• 제목/요약/키워드: Cardia

검색결과 91건 처리시간 0.02초

식도암의 임상적 고찰 [III] (Cancer of the Esophagus and Cardia [III]: A Clinical Review of 55 cases)

  • 이강식
    • Journal of Chest Surgery
    • /
    • 제23권5호
    • /
    • pp.922-928
    • /
    • 1990
  • Treatment of patients with esophageal carcinoma remains disappointing. Fewer than 20% *of patients with esophageal carcinoma treated with curative intent by surgery and radiation therapy will be alive at 5 years. Fifty five patients underwent treatment for carcinoma of the esophagus and cardia which retrospective clinical study done between January 1983, and December, 1989 in Department of Thoracic and Cardiovascular Surgery, National Medical Center, Seoul, Korea. There were 48 men. 7 women and the mean age was 56.2 years[range, 38 to 78 years]. The most frequent preoperative findings included dysphagia[46 cases], weight loss[33 cases] and substernal pain[19 cases]. 19 cases[34.5%] were underwent resectional surgery, which was total esophagectomy with esophagogastrostomy[ 5 cases], with colon interposition[3 cases], lower esophagectomy with esophagogastrostomy [10 cases], with total gastrectomy and esophagojejunostomy [1 case]. The operative mortality was 15.8%[3/19] and causes of death were respiratory failure in 2 cases, and 1 case of sepsis. Palliative procedures, such as feeding gastrostomy and jejunostomy[14 cases], bypass surgery without resection[ 4 cases], radiation therapy[ 3 cases] were done.

  • PDF

간합이론(干合理論)의 응용 - 장부(臟腑)를 중심으로 - (The Application of Ganhap(干合) Theory -Focused on Viscera and Bowels-)

  • 조용주;김진주
    • 대한한의학원전학회지
    • /
    • 제23권2호
    • /
    • pp.15-31
    • /
    • 2010
  • Objectives : The aim of this study was to understand application of Ganhap(干合) theory to human body. Methods : We investigated 5 important sphincters along the alimentary tract (Larynx, Pharynx, Cardia, Pyrolus, Iliocecal portion) comparing with the function of Viscera and Bowels, also with Meridian and collateral theory. Results & Conclusions : We can analyze 5 important sphincters along the alimentary tract into relationship of Ganhap. 1. Larynx are related with the combination of Byeong-Sin(丙辛合). 2. Pharynx are related with the combination of Jeong-Im(丁壬合). 3. The Cardia is related with the combination of Mu-Gyu(戊癸合). 4. The Pyrolus is related with the combination of Gap-Gi(甲己合). 5. Ileocecal portion is related with the combination of Eul-Gyeong(乙庚合).

Clinical and Histological Indicators of Proximal and Distal Gastric Cancer in Eight Provinces of Iran

  • Norouzinia, M.;Asadzadeh, H.;Shalmani, H. Mohaghegh;Al Dulaimi, D.;Zali, M.R.
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제13권11호
    • /
    • pp.5677-5679
    • /
    • 2012
  • Background and Aim: Gastric cancer is the second most common cancer worldwide. In this study the clinical and histological features of gastric cancer in the cardia and distal stomach were evaluated. Method: Proximal and distal gastric cancer diagnosed and treated in eight provinces of Iran from 2010-2011 were reviewed in all collected cases. The age standardized incident rates were calculated and tumor location and histological type were recorded. Results: The age-standardized incidence rate for the eight centers was 40.6 per 100,000 populations per year with an upper and lower range of 22.1 and 102.4 per 100,000 population per year. Thirty four percent of the tumors were located in the cardia, 3% in fundus, and 63% in the distal stomach. In 7 provinces the prevalence of distal tumors was significantly greater than proximal tumors (p=0.006). A significant relationship was observed between diffuse form of gastric cancer and distal gastric tumors (p=0.007) and between poor tumor differentiation and distal gastric tumors (p<0.001). Conclusions: the result of this study shows that distal gastric cancer is more common than proximal gastric cancer in Iran.

