1.Long-term Follow-up of Adult-onset Minimal Change Nephrotic Syndrome.
Kuk Jin CHANG ; Sung Bae PARK ; Hyun Chul KIM
Korean Journal of Nephrology 2003;22(2):185-194
BACKGROUND: Adult-onset minimal change nephrotic syndrome has been associated with a good response to corticosteroids and a benign prognosis. However, there are few longterm outcome data reported. METHODS: A series of 355 patients with adult-onset minimal change nephrotic syndrome (MCNS) who were admitted to Keimyung University Dongsan Medical Center from December 1978 to May 2002, was retrospectively analyzed to evaluate the initial response to corticosteroids, subsequent response to cytotoxic agents, the stability of remission, and long-term follow-up outcome. RESULTS: Of the 145 patients who followed up greater than two years, 69 patients (47.6%) showed early relapse, late relapser in 54 patients (37.2%), and no relapse in 22 patients (15.2%). Early relapsers showed younger age at onset, more frequent relapse, and longer duration of total corticosteroid treatment and shorter duration of corticosteroid used duration at relapse. Alkylating agents or cyclosporine were administered to 45 patients (19 steroid dependent, 13 frequent relapses, 8 steroid side effect, 2 infrequent relapses, 3 steroid resistant), 36 patients achieved complete remission, five in partial remission, and four in no response at all. Among 29 patients who were treated with cyclosporine, 23 patients showed complete remission, 4 achieved partial remission, and 2 showed no response. Final outcome of 145 patients who were followed for at least more than 2 years, were cyclosporine A dependent in 19 (13.2%) patients. steroid dependent in 16 (11.0%), persistent remission in 57 (39.3%), infrequent relapse in 49 (33.8%), death 2 (1.3%), renal failure 1 (0.7%), and no response to any therapy in 1 (0.7%). CONCLUSION: Adult-onset minimal change nephrotic syndrome shows favorable response to corticosteroid therapy with good long-term outcome and rarely progress to end-stage renal failure. However, new treatment regimens to minimize drug-related side effects and to maintain longer remission period should be evaluated prospectively.
Adrenal Cortex Hormones
;
Alkylating Agents
;
Cyclosporine
;
Cytotoxins
;
Follow-Up Studies*
;
Humans
;
Kidney Failure, Chronic
;
Nephrosis, Lipoid*
;
Prognosis
;
Recurrence
;
Renal Insufficiency
;
Retrospective Studies
2.MRI findings of primary CNS lymphoma.
Tae Myon KIM ; Dae Chul SUH ; Ho Kyu LEE ; Young Kuk CHO ; Ghee Young CHOI ; Chang Jin KIM
Journal of the Korean Radiological Society 1993;29(4):621-626
We retrospectively reviewed magnetic resonance image findings of primary CNS lymphomas in six patients. All patients showed parenchymal masses (n=8), a solitary mass in 4 and multiple in the other two. One patients showed leptomeningeal lesion. Parenchymal masses were located in forntal lobe (n=4), cerebellum (n=2), basal ganglia (n=1), and parietal lobe (n=1), These masses showed hypointensity on T1-weighted images (WI). On T2 WI, the signal intensity of mass was isointense to the brain parenchyma in 5 and hyperintese in 3. After Gadlinium-DTPA injection, seven lesions were enhanced homogeneously, and the margin of the mass was smooth in 5 and irregular in 3. Peritumoral edema was moderate in 4, absent in 3, and severi in 1. These characteristics may be useful in the diagnosis of primary CNS lymphoma.
Basal Ganglia
;
Brain
;
Cerebellum
;
Diagnosis
;
Edema
;
Humans
;
Lymphoma*
;
Magnetic Resonance Imaging*
;
Parietal Lobe
;
Retrospective Studies
3.Comparison of Fast FLAIR and Echo-Planar FLAIR Imaging in Cere b ral Lesions.
