Purpose: We analyzed to find out prognostic factors in the conservative treatment for the plantar fasciitis. Materials and Methods: The data were collected from 145 patients, 159 feet (M:F = 51:108) with conservative treatment and analyzed for possible prognostic factors : sex, age of onset, the duration of symptom before treatment, pain score before treatment, the duration for symptom remission, medication period, calcaneal pitch angle, and presence of calcaneal spur. Results: The duration of symptom before conservative treatment is affected to the prognosis, and the borderline of the effective period was about 6 months. Conclusion: With the conservative treatment of the plantar fasciitis, we found that (1) the duration of symptom before the conservative treatment was a prognostic factor, and (2) if the period before the conservative treatment was more than 6 months, the other treatment option such as surgery should be considered for this chronic group.

• 사상체질의학회지
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• 제24권2호
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• pp.61-70
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• 2012

1. Objectives : The aim of this study was to report significant improvement of chronic diarrhea and hematochezia after treatment with Dojeokgangki-tang in a Soyangin Patient with Crohn's Disease. 2. Methods : The patient's subjective and objective symptoms were observed daily throughout the hospitalization period, and the Crohn's disease activity index(CDAI) was calculated to gauge the progress or lack of progress. 3. Results : The symptoms of diarrhea and hematochezia disappeared by the end of the hospitalization period without recurrence, and the CDAI score dropped from 92.5 to 47. 4. Conclusions : A patient with Crohn's disease, who was in the state of repetitive relapse and remission after long term clinical courses was treated with Dojeokgangki-tang in a short period and the the symptoms of diarrhea and hematochezia disappeared without recurrence. Then the patient could stop taking corticosteriods and taper off immune-suppressing drugs.

• Journal of Korean Neurosurgical Society
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• 제30권5호
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• pp.567-574
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• 2001

Objective : As for growth hormone(GH) secreting pituitary adenoma, it's remission should be declared on the basis of satisfactory controlling of the tumor, normalization of hormonal level, and symptomatic improvement of the patient. Several modalities of treatment have been applied and administered, and yet, this disease still remains as inveterate one to be fully treated. The purpose of this study is to evaluate the outcome of gamma knife radiosurgery(GKRS) for GH secreting pituitary adenoma, and to identify various factors affecting the outcome of the treatment. Method : A group of 24 out of 35 patients, treated by Leksell gamma knife unit during the period of March of 1992 through October of 1997, had been observed for more than two years. The mean target volume of microadenoma was $449.3mm^3(range 216-880mm^3)$, and that of macroadenoma was $3183.1mm^3(range 1456-13125mm^3)$. The tumor margin was covered with 50% isodose profile, and mean marginal dose was 25.2Gy(range 15-32.4Gy). The mean number of isocenter was 4.3(range 1-6). The exposed dose to the optic apparatus was less than 8Gy. The mean follow-up period was 37.8months(range 24-102months). Result : No patients showed any increase in the tumor volume during the follow-up period. And definite shrinkage of tumor volume(tumor volume reduction rate, TVRR : more than 50%) was obtained in 10 patients(41.7%). Twenty one patients(87.5%) had reduced hormonal level compared than pre-treatment level. Among them, normalization of the hormonal level was achieved in 12 patients(50%). Clinicoendocrinological remission was seen in 3 patients (12.5%). According to the results of statistical analysis, tumor volume(p=0.016),duration of symptoms(p=0.046), initial GH level(p=0.017), and the invasion of cavernous sinus(p=0.036) were significantly favorable to post-radiosurgical outcome. The TVRR was significantly related to post-radiosurgical reduction of serum GH level. Permanent complication was not seen. Conclusion : The authors concluded that GKRS is a safe and effective treatment modality for acromegaly. To otain the better outcome of GKRS in GH secreting pituitary adenoma, more careful and sophisticated treatment-planning is recommended.