New Type of Reconstruction Method after Subtotal Gastrectomy : Noh's Operation

Noh, Seung-Moo,Jeong, Hyun-Yong,Cho, June-Sik,Shin, Kyung-Sook,Song, Kyu-Sang,So, Young,Lee, Tae-Yong 충남대학교 암공동연구소 2005 암공동연구소 업적집 Vol.4 No.

The aim of this study was to compare a new type of reconstruction method (Noh's operation) with Roux-en-Y operation after subtotal gastrectomy. Noh's operation described herein includes a jejunal occlusion, an end-to-side gastrojejunostomy, a side-to-end jejunoduodenostomy, and a side-to-side jejunojejunostomy after subtotal gastrectomy. A series of 43 patients who had the new operation were compared with 47 patients with the Roux-en-Y procedure. The postgastrectomy syndromes, and the raucosal change of the remnant stomach and esophagus were evaluated after surgery. In the new operation, the Roux stasis syndrome occurred in 34.9% at 3 months, in 23.3% at 6 months, in 14.0% at 12 months, and in 11.6% at 24 months. In patients undergoing the Roux-en-Y operation, the syndrome occurred in 42.6% at 3 months, in 34.0% at 6 months, in 31.9% at 12 months, and in 29.8% at 24 months. This study shows that the new type of operation (Noh's operation) can be a good option for reconstruction after subtotal gastrectomy.

New Type of Reconstruction Method after Subtotal Gastrectomy (Noh's Operation)

Noh, Seung-Moo,Jeong, Hyun-Yong,Cho, June-Sik,Shin, Kyung-Sook,Song, Kyu-Sang,So, Young,Lee, Tae-Yong 충남대학교 암연구소 2005 암연구소 업적집 Vol.4 No.-

The aim of this study was to compare a new type of reconstruction method (Noh's operation) with Roux-en-Y operation after subtotal gastrectomy. Noh's operation described herein includes a jejunal occlusion, an end-to-side gastrojejunostomy, a side-to-end jejunoduodenostomy, and a side-to-side jejunojejunostomy after subtotal gastrectomy. A series of 43 patients who had the new operation were compared with 47 patients with the Roux-en-Y procedure. The postgastrectomy syndromes, and the raucosal change of the remnant stomach and esophagus were evaluated after surgery. In the new operation, the Roux stasis syndrome occurred in 34.9% at 3 months, in 23.3% at 6 months, in 14.0% at 12 months, and in 11.6% at 24 months. In patients undergoing the Roux-en-Y operation, the syndrome occurred in 42.6% at 3 months, in 34.0% at 6 months, in 31.9% at 12 months, and in 29.8% at 24 months. This study shows that the new type of operation (Noh's operation) can be a good option for reconstruction after subtotal gastrectomy.

상부 위암에서 유문보존 근위부 위아전절제술과 공장간치술을 시행한 위전절제술의 비교

노승무,정현용,이병석,조준식,신경숙,송규상,이태용 충남대학교 암공동연구소 2003 암공동연구소 업적집 Vol.3 No.

Purpose: The aim of this study was to evaluate the short-term outcome of a pylorus-preserving proximal gastrectomy by comparing it with a jejunal interposition after a total gastrectomy in proximal gastric adenocarcinoma. Materials and Methods: For 22 patients (12 men and 10 women) who underwent a pylorus-preserving proximal gastrectomy, several clinical parameters were obtained from the medical records retrospectively. In this study, the data were collected between September 1993 and December 1999 at Chungnam National University Hospital, and the results were compared with those of 25 patients (17 men and 8 women) who underwent an isoperistaltic simple jejunal interposition. Results: The average operative time in the pylorus-preserving proximal gastrectomy group (220 minutes) was shorter than that in the jejunal interposition group (243 minutes) (P<0.05). The hemoglobin and hematocrit levels were significantly higher in the pylorus-preserving proximal gastrectomy group at 2 years after the operation. The body weight ratio (postoperative body weight/preoparative body weight) in patients who had a pylorus-preserving proximal gastrectomy was significantly higher than that in patients with a jejunal interposition at 2 years after the operation. The jejunal interposition procedure had better outcomes in anastomotic site stricture, duration of hospital stay, and number of removed lymph nodes (P<0.05). Conclusions: We think that from the viewpoint of quality of life, a pylorus-preserving proximal gastrectomy, as well as a jejunal interposition, is a useful reconstruction method for early adenocarcinomas of the proximal stomach. However, stricture of the esophagogastrostomy site in the pylorus-preserving proximal gastrectomy is a common problem to be solved in the future. (J korean Gastric Cancer Assoc 2002;2:145-150)

