New Type of Reconstruction Method after Subtotal Gastrectomy (Noh's Operation)

Noh, Seung-Moo,Jeong, Hyun-Yong,Cho, June-Sik,Shin, Kyung-Sook,Song, Kyu-Sang,So, Young,Lee, Tae-Yong 충남대학교 암연구소 2005 암연구소 업적집 Vol.4 No.-

The aim of this study was to compare a new type of reconstruction method (Noh's operation) with Roux-en-Y operation after subtotal gastrectomy. Noh's operation described herein includes a jejunal occlusion, an end-to-side gastrojejunostomy, a side-to-end jejunoduodenostomy, and a side-to-side jejunojejunostomy after subtotal gastrectomy. A series of 43 patients who had the new operation were compared with 47 patients with the Roux-en-Y procedure. The postgastrectomy syndromes, and the raucosal change of the remnant stomach and esophagus were evaluated after surgery. In the new operation, the Roux stasis syndrome occurred in 34.9% at 3 months, in 23.3% at 6 months, in 14.0% at 12 months, and in 11.6% at 24 months. In patients undergoing the Roux-en-Y operation, the syndrome occurred in 42.6% at 3 months, in 34.0% at 6 months, in 31.9% at 12 months, and in 29.8% at 24 months. This study shows that the new type of operation (Noh's operation) can be a good option for reconstruction after subtotal gastrectomy.

New Type of Reconstruction Method after Subtotal Gastrectomy : Noh's Operation

Noh, Seung-Moo,Jeong, Hyun-Yong,Cho, June-Sik,Shin, Kyung-Sook,Song, Kyu-Sang,So, Young,Lee, Tae-Yong 충남대학교 암공동연구소 2005 암공동연구소 업적집 Vol.4 No.

The aim of this study was to compare a new type of reconstruction method (Noh's operation) with Roux-en-Y operation after subtotal gastrectomy. Noh's operation described herein includes a jejunal occlusion, an end-to-side gastrojejunostomy, a side-to-end jejunoduodenostomy, and a side-to-side jejunojejunostomy after subtotal gastrectomy. A series of 43 patients who had the new operation were compared with 47 patients with the Roux-en-Y procedure. The postgastrectomy syndromes, and the raucosal change of the remnant stomach and esophagus were evaluated after surgery. In the new operation, the Roux stasis syndrome occurred in 34.9% at 3 months, in 23.3% at 6 months, in 14.0% at 12 months, and in 11.6% at 24 months. In patients undergoing the Roux-en-Y operation, the syndrome occurred in 42.6% at 3 months, in 34.0% at 6 months, in 31.9% at 12 months, and in 29.8% at 24 months. This study shows that the new type of operation (Noh's operation) can be a good option for reconstruction after subtotal gastrectomy.

Rat의 복강에 삽입한 Filorouracil-Polyglycolic acid제형의 Fluorouracil용출에 관한 연구

노승무,정경수,오정연,김진향,양준묵,강대영,송규상,최정목,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

A common form of relapse in adenocarcinoma of the stomach is intraperitioneal dissemination, in fact, among gastric adenocarcinoma patients who have undergone surgery intended to cure, approximately 50% of the patients develope initial recurrence in the peritoneal cavity regardless of the anatomic site of the primary tumor within the stomach. The efficacy of systemic postoperative chemotherapy to prevent peritoneal recurrence of gastrric adenocarcinoma is not satisfactory. There is still a great need for improved therapeutic strategies on the disseminated microscopic disease and small miliary nodules remaining on the peritoneal surface or lymphatics after operation. The authers have made fluorouracil-polyglycolic acid composite disks(Fu-PGA disks) with fluorouracil and biodegradable polymer: polyglycolic acid for more effective intraperitoneal chemotherapy. We inserted the Fu-PGA disk(s) in the peritoneal cavity of rat and pharmacokinetic study was performed to measure fluorouracil concentration in the peritoneal fluid, plasma, liver, kidney and heart tissue at 24 hour, 72 hour and 168 hour after insertion of Fu-PGA disk(s). Myelosuppressive action of this composite also was determined following its administration. The data of this study suggested that Fu-PGA composite will be a new device releasing drugs in a controlled manner and having targetability to peritoneum, and this device will be improving the efficacy of intraperitoneal chemotherapy for gastric adenocarcinoma.

