• Title/Summary/Keyword: Nature of Medicine

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A Case of Adenocarcinoma Presenting a Solitary Pulmonary Nodule that Grows Slowly Over 10 Years (10년간 크기가 서서히 증가한 고립성 폐결절이 선암으로 진단된 1예)

  • Kwon, Ki Du;Kim, Ji Hyeong;Kim, Dae Yong;Choi, Moon Han;Choi, Jae Huk;Shin, Dong Won;Choi, Jong Hyo;Yi, Sul Hee;Yun, Jin A;Choi, Jae Sung;Na, Ju Ok;Seo, Ki Hyun;Kim, Yong Hoon;Oh, Mi Hae
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.4
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    • pp.318-323
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    • 2008
  • It is difficult to distinguish a lung cancer from a pulmonary tuberculoma or other benign nodule. It is even more difficult to identify the type of lesion if the mass shows no change in size or demonstrates slow growth. Only a pathological confirmation can possibly reveal the nature of the lesion. A 61-year-old-woman was referred for a solitary pulmonary nodule. The nodule showed no change in size for the first two years and continued to grow slowly. Pathological and immunological analyses were conducted for confirmation of the nodule. The nodule was identified as a well-differentiated primary pulmonary adenocarcinoma. An LULobectomy was performed, and the post surgical stage of the nodule was IIIA (T2N2M0). Even though there are few risk factors, there is still the possibility of a malignancy in cases of non-growing or slow growing solitary pulmonary nodules. Therefore, pathological confirmation is encouraged to obtain a firm diagnosis.

Cardiovascular risk may be increased in women with unexplained infertility

  • Verit, Fatma Ferda;Zeyrek, Fadile Yildiz;Zebitay, Ali Galip;Akyol, Hurkan
    • Clinical and Experimental Reproductive Medicine
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    • v.44 no.1
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    • pp.28-32
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    • 2017
  • Objective: Growing evidence suggests that increased cardiovascular disease (CVD) risk is associated with female infertility caused by conditions such as polycystic ovarian disease, obesity, thyroid dysfunction, and endometriosis. The aim of this study was to evaluate whether any relationship exists between CVD and unexplained infertility. Methods: Sixty-five women with unexplained infertility and 65 fertile controls were enrolled in the study. CVD risk markers such as low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), triglycerides (TG), insulin resistance (defined by the homeostasis model assessment ratio), and high-sensitivity C-reactive protein (hs-CRP) were assessed. Results: TG, TC, LDL, and hs-CRP levels were higher and HDL levels were lower in patients with unexplained infertility than in fertile controls (p<0.05 for all). Positive associations were found between unexplained infertility and TG, TC, LDL, and hs-CRP levels, and a negative correlation was found for HDL (p<0.05 for all). Multivariate logistic regression analysis showed that TG, HDL, and hs-CRP were independent variables associated with unexplained infertility. Conclusion: Our study showed that women with unexplained infertility had an atherogenic lipid profile and elevated hs-CRP levels, suggesting a higher risk of developing CVD in the future. Further studies with larger groups are needed to investigate the nature of this link.

Trends and Future Direction of the Clinical Decision Support System in Traditional Korean Medicine

