Objectives The purpose of this study is to design a research to find clinical factors involved in the decision-making process for determining the constitutional prescription based on prospective clinical data. Methods We have created a draft of the case report form. Therefore, seven constitutional experts was interviewed for additional items to be important used to determine the constitutional prescription in clinic. Interviews were done from December 2012 to March 2014, experts per person 2-3 times, took time of about 120 minutes per interview. Since then, we developed the final case report form through the expert meeting. At the same time, the developing the electronic case report form (eCRF) and the protocol to collect constitutional treatment cases was also discussed. Results & Conclusions The items of the case report form were subject general, lifestyle, health measurement, record of expert, prescription and evaluation after medication. The part of the clinical symptoms of the record of expert allowed to be recorded in the 5-point scale for the collection of quantitative data as much as possible. Assuming a re-visit of the patient, if necessary, twice the recording were to be possible. At the same time, the eCRF and the protocol to collect constitutional treatment cases were also developed. In this study, it will be able to more objectively standardize the medical decision making process that the experts of constitutional prescription decision. As a result, it will be possible to provide the standardized constitutional medical services.
Kim, Jae Woo;Shin, Ho Sung;Kim, Jun Hyuk;Park, Eun Soo;Tark, Min Sung
Archives of Plastic Surgery
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v.34
no.1
/
pp.128-130
/
2007
Purpose: Pnumosinus dilatans is a rare disease that one or more of the paranasal sinuses are dilatated without functional alteration. The most frequently involved sites are frontal and sphenoid sinus. Facial asymmetric contour is the most common signs and nasal obstruction and pain may be combined. The purpose of reconstruction of pneumosinus dilatans is two-fold, to re-establish a permanent pressure equilibrium of sinus and to correct the possible facial deformities. Methods: We present a case of a 24-year-old female with a 7-year history of protrusion of right malar region. Plane radiography and computed tomography detailed an abnormal expansion of the right maxillary sinus without thinning of bony wall, leading to diagnosis of maxillary pneumosinus dilatans. Surgical decompression and maxilloplasty were achieved by ostectomy of anterior wall of maxillary sinus and repositioning of removed bony fragment with miniplate. Results: Post operative course was uneventful without complication and malar height became symmetric by physical and radiologic examination. Conclusion: We corrected successfully pneumosinus dilatans of maxillary sinus by surgical decompression and maxilloplasty. For this case, we reviewed literature related to this topic.
Two cases of the discrete membranous subaortic stenosis were experienced at the Department of Thoracic & Cardiovascular Surgery, National Medical Center, Seoul, Korea. Case I was 31 years old male with a history of aortic valve replacement[Ionescu-Shiley, 19mm] at the other hospital in 1980. Heart failure was noticed 6 years later. On cardiac catheterization, pressure gradient between left ventricle 4 aorta was 104 mmHg, but subvalvular aortic stenosis was not detected by preoperative 2-D echo <% left ventriculogram. Above case revealed stenoinsufficiency of the prosthetic valve. Under the diagnosis of the prosthetic valve failure, re-do aortic valve replacement[Bjork-Shiley, 23 mm] was done. During operation, the discrete membranous subaortic stenosis was incidentally found, and it was completely resected. So we thought that above discrete membranous subaortic stenosis was not detected at first operation, and it was progressed during 6 years, and accelerated the degeneration of the prosthetic valve. Case II was 20 years old female. Her complaints were exertional dyspnea, angina, syncope, which were aggravated since 5 years ago. 2-D echo <% left ventriculogram revealed the discrete membranous subaortic stenosis. Pressure gradient was 20 mmHg, but her symptoms were serious. Associated cardiac anomaly was the persistent left superior vena cava without connection with right superior vena cava. Complete excision of the membranous tissue was done. Post-operative pressure gradient between left ventricle & aorta was absent, and her complaints were nearly subsided. Both cases were type I according to the Newfeld classification of the discrete subvalvular aortic stenosis, and complete excision of the membranous tissue was done without myotomy or mymectomy. And short-term follow-up results[Case I:2 years, Case II: 1 ~ years] were good except soft systolic murmur[grade II/VI] at the aortic area in both cases.
