• Title/Summary/Keyword: 세브란스

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A Patient with Locally Advanced Pancreatic Cancer Who Refused Additional Chemotherapy (추가 항암 치료를 거부하는 국소 진행형 췌장암 환자 1례)

  • Hee Seung Lee;Moon Jae Chung;Jeong Youp Park;Seungmin Bang;Seung Woo Park;Si Young Song
    • Journal of Digestive Cancer Research
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    • v.4 no.2
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    • pp.127-129
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    • 2016
  • The prognosis for pancreatic cancer patient is very poor. Patients with locally advanced disease have a median survival time of 8 to 12 months, and patients with distant metastases have significantly worse outcomes, with a median survival time of only 3 to 6 months. Approximately 30% of patients with pancreatic cancer present with locally advanced disease defined as unresectable pancreatic cancer without evidence of distant metastatic disease. Primary treatment options in locally advanced pancreatic cancer include chemotherapy and radiotherapy. Here, we reported a patient with locally advanced pancreatic cancer who does not want further chemotherapy because of chemotherapy induced nausea and vomiting. Irreversible electroporation was performed. Irreversible electroporation was well tolerated in this case, and may be a therapeutic modality for selected patients with locally advanced pancreatic cancer.

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Post-traumatic reconstruction of skeletal Class II malocclusion with multiple teeth fracture (외상과 다수의 치아 파절을 동반한 골격성 II 급 부정교합 환자의 치험례)

  • Jang, Woowon;Baek, Eui Seon;Hwang, Soonshin;Kim, Kyung-Ho;Chung, Chooryung J.
    • Korean Journal of Cleft Lip And Palate
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    • v.20 no.1
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    • pp.49-58
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    • 2017
  • We report the rehabilitation of Class II malocclusion with multiple teeth fracture due to trauma. A multidisciplinary team approach was necessary to treat patient's problems such as bone fracture, malocclusion, and multiple teeth fracture. Emergency conservative treatment, orthodontic treatment and prosthetic restoration successfully restored the occlusion. However, special considerations were needed along the orthodontic treatment process due to the unexpected complications such as ankylosis, root resorption and detection of additional teeth fractures.

Analysis of Clinical Effects of Palivizumab for Children with Older Siblings (손위형제 또는 자매가 있는 소아에서 Palivizumab 투여 여부에 따른 임상적 효과 분석)

  • Kim, Jin Yeo;Park, Ji Eun;Jung, Min Jae;Kim, Jae Song;Kim, Soo Hyun;Son, Eun Sun
    • Journal of Korean Society of Health-System Pharmacists
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    • v.35 no.4
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    • pp.400-408
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    • 2018
  • Background : Palivizumab is an intravenous monoclonal antibody which is used in the prevention of respiratory syncytial virus (RSV) infection. It is currently recommended for infants who are at high-risk for RSV infections due to preterm birth or other medical conditions such as congenital heart disease. Palivizumab is a humanized monoclonal antibody directed against an epitope in the antigenic site A of the protein F of RSV particles. Palivizumab is given once a month via intramuscular (IM) injection throughout the duration of the RSV season. Since palivizumab is known to have preventive effects against RSV infection for children with older siblings, the insurance coverage for palivizumab was expanded in October 2016. Methods : The electronic medical records of children under 2 years old who have older siblings who visited or were admitted to the Severance Hospital from October 2015 to May 2016 and from October 2016 to May 2017 were reviewed retrospectively. The data were then divided into two groups depending on the pilivizumab administration. Results : A total of 67 patients were enrolled in this study. The effectiveness in the reduction of hospitalization was statistically significant (p=0.009). Palivizumab decreased respiratory symptoms such as cough, rhinorrhea, and fever in patients with older siblings (p 0.05). Conclusions : In this study, palivizumab administration was effective in preventing RSV infection in infants with older siblings. Expanding palivizumab-prophylaxis administration to infants with older siblings may be effective in the prevention of upper respiratory infections.

CT and MR Imaging Findings of Structural Heart Diseases Associated with Sudden Cardiac Death (급성 심장사와 관련된 구조적 심질환의 전산화단층촬영과 자기공명영상 소견)

  • Jong Sun Lee;Sung Min Ko;Hee Jung Moon;Jhi Hyun Ahn;Hyun Jung Kim;Seung Whan Cha
    • Journal of the Korean Society of Radiology
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    • v.82 no.5
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    • pp.1163-1185
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    • 2021
  • Sudden cardiac death is an unexpected death originating from the heart that occurs within an hour of the onset of symptoms. The main cause of sudden cardiac death is arrhythmia; however, diagnosing underlying structural heart disease significantly contributes to predicting the long-term risk. Cardiovascular CT and MR provide important information for diagnosing and evaluating structural heart disease, enabling the prediction and preparation of the risk of sudden cardiac death. Therefore, we would like to focus on the various structural heart diseases that increase the risk of clinically-important sudden cardiac death and the importance of imaging findings.

