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( Chi Min Park ),( Jeong Meen Seo ),( Min Gew Choi ),( Dae Sang Lee ),( Dong Kyung Chang ),( Kyeong Man Jeon ),( Mi Yong Rha ),( Hyun Jeong Kim ),( Seon Hye Lee ),( Un Mee Kim ),( Young Yun Cho ) 한국정맥경장영양학회 2012 한국정맥경장영양학회 학술대회집 Vol.2012 No.-
Background: Optimal delivery of enteral nutrition (EN) may improve clinical outcomes of critically ill patients and enteral feeding protocols help to improve EN practice. The purpose of this study was to evaluate the impact of implementation of enteral feeding protocol on the improvement in EN practice and on the clinical outcomes of adult critically ill patients. Methods: This was a retrospective cohort study with prospectively collected data. Multidisciplinary working group, including dietitian, nurse, and intensivist, developed the evidence-based protocol by extensive literatures and guideline review. We included the consecutive patients admitted to the medical and surgical ICU and received EN more than 24 hours. The EN practices and clinical outcomes were compared between before and after implementation of enteral feeding protocol. Results: A total of 270 patients were included in this study; 134 patients before implementation, 136 after implementation. Basic clinical characteristics were not different between two phases. Enteral feeding was initiated earlier (35.8 vs 87.1 hours, p=0.001) and more patients received EN within 24 hours (59.6% vs 41.0%, p=0.002) after implementation of protocol. Interval between starting and reaching caloric goal was not different, however more patients reached caloric goal after implementation (52.2% vs 38.3%, p=0.037). Post-implementation group used more prokinetics (53.7% vs 34.3%. p=0.001) and less parenteral nutrition. Diarrhea and gastrointestinal bleeding were significantly decreased after implementation. There was no difference in clinical outcomes including ICU death, ICU free day, and hospital day. Conclusion: The implementation of enteral feeding protocol significantly improved the practices of EN and decrease complications in critically ill patients. The clinical outcomes were not different before and after implementation.
Choi, Min‐,Gew,Jeong, Ji Yun,Kim, Kyoung‐,Mee,Bae, Jae Moon,Noh, Jae Hyung,Sohn, Tae Sung,Kim, Sung Wiley Subscription Services, Inc., A Wiley Company 2012 Cancer Vol.118 No.21
<P><B>Abstract</B></P><P><B>BACKGROUND:</B></P><P>Gastritis cystica profunda (GCP) is a relatively rare disorder characterized by hyperplastic and cystic down growth of gastric glands into the submucosa. In the current study, the authors attempted to clarify the clinical and pathologic features of GCP in patients with gastric cancer.</P><P><B>METHODS:</B></P><P>The records of 10,728 patients with gastric cancer who underwent gastric cancer surgery were reviewed. The clinicopathologic features of patients who had GCP (n = 161) were compared with the features of patients without GCP (n = 10,567). In situ hybridization to determine Epstein‐Barr virus (EBV) positivity was performed in cancer tissues from patients with (n = 119) and without (n = 503) GCP.</P><P><B>RESULTS:</B></P><P>GCP was associated significantly with older age, male gender, proximal tumor location, differentiated histology and Lauren intestinal type compared with non‐GCP. GCP also was present more frequently in remnant and multiple gastric cancers. Patients who had GCP presented with earlier tumor stages in terms of depth of invasion and lymph node metastasis, and they had less lymphatic and perineural invasion than patients without GCP; however, the presence of GCP was not an independent prognostic factor. The EBV‐positive rate was significantly higher in the GCP group (31.1%) than in the non‐GCP group (5.8%).</P><P><B>CONCLUSIONS:</B></P><P>Patients with gastric cancer who had GCP had clinicopathologic features that differed from the features observed in patients without GCP. GCP was associated significantly with EBV‐positive gastric cancers, and its possible role as a premalignant lesion needs to be clarified. Cancer 2012. © 2012 American Cancer Society.</P>
위 절제술 후 절제연 양성군의 임상병리학적 특성과 재발
최성희,Hyeong Geun Lee,Min Gew Choi,Jae Hyung Noh,Tae Sung Sohn,배재문,Sung Kim 대한위암학회 2010 Journal of gastric cancer Vol.10 No.3
Purpose: The purpose of this study was to analyze the clinical courses of patients with gastric cancer and positive resection margins after a gastrectomy for gastric cancer who did not undergo subsequent surgery. Materials and Methods: Among 4,452 patients who underwent surgery for gastric cancer from January 2001 to December 2007, 20patients with positive resection margins after gastrectomy for gastric cancer who did not undergo subsequent surgery were included. The recurrence patterns were confirmed by postoperative computed tomography and gastroscopy, which were performed on a planned schedule. All recurrence patterns after gastrectomy were classified as loco-regional, peritoneal, or distant metastases. Results: The patients with confirmed recurrence all had advanced stage cancer (III–IV), and the recurrence sites were variable. However,peritoneal and distant recurrences were more common than loco-regional recurrences. The patients with loco-regional recurrence also had peritoneal and/or distant recurrence. Conclusions: Patients with gastric cancer and a positive resection margin showed more frequent peritoneal and distant metastases than loco-regional recurrence. In addition, patients with loco-regional recurrence also had peritoneal and distant recurrence. A positive resection margin of gastric cancer was related with poor histological differentiation, diffuse type, and advanced stage (III–IV).
Park, Young-Wook,MIN, Byung-Il,Lee, Jin-Gew 大韓顎顔面成形再建外科學會 1991 Maxillofacial Plastic Reconstructive Surgery Vol.13 No.1
반안면왜소증이란 제1및 제2새궁에서 유래되는 기관에 결손이 옴으로써 초래되는 안면기형을 일컫는 것으로 선천성 악안면기형 중 순열 및 구개파열 다음으로 빈발하는 질환이다. 결손부는 하악골을 포함한 안면골의 여러 부위와 안면근 및 저작근, 뇌신경, 이개등여러 부위에 다양하게 나타나며, 그 기형의 발현 정도도 아주 다양하다. 본 교실에서는 안면비대칭과 교합부진을 주소로 내원한 20세된 남자환자에 있어서 먼저 경조직을 바로잡기 위하여 상ㆍ하악골에 대한 악교정수술과 onlay골이식을 시행한 후, 남아있는 연조직 결손부에 대하여 진피-지방이식을 시행하여 심미적으로 만족할만한 결과를 얻었기에 보고하는 바이다. Hemifacial microsomia is a term used to describe a facial anomalies caused by the defect of anatomic structures originated from the first and the second branchial arches. The defect area encompasses some facial areas including mandible, facial muscles, maticatory muscles, cranial nerves, auricles, etc, and the degree of manifestations of the anomalies is extmely diverse. A 20-year-old man complaining of facial asymmetry and malocclusion visited our hospital. An orthognathic surgery was performed for the correction of hard tissue anomalies and then autogenus dermis-fat autotransplantation was done for the improvement of remaining soft tissue defect. The result was esthetically good and the case was presented here.