• 대한위암학회:학술대회논문집
• /
• 2005.09a
• /
• pp.30-36
• /
• 2005

• Journal of Nutrition and Health
• /
• v.48 no.1
• /
• pp.30-45
• /
• 2015

Purpose: This study was planned to determine the characteristics of extremely obese patients during Bariatric surgery and to evaluate how the difference in the number of postsurgical personal nutritional educations they received affected the weight loss. Methods: This is a retrospective study on the basis of the medical records of extremely obese patients for 15 months after receiving gastric banding. A total of 60 people were selected as the study subjects and they were divided into the Less Educated Group and the More Educated Group according to the average number of personal nutritional educations they received. We investigated both groups to determine the general characteristic, health related lifestyle habits, obesity related complications and symptoms in possession, and eating habits before their surgery, the body composition measurement result, obesity determination indices at 1, 3, 6, 9, 12, and 15 months before and after their surgery, and the biochemical parameters at 6 months before and after their surgery. Results: Body fat and weight showed rapid reduction until 6 months after the surgery, but thereafter reduced slowly depending on the result of body composition measurement. Regarding body fat and weight, the More Educated Group, who received nutrition education more often, showed significantly lower levels than the Less Educated Group at 15 months after surgery. Regarding BMI and degree of obesity, the More Educated Group showed significantly lower levels than the Less Educated Group at 15 months after surgery. Here, we were assured that BMI is reversely proportional to the number of personal nutritional educations at 15 months, which is more outstanding after surgery than before surgery. Conclusion: Long-term nutritional education is a key factor for the extremely obese patient in maintaining the effects of Bariatric surgery on weight and body fat reduction onwards. In the next stage, considering the characteristics of the study subjects, adoption of individual nutrition education is recommended for postsurgical prospective arbitration of obesity in order to monitor blood pressure, obesity related complications, symptoms in possession, and how eating habits and health related life habits change, and to judge the actual effect of the nutritional education method at the same time.

• Annals of Hepato-Biliary-Pancreatic Surgery
• /
• v.27 no.3
• /
• pp.322-327
• /
• 2023

Situs inversus totalis (SIT) is a rare condition in which cardiac and abdominal organs are inverted from their normal left-sided orientation. Mirizzi syndrome, characterized by the obstruction of the common hepatic duct or the common bile duct by gallstone, is a rare condition. Mirizzi syndrome co-occurrence in SIT patients is rare. Gallbladder in sinistroposition is extremely uncommon in SIT patients. We report a known case of diabetes, ventricular septal defect with transposition of the great arteries in a 32-year-old female who presented with jaundice, cholangitis, chills, and fever that had lasted for 10 days. She was confirmed to have SIT with type III Mirizzi syndrome following a series of diagnostic procedures. Primarily, endoscopic retrograde cholangiopancreatography along with common bile duct stenting was performed to initially reduce cholangitis. After an eight-week follow-up after the reduction of cholangitis, surgery was conducted. Mirror-imaged ports were used for the laparoscopic procedure, and the surgeon was on the patient's right side rather than the usual left side. The patient was discharged from the hospital following two days of uneventful healing.

• Archives of Plastic Surgery
• /
• v.50 no.6
• /
• pp.535-540
• /
• 2023

Background Abdominoplasty with abdominal plication increases intra-abdominal pressure (IAP) and has been previously associated with limited diaphragmatic excursion and respiratory dysfunctions. Many factors found in abdominoplasties and among postbariatric patients predispose them to a higher occurrence. This study aims to evaluate the impact of abdominal plication among postbariatric patients, assess whether the plication increases their IAP, and analyze how these IAP correlate to their postoperative outcome. Methods This prospective study was performed on all patients who underwent circumferential Fleur-De-Lis abdominoplasty. For this intended study, the IAP was measured by an intravesical minimally invasive approach in three stages: after the initiation of general anesthesia, after a 10-cm abdominal wall plication and skin closure, and 24 hours after the procedure. Results We included 46 patients, of which 41 were female and 5 were male. Before the bariatric procedure, these patients had an average maximum weight of 121.4 kg and an average maximum body mass index of 45.78 kg/m²; 7 were grade I obese patients, 10 were grade II, and 29 were grade III. Only three patients were operated on with a gastric sleeve and 43 with gastric bypass. We presented six patients with transitory intra-abdominal hypertension in the first 24 hours, all of them from the grade I obesity group, the highest presented was 14.3 mm Hg. We presented 15% (7/46) of complication rates, which were only four seroma and five dehiscence; two patients presented both seroma and wound dehiscence. Conclusion Performing a 10-cm abdominal wall plication or greater represents a higher risk for intra-abdominal hypertension, slower general recovery, and possibly higher complication rate in patients who presented a lower degree of obesity (grade I) at the moment of the bariatric surgery.

