The Korean Journal of Medicine最新文献_第2页

Polyarteritis Nodosa Confined to the Kidneys in a Patient with Proteinuria and Mild Renal Impairment 蛋白尿和轻度肾功能不全患者肾脏局限性多发性结节性动脉炎

The Korean Journal of Medicine Pub Date : 2024-04-01 DOI: 10.3904/kjm.2024.99.2.116

Young Kyeong Seo, Taehee Kim, Yeong Hoon Kim, Yunmi Kim, H. Huh, Byeong Woo Kim

引用次数: 0

Human Understanding is Expected of the Physician: Proposing a Model of Disease Development 人类期待医生的理解：提出疾病发展模型

The Korean Journal of Medicine Pub Date : 2024-04-01 DOI: 10.3904/kjm.2024.99.2.84

Sang-Heum Park, Samel Park, Jin Young Kim, Hyeon Ah Lee, Sang Mi Lee, Tae Hoon Lee, Sang Byung Bae, Sung Hae Chang, Si Hyong Jang, Sung Wan Chun, Jong Ho Moon

{"title":"Human Understanding is Expected of the Physician: Proposing a Model of Disease Development","authors":"Sang-Heum Park, Samel Park, Jin Young Kim, Hyeon Ah Lee, Sang Mi Lee, Tae Hoon Lee, Sang Byung Bae, Sung Hae Chang, Si Hyong Jang, Sung Wan Chun, Jong Ho Moon","doi":"10.3904/kjm.2024.99.2.84","DOIUrl":"https://doi.org/10.3904/kjm.2024.99.2.84","url":null,"abstract":"In Harrison’s Principles of Internal Medicine, human understanding is emphasized as one of three necessary characteristics that a physician must have. Inflammation, which is caused by inflammatory inducers (inf-ids), is a fundamental feature of disease at the cellular and molecular levels. Inflammation protects the body, but excessive or prolonged inflammation can be damaging and can cause disease. Humans are repeatedly exposed to external and internal environmental factors that generate inf-ids throughout their lives. External environmental factors include microbial and non-microbial inf-ids, as well as stressors that inevitably arise during social interactions. Internal environmental factors include the adaptive physiological response that is present from birth. Inf-ids may also be produced by the four-step habit loop, which consists of a cue (e.g., stressor), emotions, routine act (adaptive response), and a reward. Immune cells in the circulatory system and in tissues may have positive and negative effects in inflammatory responses. However, low-grade inflammation may be difficult to detect. We propose a model of disease development that integrates external and internal environmental factors from the perspective of human understanding.","PeriodicalId":517046,"journal":{"name":"The Korean Journal of Medicine","volume":"100 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140768601","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}

引用次数: 0

Targeted Therapy of Advanced Non-Small Cell Lung Cancer 晚期非小细胞肺癌的靶向治疗

The Korean Journal of Medicine Pub Date : 2024-04-01 DOI: 10.3904/kjm.2024.99.2.96

Yun-Gyoo Lee, Hyun-Il Gil, Soo Jeong Kim, Hyunjoo Lee, Heerim Nam, Soo-Youn Ham, Du-Young Kang

引用次数: 0

Diagnosis, Clinical Course and Treatment of Hypersensitivity Pneumonitis 过敏性肺炎的诊断、临床表现和治疗

The Korean Journal of Medicine Pub Date : 2024-04-01 DOI: 10.3904/kjm.2024.99.2.69

Jong Sun Park

引用次数: 0

Various Diagnostic Methods for Helicobacter pylori Infection 幽门螺旋杆菌感染的各种诊断方法

The Korean Journal of Medicine Pub Date : 2024-04-01 DOI: 10.3904/kjm.2024.99.2.104

H. Jeon, Hyuk Soon Choi

引用次数: 0

Multiple Intramuscular Abscesses Caused by Nocardia abscessus in a Patient with Chronic Obstructive Lung Disease: Clinical Microbiology Considerations 一名慢性阻塞性肺病患者由脓肿诺卡氏菌引起的多发性肌肉内脓肿：临床微生物学考虑因素

The Korean Journal of Medicine Pub Date : 2024-02-01 DOI: 10.3904/kjm.2024.99.1.50

Jung-Ah Kim, Hyunjoo Dong, E. Lee, Jongtak Jung, Yae Jee Baek, Tae Hyong Kim, Tae Youn Choi

