S-21 Usefulness of Anchoring Technique for Prevention of Stent Migration in Esophagorespiratory Fistula

( Hyoung Joon Shim ),( Tae Yoon Lee ),( Young Koog Cheon ),( Chan Sup Shim ) 대한내과학회 2016 대한내과학회 추계학술대회 Vol.2016 No.1

Background:?Coated SEMS (self-expandable metal stent) placement is the preferred therapy for malignant esophagorespiratory fistula (ERF) at present. Migration is more frequent in coated stent than uncoated stent. Migration can occur immediately after stent placement and is likely secondary to malpositioning, inadequate anchoring, soft nonconstricting tumors, or complete coating of the stent. The overall risk of migration is approximately 10%. To prevent migration, we have used the anchoring technique, called Shim’s technique in Korea, connecting stent to ear with silk thread.?Patients and Methods:?Seven patients with malignant ERF were included. ERF conditions liable to migration of stent were selected. The selection criteria were ERFs without stricture (3 cases), with short length of stenosis (2 cases), and with soft consistency around fistula (2 cases). The anchoring method was designed to hang stent to ear lobe. Auricle was used for a post to suspend stent by a thread until the fixation of stent on the esophageal wall. The coated stent was specially designed for antimigration which has small circumferential uncoated portion on proximal flange part of stent for fixation. After 5 days of stenting, we removed the anchoring silk from the stent. Sealing of fistula were assessed with clinical improvement and esophagogram.?Results:?There were no migrations after stent placement in all 7 cases. Symptoms of aspiration were improved in all 7 cases.?Conclusions:?The anchoring technique was useful for the prevention of stent migration in esophagorespiratory (ERF) cases, especially in the conditions that stent are apt to be migrated.

담도계질환의 내시경적 치료

심찬섭 대한의학협회 1990 대한의학협회지 Vol.33 No.4

白鼠의 카드뮴中毒時 Diallyldisulfide가 카드뮴 排泄에 미치는 影響에 關한 硏究

沈贊燮,宋東彬,車喆煥 고려대학교 의과대학 1987 고려대 의대 잡지 Vol.24 No.3

The garlic has been proved to have protective effect on the poisoning of cadmium and mercury in previous studies. Diallyldisulfide, the major substance of garlic extract, was expected to have the similar protective effect to the heavy metal poisoning. In this study the effect of diallyldisulfide on the excretion of cadmium from body and accumulation of cadmium in the target organs, liver, kidney and testis was studied and was also compared with the effect to 2,3-dimercaptosuccinic acid (DMSA). For the experiment, cadmium (1 mg/kg) was injected into the peritoneal cavity of rats for 4 days and diallyldisulfide and DMSA were administered respectively per os with oral tube once a day for 11 days which was started 1 day before starting cadmium injection. The 24 hours feces and urine were collected seperately using metabolic cage for 10 days and studied the effect of diallyldisulfide and DMSA on the excretion of cadmium. The results of the experiment were as follows. 1. The simultaneously administered groups of cadmium and diallyldisulfide or cadmium and DMSA showed more excellent effect on the excretion of cadmium than the cadmium alone administered groups. Especially fecal excretion of cadmium was remarkable between at 2nd and 8th day of diallyldisulfide or DMSA administration. In comparison with the effect of two regimen, ratio of the total excretion to the total administration of cadmium in 10 days was higher in the diallyldisulfide administered group than in the DMSA administered group. The effect of urinary excretion in diallyldisulfide administred group was inferior to DMSA administered group and its excretion effect was weak comparing with the fecal excretion. 2. The accumulation of cadmium in testis and kidney was decreased markedly in diallyldisulfide or DMSA administered groups than cadmium alone administered group, but in liver and spleen it was not decreased markedly. Especially the treated with diallyldisulfide or DMSA groups showed the accumulation of cadmium in kidney 28-31% less than the cadmium alone administered group. Also in testis they showed 34% less accumulation of cadmium in diallyldisulfide administered group and 50% less accumulation in DMSA administered group than cadmium alone administered group respectively.

