가와사끼병에서 면역글로불린 사용 후 ASO 수치의 변동에 관한 고찰

황성욱,이지웅,송민섭,김철호 인제대학교 2006 仁濟醫學 Vol.27 No.-

Objective : Since Kawasaki disease was first described in 1967, the cause and prognostic factors have not been known despite many researches and efforts. The introduction of high-dose intravenous gamma-globulin (IVGG) was an epoch and IVGG is now a standard therapy. But the mode of action of IVGG in reducing inflammatory response is not clearly understood. Understanding of the mechanism should supply the clues that indicate the cause, prognosis, the better treatment of this disease. At present, the correlation of CRP, ESR and change of leukocyte numbers to Kawasaki diseases were known, but the correlation studies of ASO titers are rare. To discover this, we evaluated the interrelationship between the ASO titer and IVGG therapy. Methods and Materials : The subjects included 35 patients with Kawasaki disease who were treated by IVGG at department of pediatrics, Inje university, Busan Paik hospital from June, 2004 to December, 2005. Before and after IVGG administration, ASO titers were evaluated. Results: In the 32 among 35 patients, ASO titers checked before IVGG administration were increased prominently after IVGG therapy. Conclusion : Remarkably increased ASO titers after IVGG administration for the treatment of Kawasaki diseases were found. And changes of ASO titers seem to be due to immunoglobulin instead of streptococcal infection. Further studies will be necessary to clarify the pathogenic mechanisms of increased ASO titers.

호르몬 불응성 전립선암 환자에서 mitoxantrone과 prednisone의 병합화학요법 후 통증완화 및 삶의 질 측정

이홍우,이지열,김세웅,이충범,강성학,조용현,황태곤,박용현,윤문수 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.3

목적 : 호르몬 불응성 전립선암 환자의 생명을 연장시키는 치료법은 현재로는 없으며, 현 시점에서의 치료목표는 증상의 경감 및 소실에 따른 삶의 질 향상에 두고 있다. 호르몬 불응성 전립선암의 고식적인 치료에 일차적인 치료법으로 간주되는 mitoxantrone과 prednisone의 화학요법이 호르몬 불응성 전립선암 환자의 통증완화 및 삶의 질에 어떠한 영향을 미치는지 알아보았다. 방법 : 1998년 7월부터 1999년 12월까지 증상이 있는 18명의 호르몬 불응성 전립선암 환자를 대상으로 하였으며, 일차적인 치료의 목표는 환자 본인이 기록하는 McGill-Melzack 6단계 통증척도에서 진통제의 증량 없이 2점이 감소(또는 첫 점수가 1점일 경우 통증의 완전소실)하는 것으로 하였다. 이러한 기준은 최소 3주 간격으로 시행한 자가 기록조사에서 연속적으로 2번 이상 유지될 때 유효한 것으로 간주하였다. 건강과 관련된 삶의 질 측정은 전신적 치료의 임상적 응용을 위한 실제적인 측정방법으로 개발되어 환자가 직접 작성하는 전립선암 특이성 삶의 질 측정기구(Prostate Cancer-Specific Quality-of-Life Instrument : PROSQOLI)의 비례연속형의 자가측정 척도(linear analogue self-assessment scale : LASA)를 이용하였으며, ECOG performance status를 사용하여 전신상태의 변화도 측정하였다. 결과 : 통증의 경감으로 나타나는 고식적인 치료의 반응은 66.7%(12/18)에서 나타났으며, 반응의 지속기간은 2개월에서 10개월까지로 평균 4.2±3.6개월이었다. PROSQOLI로 측정한 삶의 질은 통증에 대한 고식적인 치료반응을 보인 12명(66.7%) 모두가 삶의 질이 개선되었으며 특히 통증, 변비, 소변보기, 전반적인 복지상태에서의 유의한(p<0.05) 증가를 보였다. 치료 후 혈장 PSA 수치는 고식적인 반응의 유무에 관계없이 별 다른 변화를 보이지 않았으며, 골주사 또는 전산화 단층촬영으로 측정한 방사선학적 병변은 고식적인 반응을 보인 2명을 제외하고 치료 전과 비교하여 차이를 보이지 않았다. 병합 화학요법과 관련된 특별한 부작용은 관찰되지 않았다. 결론 : 통증을 동반한 호르몬 불응성 전립선암에서 mitoxantrone과 prednisone의 병합화학요법은 66.7%의 환자에서 통증의 감소 및 삶의 질이 향상되었다. 현재는 혈장 PSA 수치, 병소의 크기나 개수등이 치료의 지침이나 치료결과의 판정을 위한 객관적인 기준으로 사용되는 경향이 있지만, 앞으로는 환자를 중심으로 통증을 포함한 삶의 질 측정이 고식적 치료 후 치료결과 판정에 있어 객관적이고 적절한 방법이 될 것이다. Background : There is no evidence that therapeutic modalities prolong the survival of patients with hormone-refractory prostate cancer nowadays. The main goal of treatment is therefore improvement in quality-of-life including palliation of symptoms. We performed this study to investigate the benefit of mitoxantrone and prednisone chemotherapy in patients with symptomatic hormone-refractory prostate cancer using relevant end points of palliation regarding to pain and quality-of-life. Methods : From July 1998 to December 1999, we assessed the 18 patients with symptomatic hormone-refractory prostate cancer receiving mitoxantrone and low dose prednisone. The treatment end point was a palliative response defined as a 2-point decrease in pain assessed by a 6-point pain scale complemented by patients (or complete loss of pain if initially 1+) without an increase in analgesic medication and maintained for two consecutive evaluations at least 3 weeks apart. Health-related quality-of-life was evaluated with a series of linear analogue self-assessment(LASA) scale of the Prostate Cancer-Specific Quality-of-Life Instrument (PROSQOLI) and performance status was also measured. Results : Palliative responses were observed in 12(66.7%) of 18 patients. The duration of palliative responses were 4.2±3.6 months(range: 2 to 10 months). Treatment was well tolerated without specific side effects. There were no differences in prostate-specific antigen (PSA) level following treatment and no significant changes of radiologic findings evaluated by bone scan and/or CT were noted except 2 cases after chemotherapy. All the responding patients had an improvement in quality-of-life scales and performance status, however serum PSA levels were not changed. Conclusions : Chemotherapy with mitoxantrone and prednisone provides palliation and an improvement in quality-of-life for more than half (66.7%) of the patients with symptomatic hormone-refractory prostate cancer.