중,하부 식도및 분문에 발생한 식도 종양의 위장을 이용한 식도재건술의 외과적 치험 (The surgical experiences of esophageal reconstruction with stomach at the middle and lower esophageal and cardia cancer)

  • 강경민;박재홍
    • Journal of Chest Surgery
    • /
    • 제29권6호
    • /
    • pp.626-631
    • /
    • 1996
  • The forty patients with carcirLoma of the esophagus or cardia seen at National Medical Center between November 1983 and April 1994 underwent surgical exploration. The esophagogastrectomy was carried out in 29 of 40 patients, one case through right thoracotomy, the others through left thoracotomy. Two patients underwent colon bypass surgeries due to upper esophageal cancer Transhiatal esop agectomy was performed In one case. Feeding gastrostomy or feeding jejunostomy were performed in 8 patients due to the advanced stage or malnutrition. In this report, we evaluated the long-term results in the 28 patients who underwent esophagogastrectomy for palliation through the left thoracotomy. There were 25 men(89%) and 3 women(11 %), and the mean age was 58.65$\pm$7.15 years(range, 46 to 73 years). The most frequent preoperative symptoms included dysphagia (22), weight loss (15), chest pain (6), vomiting (1), and hoarsness (1). Twenty-three patients had sqamous cell cancers of mid-and lower esophagus and five adenocarcionomas of cardia. One patient died in the hospital within 30 days of the op- eration for a hospital mortality rate of ).7%, Cause of death was sepsis due to anastomotic leakage. There were five additional complications in five patients; acute respiratory distress syndrome (1), post-op- erative bleeding (1), diaphragmatic hernia (1), acute renal failure (1) and late raft stenosis (1). The one year, 1틴o years, and three years acturial survival rate were 75.6$\pm$9.5%, 43.2$\pm$ 11.6%, 21.6: 10.5$\circledcirc$ re- spectively. The average survival was 21.8 months. The data from this study suggest that esophagogastrectomy through the left thoracotomy can achieve resonable long-term palliation for carci- noma of the esophagus. The operation can be performed with a low operative mortality and few serious postoperative complications.

  • PDF

Adverse Events in Total Artificial Heart for End-Stage Heart Failure: Insight From the Food and Drug Administration Manufacturer and User Facility Device Experience (MAUDE)

  • Min Choon Tan;Yong Hao Yeo;Jia Wei Tham;Jian Liang Tan;Hee Kong Fong;Bryan E-Xin Tan;Kwan S Lee;Justin Z Lee
    • International Journal of Heart Failure
    • /
    • 제6권2호
    • /
    • pp.76-81
    • /
    • 2024
  • Background and Objectives: Real-world clinical data, outside of clinical trials and expert centers, on adverse events related to the use of SyncCardia total artificial heart (TAH) remain limited. We aim to analyze adverse events related to the use of SynCardia TAH reported to the Food and Drug Administration (FDA)'s Manufacturers and User Defined Experience (MAUDE) database. Methods: We reviewed the FDA's MAUDE database for any adverse events involving the use of SynCardia TAH from 1/01/2012 to 9/30/2020. All the events were independently reviewed by three physicians. Results: A total of 1,512 adverse events were identified in 453 "injury and death" reports in the MAUDE database. The most common adverse events reported were infection (20.2%) and device malfunction (20.1%). These were followed by bleeding events (16.5%), respiratory failure (10.1%), cerebrovascular accident (CVA)/other neurological dysfunction (8.7%), renal dysfunction (7.5%), hepatic dysfunction (2.2%), thromboembolic events (1.8%), pericardial effusion (1.8%), and hemolysis (1%). Death was reported in 49.4% of all the reported cases (n=224/453). The most common cause of death was multiorgan failure (n=73, 32.6%), followed by CVA/other non-specific neurological dysfunction (n=44, 19.7%), sepsis (n=24, 10.7%), withdrawal of support (n=20, 8.9%), device malfunction (n=11, 4.9%), bleeding (n=7, 3.1%), respiratory failure (n=7, 3.1%), gastrointestinal disorder (n=6, 2.7%), and cardiomyopathy (n=3, 1.3%). Conclusions: Infection was the most common adverse event following the implantation of TAH. Most of the deaths reported were due to multiorgan failure. Early recognition and management of any possible adverse events after the TAH implantation are essential to improve the procedural outcome and patient survival.

