1.A Case of Metastatic Melanoma of the Rectum.
Seong Wu LEE ; Soon Koo BAIK ; Young Gyu LEE ; Dong Ki LEE ; Woo Ick JANG ; Sang Ok KWON ; Gye Keol SHIN ; Soon Hee JUNG
Korean Journal of Gastrointestinal Endoscopy 1993;13(2):411-413
A 42-year-old woman preseated with intermittent rectal bleeding of a week's duration. A large polypoid mass with pigmented, ulcerated, nodular surface was seen in the rectum at 3cm from the anal verge during flexible sigmoidoscopy. A histologic diagnosis of metastatic melanoma wae made on light microscopic examination of biopsies obtained at sigmoidoscopy. The presence of metastatic melanoma at sites other than the rectum was found at the skin, pleura and lung. We report a case of metastatic malignant melanoma of the rectum with the review of the literature.
Adult
;
Biopsy
;
Diagnosis
;
Female
;
Hemorrhage
;
Humans
;
Lung
;
Melanoma*
;
Pleura
;
Rectum*
;
Sigmoidoscopy
;
Skin
;
Ulcer
2.Pulmonary Thromboembolism during Modified Radical Mastectomy: A case report.
Young Gyun CHOI ; Sang Wu SHIN ; Geun Mu LEE ; Sun Ho CHEONG ; Chee Mahn SHIN ; Young Jae KIM ; Ju Yeol PARK
Korean Journal of Anesthesiology 2004;47(4):585-589
Anesthesiologists may encounter pulmonary thromboembolism during the perioperative period. However, the diagnosis of pulmonary thromboembolism is difficult because clinical symptoms and signs are not specific, and specialized diagnostic tools are not readily available in the operating room. We report a case of pulmonary thromboembolism during modified radical mastectomy. A 52 year old female patient underwent modified radical mastectomy under general anesthesia. 90 minutes after induction there were a sudden increase of peak airway pressure and a decrease of oxygen saturation. We treated symptomatically under the impression of pulmonary edema during operation. After operation, pulmonary thromboembolism was diagnosed and treated successfully with oxygen therapy and anticoagulant therapy. After 26th days of operation she was no longer suffered from hypoxia. At the 36th day after operation, she was discharged without any sequelae.
Anesthesia, General
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Anoxia
;
Diagnosis
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Female
;
Humans
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Mastectomy, Modified Radical*
;
Middle Aged
;
Operating Rooms
;
Oxygen
;
Perioperative Period
;
Pulmonary Edema
;
Pulmonary Embolism*
3.Relationship between the maxillofacial skeletal pattern and the morphology of the mandibular symphysis: Structural equation modeling
Mi So AHN ; Sang Min SHIN ; Tetsutaro YAMAGUCHI ; Koutaro MAKI ; Te Ju WU ; Ching Chang KO ; Yong Il KIM
The Korean Journal of Orthodontics 2019;49(3):170-180
OBJECTIVE:
The purpose of this study was to investigate the relationship between the facial skeletal patterns and the shape of the mandibular symphysis in adults with malocclusion by using a structural equation model (SEM).
METHODS:
Ninety adults who had malocclusion and had records of facial skeletal measurements performed using cone-beam computed tomography were selected for this study. The skeletal measurements were classified into three groups (vertical, anteroposterior, and transverse). Cross-sectional images of the mandibular symphysis were analyzed using generalized Procrustes and principal component (PC) analyses. A SEM was constructed after the factors were extracted via factor analysis.
RESULTS:
Two factors were extracted from the transverse, vertical, and anteroposterior skeletal measurements. Latent variables were extracted for each factor. PC1, PC2, and PC3 were selected to analyze the variations of the mandibular symphyseal shape. The SEM was constructed using the skeletal variables, PCs, and latent variables. The SEM showed that the vertical latent variable exerted the most influence on the mandibular symphyseal shape.
CONCLUSIONS
The relationship between the skeletal pattern and the mandibular symphysis was analyzed using a SEM, which showed that the vertical facial skeletal pattern had the highest effect on the shape of the mandibular symphysis.
4.Patient's Factors at Entering Hospice Affecting Length of Survival in a Hospice Center.
Guk Jin LEE ; Hye Shin AHN ; Se Eun GO ; Ji Hyun KIM ; Min Wu SEO ; Seung Hun KANG ; Yeo Ree YANG ; Mi Yeong LEE ; Ku Ock LEE ; Sang Hoon CHUN ; Jong Youl JIN
Cancer Research and Treatment 2015;47(1):1-8
PURPOSE: In order to provide effective hospice care, adequate length of survival (LOS) in hospice is necessary. However the reported average LOS is much shorter. Analysis of LOS in hospice has not been reported from Korea. We evaluated the duration of LOS and the factors associated with LOS at our hospice center. MATERIALS AND METHODS: We retrospectively examined 446 patients who were admitted to our hospice unit between January 2010 and December 2012. We performed univariate and multivariate analysis for analysis of factors associated with LOS. RESULTS: The median LOS was 9.5 days (range, 1 to 186 days). The LOS of 389 patients (86.8%) was< 1 month. At the time of admission to hospice, 112 patients (25.2%) were completely bedridden, 110 patients (24.8%) had mouth care only without intake, and 134 patients (30.1%) had decreased consciousness, from confusion to coma. The median time interval between the day of the last anticancer treatment and the day of hospice admission was 75 days. By analysis of the results of multivariate analysis, decreased intake and laboratory results showing increased total white blood cell (WBC), decreased platelet count, increased serum creatinine, increased aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lactate dehydrogenase (LDH) level were poor prognostic factors for survival in hospice. CONCLUSION: Before hospice admission, careful evaluation of the patient's performance, particularly the oral intake, and total WBC, platelet, creatinine, AST, ALT, and LDH level is essential, because these were strong predictors of shorter LOS. In the future, conduct of prospective controlled studies is warranted in order to confirm the relationship between potential prognostic factors and LOS in hospice.
