1.The Risk Factors of Septic Shock in Childhood Cancer Patients with Neutropenic Fever.
Ji Eun BAN ; Kyu Tae NOH ; Young Ho LEE
Korean Journal of Pediatric Hematology-Oncology 2001;8(2):281-289
PURPOSE: We evaluated the easily-assessable risk and prognostic factors of septic shock in children with neutropenic fever (NF) which developed after anticancer chemotherapy. METHODS: We retrospectively reviewed the medical records and laboratory data of 97 children who received anticancer chemotherapy at Dong-A University Hospital and had NF between March, 1993 and February, 2001. RESULTS: There were 223 episodes of NF in 97 children, of which 71 episodes (31.8%) of bacteremia and 18 episodes (8.1%) of septic shock developed. The incidence of septic shock was associated with fever duration (> 5 days, odds ratio=7.367, P=0.0159), tachycardia (odds ratio=11.857, P=0.0001), and serum bicarbonate level (<24 mEq/L, odds ratio=6.235, P=0.0378), whereas not with the underlying disease, age, sex, causative organisms, absolute neutrophil count, absolute monocyte count, absolute phagocyte count, the presence of central venous catheter, the accompanied focal infection, and the use of hematopoietic growth factor. Septic shock developed 3.2 (1~11) days after NF. The prognosis of septic shock patients was not associated with the therapeutic timing, antibiotics, fever duration, tachycardia, or serum bicarbonate level. CONCLUSION: We suggest that the fever duration, tachycardia, and serum bicarbonate level could be important risk factors of septic shock in children with NF. Although We could not reveal the prognostic factors in children with septic shock, further studies will be required.
Anti-Bacterial Agents
;
Bacteremia
;
Central Venous Catheters
;
Child
;
Drug Therapy
;
Fever*
;
Focal Infection
;
Humans
;
Incidence
;
Medical Records
;
Monocytes
;
Neutropenia
;
Neutrophils
;
Phagocytes
;
Prognosis
;
Retrospective Studies
;
Risk Factors*
;
Shock, Septic*
;
Tachycardia
2.Studies of the Change of Antibody Titers after Vaccination of Haemophilus Influenzae PRP-T Conjugate Vaccine.
Pil Soon YANG ; Jeong Il SEO ; Kyu Tae NOH ; Jae Ho YOO ; Kwang Soo HWANG ; Kyu Geun HWANG
Journal of the Korean Pediatric Society 2002;45(8):987-993
PURPOSE: This study was carried out to survey the serum anti-PRP titers after the completion of a primary series with 3 doses of the PRP-T conjugate vaccine(ACT-HIBTM), to evaluate the necessity of booster vaccination. METHODS: One hundred twenty healthy infants who went for consultations at Moon Hwa hospital between December 1999 to May 2001 were vaccinated at two, four and six months after birth. The serum antibody levels were measured at 7-8 months and 19-20 months of age by the "Farr" type of radioimmunological method at Aventis Pasteur International in France. RESULTS: The geometric mean of Anti-PRP titers were 24.6 microgram/mL at 7-8 months and then fell to 2.10 microgram/mL at 19-20 months. Minimum Anti-PRP titer was 0.75 microgram/mL at 7-8 months, and 0.1 microgram/mL at 19-20 months. Maximum Anti- PRP titer was 99.2 microgram/mL at 7-8 months, and 9.1 microgram/mL at 19-20 months. Subjects of Anti-PRP titers more than 0.15 microgram/mL were 100% at 7-8 months, and 97.0% at 19-20 months, and subjects of Anti-PRP titers more than 1.0 microgram/mL were 98.3% at 7-8 months, and 61.6% at 19-20 months. CONCLUSION: The Anti-PRP titers at 7-8 months were very high but rapidly decreased at 19-20 months of age, so the necessity of booster vaccination could be considered in Korean children.
Child
;
France
;
Haemophilus influenzae*
;
Haemophilus*
;
Humans
;
Infant
;
Parturition
;
Referral and Consultation
;
Vaccination*
3.A Case of Acute Necrotizing Encephalopathy with a Thalamic Hemorrhage.
