• Parasites, Hosts and Diseases
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• v.60 no.1
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• pp.25-34
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• 2022

Alveolar echinococcosis (AE) caused by infection with E. multilocularis metacestode, represents one of the most fatal helminthic diseases. AE is principally manifested with infiltrative, proliferating hepatic mass, resembling primary hepatocellular carcinoma. Sometimes metastatic lesions are found in nearby or remote tissue. AE diagnosis largely depends on imaging studies, but atypical findings of imaging features frequently require differential diagnosis from other hepatic lesions. Serological tests may provide further evidence, while obtaining reliable AE materials is not easy. In this study, alternative antigens, specific to AE were identified by analyzing E. granulosus protoscolex proteins. An immunoblot analysis of E. granulosus protoscolex showed that a group of low-molecular-weight proteins in the range from 14 kDa to 16 kDa exhibited a sensitive and specific immune response to AE patient sera. Partial purification and proteomic analysis indicated that this protein group contained myosin, tubulin polymerization promoting protein, fatty-acid binding protein, uncharacterized DM9, heat shock protein 90 cochaperone tebp P-23, and antigen S. When the serological applicability of recombinant forms of these proteins was assessed using enzyme-linked immunosorbent assay, DM9 protein (rEgDM9) showed 90.1% sensitivity (73/81 sera tested) and 94.5% specificity (172/181 sera tested), respectively. rEgDM9 showed weak cross-reactions with patient sera from the transitional and chronic stages of cystic echinococcosis (3 to 5 stages). rEgDM9 would serve as a useful alternative antigen for serodiagnosis of both early- and advanced-stage AE cases.

• Korean Journal of Transplantation
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• v.31 no.4
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• pp.193-199
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• 2017

Background: Although there more than 1,000 liver transplantations (LTs) are performed in Korea annually, their immense cost remains a great hurdle. Hence, in an attempt to reduce the medical costs of LT, a program was initiated at a public hospital affiliated with the Seoul National University Hospital. Methods: A total of 11 LTs have been successfully executed since the first LT performed at Seoul Metropolitan Government Seoul National University Boramae Medical Center in July 2011 through December 2014. Results: Nine patients (81.8%) were male and two (18.2%) were female. The mean age of patients was 53.4±11.4 years. Hepatitis B virus-related liver disease (n=6, 54.5%) was the most common causative disease, followed by alcoholic liver disease (ALD) (n=4, 36.4%). The actuarial 3-year survival rate was 90.9%. The median total medical cost of LTs was US $41,583 (calculated from operation to discharge), but only $11,860 was actually charged for patients with health insurance coverage. One female patient who had undergone deceased donor LT for alcoholic liver cirrhosis died during follow-up. This patient was non-compliant with the medical instructions after discharge, and finally expired due to septic shock at 10 months post-LT. Conclusions: In the public hospital, LT was successfully performed at a much lower cost. However, LT guidelines and peritransplant management protocols for patients with ALD must be established before escalating LT at public hospitals since ALD with poor compliance is one of the most common causes of complications at public hospitals.

• Journal of Digestive Cancer Research
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• v.5 no.1
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• pp.62-65
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• 2017

Pancreatic cancer is an aggressive disease and despite the efforts of the past few decades, the 5-year overall survival (OS) rate remains disappointing and does not exceed 10% in Korea. Especially, only 15-20% of patients are candidates for surgical resection because most patients are diagnosed with locally advanced or metastatic disease, and their only treatment approach is palliative chemotherapy. Since the first chemo-regimen of Gemcitabine and Nanoparticle albumin bound (nab) - paclitaxel was brought to clinical practice in 2013, the improvement in overall survival, progression-free survival, and response rate was achieved in patients with metastatic pancreatic adenocarcinoma. We report the case of a young patient with cardiogenic shock accompanied by multi-organ failure after 4^th cycle Gemcitabine and nab-paclitaxel chemotherapy with partial response.