  • Sung, Hyung-Kyung;Jung, Boyung;Kim, Kyeong Han;Sung, Soo-Hyun;Sung, Angela-Dong-Min;Park, Jang-Kyung
    • Journal of Pharmacopuncture
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    • v.22 no.4
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    • pp.260-268
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    • 2019
  • Objectives: The Clinical Decision Support System (CDSS), which analyzes and uses electronic health records (EHR) for medical care, pursues patient-centered medical care. It is necessary to establish the CDSS in Korean medical services for objectification and standardization. For this purpose, analyses were performed on the points to be followed for CDSS implementation with a focus on herbal medicine prescription. Methods: To establish the CDSS in the prescription of Traditional Korean Medicine, the current prescription practices of Traditional Korean Medicine doctors were analyzed. We also analyzed whether the prescription support function of the electronic chart was implemented. A questionnaire survey was conducted querying Traditional Korean Medicine doctors working at Traditional Korean Medicine clinics and hospitals, to investigate their desired CDSS functions, and their perceived effects on herbal medicine prescription. The implementation of the CDSS among the audit software developers used by the Korean medical doctors was examined. Results: On average, 41.2% of Traditional Korean Medicine doctors working in Traditional Korean Medicine clinics manipulated 1 to 4 herbs, and 31.2% adjusted 4 to 7 herbs. On average, 52.5% of Traditional Korean Medicine doctors working in Traditional Korean Medicine hospitals adjusted 1 to 4 herbs, and 35.5% adjusted 4 to 7 herbs. Questioning the desired prescription support function in the electronic medical record system, the Traditional Korean Medicine doctors working at Korean medicine clinics desired information on 'medicine name, meridian entry, flavor of medicinals, nature of medicinals, efficacy,' 'herb combination information' and 'search engine by efficacy of prescription.' The doctors also desired compounding contraindications (eighteen antagonisms, nineteen incompatibilities) and other contraindicatory prescriptions, 'medicine information' and 'prescription analysis information through basic constitution analyses.' The implementation of prescription support function varied by clinics and hospitals. Conclusion: In order to implement and utilize the CDSS in a medical service, clinical information must be generated and managed in a standardized form. For this purpose, standardization of terminology, coding of prescriptions using a combination of herbal medicines, and unification such as the preparation method and the weights and measures should be integrated.

A Case of Primary Antiphospholipid Syndrome with Pulmonary Thromboembolism (폐색전증을 동반한 원발성 항인지질증후군 1예)

  • Lee, Jae Beom;Sim, Yun Su;Noh, Young Wook;Park, Hye Sung;Tae, Chung Hyun;Lim, So Yeon;Jun, Yoon Hee;Ryu, Yon Ju;Chun, Eun Mi;Lee, Jin Hwa;Chang, Jung Hyun;Moon, Jin Wook
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.1
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    • pp.72-77
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    • 2007
  • Antiphospholipid syndrome (APS) causes recurrent thromboses and morbidity during pregnancy, including fetal loss. This malady is associated with the persistent presence of anticardiolipin antibody or lupus anticoagulant. The pulmonary manifestations of antiphospholipid syndrome include pulmonary thromboembolism, pulmonary hypertension, acute respiratory distress syndrome, etc. Pulmonary thromboembolism is often the initial manifestation of antiphospholipid syndrome and a timely diagnosis is critical due to the high mortality rate. We herein report on a 19-year-old man with pulmonary thromboembolism that was caused by primary antiphospholipid syndrome. He presented with blood-tinged sputum, fever and epigastric pain, and his chest computerized tomography showed pulmonary thromboembolism. The other possible causes of pulmonary thromboembolism were excluded and the diagnosis of primary antiphospholipid syndrome was confirmed by the lupus anticoagulant that was present on two occasions six weeks apart. We also discuss the nature and management of antiphospholipid syndrome, along with a brief review of the relevant literatures.

A Case of Mediastinal Pancreatic Pseudocyst (종격동 췌장 가성낭종 1예)

  • Maeng, Ho-Young;Jung, Jae-Hae;Lee, Sang-Won;Park, Moo-Seok;Chung, Jae-Ho;Kim, Do-Hoon;Park, Seung-Woo;Choi, Byoung-Wook;Kim, Se-Kyu;Chang, Joon;Kim, Sung-Kyu;Kim, Young-Sam
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.3
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    • pp.271-277
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    • 2002
  • Background: A pancreatic pseudocyst is one of various complications occurring in acute or chronic pancreatitis. It is usually located in the retroperitoneal space near the pancreas. However, other unusual locations are also possible. Jones initially described the mediastinal pseudocyst in 1940. Since then, fewer than 50 cases have been reported. A diagnosis of a mediastinal pseudocyst is accomplished by imaging studies revealing the cystic nature of the mass with evidences of acute or chronic pancreatitis. There is some controversy regarding the appropriate management of mediastinal pseudocyst because of the high mortality and morbidity after surgical management. Here we report a case of a mediastinal pancreatic pseudocyst found in a patient with asymptomatic alcohol-related pancreatitis complicated by the development of a mediastinal pseudocyst, which quickly resolved after endoscopic retrograde pancreatic and biliary drainage and subcutaneous injection of a somatostatin analog(octreotide acetate) without any complications.