Trends in endovascular aneurysm repair research: bibliometric analysis from 1994 to 2017

Ji Woong Hwang,Heungman Jun 대한외과학회 2019 Annals of Surgical Treatment and Research(ASRT) Vol.96 No.2

Purpose: Since endovascular aneurysm repair (EVAR) was first introduced in 1991, it has undergone rapid technical and quantitative developments. We analyzed the characteristics and trends of EVAR research through bibliometric analysis. Methods: Comprehensive online searches focused on EVAR were performed from January 1994 to August 2017. The following information was collected: title, year of publication, countries’ contribution, authorship, subspecialty, institution, subject category, and top 10 cited articles. Results: A significant increase was demonstrated globally in the number of annual publications on EVAR. The highest number of publications was from the United States (n = 849, 35.08%), followed by England (n = 343, 14.17%), and the institutions with highest number of publications were Stanford University (n = 61, 2.52%) and Skane University Hospital Malmo (n = 45, 1.86%). The Journal of Vascular Surgery published approximately one quarter of the total publications. Vascular surgeons produced the most publications (n = 1871, 78.14%), followed by radiologists (n = 377, 15.58%) and cardiologists (n = 73, 3.02%). The most studied topics on EVAR were complications and procedures. The number of publications on complex EVAR and EVAR in juxtarenal aneurysm has increased more from 2013 to 2017 (5.1%, 9.5%) compared with from 1998 to 2002 (2.1%, 1.8%). Conclusion: Our bibliometric analysis showed the characteristics and trends of publications on EVAR over a period of 25 years. The results of the bibliometric analysis revealed the quantitative improvements of publications and the qualitative improvements in challenging EVAR.

Is It Feasible to Perform the Laparoscopic Cholecystectomy in Patients with Post-Endoscopic Retrograde Cholangiographic Pancreatitis?