Sang Soo PARK ; Kyu Tae NOH ; Sun Seob CHOI ; Kyu Geun HWANG
Journal of the Korean Child Neurology Society 2004;12(2):223-228
Acute necrotizing encephalopathy predominantly affects young children and infants living in Japan and Taiwan, and is characterised by acute encephalopathy with seizures and decreased level of consciousness. The Hallmark of the disease is diffuse and symmetrical CNS lesions of both thalami, brainstem tegmentum, cerebral periventricular white matter and cerebellar medula. The clinical, radiological and pathological features of this disease, a disease entity established recently, is proposed by Masashi Mizuguchi et al in 1995. The aetiology is unknown but infectious or parainfectious process seems likely. The diagnosis can be made without difficulty on the basis of the combination of a typical clinical figures and characteristic radiologic findings. There is no specific therapy or prevention. The prognosis was poor in the 1980s but has improved recently. We experienced a case of 6-month-old female infant with acute necrotizing encephalopathy and a thalamic hemorrhage. We report this case with a review of the related literatures.
Brain Stem
;
Child
;
Consciousness
;
Diagnosis
;
Female
;
Hemorrhage*
;
Humans
;
Infant
;
Japan
;
Prognosis
;
Seizures
;
Taiwan
4.Prognostic Factors for Locally Invasive Papillary Thyroid Carcinomas.
Jin Mo KANG ; Tae Seon KIM ; Dong Young NOH ; Yeo Kyu YOUN ; Kuk Jin CHOE ; Seung Keun OH
Journal of the Korean Surgical Society 2000;59(4):478-487
PURPOSE: Although papillary thyroid carcinomas are known to have a good prognosis, invasive papillary thyroid carcinomas have different outcomes. There are many studies on the prognostic factors for thyroid carcinomas, but few studies have been performed for invasive papillary thyroid carcinomas. We performed this study to investigate the prognosis and the prognostic factors for invasive papillary thyroid carcinomas. METHODS: We analyzed 184 patients with papillary thyroid carcinomas who had undergone a thyroidectomy between 1985 and 1990, especially for the clinicopathologic entity of an invasive papillary thyroid carcinoma, and made univariate and multivariate analyses for various clinical and pathological factors to evaluate whether they would be of value in estimating the prognosis in papillary thyroid carcinoma patients. RESULTS: In the univariate analysis of the 10-year disease-free survival rate of the overall cases, sex, tumor size, and lymph-node metastasis were confirmed to be significant prognostic factors. In the multivariate analysis, all of these factors were independent significant prognostic factors. Invasive papillary thyroid carcinoma patients, compared to non-invasive papillary thyroid carcinoma patients, were older and more prone to metastasis to cervical lymph nodes. In the univariate analysis of the 10-year disease-free survival rate of patients with an invasive papillary thyroid carcinoma, sex, tumor size, and lymph-node metastasis were significant prognostic factors. However, in the multivariate analysis, sex and tumor size appeared to be independent significant prognostic factors. CONCLUSION: We conclude that invasive papillary thyroid carcinomas have a the tendency to occur in elderly patients and are more prone to metastasis to cervical lymph nodes. The male sex, a tumor size more than 5 cm, and positive cervical-lymph-node metastasis present the worse prognosis. However, a randomized prospective study may be needed to better understand how to manage invasive papillary thyroid carcinomas.
Aged
;
Disease-Free Survival
;
Humans
;
Lymph Nodes
;
Male
;
Multivariate Analysis
;
Neoplasm Metastasis
;
Prognosis
;
Thyroid Gland*
;
Thyroid Neoplasms*
;
Thyroidectomy
5.Novel anal sphincter saving procedure with partial excision of levator-ani muscle in rectal cancer invading ipsilateral pelvic floor.
Gyoung Tae NOH ; Jeonghee HAN ; Chinock CHEONG ; Yoon Dae HAN ; Nam Kyu KIM
Annals of Surgical Treatment and Research 2017;93(4):195-202
PURPOSE: Tumors at the level of the anorectal junction had required total levator-ani muscle excision to achieve an adequate resection margin. However, in the cases of tumor invading ipsilateral levator-ani muscle and intact external sphincter, en bloc resection of rectum with levator-ani muscle including tumor would be possible. This hemilevator excision (HLE) technique enables preserving the anal sphincter function while obtaining oncologic clearance and avoiding permanent colostomy in those patients. This study aimed to evaluate the surgical outcomes and feasibility of HLE. METHODS: Data on 13 consecutive patients who underwent HLE for pathologically proven low rectal cancer were retrospectively collected. All 13 patients presented low rectal cancer at the anorectal ring level that was suspected to invade or abut to the ipsilateral side of the levator-ani muscle. RESULTS: A secure resection margin was achieved in all cases, and anastomotic leakage occurred in 2 patients. During follow-up, 3 patients experienced tumor recurrence (2 systemic and 1 local). Among 6 patients who underwent diverting ileostomy closure after the index operation, 2 complained of fecal incontinence. The other 4 patients without fecal incontinence showed <10 times of bowel movement per day. Accessing their incontinence scale, mean Wexner score was 9.4. CONCLUSION: HLE is a novel sphincter-preserving technique that can be a treatment option for low rectal cancer invading ipsilateral levator-ani muscle, which has been an indication for abdominoperineal resection (APR) or extralevator APR. However, the long-term oncologic and functional outcomes of this procedure still need to be assessed to confirm its validity.