{"title":"Multiple Intramuscular Abscesses Caused by Nocardia abscessus in a Patient with Chronic Obstructive Lung Disease: Clinical Microbiology Considerations","authors":"Jung-Ah Kim, Hyunjoo Dong, E. Lee, Jongtak Jung, Yae Jee Baek, Tae Hyong Kim, Tae Youn Choi","doi":"10.3904/kjm.2024.99.1.50","DOIUrl":"https://doi.org/10.3904/kjm.2024.99.1.50","url":null,"abstract":"Nocardiosis is uncommon. Immunocompromising conditions predispose individuals to pulmonary and disseminated nocardiosis of the brain, skin, and subcutaneous tissues. The most common pathogens are Nocardia cyriacigeorgica, Nocardia nova, and Nocardia farcinica. The speciation of Nocardia to determine antimicrobial susceptibility is difficult using traditional biochemical methods. Here, we report the case of a 73-year-old man with chronic obstructive lung disease who developed a rapidly progressing intramuscular abscess around the left hip and thigh. Within 3 days, the lesions progressed to an epidural abscess at the L4 to S1 level. Although he was treated with broad-spectrum antibiotics and extensive incision and drainage, he died of rapidly progressive respiratory failure. Nocardia abscessus (N. abscessus) was identified in pus samples using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). This case shows that the diagnosis of an intramuscular abscess caused by N. abscessus is challenging and that using MALDI-TOF MS may facilitate the diagnosis and ensure appropriate treatment.","PeriodicalId":517046,"journal":{"name":"The Korean Journal of Medicine","volume":"1 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139893999","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}

引用次数: 0

Multiple Intramuscular Abscesses Caused by Nocardia abscessus in a Patient with Chronic Obstructive Lung Disease: Clinical Microbiology Considerations 一名慢性阻塞性肺病患者由脓肿诺卡氏菌引起的多发性肌肉内脓肿：临床微生物学考虑因素

The Korean Journal of Medicine Pub Date : 2024-02-01 DOI: 10.3904/kjm.2024.99.1.50

Jung-Ah Kim, Hyunjoo Dong, E. Lee, Jongtak Jung, Yae Jee Baek, Tae Hyong Kim, Tae Youn Choi

{"title":"Multiple Intramuscular Abscesses Caused by Nocardia abscessus in a Patient with Chronic Obstructive Lung Disease: Clinical Microbiology Considerations","authors":"Jung-Ah Kim, Hyunjoo Dong, E. Lee, Jongtak Jung, Yae Jee Baek, Tae Hyong Kim, Tae Youn Choi","doi":"10.3904/kjm.2024.99.1.50","DOIUrl":"https://doi.org/10.3904/kjm.2024.99.1.50","url":null,"abstract":"Nocardiosis is uncommon. Immunocompromising conditions predispose individuals to pulmonary and disseminated nocardiosis of the brain, skin, and subcutaneous tissues. The most common pathogens are Nocardia cyriacigeorgica, Nocardia nova, and Nocardia farcinica. The speciation of Nocardia to determine antimicrobial susceptibility is difficult using traditional biochemical methods. Here, we report the case of a 73-year-old man with chronic obstructive lung disease who developed a rapidly progressing intramuscular abscess around the left hip and thigh. Within 3 days, the lesions progressed to an epidural abscess at the L4 to S1 level. Although he was treated with broad-spectrum antibiotics and extensive incision and drainage, he died of rapidly progressive respiratory failure. Nocardia abscessus (N. abscessus) was identified in pus samples using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). This case shows that the diagnosis of an intramuscular abscess caused by N. abscessus is challenging and that using MALDI-TOF MS may facilitate the diagnosis and ensure appropriate treatment.","PeriodicalId":517046,"journal":{"name":"The Korean Journal of Medicine","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139897635","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}

引用次数: 0

Single-Center Real-World Experience with Primary Central Nervous System Lymphoma in the 21st Century 21 世纪原发性中枢神经系统淋巴瘤的单中心真实世界经验

The Korean Journal of Medicine Pub Date : 2024-02-01 DOI: 10.3904/kjm.2024.99.1.37

Hyungwoo Cho, Jung Yong Hong, Daeho Lee, S. Kim, Kyoungmin Lee, E. Kang, Sunjong Lee, J. Park, Jeong Hoon Kim, Jin-Sook Ryu, J. Huh, C. Suh