Alanine Transaminase
;
Aspartate Aminotransferases
;
Blood Platelets
;
Coma
;
Consciousness
;
Creatinine
;
Hospice Care
;
Hospices*
;
Humans
;
Korea
;
L-Lactate Dehydrogenase
;
Leukocytes
;
Mouth
;
Multivariate Analysis
;
Platelet Count
;
Prognosis
;
Retrospective Studies
;
Survival Analysis
5.Effectiveness of Fentanyl Transdermal Patch (Fentanyl-TTS, Durogegic(R)) for Radiotherapy Induced Pain and Cancer Pain: Multi-center Trial.
Seong Soo SHIN ; Seung Jae HUH ; Eun Kyung CHOI ; Jong Hoon KIM ; Seung Do AHN ; Sang Wook LEE ; Yeun Sil KIM ; Kyu Chan LEE ; Chang Geol LEE ; John JK LOH ; Mison CHUN ; Young Teak OH ; Ok Bae KIM ; Jin Hee KIM ; Chul Yong KIM ; Dae Sik YANG ; Woo Yoon PARK ; Bo Kyoung KIM ; Heung Lae CHO ; Ki Jung AHN ; Jong Young LEE ; Seon Min YUN ; Yong Chan AHN ; Do Hoon LIM ; Won PARK ; Ki Moon KANG ; Hong Gyun WU ; Hyun Soo SHIN ; Seong Soon JANG ; Eun Seog KIM ; Byung Sik NA ; Woong Ki JUNG ; Sung Ja AHN ; Taek Keun NAM ; Yong Ho KIM ; MI Hee SONG ; Sang Mo YUN ; Chul Seung KAY ; Ji Won YEI ; Suk Won PARK ; Seon Woo KIM
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2006;24(4):263-271
PURPOSE: To evaluate the effectiveness and safety of fentanyl-TTS in the management of radiotherapy induced acute pain and cancer pain treated with radiotherapy. MATERIALS AND METHODS: Our study was open labelled prospective phase IV multi-center study. the study population included patients with more 4 numeric rating scale(NRS) score pain although managed with other analgesics or more than 6 NRS score pain without analgesics. Patients divided into two groups; patients with radiotherapy induced pain (Group A) and patients with cancer pain treated with radiotherapy (Group B). All patients received 25 ug/hr of fentanyl transdermal patch. Primary end point was pain relief; second end points were change in patient quality of life, a degree of satisfaction for patients and clinician, side effects. RESULTS: Between March 2005 and June 2005, 312 patients from 26 participating institutes were registered, but 249 patients completed this study. Total number of patients in each group was 185 in Group A, 64 in Group B. Mean age was 60 years and male to female ratio was 76:24. Severe pain NRS score at 2 weeks after the application of fentanyl was decreased from 7.03 to 4.01, p=0.003. There was a significant improvement in insomnia, social functioning, and quality of life. A degree of satisfaction for patients and clinician was very high. The most common reasons of patients' satisfactions was good pain control. Ninety six patients reported side effect. Nausea was the most common side effect. There was no serious side effect. CONCLUSION: Fentanyl-TTS was effective in both relieving pain with good tolerability and improving the quality of life for patients with radiotherapy induced acute pain and cancer pain treated with radiotherapy. The satisfaction of the patients and doctors was good. There was no major side effect.
