| Hee Jin Kim | 5 Articles |
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[English]
Thyroid nodule is a common clinical problem and it is important to distinguish benign from malignant nodule. Although features found on history taking, physical examnation and imaging studies help the diagnosis, fine needle aspiration(FNA) has been accepted as an accurate and reliable diagnostic procedure of thyroid nodule. This study was aimed to assess the values of FNA and needle biopsy in the diagnosis of thyroid nodules. We reviewed the medical records of the 405 patients who underwent FNA and needle biopsy for the diagnosis of thyroid nodule form September 1993 to July 1996. The 414 fine needle aspiration cytologic specimens were obtained from 405 patients(male : 26, female : 379). 390 cases(94.2%) were adequate for cytologic diagnosis. And the diagnosis showed benign in 357(91.5%), malignancy in 20(5.1%) and suspicious malignancy in 13(3.3%). Among the 357 benign cases, 104 cases were benign cysts, 163 cases were adenomatous goiter and 45 cases were follicular adenoma. 46 patients underwent thyroidectomy after FNA and 21 patients(45.7%) were diagnosed as having carcinoma. The sensitivity and specificity of FNA in diagnosing malignancy were 65% and 82%, respectively, with an accuracy of 74%. Of 46 patients, needle biopsy was done in 41. The sensitivity and specificity of the needle biopsy were 79% and 73%, respectively. And the accuracy was 76%. Hoarseness was developed in one patient after FNA and needle biopsy, and small amount of hemoptysis was developed in another patient after FNA. Although it had been expected that needle biopsy may increase the diagnostic accuracy, our study didn't show the superiority of needle biopsy as compared with FNA. FNA has limitations in suspicious and nondiagnostic results but it is a safe, simple, reliable and cost-effective means of evaluating thyroid nodules. It is the preferred initial diagnostic method in all patients with thyroid nodule.
[English]
Diabetic peripheral neuropathies are one of the most frequent complications of diabetes, and multiple metabolic and vascular disturbances are involved in the pathogenetic mechanisms of diabetic neuropathies. Thirty patients with diabetic neuropathies from ischemic peripheral vascular disease were received cilostazol, an antithrombotic and vasodilating drug, 200mg a day in two divided doses for eight weeks at the Ewha Womans University Hospital. We analysed the eff-ects between before and efter treatment with cilostazol. 1) Total 30 patients were studied : 21 patients wre female and 9 patients were male. Their mean age was 60.2±9.9 years, and mean duration of diabetes was 8.0±4.9years. As comp-lications, 47% of them had retinopathy and 30% of them nephropathy. 2) No significant difference was found in physical findings, metabolic control states, CBC, blood chemistry and lipid levels before and after cilostazol treatment. 3) The score of resting pain and numbness were significantly decreased, and cold sensation and claudication were decreased after cilostazol treatment. 4) The score of arterial pulsation and Doppler wave was decreased, and the ankle pressure index was increased from 1.04±0.07 to 1.08±0.13 after cilostazol treatment, but there was no statistical significance. 5) Adverse effects were noted in 20% of cilostazol treated patients, 3 cases of headache, 2 facial flush and palpitation and 1 rash and urticaria, respectively. 6) The assessment of overall improvement of the disease, including "markedly improved", "improved" and "slightly improved" amounted to 63%. The assessment of overall safety of the drug, including "safe" and "almost safe" amounted to 80%. The assessment of overall utility of the drug, including "very useful", "useful" and "slightly useful" amounted to 63%. Cilostazol was useful in the treatment of diabetic patients with peripheral vascular disease accompanied by ischemic symptoms to improve subjective symptoms and blood flow.
[English]
Among the hematologic complications of solid tumors, leukoerythroblastosis, DIO and MAHA have been known to be clinically significant According to the recent increasing incidence of cancer, these hematologic complications have been reported frequently. However, the simutaneous developement of such manifestations is rare. Recently, we have experienced a patient with gastric adenocarcinoma in which case severe bleeding tendency were observed and laboratory studies including bone marrow examination demonstrated the findings of leukoerythroblastosis, DIC and MAHA. She died of upper gastrointestinal bleeding despite the supportive care such as vlood transfusions. We should give attention to the findings of peripheral golld smear for the patient with malignancy and it is mandatory for therapeutic plan to perform bone marrow examination if the above mentioned hemorrhagic complications are suspected.
[English]
To determine the effect of aging on left ventricular filling mitral valve flow was evaluatedwith conventional pulsed Doppler echocardiography in 100 normal subjects, aged 20 to 76 years, who had no evidence of cardiovascular disease. The subjects were classified into the5 groups, according to the age, with 20 subjects in each groups : 20-29 years(group I), 30-39 years(group II), 40-49 years(group III), 50-59 years(group IV) and 60-76 years(group V). The results were as follows : 1) The LVEDD(Left Ventricular End Diastolic Diameter) and left ventricular mass indexwere significantly increased with aging(r=0.50, r=0.60) and the ejection fraction showed nosignificant differences among these groups. 2) With aging, the peak early velocity(Peak E) was decreased(r=-0.36) and the peak atrialvelocity(Peak A) was increased(r=0.43). The E/A ratio and atrial diastolic velocity were decreased significantly with aging and showed a negative correlation with aging(r=-0.70). 3) The deceleration time of early diastolic flow was increased with aging(r=0.29) but without significance. 4) The isovolumetric relaxation time was significantly increased with aging(r=0.75). In conclusion, as myocardial stiffness increases with aging, nonuniformity of myocardialrelaxation is frequently associated in older age group. Thus, a certain echocardiographic parameter shows abnormal value with normal aging process : the IVRT and DT are prolonged, Peak E is decreased and E/A ratio increased. For correct evaluation of the left ventricular diastolicfunction, age should be considere, along with the other factors such as loading conditionsof the heant heart rate and the contractile status of the heart. Citations Citations to this article as recorded by
[English]
Priapism is the pathologic prolongation of a penile erection most often associated with pain but not with sexual excitement or desire. Recently we experienced one case of priapism accompained by chromic myelocytic leukemia. For treatment of priapism, cavernososponsiosal shunt, radiotherapy and chemotherapy with hydroxyurea were done.
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, Hee Jin Kim
