• Clinical and Experimental Pediatrics
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• 제50권7호
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• pp.606-612
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• 2007

Since the introduction of chemotherapy for the treatment of childhood leukemia more than 50 years ago, the results of childhood cancer have improved dramatically. The 5-year survival rate of disease, many of which were uniformly fatal in the prechemotherapy era, reached to more than 75%. This remarkable improvement in survival is a direct result of the incorporation of chemotherapeutics into treatment regimens that previously relied only on surgery or radiotherapy for the primary tumor. The multimodality approach, which integrates surgery and radiotherapy to control local disease with chemotherapy to eradicate systemic or metastatic disease, has become the standard approach to treating most childhood cancers. The overall improvement in outcomes in childhood solid tumors has been related to the development of multidisplinary cooperative studies that has permitted the development of well-designed tumor treatment protocols characterized by uniform staging criteria, sharing informations in pathologic classification, uniform methods for tumor markers, oncogenes, and other biologic and genetic factors. Important advances in the biologic study of cancer and its genetic basis led to a number of observations that impact directly on the management of childhood solid tumors. Identification of specific genes, oncogenes, tumor markers, and other biologic and pathologic factors plays an important role in both staging and clarifying the risk categorization of individual patients. Treatment of the patient is influenced by the recognition of specific risk factors. This knowledge has resulted in a change in the approach to care based not only on staging criteria, but also on risk-based management. This concept uses various risk factors of outcomes. Risk-based management allows for each patient to maximize survival, minimize long-term morbidity and improve the quality of life, especially for children's growth and development.

• 동의생리병리학회지
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• 제16권3호
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• pp.435-442
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• 2002

Phlegm is defined as the static fluid in excess in one or more parts of the body. It is not only a pathologic product but also a pathogen itself. However, as it says Phlegm is another title for the body fluid. phlegm can be physiological. In Hyungsang medicine. since the Hyungsang which an individual shows determines his or her illness. the principle to treat phlegm also varies according to the individual's Hyungsang. Thus, the author reviewed ‘Jisan’s Special Lectures for Clinicians’ and summarized the concepts and diagnostics of phlegm, and treatment and regimens by Hyungsang medicine. The concepts of phlegm : Phlegm is not only a pathologic product of disharmony of Jung(精), Ki(氣), Shin(神) and Hyul(血) but also a driving force to mature and transform these constituents. Phlegm is another designation for the Fluid. Phlegm can act as an alternative substance or buffering agent. If we describe our body as the habitat of worms. phlegm could be the inhabitant. Diagnostics of phlegm : The infraorbital areas have a dark-gray or blackish coloring. A man who is feminine or a woman who is masculine tends to develop phlegm. One of the major signs of phlegm is pain in Chungwan(中脘). The color of the skin does not change. Treatment of phlegm by Hyungsang medicine. For the Jung type(精科) and the Hyul type(血科), phlegm treatment is to supply Jung and Blood or eliminate Damp-phlegm. The man needs tonifying herbs and the woman needs herbs which promote the flow of Ki(氣). Children and the aged are. tegardless of the nature of disease, to be warmed and supplemented. For the heavy man. treatment is to supplement Ki and eliminate Damp; for the slim man. treatment is to supplement Yin(陰) and purge Heat.

• 한방안이비인후피부과학회지
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• 제27권2호
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• pp.1-13
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• 2014

Objective : The purpose of this study is to understand conspicuous features of geroderma with visceral manifestation theory(臟象論). Methods : We categorized skin aging into wrinkles, hyperpigmentation, dry skin and face flush. After investigating the reason, histological changes and mechanism of each classification in western medicine, we interpreted them according to the malfunction of five viscera(五臟) in Korean medicine. Result : The results are as follows. 1. Pathologic change of dermis and subcutaneous fat makes wrinkles. We consider wrinkles as the malfunction of the spleen(脾). 2. Irregular synthesis and disproportion of melanin makes hyperpigmentation. We consider hyperpigmentation as the malfunction of the liver(肝). 3. Dry skin is attributed to a subtle disorder of epidermal maturation. We consider dry skin as the malfunction of the lung(肺). 4. Facial flush is detected in rosacea and menopausal hot flush, which are both related with blood vessel abnormality. We consider facial flush as the malfunction of the heart(心) Conclusion : We interpreted the pathologic changes and mechanism of skin aging in western medicine as the decrease of five viscera(五臟) in visceral manifestation theory(臟象論) of Korean medicine. Further studies are needed to apply these hypothesis to clinical diagnosis and treatment.

