1.A Case of Vascular Leak Syndrome During Induction Chemotherapy of Acute Lymphoblastic Leukemia (T Cell Type) .
Kye Wool KANG ; Hwang Min KIM ; Won Kyu CHOI ; Baek Keun LIM ; Chang Hun LEE
Journal of the Korean Pediatric Society 2001;44(9):1041-1046
Vascular leak syndrome(VLS) is characterized by endothelial damage, which causes extravasation of plasma proteins and fluid from capillaries into the extravascular space. It has been suggested that the increased vascular permeability is the result of an IL-2-induced suppression of endothelin-1 secretion by endothelial cells, an IL-2-induced activation of the complement cascade or TNF-alpha release from IL-2-activated T-cells. A 13-year-old male patient visited our hospital with abdominal pain. He was diagnosed with acute lymphoblastic leukemia(T cell type) by bone marrow study on his 2 nd day in hospital. On the 3 rd day of induction chemotherapy(prednisone, L-asparaginase, vincristine, intrathecal methotrexate), pulmonary edema and pleural effusion, ascites and generalized edema developed and lasted for 53 days without responding to supportive care. The laboratoy finding was that TNF-alpha was increased without evidence of infection and hypoalbuminemia was noted. It was suggested that the patient's clinical feature was induced by VLS.
Abdominal Pain
;
Adolescent
;
Ascites
;
Blood Proteins
;
Bone Marrow
;
Capillaries
;
Capillary Permeability
;
Complement System Proteins
;
Edema
;
Endothelial Cells
;
Endothelin-1
;
Humans
;
Hypoalbuminemia
;
Induction Chemotherapy*
;
Male
;
Pleural Effusion
;
Precursor Cell Lymphoblastic Leukemia-Lymphoma*
;
Pulmonary Edema
;
T-Lymphocytes
;
Tumor Necrosis Factor-alpha
;
Vincristine
2.The Study for GER in Patients with Chronic Unexplained Cough Using Combined 24 Hour Esophageal pH and Motility Monitoring.
Young Koo JEE ; Yoon Seob KIM ; Chang Young LIM ; Kye Young LEE ; Kun Yeol KIM
Korean Journal of Medicine 1997;53(5):636-644
No abstract available.
Cough*
;
Humans
;
Hydrogen-Ion Concentration*
3.Anorexia Nervosa And Eating Disorder Not Otherwise Specified (Nos) In Singapore: A Seven-Year Retrospective Study
Goh Kye Hock Robin ; Lee Ee Lian ; Pearlene Lim ; Lum Shin Si
ASEAN Journal of Psychiatry 2016;17(1):1-14
Objective: Anorexia nervosa and eating disorder not otherwise specified (NOS),
an eating disorder not fulfilling anorexia nervosa DSM-IV criteria are on a
rising trend in Singapore. The aims of this paper were to study the clinical
characteristics and features of patients with anorexia and eating disorder NOS
in Singapore. Methods: A retrospective cohort analysis of 373 patients between
2003 and 2010 at a tertiary hospital was done. Inclusion criteria included
inpatients and outpatients with the age range of 12 years old to 40 years old
fulfilling the Diagnostic and Statistical Manual (DSM)-IV criteria for anorexia
nervosa and patients with the diagnosis of eating disorder NOS. The subjects are
analyzed based on the severity of the eating disorder and the presentation
subtypes. Results: An analysis of the overall demographic data revealed the
female to the male ratio to be 22.4:1. The Chinese formed the largest ethnic
group in the study population with 242 (86.1%) patients, and the bulk of the
patients (75.8%) patients were between 12 to 20 years old. Anorexia nervosarestricting
subtype was the most common eating disorder (55.2%) and the most
common body mass Index (BMI) was between BMI 14.6 – 16.5 (35.2%).
Restriction technique (p = 0.01), binge/purge (p = 0.03) and exercise (p < 0.001)
are statistically significant to cause transaminitis in patients. Conclusion: There
were significant changes in the demographics compared to the study reviewing
patients from 1994 and 2002. There was a significant increase in the Caucasian
population with changes in the Singapore immigration policy. A detail history
taken during first visit can reduce the morbidity and mortality of these patients.