We experienced a case of cerebral hypoperfusion due to cyclosporine neurotoxocity confirmed only by Tc-99m ECD brain SPECT. A 53-year-old female had received allogenic peripheral blood stem cell transplantation due to refractory plasmacytoid lymphoma. Cyclosporine and steroid had been administrated to prevent graft versus host disease. Twenty days after transplantation, she became delirious and suffered from generalized tonic-clonic seizure. Immediately, brain MRI and MR angiography were performed and these studies did not show any abnormal findings. However, Tc-99m ECD brain SPECT showed diffuse hypoperfusion in the left cerebral hemisphere and blood cyclosporine level was 962.6 ng/ml. Cyclosporine administration was stopped and discontinuation of cyclosporine resulted in disappearance of all neurological symptoms. The same neurological symptoms recurred with cyclosporine re-administration for management of exacerbated graft versus host disease. In this case, Tc-99m ECD brain SPECT proved very helpful in the diagnosis of cycloporine neurotoxicity.
Objectives Obesity is one of the most important health problem in modern society and constant studies are still in progress domestically without the effective treatment so far. The objective of this study is to analyze the recent trend of the studies about obesity in oriental medicine and to provide background for further studies. Methods All of the articles in the journal of 'Korean oriental association for study of obesity' were collected published after 2006. Search were conducted through 'http://oasis.kiom.re.kr' and the journal of 'the Korean academy of oriental rehabilitation medicine'(January 2006~October 2010) with the search word "obesity". Collected articles were classified into clinical study, experimental study, literary study, case report. Results Total 177 articles were analysed. The number of studies were increasing until 2008 and went down afterwards. According to the classification by the type of study, percentage of clinical study took 45.2%, experimental study took 31.6%, literary study took 14.7%, case report took 8.5%. Conclusion Domestic clinical studies and experimental studies are conducted more focused on the treatment and diagnosis of obesity. Future study on the obesity should be focused on the prevention in the aspect of public health and social cost.
Kim, Eunju;Yi, Seung-Won;Oh, Sang-Ik;So, Kyoung-Min;Jung, Younghun;Lee, Han Gyu;Hong, Joon Ki;Cho, Eun Seok;Kim, Young-Sin;Hur, Tai-Young
Korean Journal of Veterinary Service
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v.44
no.4
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pp.291-297
/
2021
Severe outbreaks of porcine epidemic diarrhoea virus (PEDV) have continued to re-emerge worldwide. Because of the high mortality rate of suckling piglets in PEDV outbreaks, the disease causes significant economic losses in the pig industry. The limited pre-existing immunity against this virus is thought to cause an explosive increase in infection in pig farms. This study aimed to evaluate the clinical symptoms of PEDV after intentional exposure (feedback). During the first few days of the outbreak in a breeding pig farm, 14 sows showed watery diarrhoea, and the disease subsequently spread rapidly throughout the barn. Pigs that were intentionally exposed to PEDV (n=251) showed watery diarrhoea (46.6%), reduced appetite (17.5%), and vomiting (6.0%). However, 75 exposed pigs (29.9%) showed no clinical signs of disease. Four weeks after the feedback challenge, 34 sows gave birth to litters of piglets, which survived with no diarrhoea. Five weeks after the start of the outbreak, PEDV was not detected in any of the examined samples, including environmental swabs. Thus, early diagnosis, prompt establishment of herd immunity, and strict application of biosecurity are good practices to reduce the mortality rates among new-born piglets and control economic losses in pig farms showing PEDV outbreaks.
Sorafenib, originally identified as an inhibitor of multiple oncogenic kinases, induces ferroptosis in hepatocellular carcinoma (HCC) cells. Several pathways that mitigate sorafenib-induced ferroptosis confer drug resistance; thus strategies that enhance ferroptosis increase sorafenib efficacy. Orphan nuclear receptor estrogen-related receptor γ (ERRγ) is upregulated in human HCC tissues and plays a role in cancer cell proliferation. The aim of this study was to determine whether inhibition of ERRγ with DN200434, an orally available inverse agonist, can overcome resistance to sorafenib through induction of ferroptosis. Sorafenib-resistant HCC cells were less sensitive to sorafenibinduced ferroptosis and showed significantly higher ERRγ levels than sorafenib-sensitive HCC cells. DN200434 induced lipid peroxidation and ferroptosis in sorafenib-resistant HCC cells. Mechanistically, DN200434 increased mitochondrial ROS generation by reducing glutathione/glutathione disulfide levels, which subsequently reduced mTOR activity and GPX4 levels. DN200434 induced amplification of the antitumor effects of sorafenib was confirmed in a tumor xenograft model. The present results indicate that DN200434 may be a novel therapeutic strategy to re-sensitize HCC cells to sorafenib.