Anal Canal*
;
Anastomotic Leak
;
Colostomy
;
Fecal Incontinence
;
Follow-Up Studies
;
Humans
;
Ileostomy
;
Pelvic Floor*
;
Rectal Neoplasms*
;
Rectum
;
Recurrence
;
Retrospective Studies
6.A case of Primary Transitional Cell Carcinoma of Ureteral Stump Following nephreetomy for renal tuberculosis.
Won Jae YANG ; Woong Kyu HAN ; Ju Eui HONG ; Tae Woong NOH ; Hong Hwan SHIN ; Seong Kyoo CHOI ; Seung Chul YANG
Korean Journal of Urology 2000;41(4):584-586
No abstract available.
Carcinoma, Transitional Cell*
;
Tuberculosis, Renal*
;
Ureter*
7.Clinical Analysis of Phyllodes Tumor of the Breast .
Hee Joung KIM ; Tae Seon KIM ; Hee Joon KANG ; Hang Joung CHO ; In Ae PARK ; Dong Young NOH ; Yeo Kyu YOUN ; Seung Keun OH ; Kuk Jin CHOE
Journal of the Korean Surgical Society 2000;58(3):352-360
PURPOSE: Phyllodes tumor is a rare fibroepithelial tumor of the breast, first described by Johannes Muller in 1838. Much has been written about phyllodes tumor, but very few widely accepted conclusions about its clinical behavior, treatment modality, and prognosis have been reached. This study aims to analyze the clinical, radiological, and pathological characteristics of phyllodes tumor of the breast. METHODS: The medical records of 41 patients with phyllodes tumor who had been treated between February 1982 and August 1998 at the Department of Surgery, Seoul National University Hospital, were retrospectively reviewed for clinical, radiological and pathological findings, treatment modalities, and follow-up results. RESULTS: Of these 41 cases, there were 28 cases (68.3%) of benign tumors and 13 cases (31.7%) of malignanat tumors. All patients were females, and the mean ages of onset were 33.2 years for benign tumors and 40.8 years for malignant tumors. Most patients, 100% of benign and 92.3% of malignant, presented with a papable mass in the breast. The median duration of illness was 2 months for malignant tumors and 8 months for benign tumors. The tumor size was greater than 10 cm in diameter in 5 cases (38.5%) of malignant tumors and in 3 cases (10.7%) of benign tumors. Only 4 cases were preoperatively diagnosed as having a phyllodes tumor by using radiological and fine needle aspiration cytology. Out of the 10 malignant cases reviewed, 5 cases were confirmed as malignant, and 5 cases were confirmed as borderline phyllodes tumors. Cellularity was moderate or above in all 5 malignant and 5 borderline cases. Atypism above moderate degree was found in 4 of 5 (80%) malignant tumors, in 3 of 5 (60%) borderline tumors, and in 4 of 24 (16.7%) benign tumors. Mitotic counts in all 5 malignant cases were 5 or more per 10 high power field while those in the 5 borderline tumors were 2-5 mitoses per 10 high power field. The most commonly performed operative procedures were a simple mastectomy (50%) for malignant tumors and a simple excision (64.3%) for benign tumors. Post-operative adjuvant therapy was done for 4 cases; out of these, 1 case had been initially diagnosed as a malignant phyllodes tumor, but the diagnosis was changed to a benign phyllodes tumor upon review. Of the 27 follow-up cases, recurrences developed in 3 cases (16.7%) of benign tumors. CONCLUSION: From the above results, there were no specific clinical features for differentiating benign from malignant phyllodes tumor preoperatively; therefore, we cannot help depending on the pathologic findings. Pathologic reviews showed that among several criteria, atypism, cellularity, and mitotic count were the most definite pathologic characteristics in differentiating benign from malignant phyllodes tumor. But much more experience and long-term follow-up may be needed to define optimal treatments and to analyze the prognosis for phyllodes tumors of the breast.
