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대한내과학회> 대한내과학회지 (Korean J Med)

대한내과학회지 (Korean J Med) update

The Korean Journal of Medicine (Korean J Med)

  • : 대한내과학회
  • : 의약학분야  >  내과학
  • : KCI후보
  • :
  • : 연속간행물
  • : 격월
  • : 1738-9364
  • : 2289-0769
  • : 대한내과학회잡지(~1992) → 대한내과학회지(1993~) → korean journal of medicine(1996~)

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수록범위 : 1권1호(1949)~97권5호(2022) |수록논문 수 : 12,186
대한내과학회지 (Korean J Med)
97권5호(2022년 10월) 수록논문
최근 권호 논문
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KCI후보

저자 : 최영화 ( Young Hwa Choi )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 5호 발행 연도 : 2022 페이지 : pp. 277-283 (7 pages)

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Emerging infectious diseases are increasing recently and globally. We have a long list of infectious disease epidemic in the 21th century followed by SARS, MERS, Ebola virus disease, and Zika virus infection. COVID-19 is a still ongoing pandemic. What will be the next pandemic agent? The World Health Organization proposed a research and development blueprint regarding global pandemic in 2016. The United Kingdom maintains a list of high consequence infectious diseases and is monitoring them. The Republic of Korea designates Class 1 infectious diseases capable of causing outbreak or epidemic. This article briefly describes several infectious diseases and its causative pathogen that should receive special attention. (Korean J Med 2022;97:277-283)

KCI후보

저자 : 차재명 ( Jae Myung Cha )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 5호 발행 연도 : 2022 페이지 : pp. 284-291 (8 pages)

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Although acute COVID-19 usually lasts for 12 weeks from the onset of symptoms, some patients experience variable persistent symptoms. Post-COVID-19 syndrome is defined as persistent symptoms and/or long-term complications that appear during or after COVID-19, persist for more than 12 weeks, and cannot be explained by an alternative diagnosis. The common symptoms of post-COVID-19 syndrome include general, pulmonary, hematological, cardiovascular, neuropsychiatric, renal, endocrine, gastroenterological, and dermatological symptoms. As the natural course and pathophysiology of COVID-19 are not yet clear, close monitoring is needed for various sequelae in multiple organs that occur in post-COVID-19 syndrome. In particular, patients who have been hospitalized in the intensive care unit or who have recovered from severe COVID-19 require close monitoring for the development of post-COVID-19 syndrome. Multidisciplinary collaboration is essential to provide integrated outpatient care for patients with post-COVID-19 syndrome. (Korean J Med 2022;97:284-291)

KCI후보

저자 : 정소령 ( So Lyung Jung )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 5호 발행 연도 : 2022 페이지 : pp. 292-302 (11 pages)

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The rate of detection of thyroid nodules and carcinomas has increased with the widespread use of ultrasonography (US), which is the primary imaging modality for the detection and risk stratification of thyroid nodules. The appropriate diagnosis and management of these patients is based on the risk factors related to the patients as well as the thyroid nodules. The Korean Society of Thyroid Radiology (KSThR) published consensus recommendations for US-based management of thyroid nodules in 2011 and revised them in 2016. These guidelines have been used as the standard guidelines in Korea. However, recent advances in the diagnosis and management of thyroid nodules have necessitated the revision of the original recommendations. The task force of the KSThR has revised the Korean Thyroid Imaging Reporting and Data System and recommendations for US lexicon, biopsy criteria, US criteria of extrathyroidal extension, optimal thyroid computed tomography protocol, and US follow-up of thyroid nodules before and after biopsy. The biopsy criteria were revised to reduce unnecessary biopsies for benign nodules while maintaining an appropriate sensitivity for the detection of malignant tumors. The goal of these recommendations is to provide the optimal scientific evidence and expert opinion consensus regarding US-based diagnosis and management of thyroid nodules. (Korean J Med 2022;97:292-302)

KCI후보

저자 : 이종찬 ( Jongchan Lee )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 5호 발행 연도 : 2022 페이지 : pp. 303-307 (5 pages)

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Appropriate management strategies are required to establish, maintain, and promote the growth the hospitalist system. Herein, we discuss strategies for the successful operation of the hospitalist system from the business point of view, particularly in terms of human resources and organizational management. Hospital executives should establish the vision, mission, value, and key value drivers of the hospitalist system from its inception, as well as decide its size and operation pattern according to the situation of each medical institution. Hospitalists are employed through the process of recruitment to increase the number of applicants and allow the selection of suitable candidates. Once the hospitalist system is constructed and operational, the focus must shift toward its growth. The goals and strategies for growth should be decided, leaders must be selected, and assistants must be employed. In the future, the hospitalist system is expected to play an essential role in improving the quality of medical care. Therefore, medical institutions should strategically introduce, maintain, and promote the growth of the hospitalist system. (Korean J Med 2022;97:303-307)

KCI후보

저자 : 조영욱 ( Young-uk Cho )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 5호 발행 연도 : 2022 페이지 : pp. 308-318 (11 pages)

