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Jung, Gum Mo,Lee, Seung Hyun,Myung, Dae Seong,Lee, Wan Sik,Joo, Young Eun,Jung, Mi Ran,Ryu, Seong Yeob,Park, Young Kyu,Cho, Sung Bum The Korean Gastric Cancer Association 2018 Journal of gastric cancer Vol.18 No.1
Purpose: The endoscopic management of a fully covered self-expandable metal stent (SEMS) has been suggested for the primary treatment of patients with anastomotic leaks after total gastrectomy. Embedded stents due to tissue ingrowth and migration are the main obstacles in endoscopic stent management. Materials and Methods: The effectiveness and safety of endoscopic management were evaluated for anastomotic leaks when using a benign fully covered SEMS with an anchoring thread and thick silicone covering the membrane to prevent stent embedding and migration. We retrospectively reviewed the data of 14 consecutive patients with gastric cancer and anastomotic leaks after total gastrectomy treated from January 2009 to December 2016. Results: The technical success rate of endoscopic stent replacement was 100%, and the rate of complete leaks closure was 85.7% (n=12). The mean size of leaks was 13.1 mm (range, 3-30 mm). The time interval from operation to stent replacement was 10.7 days (range, 3-35 days) and the interval from stent replacement to extraction was 32.3 days (range, 18-49 days). The complication rate was 14.1%, and included a single jejunal ulcer and delayed stricture at the site of leakage. No embedded stent or migration occurred. Two patients died due to progression of pneumonia and septic shock 2 weeks after stent replacement. Conclusions: A benign fully covered SEMS with an anchoring thread and thick membrane is an effective and safe stent in patients with anastomotic leaks after total gastrectomy. The novelty of this stent is that it provides complete prevention of stent migration and embedding, compared with conventional fully covered SEMS.
증예(症例) : 만성신부전 악화와 동반된 후천성혈우병 1예
정금모 ( Gum Mo Jung ),전성희 ( Sung Hee John ),김남돈 ( Nam Don Kim ),박용진 ( Yong Jin Park ),박요숙 ( Hyo Sook Park ) 전북대학교 의과학연구소 2003 全北醫大論文集 Vol.27 No.2
후천성혈우병은 매우 드문 질환으로 중증의 출혈이 흔하게 나타나고 이로 인한 사망률이 높기 때문에 조기에 정확히 진단하여 적절한 치료를 즉각적으로 시행하여야 한다. 저자들은 만성신부전증으로 치료중 지속적인 출혈로 인해 발견된 후천성혈우병 환자를 면역억제제를 사용하여 성공적으로 치료하고 이에 증례보고 하는 바이다. Acquired hemophilia due to factor Ⅷ inhibitor is a rare disease that occurs in about one per million people each year. In about 50% of patients the disorder is associated with other conditions, mainly the postpartum period, underlying malignancies, drug administration, or autoimmune disease, such as rheumatoid arthritis or systemic lupus erythematosus. It is associated with bleeding complications that can be life-threatening. However, these bleeding episodes can be controlled when the correct diagnosis is made quickly and appropriate therapy applied. We had a patient with acquired hemophilia who was presented with sustained bleeding during managing uremia. At first, the diagnosis was incorrect because of delayed inhibitor reactivity. But, by retestifying after 2 hour incubation of diluted plasma and assaying inhibitor titer, we could have correct diagnosis. And we successfully treated it with oral immunosuppressive agents.
