• Title/Summary/Keyword: Small-bowel

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Clinical Observations on Treatment for Chinese Patients with Gastrointestinal Stromal Tumors

  • He, Zhan-De;Huang, Xin-En;Zhou, Jian-Nong
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.12
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    • pp.5111-5113
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    • 2015
  • Background: To investigate the diagnostic and treatment methods for Chinese patients with gastrointestinal stromal tumor (GIST). Materials and Methods: From January 2004 to June 2014, patients diagnosed with primary GIST and treated by a single medical team in the Department of Digestive Disease of XuYi Hospital of Traditional Chinese Medicine were retrospectively recruited. Re-examination and follow-up was conducted regularly and abdominal enhanced CT, blood biochemistry and responses to surgery or imatinib were recorded. Results: A total of 15 patients were enrolled, including 9 male and 6 female patients, with an average age of 54 years (ranging from 32-81 years). The primary symptoms were abdominal uncomfortable in 5 patients, abdominal pain in 6 patients as well as nausea and vomiting in 4 patients. One patient was diagnosed with bowl obstruction at the first visit. All patients were treated with surgery, and tumor site was confirmed 1 esophagus, 6 stomach, 4 small bowel, and 4 colorectal and all patients were pathologically diagnosed with GIST. Immunochemical test positive for CD 117 was found 12 patients, and positive for CD 34 in7 patients. The median follow-up time was 24 months (range of 3-63). Three metastasis were confirmed 1.5, 2 and 2.6 years postoperatively. Three patients were treatment by imatinib postoperatively. Conclusions: Surgery remains the main treatment method for Chinese patients with GIST and imatinib could be feasible and safe for treating Chinese patients with GIST.

The Risk Factors of Osteoporosis in Korean Postmenopausal Women (폐경기 이후 여성의 골다공증 위험요인)

  • Lee, Hea-Young;Bak, Won-Sook
    • Korean Journal of Adult Nursing
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    • v.21 no.3
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    • pp.303-313
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    • 2009
  • Purpose: The purpose of this study was to investigate bone mineral density(BMD) and identify risk factors of osteoporosis in Korean postmenopausal women. Methods: The subjects consisted of 328 women. The BMD of the calcaneus were measured with peripheral dual energy x-ray absorptiometry. The risk factors were collected by a self-report standardized questionnaire. The differences among the osteoporosis, osteopenia, and normal group were compared by one way analysis of variance test, Scheffe's multiple comparison tests and Logistic regression. Results: The average age was 65 years old and the average T-score was 28.7% with osteoporosis. The Risk factors of osteoporosis were inclined by 24% in age (OR = 1.24, CI = 1.16 ~ 1.31), 53% in menarchal age (OR = 1.53, CI = 1.24 ~ 1.88), 3.5 times in vegetarian (OR = 3.52, CI = 1.66 ~ 7.47), 2 times in small-bowel disease (OR = 2.01, CI= 1.03 ~ 3.94), 5.3 times in arthritis (OR = 5.33, CI = 1.61 ~ 17.67), 5.5 times in eating disorder (OR = 5.50, CI = 1.43 ~ 21.17), 6 times in health perception (OR = 6.08, CI = 2.30 ~ 16.06). The Risk factors of osteoporosis were reduced by 10% in weight (OR = 0.90. CI = 0.83 ~ 0.97), and 10% in menopausal age (OR = 0.90. CI = 0.84 ~ 0.98). Conclusion: The risk factors of osteoporosis were in the general characteristics, menstrual history, history of disease, life style & diet, and health perception. Eating disorder and health perception are highest on the risk factor of osteoporosis in Korean postmenopausal women.

