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( Yun Seon Choi ),( Do Hoon Lim ),( Jeong Il Yu ),( Kyung Il Jo ),( Do Hyun Nam ),( Ho Jun Seo ),( Jung Il Lee ),( Doo Sik Kong ),( Yeon Lim Suh ),( Yun Han Lee ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Purpose: This study was performed to determine the clinical signifi cance of the Ki-67 labeling index (LI) for local control in patients with WHO grade Ⅱ meningioma. Methods: The medical records and values of Ki-67 LI`s were retrospectively reviewed for 50 patients who underwent surgical resection of intracranial WHO grade Ⅱ meningiomas at Samsung Medical Center from May 2001 to Dec 2012. Simpson grade Ⅰ, Ⅱ, Ⅲ, and Ⅳ resections were performed in 16, 23, 5, and 6 patients, respectively.Forty-three patients (86%) were treated with immediate postoperative radiotherapy (PORT). The median total radiation dose was 60 Gy (range 54-60). Results: The median follow-up was 47.4 months. The mean Ki-67 LI was 13% (range 1-47%). Twelve patients (24.0%) showed local failure, and 8 patients (16.0%) experienced local failure even after PORT. The mean Ki-67 LI was 15% in patients with local failure (n=12) and 12% in patients without local failure (n=38). The 3-year actuarial local control was 80.5%. The 3-year overall survival was 89.5%. Ki-67 LI > 13% and PORT were significant prognostic factors for local control (p=0.015 and p=0.009, respectively). In patients with Ki-67 LI > 13% (n=17), PORT (n=14) improved local control (p<0.001). However, PORT (n=29) did not affect local control (p=0.412) for patients with Ki-67 LI = 13% (n=33). Conclusions: Ki-67 LI can be a useful prognostic factor for local control in WHO grade Ⅱ meningioma. In patients with Ki-67 LI > 13%, PORT may be recommended in order to improve local control.
대퇴골 골절 환자에서 발생한 급성신손상의 위험인자와 임상경과
윤유선 ( Yu-seon Yun ),유지한 ( Ji Han Yu ),김지희 ( Ji Hee Kim ),권기욱 ( Ki Wook Kwon ),이홍석 ( Hong Seok Lee ),이영복 ( Yeong Bok Lee ),박원종 ( Won Jong Bahk ),김영옥 ( Young Ok Kim ) 대한내과학회 2013 대한내과학회지 Vol.84 No.6
Background/Aims: Femoral fracture occurs most often in elderly patients and is highly associated with medical problems such as acute kidney injury (AKI); however no reports of AKI in femoral fracture patients have been published. This study was performed to identify risk factors and the clinical course of AKI in patients with femoral fracture. Methods: We retrospectively evaluated the medical records of 110 patients with femoral fracture between November 2006 and December 2011 at Uijeongbu St. Mary`s Hospital. We investigated the incidence and clinical course of AKI in femoral fracture patients and compared the clinical findings between AKI and normal kidney function (NKF) groups. Results: Of the 110 femoral fracture patients, AKI was observed in 19 (17.3%). The peak serum creatinine level in patients with AKI was 2.59 ± 1.57 mg/dL. Two of 19 patients with AKI died and two progressed to chronic kidney disease. When compared to the NKF group, the AKI group had a higher incidence of elevated lactate dehydrogenase (LDH) (63.2% vs. 34.1%, p = 0.020), erythrocyte sedimentation rate (ESR) (31.6% vs. 6.6%, p = 0.008), and C-reactive protein (57.9% vs. 46.2%, p = 0.042). The AKI group also had a longer hospitalization duration, and more patients were prescribed an angiotensin-converting-enzyme (ACE) inhibitor than in the NKF group. Multivariate analysis demonstrated elevated LDH, ESR and ACE inhibitor prescriptions as independent risk factors for AKI in patients with a femoral fracture. Conclusions: The incidence of AKI in patients with a femoral fracture was 17.3%, and AKI was associated with a longer clinical course. We recommend monitoring of laboratory findings
유지 혈액투석 환자에서 발생한 비외상성의 자발성 신파열 12예의 분석
유혜영 ( Yu Hye Yeong ),송선화 ( Song Seon Hwa ),한창희 ( Han Chang Hui ),김재욱 ( Kim Jae Ug ),김영옥 ( Kim Yeong Og ),윤정민 ( Yun Jeong Min ),김영수 ( Kim Yeong Su ),최범순 ( Choe Beom Sun ),윤선애 ( Yun Seon Ae ),양철우 ( Yang 대한신장학회 2004 Kidney Research and Clinical Practice Vol.23 No.3
