2.Analysis of Risk Factors and Prediction of Mortality in Acute Renal Failure.
Hyun Soo SIN ; Young Ho SIN ; Il Se LEE ; Moon Gyoo KANG ; Jun SEUG ; Sung Bae PARK ; Hyun Chul KIM
Korean Journal of Medicine 1997;53(2):160-168
OBJECTIVES: Over the last 30 years, despite the increasing sophistication in medical care, the mortality of acute renal failure(ARF) has remained virtually unchanged at 40-50%, but the reasons remain unknown. This study intend to identify prognostic risk factors influencing survival and predict the mortality in ARF patients. METHODS: We retrospectively analyzed 152 patients with ARF who required renal replacement therapy, or whose serum creatinine level above 5 mg/dl, from Jan. 1988 to May. 1995. Multiple factors which may influence mortality were evaluated by univariate and multivariate analysis. RESULTS: 1) Of the 152 patients, 97 were male and 55 were female. The mean age was 47 years and the overall mortality was 36.8%. 2) Based on the univariate analysis, age>60 years, cause of ARF, APACHE II score, number of failing organs, peak serum creatinine level, PaO2, coma, hypotension, ARDS, GI bleeding, ventilatory support, need for antiarrhythmics, DIC, cardiovascular failure, pulmonary failure, neurological failure, and gastrointestinal failure were all significant factors discriminating between survivors and nonsurvivors(p<0.05) 3) By multivariate analysis, hypotension, coma, ventilatory support, and age over 60 years were significant independent predictors influencing survival in ARF patients and logistic equation and logit score were as follows : z=-2.04+1.32(age over 60)+2.18(hypotension)+2.88 (ventilatory support) + 3.28(coma) P=ez/(1+ ez) 4) In ROC(receiver-operating characteristic)curve, when the cutoff point was 0.2, maximum sensitivity was 75% and maximum specificity was 82%. CONCLUSION: In ARF, prognostic risk factors for mortality were age over 60 years, hypotension, assisted ventilation and coma. The logit score by multiple analysis is a reliable predictor of mortality in ARF patients, however the further studies are required to confirm these results.
Acute Kidney Injury*
;
APACHE
;
Coma
;
Creatinine
;
Dacarbazine
;
Female
;
Hemorrhage
;
Humans
;
Hypotension
;
Male
;
Mortality*
;
Multivariate Analysis
;
Renal Replacement Therapy
;
Retrospective Studies
;
Risk Factors*
;
Sensitivity and Specificity
;
Survivors
;
Ventilation
3.Non-Hodgkin's Malignant Lymphoma Arising in the Appendix: A case report.
Yun Sin KIM ; Mi Sook LEE ; Kwang Seok Lee LEE ; Sung Chul LIM ; Ho Jong JEON
Korean Journal of Pathology 1995;29(4):524-526
Primary malignant lymphoma of the appendix is an unconnnon neoplasm although the gastrointestinal tract is the most common extranodal site of malignant lymphoma. We report a case of primary malignant lymphoma of the appendix in a 54-year-old male, who presented with pain in the right lower abdomen. An appendectomy was performed. The appendix measured 9.5 cm in length and 5.5 cm in diameter. Cut sections showed a solitary circumferential mass in the appendiceal lumen. Light microscopic features were compatible with malignant lymphoma of diffuse large cell type(Working Formulation) and the immunophenotype was B cell type.
4.A case of IDDM associated with hypothyroidism.
Kyung Min LEE ; Kuk Sin JANG ; Mi Kyung JANG ; Chul Zoo JUNG
Journal of the Korean Pediatric Society 1991;34(1):144-147
No abstract available.
Diabetes Mellitus, Type 1*
;
Hypothyroidism*
5.Overexpression of p53 Protein in Endometrial Hyperplasia and Adenocarcinoma.
Yun Sin KIM ; Mi Sook LEE ; Sung Chul LIM ; Jang Shin SOHN ; Chae Hong SUH
Korean Journal of Pathology 1997;31(7):655-661
Proliferations of the endometrial glands form a continuum from focal glandular crowding through simple hyperplasia, complex hyperplasia and atypical hyperplasia to frank adenocarcinoma. But objective criteria to distinguish these proliferative endometrial lesions are not clear-cut and terminology is confusing. The p53 protein is a nuclear phosphoprotein that can regulate cell proliferation and suppress tumor growth. Mutation in the p53 gene have been reported in a variety of human tumors, and in selected malignancies overexpression of p53 has been associated with poor prognosis. In this study we examined a series of endometrial proliferative lesion, including hyperplasia, adenocarcinoma, and adenomyosis to determine whether or not p53 is overexpressed in these lesions. In the result, p53 immunoreactivity was observed in 3 of 17 (17.6%) simple hyperplasia, one of 6 (16.6%) complex hyperplasia, none of 3 (O%) atypical hyperplasia, 6 of 13 (46.1%) adenocarcinoma and none of 10 (O%) adenomyosis. In conclusion, p53 mutation seems to play a role in oncogenesis of endometrial adenocarcinoma in early phase but there was no significant relationship between p53 overexpression and histologic grade of adenocarcinoma.
