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Office-Based Mitomycin-C Application to Prevent Postoperative Laryngeal Stenosis (술 후 후두협착을 예방하기 위한 외래에서의 Mitomycin-C의 반복 국소적용)

  • Jang, Jeon-Yeob;Lee, Gil-Joon;Son, Young-Ik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.20 no.1
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    • pp.36-41
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    • 2009
  • Background and Objectives: Topical administration of mitomycin-C (MMC) has been reported to reduce or delay scar formation in airway surgery. However, it is not infrequent to experience recurrent stenosis or adhesion of operative wound even after a meticulous MMC application during the laryngeal surgery. Therefore we aimed to evaluate the effectiveness of repeated postoperative MMC applications and the technical feasibility of MMC applications to the laryngeal wound at an outpatient clinic. Methods: We reviewed medical records of 13 consecutive patients who received office-based MMC applications after laryngeal airway surgery at Samsung Medical Center, Seoul, Korea. The patients were grouped into 3 categories according to the site of surgical wound and the purpose of MMC application; group I : supraglottic stenosis (n=5), group II : cordectomy and arytenoidectomy site granulation prevention (n=3), Group III : laryngeal web prevention (n=5). Outcomes in each group and adverse effects of repeated MMC applications were evaluated. Results: Office-based MMC application was successfully performed one to four times with a week interval for each patient. No significant complications were observed except slightly decreased mucosal wave in one female patient who received 4 times of MMC application at the anterior commissure of vocal fold. Repeated MMC applications at the outpatient clinic resulted in wide or acceptable supraglottic airway in group I, clean wound healing without granulation formation in group II, and negligible or no web formation at the anterior commissure in group III. Conclusion : Office-based topical administration of MMC to the larynx was technically feasible. Postoperative repeated MMC applications were effective to reduce recurrent stenosis or adhesion of supraglottic structures, to prevent granuloma formation after laser arytenoidectomy and glottic web formation after anterior commissure resection.

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Clinician Experience with Using Hypoallergenic Formulas to Treat Infants with Suspected Cow's Milk Protein Allergy: A Secondary Analysis of a Prospective Survey Cohort

  • Jesse Beacker;Jerry M. Brown;Jared Florio;Jessica V. Baran;Luke Lamos;Lea Oliveros;Jon A. Vanderhoof;Panida Sriaroon;Michael J. Wilsey
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.26 no.5
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    • pp.277-283
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    • 2023
  • Purpose: Cow's milk protein allergy (CMPA) is a common condition in infants, but little is known about healthcare providers' clinical experience treating infants with CMPA. To address this gap, we analyzed prospectively collected data from healthcare providers (HCPs) who treated infants under six months old with suspected CMPA using hypoallergenic formulas. The study focused on a commercial extensively hydrolyzed formula containing Lactobacillus rhamnosus GG (ATCC53103) (eHF-LGG) or a commercial amino acid formula (AAF). Methods: In this secondary analysis of prospectively collected survey data, 52 HCPs treated 329 infants under six months old with suspected CMPA using hypoallergenic formulas. A series of two de-identified surveys per patient were collected by HCPs to assess short-term symptom relief in the patients and HCP's satisfaction with the management strategies. The initial survey was completed at the initiation of treatment of CMPA, and the second survey was completed at a follow-up visit. Results: The majority of HCPs (87%) in the study were general pediatricians, and most saw 2 to 10 CMPA patients weekly. Results showed that clinicians reported satisfaction with treatment in 95% of patients in the EHF cohort and 97% of patients in the AAF cohort and achieved expected clinical results in 93% and 97% of patients using eHF and AAF, respectively. Furthermore, few patients were switched from the hypoallergenic formula once initiated. Conclusion: The study provides new insights into HCP perspectives on treating infants with CMPA and supports using hypoallergenic formulas to manage this condition. However, additional prospective controlled studies are needed to confirm these initial findings.

