Menopause is the time at which menstruation stops in women. After menopause, women are more susceptible to some diseases, especially osteoporosis and cardiovascular disease. Vitamin D has a protective effect against osteoporosis by facilitating the absorption of calcium and affecting parathyroid hormone. Vitamin D also affects cardiovascular function by lowering the blood pressure, which affects the renin–angiotensin system and alters the low-density lipoprotein receptor activity. This paper discusses supplemental vitamin D in postmenopausal women with osteoporosis and cardiovascular disease.

Psychological stress including depression and anxiety are independent risk factors for cardiovascular disease morbidity and mortality, especially in women. Emotional regulation plays a mediating role in the development of depression and physical illness, and can alter resting physiologic responses associated with the stress response. Mindfulness-based stress reduction (MBSR) is a structured group program that employs mindfulness meditation to alleviate suffering associated with physical, psychosomatic, and psychiatric disorders. MBSR was originally developed for the management of chronic pain, which is now used widely to reduce psychological morbidity associated with chronic illnesses and to treat emotional and behavioral disorders. In cardiovascular disease, MBSR may be helpful for controlling several risk factors for coronary heart disease such as hypertension, type 2 diabetes mellitus, dyslipidemia, oxidative and psychosocial stress, obesity, and smoking, and improvements in submaximal exercise responses and heart rate variability. Although the most effective mode of stress reduction therapy is yet to be established, increasing recognition is being given to MBSR therapy.

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• Psychosomatic Approach to Fibromyalgia Syndrome: Concept, Diagnosis and Treatment
  Sang-Shin Lee
  Kosin Medical Journal.2021; 36(2): 79.     CrossRef
• Investigating the effect of meditation on spiritual wellbeing of Type-2 diabetic amputees: A clinical trial study
  Ali Heydari Movahed, Fakhri Sabouhi, Reza Mohammadpourhodki, Sepideh Mahdavi, Sima Goudarzian, Malihe Amerian, Mona Mohtashami, Mansoure Kheiri, Malihe Imeni
  Heliyon.2020; 6(11): e05567.     CrossRef

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• Prognostic role of neutrophil-to-lymphocyte ratio in diffuse large B cell lymphoma patients: an updated dose–response meta-analysis
  Shidai Mu, Lisha Ai, Fengjuan Fan, You Qin, Chunyan Sun, Yu Hu
  Cancer Cell International.2018;[Epub]     CrossRef

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• Do we need Moodle in medical education? A review of its impact and utility
  Seri Jeong, Hyunyong Hwang
  Kosin Medical Journal.2023; 38(3): 159.     CrossRef
• The effectiveness of Moodle's “Lesson” feature in pre-learning about arterial puncture and blood transfusion procedures
  Haeyoung Lee, Sang-Shin Lee, Hyunyong Hwang
  Kosin Medical Journal.2023; 38(4): 278.     CrossRef
• New approach to learning medical procedures using a smartphone and the Moodle platform to facilitate assessments and written feedback
  Sang-Shin Lee, Haeyoung Lee, Hyunyong Hwang
  Kosin Medical Journal.2022; 37(1): 75.     CrossRef
• How does quiz activity affect summative assessment outcomes? An analysis of three consecutive years’ data on self-directed learning
  Chi Eun Oh, Hyunyong Hwang
  Kosin Medical Journal.2022; 37(3): 228.     CrossRef

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• Remote health monitoring services in nursing homes
  Jiwon Kim, Hyunsoo Kim, Sungil Im, Youngin Park, Hae-Young Lee, Sookyung Kwon, Youngsik Choi, Linda Sohn, Chulho Oak
  Kosin Medical Journal.2023; 38(1): 21.     CrossRef

Totally implantable venous devices are used in medical care for parenteral nutrition, vascular access, administrating chemotherapeutic agents and so on. Although the large variety of catheter complications, catheter fracture is a rare but serious complication. The pinch off syndrome is caused by the compression of the catheter between the clavicle and first rib, and may lead to fracture and possible dislocation of the catheter. We report here the case history of a patient with metastatic breast cancer who developed a rare complication of subclavian catheter fracture as a consequence of pinch off syndrome.

