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김수연,김민지,이주훈,김건석,박영서,Kim, Su-Yon,Kim, Min-Jee,Lee, Joo Hoon,Kim, Kun Suk,Park, Young Seo 대한소아신장학회 2013 Childhood kidney diseases Vol.17 No.2
목적: 소아 요로결석은 흔하지 않은 질환이나 신장에 치명적인 손상을 야기할 수 있다. 성인 요로결석의 경우 많은 수의 문헌 보고들이 있으나, 소아에서는 대규모의 연구들이 아직 부족한 실정이다. 이에 저자들은 22년간 3차 의료기관에서 22년간 경험한 소아 요로결석 환아들을 분석하였다. 방법: 1991년 1월부터 2013년 5월까지 서울아산병원 소아청소년과, 소아비뇨기과에서 요로결석으로 진단된 환아들을 대상으로 후향적으로 의무 기록을 분석하였다. 진단 시 연령, 성별, 임상 증상, 가족력, 동반 질환, 요로결석의 위치, 결석 성분 분석, 원인 및 치료 방법, 재발 등을 조사하였다. 결과: 137례(남:여=96:41)에서 연구가 이루어졌다. 연령 분포는 생후 5일경 진단받은 경우부터 17세까지로 1세 미만이 43례(31%)로 가장 많았고 그 중 16례(37%)에서 중환자실 치료의 과거력이 있었다. 요로결석의 가족력은 13명(9.5%)의 환자에서 보였다. 진단 당시 주증상으로는 육안적 혈뇨가 56명(41%)으로 가장 많았으며 측복부 동통 또는 복통이 46명(34%)이었다. 요로결석의 위치는 신석 82례(62%), 요관석 30례(22%), 방광석 2례(1.4%) 였으며, 20례(15%)에서는 다발성으로 있었다. 요 저류를 일으킬 수 있는 구조적인 원인이 동반된 경우는 모두 26례(19%) 이었으며, 대사 검사는 91례(66%)에서 시행하여 38%(35/91)에서 이상을 발견하였고, 요로감염은 26례(19%) 에서 발견되었다. 요로결석 성분검사는 35례에서 가능하였으며 칼슘석이 20례(20/35,57%)로 가장 많았으며, 감염석 5례(5/37,14%), 요산석 4례(4/35,11%), 탄산염 인회석 3례(3/35,7%), 시스틴석 2례(2/35,6%), 인산염석 1례 순이었다. 개방 수술적 치료가 5례(4%)에서 시행되었으며 77례(56%)에서 보존적 치료를 시행하였고, 나머지 55례(40%)에서는 1가지 이상의 비개방적 치료를 시행하였다. 총 18례(13%)에서 요로결석이 재발하였다. 결론: 소아 요로결석은 흔히 비뇨 생식기계의 구조적 이상, 대사 이상, 요로감염과 연관되어 발생하며, 두가지 이상의 원인을 함께 동반하기도 하고, 특발성으로 발생하기도 한다. 따라서 이들을 배제하기 위한 검사들이 시행되어야 한다. 또한 소아 요로결석은 절반에서 자연배출이 되며, 최근 20년 들어 기구와 술기가 발전하여 최소 침습적 치료들이 가능하다. 소아 요로결석은 재발율이 높으므로 장기간의 추적관찰이 필요하며 잔류 요로결석이 완전히 사라지는 것을 확인하는 것이 중요하다. Purpose: Pediatric urolithiasis is uncommon in children but is a cause of significant morbidity and damage to the kidney. Although much information on adult urolithiasis is available in the literature, large studies on the pediatric population are still scarce. In this report, we review our experience with pediatric urolithiasis over 22 years at a tertiary referral center. Method: We retrospectively reviewed the records of children with newly diagnosed urolithiasis between January 1991 and May 2013. We assessed the age, sex, family history, initial symptoms, location of stones, underlying cause, stone analysis, treatment, and recurrence among the patients. Results: In total, 137 patients (96 male, 41 female) were assessed. The age range was 0-17 years (mean age, 6.0 years). Forty-three (31%) children were aged <1 year, and 37% (16/43) had a history of intensive care unit (ICU) admission. Thirteen patients (9.5%) had a family history of stones. The most common symptoms at presentation among the patients were gross hematuria (56/137, 41%) and flank or abdominal pain (46/137, 34%). The stones were located in the kidney (85/137, 62%), ureter (29/137, 21%), bladder (2/137, 1.4%), and multiple locations (20/137, 15 %). Congenital abnormalities of the genitourinary (G-U) tract, with or without metabolic abnormality, or urinary tract infection (UTI) was detected in 26 children (19%). Ninety-one patients (66%) underwent metabolic examination, and 38% of these patients exhibited an abnormality. UTI, with or without abnormalities of the G-U tract, or metabolic abnormality was detected in 26 children (19%). Of the 35 stones analyzed, the majority were calcium stones (20/35, 57%), followed by infected stones (5/35, 14%), uric acid stones (4/35, 11%), carbonate apatite stones (3/35, 7%), cystine stones (2/35, 6%), and phosphate stones (1/35, 3%). Five patients (4%) required open procedures, with or without non-open procedures, whereas 77 patients (56%) were managed conservatively; the remaining 55 patients (40%) received some other form of intervention. Eighteen patients (13%) had stone recurrence during the follow-up period. Conclusions: Pediatric urolithiasis is commonly associated with abnormalities of the G-U tract and/or metabolic disorders and/or UTI. Half of the patients will pass their stones spontaneously, and all the techniques of minimally invasive surgery are applicable in the treatment of children with stones. As the recurrence rates are high among this population, long-term follow-up is recommended and the complete clearance of stones is important.
