• Clinical and Experimental Pediatrics
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• 제54권1호
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• pp.6-10
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• 2011

Many patients assume that allergic reactions against foods are responsible for triggering or worsening their allergic symptoms. Therefore, it is important to identify patients who would benefit from an elimination diet, while avoiding unnecessary dietary restrictions. The diagnosis of food allergy depends on the thorough review of the patients's medical history, results of supplemented trials of dietary elimination, and in vivo and in vitro tests for measuring specific IgE levels. However, in some cases the reliability of such procedures is suboptimal. Oral food challenges are procedures employed for making an accurate diagnosis of immediate and occasionally delayed adverse reactions to foods. The timing and type of the challenge, preparation of patients, foods to be tested, and dosing schedule should be determined on the basis of the patient's history, age, and experience. Although double-blind, placebo-controlled food challenges(DBPCFC) are used to establish definitively if a food is the cause of adverse reactions, they are time-consuming, expensive and troublesome for physician and patients. In practice, An open challenge controlled by trained personnel is sufficient especially in infants and young children. The interpretation of the results and follow-up after a challenge are also important. Since theses challenges are relatively safe and informative, controlled oral food challenges could become the measure of choice in children.

• Tuberculosis and Respiratory Diseases
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• 제75권3호
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• pp.89-94
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• 2013

Pulmonary embolism (PE), which can originate as a consequence of deep vein thrombosis (DVT), is the most frequent and potentially fatal venous thromboembolic event. Despite the fact that the incidence of venous thromboembolism (VTE) in Asians is lower than that in the Western populations, a recent epidemiologic study demonstrates an increasing incidence of VTE in the Korean population. Anticoagulants, including low molecular weight heparin (LMWH) and vitamin K antagonist (VKAs), have been the main treatments for PE, however, recently new oral anticoagulants (NOACs) were introduced. We will review how well patients with PE can be managed with the existing anticoagulants and NOACs along with the time span of treatment, which still pose some challenges for clinicians.

• Journal of Preventive Medicine and Public Health
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• 제49권1호
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• pp.18-22
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• 2016

Ethical considerations are essential in planning for and responding to outbreaks of infectious diseases. During the outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) in the Republic of Korea in 2015, serious challenges emerged regarding important ethical issues, such as transparency and the protection of privacy. The development of bioethics in Korea has been influenced by individualistic perspectives applied in clinical contexts, leading to a paucity of ethical perspectives relevant to population-level phenomena such as outbreaks. Alternative theories of public health ethics include the perspectives of relational autonomy and the patient as victim and vector. Public health actions need to incorporate clear and systematic procedures founded upon ethical principles. The MERS-CoV epidemic in Korea created significant public support for more aggressive early interventions in future outbreaks. This trend makes it all the more imperative for ethical principles and procedures to be implemented in future planning and responses to outbreaks in order to promote perceptions of legitimacy and civic participation.

• Tuberculosis and Respiratory Diseases
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• 제81권2호
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• pp.91-98
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• 2018

When it comes to the use in inhalers in the management of chronic obstructive pulmonary diseases, there are many options, considerations and challenges, which health care professionals need to address. Considerations for prescribing and dispensing, administering and following up, education, and adherence; all of these factors impact on treatment success and all are intrinsically linked to the device selected. This review brings together relevant evidence, real-life data and practice tools to assist health care professionals in making decisions about the use of inhalers in the management of chronic obstructive pulmonary diseases. It covers some of the key technical device issues to be considered, the evidence behind the role of inhalers in disease control, population studies which link behaviors and adherence to inhaler devices as well as practice advice on inhaler technique education and the advantages and disadvantages in selecting different inhaler devices. Finally, a list of key considerations to aid health care providers in successfully managing the use of inhaler devices are summarized.

• 대한한방내과학회지
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• 제45권2호
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• pp.287-302
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• 2024

Background: Bronchiectasis is a chronic respiratory condition leading to recurrent respiratory infections. Despite the use of antibiotics and other standard treatments, managing bronchiectasis remains challenging due to the frequent recurrence of airway infections and concerns about antimicrobial resistance. Given these challenges, traditional Korean medicine (TKM) has gained attention due to its potential to reduce the frequency of respiratory infections, possibly minimizing the need for antibiotics. Case report: A 59-year-old female with bronchiectasis experienced recurrent pneumonia and was treated with antibiotics for over 2 weeks without any significant improvement in clinical symptoms. She received comprehensive Korean medicine treatment, including herbal medicine (Sikyungbanha-tang combined with Bigwabojungikki-tang-gami), acupuncture, and Chuna manual therapy, for pulmonary rehabilitation. Post-treatment, clinically meaningful improvements were observed in symptoms, serum C-reactive protein (CRP) levels, and bronchopneumonic lesions on chest X-rays. Conclusion: This case suggests that complex traditional Korean medicine treatments for recurrent chronic airway inflammation due to bronchiectasis can lead to clinically significant improvements in symptoms and help to prevent recurrence.