위종양성 병변에서 내시경적 절제술

沈贊燮 대한의사협회 1998 대한의사협회지 Vol.41 No.2

대망에 발생한 방선균증 1례

송상훈,심찬섭,이문성,김진오,조주영,김영석,문종호,이진우 순천향의학연구소 1999 Journal of Soonchunhyang Medical Science Vol.5 No.1

Actinomycosis is an uncommon chronic suppurative disease characterized by multiple abscess, draining sinuses, abundant granulation, and dense fibrous tissue, caused by the actinomyces organisms. It occurs in three major sites: cervicofacial, abdominal, and thoracic. The abdomen is the second most common involved site in previous studies, and there are three ways this organism can affect the gastrointestinal tract: through a blood-borne infection, by swallowing, or by proliferation at a more distal intestinal area. Abdominal actinomycosis is an unusual disease but remains an important differential diagnosis in patients with abdominal mass. Obtaining the diagnosis is difficult and rarely made preoperatively, but provide the key to its management. Medical therapy is effetive in eradicating the disease; however, because of the large amount of reactive fibrosis formed by the infection, it requires long-term therapy. Surgical treatment may be essential in many cases, primarily when malignancy cannot be excluded or if extensive necrotic tissue exists. There are a few description for actinomycosis involving omentum. We report a case of patient with omental actinomycosis, suspected to have a malignancy requiring an exploratory laparotomy with resection.

Borrmann 4형으로 진단된 진행성 위암환자의 임상적 검토

천영국,김영태,홍수진,김진오,조주영,이문성,심찬섭 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Background/Aim: It is difficult to dignosis of Borrmann type 4 gastric cancer at the early stage, because of its special morphology. Most of the cases have been detected at the advanced stage with poor survival rate. We reviewed patients with advanced gastric cancer, to define clinicopathologic characteristics of Borrmann type 4 gastric cancer comparing other types of gastric cancer. Methods: 1033 patients with advanced gastric cancer were divided into two groups, consisting of 50 patients with Borrmann type 4 gastric cancer, and the remaining 983 patients with all other types of gastric cancer, which were then compared clinicopatologically. Results: The proportion of Borrmann type 4 gastric cancer to advanced gastric cancer was 4.48%(50/1,033). The patients with Borrmann type 4 gastric cancer to advanced gastric cancer was 4.48%(50/1,033). The patients with Borrmann type 4 gastric cancer were composed 20 males and 30 males and revealed the highest frequency 3rd decade (24.0%) in age (range 26-78). In giant folds group (n=27), the number of poorly differentiated cell type, lymph node metastasis, peritoneal seeding were 20 (74.1%), 17 (63,0%), 12 (44.4%). In non-giant folds group (n=23), the number of poorly differentiated type, lymph node metastasis, peritoneal seeding were 17 (73.9%), 15 (65.2%), 6 (26.1%). Rate of tumor invasion in serosa and beyound serosa was 88.9% in giant fold group, 63.0% in non-giant fold group. Surgery was performed in only 32% as a modality of treatment (vs. 82.5%). Characteristics findings of Borrmann type 4 gastric cancer in EUS showed a thickening of the third (submucosa) and fourth (muscularis propria) layers in 72% of 50 patients, and a well preserved five-layered gastric wall structure in 33 patients. Conclusions: We concluded that Borrmann type 4 gastric cancer was diagnosed more in females, as a more advanced disease, early detection was needed. And endoscopic ultrasonography is useful for diagnosis of Borrmann type 4 gastric cancer in the cases of suspicious results of gastroscopy.

상부소화관출혈에 있어서 내시경적 분말약제산포의 효과

김상균,조주영,송상훈,김진오,이준성,이문성,심찬섭 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Background : Bleeding after endoscopic procedure of the stomach carries an increased risk of morbidity and mortality. In case of oozing hemorrhage, not in active hemorrhage, powdered sodium alginate may play a role in control of bleeding with convenience. Therefore, we evaluated the clinical effect and efficacy of sodium alginate powder in upper G-Ⅰ bleeding. Methods : Forty-five patients who had upper G-Ⅰ bleeding after endoscopic procedure were enrolled in this study. Twenty-five patients of them were managed by the application of powder preparation of Sodium alginate(ALTO). The others were observed without treatment. The next day, we performed endoscopy in all patients to ascertain the hemostasis. Results : Of 25 patients managed with Sodium alginate, only two patients(8%) had bleeding (hemostatic rate : 92%), On the other hand, of 20 patients who did not receive any treatment, 3 patient(15%) had bleeding (hemostatic rate : 85%). There was no statistical difference between the two groups(p>0.05). Using other endoscopic procedure, We successfully treated the patient who continued to bleed. Conclusion : We evaluated the effect of the spary of sodium alginate on oozing hemorrhage. Although there was no statistical significance in our study, it seems that the spray of sodium alginate may be a useful method for the prevention of bleeding after endoscopic procedure.

