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결장직장암 병기 결정에 있어서 흉부 컴퓨터 단층 촬영의 유용성
이창호(Chang Ho Lee),김종훈(Jong Hun Kim),진공용(Gong Yong Jin),이민로(Min Ro Lee) 대한외과학회 2009 Annals of Surgical Treatment and Research(ASRT) Vol.76 No.3
Purpose: The lung represents the second most metastatic site after the liver in colorectal cancer (CRC). Traditionally, pulmonary metastasis has been evaluated by means of a chest X-ray. But, recently, chest computed tomography (CT) is increasingly being performed to detect pulmonary metastasis in CRC. This study was performed to evaluate the usefulness of chest CT over chest X-ray for early detection of pulmonary metastasis in preoperative staging in CRC. Methods: We retrospectively reviewed 108 cases of CRC patients surgically treated with a curative intent at Chonbuk National University Hospital from April, 2007 to December, 2007. All evaluated by both chest X-ray and chest CT preoperatively. Results: Five among 108 patients had metastatic lesions of the lung. Four of these 5 patients (80%) had a positive chest CT. But one of these 5 patients (20%) had a positive chest X-ray. Chest CT provided a sensitivity of 80% and a positive predictive value of 80% for the detection of metastatic lesions of the lung. In contrast, chest X-ray provided a sensitivity of 20% and a positive predictive value of 50% for the detection of metastatic lesion of the lung. Nine of these 108 patients (8%) were diagnosed with solitary pulmonary nodule (SPN) and one of them was confirmed to have metastatic lesion of the lung. Conclusion: There are isolated metastatic lung lesions without other organ involvement in CRC (4.6%). Chest CT is a more accurate imaging modality for detection of pulmonary metastasis in CRC. Also, we should carefully follow-up SPN detected by preoperative chest CT.
위장관 수술 후 발생한 장관 누공 환자에서 영양집중지원팀에 의뢰된 내용 분석
정미진 ( Mi Jin Jeong ),유희철 ( Hee Chul Yu ),황시은 ( Si Eun Hwang ),김찬영 ( Chan Young Kim ),이민로 ( Min Ro Lee ),김선형 ( Sun Haeng Kim ),김행순 ( Hyeong Seon Kim ),김주신 ( Ju Sin Kim ),문미경 ( Mi Kyung Moon ),윤완기 ( Wan 한국정맥경장영양학회 2010 한국정맥경장영양학회지 Vol.3 No.1
Purpose: The role of nutrition support for the management of enterocutaneous fistula is primarily one of supportive care to prevent malnutrition and thereby halt further deterioration of an already debilitated patient. This therapy is best managed by a nutritional support team (NST). For activation of the NST, physicians must become more aware of the need for nutrition support in patients, and so referrals are required from physicians. This study examined the referrals to the nutritional support team for patients with postoperative enterocutaneous fistula. Methods: Between March 2007 and May 2009, we reviewed 34 patients with postoperative enterocutaneous fistula and who was referred to the NST. Results: The mean age of the patients was 61.1±11.5years. Twenty seven cases were males and 7 were females. The routes of nutrition support were EN+PN: 32 (55.2%), PN: 16 (27.6%), EN: 8 (13.0%) and oral intake+PN: 2 (3.4%). The direct referrals were 45 (77.6%) and the indirect referrals though the nutritional screening system were 13 (22.4%). The referrals for EN were 40 (69%) and those for PN were 18 (31.0%). The recommendations by the NST were accepted in 48 (82.8%) of the cases. The EN recommendations were accepted in all 40 (100.0%) of the cases. The PN recommendations by direct referral were accepted in 6 of 7 cases, but only 2 of 11 cases were accepted according to indirect referral. Conclusion: More aggressive and thorough follow-up on whether or not to accept the NST recommendation is required. This study shows that regular scheduled nutrition support service orientations for the different staff and departments of the hospital should be held each year. (KJPEN 2010;3(1):45-49)
김상균 ( Sang Kyoon Kim ),유창우 ( Chang Woo You ),권혁진 ( Hyeok Jin Kwon ),정혜진 ( Hey Jin Jeong ),김성훈 ( Seong Hun Kim ),김인희 ( In Hee Kim ),이승옥 ( Seung Ok Lee ),이민로 ( Min Ro Lee ),장규윤 ( Kyu Yun Jang ),김상욱 ( Sa 대한소화기기능성질환·운동학회 2006 Journal of Neurogastroenterology and Motility (JNM Vol.12 No.2
Colonic hypoganglionosis is one variant of the colonic ganglion cell disorders. It is characterized histologically by a small number of ganglion cells in the intestinal myenteric plexuses and it`s characterized functionally by severely impaired gut motility. Most cases reported in the literature have occurred relatively late in childhood, and they usually involve mild constipation. In our case, the patient had a megacolon with severe constipation. He had had repeated admissions due to chronic constipation and abdominal distention. Conservative management failed to relieve those symptoms, and so subtotal colectomy was undergone. The patient recovered normal bowel habits in five months after his operation. (Kor J Neuro-gastroenterol Motil 2006;12:161-165)