• 대한두경부종양학회지
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• 제39권2호
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• pp.1-6
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• 2023

The aging population, particularly those aged 65 and above, is on the rise, with projections indicating a substantial increase in the elderly demographic. This demographic shift brings challenges in managing age-related diseases, including head and neck cancers (HNCs). Frailty, often characterized by physiological decline and vulnerability to stressors, is a crucial factor affecting treatment outcomes of elderly cancer patients. Accordingly, the significance of assessing frailty in elderly HNC patients before their treatment should be emphasized, but current frailty assessment tools may not fully capture the unique challenges faced by HNC patients. Specific indicators, including respiratory and swallowing functions, are proposed for a more tailored assessment. This comprehensive review explores the impact of frailty on various treatment modalities, including surgery, radiation, and chemotherapy, highlighting the need for personalized interventions. Furthermore, it suggests avenues for future research to enhance frailty assessment tools and investigate interventions aimed at improving treatment outcomes in elderly HNC patients.

• Journal of Korean Neurosurgical Society
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• 제51권3호
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• pp.173-176
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• 2012

This report describes a rare case of postoperative hyperventilation attack after an endoscopic third ventriculostomy in a 46-year-old woman. About 60 min after the termination of the operation, an intractable hyperventilation started with respiratory rate of 65 breaths/min and $EtCO_2$, 16.3 mm Hg. Sedation with benzodiazepine, thiopental sodium, fentanyl, and propofol/remifentanil infusion was tried under a rebreathing mask at a 4 L/min of oxygen. With aggressive sedative challenges, ventilation pattern was gradually returned to normal during the 22 hrs of time after the surgery. A central neurogenic hyperventilation was suspected due to the stimulating central respiratory center by cold acidic irrigation solution during the neuroendoscopic procedure.

• Tuberculosis and Respiratory Diseases
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• 제59권6호
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• pp.591-599
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• 2005

Asthma is the most common disease of the lungs, and one that poses specific challenges for the physicians including radiologist. This article reviews for the clinical diagnosis, Radiologic features, and differential diagnosis of asthma, and outlines the radiologic features of the complications of asthma. Bronchial wall thickening and hyperinflation characterize the chest radiograph of the patients with asthma. On CT scan one may see airway wall thickening, thickened centrilobular structures, and focal or diffuse hyperlucency. Apparent bronchial dilatation may be seen, but the diagnosis of bronchiectasis should be made with caution. Quantification of changes in the airway wall and lung parenchyma may be valuable in understanding the mechanisms of asthma and in evaluating the effects of treatment. The challenge for the physician evaluating the images of a patient with asthma is to find complications.

• Journal of Trauma and Injury
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• 제30권3호
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• pp.107-111
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• 2017

The fat embolism syndrome (FES) represents a condition, usually with traumatic etiology, which may pose challenges to diagnosis while its treatment usually requires supportive measures in the intensive care units (ICUs). The clinical criteria, including respiratory and cerebral dysfunction and a petechial rash, along with imaging studies help in diagnosis. Here we present three case reports of young male who developed FES and were admitted to our ICUs after long bones fractures emerging after vehicle crashes and we briefly review FES literature. All patients' treatment was directed towards: 1) the restoration of circulating volume with fresh blood and/or plasma; 2) the correction of acidosis; and 3) immobilization of the affected part. All patients recovered and were released to the orthopedic wards. The incidence of cases of patients with FES admitted in our ICUs records a significant decrease. This may be explained in terms effective infrastructure reforms in Greece which brought about significant improvement in early prevention and management.

• 보건교육건강증진학회지
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• 제32권3호
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• pp.1-9
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• 2015

Objectives: The purpose of this article was to assess epidemiological characteristics and recommendations for strengthening national response and preparedness after MERS-CoV outbreak in Korea, 2015. Methods: The author reviewed epidemiological reports and policy recommendations on MERS-CoV outbreak in Korea, 2015. Results: There was no evidence that genetical difference between the MERS viruses in the Republic of Korea and recent viruses in the Middle East. From the index case to last laboratory-confirmed case, there were 186 laboratory-confirmed cases that included 36 deaths(19.4%), all of whom appear epidemiologically linked to the index cases or subsequent secondary, tertiary, and quaternary cases. This outbreak spread to hospitals through nosocomial transmission. At least, three large clusters were investigated. However, there was at least one case of community transmission of MERS-CoV. Several factors had contributed to the MERS outbreak in Korea, 2015 that including epidemiological characteristics, and infrastructure of national healthcare system for preventing and controlling emerging infectious diseases. Conclusions: It is very important that to share experiences and identify underlying causes of this outbreak for prevention and control of emerging infectious disease in the future; including epidemiology, clinical features, and public health response and preparedness.