Pub Date : 2021-01-31DOI: 10.12771/EMJ.2021.44.1.26
K. Cho, S. Kim, Ji Hyen Lee
{"title":"Acute Vulvar Ulcer (Lipschutz Ulcer) in a Sexually Inactive 11-Yearold Girl","authors":"K. Cho, S. Kim, Ji Hyen Lee","doi":"10.12771/EMJ.2021.44.1.26","DOIUrl":"https://doi.org/10.12771/EMJ.2021.44.1.26","url":null,"abstract":"","PeriodicalId":197820,"journal":{"name":"The Ewha Medical Journal","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122133234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-10-31DOI: 10.12771/emj.2020.43.4.60
H. Yun, Juhui Kim, S. Cho, E. Park, Y. J. Kim, Sunwha Park
Listeriosis is an infectious disease caused by Listeria monocytogenes. It’s rare in healthy adults, it could be fatal in pregnant women. Listeriosis in pregnant women causes fever and flu-like symptoms, but could lead to fatal consequences. However, because there are few cases of listeriosis reported in Korea, the symptoms are ambiguous and the standard diagnostic tool has yet to be determined, making accurate diagnosis difficult. We present a case of a 35-year-old pregnant woman who had fever and headache. Ini-tially, we didn’t find the cause of fever. However, after delivery, L. monocytogenes was detected in the neonatal gastric aspirate culture, blood cultures. The placenta and amniotic membrane showed acute suppurative inflammation and chorioamnionitis. The mother recovered after antibiotic treatment and delivery, but in the case of the newborn baby, the patient died despite treatment. We report a case of listeriosis in a pregnant woman and a neonate with literature review. (Ewha Med J 2020;43(4):60-64)
{"title":"Listeriosis in a Pregnant Woman and a Neonate","authors":"H. Yun, Juhui Kim, S. Cho, E. Park, Y. J. Kim, Sunwha Park","doi":"10.12771/emj.2020.43.4.60","DOIUrl":"https://doi.org/10.12771/emj.2020.43.4.60","url":null,"abstract":"Listeriosis is an infectious disease caused by Listeria monocytogenes. It’s rare in healthy adults, it could be fatal in pregnant women. Listeriosis in pregnant women causes fever and flu-like symptoms, but could lead to fatal consequences. However, because there are few cases of listeriosis reported in Korea, the symptoms are ambiguous and the standard diagnostic tool has yet to be determined, making accurate diagnosis difficult. We present a case of a 35-year-old pregnant woman who had fever and headache. Ini-tially, we didn’t find the cause of fever. However, after delivery, L. monocytogenes was detected in the neonatal gastric aspirate culture, blood cultures. The placenta and amniotic membrane showed acute suppurative inflammation and chorioamnionitis. The mother recovered after antibiotic treatment and delivery, but in the case of the newborn baby, the patient died despite treatment. We report a case of listeriosis in a pregnant woman and a neonate with literature review. (Ewha Med J 2020;43(4):60-64)","PeriodicalId":197820,"journal":{"name":"The Ewha Medical Journal","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121541182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-10-31DOI: 10.12771/emj.2020.43.4.65
Ji Yun Yun, Jung Eun Choi, H. Kim, K. Ryu
Diamond-Blackfan anemia (DBA) is a rare, inherited bone marrow failure syndrome that manifests as anemia in early infancy. Blood transfusion is a critical factor for surviv-al. However, blood transfusions can result in iron overload. Endocrinopathies, hepatic cirrhosis, and cardiomyopathy are the most common complications of iron overload. Here, we report the case of an 18-year-old boy with DBA with hyperglycemia, short stature, and absence of puberty. The patient showed endocrine dysfunction associated with iron overload caused by repeated transfusions. He was eventually diagnosed with acquired hypopituitarism and was placed on testosterone replacement therapy. Endocrine dysfunction is common in patient with DBA, with an early manifestation of symptoms, even in teenage years. Patients receiving corticosteroid treatment or those in re-mission may also exhibit endocrine dysfunction, although its prevalence is the highest among chronic transfusion patients. Ongoing monitoring and evaluation of growth and pubertal development are needed for better management of these disorders. (Ewha Med J 2020;43(4):65-69)