위전절제시 단순공장간치술의 임상적 의의

노승무,배진선,정현용,이병석,조준식,신경숙,송규상,이태용 충남대학교 암연구소 2003 암연구소 업적집 Vol.3 No.-

Purpose: The aim of this study was to evaluate the short-term outcome of a jejunal interposition, by comparing it with a conventional Roux-en-Y gastrojejunostomy, after a total gastrectomy. Materials and Methods: For 28 patients (20 men and 8 women) with a gastric adenocarcinoma, who underwent an isoperistaltic simple jejunal interposition, weight, hemoglobin, hematocrit, serum protein and albumin, and cholesterol levels were checked before the operation and at 1 year and 2 years after the surgery. Also, endoscopy was performed to confirm reflux esophagitis. In this study, the data were collected between January 1993 and July 1999 at Chungnam National University Hospital, and the results were compared with those of the Roux-en-Y procedure. Results: The body weights at 1 year and 2 years after the surgery had returned to 86.0% and 87.6% of the recent original body weight in the jejunal interposition (Jl) group and to 90.8%, 87.0%, respectively in the Roux-en-Y (RY) group. The levels of hemoglobin (g/dl) were 13.3, 12.5, and 11.9 in the Jl group, and 13.8, 12.6, and 12.1 in the RY group at the time of the operation and at 1 year, and 2 years after the surgery, respectively. The total serum protein (g/dl) levels were 7.1, 7.2, and 7.5 in the Jl group and 7.1, 7.0, and 7.2 in the RY gropu at the time of the operation and at 1 year and 2 years after the surgery, respectively. The serum albumin (g/dl) levels were 4.2, 4.1, and 4.2 in the Jl group and 4.2, 4.2, and 4.2 in the RY group at the time of the operation and at 1 year, and 2 years after the surgery, respectively. The total serum cholesterol (mg/dl) levels were 186.5, 174, and 164 in the Jl group and 213.7, 171.1, and 141.0 in the RY group at the time of the operation and at 1 year and 2 years after the surgery, respectively. The endoscopic finding showed that reflux esophagitis occurred in 7.1% of the patients in the Jl group and in 3.5% in the RY group. Conclusion: We think that from the view point of quality of life, a jejunal interposition, as well as a Roux-en-Y procedure, is a useful reconstruction methods for a total gastrectomy. (J Korean Gastric Cancer Assoc 2001;1:210-214)

위전절제시 단순공장간치술의 임상적 의의

노승무,배진선,정현용,이병석,조준식,신경숙,송규상,이태용 충남대학교 암공동연구소 2003 암공동연구소 업적집 Vol.3 No.

Purpose: The aim of this study was to evaluate the short-term outcome of a jejunal interposition, by comparing it with a conventional Roux-en-Y gastrojejunostomy, after a total gastrectomy. Materials and Methods: For 28 patients (20 men and 8 women) with a gastric adenocarcinoma, who underwent an isoperistaltic simple jejunal interposition, weight, hemoglobin, hematocrit, serum protein and albumin, and cholesterol levels were checked before the operation and at 1 year and 2 years after the surgery. Also, endoscopy was performed to confirm reflux esophagitis. In this study, the data were collected between January 1993 and July 1999 at Chungnam National University Hospital, and the results were compared with those of the Roux-en-Y procedure. Results: The body weights at 1 year and 2 years after the surgery had returned to 86.0% and 87.6% of the recent original body weight in the jejunal interposition (Jl) group and to 90.8%, 87.0%, respectively in the Roux-en-Y (RY) group. The levels of hemoglobin (g/dl) were 13.3, 12.5, and 11.9 in the Jl group, and 13.8, 12.6, and 12.1 in the RY group at the time of the operation and at 1 year, and 2 years after the surgery, respectively. The total serum protein (g/dl) levels were 7.1, 7.2, and 7.5 in the Jl group and 7.1, 7.0, and 7.2 in the RY gropu at the time of the operation and at 1 year and 2 years after the surgery, respectively. The serum albumin (g/dl) levels were 4.2, 4.1, and 4.2 in the Jl group and 4.2, 4.2, and 4.2 in the RY group at the time of the operation and at 1 year, and 2 years after the surgery, respectively. The total serum cholesterol (mg/dl) levels were 186.5, 174, and 164 in the Jl group and 213.7, 171.1, and 141.0 in the RY group at the time of the operation and at 1 year and 2 years after the surgery, respectively. The endoscopic finding showed that reflux esophagitis occurred in 7.1% of the patients in the Jl group and in 3.5% in the RY group. Conclusion: We think that from the view point of quality of life, a jejunal interposition, as well as a Roux-en-Y procedure, is a useful reconstruction methods for a total gastrectomy. (J Korean Gastric Cancer Assoc 2001;1:210-214)

