1.The impacts of the COVID-19 pandemic on emergency care utilization in patients with major emergency diseases in Chungnam Province
Il Kug CHOI ; Eul Hee ROH ; Han Joo CHOI
Journal of the Korean Society of Emergency Medicine 2023;34(6):527-539
Objective:
This study analyzed the impact of the coronavirus disease 2019 (COVID-19) pandemic on emergency care utilization in Chungnam Province by examining the status of emergency care utilization during this period.
Methods:
This study retrospectively analyzed 154,946 patients who visited emergency medical institutions in Chungnam Province for a major emergency between January 2015 and December 2021, using the National Emergency Department Information System data.
Results:
The incidence of the The three major emergency diseases are acute myocardial infarction (AMI), acute stroke, severe trauma decreased. Primary visits to the regional and local emergency medical centers increased, except for local emergency medical institutions. The utilization rate of the 119 ambulance service in 2020 decreased significantly for AMI compared to the previous year and was the lowest among the three major emergency diseases. Air transportation by helicopter decreased during the COVID-19 pandemic. The rate of emergency room arrivals within the golden hour decreased during the COVID-19 pandemic. The transfer and retransfer rates also decreased for all three major emergency diseases. Despite the decreased number of patients during the pandemic, the ratio of primary visits to the local emergency medical centers for the three major emergency diseases increased, and the lengths of stay in the emergency room increased.
Conclusion
The COVID-19 pandemic significantly impacted the occurrence, transportation, and therapeutic response to the three major emergency diseases in Chungnam Province. The vulnerability of patients with AMI in the pre-pandemic era was further exacerbated during the pandemic.
2.Clinical Features of Hypersensitivity Reactions to Cisplatin and Carboplatin.
Yeon Jin PARK ; Eul Ju MOON ; Hee Hwahn CHUNG ; Ju Won ROH ; Sang Yoon PARK ; Young Suk PARK
Korean Journal of Obstetrics and Gynecology 2003;46(5):1018-1023
OBJECTIVE: To characterize the clinical features of platinum compounds (cisplatin plus carboplatin) associated hypersensitivity reactions. METHODS: Medical records of 102 patients with gynecologic malignancy who received chemotherapy based on platinum at Center for Uterine Cancer from Jun. 2001 to Nov. 2002 were analyzed. Platinum hypersensitivity reaction was classified as acute and delayed reaction according to the time of onset, also mild and severe reaction according to the severity of symptoms and signs. RESULTS: Among the 102 patients treated with platinum compounds during this period, 20 (20%) developed hypersensitivity reaction. The median number of platinum courses for the first episode was 7 (range 4-9) and it concentrated at 7, 8, 9th cycles. Fourteen patients developed acute reaction and six patients experienced delayed reaction. Ten patients experienced severe symptoms including dyspnea. Acute reaction developed from a few minutes to 30 minutes after the initiation of the platinum infusion. Delayed reaction developed after discharge of patients with mild intensity. CONCLUSION: Platinum hypersensitivity reactions develop in patients who have been extensively pre- treated with these agents. As platinum compounds are increasingly used as neoadjuvant, initial, second-line chemotherapy of ovarian cancer and concurrent chemoradiation, palliative setting of cervical cancer, it can be anticipated that hypersensitivity reactions to these drugs will happen more frequently, at the same time it might be a important issue for clinicians engaged in chemotherapy.
Carboplatin*
;
Cisplatin*
;
Drug Therapy
;
Dyspnea
;
Humans
;
Hypersensitivity*
;
Medical Records
;
Ovarian Neoplasms
;
Platinum
;
Platinum Compounds
;
Uterine Cervical Neoplasms
;
Uterine Neoplasms
3.FDG-PET Scan in Patients with Pelvic Recurrence of Cervical Cancer.
Yeon Jin PARK ; Eul Ju MOON ; Hee Hwahn CHUNG ; Ju Won ROH ; Sang Yoon PARK ; Keon Wook KANG
Korean Journal of Obstetrics and Gynecology 2003;46(5):991-997
OBJECTIVE: The purpose of this study was to investigate the clinical feasibility of FDG-PET scan in selection of patients with pelvic recurrence of cervical cancer for surgical treatment. METHODS: From Jun. 2001 to Oct. 2002, whole body FDG-PET scan findings were compared with findings of CT, MRI, and pathologic reports in 24 patients with pelvic recurrence of cervical cancer. PET scan was obtained with a GE Advance PET scanner, beginning at 60 minutes after injection of 370-555 MBq (10- 15 mCi) of 18F FDG. Regional scan was also obtained if needed. Uptake exceeding 2.5 SUV was determined as a positive finding. RESULTS: Among these 24 patients, 10 patients had metastatic lesions at pelvic lymphnodes (4), para- aortic lymphnodes (3), mediastinal lympnnodes (1), lung (4), and bone (1). Among 14 patients with no metastasis, 10 patients underwent surgical treatment but the operations were abandoned in 2 patients due to lymphnodes metastasis and pelvic peritoneal spreads that confused as normal FDG uptake of the intestines pre- operatively. Among 8 patients whom the operation was completed, 3 patients received pelvic exenteration, 2 patients received CORT, and 3 patients received LEER. CONCLUSION: FDG-PET is clinically feasible in selection of patients with pelvic recurrence of cervical cancer for surgical treatment.
