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공은정,Hyun Lim,Sang Jin Lee,Do Hoon Kim 대한위암학회 2023 Journal of gastric cancer Vol.23 No.3
Purpose: Endoscopic submucosal dissection (ESD) is an effective treatment for early gastrointestinal neoplasms. However, this is a time-consuming procedure requiring various devices. This study aimed to evaluate the efficacy and safety of the ClearCut™ Knife H-type, which is an integrated needle-tipped and insulated-tipped (IT) knife. Materials and Methods: Between July 2020 and September 2021, 99 patients with gastric epithelial neoplasms scheduled for ESD at three tertiary care hospitals were randomly assigned to H-knife (ClearCut™ Knife H-type) or IT-knife (conventional IT knife) groups. Procedure times, therapeutic outcomes, and adverse events were analyzed. Results: A total of 98 patients (50 in the H-knife group and 48 in the IT-knife group) were analyzed. The median total procedure time was 11.9 minutes (range, 4.4–47.2 minutes) in the H-knife group and 12.7 minutes (range, 5.2–137.7 minutes) in the IT-knife group (P=0.209). Unlike the IT-knife group, which required additional devices in all cases, no additional devices were used in the H-knife group (P<0.001). En-bloc resection was performed for all lesions in both groups. The incidence of adverse events was not significantly different between groups (4.0% in the H-knife group vs. 8.3% in the IT-knife group; P=0.431). Conclusions: The newly developed hybrid device, the ClearCut™ Knife H-type, had comparable efficacy to the conventional IT knife for gastric ESD.
한국인 Helicobacter pylori 균주의 항생제 내성률 변화
공은정,안지용 대한상부위장관ㆍ헬리코박터학회 2018 Korean Journal of Helicobacter Upper Gastrointesti Vol.18 No.2
Antimicrobial resistance is a growing problem in the eradication of Helicobacter pylori. A combination therapy with proton pump inhibitor, clarithromycin, and amoxicillin is recommended as the first-line treatment regimen in Korea. However, the eradication rate with a standard triple therapy has been unsatisfactory in the last decade, and one of the main reasons for treatment failure is the increasing prevalence of strains resistant to antimicrobials. Therefore, comprehensive and detailed information on antimicrobial resistance is mandatory to optimize the strategy of eradication treatment. The antimicrobial resistance of H. pylori is reported to vary according to study population, geographical region, and test methods. In this review, the prevalence of antimicrobial resistance of H. pylori isolates in Korea is summarized on the basis of recent studies. (Korean J Helicobacter Up Gastrointest Res 2018;18:82-88)
Small bowel endoscopic bariatric therapies
공은정,Do Hoon Kim 대한소화기내시경학회 2018 Clinical Endoscopy Vol.51 No.5
Endoscopic bariatric therapies that emulate some of the principles of bariatric surgery have been developed as a less invasiveoption for the treatment of obesity and related comorbidities. Small bowel endoscopic bariatric therapies include bypasssleeves, incisionless anastomosis systems, and duodenal mucosal resurfacing. Clinical experience with small bowel devicessuggests that endoscopic bariatric procedures can be safely implemented and that these devices are effective for both weightloss and metabolic improvement. Although the mechanisms behind these effects should be further elucidated, endoscopicbariatric therapies may be more effective and safer adjunctive interventions than lifestyle modifications and pharmacologicalregimens for patients with obesity or obesity-related comorbidities.
공은정,고성애,김원제 영남대학교 의과대학 2019 Yeungnam University Journal of Medicine Vol.36 No.2
The most cases with orbital metastases have been reported in patients with a prior established diagnosis of cancer and widespread systemic involvement. However, ocular symptoms can be developed as an initial presentation of cancer in patients without cancer history. We report a case of rapid progression from trochlear nerve palsy to orbital apex syndrome as an initial presentation of advanced gastric cancer.