( Ji Woong Hwang ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Preoperative endoscopic retrograde cholangiopancreaticography (ERCP) followed by laparoscopic cholecystectomy (LC) have been generally accepted as treatment of choice for patients with combined choledocholithiasis and cholecystolithiasis. However, ERCP occasionally results in post-ERCP pancreatitis (PEP), which could defer and disturb laparoscopic approach in cholecystectomy (LC). The aim of this study was to evaluate the effect of the PEP on surgical outcome of LC. Methods: From January 2009 to December 2014, the patients who underwent ERCP followed by LC were retrospectively reviewed. Patients with biliary pancreatitis were excluded. The patients with PEP were classified as PEP group (n=22), and those without PEP were classified as NPEP group (n=46). Operative time, operative complications, conversion rate, and length of stay were compared in both groups. Student t test was used to compare continuous data and Fisher’s exact test was used for categorical data. Results: Groups were comparable in terms of age, sex, and American Society of Anesthesiologists classification. The operative time and length of stay were not significantly different in both groups (P = 0.420, P = 0.585). The morbidity occurred in 5 patients (22.6%) of PEP group and 3 patients (6.9%) of NPEP group (P = 0.105). Conversion to open cholecystectomy occurred in only NPEP group (n=2). Conclusions: PEP does not have an adverse effect on the surgical outcome of LC in PEP groups compared to NPEP groups. Therefore, it is feasible and safe to perform LC in the patients with PEP.

Sarcopenia with systemic inflammation can predict survival in patients with hepatocellular carcinoma undergoing curative resection

Ji Woong HWANG,Hanbaro KIM 한국간담췌외과학회 2022 Annals of hepato-biliary-pancreatic surgery Vol.26 No.-

The Clinicopathologic Features and Outcomes of Hepatocellular Carcinoma after Hepatectomy During 10 Years Follow-up

Ji Woong Hwang,Jong Hee Yoon,Jeong Su Nam,Young Hwan Kim,Jae Hoon Lee,Ki Byung Song,Kwang-Min Park,Young-Joo Lee 한국간담췌외과학회 2012 한국간담췌외과학회 학술대회지 Vol.2012 No.4

[Poster] Surgery of the Bismuth type IV hilar cholangiocarcinoma

Ji Woong Hwang,Kwang-Min Park,Dae Keun Song,Jae Hoon Lee,Young-Joo Lee 대한외과학회 2011 대한외과학회 학술대회 초록집 Vol.2011 No.11

[Poster] Surgical resection for hepatic colorectal metastasis

Ji Woong Hwang,Jae Hoon Lee,Dae Keun Song,Kwang-Min Park,Young-Joo Lee 대한외과학회 2011 대한외과학회 학술대회 초록집 Vol.2011 No.11

Totally Robotic Central Pancreatectomy

( Ji Woong Hwang ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: Central pancreatectomy is a parenchyma-sparing procedure that can be utilized in the resection of tumors of the neck or the proximal body of the pancreas. Despite of the benefit of CP, the complexity of pancreatic surgery has made it difficult to introduce laparoscopic or roboric surgery in this field. In this article, we descirbe a totally robotic central pancreatectomy (RCP) performed to the patient with benign central pancreatic tumor. Methods: A 43 years old woman had intraductal papillary mucinous neoplasm in the body of pancreas. She had no medical illness. Tumor size was 2.0 cm. All surgical procedures including central pancreatectomy and reconstruction were performed by using the da Vinci® Surgical System (Intuitive Surgical, Sunnyvale, CA). We performed the pancreaticojejunostomy using a dunking technique for panceraticoenteric reconstruction to the distal stump. Results: The operative time was 510 minutes and console time was 480 minutes. It took 90 minutes to perform the pancreaticojejunostomy. The blood loss was 120 mL. A postoperative pancreatic fistula (grade A) was developed at the pancreas head stump, which was managed conservatively. The postoperative hospital stay was 14 days. Conclusions: RCP enables the secure pancreaticojejunostomy compared with laparoscopic surgery. Therfore, RCP is a feasible and useful technique for the removal of benign central pancreatic tumors.

The prognosis analysis of portal venous involvement by pancreas ductal adenocarcinoma: according to the location and extent of venous involvement

Ji Woong Hwang,Song Cheol Kim,Jae Hoon Lee,Ki Byung Song,Jeong Su Nam,Jong Hee Yoon,Zunqiang Zhou,Kwang-Min Park,Young-Joo Lee 한국간담췌외과학회 2013 한국간담췌외과학회 학술대회지 Vol.2013 No.4