Biopsy, Fine-Needle
;
Breast*
;
Diagnosis
;
Female
;
Follow-Up Studies
;
Humans
;
Mastectomy, Simple
;
Medical Records
;
Mitosis
;
Phyllodes Tumor*
;
Prognosis
;
Recurrence
;
Retrospective Studies
;
Seoul
;
Surgical Procedures, Operative
8.Balloon-Occluded Retrograde Transvenous Obliteration for Gastric Variceal Bleeding patient.
Young Hwan KIM ; Chang Kyu SEONG ; Yong Joo KIM ; Tae Beom SHIN ; Noh Hyuk PARK ; Jin Soo CHOI
Journal of the Korean Radiological Society 2003;48(3):225-233
PURPOSE: To evaluate the technical feasibility and clinical efficacy of balloon-occluded retrograde transvenous obliteration (BRTO) in the treatment of gastric variceal bleeding. MATERIALS AND METHODS: Between September 2001 and March 2002, ten patients with gastric variceal bleeding and gastrorenal shunt, underwent BRTO. Three of the ten also had hepatic encephalopathy. To evaluate the gastrorenal shunt and exclude portal vein thrombosis, all patients underwent pre-procedural CT scanning. An occlusion balloon catheter was inserted from the right internal jugular vein and on ballooning was wedged into the left adrenal vein. A sclerosing agent (5% ethanolamine oleate-lipiodol mixture) was injected until the varices were completely filled. In four patients, the collateral veins seen at balloon-occluded adrenal venography were embolized with coils prior to sclerotherapy. Post-procedural follow-up CT (n=3) or endoscopy (n=8) was performed 1-4 weeks later, and both before and after the procedure, hepatic function was also monitored. RESULTS: Treatment was successful in nine cases: the failure involed rupture of the occlusion balloon during inflation, and a transjugular intrahepatic portosystemic shunt was performed. The cessation of bleeding was confirmed endoscopically or clinically; in three patients, follow-up CT showed complete obliteration of the varices. Hepatic function improved in eight patients, but three weeks after the procedure, one expired due to progressive infiltrative hepatoma. The clinical symptoms of the three patients with hepatic encephalopathy showed remarkable improvement. CONCLUSION: Although more extensive studies and long-term follow up are needed to overcome the limitations of our study, we believe that BRTO is a technically feasible and clinically effective treatment for gastric varices and hepatic encephalopathy.
Carcinoma, Hepatocellular
;
Catheters
;
Endoscopy
;
Esophageal and Gastric Varices*
;
Ethanolamine
;
Follow-Up Studies
;
Hemorrhage
;
Hepatic Encephalopathy
;
Humans
;
Inflation, Economic
;
Jugular Veins
;
Phlebography
;
Portasystemic Shunt, Surgical
;
Rupture
;
Sclerotherapy
;
Tomography, X-Ray Computed
;
Varicose Veins
;
Veins
;
Venous Thrombosis
9.Retroperitoneal Fibrosis; Diagnosed as an Aderenal Gland Orgin Tumor Preoperatively.
Tae Hoon KIM ; Do Joong PARK ; Dong Young NOH ; Yeo Kyu YOUN ; Seung Keun OH
Journal of the Korean Surgical Society 2003;65(3):254-258
Retroperitoneal fibrosis is a rare fibrosing reactive process, which is characterized by diffuse or localized fibroblastic proliferation and chronic lymphoplasmacytic infiltration in the retroperitoneum causing compression or obstruction of the ureters, aorta, or other vascular structures. The majority of cases are idiopathic. A 35-year old woman was transferred for further evaluation and the management of a mass in the left adrenal area. She suffered from vague abdominal pain, which was dull, non-colicky and poorly localized. She had no obstruction of the ureters or vascular structures. The preoperative diagnosis was a tumor of the left adrenal gland. A solitary retroperitoneal mass was excised, which was proven to be localized idiopathic retroperitoneal fibrosis. She was discharged on the 9th post operative day without any complications.
Abdominal Pain
;
Adrenal Glands
;
Aorta
;
Diagnosis
;
Female
;
Fibroblasts
;
Humans
;
Retroperitoneal Fibrosis*
;
Ureter
10.A Study on the Factors that Influence the Surgical Outcomes of Choledochal Cyst in Children.
Jong Kyu KIM ; Gyoung Tae NOH ; Seok Ki MIN ; Kum Ja CHOI
Journal of the Korean Association of Pediatric Surgeons 2012;18(1):1-11
No abstract available.
Child
;
Choledochal Cyst
;
Humans