배경 : 정상인에서 특별한 외상 없이 발생하는 자발성 신파열은 매우 드문 질환이지만 혈액 투석 환자에서는 투석기간이 장기화되면서 신낭종과 신세포암의 발생빈도가 증가로 인해 정상인에 비해 높게 나타나는 것으로 보고되고 있다. 이에 유지 혈액투석을 받고 있는 말기 신부전증 환자에서 발생한 자발성 신파열의 임상적 특성을 알아보고자 하였다. 방법 : 대상 환자는 1998년 1월부터 2003년 7월까지 가톨릭의대 3개 병원에서 유지 혈액투석을 받고 있는 환자 중에서 자발성 신파열이 발생한 12명의 환자를 대상으로 신파열의 원인, 임상증세, 치료 및 경과를 후향적으로 분석하였다. 결과 : 환자의 평균나이는 54±10세 (38-72세)였고 남자 9명, 여자 3명이었다. 일차 원인 신질환으로는 상염색체 우성 다낭신증 5명, 만성 사구체신염 2명, 당뇨병 1명, 고혈압 1명, 원인미상이 3명이었다. 신파열의 주요 임상증세는 측복부 동통이 9명이었고 육안적 혈뇨가 3명이었다. 혈액투석을 시작한 후 신파열이 발생하기까지의 기간은 평균 53±36개월 (11-103개월)이었다. 상염색체 우성 다낭신증 5명을 제외한 7명의 환자 중에서 후천성 신낭종이 발견된 환자는 6명이었다. 전체 12명 중 9명에서 신절제술을 시행하였고 나머지 3명은 수혈 등의 보존적 치료만을 받았다. 수술을 받은 9명의 환자 중 2명에서 1 ㎝ 미만의 미세 신세포암이 발견되었다. 전 환자에서 사망한 예는 없었다. 결론 : 결론적으로 혈액투석 환자에서 발생한 자발성 신파열의 주요 원인은 신낭종과 신세포 암이었으며 장기 투석 환자에서 주로 발생하였다. 그러므로 장기 혈액투석 환자에서 정기적인 초음파나 전산화 단층촬영을 시행하여 자발성 신파열의 주요 원인인 신낭종과 신세포암에 대한 추적 관찰이 필요하리라 사료된다. Background : Because of high incidence of acquired renal cyst and renal malignancy, it is suggested that spontaneous renal rupture more frequently occurs in patients receiving long-term hemodialysis than general population. This study was performed to evaluate the clinical characteristics of spontaneous renal rupture in hemodialysis patients. Methods : This retrospective study enrolled 12 hemodialysis patients who developed spontaneous renal rupture. We investigated primary renal disease, duration of dialysis, clinical symptoms and signs, radiologic findings, treatment modalities, and histologic findings. Results: The mean age of the patients was 54± 10 years old and the number of male was 9. Primary renal disease consisted of autosomal dominant polycystic kidney disease (PCKD) (n=5), chronic glomerulonephritis (n=2), diabetic nephropathy (n=l), hypertensive nephropathy (n=l), unknown cause (n=3). Presenting symptoms and signs were sudden onset of flank pain in 9 patients and gross hematuria with mild flank pain in 3 patients. Mean duration from initiation of hernodialysis to development of spontaneous renal rupture was 53±36 months. Abdominal computed tomography showed subcapsular or perinephric hematoma in all patients. Of the 7 non-PCKD patients, 6 patients had multiple acquired renal cysts. Surgical exploration was undertaken in 9 patients. Pathologic examination demonstrated small sized-renal cell carcinoma in 2 of 9 patients. Three patients were only treated with conservative management including blood transfusion. All 12 patients recovered without recurrence. Conclusion : This study demonstrated that genetic or acquired renal cyst was an important cause of spontaneous renal rupture in hemodialysis patients and presenting manifestations were sudden onset of flank pain and gross hematuria. (Korean J Nephrol 2004;23(3):453-458)
Different Persistence of Isaria javanica Isolate in Potted Greenhouse Soil
Jeong Seon Yu,Jin Ju Yun,Byung Ju Lee,Jeong Hwa Huang,Jeong Jun Kim,Ji Hee Han,Sang Yeob Lee 한국응용곤충학회 2016 한국응용곤충학회 학술대회논문집 Vol.2016 No.04
Entomopathogenic fungus is a useful control agent to sucking type insect such as whitefly and aphid. The fungi are influenced by some environmental factors such as relative humidity, temperature and UV and cause slow and fluctuation in pest control efficacy. Especially, UV kills conidia or spores of entomopathogenic fungi and a mycopesticide using fungi has short control period in field. UV intensity changes from season to season. Survival rate of entomopathognic fungi treated may differ from seasons and will show different control efficacy. Therefore, we conducted a study to estimate the persistence of an Isaria javanica isolate, which was already reported as sweet potato whitefly control agent, in potted greenhouse soil planted different crops. The number of survival spore decreased gradually and differ from seasons.
증례 : 내분비-대사 ; 무균성 뇌수막염으로 오인된 뇌하수체졸증 1예
윤유선 ( Yu Seon Yun ),김은숙 ( Eun Sook Kim ),신정아 ( Jung Ah Shin ),강무일 ( Moo Il Kang ),윤건호 ( Kun Ho Yoon ),차봉연 ( Bong Yun Cha ),손호영 ( Ho Young Son ) 대한내과학회 2011 대한내과학회지 Vol.80 No.1
본 저자들은 뇌수막염 증상으로 오인되어 치료가 지연, 부신 위기 동반으로 악화된 후 진단된 뇌하수체 선종의 뇌하수체졸증 1예를 경험하여, 무균성 뇌수막염이 호전되지 않을 경우에는 드물지만 치명적인 경과를 보일 수 있는 뇌하수체졸증일 가능성을 상기하고자 이를 보고하는 바이다. Pituitary apoplexy is a clinical syndrome caused by an acute ischemic or hemorrhagic vascular accident. Although pituitary apoplexy is an emergency, it is often overlooked because it is rare and presents with various signs and symptoms, including those of neurologic and endocrine disorders. We describe a case of pituitary apoplexy misdiagnosed as aseptic meningitis accompanied by acute-onset headache and nausea, followed by fever. Subsequently, it was revealed as pituitary apoplexy by brain magnetic resonance imaging (MRI) performed when the clinical course worsened and ophthalmoplegia developed. We suggest that pituitary apoplexy be included in the differential diagnosis of patients presenting with headache or signs of meningeal irritation; when there is no clinical improvement, prompt steroid treatment should be started, while considering neurological decompression to prevent neurological sequelae. (Korean J Med 2011;80:102-107)