1.A Case Report of Esophageal Involvement in Behcets Disease.
Cheol Hyeun JO ; Weon Yuong KIM ; Seung Oeuk LEE ; Bong Han YEUN ; Kwang Hyeun KIM ; Myuong Weon KANG ; Yeun Keun LIM ; Hyang Soon YEO ; Kyung Soo KIM
Korean Journal of Gastrointestinal Endoscopy 1998;18(2):197-201
Behcet's disease is a recurrent and multisystemic disorder which usually persists over many years and is classified under vasculitic syndrome. A classic triad in this disorder is composed of a recurrent oral ulcer, genital ulceration and uveitis. While intestinal Behcet's disease most commonly affects the ileoecal region, dysphagia associated with esophageal ulceration is very uncommon. A 34-year-old-female patient visited our hospital because of dysphagia, epigastric pain and fever. The patient had ulcers on the oral mucosa, soft palate and extemal genitalia. Multiple irregularly marginated ulcers surrounded with hyperemic edematous mucosa were found on the middle and distal esophagus and lesser curvature of the stomach by an esophagogastroduodenoscopic examination. The pathologic findings were non-specific ulcers with necrotizing vasculitis in the vulva and with suspicious vasculitis in the esophagus. So she was diagnosed to have a Behcets disease and was treated with steroid and sulfasalazine. In this study we report a case of esophageal involvement of Behcet's disease with a review of the literature.
Deglutition Disorders
;
Esophagus
;
Fever
;
Genitalia
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Humans
;
Mouth Mucosa
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Mucous Membrane
;
Oral Ulcer
;
Palate, Soft
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Stomach
;
Sulfasalazine
;
Ulcer
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Uveitis
;
Vasculitis
;
Vulva
2.Endoscopic Ligation Therapy for Upper Gastrointestinal Bleeding.
Bong Han YOON ; Won Yong KIM ; Chul Hyun CHO ; Seung Wook LEE ; Kwang Hyun KIM ; Myung Weon KWANG ; Yeun Keun LIM ; Hyang Soon YEO
Korean Journal of Gastrointestinal Endoscopy 1998;18(3):345-351
Upper gastrointestinal bleeding occurs so rapidly that emergency measures are required to avoid exsanguination. Many diseases cause bleeding from the gastrointestinal tract. Patients with upper gastrointestinal bleeding must be quickly assessed and resuscitated. An endoscopy is the diagnostic procedure of choice because of its high rate of accuracy and immediate therapeutic potential. An endoscopy however, must be performed only following adequate resuscitation and clinical assessment of the patient. Recently, reports have described the usefulness of endoscopic O-ring band ligation in the management of upper gastrointestinal bleeding. Endoscopic O-ring band ligation is mucosal ligation using intraluminal negative pressure with an elastic O-ring. We performed an emergency endoscopy in 3 patients who had massive or recurrent episodes of upper gastrointestinal bleeding, identified as having resulted from Dieulafoy lesion and Anisakiasis. We tried to perform an endoscopic ligation using an O-ring band, and were successful in achieving hemostasis. Our conclusion is that endoscopic ligation using an O-ring band can be used effectively to control active upper gastrointestinal bleeding resulting from Anisakiasis and a Dieulafoy lesion.
Anisakiasis
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Emergencies
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Endoscopy
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Exsanguination
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Gastrointestinal Tract
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Hemorrhage*
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Hemostasis
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Humans
;
Ligation*
;
Resuscitation
3.Isolated Double-Chambered Right Ventricle in a Young Adult.
Jung Gil PARK ; Han Jun RYU ; Yeun Su JUNG ; Ki Ju KIM ; Bong Ryeol LEE ; Byung Chun JUNG ; Hyunjae KANG
Korean Circulation Journal 2011;41(5):272-275
Double-chambered right ventricle (DCRV) is a rare congenital heart disorder in which the right ventricle is divided by an anomalous muscle bundle into a high pressure inlet portion and a low pressure outlet portion. We report a case of isolated DCRV without symptoms in adulthood, diagnosed through echocardiography, cardiac catheterization and cardiac magnetic resonance imaging.
Bays
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Cardiac Catheterization
;
Cardiac Catheters
;
Echocardiography
;
Heart
;
Heart Ventricles
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Humans
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Magnetic Resonance Imaging
;
Muscles
;
Young Adult
4.Laparoscopic versus Open Approaches for Sigmoid Colon and Rectal Cancer: Comparison of Intraoperative Carcinoembryonic Antigen Elevation.