4.Comparative Analysis of Simultaneous and Staged Bilateral Total Knee Arthroplasty
Dae Kyung BAE ; Young Yong KIM ; Won Suck RHI ; Kye Lim LEE
The Journal of the Korean Orthopaedic Association 1988;23(2):403-410
Between January 1982 and September 1986, at the Department of Orthopaedic Surgery of Kyung Hee University Hospital, 82 total knee arthroplasties were performed in 57 patients. We studied 25 patients (50 Knees) who had been operated by bilateral total knee arthroplasties to compare one stage and two stage operations. The follow-up ranged from 10 months to 5 years and 7 months (average 1 year and 8 months). All operations were performed by one of the authors (D.K.B.), but the follow-up study and the entire medical record were independently evaluated by another authors. The clinical results of preoperative and postoperative assessments and rehabilitation processes are as follows; 1. Group I (10 patients) had both kness replaced by one stage simultaneous operation under same anesthesia, and Group II(15 patients) had replaced by two stage operation at the intervals of 2 weeks. 2. The periods required to do bilateral weight bearing were 10.3 days for Group I, 23.6 days for Group II. 3. Complications in one stage operation was no more than the in two stage operation. 4. The postoperative pain and ROM were not significantly different in both groups. 5. Using the hospital for special surgery rating system, we found the clinical results to be similar in both groups. 6. Comparing to two stage operation, the advantages of one stage operation were shorter operative and tourniquet time, lesser use of antibiotics, reduced medical cost and hospital stay. In conclusion, if patient conditions do not prevent prolonged anesthetic time and surgeons have good surgical techniques, we recommend one stage simultaneous operation in bilateral total knee replacement.
Anesthesia
;
Anti-Bacterial Agents
;
Arthroplasty
;
Arthroplasty, Replacement, Knee
;
Follow-Up Studies
;
Humans
;
Knee
;
Length of Stay
;
Medical Records
;
Pain, Postoperative
;
Rehabilitation
;
Surgeons
;
Tourniquets
;
Weight-Bearing
5.Axisymmetric Contact Stress analysis of an Artificial Hip Joint of the Conical Fitting Type
Yong San YOON ; Young Yong KIM ; Kye Lim LEE ; Seung Key KIM ; Young Hoon KANG
The Journal of the Korean Orthopaedic Association 1989;24(6):1665-1672
The purpose of this study is to investigate the effect of the ball-cone contact interface variation on the ceramic ball stress which is the dominant factor of the design of the moldular artificial hip joint. A contact stress analysis problem is formulated using the optimization principle and finite element analysis technique on the ball-cone system of three dimensional axi-symmetrical model, Numerical procedure is employed to get the solution for varying angles of cones and angular mismatches between the ball and cone interfaces. There is a fair amount of friction in the interface and included in the analysis model.
Ceramics
;
Finite Element Analysis
;
Friction
;
Hip Joint
;
Hip
6.A Case of Acral Lentiginous Melanoma.
Seong Jun SEO ; Ee Seok LIM ; Chang Kwun HONG ; Khee Rhyong LEE ; Kye Young SONG ; Byung In RO ; Chin Yo CHANG
Korean Journal of Dermatology 1988;26(6):946-950
We report herein a case of acral lentiginous melanoma in a 65-year-old female. An about 2x3cm sized erythematous to brownish mass with central ulceration was located on the left heel accompanied by enlargement of the left inguinal lymph nodes. Histopathologic findings showed lentiginous proliferation of atypical melanocytes with pseudoepithliomatous hyperplasia and invasion of tumor cells from the epidermis into the dermis. Focal pigmented melanocytes were also noted. Complete surgical excision and chemotherapy with DTIC were done. Marked edematous swelling on the left lower leg was developed after 8 months and 1 month later she was expired.
Aged
;
Dacarbazine
;
Dermis
;
Drug Therapy
;
Epidermis
;
Female
;
Heel
;
Humans
;
Hyperplasia
;
Leg
;
Lymph Nodes
;
Melanocytes
;
Melanoma*
;
Ulcer
7.A Case of Toxic Epidermal Necrolysis Concomittantly Presented with GI Bleeding and Its Gastrofiberscopic Findings.
Na Young KIM ; Kye Heui LEE ; Seon Hee LIM ; Gyu Hyun LEE ; Yong Ju PARK ; Kyung Ju AHN ; Byung Chul LIM ; Joon Woo SHIN
Korean Journal of Gastrointestinal Endoscopy 1996;16(4):608-613
Toxic epidermal necrolysis (T~EN) is a severe mucocutaneous disease characterized by epidermal necrosis possibly extended to the entire body surface and involving multiple internal organs. Digestive tract may be involved too, but there is few report about gastrointestinal lesion in patient with TEN. Recently we experienced a case of TEN with gastrointestinal bleeding in previously healthy 32-year-old woman. The condition developed three days after the initiation of treatment with NSAID and progressed caudally, involving 60 percent of the skin surfaces. During a period of admission gastrointestinal bleeding was noticed. The gastrofiberscopy showed diffuse superficial mucosal lesion with oozing from swollen friable and erythematous mucosa. The skin lesion was progressed inspite of withdrawal of causative agents. The patient was expired due to combined septic shock 10 days later. We report this case with gastrofiberscopic findings and a brief review of literature.
