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요석의 일회 발생 환자군과 재발 환자군에서 요석대사 위험인자들의 비교
오승영,문영태 대한비뇨의학회 2004 Investigative and Clinical Urology Vol.45 No.6
Purpose: The aim of this study was to determine whether patients with recurrent stone formations have significant metabolic risk factors compared to patients with first-time stone formations. Materials and Methods: 456 patients who participated in the stone metabolic study at Chung-Ang University Hospital between January 1, 2001 and June 30, 2002 were selected as subjects. 347 patients (211 males, 136 females) with first-time stone formations and 109 patients (77 males, 32 females) with recurrent stone formations were selected. The blood test and 24-hour urine test were categorized and grouped according to: 1) gender; 2) age brackets of 40 and under, 40-49, and 60 and over; 3) and gender-based age bracket distribution. Results: Hypocitraturia was the most common metabolic abnormality in both males and females and in all age groups. Hypocitraturia, in particular, was shown to have more significant associations (p<0.05) in female patients in their 40s and 50s with recurrent stone formations (75%) compared to female patients of the same age range with first-time stone formations (38.6%). In addition, a small urine volume was found to have similar significant associations with these subject groups (p<0.05) with respect to patients with first-time stone formations and recurrent stone formations. Female Patients (especially those in their 40s and 50s) with recurrent stone formations (242.1±158.5) were found to have a higher probability (p<0.05) of hypocitraturia than patients with first-time stone formation (419.9±242.3). Conclusions: In women with recurrent stone formation, hypocitraturia and low urine volume are the risk factors that differentiate them from patients with first-time stone formation. The correction of hypocitraturia & low urine volume may significantly reduce the patients’ chances for recurrent stone formation. (Korean J Urol 2004;45:551-556)
Pylorus-Preserving Gastrectomy for Gastric Cancer
오승영,이혁준,양한광 대한위암학회 2016 Journal of gastric cancer Vol.16 No.2
Pylorus-preserving gastrectomy (PPG) is a function-preserving surgery for the treatment of early gastric cancer (EGC), aiming to decreasethe complication rate and improve postoperative quality of life. According to the Japanese gastric cancer treatment guidelines, PPG canbe performed for cT1N0M0 gastric cancer located in the middle-third of the stomach, at least 4.0 cm away from the pylorus. Althoughthe length of the antral cuff gradually increased, from 1.5 cm during the initial use of the procedure to 3.0 cm currently, its optimallength still remains unclear. Standard procedures for the preservation of pyloric function, infra-pyloric vessels, and hepatic branch of thevagus nerve, make PPG technically more difficult and raise concerns about incomplete lymph node dissection. The short- and longtermoncological and survival outcomes of PPG were comparable to those for distal gastrectomy, but with several advantages such asa lower incidence of dumping syndrome, bile reflux, and gallstone formation, and improved nutritional status. Gastric stasis, a typicalcomplication of PPG, can be effectively treated by balloon dilatation and stent insertion. Robot-assisted pylorus-preserving gastrectomy isfeasible for EGC in the middle-third of the stomach in terms of the short-term clinical outcome. However, any benefits over laparoscopyassistedPPG (LAPPG) from the patient’s perspective have not yet been proven. An ongoing Korean multicenter randomized controlledtrial (KLASS-04), which compares LAPPG and laparoscopy-assisted distal gastrectomy for EGC in the middle-third of the stomach, mayprovide more clear evidence about the advantages and oncologic safety of PPG.