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A Case of Coincidental Intrasellar Chordoma and Pituitary Adenoma
( Sehoon Park ),( Hee Sung Kim ),( Ki-su Park ),( Taek-kyun Nam ),( Yong-sook Park ),( Jeong-taik Kwon ),( Kyung-tae Kim ) 대한뇌종양학회 대한신경종양학회 2017 Brain Tumor Research and Treatment Vol.5 No.1
Although chordomas are midline tumors, primarily intrasellar chordomas are extremely rare. In this report, the authors describe the case of a 68-year-old female with partial abducens nerve palsy in the right eye due to the intrasellar cystic tumor. After endonasal trans-sphenoidal surgery, intraoperative and histopathological findings confirmed the co-occurrence of an entirely intrasellar chordoma and pituitary adenoma. To our knowledge, the present case is the third reported case of an intrasellar chordoma with a pituitary adenoma.
JeongIl Yu,HeeChul Park,DooHo Choi,JaeMyoung Noh,Dongryul Oh,JunSu Park,JiHyun Chang,SeungTae Kim,Jeeyun Lee,SeHoon Park,JoonOh Park,YoungSuk Park,HoYeong Lim,WonKi Kang 대한방사선종양학회 2016 Radiation Oncology Journal Vol.34 No.1
Purpose: A prospective phase II trial was conducted to evaluate the effectiveness and toxicity of regional hyperthermia and whole liver irradiation (WLI) for numerous chemorefractory liver metastases from colorectal cancer. Materials and Methods: Enrolled patients had numerous chemorefractory hepatic metastases from colorectal cancer. Five sessions of hyperthermia and seven fractions of 3-gray WLI were planned. Health-related quality of life (HRQoL) was determined using the Korean version of the European Organization for Research and Treatment of Cancer quality of life questionnaire C-30 and the Functional Assessment of Cancer Therapy-Hepatobiliary version 4.0. Objective and pain response was evaluated. Results: A total of 12 patients consented to the study and the 10 who received WLI and hyperthermia were analyzed. WLI was completed as planned in nine patients and hyperthermia in eight. Pain response was partial in four patients and stable in four. Partial objective response was achieved in three patients (30.0%) and stable disease was seen in four patients at the 1-month follow-up. One patient died 1 month after treatment because of respiratory failure related to pleural metastasis progression. Other grade III or higher toxicities were detected in three patients; however, all severe toxicities were related to disease progression rather than treatment. No significant difference in HRQoL was noted at the time of assessment for patients who were available for questionnaires. Conclusion: Combined WLI and hyperthermia were well tolerated without severe treatment-related toxicity with a promising response from numerous chemorefractory hepatic metastases from colorectal cancer.
Characteristics of kidney transplantation recipients over time in South Korea
Sehoon Park,김명석,Ji Eun Kim,Kwangsoo Kim,Minsu Park,Yong Chul Kim,Kwon Wook Joo,Yon Su Kim,Hajeong Lee 대한내과학회 2020 The Korean Journal of Internal Medicine Vol.35 No.6
Background/Aims: Detailed nationwide information regarding the recent status and time trends of kidney transplantation (KT) in South Korea is limited. Methods: We performed a nationwide, population-based cohort study using the national claims database of Korea. We included KT recipients from 2008 to 2016, and their demographic and clinical characteristics were collected. The prognostic outcome was graft failure consisted of patient death and death-censored graft failure (DCGF). Results: We studied 14,601 KT recipients with median follow-up duration of 3.96 years. The median age at the time of transplantation consistently increased from the past, and proportion of underlying diabetes mellitus prominently increased, reaching 35.6% in 2016. The preemptive KT accounted for approximately 30% of the total transplantation cases. The recipients showed a 10-year cumulative graft survival rate of 71.8%, consisting of 10-year DCGF free survival of 77.6% and patient survival of 92.8%. Age ≥ 20 and < 30 years, age ≥ 70 years, underlying history of diabetes, non-preemptive transplantation, and poor compliance on tacrolimus and mycophenolic acid were the significant risk factors associated with worse DCGF outcome. The economic cost of KT showed prominently increasing trends, reaching a total insured fee of > 60,000,000$ in 2016. However, the expansion was mainly burdened by the national insurance service but not by the patients. Conclusions: In South Korea, the number of kidney transplantation in elderly or in patients with comorbidities has been increasing. Complex clinical factors were associated with medication compliance and patient prognosis.