Humans
;
Intestines
;
Lung
;
Magnetic Resonance Imaging
;
Neoplasm Metastasis
;
Pelvic Exenteration
;
Positron-Emission Tomography
;
Recurrence*
;
Uterine Cervical Neoplasms*
4.A Case of Well-differentiated Papillary Mesothelioma Developing Malignant Mesothelioma with Seeding Mass on the Trocar Insertion Site of Diagnostic Laparoscopy and Malignant Change.
Min Jung KIM ; Eul Ju MOON ; Yeon Jin PARK ; Ju Won ROH ; Young Suk PARK ; So Yeon PARK ; Hee Sung KIM ; Jung Suk SIM ; Sang Yoon PARK
Cancer Research and Treatment 2001;33(4):357-361
Although well-differentiated papillary mesothelioma (WDPM) is usually classified as benign, the natural history of this lesion has not been clearly established. We present a case of WDPM in 60-year old woman developing malignant mesothelioma with seeding mass on the trocar insertion site over a period of 2 years. The initial symptom exhibited by the patient was abdominal distension from massive ascitic fluid. With an impression of peritoneal carcinomatosis, we performed a diagnostic laparoscopy. On the laparoscopic finding, a small whitish nodule was found on the liver surface and the pathologic result revealed reactive mesothelial hyperplasia. At exploro-laparotomy, multiple small nodules were found on the omentum and a biopsy revealed well-differentiated papillary mesothelioma of the peritoneum. The patient underwent pelvic lymphadenectomy and omentectomy of the colon and was followed for 2 years without any further treatment. Subsequently, she presented with abdominal distention with massive ascites and palpable abdominal wall mass at the previous trocar insertion site. Malignant mesothelioma was confirmed histologically via re- exploration. The rare transformation of well-differentiated papillary mesothelioma into a typically malignant diffuse mesothelioma and the unusual seeding on trocar insertion site prompted us to report this case.
Abdominal Wall
;
Ascites
;
Ascitic Fluid
;
Biopsy
;
Carcinoma
;
Colon
;
Female
;
Humans
;
Hyperplasia
;
Laparoscopy*
;
Liver
;
Lymph Node Excision
;
Mesothelioma*
;
Middle Aged
;
Natural History
;
Omentum
;
Peritoneum
;
Surgical Instruments*
5.A Case of Endometrial Stromal Sarcoma with Smooth Muscle Differentiation.
Si Eun LEE ; Eul Ju MOON ; Yeon Jin PARK ; Ju Won ROH ; Hee Sung KIM ; Jung Suk SIM ; Jong Du PARK ; Sang Yoon PARK
Korean Journal of Obstetrics and Gynecology 2001;44(11):2150-2154
Mixed endometrial stromal and smooth-muscle tumor is one of the uncommon forms of uterine sarcoma. Only a few cases of endometrial stromal tumors showing smooth muscle differentiation have been reported in the literature. We experienced a case of low grade endometrial stromal sarcoma with smooth muscle differentiation in a 44-year-old woman, so we report this case with brief review of literatures.
Adult
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Endometrial Stromal Tumors
;
Female
;
Humans
;
Muscle, Smooth*
;
Sarcoma
;
Sarcoma, Endometrial Stromal*
6.Qualitative Comparison of Semantic Memory Impairment in Patients with Amnestic Mild Cognitive Impairment Based on β-Amyloid Status.