{"title":"Acquired Hypopituitarism in Diamond-Blackfan Anemia","authors":"Ji Yun Yun, Jung Eun Choi, H. Kim, K. Ryu","doi":"10.12771/emj.2020.43.4.65","DOIUrl":"https://doi.org/10.12771/emj.2020.43.4.65","url":null,"abstract":"Diamond-Blackfan anemia (DBA) is a rare, inherited bone marrow failure syndrome that manifests as anemia in early infancy. Blood transfusion is a critical factor for surviv-al. However, blood transfusions can result in iron overload. Endocrinopathies, hepatic cirrhosis, and cardiomyopathy are the most common complications of iron overload. Here, we report the case of an 18-year-old boy with DBA with hyperglycemia, short stature, and absence of puberty. The patient showed endocrine dysfunction associated with iron overload caused by repeated transfusions. He was eventually diagnosed with acquired hypopituitarism and was placed on testosterone replacement therapy. Endocrine dysfunction is common in patient with DBA, with an early manifestation of symptoms, even in teenage years. Patients receiving corticosteroid treatment or those in re-mission may also exhibit endocrine dysfunction, although its prevalence is the highest among chronic transfusion patients. Ongoing monitoring and evaluation of growth and pubertal development are needed for better management of these disorders. (Ewha Med J 2020;43(4):65-69)","PeriodicalId":197820,"journal":{"name":"The Ewha Medical Journal","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114660084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-10-31DOI: 10.12771/emj.2020.43.4.53
J. Kim, Ji Hyen Lee, Hyun-Hae Cho, H. Kim
Objectives: To investigate brain magnetic resonance imaging (MRI) findings in patients with central precocious puberty (CPP) by age at onset and sex. Methods: We included 130 CPP patients with brain MRI findings of the pituitary gland treated at Ewha Womans University Mokdong Hospital between February 2007 and October 2013 and divided them by age and sex: boys, girls aged ≤6 years, and girls aged >6 years. The control group comprised 224 patients who underwent brain MRIs, and we compared their incidental brain findings with those of the CPP group. Results: In the CPP subgroups who underwent pituitary MRIs, the frequency of incidental brain lesions was 31.6% in boys, 47.1% in girls ≤6 years and 29.8% in girls >6 years. The incidence of pituitary abnormalities was 42.1% in boys, 64.7% in girls ≤6 years and 47.9% in girls >6 years. Among pituitary abnormalities, pituitary hypoplasia had a significantly higher incidence rate in girls ≤6 years (41.2%) than in boys (15.8%) or girls >6 years (13.8%, P=0.027). Hypothalamic hamartomas were detected in one girl aged ≤6 years and in one boy, but not in girls aged 6 years (P=0.075). The incidence of pineal cysts was higher in the CPP groups and significantly higher in girls ≤6 years (47.1%) than in the control group (11.2%, P=0.001). Conclusion: There was a higher incidence of brain abnormalities on pituitary MRIs and a higher incidence of pineal cysts, possibly associated with CPP pathogenesis, in younger CPP patients than in other patients. (Ewha Med J 2020;43(4):53-59) Received June 25, 2020 Revised July 30, 2020 Accepted August 24, 2020
目的:探讨中枢性性性早熟(CPP)患者在发病年龄和性别上的脑磁共振成像(MRI)表现。方法:纳入2007年2月至2013年10月在梨花女子大学木洞医院接受治疗的130例脑垂体MRI检查的CPP患者，按年龄和性别分为男孩、≤6岁的女孩和>6岁的女孩。对照组包括224名接受脑核磁共振成像的患者，我们将他们的偶然脑发现与CPP组的结果进行了比较。结果:在接受垂体mri检查的CPP亚组中，偶发脑损伤的发生率在男孩中为31.6%，在女孩≤6岁中为47.1%，在女孩>6岁中为29.8%。垂体异常发生率男生为42.1%，女生≤6岁为64.7%，女生>6岁为47.9%。在垂体异常中，女童≤6岁的发病率(41.2%)明显高于男童(15.8%)和女童>6岁的发病率(13.8%，P=0.027)。6岁以下女童1例，男童1例，6岁女童未见下丘脑错构瘤(P=0.075)。CPP组的松果体囊肿发生率高于对照组(11.2%，P=0.001)，且≤6岁女童的松果体囊肿发生率显著高于对照组(47.1%)。结论:与其他患者相比，年轻CPP患者垂体mri显示脑异常的发生率更高，松果体囊肿的发生率更高，可能与CPP的发病机制有关。(Ewha Med J 2020;43(4):53-59)收稿2020年6月25日修稿2020年7月30日收稿2020年8月24日