Kyung Jin KANG ; Myung Kwan LIM ; Choong Kun HA ; Young Kuk CHO ; Chang Keun LEE ; Hyung Jin KIM ; Chang Hae SUH
Journal of the Korean Radiological Society 1999;41(3):441-446
PURPOSE: To evaluate the usefulness of echo-planar FLAIR imaging in various cerebral lesions as compared with fast FLAIR imaging. MATERIALS AND METHODS: We obtained consecutive fast FLAIR and echo-planar FLAIR images in 33patients in whom MR imaging had revealed ischemic infarction (n=11), acute infarction (n=5), brain tumor (n=3), other conditions (n=3) or no abnormality (n=11). On both sets of images, percentage contrast and contrast to noise ratio (CNR) were calculated for white matter-gray matter and white matter-lesion. RESILTS: White matter-gray matter percentage contrast and CNR were lower on echo-planar FLAIR imaging than on fast FLAIR imaging (percentage contrast, 19 +/- 2 % vs 28 +/- 3 %, CNR, 2.77 +/- 0. 5 vs 4.86 +/- 0.7). White matter-lesion percentage contrast on echo-planar FLAIR imaging was similar to or greater than that on fast FLAIR imaging; 75 +/- 12 % vs 45 +/- 11 % in ischemic infarction, 80 +/- 12 % vs 78 +/- 11% in acute infarction, and 121 +/- 25 % vs 102 +/- 15 % for tumors. White matter-lesion CNR was similar on both sets of images: 8.3 +/- 0.9 vs 7.9 +/- 0.8 in ischemic infarction, 11 +/- 1.5 vs 9.5 +/- 1.2 in acute infarction, and 24 +/- 4 vs 27 +/- 3 for tumors. Due to high susceptibility to magnetization, echo-planar FLAIR imaging showed image degradation at the interface of the paranasal sinus and adjacent to the temporal bone. CONCLUSION: Echo-planar FLAIR imaging may be a useful pulse sequence in the diagnosis of various cerebral lesions.
Brain Neoplasms
;
Diagnosis
;
Infarction
;
Magnetic Resonance Imaging
;
Noise
;
Temporal Bone
4.Deep Submuscular Parosteal Angiomyxolipoma in a Child.
Hong Kyun KIM ; Jeong Han YOO ; Yong Wook PARK ; Jin Soo PARK ; Kyu Cheol ROWE ; Kuk Jin CHUNG ; Keun Jong CHANG ; Ji Hyo HWANG
The Journal of the Korean Bone and Joint Tumor Society 2010;16(1):42-46
Angiomyxolipoma is a rare variant of lipoma, which is described by Mai, 1996, at first. The nine cases of which have been reported to date. Microscopically, the lesion consists of adipose tissue with the paucicellular myxoid areas and fat tissue with numerous thin, dilated, and congestive blood vessels. The reported cases mostly located to the superficial layer on the scalp, subungual, extremities in adults. We report one case of angiomyxolipoma located in the submuscular and parosteal area in the distal femur around knee joint in a child.
Adipose Tissue
;
Adult
;
Blood Vessels
;
Child
;
Estrogens, Conjugated (USP)
;
Extremities
;
Femur
;
Humans
;
Knee Joint
;
Lipoma
;
Scalp
5.Post-Biopsy Arterio-Venous Fistula: Color Doppler Sonography in Evaluation of Its Incidence and Evolution.
Kuk Jin CHANG ; Sang Su LEE ; Jin Kyung KWON ; Sung Bae PARK ; Hyun Chul KIM ; Sung Mun LEE
Korean Journal of Nephrology 1998;17(1):66-70
Arteriovenous fistulae(AVF) are well documented complications of percutaneous renal biopsy. Between August 1995 and April 1997, we prospectively studied 280 consecutive ultransound-guided percutaneous renal biopsies to evaluate the incidence of post-biopsy AVF and its natural course. All biopsies patients were monitored through a routine follow-up echo-color popple sonography at post-biopsy 1, 7, 14 and 30 days. The 28 patients(10%) out of 280 consecutive percutaneous renal biopses were diagnosed to have AVF. There was no differences in the incidence of AVF between native and transplanted kidney biopsy. Most AVF were small(<2cm) and caused minimal or no symptoms. AVF was accompanied with large hematoma(thickness above 2cm) was observed in 9 cases(53%) of 17 native kidneys and none in 10 transplanted kidneys. This difference was statistically significant(P=0.008). At follow-up, AVF resolved spontaneously in 24 cases(87%). In two patients(7.1%) required superselective arterial embolization, one develoved spontaneous rupture of AVF, and one had persistence of AVF over 12 months. We concluded that color Doppler sonography provides a good, non-invasive and safe method for diagnosis and follow up of post-biopsy AVF.
Arteriovenous Fistula
;
Biopsy
;
Diagnosis
;
Fistula*
;
Follow-Up Studies
;
Humans
;
Incidence*
;
Kidney
;
Prospective Studies
;
Rupture, Spontaneous
6.Lymph Node Metastases in Thyroid Carcinomas: CT Diagnosis.
