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급성전골수성백혈병에서 백혈구성분채집술에 이은 치명적인 뇌출혈 2예
오윤정,박소윤,김윤정,한동석,김현수,최진혁,남동기,임호영,김효철,주희재 아주대학교 의과학연구소 1998 아주의학 Vol.3 No.1
The aim of this study is to report 2 cases of acute promyelocytic leukemia who died from intracranial hemorrhage following leukapheresis and to provide proper preventive measures against hemorrhage following leukapheresis. From 1994 to 1997, a total of twenty-six patients with leukemia underwent leukapheresis to control hyperleukocytosis at Ajou University Hospital. Two patients with acute promyelocytic leukemia received all-trans retinoic acid but developed drug-induced hyperleukocytosis. Shortly after leukapheresis, they died from intracranial hemorrhage. The risk factors for fatal hemorrhage are thought to be coexisting disseminated intravascular coagulation(DIC), thrombocytopenia aggravated by leukapheresis, exacerbated coagulopathy related to mechanical trauma through leukapheresis and the excess use of citrate during leukapheresis. To reduce the risk of the bleeding associated with leukapheresis, it is necessary to replace platelet sufficiently before and after leukapheresis and to give calcium to correct coagulopathy induced by excess citrate which is used as anticoagulant as well as the correction of disseminated intravascular coagulation.
선인장 양심실 보조장치의 설계 및 임상적용을 위한 평가
민병구,박찬영,최재순,이혁수,황창모,김삼성,윤걸중,김종원,선경,이경갑,정종태,김원곤 제주대학교 인공심장이식연구소 2001 인공심장 연구 Vol.2 No.1
현재 개발되고 있는 맥동형 이식형 인공심장은 완전이식형 인공심장과 좌심실보조장치 뿐이다. 좌심실보조장치를 장착한 환자의 10~15%가 우심실의 보조를 필요로하고 완전이식형 인공심장의 장착을 위해서는 자연심장을 제거해야하는 상황에서 이식형 양심실보조장치에 대한 필요성이 대두되고 있다. 본 연구진은 완전이식형 인공심장으로 개발된 한국형 인공심장을 개선하여 양심 실 보조장치를 개발하였다. 양심실보조장치는 이동형 작동기식 미케니즘을 이용하고 있으며 에너지 변환장치와 감속기로 구성된 작동기와 혈액주머니, 그리고 내장형 제어기로 구성되어 있다. 선인장 펌프로 명명된 KAH350은 캐뉼라의 연결을 위한 커넥터를 포함하여 길이 177mm, 폭 164mm, 높이 67 이고 무게 780g이며 최대 심박출량은 5L/min 이다. 양심실보조장치로 개발된 선인장펌프는 좌심실보조장치로도 응용이 가능하다. 이식적합성과 생체적합성을 평가하기 위하여 좌심실보조장치로 5회, 양싱실보조장치로 6회의 동물실험을 수행하였다. 각각 최장 28일간 생존하였으며 11회의 동물실험중 장치의 결함에 의한 것이 3회 있었는데 이들은 모두 전자장치의 결함과 방수처리문제였다. 현재 이식적합성과 일박출량을 향상시킨 KAH400모델이 개발중이다. The types of pulsatile implantable artificial hearts that are on the way of development and have been developed are totally implantable artificial heart and implantable left ventricular assist device (LVAD). Approximately 10% to 15% of all patients Implanted with wearable VADs have required right heart support with another device. And it is reluctant to patient who should remove his or her own heart to be implanted with total artificial heart. These situations drive the development of implantable bi-ventricular assist device (BVAD). The Korean BVAD was develophed by modifying the moving actuator type Korean artificial heart. This electro-mechanical BVAD comprises actuator including energy converter and reduction gear train, blood sacs, and internal motor and energy controllers. The KAH350 which is named as 'Cactus Pump' is 177mm in length, 164mm in width, and 67mm in thickness including connectors and nuts. The weight and maximum cardiac output of Cactus Pump is 780g and 5L/min, respectively. The Cactus Pump that was developed as BVAD could be used as LVAD by attaching compliance caps on the 2 ports of one ventricle. The animal experiments were undergone 5 times for LVAD, and 6 times for BVAD. The best records were 28 days survival in both applications. There were 3 times of device failure and they were all associated with electrical connection and hermetic sealing. The KAH400 that has improved anatomical fitting characterisitcs and stroke volume is on development.