Ji Eun KIM ; So Hee PARK ; Yun Jeong HONG ; Jihye HWANG ; Noh Eul HAN ; Sun Mi LEE ; Jee Hoon ROH ; Jae Seung KIM ; Jae Hong LEE
Journal of Clinical Neurology 2019;15(1):27-37
BACKGROUND AND PURPOSE: Semantic memory remains more stable than episodic memory across the lifespan, which makes it potentially useful as a marker for distinguishing pathological aging from normal senescence. To obtain a better understanding of the transitional stage evolving into Alzheimer's dementia (AD), we focused on the amnestic mild cognitive impairment (aMCI) stage stratified based on β-amyloid (Aβ) pathology. METHODS: We analyzed the raw data from Korean version of the Boston Naming Test (K-BNT) and the Controlled Oral Word Association Test (COWAT). For K-BNT, the frequencies of six error types and accuracy rates were evaluated. For a qualitative assessment of the COWAT, we computed the number of switching, number of clusters, and mean cluster size. RESULTS: The data from 217 participants were analyzed (53 normal controls, 66 with Aβ− aMCI, 56 with Aβ+ aMCI, and 42 disease controls). There were fewer semantically related errors and more semantically unrelated errors on the K-BNT in Aβ+ aMCI than in Aβ− aMCI, without a gross difference in the z score. We also found that Aβ+ aMCI showed a more prominent deficit in the number of clusters in the semantic fluency task [especially for animal names (living items)] than Aβ− aMCI. CONCLUSIONS: In spite of similar clinical manifestations, Aβ+ aMCI was more similar to AD than Aβ− aMCI in terms of semantic memory disruption. Semantic memory may serve as an early indicator of brain Aβ pathology. Therefore, semantic memory dysfunction deserves more consideration in clinical practice. Longitudinal research with the follow-up data is needed.
Aging
;
Alzheimer Disease
;
Animals
;
Brain
;
Dementia
;
Follow-Up Studies
;
Humans
;
Memory*
;
Memory, Episodic
;
Mild Cognitive Impairment*
;
Pathology
;
Semantics*
;
Word Association Tests
7.Pre-hospital Korean Triage and Acuity Scale: the results of first and second pilot projects
Changshin KANG ; Han Joo CHOI ; Sang-Il KIM ; Yong Oh KIM ; Jung-Youn KIM ; Jungho KIM ; Hyun NOH ; Hyun Ho RYU ; Jung Hee WEE ; Gyuuk HWANG ; Ki Jeong HONG ; Jae Yun AHN ; Chun Song YOUN ; Eunsil KO ; Minhee LEE ; Sung-keun KO ; Tae Young LEE ; Eul Hee ROH ; Joonbum PARK
Journal of the Korean Society of Emergency Medicine 2024;35(1):6-15
While the Korean Triage and Acuity Scale (KTAS) was introduced in 2016 as a tool to identify patients at risk of catastrophic events, including death in the ED, the triage system for the pre-hospital stage still lacks evidence. The pre-hospital stage is characterized by time-sensitive and complex scenarios, where rapid and accurate decision-making is paramount to optimize patient outcomes. Despite the vital role of pre-hospital care providers, the invalidated and subjective current triage system consisting of 4-stages is still used at the pre-hospital stage, and hence, it needs to be modified to be more objective, standardized, and reliable. To improve the Korean emergency medical system, the pre-hospital KTAS (Pre-KTAS) was developed in 2020, and then two pilot projects were conducted in 2022 and 2023. This paper not only reveals the results of the first and second pilot projects for Pre-KTAS but also highlights the potential benefits of using this newly developed triage tool in the pre-hospital setting. Furthermore, this paper suggests ways to improve the emergency medical system (EMS) in Korea by improving patient safety, resource allocation, and overall emergency response efficiency.
8.Microcatheter Looping to Facilitate Aneurysm Selection in Coil Embolization of Paraclinoid Aneurysms.
Young Dae CHO ; Jong Kook RHIM ; Jeong Jin PARK ; Jin Sue JEON ; Roh Eul YOO ; Hyun Seung KANG ; Jeong Eun KIM ; Won Sang CHO ; Moon Hee HAN
Korean Journal of Radiology 2015;16(4):899-905
OBJECTIVE: Described herein is a microcatheter looping technique to facilitate aneurysm selection in paraclinoid aneurysms, which remains to be technically challenging due to the inherent complexity of regional anatomy. MATERIALS AND METHODS: This retrospective study was approved by our Institutional Review Board, and informed consent was waived. Microcatheter looping method was employed in 59 patients with paraclinoid aneurysms between January 2012 and December 2013. In the described technique, construction of a microcatheter loop, which is steam-shaped or pre-shaped, based on the direction of aneurysms, is mandatory. The looped tip of microcatheter was advanced into distal internal carotid artery and positioned atop the target aneurysm. By steering the loop (via inner microguidewire) into the dome of aneurysm and easing tension on the microcatheter, the aneurysm was selected. Clinical and morphologic outcomes were assessed with emphasis on technical aspects of the treatment. RESULTS: Through this looping technique, a total of 59 paraclinoid aneurysms were successfully treated. After aneurysm selection as described, single microcatheter technique (n = 25) was most commonly used to facilitate coiling, followed by balloon protection (n = 21), stent protection (n = 7), multiple microcatheters (n = 3), and stent/balloon combination (n = 3). Satisfactory aneurysmal occlusion was achieved through coil embolization in 44 lesions (74.6%). During follow-up of 53 patients (mean interval, 10.9 +/- 5.9 months), only one instance (1.9%) of major recanalization was observed. There were no complications related to microcatheter looping. CONCLUSION: This microcatheter looping method facilitates safe and effective positioning of microcatheter into domes of paraclinoid aneurysms during coil embolization when other traditional microcatheter selection methods otherwise fail.