Young Bong KWON ; Gyu Seog CHOI ; Soo Yeun PARK ; Soo Han JUN ; Jun Seok PARK ; You Seok JANG ; Hye Jin KIM
Journal of the Korean Society of Endoscopic & Laparoscopic Surgeons 2010;13(2):95-101
PURPOSE: Although the overall survival and recurrence rates after open or laparoscopic surgery for colorectal cancer are similar, the potential oncological benefits of laparoscopic surgery have not been established. This study compared the effects of the two surgical approaches (open and laparoscopic) on the intraoperative inferior mesenteric vein (IMV) carcinoembryonic antigen (CEA) levels in patients who were undergoing open or laparoscopic surgery for sigmoid colon and rectal cancer. METHODS: Between December 2005 and July 2008, a total of 37 patients were enrolled in this study. Twenty one patients underwent open surgery and 16 patients were operated on laparoscopically. The baseline peripheral CEA level was measured preoperatively. The IMV blood was taken before and after mobilization of the cancer-bearing bowel segment and the CEA levels in the two groups were compared. RESULTS: The baseline CEA levels in the peripheral vein were similar in the two groups. After mobilization, the overall CEA level was elevated. The median pre-mobilization CEA levels of the open and laparoscopic group were 2.3 (range: 1.2~3.7) ng/ml and 1.5 (range: 1.0~2.6) ng/ml, respectively. Hence, the degree of CEA elevation after mobilization was significantly higher in the open surgery group compared with that of the laparoscopic approach (4.2 vs. 1.6, respectively, p=0.004). CONCLUSION: The CEA levels measured from the IMV after mobilization were elevated to a lesser degree after laparoscopic mobilization of the cancer-bearing bowel segment, as compared with that of open surgery. However, the long term oncological effects need to be examined by conducting longer, larger scale studies.
Carcinoembryonic Antigen
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Colon, Sigmoid
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Colorectal Neoplasms
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Humans
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Laparoscopy
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Mesenteric Veins
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Recurrence
;
Veins
5.A Case of Trichobezoar in a Child Who Visited with Intermittent Abdominal Pain, Nausea and Vomiting.
Seung In AHN ; Jung Suk YOO ; Kyung Chang OH ; Bong Lim KIM ; Sung Sub KIM ; Yeun Ho KIM ; Jin Keun CHANG
Korean Journal of Pediatrics 2005;48(4):433-437
Bezoars are concretions commonly found in the stomach and small bowel, and four types of bezoars have been described based on their composition: trichobezoar, phytobezoar, lactorbezoar, and miscellaneous. Bezoars most often develop after gastric operations that alter the motility, emptying, and grinding of food in the stomach. Trichobezoars are most common in female children with normal gastrointestinal function and are usually associated with pica, mental retardation, and psychiatric disorders. Although uncommon, bezoars are a well-recognized cause of chronic abdominal complaints which, when undiagnosed, can result in serious complications including gastric ulceration, bleeding, perforation, intussusception and small bowel obstruction. Mortality rates of up to 30 percent have been reported in adults. Trichotillomania is behaviors surrounding hair-pulling, including stroking and playing with hair before pulling, or biting and swallowing the hair after it has been pulled(trichophagia). The most notorious of the medical sequelae of trichotillomania is the trichobezoar. We experienced a case of trichobezoar in an 11-year-old girl who frequently swallowed her hairs from age 4 years up to age 7 years, resulting in intermittent abdominal pain, nausea, and vomiting.
Abdominal Pain*
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Adult
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Bezoars*
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Child*
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Deglutition
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Female
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Hair
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Hemorrhage
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Humans
;
Intellectual Disability
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Intussusception
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Mortality
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Nausea*
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Pica
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Stomach
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Stomach Ulcer
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Stroke
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Trichotillomania
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Vomiting*
6.A Case of Chronic Neutrophilic Leukemia with Multiple Myeloma.
Kwang Hyeun KIM ; One Young KIM ; Cheol Hyeon JO ; Seung Oeuk LEE ; Bong Han YOON ; Myung Weon KANG ; Yeun Keun LIM ; Hyang Sun YEU ; Meung Hee LEE
Korean Journal of Hematology 1998;33(3):454-459
Chronic neutrophilic leukemia(CNL) is a rare disorder characterized by persistent neutrophilia of mature cell type without evidence of infection, hepatosplenomegaly, elevated neutrophil alkaline phosphatase score and the absence of Philadelphia chromosome We report a typical case of CNL with multiple myeloma(IgG-lambda type) in 68 years old female. Many neutrophils had toxic granule and vacuole. The peripheral blood smear showed neutrophlic leukocytosis(50,940/microliter, neutrophil 94%) with rare immature form. The cytogenetic study showed normal karyotype without Philadelphia chromosome. She was diagnosed as multiple myeloma with paraproteinemia, lytic bone lesion of skull, and immature plasma cells in bone marrow.