Ji Seon JOO ; Hyung Jin KIM ; Kyung Jin KANG ; Young Kuk CHO ; Myung Kwan LIM ; Chang Hae SUH
Journal of the Korean Radiological Society 2001;45(6):581-588
PURPOSE: To determine the usefulness of CT for diagnosing metastases to primary and secondary echelon lymph nodes (LNs) and to investigate various CT findings of metastatic LNs in thyroid carcinomas. MATERIALS AND METHODS: We retrospectively reviewed the CT and histologic findings in 59 patients with thyroid carcinomas who had undergone thyroidectomy and neck dissection. Primary echelon LNs (Level VI) were removed by central neck dissection in all patients, and in 21, a total of 136 levels of secondary echelon LNs (Level II-V) were excised away by lateral neck dissection. CT criteria of metastatic LNs included large size, significant homogeneous enhancement, calcification, and cystic change. We evaluated the ability of CT to detect primary and secondary echelon LN metastasis and tried to determine which CT features were useful for the diagnosis of LN metastasis. RESULTS: Histologically, LN metastasis was found in 31 (53%) of 59 patients, including 30 with metastasis to primary echelon LNs. Of the 136 levels of secondary echelon LNs resected in 21 patients, 44 were found at histology to harbor metastatic foci. The sensitivities, specificities, positive and negative predictive values, and accuracies of CT in the diagnosis of metastasis to primary and secondary echelon LNs, respectively, were 27% and 93%, 100% and 93%, 100% and 87%, 57% and 97%, and 63% and 93%. While all secondary echelon LNs with at least one of the following CT criteria-large size (n=19), cystic or necrotic change (n=14), or calcifications (n=8)-were histologically proven to be metastatic, six (24%) of 25 such LNs with a sole sign of significant enhancement at CT were found to be due to reactive lymphadenopathy. CONCLUSION: Although CT was unable to detect metastasis to primary echelon LNs, it was useful in the detection of secondary echelon LN involvement. Large size, cystic change, and calcification are considered highly reliable signs of metastatic LNs.
Diagnosis*
;
Humans
;
Lymph Nodes*
;
Lymphatic Diseases
;
Neck Dissection
;
Neoplasm Metastasis*
;
Retrospective Studies
;
Thyroid Gland*
;
Thyroid Neoplasms*
;
Thyroidectomy
7.Down-regulation of tyrosinase, TRP-1, TRP-2 and MITF expressions by citrus press-cakes in murine B16 F10 melanoma
Kim Suk Sang ; Kim Min-Jin ; Choi Hun Young ; Kim Kuk Byung ; Kim Sik Kwang ; Park Jin Kyung ; Park Man Suk ; Lee Ho Nam ; Hyun Chang-Gu
Asian Pacific Journal of Tropical Biomedicine 2013;(8):617-622
Objective: To investigate the suitability of citrus-press cakes, by-products of the juice industry as a source for the whitening agents for cosmetic industry.
Methods:Ethylacetate extracts of citrus-press cakes (CCE) were examined for their anti-melanogenic potentials in terms of the inhibition of melanin production and mechanisim of melanogenesis by using Western Blot analysis with tyrosinese, tyrosinase-related protein-1 (TRP-1), TRP2, and microphthalmia-associated transcription factor (MITF) proteins. To apply the topical agents, citrus-press cakes was investigated the safety in human skin cell line. Finally flavonoid analysis of CCE was also determined by HPLC analysis.
Results: Results indicated that CCE were shown to down-regulate melanin content in a dose-dependent pattern. The CCE inhibited tyrosinase, TRP-2, and MITF expressions in a dose-dependent manner. To test the applicability of CCE to human skin, we used MTT assay to assess the cytotoxic effects of CCE on human keratinocyte HaCaT cells. The CCE exhibited low cytotoxicity at 50 μg/mL. Characterization of the citrus-press cakes for flavonoid contents using HPLC showed varied quantity of rutin, narirutin, and hesperidin.
Conclusions:Considering the anti-melanogenic activity and human safety, CCE is considered as a potential anti-melanogenic agent and may be effective for topical application for treating hyperpigmentation disorders.
8.Analysis on the First Fundamental Medical Sciences Examination at Kon-Kuk University College of Medicine.