상부 위암에서 유문보존 근위부 위아전절제술과 공장간치술을 시행한 위전절제술의 비교

노승무,정현용,이병석,조준식,신경숙,송규상,이태용 충남대학교 암연구소 2003 암연구소 업적집 Vol.3 No.-

Purpose: The aim of this study was to evaluate the short-term outcome of a pylorus-preserving proximal gastrectomy by comparing it with a jejunal interposition after a total gastrectomy in proximal gastric adenocarcinoma. Materials and Methods: For 22 patients (12 men and 10 women) who underwent a pylorus-preserving proximal gastrectomy, several clinical parameters were obtained from the medical records retrospectively. In this study, the data were collected between September 1993 and December 1999 at Chungnam National University Hospital, and the results were compared with those of 25 patients (17 men and 8 women) who underwent an isoperistaltic simple jejunal interposition. Results: The average operative time in the pylorus-preserving proximal gastrectomy group (220 minutes) was shorter than that in the jejunal interposition group (243 minutes) (P<0.05). The hemoglobin and hematocrit levels were significantly higher in the pylorus-preserving proximal gastrectomy group at 2 years after the operation. The body weight ratio (postoperative body weight/preoparative body weight) in patients who had a pylorus-preserving proximal gastrectomy was significantly higher than that in patients with a jejunal interposition at 2 years after the operation. The jejunal interposition procedure had better outcomes in anastomotic site stricture, duration of hospital stay, and number of removed lymph nodes (P<0.05). Conclusions: We think that from the viewpoint of quality of life, a pylorus-preserving proximal gastrectomy, as well as a jejunal interposition, is a useful reconstruction method for early adenocarcinomas of the proximal stomach. However, stricture of the esophagogastrostomy site in the pylorus-preserving proximal gastrectomy is a common problem to be solved in the future. (J korean Gastric Cancer Assoc 2002;2:145-150)

Rat의 복강에 삽입한 Fluorouracil-Polyglycolic acid 제형의 Fluorouracil 용출에 관한 연구

노승무,정경수,오정연,김진향,양준묵,강대영,송규상,최정목,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 忠南大學校 癌共同硏究所 1998 癌共同硏究所 硏究誌 Vol.2 No.1

A common form of relapse in adenocarcinoma of the stomach is intraperitoneal dissemination, in fact, among gastric adenocarcinoma patients who have undergone surgery intended to cure, approximately 50% of the patients develope initial recurrence in the peritoneal cavity regardless of the anatomic site of the primary tumor within the stomach. The efficacy of systemic postoperative chemotherapy to prevent peritoneal recurrence of gastrric adcnocarcinoma is not satisfactory. There is still a great need for improved therapeutic strategies on the disseminated microscopic disease and small miliary nodules remaining on the peritoneal surface or lymphatics after operation. The authers have made fluorouracil-polyglycolic acid composite disks(Fu-PGA disks) with fluorouracil and biodegradable polymer: polyglycolic acid for more effective intraperitoneal chemotherapy. We inserted the Fu-PGA disk(s) in the peritoneal cavity of rat and pharmacokinetic study was performed to measure fluorouracil concentration in the peritoneal fluid, plasma, liver, kidney and heart tissue at 24 hour, 72 hour and 168 hour after insertion of Fu-PGA disk(s). Myelosuppressive action of this composite also was determined following its administration. The data of this study suggested that Fu-PGA composite will be a new device releasing drugs in a controlled manner and having targetability to peritoneum, and this device will be improving the efficacy of intraperitoneal chemotherapy for gastric adenocarcinoma.