{"title":"Incidental Findings on Brain Magnetic Resonance Imaging in Children with Central Precocious Puberty","authors":"J. Kim, Ji Hyen Lee, Hyun-Hae Cho, H. Kim","doi":"10.12771/emj.2020.43.4.53","DOIUrl":"https://doi.org/10.12771/emj.2020.43.4.53","url":null,"abstract":"Objectives: To investigate brain magnetic resonance imaging (MRI) findings in patients with central precocious puberty (CPP) by age at onset and sex. Methods: We included 130 CPP patients with brain MRI findings of the pituitary gland treated at Ewha Womans University Mokdong Hospital between February 2007 and October 2013 and divided them by age and sex: boys, girls aged ≤6 years, and girls aged >6 years. The control group comprised 224 patients who underwent brain MRIs, and we compared their incidental brain findings with those of the CPP group. Results: In the CPP subgroups who underwent pituitary MRIs, the frequency of incidental brain lesions was 31.6% in boys, 47.1% in girls ≤6 years and 29.8% in girls >6 years. The incidence of pituitary abnormalities was 42.1% in boys, 64.7% in girls ≤6 years and 47.9% in girls >6 years. Among pituitary abnormalities, pituitary hypoplasia had a significantly higher incidence rate in girls ≤6 years (41.2%) than in boys (15.8%) or girls >6 years (13.8%, P=0.027). Hypothalamic hamartomas were detected in one girl aged ≤6 years and in one boy, but not in girls aged 6 years (P=0.075). The incidence of pineal cysts was higher in the CPP groups and significantly higher in girls ≤6 years (47.1%) than in the control group (11.2%, P=0.001). Conclusion: There was a higher incidence of brain abnormalities on pituitary MRIs and a higher incidence of pineal cysts, possibly associated with CPP pathogenesis, in younger CPP patients than in other patients. (Ewha Med J 2020;43(4):53-59) Received June 25, 2020 Revised July 30, 2020 Accepted August 24, 2020","PeriodicalId":197820,"journal":{"name":"The Ewha Medical Journal","volume":"80 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131660111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-31DOI: 10.12771/emj.2020.43.3.39
Hae-Sun Chung, N. Yang, Y. Kim, Miae Lee, Sholhui Park
Objectives: The Xpert Carba-R Assay is a diagnostic test designed for the rapid detection and differentiation of the bla KPC , bla NDM , bla VIM , bla OXA-48 , and bla IMP-1 genes. We verified the performance of Xpert Carba-R Assay for identification of carbapenemase gene in the clinical microbiology laboratory. Methods: The analytical limit of detection was determined with two suspensions of carbapenemase-producing Enterobacteriaceae (CPE) isolates (KPC and NDM). A total of 52 specimens were evaluated: 21 bacterial isolates from clinical specimens, 21 rectal swabs, and 10 contrived stool specimens. Results: In bacterial isolates, concordant results between the Xpert Carba-R Assay and PCR were found in 20 of 21; 8 KPC, 8 NDM, 1 IMP, and 2 multiple carbapenamase genes (KPC/NDM, NDM/OXA) were detected both by Xpert Carba-R Assay and PCR. In one GES-positive isolate, Xpert Carba-R Assay showed a negative result as expected. One VIM-positive isolate tested negative by Xpert Carba-R Assay. Complete concordance was seen in rectal swab specimens: 4 specimens with KPC and 17 specimens with negative results both by Xpert Carba-R Assay and surveillance culture. Among the 10 contrived stool specimens, Xpert Carba-R Assay detected carbapenemase genes in 9 specimens as expected according to the CPE strains spiked into the contrived stool; 2 KPC, 4 NDM, 1 IMP, and 2 multiple carabapenamase genes (NDM/KPC, NDM/OXA). One VIM-positive specimen tested negative by Xpert Carba-R Assay. Conclusion: In conclusion, the Xpert Carba-R Assay can be used to identify carbapenemase gene in bacterial isolates cultured from clinical specimens and detect CPE carrier using rectal swab in clinical laboratories. (Ewha Med J 2020;43(3):39-42)