Soung Hoon CHANG ; Won Jin LEE ; Kun Sei LEE ; Beob Yi LEE ; Ki Seok KOH
Korean Journal of Medical Education 1998;10(1):57-63
To provide the information about overall test reliability and test improvement, we analyzed the first fundamental medical sciences examination at the Kon-Kuk University College of Medicine on August 23, 1997. The results are as follows: 1. The number of the items in the test is 230. The range of the scores is from 32.5 to 61.3(average percentage score: 50.0+/-6.1). Among the 39 students, three(7.7%) passed the examination with percentage scores of higher than 60. 2. The correlation coefficients between the fundamental medical sciences examination and academic records are 0.4682(the first semester in 1st grade), 0.5933(the second semester in 1st grade), and 0.6538(the first semester of 2nd grade), respectively. 3. Among the 230 items, 47(20.4%) are too difficult or too easy. Therefore these items are recommended to be discarded. 4. Among the 230 items, 115(50%) have lower discriminative indices(lower than 0.14) and 55(23.9%) have higher discriminative indices(higher than 0.23). 5. Among the 230 items, overall acceptable items are 101; the range of difficulty is 0.15~0.84 and discriminative indices are higher than 0.15. Good acceptance is shows in pharmacology and microbiology.
Humans
;
Pharmacology
9.The Changes in the Educational Goals and Objectives of Medical Schools in Korea.
Soung Hoon CHANG ; Kun Sei LEE ; Won Jin LEE ; Cheong Sik KIM
Korean Journal of Medical Education 1998;10(1):11-20
We reviewed the educational goals and objectives of the 32 medical schools in Korea, which is based on the 1992's, 1994's, and 1996's edition of the Directory of Korea Medical Education. The purpose of this study is to find trend of their changes and to help revise them. Among the 32 medical schools in Korea, 31(96.9%) described goals and objectives separately on 1996's edition, while 26(81.3%), 19(59.4%) on 1994's, 1992's, respectively. The medical ethics and morality was becoming more important; 30(93.8%) medical schools on 1996's and 1994's edition, while 26(81.3%) on 1992's. There were more emphases on the promotion of the ability of community services in health and of self study. For the promotion of the ability of community services in health; 26(81.3%) medical schools on 1996's edition, while 23(71.9%), 19(59.4%) on 1994's, 1992's, respectively. For the promotion of the ability of self study; 25(78.1%) medical schools on 1996's edition, while 21(65.6%), 15(46.9%) on 1994's, 1992's, respectively. The cultivation of primary care physician was becoming the primary goal of medical schools; 23(71.9%) medical schools on 1996's edition, while 12(37.5%), 9(28.1%) on 1994's, 1992's respectively. Teaching medical knowledge and clinical skills were still regarded as important; 21(65.6%) medical schools on 1996's edition, while 20(62.5%), 23(71.9%) on 1994's, 1992's, respectively. The inclusion of medical scientists in the possible job lists was also eminent; 14(43.8%) medical schools on 1996's edition, while 11(34.4%), 6(18.8%) on 1994's, 1992's, respectively. The ultimate educational goal of university was becoming prominent; 21(65.6%) medical schools on 1996's edition, while 15(46.9%), 11(34.4%) on 1994's, 1992's, respectively.
Clinical Competence
;
Education, Medical
;
Ethics, Medical
;
Humans
;
Korea*
;
Morals
;
Physicians, Primary Care
;
Schools, Medical*
;
Social Welfare
10.Clinical Analysis on Open Thoracic Cordotomy of the Cancer Pain.
Jin Kuk KIM ; Ji Soo JANG ; Jae Wook SONG ; Woo Min PARK ; Heon YOO ; Chang Hun RHEE ; Seung Hoon LEE
Journal of Korean Neurosurgical Society 1999;28(11):1569-1572
Patients with pain syndromes resulting from recurrent or metastatic cancer should be evaluated carefully to determine the cause of their pain and the need for appropriate antitumor treatment. The most effective ablative pain control procedure at the current time is cordotomy, which is indicated in patients with unilateral pain. The authors results of 12 antero-lateral thoracic cordotomies performed for intractable cancer pain between 1996-1998. The follow-up of these patients was continued for at least 12 months or until death to determine the late success of this procedure. Excellent surgical results were obtained in 100% after one week and in 50% in 6 months after operation. The operation was considered to be successful for patients with malignant disease of short life expectancy.
Cordotomy*
;
Follow-Up Studies
;
Humans
;
Life Expectancy