Differential Diagnosis of Fine Needle Aspiration Cytology of Benign Lymphadenopathy (양성 림프절 증식의 세침흡인 세포검사의 감별진단)

  • Han, Eun-Mee;Song, Dong-Eun;Eom, Dae-Un;Choi, Hye-Jeong;Cha, Hee-Jeong;Huh, Joor-Yung
    • The Korean Journal of Cytopathology
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    • v.17 no.2
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    • pp.99-107
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    • 2006
  • In the investigation of superficial lymphadenopathy of unknown cause, fine needle aspiration (FNA) cytology plays an invaluable role. It enables the differentiation of benign lymphadenopathy from lymphoid and non-lymphoid malignancies, obviating the need for open biopsy, and allowing the triage of patients. Cytopathologists should be familiar with the typical FNA patterns of benign lymphadenopathy, and recognize and differentiate among categories. In a minority of cases of benign lymphadenopathy, FNA can render a specific diagnosis. Benign lymphadenopathies are generally categorized into reactive lymphoid hyperplasia (RLH), inflammatory or infectious processes, and benign lymphoproliferative disorders. RLH characteristically presents with a heterogeneous and polymorphous smear composed of normal cellular constituents of lymph nodes, in contrast with the homogeneous or monomorphic smear of most lymphomas. The caveat is that various malignant disorders may also present with polymorphous populations. It is also important to recognize thatbenign lymphoid smears may sometimes contain atypical cells that raise the suspicion of malignancy. Clinical information should always be the integral part of the diagnostic criteria in FNA of lymphadenopathy. If there is any doubt about the benign nature of the smear, it is prudent to suggest biopsy and ancillary studies.

Comparison of Dipogenic and Osteogenic Potentials of Visceral and Subcutaneous Adipose Stem Cells of Human (인체 피하지방과 내장지방에서 유래한 줄기세포의 지방분화 및 골분화 능력 차이)

  • Kang, Min Gu;Park, Jong Lim;Lee, Jin Hee;Chang, Hak;Minn, Kyung Won;Park, Gyu Ju
    • Archives of Plastic Surgery
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    • v.34 no.5
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    • pp.537-542
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    • 2007
  • Purpose: Adipose tissue contains a population of pluripotent stem cells capable of differentiating along multiple mesenchymal cell lineages. It is well known that fat depots from different part of our body shows different nature not only in morphological aspect but also physiologic aspect. The authors compared the adipogenic potentials and osteogenic potentials of adipose stem cells from different anatomical sites of human. Methods: After laparotomy by surgery team, the authors isolated these adipose stem cells successfully from 7 men with an average age of 58, and induced differentiation along adipogenic and osteogenic lineages in vitro. On the 14th day, cells cultured in adipogenic media differentiated into adipocytes in vitro, as evidenced by positive Oil Red O staining of lipid vacuoles. On the 21st day, cells cultured in osteogenic media differentiated into osteoblasts in vitro as demonstrated by Alizarin red staining of a calcified extracellular matrix. Results: After exposure to adipogenic and osteogenic differentiation medium, subcutaneous adipose stem cells were found to possess greater adipogenic and osteogenic potentials than cells isolated from visceral adipose tissues. Conclusion: This study indicates that adipogenic and osteogenic potentials of adipose stem cells vary by their anatomical sites, with subcutaneous adipose stem cells exhibiting higher adipogenic and osteogenic potential than those isolated from visceral fat.

Surgical Repair of Ventricular Septal Defect after Myocardial Infarction: A Single Center Experience during 22 Years