Adult
;
Female
;
Gastrointestinal Tract
;
Hemorrhage*
;
Humans
;
Mucous Membrane
;
Necrosis
;
Shock, Septic
;
Skin
;
Stevens-Johnson Syndrome*
8.A Case of Mediastinal Abscess following Esophageal Perforation.
Yong Sung LIM ; An Na KIM ; Sung Yong KIM ; Sun Hee LIM ; Na Young KIM ; Kye Heui LEE ; Sung Hoon PARK ; Sung Hyun SUNG
Korean Journal of Gastrointestinal Endoscopy 1992;12(1):9-12
We recently experienced a case of an elderly patient with mediastinal abscess, which is a rare complication of esophageal perforation, in whom dyspnea, chest pain and odynophagia were main clinical symptoms after eating cooked fish. During evaluation, upper mediastinal widening, with air-fluid level, and eaophageal perforation plugged with pus were detected by chest X-ray films and endoscopic examinatien. After draining of pus(about 300 cc) through the perforation site by careful manipulation of endoscope, inner wall of abacess cavity communicating with esophagus could be observed through esophago-mediastinal fistula. For further management, drainage procedure of mediastinal abscess, esophageal diversion and feeding gastrostomy were done.
Abscess*
;
Aged
;
Chest Pain
;
Drainage
;
Dyspnea
;
Eating
;
Endoscopes
;
Esophageal Perforation*
;
Esophagus
;
Fistula
;
Gastrostomy
;
Humans
;
Suppuration
;
Thorax
;
X-Ray Film
9.Evaluation of the effects of amlodipine on ambulatory blood pressure in hypertensive patients.
Seong Yong KIM ; An Na KIM ; Seon Hee LIM ; Yong Seong LIM ; Young Kwon KIM ; Kye Heui LEE ; In SON ; Seong Hoon PARK
Korean Circulation Journal 1993;23(2):281-290
BACKGROUND: A clinical trial was performed to evaluate the antihypertensive efficacy and side effects of amlodipine, a new long-action calcium antagonist, in patients with mild to moderate essential hypertension as measured by 24-h ambulatory blood pressure monitoring. METHODS AND RESULTS: 1) The study patients consisted of 4 men and 6 women, and the mean age was 51 years. Amlodipine monotherapy(5~10mg) was continued for 4 weeks, and blood pressure was measured by 24-h ambulatory blood pressure monitoring. 2) A smooth and sustained lowering of blood pressure was clearly achieved without affecting the circadian rhythm throughout dosing interval. The mean-pressure drop was 21.2/13.7mmHg after 4 weeks of amlodipine monotherapy. 3) The ambulatory pulse rate revealed virtually identical average hourly pulses during the recording period before and after amlodipine treatment. 4) All of the laboratory parameters including blood chemistry, glucose, lipid and electrolytes did not change significantly after 4 weeks of amlodipine monotherapy. 5) Amlodipine therapy resulted in minimal side effects that were well tolerated. CONCLUSIONS: Once-daily amlodipine monotherapy with 5 to 10mg in controlling blood pressure throughout each 24-h cycle is effective and well tolerated in the patients with mild to moderate essential hypertension.
Amlodipine*
;
Blood Pressure Monitoring, Ambulatory
;
Blood Pressure*
;
Calcium
;
Chemistry
;
Circadian Rhythm
;
Electrolytes
;
Female
;
Glucose
;
Heart Rate
;
Humans
;
Hypertension
;
Male
10.Doppler Echocardiographic Study on the Changes of Cardiac Performance and Valvular Regurgitation before and after Hemodialysis.
In Kweon JUNG ; Chang Bum LIM ; Bong Jun HA ; Sung Kye LEE ; Kyung Hee CHOI ; Hong Khee KIM ; Dong Sun HAN ; Jae Woo LEE ; Si Rhae LEE
Korean Circulation Journal 1989;19(3):395-403
In 22 end-stage renal disease patients on regular hemodialysis, echocardiographic study including 2-D Doppler echocardiogrphy was performed to evaluate the effect of hemodialysis on cardiac performance and the degree of valvular regurgitation. After hemodialysis, there were significant improvement of ventricular contractility and reduction of circulating volume in accordance with the reduction of degree of valvular regurgitation in comparison with before hemodialysis. We postulate that the reduction of valvular regurgitation after hemodialysis is caused by relief of hypervolemic state.
Echocardiography*
;
Echocardiography, Doppler
;
Humans
;
Kidney Failure, Chronic
;
Renal Dialysis*