• 대한두경부종양학회지
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• 제32권2호
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• pp.5-8
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• 2016

Background and Objectives: The aim of this study was to evaluate the safety and the feasibility of thyroidectomy for aged (${\geq}75$ years old) thyroid cancer by reviewing postoperative morbidity and pathologic characteristics. Materials & Methods: The clinical records of patients submitted to thyroid operation between 2014 and 2015 with histopathological diagnosis of thyroid cancer were analyzed. Clinical variables included age, gender, preoperative symptom, final pathology, length of stay, comorbidities, American Society of Anesthesiologists score, postoperative complications, and mortality. Results: There were 30 patients aged more than 75 years old, and only one patient passed over with postoperative pneumonia. There were 8 male and 22 female patients. Half of the patients presented with symptoms such as palpable mass (33.3%), voice change (6.7%) and dyspnea (6.7%). The pathologic diagnosis was thyroid cancer in all cases. The median postoperative hospitalization time was 4 days. There was one perioperative mortality case observed in this study. Conclusion: Thyroid surgery in patients 75 years or older can be performed except extensive surgical resection. Aggressive histology and extent of surgery may be an important factor of perioperative mortality and morbidity.

• 대한의생명과학회지
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• 제24권4호
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• pp.405-410
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• 2018

Stroke is a leading cause of death in the Korean population and remains a major health burden worldwide. The two main pathologic types of stroke are ischemic stroke and intracranial hemorrhage (ICH), but comparisons of risk factors for these have been limited. We under took a nationwide population-based study to analyze the relationship between these risk factor sand ischemic stroke and ICH. From January 2003 to December 2013, a total of 37,561 patients with newly diagnosed ischemic stroke or ICH were identified using the National Health Insurance Service data base as the study population. Multivariable logistic regression analysis was used to determine the association between baseline risk factors and presentation with ICH versus ischemic stroke. The incidence of ischemic stroke showed an increasing rend every year, while there was no significant change in the incidence of ICH. Of the several risk factors associated with stroke, old age (OR 2.35, 95% CI 2.12~2.49, P < 0.001) was more closely associated with ischemic stroke than ICH, whereas renal disease (OR 0.74, 95% CI 0.55~0.99, P = 0.04) and carotid disease (OR 0.25, 95% CI 0.17~0.35, P < 0.001) were more strongly associated with ICH. In addition, diabetes mellitus, dyslipidemia, hypertension, ischemic heart disease and male sex was associated with an increased risk of ischemic stroke. Old age was more strongly associated with ischemic stroke than ICH, while carotid stenosis and renal impairment were more closely associated with ICH risk. Classic risk factors for stroke have considerably different associations with the two main pathologic types of stroke.

• 대한치과의사협회지
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• 제51권2호
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• pp.84-91
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• 2013

Temporomandibular joint disorder(TMJD) was mainly characterized with joint pain, motion limitation, joint sound, resulted from pathologic conditions in temporomandibular joint and around tissue. As temporomandibular joint is one of decisive factors determining the occlusion, disorders in temporomandibular joint may cause the occlusal changes. The causes of occlusal changes related with TMJD can be classified into 2 categories; (1) those related to progression of disorder, 2) those related to treatment of the disorder. The clinical manifestation of occlusal changes depend on their causes and affected site. Therefore, whenever possible, treatment should be directed to the relief of the underlying causes, However, it is not always possible to relieve the underlying conditions. Moreover, some occlusal changes may remain irreversible even after the considerable improvement in clinical symptoms. Regarding the treatment of the permanent occlusal changes, it has been reported that the extensive occlusal treatment including occlusal adjustment, prosthodontic treatment, orthodontic treatment should be applied. Here, we present with a case report of occlusal change caused by the progressive temporomandibular joint disorder, together with introducing the intermaxillary traction appliance as the possible treatment option.

