• Journal of Chest Surgery
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• 제43권6호
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• pp.734-738
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• 2010

약 10년전 아이젠멩거 증후군으로 양측 폐이식을 시행받은 43세 여자 환자가 서서히 진행되는 호흡 곤란을 주소로 내원하였다. 환자는 폐이식 후 발생하는 만성거부반응인 폐쇄세기관지염 증후군으로 진단받고 경과 관찰 하였으나 내과적 치료에도 반응이 없이 계속 악화되어 인공 호홉기에 의존하는 상태에서 재폐이식 수술을 시행 받았다. 저자들은 폐이식 후 만성거부반응을 보이는 환자에서 국내 최초로 재폐이식을 시행하였기에 보고하는 바이다.

• 한국발생생물학회지:발생과생식
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• 제15권4호
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• pp.309-313
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• 2011

SOHLH2 is a novel germ cell-specific transcription factor that is crucial for folliculogenesis in the ovary and spermatogenesis in the testis. SOHLH2 represents a candidate gene for infertility with premature ovarian failure. We analyzed whether mutations in the SOHLH2 gene in 98 Korean women with premature ovarian failure. The sequence analysis identified six novel SNPs (c.431-41G>C, c.656A>T, c.1000+27C>T, c.1000+33G>T, c1258-106G>A, and c.2094+ 11T>C) from Korean patients with premature ovarian failure. The c.656A>T found in exon 7 results in change of an amino acid, tyrosine to phenylalanine. Functional mutations in SOHLH2 gene are rare in Korean women with premature ovarian failure.

• Clinical and Experimental Reproductive Medicine
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• 제41권4호
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• pp.168-173
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• 2014

The purpose of this study is to report a successful twin pregnancy and delivery in a female patient with X-linked dominant incontinentia pigmenti (IP) who underwent assisted reproductive technology followed by preimplantation genetic screening (PGS). A 29-year-old female with IP had a previous history of recurrent spontaneous abortion. A molecular analysis revealed the patient had a de novo mutation, 1308_1309insCCCCTTG(p.Ala438ProfsTer26), in the inhibitor of the kappa B kinase gamma gene located in the Xq28 region. IVF/ICSI and PGS was performed, in which male embryos were sexed using array-based comparative genomic hybridization (aCGH). After IVF/ICSI and PGS using aCGH on seven embryos, two euploid male blastocysts were transferred with a 50% probability of a viable male pregnancy. The dizygotic twin pregnancy was confirmed and the amniocentesis results of each twin were normal with regard to the mutation found in the mother. The patient delivered healthy twin babies during the 37th week of gestation. This case shows the beneficial role of PGS in achieving a successful pregnancy through euploid male embryo gender selection in a woman with X-linked dominant IP with a history of multiple male miscarriages.

• Journal of Korean Neurosurgical Society
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• 제48권4호
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• pp.319-324
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• 2010

Objective : The aim of this study was to analyze the correlation between thromboembolic complications and anti platelet drugs before and after neurointervention. Methods : Blood samples and radiographic data of patients who received a neurointervention (coil embolization, stent placement or both) were collected prospectively. Rapid platelet function assay-aspirin (RPFA-ASA) was used to calculate aspirin resistance in aspirin reaction units (ARU). For clopidogrel resistance, a P2Y12 assay was used to analyze the percentage of platelet inhibition. ARU > 550 and platelet inhibition < 40% were defined as aspirin and clopidogrel resistance, respectively. Results : Both aspirin and clopidogrel oral pills were administered in fifty-three patients before and after neurointerventional procedures. The mean resistance values of all patients were 484 ARU and < 39%. Ten (17.0%) of 53 patients showed resistance to aspirin with an average of 597 ARU, and 33 (62.3%) of 53 patients showed resistance to clopidogrel with an average of < 26%. Ten patients demonstrated resistance to both drugs, 5 of which suffered a thromboembolic complication after neurointervention (mean values : 640 ARU and platelet inhibition < 23%). Diabetic patients and patients with hypercholesterolemia displayed mean aspirin resistances of 513.7 and 501.8 ARU, and mean clopidogrel resistances of < 33.8% and < 40.7%, respectively. Conclusion : Identifying individuals with poor platelet inhibition using standard regimens is of great clinical importance and may help prevent cerebral ischemic events in the future. Neurointerventional research should focus on ideal doses, timing, choices, safety, and reliable measurements of anti platelet drug therapy, as well as confirming the clinical relevance of aggregometry in cerebrovascular patients.

