• 제목/요약/키워드: Upper gastric cancer

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Unusual Tc-99m MDP Uptake in the Keloid Developed after Subtotal Gastrectomy

  • Lim, Seok-Tae;Park, Soon-Ah;Sohn, Myung-Hee;Yim, Chang-Yeol
    • 대한핵의학회지
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    • 제34권5호
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    • pp.436-437
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    • 2000
  • A 63-year-old male who had subtotal gastrectomy for early gastric cancer three months ago underwent Tc-99m bone scintigraphy for the evaluation of skeletal metastases. He had no symptoms such as fever, tenderness, or wound discharge. On physical examination, the surgical scat along the midline of the upper abdomen had keloid formation and there was no radiographic evidence of calcification. Bone scintigraphy (Fig. 1A & 1B) demonstrated all unusual linear increased uptake along the midline of the upper abdomen that corresponded to the,skin incision for subtotal gastrectomy. Usually, an incisional scar will not be visualized in Tc-99m methylene diphosphate (MDP) scintigraphy beyond two weeks after surgery.$^{1)}$ Upon reviewing the literature, there were only a few reports where localization of Tc-99m MDP in surgical scars were found two months after surgery.$^{2)}$ It was also reported that a few cases with Tc-99m MDP uptake in the keloid scar developed after surgery. Although there are several potential mechanisms that may explain the uptake of Tc-99m MDP in scar tissue, the primary mechanism in older scars is suggested to be a result of pathological calcification.$^{2)}$ Siddiqui et al$^{3)}$ suggested it could be due to microscopic calcification in small resolving hematomas. However, the primary mechanism in keloid scar is not well-known. We should obtain oblique or lateral views to differentiate the uptake in healing surgical scars from the artifactual uptake.

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Factors Associated with Helicobacter Pylori Infection, Results from a Developing Country-Pakistan

  • Valliani, Arif;Khan, Fazal;Chagani, Bilawal;Khuwaja, Ali Khan;Majid, Syed;Hashmi, Syed;Nanji, Kashmira;Valliani, Salimah
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권1호
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    • pp.53-56
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    • 2013
  • Background: It is known that blood group antigens are related to the development of peptic ulcer and gastric carcinoma. Infections due to H. pylori are most widespread among the developing regions due to poor standard of public health. This study sought to determine the association of H. pylori with ABO blood groups, age, gender, and smoking status among inpatients at a public sector hospital in Karachi. Materials and Methods: A cross-sectional study was conducted at endoscopy suite at a public sector hospital in Karachi in the year 2011. All the symptomatic patients coming for upper GIT endoscopy were included in this study. Results: Biopsy for histopathology was taken from 93 patients, with an age range from 15-65 years. Age group of 15 to 20 years was found to be associated with H. pylori infection but without significance (p-value 0.83). In all, 36 (38.7%) turned out to be H. pylori positive with a significant male preponderance (p=0.04). Distribution of ABO blood groups in H. pylori positive group were A=31.4%, B=15.4%, AB=25.0% and O=53.7%, with a statistically significant link for blood group O (p=0.05). Rhesus factor was also compared but significant relationship was evident (p-value 0.73). Conclusions: This study demonstrated that H. pylori infection can be related to ABO blood group, middle age persons and male gender. People of blood group O are more prone to develop infection related gastritis, ulcers, and even perforations, so they should be more cautious against transmission of the bacterium.

위아전절제술 후 Roux-en-Y 위공장 재건술식과 Uncut Roux-en-Y 재건술식에서의 Roux Stasis Syndrome (Roux Stasis Syndrome in Conventional Roux-en-Y Gastrojejunostomy and Uncut Roux-en-Y Gastrojejunostomy after Subtotal Gastrectomy)