국소 진행된 Type II 분문부 선암의 절제연 확보를 위한 수술 방법: 좌측 대장 간치술 (Surgical Option for Sufficient Safety Margine in Locally Advanced Type II Cardia Cancer - Left Colon Interposition)

  • 윤호영;김형일;이상훈;김충배
    • Journal of Gastric Cancer
    • /
    • 제8권2호
    • /
    • pp.97-103
    • /
    • 2008
  • 목적: 분문부 위선암의 치료는 아직까지는 근치적 수술이 원칙이고 특히 식도 침윤을 갖는 type II 분문부 위선암은 충분한 절제연을 확보하기 위한 노력이 필요하다. 식도 침윤정도에 따라서 개흉과 개복을 통해 식도-위 절제를 하고 식도 대체술을 하는데, 그 중 저자들은 대장간치의 적응과 치료성적 등을 함께 알아 보고자 하였다. 대상 및 방법: 1994년 1월부터 2006년 12월까지 연세대학교 의과대학 외과학 교실에서 저자에게 위암으로 수술을 받은 1,087명의 환자 중 type II 분문부 위선암으로 좌 또는 우 흉복부 개복과 경복부 절개(경열공)를 이용해 근치적 식도-위절제술을 하고 식도 대체술로 좌측 대장을 간치한 환자 10예를 대상으로 같은 type으로 Roux-en-Y를 받은 환자들과 후향적으로 비교 분석 하였다. 결과: 남녀가 각각 9명, 1명 이었고 중간 연령은 52.5세(16~72세), 수술시간은 $449.00{\pm}87.39$ (SD)분이었고 평균 재원일수는 $20.60{\pm}6.73$ (SD)일이었다. 식도-위 동시성암은 1예가 있었고, 종양으로부터 근위부 절제연까지의 거리는 $6.56{\pm}3.65cm$였으며 종양의 크기는 $9.90{\pm}3.97cm$였는데 Roux-en-Y군의 값들과 차이를 보였다(sex and age matched analysis, P=0.019, P=0.046). 수술 사망은 없었고, 술 후 합병증은 2예가 있었는데 각각 문합부 협착과 폐기흉이었다. 사망은 총 4예가 있었고 수술 후 환자 대부분(83%)은 체중이 늘어 체중증가가 최대 16 kg까지 있었다. 결론: 식도 침윤을 하는 type II 분문부 위암에서 크기가 매우 큰 경우는 근치적 식도-위 절제술이 필요하다. 식도 대체 장기로는 좌측 대장을 이용 할 수 있는데 수술 시간이 길지만, 근치적 수술에 유리하고 식도-공장 문합술에 비해 수술 합병증이 많지는 않아, 재건술로 좌측 대장을 이용하는 방법도 가치가 있다고 생각한다.

  • PDF

Interleukin-10 Gene Promoter Polymorphisms and Risk of Gastric Cancer in a Chinese Population: Single Nucleotide and Haplotype Analyses

  • Pan, Xiong-Fei;Yang, Shu-Juan;Loh, Marie;Xie, Yao;Wen, Yuan-Yuan;Tian, Zhi;Huang, He;Lan, Hui;Chen, Feng;Soong, Richie;Yang, Chun-Xia
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제14권4호
    • /
    • pp.2577-2582
    • /
    • 2013
  • Objectives: Interleukin (IL) -10 is a potent cytokine with a dual ability to immunosuppress or immunostimulate. We aimed to explore the association of IL10 promoter polymorphisms with risk of gastric cancer (GC) in a Han population in Southwestern China. Methods: We enrolled 308 pairs of GC and control subjects from four hospitals and a community between October 2010 and August 2011 in a 1:1 matched case-control design. Demographic information was collected using a designed questionnaire. IL10-592 A>C and IL10-1082 A>G polymorphisms were determined by Sequenom MassARRAY analysis. Results: Patients with GC reported statistically higher proportions of family history of cancer (29.9% versus 10.7%, P<0.01) and alcohol drinking (54.6% versus 43.2%, P<0.01) than did controls. Similar results were observed in comparison between non-cardia GC patients and controls (P<0.01 and P=0.03). Variant genotypes of IL10-592 A>C and IL10-1082 A>G were not associated with overall GC risk (adjusted OR, 0.94, 95% CI, 0.66-1.33; adjusted OR, 1.00, 95% CI, 0.62-1.60). Sub-analysis showed that the IL10-592 AC/CC variant genotype was associated with decreased non-cardia GC risk (adjusted OR, 0.58; 95% CI, 0.36-0.95). No association was found between any of the IL10 haplotypes established from two polymorphisms and risk of non-cardia GC. Conclusions: In conclusion, our data do not link the two SNPs of IL10-592 and IL10-1082 with overall GC risk. We demonstrate that IL10-592 polymorphism is associated with protective effect against non-cardia GC. Our findings may offer insight into risk associated with the development of GC in this region.