{"title":"Performance of Xpert Carba-R Assay for Identification of Carbapenemase Gene in the Clinical Microbiology Laboratory","authors":"Hae-Sun Chung, N. Yang, Y. Kim, Miae Lee, Sholhui Park","doi":"10.12771/emj.2020.43.3.39","DOIUrl":"https://doi.org/10.12771/emj.2020.43.3.39","url":null,"abstract":"Objectives: The Xpert Carba-R Assay is a diagnostic test designed for the rapid detection and differentiation of the bla KPC , bla NDM , bla VIM , bla OXA-48 , and bla IMP-1 genes. We verified the performance of Xpert Carba-R Assay for identification of carbapenemase gene in the clinical microbiology laboratory. Methods: The analytical limit of detection was determined with two suspensions of carbapenemase-producing Enterobacteriaceae (CPE) isolates (KPC and NDM). A total of 52 specimens were evaluated: 21 bacterial isolates from clinical specimens, 21 rectal swabs, and 10 contrived stool specimens. Results: In bacterial isolates, concordant results between the Xpert Carba-R Assay and PCR were found in 20 of 21; 8 KPC, 8 NDM, 1 IMP, and 2 multiple carbapenamase genes (KPC/NDM, NDM/OXA) were detected both by Xpert Carba-R Assay and PCR. In one GES-positive isolate, Xpert Carba-R Assay showed a negative result as expected. One VIM-positive isolate tested negative by Xpert Carba-R Assay. Complete concordance was seen in rectal swab specimens: 4 specimens with KPC and 17 specimens with negative results both by Xpert Carba-R Assay and surveillance culture. Among the 10 contrived stool specimens, Xpert Carba-R Assay detected carbapenemase genes in 9 specimens as expected according to the CPE strains spiked into the contrived stool; 2 KPC, 4 NDM, 1 IMP, and 2 multiple carabapenamase genes (NDM/KPC, NDM/OXA). One VIM-positive specimen tested negative by Xpert Carba-R Assay. Conclusion: In conclusion, the Xpert Carba-R Assay can be used to identify carbapenemase gene in bacterial isolates cultured from clinical specimens and detect CPE carrier using rectal swab in clinical laboratories. (Ewha Med J 2020;43(3):39-42)","PeriodicalId":197820,"journal":{"name":"The Ewha Medical Journal","volume":"192 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129318668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-31DOI: 10.12771/emj.2020.43.3.49
Youbin Jo, Heeseung Lee, Soo In Kim, Dong Yeon Kim, H. Baik, R. K. Chung
Some patients with depression require electroconvulsive therapy performed under general anesthesia. This requires rapid loss of consciousness, with minimal interference from seizure activity, appropriate muscle relaxation status, prevention of hyperdynamic responses to the electrical stimulus, and proper recovery of spontaneous ventilation and consciousness. The authors report the first case of electroconvulsive therapy performed with the patient under general anesthesia at the University
{"title":"Anesthetic Management during Electroconvulsive Therapy","authors":"Youbin Jo, Heeseung Lee, Soo In Kim, Dong Yeon Kim, H. Baik, R. K. Chung","doi":"10.12771/emj.2020.43.3.49","DOIUrl":"https://doi.org/10.12771/emj.2020.43.3.49","url":null,"abstract":"Some patients with depression require electroconvulsive therapy performed under general anesthesia. This requires rapid loss of consciousness, with minimal interference from seizure activity, appropriate muscle relaxation status, prevention of hyperdynamic responses to the electrical stimulus, and proper recovery of spontaneous ventilation and consciousness. The authors report the first case of electroconvulsive therapy performed with the patient under general anesthesia at the University","PeriodicalId":197820,"journal":{"name":"The Ewha Medical Journal","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121950644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-31DOI: 10.12771/emj.2020.43.3.43