Current status of opioid prescription in South Korea using narcotics information management system
( Soo-hyuk Yoon ),( Jeongsoo Kim ),( Susie Yoon ),( Ho-jin Lee ) 대한통증학회 2024 The Korean Journal of Pain Vol.37 No.1
Background: Recognizing the seriousness of the misuse and abuse of medical narcotics, the South Korean government introduced the world's first narcotic management system, the Narcotics Information Management System (NIMS). This study aimed to explore the recent one-year opioid prescribing patterns in South Korea using the NIMS database. Methods: This study analyzed opioid prescription records in South Korea for the year 2022, utilizing the dispensing/ administration dataset provided by NIMS. Public data from the Korean Statistical Information Service were also utilized to explore prescription trends over the past four years. The examination covered 16 different opioid analgesics, assessed by the total number of units prescribed based on routes of administration, type of institutions, and patients’ sex and age group. Additionally, the disposal rate for each ingredient was computed. Results: In total, 206,941 records of 87,792,968 opioid analgesic units were analyzed. Recently, the overall quantity of prescribed opioid analgesic units has remained relatively stable. The most prescribed ingredient was oral oxycodone, followed by tapentadol and sublingual fentanyl. Tertiary hospitals had the highest number of dispensed units (49.4%), followed by community pharmacies (40.2%). The highest number of prescribed units was attributed to male patients in their 60s. The disposal rates of the oral and transdermal formulations were less than 0.1%. Conclusions: Opioid prescription in South Korea features a high proportion of oral formulations, tertiary hospital administration, pharmacy dispensing, and elderly patients. Sustained education and surveillance of patients and healthcare providers is required.
( Yoon Jin Choi ),( Dong Ho Lee ),( Kyung-do Han ),( Hyun Soo Kim ),( Hyuk Yoon ),( Cheol Min Shin ),( Young Soo Park ),( Nayoung Kim ) 대한소화기학회 2018 Gut and Liver Vol.12 No.6
Background/Aims: The association between metabolic syndrome and colorectal cancer (CRC) has been suggested as one of causes for the increasing incidence of CRC, particularly in younger age groups. The present study examined whether the current age threshold (50 years) for CRC screening in Korea requires modification when considering increased metabolic syndrome. Methods: We analyzed data from the National Health Insurance Corporation database, which covers ~97% of the population in Korea. CRC risk was evaluated with stratification based on age and the presence/absence of relevant metabolic syndrome components (diabetes, dyslipidemia, and hypertension). Results: A total of 51,612,316 subjects enrolled during 2014 to 2015 were analyzed. Among them, 19.3% had diabetes, hypertension, dyslipidemia, or some combination thereof. This population had a higher incidence of CRC than did those without these conditions, and this was more prominent in subjects <40 years of age. The optimal cutoff age for detecting CRC, based on the highest Youden index, was 45 years among individuals without diabetes, dyslipidemia, and hypertension. Individuals with at least one of these components of metabolic syndrome had the highest Youden index at 62 years old, but the value was only 0.2. Resetting the cutoff age from 50 years to 45 years achieved a 6% increase in sensitivity for CRC detection among the total population. Conclusions: Starting CRC screening earlier, namely, at 45 rather than at 50 years of age, may improve secondary prevention of CRC in Korea. (Gut Liver 2018;12:655-663)
Disinfection of poultry chiller water with dolomite powder
Soo-Won Choi,Ha-Na Yoon,Hyo-Seon Joo,Kyung-Min Kim,Jun-Hyuk Jang,Byoung-Yoon Kim,Dong-Hun Lee,Jae-Keun Park,Seong-Su Yuk,Jung-Hoon Kwon,Young-Ho Hong,Joong-Bok Lee,Seung-Yong Park,In-Soo Choi,Chang-Se 한국가금학회 2012 한국가금학회 정기총회 및 학술발표회 Vol.29 No.-