• Korean Journal of Radiology
• /
• v.21 no.7
• /
• pp.793-811
• /
• 2020

Surgical resection remains the primary choice of treatment and the only potentially curative option for gastric carcinoma, and is increasingly performed laparoscopically. Gastric resection represents a challenging procedure, with a significant morbidity and non-negligible postoperative mortality. The interpretation of imaging after gastric surgery can be challenging due to significant modifications of the normal anatomy. After the surgery, the familiarity with expected imaging appearances is crucial for diagnosis and appropriate management of potentially life-threatening complications in patients who underwent gastric surgery. We review various surgical techniques used in gastric surgery and describe fluoroscopic and cross-sectional imaging appearances of normal postoperative anatomic changes as well as early and late complications after gastric surgery.

• Clinical Endoscopy
• /
• v.56 no.6
• /
• pp.693-705
• /
• 2023

Upper gastrointestinal postsurgical leaks are life-threatening conditions with high mortality rates and are one of the most feared complications of surgery. Leaks are challenging to manage and often require radiological, endoscopic, or surgical intervention. Steady advancements in interventional endoscopy in recent decades have allowed the development of new endoscopic devices and techniques that provide a more effective and minimally invasive therapeutic option compared to surgery. Since there is no consensus regarding the most appropriate therapeutic approach for managing postsurgical leaks, this review aimed to summarize the best available current data. Our discussion specifically focuses on leak diagnosis, treatment aims, comparative endoscopic technique outcomes, and combined multimodality approach efficacy.

• Journal of the Korean Arthroscopy Society
• /
• v.14 no.1
• /
• pp.29-32
• /
• 2010

Several reports have described the increased perioperative risks as well as surgical techniques for performing various procedures in obese patients. However, few reports have addressed the effects of obesity on routine arthroscopic procedures known to be common and safe. Describing the case of a partial meniscectomy performed in a 17-year-old male with a body weight of 120 kg, we review literatures published to the present and provide technical problems and possible complications that can occur when performing routine knee arthroscopy in bariatric patients.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.12 no.sup1
• /
• pp.118-126
• /
• 2009

The incidence of childhood obesity has increased dramatically. Childhood obesity is an increasing health problem because of its strong associations with chronic health problems in children and adults. These health problems significantly contribute to the development of common chronic diseases in later life, including hypertension, type2 diabetes, hyperinsulinemia, coronary heart disease, and other psychological disorders. So it is an important issue to prevent and treat obesity during childhood and adolescent. Diet and exercise are the cornerstones of treatment for obesity and related complications. For obese children, some clinical trials have shown improvement with diet, exercise, and /or behavioral interventions. Promising interventions for high-risk individuals, such as bariatric surgery and novel pharmacological agents, also require rigorous assessment with attention to long-term patient important outcomes. There are various pharmacological approaches to the treatment of obesity in the adolescent population some of which have FDA approval. In the article we discuss pharmacological approaches to guide the treatment of obesity in the pediatric population, including risks of treatment, monitoring of potential side effects.

• Clinical and Experimental Pediatrics
• /
• v.64 no.10
• /
• pp.511-518
• /
• 2021

The prevalence of childhood obesity is increasing worldwide at an alarming rate. While obesity is known to increase a variety of cardiovascular and metabolic diseases, it also acts as a risk factor for the development and progression of chronic kidney disease (CKD). During childhood and adolescence, severe obesity is associated with an increased prevalence and incidence of the early stages of kidney disease. Importantly, children born to obese mothers are also at increased risk of developing obesity and CKD later in life. The potential mechanisms underlying the association between obesity and CKD include hemodynamic factors, metabolic effects, and lipid nephrotoxicity. Weight reduction via increased physical activity, caloric restriction, treatment with angiotensin-converting enzyme inhibitors, and judicious bariatric surgery can be used to control obesity and obesity-related kidney disease. Preventive strategies to halt the obesity epidemic in the healthcare community are needed to reduce the widespread deleterious consequences of obesity including CKD development and progression.

• Journal of Science and Technology Studies
• /
• v.13 no.2
• /
• pp.137-172
• /
• 2013

Globally, awareness about obesity is increasing rapidly. In Korea, obesity is recognized as a disease and steps are being taken to treat it. From the health governance point of view, such standardized measures amplify the risk of obesity and thus play an important part in the prevention of the disease. In this context, various obesity treatments act as a medium for the problem-solving process. In recent years, obesity surgery has been viewed as a rational solution to the problem of obesity. In the context of standardization of treatment, Callon's "Process of Translation" in STS theories highlights the importance of the central actor (Obligatory Passage Point; OPP). However, in the case of obesity, it is difficult to identify a single OPP to project different perspectives of an actor's needs. "Lapband surgery" often acts as a "boundary object" in this context. This article assesses this absence of central actors in the process of problem solving through a case study of adoption of Lapband surgery in Korea. Further, we attempt to suggest an analytical framework with a boundary object and multiple translation concepts to aid solving the problem of obesity.