Academies and Institutes
;
Acute Pain
;
Analgesics
;
Female
;
Fentanyl*
;
Humans
;
Male
;
Nausea
;
Prospective Studies
;
Quality of Life
;
Radiotherapy*
;
Sleep Initiation and Maintenance Disorders
;
Transdermal Patch*
6.2020 Seoul Consensus on the Diagnosis and Management of Gastroesophageal Reflux Disease
Hye-Kyung JUNG ; Chung Hyun TAE ; Kyung Ho SONG ; Seung Joo KANG ; Jong Kyu PARK ; Eun Jeong GONG ; Jeong Eun SHIN ; Hyun Chul LIM ; Sang Kil LEE ; Da Hyun JUNG ; Yoon Jin CHOI ; Seung In SEO ; Joon Sung KIM ; Jung Min LEE ; Beom Jin KIM ; Sun Hyung KANG ; Chan Hyuk PARK ; Suck Chei CHOI ; Joong Goo KWON ; Kyung Sik PARK ; Moo In PARK ; Tae Hee LEE ; Seung Young KIM ; Young Sin CHO ; Han Hong LEE ; Kee Wook JUNG ; Do Hoon KIM ; Hee Seok MOON ; Hirota MIWA ; Chien-Lin CHEN ; Sutep GONLACHANVIT ; Uday C GHOSHAL ; Justin C Y WU ; Kewin T H SIAH ; Xiaohua HOU ; Tadayuki OSHIMA ; Mi-Young CHOI ; Kwang Jae LEE ; The Korean Society of Neurogastroenterology and Motility
Journal of Neurogastroenterology and Motility 2021;27(4):453-481
Gastroesophageal reflux disease (GERD) is a condition in which gastric contents regurgitate into the esophagus or beyond, resulting in either troublesome symptoms or complications. GERD is heterogeneous in terms of varied manifestations, test findings, and treatment responsiveness. GERD diagnosis can be established with symptomatology, pathology, or physiology. Recently the Lyon consensus defined the “proven GERD” with concrete evidence for reflux, including advanced grade erosive esophagitis (Los Angeles classification grades C and or D esophagitis), long-segment Barrett’s mucosa or peptic strictures on endoscopy or distal esophageal acid exposure time > 6% on 24-hour ambulatory pH-impedance monitoring. However, some Asian researchers have different opinions on whether the same standards should be applied to the Asian population. The prevalence of GERD is increasing in Asia. The present evidence-based guidelines were developed using a systematic review and meta-analysis approach. In GERD with typical symptoms, a proton pump inhibitor test can be recommended as a sensitive, cost-effective, and practical test for GERD diagnosis.Based on a meta-analysis of 19 estimated acid-exposure time values in Asians, the reference range upper limit for esophageal acid exposure time was 3.2% (95% confidence interval, 2.7-3.9%) in the Asian countries. Esophageal manometry and novel impedance measurements, including mucosal impedance and a post-reflux swallow-induced peristaltic wave, are promising in discrimination of GERD among different reflux phenotypes, thus increasing its diagnostic yield. We also propose a long-term strategy of evidence-based GERD treatment with proton pump inhibitors and other drugs.
7.2020 Seoul Consensus on the Diagnosis and Management of Gastroesophageal Reflux Disease
Hye-Kyung JUNG ; Chung Hyun TAE ; Kyung Ho SONG ; Seung Joo KANG ; Jong Kyu PARK ; Eun Jeong GONG ; Jeong Eun SHIN ; Hyun Chul LIM ; Sang Kil LEE ; Da Hyun JUNG ; Yoon Jin CHOI ; Seung In SEO ; Joon Sung KIM ; Jung Min LEE ; Beom Jin KIM ; Sun Hyung KANG ; Chan Hyuk PARK ; Suck Chei CHOI ; Joong Goo KWON ; Kyung Sik PARK ; Moo In PARK ; Tae Hee LEE ; Seung Young KIM ; Young Sin CHO ; Han Hong LEE ; Kee Wook JUNG ; Do Hoon KIM ; Hee Seok MOON ; Hirota MIWA ; Chien-Lin CHEN ; Sutep GONLACHANVIT ; Uday C GHOSHAL ; Justin C Y WU ; Kewin T H SIAH ; Xiaohua HOU ; Tadayuki OSHIMA ; Mi-Young CHOI ; Kwang Jae LEE ; The Korean Society of Neurogastroenterology and Motility
Journal of Neurogastroenterology and Motility 2021;27(4):453-481
Gastroesophageal reflux disease (GERD) is a condition in which gastric contents regurgitate into the esophagus or beyond, resulting in either troublesome symptoms or complications. GERD is heterogeneous in terms of varied manifestations, test findings, and treatment responsiveness. GERD diagnosis can be established with symptomatology, pathology, or physiology. Recently the Lyon consensus defined the “proven GERD” with concrete evidence for reflux, including advanced grade erosive esophagitis (Los Angeles classification grades C and or D esophagitis), long-segment Barrett’s mucosa or peptic strictures on endoscopy or distal esophageal acid exposure time > 6% on 24-hour ambulatory pH-impedance monitoring. However, some Asian researchers have different opinions on whether the same standards should be applied to the Asian population. The prevalence of GERD is increasing in Asia. The present evidence-based guidelines were developed using a systematic review and meta-analysis approach. In GERD with typical symptoms, a proton pump inhibitor test can be recommended as a sensitive, cost-effective, and practical test for GERD diagnosis.Based on a meta-analysis of 19 estimated acid-exposure time values in Asians, the reference range upper limit for esophageal acid exposure time was 3.2% (95% confidence interval, 2.7-3.9%) in the Asian countries. Esophageal manometry and novel impedance measurements, including mucosal impedance and a post-reflux swallow-induced peristaltic wave, are promising in discrimination of GERD among different reflux phenotypes, thus increasing its diagnostic yield. We also propose a long-term strategy of evidence-based GERD treatment with proton pump inhibitors and other drugs.