  • 노승무;배진선;정현용;조준식;신경숙;송규상
    • Journal of Gastric Cancer
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    • 제1권1호
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    • pp.38-43
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    • 2001
  • Purpose: Roux stasis syndrome is the main complication of a Roux-en-Y gastrojejunostomy. The aim of this study was to compare the occurrence rate of Roux stasis syndrome with the passing of time in a conventional Roux-en-Y gastrojejunostomy and in an uncut Roux-en-Y gastrojejunostomy. Materials and Methods: 50 patients (31 men and 19 women) had a conventional Roux-en-Y reconstruction and 53 patients (35 men and 18 women) had an uncut Roux-en-Y reconstruction. The Roux stasis syndrome was defined by clinical criteria only. The criteria included one of the four following conditions at the time of follow-up: chronic upper abdominal pain, postprandial fullness, persistent nausea, and intermittent vomiting that are worsened by eating. Follow-up after surgery was done in all patients at $7\∼12,\;13\~18,\;19\~24,\;25\~30$, and $31\∼36$ months. Results: According to the criteria, the Roux stasis syndrome occurred in 40.0$\%$ of the patients at 7$\∼$12 months, 33.3$\%$ at $13\∼19$ months, $35.3\%$ at $19\∼24$ months, $32.0\%$ at $25\~30$ months, and $33.3\%$ at $31\∼36$ months after a conventional Roux-en-Y operation. The syndrome occurred in $22.6\%$ of the patients at $7\∼12$ months, $15.2\%$ at $13\∼18$ months, $17.1\%$ at $19\∼24$ months, $19.2\%$ at $25\∼30$ months, and $20\%$ at $31\∼36$ months after an uncut Roux-en-Y reconstruction. Conclusion: In terms of occurrence pattern, only a little variance existed one year after both procedures. Comparing the Roux stasis syndrome in both procedures, the uncut Roux operation had better results than the conventional Roux operation.

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식도 절제술 및 위-식도문합술 후 만기 합병증으로 발생한 위-심막루 (Gastropericardial Fistula as a Late Complication after Esophagectomy with Esophagogastrostomy, A Case report)

  • 김태균;강정호;정원상;김영학;김혁;지행옥;이철범;함시영;전석철
    • Journal of Chest Surgery
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    • 제35권3호
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    • pp.248-250
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    • 2002
  • 환자는 56세 남자로 과거력상 15년 전 식도암으로 본원에서 식도 절제술 및 위- 식도 문합술 후 방사선 치료받았던 환자이며 그동안 특별한 치료없이 지내오다 최근 발생한 발열 및 오한, 마른 기침, 호흡곤란, 흉통을 주소로 본원 응급실을 방문 하였다. 응급처치 후 시행한 심초음파상 소량의 심낭삼출 및 심낭기종이 관찰되었으며 상부 위장관 조영술로 위-심막루가 확진 되어 응급 수술을 시행하였으나 술 후 7일째 사망하였다. 식도절제술 및 위-식도문합술 후 양성 궤양으로 인한 위-심막루는 매우 드문 합병증으로 치명적 결과를 낳았으며 흉부 방사선, 심전도, 심초음파, 환자의 증상을 종합, 상부 위장관 조영술을 통한 조기 진단 및 적절한 치료가 즉각적으로 요할 것으로 사료된다.

위축성 위염과 장상피화생의 호전에 영향을 미치는 인자에 대한 전향적 연구 (Predictive Factors for Improvement of Atrophic Gastritis and Intestinal Metaplasia: A Long-term Prospective Clinical Study)

  • 황영재;김나영;윤창용;권민구;백성민;권영재;이혜승;이제봉;최윤진;윤혁;신철민;박영수;이동호
    • 대한상부위장관⦁헬리코박터학회지
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    • 제18권3호
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    • pp.186-197
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    • 2018
  • Background/Aims: To investigate the predictive factors for improvement of atrophic gastritis (AG) and intestinal metaplasia (IM). Materials and Methods: A total of 778 subjects were prospectively enrolled and followed up for 10 years. Histological analysis of AG and IM was performed by using the updated Sydney system. To find the predictive factors for reversibility of AG and IM, 24 factors including genetic polymorphisms and bacterial and environmental factors were analyzed. Results: In all subjects, the predictive factor by multivariate analysis for improvement of both antral and corpus AG was successful eradication. The predictive factors for improvement of antral IM were age and successful eradication. The predictive factor for improvement of corpus IM was successful eradication. In patients with Helicobacter pylori infection, age and cagA were predictive factors for improvement of AG and IM. In patients with H. pylori eradication, monthly income and cagA were predictive factors for improvement of AG and IM. Conclusions: H. pylori eradication is an important predictive factor of regression of AG and IM and would be beneficial for the prevention of intestinal-type gastric cancer. Young age, high income, and cagA are additional predictive factors for improving AG and IM status. Thus, various factors affect the improvement of AG and IM.

