• 의료법학
• /
• 제9권1호
• /
• pp.413-459
• /
• 2008

The Law has intervened to define rare circumstances in which a person should choose continuing life in United States. On the one hand, the law has traditionally acted to preservelife and to respect the sanctity of life. On the other hand, one's control over one's own body, and the right to determine what kind of medical care one will receive, is equally well respected and historically grounded. The competent patients have the right to forgo life-sustaining treatment, courts in United States have left many unanswered questions about the nature of that right. The right to choose to forgo life-sustaining treatment is a manifestation of a patient's autonomy interest. In United States, The Karen Quilan case gave rise to legislative activity in the host of state capitals, and several states had adopted statutes that formally recognized some forms of written directives describing some circumstances in which certain kinds of medical care could be terminated. These statues were sometimes dominated 'living will' acts, sometimes 'right to die' acts and ocasionally 'natural death' acts. Today virtually every state has produced a living will statue. In Korea, courts do not permit a terminally ill person to withhold or withdraw life-sustaining treatment. Living wills apply in case of terminal illness owing to a defect in legislation. Now In Korea, these lively dispute of legal policy on the preconditions and concrete procedure of living will act and natural death act. Through the legislation of living will act and natural death act, we should prepare some circumstances to respect patient's autonomy on the right to die. We should frame the cultural standard to make a decision of forgoing life-sustainin1g treatment under the discreet procedure.

• Journal of Chest Surgery
• /
• 제40권11호
• /
• pp.793-797
• /
• 2007

Communicating bronchopulmonary foregut malformation (CBPFM)은 매우 드문 선천성 기형으로 격리된 호흡계 조직과 식도 또는 위장 사이의 누관이 특징적이다. 원시위장관에서 기원한 부속의 폐조직이 모든 종류의 bronchopulmonary furegut malformation 발생의 중요한 요인이 된다. 반복되는 폐렴이 있는 환자의 chest X-ray에서 낭성 병변이 보인다면 CBPFM을 생각해봐야 하며, 진단적 방법으로 식도조영술, 기관조영술, 컴퓨터 단층촬영, 자기공명영상 그리고 혈관조영술 등이 도움이 된다. 치료는 수술적 제거가 권장되며 예후도 좋다. 좌측 완전 심낭결손증과 동반되었으며, 이중식도에 연결된 외엽성 폐격리증과 기관지성 낭종을 보인 CBPFM 1예를 보고한다.

• 대한세포병리학회지
• /
• 제16권1호
• /
• pp.52-56
• /
• 2005

Fine-needle aspiration cytology (FNAC) has been used extensively in the diagnosis of metastatic malignancies. However, metastatic soft tissue sarcomas are often overlooked, primarily due to the low frequency with/ which they occur. Here, we report a rare case of metastatic rhabdomyosarcoma in both cervical lymph nodes, which was detected by FNAC. A 45-year-old woman presented with anosmia, postnasal drip, and sneezing, symptoms which had persisted for 1 month. The patient was found to have a tumorous lesion at the upper portion of the mid-turbinate, with multiple enlarged cervical lymph nodes, and this lesion was examined closely at our facility. FNA cytology smears obtained from both cervical lymph nodes revealed a high degree of cellularity, and displayed cohesive clusters with gland-like spaces, as well as single isolated cells with abundant karyorrhectic debris. The tumor cells exhibited round to oval nuclei containing fine chromatin, occasional small nucleoli, and scanty cytoplasm, or a total lack of cytoplasm. Some of the tumor cells were arranged in multinucleated forms and abundant dense eosinophilic cytoplasms, reminiscent of a rhabdomyoblast. The histological findings on the lymph nodes revealed an outstanding sinusoidal infiltration and a prominent alveolar growth pattern, interspersed with occasional typical rhabdomyoblasts. The immunohistochemical results [desmin (+), myoglobin (+), myogenin (+), pan CK (-), synaptophysin (-), neuron specific enolase (-)] supported a confirmative diagnosis of alveolar rhabdomyosarcoma. Alveolar rhabdomyosarcoma is a representative sarcoma, which typically manifests with nodal metastasis and carcinoma-like clustering. The cytopathologist should remain alert upon encountering unusual morphology, so that the possibility of this condition, although somewhat remote, should not be dismissed or overlooked.