• Quality Improvement in Health Care
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• v.30 no.1
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• pp.132-152
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• 2024

Purpose: This study aimed to identify and evaluate interprofessional education (IPE) interventions for healthcare professional students in East Asian countries. Methods: The reporting of this study followed the Preferred Reporting Items of Systematic Reviews and Meta-Analysis guidelines. A literature search was conducted using seven electronic databases: PubMed, EMBASE, CINAHL, Scopus, Web of Science, ERIC, and ProQuest Dissertations & Theses Global. Joanna Briggs Institute Critical Appraisal Checklists were also used to appraise the quality of the included studies. The outcomes of IPE interventions were classified based on a modified Kirkpatrick model. Results: This review included 30 studies predominantly conducted in Singapore, South Korea, and Taiwan. The prevalent research design was a one-group pre-posttest design, and most IPE interventions occurred as single events. Approximately 70% of the studies involved students from two healthcare professions, mainly nursing and medicine. Simulations, group discussions, and lectures have emerged as the most common teaching methodologies, with almost half of the studies leveraging a combination of these techniques. The IPE content primarily focused on interprofessional teamwork, communication, and clinical patient care situations; these included the management of septic shock. The effectiveness of the IPE interventions was mainly evaluated through self-reported measures, indicating improvements in attitudes, perceptions, knowledge, and skills, aligning with Level 2 of the modified Kirkpatrick model. Nonetheless, the reviewed studies did not assess changes in the participants' behavior and patient results. Conclusion: IPE interventions promise to enhance interprofessional collaboration and communication skills among health professional students. Future studies should implement rigorous designs to assess the effectiveness of IPE interventions. Moreover, when designing IPE interventions, researchers and educators should consider the role of cultural characteristics in East Asian countries.

• The Korean Journal of Medicine
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• v.99 no.4
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• pp.219-223
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• 2024

Emphysematous prostatitis with an abscess is an extremely rare but lethal infection, characterized by the accumulation of gas and purulent exudates. Due to its rarity, severity, and nonspecific presentation, prompt diagnosis and treatment are crucial to achieve favorable clinical outcomes. This report presents a 43-year-old male with hemodialysis-dependent end-stage kidney disease who reported a 3-day history of fever, urinary incontinence, dysuria, and dyspnea. His condition rapidly deteriorated due to septic shock caused by emphysematous prostatitis with an abscess. Following extensive treatment including long-term parenteral antibiotics, polymyxin B hemoperfusion filter treatment, abscess drainage via transurethral resection of the prostate, and suprapubic cystostomy, the patient successfully recovered.

• Journal of Korean Neurosurgical Society
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• v.30 no.8
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• pp.1042-1046
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• 2001

The incidence of paraplegia following drain of cerebrospinal fluid(CSF) by lumbar puncure below a spinal block is rare, and most of them occurred in spinal tumor. We report a case of acute paraplegia following lumbar puncture for computed tomography myelography(CTM) in a 42-year-old man who sustained a cervical disc herniation. Four hours after lumbar puncture for CTM, sudden paraplegia was developed. After emergent anterior cervical discectomy and fusion with cervical plating, the patient recovered completely. To the authors' knowledge, this is the first case of spinal shock complicating lumbar puncture for routine myelography in a patient with cervical disc herniation. The prompt recognition of this unusual complication of lumbar puncture may lead to good clinical outcome. Instead of CTM requiring lumbar puncture, MRI should be considered as the initial diagnostic procedure in a patient of cervical disc herniation associated with myelopathy. We discuss the possible mechanisms of acute paraplegia following lumbar puncture with literature review.

• Journal of Dental Rehabilitation and Applied Science
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• v.37 no.3
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• pp.171-176
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• 2021

Pneumomediastinum is a very rare and potentially catastrophic complication of dental procedures. Its common causes are tooth extraction, endodontic treatment, and subgingival curettage using handpieces and high-pressure air/water syringes. We present a case of massive pneumomediastinum with subcutaneous emphysema in a 61-year-old female who underwent bone grafting into the maxilla for pretreatment of dental implantation using a syringe. The patient suffered from abrupt severe odynophagia and loss of consciousness. The patient transferred to emergency department and images work-up revealed a pneumomediastinum and subcutaneous emphysema on the entire face and neck. We performed conservative treatments including prophylactic antibiotics, oxygen inhalation, and fasting meals, and then discharge after 7 days uneventfully. The patient's syncope might be resulting from hypotension and pain shock induced by pneumomediastinum with a sudden chest compression. The pneumomediastinum could be resulting from concurrent perforation and massive air infiltration into the maxillary sinus during bone grafting. We suggest that pneumomediastinum needs prompt diagnosis and management because of the risk of airway obstruction when a patient present syncope in the dental room.