이규보의 문학과 풍류사상

노평규 인천가톨릭대학교 출판부 1999 누리와 말씀 Vol.- No.5

위암환자의 복강내에 투여한 Mitomycin C-Carbon Particle의 Mitomycin 용출에 관한 연구

노승무,조영훈,정경수,오정연,김진향,양준묵,강대영,송규상,조준식,최선웅,이진호,민병무,김용백,김창식,박근성,인현빈,정현용,김학용 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Locoregional recurrence is the most common type of recurrence in surgical operation of gastric adenocarcinoma, and peritoneal dissemination is one of the most difficult problems in advanced gastric adenocarcinoma treatment. Because the peritoneal cavity is the most common site of the first recurrence after gastric cancer resection, intraperitoneal chemotherpy seems a logical choice for cancer chemotherapy. The Mitomycin C(MMC) adsorbed by the activated charcoal particles(CH) is relatively released when the drug concentration surrounding the carbon particles becomes low in the peritoneum of the peritoneal cavity. For the intraperitoneal chemotherapy on the advanced gastric adenocarcnoma, mitomycin C adsorbed on activated carbon particles was administered in the peritoneal cavity just before abdominal wall closure. The closed drainage tubes were inserted in the peritoneal cavity and clamped for tuo hours after completion of operation. MMC concentrations were serially measured in peritoneal fluid, plasma and urine at 2hour, 48 hour, 72 hour and 168 hour following its administration in order to study the efficacy of the MMC-CH as a drug delivery system. There were minimal toxicities in born marrow, liver, and gastrointestinal system after intraperitoneal MMC-CH administration. The data of this study suggested that MMC-CH may have a somewhat more beneficial effect than surgery alone when administered in optimal dose and schedules, but the MMC concentration of the peritoneal fluid was not sufficient to eradicate remnant cancer cells, and effective duration of maintenance was only below 24 hours in the peritoneal fluid and plasma.

부유대역 용융응고법으로 제조된 YBa_2Cu_3O_x 산화물초전도체의 미세구조와 전기적 특성

노태형,송정환,장규철,한이섭,김소정,구본급,김호기 대전산업대학교 반도체기술연구소 2000 半導體技術硏究所報 Vol.2 No.-

The YBa_2Cu_3O_x-20 wt% Y_2BaCuO_5 composition designed in YBCO system was synthesized by solid state reaction method. The optimum condition of hot zone temperature and growth rate in floating-zone melt were 1080 ℃ and 2.5 mm/hour, respectively. In samples growth as these condition, the low angel boundaries in grain direction and small amount of amorphous phase known as decreasing characteristics of superconducting materials between grain boundaries in microstructure are investigated by polarized light microscopy on the whole. The critical current density(Jc) at 77k of sample using powder fabricated with no CeO_2 and doped 5 wt%CeO_2 were 8,000 A/㎠(Jc : 561A) and 12,000 A/㎠(Jc: 826A) at 0 T by direct current transport method, respectively.

위전절제시 단순공장간치술의 임상적 의의

노승무,배진선,정현용,이병석,조준식,신경숙,송규상,이태용 충남대학교 암공동연구소 2003 암공동연구소 업적집 Vol.3 No.

