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Proportion of Non-Medical Opioid Use of Prescription Opioids among Cancer Patients in Korea
Se-Il Go,Jung Hye Kwon,Sung Woo Park,Gyeong-Won Lee,Jung Hun Kang,Eduardo Bruera 한국호스피스완화의료학회 2023 한국호스피스.완화의료학회지 Vol.26 No.4
Purpose: Limited research has been conducted on the prevalence of non-medical opioid use (NMOU) in Korean cancer patients who have received prescription opioids (PO). This study aimed to identify the potential proportion of NMOU in cancer patients who had been prescribed opioids in Korea. Methods: A retrospective cohort analysis was conducted on 14,728 patients who underwent cancer-related treatment between January 2009 and December 2019, using electronically collected data from a tertiary hospital in Korea. Information regarding the type and duration of opioid use was gathered. A detailed review of medical charts was carried out, focusing on patients who had been prescribed opioids for over 60 days beyond a 12-month period following the completion of their cancer treatment (long-term PO users). Results: Out of the 5,587 patients who were prescribed PO and followed up for at least 12 months, 13 cases of NMOU were identified, representing 0.23% of the patient population. Among the 204 long-term PO users, the rate was 6.37% (13/204). The most commonly misused opioids were oxycodone and fentanyl. For the group confirmed to have NMOU, the median duration of prescription was 1,327 days in total. Of the 13 patients diagnosed with NMOU, 9 reported withdrawal symptoms, 3 exhibited craving behavior for opioids, and 1 experienced both symptoms. Conclusion: This study found that 0.23% of cancer patients who had been prescribed opioids in Korea demonstrated NMOU. Despite this relatively low rate, careful monitoring is necessary to minimize the risk of NMOU in this population, especially among long-term PO users.
Treatment of Opioid Withdrawal Syndrome Triggered by Oxycodone/Naloxone with Dexmedetomidine
Se-il Go,Jung Hoon Kim,Jung Hun Kang 한국호스피스완화의료학회 2023 한국호스피스.완화의료학회지 Vol.26 No.1
The combination of oxycodone and naloxone is useful for cancer pain management. Naloxone, as a pure opioid antagonist, cannot be used simultaneously with opioids. However, owing to its low bioavailability, it can be used in an oral composite formulation. We present the case of a 55-year-old man with gastric cancer who experienced severe opioid withdrawal syndrome (OWS) triggered by oxycodone/naloxone that was successfully managed with dexmedetomidine. He had been in a stable condition on intravenous morphine to alleviate cancer pain. Intravenous morphine was switched to oral oxycodone/naloxone for discharge from the hospital. The patient suddenly developed restlessness, heartburn, and violent behavior 30 minutes after taking oxycodone/naloxone. We attempted sedation with midazolam and propofol, but paradoxical agitation and desaturation occurred. Next, we tried dexmedetomidine and the patient showed a decreased heart rate and reduced agitation. The patient was eventually stabilized by increasing the dose of dexmedetomidine. This report informs clinicians of the possibility of OWS when switching from opioids to oxycodone/ naloxone, which can be overcome with the appropriate use of sedatives and dexmedetomidine depending on the patient’s condition.
Se-Il Go,이원섭,Myung Hee Kang,김인숙,김동출,이정희 대한혈액학회 2012 Blood Research Vol.47 No.2
Subcutaneous panniculitis-like T-cell lymphoma (SPTL) is a distinctive lymphoma characterized by an infiltration of subcutaneous tissue by neoplastic cytotoxic T cells. There was no distinction between TCR alpha/beta phenotype and TCR gamma/delta phenotype, and anthracycline-based chemotherapy was usually used for both. Here, we report a patient with recurrent SPTL who achieved a second long-term complete remission by repeated cyclosporine A (CsA) treatment. From 2000 to 2001, the patient received anthracycline-based combination chemotherapy. However, the treatment did not induce long-term remission. In 2002, he received cyclosporine treatment for about 6 months. This resulted in a 5-year remission that ended in relapse in 2008. He received CsA treatment once again and attained a second long-term remission. This case suggests that re-treatment with CsA can be a good option for relapsed SPTL cases and can result in long-term remission.
