• 제목/요약/키워드: abdominal

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The Role and Efficacy of Diagnostic Laparoscopy to Detect the Peritoneal Recurrence of Gastric Cancer (복막 전이가 의심되는 위암 환자에서 진단적 복강경 검사의 의의와 역할)

  • Song, Sun-Choon;Lee, Sang-Lim;Cho, Young-Kwan;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • 제9권2호
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    • pp.51-56
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    • 2009
  • Purpose: Peritoneal recurrence has been reported to be the most common form of recurrence of gastric cancer. Peritoneal recurrence can generally be suggested by several types of image studies and also if there is evidence of ascites or Bloomer's rectal shelf. It can be confirmed by explorative laparotomy, but diagnostic laparoscopy is a good alternative method and laparoscopic surgery has also been widely used. We reviewed and analyzed the ability of diagnostic laparoscopy to detect peritoneal recurrence or carcinomatosis, and especially for gastric cancer. Materials and Methods: We performed a retrospective review the 45 gastric cancer patients who were operated via diagnostic laparoscopy between 2004. 2. and 2009. 3. We analyzed the perioperative clinical characteristics and the accuracy of the diagnostic methods. Results: The study groups included 14 patients who had confirmed gastric cancer, but they suspected to have carcinomatosis, and 31 patients who had previously underwent gastric resection, but they suspected to have recurrence. The mean operation time was $44.1\pm26.9$ minutes and the mean postoperative hospital stay was $2.7\pm2.8$ days. There was one case of operation-related complication and no postoperative mortality occurred. The sensitivities for detecting peritoneal recurrence or carcinomatosis were 92.1% for diagnostic laparoscopy, 29.7% for detecting ascites and rectal shelf on the physical examination, 86.5% for abdominal computed tomography, 69.2% for PET CT and 18.8% for CEA. Conclusion: Diagnostic laparoscopy does not require a long operation time or a long hospital stay, and it showed a low complication rate in our study. It has high sensitivity for detecting peritoneal recurrence of gastric cancer. It can be an alternative diagnostic confirmative method and it is useful for deciding on further treatment.

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A Case of Child with Obstructive Sleep Apnea Syndrome Recurred after Adenotonsillectomy (편도 및 아데노이드 절제술 후 재발한 폐쇄성 수면 무호흡 증후군 소아 1례)

  • Kim, Cu-Rie;Kim, Dong-Soon;Seo, Hyun-Joo;Shin, Hong-Beom;Kim, Eui-Joong;Shim, Hyun-Joon;Ahn, Young-Min
    • Sleep Medicine and Psychophysiology
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    • 제15권2호
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    • pp.94-99
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    • 2008
  • The most common cause of obstructive sleep apnea syndrome (OSAS) in childhood is adenotonsillar hypertrophy. Adenotonsillectomy improves the symptoms quite well in most cases. However, some patients could experience the OSAS again after adenotonsillectomy, who might have several risk factors such as incomplete operation, misdiagnosis, combined anatomical malformation, sinusitis or chronic allergic rhinitis, obesity, initial severe OSAS, and early onset OSAS. We report a case of 11-year-old obese boy who presented with snoring for several years. He was obese with body mass index (BMI) of $26.3kg/m^2$ and also found to have fatty liver by ultrasonogram. Initial polysomnography (PSG) showed that he met the criteria of severe OSAS with the apnea-hypopnea index (AHI) of 70.5. He underwent adenotonsillectomy and symptoms improved immediately. Four months later symptoms were relieved with AHI of 0, but 1 year after the adenotonsillectomy he started to complain snoring again and the subsequent PSG results showed that OSAS has relapsed with AHI of 43. Paranasal sinus X-ray and physical examination showed sinusitis and re-growth of adenoid. Obesity was proved not to be a contributing factor because his BMI decreased to normal range ($23.1kg/m^2$) after diet control and regular exercise. Also, liver transaminase was normalized and fatty liver was disappeared on follow-up abdominal ultrasonogram. After treatment of sinusitis, symptoms were relieved with decreased AHI (8.5). This case suggests that simple adenotonsillectomy might not be the end of OSAS treatment in childhood. Patients who had adenotonsillectomy should be followed by subsequent PSG if symptoms recur. It is also important to be aware of risk factors in the recurrent OSAS for the proper intervention according to the cause.