Sholhui Park, Wookeun Lee, Tae-Dong Jeong, Hae-Sun Chung, K. Hong
Objectives: Six sigma is a quality management system for the assessment of precision and accuracy. We aim to apply the six sigma rule to quality control (QC) of point-of-care (POC) glucose meters in a tertiary hospital. Methods: Thirty POC glucose meters installed at Ewha Womans University Mokdong Hospital were monitored between January 2013 and March 2014. The QC data from the POC glucose meters at low and high levels were collected. The monthly mean, standard deviation, bias, coefficient of variation, and mean sigma metrics were calculated. The correlation between accuracy and precision was assessed based on the percentage bias and coefficient of variation. Comprehensive instructions on the QC and maintenance of the devices were provided in the departments with poor sigma scores. A follow-up assessment was performed after the intervention. Results: The mean sigma values for the low and high controls were 3.29 and 3.71, respectively. At the low and high controls, 36.6% and 10% of the glucose meters showed a sigma value <3. The causes of low sigma values included the use of expired control materials, prolonged air exposure of the sample strip, lack of user training, and errors in device maintenance. On follow-up monitoring for 3 months following QC intervention, 23.3% (low control) and 6.6% (high control) of the glucose meters scored a sigma value <3, indicating improved QC. Conclusion: Sigma metrics-based QC can successfully improve accuracy and precision of POC glucose meters in an objective and quantitative manner and can be used for follow up after QC intervention. (Ewha
{"title":"Application of Six Sigma Metrics to Improve Quality Control for Point-of-care Glucose Testing","authors":"Sholhui Park, Wookeun Lee, Tae-Dong Jeong, Hae-Sun Chung, K. Hong","doi":"10.12771/emj.2020.43.3.43","DOIUrl":"https://doi.org/10.12771/emj.2020.43.3.43","url":null,"abstract":"Objectives: Six sigma is a quality management system for the assessment of precision and accuracy. We aim to apply the six sigma rule to quality control (QC) of point-of-care (POC) glucose meters in a tertiary hospital. Methods: Thirty POC glucose meters installed at Ewha Womans University Mokdong Hospital were monitored between January 2013 and March 2014. The QC data from the POC glucose meters at low and high levels were collected. The monthly mean, standard deviation, bias, coefficient of variation, and mean sigma metrics were calculated. The correlation between accuracy and precision was assessed based on the percentage bias and coefficient of variation. Comprehensive instructions on the QC and maintenance of the devices were provided in the departments with poor sigma scores. A follow-up assessment was performed after the intervention. Results: The mean sigma values for the low and high controls were 3.29 and 3.71, respectively. At the low and high controls, 36.6% and 10% of the glucose meters showed a sigma value <3. The causes of low sigma values included the use of expired control materials, prolonged air exposure of the sample strip, lack of user training, and errors in device maintenance. On follow-up monitoring for 3 months following QC intervention, 23.3% (low control) and 6.6% (high control) of the glucose meters scored a sigma value <3, indicating improved QC. Conclusion: Sigma metrics-based QC can successfully improve accuracy and precision of POC glucose meters in an objective and quantitative manner and can be used for follow up after QC intervention. (Ewha","PeriodicalId":197820,"journal":{"name":"The Ewha Medical Journal","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122123669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-30DOI: 10.12771/emj.2020.43.2.35
