Dermatomyositis and Paclitaxel-Induced Cutaneous Drug Eruption Associated with Metastatic Breast Cancer / 한국유방암학회지

Dermatomyositis (DM) is an idiopathic autoimmune connective disease characterized by muscles and skin inflammation of and a well-recognized association with several human malignancies, especially breast cancer. Paclitaxel is a taxane antineoplastic agent with therapeutic effects against a wide range of cancers including breast cancer. This drug is well known for neurotoxicity and hypersensitivity reactions. However, cutaneous drug eruptions, especially those of grade III or higher, are not frequent. Here, we describe the case of a 55-year-old woman with metastatic breast cancer who developed paraneoplastic DM and a paclitaxel-induced exanthematous drug eruption. This case report emphasizes the importance of evaluating internal malignancies, such as advanced breast cancer, in newly developed DM patients. In addition, it presents a rare case of paclitaxel-induced exanthematous drug eruption. The purpose of this case report highlights the immunological pathogenic mechanism of DM and drug eruption in underlying advanced breast cancer.

Acute Adrenal Insufficiency Associated with Acute Coronary Syndrome / 대한구급학회지

Acute adrenal insufficiency (AAI) in acute coronary syndrome (ACS) patients is rare and may be frequently underestimated as simple ACS, since symptoms of AAI are nonspecific. Physicians should be fully aware of the possibility of occult AAI combined with ACS, if clinical suspicion is high. Herein, we report a rare case of a 67-year-old female patient with concomitant AAI and drug eluting stent fracture-induced ACS. To our knowledge, there have been no case reports of AAI associated with ACS in Korea.

A Case of Deep Vein Thrombosis Following Cellulitis of the Lower Leg / 대한내과학회지

Cellulitis and deep vein thrombosis (DVT) have similar symptoms (lower extremity pain, erythema, and swelling) and there is the potential for misdiagnosis. In cases of cellulitis, DVT should be ruled out, as the symptoms of cellulitis might mask those of DVT, leading to serious complications such as pulmonary thromboembolism. The reported incidence of DVT in patients with cellulitis is low, especially patients with progression to pulmonary thromboembolism. We present a case of pulmonary thromboembolism following cellulitis of the lower leg in a 54-year-old male.

The Study on the Establishment of Acupuncture / 의사학

In ancient china, four famous literatures, Huang Di Nei Jing, Nan Jing, Ben Cao, Shang Han Lun appeared, which made the foundation of oriental medicine. Huang Di Nei Jing, the book of acupuncture, is the most essential literature among these four litertures. So the question asking the identity of oriental medicine can be turned into the question about the identity of acupuncture. The investigation into origin will not be the only way to study of identity but one of the most attractive means. So we can answer with the study of origin to the question about identity. Acupuncture is comprised of theories like jing mai, qi xue and technical factors like moxibustion, bian which is like present operating knife. To trace the origin of acupuncture, we must investigate not only technical factors but also theories. But it will be impossible to trace every theories underlying the acupuncture in this small thesis. This is the reason that I restricted my attention to the principle of preventive medicine, regimen. Before the excavation of Mawangdui, the belief that acupuncture started long ago before Han period had been generally accepted. But there was not any proof proving the presence of acupuncture in the excavated literatures representing the Han period medicine. This fact announced that we must draw the time of establishment of acupuncture back after the Mawangdui literature buried in B.C. 168. But we can find the proof of the presence of acupuncture just before B.C. 168 in Shiji written by Si Mi Qian. Through these facts and inferences that we got until now, we can reach a conclusion that acupuncture would have appeared around 190-176 when Chun Yu Yi was practicing as a doctor. As you know, in the Mawangdui literature, what was associated with jing mai was moxibustion. But at the same time, moxibustion was being used just as the experience medicine technique without theory. So the moxibustion would has been about to be associated with jing mai theory in Mawangdui period. The word zhen jiu, the acupuncture and moxibustion, means there was a way to reconcile two techniques. It was by assuming bu and handing xie over to acupuncture that moxa can coexist with acupuncture. bian is used for infection treatment more than bloodletting tool in ancient china. but there is a bridge between acupuncture with bian. Acupuncture inherited its appearance from bian. It is generally believed that blood-letting is commonly developed in the classic east and west medicine. But the blood-letting could be harmonious with the old chinese belief that vitality must be retained in the body? No. The blood-letting is not generally practiced in ancient china. We can scarcely find the evidence of blood-letting in the ancient literature now in hand except Huang Di Nei Jing. Blood-Letting widened its territory in ancient chinese medicine with the help of the medical version of wuweierwubuwei principle which means 'not do anything, then everything does'. But soon lost its territory. Even in the Huang Di Nei Jing, We can find its disappearance. What is the reason? For its disharmony with chinese life idea, 'not lose essence'. Acupuncture replaced the blood-letting. It was the response of the ancient chinese healers to the regimen spirit and harmonious with chinese life view. Regimen spirit, the medical version of 'wuweierwubuwei' does not pursue cure after being ill but defense before disease. Acupuncture, meeting the demands of time, appeared in pre-han period as the association with jingmai theory which may be developed in regimen field, inheritence of moxa's esperience, and the shape of bian.

The Origin of Jingmai : Through the Investigation into Some Important Hypotheses / 의사학

In this paper, I tried to investigate the origin of Jingmai through examination of some important hypotheses brought up by modern scholars and introduce new hypothesis. Hypotheses about the origin of Jingmai that have been investigated in this paper are as follows. 1) Hypothesis by Joseph Needham and Kano Yoshimitsu that Jingmai is originated from hydraulic engineering or twelve rivers. 2) Hypothesis by some chinese scholars like Zhou yimou that Jingmai is originated from subjective experience of the Neishi daoist experience. 3) Hypothesis by Yamada Keiji that Jingmai is originated from moxibustion supported by shamanism. 4) Hypothesis by Li jianmin that Jingmai is originated from Daoyinshu one of the body-cultivation techniques. Hypothesis 1) has the problem of the fallacy of circular argument. I can drag the opposite resolution from the same basis used by Kano Yoshimitsu. There is the problem of misreading in the hypothesis 2). The words quoted by Zhou yimou are not related to the twelve Jingmai but Qijingbamai. Yamada Keiji and Li jianmin presuppose that at first Mai was just blood vessel. Then they follow each way as mentioned above. I agree their opinion that at the beginning Mai was just blood vessel. But I think that Mai was affected by the schema of shamanism. Mai as the vessel that not only blood but Qi go through is conceived by the schema of shamanism, I think.