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Effect of Protein and Energy Levels on Performance and Carcass Rate in Cross Bred Chicks (단백질 및 대사 에너지 수준이 유색 육용계의 생산성 및 도체율에 미치는 영향)

  • Na, J.C.;Park, S.B.;Bang, H.T.;Kang, H.K.;Kim, M.J.;Choi, H.C.;Seo, O.S.;Ryu, K.S.;Jang, H.K.;Choi, J.T.
    • Korean Journal of Poultry Science
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    • 제36권1호
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    • pp.23-28
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    • 2009
  • The experiment were protein and metabolizable energy level in performance and carcass rate in cross bred chicks. One day old, 720 male and female cross bred chick were used for the experiments, and 20 chicks were placed at each pen. The energy level of feed was maintained about 2,950, 3,000, 3,050 kcal/kg, and protein content was adjusted about 19, 20, 21% from 0 to 5 weeks and energy level was maintained about 3,100, 3,150, 3,200 kcal/kg, and protein content was adjusted about 17, 18, 19% from the 6 to 10 weeks old of the experiment. At the whole time, ME 3,100 (2,950), 3,150 (3,000) and 3,200 (3,050) kcal/kg treatment groups was not significant difference in weight gain, feed intake, but 3,150 (3,000), 3,200 (3,050) kcal/kg treated groups revealed to show improved feed conversion rate than the group treated with ME 3,100 (2,950) kcal (P<0.05). And CP 17 (19), 18 (20), 19 (21)% treatment groups did not significant difference weight gain and feed intake but CP 19 (21)% treated group wan significant difference feed conversion rate than the CP 17 (19)% treated group (P<0.05). ME level of 3,100 (2,950), 3,150 (3,000), 3,200 (3,050) kcal/kg treatment groups in carcass rate and abdominal fat rate was not signficant difference and protein of 17 (19), 18 (20), 19 (21)% treatment groups after end of experiment. Between ME and CP of dietary was significant appeared to interact at 6~10 weeks (P<0.05).

Clinicopathological Effects of Waterpepper (Persicaria hydropiper) on Ruminants (여뀌섭취가 반추수에 비치는 임상병리학적 영향)

  • Cho Myoung-Rae;Han Hong-Ryul
    • Journal of Veterinary Clinics
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    • 제6권2호
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    • pp.227-259
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    • 1989
  • Waterpepper is a weed which grows on damp soil. especially near swamps, and in shallow water of ponds and ditches. It Is widespread throughout the country In abundant colonies. In the present experiments, possible toxic effects of waterpepper were investigated in ruminants. Pour cows were fed waterpepper ad libitum or by force in the from of green forage, hay and/or powder, 8 goats were administered in the form of methanol extract, and 4 goats, crude juice, into the lumen. Clinical signs were examined as well as urinalysis, hematology, serum chemical analysis, pH/blood gas analysis and chclinesterase activities following administration of waterpepper. Six goats which were administered the methanol extract or crude juice were sacrificed for pathological examinations., In addition to the clini copathological examinations, the chemical constituents of waterpepper were qualitively analyzed from the methanol extract and the Effects of the waterpepper crude juice were examined on the motility of rabbit duodenum and uterus. It is revealed that waterpepper contains steroids, terpenoids, flavonoids, tannin and essential oils in the methanol extract and nitrates in the crude juice. The crude juice of waterpepper relaxed the rabbit uterine and duodenal smooth muscles. The constraction of duodenum by acetylcholine or BaCl$_2$ were partially inhibited by pretreatment of the crude juice. However, the relaxation of duodenum by the crude juice was not blocked by the pretreatments of phenoxybenzamlne, propranolol, cocaine, reserpine and tetrodotoxin. The constituents of waterpepper to evoke elaxation of duodenal smooth muscle were stable to heat. The cows administered waterpepper showed common clinical symptoms such as acrid expression, restlessness, dullness, inappetence, anorexia, severe diarrhea, mild bloat and left displacement of abomasum, while bloody feces was shown in a cow. The goats administered the mothanol extract showed common clinical signs such as acrid expression, restlessness, dullness, inappetence and soft feces, while bloody feces was shown in a goat, A goat adminstered the crude juice showde bloody feces and diarrhea. Respiratory rates and heart beats were increased along with diarrhea in the experimental cows. The erythrocyte counts and MCHC were decreased whereas PCV, MCV and neutrophils were increased in the cows administered waterpepper. In goats administered methanol extract, there were decreases in erythrocytes, PCV and hemoglobin content, and an increase in MCHC. The goats ingester with the crude juice showed negligible changes in hematologic values compared with control group which was administered the same amount of water instead of the crude juice. The contents of serum calcium, Inorganic phosphorus, magnesium, Iron, glucose, cholesterol, total protein, triglycerides and phospholipids were tended to decrease in cows. In goats serum iron, glucose, triglycerides, cholesterol, BUN and phospholipids content were decreased while the content of sodium and chloride were increased after administration of the methamol extract The goats ingested with the crude juice did not show significant changes in serum chemical analysis. Even though there were some pathological findings such as hyperemia in the small intestines and kidneys and swelling of liver parenchymal cells, the values of serum AST, ALT, LDH, alkaline phosphatase, total bilirubin and creatinine did not change significantly. While proteins, hemoglobin and blood were detected in the urine of cows, urine pH, ketone bodies, glucose, bilirubin and urobilinogen content were normal or undetected. There were no significant changes in pH/bolld gas analysis data of cows and cholinesterase activities of plasma and erythrocytes of cows and goats ingested with waterpepper or the methanol extract. It is concluded that waterpepper irritates the gatrointestinal system, causes abdominal pain, relaxes the gastrointestinal smooth muscle and dilatates blood vessels supplied to the system. The irritation and relaxation may lead to abnormal fermentation, maldigestion and malabsorption of nutrients and result in diarrhea, body feces, mild bloat and left displacement of abomasum.

