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최웅지,조남수,조수형,김성중,박광철,박진실 朝鮮大學校 附設 醫學硏究所 2004 The Medical Journal of Chosun University Vol.29 No.1
Background and Objectives: The objective of this study was to obtain circumstances about violence providers and cause of the violence in emergency room. Materials and Methods: Reports were provided to emergency department doctors, nurses and emergency medical technicians working in Chosun University Hospital Emergency Center during the sixty days from 26 May 2003 to 24 July 2003. Report form consisted of the degree of violence, the reason for the violence, dermographic information about violence providers, outbreak time of violence and response of emergency personnels. Results: SixtyUeight case of violence in the emergency department were reported. Almost all of the violence was due to the male gender and high incidence in third and fourth decade. The violence occured mostly in the night shift. 55.9% of violence was done by patient and 41.2% was done by patient's guardians. The leading cause of violence were alcohol drunken and delay of laboratory test and treatment. Verbal abuse and threats were the most concern form of violence, Conclusion: It is necessary to solve the problems faced in the emergency department not only administrative and financial aid but also regular preventive education and further study.
Full covered self-expandable metal stents for the treatment of anastomotic leak using a silk thread
Choi, Cheol Woong,Kang, Dae Hwan,Kim, Hyung Wook,Park, Su Bum,Kim, Su Jin,Hwang, Sun Hwi,Lee, Si Hak Wolters Kluwer Health 2017 Medicine Vol.96 No.29
<P><B>Abstract</B></P><P>To evaluate the safety and effectiveness of fixation of the fully covered self-expandable metal stent (SEMS) placement using a silk thread for complete closure of an anastomotic leak. An anastomotic leak is a life-threatening complication after gastrectomy. Although the traditional treatment of choice was surgical re-intervention, an endoscopic SEMS can be used alternatively.</P><P>During the study period, we retrospectively reviewed consecutive patients who received a modified covered SEMS capable of being fixed using a silk thread (Shim technique) due to an anastomotic leak after gastrectomy to prevent stent migration. Demographic data, stent placement and removal, clinical success, time to resolution, and complications were evaluated.</P><P>A total of 7 patients underwent fully covered SEMS with a silk thread placement for an anastomotic leak after gastrectomy to treat gastric cancer. The patients’ mean age was 71.3 ± 8.0 years. Man sex was predominant (85.7%). All patients’ American Society of Anesthesiologists (ASA) scores were between I and III. Total gastrectomy was performed in 5 patients (71.4%) and proximal gastrectomy was performed in 2 patients (28.6%). The time between gastrectomy and stent insertion was 22.3 ± 11.1 days. The size of the leaks was 27.1 ± 11.1 mm. Technical success and complete leak closure were achieved in all patients. Stent migration was absent. All stents were removed between 4 and 6 weeks. Delayed esophageal stricture was found in 1 patient (14.2) and successfully resolved after endoscopic balloon dilation.</P><P>For an anastomotic leak after gastrectomy, fully covered SEMS placement with a silk thread is an effective and safe treatment option without stent migration. The stent extraction time between 4 and 6 weeks was optimal without severe complications.</P>
Is obesity associated with gastropharyngeal reflux disease?
Choi, Cheol Woong,Kim, Gwang Ha,Song, Chul Soo,Wang, Soo Geun,Lee, Byung Joo,I, Hoseok,Kang, Dae Hwan,Song, Geun Am WJG Press 2008 World journal of gastroenterology Vol.14 No.2
<P>To examine the association between obesity and gastropharyngeal reflux disease (GPRD) as well as gastroesophageal reflux disease (GERD).</P>
( Cheol Hun Choi ),( Woong Mo Kim ),( Hyung Gon Lee ),( Cheol Won Jeong ),( Chang Mo Kim ),( Seong Heon Lee ),( Myung Ha Yoon ) 대한통증학회 2010 The Korean Journal of Pain Vol.23 No.4
Background: Selective inhibitors of cyclooxygenase (COX)-2 are commonly used analgesics in various pain conditions. Although their actions are largely thought to be mediated by the blockade of prostaglandin (PG) biosynthesis, evidences suggesting endogenous opioid peptide link in spinal antinociception of COX inhibitor have been reported. We investigated the roles of opioid receptor subtypes in the spinal antinociception of selective COX-2 inhibitor. Methods: To examine the antinociception of a selective COX-2 inhibitor, DUP-697 was delivered through an intrathecal catheter, 10 minutes before the formalin test in male Sprague-Dawley rats. Then, the effect of intrathecal pretreatment with CTOP, naltrindole and GNTI, which are μ, δ and κ opioid receptor antagonist, respectively, on the analgesia induced by DUP-697 was assessed. Results: Intrathecal DUP-697 reduced the flinching response evoked by formalin injection during phase 1 and 2. Naltrindole and GNTI attenuated the antinociceptive effect of intrathecal DUP-697 during both phases of the formalin test. CTOP reversed the antinociception of DUP-697 during phase 2, but not during phase 1. Conclusions: Intrathecal DUP-697, a selective COX-2 inhibitor, effectively relieved inflammatory pain in rats. The δ and κ opioid receptors are involved in the activity of COX-2 inhibitor on the facilitated state as well as acute pain at the spinal level, whereas the μ opioid receptor is related only to facilitated pain. (Korean J Pain 2010; 23: 236-241)
