2.Minimally Invasive Approach Using Digital Single-Operator Peroral Cholangioscopy-Guided Electrohydraulic Lithotripsy and Endoscopic Nasogallbladder Drainage for the Management of High-Grade Mirizzi Syndrome
Hyung Ku CHON ; Chan PARK ; Tae Hyeon KIM
Clinical Endoscopy 2021;54(6):930-934
Mirizzi syndrome is a rare complication of gallbladder disease that can be difficult to treat. In particular, endoscopic treatment often fails because of the inability to access or to capture the impacted cystic duct stone. We report a case of Mirizzi syndrome grade III that was successfully managed by digital single-operator peroral cholangioscopy-guided electrohydraulic lithotripsy with endoscopic nasogallbladder drainage and interval laparoscopic cholecystectomy. Based on our experience, digital single-operator peroral cholangioscopy-guided electrohydraulic lithotripsy with endoscopic nasogallbladder drainage is a feasible minimally invasive approach for the management of high-grade Mirizzi syndrome.
3.Successful Endoscopic Ultrasound-Guided Treatment of a Spontaneous Rupture of a Hemorrhagic Pancreatic Pseudocyst
Chan PARK ; Tae Hyeon KIM ; Hyung Ku CHON
Clinical Endoscopy 2021;54(5):763-766
Spontaneous rupture of a hemorrhagic pancreatic pseudocyst may be life-threatening. Endoscopic ultrasound (EUS)-guided drainage has been reported to be a valuable treatment option for pancreatic pseudocysts. However, its usefulness in the management of a ruptured pancreatic pseudocyst is limited. We report a rare case of a spontaneous rupture of a hemorrhagic pancreatic pseudocyst in a patient with chronic pancreatitis, which was successfully treated with EUS-guided gastrocystostomy with a fully covered self-expandable metallic stent.
4.Successful Endoscopic Ultrasound-Guided Treatment of a Spontaneous Rupture of a Hemorrhagic Pancreatic Pseudocyst
Chan PARK ; Tae Hyeon KIM ; Hyung Ku CHON
Clinical Endoscopy 2021;54(5):763-766
Spontaneous rupture of a hemorrhagic pancreatic pseudocyst may be life-threatening. Endoscopic ultrasound (EUS)-guided drainage has been reported to be a valuable treatment option for pancreatic pseudocysts. However, its usefulness in the management of a ruptured pancreatic pseudocyst is limited. We report a rare case of a spontaneous rupture of a hemorrhagic pancreatic pseudocyst in a patient with chronic pancreatitis, which was successfully treated with EUS-guided gastrocystostomy with a fully covered self-expandable metallic stent.
5.Interobserver and Intraobserver Reliability of Sub-Axial Injury Classification and Severity Scale between Radiologist, Resident and Spine Surgeon.
Woo Jin LEE ; Seung Hwan YOON ; Yeo Ju KIM ; Ji Yong KIM ; Hyung Chun PARK ; Chon Oon PARK
Journal of Korean Neurosurgical Society 2012;52(3):200-203
OBJECTIVE: The sub-axial injury classification (SLIC) and severity scale was developed to decide whether to operate the cervical injured patient or not, but the reliability of SLIC and severity scale among the different physicians was not well known. Therefore, we evaluated the reliability of SLIC among a spine surgeon, a resident of neurosurgery and a neuro-radiologist. METHODS: In retrograde review in single hospital from 2002 to 2009 years, 75 cases of sub-axial spine injured patients underwent operation. Each case was blindly reviewed for the SLIC and severity scale by 3 different observers by two times with 4 weeks interval with randomly allocated. The compared axis was the injury morphology score, the disco-ligamentous complex score, the neurological status score and total SLIC score; the neurological status score was derived from the review of medical record. The kappa value was used for the statistical analysis. RESULTS: Interobserver agreement of SLIC and severity scale was substantial agreement in the score of injury morphology [intraclass correlation (ICC)=0.603] and total SLIC and severity sacle (ICC value=0.775), but was fair agreement in the disco-ligamentous complex score (ICC value=0.304). Intraobserver agreements were almost perfect agreement in whole scales with ICC of 0.974 in a spine surgeon, 0.948 in a resident of neurosurgery, and 0.963 in a neuro-radiologist. CONCLUSION: The SLIC and severity scale is comprehensive and easily applicable tool in spine injured patient. Moreover, it is very useful tool to communicate among spine surgeons, residents of neurosurgery and neuro-radiologists with sufficient reproducibility.