상부 위암에서 유문보존 근위부 위아전절제술과 공장간치술을 시행한 위전절제술의 비교

노승무,정현용,이병석,조준식,신경숙,송규상,이태용 충남대학교 암연구소 2003 암연구소 업적집 Vol.3 No.-

Purpose: The aim of this study was to evaluate the short-term outcome of a pylorus-preserving proximal gastrectomy by comparing it with a jejunal interposition after a total gastrectomy in proximal gastric adenocarcinoma. Materials and Methods: For 22 patients (12 men and 10 women) who underwent a pylorus-preserving proximal gastrectomy, several clinical parameters were obtained from the medical records retrospectively. In this study, the data were collected between September 1993 and December 1999 at Chungnam National University Hospital, and the results were compared with those of 25 patients (17 men and 8 women) who underwent an isoperistaltic simple jejunal interposition. Results: The average operative time in the pylorus-preserving proximal gastrectomy group (220 minutes) was shorter than that in the jejunal interposition group (243 minutes) (P<0.05). The hemoglobin and hematocrit levels were significantly higher in the pylorus-preserving proximal gastrectomy group at 2 years after the operation. The body weight ratio (postoperative body weight/preoparative body weight) in patients who had a pylorus-preserving proximal gastrectomy was significantly higher than that in patients with a jejunal interposition at 2 years after the operation. The jejunal interposition procedure had better outcomes in anastomotic site stricture, duration of hospital stay, and number of removed lymph nodes (P<0.05). Conclusions: We think that from the viewpoint of quality of life, a pylorus-preserving proximal gastrectomy, as well as a jejunal interposition, is a useful reconstruction method for early adenocarcinomas of the proximal stomach. However, stricture of the esophagogastrostomy site in the pylorus-preserving proximal gastrectomy is a common problem to be solved in the future. (J korean Gastric Cancer Assoc 2002;2:145-150)

복막유착의 원인 규명과 예방을 위한 실험적 연구

강대영,송규상,노승무,조준식,이태용 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

Postoperative peritoneal adhesion is the most common cause of intestinal obstruction, and intestinal obstruction is one of the most difficult problems in abdominal surgery. In this experimental study for developing peritoneal adhesion model and its prevention, we divided rats into 5 groups; the talc powder treated group, the cotton-fluff treated group, the talc+fluff treated group, the ischemia group and the control group. There were 16 rats in each group. We made incisions on the midabdomen of the rats and administered talc powder, cotton fluff and talc powder+fluff into the peritoneal cavity respectively. In the ischemia group, we clamped the root of superior mesenteric artery for two minutes to induce ischemia on the small bowel of the rat. We counted the number of the peritoneal adhesive sites in peritoneal cavity on the 7th, 14th , 21st and 42nd postoperative day after peritoneal adhesion induced operation, and observed the characters of the adhesion state. The average number of the peritoneal adhesions were 1.25 per one rat in the talc powder group, 1.44 in the fluff group, 1.31 in the talc+fluff group and 1.31 in the ischemia group compared with 0.94 per one rat in the control group performed sham operation. 91.6% of the all adhesions were observed on the peritoneum of the previous incision sites and only 8.4% of the adhesions were adhered to the peritoneal surface of non-incision sites. The data of this study suggest that peritoneal injury and inflammatory reaction is the major cause of peritoneal adhesion. Also this study indicates that foreign bodies can develop peritoneal adhesion, but the effect is much lower than that of peritoneal injury with inflammatoty reaction.

