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( Ye Rim Chang ),( Jin Young Jang ),( Wooil Kwon ),( Jae Woo Park ),( Mee Joo Kang ),( Ji Kon Ryu ),( Yong Tae Kim ),( Young Beum Yun ),( Sun Whe Kim ) The Editorial Office of Gut and Liver 2013 Gut and Liver Vol.7 No.6
Background/Aims: The aim of this study was to investigate changes in the clinical and demographical characteristics of gallstone disease in Korea, based on 30 years of surgically treated patients at a single institute. Methods: In total, 7,949 gallstone patients who underwent surgery between 1981 and 2010 were analyzed. Patients were divided into six time periods: period I (1981 to 1985, n=831), period II (1986 to 1990, n=888), period III (1991 to 1995, n=1,040), period IV (1996 to 2000, n=1,261), period V (2001 to 2005, n=1,651) and period VI (2006 to 2010, n=2,278). Results: The total number and mean age of the patients gradually increased, and the male/female ratio decreased. The proportion of gallbladder (GB)-stone cases increased, whereas the propor-tions of common bile duct (CBD)- and intrahepatic duct (IHD)-stone cases decreased. Differences in patient geographical origins also decreased. Based on the relationship between changes in the prevalence of gallstone disease and socioeco-nomic status, the prevalence of CBD stones showed a strong correlation with Engel`s coefficient (p<0.001). Conclusions: Our study indicates that although the total number of cases and the mean age of gallstone patients have continuously in-creased, there are trends of increasing GB-stone cases and decreasing CBD- and IHD-stone cases. (Gut Liver 2013;7:719-724)
( Ye Rim Chang ),( Sung Wook Chang ),( Dong Hun Kim ),( Jeongseok Yun ),( Jung Ho Yun ),( Seok Won Lee ),( Han Cheol Jo ),( Seok Ho Choi ) 대한외상학회 2017 大韓外傷學會誌 Vol.30 No.4
Purpose: Despite the numerous protocols and evidence-based guidelines that have been published, application of the therapeutics to eligible patients is limited in clinical settings. Therefore, a rounding checklist was developed to reduce errors of omission and the implementation results were evaluated. Methods: A checklist consisting of 12 components (feeding, analgesia, sedation, thromboembolic prophylaxis, head elevation, stress ulcer prevention, glucose control, pressure sore prevention, removal of catheter, endotracheal tube and respiration, delirium monitoring, and infection control) was recorded by assigned nurses and then scored by the staff for traumatized, critically ill patients who were admitted in the trauma intensive care unit (ICU) of Dankook University Hospital for more than 2 days. A total of 170 patients (950 sheets) between April and October 2016 were divided into 3 periods (period 1, April to June; period 2, July to August; and period 3, September to October) for the analysis. Questionnaires regarding the satisfaction of the nurses were conducted twice during this implementation period. Results: Record omission rates decreased across periods 1, 2, and 3 (19.9%, 12.7%, and 4.2%, respectively). The overall clinical application rate of the checklist increased from 90.1% in period 1 to 93.8% in period 3. Among 776 (81.7%) scored sheets, the rates of full compliance were 30.2%, 46.2%, and 45.1% for periods 1, 2, and 3, respectively. The overall mean score of the questionnaire regarding satisfaction also increased from 61.7 to 67.6 points out of 100 points from period 1 to 3. Conclusions: An ICU rounding checklist could be an effective tool for minimizing the omission of preventative measures and evidence-based therapy for traumatized, critically-ill patients without overburdening nurses. The clinical outcomes of the ICU checklist will be evaluated and reported at an early date.
The natural course of pancreatic fistula and fluid collection after distal pancreatectomy
Ye Rim Chang,Mee Joo Kang,Hongbeom Kim,Jin-Young Jang,Sun-Whe Kim 대한외과학회 2016 Annals of Surgical Treatment and Research(ASRT) Vol.91 No.5
Purpose: Postoperative pancreatic fistula (POPF) is one of the most common and clinically relevant complications after distal pancreatectomy. Some aspects of POPF management remain controversial. Therefore, the aim of this study was to determine the natural course of POPF and fluid collection after distal pancreatectomy and to reappraise the necessity of intraoperative abdominal drainage insertion. Methods: For recent 10 years, 264 distal pancreatectomies were performed at Seoul National University Hospital. Clinicopathologic data including POPF and postoperative fluid collection (POFC), and its treatment modality were reviewed retrospectively. During follow-up, the location, size, and clinical impact of the POFC were determined on the basis of CT images. Results: Clinically relevant POPFs were identified in 72 patients (27.3%). Therapeutic interventions were performed in 40 patients (55.6%), and conservative management was successful in 32 patients (44.4%). POFC was detected in 191 cases (72.3%) on the first postoperative CT. During follow-up, spontaneous regressions were observed in 119 cases (93.0%). Only thick pancreatic stump increased the risk of clinically relevant POPF (≥17.3 mm, P = 0.002) and the occurrence of POFC (≥16.0 mm, P < 0.001) in multivariate analysis. Conclusion: Intraoperative abdominal drainage insertion could be selectively indwelled in patients with a thickness of pancreas ≥17.3 mm. Since radiologically-proven POFC after distal pancreatecomy showed a 93.0 rate of spontaneous regression, POFC without signs of infection can be safely monitored.
Chang, Ye Rim,Han, Sung-Sik,Park, Sang-Jae,Lee, Seung Duk,Yoo, Tae Suk,Kim, Young-Kyu,Kim, Tae Hyun,Woo, Sang Myung,Lee, Woo Jin,Hong, Eun Kyung WJG Press 2012 WORLD JOURNAL OF GASTROENTEROLOGY Vol.18 No.39
<P>To evaluate the surgical outcomes following radical antegrade modular pancreatosplenectomy (RAMPS) for pancreatic cancer.</P>
The value of palliative gastrectomy in gastric cancer with distant metastasis.
Chang, Ye Rim,Han, Dong Seok,Kong, Seong-Ho,Lee, Hyuk-Joon,Kim, Se Hyung,Kim, Woo Ho,Yang, Han-Kwang Raven Press 2012 Annals of Surgical Oncology Vol.19 No.4
<P>The purpose of this study was to examine the value of surgical resection and to find prognostic factors for metastatic gastric cancer.</P>