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Clinical Features of Sulfite-Sensitive Asthmatics (설파이트(Sulfite) 과민성 천식 환자의 임상적 특성에 관한 연구)

  • Cho, Young-Soo;Baik, Su-Hum;Park, Hae-Sim;Rhu, Nam-Soo;Cho, Dong-Ill;Kim, Jae-Won
    • Tuberculosis and Respiratory Diseases
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    • 제39권2호
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    • pp.159-166
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    • 1992
  • Background:Sulfiting agents are widely used as preservatives and antioxidants in foods, beverages and drugs including bronchodilators. There have been reports of sulfite-related reactions such as anaphylaxis, urticaria, angioedema, abdominal discomfortness as well as bronchospasm. Several investigators reported that sulfite-sensitive asthmatic patients comprised from 3.9% to 8.2% of all asthmatic patients and its prevalence was higher in steroid-dependent group than in steroid-independent group. Subjects and Method:We performed oral provocation test with sodium bisulfite and aspirin in 17 asthmatic patients who have experienced aggravation of their symptoms after administration of drugs or foods. All of them were steroid dependent asthmatics. We observed clinical symptoms and steroid requirements from 1 to 18 months. Result:Ten of them showed severe bronchoconstriction after the ingestion of sodium bisulfite (50 to 200 mg) within 30 minutes. Concurrent aspirin intolerance was noted by oral provocation test in four cases (40%). Three of them showed positive responses on skin prick test with sulfite (10 or 100 mg/ml). Mean total eosinophil counts was $844/mm^3$ at asthmatic attack. And there was no significant responses on skin prick test and IgE-RAST to common inhalant allergens. After complete avoidance from sulfite containing foods and drugs as well as antiasthmatic medication for 1 to 18 months, nine of them (90%) could stop or reduce the steroid requirements. ConcIusion:It was suggested that severe steroid dependent and intrinsic type of asthmatic patients should be evaluated for sulfite-sensitivity.

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The Predcitors of the Development of Acute Respiratory Distress Syndrome in the Patients with Acute Pancreatitis (급성 췌장염으로 내과계 중환자실에 입원한 환자들의 급성호흡곤란 증후군 발생에 연관된 인자에 관한 연구)