Difficulties in End-of-Life Care and Educational Needs of Intensive Care Unit Nurses: A Mixed Methods Study (중환자실 간호사의 임종간호 어려움과 임종간호 교육요구 조사: 혼합연구방법)

  • Kim, Hyun Sook;Choi, Eun Kyoung;Kim, Tae Hee;Yun, Hye Young;Kim, Eun Ji;Hong, Jin Ju;Hong, Jeong A;Kim, Geon Ah;Kim, Sung Ha
    • Journal of Hospice and Palliative Care
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    • v.22 no.2
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    • pp.87-99
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    • 2019
  • Purpose: This study aimed to identify the difficulties with end-of-life care (EOLC) experienced by intensive care unit (ICU) nurses and to investigate their educational needs for EOLC. Methods: Mixed methods were used to survey ICU nurses at a university hospital. Quantitative data (N=106) were collected through a questionnaire and analyzed using an independent samples t-test, ANOVA, Mann-Whitney U test and $Scheff{\acute{e}}$ test. Qualitative data (N=19) were collected through focus group interviews and analyzed through qualitative content analysis. Results: The mean score on the difficulty of EOLC was 3.41 out of 5. The education needs derived from the qualitative analysis was categorized into four themes: 1) guidelines on professional EOLC, 2) spiritual care, 3) a program to take care of feelings of patients, families and nurses, and 4) activities to think about death. Conclusion: This study confirmed that ICU nurses were experiencing an extreme difficulty in providing EOLC. In addition, a qualitative analysis confirmed that they needed an EOL nursing program. To mitigate the difficulties experienced by nurses involved in EOLC, there is an urgent need to develop an education program for EOLC tailored to nurses' needs.

인터뷰: 세브란스 족부클리닉 이진우 교수 인터뷰 "당뇨발 치료는 발목 이상 대절단 피하는 것이 중요"

  • 사단법인 한국당뇨협회
    • The Monthly Diabetes
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    • s.258
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    • pp.60-61
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    • 2011
  • 과거에는 심한 감염을 동반한 족부질환은 한 번 발생하면 절단하는 것이 최선의 치료였다. 특히 발목 이상 대절단의 경우 5년 후 50% 가량에서 나머지 다른 쪽 다리를 절단케 하고 심한 경우 사망에까지 이르러 치료결과가 좋지 않았다. 최근 세브란스 병원 족부클리닉에서 당뇨병성 족부감염환자를 대절단 없이 95%까지 치료하는 성과를 거뒀다. 정형외과 이진우 교수를 만나 인터뷰 해봤다.

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Early Diagnosis of KBG Syndrome Using Diagnostic Exome Sequencing (Diagnostic exome sequencing을 통한 KBG 증후군의 조기 진단)

  • Hong, Jun Ho;Kim, Se Hee;Lee, Seung Tae;Choi, Jong Rak;Kang, Hoon Chul;Lee, Joon Soo;Kim, Heung Dong
    • Journal of the Korean Child Neurology Society
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    • v.26 no.4
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    • pp.272-275
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    • 2018
  • KBG syndrome is a rare neurodevelopmental disorder characterized by intellectual disability, skeletal anomalies, short stature, craniofacial dysmorphism, and macrodontia. ANKRD11 gene mutation and 16q24.3 microdeletion have been reported to cause KBG syndrome. Here, we report two patients with ANKRD11 mutations who initially presented with neurologic symptoms such as developmental delay and seizures. Patient 1 was a 23-month-old boy who presented with a global developmental delay. Language delay was the most dominant feature. He had hypertelorism, hearing impairment, and behavior problems characterized as hyperactivity. A c.1903_1907delAAACA (p.Lys635GInfsTer26) mutation in ANKRD11 was identified with diagnostic exome sequencing. Patient 2 was a 14-month-old boy with developmental delay and seizure. He also had atrial septum defect, and ventricular septal defect. Generalized tonic seizures began at the age of 8 months. Electroencephalography showed generalized sharp and slow wave pattern. Seizures did not respond to antiepileptic drugs. A loss of function mutation c.5350_5351delTC (p.ser1784HisfsTer12) in ANKRD11 was identified with diagnostic exome sequencing. In both cases, characteristic features of KBG syndrome such as short stature or macrodontia, were absent, and they visited the hospital due to neurological symptoms. These findings suggest that more patients with mild phenotypes of KBG syndrome are being recognized with advances in diagnostic exome sequencing genetic technologies.

Two Cases of Mucosal Bridge Crossing the Membrane of Vocal Folds (양측 성문 점막 부위를 연결하는 성대 점막교(Mucosal Bridge) 2예)

  • Jung, Chan Min;Lee, Eun Jung;Lim, Jae-Yol;Choi, Hong-Shik
    • Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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    • v.61 no.11
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    • pp.619-623
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    • 2018
  • Mucosal bridges of vocal fold have been described as a parallel band to vocal folds with the presence of sulcus vocalis. However, the type of mucosal bridge crossing each vocal fold has not been well documented in the literature. Herein, we present two cases of mucosal bridge found in the vocal fold connecting the mid-portions of true vocal folds. Two patients who had no history of laryngeal trauma, surgery or oro-tracheal intubation visited our clinic due to voice change. Laryngoscopic examination revealed that they had a mid-portion mucosal band without any other mucosal lesions. Two patients underwent laryngomicrosurgery with pulsed dye laser. After the surgery, they showed significant improvement of voice quality.