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나용호,김동웅,임창인,김안명,이건화,김창일,김진오 대한내과학회 1992 대한내과학회지 Vol.42 No.2
Percutaneous endoscopic gastrostomy (PEG) was introduced into clinical practice in 1980 and has become a preferred method of feeding gastrostomy tube placement. Since our first description 1986 in Korea, PEG has supplanted its surgical counterpart in many Korean institutions. During the periods from January 1986 to December 1990, we have managed 102 patients with a PEG. This study reviewed our experience with PEG with respect to the incidence of PEG-related problems and the efficacy of the procedure. 1) Mean age of patients were 43 years(range 15∼78), Primary diagnosis in 102 patients undergoing PEG was head trauma; 63, stoke; 20, CO poisoning; 4, brain tumor; 2, esophageal cancer; 5, cardiac cancer; 6, esophageal poerforation; 1, esophagobronchial fistula; 1. 2) PEG was succesful in 95 patients (93%) and mean operation time was 15 minutes (range 9∼42). Seven patients failed to have a gastrostomy placed for technical reasons including; previous gastrectomy; 2, no transillumination; 2, broken silk suture during procedure; 2, large ventral hernia; 1. 3) The PEG tubes remained well in 88 patients with functioning over 3 months and the longest functioning of PEG tube was 27 months to date. 4) Weight gain was noted in 66 of 88 patients (75%) and mean weight gain was 38%. 5) The incidence of PEG-related complications was 18% and three postoperative death occurred which were related to the patients underlying disease. This author's experience with these 102 patients has led to the conclusion that PEG is safe, easy to perform, and effective means of establishing access for enteral feeding.Key Words: Percutaneous endoscopic gastrostomy, enteral feeding.
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나용호,송주흥 대한내과학회 1987 대한내과학회지 Vol.32 No.3
In 30 healthy volunteers (15 women; mean age. 45.7:15 men; mean age, 33), anorectal manometry was done to determine whether rectal or anal function is affected by sex. The high fidelity infusion system was used and tracings were coded, read and interpreted by two blind observers. Sex did not affect anal basal pressure, maximal rectal squeeze pressure, threshold of rectosphincteric reflex (RSR), threshold of sense, critical volume, constant relaxation volume and amplitude of RSR with 60 ml rectal distention, But basal rectal pressure, maximal anal squeeze pressure and anal pullthrough pressure at rest were significantly higher; and anal length, longer, in males than in females. The threshold of sense is 33.6 (±11.6) ml in man, 38.5 (±11.0) ml in woman, the critical vloume 121.4 (±41.0) ml in man, 102 (±28.3) ml in woman. These results are different from those published in Western country. But estimation of threshold of sense and critical volume is based on subjective terms and has relatively reduced reproducibility. Therefore, in order to obtain constant and reliable results, threshold of RSR or constant relaxation volume can be used in routine anorectal manometry.
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나용호,송주흥,최인태,채수인,박석,김혁제,조원섭 대한내과학회 1987 대한내과학회지 Vol.32 No.3
Nutritional assessment is a rational prerequisite to the provision of adequate patient care. Anthropometric measurement is relatively simple but valuable method of nutritional assessment and current)y widely used in clinical practice. But Korean anthropomeric data were not yet obtained. To obtain anthropometric data in Korean, we measured body weight, height, triceps skin- fold thickness (TSF), and midarm circumference (MAC) of 2021 Korean aged from 16 to 9S years. The midarm fat area (MAFA) and midarm muscle area (MAMA), based on the measurement of TSF and MAC, were calculated. The results were summarized as follows; 1) The mean value of body weight of Korean, under 65 years old was 65.6(±8.3)kg in male, 54.2(±6.9)kg in female; over 65 years old 58.8(±9.5)kg in male, 48.8(±9.4)kg in female. 2) The mean value of the height of Korean, under 65 years old was 169.0(±5.6)cm in male, 157.7(±4.7)cm in female; over 65 years old 166.1(±5.1)cm in male, 148.0(±6.8)cm in female. 3) The mean value of MAC of Korean, under 65 years old was 27.5(±2.7)cm in male, 26.6(±3.0)em in female; over 65 years old 25.4(±2.7)cm in male, 24.5(±3.6)cm in female. 4) The mean value of TSF of Korean, under 65 years old was 12.2(±5.7)mm in male, 20.6(±7.1)mm in female; over 65 years old 11.4(±5.4)mm in male, 16.1(±6.8)mm in female, 5) The mean value of MAMA of Korean, under 65 years old was 45.2(±10.2)cm² in male, 32.8(±9.1)cm² in female; over 65 years old 38.3(±7.4)cm² in male, 30.6(±7.8)cm² in female. 6) The mean value of MAFA of Korean, under 65 years old was 15.6(±7.3)cm² in male, 24.2(±9.2)cm² in female; over 65 years old 13.7(±7.4)cm² in male, 18.1(±9.2)cm² in female. This study shows that anthropometric data of Korean are considerably lower than those published in western country. These results suggest racial difference. So nutritional assessment in Korean should be done by reference chart from Korean.
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