  • Park, Sung Jun;Kim, Joon Bum;Jung, Sung-Ho;Choo, Suk Jung;Chung, Cheol Hyun;Lee, Jae Won
    • Journal of Chest Surgery
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    • v.46 no.6
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    • pp.433-438
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    • 2013
  • Background: Surgical repair of post-infarct ventricular septal defect (VSD) is considered one of the most challenging procedures having high surgical mortality. This study aimed to evaluate the outcomes of the surgical repair of post-infarct VSD. Methods: From May 1991 to July 2012, 34 patients (mean age, $67.1{\pm}7.9$ years) underwent surgical repair of post-infarct VSD. A retrospective review of clinical and surgical data was performed. Results: VSD repair involved the infarct exclusion technique using a patch in all patients. For coronary revascularization, 12 patients (35.3%) underwent concomitant coronary artery bypass graft, 3 patients (8.8%) underwent preoperative percutaneous coronary intervention, and 9 patients (26.5%) underwent both of these procedures. The early mortality rate was 20.6%. Six patients (17.6%) required reoperation due to residual shunt or newly developed VSD. During follow-up (median, 4.8 years; range, 0 to 18.4 years), late death occurred in nine patients. Overall, the 5-year and 10-year survival rates were $54.4%{\pm}8.8%$ and $44.3%{\pm}8.9%$, respectively. According to a Cox regression analysis, preoperative cardiogenic shock (p=0.069) and prolonged cardiopulmonary bypass time (p=0.008) were independent predictors of mortality. Conclusion: The early surgical outcome of post-infarct VSD was acceptable considering the high-risk nature of the disease. The long-term outcome, however, was still dismal, necessitating comprehensive optimal management through close follow-up.

Study on Medical Thoughts of Writing works of Jeon Sun Eui (전순의(全循義)의 의학사상과 저작내용에 관한 소고)

  • Yoon, Jong-Been;Jeon, Byung-Hun;Kim, Yeong-Mok
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.2
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    • pp.353-361
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    • 2007
  • This study searched the medical thought of Cheon Sun Eui (全循義). The relavance of his writings with the modern Korean Traditional Medicine, the science of food and nutrition, and the living science. His medical philosophy which was expressed in SikRyoChanYo(食療贊要), SanGaYoGok(山家要錄), ChimGuTaeKIlPeonJip(鍼灸澤日編集), etc., was investigated. The purpose of SikRyoChanYo(食療贊要) was to describe the food therapeutics before using drugs for treatment of diseases and stress the prevention of illness using foods. Second, he mentioned the science of breeding of plants and the method of food storage in his writing, SanGaYoGok(山家要錄). In this writings, the method of preparing and processing foods, storage of foods, fermentation of foods, the science of breeding of plants, etc., was mentioned. So, he could be called as a scientist. Also, he stressed the importance of food in maintaining health and curing illness in this book. Third, he wrote the good and bad luck of time and the day of getting away from the bad luck when the acupuncture and moxibustion was performed. In ChimGuTaeKIlPeonJip(鍼灸澤日編集), he reflected together the energy changes of nature and body in performing therapeutics.

Acellular dermal matrix (Insuregraf) in the prevention of Frey's syndrome and surgical site depression after parotidectomy

  • Choi, Jangyoun;Park, Song I;Rha, Eun Young;Seo, Bommie Florence;Kwon, Ho;Jung, Sung-No
    • Archives of Craniofacial Surgery
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    • v.20 no.3
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    • pp.176-180
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    • 2019
  • Background: Parotidectomy is the treatment of choice in many parotid tumors. Due to the extensive nature of the procedure, unfavorable complications such as gustatory sweating, surgical site depression are common. Various techniques using fascia, muscle or AlloDerm have been developed but debate still remains regarding its availability and affordability. We applied a newly developed acellular dermal matrix (Insuregraf) to the parotidectomy field to act as a physical barrier and to provide adequate filling effect for prevention of functional and aesthetic complications. Methods: From March 2010 to March 2017, 30 patients with parotid tumors underwent superficial parotidectomy. Twenty patients underwent only superficial parotidectomy. Ten patients had Insuregraf applied to the surgical site after superficial parotidectomy. We evaluated the incidence of Frey's syndrome, surgical site depression, and patient satisfaction rate in both groups. Results: The incidence of Frey's syndrome was lower in the Insuregraf group (0 vs. 2). Surgical site depression was also lower in the Insuregraf group (2 vs. 20). Satisfaction score for facial contour in Insuregraf group was 9.2 out of 10, which was comparable to 6.2 out of 10 in the control group. Conclusion: Application of Insuregraf after superficial parotidectomy is an effective surgical procedure to prevent complications such as Frey's syndrome and surgical site depression. This technique is affordable and safe with no immune reactions. Above all this surgical method should be considered as an option for patients who are concerned about the contour of the face after surgery.