• 대한세포병리학회지
• /
• 제7권1호
• /
• pp.69-74
• /
• 1996

Malignant rhabdold tumor is a distinct renal tumor in the pediatric age group. It was originally described as a rhabdomyosarcomatold variant of Wilms' tumor. However, subsequent studies fatted to confirm myogenous differentiation, so it is now considered to be a distinct and unique type of highly malignant tumor, histogenetically unrelated. Although extrarenal forms of this tumor are rare, several examples have been described in other sites, especially the liver, prostate, paravertebral area, urinary bladder and soft tissue. We experienced a case of malignant rhabdiod tumor located in the intraabdominal cavity in a 10 month-old boy. Smear of peritoneal fluid showed round, polygonal and irregular shaped cells with large nuclei, ample cytoplasm containing light pink to purple cytoplasmic inclusions, and one or a few prominent nucleoli. Immunocytochemistry revealed positivity to cytokeratin, epithelial membrane antigen and vimentin, and negativity to desmin and neuron-specific enolase. These distinct cytologic appearance and immunophenotypes were most consistent with a diagnosis of extrarenal malignant rhabdoid tumor. The cytoplasmic inclusions were correlated with eosinophilic inclusions seen in histologic section and electron microscopy confirmed this interpretation, showing filamentous aggregations in the cytoplasms of the tumor cells.

• 한국환경복원기술학회지
• /
• 제13권1호
• /
• pp.14-23
• /
• 2010

The vascular plants in the Haksan, Jeonju were listed 394 taxa; 94 families, 260 genera, 339 species, 1 subspecies, 46 varieties and 8 forms. Divided into woody plants were 111 taxa (28.2%) and herbaceous plants were 283 taxa (71.8%). Based on the list of rare plants by the Korea Forest Service; Viola albida (Preservation priority order : No. 202), Korean endemic plants, 6 taxa were recorded; Lespedeza maximowiczii for. tomentella, Indigofera koreana, Weigela subsessilis, etc. Specific plant species by floral region were total 19 taxa (4.8% of all 394 taxa of vascular plants); Wistaria floribunda (Planted species) in class IV, Acer palmatum (Planted species) and Melothrua japonica in class III, Nymphoides indica in class II, 15 taxa (Botrychium virginianum, Hosta capitata, Salix glandulosa, Quercus variabilis, Rhynchosia acuminatifolia, Ilex macropoda, Impatiens nolitangere, Grewia biloba var. parviflora, Vaccinium oldhami and Lonicera praeflorens, etc.) in class I. The naturalized plants in the surveyed sites were 14 families, 30 genera, 32 taxa (Bromus rigidus, Rumex obtusifolius, Chenopodium ficifloium, Amaranthus lividus, Phytolacca americana, Lepidium apetalum, Amorpha fruticosa, Geranium carolinianum, Ailanthus altissima, Euphorbia supina, Oenothera biennis, Ipomoea purpurea, Veronica persica, Bidens frondosa, etc.) and naturalization rate was 8.1% of all 394 taxa of vascular plants. The ecosystem disturbing wild plants, Rumex acetocella, Aster pilosus and Ambrosia artemisiaefolia having manage to designation with Ministry of Environment.

• Clinics in Shoulder and Elbow
• /
• 제10권1호
• /
• pp.124-130
• /
• 2007

견봉쇄골 관절 탈구는 흔한 손상으로 심한 경우 대개 오구쇄골 인대의 파열이 동반된다. 견봉쇄골 관절 탈구에 드물게 오구쇄골 인대의 파열 없이 오구돌기 골절이 동반될 수 있다. 지금까지 31례만이 보고된 상기 손상을 저자들은 두 증례에서 경험하였기에 문헌 고찰과 함께 보고하고자 한다. 오구돌기 골절은 일반적으로 시행하는 전후방 방사선 촬영에서는 발견하기 쉽지 않다. 고도의 견봉쇄골 관절 탈구가 있으면서 오구쇄골 간격이 늘어나지 않은 경우 오구돌기의 골절을 의심할 수 있다.