Axis, Cervical Vertebra
;
Humans
;
Medical Records
;
Neurosurgery
;
Spine
;
Weights and Measures
6.A Case of Rhabdomyolysis in a Body-Builder.
Hyung Soon PARK ; Sung Il JANG ; Yong Kyu LEE ; Hye Rim AN ; Hyung Chon PARK ; Sung Kyu HA ; Sung Jin MOON
Korean Journal of Nephrology 2009;28(4):335-338
Rhabdomyolysis is a serious and potentiallylethal disease that can develop from a variety of traumatic and nontraumatic conditions. In this report, the authors describe a case of rhabdomyolysis that occurredafter a body-building tournament. A 32-year-old body-builder was admitted due to quadriplegia and muscle pain. The patient had a serum potassium level of 1.8 mmol/L, creatinine phosphokinase level of 5,414 IU/L and urine myoglobin of 128.1 ng/ml. He had taken anabolic androgenic steroids for 6 months and overate himself with carbohydrate food after the tournament. Possible causes for the rhabdomyolysis were hypokalemia, exercise, and anabolic androgenic steroids, etc. His condition was fully recovered without complications after potassium replacement and general supportive care. Body- builders may be exposed to rhabdomyolysis risk factors such as diet control, weight reduction, and taking steroids. Therefore, special attention and education on rhabdomyolysis should be provided to body-builders.
Adult
;
Creatinine
;
Diet
;
Humans
;
Hypokalemia
;
Muscles
;
Myoglobin
;
Potassium
;
Quadriplegia
;
Rhabdomyolysis
;
Risk Factors
;
Somatotypes
;
Steroids
;
Weight Loss
7.A Case of Isolated Protein S Deficiency, complicated by Acute Pulmonary Thromboembolism after Coronary Angiography.
Byung Hyun YOO ; Yong Joo KIM ; Won Seok PARK ; Myung Sook KIM ; Hyun Ok PARK ; Seung Won JIN ; Doo Soo CHON ; Jong Jin KIM ; Jun Cheol PARK ; Jae Hyung KIM ; Soon Jo HONG ; Kyu Bo CHOI
Korean Circulation Journal 2000;30(7):876-880
No abstract available.
Coronary Angiography*
;
Protein S Deficiency*
;
Protein S*
;
Pulmonary Embolism*
8.A Case of Hepatic Tuberculosis Diagnosed by Peritonescopy with Liver Biopsy.
Heung Soo KIM ; Chae Yoon CHON ; Hyung Mee BAE ; Young Soo KIM ; Dong Gyoo YANG ; Joon Pyo CHUNG ; Cheon Soo HONG ; Jin Kyung KANG ; In Suh PARK ; Heung Jai CHOI ; Chan Il PARK
Korean Journal of Gastrointestinal Endoscopy 1991;11(2):323-327
Studies on hepatic tuberculosis are rare in Korea except several case repots. This is the first report on hepatic tuberculosis confirmed by the peritoneoscopic liver biopsy in Korea. A 43-year-old man was admitted due to high fever and cough for l0 days. On physical examination moist rale was audible on the both lower lung fields and hepatomegaly was noted. Chest X-ray revealed multiple fine granularity scattered uniformly throughout the both lung fields compatible with miliary pulmonary tuberculosis. On blood chemistry, SGOT, SGPT and alkaline phosphatase were elevated. Peritoneascopy revealed multiple yellowish-white small nodules evenly acattered on the entire surface of the both lobes of the liver and the needle biopsy of the liver showed chronic granulomatous inflammation with multinucleated giant cells and caseous necrosis consistent with hepatic tuberculosis. The patient was treated with antituberculous medications. Chest X-ray 6 months after treatment revealed completely healed miliary pulmonary tuberculosis and on blood chemistry 200 days after therapy SGOT, SGPT and alkaline phosphatase were within normal limits.