• Archives of Plastic Surgery
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• 제35권3호
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• pp.316-320
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• 2008

Purpose: Pachydermoperiostosis is a rare hereditary disease characterized by finger clubbing, periosteal reaction, and pachydermia. The underlying pathogenic mechanism of this disease remains unclear. This disease is known to be associated with a variety of diseases such as cranial suture defect, bone marrow failure, hypertrophic gastropathy, Crohn's disease, and female escuchen. Methods: A 50-year-old male had digital clubbing of both hands, coarse hypertrophic skin changes of face, progressive thickening and furrowing on the scalp(cutis verticis gyrata), persistent pain in the limbs and joints. Other cutaneous features include moderate blepharoptosis, pole-like lower legs and feet. Results: We performed surgical excision for hypertrophic skin change of scalp because of frequent eczematous skin change, severe itching sensation and cosmetic problem. Diagnosis is confirmed by bony proliferative periosteal reaction, pathologic findings, and characteristic clinical findings. Conclusion: Pachydermoperiostosis is manifested by finger clubbing, and hypertrophic skin changes causing coarse facial features with thickening and periosteal bone formation. We experienced a case of pachydermoperiostosis. Brief review of related literature is given.

• 대한상한금궤의학회지
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• 제8권1호
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• pp.67-85
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• 2016

Objectives: In this paper, two cases which showed the meaningful results on the patients' chief complaints were analyzed. The patients were treated with the Mahwang-Haengin-Gamcho-seokgo-tang herbal medication based on Shanghanlun disease pattern identification diagnostic system. Methods: The patients were diagnosed based on Shanghanlun, disease pattern identification diagnostic system. In case 1, the change of menstruation cycle was noted and pre-menstrual discomforts were measured with Menstrual Distress Questionnaire(MDQ). In case 2, Quality of life questionnaire for adult Korean asthmatics (QLQAKA) was used to estimate the quality of the patient's life. Results: All the symptoms were improved after the Mahwang-Haengin-Gamcho-seokgotang treatment. In case 1, the menstruation cycle decreased to 30 days average. MDQ score decreased 143 to 103. In case 2, the change of the QLQAKA score as 1.647 average point is considered as a meaningful improvement. Conclusion: With great difference to a 'Symptom-Medicine' diagnostic system, the disease pattern identification diagnostic system seeks the pathologic pattern through the patient's whole life. More studies and multiple cases based on the diagnostic system are needed to prove this possibility later.

• 대한정형외과 초음파학회지
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• 제2권2호
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• pp.99-106
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• 2009

상지의 말초신경 압박 병증의 진단은 환자의 병력 및 이학적 검사로 이환된 신경 및 부위를 임상적으로 짐작할 수 있지만 신경 압박 부위를 정확히 확인하기 위해서는 전기진단적 검사가 큰 도움이 된다. 대부분 증상의 초기에는 비 수술적 치료가 선행되지만 보존적 치료의 실패로 수술적 치료가 필요할 경우는 각 신경의 가능한 압박 부위 중 정확한 위치를 추정하는 것이 성공적인 수술의 시작이 된다. 또한 전기진단적 검사와 더불어 시행되는 근골격계 초음파 검사는 전기진단적 검사만으로는 진단이 어려운 공간 점유 병소(space occupying lesion; SOL)에 의한 말초신경 압박병증의 진단 및 신경의 해부학적 변화, 신경 내부 병변의 진단에 유용한 것으로 보고되고 있다. 성공적인 말초신경 압박병증의 치료를 위해서는 이러한 다양한 진단 방법을 동원하여 정확한 부위를 확인 후 효과적인 수술을 시행하는 것이 중요하다.

• Archives of Plastic Surgery
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• 제36권4호
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• pp.500-502
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• 2009

Purpose: Cutaneous lipomatous neurofibroma is a rare variant of neurofibroma. Histologically, it includes adipose tissue. As far as we aware, only 11 cases of this variant were reported which was predominantly on head, neck and trunk, so we present a case of left pretibial area with literature review. Method: A 17 - year old female who showed a non - tender, protruding $4{\times}4{\times}2cm$ sized mass on the left pretibial area for several months. We totally excised the mass including skin and the subcutaneous fat layer. Results: Pathologic report showed cutaneous lipomatous neurofibroma which was well circumscribed and noncapsulated neoplasm present with focal fatty change. Adipose cells were entrapped in the whirls of spindle cells. There were no lipoblasts or atypical adipocytes. Conclusion: A cutaneous lipomatous neurofibroma on the lower extremity is very rare. In our patient, there were no trauma - related histopathologic changes. Therefore, focal fatty change can be a consequence of metaplasia from multipotential neural cells after migration.