Background: Upfront surgery followed by systemic treatment is recommended to treat clinical stage I-IIA small cell lung cancer (SCLC), but data on the clinical outcomes are sparse. Thus, this study evaluated the stage migration and long-term prognosis of surgically treated clinical stage I-IIA SCLC. Methods: We retrospectively reviewed 49 patients with clinical stage I-IIA SCLC who underwent upfront surgery between 2000 and 2020. Additionally, we re-evaluated the TNM (tumor-node-metastasis) staging according to the eighth edition of the American Joint Committee on Cancer staging system for lung cancer. Results: The clinical stages of SCLC were cIA in 75.5%, cIB in 18.4%, and cIIA in 6.1% of patients. A preoperative histologic diagnosis was made in 65.3% of patients. Lobectomy and systematic lymph node dissection were performed in 77.6% and 83.7% of patients, respectively. The pathological stages were pI in 67.3%, pII in 24.5%, pIII in 4.1%, and pIV in 4.1% of patients. The concordance rate between clinical and pathological stages was 44.9%, and the upstaging rate was 49.0%. The 5-year overall survival (OS) rate was 67.8%. No significant difference in OS was found between stages pI and pII. However, the OS for stages pIII/IV was significantly worse than for stages pI/II (p<0.001). Conclusion: In clinical stage I-IIA SCLC, approximately half of the patients were pathologically upstaged, and OS was favorable after upfront surgery, particularly in pI/II patients. The poor prognosis of pIII/IV patients indicates the necessity of intensive preoperative pathologic mediastinal staging.
Park, Ji-Eun;Ahn, Eun kyoung;Jeong, Kyungsik;Lee, Siwoo
Journal of Sasang Constitutional Medicine
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v.34
no.2
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pp.1-14
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2022
Objectives The aim of this study was to investigate the change in Sasang constitution prediction value in 2 years and find the factors associated with it. Methods Cohort data from Korean medicine data center was used. Using Korean Sasang Constitutional Diagnostic Questionnaire (KS-15) which consist of questions related to body shape, temperament, and symptoms, participants were categorized into Tae-Yang (TY), Tae-Eum (TE), So-Yang (SY), and So-Eum (SE). Sasang constitution was assessed on the baseline and after two years. Result Total 5,784 participants were analyzed. (TE 3, 341; SE 911; SY 1,532). Among them, 1,402 participants (24.2%) showed different prediction value in KS-15 after two years. The proportion of participants showing different prediction value in two years was the highest in SY, and the lowest in TE group. The factors associated with the change in Sasang constitution prediction value were different by constitution type. The change in feeling after sweating was significantly associated with the change in prediction value in TE and SY groups, not in SE group. Although temperament was not significantly associated with the change in prediction value from TE to SE, it was significantly associated with that in the change from TE to SY. The change in BMI and appetite were associated with the change in constitution prediction value in all three constitution types. Conclusion Although the factors associated with the change in prediction value of Sasang constitution were different by each constitution type, BMI and appetite were significant in all three types. These factors could be useful for developing Sasang constitution questionnaire and deciding re-prediction needs of Sasang constitution. Further research about the factors related to Sasang constitution diagnosis need to be conducted.
Purpose: Maxillofacial trauma predominantly affects young adults between 20 and 40 years of age. Although radioprotection is a legal requirement, the significant potential of dose reduction in computed tomography (CT) is still underused in the clinical routine. The objective of this study was to evaluate whether maxillofacial fractures can be reliably detected and classified using ultra-low-dose CT. Materials and Methods: CT images of 123 clinical cases with maxillofacial fractures were classified by two readers using the AOCOIAC software and compared with the corresponding results from post-treatment images. In group 1, consisting of 97 patients with isolated facial trauma, pre-treatment CT images at different dose levels (volumetric computed tomography dose index: ultra-low dose, 2.6 mGy; low dose, <10 mGy; and regular dose, <20 mGy) were compared with post-treatment cone-beam computed tomography (CBCT). In group 2, consisting of 31 patients with complex midface fractures, pre-treatment shock room CT images were compared with post-treatment CT at different dose levels or CBCT. All images were presented in random order and classified by 2 readers blinded to the clinical results. All cases with an unequal classification were re-evaluated. Results: In both groups, ultra-low-dose CT had no clinically relevant effect on fracture classification. Fourteen cases in group 2 showed minor differences in the classification code, which were no longer obvious after comparing the images directly to each other. Conclusion: Ultra-low-dose CT images allowed the correct diagnosis and classification of maxillofacial fractures. These results might lead to a substantial reconsideration of current reference dose levels.
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