Choi, Cheol Woong,Kang, Dae Hwan,Kim, Hyung Wook,Park, Su Bum,Kim, Su Jin Williams & Wilkins Co 2017 Medicine Vol.96 No.31
<P><B>Abstract</B></P><P>Because an esophageal submucosa tumor (SMT) may be malignant despite its small size, a safe endoscopic resection method is needed in some small SMTs. Conventional endoscopic mucosal resection (EMR) may be simple, but incomplete pathologic resection margin status is common. We aimed to investigate the clinical outcomes of 2 kinds of EMR techniques (conventional EMR and EMR with band ligation device) and to evaluate the factors associated with incomplete pathologic resection.</P><P>We evaluated the medical records of 36 patients. All lesions were esophageal SMTs located in the submucosa or muscularis mucosa less than 10 mm in size by endoscopic ultrasound (EUS). The clinical outcomes based on the endoscopic procedures and factors associated with incomplete pathologic resection were evaluated.</P><P>The mean tumor size was 6.6 ± 4.1 mm. The overall en bloc and complete resection rates were 100% and 80.6%, respectively. No procedure-related complications, such as perforation and bleeding, were found. Univariate analysis showed that complete resection rates were higher in granular cell tumors than in leiomyomas (82.8% vs 17.2%, <I>P</I> = .029), tumors located in the submucosa layer than in the muscularis mucosa (96.6% vs 3.4%, <I>P</I> = .003), and in EMR with band ligation device than in conventional EMR (82.8% vs 17.2%, <I>P</I> < .001). Multivariate analysis showed that conventional EMR was the only significant factor associated with incomplete resection (OR, 35.594; 95% CI, 2.042–520.329; <I>P</I> = .014)</P><P>EMR with a band ligation device is an effective and safe treatment method for small esophageal SMT.</P>
Choi, Cheol-Hun,Kim, Woong-Mo,Lee, Hyung-Gon,Jeong, Cheol-Won,Kim, Chang-Mo,Lee, Seong-Heon,Yoon, Myung-Ha The Korean Pain Society 2010 The Korean Journal of Pain Vol.23 No.4
Background: Selective inhibitors of cycloosygenase (COX)-2 are commonly used analgesics in various pain conditions. Although their actions are largely thought to be mediated by the blockade of prostaglandin (PG) biosynthesis, evidences suggesting endogenous opioid peptide link in spinal antinociception of COX inhibitor have been reported. We investigated the roles of opioid receptor subtypes in the spinal antionociception of selective COX-2 inhibitor. Methods: To examine the antionociception of a selective COX-2 inhibitor, DUP-697 was delivered through an intrathecal catheter, 10 minutes before the formalin test in male Sprague-Dawley rats. Then, the effect of intrathecal pretreatment with CTOP, naltrindole and GNTI, which are ${\mu}$, $\delta$, and k opioid receptor antagonist, respectively, on the analgesia induced by DUP-697 was assessed. Results: Intrathecal DUP-697 reduced the flinching response evoked by formalin injection during phase 1 and 2 Naltrindole and GNTI attenuated the antinociceptive effect of intrathecal DUP-697 during both phases of the formalin test, CTOP reversed the antinociception of DUP-697 during phase 2, but not during phase 1, Conclusions: Intrathecal DUP-697, a selective COX-2 inhibitor, effectively relieved inflammatory pain in rats. The $\delta$ and $\kappa$ opioid receptors are involved in the activity of COX-2 inhibitor on the facilitated state as well as acute pain at the spinal level, whereas the ${\mu}$ opioid receptor is related only to facilitated pain.
( Cheol Woong Choi ),( Gwang Ha Kim ),( Dae Hwan Kang ),( Geun Am Song ),( Tae Oh Kim ) 대한소화기학회 2007 SIDDS Vol.9 No.-
Background/Aims: Hemoglobin is the predominent pigment in the gastrointestinal mucosa, and the development of electronic endoscopy has made it possible to quantitatively measure the mucosal hemoglobin volume, by using a hemoglobin index (IHb). The aims of this study were to make a software program to calculate the IHb and then to investigate whether the mucosal IHb determined from the electronic endoscopic data is a useful marker for evaluating the color of intramucosal gastric carcinoma with regard to its value for discriminating between the histologic types. Methods: We made a software program for calculating the IHb in the endoscopic images. By using this program, the mean values of the IHb for the carcinoma (IHb-C) and those of the IHb for the surrounding non-cancerous mucosa (IHb-N) were calculated in 75 intestinal-type and 34 diffuse-type intramucosal gastric carcinomas. We then analyzed the ratio of IHb-C to the IHb-N (C/N ratio). Results: The C/N ratio in the intestinal-type carcinoma group was higher than that in the diffuse-type carcinoma group (p<0.001). In the diffuse-type carcinoma group, the C/N ratio in the body was lower than that in the antrum (p=0.022). The accuracy rate, sensitivity, specificity, and the positive and negative predictive values for the differential diagnosis of the diffuse-type carcinoma from the intestinal-type carcinoma were 94.5%, 94.1%, 94.7%, 88.9% and 97.3%, respectively. Conclusions: IHb is useful for making quantitative measurement of the endoscopic color in the intramucosal gastric carcinoma, and the C/N ratio by using the IHb would be helpful for distinguishing the diffuse-type carcinoma from the intestinal-type carcinoma.