Adult
;
Carotid Artery, Internal/radiography/*surgery
;
Catheterization/methods
;
Cerebral Angiography/methods
;
Embolization, Therapeutic/*methods
;
Female
;
Humans
;
Intracranial Aneurysm/*therapy
;
Male
;
Middle Aged
;
Retrospective Studies
;
Stents
9.Metastsectomy a Feasible Treatment in Selected Patients with Gynecologic Malignancy.
Eul Ju MOON ; Yeonrk Jin PARK ; Hee Hwahn CHUNG ; Ju Won ROH ; Jung Suk SIM ; Sang Jae PARK ; Jong Lim PARK ; Jong Mog LEE ; Jae Ill ZO ; Dae Soon CHO ; Sang Hoon SHIN ; Heon YOO ; Seung Hoon LEE ; Sang Yoon PA
Korean Journal of Obstetrics and Gynecology 2003;46(5):1029-1036
To report cases of metastasectomy for metastatic gynecologic malignancies, we reviewed the medical records of all patients who have undergone metastasectomy for metastatic gynecologic malignancies in Center for Uterine Cancer from June 2001 to October 2002. Six patients were identified with median age of 55 years (range 52-66 years). The metastatic sites and primary sites were as follows: 3 liver metastasis from ovary; 1 abdominal wall metastasis from uterus (endometrial cancer), 1 brain metastasis from ovary, 1 lung metastasis from uterus (sarcoma). The median disease free interval was 48 months (range 10 months-13 years). There was no perioperative mortality. Postoperative morbidity was tolerable with 1 case of bile leakage. In three patients with hepatectomy, one patient was dead of disease after 15 months, one patient is alive with disease at 20 months of follow up, one patient have no evidence of recurrence at 7 months follow up. The patient with brain metastasis was dead due to lung metastsis after 9 months later postoperatively. Remaining two patients with abdominal wall and lung metastasis have no evidence of tumor recurrence at 4, 7 months follow up respectively. Metastasectomy for metastatic gynecologic malignancies can be performed safely and may help prolong survival in carefully selected patients.
Abdominal Wall
;
Bile
;
Brain
;
Female
;
Follow-Up Studies
;
Hepatectomy
;
Humans
;
Liver
;
Lung
;
Medical Records
;
Metastasectomy
;
Mortality
;
Neoplasm Metastasis
;
Ovary
;
Recurrence
;
Uterine Neoplasms
;
Uterus
10.Breast Tissue Reconstruction Using Polycaprolactone Ball Scaffolds in a Partial Mastectomy Pig Model
Kyu-Sik SHIM ; Da Hye RYU ; Han-Saem JO ; Ki-Bum KIM ; Do-Hyun KIM ; Yong-Kyu PARK ; Min HEO ; Hee-Eun CHO ; Eul-Sik YOON ; Won Jai LEE ; Tai Suk ROH ; Seung Yong SONG ; Wooyeol BAEK
Tissue Engineering and Regenerative Medicine 2023;20(4):607-619
BACKGROUND:
Breast cancer patients suffer from lowered quality of life (QoL) after surgery. Breast conservancy surgery (BCS) such as partial mastectomy is being practiced and studied as an alternative to solve this problem. This study confirmed breast tissue reconstruction in a pig model by fabricating a 3-dimensional (3D) printed Polycaprolactone spherical scaffold (PCL ball) to fit the tissue resected after partial mastectomy.
METHODS:
A 3D printed Polycaprolactone spherical scaffold with a structure that can help adipose tissue regeneration was produced using computer-aided design (CAD). A physical property test was conducted for optimization. In order to enhance biocompatibility, collagen coating was applied and a comparative study was conducted for 3 months in a partial mastectomy pig model.
RESULTS:
In order to identify adipose tissue and fibroglandular tissue, which mainly constitute breast tissue, the degree of adipose tissue and collagen regeneration was confirmed in a pig model after 3 months. As a result, it was confirmed that a lot of adipose tissue was regenerated in the PCL ball, whereas more collagen was regenerated in the collagen-coated Polycaprolactone spherical scaffold (PCL–COL ball). In addition, as a result of confirming the expression levels of TNF-a and IL-6, it was confirmed that PCL ball showed higher levels than PCL–COL ball.
CONCLUSION
Through this study, we were able to confirm the regeneration of adipose tissue through a 3-dimensional structure in a pig model. Studies were conducted on medium and large-sized animal models for the final purpose of clinical use and reconstruction of human breast tissue, and the possibility was confirmed.