Chest Computed Tomography (CT) Immediately after CT-Guided Transthoracic Needle Aspiration Biopsy as a Predictor of Overt Pneumothorax

( Tae June Noh ),( Chang Hoon Lee ),( Young Ae Kang ),( Sung Youn Kwon ),( Ho Il Yoon ),( Tae Jung Kim ),( Kyung Won Lee ),( Jae Ho Lee ),( Choon Taek Lee ) 대한내과학회 2009 The Korean Journal of Internal Medicine Vol.24 No.4

Background/Aims: This study examined the correlation between pneumothorax detected by immediate posttransthoracic needle aspiration-biopsy (TTNB) chest computed tomography (CT) and overt pneumothorax detected by chest PA, and investigated factors that might influence the correlation. Methods: Adult patients who had undergone CT-guided TTNB for lung lesions from May 2003 to June 2007 at Seoul National University Bundang Hospital were included. Immediate post-TTNB CT and chest PA follow-up at 4 and 16 hours after CT-guided TTNB were performed in 934 patients. Results: Pneumothorax detected by immediate chest CT (CT-pneumothorax) was found in 237 (25%) and overt pneumothorax was detected by chest PA follow-up in 92 (38.8%) of the 237 patients. However, overt pneumothorax was found in 18 (2.6%) of the 697 patients without CT-pneumothorax. The width and depth of CT-pneumothorax were predictive risk factors for overt pneumothorax. Conclusions: CT-pneumothorax is very sensitive for predicting overt pneumothorax, and the width and depth on CT-pneumothorax are reliable risk factors for predicting overt pneumothorax. (Korean J Intern Med 2009;24:343-349)

GO-17 : Voiding difficulty after radical hysterectomy for cervical cancer can be predicted by using pre-operative urodynamic study profile

( Tae Hun Kim ),( Hee Seung Kim ),( Seung June Oh ),( Noh Hyun Park ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.99 No.-

About 33% of patients who underwent radical hysterectomy (RH) suffer from voiding difficulty. Spontaneous voiding and post void residual volume has been used to assess whether the voiding function is restored or not during post-operative period. The aim of this study was to assess risk factor for voiding difficulty after radical hysterectomy. From 2006 to 2008, patients who underwent RH by single surgeon for uterine cervical cancer with a stage of 1A1 to 2B were prospectively collected and analyzed. Urodynamic studies (UDS) were performed before, 10 days after RH. Urethral catheter were removed on postoperative 8 days. If the post-void residual (PVR) did not decrease to less than 100 mL until postoperative 10 days, the patients were instructed to perform clean intermittent self-catheterization (CIC) after discharge.. Median age was 47 years old and no patient complaint voiding difficulty before RH. 33% of patients (15/45) had failed to void until discharge day. Detrusor pressure at maximal flow (PdetQmax) and detrusor pressure at opening flow (Pdet,open) on pre-operative UDS were significantly higher in voiding failure group than in spontaneous voiding group. Receiver operating characteristic curve revealed that area under the curve of PdetQmax and Pdet,open are 0.68 and 0.74 respectively. 35 cm H2O for Pdet,open was determined as cutoff value. In multivariate analysis adjusting age, mode of RH and diabetes, Pdet,open greater than 35 cm H2O in pre-operative UDS was an independent factor for predicting post-RH voiding failure (harzard ratio, . (harzard ratio, 9.54; 95% confidence interval, 2.0-44.3) Spontaneous voiding after radical hysterectomy is regarded as a parameter for restoring bladder function and performance of nerve sparing RH. Pre-operative patient`s intrinsic factors related to the bladder outlet obstruction are significantly associated with voiding difficulty after RH.

Comparison of treatment outcomes between 10 and 20 EEG electrode location system-guided and neuronavigation-guided repetitive transcranial magnetic stimulation in chronic tinnitus patients and target localization in the Asian brain

Noh, Tae-Soo,Rah, Yoon-Chan,Kyong, Jeong Sug,Kim, June Sic,Park, Moo Kyun,Lee, Jun Ho,Oh, Seung Ha,Chung, Chun Kee,Suh, Myung-Whan Informa UK (Taylor Francis) 2017 Acta oto-laryngologica Vol.137 No.9