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1. The Medical Journal of Chosun University

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소아와 청소년에서 위의 장상피화생
고호준(Ho Joon Ko),장해인(Hae In Jang),조형민(Hyoung Min Cho),김은영(Eun Young Kim),김경심(Kyoung Sim Kim),김용욱(Yong Wook Kim),김령(Young Kim)
The Medical Journal of Chosun University 제46권 제1호/ 2021
1-4 (4 pages)
의약학>의학일반
초록보기
Background: The incidence of intestinal metaplasia(IM) of stomach mucosa in children was reported ranging from approximately 1 to 3 percent. But, clinical implications, treatment, long-term prognosis, and surveillance protocols of this finding are not well established in this population. Study Objectives: This study aimed to evaluate the relationship between Helicobacter pylori (HP) infection and IM, and the treatment and long-term consequences of IM. Methods: During 6.5 years from March 2013 through August 2019, endoscopy with CLO test and multiple non-targeted biopsies were performed on 423 children and adolescents, 1 to 20 years of age, with alarm features associated with ulcer disease and gastritis. The clinical and laboratory records, macroscopic and microscopic findings of endoscopy were reviewed retrospectively. Results: Thirty-two cases (7.6%) of IM were identified. Two cases (6.3%) with HP infection were detected in 32 cases of IM, and 38 cases (9.7%) in 391 cases of non-IM. The Odds ratio was 0.619 (0.142-2.693). Proton pump inhibitor (PPI) was prescribed for six months in all cases of IM, and endoscopic follow-up was performed after a year in 11 cases. The disappearance of IM was detected in 6 cases (18.8%). Conclusions: The association of HP infection and IM was very low. After six months of PPI medication, the disappearance of IM was detected in a few cases. A close and prolonged clinical and endoscopic follow-up is needed for children and adolescents with IM.
Background: Kidney transplantation donor still concerns about postoperative pain despite the development of techniques for reducing pain after donor nephrectomy. Transversus abdominis plane (TAP) block is effective for reducing abdominal postoperative pain. The purpose of the study was to evaluate the effect of TAP block on the postoperative pain of donor nephrectomy. Methods: This retrospective study was conducted by investigation of medical records of a single center. A total of 32 patients who underwent laparoscopic donor nephrectomy from 2007 to 2020 were assessed and divided into two groups: Group T (n=8), received a TAP block; Group N (n=24), did not receive a TAP block. Patient’s characteristics, hemodynamic change, resting pain intensity using NRS (numeric rating scale) and categorized NRS scale, total administered dose of fentanyl, and the incidence of analgesic requirement were assessed. Results: There were no significant differences in patient characteristics and hemodynamic data. The NRS significantly decreased (p=0.001) at the postanesthetic care unit and more patients showed mild pain (p= 0.006) on the first postoperative day after the TAP block. The incidence of additional analgesics requirement and the total administered dose of fentanyl showed no significant differences between the two groups. Conclusions: Acute pain at the PACU and the first postoperative day was significantly lower in the patient who received TAP block.
Real data on the causes and risk factors of hypoglycemia admitted to emergency department is needed to establish treatment decisions with physicians and to guide clinical practice but available data are limited. The purpose of this study was to evaluate the characteristics of hypoglycemic patients and was to identify risk factors of hypoglycemia admitted to emergency department. We retrospectively studied of 284 (140 male, 144 female) adults aged over 18 years who presented hypoglycemic symptom admitted to emergency department at Chosun University Hospital during from 2016 to 2020. Statistical analyses were performed separately to evaluate associated risk factors with hypoglycemia according to age and deleterious clinical outcome of hypoglycemia. In the age distribution of patients who visited the emergency department, the 70s were the most common (n=98, 34.5%). Mean creatine level of two groups (adult, elerly) are 1.3, 1.4 mg/dl and incidence of renal dysfunction of each group are 39, 40%. Sulfonylurea is more common cause of hypoglycemia in elderly patients. Non-diabetic causes tended to be more common in the younger patients and alcohol was the largest cause among them. The prognosis of hypoglycemia was worsening when the mental status of consciousness was deepening at the time of the emergency department visit. In conclusion, increased attention and implementation of precise strategies for treatment of hypoglycemic patient according to age is important. And clinical outcome of hypoglycemic encephalopathy depends on initial mental status of emergency department visit.
Heterogeneity of breast cancer has been a challenge for treatment. Many studies have been conducted to improve the treatment outcome through identification of this heterogeneity. Among identified biologic makers, estrogen receptor, progesterone receptor and human epidermal growth factor receptor-2 have been used importantly as not only treatment target but also predicting prognosis. Nowadays, neoadjuvant chemotherapy is commonly used in patients with advanced breast cancer at diagnosis. Herein, we report the case in the which breast cancer subtype was changed after neoadjuvant chemotherapy.
There are many options for the reconstruction of various body defects in size and location. The keystone flap is a new concept in the fasciocutaneous island types. The keystone flap is an easy and reliable flap for defects that are small or medium-sized with some depth and in which skin grafting is difficult. This study presents the reconstruction of several defects, from scalp to lower extremities, ranging in size and location, using the keystone flap in five patients (six flaps).
Introduction: The mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome is a rare congenital disorder of mitochondrial DNA. Recently, as the prognosis of MELAS syndrome patients improves due to the development of diagnosis and treatment technology, the number of cases is increasing. Case Presentation: In this report, we discussed a case of a 24-year-old man with clinical and radiological picture of MELAS syndrome resuscitating at cardiac arrest after status epilepticus. We would like to describe characteristic radiological features of MELAS syndrome in CT, MRI and ophthalmology finding and differential diagnosis. Conclusions: The rarity of this disorder and the complexity of its clinical presentation make MELAS patients among the most difficult to diagnose. We report a patient who was successfully resuscitated and treated following cardiac arrest due to recurrent status epilepticus.
Hepatocellular carcinoma arising in intrahepatic bile duct with no parenchymal liver lesion is rare. We report a case of 72-year-old female with hepatocellular carcinoma present within intrahepatic bile duct. It is present as isolated intraductal mass spread into the biliary tree. Nontumorous liver showed biliary proliferation and periductal fibrosis without parenchymal cirrhotic change.
Bowen disease (BD) is a squamous cell carcinoma in situ on sun exposed or protected skin. Epidermal cyst (EC) of the skin is a very common cutaneous lesion. BD occurs in EC very rarely. A 53-year-old Korean female was visited because of 2.2x1.4 cm hyperpigmented plaque on the right inguinal area. This lesion has been found 2-3 years ago and thickened recently. An excisional biopsy showed epidermal BD involving EC. On serial section, epidermal BD did not demonstrate communication with EC. Immunohistochemically, atypical squamous cells of the epidermis and EC were positive for pancytokeratin AE1/3, cytokeratin (CK)-5/6, Ki-67, p40, p53, p63, and p16. They were negative for CK7, CK20, Melan A, and HMB45. Radical excision by Mohs surgery with modified keystone flap was done. To the best of the author’s knowledge, this is the first case report of BD involving EC which is associated with HPV infection.
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