• Tuberculosis and Respiratory Diseases
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• 제85권4호
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• pp.302-312
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• 2022

Chronic obstructive pulmonary disease (COPD) is a complex and heterogeneous disease. Not all patients with COPD respond to available drugs. Identifying respondents to therapy is critical to delivering the most appropriate treatment and avoiding unnecessary medication. Recognition of individual patients' dominant characteristics by phenotype is a useful tool to better understand their disease and tailor treatment accordingly. To look for a suitable phenotype, it is important to understand what makes COPD complex and heterogeneous. The pathology of COPD includes small airway disease and/or emphysema. Thus, COPD is not a single disease entity. In addition, there are two types (panlobular and centrilobular) of emphysema in COPD. The coexistence of different pathological subtypes could be the reason for the complexity and heterogeneity of COPD. Thus, it is necessary to look for the phenotype based on the difference in the underlying pathology. Review of the literature has shown that clinical manifestation and therapeutic response to pharmacological therapy are different depending on the presence of computed tomography-defined airway wall thickening in COPD patients. Defining the phenotype of COPD based on the underlying pathology is encouraging as most clinical manifestations can be distinguished by the presence of increased airway wall thickness. Pharmacological therapy has shown significant effect on COPD with airway wall thickening. However, it has limited use in COPD without an airway disease. The phenotype of COPD based on the underlying pathology can be a useful tool to better understand the disease and adjust treatment accordingly.

• Clinical Pain
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• 제20권1호
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• pp.39-42
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• 2021

A 29-year-old woman had 1-month history of back pain radiating into lower extremities, motor weakness, and sensory abnormalities in both lower extremities. Contrast-enhanced spinal magnetic resonance imaging (MRI) revealed a homogeneously enhancing mass at the T12~L1 and several intradural enhancing nodular lesions at L2~S1. Tumor resection surgery was performed and following histological examination showed that the tumor satisfied the diagnostic criteria for atypical choroid plexus papilloma (CPP). To find primary tumor sites, contrast-enhanced brain MRI, whole spine MRI, and PET-CT were carried out and additional lesions were detected at the fourth ventricle, right cerebellum, and upper thoracic spinal cord. This is a very rare case of metastatic atypical CPP that involves brain, upper thoracic spinal cord, and cauda equina with initial manifestation of radicular symptoms without clinical signs of primary brain lesion.

• Journal of Audiology & Otology
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• 제23권1호
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• pp.33-38
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• 2019

Background and Objectives: Determination of the lesion side based on the direction of the nystagmus could result in confusions to the clinicians due to mismatch between the vestibular function tests and also between vestibular and audiologic features. To minimize these mistakes, we elucidated the clinical manifestation and vestibular function test results in cases with recovery spontaneous nystagmus (rSN). Subjects and Methods: Patients who visited ENT clinic of tertiary referral hospital for acute onset continuous vertigo from January 2008 to December 2011 were enrolled. In these patients, we assessed onset time of vertigo, time point of paralytic spontaneous nystagmus (SN) and time point of rSN. At each time point of SN, vestibular function tests and hearing function tests were performed. Results: We confirmed the rSN among patients with unilateral vestibulopathy and demonstrated that high gain of the rotatory chair test (slow harmonic acceleration) and/or mismatch of the SN direction and contralateral caloric weakness could indicate the recovery state of patients and nystagmus observed in this stage is recovery phase nystagmus. Conclusions: In acute vestibulopathy patients, recovery phase nystagmus was observed and on this stage of disease vestibular function tests shows several features that could predict recovery state.

• 대한청각학회지
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• 제23권1호
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• pp.33-38
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• 2019

Background and Objectives: Determination of the lesion side based on the direction of the nystagmus could result in confusions to the clinicians due to mismatch between the vestibular function tests and also between vestibular and audiologic features. To minimize these mistakes, we elucidated the clinical manifestation and vestibular function test results in cases with recovery spontaneous nystagmus (rSN). Subjects and Methods: Patients who visited ENT clinic of tertiary referral hospital for acute onset continuous vertigo from January 2008 to December 2011 were enrolled. In these patients, we assessed onset time of vertigo, time point of paralytic spontaneous nystagmus (SN) and time point of rSN. At each time point of SN, vestibular function tests and hearing function tests were performed. Results: We confirmed the rSN among patients with unilateral vestibulopathy and demonstrated that high gain of the rotatory chair test (slow harmonic acceleration) and/or mismatch of the SN direction and contralateral caloric weakness could indicate the recovery state of patients and nystagmus observed in this stage is recovery phase nystagmus. Conclusions: In acute vestibulopathy patients, recovery phase nystagmus was observed and on this stage of disease vestibular function tests shows several features that could predict recovery state.