Adult
;
Alanine Transaminase
;
Alkaline Phosphatase
;
Aspartate Aminotransferases
;
Biopsy*
;
Biopsy, Needle
;
Chemistry
;
Cough
;
Fever
;
Giant Cells
;
Hepatomegaly
;
Humans
;
Inflammation
;
Korea
;
Liver*
;
Lung
;
Necrosis
;
Physical Examination
;
Respiratory Sounds
;
Thorax
;
Tuberculosis, Hepatic*
;
Tuberculosis, Pulmonary
9.ERCP Room Setting: What Doctors Starting ERCP Need to Know
Eaum Seok LEE ; Hyung Ku CHON ; Ju Sang PARK ; Sun Young YI ; Dong Wook LEE ; Chang-Hwan PARK ; Kwang Bum CHO ;
Korean Journal of Pancreas and Biliary Tract 2021;26(2):67-76
To date, there is no standardization of the endoscopi c retrograde cholangiopancreatography (ERCP) room setting regarding with the size, equipment or space arrangement. Therefore, the authors visited 11 tertiary hospitals that recently remodeled or newly designed the ERCP room to analyze and identify their advantages and disadvantages. The ERCP room should have enough space for equipments including fluoroscopy, endoscopy, electrosurgical unit, preparation table and for patient movement. The EUS room does not require an independent space unless it is a very large scale hospital, and the ERCP room can be shared. Considering the pros and cons of each equipment, adequate fluoroscopic device should be selected depending on the hospital circumstance. Expensive equipment for X-ray fluoroscopy system is not necessarily good, and it is necessary to install equipment suitable for each hospital situation by understanding the advantages and disadvantages of fluoroscopy. For prevention of ERCP-related radiation hazard, both endoscopist and assistants should wear radiation-blocking apron, thyroid protectors, and lead glasses. Furthermore, a shield that can block radiation between the endoscopist and the patient should be installed to protect high-energy scattered waves. One-way direction should be designed to prevent cross infection when moving the endoscopic equipment from the ERCP to the cleaning room. If possible, it is recommended to keep a cardiopulmonary resuscitation cart in the ERCP room.
10.ERCP Room Setting: What Doctors Starting ERCP Need to Know
Eaum Seok LEE ; Hyung Ku CHON ; Ju Sang PARK ; Sun Young YI ; Dong Wook LEE ; Chang-Hwan PARK ; Kwang Bum CHO ;
Korean Journal of Pancreas and Biliary Tract 2021;26(2):67-76
To date, there is no standardization of the endoscopi c retrograde cholangiopancreatography (ERCP) room setting regarding with the size, equipment or space arrangement. Therefore, the authors visited 11 tertiary hospitals that recently remodeled or newly designed the ERCP room to analyze and identify their advantages and disadvantages. The ERCP room should have enough space for equipments including fluoroscopy, endoscopy, electrosurgical unit, preparation table and for patient movement. The EUS room does not require an independent space unless it is a very large scale hospital, and the ERCP room can be shared. Considering the pros and cons of each equipment, adequate fluoroscopic device should be selected depending on the hospital circumstance. Expensive equipment for X-ray fluoroscopy system is not necessarily good, and it is necessary to install equipment suitable for each hospital situation by understanding the advantages and disadvantages of fluoroscopy. For prevention of ERCP-related radiation hazard, both endoscopist and assistants should wear radiation-blocking apron, thyroid protectors, and lead glasses. Furthermore, a shield that can block radiation between the endoscopist and the patient should be installed to protect high-energy scattered waves. One-way direction should be designed to prevent cross infection when moving the endoscopic equipment from the ERCP to the cleaning room. If possible, it is recommended to keep a cardiopulmonary resuscitation cart in the ERCP room.