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MR Images of Infarction of Wandering Spleen Associated with Intestinal Non-rotation (장 회전 이상과 함께 발생한 부유비장 경색의 자기공명영상에서의 소견: 증례 보고)

  • Kim, Eugene;Kim, Mi Young;Kim, Yeo Ju;Kim, Youn Jeong;Kim, Woo Chul;Suh, Chang Hae;Choi, Suk Jin;Cho, Jae Sung
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.3
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    • pp.253-257
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    • 2014
  • Wandering spleen is a rare clinical condition caused by lax splenic suspensory ligaments. The laxity of ligaments causes torsion of splenic vascular pedicle. CT scan of a 7-year-old girl with abdominal pain showed a non-enhancing lobular mass in lower abdomen. Small bowel loops were located at the right-sided abdomen and colonic loops at the left-sided abdomen. MRI scan showed non-enhancing heterogeneous mass with twisted vascular pedicle. To our knowledge, only a few cases have been reported about wandering spleen diagnosed on MRI.

Acalculous Cholecystitis Following Multiple Trauma with Fractures (골절을 동반한 다발성 외상 환자에서 발생한 비결석성 담낭염)

  • Kim, Ki Hoon;Kyung, Kyu Hyouk;Kim, Jin Su;Kim, Kwan U;Kim, Woon-Won;Kim, Ji Wan
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.203-208
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    • 2012
  • Purpose: The purpose of this study is to investigate the incidence of acalculous cholecystitis after multiple trauma with fractures and to analyze the characteristics of cholecystitis. Methods: We performed a retrospective study of multiple trauma patients with fractures between April 2010 and April 2012. Sixty- nine patients were identified, and the average age was 46.8(range: 15-74) years. Data were collected regarding associated injury, injury severity score (ISS), the diagnosis time after trauma, diagnostic tool, and management Results: There were three cases(4.3%) of cholecystitis among the 69 cases, and cholecystitis was diagnosed an average of 20.7(range: 8-33) days after injury. Two patients complained of abdominal pain at diagnosis, but the other patient who had undergone surgery for small bowel perforation at the time of the injury had no abdominal pain. All three patients had abnormal liver function tests (LFTs) at diagnosis. The cholecystitis was confirmed with ultrasonography or computed tomography, and all cases were acalculous cholecystitis. At first, percutaneous transhepatic gallbladder drainage was performed; then, laparoscopic cholecystectomy (LC) was tried an average of 12(range: 11-13) days later. An laparoscopic cholecystectomy was successfully done in only one case, the other cases being converted to an open cholecystectomy due to severe inflammation. Conclusion: The incidence of acaculous cholecystitis was 4.3% after multiple trauma with fractures. We should consider cholecystitis in patients with abdominal pain, fever and elevated LFTs after multiple trauma.

The Results of Postoperative Radiation Therapy in the Rectal Cancer (직장암의 수술 후 방사선치료성적)

  • Lee Kyung-Ja
    • Radiation Oncology Journal
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    • v.12 no.1
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    • pp.91-98
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    • 1994
  • Purpose: Despite apparently complete resection of cancer of the rectum, local recurrence rate was high. Radiation therapy has been used either alone or in combination with chemotherapy as an adjunct to surgery to reduce the risk of recurrence. This study was designed to evaluate the prognostic factors, survival rate and local recurrence rate of the rectal cancer who had received postoperative radiation therapy by retrospective analysis. Method: From 1982 to 1990, 63 patients with cancer of the rectum surgically staged as B2 or C disease received postoperative adjuvant radiation therapy after curative resection of tumor for cure. Postoperative radiation therapy was given to the whole pelvis(mean dose: 5040 cGy in 5-6weets) and perineum was included in irradiated field in case of abdominoperineal resection. Results: Three-year actuarial survival rate was 73.2$ \% $ overall, 87.7$ \% $ in stage B2+3 and 62.9$ \% $ in stage C2+3. Three-year disease-free survival rate was 69.5$ \% $ overall, 87.7$ \% $ in stage B2+3 and 56.8$ \% $ in stage C2+3, Three-year disease-free survival rate in anterior resection was 77.8$ \% $ and 44.4$ \% $ in abdominoperineal resection. The local recurrence rate was 15.9$ \% $ and distant failure rate was 20.6$ \% $. Severe late complication was small bowel obstruction in 6 patients and surgery was required in 4 patients(6.3$ \% $). The prognostic factors were stage(p=0.0221) and method of surgery(p= 0.0414) (anterior resection vs abdominoperineal resection). Conclusion: This study provides evidence supporting the use of postoperative radiation therapy for reducing the local recurrence rate in patients who have had curative resection of rectal cancer with involvement of perirectal fat or regional nodes or both(stage B2 and C).

