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Image and Learning : Opioid-induced Lower Esophageal Sphincter Dysfunction
( Esteban Saez Gonzalez ),( Vicente Ortiz Bellver ),( Francia Carolina Diaz Jaime ),( Juan Antonio Ortuno Cortes ),( Vicente Garrigues Gil ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2015 Journal of Neurogastroenterology and Motility (JNM Vol.21 No.4
Decreased Esophageal Sensitivity to Acid in Morbidly Obese Patients: A Cause for Concern?
( Vicente Ortiz ),( Diego Alvarez-sotomayor ),( Esteban Saez-gonzalez ),( Francia Carolina Diaz-jaime ),( Marisa Iborra ),( Julio Ponce ),( Vicente Garrigues ) 대한간학회 2017 Gut and Liver Vol.11 No.3
Background/Aims: To evaluate esophageal sensitivity to acid between morbidly obese (MO) patients and non-MO controls with abnormal esophageal acid exposure. Methods: We conducted a cross-sectional study of 58 patients: 30 MO (cases) and 28 non-MO (controls). Esophageal symptoms and esophageal sensitivity to 0.1 M hydrochloric acid solution (Bernstein test) were compared between MO and non- MO patients with a prior diagnosis of abnormal esophageal acid exposure. Results: MO patients were less symptomatic than non-MO controls (14% vs 96%; odds ratio [OR], 0.006; 95% confidence interval [CI], 0.001 to 0.075; p=0.000). MO patients were more likely to present with decreased esophageal sensitivity to the instillation of acid than non-MO controls (57% vs 14%; OR, 8; 95% CI, 1.79 to 35.74; p=0.009). Subgroup analysis revealed no differences in esophageal sensitivity in MO patients with and without abnormal esophageal acid exposure (43% vs 31%; p=0.707). Conclusions: Silent gastroesophageal reflux disease (GERD) is common among MO individuals, likely due to decreased esophageal sensitivity to acid. The absence of typical GERD symptoms in these patients may delay discovery of precancerous conditions, such as Barrett`s esophagus. We believe that these patients may require a more aggressive diagnostic work-up to rule out the presence of silent GERD. (Gut Liver 2017;11:358-362)
Osteomyelitis: A Descriptive Study
Laura Prieto-Pérez,Ramón Pérez-Tanoira,Elizabet Petkova-Saiz,Concepción Pérez-Jorge,Cristina Lopez-Rodriguez,Beatriz Alvarez-Alvarez,Jorge Polo-Sabau,Jaime Esteban 대한정형외과학회 2014 Clinics in Orthopedic Surgery Vol.6 No.1
Background: To analyze the incidence and clinical-microbiological characteristics of osteomyelitis (OM) in a tertiary Spanish hospital. Methods: All cases diagnosed with OM between January 2007 and December 2010 were retrospectively reviewed. The variablesexamined include epidemiological characteristics, risk factors, affected bone, radiographic changes, histology, microbiological cultureresults, antibiotic treatment, and the need for surgery. Results: Sixty-three cases of OM were diagnosed. Twenty-six patients (41.3%) had acute OM whereas 37 patients (58.7%) wereclassified as chronic OM. OM may result from haematogenous or contiguous microbial seeding. In this group, 49 patients (77.8%)presented with OM secondary to a contiguous source of infection and 14 patients had hematogenous OM (22.2%). Staphylococcusaureus was the most commonly found microorganism. Conclusions: OM mainly affected patients with risk factors related to the presence of vascular diseases. Antibiotic treatmentmust be guided by susceptibility patterns of individual microorganisms, although it must be performed together with surgery inmost of the cases.