진행성 위암과 동반된 후복막 섬유화증 7예의 임상적 고찰

장재영,천영국,최우봉,김진오,조주영,이준성,이문성,심찬섭 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Background/Aims: Retroperitoneal fibrosis is a fibrosing disease process which frequently develops ureteral obstruction. Malignant retroperitoneal fibrosis has been reported that various types of cancer including cancer of the breast, stomach, prostate, lung, cervix, uteri, colon, pancreas, ovary, and even Hodgkin's disease. While the pathogenesis remains obscure, small foci of metastatic neoplasm in the retroperitoneal space can elicit a desmoplastic reaction in secondary form to malignancy. Methods: Recently we experienced 7 cases of retroperitoneal fibrosis with advanced gastric cancer. So, we report 7 cases of retroperitoneal fibrosis with clinical and radiologic characteristics. Results: The most common signs and symptoms were related irreversible renal dysfunction. The urologic finding noted medial deviation of the involved ureters and hydronephrosis Conclusions: Clinical manifestations are abdominal pain, back pain, hydronephrosis, and uremia. When sudden back pain and hydronephrosis develop in advanced malignancy, physicians should be considerd for retroperitoneal fibrosis.

A New Amorphous Semiconducting Polythiophene for High-Performance Organic Thin-Film Transistors

Kong, Hoyoul,Lee, Dong Hoon,Seo, Jung-In,Oh, Ji-Young,Chung, Dae Sung,Park, Jong-Won,Kwon, Soon-Ki,Lee, Yoon Sup,Park, Chan Eon,Shim, Hong-Ku American Chemical Society 2010 ACS APPLIED MATERIALS & INTERFACES Vol.2 No.4

<P>A new amorphous semiconducting polymer containing dodecylthiophene rings and a rigid thieno[3,2-<I>b</I>]thiophene ring, poly(2,5-bis(3′-dodecyl-2,2′-bithiophen-5-yl)thieno[3,2-<I>b</I>]thiophene) (<B>NAP</B>), was synthesized via a microwave-assisted Stille coupling reaction. The presence of the flexible unsubstituted thiophene ring units next to the rigid fused thiophene ring caused <B>NAP</B> to have an amorphous structure. This structure was confirmed by XRD, AFM, and computational calculations. In particular, the out-of-plane XRD patterns of <B>NAP</B> thin films exhibited no reflection peaks before or after the annealing process, indicating that the films had amorphous microstructures. In addition, AFM images of the <B>NAP</B> thin films showed amorphous surface morphologies with very small root-mean-square (rms) surface roughnesses of 0.3−0.5 nm, independent of surface treatment or heat treatment. Computational calculations performed to investigate the preferred conformation of the polymer confirmed the amorphous characteristics of the <B>NAP</B> structure. On the basis of these findings, we propose how an amorphous <B>NAP</B> semiconductor can maintain high carrier mobility. A <B>NAP</B>-based TFT device exhibited a very high carrier mobility of 0.02 cm<SUP>2</SUP> V<SUP>−1</SUP> s<SUP>−1</SUP> with an on/off ratio of 1 × 10<SUP>5</SUP> and a very small threshold voltage of −2.0 V. This carrier mobility is the highest yet reported for TFTs based on amorphous semiconductors. Thus, the present findings suggest that an amorphous semiconductor layer comprised of <B>NAP</B> would be suitable for use in high-performance organic TFTs fabricated via simple processes in which neither surface treatment nor heat treatment is necessary.</P><P><B>Graphic Abstract</B> <IMG SRC='http://pubs.acs.org/appl/literatum/publisher/achs/journals/content/aamick/2010/aamick.2010.2.issue-4/am9008852/production/images/medium/am-2009-008852_0011.gif'></P><P><A href='http://pubs.acs.org/doi/suppl/10.1021/am9008852'>ACS Electronic Supporting Info</A></P>

Biliary Motility Disorder

( Chan Sup Shim ) 대한소화기학회 1993 SIDDS Vol.2 No.-