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Venous thromboembolism in pediatric patients: a single institution experience in Korea
최형수,Chang Won Choi,Heon Min Kim,Hye Won Park 대한혈액학회 2016 Blood Research Vol.51 No.3
BackgroundWhile venous thromboembolism (VTE) is uncommon, its incidence is increasing in children. We aimed to evaluate the incidence, risk factors, treatment, and outcome of pediatric VTE cases at a single tertiary hospital in Korea.MethodsWe retrospectively analyzed the records of consecutive pediatric VTE patients admitted to the Seoul National University Bundang Hospital between April 2003 and March 2016.ResultsAmong 70,462 hospitalizations, 25 pediatric VTE cases were identified (3.27 cases per 10,000 admissions). Fifteen patients (60%) were male, 8 were neonates (32%), and the median age at diagnosis was 10.9 years (range, 0 days‒17 yr). Doppler ultrasonography was the most frequently used imaging modality. Thrombosis occurred in the intracerebral (20%), upper venous (64%), lower venous (12%), and combined upper and lower venous systems (4%). Twenty patients (80%) had underlying clinical conditions including venous catheterization (24%), malignancy (20%), and systemic diseases (12%). Protein C, protein S, and antithrombin deficiencies occurred in 2 of 13, 4 of 13, and 1 of 14 patients tested, respectively. Six patients were treated with heparin followed by warfarin, while 4 were treated with heparin or warfarin. Thrombectomy and inferior vena cava filter and/or thrombolysis were performed in 5 patients. Two patients died of pulmonary embolism, and 2 developed a post-thrombotic syndrome.ConclusionCompared with the reports from Western countries, VTE occurrence was lower in the Korean pediatric population under study, although similar clinical characteristics includ-ing bimodal age distribution, underlying diseases, treatment pattern, and outcomes were observed.
최형수,권세곤,이찬영,김재왕,임남형 한국도시철도학회 2019 한국도시철도학회논문집 Vol.7 No.3
본 연구에서는 사전제작형 플로팅궤도 시스템에 적용된 스프링댐퍼 방진장치 실제품을 대상으로 장기 피로에 의한 장치 수명에 대한 신뢰성 평가를 위해 실험실 규모의 시험을 진행하고 시험 결과에대해 분석하였다. 또한 1,000만 cycle의 피로시험 전․후의 방진장치 수직강성을 측정하였다. 시험결과 반복시험 동안 방진장치의 정적․동적 수직강성의 변화량이 8.16% 이내로 매우 경미하게 나타났으며, 1,000만회 하중 재하 시 최소 33년 이상 방진장치의 성능유지 및 수명을 기대할 수 있는것으로 평가되었다. In this study, a laboratory scale test is conducted and analyzed to evaluate the reliability of the device life due to long - term fatigue for spring damper applied to precast floating track system. Also, fatigue tests were conducted for 10 million cycles after measuring the vertical stiffness of the isolator device before and after the fatigue test. The test results showed that the static and dynamic vertical stiffness of the vibration isolator was very small within 8.16% during fatigue test, and the performance and life expectancy if the vibration isolator could be expected for at least 33 years after 10 million load.