• 대한두개안면성형외과학회지
• /
• 제17권3호
• /
• pp.173-175
• /
• 2016

Chondroid syringoma is a rare mixed tumor of the skin which is composed of both mesenchymal and epithelial cells. Its incidence at less than 0.1% and is frequently located on the head and neck. Chondroid syringoma is easily confused with epidermal cysts. Since malignant forms of chondroid syringoma have been reported, accurate and timely diagnosis is important for proper management. We report clinical and histological features of chondroid syringoma in 5 patients treated at our institution. In most of the cases, chondroid syringoma presented as a round, firm, nodular or cystic lesion that had well marginated heterogeneity in sonography. Clinically, all of the lesions were removed by simple excision. Microscopically, all five tumors were well circumscribed and consisted of epithelial, myoepithelial, and stromal components. The epithelial component formed tubules lined by one or more rows of eosinophilic epithelial cells. The outer layer of tubules appeared to be flattened myoepithelial cells. The stroma is myxoid and contained spindle shaped myoepithelial cells. We expect that the clinical, sonographic, and histological data from our report may help clinicians who are confronted with various kinds of analogous facial lesions to decide the most proper management for their patients.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제18권4호
• /
• pp.647-651
• /
• 1996

Langerhans cell histiocytosis(LCH) appears to arise from Langerhans cell and comprises a spectrum of clinical disease previously described in the literature by a variety of eponyms including histiocytosis X, eosinophilic granuloma, Hand-Schuller-Christian disease, and Letterer-Siwe syndrome. This rare disorder occurs in all groups, predominently affecting children & young adults. LCH has a wide spectrum of clinical features. The differentiation of several forms of this disease is primarily a clinical and not a histologic one. The radiographic characteristics include the appearance of solitary "intraosseous" lesions, the multiplicity of "alveolar bone" lesions, the bone lesions, periosteal new bone formation, and slight root resorption. Prognosis of a single bone lesion, is known to be excellent. In contrast, disseminated disease has seen associated with a chronic course, a high rate of morbidity and late consequences, and possible mortality. Treatment of LCH remains problematic. Treatment of multisystem disease, where organ function is being compromised has generally been with high-dose systemic corticosteroids or multiple chemotherapy.

• 대한한의정보학회지
• /
• 제18권1호
• /
• pp.64-77
• /
• 2012

Donguibogam, Korea's cultural heritage and traditional Oriental medicine book listed in the World Heritage three years ago, is indeed great in its importance and value. Korea's posterity has sought treatment methods through the medical book and their researches on that book have continued. However, it is rare to make the concrete analysis on the medicines for prescriptions recorded in the book. In this study, we reviewed "Ears" in the Section "Bodily Appearance" among the five chapters of Donguibogam, and analyzed the 55 types of prescriptions for ear diseases, the medical characteristics, tastes, prime classification of medical herbs, and acupunctural effects, and the dosage forms depending on prescriptions. For insect-entering ear diseases and 20 kinds of a single-medicine prescription also, the treatments are presented in the book, but we presented the texts only and excluded them in the analysis. We also excluded overlapping prescriptions and adding and reducing prescriptions of the 55 prescriptions, and thus classified the left 42 proscriptions by dosage form. As a result: 1. With respect to medical characteristics, the medicine with warm characteristics reached 9 types(40.9%), the highest rate, followed by the medicine with cold characteristics 8 types (36.4%). 2. Concerning medical tastes, the medicine with bitter taste included 12 types (54.5%), the medicine with sour taste 10 types (45.5%), and the medicine with sweet taste 7 types (31.8%). It was unusual that of the 22 medicines used for multipurpose, no medicine with the taste was found. 3. For the acupunctural effects, the medicine with acupuncture effects for spleen medirian reached 12 types in total (54.5%). On the contrary, the medicine with the effects for pericardium meridian reached only one (4.5%) among the total of 22 medicines. 4. In the dosage form of 42 prescriptions, powder medicine was 15 types (35.7%), and decoction medicine was 14 (33.3%). Powder, dedoction, and pill medicines accounted for 90.4% of the total medicine type. It was found that in particular, for ear diseases powder medicine was used more frequently than decoction medicine.

• Journal of Oral Medicine and Pain
• /
• 제33권1호
• /
• pp.27-33
• /
• 2008

구강 캔디다증은 주요 기회감염 균주인 Candida 속(屬) 진균류에 의한 감염성 질환으로 구강점막에 발생하는 진균 감염 중 가장 흔하지만, 만성증식성(chronic hyperplastic type)이나 정중능형설염(median rhomboid glossitis)과 같이 드문 형태의 경우 오진의 가능성이 있고 효과적인 치료법의 결정도 어려운 경우가 있다. 본 증례에서는 만성증식성 구강 캔디다증 및 정중능형설염으로 진단된 환자에서 nystatin 처방에 효과적으로 반응하지 않아 fluconazole을 투여하여 증상의 경감과 치유를 보인 예를 보고하고자 한다.