공은정,윤성철,정훈용,임현,최기숙,안지용,이정훈,김도훈,최기돈,송호준,이진혁,김진호 대한의학회 2014 Journal of Korean medical science Vol.29 No.5
Proton pump inhibitor (PPI)-based triple therapy consisting of PPI, amoxicillin, andclarithromycin, is the recommended first-line treatment for Helicobacter pylori infection. However, the eradication rate of triple therapy has declined over the past few decades. Weanalyzed the eradication rate and adverse events of triple therapy to evaluate currentpractices in Korea. A comprehensive literature search was performed up to August 2013 of104 relevant studies comprising 42,124 patients. The overall eradication rate was 74.6%(95% confidence interval [CI], 72.1%-77.2%) by intention-to-treat analysis and 82.0%(95% CI, 80.8%-83.2%) by per-protocol analysis. The eradication rate decreasedsignificantly from 1998 to 2013 (P < 0.001 for both intention-to-treat and per-protocolanalyses). Adverse events were reported in 41 studies with 8,018 subjects with an overallincidence rate of 20.4% (95% CI, 19.6%-21.3%). The available data suggest that theeffectiveness of standard triple therapy for H. pylori eradication has decreased to anunacceptable level. A novel therapeutic strategy is warranted to improve the effectivenessof first-line treatment for H. pylori infection in Korea.
공은정,김도훈 대한상부위장관ㆍ헬리코박터학회 2019 Korean Journal of Helicobacter Upper Gastrointesti Vol.19 No.3
Although surgical resection is the mainstay of treatment for resectable esophageal cancer, it is associated with considerable morbidity and mortality. Endoscopic resection, including endoscopic mucosal resection and endoscopic submucosal dissection, has been considered as a feasible alternative to surgical resection for superficial esophageal squamous cell carcinoma based on its minimal invasiveness and favorable outcomes in suitable indications. The long-term outcomes of endoscopic resection are comparable to those of surgery when tumors are confined to the intraepithelial or lamina propria layer because these tumors have low or no risk of lymph node metastasis. The results of histopathological examination of the resected specimens should be interpreted thoroughly regarding the requirement of additional treatment. Treatment-related adverse events include bleeding, perforation, and stricture. Preventive measures should be taken during and after the procedure, particularly when the mucosal defects account for more than three-fourths of the circumference. In this review, the indications and outcomes of endoscopic treatment for esophageal squamous cell carcinoma are summarized.
강원 영동지역의 헬리코박터 파일로리 일차 제균 치료 성적
공은정,방창석,서명숙,서현일,박종규,이상진,한군희,정우진,김영돈,천갑진 대한상부위장관ㆍ헬리코박터학회 2022 Korean Journal of Helicobacter Upper Gastrointesti Vol.22 No.2
Background/Aims: The eradication success rate of Helicobacter pylori (H. pylori) infection with a first-line standard triple therapy (STT) has been decreasing in Korea. However, treatment outcomes of H. pylori infection in Yeongdong, Gangwon Province have been scarcely reported. This study aimed to investigate the treatment outcomes of H. pylori infection in a single tertiary care hospital with regional characteristics. Materials and Methods: From July 2018 to June 2019, a total of 592 patients who underwent STT consisting of a proton pump inhibitor, amoxicillin, and clarithromycin for 7 to 14 days as a first-line H. pylori eradication therapy were included. Demographic data and treatment outcomes were retrospectively reviewed using medical records. Results: The median age of 592 patients was 58 years (range 23 to 86) and 329 patients (55.6%) were men. The indication for eradication therapy included chronic atrophic gastritis (57.9%), peptic ulcer disease (19.6%), and gastric neoplasm after endoscopic resection (5.9%). Most patients (92.2%) received a 7-day course of STT. Eradication rate of STT was 64.0% (379/592). Rescue therapy was performed in 146 patients, and the final eradication rate reached 85.6% (507/592). Conclusions: Eradication rate of STT in Yeongdong area of Gangwon Province was unsatisfactory, warranting the consideration of a first-line eradication regimen other than STT.
공은정,천경아,정주혜,조인호 대한핵의학회 2013 핵의학 분자영상 Vol.47 No.2
Constraint-induced movement therapy (CIMT)was shown recently to be promising for improving upperlimb function in children with cerebral palsy (CP). This study investigated the changes in cerebral perfusion with single-photon emission computerized tomography (SPECT)after modified CIMT (child-friendly CIMT) in young hemiplegic girls. Two young children with left hemiplegic CP were studied with SPECT at rest before and after the CIMT period, and they also performed standardized upper motor function tests [Jebsen hand function test, quality of upper extremity skills test (QUEST), and dynamic electromyography (EMG)]. The cerebral perfusion SPECT revealed regional perfusion increase in the motor cortex area in the affected hemisphere, and the changes associated with functional gain. Our cases showed that intensive movement therapy appears to change local cerebral perfusion and SPECT could show these changes in children with hemiplegic CP.