C. Cho, H. Cheong, Jung Won Lee
Idiopathic renal hypouricemia is a hereditary disease characterized by abnormally high renal uric acid clearance. A defect in the SLC22A12 genes, which encodes the renal uric acid transporter, URAT1, is the known major causes of this disorder. Most patients are clinically silent, but exercise-induced acute kidney injury, urolithiasis or hematuria may develop. The patient presented with azotemia, decreased urine output and abdominal pain without vigorous exercise past history. He was diagnosed with rapidly progressive glomerulonephritis at admission, but low serum uric acid level was persisted. Since the diagnosis of the patient was familial renal hypouricemia, we performed sequence analysis of the SLC22A12 gene in all family members. We report a case of 17-year-old boy with severe acute kidney injury with familial renal hypouricemia confirmed by genotyping of SLC22A12. (Ewha Med J 2020;43(2):35-38)
{"title":"Severe Acute Kidney Injury with Familial Renal Hypouricemia Confirmed by Genotyping of SLC22A12","authors":"C. Cho, H. Cheong, Jung Won Lee","doi":"10.12771/emj.2020.43.2.35","DOIUrl":"https://doi.org/10.12771/emj.2020.43.2.35","url":null,"abstract":"Idiopathic renal hypouricemia is a hereditary disease characterized by abnormally high renal uric acid clearance. A defect in the SLC22A12 genes, which encodes the renal uric acid transporter, URAT1, is the known major causes of this disorder. Most patients are clinically silent, but exercise-induced acute kidney injury, urolithiasis or hematuria may develop. The patient presented with azotemia, decreased urine output and abdominal pain without vigorous exercise past history. He was diagnosed with rapidly progressive glomerulonephritis at admission, but low serum uric acid level was persisted. Since the diagnosis of the patient was familial renal hypouricemia, we performed sequence analysis of the SLC22A12 gene in all family members. We report a case of 17-year-old boy with severe acute kidney injury with familial renal hypouricemia confirmed by genotyping of SLC22A12. (Ewha Med J 2020;43(2):35-38)","PeriodicalId":197820,"journal":{"name":"The Ewha Medical Journal","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116877511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-30DOI: 10.12771/emj.2020.43.2.25
N. Yang
With advances in medicine and technology, treatment modalities for diseases have evolved. Consequently, physicians’ roles have also changed. Because of advances in endovascular treatment, neurosurgeons specializing in cerebrovascular surgery are increasingly using endovascular techniques. Accordingly, the number of so-called “hybrid neurosurgeons” who perform both traditional craniotomy cerebrovascular surgeries and endovascular treatments is on the rise. This phenomenon is also occurring in department of neurology, traditionally a non-surgical specialty, and the number of neurologists using endovascular treatments is also increasing. Nowadays endovascular treatments become more common across medical specialties such as neurointerveional radiology, neurosurgery, and neurology. In this time, what should be the role of neurosurgeons? Standardized hybrid surgeons should contribute to society by treating hemorrhagic stroke and ischemic stroke, maintaining a proper number of hybrid-neurosurgeons to ensure demand for such treatments is met. Further, more neurosurgeons should be trained to perform sophisticated traditional surgeries, as these surgeries cannot be performed by anyone else. Finally, neurosurgery patients often require a combination of surgical and medical treatment. In these situations, primary and secondary prevention are also crucial. And, many neurosurgery patients also have psychoneurotic symptoms. Within neurosurgery backgrounds, we, neurosurgeons, need to be intensivists for critical care medicine, hospitalization experts, epidemiologists, neuropsychiatry experts, and basic researchers. Because we have to be in charge of neurosurgical patients with various problems in our healthcare environment. Therefore, advancing beyond hybrid neurosurgeons and beginning an era of convergence neurosurgeons should be our role in the future. (Ewha Med J 2020;43(2):25-28) Received December 24, 2019 Revised January 30, 2020 Accepted February 10, 2020