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Hassan, Ahmed H.E.,Choi, Eunwoo,Yoon, Yoon Mi,Lee, Kun Won,Yoo, Sung Yeun,Cho, Min Chang,Yang, Ji Seul,Kim, Hye In,Hong, Joo Young,Shin, Ji-Sun,Chung, Kyung-Sook,Lee, Jeong-Hun,Lee, Kyung-Tae,Lee, Yon Elsevier 2019 European journal of medicinal chemistry Vol.161 No.-
<P><B>Abstract</B></P> <P>Cancer still represents a major global health problem. All currently available anticancer agents have disadvantages like resistance or side effects. Therefore, introduction of novel anticancer agents is needed. Intrigued by the high success rate for natural products-based drug discovery, we designed and synthesized antiproliferative chemical entities as hybrids of two natural products; 3,5,4′-trimethoxystilbene and 5,6,7-trimethoxyflavone. To probe the spectrum of the synthesized compounds, <I>in vitro</I> evaluation was conducted against nine panels representing major cancer diseases. The results revealed the hybrid analogs <B>4f</B>, <B>4h</B>, <B>4k</B> and <B>4q</B> as promising broad-spectrum anticancer lead compounds eliciting high growth inhibition of several cell lines representing multiple cancers diseases. Evaluation of the promising lead compounds against normal human cell lines suggested a selective cytotoxic effect on cancer cells. Mechanistic investigation of the cytotoxic activity of compound <B>4f</B> in human cervical cancer HeLa cells showed that it triggers cell death through induction of apoptosis. As a whole, this study presents the natural products hybrid analogs <B>4f</B>, <B>4h</B>, <B>4k</B> and <B>4q</B> as potential lead compounds for further development of novel anticancer therapeutics.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Design, synthesis and <I>in vitro</I> antiproliferative evaluation of 3,5,4′-trimethoxystilbene-5,6,7-trimethoxyflavone hybrids. </LI> <LI> Compounds <B>4f</B>, <B>4h</B>, <B>4k</B> and <B>4q</B> elicited promising broad spectrum antiproliferative activity. </LI> <LI> Compounds <B>4f</B>, <B>4h</B>, <B>4k</B> and <B>4q</B> were more selective to human cancer cells rather than normal human cells. </LI> <LI> Compound <B>4f</B> triggered cell death via induction of apoptosis in HeLa cells. </LI> <LI> Compounds <B>4f</B>, <B>4h</B>, <B>4k</B> and <B>4q</B> might be potential leads for development of natural-products based anticancer agents. </LI> </UL> </P> <P><B>Graphical abstract</B></P> <P>[DISPLAY OMISSION]</P>
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김민호,김병준,윤중근,오형석,문원주,고영재,정찬형,하연주 대한내과학회 1999 대한내과학회지 Vol.56 No.4
Mucormycosis is an uncommon, frequently fatal, opportunistic fungal infection. Rhino-cerebral and pulmonary involvement are the most common forms and usually occur in immunecompromised patients. Gastrointestinal involvement is extremely rare, the stomach being the most frequently involved site among them. We report a case of gastric mucormycosis in a 37 year old male alcoholic with gastric ulcer. On histological examination, characteristic findings of hyphae with irregular width and right angle branchings were observed in the gastric mucosa and ulcer debris. The diagnosis of gastric mucormycosis was made by the characteristic histological nature. The patient was treated aggressively with antibiotics and antiulcer regimen for 6 weeks, and then no fungus was present on follow up biopsy of gastric mucosa.
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