• Journal of Korean Neurosurgical Society
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• 제50권3호
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• pp.205-208
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• 2011

Objective : Retrospective analysis to compare the effect and complication of epidural patient-controlled analgesia (epidural PCA) with intravenous patient-controlled analgesia (IV PCA) for the treatment of the post-operative pain after posterior lumbar instrumented fusion. Methods : Sixty patients who underwent posterior lumbar instrumented fusion for degenerative lumbar disease at our institution from September 2007 to January 2008 were enrolled in this study. Out of sixty patients, thirty patients received IV PCA group and thirty patients received epidural PCA group. The pain scale was measured by the visual analogue scale (VAS) score. Results : There were no significant difference between IV PCA group and epidural PCA group on the PCA related complications (p=0.7168). Ten patients in IV PCA group and six patients in epidural PCA group showed PCA related complications. Also, there were no significant differences in reduction of VAS score between two groups on postoperative 2 hours (p=0.9618) and 6 hours (p=0.0744). However, postoperative 12 hours, 24 hours and 48 hours showed the significant differences as mean of reduction of VAS score (p=0.0069, 0.0165, 0.0058 respectively). Conclusion : The epidural PCA is more effective method to control the post-operative pain than IV PCA after 12 hours of spinal fusion operation. However, during the first twelve hours after operation, there were no differences between IV PCA and epidural PCA.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제38권6호
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• pp.326-331
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• 2012

Objectives: Stress may have an impact on treatment types that patients receive for temporomandibular disorders (TMDs). This study sought to investigate the relationship between the stress index and type of treatments in patients with TMD. Materials and Methods: The psychosocial well-being index-short form (PWI-SF) was used to evaluate stress levels in ninety-two patients with TMD. Treatment types were classified into two groups: one group received counseling, physical therapy or medication, while the second group received splint therapy or surgical intervention. Results: The high-risk group (PWI-SF${\geq}27$, the higher the points, the more severe the stress level) was more frequently treated by splint therapy than the low-risk group (PWI-SF<27). Female TMD patients reported higher PWI-SF scores than male TMD patients. Conclusion: This study suggests a relationship between stress levels and treatment types for patients with TMD. Thus, the appropriate evaluation and management of stress could be an important factor in treating TMD.

• 대한족부족관절학회지
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• 제14권2호
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• pp.123-129
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• 2010

Purpose: To evaluate the efficacy of the arthroscopic exploration combined with modified Brostrom operation (MBO) for the treatment of chronic lateral ankle instability (CAI). Materials and Methods: Sixty patients who diagnosed a CAI were performed MBO. We divided to 2 groups, whether simultaneously inspected by arthroscopy (group B) or not (group A). The both group's results were compared according to American Orthopedic Foot and Ankle Society Ankle-hindfoot score (AOFAS), functional ankle score and visual analog scale (VAS) at preoperative and final follow-up period. Results: There were no significant differences of AOFAS, functional ankle score and VAS between both groups at final follow-up. However, in group A, 2 cases associated with medial ankle instability and syndesmotic injuries were did not diagnosed preoperatively, showed poor prognosis. In group B, one case had a permanent peroneal nerve symptom. The match rate of intra-articular lesions between preoperative diagnosis and postoperative arthroscopic diagnosis was 30% in group B. Conclusion: Combination of arthroscopic exploration and MBO is effective strategy for intra-operatively discrimination of intra-articular associated lesions for CAI.

