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Cystic Medullary Thyroid Carcinoma: A Case of Undergoing Endoscopic Thyroid Lobectomy
Dong Hae Chung,Jae Yeon Seok,Yoo Seung Chung1,Eun Mee Oh1,Jung Won Ryu1,Young Don Lee1 대한갑상선-내분비외과학회 2015 The Koreran journal of Endocrine Surgery Vol.15 No.1
On ultrasonography, medullary thyroid carcinoma (MTC) shows hypoechogenicity, an irregular margin, a predominantly solid composition, and microcalcifications, similar to those observed in papillary thyroid carcinoma (PTC). MTC presenting as a cystic lesion is rare, and endoscopic thyroidectomy can be performed for benign thyroid masses and early stage PTC, however it is inappropriate for MTC regardless of cystic change. The authors report a case of cystic MTC found after endoscopic thyroid lobectomy and provide a review of the literature on this topic.
알레르기 ; 알레르기 환자에서 한방 이외의 대체 요법의 사용 현황에 대한 다기관 조사
이현정 ( Hyun Jung Lee ),이재현 ( Jae Hyun Lee ),이용원 ( Yong Won Lee ),김철우 ( Cheol Woo Kim ),동헌종 ( Hun Jong Dhong ),박해심 ( Hae Sim Park ),조영주 ( Young Joo Cho ),조진희 ( Jin Hee Cho ),조상헌 ( Sang Heon Cho ),편복양 ( 대한내과학회 2011 대한내과학회지 Vol.80 No.1
목적: 한국에서 알레르기 질환 치료를 위한 한방 치료뿐만 아니라 대체 요법이 많이 이용되고 있으며, 그 현황에 대하여 다기관 조사를 시행하였다. 방법: 10개의 대학병원 외래로 내원한 647명의 알레르기 환자를 대상으로 설문조사를 시행하였으며, 이 중 510명이 한방 이외의 대체 요법에 응답하였다. 이환되어 있는 알레르기 질환은 천식(50.0%), 알레르기 비염(36.0%), 아토피 피부염(36.0%), 그리고 두드러기(9.3%)였다. 각각 환자들에게 12 문항의 설문조사를 시행하였으며, 한방 이외의 대체 요법의 사용 빈도 및 종류, 대체 요법에 의지하게 된 이유, 비용, 그리고 치료효과에 대한 의견을 물어 보았다. 결과: 16.7%의 알레르기 환자에서 한방 이외의 다른 대체 요법을 받았으며, 평균 1.6종의 한방 이외의 대체 요법을 받았다. 가장 많이 의지하는 대체 요법은 민간 식이요법 (48.6%)이었고, 그 다음이 아로마 요법(23.8%), 지압(14.3%), 건강 호흡법(7.6%), 마인드 컨트롤(5.7%), 목욕요법(5.7%) 순이었다. 대체 요법을 받은 환자 중 마인드 컨트롤(50%), 식이요법(50%), 그리고 건강 호흡법(75%)의 경우 치료 효과가 만족스럽다는 응답이 높았으며, 목욕요법, 아로마 요법, 그리고 지압은 만족도가 각각 33.3%, 28.0%, 26.7%로 저조하였다. 대체 요법 사용자의 63.6%가 5회 미만의 대체 요법을 받았고, 91.8%가 1년 이내로 치료받았으며, 1인당 평균 연 37 만원을 지출하였다. 대체 요법을 선택한 가장 큰 이유는 체질이 개선될 수 있을까 해서(44.2%)였으며, 대체 요법이 몸에 부담이 없어서(31.4%), 면역기능이 강화되어서(22.9%) 순으로 나타났고, 15.7%는 양약치료가 도움이 되지 않아서 대체 요법을 선택하였다고 응답하였다. 결론: 한국에서 알레르기 환자의 상당수가 한방뿐만 아니라 여러 가지의 대체 요법을 사용하고 있음을 알 수 있었다. 대체 요법의 사용 빈도가 증가하고 그 종류가 다양함을 고려할 때, 의료진은 대체 요법의 현황에 대하여 정확히 인지하고 이에 대해 관심을 가지고 환자를 대하여야 하며 올바른 알레르기 질환 치료법에 대해 환자뿐만 아니라 의료인에게 교육하는 것이 필요하다. Background/Aims: The use of unproven complementary/alternative medicine (CAM) to treat allergies is popular in Korea. We conducted a multicenter survey of the current use of CAM other than herbal medication in Korean allergy patients. Methods: This study enrolled 510 adults with allergic diseases, including asthma, allergic rhinitis, atopic dermatitis, and chronic urticaria, from ten hospitals. They underwent a structured questionnaire interview and clinical assessment of the prevalence, motivation, costs, and subjective assessment of CAM. Results: Of the patients, 16.7% used at least one type of CAM to treat their allergic diseases. Common types of CAM were diet (48.6%), aroma therapy (23.8%), massage (14.3%), breathing exercises (7.6%), baths (5.7%), and mind control (5.7%). The therapeutic effects of CAM included improved in patients using mind control (50%), diet (50%), breathing exercises (75%), and baths (33.3%), but worse in patients using aroma therapy (28%), and massage (26.7%). About 36.4% of the patients used CAM more than four times per year, and the average cost per CAM user was 370,000 won/year. The main reason for trying CAM was `hope to improve my constitution`. Conclusions: CAM is used widely for treating allergic diseases in Korea. Detailed knowledge of CAM and patient education are important. Further studies of the clinical efficacy of CAM are needed. (Korean J Med 2011;80:68-77)
박세호(Se Ho Park),이영해(Young Hae Lee),조동원(Dong Won Cho) 한국SCM학회 2012 한국SCM학회지 Vol.12 No.2
One of the most important reasons in pursuit of supply chain management is to prevent sub-optimization caused by decentralized decision making over the various entities. As supply chain coordination approach to overcome such a setting, contract mechanisms have frequently been used. However, a coordinated supply chain might fail to provide additional profit to one of the players. In result, it is necessary that a contract mechanism is designed to achieve the same profit in a centralized situation (coordination) and to improve the benefit of all the supply chain players (winwin). In this paper, we address supply chain contract based on revenue sharing and quantity discount considering price and service level. We show that the trade parameters among different entities in the supply chain contract can be chosen to achieve coordination and a win-win outcome.