Hah, Yoon Soo,Lee, Kwang Suk,Choi, In Young,Lee, Ji Youl,Hong, Jun Hyuk,Kim, Choung-Soo,Lee, Hyun Moo,Hong, Sung Kyu,Byun, Seok-Soo,Lee, Seung Hwan,Rha, Koon Ho,Chung, Byung Ha,Koo, Kyo Chul Williams & Wilkins Co 2018 Medicine Vol.97 No.42
<P><B>Abstract</B></P><P>A multicenter Korean Prostate Cancer Database (K-CaP) has been established to provide information regarding Korean patients with prostate cancer (PCa). We used the K-CaP registry to investigate the value of age and comorbidity for predicting cancer-specific mortality (CSM) and other-cause mortality (OCM) according to risk grouping.</P><P>The K-CaP registry includes 2253 patients who underwent radical prostatectomy (RP) between May 2001 and April 2013 at 5 institutions. Preoperative clinicopathologic data were collected and stratified according to the National Comprehensive Cancer Network risk criteria. Survival was evaluated using Gray's modified log-rank test according to risk category, age (<70 years vs ≥70 years), and Charlson comorbidity index (CCI) (0 vs ≥1).</P><P>The median follow-up was 55.0 months (interquartile range: 42.0–70.0 months). Competing-risk regression analysis revealed that, independent of CCI, ≥70-year-old high-risk patients had significantly greater CSM than <70-year-old high-risk patients (<I>P</I> = .019). However, <70-year-old high-risk patients with a CCI of ≥1 had similar CSM relative to ≥70-year-old patients. Survival was not affected by age or CCI among low-risk or intermediate-risk patients. Multivariate analysis revealed that a CCI of ≥1 was independently associated with a higher risk of CSM (<I>P</I> = .003), while an age of ≥70 years was independently associated with a higher risk of OCM (<I>P</I> = .005).</P><P>Age and comorbidity were associated with survival after RP among patients with high-risk PCa, although these associations were not observed among low-risk or intermediate-risk patients. Therefore, older patients with high-risk diseases and greater comorbidity may require alternative multidisciplinary treatment.</P>
( Kichul Yoon ),( Nayoung Kim ),( Yong Hwan Kwon ),( Ju Yup Lee ),( Yoon Jin Choi ),( Jae Jin Hwang ),( Hyun Joo Lee ),( Aera Lee ),( Yeon Sang Jeong ),( Hyuk Yoon ),( Cheol Min Shin ),( Young Soo Par 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Macrophage Migration Inhibitory Factor (MIF) is known as pro-in- fi ammatory and pro-oncogenic cytokine. Its role in gastric cancer has been revealed recently. We evaluated the relationship between MIF and H. pylori in the gastric carcinogenesis. Methods: Human gastric tissue samples from 522 patients were subdivided into 6 groups according to H. pylori infection status and pathologic diagnosis (cancer, dysplasia, or control). Tissue MIF mRNA level was measured by real-time PCR, shown as 2^delta-delta CT (2^ddCT). Results: Gastric cancer tissue expressed signifi cantly higher level of MIF mRNA (n=214, mean±SE; 9.16±1.5) than non-cancer counterpart (n=308, 4.22±0.9, p=0.005). There was no signifi cant difference in MIF mRNA level between H. pylori negative and positive tissues. In subgroup analysis, H. pylori-positive cancer tissue showed signifi cantly higher MIF expression (n=137, 10.27±2.1) than that of H. pylori-positive dysplasia (n=55, 1.91±0.5, p<0.05) or H. pylori-positive control (n=113, 3.29±0.6, p<0.05). However, no such fi nding was noted among the H. pylori-negative cancer/dysplasia/control group. (fi gure) Conclusions: Tissue MIF mRNA level showed signifi cant difference between gastric cancer and dysplasia only in H. pylori-positive group. From these results we can conclude that MIF could be an important factor in the H. pylori induced gastric carcinogenesis. Now the experiments regarding underlying mechanism are undergoing.