나트륨 섭취량 감소 정책의 비용편익 분석 (Cost-benefit Analysis of Sodium Intake Reduction Policy in Korea)

  • 이철희;김대일;홍정림;고은미;강백원;김종욱;박혜경;김초일
    • 대한지역사회영양학회지
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    • 제17권3호
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    • pp.341-352
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    • 2012
  • It is well established that excessive sodium intake is related to a higher incidence of chronic diseases such as hypertension, stroke, coronary heart disease, cardiovascular disease and gastric cancer. Although the upper limit of the current sodium intake guideline by WHO is set at 2,000 mg/day for adults, sodium intake of Koreans is well over 4,700 mg/capita/day implying an urgent need to develop and implement sodium intake reduction policy at the national level. This study investigated the cost-effectiveness of the sodium intake reduction policy, for the first time, in Korea. Analyses were performed using most recent and representative data on national health insurance statistics, healthcare utilization, employment information, disease morbidity/mortality, etc. The socioeconomic benefits of the policy, resulting from reduced morbidity of those relevant diseases, included lower medical expenditures, transportation costs, caregiver cost for inpatients and income losses. The socioeconomic benefits from diminished mortality included reductions in earning losses and welfare losses caused by early deaths. It is estimated that the amount of total benefits of reducing sodium intake from 4.7 g to 3.0 g is 12.6 trillion Korean Won; and the size of its cost is 149 billion Won. Assuming that the effect of sodium intake reduction would become gradually evident over a 5-year period, the implied rate of average return to the sodium reduction policy is 7,790% for the following 25 years, suggesting a very high cost-effectiveness. Accordingly, development and implementation of a mid-to-long term plan for a consistent sodium intake reduction policy is extremely beneficial and well warranted.

위축성 위염과 장상피화생의 유병률 변화 및 위험인자의 변화: 다기관 연구 비교 (Change in the Prevalences and Risk Factors of Atrophic Gastritis and Intestinal Metaplasia in Korea: Multicenter Clinical Trials)

  • 황영재;김나영;김성은;백광호;이주엽;박경식;주영은;명대성;김현주;송현주;김흥업;남광우;신정은;김현진;김광하;이종찬;임선희;서검석;최석채
    • 대한상부위장관⦁헬리코박터학회지
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    • 제18권4호
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    • pp.247-257
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    • 2018
  • Background/Aims: The aim of this study was to analyze the trend of the prevalences of atrophic gastritis (AG) and intestinal metaplasia (IM) from 2011 to 2016~2017 in Korea. And, the risk factors of AG and IM were compared between 2011 and 2016~2017. Materials and Methods: A total of 4,023 subjects in 2011 and 2,506 subjects in 2016~2017 were enrolled. AG and IM were diagnosed on the basis of endoscopic findings. Multivariate analysis was performed for risk factors of AG and IM. Seventeen factors were analyzed. Results: The seroprevalence of Helicobacter pylori decreased from 2011 (59.8%; 2,407/4,023) to 2016~2017 (51.6%; 1,293/2,506; P<0.001). The prevalence of AG decreased from 2011 to 2016~2017 (P=0.018), but that of IM increased (P<0.001). The risk factors of AG in 2011 were male sex, old age, H. pylori immuoglobulin G (IgG) positivity, family history of gastric cancer (GC), and high-salt diet. For IM in 2011, the risk factors were male sex, old age, H. pylori IgG positivity, and family history of GC. Risk factors of AG in 2016~2017 were old age, H. pylori IgG positivity, and country of residence. For IM in 2016~2017, the risk factors were male sex, old age, family history of GC, high fasting glucose level (${\geq}126mg/dL$), H. pylori IgG positivity, and low income level. Conclusions: The difference in prevalence trends of AG and IM between 2016~2017 and 2011 could be the result of the different risk factors of AG and IM, such as decreased prevalence of H. pylori infection.