• Asian Pacific Journal of Cancer Prevention
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• 제15권7호
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• pp.3179-3183
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• 2014

Background: The purpose of study was to evaluate radiologic or clinical features of breast cancer undergoing ultrasound (US)-guided 14G core needle biopsy (CNB) and analyze the differences between underestimated and accurately diagnosed groups. Materials and Methods: Of 1,898 cases of US-guided 14G CNB in our institute, 233 cases were proven to be cancer by surgical pathology. The pathologic results from CNB were invasive ductal carcinoma (IDC) (n=157), ductal carcinoma in situ (DCIS) (n=40), high-risk lesions in 22 cases, and benign in 14 cases. Among high-risk lesions, 7 cases of atypical ductal hyperplasia (ADH) were reported as cancer and 11 cases of DCIS were proven IDC in surgical pathology. Some 29 DCIS cases and 157 cases of IDC were correctly diagnosed with CNB. The clinical and imaging features between underestimated and accurately diagnosed breast cancers were compared. Results: Of 233 cancer cases, underestimation occurred in 18 lesions (7.7%). Among underestimated cancers, CNB proven ADH (n=2) and DCIS (n=11) were diagnosed as IDC and CNB proven ADH (n=5) were diagnosed at DCIS finally. Among the 186 accurately diagnosed group, the CNB results were IDC (n=157) and DCIS (n=29). Comparison of underestimated and accurately diagnosed groups for BI-RADS category, margin of mass on mammography and US and orientation of lesion on US revealed statistically significant differences. Conclusions: Underestimation of US-guided 14G CNB occurred in 7.7% of breast cancers. Between underestimated and correctly diagnosed groups, BI-RADS category, margin of the mass on mammography and margin and orientation of the lesions on US were different.

• 한국의학물리학회지:의학물리
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• 제27권4호
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• pp.196-202
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• 2016

We aim to develop the breast bolus by using a 3D printer to minimize the air-gap, and compare it to commercial bolus used for patients undergoing reconstruction in breast cancer. The bolus-shaped region of interests (ROIs) were contoured at the surface of the intensity-modulated radiation therapy (IMRT) thorax phantom with 5 mm thickness, after which the digital imaging and communications in mdicine (DICOM)-RT structure file was acquired. The intensity-modulated radiation therapy (Tomo-IMRT) and direct mode (Tomo-Direct) using the Tomotherapy were established. The 13 point doses were measured by optically stimulated luminescence (OSLD) dosimetry. The measurement data was analyzed to quantitatively evaluate the applicability of 3D bolus. The percentage change of mean measured dose between the commercial bolus and 3D-bolus was 2.3% and 0.7% for the Tomo-direct and Tomo-IMRT, respectively. For air-gap, range of the commercial bolus was from 0.8 cm to 1.5 cm at the periphery of the right breast. In contrast, the 3D-bolus have occurred the air-gap (i.e., 0 cm). The 3D-bolus for radiation therapy reduces the air-gap on irregular body surface that believed to help in accurate and precise radiation therapy due to better property of adhesion.

• Journal of Yeungnam Medical Science
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• 제34권2호
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• pp.285-289
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• 2017

Pheochromocytoma can present with various symptoms including cardiogenic shock and cardiac arrest. Particularly, in cases of cardiogenic shock of unknown origin, pheochromocytoma should be considered. A 20-year-old woman without any medical history visited our emergency department due to nausea, vomiting, headache, and chest pain. Echocardiography revealed severe left ventricular dysfunction. Mechanical ventilation and veno-arterial extracorporeal membrane oxygenation (ECMO) were implemented owing to her unstable vital signs. For unstable vital sign and cardiogenic shock in a young woman without any previous medical history, pheochromocytoma was considered and diagnosed based on elevated levels of catecholamine derivatives in a 24-hour urine sample. Cardiac function recovered and ECMO was discontinued on the 5th day of hospitalization. She later underwent an elective adrenalectomy and no recurrence was found during the follow-up period. We reported a case of pheochromocytoma which was presented with cardiogenic shock in a young woman with no concomitant disease, and successfully treated with ECMO followed by an elective adrenalectomy.