Effect of Dietary Fiber Source on the Growth Performance and Intestinal Microflora in Piglets
Lee, Seung-Jin,Kim, Jin-Yoon,Park, Na-Hae,Awji, Elias Gebru,Suh, Joo-Won,Park, Seung-Chun VETERINARY SOLUTIONS LLC 2016 INTERNATIONAL JOURNAL OF APPLIED RESEARCH IN VETER Vol.14 No.2
<P>Growth performance and the levels and enzymatic activity of intestinal lactobacilli were studied in weaned piglets fed for 4 weeks with basal diets containing different sources of dietary fiber. These included: 1. 50% corn and 50% rice bran (T1) 2. 100% rice bran (T2) 3. 50% corn and 50% sawdust (T3) 4. 100% sawdust (T4), and 5. 100% corn used as control (T5). Most groups showed similar body weight (BW) gain as the control (T5) group, whereas T4 animals showed significantly lower (P < 0.05) BW gain than T5, which was related to the lowest feed intake in T4. While the blood chemistry profiles were similar in most groups, T4 animals had a higher (statistically non significant) serum levels of blood urea nitrogen, aspartate aminotransferase and ala-nine aminotransferase. T2 and T3 groups had the highest (P < 0.05) number of anaerobic bacteria in the feces and intestines compared to T5, while no differences were observed between T4 and T5. Initial screening for pH and bile acid resistance resulted in 23 strains of intestinal lactic acid bacteria, mostly from T3 and T4 groups, of which 61% produced one or more dietary enzymes, including protease, cellulase, phytase, and alpha-amylase. Although high level of sawdust in piglet diets negatively affects growth and health performance, if mixed with other sources of fiber, it may [GRAPHICS] offer beneficial and cheaper alternative source of dietary fiber that ensures acceptable growth performance and promotes intestinal microflora with beneficial digestive enzymes.</P>
Hae-Na Shin,Shin Hwang,Ki-Hun Kim,Chul-Soo Ahn,Deok-Bog Moon,Tae-Yong Ha,Gi-Won Song,Young-Joo Lee,Sung-Gyu Lee 한국간담췌외과학회 2013 한국간담췌외과학회지 Vol.17 No.4
Backgrounds/Aims: Tumor recurrence is very common after hepatic resection of hepatocellular carcinoma (HCC) ≥10 cm. The purpose of this study was to validate the prognostic significance of the preoperative alkaline phosphatase (ALP) level and early intrahepatic metastasis in HCC patients who underwent resection of large HCC. Methods: Clinical data of 100 large HCC patients who underwent liver resection were retrospectively reviewed. All of them underwent protocol transarterial chemoinfusion (TACI) at 1 month. Results: Median tumor diameter was 13.8 cm, and 94% were single lesions. Systematic and non-systematic resections were performed in 91% and 9%, respectively, with R0 resection achieved in 84%. Overall 1-, 3- and 5-year survival rates were 76%, 38.5%, and 30.4%, respectively. Univariate analyses on patient survival revealed that intrahepatic metastasis on 1-month protocol TACI was the only significant risk factor (p=0.002). Mean ALP values according to the intrahepatic metastasis on 1-month protocol TACI were 124.6±76.9 IU/L and 145.1±92.6 IU/L, which did not show a statistical difference (p=0.23). Conclusions: In patients with large HCC, 1-month protocol TACI combined with hepatic resection may contribute to the early detection and timely treatment of potentially preexisting metastatic lesions.
S-19 : Colonic Intramural Hematoma After Argon Plasma Coagulation
( *hae Min Yang ),( Hyun Woo Park ),( Se Young Jang ),( Sun Young Ahn ),( Hyun Seok Lee ),( Soo Young Park ),( Won Young Tak ),( Young Oh Kweon ),( Sung Kook Kim ),( Chang Min Cho ),( Min Kyu Jung ),( 대한내과학회 2013 대한내과학회 추계학술대회 Vol.2013 No.1
Argon plasma coagulation (APC) is a noncontact endoscopic method of hemostasis achieving coagulation without physical contact of APC probe with tissues. APC was first developed for surgical interventions but has been introduced to endoscopic procedures since 1991. It is currently used for the management of bleeding caused by varices, ulcers and vascular ectasias as well as for ablation of Barret`s esophagus, remnant adenomatous tissues after polypectomy and debulking malignant tumors. It is the most preferred method to manage angiodysplasia owing to its ease of application, minimum depth of thermal effects and speedy treatment for wide areas. It is known to be an effective method of hemostasis to treat colonic angiodysplasia and complication rates are also low when it is performed after submucosal injection of saline. The main advantage of APC is the safety owing to minimum depth of the thermal effect but procedure-related complications such as pneumoperitoneum, perforation, subcutaneous emphysema, bleeding, stricture and pain can occur if it is inappropriately used. However, incidence of intramural hematoma is rare. There is only one reported case of intramural hematoma which developed in the stomach after argon plasma coagulation to remove residual tissues after gastric polypectomy. Herein, we report a case of colon intramural hematoma and delayed bleeding after argon plasma coagulation performed to manage bleeding secondary to colonic angiodysplasia in a 57-year old female with liver cirrhosis and end stage renal disease.