  • Yoo, Mi-Ran;Koh, Youn-Suck;Lim, Chae-Man;Lee, Moon-Gyu;Lee, Hong-Jae;Lee, Moo-Song;An, Jong-Jun;Lee, Sung-Koo;Kim, Myung-Hwan;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • 제44권4호
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    • pp.861-870
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    • 1997
  • Background : Though acute respiratory distress(ARDS) often occurs in the early stage of severe acute pancreatitis and significantly contributed to the mortality of the condition, the characteristics of the group who develops ARDS in the patients with acute pancreatitis have not been fully found. The objective of this investigation was to identify predictable factors which distinguish a group who would develop ARDS in the patients with acute pancreatitis. Method : A retrospective analysis of 94 cases in 86 patients who were admitted the Medical Intensive Care Unit with acute pancreatitis was done. ARDS were developed in 13 cases among them (13.8%). The possible clinical factors related to the development were analyzed using univariate analysis and $x^2$-test. Results : The risk of ARDS development was increased in the patients with abonormal findings of chest X-ray at admission compared to the patients with normal chest X-ray (p<0.05). The risk was also increased according to the sevecrity index score in abdominal computed tomography at the time of admission (p<0.05). The higher APACHE III score of the first day of admission, the more risk increment of ARDS development was observed (p<0.01). Patients with more than one points of Murray's lung injury score showed higher risk of ARDS compared to the patients with 0 points of that. The patients with sepsis and the patients with more than three organ dysfunction at admission had 3.5 times and 23.3 times higher risk of the development of ARDS compared to the patients without sepsis and without organ failure in each (p<0.05, p<0.01). Conclusion : The risk of ARDS development would be higher in the acute pancreatitis patients with abnormal chest X-ray, higher CT severity index, higher APACHE III or Murray's lung injury score, accompanying sepsis, and more than three organ failure at admission.

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Single and 14-Day Repeated Oral Toxicity Studies of 70% Ethanol Extract of Lindera Obtusiloba Blume Leaves (생강나무(Lindera obtusiloba Blume) 잎 70% 에탄올 추출물의 단회와 14일 반복투여 독성시험의 안전성 평가)

  • Hong, Chung-Oui;SeoMun, Young;Koo, Yun-Chang;Nam, Mi-Hyun;Lee, Hyun-Ah;Kim, Ji-Hoon;Wang, Zeng;Yang, Sung-Yong;Lee, Sung-Hee;No, Su-Hwan;Lee, Kwang-Won
    • Journal of the Korean Society of Food Science and Nutrition
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    • 제38권10호
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    • pp.1324-1330
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    • 2009
  • Lindera obtusiloba Blume (LO), which is widely distributed in Korea, Japan and China, has traditionally been used as a popular folk medicine for the treatment of fever, abdominal pain, bruise and extravation. The purpose of this study was to examine the toxicities of the single and 14-day repeated doses in Sprague-Dawley rats orally administrated with LO at doses of 0, 500, 1000, 2000 (14-day repeated toxicity test) and 5000 (single toxicity test) mg (dry weight)/kg of body weight/day. The results showed that there was no difference in body weight change, food intake, water consumption, or organ weight among different dose groups. Also we observed no death and abnormal clinical signs during the experimental period. Between the groups orally administered LO and the control group, there was no statistical significance in hematological test or serum biochemical values. There were no evidences of histopathological alteration as well as abnormal gross finding mediated by single and 14 days treatments with LO. These results suggest that no observed adverse effect level (NOAEL) of the oral application of LO was considered to be more than 2000 mg/kg in rats under the conditions employed in this study.

Evaluation of Radiation Dose for Dual Energy CBCT Using Multi-Grid Device (에너지 변조 필터를 이용한 이중 에너지 콘빔 CT의 선량 평가)

  • Ju, Eun Bin;Ahn, So Hyun;Cho, Sam Ju;Keum, Ki Chang;Lee, Rena
    • Progress in Medical Physics
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    • 제27권1호
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    • pp.31-36
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    • 2016
  • The paper discusses radiation dose of dual energy CT on which copper modulation layer, is mounted in order to improve diagnostic performance of the dual energy CT. The radiation dose is estimated using MCNPX and its results are compared with that of the conventional dual energy CT system. CT X-ray spectra of 80 and 120 kVp, which are usually used for thorax, abdominal, head, and neck CT scans, were generated by the SPEC78 code and were used for the source specification 'SDEF' card for MCNPX dose modeling. The copper modulation layer was located 20 cm away from a source covering half of the X-ray window. The radiation dose was measured as changing its thickness from 0.5 to 2.0 mm at intervals of 0.5 mm. Since the MCNPX tally provides only normalized values to a single particle, the dose conversion coefficients of F6 tally for the modulation layer-based dual energy CBCT should be calculated for matching the modeling results into the actual dose. The dose conversion coefficient is $7.2*10^4cGy/output$ that is obtained from dose calibration curve between F6 tally and experimental results in which GAFCHORMIC EBT3 films were exposed by an already known source. Consequently, the dose of the modulation layer-based dual energy cone beam CT is 33~40% less than that of the single energy CT system. On the basis of the results, it is considered that scattered dose produced by the copper modulation layer is very small. It shows that the modulation layer-based dual energy CBCT system can effectively reduce radiation dose, which is the major disadvantage of established dual energy CT.