( Jung Hwan Yu ),( Haak Cheuul Kim ),( In Hee Kim ),( Dae-ghon Kim ),( Gum Mo Jung ),( Yong Keun Cho ),( Eun Young Cho ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: Sovaldi plus ribavirin therapy for chronic hepatitis C (CHC) genotype 2 patients are tolerable and highly effective in a shorter period of time than before. However, hematologic complication, especially anemia, can affect the efficacy of these drugs. The aim of this study was to investigate the prevalence of anemia and clinical characteristics of patients with anemia after sovaldi plus ribavirin treatment. Methods: Patients with CHC genotype 2 who underwent sovaldi plus ribavirin therapy at three referral hospitals in Jeollabuk-do Province from May 2016 to February 2017 were enrolled. Results: Total 95 patients (male 49, female 46) underwent sovaldi plus ribavirin therapy. The average age of the patients was 65.4 (30-89). Of 95 patient, 10 (10.5%) reduced ribavirin dose due to significant hemoglobin down. The incidence of anemia was 16.8% (16/95), 21.1% (20/95), 24.2% (23/95) at 4 weeks, 8 weeks, and 12weeks after treatment, respectively. Patients who reduced ribavirin dose showed predominantly low body mass index (BMI), hemoglobin (Hb), hamatocrit (Hct), and platelet at initial lab test. And, the patient with DM showed statistically higher hemoglobin reduction at the end of treatment. Sustained virologic response (SVR) at 12 weeks post-treatment was evaluated in 66 patients. SVR12 was found in 96.9% (64/66) patients. One patient who did not achieve SVR12 had ribavirin dose reduction due to anemia, the other underwent only 12 weeks treatment although he had liver cirrhosis. Conclusions: Most patient who underwent sovaldi plus ribavirin therapy showed higher SVR rate after treatment. However, because of ribavirin side effect, quite a few patients experienced the hemoglobin down and dose reduction. Therefore, we should pay attention to the patient who underwent sovaldi plus rivabirin, especially had lower BMI, Hb, Hct and platelet.
HPLC와 LC/MS에 의한 식육내 잔류 설파제의 동시 분석법
정봉수 ( Bong Su Jung ),박준조 ( Jun Jo Bark ),금모래 ( Mo Rae Gum ),김인경 ( In Kyoung Kim ),박병옥 ( Byoung Ok Park ),한정희 ( Jeong Hee Han ) 한국가축위생학회 2004 韓國家畜衛生學會誌 Vol.27 No.1
A multiresidual analysis was performed to determine 12 sulfonamides(sulfacetamide, sulfadiazine, sulfisomidine, sulfathiazole, sulfapyridine, sulfamerazine, sulfamethazine, sulfamonomethoxine, sulfisoxazole, sulfamethoxazole, sulfaquinoxaline, and sulfadimethoxine) in beef and pork simultaneously. The multiresidual analysis for the sulfonamides currently used was able to analyze 5 kinds of sulfonamides at the same time. The method of this 12 sulfonamides multiresidual analysis in this study was matrix solid-phase dispersion(MSPD) by high performance liquid chromatography(HPLC) and liquid chromatography mass spectrometry (LC/MS). The recovery rate of the materials was measured by MSPD method with 3 different extraction solvents; Dichloromethane, DCM: Ethylacetate(3:1), DCM: EA(9:1). Also, samples (84 beef and 205 pork samples) which were positive by EEC-4 plate test from 2001 to 2003 were tested to investigate the kinds of sulfonamides using HPLC. The results from the study were as follows; 1. The recovery rate of the materials was measured by MSPD method with 3 different extraction solvents; Dichioromethane, DCM Ethylacetate(3:1), DCM: EA(9:1). The method of extraction solvent with DCM: ethyl acetate(9:1) was the most excellent(87.7~99.3%) in separation and reappearance. 2. In the LC/MS analysis of sulfonamides, signal to noise ratio was showed relatively high in the positive mode and special ion in the quality analysis was determined via [M+H] and m/z 156. A spectrum of sulfonamides was showed from all 12 sulfonamides. 3. The samples positive by the EEC-4 plate, a screening test method, were categorized by sulfonamides through Charm 11 and confirmed the kinds of sulfonamides through HPLC. 1) Among 84 beef samples positive by EEC-4 plate, 20 samples were positive by Charm II and identified as 7 sulfamethazine, 9 sulfadimethoxine, 1 sulfamonomethoxine and 3 unknown status. 2) Among 205 pork samples positive by EEC-4 plate, 42 samples were positive by Charm II and identified as 19 sulfamethazine, 1 sulfadimethoxine, 4 sulfamonomethoxine and 5 unknown status.
