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Detection of Cerebrovascular Disease in a Child with Hutchinson-Gilford Progeria Syndrome Using MR Angiography: A Case Report (Hutchison-Gilford 조로증 증후군 환아에서의 뇌 자기공명 혈관조영술 소견: 증례 보고)

  • Jae Ho Lee;Ha Young Lee;Myung Kwan Lim;Young Hye Kang
    • Journal of the Korean Society of Radiology
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    • v.83 no.6
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    • pp.1360-1365
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    • 2022
  • Hutchinson-Gilford progeria syndrome (HGPS) is a rare, progressive, premature aging syndrome with early morbidity due to cardiovascular and cerebrovascular diseases. Clinical symptoms are very diverse, including non-specific symptoms such as growth retardation, scleroderma, alopecia, and osteoporosis, as well as hypertension and cardiovascular diseases that occur in childhood and adolescence due to accelerated vascular aging. In patients with HGPS, MR angiography is recommended for early diagnosis of asymptomatic stroke or vascular changes and to assess increased risk of cerebrovascular disease. We report the second domestic case of HGPS confirmed by genetic analysis in a 5-year-old child with typical clinical features, and the first English case report in Korea to present brain MR angiography findings.

A Critical Review on the Critical Communication Studies in Korea (한국의 비판언론학에 대한 비판적 성찰: 문화연구와 정치경제학을 중심으로)

  • Cho, Hang-Je
    • Korean journal of communication and information
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    • v.43
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    • pp.7-46
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    • 2008
  • The purpose of this essay explores a critical review of the Korean critical communication studies focused on the problematic of cultural studies and political economy in 2000s. The findings are as follows; The 'consumer turn' or 'audience turn' in new revisionism modelling John Fiske's cultural studies has been interpreted not to complement but to substitute the necessary criticism of the post-authoritarian media establishment of Korea at that time, arising identity crisis of Korean cultural studies as one of the critical camp. On other side, however, some political economy studies close to the unilinear theses of orthodox marxism has been appraised to neglect the complex process and structure of media and cultural production as well. While the press war between the market-dominant dailies and some progressive dailies has given rise to a whole debate as expected in consolidating period of Korean emerging democracy, the conjucturalism as modelled by Hall's 'authoritarian populism' failed to initiate a new theo tical practice in Korea. Finally, this review essay propose the some new research issues that would converge cultural studies and political economy, modernism and postmodernism; citizenship vs 'cultural citizenship'(valuing the private identity and gender) or Habermasian public sphere vs 'cultural public sphere', the culture of production, (modern)citizen/(postmodern)consumer(recently debated in English media policy), 'differentiation' in capitalist production and 'difference' in consumer sovereignty, 21c future vision of public service broadcasting as one of the 20c institutions.

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Systematic Review : Comparative Safety and Efficacy of Mono- and Combination Therapy of Anti-hypertensive Agents Acting on the Renin-Angiotensin System (레닌-안지오텐신계에 작용하는 항고혈압 약제의 단독요법과 병용요법의 안전성 및 유효성에 대한 체계적 문헌고찰)

  • Choi, Kyung-Eob;Kim, Hyun-Kyung
    • Korean Journal of Clinical Pharmacy
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    • v.21 no.4
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    • pp.364-375
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    • 2011
  • Given that single blockade with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) can achieve only partial and undurable suppression of the Renin Angiotensin System (RAS), it has been hypothesized that dual blockage would be more beneficial in the management of blood pressure (BP) reduction and prevention of progressive chronic kidney disease (CKD) than either agent alone. Thus, it has been suggested that the combination of an ACEI and an ARB might provide renal benefits to hypertensive patients over and above BP reduction. However, this might also expose patients to additive or synergistic side effects. We attempted to conduct a systematic review to evaluate the benefits and harms of combination therapy in hypertensive patients with or without kidney diseases. MEDLINE and KoreaMed were searched for relevant randomized clinical trials in adult hypertensive patients with or without diabetes (restricted to 1997, limited to trials published in English). Results were summarized using the random-effects model, and between-studies heterogeneity was estimated with $I^2$. A final analysis of ten trials (23,928 patients) revealed that the combination of an ACEI and an ARB reduced blood pressure (SBP/DBP) by 3.95/2.02 mmHg (95% confidence interval [CI], -4.38 to -3.53/-2.33 to -1.71) compared with ACEI monotherapy, and 2.83/2.64 mmHg (95% CI, -3.25 to -2.41/-4.95 to -0.33) compared with ARB monotherapy. Eight trials (391 patients) demonstrated a significant reduction in 24h-proteinuria (weighted mean difference, 0.16 g/day, 95% CI, -0.26-0.05), but they did not translate into an improvement in GFR. Tests for heterogeneity showed no difference in effect among the studies. The combination therapy reduced proteinuria by 30% (95% CI, 23% to 37%) and 39% (95% CI, 31% to 48%) compared with ACEI monotherapy and ARB monotherapy, respectively. However, in patients who had proteinuria more than 0.5 g/day, the combination therapy failed to show significant reduction in urinary protein excretion. The current cumulative evidence suggests that diabetic patients with proteinuria on dual RAS blockade have an increase risk of adverse events such as hyperkalemia, hypotension, and so on, compared with ACEI or ARB alone. It is, therefore, proposed that the combination therapy should not be routinely used for the treatment of hypertension with or without compelling indications.