• Journal of Chest Surgery
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• v.13 no.3
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• pp.198-205
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• 1980

Clinical observations were performed on 373 cases of chest trauma, those were admitted and treated at the Department of surrgery, Korea University Hospital, during the past 15 years period from August 1965 to June 1980. 1. The ratio of male to female patient of chest trauma was 4:1 in male predominence and age from 10 to 50 occupied 87.4 % of the total cases. 2. The most common cause of chest trauma was traffic accident in this series. One hundred and eight one cases (48.5%) were injuried by traffic accident and total cases due to blunt trauma (non-penetrating injury) were 282 cases (75.6%) including the cases with traffic accident, and remaining 91 cases (24.4%) were due to penetrating injury including 73 cases (19.6%) of stab wounds. 3. hemopneumothorax were observed in 49% (182 cases) of the total cases, and etiologic distribution revealed 72% due to non-penetrating trauma and 28% due to penetrating injury. 4. Rib fracture was found in 44.8% of cases. common injuries associated with rib fracture were lung, brain and liver. 5. Most common symptom was chest pain and respiratory difficulty, and common sign associated with chest injury was decreased respiratory sound and subcutaneous sound. 6. conservative non-operative treatment was performed in 281 cases (75.4%) and 92 cases (24.6%) were treated with operative treatment including 33 cases (8.9%) with open thoracotomy. 7. Overall mortality was 5.6% (21 cases) and most common cause of death were due to brain edema, cardiogenic shock, asphyxia.

• Clinical and Experimental Pediatrics
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• v.60 no.12
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• pp.408-412
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• 2017

Combined oxidative phosphorylation deficiency-17 (COXPD-17) is very rare and is caused by homozygous or compound heterozygous mutations in the ELAC2 gene on chromosome 17p12. The ELAC2 gene functions as a mitochondrial tRNA processing gene, and only 4 different pathogenic mutations have been reported in ELAC2-associated mitochondrial dysfunction involving oxidative phosphorylation. Affected patients show various clinical symptoms and prognosis, depending on the genotype. We report a novel mutation in the ELAC2 gene (c.95C>G [p.Pro32Arg], het), in an infant with COXPD-17 who presented with encephalopathy including central apnea and intractable epilepsy, and growth and developmental retardation. During hospitalization, consistently elevated serum lactic acid levels were noted, indicative of mitochondrial dysfunction. The patient suddenly died of shock of unknown cause at 5 months of age. This is the first case report of COXPD-17 in Korea and was diagnosed based on clinical characteristics and genetic analysis.

• The Journal of Korean Academy of Prosthodontics
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• v.38 no.3
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• pp.366-374
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• 2000

FRC/ceromer system provides the clinician with a durable, flexible, and esthetic alternative to conventional porcelain fused to metal crowns. FRC is the matrix which is silica-coated and embedded in a resin matrix. The ceromer material which is a second generation indirect composite resin contains silanized, microhybrid inorganic fillers embedded in a light-curing organic matrix. FRC/ceromer restoration has a several advantages: better shock absorption, less wear of occluding teeth, translucency, color stability, bonding ability to dental hard tissues, and resiliency. It has versatility of use including inlay, onlay, single crown, and esthetic veneers. With adhesive technique, it can be used for single tooth replacement in forms of inlay adhesion bridge. In single tooth missing case, conventional PFM bridge has been used for esthetic restoration. However, this restoration has several disadvantages such as high cost, potential framework distortion during fabrication, and difficulty in repairing fractures. Inlay adhesion bridge with FRC/ceromer would be a good alternative treatment plan. This article describes a cases restored with Targis/Vectris inlay adhesion bridge. Tooth preparation guide, fabrication procedure, and cementation procedure of this system will be dealt. The strength/weakness of this restoration will be mentioned, also. If it has been used appropriately in carefully selected case, it can satisfy not only dentist's demand of sparing dental hard tissue but also patient's desire of seeking a esthetic restorations with a natural appearance.