Venous thromboembolism in pediatric patients: a single institution experience in Korea
최형수,Chang Won Choi,Heon Min Kim,Hye Won Park 대한혈액학회 2016 Blood Research Vol.51 No.3
BackgroundWhile venous thromboembolism (VTE) is uncommon, its incidence is increasing in children. We aimed to evaluate the incidence, risk factors, treatment, and outcome of pediatric VTE cases at a single tertiary hospital in Korea.MethodsWe retrospectively analyzed the records of consecutive pediatric VTE patients admitted to the Seoul National University Bundang Hospital between April 2003 and March 2016.ResultsAmong 70,462 hospitalizations, 25 pediatric VTE cases were identified (3.27 cases per 10,000 admissions). Fifteen patients (60%) were male, 8 were neonates (32%), and the median age at diagnosis was 10.9 years (range, 0 days‒17 yr). Doppler ultrasonography was the most frequently used imaging modality. Thrombosis occurred in the intracerebral (20%), upper venous (64%), lower venous (12%), and combined upper and lower venous systems (4%). Twenty patients (80%) had underlying clinical conditions including venous catheterization (24%), malignancy (20%), and systemic diseases (12%). Protein C, protein S, and antithrombin deficiencies occurred in 2 of 13, 4 of 13, and 1 of 14 patients tested, respectively. Six patients were treated with heparin followed by warfarin, while 4 were treated with heparin or warfarin. Thrombectomy and inferior vena cava filter and/or thrombolysis were performed in 5 patients. Two patients died of pulmonary embolism, and 2 developed a post-thrombotic syndrome.ConclusionCompared with the reports from Western countries, VTE occurrence was lower in the Korean pediatric population under study, although similar clinical characteristics includ-ing bimodal age distribution, underlying diseases, treatment pattern, and outcomes were observed.
ADAMTS13 Gene Mutations in Children with Hemolytic Uremic Syndrome
최형수,오도연,정해일,김남근,박혜원 연세대학교의과대학 2011 Yonsei medical journal Vol.52 No.3
We investigated ADAMTS13 activity as well as the ADAMTS13 gene mutation in children with hemolytic uremic syndrome (HUS). Eighteen patients, including 6 diarrhea-negative (D-HUS) and 12 diarrhea-associated HUS (D+HUS) patients, were evaluated. The extent of von Willebrand factor (VWF) degradation was assayed by multimer analysis, and all exons of the ADAMTS13 gene were PCR-amplified using Taq DNA polymerase. The median and range for plasma activity of ADAMTS13in 6 D-HUS and 12 D+HUS patients were 71.8% (22.8-94.1%) and 84.9% (37.9-119.9%), respectively, which were not statistically significantly different from the control group (86.4%, 34.2-112.3%) (p>0.05). Five ADAMTS13 gene mutations, including 2 novel mutations [1584+2T>A, 3941C>T (S1314L)] and 3 polymorphisms (Q448E, P475S, S903L), were found in 2 D-HUS and one D+HUS patients, which were not associated with deficiency of ADAMTS13 activity. Whether these mutations without reduced ADAMTS13 activity are innocent bystanders or predisposing factors in HUS remains unanswered.
Dexrazoxane for Preventing Anthracycline Cardiotoxicity in Children with Solid Tumors
최형수,박은실,강형진,신희영,노정일,윤용수,안효섭,최정윤 대한의학회 2010 Journal of Korean medical science Vol.25 No.9
This study attempted to assess the incidence and outcome of anthracycline cardiotoxicity and the role of dexrazoxane as a cardioprotectant in childhood solid tumors. The dexrazoxane group included 47 patients and the control group of historical cohort included 42. Dexrazoxane was given in the 10:1 ratio to doxorubicin. Fractional shortening and systolic and diastolic left ventricular diameters were used to assess the cardiac function. The median follow-ups were 54 months in the dexrazoxane group and 86 months in the control group. The mean cumulative doses of doxorubicin were 280.8±83.4 mg/m2 in the dexrazoxane group and 266.1±75.0 mg/m2 in the control group. The dexrazoxane group experienced significantly fewer cardiac events (27.7% vs. 52.4%) and less severe congestive heart failure (6.4% vs. 14.3%) than the control group. Thirteen cardiotoxicities including one cardiac death and 2 congestive heart failures occurred in the dexrazoxane group, and 22 cardiotoxicities including 2 cardiac deaths and 4 congestive heart failures, in the control group. Five year cardiac event free survival rates were 69.2% in the dexrazoxane group and 45.8% in the control group (P=0.04). Dexrazoxane reduces the incidence and severity of early and late anthracycline cardiotoxicity in childhood solid tumors.