{"title":"Single-Center Real-World Experience with Primary Central Nervous System Lymphoma in the 21st Century","authors":"Hyungwoo Cho, Jung Yong Hong, Daeho Lee, S. Kim, Kyoungmin Lee, E. Kang, Sunjong Lee, J. Park, Jeong Hoon Kim, Jin-Sook Ryu, J. Huh, C. Suh","doi":"10.3904/kjm.2024.99.1.37","DOIUrl":"https://doi.org/10.3904/kjm.2024.99.1.37","url":null,"abstract":"Background/Aims: In Korea, the incidence of primary diffuse large B-cell lymphoma of the central nervous system (PCNSL) is increasing and autologous stem cell transplantation (ASCT) has improved the survival of younger patients. We explored our real-world experience with PCNSL at Asan Medical Center (AMC).Methods: We used the AMC lymphoma registry to collect patient data prospectively. We analyzed 279 patients diagnosed from 2002 until August 2019.Results: The PCNSL incidence at AMC increased progressively and comprised 7.4-8.9% of new non-Hodgkin lymphoma patients annually during the most recent 4 years. The median age was 60 years (range, 17-85) and males comprised 55%. Patients under 65 years of age (n = 183) had no significant differences in characteristics compared to those aged 65 years or over, with the exception of less occipital lobe involvement and lower beta-2 microglobulin levels. Rituximab, methotrexate, procarbazine, and vincristine (R-MPV) combination induction had the best overall response, of 95%. The median overall survival was 3.8 years with 5- and 10-year survival rates of 41.5% and 30.2%, respectively. Survival was better in younger patients and those treated with ASCT. Thiotepa, busulfan, and cytoxan (TBC) conditioning chemotherapy had better survival than other combinations. The International Extranodal Lymphoma Study Group and Memorial Sloan Kettering Cancer Center prognostic score systems were valid in this cohort. Age and performance status were independent prognostic factors. Exclusive extra-central nervous system failure occurred in six patients (5.6%) among 107 failures.Conclusions: The incidence of PCNSL is rising. R-MPV induction therapy followed by ASCT with TBC has improved the survival of young, fit PCNSL patients.","PeriodicalId":517046,"journal":{"name":"The Korean Journal of Medicine","volume":"3 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139897546","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}

引用次数: 0

Diagnosis and Treatment of Myelodysplastic Syndrome in the Era of Genetic Testing 基因检测时代骨髓增生异常综合征的诊断与治疗

The Korean Journal of Medicine Pub Date : 2024-02-01 DOI: 10.3904/kjm.2024.99.1.11

Junshik Hong

{"title":"Diagnosis and Treatment of Myelodysplastic Syndrome in the Era of Genetic Testing","authors":"Junshik Hong","doi":"10.3904/kjm.2024.99.1.11","DOIUrl":"https://doi.org/10.3904/kjm.2024.99.1.11","url":null,"abstract":"Myelodysplastic syndrome (MDS) is a heterogeneous disorder with diverse prognoses influenced by cytopenias, genetic variants, and myeloblast proportions in the bone marrow. Accurate prognosis prediction and tailored treatment plans are essential. The International Prognostic Scoring System-Molecular (IPSS-M), which additionally reflects the impact of MDS-related genetic mutations to the clinical and laboratory information, is anticipated to offer superior prognostic accuracy compared to existing systems like the Revised International Prognostic Scoring System (IPSS-R). Despite its statistical complexity, its web-based calculation and ease of discussing results with patients using intuitive data sets provide notable advantages. Progress in MDS treatment, exemplified by effective anemia correction with an erythropoiesis-maturation agent in SF3B1-mutated cases and efforts to refine poor prognoses in TP53-mutated cases, reflects the evolving landscape of genetic-based interventions in MDS. Advancements in genetic diagnostic technology, combined with enhanced knowledge of the bone marrow niche, are anticipated to lead to significant improvement in MDS treatment outcomes in the future.","PeriodicalId":517046,"journal":{"name":"The Korean Journal of Medicine","volume":"5 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139893760","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}

引用次数: 0

Trends of Endoscopic Palliation for Advanced Malignant Hilar Biliary Obstruction 晚期恶性肝胆道梗阻的内镜姑息治疗趋势

The Korean Journal of Medicine Pub Date : 2024-02-01 DOI: 10.3904/kjm.2024.99.1.4

Tae Hoon Lee

{"title":"Trends of Endoscopic Palliation for Advanced Malignant Hilar Biliary Obstruction","authors":"Tae Hoon Lee","doi":"10.3904/kjm.2024.99.1.4","DOIUrl":"https://doi.org/10.3904/kjm.2024.99.1.4","url":null,"abstract":"Malignant hilar biliary obstruction (MHO), an aggressive type of perihilar biliary obstruction caused by cholangiocarcinoma, gallbladder cancer, or other metastatic malignancies, has a poor prognosis. Surgical resection is the only curative treatment for biliary malignancies. However, most patients with MHO cannot undergo surgery upon presentation because of their advanced inoperable state or poor performance resulting from old age or comorbid diseases. Therefore, palliative biliary drainage is required to improve symptomatic jaundice and quality of life. Preoperative biliary drainage is controversial in resectable cases of MHO. Preoperative biliary drainage should be considered according to specific selection criteria. Palliative drainage is currently the mainstay of symptomatic treatment. Compared with percutaneous access, primary endoscopic palliation using plastic or metal stents has recently shown higher technical feasibility and clinical success without increasing the frequency of adverse events, even in high-degree MHO. However, the use of stents still has numerous limitations, including challenges in determining the optimal type of stent, number of stents, deployment method, and additional local therapies. Therefore, this report presents the current optimal endoscopic drainage status for MHO based on recent guidelines and published literature.","PeriodicalId":517046,"journal":{"name":"The Korean Journal of Medicine","volume":"27 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139897417","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}

引用次数: 0