Yonsei medical journal
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Yonsei medical journal · Feb 2005
Perioperative anticoagulation in patients with mechanical heart valves undergoing elective surgery: results of a survey conducted among Korean physicians.
The optimal perioperative anticoagulation management in patients on warfarin therapy is poorly defined due to the lack of randomized trials. Because guidelines are heterogeneous, it was hypothesized that "treatment strategies are not uniform in clinical practice". Between February 2003 and May 2003, a questionnaire with 4 different clinical scenarios was distributed to physicians by e-mail, or direct contact was made by a survey monitor. ⋯ Outpatient, full- dose, subcutaneous UH or low-molecular-weight heparin (LMWH) was the most selected option in the postoperative phase for all scenarios, with the exception of number 4 (52.9% in scenario 1, 34% in scenario 2, 32%, in scenario 3 and 28% in scenario 4). Even among expert clinicians, the management of perioperative anticoagulation is heterogeneous. In particular, the definition of risk categories and the optimal intensity of antithrombotic drugs need to be defined by well-designed prospective studies.
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Yonsei medical journal · Feb 2005
Comparative StudyComparison of unmonochromatized synchrotron radiation and conventional X-rays in the imaging of mammographic phantom and human breast specimens: a preliminary result.
A simple imaging setup based on the principle of coherence-based contrast X-ray imaging with unmonochromatized synchrotron radiation was used for studying mammographic phantom and human breast specimens. The use of unmonochromatized synchrotron radiation simplifies the instrumentation, decreases the cost and makes the procedure simpler and potentially more suitable for clinical applications. The imaging systems consisted of changeable silicon wafer attenuators, a tungsten slit system, a CdWO4 scintillator screen, a CCD (Charge Coupled Device) camera coupled to optical magnification lenses, and a personal computer. ⋯ Both the spatial resolution and image quality of the proposed system were compared with those of a conventional mammography system in order to establish the characteristic advantages of this approach. The images obtained with the proposed system showed a resolution of at least 25 microm on the test pattern with much better contrast, while the images of the capillary filled with air bubbles revealed coherence-based edge enhancement. This result shows that the coherence-based contrast imaging system, which emphasizes the refraction effect from the edge of materials of different refractive indexes, is applicable to imaging studies in fundamental medicine and biology, although further research works will be required before it can be used for clinical applications.
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Yonsei medical journal · Feb 2005
Development of a clinical protocol for home hospice care for Koreans.
As the Korean government's recognition of the importance of hospice service grows, the government has initiated a variety of hospice services in Korea. Each hospice organization has shown a significant difference in its health care delivery methods, constitution and care content. Developing a clinical protocol is essential for establishing standardized hospice services. ⋯ Eighteen health problems and a total of 223 interventions (173 major treatments and nursing interventions, and 50 optional interventions) were included in the final clinical protocol. This study is expected to contribute to the overall qualitative improvement of home hospice care and the subsequent shortening of documentation time. Evaluation tools and a regulatory feedback system need to be developed in order to maintain consistent evaluation procedures based on the continuous promotion and use of the protocol.
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Yonsei medical journal · Dec 2004
ReviewPolyomavirus (BK virus) nephropathy in kidney transplant patients: a pathologic perspective.
Reactivation of polyoma virus (BK virus) is a significant cause of morbidity in kidney transplant patients. This seemingly insignificant viral infection that affects the majority of population at a young age, once reactivated by immunosuppression, is a major factor contributing to graft loss. Screening techniques have been developed for early prediction of BK virus reactivation. ⋯ Unfortunately, disease outcome is often unfavorable and can culminate with eventual graft loss. Renal retransplantation has been performed with mixed results. As new data emerges, we will gain a better understanding of the disease caused by BK virus and respond with improved early diagnosis and treatment to preserve graft function.
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Yonsei medical journal · Dec 2004
Case ReportsIsolated small bowel transplantation from a living-related donor at the Catholic University of Korea--a case report of rejection -free course-.
The bowel transplantation team at the Catholic Medical Center, Korea, on April 9 2004, accomplished a case of isolated small bowel transplantation (SBT) in a 57 year-old female with short bowel syndrome. The primary surgery was a jejunocolostomy due to mesenteric vein thrombosis, while maintaining 30 cm of the jejunum and colon distal to the splenic flexure. Her renal function was partially unbalanced. ⋯ The patient was discharged on day 42. A CMV infection on day 83 was successfully treated with 3 weeks of gancyclovir therapy. She has been nutritionally independent, with complete oral feeding, and free of rejection until day 170 after the transplantation.