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• Pinch-off syndrome ou syndrome de la Pince Costo-Claviculaire
  E.A. Allassane, M. El Hammoumi, M. Bhairis, F. El Oueriachi, E.H. Kabiri
  Revue de Pneumologie Clinique.2018; 74(6): 492.     CrossRef

The percutaneous transhepatic biliary drainage (PTBD) is an effective intervention as a palliative therapy for relieving a jaundice and cholangitis. It may be used in place of Endoscopic retrograde cholangiopancreatography (ERCP) in the obstructive biliary disease. Recently, by developing invasive procedures, the incidence of the complications such as bleeding and perforation has been increasing in the diagnosis and treatment of hepatobiliary disease. We report here on a case of remained drawstring after PTBD in a 85-year-old man. The patient was conducted PTBD for relieving a jaundice and cholangitis. And then the patient had complained of abdominal pain constantly. A few days later, we removed PTBD and attempted ERCP for removal of CBD stone. The ERCP showed remained drawstring around ampulla of vater and we removed it by IT knife. The drawstring was successfully removed.

Superior sagittal sinus thrombosis is an uncommon disease, and 25% of cases are considered to be idiopathic. Hypercoagulability, local bloodstream stasis, and vessel wall abnormalities may contribute to the development of this condition. The thyrotoxic phase of Graves' disease is associated with venous thrombosis caused by hypercoagulability, which is in turn induced by increased levels of homocysteine and factor VIII and decreased fibrinolytic activity. Here, we report the case of a 39-year-old male who presented with superior sagittal sinus thrombosis and concomitant hyperthyroidism.

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• Cerebral Venous Thrombosis during Thyrotoxicosis: Case Report and Literature Update
  Emanuela Maria Raho, Annibale Antonioni, Niccolò Cotta Ramusino, Dina Jubea, Daniela Gragnaniello, Paola Franceschetti, Francesco Penitenti, Andrea Daniele, Maria Chiara Zatelli, Maurizio Naccarato, Ilaria Traluci, Maura Pugliatti, Marina Padroni
  Journal of Personalized Medicine.2023; 13(11): 1557.     CrossRef

Knotting of an epidural catheter occurs very rarely with an estimated incidence of 0.0015%. We present a case of an epidural catheter knot formed at removal of an epidural catheter following a forceful insertion of the catheter against resistance met at the entrance of the epidural space during threading of the catheter through Tuohy needle placed uneventfully in a 65 year-old male patient undergoing epidural anesthesia. During removal of the epidural catheter, significant resistance was encountered on traction and it was found that approximately 1.5 ㎝ portion of the catheter had been retained within the patient's subcutaneous tissue. Firm traction was employed to withdraw the catheter against the resistance. The catheter was pulled out uneventfully from the patient. A knot estimated to be formed during removal of the catheter was observed at 0.6 ㎝ proximal to the catheter tip. No complications and side effects were noted until the patient's discharge.

Biliary cystadenomas are benign but potentially malignant cystic neoplasm. The preferred treatment is radical resection because it is difficult to differentiate a benign from a malignant biliary cystadenoma. A 40 year-old woman presented with moderate abdominal discomfort. Esophageal varix was found up to mid-esophagus on endoscopy. She has no prior history of liver disease or chronic alcohol ingestion. About 15cm sized biliary cystadenoma was diagnosed by ultrasonography, computed tomography and magnetic resonance imaging. Serum level of bilirubin, alanine aminotransferase, alkaline phosphatase, gamma-glutamyl transpeptidase and tumor marker were elevated. The patient underwent US-guided aspiration. Tumor markers from the aspirated fluid are increased. Left hepatectomy was performed to completely remove the cyst. Histology of the resected specimen confirmed a biliary cystadenoma of the liver with ovary-like stroma. Without prior history of liver disease or chronic alcoholic ingestion, incidental finding of esophageal varix could show an important clue for diagnosis of biliary cystadenoma.