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Traumatic Organized Hematoma Mimicking Intra-peritoneal Tumor : A Case Report (복강내 종양으로 오인된 외상성 혈종: 증례보고)

  • Park, Jong-Min;Kim, Seong Yup;Chung, Il Yong;Kim, Woo-Shik;Shin, Yong-Chul;Kim, Yeong Cheol;Park, Sei Hyeog
    • Journal of Trauma and Injury
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    • v.26 no.4
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    • pp.300-303
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    • 2013
  • Blunt abdominal trauma is commonly encountered in the emergency department. The lack of historical data and the presence of distracting injuries or altered mental status, from head injury or intoxication, can make these injuries difficult to diagnose and manage. We experienced a case of traumatic organized hematoma misdiagnosed as intra-peritoneal tumor with intestinal obstruction. A 52-year-old homeless male patient who have chronic alcoholism was admitted via emergency room with infra-umbilical abdominal pain. At admission, he was drunken status and so we could not be aware of blows to the abdomen. He had a unknown large operation scar on mid abdomen. A computed tomography (CT) scan showed the intestinal obstruction of the ileum level with 5.5cm sized mesenteric tumor. We performed adhesiolysis and widely segmental resection of small bowel including tumor with side-to-side anastomosis due to great discrepancy in size. He stated later that he was a victim of the violence before 3 weeks. A final pathologic report revealed well encapsulated, traumatic mesenteric hematoma with organizing thrombi, ischemia and abscess formation with multiple adhesion bands. Finally, the patient was discharged without complications on postoperative day 14.

A Case of Successful Endoscopic and Conservative Treatment for Intentional Ingestion of Sharp Foreign Bodies in the Alimentary Tract (고의로 섭취한 커터칼날의 내시경 및 보존적 치료 증례 보고)

  • Park, Jong-Min;Kim, Seong Yup;Chung, Il Yong;Kim, Woo-Shik;Shin, Yong-Chul;Kim, Yeong Cheol;Park, Sei Hyeog
    • Journal of Trauma and Injury
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    • v.26 no.4
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    • pp.304-307
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    • 2013
  • Food bolus impaction is the most common cause of esophageal foreign body obstruction in adults. Other causes include intentional ingestion in psychiatric patients or prison inmates. We experienced successful treatment of a patient with intentional ingestion of multiple sharp foreign bodies(25 cutter and razor fragments). A 47-year-old male patient who was suffering from chronic alcoholism was admitted, via the emergency room, with dysphagia and neck pain. He was suffering from alcoholic liver cirrhosis and psychiatric problems, such as chronic alcoholism, anxiety disorder and insomnia. The patient had intended to leave the hospital after having swallowed the sharp objects. Plain radiographs and computed tomography (CT) scan showed multiple, scattered metal fragments in the esophagus, stomach, and small bowel. We performed emergent endoscopy and successfully removed one impacted blade in the upper esophagus using by a snare with an overtube. The rest of the fragments had already passed through the pylorus, so we could not find them with endoscopy. We checked the patient with simple abdominal radiographs and careful physical examinations every day. All remaining fragments were uneventfully excreted through stool during the patient's 6 day hospital stay. Finally, we were able to confirm the presence of the objects in the stool, and radiographs were negative. The patient was discharged without complications after 14 days hospital stay and then was followed by the Department of Psychiatry.