고영일(Young-Il Go),오성보(Seong-Bo Oh),김일환(Eel-Hwan Kim),김세호(Se-Ho Kim),고봉운(Bong-Woon Ko) 한국조명·전기설비학회 2009 한국조명·전기설비학회 학술대회논문집 Vol.2009 No.5월
보안구역의 외곽울타리지역의 경비체제를 인적경비에서 과학화경비로 전환함에 따라 CCTV 카메라 및 모니터 기능이 보다 향상되고 있는 반면에 이에따른 조명설비의 중요성이 인식되었다. 그러므로 본 논문에서는 보안구역내 과학화된 보안시스템에 적합한 조명개선을 위하여 기존 시설된 고압나트륨과 시범 설치된 LED 광원 및 조명등주의 위치를 변경하면서 조도를 실측하였다. 또한 CCTV 감시 화면의 특성을 고려하여 정확한 물체를 확인 할 수 있는 명암을 유지하기 위한 조명 값을 구하기 위하여 시뮬레이션을 실시하여 조도 개선안을 제시하고자 한다.
( An Na Lee ),( Se Il Go ),( Won Sup Lee ),( Un Seok Lee ),( Moon Jin Kim ),( Myung Hee Kang ),( Gyeong Won Lee ),( Hoon Gu Kim ),( Jung Hun Kang ),( Kyung Nyeo Jeon ),( Jae Min Cho ),( Jeong Hee Le ) 대한내과학회 2013 대한내과학회 추계학술대회 Vol.2013 No.1
The standard regimen has not been determined yet for taxane- and anthracycline-refractory triple-negative breast cancer (TNBC). Capecitabine was approved by Food and Drug Administration (FDA) for the treatment of the advanced breast cancer and has efficacy in the treatment of advanced breast cancer refractory to anthracycline and taxane. Irinotecan has synergism with 5-fluorouracil and shows efficacy in the advanced breast cancer. Here, we report a patient with TNBC who relapsed with wide spread bone and lung metastasis shortly after adjuvant anthracycline followed by taxane chemotherapy. She achieved metabolic complete response (CR) after irinotecan and capecitabine combination chemotherapy and showed 10-month of progression-free survival and 22-month. She relapsed with and died of brain metastasis without any definite signs of progression of the lung and bone lesions that she had had before irinotecan and capecitabine combination chemotherapy. To validate this favorable result, larger clinical trials are warranted in metastatic or relapsed TNBC patients.
( Min-sung Kim ),( Se-il Go ),( Chan Woo Wee ),( Min Ho Lee ),( Seok-gu Kang ),( Kyeong-o Go ),( Sae Min Kwon ),( Woohyun Kim ),( Yun-sik Dho ),( Sung-hye Park ),( Youngbeom Seo ),( Sang Woo Song ),( 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2023 Brain Tumor Research and Treatment Vol.11 No.2
Background During the coronavirus disease 2019 (COVID-19) pandemic, the need for appropriate treatment guidelines for patients with brain tumors was indispensable due to the lack and limitations of medical resources. Thus, the Korean Society for Neuro-Oncology (KSNO), a multidisciplinary academic society, has undertaken efforts to develop a guideline that is tailored to the domestic situation and that can be used in similar crisis situations in the future. Methods The KSNO Guideline Working Group was composed of 22 multidisciplinary experts on neuro-oncology in Korea. In order to reach consensus among the experts, the Delphi method was used to build up the final recommendations. Results All participating experts completed the series of surveys, and the results of final survey were used to draft the current consensus recommendations. Priority levels of surgery and radiotherapy during crises were proposed using appropriate time window-based criteria for management outcome. The highest priority for surgery is assigned to patients who are life-threatening or have a risk of significant impact on a patient’s prognosis unless immediate intervention is given within 24-48 hours. As for the radiotherapy, patients who are at risk of compromising their overall survival or neurological status within 4-6 weeks are assigned to the highest priority. Curative-intent chemotherapy has the highest priority, followed by neoadjuvant/adjuvant and palliative chemotherapy during a crisis period. Telemedicine should be actively considered as a management tool for brain tumor patients during the mass infection crises such as the COVID-19 pandemic. Conclusion It is crucial that adequate medical care for patients with brain tumors is maintained and provided, even during times of crisis. This guideline will serve as a valuable resource, assisting in the delivery of treatment to brain tumor patients in the event of any future crisis.