Aged
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Alkaline Phosphatase
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Bone Marrow
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Cytogenetics
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Female
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Humans
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Karyotype
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Leukemia, Neutrophilic, Chronic*
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Multiple Myeloma*
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Neutrophils
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Paraproteinemias
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Philadelphia Chromosome
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Plasma Cells
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Skull
;
Vacuoles
7.Surrogate decision making of chemotherapy consent: do we really provide informed consent of chemotherapy for patients?
Jung Hye KWON ; Sun Kyung BAEK ; Bong Seog KIM ; Su Jin KOH ; Hee Kyung AHN ; Joo Han LIM ; Chiyeon LIM ; Do Yeun KIM
The Korean Journal of Internal Medicine 2019;34(3):626-633
BACKGROUND/AIMS:
Despite increased demand for cancer patient's to make their own decisions based on an adequate understanding of what is involved in chemotherapy, the primary signing agent and the reasons for surrogate signing have not been appropriately evaluated.
METHODS:
The ethics committee of the palliative medicine subgroup of the Korean Cancer Study Group designed this study and solid cancer patients to whom chemotherapy was offered, from seven institutions, were evaluated. The details relating to surrogate's signing of chemotherapy consent were evaluated. Then, we analyzed the factors associated with surrogate's signing according to patient's demographics and characteristics related to chemotherapy consent.
RESULTS:
Surrogate's signing was noted for 20.7% (84/405) of patient and over half of surrogate signings were performed by the patients' son or daughter (60.7%). Two main reasons for surrogate signing were patient's incapacity (34.5%) and taking over authorization from patients (33.3%). The factors associated with more frequent surrogate's signing were absence of spouse, lower education level, outpatient, and when residents played a role as a principle provider of chemotherapy consent.
CONCLUSIONS
This study suggests the lack of patients' own decision making for chemotherapy in some situations. This ethical dilemma must be considered for adequately informed decision making for chemotherapy while ensuring the patients' autonomy is maintained.
8.The Reliability and Validity of Diagnostic Interview Schedule for Children Version IV-Korean Version (DISC-IV).
Soo Churl CHO ; Boong Nyun KIM ; Jae Won KIM ; Hyo Won KIM ; Hyun Jeong CHOI ; Sun Woo JUNG ; Young Hui YANG ; Dong Seon CHUNGH ; Bock Ja GO ; Bong Seog KIM ; Min Sup SHIN ; Han Ik YOO ; Hee Jeong YOO ; Dong Woo LEE ; Sang Eun LEE ; Jun Young LEE ; Jae Won LEE ; Seong Ill JEON ; Hee Yeun JUNG ; Jin Pyo HONG ; Jun Won HWANG ; Sung Hee HAN
Journal of the Korean Academy of Child and Adolescent Psychiatry 2007;18(2):138-144
OBJECTIVES: The aim of this study was to evaluate the reliability and validity of the Korean Version of the Diagnostic Interview Schedule for Children Version IV(DISC-IV), a highly structured diagnostic interview used to assess more than 30 psychiatric disorders in children and adolescents. METHODS: A total of 91 study subjects, including 67 subjects who visited the child and adolescent psychiatry outpatient clinic at our institution and 24 community-based subjects, were assessed using the Korean Version of the DISCIV. Clinical diagnosis was used as a gold standard for the examination of the validity of the DISC-IV. Forty-four of the study subjects were randomly selected for test-retest reliability measurement. RESULTS: The validity of the Korean Version of the DISC-IV showed kappa values ranging from 0.25 to 0.40 in the clinical sample and 0.65 to 1.00 in the community sample. The sensitivities varied according to the diagnostic categories, but the specificities were excellent for all diagnostic entities. CONCLUSION: The Korean Version of the DISC-IV showed good reliability and validity in Korean children and adolescents. The Korean Version of the DISC-IV might be a useful tool for assessing psychiatric disorders in children and adolescents.
Adolescent
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Adolescent Psychiatry
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Ambulatory Care Facilities
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Appointments and Schedules*
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Child*
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Diagnosis
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Humans
;
Reproducibility of Results*