Adenocarcinoma*
;
Adenomyosis
;
Carcinogenesis
;
Cell Proliferation
;
Crowding
;
Endometrial Hyperplasia*
;
Female
;
Genes, p53
;
Humans
;
Hyperplasia
;
Prognosis
6.A Case of Becker's Nevus Associated with Smooth Muscle Hamartoma.
Hong Seong JEONG ; Chul Ho YOO ; Dae Gyoo BYUN ; Joon Mo YANG ; Yu Sin LEE
Korean Journal of Dermatology 1987;25(6):832-836
We report a case of Becker's nevus associated with smooth muscle hamartoma, in a 21-year-old male patient, which shows clinically match-head sized, flat topped, round to oval, grouped papules with hairs on the outer surface of the right arm, and microscopically reveals numerous bundles of smooth muscle fiber in the dermis.
Arm
;
Dermis
;
Hair
;
Hamartoma*
;
Humans
;
Male
;
Muscle, Smooth*
;
Nevus*
;
Young Adult
7.Spinal Ganglion Cyst of Lumbar Posterior Longitudinal Ligament.
Sung Woo ROH ; Seung Chul RHIM ; Ho Kyu LEE ; Sin Kwang KANG
Journal of Korean Neurosurgical Society 2000;29(4):543-549
No abstract available.
Ganglia, Spinal*
;
Longitudinal Ligaments*
8.A clinical study of supracondylar closing wedge osteotomy for cubitus varus.
Seok Hyun LEE ; Jae Suk CHANG ; Hong Chul SIN ; Jun Suk HONG
The Journal of the Korean Orthopaedic Association 1993;28(1):240-246
No abstract available.
Osteotomy*
9.Diagnostic value of bladder tumors by excretory urography
Cho Hye LEE ; Sin Ho KOOK ; Eun Chul CHUNG ; Chung Sik RHEE
Journal of the Korean Radiological Society 1986;22(5):885-890
Bladder tumors initially may be diagnosed by excretory urography. In this study, 60 excretory urogramsincluding 40 cases of biopsy proved blaadder tumor and 20 cases of cystoscopically normal bladder were analyzed.Five experienced readers reviewed five radiographs of each case. The results were as follows: 1. Male to remaleratio was 5.7:1, and the highest incidence of age distribution was between 60 and 69 year with 48%. 2. The tumorswere chiefly located in lateral wall of bladder. (67%) 3. Among 40 cases, pathologic diagnosis was as follows:Transitional cell ca. 39 cases, and squamous cell ca. lcase. 4. The I.V.P. finding showed 82% of normal upperurinary tract, 13% of hydronephrosis, 5% of non-visualization, and 58% of filling defect in bladder. 5. Originalinterpretation of urogram was as follows: Of 40 cases with bladder ca., 45% as positive, 13% as suspicious, and38% as negative. Of 20 cases with normal, 95% as negative, and 5% as positive. 6. Analysis by this study was asfollows: Accuracy 68%, sensitivity 62%, specificity 80%, false positive rate 38%, and false negative rate 20%. 7.25 min A-P radiograph was most valuable projection and oblique projection did not significantly increasesensitivity.
Age Distribution
;
Biopsy
;
Diagnosis
;
Epithelial Cells
;
Humans
;
Hydronephrosis
;
Incidence
;
Male
;
Sensitivity and Specificity
;
Urinary Bladder Neoplasms
;
Urinary Bladder
;
Urography
10.A Diagnostic Value of C-Reactive Protein in Acute Bacterial Infection of Bone and Joint
Ik Dong KIM ; Soo Young LEE ; Poong Taek KIM ; Byung Chul PARK ; Sin Yun KIM
The Journal of the Korean Orthopaedic Association 1986;21(1):39-46
Acute bacterial infection of bone and joint presents a real challenge to orthopedist because early diagnosis and treatment are difficult and also essential. In almost all practices, fever and erythrocyte sedimentation rate(ESR) are widely used for monitoring the course, for estimating the effectiveness of treatment, and for the recovery of such illnesses. However, interpreting body temperature is difficult and ESR is nonspecific, is not not sensitive, normalizes slowly. Otherwise, C-reactive protein(CRP) is very sensitive and normalizes fast. CRP, body temperature, and ESR were sequentially measured until a normal value was reached in twenty seven patients in whom acute osteomyelitis (17 patients), acute exacerbation of chronic osteomyelitis(4 patients), and septic arthritis(6 patients) had been diagnosed by positive bacterial culture at Kyungpook National University Hospital from June 1984 to May 1985. The results were as follows: 1. CRP normalized within 8.8 days on average. 2. Fever lasted 4.5 days on average. 3. ESR normalized within 41.6 days on average. 4. Initial mean value of CRP was 4.2 positive in acute in acute osteomyelitis and septic arthritis and 3.5 positive in acute exacerbation of chronic osteomyelitis, therefore CRP can be considered as a very sensitive indicator for early detection of acute bacterial infection of bone and joint. Also sequential CRP determination can be used for monitoring the course, for estimating the effectiveness of treatment, and for the recovery of such illnesses.
Arthritis, Infectious
;
Bacterial Infections
;
Blood Sedimentation
;
Body Temperature
;
C-Reactive Protein
;
Early Diagnosis
;
Fever
;
Gyeongsangbuk-do
;
Humans
;
Joints
;
Osteomyelitis
;
Reference Values