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Acute myeloid leukemias (AMLs) are heterogeneous hematologic neoplasms characterized by myeloblast or promyelocyte proliferation without normal differentiation. The World Health Organization (WHO) classifies AMLs on the basis of chromosomal and genetic aberrations, with different prognoses for each subtype. Therefore, accurate diagnosis and classification of AMLs is critical for timely and appropriate treatment. Initial diagnostic workup includes morphologic assessment of the bone marrow aspirate and trephine biopsies, immunophenotyping using flow cytometry or immunohistochemistry stains, chromosomal analysis using the G-banding technique or fluorescence in situ hybridization, and mutation analysis using polymerase chain reaction, direct sequencing, or next-generation sequencing. The present study provides an algorithm for AML diagnosis and classification based on the WHO criteria and describes different clinicopathological stages of the workup. (Korean J Med 2022;97:308-318)

KCI후보

저자 : 이수현 ( Soohyeon Lee )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 5호 발행 연도 : 2022 페이지 : pp. 319-322 (4 pages)

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Due to rapid technical advances, steeply declining sequencing costs, and the ever-increasing number of targeted therapies, it is expected that extensive tumor DNA or RNA sequencing will be applied in standard of care. Clinicians will thus be confronted with increasingly complex genetic information and multiple test-platforms to choose from. General medical training, meanwhile, can hardly keep up with the pace of innovation. Consequently, there is a rapidly growing gap between clinical knowledge and genetic potential in cancer care. Multidisciplinary Molecular Tumor Boards (MTBs) have been suggested as a means to address this disparity, as a multidisciplinary approach to keep pace with the growing knowledge of complex molecular alterations in patients with advanced solid cancer. MTBs are designated to interpret these data and provide clinical recommendations. Not all patients with cancer have access to advice of an MTB. We aimed to determine the current status, opportunities, and challenges of the organization of MTBs in the Korea. (Korean J Med 2022;97:319-322)

KCI후보

저자 : 유지웅 ( Jiwung Ryu ) , 김중선 ( Jung-sun Kim ) , 서지원 ( Jiwon Seo )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 5호 발행 연도 : 2022 페이지 : pp. 323-327 (5 pages)

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We present a case of recurrent ischemic stroke in a 68-year-old man with a linear foreign body in the right atrium and ventricle and a patent foramen ovale (PFO). The patient developed atrial fibrillation despite taking warfarin at a therapeutic dose and had a third acute stroke. We planned left atrial appendage (LAA) occlusion via the PFO, followed by PFO closure and foreign body removal. The percutaneous LAA occlusion and PFO closure were successful. However, it was difficult to remove the radiolucent foreign body. We inserted an Omni™ catheter via the right jugular vein to contact the foreign body in the right atrium directly, grasped its distal end with a snare, and successfully extracted it. The patient was followed-up in the outpatient clinic and had no recurrent stroke. (Korean J Med 2022;97:323-327)

KCI후보

저자 : 강동혁 ( Donghyuk Kang ) , 이한비 ( Hanbi Lee ) , 정병하 ( Byung Ha Chung ) , 최범순 ( Bum Soon Choi ) , 양철우 ( Chul Woo Yang ) , 고은정 ( Eun Jeong Ko )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 5호 발행 연도 : 2022 페이지 : pp. 328-333 (6 pages)

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본 증례는 혈전 발생 위험도가 높은 MTHFR 유전자 변이와 헤파린유도 혈소판 감소증 두 질환을 동시에 가진 말기신부전 환자에서 신장 이식을 진행함에 있어, 수술 전후 혈전증 및 출혈을 최소화하는 개별화된 특수 항응고 치료 프로토콜을 적용하여 특이 합병증 없이 신장이식에 성공한 바, 이에 문헌고찰과 함께 보고하는 바이다.


Perioperative anticoagulation in a kidney transplant recipient with heparin-induced thrombocytopenia is challenging due to paradoxical hypercoagulability. A 49-year-old man with end-stage kidney disease and a previous stroke history was referred for living donor kidney transplantation. After the fifth dialysis session, the platelet count decreased to 10,000/μL, and heparin was immediately discontinued. Five days later, pulmonary thromboembolism with deep vein thrombosis was identified. Anti-heparin PF4 antibody, elevated serum homocysteine, and methylenetetrahydrofolate reductase gene mutations were discovered. Subsequent coronary angiography revealed three-vessel disease. Apixaban, folate, aspirin, and clopidogrel were administered and an inferior vena cava filter was implanted. Thereafter, coronary artery bypass graft surgery was performed using argatroban-bridging without complications. Kidney transplantation was performed 3 months later using the argatroban protocol. The graft kidney functioned well without any complications. In conclusion, we successfully conducted kidney transplantation in a thrombophilic patient with a methylenetetrahydrofolate reductase deficiency and heparin-induced thrombocytopenia by establishing an individualized perioperative anticoagulation protocol. (Korean J Med 2022;97:328-333)

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