Feeding Introlerance Due to Allergic Enterocolitis in Very Low Birth Weight Infants (극소 저체중 출생아에서 식이 불내성을 임상적 특징으로 하는 알레르기성 장염)

  • Ko, Yu-Mi;Kim, Jin-Kyu;Ahn, So-Yoon;Yoo, Hye-Soo;Jeon, Ga-Won;Kim, Eun-Sun;Chang, Yun-Sil;Park, Won-Soon
    • Neonatal Medicine
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    • 제18권2호
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    • pp.204-210
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    • 2011
  • Purpose: Feeding intolerance is common in very low birth weight infants(VLBWI); however, research on the etiology is limited. We investigated the incidence of allergic enterocolitis (AEC) as a cause of feeding intolerance and present the clinical characteristics of VLBWIs. Methods: The medical records of VLBWIs admitted to the neonatal intensive care unit of Samsung Medical Center between January 2009 and July 2010 were retrospectively analyzed. AEC was defined as patients who had feeding intolerance with eosinophila and who responded to hypoallergenic feeding intervention. Feeding intolerance symptoms included blood tinged stools, abdominal distension, residual feeding and regurgitation. Eosinophilia was defined as an eosinophil count ${\geq}$700 cells/$mm^3$. Patients with feeding intolerance were divided into the AEC or non-AEC group. Results: Of the 181 patients, 161 (88.9%) had a feeding intolerance, and 119 (65.7%) had eosinophilia. Seventeen infants were diagnosed with AEC. No difference in mean gestational age, birth weight, antibiotics duration, TPN duration, hospitalization, or symptom onset day was observed between patients with AEC and non-AEC patients. The percentage of eosinophilia was significantly higher in patients with AEC than in non-AEC patients. Two patients (12%) improved with restricted breast milk, 10 patients (59%) with extensively hydrolyzed formula and five patients (29%) with free amino acid-based formula. Conclusion: Our results suggest that AEC should be considered in VLBWIs who have clinical features of feeding intolerance and eosinophilia. An aggressive increase in feeding would be possible through feeding intervention in VLBWIs with feeding intolerance.

Gallbladder Ejection Fraction Using $^{99m}Tc$-DISIDA Scan in Diabetic Autonomic Neuropathy (당뇨병성 자율 신경병증에서 $^{99m}Tc$-DISIDA를 이용한 담낭 배출율에 관한 연구)

  • Kim, Seong-Jang;Kim, In-Ju;Kim, Yong-Ki;An, Jun-Hyup;Yoo, Seok-Dong
    • The Korean Journal of Nuclear Medicine
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    • 제34권1호
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    • pp.55-61
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    • 2000
  • Purpose: We performed this study to evaluate the changes of gallbladder ejection fraction (GBEF) in diabetic patients with or without autonomic neuropathy. Materials and Methods: This study included 37 diabetic patients (25 women, 12 men, mean age 51 years) and 24 normal controls (10 women, 14 men, mean age 38 years). After intravenous injection of 185 MBq of $^{99m}Tc$-DISIDA, serial anterior abdominal images were acquired before and after fatty meal. Regions of interest were applied on gallbladder and right hepatic lobe on 60 and 90 minute images to calculate GBEF. Results: GBEF was significantly reduced in diabetes with autonomic neuropathy ($43{\pm}12.3%$) and without autonomic neuropathy ($57.5{\pm}13.2%$) compared with normal controls ($68{\pm}11.6%$, p<0.05). And also, GBEF was significantly reduced in diabetes with autonomic neuropathy compared with diabetes without autonomic neuropathy (p<0.05). Fasting blood glucose level, age, sex, hemoglobin Alc, body mass index, serum lipid level were not different in these two diabetic patient groups (p>0.05). When 50.2% of GBEF was used as the criteria for diabetic autonomic neuropathy, the sensitivity and specificity were 80%, 76.5%, respectively. The area under receiver operating characteristic curve was 0.846. Conclusion: GBEF of diabetic patients with autonomic neuropathy was significantly reduced than that of diabetic patients without autonomic neuropathy.

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