Surgical Correction of Chronic Hypertropic Pyloric Gastropathy in a Dog (개에서의 만성 비후성 유문 위장애에 대한 수술적 치료)

  • Kim Joon-young;Jeong Soon-wuk;Park Sang-heuk;Yoon Hun-young;Han Hyun-jung;Jang Ha-young;Lee Bo-ra;Kim Gu-yuong
    • Journal of Veterinary Clinics
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    • v.21 no.4
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    • pp.398-401
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    • 2004
  • A ten-year-old, female Yorkshire terrier dog with intermittent vomiting, weight loss, polydipsia and depression was referred to the Veterinary Medical Teaching Hospital of Konkuk University. On the radiological survey, gas and fluid-filled gastric distention was detected. No contrast medium entraneed to the small bowel, in 60 minutes after contrast medium administration. And marked fluid accumulation in gastric body and thickening of the pyloric mucosa were found with ultrasonograph. So gastric obstruction by reason of pyloric stenosis was strongly suspected. At the surgery, hypertrophied mucosa was resected adequately, and Heineke-Mikulicz pyloroplasty was applied. Microscopically the symptom was characterized by gastric mucosa hyperplasia and mild diffuse Iymphoplasmocytic gastritis. So this condition was diagnosed as chronic hypertrophic pyloric gastropathy. Intermittent vomiting and mild depression were shown for 9 days after the operation. After that, the patient was recovered gradually. One month later, the patient had normal appetite and activity without complications.

In vitro Evaluation of Dextran-5-aminosalicylic Acid Conjugate as a Polymeric Colon-specific Prodrug of 5-aminosalicylic Acid

  • Jung, Yun-Jin;Jeon, Hyun-Chu;Choi, Dea-Kyu;Kim, Young-Mi
    • Journal of Pharmaceutical Investigation
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    • v.37 no.1
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    • pp.45-49
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    • 2007
  • Dextran-5-aminosalicylic acid conjugate (dextran-5-ASA) was in vitro-evaluated as a polymeric colon-spe-cific prodrug of 5-aminosalicylic acid (5-ASA). Chemical stability of dextran-5-ASA in the pH 1.2 or 6.8 buffer solutions was investigated at 37 for 6 hrs. The dextran backbone was not degraded and no 5-ASA release was detected. Moreover, dextran-5-ASA neither liberated 5-ASA in the homogenates of the small intestine of rats nor was transported across Caco-2 cell monolayers, suggesting no significant loss of dextran-5-ASA during transit through the upper intestine. Furthermore, incubation of dextran-5-ASA in 10% cecal contents of rats released about 37% and 55% of 5-ASA bound to dextran in 8 hr and 24 hr, respectively. While that with either esterase or dextranase failed to liberate 5-ASA from the polymeric prodrug, incubation of dextran-5-ASA with both esterases and dextranse released 5-ASA up to about 24% of 5-ASA bound to dextran. These results suggest that, after oral administration of dextran-5-ASA, the polymeric prodrug is delivered specifically to and releases 5-ASA in the large intestine, and reveal that the 5-ASA release by cleavage of the ester bond requires precedent depolymerization of the dextran backbone.

A Study of Dose Distribution in Postoperative Radiotherapy in Uterine Cervical Cancer (자궁 경부암의 수술후 방사선 치료에서 선량 분포에 관한 연구)

  • Shin, Sei-One;Kim, Sung-Kyu;Kim, Myung-Se
    • Journal of Yeungnam Medical Science
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    • v.8 no.1
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    • pp.166-177
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    • 1991
  • Uterine cervical cancer is the most common malignancy in korean women. In spite of recent development of early diagnostic and therapeutic modalities, about 40% of treated patient will develop relapse. So more aggressive local treatment such as more extensive surgery and higher radiation dose and administration of systemic chemotherapy will promote the curability but treatment related complications can not be avoidable. We used 22 cases of early cervical cancer, treated with surgery and post-operative radiotherapy, clinical data of these patients were analized to determine relationship between clinical parameters and final outcome. Three out of 22 cases revealed relapse and one patient showed rectovaginal fistula and another patient showed small bowel obstruction and the other patient showed rectal obstruction. Two out of three recurrence were stage IIa and the other one case was stage Ib adenocarcinoma with lymphovascular involvement. Nineteen out of 22 cases were followed without remarkable side effect or treatment related complication or sequelae. We concluded that our treatment policy was safe and effective to eradicate high risk postoperative cervical cancer with acceptable side effects or complication.

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