• 대한영상의학회지
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• 제81권2호
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• pp.337-350
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• 2020

심막 질환은 응급질환인 관상동맥, 대동맥 질환과 증상이 비슷하여 빠른 감별이 중요하다. 심막은 두겹으로 된 막으로서 다양한 해부학적 변이와 질환이 있다. 크거나 비전형적인 위치를 보이는 심막의 오목(recess)은 이상 소견으로 오인될 수도 있다. 심막에는 감염이나 종양 같은 질환이 생기며 또한 주변에서 생기는 이러한 질환의 전파경로가 될 수 있다. 심막을 평가하는데 있어 심초음파가 일차적인 검사방법이나 해상도가 떨어지고 주변의 폐나 뼈에 의한 음창이 제한될 수 있으며 수술 후 평가가 힘든 경우가 많다. 이때 CT나 MR에 의한 영상평가가 유용한 경우가 많아 검사가 점점 늘어나고 있다. 심막의 형태와 질환에 대한 지식 및 영상소견에 대한 이해는 환자 치료에 중요하다.

• Journal of Interdisciplinary Genomics
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• 제2권2호
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• pp.20-25
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• 2020

Mucopolysaccharidosis type III (MPS III or Sanfilippo syndrome) is a multisystem lysosomal storage disease that is inherited in an autosomal recessive manner. It consists of four subtypes (MPS IIIA, B, C, and D), each characterized by the deficiency of different enzymes that catalyze the metabolism of the glycosaminoglycan heparan sulfate at the lysosomal level. The typical clinical manifestation of MPS III includes progressive central nervous system (CNS) degeneration with accompanying systemic manifestations. Disease onset is typically before the age of ten years and death usually occurs in the second or third decade due to neurological regression or respiratory tract infections. However, there is currently no treatment for CNS symptoms in patients with MPS III. Invasive and non-invasive techniques that allow drugs to pass through the blood brain barrier and reach the CNS are being tested and have proven effective. In addition, the application of genistein treatment as a substrate reduction therapy is in progress.

• Journal of Oral Medicine and Pain
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• 제42권2호
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• pp.49-52
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• 2017

Leukemia is a malignant disease characterized by uncontrolled clonal proliferation of white blood cells. It is classified depending on clinical course of disease (acute or chronic) and the primary hematopoietic cell line affected (myeloid or lymphoid). Leukemia is often associated with orofacial manifestations, such as oral bleeding, petechiae, oral ulceration, gingival enlargement, mucosal pallor and mental nerve neuropathy. However, trismus has been rarely reported as a sign of leukemia. We present a case of trismus caused by acute lymphoblastic leukemia and emphasize the importance of orofacial manifestations in the early diagnosis of leukemia.

• Journal of Chest Surgery
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• 제3권1호
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• pp.17-20
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• 1970

Six cases of broncho-pleural fistula due to complicated liver abscess were experienced at the department of chest surgery, Seoul National University Hospital from October 1967 to March 1970. Amebic liver abscess was the primary cause in the 5 cases and the remaining one case was due to pyogenic liver abscess. Involved lung was right side in all case. The clinical manifestation was fever,chill,cough, sputum, dyspnea, chest pain, hemoptysis and shoulder pain. The methods of the treatment employed were closed thoracotomy [1], thoracotomy & drainage [2],decortication [1],and right lower lobectomy[3]. The average duration of the post-operative course was 19.6 days. There was no operative mortality.

• 대한임상독성학회지
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• 제1권1호
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• pp.47-50
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• 2003

Endosulfan, one of organochlorine insecticides, is $\gamma$-aminobutyric acid (GABA) antagonist. In sufficient dose, this pesticide lower the seizure threshold and produce CNS stimulation, with resultant seizures, respiratory failure, and death. In patients with endosulfan intoxication, the first manifestation of toxicity is largely a generalized seizure without prodromal signs or symptoms. So the management of airway and seizure control are essential for survival and prognosis of intoxicated patients. We report two cases of acute endosulfan poisoning who manifest 'status epilepticus' similarly, but have different prognosis.

• Journal of Chest Surgery
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• 제28권11호
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• pp.989-993
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• 1995

Patent ductus arteriosus in adult is frequently complicated with aneurysm, calcification and pulmonary hypertension. Therefore, surgical treatment of patent ductus arteriosus in adult has some differences from that of infants and children. We have experienced 25 cases of adult patent ductus arteriosus from July 1983 to December 1994. Mean age of the patients was 26.6 years[16-59 years . There were 12 males and 13 females. Exertional dyspnea was the most frequent clinical manifestation. Pulmonary hypertension was present in eight patients. Ligation was done in 20 cases and surgery using cardiopulmonary bypass was done in 5 cases. There was one hospital death, which had a 5x5cm sized main pulmonary artery aneurysm and was operated under cardiopulmonary bypass. Recanalization occured in one patient who received Teflon-felt supported ligation. Although one case of recannalization after ligation was present, we believed the fact that ligation was safe and simple method of operation in adult patent ductus arteriosus without calcification and aneurysm.