Purpose: The aim of this study was to evaluate the short-term outcome of a jejunal interposition, by comparing it with a conventional Roux-en-Y gastrojejunostomy, after a total gastrectomy. Materials and Methods: For 28 patients (20 men and 8 women) with a gastric adenocarcinoma, who underwent an isoperistaltic simple jejunal interposition, weight, hemoglobin, hematocrit, serum protein and albumin, and cholesterol levels were checked before the operation and at 1 year and 2 years after the surgery. Also, endoscopy was performed to confirm reflux esophagitis. In this study, the data were collected between January 1993 and July 1999 at Chungnam National University Hospital, and the results were compared with those of the Roux-en-Y procedure. Results: The body weights at 1 year and 2 years after the surgery had returned to 86.0% and 87.6% of the recent original body weight in the jejunal interposition (Jl) group and to 90.8%, 87.0%, respectively in the Roux-en-Y (RY) group. The levels of hemoglobin (g/dl) were 13.3, 12.5, and 11.9 in the Jl group, and 13.8, 12.6, and 12.1 in the RY group at the time of the operation and at 1 year, and 2 years after the surgery, respectively. The total serum protein (g/dl) levels were 7.1, 7.2, and 7.5 in the Jl group and 7.1, 7.0, and 7.2 in the RY gropu at the time of the operation and at 1 year and 2 years after the surgery, respectively. The serum albumin (g/dl) levels were 4.2, 4.1, and 4.2 in the Jl group and 4.2, 4.2, and 4.2 in the RY group at the time of the operation and at 1 year, and 2 years after the surgery, respectively. The total serum cholesterol (mg/dl) levels were 186.5, 174, and 164 in the Jl group and 213.7, 171.1, and 141.0 in the RY group at the time of the operation and at 1 year and 2 years after the surgery, respectively. The endoscopic finding showed that reflux esophagitis occurred in 7.1% of the patients in the Jl group and in 3.5% in the RY group. Conclusion: We think that from the view point of quality of life, a jejunal interposition, as well as a Roux-en-Y procedure, is a useful reconstruction methods for a total gastrectomy. (J Korean Gastric Cancer Assoc 2001;1:210-214)

위전절제시 단순공장간치술의 임상적 의의

노승무,배진선,정현용,이병석,조준식,신경숙,송규상,이태용 충남대학교 암연구소 2003 암연구소 업적집 Vol.3 No.-

Purpose: The aim of this study was to evaluate the short-term outcome of a jejunal interposition, by comparing it with a conventional Roux-en-Y gastrojejunostomy, after a total gastrectomy. Materials and Methods: For 28 patients (20 men and 8 women) with a gastric adenocarcinoma, who underwent an isoperistaltic simple jejunal interposition, weight, hemoglobin, hematocrit, serum protein and albumin, and cholesterol levels were checked before the operation and at 1 year and 2 years after the surgery. Also, endoscopy was performed to confirm reflux esophagitis. In this study, the data were collected between January 1993 and July 1999 at Chungnam National University Hospital, and the results were compared with those of the Roux-en-Y procedure. Results: The body weights at 1 year and 2 years after the surgery had returned to 86.0% and 87.6% of the recent original body weight in the jejunal interposition (Jl) group and to 90.8%, 87.0%, respectively in the Roux-en-Y (RY) group. The levels of hemoglobin (g/dl) were 13.3, 12.5, and 11.9 in the Jl group, and 13.8, 12.6, and 12.1 in the RY group at the time of the operation and at 1 year, and 2 years after the surgery, respectively. The total serum protein (g/dl) levels were 7.1, 7.2, and 7.5 in the Jl group and 7.1, 7.0, and 7.2 in the RY gropu at the time of the operation and at 1 year and 2 years after the surgery, respectively. The serum albumin (g/dl) levels were 4.2, 4.1, and 4.2 in the Jl group and 4.2, 4.2, and 4.2 in the RY group at the time of the operation and at 1 year, and 2 years after the surgery, respectively. The total serum cholesterol (mg/dl) levels were 186.5, 174, and 164 in the Jl group and 213.7, 171.1, and 141.0 in the RY group at the time of the operation and at 1 year and 2 years after the surgery, respectively. The endoscopic finding showed that reflux esophagitis occurred in 7.1% of the patients in the Jl group and in 3.5% in the RY group. Conclusion: We think that from the view point of quality of life, a jejunal interposition, as well as a Roux-en-Y procedure, is a useful reconstruction methods for a total gastrectomy. (J Korean Gastric Cancer Assoc 2001;1:210-214)