随着医学和技术的进步，疾病的治疗方式也在不断发展。因此，医生的角色也发生了变化。由于血管内治疗的进步，专门从事脑血管手术的神经外科医生越来越多地使用血管内技术。因此，同时进行传统开颅、脑血管手术和血管内治疗的所谓“混合神经外科医生”的数量正在增加。这一现象也出现在传统的非手术专科神经内科，使用血管内治疗的神经内科医生也在增加。如今，血管内治疗在神经介入放射学、神经外科和神经病学等医学专业中越来越普遍。在这个时候，神经外科医生应该扮演什么角色?标准化的混合外科医生应该通过治疗出血性中风和缺血性中风为社会做出贡献，保持适当数量的混合神经外科医生以确保满足此类治疗的需求。此外，应该训练更多的神经外科医生来进行复杂的传统手术，因为这些手术是其他人无法完成的。最后，神经外科患者通常需要手术和药物治疗相结合。在这些情况下，一级和二级预防也至关重要。而且，许多神经外科患者也有精神神经症症状。在神经外科背景下，我们，神经外科医生，需要成为重症监护医学的重症医师，住院专家，流行病学家，神经精神病学专家和基础研究人员。因为在我们的医疗环境中，我们必须负责神经外科病人的各种问题。因此，超越混合神经外科医生，开创融合神经外科医生的时代，才是我们未来的角色。(Ewha Med J 2020;43(2):25-28) 2019年12月24日收稿2020年1月30日修稿2020年2月10日收稿
{"title":"Future Role of Neurosurgeons: Toward Convergence Neurosurgeon Beyond Hybrid Neurosurgeon","authors":"N. Yang","doi":"10.12771/emj.2020.43.2.25","DOIUrl":"https://doi.org/10.12771/emj.2020.43.2.25","url":null,"abstract":"With advances in medicine and technology, treatment modalities for diseases have evolved. Consequently, physicians’ roles have also changed. Because of advances in endovascular treatment, neurosurgeons specializing in cerebrovascular surgery are increasingly using endovascular techniques. Accordingly, the number of so-called “hybrid neurosurgeons” who perform both traditional craniotomy cerebrovascular surgeries and endovascular treatments is on the rise. This phenomenon is also occurring in department of neurology, traditionally a non-surgical specialty, and the number of neurologists using endovascular treatments is also increasing. Nowadays endovascular treatments become more common across medical specialties such as neurointerveional radiology, neurosurgery, and neurology. In this time, what should be the role of neurosurgeons? Standardized hybrid surgeons should contribute to society by treating hemorrhagic stroke and ischemic stroke, maintaining a proper number of hybrid-neurosurgeons to ensure demand for such treatments is met. Further, more neurosurgeons should be trained to perform sophisticated traditional surgeries, as these surgeries cannot be performed by anyone else. Finally, neurosurgery patients often require a combination of surgical and medical treatment. In these situations, primary and secondary prevention are also crucial. And, many neurosurgery patients also have psychoneurotic symptoms. Within neurosurgery backgrounds, we, neurosurgeons, need to be intensivists for critical care medicine, hospitalization experts, epidemiologists, neuropsychiatry experts, and basic researchers. Because we have to be in charge of neurosurgical patients with various problems in our healthcare environment. Therefore, advancing beyond hybrid neurosurgeons and beginning an era of convergence neurosurgeons should be our role in the future. (Ewha Med J 2020;43(2):25-28) Received December 24, 2019 Revised January 30, 2020 Accepted February 10, 2020","PeriodicalId":197820,"journal":{"name":"The Ewha Medical Journal","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125268610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-30DOI: 10.12771/emj.2020.43.2.29
Kwonoh Park, Geongsil Lee, Jae-Joon Kim, Sang-Bo Oh, S. Oh, E. Park, J. Kim, J. Jang, U. Jeon