Death due to Aspergillus Tracheobronchitis: An Autopsy Case (아스페르길루스 기관기관지염에 의한 사망: 부검 1예)

  • You, Tack Kune;Choi, Byung Ha;Lee, Bong Woo;Choi, Young Shik
    • The Korean Journal of Legal Medicine
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    • v.42 no.4
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    • pp.164-167
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    • 2018
  • Aspergillus infection is the most common cause of death due to fungi in immunocompromised hosts. Aspergillus tracheobronchitis is an uncommon but severe form of invasive pulmonary aspergillosis, which is limited entirely or mainly to the tracheobronchial tree and can often be life-threatening. We report a case of a 54-year-old man who died from Aspergillus tracheobronchitis without an underlying disease. Autopsy revealed an extensive yellowish plaque adhering to the trachea and bronchial wall. The microscopic examination of the trachea and bronchus revealed septate branching hyphae of Aspergillus.

Pilot Study Results of a Longitudinal Integrated Clerkship in a Single Institution (일개 의과대학 장기추적통합임상실습 시범과정 운영경험과 고찰)

  • Yoon, Hyun Bae;Moon, Sang Hui;Myung, Sun-Jung;Park, Jun-Bean;Park, Wan Beom
    • Korean Medical Education Review
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    • v.20 no.1
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    • pp.15-19
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    • 2018
  • The longitudinal integrated clerkship is an innovative approach in medical education that emphasizes continuity as a key principle to provide student-centered experiences and learning. Seoul National University College of Medicine decided to adapt longitudinal integrated clerkships to the new curriculum beginning in 2018, and therefore conducted pilot studies in 2016 and 2017. This study aimed to analyze the program evaluation results of the two pilot programs and discuss issues related to the successful implementation of longitudinal integrated clerkships in Korea. We conducted a focus group interview with nine students who participated in the 2016 pilot program and 13 students who participated in the 2017 pilot program. We also conducted a focus group interview with 11 faculty members who either participated in the pilot program or will participate in the main program. From the 2016 experience, we found that it is not appropriate to assign each patient to a single student and let the students contact their patients personally for feasibility and safety reasons. In the 2017 pilot program, we assigned each patient to a group of students, which made it more feasible for the students to follow-up with their patients. The students were satisfied with their new experience of longitudinal patient follow-up and regular meetings in the pilot program. Faculty emphasized the importance of establishing the course objectives and holding an orientation for the students and the faculty. Further study is planned to evaluate the early outcomes of the main longitudinal integrated clerkship.

Telemedicine for Real-Time Multi-Consultation

  • Chun Hye J.;Youn HY;Yoo Sun K.
    • Journal of Biomedical Engineering Research
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    • v.26 no.5
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    • pp.301-307
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    • 2005
  • We introduce a new multimedia telemedicine system which is called Telemedicine for Real-time Emergency Multi-consultation(TREM), based on multiple connection between medical specialists. Due to the subdivision of medical specialties, the existing one-to-one telemedicine system needs be modified to a simultaneous multi-consulting system. To facilitate the consultation the designed system includes following modules: high-quality video, video conferenceing, bio-signal transmission, and file transmission. In order to enhance the operability of the system in different network environment, we made it possible for the user to choose appropriate data acquisition sources of multimedia data and video resolutions. We have tested this system set up in three different places: emergency room, radiologist's office, and surgeon's office. All three communicating systems were successful in making connections with the multi-consultation center to exchange data simultaneously in real-time.

A Bibliographic Study on Introduction to Medicine (Euihak-ipmun) in Joseon Dynasty (조선 간행 『의학입문』 판본에 대한 서지학적 연구)

  • Park, Hun-Pyeng
    • The Journal of Korean Medical History
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    • v.30 no.2
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    • pp.33-44
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    • 2017
  • Introduction to Medicine (Euihak-Ipmun), written by Lee Chun of the Ming Dynasty, is a comprehensive medical book brought to Joseon in the 1600s. It directly influenced many medical books written in the Joseon Dynasty of the same period, and became a major citation document of Dongui-Bogam. Introduction to Medicine became a major text for medical education in 1834 and has since been used as a clinical primer of Korean medicine. This article first examines the Joseon's era published version of Introduction to Medicine using documentation of the Diary of the Royal Secretariat (Seungjeongwon Ilgi), and a woodblock list. Based on these investigations, the reviewer examined the existing versions of the book, and focused on various characteristics for comparison. This article reveals facts which include : 1) All editions of Introduction to Medicine published at the present office are published by Jeolla-do provincial office (Jeolla-Gamyeong). 2) The first edition was published before 1636. 3) A finely produced version (Jeongganbon) was published around 1760. 4) The Jeongrijache-iron type publication was published around 1801.