장결핵 치료 중 Rifampin으로 유도된 심한 혈소판 감소증 및 백혈구 감소증 1예
김지웅 ( Ji Woong Kim ),정금모 ( Gum Mo Jung ),조은영 ( Eun Young Cho ),최창수 ( Chang Soo Choi ),서검석 ( Geom Seog Seo ),조진웅 ( Jin Woong Cho ),최석채 ( Suck Chei Choi ),나용호 ( Yong Ho Nah ) 대한장연구학회 2006 Intestinal Research Vol.4 No.1
Drug induced thrombocytopenia is a relatively not uncommon and potentially serious side effect of therapy. It`s characterized by thrombocytopenia, petechia, purpuric lesions and occasionally serious bleeding such as intracranial hemorrhage. The patient was 24 year-old female who was given rifampin 600mg daily for treatment of intestinal tuberculosis. Rifampin-induced immune thrombocytopenia was occurred 25 days after initiating therapy. Platelet and leukocyte count were 23,000/mm3, 2,850/mm3, respectively. Two week after discontinuation of antituberculous medication, platelet count was recovered. We report this case with a review of literature. (Intestinal Research 2006;4:64-68)
간성 뇌증과 감별이 어려웠던 C형간염 간경변증 환자의 크립토코쿠스뇌수막염
최혜미 ( Hye Mi Choi ),정금모 ( Gum Mo Jung ),이웅기 ( Woong Ki Lee ),이혁수 ( Hyeuk Soo Lee ),김병선 ( Byung Sun Kim ),성충실 ( Choong Sil Seong ),윤소희 ( So Hee Yoon ),조용근 ( Yong Keun Cho ) 대한소화기학회 2014 대한소화기학회지 Vol.64 No.5
Cryptococcus neoformans, an encapsulated fungus, is an important opportunistic pathogen that can cause meningitis in immunocompromised patients. Since patients with cryptococcemia have high mortality, it is essential to make an early diagnosis and promptly initiate antifungal therapy. However, it is often very difficult to differentiate between cryptococcal meningitis and hepatic encephalopathy in patients with liver cirrhosis, and there is delay in making the diagnosis. Therefore, these patients have a particularly grave prognosis and consequently many patients die before culture results become available. In one study, starting antifungal therapy within 48 hours of the blood culture was associated with improved survival, but patients with liver cirrhosis were significantly less likely to receive antifungal therapy within 48 hours compared to those without liver cirrhosis. Recently, the authors experience a case of a 68-year-old woman with liver cirrhosis who presented with fever and a drowsy mental status. She had a previous history of having been admitted for infection-associated hepatic encephlopathy. Cryptococcal meningitis and cryptococcemia were diagnosed by spinal puncture and culture of cerebrospinal fluid. In spite of adequate treatment, the patient developed multi-system organ failure and eventually expired. Herein, we report a case of cryptococcal meningitis mimicking hepatic encephalopathy in a patient with liver cirrhosis. (Korean J Gastroenterol 2014,64:294-297)
Underestimation of endoscopic size in large gastric epithelial neoplasms
Jae Sun Song,Byung Sun Kim,Min A Yang,Young Jae Lee,Gum Mo Jung,Ji Woong Kim,Jin Woong Cho 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.6
Background/Aims: Endoscopic submucosal dissection (ESD) is an effective method for resecting gastric adenomas and adenocarcino-mas. A significant discrepancy was observed between endoscopic and pathological sizes in samples obtained from patients undergoingESD. This study elucidates the factors affecting size discrepancy after formalin fixation. Methods: The records of 64 patients with 69 lesions were analyzed, including 50 adenomas and 19 adenocarcinomas. Data on location,gross shape, histology, and size after fixation in formalin were collected. Results: The mean size of the resected specimen appeared to decrease after formalin fixation (37.5 mm prefixation vs. 35.8 mm post-fixation, p<0.05). The mean long axis diameter of the lesions was 20.3±7.9 mm prefixation and 13.4±7.9 mm postfixation. Size differ-ences in lesions smaller than 20 mm were significantly greater than those in lesions larger than 20 mm (7.6±5.6 mm vs. 2.5±5.8 mm,p<0.01). In multivariate analysis, a tumor size of ≥20 mm was found to be an independent factor affecting size postformalin fixation(p<0.05). Conclusions: The endoscopic size of lesions before ESD may be underestimated in tumors larger than 20 mm in size. Therefore, in-creased attention must be paid during ESD to avoid instances of incomplete resection.