Objectives: Terminally ill cancer patients in hospice palliative care unit are reluctant to undergo repetitive invasive procedures due to coagulopathies and poor performance or condition, while catheter management such as regular irrigation during hospitalization is easy. The purpose of this study was to investigate the safety and efficacy of indwelling intraperitoneal (IP) catheter in hospitalized terminally ill cancer patients with recurrent ascites. Methods: A retrospective review was conducted in patients who underwent IP catheter at the hospice palliative care unit of Pusan National University Yangsan Hospital between August 2016 and June 2018. All catheters were inserted by interventional radi-ologists with radiological guidance. The primary end-points were functional IP catheter maintenance rate, which is catheter maintained with patency for drainage until the intended time. Results: A total of 25 terminally ill cancer patients underwent IP catheters placements during the study period. All catheters were successfully inserted without major complications, but one patient had trivial bleeding and one other patient had temporary pain. The median time from admission to catheter insertion was 5 days (range, 1 to 49 days). Twenty-one catheters were maintained with function until the intended time, three cases were maintained without function, and the last one was removed early due to obstruction and pain. Finally, the functional IP maintenance rate was 84% (21/25) and the median functional catheter life span was 15 days (95% confidence interval, 10.8 to 17.2). Conclusion: Our study showed relatively favorable results for IP catheter maintenance and safety in hospitalized terminally ill cancer patients with malignant ascites. (Ewha Med J 2020;43(2):29-34)
{"title":"Safety and Effectiveness of Indwelling Percutaneous Drainage in Hospitalized Terminally Ill Cancer Patients with Recurrent Ascites","authors":"Kwonoh Park, Geongsil Lee, Jae-Joon Kim, Sang-Bo Oh, S. Oh, E. Park, J. Kim, J. Jang, U. Jeon","doi":"10.12771/emj.2020.43.2.29","DOIUrl":"https://doi.org/10.12771/emj.2020.43.2.29","url":null,"abstract":"Objectives: Terminally ill cancer patients in hospice palliative care unit are reluctant to undergo repetitive invasive procedures due to coagulopathies and poor performance or condition, while catheter management such as regular irrigation during hospitalization is easy. The purpose of this study was to investigate the safety and efficacy of indwelling intraperitoneal (IP) catheter in hospitalized terminally ill cancer patients with recurrent ascites. Methods: A retrospective review was conducted in patients who underwent IP catheter at the hospice palliative care unit of Pusan National University Yangsan Hospital between August 2016 and June 2018. All catheters were inserted by interventional radi-ologists with radiological guidance. The primary end-points were functional IP catheter maintenance rate, which is catheter maintained with patency for drainage until the intended time. Results: A total of 25 terminally ill cancer patients underwent IP catheters placements during the study period. All catheters were successfully inserted without major complications, but one patient had trivial bleeding and one other patient had temporary pain. The median time from admission to catheter insertion was 5 days (range, 1 to 49 days). Twenty-one catheters were maintained with function until the intended time, three cases were maintained without function, and the last one was removed early due to obstruction and pain. Finally, the functional IP maintenance rate was 84% (21/25) and the median functional catheter life span was 15 days (95% confidence interval, 10.8 to 17.2). Conclusion: Our study showed relatively favorable results for IP catheter maintenance and safety in hospitalized terminally ill cancer patients with malignant ascites. (Ewha Med J 2020;43(2):29-34)","PeriodicalId":197820,"journal":{"name":"The Ewha Medical Journal","volume":"118 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116369067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：