An Analysis of Replication Enhancement for a High Availability Cluster
Park, Sehoon,Jung, Im Y.,Eom, Heonsang,Yeom, Heon Y. Korea Information Processing Society 2013 Journal of information processing systems Vol.9 No.2
In this paper, we analyze a technique for building a high-availability (HA) cluster system. We propose what we have termed the 'Selective Replication Manager (SRM),' which improves the throughput performance and reduces the latency of disk devices by means of a Distributed Replicated Block Device (DRBD), which is integrated in the recent Linux Kernel (version 2.6.33 or higher) and that still provides HA and failover capabilities. The proposed technique can be applied to any disk replication and database system with little customization and with a reasonably low performance overhead. We demonstrate that this approach using SRM increases the disk replication speed and reduces latency by 17% and 7%, respectively, as compared to the existing DRBD solution. This approach represents a good effort to increase HA with a minimum amount of risk and cost in terms of commodity hardware.
Gestational Estimated Glomerular Filtration Rate and Adverse Maternofetal Outcomes
Park, Sehoon,Lee, Seung Mi,Park, Joong Shin,Hong, Joon-Seok,Chin, Ho Jun,Na, Ki Young,Kim, Dong Ki,Oh, Kook-Hwan,Joo, Kwon Wook,Kim, Yon Su,Lee, Hajeong S. Karger AG 2018 Kidney & blood pressure research Vol.43 No.5
<P><B><I>Background/Aims:</I></B> The association between gestational estimated glomerular filtration rate (eGFR) and adverse pregnancy outcomes has not been fully investigated. <B><I>Methods:</I></B> This observational cohort study included pregnancy cases of singleton mothers whose serum creatinine levels were measured during pregnancy at two tertiary hospitals in Korea from 2000 to 2015. Those with identified substantial renal function impairment (eGFR < 60 mL/min/1.73 m<SUP>2</SUP> at baseline, during, or after pregnancy) were excluded. The Chronic Kidney Disease Epidemiology Collaboration equation was used for the eGFR calculation. We computed the time-averaged eGFR during gestation to determine representative values when there were multiple measurements. We studied the following three gestational complications: preterm birth (< 37 weeks’ gestational age), low birth weight (< 2.5 kg), and preeclampsia. <B><I>Results:</I></B> Among the 12,899 studied pregnancies, 4,360 cases experienced one or more gestational complications. The adjusted odds ratio (aOR) and 95% confidence interval of composite gestational complications for eGFR ranges other than the reference range of 120–150 mL/ min/1.73m<SUP>2</SUP> were: ≥150 mL/min/1.73m<SUP>2</SUP>, aOR 1.64 (1.38–1.95), P< 0.001; 90–120 mL/min/1.73m<SUP>2</SUP>, aOR 1.41 (1.28–1.56), P< 0.001; and 60–90 mL/min/1.73m<SUP>2</SUP>, aOR 2.56 (1.70–3.84), P< 0.001. Incidence of preterm birth or low birth weight showed similar U-shaped association with eGFR values; otherwise, preeclampsia or small for gestational age occurred more often in mothers with a lower gestational eGFR than in those with a higher value. <B><I>Conclusion:</I></B> Considering the unique association between gestational eGFR and pregnancy outcomes, carefully interpreting these results may help predict obstetric complications.</P>
Park, Sehoon,Lee, Soojin,Lee, Anna,Paek, Jin Hyuk,Chin, Ho Jun,Na, Ki Young,Chae, Dong-Wan,Kim, Sejoong Elsevier 2018 Surgery Vol.163 No.5
<P><B>Abstract</B></P> <P><B>Background</B></P> <P>It is unclear whether pathologic findings on preoperative urinalysis are associated with the risk of postoperative acute kidney injury (AKI). Therefore, we performed a retrospective review to investigate this association.</P> <P><B>Methods</B></P> <P>We assessed the clinical significance of preoperative dipstick urinalysis in a 10-year surgery cohort from a tertiary hospital in Korea. Patients without available information on perioperative serum creatinine levels or kidney injury prior to surgery were excluded. Preoperative dipstick urinalysis parameters, including albuminuria, hematuria, pyuria, and others were studied. The primary outcome was postoperative acute kidney injury. Secondary outcomes were postoperative 1-year mortality and progression of poor kidney function parameters.