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송락종,김선필,민영돈,Song, Rack-Jong,Kim, Sun-Pil,Min, Young-Don 대한위암학회 2007 대한위암학회지 Vol.7 No.2
목적: 약년자와 고령자에서 발생하는 위암의 차이점에 관한 연구는 이전부터 있어왔지만, 최근 한국인의 평균 수명이 연장되면서 이에 따른 약년자 군과 고령자 군을 새롭게 분류해야할 필요가 제기되었다. 약년자에서 발생하는 위암은 진단 시 간파되기 쉽고, 고령자 위암의 경우 동반질환으로 인해 수술 전후의 위험도를 증가시키는 것으로 알려져 왔다. 저자들은 약년자 군과 고령자 군에서 발생한 위암에서 각각의 임상병리학적 특성과 예후에 관하여 알아보고자 하였다. 대상 및 방법: 위암 환자를 나이에 따라 35세 이하의 약년자 군 31명과 75세 이상의 고령자 군 49명으로 분류하고 성비, 발생위치, 조직학적 분류, 병기, 수술방법, 평균생존율 등의 임상병리학적 특성을 비교하였다. 결과: 약년자 군에서 미분화 선암과 미만형의 발생률이 가장 높았으며, 고령자 군에서는 미분화와 중등도 분화 선암, 장형의 발생률이 가장 높은 것으로 관찰되었다. 그 외 두 군 간의 수술 방법의 차이나 술 후 합병증 및 수술 전후의 사망률 등의 의미있는 임상적 차이는 관찰되지 않았다. 또한, 두 군 간의 생존율 차이도 관찰되지 않았다. 결론: 약령자와 고령자 두 군 간에 임상병리학적이나 생존율의 차이를 보이지 않았고, 두 군 간 수술방법과 근치도에서 차이가 없는 수술이 시도된 결과 고령자 군에서 약년자 군에 비해 생존율 저하를 보이지 많았다. 따라서 고령 환자에서 발생한 위암의 치료 시 보다 적극적 수술 치료가 필요할 것으로 생각된다. Purpose: There have been several comparative studies that have focused on elderly groups of patients with gastric cancer. However, new criteria are needed for this elderly group because of the longer life span of Korean people. The diagnosis of gastric cancer has sometimes been missed in the young age group. The perioperative risk is high in the elderly age group because of their combined diseases. This study was designed to determine the differences of the clinicopathologic features and the prognosis between young and elderly patients with gastric cancer. Materials and Methods: Eighty patients were divided in two groups and these patients were selected for making comparison between young and elderly groups of patients with gastric cancer. The young age group consisted of 31 patients who were aged 35 years old or less. The elderly age group was made up of 49 patients who were aged 75 years old or above. Results: For the clinicopathologic features, the young age group was characterized by a high incidence of the poorly differentiated type of adenocarcinoma and the diffuse type too, according to the Lauren classification. On the other hand, the elderly group was characterized by a high incidence of poorly to moderate differentiated adenocarcinoma and also the intestinal type according to the Lauren classification. The other clinical differences were unremarkable. Additionally, there was no survival advantage in the young age group compared to the elderly group. Conclusion: There were no clinicopathologic and prognostic differences between both extreme age groups. So, active surgical treatment is recommended even for the elderly patients group.
이원희,민영돈,문경래,Lee, Won-Hee,Min, Young-Don,Moon, Kyung-Rye 대한소아소화기영양학회 2008 Pediatric gastroenterology, hepatology & nutrition Vol.11 No.1
여러 개의 자석을 삼킨 경우 자석들이 서로 잡아당겨 압력 괴사로 인한 장폐쇄, 장천공, 누공 형성 등의 합병증을 일으킬 수 있다. 따라서 영 유아나 정신과적인 문제가 있는 큰 아이의 경우 자석이나 자석이 포함된 장난감과 같은 물건들을 멀리하고, 자석을 삼킨 경우에는 즉시 확인해 보아야 한다. 저자들은 1년 전부터 주기성 구토를 호소했던 중등도 정신지체를 가진 12세 남아에서 삼킨 장난감 자석 4개로 인해 위-십이지장 누공을 형성하였고 수술 후 호전된 1예를 치험하였기에 보고하는 바이다. If multiple magnets are ingested, the potential exists for the magnets attracting one another across the gastrointestinal tract and inducing pressure necrosis, perforation, fistula formation, or intestinal obstruction. We report the case of a 12-year-old boy who suffered from a fistulous communication between the lesser curvature of the mid-body of the stomach and the duodenal bulb, caused by 4 ingested magnets (Singing Magnets, China). The patient presented with moderate mental retardation, a one-year history of cyclic vomiting, and abdominal discomfort. We present the findings of simple abdominal radiography, esophagogastroduodenoscopy, computed tomography, and upper gastrointestinal series. An emergency exploratory laparotomy was performed, which revealed a gastroduodenal fistula. Fistula repair and the removal of 4 magnetic toys were subsequently performed. We emphasize that clinicians who care for children should be aware of the hazards of magnetic toy ingestion.
정영일(Young Il Jeong),문성표(Seong Pyo Mun),장정환(Jeong Hwan Chang),김권천(Kweon Cheon Kim),민영돈(Young Don Min),김성환(Seong Hwan Kim),조현진(Hyun Jin Cho),김경종(Kyung Jong Kim),류소연(So Yeon Ryu) 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.75 No.3
Purpose: Surgical site infection (SSI) is the most common nosocomial infection in surgical patients, and this accounts for 38% of all patients with nosocomial infections. Despite the advances in techniques and knowledge to prevent infection, SSI remains a significant source of postoperative morbidity and mortality, and it results in a prolonged hospital stay and increased cost. This study aims to assess the incidence of SSI and to identify the risk factors associated with SSI for patients who undergo abdominal operation. Methods: The data on 347 abdominal operations that were done under general anesthesia from 1 August 2005 to 31 July 2006 was collected and reviewed. Results: The overall incidence of SSI was 4.9%. Comorbidity was the independent risk factor for the development of SSI (P=0.011). The development of SSI was related with the American Society of Anesthesiologists (ASA) preoperative assessment score (P=0.025). The duration of the operation had a statistically significant association with an increased risk of SSI on univariate analysis. The wound classification was not associated with SSI. Staphylococcus aureus was the most frequently isolated organism, and all of the cases were methcillin-resistant Staphylococcus aureus. Conclusion: This study demonstrate that comorbidity is a significant independent risk factor for SSI.