</P> <P><B>Results</B></P> <P>We enrolled 40,090 patients. The presence of dipstick albuminuria was associated with an increased risk of postoperative AKI (adjusted odds ratio 1.47 [1.29–1.66], <I>P</I> < .001), and the association showed a dose-response relationship. High specific gravity was significantly associated with increased risk of AKI (adjusted odds ratio 1.30 [1.04–1.63], <I>P</I> = .02). Furthermore, in patients with postoperative AKI, those with baseline albuminuria had a worse prognosis with regard to 1-year mortality (adjusted hazard ratio 2.81 [1.56–5.09], <I>P</I> < .001) and persistent renal function impairment (adjusted odds ratio 2.07 [1.21–3.46], <I>P</I> = .007), independent of estimated glomerular filtration rate values. Patients with baseline hematuria and pyuria also had an inferior postoperative AKI prognosis when compared to those without the urinalysis abnormalities.</P> <P><B>Conclusion</B></P> <P>Baseline dipstick urinalysis may predict postoperative AKI and may be significantly associated with prognosis after surgery. (Surgery 2017;160:XXX-XXX.)</P>
( Sehoon Park ),( Soojin Lee ),( Hyung Ah Jo ),( Kyungdo Han ),( Yaerim Kim ),( Jung Nam An ),( Kwon Wook Joo ),( Chun Soo Lim ),( Yon Su Kim ),( Hyeongsu Kim ),( Dong Ki Kim ) 대한신장학회 2018 Kidney Research and Clinical Practice Vol.37 No.2
Background: Continuous renal replacement therapy (CRRT) is an important treatment modality for severe acute kidney injury. As such, the epidemiology of CRRT in Korea needs further investigation. Methods: We conducted a nationwide, population-based study analyzing the claims data from National Health Insurance Service of Korea. All index intensive care unit admission cases of CRRT in government-designated tertiary referral hospitals in Korea from 2005 to 2016 were included. Patients with a history of renal replacement therapy or who were under 20 years old were not considered. In addition to baseline and treatment characteristics, patient outcomes, including all-cause mortality and renal survival rates, were investigated. We stratified the study patients according to 3-year time periods and major regions of the nation. Results: We included 37,337 patients who received CRRT in Korea. The overall use of CRRT increased over time, and more than 80% of cases of acute renal replacement therapy were CRRT after 2014. Seoul was the region in which the majority of CRRT (45.0%) was performed. The clinical characteristics of CRRT patients were significantly different among time-intervals and regions. Both all-cause mortality and renal survival rates after CRRT were prominently improved in the recent time periods (P < 0.001). Conclusion: CRRT is a widely used treatment strategy for severe acute kidney injury in Korea. The prognosis of CRRT patients has improved compared to the past. This epidemiological study of CRRT in Korea revealed notable trends with regard to time period and geographic region.
( Sehoon Park ),( Soojin Lee ),( Yaerim Kim ),( Yeonhee Lee ),( Min Woo Kang ),( Kyungdo Han ),( Hajeong Lee ),( Jung Pyo Lee ),( Kwon Wook Joo ),( Chun Soo Lim ),( Yon Su Kim ),( Dong Ki Kim ) 대한신장학회 2020 Kidney Research and Clinical Practice Vol.39 No.2
Background: Metabolic syndrome (MetS) is linked to various chronic comorbidities, including chronic kidney disease (CKD). However, few large studies have addressed whether recovery from MetS is associated with reduction in the risks of such comorbidities. Methods: This nationwide population-based study in Korea screened 10,664,268 people who received national health screening ≥ 3 times between 2012 and 2016. Those with a history of major cardiovascular events or preexisting CKD were excluded. We classified study groups into four, according to the course of MetS state, as defined by the harmonizing criteria. The main study outcome was incidental CKD (estimated glomerular filtration rate < 60 mL/min/1.73 m<sup>2</sup> which was persistent until the last health exams). The study outcomes were investigated using multivariable logistic regression analysis, which was adjusted for clinical variables and the previous severity of MetS. Results: Four study groups included 6,315,301 subjects: 4,537,869 people without MetS, 1,034,605 with chronic MetS, 438,287 who developed MetS, and 304,540 who recovered from preexisting MetS. Those who developed MetS demonstrated higher risk of CKD (adjusted odds ratio [OR], 1.26 [1.23-1.29]) than did those who did not develop MetS. In contrast, MetSrecovery was associated with decreased risk of CKD (adjusted OR, 0.84 [0.82-0.86]) than that in people with chronic MetS. Among the MetS components, change in hypertension was associated with the largest difference in CKD risk. Conclusion: Reducing or preventing MetS may reduce the burden of CKD on a population-scale. Clinicians should consider the clinical importance of altering MetS status for risk of CKD.